S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
     S. 8307                                                  A. 8807
 
                       S E N A T E - A S S E M B L Y
 
                             January 17, 2024
                                ___________
 
 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 part H of chapter 59 of the laws of 2011, amending the
   public  health  law  and  other  laws  relating  to  general  hospital
   reimbursement  for  annual  rates,  in relation to known and projected
   department of health state fund medicaid  expenditures  (Part  A);  to
   amend  the  public  health  law,  in  relation  to  extending  certain
   provisions related to the issuance of  accountable  care  organization
   certifications  and  state  oversight  of antitrust provisions; and to
   amend part D of chapter 56 of the laws of  2013  amending  the  social
   services  law  relating  to eligibility conditions, chapter 649 of the
   laws of 1996 amending the public health law, the  mental  hygiene  law
   and  the social services law relating to authorizing the establishment
   of special needs plans, part V of chapter  57  of  the  laws  of  2022
   amending  the  public  health  law  and  the insurance law relating to
   reimbursement for commercial and Medicaid services provided via  tele-
   health, chapter 659 of the laws of 1997 amending the public health law
   and  other  laws  relating  to  creation of continuing care retirement
   communities, part NN of chapter 57 of the laws of  2018  amending  the
   public  health  law and the state finance law relating to enacting the
   opioid stewardship act, part II of chapter 54  of  the  laws  of  2016
   amending  part C of chapter 58 of the laws of 2005 relating to author-
   izing reimbursements for expenditures made by or on behalf  of  social
   services districts for medical assistance for needy persons and admin-
   istration  thereof,  part B of chapter 57 of the laws of 2015 amending
   the social services law and  other  laws  relating  to  energy  audits
   and/or disaster preparedness reviews of residential healthcare facili-
   ties by the commissioner, and part H of chapter 57 of the laws of 2019
   amending  the  public  health  law relating to waiver of certain regu-
   lations, in relation to the effectiveness thereof (Part B);  to  amend
   the  education  law,  in relation to removing the exemption for school
   psychologists to render early  intervention  services;  and  to  amend
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD12671-01-4
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   chapter  217  of the laws of 2015, amending the education law relating
   to certified school psychologists and special education  services  and
   programs  for  preschool  children  with  handicapping  conditions, in
   relation  to  the  effectiveness thereof (Part C); to amend the public
   health law, in relation to reducing the hospital capital rate  add-on;
   to  amend  part  ZZ of chapter 56 of the laws of 2020 amending the tax
   law and the  social services law relating to certain Medicaid  manage-
   ment,  in  relation  to  the effectiveness thereof; to amend part E of
   chapter 57 of the laws of 2015, amending the public health law  relat-
   ing  to  the  payment  of  certain  funds  for  uncompensated care, in
   relation to certain payments being made as  outpatient  upper  payment
   limit  payments  for outpatient hospital services during certain state
   fiscal years and calendar years; to amend part B of chapter 57 of  the
   laws  of  2015,  amending  the social services law relating to supple-
   mental rebates, in relation to authorizing the department of health to
   increase operating cost component of  rates  of  payment  for  general
   hospital  outpatient services and authorizing the department of health
   to pay a public hospital adjustment to public general hospitals during
   certain state fiscal years and calendar years;  to  amend  the  public
   health  law, in relation to authorizing the commissioner to make addi-
   tional inpatient hospital payments during certain state  fiscal  years
   and  calendar  years; and to amend part B of chapter 58 of the laws of
   2010, amending the social services  law  and  the  public  health  law
   relating  to  prescription  drug coverage for needy persons and health
   care initiatives pools, in relation to authorizing the  department  of
   health  to  make  Medicaid payment increases for county operated free-
   standing clinics during certain state fiscal years and calendar  years
   (Part  D); to amend the public health law, in relation to freezing the
   operating component of  the  rates  for  skilled  nursing  facilities,
   reducing the capital component of the rates for skilled nursing facil-
   ities  by  an additional ten percent, and eligibility for admission to
   the New York state veterans'  home  (Part  E);  to  amend  the  social
   services  law, in relation to making the special needs assisted living
   residence voucher program permanent; and to amend  the  public  health
   law,  in  relation  to  assisted  living quality improvement standards
   (Part F); to amend  the public health law, in relation  to  home  care
   worker  wage  parity;  and  to repeal certain provisions of the public
   health law relating thereto (Part G); to amend the financial  services
   law,  in relation to excluding managed care plans from the independent
   resolution process; to amend the social services law  and  the  public
   health  law,  in relation to providing authority for the department of
   health to competitively procure managed care organizations participat-
   ing in medicaid managed care programs; to amend part I of  chapter  57
   of  the laws of 2022, providing a one percent across the board payment
   increase to all qualifying fee-for-service Medicaid rates, in relation
   to eliminating the one percent rate increase to managed care organiza-
   tions; and to repeal certain provisions of  the  social  services  law
   relating  thereto  (Part  H);  to  amend  the  social services law, in
   relation to copayments for drugs; to amend the public health  law,  in
   relation  to  prescriber  prevails; to amend the public health law, in
   relation to the Medicaid drug cap and pharmacy cost reporting; and  to
   repeal  certain  provisions  of  the  social  services law relating to
   coverage for certain prescription drugs (Part I); to amend the  social
   services  law, in relation to renaming the basic health program to the
   essential plan; to amend part H of chapter 57 of  the  laws  of  2021,
   amending the social services law relating to eliminating consumer-paid
 S. 8307                             3                            A. 8807
 
   premium  payments  in  the  basic  health  program, in relation to the
   effectiveness thereof; and to amend part BBB of chapter 56 of the laws
   of 2022, amending the public health law and  other  laws  relating  to
   permitting  the commissioner of health to submit a waiver that expands
   eligibility for New York's basic  health  program  and  increases  the
   federal  poverty  limit  cap for basic health program eligibility from
   two hundred to two hundred fifty percent,  in  relation  to  extending
   certain   provisions  related  to  providing  long-term  services  and
   supports under the essential plan; and to amend the public health law,
   in relation to adding references to the 1332 state innovation  waiver,
   providing  a  new  subsidy  to  assist low-income New Yorkers with the
   payment of premiums, cost sharing or both through the marketplace, and
   adding the 1332 state innovation  program  to  the  functions  of  the
   marketplace  (Part J); to amend chapter 266 of the laws of 1986 amend-
   ing the civil practice law and rules and other laws relating to  malp-
   ractice  and  professional  medical  conduct, in relation to insurance
   coverage paid for by funds from the hospital excess liability pool and
   extending the effectiveness of certain provisions  thereof;  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, in relation
   to extending certain provisions concerning the hospital excess liabil-
   ity pool; and to amend part H of chapter 57 of the laws of 2017 amend-
   ing the New York Health Care Reform Act of 1996 and other laws  relat-
   ing  to  extending certain provisions relating thereto, in relation to
   extending provisions relating to excess coverage (Part  K);  to  amend
   the  public  health  law and the state finance law, in relation to the
   discontinuation of the empire clinical research investigator  program;
   to  amend  the public health law, in relation to the discontinuance of
   participation and membership during a three year demonstration  period
   in  a  physician  committee of the Medical Society of the State of New
   York or the New York State Osteopathic Society; to repeal  subdivision
   9  of  section 2803 of the public health law, relating to the hospital
   audit program; to repeal section 461-s of  the  social  services  law,
   relating  to  enhancing  the quality of adult living program for adult
   care facilities; to repeal paragraph (c) of subdivision 1  of  section
   461-b  of  the  social services law, relating to an appropriation made
   available for the purposes of funding the  operating  assistance  sub-
   program  for  enriched  housing;  to repeal article 27-H of the public
   health law, relating to  the  tick-borne  disease  institute;  and  to
   repeal  paragraph  (g)  of subdivision 11 of section 230 of the public
   health law, relating to reporting of professional misconduct (Part L);
   to amend the social  services  law  and  the  public  health  law,  in
   relation  to  authorizing  continuous  coverage  in Medicaid and child
   health plus, for eligible children ages zero to six (Part M); to amend
   the public health law, in relation to authorizing the commissioner  of
   health  to issue a statewide standing order for the provision of doula
   services, providing medical services to pregnant minors,  and  to  the
   provision  of  contraception (Part N); to amend the public health law,
   in relation to expanding financial assistance; and to amend the gener-
   al business law, in relation to  additional  consumer  protection  for
   medical  debt  and  restricting the applications for and use of credit
   cards and medical financial products (Part O);  to  amend  part  C  of
   chapter  57 of the laws of 2022 amending the public health law and the
   education law relating  to  allowing  pharmacists  to  direct  limited
   service  laboratories  and order and administer COVID-19 and influenza
 S. 8307                             4                            A. 8807
 
   tests and modernizing nurse practitioners, and chapter 21 of the  laws
   of 2011 amending the education law relating to authorizing pharmacists
   to  perform  collaborative  drug therapy management with physicians in
   certain  settings,  in relation to the effectiveness thereof (Part P);
   to amend the education law and the public health law, in  relation  to
   the  scope of practice of physician assistants, certified nurse aides,
   medical assistants, dentists and dental hygienists (Part Q); to  amend
   the  education  law,  in  relation  to enacting the interstate medical
   licensure compact; and to amend the  education  law,  in  relation  to
   enacting  the  nurse  licensure  compact (Part R); to amend the public
   health law, in relation to  establishing  the  healthcare  safety  net
   transformation  program  (Part  S); to amend the public health law and
   the education law, in relation to making necessary changes to end  the
   HIV,  HCV,  HBV,  syphilis  and  mpox epidemics; and to repeal certain
   provisions the public health law relating thereto (Part T);  to  amend
   the public health law, in relation to increasing prescription monitor-
   ing  program data retention periods and allowing enhanced data sharing
   to combat the opioid crisis, updating controlled  substance  schedules
   to  conform with those of the federal drug enforcement administration,
   permitting providers to distribute  three-day  supplies  of  buprenor-
   phine,  and updating the term "addict" to "person with a substance use
   disorder" in certain provisions of such law;  and  to  repeal  section
   3372  of such law relating to practitioner patient reporting (Part U);
   to amend the public health law,  in  relation  to  expanding  hospital
   services  and  home care collaboration into the home and community; to
   amend the public health law and the  education  law,  in  relation  to
   modernizing the state of New York's emergency medical system and work-
   force; to amend the public health law, in relation to establishing the
   paramedic urgent care program; and to amend chapter 137 of the laws of
   2023  amending the public health law relating to establishing a commu-
   nity-based paramedicine demonstration program, in relation to  extend-
   ing  the  effectiveness  thereof  (Part V); to amend the elder law, in
   relation to establishing the interagency  elder  justice  coordinating
   council  (Part  W); to amend part NN of chapter  57  of  the  laws  of
   2018 amending the public health law and other laws relating to  enact-
   ing  the  opioid  stewardship  act,  in  relation to making the opioid
   stewardship fund permanent (Part X); 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  rein-
   vestment 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 the effectiveness thereof (Part Y); 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 making such  provisions  perma-
   nent  (Part  Z);  to  amend  the insurance law, in relation to setting
   minimal reimbursement for behavioral health treatment  (Part  AA);  to
   amend  chapter 723 of the laws of 1989 amending the mental hygiene law
   and  other  laws  relating  to  comprehensive  psychiatric   emergency
   programs,  in    relation  to  the effectiveness of certain provisions
   thereof (Part BB); to amend the social services law,  in  relation  to
   clarifying  the  requirements  related  to  referrals of substantiated
   reports of abuse or neglect from the justice center to the  office  of
   the  Medicaid  inspector general (Part CC); to amend part A of chapter
 S. 8307                             5                            A. 8807
 
   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 DD);
   to  amend  the education law, in relation to expanding the description
   of certain services which are not prohibited by statutes governing the
   practice of nursing (Part EE); and  to  establish  a  cost  of  living
   adjustment for designated human services programs (Part FF)
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. This act enacts into law major  components  of  legislation
 necessary  to  implement  the state health and mental hygiene budget for
 the 2024-2025 state fiscal year.  Each  component  is  wholly  contained
 within  a  Part identified as Parts A through FF. The effective date for
 each particular provision contained within such Part is set forth in the
 last section of such Part. Any provision in any section contained within
 a Part, including the effective date of the Part, which makes  a  refer-
 ence  to  a  section  "of  this  act", when used in connection with that
 particular component, shall be deemed to mean and refer  to  the  corre-
 sponding section of the Part in which it is found. Section three of this
 act sets forth the general effective date of this act.
 
                                  PART A
 
   Section  1.  Paragraph (a) of subdivision 1 of section 92 of part H of
 chapter 59 of the laws of 2011, amending the public health law and other
 laws relating to general hospital reimbursement  for  annual  rates,  as
 amended  by  section  1  of part A of chapter 57 of the laws of 2023, is
 amended to read as follows:
   (a) For state fiscal years  2011-12  through  [2024-25]  2025-26,  the
 director  of the budget, in consultation with the commissioner of health
 referenced as "commissioner" for purposes of this section, shall  assess
 on  a  quarterly  basis,  as  reflected in quarterly reports pursuant to
 subdivision five of this  section  known  and  projected  department  of
 health  state  funds medicaid expenditures by category of service and by
 geographic regions, as defined by the commissioner.
   § 2. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART B
 
   Section  1. Subdivision p of section 76 of part D of chapter 56 of the
 laws of 2013 amending the social services law  relating  to  eligibility
 conditions,  as amended by section 2 of part E of chapter 57 of the laws
 of 2019, is amended to read as follows:
   p. the amendments to subparagraph 7 of paragraph (b) of subdivision  1
 of  section  366  of the social services law made by section one of this
 act shall expire and be deemed repealed October 1, [2024] 2029.
   § 2. Section 10 of chapter 649 of the laws of 1996 amending the public
 health law, the mental hygiene law and the social services law  relating
 to  authorizing  the establishment of special needs plans, as amended by
 section 21 of part E of chapter 57 of the laws of 2019,  is  amended  to
 read as follows:
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   §  10.  This  act shall take effect immediately and shall be deemed to
 have been in full force and effect on and after July 1, 1996;  provided,
 however,  that  sections one, two and three of this act shall expire and
 be deemed repealed [on] March 31, [2025] 2030 provided, however that the
 amendments  to  section 364-j of the social services law made by section
 four of this act shall not affect the expiration  of  such  section  and
 shall  be  deemed  to  expire  therewith and provided, further, that the
 provisions of subdivisions 8, 9 and 10 of section  4401  of  the  public
 health  law,  as added by section one of this act; section 4403-d of the
 public health law as added by section two of this act and the provisions
 of section seven of this act, except for the provisions relating to  the
 establishment  of  no  more  than twelve comprehensive HIV special needs
 plans, shall expire and be deemed repealed on July 1, 2000.
   § 3. Subdivision 3 of section 2999-p of  the  public  health  law,  as
 amended  by  section  8 of part BB of chapter 56 of the laws of 2020, is
 amended to read as follows:
   3. The commissioner may issue a certificate of authority to an  entity
 that  meets conditions for ACO certification as set forth in regulations
 made by the commissioner pursuant to section twenty-nine  hundred  nine-
 ty-nine-q  of  this  article.  The  commissioner shall not issue any new
 certificate under this article after December thirty-first, two thousand
 [twenty-four] TWENTY-EIGHT.
   § 4. Subdivision 1 of section 2999-aa of the  public  health  law,  as
 amended  by  section  9  of part S of chapter 57 of the laws of 2021, is
 amended to read as follows:
   1. In order to promote improved quality and efficiency of, and  access
 to,  health  care  services and to promote improved clinical outcomes to
 the residents of New York, it shall  be  the  policy  of  the  state  to
 encourage, where appropriate, cooperative, collaborative and integrative
 arrangements  including  but  not  limited  to, mergers and acquisitions
 among health care providers or  among  others  who  might  otherwise  be
 competitors,  under  the  active supervision of the commissioner. To the
 extent such arrangements, or the planning and negotiations that  precede
 them,  might  be  anti-competitive  within the meaning and intent of the
 state and federal antitrust laws, the intent of the state is to supplant
 competition with such arrangements  under  the  active  supervision  and
 related  administrative  actions  of  the  commissioner  as necessary to
 accomplish the purposes of this article, and  to  provide  state  action
 immunity  under  the  state  and  federal antitrust laws with respect to
 activities undertaken by health care providers and  others  pursuant  to
 this  article,  where  the benefits of such active supervision, arrange-
 ments and actions of the commissioner outweigh any disadvantages  likely
 to  result  from  a reduction of competition. The commissioner shall not
 approve an arrangement for which state action immunity is  sought  under
 this  article without first consulting with, and receiving a recommenda-
 tion from, the public health and health planning council. No arrangement
 under this article shall be approved after  December  thirty-first,  two
 thousand [twenty-four] TWENTY-EIGHT.
   §  5.  Section  7 of part V of chapter 57 of the laws of 2022 amending
 the public health law and the insurance law  relating  to  reimbursement
 for commercial and Medicaid services provided via telehealth, is amended
 to read as follows:
   §  7.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2022; provided,
 however, this act shall expire and be deemed repealed on and after April
 1, [2024] 2025.
 S. 8307                             7                            A. 8807
 
   § 6. Section 97 of chapter 659 of the laws of 1997 amending the public
 health law and other  laws  relating  to  creation  of  continuing  care
 retirement communities, as amended by section 11 of part Z of chapter 57
 of the laws of 2018, is amended to read as follows:
   §  97. This act shall take effect immediately, provided, however, that
 the amendments to subdivision 4 of section 854 of the general  municipal
 law  made by section seventy of this act shall not affect the expiration
 of such subdivision and shall be deemed to expire therewith and provided
 further that sections sixty-seven and  sixty-eight  of  this  act  shall
 apply  to  taxable  years  beginning  on  or  after  January 1, 1998 and
 provided further that sections eighty-one through eighty-seven  of  this
 act  shall expire and be deemed repealed on December 31, [2024] 2029 and
 provided further, however, that the amendments to section ninety of this
 act shall take effect January 1, 1998 and shall apply to  all  policies,
 contracts,  certificates,  riders or other evidences of coverage of long
 term care insurance issued, renewed, altered  or  modified  pursuant  to
 section 3229 of the insurance law on or after such date.
   §  7.  Section 5 of part NN of chapter 57 of the laws of 2018 amending
 the public health law and the state finance law relating to enacting the
 opioid stewardship act, as amended by section 5 of part XX of chapter 59
 of the laws of 2019, is amended to read as follows:
   § 5. This act shall take effect July 1, 2018 and shall expire  and  be
 deemed  to be repealed on June 30, [2024] 2027, provided that, effective
 immediately, the addition, amendment and/or repeal of any rule or  regu-
 lation  necessary  for  the  implementation of this act on its effective
 date are authorized to be made and completed on or before such effective
 date, and, provided that this act  shall  only  apply  to  the  sale  or
 distribution  of  opioids in the state of New York on or before December
 31, 2018.
   § 8. Section 2 of part II of chapter 54 of the laws of  2016  amending
 part  C  of  chapter  58  of  the  laws  of 2005 relating to authorizing
 reimbursements for expenditures made by or on behalf of social  services
 districts  for  medical  assistance for needy persons and administration
 thereof, as amended by section 6 of part CC of chapter 57 of the laws of
 2022, is amended to read as follows:
   § 2. This act shall take effect immediately and shall  expire  and  be
 deemed repealed March 31, [2024] 2026.
   §  9.  Subdivision 5 of section 60 of part B of chapter 57 of the laws
 of 2015 amending the social services law  and  other  laws  relating  to
 energy  audits  and/or  disaster  preparedness  reviews  of  residential
 healthcare facilities by the commissioner, as amended by chapter 125  of
 the laws of 2021, is amended to read as follows:
   5.  section  thirty-eight  of  this  act  shall  expire  and be deemed
 repealed July 1, [2024] 2027;
   § 10. Section 7 of part H of chapter 57 of the laws of 2019,  amending
 the  public  health  law  relating  to waiver of certain regulations, as
 amended by section 1 of part GG of chapter 57 of the laws  of  2022,  is
 amended to read as follows:
   §  7.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2019, provided,
 however, that section two of this act shall expire on  April  1,  [2024]
 2026.
   § 11. This act shall take effect immediately.
 
                                  PART C
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   Section  1. Paragraph d of subdivision 6 of section 4410 of the educa-
 tion law, as amended by chapter 217 of the laws of 2015, is  amended  to
 read as follows:
   d.  Notwithstanding  any  other  provision of law to the contrary, the
 exemption in subdivision one of section seventy-six hundred five of this
 chapter shall apply to persons employed  on  a  full-time  or  part-time
 salary  basis, which may include on an hourly, weekly, or monthly basis,
 or on a fee for evaluation services basis provided that such  person  is
 employed by and under the dominion and control of a center-based program
 approved  pursuant  to  subdivision  nine of this section as a certified
 school psychologist to provide activities, services and use of the title
 psychologist to students enrolled in such approved center-based program;
 and to certified school psychologists employed on a full-time  or  part-
 time  salary  basis,  which may include on an hourly, weekly, or monthly
 basis, or on a fee for  evaluation  services  basis  provided  that  the
 school psychologist is employed by and under the dominion and control of
 a  program that has been approved pursuant to paragraph b of subdivision
 nine of this section, or subdivision nine-a of this section, to  conduct
 a multi-disciplinary evaluation of a preschool child having or suspected
 of  having a disability where authorized by paragraph a [or b] of subdi-
 vision six of section sixty-five hundred three-b of this  chapter[;  and
 to  certified  school psychologists employed on a full-time or part-time
 salary basis, which may include on an hourly, weekly, or monthly  basis,
 or  on  a  fee for evaluation services basis provided that such psychol-
 ogist is employed by and under the dominion and  control  of  an  agency
 approved  in  accordance  with title two-A of article twenty-five of the
 public health law to deliver early intervention  program  multidiscipli-
 nary  evaluations,  service coordination services and early intervention
 program services, where authorized by paragraph a or  b  of  subdivision
 six of section sixty-five hundred three-b of this chapter, each], in the
 course  of  their employment. Nothing in this section shall be construed
 to authorize a certified school psychologist or  group  of  such  school
 psychologists  to  engage in independent practice or practice outside of
 an employment relationship.
   § 2. Subdivision 1 of section 7605 of the education law, as amended by
 chapter 217 of the laws of 2015, is amended to read as follows:
   1. The activities, services, and use of the title of psychologist,  or
 any  derivation  thereof,  on  the  part  of a person in the employ of a
 federal, state, county or municipal agency, or other political  subdivi-
 sion,  or  a chartered elementary or secondary school or degree-granting
 educational institution insofar as such activities and  services  are  a
 part  of the duties of his salaried position; or on the part of a person
 in the employ as a certified school psychologist on a full-time or part-
 time salary basis, which may include on an hourly,  weekly,  or  monthly
 basis,  or  on  a  fee  for evaluation services basis provided that such
 person employed as a certified school psychologist is  employed  by  and
 under  the dominion and control of a preschool special education program
 approved pursuant to paragraph b  of  subdivision  nine  or  subdivision
 nine-a  of  section  forty-four  hundred  ten of this chapter to provide
 activities, services and to use the  title  "certified  school  psychol-
 ogist",  so long as this shall not be construed to permit the use of the
 title "licensed psychologist", to students  enrolled  in  such  approved
 program  or  to  conduct  a  multidisciplinary evaluation of a preschool
 child having or suspected of having a disability[; or on the part  of  a
 person  in  the employ as a certified school psychologist on a full-time
 or part-time salary basis, which may include on  an  hourly,  weekly  or
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 monthly  basis,  or on a fee for evaluation services basis provided that
 such person employed as a certified school psychologist is  employed  by
 and  under  the dominion and control of an agency approved in accordance
 with  title  two-A  of  article  twenty-five of the public health law to
 deliver  early  intervention  program   multidisciplinary   evaluations,
 service  coordination services and early intervention program services],
 where each such preschool special education  program  [or  early  inter-
 vention provider] is authorized by paragraph a [or b] of subdivision six
 of  section  sixty-five hundred [three] THREE-B of this title[, each] in
 the course of their employment. Nothing in  this  subdivision  shall  be
 construed  to authorize a certified school psychologist or group of such
 school psychologists to  engage  in  independent  practice  or  practice
 outside of an employment relationship.
   § 3. Section 3 of chapter 217 of the laws of 2015, amending the educa-
 tion  law  relating to certified school psychologists and special educa-
 tion services and programs  for  preschool  children  with  handicapping
 conditions, as amended by chapter 339 of the laws of 2022, is amended to
 read as follows:
   §  3.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after July 1, 2014,  provided,
 however  that  the  provisions  of  this  act shall expire and be deemed
 repealed June 30, [2024] 2026.
   § 4. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024; provided,
 however,  that the amendments to paragraph d of subdivision 6 of section
 4410 of the education law made by section one  of  this  act  shall  not
 affect  the  expiration  of such paragraph and shall be deemed to expire
 therewith; provided further, however, that the amendments to subdivision
 1 of section 7605 of the education law made by section two of  this  act
 shall  not affect the expiration of such subdivision and shall be deemed
 to expire therewith.

                                  PART D
 
   Section 1. Paragraph (c) of subdivision 8 of  section  2807-c  of  the
 public  health  law,  as amended by section 1 of part D of chapter 57 of
 the laws of 2021, is amended to read as follows:
   (c) In order to reconcile capital related inpatient expenses  included
 in  rates of payment based on a budget to actual expenses and statistics
 for the rate period for a general  hospital,  rates  of  payment  for  a
 general  hospital  shall  be adjusted to reflect the dollar value of the
 difference between capital related inpatient expenses  included  in  the
 computation of rates of payment for a prior rate period based on a budg-
 et  and  actual  capital  related inpatient expenses for such prior rate
 period, each as determined in accordance  with  paragraph  (a)  of  this
 subdivision,  adjusted  to  reflect  increases or decreases in volume of
 service in such prior rate period  compared  to  statistics  applied  in
 determining the capital related inpatient expenses component of rates of
 payment based on a budget for such prior rate period.
   For  rates  effective  April  first, two thousand twenty through March
 thirty-first, two  thousand  twenty-one,  the  budgeted  capital-related
 expenses add-on as described in paragraph (a) of this subdivision, based
 on  a  budget  submitted in accordance to paragraph (a) of this subdivi-
 sion, shall be reduced by five percent relative to the rate in effect on
 such date; and the actual capital expenses add-on as described in  para-
 graph  (a)  of this subdivision, based on actual expenses and statistics
 S. 8307                            10                            A. 8807
 
 through appropriate audit procedures in accordance with paragraph (a) of
 this subdivision shall be reduced by five percent relative to  the  rate
 in effect on such date.
   For  rates  effective [on and after] April first, two thousand twenty-
 one THROUGH SEPTEMBER THIRTIETH, TWO THOUSAND TWENTY-FOUR, the  budgeted
 capital-related  expenses  add-on  as described in paragraph (a) of this
 subdivision, based on a budget submitted in accordance to paragraph  (a)
 of  this  subdivision,  shall  be reduced by ten percent relative to the
 rate in effect on such date; and the actual capital expenses  add-on  as
 described in paragraph (a) of this subdivision, based on actual expenses
 and  statistics  through appropriate audit procedures in accordance with
 paragraph (a) of this subdivision shall be reduced by ten percent  rela-
 tive to the rate in effect on such date.
   FOR  RATES  EFFECTIVE ON AND AFTER OCTOBER FIRST, TWO THOUSAND TWENTY-
 FOUR, THE BUDGETED CAPITAL-RELATED EXPENSES ADD-ON AS DESCRIBED IN PARA-
 GRAPH (A) OF THIS SUBDIVISION, BASED ON A BUDGET SUBMITTED IN ACCORDANCE
 WITH PARAGRAPH (A) OF THIS  SUBDIVISION,  SHALL  BE  REDUCED  BY  TWENTY
 PERCENT  RELATIVE  TO  THE  RATE  IN EFFECT ON SUCH DATE; AND THE ACTUAL
 CAPITAL EXPENSES ADD-ON AS DESCRIBED IN PARAGRAPH (A) OF  THIS  SUBDIVI-
 SION  SHALL  BE REDUCED BY TWENTY PERCENT RELATIVE TO THE RATE IN EFFECT
 ON SUCH DATE.
   For any rate year, all reconciliation add-on  amounts  calculated  [on
 and  after]  FOR  THE PERIOD OF April first, two thousand twenty THROUGH
 SEPTEMBER THIRTIETH, TWO THOUSAND TWENTY-FOUR shall be  reduced  by  ten
 percent,  and  all  reconciliation  recoupment amounts calculated [on or
 after] FOR THE PERIOD  OF  April  first,  two  thousand  twenty  THROUGH
 SEPTEMBER  THIRTIETH,  TWO  THOUSAND  TWENTY-FOUR  shall increase by ten
 percent.
   FOR ANY RATE YEAR, ALL RECONCILIATION ADD-ON AMOUNTS CALCULATED ON AND
 AFTER OCTOBER FIRST, TWO THOUSAND TWENTY-FOUR SHALL BE REDUCED BY TWENTY
 PERCENT, AND ALL RECONCILIATION  RECOUPMENT  AMOUNTS  CALCULATED  ON  OR
 AFTER  OCTOBER  FIRST, TWO THOUSAND TWENTY-FOUR SHALL INCREASE BY TWENTY
 PERCENT.
   Notwithstanding any inconsistent  provision  of  subparagraph  (i)  of
 paragraph (e) of subdivision nine of this section, capital related inpa-
 tient  expenses  of  a  general  hospital included in the computation of
 rates of payment based on a budget shall not be included in the computa-
 tion of a volume adjustment made in accordance with  such  subparagraph.
 Adjustments  to rates of payment for a general hospital made pursuant to
 this paragraph shall be made in accordance with paragraph (c) of  subdi-
 vision  eleven  of  this  section. Such adjustments shall not be carried
 forward except for such  volume  adjustment  as  may  be  authorized  in
 accordance with subparagraph (i) of paragraph (e) of subdivision nine of
 this section for such general hospital.
   §  2.  Section 5 of part ZZ of chapter 56 of the laws of 2020 amending
 the tax law and the social services law  relating  to  certain  Medicaid
 management, as amended by section 3 of part RR of chapter 57 of the laws
 of 2022, is amended to read as follows:
   §  5.  This  act  shall  take  effect  immediately and shall be deemed
 repealed [five] EIGHT years after such effective date.
   § 3. Section 2 of part E of chapter 57 of the laws of  2015,  amending
 the  public  health  law  relating  to  the payment of certain funds for
 uncompensated care, is amended to read as follows:
   § 2. Notwithstanding any inconsistent provision of law, rule or  regu-
 lation  to  the  contrary,  and  subject  to the availability of federal
 financial participation pursuant to title  XIX  of  the  federal  social
 S. 8307                            11                            A. 8807
 
 security  act,  effective  for  [periods on and after] EACH STATE FISCAL
 YEAR FROM April 1, 2015, THROUGH DECEMBER 31, 2024; AND FOR THE CALENDAR
 YEAR JANUARY 1, 2025 THROUGH DECEMBER 31, 2025; AND  FOR  EACH  CALENDAR
 YEAR THEREAFTER, payments pursuant to paragraph (i) of subdivision 35 of
 section  2807-c of the public health law may be made as outpatient upper
 payment limit payments for outpatient hospital services, not  to  exceed
 an  amount of three hundred thirty-nine million dollars annually between
 payments authorized under this section and such section  of  the  public
 health  law.  Such payments shall be made as medical assistance payments
 for outpatient services pursuant to title 11 of article 5 of the  social
 services  law  for patients eligible for federal financial participation
 under title XIX of the federal social security act for general  hospital
 outpatient  services and general hospital emergency room services issued
 pursuant to paragraph (g) of subdivision 2 of section 2807 of the public
 health law to general hospitals, other than major public general  hospi-
 tals,  providing emergency room services and including safety net hospi-
 tals, which shall, for the purpose of  this  paragraph,  be  defined  as
 having  either:  a Medicaid share of total inpatient hospital discharges
 of at least thirty-five  percent,  including  both  fee-for-service  and
 managed  care  discharges  for  acute and exempt services; or a Medicaid
 share of total discharges of at least  thirty  percent,  including  both
 fee-for-service  and  managed  care  discharges  for  acute  and  exempt
 services, and also  providing  obstetrical  services.    Eligibility  to
 receive  such additional payments shall be based on data from the period
 two years prior to the rate year, as reported on the institutional  cost
 report submitted to the department as of October first of the prior rate
 year.  No  eligible general hospital's annual payment amount pursuant to
 this section shall exceed the lower of the sum of the annual amounts due
 that hospital pursuant  to  section  twenty-eight  hundred  seven-k  and
 section  twenty-eight  hundred  seven-w of the public health law; or the
 hospital's facility specific projected disproportionate  share  hospital
 payment  ceiling established pursuant to federal law, provided, however,
 that payment amounts to eligible hospitals in excess  of  the  lower  of
 such  sum  or payment ceiling shall be reallocated to eligible hospitals
 that do not have excess payment amounts.  Such  reallocations  shall  be
 proportional  to  each such hospital's aggregate payment amount pursuant
 to paragraph (i) of subdivision 35  of  section  2807-c  of  the  public
 health law and this section to the total of all payment amounts for such
 eligible  hospitals.  Such  adjustment  payment may be added to rates of
 payment or made as aggregate  payments  to  eligible  general  hospitals
 other  than  major  public general hospitals.   The distribution of such
 payments shall be pursuant to a methodology approved by the commissioner
 of health in regulation.
   § 4. Section 21 of part B of chapter 57 of the laws of 2015,  amending
 the  social services law relating to supplemental rebates, is amended to
 read as follows:
   § 21. Notwithstanding any inconsistent provision of law, rule or regu-
 lation to the contrary, and  subject  to  the  availability  of  federal
 financial  participation  pursuant  to  title  XIX of the federal social
 security act, effective for [the period] EACH  STATE  FISCAL  YEAR  FROM
 April  1, 2011 through [March 31, 2012, and state fiscal years] DECEMBER
 31, 2024; AND FOR THE CALENDAR YEAR JANUARY 1, 2025 THROUGH DECEMBER 31,
 2025; AND FOR EACH CALENDAR YEAR thereafter, the department of health is
 authorized to increase the operating cost component of rates of  payment
 for  general hospital outpatient services and general hospital emergency
 room services issued pursuant to  paragraph  (g)  of  subdivision  2  of
 S. 8307                            12                            A. 8807
 
 section  2807  of the public health law for public general hospitals, as
 defined in subdivision 10 of section 2801  of  the  public  health  law,
 other  than those operated by the state of New York or the state univer-
 sity  of  New  York,  and  located  in a city with a population over one
 million, up to two hundred  eighty-seven  million  dollars  annually  as
 medical assistance payments for outpatient services pursuant to title 11
 of article 5 of the social services law for patients eligible for feder-
 al financial participation under title XIX of the federal social securi-
 ty  act based on such criteria and methodologies as the commissioner may
 from time to time set through a memorandum of understanding with the New
 York city health and hospitals corporation, and such  adjustments  shall
 be  paid by means of one or more estimated payments, with such estimated
 payments to be reconciled to the commissioner of health's final  adjust-
 ment  determinations  after  the disproportionate share hospital payment
 adjustment caps have been calculated  for  such  period  under  sections
 1923(f)  and  (g)  of  the  federal social security act. Such adjustment
 payment may be added to rates of payment or made as  aggregate  payments
 to eligible public general hospitals.
   §  5.  The  opening  paragraph of subparagraph (i) of paragraph (i) of
 subdivision 35 of section 2807-c of the public health law, as amended by
 section 4 of part C of chapter 56 of the laws of  2013,  is  amended  to
 read as follows:
   Notwithstanding  any inconsistent provision of this subdivision or any
 other contrary provision of law  and  subject  to  the  availability  of
 federal financial participation, for [the period] EACH STATE FISCAL YEAR
 FROM July first, two thousand ten through [March thirty-first, two thou-
 sand eleven,] DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-FOUR; and [each
 state fiscal year period] FOR THE CALENDAR YEAR JANUARY FIRST, TWO THOU-
 SAND  TWENTY-FIVE  THROUGH  DECEMBER  THIRTY-FIRST, TWO THOUSAND TWENTY-
 FIVE; AND FOR EACH CALENDAR YEAR thereafter, the commissioner shall make
 additional inpatient hospital payments up to the aggregate upper payment
 limit for inpatient hospital services after all other medical assistance
 payments, but not to exceed two hundred thirty-five million five hundred
 thousand dollars for the period July first,  two  thousand  ten  through
 March  thirty-first, two thousand eleven, three hundred fourteen million
 dollars for each state fiscal year beginning April first,  two  thousand
 eleven,  through  March thirty-first, two thousand thirteen, and no less
 than three hundred thirty-nine million dollars  for  each  state  fiscal
 year [thereafter] UNTIL DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-FOUR;
 AND  THEN  FROM  CALENDAR  YEAR  JANUARY FIRST, TWO THOUSAND TWENTY-FIVE
 THROUGH DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-FIVE;  AND  FOR  EACH
 CALENDAR  YEAR THEREAFTER, to general hospitals, other than major public
 general hospitals, providing emergency room services and including safe-
 ty net hospitals, which shall, for the purpose  of  this  paragraph,  be
 defined  as  having either: a Medicaid share of total inpatient hospital
 discharges of at least thirty-five percent, including both  fee-for-ser-
 vice  and  managed  care  discharges for acute and exempt services; or a
 Medicaid share of total discharges of at least thirty percent, including
 both fee-for-service and managed care discharges for  acute  and  exempt
 services,  and  also  providing  obstetrical  services.  Eligibility  to
 receive such additional payments shall be based on data from the  period
 two  years prior to the rate year, as reported on the institutional cost
 report submitted to the department as of October first of the prior rate
 year. Such payments shall be made as  medical  assistance  payments  for
 fee-for-service  inpatient hospital services pursuant to title eleven of
 article five of the social services law for patients eligible for feder-
 S. 8307                            13                            A. 8807
 
 al financial participation under title XIX of the federal social securi-
 ty act and in accordance with the following:
   §  6. Section 18 of part B of chapter 57 of the laws of 2015, amending
 the social services law relating to supplemental rebates, is amended  to
 read as follows:
   §  18. Notwithstanding any inconsistent provision of law or regulation
 to the contrary, and subject to the availability  of  federal  financial
 participation  pursuant to title XIX of the federal social security act,
 effective for [the period] EACH STATE FISCAL YEAR FROM  April  1,  2012,
 through  [March 31, 2013, and state fiscal years] DECEMBER 31, 2024; AND
 FOR THE CALENDAR YEAR FROM JANUARY 1, 2025 THROUGH  DECEMBER  31,  2025;
 AND  FOR  EACH  CALENDAR  YEAR  thereafter,  the department of health is
 authorized to pay a public hospital adjustment to public general  hospi-
 tals,  as defined in subdivision 10 of section 2801 of the public health
 law, other than those operated by the state of New  York  or  the  state
 university  of New York, and located in a city with a population of over
 1 million, of up to one  billion  eighty  million  dollars  annually  as
 medical  assistance payments for inpatient services pursuant to title 11
 of article 5 of the social services law for patients eligible for feder-
 al financial participation under title XIX of the federal social securi-
 ty act based on such criteria and methodologies as the commissioner  may
 from time to time set through a memorandum of understanding with the New
 York  city  health and hospitals corporation, and such adjustments shall
 be paid by means of one or more estimated payments, with such  estimated
 payments  to be reconciled to the commissioner of health's final adjust-
 ment determinations after the disproportionate  share  hospital  payment
 adjustment  caps  have  been  calculated  for such period under sections
 1923(f) and (g) of the federal  social  security  act.  Such  adjustment
 payment  may  be added to rates of payment or made as aggregate payments
 to eligible public general hospitals.
   § 7. Subdivision 1 of section 3-a of part B of chapter 58 of the  laws
 of  2010,  amending  the  social  services law and the public health law
 relating to prescription drug coverage for needy persons and health care
 initiatives pools, is amended to read as follows:
   1. Notwithstanding any inconsistent provision of law,  rule  or  regu-
 lation  to  the  contrary,  and  subject  to the availability of federal
 financial participation, effective for [the period]  EACH  STATE  FISCAL
 YEAR  FROM August 1, 2010 through [March 31, 2011, and each state fiscal
 year] DECEMBER 31, 2024; AND FOR THE CALENDAR YEAR FROM JANUARY 1,  2025
 THROUGH  DECEMBER  31,  2025; AND FOR EACH CALENDAR YEAR thereafter, the
 department of health is authorized to make  Medicaid  payment  increases
 for  diagnostic  and treatment centers (DTC) services issued pursuant to
 section 2807 of the public health law for public DTCs  operated  by  the
 New  York  City Health and Hospitals Corporation, at the election of the
 social services district in which an eligible DTC is physically located,
 of up to twelve million six hundred thousand dollars  on  an  annualized
 basis  for  DTC services pursuant to title 11 of article 5 of the social
 services law for patients eligible for federal  financial  participation
 under  title  XIX  of the federal social security act based on each such
 DTC's proportionate share of the sum of all clinic visits for all facil-
 ities eligible for an adjustment pursuant to this section for  the  base
 year two years prior to the rate year. Such proportionate share payments
 may be added to rates of payment or made as aggregate payments to eligi-
 ble DTCs.
   §  8. Subdivision 1 of section 3-b of part B of chapter 58 of the laws
 of 2010, amending the social services law  and  the  public  health  law
 S. 8307                            14                            A. 8807
 
 relating to prescription drug coverage for needy persons and health care
 initiatives pools, is amended to read as follows:
   1.  Notwithstanding  any  inconsistent provision of law, rule or regu-
 lation to the contrary, and  subject  to  the  availability  of  federal
 financial  participation,  effective  for [the period] EACH STATE FISCAL
 YEAR FROM August 1, 2010 through [March 31, 2011, and each state  fiscal
 year]  DECEMBER 31, 2024; AND FOR THE CALENDAR YEAR FROM JANUARY 1, 2025
 THROUGH DECEMBER 31, 2025; AND FOR EACH CALENDAR  YEAR  thereafter,  the
 department  of  health, is authorized to make Medicaid payment increases
 for county operated diagnostic  and  treatment  centers  (DTC)  services
 issued  pursuant  to  section  2807  of  the  public  health law and for
 services provided by  county  operated  free-standing  clinics  licensed
 pursuant  to  articles  31  and  32  of  the mental hygiene law, but not
 including facilities operated by the New York City Health and  Hospitals
 Corporation,  of  up to five million four hundred thousand dollars on an
 annualized basis for such services pursuant to title 11 of article 5  of
 the  social  services  law  for  patients eligible for federal financial
 participation under title XIX of the federal social security act.  Local
 social  services  districts may decline such increased payments to their
 sponsored DTCs and free-standing clinics, provided they provide  written
 notification to the commissioner of health, within thirty days following
 receipt of notification of a payment pursuant to this section.  Distrib-
 utions  pursuant  to  this  section  shall  be  based on each facility's
 proportionate share of the sum of all DTC  and  clinic  visits  for  all
 facilities receiving payments pursuant to this section for the base year
 two  years prior to the rate year. Such proportionate share payments may
 be added to rates or payment or made as aggregate payments  to  eligible
 facilities.
   §  9.  Paragraph (e-1) of subdivision 12 of section 2808 of the public
 health law, as amended by section 15 of part B of chapter 57 of the laws
 of 2023, is amended to read as follows:
   (e-1) Notwithstanding any inconsistent provision of law or regulation,
 the commissioner shall provide,  in  addition  to  payments  established
 pursuant  to  this  article  prior to application of this section, addi-
 tional payments under the medical assistance program pursuant  to  title
 eleven of article five of the social services law for non-state operated
 public  residential health care facilities, including public residential
 health care facilities located in the county of Nassau,  the  county  of
 Westchester  and  the  county  of Erie, but excluding public residential
 health care facilities operated by a town or city within  a  county,  in
 aggregate  annual  amounts of up to one hundred fifty million dollars in
 additional payments for the state fiscal year beginning April first, two
 thousand six and for the state fiscal year beginning  April  first,  two
 thousand  seven and for the state fiscal year beginning April first, two
 thousand eight and of up to three hundred million dollars in such aggre-
 gate annual additional payments for  the  state  fiscal  year  beginning
 April  first, two thousand nine, and for the state fiscal year beginning
 April first, two thousand ten and for the state  fiscal  year  beginning
 April  first, two thousand eleven, and for the state fiscal years begin-
 ning April first, two thousand twelve  and  April  first,  two  thousand
 thirteen,  and  of  up to five hundred million dollars in such aggregate
 annual additional payments for the state fiscal  years  beginning  April
 first,  two  thousand  fourteen,  April  first, two thousand fifteen and
 April first, two thousand sixteen and of  up  to  five  hundred  million
 dollars  in  such  aggregate  annual  additional  payments for the state
 fiscal years beginning April first, two thousand seventeen, April first,
 S. 8307                            15                            A. 8807
 
 two thousand eighteen, and April first, two thousand nineteen, and of up
 to five hundred million dollars  in  such  aggregate  annual  additional
 payments  for the state fiscal years beginning April first, two thousand
 twenty, April first, two thousand twenty-one, and April first, two thou-
 sand  twenty-two,  and  of  up  to  five hundred million dollars in such
 aggregate annual additional payments for the state fiscal  years  begin-
 ning  April  first, two thousand twenty-three, AND FROM April first, two
 thousand twenty-four UNTIL DECEMBER THIRTY-FIRST, TWO  THOUSAND  TWENTY-
 FOUR,  and [April first, two thousand twenty-five] FOR THE CALENDAR YEAR
 JANUARY FIRST, TWO THOUSAND TWENTY-FIVE THROUGH  DECEMBER  THIRTY-FIRST,
 TWO  THOUSAND  TWENTY-FIVE,  AND FOR EACH CALENDAR YEAR THEREAFTER.  The
 amount allocated to each eligible public residential health care facili-
 ty for this period shall be computed in accordance with  the  provisions
 of  paragraph  (f)  of this subdivision, provided, however, that patient
 days shall be utilized for such computation reflecting  actual  reported
 data  for  two thousand three and each representative succeeding year as
 applicable, and provided further, however, that,  in  consultation  with
 impacted providers, of the funds allocated for distribution in the state
 fiscal  year beginning April first, two thousand thirteen, up to thirty-
 two million dollars may be allocated in accordance with paragraph  (f-1)
 of this subdivision.
   §  10.  This  act  shall  take  effect immediately; provided, however,
 section one of this act shall take effect October 1, 2024; and provided,
 further, that sections three, four, five, six, seven, eight and nine  of
 this act shall take effect January 1, 2025.
 
                                  PART E
 
   Section  1.  Subparagraph  (ii) of paragraph (b) of subdivision 2-b of
 section 2808 of the public health law, as added by section 47 of part  C
 of chapter 109 of the laws of 2006, is amended to read as follows:
   (ii) (A) The operating component of rates shall be subject to case mix
 adjustment  through  application  of  the  relative resource utilization
 groups system of patient classification (RUG-III) employed by the feder-
 al government with regard to  payments  to  skilled  nursing  facilities
 pursuant  to  title XVIII of the federal social security act (Medicare),
 as revised by regulation to reflect New  York  state  wages  and  fringe
 benefits,  provided,  however,  that  such RUG-III classification system
 weights shall be increased in the following amounts  for  the  following
 categories  of  residents:  [(A)]  (1)  thirty  minutes for the impaired
 cognition A category, [(B)] (2) forty minutes for the impaired cognition
 B category, and [(C)] (3) twenty-five minutes for the  reduced  physical
 functions  B  category.    Such adjustments shall be made in January and
 July of each calendar year. Such adjustments and related patient classi-
 fications in each facility shall be subject to audit review  in  accord-
 ance with regulations promulgated by the commissioner.
   (B)  EFFECTIVE  APRIL  FIRST,  TWO THOUSAND TWENTY-FOUR, THE OPERATING
 COMPONENT OF THE RATES  FOR  SKILLED  NURSING  FACILITIES  SHALL  REMAIN
 UNCHANGED  FROM  THE  JANUARY  TWO THOUSAND TWENTY-FOUR RATES DURING THE
 DEVELOPMENT AND UNTIL FULL IMPLEMENTATION  OF  A  CASE  MIX  METHODOLOGY
 USING THE PATIENT DRIVEN PAYMENT MODEL.
   §  2. Subparagraph (iv) of paragraph (b) of subdivision 2-b of section
 2808 of the public health law, as amended by section 1  of  part  NN  of
 chapter 56 of the laws of 2020, is amended to read as follows:
   (iv)  The  capital cost component of rates on and after January first,
 two thousand nine shall: (A) fully reflect the cost  of  local  property
 S. 8307                            16                            A. 8807
 
 taxes  and payments made in lieu of local property taxes, as reported in
 each facility's cost report submitted for the year two  years  prior  to
 the  rate  year; (B) provided, however, notwithstanding any inconsistent
 provision  of  this article, commencing April first, two thousand twenty
 for rates of payment for patients eligible for payments  made  by  state
 governmental  agencies, the capital cost component determined in accord-
 ance with this subparagraph and inclusive  of  any  shared  savings  for
 eligible  facilities that elect to refinance their mortgage loans pursu-
 ant to paragraph (d) of subdivision two-a  of  this  section,  shall  be
 reduced  by the commissioner by five percent; AND (C) PROVIDED, HOWEVER,
 NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS  ARTICLE,  COMMENCING
 APRIL  FIRST, TWO THOUSAND TWENTY-FOUR FOR RATES OF PAYMENT FOR PATIENTS
 ELIGIBLE FOR PAYMENTS MADE BY STATE GOVERNMENTAL AGENCIES,  THE  CAPITAL
 COST  COMPONENT  DETERMINED  IN  ACCORDANCE  WITH  THIS SUBPARAGRAPH AND
 INCLUSIVE OF ANY SHARED SAVINGS FOR ELIGIBLE FACILITIES  THAT  ELECT  TO
 REFINANCE  THEIR MORTGAGE LOANS PURSUANT TO PARAGRAPH (D) OF SUBDIVISION
 TWO-A OF THIS SECTION, SHALL BE REDUCED BY THE COMMISSIONER BY AN  ADDI-
 TIONAL TEN PERCENT.
   §  3.  Paragraph  (h)  of  subdivision 1 of section 2632 of the public
 health law, as amended by chapter 414 of the laws of 2015, is amended to
 read as follows:
   (h) in the Persian Gulf conflict from the second day of August,  nine-
 teen  hundred  ninety  to  the  end  of such conflict including military
 service in Operation Enduring Freedom, Operation Iraqi  Freedom,  Opera-
 tion New Dawn or Operation Inherent Resolve and was the recipient of the
 global  war  on terrorism expeditionary medal or the Iraq campaign medal
 or the Afghanistan campaign medal; and who was a resident of  the  state
 of New York at the time of entry upon such active duty or who shall have
 been  a  resident of this state for [one year] SIX MONTHS next preceding
 the application for admission shall be entitled  to  admission  to  said
 home  after  the  approval  of the application by the board of visitors,
 subject to the provisions of this article and to the conditions, limita-
 tions and penalties prescribed by the regulations of the department. Any
 such veteran or dependent, who otherwise fulfills the  requirements  set
 forth  in  this section, may be admitted directly to the skilled nursing
 facility or the health related facility provided such veteran or depend-
 ent is certified by a physician designated or approved by the department
 to require the type of care provided by such facilities.
   § 4. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART F
 
   Section  1.  Paragraph  (n)  of  subdivision 3 of section 461-l of the
 social services law, as amended by section 2 of part B of chapter 57  of
 the laws of 2018, is amended to read as follows:
   (n)  The  commissioner  of health is authorized to create a program to
 subsidize the cost of assisted living for those individuals living  with
 Alzheimer's  disease  and  dementia  who  are  not  eligible for medical
 assistance pursuant to title eleven of article five of this chapter  AND
 RESIDE  IN  A  SPECIAL  NEEDS  ASSISTED LIVING RESIDENCE CERTIFIED UNDER
 SECTION FORTY-SIX HUNDRED FIFTY-FIVE OF THE  PUBLIC  HEALTH  LAW.    The
 program  shall  authorize  up  to  two  hundred  vouchers to individuals
 through an application process and pay for up to seventy-five percent of
 the average private pay rate in the respective region. The  commissioner
 S. 8307                            17                            A. 8807
 
 of   health  may  propose  rules  and  regulations  to  effectuate  this
 provision.
   § 2. Subdivisions 7 and 8 of section 4656 of the public health law, as
 added  by  chapter  2 of the laws of 2004, are renumbered subdivisions 8
 and 9 and a new subdivision 7 is added to read as follows:
   7. (A) ALL ASSISTED LIVING RESIDENCES, AS DEFINED IN  SUBDIVISION  ONE
 OF  SECTION FORTY-SIX HUNDRED FIFTY-ONE OF THIS ARTICLE, INCLUDING THOSE
 LICENSED AND CERTIFIED AS AN ASSISTED LIVING  RESIDENCE,  SPECIAL  NEEDS
 ASSISTED LIVING RESIDENCE, OR ENHANCED ASSISTED LIVING RESIDENCE, SHALL:
   (I)  REPORT  ANNUALLY  ON  QUALITY  MEASURES  TO BE ESTABLISHED BY THE
 DEPARTMENT, IN THE FORM AND FORMAT PRESCRIBED BY  THE  DEPARTMENT,  WITH
 THE  FIRST  REPORT  DUE NO LATER THAN JANUARY THIRTY-FIRST, TWO THOUSAND
 TWENTY-FIVE; AND
   (II) POST THE MONTHLY  SERVICE  RATE,  STAFFING  COMPLEMENT,  APPROVED
 ADMISSION OR RESIDENCY AGREEMENT, AND A CONSUMER-FRIENDLY SUMMARY OF ALL
 SERVICE  FEES  IN A CONSPICUOUS PLACE ON THE FACILITY'S WEBSITE AND IN A
 PUBLIC SPACE WITHIN THE FACILITY. SUCH INFORMATION SHALL BE MADE  AVAIL-
 ABLE  TO  THE  PUBLIC ON FORMS DEVELOPED BY THE DEPARTMENT. BEGINNING ON
 JANUARY FIRST, TWO THOUSAND TWENTY-FIVE, THIS INFORMATION SHALL ALSO  BE
 REPORTED TO THE DEPARTMENT.
   (B)  THE  DEPARTMENT  SHALL  SCORE  THE RESULTS OF THE ASSISTED LIVING
 QUALITY REPORTING OBTAINED PURSUANT TO PARAGRAPH (A)  OF  THIS  SUBDIVI-
 SION.    TOP  SCORING  FACILITIES SHALL BE GRANTED THE CLASSIFICATION OF
 ADVANCED STANDING ON THEIR ANNUAL SURVEILLANCE SCHEDULES.
   (I) NOTWITHSTANDING SUBPARAGRAPH ONE OF PARAGRAPH (A)  OF  SUBDIVISION
 TWO  OF  SECTION  FOUR  HUNDRED  SIXTY-ONE-A OF THE SOCIAL SERVICES LAW,
 FACILITIES  ACHIEVING  AN  ADVANCED  STANDING  CLASSIFICATION  SHALL  BE
 SURVEYED  EVERY TWELVE TO EIGHTEEN MONTHS. ALL OTHER FACILITIES SHALL BE
 SURVEYED ON AN UNANNOUNCED BASIS NO LESS THAN ANNUALLY; PROVIDED, HOWEV-
 ER, THAT THIS SHALL NOT APPLY TO SURVEYS, INSPECTIONS OR  INVESTIGATIONS
 BASED ON COMPLAINTS RECEIVED BY THE DEPARTMENT UNDER ANY OTHER PROVISION
 OF LAW.
   (II)   FACILITIES  MAY  REMAIN  ON  ADVANCED  STANDING  CLASSIFICATION
 PROVIDED THEY MEET THE SCORING REQUIREMENTS IN THE ASSISTED LIVING QUAL-
 ITY REPORTING.
   (C) EFFECTIVE JANUARY  THIRTY-FIRST,  TWO  THOUSAND  TWENTY-FIVE,  THE
 DEPARTMENT  MAY  POST  ON ITS WEBSITE THE RESULTS OF THE ASSISTED LIVING
 QUALITY REPORTING COLLECTED PURSUANT TO SUBPARAGRAPH  (I)  OF  PARAGRAPH
 (A) OF THIS SUBDIVISION.
   § 3. Subparagraph 1 of paragraph (a) of subdivision 2 of section 461-a
 of  the  social  services  law, as amended by chapter 735 of the laws of
 1994, is amended and a new subparagraph 1-a is added to read as follows:
   (1) Such facilities receiving the department's highest rating shall be
 inspected at least once every eighteen months on an  unannounced  basis.
 SUCH  RATING  DETERMINATION  SHALL  BE MADE PURSUANT TO AN EVALUATION OF
 QUALITY INDICATORS AS DEVELOPED BY THE DEPARTMENT AND PUBLISHED  ON  THE
 DEPARTMENT'S WEBSITE.
   (1-A)  (I)  ADULT  CARE FACILITIES DUALLY LICENSED TO PROVIDE ASSISTED
 LIVING PURSUANT TO  THE  REQUIREMENTS  SPECIFIED  IN  SECTION  FORTY-SIX
 HUNDRED  FIFTY-THREE  OF THE PUBLIC HEALTH LAW MAY SEEK ACCREDITATION BY
 ONE OR MORE NATIONALLY RECOGNIZED ACCREDITING AGENCIES DETERMINED BY THE
 COMMISSIONER.
   (II) SUCH ACCREDITATION AGENCIES SHALL REPORT DATA AND INFORMATION, IN
 A MANNER AND FORM AS DETERMINED BY THE DEPARTMENT, PERTAINING  TO  THOSE
 ASSISTED  LIVING  RESIDENCES ACCREDITED BY SUCH AGENCIES, THOSE ASSISTED
 LIVING RESIDENCES THAT SEEK BUT DO NOT RECEIVE SUCH  ACCREDITATION,  AND
 S. 8307                            18                            A. 8807
 
 THOSE  ASSISTED  LIVING  RESIDENCES  WHICH OBTAIN BUT LOSE SUCH ACCREDI-
 TATION.
   (III) NOTWITHSTANDING THE PROVISIONS OF SUBPARAGRAPH ONE OF THIS PARA-
 GRAPH,  OR  ANY OTHER PROVISION OF LAW, ASSISTED LIVING RESIDENCES WHICH
 HAVE OBTAINED ACCREDITATION FROM A NATIONALLY  RECOGNIZED  ACCREDITATION
 ORGANIZATION  APPROVED  BY  THE  DEPARTMENT  AND  WHICH MEET ELIGIBILITY
 CRITERIA, AS DETERMINED BY THE DEPARTMENT, MAY, AT THE DISCRETION OF THE
 COMMISSIONER, BE EXEMPT FROM THE DEPARTMENT INSPECTION REQUIRED IN  THIS
 SUBDIVISION  FOR  THE DURATION THEY MAINTAIN THEIR ACCREDITATION IN GOOD
 STANDING. THE OPERATOR OF AN ADULT CARE FACILITY THAT OBTAINS BUT SUBSE-
 QUENTLY LOSES ACCREDITATION SHALL REPORT SUCH  LOSS  TO  THE  DEPARTMENT
 WITHIN  TEN BUSINESS DAYS IN A MANNER AND FORM DETERMINED BY THE DEPART-
 MENT AND WILL  NO  LONGER  BE  EXEMPT  FROM  THE  DEPARTMENT  INSPECTION
 REQUIRED IN THIS SUBDIVISION. THE DEPARTMENT SHALL POST ON ITS WEBSITE A
 LIST OF ALL ACCREDITED ASSISTED LIVING RESIDENCES.
   §  4.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024; provided,
 however, the provisions of sections two and three of this act shall take
 effect on the one hundred twentieth day after it  shall  have  become  a
 law.
 
                                  PART G
 
   Section  1.  Paragraph  (i)  of subdivision 1 of section 3614-c of the
 public health law is REPEALED.
   § 2. Paragraph (d) of subdivision 1, and subdivisions 2, 4, 5, 5-a, 6,
 6-a, 7, 7-a, 9 and 10 of section 3614-c of the public health law, subdi-
 visions 2, 4, 5, 6, 7, 9 and 10 as amended and subdivisions 6-a and  7-a
 as  added  by  section  1 and subdivision 5-a as added by section 1-a of
 part OO of chapter 56 of the laws  of  2020,  are  amended  to  read  as
 follows:
   (d)  "Home  care  aide"  means a home health aide, personal care aide,
 home  attendant,  [personal  assistant  performing   consumer   directed
 personal  assistance  services  pursuant to section three hundred sixty-
 five-f of the social services law,]  or  other  licensed  or  unlicensed
 person  whose  primary  responsibility includes the provision of in-home
 assistance with activities of daily living, instrumental  activities  of
 daily  living or health-related tasks; provided, however, that home care
 aide does not include any individual (i) working on a casual  basis,  or
 (ii) [(except for a person employed under the consumer directed personal
 assistance  program  under  section  three  hundred  sixty-five-f of the
 social services law)] who is  a  relative  through  blood,  marriage  or
 adoption  of: (1) the employer; or (2) the person for whom the worker is
 delivering services, under a program funded or administered by  federal,
 state or local government.
   2.  Notwithstanding  any  inconsistent provision of law, rule or regu-
 lation, no payments by government agencies shall be  made  to  certified
 home  health agencies, long term home health care programs, managed care
 plans, [fiscal intermediaries,] the nursing home transition  and  diver-
 sion  waiver program under section three hundred sixty-six of the social
 services law, or the traumatic brain injury waiver program under section
 twenty-seven hundred forty of this  chapter  for  any  episode  of  care
 furnished, in whole or in part, by any home care aide who is compensated
 at amounts less than the applicable minimum rate of home care aide total
 compensation established pursuant to this section.
 S. 8307                            19                            A. 8807
 
   4.  The terms of this section shall apply equally to services provided
 by home care aides who work on episodes of care as direct  employees  of
 certified  home health agencies, long term home health care programs, or
 managed care plans, or as employees of licensed home care services agen-
 cies,  limited licensed home care services agencies, [or fiscal interme-
 diaries,] or under any other arrangement.
   5. No payments by government agencies shall be made to certified  home
 health  agencies,  licensed  home care services agencies, long term home
 health care programs, managed care plans[,  fiscal  intermediaries]  for
 any  episode  of care without the certified home health agency, licensed
 home care services agency,  long  term  home  health  care  program,  OR
 managed  care  plan [or the fiscal intermediary], having delivered prior
 written certification to the commissioner annually, at a time prescribed
 by the commissioner, on forms prepared by the department in consultation
 with the department of labor, that  all  services  provided  under  each
 episode  of  care  during the period covered by the certification are in
 full compliance with the terms  of  this  section  and  any  regulations
 promulgated  pursuant to this section and that no portion of the dollars
 spent or to be spent to satisfy the wage or benefit portion  under  this
 section  shall be returned to the certified home health agency, licensed
 home care services agency,  long  term  home  health  care  program,  OR
 managed  care  plan,  [or fiscal intermediary,] related persons or enti-
 ties, other than to a home care aide as defined in this section to  whom
 the  wage  or benefits are due, as a refund, dividend, profit, or in any
 other manner.  Such written certification shall  also  verify  that  the
 certified  home  health  agency,  long term home health care program, or
 managed care plan has received from  the  licensed  home  care  services
 agency,  [fiscal intermediary,] or other third party an annual statement
 of wage parity hours and expenses on a form provided by  the  department
 of  labor  accompanied  by  an independently-audited financial statement
 verifying such expenses.
   5-a. No portion of the dollars spent or to be  spent  to  satisfy  the
 wage  or  benefit  portion  under  this section shall be returned to the
 certified home health agency, licensed home care services  agency,  long
 term home health care program, OR managed care plan, [or fiscal interme-
 diary,]  related  persons or entities, other than to a home care aide as
 defined in this section to whom the wage  or  benefits  are  due,  as  a
 refund, dividend, profit, or in any other manner.
   6.  If  a  certified  home  health  agency, long term home health care
 program or managed care plan elects to provide home care  aide  services
 through  contracts  with  licensed  home care services agencies, [fiscal
 intermediaries,] or through  other  third  parties,  provided  that  the
 episode  of  care on which the home care aide works is covered under the
 terms of this section, the certified home health agency, long term  home
 health  care  program,  or  managed  care  plan  shall  include  in  its
 contracts, a requirement that it be  provided  with  a  written  certif-
 ication,  verified by oath, from the licensed home care services agency,
 [fiscal intermediary,] or other third party, on forms  prepared  by  the
 department  in  consultation with the department of labor, which attests
 to the licensed home care services agency's, [fiscal intermediary's,] or
 other third party's compliance with the  terms  of  this  section.  Such
 contracts  shall  also  obligate the licensed home care services agency,
 [fiscal intermediary,] or other third party  to  provide  the  certified
 home  health agency, long term home health care program, or managed care
 plan all information  from  the  licensed  home  care  services  agency,
 [fiscal  intermediary]  or other third party necessary to verify compli-
 S. 8307                            20                            A. 8807
 
 ance with the terms of this  section,  which  shall  include  an  annual
 compliance  statement  of  wage  parity  hours  and  expenses  on a form
 provided by the department of labor accompanied by an  independently-au-
 dited  financial  statement  verifying such expenses. Such annual state-
 ments shall be available no less than annually for the previous calendar
 year, at a time as prescribed by the commissioner.  Such certifications,
 the information necessary to verify compliance, and the  annual  compli-
 ance  statement and financial statements shall be retained by all certi-
 fied home health agencies, long  term  home  health  care  programs,  or
 managed  care  plans,  and  all  licensed  home  care services agencies,
 [fiscal intermediaries,] or other third parties for a period of no  less
 than  ten  years, and made available to the department upon request. Any
 licensed home care services  agency,  [fiscal  intermediary,]  or  other
 third  party  who  shall  upon  oath verify any statement required to be
 transmitted under this section and any regulations promulgated  pursuant
 to this section which is known by such party to be false shall be guilty
 of perjury and punishable as provided by the penal law.
   6-a.  The  certified  home  health  agency, long term home health care
 program, or managed care plan shall review and assess the annual compli-
 ance statement of wage parity hours and  expenses  and  make  a  written
 referral  to  the department of labor for any reasonably suspected fail-
 ures of licensed home care services agencies,  [fiscal  intermediaries,]
 or  third  parties  to  conform  to the wage parity requirements of this
 section.
   7. The commissioner shall distribute  to  all  certified  home  health
 agencies,  long  term home health care programs, managed care plans, AND
 licensed home care services agencies[, and fiscal intermediaries]  offi-
 cial notice of the minimum rates of home care aide compensation at least
 one hundred twenty days prior to the effective date of each minimum rate
 for each social services district covered by the terms of this section.
   7-a.  Any  certified  home  health agency, licensed home care services
 agency, long term home health  care  program,  managed  care  plan,  [or
 fiscal intermediary,] or other third party that willfully pays less than
 such stipulated minimums regarding wages and supplements, as established
 in  this  section,  shall be guilty of a misdemeanor and upon conviction
 shall be punished, for a first offense by a fine of five hundred dollars
 or by imprisonment for not more than thirty days, or by  both  fine  and
 imprisonment;  for  a  second offense by a fine of one thousand dollars,
 and in addition thereto the contract on which the violation has occurred
 shall be forfeited; and no such person or corporation shall be  entitled
 to receive any sum nor shall any officer, agent or employee of the state
 pay  the  same  or authorize its payment from the funds under his or her
 charge or control to any person or corporation for work  done  upon  any
 contract,  on which the certified home health agency, licensed home care
 services agency, long term home health care program, managed care  plan,
 [or  fiscal  intermediary,] or other third party has been convicted of a
 second offense in violation of the provisions of this section.
   9. Nothing in this section should be construed as  applicable  to  any
 service  provided  by certified home health agencies, licensed home care
 services agencies, long term home health  care  programs[,]  OR  managed
 care  plans[,  or fiscal intermediaries] except for all episodes of care
 reimbursed in whole or in part by the New York Medicaid program.
   10. No certified home health agency, managed care plan, or  long  term
 home  health  care program shall be liable for recoupment of payments or
 any other penalty under this section for  services  provided  through  a
 licensed  home  care  services  agency,  [fiscal intermediary,] or other
 S. 8307                            21                            A. 8807
 
 third party with which the certified home health agency, long term  home
 health  care  program,  or  managed care plan has a contract because the
 licensed agency, [fiscal intermediary,] or other third party  failed  to
 comply  with the provisions of this section if the certified home health
 agency, long term home health care program, or  managed  care  plan  has
 reasonably  and  in good faith collected certifications and all informa-
 tion required pursuant to this section and conducts the  monitoring  and
 reporting required by this section.
   § 3. This act shall take effect October 1, 2024.

                                  PART H
 
   Section  1.  Section  602  of  the financial services law, as added by
 section 26 of part H of chapter 60 of the laws of 2014,  is  amended  to
 read as follows:
   §  602.  Applicability.  [(a)]  This article shall not apply to health
 care services, including emergency services, where  physician  fees  are
 subject  to schedules or other monetary limitations under any other law,
 including the workers' compensation law and  article  fifty-one  of  the
 insurance  law,  and  shall  not preempt any such law. THIS ARTICLE ALSO
 SHALL NOT APPLY TO HEALTH CARE SERVICES, INCLUDING  EMERGENCY  SERVICES,
 SUBJECT  TO  MEDICAL  ASSISTANCE  PROGRAM  COVERAGE PROVIDED PURSUANT TO
 SECTION THREE HUNDRED SIXTY-FOUR-J OF THE SOCIAL SERVICES LAW.
   § 2. Subdivision 2 of section 364-j of  the  social  services  law  is
 amended by adding a new paragraph (e) to read as follows:
   (E)  EFFECTIVE  APRIL  FIRST, TWO THOUSAND TWENTY-FOUR AND EXPIRING ON
 THE DATE THE  COMMISSIONER  PUBLISHES  ON  THE  DEPARTMENT'S  WEBSITE  A
 REQUEST  FOR  PROPOSALS  IN ACCORDANCE WITH PARAGRAPH (A) OF SUBDIVISION
 FIVE OF THIS SECTION, THE COMMISSIONER SHALL PLACE A MORATORIUM  ON  THE
 PROCESSING AND APPROVAL OF APPLICATIONS SEEKING AUTHORITY TO ESTABLISH A
 MANAGED  CARE  PROVIDER, INCLUDING APPLICATIONS SEEKING AUTHORIZATION TO
 EXPAND THE SCOPE OF ELIGIBLE ENROLLEE POPULATIONS. SUCH MORATORIUM SHALL
 NOT APPLY TO:
   (I) APPLICATIONS SUBMITTED TO THE DEPARTMENT PRIOR TO  JANUARY  FIRST,
 TWO THOUSAND TWENTY-FOUR;
   (II) APPLICATIONS SEEKING APPROVAL TO TRANSFER OWNERSHIP OR CONTROL OF
 AN EXISTING MANAGED CARE PROVIDER;
   (III) APPLICATIONS SEEKING AUTHORIZATION TO EXPAND AN EXISTING MANAGED
 CARE PROVIDER'S APPROVED SERVICE AREA;
   (IV)  APPLICATIONS  SEEKING AUTHORIZATION TO FORM OR OPERATE A MANAGED
 CARE PROVIDER THROUGH  AN  ENTITY  CERTIFIED  UNDER  SECTION  FORTY-FOUR
 HUNDRED THREE-C OR FORTY-FOUR HUNDRED THREE-G OF THE PUBLIC HEALTH LAW;
   (V) APPLICATIONS DEMONSTRATING TO THE COMMISSIONER'S SATISFACTION THAT
 SUBMISSION  OF THE APPLICATION FOR CONSIDERATION WOULD BE APPROPRIATE TO
 ADDRESS A SERIOUS CONCERN WITH CARE DELIVERY, SUCH AS A LACK OF ADEQUATE
 ACCESS TO MANAGED CARE PROVIDERS IN A  GEOGRAPHIC  AREA  OR  A  LACK  OF
 ADEQUATE  AND  APPROPRIATE  CARE,  LANGUAGE  AND CULTURAL COMPETENCE, OR
 SPECIAL NEEDS SERVICES.
   § 3. Subdivision 5 of section 364-j of the  social  services  law,  as
 amended by section 15 of part C of chapter 58 of the laws of 2004, para-
 graph  (a)  as amended by section 40 of part A of chapter 56 of the laws
 of 2013, and paragraphs (d), (e) and (f) as amended  by  section  80  of
 part H of chapter 59 of the laws of 2011, is amended to read as follows:
   5.  Managed  care  programs  shall be conducted in accordance with the
 requirements of this section and, to the extent  practicable,  encourage
 S. 8307                            22                            A. 8807
 
 the  provision of comprehensive medical services, pursuant to this arti-
 cle.
   (a) The [managed care program] COMMISSIONER OF HEALTH shall, THROUGH A
 COMPETITIVE  BID PROCESS BASED ON PROPOSALS SUBMITTED TO THE DEPARTMENT,
 provide for the selection of qualified managed care  providers  [by  the
 commissioner  of  health]  to  participate  in  the MANAGED CARE program
 PURSUANT TO A CONTRACT WITH THE DEPARTMENT, including [comprehensive HIV
 special needs plans and] special needs managed care plans in  accordance
 with the provisions of section three hundred sixty-five-m of this title;
 provided, however, that the commissioner of health may contract directly
 with  comprehensive  HIV  special needs plans [consistent with standards
 set forth in this section] WITHOUT A COMPETITIVE BID PROCESS, and assure
 that such providers are accessible taking  into  account  the  needs  of
 persons  with  disabilities and the differences between rural, suburban,
 and urban settings, and in sufficient numbers to meet  the  health  care
 needs  of  participants,  and  shall  consider the extent to which major
 public hospitals are included within such  providers'  networks[.];  AND
 PROVIDED FURTHER THAT:
   [(b) A proposal] (I) PROPOSALS submitted by a managed care provider to
 participate in the managed care program shall:
   [(i)]  (A)  designate  the  geographic [area] AREAS, AS DEFINED BY THE
 COMMISSIONER IN THE REQUEST FOR PROPOSALS, to be served [by the  provid-
 er], and estimate the number of eligible participants and actual partic-
 ipants in such designated area;
   [(ii)]  (B)  include  a network of health care providers in sufficient
 numbers and geographically accessible to service program participants;
   [(iii)] (C) describe the  procedures  for  marketing  in  the  program
 location,  including the designation of other entities which may perform
 such functions under contract with the organization;
   [(iv)] (D) describe the quality assurance, utilization review and case
 management mechanisms to be implemented;
   [(v)] (E) demonstrate the applicant's ability to meet the data  analy-
 sis and reporting requirements of the program;
   [(vi)] (F) demonstrate financial feasibility of the program; and
   [(vii)]  (G)  include  such  other  information as the commissioner of
 health may deem appropriate.
   [(c) The commissioner of health shall make a determination whether  to
 approve, disapprove or recommend modification of the proposal.
   (d)  Notwithstanding  any  inconsistent  provision  of  this title and
 section one hundred sixty-three of the state finance  law,  the  commis-
 sioner of health may contract with managed care providers approved under
 paragraph  (b) of this subdivision, without a competitive bid or request
 for proposal process, to provide coverage for participants  pursuant  to
 this title.
   (e)  Notwithstanding  any  inconsistent  provision  of  this title and
 section one hundred forty-three of  the  economic  development  law,  no
 notice in the procurement opportunities newsletter shall be required for
 contracts  awarded  by  the commissioner of health, to qualified managed
 care providers pursuant to this section.
   (f)] (II) IN ADDITION TO THE CRITERIA DESCRIBED IN SUBPARAGRAPH (I) OF
 THIS PARAGRAPH, THE COMMISSIONER SHALL ALSO CONSIDER:
   (A) ACCESSIBILITY AND GEOGRAPHIC DISTRIBUTION  OF  NETWORK  PROVIDERS,
 TAKING  INTO  ACCOUNT  THE  NEEDS  OF  PERSONS WITH DISABILITIES AND THE
 DIFFERENCES BETWEEN RURAL, SUBURBAN, AND URBAN SETTINGS;
   (B) THE EXTENT TO WHICH MAJOR PUBLIC HOSPITALS  ARE  INCLUDED  IN  THE
 SUBMITTED PROVIDER NETWORK;
 S. 8307                            23                            A. 8807
 
   (C)  DEMONSTRATED  CULTURAL  AND LANGUAGE COMPETENCIES SPECIFIC TO THE
 POPULATION OF PARTICIPANTS;
   (D)  THE CORPORATE ORGANIZATION AND STATUS OF THE BIDDER AS A CHARITA-
 BLE CORPORATION UNDER THE NOT-FOR-PROFIT CORPORATION LAW;
   (E) THE ABILITY OF A BIDDER TO OFFER PLANS IN MULTIPLE REGIONS;
   (F) THE TYPE AND NUMBER OF PRODUCTS THE BIDDER  PROPOSES  TO  OPERATE,
 INCLUDING PRODUCTS BID FOR IN ACCORDANCE WITH THE PROVISIONS OF SUBDIVI-
 SION SIX OF SECTION FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW,
 AND  OTHER  PRODUCTS  DETERMINED  BY THE COMMISSIONER, INCLUDING BUT NOT
 NECESSARILY LIMITED TO THOSE OPERATED UNDER TITLE ONE-A OF ARTICLE TWEN-
 TY-FIVE OF THE PUBLIC HEALTH LAW AND SECTION THREE HUNDRED SIXTY-NINE-GG
 OF THIS ARTICLE;
   (G) WHETHER THE BIDDER PARTICIPATES IN PRODUCTS  FOR  INTEGRATED  CARE
 FOR PARTICIPANTS WHO ARE DUALLY ELIGIBLE FOR MEDICAID AND MEDICARE;
   (H)  WHETHER  THE  BIDDER PARTICIPATES IN VALUE BASED PAYMENT ARRANGE-
 MENTS AS DEFINED BY THE DEPARTMENT, INCLUDING THE DELEGATION OF  SIGNIF-
 ICANT FINANCIAL RISK TO CLINICALLY INTEGRATED PROVIDER NETWORKS;
   (I)  THE  BIDDER'S  COMMITMENT TO PARTICIPATION IN MANAGED CARE IN THE
 STATE;
   (J) THE BIDDER'S COMMITMENT TO QUALITY IMPROVEMENT;
   (K) THE BIDDER'S COMMITMENT TO  COMMUNITY  REINVESTMENT  SPENDING,  AS
 SHALL BE DEFINED IN THE PROCUREMENT;
   (L)  FOR CURRENT OR PREVIOUSLY AUTHORIZED MANAGED CARE PROVIDERS, PAST
 PERFORMANCE IN  MEETING  MANAGED  CARE  CONTRACT  OR  FEDERAL  OR  STATE
 REQUIREMENTS, AND IF THE COMMISSIONER ISSUED ANY STATEMENTS OF FINDINGS,
 STATEMENTS  OF DEFICIENCY, INTERMEDIATE SANCTIONS OR ENFORCEMENT ACTIONS
 TO A BIDDER FOR  NON-COMPLIANCE  WITH  SUCH  REQUIREMENTS,  WHETHER  THE
 BIDDER ADDRESSED SUCH ISSUES IN A TIMELY MANNER; AND
   (M) ANY OTHER CRITERIA DEEMED APPROPRIATE BY THE COMMISSIONER.
   (III) SUBPARAGRAPHS (I) AND (II) OF THIS PARAGRAPH DESCRIBING PROPOSAL
 CONTENT  AND  SELECTION  CRITERIA REQUIREMENTS SHALL NOT BE CONSTRUED AS
 LIMITING OR REQUIRING THE  COMMISSIONER  TO  EVALUATE  SUCH  CONTENT  OR
 CRITERIA  ON  A PASS/FAIL SCALE, OR OTHER METHODOLOGICAL BASIS; PROVIDED
 HOWEVER, THAT THE COMMISSIONER MUST CONSIDER ALL SUCH CONTENT AND CRITE-
 RIA USING METHODS DETERMINED BY THE  COMMISSIONER  IN  THEIR  DISCRETION
 AND, AS APPLICABLE, IN CONSULTATION WITH THE COMMISSIONERS OF THE OFFICE
 OF MENTAL HEALTH, THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES,
 THE  OFFICE  OF ADDICTION SERVICES AND SUPPORTS, AND THE OFFICE OF CHIL-
 DREN AND FAMILY SERVICES.
   (IV) THE DEPARTMENT SHALL POST ON ITS WEBSITE:
   (A) THE REQUEST FOR  PROPOSALS  AND  A  DESCRIPTION  OF  THE  PROPOSED
 SERVICES  TO  BE  PROVIDED PURSUANT TO CONTRACTS IN ACCORDANCE WITH THIS
 SUBDIVISION;
   (B) THE CRITERIA ON WHICH THE  DEPARTMENT  SHALL  DETERMINE  QUALIFIED
 BIDDERS  AND EVALUATE THEIR PROPOSALS, INCLUDING ALL CRITERIA IDENTIFIED
 IN THIS SUBDIVISION;
   (C) THE MANNER BY WHICH A PROPOSAL MAY BE SUBMITTED, WHICH MAY INCLUDE
 SUBMISSION BY ELECTRONIC MEANS;
   (D) THE MANNER BY WHICH  A  MANAGED  CARE  PROVIDER  MAY  CONTINUE  TO
 PARTICIPATE  IN  THE  MANAGED CARE PROGRAM PENDING AWARD OF MANAGED CARE
 PROVIDERS THROUGH A COMPETITIVE BID PROCESS PURSUANT  TO  THIS  SUBDIVI-
 SION; AND
   (E)  UPON  AWARD,  THE  MANAGED  CARE  PROVIDERS THAT THE COMMISSIONER
 INTENDS TO CONTRACT WITH PURSUANT TO THIS SUBDIVISION, PROVIDED THAT THE
 COMMISSIONER SHALL UPDATE SUCH LIST  TO  INDICATE  THE  FINAL  SLATE  OF
 CONTRACTED MANAGED CARE PROVIDERS.
 S. 8307                            24                            A. 8807
 
   (V)  (A)  ALL RESPONSIBLE AND RESPONSIVE SUBMISSIONS THAT ARE RECEIVED
 FROM BIDDERS IN A TIMELY FASHION SHALL BE REVIEWED BY  THE  COMMISSIONER
 OF HEALTH IN CONSULTATION WITH THE COMMISSIONERS OF THE OFFICE OF MENTAL
 HEALTH,  THE  OFFICE  FOR  PEOPLE  WITH  DEVELOPMENTAL DISABILITIES, THE
 OFFICE  OF  ADDICTION  SERVICES AND SUPPORTS, AND THE OFFICE OF CHILDREN
 AND FAMILY SERVICES, AS  APPLICABLE.  THE  COMMISSIONER  SHALL  CONSIDER
 COMMENTS  RESULTING  FROM  THE  REVIEW  OF  PROPOSALS AND MAKE AWARDS IN
 CONSULTATION WITH SUCH AGENCIES.
   (B) THE COMMISSIONER MAY MAKE AWARDS UNDER THIS SUBDIVISION  FOR  EACH
 PRODUCT, FOR WHICH PROPOSALS WERE REQUESTED, TO TWO OR MORE MANAGED CARE
 PROVIDERS  IN  EACH GEOGRAPHIC REGION DEFINED BY THE COMMISSIONER IN THE
 REQUEST FOR PROPOSALS FOR WHICH AT LEAST TWO MANAGED CARE PROVIDERS HAVE
 SUBMITTED A PROPOSAL, AND SHALL HAVE DISCRETION TO OFFER MORE  CONTRACTS
 BASED ON NEED FOR ACCESS.
   (C)  MANAGED  CARE  PROVIDERS  AWARDED UNDER THIS SUBDIVISION SHALL BE
 ENTITLED TO ENTER INTO A CONTRACT WITH THE DEPARTMENT FOR THE PURPOSE OF
 PARTICIPATING IN THE MANAGED CARE PROGRAM. SUCH CONTRACTS SHALL RUN  FOR
 A  TERM  TO  BE  DETERMINED BY THE COMMISSIONER, WHICH MAY BE RENEWED OR
 MODIFIED FROM TIME TO TIME WITHOUT  A  NEW  REQUEST  FOR  PROPOSALS,  TO
 ENSURE  CONSISTENCY  WITH CHANGES IN FEDERAL AND STATE LAWS, REGULATIONS
 AND POLICIES, INCLUDING BUT NOT LIMITED TO THE EXPANSION OR REDUCTION OF
 MEDICAL ASSISTANCE SERVICES AVAILABLE  TO  THE  PARTICIPANTS  THROUGH  A
 MANAGED CARE PROVIDER.
   (D) NOTHING IN THIS PARAGRAPH OR OTHER PROVISION OF THIS SECTION SHALL
 BE CONSTRUED TO LIMIT IN ANY WAY THE ABILITY OF THE DEPARTMENT TO TERMI-
 NATE AWARDED CONTRACTS FOR CAUSE, WHICH SHALL INCLUDE BUT NOT BE LIMITED
 TO  ANY  VIOLATION OF THE TERMS OF SUCH CONTRACTS OR VIOLATIONS OF STATE
 OR FEDERAL LAWS AND REGULATIONS AND  ANY  LOSS  OF  NECESSARY  STATE  OR
 FEDERAL FUNDING.
   (E) NOTHING IN THIS PARAGRAPH OR OTHER PROVISION OF THIS SECTION SHALL
 BE  CONSTRUED TO LIMIT IN ANY WAY THE ABILITY OF THE DEPARTMENT TO ISSUE
 A NEW REQUEST FOR PROPOSALS FOR A TERM FOLLOWING AN EXISTING TERM OF  AN
 AWARD.
   (B)  IF  NECESSARY  TO ENSURE ACCESS TO A SUFFICIENT NUMBER OF MANAGED
 CARE PROVIDERS ON A GEOGRAPHIC OR  OTHER  BASIS,  INCLUDING  A  LACK  OF
 ADEQUATE  AND  APPROPRIATE  CARE,  LANGUAGE  AND CULTURAL COMPETENCE, OR
 SPECIAL NEEDS SERVICES, THE  COMMISSIONER  MAY  REISSUE  A  REQUEST  FOR
 PROPOSALS  AS  PROVIDED  FOR  UNDER  PARAGRAPH  (A) OF THIS SUBDIVISION,
 PROVIDED HOWEVER THAT SUCH REQUEST MAY BE LIMITED TO THE  GEOGRAPHIC  OR
 OTHER  BASIS  OF  NEED  THAT  THE  REQUEST  FOR  PROPOSALS IS SEEKING TO
 ADDRESS. ANY AWARDS MADE SHALL BE SUBJECT TO THE  REQUIREMENTS  OF  THIS
 SECTION,  INCLUDING BUT NOT LIMITED TO THE MINIMUM AND MAXIMUM NUMBER OF
 AWARDS IN A REGION.
   (C) The care and  services  described  in  subdivision  four  of  this
 section  will  be  furnished  by a managed care provider pursuant to the
 provisions of this section when such services are furnished  in  accord-
 ance  with an agreement with the department of health, and meet applica-
 ble federal law and regulations.
   [(g)] (D) The commissioner of health may delegate some or all  of  the
 tasks identified in this section to the local districts.
   [(h)]  (E)  Any  delegation  pursuant  to  paragraph [(g)] (D) of this
 subdivision shall be reflected in the contract between  a  managed  care
 provider and the commissioner of health.
   §  4.  Subdivision  4  of  section 365-m of the social services law is
 REPEALED and a new subdivision 4 is added to read as follows:
 S. 8307                            25                            A. 8807
 
   4. THE COMMISSIONER OF HEALTH, JOINTLY WITH THE COMMISSIONERS  OF  THE
 OFFICE  OF  MENTAL  HEALTH  AND  THE  OFFICE  OF  ADDICTION SERVICES AND
 SUPPORTS, SHALL SELECT A LIMITED NUMBER OF SPECIAL  NEEDS  MANAGED  CARE
 PLANS UNDER SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE, IN ACCORD-
 ANCE  WITH  SUBDIVISION  FIVE  OF  SUCH SECTION, CAPABLE OF MANAGING THE
 BEHAVIORAL AND PHYSICAL HEALTH NEEDS  OF  MEDICAL  ASSISTANCE  ENROLLEES
 WITH SIGNIFICANT BEHAVIORAL HEALTH NEEDS.
   §  5.  The opening paragraph of subdivision 2 of section 4403-f of the
 public health law, as amended by section 8 of part C of  chapter  58  of
 the laws of 2007, is amended to read as follows:
   An eligible applicant shall submit an application for a certificate of
 authority to operate a managed long term care plan upon forms prescribed
 by  the  commissioner,  INCLUDING  ANY SUCH FORMS OR PROCESSES AS MAY BE
 REQUIRED OR PRESCRIBED  BY  THE  COMMISSIONER  IN  ACCORDANCE  WITH  THE
 COMPETITIVE  BID  PROCESS  UNDER  SUBDIVISION  SIX OF THIS SECTION. Such
 eligible applicant shall submit information  and  documentation  to  the
 commissioner which shall include, but not be limited to:
   §  6.  Subdivision  3  of  section 4403-f of the public health law, as
 amended by section 41-a of part H of chapter 59 of the laws of 2011,  is
 amended to read as follows:
   3.  Certificate of authority; approval. (A) The commissioner shall not
 approve an application for a certificate of authority unless the  appli-
 cant demonstrates to the commissioner's satisfaction:
   [(a)]  (I)  that  it  will  have in place acceptable quality-assurance
 mechanisms, grievance procedures, mechanisms to protect  the  rights  of
 enrollees  and  case  management services to ensure continuity, quality,
 appropriateness and coordination of care;
   [(b)] (II) that it will include  an  enrollment  process  which  shall
 ensure  that  enrollment  in the plan is informed. The application shall
 describe the disenrollment process, which shall provide that  an  other-
 wise  eligible  enrollee  shall  not be involuntarily disenrolled on the
 basis of health status;
   [(c)] (III) satisfactory evidence of the character and  competence  of
 the  proposed operators and reasonable assurance that the applicant will
 provide high quality services to an enrolled population;
   [(d)] (IV) sufficient management systems capacity to meet the require-
 ments of this section and the ability to efficiently process payment for
 covered services;
   [(e)] (V) readiness and capability to maximize  reimbursement  of  and
 coordinate  services  reimbursed  pursuant to title XVIII of the federal
 social security act and all other applicable benefits, with such benefit
 coordination including, but not limited to, measures  to  support  sound
 clinical  decisions, reduce administrative complexity, coordinate access
 to services, maximize benefits available  pursuant  to  such  title  and
 ensure that necessary care is provided;
   [(f)]  (VI)  readiness  and  capability  to arrange and manage covered
 services and coordinate non-covered services which could include  prima-
 ry,  specialty, and acute care services reimbursed pursuant to title XIX
 of the federal social security act;
   [(g)] (VII) willingness and capability of taking, or  cooperating  in,
 all  steps  necessary  to  secure and integrate any potential sources of
 funding for services provided  by  the  managed  long  term  care  plan,
 including,  but  not  limited  to,  funding  available under titles XVI,
 XVIII, XIX and XX of the federal social security act, the federal  older
 Americans act of nineteen hundred sixty-five, as amended, or any succes-
 sor  provisions  subject to approval of the director of the state office
 S. 8307                            26                            A. 8807
 
 for aging, and through financing options such as those authorized pursu-
 ant to section three hundred sixty-seven-f of the social services law;
   [(h)] (VIII) that the contractual arrangements for providers of health
 and  long  term  care  services in the benefit package are sufficient to
 ensure the availability  and  accessibility  of  such  services  to  the
 proposed  enrolled  population consistent with guidelines established by
 the commissioner;  with  respect  to  individuals  in  receipt  of  such
 services  prior to enrollment, such guidelines shall require the managed
 long term care plan to contract with agencies currently  providing  such
 services,  in  order  to  promote  continuity of care. In addition, such
 guidelines shall require managed long term care plans to offer and cover
 consumer directed personal assistance services for eligible  individuals
 who  elect  such services pursuant to section three hundred sixty-five-f
 of the social services law; and
   [(i)] (IX) that the applicant is financially responsible  and  may  be
 expected to meet its obligations to its enrolled members.
   (B) NOTWITHSTANDING PARAGRAPH (A) OF THIS SUBDIVISION, THE APPROVAL OF
 ANY APPLICATION FOR CERTIFICATION AS A MANAGED LONG TERM CARE PLAN UNDER
 THIS  SECTION  FOR  A PLAN THAT SEEKS TO COVER A POPULATION OF ENROLLEES
 ELIGIBLE FOR SERVICES UNDER TITLE XIX OF  THE  FEDERAL  SOCIAL  SECURITY
 ACT,  SHALL  BE  SUBJECT  TO  AND  CONDITIONED  ON SELECTION THROUGH THE
 COMPETITIVE BID PROCESS PROVIDED UNDER SUBDIVISION SIX OF THIS SECTION.
   § 7. Subdivision 6 of section 4403-f of  the  public  health  law,  as
 amended  by  section  41-b  of part H of chapter 59 of the laws of 2011,
 paragraph (a) as amended by section 2 of part I of  chapter  57  of  the
 laws of 2023, paragraphs (d), (e), and (f) as added by section 5 of part
 MM  of  chapter  56  of  the  laws of 2020, and the opening paragraph of
 subparagraph (i) of paragraph (d) as amended by section 3 of part  I  of
 chapter 57 of the laws of 2023, is amended to read as follows:
   6.  Approval authority.   [(a)] An applicant shall be issued a certif-
 icate of authority as a managed long term care plan upon a determination
 by the commissioner that  the  applicant  complies  with  the  operating
 requirements  for  a  managed  long  term  care plan under this section;
 PROVIDED, HOWEVER, THAT ANY MANAGED  LONG  TERM  CARE  PLAN  SEEKING  TO
 PROVIDE  HEALTH AND LONG TERM CARE SERVICES TO A POPULATION OF ENROLLEES
 THAT ARE ELIGIBLE UNDER TITLE XIX OF THE  FEDERAL  SOCIAL  SECURITY  ACT
 SHALL  NOT  RECEIVE  A  CERTIFICATE  OF AUTHORITY, NOR BE ELIGIBLE FOR A
 CONTRACT TO PROVIDE SUCH SERVICES WITH THE DEPARTMENT,  UNLESS  SELECTED
 THROUGH  THE COMPETITIVE BID PROCESS DESCRIBED IN THIS SUBDIVISION. [The
 commissioner shall issue  no  more  than  seventy-five  certificates  of
 authority to managed long term care plans pursuant to this section.
   (a-1)  Nothing  in  this  section  shall be construed as requiring the
 department to contract with or to contract  for  a  particular  line  of
 business  with  an entity certified under this section for the provision
 of services available under title eleven of article five of  the  social
 services  law.  A  managed  long  term  care plan that has been issued a
 certificate of authority, or an applicant for a certificate of authority
 as a managed long term care plan that has in any of the  three  calendar
 years  immediately  preceding  the application, met any of the following
 criteria shall not be eligible for  a  contract  for  the  provision  of
 services  available  under  title  eleven  of article five of the social
 services law: (i) classified as a poor performer, or substantially simi-
 lar terminology, by the centers for medicare and medicaid  services;  or
 (ii)  an  excessive  volume of penalties, statements of findings, state-
 ments of deficiency,  intermediate  sanctions  or  enforcement  actions,
 S. 8307                            27                            A. 8807

 regardless of whether the applicant has addressed such issues in a time-
 ly manner.
   (b)  An  operating  demonstration  shall  be  issued  a certificate of
 authority as a managed long term care plan upon a determination  by  the
 commissioner   that  such  demonstration  complies  with  the  operating
 requirements for a managed long  term  care  plan  under  this  section.
 Nothing in this section shall be construed to affect the continued legal
 authority  of  an  operating  demonstration  to  operate  its previously
 approved program.
   (c) For the period beginning April  first,  two  thousand  twelve  and
 ending  March thirty-first, two thousand fifteen, the majority leader of
 the senate and the speaker of the assembly may  each  recommend  to  the
 commissioner,  in  writing, up to four eligible applicants to convert to
 be approved managed long term care plans. An  applicant  shall  only  be
 approved  and  issued  a  certificate  of  authority if the commissioner
 determines that the applicant  meets  the  requirements  of  subdivision
 three  of this section. The majority leader of the senate or the speaker
 of the assembly may assign their authority  to  recommend  one  or  more
 applicants under this section to the commissioner]
   (A)  NOTWITHSTANDING  SECTIONS  ONE  HUNDRED  TWELVE  AND  ONE HUNDRED
 SIXTY-THREE OF THE STATE FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND
 ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOPMENT LAW, AND  ANY  OTHER
 INCONSISTENT PROVISION OF LAW, THE COMMISSIONER SHALL, THROUGH A COMPET-
 ITIVE  BID  PROCESS  BASED  ON  PROPOSALS  SUBMITTED  TO THE DEPARTMENT,
 PROVIDE FOR THE SELECTION OF QUALIFIED MANAGED LONG TERM CARE  PLANS  TO
 PROVIDE HEALTH AND LONG TERM CARE SERVICES TO ENROLLEES WHO ARE ELIGIBLE
 UNDER  TITLE  XIX  OF  THE  FEDERAL  SOCIAL  SECURITY  ACT PURSUANT TO A
 CONTRACT WITH THE DEPARTMENT; PROVIDED, HOWEVER, THAT:
   (I) A PROPOSAL SUBMITTED BY  A  MANAGED  LONG  TERM  CARE  PLAN  SHALL
 INCLUDE INFORMATION SUFFICIENT TO ALLOW THE COMMISSIONER TO EVALUATE THE
 BIDDER  IN  ACCORDANCE  WITH THE REQUIREMENTS IDENTIFIED IN SUBDIVISIONS
 TWO, THREE AND FOUR OF THIS SECTION.
   (II) IN ADDITION TO THE CRITERIA DESCRIBED IN SUBPARAGRAPH (I) OF THIS
 PARAGRAPH, THE COMMISSIONER SHALL ALSO CONSIDER:
   (A) ACCESSIBILITY AND GEOGRAPHIC DISTRIBUTION  OF  NETWORK  PROVIDERS,
 TAKING  INTO  ACCOUNT  THE  NEEDS  OF  PERSONS WITH DISABILITIES AND THE
 DIFFERENCES BETWEEN RURAL, SUBURBAN, AND URBAN SETTINGS;
   (B) THE EXTENT TO WHICH MAJOR PUBLIC HOSPITALS  ARE  INCLUDED  IN  THE
 SUBMITTED PROVIDER NETWORK;
   (C)  DEMONSTRATED  CULTURAL  AND LANGUAGE COMPETENCIES SPECIFIC TO THE
 POPULATION OF PARTICIPANTS;
   (D) THE CORPORATE ORGANIZATION AND STATUS OF THE BIDDER AS A  CHARITA-
 BLE CORPORATION UNDER THE NOT-FOR-PROFIT CORPORATION LAW;
   (E) THE ABILITY OF A BIDDER TO OFFER PLANS IN MULTIPLE REGIONS;
   (F)  THE  TYPE  AND NUMBER OF PRODUCTS THE BIDDER PROPOSES TO OPERATE,
 INCLUDING PRODUCTS APPLIED FOR IN  ACCORDANCE  WITH  THE  PROVISIONS  OF
 SUBDIVISION  FIVE  OF  SECTION  THREE HUNDRED SIXTY-FOUR-J OF THE SOCIAL
 SERVICES LAW, AND OTHER PRODUCTS DETERMINED BY THE COMMISSIONER, INCLUD-
 ING BUT NOT NECESSARILY LIMITED TO THOSE OPERATED UNDER TITLE  ONE-A  OF
 ARTICLE  TWENTY-FIVE  OF  THIS  CHAPTER AND SECTION THREE HUNDRED SIXTY-
 NINE-GG OF THE SOCIAL SERVICES LAW;
   (G) WHETHER THE BIDDER PARTICIPATES IN PRODUCTS  FOR  INTEGRATED  CARE
 FOR PARTICIPANTS WHO ARE DUALLY ELIGIBLE FOR MEDICAID AND MEDICARE;
   (H)  WHETHER  THE  BIDDER PARTICIPATES IN VALUE BASED PAYMENT ARRANGE-
 MENTS AS DEFINED BY THE DEPARTMENT, INCLUDING THE DELEGATION OF  SIGNIF-
 ICANT FINANCIAL RISK TO CLINICALLY INTEGRATED PROVIDER NETWORKS;
 S. 8307                            28                            A. 8807
 
   (I)  THE  BIDDER'S  COMMITMENT TO PARTICIPATION IN MANAGED CARE IN THE
 STATE;
   (J) THE BIDDER'S COMMITMENT TO QUALITY IMPROVEMENT;
   (K)  THE  BIDDER'S  COMMITMENT  TO COMMUNITY REINVESTMENT SPENDING, AS
 SHALL BE DEFINED IN THE PROCUREMENT;
   (L) FOR CURRENT OR PREVIOUSLY AUTHORIZED MANAGED CARE PROVIDERS,  PAST
 PERFORMANCE  IN  MEETING  MANAGED  CARE  CONTRACT  OR  FEDERAL  OR STATE
 REQUIREMENTS, AND IF THE COMMISSIONER ISSUED ANY STATEMENTS OF FINDINGS,
 STATEMENTS OF DEFICIENCY, INTERMEDIATE SANCTIONS OR ENFORCEMENT  ACTIONS
 TO  A  BIDDER  FOR  NON-COMPLIANCE  WITH  SUCH REQUIREMENTS, WHETHER THE
 BIDDER ADDRESSED SUCH ISSUES IN A TIMELY MANNER; AND
   (M) ANY OTHER CRITERIA DEEMED APPROPRIATE BY THE COMMISSIONER.
   (III) SUBPARAGRAPHS (I) AND (II) OF THIS PARAGRAPH DESCRIBING PROPOSAL
 CONTENT AND SELECTION CRITERIA REQUIREMENTS SHALL NOT  BE  CONSTRUED  AS
 LIMITING  OR  REQUIRING  THE  COMMISSIONER  TO  EVALUATE SUCH CONTENT OR
 CRITERIA ON A PASS/FAIL SCALE, OR OTHER PARTICULAR METHODOLOGICAL BASIS;
 PROVIDED HOWEVER, THAT THE COMMISSIONER MUST CONSIDER ALL  SUCH  CONTENT
 AND  CRITERIA  USING  METHODS  DETERMINED  BY  THE COMMISSIONER IN THEIR
 DISCRETION AND, AS APPLICABLE, IN CONSULTATION WITH THE COMMISSIONERS OF
 THE OFFICE OF MENTAL HEALTH, THE OFFICE FOR  PEOPLE  WITH  DEVELOPMENTAL
 DISABILITIES,  THE  OFFICE  OF  ADDICTION SERVICES AND SUPPORTS, AND THE
 OFFICE OF CHILDREN AND FAMILY SERVICES.
   (IV) THE DEPARTMENT SHALL POST ON ITS WEBSITE:
   (A) THE REQUEST FOR  PROPOSALS  AND  A  DESCRIPTION  OF  THE  PROPOSED
 SERVICES  TO  BE  PROVIDED PURSUANT TO CONTRACTS IN ACCORDANCE WITH THIS
 SUBDIVISION;
   (B) THE CRITERIA ON WHICH THE  DEPARTMENT  SHALL  DETERMINE  QUALIFIED
 BIDDERS  AND EVALUATE THEIR APPLICATIONS, INCLUDING ALL CRITERIA IDENTI-
 FIED IN THIS SUBDIVISION;
   (C) THE MANNER BY WHICH A PROPOSAL MAY BE SUBMITTED, WHICH MAY INCLUDE
 SUBMISSION BY ELECTRONIC MEANS;
   (D) THE MANNER BY WHICH A MANAGED LONG TERM CARE PLAN MAY CONTINUE  TO
 PROVIDE HEALTH AND LONG TERM CARE SERVICES TO ENROLLEES WHO ARE ELIGIBLE
 UNDER  TITLE  XIX  OF  THE FEDERAL SOCIAL SECURITY ACT PENDING AWARDS TO
 MANAGED LONG TERM CARE PLANS THROUGH A COMPETITIVE BID PROCESS  PURSUANT
 TO THIS SUBDIVISION; AND
   (E) UPON AWARD, THE MANAGED LONG TERM CARE PLANS THAT THE COMMISSIONER
 INTENDS TO CONTRACT WITH PURSUANT TO THIS SUBDIVISION, PROVIDED THAT THE
 COMMISSIONER  SHALL  UPDATE  SUCH  LIST  TO  INDICATE THE FINAL SLATE OF
 CONTRACTED MANAGED LONG TERM CARE PLANS.
   (V) (A) ALL RESPONSIBLE AND RESPONSIVE SUBMISSIONS THAT  ARE  RECEIVED
 FROM  BIDDERS  IN A TIMELY FASHION SHALL BE REVIEWED BY THE COMMISSIONER
 IN CONSULTATION WITH THE COMMISSIONERS OF THE OFFICE OF  MENTAL  HEALTH,
 THE  OFFICE  FOR  PEOPLE  WITH DEVELOPMENTAL DISABILITIES, THE OFFICE OF
 ADDICTION SERVICES AND SUPPORTS, AND THE OFFICE OF CHILDREN  AND  FAMILY
 SERVICES,  AS  APPLICABLE.  THE  COMMISSIONER  SHALL  CONSIDER  COMMENTS
 RESULTING FROM THE REVIEW OF PROPOSALS AND MAKE AWARDS  IN  CONSULTATION
 WITH SUCH AGENCIES.
   (B)  THE COMMISSIONER MAY MAKE AWARDS UNDER THIS SUBDIVISION, FOR EACH
 PRODUCT FOR WHICH PROPOSALS WERE REQUESTED, TO TWO OR MORE MANAGED  LONG
 TERM CARE PLANS IN EACH GEOGRAPHIC REGION DEFINED BY THE COMMISSIONER IN
 THE  REQUEST FOR PROPOSALS FOR WHICH AT LEAST TWO MANAGED LONG TERM CARE
 PLANS HAVE SUBMITTED A PROPOSAL, AND SHALL HAVE DISCRETION TO OFFER MORE
 CONTRACTS BASED ON NEED FOR ACCESS.
   (C) MANAGED LONG TERM CARE PLANS AWARDED UNDER THIS SUBDIVISION  SHALL
 BE ENTITLED TO ENTER INTO A CONTRACT WITH THE DEPARTMENT FOR THE PURPOSE
 S. 8307                            29                            A. 8807
 
 OF  PROVIDING  HEALTH  AND  LONG TERM CARE SERVICES TO ENROLLEES WHO ARE
 ELIGIBLE UNDER TITLE XIX  OF  THE  FEDERAL  SOCIAL  SECURITY  ACT.  SUCH
 CONTRACTS  SHALL  RUN  FOR  A TERM TO BE DETERMINED BY THE COMMISSIONER,
 WHICH MAY BE RENEWED OR MODIFIED FROM TIME TO TIME WITHOUT A NEW REQUEST
 FOR  PROPOSALS,  TO ENSURE CONSISTENCY WITH CHANGES IN FEDERAL AND STATE
 LAWS, REGULATIONS AND POLICIES, INCLUDING BUT NOT LIMITED TO THE  EXPAN-
 SION  OR  REDUCTION  OF  MEDICAL  ASSISTANCE  SERVICES  AVAILABLE TO THE
 PARTICIPANTS THROUGH A MANAGED LONG TERM CARE PLAN.
   (D) NOTHING IN THIS PARAGRAPH OR OTHER PROVISION OF THIS SECTION SHALL
 BE CONSTRUED TO LIMIT IN ANY WAY THE ABILITY OF THE DEPARTMENT TO TERMI-
 NATE AWARDED CONTRACTS FOR CAUSE, WHICH SHALL INCLUDE BUT NOT BE LIMITED
 TO ANY VIOLATION OF THE TERMS OF SUCH CONTRACTS OR VIOLATIONS  OF  STATE
 OR  FEDERAL  LAWS  AND  REGULATIONS  AND  ANY LOSS OF NECESSARY STATE OR
 FEDERAL FUNDING.
   (E) NOTHING IN THIS PARAGRAPH OR OTHER PROVISION OF THIS SECTION SHALL
 BE CONSTRUED TO LIMIT IN ANY WAY THE ABILITY OF THE DEPARTMENT TO  ISSUE
 A  NEW REQUEST FOR PROPOSALS FOR A TERM FOLLOWING AN EXISTING TERM OF AN
 AWARD.
   (B) ADDRESSING NEEDS FOR ADDITIONAL MANAGED LONG TERM  CARE  PLANS  TO
 ENSURE  ACCESS  AND CHOICE FOR ENROLLEES ELIGIBLE UNDER TITLE XIX OF THE
 FEDERAL SOCIAL SECURITY ACT. IF NECESSARY TO ENSURE ACCESS TO  A  SUFFI-
 CIENT  NUMBER  OF  MANAGED LONG TERM CARE PLANS ON A GEOGRAPHIC OR OTHER
 BASIS, INCLUDING A LACK OF ADEQUATE AND APPROPRIATE CARE,  LANGUAGE  AND
 CULTURAL  COMPETENCE,  OR  SPECIAL  NEEDS SERVICES, THE COMMISSIONER MAY
 REISSUE A REQUEST FOR PROPOSALS AS PROVIDED FOR UNDER PARAGRAPH  (A)  OF
 THIS  SUBDIVISION,  PROVIDED HOWEVER THAT SUCH REQUEST MAY BE LIMITED TO
 THE GEOGRAPHIC OR OTHER BASIS OF NEED THAT  THE  REQUEST  FOR  PROPOSALS
 SEEKS  TO  ADDRESS. ANY AWARDS MADE SHALL BE SUBJECT TO THE REQUIREMENTS
 OF THIS SECTION, INCLUDING BUT NOT LIMITED TO THE  MINIMUM  AND  MAXIMUM
 NUMBER OF AWARDS IN A REGION.
   [(d)] (C) (i) Effective April first, two thousand twenty, and expiring
 [March  thirty-first, two thousand twenty-seven] ON THE DATE THE COMMIS-
 SIONER PUBLISHES ON THE DEPARTMENT'S WEBSITE A REQUEST FOR PROPOSALS  IN
 ACCORDANCE  WITH SUBPARAGRAPH (IV) OF PARAGRAPH (A) OF THIS SUBDIVISION,
 the commissioner shall place a moratorium on the processing and approval
 of applications seeking a certificate of authority  as  a  managed  long
 term  care plan pursuant to this section, including applications seeking
 authorization to expand  an  existing  managed  long  term  care  plan's
 approved  service  area  or scope of eligible enrollee populations. Such
 moratorium shall not apply to:
   (A) applications submitted to the department prior to  January  first,
 two thousand twenty;
   (B)  applications seeking approval to transfer ownership or control of
 an existing managed long term care plan;
   (C) applications demonstrating to the commissioner's satisfaction that
 submission of the application for consideration would be appropriate  to
 address a serious concern with care delivery, such as a lack of adequate
 access to managed long term care plans in a geographic area or a lack of
 adequate  and  appropriate  care,  language  and cultural competence, or
 special needs services; and
   (D) applications seeking to operate under the PACE (Program of All-In-
 clusive Care for the Elderly) model as authorized by federal public  law
 105-33, subtitle I of title IV of the Balanced Budget Act of 1997, or to
 serve individuals dually eligible for services and benefits under titles
 XVIII  and XIX of the federal social security act in conjunction with an
 affiliated Medicare Dual Eligible Special Needs Plan, based on the  need
 S. 8307                            30                            A. 8807

 for such plans and the experience of applicants in serving dually eligi-
 ble individuals as determined by the commissioner in their discretion.
   (ii) For the duration of the moratorium, the commissioner shall assess
 the public need for managed long term care plans that are not integrated
 with  an  affiliated Medicare plan, the ability of such plans to provide
 high quality and cost effective care for their membership, and based  on
 such  assessment  develop a process and conduct an orderly wind-down and
 elimination of such plans, which shall coincide with the  expiration  of
 the  moratorium  unless  the commissioner determines that a longer wind-
 down period is needed.
   [(e) For the duration of the moratorium under paragraph  (d)  of  this
 subdivision]  (D)  FROM  APRIL  FIRST,  TWO THOUSAND TWENTY, UNTIL MARCH
 THIRTY-FIRST, TWO THOUSAND TWENTY-FOUR, the  commissioner  shall  estab-
 lish,  and  enforce  by  means  of  a premium withholding equal to three
 percent of the base rate, an annual cap on total enrollment  (enrollment
 cap) for each managed long term care plan, subject to subparagraphs (ii)
 and  (iii)  of  this  paragraph,  based  on  a percentage of each plan's
 reported enrollment as of October first, two thousand twenty.
   (i) The specific percentage of each plan's  enrollment  cap  shall  be
 established by the commissioner based on: (A) the ability of individuals
 eligible  for  such  plans to access health and long term care services,
 (B) plan quality of care scores, (C) historical plan disenrollment,  (D)
 the projected growth of individuals eligible for such plans in different
 regions  of  the  state, (E) historical plan enrollment of patients with
 varying levels of need and acuity, and (F) other factors in the  commis-
 sioner's  discretion  to  ensure  compliance  with federal requirements,
 appropriate access to plan services, and choice by eligible individuals.
   (ii) In the event that a plan exceeds its annual enrollment  cap,  the
 commissioner  is  authorized  under  this  paragraph  to retain all or a
 portion of the premium withheld based on the amount over  which  a  plan
 exceeds its enrollment cap. Penalties assessed pursuant to this subdivi-
 sion shall be determined by regulation.
   (iii)  The  commissioner  may  not  establish  an  annual cap on total
 enrollment under this paragraph for plans' lines of  business  operating
 under  the PACE (Program of All-Inclusive Care for the Elderly) model as
 authorized by federal public law 105-33, subtitle I of title IV  of  the
 Balanced  Budget  Act of 1997, or that serve individuals dually eligible
 for services and benefits under titles XVIII  and  XIX  of  the  federal
 social  security  act  in  conjunction  with an affiliated Medicare Dual
 Eligible Special Needs Plan.
   [(f) In implementing the provisions of paragraphs (d) and (e) of  this
 subdivision, the commissioner shall, to the extent practicable, consider
 and  select  methodologies  that seek to maximize continuity of care and
 minimize disruption to the provider labor workforce, and shall,  to  the
 extent  practicable  and  consistent  with  the ratios set forth herein,
 continue to support contracts between managed long term care  plans  and
 licensed  home  care services agencies that are based on a commitment to
 quality and value.]
   § 8. Section 1 of part I of chapter 57 of the laws of 2022,  providing
 a  one  percent across the board payment increase to all qualifying fee-
 for-service Medicaid rates, is amended by adding two new subdivisions  3
 and 4 to read as follows:
   3. FOR THE STATE FISCAL YEARS BEGINNING APRIL 1, 2024, AND THEREAFTER,
 ALL DEPARTMENT OF HEALTH MEDICAID PAYMENTS MADE TO MEDICAID MANAGED CARE
 ORGANIZATIONS  WILL NO LONGER BE SUBJECT TO THE UNIFORM RATE INCREASE IN
 SUBDIVISION ONE OF THIS SECTION.
 S. 8307                            31                            A. 8807
 
   4. RATE ADJUSTMENTS MADE PURSUANT TO SUBDIVISIONS ONE THROUGH THREE OF
 THIS SECTION SHALL NOT BE SUBJECT TO THE NOTIFICATION  REQUIREMENTS  SET
 FORTH IN SUBDIVISION 7 OF SECTION 2807 OF THE PUBLIC HEALTH LAW.
   §  9.  Section 364-j of the social services law is amended by adding a
 new subdivision 40 to read as follows:
   40. (A) THE COMMISSIONER  SHALL  BE  ENTITLED  TO  RECOVER  LIQUIDATED
 DAMAGES FROM MANAGED CARE ORGANIZATIONS FOR FAILURE TO MEET THE CONTRAC-
 TUAL OBLIGATIONS AND PERFORMANCE STANDARDS OF THEIR CONTRACT.
   (B) THE COMMISSIONER SHALL HAVE SOLE DISCRETION IN DETERMINING WHETHER
 TO IMPOSE A RECOVERY OF THE FINANCIAL LOSS AND DAMAGES FOR NONCOMPLIANCE
 WITH ANY PROVISION OF THE CONTRACT.
   (C)  (I)  LIQUIDATED  DAMAGES  IMPOSED  BY  THIS SUBDIVISION AGAINST A
 MANAGED CARE ORGANIZATION SHALL BE FROM TWO HUNDRED FIFTY DOLLARS UP  TO
 TWENTY-FIVE  THOUSAND DOLLARS PER VIOLATION DEPENDING ON THE SEVERITY OF
 THE NONCOMPLIANCE DETERMINED BY THE COMMISSIONER.
   (II) ANY LIQUIDATED  DAMAGES  FINDINGS  AS  A  RESULT  OF  THE  REVIEW
 REQUIRED  BY  THIS  SUBDIVISION  SHALL BE DUE AND PAYABLE SIXTY CALENDAR
 DAYS FROM THE ISSUANCE OF A  STATEMENT  OF  DAMAGES  REGARDLESS  OF  ANY
 DISPUTE  IN  THE AMOUNT OR INTERPRETATION OF THE AMOUNT DUE CONTAINED IN
 THE NOTICE.
   (III) THE COMMISSIONER MAY ELECT, IN THEIR SOLE DISCRETION, TO COLLECT
 DAMAGES IMPOSED BY THIS SECTION FROM, AND AS A SET OFF AGAINST, PAYMENTS
 DUE TO THE MANAGED CARE ORGANIZATION, OR PAYMENTS THAT BECOMES  DUE  ANY
 TIME  AFTER  THE  CALCULATION  OF  LIQUIDATED  DAMAGES. DEDUCTIONS SHALL
 CONTINUE UNTIL THE FULL AMOUNT OF THE NOTICED DAMAGES ARE PAID IN FULL.
   (IV) ALL LIQUIDATED DAMAGES IMPOSED BY THIS SUBDIVISION SHALL BE  PAID
 OUT  OF  THE ADMINISTRATIVE COSTS AND PROFITS OF THE MANAGED CARE ORGAN-
 IZATION.
   (V) THE MANAGED  CARE  ORGANIZATION  SHALL  NOT  PASS  THE  LIQUIDATED
 DAMAGES  IMPOSED  UNDER  THIS SUBDIVISION THROUGH TO ANY PROVIDER AND/OR
 SUBCONTRACTOR.
   (D) (I) TO DISPUTE LIQUIDATED DAMAGES IMPOSED BY THIS SUBDIVISION  THE
 MANAGED  CARE  ORGANIZATION MUST SUBMIT A WRITTEN REQUEST OF ITS DISPUTE
 TO THE COMMISSIONER WITHIN THIRTY CALENDAR DAYS FROM  THE  DATE  OF  THE
 STATEMENT  OF DAMAGES. SUCH DISPUTE SHALL BE MADE IN THE FORM AND MANNER
 PRESCRIBED BY THE COMMISSIONER.
   (II) THE DEPARTMENT WILL DENY ANY DISPUTES THAT ARE NOT  DELIVERED  IN
 THE FORMAT AND TIMEFRAME SPECIFIED BY THE DEPARTMENT.
   (III)  THE  MANAGED  CARE  ORGANIZATION  WAIVES ANY DISPUTE NOT RAISED
 WITHIN THIRTY CALENDAR DAYS OF ISSUANCE OF THE STATEMENT OF DAMAGES.  IT
 ALSO  WAIVES  ANY  ARGUMENTS  IT FAILS TO RAISE IN WRITING WITHIN THIRTY
 CALENDAR DAYS OF ISSUANCE OF THE STATEMENT OF DAMAGES,  AND  WAIVES  THE
 RIGHT TO USE ANY MATERIALS, DATA, AND/OR INFORMATION NOT CONTAINED IN OR
 ACCOMPANYING THE MANAGED CARE ORGANIZATION'S SUBMISSION SUBMITTED WITHIN
 THE  THIRTY CALENDAR DAYS OF ISSUANCE OF THE STATEMENT OF DAMAGES IN ANY
 SUBSEQUENT LEGAL OR ADMINISTRATIVE PROCEEDING.
   (IV) THE COMMISSIONER OR THEIR  DESIGNEE  SHALL  DECIDE  THE  DISPUTE,
 REDUCE  THE  DECISION TO WRITING AND ISSUE THEIR DECISION TO THE MANAGED
 CARE ORGANIZATION WITHIN NINETY CALENDAR DAYS OF RECEIPT OF THE DISPUTE.
 THIS WRITTEN DECISION SHALL BE FINAL.
   (E) FOR PURPOSES OF THIS SUBDIVISION A VIOLATION SHALL MEAN A DETERMI-
 NATION BY THE COMMISSIONER THAT THE MANAGED CARE ORGANIZATION FAILED  TO
 ACT AS REQUIRED UNDER THE MODEL CONTRACT OR APPLICABLE FEDERAL AND STATE
 STATUTES,  RULES OR REGULATIONS GOVERNING MANAGED CARE ORGANIZATION. FOR
 THE PURPOSES OF THIS SUBDIVISION, EACH DAY  THAT  AN  ONGOING  VIOLATION
 CONTINUES  SHALL  BE A SEPARATE VIOLATION. IN ADDITION, EACH INSTANCE OF
 S. 8307                            32                            A. 8807

 FAILING TO FURNISH NECESSARY AND/OR REQUIRED MEDICAL SERVICES  OR  ITEMS
 TO  EACH  ENROLLEE SHALL BE A SEPARATE VIOLATION. AS WELL, EACH DAY THAT
 THE MANAGED CARE ORGANIZATION FAILS TO FURNISH NECESSARY AND/OR REQUIRED
 MEDICAL SERVICES OR ITEMS TO ENROLLEES SHALL BE A SEPARATE VIOLATION.
   (F)  FOR  PURPOSES OF THIS SUBDIVISION MANAGED CARE ORGANIZATION SHALL
 MEAN ANY MANAGED CARE ORGANIZATIONS SUBJECT TO THIS SECTION AND  ARTICLE
 FORTY-FOUR  OF  THE  PUBLIC HEALTH LAW, INCLUDING MANAGED LONG TERM CARE
 PLANS.
   (G) NOTHING IN THIS  SUBDIVISION  SHALL  PROHIBIT  THE  IMPOSITION  OF
 DAMAGES, PENALTIES OR OTHER RELIEF, OTHERWISE AUTHORIZED BY LAW, INCLUD-
 ING BUT NOT LIMITED TO CASES OF FRAUD, WASTE OR ABUSE.
   § 10. This act shall not be construed to prohibit managed care provid-
 ers participating in the managed care program and managed long term care
 plans  approved  to provide health and long term care services to enrol-
 lees who are eligible under title XIX of  the  federal  social  security
 act,  that  were so authorized as of the effective date of this act from
 continuing operations as authorized until such time as awards  are  made
 in  accordance  with this act and such additional time subject to direc-
 tion from the commissioner of health to  ensure  the  safe  and  orderly
 transfer of participants.
   §  11.  This  act  shall  take  effect  immediately and shall apply to
 disputes filed with the superintendent of financial services pursuant to
 article six of the financial services law on  or  after  such  effective
 date; provided that:
   (a) the amendments to section 364-j of the social services law made by
 sections  two, three and nine of this act shall not affect the repeal of
 such section and shall be deemed repealed therewith; and
   (b) the amendments to section 4403-f of the public health law made  by
 sections  five, six and seven of this act shall not affect the repeal of
 such section and shall be deemed repealed therewith.
 
                                  PART I
 
   Section 1. Paragraph (a) of subdivision 4  of  section  365-a  of  the
 social  services  law, as amended by chapter 493 of the laws of 2010, is
 amended to read as follows:
   (a) drugs which may be dispensed without a prescription as required by
 section sixty-eight hundred ten of the education law; provided, however,
 that the state commissioner of health may by regulation specify  certain
 of  such  drugs which may be reimbursed as an item of medical assistance
 in accordance with the price schedule established by such  commissioner.
 Notwithstanding any other provision of law, [additions] MODIFICATIONS to
 the  list  of  drugs  reimbursable  under this paragraph may be filed as
 regulations by the commissioner  of  health  without  prior  notice  and
 comment;
   §  2.  Paragraph  (b)  of  subdivision  3 of section 273 of the public
 health law, as added by section 10 of part C of chapter 58 of  the  laws
 of 2005, is amended to read as follows:
   (b)  In the event that the patient does not meet the criteria in para-
 graph (a) of this subdivision, the  prescriber  may  provide  additional
 information  to  the  program  to justify the use of a prescription drug
 that is not on the preferred drug list.  The  program  shall  provide  a
 reasonable opportunity for a prescriber to reasonably present his or her
 justification  of  prior authorization. [If, after consultation with the
 program, the prescriber, in his or her reasonable professional judgment,
 determines that] THE PROGRAM WILL CONSIDER  THE  ADDITIONAL  INFORMATION
 S. 8307                            33                            A. 8807
 
 AND  THE  JUSTIFICATION  PRESENTED  TO  DETERMINE  WHETHER  the use of a
 prescription drug that is not on the preferred drug list  is  warranted,
 AND the [prescriber's] PROGRAM'S determination shall be final.
   §  3. Subdivisions 25 and 25-a of section 364-j of the social services
 law are REPEALED.
   § 4. Section 280 of the public health law, as amended by section 8  of
 part D of chapter 57 of the laws of 2018, paragraph (b) of subdivision 2
 as  amended  by  section 5, subdivision 3 as amended by section 6, para-
 graph (a) of subdivision 5 as amended by section 7,  subparagraph  (iii)
 of  paragraph (e) as amended by section 6-a and subdivision 8 as amended
 by section 9 of part B of chapter 57 of the laws of  2019,    paragraphs
 (c) and (d) of subdivision 2 as amended and paragraph (e) of subdivision
 2  as  added by section 2 of part FFF of chapter 56 of the laws of 2020,
 the opening paragraph of paragraph (a) of subdivision  6  and  paragraph
 (a)  of  subdivision  7 as amended by sections 3 and 4, respectively, of
 part GG of chapter 56 of the laws of  2020,    is  amended  to  read  as
 follows:
   § 280. Medicaid drug cap. 1. The legislature hereby finds and declares
 that  there is a significant public interest for the Medicaid program to
 manage drug costs in a manner that ensures patient access while  provid-
 ing  financial  stability  for  the  state  and participating providers.
 Since two thousand eleven, the state  has  taken  significant  steps  to
 contain  costs  in the Medicaid program by imposing a statutory limit on
 annual growth. Drug expenditures,  however,  continually  outpace  other
 cost  components  causing  significant pressure on the state, providers,
 and patient access operating under the Medicaid global cap. It is there-
 fore intended that the department establish a [Medicaid drug  cap  as  a
 separate  component  within the Medicaid global cap] SUPPLEMENTAL REBATE
 PROGRAM as part of a focused and sustained effort to balance the  growth
 of drug expenditures with the growth of total Medicaid expenditures.
   2.  The  commissioner shall [establish a year to year] REVIEW AT LEAST
 ANNUALLY THE department of health state funds Medicaid drug [expenditure
 growth target as follows:
   (a) for state fiscal year two thousand seventeen--two  thousand  eigh-
 teen,  be  limited to the ten-year rolling average of the medical compo-
 nent of the consumer price index plus five percent and minus a  pharmacy
 savings target of fifty-five million dollars; and
   (b)  for  state  fiscal year two thousand eighteen--two thousand nine-
 teen, be limited to the ten-year rolling average of the  medical  compo-
 nent  of the consumer price index plus four percent and minus a pharmacy
 savings target of eighty-five million dollars;
   (c) for state fiscal year two thousand nineteen--two thousand  twenty,
 be  limited  to the ten-year rolling average of the medical component of
 the consumer price index plus four percent and minus a pharmacy  savings
 target of eighty-five million dollars;
   (d)  for  state  fiscal year two thousand twenty--two thousand twenty-
 one, be limited to the ten-year rolling average of the medical component
 of the consumer price index plus two percent; and
   (e) for state fiscal year two thousand twenty-one--two thousand  twen-
 ty-two and fiscal years thereafter, be limited in accordance with subdi-
 vision  one of section ninety-one of part H of chapter fifty-nine of the
 laws of two thousand eleven, as amended] EXPENDITURES TO IDENTIFY DRUGS,
 INCLUDING BUT NOT LIMITED TO, DRUGS IN THE EIGHTIETH PERCENTILE OR HIGH-
 ER OF TOTAL SPEND, NET OF REBATE OR IN THE EIGHTIETH PERCENTILE OR HIGH-
 ER BASED ON COST PER CLAIM, NET OF REBATE.
 S. 8307                            34                            A. 8807
 
   3. (A) The [department and the division of the budget shall assess  on
 a  quarterly basis the projected total amount to be expended in the year
 on a cash basis by the Medicaid program for each drug, and the projected
 annual amount of state funds Medicaid drug expenditures on a cash  basis
 for all drugs, which shall be a component of the projected department of
 health  state  funds  Medicaid  expenditures  calculated for purposes of
 sections ninety-one and ninety-two of part H of  chapter  fifty-nine  of
 the  laws  of  two  thousand eleven. For purposes of this section, state
 funds Medicaid drug expenditures include amounts expended for  drugs  in
 both  the  Medicaid  fee-for-service  program  and Medicaid managed care
 programs, minus the amount of any  drug  rebates  or  supplemental  drug
 rebates received by the department, including rebates pursuant to subdi-
 vision  five of this section with respect to rebate targets. The depart-
 ment and the division of the budget shall report  in  December  of  each
 year,  for  the  prior  April  through  October, to the drug utilization
 review board  the  projected  state  funds  Medicaid  drug  expenditures
 including  the  amounts,  in  aggregate thereof, attributable to the net
 cost of: changes in the utilization of  drugs  by  Medicaid  recipients;
 changes  in  the  number  of Medicaid recipients; changes to the cost of
 brand name drugs and changes to the cost of generic drugs. The  informa-
 tion  contained in the report shall not be publicly released in a manner
 that allows for the identification of an individual drug or manufacturer
 or that is likely to compromise the financial competitive,  or  proprie-
 tary nature of the information.
   (a) In the event the director of the budget determines, based on Medi-
 caid drug expenditures for the previous quarter or other relevant infor-
 mation,  that  the  total department of health state funds Medicaid drug
 expenditure is projected to exceed the annual growth limitation  imposed
 by  subdivision  two of this section, the] commissioner may identify and
 refer drugs, INCLUDING BUT  NOT  LIMITED  TO,  DRUGS  IN  THE  EIGHTIETH
 PERCENTILE  OR  HIGHER OF TOTAL SPEND, NET OF REBATE OR IN THE EIGHTIETH
 PERCENTILE OR HIGHER BASED ON COST PER CLAIM, NET OF REBATE, to the drug
 utilization review board established by  section  three  hundred  sixty-
 nine-bb  of the social services law for a recommendation as to whether a
 target supplemental Medicaid rebate should be paid by  the  manufacturer
 of the drug to the department and the target amount of the rebate.
   (b)  If the department intends to refer a drug to the drug utilization
 review board pursuant to paragraph (a) of this subdivision, the  depart-
 ment  shall  notify  the  manufacturer of such drug and shall attempt to
 reach agreement with the manufacturer on a rebate for the drug prior  to
 referring  the  drug  to  the  drug utilization review board for review.
 Such rebate may be based on evidence-based research, including, but  not
 limited  to,  such  research operated or conducted by or for other state
 governments, the federal government, the governments of  other  nations,
 and  third party payers or multi-state coalitions, provided however that
 the department shall account for the effectiveness of the drug in treat-
 ing the conditions  for  which  it  is  prescribed  or  in  improving  a
 patient's  health,  quality of life, or overall health outcomes, and the
 likelihood that use of the drug will reduce the need for  other  medical
 care, including hospitalization.
   (c)  In  the  event  that  the  commissioner and the manufacturer have
 previously agreed to a supplemental rebate for a drug pursuant to  para-
 graph  (b)  of this subdivision or paragraph (e) of subdivision seven of
 section three hundred sixty-seven-a of the social services law, the drug
 shall not be referred to the  drug  utilization  review  board  for  any
 further  supplemental  rebate  for  the  duration of the previous rebate
 S. 8307                            35                            A. 8807
 
 agreement, provided however, the commissioner may refer a  drug  to  the
 drug  utilization  review board if the commissioner determines there are
 significant  and  substantiated  utilization  or  market  changes,   new
 evidence-based research, or statutory or federal regulatory changes that
 warrant  additional  rebates. In such cases, the department shall notify
 the manufacturer and provide evidence of the changes  or  research  that
 would  warrant  additional rebates, and shall attempt to reach agreement
 with the manufacturer on a rebate for the drug prior  to  referring  the
 drug to the drug utilization review board for review.
   (d)  The  department shall consider a drug's actual cost to the state,
 including current rebate amounts, prior to seeking an additional  rebate
 pursuant to paragraph (b) or (c) of this subdivision.
   (e)  [The  commissioner  shall  be  authorized  to  take  the  actions
 described in this section only so long as total Medicaid  drug  expendi-
 tures  are  projected  to exceed the annual growth limitation imposed by
 subdivision two of this section.] IF THE COMMISSIONER IS UNSUCCESSFUL IN
 ENTERING INTO A REBATE ARRANGEMENT WITH THE  MANUFACTURER  OF  THE  DRUG
 SATISFACTORY  TO  THE  DEPARTMENT,  THE DRUG MANUFACTURER SHALL, IN THAT
 EVENT BE REQUIRED TO PROVIDE TO THE DEPARTMENT, ON A STANDARD  REPORTING
 FORM DEVELOPED BY THE DEPARTMENT, THE FOLLOWING INFORMATION:
   (I) THE ACTUAL COST OF DEVELOPING, MANUFACTURING, PRODUCING (INCLUDING
 THE COST PER DOSE OF PRODUCTION), AND DISTRIBUTING THE DRUG;
   (II) RESEARCH AND DEVELOPMENT COSTS OF THE DRUG, INCLUDING PAYMENTS TO
 PREDECESSOR  ENTITIES  CONDUCTING  RESEARCH  AND  DEVELOPMENT,  SUCH  AS
 BIOTECHNOLOGY COMPANIES, UNIVERSITIES AND MEDICAL SCHOOLS,  AND  PRIVATE
 RESEARCH INSTITUTIONS;
   (III)  ADMINISTRATIVE,  MARKETING, AND ADVERTISING COSTS FOR THE DRUG,
 APPORTIONED BY MARKETING ACTIVITIES  THAT  ARE  DIRECTED  TO  CONSUMERS,
 MARKETING  ACTIVITIES  THAT  ARE  DIRECTED TO PRESCRIBERS, AND THE TOTAL
 COST OF ALL MARKETING AND ADVERTISING  THAT  IS  DIRECTED  PRIMARILY  TO
 CONSUMERS  AND  PRESCRIBERS  IN  NEW  YORK, INCLUDING BUT NOT LIMITED TO
 PRESCRIBER DETAILING, COPAYMENT DISCOUNT PROGRAMS, AND DIRECT-TO-CONSUM-
 ER MARKETING;
   (IV) THE EXTENT OF UTILIZATION OF THE DRUG;
   (V) PRICES FOR THE DRUG THAT ARE CHARGED  TO  PURCHASERS  OUTSIDE  THE
 UNITED STATES;
   (VI)  PRICES CHARGED TO TYPICAL PURCHASERS IN THE STATE, INCLUDING BUT
 NOT LIMITED TO PHARMACIES, PHARMACY  CHAINS,  PHARMACY  WHOLESALERS,  OR
 OTHER DIRECT PURCHASERS;
   (VII) THE AVERAGE REBATES AND DISCOUNTS PROVIDED PER PAYER TYPE IN THE
 STATE; AND
   (VIII) THE AVERAGE PROFIT MARGIN OF EACH DRUG OVER THE PRIOR FIVE-YEAR
 PERIOD AND THE PROJECTED PROFIT MARGIN ANTICIPATED FOR SUCH DRUG.
   (F) ALL INFORMATION DISCLOSED PURSUANT TO PARAGRAPH (E) OF THIS SUBDI-
 VISION  SHALL  BE  CONSIDERED CONFIDENTIAL AND SHALL NOT BE DISCLOSED BY
 THE DEPARTMENT IN A FORM THAT  IDENTIFIES  A  SPECIFIC  MANUFACTURER  OR
 PRICES CHARGED FOR DRUGS BY SUCH MANUFACTURER.
   4.  In  determining  whether to recommend a target supplemental rebate
 for a drug, the drug utilization review board shall consider the  actual
 cost  of  the  drug to the Medicaid program, including federal and state
 rebates, and may consider, among other things:
   (a) the drug's impact on the Medicaid drug spending growth target  and
 the  adequacy of capitation rates of participating Medicaid managed care
 plans, and the drug's affordability and value to the  Medicaid  program;
 or
   (b) significant and unjustified increases in the price of the drug; or
 S. 8307                            36                            A. 8807
 
   (c) whether the drug may be priced disproportionately to its therapeu-
 tic benefits.
   5. (a) If the drug utilization review board recommends a target rebate
 amount  on  a  drug  referred  by the commissioner, the department shall
 negotiate with the drug's manufacturer for a supplemental rebate  to  be
 paid  by  the manufacturer in an amount not to exceed such target rebate
 amount. [A rebate requirement shall apply beginning with the  first  day
 of  the  state  fiscal year during which the rebate was required without
 regard to the date the department enters into the rebate agreement  with
 the manufacturer.]
   (b) The supplemental rebate required by paragraph (a) of this subdivi-
 sion shall apply to drugs dispensed to enrollees of managed care provid-
 ers  pursuant  to  section  three  hundred  sixty-four-j  of  the social
 services law and to drugs dispensed to Medicaid recipients who  are  not
 enrollees of such providers.
   (c)  [If  the drug utilization review board recommends a target rebate
 amount for a drug and the department is unable  to  negotiate  a  rebate
 from the manufacturer in an amount that is at least seventy-five percent
 of the target rebate amount, the commissioner is authorized to waive the
 provisions  of paragraph (b) of subdivision three of section two hundred
 seventy-three of this article and the provisions of  subdivisions  twen-
 ty-five  and  twenty-five-a of section three hundred sixty-four-j of the
 social services law with respect to  such  drug;  however,  this  waiver
 shall  not be implemented in situations where it would prevent access by
 a Medicaid recipient to a drug which is the only treatment for a partic-
 ular disease or condition. Under no circumstances shall the commissioner
 be authorized to waive such provisions with respect  to  more  than  two
 drugs in a given time.
   (d)]  Where  the  department  and  a  manufacturer enter into a rebate
 agreement pursuant to this section, which may be in addition to existing
 rebate agreements entered into by the manufacturer with respect  to  the
 same  drug,  no  additional  rebates shall be required to be paid by the
 manufacturer to a managed care provider or any of a managed care provid-
 er's agents, including but not limited to any pharmacy benefit  manager,
 while the department is collecting the rebate pursuant to this section.
   [(e)]  (D)  In formulating a recommendation concerning a target rebate
 amount for a drug, the drug utilization review board may consider:
   (i) publicly available information relevant  to  the  pricing  of  the
 drug;
   (ii) information supplied by the department relevant to the pricing of
 the drug;
   (iii)  information  relating to value-based pricing provided, however,
 if the department directly invites any third party to  provide  cost-ef-
 fectiveness analysis or research related to value-based pricing, and the
 department  receives  and considers such analysis or research for use by
 the board, such third party shall disclose any  funding  sources.    The
 department  shall,  if  reasonably possible, make publicly available the
 following documents in its possession that it  relies  upon  to  provide
 cost  effectiveness analyses or research related to value-based pricing:
 (A) descriptions of underlying methodologies; (B) assumptions and  limi-
 tations  of  research findings; and (C) if available, data that presents
 results in a way that reflects different outcomes for affected  subpopu-
 lations;
   (iv)  the  seriousness and prevalence of the disease or condition that
 is treated by the drug;
   (v) the extent of utilization of the drug;
 S. 8307                            37                            A. 8807
 
   (vi) the effectiveness of the drug  in  treating  the  conditions  for
 which  it  is prescribed, or in improving a patient's health, quality of
 life, or overall health outcomes;
   (vii)  the  likelihood  that  use of the drug will reduce the need for
 other medical care, including hospitalization;
   (viii) the average wholesale price, wholesale acquisition cost, retail
 price of the drug, and the cost of the  drug  to  the  Medicaid  program
 minus rebates received by the state;
   (ix)  in  the  case  of  generic  drugs,  the number of pharmaceutical
 manufacturers that produce the drug;
   (x) whether there are pharmaceutical equivalents to the drug; and
   (xi) information supplied by the manufacturer, if any, explaining  the
 relationship between the pricing of the drug and the cost of development
 of  the  drug  and/or  the  therapeutic  benefit of the drug, or that is
 otherwise pertinent to the manufacturer's  pricing  decision;  any  such
 information,  INCLUDING  THE  INFORMATION ON THE STANDARD REPORTING FORM
 REQUIREMENT IN PARAGRAPH (E)  OF  SUBDIVISION  THREE  OF  THIS  SECTION,
 provided  shall be considered confidential and shall not be disclosed by
 the drug utilization review board in a form that identifies  a  specific
 manufacturer or prices charged for drugs by such manufacturer.
   6.  [(a)  If  the  drug  utilization  review board recommends a target
 rebate amount or if the commissioner identifies a drug as  a  high  cost
 drug pursuant to subparagraph (vii) of paragraph (e) of subdivision 7 of
 section  three  hundred sixty-seven-a of the social services law and the
 department is unsuccessful in entering into a  rebate  arrangement  with
 the  manufacturer  of  the drug satisfactory to the department, the drug
 manufacturer shall in that event be required to provide to  the  depart-
 ment,  on  a  standard  reporting  form developed by the department, the
 following information:
   (i) the actual cost of developing, manufacturing, producing (including
 the cost per dose of production), and distributing the drug;
   (ii) research and development costs of the drug, including payments to
 predecessor  entities  conducting  research  and  development,  such  as
 biotechnology  companies,  universities and medical schools, and private
 research institutions;
   (iii) administrative, marketing, and advertising costs for  the  drug,
 apportioned  by  marketing  activities  that  are directed to consumers,
 marketing activities that are directed to  prescribers,  and  the  total
 cost  of  all  marketing  and  advertising that is directed primarily to
 consumers and prescribers in New York,  including  but  not  limited  to
 prescriber detailing, copayment discount programs, and direct-to-consum-
 er marketing;
   (iv) the extent of utilization of the drug;
   (v)  prices  for  the  drug that are charged to purchasers outside the
 United States;
   (vi) prices charged to typical purchasers in the state, including  but
 not  limited  to  pharmacies,  pharmacy chains, pharmacy wholesalers, or
 other direct purchasers;
   (vii) the average rebates and discounts provided per payer type in the
 State; and
   (viii) the average profit margin of each drug over the prior five-year
 period and the projected profit margin anticipated for such drug.
   (b) All information disclosed pursuant to paragraph (a) of this subdi-
 vision shall be considered confidential and shall not  be  disclosed  by
 the  department  in  a  form  that identifies a specific manufacturer or
 prices charged for drugs by such manufacturer.
 S. 8307                            38                            A. 8807

   7.] (a) [If, after] AFTER taking into account all rebates and  supple-
 mental rebates received by the department, including rebates received to
 date  pursuant  to  this  section[, total Medicaid drug expenditures are
 still projected to exceed the annual growth limitation imposed by subdi-
 vision two of this section], the commissioner may: subject any drug of a
 manufacturer  referred  to  the drug utilization review board under this
 section to prior approval in  accordance  with  existing  processes  and
 procedures  when  such  manufacturer has not entered into a supplemental
 rebate arrangement as required by this section; direct  a  managed  care
 plan  to  limit or reduce reimbursement for a drug provided by a medical
 practitioner if the drug utilization review board  recommends  a  target
 rebate  amount  for  such  drug and the manufacturer has failed to enter
 into a rebate arrangement required by this section; direct managed  care
 plans  to remove from their Medicaid formularies any drugs of a manufac-
 turer who has a drug that the drug utilization review board recommends a
 target rebate amount for and the manufacturer has failed to enter into a
 rebate arrangement required by this section; promote  the  use  of  cost
 effective  and  clinically  appropriate  drugs  other  than  those  of a
 manufacturer who has a drug  that  the  drug  utilization  review  board
 recommends  a  target  rebate  amount and the manufacturer has failed to
 enter into a rebate arrangement required by this section; allow manufac-
 turers to accelerate rebate payments under  existing  rebate  contracts;
 and  such  other  actions  as authorized by law. [The commissioner shall
 provide written notice to the legislature thirty days  prior  to  taking
 action  pursuant  to  this  paragraph, unless action is necessary in the
 fourth quarter of a fiscal year to prevent total Medicaid drug  expendi-
 tures  from  exceeding the limitation imposed by subdivision two of this
 section, in which case such notice to the legislature may be  less  than
 thirty days.]
   (b) The commissioner shall be authorized to take the actions described
 in  paragraph  (a)  of  this subdivision [only so long as total Medicaid
 drug expenditures are projected to exceed the annual  growth  limitation
 imposed  by  subdivision  two  of  this  section].  In addition, no such
 actions shall be deemed to supersede the provisions of paragraph (b)  of
 subdivision  three  of section two hundred seventy-three of this article
 or the provisions  of  subdivisions  twenty-five  and  twenty-five-a  of
 section  three  hundred sixty-four-j of the social services law[, except
 as allowed by paragraph  (c)  of  subdivision  five  of  this  section];
 provided  further that nothing in this section shall prevent access by a
 Medicaid recipient to a drug which is the only treatment for  a  partic-
 ular disease or condition.
   [8.] 7. The commissioner, UPON REQUEST OF THE CHAIR OF THE DRUG UTILI-
 ZATION  REVIEW  BOARD, shall PROVIDE A report [by July first annually to
 the drug utilization review board] on savings achieved through the  drug
 cap  in  the  last  fiscal  year. Such report shall provide data on what
 savings were achieved [through actions pursuant to  subdivisions  three,
 five  and  seven  of  this  section, respectively, and what savings were
 achieved through other means] and how such savings were  calculated  and
 implemented.
   §  5.  Paragraph  (e)  of subdivision 7 of section 367-a of the social
 services law, as amended by section 1 of part GG of chapter  56  of  the
 laws  of  2020, the opening paragraph as amended by section 24 of part B
 of chapter 57 of the laws of 2023, is amended to read as follows:
   (e) During the period from April first, two thousand  fifteen  through
 March  thirty-first,  two  thousand twenty-six, the commissioner may, in
 lieu of a managed care provider or pharmacy benefit  manager,  negotiate
 S. 8307                            39                            A. 8807

 directly and enter into an arrangement with a pharmaceutical manufactur-
 er  for the provision of supplemental rebates relating to pharmaceutical
 utilization by enrollees of managed care providers pursuant  to  section
 three hundred sixty-four-j of this title and may also negotiate directly
 and  enter into such an agreement relating to pharmaceutical utilization
 by medical assistance recipients not so enrolled. Such  rebate  arrange-
 ments shall be limited to the following: antiretrovirals approved by the
 FDA  for  the  treatment  of HIV/AIDS, ACCELERATED APPROVAL DRUGS ESTAB-
 LISHED PURSUANT TO SUBPARAGRAPH (IX) OF THIS PARAGRAPH,  opioid  depend-
 ence  agents  and  opioid  antagonists  listed  in a statewide formulary
 established pursuant to subparagraph (vii) of this paragraph,  hepatitis
 C agents, high cost drugs as provided for in subparagraph (viii) of this
 paragraph,  gene  therapies as provided for in subparagraph (ix) of this
 paragraph, and any other class or drug designated  by  the  commissioner
 for  which  the  pharmaceutical  manufacturer  has  in  effect  a rebate
 arrangement with the federal secretary  of  health  and  human  services
 pursuant to 42 U.S.C. § 1396r-8, and for which the state has established
 standard  clinical  criteria. No agreement entered into pursuant to this
 paragraph shall have an initial term or be extended beyond  the  expira-
 tion or repeal of this paragraph.
   (i) The manufacturer shall not enter into any rebate arrangements with
 a  managed  care  provider,  or any of a managed care provider's agents,
 including but not limited to any pharmacy benefit manager  on  the  gene
 therapy,  drug, or drug classes subject to this paragraph when the state
 has a rebate arrangement in place and  standard  clinical  criteria  are
 imposed on the managed care provider.
   (ii)  The commissioner shall establish adequate rates of reimbursement
 which shall take into account both the impact of the commissioner  nego-
 tiating  such  arrangements  and  any limitations imposed on the managed
 care provider's ability to establish clinical criteria relating  to  the
 utilization  of  such  drugs.  In developing the managed care provider's
 reimbursement rate,  the  commissioner  shall  identify  the  amount  of
 reimbursement  for  such drugs as a separate and distinct component from
 the reimbursement otherwise made for prescription drugs as prescribed by
 this section.
   (iii) [The commissioner shall submit a report to the temporary  presi-
 dent  of the senate and the speaker of the assembly annually by December
 thirty-first. The report shall analyze the adequacy of rates to  managed
 care  providers  for drug expenditures related to the classes under this
 paragraph.
   (iv)] Nothing in this paragraph shall be construed to require a  phar-
 maceutical  manufacturer to enter into a rebate arrangement satisfactory
 to the commissioner relating to pharmaceutical utilization by  enrollees
 of managed care providers pursuant to section three hundred sixty-four-j
 of  this  title  or  relating  to  pharmaceutical utilization by medical
 assistance recipients not so enrolled.
   [(v)] (IV) All clinical criteria,  including  requirements  for  prior
 approval,  and  all utilization review determinations established by the
 state as described in this paragraph for the gene therapies,  drugs,  or
 drug  classes  subject  to  this  paragraph  shall  be  developed  using
 evidence-based and peer-reviewed clinical review criteria in  accordance
 with article two-A of the public health law, as applicable.
   [(vi)]  (V)  All  prior  authorization and utilization review determi-
 nations related to the coverage of any drug subject  to  this  paragraph
 shall be subject to article forty-nine of the public health law, section
 three  hundred sixty-four-j of this title, and article forty-nine of the
 S. 8307                            40                            A. 8807
 
 insurance law, as applicable. Nothing in this paragraph  shall  diminish
 any  rights  relating to access, prior authorization, or appeal relating
 to any drug class or drug  afforded  to  a  recipient  under  any  other
 provision of law.
   [(vii)]  (VI)  The  department  shall publish a statewide formulary of
 opioid dependence agents and opioid antagonists, which shall include  as
 "preferred  drugs"  all  drugs  in such classes, which shall include all
 subclasses of a given drug that have a different  pharmacological  route
 of administration, provided that:
   (A) for all drugs that are included as of the date of the enactment of
 this  subparagraph on a formulary of a managed care provider, as defined
 in section three hundred sixty-four-j of this title, or in the  Medicaid
 fee-for-service  preferred  drug program pursuant to section two hundred
 seventy-two of the public health law, the cost  to  the  department  for
 such  drug is equal to or less than the lowest cost paid for the drug by
 any managed care provider or by  the  Medicaid  fee-for-service  program
 after the application of any rebates, as of the date that the department
 implements  the  statewide  formulary  established by this subparagraph.
 Where there is a generic version of the drug approved by  the  Food  and
 Drug Administration as bioequivalent to a brand name drug pursuant to 21
 U.S.C.  §  355(j)(8)(B),  the  cost  to the department for the brand and
 generic versions shall be equal to or less than the  lower  of  the  two
 maximum costs determined pursuant to the previous sentence; and
   (B)  for  all drugs that are not included as of the date of the enact-
 ment of this subparagraph on a formulary of a managed care provider,  as
 defined  in  section three hundred sixty-four-j of this title, or in the
 Medicaid fee-for-service preferred drug program pursuant to section  two
 hundred  seventy-two of the public health law, the department is able to
 obtain the drug at a cost that is equal to or less than the lowest  cost
 to  the  department  of  other  comparable drugs in the class, after the
 application of any rebates. Where there is a generic version of the drug
 approved by the Food and Drug Administration as bioequivalent to a brand
 name drug pursuant to 21 U.S.C. § 355(j)(8)(B), the cost to the  depart-
 ment  for  the brand and generic versions shall be equal to or less than
 the lower of the two maximum costs determined pursuant to  the  previous
 sentence.
   [(viii)]  (VII)  The  commissioner  may  identify  and refer high cost
 drugs, as defined in clause (D)  of  this  subparagraph,  that  are  not
 included  as  of  the  date  of  the enactment of this subparagraph on a
 formulary of a managed care provider or covered by the Medicaid fee  for
 service  of  program to the drug utilization review board established by
 section three hundred sixty-nine-bb of this article for a recommendation
 as to whether a target supplemental Medicaid rebate should  be  paid  by
 the  manufacturer of the drug to the department and the target amount of
 the rebate.
   (A) If the commissioner intends to refer a high cost drug to the  drug
 utilization review board pursuant to this subparagraph, the commissioner
 shall  notify  the  manufacturer of such drug and shall attempt to reach
 agreement with the manufacturer on a rebate arrangement satisfactory  to
 the  commissioner  for  the drug prior to referring the drug to the drug
 utilization review board for review. Such arrangement may  be  based  on
 evidence  based  research,  including, but not limited to, such research
 operated or conducted by or for other  state  governments,  the  federal
 government,  the governments of other nations, and third party payers or
 multi-state coalitions,  provided  however  that  the  department  shall
 account for the effectiveness of the drug in treating the conditions for
 S. 8307                            41                            A. 8807
 
 which  it  is  prescribed or in improving a patient's health, quality of
 life, or overall health outcomes, and the likelihood  that  use  of  the
 drug will reduce the need for other medical care, including hospitaliza-
 tion.
   (B)  In  the  event  that  the  commissioner and the manufacturer have
 previously agreed to a rebate arrangement for a drug  pursuant  to  this
 paragraph, the drug shall not be referred to the drug utilization review
 board  for any further rebate agreement for the duration of the previous
 rebate agreement, provided however, the commissioner may refer a drug to
 the drug utilization review board if the commissioner  determines  there
 are  significant  and  substantiated  utilization or market changes, new
 evidence-based research, or statutory or federal regulatory changes that
 warrant additional rebates. In such cases, the department  shall  notify
 the  manufacturer  and  provide evidence of the changes or research that
 would warrant additional rebates, and shall attempt to  reach  agreement
 with  the  manufacturer  on a rebate for the drug prior to referring the
 drug to the drug utilization review board for review.
   (C) If the commissioner is unsuccessful  in  entering  into  a  rebate
 arrangement  with  the  manufacturer  of  the  drug  satisfactory to the
 department, the drug manufacturer shall in that  event  be  required  to
 provide to the department, on a standard reporting form developed by the
 department, the information as described in PARAGRAPH (E) OF subdivision
 [six]  THREE of section two hundred eighty of the public health law. All
 information disclosed pursuant to this clause shall be considered confi-
 dential and shall not be disclosed by the  department  in  a  form  that
 identifies  a  specific manufacturer or prices charged for drugs by such
 manufacturer.
   (D) For the purposes of this subparagraph, the term "high  cost  drug"
 shall  mean  a  brand  name drug or biologic that has a launch wholesale
 acquisition cost of thirty thousand dollars or more per year  or  course
 of  treatment, or a biosimilar drug that has a launch wholesale acquisi-
 tion cost that is not at least fifteen percent lower than the referenced
 brand biologic at the time the biosimilar is launched, or a generic drug
 that has a wholesale acquisition cost of one hundred dollars or more for
 a thirty day supply or recommended dosage approved for labeling  by  the
 federal  Food  and Drug Administration, or a brand name drug or biologic
 that has a wholesale acquisition cost increase of three thousand dollars
 or more in any twelve-month period, or course of treatment if less  than
 twelve months.
   [(ix)]  (VIII)  For  purposes of this paragraph, a "gene therapy" is a
 drug (A) approved under section  505  of  the  Federal  Food,  Drug  and
 Cosmetics  Act or licensed under subsection (a) or (k) of section 351 of
 the Public Health Services Act; (B) that treats a rare disease or condi-
 tion, as defined in 21 USC § 360bb(a)(2), that is  life-threatening,  as
 defined in 42 CFR 321.18; (C) is considered a gene therapy by the feder-
 al  Food  and Drug Administration for which a biologics license pursuant
 to 21 CFR 600-680 is held; (D) if administered in  accordance  with  the
 labeling  of such drug, is expected to result in either the cure of such
 disease or condition or a reduction in the symptoms of such  disease  or
 condition  that  materially  improves the patient's length or quality of
 life; and (E) is expected to achieve the result described in clause  (D)
 of this subparagraph after not more than three administrations.
   (IX)  FOR  PURPOSES  OF THIS PARAGRAPH, AN "ACCELERATED APPROVAL" IS A
 DRUG OR LABELED INDICATION OF A DRUG AUTHORIZED  BY  THE  FEDERAL  FOOD,
 DRUG  AND  COSMETIC  ACT  FOR  DRUGS FOR SERIOUS CONDITIONS THAT FILL AN
 UNMET MEDICAL NEED BASED ON WHETHER THE DRUG HAS AN EFFECT ON  A  SURRO-
 S. 8307                            42                            A. 8807
 
 GATE  CLINICAL  ENDPOINT,  AND  CONTINGENT UPON VERIFICATION OF CLINICAL
 BENEFIT IN CONFIRMATORY TRIALS.
   §  6.  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, prosthetic appliances and dental
 prosthetic appliances furnished in accordance with  the  regulations  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  preferred
 manufacturers  [of] FOR PRODUCTS AND SUPPLIES, INCLUDING BUT NOT LIMITED
 TO, glucometers and test strips, and may subject non-preferred  manufac-
 turers' PRODUCTS AND SUPPLIES, INCLUDING BUT NOT LIMITED TO, glucometers
 and  test strips to prior authorization under section two hundred seven-
 ty-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;
   § 7. The public health law is amended by adding a new section 280-d to
 read as follows:
   §  280-D. PHARMACY COST REPORTING. 1. THE DEPARTMENT SHALL DEVELOP AND
 IMPLEMENT A COST REPORTING PROGRAM FOR LICENSED PHARMACIES THAT  PARTIC-
 IPATE  IN THE MEDICAID PROGRAM. SUCH PROGRAM SHALL INCLUDE A REQUIREMENT
 TO SUBMIT AN ANNUAL COST REPORT  ON A FORM DESIGNATED BY THE DEPARTMENT.
 INFORMATION SHALL INCLUDE, BUT NOT BE LIMITED TO, COSTS INCURRED  DURING
 PROCUREMENT AND DISPENSING OF PRESCRIPTION DRUGS.
   2.  SUCH  COST  REPORTS  ARE  SUBJECT  TO AUDIT. IN THE EVENT THAT ANY
 INFORMATION OR DATA WHICH A PHARMACY HAS SUBMITTED TO THE DEPARTMENT, ON
 THE  REQUIRED REPORTING FORMS IS INACCURATE OR INCORRECT, SUCH  PHARMACY
 SHALL   WITHIN  FIFTEEN  BUSINESS  DAYS,  SUBMIT  TO  THE  DEPARTMENT  A
 CORRECTION OF SUCH INFORMATION OR DATA.
   3. TIMELY FILING OF SUCH REPORT IS A REQUIREMENT OF  PARTICIPATION  IN
 THE  MEDICAID  PHARMACY  PROGRAM.  IN THE EVENT THAT A PHARMACY FAILS TO
 FILE THE REQUIRED REPORTS ON OR BEFORE THE REQUIRED DUE DATE, SUCH PHAR-
 MACY MAY BE SUBJECT TO REMOVAL AS A PROVIDER  FROM  THE  FEE-FOR-SERVICE
 PHARMACY PROGRAM.
 S. 8307                            43                            A. 8807

   §  8. Paragraphs (a), (b) and (c) of subdivision 9 of section 367-a of
 the social services law, paragraphs (a) and (c) as amended by chapter 19
 of the laws of 1998, paragraph (b) as amended by section 3 of part C  of
 chapter  58 of the laws of 2004, subparagraphs (i) and (ii) of paragraph
 (b) as amended by section 7 of part D of chapter 57 of the laws of 2017,
 and subparagraph (iii) of paragraph (b) as added by section 29 of part E
 of chapter 63 of the laws of 2005, are amended to read as follows:
   (a) for drugs provided by medical practitioners and claimed separately
 by  the  practitioners[, the actual cost of the drugs to the practition-
 ers; and] THE LOWER OF:
   (I) (1) AN AMOUNT EQUAL TO THE NATIONAL AVERAGE DRUG ACQUISITION  COST
 SET  BY  THE  FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES FOR THE
 DRUG, IF ANY, OR IF SUCH AMOUNT IS NOT AVAILABLE, THE WHOLESALE ACQUISI-
 TION COST OF THE DRUG BASED ON  THE  PACKAGE  SIZE  DISPENSED  FROM,  AS
 REPORTED  BY  THE  PRESCRIPTION DRUG PRICING SERVICE USED BY THE DEPART-
 MENT, (2) THE FEDERAL UPPER LIMIT, IF ANY, ESTABLISHED  BY  THE  FEDERAL
 CENTERS FOR MEDICARE AND MEDICAID SERVICES; (3) THE STATE MAXIMUM ACQUI-
 SITION  COST,  IF  ANY,  ESTABLISHED  PURSUANT  TO PARAGRAPH (E) OF THIS
 SUBDIVISION; OR (4) THE ACTUAL COST OF THE DRUG TO THE PRACTITIONER.
   (II) NOTWITHSTANDING SUBPARAGRAPH (I) AND PARAGRAPH (E) OF THIS SUBDI-
 VISION, IF A DRUG HAS BEEN PURCHASED FROM A MANUFACTURER  BY  A  COVERED
 ENTITY PURSUANT TO SECTION 340B OF THE FEDERAL PUBLIC HEALTH SERVICE ACT
 (42  USCA  §  256B),  THE ACTUAL AMOUNT PAID BY SUCH COVERED ENTITY. FOR
 PURPOSES OF THIS SUBPARAGRAPH, A "COVERED  ENTITY"  IS  AN  ENTITY  THAT
 MEETS  THE  REQUIREMENTS  OF  PARAGRAPH  FOUR  OF SUBSECTION (A) OF SUCH
 SECTION, THAT ELECTS TO PARTICIPATE IN THE PROGRAM ESTABLISHED  BY  SUCH
 SECTION,  AND  THAT  CAUSES CLAIMS FOR PAYMENT FOR DRUGS COVERED BY THIS
 SUBPARAGRAPH TO BE SUBMITTED TO THE MEDICAL ASSISTANCE  PROGRAM,  EITHER
 DIRECTLY  OR THROUGH AN AUTHORIZED CONTRACT PHARMACY. NO MEDICAL ASSIST-
 ANCE PAYMENTS MAY BE MADE TO  A  COVERED  ENTITY  OR  TO  AN  AUTHORIZED
 CONTRACT  PHARMACY  OF  A COVERED ENTITY FOR DRUGS THAT ARE ELIGIBLE FOR
 PURCHASE UNDER THE SECTION 340B PROGRAM AND ARE DISPENSED ON  AN  OUTPA-
 TIENT  BASIS  TO  PATIENTS  OF  THE COVERED ENTITY, OTHER THAN UNDER THE
 PROVISIONS OF THIS SUBPARAGRAPH.
   (b) for drugs dispensed by pharmacies:
   (i) (A) if the drug dispensed is  a  generic  prescription  drug,  the
 lower  of:  (1) an amount equal to the national average drug acquisition
 cost set by the federal centers for medicare and medicaid  services  for
 the  drug,  if  any,  or  if such amount if not available, the wholesale
 acquisition cost of the drug based on the package size  dispensed  from,
 as reported by the prescription drug pricing service used by the depart-
 ment, less seventeen and one-half percent thereof; (2) the federal upper
 limit, if any, established by the federal centers for medicare and medi-
 caid  services;  (3)  the state maximum acquisition cost, if any, estab-
 lished pursuant to  paragraph  (e)  of  this  subdivision;  or  (4)  the
 dispensing  pharmacy's  usual and customary price charged to the general
 public; (B) if the drug dispensed is available without a prescription as
 required by section sixty-eight hundred ten of the education law but  is
 reimbursed as an item of medical assistance pursuant to paragraph (a) of
 subdivision  four  of  section three hundred sixty-five-a of this title,
 the lower of (1) an amount equal to the national average  drug  acquisi-
 tion  cost set by the federal centers for medicare and medicaid services
 for the drug, if any, or if such amount is not available, the  wholesale
 acquisition  cost  of the drug based on the package size dispensed from,
 as reported by the prescription drug pricing service used by the depart-
 ment, (2) the federal upper limit, if any, established  by  the  federal
 S. 8307                            44                            A. 8807
 
 centers for medicare and medicaid services; (3) the state maximum acqui-
 sition cost if any, established pursuant to paragraph (e) of this subdi-
 vision;  or  (4)  the  dispensing  pharmacy's  usual and customary price
 charged to the general public;
   (ii)  if  the  drug  dispensed  is a brand-name prescription drug, the
 lower of:
   (A) an amount equal to the national average drug acquisition cost  set
 by  the federal centers for medicare and medicaid services for the drug,
 if any, or if such amount is not available,  the  wholesale  acquisition
 cost  of  the drug based on the package size dispensed from, as reported
 by the prescription drug pricing service used by the  department[,  less
 three  and  three-tenths percent thereof]; or (B) the dispensing pharma-
 cy's usual and customary price charged to the general public; and
   (iii) notwithstanding subparagraphs (i) and (ii) of this paragraph and
 paragraphs (d) and (e) of this subdivision, if the drug dispensed  is  a
 drug  that  has  been  purchased from a manufacturer by a covered entity
 pursuant to section 340B of the federal public health  service  act  (42
 USCA  § 256b), the actual amount paid by such covered entity pursuant to
 such section, plus the reasonable administrative costs, as determined by
 the commissioner, incurred by the covered entity  or  by  an  authorized
 contract pharmacy in connection with the purchase and dispensing of such
 drug and the tracking of such transactions. For purposes of this subpar-
 agraph,  a  "covered entity" is an entity that meets the requirements of
 paragraph four of subsection (a) of such section, that elects to partic-
 ipate in the program established by such section, and that causes claims
 for payment for drugs covered by this subparagraph to  be  submitted  to
 the medical assistance program, either directly or through an authorized
 contract  pharmacy.  No  medical  assistance  payments  may be made to a
 covered entity or to an authorized contract pharmacy of a covered entity
 for drugs that are eligible for purchase under the section 340B  program
 and  are  dispensed  on  an  outpatient basis to patients of the covered
 entity, other than under the provisions of this subparagraph. Pharmacies
 submitting claims for  reimbursement  of  drugs  purchased  pursuant  to
 section  340B  of the public health service act shall notify the depart-
 ment that the claim is eligible for purchase  under  the  340B  program,
 consistent  with claiming instructions issued by the department to iden-
 tify such claims.
   (c) Notwithstanding subparagraph (i) of paragraph (b) of this subdivi-
 sion, if a qualified prescriber certifies "brand medically necessary" or
 "brand necessary" in his or her own handwriting directly on the face  of
 a  prescription,  OR IN THE CASE OF ELECTRONIC PRESCRIPTIONS, INSERTS AN
 ELECTRONIC DIRECTION TO CLARIFY "BRAND MEDICALLY  NECESSARY"  OR  "BRAND
 NECESSARY",  for a multiple source drug for which a specific upper limit
 of reimbursement has been established by the federal agency, in addition
 to writing "d a  w"  in  the  box  provided  for  such  purpose  on  the
 prescription  form,  payment under this title for such drug must be made
 under the provisions of subparagraph (ii) of such paragraph.
   § 9. This act  shall  take  effect  October  1,  2024;  provided  that
 sections two and three of this act shall take effect  January  1,  2025;
 and  provided  however, that the amendments to paragraph (e) of subdivi-
 sion 7 of section 367-a of the social services law made by section  five
 of  this  act shall not affect the repeal of such paragraph and shall be
 deemed repealed therewith provided,  further,  that  the  amendments  to
 subdivision  9  of  section  367-a  of  the  social services law made by
 section eight of this act shall not affect the expiration of such subdi-
 S. 8307                            45                            A. 8807
 
 vision pursuant to section 4 of chapter 19  of  the  laws  of  1998,  as
 amended, and shall expire therewith.
 
                                  PART J

   Section  1. The title heading of title 11-D of article 5 of the social
 services law, as amended by section 1 of part H of  chapter  57  of  the
 laws of 2021, is amended to read as follows:
                    [BASIC HEALTH PROGRAM] ESSENTIAL PLAN
   §  2.  Section 3 of part H of chapter 57 of the laws of 2021, amending
 the social services law relating to  eliminating  consumer-paid  premium
 payments in the basic health program, is amended to read as follows:
   § 3. This act shall take effect June 1, 2021 [and]; PROVIDED, HOWEVER,
 SECTION  TWO  OF  THIS  ACT  shall  expire and be deemed repealed should
 federal approval be withdrawn or 42 U.S.C. 18051 be  repealed;  provided
 that the commissioner of health shall notify the legislative bill draft-
 ing  commission upon the withdrawal of federal approval or the repeal of
 42 U.S.C. 18051 in order that the commission may  maintain  an  accurate
 and  timely  effective data base of the official text of the laws of the
 state of New York in  furtherance  of  effectuating  the  provisions  of
 section  44  of the legislative law and section 70-b of the public offi-
 cers law.
   § 3. Subdivisions (b) and (c) of section 8 of part BBB of  chapter  56
 of  the  laws  of  2022,  amending  the public health law and other laws
 relating to permitting the commissioner of health  to  submit  a  waiver
 that  expands  eligibility  for  New  York's  basic  health  program and
 increases the federal poverty limit cap for basic health  program eligi-
 bility from  two hundred to two hundred  fifty percent, are  amended  to
 read as follows:
   (b)  section  four  of  this  act  shall expire and be deemed repealed
 December 31, [2024] 2025; provided, however, the amendments to paragraph
 (c) of subdivision 1 of section 369-gg of the social services  law  made
 by  such  section  of  this  act  shall be subject to the expiration and
 reversion of such paragraph pursuant to section 2 of part H  of  chapter
 57  of  the  laws of 2021 when upon such date, the provisions of section
 five of this act shall take effect; provided, however, the amendments to
 such paragraph made by section five of this  act  shall  expire  and  be
 deemed repealed December 31, [2024] 2025;
   (c)  section six of this act shall take effect January 1, [2025] 2026;
 provided, however, the amendments to paragraph (c) of subdivision  1  of
 section  369-gg  of the social services law made by such section of this
 act shall be subject to the expiration and reversion of  such  paragraph
 pursuant  to  section 2 of part H of chapter 57 of the laws of 2021 when
 upon such date, the provisions of section seven of this act  shall  take
 effect; and
   §  4.  Paragraph  (a)  of subdivision 1 of section 268-c of the public
 health law, as added by section 2 of part T of chapter 57 of the laws of
 2019, is amended to read as follows:
   (a) Perform eligibility determinations for federal and state insurance
 affordability programs including medical assistance in  accordance  with
 section three hundred sixty-six of the social services law, child health
 plus in accordance with section twenty-five hundred eleven of this chap-
 ter,  the  basic health program in accordance with section three hundred
 sixty-nine-gg of the social services  law,  THE  1332  STATE  INNOVATION
 PROGRAM  IN  ACCORDANCE  WITH SECTION THREE HUNDRED SIXTY-NINE-II OF THE
 SOCIAL SERVICES LAW, premium tax credits and cost-sharing reductions and
 S. 8307                            46                            A. 8807
 
 qualified health plans in  accordance  with  applicable  law  and  other
 health insurance programs as determined by the commissioner;
   §  5.  Subdivision  16  of  section 268-c of the public health law, as
 added by section 2 of part T of chapter 57  of  the  laws  of  2019,  is
 amended to read as follows:
   16.  In accordance with applicable federal and state law, inform indi-
 viduals of eligibility requirements for the Medicaid program under title
 XIX of the social security act and the social services  law,  the  chil-
 dren's  health  insurance  program  (CHIP) under title XXI of the social
 security act and this chapter, the basic health  program  under  section
 three  hundred  sixty-nine-gg of the social services law, THE 1332 STATE
 INNOVATION PROGRAM IN ACCORDANCE WITH SECTION THREE HUNDRED  SIXTY-NINE-
 II  OF  THE SOCIAL SERVICES LAW, or any applicable state or local public
 health insurance program and if, through screening of the application by
 the Marketplace, the Marketplace determines that  such  individuals  are
 eligible for any such program, enroll such individuals in such program.
   § 6. Section 268-c of the public health law is amended by adding a new
 subdivision 26 to read as follows:
   26.  SUBJECT  TO  FEDERAL APPROVAL IF REQUIRED, THE USE OF STATE FUNDS
 AND THE AVAILABILITY OF FUNDS IN THE 1332 STATE INNOVATION PROGRAM  FUND
 ESTABLISHED PURSUANT TO SECTION NINETY-EIGHT-D OF THE STATE FINANCE LAW,
 THE  COMMISSIONER  SHALL  HAVE  THE  AUTHORITY TO ESTABLISH A PROGRAM TO
 PROVIDE SUBSIDIES FOR THE PAYMENT OF PREMIUM OR COST SHARING OR BOTH  TO
 ASSIST  INDIVIDUALS  WHO ARE ELIGIBLE TO PURCHASE QUALIFIED HEALTH PLANS
 THROUGH THE MARKETPLACE, OR TAKE SUCH OTHER  ACTION  AS  APPROPRIATE  TO
 REDUCE  OR  ELIMINATE  QUALIFIED HEALTH PLAN PREMIUMS OR COST-SHARING OR
 BOTH.
   § 7. Subparagraph (i) of paragraph (a) of  subdivision  4  of  section
 268-e of the public health law, as added by section 2 of part T of chap-
 ter 57 of the laws of 2019, is amended to read as follows:
   (i) An initial determination of eligibility, including:
   (A) eligibility to enroll in a qualified health plan;
   (B) eligibility for Medicaid;
   (C) eligibility for Child Health Plus;
   (D) eligibility for the Basic Health Program;
   (E) ELIGIBILITY FOR THE 1332 STATE INNOVATION PROGRAM;
   (F) the amount of advance payments of the premium tax credit and level
 of cost-sharing reductions;
   [(F)]  (G) the amount of any other subsidy that may be available under
 law; and
   [(G)] (H) eligibility for such  other  health  insurance  programs  as
 determined by the commissioner; and
   §  8.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024; provided,
 however, that sections four, five, six, and seven of this act shall take
 effect January 1, 2025; provided, further, that section six of this  act
 shall  only  take  effect  upon the commissioner of health obtaining and
 maintaining all necessary approvals from the  secretary  of  health  and
 human  services  and  the  secretary of the treasury based on an amended
 application for a waiver for state innovation pursuant to  section  1332
 of  the  patient  protection  and affordable care act (P.L. 111-148) and
 subdivision 25 of section 268-c of the public health law; and  provided,
 further,  that  the  commissioner of health shall notify the legislative
 bill drafting commission upon the occurrence of  the  enactment  of  the
 legislation  provided  for  in section six of this act in order that the
 commission may maintain an accurate and timely effective  data  base  of
 S. 8307                            47                            A. 8807
 
 the official text of the laws of the state of New York in furtherance of
 effectuating  the  provisions  of  section 44 of the legislative law and
 section 70-b of the public officers law.
 
                                  PART K
 
   Section 1. Paragraph (a) of subdivision 1 of section 18 of chapter 266
 of the laws of 1986, amending the civil practice law and rules and other
 laws  relating  to  malpractice  and  professional  medical  conduct, as
 amended by section 1 of part F of chapter 57 of the  laws  of  2023,  is
 amended and a new subdivision 9 is added to read as follows:
   (a)  The  superintendent of financial services and the commissioner of
 health or their designee shall, from funds  available  in  the  hospital
 excess liability pool created pursuant to subdivision 5 of this section,
 purchase  a policy or policies for excess insurance coverage, as author-
 ized by paragraph 1 of subsection (e) of section 5502 of  the  insurance
 law; or from an insurer, other than an insurer described in section 5502
 of the insurance law, duly authorized to write such coverage and actual-
 ly  writing  medical  malpractice  insurance  in  this  state;  or shall
 purchase equivalent excess coverage in a form previously approved by the
 superintendent of financial services for purposes  of  providing  equiv-
 alent  excess  coverage  in accordance with section 19 of chapter 294 of
 the laws of 1985, for medical or dental malpractice occurrences  between
 July  1, 1986 and June 30, 1987, between July 1, 1987 and June 30, 1988,
 between July 1, 1988 and June 30, 1989, between July 1,  1989  and  June
 30,  1990,  between July 1, 1990 and June 30, 1991, between July 1, 1991
 and June 30, 1992, between July 1, 1992 and June 30, 1993, between  July
 1,  1993  and  June  30,  1994,  between July 1, 1994 and June 30, 1995,
 between July 1, 1995 and June 30, 1996, between July 1,  1996  and  June
 30,  1997,  between July 1, 1997 and June 30, 1998, between July 1, 1998
 and June 30, 1999, between July 1, 1999 and June 30, 2000, between  July
 1,  2000  and  June  30,  2001,  between July 1, 2001 and June 30, 2002,
 between July 1, 2002 and June 30, 2003, between July 1,  2003  and  June
 30,  2004,  between July 1, 2004 and June 30, 2005, between July 1, 2005
 and June 30, 2006, between July 1, 2006 and June 30, 2007, between  July
 1,  2007  and  June  30,  2008,  between July 1, 2008 and June 30, 2009,
 between July 1, 2009 and June 30, 2010, between July 1,  2010  and  June
 30,  2011,  between July 1, 2011 and June 30, 2012, between July 1, 2012
 and June 30, 2013, between July 1, 2013 and June 30, 2014, between  July
 1,  2014  and  June  30,  2015,  between July 1, 2015 and June 30, 2016,
 between July 1, 2016 and June 30, 2017, between July 1,  2017  and  June
 30,  2018,  between July 1, 2018 and June 30, 2019, between July 1, 2019
 and June 30, 2020, between July 1, 2020 and June 30, 2021, between  July
 1, 2021 and June 30, 2022, between July 1, 2022 and June 30, 2023, [and]
 between  July  1,  2023  and June 30, 2024, AND BETWEEN JULY 1, 2024 AND
 JUNE 30, 2025 or reimburse the hospital  where  the  hospital  purchases
 equivalent  excess  coverage as defined in subparagraph (i) of paragraph
 (a) of subdivision 1-a of this section for medical or dental malpractice
 occurrences between July 1, 1987 and June 30, 1988, between July 1, 1988
 and June 30, 1989, between July 1, 1989 and June 30, 1990, between  July
 1,  1990  and  June  30,  1991,  between July 1, 1991 and June 30, 1992,
 between July 1, 1992 and June 30, 1993, between July 1,  1993  and  June
 30,  1994,  between July 1, 1994 and June 30, 1995, between July 1, 1995
 and June 30, 1996, between July 1, 1996 and June 30, 1997, between  July
 1,  1997  and  June  30,  1998,  between July 1, 1998 and June 30, 1999,
 between July 1, 1999 and June 30, 2000, between July 1,  2000  and  June
 S. 8307                            48                            A. 8807
 
 30,  2001,  between July 1, 2001 and June 30, 2002, between July 1, 2002
 and June 30, 2003, between July 1, 2003 and June 30, 2004, between  July
 1,  2004  and  June  30,  2005,  between July 1, 2005 and June 30, 2006,
 between  July  1,  2006 and June 30, 2007, between July 1, 2007 and June
 30, 2008, between July 1, 2008 and June 30, 2009, between July  1,  2009
 and  June 30, 2010, between July 1, 2010 and June 30, 2011, between July
 1, 2011 and June 30, 2012, between July  1,  2012  and  June  30,  2013,
 between  July  1,  2013 and June 30, 2014, between July 1, 2014 and June
 30, 2015, between July 1, 2015 and June 30, 2016, between July  1,  2016
 and  June 30, 2017, between July 1, 2017 and June 30, 2018, between July
 1, 2018 and June 30, 2019, between July  1,  2019  and  June  30,  2020,
 between  July  1,  2020 and June 30, 2021, between July 1, 2021 and June
 30, 2022, between July 1, 2022 and June 30, 2023, [and] between July  1,
 2023  and  June 30, 2024, AND BETWEEN JULY 1, 2024 AND JUNE 30, 2025 for
 physicians or dentists certified as eligible for  each  such  period  or
 periods  pursuant to subdivision 2 of this section by a general hospital
 licensed pursuant to article 28 of the public health law; provided  that
 no  single  insurer  shall  write  more  than fifty percent of the total
 excess premium for a given policy year; and provided, however, that such
 eligible physicians or dentists must have in force an individual policy,
 from an insurer licensed in this state of primary malpractice  insurance
 coverage  in  amounts of no less than one million three hundred thousand
 dollars for each  claimant  and  three  million  nine  hundred  thousand
 dollars  for  all  claimants under that policy during the period of such
 excess coverage for  such  occurrences  or  be  endorsed  as  additional
 insureds under a hospital professional liability policy which is offered
 through a voluntary attending physician ("channeling") program previous-
 ly  permitted  by  the  superintendent  of financial services during the
 period of such excess coverage for such occurrences. During such period,
 such policy for excess  coverage  or  such  equivalent  excess  coverage
 shall,  when combined with the physician's or dentist's primary malprac-
 tice insurance coverage or coverage provided through a voluntary attend-
 ing physician ("channeling") program, total an aggregate  level  of  two
 million three hundred thousand dollars for each claimant and six million
 nine  hundred  thousand dollars for all claimants from all such policies
 with respect to occurrences in each of such years provided, however,  if
 the  cost  of  primary  malpractice  insurance coverage in excess of one
 million dollars, but below  the  excess  medical  malpractice  insurance
 coverage provided pursuant to this act, exceeds the rate of nine percent
 per  annum,  then  the  required  level of primary malpractice insurance
 coverage in excess of one million dollars for each claimant shall be  in
 an  amount of not less than the dollar amount of such coverage available
 at nine percent per annum; the required level of such coverage  for  all
 claimants  under  that  policy shall be in an amount not less than three
 times the dollar amount of coverage for each claimant; and excess cover-
 age, when combined with such  primary  malpractice  insurance  coverage,
 shall  increase  the  aggregate  level  for each claimant by one million
 dollars and three  million  dollars  for  all  claimants;  and  provided
 further,  that,  with respect to policies of primary medical malpractice
 coverage that include occurrences between April 1,  2002  and  June  30,
 2002,  such  requirement  that  coverage  be in amounts no less than one
 million three hundred thousand  dollars  for  each  claimant  and  three
 million  nine hundred thousand dollars for all claimants for such occur-
 rences shall be effective April 1, 2002.
   (9) THIS SUBDIVISION SHALL APPLY ONLY TO EXCESS INSURANCE COVERAGE  OR
 EQUIVALENT  EXCESS  COVERAGE FOR PHYSICIANS OR DENTISTS THAT IS ELIGIBLE
 S. 8307                            49                            A. 8807
 
 TO BE PAID FOR FROM FUNDS AVAILABLE IN  THE  HOSPITAL  EXCESS  LIABILITY
 POOL.
   (A)  NOTWITHSTANDING  ANY  LAW  TO THE CONTRARY, FOR ANY POLICY PERIOD
 BEGINNING ON OR AFTER JULY 1, 2023, EXCESS COVERAGE SHALL  BE  PURCHASED
 BY  A  PHYSICIAN OR DENTIST DIRECTLY FROM A PROVIDER OF EXCESS INSURANCE
 COVERAGE OR EQUIVALENT EXCESS COVERAGE. AT THE CONCLUSION OF THE  POLICY
 PERIOD  THE SUPERINTENDENT OF FINANCIAL SERVICES AND THE COMMISSIONER OF
 HEALTH OR THEIR DESIGNEE SHALL, FROM FUNDS  AVAILABLE  IN  THE  HOSPITAL
 EXCESS LIABILITY POOL CREATED PURSUANT TO SUBDIVISION 5 OF THIS SECTION,
 PAY  FIFTY  PERCENT  OF  THE PREMIUM TO THE PROVIDER OF EXCESS INSURANCE
 COVERAGE OR EQUIVALENT EXCESS COVERAGE, AND THE REMAINING FIFTY  PERCENT
 SHALL BE PAID ONE YEAR THEREAFTER.
   (B)  NOTWITHSTANDING  ANY  LAW  TO THE CONTRARY, FOR ANY POLICY PERIOD
 BEGINNING ON OR AFTER JULY 1, 2024, EXCESS COVERAGE SHALL  BE  PURCHASED
 BY  A  PHYSICIAN OR DENTIST DIRECTLY FROM A PROVIDER OF EXCESS INSURANCE
 COVERAGE OR EQUIVALENT EXCESS COVERAGE. SUCH PROVIDER OF  EXCESS  INSUR-
 ANCE  COVERAGE  OR  EQUIVALENT  EXCESS  COVERAGE SHALL BILL, IN A MANNER
 CONSISTENT WITH PARAGRAPH (F) OF  THIS  SUBDIVISION,  THE  PHYSICIAN  OR
 DENTIST  FOR  AN  AMOUNT  EQUAL TO FIFTY PERCENT OF THE PREMIUM FOR SUCH
 COVERAGE, AS ESTABLISHED PURSUANT TO PARAGRAPH (D) OF THIS  SUBDIVISION,
 DURING  THE  POLICY  PERIOD.  AT THE CONCLUSION OF THE POLICY PERIOD THE
 SUPERINTENDENT OF FINANCIAL SERVICES AND THE COMMISSIONER OF  HEALTH  OR
 THEIR  DESIGNEE  SHALL,  FROM  FUNDS  AVAILABLE  IN  THE HOSPITAL EXCESS
 LIABILITY POOL CREATED PURSUANT TO SUBDIVISION 5 OF  THIS  SECTION,  PAY
 HALF  OF  THE  REMAINING FIFTY PERCENT OF THE PREMIUM TO THE PROVIDER OF
 EXCESS INSURANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE, AND THE REMAIN-
 ING TWENTY-FIVE PERCENT SHALL BE PAID ONE YEAR THEREAFTER. IF THE  FUNDS
 AVAILABLE IN THE HOSPITAL EXCESS LIABILITY POOL ARE INSUFFICIENT TO MEET
 THE  PERCENT  OF  THE  COSTS  OF  THE EXCESS COVERAGE, THE PROVISIONS OF
 SUBDIVISION 8 OF THIS SECTION SHALL APPLY.
   (C) IF AT THE CONCLUSION OF THE POLICY PERIOD, A PHYSICIAN OR DENTIST,
 ELIGIBLE FOR EXCESS COVERAGE PAID FOR FROM FUNDS AVAILABLE IN THE HOSPI-
 TAL EXCESS LIABILITY POOL, HAS FAILED TO PAY AN AMOUNT  EQUAL  TO  FIFTY
 PERCENT  OF THE PREMIUM AS ESTABLISHED PURSUANT TO PARAGRAPH (D) OF THIS
 SUBDIVISION, SUCH EXCESS COVERAGE SHALL BE CANCELLED AND SHALL  BE  NULL
 AND  VOID  AS  OF THE FIRST DAY ON OR AFTER THE COMMENCEMENT OF A POLICY
 PERIOD WHERE THE LIABILITY FOR PAYMENT PURSUANT TO THIS SUBDIVISION  HAS
 NOT BEEN MET. THE PROVIDER OF EXCESS COVERAGE SHALL REMIT ANY PORTION OF
 PREMIUM  PAID  BY  THE  ELIGIBLE  PHYSICIAN OR DENTIST FOR SUCH A POLICY
 PERIOD.
   (D) THE SUPERINTENDENT OF FINANCIAL SERVICES SHALL  ESTABLISH  A  RATE
 CONSISTENT  WITH  SUBDIVISION 3 OF THIS SECTION THAT PROVIDERS OF EXCESS
 INSURANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE WILL  CHARGE  FOR  SUCH
 COVERAGE FOR EACH POLICY PERIOD. FOR THE POLICY PERIOD BEGINNING JULY 1,
 2024,  THE  SUPERINTENDENT  OF  FINANCIAL  SERVICES  MAY DIRECT THAT THE
 PREMIUM FOR THAT POLICY PERIOD BE THE SAME AS  IT  WAS  FOR  THE  POLICY
 PERIOD THAT CONCLUDED JUNE 30, 2023.
   (E)  NO  PROVIDER  OF  EXCESS  INSURANCE COVERAGE OR EQUIVALENT EXCESS
 COVERAGE SHALL ISSUE EXCESS COVERAGE TO WHICH THIS  SUBDIVISION  APPLIES
 TO  ANY  PHYSICIAN OR DENTIST UNLESS THAT PHYSICIAN OR DENTIST MEETS THE
 ELIGIBILITY REQUIREMENTS FOR SUCH COVERAGE SET FORTH  IN  THIS  SECTION.
 THE  SUPERINTENDENT OF FINANCIAL SERVICES AND THE COMMISSIONER OF HEALTH
 OR THEIR DESIGNEE SHALL NOT MAKE ANY PAYMENT UNDER THIS SUBDIVISION TO A
 PROVIDER OF EXCESS INSURANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE  FOR
 EXCESS  COVERAGE  ISSUED TO A PHYSICIAN OR DENTIST WHO DOES NOT MEET THE
 S. 8307                            50                            A. 8807

 ELIGIBILITY  REQUIREMENTS  FOR  PARTICIPATION  IN  THE  HOSPITAL  EXCESS
 LIABILITY POOL PROGRAM SET FORTH IN THIS SECTION.
   (F)  A  PROVIDER  OF  EXCESS INSURANCE COVERAGE OR EQUIVALENT COVERAGE
 THAT ISSUES EXCESS COVERAGE UNDER THIS SUBDIVISION SHALL BILL THE PHYSI-
 CIAN OR DENTIST FOR THE PORTION OF THE PREMIUM REQUIRED UNDER  PARAGRAPH
 (A)  OF THIS SUBDIVISION IN TWELVE EQUAL MONTHLY INSTALLMENTS OR IN SUCH
 OTHER MANNER AS THE PHYSICIAN OR DENTIST MAY AGREE.
   (G) THE SUPERINTENDENT OF FINANCIAL SERVICES IN CONSULTATION WITH  THE
 COMMISSIONER  OF  HEALTH MAY PROMULGATE REGULATIONS GIVING EFFECT TO THE
 PROVISIONS OF THIS SUBDIVISION.
   § 2. Subdivision 3 of section 18 of chapter 266 of the laws  of  1986,
 amending  the  civil  practice  law and rules and other laws relating to
 malpractice and professional medical conduct, as amended by section 2 of
 part F of chapter 57 of the laws of 2023, is amended to read as follows:
   (3)(a) The superintendent of financial services  shall  determine  and
 certify  to  each general hospital and to the commissioner of health the
 cost of excess malpractice insurance for medical or  dental  malpractice
 occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988
 and  June 30, 1989, between July 1, 1989 and June 30, 1990, between July
 1, 1990 and June 30, 1991, between July  1,  1991  and  June  30,  1992,
 between  July  1,  1992 and June 30, 1993, between July 1, 1993 and June
 30, 1994, between July 1, 1994 and June 30, 1995, between July  1,  1995
 and  June 30, 1996, between July 1, 1996 and June 30, 1997, between July
 1, 1997 and June 30, 1998, between July  1,  1998  and  June  30,  1999,
 between  July  1,  1999 and June 30, 2000, between July 1, 2000 and June
 30, 2001, between July 1, 2001 and June 30, 2002, between July  1,  2002
 and  June 30, 2003, between July 1, 2003 and June 30, 2004, between July
 1, 2004 and June 30, 2005, between July  1,  2005  and  June  30,  2006,
 between  July  1,  2006 and June 30, 2007, between July 1, 2007 and June
 30, 2008, between July 1, 2008 and June 30, 2009, between July  1,  2009
 and  June 30, 2010, between July 1, 2010 and June 30, 2011, between July
 1, 2011 and June 30, 2012, between July  1,  2012  and  June  30,  2013,
 between  July  1,  2013 and June 30, 2014, between July 1, 2014 and June
 30, 2015, between July 1, 2015 and June 30, 2016, between July  1,  2016
 and  June 30, 2017, between July 1, 2017 and June 30, 2018, between July
 1, 2018 and June 30, 2019, between July  1,  2019  and  June  30,  2020,
 between  July  1,  2020 and June 30, 2021, between July 1, 2021 and June
 30, 2022, between July 1, 2022 and June 30, 2023, [and] between July  1,
 2023 and June 30, 2024, AND BETWEEN JULY 1, 2024 AND JUNE 30, 2025 allo-
 cable  to  each general hospital for physicians or dentists certified as
 eligible for purchase of a policy for excess insurance coverage by  such
 general  hospital  in accordance with subdivision 2 of this section, and
 may amend such determination and certification as necessary.
   (b) The superintendent  of  financial  services  shall  determine  and
 certify  to  each general hospital and to the commissioner of health the
 cost of excess malpractice insurance or equivalent excess  coverage  for
 medical  or dental malpractice occurrences between July 1, 1987 and June
 30, 1988, between July 1, 1988 and June 30, 1989, between July  1,  1989
 and  June 30, 1990, between July 1, 1990 and June 30, 1991, between July
 1, 1991 and June 30, 1992, between July  1,  1992  and  June  30,  1993,
 between  July  1,  1993 and June 30, 1994, between July 1, 1994 and June
 30, 1995, between July 1, 1995 and June 30, 1996, between July  1,  1996
 and  June 30, 1997, between July 1, 1997 and June 30, 1998, between July
 1, 1998 and June 30, 1999, between July  1,  1999  and  June  30,  2000,
 between  July  1,  2000 and June 30, 2001, between July 1, 2001 and June
 30, 2002, between July 1, 2002 and June 30, 2003, between July  1,  2003
 S. 8307                            51                            A. 8807
 
 and  June 30, 2004, between July 1, 2004 and June 30, 2005, between July
 1, 2005 and June 30, 2006, between July  1,  2006  and  June  30,  2007,
 between  July  1,  2007 and June 30, 2008, between July 1, 2008 and June
 30,  2009,  between July 1, 2009 and June 30, 2010, between July 1, 2010
 and June 30, 2011, between July 1, 2011 and June 30, 2012, between  July
 1,  2012  and  June  30,  2013,  between July 1, 2013 and June 30, 2014,
 between July 1, 2014 and June 30, 2015, between July 1,  2015  and  June
 30,  2016,  between July 1, 2016 and June 30, 2017, between July 1, 2017
 and June 30, 2018, between July 1, 2018 and June 30, 2019, between  July
 1,  2019  and  June  30,  2020,  between July 1, 2020 and June 30, 2021,
 between July 1, 2021 and June 30, 2022, between July 1,  2022  and  June
 30, 2023, [and] between July 1, 2023 and June 30, 2024, AND BETWEEN JULY
 1,  2024 AND JUNE 30, 2025 allocable to each general hospital for physi-
 cians or dentists certified as eligible for purchase  of  a  policy  for
 excess  insurance coverage or equivalent excess coverage by such general
 hospital in accordance with subdivision 2 of this section, and may amend
 such determination and certification as necessary. The superintendent of
 financial services shall determine and certify to each general  hospital
 and to the commissioner of health the ratable share of such cost alloca-
 ble to the period July 1, 1987 to December 31, 1987, to the period Janu-
 ary 1, 1988 to June 30, 1988, to the period July 1, 1988 to December 31,
 1988, to the period January 1, 1989 to June 30, 1989, to the period July
 1,  1989 to December 31, 1989, to the period January 1, 1990 to June 30,
 1990, to the period July 1, 1990 to December 31,  1990,  to  the  period
 January 1, 1991 to June 30, 1991, to the period July 1, 1991 to December
 31,  1991, to the period January 1, 1992 to June 30, 1992, to the period
 July 1, 1992 to December 31, 1992, to the period January 1, 1993 to June
 30, 1993, to the period July 1, 1993 to December 31, 1993, to the period
 January 1, 1994 to June 30, 1994, to the period July 1, 1994 to December
 31, 1994, to the period January 1, 1995 to June 30, 1995, to the  period
 July 1, 1995 to December 31, 1995, to the period January 1, 1996 to June
 30, 1996, to the period July 1, 1996 to December 31, 1996, to the period
 January 1, 1997 to June 30, 1997, to the period July 1, 1997 to December
 31,  1997, to the period January 1, 1998 to June 30, 1998, to the period
 July 1, 1998 to December 31, 1998, to the period January 1, 1999 to June
 30, 1999, to the period July 1, 1999 to December 31, 1999, to the period
 January 1, 2000 to June 30, 2000, to the period July 1, 2000 to December
 31, 2000, to the period January 1, 2001 to June 30, 2001, to the  period
 July  1,  2001  to June 30, 2002, to the period July 1, 2002 to June 30,
 2003, to the period July 1, 2003 to June 30, 2004, to the period July 1,
 2004 to June 30, 2005, to the period July 1, 2005 and June 30, 2006,  to
 the  period  July  1, 2006 and June 30, 2007, to the period July 1, 2007
 and June 30, 2008, to the period July 1, 2008 and June 30, 2009, to  the
 period  July  1,  2009 and June 30, 2010, to the period July 1, 2010 and
 June 30, 2011, to the period July 1, 2011 and  June  30,  2012,  to  the
 period  July  1,  2012 and June 30, 2013, to the period July 1, 2013 and
 June 30, 2014, to the period July 1, 2014 and  June  30,  2015,  to  the
 period  July  1,  2015 and June 30, 2016, to the period July 1, 2016 and
 June 30, 2017, to the period July 1, 2017 to June 30, 2018, to the peri-
 od July 1, 2018 to June 30, 2019, to the period July 1, 2019 to June 30,
 2020, to the period July 1, 2020 to June 30, 2021, to the period July 1,
 2021 to June 30, 2022, to the period July 1,  2022  to  June  30,  2023,
 [and]  to  the  period  July 1, 2023 to June 30, 2024, AND TO THE PERIOD
 JULY 1, 2024 TO JUNE 30, 2025.
   § 3. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
 18 of chapter 266 of the laws of 1986, amending the civil  practice  law
 S. 8307                            52                            A. 8807
 
 and  rules  and  other  laws  relating  to  malpractice and professional
 medical conduct, as amended by section 3 of part F of chapter 57 of  the
 laws of 2023, are amended to read as follows:
   (a)  To  the  extent  funds available to the hospital excess liability
 pool pursuant to subdivision 5 of this section as amended, and  pursuant
 to  section  6  of part J of chapter 63 of the laws of 2001, as may from
 time to time be amended, which amended this  subdivision,  are  insuffi-
 cient  to  meet  the  costs  of  excess insurance coverage or equivalent
 excess coverage for coverage periods during the period July 1,  1992  to
 June  30,  1993, during the period July 1, 1993 to June 30, 1994, during
 the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
 to June 30, 1996, during the period July  1,  1996  to  June  30,  1997,
 during  the period July 1, 1997 to June 30, 1998, during the period July
 1, 1998 to June 30, 1999, during the period July 1,  1999  to  June  30,
 2000, during the period July 1, 2000 to June 30, 2001, during the period
 July  1,  2001  to  October 29, 2001, during the period April 1, 2002 to
 June 30, 2002, during the period July 1, 2002 to June 30,  2003,  during
 the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
 to  June  30,  2005,  during  the  period July 1, 2005 to June 30, 2006,
 during the period July 1, 2006 to June 30, 2007, during the period  July
 1,  2007  to  June  30, 2008, during the period July 1, 2008 to June 30,
 2009, during the period July 1, 2009 to June 30, 2010, during the period
 July 1, 2010 to June 30, 2011, during the period July 1,  2011  to  June
 30,  2012,  during  the period July 1, 2012 to June 30, 2013, during the
 period July 1, 2013 to June 30, 2014, during the period July 1, 2014  to
 June  30,  2015, during the period July 1, 2015 to June 30, 2016, during
 the period July 1, 2016 to June 30, 2017, during the period July 1, 2017
 to June 30, 2018, during the period July  1,  2018  to  June  30,  2019,
 during  the period July 1, 2019 to June 30, 2020, during the period July
 1, 2020 to June 30, 2021, during the period July 1,  2021  to  June  30,
 2022,  during the period July 1, 2022 to June 30, 2023, [and] during the
 period July 1, 2023 to June 30, 2024, AND DURING THE PERIOD JULY 1, 2024
 TO JUNE 30, 2025 allocated or reallocated in accordance  with  paragraph
 (a) of subdivision 4-a of this section to rates of payment applicable to
 state governmental agencies, each physician or dentist for whom a policy
 for excess insurance coverage or equivalent excess coverage is purchased
 for  such  period  shall  be  responsible for payment to the provider of
 excess insurance coverage or equivalent excess coverage of an  allocable
 share  of  such  insufficiency,  based on the ratio of the total cost of
 such coverage for such physician to the sum of the total  cost  of  such
 coverage for all physicians applied to such insufficiency.
   (b)  Each  provider  of excess insurance coverage or equivalent excess
 coverage covering the period July 1, 1992 to June 30, 1993, or  covering
 the period July 1, 1993 to June 30, 1994, or covering the period July 1,
 1994  to  June 30, 1995, or covering the period July 1, 1995 to June 30,
 1996, or covering the period July 1, 1996 to June 30, 1997, or  covering
 the period July 1, 1997 to June 30, 1998, or covering the period July 1,
 1998  to  June 30, 1999, or covering the period July 1, 1999 to June 30,
 2000, or covering the period July 1, 2000 to June 30, 2001, or  covering
 the  period  July  1,  2001  to October 29, 2001, or covering the period
 April 1, 2002 to June 30, 2002, or covering the period July 1,  2002  to
 June  30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
 covering the period July 1, 2004 to June 30, 2005, or covering the peri-
 od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
 June 30, 2007, or covering the period July 1, 2007 to June 30, 2008,  or
 covering the period July 1, 2008 to June 30, 2009, or covering the peri-
 S. 8307                            53                            A. 8807
 
 od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
 June  30, 2011, or covering the period July 1, 2011 to June 30, 2012, or
 covering the period July 1, 2012 to June 30, 2013, or covering the peri-
 od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to
 June  30, 2015, or covering the period July 1, 2015 to June 30, 2016, or
 covering the period July 1, 2016 to June 30, 2017, or covering the peri-
 od July 1, 2017 to June 30, 2018, or covering the period July 1, 2018 to
 June 30, 2019, or covering the period July 1, 2019 to June 30, 2020,  or
 covering the period July 1, 2020 to June 30, 2021, or covering the peri-
 od July 1, 2021 to June 30, 2022, or covering the period July 1, 2022 to
 June  30, 2023, or covering the period July 1, 2023 to June 30, 2024, OR
 COVERING THE PERIOD JULY 1, 2024 TO JUNE 30, 2025 shall notify a covered
 physician or dentist by mail, mailed to the address shown  on  the  last
 application for excess insurance coverage or equivalent excess coverage,
 of  the  amount  due to such provider from such physician or dentist for
 such coverage period determined in accordance with paragraph (a) of this
 subdivision. Such amount shall be due from such physician or dentist  to
 such provider of excess insurance coverage or equivalent excess coverage
 in  a  time  and  manner  determined  by the superintendent of financial
 services.
   (c) If a physician or dentist liable for payment of a portion  of  the
 costs  of excess insurance coverage or equivalent excess coverage cover-
 ing the period July 1, 1992 to June 30, 1993,  or  covering  the  period
 July  1,  1993  to June 30, 1994, or covering the period July 1, 1994 to
 June 30, 1995, or covering the period July 1, 1995 to June 30, 1996,  or
 covering the period July 1, 1996 to June 30, 1997, or covering the peri-
 od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
 June  30, 1999, or covering the period July 1, 1999 to June 30, 2000, or
 covering the period July 1, 2000 to June 30, 2001, or covering the peri-
 od July 1, 2001 to October 29, 2001, or covering  the  period  April  1,
 2002  to  June 30, 2002, or covering the period July 1, 2002 to June 30,
 2003, or covering the period July 1, 2003 to June 30, 2004, or  covering
 the period July 1, 2004 to June 30, 2005, or covering the period July 1,
 2005  to  June 30, 2006, or covering the period July 1, 2006 to June 30,
 2007, or covering the period July 1, 2007 to June 30, 2008, or  covering
 the period July 1, 2008 to June 30, 2009, or covering the period July 1,
 2009  to  June 30, 2010, or covering the period July 1, 2010 to June 30,
 2011, or covering the period July 1, 2011 to June 30, 2012, or  covering
 the period July 1, 2012 to June 30, 2013, or covering the period July 1,
 2013  to  June 30, 2014, or covering the period July 1, 2014 to June 30,
 2015, or covering the period July 1, 2015 to June 30, 2016, or  covering
 the period July 1, 2016 to June 30, 2017, or covering the period July 1,
 2017  to  June 30, 2018, or covering the period July 1, 2018 to June 30,
 2019, or covering the period July 1, 2019 to June 30, 2020, or  covering
 the period July 1, 2020 to June 30, 2021, or covering the period July 1,
 2021  to  June 30, 2022, or covering the period July 1, 2022 to June 30,
 2023, or covering the period July 1, 2023 to June 30, 2024, OR  COVERING
 THE  PERIOD  JULY 1, 2024 TO JUNE 30, 2025 determined in accordance with
 paragraph (a) of this subdivision fails, refuses  or  neglects  to  make
 payment  to  the  provider  of  excess  insurance coverage or equivalent
 excess coverage in such time and manner as determined by the superinten-
 dent of financial services pursuant to paragraph (b)  of  this  subdivi-
 sion,  excess insurance coverage or equivalent excess coverage purchased
 for such physician or dentist in accordance with this section  for  such
 coverage  period shall be cancelled and shall be null and void as of the
 S. 8307                            54                            A. 8807
 
 first day on or after the commencement of  a  policy  period  where  the
 liability for payment pursuant to this subdivision has not been met.
   (d)  Each  provider  of excess insurance coverage or equivalent excess
 coverage shall notify the superintendent of financial services  and  the
 commissioner  of  health or their designee of each physician and dentist
 eligible for purchase of a  policy  for  excess  insurance  coverage  or
 equivalent  excess coverage covering the period July 1, 1992 to June 30,
 1993, or covering the period July 1, 1993 to June 30, 1994, or  covering
 the period July 1, 1994 to June 30, 1995, or covering the period July 1,
 1995  to  June 30, 1996, or covering the period July 1, 1996 to June 30,
 1997, or covering the period July 1, 1997 to June 30, 1998, or  covering
 the period July 1, 1998 to June 30, 1999, or covering the period July 1,
 1999  to  June 30, 2000, or covering the period July 1, 2000 to June 30,
 2001, or covering the period July 1, 2001 to October 29, 2001, or cover-
 ing the period April 1, 2002 to June 30, 2002, or  covering  the  period
 July  1,  2002  to June 30, 2003, or covering the period July 1, 2003 to
 June 30, 2004, or covering the period July 1, 2004 to June 30, 2005,  or
 covering the period July 1, 2005 to June 30, 2006, or covering the peri-
 od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to
 June  30, 2008, or covering the period July 1, 2008 to June 30, 2009, or
 covering the period July 1, 2009 to June 30, 2010, or covering the peri-
 od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to
 June 30, 2012, or covering the period July 1, 2012 to June 30, 2013,  or
 covering the period July 1, 2013 to June 30, 2014, or covering the peri-
 od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to
 June  30, 2016, or covering the period July 1, 2016 to June 30, 2017, or
 covering the period July 1, 2017 to June 30, 2018, or covering the peri-
 od July 1, 2018 to June 30, 2019, or covering the period July 1, 2019 to
 June 30, 2020, or covering the period July 1, 2020 to June 30, 2021,  or
 covering the period July 1, 2021 to June 30, 2022, or covering the peri-
 od July 1, 2022 to June 30, 2023, or covering the period July 1, 2023 to
 June 30, 2024, OR COVERING THE PERIOD JULY 1, 2024 TO JUNE 30, 2025 that
 has made payment to such provider of excess insurance coverage or equiv-
 alent  excess coverage in accordance with paragraph (b) of this subdivi-
 sion and of each physician  and  dentist  who  has  failed,  refused  or
 neglected to make such payment.
   (e)  A  provider  of  excess  insurance  coverage or equivalent excess
 coverage shall refund to the hospital excess liability pool  any  amount
 allocable to the period July 1, 1992 to June 30, 1993, and to the period
 July  1,  1993  to June 30, 1994, and to the period July 1, 1994 to June
 30, 1995, and to the period July 1, 1995 to June 30, 1996,  and  to  the
 period  July 1, 1996 to June 30, 1997, and to the period July 1, 1997 to
 June 30, 1998, and to the period July 1, 1998 to June 30, 1999,  and  to
 the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
 to  June  30,  2001, and to the period July 1, 2001 to October 29, 2001,
 and to the period April 1, 2002 to June 30, 2002, and to the period July
 1, 2002 to June 30, 2003, and to the period July 1,  2003  to  June  30,
 2004, and to the period July 1, 2004 to June 30, 2005, and to the period
 July  1,  2005  to June 30, 2006, and to the period July 1, 2006 to June
 30, 2007, and to the period July 1, 2007 to June 30, 2008,  and  to  the
 period  July 1, 2008 to June 30, 2009, and to the period July 1, 2009 to
 June 30, 2010, and to the period July 1, 2010 to June 30, 2011,  and  to
 the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
 to  June  30, 2013, and to the period July 1, 2013 to June 30, 2014, and
 to the period July 1, 2014 to June 30, 2015, and to the period  July  1,
 2015  to June 30, 2016, to the period July 1, 2016 to June 30, 2017, and
 S. 8307                            55                            A. 8807
 
 to the period July 1, 2017 to June 30, 2018, and to the period  July  1,
 2018  to June 30, 2019, and to the period July 1, 2019 to June 30, 2020,
 and to the period July 1, 2020 to June 30, 2021, and to the period  July
 1,  2021  to  June  30, 2022, and to the period July 1, 2022 to June 30,
 2023, and to the period July 1, 2023 to June 30, 2024, AND TO THE PERIOD
 JULY 1, 2024 TO JUNE 30, 2025 received from the hospital excess  liabil-
 ity  pool for purchase of excess insurance coverage or equivalent excess
 coverage covering the period July 1, 1992 to June 30, 1993, and covering
 the period July 1, 1993 to June 30, 1994, and covering the  period  July
 1,  1994  to June 30, 1995, and covering the period July 1, 1995 to June
 30, 1996, and covering the period July 1, 1996 to  June  30,  1997,  and
 covering  the  period  July  1,  1997 to June 30, 1998, and covering the
 period July 1, 1998 to June 30, 1999, and covering the  period  July  1,
 1999  to June 30, 2000, and covering the period July 1, 2000 to June 30,
 2001, and covering the period July 1, 2001  to  October  29,  2001,  and
 covering  the  period  April  1, 2002 to June 30, 2002, and covering the
 period July 1, 2002 to June 30, 2003, and covering the  period  July  1,
 2003  to June 30, 2004, and covering the period July 1, 2004 to June 30,
 2005, and covering the period July 1, 2005 to June 30, 2006, and  cover-
 ing  the  period  July 1, 2006 to June 30, 2007, and covering the period
 July 1, 2007 to June 30, 2008, and covering the period July 1,  2008  to
 June  30,  2009,  and covering the period July 1, 2009 to June 30, 2010,
 and covering the period July 1, 2010 to June 30, 2011, and covering  the
 period  July  1,  2011 to June 30, 2012, and covering the period July 1,
 2012 to June 30, 2013, and covering the period July 1, 2013 to June  30,
 2014,  and covering the period July 1, 2014 to June 30, 2015, and cover-
 ing the period July 1, 2015 to June 30, 2016, and  covering  the  period
 July  1,  2016 to June 30, 2017, and covering the period July 1, 2017 to
 June 30, 2018, and covering the period July 1, 2018 to  June  30,  2019,
 and  covering the period July 1, 2019 to June 30, 2020, and covering the
 period July 1, 2020 to June 30, 2021, and covering the  period  July  1,
 2021  to June 30, 2022, and covering the period July 1, 2022 to June 30,
 2023 for, and covering the period July 1, 2023 to  June  30,  2024,  AND
 COVERING THE PERIOD JULY 1, 2024 TO JUNE 30, 2025 a physician or dentist
 where  such  excess  insurance coverage or equivalent excess coverage is
 cancelled in accordance with paragraph (c) of this subdivision.
   § 4. Section 40 of chapter 266 of the laws of 1986, amending the civil
 practice law and rules  and  other  laws  relating  to  malpractice  and
 professional medical conduct, as amended by section 4 of part F of chap-
 ter 57 of the laws of 2023, is amended to read as follows:
   §  40.  The superintendent of financial services shall establish rates
 for policies providing coverage  for  physicians  and  surgeons  medical
 malpractice  for the periods commencing July 1, 1985 and ending June 30,
 [2024] 2025; provided, however, that notwithstanding any other provision
 of law, the superintendent shall not establish or approve  any  increase
 in  rates  for  the  period  commencing July 1, 2009 and ending June 30,
 2010. The superintendent shall direct insurers to  establish  segregated
 accounts  for premiums, payments, reserves and investment income attrib-
 utable to such premium periods and shall require periodic reports by the
 insurers regarding claims and expenses attributable to such  periods  to
 monitor whether such accounts will be sufficient to meet incurred claims
 and  expenses. On or after July 1, 1989, the superintendent shall impose
 a surcharge on premiums  to  satisfy  a  projected  deficiency  that  is
 attributable  to the premium levels established pursuant to this section
 for such periods; provided, however, that such  annual  surcharge  shall
 not  exceed  eight  percent of the established rate until July 1, [2024]
 S. 8307                            56                            A. 8807

 2025, at which time and thereafter such surcharge shall not exceed twen-
 ty-five percent of the approved adequate  rate,  and  that  such  annual
 surcharges shall continue for such period of time as shall be sufficient
 to  satisfy  such  deficiency.  The superintendent shall not impose such
 surcharge during the period commencing July 1, 2009 and ending June  30,
 2010.  On  and  after  July  1,  1989,  the surcharge prescribed by this
 section shall be retained by insurers to the extent  that  they  insured
 physicians  and surgeons during the July 1, 1985 through June 30, [2024]
 2025 policy periods; in the event  and  to  the  extent  physicians  and
 surgeons  were  insured by another insurer during such periods, all or a
 pro rata share of the surcharge, as the case may be, shall  be  remitted
 to  such  other  insurer  in accordance with rules and regulations to be
 promulgated by the superintendent.  Surcharges collected from physicians
 and surgeons who were not insured during such policy  periods  shall  be
 apportioned  among  all insurers in proportion to the premium written by
 each insurer during such policy periods; if a physician or  surgeon  was
 insured by an insurer subject to rates established by the superintendent
 during  such  policy  periods,  and  at  any time thereafter a hospital,
 health maintenance organization, employer or institution is  responsible
 for  responding in damages for liability arising out of such physician's
 or surgeon's practice of medicine, such responsible  entity  shall  also
 remit  to  such  prior  insurer the equivalent amount that would then be
 collected as a surcharge if the physician or surgeon  had  continued  to
 remain  insured  by  such  prior  insurer. In the event any insurer that
 provided coverage during such policy  periods  is  in  liquidation,  the
 property/casualty  insurance  security fund shall receive the portion of
 surcharges to which the insurer in liquidation would have been entitled.
 The surcharges authorized herein shall be deemed to be income earned for
 the purposes of section 2303 of the insurance law.  The  superintendent,
 in  establishing  adequate  rates and in determining any projected defi-
 ciency pursuant to the requirements of this section  and  the  insurance
 law,  shall  give  substantial  weight, determined in his discretion and
 judgment, to the  prospective  anticipated  effect  of  any  regulations
 promulgated  and  laws  enacted  and the public benefit of   stabilizing
 malpractice rates and minimizing rate level fluctuation during the peri-
 od of time necessary for the development of  more  reliable  statistical
 experience  as  to  the  efficacy of such laws and regulations affecting
 medical, dental or podiatric malpractice enacted or promulgated in 1985,
 1986, by this act and at any other time.  Notwithstanding any  provision
 of the insurance law, rates already established and to be established by
 the  superintendent pursuant to this section are deemed adequate if such
 rates would be adequate when taken together with the maximum  authorized
 annual  surcharges to be imposed for a reasonable period of time whether
 or not any such annual surcharge has been actually  imposed  as  of  the
 establishment of such rates.
   §  5. Section 5 and subdivisions (a) and (e) of section 6 of 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, as amended by section 5
 of part F of chapter 57 of the laws of 2023,  are  amended  to  read  as
 follows:
   §  5. The superintendent of financial services and the commissioner of
 health shall determine, no later than June 15, 2002, June 15, 2003, June
 15, 2004, June 15, 2005, June 15, 2006, June 15, 2007,  June  15,  2008,
 June  15,  2009,  June  15, 2010, June 15, 2011, June 15, 2012, June 15,
 2013, June 15, 2014, June 15, 2015, June 15, 2016, June 15,  2017,  June
 S. 8307                            57                            A. 8807
 
 15,  2018,  June  15, 2019, June 15, 2020, June 15, 2021, June 15, 2022,
 June 15, 2023, [and] June 15, 2024, AND JUNE  15,  2025  the  amount  of
 funds  available in the hospital excess liability pool, created pursuant
 to section 18 of chapter 266 of the laws of 1986, and whether such funds
 are  sufficient for purposes of purchasing excess insurance coverage for
 eligible participating physicians and dentists during the period July 1,
 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003
 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1,  2005  to
 June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007 to June
 30,  2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to June 30,
 2010, or July 1, 2010 to June 30, 2011, or July  1,  2011  to  June  30,
 2012,  or  July  1,  2012  to June 30, 2013, or July 1, 2013 to June 30,
 2014, or July 1, 2014 to June 30, 2015, or July  1,  2015  to  June  30,
 2016,  or  July  1,  2016  to June 30, 2017, or July 1, 2017 to June 30,
 2018, or July 1, 2018 to June 30, 2019, or July  1,  2019  to  June  30,
 2020,  or  July  1,  2020  to June 30, 2021, or July 1, 2021 to June 30,
 2022, or July 1, 2022 to June 30, 2023, or July  1,  2023  to  June  30,
 2024, OR JULY 1, 2024 TO JUNE 30, 2025 as applicable.
   (a)  This section shall be effective only upon a determination, pursu-
 ant to section five of this act,  by  the  superintendent  of  financial
 services  and  the  commissioner  of health, and a certification of such
 determination to the state director of the  budget,  the  chair  of  the
 senate  committee  on finance and the chair of the assembly committee on
 ways and means, that the amount of funds in the hospital excess  liabil-
 ity  pool,  created pursuant to section 18 of chapter 266 of the laws of
 1986, is insufficient for purposes of purchasing excess insurance cover-
 age for eligible participating physicians and dentists during the period
 July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July
 1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or  July  1,
 2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007
 to  June  30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to
 June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June
 30, 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June  30,
 2014,  or  July  1,  2014  to June 30, 2015, or July 1, 2015 to June 30,
 2016, or July 1, 2016 to June 30, 2017, or July  1,  2017  to  June  30,
 2018,  or  July  1,  2018  to June 30, 2019, or July 1, 2019 to June 30,
 2020, or July 1, 2020 to June 30, 2021, or July  1,  2021  to  June  30,
 2022, or July 1, 2022 to June 30, 2023, or July 1, 2023 to June 30, 2024
 , OR JULY 1, 2024 TO JUNE 30, 2025 as applicable.
   (e)  The  commissioner  of  health  shall  transfer for deposit to the
 hospital excess liability pool created pursuant to section 18 of chapter
 266 of the laws of 1986 such amounts as directed by  the  superintendent
 of  financial  services  for  the purchase of excess liability insurance
 coverage for eligible participating  physicians  and  dentists  for  the
 policy  year  July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30,
 2003, or July 1, 2003 to June 30, 2004, or July  1,  2004  to  June  30,
 2005,  or  July  1,  2005  to June 30, 2006, or July 1, 2006 to June 30,
 2007, as applicable, and the cost of administering the  hospital  excess
 liability pool for such applicable policy year,  pursuant to the program
 established  in  chapter  266  of the laws of 1986, as amended, no later
 than June 15, 2002, June 15, 2003, June 15, 2004, June  15,  2005,  June
 15,  2006,  June  15, 2007, June 15, 2008, June 15, 2009, June 15, 2010,
 June 15, 2011, June 15, 2012, June 15, 2013, June  15,  2014,  June  15,
 2015,  June  15, 2016, June 15, 2017, June 15, 2018, June 15, 2019, June
 15, 2020, June 15, 2021, June 15, 2022, June 15, 2023,  [and]  June  15,
 2024, AND JUNE 15, 2025 as applicable.
 S. 8307                            58                            A. 8807
 
   §  6. Section 20 of 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 thereto, as amended by section 6 of part F
 of chapter 57 of the laws of 2023, is amended to read as follows:
   §  20.  Notwithstanding  any  law, rule or regulation to the contrary,
 only physicians or dentists who were eligible, and for whom  the  super-
 intendent of financial services and the commissioner of health, or their
 designee, purchased, with funds available in the hospital excess liabil-
 ity  pool,  a  full  or partial policy for excess coverage or equivalent
 excess coverage for the coverage period ending the  thirtieth  of  June,
 two  thousand [twenty-three] TWENTY-FOUR, shall be eligible to apply for
 such coverage for the coverage period beginning the first of  July,  two
 thousand  [twenty-three]  TWENTY-FOUR;  provided,  however, if the total
 number of physicians or dentists for whom such excess coverage or equiv-
 alent excess coverage was purchased for the policy year ending the thir-
 tieth of June, two thousand [twenty-three] TWENTY-FOUR exceeds the total
 number of physicians or dentists certified as eligible for the  coverage
 period  beginning the first of July, two thousand [twenty-three] TWENTY-
 FOUR, then the general hospitals may certify additional eligible  physi-
 cians  or  dentists in a number equal to such general hospital's propor-
 tional share of the total number of  physicians  or  dentists  for  whom
 excess  coverage  or equivalent excess coverage was purchased with funds
 available in the hospital excess liability pool as of the  thirtieth  of
 June, two thousand [twenty-three] TWENTY-FOUR, as applied to the differ-
 ence  between  the  number of eligible physicians or dentists for whom a
 policy for excess coverage or equivalent excess coverage  was  purchased
 for  the  coverage  period  ending  the  thirtieth of June, two thousand
 [twenty-three] TWENTY-FOUR and the number of such eligible physicians or
 dentists who have applied  for  excess  coverage  or  equivalent  excess
 coverage  for the coverage period beginning the first of July, two thou-
 sand [twenty-three] TWENTY-FOUR.
   § 7. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART L
 
   Section  1.  Subdivision 9 of section 2803 of the public health law is
 REPEALED.
   § 2. Section 461-s of the social services law is REPEALED.
   § 3. Subdivision 1, paragraph (f) of subdivision 3, paragraphs (a) and
 (d) of subdivision 5 and subdivisions 5-a and 12 of  section  2807-m  of
 the  public  health  law, subdivision 1, paragraph (f) of subdivision 3,
 paragraph (a) of subdivision 5 and subdivision 12 as amended  and  para-
 graph (d) of subdivision 5 as added by section 6 of part Y of chapter 56
 of  the laws of 2020 and subdivision 5-a as amended by section 6 of part
 C of chapter 57 of the laws of 2023, are amended to read as follows:
   1.  Definitions. For purposes of this  section,  the  following  defi-
 nitions shall apply, unless the context clearly requires otherwise:
   (a) ["Clinical research" means patient-oriented research, epidemiolog-
 ic  and  behavioral  studies,  or  outcomes research and health services
 research that is approved by an institutional review board by  the  time
 the clinical research position is filled.
   (b) "Clinical research plan" means a plan submitted by a consortium or
 teaching  general hospital for a clinical research position which demon-
 strates, in a form to be provided by the commissioner, the following:
 S. 8307                            59                            A. 8807

   (i) financial support for overhead, supervision, equipment  and  other
 resources  equal  to the amount of funding provided pursuant to subpara-
 graph (i) of paragraph (b) of subdivision five-a of this section by  the
 teaching  general hospital or consortium for the clinical research posi-
 tion;
   (ii)  experience  the sponsor-mentor and teaching general hospital has
 in clinical research and the medical field of the study;
   (iii) methods, data collection and anticipated measurable outcomes  of
 the clinical research to be performed;
   (iv)  training goals, objectives and experience the researcher will be
 provided to assess a future career in clinical research;
   (v)  scientific  relevance,  merit  and  health  implications  of  the
 research to be performed;
   (vi)  information  on  potential  scientific  meetings and peer review
 journals where research results can be disseminated;
   (vii) clear and comprehensive details on the clinical  research  posi-
 tion;
   (viii) qualifications necessary for the clinical research position and
 strategy for recruitment;
   (ix)  non-duplication  with other clinical research positions from the
 same teaching general hospital or consortium;
   (x) methods to track the career of the clinical  researcher  once  the
 term of the position is complete; and
   (xi)  any  other information required by the commissioner to implement
 subparagraph (i) of paragraph (b) of subdivision five-a of this section.
   (xii) The clinical review plan submitted in accordance with this para-
 graph may be reviewed by the commissioner in consultation  with  experts
 outside the department of health.
   (c) "Clinical research position" means a post-graduate residency posi-
 tion which:
   (i)  shall  not  be required in order for the researcher to complete a
 graduate medical education program;
   (ii) may be reimbursed by other sources but only for costs  in  excess
 of  the funding distributed in accordance with subparagraph (i) of para-
 graph (b) of subdivision five-a of this section;
   (iii) shall exceed the minimum standards  that  are  required  by  the
 residency  review  committee in the specialty the researcher has trained
 or is currently training;
   (iv) shall not be previously funded by the teaching  general  hospital
 or  supported by another funding source at the teaching general hospital
 in the past three years from the date  the  clinical  research  plan  is
 submitted to the commissioner;
   (v) may supplement an existing research project;
   (vi) shall be equivalent to a full-time position comprising of no less
 than thirty-five hours per week for one or two years;
   (vii)  shall  provide, or be filled by a researcher who has formalized
 instruction in  clinical  research,  including  biostatistics,  clinical
 trial design, grant writing and research ethics;
   (viii) shall be supervised by a sponsor-mentor who shall either (A) be
 employed, contracted for employment or paid through an affiliated facul-
 ty  practice  plan  by a teaching general hospital which has received at
 least one research grant from the National Institutes of Health  in  the
 past five years from the date the clinical research plan is submitted to
 the  commissioner;  (B)  maintain  a  faculty  appointment at a medical,
 dental or podiatric school located in New York state that  has  received
 at  least  one  research grant from the National Institutes of Health in
 S. 8307                            60                            A. 8807

 the past five years from the date the clinical research plan is  submit-
 ted  to  the  commissioner;  or  (C)  be  collaborating  in the clinical
 research plan with  a  researcher  from  another  institution  that  has
 received  at  least  one  research grant from the National Institutes of
 Health in the past five years from the date the clinical  research  plan
 is submitted to the commissioner; and
   (ix)  shall  be  filled  by  a  researcher  who is (A) enrolled or has
 completed a graduate medical education program, as defined in  paragraph
 (i)  of  this  subdivision;  (B)  a  United States citizen, national, or
 permanent resident of the  United  States;  and  (C)  a  graduate  of  a
 medical,  dental or podiatric school located in New York state, a gradu-
 ate or resident in a graduate medical education program, as  defined  in
 paragraph  (i) of this subdivision, where the sponsoring institution, as
 defined in paragraph (q) of this subdivision, is  located  in  New  York
 state,  or  resides  in New York state at the time the clinical research
 plan is submitted to the commissioner.
   (d)] "Consortium" means an organization or  association,  approved  by
 the  commissioner in consultation with the council, of general hospitals
 which provide graduate medical education, together with  any  affiliated
 site;  provided  that  such organization or association may also include
 other providers of health care  services,  medical  schools,  payors  or
 consumers,  and which meet other criteria pursuant to subdivision six of
 this section.
   [(e)] (B) "Council" means the  New  York  state  council  on  graduate
 medical education.
   [(f)]  (C)  "Direct medical education" means the direct costs of resi-
 dents, interns and supervising physicians.
   [(g)] (D) "Distribution period" means each calendar year set forth  in
 subdivision two of this section.
   [(h)]  (E)  "Faculty"  means  persons  who  are  employed  by or under
 contract for employment with a teaching general  hospital  or  are  paid
 through  a  teaching general hospital's affiliated faculty practice plan
 and maintain a faculty appointment at a  medical  school.  Such  persons
 shall not be limited to persons with a degree in medicine.
   [(i)]  (F)  "Graduate medical education program" means a post-graduate
 medical education residency in the  United  States  which  has  received
 accreditation  from  a  nationally  recognized accreditation body or has
 been approved by  a  nationally  recognized  organization  for  medical,
 osteopathic,  podiatric  or dental residency programs including, but not
 limited to, specialty boards.
   [(j)] (G) "Indirect medical education" means the  estimate  of  costs,
 other than direct costs, of educational activities in teaching hospitals
 as determined in accordance with the methodology applicable for purposes
 of  determining  an  estimate  of  indirect  medical education costs for
 reimbursement for inpatient hospital service pursuant to title XVIII  of
 the federal social security act (medicare).
   [(k)]  (H) "Medicare" means the methodology used for purposes of reim-
 bursing inpatient hospital services provided to beneficiaries  of  title
 XVIII of the federal social security act.
   [(l)]  (I)  "Primary  care" residents specialties shall include family
 medicine, general pediatrics, primary care internal medicine, and prima-
 ry care obstetrics and gynecology. In determining whether a residency is
 in primary care, the commissioner shall consult with the council.
   [(m)] (J) "Regions", for purposes of  this  section,  shall  mean  the
 regions  as  defined  in paragraph (b) of subdivision sixteen of section
 twenty-eight hundred seven-c of this article as in effect on June  thir-
 S. 8307                            61                            A. 8807
 
 tieth, nineteen hundred ninety-six. For purposes of distributions pursu-
 ant  to subdivision five-a of this section, except distributions made in
 accordance with paragraph (a) of subdivision  five-a  of  this  section,
 "regions" shall be defined as New York city and the rest of the state.
   [(n)]  (K)  "Regional pool" means a professional education pool estab-
 lished on a regional basis by  the  commissioner  from  funds  available
 pursuant  to  sections  twenty-eight  hundred  seven-s  and twenty-eight
 hundred seven-t of this article.
   [(o)] (L) "Resident" means a person in a  graduate  medical  education
 program  which  has  received accreditation from a nationally recognized
 accreditation body or in a program  approved  by  any  other  nationally
 recognized  organization  for  medical,  osteopathic or dental residency
 programs including, but not limited to, specialty boards.
   [(p) "Shortage specialty" means a specialty determined by the  commis-
 sioner,  in  consultation with the council, to be in short supply in the
 state of New York.
   (q)] (M) "Sponsoring institution" means the entity that has the  over-
 all  responsibility  for  a  program of graduate medical education. Such
 institutions shall include teaching general hospitals, medical  schools,
 consortia and diagnostic and treatment centers.
   [(r)]  (N)  "Weighted  resident count" means a teaching general hospi-
 tal's total number of residents as of July first, nineteen hundred nine-
 ty-five,  including  residents  in  affiliated  non-hospital  ambulatory
 settings,  reported  to  the  commissioner.  Such  resident counts shall
 reflect the weights established in accordance with rules and regulations
 adopted by the state hospital review and planning council  and  approved
 by the commissioner for purposes of implementing subdivision twenty-five
 of section twenty-eight hundred seven-c of this article and in effect on
 July  first,  nineteen  hundred  ninety-five.  Such weights shall not be
 applied to specialty hospitals, specified  by  the  commissioner,  whose
 primary  care  mission  is  to engage in research, training and clinical
 care in specialty  eye  and  ear,  special  surgery,  orthopedic,  joint
 disease, cancer, chronic care or rehabilitative services.
   [(s)]  (O)  "Adjustment  amount"  means  an amount determined for each
 teaching hospital for periods prior to January first, two thousand  nine
 by:
   (i)  determining the difference between (A) a calculation of what each
 teaching general hospital would have been paid if payments made pursuant
 to paragraph (a-3) of subdivision one of  section  twenty-eight  hundred
 seven-c  of this article between January first, nineteen hundred ninety-
 six and December thirty-first, two thousand three were based  solely  on
 the  case  mix  of  persons  eligible  for  medical assistance under the
 medical assistance program pursuant to title eleven of article  five  of
 the social services law who are enrolled in health maintenance organiza-
 tions and persons paid for under the family health plus program enrolled
 in  approved organizations pursuant to title eleven-D of article five of
 the social services law during those years, and (B) the actual  payments
 to  each such hospital pursuant to paragraph (a-3) of subdivision one of
 section twenty-eight hundred seven-c of  this  article  between  January
 first,  nineteen hundred ninety-six and December thirty-first, two thou-
 sand three.
   (ii) reducing proportionally each of the amounts determined in subpar-
 agraph (i) of this paragraph so that the sum of all such amounts  totals
 no more than one hundred million dollars;
   (iii)  further reducing each of the amounts determined in subparagraph
 (ii) of this paragraph by the amount received  by  each  hospital  as  a
 S. 8307                            62                            A. 8807
 
 distribution  from funds designated in paragraph (a) of subdivision five
 of this section attributable to the period January first,  two  thousand
 three  through December thirty-first, two thousand three, except that if
 such  amount  was  provided  to  a  consortium  then  the  amount of the
 reduction for each hospital in the consortium  shall  be  determined  by
 applying  the  proportion  of  each  hospital's  amount determined under
 subparagraph (i) of this paragraph to the total of such amounts  of  all
 hospitals in such consortium to the consortium award;
   (iv)  further  reducing each of the amounts determined in subparagraph
 (iii) of this paragraph by the amounts specified in paragraph [(t)]  (P)
 of this subdivision; and
   (v)  dividing  each of the amounts determined in subparagraph (iii) of
 this paragraph by seven.
   [(t)] (P) "Extra reduction amount" shall mean an amount determined for
 a teaching hospital for which an adjustment amount is calculated  pursu-
 ant  to  paragraph  [(s)] (O) of this subdivision that is the hospital's
 proportionate share of the sum of the  amounts  specified  in  paragraph
 [(u)]  (Q) of this subdivision determined based upon a comparison of the
 hospital's remaining liability calculated pursuant  to  paragraph  [(s)]
 (O)  of  this  subdivision  to  the sum of all such hospital's remaining
 liabilities.
   [(u)] (Q) "Allotment amount"  shall  mean  an  amount  determined  for
 teaching hospitals as follows:
   (i)  for  a  hospital for which an adjustment amount pursuant to para-
 graph [(s)] (O) of this subdivision does not apply, the amount  received
 by  the  hospital  pursuant to paragraph (a) of subdivision five of this
 section attributable to the period January  first,  two  thousand  three
 through December thirty-first, two thousand three, or
   (ii)  for  a hospital for which an adjustment amount pursuant to para-
 graph [(s)] (O)  of  this  subdivision  applies  and  which  received  a
 distribution  pursuant  to  paragraph  (a)  of  subdivision five of this
 section attributable to the period January  first,  two  thousand  three
 through  December  thirty-first, two thousand three that is greater than
 the hospital's adjustment amount, the difference  between  the  distrib-
 ution amount and the adjustment amount.
   (f)  Effective January first, two thousand five through December thir-
 ty-first, two thousand  eight,  each  teaching  general  hospital  shall
 receive  a  distribution  from the applicable regional pool based on its
 distribution amount determined under paragraphs (c), (d) and (e) of this
 subdivision and reduced by its adjustment amount calculated pursuant  to
 paragraph [(s)] (O) of subdivision one of this section and, for distrib-
 utions  for the period January first, two thousand five through December
 thirty-first, two thousand five, further reduced by its extra  reduction
 amount  calculated pursuant to paragraph [(t)] (P) of subdivision one of
 this section.
   (a) Up to thirty-one million dollars annually for the periods  January
 first,  two  thousand through December thirty-first, two thousand three,
 and up to twenty-five million dollars plus the sum of the amounts speci-
 fied in paragraph [(n)] (K) of subdivision one of this section  for  the
 period  January  first, two thousand five through December thirty-first,
 two thousand five, and up to thirty-one million dollars annually for the
 period January first, two thousand six  through  December  thirty-first,
 two  thousand seven, shall be set aside and reserved by the commissioner
 from the regional pools established pursuant to subdivision two of  this
 section for supplemental distributions in each such region to be made by
 the  commissioner to consortia and teaching general hospitals in accord-
 S. 8307                            63                            A. 8807
 
 ance with a distribution methodology developed in consultation with  the
 council  and  specified  in rules and regulations adopted by the commis-
 sioner.
   (d)  Notwithstanding any other provision of law or regulation, for the
 period January first, two thousand five through  December  thirty-first,
 two  thousand  five,  the  commissioner shall distribute as supplemental
 payments the allotment specified in paragraph [(n)] (K)  of  subdivision
 one of this section.
   5-a.  Graduate  medical  education  innovations pool. (a) Supplemental
 distributions. (i) Thirty-one million dollars  for  the  period  January
 first,  two  thousand  eight through December thirty-first, two thousand
 eight, shall be set aside and reserved  by  the  commissioner  from  the
 regional  pools  established pursuant to subdivision two of this section
 and shall be available for distributions pursuant to subdivision five of
 this section and in accordance with section 86-1.89 of title 10  of  the
 codes,  rules  and  regulations of the state of New York as in effect on
 January first, two thousand eight[; provided, however, for  purposes  of
 funding  the  empire  clinical research investigation program (ECRIP) in
 accordance with paragraph eight of subdivision (e) and paragraph two  of
 subdivision  (f)  of section 86-1.89 of title 10 of the codes, rules and
 regulations of the state of New York, distributions shall be made  using
 two  regions  defined as New York city and the rest of the state and the
 dollar amount set forth in subparagraph (i) of paragraph two of subdivi-
 sion (f) of section 86-1.89 of title 10 of the codes,  rules  and  regu-
 lations  of the state of New York shall be increased from sixty thousand
 dollars to seventy-five thousand dollars].
   (ii) For periods on  and  after  January  first,  two  thousand  nine,
 supplemental  distributions pursuant to subdivision five of this section
 and in accordance with section 86-1.89 of title 10 of the  codes,  rules
 and regulations of the state of New York shall no longer be made and the
 provisions  of section 86-1.89 of title 10 of the codes, rules and regu-
 lations of the state of New York shall be null and void.
   (b) [Empire  clinical  research  investigator  program  (ECRIP).  Nine
 million  one  hundred  twenty  thousand  dollars annually for the period
 January first, two thousand  nine  through  December  thirty-first,  two
 thousand  ten,  and  two million two hundred eighty thousand dollars for
 the period January first, two thousand  eleven,  through  March  thirty-
 first,  two  thousand  eleven,  nine million one hundred twenty thousand
 dollars each state fiscal year for the period April first, two  thousand
 eleven  through  March  thirty-first, two thousand fourteen, up to eight
 million six hundred twelve thousand dollars each state fiscal  year  for
 the  period  April  first,  two  thousand fourteen through March thirty-
 first, two thousand seventeen, up to eight million  six  hundred  twelve
 thousand  dollars each state fiscal year for the period April first, two
 thousand seventeen through March thirty-first, two thousand  twenty,  up
 to  eight  million six hundred twelve thousand dollars each state fiscal
 year for the period April first, two thousand twenty through March thir-
 ty-first, two thousand twenty-three, and up to eight million six hundred
 twelve thousand dollars each state fiscal  year  for  the  period  April
 first,  two  thousand twenty-three through March thirty-first, two thou-
 sand twenty-six, shall be set aside and  reserved  by  the  commissioner
 from  the regional pools established pursuant to subdivision two of this
 section to be allocated regionally  with  two-thirds  of  the  available
 funding  going  to  New York city and one-third of the available funding
 going to the rest of the state and shall be available  for  distribution
 as follows:
 S. 8307                            64                            A. 8807

   Distributions  shall  first  be made to consortia and teaching general
 hospitals for the empire clinical research investigator program  (ECRIP)
 to  help  secure federal funding for biomedical research, train clinical
 researchers, recruit national leaders as faculty to act as mentors,  and
 train  residents  and  fellows  in  biomedical  research skills based on
 hospital-specific data submitted to the commissioner  by  consortia  and
 teaching general hospitals in accordance with clause (G) of this subpar-
 agraph.  Such distributions shall be made in accordance with the follow-
 ing methodology:
   (A) The greatest number of clinical research  positions  for  which  a
 consortium  or  teaching general hospital may be funded pursuant to this
 subparagraph shall be one percent  of  the  total  number  of  residents
 training  at  the consortium or teaching general hospital on July first,
 two thousand eight for the  period  January  first,  two  thousand  nine
 through December thirty-first, two thousand nine rounded up to the near-
 est one position.
   (B)  Distributions  made  to a consortium or teaching general hospital
 shall equal the product of the total number of clinical  research  posi-
 tions  submitted  by  a  consortium  or  teaching  general  hospital and
 accepted by the commissioner as meeting the criteria set forth in  para-
 graph  (b)  of subdivision one of this section, subject to the reduction
 calculation set forth in clause (C)  of  this  subparagraph,  times  one
 hundred ten thousand dollars.
   (C)  If  the  dollar  amount for the total number of clinical research
 positions in the region  calculated  pursuant  to  clause  (B)  of  this
 subparagraph  exceeds the total amount appropriated for purposes of this
 paragraph, including clinical research positions that continue from  and
 were funded in prior distribution periods, the commissioner shall elimi-
 nate  one-half  of  the  clinical  research  positions submitted by each
 consortium or teaching general hospital rounded down to the nearest  one
 position.  Such  reduction shall be repeated until the dollar amount for
 the total number of clinical research positions in the region  does  not
 exceed  the total amount appropriated for purposes of this paragraph. If
 the repeated reduction of the total number of  clinical  research  posi-
 tions  in  the region by one-half does not render a total funding amount
 that is equal to or less than the total amount reserved for that  region
 within  the  appropriation, the funding for each clinical research posi-
 tion in that region shall be  reduced  proportionally  in  one  thousand
 dollar  increments until the total dollar amount for the total number of
 clinical research positions in that region does  not  exceed  the  total
 amount  reserved for that region within the appropriation. Any reduction
 in funding will be effective for the duration of the award. No  clinical
 research  positions that continue from and were funded in prior distrib-
 ution periods shall be eliminated or reduced by such methodology.
   (D) Each consortium or teaching general  hospital  shall  receive  its
 annual distribution amount in accordance with the following:
   (I) Each consortium or teaching general hospital with a one-year ECRIP
 award  shall  receive  its  annual  distribution  amount  in  full  upon
 completion of the requirements set forth in items (I) and (II) of clause
 (G) of this subparagraph. The requirements set forth in items  (IV)  and
 (V)  of clause (G) of this subparagraph must be completed by the consor-
 tium or teaching general hospital in order for the consortium or  teach-
 ing  general  hospital  to be eligible to apply for ECRIP funding in any
 subsequent funding cycle.
   (II) Each consortium or teaching  general  hospital  with  a  two-year
 ECRIP  award  shall receive its first annual distribution amount in full
 S. 8307                            65                            A. 8807

 upon completion of the requirements set forth in items (I) and  (II)  of
 clause  (G)  of  this  subparagraph. Each consortium or teaching general
 hospital will receive its second annual distribution amount in full upon
 completion  of the requirements set forth in item (III) of clause (G) of
 this subparagraph. The requirements set forth in items (IV) and  (V)  of
 clause  (G)  of this subparagraph must be completed by the consortium or
 teaching general hospital in order for the consortium or teaching gener-
 al hospital to be eligible to apply for ECRIP funding in any  subsequent
 funding cycle.
   (E)  Each  consortium  or teaching general hospital receiving distrib-
 utions pursuant to this subparagraph shall reserve seventy-five thousand
 dollars to primarily fund salary and fringe  benefits  of  the  clinical
 research  position  with  the remainder going to fund the development of
 faculty who are involved in biomedical research, training  and  clinical
 care.
   (F)  Undistributed  or  returned  funds  available  to  fund  clinical
 research positions pursuant to this paragraph for a distribution  period
 shall  be  available to fund clinical research positions in a subsequent
 distribution period.
   (G) In order to be eligible for distributions pursuant to this subpar-
 agraph, each consortium and teaching general hospital shall  provide  to
 the  commissioner by July first of each distribution period, the follow-
 ing data and information on a hospital-specific  basis.  Such  data  and
 information  shall  be  certified as to accuracy and completeness by the
 chief executive officer, chief financial officer or chair of the consor-
 tium governing body of each consortium or teaching general hospital  and
 shall be maintained by each consortium and teaching general hospital for
 five years from the date of submission:
   (I)  For  each  clinical  research  position, information on the type,
 scope, training objectives,  institutional  support,  clinical  research
 experience of the sponsor-mentor, plans for submitting research outcomes
 to  peer reviewed journals and at scientific meetings, including a meet-
 ing sponsored by the department, the name of a principal contact  person
 responsible for tracking the career development of researchers placed in
 clinical  research positions, as defined in paragraph (c) of subdivision
 one of this section, and who is authorized to certify to the commission-
 er that all the requirements of the clinical  research  training  objec-
 tives  set  forth  in this subparagraph shall be met. Such certification
 shall be provided by July first of each distribution period;
   (II) For each clinical research position,  information  on  the  name,
 citizenship  status, medical education and training, and medical license
 number of the researcher, if applicable, shall be provided  by  December
 thirty-first of the calendar year following the distribution period;
   (III)  Information on the status of the clinical research plan, accom-
 plishments, changes in research activities, progress, and performance of
 the researcher shall be provided upon  completion  of  one-half  of  the
 award term;
   (IV)  A  final report detailing training experiences, accomplishments,
 activities and performance of the clinical researcher, and  data,  meth-
 ods,  results  and  analyses  of  the  clinical  research  plan shall be
 provided three months after the clinical research position ends; and
   (V) Tracking information concerning past  researchers,  including  but
 not  limited  to (A) background information, (B) employment history, (C)
 research status, (D) current research activities, (E)  publications  and
 presentations,  (F)  research  support,  and  (G)  any other information
 necessary to track the researcher; and
 S. 8307                            66                            A. 8807

   (VI) Any other data or information required  by  the  commissioner  to
 implement this subparagraph.
   (H)  Notwithstanding  any  inconsistent provision of this subdivision,
 for periods on and after April first, two thousand thirteen, ECRIP grant
 awards shall be made in accordance with rules and regulations promulgat-
 ed by the commissioner. Such regulations shall, at a minimum:
   (1) provide that ECRIP grant awards shall be made with  the  objective
 of  securing  federal funding for biomedical research, training clinical
 researchers, recruiting national leaders as faculty to act  as  mentors,
 and training residents and fellows in biomedical research skills;
   (2)  provide that ECRIP grant applicants may include interdisciplinary
 research teams comprised of teaching general hospitals acting in collab-
 oration with entities including but  not  limited  to  medical  centers,
 hospitals, universities and local health departments;
   (3) provide that applications for ECRIP grant awards shall be based on
 such  information requested by the commissioner, which shall include but
 not be limited to hospital-specific data;
   (4) establish the qualifications for  investigators  and  other  staff
 required for grant projects eligible for ECRIP grant awards; and
   (5)  establish a methodology for the distribution of funds under ECRIP
 grant awards.
   (c)] Physician loan repayment program. One million nine hundred  sixty
 thousand  dollars  for  the  period  January  first,  two thousand eight
 through December thirty-first, two  thousand  eight,  one  million  nine
 hundred  sixty  thousand dollars for the period January first, two thou-
 sand nine through December thirty-first, two thousand nine, one  million
 nine  hundred  sixty  thousand dollars for the period January first, two
 thousand ten through  December  thirty-first,  two  thousand  ten,  four
 hundred  ninety thousand dollars for the period January first, two thou-
 sand eleven through March thirty-first, two thousand eleven, one million
 seven hundred thousand dollars each state fiscal  year  for  the  period
 April  first,  two thousand eleven through March thirty-first, two thou-
 sand fourteen, up to one million seven  hundred  five  thousand  dollars
 each state fiscal year for the period April first, two thousand fourteen
 through  March  thirty-first,  two thousand seventeen, up to one million
 seven hundred five thousand dollars each state fiscal year for the peri-
 od April first, two thousand seventeen through March  thirty-first,  two
 thousand  twenty,  up to one million seven hundred five thousand dollars
 each state fiscal year for the period April first, two  thousand  twenty
 through  March  thirty-first,  two  thousand twenty-three, and up to one
 million seven hundred five thousand dollars each state fiscal  year  for
 the  period April first, two thousand twenty-three through March thirty-
 first, two thousand twenty-six, shall be set aside and reserved  by  the
 commissioner from the regional pools established pursuant to subdivision
 two  of  this  section  and shall be available for purposes of physician
 loan repayment in accordance  with  subdivision  ten  of  this  section.
 Notwithstanding  any  contrary  provision  of this section, sections one
 hundred twelve and one hundred sixty-three of the state finance law,  or
 any  other  contrary  provision  of law, such funding shall be allocated
 regionally with one-third of available funds going to New York city  and
 two-thirds  of  available funds going to the rest of the state and shall
 be distributed in a manner to be determined by the commissioner  without
 a competitive bid or request for proposal process as follows:
   (i) Funding shall first be awarded to repay loans of up to twenty-five
 physicians  who  train  in  primary care or specialty tracks in teaching
 S. 8307                            67                            A. 8807
 
 general hospitals, and who enter and remain in primary care or specialty
 practices in underserved communities, as determined by the commissioner.
   (ii)  After  distributions in accordance with subparagraph (i) of this
 paragraph, all remaining funds shall be awarded to repay loans of physi-
 cians who enter and remain in primary care  or  specialty  practices  in
 underserved  communities,  as  determined by the commissioner, including
 but not limited to physicians working in  general  hospitals,  or  other
 health care facilities.
   (iii)  In no case shall less than fifty percent of the funds available
 pursuant to this paragraph be distributed in  accordance  with  subpara-
 graphs (i) and (ii) of this paragraph to physicians identified by gener-
 al hospitals.
   (iv)  In addition to the funds allocated under this paragraph, for the
 period April first, two thousand fifteen through March thirty-first, two
 thousand sixteen,  two  million  dollars  shall  be  available  for  the
 purposes described in subdivision ten of this section;
   (v)  In  addition to the funds allocated under this paragraph, for the
 period April first, two thousand sixteen through March thirty-first, two
 thousand seventeen, two million  dollars  shall  be  available  for  the
 purposes described in subdivision ten of this section;
   (vi) Notwithstanding any provision of law to the contrary, and subject
 to the extension of the Health Care Reform Act of 1996, sufficient funds
 shall be available for the purposes described in subdivision ten of this
 section  in amounts necessary to fund the remaining year commitments for
 awards made pursuant to subparagraphs (iv) and (v) of this paragraph.
   [(d)] (C) Physician practice support. Four million nine hundred  thou-
 sand  dollars  for  the period January first, two thousand eight through
 December thirty-first, two thousand eight,  four  million  nine  hundred
 thousand  dollars  annually  for  the period January first, two thousand
 nine through December thirty-first, two thousand ten,  one  million  two
 hundred  twenty-five  thousand dollars for the period January first, two
 thousand eleven through March thirty-first, two  thousand  eleven,  four
 million  three  hundred  thousand dollars each state fiscal year for the
 period April first, two thousand eleven through March thirty-first,  two
 thousand  fourteen,  up  to  four  million  three hundred sixty thousand
 dollars each state fiscal year for the period April first, two  thousand
 fourteen  through March thirty-first, two thousand seventeen, up to four
 million three hundred sixty thousand dollars for each state fiscal  year
 for  the  period April first, two thousand seventeen through March thir-
 ty-first, two thousand twenty, up to four million  three  hundred  sixty
 thousand  dollars  for  each fiscal year for the period April first, two
 thousand twenty through March thirty-first, two  thousand  twenty-three,
 and  up  to  four  million three hundred sixty thousand dollars for each
 fiscal year for  the  period  April  first,  two  thousand  twenty-three
 through  March thirty-first, two thousand twenty-six, shall be set aside
 and reserved by the commissioner from  the  regional  pools  established
 pursuant  to  subdivision two of this section and shall be available for
 purposes of physician practice  support.  Notwithstanding  any  contrary
 provision  of  this section, sections one hundred twelve and one hundred
 sixty-three of the state finance law, or any other contrary provision of
 law, such funding shall be allocated regionally with one-third of avail-
 able funds going to New York city  and  two-thirds  of  available  funds
 going  to  the rest of the state and shall be distributed in a manner to
 be determined by the commissioner without a competitive bid  or  request
 for proposal process as follows:
 S. 8307                            68                            A. 8807
 
   (i)  Preference in funding shall first be accorded to teaching general
 hospitals for up to twenty-five awards, to  support  costs  incurred  by
 physicians  trained in primary or specialty tracks who thereafter estab-
 lish or join practices in underserved communities, as determined by  the
 commissioner.
   (ii)  After  distributions in accordance with subparagraph (i) of this
 paragraph, all remaining funds shall be awarded to physicians to support
 the cost of establishing or joining practices  in  underserved  communi-
 ties,  as  determined  by  the  commissioner, and to hospitals and other
 health care providers to recruit new physicians to provide  services  in
 underserved communities, as determined by the commissioner.
   (iii)  In no case shall less than fifty percent of the funds available
 pursuant to this  paragraph  be  distributed  to  general  hospitals  in
 accordance with subparagraphs (i) and (ii) of this paragraph.
   [(e)] (D) Work group. For funding available pursuant to paragraphs (B)
 AND (c)[, (d) and (e)] of this subdivision:
   (i)  The  department  shall  appoint a work group from recommendations
 made by associations  representing  physicians,  general  hospitals  and
 other  health care facilities to develop a streamlined application proc-
 ess by June first, two thousand twelve.
   (ii) Subject to available funding, applications shall be accepted on a
 continuous basis. The department shall provide technical  assistance  to
 applicants  to facilitate their completion of applications. An applicant
 shall be notified in writing  by  the  department  within  ten  days  of
 receipt  of an application as to whether the application is complete and
 if the application is incomplete, what information is  outstanding.  The
 department  shall act on an application within thirty days of receipt of
 a complete application.
   [(f)] (E) Study on physician workforce. Five hundred  ninety  thousand
 dollars  annually  for  the  period  January  first,  two thousand eight
 through December thirty-first, two thousand ten, one hundred forty-eight
 thousand dollars for the  period  January  first,  two  thousand  eleven
 through  March  thirty-first,  two thousand eleven, five hundred sixteen
 thousand dollars each state fiscal year for the period April first,  two
 thousand eleven through March thirty-first, two thousand fourteen, up to
 four  hundred  eighty-seven  thousand dollars each state fiscal year for
 the period April first, two  thousand  fourteen  through  March  thirty-
 first,  two thousand seventeen, up to four hundred eighty-seven thousand
 dollars for each state fiscal year for the period April first, two thou-
 sand seventeen through March thirty-first, two thousand  twenty,  up  to
 four  hundred  eighty-seven  thousand dollars each state fiscal year for
 the period April first, two thousand twenty through March  thirty-first,
 two  thousand twenty-three, and up to four hundred eighty-seven thousand
 dollars each state fiscal year for the period April first, two  thousand
 twenty-three  through March thirty-first, two thousand twenty-six, shall
 be set aside and reserved by the commissioner from  the  regional  pools
 established  pursuant  to  subdivision  two of this section and shall be
 available to fund a study of physician  workforce  needs  and  solutions
 including,  but  not  limited  to, an analysis of residency programs and
 projected physician workforce  and  community  needs.  The  commissioner
 shall  enter  into  agreements with one or more organizations to conduct
 such study based on a request for proposal process.
   [(g)] (F) Diversity in medicine/post-baccalaureate  program.  Notwith-
 standing any inconsistent provision of section one hundred twelve or one
 hundred  sixty-three  of  the  state  finance  law or any other law, one
 million nine hundred sixty thousand  dollars  annually  for  the  period
 S. 8307                            69                            A. 8807
 
 January  first,  two  thousand  eight through December thirty-first, two
 thousand ten, four hundred ninety thousand dollars for the period  Janu-
 ary  first, two thousand eleven through March thirty-first, two thousand
 eleven,  one  million  seven  hundred thousand dollars each state fiscal
 year for the period April first, two thousand eleven through March thir-
 ty-first, two thousand fourteen, up to  one  million  six  hundred  five
 thousand  dollars each state fiscal year for the period April first, two
 thousand fourteen through March thirty-first, two thousand seventeen, up
 to one million six hundred five thousand dollars each state fiscal  year
 for  the  period April first, two thousand seventeen through March thir-
 ty-first, two thousand twenty, up to one million six hundred five  thou-
 sand  dollars  each  state  fiscal  year for the period April first, two
 thousand twenty through March thirty-first, two  thousand  twenty-three,
 and  up  to  one  million  six  hundred five thousand dollars each state
 fiscal year for  the  period  April  first,  two  thousand  twenty-three
 through  March thirty-first, two thousand twenty-six, shall be set aside
 and reserved by the commissioner from  the  regional  pools  established
 pursuant  to  subdivision two of this section and shall be available for
 distributions to the Associated Medical Schools of New York to fund  its
 diversity program including existing and new post-baccalaureate programs
 for  minority  and  economically  disadvantaged  students  and encourage
 participation from all medical  schools  in  New  York.  The  associated
 medical schools of New York shall report to the commissioner on an annu-
 al  basis  regarding  the use of funds for such purpose in such form and
 manner as specified by the commissioner.
   [(h)] (G) In the event there are undistributed  funds  within  amounts
 made  available  for  distributions  pursuant  to this subdivision, such
 funds may be  reallocated  and  distributed  in  current  or  subsequent
 distribution  periods in a manner determined by the commissioner for any
 purpose set forth in this subdivision.
   12. Notwithstanding any provision of law to the contrary, applications
 submitted on or after April first, two thousand sixteen, for the  physi-
 cian  loan repayment program pursuant to paragraph [(c)] (B) of subdivi-
 sion five-a of this section and subdivision ten of this section  or  the
 physician  practice  support  program pursuant to paragraph [(d)] (C) of
 subdivision five-a of this section, shall be subject  to  the  following
 changes:
   (a)  Awards  shall  be  made  from the total funding available for new
 awards under the physician loan  repayment  program  and  the  physician
 practice  support  program,  with  neither program limited to a specific
 funding amount within such total funding available;
   (b) An applicant may apply for an  award  for  either  physician  loan
 repayment or physician practice support, but not both;
   (c)  An applicant shall agree to practice for three years in an under-
 served area and each award shall provide up to  forty  thousand  dollars
 for each of the three years; and
   (d)  To the extent practicable, awards shall be timed to be of use for
 job offers made to applicants.
   § 4. Subparagraph (xvi) of paragraph (a) of subdivision 7  of  section
 2807-s  of  the  public health law, as amended by section 8 of part Y of
 chapter 56 of the laws of 2020, is amended to read as follows:
   (xvi) provided further, however, for periods prior to July first,  two
 thousand  nine,  amounts set forth in this paragraph shall be reduced by
 an amount equal to the actual distribution reductions for all facilities
 pursuant to paragraph [(s)] (O) of subdivision one  of  section  twenty-
 eight hundred seven-m of this article.
 S. 8307                            70                            A. 8807
 
   §  5.  Subdivision  (c)  of section 92-dd of the state finance law, as
 amended by section 9 of part Y of chapter 56 of the  laws  of  2020,  is
 amended to read as follows:
   (c)  The pool administrator shall, from appropriated funds transferred
 to the  pool  administrator  from  the  comptroller,  continue  to  make
 payments  as required pursuant to sections twenty-eight hundred seven-k,
 twenty-eight hundred seven-m (not including payments  made  pursuant  to
 SUBDIVISION FIVE-B AND paragraphs (B), (c)[, (d),, (f)] and [(g)] (F) of
 subdivision  five-a  of section twenty-eight hundred seven-m), and twen-
 ty-eight hundred seven-w of the public  health  law,  paragraph  (e)  of
 subdivision  twenty-five  of section twenty-eight hundred seven-c of the
 public health law, paragraphs (b)  and  (c)  of  subdivision  thirty  of
 section twenty-eight hundred seven-c of the public health law, paragraph
 (b) of subdivision eighteen of section twenty-eight hundred eight of the
 public health law, subdivision seven of section twenty-five hundred-d of
 the  public  health  law  and section eighty-eight of chapter one of the
 laws of nineteen hundred ninety-nine.
   § 6. Paragraph (c) of subdivision 1 of section  461-b  of  the  social
 services law is REPEALED.
   § 7. Article 27-H of the public health law is REPEALED.
   §  8.  Paragraph  (c)  of  subdivision 11 of section 230 of the public
 health law, as amended by chapter 343 of the laws of 1980,  subparagraph
 (ii)  as  amended  by  section 10 of part B of chapter 57 of the laws of
 2023, is amended to read as follows:
   (c) Notwithstanding the foregoing, no physician shall  be  responsible
 for reporting pursuant to paragraph (a) of this subdivision with respect
 to any information discovered by such physician solely as a result of:
   [(i)] Participation in a properly conducted mortality and/or morbidity
 conference,  departmental  meeting  or  a  medical  or  tissue committee
 constituted pursuant to the by-laws of a hospital which is  duly  estab-
 lished pursuant to article twenty-eight of the public health law, unless
 the  procedures  of  such  conference,  department  or committee of such
 hospital shall have been declared to be  unacceptable  for  the  purpose
 hereof by the commissioner, and provided that the obligations of report-
 ing such information when appropriate to do so shall be the responsibil-
 ity of the chairperson of such conference, department or committee, or
   [(ii)  Participation  and membership during a three year demonstration
 period in a physician committee of the Medical Society of the  State  of
 New  York  or the New York State Osteopathic Society whose purpose is to
 confront and refer to treatment physicians who are thought to be suffer-
 ing from alcoholism, drug abuse, or mental illness.  Such  demonstration
 period shall commence on April first, nineteen hundred eighty and termi-
 nate  on May thirty-first, nineteen hundred eighty-three.  An additional
 demonstration period shall commence  on  June  first,  nineteen  hundred
 eighty-three  and  terminate  on  March  thirty-first,  nineteen hundred
 eighty-six. An additional demonstration period shall commence  on  April
 first,  nineteen hundred eighty-six and terminate on March thirty-first,
 nineteen hundred eighty-nine. An additional demonstration  period  shall
 commence  April  first, nineteen hundred eighty-nine and terminate March
 thirty-first, nineteen hundred ninety-two. An  additional  demonstration
 period  shall  commence  April  first,  nineteen  hundred ninety-two and
 terminate March thirty-first, nineteen  hundred  ninety-five.  An  addi-
 tional  demonstration  period  shall  commence  on April first, nineteen
 hundred  ninety-five  and  terminate  on  March  thirty-first,  nineteen
 hundred  ninety-eight. An additional demonstration period shall commence
 on April first, nineteen hundred ninety-eight  and  terminate  on  March
 S. 8307                            71                            A. 8807

 thirty-first,  two  thousand  three.  An additional demonstration period
 shall commence on April first, two thousand three and terminate on March
 thirty-first, two thousand thirteen. An additional demonstration  period
 shall commence April first, two thousand thirteen and terminate on March
 thirty-first,  two thousand eighteen. An additional demonstration period
 shall commence April first, two thousand eighteen and terminate on  July
 first, two thousand twenty-eight provided, however, that the commission-
 er may prescribe requirements for the continuation of such demonstration
 program,  including  periodic reviews of such programs and submission of
 any reports and data necessary to  permit  such  reviews.  During  these
 additional periods, the provisions of this subparagraph shall also apply
 to a physician committee of a county medical society.]
   §  9.  Paragraph  (g)  of  subdivision 11 of section 230 of the public
 health law is REPEALED and paragraph (h) is relettered paragraph (g).
   § 10. This act shall take effect immediately and shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024; provided,
 however, the amendments to subparagraph (xvi) of paragraph (a) of subdi-
 vision 7 of section 2807-s of the public health law made by section four
 of this act shall not affect the expiration of such section and shall be
 deemed to expire therewith.
 
                                  PART M
 
   Section 1. Subparagraph 3 of paragraph (b) of subdivision 4 of section
 366 of the social services law, as added by section 2 of part D of chap-
 ter 56 of the laws of 2013, is amended to read as follows:
   (3) (A) A child [under] BETWEEN the [age] AGES of SIX AND nineteen who
 is  determined  eligible  for medical assistance under the provisions of
 this section, shall, consistent with  applicable  federal  requirements,
 remain eligible for such assistance until [the earlier of:
   (i)]  the  last  day of the month which is twelve months following the
 determination [or redetermination] OR RENEWAL of  eligibility  for  such
 assistance[; or
   (ii)  the  last day of the month in which the child reaches the age of
 nineteen].
   (B) A CHILD UNDER THE AGE  OF  SIX  WHO  IS  DETERMINED  ELIGIBLE  FOR
 MEDICAL ASSISTANCE UNDER THE PROVISIONS OF THIS SECTION, SHALL, CONSIST-
 ENT  WITH  APPLICABLE FEDERAL REQUIREMENTS, REMAIN CONTINUOUSLY ELIGIBLE
 FOR MEDICAL ASSISTANCE COVERAGE UNTIL THE LATER OF:
   (I) THE LAST DAY OF THE TWELFTH MONTH FOLLOWING THE  DETERMINATION  OR
 RENEWAL OF ELIGIBILITY FOR SUCH ASSISTANCE; OR
   (II)  THE  LAST DAY OF THE MONTH IN WHICH THE CHILD REACHES THE AGE OF
 SIX.
   § 2. Subdivision 6 of section 2510 of the public health law is amended
 by adding a new paragraph (e) to read as follows:
   (E) AN ELIGIBLE CHILD UNDER SIX YEARS OF AGE  SHALL,  CONSISTENT  WITH
 APPLICABLE  FEDERAL REQUIREMENTS, REMAIN CONTINUOUSLY ENROLLED UNTIL THE
 LATER OF:
   (I) THE LAST DAY OF THE TWELFTH MONTH FOLLOWING THE DATE OF ENROLLMENT
 OR RECERTIFICATION IN THE CHILD HEALTH INSURANCE PLAN; OR
   (II) THE LAST DAY OF THE MONTH IN WHICH THE CHILD REACHES THE  AGE  OF
 SIX.
   § 3. This act shall take effect January 1, 2025.
 
                                  PART N
 S. 8307                            72                            A. 8807
 
   Section 1. Paragraph (d) of subdivision 4 of section 206 of the public
 health  law, as added by chapter 602 of the laws of 2007, is amended and
 a new paragraph (e) is added  to read as follows:
   (d)  assess  civil  penalties  against  a  public  water  system which
 provides water to the public for  human  consumption  through  pipes  or
 other  constructed conveyances, as further defined in the state sanitary
 code or, in the case  of  mass  gatherings,  the  person  who  holds  or
 promotes  the  mass  gathering as defined in subdivision five of section
 two hundred twenty-five of this article not to exceed twenty-five  thou-
 sand  dollars  per  day, for each violation of or failure to comply with
 any term or provision of the state sanitary code as it relates to public
 water systems that serve a population of five thousand or  more  persons
 or any mass gatherings, which penalty may be assessed after a hearing or
 an opportunity to be heard[.];
   (E) NOTWITHSTANDING SECTION SIXTY-FIVE HUNDRED THIRTY OF THE EDUCATION
 LAW,  ISSUE  A  NON-PATIENT  SPECIFIC  STATEWIDE  STANDING ORDER FOR THE
 PROVISION OF DOULA SERVICES FOR PREGNANT, BIRTHING, AND POSTPARTUM INDI-
 VIDUALS THROUGH TWELVE MONTHS POSTPARTUM.
   § 2.  Subdivision 3 of section 2504 of the public health law, as added
 by chapter 976 of the laws of 1984, is amended to read as follows:
   3. Any person, INCLUDING A MINOR, who is pregnant may  give  effective
 consent  for  ANY  AND ALL medical, dental, health and hospital services
 relating to [prenatal] REPRODUCTIVE HEALTH care,  INCLUDING  CONSENT  TO
 TERMINATE A PREGNANCY FOR ANY REASON.
   §  3.  The  opening  paragraph of section 2599-aa of the public health
 law, as added by chapter 1 of the laws of 2019, is amended  to  read  as
 follows:
   The legislature finds that comprehensive reproductive health care is a
 fundamental   component   of  every  individual's  health,  privacy  and
 equality, INCLUDING MINORS. Therefore, it is the  policy  of  the  state
 that:
   §  4.  The  public  health  law  is  amended  by  adding a new section
 2599-bb-1 to read as follows:
   § 2599-BB-1. CONTRACEPTION. 1. A HEALTH  CARE  PRACTITIONER  LICENSED,
 CERTIFIED,  OR AUTHORIZED UNDER TITLE EIGHT OF THE EDUCATION LAW, ACTING
 WITHIN THEIR LAWFUL SCOPE OF PRACTICE, MAY  PRESCRIBE  OR  DISTRIBUTE  A
 CONTRACEPTIVE DEVICE OR MEDICATION WHEN, ACCORDING TO THE PRACTITIONER'S
 REASONABLE  AND  GOOD  FAITH PROFESSIONAL JUDGMENT BASED ON THE FACTS OF
 THE PATIENT'S CASE, THEY DETERMINE THE  PATIENT  IS  ABLE  TO  MEDICALLY
 TOLERATE SUCH TREATMENT.
   2.  THIS  ARTICLE  SHALL  BE CONSTRUED AND APPLIED CONSISTENT WITH AND
 SUBJECT TO APPLICABLE LAWS AND  APPLICABLE  AND  AUTHORIZED  REGULATIONS
 GOVERNING HEALTH CARE PROCEDURES.
   §  5.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART O
 
   Section 1. Subdivision 1 of section 2807-k of the public health law is
 amended by adding a new paragraph (h) to read as follows:
   (H) "UNDERINSURED" SHALL MEAN AN INDIVIDUAL WITH OUT OF POCKET MEDICAL
 COSTS THAT AMOUNT TO MORE THAN TEN PERCENT OF  SUCH  INDIVIDUAL'S  GROSS
 ANNUAL INCOME FOR THE PAST TWELVE MONTHS.
   §  2.  Subdivision  9-a of section 2807-k of the public health law, as
 added by section 39-a of part A of chapter 57 of the laws  of  2006  and
 S. 8307                            73                            A. 8807
 
 paragraph (k) as added by section 43 of part B of chapter 58 of the laws
 of 2008, is amended to read as follows:
   9-a.  (a)  As  a  condition  for  participation  in pool distributions
 authorized pursuant to this section  and  section  twenty-eight  hundred
 seven-w  of  this  article  for  periods on and after January first, two
 thousand nine, general hospitals shall, effective  for  periods  on  and
 after  January  first, two thousand seven, establish financial aid poli-
 cies and procedures, in accordance with the provisions of this  subdivi-
 sion,  for  reducing charges otherwise applicable to low-income individ-
 uals without health insurance OR UNDERINSURED INDIVIDUALS, or  who  have
 exhausted  their  health  insurance benefits, and who can demonstrate an
 inability to pay full charges, and also, at the  hospital's  discretion,
 for  reducing  or  discounting  the collection of co-pays and deductible
 payments from those individuals who can demonstrate an inability to  pay
 such amounts.
   (b) Such reductions from charges for [uninsured] patients with incomes
 below at least [three] FOUR hundred percent of the federal poverty level
 shall  result  in a charge to such individuals that does not exceed [the
 greater of] the amount that would have been paid for the  same  services
 [by  the  "highest volume payor" for such general hospital as defined in
 subparagraph (v) of this paragraph, or for services provided pursuant to
 title XVIII of the  federal  social  security  act  (medicare),  or  for
 services]  provided pursuant to title XIX of the federal social security
 act (medicaid), and provided further that such amounts shall be adjusted
 according to income level as follows:
   (i) For patients with incomes [at or] below at least [one] TWO hundred
 percent of the federal poverty level, the  hospital  shall  [collect  no
 more  than  a  nominal payment amount, consistent with guidelines estab-
 lished by the commissioner] WAIVE ALL CHARGES. NO NOMINAL PAYMENT  SHALL
 BE COLLECTED;
   (ii)  For  patients  with  incomes  between at least [one] TWO hundred
 [one] percent and [one] UP TO  THREE  hundred  [fifty]  percent  of  the
 federal  poverty  level,  the  hospital  shall  collect no more than the
 amount identified after application of a proportional sliding fee sched-
 ule under which patients with lower incomes shall pay the lowest amount.
 Such schedule shall provide that the amount the hospital may collect for
 such patients increases [from the nominal amount described  in  subpara-
 graph  (i)  of  this paragraph] in equal increments as the income of the
 patient increases, up to a  maximum  of  [twenty]  TEN  percent  of  the
 [greater  of the] amount that would have been paid for the same services
 [by the "highest volume payor" for such general hospital, as defined  in
 subparagraph (v) of this paragraph, or for services provided pursuant to
 title  XVIII  of  the  federal  social  security  act  (medicare) or for
 services] provided pursuant to title XIX of the federal social  security
 act  (medicaid),  OR  FOR  UNDERINSURED PATIENTS, UP TO A MAXIMUM OF TEN
 PERCENT OF THE AMOUNT  THAT  WOULD  HAVE  BEEN  PAID  PURSUANT  TO  SUCH
 PATIENT'S INSURANCE COST SHARING;
   (iii)  For  patients with incomes between at least [one] THREE hundred
 [fifty-one] ONE percent and [two] FOUR hundred [fifty]  percent  of  the
 federal  poverty  level,  the  hospital  shall  collect no more than the
 amount identified after application of a proportional sliding fee sched-
 ule under which patients with lower income shall pay the lowest amounts.
 Such schedule shall provide that the amount the hospital may collect for
 such patients increases from the [twenty] TEN percent  figure  described
 in subparagraph (ii) of this paragraph in equal increments as the income
 of  the  patient  increases,  up  to  a  maximum of [the greater] TWENTY
 S. 8307                            74                            A. 8807
 
 PERCENT of the amount that would have been paid for  the  same  services
 [by  the "highest volume payor" for such general hospital, as defined in
 subparagraph (v) of this paragraph, or for services provided pursuant to
 title  XVIII  of  the  federal  social  security  act  (medicare) or for
 services] provided pursuant to title XIX of the federal social  security
 act  (medicaid), OR FOR UNDERINSURED PATIENTS, UP TO A MAXIMUM OF TWENTY
 PERCENT OF THE AMOUNT  THAT  WOULD  HAVE  BEEN  PAID  PURSUANT  TO  SUCH
 PATIENT'S INSURANCE COST SHARING; [and
   (iv)  For patients with incomes between at least two hundred fifty-one
 percent and three hundred percent of  the  federal  poverty  level,  the
 hospital shall collect no more than the greater of the amount that would
 have  been  paid for the same services by the "highest volume payor" for
 such general hospital as defined in subparagraph (v) of this  paragraph,
 or  for  services provided pursuant to title XVIII of the federal social
 security act (medicare), or for services provided pursuant to title  XIX
 of the federal social security act (medicaid).
   (v)  For  the purposes of this paragraph, "highest volume payor" shall
 mean the insurer, corporation or  organization  licensed,  organized  or
 certified  pursuant  to  article thirty-two, forty-two or forty-three of
 the insurance law or article forty-four of this chapter, or other third-
 party payor, which has  a  contract  or  agreement  to  pay  claims  for
 services  provided  by  the  general  hospital  and incurred the highest
 volume of claims in the previous calendar year.
   (vi) A hospital may implement policies and procedures to  permit,  but
 not  require, consideration on a case-by-case basis of exceptions to the
 requirements described in subparagraphs (i) and (ii) of  this  paragraph
 based upon the existence of significant assets owned by the patient that
 should  be  taken  into  account  in determining the appropriate payment
 amount for that patient's care, provided, however,  that  such  proposed
 policies  and  procedures  shall  be  subject  to  the  prior review and
 approval of the commissioner and, if approved, shall be included in  the
 hospital's  financial  assistance  policy  established  pursuant to this
 section, and provided further that, if such  approval  is  granted,  the
 maximum amount that may be collected shall not exceed the greater of the
 amount  that  would have been paid for the same services by the "highest
 volume payor" for such general hospital as defined in  subparagraph  (v)
 of  this  paragraph, or for services provided pursuant to title XVIII of
 the federal social security act (medicare),  or  for  services  provided
 pursuant  to title XIX of the federal social security act (medicaid). In
 the event that a general hospital reviews a patient's assets  in  deter-
 mining  payment  adjustments  such  policies  and  procedures  shall not
 consider as assets a patient's primary residence, assets held in a  tax-
 deferred  or  comparable  retirement  savings  account,  college savings
 accounts, or cars used  regularly  by  a  patient  or  immediate  family
 members.
   (vii)]  (IV)  Nothing  in this paragraph shall be construed to limit a
 hospital's  ability  to  establish  patient  eligibility   for   payment
 discounts  at income levels higher than those specified herein and/or to
 provide greater payment  discounts  for  eligible  patients  than  those
 required by this paragraph.
   (c)  Such  policies  and procedures shall be clear, understandable, in
 writing and publicly available in summary form and each general hospital
 participating in the pool shall ensure that every patient is made  aware
 of  the  existence of such policies and procedures and is provided, in a
 timely manner, with a summary of  such  policies  and  procedures  [upon
 request].  Any summary provided to patients shall, at a minimum, include
 S. 8307                            75                            A. 8807
 
 specific information as to income levels used to  determine  eligibility
 for  assistance, a description of the primary service area of the hospi-
 tal and the means of applying for assistance. For general hospitals with
 twenty-four  hour  emergency  departments,  such policies and procedures
 shall require the WRITTEN notification of patients during the intake and
 registration process, AND DURING DISCHARGE OF THE PATIENT,  AND  through
 the  conspicuous  posting  of  language-appropriate  information  in the
 general hospital, and  information  on  bills  and  statements  sent  to
 patients,  that financial aid may be available to qualified patients and
 how to obtain further information. For specialty hospitals without twen-
 ty-four hour emergency departments, such notification shall  take  place
 through  written  materials  provided  to patients during the intake and
 registration process prior to the provision of any health care  services
 or procedures, AND DURING DISCHARGE OF THE PATIENT, and through informa-
 tion on bills and statements sent to patients, that financial aid may be
 available  to  qualified patients and how to obtain further information.
 Application materials shall include  a  notice  to  patients  that  upon
 submission  of  a  completed  application,  including any information or
 documentation needed to determine the patient's eligibility pursuant  to
 the  hospital's  financial  assistance policy, the patient may disregard
 any bills until the hospital has rendered a decision on the  application
 in accordance with this paragraph.
   (d) Such policies and procedures shall include clear, objective crite-
 ria  for  determining  a patient's ability to pay and for providing such
 adjustments to payment requirements as are  necessary.  In  addition  to
 adjustment  mechanisms  such  as  sliding fee schedules and discounts to
 fixed standards, such policies and procedures shall also provide for the
 use of installment plans for the  payment  of  outstanding  balances  by
 patients  pursuant to the provisions of the hospital's financial assist-
 ance policy. The monthly payment under such  a  plan  shall  not  exceed
 [ten]  FIVE  percent  of  the  gross  monthly  income  of  the patient[,
 provided, however, that if patient assets are considered  under  such  a
 policy,  then  patient  assets which are not excluded assets pursuant to
 subparagraph (vi) of paragraph (b) of this subdivision may be considered
 in addition to the limit on monthly  payments].  The  rate  of  interest
 charged  to  the patient on the unpaid balance, if any, shall not exceed
 [the rate for a ninety-day security issued by the United States  Depart-
 ment  of  Treasury,  plus  .5]  TWO percent and no plan shall include an
 accelerator or similar clause under which a higher rate of  interest  is
 triggered upon a missed payment. If such policies and procedures include
 a  requirement  of  a deposit prior to non-emergent, medically-necessary
 care, such deposit must be included as part of any financial aid consid-
 eration. Such policies and procedures shall be applied  consistently  to
 all eligible patients.
   (e)  Such  policies  and procedures shall permit patients to apply for
 assistance [within at least ninety days of the date of discharge or date
 of service and provide at least twenty days for  patients  to  submit  a
 completed  application] AT ANY TIME DURING THE COLLECTION PROCESS.  Such
 policies and  procedures  may  require  that  patients  seeking  payment
 adjustments  provide appropriate financial information and documentation
 in support of their application, provided, however, that  such  applica-
 tion  process  shall not be unduly burdensome or complex. General hospi-
 tals shall, upon request, assist patients in  understanding  the  hospi-
 tal's  policies  and procedures and in applying for payment adjustments.
 Application forms  shall  be  printed  in  the  "primary  languages"  of
 patients  served by the general hospital. For the purposes of this para-
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 graph, "primary languages" shall include any language that is either (i)
 used to communicate, during at least five percent of patient visits in a
 year, by patients who  cannot  speak,  read,  write  or  understand  the
 English  language  at  the  level of proficiency necessary for effective
 communication with health care providers, or (ii) spoken by  non-English
 speaking  individuals  comprising  more  than one percent of the primary
 hospital service area population, as calculated using demographic infor-
 mation available from the United States Bureau of  the  Census,  supple-
 mented  by  data  from school systems. Decisions regarding such applica-
 tions shall be made  within  thirty  days  of  receipt  of  a  completed
 application.  Such policies and procedures shall require that the hospi-
 tal issue any denial/approval of such application in writing with infor-
 mation on how to appeal the denial and shall  require  the  hospital  to
 establish  an appeals process under which it will evaluate the denial of
 an application. Nothing in this  subdivision  shall  be  interpreted  as
 prohibiting a hospital from making the availability of financial assist-
 ance contingent upon the patient first applying for coverage under title
 XIX  of  the social security act (medicaid) or another insurance program
 if, in the judgment of the hospital, the patient  may  be  eligible  for
 medicaid  or  another  insurance program, and upon the patient's cooper-
 ation in  following  the  hospital's  financial  assistance  application
 requirements,  including  the  provision of information needed to make a
 determination on the patient's application in accordance with the hospi-
 tal's financial assistance policy.
   (f) Such policies and procedures  shall  provide  that  patients  with
 incomes  below [three] FOUR hundred percent of the federal poverty level
 are deemed presumptively eligible  for  payment  adjustments  and  shall
 conform  to the requirements set forth in paragraph (b) of this subdivi-
 sion, provided, however, that  nothing  in  this  subdivision  shall  be
 interpreted  as precluding hospitals from extending such payment adjust-
 ments to other patients, either generally or on  a  case-by-case  basis.
 Such  policies  and procedures shall provide financial aid for emergency
 hospital services, including emergency transfers pursuant to the federal
 emergency medical treatment and active labor act  (42  USC  1395dd),  to
 patients who reside in New York state and for medically necessary hospi-
 tal  services  for patients who reside in the hospital's primary service
 area as determined according to criteria established by the  commission-
 er.  In  developing  such  criteria, the commissioner shall consult with
 representatives of the hospital industry, health care consumer advocates
 and local public health officials. Such criteria shall be made available
 to the public no less than thirty days prior to the date of  implementa-
 tion and shall, at a minimum:
   (i)  prohibit  a  hospital  from  developing  or  altering its primary
 service area in a manner designed to avoid medically underserved  commu-
 nities or communities with high percentages of uninsured residents;
   (ii)  ensure that every geographic area of the state is included in at
 least one general hospital's  primary  service  area  so  that  eligible
 patients may access care and financial assistance; and
   (iii)  require the hospital to notify the commissioner upon making any
 change to its primary service area, and to include a description of  its
 primary  service  area  in  the  hospital's annual implementation report
 filed pursuant to subdivision  three  of  section  twenty-eight  hundred
 three-l of this article.
   (g)  Nothing  in  this  subdivision shall be interpreted as precluding
 hospitals from extending payment  adjustments  for  medically  necessary
 non-emergency  hospital  services  to patients outside of the hospital's
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 primary service area. For patients determined to be eligible for  finan-
 cial  aid  under  the  terms  of a hospital's financial aid policy, such
 policies and procedures shall prohibit any limitations on financial  aid
 for services based on the medical condition of the applicant, other than
 typical  limitations  or  exclusions  based  on medical necessity or the
 clinical or therapeutic benefit of a procedure or treatment.
   (h) SUCH POLICIES AND PROCEDURES SHALL PROHIBIT THE DENIAL  OF  ADMIS-
 SION OR DENIAL OF TREATMENT FOR SERVICES THAT ARE REASONABLY ANTICIPATED
 TO  BE  MEDICALLY  NECESSARY  BECAUSE  THE PATIENT HAS AN UNPAID MEDICAL
 BILL. Such policies and  procedures  shall  [not  permit]  PROHIBIT  the
 forced  sale or foreclosure of a patient's primary residence in order to
 collect an outstanding medical bill and shall require  the  hospital  to
 refrain from sending an account to collection if the patient has submit-
 ted  a  completed  application for financial aid, including any required
 supporting documentation, while the hospital  determines  the  patient's
 eligibility  for  such  aid. SUCH POLICIES AND PROCEDURES SHALL PROHIBIT
 THE SALE OF MEDICAL DEBT ACCUMULATED PURSUANT TO THIS SECTION TO A THIRD
 PARTY, UNLESS THE THIRD PARTY EXPLICITLY PURCHASES SUCH MEDICAL DEBT  IN
 ORDER  TO  RELIEVE THE DEBT OF THE PATIENT. Such policies and procedures
 shall provide for written notification, which shall include notification
 on a patient bill, to a patient not less than thirty days prior  to  the
 referral  of  debts for collection and shall require that the collection
 agency obtain the hospital's written consent prior to commencing a legal
 action. SUCH POLICIES AND PROCEDURES  SHALL  PROHIBIT  A  HOSPITAL  FROM
 COMMENCING  A  LEGAL  ACTION  RELATED TO THE RECOVERY OF MEDICAL DEBT OR
 UNPAID BILLS AGAINST PATIENTS WITH INCOMES BELOW FOUR HUNDRED PERCENT OF
 THE FEDERAL POVERTY LEVEL. IN ANY LEGAL ACTION RELATED TO  THE  RECOVERY
 OF  MEDICAL  DEBT  OR  UNPAID  BILLS  BY OR ON BEHALF OF A HOSPITAL, THE
 COMPLAINT SHALL BE ACCOMPANIED BY AN AFFIDAVIT BY THE  HOSPITAL'S  CHIEF
 FINANCIAL  OFFICER  STATING  THAT  BASED  UPON THE HOSPITAL'S REASONABLE
 EFFORT TO DETERMINE THE PATIENT'S INCOME,  THE  PATIENT  WHOM  THEY  ARE
 TAKING  LEGAL  ACTION AGAINST DOES NOT HAVE AN INCOME BELOW FOUR HUNDRED
 PERCENT OF THE FEDERAL POVERTY LEVEL. Such policies and procedures shall
 require all general hospital staff who interact with  patients  or  have
 responsibility  for  billing and collections to be trained in such poli-
 cies and procedures, and require the implementation of a  mechanism  for
 the  general  hospital  to measure its compliance with such policies and
 procedures.  Such  policies  and  procedures  shall  require  that   any
 collection  agency  under  contract  with  a  general  hospital  for the
 collection of debts follow the hospital's financial  assistance  policy,
 including  providing  information to patients on how to apply for finan-
 cial assistance where appropriate. Such policies  and  procedures  shall
 prohibit collections from a patient who is determined to be eligible for
 medical  assistance pursuant to title XIX of the federal social security
 act at the time services were rendered and for which  services  medicaid
 payment is available.
   (i) Reports required to be submitted to the department by each general
 hospital  as  a  condition  for  participation  in  the pools, and which
 contain, in accordance with applicable regulations, a certification from
 an independent  certified  public  accountant  or  independent  licensed
 public accountant or an attestation from a senior official of the hospi-
 tal  that the hospital is in compliance with conditions of participation
 in the pools, shall also contain, for reporting  periods  on  and  after
 January first, two thousand seven:
   (i)  a  report  on  hospital costs incurred and uncollected amounts in
 providing services to eligible patients  without  insurance[,  including
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 the  amount  of  care provided for a nominal payment amount,] during the
 period covered by the report;
   (ii)  hospital  costs incurred and uncollected amounts for deductibles
 and coinsurance for eligible patients with insurance or other third-par-
 ty payor coverage;
   (iii) the number of patients, INCLUDING THEIR  AGE,  RACE,  ETHNICITY,
 GENDER AND INSURANCE STATUS, organized according to United States postal
 service  zip  code, who applied for financial assistance pursuant to the
 hospital's  financial  assistance  policy,  and  the  number,  organized
 according  to  United States postal service zip code, whose applications
 were approved and whose applications were denied;
   (iv) the reimbursement received for indigent care from the pool estab-
 lished pursuant to this section;
   (v) the amount of funds that have been expended on charity  care  from
 charitable  bequests  made  or  trusts  established  for  the purpose of
 providing financial assistance to patients who are eligible  in  accord-
 ance with the terms of such bequests or trusts;
   (vi)  for  hospitals located in social services districts in which the
 district allows hospitals to assist patients with such applications, the
 number of applications for eligibility under title  XIX  of  the  social
 security  act (medicaid) that the hospital assisted patients in complet-
 ing and the number denied and approved; AND
   (vii) the hospital's financial losses resulting from services provided
 under medicaid[; and
   (viii) the number  of  liens  placed  on  the  primary  residences  of
 patients through the collection process used by a hospital].
   (j)  Within ninety days of the effective date of this subdivision each
 hospital shall submit to the commissioner a written report on its  poli-
 cies  and procedures for financial assistance to patients which are used
 by the hospital on the effective date of this subdivision.  Such  report
 shall  include copies of its policies and procedures, including material
 which is distributed to patients, and a description  of  the  hospital's
 financial  aid  policies  and procedures. Such description shall include
 the income levels of patients on which eligibility is based, the  finan-
 cial  aid  eligible  patients  receive and the means of calculating such
 aid, and the service area, if any, used by  the  hospital  to  determine
 eligibility.
   (k)  In  the event it is determined by the commissioner that the state
 will be unable to secure all necessary federal approvals to include,  as
 part  of  the  state's  approved  state plan under title nineteen of the
 federal social security act, a requirement, as set  forth  in  paragraph
 [one]  (A) of this subdivision, that compliance with this subdivision is
 a condition of participation in pool distributions  authorized  pursuant
 to  this  section and section twenty-eight hundred seven-w of this arti-
 cle, then such condition of participation shall be deemed null and  void
 and,  notwithstanding  section twelve of this chapter, failure to comply
 with the provisions of this subdivision by a hospital on and  after  the
 date  of  such determination shall make such hospital liable for a civil
 penalty not to exceed ten thousand dollars for each such violation.  The
 imposition of such civil penalties shall be subject to the provisions of
 section twelve-a of this chapter.
   (L)  A  HOSPITAL  OR  ITS  COLLECTION AGENT SHALL NOT COMMENCE A CIVIL
 ACTION AGAINST A PATIENT OR DELEGATE A COLLECTION  ACTIVITY  TO  A  DEBT
 COLLECTOR  FOR NONPAYMENT FOR AT LEAST ONE HUNDRED EIGHTY DAYS AFTER THE
 FIRST POST-SERVICE BILL IS ISSUED AND UNTIL A HOSPITAL HAS MADE  REASON-
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 ABLE  EFFORTS  TO  DETERMINE  WHETHER  A PATIENT QUALIFIES FOR FINANCIAL
 ASSISTANCE.
   §  3. The public health law is amended by adding a new section 18-c to
 read as follows:
   § 18-C. SEPARATE PATIENT CONSENT FOR TREATMENT AND PAYMENT FOR  HEALTH
 CARE SERVICES. INFORMED CONSENT FROM A PATIENT TO PROVIDE ANY TREATMENT,
 PROCEDURE,  EXAMINATION  OR  OTHER  DIRECT HEALTH CARE SERVICES SHALL BE
 OBTAINED SEPARATELY FROM SUCH PATIENT'S CONSENT TO PAY FOR THE SERVICES.
 CONSENT TO PAY FOR ANY HEALTH CARE SERVICES BY A PATIENT  SHALL  NOT  BE
 GIVEN PRIOR TO THE PATIENT RECEIVING SUCH SERVICES AND DISCUSSING TREAT-
 MENT  COSTS.  FOR  PURPOSES  OF  THIS SECTION, "CONSENT" MEANS AN ACTION
 WHICH: (A)  CLEARLY  AND  CONSPICUOUSLY  COMMUNICATES  THE  INDIVIDUAL'S
 AUTHORIZATION  OF  AN ACT OR PRACTICE; (B) IS MADE IN THE ABSENCE OF ANY
 MECHANISM IN THE USER INTERFACE THAT  HAS  THE  PURPOSE  OR  SUBSTANTIAL
 EFFECT  OF OBSCURING, SUBVERTING, OR IMPAIRING DECISION-MAKING OR CHOICE
 TO OBTAIN CONSENT; AND (C) CANNOT BE INFERRED FROM INACTION.
   § 4. The general business law is amended by adding  two  new  sections
 349-g and 519-a to read as follows:
   § 349-G.  RESTRICTIONS ON APPLICATIONS FOR AND USE OF CREDIT CARDS AND
 MEDICAL FINANCIAL PRODUCTS. 1. FOR PURPOSES OF THIS SECTION, THE FOLLOW-
 ING TERMS SHALL HAVE THE FOLLOWING MEANINGS:
   (A)  "MEDICAL  FINANCIAL PRODUCTS" SHALL MEAN MEDICAL CREDIT CARDS AND
 THIRD-PARTY MEDICAL INSTALLMENT LOANS.
   (B) "HEALTH CARE PROVIDER"  SHALL  MEAN  A  HEALTH  CARE  PROFESSIONAL
 LICENSED,  REGISTERED OR CERTIFIED PURSUANT TO TITLE EIGHT OF THE EDUCA-
 TION LAW.
   (C) "PROVIDER OFFICES" SHALL MEAN EITHER OF THE FOLLOWING:
   (I) AN OFFICE OF A HEALTH CARE PROVIDER IN SOLO PRACTICE; OR
   (II) AN OFFICE IN WHICH SERVICES OR GOODS ARE PERSONALLY  PROVIDED  BY
 THE  HEALTH  CARE PROVIDER OR BY EMPLOYEES IN THAT OFFICE, OR PERSONALLY
 BY INDEPENDENT CONTRACTORS IN  THAT  OFFICE,  IN  ACCORDANCE  WITH  LAW.
 EMPLOYEES  AND  INDEPENDENT  CONTRACTORS  SHALL BE LICENSED OR CERTIFIED
 WHEN LICENSURE OR CERTIFICATION IS REQUIRED BY LAW.
   2. IT SHALL BE PROHIBITED FOR ANY INDIVIDUAL TO COMPLETE  ANY  PORTION
 OF  AN  APPLICATION  FOR  MEDICAL  FINANCIAL PRODUCTS FOR THE PATIENT OR
 OTHERWISE ARRANGE FOR OR ESTABLISH AN APPLICATION THAT IS NOT COMPLETELY
 FILLED OUT BY THE PATIENT.
   § 519-A. MEDICAL FINANCIAL PRODUCTS; PAYMENT FOR HEALTH CARE SERVICES.
 1. FOR PURPOSES OF THIS SECTION, THE  FOLLOWING  TERMS  SHALL  HAVE  THE
 FOLLOWING MEANINGS:
   (A)  "CREDIT  CARD"  SHALL  HAVE  THE  SAME MEANING AS IN SECTION FIVE
 HUNDRED ELEVEN OF THIS ARTICLE.
   (B) "MEDICAL CREDIT CARD" MEANS A CREDIT CARD ISSUED UNDER AN OPEN-END
 OR CLOSED-END PLAN OFFERED SPECIFICALLY FOR THE PAYMENT OF  HEALTH  CARE
 SERVICES, PRODUCTS, OR DEVICES PROVIDED TO A PERSON.
   2. NO HEALTH CARE PROVIDER SHALL REQUIRE CREDIT CARD PRE-AUTHORIZATION
 NOR REQUIRE THE PATIENT TO HAVE A CREDIT CARD ON FILE PRIOR TO PROVIDING
 EMERGENCY OR MEDICALLY NECESSARY MEDICAL SERVICES TO SUCH PATIENT.
   3.  HEALTH CARE PROVIDERS SHALL NOTIFY ALL PATIENTS ABOUT THE RISKS OF
 PAYING FOR MEDICAL SERVICES WITH A CREDIT CARD. SUCH NOTIFICATION  SHALL
 HIGHLIGHT  THE  FACT  THAT  BY  USING  A  CREDIT CARD TO PAY FOR MEDICAL
 SERVICES, THE PATIENT IS FORGOING STATE  AND  FEDERAL  PROTECTIONS  THAT
 REGARD MEDICAL DEBT.  THE COMMISSIONER OF HEALTH SHALL HAVE THE AUTHORI-
 TY  AND  SOLE  DISCRETION  TO  SET REQUIREMENTS FOR THE CONTENTS OF SUCH
 NOTICES.
 S. 8307                            80                            A. 8807
 
   § 5. This act shall take effect six months after it shall have  become
 a law.
 
                                  PART P
 
   Section  1.  Section  8  of  part  C of chapter 57 of the laws of 2022
 amending the public health law and the education law relating to  allow-
 ing  pharmacists  to  direct  limited service laboratories and order and
 administer COVID-19 and influenza tests and  modernizing  nurse  practi-
 tioners, is amended to read as follows:
   §  8.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2022; provided,
 however, that sections [one, two,] three[,] AND four[, six and seven] of
 this act shall expire and be deemed repealed [two years after  it  shall
 have become a law] APRIL 1, 2026.
   §  2.  Section 5 of chapter 21 of the laws of 2011 amending the educa-
 tion law relating to authorizing pharmacists  to  perform  collaborative
 drug  therapy management with physicians in certain settings, as amended
 by section 5 of part CC of chapter 57 of the laws of 2022, is amended to
 read as follows:
   § 5. This act shall take effect on the one hundred twentieth day after
 it shall have become a law[, provided, however, that the  provisions  of
 sections  two,  three,  and  four of this act shall expire and be deemed
 repealed July 1, 2024]; provided, however, that the amendments to subdi-
 vision 1 of section 6801 of the education law made  by  section  one  of
 this act shall be subject to the expiration and reversion of such subdi-
 vision  pursuant  to  section 8 of chapter 563 of the laws of 2008, when
 upon such date the provisions of section one-a of this  act  shall  take
 effect;  provided,  further,  that  effective immediately, the addition,
 amendment and/or repeal of any rule  or  regulation  necessary  for  the
 implementation  of  this  act  on  its effective date are authorized and
 directed to be made and completed on or before such effective date.
   § 3. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART Q
 
   Section 1. Section 6542 of the education law, as amended by chapter 48
 of  the  laws  of  2012, subdivisions 3 and 5 as amended by section 1 of
 part T of chapter 57 of the laws of 2013, is amended to read as follows:
   § 6542. Performance of medical services. 1. Notwithstanding any  other
 provision  of  law,  a physician assistant may perform medical services,
 but only when under the supervision of a physician and  only  when  such
 acts  and  duties  as are assigned to him or her are within the scope of
 practice of such supervising physician  UNLESS  OTHERWISE  PERMITTED  BY
 THIS SECTION.
   1-A. (A) A PHYSICIAN ASSISTANT MAY PRACTICE WITHOUT THE SUPERVISION OF
 A PHYSICIAN UNDER THE FOLLOWING CIRCUMSTANCES:
   (I)  WHERE  THE PHYSICIAN ASSISTANT, LICENSED UNDER SECTION SIXTY-FIVE
 HUNDRED FORTY-ONE OF THIS ARTICLE HAS  PRACTICED  FOR  MORE  THAN  EIGHT
 THOUSAND HOURS; AND
   (A)  IS  PRACTICING  IN  PRIMARY  CARE.   FOR PURPOSES OF THIS CLAUSE,
 "PRIMARY CARE" SHALL MEAN NON-SURGICAL CARE IN  THE  FIELDS  OF  GENERAL
 PEDIATRICS, GENERAL ADULT MEDICINE, GENERAL GERIATRIC  MEDICINE, GENERAL
 INTERNAL  MEDICINE,  OBSTETRICS AND GYNECOLOGY, FAMILY MEDICINE, OR SUCH
 OTHER RELATED AREAS AS DETERMINED BY THE COMMISSIONER OF HEALTH; OR
 S. 8307                            81                            A. 8807
 
   (B) IS EMPLOYED BY A HEALTH SYSTEM OR HOSPITAL ESTABLISHED UNDER ARTI-
 CLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW,  AND  THE  HEALTH  SYSTEM  OR
 HOSPITAL  DETERMINES THE PHYSICIAN ASSISTANT MEETS THE QUALIFICATIONS OF
 THE MEDICAL STAFF BYLAWS AND THE HEALTH SYSTEM  OR  HOSPITAL  GIVES  THE
 PHYSICIAN ASSISTANT PRIVILEGES; AND
   (II)  WHERE  A  PHYSICIAN  ASSISTANT LICENSED UNDER SECTION SIXTY-FIVE
 HUNDRED FORTY-ONE OF THIS ARTICLE HAS COMPLETED A  PROGRAM  APPROVED  BY
 THE DEPARTMENT OF HEALTH, IN CONSULTATION WITH THE DEPARTMENT, WHEN SUCH
 SERVICES ARE PERFORMED WITHIN THE SCOPE OF SUCH PROGRAM.
   (B)  THE  DEPARTMENT  AND  THE  DEPARTMENT OF HEALTH ARE AUTHORIZED TO
 PROMULGATE AND UPDATE REGULATIONS PURSUANT TO THIS SECTION.
   2. [Supervision] WHERE SUPERVISION IS REQUIRED  BY  THIS  SECTION,  IT
 shall  be continuous but shall not be construed as necessarily requiring
 the physical presence of the supervising physician at the time and place
 where such services are performed.
   3. [No physician shall employ or supervise more  than  four  physician
 assistants in his or her private practice.
   4.]  Nothing  in this article shall prohibit a hospital from employing
 physician assistants provided they [work  under  the  supervision  of  a
 physician  designated  by the hospital and not beyond the scope of prac-
 tice of such physician. The numerical limitation of subdivision three of
 this section shall not apply to services performed in a hospital.
   5. Notwithstanding any other provision of this article, nothing  shall
 prohibit a physician employed by or rendering services to the department
 of corrections and community supervision under contract from supervising
 no  more  than  six  physician assistants in his or her practice for the
 department of corrections and community supervision.
   6. Notwithstanding any  other  provision  of  law,  a  trainee  in  an
 approved  program  may  perform  medical services when such services are
 performed within the scope of such program.] MEET THE QUALIFICATIONS  OF
 THE MEDICAL STAFF BYLAWS AND ARE GIVEN PRIVILEGES AND OTHERWISE MEET THE
 REQUIREMENTS OF THIS SECTION.
   4.  A  PHYSICIAN ASSISTANT SHALL BE AUTHORIZED TO PRESCRIBE, DISPENSE,
 ORDER, ADMINISTER, OR PROCURE ITEMS NECESSARY TO COMMENCE OR COMPLETE  A
 COURSE OF THERAPY.
   5.  A  PHYSICIAN  ASSISTANT MAY PRESCRIBE AND ORDER A PATIENT SPECIFIC
 ORDER OR NON-PATIENT SPECIFIC REGIMEN TO A LICENSED PHARMACIST OR REGIS-
 TERED PROFESSIONAL NURSE, PURSUANT TO  REGULATIONS  PROMULGATED  BY  THE
 COMMISSIONER  OF  HEALTH, AND CONSISTENT WITH THE PUBLIC HEALTH LAW, FOR
 ADMINISTERING IMMUNIZATIONS. NOTHING IN THIS SUBDIVISION SHALL AUTHORIZE
 UNLICENSED PERSONS TO ADMINISTER IMMUNIZATIONS, VACCINES OR OTHER DRUGS.
   [7] 6. Nothing in this article, or  in  article  thirty-seven  of  the
 public  health law, shall be construed to authorize physician assistants
 to perform those specific functions and duties specifically delegated by
 law to those persons licensed as allied health professionals  under  the
 public health law or this chapter.
   §  2.  Subdivision  1  of  section  3701  of the public health law, as
 amended by chapter 48 of the  laws  of  2012,  is  amended  to  read  as
 follows:
   1.  to  promulgate  regulations  defining  and  restricting the duties
 [which may be assigned to] OF physician assistants [by their supervising
 physician, the degree of supervision required and the  manner  in  which
 such duties may be performed] CONSISTENT WITH SECTION SIXTY-FIVE HUNDRED
 FORTY-TWO OF THE EDUCATION LAW.;
   §  3.  Section 3702 of the public health law, as amended by chapter 48
 of the laws of 2012, is amended to read as follows:
 S. 8307                            82                            A. 8807
 
   § 3702. Special provisions. 1. Inpatient medical  orders.  A  licensed
 physician  assistant  employed or extended privileges by a hospital may,
 if permissible under the bylaws, rules and regulations of the  hospital,
 write  medical  orders,  including  those  for controlled substances AND
 DURABLE  MEDICAL EQUIPMENT, for inpatients [under the care of the physi-
 cian responsible for his or her supervision.  Countersignature  of  such
 orders may be required if deemed necessary and appropriate by the super-
 vising physician or the hospital, but in no event shall countersignature
 be required prior to execution].
   2.  Withdrawing  blood.  A  licensed  physician assistant or certified
 nurse practitioner acting within his or her lawful scope of practice may
 supervise and direct the withdrawal of blood for the purpose  of  deter-
 mining  the  alcoholic or drug content therein under subparagraph one of
 paragraph (a) of subdivision four of section eleven hundred  ninety-four
 of  the  vehicle  and  traffic law, notwithstanding any provision to the
 contrary in clause (ii) of such subparagraph.
   3. Prescriptions  for  controlled  substances.  A  licensed  physician
 assistant,  in  good  faith and acting within his or her lawful scope of
 practice, and to the extent assigned by his or her supervising physician
 AS APPLICABLE BY SECTION SIXTY-FIVE HUNDRED FORTY-TWO OF  THE  EDUCATION
 LAW, may prescribe controlled substances as a practitioner under article
 thirty-three  of this chapter, to patients under the care of such physi-
 cian responsible for  his  or  her  supervision.  The  commissioner,  in
 consultation  with  the  commissioner  of education, may promulgate such
 regulations as are necessary to carry out the purposes of this section.
   § 4. Section 3703 of the public health law, as amended by  chapter  48
 of the laws of 2012, is amended to read as follows:
   §  3703. Statutory construction. A physician assistant may perform any
 function in conjunction with a medical service lawfully performed by the
 physician assistant, in any health care setting, that a statute  author-
 izes  or  directs  a physician to perform and that is appropriate to the
 education, training and experience of the licensed  physician  assistant
 and within the ordinary practice of the supervising physician, AS APPLI-
 CABLE  PURSUANT TO SECTION SIXTY-FIVE HUNDRED FORTY-TWO OF THE EDUCATION
 LAW. This section shall not be construed to  increase  or  decrease  the
 lawful  scope  of  practice of a physician assistant under the education
 law.
   § 5. Paragraph a of subdivision 2 of section 902 of the education law,
 as amended by chapter 376 of the laws of 2015, is  amended  to  read  as
 follows:
   a.  The  board  of  education, and the trustee or board of trustees of
 each school district, shall employ, at a compensation to be agreed  upon
 by the parties, a qualified physician, A PHYSICIAN ASSISTANT, or a nurse
 practitioner  to  the  extent  authorized  by the nurse practice act and
 consistent with subdivision three of section six thousand  nine  hundred
 two  of  this  chapter,  to perform the duties of the director of school
 health services, including any duties conferred on the school  physician
 or  school  medical inspector under any provision of law, to perform and
 coordinate the provision of health services in the public schools and to
 provide health appraisals of students attending the  public  schools  in
 the  city  or  district.  The physicians, PHYSICIANS ASSISTANTS or nurse
 practitioners so employed shall be duly licensed pursuant to  applicable
 law.
   §  6.  Subdivision 5 of section 6810 of the education law, as added by
 chapter 881 of the laws of 1972, is amended to read as follows:
 S. 8307                            83                            A. 8807
 
   5. Records of all prescriptions filled or refilled shall be maintained
 for a period of at least five years and upon request made available  for
 inspection  and  copying  by  a  representative  of the department. Such
 records  shall  indicate  date  of  filling  or  refilling,   [doctor's]
 PRESCRIBER'S  name,  patient's name and address and the name or initials
 of  the  pharmacist  who  prepared,   compounded,   or   dispensed   the
 prescription.  Records  of prescriptions for controlled substances shall
 be maintained pursuant to requirements of article  thirty-three  of  the
 public health law.
   §  7.  Subdivision  27  of  section  3302 of the public health law, as
 amended by chapter 92 of the  laws  of  2021,  is  amended  to  read  as
 follows:
   27. "Practitioner" means:
   A  physician,  PHYSICIAN ASSISTANT, dentist, podiatrist, veterinarian,
 scientific investigator, or other person licensed, or otherwise  permit-
 ted  to  dispense,  administer  or  conduct  research  with respect to a
 controlled substance in the course of a licensed  professional  practice
 or  research  licensed  pursuant  to  this article. Such person shall be
 deemed a "practitioner" only as to such substances, or conduct  relating
 to  such  substances,  as is permitted by [his] THEIR license, permit or
 otherwise permitted by law.
   § 8. Section 6908 of the education law is  amended  by  adding  a  new
 subdivision 3 to read as follows:
   3.  THIS  ARTICLE  SHALL  NOT  BE  CONSTRUED AS PROHIBITING MEDICATION
 RELATED TASKS PROVIDED BY A CERTIFIED MEDICATION AIDE WORKING IN A RESI-
 DENTIAL HEALTH CARE FACILITY, AS DEFINED IN SECTION TWENTY-EIGHT HUNDRED
 ONE OF THE PUBLIC HEALTH LAW, IN ACCORDANCE WITH  REGULATIONS  DEVELOPED
 BY  THE  COMMISSIONER,  IN CONSULTATION WITH THE COMMISSIONER OF HEALTH.
 THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF HEALTH, SHALL
 ADOPT REGULATIONS GOVERNING CERTIFIED MEDICATION AIDES THAT, AT A  MINI-
 MUM, SHALL:
   A.  SPECIFY  THE  MEDICATION-RELATED  TASKS  THAT  MAY BE PERFORMED BY
 CERTIFIED MEDICATION AIDES PURSUANT  TO  THIS  SUBDIVISION.  SUCH  TASKS
 SHALL  INCLUDE  THE  ADMINISTRATION OF MEDICATIONS WHICH ARE ROUTINE AND
 PRE-FILLED OR OTHERWISE PACKAGED IN A MANNER THAT PROMOTES RELATIVE EASE
 OF  ADMINISTRATION,  PROVIDED  THAT  ADMINISTRATION  OF  MEDICATIONS  BY
 INJECTION,  STERILE  PROCEDURES,  AND  CENTRAL LINE MAINTENANCE SHALL BE
 PROHIBITED. PROVIDED, HOWEVER,  SUCH  PROHIBITION  SHALL  NOT  APPLY  TO
 INJECTIONS  OF  INSULIN  OR  OTHER  INJECTIONS  FOR  DIABETES  CARE,  TO
 INJECTIONS OF LOW MOLECULAR WEIGHT HEPARIN, AND TO  PRE-FILLED  AUTO-IN-
 JECTIONS  OF  NALOXONE  AND  EPINEPHRINE  FOR  EMERGENCY  PURPOSES,  AND
 PROVIDED, FURTHER, THAT ENTITIES EMPLOYING  CERTIFIED  MEDICATION  AIDES
 PURSUANT  TO  THIS  SUBDIVISION SHALL ESTABLISH A SYSTEMATIC APPROACH TO
 ADDRESS DRUG DIVERSION;
   B. PROVIDE THAT MEDICATION-RELATED TASKS PERFORMED BY CERTIFIED  MEDI-
 CATION AIDES MAY BE PERFORMED ONLY UNDER THE SUPERVISION OF A REGISTERED
 PROFESSIONAL  NURSE  LICENSED  IN  NEW  YORK STATE, AS SET FORTH IN THIS
 SUBDIVISION AND SUBDIVISION TWELVE OF SECTION SIXTY-NINE HUNDRED NINE OF
 THIS ARTICLE;
   C. ESTABLISH A PROCESS BY WHICH A REGISTERED  PROFESSIONAL  NURSE  MAY
 ASSIGN  MEDICATION-RELATED  TASKS  TO  A CERTIFIED MEDICATION AIDE. SUCH
 PROCESS SHALL INCLUDE, BUT NOT BE LIMITED TO:
   (I) ALLOWING ASSIGNMENT OF MEDICATION-RELATED  TASKS  TO  A  CERTIFIED
 MEDICATION  AIDE  ONLY  WHERE  SUCH CERTIFIED MEDICATION AIDE HAS DEMON-
 STRATED TO THE SATISFACTION OF THE SUPERVISING  REGISTERED  PROFESSIONAL
 NURSE  COMPETENCY  IN  EVERY MEDICATION-RELATED TASK THAT SUCH CERTIFIED
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 MEDICATION AIDE IS AUTHORIZED TO PERFORM, A WILLINGNESS TO PERFORM  SUCH
 MEDICATION-RELATED TASKS, AND THE ABILITY TO EFFECTIVELY AND EFFICIENTLY
 COMMUNICATE  WITH  THE INDIVIDUAL RECEIVING SERVICES AND UNDERSTAND SUCH
 INDIVIDUAL'S NEEDS;
   (II)  AUTHORIZING  THE  SUPERVISING  REGISTERED  PROFESSIONAL NURSE TO
 REVOKE ANY ASSIGNED MEDICATION-RELATED TASK FROM A CERTIFIED  MEDICATION
 AIDE FOR ANY REASON; AND
   (III)  AUTHORIZING  MULTIPLE REGISTERED PROFESSIONAL NURSES TO JOINTLY
 AGREE TO ASSIGN MEDICATION-RELATED TASKS TO A CERTIFIED MEDICATION AIDE,
 PROVIDED FURTHER THAT ONLY ONE REGISTERED PROFESSIONAL  NURSE  SHALL  BE
 REQUIRED  TO DETERMINE IF THE CERTIFIED MEDICATION AIDE HAS DEMONSTRATED
 COMPETENCY IN THE MEDICATION-RELATED TASK TO BE PERFORMED;
   D. PROVIDE THAT MEDICATION-RELATED TASKS  MAY  BE  PERFORMED  ONLY  IN
 ACCORDANCE  WITH  AND  PURSUANT  TO  AN AUTHORIZED HEALTH PRACTITIONER'S
 ORDERED CARE;
   E. PROVIDE THAT ONLY A CERTIFIED NURSE AIDE MAY PERFORM MEDICATION-RE-
 LATED TASKS AS A CERTIFIED MEDICATION AIDE WHEN SUCH AIDE HAS:
   (I) A VALID NEW YORK STATE NURSE AIDE CERTIFICATE;
   (II) A HIGH SCHOOL DIPLOMA, OR ITS EQUIVALENT;
   (III) EVIDENCE OF BEING AT LEAST EIGHTEEN YEARS OLD;
   (IV) AT LEAST ONE YEAR OF EXPERIENCE PROVIDING NURSE AIDE SERVICES  IN
 A  RESIDENTIAL HEALTH CARE FACILITY LICENSED PURSUANT TO ARTICLE TWENTY-
 EIGHT OF THE PUBLIC HEALTH LAW  OR  A  SIMILARLY  LICENSED  FACILITY  IN
 ANOTHER STATE OR UNITED STATES TERRITORY;
   (V) THE ABILITY TO READ, WRITE, AND SPEAK ENGLISH AND TO PERFORM BASIC
 MATH SKILLS;
   (VI) COMPLETED THE REQUISITE TRAINING AND DEMONSTRATED COMPETENCIES OF
 A  CERTIFIED MEDICATION AIDE AS DETERMINED BY THE COMMISSIONER OF HEALTH
 IN CONSULTATION WITH THE COMMISSIONER;
   (VII) SUCCESSFULLY COMPLETED COMPETENCY EXAMINATIONS  SATISFACTORY  TO
 THE COMMISSIONER OF HEALTH IN CONSULTATION WITH THE COMMISSIONER; AND
   (VIII)  MEETS  OTHER  APPROPRIATE  QUALIFICATIONS AS DETERMINED BY THE
 COMMISSIONER OF HEALTH IN CONSULTATION WITH THE COMMISSIONER;
   F. PROHIBIT A CERTIFIED MEDICATION AIDE FROM HOLDING  THEMSELVES  OUT,
 OR  ACCEPTING EMPLOYMENT AS, A PERSON LICENSED TO PRACTICE NURSING UNDER
 THE PROVISIONS OF THIS ARTICLE;
   G. PROVIDE THAT A  CERTIFIED  MEDICATION  AIDE  IS  NOT  REQUIRED  NOR
 PERMITTED TO ASSESS THE MEDICATION OR MEDICAL NEEDS OF AN INDIVIDUAL;
   H. PROVIDE THAT A CERTIFIED MEDICATION AIDE SHALL NOT BE AUTHORIZED TO
 PERFORM  ANY  MEDICATION-RELATED  TASKS  OR  ACTIVITIES PURSUANT TO THIS
 SUBDIVISION THAT ARE OUTSIDE THE SCOPE OF PRACTICE OF A LICENSED PRACTI-
 CAL NURSE OR ANY MEDICATION-RELATED TASKS THAT HAVE NOT  BEEN  APPROPRI-
 ATELY ASSIGNED BY THE SUPERVISING REGISTERED PROFESSIONAL NURSE;
   I. PROVIDE THAT A CERTIFIED MEDICATION AIDE SHALL DOCUMENT ALL MEDICA-
 TION-RELATED  TASKS  PROVIDED  TO  AN  INDIVIDUAL,  INCLUDING MEDICATION
 ADMINISTRATION TO EACH INDIVIDUAL THROUGH THE USE OF A MEDICATION ADMIN-
 ISTRATION RECORD; AND
   J. PROVIDE THAT THE SUPERVISING REGISTERED  PROFESSIONAL  NURSE  SHALL
 RETAIN  THE  DISCRETION  TO  DECIDE WHETHER TO ASSIGN MEDICATION-RELATED
 TASKS TO CERTIFIED MEDICATION AIDES UNDER THIS PROGRAM AND SHALL NOT  BE
 SUBJECT TO COERCION, RETALIATION, OR THE THREAT OF RETALIATION.
   §  9.  Section  6909 of the education law is amended by adding two new
 subdivisions 12 and 13 to read as follows:
   12. A REGISTERED PROFESSIONAL NURSE, WHILE WORKING FOR  A  RESIDENTIAL
 HEALTH  CARE  FACILITY  LICENSED PURSUANT TO ARTICLE TWENTY-EIGHT OF THE
 PUBLIC HEALTH LAW, MAY, IN  ACCORDANCE  WITH  THIS  SUBDIVISION,  ASSIGN
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 CERTIFIED MEDICATION AIDES TO PERFORM MEDICATION-RELATED TASKS FOR INDI-
 VIDUALS  PURSUANT  TO  THE  PROVISIONS  OF  SUBDIVISION THREE OF SECTION
 SIXTY-NINE HUNDRED EIGHT OF THIS ARTICLE AND SUPERVISE CERTIFIED MEDICA-
 TION AIDES WHO PERFORM ASSIGNED MEDICATION-RELATED TASKS.
   13.  NOTWITHSTANDING  SUBDIVISION  SEVEN OF SECTION SIXTY-FIVE HUNDRED
 NINE OF THIS TITLE, A CERTIFIED NURSE PRACTITIONER MAY  DIRECTLY  ASSIGN
 AND  SUPERVISE  A MEDICAL ASSISTANT IN AN OUTPATIENT SETTING THE TASK OF
 DRAWING AND  ADMINISTERING  IMMUNIZATIONS  TO  PATIENTS,  PROVIDED  SUCH
 MEDICAL ASSISTANT RECEIVES APPROPRIATE TRAINING FROM THE CERTIFIED NURSE
 PRACTITIONER  AND  THE  CERTIFIED NURSE PRACTITIONER REMAINS RESPONSIBLE
 FOR THE ACTIONS OF THE MEDICAL ASSISTANT.
   § 10. Paragraph (a) of subdivision 3 of section 2803-j of  the  public
 health  law,  as added by chapter 717 of the laws of 1989, is amended to
 read as follows:
   (a) Identification of individuals who have  successfully  completed  a
 nurse aide training and competency evaluation program, [or] a nurse aide
 competency evaluation program, OR A MEDICATION AIDE PROGRAM;
   §  11.  Section  6527  of the education law is amended by adding a new
 subdivision 12 to read as follows:
   12. NOTWITHSTANDING SUBDIVISION ELEVEN OF SECTION  SIXTY-FIVE  HUNDRED
 THIRTY  OF  THIS  TITLE,  A  LICENSED  PHYSICIAN MAY DIRECTLY ASSIGN AND
 SUPERVISE A MEDICAL ASSISTANT IN AN OUTPATIENT SETTING THE TASK OF DRAW-
 ING AND ADMINISTERING IMMUNIZATIONS TO PATIENTS, PROVIDED  SUCH  MEDICAL
 ASSISTANT  RECEIVES APPROPRIATE TRAINING FROM THE LICENSED PHYSICIAN AND
 THE LICENSED PHYSICIAN  REMAINS  RESPONSIBLE  FOR  THE  ACTIONS  OF  THE
 MEDICAL ASSISTANT.
   §  12.  Section 6545 of the education law, as amended by chapter 48 of
 the laws of 2012, is amended to read as follows:
   § 6545. [Emergency services rendered by physician  assistant]  SPECIAL
 PROVISIONS.  1. Notwithstanding any inconsistent provision of any gener-
 al,  special  or local law, any physician assistant properly licensed in
 this state who voluntarily  and  without  the  expectation  of  monetary
 compensation renders first aid or emergency treatment at the scene of an
 accident  or other emergency, outside a hospital, doctor's office or any
 other place having proper and necessary medical equipment, to  a  person
 who  is unconscious, ill or injured, shall not be liable for damages for
 injuries alleged to have been sustained by such person  or  for  damages
 for  the  death  of such person alleged to have occurred by reason of an
 act or omission in the rendering of such first aid or  emergency  treat-
 ment  unless it is established that such injuries were or such death was
 caused by gross negligence on the  part  of  such  physician  assistant.
 Nothing  in  this  section  shall  be  deemed  or construed to relieve a
 licensed physician assistant from liability for damages for injuries  or
 death  caused by an act or omission on the part of a physician assistant
 while rendering professional services in the normal and ordinary  course
 of his or her practice.
   2.  NOTWITHSTANDING  SUBDIVISION  ELEVEN OF SECTION SIXTY-FIVE HUNDRED
 THIRTY OF THIS TITLE, A LICENSED PHYSICIAN ASSISTANT AUTHORIZED PURSUANT
 TO SECTION SIXTY-FIVE HUNDRED FORTY-TWO  OF  THIS  ARTICLE  TO  PRACTICE
 WITHOUT  SUPERVISION OF A PHYSICIAN, MAY DIRECTLY ASSIGN AND SUPERVISE A
 MEDICAL ASSISTANT IN AN OUTPATIENT  SETTING  THE  TASK  OF  DRAWING  AND
 ADMINISTERING IMMUNIZATIONS TO PATIENTS, PROVIDED SUCH MEDICAL ASSISTANT
 RECEIVES  APPROPRIATE TRAINING FROM THE LICENSED PHYSICIAN ASSISTANT AND
 THE LICENSED PHYSICIAN ASSISTANT REMAINS RESPONSIBLE FOR THE ACTIONS  OF
 THE MEDICAL ASSISTANT.
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   §  13. Section 6601 of the education law, as amended by chapter 576 of
 the laws of 2001, is amended to read as follows:
   § 6601. Definition  of  practice  of  dentistry.  The  practice of the
 profession of dentistry is defined as diagnosing,  treating,  operating,
 or  prescribing  for  any  disease, pain, injury, deformity, or physical
 condition of the oral and maxillofacial area related  to  restoring  and
 maintaining  dental  health.  The  practice  of  dentistry  includes the
 prescribing and fabrication of dental  prostheses  and  appliances.  The
 practice  of  dentistry  may  include performing physical evaluations in
 conjunction with the provision of dental treatment, INCLUDING THE ADMIN-
 ISTRATION OF VACCINATIONS AGAINST INFLUENZA, SARS-COV-2, HUMAN  PAPILLO-
 MAVIRUS  (HPV),  AND  VACCINATIONS  RELATED  TO A DECLARED PUBLIC HEALTH
 EMERGENCY. THE PRACTICE OF DENTISTRY MAY ALSO INCLUDE OFFERING  OF  HIV,
 HEPATITIS C, AND HEMOGLOBIN A1C SCREENING OR DIAGNOSTIC TESTS.
   §  14. Section 6605-b of the education law, as added by chapter 437 of
 the laws of 2001 and subdivision 1 as amended by chapter 198 of the laws
 of 2022, is amended to read as follows:
   § 6605-b. Dental  hygiene  restricted  local  infiltration  AND  BLOCK
 anesthesia/nitrous  oxide  analgesia certificate.  1. A dental hygienist
 shall not administer or monitor nitrous oxide analgesia or local  infil-
 tration  OR BLOCK anesthesia in the practice of dental hygiene without a
 dental    hygiene    restricted    local    infiltration    AND    BLOCK
 anesthesia/nitrous  oxide  analgesia  certificate  and  except under the
 personal supervision of a dentist and  in  accordance  with  regulations
 promulgated  by  the commissioner. Personal supervision, for purposes of
 this section, means that the supervising dentist remains in  the  dental
 office where the local infiltration OR BLOCK anesthesia or nitrous oxide
 analgesia  services  are  being  performed,  personally  authorizes  and
 prescribes the use of local infiltration OR BLOCK anesthesia or  nitrous
 oxide  analgesia  for  the patient and, before dismissal of the patient,
 personally examines the condition of the patient after the use of  local
 infiltration   OR   BLOCK  anesthesia  or  nitrous  oxide  analgesia  is
 completed. It is professional  misconduct  for  a  dentist  to  fail  to
 provide  the supervision required by this section, and any dentist found
 guilty of such misconduct under the  procedures  prescribed  in  section
 sixty-five  hundred  ten of this title shall be subject to the penalties
 prescribed in section sixty-five hundred eleven of this title.
   2. The commissioner shall promulgate regulations  establishing  stand-
 ards and procedures for the issuance of such certificate. Such standards
 shall  require  completion  of  an  educational program and/or course of
 training or experience sufficient to ensure that a dental  hygienist  is
 specifically  trained  in  the  administration and monitoring of nitrous
 oxide analgesia and local infiltration OR BLOCK anesthesia, the possible
 effects of such use, and in the recognition of and response to  possible
 emergency situations.
   3.  The  fee  for  a  dental hygiene restricted local infiltration AND
 BLOCK anesthesia/nitrous oxide analgesia certificate  shall  be  twenty-
 five dollars and shall be paid on a triennial basis upon renewal of such
 certificate.  A  certificate  may  be  suspended  or revoked in the same
 manner as a license to practice dental hygiene.
   § 15. Subdivision 1 of section 6606 of the education law,  as  amended
 by chapter 239 of the laws of 2013, is amended to read as follows:
   1.  The practice of the profession of dental hygiene is defined as the
 performance of dental services which shall include  removing  calcareous
 deposits,  accretions  and stains from the exposed surfaces of the teeth
 which begin at the epithelial attachment  and  applying  topical  agents
 S. 8307                            87                            A. 8807
 
 indicated for a complete dental prophylaxis, removing cement, placing or
 removing  rubber  dam,  removing sutures, placing matrix band, providing
 patient education, applying topical medication, PLACING  PRE-FIT  ORTHO-
 DONTIC  BANDS, USING LIGHT-CURE COMPOSITE MATERIAL, TAKING CEPHALOMETRIC
 RADIOGRAPHS, TAKING TWO-DIMENSIONAL AND THREE-DIMENSIONAL PHOTOGRAPHY OF
 DENTITION, ADJUSTING REMOVABLE APPLIANCES INCLUDING NIGHTGUARDS, BLEACH-
 ING TRAYS, RETAINERS  AND  DENTURES,  placing  and  exposing  diagnostic
 dental X-ray films, performing topical fluoride applications and topical
 anesthetic applications, polishing teeth, taking medical history, chart-
 ing  caries,  taking  impressions  for study casts, placing and removing
 temporary  restorations,  administering  and  monitoring  nitrous  oxide
 analgesia  and administering and monitoring local infiltration AND BLOCK
 anesthesia, subject to certification in accordance with  section  sixty-
 six  hundred five-b of this article, and any other function in the defi-
 nition of the practice of dentistry as may be delegated  by  a  licensed
 dentist  in accordance with regulations promulgated by the commissioner.
 The practice of dental hygiene may be conducted in  the  office  of  any
 licensed  dentist  or  in  any  appropriately  equipped school or public
 institution but must be done either under the supervision of a  licensed
 dentist  or,  in the case of a registered dental hygienist working for a
 hospital as defined in article twenty-eight of the public health  law[,]
 OR  pursuant  to  a collaborative arrangement with a licensed and regis-
 tered dentist [who has a formal relationship  with  the  same  hospital]
 PURSUANT  TO  SECTION  SIXTY-SIX  HUNDRED SEVEN-A OF THIS ARTICLE AND in
 accordance with regulations promulgated by the department  in  consulta-
 tion  with  the  department  of  health. [Such collaborative arrangement
 shall not obviate or supersede any  law  or  regulation  which  requires
 identified  services to be performed under the personal supervision of a
 dentist. When dental hygiene services are provided pursuant to a  colla-
 borative  agreement, such dental hygienist shall instruct individuals to
 visit a licensed dentist for comprehensive examination or treatment.]
   § 16. The education law is amended by adding a new section  6607-a  to
 read as follows:
   § 6607-A. PRACTICE OF COLLABORATIVE PRACTICE DENTAL HYGIENE AND USE OF
 TITLE "REGISTERED DENTAL HYGIENIST, COLLABORATIVE PRACTICE" (RDH-CP). 1.
 THE  PRACTICE OF THE PROFESSION OF DENTAL HYGIENE, AS DEFINED UNDER THIS
 ARTICLE, MAY BE PERFORMED  IN  COLLABORATION  WITH  A  LICENSED  DENTIST
 PROVIDED  SUCH SERVICES ARE PERFORMED IN ACCORDANCE WITH A WRITTEN PRAC-
 TICE AGREEMENT AND WRITTEN PRACTICE PROTOCOLS TO BE KNOWN AS A  COLLABO-
 RATIVE  PRACTICE  AGREEMENT.  UNDER  A COLLABORATIVE PRACTICE AGREEMENT,
 DENTAL HYGIENISTS MAY PERFORM ALL SERVICES WHICH ARE DESIGNATED IN REGU-
 LATION WITHOUT PRIOR EVALUATION OF A DENTIST OR MEDICAL PROFESSIONAL AND
 MAY  BE  PERFORMED  WITHOUT  SUPERVISION  IN  A  COLLABORATIVE  PRACTICE
 SETTING.
   2.  (A)  THE  COLLABORATIVE PRACTICE AGREEMENT SHALL INCLUDE CONSIDER-
 ATION FOR MEDICALLY COMPROMISED PATIENTS, SPECIFIC  MEDICAL  CONDITIONS,
 AND  AGE-AND  PROCEDURE-SPECIFIC  PRACTICE PROTOCOLS, INCLUDING, BUT NOT
 LIMITED TO RECOMMENDED INTERVALS FOR THE PERFORMANCE OF  DENTAL  HYGIENE
 SERVICES  AND  A PERIODICITY IN WHICH AN EXAMINATION BY A DENTIST SHOULD
 OCCUR.
   (B) THE COLLABORATIVE AGREEMENT SHALL BE:
   (I) SIGNED AND MAINTAINED BY THE DENTIST, THE  DENTAL  HYGIENIST,  AND
 THE FACILITY, PROGRAM, OR ORGANIZATION;
   (II) REVIEWED ANNUALLY BY THE COLLABORATING DENTIST AND DENTAL HYGIEN-
 IST; AND
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   (III)  MADE  AVAILABLE  TO THE DEPARTMENT AND OTHER INTERESTED PARTIES
 UPON REQUEST.
   (C)  ONLY ONE AGREEMENT BETWEEN A COLLABORATING DENTIST AND REGISTERED
 DENTAL HYGIENIST, COLLABORATIVE PRACTICE (RDH-CP) MAY BE IN FORCE  AT  A
 TIME.
   3.  BEFORE  PERFORMING  ANY  SERVICES AUTHORIZED UNDER THIS SECTION, A
 DENTAL HYGIENIST SHALL PROVIDE THE  PATIENT  WITH  A  WRITTEN  STATEMENT
 ADVISING THE PATIENT THAT THE DENTAL HYGIENE SERVICES PROVIDED ARE NOT A
 SUBSTITUTE  FOR A DENTAL EXAMINATION BY A LICENSED DENTIST AND INSTRUCT-
 ING INDIVIDUALS TO VISIT A LICENSED DENTIST FOR  COMPREHENSIVE  EXAMINA-
 TION  OR  TREATMENT.  IF THE DENTAL HYGIENIST MAKES ANY REFERRALS TO THE
 PATIENT FOR FURTHER DENTAL PROCEDURES, THE DENTAL  HYGIENIST  MUST  FILL
 OUT  A REFERRAL FORM AND PROVIDE A COPY OF THE FORM TO THE COLLABORATING
 DENTIST.
   4. THE COLLABORATIVE  PRACTICE  DENTAL  HYGIENIST  MAY  ENTER  INTO  A
 CONTRACTUAL  ARRANGEMENT WITH ANY NEW YORK STATE LICENSED AND REGISTERED
 DENTIST, HEALTH CARE FACILITY, PROGRAM, AND/OR  NON-PROFIT  ORGANIZATION
 TO  PERFORM  DENTAL  HYGIENE  SERVICES IN THE FOLLOWING SETTINGS: DENTAL
 OFFICES; LONG-TERM CARE FACILITIES/SKILLED NURSING FACILITIES; PUBLIC OR
 PRIVATE  SCHOOLS;  PUBLIC  HEALTH  AGENCIES/FEDERALLY  QUALIFIED  HEALTH
 CENTERS;  CORRECTIONAL  FACILITIES;  PUBLIC  INSTITUTIONS/MENTAL  HEALTH
 FACILITIES; DRUG TREATMENT FACILITIES; AND DOMESTIC VIOLENCE SHELTERS.
   5. A COLLABORATING DENTIST SHALL HAVE COLLABORATIVE AGREEMENTS WITH NO
 MORE THAN SIX COLLABORATIVE PRACTICE DENTAL HYGIENISTS.  THE  DEPARTMENT
 MAY  GRANT EXCEPTIONS TO THESE LIMITATIONS FOR PUBLIC HEALTH SETTINGS ON
 A CASE-BY-CASE BASIS.
   6. A DENTAL HYGIENIST MUST MAKE APPLICATION TO THE DEPARTMENT TO PRAC-
 TICE AS A REGISTERED DENTAL HYGIENIST, COLLABORATIVE  PRACTICE  (RDH-CP)
 AND  PAY  A  FEE  SET BY THE DEPARTMENT. AS A CONDITION OF COLLABORATIVE
 PRACTICE, THE DENTAL HYGIENIST SHALL HAVE BEEN ENGAGED IN  PRACTICE  FOR
 AT  LEAST THREE YEARS WITH A MINIMUM OF FOUR THOUSAND FIVE HUNDRED PRAC-
 TICE HOURS AND SHALL COMPLETE AN EIGHT HOUR CONTINUING EDUCATION PROGRAM
 THAT INCLUDES INSTRUCTION IN MEDICAL EMERGENCY PROCEDURES, RISK  MANAGE-
 MENT, DENTAL HYGIENE JURISPRUDENCE AND PROFESSIONAL ETHICS.
   §  17.  This  act shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024; provided,
 however, that sections one through seven of this act shall  take  effect
 one year after this act shall have become a law.
 
                                  PART R
 
   Section 1. The education law is amended by adding a new article 169 to
 read as follows:
                                ARTICLE 169
                   INTERSTATE MEDICAL LICENSURE COMPACT
 SECTION 8860. SHORT TITLE.
         8861. PURPOSE.
         8862. DEFINITIONS.
         8863. ELIGIBILITY.
         8864. DESIGNATION OF STATE OF PRINCIPAL LICENSE.
         8865. APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE.
         8866. FEES FOR EXPEDITED LICENSURE.
         8867. RENEWAL AND CONTINUED PARTICIPATION.
         8868. COORDINATED INFORMATION SYSTEM.
         8869. JOINT INVESTIGATIONS.
         8870. DISCIPLINARY ACTIONS.
 S. 8307                            89                            A. 8807

         8871. INTERSTATE MEDICAL LICENSURE COMPACT COMMISSION.
         8872. POWERS AND DUTIES OF THE INTERSTATE COMMISSION.
         8873. FINANCE POWERS.
         8874. ORGANIZATION AND OPERATION OF THE INTERSTATE COMMISSION.
         8875. RULEMAKING FUNCTIONS OF THE INTERSTATE COMMISSION.
         8876. OVERSIGHT OF INTERSTATE COMPACT.
         8877. ENFORCEMENT OF INTERSTATE COMPACT.
         8878. DEFAULT PROCEDURES.
         8879. DISPUTE RESOLUTION.
         8880. MEMBER STATES, EFFECTIVE DATE AND AMENDMENT.
         8881. WITHDRAWAL.
         8882. DISSOLUTION.
         8883. SEVERABILITY AND CONSTRUCTION.
         8884. BINDING EFFECT OF COMPACT AND OTHER LAWS.
   § 8860. SHORT  TITLE.  THIS ARTICLE SHALL BE KNOWN AND MAY BE CITED AS
 THE "INTERSTATE MEDICAL LICENSURE COMPACT".
   § 8861. PURPOSE. IN ORDER TO STRENGTHEN ACCESS TO HEALTH CARE, AND  IN
 RECOGNITION  OF  THE ADVANCES IN THE DELIVERY OF HEALTH CARE, THE MEMBER
 STATES OF THE INTERSTATE MEDICAL LICENSURE COMPACT HAVE ALLIED IN COMMON
 PURPOSE TO DEVELOP A COMPREHENSIVE PROCESS THAT COMPLEMENTS THE EXISTING
 LICENSING AND REGULATORY AUTHORITY OF STATE MEDICAL BOARDS,  PROVIDES  A
 STREAMLINED  PROCESS THAT ALLOWS PHYSICIANS TO BECOME LICENSED IN MULTI-
 PLE STATES, THEREBY ENHANCING THE PORTABILITY OF A MEDICAL  LICENSE  AND
 ENSURING  THE  SAFETY OF PATIENTS.   THE COMPACT CREATES ANOTHER PATHWAY
 FOR LICENSURE AND DOES NOT OTHERWISE CHANGE A STATE'S  EXISTING  MEDICAL
 PRACTICE ACT. THE COMPACT ALSO ADOPTS THE PREVAILING STANDARD FOR LICEN-
 SURE  AND AFFIRMS THAT THE PRACTICE OF MEDICINE OCCURS WHERE THE PATIENT
 IS LOCATED AT THE TIME OF THE PHYSICIAN-PATIENT  ENCOUNTER,  AND  THERE-
 FORE,  REQUIRES  THE PHYSICIAN TO BE UNDER THE JURISDICTION OF THE STATE
 MEDICAL BOARD WHERE THE PATIENT IS LOCATED. STATE  MEDICAL  BOARDS  THAT
 PARTICIPATE  IN THE COMPACT RETAIN THE JURISDICTION TO IMPOSE AN ADVERSE
 ACTION AGAINST A LICENSE TO PRACTICE MEDICINE IN THAT STATE ISSUED TO  A
 PHYSICIAN THROUGH THE PROCEDURES IN THE COMPACT.
   § 8862. DEFINITIONS. IN THIS COMPACT:
   1.  "BYLAWS"  MEANS THOSE BYLAWS ESTABLISHED BY THE INTERSTATE COMMIS-
 SION PURSUANT TO SECTION EIGHTY-EIGHT HUNDRED SEVENTY-ONE OF THIS  ARTI-
 CLE FOR ITS GOVERNANCE, OR FOR DIRECTING AND CONTROLLING ITS ACTIONS AND
 CONDUCT.
   2.  "COMMISSIONER"  MEANS  THE VOTING REPRESENTATIVE APPOINTED BY EACH
 MEMBER BOARD PURSUANT TO SECTION  EIGHTY-EIGHT  HUNDRED  SEVENTY-ONE  OF
 THIS ARTICLE.
   3. "CONVICTION" MEANS A FINDING BY A COURT THAT AN INDIVIDUAL IS GUIL-
 TY  OF  A  CRIMINAL  OFFENSE THROUGH ADJUDICATION, OR ENTRY OF A PLEA OF
 GUILT OR NO CONTEST TO THE CHARGE BY THE OFFENDER. EVIDENCE OF AN  ENTRY
 OF  A  CONVICTION OF A CRIMINAL OFFENSE BY THE COURT SHALL BE CONSIDERED
 FINAL FOR PURPOSES OF DISCIPLINARY ACTION BY A MEMBER BOARD.
   4. "EXPEDITED LICENSE" MEANS A FULL AND UNRESTRICTED  MEDICAL  LICENSE
 GRANTED  BY  A MEMBER STATE TO AN ELIGIBLE PHYSICIAN THROUGH THE PROCESS
 SET FORTH IN THE COMPACT.
   5. "INTERSTATE COMMISSION" MEANS  THE  INTERSTATE  COMMISSION  CREATED
 PURSUANT TO SECTION EIGHTY-EIGHT HUNDRED SEVENTY-ONE OF THIS ARTICLE.
   6.  "LICENSE" MEANS AUTHORIZATION BY A MEMBER STATE FOR A PHYSICIAN TO
 ENGAGE IN THE PRACTICE OF MEDICINE,  WHICH  WOULD  BE  UNLAWFUL  WITHOUT
 AUTHORIZATION.
   7.  "MEDICAL  PRACTICE  ACT"  MEANS LAWS AND REGULATIONS GOVERNING THE
 PRACTICE OF ALLOPATHIC AND OSTEOPATHIC MEDICINE WITHIN A MEMBER STATE.
 S. 8307                            90                            A. 8807

   8. "MEMBER BOARD" MEANS A STATE AGENCY IN A MEMBER STATE THAT ACTS  IN
 THE  SOVEREIGN  INTERESTS  OF THE STATE BY PROTECTING THE PUBLIC THROUGH
 LICENSURE, REGULATION, AND EDUCATION OF PHYSICIANS AS  DIRECTED  BY  THE
 STATE GOVERNMENT.
   9. "MEMBER STATE" MEANS A STATE THAT HAS ENACTED THE COMPACT.
   10.  "PRACTICE  OF MEDICINE" MEANS THE CLINICAL PREVENTION, DIAGNOSIS,
 OR TREATMENT OF HUMAN DISEASE, INJURY, OR CONDITION REQUIRING  A  PHYSI-
 CIAN  TO  OBTAIN  AND  MAINTAIN A LICENSE IN COMPLIANCE WITH THE MEDICAL
 PRACTICE ACT OF A MEMBER STATE.
   11. "PHYSICIAN" MEANS ANY PERSON WHO:
   (A) IS A GRADUATE OF  A  MEDICAL  SCHOOL  ACCREDITED  BY  THE  LIAISON
 COMMITTEE  ON  MEDICAL  EDUCATION, THE COMMISSION ON OSTEOPATHIC COLLEGE
 ACCREDITATION, OR A MEDICAL SCHOOL LISTED IN THE  INTERNATIONAL  MEDICAL
 EDUCATION DIRECTORY OR ITS EQUIVALENT;
   (B) PASSED EACH COMPONENT OF THE UNITED STATES MEDICAL LICENSING EXAM-
 INATION (USMLE) OR THE COMPREHENSIVE OSTEOPATHIC MEDICAL LICENSING EXAM-
 INATION  (COMLEX-USA)  WITHIN  THREE ATTEMPTS, OR ANY OF ITS PREDECESSOR
 EXAMINATIONS ACCEPTED BY A STATE MEDICAL BOARD AS AN EQUIVALENT EXAMINA-
 TION FOR LICENSURE PURPOSES;
   (C) SUCCESSFULLY COMPLETED GRADUATE MEDICAL EDUCATION APPROVED BY  THE
 ACCREDITATION  COUNCIL  FOR  GRADUATE  MEDICAL EDUCATION OR THE AMERICAN
 OSTEOPATHIC ASSOCIATION;
   (D)  HOLDS  SPECIALTY  CERTIFICATION  OR  A  TIME-UNLIMITED  SPECIALTY
 CERTIFICATE  RECOGNIZED  BY THE AMERICAN BOARD OF MEDICAL SPECIALTIES OR
 THE AMERICAN OSTEOPATHIC ASSOCIATION'S BUREAU  OF  OSTEOPATHIC  SPECIAL-
 ISTS;
   (E)  POSSESSES  A FULL AND UNRESTRICTED LICENSE TO ENGAGE IN THE PRAC-
 TICE OF MEDICINE ISSUED BY A MEMBER BOARD;
   (F) HAS NEVER BEEN CONVICTED, RECEIVED ADJUDICATION, DEFERRED  ADJUDI-
 CATION,  COMMUNITY  SUPERVISION, OR DEFERRED DISPOSITION FOR ANY OFFENSE
 BY A COURT OF APPROPRIATE JURISDICTION;
   (G) HAS NEVER HELD A LICENSE  AUTHORIZING  THE  PRACTICE  OF  MEDICINE
 SUBJECTED  TO DISCIPLINE BY A LICENSING AGENCY IN ANY STATE, FEDERAL, OR
 FOREIGN JURISDICTION, EXCLUDING ANY ACTION  RELATED  TO  NON-PAYMENT  OF
 FEES RELATED TO A LICENSE;
   (H)  HAS  NEVER HAD A CONTROLLED SUBSTANCE LICENSE OR PERMIT SUSPENDED
 OR REVOKED BY A STATE OR THE UNITED  STATES  DRUG  ENFORCEMENT  ADMINIS-
 TRATION; AND
   (I)  IS  NOT  UNDER  ACTIVE INVESTIGATION BY A LICENSING AGENCY OR LAW
 ENFORCEMENT AUTHORITY IN ANY STATE, FEDERAL, OR FOREIGN JURISDICTION.
   12. "OFFENSE" MEANS A FELONY, GROSS MISDEMEANOR,  OR  CRIME  OF  MORAL
 TURPITUDE.
   13.  "RULE"  MEANS  A  WRITTEN  STATEMENT BY THE INTERSTATE COMMISSION
 PROMULGATED PURSUANT TO SECTION EIGHTY-EIGHT HUNDRED SEVENTY-TWO OF THIS
 ARTICLE THAT IS OF GENERAL  APPLICABILITY,  IMPLEMENTS,  INTERPRETS,  OR
 PRESCRIBES  A  POLICY OR PROVISION OF THE COMPACT, OR AN ORGANIZATIONAL,
 PROCEDURAL, OR PRACTICE REQUIREMENT OF THE  INTERSTATE  COMMISSION,  AND
 HAS  THE  FORCE  AND  EFFECT  OF  STATUTORY  LAW  IN A MEMBER STATE, AND
 INCLUDES THE AMENDMENT, REPEAL, OR SUSPENSION OF AN EXISTING RULE.
   14. "STATE" MEANS ANY STATE, COMMONWEALTH, DISTRICT, OR  TERRITORY  OF
 THE UNITED STATES.
   15.  "STATE  OF PRINCIPAL LICENSE" MEANS A MEMBER STATE WHERE A PHYSI-
 CIAN HOLDS A LICENSE TO PRACTICE MEDICINE AND WHICH HAS BEEN  DESIGNATED
 AS  SUCH BY THE PHYSICIAN FOR PURPOSES OF REGISTRATION AND PARTICIPATION
 IN THE COMPACT.
 S. 8307                            91                            A. 8807

   § 8863. ELIGIBILITY. 1. A PHYSICIAN MUST MEET THE ELIGIBILITY REQUIRE-
 MENTS AS DEFINED IN SUBDIVISION ELEVEN OF SECTION  EIGHTY-EIGHT  HUNDRED
 SIXTY-TWO  OF  THIS  ARTICLE  TO  RECEIVE AN EXPEDITED LICENSE UNDER THE
 TERMS AND PROVISIONS OF THE COMPACT.
   2. A PHYSICIAN WHO DOES NOT MEET THE REQUIREMENTS OF SUBDIVISION ELEV-
 EN  OF SECTION EIGHTY-EIGHT HUNDRED SIXTY-TWO OF THIS ARTICLE MAY OBTAIN
 A LICENSE TO PRACTICE MEDICINE IN  A  MEMBER  STATE  IF  THE  INDIVIDUAL
 COMPLIES  WITH ALL LAWS AND REQUIREMENTS, OTHER THAN THE COMPACT, RELAT-
 ING TO THE ISSUANCE OF A LICENSE TO PRACTICE MEDICINE IN THAT STATE.
   § 8864. DESIGNATION OF STATE OF  PRINCIPAL  LICENSE.  1.  A  PHYSICIAN
 SHALL  DESIGNATE  A  MEMBER  STATE AS THE STATE OF PRINCIPAL LICENSE FOR
 PURPOSES OF REGISTRATION FOR EXPEDITED LICENSURE THROUGH THE COMPACT  IF
 THE  PHYSICIAN  POSSESSES  A  FULL  AND UNRESTRICTED LICENSE TO PRACTICE
 MEDICINE IN THAT STATE, AND THE STATE IS:
   (A) THE STATE OF PRINCIPAL RESIDENCE FOR THE PHYSICIAN, OR
   (B) THE STATE WHERE AT LEAST TWENTY-FIVE PERCENT OF  THE  PRACTICE  OF
 MEDICINE OCCURS, OR
   (C) THE LOCATION OF THE PHYSICIAN'S EMPLOYER, OR
   (D)  IF  NO  STATE  QUALIFIES UNDER PARAGRAPH (A), (B), OR (C) OF THIS
 SUBDIVISION, THE STATE DESIGNATED AS STATE OF RESIDENCE FOR  PURPOSE  OF
 FEDERAL INCOME TAX.
   2.  A  PHYSICIAN  MAY REDESIGNATE A MEMBER STATE AS STATE OF PRINCIPAL
 LICENSE AT ANY TIME, AS LONG AS THE  STATE  MEETS  THE  REQUIREMENTS  OF
 SUBDIVISION ONE OF THIS SECTION.
   3. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES TO FACILI-
 TATE  REDESIGNATION  OF  ANOTHER  MEMBER STATE AS THE STATE OF PRINCIPAL
 LICENSE.
   § 8865. APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE. 1.  A  PHYSI-
 CIAN SEEKING LICENSURE THROUGH THE COMPACT SHALL FILE AN APPLICATION FOR
 AN  EXPEDITED LICENSE WITH THE MEMBER BOARD OF THE STATE SELECTED BY THE
 PHYSICIAN AS THE STATE OF PRINCIPAL LICENSE.
   2. UPON RECEIPT OF AN APPLICATION FOR AN EXPEDITED LICENSE, THE MEMBER
 BOARD WITHIN THE STATE SELECTED AS THE STATE OF PRINCIPAL LICENSE  SHALL
 EVALUATE  WHETHER  THE PHYSICIAN IS ELIGIBLE FOR EXPEDITED LICENSURE AND
 ISSUE A LETTER OF QUALIFICATION, VERIFYING OR  DENYING  THE  PHYSICIAN'S
 ELIGIBILITY, TO THE INTERSTATE COMMISSION.
   (A)  STATIC  QUALIFICATIONS,  WHICH  INCLUDE  VERIFICATION  OF MEDICAL
 EDUCATION, GRADUATE MEDICAL EDUCATION, RESULTS OF ANY MEDICAL OR LICENS-
 ING EXAMINATION, AND OTHER QUALIFICATIONS AS DETERMINED  BY  THE  INTER-
 STATE COMMISSION THROUGH RULE, SHALL NOT BE SUBJECT TO ADDITIONAL PRIMA-
 RY  SOURCE  VERIFICATION  WHERE  ALREADY  PRIMARY SOURCE VERIFIED BY THE
 STATE OF PRINCIPAL LICENSE.
   (B) THE MEMBER BOARD WITHIN THE STATE SELECTED AS THE STATE OF PRINCI-
 PAL LICENSE SHALL, IN THE COURSE OF  VERIFYING  ELIGIBILITY,  PERFORM  A
 CRIMINAL  BACKGROUND  CHECK  OF  AN  APPLICANT, INCLUDING THE USE OF THE
 RESULTS OF FINGERPRINT OR OTHER BIOMETRIC DATA CHECKS COMPLIANT WITH THE
 REQUIREMENTS OF THE FEDERAL BUREAU OF INVESTIGATION, WITH THE  EXCEPTION
 OF  FEDERAL  EMPLOYEES  WHO HAVE SUITABILITY DETERMINATION IN ACCORDANCE
 WITH U.S. C.F.R. § 731.202.
   (C) APPEAL ON THE DETERMINATION OF ELIGIBILITY SHALL BE  MADE  TO  THE
 MEMBER STATE WHERE THE APPLICATION WAS FILED AND SHALL BE SUBJECT TO THE
 LAW OF THAT STATE.
   3. UPON VERIFICATION UNDER SUBDIVISION TWO OF THIS SECTION, PHYSICIANS
 ELIGIBLE  FOR AN EXPEDITED LICENSE SHALL COMPLETE THE REGISTRATION PROC-
 ESS ESTABLISHED BY THE INTERSTATE COMMISSION TO RECEIVE A LICENSE  IN  A
 S. 8307                            92                            A. 8807
 
 MEMBER  STATE  SELECTED  PURSUANT  TO  SUBDIVISION  ONE OF THIS SECTION,
 INCLUDING THE PAYMENT OF ANY APPLICABLE FEES.
   4.  AFTER  RECEIVING VERIFICATION OF ELIGIBILITY UNDER SUBDIVISION TWO
 OF THIS SECTION AND ANY FEES UNDER SUBDIVISION THREE OF THIS SECTION,  A
 MEMBER  BOARD  SHALL  ISSUE  AN EXPEDITED LICENSE TO THE PHYSICIAN. THIS
 LICENSE SHALL AUTHORIZE THE PHYSICIAN TO PRACTICE MEDICINE IN THE  ISSU-
 ING  STATE  CONSISTENT  WITH THE MEDICAL PRACTICE ACT AND ALL APPLICABLE
 LAWS AND REGULATIONS OF THE ISSUING MEMBER BOARD AND MEMBER STATE.
   5. AN EXPEDITED LICENSE SHALL BE VALID FOR A  PERIOD  CONSISTENT  WITH
 THE  LICENSURE  PERIOD  IN  THE  MEMBER  STATE AND IN THE SAME MANNER AS
 REQUIRED FOR OTHER PHYSICIANS HOLDING A FULL  AND  UNRESTRICTED  LICENSE
 WITHIN THE MEMBER STATE.
   6.  AN  EXPEDITED  LICENSE OBTAINED THOUGH THE COMPACT SHALL BE TERMI-
 NATED IF A PHYSICIAN FAILS TO MAINTAIN A LICENSE IN THE STATE OF PRINCI-
 PAL LICENSURE FOR A NON-DISCIPLINARY REASON, WITHOUT REDESIGNATION OF  A
 NEW STATE OF PRINCIPAL LICENSURE.
   7.  THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES REGARDING
 THE APPLICATION PROCESS, INCLUDING PAYMENT OF ANY APPLICABLE  FEES,  AND
 THE ISSUANCE OF AN EXPEDITED LICENSE.
   § 8866. FEES  FOR  EXPEDITED  LICENSURE.  1. A MEMBER STATE ISSUING AN
 EXPEDITED LICENSE AUTHORIZING THE PRACTICE OF MEDICINE IN THAT STATE MAY
 IMPOSE A FEE FOR A LICENSE ISSUED OR RENEWED THROUGH THE COMPACT.
   2. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES  REGARDING
 FEES FOR EXPEDITED LICENSES.
   § 8867. RENEWAL AND CONTINUED PARTICIPATION. 1. A PHYSICIAN SEEKING TO
 RENEW  AN  EXPEDITED  LICENSE GRANTED IN A MEMBER STATE SHALL COMPLETE A
 RENEWAL PROCESS WITH THE INTERSTATE COMMISSION IF THE PHYSICIAN:
   (A) MAINTAINS A FULL AND UNRESTRICTED LICENSE IN A STATE OF  PRINCIPAL
 LICENSE;
   (B)  HAS  NOT  BEEN CONVICTED, RECEIVED ADJUDICATION, DEFERRED ADJUDI-
 CATION, COMMUNITY SUPERVISION, OR DEFERRED DISPOSITION FOR  ANY  OFFENSE
 BY A COURT OF APPROPRIATE JURISDICTION;
   (C) HAS NOT HAD A LICENSE AUTHORIZING THE PRACTICE OF MEDICINE SUBJECT
 TO  DISCIPLINE  BY  A LICENSING AGENCY IN ANY STATE, FEDERAL, OR FOREIGN
 JURISDICTION, EXCLUDING  ANY  ACTION  RELATED  TO  NON-PAYMENT  OF  FEES
 RELATED TO A LICENSE; AND
   (D)  HAS NOT HAD A CONTROLLED SUBSTANCE LICENSE OR PERMIT SUSPENDED OR
 REVOKED BY A STATE OR THE UNITED STATES DRUG ENFORCEMENT ADMINISTRATION.
   2. PHYSICIANS SHALL COMPLY WITH ALL CONTINUING  PROFESSIONAL  DEVELOP-
 MENT  OR  CONTINUING  MEDICAL  EDUCATION  REQUIREMENTS  FOR RENEWAL OF A
 LICENSE ISSUED BY A MEMBER STATE.
   3. THE INTERSTATE COMMISSION SHALL COLLECT ANY  RENEWAL  FEES  CHARGED
 FOR  THE  RENEWAL OF A LICENSE AND DISTRIBUTE THE FEES TO THE APPLICABLE
 MEMBER BOARD.
   4. UPON RECEIPT OF ANY RENEWAL FEES COLLECTED IN SUBDIVISION THREE  OF
 THIS SECTION, A MEMBER BOARD SHALL RENEW THE PHYSICIAN'S LICENSE.
   5. PHYSICIAN INFORMATION COLLECTED BY THE INTERSTATE COMMISSION DURING
 THE RENEWAL PROCESS WILL BE DISTRIBUTED TO ALL MEMBER BOARDS.
   6. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES TO ADDRESS
 RENEWAL OF LICENSES OBTAINED THROUGH THE COMPACT.
   § 8868. COORDINATED  INFORMATION  SYSTEM. 1. THE INTERSTATE COMMISSION
 SHALL ESTABLISH A DATABASE OF  ALL  PHYSICIANS  LICENSED,  OR  WHO  HAVE
 APPLIED  FOR LICENSURE, UNDER SECTION EIGHTY-EIGHT HUNDRED SIXTY-FIVE OF
 THIS ARTICLE.
   2. NOTWITHSTANDING ANY OTHER PROVISION OF  LAW,  MEMBER  BOARDS  SHALL
 REPORT  TO  THE  INTERSTATE  COMMISSION  ANY PUBLIC ACTION OR COMPLAINTS
 S. 8307                            93                            A. 8807
 
 AGAINST A LICENSED PHYSICIAN WHO HAS APPLIED OR  RECEIVED  AN  EXPEDITED
 LICENSE THROUGH THE COMPACT.
   3.  MEMBER  BOARDS SHALL REPORT DISCIPLINARY OR INVESTIGATORY INFORMA-
 TION DETERMINED AS NECESSARY  AND  PROPER  BY  RULE  OF  THE  INTERSTATE
 COMMISSION.
   4. MEMBER BOARDS MAY REPORT ANY NON-PUBLIC COMPLAINT, DISCIPLINARY, OR
 INVESTIGATORY  INFORMATION  NOT  REQUIRED  BY  SUBDIVISION THREE OF THIS
 SECTION TO THE INTERSTATE COMMISSION.
   5. MEMBER BOARDS SHALL SHARE  COMPLAINT  OR  DISCIPLINARY  INFORMATION
 ABOUT A PHYSICIAN UPON REQUEST OF ANOTHER MEMBER BOARD.
   6.  ALL  INFORMATION PROVIDED TO THE INTERSTATE COMMISSION OR DISTRIB-
 UTED BY MEMBER BOARDS SHALL BE CONFIDENTIAL, FILED UNDER SEAL, AND  USED
 ONLY FOR INVESTIGATORY OR DISCIPLINARY MATTERS.
   7.  THE  INTERSTATE  COMMISSION  IS  AUTHORIZED  TO  DEVELOP RULES FOR
 MANDATED OR DISCRETIONARY SHARING OF INFORMATION BY MEMBER BOARDS.
   § 8869. JOINT INVESTIGATIONS. 1. LICENSURE AND DISCIPLINARY RECORDS OF
 PHYSICIANS ARE DEEMED INVESTIGATIVE.
   2. IN ADDITION TO THE AUTHORITY GRANTED  TO  A  MEMBER  BOARD  BY  ITS
 RESPECTIVE  MEDICAL PRACTICE ACT OR OTHER APPLICABLE STATE LAW, A MEMBER
 BOARD MAY PARTICIPATE WITH OTHER MEMBER BOARDS IN  JOINT  INVESTIGATIONS
 OF PHYSICIANS LICENSED BY THE MEMBER BOARDS.
   3.  A  SUBPOENA ISSUED BY A MEMBER STATE SHALL BE ENFORCEABLE IN OTHER
 MEMBER STATES.
   4. MEMBER BOARDS MAY SHARE ANY INVESTIGATIVE, LITIGATION,  OR  COMPLI-
 ANCE  MATERIALS  IN FURTHERANCE OF ANY JOINT OR INDIVIDUAL INVESTIGATION
 INITIATED UNDER THE COMPACT.
   5. ANY MEMBER STATE MAY INVESTIGATE ACTUAL OR  ALLEGED  VIOLATIONS  OF
 THE  STATUTES  AUTHORIZING  THE PRACTICE OF MEDICINE IN ANY OTHER MEMBER
 STATE IN WHICH A PHYSICIAN HOLDS A LICENSE TO PRACTICE MEDICINE.
   § 8870. DISCIPLINARY ACTIONS. 1. ANY DISCIPLINARY ACTION TAKEN BY  ANY
 MEMBER  BOARD  AGAINST A PHYSICIAN LICENSED THROUGH THE COMPACT SHALL BE
 DEEMED UNPROFESSIONAL CONDUCT WHICH MAY  BE  SUBJECT  TO  DISCIPLINE  BY
 OTHER  MEMBER  BOARDS, IN ADDITION TO ANY VIOLATION OF THE MEDICAL PRAC-
 TICE ACT OR REGULATIONS IN THAT STATE.
   2. IF A LICENSE GRANTED TO A PHYSICIAN BY  THE  MEMBER  BOARD  IN  THE
 STATE  OF  PRINCIPAL  LICENSE IS REVOKED, SURRENDERED OR RELINQUISHED IN
 LIEU OF DISCIPLINE, OR SUSPENDED, THEN ALL LICENSES ISSUED TO THE PHYSI-
 CIAN BY MEMBER BOARDS SHALL AUTOMATICALLY  BE  PLACED,  WITHOUT  FURTHER
 ACTION  NECESSARY BY ANY MEMBER BOARD, ON THE SAME STATUS. IF THE MEMBER
 BOARD IN THE STATE OF  PRINCIPAL  LICENSE  SUBSEQUENTLY  REINSTATES  THE
 PHYSICIAN'S  LICENSE,  A  LICENSE  ISSUED  TO THE PHYSICIAN BY ANY OTHER
 MEMBER BOARD SHALL REMAIN ENCUMBERED UNTIL THAT RESPECTIVE MEMBER  BOARD
 TAKES  ACTION  TO  REINSTATE THE LICENSE IN A MANNER CONSISTENT WITH THE
 MEDICAL PRACTICE ACT OF THAT STATE.
   3. IF DISCIPLINARY ACTION IS TAKEN AGAINST A  PHYSICIAN  BY  A  MEMBER
 BOARD  NOT IN THE STATE OF PRINCIPAL LICENSE, ANY OTHER MEMBER BOARD MAY
 DEEM THE ACTION CONCLUSIVE AS TO MATTER OF LAW AND FACT DECIDED, AND:
   (A) IMPOSE THE SAME OR LESSER SANCTION OR SANCTIONS AGAINST THE PHYSI-
 CIAN SO LONG AS SUCH SANCTIONS ARE CONSISTENT WITH THE MEDICAL  PRACTICE
 ACT OF THAT STATE; OR
   (B)  PURSUE  SEPARATE  DISCIPLINARY ACTION AGAINST THE PHYSICIAN UNDER
 ITS RESPECTIVE MEDICAL PRACTICE ACT, REGARDLESS OF THE ACTION  TAKEN  IN
 OTHER MEMBER STATES.
   4.  IF  A LICENSE GRANTED TO A PHYSICIAN BY A MEMBER BOARD IS REVOKED,
 SURRENDERED, OR RELINQUISHED IN LIEU OF DISCIPLINE, OR  SUSPENDED,  THEN
 ANY  LICENSE  OR  LICENSES  ISSUED  TO THE PHYSICIAN BY ANY OTHER MEMBER
 S. 8307                            94                            A. 8807
 
 BOARD OR BOARDS SHALL BE SUSPENDED, AUTOMATICALLY AND IMMEDIATELY  WITH-
 OUT  FURTHER  ACTION  NECESSARY BY THE OTHER MEMBER BOARD OR BOARDS, FOR
 NINETY DAYS UPON ENTRY OF THE ORDER BY THE DISCIPLINING BOARD, TO PERMIT
 THE MEMBER BOARD OR BOARDS TO INVESTIGATE THE BASIS FOR THE ACTION UNDER
 THE MEDICAL PRACTICE ACT OF THAT STATE. A MEMBER BOARD MAY TERMINATE THE
 AUTOMATIC SUSPENSION OF THE LICENSE IT ISSUED PRIOR TO THE COMPLETION OF
 THE NINETY DAY SUSPENSION PERIOD IN A MANNER CONSISTENT WITH THE MEDICAL
 PRACTICE ACT OF THAT STATE.
   § 8871. INTERSTATE MEDICAL LICENSURE COMPACT COMMISSION. 1. THE MEMBER
 STATES  HEREBY  CREATE THE "INTERSTATE MEDICAL LICENSURE COMPACT COMMIS-
 SION".
   2. THE PURPOSE OF THE INTERSTATE COMMISSION IS THE  ADMINISTRATION  OF
 THE INTERSTATE MEDICAL LICENSURE COMPACT, WHICH IS A DISCRETIONARY STATE
 FUNCTION.
   3. THE INTERSTATE COMMISSION SHALL BE A BODY CORPORATE AND JOINT AGEN-
 CY OF THE MEMBER STATES AND SHALL HAVE ALL THE RESPONSIBILITIES, POWERS,
 AND  DUTIES  SET FORTH IN THE COMPACT, AND SUCH ADDITIONAL POWERS AS MAY
 BE CONFERRED UPON IT BY A SUBSEQUENT CONCURRENT ACTION OF THE RESPECTIVE
 LEGISLATURES OF THE MEMBER STATES IN ACCORDANCE WITH THE  TERMS  OF  THE
 COMPACT.
   4.  THE  INTERSTATE  COMMISSION  SHALL CONSIST OF TWO VOTING REPRESEN-
 TATIVES APPOINTED BY EACH MEMBER STATE WHO SHALL SERVE AS COMMISSIONERS.
 IN STATES WHERE ALLOPATHIC AND OSTEOPATHIC PHYSICIANS ARE  REGULATED  BY
 SEPARATE  MEMBER  BOARDS, OR IF THE LICENSING AND DISCIPLINARY AUTHORITY
 IS SPLIT BETWEEN MULTIPLE MEMBER  BOARDS  WITHIN  A  MEMBER  STATE,  THE
 MEMBER  STATE SHALL APPOINT ONE REPRESENTATIVE FROM EACH MEMBER BOARD. A
 COMMISSIONER SHALL BE A OR AN:
   (A) ALLOPATHIC OR OSTEOPATHIC PHYSICIAN APPOINTED TO A MEMBER BOARD;
   (B) EXECUTIVE DIRECTOR, EXECUTIVE SECRETARY, OR SIMILAR EXECUTIVE OF A
 MEMBER BOARD; OR
   (C) MEMBER OF THE PUBLIC APPOINTED TO A MEMBER BOARD.
   5. THE INTERSTATE COMMISSION SHALL MEET AT LEAST  ONCE  EACH  CALENDAR
 YEAR.  A  PORTION OF THIS MEETING SHALL BE A BUSINESS MEETING TO ADDRESS
 SUCH MATTERS AS MAY PROPERLY COME BEFORE THE COMMISSION,  INCLUDING  THE
 ELECTION  OF  OFFICERS. THE CHAIRPERSON MAY CALL ADDITIONAL MEETINGS AND
 SHALL CALL FOR A MEETING UPON THE REQUEST OF A MAJORITY  OF  THE  MEMBER
 STATES.
   6. THE BYLAWS MAY PROVIDE FOR MEETINGS OF THE INTERSTATE COMMISSION TO
 BE CONDUCTED BY TELECOMMUNICATION OR ELECTRONIC COMMUNICATION.
   7.  EACH  COMMISSIONER  PARTICIPATING  AT  A MEETING OF THE INTERSTATE
 COMMISSION IS ENTITLED TO ONE VOTE. A MAJORITY  OF  COMMISSIONERS  SHALL
 CONSTITUTE  A  QUORUM  FOR  THE TRANSACTION OF BUSINESS, UNLESS A LARGER
 QUORUM IS REQUIRED BY THE BYLAWS OF THE INTERSTATE COMMISSION. A COMMIS-
 SIONER SHALL NOT DELEGATE A VOTE TO ANOTHER COMMISSIONER. IN THE ABSENCE
 OF ITS COMMISSIONER, A MEMBER STATE MAY DELEGATE VOTING AUTHORITY FOR  A
 SPECIFIED  MEETING  TO ANOTHER PERSON FROM THAT STATE WHO SHALL MEET THE
 REQUIREMENTS OF SUBDIVISION FOUR OF THIS SECTION.
   8. THE INTERSTATE COMMISSION SHALL PROVIDE PUBLIC NOTICE OF ALL  MEET-
 INGS  AND  ALL  MEETINGS  SHALL  BE  OPEN  TO THE PUBLIC. THE INTERSTATE
 COMMISSION MAY CLOSE A MEETING, IN FULL OR IN PORTION, WHERE  IT  DETER-
 MINES  BY  A  TWO-THIRDS  VOTE OF THE COMMISSIONERS PRESENT THAT AN OPEN
 MEETING WOULD BE LIKELY TO:
   (A) RELATE SOLELY TO THE INTERNAL PERSONNEL PRACTICES  AND  PROCEDURES
 OF THE INTERSTATE COMMISSION;
   (B)  DISCUSS  MATTERS SPECIFICALLY EXEMPTED FROM DISCLOSURE BY FEDERAL
 STATUTE;
 S. 8307                            95                            A. 8807
 
   (C) DISCUSS TRADE SECRETS, COMMERCIAL, OR FINANCIAL  INFORMATION  THAT
 IS PRIVILEGED OR CONFIDENTIAL;
   (D)  INVOLVE  ACCUSING  A  PERSON  OF A CRIME, OR FORMALLY CENSURING A
 PERSON;
   (E) DISCUSS INFORMATION OF A PERSONAL NATURE  WHERE  DISCLOSURE  WOULD
 CONSTITUTE A CLEARLY UNWARRANTED INVASION OF PERSONAL PRIVACY;
   (F)   DISCUSS  INVESTIGATIVE  RECORDS  COMPILED  FOR  LAW  ENFORCEMENT
 PURPOSES; OR
   (G) SPECIFICALLY RELATE TO THE PARTICIPATION  IN  A  CIVIL  ACTION  OR
 OTHER LEGAL PROCEEDING.
   9.  THE  INTERSTATE  COMMISSION  SHALL  KEEP MINUTES WHICH SHALL FULLY
 DESCRIBE ALL MATTERS DISCUSSED IN A MEETING AND SHALL PROVIDE A FULL AND
 ACCURATE SUMMARY OF ACTIONS TAKEN, INCLUDING RECORD  OF  ANY  ROLL  CALL
 VOTES.
   10.  THE INTERSTATE COMMISSION SHALL MAKE ITS INFORMATION AND OFFICIAL
 RECORDS, TO THE EXTENT NOT OTHERWISE DESIGNATED IN THE COMPACT OR BY ITS
 RULES, AVAILABLE TO THE PUBLIC FOR INSPECTION.
   11. THE INTERSTATE COMMISSION SHALL ESTABLISH AN EXECUTIVE  COMMITTEE,
 WHICH  SHALL  INCLUDE OFFICERS, MEMBERS, AND OTHERS AS DETERMINED BY THE
 BYLAWS. THE EXECUTIVE COMMITTEE SHALL HAVE THE POWER TO ACT ON BEHALF OF
 THE INTERSTATE COMMISSION, WITH  THE  EXCEPTION  OF  RULEMAKING,  DURING
 PERIODS WHEN THE INTERSTATE COMMISSION IS NOT IN SESSION. WHEN ACTING ON
 BEHALF OF THE INTERSTATE COMMISSION, THE EXECUTIVE COMMITTEE SHALL OVER-
 SEE  THE ADMINISTRATION OF THE COMPACT INCLUDING ENFORCEMENT AND COMPLI-
 ANCE WITH THE PROVISIONS OF THE COMPACT, ITS BYLAWS AND RULES, AND OTHER
 SUCH DUTIES AS NECESSARY.
   12. THE INTERSTATE COMMISSION SHALL  ESTABLISH  OTHER  COMMITTEES  FOR
 GOVERNANCE AND ADMINISTRATION OF THE COMPACT.
   § 8872. POWERS AND DUTIES OF THE INTERSTATE COMMISSION. THE INTERSTATE
 COMMISSION SHALL HAVE THE DUTY AND POWER TO:
   1. OVERSEE AND MAINTAIN THE ADMINISTRATION OF THE COMPACT;
   2.  PROMULGATE  RULES  WHICH SHALL BE BINDING TO THE EXTENT AND IN THE
 MANNER PROVIDED FOR IN THE COMPACT;
   3. ISSUE, UPON THE REQUEST OF A MEMBER STATE OR MEMBER BOARD, ADVISORY
 OPINIONS CONCERNING THE MEANING OR INTERPRETATION OF  THE  COMPACT,  ITS
 BYLAWS, RULES, AND ACTIONS;
   4.  ENFORCE  COMPLIANCE WITH COMPACT PROVISIONS, THE RULES PROMULGATED
 BY THE INTERSTATE COMMISSION, AND THE BYLAWS, USING  ALL  NECESSARY  AND
 PROPER MEANS, INCLUDING BUT NOT LIMITED TO THE USE OF JUDICIAL PROCESS;
   5.  ESTABLISH AND APPOINT COMMITTEES INCLUDING, BUT NOT LIMITED TO, AN
 EXECUTIVE COMMITTEE AS REQUIRED BY SECTION EIGHTY-EIGHT  HUNDRED  SEVEN-
 TY-ONE  OF  THIS ARTICLE, WHICH SHALL HAVE THE POWER TO ACT ON BEHALF OF
 THE INTERSTATE COMMISSION IN CARRYING OUT ITS POWERS AND DUTIES;
   6. PAY, OR PROVIDE FOR THE PAYMENT OF  THE  EXPENSES  RELATED  TO  THE
 ESTABLISHMENT,  ORGANIZATION,  AND  ONGOING ACTIVITIES OF THE INTERSTATE
 COMMISSION;
   7. ESTABLISH AND MAINTAIN ONE OR MORE OFFICES;
   8. BORROW, ACCEPT, HIRE, OR CONTRACT FOR SERVICES OF PERSONNEL;
   9. PURCHASE AND MAINTAIN INSURANCE AND BONDS;
   10. EMPLOY AN EXECUTIVE DIRECTOR WHO SHALL HAVE SUCH POWERS TO EMPLOY,
 SELECT OR APPOINT EMPLOYEES, AGENTS, OR CONSULTANTS,  AND  TO  DETERMINE
 THEIR QUALIFICATIONS, DEFINE THEIR DUTIES, AND FIX THEIR COMPENSATION;
   11. ESTABLISH PERSONNEL POLICIES AND PROGRAMS RELATING TO CONFLICTS OF
 INTEREST, RATES OF COMPENSATION, AND QUALIFICATIONS OF PERSONNEL;
   12. ACCEPT DONATIONS AND GRANTS OF MONEY, EQUIPMENT, SUPPLIES, MATERI-
 ALS AND SERVICES, AND TO RECEIVE, UTILIZE, AND DISPOSE OF IT IN A MANNER
 S. 8307                            96                            A. 8807
 
 CONSISTENT  WITH  THE  CONFLICT  OF INTEREST POLICIES ESTABLISHED BY THE
 INTERSTATE COMMISSION;
   13.  LEASE,  PURCHASE, ACCEPT CONTRIBUTIONS OR DONATIONS OF, OR OTHER-
 WISE TO OWN, HOLD, IMPROVE, OR USE, ANY  PROPERTY,  REAL,  PERSONAL,  OR
 MIXED;
   14.  SELL,  CONVEY,  MORTGAGE,  PLEDGE,  LEASE,  EXCHANGE, ABANDON, OR
 OTHERWISE DISPOSE OF ANY PROPERTY, REAL, PERSONAL, OR MIXED;
   15. ESTABLISH A BUDGET AND MAKE EXPENDITURES;
   16. ADOPT A SEAL AND BYLAWS GOVERNING THE MANAGEMENT AND OPERATION  OF
 THE INTERSTATE COMMISSION;
   17.  REPORT  ANNUALLY  TO THE LEGISLATURES AND GOVERNORS OF THE MEMBER
 STATES CONCERNING THE ACTIVITIES OF THE INTERSTATE COMMISSION DURING THE
 PRECEDING YEAR.  SUCH REPORTS SHALL ALSO INCLUDE  REPORTS  OF  FINANCIAL
 AUDITS  AND ANY RECOMMENDATIONS THAT MAY HAVE BEEN ADOPTED BY THE INTER-
 STATE COMMISSION;
   18. COORDINATE EDUCATION, TRAINING, AND PUBLIC AWARENESS REGARDING THE
 COMPACT, ITS IMPLEMENTATION, AND ITS OPERATION;
   19. MAINTAIN RECORDS IN ACCORDANCE WITH THE BYLAWS;
   20. SEEK AND OBTAIN TRADEMARKS, COPYRIGHTS, AND PATENTS; AND
   21. PERFORM SUCH FUNCTIONS AS  MAY  BE  NECESSARY  OR  APPROPRIATE  TO
 ACHIEVE THE PURPOSES OF THE COMPACT.
   § 8873. FINANCE  POWERS.  1. THE INTERSTATE COMMISSION MAY LEVY ON AND
 COLLECT AN ANNUAL ASSESSMENT FROM EACH MEMBER STATE TO COVER THE COST OF
 THE OPERATIONS AND ACTIVITIES  OF  THE  INTERSTATE  COMMISSION  AND  ITS
 STAFF. THE TOTAL ASSESSMENT MUST BE SUFFICIENT TO COVER THE ANNUAL BUDG-
 ET  APPROVED EACH YEAR FOR WHICH REVENUE IS NOT PROVIDED BY OTHER SOURC-
 ES. THE AGGREGATE ANNUAL ASSESSMENT AMOUNT SHALL  BE  ALLOCATED  UPON  A
 FORMULA  TO  BE  DETERMINED  BY  THE  INTERSTATE COMMISSION, WHICH SHALL
 PROMULGATE A RULE BINDING UPON ALL MEMBER STATES.
   2. THE INTERSTATE COMMISSION SHALL NOT INCUR OBLIGATIONS OF  ANY  KIND
 PRIOR TO SECURING THE FUNDS ADEQUATE TO MEET THE SAME.
   3. THE INTERSTATE COMMISSION SHALL NOT PLEDGE THE CREDIT OF ANY OF THE
 MEMBER STATES, EXCEPT BY, AND WITH THE AUTHORITY OF, THE MEMBER STATE.
   4.  THE  INTERSTATE  COMMISSION SHALL BE SUBJECT TO A YEARLY FINANCIAL
 AUDIT CONDUCTED BY A CERTIFIED OR LICENSED  PUBLIC  ACCOUNTANT  AND  THE
 REPORT OF THE AUDIT SHALL BE INCLUDED IN THE ANNUAL REPORT OF THE INTER-
 STATE COMMISSION.
   § 8874. ORGANIZATION  AND  OPERATION  OF THE INTERSTATE COMMISSION. 1.
 THE INTERSTATE COMMISSION SHALL, BY A MAJORITY OF COMMISSIONERS  PRESENT
 AND  VOTING,  ADOPT  BYLAWS TO GOVERN ITS CONDUCT AS MAY BE NECESSARY OR
 APPROPRIATE TO CARRY OUT THE  PURPOSES  OF  THE  COMPACT  WITHIN  TWELVE
 MONTHS OF THE FIRST INTERSTATE COMMISSION MEETING.
   2.  THE  INTERSTATE  COMMISSION  SHALL  ELECT OR APPOINT ANNUALLY FROM
 AMONG ITS COMMISSIONERS A CHAIRPERSON, A VICE-CHAIRPERSON, AND A  TREAS-
 URER, EACH OF WHOM SHALL HAVE SUCH AUTHORITY AND DUTIES AS MAY BE SPECI-
 FIED  IN THE BYLAWS. THE CHAIRPERSON, OR IN THE CHAIRPERSON'S ABSENCE OR
 DISABILITY, THE VICE-CHAIRPERSON, SHALL PRESIDE AT ALL MEETINGS  OF  THE
 INTERSTATE COMMISSION.
   3. OFFICERS SELECTED PURSUANT TO SUBDIVISION TWO OF THIS SECTION SHALL
 SERVE WITHOUT REMUNERATION FROM THE INTERSTATE COMMISSION.
   4.  THE  OFFICERS  AND EMPLOYEES OF THE INTERSTATE COMMISSION SHALL BE
 IMMUNE FROM SUIT AND LIABILITY, EITHER PERSONALLY OR IN  THEIR  OFFICIAL
 CAPACITY,  FOR  A  CLAIM  FOR  DAMAGE TO OR LOSS OF PROPERTY OR PERSONAL
 INJURY OR OTHER CIVIL LIABILITY CAUSED OR ARISING OUT  OF,  OR  RELATING
 TO,  AN ACTUAL OR ALLEGED ACT, ERROR, OR OMISSION THAT OCCURRED, OR THAT
 SUCH PERSON HAD A REASONABLE BASIS FOR BELIEVING  OCCURRED,  WITHIN  THE
 S. 8307                            97                            A. 8807
 
 SCOPE  OF INTERSTATE COMMISSION EMPLOYMENT, DUTIES, OR RESPONSIBILITIES;
 PROVIDED THAT SUCH PERSON SHALL NOT BE PROTECTED FROM SUIT OR  LIABILITY
 FOR  DAMAGE,  LOSS,  INJURY,  OR  LIABILITY CAUSED BY THE INTENTIONAL OR
 WILLFUL AND WANTON MISCONDUCT OF SUCH PERSON.
   (A)  THE  LIABILITY  OF  THE  EXECUTIVE  DIRECTOR AND EMPLOYEES OF THE
 INTERSTATE COMMISSION OR REPRESENTATIVES OF THE  INTERSTATE  COMMISSION,
 ACTING  WITHIN THE SCOPE OF SUCH PERSON'S EMPLOYMENT OR DUTIES FOR ACTS,
 ERRORS, OR OMISSIONS OCCURRING  WITHIN  SUCH  PERSON'S  STATE,  MAY  NOT
 EXCEED THE LIMITS OF LIABILITY SET FORTH UNDER THE CONSTITUTION AND LAWS
 OF THAT STATE FOR STATE OFFICIALS, EMPLOYEES, AND AGENTS. THE INTERSTATE
 COMMISSION  IS CONSIDERED TO BE AN INSTRUMENTALITY OF THE STATES FOR THE
 PURPOSES OF ANY SUCH  ACTION.    NOTHING  IN  THIS  PARAGRAPH  SHALL  BE
 CONSTRUED  TO  PROTECT  SUCH  PERSON  FROM SUIT OR LIABILITY FOR DAMAGE,
 LOSS, INJURY, OR LIABILITY CAUSED BY  THE  INTENTIONAL  OR  WILLFUL  AND
 WANTON MISCONDUCT OF SUCH PERSON.
   (B) THE INTERSTATE COMMISSION SHALL DEFEND THE EXECUTIVE DIRECTOR, ITS
 EMPLOYEES,  AND SUBJECT TO THE APPROVAL OF THE ATTORNEY GENERAL OR OTHER
 APPROPRIATE LEGAL COUNSEL OF THE MEMBER STATE REPRESENTED BY  AN  INTER-
 STATE COMMISSION REPRESENTATIVE, SHALL DEFEND SUCH INTERSTATE COMMISSION
 REPRESENTATIVE  IN  ANY CIVIL ACTION SEEKING TO IMPOSE LIABILITY ARISING
 OUT OF AN ACTUAL OR ALLEGED ACT, ERROR OR OMISSION THAT OCCURRED  WITHIN
 THE  SCOPE  OF  INTERSTATE COMMISSION EMPLOYMENT, DUTIES OR RESPONSIBIL-
 ITIES, OR THAT THE  DEFENDANT  HAD  A  REASONABLE  BASIS  FOR  BELIEVING
 OCCURRED  WITHIN  THE SCOPE OF INTERSTATE COMMISSION EMPLOYMENT, DUTIES,
 OR RESPONSIBILITIES, PROVIDED THAT THE ACTUAL OR ALLEGED ACT, ERROR,  OR
 OMISSION  DID  NOT RESULT FROM INTENTIONAL OR WILLFUL AND WANTON MISCON-
 DUCT ON THE PART OF SUCH PERSON.
   (C) TO THE EXTENT NOT COVERED BY THE STATE INVOLVED, MEMBER STATE,  OR
 THE  INTERSTATE  COMMISSION,  THE  REPRESENTATIVES  OR  EMPLOYEES OF THE
 INTERSTATE COMMISSION SHALL BE HELD HARMLESS IN THE AMOUNT OF A  SETTLE-
 MENT  OR JUDGMENT, INCLUDING ATTORNEY'S FEES AND COSTS, OBTAINED AGAINST
 SUCH PERSONS ARISING OUT OF AN ACTUAL OR ALLEGED ACT, ERROR, OR OMISSION
 THAT OCCURRED WITHIN THE  SCOPE  OF  INTERSTATE  COMMISSION  EMPLOYMENT,
 DUTIES, OR RESPONSIBILITIES, OR THAT SUCH PERSONS HAD A REASONABLE BASIS
 FOR BELIEVING OCCURRED WITHIN THE SCOPE OF INTERSTATE COMMISSION EMPLOY-
 MENT,  DUTIES,  OR RESPONSIBILITIES, PROVIDED THAT THE ACTUAL OR ALLEGED
 ACT, ERROR, OR OMISSION DID NOT RESULT FROM INTENTIONAL OR  WILLFUL  AND
 WANTON MISCONDUCT ON THE PART OF SUCH PERSONS.
   § 8875. RULEMAKING  FUNCTIONS  OF  THE INTERSTATE COMMISSION. 1.   THE
 INTERSTATE COMMISSION SHALL PROMULGATE  REASONABLE  RULES  IN  ORDER  TO
 EFFECTIVELY  AND  EFFICIENTLY  ACHIEVE  THE  PURPOSES  OF  THE  COMPACT.
 NOTWITHSTANDING THE FOREGOING, IN THE EVENT  THE  INTERSTATE  COMMISSION
 EXERCISES  ITS RULEMAKING AUTHORITY IN A MANNER THAT IS BEYOND THE SCOPE
 OF THE PURPOSES OF THE COMPACT, OR THE POWERS  GRANTED  HEREUNDER,  THEN
 SUCH AN ACTION BY THE INTERSTATE COMMISSION SHALL BE INVALID AND HAVE NO
 FORCE OR EFFECT.
   2.  RULES  DEEMED  APPROPRIATE  FOR  THE  OPERATIONS OF THE INTERSTATE
 COMMISSION SHALL BE MADE PURSUANT TO A RULEMAKING PROCESS THAT  SUBSTAN-
 TIALLY  CONFORMS TO THE FEDERAL MODEL STATE ADMINISTRATIVE PROCEDURE ACT
 OF 2010, AND SUBSEQUENT AMENDMENTS THERETO.
   3. NOT LATER THAN THIRTY DAYS AFTER A RULE IS PROMULGATED, ANY  PERSON
 MAY FILE A PETITION FOR JUDICIAL REVIEW OF THE RULE IN THE UNITED STATES
 DISTRICT  COURT  FOR  THE  DISTRICT  OF COLUMBIA OR THE FEDERAL DISTRICT
 WHERE THE INTERSTATE COMMISSION HAS ITS PRINCIPAL OFFICES, PROVIDED THAT
 THE FILING OF SUCH A PETITION SHALL NOT STAY OR  OTHERWISE  PREVENT  THE
 RULE  FROM BECOMING EFFECTIVE UNLESS THE COURT FINDS THAT THE PETITIONER
 S. 8307                            98                            A. 8807
 
 HAS A SUBSTANTIAL LIKELIHOOD OF SUCCESS. THE COURT SHALL GIVE  DEFERENCE
 TO  THE  ACTIONS OF THE INTERSTATE COMMISSION CONSISTENT WITH APPLICABLE
 LAW AND SHALL NOT FIND THE RULE TO BE UNLAWFUL IF THE RULE REPRESENTS  A
 REASONABLE  EXERCISE  OF THE AUTHORITY GRANTED TO THE INTERSTATE COMMIS-
 SION.
   § 8876. OVERSIGHT OF INTERSTATE COMPACT. 1.  THE  EXECUTIVE,  LEGISLA-
 TIVE,  AND  JUDICIAL  BRANCHES  OF STATE GOVERNMENT IN EACH MEMBER STATE
 SHALL ENFORCE THE COMPACT AND  SHALL  TAKE  ALL  ACTIONS  NECESSARY  AND
 APPROPRIATE  TO  EFFECTUATE  THE  COMPACT'S  PURPOSES  AND  INTENT.  THE
 PROVISIONS OF THE COMPACT AND THE RULES PROMULGATED HEREUNDER SHALL HAVE
 STANDING AS STATUTORY LAW BUT SHALL NOT OVERRIDE EXISTING STATE AUTHORI-
 TY TO REGULATE THE PRACTICE OF MEDICINE.
   2. ALL COURTS SHALL TAKE JUDICIAL NOTICE OF THE COMPACT AND THE  RULES
 IN  ANY JUDICIAL OR ADMINISTRATIVE PROCEEDING IN A MEMBER STATE PERTAIN-
 ING TO THE SUBJECT MATTER OF THE COMPACT WHICH MAY  AFFECT  THE  POWERS,
 RESPONSIBILITIES OR ACTIONS OF THE INTERSTATE COMMISSION.
   3.  THE INTERSTATE COMMISSION SHALL BE ENTITLED TO RECEIVE ALL SERVICE
 OF PROCESS IN ANY SUCH PROCEEDING, AND SHALL HAVE STANDING TO  INTERVENE
 IN  THE PROCEEDING FOR ALL PURPOSES. FAILURE TO PROVIDE SERVICE OF PROC-
 ESS TO THE INTERSTATE COMMISSION SHALL RENDER A JUDGMENT OR  ORDER  VOID
 AS TO THE INTERSTATE COMMISSION, THE COMPACT, OR PROMULGATED RULES.
   § 8877. ENFORCEMENT  OF  INTERSTATE COMPACT. 1. THE INTERSTATE COMMIS-
 SION, IN THE REASONABLE EXERCISE OF ITS DISCRETION,  SHALL  ENFORCE  THE
 PROVISIONS AND RULES OF THE COMPACT.
   2.  THE INTERSTATE COMMISSION MAY, BY MAJORITY VOTE OF THE COMMISSION-
 ERS, INITIATE LEGAL ACTION IN THE UNITED STATES DISTRICT COURT  FOR  THE
 DISTRICT  OF  COLUMBIA,  OR, AT THE DISCRETION OF THE INTERSTATE COMMIS-
 SION, IN THE FEDERAL DISTRICT WHERE THE INTERSTATE  COMMISSION  HAS  ITS
 PRINCIPAL  OFFICES,  TO  ENFORCE  COMPLIANCE  WITH THE PROVISIONS OF THE
 COMPACT, AND ITS PROMULGATED RULES AND BYLAWS, AGAINST A MEMBER STATE IN
 DEFAULT. THE RELIEF  SOUGHT  MAY  INCLUDE  BOTH  INJUNCTIVE  RELIEF  AND
 DAMAGES.  IN THE EVENT JUDICIAL ENFORCEMENT IS NECESSARY, THE PREVAILING
 PARTY SHALL BE AWARDED ALL COSTS OF SUCH LITIGATION INCLUDING REASONABLE
 ATTORNEY'S FEES.
   3. THE REMEDIES HEREIN SHALL NOT BE  THE  EXCLUSIVE  REMEDIES  OF  THE
 INTERSTATE  COMMISSION.    THE INTERSTATE COMMISSION MAY AVAIL ITSELF OF
 ANY OTHER REMEDIES AVAILABLE UNDER STATE LAW  OR  THE  REGULATION  OF  A
 PROFESSION.
   § 8878. DEFAULT  PROCEDURES.  1.  THE GROUNDS FOR DEFAULT INCLUDE, BUT
 ARE NOT LIMITED TO, FAILURE OF A MEMBER  STATE  TO  PERFORM  SUCH  OBLI-
 GATIONS OR RESPONSIBILITIES IMPOSED UPON IT BY THE COMPACT, OR THE RULES
 AND BYLAWS OF THE INTERSTATE COMMISSION PROMULGATED UNDER THE COMPACT.
   2.  IF  THE  INTERSTATE  COMMISSION DETERMINES THAT A MEMBER STATE HAS
 DEFAULTED IN THE PERFORMANCE  OF  ITS  OBLIGATIONS  OR  RESPONSIBILITIES
 UNDER  THE  COMPACT,  OR THE BYLAWS OR PROMULGATED RULES, THE INTERSTATE
 COMMISSION SHALL:
   (A) PROVIDE WRITTEN NOTICE TO THE DEFAULTING STATE  AND  OTHER  MEMBER
 STATES,  OF  THE NATURE OF THE DEFAULT, THE MEANS OF CURING THE DEFAULT,
 AND ANY ACTION TAKEN BY  THE  INTERSTATE  COMMISSION.    THE  INTERSTATE
 COMMISSION  SHALL  SPECIFY  THE CONDITIONS BY WHICH THE DEFAULTING STATE
 MUST CURE ITS DEFAULT; AND
   (B)  PROVIDE  REMEDIAL  TRAINING  AND  SPECIFIC  TECHNICAL  ASSISTANCE
 REGARDING THE DEFAULT.
   3.  IF  THE DEFAULTING STATE FAILS TO CURE THE DEFAULT, THE DEFAULTING
 STATE SHALL BE TERMINATED FROM THE COMPACT UPON AN AFFIRMATIVE VOTE OF A
 MAJORITY OF THE COMMISSIONERS AND ALL RIGHTS, PRIVILEGES,  AND  BENEFITS
 S. 8307                            99                            A. 8807
 
 CONFERRED BY THE COMPACT SHALL TERMINATE ON THE EFFECTIVE DATE OF TERMI-
 NATION.  A  CURE  OF THE DEFAULT DOES NOT RELIEVE THE OFFENDING STATE OF
 OBLIGATIONS OR LIABILITIES INCURRED DURING THE PERIOD OF THE DEFAULT.
   4.  TERMINATION  OF  MEMBERSHIP  IN  THE COMPACT SHALL BE IMPOSED ONLY
 AFTER ALL OTHER MEANS OF SECURING COMPLIANCE HAVE BEEN EXHAUSTED. NOTICE
 OF INTENT TO TERMINATE SHALL BE GIVEN BY THE  INTERSTATE  COMMISSION  TO
 THE  GOVERNOR,  THE  MAJORITY  AND  MINORITY  LEADERS  OF THE DEFAULTING
 STATE'S LEGISLATURE, AND EACH OF THE MEMBER STATES.
   5. THE INTERSTATE COMMISSION SHALL ESTABLISH RULES AND  PROCEDURES  TO
 ADDRESS  LICENSES  AND  PHYSICIANS  THAT  ARE MATERIALLY IMPACTED BY THE
 TERMINATION OF A MEMBER STATE, OR THE WITHDRAWAL OF A MEMBER STATE.
   6. THE MEMBER STATE WHICH HAS BEEN TERMINATED IS RESPONSIBLE  FOR  ALL
 DUES,  OBLIGATIONS,  AND LIABILITIES INCURRED THROUGH THE EFFECTIVE DATE
 OF TERMINATION INCLUDING OBLIGATIONS, THE PERFORMANCE OF  WHICH  EXTENDS
 BEYOND THE EFFECTIVE DATE OF TERMINATION.
   7.  THE INTERSTATE COMMISSION SHALL NOT BEAR ANY COSTS RELATING TO ANY
 STATE THAT HAS BEEN FOUND TO BE IN DEFAULT OR WHICH HAS BEEN  TERMINATED
 FROM  THE  COMPACT,  UNLESS  OTHERWISE  MUTUALLY  AGREED UPON IN WRITING
 BETWEEN THE INTERSTATE COMMISSION AND THE DEFAULTING STATE.
   8. THE DEFAULTING STATE  MAY  APPEAL  THE  ACTION  OF  THE  INTERSTATE
 COMMISSION  BY  PETITIONING  THE  UNITED  STATES  DISTRICT COURT FOR THE
 DISTRICT OF COLUMBIA  OR  THE  FEDERAL  DISTRICT  WHERE  THE  INTERSTATE
 COMMISSION  HAS  ITS  PRINCIPAL  OFFICES.  THE PREVAILING PARTY SHALL BE
 AWARDED ALL COSTS OF SUCH  LITIGATION  INCLUDING  REASONABLE  ATTORNEY'S
 FEES.
   § 8879. DISPUTE   RESOLUTION.   1.  THE  INTERSTATE  COMMISSION  SHALL
 ATTEMPT, UPON THE REQUEST OF A MEMBER STATE, TO RESOLVE  DISPUTES  WHICH
 ARE  SUBJECT  TO  THE COMPACT AND WHICH MAY ARISE AMONG MEMBER STATES OR
 MEMBER BOARDS.
   2. THE INTERSTATE COMMISSION SHALL PROMULGATE RULES PROVIDING FOR BOTH
 MEDIATION AND BINDING DISPUTE RESOLUTION AS APPROPRIATE.
   § 8880. MEMBER STATES, EFFECTIVE DATE AND AMENDMENT. 1. ANY  STATE  IS
 ELIGIBLE TO BECOME A MEMBER STATE OF THE COMPACT.
   2.  THE  COMPACT  SHALL  BECOME EFFECTIVE AND BINDING UPON LEGISLATIVE
 ENACTMENT OF THE COMPACT INTO LAW BY NO LESS THAN SEVEN  STATES.  THERE-
 AFTER,  IT  SHALL BECOME EFFECTIVE AND BINDING ON A STATE UPON ENACTMENT
 OF THE COMPACT INTO LAW BY THAT STATE.
   3. THE GOVERNORS OF NON-MEMBER STATES, OR THEIR  DESIGNEES,  SHALL  BE
 INVITED TO PARTICIPATE IN THE ACTIVITIES OF THE INTERSTATE COMMISSION ON
 A NON-VOTING BASIS PRIOR TO ADOPTION OF THE COMPACT BY ALL STATES.
   4. THE INTERSTATE COMMISSION MAY PROPOSE AMENDMENTS TO THE COMPACT FOR
 ENACTMENT  BY THE MEMBER STATES. NO AMENDMENT SHALL BECOME EFFECTIVE AND
 BINDING UPON THE INTERSTATE COMMISSION AND THE MEMBER STATES UNLESS  AND
 UNTIL IT IS ENACTED INTO LAW BY UNANIMOUS CONSENT OF THE MEMBER STATES.
   § 8881. WITHDRAWAL.  1.  ONCE EFFECTIVE, THE COMPACT SHALL CONTINUE IN
 FORCE AND REMAIN BINDING UPON EACH AND EVERY MEMBER STATE; PROVIDED THAT
 A MEMBER STATE MAY WITHDRAW FROM THE COMPACT BY  SPECIFICALLY  REPEALING
 THE STATUTE WHICH ENACTED THE COMPACT INTO LAW.
   2.  WITHDRAWAL FROM THE COMPACT SHALL BE BY THE ENACTMENT OF A STATUTE
 REPEALING THE SAME, BUT SHALL NOT TAKE EFFECT UNTIL ONE YEAR  AFTER  THE
 EFFECTIVE  DATE  OF  SUCH  STATUTE AND UNTIL WRITTEN NOTICE OF THE WITH-
 DRAWAL HAS BEEN GIVEN BY THE WITHDRAWING STATE TO THE GOVERNOR  OF  EACH
 OTHER MEMBER STATE.
   3.  THE  WITHDRAWING STATE SHALL IMMEDIATELY NOTIFY THE CHAIRPERSON OF
 THE INTERSTATE COMMISSION IN WRITING UPON  THE  INTRODUCTION  OF  LEGIS-
 LATION REPEALING THE COMPACT IN THE WITHDRAWING STATE.
 S. 8307                            100                           A. 8807
 
   4.  THE  INTERSTATE COMMISSION SHALL NOTIFY THE OTHER MEMBER STATES OF
 THE WITHDRAWING STATE'S INTENT TO WITHDRAW  WITHIN  SIXTY  DAYS  OF  ITS
 RECEIPT OF NOTICE PROVIDED UNDER SUBDIVISION THREE OF THIS SECTION.
   5.  THE WITHDRAWING STATE IS RESPONSIBLE FOR ALL DUES, OBLIGATIONS AND
 LIABILITIES INCURRED THROUGH THE EFFECTIVE DATE OF WITHDRAWAL, INCLUDING
 OBLIGATIONS, THE PERFORMANCE OF WHICH EXTEND BEYOND THE  EFFECTIVE  DATE
 OF WITHDRAWAL.
   6.  REINSTATEMENT  FOLLOWING  WITHDRAWAL OF A MEMBER STATE SHALL OCCUR
 UPON THE WITHDRAWING STATE REENACTING THE COMPACT  OR  UPON  SUCH  LATER
 DATE AS DETERMINED BY THE INTERSTATE COMMISSION.
   7. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES TO ADDRESS
 THE  IMPACT  OF  THE WITHDRAWAL OF A MEMBER STATE ON LICENSES GRANTED IN
 OTHER MEMBER STATES TO PHYSICIANS WHO DESIGNATED THE WITHDRAWING  MEMBER
 STATE AS THE STATE OF PRINCIPAL LICENSE.
   § 8882. DISSOLUTION.  1. THE COMPACT SHALL DISSOLVE EFFECTIVE UPON THE
 DATE OF THE WITHDRAWAL OR DEFAULT OF THE MEMBER STATE WHICH REDUCES  THE
 MEMBERSHIP IN THE COMPACT TO ONE MEMBER STATE.
   2.  UPON  THE DISSOLUTION OF THE COMPACT, THE COMPACT BECOMES NULL AND
 VOID AND SHALL BE OF NO FURTHER FORCE OR EFFECT, AND  THE  BUSINESS  AND
 AFFAIRS  OF  THE  INTERSTATE  COMMISSION  SHALL BE CONCLUDED AND SURPLUS
 FUNDS SHALL BE DISTRIBUTED IN ACCORDANCE WITH THE BYLAWS.
   § 8883. SEVERABILITY  AND  CONSTRUCTION.  1.  THE  PROVISIONS  OF  THE
 COMPACT  SHALL  BE  SEVERABLE,  AND  IF ANY PHRASE, CLAUSE, SENTENCE, OR
 PROVISION IS DEEMED  UNENFORCEABLE,  THE  REMAINING  PROVISIONS  OF  THE
 COMPACT SHALL BE ENFORCEABLE.
   2.  THE  PROVISIONS  OF  THE  COMPACT  SHALL BE LIBERALLY CONSTRUED TO
 EFFECTUATE ITS PURPOSES.
   3. NOTHING IN THE COMPACT SHALL BE CONSTRUED TO PROHIBIT THE  APPLICA-
 BILITY OF OTHER INTERSTATE COMPACTS TO WHICH THE STATES ARE MEMBERS.
   § 8884. BINDING EFFECT OF COMPACT AND OTHER LAWS. 1. NOTHING CONTAINED
 IN  THIS  ARTICLE  SHALL  PREVENT  THE ENFORCEMENT OF ANY OTHER LAW OF A
 MEMBER STATE THAT IS NOT INCONSISTENT WITH THE COMPACT.
   2. ALL LAWS IN A MEMBER STATE IN CONFLICT WITH THE COMPACT ARE  SUPER-
 SEDED TO THE EXTENT OF THE CONFLICT.
   3.  ALL  LAWFUL  ACTIONS  OF  THE INTERSTATE COMMISSION, INCLUDING ALL
 RULES AND BYLAWS PROMULGATED BY THE COMMISSION,  ARE  BINDING  UPON  THE
 MEMBER STATES.
   4.  ALL  AGREEMENTS  BETWEEN  THE INTERSTATE COMMISSION AND THE MEMBER
 STATES ARE BINDING IN ACCORDANCE WITH THEIR TERMS.
   5. IN THE EVENT ANY PROVISION OF THE  COMPACT  EXCEEDS  THE  CONSTITU-
 TIONAL  LIMITS  IMPOSED  ON  THE  LEGISLATURE  OF ANY MEMBER STATE, SUCH
 PROVISION SHALL BE INEFFECTIVE TO THE EXTENT OF THE  CONFLICT  WITH  THE
 CONSTITUTIONAL PROVISION IN QUESTION IN THAT MEMBER STATE.
   §  2. Article 170 of the education law is renumbered article 171 and a
 new article 170 is added to title 8 of the  education  law  to  read  as
 follows:
                                ARTICLE 170
                          NURSE LICENSURE COMPACT
 SECTION 8900. NURSE LICENSURE COMPACT.
         8901. FINDINGS AND DECLARATION OF PURPOSE.
         8902. DEFINITIONS.
         8903. GENERAL PROVISIONS AND JURISDICTION.
         8904. APPLICATIONS FOR LICENSURE IN A PARTY STATE.
         8905. ADDITIONAL  AUTHORITIES  INVESTED IN PARTY STATE LICENSING
                 BOARDS.
 S. 8307                            101                           A. 8807
 
         8906. COORDINATED LICENSURE INFORMATION SYSTEM AND  EXCHANGE  OF
                 INFORMATION.
         8907. ESTABLISHMENT OF THE INTERSTATE COMMISSION OF NURSE LICEN-
                 SURE COMPACT ADMINISTRATORS.
         8908. RULEMAKING.
         8909. OVERSIGHT, DISPUTE RESOLUTION AND ENFORCEMENT.
         8910. EFFECTIVE DATE, WITHDRAWAL AND AMENDMENT.
         8911. CONSTRUCTION AND SEVERABILITY.
   § 8900. NURSE  LICENSURE  COMPACT.  THE  NURSE  LICENSE COMPACT AS SET
 FORTH IN THE ARTICLE IS HEREBY ADOPTED AND ENTERED INTO WITH  ALL  PARTY
 STATES JOINING THEREIN.
   § 8901. FINDINGS  AND  DECLARATION OF PURPOSE  1. FINDINGS.  THE PARTY
 STATES FIND THAT:
   A. THE HEALTH AND SAFETY OF THE PUBLIC ARE AFFECTED BY THE  DEGREE  OF
 COMPLIANCE  WITH AND THE EFFECTIVENESS OF ENFORCEMENT ACTIVITIES RELATED
 TO STATE NURSE LICENSURE LAWS;
   B. VIOLATIONS OF NURSE LICENSURE AND OTHER LAWS REGULATING  THE  PRAC-
 TICE OF NURSING MAY RESULT IN INJURY OR HARM TO THE PUBLIC;
   C.  THE  EXPANDED  MOBILITY OF NURSES AND THE USE OF ADVANCED COMMUNI-
 CATION TECHNOLOGIES AS PART OF OUR NATION'S HEALTH CARE DELIVERY  SYSTEM
 REQUIRE  GREATER  COORDINATION AND COOPERATION AMONG STATES IN THE AREAS
 OF NURSE LICENSURE AND REGULATION;
   D. NEW PRACTICE MODALITIES AND TECHNOLOGY MAKE COMPLIANCE  WITH  INDI-
 VIDUAL STATE NURSE LICENSURE LAWS DIFFICULT AND COMPLEX;
   E.  THE  CURRENT SYSTEM OF DUPLICATIVE LICENSURE FOR NURSES PRACTICING
 IN MULTIPLE STATES IS CUMBERSOME  AND  REDUNDANT  FOR  BOTH  NURSES  AND
 STATES; AND
   F.  UNIFORMITY  OF  NURSE LICENSURE REQUIREMENTS THROUGHOUT THE STATES
 PROMOTES PUBLIC SAFETY AND PUBLIC HEALTH BENEFITS.
   2. DECLARATION OF PURPOSE. THE GENERAL PURPOSES OF  THIS  COMPACT  ARE
 TO:
   A.  FACILITATE  THE  STATES'  RESPONSIBILITY  TO  PROTECT THE PUBLIC'S
 HEALTH AND SAFETY;
   B. ENSURE AND ENCOURAGE THE COOPERATION OF PARTY STATES IN  THE  AREAS
 OF NURSE LICENSURE AND REGULATION;
   C.  FACILITATE THE EXCHANGE OF INFORMATION BETWEEN PARTY STATES IN THE
 AREAS OF NURSE REGULATION, INVESTIGATION AND ADVERSE ACTIONS;
   D. PROMOTE COMPLIANCE WITH THE LAWS GOVERNING THE PRACTICE OF  NURSING
 IN EACH JURISDICTION;
   E. INVEST ALL PARTY STATES WITH THE AUTHORITY TO HOLD A NURSE ACCOUNT-
 ABLE  FOR  MEETING  ALL  STATE  PRACTICE  LAWS IN THE STATE IN WHICH THE
 PATIENT IS LOCATED AT THE TIME  CARE  IS  RENDERED  THROUGH  THE  MUTUAL
 RECOGNITION OF PARTY STATE LICENSES;
   F.  DECREASE  REDUNDANCIES  IN THE CONSIDERATION AND ISSUANCE OF NURSE
 LICENSES; AND
   G. PROVIDE OPPORTUNITIES FOR INTERSTATE PRACTICE BY  NURSES  WHO  MEET
 UNIFORM LICENSURE REQUIREMENTS.
   § 8902. DEFINITIONS. 1. DEFINITIONS. AS USED IN THIS COMPACT:
   A.  "ADVERSE  ACTION"  MEANS  ANY  ADMINISTRATIVE, CIVIL, EQUITABLE OR
 CRIMINAL ACTION PERMITTED BY A  STATE'S  LAWS  WHICH  IS  IMPOSED  BY  A
 LICENSING  BOARD  OR  OTHER AUTHORITY AGAINST A NURSE, INCLUDING ACTIONS
 AGAINST AN INDIVIDUAL'S LICENSE OR MULTISTATE LICENSURE  PRIVILEGE  SUCH
 AS  REVOCATION, SUSPENSION, PROBATION, MONITORING OF THE LICENSEE, LIMI-
 TATION ON THE LICENSEE'S PRACTICE, OR ANY OTHER ENCUMBRANCE ON LICENSURE
 AFFECTING A NURSE'S AUTHORIZATION TO PRACTICE, INCLUDING ISSUANCE  OF  A
 CEASE AND DESIST ACTION.
 S. 8307                            102                           A. 8807
 
   B.  "ALTERNATIVE  PROGRAM" MEANS A NON-DISCIPLINARY MONITORING PROGRAM
 APPROVED BY A LICENSING BOARD.
   C.  "COORDINATED  LICENSURE  INFORMATION  SYSTEM"  MEANS AN INTEGRATED
 PROCESS FOR COLLECTING, STORING AND SHARING INFORMATION ON NURSE  LICEN-
 SURE  AND ENFORCEMENT ACTIVITIES RELATED TO NURSE LICENSURE LAWS THAT IS
 ADMINISTERED BY A NONPROFIT ORGANIZATION COMPOSED OF AND  CONTROLLED  BY
 LICENSING BOARDS.
   D.  "COMMISSION"  MEANS  THE  INTERSTATE COMMISSION OF NURSE LICENSURE
 COMPACT ADMINISTRATORS.
   E. "CURRENT SIGNIFICANT INVESTIGATIVE INFORMATION" MEANS:
   1. INVESTIGATIVE INFORMATION THAT A LICENSING BOARD, AFTER A  PRELIMI-
 NARY INQUIRY THAT INCLUDES NOTIFICATION AND AN OPPORTUNITY FOR THE NURSE
 TO  RESPOND,  IF  REQUIRED  BY  STATE  LAW, HAS REASON TO BELIEVE IS NOT
 GROUNDLESS AND, IF PROVED TRUE, WOULD INDICATE MORE THAN A MINOR INFRAC-
 TION; OR
   2. INVESTIGATIVE INFORMATION THAT INDICATES THAT THE NURSE  REPRESENTS
 AN  IMMEDIATE  THREAT  TO PUBLIC HEALTH AND SAFETY REGARDLESS OF WHETHER
 THE NURSE HAS BEEN NOTIFIED AND HAD AN OPPORTUNITY TO RESPOND.
   F. "ENCUMBRANCE" MEANS A REVOCATION OR SUSPENSION OF, OR  ANY  LIMITA-
 TION  ON,  THE  FULL  AND  UNRESTRICTED PRACTICE OF NURSING IMPOSED BY A
 LICENSING BOARD.
   G. "HOME STATE" MEANS THE PARTY STATE WHICH  IS  THE  NURSE'S  PRIMARY
 STATE OF RESIDENCE.
   H. "LICENSING BOARD" MEANS A PARTY STATE'S REGULATORY BODY RESPONSIBLE
 FOR ISSUING NURSE LICENSES.
   I.  "MULTISTATE  LICENSE"  MEANS A LICENSE TO PRACTICE AS A REGISTERED
 NURSE (RN) OR AS A LICENSED PRACTICAL/VOCATIONAL NURSE  (LPN/VN),  WHICH
 IS  ISSUED  BY  A  HOME  STATE LICENSING BOARD, AND WHICH AUTHORIZES THE
 LICENSED NURSE TO PRACTICE IN ALL PARTY STATES UNDER A MULTISTATE LICEN-
 SURE PRIVILEGE.
   J. "MULTISTATE LICENSURE PRIVILEGE" MEANS A LEGAL AUTHORIZATION  ASSO-
 CIATED  WITH  A MULTISTATE LICENSE PERMITTING THE PRACTICE OF NURSING AS
 EITHER A RN OR A LPN/VN IN A REMOTE STATE.
   K. "NURSE" MEANS RN OR LPN/VN, AS THOSE  TERMS  ARE  DEFINED  BY  EACH
 PARTY STATE'S PRACTICE LAWS.
   L. "PARTY STATE" MEANS ANY STATE THAT HAS ADOPTED THIS COMPACT.
   M. "REMOTE STATE" MEANS A PARTY STATE, OTHER THAN THE HOME STATE.
   N.  "SINGLE-STATE  LICENSE"  MEANS  A  NURSE LICENSE ISSUED BY A PARTY
 STATE THAT AUTHORIZES PRACTICE ONLY WITHIN THE ISSUING  STATE  AND  DOES
 NOT  INCLUDE  A  MULTISTATE LICENSURE PRIVILEGE TO PRACTICE IN ANY OTHER
 PARTY STATE.
   O. "STATE" MEANS A STATE, TERRITORY OR POSSESSION OF THE UNITED STATES
 AND THE DISTRICT OF COLUMBIA.
   P. "STATE PRACTICE LAWS" MEANS A PARTY STATE'S LAWS, RULES  AND  REGU-
 LATIONS THAT GOVERN THE PRACTICE OF NURSING, DEFINE THE SCOPE OF NURSING
 PRACTICE,  AND  CREATE  THE METHODS AND GROUNDS FOR IMPOSING DISCIPLINE.
 "STATE PRACTICE LAWS" SHALL NOT INCLUDE REQUIREMENTS NECESSARY TO OBTAIN
 AND RETAIN A LICENSE, EXCEPT FOR QUALIFICATIONS OR REQUIREMENTS  OF  THE
 HOME STATE.
   § 8903. GENERAL PROVISIONS AND JURISDICTION. 1. GENERAL PROVISIONS AND
 JURISDICTION. A. A MULTISTATE LICENSE TO PRACTICE REGISTERED OR LICENSED
 PRACTICAL/VOCATIONAL  NURSING  ISSUED  BY  A HOME STATE TO A RESIDENT IN
 THAT STATE WILL BE RECOGNIZED BY EACH PARTY STATE AS AUTHORIZING A NURSE
 TO  PRACTICE  AS  A   REGISTERED   NURSE   (RN)   OR   AS   A   LICENSED
 PRACTICAL/VOCATIONAL NURSE (LPN/VN), UNDER A MULTISTATE LICENSURE PRIVI-
 LEGE, IN EACH PARTY STATE.
 S. 8307                            103                           A. 8807

   B.  A  STATE  SHALL  IMPLEMENT PROCEDURES FOR CONSIDERING THE CRIMINAL
 HISTORY RECORDS OF APPLICANTS  FOR  AN  INITIAL  MULTISTATE  LICENSE  OR
 LICENSURE  BY  ENDORSEMENT. SUCH PROCEDURES SHALL INCLUDE THE SUBMISSION
 OF FINGERPRINTS OR OTHER BIOMETRIC-BASED INFORMATION BY  APPLICANTS  FOR
 THE PURPOSE OF OBTAINING AN APPLICANT'S CRIMINAL HISTORY RECORD INFORMA-
 TION FROM THE FEDERAL BUREAU OF INVESTIGATION AND THE AGENCY RESPONSIBLE
 FOR RETAINING THAT STATE'S CRIMINAL RECORDS.
   C.  EACH PARTY STATE SHALL REQUIRE ITS LICENSING BOARD TO AUTHORIZE AN
 APPLICANT TO OBTAIN OR RETAIN A MULTISTATE LICENSE  IN  THE  HOME  STATE
 ONLY IF THE APPLICANT:
   I.  MEETS  THE HOME STATE'S QUALIFICATIONS FOR LICENSURE OR RENEWAL OF
 LICENSURE, AND COMPLIES WITH ALL OTHER APPLICABLE STATE LAWS;
   II. (1) HAS GRADUATED OR IS ELIGIBLE  TO  GRADUATE  FROM  A  LICENSING
 BOARD-APPROVED RN OR LPN/VN PRELICENSURE EDUCATION PROGRAM; OR
   (2)  HAS  GRADUATED FROM A FOREIGN RN OR LPN/VN PRELICENSURE EDUCATION
 PROGRAM THAT HAS BEEN: (A) APPROVED BY THE AUTHORIZED  ACCREDITING  BODY
 IN  THE  APPLICABLE  COUNTRY, AND (B) VERIFIED BY AN INDEPENDENT CREDEN-
 TIALS REVIEW AGENCY TO BE COMPARABLE TO A LICENSING BOARD-APPROVED PREL-
 ICENSURE EDUCATION PROGRAM;
   III. HAS, IF A GRADUATE OF A FOREIGN  PRELICENSURE  EDUCATION  PROGRAM
 NOT  TAUGHT  IN  ENGLISH  OR  IF  ENGLISH IS NOT THE INDIVIDUAL'S NATIVE
 LANGUAGE, SUCCESSFULLY PASSED AN ENGLISH  PROFICIENCY  EXAMINATION  THAT
 INCLUDES THE COMPONENTS OF READING, SPEAKING, WRITING AND LISTENING;
   IV.  HAS  SUCCESSFULLY  PASSED  AN NCLEX-RN OR NCLEX-PN EXAMINATION OR
 RECOGNIZED PREDECESSOR, AS APPLICABLE;
   V. IS ELIGIBLE FOR OR HOLDS AN ACTIVE, UNENCUMBERED LICENSE;
   VI. HAS SUBMITTED, IN  CONNECTION  WITH  AN  APPLICATION  FOR  INITIAL
 LICENSURE  OR  LICENSURE BY ENDORSEMENT, FINGERPRINTS OR OTHER BIOMETRIC
 DATA FOR THE PURPOSE OF OBTAINING CRIMINAL  HISTORY  RECORD  INFORMATION
 FROM  THE FEDERAL BUREAU OF INVESTIGATION AND THE AGENCY RESPONSIBLE FOR
 RETAINING THAT STATE'S CRIMINAL RECORDS;
   VII. HAS NOT BEEN CONVICTED OR FOUND GUILTY, OR HAS  ENTERED  INTO  AN
 AGREED DISPOSITION, OF A FELONY OFFENSE UNDER APPLICABLE STATE OR FEDER-
 AL CRIMINAL LAW;
   VIII.  HAS  NOT BEEN CONVICTED OR FOUND GUILTY, OR HAS ENTERED INTO AN
 AGREED DISPOSITION, OF A MISDEMEANOR OFFENSE RELATED TO THE PRACTICE  OF
 NURSING AS DETERMINED ON A CASE-BY-CASE BASIS;
   IX. IS NOT CURRENTLY ENROLLED IN AN ALTERNATIVE PROGRAM;
   X.  IS  SUBJECT  TO  SELF-DISCLOSURE  REQUIREMENTS  REGARDING  CURRENT
 PARTICIPATION IN AN ALTERNATIVE PROGRAM; AND
   XI. HAS A VALID UNITED STATES SOCIAL SECURITY NUMBER.
   D. ALL PARTY STATES SHALL BE AUTHORIZED, IN ACCORDANCE  WITH  EXISTING
 STATE  DUE  PROCESS LAW, TO TAKE ADVERSE ACTION AGAINST A NURSE'S MULTI-
 STATE LICENSURE PRIVILEGE SUCH AS REVOCATION, SUSPENSION,  PROBATION  OR
 ANY  OTHER ACTION THAT AFFECTS A NURSE'S AUTHORIZATION TO PRACTICE UNDER
 A MULTISTATE LICENSURE PRIVILEGE, INCLUDING CEASE AND DESIST ACTIONS. IF
 A PARTY STATE TAKES SUCH ACTION, IT SHALL PROMPTLY NOTIFY  THE  ADMINIS-
 TRATOR  OF THE COORDINATED LICENSURE INFORMATION SYSTEM. THE ADMINISTRA-
 TOR OF THE COORDINATED LICENSURE INFORMATION SYSTEM SHALL PROMPTLY NOTI-
 FY THE HOME STATE OF ANY SUCH ACTIONS BY REMOTE STATES.
   E. A NURSE PRACTICING IN A PARTY STATE SHALL  COMPLY  WITH  THE  STATE
 PRACTICE  LAWS  OF  THE STATE IN WHICH THE CLIENT IS LOCATED AT THE TIME
 SERVICE IS PROVIDED. THE PRACTICE OF NURSING IS NOT LIMITED  TO  PATIENT
 CARE  BUT  SHALL  INCLUDE  ALL  NURSING PRACTICE AS DEFINED BY THE STATE
 PRACTICE LAWS OF THE PARTY STATE IN WHICH THE  CLIENT  IS  LOCATED.  THE
 PRACTICE OF NURSING IN A PARTY STATE UNDER A MULTISTATE LICENSURE PRIVI-
 S. 8307                            104                           A. 8807
 
 LEGE  WILL  SUBJECT  A NURSE TO THE JURISDICTION OF THE LICENSING BOARD,
 THE COURTS AND THE LAWS OF THE  PARTY  STATE  IN  WHICH  THE  CLIENT  IS
 LOCATED AT THE TIME SERVICE IS PROVIDED.
   F. INDIVIDUALS NOT RESIDING IN A PARTY STATE SHALL CONTINUE TO BE ABLE
 TO  APPLY FOR A PARTY STATE'S SINGLE-STATE LICENSE AS PROVIDED UNDER THE
 LAWS OF EACH PARTY STATE. HOWEVER, THE SINGLE-STATE LICENSE  GRANTED  TO
 THESE  INDIVIDUALS  WILL  NOT BE RECOGNIZED AS GRANTING THE PRIVILEGE TO
 PRACTICE NURSING IN ANY OTHER PARTY STATE. NOTHING IN THIS COMPACT SHALL
 AFFECT THE REQUIREMENTS ESTABLISHED BY A PARTY STATE FOR THE ISSUANCE OF
 A SINGLE-STATE LICENSE.
   G. ANY NURSE HOLDING A HOME STATE MULTISTATE LICENSE, ON THE EFFECTIVE
 DATE OF THIS COMPACT, MAY RETAIN AND RENEW THE MULTISTATE LICENSE ISSUED
 BY THE NURSE'S THEN-CURRENT HOME STATE, PROVIDED THAT:
   I. A  NURSE,  WHO  CHANGES  PRIMARY  STATE  OF  RESIDENCE  AFTER  THIS
 COMPACT'S  EFFECTIVE  DATE,  SHALL  MEET ALL APPLICABLE REQUIREMENTS SET
 FORTH IN THIS ARTICLE TO OBTAIN A MULTISTATE LICENSE  FROM  A  NEW  HOME
 STATE.
   II. A NURSE WHO FAILS TO SATISFY THE MULTISTATE LICENSURE REQUIREMENTS
 SET  FORTH  IN THIS ARTICLE DUE TO A DISQUALIFYING EVENT OCCURRING AFTER
 THIS COMPACT'S EFFECTIVE DATE SHALL BE INELIGIBLE TO RETAIN OR  RENEW  A
 MULTISTATE  LICENSE, AND THE NURSE'S MULTISTATE LICENSE SHALL BE REVOKED
 OR DEACTIVATED IN  ACCORDANCE  WITH  APPLICABLE  RULES  ADOPTED  BY  THE
 COMMISSION.
   § 8904. APPLICATIONS  FOR  LICENSURE IN A PARTY STATE. 1. APPLICATIONS
 FOR LICENSURE IN A PARTY STATE. A. UPON  APPLICATION  FOR  A  MULTISTATE
 LICENSE, THE LICENSING BOARD IN THE ISSUING PARTY STATE SHALL ASCERTAIN,
 THROUGH THE COORDINATED LICENSURE INFORMATION SYSTEM, WHETHER THE APPLI-
 CANT  HAS  EVER HELD, OR IS THE HOLDER OF, A LICENSE ISSUED BY ANY OTHER
 STATE, WHETHER THERE ARE ANY ENCUMBRANCES ON ANY LICENSE  OR  MULTISTATE
 LICENSURE  PRIVILEGE  HELD  BY THE APPLICANT, WHETHER ANY ADVERSE ACTION
 HAS BEEN TAKEN AGAINST ANY LICENSE  OR  MULTISTATE  LICENSURE  PRIVILEGE
 HELD BY THE APPLICANT AND WHETHER THE APPLICANT IS CURRENTLY PARTICIPAT-
 ING IN AN ALTERNATIVE PROGRAM.
   B. A NURSE MAY HOLD A MULTISTATE LICENSE, ISSUED BY THE HOME STATE, IN
 ONLY ONE PARTY STATE AT A TIME.
   C. IF A NURSE CHANGES PRIMARY STATE OF RESIDENCE BY MOVING BETWEEN TWO
 PARTY  STATES, THE NURSE MUST APPLY FOR LICENSURE IN THE NEW HOME STATE,
 AND THE MULTISTATE LICENSE ISSUED BY THE PRIOR HOME STATE WILL BE  DEAC-
 TIVATED IN ACCORDANCE WITH APPLICABLE RULES ADOPTED BY THE COMMISSION.
   I. THE NURSE MAY APPLY FOR LICENSURE IN ADVANCE OF A CHANGE IN PRIMARY
 STATE OF RESIDENCE.
   II.  A  MULTISTATE  LICENSE  SHALL NOT BE ISSUED BY THE NEW HOME STATE
 UNTIL THE NURSE PROVIDES SATISFACTORY EVIDENCE OF A  CHANGE  IN  PRIMARY
 STATE  OF  RESIDENCE  TO THE NEW HOME STATE AND SATISFIES ALL APPLICABLE
 REQUIREMENTS TO OBTAIN A MULTISTATE LICENSE FROM THE NEW HOME STATE.
   D. IF A NURSE CHANGES PRIMARY STATE OF  RESIDENCE  BY  MOVING  FROM  A
 PARTY  STATE  TO A NON-PARTY STATE, THE MULTISTATE LICENSE ISSUED BY THE
 PRIOR HOME STATE WILL CONVERT TO A SINGLE-STATE LICENSE, VALID  ONLY  IN
 THE FORMER HOME STATE.
   § 8905. ADDITIONAL  AUTHORITIES  INVESTED  IN  PARTY  STATE  LICENSING
 BOARDS. 1. LICENSING BOARD AUTHORITY. IN ADDITION TO  THE  OTHER  POWERS
 CONFERRED BY STATE LAW, A LICENSING BOARD SHALL HAVE THE AUTHORITY TO:
   A.  TAKE  ADVERSE ACTION AGAINST A NURSE'S MULTISTATE LICENSURE PRIVI-
 LEGE TO PRACTICE WITHIN THAT PARTY STATE.
   I. ONLY THE HOME STATE SHALL HAVE THE POWER  TO  TAKE  ADVERSE  ACTION
 AGAINST A NURSE'S LICENSE ISSUED BY THE HOME STATE.
 S. 8307                            105                           A. 8807
 
   II.  FOR  PURPOSES  OF TAKING ADVERSE ACTION, THE HOME STATE LICENSING
 BOARD SHALL GIVE THE  SAME  PRIORITY  AND  EFFECT  TO  REPORTED  CONDUCT
 RECEIVED  FROM  A  REMOTE STATE AS IT WOULD IF SUCH CONDUCT HAD OCCURRED
 WITHIN THE HOME STATE. IN SO DOING, THE HOME STATE SHALL APPLY  ITS  OWN
 STATE LAWS TO DETERMINE APPROPRIATE ACTION.
   B. ISSUE CEASE AND DESIST ORDERS OR IMPOSE AN ENCUMBRANCE ON A NURSE'S
 AUTHORITY TO PRACTICE WITHIN THAT PARTY STATE.
   C.  COMPLETE ANY PENDING INVESTIGATIONS OF A NURSE WHO CHANGES PRIMARY
 STATE OF RESIDENCE DURING THE COURSE OF SUCH INVESTIGATIONS. THE LICENS-
 ING BOARD SHALL ALSO HAVE THE AUTHORITY TO TAKE  APPROPRIATE  ACTION  OR
 ACTIONS AND SHALL PROMPTLY REPORT THE CONCLUSIONS OF SUCH INVESTIGATIONS
 TO  THE  ADMINISTRATOR  OF THE COORDINATED LICENSURE INFORMATION SYSTEM.
 THE ADMINISTRATOR OF THE COORDINATED LICENSURE INFORMATION SYSTEM  SHALL
 PROMPTLY NOTIFY THE NEW HOME STATE OF ANY SUCH ACTIONS.
   D.  ISSUE  SUBPOENAS FOR BOTH HEARINGS AND INVESTIGATIONS THAT REQUIRE
 THE ATTENDANCE AND TESTIMONY OF WITNESSES, AS WELL AS THE PRODUCTION  OF
 EVIDENCE. SUBPOENAS ISSUED BY A LICENSING BOARD IN A PARTY STATE FOR THE
 ATTENDANCE AND TESTIMONY OF WITNESSES OR THE PRODUCTION OF EVIDENCE FROM
 ANOTHER  PARTY  STATE SHALL BE ENFORCED IN THE LATTER STATE BY ANY COURT
 OF COMPETENT JURISDICTION, ACCORDING TO THE PRACTICE  AND  PROCEDURE  OF
 THAT  COURT APPLICABLE TO SUBPOENAS ISSUED IN PROCEEDINGS PENDING BEFORE
 IT.  THE ISSUING AUTHORITY SHALL PAY ANY WITNESS FEES, TRAVEL  EXPENSES,
 MILEAGE  AND OTHER FEES REQUIRED BY THE SERVICE STATUTES OF THE STATE IN
 WHICH THE WITNESSES OR EVIDENCE ARE LOCATED.
   E. OBTAIN AND SUBMIT, FOR EACH NURSE LICENSURE APPLICANT,  FINGERPRINT
 OR  OTHER  BIOMETRIC-BASED INFORMATION TO THE FEDERAL BUREAU OF INVESTI-
 GATION FOR CRIMINAL BACKGROUND CHECKS, RECEIVE THE RESULTS OF THE FEDER-
 AL BUREAU OF INVESTIGATION RECORD SEARCH ON CRIMINAL  BACKGROUND  CHECKS
 AND USE THE RESULTS IN MAKING LICENSURE DECISIONS.
   F.  IF  OTHERWISE  PERMITTED  BY  STATE LAW, RECOVER FROM THE AFFECTED
 NURSE THE COSTS OF INVESTIGATIONS AND  DISPOSITION  OF  CASES  RESULTING
 FROM ANY ADVERSE ACTION TAKEN AGAINST THAT NURSE.
   G.  TAKE  ADVERSE  ACTION  BASED ON THE FACTUAL FINDINGS OF THE REMOTE
 STATE, PROVIDED THAT THE LICENSING BOARD FOLLOWS ITS OWN PROCEDURES  FOR
 TAKING SUCH ADVERSE ACTION.
   2.  ADVERSE  ACTIONS.  A. IF ADVERSE ACTION IS TAKEN BY THE HOME STATE
 AGAINST A NURSE'S MULTISTATE LICENSE, THE NURSE'S  MULTISTATE  LICENSURE
 PRIVILEGE  TO  PRACTICE  IN  ALL OTHER PARTY STATES SHALL BE DEACTIVATED
 UNTIL ALL ENCUMBRANCES HAVE BEEN REMOVED FROM  THE  MULTISTATE  LICENSE.
 ALL  HOME STATE DISCIPLINARY ORDERS THAT IMPOSE ADVERSE ACTION AGAINST A
 NURSE'S MULTISTATE LICENSE SHALL INCLUDE A STATEMENT  THAT  THE  NURSE'S
 MULTISTATE LICENSURE PRIVILEGE IS DEACTIVATED IN ALL PARTY STATES DURING
 THE PENDENCY OF THE ORDER.
   B.  NOTHING  IN  THIS  COMPACT SHALL OVERRIDE A PARTY STATE'S DECISION
 THAT PARTICIPATION IN AN ALTERNATIVE PROGRAM MAY  BE  USED  IN  LIEU  OF
 ADVERSE  ACTION.  THE  HOME  STATE  LICENSING BOARD SHALL DEACTIVATE THE
 MULTISTATE LICENSURE PRIVILEGE UNDER THE MULTISTATE LICENSE OF ANY NURSE
 FOR THE DURATION OF THE NURSE'S PARTICIPATION IN AN ALTERNATIVE PROGRAM.
   § 8906. COORDINATED  LICENSURE  INFORMATION  SYSTEM  AND  EXCHANGE  OF
 INFORMATION.  1.   COORDINATED LICENSURE INFORMATION SYSTEM AND EXCHANGE
 OF INFORMATION. A. ALL PARTY STATES SHALL PARTICIPATE IN  A  COORDINATED
 LICENSURE INFORMATION SYSTEM OF ALL LICENSED REGISTERED NURSES (RNS) AND
 LICENSED   PRACTICAL/VOCATIONAL  NURSES  (LPNS/VNS).  THIS  SYSTEM  WILL
 INCLUDE INFORMATION ON THE LICENSURE AND DISCIPLINARY  HISTORY  OF  EACH
 NURSE,  AS  SUBMITTED  BY PARTY STATES, TO ASSIST IN THE COORDINATION OF
 NURSE LICENSURE AND ENFORCEMENT EFFORTS.
 S. 8307                            106                           A. 8807
 
   B. THE COMMISSION, IN CONSULTATION WITH THE ADMINISTRATOR OF THE COOR-
 DINATED LICENSURE INFORMATION  SYSTEM,  SHALL  FORMULATE  NECESSARY  AND
 PROPER  PROCEDURES  FOR  THE  IDENTIFICATION, COLLECTION AND EXCHANGE OF
 INFORMATION UNDER THIS COMPACT.
   C.  ALL  LICENSING  BOARDS  SHALL  PROMPTLY  REPORT TO THE COORDINATED
 LICENSURE INFORMATION SYSTEM ANY ADVERSE ACTION, ANY CURRENT SIGNIFICANT
 INVESTIGATIVE INFORMATION, DENIALS OF APPLICATIONS WITH THE REASONS  FOR
 SUCH  DENIALS  AND  NURSE PARTICIPATION IN ALTERNATIVE PROGRAMS KNOWN TO
 THE LICENSING BOARD REGARDLESS OF WHETHER SUCH PARTICIPATION  IS  DEEMED
 NONPUBLIC OR CONFIDENTIAL UNDER STATE LAW.
   D.  CURRENT SIGNIFICANT INVESTIGATIVE INFORMATION AND PARTICIPATION IN
 NONPUBLIC OR CONFIDENTIAL  ALTERNATIVE  PROGRAMS  SHALL  BE  TRANSMITTED
 THROUGH THE COORDINATED LICENSURE INFORMATION SYSTEM ONLY TO PARTY STATE
 LICENSING BOARDS.
   E. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, ALL PARTY STATE LICENS-
 ING  BOARDS CONTRIBUTING INFORMATION TO THE COORDINATED LICENSURE INFOR-
 MATION SYSTEM MAY DESIGNATE INFORMATION THAT  MAY  NOT  BE  SHARED  WITH
 NON-PARTY  STATES  OR DISCLOSED TO OTHER ENTITIES OR INDIVIDUALS WITHOUT
 THE EXPRESS PERMISSION OF THE CONTRIBUTING STATE.
   F. ANY PERSONALLY IDENTIFIABLE INFORMATION OBTAINED FROM  THE  COORDI-
 NATED  LICENSURE  INFORMATION  SYSTEM  BY  A PARTY STATE LICENSING BOARD
 SHALL NOT BE SHARED WITH NON-PARTY STATES OR DISCLOSED TO OTHER ENTITIES
 OR INDIVIDUALS EXCEPT TO THE EXTENT PERMITTED BY THE LAWS OF  THE  PARTY
 STATE CONTRIBUTING THE INFORMATION.
   G.  ANY  INFORMATION CONTRIBUTED TO THE COORDINATED LICENSURE INFORMA-
 TION SYSTEM THAT IS SUBSEQUENTLY REQUIRED TO BE EXPUNGED BY THE LAWS  OF
 THE  PARTY  STATE  CONTRIBUTING  THAT INFORMATION SHALL ALSO BE EXPUNGED
 FROM THE COORDINATED LICENSURE INFORMATION SYSTEM.
   H. THE COMPACT ADMINISTRATOR OF  EACH  PARTY  STATE  SHALL  FURNISH  A
 UNIFORM DATA SET TO THE COMPACT ADMINISTRATOR OF EACH OTHER PARTY STATE,
 WHICH SHALL INCLUDE, AT A MINIMUM:
   I. IDENTIFYING INFORMATION;
   II. LICENSURE DATA;
   III. INFORMATION RELATED TO ALTERNATIVE PROGRAM PARTICIPATION; AND
   IV.  OTHER  INFORMATION THAT MAY FACILITATE THE ADMINISTRATION OF THIS
 COMPACT, AS DETERMINED BY COMMISSION RULES.
   I. THE COMPACT ADMINISTRATOR OF A PARTY STATE SHALL PROVIDE ALL INVES-
 TIGATIVE DOCUMENTS AND INFORMATION REQUESTED BY ANOTHER PARTY STATE.
   § 8907. ESTABLISHMENT OF THE INTERSTATE COMMISSION OF NURSE  LICENSURE
 COMPACT ADMINISTRATORS.  1. COMMISSION OF NURSE LICENSURE COMPACT ADMIN-
 ISTRATORS.  THE  PARTY STATES HEREBY CREATE AND ESTABLISH A JOINT PUBLIC
 ENTITY KNOWN AS THE INTERSTATE COMMISSION  OF  NURSE  LICENSURE  COMPACT
 ADMINISTRATORS.  THE  COMMISSION  IS  AN  INSTRUMENTALITY  OF  THE PARTY
 STATES.
   2. VENUE. VENUE IS PROPER, AND JUDICIAL PROCEEDINGS BY OR AGAINST  THE
 COMMISSION SHALL BE BROUGHT SOLELY AND EXCLUSIVELY, IN A COURT OF COMPE-
 TENT  JURISDICTION  WHERE  THE  PRINCIPAL  OFFICE  OF  THE COMMISSION IS
 LOCATED. THE COMMISSION MAY WAIVE VENUE AND JURISDICTIONAL  DEFENSES  TO
 THE  EXTENT  IT ADOPTS OR CONSENTS TO PARTICIPATE IN ALTERNATIVE DISPUTE
 RESOLUTION PROCEEDINGS.
   3. SOVEREIGN IMMUNITY. NOTHING IN THIS COMPACT SHALL BE  CONSTRUED  TO
 BE A WAIVER OF SOVEREIGN IMMUNITY.
   4. MEMBERSHIP, VOTING AND MEETINGS. A. EACH PARTY STATE SHALL HAVE AND
 BE  LIMITED  TO ONE ADMINISTRATOR. THE HEAD OF THE STATE LICENSING BOARD
 OR DESIGNEE SHALL BE THE ADMINISTRATOR OF THIS COMPACT  FOR  EACH  PARTY
 STATE.    ANY  ADMINISTRATOR  MAY BE REMOVED OR SUSPENDED FROM OFFICE AS
 S. 8307                            107                           A. 8807

 PROVIDED BY THE LAW  OF  THE  STATE  FROM  WHICH  THE  ADMINISTRATOR  IS
 APPOINTED.  ANY  VACANCY  OCCURRING IN THE COMMISSION SHALL BE FILLED IN
 ACCORDANCE WITH THE LAWS OF THE PARTY STATE IN WHICH THE VACANCY EXISTS.
   B. EACH ADMINISTRATOR SHALL BE ENTITLED TO ONE VOTE WITH REGARD TO THE
 PROMULGATION OF RULES AND CREATION OF BYLAWS AND SHALL OTHERWISE HAVE AN
 OPPORTUNITY  TO  PARTICIPATE  IN THE BUSINESS AND AFFAIRS OF THE COMMIS-
 SION.  AN ADMINISTRATOR SHALL VOTE IN PERSON OR BY SUCH OTHER  MEANS  AS
 PROVIDED  IN  THE  BYLAWS. THE BYLAWS MAY PROVIDE FOR AN ADMINISTRATOR'S
 PARTICIPATION IN MEETINGS BY TELEPHONE OR OTHER MEANS OF COMMUNICATION.
   C. THE COMMISSION SHALL MEET AT LEAST ONCE DURING EACH CALENDAR  YEAR.
 ADDITIONAL MEETINGS SHALL BE HELD AS SET FORTH IN THE BYLAWS OR RULES OF
 THE COMMISSION.
   D.  ALL  MEETINGS  SHALL  BE  OPEN TO THE PUBLIC, AND PUBLIC NOTICE OF
 MEETINGS SHALL BE GIVEN IN THE SAME MANNER AS REQUIRED UNDER  THE  RULE-
 MAKING PROVISIONS IN SECTION EIGHTY-NINE HUNDRED EIGHT OF THIS ARTICLE.
   5. CLOSED MEETINGS. A. THE COMMISSION MAY CONVENE IN A CLOSED, NONPUB-
 LIC MEETING IF THE COMMISSION SHALL DISCUSS:
   I.  NONCOMPLIANCE  OF  A  PARTY  STATE WITH ITS OBLIGATIONS UNDER THIS
 COMPACT;
   II.  THE  EMPLOYMENT,  COMPENSATION,  DISCIPLINE  OR  OTHER  PERSONNEL
 MATTERS,  PRACTICES OR PROCEDURES RELATED TO SPECIFIC EMPLOYEES OR OTHER
 MATTERS RELATED TO THE COMMISSION'S  INTERNAL  PERSONNEL  PRACTICES  AND
 PROCEDURES;
   III. CURRENT, THREATENED OR REASONABLY ANTICIPATED LITIGATION;
   IV.  NEGOTIATION  OF  CONTRACTS  FOR  THE  PURCHASE  OR SALE OF GOODS,
 SERVICES OR REAL ESTATE;
   V. ACCUSING ANY PERSON OF A CRIME OR FORMALLY CENSURING ANY PERSON;
   VI. DISCLOSURE OF TRADE SECRETS OR COMMERCIAL OR FINANCIAL INFORMATION
 THAT IS PRIVILEGED OR CONFIDENTIAL;
   VII. DISCLOSURE OF INFORMATION OF A PERSONAL NATURE  WHERE  DISCLOSURE
 WOULD CONSTITUTE A CLEARLY UNWARRANTED INVASION OF PERSONAL PRIVACY;
   VIII. DISCLOSURE OF INVESTIGATORY RECORDS COMPILED FOR LAW ENFORCEMENT
 PURPOSES;
   IX. DISCLOSURE OF INFORMATION RELATED TO ANY REPORTS PREPARED BY OR ON
 BEHALF  OF THE COMMISSION FOR THE PURPOSE OF INVESTIGATION OF COMPLIANCE
 WITH THIS COMPACT; OR
   X. MATTERS SPECIFICALLY EXEMPTED FROM DISCLOSURE BY FEDERAL  OR  STATE
 STATUTE.
   B.  IF  A MEETING, OR PORTION OF A MEETING, IS CLOSED PURSUANT TO THIS
 PARAGRAPH THE COMMISSION'S LEGAL COUNSEL OR DESIGNEE SHALL CERTIFY  THAT
 THE  MEETING  MAY  BE CLOSED AND SHALL REFERENCE EACH RELEVANT EXEMPTING
 PROVISION. THE COMMISSION SHALL KEEP  MINUTES  THAT  FULLY  AND  CLEARLY
 DESCRIBE ALL MATTERS DISCUSSED IN A MEETING AND SHALL PROVIDE A FULL AND
 ACCURATE SUMMARY OF ACTIONS TAKEN, AND THE REASONS THEREFOR, INCLUDING A
 DESCRIPTION   OF  THE  VIEWS  EXPRESSED.  ALL  DOCUMENTS  CONSIDERED  IN
 CONNECTION WITH AN ACTION SHALL  BE  IDENTIFIED  IN  SUCH  MINUTES.  ALL
 MINUTES  AND  DOCUMENTS  OF  A  CLOSED  MEETING SHALL REMAIN UNDER SEAL,
 SUBJECT TO RELEASE BY A MAJORITY VOTE OF THE COMMISSION OR  ORDER  OF  A
 COURT OF COMPETENT JURISDICTION.
   C.  THE  COMMISSION  SHALL,  BY A MAJORITY VOTE OF THE ADMINISTRATORS,
 PRESCRIBE BYLAWS OR RULES TO GOVERN ITS CONDUCT AS MAY BE  NECESSARY  OR
 APPROPRIATE  TO  CARRY  OUT THE PURPOSES AND EXERCISE THE POWERS OF THIS
 COMPACT, INCLUDING BUT NOT LIMITED TO:
   I. ESTABLISHING THE FISCAL YEAR OF THE COMMISSION;
   II. PROVIDING REASONABLE STANDARDS AND PROCEDURES:
   (1) FOR THE ESTABLISHMENT AND MEETINGS OF OTHER COMMITTEES; AND
 S. 8307                            108                           A. 8807
 
   (2) GOVERNING ANY GENERAL OR SPECIFIC DELEGATION OF ANY  AUTHORITY  OR
 FUNCTION OF THE COMMISSION;
   III.  PROVIDING REASONABLE PROCEDURES FOR CALLING AND CONDUCTING MEET-
 INGS OF THE COMMISSION, ENSURING REASONABLE ADVANCE NOTICE OF ALL  MEET-
 INGS  AND  PROVIDING  AN  OPPORTUNITY FOR ATTENDANCE OF SUCH MEETINGS BY
 INTERESTED PARTIES, WITH ENUMERATED EXCEPTIONS DESIGNED TO  PROTECT  THE
 PUBLIC'S  INTEREST, THE PRIVACY OF INDIVIDUALS, AND PROPRIETARY INFORMA-
 TION, INCLUDING TRADE SECRETS. THE COMMISSION MAY MEET IN CLOSED SESSION
 ONLY AFTER A MAJORITY OF THE ADMINISTRATORS VOTE TO CLOSE A  MEETING  IN
 WHOLE  OR  IN  PART.  AS  SOON  AS PRACTICABLE, THE COMMISSION MUST MAKE
 PUBLIC A COPY OF THE VOTE TO CLOSE THE MEETING  REVEALING  THE  VOTE  OF
 EACH ADMINISTRATOR, WITH NO PROXY VOTES ALLOWED;
   IV.  ESTABLISHING  THE  TITLES,  DUTIES  AND  AUTHORITY AND REASONABLE
 PROCEDURES FOR THE ELECTION OF THE OFFICERS OF THE COMMISSION;
   V. PROVIDING REASONABLE STANDARDS AND PROCEDURES FOR THE ESTABLISHMENT
 OF THE PERSONNEL POLICIES AND PROGRAMS OF THE COMMISSION.  NOTWITHSTAND-
 ING  ANY  CIVIL  SERVICE  OR  OTHER SIMILAR LAWS OF ANY PARTY STATE, THE
 BYLAWS SHALL EXCLUSIVELY GOVERN THE PERSONNEL POLICIES AND  PROGRAMS  OF
 THE COMMISSION; AND
   VI. PROVIDING A MECHANISM FOR WINDING UP THE OPERATIONS OF THE COMMIS-
 SION  AND  THE EQUITABLE DISPOSITION OF ANY SURPLUS FUNDS THAT MAY EXIST
 AFTER THE TERMINATION OF THIS COMPACT AFTER THE PAYMENT OR RESERVING  OF
 ALL OF ITS DEBTS AND OBLIGATIONS.
   6.  GENERAL PROVISIONS. A. THE COMMISSION SHALL PUBLISH ITS BYLAWS AND
 RULES, AND ANY AMENDMENTS THERETO, IN A CONVENIENT FORM ON  THE  WEBSITE
 OF THE COMMISSION.
   B.  THE  COMMISSION SHALL MAINTAIN ITS FINANCIAL RECORDS IN ACCORDANCE
 WITH THE BYLAWS.
   C. THE COMMISSION SHALL MEET AND TAKE SUCH ACTIONS AS  ARE  CONSISTENT
 WITH THE PROVISIONS OF THIS COMPACT AND THE BYLAWS.
    7.  POWERS OF THE COMMISSION. THE COMMISSION SHALL HAVE THE FOLLOWING
 POWERS:
   A. TO PROMULGATE UNIFORM RULES TO FACILITATE AND COORDINATE  IMPLEMEN-
 TATION  AND  ADMINISTRATION  OF  THIS  COMPACT. THE RULES SHALL HAVE THE
 FORCE AND EFFECT OF LAW AND SHALL BE BINDING IN ALL PARTY STATES;
   B. TO BRING AND PROSECUTE LEGAL PROCEEDINGS OR ACTIONS IN THE NAME  OF
 THE COMMISSION, PROVIDED THAT THE STANDING OF ANY LICENSING BOARD TO SUE
 OR BE SUED UNDER APPLICABLE LAW SHALL NOT BE AFFECTED;
   C. TO PURCHASE AND MAINTAIN INSURANCE AND BONDS;
   D. TO BORROW, ACCEPT OR CONTRACT FOR SERVICES OF PERSONNEL, INCLUDING,
 BUT  NOT  LIMITED  TO, EMPLOYEES OF A PARTY STATE OR NONPROFIT ORGANIZA-
 TIONS;
   E.  TO  COOPERATE  WITH  OTHER  ORGANIZATIONS  THAT  ADMINISTER  STATE
 COMPACTS RELATED TO THE REGULATION OF NURSING, INCLUDING BUT NOT LIMITED
 TO  SHARING  ADMINISTRATIVE  OR  STAFF  EXPENSES,  OFFICE SPACE OR OTHER
 RESOURCES;
   F. TO HIRE EMPLOYEES, ELECT OR  APPOINT  OFFICERS,  FIX  COMPENSATION,
 DEFINE DUTIES, GRANT SUCH INDIVIDUALS APPROPRIATE AUTHORITY TO CARRY OUT
 THE  PURPOSES OF THIS COMPACT, AND TO ESTABLISH THE COMMISSION'S PERSON-
 NEL POLICIES AND PROGRAMS RELATING TO CONFLICTS OF INTEREST,  QUALIFICA-
 TIONS OF PERSONNEL AND OTHER RELATED PERSONNEL MATTERS;
   G.  TO  ACCEPT  ANY AND ALL APPROPRIATE DONATIONS, GRANTS AND GIFTS OF
 MONEY, EQUIPMENT, SUPPLIES, MATERIALS  AND  SERVICES,  AND  TO  RECEIVE,
 UTILIZE  AND DISPOSE OF THE SAME; PROVIDED THAT AT ALL TIMES THE COMMIS-
 SION SHALL AVOID ANY APPEARANCE OF IMPROPRIETY OR CONFLICT OF INTEREST;
 S. 8307                            109                           A. 8807

   H. TO LEASE, PURCHASE, ACCEPT APPROPRIATE GIFTS OR  DONATIONS  OF,  OR
 OTHERWISE  TO  OWN,  HOLD,  IMPROVE  OR USE, ANY PROPERTY, WHETHER REAL,
 PERSONAL OR MIXED; PROVIDED THAT AT ALL TIMES THE COMMISSION SHALL AVOID
 ANY APPEARANCE OF IMPROPRIETY;
   I.  TO  SELL,  CONVEY,  MORTGAGE,  PLEDGE, LEASE, EXCHANGE, ABANDON OR
 OTHERWISE DISPOSE OF ANY PROPERTY, WHETHER REAL, PERSONAL OR MIXED;
   J. TO ESTABLISH A BUDGET AND MAKE EXPENDITURES;
   K. TO BORROW MONEY;
   L. TO APPOINT COMMITTEES, INCLUDING ADVISORY COMMITTEES  COMPRISED  OF
 ADMINISTRATORS,  STATE  NURSING  REGULATORS,  STATE LEGISLATORS OR THEIR
 REPRESENTATIVES, AND CONSUMER REPRESENTATIVES, AND OTHER SUCH INTERESTED
 PERSONS;
   M. TO PROVIDE AND RECEIVE INFORMATION FROM, AND TO COOPERATE WITH, LAW
 ENFORCEMENT AGENCIES;
   N. TO ADOPT AND USE AN OFFICIAL SEAL; AND
   O. TO PERFORM SUCH OTHER FUNCTIONS AS MAY BE NECESSARY OR  APPROPRIATE
 TO  ACHIEVE THE PURPOSES OF THIS COMPACT CONSISTENT WITH THE STATE REGU-
 LATION OF NURSE LICENSURE AND PRACTICE.
   8. FINANCING OF THE  COMMISSION.  A.  THE  COMMISSION  SHALL  PAY,  OR
 PROVIDE  FOR  THE  PAYMENT OF, THE REASONABLE EXPENSES OF ITS ESTABLISH-
 MENT, ORGANIZATION AND ONGOING ACTIVITIES.
   B. THE COMMISSION MAY ALSO LEVY ON AND COLLECT  AN  ANNUAL  ASSESSMENT
 FROM  EACH  PARTY  STATE TO COVER THE COST OF ITS OPERATIONS, ACTIVITIES
 AND STAFF IN ITS ANNUAL BUDGET AS  APPROVED  EACH  YEAR.  THE  AGGREGATE
 ANNUAL ASSESSMENT AMOUNT, IF ANY, SHALL BE ALLOCATED BASED UPON A FORMU-
 LA  TO  BE  DETERMINED  BY THE COMMISSION, WHICH SHALL PROMULGATE A RULE
 THAT IS BINDING UPON ALL PARTY STATES.
   C. THE COMMISSION SHALL NOT INCUR OBLIGATIONS OF  ANY  KIND  PRIOR  TO
 SECURING  THE  FUNDS ADEQUATE TO MEET THE SAME; NOR SHALL THE COMMISSION
 PLEDGE THE CREDIT OF ANY OF THE PARTY STATES, EXCEPT BY,  AND  WITH  THE
 AUTHORITY OF, SUCH PARTY STATE.
   D.  THE  COMMISSION  SHALL  KEEP ACCURATE ACCOUNTS OF ALL RECEIPTS AND
 DISBURSEMENTS. THE RECEIPTS AND DISBURSEMENTS OF THE COMMISSION SHALL BE
 SUBJECT TO THE AUDIT AND ACCOUNTING  PROCEDURES  ESTABLISHED  UNDER  ITS
 BYLAWS.  HOWEVER, ALL RECEIPTS AND DISBURSEMENTS OF FUNDS HANDLED BY THE
 COMMISSION SHALL BE AUDITED YEARLY BY A  CERTIFIED  OR  LICENSED  PUBLIC
 ACCOUNTANT,  AND THE REPORT OF THE AUDIT SHALL BE INCLUDED IN AND BECOME
 PART OF THE ANNUAL REPORT OF THE COMMISSION.
   9. QUALIFIED IMMUNITY, DEFENSE AND INDEMNIFICATION. A. THE ADMINISTRA-
 TORS, OFFICERS, EXECUTIVE DIRECTOR, EMPLOYEES AND REPRESENTATIVES OF THE
 COMMISSION SHALL BE IMMUNE FROM SUIT AND LIABILITY, EITHER PERSONALLY OR
 IN THEIR OFFICIAL CAPACITY, FOR ANY CLAIM FOR DAMAGE TO OR LOSS OF PROP-
 ERTY OR PERSONAL INJURY OR OTHER CIVIL LIABILITY CAUSED  BY  OR  ARISING
 OUT  OF  ANY  ACTUAL OR ALLEGED ACT, ERROR OR OMISSION THAT OCCURRED, OR
 THAT THE PERSON AGAINST WHOM THE CLAIM IS MADE HAD  A  REASONABLE  BASIS
 FOR BELIEVING OCCURRED, WITHIN THE SCOPE OF THE COMMISSION'S EMPLOYMENT,
 DUTIES  OR  RESPONSIBILITIES;  PROVIDED  THAT  NOTHING IN THIS PARAGRAPH
 SHALL BE CONSTRUED TO PROTECT ANY SUCH PERSON FROM SUIT OR LIABILITY FOR
 ANY DAMAGE, LOSS, INJURY OR LIABILITY CAUSED BY THE INTENTIONAL, WILLFUL
 OR WANTON MISCONDUCT OF THAT PERSON.
   B. THE COMMISSION SHALL DEFEND ANY ADMINISTRATOR,  OFFICER,  EXECUTIVE
 DIRECTOR,  EMPLOYEE  OR  REPRESENTATIVE  OF  THE COMMISSION IN ANY CIVIL
 ACTION SEEKING TO IMPOSE LIABILITY ARISING OUT OF ANY ACTUAL OR  ALLEGED
 ACT,  ERROR  OR  OMISSION  THAT OCCURRED WITHIN THE SCOPE OF THE COMMIS-
 SION'S EMPLOYMENT,  DUTIES  OR  RESPONSIBILITIES,  OR  THAT  THE  PERSON
 AGAINST  WHOM  THE  CLAIM  IS  MADE HAD A REASONABLE BASIS FOR BELIEVING
 S. 8307                            110                           A. 8807
 
 OCCURRED WITHIN THE SCOPE OF  THE  COMMISSION'S  EMPLOYMENT,  DUTIES  OR
 RESPONSIBILITIES;  PROVIDED  THAT  NOTHING  HEREIN SHALL BE CONSTRUED TO
 PROHIBIT THAT PERSON FROM RETAINING HIS OR HER OWN COUNSEL; AND PROVIDED
 FURTHER THAT THE ACTUAL OR ALLEGED ACT, ERROR OR OMISSION DID NOT RESULT
 FROM THAT PERSON'S INTENTIONAL, WILLFUL OR WANTON MISCONDUCT.
   C. THE COMMISSION SHALL INDEMNIFY AND HOLD HARMLESS ANY ADMINISTRATOR,
 OFFICER,  EXECUTIVE  DIRECTOR, EMPLOYEE OR REPRESENTATIVE OF THE COMMIS-
 SION FOR THE AMOUNT OF ANY SETTLEMENT OR JUDGMENT OBTAINED AGAINST  THAT
 PERSON  ARISING OUT OF ANY ACTUAL OR ALLEGED ACT, ERROR OR OMISSION THAT
 OCCURRED WITHIN THE SCOPE OF  THE  COMMISSION'S  EMPLOYMENT,  DUTIES  OR
 RESPONSIBILITIES, OR THAT SUCH PERSON HAD A REASONABLE BASIS FOR BELIEV-
 ING  OCCURRED WITHIN THE SCOPE OF THE COMMISSION'S EMPLOYMENT, DUTIES OR
 RESPONSIBILITIES, PROVIDED THAT THE ACTUAL  OR  ALLEGED  ACT,  ERROR  OR
 OMISSION  DID NOT RESULT FROM THE INTENTIONAL, WILLFUL OR WANTON MISCON-
 DUCT OF THAT PERSON.
   § 8908. RULEMAKING. 1. RULEMAKING. A. THE  COMMISSION  SHALL  EXERCISE
 ITS RULEMAKING POWERS PURSUANT TO THE CRITERIA SET FORTH IN THIS ARTICLE
 AND  THE  RULES  ADOPTED  THEREUNDER.  RULES AND AMENDMENTS SHALL BECOME
 BINDING AS OF THE DATE SPECIFIED IN EACH RULE  OR  AMENDMENT  AND  SHALL
 HAVE THE SAME FORCE AND EFFECT AS PROVISIONS OF THIS COMPACT.
   B.  RULES  OR AMENDMENTS TO THE RULES SHALL BE ADOPTED AT A REGULAR OR
 SPECIAL MEETING OF THE COMMISSION.
   2. NOTICE. A. PRIOR TO PROMULGATION AND ADOPTION OF A  FINAL  RULE  OR
 RULES BY THE COMMISSION, AND AT LEAST SIXTY DAYS IN ADVANCE OF THE MEET-
 ING  AT WHICH THE RULE WILL BE CONSIDERED AND VOTED UPON, THE COMMISSION
 SHALL FILE A NOTICE OF PROPOSED RULEMAKING:
   I. ON THE WEBSITE OF THE COMMISSION; AND
   II. ON THE WEBSITE OF EACH LICENSING BOARD OR THE PUBLICATION IN WHICH
 EACH STATE WOULD OTHERWISE PUBLISH PROPOSED RULES.
   B. THE NOTICE OF PROPOSED RULEMAKING SHALL INCLUDE:
   I. THE PROPOSED TIME, DATE AND LOCATION OF THE MEETING  IN  WHICH  THE
 RULE WILL BE CONSIDERED AND VOTED UPON;
   II. THE TEXT OF THE PROPOSED RULE OR AMENDMENT, AND THE REASON FOR THE
 PROPOSED RULE;
   III.  A  REQUEST FOR COMMENTS ON THE PROPOSED RULE FROM ANY INTERESTED
 PERSON; AND
   IV. THE MANNER IN WHICH INTERESTED PERSONS MAY SUBMIT  NOTICE  TO  THE
 COMMISSION OF THEIR INTENTION TO ATTEND THE PUBLIC HEARING AND ANY WRIT-
 TEN COMMENTS.
   C.  PRIOR  TO  ADOPTION OF A PROPOSED RULE, THE COMMISSION SHALL ALLOW
 PERSONS TO SUBMIT WRITTEN DATA, FACTS,  OPINIONS  AND  ARGUMENTS,  WHICH
 SHALL BE MADE AVAILABLE TO THE PUBLIC.
   3. PUBLIC HEARINGS ON RULES. A. THE COMMISSION SHALL GRANT AN OPPORTU-
 NITY FOR A PUBLIC HEARING BEFORE IT ADOPTS A RULE OR AMENDMENT.
   B. THE COMMISSION SHALL PUBLISH THE PLACE, TIME AND DATE OF THE SCHED-
 ULED PUBLIC HEARING.
   I.  HEARINGS  SHALL BE CONDUCTED IN A MANNER PROVIDING EACH PERSON WHO
 WISHES TO COMMENT A FAIR AND REASONABLE OPPORTUNITY TO COMMENT ORALLY OR
 IN WRITING. ALL HEARINGS WILL BE RECORDED,  AND  A  COPY  WILL  BE  MADE
 AVAILABLE UPON REQUEST.
   II. NOTHING IN THIS SECTION SHALL BE CONSTRUED AS REQUIRING A SEPARATE
 HEARING  ON  EACH  RULE. RULES MAY BE GROUPED FOR THE CONVENIENCE OF THE
 COMMISSION AT HEARINGS REQUIRED BY THIS SECTION.
   C. IF NO ONE APPEARS AT THE PUBLIC HEARING, THE COMMISSION MAY PROCEED
 WITH PROMULGATION OF THE PROPOSED RULE.
 S. 8307                            111                           A. 8807
 
   D. FOLLOWING THE SCHEDULED HEARING DATE, OR BY THE CLOSE  OF  BUSINESS
 ON  THE  SCHEDULED HEARING DATE IF THE HEARING WAS NOT HELD, THE COMMIS-
 SION SHALL CONSIDER ALL WRITTEN AND ORAL COMMENTS RECEIVED.
   4.  VOTING  ON  RULES.  THE  COMMISSION SHALL, BY MAJORITY VOTE OF ALL
 ADMINISTRATORS, TAKE FINAL ACTION ON THE PROPOSED RULE AND SHALL  DETER-
 MINE  THE  EFFECTIVE  DATE  OF THE RULE, IF ANY, BASED ON THE RULEMAKING
 RECORD AND THE FULL TEXT OF THE RULE.
   5. EMERGENCY RULES. UPON DETERMINATION THAT AN EMERGENCY  EXISTS,  THE
 COMMISSION  MAY  CONSIDER  AND  ADOPT  AN  EMERGENCY  RULE WITHOUT PRIOR
 NOTICE, OPPORTUNITY FOR COMMENT OR  HEARING,  PROVIDED  THAT  THE  USUAL
 RULEMAKING PROCEDURES PROVIDED IN THIS COMPACT AND IN THIS SECTION SHALL
 BE  RETROACTIVELY APPLIED TO THE RULE AS SOON AS REASONABLY POSSIBLE, IN
 NO EVENT LATER THAN NINETY DAYS AFTER THE EFFECTIVE DATE  OF  THE  RULE.
 FOR  THE  PURPOSES OF THIS PROVISION, AN EMERGENCY RULE IS ONE THAT MUST
 BE ADOPTED IMMEDIATELY IN ORDER TO:
   A. MEET AN IMMINENT THREAT TO PUBLIC HEALTH, SAFETY OR WELFARE;
   B. PREVENT A LOSS OF THE COMMISSION OR PARTY STATE FUNDS; OR
   C. MEET A DEADLINE FOR THE PROMULGATION OF AN ADMINISTRATIVE RULE THAT
 IS REQUIRED BY FEDERAL LAW OR RULE.
   6. REVISIONS. THE COMMISSION MAY  DIRECT  REVISIONS  TO  A  PREVIOUSLY
 ADOPTED  RULE  OR  AMENDMENT  FOR  PURPOSES  OF CORRECTING TYPOGRAPHICAL
 ERRORS, ERRORS IN FORMAT, ERRORS IN CONSISTENCY OR  GRAMMATICAL  ERRORS.
 PUBLIC  NOTICE  OF  ANY  REVISIONS SHALL BE POSTED ON THE WEBSITE OF THE
 COMMISSION. THE REVISION SHALL BE SUBJECT TO CHALLENGE BY ANY PERSON FOR
 A PERIOD OF THIRTY DAYS AFTER POSTING. THE REVISION  MAY  BE  CHALLENGED
 ONLY  ON  GROUNDS  THAT  THE  REVISION RESULTS IN A MATERIAL CHANGE TO A
 RULE.   A CHALLENGE SHALL BE MADE  IN  WRITING,  AND  DELIVERED  TO  THE
 COMMISSION,  PRIOR  TO  THE END OF THE NOTICE PERIOD. IF NO CHALLENGE IS
 MADE, THE REVISION WILL TAKE  EFFECT  WITHOUT  FURTHER  ACTION.  IF  THE
 REVISION  IS  CHALLENGED,  THE  REVISION MAY NOT TAKE EFFECT WITHOUT THE
 APPROVAL OF THE COMMISSION.
   § 8909. OVERSIGHT, DISPUTE RESOLUTION AND ENFORCEMENT.  1.  OVERSIGHT.
 A.  EACH  PARTY  STATE  SHALL  ENFORCE THIS COMPACT AND TAKE ALL ACTIONS
 NECESSARY AND APPROPRIATE TO  EFFECTUATE  THIS  COMPACT'S  PURPOSES  AND
 INTENT.
   B.  THE  COMMISSION SHALL BE ENTITLED TO RECEIVE SERVICE OF PROCESS IN
 ANY PROCEEDING THAT MAY AFFECT THE POWERS, RESPONSIBILITIES  OR  ACTIONS
 OF  THE  COMMISSION,  AND  SHALL  HAVE  STANDING  TO INTERVENE IN SUCH A
 PROCEEDING FOR ALL PURPOSES. FAILURE TO PROVIDE SERVICE  OF  PROCESS  IN
 SUCH  PROCEEDING TO THE COMMISSION SHALL RENDER A JUDGMENT OR ORDER VOID
 AS TO THE COMMISSION, THIS COMPACT OR PROMULGATED RULES.
   2. DEFAULT, TECHNICAL ASSISTANCE AND TERMINATION. A. IF THE COMMISSION
 DETERMINES THAT A PARTY STATE HAS DEFAULTED IN THE  PERFORMANCE  OF  ITS
 OBLIGATIONS  OR  RESPONSIBILITIES  UNDER THIS COMPACT OR THE PROMULGATED
 RULES, THE COMMISSION SHALL:
   I. PROVIDE WRITTEN NOTICE TO THE  DEFAULTING  STATE  AND  OTHER  PARTY
 STATES  OF  THE  NATURE OF THE DEFAULT, THE PROPOSED MEANS OF CURING THE
 DEFAULT OR ANY OTHER ACTION TO BE TAKEN BY THE COMMISSION; AND
   II.  PROVIDE  REMEDIAL  TRAINING  AND  SPECIFIC  TECHNICAL  ASSISTANCE
 REGARDING THE DEFAULT.
   B.  IF  A  STATE  IN DEFAULT FAILS TO CURE THE DEFAULT, THE DEFAULTING
 STATE'S MEMBERSHIP IN THIS COMPACT MAY BE TERMINATED UPON AN AFFIRMATIVE
 VOTE OF A MAJORITY OF THE ADMINISTRATORS, AND ALL RIGHTS, PRIVILEGES AND
 BENEFITS CONFERRED BY THIS COMPACT MAY BE TERMINATED  ON  THE  EFFECTIVE
 DATE  OF TERMINATION. A CURE OF THE DEFAULT DOES NOT RELIEVE THE OFFEND-
 S. 8307                            112                           A. 8807
 
 ING STATE OF OBLIGATIONS OR LIABILITIES INCURRED DURING  THE  PERIOD  OF
 DEFAULT.
   C.  TERMINATION  OF  MEMBERSHIP  IN THIS COMPACT SHALL BE IMPOSED ONLY
 AFTER ALL OTHER MEANS OF SECURING COMPLIANCE HAVE BEEN EXHAUSTED. NOTICE
 OF INTENT TO SUSPEND OR TERMINATE SHALL BE GIVEN BY  THE  COMMISSION  TO
 THE GOVERNOR OF THE DEFAULTING STATE AND TO THE EXECUTIVE OFFICER OF THE
 DEFAULTING STATE'S LICENSING BOARD AND EACH OF THE PARTY STATES.
   D.  A  STATE  WHOSE  MEMBERSHIP IN THIS COMPACT HAS BEEN TERMINATED IS
 RESPONSIBLE FOR ALL ASSESSMENTS, OBLIGATIONS  AND  LIABILITIES  INCURRED
 THROUGH  THE  EFFECTIVE  DATE OF TERMINATION, INCLUDING OBLIGATIONS THAT
 EXTEND BEYOND THE EFFECTIVE DATE OF TERMINATION.
   E. THE COMMISSION SHALL NOT BEAR ANY COSTS RELATED TO A STATE THAT  IS
 FOUND  TO  BE  IN  DEFAULT  OR WHOSE MEMBERSHIP IN THIS COMPACT HAS BEEN
 TERMINATED UNLESS AGREED UPON IN WRITING BETWEEN THE COMMISSION AND  THE
 DEFAULTING STATE.
   F.  THE  DEFAULTING  STATE  MAY APPEAL THE ACTION OF THE COMMISSION BY
 PETITIONING THE U.S. DISTRICT COURT FOR THE DISTRICT OF COLUMBIA OR  THE
 FEDERAL  DISTRICT IN WHICH THE COMMISSION HAS ITS PRINCIPAL OFFICES. THE
 PREVAILING PARTY SHALL BE AWARDED ALL COSTS OF SUCH LITIGATION,  INCLUD-
 ING REASONABLE ATTORNEYS' FEES.
   3.  DISPUTE  RESOLUTION. A. UPON REQUEST BY A PARTY STATE, THE COMMIS-
 SION SHALL ATTEMPT TO RESOLVE DISPUTES RELATED TO THE COMPACT THAT ARISE
 AMONG PARTY STATES AND BETWEEN PARTY AND NON-PARTY STATES.
   B. THE COMMISSION SHALL PROMULGATE A RULE PROVIDING FOR BOTH MEDIATION
 AND BINDING DISPUTE RESOLUTION FOR DISPUTES, AS APPROPRIATE.
   C. IN THE EVENT THE COMMISSION CANNOT  RESOLVE  DISPUTES  AMONG  PARTY
 STATES ARISING UNDER THIS COMPACT:
   I. THE PARTY STATES MAY SUBMIT THE ISSUES IN DISPUTE TO AN ARBITRATION
 PANEL,  WHICH  WILL BE COMPRISED OF INDIVIDUALS APPOINTED BY THE COMPACT
 ADMINISTRATOR IN EACH OF THE AFFECTED PARTY STATES,  AND  AN  INDIVIDUAL
 MUTUALLY  AGREED  UPON  BY  THE  COMPACT ADMINISTRATORS OF ALL THE PARTY
 STATES INVOLVED IN THE DISPUTE.
   II. THE DECISION OF A MAJORITY OF THE ARBITRATORS SHALL BE  FINAL  AND
 BINDING.
   4.  ENFORCEMENT.  A. THE COMMISSION, IN THE REASONABLE EXERCISE OF ITS
 DISCRETION, SHALL ENFORCE THE PROVISIONS AND RULES OF THIS COMPACT.
   B. BY MAJORITY VOTE, THE COMMISSION MAY INITIATE LEGAL ACTION  IN  THE
 U.S.    DISTRICT  COURT  FOR  THE  DISTRICT  OF  COLUMBIA OR THE FEDERAL
 DISTRICT IN WHICH THE COMMISSION HAS ITS  PRINCIPAL  OFFICES  AGAINST  A
 PARTY STATE THAT IS IN DEFAULT TO ENFORCE COMPLIANCE WITH THE PROVISIONS
 OF  THIS COMPACT AND ITS PROMULGATED RULES AND BYLAWS. THE RELIEF SOUGHT
 MAY INCLUDE BOTH INJUNCTIVE RELIEF AND DAMAGES. IN  THE  EVENT  JUDICIAL
 ENFORCEMENT  IS  NECESSARY,  THE  PREVAILING  PARTY SHALL BE AWARDED ALL
 COSTS OF SUCH LITIGATION, INCLUDING REASONABLE ATTORNEYS' FEES.
   C. THE REMEDIES HEREIN SHALL NOT BE  THE  EXCLUSIVE  REMEDIES  OF  THE
 COMMISSION. THE COMMISSION MAY PURSUE ANY OTHER REMEDIES AVAILABLE UNDER
 FEDERAL OR STATE LAW.
   § 8910. EFFECTIVE  DATE,  WITHDRAWAL AND AMENDMENT. 1. EFFECTIVE DATE.
 A.  THIS COMPACT SHALL BECOME EFFECTIVE AND BINDING ON  THE  EARLIER  OF
 THE  DATE  OF  LEGISLATIVE ENACTMENT OF THIS COMPACT INTO LAW BY NO LESS
 THAN TWENTY-SIX STATES OR THE EFFECTIVE DATE OF THE CHAPTER OF THE  LAWS
 OF  TWO THOUSAND TWENTY-FOUR THAT ENACTED THIS COMPACT.  THEREAFTER, THE
 COMPACT SHALL BECOME EFFECTIVE AND BINDING AS TO  ANY  OTHER  COMPACTING
 STATE  UPON  ENACTMENT  OF THE COMPACT INTO LAW BY THAT STATE. ALL PARTY
 STATES TO THIS COMPACT, THAT ALSO WERE PARTIES TO THE PRIOR NURSE LICEN-
 SURE COMPACT, SUPERSEDED BY THIS COMPACT, (HEREIN REFERRED TO AS  "PRIOR
 S. 8307                            113                           A. 8807
 
 COMPACT"),  SHALL  BE  DEEMED  TO HAVE WITHDRAWN FROM SAID PRIOR COMPACT
 WITHIN SIX MONTHS AFTER THE EFFECTIVE DATE OF THIS COMPACT.
   B.  EACH  PARTY  STATE  TO  THIS COMPACT SHALL CONTINUE TO RECOGNIZE A
 NURSE'S MULTISTATE LICENSURE PRIVILEGE TO PRACTICE IN THAT  PARTY  STATE
 ISSUED UNDER THE PRIOR COMPACT UNTIL SUCH PARTY STATE HAS WITHDRAWN FROM
 THE PRIOR COMPACT.
   2.  WITHDRAWAL.  A.  ANY PARTY STATE MAY WITHDRAW FROM THIS COMPACT BY
 ENACTING A STATUTE REPEALING THE SAME. A PARTY STATE'S WITHDRAWAL  SHALL
 NOT  TAKE EFFECT UNTIL SIX MONTHS AFTER ENACTMENT OF THE REPEALING STAT-
 UTE.
   B. A PARTY STATE'S WITHDRAWAL OR  TERMINATION  SHALL  NOT  AFFECT  THE
 CONTINUING  REQUIREMENT OF THE WITHDRAWING OR TERMINATED STATE'S LICENS-
 ING BOARD TO  REPORT  ADVERSE  ACTIONS  AND  SIGNIFICANT  INVESTIGATIONS
 OCCURRING PRIOR TO THE EFFECTIVE DATE OF SUCH WITHDRAWAL OR TERMINATION.
   C.  NOTHING CONTAINED IN THIS COMPACT SHALL BE CONSTRUED TO INVALIDATE
 OR PREVENT ANY NURSE LICENSURE AGREEMENT OR OTHER  COOPERATIVE  ARRANGE-
 MENT BETWEEN A PARTY STATE AND A NON-PARTY STATE THAT IS MADE IN ACCORD-
 ANCE WITH THE OTHER PROVISIONS OF THIS COMPACT.
   3.  AMENDMENT.  A. THIS COMPACT MAY BE AMENDED BY THE PARTY STATES. NO
 AMENDMENT TO THIS COMPACT SHALL BECOME EFFECTIVE AND  BINDING  UPON  THE
 PARTY  STATES  UNLESS AND UNTIL IT IS ENACTED INTO THE LAWS OF ALL PARTY
 STATES.
   B. REPRESENTATIVES OF  NON-PARTY  STATES  TO  THIS  COMPACT  SHALL  BE
 INVITED TO PARTICIPATE IN THE ACTIVITIES OF THE COMMISSION, ON A NONVOT-
 ING BASIS, PRIOR TO THE ADOPTION OF THIS COMPACT BY ALL STATES.
   § 8911. CONSTRUCTION AND SEVERABILITY.  1. CONSTRUCTION AND SEVERABIL-
 ITY.  THIS  COMPACT SHALL BE LIBERALLY CONSTRUED SO AS TO EFFECTUATE THE
 PURPOSES THEREOF. THE PROVISIONS OF THIS COMPACT SHALL BE SEVERABLE, AND
 IF ANY PHRASE, CLAUSE, SENTENCE OR PROVISION OF THIS COMPACT IS DECLARED
 TO BE CONTRARY TO THE CONSTITUTION OF ANY PARTY STATE OR OF  THE  UNITED
 STATES,  OR  IF  THE  APPLICABILITY  THEREOF  TO ANY GOVERNMENT, AGENCY,
 PERSON OR CIRCUMSTANCE IS HELD  TO  BE  INVALID,  THE  VALIDITY  OF  THE
 REMAINDER  OF  THIS COMPACT AND THE APPLICABILITY THEREOF TO ANY GOVERN-
 MENT, AGENCY, PERSON OR CIRCUMSTANCE SHALL NOT BE AFFECTED  THEREBY.  IF
 THIS  COMPACT  SHALL  BE  HELD TO BE CONTRARY TO THE CONSTITUTION OF ANY
 PARTY STATE, THIS COMPACT SHALL REMAIN IN FULL FORCE AND  EFFECT  AS  TO
 THE  REMAINING PARTY STATES AND IN FULL FORCE AND EFFECT AS TO THE PARTY
 STATE AFFECTED AS TO ALL SEVERABLE MATTERS.
   § 3. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART S
 
   Section  1.  The  public health law is amended by adding a new section
 2825-i to read as follows:
   § 2825-I. HEALTHCARE SAFETY NET TRANSFORMATION PROGRAM. 1. A STATEWIDE
 HEALTHCARE SAFETY NET TRANSFORMATION PROGRAM SHALL BE ESTABLISHED WITHIN
 THE DEPARTMENT FOR THE PURPOSE OF SUPPORTING THE TRANSFORMATION OF SAFE-
 TY NET HOSPITALS TO IMPROVE ACCESS, EQUITY, QUALITY, AND OUTCOMES  WHILE
 INCREASING  THE  FINANCIAL  SUSTAINABILITY OF SAFETY NET HOSPITALS. SUCH
 PROGRAM MAY PROVIDE OR UTILIZE NEW OR EXISTING CAPITAL FUNDING, OR OPER-
 ATING SUBSIDIES, OR BOTH. A SAFETY NET HOSPITAL AND A PARTNER  ORGANIZA-
 TION MAY JOINTLY APPLY FOR THIS PROGRAM.
   2. THE COMMISSIONER SHALL ENTER AN AGREEMENT WITH THE PRESIDENT OF THE
 DORMITORY AUTHORITY OF THE STATE OF NEW YORK PURSUANT TO SECTION SIXTEEN
 HUNDRED EIGHTY-R OF THE PUBLIC AUTHORITIES LAW, AS REQUIRED, WHICH SHALL
 S. 8307                            114                           A. 8807
 
 APPLY  TO THIS AGREEMENT, SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE
 DIVISION OF THE BUDGET, FOR THE PURPOSES OF THE DISTRIBUTION AND  ADMIN-
 ISTRATION  OF AVAILABLE FUNDS PURSUANT TO SUCH AGREEMENT AND MADE AVAIL-
 ABLE  PURSUANT  TO THIS SECTION AND SUBJECT TO APPROPRIATION. SUCH FUNDS
 MAY BE AWARDED AND DISTRIBUTED BY THE DEPARTMENT TO  SAFETY  NET  HOSPI-
 TALS,  OR A PARTNER ORGANIZATION, IN THE FORM OF GRANTS. TO QUALIFY AS A
 SAFETY NET HOSPITAL FOR PURPOSES OF THIS SECTION, A HOSPITAL SHALL:
   (A) BE EITHER A PUBLIC HOSPITAL, A RURAL EMERGENCY HOSPITAL,  CRITICAL
 ACCESS HOSPITAL OR SOLE COMMUNITY HOSPITAL;
   (B)  HAVE  AT LEAST THIRTY PERCENT OF ITS INPATIENT DISCHARGES MADE UP
 OF MEDICAL ASSISTANCE PROGRAM ELIGIBLE INDIVIDUALS,  UNINSURED  INDIVID-
 UALS  OR  MEDICAL  ASSISTANCE PROGRAM DUALLY ELIGIBLE INDIVIDUALS AND AT
 LEAST THIRTY-FIVE PERCENT OF ITS OUTPATIENT VISITS MADE  UP  OF  MEDICAL
 ASSISTANCE   PROGRAM  ELIGIBLE  INDIVIDUALS,  UNINSURED  INDIVIDUALS  OR
 MEDICAL ASSISTANCE PROGRAM DUALLY-ELIGIBLE INDIVIDUALS;
   (C) SERVE AT LEAST THIRTY PERCENT OF THE RESIDENTS OF A  COUNTY  OR  A
 MULTI-COUNTY  AREA  WHO ARE MEDICAL ASSISTANCE PROGRAM ELIGIBLE INDIVID-
 UALS, UNINSURED INDIVIDUALS OR MEDICAL ASSISTANCE PROGRAM  DUALLY-ELIGI-
 BLE INDIVIDUALS; OR
   (D)  IN  THE DISCRETION OF THE COMMISSIONER, SERVE A SIGNIFICANT POPU-
 LATION OF MEDICAL ASSISTANCE  PROGRAM  ELIGIBLE  INDIVIDUALS,  UNINSURED
 INDIVIDUALS OR MEDICAL ASSISTANCE PROGRAM DUALLY-ELIGIBLE INDIVIDUALS.
   3.  PARTNER  ORGANIZATIONS MAY INCLUDE, BUT ARE NOT LIMITED TO, HEALTH
 SYSTEMS, HOSPITALS, HEALTH PLANS, RESIDENTIAL  HEALTH  CARE  FACILITIES,
 PHYSICIAN  GROUPS,  COMMUNITY-BASED  ORGANIZATION,  OR  OTHER HEALTHCARE
 ENTITIES WHO CAN SERVE AS PARTNERS IN THE TRANSFORMATION OF  THE  SAFETY
 NET  HOSPITAL.    THE COMMISSIONER SHALL HAVE THE DISCRETION TO DEEM ANY
 ORGANIZATION A PARTNER ORGANIZATION UPON A FINDING THAT DEEMING SO  WILL
 ADVANCE THE GOALS OF THIS SECTION.
   4.  NOTWITHSTANDING  ANY  LAW  TO THE CONTRARY, AND IN ACCORDANCE WITH
 ARTICLE FOUR OF THE STATE FINANCE LAW, THE COMPTROLLER IS HEREBY AUTHOR-
 IZED AND DIRECTED TO TRANSFER, UPON REQUEST OF THE DIRECTOR  OF  BUDGET,
 ON  OR  BEFORE  MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-FIVE, UP TO FIVE
 HUNDRED MILLION DOLLARS TO THE DEPARTMENT FROM AMOUNTS  APPROPRIATED  TO
 ADMINISTER  THE  PROGRAMS  ESTABLISHED  IN SECTIONS TWENTY-EIGHT HUNDRED
 TWENTY-FIVE-G AND TWENTY-EIGHT HUNDRED TWENTY-FIVE-H OF THIS ARTICLE  TO
 SUPPORT  THIS PROGRAM.   NOTWITHSTANDING SECTION ONE HUNDRED SIXTY-THREE
 OF THE STATE FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND ONE HUNDRED
 FORTY-THREE  OF  THE  ECONOMIC  DEVELOPMENT  LAW  OR  ANY   INCONSISTENT
 PROVISIONS  OF  LAW  TO  THE  CONTRARY, AWARDS MAY BE PROVIDED WITHOUT A
 COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS TO SAFETY NET  HOSPITALS
 OR  PARTNER  ORGANIZATIONS  FOR  PURPOSES  OF INCREASING ACCESS, EQUITY,
 QUALITY, OUTCOMES, AND LONG-TERM FINANCIAL SUSTAINABILITY OF SUCH SAFETY
 NET HOSPITALS.
   5. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY,  THE  COMMIS-
 SIONER  IS  AUTHORIZED  TO  WAIVE  ANY  REGULATORY REQUIREMENTS TO ALLOW
 APPLICANTS TO MORE EFFECTIVELY OR EFFICIENTLY IMPLEMENT PROJECTS AWARDED
 THROUGH THE HEALTHCARE  SAFETY  NET  TRANSFORMATION  PROGRAM,  PROVIDED,
 HOWEVER,  THAT  REGULATIONS PERTAINING TO PATIENT SAFETY, PATIENT AUTON-
 OMY, PATIENT PRIVACY, PATIENT RIGHTS, DUE PROCESS,  SCOPE  OF  PRACTICE,
 PROFESSIONAL  LICENSURE,  ENVIRONMENTAL PROTECTIONS, PROVIDER REIMBURSE-
 MENT METHODOLOGIES, OR OCCUPATIONAL STANDARDS AND  EMPLOYEE  RIGHTS  MAY
 NOT  BE WAIVED, NOR SHALL ANY REGULATIONS BE WAIVED IF SUCH WAIVER WOULD
 RISK PATIENT SAFETY. SUCH WAIVER  SHALL  NOT  EXCEED  THE  LIFE  OF  THE
 PROJECT  OR SUCH SHORTER TIME PERIODS AS THE COMMISSIONER MAY DETERMINE.
 ANY REGULATORY RELIEF GRANTED PURSUANT  TO  THIS  SUBDIVISION  SHALL  BE
 S. 8307                            115                           A. 8807

 SPECIFICALLY DESCRIBED AND REQUESTED WITHIN EACH PROJECT APPLICATION AND
 BE  REVIEWED  BY THE COMMISSIONER. THE WAIVER OF ANY REGULATORY REQUIRE-
 MENTS SHALL BE MADE IN THE SOLE DISCRETION OF THE COMMISSIONER.
   6. QUALIFYING SAFETY NET HOSPITALS AND THEIR DESIGNATED PARTNER ORGAN-
 IZATION  OR  ORGANIZATIONS  SHALL  PROVIDE,  AS PART OF THE APPLICATION,
 WHICH SHALL BE IN A MANNER AS PRESCRIBED BY THE COMMISSIONER,  A  TRANS-
 FORMATION  PLAN  THAT INCLUDES AT LEAST A FIVE-YEAR STRATEGIC AND OPERA-
 TIONAL PLAN OUTLINING THE ROLES AND RESPONSIBILITIES OF EACH ENTITY  AND
 SPECIFICALLY  STATE  ANY REGULATORY FLEXIBILITY WHICH MAY BE REQUIRED TO
 IMPLEMENT SUCH PLAN. THE TRANSFORMATION PLAN SHALL ALSO INCLUDE A  TIME-
 LINE OF KEY METRICS AND GOALS RELATED TO IMPROVED ACCESS, EQUITY, QUALI-
 TY,  OUTCOMES,  AND INCREASED FINANCIAL SUSTAINABILITY OF THE SAFETY NET
 HOSPITAL. THE REQUEST FOR LEVEL AND TYPE OF SUPPORT  SHALL  BE  SPECIFIC
 AND  DETAILED  IN THE APPLICATION. CONTINUED SUPPORT SHALL BE CONTINGENT
 UPON THE IMPLEMENTATION OF THE APPROVED PLAN AND KEY MILESTONES.  APPLI-
 CATIONS  MAY  INCLUDE A RANGE OF COLLABORATION MODELS, INCLUDING BUT NOT
 BE LIMITED TO MERGER, ACQUISITION, A MANAGEMENT SERVICES CONTRACT, OR  A
 CLINICAL INTEGRATION.
   7.  THE RELEASE OF ANY FUNDING WILL BE CONTINGENT UPON COMPLIANCE WITH
 THE TRANSFORMATION PLAN AND A DETERMINATION THAT ACCEPTABLE PROGRESS HAS
 BEEN MADE WITH SUCH PLAN. IF KEY MILESTONES AND GOALS ARE NOT MET, ADDI-
 TIONAL FINANCIAL RESOURCES MAY BE  WITHHELD  AND  REDIRECTED,  UPON  THE
 RECOMMENDATION OF THE COMMISSIONER AND APPROVAL BY THE DIRECTOR OF BUDG-
 ET.
   §  2.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART T
 
   Section 1. Subdivision 1 of section 2130 of the public health law,  as
 amended  by  chapter  308  of  the  laws  of 2010, is amended to read as
 follows:
   1. (A) Every physician or other person  authorized  by  law  to  order
 diagnostic tests or make a medical diagnosis, or any laboratory perform-
 ing  such  tests  shall  immediately [(a)] (I) upon determination that a
 person is [infected] POSITIVE/REACTIVE with human immunodeficiency virus
 (HIV), [(b)] (II) upon diagnosis [that a person is afflicted] with  [the
 disease  known  as]  acquired  immune  deficiency syndrome (AIDS), [(c)]
 (III) upon diagnosis [that a  person  is  afflicted]  with  HIV  related
 illness, and [(d)] (IV) upon periodic monitoring of HIV infection by any
 laboratory tests report such case or data to the commissioner.
   (B)  ANY  PERMITTED  CLINICAL  LABORATORY,  AS DEFINED IN SECTION FIVE
 HUNDRED SEVENTY-ONE OF THIS CHAPTER, PERFORMING  SUCH  DIAGNOSTIC  TESTS
 SHALL   ALSO,   UPON   DETERMINATION   THAT   A   TEST   RESULT  IS  NOT
 POSITIVE/REACTIVE FOR HIV, REPORT SUCH NEGATIVE HIV TEST RESULT  TO  THE
 COMMISSIONER.
   § 2. Subdivision 1 of section 2102 of the public health law is amended
 to read as follows:
   1.  Whenever any laboratory examination discloses evidence of communi-
 cable disease, AND FOR HEPATITIS B VIRUS OR SYPHILIS UPON  DETERMINATION
 THAT  A  TEST RESULT IS NOT POSITIVE/REACTIVE, the results of such exam-
 ination together with all required pertinent facts, shall be immediately
 reported by the person in charge of the laboratory or the person  making
 such  examination  to  the  local  or  state health official to whom the
 attending physician is required to report such case.
 S. 8307                            116                           A. 8807
 
   § 3. The public health law is amended by adding a new section 2172  to
 read as follows:
   § 2172. HCV INFECTION; DUTY TO REPORT. IN ADDITION TO REPORTING THAT A
 HEPATITIS C VIRUS (HCV) CLINICAL LABORATORY TEST IS REACTIVE/POSITIVE AS
 REQUIRED  BY SECTION TWENTY-ONE HUNDRED TWO OF THIS ARTICLE, ANY PERMIT-
 TED CLINICAL LABORATORY, AS DEFINED IN SECTION FIVE HUNDRED  SEVENTY-ONE
 OF  THIS  CHAPTER,  PERFORMING SUCH TESTS SHALL ALSO, UPON DETERMINATION
 THAT A TEST RESULT IS NOT POSITIVE/REACTIVE WITH HCV, REPORT SUCH  NEGA-
 TIVE HCV TEST RESULT TO THE COMMISSIONER.
   §  4. Section 2781 of the public health law, as amended by chapter 308
 of the laws of 2010, subdivisions 1 and 2 as amended by chapter  502  of
 the  laws of 2016 and subdivision 4 as amended by section 2 of part A of
 chapter 60 of the laws of 2014, is amended to read as follows:
   § 2781. HIV related testing. 1. Except as provided  in  section  three
 thousand  one hundred twenty-one of the civil practice law and rules, or
 unless otherwise specifically authorized  or  required  by  a  state  or
 federal  law,  no  person  shall order the performance of an HIV related
 test without first, at a minimum, [orally advising] PROVIDING NOTICE  BY
 MEANS READILY ACCESSIBLE IN MULTIPLE LANGUAGES TO the protected individ-
 ual,  or,  when  the  protected  individual lacks capacity to consent, a
 person authorized to consent to health care for such individual, that an
 HIV-related test is being performed, or over the objection of such indi-
 vidual or authorized  persons.  Such  [advisement  and  objection,  when
 applicable]  NOTICE  MAY  BE PROVIDED ORALLY, IN WRITING, BY PROMINENTLY
 DISPLAYED SIGNAGE, OR BY ELECTRONIC MEANS OR OTHER APPROPRIATE  FORM  OF
 COMMUNICATION. SUCH NOTICE SHALL INCLUDE INFORMATION THAT HIV TESTING IS
 VOLUNTARY.  A REFUSAL OF AN HIV RELATED TEST shall be noted in the indi-
 vidual's record.
   2. A person ordering the performance of  an  HIV  related  test  shall
 provide either directly or through a representative to the subject of an
 HIV  related  test  or,  if  the subject lacks capacity to consent, to a
 person authorized pursuant to law to consent  to  health  care  for  the
 subject, an explanation that:
   (a)  HIV  causes AIDS and can be transmitted through sexual activities
 and needle-sharing, by pregnant women  to  their  fetuses,  and  through
 breastfeeding infants;
   (b)  there is treatment for HIV that can help an individual stay heal-
 thy;
   (c) individuals with HIV or AIDS can adopt safe practices  to  protect
 uninfected  and infected people in their lives from becoming infected or
 multiply infected with HIV;
   (d) testing is voluntary and can be done anonymously at a public test-
 ing center;
   (e) the law protects the confidentiality of HIV related test results;
   (f) the law prohibits discrimination  based  on  an  individual's  HIV
 status and services are available to help with such consequences; and
   (g)  the  law requires that an individual be advised before an HIV-re-
 lated test is performed, and that no test shall be performed over his or
 her objection.
   Protocols shall be in place to ensure compliance with this section.
   4. [A person authorized pursuant to law to order the performance of an
 HIV related test shall provide directly or through a  representative  to
 the person seeking such test, an opportunity to remain anonymous through
 use of a coded system with no linking of individual identity to the test
 request or results.] A health care provider who is not authorized by the
 commissioner  to  provide  HIV related tests on an anonymous basis shall
 S. 8307                            117                           A. 8807
 
 refer a person who requests an anonymous test to a test site which  does
 provide  anonymous testing. The provisions of this subdivision shall not
 apply to a health care provider  ordering  the  performance  of  an  HIV
 related test on an individual proposed for insurance coverage.
   5.  At the time of communicating the test result to the subject of the
 test, a person ordering the performance of an HIV  related  test  shall,
 directly or through a representative:
   (a)  in  the  case  of  a  test  indicating evidence of HIV infection,
 provide the subject of the test or, if the  subject  lacks  capacity  to
 consent, the person authorized pursuant to law to consent to health care
 for the subject with counseling or referrals for counseling:
   (i) for coping with the emotional consequences of learning the result;
   (ii)  regarding  the  discrimination  problems  that disclosure of the
 result could cause;
   (iii) for behavior change to prevent transmission  or  contraction  of
 HIV infection;
   (iv) to inform such person of available medical treatments; [and]
   (v) regarding the need to notify his or her contacts; AND
   (VI)  REGARDING  PRE- AND POST-EXPOSURE PROPHYLAXIS MEDICATIONS AVAIL-
 ABLE TO SEXUAL PARTNERS TO PREVENT HIV INFECTION; and
   (b) in the case of a test not indicating evidence  of  HIV  infection,
 provide  (in  a manner which may consist of oral or written reference to
 information previously provided) the subject of  the  test,  or  if  the
 subject lacks capacity to consent, the person authorized pursuant to law
 to consent to health care for the subject, with information:
   (I)  concerning  the  risks  of  participating  in high risk sexual or
 needle-sharing behavior; AND
   (II) REGARDING PRE- AND POST-EXPOSURE PROPHYLAXIS  MEDICATIONS  AVAIL-
 ABLE TO PREVENT HIV INFECTION.
   5-a.  With the consent of the subject of a test indicating evidence of
 HIV infection or, if the subject lacks capacity  to  consent,  with  the
 consent  of  the  person authorized pursuant to law to consent to health
 care for the subject, the person who ordered the performance of the  HIV
 related  test, or such person's representative, shall provide or arrange
 with a health care provider for an  appointment  for  follow-up  medical
 care for HIV for such subject.
   6.  The  provisions of this section shall not apply to the performance
 of an HIV related test:
   (a) by a health care provider or health facility in  relation  to  the
 procuring,  processing,  distributing  or use of a human body or a human
 body part, including organs,  tissues,  eyes,  bones,  arteries,  blood,
 semen,  or other body fluids, for use in medical research or therapy, or
 for transplantation to individuals provided,  however,  that  where  the
 test  results  are communicated to the subject, post-test counseling, as
 described in subdivision five of  this  section,  shall  nonetheless  be
 required; or
   (b)  for  the  purpose  of  research  if the testing is performed in a
 manner by which the identity of the test subject is not  known  and  may
 not be retrieved by the researcher; or
   (c) on a deceased person, when such test is conducted to determine the
 cause of death or for epidemiological purposes; or
   (d)  conducted pursuant to section twenty-five hundred-f of this chap-
 ter; or
   (e) in situations involving  occupational  exposures  which  create  a
 significant  risk  of  contracting  or  transmitting  HIV  infection, as
 S. 8307                            118                           A. 8807
 
 defined in regulations of  the  department  and  pursuant  to  protocols
 adopted by the department,
   (i) provided that:
   (A)  the  person  who  is  the  source of the occupational exposure is
 deceased, comatose or is determined by his or her attending health  care
 professional  to  lack mental capacity to consent to an HIV related test
 and is not reasonably expected to recover in time for the exposed person
 to receive appropriate medical treatment, as determined by  the  exposed
 person's  attending  health care professional who would order or provide
 such treatment;
   (B) there is no person available or reasonably likely to become avail-
 able who has the legal authority to consent to the HIV related  test  on
 behalf  of  the  source person in time for the exposed person to receive
 appropriate medical treatment; and
   (C) the exposed person will benefit medically by  knowing  the  source
 person's  HIV test results, as determined by the exposed person's health
 care professional and documented in the exposed person's medical record;
   (ii) in which case
   (A) a provider shall order an anonymous HIV test of the source person;
 and
   (B) the results of such anonymous test, but not the  identity  of  the
 source  person,  shall  be  disclosed  only to the attending health care
 professional of the exposed person solely for the purpose  of  assisting
 the  exposed person in making appropriate decisions regarding post-expo-
 sure medical treatment; and
   (C) the results of the test shall  not  be  disclosed  to  the  source
 person or placed in the source person's medical record.
   7.  In the event that an HIV related test is ordered by a physician or
 certified nurse practitioner pursuant to the provisions of the education
 law providing for non-patient specific regimens, then for  the  purposes
 of this section the individual administering the test shall be deemed to
 be the individual ordering the test.
   §  5. Subdivision 4 of section 6909 of the education law is amended by
 adding a new paragraph (m) to read as follows:
   (M) UNDERTAKING THE COLLECTION  OF  SPECIMENS  NECESSARY  TO  TEST  TO
 DETERMINE THE PRESENCE OF THE HEPATITIS B VIRUS.
   §  6. Subdivision 6 of section 6527 of the education law is amended by
 adding a new paragraph (m) to read as follows:
   (M) UNDERTAKING THE COLLECTION  OF  SPECIMENS  NECESSARY  TO  TEST  TO
 DETERMINE THE PRESENCE OF THE HEPATITIS B VIRUS.
   §  7.  Section  6801  of  the education law is amended by adding a new
 subdivision 10 to read as follows:
   10. A. A LICENSED PHARMACIST MAY EXECUTE A NON-PATIENT SPECIFIC  ORDER
 FOR  THE DISPENSING OF HIV PRE-EXPOSURE PROPHYLAXIS (PREP) PRESCRIBED OR
 ORDERED BY THE COMMISSIONER OF HEALTH,  A  PHYSICIAN  LICENSED  IN  THIS
 STATE  OR A NURSE PRACTITIONER CERTIFIED IN THIS STATE PURSUANT TO RULES
 AND REGULATIONS PROMULGATED BY THE COMMISSIONER.
   B.  PRIOR TO DISPENSING HIV PREP TO A PATIENT, AND  AT  A  MINIMUM  OF
 EVERY TWELVE MONTHS FOR EACH RETURNING PATIENT, THE PHARMACIST SHALL:
   (I)  ENSURE THAT THE PATIENT IS HIV NEGATIVE, AS DOCUMENTED BY A NEGA-
 TIVE HIV TEST RESULT OBTAINED WITHIN THE PREVIOUS SEVEN DAYS FROM AN HIV
 ANTIGEN/ANTIBODY TEST OR ANTIBODY-ONLY TEST OR FROM A  RAPID,  POINT-OF-
 CARE FINGERSTICK BLOOD TEST APPROVED BY THE FEDERAL FOOD AND DRUG ADMIN-
 ISTRATION.  IF  THE  PATIENT DOES NOT PROVIDE EVIDENCE OF A NEGATIVE HIV
 TEST IN ACCORDANCE WITH THIS PARAGRAPH, THE PHARMACIST MAY RECOMMEND  OR
 PRESCRIBE  AN HIV TEST. IF THE PATIENT TESTS POSITIVE FOR HIV INFECTION,
 S. 8307                            119                           A. 8807
 
 THE PHARMACIST SHALL DIRECT THE PATIENT  TO  A  LICENSED  PHYSICIAN  AND
 PROVIDE  THE  PATIENT  WITH  A LIST OF HEALTH CARE SERVICE PROVIDERS AND
 CLINICS WITHIN THE COUNTY WHERE THE PHARMACIST IS  LOCATED  OR  ADJACENT
 COUNTIES;
   (II)  PROVIDE  THE PATIENT WITH A SELF-SCREENING RISK ASSESSMENT QUES-
 TIONNAIRE, DEVELOPED BY THE COMMISSIONER OF HEALTH IN CONSULTATION  WITH
 THE COMMISSIONER, TO BE REVIEWED BY THE PHARMACIST TO IDENTIFY ANY KNOWN
 RISK  FACTORS  AND ASSIST THE PATIENT'S SELECTION OF AN APPROPRIATE PREP
 MEDICATION; AND
   (III) PROVIDE THE PATIENT WITH A FACT SHEET, DEVELOPED BY THE  COMMIS-
 SIONER  OF  HEALTH,  THAT  INCLUDES  BUT IS NOT LIMITED TO, THE CLINICAL
 CONSIDERATIONS AND RECOMMENDATIONS FOR  USE  OF  PREP,  THE  APPROPRIATE
 METHOD FOR USING PREP, INFORMATION ON THE IMPORTANCE OF FOLLOW-UP HEALTH
 CARE,  HEALTH  CARE REFERRAL INFORMATION, AND THE ABILITY OF THE PATIENT
 TO OPT OUT OF PRACTITIONER REPORTING REQUIREMENTS.
   C. NO PHARMACIST SHALL DISPENSE PREP UNDER  THIS  SUBDIVISION  WITHOUT
 RECEIVING  TRAINING  IN  ACCORDANCE  WITH REGULATIONS PROMULGATED BY THE
 COMMISSIONER OF HEALTH IN CONSULTATION WITH THE COMMISSIONER.
   D. A PHARMACIST SHALL NOTIFY THE PATIENT'S PRIMARY HEALTH CARE PRACTI-
 TIONER, UNLESS THE PATIENT OPTS OUT OF SUCH NOTIFICATION, WITHIN  SEVEN-
 TY-TWO  HOURS  OF DISPENSING PREP, THAT PREP HAS BEEN DISPENSED.  IF THE
 PATIENT DOES NOT HAVE A PRIMARY HEALTH CARE PRACTITIONER, OR  IS  UNABLE
 TO PROVIDE CONTACT INFORMATION FOR THEIR PRIMARY HEALTH CARE PRACTITION-
 ER,  THE  PHARMACIST  SHALL PROVIDE THE PATIENT WITH A WRITTEN RECORD OF
 THE PREP MEDICATIONS DISPENSED, AND ADVISE THE  PATIENT  TO  CONSULT  AN
 APPROPRIATE HEALTH CARE PRACTITIONER.
   E.  NOTHING IN THIS SUBDIVISION SHALL PREVENT A PHARMACIST FROM REFUS-
 ING TO DISPENSE A NON-PATIENT SPECIFIC ORDER OF PREP  PURSUANT  TO  THIS
 SUBDIVISION  IF,  IN  THEIR  PROFESSIONAL  JUDGMENT,  POTENTIAL  ADVERSE
 EFFECTS, INTERACTIONS, OR OTHER THERAPEUTIC COMPLICATIONS COULD ENDANGER
 THE HEALTH OF THE PATIENT.
   § 8. Section 6801 of the education law is  amended  by  adding  a  new
 subdivision 11 to read as follows:
   11.    A LICENSED PHARMACIST WITHIN THEIR LAWFUL SCOPE OF PRACTICE MAY
 ADMINISTER TO PATIENTS EIGHTEEN YEARS OF AGE OR OLDER, IMMUNIZING AGENTS
 TO PREVENT MPOX PURSUANT TO A PATIENT SPECIFIC ORDER  OR  A  NON-PATIENT
 SPECIFIC ORDER.  WHEN A LICENSED PHARMACIST ADMINISTERS AN MPOX IMMUNIZ-
 ING  AGENT,  THEY  SHALL COMPLY WITH SUBDIVISIONS TWO, THREE AND FOUR OF
 THIS SECTION.
   § 9. Section 2307 of the public health law is REPEALED.
   § 10. This act  shall  take  effect  immediately;  provided,  however,
 sections  one,  two,  and three of this act shall take effect on the one
 hundred eightieth day after it shall have become a law.  Effective imme-
 diately, the addition, amendment and/or repeal of any rule or regulation
 necessary for the implementation of this act on its effective  date  are
 authorized to be made and completed on or before such effective date.
 
                                  PART U
 
   Section  1. Section 3302 of the public health law is amended by adding
 two new subdivisions 42 and 43 to read as follows:
   42. "PUBLIC HEALTH  SURVEILLANCE"  MEANS  THE  CONTINUOUS,  SYSTEMATIC
 COLLECTION,  ANALYSIS,  AND INTERPRETATION OF HEALTH-RELATED DATA NEEDED
 FOR THE PLANNING, IMPLEMENTATION, AND EVALUATION OF PUBLIC HEALTH  PRAC-
 TICE.  PUBLIC  HEALTH  SURVEILLANCE MAY BE USED FOR ALL OF THE FOLLOWING
 PURPOSES:
 S. 8307                            120                           A. 8807
 
   (A) AS AN EARLY WARNING SYSTEM FOR IMPENDING  PUBLIC  HEALTH  EMERGEN-
 CIES;
   (B) TO DOCUMENT THE IMPACT OF AN INTERVENTION;
   (C) TO TRACK PROGRESS TOWARDS SPECIFIED GOALS;
   (D) TO MONITOR AND CLARIFY THE EPIDEMIOLOGY OF HEALTH OUTCOMES;
   (E) TO ESTABLISH PUBLIC HEALTH PRIORITIES; AND
   (F) TO INFORM PUBLIC HEALTH POLICY AND STRATEGIES.
   43.  "PATIENT  IDENTIFYING  INFORMATION"  MEANS  INFORMATION OR DIRECT
 IDENTIFIERS AND DEMOGRAPHIC INFORMATION THAT  CAN  BE  USED  TO  READILY
 IDENTIFY  A  PARTICULAR  PATIENT  AS  MAY BE SPECIFIED IN MORE DETAIL IN
 REGULATIONS PROMULGATED BY THE COMMISSIONER.
   § 2. Subparagraphs (ix) and (x) of paragraph (a) of subdivision  2  of
 section 3343-a of the public health law, as added by section 2 of part A
 of  chapter  447 of the laws of 2012, are amended and a new subparagraph
 (xi) is added to read as follows:
   (ix) a situation where the registry is not operational  as  determined
 by the department or where it cannot be accessed by the practitioner due
 to  a  temporary  technological  or  electrical failure, as set forth in
 regulation; [or]
   (x) a practitioner who has been granted a waiver due to  technological
 limitations  that  are  not reasonably within the control of the practi-
 tioner, or other exceptional circumstance demonstrated  by  the  practi-
 tioner,  pursuant  to  a  process  established in regulation, and in the
 discretion of the commissioner[.]; OR
   (XI) A PRACTITIONER PRESCRIBING OR ORDERING A CONTROLLED SUBSTANCE FOR
 USE ON THE PREMISES OF A  CORRECTIONAL  FACILITY,  AN  INPATIENT  MENTAL
 HEALTH FACILITY LICENSED UNDER THE MENTAL HYGIENE LAW, OR A NURSING HOME
 LICENSED UNDER ARTICLE TWENTY-EIGHT OF THIS CHAPTER.
   §  3. Subdivision 4 of section 3370 of the public health law, as added
 by chapter 965 of the laws of 1974 and as renumbered by chapter  178  of
 the laws of 2010, is amended to read as follows:
   4.  The  department shall cause to be expunged or otherwise destroyed,
 within [five] TEN years from the date of receipt thereof, any record  of
 the  name  of any patient received by it pursuant to the filing require-
 ments of subdivision six of  section  thirty-three  hundred  thirty-one,
 subdivision  four  of  section  thirty-three  hundred  thirty-three, and
 subdivision four of section thirty-three  hundred  thirty-four  of  this
 article.
   §  4.  Subdivision  1  of  section  3371  of the public health law, as
 amended by chapter 178 of the laws of 2010, paragraphs (d)  and  (e)  as
 amended and paragraphs (f), (g), (h), (i), and (j) as added by section 4
 of  part  A  of  chapter  447 of the laws of 2012, is amended to read as
 follows:
   1. No person, who has knowledge by virtue of his or her office of  the
 identity  of  a  particular patient or research subject, a manufacturing
 process, a trade secret or a formula OR  POSSESSES  PATIENT  IDENTIFYING
 INFORMATION shall disclose such knowledge, or any report or record ther-
 eof, except:
   (a)  to  another  person  employed  by the department, for purposes of
 executing provisions of this article;
   (b) pursuant to judicial subpoena or court order in a criminal  inves-
 tigation or proceeding;
   (c)  to an agency, department of government, or official board author-
 ized to regulate, license or otherwise supervise a person who is author-
 ized by this article to deal in controlled substances, or in the  course
 S. 8307                            121                           A. 8807
 
 of  any investigation or proceeding by or before such agency, department
 or board;
   (d)  to the prescription monitoring program registry and to authorized
 users of such registry as set forth in subdivision two of this section;
   (e) A VENDOR OR CONTRACTOR, AS AUTHORIZED BY THE DEPARTMENT AS  NECES-
 SARY  FOR  THE  OPERATION AND MAINTENANCE OF THE PRESCRIPTION MONITORING
 PROGRAM REGISTRY;
   (F) to a practitioner to inform him or her that a patient may be under
 treatment with a controlled substance by another  practitioner  for  the
 purposes  of  subdivision  two  of  this  section, and to facilitate the
 department's  review  of  individual  challenges  to  the  accuracy   of
 controlled  substances  histories pursuant to subdivision six of section
 thirty-three hundred forty-three-a of this article;
   [(f)]  (G)  to  a  pharmacist   to   provide   information   regarding
 prescriptions  for controlled substances presented to the pharmacist for
 the purposes of subdivision two of this section and  to  facilitate  the
 department's   review  of  individual  challenges  to  the  accuracy  of
 controlled substances histories pursuant to subdivision six  of  section
 thirty-three hundred forty-three-a of this article;
   [(g)]  (H)  to the deputy attorney general for medicaid fraud control,
 or his or her designee, in furtherance of  an  investigation  of  fraud,
 waste  or  abuse  of the Medicaid program, pursuant to an agreement with
 the department;
   [(h)] (I) TO A PROGRAM AREA WITHIN THE DEPARTMENT FOR THE  PURPOSE  OF
 CONDUCTING PUBLIC HEALTH RESEARCH, PUBLIC HEALTH SURVEILLANCE, OR EDUCA-
 TION  WITH DATA CONTAINED IN THE PRESCRIPTION MONITORING PROGRAM AND NOT
 FOR PATIENT-LEVEL OUTREACH:
   (I) PURSUANT TO AN AGREEMENT WITH THE COMMISSIONER;
   (II) WHEN THE RELEASE OF SUCH INFORMATION IS DEEMED APPROPRIATE BY THE
 COMMISSIONER;
   (III) FOR USE IN ACCORDANCE WITH MEASURES REQUIRED BY THE COMMISSIONER
 TO  ENSURE  THAT  THE  SECURITY  AND  CONFIDENTIALITY  OF  THE  DATA  IS
 PROTECTED;
   (IV) FOR USE AND RETENTION NO LONGER THAN TEN YEARS; AND
   (V)  PROVIDED  THAT DISCLOSURE IS RESTRICTED TO INDIVIDUALS WITHIN THE
 DEPARTMENT WHO ARE ENGAGED IN  PUBLIC  HEALTH  RESEARCH,  PUBLIC  HEALTH
 SURVEILLANCE, OR EDUCATION;
   (J)  to a local health department for the purpose of conducting public
 health research, PUBLIC HEALTH SURVEILLANCE or  education  AND  NOT  FOR
 PATIENT-LEVEL  OUTREACH:   (i) pursuant to an agreement with the commis-
 sioner; (ii) when the release of such information is deemed  appropriate
 by  the commissioner; (iii) for use in accordance with measures required
 by the commissioner to ensure that the security and  confidentiality  of
 the  data  is  protected;  (IV) FOR USE AND RETENTION NO LONGER THAN TEN
 YEARS; and [(iv)] (V) provided that disclosure is restricted to individ-
 uals within the local health department who are engaged in the  research
 or education;
   [(i)]  (K)  to  a  medical examiner or coroner who is an officer of or
 employed by a state or local government, pursuant to his or her official
 duties; and
   [(j)] (L) to an individual for the purpose of providing such  individ-
 ual  with his or her own controlled substance history or, in appropriate
 circumstances, in the case of a  patient  who  lacks  capacity  to  make
 health  care  decisions,  a  person who has legal authority to make such
 decisions for the patient  and  who  would  have  legal  access  to  the
 patient's health care records, if requested from the department pursuant
 S. 8307                            122                           A. 8807
 
 to subdivision six of section thirty-three hundred forty-three-a of this
 article or from a treating practitioner pursuant to subparagraph (iv) of
 paragraph (a) of subdivision two of this section.
   §  5.  Subdivision  (b)  of  schedule  I of section 3306 of the public
 health law is amended by adding eleven new paragraphs 93,  94,  95,  96,
 97, 98, 99, 100, 101, 102 and 103 to read as follows:
   (93) ZIPEPROL (1-METHOXY-3-[4-(2-methoxy-2-phenylethyl)piperazin-1-yl]
 -1-PHENYLPROPAN-2-OL).
   (94) N,N-DIETHYL-2-(2-(4-METHOXYBENZYL)-5-NITRO-1H-BENZIMIDAZOL-1-YL)E
 THAN-1-AMINE. SOME TRADE OR OTHER NAMES: METONITAZENE.
   (95) META-FLUOROFENTANYL(N-(3-FLUOROPHENYL)-N-(1-PHENETHYLPIPERIDIN-4-
 YL)PROPIONAMIDE).
   (96) META-FLUOROISOBUTYRYL FENTANYL(N-(3-FLUOROPHENYL)-N-(1-PHENETHYLP
 IPERIDIN-4-YL)ISOBUTYRAMIDE).
   (97) PARA-METHOXYFURANYL FENTANYL (N-(4-METHOXYPHENYL)-N-(1-PHENETHYLP
 IPERIDIN-4-YL)FURAN-2-CARBOXAMIDE).
   (98) 3-FURANYL FENTANYL(N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLFURAN-3-
 CARBOXAMIDE).
   (99) 2',5'-DIMETHOXYFENTANYL(N-(1-(2,5-DIMETHOXYPHENETHYL)PIPERIDIN-4-
 YL)-N-PHENYLPROPIONAMIDE).
   (100) ISOVALERYL FENTANYL(3-METHYL-N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHE
 NYLBUTANAMIDE).
   (101) ORTHO-FLUOROFURANYL FENTANYL(N-(2-FLUOROPHENYL)-N-(1-PHENETHYLPI
 PERIDIN-4-YL)FURAN-2-CARBOXAMIDE).
   (102) ALPHA'-METHYL BUTYRYL FENTANYL(2-METHYL-N-(1-PHENETHYLPIPERIDIN-
 4-YL)-N-PHENYLBUTANAMIDE).
   (103) PARA-METHYLCYCLOPROPYL FENTANYL (N-(4-METHYLPHENYL)-N-(1-PHENETH
 YLPIPERIDIN-4-YL)CYCLOPROPANECARBOXAMIDE).
   §  6. Paragraphs 11 and 36 of subdivision (d) of schedule I of section
 3306 of the public health law, paragraph 11 as added by chapter  664  of
 the  laws  of  1985 and paragraph 36 as added by section 5 of part BB of
 chapter 57 of the laws of 2018, are amended to read as follows:
   (11) [Ibogane] IBOGAINE. Some trade and other names: 7-ethyl-6, 6&, 7,
 8, 9, 10, 12, 13-octahydro-2-methoxy-6, 9-methano-5h-pyrido  {1',2':1,2}
 azepino {5,4-b} indole: tabernanthe iboga.
   (36)  5-methoxy-N,N-dimethyltryptamine.  SOME  TRADE  OR  OTHER NAMES:
 5-METHOXY-3-[2-(dimethylamino)ethyl]INDOLE; 5-MEO-DMT.
   § 7. Subdivision (d) of schedule I  of  section  3306  of  the  public
 health  law is amended by adding nineteen new paragraphs 32, 39, 40, 41,
 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55 and 56 to read as
 follows:
   (32) 4-METHYL-N-ETHYLCATHINONE.  SOME TRADE OR OTHER NAMES: 4-MEC.
   (39)  4-METHYL-ALPHA-PYRROLIDINOPROPIOPHENONE.  SOME  TRADE  OR  OTHER
 NAMES:  4-MEPPP.
   (40) ALPHA-PYRROLIDINOPENTIOPHENONE. SOME TRADE OR OTHER NAMES: @-PVP.
   (41)  1-(1,3-BENZODIOXOL-5-YL)-2-(METHYLAMINO)BUTAN-1-ONE.  SOME TRADE
 OR OTHER NAMES: BUTYLONE; BK-MBDB.
   (42) 2-(METHYLAMINO)-1-PHENYLPENTAN-1-ONE. SOME TRADE OR OTHER  NAMES:
 PENTEDRONE.
   (43)  1-(1,3-BENZODIOXOL-5-YL)-2-(METHYLAMINO)PENTAN-1-ONE. SOME TRADE
 OR OTHER NAMES: PENTYLONE; BK-MBDP.
   (44) 1-(NAPHTHALEN-2-YL)-2-(PYRROLIDIN-1-YL)PENTAN-1-ONE.  SOME  TRADE
 OR OTHER NAMES: NAPHYRONE.
   (45) ALPHA-PYRROLIDINOBUTIOPHENONE. SOME TRADE OR OTHER NAMES: @-PBP.
   (46) 1-(1,3-BENZODIOXOL-5-YL)-2-(ETHYLAMINO)PROPAN-1-ONE (ETHYLONE).
 S. 8307                            123                           A. 8807

   (47)  N-ETHYLPENTYLONE.    SOME  TRADE  OR  OTHER  NAMES:    EPHYLONE,
 1-(1,3-BENZODIOXOL-5-YL)-2-(ETHYLAMINO)PENTAN-1-ONE).
   (48)  1-(4-METHOXYPHENYL)-N-METHYLPROPAN-2-AMINE.  SOME TRADE OR OTHER
 NAMES: PARA-METHOXYMETHAMPHETAMINE; PMMA.
   (49)   N-ETHYLHEXEDRONE.        SOME    TRADE    OR    OTHER    NAMES:
 @-ETHYLAMINOHEXANOPHENONE; 2-(ETHYLAMINO)-1-PHENYLHEXAN-1-ONE.
   (50) ALPHA-PYRROLIDINOHEXANOPHENONE. SOME TRADE OR OTHER NAMES: @-PHP;
 ALPHA-PYRROLIDINOHEXANOPHENONE; 1-PHENYL-2-(PYRROLIDIN-1-YL)HEXAN-1-ONE.
   (51)  4-METHYL-ALPHA-ETHYLAMINOPENTIOPHENONE.    SOME  TRADE  OR OTHER
 NAMES:  4-MEAP; 2-(ETHYLAMINO)-1-(4-METHYLPHENYL)PENTAN-1-ONE.
   (52) 4'-METHYL-ALPHA-PYRROLIDINOHEXIOPHENONE.    SOME TRADE  OR  OTHER
 NAMES:          MPHP;          4'-METHYL-ALPHA-PYRROLIDINOHEXANOPHENONE;
 1-(4-METHYLPHENYL)-2-(PYRROLIDIN-1-YL)HEXAN-1-ONE.
   (53) ALPHA-PYRROLIDINOHEPTAPHENONE.   SOME TRADE OR OTHER NAMES:  PV8;
 1-PHENYL-2-(PYRROLIDIN-1-YL)HEPTAN-1-ONE.
   (54)  4-CHLORO-ALPHA-PYRROLIDINOVALEROPHENONE.  SOME  TRADE  OR  OTHER
 NAMES:      4-CHLORO-@-PVP;    4'-CHLORO-ALPHA-PYRROLIDINOPENTIOPHENONE;
 1-(4-CHLOROPHENYL)-2-(PYRROLIDIN-1-YL)PENTAN-1-ONE.
   (55)   2-(ETHYLAMINO)-2-(3-METHOXYPHENYL)CYCLOHEXAN-1-ONE  (METHOXETA-
 MINE, MXE).
   (56) 1-(1,3-BENZODIOXOL-5-YL)-2-(ETHYLAMINO)BUTAN-1-ONE. SOME TRADE OR
 OTHER NAMES: EUTYLONE; BK-EBDB.
   § 8. Subdivision (e) of schedule I  of  section  3306  of  the  public
 health  law  is amended by adding five new paragraphs 7, 8, 9, 10 and 11
 to read as follows:
   (7) 4-(2-CHLOROPHENYL)-2-ETHYL-9-METHYL-6H-THIENO{3,2-F}{1,2,4}TRIAZOL
 O{4,3-A}{1,4}DIAZEPINE. SOME TRADE OR OTHER NAMES: ETIZOLAM.
   (8) 8-CHLORO-6-(2-FLUOROPHENYL)-1-METHYL-4H-BENZO{F}{1,2,4}TRIAZOLO{4,
 3-A}{1,4}DIAZEPINE. SOME TRADE OR OTHER NAMES: FLUALPRAZOLAM.
   (9) 6-(2-CHLOROPHENYL)-1-METHYL-8-NITRO-4H-BENZO{F}{1,2,4}TRIAZOLO{4,3
 -A}{1,4}DIAZEPINE. SOME TRADE OR OTHER NAMES: CLONAZOLAM.
   (10) 8-BROMO-6-(2-FLUOROPHENYL)-1-METHYL-4H-BENZO{F}{1,2,4}TRIAZOLO{4,
 3-A}{1,4}DIAZEPINE (ALTERNATE CHEMICAL NAME: 8-BROMO-6-(2-FLUOROPHENYL)-
 1-METHYL-4H-{1,2,4}TRIAZOLO{4,3-A}{1,4}BENZODIAZEPINE).  SOME  TRADE  OR
 OTHER NAMES: FLUBROMAZOLAM.
   (11) 7-CHLORO-5-(2-CHLOROPHENYL)-1-METHYL-1,3-DIHYDRO-2H-BENZO{E}{1,4}
 DIAZEPIN-2-ONE. SOME TRADE OR OTHER NAMES: DICLAZEPAM.
   §  9. Paragraphs 13 and 14 of subdivision (f) of schedule I of section
 3306 of the public health law, as added by chapter 341 of  the  laws  of
 2013, are amended and four new paragraphs 25, 26, 27 and 28 are added to
 read as follows:
   (13) 3-Fluoromethcathinone.  SOME  TRADE  OR  OTHER  NAMES: 3-FLUORO-N
 -METHYLCATHINONE; 3-FMC.
   (14) 4-Fluoromethcathinone. SOME TRADE OR OTHER NAMES:  4-FLUORO-N-ME-
 THYLCATHINONE; 4-FMC; FLEPHEDRONE.
   (25) 7-[(10,11-dihydro-5H-dibenzo]A,D[cyclohepten-5-yl)amino]HEPTANOIC
 ACID. OTHER NAME: AMINEPTINE.
   (26)  N-PHENYL-N'-(3-(1-PHENYLPROPAN-2-YL)-1,2,3-OXADIAZOL-3-IUM-5-YL)
 CARBAMIMIDATE. OTHER NAME: MESOCARB.
   (27) N-METHYL-1-(THIOPHEN-2-YL)PROPAN-2-AMINE. OTHER NAME:  METHIOPRO-
 PAMINE.
   (28) 4,4'-DIMETHYLAMINOREX.    SOME  TRADE  OR OTHER NAMES: 4,4'-DMAR;
 4,5-DIHYDRO-4-METHYL-5-(4-METHYLPHENYL)-2-OXAZOLAMINE; 4-METHYL-5-(4 MET
 HYLPHENYL)-4,5-DIHYDRO-1,3-OXAZOL-2-AMINE.
 S. 8307                            124                           A. 8807
 
   § 10. Paragraphs 2, 6 and 10 of  subdivision  (g)  of  schedule  I  of
 section  3306 of the public health law, as added by section 7 of part BB
 of chapter 57 of the laws of 2018, are amended to read as follows:
   (2) {1-(5-fluro-pentyl)-1H-indol-3-yl}(2,2,3,3-tetramethylcyclopropyl)
 methanone. Some trade names or other names: 5-fluoro-UR-144[,]; XLR11.
   (6) N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(4-fluorobenzyl)-1H-indazo
 [-] le-3-carboxamide. Some trade or other names: AB-FUBINACA.
   (10) {1-(5-fluoropentyl)-1H-indazol-3-yl}(naphthalen-1-[y1]  YL)metha-
 none. Some trade or other names: THJ-2201.
   § 11. Subdivision (g) of schedule I of  section  3306  of  the  public
 health  law is amended by adding nineteen new paragraphs 11, 12, 13, 14,
 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28 and 29 to read as
 follows:
   (11) N-(1-AMINO-3,3-DIMETHYL-1-OXOBUTAN-2-YL)-1-(CYCLOHEXYLMETHYL)-1H-
 INDAZOLE-3-CARBOXAMIDE. SOME  TRADE  OR   OTHER   NAMES:   MAB-CHMINACA;
 ADB-CHMINACA.
   (12) METHYL 2-(1-(4-FLUOROBENZYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3-METHYLB
 UTANOATE.  SOME TRADE OR OTHER NAMES: FUB-AMB; MMB-FUBINACA; AMB-FUBINA-
 CA.
   (13) METHYL 2-(1-(CYCLOHEXYLMETHYL)-1H-INDOLE-3-CARBOXAMIDO)-3,3-
 DIMETHYLBUTANOATE. SOME TRADE OR OTHER NAMES: MDMB-CHMICA; MMB-CHMINACA.
   (14) METHYL 2-(1-(4-FLUOROBENZYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3,3-
 DIMETHYLBUTANOATE. SOME TRADE OR OTHER NAMES: MDMB-FUBINACA.
   (15) N-(1-AMINO-3,3-DIMETHYL-1-OXOBUTAN-2-YL)-1-(4-FLUOROBENZYL)-1H-IN
 DAZOLE-3-CARBOXAMIDE. SOME TRADE OR OTHER NAMES: ADB-FUBINACA.
   (16)  N-(ADAMANTAN-1-YL)-1-(5-FLUOROPENTYL)-1H-INDAZOLE-3-CARBOXAMIDE.
 SOME TRADE OR OTHER NAMES: 5F-APINACA; 5F-AKB48.
   (17)  METHYL   2-(1-(5-FLUOROPENTYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3-METH
 YLBUTANOATE. SOME TRADE OR OTHER NAMES: 5F-AMB.
   (18) METHYL 2-(1-(5-FLUOROPENTYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3,3-
 DIMETHYLBUTANOATE. SOME TRADE OR OTHER NAMES: 5F-ADB; 5F-MDMB-PINACA.
   (19)  NAPHTHALEN-1-YL 1-(5-FLUOROPENTYL)-1H-INDOLE-3-CARBOXYLATE. SOME
 TRADE OR OTHER NAMES: NM2201; CBL2201.
   (20)N-(1-AMINO-3-METHYL-1-OXOBUTAN-2-YL)-1-(5-FLUOROPENTYL)-1H-INDAZOL
 E-3-CARBOXAMIDE. SOME TRADE OR OTHER NAMES: 5F-AB-PINACA.
   (21) 1-(4-CYANOBUTYL)-N-(2-PHENYLPROPAN-2-YL)-1H-INDAZOLE-3-CARBOXAMID
 E. SOME TRADE OR OTHER NAMES: 4-CN-CUMYL-BUTINACA; 4-CYANO-CUMYL-  BUTI-
 NACA;4-CN-CUMYL BINACA; CUMYL-4CN-BINACA; SGT-78.
   (22)  METHYL 2-(1-(CYCLOHEXYLMETHYL)-1H-INDOLE-3-CARBOXAMIDO)-3-METHYL
 BUTANOATE. SOME TRADE OR OTHER NAMES: MMB-CHMICA; AMB-CHMICA.
   (23) 1-(5-FLUOROPENTYL)-N-(2-PHENYLPROPAN-2-YL)-1H-PYRROLO{2,3-B}PYRID
 INE-3-CARBOXAMIDE. SOME TRADE OR OTHER NAMES: 5F-CUMYL-P7AICA.
   (24) METHYL  2-(1-(4-FLUOROBUTYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3,3-DIMET
 HYLBUTANOATE. SOME TRADE OR OTHER NAMES: 4F-MDMB-BINACA; 4F-MDMB-BUTINA-
 CA.
   (25)  ETHYL 2-(1-(5-FLUOROPENTYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3,3-DIMET
 HYLBUTANOATE.  SOME TRADE OR OTHER NAMES: 5F-EDMB-PINACA.
   (26) METHYL  2-(1-(5-FLUOROPENTYL)-1H-INDOLE-3-CARBOXAMIDO)-3,3-DIMETH
 YLBUTANOATE.  SOME TRADE OR OTHER NAMES: 5F-MDMB-PICA; 5F-MDMB-2201.
   (27)  N-(ADAMANTAN-1-YL)-1-(4-FLUOROBENZYL)-1H-INDAZOLE-3-CARBOXAMIDE.
 SOME   TRADE   OR   OTHER   NAMES:   FUB-AKB48;    FUB-APINACA;    AKB48
 N-(4-FLUOROBENZYL).
   (28)   1-(5-FLUOROPENTYL)-N-(2-PHENYLPROPAN-2-YL)-1H-INDAZOLE-3-CARBOX
 AMIDE. SOME TRADE OR OTHER NAMES: 5F-CUMYL-PINACA; SGT-25.
   (29) (1-4-FLUOROBENZYL)-1H-INDOL-3-YL)(2,2,3,3-TETRAMETHYLCYCLOPROPYL)
 METHANONE. SOME TRADE OR OTHER NAMES: FUB-144.
 S. 8307                            125                           A. 8807
 
   § 12. Paragraph 1 of subdivision (b) of schedule II of section 3306 of
 the public health law, as amended by section 1 of part C of chapter  447
 of the laws of 2012, is amended to read as follows:
   (1)  Opium and opiate, and any salt, compound, derivative, or prepara-
 tion of opium or opiate, excluding apomorphine, dextrorphan, nalbuphine,
 NALDEMEDINE,  nalmefene,  NALOXEFOL,   naloxone,   [and]   6&-NALTREXOL,
 naltrexone,  AND  SAMIDORPHAN, and their respective salts, but including
 the following:
   1. Raw opium.
   2. Opium extracts.
   3. Opium fluid.
   4. Powdered opium.
   5. Granulated opium.
   6. Tincture of opium.
   7. Codeine.
   8. Ethylmorphine.
   9. Etorphine hydrochloride.
   10. Hydrocodone (also known as dihydrocodeinone).
   11. Hydromorphone.
   12. Metopon.
   13. Morphine.
   14. Oxycodone.
   15. Oxymorphone.
   16. Thebaine.
   17. Dihydroetorphine.
   18. Oripavine.
   19. NOROXYMORPHONE.
   § 13. Subdivision (c) of schedule II of section  3306  of  the  public
 health law is amended by adding a new paragraph 30 to read as follows:
   30.    OLICERIDINE.    (N-{(3-METHOXYTHIOPHEN-2-YL)METHYL}({2-{(9R)-9-
 (PYRIDIN-2-YL)-6-OXASPIRO{4.5}DECAN-9-YL}ETHYL})AMINE).
   § 14. Subdivision (f) of schedule II of section  3306  of  the  public
 health  law, as amended by chapter 589 of the laws of 1996, the undesig-
 nated paragraph as amended by chapter  575  of  the  laws  of  2001,  is
 amended to read as follows:
   (f) Hallucinogenic substances.
   (1)    Nabilone:    Another    name    for    nabilone:    (+,-)-trans
 -3-(1,1-dimethylheptyl)-6,  6a,  7,  8,  10,  10a-hexahydro-1-hydroxy-6,
 6-dimethyl-9H-dibenzo{b,d}pyran-9-one.
   (2)  DRONABINOL  {(-)-DELTA-9-TRANS  TETRAHYDROCANNABINOL}  IN AN ORAL
 SOLUTION IN A DRUG PRODUCT APPROVED FOR MARKETING BY THE  UNITED  STATES
 FOOD AND DRUG ADMINISTRATION.
   §  15.  Subparagraph (i) of paragraph 3 of subdivision (g) of schedule
 II of section 3306 of the public health law, as amended by section 2  of
 part  BB  of  chapter  57  of  the  laws  of 2023, is amended to read as
 follows:
   (i)  [4-anilino-N-phenenethylpiperidine]  4-ANILINO-N-PHENETHYLPIPERI-
 DINE (ANPP).
   §  16.  Subdivision  (h)  of schedule II of section 3306 of the public
 health law, as amended by section 8 of part C of chapter 447 of the laws
 of 2012, is amended to read as follows:
   (h) (1) Anabolic steroids.  Unless  specifically  excepted  or  unless
 listed  in  another  schedule, "anabolic steroid" shall mean any drug or
 hormonal substance, chemically and pharmacologically related to  testos-
 terone  (other than estrogens, progestins, corticosteroids and dehydroe-
 piandrosterone) and includes:
 S. 8307                            126                           A. 8807
 
   [(1)] (I) 3{beta}, 17-dihydroxy-5a-androstane.
   [(2)] (II) 3{alpha}, 17{beta}-dihydroxy-5a-androstane.
   [(3)] (III) 5{alpha}-androstan-3,17-dione.
   [(4)] (IV) 1-androstenediol (3{beta},17{beta}-dihydroxy-5
 {alpha}-androst-1- ene).
   [(5)] (V) 1-androstenediol (3{alpha},17{beta}-dihydroxy-5
 {alpha}-androst-1- ene).
   [(6)] (VI) 4-androstenediol (3{beta}, 17{beta}-dihydroxy-
 androst-4-ene).
   [(7)] (VII) 5-androstenediol (3{beta}, 17{beta}-dihydroxy-  androst-5-
 ene).
   [(8)] (VIII) 1-androstenedione ({5{alpha}}-androst-1-en-3, 17-dione).
   [(9)] (IX) 4-androstenedione (androst-4-en-3,17-dione).
   [(10)] (X) 5-androstenedione (androst-5-en-3,17-dione).
   [(11)] (XI) Bolasterone (7{alpha},17{alpha}-dimethyl-17{beta} -hydrox-
 yandrost-4-en-3-one).
   [(12)] (XII) Boldenone (17{beta}-hydroxyandrost-1, 4,-diene -3-one).
   [(13)] (XIII) Boldione (androsta-1,4-diene-3,17-dione).
   [(14)] (XIV) Calusterone (7{beta}, 17{alpha}-dimethyl-17{beta}-hydrox-
 yandrost- 4-en-3-one).
   [(15)] (XV) Clostebol (4-chloro-17{beta}-hydroxyandrost-4-e n-3-one).
   [(16)] (XVI) Dehydrochloromethyltestosterone (4-chloro-17
 {beta}-hydroxy-17{alpha}-methyl-androst-1, 4-dien-3-one).
   [(17)] (XVII) {Delta} 1-dihydrotestosterone (a.k.a. '1-
 testosterone')(17{beta}-hydroxy-5{alpha}-androst-1-en-3-one).
   [(18)] (XVIII) 4-dihydrotestosterone (17{beta}-hydroxy-
 androstan-3-one).
   [(19)] (XIX) Drostanolone (17{beta}-hydroxy-2{alpha}-methyl
 -5{alpha} -androstan-3-one).
   [(20)] (XX) Ethylestrenol (17{alpha}-ethyl-17{beta}-hydroxy
 estr-4-ene).
   [(21)] (XXI) Fluoxymesterone (9-fluoro-17{alpha}-methyl-11{beta},
 17 {beta}-dihydroxyandrost-4-en-3-one).
   [(22)] (XXII) Formebolone (2-formyl-17{alpha}-methyl-11{alpha},
 17{beta}-dihydroxyandrost-1, 4-dien-3-one).
   [(23)] (XXIII) Furazabol (17{alpha}-methyl-17{beta}-hydroxyandros
 tano {2, 3-c}-furazan).
   [(24)] (XXIV) 13{beta}-ethyl-17{beta}-hyroxygon-4-en-3-one.
   [(25)] (XXV) 4-hydroxytestosterone (4, 17{beta}-dihydroxy-androst-
 4-en-3-one).
   [(26)] (XXVI) 4-hydroxy-19-nortestosterone (4,17{beta}-dihydroxy-
 estr-4-en-3-one).
   [(27)] (XXVII) desoxymethyltestosterone (17{alpha}-methyl-5
 {alpha}-androst-2-en-17{beta}-ol) (a.k.a., madol).
   [(28)] (XXVIII) Mestanolone (17{alpha}-methyl-17{beta}- hydroxy- 5-an-
 drostan-3-one).
   [(29)] (XXIX) Mesterolone (1{alpha}methyl-17{beta}-hydroxy-
 {5{alpha}}-androstan-3-one).
   [(30)] (XXX) Methandienone (17{alpha}-methyl-17{beta}-hydroxyandr
 ost-1, 4-dien-3-one).
   [(31)] (XXXI) Methandriol (17{alpha}-methyl-3{beta}, 17
 {beta}-dihydroxyandrost-5-ene).
   [(32)] (XXXII) Methenolone (1-methyl- 17{beta}-hydroxy-5      {alpha}-
 androst- 1-en-3-one).
   [(33)] (XXXIII) 17{alpha}-methyl-3{beta},17{beta}-dihydroxy   - 5a-an-
 drostane.
 S. 8307                            127                           A. 8807
 
   [(34)] (XXXIV) 17{alpha}-methyl-3{alpha}, 17{beta}-  dihydroxy- 5a-an-
 drostane
   [(35)] (XXXV) 17{alpha}-methyl-3{beta}, 17{beta}-dihydroxyandrost
 -4-ene.
   [(36)] (XXXVI) 17{alpha}-methyl-4-hydroxynandrolone (17{alpha}-
 methyl-4-hydroxy-17{beta}-hydroxyestr-4-en-3-one).
   [(37)] (XXXVII) Methyldienolone (17{alpha}-methyl-17{beta}- hydroxyes-
 tra- 4,9(10)-dien-3-one).
   [(38)] (XXXVIII) Methyltrienolone (17{alpha}-methyl-17{beta}-hyd
 roxyestra-4, 9-11-trien-3-one).
   [(39)] (XXXIX) Methyltestosterone(17{alpha}-methyl-17{beta}-hyd
 roxyandrost-4-en-3-one).
   [(40)] (XL) Mibolerone (7{alpha},17{alpha}-dimethyl-17
 {beta}-hydroxyestr-4-en-3-one).
   [(41)] (XLI) 17{alpha}-methyl-{Delta} 1-dihydrotestosterone
 (17b{beta}-hydroxy-17{alpha}-methyl-5{alpha}-androst-1-en-3-one)
 (a.k.a. '17-{alpha}-methyl-1-testosterone').
   [(42)] (XLII) Nandrolone(17{beta}-hydroxyestr-4-en-3-one).
   [(43)] (XLIII) 19-nor-4-androstenediol (3{beta},17{beta}-dihydro
 xyestr- 4-ene).
   [(44)] (XLIV) 19-nor-4-androstenediol (3{alpha},17{beta}-dihydrox-
 yestr-4-ene).
   [(45)] (XLV) 19-nor-5-androstenediol (3{beta},17{beta}-dihydroxyestr -5-ene).
   [(46)] (XLVI) 19-nor-5-androstenediol (3{alpha},17{beta}-dihydrox-
 yestr-5-ene).
   [(47)] (XLVII) 19-nor-4,9(10)-androstadienedione (estra-4,9(10)-
 diene-3,17-dione).
   [(48)] (XLVIII) 19-nor-4-androstenedione (estr-4-en-3,17-dione).
   [(49)] (XLIX) 19-nor-5-androstenedione (estr-5-en-3,17-dione).
   [(50)] (L) Norbolethone (13{beta}, 17{alpha}-diethyl-17
 {beta} -hydroxygon-4-en-3-one).
   [(51)] (LI) Norclostebol (4-chloro-17{beta}-hydroxyestr-4- en-3-one).
   [(52)] (LII) Norethandrolone (17{alpha}-ethyl-17{beta}-hydroxyes
 tr-4-en-3-one).
   [(53)] (LIII) Normethandrolone (17 {alpha}-methyl-17{beta}-hydroxy
 estr-4-en-3-one).
   [(54)] (LIV) Oxandrolone (17{alpha}-methyl-17{beta}-hydroxy-2-
 oxa- {5{alpha}}-androstan-3-one).
   [(55)] (LV) Oxymesterone (17{alpha}-methyl-4, 17 {beta}-dihydroxy
 androst-4-en-3-one).
   [(56)] (LVI) Oxymetholone (17 {alpha}-methyl-2-hydroxymethylene-
 17 {beta}-hydroxy-{5{alpha}}- androstan-3-one).
   [(57)] (LVII) Stanozolol (17{alpha}-methyl-17{beta}-hydroxy-{5
 {alpha}}- androst-2-eno{3, 2-c}-pyrazole).
   [(58)] (LVIII) Stenbolone (17{beta}-hydroxy-2-methyl-{5{alpha}}-
 androst- 1-en-3-one).
   [(59)] (LIX) Testolactone (13-hydroxy-3-oxo-13, 17-secoandrosta-
 1, 4-dien-17-oic acid lactone).
   [(60)] (LX) Testosterone (17{beta}-hydroxyandrost-4-en-3-one).
   [(61)] (LXI) Tetrahydrogestrinone (13{beta}, 17{alpha}
 -diethyl-17{beta}-hydroxygon-4, 9, 11 -trien-3-one).
   [(62)] (LXII) Trenbolone (17{beta}-hydroxyestr-4, 9, 11-trien- 3-one).
   [(63)] (LXIII)5{ALPHA}-ANDROSTAN-3,6,17-TRIONE.
   (LXIV) 6-BROMO-ANDROSTA-1,4-DIENE-3,17-DIONE.
   (LXV) 6-BROMO-ANDROSTAN-3,17-DIONE.
   (LXVI) 4-CHLORO-17{ALPHA}-METHYL-ANDROSTA-1,4-DIENE-3,17{BETA}-DIOL.
 S. 8307                            128                           A. 8807
 
   (LXVII) 4-CHLORO-17{ALPHA}-METHYL-ANDROST-4-ENE-3{BETA},17{BETA}-DIOL.
   (LXVIII) 4-CHLORO-17{ALPHA}-METHYL-17{BETA}HYDROXY-ANDROST-4-EN-3-ONE.
   (LXIX) 4-CHLORO-17{ALPHA}-METHYL-17{BETA}HYDROXY-ANDROST-4-ENE-3,11-DI
 ONE.
   (LXX) 2{ALPHA}, 17{ALPHA}-DIMETHYL-17{BETA}-HYDROXY-5{BETA}-ANDROSTAN-3
 -ONE.
   (LXXI) 2{ALPHA},3{ALPHA}-EPITHIO-17{ALPHA}-METHYL-5{ALPHA}ANDROSTAN-17
 {BETA}-OL.
   (LXXII) ESTRA-4,9,11-TRIENE-3,17-DIONE.
   (LXXIII) [3,2-c]FURAZAN-5{ALPHA}-ANDROSTAN-17{BETA}OL.
   (LXXIV) 18A-HOMO-3-HYDROXY-ESTRA-2,5(10)-DIEN-17-ONE.
   (LXXV) 4-HYDROXY-ANDROST-4-ENE-3,17-DIONE.
   (LXXVI) 17{BETA}-HYDROXY-ANDROSTANO[2,3-d]ISOXAZOLE.
   ((LXXVII) 17{BETA}-HYDROXY-ANDROSTANO[3,2-c]ISOXAZOLE.
   (LXXVIII) 3{BETA}-HYDROXY-ESTRA-4,9,11-TRIEN-17-ONE.
   (LXXIX) METHASTERONE  (2{ALPHA},17{ALPHA}-DIMETHYL-5{ALPHA}-ANDROSTAN-
 7{BETA}-OL-3-ONE)OR        2{ALPHA}17{ALPHA}-DIMETHYL-17{BETA}-HYDROXY-5
 {ALPHA}-ANDROSTAN-3-ONE).
   (LXXX) 17{ALPHA}-METHYL-ANDROSTA-1,4-DIENE-3,17{BETA}-DIOL.
   (LXXXI) 17{ALPHA}-METHYL-5{ALPHA}-ANDROSTAN-17{BETA}-OL.
   (LXXXII) 17{ALPHA}-METHYL-ANDROSTAN-3-HYDROXYIMINE-17{BETA}-OL.
   (LXXXIII) 6{ALPHA}-METHYL-ANDROST-4-ENE-3,17-DIONE.
   (LXXXIV) 17{ALPHA}-METHYL-ANDROST-2-ENE-3,17{BETA}DIOL.
   (LXXXV) PROSTANOZOL(17{BETA}-HYDROXY-5{ALPHA}-ANDROSTANO[3,2-c]PYRAZOLE)
 OR[3,2-c]PYRAZOLE-5{ALPHA}-ANDROSTAN-17{BETA}-OL.
   (LXXXVI) [3,2-c]PYRAZOLE-ANDROST-4-EN-17{BETA}-OL.
   (LXXXVII) Any salt, ester or ether of a drug or substance described or
 listed in this subdivision.
   (2)  (I)  SUBJECT  TO  SUBPARAGRAPH  (II) OF THIS PARAGRAPH, A DRUG OR
 HORMONAL SUBSTANCE, OTHER THAN ESTROGENS,  PROGESTINS,  CORTICOSTEROIDS,
 AND  DEHYDROEPIANDROSTERONE, THAT IS NOT LISTED IN PARAGRAPH ONE OF THIS
 SUBDIVISION AND IS DERIVED FROM, OR HAS A  CHEMICAL  STRUCTURE  SUBSTAN-
 TIALLY SIMILAR TO, ONE OR MORE ANABOLIC STEROIDS LISTED IN PARAGRAPH ONE
 OF  THIS  SUBDIVISION  SHALL BE CONSIDERED TO BE AN ANABOLIC STEROID FOR
 PURPOSES OF THIS SCHEDULE IF:
   (A) THE DRUG OR SUBSTANCE HAS BEEN CREATED OR  MANUFACTURED  WITH  THE
 INTENT OF PRODUCING A DRUG OR OTHER SUBSTANCE THAT EITHER:
   1. PROMOTES MUSCLE GROWTH; OR
   2.  OTHERWISE  CAUSES  A  PHARMACOLOGICAL  EFFECT  SIMILAR  TO THAT OF
 TESTOSTERONE; OR
   (B) THE DRUG OR SUBSTANCE HAS BEEN, OR IS INTENDED TO BE, MARKETED  OR
 OTHERWISE  PROMOTED  IN  ANY  MANNER  SUGGESTING  THAT CONSUMING IT WILL
 PROMOTE MUSCLE GROWTH OR ANY OTHER  PHARMACOLOGICAL  EFFECT  SIMILAR  TO
 THAT OF TESTOSTERONE.
   (II)  A  SUBSTANCE  SHALL  NOT  BE CONSIDERED TO BE A DRUG OR HORMONAL
 SUBSTANCE FOR PURPOSES OF THIS SUBDIVISION IF:
   (A) IT IS:
   1. AN HERB OR OTHER BOTANICAL;
   2. A CONCENTRATE, METABOLITE, OR EXTRACT OF, OR A CONSTITUENT ISOLATED
 DIRECTLY FROM, AN HERB OR OTHER BOTANICAL; OR
   3. A COMBINATION OF TWO OR MORE SUBSTANCES DESCRIBED IN CLAUSE ONE  OR
 TWO OF THIS ITEM;
   (B) IT IS A DIETARY INGREDIENT FOR PURPOSES OF THE FEDERAL FOOD, DRUG,
 AND COSMETIC ACT (21 U.S.C. 301 ET SEQ.); AND
   (C) IT IS NOT ANABOLIC OR ANDROGENIC.
 S. 8307                            129                           A. 8807
 
   (III)  IN  ACCORDANCE  WITH  SUBDIVISION  ONE  OF SECTION THIRTY-THREE
 HUNDRED NINETY-SIX OF THIS ARTICLE, ANY PERSON CLAIMING THE  BENEFIT  OF
 AN  EXEMPTION  OR  EXCEPTION  UNDER  SUBPARAGRAPH (II) OF THIS PARAGRAPH
 SHALL BEAR THE BURDEN OF GOING FORWARD WITH THE EVIDENCE WITH RESPECT TO
 SUCH EXEMPTION OR EXCEPTION.
   §  17.  Subdivision  (c) of schedule III of section 3306 of the public
 health law is amended by adding two new paragraphs 15 and 16 to read  as
 follows:
   (15) PERAMPANEL.
   (16) XYLAZINE, ITS SALTS, ISOMERS AND SALTS OF ISOMERS.
   §  18.  Subdivision  (c)  of schedule IV of section 3306 of the public
 health law is amended by adding seven new paragraphs 54, 55, 56, 57, 58,
 59 and 60 to read as follows:
   (54) ALFAXALONE.
   (55) BREXANOLONE.
   (56) DARIDOREXANT.
   (57) LEMBOREXANT.
   (58) REMIMAZOLAM.
   (59) SUVOREXANT.
   (60) ZURANOLONE.
   § 19. Subdivision (e) of schedule IV of section  3306  of  the  public
 health  law is amended by adding two new paragraphs 13 and 14 to read as
 follows:
   (13) SERDEXMETHYLPHENIDATE.
   (14) SOLRIAMFETOL.
   § 20. Subdivision (f) of schedule IV of section  3306  of  the  public
 health  law, as added by chapter 664 of the laws of 1985, paragraph 2 as
 added by chapter 457 of the laws of 2006 and paragraph  3  as  added  by
 section  14  of part C of chapter 447 of the laws of 2012, is amended to
 read as follows:
   (f) Other substances. Unless specifically excepted or unless listed in
 another schedule, any material, compound, mixture or  preparation  which
 contains  any quantity of the following substances, including its salts,
 ISOMERS, AND SALTS OF SUCH  ISOMERS,  WHENEVER  THE  EXISTENCE  OF  SUCH
 SALTS, ISOMERS, AND SALTS OF ISOMERS IS POSSIBLE:
   (1) Pentazocine.
   (2) Butorphanol (including its optical isomers).
   (3) Tramadol in any quantities.
   (4)  ELUXADOLINE.  (5-{{{(2S)-2-AMINO-3-{4-AMINOCARBONYL)-2,6-DIMETHYL
 PHENYL}-1-OXOPROPYL}{(1S)-1-(4-PHENYL-1H-IMIDAZOL-2-YL)ETHYL}AMINO}METH
 YL}-2-METHOXYBENZOIC ACID).
   (5) LORCASERIN.
   § 21. Subdivision (d) of schedule V of  section  3306  of  the  public
 health  law  is  amended  by adding four new paragraphs 4, 5, 6 and 7 to
 read as follows:
   (4) BRIVARACETAM ((2S)-2-{(4R)-2-OXO-4-PROPYLPYRROLIDIN-1-YL} BUTANAM-
 IDE). SOME TRADE OR OTHER NAMES: BRV;  UCB-34714;  BRIVIACT)  (INCLUDING
 ITS SALTS).
   (5)   CENOBAMATE      ({1R)-1-(2-CHLOROPHENYL)-2-(TETRAZOL-2-YL)ETHYL}
 CARBAMATE;  2H-TETRAZOLE-2-ETHANOL,  ALPHA-(2-CHLOROPHENYL)-,  CARBAMATE
 (ESTER), (ALPHAR)-; CARBAMIC ACID
 (R)-(+)-1-(2-CHLOROPHENYL)-2-(2H-TETRAZOL-2-YL)ETHYL ESTER).
   (6) GANAXOLONE. 3@-HYDROXY-3&-METHYL-5@-PREGNAN-20-ONE.
   (7) LASMIDITAN
 {2,4,6-TRIFLUORO-N-(6-(1-METHYLPIPERIDINE-4-CARBONYL)PYRIDINE-2-YL-BENZAM
 IDE}.
 S. 8307                            130                           A. 8807
 
   §  22.  Subdivision  2  of  section  3342 of the public health law, as
 amended by chapter 692 of the laws  of  1976,  is  amended  to  read  as
 follows:
   2.  An  institutional dispenser may dispense controlled substances for
 use off its premises only pursuant to a prescription, prepared and filed
 in conformity with this title, provided, however, that, in an  emergency
 situation  as defined by rule or regulation of the department, a practi-
 tioner  in  a  hospital  without  a  full-time  pharmacy  may   dispense
 controlled  substances to a patient in a hospital emergency room for use
 off the premises of the institutional dispenser  for  a  period  not  to
 exceed  twenty-four  hours, UNLESS THE FEDERAL DRUG ENFORCEMENT ADMINIS-
 TRATION HAS AUTHORIZED A LONGER TIME PERIOD FOR THE PURPOSE OF  INITIAT-
 ING MAINTENANCE TREATMENT, DETOXIFICATION TREATMENT, OR BOTH.
   §  23.  Subdivision  1  of  section  3302 of the public health law, as
 amended by chapter 92 of the  laws  of  2021,  is  amended  to  read  as
 follows:
   1.  "[Addict] PERSON WITH A SUBSTANCE USE DISORDER" means a person who
 habitually uses a controlled substance for a non-legitimate or  unlawful
 use, and who by reason of such use is dependent thereon.
   § 24. Subdivision 1 of section 3331 of the public health law, as added
 by chapter 878 of the laws of 1972, is amended to read as follows:
   1. Except as provided in titles III or V of this article, no substance
 in  schedules  II,  III,  IV, or V may be prescribed for or dispensed or
 administered to [an addict] A PERSON WITH A SUBSTANCE  USE  DISORDER  or
 habitual user.
   §  25. The title heading of title 5 of article 33 of the public health
 law, as added by chapter 878 of the laws of 1972, is amended to read  as
 follows:

           DISPENSING TO [ADDICTS] PERSONS WITH A SUBSTANCE USE
                        DISORDER AND HABITUAL USERS
 
 §  26. Section 3350 of the public health law, as added by chapter 878 of
 the laws of 1972, is amended to read as follows:
   § 3350. Dispensing prohibition.   Controlled  substances  may  not  be
 prescribed for, or administered or dispensed to [addicts] PERSONS WITH A
 SUBSTANCE  USE  DISORDER  or  habitual  users  of controlled substances,
 except as provided by this title or title III.
   § 27. Section 3351 of the public health law, as added by  chapter  878
 of the laws of 1972, subdivision 5 as amended by chapter 558 of the laws
 of 1999, is amended to read as follows:
   §  3351.  Dispensing for medical use.  1. Controlled substances may be
 prescribed for, or administered or dispensed to  [an  addict]  A  PERSON
 WITH A SUBSTANCE USE DISORDER or habitual user:
   (a)  during  emergency  medical  treatment  unrelated  to [abuse] SUCH
 SUBSTANCE USE DISORDER OR HABITUAL USE of controlled substances;
   (b) who is a bona fide patient suffering from an incurable  and  fatal
 disease such as cancer or advanced tuberculosis;
   (c)  who  is aged, infirm, or suffering from serious injury or illness
 and the withdrawal from controlled substances would endanger the life or
 impede or inhibit the recovery of such person.
   1-A. A PRACTITIONER MAY PRESCRIBE, ORDER  AND  DISPENSE  ANY  SCHEDULE
 III, IV, OR V NARCOTIC DRUG APPROVED BY THE FEDERAL FOOD AND DRUG ADMIN-
 ISTRATION  SPECIFICALLY  FOR USE IN MAINTENANCE OR DETOXIFICATION TREAT-
 MENT TO A PERSON WITH A SUBSTANCE USE DISORDER OR HABITUAL USER.
 S. 8307                            131                           A. 8807
 
   2. Controlled substances may be ordered  for  use  by  [an  addict]  A
 PERSON  WITH A SUBSTANCE USE DISORDER or habitual user by a practitioner
 and administered by a practitioner [or], registered nurse, OR  PARAMEDIC
 to relieve acute withdrawal symptoms.
   3.  Methadone,  or  such  other controlled substance designated by the
 commissioner as appropriate for such use, may be ordered for use of  [an
 addict]  A  PERSON  WITH  A SUBSTANCE USE DISORDER by a practitioner and
 dispensed or administered by a practitioner or his designated  agent  as
 interim  treatment  for [an addict on a waiting list for admission to an
 authorized maintenance program] A PERSON WITH A SUBSTANCE  USE  DISORDER
 WHILE  ARRANGEMENTS  ARE  BEING  MADE FOR REFERRAL TO TREATMENT FOR SUCH
 ADDICTION TO CONTROLLED SUBSTANCES.
   4. Methadone, or such other controlled  substance  designated  by  the
 commissioner  as  appropriate  for  such use, may be administered to [an
 addict] A PERSON WITH A SUBSTANCE USE DISORDER by a practitioner  or  by
 [his]  THEIR designated agent acting under the direction and supervision
 of a practitioner, as part of a [regime] REGIMEN designed  and  intended
 AS MAINTENANCE OR DETOXIFICATION TREATMENT OR to withdraw a patient from
 addiction to controlled substances.
   5.  [Methadone]  NOTWITHSTANDING  ANY  OTHER  LAW  AND CONSISTENT WITH
 FEDERAL REQUIREMENTS, METHADONE,  or  such  other  controlled  substance
 designated  by  the  commissioner  as  appropriate  for such use, may be
 administered OR DISPENSED DIRECTLY  to  [an  addict]  A  PERSON  WITH  A
 SUBSTANCE  USE  DISORDER  by a practitioner or by [his] THEIR designated
 agent acting under the direction and supervision of a  practitioner,  as
 part  of a substance [abuse or chemical dependence] USE DISORDER program
 approved pursuant to article [twenty-three or] thirty-two of the  mental
 hygiene law.
   § 28. Section 3372 of the public health law is REPEALED.
   § 29. This act shall take effect immediately.
 
                                  PART V
 
   Section  1.  Section  2805-x  of  the  public  health law, as added by
 section 48 of part B of chapter 57 of the laws of 2015, paragraph (d) of
 subdivision 4 as added by chapter 697 of the laws of 2023, is amended to
 read as follows:
   § 2805-x. [Hospital-home care-physician] HEALTH CARE DELIVERY  collab-
 oration  program.  1. The purpose of this section shall be to facilitate
 innovation in [hospital, home care agency and physician collaboration in
 meeting] COLLABORATIONS  BETWEEN  LICENSED  AND  CERTIFIED  HEALTH  CARE
 PROVIDERS  AND AGENCIES, INCLUDING: HOSPITALS, HOME CARE AGENCIES, EMER-
 GENCY MEDICAL SERVICES, SKILLED NURSING  FACILITIES,  AND  HOSPICES,  AS
 WELL  AS PAYORS AND OTHER INTERDISCIPLINARY PROVIDERS, PRACTITIONERS AND
 SERVICE ENTITIES, TO MEET the community's EVOLVING health care needs  IN
 A CHANGING HEALTH CARE DELIVERY LANDSCAPE.  It shall provide a framework
 to  support  voluntary  initiatives  in collaboration to improve patient
 care access and management, patient health outcomes,  cost-effectiveness
 in  the  use  of  health  care services and community population health.
 [Such collaborative initiatives may also include payors, skilled nursing
 facilities and  other  interdisciplinary  providers,  practitioners  and
 service entities.]
   2. For purposes of this section:
   (a)  "Hospital"  shall  include  a general hospital as defined in this
 article or other inpatient facility for rehabilitation or specialty care
 within the definition of hospital in this article.
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   (b) "Home care agency" shall mean a certified home health agency, long
 term home health care program or licensed home care services  agency  as
 defined in article thirty-six of this chapter.
   (c)  "Payor"  shall  mean  a  health plan approved pursuant to article
 forty-four of this chapter, or article thirty-two or forty-three of  the
 insurance law.
   (d)  "Practitioner"  shall  mean  any  of the health, mental health or
 health related professions licensed  pursuant  to  title  eight  of  the
 education law.
   (E)  "PHYSICIAN" SHALL MEAN A PERSON DULY LICENSED PURSUANT TO ARTICLE
 ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW.
   (F) "HOSPICE" SHALL MEAN AN AGENCY APPROVED  UNDER  ARTICLE  FORTY  OF
 THIS CHAPTER.
   (G)  "EMERGENCY  MEDICAL SERVICES" SHALL MEAN AN AGENCY APPROVED UNDER
 ARTICLE THIRTY OF THIS CHAPTER AND AUTHORIZED PURSUANT TO SECTION  THREE
 THOUSAND EIGHTEEN OF THIS CHAPTER TO PROVIDE COMMUNITY PARAMEDICINE.
   (H)  "SKILLED  NURSING  FACILITY" SHALL MEAN A RESIDENTIAL HEALTH CARE
 FACILITY OR NURSING HOME LICENSED PURSUANT TO  ARTICLE  TWENTY-EIGHT  OF
 THIS CHAPTER.
   3.  The commissioner is authorized to provide financing including, but
 not limited to, grants or positive  adjustments  in  medical  assistance
 rates  or  premium  payments, to the extent of funds available and allo-
 cated or appropriated therefor, including funds provided  to  the  state
 through  federal  waivers,  funds made available through state appropri-
 ations and/or funding through section twenty-eight  hundred  seven-v  of
 this  article,  as well as waivers of regulations under title ten of the
 New York codes, rules and regulations, to support the  voluntary  initi-
 atives and objectives of this section.
   4.  [Hospital-home  care-physician] HEALTH CARE DELIVERY collaborative
 initiatives under this section may include, but shall not be limited to:
   (a) [Hospital-home care-physician integration] INTEGRATION initiatives
 BETWEEN AT LEAST TWO OF THE FOLLOWING: HOSPITALS,  HOME  CARE  AGENCIES,
 PHYSICIAN,  PHYSICIANS'  GROUP, EMERGENCY MEDICAL SERVICES, HOSPICE, AND
 SKILLED NURSING FACILITIES, including but not limited to:
   (i) transitions in care initiatives  to  help  effectively  transition
 patients  to  post-acute  care  at  home,  coordinate follow-up care and
 address issues critical to care plan success and readmission avoidance;
   (ii) clinical pathways for  specified  conditions,  guiding  patients'
 progress and outcome goals, as well as effective health services use;
   (iii)  application  of  telehealth/telemedicine services in monitoring
 and managing patient  conditions,  and  promoting  self-care/management,
 improved outcomes and effective services use;
   (iv)  facilitation  of  physician  house  calls  to homebound patients
 and/or to patients for whom such home visits  are  determined  necessary
 and effective for patient care management;
   (v)  additional  models  for prevention of avoidable hospital readmis-
 sions and emergency room visits;
   (vi) health home development;
   (vii) development and demonstration of new  models  of  integrated  or
 collaborative  care and care management not otherwise achievable through
 existing models; and
   (viii) bundled payment demonstrations for  hospital-to-post-acute-care
 for  specified  conditions  or  categories of conditions, in particular,
 conditions predisposed to  high  prevalence  of  readmission,  including
 those  currently  subject to federal/state penalty, and other discharges
 with extensive post-acute needs;
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   (b) Recruitment, training and retention of hospital/home  care  direct
 care  staff  and  physicians,  in geographic or clinical areas of demon-
 strated need. Such initiatives may include, but are not limited to,  the
 following activities:
   (i)  outreach and public education about the need and value of service
 in health occupations;
   (ii) training/continuing education  and  regulatory  facilitation  for
 cross-training  to  maximize  flexibility  in  the utilization of staff,
 including:
   (A) training of hospital nurses in home care;
   (B) dual certified nurse aide/home health aide certification; and
   (C) dual personal care aide/HHA certification;
   (iii) salary/benefit enhancement;
   (iv) career ladder development; and
   (v) other incentives to practice in shortage areas; and
   (c) [Hospital - home care - physician] HEALTH CARE DELIVERY collabora-
 tives for the care and management of special needs, high-risk and  high-
 cost patients, including but not limited to best practices, and training
 and education of direct care practitioners and service employees.
   (d)  Collaborative  programs  to  address  disparities  in health care
 access or treatment, and/or conditions of higher prevalence, in  certain
 populations,  where such collaborative programs could provide and manage
 services in a more effective, person-centered and cost-efficient  manner
 for reduction or elimination of such disparities.
   (i)  Such  programs  may  target  one or more disparate conditions, or
 areas of under-service, evidenced in defined populations, including  but
 not be limited to:
   (A) cardiovascular disease;
   (B) hypertension;
   (C) diabetes;
   (D) chronic kidney disease;
   (E) obesity;
   (F) asthma;
   (G) sickle cell disease;
   (H) sepsis;
   (I) lupus;
   (J) breast, lung, prostate and colorectal cancers;
   (K)  geographic  shortage  of  primary  care, prenatal/obstetric care,
 specialty medical care, home health care,  or  culturally  and  linguis-
 tically compatible care;
   (L) alcohol, tobacco, or substance abuse;
   (M) post-traumatic stress disorder and other conditions more prevalent
 among veterans of the United States military services;
   (N)  attracting members of minority populations to the field and prac-
 tice of medicine; and
   (O) such other areas approved by the commissioner.
   (ii)  Collaborative   [hospital-home   care-physician]   HEALTH   CARE
 DELIVERY, and as applicable additional partner, models may include under
 such disparities programs:
   (A) service planning and design;
   (B)  recruitment  of  specialty personnel and/or specialty training of
 professionals or other direct care personnel (including physicians, home
 care and hospital staffs), patients and informal caregivers;
   (C) continuing medical education and clinical training for physicians,
 follow-up evaluations, and supporting educational materials;
 S. 8307                            134                           A. 8807
 
   (D) use of evidenced-based approaches and/or best practices to  treat-
 ment;
   (E) reimbursement of uncovered services;
   (F)  bundled or other integrated payment methods to support the neces-
 sary, coordinated and cost-effective services;
   (G) regulatory waivers to facilitate flexibility in  provider  collab-
 oration and person-centered care;
   (H) patient/family peer support and education;
   (I) data collection, research and evaluation of efficacy; and/or
   (J) other components or innovations satisfactory to the commissioner.
   (iii)  Nothing  contained in this paragraph shall prevent a physician,
 [physicians] PHYSICIANS' group, home care agency, or hospital from indi-
 vidually applying for said grant.
   (iv) The commissioner shall consult with physicians, home  care  agen-
 cies,  hospitals,  consumers,  statewide  associations representative of
 such participants, and other experts  in  health  care  disparities,  in
 developing  an application process for grant funding or rate adjustment,
 and for request of state regulatory waivers, to  facilitate  implementa-
 tion of disparities programs under this paragraph.
   5.    AT  A  MINIMUM, APPLICATIONS FOR COLLABORATIVE INITIATIVES UNDER
 THIS SECTION MUST SPECIFICALLY IDENTIFY THE SERVICE GAPS AND/OR COMMUNI-
 TY NEED THE COLLABORATION SEEKS TO  ADDRESS,  AND  OUTLINE  A  PROJECTED
 TIMELINE  FOR  IMPLEMENTATION  AND DELIVERABLE DATA TO DEMONSTRATE MILE-
 STONES TO SUCCESS.
   6. Hospitals and home care agencies which are  provided  financing  or
 waivers pursuant to this section shall report to the commissioner on the
 patient,  service and cost experiences pursuant to this section, includ-
 ing the extent to which the project goals are achieved. The commissioner
 shall compile and  make  such  reports  available  on  the  department's
 website.
   §  2. Subdivision 2 of section 3602 of the public health law, as added
 by chapter 895 of the laws of 1977, is amended to read as follows:
   2. "Home care services agency" means an organization primarily engaged
 in arranging and/or providing directly or through  contract  arrangement
 one  or  more  of  the  following:  Nursing  services,  home health aide
 services, and other therapeutic and related services which may  include,
 but  shall not be limited to, physical, speech and occupational therapy,
 nutritional services, medical social services, personal  care  services,
 homemaker services, and housekeeper or chore services, which may be of a
 preventive,   therapeutic,   rehabilitative,   health  guidance,  and/or
 supportive nature to persons at home.  FOR THE PURPOSES OF THIS ARTICLE,
 A GENERAL HOSPITAL LICENSED PURSUANT TO  ARTICLE  TWENTY-EIGHT  OF  THIS
 CHAPTER  SHALL  NOT BE CONSIDERED "PRIMARILY ENGAGED IN ARRANGING AND/OR
 PROVIDING" NURSING, HOME HEALTH, OR OTHER THERAPEUTIC SERVICES  NOTWITH-
 STANDING  THAT  SUCH  SERVICES MAY BE PROVIDED IN A PATIENT'S RESIDENCE,
 PROVIDED THAT AT LEAST FIFTY-ONE PERCENT OF PATIENT CARE HOURS FOR  SUCH
 GENERAL  HOSPITAL IS GENERATED FROM THE TREATMENT OF PATIENTS WITHIN THE
 HOSPITAL, AND THAT ANY PATIENTS TREATED IN THEIR RESIDENCE HAVE A PREEX-
 ISTING CLINICAL RELATIONSHIP WITH THE GENERAL HOSPITAL.
   § 3. Section 2803 of the public health law is amended by adding a  new
 subdivision 15 to read as follows:
   15.    NOTWITHSTANDING  ANY CONTRARY PROVISION OF THIS ARTICLE, OR ANY
 RULE OR REGULATION TO THE CONTRARY, THE COMMISSIONER SHALL ALLOW GENERAL
 HOSPITALS TO PROVIDE OFF-SITE PRIMARY CARE AND  MEDICAL  CARE  SERVICES,
 INCLUDING  BUT NOT LIMITED TO ACUTE CARE AND PREVENTATIVE WELLNESS CARE,
 THAT ARE:
 S. 8307                            135                           A. 8807
 
   (A) NOT HOME CARE SERVICES DEFINED IN SUBDIVISION ONE OF SECTION THIR-
 TY-SIX HUNDRED TWO OF THIS CHAPTER OR THE PROFESSIONAL SERVICES  ENUMER-
 ATED IN SUBDIVISION TWO OF SUCH SECTION;
   (B)  PROVIDED  BY  A PRIMARY CARE PROFESSIONAL, INCLUDING A PHYSICIAN,
 REGISTERED NURSE, OR PHYSICIAN ASSISTANT, TO A PATIENT WITH A PRE-EXIST-
 ING CLINICAL RELATIONSHIP WITH THE GENERAL HOSPITAL, OR WITH THE  HEALTH
 CARE PROFESSIONAL PROVIDING THE SERVICE; AND
   (C)  PROVIDED TO A PATIENT WHO IS UNABLE TO LEAVE HIS OR HER RESIDENCE
 TO RECEIVE SERVICES AT THE GENERAL HOSPITAL WITHOUT UNREASONABLE  DIFFI-
 CULTY  DUE  TO  CIRCUMSTANCES,  INCLUDING  BUT  NOT LIMITED TO, CLINICAL
 IMPAIRMENT AND CONDITIONS OF IMMUNOSUPPRESSION.
   (D) NOTHING IN THIS SUBDIVISION SHALL PRECLUDE A  FEDERALLY  QUALIFIED
 HEALTH  CENTER  FROM  PROVIDING  OFF-SITE  SERVICES  IN  ACCORDANCE WITH
 DEPARTMENT REGULATIONS.
   (E) THE DEPARTMENT  IS  AUTHORIZED  TO  ESTABLISH  MEDICAL  ASSISTANCE
 PROGRAM  RATES  TO  EFFECTUATE THIS SUBDIVISION. FOR THE PURPOSES OF THE
 DEPARTMENT DETERMINING THE APPLICABLE RATES PURSUANT TO SUCH  AUTHORITY,
 ANY  GENERAL HOSPITAL APPROVED PURSUANT TO THIS SUBDIVISION SHALL REPORT
 TO THE DEPARTMENT, IN THE FORM AND FORMAT REQUIRED  BY  THE  DEPARTMENT,
 ITS  ANNUAL  OPERATING  COSTS,  SPECIFICALLY  FOR  SUCH  OFF-SITE  ACUTE
 SERVICES. FAILURE TO TIMELY SUBMIT SUCH COST DATA TO THE DEPARTMENT  MAY
 RESULT IN REVOCATION OF AUTHORITY TO PARTICIPATE IN A PROGRAM UNDER THIS
 SECTION  DUE  TO  THE  INABILITY  TO ESTABLISH APPROPRIATE REIMBURSEMENT
 RATES.
   § 4. Subdivision 3 of section 3018 of the public health law, as  added
 by chapter 137 of the laws of 2023, is amended to read as follows:
   3.  (A)  This  program shall authorize mobile integrated and community
 paramedicine programs presently operating and approved by the department
 as of May eleventh, two thousand twenty-three, under  the  authority  of
 Executive Order Number 4 of two thousand twenty-one, entitled "Declaring
 a  Statewide  Disaster Emergency Due to Healthcare staffing shortages in
 the State of New York" to continue in the same manner  and  capacity  as
 currently  approved  [for  a period of two years following the effective
 date of this section] THROUGH MARCH THIRTY-FIRST, TWO  THOUSAND  THIRTY-
 ONE.
   (B)  ANY  PROGRAM  NOT  LAWFULLY OPERATING AND ESTABLISHED PURSUANT TO
 PARAGRAPH (A) OF THIS  SUBDIVISION  MAY  APPLY  TO  THE  DEPARTMENT  FOR
 APPROVAL  TO  OPERATE  A  MOBILE  INTEGRATED  AND COMMUNITY PARAMEDICINE
 PROGRAM, AND ANY PROGRAM CURRENTLY OPERATING PURSUANT TO  PARAGRAPH  (A)
 OF  THIS SUBDIVISION FOR A LIMITED PURPOSE, INCLUDING BUT NOT LIMITED TO
 VACCINATION ADMINISTRATION, MAY APPLY TO THE DEPARTMENT FOR APPROVAL  TO
 MODIFY  ITS  EXISTING COMMUNITY PARAMEDICINE PROGRAM. THE DEPARTMENT MAY
 APPROVE UP TO TWO HUNDRED NEW OR  EXPANDED  PROGRAMS  PURSUANT  TO  THIS
 PARAGRAPH.  SUCH  APPLICATIONS  MUST BE SUBMITTED IN THE FORM AND FORMAT
 PRESCRIBED BY THE DEPARTMENT. PROGRAMS APPROVED PURSUANT TO  THIS  PARA-
 GRAPH  SHALL  BE  PERMITTED  TO  OPERATE THROUGH MARCH THIRTY-FIRST, TWO
 THOUSAND THIRTY-ONE.
   § 5. Section 2 of chapter 137 of the laws of 2023 amending the  public
 health  law  relating  to  establishing  a  community-based paramedicine
 demonstration program, is amended to read as follows:
   § 2. This act shall take effect immediately and shall  expire  and  be
 deemed  repealed  [2  years  after  such date] MARCH 31, 2031; provided,
 however, that if this act shall have become a law on or  after  May  22,
 2023  this act shall take effect immediately and shall be deemed to have
 been in full force and effect on and after May 22, 2023.
 S. 8307                            136                           A. 8807
 
   § 6. Subdivision 1 of section  3001  of  the  public  health  law,  as
 amended  by  chapter  804  of  the  laws  of 1992, is amended to read as
 follows:
   1.  "Emergency  medical  service"  means  [initial  emergency  medical
 assistance including, but not  limited  to,  the  treatment  of  trauma,
 burns,  respiratory,  circulatory and obstetrical emergencies] A COORDI-
 NATED SYSTEM OF HEALTHCARE DELIVERY THAT RESPONDS TO THE NEEDS  OF  SICK
 AND INJURED INDIVIDUALS, BY PROVIDING: ESSENTIAL EMERGENCY, NON-EMERGEN-
 CY, SPECIALTY NEED OR PUBLIC EVENT MEDICAL CARE; COMMUNITY EDUCATION AND
 PREVENTION  PROGRAMS;  GROUND  AND  AIR  AMBULANCE  SERVICES;  EMERGENCY
 MEDICAL DISPATCH; TRAINING FOR EMERGENCY MEDICAL SERVICES PRACTITIONERS;
 MEDICAL FIRST  RESPONSE;  MOBILE  TRAUMA  CARE  SYSTEMS;  MASS  CASUALTY
 MANAGEMENT; AND MEDICAL DIRECTION.
   §  7.  Section  6909  of  the education law is amended by adding a new
 subdivision 12 to read as follows:
   12. A CERTIFIED NURSE PRACTITIONER MAY PRESCRIBE AND ORDER  A  NON-PA-
 TIENT  SPECIFIC  REGIMEN  TO  AN EMERGENCY MEDICAL SERVICES PRACTITIONER
 LICENSED BY THE DEPARTMENT OF HEALTH PURSUANT TO ARTICLE THIRTY  OF  THE
 PUBLIC  HEALTH  LAW,  PURSUANT TO REGULATIONS PROMULGATED BY THE COMMIS-
 SIONER, AND CONSISTENT WITH THE PUBLIC  HEALTH  LAW,  FOR  ADMINISTERING
 IMMUNIZATIONS.    NOTHING IN THIS SUBDIVISION SHALL AUTHORIZE UNLICENSED
 PERSONS TO ADMINISTER IMMUNIZATIONS, VACCINES OR OTHER DRUGS.
   § 8. Section 6527 of the education law is  amended  by  adding  a  new
 subdivision 12 to read as follows:
   12. A LICENSED PHYSICIAN MAY PRESCRIBE AND ORDER A NON-PATIENT SPECIF-
 IC REGIMEN TO AN EMERGENCY MEDICAL SERVICES PRACTITIONER LICENSED BY THE
 DEPARTMENT  OF  HEALTH  PURSUANT  TO ARTICLE THIRTY OF THE PUBLIC HEALTH
 LAW, PURSUANT  TO  REGULATIONS  PROMULGATED  BY  THE  COMMISSIONER,  AND
 CONSISTENT  WITH THE PUBLIC HEALTH LAW, FOR ADMINISTERING IMMUNIZATIONS.
 NOTHING IN THIS SUBDIVISION SHALL AUTHORIZE UNLICENSED PERSONS TO ADMIN-
 ISTER IMMUNIZATIONS, VACCINES OR OTHER DRUGS.
   § 9. The public health law is amended by adding a new article 30-D  to
 read as follows:
                               ARTICLE 30-D
             EMERGENCY MEDICAL SERVICES ESSENTIAL SERVICES ACT
 SECTION 3080. DECLARATION OF PURPOSE.
         3081. APPLICATION OF ARTICLE.
         3082. DEFINITIONS.
         3083. DESIGNATION  OF  MEDICAL  EMERGENCY RESPONSE AND EMERGENCY
                 MEDICAL DISPATCH AGENCIES AS ESSENTIAL SERVICES.
         3084. PROVISION OF EMERGENCY MEDICAL DISPATCH.
         3085. RULES AND REGULATIONS.
   § 3080. DECLARATION OF PURPOSE. 1. THE PROVISION OF PROMPT, EFFICIENT,
 AND EFFECTIVE EMERGENCY MEDICAL SERVICES AND EMERGENCY MEDICAL  DISPATCH
 IS CRUCIAL TO THE HEALTH AND SAFETY OF THE RESIDENTS OF NEW YORK STATE.
   2.  THE  ESTABLISHMENT  OF A COMPREHENSIVE AND STANDARDIZED SYSTEM FOR
 MEDICAL EMERGENCY RESPONSE  IS  ESSENTIAL  TO  ADDRESS  LIFE-THREATENING
 CONDITIONS  AND  ENSURE  THE WELL-BEING OF INDIVIDUALS IN NEED OF URGENT
 MEDICAL CARE.
   3. ENSURING THAT EVERY COUNTY WITHIN NEW YORK STATE HAS THE  NECESSARY
 RESOURCES,  TRAINED  PERSONNEL,  AND OPERATIONAL CAPABILITIES TO PROVIDE
 MEDICAL EMERGENCY RESPONSE IS A MATTER  OF  PUBLIC  INTEREST  AND  STATE
 PRIORITY.
   4.  IT  IS IMPERATIVE TO STANDARDIZE THE APPROACH TO MEDICAL EMERGENCY
 RESPONSE AND DISPATCH SERVICES TO ENHANCE THE QUALITY OF CARE,  MAXIMIZE
 S. 8307                            137                           A. 8807
 
 EFFICIENCY, AND IMPROVE OUTCOMES FOR PATIENTS EXPERIENCING MEDICAL EMER-
 GENCIES.
   5. THE DESIGNATION OF MEDICAL EMERGENCY RESPONSE AND EMERGENCY MEDICAL
 DISPATCH  AS  ESSENTIAL  SERVICES  WILL ENSURE A UNIFORM, EFFECTIVE, AND
 COORDINATED RESPONSE TO MEDICAL EMERGENCIES ACROSS THE STATE.
   6. THIS ARTICLE AIMS TO ESTABLISH A FRAMEWORK FOR THE PROVISION, OPER-
 ATION,  AND  REGULATION  OF  MEDICAL  EMERGENCY  RESPONSE  AND  DISPATCH
 SERVICES, THEREBY SAFEGUARDING THE HEALTH AND SAFETY OF NEW YORK STATE'S
 RESIDENTS AND VISITORS.
   §  3081.  APPLICATION  OF  ARTICLE.  THIS ARTICLE SHALL APPLY TO EVERY
 COUNTY EXCEPT A COUNTY WHOLLY CONTAINED WITHIN A CITY.
   § 3082. DEFINITIONS. AS USED IN  THIS  ARTICLE,  THE  FOLLOWING  TERMS
 SHALL HAVE THE FOLLOWING MEANINGS:
   1.  "MEDICAL  EMERGENCY  RESPONSE"  SHALL MEAN THE RAPID DEPLOYMENT OF
 AMBULANCE SERVICES, ADVANCED LIFE SUPPORT FIRST RESPONSE  SERVICES,  AND
 OTHER  FIRST  RESPONSE  SERVICES AUTHORIZED BY THE DEPARTMENT TO PROVIDE
 EMERGENCY MEDICAL SERVICES, AS DEFINED IN SECTION THREE THOUSAND ONE  OF
 THIS  CHAPTER,  FOR THE PURPOSE OF PROVIDING IMMEDIATE EMERGENCY MEDICAL
 CARE IN RESPONSE TO EMERGENCY CALLS FOR  ACUTE  CONDITIONS  WHERE  RAPID
 INTERVENTION IS VITAL TO PREVENT DEATH OR SERIOUS HARM.
   2.   "EMERGENCY  MEDICAL  DISPATCH"  MEANS  A  PROTOCOL-DRIVEN  SYSTEM
 APPROVED BY THE DEPARTMENT DESIGNED TO MANAGE,  ASSESS,  AND  PRIORITIZE
 MEDICAL  EMERGENCY CALLS, PROVIDE CRITICAL PRE-ARRIVAL INSTRUCTIONS, AND
 DISPATCH MEDICAL EMERGENCY RESPONSE  SERVICES  OR  PROVIDE  REFERRAL  TO
 APPROPRIATE NON-EMERGENCY MEDICAL SERVICES WHERE APPROPRIATE.
   3.  "EMS  MEDICAL  DISPATCH AGENCY" MEANS ANY INDIVIDUAL, PARTNERSHIP,
 ASSOCIATION, CORPORATION, MUNICIPALITY OR ANY LEGAL OR PUBLIC ENTITY  OR
 SUBDIVISION THEREOF LICENSED BY THE DEPARTMENT WHO IS ENGAGED IN RECEIV-
 ING  REQUESTS  FOR  EMERGENCY  MEDICAL  ASSISTANCE  FROM  THE PUBLIC AND
 DISPATCHING MEDICAL EMERGENCY RESPONSE SERVICES AS NEEDED.
   4. "MEDICAL EMERGENCY READINESS ASSESSMENT" MEANS  THE  RATING  SYSTEM
 EVALUATING  THE  PREPAREDNESS,  EFFICIENCY, AND EFFECTIVENESS OF MEDICAL
 EMERGENCY RESPONSE WITHIN A COMMUNITY.
   § 3083.  DESIGNATION  OF  MEDICAL  EMERGENCY  RESPONSE  AND  EMERGENCY
 MEDICAL  DISPATCH  AGENCIES  AS ESSENTIAL SERVICES. 1. MEDICAL EMERGENCY
 RESPONSE AND EMERGENCY MEDICAL DISPATCH  AGENCIES  ARE  HEREBY  DECLARED
 ESSENTIAL SERVICES WITHIN NEW YORK STATE.
   2. EVERY COUNTY, ACTING INDIVIDUALLY OR JOINTLY WITH ANY OTHER COUNTY,
 CITY, TOWN, AND VILLAGE, SHALL ENSURE THAT AN EMERGENCY MEDICAL SERVICE,
 AMBULANCE  SERVICE,  ADVANCED LIFE SUPPORT FIRST RESPONSE SERVICE, OTHER
 FIRST RESPONSE SERVICES AUTHORIZED BY THE DEPARTMENT TO PROVIDE EMERGEN-
 CY MEDICAL SERVICES, OR A COMBINATION OF SUCH SERVICES ARE PROVIDED  FOR
 THE PURPOSES OF EFFECTUATING MEDICAL EMERGENCY RESPONSE WITHIN THE BOUN-
 DARIES OF THE COUNTY.
   3.  EVERY COUNTY ACTING INDIVIDUALLY OR JOINTLY WITH ANY OTHER COUNTY,
 CITY, TOWN, AND  VILLAGE,  SHALL  DEVELOP,  IMPLEMENT,  AND  MAINTAIN  A
 COMPREHENSIVE  COUNTY  MEDICAL  EMERGENCY  RESPONSE  PLAN,  IN  A FORMAT
 APPROVED BY THE DEPARTMENT, ENSURING THE  EFFECTIVE  OPERATION,  COORDI-
 NATION,  AND  FUNDING  OF  MEDICAL EMERGENCY RESPONSE. IN FURTHERANCE OF
 THAT PURPOSE, THE COUNTY SHALL DESIGNATE ONE  OR  MORE  PRIMARY  MEDICAL
 EMERGENCY  RESPONSE AGENCIES THAT SHALL RESPOND TO ALL CALLS AND DEMANDS
 FOR SUCH MEDICAL EMERGENCY RESPONSE TO PERSONS ENTITLED THERETO, SUBJECT
 TO ANY LIMITATIONS UPON SUCH SERVICE SPECIFIED IN AN  AGREEMENT,  WITHIN
 THE  BOUNDARIES  OF  THE  COUNTY.  NO MEDICAL EMERGENCY RESPONSE AGENCY,
 DESIGNATED BY THE COUNTY IN THE PLAN, MAY REFUSE TO RESPOND TO A REQUEST
 S. 8307                            138                           A. 8807
 
 FOR SERVICE UNLESS THEY CAN PROVE, TO THE SATISFACTION  OF  THE  DEPART-
 MENT, THAT THEY ARE UNABLE TO RESPOND BECAUSE OF CAPACITY LIMITATIONS.
   4.  NOTWITHSTANDING  THE PROVISIONS OF SECTION THREE THOUSAND EIGHT OF
 THIS CHAPTER, ANY COUNTY ACTING INDIVIDUALLY OR JOINTLY WITH  ANY  OTHER
 COUNTY,  CITY,  TOWN,  AND  VILLAGE,  THAT  PROVIDES, EITHER DIRECTLY OR
 THROUGH AGREEMENT WITH EXISTING SERVICES, AN EMERGENCY  MEDICAL  SERVICE
 OR  GENERAL  AMBULANCE  SERVICE  IN  ACCORDANCE WITH SECTION ONE HUNDRED
 TWENTY-TWO-B OF THE GENERAL MUNICIPAL LAW, FOR THE PURPOSE OF EFFECTUAT-
 ING MEDICAL EMERGENCY RESPONSE, UPON MEETING OR EXCEEDING  ALL  ADMINIS-
 TRATIVE AND OPERATIONAL STANDARDS SET BY THE DEPARTMENT, AND UPON FILING
 WRITTEN  NOTICE  TO THE DEPARTMENT IN A MANNER PRESCRIBED BY THE DEPART-
 MENT, SHALL BE DEEMED TO HAVE SATISFIED ANY  AND  ALL  REQUIREMENTS  FOR
 DETERMINATION  OF  PUBLIC NEED FOR THE ESTABLISHMENT OF ADDITIONAL EMER-
 GENCY MEDICAL SERVICES AND THE DEPARTMENT SHALL ISSUE  A  NON-TRANSFERA-
 BLE,  PERMANENT MUNICIPAL AMBULANCE SERVICE OPERATING CERTIFICATE. NOTH-
 ING IN THIS ARTICLE SHALL BE DEEMED  TO  EXCLUDE  ANY  COUNTY  ISSUED  A
 MUNICIPAL  AMBULANCE  SERVICE  OPERATING CERTIFICATE FROM COMPLYING WITH
 ANY OTHER REQUIREMENT OF ARTICLE THIRTY OF THIS  CHAPTER  OR  ANY  OTHER
 APPLICABLE PROVISION OF LAW OR REGULATIONS PROMULGATED THEREUNDER.
   5.  ANY  COUNTY  ACTING INDIVIDUALLY OR JOINTLY WITH ANY OTHER COUNTY,
 CITY, TOWN, AND VILLAGE,  THAT  PROVIDES,  EITHER  DIRECTLY  OR  THROUGH
 AGREEMENT  WITH  AN  EXISTING  SERVICE,  AN EMERGENCY MEDICAL SERVICE OR
 GENERAL AMBULANCE SERVICE IN ACCORDANCE WITH SECTION ONE  HUNDRED  TWEN-
 TY-TWO-B  OF  THE GENERAL MUNICIPAL LAW, FOR THE PURPOSE OF EFFECTUATING
 MEDICAL EMERGENCY RESPONSE MAY ESTABLISH A SPECIAL DISTRICT, AFTER NINE-
 TY DAYS NOTICE TO THE DEPARTMENT, AS DEFINED IN SUBDIVISION  SIXTEEN  OF
 SECTION  ONE HUNDRED TWO OF THE REAL PROPERTY TAX LAW, FOR THE FINANCING
 AND OPERATION OF SUCH EMERGENCY MEDICAL  SERVICE  OR  GENERAL  AMBULANCE
 SERVICE  IN  ACCORDANCE  WITH  SECTION  ONE  HUNDRED TWENTY-TWO-B OF THE
 GENERAL MUNICIPAL LAW WITH AN EMERGENCY MEDICAL SERVICES AGENCY LICENSED
 BY THE DEPARTMENT TO PROVIDE EMERGENCY MEDICAL SERVICES  IN  THE  STATE.
 SUCH  SPECIAL  DISTRICT  SHALL  BE EXEMPT FROM THE PROVISIONS OF SECTION
 THREE-C OF THE GENERAL MUNICIPAL LAW UNTIL FIVE YEARS AFTER  THE  ESTAB-
 LISHMENT OF THE SPECIAL DISTRICT.
   6.  THE DEPARTMENT SHALL ESTABLISH STANDARDS, WITH THE ADVICE FROM THE
 STATE EMERGENCY MEDICAL SERVICES COUNCIL, THE  STATE  EMERGENCY  MEDICAL
 ADVISORY COMMITTEE AND THE STATE TRAUMA ADVISORY COMMITTEE, ESTABLISHING
 MINIMUM  STANDARDS  FOR  THE  PROVISION OF EMERGENCY MEDICAL SERVICES BY
 FIRST AID SQUADS, BASIC LIFE SUPPORT FIRST  RESPONSE  SERVICES,  SPECIAL
 EVENT  MEDICAL SERVICES, AND OTHER FIRST RESPONSE SERVICES NOT OTHERWISE
 DEFINED IN ARTICLE THIRTY OF THIS CHAPTER.
   § 3084. PROVISION OF EMERGENCY MEDICAL DISPATCH.  1.  EVERY  EMERGENCY
 MEDICAL  DISPATCH  AGENCY  OPERATING WITHIN NEW YORK STATE SHALL PROVIDE
 EMERGENCY  MEDICAL  DISPATCH  SERVICES  IN  ACCORDANCE  WITH   PROTOCOLS
 APPROVED BY THE DEPARTMENT.
   2.  ALL  EMERGENCY  MEDICAL DISPATCH AGENCIES SHALL BE LICENSED BY THE
 DEPARTMENT. THE DEPARTMENT SHALL ESTABLISH CRITERIA FOR THE LICENSING OF
 EMERGENCY MEDICAL DISPATCH AGENCIES TO ENSURE COMPLIANCE WITH  EMERGENCY
 MEDICAL DISPATCH STANDARDS.
   3.  ALL  EMERGENCY  MEDICAL  DISPATCHERS EMPLOYED BY EMERGENCY MEDICAL
 DISPATCH AGENCIES MUST COMPLETE A CERTIFICATION TRAINING COURSE APPROVED
 BY THE DEPARTMENT AND MAINTAIN CONTINUOUS CERTIFICATION  WHILE  EMPLOYED
 BY  THE  EMERGENCY  MEDICAL  DISPATCH  AGENCY  AS  AN  EMERGENCY MEDICAL
 DISPATCHER.  THE DEPARTMENT SHALL ESTABLISH MINIMUM STANDARDS FOR  EMER-
 GENCY MEDICAL DISPATCH TRAINING COURSES AND DISPATCHER CERTIFICATION.
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   §  3085.  RULES AND REGULATIONS. THE COMMISSIONER MAY PROMULGATE RULES
 AND REGULATIONS TO EFFECTUATE THE PURPOSES OF THIS ARTICLE.
   § 10. The public health law is amended by adding a new section 3019 to
 read as follows:
   §  3019.  EMERGENCY  MEDICAL  SERVICES  DEMONSTRATION PROGRAMS. 1. THE
 PURPOSE OF THIS SECTION SHALL BE TO  FACILITATE  INNOVATION  IN  MEDICAL
 CARE  PROVIDED BY EMERGENCY MEDICAL SERVICE PRACTITIONERS IN MEETING THE
 COMMUNITY'S HEALTH CARE NEEDS, INCLUDING COLLABORATION WITH OTHER HEALTH
 CARE ORGANIZATIONS OPERATING UNDER THE  PROVISIONS  OF  SECTION  TWENTY-
 EIGHT  HUNDRED  FIVE-X  OF THIS CHAPTER. IT SHALL PROVIDE A FRAMEWORK TO
 SUPPORT VOLUNTARY INITIATIVES TO IMPROVE PATIENT CARE ACCESS AND MANAGE-
 MENT, PATIENT HEALTH OUTCOMES, AND  COST-EFFECTIVENESS  IN  THE  USE  OF
 HEALTH CARE SERVICES AND COMMUNITY POPULATION HEALTH.
   2.  THE  COMMISSIONER IS AUTHORIZED TO PROVIDE FINANCING INCLUDING, TO
 THE EXTENT OF FUNDS AVAILABLE AND ALLOCATED OR APPROPRIATED THEREFOR, AS
 WELL AS WAIVERS OF CERTAIN PARTS OF THIS ARTICLE,  ARTICLE  THIRTY-A  OF
 THIS  CHAPTER,  AND  REGULATIONS  UNDER TITLE TEN OF THE NEW YORK CODES,
 RULES AND REGULATIONS, TO SUPPORT THE VOLUNTARY INITIATIVES  AND  OBJEC-
 TIVES OF THIS SECTION.
   § 11. The public health law is amended by adding a new section 3055 to
 read as follows:
   §  3055.  EMS LICENSURE AND CREDENTIALING. 1. THE DEPARTMENT, WITH THE
 APPROVAL OF THE STATE EMERGENCY MEDICAL SERVICES COUNCIL, MAY  ESTABLISH
 MINIMUM  STANDARDS FOR THE LICENSURE OF EMERGENCY MEDICAL SERVICES PRAC-
 TITIONERS INCLUDING BUT NOT LIMITED TO EMERGENCY MEDICAL TECHNICIANS AND
 ADVANCED EMERGENCY MEDICAL TECHNICIANS BY THE DEPARTMENT.
   2. THE DEPARTMENT, WITH THE APPROVAL OF THE  STATE  EMERGENCY  MEDICAL
 SERVICES  COUNCIL,  MAY  ESTABLISH  MINIMUM  STANDARDS  FOR  SPECIALIZED
 CREDENTIALING OF EMERGENCY MEDICAL  SERVICE  PRACTITIONERS  WHICH  SHALL
 INCLUDE,  BUT  NOT  BE  LIMITED TO, EMERGENCY VEHICLE OPERATOR, CRITICAL
 CARE PARAMEDIC, EMERGENCY MEDICAL DISPATCHER, EMERGENCY MEDICAL SERVICES
 FIELD TRAINING OFFICER, EMERGENCY MEDICAL SERVICES ADMINISTRATOR,  EMER-
 GENCY  MEDICAL  CONTROL PHYSICIAN, AND EMERGENCY MEDICAL SERVICES AGENCY
 MEDICAL DIRECTOR.
   § 12. The public health law is amended by adding a new section 3029 to
 read as follows:
   § 3029. PARAMEDIC URGENT CARE PROGRAM. 1. THE DEPARTMENT SHALL  ESTAB-
 LISH  A  PARAMEDIC URGENT CARE PROGRAM TO EVALUATE THE ROLE OF EMERGENCY
 MEDICAL SERVICES PERSONNEL IN THE DELIVERY OF HEALTH  CARE  SERVICES  IN
 RURAL COUNTIES OF NEW YORK STATE.
   2.  ANY  ORGANIZATION  THAT  IS  AUTHORIZED  TO  PROVIDE ADVANCED LIFE
 SUPPORT SERVICES, IN ACCORDANCE WITH SECTION THREE  THOUSAND  THIRTY  OF
 THIS  ARTICLE,  MAY  APPLY  TO  THE DEPARTMENT FOR APPROVAL TO OPERATE A
 PARAMEDIC URGENT CARE.
   3. ANY PARAMEDIC URGENT CARE PROGRAMS APPROVED BY THE DEPARTMENT UNDER
 THIS SECTION SHALL: (A) BE UNDER THE OVERALL SUPERVISION  AND  DIRECTION
 OF A QUALIFIED PHYSICIAN; (B) BE STAFFED BY QUALIFIED MEDICAL AND HEALTH
 PERSONNEL,  PHYSICIAN  ASSISTANTS,  OR  NURSE PRACTITIONERS; (C) UTILIZE
 ADVANCED EMERGENCY MEDICAL TECHNICIANS WHOSE SCOPE OF PRACTICE IS APPRO-
 PRIATE FOR THE MEDICAL SERVICES PROVIDED; (D) MAINTAIN A  TREATMENT-MAN-
 AGEMENT  RECORD  FOR EACH PATIENT; AND (E) BE INTEGRATED WITH A HOSPITAL
 OR OTHER APPROPRIATE HEALTHCARE ORGANIZATION.
   4. PARAMEDIC URGENT CARE PROGRAMS MAY INTEGRATE TELEHEALTH PROVIDED BY
 A TELEHEALTH PROVIDER, AS THOSE TERMS ARE DEFINED IN SECTION TWENTY-NINE
 HUNDRED NINETY-NINE-CC OF THIS CHAPTER.  THE COMMISSIONER MAY SPECIFY IN
 REGULATION ADDITIONAL ACCEPTABLE MODALITIES FOR THE DELIVERY  OF  HEALTH
 S. 8307                            140                           A. 8807

 CARE  SERVICES  BY PARAMEDIC CARE PROGRAMS VIA TELEHEALTH, INCLUDING BUT
 NOT LIMITED TO AUDIO-ONLY OR VIDEO-ONLY TELEPHONE COMMUNICATIONS, ONLINE
 PORTALS AND SURVEY APPLICATIONS.
   5.  NOTHING  IN  THIS  SECTION  SHALL  BE  DEEMED TO ALLOW A PERSON TO
 PROVIDE ANY SERVICE FOR WHICH A LICENSE, REGISTRATION, CERTIFICATION  OR
 OTHER  AUTHORIZATION  UNDER TITLE EIGHT OF THE EDUCATION LAW IS REQUIRED
 AND WHICH THE PERSON DOES NOT POSSESS, PROVIDED THAT ANY  SERVICE  BEING
 EXCLUDED  PURSUANT  TO THIS SUBDIVISION SHALL NOT INCLUDE A SERVICE THAT
 IS WITHIN THE SCOPE OF PRACTICE FOR  THE  RESPECTIVE  EMERGENCY  MEDICAL
 SERVICES PERSONNEL.
   §  13.  This  act shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024; provided,
 however, that the amendments to subdivision 3 of  section  3018  of  the
 public  health law made by section four of this act shall not affect the
 repeal of such section and shall be deemed repealed therewith.
 
                                  PART W
 
   Section 1. The elder law is amended by adding a  new  section  226  to
 read as follows:
   §  226.  INTERAGENCY  ELDER  JUSTICE COORDINATING COUNCIL. 1. THERE IS
 HEREBY CREATED WITHIN THE OFFICE AN ELDER JUSTICE  COORDINATING  COUNCIL
 CONSISTING  OF  REPRESENTATIVES  OF  STATE  AGENCIES WHOSE WORK INVOLVES
 ELDER JUSTICE TO CREATE GREATER COLLABORATION  AND  DEVELOP  OVERARCHING
 STRATEGIES,  SYSTEMS,  AND PROGRAMS TO BE CARRIED OUT IN ACCORDANCE WITH
 THE GOVERNOR'S ELDER JUSTICE PRIORITIES, WITH A GOAL OF PROTECTING OLDER
 ADULTS FROM ABUSE AND MISTREATMENT. THE  COUNCIL  SHALL  COLLABORATE  TO
 IDENTIFY  AND SUPPORT CONSISTENT POLICIES AND PROGRAM OPERATION, FACILI-
 TATE COMMUNICATION AMONG STATE AGENCIES, FOSTER COLLABORATIVE  RELATION-
 SHIPS,  AND  HELP  STATE  AGENCIES  KEEP  INFORMED  OF LOCAL, STATE, AND
 NATIONAL DEVELOPMENTS IN ELDER JUSTICE.
   2. THE COUNCIL SHALL BE CHAIRED BY THE DIRECTOR OF THE OFFICE FOR  THE
 AGING,  AND  SHALL  INCLUDE  REPRESENTATION  FROM  THE OFFICE OF VICTIMS
 SERVICES, THE OFFICE OF CHILDREN AND FAMILY SERVICES, THE DEPARTMENT  OF
 FINANCIAL  SERVICES,  THE  DIVISION  OF  CRIMINAL  JUSTICE SERVICES, THE
 OFFICE OF MENTAL HEALTH, THE  OFFICE  FOR  THE  PREVENTION  OF  DOMESTIC
 VIOLENCE,  THE DEPARTMENT OF HEALTH, THE OFFICE FOR PEOPLE WITH DEVELOP-
 MENTAL DISABILITIES, THE NEW YORK STATE POLICE, THE JUSTICE  CENTER  FOR
 THE  PROTECTION  OF  PEOPLE  WITH  SPECIAL  NEEDS, AND THE DEPARTMENT OF
 STATE'S DIVISION OF CONSUMER PROTECTION. ADDITIONALLY, THE COUNCIL SHALL
 REQUEST INPUT FROM STAKEHOLDERS, ADVOCATES, EXPERTS, AND COALITIONS.
   3. THE COUNCIL SHALL:
   (A) DEVELOP AND IMPLEMENT A  COHESIVE,  COMPREHENSIVE  STATE  PLAN  ON
 ELDER JUSTICE THAT ALIGNS STATE ELDER JUSTICE POLICY AND PROGRAMS ACROSS
 STATE AGENCY RESPONSIBILITIES;
   (B)  DEVELOP  PLANS  FOR A COORDINATED AND COMPREHENSIVE RESPONSE FROM
 STATE AND LOCAL GOVERNMENT  AND  OTHER  ENTITIES  WHEN  ELDER  ABUSE  IS
 REPORTED;
   (C)  FACILITATE  INTERAGENCY  PLANNING AND POLICY DEVELOPMENT ON ELDER
 JUSTICE;
   (D) REVIEW AND PROPOSE SPECIFIC AGENCY INITIATIVES FOR THEIR IMPACT ON
 SYSTEMS AND SERVICES RELATED TO ELDER JUSTICE;
   (E) COORDINATE ACTIVITIES FOR WORLD  ELDER  ABUSE  AWARENESS  DAY  AND
 OTHER EVENTS; AND
   (F)  MAKE RECOMMENDATIONS TO THE GOVERNOR THAT WILL IMPROVE NEW YORK'S
 ELDER ABUSE PREVENTION AND INTERVENTION EFFORTS.
 S. 8307                            141                           A. 8807
 
   4. EACH MEMBER AGENCY SHALL MAINTAIN CONTROL OVER, AND  RESPONSIBILITY
 FOR, ITS OWN PROGRAMS AND POLICIES. THE COUNCIL SHALL NOT TAKE THE PLACE
 OF  ANY  EXISTING INTERAGENCY COUNCILS AND COMMITTEES. THE COUNCIL SHALL
 SERVE TO FOCUS ATTENTION ON ELDER JUSTICE COMPREHENSIVELY AND  CREATE  A
 MULTIDISCIPLINARY  MECHANISM TO WORK TOWARD ALIGNMENT ACROSS AGENCIES TO
 HELP ACHIEVE THE GOVERNOR'S ELDER JUSTICE PRIORITIES.
   5. THE COUNCIL SHALL MEET REGULARLY AND SHALL SUBMIT A REPORT  ON  ITS
 ACTIVITIES  TO  THE  GOVERNOR AND THE LEGISLATURE NO LATER THAN DECEMBER
 THIRTY-FIRST, TWO THOUSAND TWENTY-FIVE AND ANNUALLY THEREAFTER.
   § 2. This act shall take effect immediately.
 
                                  PART X
 
   Section 1. Section 5 of part NN of chapter 57 of laws of 2018 amending
 the public health law and other laws relating to the opioid  stewardship
 act,  as  amended  by  section 5 of part XX of chapter 59 of the laws of
 2019, is amended to read as follows:
   § 5. This act shall take effect July 1, 2018 and SECTIONS ONE, TWO AND
 FOUR OF THIS PART shall expire and be deemed to be repealed on June  30,
 2024,  provided  that,  effective  immediately,  the addition, amendment
 and/or repeal of any rule or regulation necessary for the implementation
 of this act on  its  effective  date  are  authorized  to  be  made  and
 completed  on or before such effective date, and, provided that this act
 shall only apply to the sale or distribution of opioids in the state  of
 New York on or before December 31, 2018.
   § 2. This act shall take effect immediately.
 
                                  PART Y

   Section  1.  Section  7  of part R2 of 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, as amended by  section
 1  of  part  W  of chapter 57 of the laws of 2021, is amended to read as
 follows:
   § 7. This act shall take effect immediately [and  shall  expire  March
 31,  2024 when upon such date the provisions of this act shall be deemed
 repealed].
   § 2. This act shall take effect immediately.
 
                                  PART Z

   Section 1. Section 2 of 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, as amended by section 1
 of part V of chapter 57 of the laws of  2021,  is  amended  to  read  as
 follows:
   §  2.  This act shall take effect immediately [and shall expire and be
 deemed repealed March 31, 2024].
   § 2. This act shall take effect immediately.
 
                                  PART AA
 S. 8307                            142                           A. 8807
 
   Section 1. Paragraph 31 of subsection  (i)  of  section  3216  of  the
 insurance  law  is  amended  by adding a new subparagraph (J) to read as
 follows:
   (J) THIS SUBPARAGRAPH SHALL APPLY TO FACILITIES IN THIS STATE THAT ARE
 LICENSED,  CERTIFIED, OR OTHERWISE AUTHORIZED BY THE OFFICE OF ADDICTION
 SERVICES AND SUPPORTS FOR THE PROVISION OF OUTPATIENT, INTENSIVE  OUTPA-
 TIENT,  OUTPATIENT  REHABILITATION AND OPIOID TREATMENT THAT ARE PARTIC-
 IPATING IN THE INSURER'S PROVIDER  NETWORK.  REIMBURSEMENT  FOR  COVERED
 OUTPATIENT TREATMENT PROVIDED BY SUCH FACILITIES SHALL BE AT A RATE THAT
 IS NOT LESS THAN THE RATE THAT WOULD BE PAID FOR SUCH TREATMENT PURSUANT
 TO  THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE OF
 THE SOCIAL SERVICES LAW.
   § 2. Paragraph 35 of subsection (i) of section 3216 of  the  insurance
 law is amended by adding a new subparagraph (K) to read as follows:
   (K)  THIS SUBPARAGRAPH SHALL APPLY TO OUTPATIENT TREATMENT PROVIDED IN
 A FACILITY ISSUED AN OPERATING CERTIFICATE BY THE COMMISSIONER OF MENTAL
 HEALTH PURSUANT TO THE PROVISIONS OF ARTICLE THIRTY-ONE  OF  THE  MENTAL
 HYGIENE  LAW,  OR IN A FACILITY OPERATED BY THE OFFICE OF MENTAL HEALTH,
 OR IN A CRISIS STABILIZATION CENTER LICENSED PURSUANT TO  SECTION  36.01
 OF  THE  MENTAL  HYGIENE  LAW,  THAT  IS  PARTICIPATING IN THE INSURER'S
 PROVIDER  NETWORK.  REIMBURSEMENT  FOR  COVERED   OUTPATIENT   TREATMENT
 PROVIDED BY SUCH A FACILITY SHALL BE AT A RATE THAT IS NOT LESS THAN THE
 RATE  THAT  WOULD  BE  PAID  FOR  SUCH TREATMENT PURSUANT TO THE MEDICAL
 ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF  ARTICLE  FIVE  OF  THE  SOCIAL
 SERVICES LAW.
   §  3.  Paragraph  5 of subsection (l) of section 3221 of the insurance
 law is amended by adding a new subparagraph (K) to read as follows:
   (K) THIS SUBPARAGRAPH SHALL APPLY TO OUTPATIENT TREATMENT PROVIDED  IN
 A FACILITY ISSUED AN OPERATING CERTIFICATE BY THE COMMISSIONER OF MENTAL
 HEALTH  PURSUANT  TO  THE PROVISIONS OF ARTICLE THIRTY-ONE OF THE MENTAL
 HYGIENE LAW, OR IN A FACILITY OPERATED BY THE OFFICE OF  MENTAL  HEALTH,
 OR  IN  A CRISIS STABILIZATION CENTER LICENSED PURSUANT TO SECTION 36.01
 OF THE MENTAL HYGIENE  LAW,  THAT  IS  PARTICIPATING  IN  THE  INSURER'S
 PROVIDER   NETWORK.   REIMBURSEMENT  FOR  COVERED  OUTPATIENT  TREATMENT
 PROVIDED BY SUCH A FACILITY SHALL BE AT A RATE THAT IS NOT LESS THAN THE
 RATE THAT WOULD BE PAID FOR  SUCH  TREATMENT  PURSUANT  TO  THE  MEDICAL
 ASSISTANCE  PROGRAM  UNDER  TITLE  ELEVEN  OF ARTICLE FIVE OF THE SOCIAL
 SERVICES LAW.
   § 4. Paragraph 7 of subsection (l) of section 3221  of  the  insurance
 law is amended by adding a new subparagraph (J) to read as follows:
   (J) THIS SUBPARAGRAPH SHALL APPLY TO FACILITIES IN THIS STATE THAT ARE
 LICENSED,  CERTIFIED, OR OTHERWISE AUTHORIZED BY THE OFFICE OF ADDICTION
 SERVICES AND SUPPORTS FOR THE PROVISION OF OUTPATIENT, INTENSIVE  OUTPA-
 TIENT,  OUTPATIENT  REHABILITATION AND OPIOID TREATMENT THAT ARE PARTIC-
 IPATING IN THE INSURER'S PROVIDER  NETWORK.  REIMBURSEMENT  FOR  COVERED
 OUTPATIENT TREATMENT PROVIDED BY SUCH FACILITIES SHALL BE AT A RATE THAT
 IS NOT LESS THAN THE RATE THAT WOULD BE PAID FOR SUCH TREATMENT PURSUANT
 TO  THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE OF
 THE SOCIAL SERVICES LAW.
   § 5. Subsection (g) of section 4303 of the insurance law is amended by
 adding a new paragraph 12 to read as follows:
   (12) THIS PARAGRAPH SHALL APPLY TO OUTPATIENT TREATMENT PROVIDED IN  A
 FACILITY  ISSUED  AN OPERATING CERTIFICATE BY THE COMMISSIONER OF MENTAL
 HEALTH PURSUANT TO THE PROVISIONS OF ARTICLE THIRTY-ONE  OF  THE  MENTAL
 HYGIENE  LAW,  OR IN A FACILITY OPERATED BY THE OFFICE OF MENTAL HEALTH,
 OR IN A CRISIS STABILIZATION CENTER LICENSED PURSUANT TO  SECTION  36.01
 S. 8307                            143                           A. 8807

 OF  THE  MENTAL  HYGIENE LAW, THAT IS PARTICIPATING IN THE CORPORATION'S
 PROVIDER  NETWORK.  REIMBURSEMENT  FOR  COVERED   OUTPATIENT   TREATMENT
 PROVIDED  BY  SUCH FACILITY SHALL BE AT A RATE THAT IS NOT LESS THAN THE
 RATE  THAT  WOULD  BE  PAID  FOR  SUCH TREATMENT PURSUANT TO THE MEDICAL
 ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF  ARTICLE  FIVE  OF  THE  SOCIAL
 SERVICES LAW.
   § 6. Subsection (l) of section 4303 of the insurance law is amended by
 adding a new paragraph 10 to read as follows:
   (10)  THIS  PARAGRAPH SHALL APPLY TO FACILITIES IN THIS STATE THAT ARE
 LICENSED, CERTIFIED, OR OTHERWISE AUTHORIZED BY THE OFFICE OF  ADDICTION
 SERVICES  AND SUPPORTS FOR THE PROVISION OF OUTPATIENT, INTENSIVE OUTPA-
 TIENT, OUTPATIENT REHABILITATION AND OPIOID TREATMENT THAT  ARE  PARTIC-
 IPATING IN THE CORPORATION'S PROVIDER NETWORK. REIMBURSEMENT FOR COVERED
 OUTPATIENT TREATMENT PROVIDED BY SUCH FACILITIES SHALL BE AT A RATE THAT
 IS NOT LESS THAN THE RATE THAT WOULD BE PAID FOR SUCH TREATMENT PURSUANT
 TO  THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE OF
 THE SOCIAL SERVICES LAW.
   § 7. This act shall take effect January 1, 2025  and  shall  apply  to
 policies and contracts issued, renewed, modified, altered, or amended on
 and after such date.
 
                                  PART BB
 
   Section  1.  Sections  19  and  21  of chapter 723 of the laws of 1989
 amending the mental hygiene law and other laws relating to comprehensive
 psychiatric emergency programs, as amended by section 1 of part  PPP  of
 chapter 58 of the laws of 2020, are amended to read as follows:
   §  19. Notwithstanding any other provision of law, the commissioner of
 mental health shall[, until July 1, 2024,] be solely authorized, in  his
 or  her  discretion, to designate those general hospitals, local govern-
 mental units and voluntary agencies which may apply  and  be  considered
 for  the  approval  and issuance of an operating certificate pursuant to
 article 31 of the mental hygiene law for the operation of  a  comprehen-
 sive psychiatric emergency program.
   §  21.  This act shall take effect immediately[, and sections one, two
 and four through twenty of this act  shall  remain  in  full  force  and
 effect,  until  July 1, 2024, at which time the amendments and additions
 made by such sections of this act shall be deemed to  be  repealed,  and
 any  provision  of law amended by any of such sections of this act shall
 revert to its text as it existed prior to the  effective  date  of  this
 act].
   § 2. This act shall take effect immediately.
 
                                  PART CC
 
   Section 1. Subdivision 2 of section 493 of the social services law, as
 added  by  section  1  of  part B of chapter 501 of the laws of 2012, is
 amended to read as follows:
   2. For substantiated reports of abuse  or  neglect  in  facilities  or
 provider  agencies  in  receipt  of  medical assistance AND WHICH ARE NO
 LONGER SUBJECT TO AMENDMENT OR APPEAL PURSUANT TO SECTION  FOUR  HUNDRED
 NINETY-FOUR OF THIS ARTICLE, such information shall also be forwarded by
 the  justice center to the office of the Medicaid inspector general when
 such abuse or neglect may [be relevant to an investigation of unaccepta-
 ble practices as such practices are defined] RESULT in [regulations  of]
 POSSIBLE  EXCLUSION  OR  OTHER  SANCTION  BY  the office of the Medicaid
 S. 8307                            144                           A. 8807
 
 inspector general AS DETERMINED IN CONSULTATION WITH THE OFFICE  OF  THE
 MEDICAID INSPECTOR GENERAL.
   § 2. This act shall take effect immediately.
 
                                  PART DD
 
   Section  1.  Section  3  of  part A of 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, as amended by
 section 1 of part T of chapter 57 of the laws of  2021,  is  amended  to
 read as follows:
   §  3. This act shall take effect immediately[; and shall expire and be
 deemed repealed June 30, 2024].
   § 2. This act shall take effect immediately.
 
                                  PART EE
 
   Section 1. Subparagraph (v) of  paragraph  (a)  of  subdivision  1  of
 section  6908 of the education law is renumbered subparagraph (vi) and a
 new subparagraph (v) is added to read as follows:
   (V) TASKS PROVIDED BY A DIRECT SUPPORT  STAFF  IN  NON-FACILITY  BASED
 PROGRAMS CERTIFIED, AUTHORIZED OR APPROVED BY THE OFFICE FOR PEOPLE WITH
 DEVELOPMENTAL DISABILITIES, SO LONG AS SUCH STAFF DOES NOT HOLD THEMSELF
 OUT  AS  ONE WHO ACCEPTS EMPLOYMENT SOLELY FOR PERFORMING SUCH CARE, AND
 WHERE NURSING SERVICES ARE UNDER THE INSTRUCTION OF A SERVICE  RECIPIENT
 OR  FAMILY  OR  HOUSEHOLD MEMBER DETERMINED BY A REGISTERED PROFESSIONAL
 NURSE TO BE CAPABLE OF PROVIDING SUCH INSTRUCTION.   IN THE  EVENT  THAT
 THE  REGISTERED  NURSE DETERMINES THAT THE SERVICE RECIPIENT, FAMILY, OR
 HOUSEHOLD MEMBER IS NOT CAPABLE OF PROVIDING SUCH  INSTRUCTION,  NURSING
 TASKS  MAY BE PERFORMED BY DIRECT SUPPORT STAFF PURSUANT TO SUBPARAGRAPH
 (VI) OF THIS PARAGRAPH SUBJECT TO THE REQUIREMENTS SET FORTH THEREIN; OR
   § 2. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART FF
 
   Section  1. 1. Subject to available appropriations and approval of the
 director of the budget,  the  commissioners  of  the  office  of  mental
 health,  office  for  people  with developmental disabilities, office of
 addiction services and supports,  office  of  temporary  and  disability
 assistance, office of children and family services, and the state office
 for  the  aging  shall  establish  a state fiscal year 2024-2025 cost of
 living adjustment (COLA), effective April 1, 2024,  for  projecting  for
 the effects of inflation upon rates of payments, contracts, or any other
 form of reimbursement for the programs and services listed in paragraphs
 (i),  (ii),  (iii),  (iv),  (v),  and  (vi)  of subdivision four of this
 section. The COLA established herein shall be applied to the appropriate
 portion of reimbursable costs or contract  amounts.  Where  appropriate,
 transfers  to the department of health (DOH) shall be made as reimburse-
 ment for the state share of medical assistance.
   2. Notwithstanding any inconsistent provision of law, subject  to  the
 approval  of  the  director  of  the budget and available appropriations
 therefore, for the period of April 1, 2024 through March 31,  2025,  the
 commissioners  shall  provide  funding  to support a one and five-tenths
 percent (1.5%) cost of living adjustment  under  this  section  for  all
 S. 8307                            145                           A. 8807
 
 eligible  programs  and  services  as determined pursuant to subdivision
 four of this section.
   3.  Notwithstanding any inconsistent provision of law, and as approved
 by the director of the budget, the 1.5 percent cost of living adjustment
 (COLA) established herein shall be inclusive of all other cost of living
 type increases, inflation factors,  or  trend  factors  that  are  newly
 applied  effective  April  1,  2024.  Except for the 1.5 percent cost of
 living adjustment (COLA) established herein, for the  period  commencing
 on  April  1, 2024 and ending March 31, 2025 the commissioners shall not
 apply any other new cost of living adjustments for the purpose of estab-
 lishing rates of payments, contracts or any other form of reimbursement.
 The phrase "all other cost of living type increases, inflation  factors,
 or  trend  factors"  as  defined  in  this subdivision shall not include
 payments made pursuant to the American Rescue Plan Act or other  federal
 relief  programs  related  to  the  Coronavirus  Disease 2019 (COVID-19)
 pandemic public health emergency. This subdivision shall not prevent the
 office of children and family services from  applying  additional  trend
 factors  or  staff  retention  factors to eligible programs and services
 under paragraph (v) of subdivision four of this section.
   4. Eligible programs and services. (i) Programs and  services  funded,
 licensed, or certified by the office of mental health (OMH) eligible for
 the  cost  of  living  adjustment  established  herein,  pending federal
 approval where applicable, include: office  of  mental  health  licensed
 outpatient programs, pursuant to parts 587 and 599 of title 14 CRR-NY of
 the office of mental health regulations including clinic, continuing day
 treatment,  day  treatment,  intensive  outpatient  programs and partial
 hospitalization;  outreach;  crisis  residence;  crisis   stabilization,
 crisis/respite  beds;  mobile crisis, part 590 comprehensive psychiatric
 emergency program  services;  crisis  intervention;  home  based  crisis
 intervention;  family  care;  supported single room occupancy; supported
 housing; supported housing  community  services;  treatment  congregate;
 supported   congregate;   community  residence  -  children  and  youth;
 treatment/apartment; supported  apartment;  community  residence  single
 room occupancy; on-site rehabilitation; employment programs; recreation;
 respite  care;  transportation;  psychosocial  club; assertive community
 treatment; case management; care  coordination,  including  health  home
 plus  services;  local  government  unit  administration; monitoring and
 evaluation; children and youth  vocational  services;  single  point  of
 access;  school-based mental health program; family support children and
 youth; advocacy/support services; drop  in  centers;  recovery  centers;
 transition management services; bridger; home and community based waiver
 services;  behavioral  health waiver services authorized pursuant to the
 section 1115 MRT waiver; self-help programs; consumer  service  dollars;
 conference  of local mental hygiene directors; multicultural initiative;
 ongoing integrated supported employment services;  supported  education;
 mentally   ill/chemical  abuse  (MICA)  network;  personalized  recovery
 oriented services; children and family treatment and  support  services;
 residential treatment facilities operating pursuant to part 584 of title
 14-NYCRR;   geriatric  demonstration  programs;  community-based  mental
 health family treatment  and  support;  coordinated  children's  service
 initiative; homeless services; and promises zone.
   (ii)  Programs  and  services  funded,  licensed,  or certified by the
 office for people with developmental disabilities (OPWDD)  eligible  for
 the  cost  of  living  adjustment  established  herein,  pending federal
 approval where applicable, include: local/unified services; chapter  620
 services;  voluntary operated community residential services; article 16
 S. 8307                            146                           A. 8807
 
 clinics; day treatment  services;  family  support  services;  100%  day
 training;  epilepsy services; traumatic brain injury services; hepatitis
 B services;  independent  practitioner  services  for  individuals  with
 intellectual  and/or  developmental  disabilities;  crisis  services for
 individuals with intellectual and/or developmental disabilities;  family
 care  residential  habilitation;  supervised  residential  habilitation;
 supportive residential habilitation; respite; day habilitation; prevoca-
 tional services; supported employment; community habilitation;  interme-
 diate  care  facility  day and residential services; specialty hospital;
 pathways to employment; intensive behavioral services;  basic  home  and
 community  based  services  (HCBS)  plan  support;  community transition
 services; family education and training;  fiscal  intermediary;  support
 broker; and personal resource accounts.
   (iii)  Programs  and  services  funded,  licensed, or certified by the
 office of addiction services and supports (OASAS) eligible for the  cost
 of  living adjustment established herein, pending federal approval where
 applicable, include: medically supervised withdrawal services - residen-
 tial; medically supervised withdrawal services -  outpatient;  medically
 managed  detoxification; medically monitored withdrawal; inpatient reha-
 bilitation services; outpatient  opioid  treatment;  residential  opioid
 treatment; KEEP units outpatient; residential opioid treatment to absti-
 nence;  problem  gambling  treatment;  medically  supervised outpatient;
 outpatient  rehabilitation;   specialized   services   substance   abuse
 programs;  home and community based waiver services pursuant to subdivi-
 sion 9 of section 366 of the social services law;  children  and  family
 treatment and support services; continuum of care rental assistance case
 management;  NY/NY  III  post-treatment  housing;  NY/NY III housing for
 persons at risk for homelessness;  permanent  supported  housing;  youth
 clubhouse;  recovery  community  centers;  recovery community organizing
 initiative; residential rehabilitation services for youth (RRSY); inten-
 sive residential; community residential; supportive living;  residential
 services;  job  placement  initiative;  case  management; family support
 navigator; local government unit administration; peer engagement;  voca-
 tional   rehabilitation;   support   services;  HIV  early  intervention
 services; dual diagnosis coordinator; problem gambling resource centers;
 problem  gambling  prevention;  prevention  resource  centers;   primary
 prevention services; other prevention services; and community services.
   (iv)  Programs  and  services  funded,  licensed,  or certified by the
 office of temporary and disability assistance (OTDA)  eligible  for  the
 cost  of  living adjustment established herein, pending federal approval
 where applicable, include:  nutrition  outreach  and  education  program
 (NOEP).
   (v) Programs and services funded, licensed, or certified by the office
 of  children  and family services (OCFS) eligible for the cost of living
 adjustment established herein, pending federal approval  where  applica-
 ble,  include:  programs  for  which  the  office of children and family
 services establishes maximum state aid rates pursuant to  section  398-a
 of  the social services law and section 4003 of the education law; emer-
 gency foster homes; foster family boarding homes and therapeutic  foster
 homes;  supervised  settings  as  defined  by  subdivision twenty-two of
 section 371 of the  social  services  law;  adoptive  parents  receiving
 adoption subsidy pursuant to section 453 of the social services law; and
 congregate  and  scattered  supportive  housing  programs and supportive
 services provided under the NY/NY III supportive  housing  agreement  to
 young adults leaving or having recently left foster care.
 S. 8307                            147                           A. 8807
 
   (vi) Programs and services funded, licensed, or certified by the state
 office  for  the aging (SOFA) eligible for the cost of living adjustment
 established herein, pending federal approval where applicable,  include:
 community  services  for  the elderly; expanded in-home services for the
 elderly; and supplemental nutrition assistance program.
   5.  Each  local  government unit or direct contract provider receiving
 funding for the cost  of  living  adjustment  established  herein  shall
 submit  a  written  certification, in such form and at such time as each
 commissioner shall prescribe, attesting how such funding will be or  was
 used  to  first  promote  the recruitment and retention of non-executive
 direct care staff, non-executive direct support professionals,  non-exe-
 cutive clinical staff, or respond to other critical non-personal service
 costs prior to supporting any salary increases or other compensation for
 executive level job titles.
   6.  Notwithstanding any inconsistent provision of law to the contrary,
 agency commissioners shall be authorized to recoup funding from a  local
 governmental  unit  or  direct  contract provider for the cost of living
 adjustment established herein determined to have been used in  a  manner
 inconsistent  with  the  appropriation,  or  any other provision of this
 section. Such agency commissioners shall be  authorized  to  employ  any
 legal mechanism to recoup such funds, including an offset of other funds
 that are owed to such local governmental unit or direct contract provid-
 er.
   §  2.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024.
   § 2. Severability clause. If any clause, sentence, paragraph, subdivi-
 sion, section or part of this act shall be  adjudged  by  any  court  of
 competent  jurisdiction  to  be invalid, such judgment shall not affect,
 impair, or invalidate the remainder thereof, but shall  be  confined  in
 its  operation  to the clause, sentence, paragraph, subdivision, section
 or part thereof directly involved in the controversy in which such judg-
 ment shall have been rendered. It is hereby declared to be the intent of
 the legislature that this act would  have  been  enacted  even  if  such
 invalid provisions had not been included herein.
   §  3.  This  act shall take effect immediately provided, however, that
 the applicable effective date of Parts A through FF of this act shall be
 as specifically set forth in the last section of such Parts.

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
     S. 8307--A                                            A. 8807--A
 
                       S E N A T E - A S S E M B L Y
 
                             January 17, 2024
                                ___________
 
 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 -- committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to said committee
 
 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 --  committee  discharged,  bill  amended,
   ordered reprinted as amended and recommitted to said committee
 
 AN  ACT  to amend part H of chapter 59 of the laws of 2011, amending the
   public  health  law  and  other  laws  relating  to  general  hospital
   reimbursement  for  annual  rates,  in relation to known and projected
   department of health state fund medicaid  expenditures  (Part  A);  to
   amend  the  public  health  law,  in  relation  to  extending  certain
   provisions related to the issuance of  accountable  care  organization
   certifications  and  state  oversight  of antitrust provisions; and to
   amend part D of chapter 56 of the laws of  2013  amending  the  social
   services  law  relating  to eligibility conditions, chapter 649 of the
   laws of 1996 amending the public health law, the  mental  hygiene  law
   and  the social services law relating to authorizing the establishment
   of special needs plans, part V of chapter  57  of  the  laws  of  2022
   amending  the  public  health  law  and  the insurance law relating to
   reimbursement for commercial and Medicaid services provided via  tele-
   health, chapter 659 of the laws of 1997 amending the public health law
   and  other  laws  relating  to  creation of continuing care retirement
   communities, part NN of chapter 57 of the laws of  2018  amending  the
   public  health  law and the state finance law relating to enacting the
   opioid stewardship act, part II of chapter 54  of  the  laws  of  2016
   amending  part C of chapter 58 of the laws of 2005 relating to author-
   izing reimbursements for expenditures made by or on behalf  of  social
   services districts for medical assistance for needy persons and admin-
   istration  thereof,  part B of chapter 57 of the laws of 2015 amending
   the social services law and  other  laws  relating  to  energy  audits
   and/or disaster preparedness reviews of residential healthcare facili-
   ties by the commissioner, and part H of chapter 57 of the laws of 2019
   amending  the  public  health  law relating to waiver of certain regu-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD12671-02-4
 S. 8307--A                          2                         A. 8807--A
 
   lations, in relation to the effectiveness thereof (Part B);  to  amend
   the  education  law,  in relation to removing the exemption for school
   psychologists to render early  intervention  services;  and  to  amend
   chapter  217  of the laws of 2015, amending the education law relating
   to certified school psychologists and special education  services  and
   programs  for  preschool  children  with  handicapping  conditions, in
   relation to the effectiveness thereof (Part C); to  amend  the  public
   health  law, in relation to reducing the hospital capital rate add-on;
   to amend part ZZ of chapter 56 of the laws of 2020  amending  the  tax
   law  and the  social services law relating to certain Medicaid manage-
   ment, in relation to the effectiveness thereof; to  amend  part  E  of
   chapter  57 of the laws of 2015, amending the public health law relat-
   ing to the  payment  of  certain  funds  for  uncompensated  care,  in
   relation  to  certain  payments being made as outpatient upper payment
   limit payments for outpatient hospital services during  certain  state
   fiscal  years and calendar years; to amend part B of chapter 57 of the
   laws of 2015, amending the social services  law  relating  to  supple-
   mental rebates, in relation to authorizing the department of health to
   increase  operating  cost  component  of  rates of payment for general
   hospital outpatient services and authorizing the department of  health
   to pay a public hospital adjustment to public general hospitals during
   certain  state  fiscal  years  and calendar years; to amend the public
   health law, in relation to authorizing the commissioner to make  addi-
   tional  inpatient  hospital payments during certain state fiscal years
   and calendar years; and to amend part B of chapter 58 of the  laws  of
   2010,  amending  the  social  services  law  and the public health law
   relating to prescription drug coverage for needy  persons  and  health
   care  initiatives  pools, in relation to authorizing the department of
   health to make Medicaid payment increases for  county  operated  free-
   standing  clinics during certain state fiscal years and calendar years
   (Part D); to amend the public health law, in relation to freezing  the
   operating  component  of  the  rates  for  skilled nursing facilities,
   reducing the capital component of the rates for skilled nursing facil-
   ities by an additional ten percent, and eligibility for  admission  to
   the  New  York  state  veterans'  home  (Part  E); to amend the social
   services law, in relation to making the special needs assisted  living
   residence  voucher  program  permanent; and to amend the public health
   law, in relation to  assisted  living  quality  improvement  standards
   (Part  F);  to amend   the public health law, in relation to home care
   worker wage parity; and to repeal certain  provisions  of  the  public
   health  law relating thereto (Part G); to amend the financial services
   law, in relation to excluding managed care plans from the  independent
   resolution  process;  to  amend the social services law and the public
   health law, in relation to providing authority for the  department  of
   health to competitively procure managed care organizations participat-
   ing  in  medicaid managed care programs; to amend part I of chapter 57
   of the laws of 2022, providing a one percent across the board  payment
   increase to all qualifying fee-for-service Medicaid rates, in relation
   to eliminating the one percent rate increase to managed care organiza-
   tions;  and  to  repeal  certain provisions of the social services law
   relating thereto (Part H);  to  amend  the  social  services  law,  in
   relation  to  copayments for drugs; to amend the public health law, in
   relation to prescriber prevails; to amend the public  health  law,  in
   relation  to the Medicaid drug cap and pharmacy cost reporting; and to
   repeal certain provisions of  the  social  services  law  relating  to
   coverage  for certain prescription drugs (Part I); to amend the social
 S. 8307--A                          3                         A. 8807--A
 
   services law, in relation to renaming the basic health program to  the
   essential  plan;  to  amend  part H of chapter 57 of the laws of 2021,
   amending the social services law relating to eliminating consumer-paid
   premium  payments  in  the  basic  health  program, in relation to the
   effectiveness thereof; and to amend part BBB of chapter 56 of the laws
   of 2022, amending the public health law and  other  laws  relating  to
   permitting  the commissioner of health to submit a waiver that expands
   eligibility for New York's basic  health  program  and  increases  the
   federal  poverty  limit  cap for basic health program eligibility from
   two hundred to two hundred fifty percent,  in  relation  to  extending
   certain   provisions  related  to  providing  long-term  services  and
   supports under the essential plan; and to amend the public health law,
   in relation to adding references to the 1332 state innovation  waiver,
   providing  a  new  subsidy  to  assist low-income New Yorkers with the
   payment of premiums, cost sharing or both through the marketplace, and
   adding the 1332 state innovation  program  to  the  functions  of  the
   marketplace  (Part J); to amend chapter 266 of the laws of 1986 amend-
   ing the civil practice law and rules and other laws relating to  malp-
   ractice  and  professional  medical  conduct, in relation to insurance
   coverage paid for by funds from the hospital excess liability pool and
   extending the effectiveness of certain provisions  thereof;  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, in relation
   to extending certain provisions concerning the hospital excess liabil-
   ity pool; and to amend part H of chapter 57 of the laws of 2017 amend-
   ing the New York Health Care Reform Act of 1996 and other laws  relat-
   ing  to  extending certain provisions relating thereto, in relation to
   extending provisions relating to excess coverage (Part  K);  to  amend
   the  public  health  law and the state finance law, in relation to the
   discontinuation of the empire clinical research investigator  program;
   to  amend  the public health law, in relation to the discontinuance of
   participation and membership during a three year demonstration  period
   in  a  physician  committee of the Medical Society of the State of New
   York or the New York State Osteopathic Society; to repeal  subdivision
   9  of  section 2803 of the public health law, relating to the hospital
   audit program; to repeal section 461-s of  the  social  services  law,
   relating  to  enhancing  the quality of adult living program for adult
   care facilities; to repeal paragraph (c) of subdivision 1  of  section
   461-b  of  the  social services law, relating to an appropriation made
   available for the purposes of funding the  operating  assistance  sub-
   program  for  enriched  housing;  to repeal article 27-H of the public
   health law, relating to  the  tick-borne  disease  institute;  and  to
   repeal  paragraph  (g)  of subdivision 11 of section 230 of the public
   health law, relating to reporting of professional misconduct (Part L);
   to amend the social  services  law  and  the  public  health  law,  in
   relation  to  authorizing  continuous  coverage  in Medicaid and child
   health plus, for eligible children ages zero to six (Part M); to amend
   the public health law, in relation to authorizing the commissioner  of
   health  to issue a statewide standing order for the provision of doula
   services, providing medical services to pregnant minors,  and  to  the
   provision  of  contraception (Part N); to amend the public health law,
   in relation to expanding financial assistance; and to amend the gener-
   al business law, in relation to  additional  consumer  protection  for
   medical  debt  and  restricting the applications for and use of credit
   cards and medical financial products (Part O);  to  amend  part  C  of
 S. 8307--A                          4                         A. 8807--A
 
   chapter  57 of the laws of 2022 amending the public health law and the
   education law relating  to  allowing  pharmacists  to  direct  limited
   service  laboratories  and order and administer COVID-19 and influenza
   tests  and modernizing nurse practitioners, and chapter 21 of the laws
   of 2011 amending the education law relating to authorizing pharmacists
   to perform collaborative drug therapy management  with  physicians  in
   certain  settings,  in relation to the effectiveness thereof (Part P);
   to amend the education law and the public health law, in  relation  to
   the  scope of practice of physician assistants, certified nurse aides,
   medical assistants, dentists and dental hygienists (Part Q); to  amend
   the  education  law,  in  relation  to enacting the interstate medical
   licensure compact; and to amend the  education  law,  in  relation  to
   enacting  the  nurse  licensure  compact (Part R); to amend the public
   health law, in relation to  establishing  the  healthcare  safety  net
   transformation  program  (Part  S); to amend the public health law and
   the education law, in relation to making necessary changes to end  the
   HIV,  HCV,  HBV,  syphilis  and  mpox epidemics; and to repeal certain
   provisions the public health law relating thereto (Part T);  to  amend
   the public health law, in relation to increasing prescription monitor-
   ing  program data retention periods and allowing enhanced data sharing
   to combat the opioid crisis, updating controlled  substance  schedules
   to  conform with those of the federal drug enforcement administration,
   permitting providers to distribute  three-day  supplies  of  buprenor-
   phine,  and updating the term "addict" to "person with a substance use
   disorder" in certain provisions of such law;  and  to  repeal  section
   3372  of such law relating to practitioner patient reporting (Part U);
   to amend the public health law,  in  relation  to  expanding  hospital
   services  and  home care collaboration into the home and community; to
   amend the public health law and the  education  law,  in  relation  to
   modernizing the state of New York's emergency medical system and work-
   force; to amend the public health law, in relation to establishing the
   paramedic urgent care program; and to amend chapter 137 of the laws of
   2023  amending the public health law relating to establishing a commu-
   nity-based paramedicine demonstration program, in relation to  extend-
   ing  the  effectiveness  thereof  (Part V); to amend the elder law, in
   relation to establishing the interagency  elder  justice  coordinating
   council  (Part W); intentionally omitted (Part X); 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 work-
   force reinvestment program, the membership of subcommittees for mental
   health of community services boards and the duties of such  subcommit-
   tees  and creating the community mental health and workforce reinvest-
   ment account, in relation to the effectiveness thereof  (Part  Y);  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-lim-
   ited demonstration programs, in relation  to  making  such  provisions
   permanent (Part Z); to amend the insurance law, in relation to setting
   minimal  reimbursement  for  behavioral health treatment (Part AA); to
   amend chapter 723 of the laws of 1989 amending the mental hygiene  law
   and   other  laws  relating  to  comprehensive  psychiatric  emergency
   programs, in   relation to the  effectiveness  of  certain  provisions
   thereof  (Part  BB);  to amend the social services law, in relation to
   clarifying the requirements  related  to  referrals  of  substantiated
   reports  of  abuse or neglect from the justice center to the office of
   the Medicaid inspector general (Part CC); to amend part A  of  chapter
 S. 8307--A                          5                         A. 8807--A
 
   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 DD);
   to  amend  the education law, in relation to expanding the description
   of certain services which are not prohibited by statutes governing the
   practice of nursing (Part EE); to establish a cost of  living  adjust-
   ment  for  designated  human services programs (Part FF); to amend the
   social services law, in relation to providing contracting  flexibility
   in  relation  to  1115  medicaid  waivers  (Part GG); and to amend the
   social services law, in relation to the removal of the fiscal interme-
   diary procurement and replacing it with an authorization  process;  to
   amend  the  public health law, in relation to eliminating conflicts of
   interest between consumer directed personal assistance program  fiscal
   intermediaries  and licensed home care services agencies; to amend the
   social services law, in relation to  the  consumer  directed  personal
   assistance  program;  and  to  repeal certain provisions of the social
   services law relating thereto (Part HH)
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  This  act enacts into law major components of legislation
 necessary to implement the state health and mental  hygiene  budget  for
 the  2024-2025  state  fiscal  year.  Each component is wholly contained
 within a Part identified as Parts A through HH. The effective  date  for
 each particular provision contained within such Part is set forth in the
 last section of such Part. Any provision in any section contained within
 a  Part,  including the effective date of the Part, which makes a refer-
 ence to a section "of this act",  when  used  in  connection  with  that
 particular  component,  shall  be deemed to mean and refer to the corre-
 sponding section of the Part in which it is found. Section three of this
 act sets forth the general effective date of this act.
 
                                  PART A

   Section 1. Paragraph (a) of subdivision 1 of section 92 of part  H  of
 chapter 59 of the laws of 2011, amending the public health law and other
 laws  relating  to  general  hospital reimbursement for annual rates, as
 amended by section 1 of part A of chapter 57 of the  laws  of  2023,  is
 amended to read as follows:
   (a)  For  state  fiscal  years  2011-12 through [2024-25] 2025-26, the
 director of the budget, in consultation with the commissioner of  health
 referenced  as "commissioner" for purposes of this section, shall assess
 on a quarterly basis, as reflected  in  quarterly  reports  pursuant  to
 subdivision  five  of  this  section  known  and projected department of
 health state funds medicaid expenditures by category of service  and  by
 geographic regions, as defined by the commissioner.
   §  2.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART B
 
   Section 1. Subdivision p of section 76 of part D of chapter 56 of  the
 laws  of  2013  amending the social services law relating to eligibility
 S. 8307--A                          6                         A. 8807--A
 
 conditions, as amended by section 2 of part E of chapter 57 of the  laws
 of 2019, is amended to read as follows:
   p.  the amendments to subparagraph 7 of paragraph (b) of subdivision 1
 of section 366 of the social services law made by section  one  of  this
 act shall expire and be deemed repealed October 1, [2024] 2029.
   § 2. Section 10 of chapter 649 of the laws of 1996 amending the public
 health  law, the mental hygiene law and the social services law relating
 to authorizing the establishment of special needs plans, as  amended  by
 section  21  of  part E of chapter 57 of the laws of 2019, is amended to
 read as follows:
   § 10. This act shall take effect immediately and shall  be  deemed  to
 have  been in full force and effect on and after July 1, 1996; provided,
 however, that sections one, two and three of this act shall  expire  and
 be deemed repealed [on] March 31, [2025] 2030 provided, however that the
 amendments  to  section 364-j of the social services law made by section
 four of this act shall not affect the expiration  of  such  section  and
 shall  be  deemed  to  expire  therewith and provided, further, that the
 provisions of subdivisions 8, 9 and 10 of section  4401  of  the  public
 health  law,  as added by section one of this act; section 4403-d of the
 public health law as added by section two of this act and the provisions
 of section seven of this act, except for the provisions relating to  the
 establishment  of  no  more  than twelve comprehensive HIV special needs
 plans, shall expire and be deemed repealed on July 1, 2000.
   § 3. Subdivision 3 of section 2999-p of  the  public  health  law,  as
 amended  by  section  8 of part BB of chapter 56 of the laws of 2020, is
 amended to read as follows:
   3. The commissioner may issue a certificate of authority to an  entity
 that  meets conditions for ACO certification as set forth in regulations
 made by the commissioner pursuant to section twenty-nine  hundred  nine-
 ty-nine-q  of  this  article.  The  commissioner shall not issue any new
 certificate under this article after December thirty-first, two thousand
 [twenty-four] TWENTY-EIGHT.
   § 4. Subdivision 1 of section 2999-aa of the  public  health  law,  as
 amended  by  section  9  of part S of chapter 57 of the laws of 2021, is
 amended to read as follows:
   1. In order to promote improved quality and efficiency of, and  access
 to,  health  care  services and to promote improved clinical outcomes to
 the residents of New York, it shall  be  the  policy  of  the  state  to
 encourage, where appropriate, cooperative, collaborative and integrative
 arrangements  including  but  not  limited  to, mergers and acquisitions
 among health care providers or  among  others  who  might  otherwise  be
 competitors,  under  the  active supervision of the commissioner. To the
 extent such arrangements, or the planning and negotiations that  precede
 them,  might  be  anti-competitive  within the meaning and intent of the
 state and federal antitrust laws, the intent of the state is to supplant
 competition with such arrangements  under  the  active  supervision  and
 related  administrative  actions  of  the  commissioner  as necessary to
 accomplish the purposes of this article, and  to  provide  state  action
 immunity  under  the  state  and  federal antitrust laws with respect to
 activities undertaken by health care providers and  others  pursuant  to
 this  article,  where  the benefits of such active supervision, arrange-
 ments and actions of the commissioner outweigh any disadvantages  likely
 to  result  from  a reduction of competition. The commissioner shall not
 approve an arrangement for which state action immunity is  sought  under
 this  article without first consulting with, and receiving a recommenda-
 tion from, the public health and health planning council. No arrangement
 S. 8307--A                          7                         A. 8807--A
 
 under this article shall be approved after  December  thirty-first,  two
 thousand [twenty-four] TWENTY-EIGHT.
   §  5.  Section  7 of part V of chapter 57 of the laws of 2022 amending
 the public health law and the insurance law  relating  to  reimbursement
 for commercial and Medicaid services provided via telehealth, is amended
 to read as follows:
   §  7.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2022; provided,
 however, this act shall expire and be deemed repealed on and after April
 1, [2024] 2025.
   § 6. Section 97 of chapter 659 of the laws of 1997 amending the public
 health law and other  laws  relating  to  creation  of  continuing  care
 retirement communities, as amended by section 11 of part Z of chapter 57
 of the laws of 2018, is amended to read as follows:
   §  97. This act shall take effect immediately, provided, however, that
 the amendments to subdivision 4 of section 854 of the general  municipal
 law  made by section seventy of this act shall not affect the expiration
 of such subdivision and shall be deemed to expire therewith and provided
 further that sections sixty-seven and  sixty-eight  of  this  act  shall
 apply  to  taxable  years  beginning  on  or  after  January 1, 1998 and
 provided further that sections eighty-one through eighty-seven  of  this
 act  shall expire and be deemed repealed on December 31, [2024] 2029 and
 provided further, however, that the amendments to section ninety of this
 act shall take effect January 1, 1998 and shall apply to  all  policies,
 contracts,  certificates,  riders or other evidences of coverage of long
 term care insurance issued, renewed, altered  or  modified  pursuant  to
 section 3229 of the insurance law on or after such date.
   §  7.  Section 5 of part NN of chapter 57 of the laws of 2018 amending
 the public health law and the state finance law relating to enacting the
 opioid stewardship act, as amended by section 5 of part XX of chapter 59
 of the laws of 2019, is amended to read as follows:
   § 5. This act shall take effect July 1, 2018 and shall expire  and  be
 deemed  to be repealed on June 30, [2024] 2027, provided that, effective
 immediately, the addition, amendment and/or repeal of any rule or  regu-
 lation  necessary  for  the  implementation of this act on its effective
 date are authorized to be made and completed on or before such effective
 date, and, provided that this act  shall  only  apply  to  the  sale  or
 distribution  of  opioids in the state of New York on or before December
 31, 2018.
   § 8. Section 2 of part II of chapter 54 of the laws of  2016  amending
 part  C  of  chapter  58  of  the  laws  of 2005 relating to authorizing
 reimbursements for expenditures made by or on behalf of social  services
 districts  for  medical  assistance for needy persons and administration
 thereof, as amended by section 6 of part CC of chapter 57 of the laws of
 2022, is amended to read as follows:
   § 2. This act shall take effect immediately and shall  expire  and  be
 deemed repealed March 31, [2024] 2026.
   §  9.  Subdivision 5 of section 60 of part B of chapter 57 of the laws
 of 2015 amending the social services law  and  other  laws  relating  to
 energy  audits  and/or  disaster  preparedness  reviews  of  residential
 healthcare facilities by the commissioner, as amended by chapter 125  of
 the laws of 2021, is amended to read as follows:
   5.  section  thirty-eight  of  this  act  shall  expire  and be deemed
 repealed July 1, [2024] 2027;
   § 10. Section 7 of part H of chapter 57 of the laws of 2019,  amending
 the  public  health  law  relating  to waiver of certain regulations, as
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 amended by section 1 of part GG of chapter 57 of the laws  of  2022,  is
 amended to read as follows:
   §  7.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2019, provided,
 however, that section two of this act shall expire on  April  1,  [2024]
 2026.
   § 11. This act shall take effect immediately.
 
                                  PART C
 
   Section  1. Paragraph d of subdivision 6 of section 4410 of the educa-
 tion law, as amended by chapter 217 of the laws of 2015, is  amended  to
 read as follows:
   d.  Notwithstanding  any  other  provision of law to the contrary, the
 exemption in subdivision one of section seventy-six hundred five of this
 chapter shall apply to persons employed  on  a  full-time  or  part-time
 salary  basis, which may include on an hourly, weekly, or monthly basis,
 or on a fee for evaluation services basis provided that such  person  is
 employed by and under the dominion and control of a center-based program
 approved  pursuant  to  subdivision  nine of this section as a certified
 school psychologist to provide activities, services and use of the title
 psychologist to students enrolled in such approved center-based program;
 and to certified school psychologists employed on a full-time  or  part-
 time  salary  basis,  which may include on an hourly, weekly, or monthly
 basis, or on a fee for  evaluation  services  basis  provided  that  the
 school psychologist is employed by and under the dominion and control of
 a  program that has been approved pursuant to paragraph b of subdivision
 nine of this section, or subdivision nine-a of this section, to  conduct
 a multi-disciplinary evaluation of a preschool child having or suspected
 of  having a disability where authorized by paragraph a [or b] of subdi-
 vision six of section sixty-five hundred three-b of this  chapter[;  and
 to  certified  school psychologists employed on a full-time or part-time
 salary basis, which may include on an hourly, weekly, or monthly  basis,
 or  on  a  fee for evaluation services basis provided that such psychol-
 ogist is employed by and under the dominion and  control  of  an  agency
 approved  in  accordance  with title two-A of article twenty-five of the
 public health law to deliver early intervention  program  multidiscipli-
 nary  evaluations,  service coordination services and early intervention
 program services, where authorized by paragraph a or  b  of  subdivision
 six of section sixty-five hundred three-b of this chapter, each], in the
 course  of  their employment. Nothing in this section shall be construed
 to authorize a certified school psychologist or  group  of  such  school
 psychologists  to  engage in independent practice or practice outside of
 an employment relationship.
   § 2. Subdivision 1 of section 7605 of the education law, as amended by
 chapter 217 of the laws of 2015, is amended to read as follows:
   1. The activities, services, and use of the title of psychologist,  or
 any  derivation  thereof,  on  the  part  of a person in the employ of a
 federal, state, county or municipal agency, or other political  subdivi-
 sion,  or  a chartered elementary or secondary school or degree-granting
 educational institution insofar as such activities and  services  are  a
 part  of the duties of his salaried position; or on the part of a person
 in the employ as a certified school psychologist on a full-time or part-
 time salary basis, which may include on an hourly,  weekly,  or  monthly
 basis,  or  on  a  fee  for evaluation services basis provided that such
 person employed as a certified school psychologist is  employed  by  and
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 under  the dominion and control of a preschool special education program
 approved pursuant to paragraph b  of  subdivision  nine  or  subdivision
 nine-a  of  section  forty-four  hundred  ten of this chapter to provide
 activities,  services  and  to  use the title "certified school psychol-
 ogist", so long as this shall not be construed to permit the use of  the
 title  "licensed  psychologist",  to  students enrolled in such approved
 program or to conduct a  multidisciplinary  evaluation  of  a  preschool
 child  having  or suspected of having a disability[; or on the part of a
 person in the employ as a certified school psychologist on  a  full-time
 or  part-time  salary  basis,  which may include on an hourly, weekly or
 monthly basis, or on a fee for evaluation services basis  provided  that
 such  person  employed as a certified school psychologist is employed by
 and under the dominion and control of an agency approved  in  accordance
 with  title  two-A  of  article  twenty-five of the public health law to
 deliver  early  intervention  program   multidisciplinary   evaluations,
 service  coordination services and early intervention program services],
 where each such preschool special education  program  [or  early  inter-
 vention provider] is authorized by paragraph a [or b] of subdivision six
 of  section  sixty-five hundred [three] THREE-B of this title[, each] in
 the course of their employment. Nothing in  this  subdivision  shall  be
 construed  to authorize a certified school psychologist or group of such
 school psychologists to  engage  in  independent  practice  or  practice
 outside of an employment relationship.
   § 3. Section 3 of chapter 217 of the laws of 2015, amending the educa-
 tion  law  relating to certified school psychologists and special educa-
 tion services and programs  for  preschool  children  with  handicapping
 conditions, as amended by chapter 339 of the laws of 2022, is amended to
 read as follows:
   §  3.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after July 1, 2014,  provided,
 however  that  the  provisions  of  this  act shall expire and be deemed
 repealed June 30, [2024] 2026.
   § 4. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024; provided,
 however,  that the amendments to paragraph d of subdivision 6 of section
 4410 of the education law made by section one  of  this  act  shall  not
 affect  the  expiration  of such paragraph and shall be deemed to expire
 therewith; provided further, however, that the amendments to subdivision
 1 of section 7605 of the education law made by section two of  this  act
 shall  not affect the expiration of such subdivision and shall be deemed
 to expire therewith.
 
                                  PART D

   Section 1. Paragraph (c) of subdivision 8 of  section  2807-c  of  the
 public  health  law,  as amended by section 1 of part D of chapter 57 of
 the laws of 2021, is amended to read as follows:
   (c) In order to reconcile capital related inpatient expenses  included
 in  rates of payment based on a budget to actual expenses and statistics
 for the rate period for a general  hospital,  rates  of  payment  for  a
 general  hospital  shall  be adjusted to reflect the dollar value of the
 difference between capital related inpatient expenses  included  in  the
 computation of rates of payment for a prior rate period based on a budg-
 et  and  actual  capital  related inpatient expenses for such prior rate
 period, each as determined in accordance  with  paragraph  (a)  of  this
 subdivision,  adjusted  to  reflect  increases or decreases in volume of
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 service in such prior rate period  compared  to  statistics  applied  in
 determining the capital related inpatient expenses component of rates of
 payment based on a budget for such prior rate period.
   For  rates  effective  April  first, two thousand twenty through March
 thirty-first, two  thousand  twenty-one,  the  budgeted  capital-related
 expenses add-on as described in paragraph (a) of this subdivision, based
 on  a  budget  submitted in accordance to paragraph (a) of this subdivi-
 sion, shall be reduced by five percent relative to the rate in effect on
 such date; and the actual capital expenses add-on as described in  para-
 graph  (a)  of this subdivision, based on actual expenses and statistics
 through appropriate audit procedures in accordance with paragraph (a) of
 this subdivision shall be reduced by five percent relative to  the  rate
 in effect on such date.
   For  rates  effective [on and after] April first, two thousand twenty-
 one THROUGH SEPTEMBER THIRTIETH, TWO THOUSAND TWENTY-FOUR, the  budgeted
 capital-related  expenses  add-on  as described in paragraph (a) of this
 subdivision, based on a budget submitted in accordance to paragraph  (a)
 of  this  subdivision,  shall  be reduced by ten percent relative to the
 rate in effect on such date; and the actual capital expenses  add-on  as
 described in paragraph (a) of this subdivision, based on actual expenses
 and  statistics  through appropriate audit procedures in accordance with
 paragraph (a) of this subdivision shall be reduced by ten percent  rela-
 tive to the rate in effect on such date.
   FOR  RATES  EFFECTIVE ON AND AFTER OCTOBER FIRST, TWO THOUSAND TWENTY-
 FOUR, THE BUDGETED CAPITAL-RELATED EXPENSES ADD-ON AS DESCRIBED IN PARA-
 GRAPH (A) OF THIS SUBDIVISION, BASED ON A BUDGET SUBMITTED IN ACCORDANCE
 WITH PARAGRAPH (A) OF THIS  SUBDIVISION,  SHALL  BE  REDUCED  BY  TWENTY
 PERCENT  RELATIVE  TO  THE  RATE  IN EFFECT ON SUCH DATE; AND THE ACTUAL
 CAPITAL EXPENSES ADD-ON AS DESCRIBED IN PARAGRAPH (A) OF  THIS  SUBDIVI-
 SION  SHALL  BE REDUCED BY TWENTY PERCENT RELATIVE TO THE RATE IN EFFECT
 ON SUCH DATE.
   For any rate year, all reconciliation add-on  amounts  calculated  [on
 and  after]  FOR  THE PERIOD OF April first, two thousand twenty THROUGH
 SEPTEMBER THIRTIETH, TWO THOUSAND TWENTY-FOUR shall be  reduced  by  ten
 percent,  and  all  reconciliation  recoupment amounts calculated [on or
 after] FOR THE PERIOD  OF  April  first,  two  thousand  twenty  THROUGH
 SEPTEMBER  THIRTIETH,  TWO  THOUSAND  TWENTY-FOUR  shall increase by ten
 percent.
   FOR ANY RATE YEAR, ALL RECONCILIATION ADD-ON AMOUNTS CALCULATED ON AND
 AFTER OCTOBER FIRST, TWO THOUSAND TWENTY-FOUR SHALL BE REDUCED BY TWENTY
 PERCENT, AND ALL RECONCILIATION  RECOUPMENT  AMOUNTS  CALCULATED  ON  OR
 AFTER  OCTOBER  FIRST, TWO THOUSAND TWENTY-FOUR SHALL INCREASE BY TWENTY
 PERCENT.
   Notwithstanding any inconsistent  provision  of  subparagraph  (i)  of
 paragraph (e) of subdivision nine of this section, capital related inpa-
 tient  expenses  of  a  general  hospital included in the computation of
 rates of payment based on a budget shall not be included in the computa-
 tion of a volume adjustment made in accordance with  such  subparagraph.
 Adjustments  to rates of payment for a general hospital made pursuant to
 this paragraph shall be made in accordance with paragraph (c) of  subdi-
 vision  eleven  of  this  section. Such adjustments shall not be carried
 forward except for such  volume  adjustment  as  may  be  authorized  in
 accordance with subparagraph (i) of paragraph (e) of subdivision nine of
 this section for such general hospital.
   §  2.  Section 5 of part ZZ of chapter 56 of the laws of 2020 amending
 the tax law and the social services law  relating  to  certain  Medicaid
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 management, as amended by section 3 of part RR of chapter 57 of the laws
 of 2022, is amended to read as follows:
   §  5.  This  act  shall  take  effect  immediately and shall be deemed
 repealed [five] EIGHT years after such effective date.
   § 3. Section 2 of part E of chapter 57 of the laws of  2015,  amending
 the  public  health  law  relating  to  the payment of certain funds for
 uncompensated care, is amended to read as follows:
   § 2. Notwithstanding any inconsistent provision of law, rule or  regu-
 lation  to  the  contrary,  and  subject  to the availability of federal
 financial participation pursuant to title  XIX  of  the  federal  social
 security  act,  effective  for  [periods on and after] EACH STATE FISCAL
 YEAR FROM April 1, 2015, THROUGH DECEMBER 31, 2024; AND FOR THE CALENDAR
 YEAR JANUARY 1, 2025 THROUGH DECEMBER 31, 2025; AND  FOR  EACH  CALENDAR
 YEAR THEREAFTER, payments pursuant to paragraph (i) of subdivision 35 of
 section  2807-c of the public health law may be made as outpatient upper
 payment limit payments for outpatient hospital services, not  to  exceed
 an  amount of three hundred thirty-nine million dollars annually between
 payments authorized under this section and such section  of  the  public
 health  law.  Such payments shall be made as medical assistance payments
 for outpatient services pursuant to title 11 of article 5 of the  social
 services  law  for patients eligible for federal financial participation
 under title XIX of the federal social security act for general  hospital
 outpatient  services and general hospital emergency room services issued
 pursuant to paragraph (g) of subdivision 2 of section 2807 of the public
 health law to general hospitals, other than major public general  hospi-
 tals,  providing emergency room services and including safety net hospi-
 tals, which shall, for the purpose of  this  paragraph,  be  defined  as
 having  either:  a Medicaid share of total inpatient hospital discharges
 of at least thirty-five  percent,  including  both  fee-for-service  and
 managed  care  discharges  for  acute and exempt services; or a Medicaid
 share of total discharges of at least  thirty  percent,  including  both
 fee-for-service  and  managed  care  discharges  for  acute  and  exempt
 services, and also  providing  obstetrical  services.    Eligibility  to
 receive  such additional payments shall be based on data from the period
 two years prior to the rate year, as reported on the institutional  cost
 report submitted to the department as of October first of the prior rate
 year.  No  eligible general hospital's annual payment amount pursuant to
 this section shall exceed the lower of the sum of the annual amounts due
 that hospital pursuant  to  section  twenty-eight  hundred  seven-k  and
 section  twenty-eight  hundred  seven-w of the public health law; or the
 hospital's facility specific projected disproportionate  share  hospital
 payment  ceiling established pursuant to federal law, provided, however,
 that payment amounts to eligible hospitals in excess  of  the  lower  of
 such  sum  or payment ceiling shall be reallocated to eligible hospitals
 that do not have excess payment amounts.  Such  reallocations  shall  be
 proportional  to  each such hospital's aggregate payment amount pursuant
 to paragraph (i) of subdivision 35  of  section  2807-c  of  the  public
 health law and this section to the total of all payment amounts for such
 eligible  hospitals.  Such  adjustment  payment may be added to rates of
 payment or made as aggregate  payments  to  eligible  general  hospitals
 other  than  major  public general hospitals.   The distribution of such
 payments shall be pursuant to a methodology approved by the commissioner
 of health in regulation.
   § 4. Section 21 of part B of chapter 57 of the laws of 2015,  amending
 the  social services law relating to supplemental rebates, is amended to
 read as follows:
 S. 8307--A                         12                         A. 8807--A
 
   § 21. Notwithstanding any inconsistent provision of law, rule or regu-
 lation to the contrary, and  subject  to  the  availability  of  federal
 financial  participation  pursuant  to  title  XIX of the federal social
 security act, effective for [the period] EACH  STATE  FISCAL  YEAR  FROM
 April  1, 2011 through [March 31, 2012, and state fiscal years] DECEMBER
 31, 2024; AND FOR THE CALENDAR YEAR JANUARY 1, 2025 THROUGH DECEMBER 31,
 2025; AND FOR EACH CALENDAR YEAR thereafter, the department of health is
 authorized to increase the operating cost component of rates of  payment
 for  general hospital outpatient services and general hospital emergency
 room services issued pursuant to  paragraph  (g)  of  subdivision  2  of
 section  2807  of the public health law for public general hospitals, as
 defined in subdivision 10 of section 2801  of  the  public  health  law,
 other  than those operated by the state of New York or the state univer-
 sity of New York, and located in a  city  with  a  population  over  one
 million,  up  to  two  hundred  eighty-seven million dollars annually as
 medical assistance payments for outpatient services pursuant to title 11
 of article 5 of the social services law for patients eligible for feder-
 al financial participation under title XIX of the federal social securi-
 ty act based on such criteria and methodologies as the commissioner  may
 from time to time set through a memorandum of understanding with the New
 York  city  health and hospitals corporation, and such adjustments shall
 be paid by means of one or more estimated payments, with such  estimated
 payments  to be reconciled to the commissioner of health's final adjust-
 ment determinations after the disproportionate  share  hospital  payment
 adjustment  caps  have  been  calculated  for such period under sections
 1923(f) and (g) of the federal  social  security  act.  Such  adjustment
 payment  may  be added to rates of payment or made as aggregate payments
 to eligible public general hospitals.
   § 5. The opening paragraph of subparagraph (i)  of  paragraph  (i)  of
 subdivision 35 of section 2807-c of the public health law, as amended by
 section  4  of  part  C of chapter 56 of the laws of 2013, is amended to
 read as follows:
   Notwithstanding any inconsistent provision of this subdivision or  any
 other  contrary  provision  of  law  and  subject to the availability of
 federal financial participation, for [the period] EACH STATE FISCAL YEAR
 FROM July first, two thousand ten through [March thirty-first, two thou-
 sand eleven,] DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-FOUR; and [each
 state fiscal year period] FOR THE CALENDAR YEAR JANUARY FIRST, TWO THOU-
 SAND TWENTY-FIVE THROUGH DECEMBER  THIRTY-FIRST,  TWO  THOUSAND  TWENTY-
 FIVE; AND FOR EACH CALENDAR YEAR thereafter, the commissioner shall make
 additional inpatient hospital payments up to the aggregate upper payment
 limit for inpatient hospital services after all other medical assistance
 payments, but not to exceed two hundred thirty-five million five hundred
 thousand  dollars  for  the  period July first, two thousand ten through
 March thirty-first, two thousand eleven, three hundred fourteen  million
 dollars  for  each state fiscal year beginning April first, two thousand
 eleven, through March thirty-first, two thousand thirteen, and  no  less
 than  three  hundred  thirty-nine  million dollars for each state fiscal
 year [thereafter] UNTIL DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-FOUR;
 AND THEN FROM CALENDAR YEAR  JANUARY  FIRST,  TWO  THOUSAND  TWENTY-FIVE
 THROUGH  DECEMBER  THIRTY-FIRST,  TWO THOUSAND TWENTY-FIVE; AND FOR EACH
 CALENDAR YEAR THEREAFTER, to general hospitals, other than major  public
 general hospitals, providing emergency room services and including safe-
 ty  net  hospitals,  which  shall, for the purpose of this paragraph, be
 defined as having either: a Medicaid share of total  inpatient  hospital
 discharges  of at least thirty-five percent, including both fee-for-ser-
 S. 8307--A                         13                         A. 8807--A
 
 vice and managed care discharges for acute and  exempt  services;  or  a
 Medicaid share of total discharges of at least thirty percent, including
 both  fee-for-service  and  managed care discharges for acute and exempt
 services,  and  also  providing  obstetrical  services.  Eligibility  to
 receive such additional payments shall be based on data from the  period
 two  years prior to the rate year, as reported on the institutional cost
 report submitted to the department as of October first of the prior rate
 year. Such payments shall be made as  medical  assistance  payments  for
 fee-for-service  inpatient hospital services pursuant to title eleven of
 article five of the social services law for patients eligible for feder-
 al financial participation under title XIX of the federal social securi-
 ty act and in accordance with the following:
   § 6. Section 18 of part B of chapter 57 of the laws of 2015,  amending
 the  social services law relating to supplemental rebates, is amended to
 read as follows:
   § 18. Notwithstanding any inconsistent provision of law or  regulation
 to  the  contrary,  and subject to the availability of federal financial
 participation pursuant to title XIX of the federal social security  act,
 effective  for  [the  period] EACH STATE FISCAL YEAR FROM April 1, 2012,
 through [March 31, 2013, and state fiscal years] DECEMBER 31, 2024;  AND
 FOR  THE  CALENDAR  YEAR FROM JANUARY 1, 2025 THROUGH DECEMBER 31, 2025;
 AND FOR EACH CALENDAR YEAR  thereafter,  the  department  of  health  is
 authorized  to pay a public hospital adjustment to public general hospi-
 tals, as defined in subdivision 10 of section 2801 of the public  health
 law,  other  than  those  operated by the state of New York or the state
 university of New York, and located in a city with a population of  over
 1  million,  of  up  to  one  billion eighty million dollars annually as
 medical assistance payments for inpatient services pursuant to title  11
 of article 5 of the social services law for patients eligible for feder-
 al financial participation under title XIX of the federal social securi-
 ty  act based on such criteria and methodologies as the commissioner may
 from time to time set through a memorandum of understanding with the New
 York city health and hospitals corporation, and such  adjustments  shall
 be  paid by means of one or more estimated payments, with such estimated
 payments to be reconciled to the commissioner of health's final  adjust-
 ment  determinations  after  the disproportionate share hospital payment
 adjustment caps have been calculated  for  such  period  under  sections
 1923(f)  and  (g)  of  the  federal social security act. Such adjustment
 payment may be added to rates of payment or made as  aggregate  payments
 to eligible public general hospitals.
   §  7. Subdivision 1 of section 3-a of part B of chapter 58 of the laws
 of 2010, amending the social services law  and  the  public  health  law
 relating to prescription drug coverage for needy persons and health care
 initiatives pools, is amended to read as follows:
   1.  Notwithstanding  any  inconsistent provision of law, rule or regu-
 lation to the contrary, and  subject  to  the  availability  of  federal
 financial  participation,  effective  for [the period] EACH STATE FISCAL
 YEAR FROM August 1, 2010 through [March 31, 2011, and each state  fiscal
 year]  DECEMBER 31, 2024; AND FOR THE CALENDAR YEAR FROM JANUARY 1, 2025
 THROUGH DECEMBER 31, 2025; AND FOR EACH CALENDAR  YEAR  thereafter,  the
 department  of  health  is authorized to make Medicaid payment increases
 for diagnostic and treatment centers (DTC) services issued  pursuant  to
 section  2807  of  the public health law for public DTCs operated by the
 New York City Health and Hospitals Corporation, at the election  of  the
 social services district in which an eligible DTC is physically located,
 of  up  to  twelve million six hundred thousand dollars on an annualized
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 basis for DTC services pursuant to title 11 of article 5 of  the  social
 services  law  for patients eligible for federal financial participation
 under title XIX of the federal social security act based  on  each  such
 DTC's proportionate share of the sum of all clinic visits for all facil-
 ities  eligible  for an adjustment pursuant to this section for the base
 year two years prior to the rate year. Such proportionate share payments
 may be added to rates of payment or made as aggregate payments to eligi-
 ble DTCs.
   § 8. Subdivision 1 of section 3-b of part B of chapter 58 of the  laws
 of  2010,  amending  the  social  services law and the public health law
 relating to prescription drug coverage for needy persons and health care
 initiatives pools, is amended to read as follows:
   1. Notwithstanding any inconsistent provision of law,  rule  or  regu-
 lation  to  the  contrary,  and  subject  to the availability of federal
 financial participation, effective for [the period]  EACH  STATE  FISCAL
 YEAR  FROM August 1, 2010 through [March 31, 2011, and each state fiscal
 year] DECEMBER 31, 2024; AND FOR THE CALENDAR YEAR FROM JANUARY 1,  2025
 THROUGH  DECEMBER  31,  2025; AND FOR EACH CALENDAR YEAR thereafter, the
 department of health, is authorized to make Medicaid  payment  increases
 for  county  operated  diagnostic  and  treatment centers (DTC) services
 issued pursuant to section  2807  of  the  public  health  law  and  for
 services  provided  by  county  operated  free-standing clinics licensed
 pursuant to articles 31 and 32  of  the  mental  hygiene  law,  but  not
 including  facilities operated by the New York City Health and Hospitals
 Corporation, of up to five million four hundred thousand dollars  on  an
 annualized  basis for such services pursuant to title 11 of article 5 of
 the social services law for  patients  eligible  for  federal  financial
 participation  under title XIX of the federal social security act. Local
 social services districts may decline such increased payments  to  their
 sponsored  DTCs and free-standing clinics, provided they provide written
 notification to the commissioner of health, within thirty days following
 receipt of notification of a payment pursuant to this section.  Distrib-
 utions pursuant to this  section  shall  be  based  on  each  facility's
 proportionate  share  of  the  sum  of all DTC and clinic visits for all
 facilities receiving payments pursuant to this section for the base year
 two years prior to the rate year. Such proportionate share payments  may
 be  added  to rates or payment or made as aggregate payments to eligible
 facilities.
   § 9. Paragraph (e-1) of subdivision 12 of section 2808 of  the  public
 health law, as amended by section 15 of part B of chapter 57 of the laws
 of 2023, is amended to read as follows:
   (e-1) Notwithstanding any inconsistent provision of law or regulation,
 the  commissioner  shall  provide,  in  addition to payments established
 pursuant to this article prior to application  of  this  section,  addi-
 tional  payments  under the medical assistance program pursuant to title
 eleven of article five of the social services law for non-state operated
 public residential health care facilities, including public  residential
 health  care  facilities  located in the county of Nassau, the county of
 Westchester and the county of Erie,  but  excluding  public  residential
 health  care  facilities  operated by a town or city within a county, in
 aggregate annual amounts of up to one hundred fifty million  dollars  in
 additional payments for the state fiscal year beginning April first, two
 thousand  six  and  for the state fiscal year beginning April first, two
 thousand seven and for the state fiscal year beginning April first,  two
 thousand eight and of up to three hundred million dollars in such aggre-
 gate  annual  additional  payments  for  the state fiscal year beginning
 S. 8307--A                         15                         A. 8807--A
 
 April first, two thousand nine, and for the state fiscal year  beginning
 April  first,  two  thousand ten and for the state fiscal year beginning
 April first, two thousand eleven, and for the state fiscal years  begin-
 ning  April  first,  two  thousand  twelve and April first, two thousand
 thirteen, and of up to five hundred million dollars  in  such  aggregate
 annual  additional  payments  for the state fiscal years beginning April
 first, two thousand fourteen, April  first,  two  thousand  fifteen  and
 April  first,  two  thousand  sixteen  and of up to five hundred million
 dollars in such aggregate  annual  additional  payments  for  the  state
 fiscal years beginning April first, two thousand seventeen, April first,
 two thousand eighteen, and April first, two thousand nineteen, and of up
 to  five  hundred  million  dollars  in such aggregate annual additional
 payments for the state fiscal years beginning April first, two  thousand
 twenty, April first, two thousand twenty-one, and April first, two thou-
 sand  twenty-two,  and  of  up  to  five hundred million dollars in such
 aggregate annual additional payments for the state fiscal  years  begin-
 ning  April  first, two thousand twenty-three, AND FROM April first, two
 thousand twenty-four UNTIL DECEMBER THIRTY-FIRST, TWO  THOUSAND  TWENTY-
 FOUR,  and [April first, two thousand twenty-five] FOR THE CALENDAR YEAR
 JANUARY FIRST, TWO THOUSAND TWENTY-FIVE THROUGH  DECEMBER  THIRTY-FIRST,
 TWO  THOUSAND  TWENTY-FIVE,  AND FOR EACH CALENDAR YEAR THEREAFTER.  The
 amount allocated to each eligible public residential health care facili-
 ty for this period shall be computed in accordance with  the  provisions
 of  paragraph  (f)  of this subdivision, provided, however, that patient
 days shall be utilized for such computation reflecting  actual  reported
 data  for  two thousand three and each representative succeeding year as
 applicable, and provided further, however, that,  in  consultation  with
 impacted providers, of the funds allocated for distribution in the state
 fiscal  year beginning April first, two thousand thirteen, up to thirty-
 two million dollars may be allocated in accordance with paragraph  (f-1)
 of this subdivision.
   §  10.  This  act  shall  take  effect immediately; provided, however,
 section one of this act shall take effect October 1, 2024; and provided,
 further, that sections three, four, five, six, seven, eight and nine  of
 this act shall take effect January 1, 2025.
 
                                  PART E
 
   Section  1.  Subparagraph  (ii) of paragraph (b) of subdivision 2-b of
 section 2808 of the public health law, as added by section 47 of part  C
 of chapter 109 of the laws of 2006, is amended to read as follows:
   (ii) (A) The operating component of rates shall be subject to case mix
 adjustment  through  application  of  the  relative resource utilization
 groups system of patient classification (RUG-III) employed by the feder-
 al government with regard to  payments  to  skilled  nursing  facilities
 pursuant  to  title XVIII of the federal social security act (Medicare),
 as revised by regulation to reflect New  York  state  wages  and  fringe
 benefits,  provided,  however,  that  such RUG-III classification system
 weights shall be increased in the following amounts  for  the  following
 categories  of  residents:  [(A)]  (1)  thirty  minutes for the impaired
 cognition A category, [(B)] (2) forty minutes for the impaired cognition
 B category, and [(C)] (3) twenty-five minutes for the  reduced  physical
 functions  B  category.    Such adjustments shall be made in January and
 July of each calendar year. Such adjustments and related patient classi-
 fications in each facility shall be subject to audit review  in  accord-
 ance with regulations promulgated by the commissioner.
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   (B)  EFFECTIVE  APRIL  FIRST,  TWO  THOUSAND TWENTY-FOUR, THE CASE MIX
 ADJUSTMENT FROM THE OPERATING COMPONENT OF THE RATES FOR SKILLED NURSING
 FACILITIES SHALL REMAIN UNCHANGED FROM THE  JULY  TWO  THOUSAND  TWENTY-
 THREE  RATES  DURING  THE DEVELOPMENT AND UNTIL FULL IMPLEMENTATION OF A
 CASE MIX METHODOLOGY USING THE PATIENT DRIVEN PAYMENT MODEL.
   §  2. Subparagraph (iv) of paragraph (b) of subdivision 2-b of section
 2808 of the public health law, as amended by section 1  of  part  NN  of
 chapter 56 of the laws of 2020, is amended to read as follows:
   (iv)  The  capital cost component of rates on and after January first,
 two thousand nine shall: (A) fully reflect the cost  of  local  property
 taxes  and payments made in lieu of local property taxes, as reported in
 each facility's cost report submitted for the year two  years  prior  to
 the  rate  year; (B) provided, however, notwithstanding any inconsistent
 provision of this article, commencing April first, two  thousand  twenty
 for  rates  of  payment for patients eligible for payments made by state
 governmental agencies, the capital cost component determined in  accord-
 ance  with  this  subparagraph  and  inclusive of any shared savings for
 eligible facilities that elect to refinance their mortgage loans  pursu-
 ant  to  paragraph  (d)  of  subdivision two-a of this section, shall be
 reduced by the commissioner by five percent; AND (C) PROVIDED,  HOWEVER,
 NOTWITHSTANDING  ANY  INCONSISTENT PROVISION OF THIS ARTICLE, COMMENCING
 APRIL FIRST, TWO THOUSAND TWENTY-FOUR FOR RATES OF PAYMENT FOR  PATIENTS
 ELIGIBLE  FOR  PAYMENTS MADE BY STATE GOVERNMENTAL AGENCIES, THE CAPITAL
 COST COMPONENT DETERMINED  IN  ACCORDANCE  WITH  THIS  SUBPARAGRAPH  AND
 INCLUSIVE  OF  ANY  SHARED SAVINGS FOR ELIGIBLE FACILITIES THAT ELECT TO
 REFINANCE THEIR MORTGAGE LOANS PURSUANT TO PARAGRAPH (D) OF  SUBDIVISION
 TWO-A  OF THIS SECTION, SHALL BE REDUCED BY THE COMMISSIONER BY AN ADDI-
 TIONAL TEN PERCENT.
   § 3. Paragraph (h) of subdivision 1 of  section  2632  of  the  public
 health law, as amended by chapter 414 of the laws of 2015, is amended to
 read as follows:
   (h)  in the Persian Gulf conflict from the second day of August, nine-
 teen hundred ninety to the  end  of  such  conflict  including  military
 service  in  Operation Enduring Freedom, Operation Iraqi Freedom, Opera-
 tion New Dawn or Operation Inherent Resolve and was the recipient of the
 global war on terrorism expeditionary medal or the Iraq  campaign  medal
 or  the  Afghanistan campaign medal; and who was a resident of the state
 of New York at the time of entry upon such active duty or who shall have
 been a resident of this state for [one year] SIX MONTHS  next  preceding
 the  application  for  admission  shall be entitled to admission to said
 home after the approval of the application by  the  board  of  visitors,
 subject to the provisions of this article and to the conditions, limita-
 tions and penalties prescribed by the regulations of the department. Any
 such  veteran  or dependent, who otherwise fulfills the requirements set
 forth in this section, may be admitted directly to the  skilled  nursing
 facility or the health related facility provided such veteran or depend-
 ent is certified by a physician designated or approved by the department
 to require the type of care provided by such facilities.
   §  4.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART F
 
   Section 1. Paragraph (n) of subdivision 3  of  section  461-l  of  the
 social  services law, as amended by section 2 of part B of chapter 57 of
 the laws of 2018, is amended to read as follows:
 S. 8307--A                         17                         A. 8807--A
 
   (n) The commissioner of health is authorized to create  a  program  to
 subsidize  the cost of assisted living for those individuals living with
 Alzheimer's disease and  dementia  who  are  not  eligible  for  medical
 assistance  pursuant to title eleven of article five of this chapter AND
 RESIDE  IN  A  SPECIAL  NEEDS  ASSISTED LIVING RESIDENCE CERTIFIED UNDER
 SECTION FORTY-SIX HUNDRED FIFTY-FIVE OF THE  PUBLIC  HEALTH  LAW.    The
 program  shall  authorize  up  to  two  hundred  vouchers to individuals
 through an application process and pay for up to seventy-five percent of
 the average private pay rate in the respective region. The  commissioner
 of   health  may  propose  rules  and  regulations  to  effectuate  this
 provision.
   § 2. Subdivisions 7 and 8 of section 4656 of the public health law, as
 added by chapter 2 of the laws of 2004, are  renumbered  subdivisions  8
 and 9 and a new subdivision 7 is added to read as follows:
   7.  (A)  ALL ASSISTED LIVING RESIDENCES, AS DEFINED IN SUBDIVISION ONE
 OF SECTION FORTY-SIX HUNDRED FIFTY-ONE OF THIS ARTICLE, INCLUDING  THOSE
 LICENSED  AND  CERTIFIED  AS AN ASSISTED LIVING RESIDENCE, SPECIAL NEEDS
 ASSISTED LIVING RESIDENCE, OR ENHANCED ASSISTED LIVING RESIDENCE, SHALL:
   (I) REPORT ANNUALLY ON QUALITY  MEASURES  TO  BE  ESTABLISHED  BY  THE
 DEPARTMENT,  IN  THE  FORM AND FORMAT PRESCRIBED BY THE DEPARTMENT, WITH
 THE FIRST REPORT DUE NO LATER THAN JANUARY  THIRTY-FIRST,  TWO  THOUSAND
 TWENTY-FIVE; AND
   (II)  POST  THE  MONTHLY  SERVICE  RATE, STAFFING COMPLEMENT, APPROVED
 ADMISSION OR RESIDENCY AGREEMENT, AND A CONSUMER-FRIENDLY SUMMARY OF ALL
 SERVICE FEES IN A CONSPICUOUS PLACE ON THE FACILITY'S WEBSITE AND  IN  A
 PUBLIC  SPACE WITHIN THE FACILITY. SUCH INFORMATION SHALL BE MADE AVAIL-
 ABLE TO THE PUBLIC ON FORMS DEVELOPED BY THE  DEPARTMENT.  BEGINNING  ON
 JANUARY  FIRST, TWO THOUSAND TWENTY-FIVE, THIS INFORMATION SHALL ALSO BE
 REPORTED TO THE DEPARTMENT.
   (B) THE DEPARTMENT SHALL SCORE THE  RESULTS  OF  THE  ASSISTED  LIVING
 QUALITY  REPORTING  OBTAINED  PURSUANT TO PARAGRAPH (A) OF THIS SUBDIVI-
 SION.  TOP SCORING FACILITIES SHALL BE  GRANTED  THE  CLASSIFICATION  OF
 ADVANCED STANDING ON THEIR ANNUAL SURVEILLANCE SCHEDULES.
   (I)  NOTWITHSTANDING  SUBPARAGRAPH ONE OF PARAGRAPH (A) OF SUBDIVISION
 TWO OF SECTION FOUR HUNDRED SIXTY-ONE-A  OF  THE  SOCIAL  SERVICES  LAW,
 FACILITIES  ACHIEVING  AN  ADVANCED  STANDING  CLASSIFICATION  SHALL  BE
 SURVEYED EVERY TWELVE TO EIGHTEEN MONTHS. ALL OTHER FACILITIES SHALL  BE
 SURVEYED ON AN UNANNOUNCED BASIS NO LESS THAN ANNUALLY; PROVIDED, HOWEV-
 ER,  THAT THIS SHALL NOT APPLY TO SURVEYS, INSPECTIONS OR INVESTIGATIONS
 BASED ON COMPLAINTS RECEIVED BY THE DEPARTMENT UNDER ANY OTHER PROVISION
 OF LAW.
   (II)  FACILITIES  MAY  REMAIN  ON  ADVANCED  STANDING   CLASSIFICATION
 PROVIDED THEY MEET THE SCORING REQUIREMENTS IN THE ASSISTED LIVING QUAL-
 ITY REPORTING.
   (C)  EFFECTIVE  JANUARY  THIRTY-FIRST,  TWO  THOUSAND TWENTY-FIVE, THE
 DEPARTMENT MAY POST ON ITS WEBSITE THE RESULTS OF  THE  ASSISTED  LIVING
 QUALITY  REPORTING  COLLECTED  PURSUANT TO SUBPARAGRAPH (I) OF PARAGRAPH
 (A) OF THIS SUBDIVISION.
   § 3. Subparagraph 1 of paragraph (a) of subdivision 2 of section 461-a
 of the social services law, as amended by chapter 735  of  the  laws  of
 1994, is amended and a new subparagraph 1-a is added to read as follows:
   (1) Such facilities receiving the department's highest rating shall be
 inspected  at  least once every eighteen months on an unannounced basis.
 SUCH RATING DETERMINATION SHALL BE MADE PURSUANT  TO  AN  EVALUATION  OF
 QUALITY  INDICATORS  AS DEVELOPED BY THE DEPARTMENT AND PUBLISHED ON THE
 DEPARTMENT'S WEBSITE.
 S. 8307--A                         18                         A. 8807--A

   (1-A) (I) ADULT CARE FACILITIES DUALLY LICENSED  TO  PROVIDE  ASSISTED
 LIVING  PURSUANT  TO  THE  REQUIREMENTS  SPECIFIED  IN SECTION FORTY-SIX
 HUNDRED FIFTY-THREE OF THE PUBLIC HEALTH LAW MAY SEEK  ACCREDITATION  BY
 ONE OR MORE NATIONALLY RECOGNIZED ACCREDITING AGENCIES DETERMINED BY THE
 COMMISSIONER.
   (II) SUCH ACCREDITATION AGENCIES SHALL REPORT DATA AND INFORMATION, IN
 A  MANNER  AND FORM AS DETERMINED BY THE DEPARTMENT, PERTAINING TO THOSE
 ASSISTED LIVING RESIDENCES ACCREDITED BY SUCH AGENCIES,  THOSE  ASSISTED
 LIVING  RESIDENCES  THAT SEEK BUT DO NOT RECEIVE SUCH ACCREDITATION, AND
 THOSE ASSISTED LIVING RESIDENCES WHICH OBTAIN  BUT  LOSE  SUCH  ACCREDI-
 TATION.
   (III) NOTWITHSTANDING THE PROVISIONS OF SUBPARAGRAPH ONE OF THIS PARA-
 GRAPH,  OR  ANY OTHER PROVISION OF LAW, ASSISTED LIVING RESIDENCES WHICH
 HAVE OBTAINED ACCREDITATION FROM A NATIONALLY  RECOGNIZED  ACCREDITATION
 ORGANIZATION  APPROVED  BY  THE  DEPARTMENT  AND  WHICH MEET ELIGIBILITY
 CRITERIA, AS DETERMINED BY THE DEPARTMENT, MAY, AT THE DISCRETION OF THE
 COMMISSIONER, BE EXEMPT FROM THE DEPARTMENT INSPECTION REQUIRED IN  THIS
 SUBDIVISION  FOR  THE DURATION THEY MAINTAIN THEIR ACCREDITATION IN GOOD
 STANDING. THE OPERATOR OF AN ADULT CARE FACILITY THAT OBTAINS BUT SUBSE-
 QUENTLY LOSES ACCREDITATION SHALL REPORT SUCH  LOSS  TO  THE  DEPARTMENT
 WITHIN  TEN BUSINESS DAYS IN A MANNER AND FORM DETERMINED BY THE DEPART-
 MENT AND WILL  NO  LONGER  BE  EXEMPT  FROM  THE  DEPARTMENT  INSPECTION
 REQUIRED IN THIS SUBDIVISION. THE DEPARTMENT SHALL POST ON ITS WEBSITE A
 LIST OF ALL ACCREDITED ASSISTED LIVING RESIDENCES.
   §  4.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024; provided,
 however, the provisions of sections two and three of this act shall take
 effect on the one hundred twentieth day after it  shall  have  become  a
 law.
 
                                  PART G
 
   Section  1.  Paragraph  (i)  of subdivision 1 of section 3614-c of the
 public health law is REPEALED.
   § 2. Paragraph (d) of subdivision 1, and subdivisions 2, 4, 5, 5-a, 6,
 6-a, 7, 7-a, 9 and 10 of section 3614-c of the public health law, subdi-
 visions 2, 4, 5, 6, 7, 9 and 10 as amended and subdivisions 6-a and  7-a
 as  added  by  section  1 and subdivision 5-a as added by section 1-a of
 part OO of chapter 56 of the laws  of  2020,  are  amended  to  read  as
 follows:
   (d)  "Home  care  aide"  means a home health aide, personal care aide,
 home  attendant,  [personal  assistant  performing   consumer   directed
 personal  assistance  services  pursuant to section three hundred sixty-
 five-f of the social services law,]  or  other  licensed  or  unlicensed
 person  whose  primary  responsibility includes the provision of in-home
 assistance with activities of daily living, instrumental  activities  of
 daily  living or health-related tasks; provided, however, that home care
 aide does not include any individual (i) working on a casual  basis,  or
 (ii) [(except for a person employed under the consumer directed personal
 assistance  program  under  section  three  hundred  sixty-five-f of the
 social services law)] who is  a  relative  through  blood,  marriage  or
 adoption  of: (1) the employer; or (2) the person for whom the worker is
 delivering services, under a program funded or administered by  federal,
 state or local government.
   2.  Notwithstanding  any  inconsistent provision of law, rule or regu-
 lation, no payments by government agencies shall be  made  to  certified
 S. 8307--A                         19                         A. 8807--A
 
 home  health agencies, long term home health care programs, managed care
 plans, [fiscal intermediaries,] the nursing home transition  and  diver-
 sion  waiver program under section three hundred sixty-six of the social
 services law, or the traumatic brain injury waiver program under section
 twenty-seven  hundred  forty  of  this  chapter  for any episode of care
 furnished, in whole or in part, by any home care aide who is compensated
 at amounts less than the applicable minimum rate of home care aide total
 compensation established pursuant to this section.
   4. The terms of this section shall apply equally to services  provided
 by  home  care aides who work on episodes of care as direct employees of
 certified home health agencies, long term home health care programs,  or
 managed care plans, or as employees of licensed home care services agen-
 cies,  limited licensed home care services agencies, [or fiscal interme-
 diaries,] or under any other arrangement.
   5. No payments by government agencies shall be made to certified  home
 health  agencies,  licensed  home care services agencies, long term home
 health care programs, managed care plans[,  fiscal  intermediaries]  for
 any  episode  of care without the certified home health agency, licensed
 home care services agency,  long  term  home  health  care  program,  OR
 managed  care  plan [or the fiscal intermediary], having delivered prior
 written certification to the commissioner annually, at a time prescribed
 by the commissioner, on forms prepared by the department in consultation
 with the department of labor, that  all  services  provided  under  each
 episode  of  care  during the period covered by the certification are in
 full compliance with the terms  of  this  section  and  any  regulations
 promulgated  pursuant to this section and that no portion of the dollars
 spent or to be spent to satisfy the wage or benefit portion  under  this
 section  shall be returned to the certified home health agency, licensed
 home care services agency,  long  term  home  health  care  program,  OR
 managed  care  plan,  [or fiscal intermediary,] related persons or enti-
 ties, other than to a home care aide as defined in this section to  whom
 the  wage  or benefits are due, as a refund, dividend, profit, or in any
 other manner.  Such written certification shall  also  verify  that  the
 certified  home  health  agency,  long term home health care program, or
 managed care plan has received from  the  licensed  home  care  services
 agency,  [fiscal intermediary,] or other third party an annual statement
 of wage parity hours and expenses on a form provided by  the  department
 of  labor  accompanied  by  an independently-audited financial statement
 verifying such expenses.
   5-a. No portion of the dollars spent or to be  spent  to  satisfy  the
 wage  or  benefit  portion  under  this section shall be returned to the
 certified home health agency, licensed home care services  agency,  long
 term home health care program, OR managed care plan, [or fiscal interme-
 diary,]  related  persons or entities, other than to a home care aide as
 defined in this section to whom the wage  or  benefits  are  due,  as  a
 refund, dividend, profit, or in any other manner.
   6.  If  a  certified  home  health  agency, long term home health care
 program or managed care plan elects to provide home care  aide  services
 through  contracts  with  licensed  home care services agencies, [fiscal
 intermediaries,] or through  other  third  parties,  provided  that  the
 episode  of  care on which the home care aide works is covered under the
 terms of this section, the certified home health agency, long term  home
 health  care  program,  or  managed  care  plan  shall  include  in  its
 contracts, a requirement that it be  provided  with  a  written  certif-
 ication,  verified by oath, from the licensed home care services agency,
 [fiscal intermediary,] or other third party, on forms  prepared  by  the
 S. 8307--A                         20                         A. 8807--A
 
 department  in  consultation with the department of labor, which attests
 to the licensed home care services agency's, [fiscal intermediary's,] or
 other third party's compliance with the  terms  of  this  section.  Such
 contracts  shall  also  obligate the licensed home care services agency,
 [fiscal intermediary,] or other third party  to  provide  the  certified
 home  health agency, long term home health care program, or managed care
 plan all information  from  the  licensed  home  care  services  agency,
 [fiscal  intermediary]  or other third party necessary to verify compli-
 ance with the terms of this  section,  which  shall  include  an  annual
 compliance  statement  of  wage  parity  hours  and  expenses  on a form
 provided by the department of labor accompanied by an  independently-au-
 dited  financial  statement  verifying such expenses. Such annual state-
 ments shall be available no less than annually for the previous calendar
 year, at a time as prescribed by the commissioner.  Such certifications,
 the information necessary to verify compliance, and the  annual  compli-
 ance  statement and financial statements shall be retained by all certi-
 fied home health agencies, long  term  home  health  care  programs,  or
 managed  care  plans,  and  all  licensed  home  care services agencies,
 [fiscal intermediaries,] or other third parties for a period of no  less
 than  ten  years, and made available to the department upon request. Any
 licensed home care services  agency,  [fiscal  intermediary,]  or  other
 third  party  who  shall  upon  oath verify any statement required to be
 transmitted under this section and any regulations promulgated  pursuant
 to this section which is known by such party to be false shall be guilty
 of perjury and punishable as provided by the penal law.
   6-a.  The  certified  home  health  agency, long term home health care
 program, or managed care plan shall review and assess the annual compli-
 ance statement of wage parity hours and  expenses  and  make  a  written
 referral  to  the department of labor for any reasonably suspected fail-
 ures of licensed home care services agencies,  [fiscal  intermediaries,]
 or  third  parties  to  conform  to the wage parity requirements of this
 section.
   7. The commissioner shall distribute  to  all  certified  home  health
 agencies,  long  term home health care programs, managed care plans, AND
 licensed home care services agencies[, and fiscal intermediaries]  offi-
 cial notice of the minimum rates of home care aide compensation at least
 one hundred twenty days prior to the effective date of each minimum rate
 for each social services district covered by the terms of this section.
   7-a.  Any  certified  home  health agency, licensed home care services
 agency, long term home health  care  program,  managed  care  plan,  [or
 fiscal intermediary,] or other third party that willfully pays less than
 such stipulated minimums regarding wages and supplements, as established
 in  this  section,  shall be guilty of a misdemeanor and upon conviction
 shall be punished, for a first offense by a fine of five hundred dollars
 or by imprisonment for not more than thirty days, or by  both  fine  and
 imprisonment;  for  a  second offense by a fine of one thousand dollars,
 and in addition thereto the contract on which the violation has occurred
 shall be forfeited; and no such person or corporation shall be  entitled
 to receive any sum nor shall any officer, agent or employee of the state
 pay  the  same  or authorize its payment from the funds under his or her
 charge or control to any person or corporation for work  done  upon  any
 contract,  on which the certified home health agency, licensed home care
 services agency, long term home health care program, managed care  plan,
 [or  fiscal  intermediary,] or other third party has been convicted of a
 second offense in violation of the provisions of this section.
 S. 8307--A                         21                         A. 8807--A
 
   9. Nothing in this section should be construed as  applicable  to  any
 service  provided  by certified home health agencies, licensed home care
 services agencies, long term home health  care  programs[,]  OR  managed
 care  plans[,  or fiscal intermediaries] except for all episodes of care
 reimbursed in whole or in part by the New York Medicaid program.
   10.  No  certified home health agency, managed care plan, or long term
 home health care program shall be liable for recoupment of  payments  or
 any  other  penalty  under  this section for services provided through a
 licensed home care services  agency,  [fiscal  intermediary,]  or  other
 third  party with which the certified home health agency, long term home
 health care program, or managed care plan has  a  contract  because  the
 licensed  agency,  [fiscal intermediary,] or other third party failed to
 comply with the provisions of this section if the certified home  health
 agency,  long  term  home  health care program, or managed care plan has
 reasonably and in good faith collected certifications and  all  informa-
 tion  required  pursuant to this section and conducts the monitoring and
 reporting required by this section.
   § 3. Paragraph (a) of subdivision 1 of section 3614-f  of  the  public
 health  law,  as added by section 3 of part NN of chapter 57 of the laws
 of 2023, is amended to read as follows:
   (a) "Home care aide" [shall  have  the  same  meaning  as  defined  in
 section  thirty-six  hundred  fourteen-c of this article] means, for the
 purpose of this section, a home health aide, personal  care  aide,  home
 attendant,  personal  assistant  performing  consumer  directed personal
 assistance services pursuant to section three  hundred  sixty-five-f  of
 the  social  services  law, or other licensed or unlicensed person whose
 primary responsibility includes the provision of in-home assistance with
 activities of daily living, instrumental activities of daily  living  or
 health-related  tasks;  provided,  however, that home care aide does not
 include any individual (i)working on a casual basis, or (ii) (except for
 a person  employed  under  the  consumer  directed  personal  assistance
 program  under section three hundred sixty-five-f of the social services
 law) who is a relative through blood, marriage or adoption of:  (1)  the
 employer;  or (2) the person for whom the worker is delivering services,
 under a program funded  or  administered  by  federal,  state  or  local
 government.
   § 4. This act shall take effect October 1, 2024.
 
                                  PART H
 
   Section  1.  Section  602  of  the financial services law, as added by
 section 26 of part H of chapter 60 of the laws of 2014,  is  amended  to
 read as follows:
   §  602.  Applicability.  [(a)]  This article shall not apply to health
 care services, including emergency services, where  physician  fees  are
 subject  to schedules or other monetary limitations under any other law,
 including the workers' compensation law and  article  fifty-one  of  the
 insurance  law,  and  shall  not preempt any such law. THIS ARTICLE ALSO
 SHALL NOT APPLY TO HEALTH CARE SERVICES, INCLUDING  EMERGENCY  SERVICES,
 SUBJECT  TO  MEDICAL  ASSISTANCE  PROGRAM  COVERAGE PROVIDED PURSUANT TO
 SECTION THREE HUNDRED SIXTY-FOUR-J OF THE SOCIAL SERVICES LAW.
   § 2. Subdivision 2 of section 364-j of  the  social  services  law  is
 amended by adding a new paragraph (e) to read as follows:
   (E)  EFFECTIVE  APRIL  FIRST, TWO THOUSAND TWENTY-FOUR AND EXPIRING ON
 THE DATE THE  COMMISSIONER  PUBLISHES  ON  THE  DEPARTMENT'S  WEBSITE  A
 REQUEST  FOR  PROPOSALS  IN ACCORDANCE WITH PARAGRAPH (A) OF SUBDIVISION
 S. 8307--A                         22                         A. 8807--A
 
 FIVE OF THIS SECTION, THE COMMISSIONER SHALL PLACE A MORATORIUM  ON  THE
 PROCESSING AND APPROVAL OF APPLICATIONS SEEKING AUTHORITY TO ESTABLISH A
 MANAGED  CARE  PROVIDER, INCLUDING APPLICATIONS SEEKING AUTHORIZATION TO
 EXPAND THE SCOPE OF ELIGIBLE ENROLLEE POPULATIONS. SUCH MORATORIUM SHALL
 NOT APPLY TO:
   (I)  APPLICATIONS  SUBMITTED TO THE DEPARTMENT PRIOR TO JANUARY FIRST,
 TWO THOUSAND TWENTY-FOUR;
   (II) APPLICATIONS SEEKING APPROVAL TO TRANSFER OWNERSHIP OR CONTROL OF
 AN EXISTING MANAGED CARE PROVIDER;
   (III) APPLICATIONS SEEKING AUTHORIZATION TO EXPAND AN EXISTING MANAGED
 CARE PROVIDER'S APPROVED SERVICE AREA;
   (IV) APPLICATIONS SEEKING AUTHORIZATION TO FORM OR OPERATE  A  MANAGED
 CARE  PROVIDER  THROUGH  AN  ENTITY  CERTIFIED  UNDER SECTION FORTY-FOUR
 HUNDRED THREE-C OR FORTY-FOUR HUNDRED THREE-G OF THE PUBLIC HEALTH LAW;
   (V) APPLICATIONS DEMONSTRATING TO THE COMMISSIONER'S SATISFACTION THAT
 SUBMISSION OF THE APPLICATION FOR CONSIDERATION WOULD BE APPROPRIATE  TO
 ADDRESS A SERIOUS CONCERN WITH CARE DELIVERY, SUCH AS A LACK OF ADEQUATE
 ACCESS  TO  MANAGED  CARE  PROVIDERS  IN  A GEOGRAPHIC AREA OR A LACK OF
 ADEQUATE AND APPROPRIATE CARE,  LANGUAGE  AND  CULTURAL  COMPETENCE,  OR
 SPECIAL NEEDS SERVICES.
   §  3.  Subdivision  5  of section 364-j of the social services law, as
 amended by section 15 of part C of chapter 58 of the laws of 2004, para-
 graph (a) as amended by section 40 of part A of chapter 56 of  the  laws
 of  2013,  and  paragraphs  (d), (e) and (f) as amended by section 80 of
 part H of chapter 59 of the laws of 2011, is amended to read as follows:
   5. Managed care programs shall be conducted  in  accordance  with  the
 requirements  of  this section and, to the extent practicable, encourage
 the provision of comprehensive medical services, pursuant to this  arti-
 cle.
   (a)  NOTWITHSTANDING  SECTIONS  ONE  HUNDRED  TWELVE  AND  ONE HUNDRED
 SIXTY-THREE OF THE STATE FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND
 ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOPMENT LAW, AND  ANY  OTHER
 INCONSISTENT  PROVISION OF LAW, [The] THE [managed care program] COMMIS-
 SIONER OF HEALTH shall, THROUGH  A  COMPETITIVE  BID  PROCESS  BASED  ON
 PROPOSALS  SUBMITTED  TO  THE  DEPARTMENT,  provide for the selection of
 qualified managed care providers [by  the  commissioner  of  health]  to
 participate  in the MANAGED CARE program PURSUANT TO A CONTRACT WITH THE
 DEPARTMENT,  including  [comprehensive  HIV  special  needs  plans  and]
 special  needs  managed  care plans in accordance with the provisions of
 section three hundred sixty-five-m of  this  title;  provided,  however,
 [that]  NOTWITHSTANDING  SECTIONS  ONE  HUNDRED  TWELVE  AND ONE HUNDRED
 SIXTY-THREE OF THE STATE FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND
 ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOPMENT LAW, AND  ANY  OTHER
 INCONSISTENT  PROVISION  OF LAW, the commissioner of health may contract
 directly with comprehensive HIV special  needs  plans  [consistent  with
 standards  set forth in this section] WITHOUT A COMPETITIVE BID PROCESS,
 and assure that such providers are accessible taking  into  account  the
 needs  of  persons  with disabilities and the differences between rural,
 suburban, and urban settings, and in  sufficient  numbers  to  meet  the
 health  care  needs  of  participants,  and shall consider the extent to
 which  major  public  hospitals  are  included  within  such  providers'
 networks[.]; AND PROVIDED FURTHER THAT:
   [(b) A proposal] (I) PROPOSALS submitted by a managed care provider to
 participate in the managed care program shall:
   [(i)]  (A)  designate  the  geographic [area] AREAS, AS DEFINED BY THE
 COMMISSIONER IN THE REQUEST FOR PROPOSALS, to be served [by the  provid-
 S. 8307--A                         23                         A. 8807--A

 er], and estimate the number of eligible participants and actual partic-
 ipants in such designated area;
   [(ii)]  (B)  include  a network of health care providers in sufficient
 numbers and geographically accessible to service program participants;
   [(iii)] (C) describe the  procedures  for  marketing  in  the  program
 location,  including the designation of other entities which may perform
 such functions under contract with the organization;
   [(iv)] (D) describe the quality assurance, utilization review and case
 management mechanisms to be implemented;
   [(v)] (E) demonstrate the applicant's ability to meet the data  analy-
 sis and reporting requirements of the program;
   [(vi)] (F) demonstrate financial feasibility of the program; and
   [(vii)]  (G)  include  such  other  information as the commissioner of
 health may deem appropriate.
   [(c) The commissioner of health shall make a determination whether  to
 approve, disapprove or recommend modification of the proposal.
   (d)  Notwithstanding  any  inconsistent  provision  of  this title and
 section one hundred sixty-three of the state finance  law,  the  commis-
 sioner of health may contract with managed care providers approved under
 paragraph  (b) of this subdivision, without a competitive bid or request
 for proposal process, to provide coverage for participants  pursuant  to
 this title.
   (e)  Notwithstanding  any  inconsistent  provision  of  this title and
 section one hundred forty-three of  the  economic  development  law,  no
 notice in the procurement opportunities newsletter shall be required for
 contracts  awarded  by  the commissioner of health, to qualified managed
 care providers pursuant to this section.
   (f)] (II) IN ADDITION TO THE CRITERIA DESCRIBED IN SUBPARAGRAPH (I) OF
 THIS PARAGRAPH, THE COMMISSIONER SHALL ALSO CONSIDER:
   (A) ACCESSIBILITY AND GEOGRAPHIC DISTRIBUTION  OF  NETWORK  PROVIDERS,
 TAKING  INTO  ACCOUNT  THE  NEEDS  OF  PERSONS WITH DISABILITIES AND THE
 DIFFERENCES BETWEEN RURAL, SUBURBAN, AND URBAN SETTINGS;
   (B) THE EXTENT TO WHICH MAJOR PUBLIC HOSPITALS  ARE  INCLUDED  IN  THE
 SUBMITTED PROVIDER NETWORK;
   (C)  DEMONSTRATED  CULTURAL  AND LANGUAGE COMPETENCIES SPECIFIC TO THE
 POPULATION OF PARTICIPANTS;
   (D) THE CORPORATE ORGANIZATION AND STATUS OF THE BIDDER AS A  CHARITA-
 BLE CORPORATION UNDER THE NOT-FOR-PROFIT CORPORATION LAW;
   (E) THE ABILITY OF A BIDDER TO OFFER PLANS IN MULTIPLE REGIONS;
   (F)  THE  TYPE  AND NUMBER OF PRODUCTS THE BIDDER PROPOSES TO OPERATE,
 INCLUDING PRODUCTS BID FOR IN ACCORDANCE WITH THE PROVISIONS OF SUBDIVI-
 SION SIX OF SECTION FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW,
 AND OTHER PRODUCTS DETERMINED BY THE  COMMISSIONER,  INCLUDING  BUT  NOT
 NECESSARILY LIMITED TO THOSE OPERATED UNDER TITLE ONE-A OF ARTICLE TWEN-
 TY-FIVE OF THE PUBLIC HEALTH LAW AND SECTION THREE HUNDRED SIXTY-NINE-GG
 OF THIS ARTICLE;
   (G)  WHETHER  THE  BIDDER PARTICIPATES IN PRODUCTS FOR INTEGRATED CARE
 FOR PARTICIPANTS WHO ARE DUALLY ELIGIBLE FOR MEDICAID AND MEDICARE;
   (H) WHETHER THE BIDDER PARTICIPATES IN VALUE  BASED  PAYMENT  ARRANGE-
 MENTS  AS DEFINED BY THE DEPARTMENT, INCLUDING THE DELEGATION OF SIGNIF-
 ICANT FINANCIAL RISK TO CLINICALLY INTEGRATED PROVIDER NETWORKS;
   (I) THE BIDDER'S COMMITMENT TO PARTICIPATION IN MANAGED  CARE  IN  THE
 STATE;
   (J) THE BIDDER'S COMMITMENT TO QUALITY IMPROVEMENT;
   (K)  THE  BIDDER'S  COMMITMENT  TO COMMUNITY REINVESTMENT SPENDING, AS
 SHALL BE DEFINED IN THE PROCUREMENT;
 S. 8307--A                         24                         A. 8807--A
 
   (L) FOR CURRENT OR PREVIOUSLY AUTHORIZED MANAGED CARE PROVIDERS,  PAST
 PERFORMANCE  IN  MEETING  MANAGED  CARE  CONTRACT  OR  FEDERAL  OR STATE
 REQUIREMENTS, AND IF THE COMMISSIONER ISSUED ANY STATEMENTS OF FINDINGS,
 STATEMENTS OF DEFICIENCY, INTERMEDIATE SANCTIONS OR ENFORCEMENT  ACTIONS
 TO  A  BIDDER  FOR  NON-COMPLIANCE  WITH  SUCH REQUIREMENTS, WHETHER THE
 BIDDER ADDRESSED SUCH ISSUES IN A TIMELY MANNER; AND
   (M) ANY OTHER CRITERIA DEEMED APPROPRIATE BY THE COMMISSIONER.
   (III) SUBPARAGRAPHS (I) AND (II) OF THIS PARAGRAPH DESCRIBING PROPOSAL
 CONTENT AND SELECTION CRITERIA REQUIREMENTS SHALL NOT  BE  CONSTRUED  AS
 LIMITING  OR  REQUIRING  THE  COMMISSIONER  TO  EVALUATE SUCH CONTENT OR
 CRITERIA ON A PASS/FAIL SCALE, OR OTHER METHODOLOGICAL  BASIS;  PROVIDED
 HOWEVER, THAT THE COMMISSIONER MUST CONSIDER ALL SUCH CONTENT AND CRITE-
 RIA  USING  METHODS  DETERMINED  BY THE COMMISSIONER IN THEIR DISCRETION
 AND, AS APPLICABLE, IN CONSULTATION WITH THE COMMISSIONERS OF THE OFFICE
 OF MENTAL HEALTH, THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES,
 THE OFFICE OF ADDICTION SERVICES AND SUPPORTS, AND THE OFFICE  OF  CHIL-
 DREN AND FAMILY SERVICES.
   (IV) THE DEPARTMENT SHALL POST ON ITS WEBSITE:
   (A)  THE  REQUEST  FOR  PROPOSALS  AND  A  DESCRIPTION OF THE PROPOSED
 SERVICES TO BE PROVIDED PURSUANT TO CONTRACTS IN  ACCORDANCE  WITH  THIS
 SUBDIVISION;
   (B)  THE  CRITERIA  ON  WHICH THE DEPARTMENT SHALL DETERMINE QUALIFIED
 BIDDERS AND EVALUATE THEIR PROPOSALS, INCLUDING ALL CRITERIA  IDENTIFIED
 IN THIS SUBDIVISION;
   (C) THE MANNER BY WHICH A PROPOSAL MAY BE SUBMITTED, WHICH MAY INCLUDE
 SUBMISSION BY ELECTRONIC MEANS;
   (D)  THE  MANNER  BY  WHICH  A  MANAGED  CARE PROVIDER MAY CONTINUE TO
 PARTICIPATE IN THE MANAGED CARE PROGRAM PENDING AWARD  OF  MANAGED  CARE
 PROVIDERS  THROUGH  A  COMPETITIVE BID PROCESS PURSUANT TO THIS SUBDIVI-
 SION; AND
   (E) UPON AWARD, THE  MANAGED  CARE  PROVIDERS  THAT  THE  COMMISSIONER
 INTENDS TO CONTRACT WITH PURSUANT TO THIS SUBDIVISION, PROVIDED THAT THE
 COMMISSIONER  SHALL  UPDATE  SUCH  LIST  TO  INDICATE THE FINAL SLATE OF
 CONTRACTED MANAGED CARE PROVIDERS.
   (V)  AWARDS  AND  CONTRACTING.  (A)  ALL  RESPONSIBLE  AND  RESPONSIVE
 SUBMISSIONS  THAT ARE RECEIVED FROM BIDDERS IN A TIMELY FASHION SHALL BE
 REVIEWED BY THE COMMISSIONER OF HEALTH IN CONSULTATION WITH THE  COMMIS-
 SIONERS  OF  THE  OFFICE  OF  MENTAL  HEALTH, THE OFFICE FOR PEOPLE WITH
 DEVELOPMENTAL  DISABILITIES,  THE  OFFICE  OF  ADDICTION  SERVICES   AND
 SUPPORTS, AND THE OFFICE OF CHILDREN AND FAMILY SERVICES, AS APPLICABLE.
 THE  COMMISSIONER  SHALL  CONSIDER COMMENTS RESULTING FROM THE REVIEW OF
 PROPOSALS AND MAKE AWARDS IN CONSULTATION WITH SUCH AGENCIES.
   (B) THE COMMISSIONER MAY MAKE AWARDS UNDER THIS SUBDIVISION  FOR  EACH
 PRODUCT, FOR WHICH PROPOSALS WERE REQUESTED, TO TWO OR MORE MANAGED CARE
 PROVIDERS  IN  EACH GEOGRAPHIC REGION DEFINED BY THE COMMISSIONER IN THE
 REQUEST FOR PROPOSALS FOR WHICH AT LEAST TWO MANAGED CARE PROVIDERS HAVE
 SUBMITTED A PROPOSAL, AND SHALL HAVE DISCRETION TO OFFER MORE  CONTRACTS
 BASED ON NEED FOR ACCESS.
   (C)  MANAGED  CARE  PROVIDERS  AWARDED UNDER THIS SUBDIVISION SHALL BE
 ENTITLED TO ENTER INTO A CONTRACT WITH THE DEPARTMENT FOR THE PURPOSE OF
 PARTICIPATING IN THE MANAGED CARE PROGRAM. SUCH CONTRACTS SHALL RUN  FOR
 A  TERM  TO  BE  DETERMINED BY THE COMMISSIONER, WHICH MAY BE RENEWED OR
 MODIFIED FROM TIME TO TIME WITHOUT  A  NEW  REQUEST  FOR  PROPOSALS,  TO
 ENSURE  CONSISTENCY  WITH CHANGES IN FEDERAL AND STATE LAWS, REGULATIONS
 AND POLICIES, INCLUDING BUT NOT LIMITED TO THE EXPANSION OR REDUCTION OF
 S. 8307--A                         25                         A. 8807--A
 
 MEDICAL ASSISTANCE SERVICES AVAILABLE  TO  THE  PARTICIPANTS  THROUGH  A
 MANAGED CARE PROVIDER.
   (D) NOTHING IN THIS PARAGRAPH OR OTHER PROVISION OF THIS SECTION SHALL
 BE CONSTRUED TO LIMIT IN ANY WAY THE ABILITY OF THE DEPARTMENT TO TERMI-
 NATE AWARDED CONTRACTS FOR CAUSE, WHICH SHALL INCLUDE BUT NOT BE LIMITED
 TO  ANY  VIOLATION OF THE TERMS OF SUCH CONTRACTS OR VIOLATIONS OF STATE
 OR FEDERAL LAWS AND REGULATIONS AND  ANY  LOSS  OF  NECESSARY  STATE  OR
 FEDERAL FUNDING.
   (E) NOTHING IN THIS PARAGRAPH OR OTHER PROVISION OF THIS SECTION SHALL
 BE  CONSTRUED TO LIMIT IN ANY WAY THE ABILITY OF THE DEPARTMENT TO ISSUE
 A NEW REQUEST FOR PROPOSALS FOR A TERM FOLLOWING AN EXISTING TERM OF  AN
 AWARD.
   (B)  TRANSITIONING  THE MANAGED CARE PROGRAM. (I) WITHIN SIXTY-DAYS OF
 THE DEPARTMENT ISSUING THE REQUEST FOR PROPOSALS UNDER PARAGRAPH (A)  OF
 THIS  SUBDIVISION,  A MANAGED CARE PROVIDER THAT WAS APPROVED TO PARTIC-
 IPATE IN THE MANAGED CARE PROGRAM PRIOR TO THE ISSUANCE OF  THE  REQUEST
 FOR  PROPOSALS,  SHALL SUBMIT ITS INTENTION TO COMPLETE SUCH PROPOSAL TO
 THE DEPARTMENT.  (II) A MANAGED CARE PROVIDER THAT: (A) FAILS TO  SUBMIT
 ITS INTENT TIMELY, (B) INDICATES WITHIN THE SIXTY-DAYS ITS INTENT NOT TO
 COMPLETE  SUCH  A  PROPOSAL,  (C)  FAILS TO SUBMIT A PROPOSAL WITHIN THE
 FURTHER TIMEFRAME SPECIFIED BY  THE  COMMISSIONER  IN  THE  REQUEST  FOR
 PROPOSALS,  OR  (D)  IS  NOT  AWARDED  THE ABILITY TO PARTICIPATE IN THE
 MANAGED CARE PROGRAM UNDER PARAGRAPH (A)  OF  THIS  SUBDIVISION,  SHALL,
 UPON  DIRECTION  FROM THE COMMISSIONER, TERMINATE ITS SERVICES AND OPER-
 ATIONS IN ACCORDANCE WITH THE CONTRACT BETWEEN THE MANAGED CARE PROVIDER
 AND THE DEPARTMENT AND SHALL BE ADDITIONALLY REQUIRED TO MAINTAIN COVER-
 AGE OF PARTICIPANTS FOR SUCH PERIOD OF  TIME AS DETERMINED NECESSARY  BY
 THE  COMMISSIONER  TO  ACHIEVE  THE SAFE AND ORDERLY TRANSFER OF PARTIC-
 IPANTS.
   (C) ADDRESSING NEEDS FOR ADDITIONAL MANAGED CARE PROVIDERS  TO  ENSURE
 PARTICIPANT ACCESS AND CHOICE. IF NECESSARY TO ENSURE ACCESS TO A SUFFI-
 CIENT  NUMBER  OF MANAGED CARE PROVIDERS ON A GEOGRAPHIC OR OTHER BASIS,
 INCLUDING A LACK OF ADEQUATE AND APPROPRIATE CARE, LANGUAGE AND CULTURAL
 COMPETENCE, OR SPECIAL NEEDS SERVICES, THE COMMISSIONER  MAY  REISSUE  A
 REQUEST FOR PROPOSALS AS PROVIDED FOR UNDER PARAGRAPH (A) OF THIS SUBDI-
 VISION,  PROVIDED  HOWEVER  THAT  SUCH  REQUEST  MAY  BE  LIMITED TO THE
 GEOGRAPHIC OR OTHER BASIS OF NEED THAT  THE  REQUEST  FOR  PROPOSALS  IS
 SEEKING TO ADDRESS. ANY AWARDS MADE SHALL BE SUBJECT TO THE REQUIREMENTS
 OF  THIS  SECTION,  INCLUDING BUT NOT LIMITED TO THE MINIMUM AND MAXIMUM
 NUMBER OF AWARDS IN A REGION.
   (D) The care and  services  described  in  subdivision  four  of  this
 section  will  be  furnished  by a managed care provider pursuant to the
 provisions of this section when such services are furnished  in  accord-
 ance  with an agreement with the department of health, and meet applica-
 ble federal law and regulations.
   [(g)] (E) The commissioner of health may delegate some or all  of  the
 tasks identified in this section to the local districts.
   [(h)]  (F)  Any  delegation  pursuant  to  paragraph [(g)] (E) of this
 subdivision shall be reflected in the contract between  a  managed  care
 provider and the commissioner of health.
   §  4.  Subdivision  4  of  section 365-m of the social services law is
 REPEALED and a new subdivision 4 is added to read as follows:
   4. THE COMMISSIONER OF HEALTH, JOINTLY WITH THE COMMISSIONERS  OF  THE
 OFFICE  OF  MENTAL  HEALTH  AND  THE  OFFICE  OF  ADDICTION SERVICES AND
 SUPPORTS, SHALL SELECT A LIMITED NUMBER OF SPECIAL  NEEDS  MANAGED  CARE
 PLANS UNDER SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE, IN ACCORD-
 S. 8307--A                         26                         A. 8807--A

 ANCE  WITH  SUBDIVISION  FIVE  OF  SUCH SECTION, CAPABLE OF MANAGING THE
 BEHAVIORAL AND PHYSICAL HEALTH NEEDS  OF  MEDICAL  ASSISTANCE  ENROLLEES
 WITH SIGNIFICANT BEHAVIORAL HEALTH NEEDS.
   §  5.  The opening paragraph of subdivision 2 of section 4403-f of the
 public health law, as amended by section 8 of part C of  chapter  58  of
 the laws of 2007, is amended to read as follows:
   CERTIFICATE  OF AUTHORITY; FORM. An eligible applicant shall submit an
 application for a certificate of authority to  operate  a  managed  long
 term  care plan upon forms prescribed by the commissioner, INCLUDING ANY
 SUCH FORMS OR PROCESSES AS MAY BE REQUIRED OR PRESCRIBED BY THE  COMMIS-
 SIONER  IN ACCORDANCE WITH THE COMPETITIVE BID PROCESS UNDER SUBDIVISION
 SIX OF THIS SECTION. Such eligible applicant  shall  submit  information
 and  documentation  to  the commissioner which shall include, but not be
 limited to:
   § 6. Subdivision 3 of section 4403-f of  the  public  health  law,  as
 amended  by section 41-a of part H of chapter 59 of the laws of 2011, is
 amended to read as follows:
   3. Certificate of authority; approval. (A) The commissioner shall  not
 approve  an application for a certificate of authority unless the appli-
 cant demonstrates to the commissioner's satisfaction:
   [(a)] (I) that it will  have  in  place  acceptable  quality-assurance
 mechanisms,  grievance  procedures,  mechanisms to protect the rights of
 enrollees and case management services to  ensure  continuity,  quality,
 appropriateness and coordination of care;
   [(b)]  (II)  that  it  will  include an enrollment process which shall
 ensure that enrollment in the plan is informed.  The  application  shall
 describe  the  disenrollment process, which shall provide that an other-
 wise eligible enrollee shall not be  involuntarily  disenrolled  on  the
 basis of health status;
   [(c)]  (III)  satisfactory evidence of the character and competence of
 the proposed operators and reasonable assurance that the applicant  will
 provide high quality services to an enrolled population;
   [(d)] (IV) sufficient management systems capacity to meet the require-
 ments of this section and the ability to efficiently process payment for
 covered services;
   [(e)]  (V)  readiness  and capability to maximize reimbursement of and
 coordinate services reimbursed pursuant to title XVIII  of  the  federal
 social security act and all other applicable benefits, with such benefit
 coordination  including,  but  not limited to, measures to support sound
 clinical decisions, reduce administrative complexity, coordinate  access
 to  services,  maximize  benefits  available  pursuant to such title and
 ensure that necessary care is provided;
   [(f)] (VI) readiness and capability  to  arrange  and  manage  covered
 services  and coordinate non-covered services which could include prima-
 ry, specialty, and acute care services reimbursed pursuant to title  XIX
 of the federal social security act;
   [(g)]  (VII)  willingness and capability of taking, or cooperating in,
 all steps necessary to secure and integrate  any  potential  sources  of
 funding  for  services  provided  by  the  managed  long term care plan,
 including, but not limited  to,  funding  available  under  titles  XVI,
 XVIII,  XIX and XX of the federal social security act, the federal older
 Americans act of nineteen hundred sixty-five, as amended, or any succes-
 sor provisions subject to approval of the director of the  state  office
 for aging, and through financing options such as those authorized pursu-
 ant to section three hundred sixty-seven-f of the social services law;
 S. 8307--A                         27                         A. 8807--A
 
   [(h)] (VIII) that the contractual arrangements for providers of health
 and  long  term  care  services in the benefit package are sufficient to
 ensure the availability  and  accessibility  of  such  services  to  the
 proposed  enrolled  population consistent with guidelines established by
 the  commissioner;  with  respect  to  individuals  in  receipt  of such
 services prior to enrollment, such guidelines shall require the  managed
 long  term  care plan to contract with agencies currently providing such
 services, in order to promote continuity  of  care.  In  addition,  such
 guidelines shall require managed long term care plans to offer and cover
 consumer  directed personal assistance services for eligible individuals
 who elect such services pursuant to section three  hundred  sixty-five-f
 of the social services law; and
   [(i)]  (IX)  that  the applicant is financially responsible and may be
 expected to meet its obligations to its enrolled members.
   (B) NOTWITHSTANDING PARAGRAPH (A) OF THIS SUBDIVISION, THE APPROVAL OF
 ANY APPLICATION FOR CERTIFICATION AS A MANAGED LONG TERM CARE PLAN UNDER
 THIS SECTION FOR A PLAN THAT SEEKS TO COVER A  POPULATION  OF  ENROLLEES
 ELIGIBLE  FOR  SERVICES  UNDER  TITLE XIX OF THE FEDERAL SOCIAL SECURITY
 ACT, SHALL BE SUBJECT  TO  AND  CONDITIONED  ON  SELECTION  THROUGH  THE
 COMPETITIVE BID PROCESS PROVIDED UNDER SUBDIVISION SIX OF THIS SECTION.
   §  7.  Subdivision  6  of  section 4403-f of the public health law, as
 amended by section 41-b of part H of chapter 59 of  the  laws  of  2011,
 paragraph  (a)  as  amended  by section 2 of part I of chapter 57 of the
 laws of 2023, paragraphs (d), (e), and (f) as added by section 5 of part
 MM of chapter 56 of the laws of  2020,  and  the  opening  paragraph  of
 subparagraph  (i)  of paragraph (d) as amended by section 3 of part I of
 chapter 57 of the laws of 2023, is amended to read as follows:
   6. Approval authority.  [(a)] An applicant shall be issued  a  certif-
 icate of authority as a managed long term care plan upon a determination
 by  the  commissioner  that  the  applicant  complies with the operating
 requirements for a managed long  term  care  plan  under  this  section;
 PROVIDED,  HOWEVER,  THAT  ANY  MANAGED  LONG  TERM CARE PLAN SEEKING TO
 PROVIDE HEALTH AND LONG TERM CARE SERVICES TO A POPULATION OF  ENROLLEES
 THAT  ARE  ELIGIBLE  UNDER  TITLE XIX OF THE FEDERAL SOCIAL SECURITY ACT
 SHALL NOT RECEIVE A CERTIFICATE OF AUTHORITY,  NOR  BE  ELIGIBLE  FOR  A
 CONTRACT  TO  PROVIDE SUCH SERVICES WITH THE DEPARTMENT, UNLESS SELECTED
 THROUGH THE COMPETITIVE BID PROCESS DESCRIBED IN THIS SUBDIVISION.  [The
 commissioner  shall  issue  no  more  than  seventy-five certificates of
 authority to managed long term care plans pursuant to this section.
   (a-1) Nothing in this section shall  be  construed  as  requiring  the
 department  to  contract  with  or  to contract for a particular line of
 business with an entity certified under this section for  the  provision
 of  services  available under title eleven of article five of the social
 services law. A managed long term care  plan  that  has  been  issued  a
 certificate of authority, or an applicant for a certificate of authority
 as  a  managed long term care plan that has in any of the three calendar
 years immediately preceding the application, met any  of  the  following
 criteria  shall  not  be  eligible  for  a contract for the provision of
 services available under title eleven of  article  five  of  the  social
 services law: (i) classified as a poor performer, or substantially simi-
 lar  terminology,  by the centers for medicare and medicaid services; or
 (ii) an excessive volume of penalties, statements  of  findings,  state-
 ments  of  deficiency,  intermediate  sanctions  or enforcement actions,
 regardless of whether the applicant has addressed such issues in a time-
 ly manner.
 S. 8307--A                         28                         A. 8807--A

   (b) An operating  demonstration  shall  be  issued  a  certificate  of
 authority  as  a managed long term care plan upon a determination by the
 commissioner  that  such  demonstration  complies  with  the   operating
 requirements  for  a  managed  long  term  care plan under this section.
 Nothing in this section shall be construed to affect the continued legal
 authority  of  an  operating  demonstration  to  operate  its previously
 approved program.
   (c) For the period beginning April  first,  two  thousand  twelve  and
 ending  March thirty-first, two thousand fifteen, the majority leader of
 the senate and the speaker of the assembly may  each  recommend  to  the
 commissioner,  in  writing, up to four eligible applicants to convert to
 be approved managed long term care plans. An  applicant  shall  only  be
 approved  and  issued  a  certificate  of  authority if the commissioner
 determines that the applicant  meets  the  requirements  of  subdivision
 three  of this section. The majority leader of the senate or the speaker
 of the assembly may assign their authority  to  recommend  one  or  more
 applicants under this section to the commissioner]
   (A)  NOTWITHSTANDING  SECTIONS  ONE  HUNDRED  TWELVE  AND  ONE HUNDRED
 SIXTY-THREE OF THE STATE FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND
 ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOPMENT LAW, AND  ANY  OTHER
 INCONSISTENT PROVISION OF LAW, THE COMMISSIONER SHALL, THROUGH A COMPET-
 ITIVE  BID  PROCESS  BASED  ON  PROPOSALS  SUBMITTED  TO THE DEPARTMENT,
 PROVIDE FOR THE SELECTION OF QUALIFIED MANAGED LONG TERM CARE  PLANS  TO
 PROVIDE HEALTH AND LONG TERM CARE SERVICES TO ENROLLEES WHO ARE ELIGIBLE
 UNDER  TITLE  XIX  OF  THE  FEDERAL  SOCIAL  SECURITY  ACT PURSUANT TO A
 CONTRACT WITH THE DEPARTMENT; PROVIDED, HOWEVER, THAT:
   (I) A PROPOSAL SUBMITTED BY  A  MANAGED  LONG  TERM  CARE  PLAN  SHALL
 INCLUDE INFORMATION SUFFICIENT TO ALLOW THE COMMISSIONER TO EVALUATE THE
 BIDDER  IN  ACCORDANCE  WITH THE REQUIREMENTS IDENTIFIED IN SUBDIVISIONS
 TWO, THREE AND FOUR OF THIS SECTION.
   (II) IN ADDITION TO THE CRITERIA DESCRIBED IN SUBPARAGRAPH (I) OF THIS
 PARAGRAPH, THE COMMISSIONER SHALL ALSO CONSIDER:
   (A) ACCESSIBILITY AND GEOGRAPHIC DISTRIBUTION  OF  NETWORK  PROVIDERS,
 TAKING  INTO  ACCOUNT  THE  NEEDS  OF  PERSONS WITH DISABILITIES AND THE
 DIFFERENCES BETWEEN RURAL, SUBURBAN, AND URBAN SETTINGS;
   (B) THE EXTENT TO WHICH MAJOR PUBLIC HOSPITALS  ARE  INCLUDED  IN  THE
 SUBMITTED PROVIDER NETWORK;
   (C)  DEMONSTRATED  CULTURAL  AND LANGUAGE COMPETENCIES SPECIFIC TO THE
 POPULATION OF PARTICIPANTS;
   (D) THE CORPORATE ORGANIZATION AND STATUS OF THE BIDDER AS A  CHARITA-
 BLE CORPORATION UNDER THE NOT-FOR-PROFIT CORPORATION LAW;
   (E) THE ABILITY OF A BIDDER TO OFFER PLANS IN MULTIPLE REGIONS;
   (F)  THE  TYPE  AND NUMBER OF PRODUCTS THE BIDDER PROPOSES TO OPERATE,
 INCLUDING PRODUCTS APPLIED FOR IN  ACCORDANCE  WITH  THE  PROVISIONS  OF
 SUBDIVISION  FIVE  OF  SECTION  THREE HUNDRED SIXTY-FOUR-J OF THE SOCIAL
 SERVICES LAW, AND OTHER PRODUCTS DETERMINED BY THE COMMISSIONER, INCLUD-
 ING BUT NOT NECESSARILY LIMITED TO THOSE OPERATED UNDER TITLE  ONE-A  OF
 ARTICLE  TWENTY-FIVE  OF  THIS  CHAPTER AND SECTION THREE HUNDRED SIXTY-
 NINE-GG OF THE SOCIAL SERVICES LAW;
   (G) WHETHER THE BIDDER PARTICIPATES IN PRODUCTS  FOR  INTEGRATED  CARE
 FOR PARTICIPANTS WHO ARE DUALLY ELIGIBLE FOR MEDICAID AND MEDICARE;
   (H)  WHETHER  THE  BIDDER PARTICIPATES IN VALUE BASED PAYMENT ARRANGE-
 MENTS AS DEFINED BY THE DEPARTMENT, INCLUDING THE DELEGATION OF  SIGNIF-
 ICANT FINANCIAL RISK TO CLINICALLY INTEGRATED PROVIDER NETWORKS;
   (I)  THE  BIDDER'S  COMMITMENT TO PARTICIPATION IN MANAGED CARE IN THE
 STATE;
 S. 8307--A                         29                         A. 8807--A
 
   (J) THE BIDDER'S COMMITMENT TO QUALITY IMPROVEMENT;
   (K)  THE  BIDDER'S  COMMITMENT  TO COMMUNITY REINVESTMENT SPENDING, AS
 SHALL BE DEFINED IN THE PROCUREMENT;
   (L) FOR CURRENT OR PREVIOUSLY AUTHORIZED MANAGED CARE PROVIDERS,  PAST
 PERFORMANCE  IN  MEETING  MANAGED  CARE  CONTRACT  OR  FEDERAL  OR STATE
 REQUIREMENTS, AND IF THE COMMISSIONER ISSUED ANY STATEMENTS OF FINDINGS,
 STATEMENTS OF DEFICIENCY, INTERMEDIATE SANCTIONS OR ENFORCEMENT  ACTIONS
 TO  A  BIDDER  FOR  NON-COMPLIANCE  WITH  SUCH REQUIREMENTS, WHETHER THE
 BIDDER ADDRESSED SUCH ISSUES IN A TIMELY MANNER; AND
   (M) ANY OTHER CRITERIA DEEMED APPROPRIATE BY THE COMMISSIONER.
   (III) SUBPARAGRAPHS (I) AND (II) OF THIS PARAGRAPH DESCRIBING PROPOSAL
 CONTENT AND SELECTION CRITERIA REQUIREMENTS SHALL NOT  BE  CONSTRUED  AS
 LIMITING  OR  REQUIRING  THE  COMMISSIONER  TO  EVALUATE SUCH CONTENT OR
 CRITERIA ON A PASS/FAIL SCALE, OR OTHER PARTICULAR METHODOLOGICAL BASIS;
 PROVIDED HOWEVER, THAT THE COMMISSIONER MUST CONSIDER ALL  SUCH  CONTENT
 AND  CRITERIA  USING  METHODS  DETERMINED  BY  THE COMMISSIONER IN THEIR
 DISCRETION AND, AS APPLICABLE, IN CONSULTATION WITH THE COMMISSIONERS OF
 THE OFFICE OF MENTAL HEALTH, THE OFFICE FOR  PEOPLE  WITH  DEVELOPMENTAL
 DISABILITIES,  THE  OFFICE  OF  ADDICTION SERVICES AND SUPPORTS, AND THE
 OFFICE OF CHILDREN AND FAMILY SERVICES.
   (IV) THE DEPARTMENT SHALL POST ON ITS WEBSITE:
   (A) THE REQUEST FOR  PROPOSALS  AND  A  DESCRIPTION  OF  THE  PROPOSED
 SERVICES  TO  BE  PROVIDED PURSUANT TO CONTRACTS IN ACCORDANCE WITH THIS
 SUBDIVISION;
   (B) THE CRITERIA ON WHICH THE  DEPARTMENT  SHALL  DETERMINE  QUALIFIED
 BIDDERS  AND EVALUATE THEIR APPLICATIONS, INCLUDING ALL CRITERIA IDENTI-
 FIED IN THIS SUBDIVISION;
   (C) THE MANNER BY WHICH A PROPOSAL MAY BE SUBMITTED, WHICH MAY INCLUDE
 SUBMISSION BY ELECTRONIC MEANS;
   (D) THE MANNER BY WHICH A MANAGED LONG TERM CARE PLAN MAY CONTINUE  TO
 PROVIDE HEALTH AND LONG TERM CARE SERVICES TO ENROLLEES WHO ARE ELIGIBLE
 UNDER  TITLE  XIX  OF  THE FEDERAL SOCIAL SECURITY ACT PENDING AWARDS TO
 MANAGED LONG TERM CARE PLANS THROUGH A COMPETITIVE BID PROCESS  PURSUANT
 TO THIS SUBDIVISION; AND
   (E) UPON AWARD, THE MANAGED LONG TERM CARE PLANS THAT THE COMMISSIONER
 INTENDS TO CONTRACT WITH PURSUANT TO THIS SUBDIVISION, PROVIDED THAT THE
 COMMISSIONER  SHALL  UPDATE  SUCH  LIST  TO  INDICATE THE FINAL SLATE OF
 CONTRACTED MANAGED LONG TERM CARE PLANS.
   (V)  AWARD  AND  CONTRACTING.  (A)  ALL  RESPONSIBLE  AND   RESPONSIVE
 SUBMISSIONS  THAT ARE RECEIVED FROM BIDDERS IN A TIMELY FASHION SHALL BE
 REVIEWED BY THE COMMISSIONER IN CONSULTATION WITH THE  COMMISSIONERS  OF
 THE  OFFICE  OF  MENTAL HEALTH, THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL
 DISABILITIES, THE OFFICE OF ADDICTION SERVICES  AND  SUPPORTS,  AND  THE
 OFFICE  OF CHILDREN AND FAMILY SERVICES, AS APPLICABLE. THE COMMISSIONER
 SHALL CONSIDER COMMENTS RESULTING FROM THE REVIEW OF PROPOSALS AND  MAKE
 AWARDS IN CONSULTATION WITH SUCH AGENCIES.
   (B)  THE COMMISSIONER MAY MAKE AWARDS UNDER THIS SUBDIVISION, FOR EACH
 PRODUCT FOR WHICH PROPOSALS WERE REQUESTED, TO TWO OR MORE MANAGED  LONG
 TERM CARE PLANS IN EACH GEOGRAPHIC REGION DEFINED BY THE COMMISSIONER IN
 THE  REQUEST FOR PROPOSALS FOR WHICH AT LEAST TWO MANAGED LONG TERM CARE
 PLANS HAVE SUBMITTED A PROPOSAL, AND SHALL HAVE DISCRETION TO OFFER MORE
 CONTRACTS BASED ON NEED FOR ACCESS.
   (C) MANAGED LONG TERM CARE PLANS AWARDED UNDER THIS SUBDIVISION  SHALL
 BE ENTITLED TO ENTER INTO A CONTRACT WITH THE DEPARTMENT FOR THE PURPOSE
 OF  PROVIDING  HEALTH  AND  LONG TERM CARE SERVICES TO ENROLLEES WHO ARE
 ELIGIBLE UNDER TITLE XIX  OF  THE  FEDERAL  SOCIAL  SECURITY  ACT.  SUCH
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 CONTRACTS  SHALL  RUN  FOR  A TERM TO BE DETERMINED BY THE COMMISSIONER,
 WHICH MAY BE RENEWED OR MODIFIED FROM TIME TO TIME WITHOUT A NEW REQUEST
 FOR PROPOSALS, TO ENSURE CONSISTENCY WITH CHANGES IN FEDERAL  AND  STATE
 LAWS,  REGULATIONS AND POLICIES, INCLUDING BUT NOT LIMITED TO THE EXPAN-
 SION OR REDUCTION  OF  MEDICAL  ASSISTANCE  SERVICES  AVAILABLE  TO  THE
 PARTICIPANTS THROUGH A MANAGED LONG TERM CARE PLAN.
   (D) NOTHING IN THIS PARAGRAPH OR OTHER PROVISION OF THIS SECTION SHALL
 BE CONSTRUED TO LIMIT IN ANY WAY THE ABILITY OF THE DEPARTMENT TO TERMI-
 NATE AWARDED CONTRACTS FOR CAUSE, WHICH SHALL INCLUDE BUT NOT BE LIMITED
 TO  ANY  VIOLATION OF THE TERMS OF SUCH CONTRACTS OR VIOLATIONS OF STATE
 OR FEDERAL LAWS AND REGULATIONS AND  ANY  LOSS  OF  NECESSARY  STATE  OR
 FEDERAL FUNDING.
   (E) NOTHING IN THIS PARAGRAPH OR OTHER PROVISION OF THIS SECTION SHALL
 BE  CONSTRUED TO LIMIT IN ANY WAY THE ABILITY OF THE DEPARTMENT TO ISSUE
 A NEW REQUEST FOR PROPOSALS FOR A TERM FOLLOWING AN EXISTING TERM OF  AN
 AWARD.
   (B)  TRANSITIONING  ENROLLEES  WHO ARE ELIGIBLE UNDER TITLE XIX OF THE
 FEDERAL SOCIAL SECURITY ACT (I)  WITHIN  SIXTY-DAYS  OF  THE  DEPARTMENT
 ISSUING  THE  REQUEST FOR PROPOSALS UNDER PARAGRAPH (A) OF THIS SUBDIVI-
 SION, A MANAGED LONG TERM CARE PLAN THAT WAS APPROVED TO PROVIDE  HEALTH
 AND  LONG  TERM  CARE SERVICES TO ENROLLEES WHO ARE ELIGIBLE UNDER TITLE
 XIX OF THE FEDERAL SOCIAL SECURITY ACT PRIOR  TO  THE  ISSUANCE  OF  THE
 REQUEST  FOR  PROPOSALS,  SHALL  SUBMIT  ITS  INTENTION TO COMPLETE SUCH
 PROPOSAL TO THE DEPARTMENT.
   (II) A MANAGED LONG TERM CARE PLAN  THAT:  (A)  FAILS  TO  SUBMIT  ITS
 INTENT  TIMELY;  (B)  INDICATES  WITHIN THE SIXTY-DAYS ITS INTENT NOT TO
 COMPLETE SUCH A PROPOSAL, (C) FAILS TO  SUBMIT  A  PROPOSAL  WITHIN  THE
 FURTHER  TIMEFRAME  SPECIFIED  BY  THE  COMMISSIONER  IN THE REQUEST FOR
 PROPOSALS, OR (D) IS NOT AWARDED THE ABILITY TO PROVIDE HEALTH AND  LONG
 TERM  CARE SERVICES TO ENROLLEES WHO ARE ELIGIBLE UNDER TITLE XIX OF THE
 FEDERAL SOCIAL SECURITY ACT UNDER PARAGRAPH  (A)  OF  THIS  SUBDIVISION,
 SHALL,  UPON DIRECTION FROM THE COMMISSIONER, TERMINATE ITS SERVICES AND
 OPERATIONS IN ACCORDANCE WITH THE CONTRACT BETWEEN THE MANAGED LONG TERM
 CARE PLAN AND THE DEPARTMENT AND SHALL BE ADDITIONALLY REQUIRED TO MAIN-
 TAIN COVERAGE OF ENROLLEES FOR SUCH PERIOD OF TIME AS DETERMINED  NECES-
 SARY  BY  THE  COMMISSIONER  TO ACHIEVE THE SAFE AND ORDERLY TRANSFER OF
 ENROLLEES.
   (C) ADDRESSING NEEDS FOR ADDITIONAL MANAGED LONG TERM  CARE  PLANS  TO
 ENSURE  ACCESS  AND CHOICE FOR ENROLLEES ELIGIBLE UNDER TITLE XIX OF THE
 FEDERAL SOCIAL SECURITY ACT. IF NECESSARY TO ENSURE ACCESS TO  A  SUFFI-
 CIENT  NUMBER  OF  MANAGED LONG TERM CARE PLANS ON A GEOGRAPHIC OR OTHER
 BASIS, INCLUDING A LACK OF ADEQUATE AND APPROPRIATE CARE,  LANGUAGE  AND
 CULTURAL  COMPETENCE,  OR  SPECIAL  NEEDS SERVICES, THE COMMISSIONER MAY
 REISSUE A REQUEST FOR PROPOSALS AS PROVIDED FOR UNDER PARAGRAPH  (A)  OF
 THIS  SUBDIVISION,  PROVIDED HOWEVER THAT SUCH REQUEST MAY BE LIMITED TO
 THE GEOGRAPHIC OR OTHER BASIS OF NEED THAT  THE  REQUEST  FOR  PROPOSALS
 SEEKS  TO  ADDRESS. ANY AWARDS MADE SHALL BE SUBJECT TO THE REQUIREMENTS
 OF THIS SECTION, INCLUDING BUT NOT LIMITED TO THE  MINIMUM  AND  MAXIMUM
 NUMBER OF AWARDS IN A REGION.
   (d)  (i)  Effective  April  first,  two  thousand twenty, and expiring
 [March thirty-first, two thousand twenty-seven] ON THE DATE THE  COMMIS-
 SIONER  PUBLISHES ON THE DEPARTMENT'S WEBSITE A REQUEST FOR PROPOSALS IN
 ACCORDANCE WITH SUBPARAGRAPH (IV) OF PARAGRAPH (A) OF THIS  SUBDIVISION,
 the commissioner shall place a moratorium on the processing and approval
 of  applications  seeking  a  certificate of authority as a managed long
 term care plan pursuant to this section, including applications  seeking
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 authorization  to  expand  an  existing  managed  long  term care plan's
 approved service area or scope of eligible  enrollee  populations.  Such
 moratorium shall not apply to:
   (A)  applications  submitted to the department prior to January first,
 two thousand twenty;
   (B) applications seeking approval to transfer ownership or control  of
 an existing managed long term care plan;
   (C) applications demonstrating to the commissioner's satisfaction that
 submission  of the application for consideration would be appropriate to
 address a serious concern with care delivery, such as a lack of adequate
 access to managed long term care plans in a geographic area or a lack of
 adequate and appropriate care,  language  and  cultural  competence,  or
 special needs services; and
   (D) applications seeking to operate under the PACE (Program of All-In-
 clusive  Care for the Elderly) model as authorized by federal public law
 105-33, subtitle I of title IV of the Balanced Budget Act of 1997, or to
 serve individuals dually eligible for services and benefits under titles
 XVIII and XIX of the federal social security act in conjunction with  an
 affiliated  Medicare Dual Eligible Special Needs Plan, based on the need
 for such plans and the experience of applicants in serving dually eligi-
 ble individuals as determined by the commissioner in their discretion.
   (ii) For the duration of the moratorium, the commissioner shall assess
 the public need for managed long term care plans that are not integrated
 with an affiliated Medicare plan, the ability of such plans  to  provide
 high  quality and cost effective care for their membership, and based on
 such assessment develop a process and conduct an orderly  wind-down  and
 elimination  of  such plans, which shall coincide with the expiration of
 the moratorium unless the commissioner determines that  a  longer  wind-
 down period is needed.
   (e)  [For  the  duration of the moratorium under paragraph (d) of this
 subdivision] FROM APRIL FIRST, TWO THOUSAND TWENTY, UNTIL MARCH  THIRTY-
 FIRST,  TWO  THOUSAND TWENTY-FOUR, the commissioner shall establish, and
 enforce by means of a premium withholding equal to three percent of  the
 base  rate,  an annual cap on total enrollment (enrollment cap) for each
 managed long term care plan, subject to subparagraphs (ii) and (iii)  of
 this paragraph, based on a percentage of each plan's reported enrollment
 as of October first, two thousand twenty.
   (i)  The  specific  percentage  of each plan's enrollment cap shall be
 established by the commissioner based on: (A) the ability of individuals
 eligible for such plans to access health and long  term  care  services,
 (B)  plan quality of care scores, (C) historical plan disenrollment, (D)
 the projected growth of individuals eligible for such plans in different
 regions of the state, (E) historical plan enrollment  of  patients  with
 varying  levels of need and acuity, and (F) other factors in the commis-
 sioner's discretion to  ensure  compliance  with  federal  requirements,
 appropriate access to plan services, and choice by eligible individuals.
   (ii)  In  the event that a plan exceeds its annual enrollment cap, the
 commissioner is authorized under this  paragraph  to  retain  all  or  a
 portion  of  the  premium withheld based on the amount over which a plan
 exceeds its enrollment cap. Penalties assessed pursuant to this subdivi-
 sion shall be determined by regulation.
   (iii) The commissioner may  not  establish  an  annual  cap  on  total
 enrollment  under  this paragraph for plans' lines of business operating
 under the PACE (Program of All-Inclusive Care for the Elderly) model  as
 authorized  by  federal public law 105-33, subtitle I of title IV of the
 Balanced Budget Act of 1997, or that serve individuals  dually  eligible
 S. 8307--A                         32                         A. 8807--A
 
 for  services  and  benefits  under  titles XVIII and XIX of the federal
 social security act in conjunction  with  an  affiliated  Medicare  Dual
 Eligible Special Needs Plan.
   [(f)  In implementing the provisions of paragraphs (d) and (e) of this
 subdivision, the commissioner shall, to the extent practicable, consider
 and select methodologies that seek to maximize continuity  of  care  and
 minimize  disruption  to the provider labor workforce, and shall, to the
 extent practicable and consistent with  the  ratios  set  forth  herein,
 continue  to  support contracts between managed long term care plans and
 licensed home care services agencies that are based on a  commitment  to
 quality and value.]
   §  8. Section 1 of part I of chapter 57 of the laws of 2022, providing
 a one percent across the board payment increase to all  qualifying  fee-
 for-service  Medicaid rates, is amended by adding two new subdivisions 3
 and 4 to read as follows:
   3. FOR THE STATE FISCAL YEARS BEGINNING APRIL 1, 2024, AND THEREAFTER,
 ALL DEPARTMENT OF HEALTH MEDICAID PAYMENTS MADE TO MEDICAID MANAGED CARE
 ORGANIZATIONS WILL NO LONGER BE SUBJECT TO THE UNIFORM RATE INCREASE  IN
 SUBDIVISION ONE OF THIS SECTION.
   4. RATE ADJUSTMENTS MADE PURSUANT TO SUBDIVISIONS ONE THROUGH THREE OF
 THIS  SECTION  SHALL NOT BE SUBJECT TO THE NOTIFICATION REQUIREMENTS SET
 FORTH IN SUBDIVISION 7 OF SECTION 2807 OF THE PUBLIC HEALTH LAW.
   § 9. Section 364-j of the social services law is amended by  adding  a
 new subdivision 40 to read as follows:
   40.  (A)  THE  COMMISSIONER  SHALL  BE  ENTITLED TO RECOVER LIQUIDATED
 DAMAGES FROM MANAGED CARE ORGANIZATIONS FOR FAILURE TO MEET THE CONTRAC-
 TUAL OBLIGATIONS AND PERFORMANCE STANDARDS OF THEIR CONTRACT.
   (B) THE COMMISSIONER SHALL HAVE SOLE DISCRETION IN DETERMINING WHETHER
 TO IMPOSE A RECOVERY OF THE FINANCIAL LOSS AND DAMAGES FOR NONCOMPLIANCE
 WITH ANY PROVISION OF THE CONTRACT.
   (C) (I) LIQUIDATED DAMAGES  IMPOSED  BY  THIS  SUBDIVISION  AGAINST  A
 MANAGED  CARE ORGANIZATION SHALL BE FROM TWO HUNDRED FIFTY DOLLARS UP TO
 TWENTY-FIVE THOUSAND DOLLARS PER VIOLATION DEPENDING ON THE SEVERITY  OF
 THE NONCOMPLIANCE DETERMINED BY THE COMMISSIONER.
   (II)  ANY  LIQUIDATED  DAMAGES  FINDINGS  AS  A  RESULT  OF THE REVIEW
 REQUIRED BY THIS SUBDIVISION SHALL BE DUE  AND  PAYABLE  SIXTY  CALENDAR
 DAYS  FROM  THE  ISSUANCE  OF  A  STATEMENT OF DAMAGES REGARDLESS OF ANY
 DISPUTE IN THE AMOUNT OR INTERPRETATION OF THE AMOUNT DUE  CONTAINED  IN
 THE STATEMENT OF DAMAGES.
   (III) THE COMMISSIONER MAY ELECT, IN THEIR SOLE DISCRETION, TO COLLECT
 DAMAGES IMPOSED BY THIS SECTION FROM, AND AS A SET OFF AGAINST, PAYMENTS
 DUE  TO  THE MANAGED CARE ORGANIZATION, OR PAYMENTS THAT BECOMES DUE ANY
 TIME AFTER THE  CALCULATION  OF  LIQUIDATED  DAMAGES.  DEDUCTIONS  SHALL
 CONTINUE UNTIL THE FULL AMOUNT OF THE NOTICED DAMAGES ARE PAID IN FULL.
   (IV)  ALL LIQUIDATED DAMAGES IMPOSED BY THIS SUBDIVISION SHALL BE PAID
 OUT OF THE ADMINISTRATIVE COSTS AND PROFITS OF THE MANAGED  CARE  ORGAN-
 IZATION.
   (V)  THE  MANAGED  CARE  ORGANIZATION  SHALL  NOT  PASS THE LIQUIDATED
 DAMAGES IMPOSED UNDER THIS SUBDIVISION THROUGH TO  ANY  PROVIDER  AND/OR
 SUBCONTRACTOR.
   (D)(I)  MANAGED CARE ORGANIZATION MUST SUBMIT A WRITTEN REQUEST OF ITS
 DISPUTE A MANAGED CARE ORGANIZATION MAY DISPUTE THE IMPOSITION OF LIQUI-
 DATED DAMAGES IN WRITING, AND IN THE FORM AND MANNER PRESCRIBED  BY  THE
 COMMISSIONER,  WITHIN THIRTY   CALENDAR DAYS FROM THE DATE OF THE STATE-
 MENT OF DAMAGES.
 S. 8307--A                         33                         A. 8807--A
 
   (II) DISPUTES THAT ARE NOT DELIVERED IN THE FORMAT AND TIMEFRAME SPEC-
 IFIED BY THE DEPARTMENT SHALL BE DENIED BY  THE  DEPARTMENT  AND  DEEMED
 WAIVED BY THE MANAGED CARE ORGANIZATION.
   (III)  A  MANAGED CARE ORGANIZATION SHALL WAIVE ANY ARGUMENTS, MATERI-
 ALS, DATA, AND INFORMATION NOT CONTAINED IN  OR  ACCOMPANYING  A  TIMELY
 SUBMITTED  WRITTEN DISPUTE, INCLUDING FOR USE IN ANY SUBSEQUENT LEGAL OR
 ADMINISTRATIVE PROCEEDING.
   (IV) THE COMMISSIONER OR THEIR  DESIGNEE  SHALL  DECIDE  THE  DISPUTE,
 REDUCE  THE  DECISION TO WRITING AND ISSUE THEIR DECISION TO THE MANAGED
 CARE ORGANIZATION WITHIN NINETY CALENDAR DAYS OF RECEIPT OF THE DISPUTE.
 THIS WRITTEN DECISION SHALL BE FINAL.
   (E) FOR THE PURPOSES OF THIS SUBDIVISION A VIOLATION SHALL MEAN: (I) A
 DETERMINATION BY THE COMMISSIONER THAT  THE  MANAGED  CARE  ORGANIZATION
 FAILED TO ACT AS REQUIRED UNDER THE MODEL CONTRACT OR APPLICABLE FEDERAL
 AND  STATE  STATUTES, RULES OR REGULATIONS GOVERNING MANAGED CARE ORGAN-
 IZATION; (II) EACH INSTANCE OF A MANAGED CARE  ORGANIZATION  FAILING  TO
 FURNISH  NECESSARY  AND/OR  REQUIRED  MEDICAL  SERVICES OR ITEMS TO EACH
 ENROLLEE SHALL BE A SEPARATE VIOLATION.  FOR THE PURPOSES OF THIS SUBDI-
 VISION, EACH DAY THAT AN ONGOING VIOLATION CONTINUES SHALL BE A SEPARATE
 VIOLATION.
   (F) FOR PURPOSES OF THIS SUBDIVISION MANAGED CARE  ORGANIZATION  SHALL
 MEAN  ANY MANAGED CARE ORGANIZATIONS SUBJECT TO THIS SECTION AND ARTICLE
 FORTY-FOUR OF THE PUBLIC HEALTH LAW, INCLUDING MANAGED  LONG  TERM  CARE
 PLANS.
   (G)  NOTHING  IN  THIS  SUBDIVISION  SHALL  PROHIBIT THE IMPOSITION OF
 DAMAGES, PENALTIES OR OTHER RELIEF, OTHERWISE AUTHORIZED BY LAW, INCLUD-
 ING BUT NOT LIMITED TO CASES OF FRAUD, WASTE OR ABUSE.
   § 10. This act shall not be construed to prohibit managed care provid-
 ers participating in the managed care program and managed long term care
 plans approved to provide health and long term care services  to  enrol-
 lees  who  are  eligible  under title XIX of the federal social security
 act, that were so authorized as of the effective date of this  act  from
 continuing  operations  as authorized until such time as awards are made
 in accordance with this act and such additional time subject  to  direc-
 tion  from  the  commissioner  of  health to ensure the safe and orderly
 transfer of participants.
   § 11. This act shall  take  effect  immediately  and  shall  apply  to
 disputes filed with the superintendent of financial services pursuant to
 article  six  of  the  financial services law on or after such effective
 date; provided that:
   (a) the amendments to section 364-j of the social services law made by
 sections two, three and nine of this act shall not affect the repeal  of
 such section and shall be deemed repealed therewith; and
   (b)  the amendments to section 4403-f of the public health law made by
 sections five, six and seven of this act shall not affect the repeal  of
 such section and shall be deemed repealed therewith.
 
                                  PART I
 
   Section  1.  Paragraph  (a)  of  subdivision 4 of section 365-a of the
 social services law, as amended by chapter 493 of the laws of  2010,  is
 amended to read as follows:
   (a) drugs which may be dispensed without a prescription as required by
 section sixty-eight hundred ten of the education law; provided, however,
 that  the state commissioner of health may by regulation specify certain
 of such drugs which may be reimbursed as an item of  medical  assistance
 S. 8307--A                         34                         A. 8807--A
 
 in  accordance with the price schedule established by such commissioner.
 Notwithstanding any other provision of law, [additions] MODIFICATIONS to
 the list of drugs reimbursable under this  paragraph  may  be  filed  as
 regulations  by  the  commissioner  of  health  without prior notice and
 comment;
   § 2. Paragraph (b) of subdivision 3  of  section  273  of  the  public
 health  law,  as added by section 10 of part C of chapter 58 of the laws
 of 2005, is amended to read as follows:
   (b) In the event that the patient does not meet the criteria in  para-
 graph  (a)  of  this  subdivision, the prescriber may provide additional
 information to the program to justify the use  of  a  prescription  drug
 that  is  not  on  the  preferred drug list. The program shall provide a
 reasonable opportunity for a prescriber to reasonably present his or her
 justification of prior authorization. [If, after consultation  with  the
 program, the prescriber, in his or her reasonable professional judgment,
 determines  that]  THE  PROGRAM WILL CONSIDER THE ADDITIONAL INFORMATION
 AND THE JUSTIFICATION PRESENTED  TO  DETERMINE  WHETHER  the  use  of  a
 prescription  drug  that is not on the preferred drug list is warranted,
 AND the [prescriber's] PROGRAM'S determination shall be final.
   § 3. Subdivisions 25 and 25-a of section 364-j of the social  services
 law are REPEALED.
   §  4. Section 280 of the public health law, as amended by section 8 of
 part D of chapter 57 of the laws of 2018, paragraph (b) of subdivision 2
 as amended by section 5, subdivision 3 as amended by  section  6,  para-
 graph  (a)  of subdivision 5 as amended by section 7, subparagraph (iii)
 of paragraph (e) as amended by section 6-a and subdivision 8 as  amended
 by  section  9  of part B of chapter 57 of the laws of 2019,  paragraphs
 (c) and (d) of subdivision 2 as amended and paragraph (e) of subdivision
 2 as added by section 2 of part FFF of chapter 56 of the laws  of  2020,
 the  opening  paragraph  of paragraph (a) of subdivision 6 and paragraph
 (a) of subdivision 7 as amended by sections 3 and  4,  respectively,  of
 part  GG  of  chapter  56  of  the laws of 2020,   is amended to read as
 follows:
   § 280. Medicaid drug cap. 1. The legislature hereby finds and declares
 that there is a significant public interest for the Medicaid program  to
 manage  drug costs in a manner that ensures patient access while provid-
 ing financial stability  for  the  state  and  participating  providers.
 Since  two  thousand  eleven,  the  state has taken significant steps to
 contain costs in the Medicaid program by imposing a statutory  limit  on
 annual  growth.  Drug  expenditures,  however, continually outpace other
 cost components causing significant pressure on  the  state,  providers,
 and patient access operating under the Medicaid global cap. It is there-
 fore  intended  that  the department establish a [Medicaid drug cap as a
 separate component within the Medicaid global cap]  SUPPLEMENTAL  REBATE
 PROGRAM  as part of a focused and sustained effort to balance the growth
 of drug expenditures with the growth of total Medicaid expenditures.
   2. The commissioner shall [establish a year to year] REVIEW  AT  LEAST
 ANNUALLY THE department of health state funds Medicaid drug [expenditure
 growth target as follows:
   (a)  for  state fiscal year two thousand seventeen--two thousand eigh-
 teen, be limited to the ten-year rolling average of the  medical  compo-
 nent  of the consumer price index plus five percent and minus a pharmacy
 savings target of fifty-five million dollars; and
   (b) for state fiscal year two thousand  eighteen--two  thousand  nine-
 teen,  be  limited to the ten-year rolling average of the medical compo-
 S. 8307--A                         35                         A. 8807--A

 nent of the consumer price index plus four percent and minus a  pharmacy
 savings target of eighty-five million dollars;
   (c)  for state fiscal year two thousand nineteen--two thousand twenty,
 be limited to the ten-year rolling average of the medical  component  of
 the  consumer price index plus four percent and minus a pharmacy savings
 target of eighty-five million dollars;
   (d) for state fiscal year two thousand  twenty--two  thousand  twenty-
 one, be limited to the ten-year rolling average of the medical component
 of the consumer price index plus two percent; and
   (e)  for state fiscal year two thousand twenty-one--two thousand twen-
 ty-two and fiscal years thereafter, be limited in accordance with subdi-
 vision one of section ninety-one of part H of chapter fifty-nine of  the
 laws of two thousand eleven, as amended] EXPENDITURES TO IDENTIFY DRUGS,
 INCLUDING BUT NOT LIMITED TO, DRUGS IN THE EIGHTIETH PERCENTILE OR HIGH-
 ER OF TOTAL SPEND, NET OF REBATE OR IN THE EIGHTIETH PERCENTILE OR HIGH-
 ER BASED ON COST PER CLAIM, NET OF REBATE.
   3.  (A) The [department and the division of the budget shall assess on
 a quarterly basis the projected total amount to be expended in the  year
 on a cash basis by the Medicaid program for each drug, and the projected
 annual  amount of state funds Medicaid drug expenditures on a cash basis
 for all drugs, which shall be a component of the projected department of
 health state funds Medicaid  expenditures  calculated  for  purposes  of
 sections  ninety-one  and  ninety-two of part H of chapter fifty-nine of
 the laws of two thousand eleven. For purposes  of  this  section,  state
 funds  Medicaid  drug expenditures include amounts expended for drugs in
 both the Medicaid fee-for-service  program  and  Medicaid  managed  care
 programs,  minus  the  amount  of  any drug rebates or supplemental drug
 rebates received by the department, including rebates pursuant to subdi-
 vision five of this section with respect to rebate targets. The  depart-
 ment  and  the  division  of the budget shall report in December of each
 year, for the prior April  through  October,  to  the  drug  utilization
 review  board  the  projected  state  funds  Medicaid  drug expenditures
 including the amounts, in aggregate thereof,  attributable  to  the  net
 cost  of:  changes  in  the utilization of drugs by Medicaid recipients;
 changes in the number of Medicaid recipients; changes  to  the  cost  of
 brand  name drugs and changes to the cost of generic drugs. The informa-
 tion contained in the report shall not be publicly released in a  manner
 that allows for the identification of an individual drug or manufacturer
 or  that  is likely to compromise the financial competitive, or proprie-
 tary nature of the information.
   (a) In the event the director of the budget determines, based on Medi-
 caid drug expenditures for the previous quarter or other relevant infor-
 mation, that the total department of health state  funds  Medicaid  drug
 expenditure  is projected to exceed the annual growth limitation imposed
 by subdivision two of this section, the] commissioner may  identify  and
 refer  drugs,  INCLUDING  BUT  NOT  LIMITED  TO,  DRUGS IN THE EIGHTIETH
 PERCENTILE OR HIGHER OF TOTAL SPEND, NET OF REBATE OR IN  THE  EIGHTIETH
 PERCENTILE OR HIGHER BASED ON COST PER CLAIM, NET OF REBATE, to the drug
 utilization  review  board  established  by section three hundred sixty-
 nine-bb of the social services law for a recommendation as to whether  a
 target  supplemental  Medicaid rebate should be paid by the manufacturer
 of the drug to the department and the target amount of the rebate.
   (b) If the department intends to refer a drug to the drug  utilization
 review  board pursuant to paragraph (a) of this subdivision, the depart-
 ment shall notify the manufacturer of such drug  and  shall  attempt  to
 reach  agreement with the manufacturer on a rebate for the drug prior to
 S. 8307--A                         36                         A. 8807--A
 
 referring the drug to the drug  utilization  review  board  for  review.
 Such  rebate may be based on evidence-based research, including, but not
 limited to, such research operated or conducted by or  for  other  state
 governments,  the  federal government, the governments of other nations,
 and third party payers or multi-state coalitions, provided however  that
 the department shall account for the effectiveness of the drug in treat-
 ing  the  conditions  for  which  it  is  prescribed  or  in improving a
 patient's health, quality of life, or overall health outcomes,  and  the
 likelihood  that  use of the drug will reduce the need for other medical
 care, including hospitalization.
   (c) In the event that  the  commissioner  and  the  manufacturer  have
 previously  agreed to a supplemental rebate for a drug pursuant to para-
 graph (b) of this subdivision or paragraph (e) of subdivision  seven  of
 section three hundred sixty-seven-a of the social services law, the drug
 shall  not  be  referred  to  the  drug utilization review board for any
 further supplemental rebate for the  duration  of  the  previous  rebate
 agreement,  provided  however,  the commissioner may refer a drug to the
 drug utilization review board if the commissioner determines  there  are
 significant   and  substantiated  utilization  or  market  changes,  new
 evidence-based research, or statutory or federal regulatory changes that
 warrant additional rebates. In such cases, the department  shall  notify
 the  manufacturer  and  provide evidence of the changes or research that
 would warrant additional rebates, and shall attempt to  reach  agreement
 with  the  manufacturer  on a rebate for the drug prior to referring the
 drug to the drug utilization review board for review.
   (d) The department shall consider a drug's actual cost to  the  state,
 including  current rebate amounts, prior to seeking an additional rebate
 pursuant to paragraph (b) or (c) of this subdivision.
   (e)  [The  commissioner  shall  be  authorized  to  take  the  actions
 described  in  this section only so long as total Medicaid drug expendi-
 tures are projected to exceed the annual growth  limitation  imposed  by
 subdivision two of this section.] IF THE COMMISSIONER IS UNSUCCESSFUL IN
 ENTERING  INTO  A  REBATE  ARRANGEMENT WITH THE MANUFACTURER OF THE DRUG
 SATISFACTORY TO THE DEPARTMENT, THE DRUG  MANUFACTURER  SHALL,  IN  THAT
 EVENT  BE REQUIRED TO PROVIDE TO THE DEPARTMENT, ON A STANDARD REPORTING
 FORM DEVELOPED BY THE DEPARTMENT, THE FOLLOWING INFORMATION:
   (I) THE ACTUAL COST OF DEVELOPING, MANUFACTURING, PRODUCING (INCLUDING
 THE COST PER DOSE OF PRODUCTION), AND DISTRIBUTING THE DRUG;
   (II) RESEARCH AND DEVELOPMENT COSTS OF THE DRUG, INCLUDING PAYMENTS TO
 PREDECESSOR  ENTITIES  CONDUCTING  RESEARCH  AND  DEVELOPMENT,  SUCH  AS
 BIOTECHNOLOGY  COMPANIES,  UNIVERSITIES AND MEDICAL SCHOOLS, AND PRIVATE
 RESEARCH INSTITUTIONS;
   (III) ADMINISTRATIVE, MARKETING, AND ADVERTISING COSTS FOR  THE  DRUG,
 APPORTIONED  BY  MARKETING  ACTIVITIES  THAT  ARE DIRECTED TO CONSUMERS,
 MARKETING ACTIVITIES THAT ARE DIRECTED TO  PRESCRIBERS,  AND  THE  TOTAL
 COST  OF  ALL  MARKETING  AND  ADVERTISING THAT IS DIRECTED PRIMARILY TO
 CONSUMERS AND PRESCRIBERS IN NEW YORK,  INCLUDING  BUT  NOT  LIMITED  TO
 PRESCRIBER DETAILING, COPAYMENT DISCOUNT PROGRAMS, AND DIRECT-TO-CONSUM-
 ER MARKETING;
   (IV) THE EXTENT OF UTILIZATION OF THE DRUG;
   (V)  PRICES  FOR  THE  DRUG THAT ARE CHARGED TO PURCHASERS OUTSIDE THE
 UNITED STATES;
   (VI) PRICES CHARGED TO TYPICAL PURCHASERS IN THE STATE, INCLUDING  BUT
 NOT  LIMITED  TO  PHARMACIES,  PHARMACY CHAINS, PHARMACY WHOLESALERS, OR
 OTHER DIRECT PURCHASERS;
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   (VII) THE AVERAGE REBATES AND DISCOUNTS PROVIDED PER PAYER TYPE IN THE
 STATE; AND
   (VIII) THE AVERAGE PROFIT MARGIN OF EACH DRUG OVER THE PRIOR FIVE-YEAR
 PERIOD AND THE PROJECTED PROFIT MARGIN ANTICIPATED FOR SUCH DRUG.
   (F) ALL INFORMATION DISCLOSED PURSUANT TO PARAGRAPH (E) OF THIS SUBDI-
 VISION  SHALL  BE  CONSIDERED CONFIDENTIAL AND SHALL NOT BE DISCLOSED BY
 THE DEPARTMENT IN A FORM THAT  IDENTIFIES  A  SPECIFIC  MANUFACTURER  OR
 PRICES CHARGED FOR DRUGS BY SUCH MANUFACTURER.
   4.  In  determining  whether to recommend a target supplemental rebate
 for a drug, the drug utilization review board shall consider the  actual
 cost  of  the  drug to the Medicaid program, including federal and state
 rebates, and may consider, among other things:
   (a) the drug's impact on the Medicaid drug spending growth target  and
 the  adequacy of capitation rates of participating Medicaid managed care
 plans, and the drug's affordability and value to the  Medicaid  program;
 or
   (b) significant and unjustified increases in the price of the drug; or
   (c) whether the drug may be priced disproportionately to its therapeu-
 tic benefits.
   5. (a) If the drug utilization review board recommends a target rebate
 amount  on  a  drug  referred  by the commissioner, the department shall
 negotiate with the drug's manufacturer for a supplemental rebate  to  be
 paid  by  the manufacturer in an amount not to exceed such target rebate
 amount. [A rebate requirement shall apply beginning with the  first  day
 of  the  state  fiscal year during which the rebate was required without
 regard to the date the department enters into the rebate agreement  with
 the manufacturer.]
   (b) The supplemental rebate required by paragraph (a) of this subdivi-
 sion shall apply to drugs dispensed to enrollees of managed care provid-
 ers  pursuant  to  section  three  hundred  sixty-four-j  of  the social
 services law and to drugs dispensed to Medicaid recipients who  are  not
 enrollees of such providers.
   (c)  [If  the drug utilization review board recommends a target rebate
 amount for a drug and the department is unable  to  negotiate  a  rebate
 from the manufacturer in an amount that is at least seventy-five percent
 of the target rebate amount, the commissioner is authorized to waive the
 provisions  of paragraph (b) of subdivision three of section two hundred
 seventy-three of this article and the provisions of  subdivisions  twen-
 ty-five  and  twenty-five-a of section three hundred sixty-four-j of the
 social services law with respect to  such  drug;  however,  this  waiver
 shall  not be implemented in situations where it would prevent access by
 a Medicaid recipient to a drug which is the only treatment for a partic-
 ular disease or condition. Under no circumstances shall the commissioner
 be authorized to waive such provisions with respect  to  more  than  two
 drugs in a given time.
   (d)]  Where  the  department  and  a  manufacturer enter into a rebate
 agreement pursuant to this section, which may be in addition to existing
 rebate agreements entered into by the manufacturer with respect  to  the
 same  drug,  no  additional  rebates shall be required to be paid by the
 manufacturer to a managed care provider or any of a managed care provid-
 er's agents, including but not limited to any pharmacy benefit  manager,
 while the department is collecting the rebate pursuant to this section.
   [(e)]  (D)  In formulating a recommendation concerning a target rebate
 amount for a drug, the drug utilization review board may consider:
   (i) publicly available information relevant  to  the  pricing  of  the
 drug;
 S. 8307--A                         38                         A. 8807--A
 
   (ii) information supplied by the department relevant to the pricing of
 the drug;
   (iii)  information  relating to value-based pricing provided, however,
 if the department directly invites any third party to  provide  cost-ef-
 fectiveness analysis or research related to value-based pricing, and the
 department  receives  and considers such analysis or research for use by
 the board, such third party shall disclose any  funding  sources.    The
 department  shall,  if  reasonably possible, make publicly available the
 following documents in its possession that it  relies  upon  to  provide
 cost  effectiveness analyses or research related to value-based pricing:
 (A) descriptions of underlying methodologies; (B) assumptions and  limi-
 tations  of  research findings; and (C) if available, data that presents
 results in a way that reflects different outcomes for affected  subpopu-
 lations;
   (iv)  the  seriousness and prevalence of the disease or condition that
 is treated by the drug;
   (v) the extent of utilization of the drug;
   (vi) the effectiveness of the drug  in  treating  the  conditions  for
 which  it  is prescribed, or in improving a patient's health, quality of
 life, or overall health outcomes;
   (vii) the likelihood that use of the drug will  reduce  the  need  for
 other medical care, including hospitalization;
   (viii) the average wholesale price, wholesale acquisition cost, retail
 price  of  the  drug,  and  the cost of the drug to the Medicaid program
 minus rebates received by the state;
   (ix) in the case  of  generic  drugs,  the  number  of  pharmaceutical
 manufacturers that produce the drug;
   (x) whether there are pharmaceutical equivalents to the drug; and
   (xi)  information supplied by the manufacturer, if any, explaining the
 relationship between the pricing of the drug and the cost of development
 of the drug and/or the therapeutic benefit  of  the  drug,  or  that  is
 otherwise  pertinent  to  the  manufacturer's pricing decision; any such
 information, INCLUDING THE INFORMATION ON THE  STANDARD  REPORTING  FORM
 REQUIREMENT  IN  PARAGRAPH  (E)  OF  SUBDIVISION  THREE OF THIS SECTION,
 provided shall be considered confidential and shall not be disclosed  by
 the  drug  utilization review board in a form that identifies a specific
 manufacturer or prices charged for drugs by such manufacturer.
   6. [(a) If the drug  utilization  review  board  recommends  a  target
 rebate  amount  or  if the commissioner identifies a drug as a high cost
 drug pursuant to subparagraph (vii) of paragraph (e) of subdivision 7 of
 section three hundred sixty-seven-a of the social services law  and  the
 department  is  unsuccessful  in entering into a rebate arrangement with
 the manufacturer of the drug satisfactory to the  department,  the  drug
 manufacturer  shall  in that event be required to provide to the depart-
 ment, on a standard reporting form  developed  by  the  department,  the
 following information:
   (i) the actual cost of developing, manufacturing, producing (including
 the cost per dose of production), and distributing the drug;
   (ii) research and development costs of the drug, including payments to
 predecessor  entities  conducting  research  and  development,  such  as
 biotechnology companies, universities and medical schools,  and  private
 research institutions;
   (iii)  administrative,  marketing, and advertising costs for the drug,
 apportioned by marketing activities  that  are  directed  to  consumers,
 marketing  activities  that  are  directed to prescribers, and the total
 cost of all marketing and advertising  that  is  directed  primarily  to
 S. 8307--A                         39                         A. 8807--A

 consumers  and  prescribers  in  New  York, including but not limited to
 prescriber detailing, copayment discount programs, and direct-to-consum-
 er marketing;
   (iv) the extent of utilization of the drug;
   (v)  prices  for  the  drug that are charged to purchasers outside the
 United States;
   (vi) prices charged to typical purchasers in the state, including  but
 not  limited  to  pharmacies,  pharmacy chains, pharmacy wholesalers, or
 other direct purchasers;
   (vii) the average rebates and discounts provided per payer type in the
 State; and
   (viii) the average profit margin of each drug over the prior five-year
 period and the projected profit margin anticipated for such drug.
   (b) All information disclosed pursuant to paragraph (a) of this subdi-
 vision shall be considered confidential and shall not  be  disclosed  by
 the  department  in  a  form  that identifies a specific manufacturer or
 prices charged for drugs by such manufacturer.
   7.] (a) [If, after] AFTER taking into account all rebates and  supple-
 mental rebates received by the department, including rebates received to
 date  pursuant  to  this  section[, total Medicaid drug expenditures are
 still projected to exceed the annual growth limitation imposed by subdi-
 vision two of this section], the commissioner may: subject any drug of a
 manufacturer referred to the drug utilization review  board  under  this
 section  to  prior  approval  in  accordance with existing processes and
 procedures when such manufacturer has not entered  into  a  supplemental
 rebate  arrangement  as  required by this section; direct a managed care
 plan to limit or reduce reimbursement for a drug provided by  a  medical
 practitioner  if  the  drug utilization review board recommends a target
 rebate amount for such drug and the manufacturer  has  failed  to  enter
 into  a rebate arrangement required by this section; direct managed care
 plans to remove from their Medicaid formularies any drugs of a  manufac-
 turer who has a drug that the drug utilization review board recommends a
 target rebate amount for and the manufacturer has failed to enter into a
 rebate  arrangement  required  by  this section; promote the use of cost
 effective and  clinically  appropriate  drugs  other  than  those  of  a
 manufacturer  who  has  a  drug  that  the drug utilization review board
 recommends a target rebate amount and the  manufacturer  has  failed  to
 enter into a rebate arrangement required by this section; allow manufac-
 turers  to  accelerate  rebate payments under existing rebate contracts;
 and such other actions as authorized by  law.  [The  commissioner  shall
 provide  written  notice  to the legislature thirty days prior to taking
 action pursuant to this paragraph, unless action  is  necessary  in  the
 fourth  quarter of a fiscal year to prevent total Medicaid drug expendi-
 tures from exceeding the limitation imposed by subdivision two  of  this
 section,  in  which case such notice to the legislature may be less than
 thirty days.]
   (b) The commissioner shall be authorized to take the actions described
 in paragraph (a) of this subdivision [only so  long  as  total  Medicaid
 drug  expenditures  are projected to exceed the annual growth limitation
 imposed by subdivision two  of  this  section].  In  addition,  no  such
 actions  shall be deemed to supersede the provisions of paragraph (b) of
 subdivision three of section two hundred seventy-three of  this  article
 or  the  provisions  of  subdivisions  twenty-five  and twenty-five-a of
 section three hundred sixty-four-j of the social services  law[,  except
 as  allowed  by  paragraph  (c)  of  subdivision  five of this section];
 provided further that nothing in this section shall prevent access by  a
 S. 8307--A                         40                         A. 8807--A
 
 Medicaid  recipient  to a drug which is the only treatment for a partic-
 ular disease or condition.
   [8.] 7. The commissioner, UPON REQUEST OF THE CHAIR OF THE DRUG UTILI-
 ZATION  REVIEW  BOARD, shall PROVIDE A report [by July first annually to
 the drug utilization review board] on savings achieved through the  drug
 cap  in  the  last  fiscal  year. Such report shall provide data on what
 savings were achieved [through actions pursuant to  subdivisions  three,
 five  and  seven  of  this  section, respectively, and what savings were
 achieved through other means] and how such savings were  calculated  and
 implemented.
   §  5.  Paragraph  (e)  of subdivision 7 of section 367-a of the social
 services law, as amended by section 1 of part GG of chapter  56  of  the
 laws  of  2020, the opening paragraph as amended by section 24 of part B
 of chapter 57 of the laws of 2023, is amended to read as follows:
   (e) During the period from April first, two thousand  fifteen  through
 March  thirty-first,  two  thousand twenty-six, the commissioner may, in
 lieu of a managed care provider or pharmacy benefit  manager,  negotiate
 directly and enter into an arrangement with a pharmaceutical manufactur-
 er  for the provision of supplemental rebates relating to pharmaceutical
 utilization by enrollees of managed care providers pursuant  to  section
 three hundred sixty-four-j of this title and may also negotiate directly
 and  enter into such an agreement relating to pharmaceutical utilization
 by medical assistance recipients not so enrolled. Such  rebate  arrange-
 ments shall be limited to the following: antiretrovirals approved by the
 FDA  for  the  treatment  of HIV/AIDS, ACCELERATED APPROVAL DRUGS ESTAB-
 LISHED PURSUANT TO SUBPARAGRAPH (IX) OF THIS PARAGRAPH,  opioid  depend-
 ence  agents  and  opioid  antagonists  listed  in a statewide formulary
 established pursuant to subparagraph (vii) of this paragraph,  hepatitis
 C agents, high cost drugs as provided for in subparagraph (viii) of this
 paragraph,  gene  therapies as provided for in subparagraph (ix) of this
 paragraph, and any other class or drug designated  by  the  commissioner
 for  which  the  pharmaceutical  manufacturer  has  in  effect  a rebate
 arrangement with the federal secretary  of  health  and  human  services
 pursuant to 42 U.S.C. § 1396r-8, and for which the state has established
 standard  clinical  criteria. No agreement entered into pursuant to this
 paragraph shall have an initial term or be extended beyond  the  expira-
 tion or repeal of this paragraph.
   (i) The manufacturer shall not enter into any rebate arrangements with
 a  managed  care  provider,  or any of a managed care provider's agents,
 including but not limited to any pharmacy benefit manager  on  the  gene
 therapy,  drug, or drug classes subject to this paragraph when the state
 has a rebate arrangement in place and  standard  clinical  criteria  are
 imposed on the managed care provider.
   (ii)  The commissioner shall establish adequate rates of reimbursement
 which shall take into account both the impact of the commissioner  nego-
 tiating  such  arrangements  and  any limitations imposed on the managed
 care provider's ability to establish clinical criteria relating  to  the
 utilization  of  such  drugs.  In developing the managed care provider's
 reimbursement rate,  the  commissioner  shall  identify  the  amount  of
 reimbursement  for  such drugs as a separate and distinct component from
 the reimbursement otherwise made for prescription drugs as prescribed by
 this section.
   (iii) [The commissioner shall submit a report to the temporary  presi-
 dent  of the senate and the speaker of the assembly annually by December
 thirty-first. The report shall analyze the adequacy of rates to  managed
 S. 8307--A                         41                         A. 8807--A

 care  providers  for drug expenditures related to the classes under this
 paragraph.
   (iv)]  Nothing in this paragraph shall be construed to require a phar-
 maceutical manufacturer to enter into a rebate arrangement  satisfactory
 to  the commissioner relating to pharmaceutical utilization by enrollees
 of managed care providers pursuant to section three hundred sixty-four-j
 of this title or  relating  to  pharmaceutical  utilization  by  medical
 assistance recipients not so enrolled.
   [(v)]  (IV)  All  clinical  criteria, including requirements for prior
 approval, and all utilization review determinations established  by  the
 state  as  described in this paragraph for the gene therapies, drugs, or
 drug  classes  subject  to  this  paragraph  shall  be  developed  using
 evidence-based  and peer-reviewed clinical review criteria in accordance
 with article two-A of the public health law, as applicable.
   [(vi)] (V) All prior authorization  and  utilization  review  determi-
 nations  related  to  the coverage of any drug subject to this paragraph
 shall be subject to article forty-nine of the public health law, section
 three hundred sixty-four-j of this title, and article forty-nine of  the
 insurance  law,  as applicable. Nothing in this paragraph shall diminish
 any rights relating to access, prior authorization, or  appeal  relating
 to  any  drug  class  or  drug  afforded  to a recipient under any other
 provision of law.
   [(vii)] (VI) The department shall publish  a  statewide  formulary  of
 opioid  dependence agents and opioid antagonists, which shall include as
 "preferred drugs" all drugs in such classes,  which  shall  include  all
 subclasses  of  a given drug that have a different pharmacological route
 of administration, provided that:
   (A) for all drugs that are included as of the date of the enactment of
 this subparagraph on a formulary of a managed care provider, as  defined
 in  section three hundred sixty-four-j of this title, or in the Medicaid
 fee-for-service preferred drug program pursuant to section  two  hundred
 seventy-two  of  the  public  health law, the cost to the department for
 such drug is equal to or less than the lowest cost paid for the drug  by
 any  managed  care  provider  or by the Medicaid fee-for-service program
 after the application of any rebates, as of the date that the department
 implements the statewide formulary  established  by  this  subparagraph.
 Where  there  is  a generic version of the drug approved by the Food and
 Drug Administration as bioequivalent to a brand name drug pursuant to 21
 U.S.C. § 355(j)(8)(B), the cost to the  department  for  the  brand  and
 generic  versions  shall  be  equal to or less than the lower of the two
 maximum costs determined pursuant to the previous sentence; and
   (B) for all drugs that are not included as of the date of  the  enact-
 ment  of this subparagraph on a formulary of a managed care provider, as
 defined in section three hundred sixty-four-j of this title, or  in  the
 Medicaid  fee-for-service preferred drug program pursuant to section two
 hundred seventy-two of the public health law, the department is able  to
 obtain  the drug at a cost that is equal to or less than the lowest cost
 to the department of other comparable drugs  in  the  class,  after  the
 application of any rebates. Where there is a generic version of the drug
 approved by the Food and Drug Administration as bioequivalent to a brand
 name  drug pursuant to 21 U.S.C. § 355(j)(8)(B), the cost to the depart-
 ment for the brand and generic versions shall be equal to or  less  than
 the  lower  of the two maximum costs determined pursuant to the previous
 sentence.
   [(viii)] (VII) The commissioner  may  identify  and  refer  high  cost
 drugs,  as  defined  in  clause  (D)  of this subparagraph, that are not
 S. 8307--A                         42                         A. 8807--A
 
 included as of the date of the  enactment  of  this  subparagraph  on  a
 formulary  of a managed care provider or covered by the Medicaid fee for
 service of program to the drug utilization review board  established  by
 section three hundred sixty-nine-bb of this article for a recommendation
 as  to  whether  a target supplemental Medicaid rebate should be paid by
 the manufacturer of the drug to the department and the target amount  of
 the rebate.
   (A)  If the commissioner intends to refer a high cost drug to the drug
 utilization review board pursuant to this subparagraph, the commissioner
 shall notify the manufacturer of such drug and shall  attempt  to  reach
 agreement  with the manufacturer on a rebate arrangement satisfactory to
 the commissioner for the drug prior to referring the drug  to  the  drug
 utilization  review  board  for review. Such arrangement may be based on
 evidence based research, including, but not limited  to,  such  research
 operated  or  conducted  by  or for other state governments, the federal
 government, the governments of other nations, and third party payers  or
 multi-state  coalitions,  provided  however  that  the  department shall
 account for the effectiveness of the drug in treating the conditions for
 which it is prescribed or in improving a patient's  health,  quality  of
 life,  or  overall  health  outcomes, and the likelihood that use of the
 drug will reduce the need for other medical care, including hospitaliza-
 tion.
   (B) In the event that  the  commissioner  and  the  manufacturer  have
 previously  agreed  to  a rebate arrangement for a drug pursuant to this
 paragraph, the drug shall not be referred to the drug utilization review
 board for any further rebate agreement for the duration of the  previous
 rebate agreement, provided however, the commissioner may refer a drug to
 the  drug  utilization review board if the commissioner determines there
 are significant and substantiated utilization  or  market  changes,  new
 evidence-based research, or statutory or federal regulatory changes that
 warrant  additional  rebates. In such cases, the department shall notify
 the manufacturer and provide evidence of the changes  or  research  that
 would  warrant  additional rebates, and shall attempt to reach agreement
 with the manufacturer on a rebate for the drug prior  to  referring  the
 drug to the drug utilization review board for review.
   (C)  If  the  commissioner  is  unsuccessful in entering into a rebate
 arrangement with the  manufacturer  of  the  drug  satisfactory  to  the
 department,  the  drug  manufacturer  shall in that event be required to
 provide to the department, on a standard reporting form developed by the
 department, the information as described in PARAGRAPH (E) OF subdivision
 [six] THREE of section two hundred eighty of the public health law.  All
 information disclosed pursuant to this clause shall be considered confi-
 dential  and  shall  not  be  disclosed by the department in a form that
 identifies a specific manufacturer or prices charged for drugs  by  such
 manufacturer.
   (D)  For  the purposes of this subparagraph, the term "high cost drug"
 shall mean a brand name drug or biologic that  has  a  launch  wholesale
 acquisition  cost  of thirty thousand dollars or more per year or course
 of treatment, or a biosimilar drug that has a launch wholesale  acquisi-
 tion cost that is not at least fifteen percent lower than the referenced
 brand biologic at the time the biosimilar is launched, or a generic drug
 that has a wholesale acquisition cost of one hundred dollars or more for
 a  thirty  day supply or recommended dosage approved for labeling by the
 federal Food and Drug Administration, or a brand name drug  or  biologic
 that has a wholesale acquisition cost increase of three thousand dollars
 S. 8307--A                         43                         A. 8807--A
 
 or  more in any twelve-month period, or course of treatment if less than
 twelve months.
   [(ix)]  (VIII)  For  purposes of this paragraph, a "gene therapy" is a
 drug (A) approved under section  505  of  the  Federal  Food,  Drug  and
 Cosmetics  Act or licensed under subsection (a) or (k) of section 351 of
 the Public Health Services Act; (B) that treats a rare disease or condi-
 tion, as defined in 21 USC § 360bb(a)(2), that is  life-threatening,  as
 defined in 42 CFR 321.18; (C) is considered a gene therapy by the feder-
 al  Food  and Drug Administration for which a biologics license pursuant
 to 21 CFR 600-680 is held; (D) if administered in  accordance  with  the
 labeling  of such drug, is expected to result in either the cure of such
 disease or condition or a reduction in the symptoms of such  disease  or
 condition  that  materially  improves the patient's length or quality of
 life; and (E) is expected to achieve the result described in clause  (D)
 of this subparagraph after not more than three administrations.
   (IX)  FOR  PURPOSES  OF THIS PARAGRAPH, AN "ACCELERATED APPROVAL" IS A
 DRUG OR LABELED INDICATION OF A DRUG AUTHORIZED  BY  THE  FEDERAL  FOOD,
 DRUG  AND  COSMETIC  ACT  FOR  DRUGS FOR SERIOUS CONDITIONS THAT FILL AN
 UNMET MEDICAL NEED BASED ON WHETHER THE DRUG HAS AN EFFECT ON  A  SURRO-
 GATE  CLINICAL  ENDPOINT,  AND  CONTINGENT UPON VERIFICATION OF CLINICAL
 BENEFIT IN CONFIRMATORY TRIALS.
   § 6. 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, prosthetic  appliances  and  dental
 prosthetic  appliances  furnished  in accordance with the regulations 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 preferred
 manufacturers [of] FOR PRODUCTS AND SUPPLIES, INCLUDING BUT NOT  LIMITED
 TO,  glucometers and test strips, and may subject non-preferred manufac-
 turers' PRODUCTS AND SUPPLIES, INCLUDING BUT NOT LIMITED TO, glucometers
 and test strips to prior authorization under section two hundred  seven-
 ty-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;
 S. 8307--A                         44                         A. 8807--A
 
   § 7. The public health law is amended by adding a new section 280-d to
 read as follows:
   §  280-D. PHARMACY COST REPORTING. 1. THE DEPARTMENT SHALL DEVELOP AND
 IMPLEMENT A COST REPORTING PROGRAM FOR LICENSED PHARMACIES THAT  PARTIC-
 IPATE  IN THE MEDICAID PROGRAM. SUCH PROGRAM SHALL INCLUDE A REQUIREMENT
 TO SUBMIT AN ANNUAL COST REPORT  ON A FORM DESIGNATED BY THE DEPARTMENT.
 INFORMATION SHALL INCLUDE, BUT NOT BE LIMITED TO, COSTS INCURRED  DURING
 PROCUREMENT AND DISPENSING OF PRESCRIPTION DRUGS.
   2.  SUCH  COST  REPORTS  ARE  SUBJECT  TO AUDIT. IN THE EVENT THAT ANY
 INFORMATION OR DATA WHICH A PHARMACY HAS SUBMITTED TO THE DEPARTMENT, ON
 THE  REQUIRED REPORTING FORMS IS INACCURATE OR INCORRECT, SUCH  PHARMACY
 SHALL   WITHIN  FIFTEEN  BUSINESS  DAYS,  SUBMIT  TO  THE  DEPARTMENT  A
 CORRECTION OF SUCH INFORMATION OR DATA.
   3. TIMELY FILING OF SUCH REPORT IS A REQUIREMENT OF  PARTICIPATION  IN
 THE  MEDICAID  PHARMACY  PROGRAM.  IN THE EVENT THAT A PHARMACY FAILS TO
 FILE THE REQUIRED REPORTS ON OR BEFORE THE REQUIRED DUE DATE, SUCH PHAR-
 MACY MAY BE SUBJECT TO REMOVAL AS A PROVIDER  FROM  THE  FEE-FOR-SERVICE
 PHARMACY PROGRAM.
   §  8. Paragraphs (a), (b) and (c) of subdivision 9 of section 367-a of
 the social services law, paragraphs (a) and (c) as amended by chapter 19
 of the laws of 1998, paragraph (b) as amended by section 3 of part C  of
 chapter  58 of the laws of 2004, subparagraphs (i) and (ii) of paragraph
 (b) as amended by section 7 of part D of chapter 57 of the laws of 2017,
 and subparagraph (iii) of paragraph (b) as added by section 29 of part E
 of chapter 63 of the laws of 2005, are amended to read as follows:
   (a) for drugs provided by medical practitioners and claimed separately
 by the practitioners[, the actual cost of the drugs to  the  practition-
 ers; and] THE LOWER OF:
   (I)  (1) AN AMOUNT EQUAL TO THE NATIONAL AVERAGE DRUG ACQUISITION COST
 SET BY THE FEDERAL CENTERS FOR MEDICARE AND MEDICAID  SERVICES  FOR  THE
 DRUG, IF ANY, OR IF SUCH AMOUNT IS NOT AVAILABLE, THE WHOLESALE ACQUISI-
 TION  COST  OF  THE  DRUG  BASED  ON THE PACKAGE SIZE DISPENSED FROM, AS
 REPORTED BY THE PRESCRIPTION DRUG PRICING SERVICE USED  BY  THE  DEPART-
 MENT,  (2)  THE  FEDERAL UPPER LIMIT, IF ANY, ESTABLISHED BY THE FEDERAL
 CENTERS FOR MEDICARE AND MEDICAID SERVICES; (3) THE STATE MAXIMUM ACQUI-
 SITION COST, IF ANY, ESTABLISHED  PURSUANT  TO  PARAGRAPH  (E)  OF  THIS
 SUBDIVISION; OR (4) THE ACTUAL COST OF THE DRUG TO THE PRACTITIONER.
   (II) NOTWITHSTANDING SUBPARAGRAPH (I) AND PARAGRAPH (E) OF THIS SUBDI-
 VISION,  IF  A  DRUG HAS BEEN PURCHASED FROM A MANUFACTURER BY A COVERED
 ENTITY PURSUANT TO SECTION 340B OF THE FEDERAL PUBLIC HEALTH SERVICE ACT
 (42 USCA § 256B), THE ACTUAL AMOUNT PAID BY  SUCH  COVERED  ENTITY.  FOR
 PURPOSES  OF  THIS  SUBPARAGRAPH,  A  "COVERED ENTITY" IS AN ENTITY THAT
 MEETS THE REQUIREMENTS OF PARAGRAPH  FOUR  OF  SUBSECTION  (A)  OF  SUCH
 SECTION,  THAT  ELECTS TO PARTICIPATE IN THE PROGRAM ESTABLISHED BY SUCH
 SECTION, AND THAT CAUSES CLAIMS FOR PAYMENT FOR DRUGS  COVERED  BY  THIS
 SUBPARAGRAPH  TO  BE SUBMITTED TO THE MEDICAL ASSISTANCE PROGRAM, EITHER
 DIRECTLY OR THROUGH AN AUTHORIZED CONTRACT PHARMACY. NO MEDICAL  ASSIST-
 ANCE  PAYMENTS  MAY  BE  MADE  TO  A  COVERED ENTITY OR TO AN AUTHORIZED
 CONTRACT PHARMACY OF A COVERED ENTITY FOR DRUGS THAT  ARE  ELIGIBLE  FOR
 PURCHASE  UNDER  THE SECTION 340B PROGRAM AND ARE DISPENSED ON AN OUTPA-
 TIENT BASIS TO PATIENTS OF THE COVERED  ENTITY,  OTHER  THAN  UNDER  THE
 PROVISIONS OF THIS SUBPARAGRAPH.
   (b) for drugs dispensed by pharmacies:
   (i)  (A)  if  the  drug  dispensed is a generic prescription drug, the
 lower of: (1) an amount equal to the national average  drug  acquisition
 cost  set  by the federal centers for medicare and medicaid services for
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 the drug, if any, or if such amount  if  not  available,  the  wholesale
 acquisition  cost  of the drug based on the package size dispensed from,
 as reported by the prescription drug pricing service used by the depart-
 ment, less seventeen and one-half percent thereof; (2) the federal upper
 limit, if any, established by the federal centers for medicare and medi-
 caid  services;  (3)  the state maximum acquisition cost, if any, estab-
 lished pursuant to  paragraph  (e)  of  this  subdivision;  or  (4)  the
 dispensing  pharmacy's  usual and customary price charged to the general
 public; (B) if the drug dispensed is available without a prescription as
 required by section sixty-eight hundred ten of the education law but  is
 reimbursed as an item of medical assistance pursuant to paragraph (a) of
 subdivision  four  of  section three hundred sixty-five-a of this title,
 the lower of (1) an amount equal to the national average  drug  acquisi-
 tion  cost set by the federal centers for medicare and medicaid services
 for the drug, if any, or if such amount is not available, the  wholesale
 acquisition  cost  of the drug based on the package size dispensed from,
 as reported by the prescription drug pricing service used by the depart-
 ment, (2) the federal upper limit, if any, established  by  the  federal
 centers for medicare and medicaid services; (3) the state maximum acqui-
 sition cost if any, established pursuant to paragraph (e) of this subdi-
 vision;  or  (4)  the  dispensing  pharmacy's  usual and customary price
 charged to the general public;
   (ii) if the drug dispensed is  a  brand-name  prescription  drug,  the
 lower of:
   (A)  an amount equal to the national average drug acquisition cost set
 by the federal centers for medicare and medicaid services for the  drug,
 if  any,  or  if such amount is not available, the wholesale acquisition
 cost of the drug based on the package size dispensed from,  as  reported
 by  the  prescription drug pricing service used by the department[, less
 three and three-tenths percent thereof]; or (B) the  dispensing  pharma-
 cy's usual and customary price charged to the general public; and
   (iii) notwithstanding subparagraphs (i) and (ii) of this paragraph and
 paragraphs  (d)  and (e) of this subdivision, if the drug dispensed is a
 drug that has been purchased from a manufacturer  by  a  covered  entity
 pursuant  to  section  340B of the federal public health service act (42
 USCA § 256b), the actual amount paid by such covered entity pursuant  to
 such section, plus the reasonable administrative costs, as determined by
 the  commissioner,  incurred  by  the covered entity or by an authorized
 contract pharmacy in connection with the purchase and dispensing of such
 drug and the tracking of such transactions. For purposes of this subpar-
 agraph, a "covered entity" is an entity that meets the  requirements  of
 paragraph four of subsection (a) of such section, that elects to partic-
 ipate in the program established by such section, and that causes claims
 for  payment  for  drugs covered by this subparagraph to be submitted to
 the medical assistance program, either directly or through an authorized
 contract pharmacy. No medical assistance  payments  may  be  made  to  a
 covered entity or to an authorized contract pharmacy of a covered entity
 for  drugs that are eligible for purchase under the section 340B program
 and are dispensed on an outpatient basis  to  patients  of  the  covered
 entity, other than under the provisions of this subparagraph. Pharmacies
 submitting  claims  for  reimbursement  of  drugs  purchased pursuant to
 section 340B of the public health service act shall notify  the  depart-
 ment  that  the  claim  is eligible for purchase under the 340B program,
 consistent with claiming instructions issued by the department to  iden-
 tify such claims.
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   (c) Notwithstanding subparagraph (i) of paragraph (b) of this subdivi-
 sion, if a qualified prescriber certifies "brand medically necessary" or
 "brand  necessary" in his or her own handwriting directly on the face of
 a prescription, OR IN THE CASE OF ELECTRONIC PRESCRIPTIONS,  INSERTS  AN
 ELECTRONIC  DIRECTION  TO  CLARIFY "BRAND MEDICALLY NECESSARY" OR "BRAND
 NECESSARY", for a multiple source drug for which a specific upper  limit
 of reimbursement has been established by the federal agency, in addition
 to  writing  "d  a  w"  in  the  box  provided  for  such purpose on the
 prescription form, payment under this title for such drug must  be  made
 under the provisions of subparagraph (ii) of such paragraph.
   § 9. This act  shall  take  effect  October  1,  2024;  provided  that
 sections  two  and  three of this act shall take effect January 1, 2025;
 and provided however, that the amendments to paragraph (e)  of  subdivi-
 sion  7 of section 367-a of the social services law made by section five
 of this act shall not affect the repeal of such paragraph and  shall  be
 deemed  repealed  therewith  provided,  further,  that the amendments to
 subdivision 9 of section 367-a  of  the  social  services  law  made  by
 section eight of this act shall not affect the expiration of such subdi-
 vision  pursuant  to  section  4  of  chapter 19 of the laws of 1998, as
 amended, and shall expire therewith.
 
                                  PART J
 
   Section 1. The title heading of title 11-D of article 5 of the  social
 services  law,  as  amended  by section 1 of part H of chapter 57 of the
 laws of 2021, is amended to read as follows:
                    [BASIC HEALTH PROGRAM] ESSENTIAL PLAN
   § 2. Section 3 of part H of chapter 57 of the laws of  2021,  amending
 the  social  services  law relating to eliminating consumer-paid premium
 payments in the basic health program, is amended to read as follows:
   § 3. This act shall take effect June 1, 2021 [and]; PROVIDED, HOWEVER,
 SECTION TWO OF THIS ACT shall  expire  and  be  deemed  repealed  should
 federal  approval  be withdrawn or 42 U.S.C. 18051 be repealed; provided
 that the commissioner of health shall notify the legislative bill draft-
 ing commission upon the withdrawal of federal approval or the repeal  of
 42  U.S.C.  18051  in order that the commission may maintain an accurate
 and timely effective data base of the official text of the laws  of  the
 state  of  New  York  in  furtherance  of effectuating the provisions of
 section 44 of the legislative law and section 70-b of the  public  offi-
 cers law.
   §  3.  Subdivisions (b) and (c) of section 8 of part BBB of chapter 56
 of the laws of 2022, amending the  public  health  law  and  other  laws
 relating  to  permitting  the  commissioner of health to submit a waiver
 that expands  eligibility  for  New  York's  basic  health  program  and
 increases the federal poverty limit cap for basic health  program eligi-
 bility  from   two hundred to two hundred  fifty percent, are amended to
 read as follows:
   (b) section four of this act  shall  expire  and  be  deemed  repealed
 December 31, [2024] 2025; provided, however, the amendments to paragraph
 (c)  of  subdivision 1 of section 369-gg of the social services law made
 by such section of this act shall  be  subject  to  the  expiration  and
 reversion  of  such paragraph pursuant to section 2 of part H of chapter
 57 of the laws of 2021 when upon such date, the  provisions  of  section
 five of this act shall take effect; provided, however, the amendments to
 such  paragraph  made  by  section  five of this act shall expire and be
 deemed repealed December 31, [2024] 2025;
 S. 8307--A                         47                         A. 8807--A
 
   (c) section six of this act shall take effect January 1, [2025]  2026;
 provided,  however,  the amendments to paragraph (c) of subdivision 1 of
 section 369-gg of the social services law made by such section  of  this
 act  shall  be subject to the expiration and reversion of such paragraph
 pursuant  to  section 2 of part H of chapter 57 of the laws of 2021 when
 upon such date, the provisions of section seven of this act  shall  take
 effect; and
   §  4.  Paragraph  (a)  of subdivision 1 of section 268-c of the public
 health law, as added by section 2 of part T of chapter 57 of the laws of
 2019, is amended to read as follows:
   (a) Perform eligibility determinations for federal and state insurance
 affordability programs including medical assistance in  accordance  with
 section three hundred sixty-six of the social services law, child health
 plus in accordance with section twenty-five hundred eleven of this chap-
 ter,  the  basic health program in accordance with section three hundred
 sixty-nine-gg of the social services  law,  THE  1332  STATE  INNOVATION
 PROGRAM  IN  ACCORDANCE  WITH SECTION THREE HUNDRED SIXTY-NINE-II OF THE
 SOCIAL SERVICES LAW, premium tax credits and cost-sharing reductions and
 qualified health plans in  accordance  with  applicable  law  and  other
 health insurance programs as determined by the commissioner;
   §  5.  Subdivision  16  of  section 268-c of the public health law, as
 added by section 2 of part T of chapter 57  of  the  laws  of  2019,  is
 amended to read as follows:
   16.  In accordance with applicable federal and state law, inform indi-
 viduals of eligibility requirements for the Medicaid program under title
 XIX of the social security act and the social services  law,  the  chil-
 dren's  health  insurance  program  (CHIP) under title XXI of the social
 security act and this chapter, the basic health  program  under  section
 three  hundred  sixty-nine-gg of the social services law, THE 1332 STATE
 INNOVATION PROGRAM IN ACCORDANCE WITH SECTION THREE HUNDRED  SIXTY-NINE-
 II  OF  THE SOCIAL SERVICES LAW, or any applicable state or local public
 health insurance program and if, through screening of the application by
 the Marketplace, the Marketplace determines that  such  individuals  are
 eligible for any such program, enroll such individuals in such program.
   § 6. Section 268-c of the public health law is amended by adding a new
 subdivision 26 to read as follows:
   26.  SUBJECT  TO  FEDERAL APPROVAL IF REQUIRED, THE USE OF STATE FUNDS
 AND THE AVAILABILITY OF FUNDS IN THE 1332 STATE INNOVATION PROGRAM  FUND
 ESTABLISHED PURSUANT TO SECTION NINETY-EIGHT-D OF THE STATE FINANCE LAW,
 THE  COMMISSIONER  SHALL  HAVE  THE  AUTHORITY TO ESTABLISH A PROGRAM TO
 PROVIDE SUBSIDIES FOR THE PAYMENT OF PREMIUM OR COST SHARING OR BOTH  TO
 ASSIST  INDIVIDUALS  WHO ARE ELIGIBLE TO PURCHASE QUALIFIED HEALTH PLANS
 THROUGH THE MARKETPLACE, OR TAKE SUCH OTHER  ACTION  AS  APPROPRIATE  TO
 REDUCE  OR  ELIMINATE  QUALIFIED HEALTH PLAN PREMIUMS OR COST-SHARING OR
 BOTH.
   § 7. Subparagraph (i) of paragraph (a) of  subdivision  4  of  section
 268-e of the public health law, as added by section 2 of part T of chap-
 ter 57 of the laws of 2019, is amended to read as follows:
   (i) An initial determination of eligibility, including:
   (A) eligibility to enroll in a qualified health plan;
   (B) eligibility for Medicaid;
   (C) eligibility for Child Health Plus;
   (D) eligibility for the Basic Health Program;
   (E) ELIGIBILITY FOR THE 1332 STATE INNOVATION PROGRAM;
   (F) the amount of advance payments of the premium tax credit and level
 of cost-sharing reductions;
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   [(F)]  (G) the amount of any other subsidy that may be available under
 law; and
   [(G)]  (H)  eligibility  for  such  other health insurance programs as
 determined by the commissioner; and
   § 8. Section 268 of the public health law, as added by  section  2  of
 part T of chapter 57 of the laws of 2019, is amended to read as follows:
   The purpose of this title is to codify the establishment of the health
 benefit  exchange in New York, known as NY State of Health, The Official
 Health Plan Marketplace (Marketplace),  in  conformance  with  Executive
 Order  42  (Cuomo) issued April 12, 2012. The Marketplace shall continue
 to perform eligibility determinations for federal  and  state  insurance
 affordability  programs  including medical assistance in accordance with
 section three hundred sixty-six of the social services law, child health
 plus in accordance with section twenty-five hundred eleven of this chap-
 ter, the basic health program in accordance with section  three  hundred
 sixty-nine-gg  of  the  social  services  law, THE 1332 STATE INNOVATION
 PROGRAM IN ACCORDANCE WITH SECTION THREE HUNDRED  SIXTY-NINE-II  OF  THE
 SOCIAL SERVICE LAW, and premium tax credits and cost-sharing reductions,
 together with performing eligibility determinations for qualified health
 plans  and  such  other  health  insurance programs as determined by the
 commissioner. The Marketplace shall also facilitate enrollment in insur-
 ance affordability programs, qualified health  plans  and  other  health
 insurance  programs  as determined by the commissioner, the purchase and
 sale of qualified health plans and/or other or additional  health  plans
 certified  by the Marketplace pursuant to this title, and shall continue
 to have the authority to operate a small business health options program
 ("SHOP") to assist  eligible  small  employers  in  selecting  qualified
 health  plans  and/or  other or additional health plans certified by the
 Marketplace and to determine small employer eligibility for purposes  of
 small  employer  tax  credits.  It  is the intent of the legislature, by
 codifying the Marketplace in state statute, to continue to promote qual-
 ity and affordable health coverage and care, reduce the number of  unin-
 sured  persons, provide a transparent marketplace, educate consumers and
 assist individuals with access to coverage, premium assistance tax cred-
 its and cost-sharing reductions. In addition, the  legislature  declares
 the  intent that the Marketplace continue to be properly integrated with
 insurance affordability programs, including Medicaid, child health  plus
 and  the  basic  health  program, THE 1332 STATE INNOVATION PROGRAM, and
 such other health insurance programs as determined by the commissioner.
   § 9. Subdivision 8 of section 268-a of the public health law, as added
 by section 2 of part T of chapter 57 of the laws of 2019, is  amened  to
 read as follows:
   8.  "Insurance  affordability  program"  means  Medicaid, child health
 plus, the basic health program, THE 1332 STATE INNOVATION PROGRAM, post-
 partum extended coverage and any other health insurance subsidy  program
 designated as such by the commissioner.
   §  10.  This  act shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024; provided,
 however, that section six of this act shall only take  effect  upon  the
 commissioner of health obtaining and maintaining all necessary approvals
 from the secretary of health and human services and the secretary of the
 treasury  based  on  an amended application for a waiver for state inno-
 vation pursuant to section 1332 of the patient protection and affordable
 care act (P.L. 111-148) and subdivision  25  of  section  268-c  of  the
 public  health  law;  and  provided,  further,  that the commissioner of
 health shall notify the legislative bill drafting  commission  upon  the
 S. 8307--A                         49                         A. 8807--A
 
 occurrence  of  the enactment of the legislation provided for in section
 six of this act in order that the commission may  maintain  an  accurate
 and  timely  effective data base of the official text of the laws of the
 state  of  New  York  in  furtherance  of effectuating the provisions of
 section 44 of the legislative law and section 70-b of the  public  offi-
 cers law.
 
                                  PART K
 
   Section 1. Paragraph (a) of subdivision 1 of section 18 of chapter 266
 of the laws of 1986, amending the civil practice law and rules and other
 laws  relating  to  malpractice  and  professional  medical  conduct, as
 amended by section 1 of part F of chapter 57 of the  laws  of  2023,  is
 amended and a new subdivision 9 is added to read as follows:
   (a)  The  superintendent of financial services and the commissioner of
 health or their designee shall, from funds  available  in  the  hospital
 excess liability pool created pursuant to subdivision 5 of this section,
 purchase  a policy or policies for excess insurance coverage, as author-
 ized by paragraph 1 of subsection (e) of section 5502 of  the  insurance
 law; or from an insurer, other than an insurer described in section 5502
 of the insurance law, duly authorized to write such coverage and actual-
 ly  writing  medical  malpractice  insurance  in  this  state;  or shall
 purchase equivalent excess coverage in a form previously approved by the
 superintendent of financial services for purposes  of  providing  equiv-
 alent  excess  coverage  in accordance with section 19 of chapter 294 of
 the laws of 1985, for medical or dental malpractice occurrences  between
 July  1, 1986 and June 30, 1987, between July 1, 1987 and June 30, 1988,
 between July 1, 1988 and June 30, 1989, between July 1,  1989  and  June
 30,  1990,  between July 1, 1990 and June 30, 1991, between July 1, 1991
 and June 30, 1992, between July 1, 1992 and June 30, 1993, between  July
 1,  1993  and  June  30,  1994,  between July 1, 1994 and June 30, 1995,
 between July 1, 1995 and June 30, 1996, between July 1,  1996  and  June
 30,  1997,  between July 1, 1997 and June 30, 1998, between July 1, 1998
 and June 30, 1999, between July 1, 1999 and June 30, 2000, between  July
 1,  2000  and  June  30,  2001,  between July 1, 2001 and June 30, 2002,
 between July 1, 2002 and June 30, 2003, between July 1,  2003  and  June
 30,  2004,  between July 1, 2004 and June 30, 2005, between July 1, 2005
 and June 30, 2006, between July 1, 2006 and June 30, 2007, between  July
 1,  2007  and  June  30,  2008,  between July 1, 2008 and June 30, 2009,
 between July 1, 2009 and June 30, 2010, between July 1,  2010  and  June
 30,  2011,  between July 1, 2011 and June 30, 2012, between July 1, 2012
 and June 30, 2013, between July 1, 2013 and June 30, 2014, between  July
 1,  2014  and  June  30,  2015,  between July 1, 2015 and June 30, 2016,
 between July 1, 2016 and June 30, 2017, between July 1,  2017  and  June
 30,  2018,  between July 1, 2018 and June 30, 2019, between July 1, 2019
 and June 30, 2020, between July 1, 2020 and June 30, 2021, between  July
 1, 2021 and June 30, 2022, between July 1, 2022 and June 30, 2023, [and]
 between  July  1,  2023  and June 30, 2024, AND BETWEEN JULY 1, 2024 AND
 JUNE 30, 2025 or reimburse the hospital  where  the  hospital  purchases
 equivalent  excess  coverage as defined in subparagraph (i) of paragraph
 (a) of subdivision 1-a of this section for medical or dental malpractice
 occurrences between July 1, 1987 and June 30, 1988, between July 1, 1988
 and June 30, 1989, between July 1, 1989 and June 30, 1990, between  July
 1,  1990  and  June  30,  1991,  between July 1, 1991 and June 30, 1992,
 between July 1, 1992 and June 30, 1993, between July 1,  1993  and  June
 30,  1994,  between July 1, 1994 and June 30, 1995, between July 1, 1995
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 and June 30, 1996, between July 1, 1996 and June 30, 1997, between  July
 1,  1997  and  June  30,  1998,  between July 1, 1998 and June 30, 1999,
 between July 1, 1999 and June 30, 2000, between July 1,  2000  and  June
 30,  2001,  between July 1, 2001 and June 30, 2002, between July 1, 2002
 and June 30, 2003, between July 1, 2003 and June 30, 2004, between  July
 1,  2004  and  June  30,  2005,  between July 1, 2005 and June 30, 2006,
 between July 1, 2006 and June 30, 2007, between July 1,  2007  and  June
 30,  2008,  between July 1, 2008 and June 30, 2009, between July 1, 2009
 and June 30, 2010, between July 1, 2010 and June 30, 2011, between  July
 1,  2011  and  June  30,  2012,  between July 1, 2012 and June 30, 2013,
 between July 1, 2013 and June 30, 2014, between July 1,  2014  and  June
 30,  2015,  between July 1, 2015 and June 30, 2016, between July 1, 2016
 and June 30, 2017, between July 1, 2017 and June 30, 2018, between  July
 1,  2018  and  June  30,  2019,  between July 1, 2019 and June 30, 2020,
 between July 1, 2020 and June 30, 2021, between July 1,  2021  and  June
 30,  2022, between July 1, 2022 and June 30, 2023, [and] between July 1,
 2023 and June 30, 2024, AND BETWEEN JULY 1, 2024 AND JUNE 30,  2025  for
 physicians  or  dentists  certified  as eligible for each such period or
 periods pursuant to subdivision 2 of this section by a general  hospital
 licensed  pursuant to article 28 of the public health law; provided that
 no single insurer shall write more  than  fifty  percent  of  the  total
 excess premium for a given policy year; and provided, however, that such
 eligible physicians or dentists must have in force an individual policy,
 from  an insurer licensed in this state of primary malpractice insurance
 coverage in amounts of no less than one million three  hundred  thousand
 dollars  for  each  claimant  and  three  million  nine hundred thousand
 dollars for all claimants under that policy during the  period  of  such
 excess  coverage  for  such  occurrences  or  be  endorsed as additional
 insureds under a hospital professional liability policy which is offered
 through a voluntary attending physician ("channeling") program previous-
 ly permitted by the superintendent  of  financial  services  during  the
 period of such excess coverage for such occurrences. During such period,
 such  policy  for  excess  coverage  or  such equivalent excess coverage
 shall, when combined with the physician's or dentist's primary  malprac-
 tice insurance coverage or coverage provided through a voluntary attend-
 ing  physician  ("channeling")  program, total an aggregate level of two
 million three hundred thousand dollars for each claimant and six million
 nine hundred thousand dollars for all claimants from all  such  policies
 with  respect to occurrences in each of such years provided, however, if
 the cost of primary malpractice insurance  coverage  in  excess  of  one
 million  dollars,  but  below  the  excess medical malpractice insurance
 coverage provided pursuant to this act, exceeds the rate of nine percent
 per annum, then the required  level  of  primary  malpractice  insurance
 coverage  in excess of one million dollars for each claimant shall be in
 an amount of not less than the dollar amount of such coverage  available
 at  nine  percent per annum; the required level of such coverage for all
 claimants under that policy shall be in an amount not  less  than  three
 times the dollar amount of coverage for each claimant; and excess cover-
 age,  when  combined  with  such primary malpractice insurance coverage,
 shall increase the aggregate level for  each  claimant  by  one  million
 dollars  and  three  million  dollars  for  all  claimants; and provided
 further, that, with respect to policies of primary  medical  malpractice
 coverage  that  include  occurrences  between April 1, 2002 and June 30,
 2002, such requirement that coverage be in  amounts  no  less  than  one
 million  three  hundred  thousand  dollars  for  each claimant and three
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 million nine hundred thousand dollars for all claimants for such  occur-
 rences shall be effective April 1, 2002.
   (9)  THIS SUBDIVISION SHALL APPLY ONLY TO EXCESS INSURANCE COVERAGE OR
 EQUIVALENT EXCESS COVERAGE FOR PHYSICIANS OR DENTISTS THAT  IS  ELIGIBLE
 TO  BE  PAID  FOR  FROM FUNDS AVAILABLE IN THE HOSPITAL EXCESS LIABILITY
 POOL.
   (A) NOTWITHSTANDING ANY LAW TO THE CONTRARY,  FOR  ANY  POLICY  PERIOD
 BEGINNING  ON  OR AFTER JULY 1, 2023, EXCESS COVERAGE SHALL BE PURCHASED
 BY A PHYSICIAN OR DENTIST DIRECTLY FROM A PROVIDER OF  EXCESS  INSURANCE
 COVERAGE  OR EQUIVALENT EXCESS COVERAGE. AT THE CONCLUSION OF THE POLICY
 PERIOD THE SUPERINTENDENT OF FINANCIAL SERVICES AND THE COMMISSIONER  OF
 HEALTH  OR  THEIR  DESIGNEE  SHALL, FROM FUNDS AVAILABLE IN THE HOSPITAL
 EXCESS LIABILITY POOL CREATED PURSUANT TO SUBDIVISION 5 OF THIS SECTION,
 PAY FIFTY PERCENT OF THE PREMIUM TO THE  PROVIDER  OF  EXCESS  INSURANCE
 COVERAGE  OR EQUIVALENT EXCESS COVERAGE, AND THE REMAINING FIFTY PERCENT
 SHALL BE PAID ONE YEAR THEREAFTER.
   (B) NOTWITHSTANDING ANY LAW TO THE CONTRARY,  FOR  ANY  POLICY  PERIOD
 BEGINNING  ON  OR AFTER JULY 1, 2024, EXCESS COVERAGE SHALL BE PURCHASED
 BY A PHYSICIAN OR DENTIST DIRECTLY FROM A PROVIDER OF  EXCESS  INSURANCE
 COVERAGE  OR  EQUIVALENT EXCESS COVERAGE. SUCH PROVIDER OF EXCESS INSUR-
 ANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE  SHALL  BILL,  IN  A  MANNER
 CONSISTENT  WITH  PARAGRAPH  (F)  OF  THIS SUBDIVISION, THE PHYSICIAN OR
 DENTIST FOR AN AMOUNT EQUAL TO FIFTY PERCENT OF  THE  PREMIUM  FOR  SUCH
 COVERAGE,  AS ESTABLISHED PURSUANT TO PARAGRAPH (D) OF THIS SUBDIVISION,
 DURING THE POLICY PERIOD. AT THE CONCLUSION OF  THE  POLICY  PERIOD  THE
 SUPERINTENDENT  OF  FINANCIAL SERVICES AND THE COMMISSIONER OF HEALTH OR
 THEIR DESIGNEE SHALL,  FROM  FUNDS  AVAILABLE  IN  THE  HOSPITAL  EXCESS
 LIABILITY  POOL  CREATED  PURSUANT TO SUBDIVISION 5 OF THIS SECTION, PAY
 HALF OF THE REMAINING FIFTY PERCENT OF THE PREMIUM TO  THE  PROVIDER  OF
 EXCESS INSURANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE, AND THE REMAIN-
 ING  TWENTY-FIVE PERCENT SHALL BE PAID ONE YEAR THEREAFTER. IF THE FUNDS
 AVAILABLE IN THE HOSPITAL EXCESS LIABILITY POOL ARE INSUFFICIENT TO MEET
 THE PERCENT OF THE COSTS OF  THE  EXCESS  COVERAGE,  THE  PROVISIONS  OF
 SUBDIVISION 8 OF THIS SECTION SHALL APPLY.
   (C) IF AT THE CONCLUSION OF THE POLICY PERIOD, A PHYSICIAN OR DENTIST,
 ELIGIBLE FOR EXCESS COVERAGE PAID FOR FROM FUNDS AVAILABLE IN THE HOSPI-
 TAL  EXCESS  LIABILITY  POOL, HAS FAILED TO PAY AN AMOUNT EQUAL TO FIFTY
 PERCENT OF THE PREMIUM AS ESTABLISHED PURSUANT TO PARAGRAPH (D) OF  THIS
 SUBDIVISION,  SUCH  EXCESS COVERAGE SHALL BE CANCELLED AND SHALL BE NULL
 AND VOID AS OF THE FIRST DAY ON OR AFTER THE COMMENCEMENT  OF  A  POLICY
 PERIOD  WHERE THE LIABILITY FOR PAYMENT PURSUANT TO THIS SUBDIVISION HAS
 NOT BEEN MET. THE PROVIDER OF EXCESS COVERAGE SHALL REMIT ANY PORTION OF
 PREMIUM PAID BY THE ELIGIBLE PHYSICIAN OR  DENTIST  FOR  SUCH  A  POLICY
 PERIOD.
   (D)  THE  SUPERINTENDENT  OF FINANCIAL SERVICES SHALL ESTABLISH A RATE
 CONSISTENT WITH SUBDIVISION 3 OF THIS SECTION THAT PROVIDERS  OF  EXCESS
 INSURANCE  COVERAGE  OR  EQUIVALENT EXCESS COVERAGE WILL CHARGE FOR SUCH
 COVERAGE FOR EACH POLICY PERIOD. FOR THE POLICY PERIOD BEGINNING JULY 1,
 2024, THE SUPERINTENDENT OF  FINANCIAL  SERVICES  MAY  DIRECT  THAT  THE
 PREMIUM  FOR  THAT  POLICY  PERIOD  BE THE SAME AS IT WAS FOR THE POLICY
 PERIOD THAT CONCLUDED JUNE 30, 2023.
   (E) NO PROVIDER OF EXCESS  INSURANCE  COVERAGE  OR  EQUIVALENT  EXCESS
 COVERAGE  SHALL  ISSUE EXCESS COVERAGE TO WHICH THIS SUBDIVISION APPLIES
 TO ANY PHYSICIAN OR DENTIST UNLESS THAT PHYSICIAN OR DENTIST  MEETS  THE
 ELIGIBILITY  REQUIREMENTS  FOR  SUCH COVERAGE SET FORTH IN THIS SECTION.
 THE SUPERINTENDENT OF FINANCIAL SERVICES AND THE COMMISSIONER OF  HEALTH
 S. 8307--A                         52                         A. 8807--A

 OR THEIR DESIGNEE SHALL NOT MAKE ANY PAYMENT UNDER THIS SUBDIVISION TO A
 PROVIDER  OF EXCESS INSURANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE FOR
 EXCESS COVERAGE ISSUED TO A PHYSICIAN OR DENTIST WHO DOES NOT  MEET  THE
 ELIGIBILITY  REQUIREMENTS  FOR  PARTICIPATION  IN  THE  HOSPITAL  EXCESS
 LIABILITY POOL PROGRAM SET FORTH IN THIS SECTION.
   (F) A PROVIDER OF EXCESS INSURANCE  COVERAGE  OR  EQUIVALENT  COVERAGE
 THAT ISSUES EXCESS COVERAGE UNDER THIS SUBDIVISION SHALL BILL THE PHYSI-
 CIAN  OR DENTIST FOR THE PORTION OF THE PREMIUM REQUIRED UNDER PARAGRAPH
 (A) OF THIS SUBDIVISION IN TWELVE EQUAL MONTHLY INSTALLMENTS OR IN  SUCH
 OTHER MANNER AS THE PHYSICIAN OR DENTIST MAY AGREE.
   (G)  THE SUPERINTENDENT OF FINANCIAL SERVICES IN CONSULTATION WITH THE
 COMMISSIONER OF HEALTH MAY PROMULGATE REGULATIONS GIVING EFFECT  TO  THE
 PROVISIONS OF THIS SUBDIVISION.
   §  2.  Subdivision 3 of section 18 of chapter 266 of the laws of 1986,
 amending the civil practice law and rules and  other  laws  relating  to
 malpractice and professional medical conduct, as amended by section 2 of
 part F of chapter 57 of the laws of 2023, is amended to read as follows:
   (3)(a)  The  superintendent  of financial services shall determine and
 certify to each general hospital and to the commissioner of  health  the
 cost  of  excess malpractice insurance for medical or dental malpractice
 occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988
 and June 30, 1989, between July 1, 1989 and June 30, 1990, between  July
 1,  1990  and  June  30,  1991,  between July 1, 1991 and June 30, 1992,
 between July 1, 1992 and June 30, 1993, between July 1,  1993  and  June
 30,  1994,  between July 1, 1994 and June 30, 1995, between July 1, 1995
 and June 30, 1996, between July 1, 1996 and June 30, 1997, between  July
 1,  1997  and  June  30,  1998,  between July 1, 1998 and June 30, 1999,
 between July 1, 1999 and June 30, 2000, between July 1,  2000  and  June
 30,  2001,  between July 1, 2001 and June 30, 2002, between July 1, 2002
 and June 30, 2003, between July 1, 2003 and June 30, 2004, between  July
 1,  2004  and  June  30,  2005,  between July 1, 2005 and June 30, 2006,
 between July 1, 2006 and June 30, 2007, between July 1,  2007  and  June
 30,  2008,  between July 1, 2008 and June 30, 2009, between July 1, 2009
 and June 30, 2010, between July 1, 2010 and June 30, 2011, between  July
 1,  2011  and  June  30,  2012,  between July 1, 2012 and June 30, 2013,
 between July 1, 2013 and June 30, 2014, between July 1,  2014  and  June
 30,  2015,  between July 1, 2015 and June 30, 2016, between July 1, 2016
 and June 30, 2017, between July 1, 2017 and June 30, 2018, between  July
 1,  2018  and  June  30,  2019,  between July 1, 2019 and June 30, 2020,
 between July 1, 2020 and June 30, 2021, between July 1,  2021  and  June
 30,  2022, between July 1, 2022 and June 30, 2023, [and] between July 1,
 2023 and June 30, 2024, AND BETWEEN JULY 1, 2024 AND JUNE 30, 2025 allo-
 cable to each general hospital for physicians or dentists  certified  as
 eligible  for purchase of a policy for excess insurance coverage by such
 general hospital in accordance with subdivision 2 of this  section,  and
 may amend such determination and certification as necessary.
   (b)  The  superintendent  of  financial  services  shall determine and
 certify to each general hospital and to the commissioner of  health  the
 cost  of  excess malpractice insurance or equivalent excess coverage for
 medical or dental malpractice occurrences between July 1, 1987 and  June
 30,  1988,  between July 1, 1988 and June 30, 1989, between July 1, 1989
 and June 30, 1990, between July 1, 1990 and June 30, 1991, between  July
 1,  1991  and  June  30,  1992,  between July 1, 1992 and June 30, 1993,
 between July 1, 1993 and June 30, 1994, between July 1,  1994  and  June
 30,  1995,  between July 1, 1995 and June 30, 1996, between July 1, 1996
 and June 30, 1997, between July 1, 1997 and June 30, 1998, between  July
 S. 8307--A                         53                         A. 8807--A
 
 1,  1998  and  June  30,  1999,  between July 1, 1999 and June 30, 2000,
 between July 1, 2000 and June 30, 2001, between July 1,  2001  and  June
 30,  2002,  between July 1, 2002 and June 30, 2003, between July 1, 2003
 and  June 30, 2004, between July 1, 2004 and June 30, 2005, between July
 1, 2005 and June 30, 2006, between July  1,  2006  and  June  30,  2007,
 between  July  1,  2007 and June 30, 2008, between July 1, 2008 and June
 30, 2009, between July 1, 2009 and June 30, 2010, between July  1,  2010
 and  June 30, 2011, between July 1, 2011 and June 30, 2012, between July
 1, 2012 and June 30, 2013, between July  1,  2013  and  June  30,  2014,
 between  July  1,  2014 and June 30, 2015, between July 1, 2015 and June
 30, 2016, between July 1, 2016 and June 30, 2017, between July  1,  2017
 and  June 30, 2018, between July 1, 2018 and June 30, 2019, between July
 1, 2019 and June 30, 2020, between July  1,  2020  and  June  30,  2021,
 between  July  1,  2021 and June 30, 2022, between July 1, 2022 and June
 30, 2023, [and] between July 1, 2023 and June 30, 2024, AND BETWEEN JULY
 1, 2024 AND JUNE 30, 2025 allocable to each general hospital for  physi-
 cians  or  dentists  certified  as eligible for purchase of a policy for
 excess insurance coverage or equivalent excess coverage by such  general
 hospital in accordance with subdivision 2 of this section, and may amend
 such determination and certification as necessary. The superintendent of
 financial  services shall determine and certify to each general hospital
 and to the commissioner of health the ratable share of such cost alloca-
 ble to the period July 1, 1987 to December 31, 1987, to the period Janu-
 ary 1, 1988 to June 30, 1988, to the period July 1, 1988 to December 31,
 1988, to the period January 1, 1989 to June 30, 1989, to the period July
 1, 1989 to December 31, 1989, to the period January 1, 1990 to June  30,
 1990,  to  the  period  July 1, 1990 to December 31, 1990, to the period
 January 1, 1991 to June 30, 1991, to the period July 1, 1991 to December
 31, 1991, to the period January 1, 1992 to June 30, 1992, to the  period
 July 1, 1992 to December 31, 1992, to the period January 1, 1993 to June
 30, 1993, to the period July 1, 1993 to December 31, 1993, to the period
 January 1, 1994 to June 30, 1994, to the period July 1, 1994 to December
 31,  1994, to the period January 1, 1995 to June 30, 1995, to the period
 July 1, 1995 to December 31, 1995, to the period January 1, 1996 to June
 30, 1996, to the period July 1, 1996 to December 31, 1996, to the period
 January 1, 1997 to June 30, 1997, to the period July 1, 1997 to December
 31, 1997, to the period January 1, 1998 to June 30, 1998, to the  period
 July 1, 1998 to December 31, 1998, to the period January 1, 1999 to June
 30, 1999, to the period July 1, 1999 to December 31, 1999, to the period
 January 1, 2000 to June 30, 2000, to the period July 1, 2000 to December
 31,  2000, to the period January 1, 2001 to June 30, 2001, to the period
 July 1, 2001 to June 30, 2002, to the period July 1, 2002  to  June  30,
 2003, to the period July 1, 2003 to June 30, 2004, to the period July 1,
 2004  to June 30, 2005, to the period July 1, 2005 and June 30, 2006, to
 the period July 1, 2006 and June 30, 2007, to the period  July  1,  2007
 and  June 30, 2008, to the period July 1, 2008 and June 30, 2009, to the
 period July 1, 2009 and June 30, 2010, to the period July  1,  2010  and
 June  30,  2011,  to  the  period July 1, 2011 and June 30, 2012, to the
 period July 1, 2012 and June 30, 2013, to the period July  1,  2013  and
 June  30,  2014,  to  the  period July 1, 2014 and June 30, 2015, to the
 period July 1, 2015 and June 30, 2016, to the period July  1,  2016  and
 June 30, 2017, to the period July 1, 2017 to June 30, 2018, to the peri-
 od July 1, 2018 to June 30, 2019, to the period July 1, 2019 to June 30,
 2020, to the period July 1, 2020 to June 30, 2021, to the period July 1,
 2021  to  June  30,  2022,  to the period July 1, 2022 to June 30, 2023,
 S. 8307--A                         54                         A. 8807--A
 
 [and] to the period July 1, 2023 to June 30, 2024,  AND  TO  THE  PERIOD
 JULY 1, 2024 TO JUNE 30, 2025.
   § 3. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
 18  of  chapter 266 of the laws of 1986, amending the civil practice law
 and rules and  other  laws  relating  to  malpractice  and  professional
 medical  conduct, as amended by section 3 of part F of chapter 57 of the
 laws of 2023, are amended to read as follows:
   (a) To the extent funds available to  the  hospital  excess  liability
 pool  pursuant to subdivision 5 of this section as amended, and pursuant
 to section 6 of part J of chapter 63 of the laws of 2001,  as  may  from
 time  to  time  be amended, which amended this subdivision, are insuffi-
 cient to meet the costs  of  excess  insurance  coverage  or  equivalent
 excess  coverage  for coverage periods during the period July 1, 1992 to
 June 30, 1993, during the period July 1, 1993 to June 30,  1994,  during
 the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
 to  June  30,  1996,  during  the  period July 1, 1996 to June 30, 1997,
 during the period July 1, 1997 to June 30, 1998, during the period  July
 1,  1998  to  June  30, 1999, during the period July 1, 1999 to June 30,
 2000, during the period July 1, 2000 to June 30, 2001, during the period
 July 1, 2001 to October 29, 2001, during the period  April  1,  2002  to
 June  30,  2002, during the period July 1, 2002 to June 30, 2003, during
 the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
 to June 30, 2005, during the period July  1,  2005  to  June  30,  2006,
 during  the period July 1, 2006 to June 30, 2007, during the period July
 1, 2007 to June 30, 2008, during the period July 1,  2008  to  June  30,
 2009, during the period July 1, 2009 to June 30, 2010, during the period
 July  1,  2010  to June 30, 2011, during the period July 1, 2011 to June
 30, 2012, during the period July 1, 2012 to June 30,  2013,  during  the
 period  July 1, 2013 to June 30, 2014, during the period July 1, 2014 to
 June 30, 2015, during the period July 1, 2015 to June 30,  2016,  during
 the period July 1, 2016 to June 30, 2017, during the period July 1, 2017
 to  June  30,  2018,  during  the  period July 1, 2018 to June 30, 2019,
 during the period July 1, 2019 to June 30, 2020, during the period  July
 1,  2020  to  June  30, 2021, during the period July 1, 2021 to June 30,
 2022, during the period July 1, 2022 to June 30, 2023, [and] during  the
 period July 1, 2023 to June 30, 2024, AND DURING THE PERIOD JULY 1, 2024
 TO  JUNE  30, 2025 allocated or reallocated in accordance with paragraph
 (a) of subdivision 4-a of this section to rates of payment applicable to
 state governmental agencies, each physician or dentist for whom a policy
 for excess insurance coverage or equivalent excess coverage is purchased
 for such period shall be responsible for  payment  to  the  provider  of
 excess  insurance coverage or equivalent excess coverage of an allocable
 share of such insufficiency, based on the ratio of  the  total  cost  of
 such  coverage  for  such physician to the sum of the total cost of such
 coverage for all physicians applied to such insufficiency.
   (b) Each provider of excess insurance coverage  or  equivalent  excess
 coverage  covering the period July 1, 1992 to June 30, 1993, or covering
 the period July 1, 1993 to June 30, 1994, or covering the period July 1,
 1994 to June 30, 1995, or covering the period July 1, 1995 to  June  30,
 1996,  or covering the period July 1, 1996 to June 30, 1997, or covering
 the period July 1, 1997 to June 30, 1998, or covering the period July 1,
 1998 to June 30, 1999, or covering the period July 1, 1999 to  June  30,
 2000,  or covering the period July 1, 2000 to June 30, 2001, or covering
 the period July 1, 2001 to October 29,  2001,  or  covering  the  period
 April  1,  2002 to June 30, 2002, or covering the period July 1, 2002 to
 June 30, 2003, or covering the period July 1, 2003 to June 30, 2004,  or
 S. 8307--A                         55                         A. 8807--A
 
 covering the period July 1, 2004 to June 30, 2005, or covering the peri-
 od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
 June  30, 2007, or covering the period July 1, 2007 to June 30, 2008, or
 covering the period July 1, 2008 to June 30, 2009, or covering the peri-
 od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
 June  30, 2011, or covering the period July 1, 2011 to June 30, 2012, or
 covering the period July 1, 2012 to June 30, 2013, or covering the peri-
 od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to
 June 30, 2015, or covering the period July 1, 2015 to June 30, 2016,  or
 covering the period July 1, 2016 to June 30, 2017, or covering the peri-
 od July 1, 2017 to June 30, 2018, or covering the period July 1, 2018 to
 June  30, 2019, or covering the period July 1, 2019 to June 30, 2020, or
 covering the period July 1, 2020 to June 30, 2021, or covering the peri-
 od July 1, 2021 to June 30, 2022, or covering the period July 1, 2022 to
 June 30, 2023, or covering the period July 1, 2023 to June 30, 2024,  OR
 COVERING THE PERIOD JULY 1, 2024 TO JUNE 30, 2025 shall notify a covered
 physician  or  dentist  by mail, mailed to the address shown on the last
 application for excess insurance coverage or equivalent excess coverage,
 of the amount due to such provider from such physician  or  dentist  for
 such coverage period determined in accordance with paragraph (a) of this
 subdivision.  Such amount shall be due from such physician or dentist to
 such provider of excess insurance coverage or equivalent excess coverage
 in a time and manner  determined  by  the  superintendent  of  financial
 services.
   (c)  If  a physician or dentist liable for payment of a portion of the
 costs of excess insurance coverage or equivalent excess coverage  cover-
 ing  the  period  July  1, 1992 to June 30, 1993, or covering the period
 July 1, 1993 to June 30, 1994, or covering the period July  1,  1994  to
 June  30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
 covering the period July 1, 1996 to June 30, 1997, or covering the peri-
 od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
 June 30, 1999, or covering the period July 1, 1999 to June 30, 2000,  or
 covering the period July 1, 2000 to June 30, 2001, or covering the peri-
 od  July  1,  2001  to October 29, 2001, or covering the period April 1,
 2002 to June 30, 2002, or covering the period July 1, 2002 to  June  30,
 2003,  or covering the period July 1, 2003 to June 30, 2004, or covering
 the period July 1, 2004 to June 30, 2005, or covering the period July 1,
 2005 to June 30, 2006, or covering the period July 1, 2006 to  June  30,
 2007,  or covering the period July 1, 2007 to June 30, 2008, or covering
 the period July 1, 2008 to June 30, 2009, or covering the period July 1,
 2009 to June 30, 2010, or covering the period July 1, 2010 to  June  30,
 2011,  or covering the period July 1, 2011 to June 30, 2012, or covering
 the period July 1, 2012 to June 30, 2013, or covering the period July 1,
 2013 to June 30, 2014, or covering the period July 1, 2014 to  June  30,
 2015,  or covering the period July 1, 2015 to June 30, 2016, or covering
 the period July 1, 2016 to June 30, 2017, or covering the period July 1,
 2017 to June 30, 2018, or covering the period July 1, 2018 to  June  30,
 2019,  or covering the period July 1, 2019 to June 30, 2020, or covering
 the period July 1, 2020 to June 30, 2021, or covering the period July 1,
 2021 to June 30, 2022, or covering the period July 1, 2022 to  June  30,
 2023,  or covering the period July 1, 2023 to June 30, 2024, OR COVERING
 THE PERIOD JULY 1, 2024 TO JUNE 30, 2025 determined in  accordance  with
 paragraph  (a)  of  this  subdivision fails, refuses or neglects to make
 payment to the provider  of  excess  insurance  coverage  or  equivalent
 excess coverage in such time and manner as determined by the superinten-
 dent  of  financial  services pursuant to paragraph (b) of this subdivi-
 S. 8307--A                         56                         A. 8807--A
 
 sion, excess insurance coverage or equivalent excess coverage  purchased
 for  such  physician or dentist in accordance with this section for such
 coverage period shall be cancelled and shall be null and void as of  the
 first  day  on  or  after  the commencement of a policy period where the
 liability for payment pursuant to this subdivision has not been met.
   (d) Each provider of excess insurance coverage  or  equivalent  excess
 coverage  shall  notify the superintendent of financial services and the
 commissioner of health or their designee of each physician  and  dentist
 eligible  for  purchase  of  a  policy  for excess insurance coverage or
 equivalent excess coverage covering the period July 1, 1992 to June  30,
 1993,  or covering the period July 1, 1993 to June 30, 1994, or covering
 the period July 1, 1994 to June 30, 1995, or covering the period July 1,
 1995 to June 30, 1996, or covering the period July 1, 1996 to  June  30,
 1997,  or covering the period July 1, 1997 to June 30, 1998, or covering
 the period July 1, 1998 to June 30, 1999, or covering the period July 1,
 1999 to June 30, 2000, or covering the period July 1, 2000 to  June  30,
 2001, or covering the period July 1, 2001 to October 29, 2001, or cover-
 ing  the  period  April 1, 2002 to June 30, 2002, or covering the period
 July 1, 2002 to June 30, 2003, or covering the period July  1,  2003  to
 June  30, 2004, or covering the period July 1, 2004 to June 30, 2005, or
 covering the period July 1, 2005 to June 30, 2006, or covering the peri-
 od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to
 June 30, 2008, or covering the period July 1, 2008 to June 30, 2009,  or
 covering the period July 1, 2009 to June 30, 2010, or covering the peri-
 od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to
 June  30, 2012, or covering the period July 1, 2012 to June 30, 2013, or
 covering the period July 1, 2013 to June 30, 2014, or covering the peri-
 od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to
 June 30, 2016, or covering the period July 1, 2016 to June 30, 2017,  or
 covering the period July 1, 2017 to June 30, 2018, or covering the peri-
 od July 1, 2018 to June 30, 2019, or covering the period July 1, 2019 to
 June  30, 2020, or covering the period July 1, 2020 to June 30, 2021, or
 covering the period July 1, 2021 to June 30, 2022, or covering the peri-
 od July 1, 2022 to June 30, 2023, or covering the period July 1, 2023 to
 June 30, 2024, OR COVERING THE PERIOD JULY 1, 2024 TO JUNE 30, 2025 that
 has made payment to such provider of excess insurance coverage or equiv-
 alent excess coverage in accordance with paragraph (b) of this  subdivi-
 sion  and  of  each  physician  and  dentist  who has failed, refused or
 neglected to make such payment.
   (e) A provider of  excess  insurance  coverage  or  equivalent  excess
 coverage  shall  refund to the hospital excess liability pool any amount
 allocable to the period July 1, 1992 to June 30, 1993, and to the period
 July 1, 1993 to June 30, 1994, and to the period July 1,  1994  to  June
 30,  1995,  and  to the period July 1, 1995 to June 30, 1996, and to the
 period July 1, 1996 to June 30, 1997, and to the period July 1, 1997  to
 June  30,  1998, and to the period July 1, 1998 to June 30, 1999, and to
 the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
 to June 30, 2001, and to the period July 1, 2001 to  October  29,  2001,
 and to the period April 1, 2002 to June 30, 2002, and to the period July
 1,  2002  to  June  30, 2003, and to the period July 1, 2003 to June 30,
 2004, and to the period July 1, 2004 to June 30, 2005, and to the period
 July 1, 2005 to June 30, 2006, and to the period July 1,  2006  to  June
 30,  2007,  and  to the period July 1, 2007 to June 30, 2008, and to the
 period July 1, 2008 to June 30, 2009, and to the period July 1, 2009  to
 June  30,  2010, and to the period July 1, 2010 to June 30, 2011, and to
 the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
 S. 8307--A                         57                         A. 8807--A
 
 to June 30, 2013, and to the period July 1, 2013 to June 30,  2014,  and
 to  the  period July 1, 2014 to June 30, 2015, and to the period July 1,
 2015 to June 30, 2016, to the period July 1, 2016 to June 30, 2017,  and
 to  the  period July 1, 2017 to June 30, 2018, and to the period July 1,
 2018 to June 30, 2019, and to the period July 1, 2019 to June 30,  2020,
 and  to the period July 1, 2020 to June 30, 2021, and to the period July
 1, 2021 to June 30, 2022, and to the period July 1,  2022  to  June  30,
 2023, and to the period July 1, 2023 to June 30, 2024, AND TO THE PERIOD
 JULY  1, 2024 TO JUNE 30, 2025 received from the hospital excess liabil-
 ity pool for purchase of excess insurance coverage or equivalent  excess
 coverage covering the period July 1, 1992 to June 30, 1993, and covering
 the  period  July 1, 1993 to June 30, 1994, and covering the period July
 1, 1994 to June 30, 1995, and covering the period July 1, 1995  to  June
 30,  1996,  and  covering  the period July 1, 1996 to June 30, 1997, and
 covering the period July 1, 1997 to June  30,  1998,  and  covering  the
 period  July  1,  1998 to June 30, 1999, and covering the period July 1,
 1999 to June 30, 2000, and covering the period July 1, 2000 to June  30,
 2001,  and  covering  the  period  July 1, 2001 to October 29, 2001, and
 covering the period April 1, 2002 to June 30,  2002,  and  covering  the
 period  July  1,  2002 to June 30, 2003, and covering the period July 1,
 2003 to June 30, 2004, and covering the period July 1, 2004 to June  30,
 2005,  and covering the period July 1, 2005 to June 30, 2006, and cover-
 ing the period July 1, 2006 to June 30, 2007, and  covering  the  period
 July  1,  2007 to June 30, 2008, and covering the period July 1, 2008 to
 June 30, 2009, and covering the period July 1, 2009 to  June  30,  2010,
 and  covering the period July 1, 2010 to June 30, 2011, and covering the
 period July 1, 2011 to June 30, 2012, and covering the  period  July  1,
 2012  to June 30, 2013, and covering the period July 1, 2013 to June 30,
 2014, and covering the period July 1, 2014 to June 30, 2015, and  cover-
 ing  the  period  July 1, 2015 to June 30, 2016, and covering the period
 July 1, 2016 to June 30, 2017, and covering the period July 1,  2017  to
 June  30,  2018,  and covering the period July 1, 2018 to June 30, 2019,
 and covering the period July 1, 2019 to June 30, 2020, and covering  the
 period  July  1,  2020 to June 30, 2021, and covering the period July 1,
 2021 to June 30, 2022, and covering the period July 1, 2022 to June  30,
 2023  for,  and  covering  the period July 1, 2023 to June 30, 2024, AND
 COVERING THE PERIOD JULY 1, 2024 TO JUNE 30, 2025 a physician or dentist
 where such excess insurance coverage or equivalent  excess  coverage  is
 cancelled in accordance with paragraph (c) of this subdivision.
   § 4. Section 40 of chapter 266 of the laws of 1986, amending the civil
 practice  law  and  rules  and  other  laws  relating to malpractice and
 professional medical conduct, as amended by section 4 of part F of chap-
 ter 57 of the laws of 2023, is amended to read as follows:
   § 40. The superintendent of financial services shall  establish  rates
 for  policies  providing  coverage  for  physicians and surgeons medical
 malpractice for the periods commencing July 1, 1985 and ending June  30,
 [2024] 2025; provided, however, that notwithstanding any other provision
 of  law,  the superintendent shall not establish or approve any increase
 in rates for the period commencing July 1,  2009  and  ending  June  30,
 2010.  The  superintendent shall direct insurers to establish segregated
 accounts for premiums, payments, reserves and investment income  attrib-
 utable to such premium periods and shall require periodic reports by the
 insurers  regarding  claims and expenses attributable to such periods to
 monitor whether such accounts will be sufficient to meet incurred claims
 and expenses. On or after July 1, 1989, the superintendent shall  impose
 a  surcharge  on  premiums  to  satisfy  a  projected deficiency that is
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 attributable to the premium levels established pursuant to this  section
 for  such  periods;  provided, however, that such annual surcharge shall
 not exceed eight percent of the established rate until  July  1,  [2024]
 2025, at which time and thereafter such surcharge shall not exceed twen-
 ty-five  percent  of  the  approved  adequate rate, and that such annual
 surcharges shall continue for such period of time as shall be sufficient
 to satisfy such deficiency. The superintendent  shall  not  impose  such
 surcharge  during the period commencing July 1, 2009 and ending June 30,
 2010. On and after July  1,  1989,  the  surcharge  prescribed  by  this
 section  shall  be  retained by insurers to the extent that they insured
 physicians and surgeons during the July 1, 1985 through June 30,  [2024]
 2025  policy  periods;  in  the  event  and to the extent physicians and
 surgeons were insured by another insurer during such periods, all  or  a
 pro  rata  share of the surcharge, as the case may be, shall be remitted
 to such other insurer in accordance with rules  and  regulations  to  be
 promulgated by the superintendent.  Surcharges collected from physicians
 and  surgeons  who  were not insured during such policy periods shall be
 apportioned among all insurers in proportion to the premium  written  by
 each  insurer  during such policy periods; if a physician or surgeon was
 insured by an insurer subject to rates established by the superintendent
 during such policy periods, and  at  any  time  thereafter  a  hospital,
 health  maintenance organization, employer or institution is responsible
 for responding in damages for liability arising out of such  physician's
 or  surgeon's  practice  of medicine, such responsible entity shall also
 remit to such prior insurer the equivalent amount  that  would  then  be
 collected  as  a  surcharge if the physician or surgeon had continued to
 remain insured by such prior insurer. In  the  event  any  insurer  that
 provided  coverage  during  such  policy  periods is in liquidation, the
 property/casualty insurance security fund shall receive the  portion  of
 surcharges to which the insurer in liquidation would have been entitled.
 The surcharges authorized herein shall be deemed to be income earned for
 the  purposes of section 2303 of the insurance law.  The superintendent,
 in establishing adequate rates and in determining  any  projected  defi-
 ciency  pursuant  to  the requirements of this section and the insurance
 law, shall give substantial weight, determined  in  his  discretion  and
 judgment,  to  the  prospective  anticipated  effect  of any regulations
 promulgated and laws enacted and the  public  benefit  of    stabilizing
 malpractice rates and minimizing rate level fluctuation during the peri-
 od  of  time  necessary for the development of more reliable statistical
 experience as to the efficacy of such  laws  and  regulations  affecting
 medical, dental or podiatric malpractice enacted or promulgated in 1985,
 1986,  by this act and at any other time.  Notwithstanding any provision
 of the insurance law, rates already established and to be established by
 the superintendent pursuant to this section are deemed adequate if  such
 rates  would be adequate when taken together with the maximum authorized
 annual surcharges to be imposed for a reasonable period of time  whether
 or  not  any  such  annual surcharge has been actually imposed as of the
 establishment of such rates.
   § 5. Section 5 and subdivisions (a) and (e) of section 6 of 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, as amended by section 5
 of  part  F  of  chapter  57 of the laws of 2023, are amended to read as
 follows:
   § 5. The superintendent of financial services and the commissioner  of
 health shall determine, no later than June 15, 2002, June 15, 2003, June
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 15,  2004,  June  15, 2005, June 15, 2006, June 15, 2007, June 15, 2008,
 June 15, 2009, June 15, 2010, June 15, 2011, June  15,  2012,  June  15,
 2013,  June  15, 2014, June 15, 2015, June 15, 2016, June 15, 2017, June
 15,  2018,  June  15, 2019, June 15, 2020, June 15, 2021, June 15, 2022,
 June 15, 2023, [and] June 15, 2024, AND JUNE  15,  2025  the  amount  of
 funds  available in the hospital excess liability pool, created pursuant
 to section 18 of chapter 266 of the laws of 1986, and whether such funds
 are sufficient for purposes of purchasing excess insurance coverage  for
 eligible participating physicians and dentists during the period July 1,
 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003
 to  June  30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to
 June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007 to June
 30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to June  30,
 2010,  or  July  1,  2010  to June 30, 2011, or July 1, 2011 to June 30,
 2012, or July 1, 2012 to June 30, 2013, or July  1,  2013  to  June  30,
 2014,  or  July  1,  2014  to June 30, 2015, or July 1, 2015 to June 30,
 2016, or July 1, 2016 to June 30, 2017, or July  1,  2017  to  June  30,
 2018,  or  July  1,  2018  to June 30, 2019, or July 1, 2019 to June 30,
 2020, or July 1, 2020 to June 30, 2021, or July  1,  2021  to  June  30,
 2022,  or  July  1,  2022  to June 30, 2023, or July 1, 2023 to June 30,
 2024, OR JULY 1, 2024 TO JUNE 30, 2025 as applicable.
   (a) This section shall be effective only upon a determination,  pursu-
 ant  to  section  five  of  this act, by the superintendent of financial
 services and the commissioner of health, and  a  certification  of  such
 determination  to  the  state  director  of the budget, the chair of the
 senate committee on finance and the chair of the assembly  committee  on
 ways  and means, that the amount of funds in the hospital excess liabil-
 ity pool, created pursuant to section 18 of chapter 266 of the  laws  of
 1986, is insufficient for purposes of purchasing excess insurance cover-
 age for eligible participating physicians and dentists during the period
 July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July
 1,  2003  to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1,
 2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007
 to June 30, 2008, or July 1, 2008 to June 30, 2009, or July 1,  2009  to
 June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June
 30,  2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30,
 2014, or July 1, 2014 to June 30, 2015, or July  1,  2015  to  June  30,
 2016,  or  July  1,  2016  to June 30, 2017, or July 1, 2017 to June 30,
 2018, or July 1, 2018 to June 30, 2019, or July  1,  2019  to  June  30,
 2020,  or  July  1,  2020  to June 30, 2021, or July 1, 2021 to June 30,
 2022, or July 1, 2022 to June 30, 2023, or July 1, 2023 to June 30, 2024
 , OR JULY 1, 2024 TO JUNE 30, 2025 as applicable.
   (e) The commissioner of health  shall  transfer  for  deposit  to  the
 hospital excess liability pool created pursuant to section 18 of chapter
 266  of  the laws of 1986 such amounts as directed by the superintendent
 of financial services for the purchase  of  excess  liability  insurance
 coverage  for  eligible  participating  physicians  and dentists for the
 policy year July 1, 2001 to June 30, 2002, or July 1, 2002 to  June  30,
 2003,  or  July  1,  2003  to June 30, 2004, or July 1, 2004 to June 30,
 2005, or July 1, 2005 to June 30, 2006, or July  1,  2006  to  June  30,
 2007,  as  applicable, and the cost of administering the hospital excess
 liability pool for such applicable policy year,  pursuant to the program
 established in chapter 266 of the laws of 1986,  as  amended,  no  later
 than  June  15,  2002, June 15, 2003, June 15, 2004, June 15, 2005, June
 15, 2006, June 15, 2007, June 15, 2008, June 15, 2009,  June  15,  2010,
 June  15,  2011,  June  15, 2012, June 15, 2013, June 15, 2014, June 15,
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 2015, June 15, 2016, June 15, 2017, June 15, 2018, June 15,  2019,  June
 15,  2020,  June  15, 2021, June 15, 2022, June 15, 2023, [and] June 15,
 2024, AND JUNE 15, 2025 as applicable.
   §  6. Section 20 of 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 thereto, as amended by section 6 of part F
 of chapter 57 of the laws of 2023, is amended to read as follows:
   § 20. Notwithstanding any law, rule or  regulation  to  the  contrary,
 only  physicians  or dentists who were eligible, and for whom the super-
 intendent of financial services and the commissioner of health, or their
 designee, purchased, with funds available in the hospital excess liabil-
 ity pool, a full or partial policy for  excess  coverage  or  equivalent
 excess  coverage  for  the coverage period ending the thirtieth of June,
 two thousand [twenty-three] TWENTY-FOUR, shall be eligible to apply  for
 such  coverage  for the coverage period beginning the first of July, two
 thousand [twenty-three] TWENTY-FOUR; provided,  however,  if  the  total
 number of physicians or dentists for whom such excess coverage or equiv-
 alent excess coverage was purchased for the policy year ending the thir-
 tieth of June, two thousand [twenty-three] TWENTY-FOUR exceeds the total
 number  of physicians or dentists certified as eligible for the coverage
 period beginning the first of July, two thousand [twenty-three]  TWENTY-
 FOUR,  then the general hospitals may certify additional eligible physi-
 cians or dentists in a number equal to such general  hospital's  propor-
 tional  share  of  the  total  number of physicians or dentists for whom
 excess coverage or equivalent excess coverage was purchased  with  funds
 available  in  the hospital excess liability pool as of the thirtieth of
 June, two thousand [twenty-three] TWENTY-FOUR, as applied to the differ-
 ence between the number of eligible physicians or dentists  for  whom  a
 policy  for  excess coverage or equivalent excess coverage was purchased
 for the coverage period ending  the  thirtieth  of  June,  two  thousand
 [twenty-three] TWENTY-FOUR and the number of such eligible physicians or
 dentists  who  have  applied  for  excess  coverage or equivalent excess
 coverage for the coverage period beginning the first of July, two  thou-
 sand [twenty-three] TWENTY-FOUR.
   §  7.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART L
 
   Section 1. Subdivision 9 of section 2803 of the public health  law  is
 REPEALED.
   § 2. Section 461-s of the social services law is REPEALED.
   § 3. Subdivision 1, paragraph (f) of subdivision 3, paragraphs (a) and
 (d)  of  subdivision  5 and subdivisions 5-a and 12 of section 2807-m of
 the public health law, subdivision 1, paragraph (f)  of  subdivision  3,
 paragraph  (a)  of subdivision 5 and subdivision 12 as amended and para-
 graph (d) of subdivision 5 as added by section 6 of part Y of chapter 56
 of the laws of 2020 and subdivision 5-a as amended by section 6 of  part
 C of chapter 57 of the laws of 2023, are amended to read as follows:
   1.    Definitions.  For  purposes of this section, the following defi-
 nitions shall apply, unless the context clearly requires otherwise:
   (a) ["Clinical research" means patient-oriented research, epidemiolog-
 ic and behavioral studies, or  outcomes  research  and  health  services
 research  that  is approved by an institutional review board by the time
 the clinical research position is filled.
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   (b) "Clinical research plan" means a plan submitted by a consortium or
 teaching general hospital for a clinical research position which  demon-
 strates, in a form to be provided by the commissioner, the following:
   (i)  financial  support for overhead, supervision, equipment and other
 resources equal to the amount of funding provided pursuant  to  subpara-
 graph  (i) of paragraph (b) of subdivision five-a of this section by the
 teaching general hospital or consortium for the clinical research  posi-
 tion;
   (ii)  experience  the sponsor-mentor and teaching general hospital has
 in clinical research and the medical field of the study;
   (iii) methods, data collection and anticipated measurable outcomes  of
 the clinical research to be performed;
   (iv)  training goals, objectives and experience the researcher will be
 provided to assess a future career in clinical research;
   (v)  scientific  relevance,  merit  and  health  implications  of  the
 research to be performed;
   (vi)  information  on  potential  scientific  meetings and peer review
 journals where research results can be disseminated;
   (vii) clear and comprehensive details on the clinical  research  posi-
 tion;
   (viii) qualifications necessary for the clinical research position and
 strategy for recruitment;
   (ix)  non-duplication  with other clinical research positions from the
 same teaching general hospital or consortium;
   (x) methods to track the career of the clinical  researcher  once  the
 term of the position is complete; and
   (xi)  any  other information required by the commissioner to implement
 subparagraph (i) of paragraph (b) of subdivision five-a of this section.
   (xii) The clinical review plan submitted in accordance with this para-
 graph may be reviewed by the commissioner in consultation  with  experts
 outside the department of health.
   (c) "Clinical research position" means a post-graduate residency posi-
 tion which:
   (i)  shall  not  be required in order for the researcher to complete a
 graduate medical education program;
   (ii) may be reimbursed by other sources but only for costs  in  excess
 of  the funding distributed in accordance with subparagraph (i) of para-
 graph (b) of subdivision five-a of this section;
   (iii) shall exceed the minimum standards  that  are  required  by  the
 residency  review  committee in the specialty the researcher has trained
 or is currently training;
   (iv) shall not be previously funded by the teaching  general  hospital
 or  supported by another funding source at the teaching general hospital
 in the past three years from the date  the  clinical  research  plan  is
 submitted to the commissioner;
   (v) may supplement an existing research project;
   (vi) shall be equivalent to a full-time position comprising of no less
 than thirty-five hours per week for one or two years;
   (vii)  shall  provide, or be filled by a researcher who has formalized
 instruction in  clinical  research,  including  biostatistics,  clinical
 trial design, grant writing and research ethics;
   (viii) shall be supervised by a sponsor-mentor who shall either (A) be
 employed, contracted for employment or paid through an affiliated facul-
 ty  practice  plan  by a teaching general hospital which has received at
 least one research grant from the National Institutes of Health  in  the
 past five years from the date the clinical research plan is submitted to
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 the  commissioner;  (B)  maintain  a  faculty  appointment at a medical,
 dental or podiatric school located in New York state that  has  received
 at  least  one  research grant from the National Institutes of Health in
 the  past five years from the date the clinical research plan is submit-
 ted to the  commissioner;  or  (C)  be  collaborating  in  the  clinical
 research  plan  with  a  researcher  from  another  institution that has
 received at least one research grant from  the  National  Institutes  of
 Health  in  the past five years from the date the clinical research plan
 is submitted to the commissioner; and
   (ix) shall be filled by a  researcher  who  is  (A)  enrolled  or  has
 completed  a graduate medical education program, as defined in paragraph
 (i) of this subdivision; (B)  a  United  States  citizen,  national,  or
 permanent  resident  of  the  United  States;  and  (C)  a graduate of a
 medical, dental or podiatric school located in New York state, a  gradu-
 ate  or  resident in a graduate medical education program, as defined in
 paragraph (i) of this subdivision, where the sponsoring institution,  as
 defined  in  paragraph  (q)  of this subdivision, is located in New York
 state, or resides in New York state at the time  the  clinical  research
 plan is submitted to the commissioner.
   (d)]  "Consortium"  means  an organization or association, approved by
 the commissioner in consultation with the council, of general  hospitals
 which  provide  graduate medical education, together with any affiliated
 site; provided that such organization or association  may  also  include
 other  providers  of  health  care  services, medical schools, payors or
 consumers, and which meet other criteria pursuant to subdivision six  of
 this section.
   [(e)]  (B)  "Council"  means  the  New  York state council on graduate
 medical education.
   [(f)] (C) "Direct medical education" means the direct costs  of  resi-
 dents, interns and supervising physicians.
   [(g)]  (D) "Distribution period" means each calendar year set forth in
 subdivision two of this section.
   [(h)] (E) "Faculty"  means  persons  who  are  employed  by  or  under
 contract  for  employment  with  a teaching general hospital or are paid
 through a teaching general hospital's affiliated faculty  practice  plan
 and  maintain  a  faculty  appointment at a medical school. Such persons
 shall not be limited to persons with a degree in medicine.
   [(i)] (F) "Graduate medical education program" means  a  post-graduate
 medical  education  residency  in  the  United States which has received
 accreditation from a nationally recognized  accreditation  body  or  has
 been  approved  by  a  nationally  recognized  organization for medical,
 osteopathic, podiatric or dental residency programs including,  but  not
 limited to, specialty boards.
   [(j)]  (G)  "Indirect  medical education" means the estimate of costs,
 other than direct costs, of educational activities in teaching hospitals
 as determined in accordance with the methodology applicable for purposes
 of determining an estimate  of  indirect  medical  education  costs  for
 reimbursement  for inpatient hospital service pursuant to title XVIII of
 the federal social security act (medicare).
   [(k)] (H) "Medicare" means the methodology used for purposes of  reim-
 bursing  inpatient  hospital services provided to beneficiaries of title
 XVIII of the federal social security act.
   [(l)] (I) "Primary care" residents specialties  shall  include  family
 medicine, general pediatrics, primary care internal medicine, and prima-
 ry care obstetrics and gynecology. In determining whether a residency is
 in primary care, the commissioner shall consult with the council.
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   [(m)]  (J)  "Regions",  for  purposes  of this section, shall mean the
 regions as defined in paragraph (b) of subdivision  sixteen  of  section
 twenty-eight  hundred seven-c of this article as in effect on June thir-
 tieth, nineteen hundred ninety-six. For purposes of distributions pursu-
 ant  to subdivision five-a of this section, except distributions made in
 accordance with paragraph (a) of subdivision  five-a  of  this  section,
 "regions" shall be defined as New York city and the rest of the state.
   [(n)]  (K)  "Regional pool" means a professional education pool estab-
 lished on a regional basis by  the  commissioner  from  funds  available
 pursuant  to  sections  twenty-eight  hundred  seven-s  and twenty-eight
 hundred seven-t of this article.
   [(o)] (L) "Resident" means a person in a  graduate  medical  education
 program  which  has  received accreditation from a nationally recognized
 accreditation body or in a program  approved  by  any  other  nationally
 recognized  organization  for  medical,  osteopathic or dental residency
 programs including, but not limited to, specialty boards.
   [(p) "Shortage specialty" means a specialty determined by the  commis-
 sioner,  in  consultation with the council, to be in short supply in the
 state of New York.
   (q)] (M) "Sponsoring institution" means the entity that has the  over-
 all  responsibility  for  a  program of graduate medical education. Such
 institutions shall include teaching general hospitals, medical  schools,
 consortia and diagnostic and treatment centers.
   [(r)]  (N)  "Weighted  resident count" means a teaching general hospi-
 tal's total number of residents as of July first, nineteen hundred nine-
 ty-five,  including  residents  in  affiliated  non-hospital  ambulatory
 settings,  reported  to  the  commissioner.  Such  resident counts shall
 reflect the weights established in accordance with rules and regulations
 adopted by the state hospital review and planning council  and  approved
 by the commissioner for purposes of implementing subdivision twenty-five
 of section twenty-eight hundred seven-c of this article and in effect on
 July  first,  nineteen  hundred  ninety-five.  Such weights shall not be
 applied to specialty hospitals, specified  by  the  commissioner,  whose
 primary  care  mission  is  to engage in research, training and clinical
 care in specialty  eye  and  ear,  special  surgery,  orthopedic,  joint
 disease, cancer, chronic care or rehabilitative services.
   [(s)]  (O)  "Adjustment  amount"  means  an amount determined for each
 teaching hospital for periods prior to January first, two thousand  nine
 by:
   (i)  determining the difference between (A) a calculation of what each
 teaching general hospital would have been paid if payments made pursuant
 to paragraph (a-3) of subdivision one of  section  twenty-eight  hundred
 seven-c  of this article between January first, nineteen hundred ninety-
 six and December thirty-first, two thousand three were based  solely  on
 the  case  mix  of  persons  eligible  for  medical assistance under the
 medical assistance program pursuant to title eleven of article  five  of
 the social services law who are enrolled in health maintenance organiza-
 tions and persons paid for under the family health plus program enrolled
 in  approved organizations pursuant to title eleven-D of article five of
 the social services law during those years, and (B) the actual  payments
 to  each such hospital pursuant to paragraph (a-3) of subdivision one of
 section twenty-eight hundred seven-c of  this  article  between  January
 first,  nineteen hundred ninety-six and December thirty-first, two thou-
 sand three.
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   (ii) reducing proportionally each of the amounts determined in subpar-
 agraph (i) of this paragraph so that the sum of all such amounts  totals
 no more than one hundred million dollars;
   (iii)  further reducing each of the amounts determined in subparagraph
 (ii) of this paragraph by the amount received  by  each  hospital  as  a
 distribution  from funds designated in paragraph (a) of subdivision five
 of this section attributable to the period January first,  two  thousand
 three  through December thirty-first, two thousand three, except that if
 such amount was  provided  to  a  consortium  then  the  amount  of  the
 reduction  for  each  hospital  in the consortium shall be determined by
 applying the proportion  of  each  hospital's  amount  determined  under
 subparagraph  (i)  of this paragraph to the total of such amounts of all
 hospitals in such consortium to the consortium award;
   (iv) further reducing each of the amounts determined  in  subparagraph
 (iii)  of this paragraph by the amounts specified in paragraph [(t)] (P)
 of this subdivision; and
   (v) dividing each of the amounts determined in subparagraph  (iii)  of
 this paragraph by seven.
   [(t)] (P) "Extra reduction amount" shall mean an amount determined for
 a  teaching hospital for which an adjustment amount is calculated pursu-
 ant to paragraph [(s)] (O) of this subdivision that  is  the  hospital's
 proportionate  share  of  the  sum of the amounts specified in paragraph
 [(u)] (Q) of this subdivision determined based upon a comparison of  the
 hospital's  remaining  liability  calculated pursuant to paragraph [(s)]
 (O) of this subdivision to the sum  of  all  such  hospital's  remaining
 liabilities.
   [(u)]  (Q)  "Allotment  amount"  shall  mean  an amount determined for
 teaching hospitals as follows:
   (i) for a hospital for which an adjustment amount  pursuant  to  para-
 graph  [(s)] (O) of this subdivision does not apply, the amount received
 by the hospital pursuant to paragraph (a) of subdivision  five  of  this
 section  attributable  to  the  period January first, two thousand three
 through December thirty-first, two thousand three, or
   (ii) for a hospital for which an adjustment amount pursuant  to  para-
 graph  [(s)]  (O)  of  this  subdivision  applies  and  which received a
 distribution pursuant to paragraph  (a)  of  subdivision  five  of  this
 section  attributable  to  the  period January first, two thousand three
 through December thirty-first, two thousand three that is  greater  than
 the  hospital's  adjustment  amount, the difference between the distrib-
 ution amount and the adjustment amount.
   (f) Effective January first, two thousand five through December  thir-
 ty-first,  two  thousand  eight,  each  teaching  general hospital shall
 receive a distribution from the applicable regional pool  based  on  its
 distribution amount determined under paragraphs (c), (d) and (e) of this
 subdivision  and reduced by its adjustment amount calculated pursuant to
 paragraph [(s)] (O) of subdivision one of this section and, for distrib-
 utions for the period January first, two thousand five through  December
 thirty-first,  two thousand five, further reduced by its extra reduction
 amount calculated pursuant to paragraph [(t)] (P) of subdivision one  of
 this section.
   (a)  Up to thirty-one million dollars annually for the periods January
 first, two thousand through December thirty-first, two  thousand  three,
 and up to twenty-five million dollars plus the sum of the amounts speci-
 fied  in  paragraph [(n)] (K) of subdivision one of this section for the
 period January first, two thousand five through  December  thirty-first,
 two thousand five, and up to thirty-one million dollars annually for the
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 period  January  first,  two thousand six through December thirty-first,
 two thousand seven, shall be set aside and reserved by the  commissioner
 from  the regional pools established pursuant to subdivision two of this
 section for supplemental distributions in each such region to be made by
 the  commissioner to consortia and teaching general hospitals in accord-
 ance with a distribution methodology developed in consultation with  the
 council  and  specified  in rules and regulations adopted by the commis-
 sioner.
   (d) Notwithstanding any other provision of law or regulation, for  the
 period  January  first, two thousand five through December thirty-first,
 two thousand five, the commissioner  shall  distribute  as  supplemental
 payments  the  allotment specified in paragraph [(n)] (K) of subdivision
 one of this section.
   5-a. Graduate medical education  innovations  pool.  (a)  Supplemental
 distributions.  (i)  Thirty-one  million  dollars for the period January
 first, two thousand eight through December  thirty-first,  two  thousand
 eight,  shall  be  set  aside  and reserved by the commissioner from the
 regional pools established pursuant to subdivision two of  this  section
 and shall be available for distributions pursuant to subdivision five of
 this  section  and in accordance with section 86-1.89 of title 10 of the
 codes, rules and regulations of the state of New York as  in  effect  on
 January  first,  two thousand eight[; provided, however, for purposes of
 funding the empire clinical research investigation  program  (ECRIP)  in
 accordance  with paragraph eight of subdivision (e) and paragraph two of
 subdivision (f) of section 86-1.89 of title 10 of the codes,  rules  and
 regulations  of the state of New York, distributions shall be made using
 two regions defined as New York city and the rest of the state  and  the
 dollar amount set forth in subparagraph (i) of paragraph two of subdivi-
 sion  (f)  of  section 86-1.89 of title 10 of the codes, rules and regu-
 lations of the state of New York shall be increased from sixty  thousand
 dollars to seventy-five thousand dollars].
   (ii)  For  periods  on  and  after  January  first, two thousand nine,
 supplemental distributions pursuant to subdivision five of this  section
 and  in  accordance with section 86-1.89 of title 10 of the codes, rules
 and regulations of the state of New York shall no longer be made and the
 provisions of section 86-1.89 of title 10 of the codes, rules and  regu-
 lations of the state of New York shall be null and void.
   (b)  [Empire  clinical  research  investigator  program  (ECRIP). Nine
 million one hundred twenty thousand  dollars  annually  for  the  period
 January  first,  two  thousand  nine  through December thirty-first, two
 thousand ten, and two million two hundred eighty  thousand  dollars  for
 the  period  January  first,  two thousand eleven, through March thirty-
 first, two thousand eleven, nine million  one  hundred  twenty  thousand
 dollars  each state fiscal year for the period April first, two thousand
 eleven through March thirty-first, two thousand fourteen,  up  to  eight
 million  six  hundred twelve thousand dollars each state fiscal year for
 the period April first, two  thousand  fourteen  through  March  thirty-
 first,  two  thousand  seventeen, up to eight million six hundred twelve
 thousand dollars each state fiscal year for the period April first,  two
 thousand  seventeen  through March thirty-first, two thousand twenty, up
 to eight million six hundred twelve thousand dollars each  state  fiscal
 year for the period April first, two thousand twenty through March thir-
 ty-first, two thousand twenty-three, and up to eight million six hundred
 twelve  thousand  dollars  each  state  fiscal year for the period April
 first, two thousand twenty-three through March thirty-first,  two  thou-
 sand  twenty-six,  shall  be  set aside and reserved by the commissioner
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 from the regional pools established pursuant to subdivision two of  this
 section  to  be  allocated  regionally  with two-thirds of the available
 funding going to New York city and one-third of  the  available  funding
 going  to  the rest of the state and shall be available for distribution
 as follows:
   Distributions shall first be made to consortia  and  teaching  general
 hospitals  for the empire clinical research investigator program (ECRIP)
 to help secure federal funding for biomedical research,  train  clinical
 researchers,  recruit national leaders as faculty to act as mentors, and
 train residents and fellows  in  biomedical  research  skills  based  on
 hospital-specific  data  submitted  to the commissioner by consortia and
 teaching general hospitals in accordance with clause (G) of this subpar-
 agraph. Such distributions shall be made in accordance with the  follow-
 ing methodology:
   (A)  The  greatest  number  of clinical research positions for which a
 consortium or teaching general hospital may be funded pursuant  to  this
 subparagraph  shall  be  one  percent  of  the total number of residents
 training at the consortium or teaching general hospital on  July  first,
 two  thousand  eight  for  the  period  January first, two thousand nine
 through December thirty-first, two thousand nine rounded up to the near-
 est one position.
   (B) Distributions made to a consortium or  teaching  general  hospital
 shall  equal  the product of the total number of clinical research posi-
 tions submitted  by  a  consortium  or  teaching  general  hospital  and
 accepted  by the commissioner as meeting the criteria set forth in para-
 graph (b) of subdivision one of this section, subject to  the  reduction
 calculation  set  forth  in  clause  (C) of this subparagraph, times one
 hundred ten thousand dollars.
   (C) If the dollar amount for the total  number  of  clinical  research
 positions  in  the  region  calculated  pursuant  to  clause (B) of this
 subparagraph exceeds the total amount appropriated for purposes of  this
 paragraph,  including clinical research positions that continue from and
 were funded in prior distribution periods, the commissioner shall elimi-
 nate one-half of the  clinical  research  positions  submitted  by  each
 consortium  or teaching general hospital rounded down to the nearest one
 position. Such reduction shall be repeated until the dollar  amount  for
 the  total  number of clinical research positions in the region does not
 exceed the total amount appropriated for purposes of this paragraph.  If
 the  repeated  reduction  of the total number of clinical research posi-
 tions in the region by one-half does not render a total  funding  amount
 that  is equal to or less than the total amount reserved for that region
 within the appropriation, the funding for each clinical  research  posi-
 tion  in  that  region  shall  be reduced proportionally in one thousand
 dollar increments until the total dollar amount for the total number  of
 clinical  research  positions  in  that region does not exceed the total
 amount reserved for that region within the appropriation. Any  reduction
 in  funding will be effective for the duration of the award. No clinical
 research positions that continue from and were funded in prior  distrib-
 ution periods shall be eliminated or reduced by such methodology.
   (D)  Each  consortium  or  teaching general hospital shall receive its
 annual distribution amount in accordance with the following:
   (I) Each consortium or teaching general hospital with a one-year ECRIP
 award  shall  receive  its  annual  distribution  amount  in  full  upon
 completion of the requirements set forth in items (I) and (II) of clause
 (G)  of  this subparagraph. The requirements set forth in items (IV) and
 (V) of clause (G) of this subparagraph must be completed by the  consor-
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 tium  or teaching general hospital in order for the consortium or teach-
 ing general hospital to be eligible to apply for ECRIP  funding  in  any
 subsequent funding cycle.
   (II)  Each  consortium  or  teaching  general hospital with a two-year
 ECRIP award shall receive its first annual distribution amount  in  full
 upon  completion  of the requirements set forth in items (I) and (II) of
 clause (G) of this subparagraph. Each  consortium  or  teaching  general
 hospital will receive its second annual distribution amount in full upon
 completion  of the requirements set forth in item (III) of clause (G) of
 this subparagraph. The requirements set forth in items (IV) and  (V)  of
 clause  (G)  of this subparagraph must be completed by the consortium or
 teaching general hospital in order for the consortium or teaching gener-
 al hospital to be eligible to apply for ECRIP funding in any  subsequent
 funding cycle.
   (E)  Each  consortium  or teaching general hospital receiving distrib-
 utions pursuant to this subparagraph shall reserve seventy-five thousand
 dollars to primarily fund salary and fringe  benefits  of  the  clinical
 research  position  with  the remainder going to fund the development of
 faculty who are involved in biomedical research, training  and  clinical
 care.
   (F)  Undistributed  or  returned  funds  available  to  fund  clinical
 research positions pursuant to this paragraph for a distribution  period
 shall  be  available to fund clinical research positions in a subsequent
 distribution period.
   (G) In order to be eligible for distributions pursuant to this subpar-
 agraph, each consortium and teaching general hospital shall  provide  to
 the  commissioner by July first of each distribution period, the follow-
 ing data and information on a hospital-specific  basis.  Such  data  and
 information  shall  be  certified as to accuracy and completeness by the
 chief executive officer, chief financial officer or chair of the consor-
 tium governing body of each consortium or teaching general hospital  and
 shall be maintained by each consortium and teaching general hospital for
 five years from the date of submission:
   (I)  For  each  clinical  research  position, information on the type,
 scope, training objectives,  institutional  support,  clinical  research
 experience of the sponsor-mentor, plans for submitting research outcomes
 to  peer reviewed journals and at scientific meetings, including a meet-
 ing sponsored by the department, the name of a principal contact  person
 responsible for tracking the career development of researchers placed in
 clinical  research positions, as defined in paragraph (c) of subdivision
 one of this section, and who is authorized to certify to the commission-
 er that all the requirements of the clinical  research  training  objec-
 tives  set  forth  in this subparagraph shall be met. Such certification
 shall be provided by July first of each distribution period;
   (II) For each clinical research position,  information  on  the  name,
 citizenship  status, medical education and training, and medical license
 number of the researcher, if applicable, shall be provided  by  December
 thirty-first of the calendar year following the distribution period;
   (III)  Information on the status of the clinical research plan, accom-
 plishments, changes in research activities, progress, and performance of
 the researcher shall be provided upon  completion  of  one-half  of  the
 award term;
   (IV)  A  final report detailing training experiences, accomplishments,
 activities and performance of the clinical researcher, and  data,  meth-
 ods,  results  and  analyses  of  the  clinical  research  plan shall be
 provided three months after the clinical research position ends; and
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   (V) Tracking information concerning past  researchers,  including  but
 not  limited  to (A) background information, (B) employment history, (C)
 research status, (D) current research activities, (E)  publications  and
 presentations,  (F)  research  support,  and  (G)  any other information
 necessary to track the researcher; and
   (VI)  Any  other  data  or information required by the commissioner to
 implement this subparagraph.
   (H) Notwithstanding any inconsistent provision  of  this  subdivision,
 for periods on and after April first, two thousand thirteen, ECRIP grant
 awards shall be made in accordance with rules and regulations promulgat-
 ed by the commissioner. Such regulations shall, at a minimum:
   (1)  provide  that ECRIP grant awards shall be made with the objective
 of securing federal funding for biomedical research,  training  clinical
 researchers,  recruiting  national leaders as faculty to act as mentors,
 and training residents and fellows in biomedical research skills;
   (2) provide that ECRIP grant applicants may include  interdisciplinary
 research teams comprised of teaching general hospitals acting in collab-
 oration  with  entities  including  but  not limited to medical centers,
 hospitals, universities and local health departments;
   (3) provide that applications for ECRIP grant awards shall be based on
 such information requested by the commissioner, which shall include  but
 not be limited to hospital-specific data;
   (4)  establish  the  qualifications  for investigators and other staff
 required for grant projects eligible for ECRIP grant awards; and
   (5) establish a methodology for the distribution of funds under  ECRIP
 grant awards.
   (c)]  Physician loan repayment program. One million nine hundred sixty
 thousand dollars for  the  period  January  first,  two  thousand  eight
 through  December  thirty-first,  two  thousand  eight, one million nine
 hundred sixty thousand dollars for the period January first,  two  thou-
 sand  nine through December thirty-first, two thousand nine, one million
 nine hundred sixty thousand dollars for the period  January  first,  two
 thousand  ten  through  December  thirty-first,  two  thousand ten, four
 hundred ninety thousand dollars for the period January first, two  thou-
 sand eleven through March thirty-first, two thousand eleven, one million
 seven  hundred  thousand  dollars  each state fiscal year for the period
 April first, two thousand eleven through March thirty-first,  two  thou-
 sand  fourteen,  up  to  one million seven hundred five thousand dollars
 each state fiscal year for the period April first, two thousand fourteen
 through March thirty-first, two thousand seventeen, up  to  one  million
 seven hundred five thousand dollars each state fiscal year for the peri-
 od  April  first, two thousand seventeen through March thirty-first, two
 thousand twenty, up to one million seven hundred five  thousand  dollars
 each  state  fiscal year for the period April first, two thousand twenty
 through March thirty-first, two thousand twenty-three,  and  up  to  one
 million  seven  hundred five thousand dollars each state fiscal year for
 the period April first, two thousand twenty-three through March  thirty-
 first,  two  thousand twenty-six, shall be set aside and reserved by the
 commissioner from the regional pools established pursuant to subdivision
 two of this section and shall be available  for  purposes  of  physician
 loan  repayment  in  accordance  with  subdivision  ten of this section.
 Notwithstanding any contrary provision of  this  section,  sections  one
 hundred  twelve and one hundred sixty-three of the state finance law, or
 any other contrary provision of law, such  funding  shall  be  allocated
 regionally  with one-third of available funds going to New York city and
 two-thirds of available funds going to the rest of the state  and  shall
 S. 8307--A                         69                         A. 8807--A
 
 be  distributed in a manner to be determined by the commissioner without
 a competitive bid or request for proposal process as follows:
   (i) Funding shall first be awarded to repay loans of up to twenty-five
 physicians  who  train  in  primary care or specialty tracks in teaching
 general hospitals, and who enter and remain in primary care or specialty
 practices in underserved communities, as determined by the commissioner.
   (ii) After distributions in accordance with subparagraph (i)  of  this
 paragraph, all remaining funds shall be awarded to repay loans of physi-
 cians  who  enter  and  remain in primary care or specialty practices in
 underserved communities, as determined by  the  commissioner,  including
 but  not  limited  to  physicians working in general hospitals, or other
 health care facilities.
   (iii) In no case shall less than fifty percent of the funds  available
 pursuant  to  this  paragraph be distributed in accordance with subpara-
 graphs (i) and (ii) of this paragraph to physicians identified by gener-
 al hospitals.
   (iv) In addition to the funds allocated under this paragraph, for  the
 period April first, two thousand fifteen through March thirty-first, two
 thousand  sixteen,  two  million  dollars  shall  be  available  for the
 purposes described in subdivision ten of this section;
   (v) In addition to the funds allocated under this paragraph,  for  the
 period April first, two thousand sixteen through March thirty-first, two
 thousand  seventeen,  two  million  dollars  shall  be available for the
 purposes described in subdivision ten of this section;
   (vi) Notwithstanding any provision of law to the contrary, and subject
 to the extension of the Health Care Reform Act of 1996, sufficient funds
 shall be available for the purposes described in subdivision ten of this
 section in amounts necessary to fund the remaining year commitments  for
 awards made pursuant to subparagraphs (iv) and (v) of this paragraph.
   [(d)]  (C) Physician practice support. Four million nine hundred thou-
 sand dollars for the period January first, two  thousand  eight  through
 December  thirty-first,  two  thousand  eight, four million nine hundred
 thousand dollars annually for the period  January  first,  two  thousand
 nine  through  December  thirty-first, two thousand ten, one million two
 hundred twenty-five thousand dollars for the period January  first,  two
 thousand  eleven  through  March thirty-first, two thousand eleven, four
 million three hundred thousand dollars each state fiscal  year  for  the
 period  April first, two thousand eleven through March thirty-first, two
 thousand fourteen, up to  four  million  three  hundred  sixty  thousand
 dollars  each state fiscal year for the period April first, two thousand
 fourteen through March thirty-first, two thousand seventeen, up to  four
 million  three hundred sixty thousand dollars for each state fiscal year
 for the period April first, two thousand seventeen through  March  thir-
 ty-first,  two  thousand  twenty, up to four million three hundred sixty
 thousand dollars for each fiscal year for the period  April  first,  two
 thousand  twenty  through March thirty-first, two thousand twenty-three,
 and up to four million three hundred sixty  thousand  dollars  for  each
 fiscal  year  for  the  period  April  first,  two thousand twenty-three
 through March thirty-first, two thousand twenty-six, shall be set  aside
 and  reserved  by  the  commissioner from the regional pools established
 pursuant to subdivision two of this section and shall be  available  for
 purposes  of  physician  practice  support. Notwithstanding any contrary
 provision of this section, sections one hundred twelve and  one  hundred
 sixty-three of the state finance law, or any other contrary provision of
 law, such funding shall be allocated regionally with one-third of avail-
 able  funds  going  to  New  York city and two-thirds of available funds
 S. 8307--A                         70                         A. 8807--A
 
 going to the rest of the state and shall be distributed in a  manner  to
 be  determined  by the commissioner without a competitive bid or request
 for proposal process as follows:
   (i)  Preference in funding shall first be accorded to teaching general
 hospitals for up to twenty-five awards, to  support  costs  incurred  by
 physicians  trained in primary or specialty tracks who thereafter estab-
 lish or join practices in underserved communities, as determined by  the
 commissioner.
   (ii)  After  distributions in accordance with subparagraph (i) of this
 paragraph, all remaining funds shall be awarded to physicians to support
 the cost of establishing or joining practices  in  underserved  communi-
 ties,  as  determined  by  the  commissioner, and to hospitals and other
 health care providers to recruit new physicians to provide  services  in
 underserved communities, as determined by the commissioner.
   (iii)  In no case shall less than fifty percent of the funds available
 pursuant to this  paragraph  be  distributed  to  general  hospitals  in
 accordance with subparagraphs (i) and (ii) of this paragraph.
   [(e)] (D) Work group. For funding available pursuant to paragraphs (B)
 AND (c)[, (d) and (e)] of this subdivision:
   (i)  The  department  shall  appoint a work group from recommendations
 made by associations  representing  physicians,  general  hospitals  and
 other  health care facilities to develop a streamlined application proc-
 ess by June first, two thousand twelve.
   (ii) Subject to available funding, applications shall be accepted on a
 continuous basis. The department shall provide technical  assistance  to
 applicants  to facilitate their completion of applications. An applicant
 shall be notified in writing  by  the  department  within  ten  days  of
 receipt  of an application as to whether the application is complete and
 if the application is incomplete, what information is  outstanding.  The
 department  shall act on an application within thirty days of receipt of
 a complete application.
   [(f)] (E) Study on physician workforce. Five hundred  ninety  thousand
 dollars  annually  for  the  period  January  first,  two thousand eight
 through December thirty-first, two thousand ten, one hundred forty-eight
 thousand dollars for the  period  January  first,  two  thousand  eleven
 through  March  thirty-first,  two thousand eleven, five hundred sixteen
 thousand dollars each state fiscal year for the period April first,  two
 thousand eleven through March thirty-first, two thousand fourteen, up to
 four  hundred  eighty-seven  thousand dollars each state fiscal year for
 the period April first, two  thousand  fourteen  through  March  thirty-
 first,  two thousand seventeen, up to four hundred eighty-seven thousand
 dollars for each state fiscal year for the period April first, two thou-
 sand seventeen through March thirty-first, two thousand  twenty,  up  to
 four  hundred  eighty-seven  thousand dollars each state fiscal year for
 the period April first, two thousand twenty through March  thirty-first,
 two  thousand twenty-three, and up to four hundred eighty-seven thousand
 dollars each state fiscal year for the period April first, two  thousand
 twenty-three  through March thirty-first, two thousand twenty-six, shall
 be set aside and reserved by the commissioner from  the  regional  pools
 established  pursuant  to  subdivision  two of this section and shall be
 available to fund a study of physician  workforce  needs  and  solutions
 including,  but  not  limited  to, an analysis of residency programs and
 projected physician workforce  and  community  needs.  The  commissioner
 shall  enter  into  agreements with one or more organizations to conduct
 such study based on a request for proposal process.
 S. 8307--A                         71                         A. 8807--A
 
   [(g)] (F) Diversity in medicine/post-baccalaureate  program.  Notwith-
 standing any inconsistent provision of section one hundred twelve or one
 hundred  sixty-three  of  the  state  finance  law or any other law, one
 million nine hundred sixty thousand  dollars  annually  for  the  period
 January  first,  two  thousand  eight through December thirty-first, two
 thousand ten, four hundred ninety thousand dollars for the period  Janu-
 ary  first, two thousand eleven through March thirty-first, two thousand
 eleven, one million seven hundred thousand  dollars  each  state  fiscal
 year for the period April first, two thousand eleven through March thir-
 ty-first,  two  thousand  fourteen,  up  to one million six hundred five
 thousand dollars each state fiscal year for the period April first,  two
 thousand fourteen through March thirty-first, two thousand seventeen, up
 to  one million six hundred five thousand dollars each state fiscal year
 for the period April first, two thousand seventeen through  March  thir-
 ty-first,  two thousand twenty, up to one million six hundred five thou-
 sand dollars each state fiscal year for  the  period  April  first,  two
 thousand  twenty  through March thirty-first, two thousand twenty-three,
 and up to one million six  hundred  five  thousand  dollars  each  state
 fiscal  year  for  the  period  April  first,  two thousand twenty-three
 through March thirty-first, two thousand twenty-six, shall be set  aside
 and  reserved  by  the  commissioner from the regional pools established
 pursuant to subdivision two of this section and shall be  available  for
 distributions  to the Associated Medical Schools of New York to fund its
 diversity program including existing and new post-baccalaureate programs
 for minority  and  economically  disadvantaged  students  and  encourage
 participation  from  all  medical  schools  in  New York. The associated
 medical schools of New York shall report to the commissioner on an annu-
 al basis regarding the use of funds for such purpose in  such  form  and
 manner as specified by the commissioner.
   [(h)]  (G)  In  the event there are undistributed funds within amounts
 made available for distributions  pursuant  to  this  subdivision,  such
 funds  may  be  reallocated  and  distributed  in  current or subsequent
 distribution periods in a manner determined by the commissioner for  any
 purpose set forth in this subdivision.
   12. Notwithstanding any provision of law to the contrary, applications
 submitted  on or after April first, two thousand sixteen, for the physi-
 cian loan repayment program pursuant to paragraph [(c)] (B) of  subdivi-
 sion  five-a  of this section and subdivision ten of this section or the
 physician practice support program pursuant to paragraph  [(d)]  (C)  of
 subdivision  five-a  of  this section, shall be subject to the following
 changes:
   (a) Awards shall be made from the  total  funding  available  for  new
 awards  under  the  physician  loan  repayment program and the physician
 practice support program, with neither program  limited  to  a  specific
 funding amount within such total funding available;
   (b)  An  applicant  may  apply  for an award for either physician loan
 repayment or physician practice support, but not both;
   (c) An applicant shall agree to practice for three years in an  under-
 served  area  and  each award shall provide up to forty thousand dollars
 for each of the three years; and
   (d) To the extent practicable, awards shall be timed to be of use  for
 job offers made to applicants.
   §  4.  Subparagraph (xvi) of paragraph (a) of subdivision 7 of section
 2807-s of the public health law, as amended by section 8 of  part  Y  of
 chapter 56 of the laws of 2020, is amended to read as follows:
 S. 8307--A                         72                         A. 8807--A
 
   (xvi)  provided further, however, for periods prior to July first, two
 thousand nine, amounts set forth in this paragraph shall be  reduced  by
 an amount equal to the actual distribution reductions for all facilities
 pursuant  to  paragraph  [(s)] (O) of subdivision one of section twenty-
 eight hundred seven-m of this article.
   §  5.  Subdivision  (c)  of section 92-dd of the state finance law, as
 amended by section 9 of part Y of chapter 56 of the  laws  of  2020,  is
 amended to read as follows:
   (c)  The pool administrator shall, from appropriated funds transferred
 to the  pool  administrator  from  the  comptroller,  continue  to  make
 payments  as required pursuant to sections twenty-eight hundred seven-k,
 twenty-eight hundred seven-m (not including payments  made  pursuant  to
 SUBDIVISION FIVE-B AND paragraphs (B), (c)[, (d),, (f)] and [(g)] (F) of
 subdivision  five-a  of section twenty-eight hundred seven-m), and twen-
 ty-eight hundred seven-w of the public  health  law,  paragraph  (e)  of
 subdivision  twenty-five  of section twenty-eight hundred seven-c of the
 public health law, paragraphs (b)  and  (c)  of  subdivision  thirty  of
 section twenty-eight hundred seven-c of the public health law, paragraph
 (b) of subdivision eighteen of section twenty-eight hundred eight of the
 public health law, subdivision seven of section twenty-five hundred-d of
 the  public  health  law  and section eighty-eight of chapter one of the
 laws of nineteen hundred ninety-nine.
   § 6. Paragraph (c) of subdivision 1 of section  461-b  of  the  social
 services law is REPEALED.
   § 7. Article 27-H of the public health law is REPEALED.
   §  8.  Paragraph  (c)  of  subdivision 11 of section 230 of the public
 health law, as amended by chapter 343 of the laws of 1980,  subparagraph
 (ii)  as  amended  by  section 10 of part B of chapter 57 of the laws of
 2023, is amended to read as follows:
   (c) Notwithstanding the foregoing, no physician shall  be  responsible
 for reporting pursuant to paragraph (a) of this subdivision with respect
 to any information discovered by such physician solely as a result of:
   [(i)] Participation in a properly conducted mortality and/or morbidity
 conference,  departmental  meeting  or  a  medical  or  tissue committee
 constituted pursuant to the by-laws of a hospital which is  duly  estab-
 lished pursuant to article twenty-eight of the public health law, unless
 the  procedures  of  such  conference,  department  or committee of such
 hospital shall have been declared to be  unacceptable  for  the  purpose
 hereof by the commissioner, and provided that the obligations of report-
 ing such information when appropriate to do so shall be the responsibil-
 ity  of  the  chairperson  of such conference, department or committee[,
 or].
   [(ii) Participation and membership during a three  year  demonstration
 period  in  a physician committee of the Medical Society of the State of
 New York or the New York State Osteopathic Society whose purpose  is  to
 confront and refer to treatment physicians who are thought to be suffer-
 ing  from  alcoholism, drug abuse, or mental illness. Such demonstration
 period shall commence on April first, nineteen hundred eighty and termi-
 nate on May thirty-first, nineteen hundred eighty-three.  An  additional
 demonstration  period  shall  commence  on  June first, nineteen hundred
 eighty-three and  terminate  on  March  thirty-first,  nineteen  hundred
 eighty-six.  An  additional demonstration period shall commence on April
 first, nineteen hundred eighty-six and terminate on March  thirty-first,
 nineteen  hundred  eighty-nine. An additional demonstration period shall
 commence April first, nineteen hundred eighty-nine and  terminate  March
 thirty-first,  nineteen  hundred ninety-two. An additional demonstration
 S. 8307--A                         73                         A. 8807--A

 period shall commence  April  first,  nineteen  hundred  ninety-two  and
 terminate  March  thirty-first,  nineteen  hundred ninety-five. An addi-
 tional demonstration period shall  commence  on  April  first,  nineteen
 hundred  ninety-five  and  terminate  on  March  thirty-first,  nineteen
 hundred ninety-eight. An additional demonstration period shall  commence
 on  April  first,  nineteen  hundred ninety-eight and terminate on March
 thirty-first, two thousand three.  An  additional  demonstration  period
 shall commence on April first, two thousand three and terminate on March
 thirty-first,  two thousand thirteen. An additional demonstration period
 shall commence April first, two thousand thirteen and terminate on March
 thirty-first, two thousand eighteen. An additional demonstration  period
 shall  commence April first, two thousand eighteen and terminate on July
 first, two thousand twenty-eight provided, however, that the commission-
 er may prescribe requirements for the continuation of such demonstration
 program, including periodic reviews of such programs and  submission  of
 any  reports  and  data  necessary  to permit such reviews. During these
 additional periods, the provisions of this subparagraph shall also apply
 to a physician committee of a county medical society.]
   § 9. Paragraph (g) of subdivision 11 of  section  230  of  the  public
 health law is REPEALED and paragraph (h) is relettered paragraph (g).
   §  10.  This  act shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024; provided,
 however, the amendments to subparagraph (xvi) of paragraph (a) of subdi-
 vision 7 of section 2807-s of the public health law made by section four
 of this act shall not affect the expiration of such section and shall be
 deemed to expire therewith.
 
                                  PART M
 
   Section 1. Subparagraph 3 of paragraph (b) of subdivision 4 of section
 366 of the social services law, as added by section 2 of part D of chap-
 ter 56 of the laws of 2013, is amended to read as follows:
   (3) (A) A child [under] BETWEEN the [age] AGES of SIX AND nineteen who
 is determined eligible for medical assistance under  the  provisions  of
 this  section,  shall,  consistent with applicable federal requirements,
 remain eligible for such assistance until [the earlier of:
   (i)] the last day of the month which is twelve  months  following  the
 determination  [or  redetermination]  OR RENEWAL of eligibility for such
 assistance[; or
   (ii) the last day of the month in which the child reaches the  age  of
 nineteen].
   (B)  A  CHILD  UNDER  THE  AGE  OF  SIX WHO IS DETERMINED ELIGIBLE FOR
 MEDICAL ASSISTANCE UNDER THE PROVISIONS OF THIS SECTION, SHALL, CONSIST-
 ENT WITH APPLICABLE FEDERAL REQUIREMENTS, REMAIN  CONTINUOUSLY  ELIGIBLE
 FOR MEDICAL ASSISTANCE COVERAGE UNTIL THE LATER OF:
   (I)  THE  LAST DAY OF THE TWELFTH MONTH FOLLOWING THE DETERMINATION OR
 RENEWAL OF ELIGIBILITY FOR SUCH ASSISTANCE; OR
   (II) THE LAST DAY OF THE MONTH IN WHICH THE CHILD REACHES THE  AGE  OF
 SIX.
   § 2. Subdivision 6 of section 2510 of the public health law is amended
 by adding a new paragraph (e) to read as follows:
   (E)  AN  ELIGIBLE  CHILD UNDER SIX YEARS OF AGE SHALL, CONSISTENT WITH
 APPLICABLE FEDERAL REQUIREMENTS, REMAIN CONTINUOUSLY ENROLLED UNTIL  THE
 LATER OF:
   (I) THE LAST DAY OF THE TWELFTH MONTH FOLLOWING THE DATE OF ENROLLMENT
 OR RECERTIFICATION IN THE CHILD HEALTH INSURANCE PLAN; OR
 S. 8307--A                         74                         A. 8807--A
 
   (II)  THE  LAST DAY OF THE MONTH IN WHICH THE CHILD REACHES THE AGE OF
 SIX.
   § 3. This act shall take effect January 1, 2025.
 
                                  PART N
 
   Section 1. Paragraph (d) of subdivision 4 of section 206 of the public
 health  law, as added by chapter 602 of the laws of 2007, is amended and
 a new paragraph (e) is added  to read as follows:
   (d) assess  civil  penalties  against  a  public  water  system  which
 provides  water  to  the  public  for human consumption through pipes or
 other constructed conveyances, as further defined in the state  sanitary
 code  or,  in  the  case  of  mass  gatherings,  the person who holds or
 promotes the mass gathering as defined in subdivision  five  of  section
 two  hundred twenty-five of this article not to exceed twenty-five thou-
 sand dollars per day, for each violation of or failure  to  comply  with
 any term or provision of the state sanitary code as it relates to public
 water  systems  that serve a population of five thousand or more persons
 or any mass gatherings, which penalty may be assessed after a hearing or
 an opportunity to be heard[.];
   (E) NOTWITHSTANDING SECTION SIXTY-FIVE HUNDRED THIRTY OF THE EDUCATION
 LAW, ISSUE A NON-PATIENT  SPECIFIC  STATEWIDE  STANDING  ORDER  FOR  THE
 PROVISION OF DOULA SERVICES FOR PREGNANT, BIRTHING, AND POSTPARTUM INDI-
 VIDUALS THROUGH TWELVE MONTHS POSTPARTUM.
   § 2.  Subdivision 3 of section 2504 of the public health law, as added
 by chapter 976 of the laws of 1984, is amended to read as follows:
   3.  Any  person, INCLUDING A MINOR, who is pregnant may give effective
 consent for ANY AND ALL medical, dental, health  and  hospital  services
 relating  to  [prenatal]  REPRODUCTIVE HEALTH care, INCLUDING CONSENT TO
 TERMINATE A PREGNANCY FOR ANY REASON.
   § 3. The opening paragraph of section 2599-aa  of  the  public  health
 law,  as  added  by chapter 1 of the laws of 2019, is amended to read as
 follows:
   The legislature finds that comprehensive reproductive health care is a
 fundamental  component  of  every  individual's  health,   privacy   and
 equality,  INCLUDING  MINORS.  Therefore,  it is the policy of the state
 that:
   § 4. The public  health  law  is  amended  by  adding  a  new  section
 2599-bb-1 to read as follows:
   §  2599-BB-1.  CONTRACEPTION.  1. A HEALTH CARE PRACTITIONER LICENSED,
 CERTIFIED, OR AUTHORIZED UNDER TITLE EIGHT OF THE EDUCATION LAW,  ACTING
 WITHIN  THEIR  LAWFUL  SCOPE  OF PRACTICE, MAY PRESCRIBE OR DISTRIBUTE A
 CONTRACEPTIVE DEVICE OR MEDICATION WHEN, ACCORDING TO THE PRACTITIONER'S
 REASONABLE AND GOOD FAITH PROFESSIONAL JUDGMENT BASED ON  THE  FACTS  OF
 THE  PATIENT'S  CASE,  THEY  DETERMINE  THE PATIENT IS ABLE TO MEDICALLY
 TOLERATE SUCH TREATMENT.
   2. THIS ARTICLE SHALL BE CONSTRUED AND  APPLIED  CONSISTENT  WITH  AND
 SUBJECT  TO  APPLICABLE  LAWS  AND APPLICABLE AND AUTHORIZED REGULATIONS
 GOVERNING HEALTH CARE PROCEDURES.
   § 5. SECTION 2504 OF THE PUBLIC HEALTH LAW IS AMENDED BY ADDING A  NEW
 SUBDIVISION 8 TO READ AS FOLLOWS:
   8. DRUG, CANNABIS, OR ALCOHOL TESTING FOR PREGNANT OR POSTPARTUM INDI-
 VIDUALS.
   (A)  DEFINITION. AS USED IN THIS SUBDIVISION, "TEST" SHALL MEAN A TEST
 USING A BIOLOGICAL SAMPLE, INCLUDING, BUT NOT LIMITED TO, URINE,  BLOOD,
 OR HAIR, FOR THE PRESENCE OF DRUGS, CANNABIS, OR ALCOHOL.
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   (B)  UNLESS  LEGALLY  AUTHORIZED TO DO SO, NO HEALTH CARE PROFESSIONAL
 LICENSED, CERTIFIED, OR AUTHORIZED UNDER TITLE EIGHT  OF  THE  EDUCATION
 LAW SHALL:
   (I) PERFORM A DRUG, CANNABIS, OR ALCOHOL TEST ON A PERSON WHO IS PREG-
 NANT OR UP TO ONE YEAR POSTPARTUM UNLESS:
   (A)  THE  PREGNANT OR POSTPARTUM PATIENT GIVES PRIOR VERBAL OR WRITTEN
 INFORMED CONSENT SPECIFIC TO THE DRUG, CANNABIS, OR ALCOHOL TEST; AND
   (B) THE PERFORMANCE OF THE DRUG, CANNABIS, OR ALCOHOL TEST  IS  WITHIN
 THE SCOPE OF MEDICAL CARE BEING PROVIDED TO THE PATIENT.
   (C) VERBAL OR WRITTEN INFORMED CONSENT TO A DRUG, CANNABIS, OR ALCOHOL
 TEST  PURSUANT  TO THIS SUBDIVISION SHALL OCCUR PRIOR TO ADMINISTRATION,
 IN LANGUAGE UNDERSTANDABLE TO THE PREGNANT OR POSTPARTUM PATIENT,  UNDER
 CIRCUMSTANCES THAT PROVIDE SUCH PERSON SUFFICIENT OPPORTUNITY TO CONSID-
 ER  WHETHER  OR NOT TO AUTHORIZE THE DRUG, CANNABIS, OR ALCOHOL TEST AND
 MINIMIZE THE POSSIBILITY OF  COERCION  OR  UNDUE  INFLUENCE,  AND  SHALL
 CONSIST  OF  VERBAL  AUTHORIZATION MEMORIALIZED IN THE MEDICAL RECORD OR
 WRITTEN AUTHORIZATION THAT IS DATED AND SIGNED. SUCH AUTHORIZATION SHALL
 INCLUDE THE FOLLOWING:
   (I) A STATEMENT EXPLAINING THAT CONSENTING TO  A  DRUG,  CANNABIS,  OR
 ALCOHOL  TEST  IS  VOLUNTARY  AND  REQUIRES  WRITTEN  OR VERBAL INFORMED
 CONSENT, EXCEPT WHEN CONDITIONS UNDER SUBDIVISION FOUR OF  THIS  SECTION
 OR PARAGRAPH (D) OF THIS SUBDIVISION ARE MET;
   (II) A STATEMENT THAT TESTING POSITIVE FOR DRUGS, CANNABIS, OR ALCOHOL
 COULD HAVE LEGAL CONSEQUENCES;
   (III) A STATEMENT EXPLAINING THE EXTENT OF CONFIDENTIALITY OF THE TEST
 RESULTS;
   (IV) A STATEMENT OF THE MEDICAL PURPOSE OF THE TEST; AND
   (V) A GENERAL DESCRIPTION OF THE TEST.
   (D)  DRUG,  CANNABIS,  OR ALCOHOL TESTING PURSUANT TO THIS SUBDIVISION
 MAY BE PERFORMED WITHOUT CONSENT OF THE PATIENT WHEN, IN THE HEALTH CARE
 PROFESSIONAL'S JUDGMENT, AN EMERGENCY EXISTS AND THE PATIENT IS IN IMME-
 DIATE NEED OF MEDICAL ATTENTION, AND AN ATTEMPT TO SECURE CONSENT  WOULD
 RESULT  IN  DELAY  OF  TREATMENT  THAT  COULD  INCREASE  THE RISK TO THE
 PATIENT'S LIFE OR HEALTH. IN THE CASE THAT DRUG,  CANNABIS,  OR  ALCOHOL
 TESTING  IS  PERFORMED  UNDER  THESE CIRCUMSTANCES, THE RESULTS SHALL BE
 DISCUSSED WITH THE PATIENT, IN LANGUAGE UNDERSTANDABLE  TO  THE  PATIENT
 AND SHALL CONSIST OF VERBAL NOTIFICATION OR WRITTEN NOTIFICATION THAT IS
 DATED, SIGNED, AND INCLUDES THE FOLLOWING:
   (I)  A STATEMENT THAT TESTING POSITIVE FOR DRUGS, CANNABIS, OR ALCOHOL
 COULD HAVE LEGAL CONSEQUENCES;
   (II) A STATEMENT IN THE MEDICAL RECORD WITH A DESCRIPTION OF THE EMER-
 GENCY THAT NECESSITATED UNCONSENTED DRUG, CANNABIS, OR ALCOHOL  TESTING;
 AND
   (III)  A  STATEMENT  EXPLAINING  THE  EXTENT OF CONFIDENTIALITY OF THE
 RESULTS.
   (E) NOTHING IN THIS SECTION SHALL DIMINISH ANY  OTHER  REQUIREMENT  TO
 OBTAIN  INFORMED  CONSENT  FOR  A DRUG, CANNABIS, OR ALCOHOL TEST OR ANY
 OTHER PROCEDURE.
   § 6. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART O

   Section 1. Subdivision 1 of section 2807-k of the public health law is
 amended by adding a new paragraph (h) to read as follows:
 S. 8307--A                         76                         A. 8807--A
 
   (H) "UNDERINSURED" SHALL MEAN AN INDIVIDUAL WITH OUT OF POCKET MEDICAL
 COSTS  THAT  AMOUNT  TO MORE THAN TEN PERCENT OF SUCH INDIVIDUAL'S GROSS
 ANNUAL INCOME FOR THE PAST TWELVE MONTHS.
   §  2.  Subdivision  9-a of section 2807-k of the public health law, as
 added by section 39-a of part A of chapter 57 of the laws  of  2006  and
 paragraph (k) as added by section 43 of part B of chapter 58 of the laws
 of 2008, is amended to read as follows:
   9-a.  (a)  As  a  condition  for  participation  in pool distributions
 authorized pursuant to this section  and  section  twenty-eight  hundred
 seven-w  of  this  article  for  periods on and after January first, two
 thousand nine, general hospitals shall, effective  for  periods  on  and
 after  January  first, two thousand seven, establish financial aid poli-
 cies and procedures, in accordance with the provisions of this  subdivi-
 sion,  for  reducing charges otherwise applicable to low-income individ-
 uals without health insurance OR UNDERINSURED INDIVIDUALS, or  who  have
 exhausted  their  health  insurance benefits, and who can demonstrate an
 inability to pay full charges, and also, at the  hospital's  discretion,
 for  reducing  or  discounting  the collection of co-pays and deductible
 payments from those individuals who can demonstrate an inability to  pay
 such amounts.
   (b) Such reductions from charges for [uninsured] patients with incomes
 below at least [three] FOUR hundred percent of the federal poverty level
 shall  result  in a charge to such individuals that does not exceed [the
 greater of] the amount that would have been paid for the  same  services
 [by  the  "highest volume payor" for such general hospital as defined in
 subparagraph (v) of this paragraph, or for services provided pursuant to
 title XVIII of the  federal  social  security  act  (medicare),  or  for
 services]  provided pursuant to title XIX of the federal social security
 act (medicaid), and provided further that such amounts shall be adjusted
 according to income level as follows:
   (i) For patients with incomes [at or] below at least [one] TWO hundred
 percent of the federal poverty level, the  hospital  shall  [collect  no
 more  than  a  nominal payment amount, consistent with guidelines estab-
 lished by the commissioner] WAIVE ALL CHARGES. NO NOMINAL PAYMENT  SHALL
 BE COLLECTED;
   (ii)  For  patients  with  incomes  between at least [one] TWO hundred
 [one] percent and [one] UP TO  THREE  hundred  [fifty]  percent  of  the
 federal  poverty  level,  the  hospital  shall  collect no more than the
 amount identified after application of a proportional sliding fee sched-
 ule under which patients with lower incomes shall pay the lowest amount.
 Such schedule shall provide that the amount the hospital may collect for
 such patients increases [from the nominal amount described  in  subpara-
 graph  (i)  of  this paragraph] in equal increments as the income of the
 patient increases, up to a  maximum  of  [twenty]  TEN  percent  of  the
 [greater  of the] amount that would have been paid for the same services
 [by the "highest volume payor" for such general hospital, as defined  in
 subparagraph (v) of this paragraph, or for services provided pursuant to
 title  XVIII  of  the  federal  social  security  act  (medicare) or for
 services] provided pursuant to title XIX of the federal social  security
 act  (medicaid),  OR  FOR  UNDERINSURED PATIENTS, UP TO A MAXIMUM OF TEN
 PERCENT OF THE AMOUNT  THAT  WOULD  HAVE  BEEN  PAID  PURSUANT  TO  SUCH
 PATIENT'S INSURANCE COST SHARING;
   (iii)  For  patients with incomes between at least [one] THREE hundred
 [fifty-one] ONE percent and [two] FOUR hundred [fifty]  percent  of  the
 federal  poverty  level,  the  hospital  shall  collect no more than the
 amount identified after application of a proportional sliding fee sched-
 S. 8307--A                         77                         A. 8807--A
 
 ule under which patients with lower income shall pay the lowest amounts.
 Such schedule shall provide that the amount the hospital may collect for
 such patients increases from the [twenty] TEN percent  figure  described
 in subparagraph (ii) of this paragraph in equal increments as the income
 of  the  patient  increases,  up  to  a  maximum of [the greater] TWENTY
 PERCENT of the amount that would have been paid for  the  same  services
 [by  the "highest volume payor" for such general hospital, as defined in
 subparagraph (v) of this paragraph, or for services provided pursuant to
 title XVIII of  the  federal  social  security  act  (medicare)  or  for
 services]  provided pursuant to title XIX of the federal social security
 act (medicaid), OR FOR UNDERINSURED PATIENTS, UP TO A MAXIMUM OF  TWENTY
 PERCENT  OF  THE  AMOUNT  THAT  WOULD  HAVE  BEEN  PAID PURSUANT TO SUCH
 PATIENT'S INSURANCE COST SHARING; [and
   (iv) For patients with incomes between at least two hundred  fifty-one
 percent  and  three  hundred  percent  of the federal poverty level, the
 hospital shall collect no more than the greater of the amount that would
 have been paid for the same services by the "highest volume  payor"  for
 such  general hospital as defined in subparagraph (v) of this paragraph,
 or for services provided pursuant to title XVIII of the  federal  social
 security  act (medicare), or for services provided pursuant to title XIX
 of the federal social security act (medicaid).
   (v) For the purposes of this paragraph, "highest volume  payor"  shall
 mean  the  insurer,  corporation  or organization licensed, organized or
 certified pursuant to article thirty-two, forty-two  or  forty-three  of
 the insurance law or article forty-four of this chapter, or other third-
 party  payor,  which  has  a  contract  or  agreement  to pay claims for
 services provided by the  general  hospital  and  incurred  the  highest
 volume of claims in the previous calendar year.
   (vi)  A  hospital may implement policies and procedures to permit, but
 not require, consideration on a case-by-case basis of exceptions to  the
 requirements  described  in subparagraphs (i) and (ii) of this paragraph
 based upon the existence of significant assets owned by the patient that
 should be taken into account  in  determining  the  appropriate  payment
 amount  for  that  patient's care, provided, however, that such proposed
 policies and procedures  shall  be  subject  to  the  prior  review  and
 approval  of the commissioner and, if approved, shall be included in the
 hospital's financial assistance  policy  established  pursuant  to  this
 section,  and  provided  further  that, if such approval is granted, the
 maximum amount that may be collected shall not exceed the greater of the
 amount that would have been paid for the same services by  the  "highest
 volume  payor"  for such general hospital as defined in subparagraph (v)
 of this paragraph, or for services provided pursuant to title  XVIII  of
 the  federal  social  security  act (medicare), or for services provided
 pursuant to title XIX of the federal social security act (medicaid).  In
 the  event  that a general hospital reviews a patient's assets in deter-
 mining payment  adjustments  such  policies  and  procedures  shall  not
 consider  as assets a patient's primary residence, assets held in a tax-
 deferred or  comparable  retirement  savings  account,  college  savings
 accounts,  or  cars  used  regularly  by  a  patient or immediate family
 members.
   (vii)] (IV) Nothing in this paragraph shall be construed  to  limit  a
 hospital's   ability   to  establish  patient  eligibility  for  payment
 discounts at income levels higher than those specified herein and/or  to
 provide  greater  payment  discounts  for  eligible  patients than those
 required by this paragraph.
 S. 8307--A                         78                         A. 8807--A
 
   (c) Such policies and procedures shall be  clear,  understandable,  in
 writing and publicly available in summary form and each general hospital
 participating  in the pool shall ensure that every patient is made aware
 of the existence of such policies and procedures and is provided,  in  a
 timely  manner,  with  a  summary  of such policies and procedures [upon
 request]. Any summary provided to patients shall, at a minimum,  include
 specific  information  as to income levels used to determine eligibility
 for assistance, a description of the primary service area of the  hospi-
 tal and the means of applying for assistance. For general hospitals with
 twenty-four  hour  emergency  departments,  such policies and procedures
 shall require the WRITTEN notification of patients during the intake and
 registration process, AND DURING DISCHARGE OF THE PATIENT,  AND  through
 the  conspicuous  posting  of  language-appropriate  information  in the
 general hospital, and  information  on  bills  and  statements  sent  to
 patients,  that financial aid may be available to qualified patients and
 how to obtain further information. For specialty hospitals without twen-
 ty-four hour emergency departments, such notification shall  take  place
 through  written  materials  provided  to patients during the intake and
 registration process prior to the provision of any health care  services
 or procedures, AND DURING DISCHARGE OF THE PATIENT, and through informa-
 tion on bills and statements sent to patients, that financial aid may be
 available  to  qualified patients and how to obtain further information.
 Application materials shall include  a  notice  to  patients  that  upon
 submission  of  a  completed  application,  including any information or
 documentation needed to determine the patient's eligibility pursuant  to
 the  hospital's  financial  assistance policy, the patient may disregard
 any bills until the hospital has rendered a decision on the  application
 in accordance with this paragraph.
   (d) Such policies and procedures shall include clear, objective crite-
 ria  for  determining  a patient's ability to pay and for providing such
 adjustments to payment requirements as are  necessary.  In  addition  to
 adjustment  mechanisms  such  as  sliding fee schedules and discounts to
 fixed standards, such policies and procedures shall also provide for the
 use of installment plans for the  payment  of  outstanding  balances  by
 patients  pursuant to the provisions of the hospital's financial assist-
 ance policy. The monthly payment under such  a  plan  shall  not  exceed
 [ten]  FIVE  percent  of  the  gross  monthly  income  of  the patient[,
 provided, however, that if patient assets are considered  under  such  a
 policy,  then  patient  assets which are not excluded assets pursuant to
 subparagraph (vi) of paragraph (b) of this subdivision may be considered
 in addition to the limit on monthly  payments].  The  rate  of  interest
 charged  to  the patient on the unpaid balance, if any, shall not exceed
 [the rate for a ninety-day security issued by the United States  Depart-
 ment  of  Treasury,  plus  .5]  TWO percent and no plan shall include an
 accelerator or similar clause under which a higher rate of  interest  is
 triggered upon a missed payment. If such policies and procedures include
 a  requirement  of  a deposit prior to non-emergent, medically-necessary
 care, such deposit must be included as part of any financial aid consid-
 eration. Such policies and procedures shall be applied  consistently  to
 all eligible patients.
   (e)  Such  policies  and procedures shall permit patients to apply for
 assistance [within at least ninety days of the date of discharge or date
 of service and provide at least twenty days for  patients  to  submit  a
 completed  application] AT ANY TIME DURING THE COLLECTION PROCESS.  Such
 policies and  procedures  may  require  that  patients  seeking  payment
 adjustments  provide appropriate financial information and documentation
 S. 8307--A                         79                         A. 8807--A
 
 in support of their application, provided, however, that  such  applica-
 tion  process  shall not be unduly burdensome or complex. General hospi-
 tals shall, upon request, assist patients in  understanding  the  hospi-
 tal's  policies  and procedures and in applying for payment adjustments.
 Application forms  shall  be  printed  in  the  "primary  languages"  of
 patients  served by the general hospital. For the purposes of this para-
 graph, "primary languages" shall include any language that is either (i)
 used to communicate, during at least five percent of patient visits in a
 year, by patients who  cannot  speak,  read,  write  or  understand  the
 English  language  at  the  level of proficiency necessary for effective
 communication with health care providers, or (ii) spoken by  non-English
 speaking  individuals  comprising  more  than one percent of the primary
 hospital service area population, as calculated using demographic infor-
 mation available from the United States Bureau of  the  Census,  supple-
 mented  by  data  from school systems. Decisions regarding such applica-
 tions shall be made  within  thirty  days  of  receipt  of  a  completed
 application.  Such policies and procedures shall require that the hospi-
 tal issue any denial/approval of such application in writing with infor-
 mation on how to appeal the denial and shall  require  the  hospital  to
 establish  an appeals process under which it will evaluate the denial of
 an application. Nothing in this  subdivision  shall  be  interpreted  as
 prohibiting a hospital from making the availability of financial assist-
 ance contingent upon the patient first applying for coverage under title
 XIX  of  the social security act (medicaid) or another insurance program
 if, in the judgment of the hospital, the patient  may  be  eligible  for
 medicaid  or  another  insurance program, and upon the patient's cooper-
 ation in  following  the  hospital's  financial  assistance  application
 requirements,  including  the  provision of information needed to make a
 determination on the patient's application in accordance with the hospi-
 tal's financial assistance policy.
   (f) Such policies and procedures  shall  provide  that  patients  with
 incomes  below [three] FOUR hundred percent of the federal poverty level
 are deemed presumptively eligible  for  payment  adjustments  and  shall
 conform  to the requirements set forth in paragraph (b) of this subdivi-
 sion, provided, however, that  nothing  in  this  subdivision  shall  be
 interpreted  as precluding hospitals from extending such payment adjust-
 ments to other patients, either generally or on  a  case-by-case  basis.
 Such  policies  and procedures shall provide financial aid for emergency
 hospital services, including emergency transfers pursuant to the federal
 emergency medical treatment and active labor act  (42  USC  1395dd),  to
 patients who reside in New York state and for medically necessary hospi-
 tal  services  for patients who reside in the hospital's primary service
 area as determined according to criteria established by the  commission-
 er.  In  developing  such  criteria, the commissioner shall consult with
 representatives of the hospital industry, health care consumer advocates
 and local public health officials. Such criteria shall be made available
 to the public no less than thirty days prior to the date of  implementa-
 tion and shall, at a minimum:
   (i)  prohibit  a  hospital  from  developing  or  altering its primary
 service area in a manner designed to avoid medically underserved  commu-
 nities or communities with high percentages of uninsured residents;
   (ii)  ensure that every geographic area of the state is included in at
 least one general hospital's  primary  service  area  so  that  eligible
 patients may access care and financial assistance; and
   (iii)  require the hospital to notify the commissioner upon making any
 change to its primary service area, and to include a description of  its
 S. 8307--A                         80                         A. 8807--A
 
 primary  service  area  in  the  hospital's annual implementation report
 filed pursuant to subdivision  three  of  section  twenty-eight  hundred
 three-l of this article.
   (g)  Nothing  in  this  subdivision shall be interpreted as precluding
 hospitals from extending payment  adjustments  for  medically  necessary
 non-emergency  hospital  services  to patients outside of the hospital's
 primary service area. For patients determined to be eligible for  finan-
 cial  aid  under  the  terms  of a hospital's financial aid policy, such
 policies and procedures shall prohibit any limitations on financial  aid
 for services based on the medical condition of the applicant, other than
 typical  limitations  or  exclusions  based  on medical necessity or the
 clinical or therapeutic benefit of a procedure or treatment.
   (h) SUCH POLICIES AND PROCEDURES SHALL PROHIBIT THE DENIAL  OF  ADMIS-
 SION OR DENIAL OF TREATMENT FOR SERVICES THAT ARE REASONABLY ANTICIPATED
 TO  BE  MEDICALLY  NECESSARY  BECAUSE  THE PATIENT HAS AN UNPAID MEDICAL
 BILL. Such policies and  procedures  shall  [not  permit]  PROHIBIT  the
 forced  sale or foreclosure of a patient's primary residence in order to
 collect an outstanding medical bill and shall require  the  hospital  to
 refrain from sending an account to collection if the patient has submit-
 ted  a  completed  application for financial aid, including any required
 supporting documentation, while the hospital  determines  the  patient's
 eligibility  for  such  aid. SUCH POLICIES AND PROCEDURES SHALL PROHIBIT
 THE SALE OF MEDICAL DEBT ACCUMULATED PURSUANT TO THIS SECTION TO A THIRD
 PARTY, UNLESS THE THIRD PARTY EXPLICITLY PURCHASES SUCH MEDICAL DEBT  IN
 ORDER  TO  RELIEVE THE DEBT OF THE PATIENT. Such policies and procedures
 shall provide for written notification, which shall include notification
 on a patient bill, to a patient not less than thirty days prior  to  the
 referral  of  debts for collection and shall require that the collection
 agency obtain the hospital's written consent prior to commencing a legal
 action. SUCH POLICIES AND PROCEDURES  SHALL  PROHIBIT  A  HOSPITAL  FROM
 COMMENCING  A  LEGAL  ACTION  RELATED TO THE RECOVERY OF MEDICAL DEBT OR
 UNPAID BILLS AGAINST PATIENTS WITH INCOMES BELOW FOUR HUNDRED PERCENT OF
 THE FEDERAL POVERTY LEVEL. IN ANY LEGAL ACTION RELATED TO  THE  RECOVERY
 OF  MEDICAL  DEBT  OR  UNPAID  BILLS  BY OR ON BEHALF OF A HOSPITAL, THE
 COMPLAINT SHALL BE ACCOMPANIED BY AN AFFIDAVIT BY THE  HOSPITAL'S  CHIEF
 FINANCIAL  OFFICER  STATING  THAT  BASED  UPON THE HOSPITAL'S REASONABLE
 EFFORT TO DETERMINE THE PATIENT'S INCOME,  THE  PATIENT  WHOM  THEY  ARE
 TAKING  LEGAL  ACTION AGAINST DOES NOT HAVE AN INCOME BELOW FOUR HUNDRED
 PERCENT OF THE FEDERAL POVERTY LEVEL. Such policies and procedures shall
 require all general hospital staff who interact with  patients  or  have
 responsibility  for  billing and collections to be trained in such poli-
 cies and procedures, and require the implementation of a  mechanism  for
 the  general  hospital  to measure its compliance with such policies and
 procedures.  Such  policies  and  procedures  shall  require  that   any
 collection  agency  under  contract  with  a  general  hospital  for the
 collection of debts follow the hospital's financial  assistance  policy,
 including  providing  information to patients on how to apply for finan-
 cial assistance where appropriate. Such policies  and  procedures  shall
 prohibit collections from a patient who is determined to be eligible for
 medical  assistance pursuant to title XIX of the federal social security
 act at the time services were rendered and for which  services  medicaid
 payment is available.
   (i) Reports required to be submitted to the department by each general
 hospital  as  a  condition  for  participation  in  the pools, and which
 contain, in accordance with applicable regulations, a certification from
 an independent  certified  public  accountant  or  independent  licensed
 S. 8307--A                         81                         A. 8807--A
 
 public accountant or an attestation from a senior official of the hospi-
 tal  that the hospital is in compliance with conditions of participation
 in the pools, shall also contain, for reporting  periods  on  and  after
 January first, two thousand seven:
   (i)  a  report  on  hospital costs incurred and uncollected amounts in
 providing services to eligible patients  without  insurance[,  including
 the  amount  of  care provided for a nominal payment amount,] during the
 period covered by the report;
   (ii) hospital costs incurred and uncollected amounts  for  deductibles
 and coinsurance for eligible patients with insurance or other third-par-
 ty payor coverage;
   (iii)  the  number  of patients, INCLUDING THEIR AGE, RACE, ETHNICITY,
 GENDER AND INSURANCE STATUS, organized according to United States postal
 service zip code, who applied for financial assistance pursuant  to  the
 hospital's  financial  assistance  policy,  and  the  number,  organized
 according to United States postal service zip code,  whose  applications
 were approved and whose applications were denied;
   (iv) the reimbursement received for indigent care from the pool estab-
 lished pursuant to this section;
   (v)  the  amount of funds that have been expended on charity care from
 charitable bequests made  or  trusts  established  for  the  purpose  of
 providing  financial  assistance to patients who are eligible in accord-
 ance with the terms of such bequests or trusts;
   (vi) for hospitals located in social services districts in  which  the
 district allows hospitals to assist patients with such applications, the
 number  of  applications  for  eligibility under title XIX of the social
 security act (medicaid) that the hospital assisted patients in  complet-
 ing and the number denied and approved; AND
   (vii) the hospital's financial losses resulting from services provided
 under medicaid[; and
   (viii)  the  number  of  liens  placed  on  the  primary residences of
 patients through the collection process used by a hospital].
   (j) Within ninety days of the effective date of this subdivision  each
 hospital  shall submit to the commissioner a written report on its poli-
 cies and procedures for financial assistance to patients which are  used
 by  the  hospital on the effective date of this subdivision. Such report
 shall include copies of its policies and procedures, including  material
 which  is  distributed  to patients, and a description of the hospital's
 financial aid policies and procedures. Such  description  shall  include
 the  income levels of patients on which eligibility is based, the finan-
 cial aid eligible patients receive and the  means  of  calculating  such
 aid,  and  the  service  area, if any, used by the hospital to determine
 eligibility.
   (k) In the event it is determined by the commissioner that  the  state
 will  be unable to secure all necessary federal approvals to include, as
 part of the state's approved state plan  under  title  nineteen  of  the
 federal  social  security  act, a requirement, as set forth in paragraph
 [one] (A) of this subdivision, that compliance with this subdivision  is
 a  condition  of participation in pool distributions authorized pursuant
 to this section and section twenty-eight hundred seven-w of  this  arti-
 cle,  then such condition of participation shall be deemed null and void
 and, notwithstanding section twelve of this chapter, failure  to  comply
 with  the  provisions of this subdivision by a hospital on and after the
 date of such determination shall make such hospital liable for  a  civil
 penalty  not to exceed ten thousand dollars for each such violation. The
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 imposition of such civil penalties shall be subject to the provisions of
 section twelve-a of this chapter.
   (L)  A  HOSPITAL  OR  ITS  COLLECTION AGENT SHALL NOT COMMENCE A CIVIL
 ACTION AGAINST A PATIENT OR DELEGATE A COLLECTION  ACTIVITY  TO  A  DEBT
 COLLECTOR  FOR NONPAYMENT FOR AT LEAST ONE HUNDRED EIGHTY DAYS AFTER THE
 FIRST POST-SERVICE BILL IS ISSUED AND UNTIL A HOSPITAL HAS MADE  REASON-
 ABLE  EFFORTS  TO  DETERMINE  WHETHER  A PATIENT QUALIFIES FOR FINANCIAL
 ASSISTANCE.
   § 3. The public health law is amended by adding a new section 18-c  to
 read as follows:
   §  18-C. SEPARATE PATIENT CONSENT FOR TREATMENT AND PAYMENT FOR HEALTH
 CARE SERVICES. INFORMED CONSENT FROM A PATIENT TO PROVIDE ANY TREATMENT,
 PROCEDURE, EXAMINATION OR OTHER DIRECT HEALTH  CARE  SERVICES  SHALL  BE
 OBTAINED SEPARATELY FROM SUCH PATIENT'S CONSENT TO PAY FOR THE SERVICES.
 CONSENT  TO  PAY  FOR ANY HEALTH CARE SERVICES BY A PATIENT SHALL NOT BE
 GIVEN PRIOR TO THE PATIENT RECEIVING SUCH SERVICES AND DISCUSSING TREAT-
 MENT COSTS. FOR PURPOSES OF THIS  SECTION,  "CONSENT"  MEANS  AN  ACTION
 WHICH:  (A)  CLEARLY  AND  CONSPICUOUSLY  COMMUNICATES  THE INDIVIDUAL'S
 AUTHORIZATION OF AN ACT OR PRACTICE; (B) IS MADE IN THE ABSENCE  OF  ANY
 MECHANISM  IN  THE  USER  INTERFACE  THAT HAS THE PURPOSE OR SUBSTANTIAL
 EFFECT OF OBSCURING, SUBVERTING, OR IMPAIRING DECISION-MAKING OR  CHOICE
 TO OBTAIN CONSENT; AND (C) CANNOT BE INFERRED FROM INACTION.
   §  4.  The  general business law is amended by adding two new sections
 349-g and 519-a to read as follows:
   § 349-G.  RESTRICTIONS ON APPLICATIONS FOR AND USE OF CREDIT CARDS AND
 MEDICAL FINANCIAL PRODUCTS. 1. FOR PURPOSES OF THIS SECTION, THE FOLLOW-
 ING TERMS SHALL HAVE THE FOLLOWING MEANINGS:
   (A) "MEDICAL FINANCIAL PRODUCTS" SHALL MEAN MEDICAL CREDIT  CARDS  AND
 THIRD-PARTY MEDICAL INSTALLMENT LOANS.
   (B)  "HEALTH  CARE  PROVIDER"  SHALL  MEAN  A HEALTH CARE PROFESSIONAL
 LICENSED, REGISTERED OR CERTIFIED PURSUANT TO TITLE EIGHT OF THE  EDUCA-
 TION LAW.
   (C) "PROVIDER OFFICES" SHALL MEAN EITHER OF THE FOLLOWING:
   (I) AN OFFICE OF A HEALTH CARE PROVIDER IN SOLO PRACTICE; OR
   (II)  AN  OFFICE IN WHICH SERVICES OR GOODS ARE PERSONALLY PROVIDED BY
 THE HEALTH CARE PROVIDER OR BY EMPLOYEES IN THAT OFFICE,  OR  PERSONALLY
 BY  INDEPENDENT  CONTRACTORS  IN  THAT  OFFICE,  IN ACCORDANCE WITH LAW.
 EMPLOYEES AND INDEPENDENT CONTRACTORS SHALL  BE  LICENSED  OR  CERTIFIED
 WHEN LICENSURE OR CERTIFICATION IS REQUIRED BY LAW.
   2.  IT  SHALL BE PROHIBITED FOR ANY INDIVIDUAL TO COMPLETE ANY PORTION
 OF AN APPLICATION FOR MEDICAL FINANCIAL  PRODUCTS  FOR  THE  PATIENT  OR
 OTHERWISE ARRANGE FOR OR ESTABLISH AN APPLICATION THAT IS NOT COMPLETELY
 FILLED OUT BY THE PATIENT.
   § 519-A. MEDICAL FINANCIAL PRODUCTS; PAYMENT FOR HEALTH CARE SERVICES.
 1.  FOR  PURPOSES  OF  THIS  SECTION, THE FOLLOWING TERMS SHALL HAVE THE
 FOLLOWING MEANINGS:
   (A) "CREDIT CARD" SHALL HAVE THE  SAME  MEANING  AS  IN  SECTION  FIVE
 HUNDRED ELEVEN OF THIS ARTICLE.
   (B) "MEDICAL CREDIT CARD" MEANS A CREDIT CARD ISSUED UNDER AN OPEN-END
 OR  CLOSED-END  PLAN OFFERED SPECIFICALLY FOR THE PAYMENT OF HEALTH CARE
 SERVICES, PRODUCTS, OR DEVICES PROVIDED TO A PERSON.
   2. NO HEALTH CARE PROVIDER SHALL REQUIRE CREDIT CARD PRE-AUTHORIZATION
 NOR REQUIRE THE PATIENT TO HAVE A CREDIT CARD ON FILE PRIOR TO PROVIDING
 EMERGENCY OR MEDICALLY NECESSARY MEDICAL SERVICES TO SUCH PATIENT.
   3. HEALTH CARE PROVIDERS SHALL NOTIFY ALL PATIENTS ABOUT THE RISKS  OF
 PAYING  FOR MEDICAL SERVICES WITH A CREDIT CARD. SUCH NOTIFICATION SHALL
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 HIGHLIGHT THE FACT THAT BY USING  A  CREDIT  CARD  TO  PAY  FOR  MEDICAL
 SERVICES,  THE  PATIENT  IS  FORGOING STATE AND FEDERAL PROTECTIONS THAT
 REGARD MEDICAL DEBT.  THE COMMISSIONER OF HEALTH SHALL HAVE THE AUTHORI-
 TY  AND  SOLE  DISCRETION  TO  SET REQUIREMENTS FOR THE CONTENTS OF SUCH
 NOTICES.
   § 5. This act shall take effect six months after it shall have  become
 a law.
 
                                  PART P
 
   Section  1.  Section  8  of  part  C of chapter 57 of the laws of 2022
 amending the public health law and the education law relating to  allow-
 ing  pharmacists  to  direct  limited service laboratories and order and
 administer COVID-19 and influenza tests and  modernizing  nurse  practi-
 tioners, is amended to read as follows:
   §  8.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2022; provided,
 however, that sections [one, two,] three[,] AND four[, six and seven] of
 this act shall expire and be deemed repealed [two years after  it  shall
 have become a law] APRIL 1, 2026.
   §  2.  Section 5 of chapter 21 of the laws of 2011 amending the educa-
 tion law relating to authorizing pharmacists  to  perform  collaborative
 drug  therapy management with physicians in certain settings, as amended
 by section 5 of part CC of chapter 57 of the laws of 2022, is amended to
 read as follows:
   § 5. This act shall take effect on the one hundred twentieth day after
 it shall have become a law[, provided, however, that the  provisions  of
 sections  two,  three,  and  four of this act shall expire and be deemed
 repealed July 1, 2024]; provided, however, that the amendments to subdi-
 vision 1 of section 6801 of the education law made  by  section  one  of
 this act shall be subject to the expiration and reversion of such subdi-
 vision  pursuant  to  section 8 of chapter 563 of the laws of 2008, when
 upon such date the provisions of section one-a of this  act  shall  take
 effect;  provided,  further,  that  effective immediately, the addition,
 amendment and/or repeal of any rule  or  regulation  necessary  for  the
 implementation  of  this  act  on  its effective date are authorized and
 directed to be made and completed on or before such effective date.
   § 3. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART Q
 
   Section 1. Section 6542 of the education law, as amended by chapter 48
 of  the  laws  of  2012, subdivisions 3 and 5 as amended by section 1 of
 part T of chapter 57 of the laws of 2013, is amended to read as follows:
   § 6542. Performance of medical services. 1. Notwithstanding any  other
 provision  of  law,  a physician assistant may perform medical services,
 but only when under the supervision of a physician and  only  when  such
 acts  and  duties  as are assigned to him or her are within the scope of
 practice of such supervising physician  UNLESS  OTHERWISE  PERMITTED  BY
 THIS SECTION.
   1-A. (A) A PHYSICIAN ASSISTANT MAY PRACTICE WITHOUT THE SUPERVISION OF
 A PHYSICIAN UNDER THE FOLLOWING CIRCUMSTANCES:
   (I)  WHERE  THE PHYSICIAN ASSISTANT, LICENSED UNDER SECTION SIXTY-FIVE
 HUNDRED FORTY-ONE OF THIS ARTICLE HAS  PRACTICED  FOR  MORE  THAN  EIGHT
 THOUSAND HOURS; AND
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   (A)  IS  PRACTICING  IN  PRIMARY  CARE.   FOR PURPOSES OF THIS CLAUSE,
 "PRIMARY CARE" SHALL MEAN NON-SURGICAL CARE IN  THE  FIELDS  OF  GENERAL
 PEDIATRICS, GENERAL ADULT MEDICINE, GENERAL GERIATRIC  MEDICINE, GENERAL
 INTERNAL  MEDICINE,  OBSTETRICS AND GYNECOLOGY, FAMILY MEDICINE, OR SUCH
 OTHER RELATED AREAS AS DETERMINED BY THE COMMISSIONER OF HEALTH; OR
   (B) IS EMPLOYED BY A HEALTH SYSTEM OR HOSPITAL ESTABLISHED UNDER ARTI-
 CLE  TWENTY-EIGHT  OF  THE  PUBLIC  HEALTH LAW, AND THE HEALTH SYSTEM OR
 HOSPITAL DETERMINES THE PHYSICIAN ASSISTANT MEETS THE QUALIFICATIONS  OF
 THE  MEDICAL  STAFF  BYLAWS  AND THE HEALTH SYSTEM OR HOSPITAL GIVES THE
 PHYSICIAN ASSISTANT PRIVILEGES; AND
   (II) WHERE A PHYSICIAN ASSISTANT  LICENSED  UNDER  SECTION  SIXTY-FIVE
 HUNDRED  FORTY-ONE  OF  THIS ARTICLE HAS COMPLETED A PROGRAM APPROVED BY
 THE DEPARTMENT OF HEALTH, IN CONSULTATION WITH THE DEPARTMENT, WHEN SUCH
 SERVICES ARE PERFORMED WITHIN THE SCOPE OF SUCH PROGRAM.
   (B) THE DEPARTMENT AND THE DEPARTMENT  OF  HEALTH  ARE  AUTHORIZED  TO
 PROMULGATE AND UPDATE REGULATIONS PURSUANT TO THIS SECTION.
   2.  [Supervision]  WHERE  SUPERVISION  IS REQUIRED BY THIS SECTION, IT
 shall be continuous but shall not be construed as necessarily  requiring
 the physical presence of the supervising physician at the time and place
 where such services are performed.
   3.  [No  physician  shall employ or supervise more than four physician
 assistants in his or her private practice.
   4.] Nothing in this article shall prohibit a hospital  from  employing
 physician  assistants  provided  they  [work  under the supervision of a
 physician designated by the hospital and not beyond the scope  of  prac-
 tice of such physician. The numerical limitation of subdivision three of
 this section shall not apply to services performed in a hospital.
   5.  Notwithstanding any other provision of this article, nothing shall
 prohibit a physician employed by or rendering services to the department
 of corrections and community supervision under contract from supervising
 no more than six physician assistants in his or  her  practice  for  the
 department of corrections and community supervision.
   6.  Notwithstanding  any  other  provision  of  law,  a  trainee in an
 approved program may perform medical services  when  such  services  are
 performed  within the scope of such program.] MEET THE QUALIFICATIONS OF
 THE MEDICAL STAFF BYLAWS AND ARE GIVEN PRIVILEGES AND OTHERWISE MEET THE
 REQUIREMENTS OF THIS SECTION.
   4. A PHYSICIAN ASSISTANT SHALL BE AUTHORIZED TO  PRESCRIBE,  DISPENSE,
 ORDER,  ADMINISTER, OR PROCURE ITEMS NECESSARY TO COMMENCE OR COMPLETE A
 COURSE OF THERAPY.
   5. A PHYSICIAN ASSISTANT MAY PRESCRIBE AND ORDER  A  PATIENT  SPECIFIC
 ORDER OR NON-PATIENT SPECIFIC REGIMEN TO A LICENSED PHARMACIST OR REGIS-
 TERED  PROFESSIONAL  NURSE,  PURSUANT  TO REGULATIONS PROMULGATED BY THE
 COMMISSIONER OF HEALTH, AND CONSISTENT WITH THE PUBLIC HEALTH  LAW,  FOR
 ADMINISTERING IMMUNIZATIONS. NOTHING IN THIS SUBDIVISION SHALL AUTHORIZE
 UNLICENSED PERSONS TO ADMINISTER IMMUNIZATIONS, VACCINES OR OTHER DRUGS.
   [7]  6.  Nothing  in  this  article, or in article thirty-seven of the
 public health law, shall be construed to authorize physician  assistants
 to perform those specific functions and duties specifically delegated by
 law  to  those persons licensed as allied health professionals under the
 public health law or this chapter.
   § 2. Subdivision 1 of section  3701  of  the  public  health  law,  as
 amended  by  chapter  48  of  the  laws  of  2012, is amended to read as
 follows:
   1. to promulgate  regulations  defining  and  restricting  the  duties
 [which may be assigned to] OF physician assistants [by their supervising
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 physician,  the  degree  of supervision required and the manner in which
 such duties may be performed] CONSISTENT WITH SECTION SIXTY-FIVE HUNDRED
 FORTY-TWO OF THE EDUCATION LAW.;
   §  3.  Section 3702 of the public health law, as amended by chapter 48
 of the laws of 2012, is amended to read as follows:
   § 3702. Special provisions. 1. Inpatient medical  orders.  A  licensed
 physician  assistant  employed or extended privileges by a hospital may,
 if permissible under the bylaws, rules and regulations of the  hospital,
 write  medical  orders,  including  those  for controlled substances AND
 DURABLE MEDICAL EQUIPMENT, for inpatients [under the care of the  physi-
 cian  responsible  for  his or her supervision. Countersignature of such
 orders may be required if deemed necessary and appropriate by the super-
 vising physician or the hospital, but in no event shall countersignature
 be required prior to execution].
   2. Withdrawing blood. A  licensed  physician  assistant  or  certified
 nurse practitioner acting within his or her lawful scope of practice may
 supervise  and  direct the withdrawal of blood for the purpose of deter-
 mining the alcoholic or drug content therein under subparagraph  one  of
 paragraph  (a) of subdivision four of section eleven hundred ninety-four
 of the vehicle and traffic law, notwithstanding  any  provision  to  the
 contrary in clause (ii) of such subparagraph.
   3.  Prescriptions  for  controlled  substances.  A  licensed physician
 assistant, in good faith and acting within his or her  lawful  scope  of
 practice, and to the extent assigned by his or her supervising physician
 AS  APPLICABLE  BY SECTION SIXTY-FIVE HUNDRED FORTY-TWO OF THE EDUCATION
 LAW, may prescribe controlled substances as a practitioner under article
 thirty-three of this chapter, to patients under the care of such  physi-
 cian  responsible  for  his  or  her  supervision.  The commissioner, in
 consultation with the commissioner of  education,  may  promulgate  such
 regulations as are necessary to carry out the purposes of this section.
   §  4.  Section 3703 of the public health law, as amended by chapter 48
 of the laws of 2012, is amended to read as follows:
   § 3703. Statutory construction. A physician assistant may perform  any
 function in conjunction with a medical service lawfully performed by the
 physician  assistant, in any health care setting, that a statute author-
 izes or directs a physician to perform and that is  appropriate  to  the
 education,  training  and experience of the licensed physician assistant
 and within the ordinary practice of the supervising physician, AS APPLI-
 CABLE PURSUANT TO SECTION SIXTY-FIVE HUNDRED FORTY-TWO OF THE  EDUCATION
 LAW.  This  section  shall  not be construed to increase or decrease the
 lawful scope of practice of a physician assistant  under  the  education
 law.
   § 5. Paragraph a of subdivision 2 of section 902 of the education law,
 as  amended  by  chapter  376 of the laws of 2015, is amended to read as
 follows:
   a. The board of education, and the trustee or  board  of  trustees  of
 each  school district, shall employ, at a compensation to be agreed upon
 by the parties, a qualified physician, A PHYSICIAN ASSISTANT, or a nurse
 practitioner to the extent authorized by  the  nurse  practice  act  and
 consistent  with  subdivision three of section six thousand nine hundred
 two of this chapter, to perform the duties of  the  director  of  school
 health  services, including any duties conferred on the school physician
 or school medical inspector under any provision of law, to  perform  and
 coordinate the provision of health services in the public schools and to
 provide  health  appraisals  of students attending the public schools in
 the city or district. The physicians,  PHYSICIANS  ASSISTANTS  or  nurse
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 practitioners  so employed shall be duly licensed pursuant to applicable
 law.
   §  6.  Subdivision 5 of section 6810 of the education law, as added by
 chapter 881 of the laws of 1972, is amended to read as follows:
   5. Records of all prescriptions filled or refilled shall be maintained
 for a period of at least five years and upon request made available  for
 inspection  and  copying  by  a  representative  of the department. Such
 records  shall  indicate  date  of  filling  or  refilling,   [doctor's]
 PRESCRIBER'S  name,  patient's name and address and the name or initials
 of  the  pharmacist  who  prepared,   compounded,   or   dispensed   the
 prescription.  Records  of prescriptions for controlled substances shall
 be maintained pursuant to requirements of article  thirty-three  of  the
 public health law.
   §  7.  Subdivision  27  of  section  3302 of the public health law, as
 amended by chapter 92 of the  laws  of  2021,  is  amended  to  read  as
 follows:
   27. "Practitioner" means:
   A  physician,  PHYSICIAN ASSISTANT, dentist, podiatrist, veterinarian,
 scientific investigator, or other person licensed, or otherwise  permit-
 ted  to  dispense,  administer  or  conduct  research  with respect to a
 controlled substance in the course of a licensed  professional  practice
 or  research  licensed  pursuant  to  this article. Such person shall be
 deemed a "practitioner" only as to such substances, or conduct  relating
 to  such  substances,  as is permitted by [his] THEIR license, permit or
 otherwise permitted by law.
   § 8. Section 6908 of the education law is  amended  by  adding  a  new
 subdivision 3 to read as follows:
   3.  THIS  ARTICLE  SHALL  NOT  BE  CONSTRUED AS PROHIBITING MEDICATION
 RELATED TASKS PROVIDED BY A CERTIFIED MEDICATION AIDE WORKING IN A RESI-
 DENTIAL HEALTH CARE FACILITY, AS DEFINED IN SECTION TWENTY-EIGHT HUNDRED
 ONE OF THE PUBLIC HEALTH LAW, IN ACCORDANCE WITH  REGULATIONS  DEVELOPED
 BY  THE  COMMISSIONER,  IN CONSULTATION WITH THE COMMISSIONER OF HEALTH.
 THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF HEALTH, SHALL
 ADOPT REGULATIONS GOVERNING CERTIFIED MEDICATION AIDES THAT, AT A  MINI-
 MUM, SHALL:
   A.  SPECIFY  THE  MEDICATION-RELATED  TASKS  THAT  MAY BE PERFORMED BY
 CERTIFIED MEDICATION AIDES PURSUANT  TO  THIS  SUBDIVISION.  SUCH  TASKS
 SHALL  INCLUDE  THE  ADMINISTRATION OF MEDICATIONS WHICH ARE ROUTINE AND
 PRE-FILLED OR OTHERWISE PACKAGED IN A MANNER THAT PROMOTES RELATIVE EASE
 OF  ADMINISTRATION,  PROVIDED  THAT  ADMINISTRATION  OF  MEDICATIONS  BY
 INJECTION,  STERILE  PROCEDURES,  AND  CENTRAL LINE MAINTENANCE SHALL BE
 PROHIBITED. PROVIDED, HOWEVER,  SUCH  PROHIBITION  SHALL  NOT  APPLY  TO
 INJECTIONS  OF  INSULIN  OR  OTHER  INJECTIONS  FOR  DIABETES  CARE,  TO
 INJECTIONS OF LOW MOLECULAR WEIGHT HEPARIN, AND TO  PRE-FILLED  AUTO-IN-
 JECTIONS  OF  NALOXONE  AND  EPINEPHRINE  FOR  EMERGENCY  PURPOSES,  AND
 PROVIDED, FURTHER, THAT ENTITIES EMPLOYING  CERTIFIED  MEDICATION  AIDES
 PURSUANT  TO  THIS  SUBDIVISION SHALL ESTABLISH A SYSTEMATIC APPROACH TO
 ADDRESS DRUG DIVERSION;
   B. PROVIDE THAT MEDICATION-RELATED TASKS PERFORMED BY CERTIFIED  MEDI-
 CATION AIDES MAY BE PERFORMED ONLY UNDER THE SUPERVISION OF A REGISTERED
 PROFESSIONAL  NURSE  LICENSED  IN  NEW  YORK STATE, AS SET FORTH IN THIS
 SUBDIVISION AND SUBDIVISION TWELVE OF SECTION SIXTY-NINE HUNDRED NINE OF
 THIS ARTICLE;
   C. ESTABLISH A PROCESS BY WHICH A REGISTERED  PROFESSIONAL  NURSE  MAY
 ASSIGN  MEDICATION-RELATED  TASKS  TO  A CERTIFIED MEDICATION AIDE. SUCH
 PROCESS SHALL INCLUDE, BUT NOT BE LIMITED TO:
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   (I) ALLOWING ASSIGNMENT OF MEDICATION-RELATED  TASKS  TO  A  CERTIFIED
 MEDICATION  AIDE  ONLY  WHERE  SUCH CERTIFIED MEDICATION AIDE HAS DEMON-
 STRATED TO THE SATISFACTION OF THE SUPERVISING  REGISTERED  PROFESSIONAL
 NURSE  COMPETENCY  IN  EVERY MEDICATION-RELATED TASK THAT SUCH CERTIFIED
 MEDICATION  AIDE IS AUTHORIZED TO PERFORM, A WILLINGNESS TO PERFORM SUCH
 MEDICATION-RELATED TASKS, AND THE ABILITY TO EFFECTIVELY AND EFFICIENTLY
 COMMUNICATE WITH THE INDIVIDUAL RECEIVING SERVICES AND  UNDERSTAND  SUCH
 INDIVIDUAL'S NEEDS;
   (II)  AUTHORIZING  THE  SUPERVISING  REGISTERED  PROFESSIONAL NURSE TO
 REVOKE ANY ASSIGNED MEDICATION-RELATED TASK FROM A CERTIFIED  MEDICATION
 AIDE FOR ANY REASON; AND
   (III)  AUTHORIZING  MULTIPLE REGISTERED PROFESSIONAL NURSES TO JOINTLY
 AGREE TO ASSIGN MEDICATION-RELATED TASKS TO A CERTIFIED MEDICATION AIDE,
 PROVIDED FURTHER THAT ONLY ONE REGISTERED PROFESSIONAL  NURSE  SHALL  BE
 REQUIRED  TO DETERMINE IF THE CERTIFIED MEDICATION AIDE HAS DEMONSTRATED
 COMPETENCY IN THE MEDICATION-RELATED TASK TO BE PERFORMED;
   D. PROVIDE THAT MEDICATION-RELATED TASKS  MAY  BE  PERFORMED  ONLY  IN
 ACCORDANCE  WITH  AND  PURSUANT  TO  AN AUTHORIZED HEALTH PRACTITIONER'S
 ORDERED CARE;
   E. PROVIDE THAT ONLY A CERTIFIED NURSE AIDE MAY PERFORM MEDICATION-RE-
 LATED TASKS AS A CERTIFIED MEDICATION AIDE WHEN SUCH AIDE HAS:
   (I) A VALID NEW YORK STATE NURSE AIDE CERTIFICATE;
   (II) A HIGH SCHOOL DIPLOMA, OR ITS EQUIVALENT;
   (III) EVIDENCE OF BEING AT LEAST EIGHTEEN YEARS OLD;
   (IV) AT LEAST ONE YEAR OF EXPERIENCE PROVIDING NURSE AIDE SERVICES  IN
 A  RESIDENTIAL HEALTH CARE FACILITY LICENSED PURSUANT TO ARTICLE TWENTY-
 EIGHT OF THE PUBLIC HEALTH LAW  OR  A  SIMILARLY  LICENSED  FACILITY  IN
 ANOTHER STATE OR UNITED STATES TERRITORY;
   (V) THE ABILITY TO READ, WRITE, AND SPEAK ENGLISH AND TO PERFORM BASIC
 MATH SKILLS;
   (VI) COMPLETED THE REQUISITE TRAINING AND DEMONSTRATED COMPETENCIES OF
 A  CERTIFIED MEDICATION AIDE AS DETERMINED BY THE COMMISSIONER OF HEALTH
 IN CONSULTATION WITH THE COMMISSIONER;
   (VII) SUCCESSFULLY COMPLETED COMPETENCY EXAMINATIONS  SATISFACTORY  TO
 THE COMMISSIONER OF HEALTH IN CONSULTATION WITH THE COMMISSIONER; AND
   (VIII)  MEETS  OTHER  APPROPRIATE  QUALIFICATIONS AS DETERMINED BY THE
 COMMISSIONER OF HEALTH IN CONSULTATION WITH THE COMMISSIONER;
   F. PROHIBIT A CERTIFIED MEDICATION AIDE FROM HOLDING  THEMSELVES  OUT,
 OR  ACCEPTING EMPLOYMENT AS, A PERSON LICENSED TO PRACTICE NURSING UNDER
 THE PROVISIONS OF THIS ARTICLE;
   G. PROVIDE THAT A  CERTIFIED  MEDICATION  AIDE  IS  NOT  REQUIRED  NOR
 PERMITTED TO ASSESS THE MEDICATION OR MEDICAL NEEDS OF AN INDIVIDUAL;
   H. PROVIDE THAT A CERTIFIED MEDICATION AIDE SHALL NOT BE AUTHORIZED TO
 PERFORM  ANY  MEDICATION-RELATED  TASKS  OR  ACTIVITIES PURSUANT TO THIS
 SUBDIVISION THAT ARE OUTSIDE THE SCOPE OF PRACTICE OF A LICENSED PRACTI-
 CAL NURSE OR ANY MEDICATION-RELATED TASKS THAT HAVE NOT  BEEN  APPROPRI-
 ATELY ASSIGNED BY THE SUPERVISING REGISTERED PROFESSIONAL NURSE;
   I. PROVIDE THAT A CERTIFIED MEDICATION AIDE SHALL DOCUMENT ALL MEDICA-
 TION-RELATED  TASKS  PROVIDED  TO  AN  INDIVIDUAL,  INCLUDING MEDICATION
 ADMINISTRATION TO EACH INDIVIDUAL THROUGH THE USE OF A MEDICATION ADMIN-
 ISTRATION RECORD; AND
   J. PROVIDE THAT THE SUPERVISING REGISTERED  PROFESSIONAL  NURSE  SHALL
 RETAIN  THE  DISCRETION  TO  DECIDE WHETHER TO ASSIGN MEDICATION-RELATED
 TASKS TO CERTIFIED MEDICATION AIDES UNDER THIS PROGRAM AND SHALL NOT  BE
 SUBJECT TO COERCION, RETALIATION, OR THE THREAT OF RETALIATION.
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   §  9.  Section  6909 of the education law is amended by adding two new
 subdivisions 12 and 13 to read as follows:
   12.  A  REGISTERED PROFESSIONAL NURSE, WHILE WORKING FOR A RESIDENTIAL
 HEALTH CARE FACILITY LICENSED PURSUANT TO ARTICLE  TWENTY-EIGHT  OF  THE
 PUBLIC  HEALTH  LAW,  MAY,  IN  ACCORDANCE WITH THIS SUBDIVISION, ASSIGN
 CERTIFIED MEDICATION AIDES TO PERFORM MEDICATION-RELATED TASKS FOR INDI-
 VIDUALS PURSUANT TO THE  PROVISIONS  OF  SUBDIVISION  THREE  OF  SECTION
 SIXTY-NINE HUNDRED EIGHT OF THIS ARTICLE AND SUPERVISE CERTIFIED MEDICA-
 TION AIDES WHO PERFORM ASSIGNED MEDICATION-RELATED TASKS.
   13.  NOTWITHSTANDING  SUBDIVISION  SEVEN OF SECTION SIXTY-FIVE HUNDRED
 NINE OF THIS TITLE, A CERTIFIED NURSE PRACTITIONER MAY  DIRECTLY  ASSIGN
 AND  SUPERVISE  A MEDICAL ASSISTANT IN AN OUTPATIENT SETTING THE TASK OF
 DRAWING AND  ADMINISTERING  IMMUNIZATIONS  TO  PATIENTS,  PROVIDED  SUCH
 MEDICAL ASSISTANT RECEIVES APPROPRIATE TRAINING FROM THE CERTIFIED NURSE
 PRACTITIONER  AND  THE  CERTIFIED NURSE PRACTITIONER REMAINS RESPONSIBLE
 FOR THE ACTIONS OF THE MEDICAL ASSISTANT.
   § 10. Paragraph (a) of subdivision 3 of section 2803-j of  the  public
 health  law,  as added by chapter 717 of the laws of 1989, is amended to
 read as follows:
   (a) Identification of individuals who have  successfully  completed  a
 nurse aide training and competency evaluation program, [or] a nurse aide
 competency evaluation program, OR A MEDICATION AIDE PROGRAM;
   §  11.  Section  6527  of the education law is amended by adding a new
 subdivision 12 to read as follows:
   12. NOTWITHSTANDING SUBDIVISION ELEVEN OF SECTION  SIXTY-FIVE  HUNDRED
 THIRTY  OF  THIS  TITLE,  A  LICENSED  PHYSICIAN MAY DIRECTLY ASSIGN AND
 SUPERVISE A MEDICAL ASSISTANT IN AN OUTPATIENT SETTING THE TASK OF DRAW-
 ING AND ADMINISTERING IMMUNIZATIONS TO PATIENTS, PROVIDED  SUCH  MEDICAL
 ASSISTANT  RECEIVES APPROPRIATE TRAINING FROM THE LICENSED PHYSICIAN AND
 THE LICENSED PHYSICIAN  REMAINS  RESPONSIBLE  FOR  THE  ACTIONS  OF  THE
 MEDICAL ASSISTANT.
   §  12.  Section 6545 of the education law, as amended by chapter 48 of
 the laws of 2012, is amended to read as follows:
   § 6545. [Emergency services rendered by physician  assistant]  SPECIAL
 PROVISIONS.  1. Notwithstanding any inconsistent provision of any gener-
 al,  special  or local law, any physician assistant properly licensed in
 this state who voluntarily  and  without  the  expectation  of  monetary
 compensation renders first aid or emergency treatment at the scene of an
 accident  or other emergency, outside a hospital, doctor's office or any
 other place having proper and necessary medical equipment, to  a  person
 who  is unconscious, ill or injured, shall not be liable for damages for
 injuries alleged to have been sustained by such person  or  for  damages
 for  the  death  of such person alleged to have occurred by reason of an
 act or omission in the rendering of such first aid or  emergency  treat-
 ment  unless it is established that such injuries were or such death was
 caused by gross negligence on the  part  of  such  physician  assistant.
 Nothing  in  this  section  shall  be  deemed  or construed to relieve a
 licensed physician assistant from liability for damages for injuries  or
 death  caused by an act or omission on the part of a physician assistant
 while rendering professional services in the normal and ordinary  course
 of his or her practice.
   2.  NOTWITHSTANDING  SUBDIVISION  ELEVEN OF SECTION SIXTY-FIVE HUNDRED
 THIRTY OF THIS TITLE, A LICENSED PHYSICIAN ASSISTANT AUTHORIZED PURSUANT
 TO SECTION SIXTY-FIVE HUNDRED FORTY-TWO  OF  THIS  ARTICLE  TO  PRACTICE
 WITHOUT  SUPERVISION OF A PHYSICIAN, MAY DIRECTLY ASSIGN AND SUPERVISE A
 MEDICAL ASSISTANT IN AN OUTPATIENT  SETTING  THE  TASK  OF  DRAWING  AND
 S. 8307--A                         89                         A. 8807--A
 
 ADMINISTERING IMMUNIZATIONS TO PATIENTS, PROVIDED SUCH MEDICAL ASSISTANT
 RECEIVES  APPROPRIATE TRAINING FROM THE LICENSED PHYSICIAN ASSISTANT AND
 THE LICENSED PHYSICIAN ASSISTANT REMAINS RESPONSIBLE FOR THE ACTIONS  OF
 THE MEDICAL ASSISTANT.
   §  13. Section 6601 of the education law, as amended by chapter 576 of
 the laws of 2001, is amended to read as follows:
   § 6601. Definition of practice  of  dentistry.  The  practice  of  the
 profession  of  dentistry is defined as diagnosing, treating, operating,
 or prescribing for any disease, pain,  injury,  deformity,  or  physical
 condition  of  the  oral and maxillofacial area related to restoring and
 maintaining dental  health.  The  practice  of  dentistry  includes  the
 prescribing  and  fabrication  of  dental prostheses and appliances. The
 practice of dentistry may include  performing  physical  evaluations  in
 conjunction with the provision of dental treatment, INCLUDING THE ADMIN-
 ISTRATION  OF VACCINATIONS AGAINST INFLUENZA, SARS-COV-2, HUMAN PAPILLO-
 MAVIRUS (HPV), AND VACCINATIONS RELATED  TO  A  DECLARED  PUBLIC  HEALTH
 EMERGENCY.  THE  PRACTICE OF DENTISTRY MAY ALSO INCLUDE OFFERING OF HIV,
 HEPATITIS C, AND HEMOGLOBIN A1C SCREENING OR DIAGNOSTIC TESTS.
   § 14. Section 6605-b of the education law, as added by chapter 437  of
 the laws of 2001 and subdivision 1 as amended by chapter 198 of the laws
 of 2022, is amended to read as follows:
   § 6605-b.  Dental  hygiene  restricted  local  infiltration  AND BLOCK
 anesthesia/nitrous oxide analgesia certificate.  1. A  dental  hygienist
 shall  not administer or monitor nitrous oxide analgesia or local infil-
 tration OR BLOCK anesthesia in the practice of dental hygiene without  a
 dental    hygiene    restricted    local    infiltration    AND    BLOCK
 anesthesia/nitrous oxide analgesia  certificate  and  except  under  the
 personal  supervision  of  a  dentist and in accordance with regulations
 promulgated by the commissioner. Personal supervision, for  purposes  of
 this  section,  means that the supervising dentist remains in the dental
 office where the local infiltration OR BLOCK anesthesia or nitrous oxide
 analgesia  services  are  being  performed,  personally  authorizes  and
 prescribes  the use of local infiltration OR BLOCK anesthesia or nitrous
 oxide analgesia for the patient and, before dismissal  of  the  patient,
 personally  examines the condition of the patient after the use of local
 infiltration  OR  BLOCK  anesthesia  or  nitrous  oxide   analgesia   is
 completed.  It  is  professional  misconduct  for  a  dentist to fail to
 provide the supervision required by this section, and any dentist  found
 guilty  of  such  misconduct  under the procedures prescribed in section
 sixty-five hundred ten of this title shall be subject to  the  penalties
 prescribed in section sixty-five hundred eleven of this title.
   2.  The  commissioner shall promulgate regulations establishing stand-
 ards and procedures for the issuance of such certificate. Such standards
 shall require completion of an  educational  program  and/or  course  of
 training  or  experience sufficient to ensure that a dental hygienist is
 specifically trained in the administration  and  monitoring  of  nitrous
 oxide analgesia and local infiltration OR BLOCK anesthesia, the possible
 effects  of such use, and in the recognition of and response to possible
 emergency situations.
   3. The fee for a dental  hygiene  restricted  local  infiltration  AND
 BLOCK  anesthesia/nitrous  oxide  analgesia certificate shall be twenty-
 five dollars and shall be paid on a triennial basis upon renewal of such
 certificate. A certificate may be  suspended  or  revoked  in  the  same
 manner as a license to practice dental hygiene.
   §  15.  Subdivision 1 of section 6606 of the education law, as amended
 by chapter 239 of the laws of 2013, is amended to read as follows:
 S. 8307--A                         90                         A. 8807--A
 
   1. The practice of the profession of dental hygiene is defined as  the
 performance  of  dental services which shall include removing calcareous
 deposits, accretions and stains from the exposed surfaces of  the  teeth
 which  begin  at  the  epithelial attachment and applying topical agents
 indicated for a complete dental prophylaxis, removing cement, placing or
 removing  rubber  dam,  removing sutures, placing matrix band, providing
 patient education, applying topical medication, PLACING  PRE-FIT  ORTHO-
 DONTIC  BANDS, USING LIGHT-CURE COMPOSITE MATERIAL, TAKING CEPHALOMETRIC
 RADIOGRAPHS, TAKING TWO-DIMENSIONAL AND THREE-DIMENSIONAL PHOTOGRAPHY OF
 DENTITION, ADJUSTING REMOVABLE APPLIANCES INCLUDING NIGHTGUARDS, BLEACH-
 ING TRAYS, RETAINERS  AND  DENTURES,  placing  and  exposing  diagnostic
 dental X-ray films, performing topical fluoride applications and topical
 anesthetic applications, polishing teeth, taking medical history, chart-
 ing  caries,  taking  impressions  for study casts, placing and removing
 temporary  restorations,  administering  and  monitoring  nitrous  oxide
 analgesia  and administering and monitoring local infiltration AND BLOCK
 anesthesia, subject to certification in accordance with  section  sixty-
 six  hundred five-b of this article, and any other function in the defi-
 nition of the practice of dentistry as may be delegated  by  a  licensed
 dentist  in accordance with regulations promulgated by the commissioner.
 The practice of dental hygiene may be conducted in  the  office  of  any
 licensed  dentist  or  in  any  appropriately  equipped school or public
 institution but must be done either under the supervision of a  licensed
 dentist  or,  in the case of a registered dental hygienist working for a
 hospital as defined in article twenty-eight of the public health  law[,]
 OR  pursuant  to  a collaborative arrangement with a licensed and regis-
 tered dentist [who has a formal relationship  with  the  same  hospital]
 PURSUANT  TO  SECTION  SIXTY-SIX  HUNDRED SEVEN-A OF THIS ARTICLE AND in
 accordance with regulations promulgated by the department  in  consulta-
 tion  with  the  department  of  health. [Such collaborative arrangement
 shall not obviate or supersede any  law  or  regulation  which  requires
 identified  services to be performed under the personal supervision of a
 dentist. When dental hygiene services are provided pursuant to a  colla-
 borative  agreement, such dental hygienist shall instruct individuals to
 visit a licensed dentist for comprehensive examination or treatment.]
   § 16. The education law is amended by adding a new section  6607-a  to
 read as follows:
   § 6607-A. PRACTICE OF COLLABORATIVE PRACTICE DENTAL HYGIENE AND USE OF
 TITLE "REGISTERED DENTAL HYGIENIST, COLLABORATIVE PRACTICE" (RDH-CP). 1.
 THE  PRACTICE OF THE PROFESSION OF DENTAL HYGIENE, AS DEFINED UNDER THIS
 ARTICLE, MAY BE PERFORMED  IN  COLLABORATION  WITH  A  LICENSED  DENTIST
 PROVIDED  SUCH SERVICES ARE PERFORMED IN ACCORDANCE WITH A WRITTEN PRAC-
 TICE AGREEMENT AND WRITTEN PRACTICE PROTOCOLS TO BE KNOWN AS A  COLLABO-
 RATIVE  PRACTICE  AGREEMENT.  UNDER  A COLLABORATIVE PRACTICE AGREEMENT,
 DENTAL HYGIENISTS MAY PERFORM ALL SERVICES WHICH ARE DESIGNATED IN REGU-
 LATION WITHOUT PRIOR EVALUATION OF A DENTIST OR MEDICAL PROFESSIONAL AND
 MAY  BE  PERFORMED  WITHOUT  SUPERVISION  IN  A  COLLABORATIVE  PRACTICE
 SETTING.
   2.  (A)  THE  COLLABORATIVE PRACTICE AGREEMENT SHALL INCLUDE CONSIDER-
 ATION FOR MEDICALLY COMPROMISED PATIENTS, SPECIFIC  MEDICAL  CONDITIONS,
 AND  AGE-AND  PROCEDURE-SPECIFIC  PRACTICE PROTOCOLS, INCLUDING, BUT NOT
 LIMITED TO RECOMMENDED INTERVALS FOR THE PERFORMANCE OF  DENTAL  HYGIENE
 SERVICES  AND  A PERIODICITY IN WHICH AN EXAMINATION BY A DENTIST SHOULD
 OCCUR.
   (B) THE COLLABORATIVE AGREEMENT SHALL BE:
 S. 8307--A                         91                         A. 8807--A
 
   (I) SIGNED AND MAINTAINED BY THE DENTIST, THE  DENTAL  HYGIENIST,  AND
 THE FACILITY, PROGRAM, OR ORGANIZATION;
   (II) REVIEWED ANNUALLY BY THE COLLABORATING DENTIST AND DENTAL HYGIEN-
 IST; AND
   (III)  MADE  AVAILABLE  TO THE DEPARTMENT AND OTHER INTERESTED PARTIES
 UPON REQUEST.
   (C) ONLY ONE AGREEMENT BETWEEN A COLLABORATING DENTIST AND  REGISTERED
 DENTAL  HYGIENIST,  COLLABORATIVE PRACTICE (RDH-CP) MAY BE IN FORCE AT A
 TIME.
   3. BEFORE PERFORMING ANY SERVICES AUTHORIZED  UNDER  THIS  SECTION,  A
 DENTAL  HYGIENIST  SHALL  PROVIDE  THE  PATIENT WITH A WRITTEN STATEMENT
 ADVISING THE PATIENT THAT THE DENTAL HYGIENE SERVICES PROVIDED ARE NOT A
 SUBSTITUTE FOR A DENTAL EXAMINATION BY A LICENSED DENTIST AND  INSTRUCT-
 ING  INDIVIDUALS  TO VISIT A LICENSED DENTIST FOR COMPREHENSIVE EXAMINA-
 TION OR TREATMENT. IF THE DENTAL HYGIENIST MAKES ANY  REFERRALS  TO  THE
 PATIENT  FOR  FURTHER  DENTAL PROCEDURES, THE DENTAL HYGIENIST MUST FILL
 OUT A REFERRAL FORM AND PROVIDE A COPY OF THE FORM TO THE  COLLABORATING
 DENTIST.
   4.  THE  COLLABORATIVE  PRACTICE  DENTAL  HYGIENIST  MAY  ENTER INTO A
 CONTRACTUAL ARRANGEMENT WITH ANY NEW YORK STATE LICENSED AND  REGISTERED
 DENTIST,  HEALTH  CARE FACILITY, PROGRAM, AND/OR NON-PROFIT ORGANIZATION
 TO PERFORM DENTAL HYGIENE SERVICES IN  THE  FOLLOWING  SETTINGS:  DENTAL
 OFFICES; LONG-TERM CARE FACILITIES/SKILLED NURSING FACILITIES; PUBLIC OR
 PRIVATE  SCHOOLS;  PUBLIC  HEALTH  AGENCIES/FEDERALLY  QUALIFIED  HEALTH
 CENTERS;  CORRECTIONAL  FACILITIES;  PUBLIC  INSTITUTIONS/MENTAL  HEALTH
 FACILITIES; DRUG TREATMENT FACILITIES; AND DOMESTIC VIOLENCE SHELTERS.
   5. A COLLABORATING DENTIST SHALL HAVE COLLABORATIVE AGREEMENTS WITH NO
 MORE  THAN  SIX COLLABORATIVE PRACTICE DENTAL HYGIENISTS. THE DEPARTMENT
 MAY GRANT EXCEPTIONS TO THESE LIMITATIONS FOR PUBLIC HEALTH SETTINGS  ON
 A CASE-BY-CASE BASIS.
   6. A DENTAL HYGIENIST MUST MAKE APPLICATION TO THE DEPARTMENT TO PRAC-
 TICE  AS  A REGISTERED DENTAL HYGIENIST, COLLABORATIVE PRACTICE (RDH-CP)
 AND PAY A FEE SET BY THE DEPARTMENT. AS  A  CONDITION  OF  COLLABORATIVE
 PRACTICE,  THE  DENTAL HYGIENIST SHALL HAVE BEEN ENGAGED IN PRACTICE FOR
 AT LEAST THREE YEARS WITH A MINIMUM OF FOUR THOUSAND FIVE HUNDRED  PRAC-
 TICE HOURS AND SHALL COMPLETE AN EIGHT HOUR CONTINUING EDUCATION PROGRAM
 THAT  INCLUDES INSTRUCTION IN MEDICAL EMERGENCY PROCEDURES, RISK MANAGE-
 MENT, DENTAL HYGIENE JURISPRUDENCE AND PROFESSIONAL ETHICS.
   § 17. This act shall take effect immediately and shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024; provided,
 however,  that  sections one through seven of this act shall take effect
 one year after this act shall have become a law.
 
                                  PART R
 
   Section 1. The education law is amended by adding a new article 169 to
 read as follows:
                                ARTICLE 169
                   INTERSTATE MEDICAL LICENSURE COMPACT
 SECTION 8860. SHORT TITLE.
         8861. PURPOSE.
         8862. DEFINITIONS.
         8863. ELIGIBILITY.
         8864. DESIGNATION OF STATE OF PRINCIPAL LICENSE.
         8865. APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE.
         8866. FEES FOR EXPEDITED LICENSURE.
 S. 8307--A                         92                         A. 8807--A
 
         8867. RENEWAL AND CONTINUED PARTICIPATION.
         8868. COORDINATED INFORMATION SYSTEM.
         8869. JOINT INVESTIGATIONS.
         8870. DISCIPLINARY ACTIONS.
         8871. INTERSTATE MEDICAL LICENSURE COMPACT COMMISSION.
         8872. POWERS AND DUTIES OF THE INTERSTATE COMMISSION.
         8873. FINANCE POWERS.
         8874. ORGANIZATION AND OPERATION OF THE INTERSTATE COMMISSION.
         8875. RULEMAKING FUNCTIONS OF THE INTERSTATE COMMISSION.
         8876. OVERSIGHT OF INTERSTATE COMPACT.
         8877. ENFORCEMENT OF INTERSTATE COMPACT.
         8878. DEFAULT PROCEDURES.
         8879. DISPUTE RESOLUTION.
         8880. MEMBER STATES, EFFECTIVE DATE AND AMENDMENT.
         8881. WITHDRAWAL.
         8882. DISSOLUTION.
         8883. SEVERABILITY AND CONSTRUCTION.
         8884. BINDING EFFECT OF COMPACT AND OTHER LAWS.
   § 8860. SHORT  TITLE.  THIS ARTICLE SHALL BE KNOWN AND MAY BE CITED AS
 THE "INTERSTATE MEDICAL LICENSURE COMPACT".
   § 8861. PURPOSE. IN ORDER TO STRENGTHEN ACCESS TO HEALTH CARE, AND  IN
 RECOGNITION  OF  THE ADVANCES IN THE DELIVERY OF HEALTH CARE, THE MEMBER
 STATES OF THE INTERSTATE MEDICAL LICENSURE COMPACT HAVE ALLIED IN COMMON
 PURPOSE TO DEVELOP A COMPREHENSIVE PROCESS THAT COMPLEMENTS THE EXISTING
 LICENSING AND REGULATORY AUTHORITY OF STATE MEDICAL BOARDS,  PROVIDES  A
 STREAMLINED  PROCESS THAT ALLOWS PHYSICIANS TO BECOME LICENSED IN MULTI-
 PLE STATES, THEREBY ENHANCING THE PORTABILITY OF A MEDICAL  LICENSE  AND
 ENSURING  THE  SAFETY OF PATIENTS.   THE COMPACT CREATES ANOTHER PATHWAY
 FOR LICENSURE AND DOES NOT OTHERWISE CHANGE A STATE'S  EXISTING  MEDICAL
 PRACTICE ACT. THE COMPACT ALSO ADOPTS THE PREVAILING STANDARD FOR LICEN-
 SURE  AND AFFIRMS THAT THE PRACTICE OF MEDICINE OCCURS WHERE THE PATIENT
 IS LOCATED AT THE TIME OF THE PHYSICIAN-PATIENT  ENCOUNTER,  AND  THERE-
 FORE,  REQUIRES  THE PHYSICIAN TO BE UNDER THE JURISDICTION OF THE STATE
 MEDICAL BOARD WHERE THE PATIENT IS LOCATED. STATE  MEDICAL  BOARDS  THAT
 PARTICIPATE  IN THE COMPACT RETAIN THE JURISDICTION TO IMPOSE AN ADVERSE
 ACTION AGAINST A LICENSE TO PRACTICE MEDICINE IN THAT STATE ISSUED TO  A
 PHYSICIAN THROUGH THE PROCEDURES IN THE COMPACT.
   § 8862. DEFINITIONS. IN THIS COMPACT:
   1.  "BYLAWS"  MEANS THOSE BYLAWS ESTABLISHED BY THE INTERSTATE COMMIS-
 SION PURSUANT TO SECTION EIGHTY-EIGHT HUNDRED SEVENTY-ONE OF THIS  ARTI-
 CLE FOR ITS GOVERNANCE, OR FOR DIRECTING AND CONTROLLING ITS ACTIONS AND
 CONDUCT.
   2.  "COMMISSIONER"  MEANS  THE VOTING REPRESENTATIVE APPOINTED BY EACH
 MEMBER BOARD PURSUANT TO SECTION  EIGHTY-EIGHT  HUNDRED  SEVENTY-ONE  OF
 THIS ARTICLE.
   3. "CONVICTION" MEANS A FINDING BY A COURT THAT AN INDIVIDUAL IS GUIL-
 TY  OF  A  CRIMINAL  OFFENSE THROUGH ADJUDICATION, OR ENTRY OF A PLEA OF
 GUILT OR NO CONTEST TO THE CHARGE BY THE OFFENDER. EVIDENCE OF AN  ENTRY
 OF  A  CONVICTION OF A CRIMINAL OFFENSE BY THE COURT SHALL BE CONSIDERED
 FINAL FOR PURPOSES OF DISCIPLINARY ACTION BY A MEMBER BOARD.
   4. "EXPEDITED LICENSE" MEANS A FULL AND UNRESTRICTED  MEDICAL  LICENSE
 GRANTED  BY  A MEMBER STATE TO AN ELIGIBLE PHYSICIAN THROUGH THE PROCESS
 SET FORTH IN THE COMPACT.
   5. "INTERSTATE COMMISSION" MEANS  THE  INTERSTATE  COMMISSION  CREATED
 PURSUANT TO SECTION EIGHTY-EIGHT HUNDRED SEVENTY-ONE OF THIS ARTICLE.
 S. 8307--A                         93                         A. 8807--A
 
   6.  "LICENSE" MEANS AUTHORIZATION BY A MEMBER STATE FOR A PHYSICIAN TO
 ENGAGE IN THE PRACTICE OF MEDICINE,  WHICH  WOULD  BE  UNLAWFUL  WITHOUT
 AUTHORIZATION.
   7.  "MEDICAL  PRACTICE  ACT"  MEANS LAWS AND REGULATIONS GOVERNING THE
 PRACTICE OF ALLOPATHIC AND OSTEOPATHIC MEDICINE WITHIN A MEMBER STATE.
   8. "MEMBER BOARD" MEANS A STATE AGENCY IN A MEMBER STATE THAT ACTS  IN
 THE  SOVEREIGN  INTERESTS  OF THE STATE BY PROTECTING THE PUBLIC THROUGH
 LICENSURE, REGULATION, AND EDUCATION OF PHYSICIANS AS  DIRECTED  BY  THE
 STATE GOVERNMENT.
   9. "MEMBER STATE" MEANS A STATE THAT HAS ENACTED THE COMPACT.
   10.  "PRACTICE  OF MEDICINE" MEANS THE CLINICAL PREVENTION, DIAGNOSIS,
 OR TREATMENT OF HUMAN DISEASE, INJURY, OR CONDITION REQUIRING  A  PHYSI-
 CIAN  TO  OBTAIN  AND  MAINTAIN A LICENSE IN COMPLIANCE WITH THE MEDICAL
 PRACTICE ACT OF A MEMBER STATE.
   11. "PHYSICIAN" MEANS ANY PERSON WHO:
   (A) IS A GRADUATE OF  A  MEDICAL  SCHOOL  ACCREDITED  BY  THE  LIAISON
 COMMITTEE  ON  MEDICAL  EDUCATION, THE COMMISSION ON OSTEOPATHIC COLLEGE
 ACCREDITATION, OR A MEDICAL SCHOOL LISTED IN THE  INTERNATIONAL  MEDICAL
 EDUCATION DIRECTORY OR ITS EQUIVALENT;
   (B) PASSED EACH COMPONENT OF THE UNITED STATES MEDICAL LICENSING EXAM-
 INATION (USMLE) OR THE COMPREHENSIVE OSTEOPATHIC MEDICAL LICENSING EXAM-
 INATION  (COMLEX-USA)  WITHIN  THREE ATTEMPTS, OR ANY OF ITS PREDECESSOR
 EXAMINATIONS ACCEPTED BY A STATE MEDICAL BOARD AS AN EQUIVALENT EXAMINA-
 TION FOR LICENSURE PURPOSES;
   (C) SUCCESSFULLY COMPLETED GRADUATE MEDICAL EDUCATION APPROVED BY  THE
 ACCREDITATION  COUNCIL  FOR  GRADUATE  MEDICAL EDUCATION OR THE AMERICAN
 OSTEOPATHIC ASSOCIATION;
   (D)  HOLDS  SPECIALTY  CERTIFICATION  OR  A  TIME-UNLIMITED  SPECIALTY
 CERTIFICATE  RECOGNIZED  BY THE AMERICAN BOARD OF MEDICAL SPECIALTIES OR
 THE AMERICAN OSTEOPATHIC ASSOCIATION'S BUREAU  OF  OSTEOPATHIC  SPECIAL-
 ISTS;
   (E)  POSSESSES  A FULL AND UNRESTRICTED LICENSE TO ENGAGE IN THE PRAC-
 TICE OF MEDICINE ISSUED BY A MEMBER BOARD;
   (F) HAS NEVER BEEN CONVICTED, RECEIVED ADJUDICATION, DEFERRED  ADJUDI-
 CATION,  COMMUNITY  SUPERVISION, OR DEFERRED DISPOSITION FOR ANY OFFENSE
 BY A COURT OF APPROPRIATE JURISDICTION;
   (G) HAS NEVER HELD A LICENSE  AUTHORIZING  THE  PRACTICE  OF  MEDICINE
 SUBJECTED  TO DISCIPLINE BY A LICENSING AGENCY IN ANY STATE, FEDERAL, OR
 FOREIGN JURISDICTION, EXCLUDING ANY ACTION  RELATED  TO  NON-PAYMENT  OF
 FEES RELATED TO A LICENSE;
   (H)  HAS  NEVER HAD A CONTROLLED SUBSTANCE LICENSE OR PERMIT SUSPENDED
 OR REVOKED BY A STATE OR THE UNITED  STATES  DRUG  ENFORCEMENT  ADMINIS-
 TRATION; AND
   (I)  IS  NOT  UNDER  ACTIVE INVESTIGATION BY A LICENSING AGENCY OR LAW
 ENFORCEMENT AUTHORITY IN ANY STATE, FEDERAL, OR FOREIGN JURISDICTION.
   12. "OFFENSE" MEANS A FELONY, GROSS MISDEMEANOR,  OR  CRIME  OF  MORAL
 TURPITUDE.
   13.  "RULE"  MEANS  A  WRITTEN  STATEMENT BY THE INTERSTATE COMMISSION
 PROMULGATED PURSUANT TO SECTION EIGHTY-EIGHT HUNDRED SEVENTY-TWO OF THIS
 ARTICLE THAT IS OF GENERAL  APPLICABILITY,  IMPLEMENTS,  INTERPRETS,  OR
 PRESCRIBES  A  POLICY OR PROVISION OF THE COMPACT, OR AN ORGANIZATIONAL,
 PROCEDURAL, OR PRACTICE REQUIREMENT OF THE  INTERSTATE  COMMISSION,  AND
 HAS  THE  FORCE  AND  EFFECT  OF  STATUTORY  LAW  IN A MEMBER STATE, AND
 INCLUDES THE AMENDMENT, REPEAL, OR SUSPENSION OF AN EXISTING RULE.
   14. "STATE" MEANS ANY STATE, COMMONWEALTH, DISTRICT, OR  TERRITORY  OF
 THE UNITED STATES.
 S. 8307--A                         94                         A. 8807--A
 
   15.  "STATE  OF PRINCIPAL LICENSE" MEANS A MEMBER STATE WHERE A PHYSI-
 CIAN HOLDS A LICENSE TO PRACTICE MEDICINE AND WHICH HAS BEEN  DESIGNATED
 AS  SUCH BY THE PHYSICIAN FOR PURPOSES OF REGISTRATION AND PARTICIPATION
 IN THE COMPACT.
   § 8863. ELIGIBILITY. 1. A PHYSICIAN MUST MEET THE ELIGIBILITY REQUIRE-
 MENTS  AS  DEFINED IN SUBDIVISION ELEVEN OF SECTION EIGHTY-EIGHT HUNDRED
 SIXTY-TWO OF THIS ARTICLE TO RECEIVE  AN  EXPEDITED  LICENSE  UNDER  THE
 TERMS AND PROVISIONS OF THE COMPACT.
   2. A PHYSICIAN WHO DOES NOT MEET THE REQUIREMENTS OF SUBDIVISION ELEV-
 EN  OF SECTION EIGHTY-EIGHT HUNDRED SIXTY-TWO OF THIS ARTICLE MAY OBTAIN
 A LICENSE TO PRACTICE MEDICINE IN  A  MEMBER  STATE  IF  THE  INDIVIDUAL
 COMPLIES  WITH ALL LAWS AND REQUIREMENTS, OTHER THAN THE COMPACT, RELAT-
 ING TO THE ISSUANCE OF A LICENSE TO PRACTICE MEDICINE IN THAT STATE.
   § 8864. DESIGNATION OF STATE OF  PRINCIPAL  LICENSE.  1.  A  PHYSICIAN
 SHALL  DESIGNATE  A  MEMBER  STATE AS THE STATE OF PRINCIPAL LICENSE FOR
 PURPOSES OF REGISTRATION FOR EXPEDITED LICENSURE THROUGH THE COMPACT  IF
 THE  PHYSICIAN  POSSESSES  A  FULL  AND UNRESTRICTED LICENSE TO PRACTICE
 MEDICINE IN THAT STATE, AND THE STATE IS:
   (A) THE STATE OF PRINCIPAL RESIDENCE FOR THE PHYSICIAN, OR
   (B) THE STATE WHERE AT LEAST TWENTY-FIVE PERCENT OF  THE  PRACTICE  OF
 MEDICINE OCCURS, OR
   (C) THE LOCATION OF THE PHYSICIAN'S EMPLOYER, OR
   (D)  IF  NO  STATE  QUALIFIES UNDER PARAGRAPH (A), (B), OR (C) OF THIS
 SUBDIVISION, THE STATE DESIGNATED AS STATE OF RESIDENCE FOR  PURPOSE  OF
 FEDERAL INCOME TAX.
   2.  A  PHYSICIAN  MAY REDESIGNATE A MEMBER STATE AS STATE OF PRINCIPAL
 LICENSE AT ANY TIME, AS LONG AS THE  STATE  MEETS  THE  REQUIREMENTS  OF
 SUBDIVISION ONE OF THIS SECTION.
   3. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES TO FACILI-
 TATE  REDESIGNATION  OF  ANOTHER  MEMBER STATE AS THE STATE OF PRINCIPAL
 LICENSE.
   § 8865. APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE. 1.  A  PHYSI-
 CIAN SEEKING LICENSURE THROUGH THE COMPACT SHALL FILE AN APPLICATION FOR
 AN  EXPEDITED LICENSE WITH THE MEMBER BOARD OF THE STATE SELECTED BY THE
 PHYSICIAN AS THE STATE OF PRINCIPAL LICENSE.
   2. UPON RECEIPT OF AN APPLICATION FOR AN EXPEDITED LICENSE, THE MEMBER
 BOARD WITHIN THE STATE SELECTED AS THE STATE OF PRINCIPAL LICENSE  SHALL
 EVALUATE  WHETHER  THE PHYSICIAN IS ELIGIBLE FOR EXPEDITED LICENSURE AND
 ISSUE A LETTER OF QUALIFICATION, VERIFYING OR  DENYING  THE  PHYSICIAN'S
 ELIGIBILITY, TO THE INTERSTATE COMMISSION.
   (A)  STATIC  QUALIFICATIONS,  WHICH  INCLUDE  VERIFICATION  OF MEDICAL
 EDUCATION, GRADUATE MEDICAL EDUCATION, RESULTS OF ANY MEDICAL OR LICENS-
 ING EXAMINATION, AND OTHER QUALIFICATIONS AS DETERMINED  BY  THE  INTER-
 STATE COMMISSION THROUGH RULE, SHALL NOT BE SUBJECT TO ADDITIONAL PRIMA-
 RY  SOURCE  VERIFICATION  WHERE  ALREADY  PRIMARY SOURCE VERIFIED BY THE
 STATE OF PRINCIPAL LICENSE.
   (B) THE MEMBER BOARD WITHIN THE STATE SELECTED AS THE STATE OF PRINCI-
 PAL LICENSE SHALL, IN THE COURSE OF  VERIFYING  ELIGIBILITY,  PERFORM  A
 CRIMINAL  BACKGROUND  CHECK  OF  AN  APPLICANT, INCLUDING THE USE OF THE
 RESULTS OF FINGERPRINT OR OTHER BIOMETRIC DATA CHECKS COMPLIANT WITH THE
 REQUIREMENTS OF THE FEDERAL BUREAU OF INVESTIGATION, WITH THE  EXCEPTION
 OF  FEDERAL  EMPLOYEES  WHO HAVE SUITABILITY DETERMINATION IN ACCORDANCE
 WITH U.S. C.F.R. § 731.202.
   (C) APPEAL ON THE DETERMINATION OF ELIGIBILITY SHALL BE  MADE  TO  THE
 MEMBER STATE WHERE THE APPLICATION WAS FILED AND SHALL BE SUBJECT TO THE
 LAW OF THAT STATE.
 S. 8307--A                         95                         A. 8807--A
 
   3. UPON VERIFICATION UNDER SUBDIVISION TWO OF THIS SECTION, PHYSICIANS
 ELIGIBLE  FOR AN EXPEDITED LICENSE SHALL COMPLETE THE REGISTRATION PROC-
 ESS ESTABLISHED BY THE INTERSTATE COMMISSION TO RECEIVE A LICENSE  IN  A
 MEMBER  STATE  SELECTED  PURSUANT  TO  SUBDIVISION  ONE OF THIS SECTION,
 INCLUDING THE PAYMENT OF ANY APPLICABLE FEES.
   4.  AFTER  RECEIVING VERIFICATION OF ELIGIBILITY UNDER SUBDIVISION TWO
 OF THIS SECTION AND ANY FEES UNDER SUBDIVISION THREE OF THIS SECTION,  A
 MEMBER  BOARD  SHALL  ISSUE  AN EXPEDITED LICENSE TO THE PHYSICIAN. THIS
 LICENSE SHALL AUTHORIZE THE PHYSICIAN TO PRACTICE MEDICINE IN THE  ISSU-
 ING  STATE  CONSISTENT  WITH THE MEDICAL PRACTICE ACT AND ALL APPLICABLE
 LAWS AND REGULATIONS OF THE ISSUING MEMBER BOARD AND MEMBER STATE.
   5. AN EXPEDITED LICENSE SHALL BE VALID FOR A  PERIOD  CONSISTENT  WITH
 THE  LICENSURE  PERIOD  IN  THE  MEMBER  STATE AND IN THE SAME MANNER AS
 REQUIRED FOR OTHER PHYSICIANS HOLDING A FULL  AND  UNRESTRICTED  LICENSE
 WITHIN THE MEMBER STATE.
   6.  AN  EXPEDITED  LICENSE OBTAINED THOUGH THE COMPACT SHALL BE TERMI-
 NATED IF A PHYSICIAN FAILS TO MAINTAIN A LICENSE IN THE STATE OF PRINCI-
 PAL LICENSURE FOR A NON-DISCIPLINARY REASON, WITHOUT REDESIGNATION OF  A
 NEW STATE OF PRINCIPAL LICENSURE.
   7.  THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES REGARDING
 THE APPLICATION PROCESS, INCLUDING PAYMENT OF ANY APPLICABLE  FEES,  AND
 THE ISSUANCE OF AN EXPEDITED LICENSE.
   § 8866. FEES  FOR  EXPEDITED  LICENSURE.  1. A MEMBER STATE ISSUING AN
 EXPEDITED LICENSE AUTHORIZING THE PRACTICE OF MEDICINE IN THAT STATE MAY
 IMPOSE A FEE FOR A LICENSE ISSUED OR RENEWED THROUGH THE COMPACT.
   2. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES  REGARDING
 FEES FOR EXPEDITED LICENSES.
   § 8867. RENEWAL AND CONTINUED PARTICIPATION. 1. A PHYSICIAN SEEKING TO
 RENEW  AN  EXPEDITED  LICENSE GRANTED IN A MEMBER STATE SHALL COMPLETE A
 RENEWAL PROCESS WITH THE INTERSTATE COMMISSION IF THE PHYSICIAN:
   (A) MAINTAINS A FULL AND UNRESTRICTED LICENSE IN A STATE OF  PRINCIPAL
 LICENSE;
   (B)  HAS  NOT  BEEN CONVICTED, RECEIVED ADJUDICATION, DEFERRED ADJUDI-
 CATION, COMMUNITY SUPERVISION, OR DEFERRED DISPOSITION FOR  ANY  OFFENSE
 BY A COURT OF APPROPRIATE JURISDICTION;
   (C) HAS NOT HAD A LICENSE AUTHORIZING THE PRACTICE OF MEDICINE SUBJECT
 TO  DISCIPLINE  BY  A LICENSING AGENCY IN ANY STATE, FEDERAL, OR FOREIGN
 JURISDICTION, EXCLUDING  ANY  ACTION  RELATED  TO  NON-PAYMENT  OF  FEES
 RELATED TO A LICENSE; AND
   (D)  HAS NOT HAD A CONTROLLED SUBSTANCE LICENSE OR PERMIT SUSPENDED OR
 REVOKED BY A STATE OR THE UNITED STATES DRUG ENFORCEMENT ADMINISTRATION.
   2. PHYSICIANS SHALL COMPLY WITH ALL CONTINUING  PROFESSIONAL  DEVELOP-
 MENT  OR  CONTINUING  MEDICAL  EDUCATION  REQUIREMENTS  FOR RENEWAL OF A
 LICENSE ISSUED BY A MEMBER STATE.
   3. THE INTERSTATE COMMISSION SHALL COLLECT ANY  RENEWAL  FEES  CHARGED
 FOR  THE  RENEWAL OF A LICENSE AND DISTRIBUTE THE FEES TO THE APPLICABLE
 MEMBER BOARD.
   4. UPON RECEIPT OF ANY RENEWAL FEES COLLECTED IN SUBDIVISION THREE  OF
 THIS SECTION, A MEMBER BOARD SHALL RENEW THE PHYSICIAN'S LICENSE.
   5. PHYSICIAN INFORMATION COLLECTED BY THE INTERSTATE COMMISSION DURING
 THE RENEWAL PROCESS WILL BE DISTRIBUTED TO ALL MEMBER BOARDS.
   6. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES TO ADDRESS
 RENEWAL OF LICENSES OBTAINED THROUGH THE COMPACT.
   § 8868. COORDINATED  INFORMATION  SYSTEM. 1. THE INTERSTATE COMMISSION
 SHALL ESTABLISH A DATABASE OF  ALL  PHYSICIANS  LICENSED,  OR  WHO  HAVE
 S. 8307--A                         96                         A. 8807--A
 
 APPLIED  FOR LICENSURE, UNDER SECTION EIGHTY-EIGHT HUNDRED SIXTY-FIVE OF
 THIS ARTICLE.
   2.  NOTWITHSTANDING  ANY  OTHER  PROVISION OF LAW, MEMBER BOARDS SHALL
 REPORT TO THE INTERSTATE COMMISSION  ANY  PUBLIC  ACTION  OR  COMPLAINTS
 AGAINST  A  LICENSED  PHYSICIAN WHO HAS APPLIED OR RECEIVED AN EXPEDITED
 LICENSE THROUGH THE COMPACT.
   3. MEMBER BOARDS SHALL REPORT DISCIPLINARY OR  INVESTIGATORY  INFORMA-
 TION  DETERMINED  AS  NECESSARY  AND  PROPER  BY  RULE OF THE INTERSTATE
 COMMISSION.
   4. MEMBER BOARDS MAY REPORT ANY NON-PUBLIC COMPLAINT, DISCIPLINARY, OR
 INVESTIGATORY INFORMATION NOT REQUIRED  BY  SUBDIVISION  THREE  OF  THIS
 SECTION TO THE INTERSTATE COMMISSION.
   5.  MEMBER  BOARDS  SHALL  SHARE COMPLAINT OR DISCIPLINARY INFORMATION
 ABOUT A PHYSICIAN UPON REQUEST OF ANOTHER MEMBER BOARD.
   6. ALL INFORMATION PROVIDED TO THE INTERSTATE COMMISSION  OR  DISTRIB-
 UTED  BY MEMBER BOARDS SHALL BE CONFIDENTIAL, FILED UNDER SEAL, AND USED
 ONLY FOR INVESTIGATORY OR DISCIPLINARY MATTERS.
   7. THE INTERSTATE  COMMISSION  IS  AUTHORIZED  TO  DEVELOP  RULES  FOR
 MANDATED OR DISCRETIONARY SHARING OF INFORMATION BY MEMBER BOARDS.
   § 8869. JOINT INVESTIGATIONS. 1. LICENSURE AND DISCIPLINARY RECORDS OF
 PHYSICIANS ARE DEEMED INVESTIGATIVE.
   2.  IN  ADDITION  TO  THE  AUTHORITY  GRANTED TO A MEMBER BOARD BY ITS
 RESPECTIVE MEDICAL PRACTICE ACT OR OTHER APPLICABLE STATE LAW, A  MEMBER
 BOARD  MAY  PARTICIPATE WITH OTHER MEMBER BOARDS IN JOINT INVESTIGATIONS
 OF PHYSICIANS LICENSED BY THE MEMBER BOARDS.
   3. A SUBPOENA ISSUED BY A MEMBER STATE SHALL BE ENFORCEABLE  IN  OTHER
 MEMBER STATES.
   4.  MEMBER  BOARDS MAY SHARE ANY INVESTIGATIVE, LITIGATION, OR COMPLI-
 ANCE MATERIALS IN FURTHERANCE OF ANY JOINT OR  INDIVIDUAL  INVESTIGATION
 INITIATED UNDER THE COMPACT.
   5.  ANY  MEMBER  STATE MAY INVESTIGATE ACTUAL OR ALLEGED VIOLATIONS OF
 THE STATUTES AUTHORIZING THE PRACTICE OF MEDICINE IN  ANY  OTHER  MEMBER
 STATE IN WHICH A PHYSICIAN HOLDS A LICENSE TO PRACTICE MEDICINE.
   § 8870. DISCIPLINARY  ACTIONS. 1. ANY DISCIPLINARY ACTION TAKEN BY ANY
 MEMBER BOARD AGAINST A PHYSICIAN LICENSED THROUGH THE COMPACT  SHALL  BE
 DEEMED  UNPROFESSIONAL  CONDUCT  WHICH  MAY  BE SUBJECT TO DISCIPLINE BY
 OTHER MEMBER BOARDS, IN ADDITION TO ANY VIOLATION OF THE  MEDICAL  PRAC-
 TICE ACT OR REGULATIONS IN THAT STATE.
   2.  IF  A  LICENSE  GRANTED  TO A PHYSICIAN BY THE MEMBER BOARD IN THE
 STATE OF PRINCIPAL LICENSE IS REVOKED, SURRENDERED  OR  RELINQUISHED  IN
 LIEU OF DISCIPLINE, OR SUSPENDED, THEN ALL LICENSES ISSUED TO THE PHYSI-
 CIAN  BY  MEMBER  BOARDS  SHALL AUTOMATICALLY BE PLACED, WITHOUT FURTHER
 ACTION NECESSARY BY ANY MEMBER BOARD, ON THE SAME STATUS. IF THE  MEMBER
 BOARD  IN  THE  STATE  OF  PRINCIPAL LICENSE SUBSEQUENTLY REINSTATES THE
 PHYSICIAN'S LICENSE, A LICENSE ISSUED TO  THE  PHYSICIAN  BY  ANY  OTHER
 MEMBER  BOARD SHALL REMAIN ENCUMBERED UNTIL THAT RESPECTIVE MEMBER BOARD
 TAKES ACTION TO REINSTATE THE LICENSE IN A MANNER  CONSISTENT  WITH  THE
 MEDICAL PRACTICE ACT OF THAT STATE.
   3.  IF  DISCIPLINARY  ACTION  IS TAKEN AGAINST A PHYSICIAN BY A MEMBER
 BOARD NOT IN THE STATE OF PRINCIPAL LICENSE, ANY OTHER MEMBER BOARD  MAY
 DEEM THE ACTION CONCLUSIVE AS TO MATTER OF LAW AND FACT DECIDED, AND:
   (A) IMPOSE THE SAME OR LESSER SANCTION OR SANCTIONS AGAINST THE PHYSI-
 CIAN  SO LONG AS SUCH SANCTIONS ARE CONSISTENT WITH THE MEDICAL PRACTICE
 ACT OF THAT STATE; OR
 S. 8307--A                         97                         A. 8807--A
 
   (B) PURSUE SEPARATE DISCIPLINARY ACTION AGAINST  THE  PHYSICIAN  UNDER
 ITS  RESPECTIVE  MEDICAL PRACTICE ACT, REGARDLESS OF THE ACTION TAKEN IN
 OTHER MEMBER STATES.
   4.  IF  A LICENSE GRANTED TO A PHYSICIAN BY A MEMBER BOARD IS REVOKED,
 SURRENDERED, OR RELINQUISHED IN LIEU OF DISCIPLINE, OR  SUSPENDED,  THEN
 ANY  LICENSE  OR  LICENSES  ISSUED  TO THE PHYSICIAN BY ANY OTHER MEMBER
 BOARD OR BOARDS SHALL BE SUSPENDED, AUTOMATICALLY AND IMMEDIATELY  WITH-
 OUT  FURTHER  ACTION  NECESSARY BY THE OTHER MEMBER BOARD OR BOARDS, FOR
 NINETY DAYS UPON ENTRY OF THE ORDER BY THE DISCIPLINING BOARD, TO PERMIT
 THE MEMBER BOARD OR BOARDS TO INVESTIGATE THE BASIS FOR THE ACTION UNDER
 THE MEDICAL PRACTICE ACT OF THAT STATE. A MEMBER BOARD MAY TERMINATE THE
 AUTOMATIC SUSPENSION OF THE LICENSE IT ISSUED PRIOR TO THE COMPLETION OF
 THE NINETY DAY SUSPENSION PERIOD IN A MANNER CONSISTENT WITH THE MEDICAL
 PRACTICE ACT OF THAT STATE.
   § 8871. INTERSTATE MEDICAL LICENSURE COMPACT COMMISSION. 1. THE MEMBER
 STATES HEREBY CREATE THE "INTERSTATE MEDICAL LICENSURE  COMPACT  COMMIS-
 SION".
   2.  THE  PURPOSE OF THE INTERSTATE COMMISSION IS THE ADMINISTRATION OF
 THE INTERSTATE MEDICAL LICENSURE COMPACT, WHICH IS A DISCRETIONARY STATE
 FUNCTION.
   3. THE INTERSTATE COMMISSION SHALL BE A BODY CORPORATE AND JOINT AGEN-
 CY OF THE MEMBER STATES AND SHALL HAVE ALL THE RESPONSIBILITIES, POWERS,
 AND DUTIES SET FORTH IN THE COMPACT, AND SUCH ADDITIONAL POWERS  AS  MAY
 BE CONFERRED UPON IT BY A SUBSEQUENT CONCURRENT ACTION OF THE RESPECTIVE
 LEGISLATURES  OF  THE  MEMBER STATES IN ACCORDANCE WITH THE TERMS OF THE
 COMPACT.
   4. THE INTERSTATE COMMISSION SHALL CONSIST  OF  TWO  VOTING  REPRESEN-
 TATIVES APPOINTED BY EACH MEMBER STATE WHO SHALL SERVE AS COMMISSIONERS.
 IN  STATES  WHERE ALLOPATHIC AND OSTEOPATHIC PHYSICIANS ARE REGULATED BY
 SEPARATE MEMBER BOARDS, OR IF THE LICENSING AND  DISCIPLINARY  AUTHORITY
 IS  SPLIT  BETWEEN  MULTIPLE  MEMBER  BOARDS  WITHIN A MEMBER STATE, THE
 MEMBER STATE SHALL APPOINT ONE REPRESENTATIVE FROM EACH MEMBER BOARD.  A
 COMMISSIONER SHALL BE A OR AN:
   (A) ALLOPATHIC OR OSTEOPATHIC PHYSICIAN APPOINTED TO A MEMBER BOARD;
   (B) EXECUTIVE DIRECTOR, EXECUTIVE SECRETARY, OR SIMILAR EXECUTIVE OF A
 MEMBER BOARD; OR
   (C) MEMBER OF THE PUBLIC APPOINTED TO A MEMBER BOARD.
   5.  THE  INTERSTATE  COMMISSION SHALL MEET AT LEAST ONCE EACH CALENDAR
 YEAR. A PORTION OF THIS MEETING SHALL BE A BUSINESS MEETING  TO  ADDRESS
 SUCH  MATTERS  AS MAY PROPERLY COME BEFORE THE COMMISSION, INCLUDING THE
 ELECTION OF OFFICERS. THE CHAIRPERSON MAY CALL ADDITIONAL  MEETINGS  AND
 SHALL  CALL  FOR  A MEETING UPON THE REQUEST OF A MAJORITY OF THE MEMBER
 STATES.
   6. THE BYLAWS MAY PROVIDE FOR MEETINGS OF THE INTERSTATE COMMISSION TO
 BE CONDUCTED BY TELECOMMUNICATION OR ELECTRONIC COMMUNICATION.
   7. EACH COMMISSIONER PARTICIPATING AT  A  MEETING  OF  THE  INTERSTATE
 COMMISSION  IS  ENTITLED  TO ONE VOTE. A MAJORITY OF COMMISSIONERS SHALL
 CONSTITUTE A QUORUM FOR THE TRANSACTION OF  BUSINESS,  UNLESS  A  LARGER
 QUORUM IS REQUIRED BY THE BYLAWS OF THE INTERSTATE COMMISSION. A COMMIS-
 SIONER SHALL NOT DELEGATE A VOTE TO ANOTHER COMMISSIONER. IN THE ABSENCE
 OF  ITS COMMISSIONER, A MEMBER STATE MAY DELEGATE VOTING AUTHORITY FOR A
 SPECIFIED MEETING TO ANOTHER PERSON FROM THAT STATE WHO SHALL  MEET  THE
 REQUIREMENTS OF SUBDIVISION FOUR OF THIS SECTION.
   8.  THE INTERSTATE COMMISSION SHALL PROVIDE PUBLIC NOTICE OF ALL MEET-
 INGS AND ALL MEETINGS SHALL  BE  OPEN  TO  THE  PUBLIC.  THE  INTERSTATE
 COMMISSION  MAY  CLOSE A MEETING, IN FULL OR IN PORTION, WHERE IT DETER-
 S. 8307--A                         98                         A. 8807--A
 
 MINES BY A TWO-THIRDS VOTE OF THE COMMISSIONERS  PRESENT  THAT  AN  OPEN
 MEETING WOULD BE LIKELY TO:
   (A)  RELATE  SOLELY TO THE INTERNAL PERSONNEL PRACTICES AND PROCEDURES
 OF THE INTERSTATE COMMISSION;
   (B) DISCUSS MATTERS SPECIFICALLY EXEMPTED FROM DISCLOSURE  BY  FEDERAL
 STATUTE;
   (C)  DISCUSS  TRADE SECRETS, COMMERCIAL, OR FINANCIAL INFORMATION THAT
 IS PRIVILEGED OR CONFIDENTIAL;
   (D) INVOLVE ACCUSING A PERSON OF A  CRIME,  OR  FORMALLY  CENSURING  A
 PERSON;
   (E)  DISCUSS  INFORMATION  OF A PERSONAL NATURE WHERE DISCLOSURE WOULD
 CONSTITUTE A CLEARLY UNWARRANTED INVASION OF PERSONAL PRIVACY;
   (F)  DISCUSS  INVESTIGATIVE  RECORDS  COMPILED  FOR  LAW   ENFORCEMENT
 PURPOSES; OR
   (G)  SPECIFICALLY  RELATE  TO  THE  PARTICIPATION IN A CIVIL ACTION OR
 OTHER LEGAL PROCEEDING.
   9. THE INTERSTATE COMMISSION SHALL  KEEP  MINUTES  WHICH  SHALL  FULLY
 DESCRIBE ALL MATTERS DISCUSSED IN A MEETING AND SHALL PROVIDE A FULL AND
 ACCURATE  SUMMARY  OF  ACTIONS  TAKEN, INCLUDING RECORD OF ANY ROLL CALL
 VOTES.
   10. THE INTERSTATE COMMISSION SHALL MAKE ITS INFORMATION AND  OFFICIAL
 RECORDS, TO THE EXTENT NOT OTHERWISE DESIGNATED IN THE COMPACT OR BY ITS
 RULES, AVAILABLE TO THE PUBLIC FOR INSPECTION.
   11.  THE INTERSTATE COMMISSION SHALL ESTABLISH AN EXECUTIVE COMMITTEE,
 WHICH SHALL INCLUDE OFFICERS, MEMBERS, AND OTHERS AS DETERMINED  BY  THE
 BYLAWS. THE EXECUTIVE COMMITTEE SHALL HAVE THE POWER TO ACT ON BEHALF OF
 THE  INTERSTATE  COMMISSION,  WITH  THE  EXCEPTION OF RULEMAKING, DURING
 PERIODS WHEN THE INTERSTATE COMMISSION IS NOT IN SESSION. WHEN ACTING ON
 BEHALF OF THE INTERSTATE COMMISSION, THE EXECUTIVE COMMITTEE SHALL OVER-
 SEE THE ADMINISTRATION OF THE COMPACT INCLUDING ENFORCEMENT AND  COMPLI-
 ANCE WITH THE PROVISIONS OF THE COMPACT, ITS BYLAWS AND RULES, AND OTHER
 SUCH DUTIES AS NECESSARY.
   12.  THE  INTERSTATE  COMMISSION  SHALL ESTABLISH OTHER COMMITTEES FOR
 GOVERNANCE AND ADMINISTRATION OF THE COMPACT.
   § 8872. POWERS AND DUTIES OF THE INTERSTATE COMMISSION. THE INTERSTATE
 COMMISSION SHALL HAVE THE DUTY AND POWER TO:
   1. OVERSEE AND MAINTAIN THE ADMINISTRATION OF THE COMPACT;
   2. PROMULGATE RULES WHICH SHALL BE BINDING TO THE EXTENT  AND  IN  THE
 MANNER PROVIDED FOR IN THE COMPACT;
   3. ISSUE, UPON THE REQUEST OF A MEMBER STATE OR MEMBER BOARD, ADVISORY
 OPINIONS  CONCERNING  THE  MEANING OR INTERPRETATION OF THE COMPACT, ITS
 BYLAWS, RULES, AND ACTIONS;
   4. ENFORCE COMPLIANCE WITH COMPACT PROVISIONS, THE  RULES  PROMULGATED
 BY  THE  INTERSTATE  COMMISSION, AND THE BYLAWS, USING ALL NECESSARY AND
 PROPER MEANS, INCLUDING BUT NOT LIMITED TO THE USE OF JUDICIAL PROCESS;
   5. ESTABLISH AND APPOINT COMMITTEES INCLUDING, BUT NOT LIMITED TO,  AN
 EXECUTIVE  COMMITTEE  AS REQUIRED BY SECTION EIGHTY-EIGHT HUNDRED SEVEN-
 TY-ONE OF THIS ARTICLE, WHICH SHALL HAVE THE POWER TO ACT ON  BEHALF  OF
 THE INTERSTATE COMMISSION IN CARRYING OUT ITS POWERS AND DUTIES;
   6.  PAY,  OR  PROVIDE  FOR  THE PAYMENT OF THE EXPENSES RELATED TO THE
 ESTABLISHMENT, ORGANIZATION, AND ONGOING ACTIVITIES  OF  THE  INTERSTATE
 COMMISSION;
   7. ESTABLISH AND MAINTAIN ONE OR MORE OFFICES;
   8. BORROW, ACCEPT, HIRE, OR CONTRACT FOR SERVICES OF PERSONNEL;
   9. PURCHASE AND MAINTAIN INSURANCE AND BONDS;
 S. 8307--A                         99                         A. 8807--A
 
   10. EMPLOY AN EXECUTIVE DIRECTOR WHO SHALL HAVE SUCH POWERS TO EMPLOY,
 SELECT  OR  APPOINT  EMPLOYEES, AGENTS, OR CONSULTANTS, AND TO DETERMINE
 THEIR QUALIFICATIONS, DEFINE THEIR DUTIES, AND FIX THEIR COMPENSATION;
   11. ESTABLISH PERSONNEL POLICIES AND PROGRAMS RELATING TO CONFLICTS OF
 INTEREST, RATES OF COMPENSATION, AND QUALIFICATIONS OF PERSONNEL;
   12. ACCEPT DONATIONS AND GRANTS OF MONEY, EQUIPMENT, SUPPLIES, MATERI-
 ALS AND SERVICES, AND TO RECEIVE, UTILIZE, AND DISPOSE OF IT IN A MANNER
 CONSISTENT  WITH  THE  CONFLICT  OF INTEREST POLICIES ESTABLISHED BY THE
 INTERSTATE COMMISSION;
   13. LEASE, PURCHASE, ACCEPT CONTRIBUTIONS OR DONATIONS OF,  OR  OTHER-
 WISE  TO  OWN,  HOLD,  IMPROVE, OR USE, ANY PROPERTY, REAL, PERSONAL, OR
 MIXED;
   14. SELL, CONVEY,  MORTGAGE,  PLEDGE,  LEASE,  EXCHANGE,  ABANDON,  OR
 OTHERWISE DISPOSE OF ANY PROPERTY, REAL, PERSONAL, OR MIXED;
   15. ESTABLISH A BUDGET AND MAKE EXPENDITURES;
   16.  ADOPT A SEAL AND BYLAWS GOVERNING THE MANAGEMENT AND OPERATION OF
 THE INTERSTATE COMMISSION;
   17. REPORT ANNUALLY TO THE LEGISLATURES AND GOVERNORS  OF  THE  MEMBER
 STATES CONCERNING THE ACTIVITIES OF THE INTERSTATE COMMISSION DURING THE
 PRECEDING  YEAR.    SUCH REPORTS SHALL ALSO INCLUDE REPORTS OF FINANCIAL
 AUDITS AND ANY RECOMMENDATIONS THAT MAY HAVE BEEN ADOPTED BY THE  INTER-
 STATE COMMISSION;
   18. COORDINATE EDUCATION, TRAINING, AND PUBLIC AWARENESS REGARDING THE
 COMPACT, ITS IMPLEMENTATION, AND ITS OPERATION;
   19. MAINTAIN RECORDS IN ACCORDANCE WITH THE BYLAWS;
   20. SEEK AND OBTAIN TRADEMARKS, COPYRIGHTS, AND PATENTS; AND
   21.  PERFORM  SUCH  FUNCTIONS  AS  MAY  BE NECESSARY OR APPROPRIATE TO
 ACHIEVE THE PURPOSES OF THE COMPACT.
   § 8873. FINANCE POWERS. 1. THE INTERSTATE COMMISSION MAY LEVY  ON  AND
 COLLECT AN ANNUAL ASSESSMENT FROM EACH MEMBER STATE TO COVER THE COST OF
 THE  OPERATIONS  AND  ACTIVITIES  OF  THE  INTERSTATE COMMISSION AND ITS
 STAFF. THE TOTAL ASSESSMENT MUST BE SUFFICIENT TO COVER THE ANNUAL BUDG-
 ET APPROVED EACH YEAR FOR WHICH REVENUE IS NOT PROVIDED BY OTHER  SOURC-
 ES.  THE  AGGREGATE  ANNUAL  ASSESSMENT AMOUNT SHALL BE ALLOCATED UPON A
 FORMULA TO BE DETERMINED  BY  THE  INTERSTATE  COMMISSION,  WHICH  SHALL
 PROMULGATE A RULE BINDING UPON ALL MEMBER STATES.
   2.  THE  INTERSTATE COMMISSION SHALL NOT INCUR OBLIGATIONS OF ANY KIND
 PRIOR TO SECURING THE FUNDS ADEQUATE TO MEET THE SAME.
   3. THE INTERSTATE COMMISSION SHALL NOT PLEDGE THE CREDIT OF ANY OF THE
 MEMBER STATES, EXCEPT BY, AND WITH THE AUTHORITY OF, THE MEMBER STATE.
   4. THE INTERSTATE COMMISSION SHALL BE SUBJECT TO  A  YEARLY  FINANCIAL
 AUDIT  CONDUCTED  BY  A  CERTIFIED OR LICENSED PUBLIC ACCOUNTANT AND THE
 REPORT OF THE AUDIT SHALL BE INCLUDED IN THE ANNUAL REPORT OF THE INTER-
 STATE COMMISSION.
   § 8874. ORGANIZATION AND OPERATION OF THE  INTERSTATE  COMMISSION.  1.
 THE  INTERSTATE COMMISSION SHALL, BY A MAJORITY OF COMMISSIONERS PRESENT
 AND VOTING, ADOPT BYLAWS TO GOVERN ITS CONDUCT AS MAY  BE  NECESSARY  OR
 APPROPRIATE  TO  CARRY  OUT  THE  PURPOSES  OF THE COMPACT WITHIN TWELVE
 MONTHS OF THE FIRST INTERSTATE COMMISSION MEETING.
   2. THE INTERSTATE COMMISSION SHALL  ELECT  OR  APPOINT  ANNUALLY  FROM
 AMONG  ITS COMMISSIONERS A CHAIRPERSON, A VICE-CHAIRPERSON, AND A TREAS-
 URER, EACH OF WHOM SHALL HAVE SUCH AUTHORITY AND DUTIES AS MAY BE SPECI-
 FIED IN THE BYLAWS. THE CHAIRPERSON, OR IN THE CHAIRPERSON'S ABSENCE  OR
 DISABILITY,  THE  VICE-CHAIRPERSON, SHALL PRESIDE AT ALL MEETINGS OF THE
 INTERSTATE COMMISSION.
 S. 8307--A                         100                        A. 8807--A
 
   3. OFFICERS SELECTED PURSUANT TO SUBDIVISION TWO OF THIS SECTION SHALL
 SERVE WITHOUT REMUNERATION FROM THE INTERSTATE COMMISSION.
   4.  THE  OFFICERS  AND EMPLOYEES OF THE INTERSTATE COMMISSION SHALL BE
 IMMUNE FROM SUIT AND LIABILITY, EITHER PERSONALLY OR IN  THEIR  OFFICIAL
 CAPACITY,  FOR  A  CLAIM  FOR  DAMAGE TO OR LOSS OF PROPERTY OR PERSONAL
 INJURY OR OTHER CIVIL LIABILITY CAUSED OR ARISING OUT  OF,  OR  RELATING
 TO,  AN ACTUAL OR ALLEGED ACT, ERROR, OR OMISSION THAT OCCURRED, OR THAT
 SUCH PERSON HAD A REASONABLE BASIS FOR BELIEVING  OCCURRED,  WITHIN  THE
 SCOPE  OF INTERSTATE COMMISSION EMPLOYMENT, DUTIES, OR RESPONSIBILITIES;
 PROVIDED THAT SUCH PERSON SHALL NOT BE PROTECTED FROM SUIT OR  LIABILITY
 FOR  DAMAGE,  LOSS,  INJURY,  OR  LIABILITY CAUSED BY THE INTENTIONAL OR
 WILLFUL AND WANTON MISCONDUCT OF SUCH PERSON.
   (A) THE LIABILITY OF THE  EXECUTIVE  DIRECTOR  AND  EMPLOYEES  OF  THE
 INTERSTATE  COMMISSION  OR REPRESENTATIVES OF THE INTERSTATE COMMISSION,
 ACTING WITHIN THE SCOPE OF SUCH PERSON'S EMPLOYMENT OR DUTIES FOR  ACTS,
 ERRORS,  OR  OMISSIONS  OCCURRING  WITHIN  SUCH  PERSON'S STATE, MAY NOT
 EXCEED THE LIMITS OF LIABILITY SET FORTH UNDER THE CONSTITUTION AND LAWS
 OF THAT STATE FOR STATE OFFICIALS, EMPLOYEES, AND AGENTS. THE INTERSTATE
 COMMISSION IS CONSIDERED TO BE AN INSTRUMENTALITY OF THE STATES FOR  THE
 PURPOSES  OF  ANY  SUCH  ACTION.    NOTHING  IN  THIS PARAGRAPH SHALL BE
 CONSTRUED TO PROTECT SUCH PERSON FROM  SUIT  OR  LIABILITY  FOR  DAMAGE,
 LOSS,  INJURY,  OR  LIABILITY  CAUSED  BY THE INTENTIONAL OR WILLFUL AND
 WANTON MISCONDUCT OF SUCH PERSON.
   (B) THE INTERSTATE COMMISSION SHALL DEFEND THE EXECUTIVE DIRECTOR, ITS
 EMPLOYEES, AND SUBJECT TO THE APPROVAL OF THE ATTORNEY GENERAL OR  OTHER
 APPROPRIATE  LEGAL  COUNSEL OF THE MEMBER STATE REPRESENTED BY AN INTER-
 STATE COMMISSION REPRESENTATIVE, SHALL DEFEND SUCH INTERSTATE COMMISSION
 REPRESENTATIVE IN ANY CIVIL ACTION SEEKING TO IMPOSE  LIABILITY  ARISING
 OUT  OF AN ACTUAL OR ALLEGED ACT, ERROR OR OMISSION THAT OCCURRED WITHIN
 THE SCOPE OF INTERSTATE COMMISSION EMPLOYMENT,  DUTIES  OR  RESPONSIBIL-
 ITIES,  OR  THAT  THE  DEFENDANT  HAD  A  REASONABLE BASIS FOR BELIEVING
 OCCURRED WITHIN THE SCOPE OF INTERSTATE COMMISSION  EMPLOYMENT,  DUTIES,
 OR  RESPONSIBILITIES, PROVIDED THAT THE ACTUAL OR ALLEGED ACT, ERROR, OR
 OMISSION DID NOT RESULT FROM INTENTIONAL OR WILLFUL AND  WANTON  MISCON-
 DUCT ON THE PART OF SUCH PERSON.
   (C)  TO THE EXTENT NOT COVERED BY THE STATE INVOLVED, MEMBER STATE, OR
 THE INTERSTATE COMMISSION,  THE  REPRESENTATIVES  OR  EMPLOYEES  OF  THE
 INTERSTATE  COMMISSION SHALL BE HELD HARMLESS IN THE AMOUNT OF A SETTLE-
 MENT OR JUDGMENT, INCLUDING ATTORNEY'S FEES AND COSTS, OBTAINED  AGAINST
 SUCH PERSONS ARISING OUT OF AN ACTUAL OR ALLEGED ACT, ERROR, OR OMISSION
 THAT  OCCURRED  WITHIN  THE  SCOPE  OF INTERSTATE COMMISSION EMPLOYMENT,
 DUTIES, OR RESPONSIBILITIES, OR THAT SUCH PERSONS HAD A REASONABLE BASIS
 FOR BELIEVING OCCURRED WITHIN THE SCOPE OF INTERSTATE COMMISSION EMPLOY-
 MENT, DUTIES, OR RESPONSIBILITIES, PROVIDED THAT THE ACTUAL  OR  ALLEGED
 ACT,  ERROR,  OR OMISSION DID NOT RESULT FROM INTENTIONAL OR WILLFUL AND
 WANTON MISCONDUCT ON THE PART OF SUCH PERSONS.
   § 8875. RULEMAKING FUNCTIONS OF THE INTERSTATE  COMMISSION.  1.    THE
 INTERSTATE  COMMISSION  SHALL  PROMULGATE  REASONABLE  RULES IN ORDER TO
 EFFECTIVELY  AND  EFFICIENTLY  ACHIEVE  THE  PURPOSES  OF  THE  COMPACT.
 NOTWITHSTANDING  THE  FOREGOING,  IN THE EVENT THE INTERSTATE COMMISSION
 EXERCISES ITS RULEMAKING AUTHORITY IN A MANNER THAT IS BEYOND THE  SCOPE
 OF  THE  PURPOSES  OF THE COMPACT, OR THE POWERS GRANTED HEREUNDER, THEN
 SUCH AN ACTION BY THE INTERSTATE COMMISSION SHALL BE INVALID AND HAVE NO
 FORCE OR EFFECT.
   2. RULES DEEMED APPROPRIATE  FOR  THE  OPERATIONS  OF  THE  INTERSTATE
 COMMISSION  SHALL BE MADE PURSUANT TO A RULEMAKING PROCESS THAT SUBSTAN-
 S. 8307--A                         101                        A. 8807--A
 
 TIALLY CONFORMS TO THE FEDERAL MODEL STATE ADMINISTRATIVE PROCEDURE  ACT
 OF 2010, AND SUBSEQUENT AMENDMENTS THERETO.
   3.  NOT LATER THAN THIRTY DAYS AFTER A RULE IS PROMULGATED, ANY PERSON
 MAY FILE A PETITION FOR JUDICIAL REVIEW OF THE RULE IN THE UNITED STATES
 DISTRICT COURT FOR THE DISTRICT OF  COLUMBIA  OR  THE  FEDERAL  DISTRICT
 WHERE THE INTERSTATE COMMISSION HAS ITS PRINCIPAL OFFICES, PROVIDED THAT
 THE  FILING  OF  SUCH A PETITION SHALL NOT STAY OR OTHERWISE PREVENT THE
 RULE FROM BECOMING EFFECTIVE UNLESS THE COURT FINDS THAT THE  PETITIONER
 HAS  A SUBSTANTIAL LIKELIHOOD OF SUCCESS. THE COURT SHALL GIVE DEFERENCE
 TO THE ACTIONS OF THE INTERSTATE COMMISSION CONSISTENT  WITH  APPLICABLE
 LAW  AND SHALL NOT FIND THE RULE TO BE UNLAWFUL IF THE RULE REPRESENTS A
 REASONABLE EXERCISE OF THE AUTHORITY GRANTED TO THE  INTERSTATE  COMMIS-
 SION.
   § 8876. OVERSIGHT  OF  INTERSTATE  COMPACT. 1. THE EXECUTIVE, LEGISLA-
 TIVE, AND JUDICIAL BRANCHES OF STATE GOVERNMENT  IN  EACH  MEMBER  STATE
 SHALL  ENFORCE  THE  COMPACT  AND  SHALL  TAKE ALL ACTIONS NECESSARY AND
 APPROPRIATE  TO  EFFECTUATE  THE  COMPACT'S  PURPOSES  AND  INTENT.  THE
 PROVISIONS OF THE COMPACT AND THE RULES PROMULGATED HEREUNDER SHALL HAVE
 STANDING AS STATUTORY LAW BUT SHALL NOT OVERRIDE EXISTING STATE AUTHORI-
 TY TO REGULATE THE PRACTICE OF MEDICINE.
   2.  ALL COURTS SHALL TAKE JUDICIAL NOTICE OF THE COMPACT AND THE RULES
 IN ANY JUDICIAL OR ADMINISTRATIVE PROCEEDING IN A MEMBER STATE  PERTAIN-
 ING  TO  THE  SUBJECT MATTER OF THE COMPACT WHICH MAY AFFECT THE POWERS,
 RESPONSIBILITIES OR ACTIONS OF THE INTERSTATE COMMISSION.
   3. THE INTERSTATE COMMISSION SHALL BE ENTITLED TO RECEIVE ALL  SERVICE
 OF  PROCESS IN ANY SUCH PROCEEDING, AND SHALL HAVE STANDING TO INTERVENE
 IN THE PROCEEDING FOR ALL PURPOSES. FAILURE TO PROVIDE SERVICE OF  PROC-
 ESS  TO  THE INTERSTATE COMMISSION SHALL RENDER A JUDGMENT OR ORDER VOID
 AS TO THE INTERSTATE COMMISSION, THE COMPACT, OR PROMULGATED RULES.
   § 8877. ENFORCEMENT OF INTERSTATE COMPACT. 1. THE  INTERSTATE  COMMIS-
 SION,  IN  THE  REASONABLE EXERCISE OF ITS DISCRETION, SHALL ENFORCE THE
 PROVISIONS AND RULES OF THE COMPACT.
   2. THE INTERSTATE COMMISSION MAY, BY MAJORITY VOTE OF THE  COMMISSION-
 ERS,  INITIATE  LEGAL ACTION IN THE UNITED STATES DISTRICT COURT FOR THE
 DISTRICT OF COLUMBIA, OR, AT THE DISCRETION OF  THE  INTERSTATE  COMMIS-
 SION,  IN  THE  FEDERAL DISTRICT WHERE THE INTERSTATE COMMISSION HAS ITS
 PRINCIPAL OFFICES, TO ENFORCE COMPLIANCE  WITH  THE  PROVISIONS  OF  THE
 COMPACT, AND ITS PROMULGATED RULES AND BYLAWS, AGAINST A MEMBER STATE IN
 DEFAULT.  THE  RELIEF  SOUGHT  MAY  INCLUDE  BOTH  INJUNCTIVE RELIEF AND
 DAMAGES. IN THE EVENT JUDICIAL ENFORCEMENT IS NECESSARY, THE  PREVAILING
 PARTY SHALL BE AWARDED ALL COSTS OF SUCH LITIGATION INCLUDING REASONABLE
 ATTORNEY'S FEES.
   3.  THE  REMEDIES  HEREIN  SHALL  NOT BE THE EXCLUSIVE REMEDIES OF THE
 INTERSTATE COMMISSION.  THE INTERSTATE COMMISSION MAY  AVAIL  ITSELF  OF
 ANY  OTHER  REMEDIES  AVAILABLE  UNDER  STATE LAW OR THE REGULATION OF A
 PROFESSION.
   § 8878. DEFAULT PROCEDURES. 1. THE GROUNDS FOR  DEFAULT  INCLUDE,  BUT
 ARE  NOT  LIMITED  TO,  FAILURE  OF A MEMBER STATE TO PERFORM SUCH OBLI-
 GATIONS OR RESPONSIBILITIES IMPOSED UPON IT BY THE COMPACT, OR THE RULES
 AND BYLAWS OF THE INTERSTATE COMMISSION PROMULGATED UNDER THE COMPACT.
   2. IF THE INTERSTATE COMMISSION DETERMINES THAT  A  MEMBER  STATE  HAS
 DEFAULTED  IN  THE  PERFORMANCE  OF  ITS OBLIGATIONS OR RESPONSIBILITIES
 UNDER THE COMPACT, OR THE BYLAWS OR PROMULGATED  RULES,  THE  INTERSTATE
 COMMISSION SHALL:
   (A)  PROVIDE  WRITTEN  NOTICE TO THE DEFAULTING STATE AND OTHER MEMBER
 STATES, OF THE NATURE OF THE DEFAULT, THE MEANS OF CURING  THE  DEFAULT,
 S. 8307--A                         102                        A. 8807--A
 
 AND  ANY  ACTION  TAKEN  BY  THE INTERSTATE COMMISSION.   THE INTERSTATE
 COMMISSION SHALL SPECIFY THE CONDITIONS BY WHICH  THE  DEFAULTING  STATE
 MUST CURE ITS DEFAULT; AND
   (B)  PROVIDE  REMEDIAL  TRAINING  AND  SPECIFIC  TECHNICAL  ASSISTANCE
 REGARDING THE DEFAULT.
   3. IF THE DEFAULTING STATE FAILS TO CURE THE DEFAULT,  THE  DEFAULTING
 STATE SHALL BE TERMINATED FROM THE COMPACT UPON AN AFFIRMATIVE VOTE OF A
 MAJORITY  OF  THE COMMISSIONERS AND ALL RIGHTS, PRIVILEGES, AND BENEFITS
 CONFERRED BY THE COMPACT SHALL TERMINATE ON THE EFFECTIVE DATE OF TERMI-
 NATION. A CURE OF THE DEFAULT DOES NOT RELIEVE THE  OFFENDING  STATE  OF
 OBLIGATIONS OR LIABILITIES INCURRED DURING THE PERIOD OF THE DEFAULT.
   4.  TERMINATION  OF  MEMBERSHIP  IN  THE COMPACT SHALL BE IMPOSED ONLY
 AFTER ALL OTHER MEANS OF SECURING COMPLIANCE HAVE BEEN EXHAUSTED. NOTICE
 OF INTENT TO TERMINATE SHALL BE GIVEN BY THE  INTERSTATE  COMMISSION  TO
 THE  GOVERNOR,  THE  MAJORITY  AND  MINORITY  LEADERS  OF THE DEFAULTING
 STATE'S LEGISLATURE, AND EACH OF THE MEMBER STATES.
   5. THE INTERSTATE COMMISSION SHALL ESTABLISH RULES AND  PROCEDURES  TO
 ADDRESS  LICENSES  AND  PHYSICIANS  THAT  ARE MATERIALLY IMPACTED BY THE
 TERMINATION OF A MEMBER STATE, OR THE WITHDRAWAL OF A MEMBER STATE.
   6. THE MEMBER STATE WHICH HAS BEEN TERMINATED IS RESPONSIBLE  FOR  ALL
 DUES,  OBLIGATIONS,  AND LIABILITIES INCURRED THROUGH THE EFFECTIVE DATE
 OF TERMINATION INCLUDING OBLIGATIONS, THE PERFORMANCE OF  WHICH  EXTENDS
 BEYOND THE EFFECTIVE DATE OF TERMINATION.
   7.  THE INTERSTATE COMMISSION SHALL NOT BEAR ANY COSTS RELATING TO ANY
 STATE THAT HAS BEEN FOUND TO BE IN DEFAULT OR WHICH HAS BEEN  TERMINATED
 FROM  THE  COMPACT,  UNLESS  OTHERWISE  MUTUALLY  AGREED UPON IN WRITING
 BETWEEN THE INTERSTATE COMMISSION AND THE DEFAULTING STATE.
   8. THE DEFAULTING STATE  MAY  APPEAL  THE  ACTION  OF  THE  INTERSTATE
 COMMISSION  BY  PETITIONING  THE  UNITED  STATES  DISTRICT COURT FOR THE
 DISTRICT OF COLUMBIA  OR  THE  FEDERAL  DISTRICT  WHERE  THE  INTERSTATE
 COMMISSION  HAS  ITS  PRINCIPAL  OFFICES.  THE PREVAILING PARTY SHALL BE
 AWARDED ALL COSTS OF SUCH  LITIGATION  INCLUDING  REASONABLE  ATTORNEY'S
 FEES.
   § 8879. DISPUTE   RESOLUTION.   1.  THE  INTERSTATE  COMMISSION  SHALL
 ATTEMPT, UPON THE REQUEST OF A MEMBER STATE, TO RESOLVE  DISPUTES  WHICH
 ARE  SUBJECT  TO  THE COMPACT AND WHICH MAY ARISE AMONG MEMBER STATES OR
 MEMBER BOARDS.
   2. THE INTERSTATE COMMISSION SHALL PROMULGATE RULES PROVIDING FOR BOTH
 MEDIATION AND BINDING DISPUTE RESOLUTION AS APPROPRIATE.
   § 8880. MEMBER STATES, EFFECTIVE DATE AND AMENDMENT. 1. ANY  STATE  IS
 ELIGIBLE TO BECOME A MEMBER STATE OF THE COMPACT.
   2.  THE  COMPACT  SHALL  BECOME EFFECTIVE AND BINDING UPON LEGISLATIVE
 ENACTMENT OF THE COMPACT INTO LAW BY NO LESS THAN SEVEN  STATES.  THERE-
 AFTER,  IT  SHALL BECOME EFFECTIVE AND BINDING ON A STATE UPON ENACTMENT
 OF THE COMPACT INTO LAW BY THAT STATE.
   3. THE GOVERNORS OF NON-MEMBER STATES, OR THEIR  DESIGNEES,  SHALL  BE
 INVITED TO PARTICIPATE IN THE ACTIVITIES OF THE INTERSTATE COMMISSION ON
 A NON-VOTING BASIS PRIOR TO ADOPTION OF THE COMPACT BY ALL STATES.
   4. THE INTERSTATE COMMISSION MAY PROPOSE AMENDMENTS TO THE COMPACT FOR
 ENACTMENT  BY THE MEMBER STATES. NO AMENDMENT SHALL BECOME EFFECTIVE AND
 BINDING UPON THE INTERSTATE COMMISSION AND THE MEMBER STATES UNLESS  AND
 UNTIL IT IS ENACTED INTO LAW BY UNANIMOUS CONSENT OF THE MEMBER STATES.
   § 8881. WITHDRAWAL.  1.  ONCE EFFECTIVE, THE COMPACT SHALL CONTINUE IN
 FORCE AND REMAIN BINDING UPON EACH AND EVERY MEMBER STATE; PROVIDED THAT
 A MEMBER STATE MAY WITHDRAW FROM THE COMPACT BY  SPECIFICALLY  REPEALING
 THE STATUTE WHICH ENACTED THE COMPACT INTO LAW.
 S. 8307--A                         103                        A. 8807--A
 
   2.  WITHDRAWAL FROM THE COMPACT SHALL BE BY THE ENACTMENT OF A STATUTE
 REPEALING THE SAME, BUT SHALL NOT TAKE EFFECT UNTIL ONE YEAR  AFTER  THE
 EFFECTIVE  DATE  OF  SUCH  STATUTE AND UNTIL WRITTEN NOTICE OF THE WITH-
 DRAWAL HAS BEEN GIVEN BY THE WITHDRAWING STATE TO THE GOVERNOR  OF  EACH
 OTHER MEMBER STATE.
   3.  THE  WITHDRAWING STATE SHALL IMMEDIATELY NOTIFY THE CHAIRPERSON OF
 THE INTERSTATE COMMISSION IN WRITING UPON  THE  INTRODUCTION  OF  LEGIS-
 LATION REPEALING THE COMPACT IN THE WITHDRAWING STATE.
   4.  THE  INTERSTATE COMMISSION SHALL NOTIFY THE OTHER MEMBER STATES OF
 THE WITHDRAWING STATE'S INTENT TO WITHDRAW  WITHIN  SIXTY  DAYS  OF  ITS
 RECEIPT OF NOTICE PROVIDED UNDER SUBDIVISION THREE OF THIS SECTION.
   5.  THE WITHDRAWING STATE IS RESPONSIBLE FOR ALL DUES, OBLIGATIONS AND
 LIABILITIES INCURRED THROUGH THE EFFECTIVE DATE OF WITHDRAWAL, INCLUDING
 OBLIGATIONS, THE PERFORMANCE OF WHICH EXTEND BEYOND THE  EFFECTIVE  DATE
 OF WITHDRAWAL.
   6.  REINSTATEMENT  FOLLOWING  WITHDRAWAL OF A MEMBER STATE SHALL OCCUR
 UPON THE WITHDRAWING STATE REENACTING THE COMPACT  OR  UPON  SUCH  LATER
 DATE AS DETERMINED BY THE INTERSTATE COMMISSION.
   7. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES TO ADDRESS
 THE  IMPACT  OF  THE WITHDRAWAL OF A MEMBER STATE ON LICENSES GRANTED IN
 OTHER MEMBER STATES TO PHYSICIANS WHO DESIGNATED THE WITHDRAWING  MEMBER
 STATE AS THE STATE OF PRINCIPAL LICENSE.
   § 8882. DISSOLUTION.  1. THE COMPACT SHALL DISSOLVE EFFECTIVE UPON THE
 DATE OF THE WITHDRAWAL OR DEFAULT OF THE MEMBER STATE WHICH REDUCES  THE
 MEMBERSHIP IN THE COMPACT TO ONE MEMBER STATE.
   2.  UPON  THE DISSOLUTION OF THE COMPACT, THE COMPACT BECOMES NULL AND
 VOID AND SHALL BE OF NO FURTHER FORCE OR EFFECT, AND  THE  BUSINESS  AND
 AFFAIRS  OF  THE  INTERSTATE  COMMISSION  SHALL BE CONCLUDED AND SURPLUS
 FUNDS SHALL BE DISTRIBUTED IN ACCORDANCE WITH THE BYLAWS.
   § 8883. SEVERABILITY  AND  CONSTRUCTION.  1.  THE  PROVISIONS  OF  THE
 COMPACT  SHALL  BE  SEVERABLE,  AND  IF ANY PHRASE, CLAUSE, SENTENCE, OR
 PROVISION IS DEEMED  UNENFORCEABLE,  THE  REMAINING  PROVISIONS  OF  THE
 COMPACT SHALL BE ENFORCEABLE.
   2.  THE  PROVISIONS  OF  THE  COMPACT  SHALL BE LIBERALLY CONSTRUED TO
 EFFECTUATE ITS PURPOSES.
   3. NOTHING IN THE COMPACT SHALL BE CONSTRUED TO PROHIBIT THE  APPLICA-
 BILITY OF OTHER INTERSTATE COMPACTS TO WHICH THE STATES ARE MEMBERS.
   § 8884. BINDING EFFECT OF COMPACT AND OTHER LAWS. 1. NOTHING CONTAINED
 IN  THIS  ARTICLE  SHALL  PREVENT  THE ENFORCEMENT OF ANY OTHER LAW OF A
 MEMBER STATE THAT IS NOT INCONSISTENT WITH THE COMPACT.
   2. ALL LAWS IN A MEMBER STATE IN CONFLICT WITH THE COMPACT ARE  SUPER-
 SEDED TO THE EXTENT OF THE CONFLICT.
   3.  ALL  LAWFUL  ACTIONS  OF  THE INTERSTATE COMMISSION, INCLUDING ALL
 RULES AND BYLAWS PROMULGATED BY THE COMMISSION,  ARE  BINDING  UPON  THE
 MEMBER STATES.
   4.  ALL  AGREEMENTS  BETWEEN  THE INTERSTATE COMMISSION AND THE MEMBER
 STATES ARE BINDING IN ACCORDANCE WITH THEIR TERMS.
   5. IN THE EVENT ANY PROVISION OF THE  COMPACT  EXCEEDS  THE  CONSTITU-
 TIONAL  LIMITS  IMPOSED  ON  THE  LEGISLATURE  OF ANY MEMBER STATE, SUCH
 PROVISION SHALL BE INEFFECTIVE TO THE EXTENT OF THE  CONFLICT  WITH  THE
 CONSTITUTIONAL PROVISION IN QUESTION IN THAT MEMBER STATE.
   §  2. Article 170 of the education law is renumbered article 171 and a
 new article 170 is added to title 8 of the  education  law  to  read  as
 follows:
                                ARTICLE 170
                          NURSE LICENSURE COMPACT
 S. 8307--A                         104                        A. 8807--A
 
 SECTION 8900. NURSE LICENSURE COMPACT.
         8901. FINDINGS AND DECLARATION OF PURPOSE.
         8902. DEFINITIONS.
         8903. GENERAL PROVISIONS AND JURISDICTION.
         8904. APPLICATIONS FOR LICENSURE IN A PARTY STATE.
         8905. ADDITIONAL  AUTHORITIES  INVESTED IN PARTY STATE LICENSING
                 BOARDS.
         8906. COORDINATED LICENSURE INFORMATION SYSTEM AND  EXCHANGE  OF
                 INFORMATION.
         8907. ESTABLISHMENT OF THE INTERSTATE COMMISSION OF NURSE LICEN-
                 SURE COMPACT ADMINISTRATORS.
         8908. RULEMAKING.
         8909. OVERSIGHT, DISPUTE RESOLUTION AND ENFORCEMENT.
         8910. EFFECTIVE DATE, WITHDRAWAL AND AMENDMENT.
         8911. CONSTRUCTION AND SEVERABILITY.
   § 8900. NURSE  LICENSURE  COMPACT.  THE  NURSE  LICENSE COMPACT AS SET
 FORTH IN THE ARTICLE IS HEREBY ADOPTED AND ENTERED INTO WITH  ALL  PARTY
 STATES JOINING THEREIN.
   § 8901. FINDINGS  AND  DECLARATION OF PURPOSE  1. FINDINGS.  THE PARTY
 STATES FIND THAT:
   A. THE HEALTH AND SAFETY OF THE PUBLIC ARE AFFECTED BY THE  DEGREE  OF
 COMPLIANCE  WITH AND THE EFFECTIVENESS OF ENFORCEMENT ACTIVITIES RELATED
 TO STATE NURSE LICENSURE LAWS;
   B. VIOLATIONS OF NURSE LICENSURE AND OTHER LAWS REGULATING  THE  PRAC-
 TICE OF NURSING MAY RESULT IN INJURY OR HARM TO THE PUBLIC;
   C.  THE  EXPANDED  MOBILITY OF NURSES AND THE USE OF ADVANCED COMMUNI-
 CATION TECHNOLOGIES AS PART OF OUR NATION'S HEALTH CARE DELIVERY  SYSTEM
 REQUIRE  GREATER  COORDINATION AND COOPERATION AMONG STATES IN THE AREAS
 OF NURSE LICENSURE AND REGULATION;
   D. NEW PRACTICE MODALITIES AND TECHNOLOGY MAKE COMPLIANCE  WITH  INDI-
 VIDUAL STATE NURSE LICENSURE LAWS DIFFICULT AND COMPLEX;
   E.  THE  CURRENT SYSTEM OF DUPLICATIVE LICENSURE FOR NURSES PRACTICING
 IN MULTIPLE STATES IS CUMBERSOME  AND  REDUNDANT  FOR  BOTH  NURSES  AND
 STATES; AND
   F.  UNIFORMITY  OF  NURSE LICENSURE REQUIREMENTS THROUGHOUT THE STATES
 PROMOTES PUBLIC SAFETY AND PUBLIC HEALTH BENEFITS.
   2. DECLARATION OF PURPOSE. THE GENERAL PURPOSES OF  THIS  COMPACT  ARE
 TO:
   A.  FACILITATE  THE  STATES'  RESPONSIBILITY  TO  PROTECT THE PUBLIC'S
 HEALTH AND SAFETY;
   B. ENSURE AND ENCOURAGE THE COOPERATION OF PARTY STATES IN  THE  AREAS
 OF NURSE LICENSURE AND REGULATION;
   C.  FACILITATE THE EXCHANGE OF INFORMATION BETWEEN PARTY STATES IN THE
 AREAS OF NURSE REGULATION, INVESTIGATION AND ADVERSE ACTIONS;
   D. PROMOTE COMPLIANCE WITH THE LAWS GOVERNING THE PRACTICE OF  NURSING
 IN EACH JURISDICTION;
   E. INVEST ALL PARTY STATES WITH THE AUTHORITY TO HOLD A NURSE ACCOUNT-
 ABLE  FOR  MEETING  ALL  STATE  PRACTICE  LAWS IN THE STATE IN WHICH THE
 PATIENT IS LOCATED AT THE TIME  CARE  IS  RENDERED  THROUGH  THE  MUTUAL
 RECOGNITION OF PARTY STATE LICENSES;
   F.  DECREASE  REDUNDANCIES  IN THE CONSIDERATION AND ISSUANCE OF NURSE
 LICENSES; AND
   G. PROVIDE OPPORTUNITIES FOR INTERSTATE PRACTICE BY  NURSES  WHO  MEET
 UNIFORM LICENSURE REQUIREMENTS.
   § 8902. DEFINITIONS. 1. DEFINITIONS. AS USED IN THIS COMPACT:
 S. 8307--A                         105                        A. 8807--A
 
   A.  "ADVERSE  ACTION"  MEANS  ANY  ADMINISTRATIVE, CIVIL, EQUITABLE OR
 CRIMINAL ACTION PERMITTED BY A  STATE'S  LAWS  WHICH  IS  IMPOSED  BY  A
 LICENSING  BOARD  OR  OTHER AUTHORITY AGAINST A NURSE, INCLUDING ACTIONS
 AGAINST AN INDIVIDUAL'S LICENSE OR MULTISTATE LICENSURE  PRIVILEGE  SUCH
 AS  REVOCATION, SUSPENSION, PROBATION, MONITORING OF THE LICENSEE, LIMI-
 TATION ON THE LICENSEE'S PRACTICE, OR ANY OTHER ENCUMBRANCE ON LICENSURE
 AFFECTING A NURSE'S AUTHORIZATION TO PRACTICE, INCLUDING ISSUANCE  OF  A
 CEASE AND DESIST ACTION.
   B.  "ALTERNATIVE  PROGRAM" MEANS A NON-DISCIPLINARY MONITORING PROGRAM
 APPROVED BY A LICENSING BOARD.
   C. "COORDINATED LICENSURE  INFORMATION  SYSTEM"  MEANS  AN  INTEGRATED
 PROCESS  FOR COLLECTING, STORING AND SHARING INFORMATION ON NURSE LICEN-
 SURE AND ENFORCEMENT ACTIVITIES RELATED TO NURSE LICENSURE LAWS THAT  IS
 ADMINISTERED  BY  A NONPROFIT ORGANIZATION COMPOSED OF AND CONTROLLED BY
 LICENSING BOARDS.
   D. "COMMISSION" MEANS THE INTERSTATE  COMMISSION  OF  NURSE  LICENSURE
 COMPACT ADMINISTRATORS.
   E. "CURRENT SIGNIFICANT INVESTIGATIVE INFORMATION" MEANS:
   1.  INVESTIGATIVE INFORMATION THAT A LICENSING BOARD, AFTER A PRELIMI-
 NARY INQUIRY THAT INCLUDES NOTIFICATION AND AN OPPORTUNITY FOR THE NURSE
 TO RESPOND, IF REQUIRED BY STATE LAW,  HAS  REASON  TO  BELIEVE  IS  NOT
 GROUNDLESS AND, IF PROVED TRUE, WOULD INDICATE MORE THAN A MINOR INFRAC-
 TION; OR
   2.  INVESTIGATIVE INFORMATION THAT INDICATES THAT THE NURSE REPRESENTS
 AN IMMEDIATE THREAT TO PUBLIC HEALTH AND SAFETY  REGARDLESS  OF  WHETHER
 THE NURSE HAS BEEN NOTIFIED AND HAD AN OPPORTUNITY TO RESPOND.
   F.  "ENCUMBRANCE"  MEANS A REVOCATION OR SUSPENSION OF, OR ANY LIMITA-
 TION ON, THE FULL AND UNRESTRICTED PRACTICE  OF  NURSING  IMPOSED  BY  A
 LICENSING BOARD.
   G.  "HOME  STATE"  MEANS  THE PARTY STATE WHICH IS THE NURSE'S PRIMARY
 STATE OF RESIDENCE.
   H. "LICENSING BOARD" MEANS A PARTY STATE'S REGULATORY BODY RESPONSIBLE
 FOR ISSUING NURSE LICENSES.
   I. "MULTISTATE LICENSE" MEANS A LICENSE TO PRACTICE  AS  A  REGISTERED
 NURSE  (RN)  OR AS A LICENSED PRACTICAL/VOCATIONAL NURSE (LPN/VN), WHICH
 IS ISSUED BY A HOME STATE LICENSING  BOARD,  AND  WHICH  AUTHORIZES  THE
 LICENSED NURSE TO PRACTICE IN ALL PARTY STATES UNDER A MULTISTATE LICEN-
 SURE PRIVILEGE.
   J.  "MULTISTATE LICENSURE PRIVILEGE" MEANS A LEGAL AUTHORIZATION ASSO-
 CIATED WITH A MULTISTATE LICENSE PERMITTING THE PRACTICE OF  NURSING  AS
 EITHER A RN OR A LPN/VN IN A REMOTE STATE.
   K.  "NURSE"  MEANS  RN  OR  LPN/VN, AS THOSE TERMS ARE DEFINED BY EACH
 PARTY STATE'S PRACTICE LAWS.
   L. "PARTY STATE" MEANS ANY STATE THAT HAS ADOPTED THIS COMPACT.
   M. "REMOTE STATE" MEANS A PARTY STATE, OTHER THAN THE HOME STATE.
   N. "SINGLE-STATE LICENSE" MEANS A NURSE  LICENSE  ISSUED  BY  A  PARTY
 STATE  THAT  AUTHORIZES  PRACTICE ONLY WITHIN THE ISSUING STATE AND DOES
 NOT INCLUDE A MULTISTATE LICENSURE PRIVILEGE TO PRACTICE  IN  ANY  OTHER
 PARTY STATE.
   O. "STATE" MEANS A STATE, TERRITORY OR POSSESSION OF THE UNITED STATES
 AND THE DISTRICT OF COLUMBIA.
   P.  "STATE  PRACTICE LAWS" MEANS A PARTY STATE'S LAWS, RULES AND REGU-
 LATIONS THAT GOVERN THE PRACTICE OF NURSING, DEFINE THE SCOPE OF NURSING
 PRACTICE, AND CREATE THE METHODS AND GROUNDS  FOR  IMPOSING  DISCIPLINE.
 "STATE PRACTICE LAWS" SHALL NOT INCLUDE REQUIREMENTS NECESSARY TO OBTAIN
 S. 8307--A                         106                        A. 8807--A
 
 AND  RETAIN  A LICENSE, EXCEPT FOR QUALIFICATIONS OR REQUIREMENTS OF THE
 HOME STATE.
   § 8903. GENERAL PROVISIONS AND JURISDICTION. 1. GENERAL PROVISIONS AND
 JURISDICTION. A. A MULTISTATE LICENSE TO PRACTICE REGISTERED OR LICENSED
 PRACTICAL/VOCATIONAL  NURSING  ISSUED  BY  A HOME STATE TO A RESIDENT IN
 THAT STATE WILL BE RECOGNIZED BY EACH PARTY STATE AS AUTHORIZING A NURSE
 TO  PRACTICE  AS  A   REGISTERED   NURSE   (RN)   OR   AS   A   LICENSED
 PRACTICAL/VOCATIONAL NURSE (LPN/VN), UNDER A MULTISTATE LICENSURE PRIVI-
 LEGE, IN EACH PARTY STATE.
   B.  A  STATE  SHALL  IMPLEMENT PROCEDURES FOR CONSIDERING THE CRIMINAL
 HISTORY RECORDS OF APPLICANTS  FOR  AN  INITIAL  MULTISTATE  LICENSE  OR
 LICENSURE  BY  ENDORSEMENT. SUCH PROCEDURES SHALL INCLUDE THE SUBMISSION
 OF FINGERPRINTS OR OTHER BIOMETRIC-BASED INFORMATION BY  APPLICANTS  FOR
 THE PURPOSE OF OBTAINING AN APPLICANT'S CRIMINAL HISTORY RECORD INFORMA-
 TION FROM THE FEDERAL BUREAU OF INVESTIGATION AND THE AGENCY RESPONSIBLE
 FOR RETAINING THAT STATE'S CRIMINAL RECORDS.
   C.  EACH PARTY STATE SHALL REQUIRE ITS LICENSING BOARD TO AUTHORIZE AN
 APPLICANT TO OBTAIN OR RETAIN A MULTISTATE LICENSE  IN  THE  HOME  STATE
 ONLY IF THE APPLICANT:
   I.  MEETS  THE HOME STATE'S QUALIFICATIONS FOR LICENSURE OR RENEWAL OF
 LICENSURE, AND COMPLIES WITH ALL OTHER APPLICABLE STATE LAWS;
   II. (1) HAS GRADUATED OR IS ELIGIBLE  TO  GRADUATE  FROM  A  LICENSING
 BOARD-APPROVED RN OR LPN/VN PRELICENSURE EDUCATION PROGRAM; OR
   (2)  HAS  GRADUATED FROM A FOREIGN RN OR LPN/VN PRELICENSURE EDUCATION
 PROGRAM THAT HAS BEEN: (A) APPROVED BY THE AUTHORIZED  ACCREDITING  BODY
 IN  THE  APPLICABLE  COUNTRY, AND (B) VERIFIED BY AN INDEPENDENT CREDEN-
 TIALS REVIEW AGENCY TO BE COMPARABLE TO A LICENSING BOARD-APPROVED PREL-
 ICENSURE EDUCATION PROGRAM;
   III. HAS, IF A GRADUATE OF A FOREIGN  PRELICENSURE  EDUCATION  PROGRAM
 NOT  TAUGHT  IN  ENGLISH  OR  IF  ENGLISH IS NOT THE INDIVIDUAL'S NATIVE
 LANGUAGE, SUCCESSFULLY PASSED AN ENGLISH  PROFICIENCY  EXAMINATION  THAT
 INCLUDES THE COMPONENTS OF READING, SPEAKING, WRITING AND LISTENING;
   IV.  HAS  SUCCESSFULLY  PASSED  AN NCLEX-RN OR NCLEX-PN EXAMINATION OR
 RECOGNIZED PREDECESSOR, AS APPLICABLE;
   V. IS ELIGIBLE FOR OR HOLDS AN ACTIVE, UNENCUMBERED LICENSE;
   VI. HAS SUBMITTED, IN  CONNECTION  WITH  AN  APPLICATION  FOR  INITIAL
 LICENSURE  OR  LICENSURE BY ENDORSEMENT, FINGERPRINTS OR OTHER BIOMETRIC
 DATA FOR THE PURPOSE OF OBTAINING CRIMINAL  HISTORY  RECORD  INFORMATION
 FROM  THE FEDERAL BUREAU OF INVESTIGATION AND THE AGENCY RESPONSIBLE FOR
 RETAINING THAT STATE'S CRIMINAL RECORDS;
   VII. HAS NOT BEEN CONVICTED OR FOUND GUILTY, OR HAS  ENTERED  INTO  AN
 AGREED DISPOSITION, OF A FELONY OFFENSE UNDER APPLICABLE STATE OR FEDER-
 AL CRIMINAL LAW;
   VIII.  HAS  NOT BEEN CONVICTED OR FOUND GUILTY, OR HAS ENTERED INTO AN
 AGREED DISPOSITION, OF A MISDEMEANOR OFFENSE RELATED TO THE PRACTICE  OF
 NURSING AS DETERMINED ON A CASE-BY-CASE BASIS;
   IX. IS NOT CURRENTLY ENROLLED IN AN ALTERNATIVE PROGRAM;
   X.  IS  SUBJECT  TO  SELF-DISCLOSURE  REQUIREMENTS  REGARDING  CURRENT
 PARTICIPATION IN AN ALTERNATIVE PROGRAM; AND
   XI. HAS A VALID UNITED STATES SOCIAL SECURITY NUMBER.
   D. ALL PARTY STATES SHALL BE AUTHORIZED, IN ACCORDANCE  WITH  EXISTING
 STATE  DUE  PROCESS LAW, TO TAKE ADVERSE ACTION AGAINST A NURSE'S MULTI-
 STATE LICENSURE PRIVILEGE SUCH AS REVOCATION, SUSPENSION,  PROBATION  OR
 ANY  OTHER ACTION THAT AFFECTS A NURSE'S AUTHORIZATION TO PRACTICE UNDER
 A MULTISTATE LICENSURE PRIVILEGE, INCLUDING CEASE AND DESIST ACTIONS. IF
 A PARTY STATE TAKES SUCH ACTION, IT SHALL PROMPTLY NOTIFY  THE  ADMINIS-
 S. 8307--A                         107                        A. 8807--A

 TRATOR  OF THE COORDINATED LICENSURE INFORMATION SYSTEM. THE ADMINISTRA-
 TOR OF THE COORDINATED LICENSURE INFORMATION SYSTEM SHALL PROMPTLY NOTI-
 FY THE HOME STATE OF ANY SUCH ACTIONS BY REMOTE STATES.
   E.  A  NURSE  PRACTICING  IN A PARTY STATE SHALL COMPLY WITH THE STATE
 PRACTICE LAWS OF THE STATE IN WHICH THE CLIENT IS LOCATED  AT  THE  TIME
 SERVICE  IS  PROVIDED. THE PRACTICE OF NURSING IS NOT LIMITED TO PATIENT
 CARE BUT SHALL INCLUDE ALL NURSING PRACTICE  AS  DEFINED  BY  THE  STATE
 PRACTICE  LAWS  OF  THE  PARTY STATE IN WHICH THE CLIENT IS LOCATED. THE
 PRACTICE OF NURSING IN A PARTY STATE UNDER A MULTISTATE LICENSURE PRIVI-
 LEGE WILL SUBJECT A NURSE TO THE JURISDICTION OF  THE  LICENSING  BOARD,
 THE  COURTS  AND  THE  LAWS  OF  THE  PARTY STATE IN WHICH THE CLIENT IS
 LOCATED AT THE TIME SERVICE IS PROVIDED.
   F. INDIVIDUALS NOT RESIDING IN A PARTY STATE SHALL CONTINUE TO BE ABLE
 TO APPLY FOR A PARTY STATE'S SINGLE-STATE LICENSE AS PROVIDED UNDER  THE
 LAWS  OF  EACH PARTY STATE. HOWEVER, THE SINGLE-STATE LICENSE GRANTED TO
 THESE INDIVIDUALS WILL NOT BE RECOGNIZED AS GRANTING  THE  PRIVILEGE  TO
 PRACTICE NURSING IN ANY OTHER PARTY STATE. NOTHING IN THIS COMPACT SHALL
 AFFECT THE REQUIREMENTS ESTABLISHED BY A PARTY STATE FOR THE ISSUANCE OF
 A SINGLE-STATE LICENSE.
   G. ANY NURSE HOLDING A HOME STATE MULTISTATE LICENSE, ON THE EFFECTIVE
 DATE OF THIS COMPACT, MAY RETAIN AND RENEW THE MULTISTATE LICENSE ISSUED
 BY THE NURSE'S THEN-CURRENT HOME STATE, PROVIDED THAT:
   I.  A  NURSE,  WHO  CHANGES  PRIMARY  STATE  OF  RESIDENCE  AFTER THIS
 COMPACT'S EFFECTIVE DATE, SHALL MEET  ALL  APPLICABLE  REQUIREMENTS  SET
 FORTH  IN  THIS  ARTICLE  TO OBTAIN A MULTISTATE LICENSE FROM A NEW HOME
 STATE.
   II. A NURSE WHO FAILS TO SATISFY THE MULTISTATE LICENSURE REQUIREMENTS
 SET FORTH IN THIS ARTICLE DUE TO A DISQUALIFYING EVENT  OCCURRING  AFTER
 THIS  COMPACT'S  EFFECTIVE DATE SHALL BE INELIGIBLE TO RETAIN OR RENEW A
 MULTISTATE LICENSE, AND THE NURSE'S MULTISTATE LICENSE SHALL BE  REVOKED
 OR  DEACTIVATED  IN  ACCORDANCE  WITH  APPLICABLE  RULES  ADOPTED BY THE
 COMMISSION.
   § 8904. APPLICATIONS FOR LICENSURE IN A PARTY STATE.  1.  APPLICATIONS
 FOR  LICENSURE  IN  A  PARTY STATE. A. UPON APPLICATION FOR A MULTISTATE
 LICENSE, THE LICENSING BOARD IN THE ISSUING PARTY STATE SHALL ASCERTAIN,
 THROUGH THE COORDINATED LICENSURE INFORMATION SYSTEM, WHETHER THE APPLI-
 CANT HAS EVER HELD, OR IS THE HOLDER OF, A LICENSE ISSUED BY  ANY  OTHER
 STATE,  WHETHER  THERE ARE ANY ENCUMBRANCES ON ANY LICENSE OR MULTISTATE
 LICENSURE PRIVILEGE HELD BY THE APPLICANT, WHETHER  ANY  ADVERSE  ACTION
 HAS  BEEN  TAKEN  AGAINST  ANY LICENSE OR MULTISTATE LICENSURE PRIVILEGE
 HELD BY THE APPLICANT AND WHETHER THE APPLICANT IS CURRENTLY PARTICIPAT-
 ING IN AN ALTERNATIVE PROGRAM.
   B. A NURSE MAY HOLD A MULTISTATE LICENSE, ISSUED BY THE HOME STATE, IN
 ONLY ONE PARTY STATE AT A TIME.
   C. IF A NURSE CHANGES PRIMARY STATE OF RESIDENCE BY MOVING BETWEEN TWO
 PARTY STATES, THE NURSE MUST APPLY FOR LICENSURE IN THE NEW HOME  STATE,
 AND  THE MULTISTATE LICENSE ISSUED BY THE PRIOR HOME STATE WILL BE DEAC-
 TIVATED IN ACCORDANCE WITH APPLICABLE RULES ADOPTED BY THE COMMISSION.
   I. THE NURSE MAY APPLY FOR LICENSURE IN ADVANCE OF A CHANGE IN PRIMARY
 STATE OF RESIDENCE.
   II. A MULTISTATE LICENSE SHALL NOT BE ISSUED BY  THE  NEW  HOME  STATE
 UNTIL  THE  NURSE  PROVIDES SATISFACTORY EVIDENCE OF A CHANGE IN PRIMARY
 STATE OF RESIDENCE TO THE NEW HOME STATE AND  SATISFIES  ALL  APPLICABLE
 REQUIREMENTS TO OBTAIN A MULTISTATE LICENSE FROM THE NEW HOME STATE.
   D.  IF  A  NURSE  CHANGES  PRIMARY STATE OF RESIDENCE BY MOVING FROM A
 PARTY STATE TO A NON-PARTY STATE, THE MULTISTATE LICENSE ISSUED  BY  THE
 S. 8307--A                         108                        A. 8807--A
 
 PRIOR  HOME  STATE WILL CONVERT TO A SINGLE-STATE LICENSE, VALID ONLY IN
 THE FORMER HOME STATE.
   § 8905. ADDITIONAL  AUTHORITIES  INVESTED  IN  PARTY  STATE  LICENSING
 BOARDS. 1. LICENSING BOARD AUTHORITY. IN ADDITION TO  THE  OTHER  POWERS
 CONFERRED BY STATE LAW, A LICENSING BOARD SHALL HAVE THE AUTHORITY TO:
   A.  TAKE  ADVERSE ACTION AGAINST A NURSE'S MULTISTATE LICENSURE PRIVI-
 LEGE TO PRACTICE WITHIN THAT PARTY STATE.
   I. ONLY THE HOME STATE SHALL HAVE THE POWER  TO  TAKE  ADVERSE  ACTION
 AGAINST A NURSE'S LICENSE ISSUED BY THE HOME STATE.
   II.  FOR  PURPOSES  OF TAKING ADVERSE ACTION, THE HOME STATE LICENSING
 BOARD SHALL GIVE THE  SAME  PRIORITY  AND  EFFECT  TO  REPORTED  CONDUCT
 RECEIVED  FROM  A  REMOTE STATE AS IT WOULD IF SUCH CONDUCT HAD OCCURRED
 WITHIN THE HOME STATE. IN SO DOING, THE HOME STATE SHALL APPLY  ITS  OWN
 STATE LAWS TO DETERMINE APPROPRIATE ACTION.
   B. ISSUE CEASE AND DESIST ORDERS OR IMPOSE AN ENCUMBRANCE ON A NURSE'S
 AUTHORITY TO PRACTICE WITHIN THAT PARTY STATE.
   C.  COMPLETE ANY PENDING INVESTIGATIONS OF A NURSE WHO CHANGES PRIMARY
 STATE OF RESIDENCE DURING THE COURSE OF SUCH INVESTIGATIONS. THE LICENS-
 ING BOARD SHALL ALSO HAVE THE AUTHORITY TO TAKE  APPROPRIATE  ACTION  OR
 ACTIONS AND SHALL PROMPTLY REPORT THE CONCLUSIONS OF SUCH INVESTIGATIONS
 TO  THE  ADMINISTRATOR  OF THE COORDINATED LICENSURE INFORMATION SYSTEM.
 THE ADMINISTRATOR OF THE COORDINATED LICENSURE INFORMATION SYSTEM  SHALL
 PROMPTLY NOTIFY THE NEW HOME STATE OF ANY SUCH ACTIONS.
   D.  ISSUE  SUBPOENAS FOR BOTH HEARINGS AND INVESTIGATIONS THAT REQUIRE
 THE ATTENDANCE AND TESTIMONY OF WITNESSES, AS WELL AS THE PRODUCTION  OF
 EVIDENCE. SUBPOENAS ISSUED BY A LICENSING BOARD IN A PARTY STATE FOR THE
 ATTENDANCE AND TESTIMONY OF WITNESSES OR THE PRODUCTION OF EVIDENCE FROM
 ANOTHER  PARTY  STATE SHALL BE ENFORCED IN THE LATTER STATE BY ANY COURT
 OF COMPETENT JURISDICTION, ACCORDING TO THE PRACTICE  AND  PROCEDURE  OF
 THAT  COURT APPLICABLE TO SUBPOENAS ISSUED IN PROCEEDINGS PENDING BEFORE
 IT.  THE ISSUING AUTHORITY SHALL PAY ANY WITNESS FEES, TRAVEL  EXPENSES,
 MILEAGE  AND OTHER FEES REQUIRED BY THE SERVICE STATUTES OF THE STATE IN
 WHICH THE WITNESSES OR EVIDENCE ARE LOCATED.
   E. OBTAIN AND SUBMIT, FOR EACH NURSE LICENSURE APPLICANT,  FINGERPRINT
 OR  OTHER  BIOMETRIC-BASED INFORMATION TO THE FEDERAL BUREAU OF INVESTI-
 GATION FOR CRIMINAL BACKGROUND CHECKS, RECEIVE THE RESULTS OF THE FEDER-
 AL BUREAU OF INVESTIGATION RECORD SEARCH ON CRIMINAL  BACKGROUND  CHECKS
 AND USE THE RESULTS IN MAKING LICENSURE DECISIONS.
   F.  IF  OTHERWISE  PERMITTED  BY  STATE LAW, RECOVER FROM THE AFFECTED
 NURSE THE COSTS OF INVESTIGATIONS AND  DISPOSITION  OF  CASES  RESULTING
 FROM ANY ADVERSE ACTION TAKEN AGAINST THAT NURSE.
   G.  TAKE  ADVERSE  ACTION  BASED ON THE FACTUAL FINDINGS OF THE REMOTE
 STATE, PROVIDED THAT THE LICENSING BOARD FOLLOWS ITS OWN PROCEDURES  FOR
 TAKING SUCH ADVERSE ACTION.
   2.  ADVERSE  ACTIONS.  A. IF ADVERSE ACTION IS TAKEN BY THE HOME STATE
 AGAINST A NURSE'S MULTISTATE LICENSE, THE NURSE'S  MULTISTATE  LICENSURE
 PRIVILEGE  TO  PRACTICE  IN  ALL OTHER PARTY STATES SHALL BE DEACTIVATED
 UNTIL ALL ENCUMBRANCES HAVE BEEN REMOVED FROM  THE  MULTISTATE  LICENSE.
 ALL  HOME STATE DISCIPLINARY ORDERS THAT IMPOSE ADVERSE ACTION AGAINST A
 NURSE'S MULTISTATE LICENSE SHALL INCLUDE A STATEMENT  THAT  THE  NURSE'S
 MULTISTATE LICENSURE PRIVILEGE IS DEACTIVATED IN ALL PARTY STATES DURING
 THE PENDENCY OF THE ORDER.
   B.  NOTHING  IN  THIS  COMPACT SHALL OVERRIDE A PARTY STATE'S DECISION
 THAT PARTICIPATION IN AN ALTERNATIVE PROGRAM MAY  BE  USED  IN  LIEU  OF
 ADVERSE  ACTION.  THE  HOME  STATE  LICENSING BOARD SHALL DEACTIVATE THE
 S. 8307--A                         109                        A. 8807--A
 
 MULTISTATE LICENSURE PRIVILEGE UNDER THE MULTISTATE LICENSE OF ANY NURSE
 FOR THE DURATION OF THE NURSE'S PARTICIPATION IN AN ALTERNATIVE PROGRAM.
   § 8906. COORDINATED  LICENSURE  INFORMATION  SYSTEM  AND  EXCHANGE  OF
 INFORMATION. 1.  COORDINATED LICENSURE INFORMATION SYSTEM  AND  EXCHANGE
 OF  INFORMATION.  A. ALL PARTY STATES SHALL PARTICIPATE IN A COORDINATED
 LICENSURE INFORMATION SYSTEM OF ALL LICENSED REGISTERED NURSES (RNS) AND
 LICENSED  PRACTICAL/VOCATIONAL  NURSES  (LPNS/VNS).  THIS  SYSTEM   WILL
 INCLUDE  INFORMATION  ON  THE LICENSURE AND DISCIPLINARY HISTORY OF EACH
 NURSE, AS SUBMITTED BY PARTY STATES, TO ASSIST IN  THE  COORDINATION  OF
 NURSE LICENSURE AND ENFORCEMENT EFFORTS.
   B. THE COMMISSION, IN CONSULTATION WITH THE ADMINISTRATOR OF THE COOR-
 DINATED  LICENSURE  INFORMATION  SYSTEM,  SHALL  FORMULATE NECESSARY AND
 PROPER PROCEDURES FOR THE IDENTIFICATION,  COLLECTION  AND  EXCHANGE  OF
 INFORMATION UNDER THIS COMPACT.
   C.  ALL  LICENSING  BOARDS  SHALL  PROMPTLY  REPORT TO THE COORDINATED
 LICENSURE INFORMATION SYSTEM ANY ADVERSE ACTION, ANY CURRENT SIGNIFICANT
 INVESTIGATIVE INFORMATION, DENIALS OF APPLICATIONS WITH THE REASONS  FOR
 SUCH  DENIALS  AND  NURSE PARTICIPATION IN ALTERNATIVE PROGRAMS KNOWN TO
 THE LICENSING BOARD REGARDLESS OF WHETHER SUCH PARTICIPATION  IS  DEEMED
 NONPUBLIC OR CONFIDENTIAL UNDER STATE LAW.
   D.  CURRENT SIGNIFICANT INVESTIGATIVE INFORMATION AND PARTICIPATION IN
 NONPUBLIC OR CONFIDENTIAL  ALTERNATIVE  PROGRAMS  SHALL  BE  TRANSMITTED
 THROUGH THE COORDINATED LICENSURE INFORMATION SYSTEM ONLY TO PARTY STATE
 LICENSING BOARDS.
   E. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, ALL PARTY STATE LICENS-
 ING  BOARDS CONTRIBUTING INFORMATION TO THE COORDINATED LICENSURE INFOR-
 MATION SYSTEM MAY DESIGNATE INFORMATION THAT  MAY  NOT  BE  SHARED  WITH
 NON-PARTY  STATES  OR DISCLOSED TO OTHER ENTITIES OR INDIVIDUALS WITHOUT
 THE EXPRESS PERMISSION OF THE CONTRIBUTING STATE.
   F. ANY PERSONALLY IDENTIFIABLE INFORMATION OBTAINED FROM  THE  COORDI-
 NATED  LICENSURE  INFORMATION  SYSTEM  BY  A PARTY STATE LICENSING BOARD
 SHALL NOT BE SHARED WITH NON-PARTY STATES OR DISCLOSED TO OTHER ENTITIES
 OR INDIVIDUALS EXCEPT TO THE EXTENT PERMITTED BY THE LAWS OF  THE  PARTY
 STATE CONTRIBUTING THE INFORMATION.
   G.  ANY  INFORMATION CONTRIBUTED TO THE COORDINATED LICENSURE INFORMA-
 TION SYSTEM THAT IS SUBSEQUENTLY REQUIRED TO BE EXPUNGED BY THE LAWS  OF
 THE  PARTY  STATE  CONTRIBUTING  THAT INFORMATION SHALL ALSO BE EXPUNGED
 FROM THE COORDINATED LICENSURE INFORMATION SYSTEM.
   H. THE COMPACT ADMINISTRATOR OF  EACH  PARTY  STATE  SHALL  FURNISH  A
 UNIFORM DATA SET TO THE COMPACT ADMINISTRATOR OF EACH OTHER PARTY STATE,
 WHICH SHALL INCLUDE, AT A MINIMUM:
   I. IDENTIFYING INFORMATION;
   II. LICENSURE DATA;
   III. INFORMATION RELATED TO ALTERNATIVE PROGRAM PARTICIPATION; AND
   IV.  OTHER  INFORMATION THAT MAY FACILITATE THE ADMINISTRATION OF THIS
 COMPACT, AS DETERMINED BY COMMISSION RULES.
   I. THE COMPACT ADMINISTRATOR OF A PARTY STATE SHALL PROVIDE ALL INVES-
 TIGATIVE DOCUMENTS AND INFORMATION REQUESTED BY ANOTHER PARTY STATE.
   § 8907. ESTABLISHMENT OF THE INTERSTATE COMMISSION OF NURSE  LICENSURE
 COMPACT ADMINISTRATORS.  1. COMMISSION OF NURSE LICENSURE COMPACT ADMIN-
 ISTRATORS.  THE  PARTY STATES HEREBY CREATE AND ESTABLISH A JOINT PUBLIC
 ENTITY KNOWN AS THE INTERSTATE COMMISSION  OF  NURSE  LICENSURE  COMPACT
 ADMINISTRATORS.  THE  COMMISSION  IS  AN  INSTRUMENTALITY  OF  THE PARTY
 STATES.
   2. VENUE. VENUE IS PROPER, AND JUDICIAL PROCEEDINGS BY OR AGAINST  THE
 COMMISSION SHALL BE BROUGHT SOLELY AND EXCLUSIVELY, IN A COURT OF COMPE-
 S. 8307--A                         110                        A. 8807--A
 
 TENT  JURISDICTION  WHERE  THE  PRINCIPAL  OFFICE  OF  THE COMMISSION IS
 LOCATED. THE COMMISSION MAY WAIVE VENUE AND JURISDICTIONAL  DEFENSES  TO
 THE  EXTENT  IT ADOPTS OR CONSENTS TO PARTICIPATE IN ALTERNATIVE DISPUTE
 RESOLUTION PROCEEDINGS.
   3.  SOVEREIGN  IMMUNITY. NOTHING IN THIS COMPACT SHALL BE CONSTRUED TO
 BE A WAIVER OF SOVEREIGN IMMUNITY.
   4. MEMBERSHIP, VOTING AND MEETINGS. A. EACH PARTY STATE SHALL HAVE AND
 BE LIMITED TO ONE ADMINISTRATOR. THE HEAD OF THE STATE  LICENSING  BOARD
 OR  DESIGNEE  SHALL  BE THE ADMINISTRATOR OF THIS COMPACT FOR EACH PARTY
 STATE.  ANY ADMINISTRATOR MAY BE REMOVED OR  SUSPENDED  FROM  OFFICE  AS
 PROVIDED  BY  THE  LAW  OF  THE  STATE  FROM  WHICH THE ADMINISTRATOR IS
 APPOINTED. ANY VACANCY OCCURRING IN THE COMMISSION SHALL  BE  FILLED  IN
 ACCORDANCE WITH THE LAWS OF THE PARTY STATE IN WHICH THE VACANCY EXISTS.
   B. EACH ADMINISTRATOR SHALL BE ENTITLED TO ONE VOTE WITH REGARD TO THE
 PROMULGATION OF RULES AND CREATION OF BYLAWS AND SHALL OTHERWISE HAVE AN
 OPPORTUNITY  TO  PARTICIPATE  IN THE BUSINESS AND AFFAIRS OF THE COMMIS-
 SION.  AN ADMINISTRATOR SHALL VOTE IN PERSON OR BY SUCH OTHER  MEANS  AS
 PROVIDED  IN  THE  BYLAWS. THE BYLAWS MAY PROVIDE FOR AN ADMINISTRATOR'S
 PARTICIPATION IN MEETINGS BY TELEPHONE OR OTHER MEANS OF COMMUNICATION.
   C. THE COMMISSION SHALL MEET AT LEAST ONCE DURING EACH CALENDAR  YEAR.
 ADDITIONAL MEETINGS SHALL BE HELD AS SET FORTH IN THE BYLAWS OR RULES OF
 THE COMMISSION.
   D.  ALL  MEETINGS  SHALL  BE  OPEN TO THE PUBLIC, AND PUBLIC NOTICE OF
 MEETINGS SHALL BE GIVEN IN THE SAME MANNER AS REQUIRED UNDER  THE  RULE-
 MAKING PROVISIONS IN SECTION EIGHTY-NINE HUNDRED EIGHT OF THIS ARTICLE.
   5. CLOSED MEETINGS. A. THE COMMISSION MAY CONVENE IN A CLOSED, NONPUB-
 LIC MEETING IF THE COMMISSION SHALL DISCUSS:
   I.  NONCOMPLIANCE  OF  A  PARTY  STATE WITH ITS OBLIGATIONS UNDER THIS
 COMPACT;
   II.  THE  EMPLOYMENT,  COMPENSATION,  DISCIPLINE  OR  OTHER  PERSONNEL
 MATTERS,  PRACTICES OR PROCEDURES RELATED TO SPECIFIC EMPLOYEES OR OTHER
 MATTERS RELATED TO THE COMMISSION'S  INTERNAL  PERSONNEL  PRACTICES  AND
 PROCEDURES;
   III. CURRENT, THREATENED OR REASONABLY ANTICIPATED LITIGATION;
   IV.  NEGOTIATION  OF  CONTRACTS  FOR  THE  PURCHASE  OR SALE OF GOODS,
 SERVICES OR REAL ESTATE;
   V. ACCUSING ANY PERSON OF A CRIME OR FORMALLY CENSURING ANY PERSON;
   VI. DISCLOSURE OF TRADE SECRETS OR COMMERCIAL OR FINANCIAL INFORMATION
 THAT IS PRIVILEGED OR CONFIDENTIAL;
   VII. DISCLOSURE OF INFORMATION OF A PERSONAL NATURE  WHERE  DISCLOSURE
 WOULD CONSTITUTE A CLEARLY UNWARRANTED INVASION OF PERSONAL PRIVACY;
   VIII. DISCLOSURE OF INVESTIGATORY RECORDS COMPILED FOR LAW ENFORCEMENT
 PURPOSES;
   IX. DISCLOSURE OF INFORMATION RELATED TO ANY REPORTS PREPARED BY OR ON
 BEHALF  OF THE COMMISSION FOR THE PURPOSE OF INVESTIGATION OF COMPLIANCE
 WITH THIS COMPACT; OR
   X. MATTERS SPECIFICALLY EXEMPTED FROM DISCLOSURE BY FEDERAL  OR  STATE
 STATUTE.
   B.  IF  A MEETING, OR PORTION OF A MEETING, IS CLOSED PURSUANT TO THIS
 PARAGRAPH THE COMMISSION'S LEGAL COUNSEL OR DESIGNEE SHALL CERTIFY  THAT
 THE  MEETING  MAY  BE CLOSED AND SHALL REFERENCE EACH RELEVANT EXEMPTING
 PROVISION. THE COMMISSION SHALL KEEP  MINUTES  THAT  FULLY  AND  CLEARLY
 DESCRIBE ALL MATTERS DISCUSSED IN A MEETING AND SHALL PROVIDE A FULL AND
 ACCURATE SUMMARY OF ACTIONS TAKEN, AND THE REASONS THEREFOR, INCLUDING A
 DESCRIPTION   OF  THE  VIEWS  EXPRESSED.  ALL  DOCUMENTS  CONSIDERED  IN
 CONNECTION WITH AN ACTION SHALL  BE  IDENTIFIED  IN  SUCH  MINUTES.  ALL
 S. 8307--A                         111                        A. 8807--A
 
 MINUTES  AND  DOCUMENTS  OF  A  CLOSED  MEETING SHALL REMAIN UNDER SEAL,
 SUBJECT TO RELEASE BY A MAJORITY VOTE OF THE COMMISSION OR  ORDER  OF  A
 COURT OF COMPETENT JURISDICTION.
   C.  THE  COMMISSION  SHALL,  BY A MAJORITY VOTE OF THE ADMINISTRATORS,
 PRESCRIBE BYLAWS OR RULES TO GOVERN ITS CONDUCT AS MAY BE  NECESSARY  OR
 APPROPRIATE  TO  CARRY  OUT THE PURPOSES AND EXERCISE THE POWERS OF THIS
 COMPACT, INCLUDING BUT NOT LIMITED TO:
   I. ESTABLISHING THE FISCAL YEAR OF THE COMMISSION;
   II. PROVIDING REASONABLE STANDARDS AND PROCEDURES:
   (1) FOR THE ESTABLISHMENT AND MEETINGS OF OTHER COMMITTEES; AND
   (2) GOVERNING ANY GENERAL OR SPECIFIC DELEGATION OF ANY  AUTHORITY  OR
 FUNCTION OF THE COMMISSION;
   III.  PROVIDING REASONABLE PROCEDURES FOR CALLING AND CONDUCTING MEET-
 INGS OF THE COMMISSION, ENSURING REASONABLE ADVANCE NOTICE OF ALL  MEET-
 INGS  AND  PROVIDING  AN  OPPORTUNITY FOR ATTENDANCE OF SUCH MEETINGS BY
 INTERESTED PARTIES, WITH ENUMERATED EXCEPTIONS DESIGNED TO  PROTECT  THE
 PUBLIC'S  INTEREST, THE PRIVACY OF INDIVIDUALS, AND PROPRIETARY INFORMA-
 TION, INCLUDING TRADE SECRETS. THE COMMISSION MAY MEET IN CLOSED SESSION
 ONLY AFTER A MAJORITY OF THE ADMINISTRATORS VOTE TO CLOSE A  MEETING  IN
 WHOLE  OR  IN  PART.  AS  SOON  AS PRACTICABLE, THE COMMISSION MUST MAKE
 PUBLIC A COPY OF THE VOTE TO CLOSE THE MEETING  REVEALING  THE  VOTE  OF
 EACH ADMINISTRATOR, WITH NO PROXY VOTES ALLOWED;
   IV.  ESTABLISHING  THE  TITLES,  DUTIES  AND  AUTHORITY AND REASONABLE
 PROCEDURES FOR THE ELECTION OF THE OFFICERS OF THE COMMISSION;
   V. PROVIDING REASONABLE STANDARDS AND PROCEDURES FOR THE ESTABLISHMENT
 OF THE PERSONNEL POLICIES AND PROGRAMS OF THE COMMISSION.  NOTWITHSTAND-
 ING  ANY  CIVIL  SERVICE  OR  OTHER SIMILAR LAWS OF ANY PARTY STATE, THE
 BYLAWS SHALL EXCLUSIVELY GOVERN THE PERSONNEL POLICIES AND  PROGRAMS  OF
 THE COMMISSION; AND
   VI. PROVIDING A MECHANISM FOR WINDING UP THE OPERATIONS OF THE COMMIS-
 SION  AND  THE EQUITABLE DISPOSITION OF ANY SURPLUS FUNDS THAT MAY EXIST
 AFTER THE TERMINATION OF THIS COMPACT AFTER THE PAYMENT OR RESERVING  OF
 ALL OF ITS DEBTS AND OBLIGATIONS.
   6.  GENERAL PROVISIONS. A. THE COMMISSION SHALL PUBLISH ITS BYLAWS AND
 RULES, AND ANY AMENDMENTS THERETO, IN A CONVENIENT FORM ON  THE  WEBSITE
 OF THE COMMISSION.
   B.  THE  COMMISSION SHALL MAINTAIN ITS FINANCIAL RECORDS IN ACCORDANCE
 WITH THE BYLAWS.
   C. THE COMMISSION SHALL MEET AND TAKE SUCH ACTIONS AS  ARE  CONSISTENT
 WITH THE PROVISIONS OF THIS COMPACT AND THE BYLAWS.
    7.  POWERS OF THE COMMISSION. THE COMMISSION SHALL HAVE THE FOLLOWING
 POWERS:
   A. TO PROMULGATE UNIFORM RULES TO FACILITATE AND COORDINATE  IMPLEMEN-
 TATION  AND  ADMINISTRATION  OF  THIS  COMPACT. THE RULES SHALL HAVE THE
 FORCE AND EFFECT OF LAW AND SHALL BE BINDING IN ALL PARTY STATES;
   B. TO BRING AND PROSECUTE LEGAL PROCEEDINGS OR ACTIONS IN THE NAME  OF
 THE COMMISSION, PROVIDED THAT THE STANDING OF ANY LICENSING BOARD TO SUE
 OR BE SUED UNDER APPLICABLE LAW SHALL NOT BE AFFECTED;
   C. TO PURCHASE AND MAINTAIN INSURANCE AND BONDS;
   D. TO BORROW, ACCEPT OR CONTRACT FOR SERVICES OF PERSONNEL, INCLUDING,
 BUT  NOT  LIMITED  TO, EMPLOYEES OF A PARTY STATE OR NONPROFIT ORGANIZA-
 TIONS;
   E.  TO  COOPERATE  WITH  OTHER  ORGANIZATIONS  THAT  ADMINISTER  STATE
 COMPACTS RELATED TO THE REGULATION OF NURSING, INCLUDING BUT NOT LIMITED
 TO  SHARING  ADMINISTRATIVE  OR  STAFF  EXPENSES,  OFFICE SPACE OR OTHER
 RESOURCES;
 S. 8307--A                         112                        A. 8807--A
 
   F. TO HIRE EMPLOYEES, ELECT OR  APPOINT  OFFICERS,  FIX  COMPENSATION,
 DEFINE DUTIES, GRANT SUCH INDIVIDUALS APPROPRIATE AUTHORITY TO CARRY OUT
 THE  PURPOSES OF THIS COMPACT, AND TO ESTABLISH THE COMMISSION'S PERSON-
 NEL POLICIES AND PROGRAMS RELATING TO CONFLICTS OF INTEREST,  QUALIFICA-
 TIONS OF PERSONNEL AND OTHER RELATED PERSONNEL MATTERS;
   G.  TO  ACCEPT  ANY AND ALL APPROPRIATE DONATIONS, GRANTS AND GIFTS OF
 MONEY, EQUIPMENT, SUPPLIES, MATERIALS  AND  SERVICES,  AND  TO  RECEIVE,
 UTILIZE  AND DISPOSE OF THE SAME; PROVIDED THAT AT ALL TIMES THE COMMIS-
 SION SHALL AVOID ANY APPEARANCE OF IMPROPRIETY OR CONFLICT OF INTEREST;
   H. TO LEASE, PURCHASE, ACCEPT APPROPRIATE GIFTS OR  DONATIONS  OF,  OR
 OTHERWISE  TO  OWN,  HOLD,  IMPROVE  OR USE, ANY PROPERTY, WHETHER REAL,
 PERSONAL OR MIXED; PROVIDED THAT AT ALL TIMES THE COMMISSION SHALL AVOID
 ANY APPEARANCE OF IMPROPRIETY;
   I. TO SELL, CONVEY, MORTGAGE,  PLEDGE,  LEASE,  EXCHANGE,  ABANDON  OR
 OTHERWISE DISPOSE OF ANY PROPERTY, WHETHER REAL, PERSONAL OR MIXED;
   J. TO ESTABLISH A BUDGET AND MAKE EXPENDITURES;
   K. TO BORROW MONEY;
   L.  TO  APPOINT COMMITTEES, INCLUDING ADVISORY COMMITTEES COMPRISED OF
 ADMINISTRATORS, STATE NURSING REGULATORS,  STATE  LEGISLATORS  OR  THEIR
 REPRESENTATIVES, AND CONSUMER REPRESENTATIVES, AND OTHER SUCH INTERESTED
 PERSONS;
   M. TO PROVIDE AND RECEIVE INFORMATION FROM, AND TO COOPERATE WITH, LAW
 ENFORCEMENT AGENCIES;
   N. TO ADOPT AND USE AN OFFICIAL SEAL; AND
   O.  TO PERFORM SUCH OTHER FUNCTIONS AS MAY BE NECESSARY OR APPROPRIATE
 TO ACHIEVE THE PURPOSES OF THIS COMPACT CONSISTENT WITH THE STATE  REGU-
 LATION OF NURSE LICENSURE AND PRACTICE.
   8.  FINANCING  OF  THE  COMMISSION.  A.  THE  COMMISSION SHALL PAY, OR
 PROVIDE FOR THE PAYMENT OF, THE REASONABLE EXPENSES  OF  ITS  ESTABLISH-
 MENT, ORGANIZATION AND ONGOING ACTIVITIES.
   B.  THE  COMMISSION  MAY ALSO LEVY ON AND COLLECT AN ANNUAL ASSESSMENT
 FROM EACH PARTY STATE TO COVER THE COST OF  ITS  OPERATIONS,  ACTIVITIES
 AND  STAFF  IN  ITS  ANNUAL  BUDGET AS APPROVED EACH YEAR. THE AGGREGATE
 ANNUAL ASSESSMENT AMOUNT, IF ANY, SHALL BE ALLOCATED BASED UPON A FORMU-
 LA TO BE DETERMINED BY THE COMMISSION, WHICH  SHALL  PROMULGATE  A  RULE
 THAT IS BINDING UPON ALL PARTY STATES.
   C.  THE  COMMISSION  SHALL  NOT INCUR OBLIGATIONS OF ANY KIND PRIOR TO
 SECURING THE FUNDS ADEQUATE TO MEET THE SAME; NOR SHALL  THE  COMMISSION
 PLEDGE  THE  CREDIT  OF ANY OF THE PARTY STATES, EXCEPT BY, AND WITH THE
 AUTHORITY OF, SUCH PARTY STATE.
   D. THE COMMISSION SHALL KEEP ACCURATE ACCOUNTS  OF  ALL  RECEIPTS  AND
 DISBURSEMENTS. THE RECEIPTS AND DISBURSEMENTS OF THE COMMISSION SHALL BE
 SUBJECT  TO  THE  AUDIT  AND ACCOUNTING PROCEDURES ESTABLISHED UNDER ITS
 BYLAWS. HOWEVER, ALL RECEIPTS AND DISBURSEMENTS OF FUNDS HANDLED BY  THE
 COMMISSION  SHALL  BE  AUDITED  YEARLY BY A CERTIFIED OR LICENSED PUBLIC
 ACCOUNTANT, AND THE REPORT OF THE AUDIT SHALL BE INCLUDED IN AND  BECOME
 PART OF THE ANNUAL REPORT OF THE COMMISSION.
   9. QUALIFIED IMMUNITY, DEFENSE AND INDEMNIFICATION. A. THE ADMINISTRA-
 TORS, OFFICERS, EXECUTIVE DIRECTOR, EMPLOYEES AND REPRESENTATIVES OF THE
 COMMISSION SHALL BE IMMUNE FROM SUIT AND LIABILITY, EITHER PERSONALLY OR
 IN THEIR OFFICIAL CAPACITY, FOR ANY CLAIM FOR DAMAGE TO OR LOSS OF PROP-
 ERTY  OR  PERSONAL  INJURY OR OTHER CIVIL LIABILITY CAUSED BY OR ARISING
 OUT OF ANY ACTUAL OR ALLEGED ACT, ERROR OR OMISSION  THAT  OCCURRED,  OR
 THAT  THE  PERSON  AGAINST WHOM THE CLAIM IS MADE HAD A REASONABLE BASIS
 FOR BELIEVING OCCURRED, WITHIN THE SCOPE OF THE COMMISSION'S EMPLOYMENT,
 DUTIES OR RESPONSIBILITIES; PROVIDED  THAT  NOTHING  IN  THIS  PARAGRAPH
 S. 8307--A                         113                        A. 8807--A
 
 SHALL BE CONSTRUED TO PROTECT ANY SUCH PERSON FROM SUIT OR LIABILITY FOR
 ANY DAMAGE, LOSS, INJURY OR LIABILITY CAUSED BY THE INTENTIONAL, WILLFUL
 OR WANTON MISCONDUCT OF THAT PERSON.
   B.  THE  COMMISSION SHALL DEFEND ANY ADMINISTRATOR, OFFICER, EXECUTIVE
 DIRECTOR, EMPLOYEE OR REPRESENTATIVE OF  THE  COMMISSION  IN  ANY  CIVIL
 ACTION  SEEKING TO IMPOSE LIABILITY ARISING OUT OF ANY ACTUAL OR ALLEGED
 ACT, ERROR OR OMISSION THAT OCCURRED WITHIN THE  SCOPE  OF  THE  COMMIS-
 SION'S  EMPLOYMENT,  DUTIES  OR  RESPONSIBILITIES,  OR  THAT  THE PERSON
 AGAINST WHOM THE CLAIM IS MADE HAD  A  REASONABLE  BASIS  FOR  BELIEVING
 OCCURRED  WITHIN  THE  SCOPE  OF  THE COMMISSION'S EMPLOYMENT, DUTIES OR
 RESPONSIBILITIES; PROVIDED THAT NOTHING HEREIN  SHALL  BE  CONSTRUED  TO
 PROHIBIT THAT PERSON FROM RETAINING HIS OR HER OWN COUNSEL; AND PROVIDED
 FURTHER THAT THE ACTUAL OR ALLEGED ACT, ERROR OR OMISSION DID NOT RESULT
 FROM THAT PERSON'S INTENTIONAL, WILLFUL OR WANTON MISCONDUCT.
   C. THE COMMISSION SHALL INDEMNIFY AND HOLD HARMLESS ANY ADMINISTRATOR,
 OFFICER,  EXECUTIVE  DIRECTOR, EMPLOYEE OR REPRESENTATIVE OF THE COMMIS-
 SION FOR THE AMOUNT OF ANY SETTLEMENT OR JUDGMENT OBTAINED AGAINST  THAT
 PERSON  ARISING OUT OF ANY ACTUAL OR ALLEGED ACT, ERROR OR OMISSION THAT
 OCCURRED WITHIN THE SCOPE OF  THE  COMMISSION'S  EMPLOYMENT,  DUTIES  OR
 RESPONSIBILITIES, OR THAT SUCH PERSON HAD A REASONABLE BASIS FOR BELIEV-
 ING  OCCURRED WITHIN THE SCOPE OF THE COMMISSION'S EMPLOYMENT, DUTIES OR
 RESPONSIBILITIES, PROVIDED THAT THE ACTUAL  OR  ALLEGED  ACT,  ERROR  OR
 OMISSION  DID NOT RESULT FROM THE INTENTIONAL, WILLFUL OR WANTON MISCON-
 DUCT OF THAT PERSON.
   § 8908. RULEMAKING. 1. RULEMAKING. A. THE  COMMISSION  SHALL  EXERCISE
 ITS RULEMAKING POWERS PURSUANT TO THE CRITERIA SET FORTH IN THIS ARTICLE
 AND  THE  RULES  ADOPTED  THEREUNDER.  RULES AND AMENDMENTS SHALL BECOME
 BINDING AS OF THE DATE SPECIFIED IN EACH RULE  OR  AMENDMENT  AND  SHALL
 HAVE THE SAME FORCE AND EFFECT AS PROVISIONS OF THIS COMPACT.
   B.  RULES  OR AMENDMENTS TO THE RULES SHALL BE ADOPTED AT A REGULAR OR
 SPECIAL MEETING OF THE COMMISSION.
   2. NOTICE. A. PRIOR TO PROMULGATION AND ADOPTION OF A  FINAL  RULE  OR
 RULES BY THE COMMISSION, AND AT LEAST SIXTY DAYS IN ADVANCE OF THE MEET-
 ING  AT WHICH THE RULE WILL BE CONSIDERED AND VOTED UPON, THE COMMISSION
 SHALL FILE A NOTICE OF PROPOSED RULEMAKING:
   I. ON THE WEBSITE OF THE COMMISSION; AND
   II. ON THE WEBSITE OF EACH LICENSING BOARD OR THE PUBLICATION IN WHICH
 EACH STATE WOULD OTHERWISE PUBLISH PROPOSED RULES.
   B. THE NOTICE OF PROPOSED RULEMAKING SHALL INCLUDE:
   I. THE PROPOSED TIME, DATE AND LOCATION OF THE MEETING  IN  WHICH  THE
 RULE WILL BE CONSIDERED AND VOTED UPON;
   II. THE TEXT OF THE PROPOSED RULE OR AMENDMENT, AND THE REASON FOR THE
 PROPOSED RULE;
   III.  A  REQUEST FOR COMMENTS ON THE PROPOSED RULE FROM ANY INTERESTED
 PERSON; AND
   IV. THE MANNER IN WHICH INTERESTED PERSONS MAY SUBMIT  NOTICE  TO  THE
 COMMISSION OF THEIR INTENTION TO ATTEND THE PUBLIC HEARING AND ANY WRIT-
 TEN COMMENTS.
   C.  PRIOR  TO  ADOPTION OF A PROPOSED RULE, THE COMMISSION SHALL ALLOW
 PERSONS TO SUBMIT WRITTEN DATA, FACTS,  OPINIONS  AND  ARGUMENTS,  WHICH
 SHALL BE MADE AVAILABLE TO THE PUBLIC.
   3. PUBLIC HEARINGS ON RULES. A. THE COMMISSION SHALL GRANT AN OPPORTU-
 NITY FOR A PUBLIC HEARING BEFORE IT ADOPTS A RULE OR AMENDMENT.
   B. THE COMMISSION SHALL PUBLISH THE PLACE, TIME AND DATE OF THE SCHED-
 ULED PUBLIC HEARING.
 S. 8307--A                         114                        A. 8807--A
 
   I.  HEARINGS  SHALL BE CONDUCTED IN A MANNER PROVIDING EACH PERSON WHO
 WISHES TO COMMENT A FAIR AND REASONABLE OPPORTUNITY TO COMMENT ORALLY OR
 IN WRITING. ALL HEARINGS WILL BE RECORDED,  AND  A  COPY  WILL  BE  MADE
 AVAILABLE UPON REQUEST.
   II. NOTHING IN THIS SECTION SHALL BE CONSTRUED AS REQUIRING A SEPARATE
 HEARING  ON  EACH  RULE. RULES MAY BE GROUPED FOR THE CONVENIENCE OF THE
 COMMISSION AT HEARINGS REQUIRED BY THIS SECTION.
   C. IF NO ONE APPEARS AT THE PUBLIC HEARING, THE COMMISSION MAY PROCEED
 WITH PROMULGATION OF THE PROPOSED RULE.
   D. FOLLOWING THE SCHEDULED HEARING DATE, OR BY THE CLOSE  OF  BUSINESS
 ON  THE  SCHEDULED HEARING DATE IF THE HEARING WAS NOT HELD, THE COMMIS-
 SION SHALL CONSIDER ALL WRITTEN AND ORAL COMMENTS RECEIVED.
   4. VOTING ON RULES. THE COMMISSION SHALL,  BY  MAJORITY  VOTE  OF  ALL
 ADMINISTRATORS,  TAKE FINAL ACTION ON THE PROPOSED RULE AND SHALL DETER-
 MINE THE EFFECTIVE DATE OF THE RULE, IF ANY,  BASED  ON  THE  RULEMAKING
 RECORD AND THE FULL TEXT OF THE RULE.
   5.  EMERGENCY  RULES. UPON DETERMINATION THAT AN EMERGENCY EXISTS, THE
 COMMISSION MAY CONSIDER  AND  ADOPT  AN  EMERGENCY  RULE  WITHOUT  PRIOR
 NOTICE,  OPPORTUNITY  FOR  COMMENT  OR  HEARING, PROVIDED THAT THE USUAL
 RULEMAKING PROCEDURES PROVIDED IN THIS COMPACT AND IN THIS SECTION SHALL
 BE RETROACTIVELY APPLIED TO THE RULE AS SOON AS REASONABLY POSSIBLE,  IN
 NO  EVENT  LATER  THAN NINETY DAYS AFTER THE EFFECTIVE DATE OF THE RULE.
 FOR THE PURPOSES OF THIS PROVISION, AN EMERGENCY RULE IS ONE  THAT  MUST
 BE ADOPTED IMMEDIATELY IN ORDER TO:
   A. MEET AN IMMINENT THREAT TO PUBLIC HEALTH, SAFETY OR WELFARE;
   B. PREVENT A LOSS OF THE COMMISSION OR PARTY STATE FUNDS; OR
   C. MEET A DEADLINE FOR THE PROMULGATION OF AN ADMINISTRATIVE RULE THAT
 IS REQUIRED BY FEDERAL LAW OR RULE.
   6.  REVISIONS.  THE  COMMISSION  MAY  DIRECT REVISIONS TO A PREVIOUSLY
 ADOPTED RULE OR  AMENDMENT  FOR  PURPOSES  OF  CORRECTING  TYPOGRAPHICAL
 ERRORS,  ERRORS  IN FORMAT, ERRORS IN CONSISTENCY OR GRAMMATICAL ERRORS.
 PUBLIC NOTICE OF ANY REVISIONS SHALL BE POSTED ON  THE  WEBSITE  OF  THE
 COMMISSION. THE REVISION SHALL BE SUBJECT TO CHALLENGE BY ANY PERSON FOR
 A  PERIOD  OF  THIRTY DAYS AFTER POSTING. THE REVISION MAY BE CHALLENGED
 ONLY ON GROUNDS THAT THE REVISION RESULTS IN  A  MATERIAL  CHANGE  TO  A
 RULE.    A  CHALLENGE  SHALL  BE  MADE  IN WRITING, AND DELIVERED TO THE
 COMMISSION, PRIOR TO THE END OF THE NOTICE PERIOD. IF  NO  CHALLENGE  IS
 MADE,  THE  REVISION  WILL  TAKE  EFFECT  WITHOUT FURTHER ACTION. IF THE
 REVISION IS CHALLENGED, THE REVISION MAY NOT  TAKE  EFFECT  WITHOUT  THE
 APPROVAL OF THE COMMISSION.
   § 8909. OVERSIGHT,  DISPUTE  RESOLUTION AND ENFORCEMENT. 1. OVERSIGHT.
 A. EACH PARTY STATE SHALL ENFORCE THIS  COMPACT  AND  TAKE  ALL  ACTIONS
 NECESSARY  AND  APPROPRIATE  TO  EFFECTUATE  THIS COMPACT'S PURPOSES AND
 INTENT.
   B. THE COMMISSION SHALL BE ENTITLED TO RECEIVE SERVICE OF  PROCESS  IN
 ANY  PROCEEDING  THAT MAY AFFECT THE POWERS, RESPONSIBILITIES OR ACTIONS
 OF THE COMMISSION, AND SHALL  HAVE  STANDING  TO  INTERVENE  IN  SUCH  A
 PROCEEDING  FOR  ALL  PURPOSES. FAILURE TO PROVIDE SERVICE OF PROCESS IN
 SUCH PROCEEDING TO THE COMMISSION SHALL RENDER A JUDGMENT OR ORDER  VOID
 AS TO THE COMMISSION, THIS COMPACT OR PROMULGATED RULES.
   2. DEFAULT, TECHNICAL ASSISTANCE AND TERMINATION. A. IF THE COMMISSION
 DETERMINES  THAT  A  PARTY STATE HAS DEFAULTED IN THE PERFORMANCE OF ITS
 OBLIGATIONS OR RESPONSIBILITIES UNDER THIS COMPACT  OR  THE  PROMULGATED
 RULES, THE COMMISSION SHALL:
 S. 8307--A                         115                        A. 8807--A
 
   I.  PROVIDE  WRITTEN  NOTICE  TO  THE DEFAULTING STATE AND OTHER PARTY
 STATES OF THE NATURE OF THE DEFAULT, THE PROPOSED MEANS  OF  CURING  THE
 DEFAULT OR ANY OTHER ACTION TO BE TAKEN BY THE COMMISSION; AND
   II.  PROVIDE  REMEDIAL  TRAINING  AND  SPECIFIC  TECHNICAL  ASSISTANCE
 REGARDING THE DEFAULT.
   B. IF A STATE IN DEFAULT FAILS TO CURE  THE  DEFAULT,  THE  DEFAULTING
 STATE'S MEMBERSHIP IN THIS COMPACT MAY BE TERMINATED UPON AN AFFIRMATIVE
 VOTE OF A MAJORITY OF THE ADMINISTRATORS, AND ALL RIGHTS, PRIVILEGES AND
 BENEFITS  CONFERRED  BY  THIS COMPACT MAY BE TERMINATED ON THE EFFECTIVE
 DATE OF TERMINATION. A CURE OF THE DEFAULT DOES NOT RELIEVE THE  OFFEND-
 ING  STATE  OF  OBLIGATIONS OR LIABILITIES INCURRED DURING THE PERIOD OF
 DEFAULT.
   C. TERMINATION OF MEMBERSHIP IN THIS COMPACT  SHALL  BE  IMPOSED  ONLY
 AFTER ALL OTHER MEANS OF SECURING COMPLIANCE HAVE BEEN EXHAUSTED. NOTICE
 OF  INTENT  TO  SUSPEND OR TERMINATE SHALL BE GIVEN BY THE COMMISSION TO
 THE GOVERNOR OF THE DEFAULTING STATE AND TO THE EXECUTIVE OFFICER OF THE
 DEFAULTING STATE'S LICENSING BOARD AND EACH OF THE PARTY STATES.
   D. A STATE WHOSE MEMBERSHIP IN THIS COMPACT  HAS  BEEN  TERMINATED  IS
 RESPONSIBLE  FOR  ALL  ASSESSMENTS, OBLIGATIONS AND LIABILITIES INCURRED
 THROUGH THE EFFECTIVE DATE OF TERMINATION,  INCLUDING  OBLIGATIONS  THAT
 EXTEND BEYOND THE EFFECTIVE DATE OF TERMINATION.
   E.  THE COMMISSION SHALL NOT BEAR ANY COSTS RELATED TO A STATE THAT IS
 FOUND TO BE IN DEFAULT OR WHOSE MEMBERSHIP  IN  THIS  COMPACT  HAS  BEEN
 TERMINATED  UNLESS AGREED UPON IN WRITING BETWEEN THE COMMISSION AND THE
 DEFAULTING STATE.
   F. THE DEFAULTING STATE MAY APPEAL THE ACTION  OF  THE  COMMISSION  BY
 PETITIONING  THE U.S. DISTRICT COURT FOR THE DISTRICT OF COLUMBIA OR THE
 FEDERAL DISTRICT IN WHICH THE COMMISSION HAS ITS PRINCIPAL OFFICES.  THE
 PREVAILING  PARTY SHALL BE AWARDED ALL COSTS OF SUCH LITIGATION, INCLUD-
 ING REASONABLE ATTORNEYS' FEES.
   3. DISPUTE RESOLUTION. A. UPON REQUEST BY A PARTY STATE,  THE  COMMIS-
 SION SHALL ATTEMPT TO RESOLVE DISPUTES RELATED TO THE COMPACT THAT ARISE
 AMONG PARTY STATES AND BETWEEN PARTY AND NON-PARTY STATES.
   B. THE COMMISSION SHALL PROMULGATE A RULE PROVIDING FOR BOTH MEDIATION
 AND BINDING DISPUTE RESOLUTION FOR DISPUTES, AS APPROPRIATE.
   C.  IN  THE  EVENT  THE COMMISSION CANNOT RESOLVE DISPUTES AMONG PARTY
 STATES ARISING UNDER THIS COMPACT:
   I. THE PARTY STATES MAY SUBMIT THE ISSUES IN DISPUTE TO AN ARBITRATION
 PANEL, WHICH WILL BE COMPRISED OF INDIVIDUALS APPOINTED BY  THE  COMPACT
 ADMINISTRATOR  IN  EACH  OF THE AFFECTED PARTY STATES, AND AN INDIVIDUAL
 MUTUALLY AGREED UPON BY THE COMPACT  ADMINISTRATORS  OF  ALL  THE  PARTY
 STATES INVOLVED IN THE DISPUTE.
   II.  THE  DECISION OF A MAJORITY OF THE ARBITRATORS SHALL BE FINAL AND
 BINDING.
   4. ENFORCEMENT. A. THE COMMISSION, IN THE REASONABLE EXERCISE  OF  ITS
 DISCRETION, SHALL ENFORCE THE PROVISIONS AND RULES OF THIS COMPACT.
   B.  BY  MAJORITY VOTE, THE COMMISSION MAY INITIATE LEGAL ACTION IN THE
 U.S.   DISTRICT COURT FOR  THE  DISTRICT  OF  COLUMBIA  OR  THE  FEDERAL
 DISTRICT  IN  WHICH  THE  COMMISSION HAS ITS PRINCIPAL OFFICES AGAINST A
 PARTY STATE THAT IS IN DEFAULT TO ENFORCE COMPLIANCE WITH THE PROVISIONS
 OF THIS COMPACT AND ITS PROMULGATED RULES AND BYLAWS. THE RELIEF  SOUGHT
 MAY  INCLUDE  BOTH  INJUNCTIVE RELIEF AND DAMAGES. IN THE EVENT JUDICIAL
 ENFORCEMENT IS NECESSARY, THE PREVAILING  PARTY  SHALL  BE  AWARDED  ALL
 COSTS OF SUCH LITIGATION, INCLUDING REASONABLE ATTORNEYS' FEES.
 S. 8307--A                         116                        A. 8807--A
 
   C.  THE  REMEDIES  HEREIN  SHALL  NOT BE THE EXCLUSIVE REMEDIES OF THE
 COMMISSION. THE COMMISSION MAY PURSUE ANY OTHER REMEDIES AVAILABLE UNDER
 FEDERAL OR STATE LAW.
   § 8910. EFFECTIVE  DATE,  WITHDRAWAL AND AMENDMENT. 1. EFFECTIVE DATE.
 A.  THIS COMPACT SHALL BECOME EFFECTIVE AND BINDING ON  THE  EARLIER  OF
 THE  DATE  OF  LEGISLATIVE ENACTMENT OF THIS COMPACT INTO LAW BY NO LESS
 THAN TWENTY-SIX STATES OR THE EFFECTIVE DATE OF THE CHAPTER OF THE  LAWS
 OF  TWO THOUSAND TWENTY-FOUR THAT ENACTED THIS COMPACT.  THEREAFTER, THE
 COMPACT SHALL BECOME EFFECTIVE AND BINDING AS TO  ANY  OTHER  COMPACTING
 STATE  UPON  ENACTMENT  OF THE COMPACT INTO LAW BY THAT STATE. ALL PARTY
 STATES TO THIS COMPACT, THAT ALSO WERE PARTIES TO THE PRIOR NURSE LICEN-
 SURE COMPACT, SUPERSEDED BY THIS COMPACT, (HEREIN REFERRED TO AS  "PRIOR
 COMPACT"),  SHALL  BE  DEEMED  TO HAVE WITHDRAWN FROM SAID PRIOR COMPACT
 WITHIN SIX MONTHS AFTER THE EFFECTIVE DATE OF THIS COMPACT.
   B. EACH PARTY STATE TO THIS COMPACT  SHALL  CONTINUE  TO  RECOGNIZE  A
 NURSE'S  MULTISTATE  LICENSURE PRIVILEGE TO PRACTICE IN THAT PARTY STATE
 ISSUED UNDER THE PRIOR COMPACT UNTIL SUCH PARTY STATE HAS WITHDRAWN FROM
 THE PRIOR COMPACT.
   2. WITHDRAWAL. A. ANY PARTY STATE MAY WITHDRAW FROM  THIS  COMPACT  BY
 ENACTING  A STATUTE REPEALING THE SAME. A PARTY STATE'S WITHDRAWAL SHALL
 NOT TAKE EFFECT UNTIL SIX MONTHS AFTER ENACTMENT OF THE REPEALING  STAT-
 UTE.
   B.  A  PARTY  STATE'S  WITHDRAWAL  OR TERMINATION SHALL NOT AFFECT THE
 CONTINUING REQUIREMENT OF THE WITHDRAWING OR TERMINATED STATE'S  LICENS-
 ING  BOARD  TO  REPORT  ADVERSE  ACTIONS  AND SIGNIFICANT INVESTIGATIONS
 OCCURRING PRIOR TO THE EFFECTIVE DATE OF SUCH WITHDRAWAL OR TERMINATION.
   C. NOTHING CONTAINED IN THIS COMPACT SHALL BE CONSTRUED TO  INVALIDATE
 OR  PREVENT  ANY NURSE LICENSURE AGREEMENT OR OTHER COOPERATIVE ARRANGE-
 MENT BETWEEN A PARTY STATE AND A NON-PARTY STATE THAT IS MADE IN ACCORD-
 ANCE WITH THE OTHER PROVISIONS OF THIS COMPACT.
   3. AMENDMENT. A. THIS COMPACT MAY BE AMENDED BY THE PARTY  STATES.  NO
 AMENDMENT  TO  THIS  COMPACT SHALL BECOME EFFECTIVE AND BINDING UPON THE
 PARTY STATES UNLESS AND UNTIL IT IS ENACTED INTO THE LAWS OF  ALL  PARTY
 STATES.
   B.  REPRESENTATIVES  OF  NON-PARTY  STATES  TO  THIS  COMPACT SHALL BE
 INVITED TO PARTICIPATE IN THE ACTIVITIES OF THE COMMISSION, ON A NONVOT-
 ING BASIS, PRIOR TO THE ADOPTION OF THIS COMPACT BY ALL STATES.
   § 8911. CONSTRUCTION AND SEVERABILITY.  1. CONSTRUCTION AND SEVERABIL-
 ITY. THIS COMPACT SHALL BE LIBERALLY CONSTRUED SO AS TO  EFFECTUATE  THE
 PURPOSES THEREOF. THE PROVISIONS OF THIS COMPACT SHALL BE SEVERABLE, AND
 IF ANY PHRASE, CLAUSE, SENTENCE OR PROVISION OF THIS COMPACT IS DECLARED
 TO  BE  CONTRARY TO THE CONSTITUTION OF ANY PARTY STATE OR OF THE UNITED
 STATES, OR IF THE  APPLICABILITY  THEREOF  TO  ANY  GOVERNMENT,  AGENCY,
 PERSON  OR  CIRCUMSTANCE  IS  HELD  TO  BE  INVALID, THE VALIDITY OF THE
 REMAINDER OF THIS COMPACT AND THE APPLICABILITY THEREOF TO  ANY  GOVERN-
 MENT,  AGENCY,  PERSON OR CIRCUMSTANCE SHALL NOT BE AFFECTED THEREBY. IF
 THIS COMPACT SHALL BE HELD TO BE CONTRARY TO  THE  CONSTITUTION  OF  ANY
 PARTY  STATE,  THIS  COMPACT SHALL REMAIN IN FULL FORCE AND EFFECT AS TO
 THE REMAINING PARTY STATES AND IN FULL FORCE AND EFFECT AS TO THE  PARTY
 STATE AFFECTED AS TO ALL SEVERABLE MATTERS.
   §  3.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART S
 S. 8307--A                         117                        A. 8807--A

   Section 1. The public health law is amended by adding  a  new  section
 2825-i to read as follows:
   § 2825-I. HEALTHCARE SAFETY NET TRANSFORMATION PROGRAM. 1. A STATEWIDE
 HEALTHCARE SAFETY NET TRANSFORMATION PROGRAM SHALL BE ESTABLISHED WITHIN
 THE DEPARTMENT FOR THE PURPOSE OF SUPPORTING THE TRANSFORMATION OF SAFE-
 TY  NET HOSPITALS TO IMPROVE ACCESS, EQUITY, QUALITY, AND OUTCOMES WHILE
 INCREASING THE FINANCIAL SUSTAINABILITY OF SAFETY  NET  HOSPITALS.  SUCH
 PROGRAM MAY PROVIDE OR UTILIZE NEW OR EXISTING CAPITAL FUNDING, OR OPER-
 ATING  SUBSIDIES,  OR  BOTH.  ANY  APPLICATION  FOR THIS PROGRAM MUST BE
 JOINTLY SUBMITTED BY A SAFETY NET HOSPITAL  AND  AT  LEAST  ONE  PARTNER
 ORGANIZATION.
   2. THE COMMISSIONER SHALL ENTER AN AGREEMENT WITH THE PRESIDENT OF THE
 DORMITORY AUTHORITY OF THE STATE OF NEW YORK PURSUANT TO SECTION SIXTEEN
 HUNDRED EIGHTY-R OF THE PUBLIC AUTHORITIES LAW, AS REQUIRED, WHICH SHALL
 APPLY  TO THIS AGREEMENT, SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE
 DIVISION OF THE BUDGET, FOR THE PURPOSES OF THE DISTRIBUTION AND  ADMIN-
 ISTRATION  OF AVAILABLE FUNDS PURSUANT TO SUCH AGREEMENT AND MADE AVAIL-
 ABLE PURSUANT TO THIS SECTION AND SUBJECT TO APPROPRIATION.  SUCH  FUNDS
 MAY  BE  AWARDED  AND DISTRIBUTED BY THE DEPARTMENT TO SAFETY NET HOSPI-
 TALS, OR A PARTNER ORGANIZATION, IN THE FORM OF GRANTS. TO QUALIFY AS  A
 SAFETY NET HOSPITAL FOR PURPOSES OF THIS SECTION, A HOSPITAL SHALL:
   (A)  BE EITHER A PUBLIC HOSPITAL, A RURAL EMERGENCY HOSPITAL, CRITICAL
 ACCESS HOSPITAL OR SOLE COMMUNITY HOSPITAL;
   (B) HAVE AT LEAST THIRTY PERCENT OF ITS INPATIENT DISCHARGES  MADE  UP
 OF  MEDICAL  ASSISTANCE PROGRAM ELIGIBLE INDIVIDUALS, UNINSURED INDIVID-
 UALS OR MEDICAL ASSISTANCE PROGRAM DUALLY ELIGIBLE  INDIVIDUALS  AND  AT
 LEAST  THIRTY-FIVE  PERCENT  OF ITS OUTPATIENT VISITS MADE UP OF MEDICAL
 ASSISTANCE  PROGRAM  ELIGIBLE  INDIVIDUALS,  UNINSURED  INDIVIDUALS   OR
 MEDICAL ASSISTANCE PROGRAM DUALLY-ELIGIBLE INDIVIDUALS;
   (C)  SERVE  AT  LEAST THIRTY PERCENT OF THE RESIDENTS OF A COUNTY OR A
 MULTI-COUNTY AREA WHO ARE MEDICAL ASSISTANCE PROGRAM  ELIGIBLE  INDIVID-
 UALS,  UNINSURED INDIVIDUALS OR MEDICAL ASSISTANCE PROGRAM DUALLY-ELIGI-
 BLE INDIVIDUALS; OR
   (D) IN THE DISCRETION OF THE COMMISSIONER, SERVE A  SIGNIFICANT  POPU-
 LATION  OF  MEDICAL  ASSISTANCE  PROGRAM ELIGIBLE INDIVIDUALS, UNINSURED
 INDIVIDUALS OR MEDICAL ASSISTANCE PROGRAM DUALLY-ELIGIBLE INDIVIDUALS.
   3. PARTNER ORGANIZATIONS MAY INCLUDE, BUT ARE NOT LIMITED  TO,  HEALTH
 SYSTEMS,  HOSPITALS,  HEALTH  PLANS, RESIDENTIAL HEALTH CARE FACILITIES,
 PHYSICIAN GROUPS,  COMMUNITY-BASED  ORGANIZATION,  OR  OTHER  HEALTHCARE
 ENTITIES  WHO  CAN SERVE AS PARTNERS IN THE TRANSFORMATION OF THE SAFETY
 NET HOSPITAL.  THE COMMISSIONER SHALL HAVE THE DISCRETION  TO  DEEM  ANY
 ORGANIZATION  A PARTNER ORGANIZATION UPON A FINDING THAT DEEMING SO WILL
 ADVANCE THE GOALS OF THIS SECTION.
   4. NOTWITHSTANDING ANY LAW TO THE CONTRARY,  AND  IN  ACCORDANCE  WITH
 SECTION FOUR OF THE STATE FINANCE LAW, THE COMPTROLLER IS HEREBY AUTHOR-
 IZED  AND  DIRECTED TO TRANSFER, UPON REQUEST OF THE DIRECTOR OF BUDGET,
 ON OR BEFORE MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-FIVE,  UP  TO  FIVE
 HUNDRED  MILLION  DOLLARS TO THE DEPARTMENT FROM AMOUNTS APPROPRIATED TO
 ADMINISTER THE PROGRAMS ESTABLISHED  IN  SECTIONS  TWENTY-EIGHT  HUNDRED
 TWENTY-FIVE-G  AND TWENTY-EIGHT HUNDRED TWENTY-FIVE-H OF THIS ARTICLE TO
 SUPPORT THIS PROGRAM.  NOTWITHSTANDING SECTION ONE  HUNDRED  SIXTY-THREE
 OF THE STATE FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND ONE HUNDRED
 FORTY-THREE   OF  THE  ECONOMIC  DEVELOPMENT  LAW  OR  ANY  INCONSISTENT
 PROVISIONS OF LAW TO THE CONTRARY, AWARDS  MAY  BE  PROVIDED  WITHOUT  A
 COMPETITIVE  BID OR REQUEST FOR PROPOSAL PROCESS TO SAFETY NET HOSPITALS
 OR PARTNER ORGANIZATIONS FOR  PURPOSES  OF  INCREASING  ACCESS,  EQUITY,
 S. 8307--A                         118                        A. 8807--A
 
 QUALITY, OUTCOMES, AND LONG-TERM FINANCIAL SUSTAINABILITY OF SUCH SAFETY
 NET HOSPITALS.
   5.  NOTWITHSTANDING  ANY PROVISION OF LAW TO THE CONTRARY, THE COMMIS-
 SIONER IS AUTHORIZED TO  WAIVE  ANY  REGULATORY  REQUIREMENTS  TO  ALLOW
 APPLICANTS TO MORE EFFECTIVELY OR EFFICIENTLY IMPLEMENT PROJECTS AWARDED
 THROUGH  THE  HEALTHCARE  SAFETY  NET  TRANSFORMATION PROGRAM, PROVIDED,
 HOWEVER, THAT REGULATIONS PERTAINING TO PATIENT SAFETY,  PATIENT  AUTON-
 OMY,  PATIENT  PRIVACY,  PATIENT RIGHTS, DUE PROCESS, SCOPE OF PRACTICE,
 PROFESSIONAL LICENSURE, ENVIRONMENTAL PROTECTIONS,  PROVIDER  REIMBURSE-
 MENT  METHODOLOGIES,  OR  OCCUPATIONAL STANDARDS AND EMPLOYEE RIGHTS MAY
 NOT BE WAIVED, NOR SHALL ANY REGULATIONS BE WAIVED IF SUCH WAIVER  WOULD
 RISK  PATIENT  SAFETY.  SUCH  WAIVER  SHALL  NOT  EXCEED THE LIFE OF THE
 PROJECT OR SUCH SHORTER TIME PERIODS AS THE COMMISSIONER MAY  DETERMINE.
 ANY  REGULATORY  RELIEF  GRANTED  PURSUANT  TO THIS SUBDIVISION SHALL BE
 SPECIFICALLY DESCRIBED AND REQUESTED WITHIN EACH PROJECT APPLICATION AND
 BE REVIEWED BY THE COMMISSIONER. THE WAIVER OF ANY  REGULATORY  REQUIRE-
 MENTS SHALL BE MADE IN THE SOLE DISCRETION OF THE COMMISSIONER.
   6. QUALIFYING SAFETY NET HOSPITALS AND THEIR DESIGNATED PARTNER ORGAN-
 IZATION  OR  ORGANIZATIONS  SHALL  PROVIDE,  AS PART OF THE APPLICATION,
 WHICH SHALL BE IN A MANNER AS PRESCRIBED BY THE COMMISSIONER,  A  TRANS-
 FORMATION  PLAN  THAT INCLUDES AT LEAST A FIVE-YEAR STRATEGIC AND OPERA-
 TIONAL PLAN OUTLINING THE ROLES AND RESPONSIBILITIES OF EACH ENTITY  AND
 SPECIFICALLY  STATE  ANY REGULATORY FLEXIBILITY WHICH MAY BE REQUIRED TO
 IMPLEMENT SUCH PLAN. THE TRANSFORMATION PLAN SHALL ALSO INCLUDE A  TIME-
 LINE OF KEY METRICS AND GOALS RELATED TO IMPROVED ACCESS, EQUITY, QUALI-
 TY,  OUTCOMES,  AND INCREASED FINANCIAL SUSTAINABILITY OF THE SAFETY NET
 HOSPITAL. THE REQUEST FOR LEVEL AND TYPE OF SUPPORT  SHALL  BE  SPECIFIC
 AND  DETAILED  IN THE APPLICATION. CONTINUED SUPPORT SHALL BE CONTINGENT
 UPON THE IMPLEMENTATION OF THE APPROVED PLAN AND KEY MILESTONES.  APPLI-
 CATIONS  MAY  INCLUDE A RANGE OF COLLABORATION MODELS, INCLUDING BUT NOT
 BE LIMITED TO MERGER, ACQUISITION, A MANAGEMENT SERVICES CONTRACT, OR  A
 CLINICAL INTEGRATION.
   7.  THE RELEASE OF ANY FUNDING WILL BE CONTINGENT UPON COMPLIANCE WITH
 THE TRANSFORMATION PLAN AND A DETERMINATION THAT ACCEPTABLE PROGRESS HAS
 BEEN MADE WITH SUCH PLAN. IF KEY MILESTONES AND GOALS ARE NOT MET, ADDI-
 TIONAL FINANCIAL RESOURCES MAY BE  WITHHELD  AND  REDIRECTED,  UPON  THE
 RECOMMENDATION OF THE COMMISSIONER AND APPROVAL BY THE DIRECTOR OF BUDG-
 ET.
   §  2.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART T
 
   Section 1. Subdivision 1 of section 2130 of the public health law,  as
 amended  by  chapter  308  of  the  laws  of 2010, is amended to read as
 follows:
   1. (A) Every physician or other person  authorized  by  law  to  order
 diagnostic tests or make a medical diagnosis, or any laboratory perform-
 ing  such  tests  shall  immediately [(a)] (I) upon determination that a
 person is [infected] POSITIVE/REACTIVE with human immunodeficiency virus
 (HIV), [(b)] (II) upon diagnosis [that a person is afflicted] with  [the
 disease  known  as]  acquired  immune  deficiency syndrome (AIDS), [(c)]
 (III) upon diagnosis [that a  person  is  afflicted]  with  HIV  related
 illness, and [(d)] (IV) upon periodic monitoring of HIV infection by any
 laboratory tests report such case or data to the commissioner.
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   (B)  ANY  PERMITTED  CLINICAL  LABORATORY,  AS DEFINED IN SECTION FIVE
 HUNDRED SEVENTY-ONE OF THIS CHAPTER, PERFORMING  SUCH  DIAGNOSTIC  TESTS
 SHALL   ALSO,   UPON   DETERMINATION   THAT   A   TEST   RESULT  IS  NOT
 POSITIVE/REACTIVE FOR HIV, REPORT SUCH NEGATIVE HIV TEST RESULT  TO  THE
 COMMISSIONER.
   § 2. Subdivision 1 of section 2102 of the public health law is amended
 to read as follows:
   1.  Whenever any laboratory examination discloses evidence of communi-
 cable disease, AND FOR HEPATITIS B VIRUS OR SYPHILIS UPON  DETERMINATION
 THAT  A  TEST RESULT IS NOT POSITIVE/REACTIVE, the results of such exam-
 ination together with all required pertinent facts, shall be immediately
 reported by the person in charge of the laboratory or the person  making
 such  examination  to  the  local  or  state health official to whom the
 attending physician is required to report such case.
   § 3. The public health law is amended by adding a new section 2172  to
 read as follows:
   § 2172. HCV INFECTION; DUTY TO REPORT. IN ADDITION TO REPORTING THAT A
 HEPATITIS C VIRUS (HCV) CLINICAL LABORATORY TEST IS REACTIVE/POSITIVE AS
 REQUIRED  BY SECTION TWENTY-ONE HUNDRED TWO OF THIS ARTICLE, ANY PERMIT-
 TED CLINICAL LABORATORY, AS DEFINED IN SECTION FIVE HUNDRED  SEVENTY-ONE
 OF  THIS  CHAPTER,  PERFORMING SUCH TESTS SHALL ALSO, UPON DETERMINATION
 THAT A TEST RESULT IS NOT POSITIVE/REACTIVE WITH HCV, REPORT SUCH  NEGA-
 TIVE HCV TEST RESULT TO THE COMMISSIONER.
   §  4. Section 2781 of the public health law, as amended by chapter 308
 of the laws of 2010, subdivisions 1 and 2 as amended by chapter  502  of
 the  laws of 2016 and subdivision 4 as amended by section 2 of part A of
 chapter 60 of the laws of 2014, is amended to read as follows:
   § 2781. HIV related testing. 1. Except as provided  in  section  three
 thousand  one hundred twenty-one of the civil practice law and rules, or
 unless otherwise specifically authorized  or  required  by  a  state  or
 federal  law,  no  person  shall order the performance of an HIV related
 test without first, at a minimum, [orally advising] PROVIDING NOTICE  BY
 MEANS READILY ACCESSIBLE IN MULTIPLE LANGUAGES TO the protected individ-
 ual,  or,  when  the  protected  individual lacks capacity to consent, a
 person authorized to consent to health care for such individual, that an
 HIV-related test is being performed, or over the objection of such indi-
 vidual or authorized  persons.  Such  [advisement  and  objection,  when
 applicable]  NOTICE  MAY  BE PROVIDED ORALLY, IN WRITING, BY PROMINENTLY
 DISPLAYED SIGNAGE, OR BY ELECTRONIC MEANS OR OTHER APPROPRIATE  FORM  OF
 COMMUNICATION. SUCH NOTICE SHALL INCLUDE INFORMATION THAT HIV TESTING IS
 VOLUNTARY.  A REFUSAL OF AN HIV RELATED TEST shall be noted in the indi-
 vidual's record.
   2. A person ordering the performance of  an  HIV  related  test  shall
 provide either directly or through a representative to the subject of an
 HIV  related  test  or,  if  the subject lacks capacity to consent, to a
 person authorized pursuant to law to consent  to  health  care  for  the
 subject, an explanation that:
   (a)  HIV  causes AIDS and can be transmitted through sexual activities
 and needle-sharing, by pregnant women  to  their  fetuses,  and  through
 breastfeeding infants;
   (b)  there is treatment for HIV that can help an individual stay heal-
 thy;
   (c) individuals with HIV or AIDS can adopt safe practices  to  protect
 uninfected  and infected people in their lives from becoming infected or
 multiply infected with HIV;
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   (d) testing is voluntary and can be done anonymously at a public test-
 ing center;
   (e) the law protects the confidentiality of HIV related test results;
   (f)  the  law  prohibits  discrimination  based on an individual's HIV
 status and services are available to help with such consequences; and
   (g) the law requires that an individual be advised before  an  HIV-re-
 lated test is performed, and that no test shall be performed over his or
 her objection.
   Protocols shall be in place to ensure compliance with this section.
   4. [A person authorized pursuant to law to order the performance of an
 HIV  related  test shall provide directly or through a representative to
 the person seeking such test, an opportunity to remain anonymous through
 use of a coded system with no linking of individual identity to the test
 request or results.] A health care provider who is not authorized by the
 commissioner to provide HIV related tests on an  anonymous  basis  shall
 refer  a person who requests an anonymous test to a test site which does
 provide anonymous testing. The provisions of this subdivision shall  not
 apply  to  a  health  care  provider  ordering the performance of an HIV
 related test on an individual proposed for insurance coverage.
   5. At the time of communicating the test result to the subject of  the
 test,  a  person  ordering the performance of an HIV related test shall,
 directly or through a representative:
   (a) in the case of  a  test  indicating  evidence  of  HIV  infection,
 provide  the  subject  of  the test or, if the subject lacks capacity to
 consent, the person authorized pursuant to law to consent to health care
 for the subject with counseling or referrals for counseling:
   (i) for coping with the emotional consequences of learning the result;
   (ii) regarding the discrimination  problems  that  disclosure  of  the
 result could cause;
   (iii)  for  behavior  change to prevent transmission or contraction of
 HIV infection;
   (iv) to inform such person of available medical treatments; [and]
   (v) regarding the need to notify his or her contacts; AND
   (VI) REGARDING PRE- AND POST-EXPOSURE PROPHYLAXIS  MEDICATIONS  AVAIL-
 ABLE TO SEXUAL PARTNERS TO PREVENT HIV INFECTION; and
   (b)  in  the  case of a test not indicating evidence of HIV infection,
 provide (in a manner which may consist of oral or written  reference  to
 information  previously  provided)  the  subject  of the test, or if the
 subject lacks capacity to consent, the person authorized pursuant to law
 to consent to health care for the subject, with information:
   (I) concerning the risks of  participating  in  high  risk  sexual  or
 needle-sharing behavior; AND
   (II)  REGARDING  PRE- AND POST-EXPOSURE PROPHYLAXIS MEDICATIONS AVAIL-
 ABLE TO PREVENT HIV INFECTION.
   5-a. With the consent of the subject of a test indicating evidence  of
 HIV  infection  or,  if  the subject lacks capacity to consent, with the
 consent of the person authorized pursuant to law to  consent  to  health
 care  for the subject, the person who ordered the performance of the HIV
 related test, or such person's representative, shall provide or  arrange
 with  a  health  care  provider for an appointment for follow-up medical
 care for HIV for such subject.
   6. The provisions of this section shall not apply to  the  performance
 of an HIV related test:
   (a)  by  a  health care provider or health facility in relation to the
 procuring, processing, distributing or use of a human body  or  a  human
 body  part,  including  organs,  tissues,  eyes, bones, arteries, blood,
 S. 8307--A                         121                        A. 8807--A
 
 semen, or other body fluids, for use in medical research or therapy,  or
 for  transplantation  to  individuals  provided, however, that where the
 test results are communicated to the subject, post-test  counseling,  as
 described  in  subdivision  five  of  this section, shall nonetheless be
 required; or
   (b) for the purpose of research if  the  testing  is  performed  in  a
 manner  by  which  the identity of the test subject is not known and may
 not be retrieved by the researcher; or
   (c) on a deceased person, when such test is conducted to determine the
 cause of death or for epidemiological purposes; or
   (d) conducted pursuant to section twenty-five hundred-f of this  chap-
 ter; or
   (e)  in  situations  involving  occupational  exposures which create a
 significant risk  of  contracting  or  transmitting  HIV  infection,  as
 defined  in  regulations  of  the  department  and pursuant to protocols
 adopted by the department,
   (i) provided that:
   (A) the person who is the  source  of  the  occupational  exposure  is
 deceased,  comatose or is determined by his or her attending health care
 professional to lack mental capacity to consent to an HIV  related  test
 and is not reasonably expected to recover in time for the exposed person
 to  receive  appropriate medical treatment, as determined by the exposed
 person's attending health care professional who would order  or  provide
 such treatment;
   (B) there is no person available or reasonably likely to become avail-
 able  who  has the legal authority to consent to the HIV related test on
 behalf of the source person in time for the exposed  person  to  receive
 appropriate medical treatment; and
   (C)  the  exposed  person will benefit medically by knowing the source
 person's HIV test results, as determined by the exposed person's  health
 care professional and documented in the exposed person's medical record;
   (ii) in which case
   (A) a provider shall order an anonymous HIV test of the source person;
 and
   (B)  the  results  of such anonymous test, but not the identity of the
 source person, shall be disclosed only  to  the  attending  health  care
 professional  of  the exposed person solely for the purpose of assisting
 the exposed person in making appropriate decisions regarding  post-expo-
 sure medical treatment; and
   (C)  the  results  of  the  test  shall not be disclosed to the source
 person or placed in the source person's medical record.
   7. In the event that an HIV related test is ordered by a physician  or
 certified nurse practitioner pursuant to the provisions of the education
 law  providing  for non-patient specific regimens, then for the purposes
 of this section the individual administering the test shall be deemed to
 be the individual ordering the test.
   § 5. Subdivision 4 of section 6909 of the education law is amended  by
 adding a new paragraph (m) to read as follows:
   (M)  UNDERTAKING  THE  COLLECTION  OF  SPECIMENS  NECESSARY TO TEST TO
 DETERMINE THE PRESENCE OF THE HEPATITIS B VIRUS.
   § 6. Subdivision 6 of section 6527 of the education law is amended  by
 adding a new paragraph (m) to read as follows:
   (M)  UNDERTAKING  THE  COLLECTION  OF  SPECIMENS  NECESSARY TO TEST TO
 DETERMINE THE PRESENCE OF THE HEPATITIS B VIRUS.
   § 7. Section 6801 of the education law is  amended  by  adding  a  new
 subdivision 10 to read as follows:
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   10.  A. A LICENSED PHARMACIST MAY EXECUTE A NON-PATIENT SPECIFIC ORDER
 FOR THE DISPENSING OF HIV PRE-EXPOSURE PROPHYLAXIS (PREP) PRESCRIBED  OR
 ORDERED  BY  THE  COMMISSIONER  OF  HEALTH, A PHYSICIAN LICENSED IN THIS
 STATE OR A NURSE PRACTITIONER CERTIFIED IN THIS STATE PURSUANT TO  RULES
 AND REGULATIONS PROMULGATED BY THE COMMISSIONER.
   B.    PRIOR  TO  DISPENSING HIV PREP TO A PATIENT, AND AT A MINIMUM OF
 EVERY TWELVE MONTHS FOR EACH RETURNING PATIENT, THE PHARMACIST SHALL:
   (I) ENSURE THAT THE PATIENT IS HIV NEGATIVE, AS DOCUMENTED BY A  NEGA-
 TIVE HIV TEST RESULT OBTAINED WITHIN THE PREVIOUS SEVEN DAYS FROM AN HIV
 ANTIGEN/ANTIBODY  TEST  OR ANTIBODY-ONLY TEST OR FROM A RAPID, POINT-OF-
 CARE FINGERSTICK BLOOD TEST APPROVED BY THE FEDERAL FOOD AND DRUG ADMIN-
 ISTRATION. IF THE PATIENT DOES NOT PROVIDE EVIDENCE OF  A  NEGATIVE  HIV
 TEST  IN ACCORDANCE WITH THIS PARAGRAPH, THE PHARMACIST MAY RECOMMEND OR
 PRESCRIBE AN HIV TEST. IF THE PATIENT TESTS POSITIVE FOR HIV  INFECTION,
 THE  PHARMACIST  SHALL  DIRECT  THE  PATIENT TO A LICENSED PHYSICIAN AND
 PROVIDE THE PATIENT WITH A LIST OF HEALTH  CARE  SERVICE  PROVIDERS  AND
 CLINICS  WITHIN  THE  COUNTY WHERE THE PHARMACIST IS LOCATED OR ADJACENT
 COUNTIES;
   (II) PROVIDE THE PATIENT WITH A SELF-SCREENING RISK  ASSESSMENT  QUES-
 TIONNAIRE,  DEVELOPED BY THE COMMISSIONER OF HEALTH IN CONSULTATION WITH
 THE COMMISSIONER, TO BE REVIEWED BY THE PHARMACIST TO IDENTIFY ANY KNOWN
 RISK FACTORS AND ASSIST THE PATIENT'S SELECTION OF AN  APPROPRIATE  PREP
 MEDICATION; AND
   (III)  PROVIDE THE PATIENT WITH A FACT SHEET, DEVELOPED BY THE COMMIS-
 SIONER OF HEALTH, THAT INCLUDES BUT IS  NOT  LIMITED  TO,  THE  CLINICAL
 CONSIDERATIONS  AND  RECOMMENDATIONS  FOR  USE  OF PREP, THE APPROPRIATE
 METHOD FOR USING PREP, INFORMATION ON THE IMPORTANCE OF FOLLOW-UP HEALTH
 CARE, HEALTH CARE REFERRAL INFORMATION, AND THE ABILITY OF  THE  PATIENT
 TO OPT OUT OF PRACTITIONER REPORTING REQUIREMENTS.
   C.  NO  PHARMACIST  SHALL DISPENSE PREP UNDER THIS SUBDIVISION WITHOUT
 RECEIVING TRAINING IN ACCORDANCE WITH  REGULATIONS  PROMULGATED  BY  THE
 COMMISSIONER OF HEALTH IN CONSULTATION WITH THE COMMISSIONER.
   D. A PHARMACIST SHALL NOTIFY THE PATIENT'S PRIMARY HEALTH CARE PRACTI-
 TIONER,  UNLESS THE PATIENT OPTS OUT OF SUCH NOTIFICATION, WITHIN SEVEN-
 TY-TWO HOURS OF DISPENSING PREP, THAT PREP HAS BEEN DISPENSED.   IF  THE
 PATIENT  DOES  NOT HAVE A PRIMARY HEALTH CARE PRACTITIONER, OR IS UNABLE
 TO PROVIDE CONTACT INFORMATION FOR THEIR PRIMARY HEALTH CARE PRACTITION-
 ER, THE PHARMACIST SHALL PROVIDE THE PATIENT WITH A  WRITTEN  RECORD  OF
 THE  PREP  MEDICATIONS  DISPENSED,  AND ADVISE THE PATIENT TO CONSULT AN
 APPROPRIATE HEALTH CARE PRACTITIONER.
   E. NOTHING IN THIS SUBDIVISION SHALL PREVENT A PHARMACIST FROM  REFUS-
 ING  TO  DISPENSE  A NON-PATIENT SPECIFIC ORDER OF PREP PURSUANT TO THIS
 SUBDIVISION  IF,  IN  THEIR  PROFESSIONAL  JUDGMENT,  POTENTIAL  ADVERSE
 EFFECTS, INTERACTIONS, OR OTHER THERAPEUTIC COMPLICATIONS COULD ENDANGER
 THE HEALTH OF THE PATIENT.
   §  8.  Section  6801  of  the education law is amended by adding a new
 subdivision 11 to read as follows:
   11.  A LICENSED PHARMACIST WITHIN THEIR LAWFUL SCOPE OF  PRACTICE  MAY
 ADMINISTER TO PATIENTS EIGHTEEN YEARS OF AGE OR OLDER, IMMUNIZING AGENTS
 TO  PREVENT  MPOX  PURSUANT TO A PATIENT SPECIFIC ORDER OR A NON-PATIENT
 SPECIFIC ORDER.  WHEN A LICENSED PHARMACIST ADMINISTERS AN MPOX IMMUNIZ-
 ING AGENT, THEY SHALL COMPLY WITH SUBDIVISIONS TWO, THREE  AND  FOUR  OF
 THIS SECTION.
   § 9. Section 2307 of the public health law is REPEALED.
   §  10.  This  act  shall  take  effect immediately; provided, however,
 sections one, two, and three of this act shall take effect  on  the  one
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 hundred eightieth day after it shall have become a law.  Effective imme-
 diately, the addition, amendment and/or repeal of any rule or regulation
 necessary  for  the implementation of this act on its effective date are
 authorized to be made and completed on or before such effective date.
 
                                  PART U
 
   Section  1. Section 3302 of the public health law is amended by adding
 a new subdivision 42 to read as follows:
   42. "PUBLIC HEALTH  SURVEILLANCE"  MEANS  THE  CONTINUOUS,  SYSTEMATIC
 COLLECTION,  ANALYSIS,  AND INTERPRETATION OF HEALTH-RELATED DATA NEEDED
 FOR THE PLANNING, IMPLEMENTATION, AND EVALUATION OF PUBLIC HEALTH  PRAC-
 TICE.  PUBLIC  HEALTH  SURVEILLANCE MAY BE USED FOR ALL OF THE FOLLOWING
 PURPOSES:
   (A) AS AN EARLY WARNING SYSTEM FOR IMPENDING  PUBLIC  HEALTH  EMERGEN-
 CIES;
   (B) TO DOCUMENT THE IMPACT OF AN INTERVENTION;
   (C) TO TRACK PROGRESS TOWARDS SPECIFIED GOALS;
   (D) TO MONITOR AND CLARIFY THE EPIDEMIOLOGY OF HEALTH OUTCOMES;
   (E) TO ESTABLISH PUBLIC HEALTH PRIORITIES; AND
   (F) TO INFORM PUBLIC HEALTH POLICY AND STRATEGIES.
   §  2.  Subparagraphs (ix) and (x) of paragraph (a) of subdivision 2 of
 section 3343-a of the public health law, as added by section 2 of part A
 of chapter 447 of the laws of 2012, are amended and a  new  subparagraph
 (xi) is added to read as follows:
   (ix)  a  situation where the registry is not operational as determined
 by the department or where it cannot be accessed by the practitioner due
 to a temporary technological or electrical  failure,  as  set  forth  in
 regulation; [or]
   (x)  a practitioner who has been granted a waiver due to technological
 limitations that are not reasonably within the control  of  the  practi-
 tioner,  or  other  exceptional circumstance demonstrated by the practi-
 tioner, pursuant to a process established  in  regulation,  and  in  the
 discretion of the commissioner[.]; OR
   (XI) A PRACTITIONER PRESCRIBING OR ORDERING A CONTROLLED SUBSTANCE FOR
 USE  ON  THE  PREMISES  OF  A CORRECTIONAL FACILITY, AN INPATIENT MENTAL
 HEALTH FACILITY LICENSED UNDER THE MENTAL HYGIENE LAW, OR A NURSING HOME
 LICENSED UNDER ARTICLE TWENTY-EIGHT OF THIS CHAPTER.
   § 3. Subdivision 4 of section 3370 of the public health law, as  added
 by  chapter  965 of the laws of 1974 and as renumbered by chapter 178 of
 the laws of 2010, is amended to read as follows:
   4. The department shall cause to be expunged or  otherwise  destroyed,
 within  [five] TEN years from the date of receipt thereof, any record of
 the name of any patient received by it pursuant to the  filing  require-
 ments  of  subdivision  six  of section thirty-three hundred thirty-one,
 subdivision four  of  section  thirty-three  hundred  thirty-three,  and
 subdivision  four  of  section  thirty-three hundred thirty-four of this
 article.
   § 4. Subdivision 1 of section  3371  of  the  public  health  law,  as
 amended  by  chapter  178 of the laws of 2010, paragraphs (d) and (e) as
 amended and paragraphs (f), (g), (h), (i), and (j) as added by section 4
 of part A of chapter 447 of the laws of 2012,  is  amended  to  read  as
 follows:
   1.  No person, who has knowledge by virtue of his or her office of the
 identity of a particular patient or research  subject,  a  manufacturing
 S. 8307--A                         124                        A. 8807--A
 
 process,  a  trade secret or a formula shall disclose such knowledge, or
 any report or record thereof, except:
   (a)  to  another  person  employed  by the department, for purposes of
 executing provisions of this article;
   (b) pursuant to judicial subpoena or court order in a criminal  inves-
 tigation or proceeding;
   (c)  to an agency, department of government, or official board author-
 ized to regulate, license or otherwise supervise a person who is author-
 ized by this article to deal in controlled substances, or in the  course
 of  any investigation or proceeding by or before such agency, department
 or board;
   (d) to the prescription monitoring program registry and to  authorized
 users of such registry as set forth in subdivision two of this section;
   (e)  TO  A  VENDOR  OR  CONTRACTOR, AS AUTHORIZED BY THE DEPARTMENT AS
 NECESSARY FOR THE OPERATION AND MAINTENANCE OF THE PRESCRIPTION MONITOR-
 ING PROGRAM REGISTRY;
   (F) to a practitioner to inform him or her that a patient may be under
 treatment with a controlled substance by another  practitioner  for  the
 purposes  of  subdivision  two  of  this  section, and to facilitate the
 department's  review  of  individual  challenges  to  the  accuracy   of
 controlled  substances  histories pursuant to subdivision six of section
 thirty-three hundred forty-three-a of this article;
   [(f)]  (G)  to  a  pharmacist   to   provide   information   regarding
 prescriptions  for controlled substances presented to the pharmacist for
 the purposes of subdivision two of this section and  to  facilitate  the
 department's   review  of  individual  challenges  to  the  accuracy  of
 controlled substances histories pursuant to subdivision six  of  section
 thirty-three hundred forty-three-a of this article;
   [(g)]  (H)  to the deputy attorney general for medicaid fraud control,
 or his or her designee, in furtherance of  an  investigation  of  fraud,
 waste  or  abuse  of the Medicaid program, pursuant to an agreement with
 the department;
   [(h)] (I) TO A PROGRAM AREA WITHIN THE DEPARTMENT FOR THE  PURPOSE  OF
 CONDUCTING PUBLIC HEALTH RESEARCH, PUBLIC HEALTH SURVEILLANCE, OR EDUCA-
 TION WITH DATA CONTAINED IN THE PRESCRIPTION MONITORING PROGRAM REGISTRY
 AND NOT FOR PATIENT-LEVEL OUTREACH:
   (I) PURSUANT TO AN AGREEMENT WITH THE COMMISSIONER;
   (II) WHEN THE RELEASE OF SUCH INFORMATION IS DEEMED APPROPRIATE BY THE
 COMMISSIONER;
   (III) FOR USE IN ACCORDANCE WITH MEASURES REQUIRED BY THE COMMISSIONER
 TO  ENSURE  THAT  THE  SECURITY  AND  CONFIDENTIALITY  OF  THE  DATA  IS
 PROTECTED;
   (IV) FOR USE AND RETENTION NO LONGER THAN TEN YEARS; AND
   (V) PROVIDED THAT DISCLOSURE IS RESTRICTED TO INDIVIDUALS  WITHIN  THE
 DEPARTMENT  WHO  ARE  ENGAGED  IN  PUBLIC HEALTH RESEARCH, PUBLIC HEALTH
 SURVEILLANCE, OR EDUCATION;
   (J) to a local health department for the purpose of conducting  public
 health  research,  PUBLIC  HEALTH SURVEILLANCE, or education AND NOT FOR
 PATIENT-LEVEL OUTREACH:
   (i) pursuant to an agreement with the commissioner;
   (ii) when the release of such information is deemed appropriate by the
 commissioner;
   (iii) for use in accordance with measures required by the commissioner
 to  ensure  that  the  security  and  confidentiality  of  the  data  is
 protected;
   (IV) FOR USE AND RETENTION NO LONGER THAN TEN YEARS; and
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   [(iv)] (V) provided that disclosure is restricted to individuals with-
 in the local health department who are engaged in the research or educa-
 tion;
   [(i)]  (K)  to  a  medical examiner or coroner who is an officer of or
 employed by a state or local government, pursuant to his or her official
 duties; and
   [(j)] (L) to an individual for the purpose of providing such  individ-
 ual  with his or her own controlled substance history or, in appropriate
 circumstances, in the case of a  patient  who  lacks  capacity  to  make
 health  care  decisions,  a  person who has legal authority to make such
 decisions for the patient  and  who  would  have  legal  access  to  the
 patient's health care records, if requested from the department pursuant
 to subdivision six of section thirty-three hundred forty-three-a of this
 article or from a treating practitioner pursuant to subparagraph (iv) of
 paragraph (a) of subdivision two of this section.
   §  5.  Subdivision  (b)  of  schedule  I of section 3306 of the public
 health law is amended by adding eleven new paragraphs 93,  94,  95,  96,
 97, 98, 99, 100, 101, 102 and 103 to read as follows:
   (93) 1-METHOXY-3-{4-(2-METHOXY-2-PHENYLETHYL)PIPERAZIN-1-YL}-1-PHENYLP
 ROPAN-2-OL. OTHER NAME: ZIPEPROL.
   (94) N,N-DIETHYL-2-(2-(4-METHOXYBENZYL)-5-NITRO-1H-BENZIMIDAZOL-1-YL)E
 THAN-1-AMINE. OTHER NAMES: METONITAZENE.
   (95) META-FLUOROFENTANYL (N-(3-FLUOROPHENYL)-N-(1-PHENETHYLPIPERIDIN-4
 -YL)PROPIONAMIDE).
   (96) META-FLUOROISOBUTYRYL FENTANYL (N-(3-FLUOROPHENYL)-N-(1-PHENETHY
 LPIPERIDIN-4-YL)ISOBUTYRAMIDE).
   (97) PARA-METHOXYFURANYL  FENTANYL (N-(4-METHOXYPHENYL)-N-(1-PHENETHYL
 PIPERIDIN-4-YL)FURAN-2-CARBOXAMIDE).
   (98) 3-FURANYL FENTANYL (N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLFURAN-
 3-CARBOXAMIDE).
   (99) 2',5'-DIMETHOXYFENTANYL (N-(1-(2,5-DIMETHOXYPHENETHYL)PIPERIDIN-4
 -YL)-N-PHENYLPROPIONAMIDE).
   (100) ISOVALERYL FENTANYL (3-METHYL-N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PH
 ENYLBUTANAMIDE).
   (101) ORTHO-FLUOROFURANYL FENTANYL (N-(2-FLUOROPHENYL)-N-(1-PHENETHYLP
 IPERIDIN-4-YL)FURAN-2-CARBOXAMIDE).
   (102) ALPHA'-METHYL BUTYRYL FENTANYL (2-METHYL-N-(1-PHENETHYLPIPERIDIN
 -4-YL)-N-PHENYLBUTANAMIDE).
   (103) PARA-METHYLCYCLOPROPYL FENTANYL (N-(4-METHYLPHENYL)-N-(1-PHENETH
 YLPIPERIDIN-4-YL)CYCLOPROPANECARBOXAMIDE).
   § 6. Paragraphs 11 and 36 of subdivision (d) of schedule I of  section
 3306  of  the public health law, paragraph 11 as added by chapter 664 of
 the laws of 1985 and paragraph 36 as added by section 5 of  part  BB  of
 chapter 57 of the laws of 2018, are amended to read as follows:
   (11) [Ibogane]  IBOGAINE.  Some trade and other names: [7-ethyl-6, 6&,
 7,  8,  9,   10,   12,   13-octahydro-2-methoxy-6,   9-methano-5h-pyrido
 {1',2':1,2}     azepino     {5,4-b}    indole:    tabernanthe    iboga.]
 7-ETHYL-6,6&,7,8,9,10,12,13-OCTAHYDRO-2-METHOXY-6,9-METHANO-5H-PYRIOD{1'
 ,2':1,2} AZEPINO {5,4-B} INDOLE; TABERNANTHE IBOGA.
   (36) 5-methoxy-N,N-dimethyltryptamine.  SOME  TRADE  OR  OTHER  NAMES:
 5-METHOXY-3-{2-(DIMETHYLAMINO)ETHYL}INDOLE; 5-MEO-DMT.
   §  7.  Subdivision  (d)  of  schedule  I of section 3306 of the public
 health law is amended by adding nineteen new paragraphs 32, 39, 40,  41,
 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55 and 56 to read as
 follows:
   (32) 4-METHYL-N-ETHYLCATHINONE.  SOME TRADE OR OTHER NAMES: 4-MEC.
 S. 8307--A                         126                        A. 8807--A
 
   (39)  4-METHYL-ALPHA-PYRROLIDINOPROPIOPHENONE.  SOME  TRADE  OR  OTHER
 NAMES:  4-MEPPP.
   (40) ALPHA-PYRROLIDINOPENTIOPHENONE. SOME TRADE OR OTHER NAMES: @-PVP.
   (41)  1-(1,3-BENZODIOXOL-5-YL)-2-(METHYLAMINO)BUTAN-1-ONE.  SOME TRADE
 OR OTHER NAMES: BUTYLONE; BK-MBDB.
   (42) 2-(METHYLAMINO)-1-PHENYLPENTAN-1-ONE. SOME TRADE OR OTHER  NAMES:
 PENTEDRONE.
   (43)  1-(1,3-BENZODIOXOL-5-YL)-2-(METHYLAMINO)PENTAN-1-ONE. SOME TRADE
 OR OTHER NAMES: PENTYLONE; BK-MBDP.
   (44) 1-(NAPHTHALEN-2-YL)-2-(PYRROLIDIN-1-YL)PENTAN-1-ONE.  SOME  TRADE
 OR OTHER NAMES: NAPHYRONE.
   (45) ALPHA-PYRROLIDINOBUTIOPHENONE. SOME TRADE OR OTHER NAMES: @-PBP.
   (46) 1-(1,3-BENZODIOXOL-5-YL)-2-(ETHYLAMINO)PROPAN-1-ONE (ETHYLONE).
   (47)  N-ETHYLPENTYLONE.    SOME  TRADE  OR  OTHER  NAMES:    EPHYLONE,
 1-(1,3-BENZODIOXOL-5-YL)-2-(ETHYLAMINO)PENTAN-1-ONE).
   (48) 1-(4-METHOXYPHENYL)-N-METHYLPROPAN-2-AMINE. SOME TRADE  OR  OTHER
 NAMES: PARA-METHOXYMETHAMPHETAMINE; PMMA.
   (49)    N-ETHYLHEXEDRONE.        SOME    TRADE    OR    OTHER   NAMES:
 @-ETHYLAMINOHEXANOPHENONE; 2-(ETHYLAMINO)-1-PHENYLHEXAN-1-ONE.
   (50) ALPHA-PYRROLIDINOHEXANOPHENONE. SOME TRADE OR OTHER NAMES: @-PHP;
 ALPHA-PYRROLIDINOHEXANOPHENONE; 1-PHENYL-2-(PYRROLIDIN-1-YL)HEXAN-1-ONE.
   (51) 4-METHYL-ALPHA-ETHYLAMINOPENTIOPHENONE.    SOME  TRADE  OR  OTHER
 NAMES:  4-MEAP; 2-(ETHYLAMINO)-1-(4-METHYLPHENYL)PENTAN-1-ONE.
   (52)  4'-METHYL-ALPHA-PYRROLIDINOHEXIOPHENONE.     SOME TRADE OR OTHER
 NAMES:          MPHP;          4'-METHYL-ALPHA-PYRROLIDINOHEXANOPHENONE;
 1-(4-METHYLPHENYL)-2-(PYRROLIDIN-1-YL)HEXAN-1-ONE.
   (53)  ALPHA-PYRROLIDINOHEPTAPHENONE.   SOME TRADE OR OTHER NAMES: PV8;
 1-PHENYL-2-(PYRROLIDIN-1-YL)HEPTAN-1-ONE.
   (54) 4'-CHLORO-ALPHA-PYRROLIDINOVALEROPHENONE.  SOME  TRADE  OR  OTHER
 NAMES:       4-CHLORO-@-PVP;   4'-CHLORO-ALPHA-PYRROLIDINOPENTIOPHENONE;
 1-(4-CHLOROPHENYL)-2-(PYRROLIDIN-1-YL)PENTAN-1-ONE.
   (55) 2-(ETHYLAMINO)-2-(3-METHOXYPHENYL)CYCLOHEXAN-1-ONE (METHOXETAMIN
 E, MXE).
   (56) 1-(1,3-BENZODIOXOL-5-YL)-2-(ETHYLAMINO)BUTAN-1-ONE. SOME TRADE OR
 OTHER NAMES: EUTYLONE; BK-EBDB.
   § 8. Subdivision (e) of schedule I  of  section  3306  of  the  public
 health  law  is amended by adding five new paragraphs 7, 8, 9, 10 and 11
 to read as follows:
   (7) 4-(2-CHLOROPHENYL)-2-ETHYL-9-METHYL-6H-THIENO{3,2-F}{1,2,4}TRIAZOL
 O{4,3-{ALPHA}}{1,4}DIAZEPINE. SOME TRADE OR OTHER NAMES: ETIZOLAM.
   (8) 8-CHLORO-6-(2-FLUOROPHENYL)-1-METHYL-4H-BENZO{F}{1,2,4}TRIAZOLO{4,
 3-{ALPHA}}{1,4}DIAZEPINE. SOME TRADE OR OTHER NAMES: FLUALPRAZOLAM.
   (9) 6-(2-CHLOROPHENYL)-1-METHYL-8-NITRO-4H-BENZO{F}{1,2,4}TRIAZOLO{4,3
 -{ALPHA}}{1,4}DIAZEPINE. SOME TRADE OR OTHER NAMES: CLONAZOLAM.
   (10) 8-BROMO-6-(2-FLUOROPHENYL)-1-METHYL-4H-BENZO{F}{1,2,4}TRIAZOLO{4,
 3-{ALPHA}}{1,4}DIAZEPINE.  SOME TRADE OR OTHER NAMES: FLUBROMAZOLAM.
   (11) 7-CHLORO-5-(2-CHLOROPHENYL)-1-METHYL-1,3-DIHYDRO-2H-BENZO{E}{1,4}
 DIAZEPIN-2-ONE. SOME TRADE OR OTHER NAMES: DICLAZEPAM.
   § 9. Paragraphs 13 and 14 of subdivision (f) of schedule I of  section
 3306  of  the  public health law, as added by chapter 341 of the laws of
 2013, are amended and four new paragraphs 25, 26, 27 and 28 are added to
 read as follows:
   (13) 3-Fluoromethcathinone. SOME  TRADE  OR  OTHER  NAMES:  3-FLUORO-N
 -METHYLCATHINONE; 3-FMC.
   (14) 4-Fluoromethcathinone. SOME TRADE OR OTHER NAMES:  4-FLUORO-N-ME-
 THYLCATHINONE; 4-FMC; FLEPHEDRONE.
 S. 8307--A                         127                        A. 8807--A
 
   (25) 7-{(10,11-DIHYDRO-5H-DIBENZO{A,D}CYCLOHEPTEN-5-YL)AMINO}HEPTANOIC
 ACID. OTHER NAME: AMINEPTINE.
   (26)  N-PHENYL-N'-(3-(1-PHENYLPROPAN-2-YL)-1,2,3-OXADIAZOL-3-IUM-5-YL)
 CARBAMIMIDATE. OTHER NAME: MESOCARB.
   (27) N-METHYL-1-(THIOPHEN-2-YL)PROPAN-2-AMINE.  OTHER NAME: METHIOPRO-
 PAMINE.
   (28) 4,4'-DIMETHYLAMINOREX.   SOME TRADE OR  OTHER  NAMES:  4,4'-DMAR;
 4,5-DIHYDRO-4-METHYL-5-(4-METHYLPHENYL)-2-OXAZOLAMINE; 4-METHYL-5-(4-MET
 HYLPHENYL)-4,5-DIHYDRO-1,3-OXAZOL-2-AMINE.
   §  10.  Paragraphs  2,  6  and  10 of subdivision (g) of schedule I of
 section 3306 of the public health law, as added by section 7 of part  BB
 of chapter 57 of the laws of 2018, are amended to read as follows:
   (2) [{1-(5-fluro-pentyl)-1H-indol-3-yl}(2,2,3,3-tetramethylcyclopropyl)
 methanone.]      {1-(5-FLUORO-PENTYL)-1H-INDOL-3-YL}(2,2,3,3-TETRAMETHYL
 CYCLOPROPYL)METHONE.    Some    trade    names    or    other     names:
 5-fluoro-UR-144[,]; XLR11.
   (6) [N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(4-fluorobenzyl)-1H-indazo
 [-]le-3-carboxamide.]  N-(1-AMINO-3-METHYL-1-OXOBUTAN-2-YL)-1-(4-FLUOROB
 ENZYL)-1H-INDAZO[-]LE-3-CARBOXAMIDE. Some  trade  or  other  names:  AB-
 FUBINACA.
   (10) [{1-(5-fluoropentyl)-1H-indazol-3-yl}(naphthalen-1- [y1] YL)meth-
 anone.]       {1-(5-FLUOROPENTYL)-1H-INDAZOL     -3-YL}(NAPHTHALEN-1-[y1
 ]YL)METHANONE.
 Some trade or other names: THJ-2201.
   § 11. Subdivision (g) of schedule I of  section  3306  of  the  public
 health  law is amended by adding nineteen new paragraphs 11, 12, 13, 14,
 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28 and 29 to read as
 follows:
   (11) N-(1-AMINO-3,3-DIMETHYL-1-OXOBUTAN-2-YL)-1-(CYCLOHEXYLMETHYL)-1H-
 INDAZOLE-3-CARBOXAMIDE. SOME  TRADE  OR   OTHER   NAMES:   MAB-CHMINACA;
 ADB-CHMINACA.
   (12) METHYL 2-(1-(4-FLUOROBENZYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3-METHYLB
 UTANOATE. SOME TRADE OR OTHER NAMES: FUB-AMB; MMB-FUBINACA; AMBFUBINACA.
   (13) METHYL 2-(1-(CYCLOHEXYLMETHYL)-1H-INDOLE-3-CARBOXAMIDO)-3,3-
 DIMETHYLBUTANOATE. SOME TRADE OR OTHER NAMES: MDMB-CHMICA; MMB-CHMINACA.
   (14) METHYL 2-(1-(4-FLUOROBENZYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3,3-
 DIMETHYLBUTANOATE. SOME TRADE OR OTHER NAMES: MDMB-FUBINACA.
   (15) N-(1-AMINO-3,3-DIMETHYL-1-OXOBUTAN-2-YL)-1-(4-FLUOROBENZYL)-1H-IN
 DAZOLE-3-CARBOXAMIDE. SOME TRADE OR OTHER NAMES: ADB-FUBINACA.
   (16)  N-(ADAMANTAN-1-YL)-1-(5-FLUOROPENTYL)-1H-INDAZOLE-3-CARBOXAMIDE.
 SOME TRADE OR OTHER NAMES: 5F-APINACA; 5F-AKB48.
   (17)  METHYL   2-(1-(5-FLUOROPENTYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3-METH
 YLBUTANOATE. SOME TRADE OR OTHER NAMES: 5F-AMB.
   (18) METHYL 2-(1-(5-FLUOROPENTYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3,3-
 DIMETHYLBUTANOATE. SOME TRADE OR OTHER NAMES: 5F-ADB; 5F-MDMB-PINACA.
   (19)  NAPHTHALEN-1-YL 1-(5-FLUOROPENTYL)-1H-INDOLE-3-CARBOXYLATE. SOME
 TRADE OR OTHER NAMES: NM2201; CBL2201.
   (20) N-(1-AMINO-3-METHYL-1-OXOBUTAN-2-YL)-1-(5-FLUOROPENTYL)-1H-INDAZOL
 E-3-CAR BOXAMIDE.  SOME TRADE OR OTHER NAMES: 5F-AB-PINACA.
   (21) 1-(4-CYANOBUTYL)-N-(2-PHENYLPROPAN-2-YL)-1H-INDAZOLE-3-CARBOXAMID
 E. SOME TRADE OR OTHER NAMES: 4-CN-CUMYL-BUTINACA;
 4-CYANO-CUMYL-BUTINACA; 4-CN-CUMYL BINACA; CUMYL-4CN-BINACA; SGT-78.
   (22) METHYL  2-(1-(CYCLOHEXYLMETHYL)-1H-INDOLE-3-CARBOXAMIDO)-3-METHYL
 BUTANOATE. SOME TRADE OR OTHER NAMES: MMB-CHMICA; AMB-CHMICA.
   (23) 1-(5-FLUOROPENTYL)-N-(2-PHENYLPROPAN-2-YL)-1H-PYRROLO{2,3-B}PYRID
 INE-3-CARBOXAMIDE. SOME TRADE OR OTHER NAMES: 5F-CUMYL-P7AICA.
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   (24)  METHYL 2-(1-(4-FLUOROBUTYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3,3-DIMET
 HYLBUTANOATE.  SOME  TRADE   OR   OTHER  NAMES:   4F-MDMB-BINACA;       
 4F-MDMB-BUTINACA.
   (25)  ETHYL 2-(1-(5-FLUOROPENTYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3,3-DIMET
 HYLBUTANOATE.  SOME TRADE OR OTHER NAMES: 5F-EDMB-PINACA.
   (26) METHYL  2-(1-(5-FLUOROPENTYL)-1H-INDOLE-3-CARBOXAMIDO)-3,3-DIMETH
 YLBUTANOATE.  SOME TRADE OR OTHER NAMES: 5F-MDMB-PICA; 5F-MDMB-2201.
   (27)  N-(ADAMANTAN-1-YL)-1-(4-FLUOROBENZYL)-1H-INDAZOLE-3-CARBOXAMIDE.
 SOME   TRADE   OR   OTHER   NAMES:   FUB-AKB48;    FUB-APINACA;    AKB48
 N-(4-FLUOROBENZYL).
   (28)   1-(5-FLUOROPENTYL)-N-(2-PHENYLPROPAN-2-YL)-1H-INDAZOLE-3-CARBOX
 AMIDE. SOME TRADE OR OTHER NAMES: 5F-CUMYL-PINACA; SGT-25.
   (29) (1-4-FLUOROBENZYL)-1H-INDOL-3-YL)(2,2,3,3-TETRAMETHYLCYCLOPROPYL)
 METHANONE. SOME TRADE OR OTHER NAMES: FUB-144.
   § 12. Paragraph 1 of subdivision (b) of schedule II of section 3306 of
 the public health law, as amended by section 1 of part C of chapter  447
 of the laws of 2012, is amended to read as follows:
   (1)  Opium and opiate, and any salt, compound, derivative, or prepara-
 tion of opium or opiate, excluding apomorphine, dextrorphan, nalbuphine,
 NALDEMEDINE,  nalmefene,  NALOXEGOL,   naloxone,   [and]   6&-NALTREXOL,
 naltrexone,  AND  SAMIDORPHAN, and their respective salts, but including
 the following:
   1. Raw opium.
   2. Opium extracts.
   3. Opium fluid.
   4. Powdered opium.
   5. Granulated opium.
   6. Tincture of opium.
   7. Codeine.
   8. Ethylmorphine.
   9. Etorphine hydrochloride.
   10. Hydrocodone (also known as dihydrocodeinone).
   11. Hydromorphone.
   12. Metopon.
   13. Morphine.
   14. Oxycodone.
   15. Oxymorphone.
   16. Thebaine.
   17. Dihydroetorphine.
   18. Oripavine.
   19. NOROXYMORPHONE.
   § 13. Subdivision (c) of schedule II of section  3306  of  the  public
 health law is amended by adding a new paragraph 30 to read as follows:
   (30)    OLICERIDINE.   (N-{(3-METHOXYTHIOPHEN-2-YL)METHYL}({2-{(9R)-9-
 (PYRIDIN-2-YL)-6-OXASPIRO{4.5}DECAN-9-YL}ETHYL})AMINE).
   § 14. Subdivision (f) of schedule II of section  3306  of  the  public
 health  law, as amended by chapter 589 of the laws of 1996, the undesig-
 nated paragraph as amended by chapter  575  of  the  laws  of  2001,  is
 amended to read as follows:
   (f) Hallucinogenic substances.
   (1)    [Nabilone:    Another    name    for    nabilone:   (+,-)-trans
 -3-(1,1-dimethylheptyl)-6,  6a,  7,  8,  10,  10a-hexahydro-1-hydroxy-6,
 6-dimethyl-9H-dibenzo{b,d}pyran-9-one.] NABILONE. ANOTHER NAME FOR NABI-
 LONE. +,-)-TRANS-3-(1,1-DIMETHYLHEPTYL)-6,6A,7,8,10,10A-HEX AHYDRO-1-HYD
 ROXY-6,6-DIMETHYL-9H-DIBENZO{B,D}PYRAN-9-ONE.
 S. 8307--A                         129                        A. 8807--A
 
   (2)  DRONABINOL  {(-)-DELTA-9-TRANS  TETRAHYDROCANNABINOL}  IN AN ORAL
 SOLUTION IN A DRUG PRODUCT APPROVED FOR MARKETING BY THE  UNITED  STATES
 FOOD AND DRUG ADMINISTRATION.
   §  15.  Subparagraph (i) of paragraph 3 of subdivision (g) of schedule
 II of section 3306 of the public health law, as amended by section 2  of
 part  BB  of  chapter  57  of  the  laws  of 2023, is amended to read as
 follows:
   (i)  [4-anilino-N-phenenethylpiperidine]   [(ANPP)]   4-ANILINO-N-PHEN
 ETHYLPIPERIDINE (ANPP)..
   §  16.  Subdivision  (h)  of schedule II of section 3306 of the public
 health law, as amended by section 8 of part C of chapter 447 of the laws
 of 2012, is amended to read as follows:
   (h) (1) Anabolic steroids.  Unless  specifically  excepted  or  unless
 listed  in  another  schedule, "anabolic steroid" shall mean any drug or
 hormonal substance, chemically and pharmacologically related to  testos-
 terone  (other than estrogens, progestins, corticosteroids and dehydroe-
 piandrosterone) and includes:
   [(1)] (I) [3{beta}, 17-dihydroxy-5a-androstane] 3{BETA},17{BETA}-DIHYD
 ROXY-5{ALPHA}-ANDROSTANE.
   [(2)] (II)  [3{alpha},  17{beta}-dihydroxy-5a-androstane]  3{ALPHA},17
 {BETA}-DIHYDROXY-5{ALPHA}-ANDROSTANE.
   [(3)] (III) 5{alpha}-androstan-3,17-dione.
   [(4)] (IV) 1-androstenediol (3{beta},17{beta}-dihydroxy-5
 {alpha}-androst-1- ene).
   [(5)] (V) 1-androstenediol (3{alpha},17{beta}-dihydroxy-5
 {alpha}-androst-1- ene).
   [(6)] (VI) 4-androstenediol [(3{beta}, 17{beta}-dihydroxy-androst
 -4-ene)] (3{BETA},17{BETA}-DIHYDROXY-ANDROST-4-ENE).
   [(7)] (VII)   5-androstenediol [(3{beta}, 17{beta}-dihydroxy- androst-
 5-ene)]  (3{BETA},17{BETA}-DIHYDROXY-ANDROST-5-ENE).
   [(8)] (VIII) 1-androstenedione [({5{alpha}}-androst-1-en-3, 17-dione)]
 (5{ALPHA}-ANDROST-1-EN-3,17-DIONE).
   [(9)] (IX) 4-androstenedione (androst-4-en-3,17-dione).
   [(10)] (X) 5-androstenedione (androst-5-en-3,17-dione).
   [(11)] (XI) Bolasterone [(7{alpha},17{alpha}-dimethyl-17{beta}-
 hydroxyandrost-4-en-3-one)]  (7{ALPHA},17{ALPHA}-DIMETHYL-17{BETA}-HYDRO
 XYANDROST-4-EN-3-ONE).
   [(12)] (XII) Boldenone  [(17{beta}-hydroxyandrost-1,  4,-diene-3-one)]
 (17{BETA}-HYDROXYANDROST-1,4,-DIENE-3-ONE).
   [(13)] (XIII) Boldione (androsta-1,4-diene-3,17-dione).
   [(14)]  (XIV)  Calusterone [(7{beta}, 17{alpha}-dimethyl-17{b -hydrox-
 yandrost-4-en-3-one)]   (7{BETA},17{ALPHA}-DIMETHYL-17{BETA}-HYDROXYANDR
 OST-4-EN-3-ONE).
   [(15)] (XV) Clostebol [(4-chloro-17{beta}-hydroxyandrost-4-en-3-o ne)]
 (4-CHLORO-17{BETA}-HYDROXYANDROST-4-EN-3-ONE).
   [(16)] (XVI) Dehydrochloromethyltestosterone (4-chloro-17
 {beta}-hydroxy-17{alpha}-methyl-androst-1, 4-dien- 3-one).
   [(17)] (XVII) [{Delta} 1-dihydrotestosterone]  {DELTA}1-DIHYDROTESTOST
 ERONE (a.k.a. '1-testosterone') (17{beta}-hydroxy-5{alpha}-androst-1-en-
 3-one).
   [(18)] (XVIII) 4-dihydrotestosterone (17{beta}-hydroxy-
 androstan-3-one).
   [(19)] (XIX) Drostanolone (17{beta}-hydroxy-2{alpha}-methyl
 -5{alpha} -androstan-3-one).
   [(20)] (XX) Ethylestrenol (17{alpha}-ethyl-17{beta}-hydroxy
 estr-4-ene).
 S. 8307--A                         130                        A. 8807--A

   [(21)] (XXI) Fluoxymesterone [(9-fluoro-17{alpha}-methyl-11{beta},
 17 {beta}-dihydroxyandrost-4-en-3-one)]      (9-FLUORO-17{ALPHA}-METHYL-
 11{BETA},17{BETA}-DIHYDROXYANDROST-4-EN-3-ONE).
   [(22)] (XXII) Formebolone [(2-formyl-17{alpha}-methyl-11{alpha},
 17{beta}-dihydroxyandrost-1,  4-dien-3-one)]  (2-FORMYL-17{ALPHA}-METHYL
 -11{ALPHA},17{BETA}-DIHYDROXYANDROST-1,4-DIEN-3-ONE).
   [(23)] (XXIII) Furazabol [(17{alpha}-methyl-17{beta}-hydroxyandro
 stano {2, 3-c}-furazan)]    (17{ALPHA}-METHYL-17{BETA}-HYDROXYANDROSTANO
 {2,3-C}-FURAZAN).
   [(24)] (XXIV) [13{beta}-ethyl-17{beta}-hyroxygon-4-en-3-one] 13{BETA}-
 ETHYL-17{BETA}-HYDROXYGON-4-EN-3-ONE.
   [(25)] (XXV) 4-hydroxytestosterone [(4, 17{beta}-dihydroxy-andros
 t-4-en-3-one)] (4,17{BETA}-DIHYDROXY-ANDROST-4-EN-3-ONE).
   [(26)] (XXVI) 4-hydroxy-19-nortestosterone [(4,17{beta}-dihydroxy
 -estr-4-en-3-one)] (4,17{BETA}-DIHYDROXYESTR-4-EN-3-ONE).
   [(27)] (XXVII) [desoxymethyltestosterone]     DESOXYMETHYLTESTOSTERONE
 (17{alpha}-methyl-5 {alpha}-androst-2-en-17{beta}-ol) (a.k.a.,  [madol)]
 'MADOL').
   [(28)] (XXVIII) Mestanolone [(17{alpha}-methyl-17{beta}-hydroxy-
  5-androstan-3-one)]      (17{ALPHA}-METHYL-17{BETA}-HYDROXY-5-ANDROSTAN
 -3-ONE).
   [(29)] (XXIX) Mesterolone [(1{alpha}methyl-17{beta}-hydroxy-
 {5{alpha}}-androstan-3-one)]  (1{ALPHA}-METHYL-17{BETA}-HYDROXY-5{ALPHA}
 -ANDROSTAN-3-ONE).
   [(30)] (XXX) Methandienone [(17{alpha}-methyl-17{beta}-hydroxyand
 rost-1,    4-dien-3-one)]   (17{ALPHA}-METHYL-17{BETA}-HYDROXYANDROST-1,
 4-DIEN-3-ONE.
   [(31)] (XXXI) Methandriol [(17{alpha}-methyl-3{beta}, 17
 {beta}-dihydroxyandrost-5-ene)]      (17{ALPHA}-METHYL-3{BETA},17{BETA}-
 DIHYDROXYANDROST-5-ENE).
   [(32)] (XXXII)      Methenolone [(1-methyl- 17{beta}-hydroxy-5 {alpha}
 -androst- 1-en-3-one)]  (1-METHYL-17{BETA}-HYDROXY-5  {ALPHA}-ANDROST-1-
 EN-3-ONE).
   [(33)] (XXXIII) [17{alpha}-methyl-3{beta},17{beta}-dihydroxydroxy
 oxy- 5a-androstane]       17{ALPHA}-METHYL-3{BETA},17{BETA}-DIHYDROXY-5A
 {ALPHA}-ANDROSTANE.
   [(34)] (XXXIV) [17{alpha}-methyl-3{alpha}, 17{beta}- dihydroxy- 5a-an-
 drostane]   17{ALPHA}-METHYL-3{ALPHA},17{BETA}-DIHYDROXY5A{ALPHA}-ANDROS
 TANE
   [(35)] (XXXV) [17{alpha}-methyl-3{beta}, 17{beta}-dihyd
 roxyandrost-4-ene.]   17{ALPHA}-METHYL-3{BETA},17{BETA}-DIHYDROXYANDROST
 -4-ENE.
   [(36)] (XXXVI)        [17{alpha}-methyl-4-hydroxynandrolone(17{alpha}-
 methyl-4-hydroxy-17{beta}-hydroxyestr-4-en-3-one).]     17{ALPHA}-METHYL
 -4-HYDROXYNANDROLONE(17{ALPHA}-METHYL-4-HYDROXY-17{BETA}-HYDROXYESTR-4-
 EN-3-ONE).
   [(37)] (XXXVII) Methyldienolone [(17{alpha}-methyl-17{beta}   -hydrox-
 yestra- 4,9(10)-dien-3-one).]    (17{ALPHA}-METHYL-17{BETA}-HYDROXYES-TR
 A-4,9(10)-DIEN-3-ONE).
   [(38)]  (XXXVIII) Methyltrienolone [(17{alpha}-methyl-17{beta}-hydroxy
 estra-4,9-11-trien-3-one).]   (17{ALPHA}-METHYL-17{BETA}-HYDROXYESTRA-4,
 9-11-TRIEN-3-ONE).
   [(39)] (XXXIX) Methyltestosterone(17{alpha}-methyl-17{beta}   -hydrox-
 yandrost-4-en-3-one).
   [(40)] (XL) Mibolerone (7{alpha},17{alpha}-dimethyl-17
 {beta}-hydroxyestr-4-en-3-one).
 S. 8307--A                         131                        A. 8807--A
 
   [(41)] (XLI) [17{alpha}-methyl-{Delta} 1-dihydrotestosterone(17b{beta}
 -hydroxy-17{alpha}-methyl-5{alpha}-androst-1-en-3-one)]       17{ALPHA}-
 METHYL-{DELTA}1-DIHYDROTESTOSTERONE(17{BETA}-HYDROXY-17{ALPHA}-METHYL-5{
 ALPHA}-ANDROST-1-EN-3-ONE) (a.k.a. '17-{alpha}-methyl-1-testosterone').
   [(42)] (XLII) [Nandrolone(17{beta}-hydroxyestr-4-en-3-one).]   NANDRO-
 LONE (17{BETA}-HYDROXYESTR-4-EN-3-ONE).
   [(43)] (XLIII) 19-nor-4-androstenediol [(3{beta},17{beta}-dihydro
 xyestr- 4-ene).] (3{BETA},17{BETA}-DIHYDROXYESTR-4-ENE).
   [(44)] (XLIV) 19-nor-4-androstenediol [(3{alpha},17{beta}-dihydrox-
 yestr-4-ene).] (3{ALPHA},17{BETA}-DIHYDROXYESTR-4 -ENE).
   [(45)] (XLV) 19-nor-5-androstenediol [(3{beta},17{bet           a}.ct-
 dihydroxyestr -5-ene).] (3{BETA},17{BETA}-DIHYDROXYESTR-5- ENE).
   [(46)] (XLVI) 19-nor-5-androstenediol [(3{alpha},17{beta}-dihydrox-
 yestr-5-ene).] (3{ALPHA},17{BETA}-DIHYDROXYESTR-5-ENE).
   [(47)] (XLVII) [19-nor-4,9(10)-androstadienedione (estra-4,9(10)-
 diene-3,17-dione).]      19-NOR-4,9(10)-ANDROSTADIENEDIONE(ESTRA-4,9(10)
 -DIENE-3,17-DIONE).
   [(48)] (XLVIII) 19-nor-4-androstenedione (estr-4-en-3,17-dione).
   [(49)] (XLIX) 19-nor-5-androstenedione (estr-5-en-3,17-dione).
   [(50)] (L) Norbolethone [(13{beta}, 17{alpha}-diethyl-17
 {beta} -hydroxygon-4-en-3-one).]
   (13{BETA},17{ALPHA}-DIETHYL-17{BETA}-HYDROXYGON-4-EN-3-ONE).
   [(51)] (LI) Norclostebol [(4-chloro-17{beta}-hydroxyestr-4-
 en-3-one).] (4-CHLORO-17{BETA}-HYDROXYESTR-4-EN-3-ONE).
   [(52)] (LII) Norethandrolone (17{alpha}-ethyl-17{beta}-hydroxyes
 tr-4-en-3-one).
   [(53)] (LIII) Normethandrolone [(17 {alpha}-methyl-17{beta}-hydrox
 estr-4-en-3-one).] (17{ALPHA}-METHYL-17{BETA}-HYDROXYESTR-4-EN-3-ONE).
   [(54)] (LIV) Oxandrolone [(17{alpha}-methyl-17{beta}-hydroxy-2-
 oxa- {5{alpha}}-androstan-3-one).]
   (17{ALPHA}-METHYL-17{BETA}-HYDROXY-2-OXA-5{ALPHA}-ANDROSTAN-3-ONE).
   [(55)] (LV) Oxymesterone [(17{alpha}-methyl-4, 17 {beta}-dihydroxy
 androst-4-en-3-one).]
   (17{ALPHA}-METHYL-4,17{BETA}-DIHYDROXYANDROST-4-EN-3-ONE).
   [(56)] (LVI) Oxymetholone [(17 {alpha}-methyl-2-hydroxymet
 hylene-17 {beta}-hydroxy-{5{alpha}}- androstan-3-one).]      (17{ALPHA}-
 METHYL-2-HYDROXYMETHYLENE-17{BETA}-HYDROXY-5{ALPHA}-ANDROST AN-3-ONE).
   [(57)] (LVII) Stanozolol [(17{alpha}-methyl-17{beta}-hydro
 xy-{5{alpha}}- androst-2-eno{3, 2-c}-pyrazole).]
   (17{ALPHA}-METHYL-17{BETA}-HYDROXY-5{ALPHA}-ANDROST-2-ENO{3,2-C}-PYRAZ
 OLE).
   [(58)] (LVIII) Stenbolone      [(17{beta}-hydroxy-2-methyl-{5{alpha}}-
 androst- 1-en-3- one).] (17{BETA}-HYDROXY-2-METHYL-5{ALPHA}  -ANDROST-1-
 EN-3-ONE).
   [(59)] (LIX) Testolactone [(13-hydroxy-3-oxo-13, 17-secoandrosta-
 1, 4-dien-17-oic acid lactone).]                (13-HYDROXY-3-OXO-13,17-
 SECOANDROSTA1,4-DIEN-17-OIC ACID LACTONE).
   [(60)] (LX) Testosterone (17{beta}-hydroxyandrost-4-en-3-one).
   [(61)] (LXI) Tetrahydrogestrinone [(13{beta}, 17{alpha}
 -diethyl-17{beta}-hydroxygon-4, 9, 11 -trien-3-one).]
   (13{BETA}, 17{ALPHA}-DIETHYL-17{BETA}-HYDROXYGON-4,9,11-TRIEN-3-ONE).
   [(62)] (LXII) Trenbolone [(17{beta}-hydroxyestr-4, 9, 11-trien-
 3-one).] (17{BETA}-HYDROXYESTR-4,9,11-TRIEN-3-ONE).
   [(63)] (LXIII)5{ALPHA}-ANDROSTAN-3,6,17-TRIONE.
   (LXIV) 6-BROMO-ANDROSTA-1,4-DIENE-3,17-DIONE.
   (LXV) 6-BROMO-ANDROSTAN-3,17-DIONE.
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   (LXVI) 4-CHLORO-17{ALPHA}-METHYL-ANDROSTA-1,4-DIENE-3,17{BETA}-DIOL.
   (LXVII) 4-CHLORO-17{ALPHA}-METHYL-ANDROST-4-ENE-3{BETA},17{BETA}-DIOL.
   (LXVIII) 4-CHLORO-17{ALPHA}-METHYL-17{BETA}HYDROXY-ANDROST-4-EN-3-ONE.
   (LXIX) 4-CHLORO-17{ALPHA}-METHYL-17{BETA}HYDROXY-ANDROST-4-ENE-3,11-DI
 ONE.
   (LXX)  2{ALPHA},17{ALPHA}-DIMETHYL-17{BETA}-HYDROXY-5{BETA}-ANDROSTAN-
 3-ONE.
   (LXXI) 2{ALPHA},3{ALPHA}-EPITHIO-17{ALPHA}-METHYL-5{ALPHA}ANDROSTAN-17
 {BETA}-OL.
   (LXXII) ESTRA-4,9,11-TRIENE-3,17-DIONE.
   (LXXIII) {3,2-C}FURAZAN-5{ALPHA}-ANDROSTAN-17{BETA}-OL.
   (LXXIV) 18A-HOMO-3-HYDROXY-ESTRA-2,5(10)-DIEN-17-ONE.
   (LXXV) 4-HYDROXY-ANDROST-4-ENE-3,17-DIONE.
   (LXXVI) 17{BETA}-HYDROXY-ANDROSTANO{2,3-D}ISOXAZOLE.
   (LXXVII) 17{BETA}-HYDROXY-ANDROSTANO{3,2-C}ISOXAZOLE.
   (LXXVIII) 3{BETA}-HYDROXY-ESTRA-4,9,11-TRIEN-17-ONE.
   (LXXIX) METHASTERONE (2{ALPHA},17{ALPHA}-DIMETHYL-5{ALPHA}-ANDROSTAN-1
 7{BETA}-OL3-ONE OR 2{ALPHA},17{ALPHA}-DIMETHYL-17{BETA}-HYDROXY-5{ALPHA}
 -ANDROSTAN-3-ONE).
   (LXXX) 17{ALPHA}-METHYL-ANDROSTA-1,4-DIENE-3,17{BETA}-DIOL.
   (LXXXI) 17{ALPHA}-METHYL-5{ALPHA}-ANDROSTAN-17{BETA}-OL.
   (LXXXII) 17{ALPHA}-METHYL-ANDROSTAN-3-HYDROXYIMINE-17{BETA}-OL.
   (LXXXIII) 6{ALPHA}-METHYL-ANDROST-4-ENE-3,17-DIONE.
   (LXXXIV) 17{ALPHA}-METHYL-ANDROST-2-ENE-3,17{BETA}DIOL.
   (LXXXV) PROSTANOZOL (17{BETA}-HYDROXY-5{ALPHA}-ANDROSTANO{3,2-C}PYRAZOLE) OR
 {3,2-C}PYRAZOLE-5{ALPHA}-ANDROSTAN-17{BETA}-OL.
   (LXXXVI) {3,2-C}PYRAZOLE-ANDROST-4-EN-17{BETA}-OL.
   (LXXXVII) Any salt, ester or ether of a drug or substance described or
 listed in this subdivision.
   (2) (I) SUBJECT TO SUBPARAGRAPH (II) OF  THIS  PARAGRAPH,  A  DRUG  OR
 HORMONAL  SUBSTANCE,  OTHER THAN ESTROGENS, PROGESTINS, CORTICOSTEROIDS,
 AND DEHYDROEPIANDROSTERONE, THAT IS NOT LISTED IN PARAGRAPH ONE OF  THIS
 SUBDIVISION  AND  IS  DERIVED FROM, OR HAS A CHEMICAL STRUCTURE SUBSTAN-
 TIALLY SIMILAR TO, ONE OR MORE ANABOLIC STEROIDS LISTED IN PARAGRAPH ONE
 OF THIS SUBDIVISION SHALL BE CONSIDERED TO BE AN  ANABOLIC  STEROID  FOR
 PURPOSES OF THIS SCHEDULE IF:
   (A)  THE  DRUG  OR SUBSTANCE HAS BEEN CREATED OR MANUFACTURED WITH THE
 INTENT OF PRODUCING A DRUG OR OTHER SUBSTANCE THAT EITHER:
   1. PROMOTES MUSCLE GROWTH; OR
   2. OTHERWISE CAUSES  A  PHARMACOLOGICAL  EFFECT  SIMILAR  TO  THAT  OF
 TESTOSTERONE; OR
   (B)  THE DRUG OR SUBSTANCE HAS BEEN, OR IS INTENDED TO BE, MARKETED OR
 OTHERWISE PROMOTED IN ANY  MANNER  SUGGESTING  THAT  CONSUMING  IT  WILL
 PROMOTE  MUSCLE  GROWTH  OR  ANY OTHER PHARMACOLOGICAL EFFECT SIMILAR TO
 THAT OF TESTOSTERONE.
   (II) A SUBSTANCE SHALL NOT BE CONSIDERED TO  BE  A  DRUG  OR  HORMONAL
 SUBSTANCE FOR PURPOSES OF THIS SUBDIVISION IF:
   (A) IT IS:
   1. AN HERB OR OTHER BOTANICAL;
   2. A CONCENTRATE, METABOLITE, OR EXTRACT OF, OR A CONSTITUENT ISOLATED
 DIRECTLY FROM, AN HERB OR OTHER BOTANICAL; OR
   3.  A COMBINATION OF TWO OR MORE SUBSTANCES DESCRIBED IN CLAUSE ONE OR
 TWO OF THIS ITEM;
   (B) IT IS A DIETARY INGREDIENT FOR PURPOSES OF THE FEDERAL FOOD, DRUG,
 AND COSMETIC ACT (21 U.S.C. 301 ET SEQ.); AND
   (C) IT IS NOT ANABOLIC OR ANDROGENIC.
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   (III) IN ACCORDANCE  WITH  SUBDIVISION  ONE  OF  SECTION  THIRTY-THREE
 HUNDRED  NINETY-SIX  OF THIS ARTICLE, ANY PERSON CLAIMING THE BENEFIT OF
 AN EXEMPTION OR EXCEPTION UNDER  SUBPARAGRAPH  (II)  OF  THIS  PARAGRAPH
 SHALL BEAR THE BURDEN OF GOING FORWARD WITH THE EVIDENCE WITH RESPECT TO
 SUCH EXEMPTION OR EXCEPTION.
   §  17.  Subdivision  (c) of schedule III of section 3306 of the public
 health law is amended by adding two new paragraphs 15 and 16 to read  as
 follows:
   (15) PERAMPANEL, ITS SALTS, ISOMERS AND SALTS OF ISOMERS.
   (16)  XYLAZINE,  ITS  SALTS, ISOMERS AND SALTS OF ISOMERS, EXCEPT WHEN
 EXPRESSLY INTENDED FOR USE BY  A  VETERINARIAN  IN  THE  COURSE  OF  THE
 PROFESSIONAL  PRACTICE  OF  VETERINARY MEDICINE; PROVIDED, HOWEVER, THAT
 SUCH SUBSTANCE STOCKS SHALL BE AT ALL  TIMES  PROPERLY  SAFEGUARDED  AND
 SECURED,  AND ACCESS SHALL BE LIMITED TO THE MINIMUM NUMBER OF EMPLOYEES
 ACTUALLY REQUIRED TO EFFICIENTLY HANDLE THE CUSTODY, DISPENSING,  ADMIN-
 ISTRATION  OR  OTHER  HANDLING  OF SUCH SUBSTANCE; AND FURTHER PROVIDED,
 HOWEVER, THAT ALL  VETERINARIANS  SHALL  MAINTAIN  RECORDS,  ORDERS  AND
 PRESCRIPTIONS  OF THE SUBSTANCE FOR A PERIOD OF FIVE YEARS FROM THE DATE
 OF TRANSACTION, WHICH SHALL BE READILY AVAILABLE AND PROMPTLY  PRODUCED,
 IN  ELECTRONIC  OR  HARDCOPY  FORMAT THAT IS READILY UNDERSTANDABLE, FOR
 INSPECTION AND COPYING UPON REQUEST BY AUTHORIZED REPRESENTATIVES OF THE
 DEPARTMENT. ANY INDIVIDUAL WHO KNOWINGLY AND WILLFULLY ADMINISTERS THEM-
 SELVES OR ANOTHER PERSON,  PRESCRIBES,  DISPENSES  OR  DISTRIBUTES  SUCH
 SUBSTANCE  WHEN  ANY SUCH SUBSTANCE IS INTENDED FOR HUMAN CONSUMPTION OR
 FOR ANY PURPOSE OTHER THAN THE NORMAL COURSE OF PRACTICE  OF  VETERINARY
 MEDICINE  SHALL  BE  SUBJECT  TO THE SAME PENALTIES AS ANY INDIVIDUAL OR
 PRACTITIONER WHO VIOLATES THE PROVISIONS OF THIS SECTION AND  ANY  OTHER
 PENALTIES PRESCRIBED BY LAW.
   §  18.  Subdivision  (c)  of schedule IV of section 3306 of the public
 health law is amended by adding seven new paragraphs 54, 55, 56, 57, 58,
 59 and 60 to read as follows:
   (54) ALFAXALONE.
   (55) BREXANOLONE.
   (56) DARIDOREXANT.
   (57) LEMBOREXANT.
   (58) REMIMAZOLAM.
   (59) SUVOREXANT.
   (60) ZURANOLONE.
   § 19. Subdivision (e) of schedule IV of section  3306  of  the  public
 health  law is amended by AMENDING PARAGRAPH 10 AND adding two new para-
 graphs 13 and 14 to read as follows:
   (10) SPA((-)[)]-1-DIMETHYLAMINO-1,2-DIPHENYLETHANE).
   (13) SERDEXMETHYLPHENIDATE.
   (14) SOLRIAMFETOL.(2-AMINO-3-PHENYLPROPYL CARBAMATE;  BENZENEPROPANOL,
 BETA-AMINO-, CARBAMATE(ESTER)).
   §  20.  Subdivision  (f)  of schedule IV of section 3306 of the public
 health law, as added by chapter 664 of the laws of 1985, paragraph 2  as
 added  by  chapter  457  of the laws of 2006 and paragraph 3 as added by
 section 14 of part C of chapter 447 of the laws of 2012, is  amended  to
 read as follows:
   (f) Other substances. Unless specifically excepted or unless listed in
 another  schedule,  any material, compound, mixture or preparation which
 contains any quantity of the following substances, including its  salts,
 ISOMERS,  AND  SALTS  OF  SUCH  ISOMERS,  WHENEVER THE EXISTENCE OF SUCH
 SALTS, ISOMERS, AND SALTS OF ISOMERS IS POSSIBLE:
   (1) Pentazocine.
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   (2) Butorphanol (including its optical isomers).
   (3) Tramadol in any quantities.
   (4)  ELUXADOLINE. (5-{{{(2S))-2-AMINO-3-{4-AMINOCARBONYL)-2,6-DIMETHYL
 PHENYL}-1-OXOPROPYL}{(1S)-1-(4-PHENYL-1H-IMIDAZOL-2-YL)ETHYL}AMINO}METH
 YL}-2-METHOXYBENZOIC ACID)  (INCLUDING  ITS  OPTICAL  ISOMERS)  AND  ITS
 SALTS, ISOMERS, AND SALTS OF ISOMERS.
   (5) LORCASERIN.
   §  21.  Subdivision  (d)  of  schedule V of section 3306 of the public
 health law is amended by adding four new paragraphs 4, 5,  6  and  7  to
 read as follows:
   (4)      BRIVARACETAM (  (2S)-2-{ (4R) -2-OXO-4-PROPYLPYRROLIDIN-1-YL}
 BUTANAMIDE). SOME  TRADE  OR  OTHER  NAMES:  BRV;  UCB-34714;  BRIVIACT)
 (INCLUDING ITS SALTS).
   (5)   CENOBAMATE      ({1R)-1-(2-CHLOROPHENYL)-2-(TETRAZOL-2-YL)ETHYL}
 CARBAMATE;  2H-TETRAZOLE-2-ETHANOL,  ALPHA-(2-CHLOROPHENYL)-,  CARBAMATE
 (ESTER), (ALPHAR)-; CARBAMIC ACID(R)-(+)-1-(2-CHLOROPHENYL)  -2- (2H-TE-
 TRA ZOL-2-YL)ETHYL ESTER).
   (6) GANAXOLONE. 3{ALPHA}-HYDROXY-3{BETA}-METHYL-5{ALPHA}-PREGNAN-20-
 ONE.
   (7) LASMIDITAN
 {2,4,6-TRIFLUORO-N-(6-(1-METHYLPIPERIDINE-4-CARBONYL)PYRIDINE-2-YL-BENZAM
 IDE}.
   § 22. Subdivision 2 of section 3342  of  the  public  health  law,  as
 amended  by  chapter  692  of  the  laws  of 1976, is amended to read as
 follows:
   2. An institutional dispenser may dispense controlled  substances  for
 use off its premises only pursuant to a prescription, prepared and filed
 in  conformity with this title, provided, however, that, in an emergency
 situation as defined by rule or regulation of the department, a  practi-
 tioner   in  a  hospital  without  a  full-time  pharmacy  may  dispense
 controlled substances to a patient in a hospital emergency room for  use
 off  the  premises  of  the  institutional dispenser for a period not to
 exceed twenty-four hours, UNLESS THE FEDERAL DRUG  ENFORCEMENT  ADMINIS-
 TRATION  HAS AUTHORIZED A LONGER TIME PERIOD FOR THE PURPOSE OF INITIAT-
 ING MAINTENANCE TREATMENT, DETOXIFICATION TREATMENT, OR BOTH.
   § 23. Subdivision 1 of section 3302  of  the  public  health  law,  as
 amended  by  chapter  92  of  the  laws  of  2021, is amended to read as
 follows:
   1. "[Addict] PERSON WITH A SUBSTANCE USE DISORDER" means a person  who
 habitually  uses a controlled substance for a non-legitimate or unlawful
 use, and who by reason of such use is dependent thereon.
   § 24. Subdivision 1 of section 3331 of the public health law, as added
 by chapter 878 of the laws of 1972, is amended to read as follows:
   1. Except as provided in titles III or V of this article, no substance
 in schedules II, III, IV, or V may be prescribed  for  or  dispensed  or
 administered  to  [an  addict] A PERSON WITH A SUBSTANCE USE DISORDER or
 habitual user.
   § 25. The title heading of title 5 of article 33 of the public  health
 law,  as added by chapter 878 of the laws of 1972, is amended to read as
 follows:

           DISPENSING TO [ADDICTS] PERSONS WITH A SUBSTANCE USE
                        DISORDER AND HABITUAL USERS
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 § 26. Section 3350 of the public health law, as added by chapter 878  of
 the laws of 1972, is amended to read as follows:
   §  3350.  Dispensing  prohibition.    Controlled substances may not be
 prescribed for, or administered or dispensed to [addicts] PERSONS WITH A
 SUBSTANCE USE DISORDER  or  habitual  users  of  controlled  substances,
 except as provided by this title or title III.
   §  27.  Section 3351 of the public health law, as added by chapter 878
 of the laws of 1972, subdivision 5 as amended by chapter 558 of the laws
 of 1999, is amended to read as follows:
   § 3351. Dispensing for medical use.  1. Controlled substances  may  be
 prescribed  for,  or  administered  or dispensed to [an addict] A PERSON
 WITH A SUBSTANCE USE DISORDER or habitual user:
   (a) during emergency  medical  treatment  unrelated  to  [abuse]  SUCH
 SUBSTANCE USE DISORDER OR HABITUAL USE of controlled substances;
   (b)  who  is a bona fide patient suffering from an incurable and fatal
 disease such as cancer or advanced tuberculosis;
   (c) who is aged, infirm, or suffering from serious injury  or  illness
 and the withdrawal from controlled substances would endanger the life or
 impede or inhibit the recovery of such person.
   1-A.  A  PRACTITIONER  MAY  PRESCRIBE, ORDER AND DISPENSE ANY SCHEDULE
 III, IV, OR V NARCOTIC DRUG APPROVED BY THE FEDERAL FOOD AND DRUG ADMIN-
 ISTRATION SPECIFICALLY FOR USE IN MAINTENANCE OR  DETOXIFICATION  TREAT-
 MENT TO A PERSON WITH A SUBSTANCE USE DISORDER OR HABITUAL USER.
   2.  Controlled  substances  may  be  ordered  for use by [an addict] A
 PERSON WITH A SUBSTANCE USE DISORDER or habitual user by a  practitioner
 and  administered by a practitioner [or], registered nurse, OR PARAMEDIC
 to relieve acute withdrawal symptoms.
   3. Methadone, or such other controlled  substance  designated  by  the
 commissioner  as appropriate for such use, may be ordered for use of [an
 addict] A PERSON WITH A SUBSTANCE USE DISORDER  by  a  practitioner  and
 dispensed  or  administered by a practitioner or his designated agent as
 interim treatment for [an addict on a waiting list for admission  to  an
 authorized  maintenance  program] A PERSON WITH A SUBSTANCE USE DISORDER
 WHILE ARRANGEMENTS ARE BEING MADE FOR REFERRAL  TO  TREATMENT  FOR  SUCH
 ADDICTION TO CONTROLLED SUBSTANCES.
   4.  Methadone,  or  such  other controlled substance designated by the
 commissioner as appropriate for such use, may  be  administered  to  [an
 addict]  A  PERSON WITH A SUBSTANCE USE DISORDER by a practitioner or by
 [his] THEIR designated agent acting under the direction and  supervision
 of  a  practitioner, as part of a [regime] REGIMEN designed and intended
 AS MAINTENANCE OR DETOXIFICATION TREATMENT OR to withdraw a patient from
 addiction to controlled substances.
   5. [Methadone] NOTWITHSTANDING  ANY  OTHER  LAW  AND  CONSISTENT  WITH
 FEDERAL  REQUIREMENTS,  METHADONE,  or  such  other controlled substance
 designated by the commissioner as  appropriate  for  such  use,  may  be
 administered  OR  DISPENSED  DIRECTLY  to  [an  addict]  A PERSON WITH A
 SUBSTANCE USE DISORDER by a practitioner or by  [his]  THEIR  designated
 agent  acting  under the direction and supervision of a practitioner, as
 part of a substance [abuse or chemical dependence] USE DISORDER  program
 approved  pursuant to article [twenty-three or] thirty-two of the mental
 hygiene law.
   § 28. Section 3372 of the public health law is REPEALED.
   § 29. This act shall take effect immediately.
 
                                  PART V
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   Section 1. Section 2805-x of  the  public  health  law,  as  added  by
 section 48 of part B of chapter 57 of the laws of 2015, paragraph (d) of
 subdivision 4 as added by chapter 697 of the laws of 2023, is amended to
 read as follows:
   §  2805-x. [Hospital-home care-physician] HEALTH CARE DELIVERY collab-
 oration program. 1. The purpose of this section shall be  to  facilitate
 innovation in [hospital, home care agency and physician collaboration in
 meeting]  COLLABORATIONS  BETWEEN  LICENSED  AND  CERTIFIED  HEALTH CARE
 PROVIDERS AND AGENCIES, INCLUDING: HOSPITALS, HOME CARE AGENCIES,  EMER-
 GENCY  MEDICAL  SERVICES,  SKILLED  NURSING FACILITIES, AND HOSPICES, AS
 WELL AS PAYORS AND OTHER INTERDISCIPLINARY PROVIDERS, PRACTITIONERS  AND
 SERVICE  ENTITIES, TO MEET the community's EVOLVING health care needs IN
 A CHANGING HEALTH CARE DELIVERY LANDSCAPE.  It shall provide a framework
 to support voluntary initiatives in  collaboration  to  improve  patient
 care  access and management, patient health outcomes, cost-effectiveness
 in the use of health care  services  and  community  population  health.
 [Such collaborative initiatives may also include payors, skilled nursing
 facilities  and  other  interdisciplinary  providers,  practitioners and
 service entities.]
   2. For purposes of this section:
   (a) "Hospital" shall include a general hospital  as  defined  in  this
 article or other inpatient facility for rehabilitation or specialty care
 within the definition of hospital in this article.
   (b) "Home care agency" shall mean a certified home health agency, long
 term  home  health care program or licensed home care services agency as
 defined in article thirty-six of this chapter.
   (c) "Payor" shall mean a health  plan  approved  pursuant  to  article
 forty-four  of this chapter, or article thirty-two or forty-three of the
 insurance law.
   (d) "Practitioner" shall mean any of  the  health,  mental  health  or
 health  related  professions  licensed  pursuant  to  title eight of the
 education law.
   (E) "PHYSICIAN" SHALL MEAN A PERSON DULY LICENSED PURSUANT TO  ARTICLE
 ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW.
   (F)  "HOSPICE"  SHALL  MEAN  AN AGENCY APPROVED UNDER ARTICLE FORTY OF
 THIS CHAPTER.
   (G) "EMERGENCY MEDICAL SERVICES" SHALL MEAN AN AGENCY  APPROVED  UNDER
 ARTICLE THIRTY OF THIS CHAPTER.
   (H)  "SKILLED  NURSING  FACILITY" SHALL MEAN A RESIDENTIAL HEALTH CARE
 FACILITY OR NURSING HOME LICENSED PURSUANT TO  ARTICLE  TWENTY-EIGHT  OF
 THIS CHAPTER.
   3.  The commissioner is authorized to provide financing including, but
 not limited to, grants or positive  adjustments  in  medical  assistance
 rates  or  premium  payments, to the extent of funds available and allo-
 cated or appropriated therefor, including funds provided  to  the  state
 through  federal  waivers,  funds made available through state appropri-
 ations and/or funding through section twenty-eight  hundred  seven-v  of
 this  article,  as well as waivers of regulations under title ten of the
 New York codes, rules and regulations, to support the  voluntary  initi-
 atives and objectives of this section.
   4.  [Hospital-home  care-physician] HEALTH CARE DELIVERY collaborative
 initiatives under this section may include, but shall not be limited to:
   (a) [Hospital-home care-physician integration] INTEGRATION initiatives
 BETWEEN AT LEAST TWO OF THE FOLLOWING: HOSPITALS,  HOME  CARE  AGENCIES,
 PHYSICIAN,  PHYSICIANS'  GROUP, EMERGENCY MEDICAL SERVICES, HOSPICE, AND
 SKILLED NURSING FACILITIES, including but not limited to:
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   (i) transitions in care initiatives  to  help  effectively  transition
 patients  to  post-acute  care  at  home,  coordinate follow-up care and
 address issues critical to care plan success and readmission avoidance;
   (ii)  clinical  pathways  for  specified conditions, guiding patients'
 progress and outcome goals, as well as effective health services use;
   (iii) application of telehealth/telemedicine  services  in  monitoring
 and  managing  patient  conditions,  and promoting self-care/management,
 improved outcomes and effective services use;
   (iv) facilitation of  physician  house  calls  to  homebound  patients
 and/or  to  patients  for whom such home visits are determined necessary
 and effective for patient care management;
   (v) additional models for prevention of  avoidable  hospital  readmis-
 sions and emergency room visits;
   (vi) health home development;
   (vii)  development  and  demonstration  of new models of integrated or
 collaborative care and care management not otherwise achievable  through
 existing models; and
   (viii)  bundled payment demonstrations for hospital-to-post-acute-care
 for specified conditions or categories  of  conditions,  in  particular,
 conditions  predisposed  to  high  prevalence  of readmission, including
 those currently subject to federal/state penalty, and  other  discharges
 with extensive post-acute needs;
   (b)  Recruitment,  training and retention of hospital/home care direct
 care staff and physicians, in geographic or  clinical  areas  of  demon-
 strated  need. Such initiatives may include, but are not limited to, the
 following activities:
   (i) outreach and public education about the need and value of  service
 in health occupations;
   (ii)  training/continuing  education  and  regulatory facilitation for
 cross-training to maximize flexibility  in  the  utilization  of  staff,
 including:
   (A) training of hospital nurses in home care;
   (B) dual certified nurse aide/home health aide certification; and
   (C) dual personal care aide/HHA certification;
   (iii) salary/benefit enhancement;
   (iv) career ladder development; and
   (v) other incentives to practice in shortage areas; and
   (c) [Hospital - home care - physician] HEALTH CARE DELIVERY collabora-
 tives  for the care and management of special needs, high-risk and high-
 cost patients, including but not limited to best practices, and training
 and education of direct care practitioners and service employees.
   (d) Collaborative programs  to  address  disparities  in  health  care
 access  or treatment, and/or conditions of higher prevalence, in certain
 populations, where such collaborative programs could provide and  manage
 services  in a more effective, person-centered and cost-efficient manner
 for reduction or elimination of such disparities.
   (i) Such programs may target one  or  more  disparate  conditions,  or
 areas  of under-service, evidenced in defined populations, including but
 not be limited to:
   (A) cardiovascular disease;
   (B) hypertension;
   (C) diabetes;
   (D) chronic kidney disease;
   (E) obesity;
   (F) asthma;
   (G) sickle cell disease;
 S. 8307--A                         138                        A. 8807--A
 
   (H) sepsis;
   (I) lupus;
   (J) breast, lung, prostate and colorectal cancers;
   (K)  geographic  shortage  of  primary  care, prenatal/obstetric care,
 specialty medical care, home health care,  or  culturally  and  linguis-
 tically compatible care;
   (L) alcohol, tobacco, or substance abuse;
   (M) post-traumatic stress disorder and other conditions more prevalent
 among veterans of the United States military services;
   (N)  attracting members of minority populations to the field and prac-
 tice of medicine; and
   (O) such other areas approved by the commissioner.
   (ii)  Collaborative   [hospital-home   care-physician]   HEALTH   CARE
 DELIVERY, and as applicable additional partner, models may include under
 such disparities programs:
   (A) service planning and design;
   (B)  recruitment  of  specialty personnel and/or specialty training of
 professionals or other direct care personnel (including physicians, home
 care and hospital staffs), patients and informal caregivers;
   (C) continuing medical education and clinical training for physicians,
 follow-up evaluations, and supporting educational materials;
   (D) use of evidenced-based approaches and/or best practices to  treat-
 ment;
   (E) reimbursement of uncovered services;
   (F)  bundled or other integrated payment methods to support the neces-
 sary, coordinated and cost-effective services;
   (G) regulatory waivers to facilitate flexibility in  provider  collab-
 oration and person-centered care;
   (H) patient/family peer support and education;
   (I) data collection, research and evaluation of efficacy; and/or
   (J) other components or innovations satisfactory to the commissioner.
   (iii)  Nothing  contained in this paragraph shall prevent a physician,
 [physicians] PHYSICIANS' group, home care agency, or hospital from indi-
 vidually applying for said grant.
   (iv) The commissioner shall consult with physicians, home  care  agen-
 cies,  hospitals,  consumers,  statewide  associations representative of
 such participants, and other experts  in  health  care  disparities,  in
 developing  an application process for grant funding or rate adjustment,
 and for request of state regulatory waivers, to  facilitate  implementa-
 tion of disparities programs under this paragraph.
   5.    AT  A  MINIMUM, APPLICATIONS FOR COLLABORATIVE INITIATIVES UNDER
 THIS SECTION MUST SPECIFICALLY IDENTIFY THE SERVICE GAPS AND/OR COMMUNI-
 TY NEED THE COLLABORATION SEEKS TO  ADDRESS,  AND  OUTLINE  A  PROJECTED
 TIMELINE  FOR  IMPLEMENTATION  AND DELIVERABLE DATA TO DEMONSTRATE MILE-
 STONES TO SUCCESS.
   6. Hospitals and home care agencies which are  provided  financing  or
 waivers pursuant to this section shall report to the commissioner on the
 patient,  service and cost experiences pursuant to this section, includ-
 ing the extent to which the project goals are achieved. The commissioner
 shall compile and  make  such  reports  available  on  the  department's
 website.
   §  2. Subdivision 2 of section 3602 of the public health law, as added
 by chapter 895 of the laws of 1977, is amended to read as follows:
   2. "Home care services agency" means an organization primarily engaged
 in arranging and/or providing directly or through  contract  arrangement
 one  or  more  of  the  following:  Nursing  services,  home health aide
 S. 8307--A                         139                        A. 8807--A
 
 services, and other therapeutic and related services which may  include,
 but  shall not be limited to, physical, speech and occupational therapy,
 nutritional services, medical social services, personal  care  services,
 homemaker services, and housekeeper or chore services, which may be of a
 preventive,   therapeutic,   rehabilitative,   health  guidance,  and/or
 supportive nature to persons at home.  FOR THE PURPOSES OF THIS ARTICLE,
 A GENERAL HOSPITAL LICENSED PURSUANT TO  ARTICLE  TWENTY-EIGHT  OF  THIS
 CHAPTER  SHALL  NOT BE CONSIDERED "PRIMARILY ENGAGED IN ARRANGING AND/OR
 PROVIDING" NURSING, HOME HEALTH, OR OTHER THERAPEUTIC SERVICES  NOTWITH-
 STANDING  THAT  SUCH  SERVICES MAY BE PROVIDED IN A PATIENT'S RESIDENCE,
 PROVIDED THAT AT LEAST FIFTY-ONE PERCENT OF PATIENT CARE HOURS FOR  SUCH
 GENERAL  HOSPITAL IS GENERATED FROM THE TREATMENT OF PATIENTS WITHIN THE
 HOSPITAL, AND THAT ANY PATIENTS TREATED IN THEIR RESIDENCE HAVE A PREEX-
 ISTING CLINICAL RELATIONSHIP WITH THE GENERAL HOSPITAL.
   § 3. Section 2803 of the public health law is amended by adding a  new
 subdivision 15 to read as follows:
   15. SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION AND
 NOTWITHSTANDING  ANY  CONTRARY PROVISION OF THIS ARTICLE, OR ANY RULE OR
 REGULATION TO THE CONTRARY, THE COMMISSIONER SHALL ALLOW GENERAL  HOSPI-
 TALS TO PROVIDE OFF-SITE ACUTE CARE MEDICAL SERVICES, THAT ARE:
   (A) NOT HOME CARE SERVICES DEFINED IN SUBDIVISION ONE OF SECTION THIR-
 TY-SIX  HUNDRED TWO OF THIS CHAPTER OR THE PROFESSIONAL SERVICES ENUMER-
 ATED IN SUBDIVISION TWO OF SUCH SECTION;
   (B) PROVIDED BY A MEDICAL PROFESSIONAL, INCLUDING A PHYSICIAN,  REGIS-
 TERED  NURSE,  NURSE  PRACTITIONER, OR PHYSICIAN ASSISTANT, TO A PATIENT
 WITH A PRE-EXISTING CLINICAL RELATIONSHIP WITH THE GENERAL HOSPITAL,  OR
 WITH THE HEALTH CARE PROFESSIONAL PROVIDING THE SERVICE; AND
   (C)  PROVIDED  TO A PATIENT FOR WHOM A MEDICAL PROFESSIONAL HAS DETER-
 MINED IS APPROPRIATE TO RECEIVE ACUTE MEDICAL SERVICES  AT  THEIR  RESI-
 DENCE.
   (D)  NOTHING  IN THIS SUBDIVISION SHALL PRECLUDE A FEDERALLY QUALIFIED
 HEALTH CENTER  FROM  PROVIDING  OFF-SITE  SERVICES  IN  ACCORDANCE  WITH
 DEPARTMENT REGULATIONS.
   (E)  THE  DEPARTMENT  IS  AUTHORIZED  TO  ESTABLISH MEDICAL ASSISTANCE
 PROGRAM RATES TO EFFECTUATE THIS SUBDIVISION. FOR THE  PURPOSES  OF  THE
 DEPARTMENT  DETERMINING THE APPLICABLE RATES PURSUANT TO SUCH AUTHORITY,
 ANY GENERAL HOSPITAL APPROVED PURSUANT TO THIS SUBDIVISION SHALL  REPORT
 TO  THE  DEPARTMENT,  IN THE FORM AND FORMAT REQUIRED BY THE DEPARTMENT,
 ITS  ANNUAL  OPERATING  COSTS,  SPECIFICALLY  FOR  SUCH  OFF-SITE  ACUTE
 SERVICES.  FAILURE TO TIMELY SUBMIT SUCH COST DATA TO THE DEPARTMENT MAY
 RESULT IN REVOCATION OF AUTHORITY TO PARTICIPATE IN A PROGRAM UNDER THIS
 SECTION DUE TO THE  INABILITY  TO  ESTABLISH  APPROPRIATE  REIMBURSEMENT
 RATES.
   §  4. Subdivision 3 of section 3018 of the public health law, as added
 by chapter 137 of the laws of 2023, is amended to read as follows:
   3. (A) This program shall authorize mobile  integrated  and  community
 paramedicine programs presently operating and approved by the department
 as  of  May  eleventh, two thousand twenty-three, under the authority of
 Executive Order Number 4 of two thousand twenty-one, entitled "Declaring
 a Statewide Disaster Emergency Due to Healthcare staffing  shortages  in
 the  State  of  New York" to continue in the same manner and capacity as
 currently approved [for a period of two years  following  the  effective
 date  of  this section] THROUGH MARCH THIRTY-FIRST, TWO THOUSAND THIRTY-
 ONE.
   (B) ANY PROGRAM NOT CURRENTLY APPROVED  AND  OPERATING  IN  ACCORDANCE
 WITH  PARAGRAPH  (A) OF THIS SUBDIVISION MAY APPLY TO THE DEPARTMENT FOR
 S. 8307--A                         140                        A. 8807--A
 
 APPROVAL TO OPERATE  A  MOBILE  INTEGRATED  AND  COMMUNITY  PARAMEDICINE
 PROGRAM,  AND  ANY PROGRAM CURRENTLY OPERATING PURSUANT TO PARAGRAPH (A)
 OF THIS SUBDIVISION FOR A LIMITED PURPOSE, INCLUDING BUT NOT LIMITED  TO
 VACCINATION  ADMINISTRATION, MAY APPLY TO THE DEPARTMENT FOR APPROVAL TO
 MODIFY ITS EXISTING COMMUNITY PARAMEDICINE PROGRAM. THE  DEPARTMENT  MAY
 APPROVE  UP  TO  TWO  HUNDRED  NEW OR MODIFIED PROGRAMS PURSUANT TO THIS
 PARAGRAPH. SUCH APPLICATIONS MUST BE SUBMITTED IN THE  FORM  AND  FORMAT
 PRESCRIBED  BY  THE DEPARTMENT. PROGRAMS APPROVED PURSUANT TO THIS PARA-
 GRAPH MAY BE PERMITTED TO OPERATE THROUGH MARCH THIRTY-FIRST, TWO  THOU-
 SAND THIRTY-ONE.
   §  5. Section 2 of chapter 137 of the laws of 2023 amending the public
 health law  relating  to  establishing  a  community-based  paramedicine
 demonstration program, is amended to read as follows:
   §  2.  This  act shall take effect immediately and shall expire and be
 deemed repealed [2 years after such  date]  MARCH  31,  2031;  provided,
 however,  that  if  this act shall have become a law on or after May 22,
 2023 this act shall take effect immediately and shall be deemed to  have
 been in full force and effect on and after May 22, 2023.
   §  6.  Subdivision  1  of  section  3001  of the public health law, as
 amended by chapter 804 of the laws  of  1992,  is  amended  to  read  as
 follows:
   1.  "Emergency  medical  service"  means  [initial  emergency  medical
 assistance including, but not  limited  to,  the  treatment  of  trauma,
 burns,  respiratory,  circulatory and obstetrical emergencies] A COORDI-
 NATED SYSTEM OF HEALTHCARE DELIVERY THAT RESPONDS TO THE NEEDS  OF  SICK
 AND INJURED INDIVIDUALS, BY PROVIDING: ESSENTIAL EMERGENCY, NON-EMERGEN-
 CY, SPECIALTY NEED OR PUBLIC EVENT MEDICAL CARE; COMMUNITY EDUCATION AND
 PREVENTION  PROGRAMS;  GROUND  AND  AIR  AMBULANCE  SERVICES;  EMERGENCY
 MEDICAL DISPATCH; TRAINING FOR EMERGENCY MEDICAL SERVICES PRACTITIONERS;
 MEDICAL FIRST  RESPONSE;  MOBILE  TRAUMA  CARE  SYSTEMS;  MASS  CASUALTY
 MANAGEMENT; AND MEDICAL DIRECTION.
   §  7.  Section  6909  of  the education law is amended by adding a new
 subdivision 12 to read as follows:
   12. A CERTIFIED NURSE PRACTITIONER MAY PRESCRIBE AND ORDER  A  NON-PA-
 TIENT  SPECIFIC  REGIMEN  TO  AN EMERGENCY MEDICAL SERVICES PRACTITIONER
 LICENSED BY THE DEPARTMENT OF HEALTH PURSUANT TO ARTICLE THIRTY  OF  THE
 PUBLIC  HEALTH  LAW,  PURSUANT TO REGULATIONS PROMULGATED BY THE COMMIS-
 SIONER, AND CONSISTENT WITH THE PUBLIC  HEALTH  LAW,  FOR  ADMINISTERING
 IMMUNIZATIONS.    NOTHING IN THIS SUBDIVISION SHALL AUTHORIZE UNLICENSED
 PERSONS TO ADMINISTER IMMUNIZATIONS, VACCINES OR OTHER DRUGS.
   § 8. Section 6527 of the education law is  amended  by  adding  a  new
 subdivision 12 to read as follows:
   12. A LICENSED PHYSICIAN MAY PRESCRIBE AND ORDER A NON-PATIENT SPECIF-
 IC REGIMEN TO AN EMERGENCY MEDICAL SERVICES PRACTITIONER LICENSED BY THE
 DEPARTMENT  OF  HEALTH  PURSUANT  TO ARTICLE THIRTY OF THE PUBLIC HEALTH
 LAW, PURSUANT  TO  REGULATIONS  PROMULGATED  BY  THE  COMMISSIONER,  AND
 CONSISTENT  WITH THE PUBLIC HEALTH LAW, FOR ADMINISTERING IMMUNIZATIONS.
 NOTHING IN THIS SUBDIVISION SHALL AUTHORIZE UNLICENSED PERSONS TO ADMIN-
 ISTER IMMUNIZATIONS, VACCINES OR OTHER DRUGS.
   § 9. The public health law is amended by adding a new article 30-D  to
 read as follows:
                               ARTICLE 30-D
             EMERGENCY MEDICAL SERVICES ESSENTIAL SERVICES ACT
 SECTION 3080. DECLARATION OF PURPOSE.
         3081. APPLICATION OF ARTICLE.
         3082. DEFINITIONS.
 S. 8307--A                         141                        A. 8807--A

         3083. DESIGNATION  OF  MEDICAL  EMERGENCY RESPONSE AND EMERGENCY
                 MEDICAL DISPATCH AGENCIES AS ESSENTIAL SERVICES.
         3084. PROVISION OF EMERGENCY MEDICAL DISPATCH.
         3085. RULES AND REGULATIONS.
   § 3080. DECLARATION OF PURPOSE. 1. THE PROVISION OF PROMPT, EFFICIENT,
 AND  EFFECTIVE EMERGENCY MEDICAL SERVICES AND EMERGENCY MEDICAL DISPATCH
 IS CRUCIAL TO THE HEALTH AND SAFETY OF THE RESIDENTS OF NEW YORK STATE.
   2. THE ESTABLISHMENT OF A COMPREHENSIVE AND  STANDARDIZED  SYSTEM  FOR
 MEDICAL  EMERGENCY  RESPONSE  IS  ESSENTIAL  TO ADDRESS LIFE-THREATENING
 CONDITIONS AND ENSURE THE WELL-BEING OF INDIVIDUALS IN  NEED  OF  URGENT
 MEDICAL CARE.
   3.  ENSURING THAT EVERY COUNTY WITHIN NEW YORK STATE HAS THE NECESSARY
 RESOURCES, TRAINED PERSONNEL, AND OPERATIONAL  CAPABILITIES  TO  PROVIDE
 MEDICAL  EMERGENCY  RESPONSE  IS  A  MATTER OF PUBLIC INTEREST AND STATE
 PRIORITY.
   4. IT IS IMPERATIVE TO STANDARDIZE THE APPROACH TO  MEDICAL  EMERGENCY
 RESPONSE  AND DISPATCH SERVICES TO ENHANCE THE QUALITY OF CARE, MAXIMIZE
 EFFICIENCY, AND IMPROVE OUTCOMES FOR PATIENTS EXPERIENCING MEDICAL EMER-
 GENCIES.
   5. THE DESIGNATION OF MEDICAL EMERGENCY RESPONSE AND EMERGENCY MEDICAL
 DISPATCH AS ESSENTIAL SERVICES WILL ENSURE  A  UNIFORM,  EFFECTIVE,  AND
 COORDINATED RESPONSE TO MEDICAL EMERGENCIES ACROSS THE STATE.
   6. THIS ARTICLE AIMS TO ESTABLISH A FRAMEWORK FOR THE PROVISION, OPER-
 ATION,  AND  REGULATION  OF  MEDICAL  EMERGENCY  RESPONSE  AND  DISPATCH
 SERVICES, THEREBY SAFEGUARDING THE HEALTH AND SAFETY OF NEW YORK STATE'S
 RESIDENTS AND VISITORS.
   § 3081. APPLICATION OF ARTICLE. THIS  ARTICLE  SHALL  APPLY  TO  EVERY
 COUNTY EXCEPT A COUNTY WHOLLY CONTAINED WITHIN A CITY.
   §  3082.  DEFINITIONS.  AS  USED  IN THIS ARTICLE, THE FOLLOWING TERMS
 SHALL HAVE THE FOLLOWING MEANINGS:
   1. "MEDICAL EMERGENCY RESPONSE" SHALL MEAN  THE  RAPID  DEPLOYMENT  OF
 AMBULANCE  SERVICES,  ADVANCED LIFE SUPPORT FIRST RESPONSE SERVICES, AND
 OTHER FIRST RESPONSE SERVICES AUTHORIZED BY THE  DEPARTMENT  TO  PROVIDE
 EMERGENCY  MEDICAL SERVICES, AS DEFINED IN SECTION THREE THOUSAND ONE OF
 THIS CHAPTER, FOR THE PURPOSE OF PROVIDING IMMEDIATE  EMERGENCY  MEDICAL
 CARE  IN  RESPONSE  TO  EMERGENCY CALLS FOR ACUTE CONDITIONS WHERE RAPID
 INTERVENTION IS VITAL TO PREVENT DEATH OR SERIOUS HARM.
   2.  "EMERGENCY  MEDICAL  DISPATCH"  MEANS  A  PROTOCOL-DRIVEN   SYSTEM
 APPROVED  BY  THE  DEPARTMENT DESIGNED TO MANAGE, ASSESS, AND PRIORITIZE
 MEDICAL EMERGENCY CALLS, PROVIDE CRITICAL PRE-ARRIVAL INSTRUCTIONS,  AND
 DISPATCH  MEDICAL EMERGENCY RESPONSE SERVICES BY AN EMS MEDICAL DISPATCH
 AGENCY OR PROVIDE REFERRAL TO APPROPRIATE NON-EMERGENCY MEDICAL SERVICES
 WHERE APPROPRIATE.
   3. "EMS MEDICAL DISPATCH AGENCY" MEANS  ANY  INDIVIDUAL,  PARTNERSHIP,
 ASSOCIATION,  CORPORATION, MUNICIPALITY OR ANY LEGAL OR PUBLIC ENTITY OR
 SUBDIVISION THEREOF LICENSED BY THE DEPARTMENT WHO IS ENGAGED IN RECEIV-
 ING REQUESTS FOR  EMERGENCY  MEDICAL  ASSISTANCE  FROM  THE  PUBLIC  AND
 DISPATCHING  MEDICAL  EMERGENCY  RESPONSE SERVICES AS NEEDED, EXCEPT FOR
 ANY SUCH INDIVIDUAL OR ENTITY  THAT  IS  SUBJECT  TO  MINIMUM  STANDARDS
 PROMULGATED UNDER SECTION THREE-HUNDRED TWENTY-EIGHT OF COUNTY LAW.
   4.  "MEDICAL  EMERGENCY  READINESS ASSESSMENT" MEANS THE RATING SYSTEM
 EVALUATING THE PREPAREDNESS, EFFICIENCY, AND  EFFECTIVENESS  OF  MEDICAL
 EMERGENCY RESPONSE WITHIN A COMMUNITY.
   §  3083.  DESIGNATION  OF  MEDICAL  EMERGENCY  RESPONSE  AND EMERGENCY
 MEDICAL DISPATCH AGENCIES AS ESSENTIAL SERVICES.  1.  MEDICAL  EMERGENCY
 S. 8307--A                         142                        A. 8807--A
 
 RESPONSE  AND  EMERGENCY  MEDICAL  DISPATCH AGENCIES ARE HEREBY DECLARED
 ESSENTIAL SERVICES WITHIN NEW YORK STATE.
   2. EVERY COUNTY, ACTING INDIVIDUALLY OR JOINTLY WITH ANY OTHER COUNTY,
 CITY, TOWN, AND VILLAGE, SHALL ENSURE THAT AN EMERGENCY MEDICAL SERVICE,
 AMBULANCE  SERVICE,  ADVANCED LIFE SUPPORT FIRST RESPONSE SERVICE, OTHER
 FIRST RESPONSE SERVICES AUTHORIZED BY THE DEPARTMENT TO PROVIDE EMERGEN-
 CY MEDICAL SERVICES, OR A COMBINATION OF SUCH SERVICES ARE PROVIDED  FOR
 THE PURPOSES OF EFFECTUATING MEDICAL EMERGENCY RESPONSE WITHIN THE BOUN-
 DARIES OF THE COUNTY.
   3.  EVERY COUNTY ACTING INDIVIDUALLY OR JOINTLY WITH ANY OTHER COUNTY,
 CITY, TOWN, AND  VILLAGE,  SHALL  DEVELOP,  IMPLEMENT,  AND  MAINTAIN  A
 COMPREHENSIVE  COUNTY  MEDICAL  EMERGENCY  RESPONSE PLAN APPROVED BY THE
 DEPARTMENT, ENSURING THE EFFECTIVE OPERATION, COORDINATION,  UTILIZATION
 OF  EXISTING  AMBULANCE SERVICES LICENSED BY THE DEPARTMENT, AND FUNDING
 OF MEDICAL EMERGENCY RESPONSE. IN FURTHERANCE OF THAT PURPOSE, THE COUN-
 TY SHALL DESIGNATE ONE OR MORE PRIMARY MEDICAL EMERGENCY RESPONSE  AGEN-
 CIES  THAT SHALL RESPOND TO ALL CALLS AND DEMANDS FOR SUCH MEDICAL EMER-
 GENCY RESPONSE TO PERSONS ENTITLED THERETO, SUBJECT TO  ANY  LIMITATIONS
 UPON  SUCH  SERVICE  SPECIFIED IN AN AGREEMENT, WITHIN THE BOUNDARIES OF
 THE COUNTY.  ANY PROPOSED PERMANENT CHANGES, INCLUDING A FULL CLOSURE OR
 SIGNIFICANT MODIFICATION OF COVERAGE  OF  A  PRIMARY  MEDICAL  EMERGENCY
 RESPONSE  AGENCY DESIGNATED BY A COUNTY SHALL BE SUBMITTED IN WRITING TO
 THE COUNTY AND THE DEPARTMENT NO LATER THAN 180 DAYS BEFORE THE  CHANGE.
 SUCH  CHANGES SHALL NOT BE MADE UNTIL RECEIPT OF THE APPROPRIATE DEPART-
 MENT APPROVAL.  NO COUNTY SHALL REMOVE OR REASSIGN AN AREA SERVED BY  AN
 EXISTING  MEDICAL EMERGENCY RESPONSE AGENCY WHERE THAT AGENCY IS COMPLI-
 ANT WITH ALL STATUTORY AND REGULATORY REQUIREMENTS  OF  THE  DEPARTMENT,
 AND  THAT HAS AGREED TO THE PROVISION OF APPROVED PLAN. NO MEDICAL EMER-
 GENCY RESPONSE AGENCY, DESIGNATED BY THE COUNTY IN THE PLAN, MAY  REFUSE
 TO RESPOND TO A REQUEST FOR SERVICE UNLESS THEY CAN PROVE, TO THE SATIS-
 FACTION  OF  THE  DEPARTMENT, THAT THEY ARE UNABLE TO RESPOND BECAUSE OF
 CAPACITY LIMITATIONS.
   4. NOTWITHSTANDING THE PROVISIONS OF SECTION THREE THOUSAND  EIGHT  OF
 THIS  CHAPTER,  ANY COUNTY ACTING INDIVIDUALLY OR JOINTLY WITH ANY OTHER
 COUNTY, CITY, TOWN, AND  VILLAGE,  THAT  PROVIDES,  EITHER  DIRECTLY  OR
 THROUGH  AGREEMENT  WITH EXISTING SERVICES, AN EMERGENCY MEDICAL SERVICE
 OR GENERAL AMBULANCE SERVICE IN  ACCORDANCE  WITH  SECTION  ONE  HUNDRED
 TWENTY-TWO-B OF THE GENERAL MUNICIPAL LAW, FOR THE PURPOSE OF EFFECTUAT-
 ING  MEDICAL  EMERGENCY RESPONSE, UPON MEETING OR EXCEEDING ALL ADMINIS-
 TRATIVE AND OPERATIONAL STANDARDS SET BY THE DEPARTMENT, AND UPON FILING
 WRITTEN NOTICE TO THE DEPARTMENT IN A MANNER PRESCRIBED BY  THE  DEPART-
 MENT,  SHALL  BE  DEEMED  TO HAVE SATISFIED ANY AND ALL REQUIREMENTS FOR
 DETERMINATION OF PUBLIC NEED FOR THE ESTABLISHMENT OF  ADDITIONAL  EMER-
 GENCY  MEDICAL  SERVICES AND THE DEPARTMENT SHALL ISSUE A NON-TRANSFERA-
 BLE, PERMANENT MUNICIPAL AMBULANCE SERVICE OPERATING CERTIFICATE.  NOTH-
 ING  IN  THIS  ARTICLE  SHALL  BE  DEEMED TO EXCLUDE ANY COUNTY ISSUED A
 MUNICIPAL AMBULANCE SERVICE OPERATING CERTIFICATE  FROM  COMPLYING  WITH
 ANY  OTHER  REQUIREMENT  OF  ARTICLE THIRTY OF THIS CHAPTER OR ANY OTHER
 APPLICABLE PROVISION OF LAW OR REGULATIONS PROMULGATED THEREUNDER.
   5. ANY COUNTY ACTING INDIVIDUALLY OR JOINTLY WITH  ANY  OTHER  COUNTY,
 CITY,  TOWN,  AND  VILLAGE,  THAT  PROVIDES,  EITHER DIRECTLY OR THROUGH
 AGREEMENT WITH AN EXISTING SERVICE,  AN  EMERGENCY  MEDICAL  SERVICE  OR
 GENERAL  AMBULANCE  SERVICE IN ACCORDANCE WITH SECTION ONE HUNDRED TWEN-
 TY-TWO-B OF THE GENERAL MUNICIPAL LAW, FOR THE PURPOSE  OF  EFFECTUATING
 MEDICAL EMERGENCY RESPONSE MAY ESTABLISH A SPECIAL DISTRICT, AFTER NINE-
 TY  DAYS  NOTICE TO THE DEPARTMENT, AS DEFINED IN SUBDIVISION SIXTEEN OF
 S. 8307--A                         143                        A. 8807--A
 
 SECTION ONE HUNDRED TWO OF THE REAL PROPERTY TAX LAW, FOR THE  FINANCING
 AND  OPERATION  OF  SUCH  EMERGENCY MEDICAL SERVICE OR GENERAL AMBULANCE
 SERVICE IN ACCORDANCE WITH  SECTION  ONE  HUNDRED  TWENTY-TWO-B  OF  THE
 GENERAL MUNICIPAL LAW WITH AN EMERGENCY MEDICAL SERVICES AGENCY LICENSED
 BY  THE  DEPARTMENT  TO PROVIDE EMERGENCY MEDICAL SERVICES IN THE STATE.
 SUCH SPECIAL DISTRICT SHALL BE EXEMPT FROM  THE  PROVISIONS  OF  SECTION
 THREE-C  OF  THE GENERAL MUNICIPAL LAW UNTIL FIVE YEARS AFTER THE ESTAB-
 LISHMENT OF THE SPECIAL DISTRICT.
   6. THE DEPARTMENT SHALL ESTABLISH STANDARDS, WITH THE ADVICE FROM  THE
 STATE  EMERGENCY  MEDICAL  SERVICES COUNCIL, THE STATE EMERGENCY MEDICAL
 ADVISORY COMMITTEE AND THE STATE TRAUMA ADVISORY COMMITTEE, ESTABLISHING
 MINIMUM STANDARDS FOR THE PROVISION OF  EMERGENCY  MEDICAL  SERVICES  BY
 FIRST  AID  SQUADS,  BASIC LIFE SUPPORT FIRST RESPONSE SERVICES, SPECIAL
 EVENT MEDICAL SERVICES, AND OTHER FIRST RESPONSE SERVICES NOT  OTHERWISE
 DEFINED IN ARTICLE THIRTY OF THIS CHAPTER.
   §  3084. PROVISION OF EMERGENCY MEDICAL DISPATCH. 1. EVERY EMS MEDICAL
 DISPATCH AGENCY, AS DEFINED IN THIS SECTION, OPERATING WITHIN  NEW  YORK
 STATE  SHALL  PROVIDE  EMERGENCY MEDICAL DISPATCH SERVICES IN ACCORDANCE
 WITH  EMERGENCY MEDICAL DISPATCH PROTOCOLS APPROVED BY THE DEPARTMENT.
   2. ALL EMS MEDICAL DISPATCH AGENCIES MAY BE REQUIRED TO BE LICENSED BY
 THE DEPARTMENT. THE DEPARTMENT, IN CONSULTATION WITH THE STATE  INTEROP-
 ERABLE  EMERGENCY  COMMUNICATIONS  BOARD, MAY ESTABLISH CRITERIA FOR THE
 LICENSING OF EMS MEDICAL DISPATCH AGENCIES, AS DEFINED IN THIS  SECTION,
 TO ENSURE COMPLIANCE WITH EMS MEDICAL DISPATCH STANDARDS.
   3.  ALL EMERGENCY MEDICAL DISPATCHERS WITH A PRIMARY ROLE OF PROVIDING
 EMERGENCY MEDICAL  DISPATCH  SERVICES  WHILE  EMPLOYED  BY  EMS  MEDICAL
 DISPATCH AGENCIES, AS DEFINED IN THIS SECTION, MUST COMPLETE AN EMERGEN-
 CY  MEDICAL  DISPATCH  CERTIFICATION  TRAINING  COURSE  APPROVED  BY THE
 DEPARTMENT, IN  CONSULTATION  WITH  THE  STATE  INTEROPERABLE  EMERGENCY
 COMMUNICATIONS   BOARD,  AND  MAINTAIN  CONTINUOUS  CERTIFICATION  WHILE
 EMPLOYED BY THE EMS MEDICAL DISPATCH AGENCY, AS DEFINED IN THIS SECTION,
 WITH A PRIMARY ROLE AS AN  EMERGENCY  MEDICAL  DISPATCHER,  AND  MAY  BE
 REQUIRED TO BE LICENSED BY THE DEPARTMENT.  THE DEPARTMENT, IN CONSULTA-
 TION  WITH  THE  STATE INTEROPERABLE EMERGENCY COMMUNICATIONS BOARD, MAY
 ESTABLISH MINIMUM STANDARDS FOR EMERGENCY MEDICAL DISPATCH CERTIFICATION
 TRAINING COURSES AND DISPATCHER LICENSURE.
   § 3085. RULES AND REGULATIONS. THE COMMISSIONER MAY  PROMULGATE  RULES
 AND REGULATIONS TO EFFECTUATE THE PURPOSES OF THIS ARTICLE.
   § 10. The public health law is amended by adding a new section 3019 to
 read as follows:
   §  3019.  EMERGENCY  MEDICAL  SERVICES  DEMONSTRATION PROGRAMS. 1. THE
 PURPOSE OF THIS SECTION SHALL BE TO  FACILITATE  INNOVATION  IN  MEDICAL
 CARE  PROVIDED BY EMERGENCY MEDICAL SERVICE PRACTITIONERS IN MEETING THE
 COMMUNITY'S HEALTH CARE NEEDS, INCLUDING COLLABORATION WITH OTHER HEALTH
 CARE ORGANIZATIONS OPERATING UNDER THE  PROVISIONS  OF  SECTION  TWENTY-
 EIGHT  HUNDRED  FIVE-X  OF THIS CHAPTER. IT SHALL PROVIDE A FRAMEWORK TO
 SUPPORT VOLUNTARY INITIATIVES TO IMPROVE PATIENT CARE ACCESS AND MANAGE-
 MENT, PATIENT HEALTH OUTCOMES, AND  COST-EFFECTIVENESS  IN  THE  USE  OF
 HEALTH CARE SERVICES AND COMMUNITY POPULATION HEALTH.
   2.  THE  COMMISSIONER IS AUTHORIZED TO PROVIDE FINANCING INCLUDING, TO
 THE EXTENT OF FUNDS AVAILABLE AND ALLOCATED OR APPROPRIATED THEREFOR, AS
 WELL AS WAIVERS OF CERTAIN PARTS OF THIS ARTICLE,  ARTICLE  THIRTY-A  OF
 THIS  CHAPTER,  AND  REGULATIONS  UNDER TITLE TEN OF THE NEW YORK CODES,
 RULES AND REGULATIONS, TO SUPPORT THE VOLUNTARY INITIATIVES  AND  OBJEC-
 TIVES OF THIS SECTION.
 S. 8307--A                         144                        A. 8807--A
 
   § 11. The public health law is amended by adding a new section 3055 to
 read as follows:
   §  3055.  EMS LICENSURE AND CREDENTIALING. 1. THE DEPARTMENT, WITH THE
 APPROVAL OF THE STATE EMERGENCY MEDICAL SERVICES COUNCIL, MAY  ESTABLISH
 MINIMUM  STANDARDS FOR THE LICENSURE OF EMERGENCY MEDICAL SERVICES PRAC-
 TITIONERS INCLUDING BUT NOT LIMITED TO EMERGENCY MEDICAL TECHNICIANS AND
 ADVANCED EMERGENCY MEDICAL TECHNICIANS BY THE DEPARTMENT.
   2. THE DEPARTMENT, WITH THE APPROVAL OF THE  STATE  EMERGENCY  MEDICAL
 SERVICES  COUNCIL,  MAY  ESTABLISH  MINIMUM  STANDARDS  FOR  SPECIALIZED
 CREDENTIALING OF EMERGENCY MEDICAL  SERVICE  PRACTITIONERS  WHICH  SHALL
 INCLUDE,  BUT  NOT  BE  LIMITED TO, EMERGENCY VEHICLE OPERATOR, CRITICAL
 CARE PARAMEDIC, EMERGENCY MEDICAL DISPATCHER, EMERGENCY MEDICAL SERVICES
 FIELD TRAINING OFFICER, EMERGENCY MEDICAL SERVICES ADMINISTRATOR,  EMER-
 GENCY  MEDICAL  CONTROL PHYSICIAN, AND EMERGENCY MEDICAL SERVICES AGENCY
 MEDICAL DIRECTOR.
   § 12. The public health law is amended by adding a new section 3029 to
 read as follows:
   § 3029. PARAMEDIC URGENT CARE PROGRAM. 1. THE DEPARTMENT SHALL  ESTAB-
 LISH A PARAMEDIC URGENT CARE PROGRAM TO EFFECTUATE THE ROLE OF EMERGENCY
 MEDICAL  SERVICES  PERSONNEL  IN THE DELIVERY OF HEALTH CARE SERVICES IN
 RURAL COUNTIES OF NEW YORK STATE.
   2. ANY ORGANIZATION  THAT  IS  AUTHORIZED  TO  PROVIDE  ADVANCED  LIFE
 SUPPORT  SERVICES,  IN  ACCORDANCE WITH SECTION THREE THOUSAND THIRTY OF
 THIS ARTICLE, MAY APPLY TO THE DEPARTMENT  FOR  APPROVAL  TO  OPERATE  A
 PARAMEDIC URGENT CARE.
   3. ANY PARAMEDIC URGENT CARE PROGRAMS APPROVED BY THE DEPARTMENT UNDER
 THIS  SECTION  SHALL: (A) BE UNDER THE OVERALL SUPERVISION AND DIRECTION
 OF A QUALIFIED PHYSICIAN; (B) BE STAFFED BY QUALIFIED MEDICAL AND HEALTH
 PERSONNEL, PHYSICIAN ASSISTANTS, OR  NURSE  PRACTITIONERS;  (C)  UTILIZE
 ADVANCED EMERGENCY MEDICAL TECHNICIANS WHOSE SCOPE OF PRACTICE IS APPRO-
 PRIATE  FOR THE MEDICAL SERVICES PROVIDED; (D) MAINTAIN A TREATMENT-MAN-
 AGEMENT RECORD FOR EACH PATIENT; AND (E) BE INTEGRATED WITH  A  HOSPITAL
 OR OTHER APPROPRIATE HEALTHCARE ORGANIZATION.
   4. PARAMEDIC URGENT CARE PROGRAMS MAY INTEGRATE TELEHEALTH PROVIDED BY
 A TELEHEALTH PROVIDER, AS THOSE TERMS ARE DEFINED IN SECTION TWENTY-NINE
 HUNDRED NINETY-NINE-CC OF THIS CHAPTER.  THE COMMISSIONER MAY SPECIFY IN
 REGULATION  ADDITIONAL  ACCEPTABLE MODALITIES FOR THE DELIVERY OF HEALTH
 CARE SERVICES BY PARAMEDIC CARE PROGRAMS VIA TELEHEALTH,  INCLUDING  BUT
 NOT LIMITED TO AUDIO-ONLY OR VIDEO-ONLY TELEPHONE COMMUNICATIONS, ONLINE
 PORTALS AND SURVEY APPLICATIONS.
   5.  NOTHING  IN  THIS  SECTION  SHALL  BE  DEEMED TO ALLOW A PERSON TO
 PROVIDE ANY SERVICE FOR WHICH A LICENSE, REGISTRATION, CERTIFICATION  OR
 OTHER  AUTHORIZATION  UNDER TITLE EIGHT OF THE EDUCATION LAW IS REQUIRED
 AND WHICH THE PERSON DOES NOT POSSESS, PROVIDED THAT ANY  SERVICE  BEING
 EXCLUDED  PURSUANT  TO THIS SUBDIVISION SHALL NOT INCLUDE A SERVICE THAT
 IS WITHIN THE SCOPE OF PRACTICE FOR  THE  RESPECTIVE  EMERGENCY  MEDICAL
 SERVICES PERSONNEL.
   §  13.  This  act shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024; provided,
 however, that the amendments to subdivision 3 of  section  3018  of  the
 public  health law made by section four of this act shall not affect the
 repeal of such section and shall be deemed repealed therewith.
 
                                  PART W
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   Section 1. The elder law is amended by adding a  new  section  226  to
 read as follows:
   §  226.  INTERAGENCY  ELDER  JUSTICE COORDINATING COUNCIL. 1. THERE IS
 HEREBY CREATED WITHIN THE OFFICE AN ELDER JUSTICE  COORDINATING  COUNCIL
 CONSISTING  OF  REPRESENTATIVES  OF  STATE  AGENCIES WHOSE WORK INVOLVES
 ELDER JUSTICE TO CREATE GREATER COLLABORATION  AND  DEVELOP  OVERARCHING
 STRATEGIES,  SYSTEMS,  AND PROGRAMS TO BE CARRIED OUT IN ACCORDANCE WITH
 THE GOVERNOR'S ELDER JUSTICE PRIORITIES, WITH A GOAL OF PROTECTING OLDER
 ADULTS FROM ABUSE AND MISTREATMENT. THE  COUNCIL  SHALL  COLLABORATE  TO
 IDENTIFY  AND SUPPORT CONSISTENT POLICIES AND PROGRAM OPERATION, FACILI-
 TATE COMMUNICATION AMONG STATE AGENCIES, FOSTER COLLABORATIVE  RELATION-
 SHIPS,  AND  HELP  STATE  AGENCIES  KEEP  INFORMED  OF LOCAL, STATE, AND
 NATIONAL DEVELOPMENTS IN ELDER JUSTICE.
   2. THE COUNCIL SHALL BE CHAIRED BY THE DIRECTOR OF THE OFFICE FOR  THE
 AGING,  AND  SHALL  INCLUDE  REPRESENTATION  FROM  THE OFFICE OF VICTIMS
 SERVICES, THE OFFICE OF CHILDREN AND FAMILY SERVICES, THE DEPARTMENT  OF
 FINANCIAL  SERVICES,  THE  DIVISION  OF  CRIMINAL  JUSTICE SERVICES, THE
 OFFICE OF MENTAL HEALTH, THE  OFFICE  FOR  THE  PREVENTION  OF  DOMESTIC
 VIOLENCE,  THE DEPARTMENT OF HEALTH, THE OFFICE FOR PEOPLE WITH DEVELOP-
 MENTAL DISABILITIES, THE NEW YORK STATE POLICE, THE JUSTICE  CENTER  FOR
 THE  PROTECTION  OF  PEOPLE  WITH  SPECIAL  NEEDS, AND THE DEPARTMENT OF
 STATE'S DIVISION OF CONSUMER PROTECTION. ADDITIONALLY, THE COUNCIL SHALL
 REQUEST INPUT FROM STAKEHOLDERS, ADVOCATES, EXPERTS, AND COALITIONS.
   3. THE COUNCIL SHALL:
   (A) DEVELOP AND IMPLEMENT A  COHESIVE,  COMPREHENSIVE  STATE  PLAN  ON
 ELDER JUSTICE THAT ALIGNS STATE ELDER JUSTICE POLICY AND PROGRAMS ACROSS
 STATE AGENCY RESPONSIBILITIES;
   (B)  DEVELOP  PLANS  FOR A COORDINATED AND COMPREHENSIVE RESPONSE FROM
 STATE AND LOCAL GOVERNMENT  AND  OTHER  ENTITIES  WHEN  ELDER  ABUSE  IS
 REPORTED;
   (C)  FACILITATE  INTERAGENCY  PLANNING AND POLICY DEVELOPMENT ON ELDER
 JUSTICE;
   (D) REVIEW AND PROPOSE SPECIFIC AGENCY INITIATIVES FOR THEIR IMPACT ON
 SYSTEMS AND SERVICES RELATED TO ELDER JUSTICE;
   (E) COORDINATE ACTIVITIES FOR WORLD  ELDER  ABUSE  AWARENESS  DAY  AND
 OTHER EVENTS; AND
   (F)  MAKE RECOMMENDATIONS TO THE GOVERNOR THAT WILL IMPROVE NEW YORK'S
 ELDER ABUSE PREVENTION AND INTERVENTION EFFORTS.
   4. EACH MEMBER AGENCY SHALL MAINTAIN CONTROL OVER, AND  RESPONSIBILITY
 FOR, ITS OWN PROGRAMS AND POLICIES. THE COUNCIL SHALL NOT TAKE THE PLACE
 OF  ANY  EXISTING INTERAGENCY COUNCILS AND COMMITTEES. THE COUNCIL SHALL
 SERVE TO FOCUS ATTENTION ON ELDER JUSTICE COMPREHENSIVELY AND  CREATE  A
 MULTIDISCIPLINARY  MECHANISM TO WORK TOWARD ALIGNMENT ACROSS AGENCIES TO
 HELP ACHIEVE THE GOVERNOR'S ELDER JUSTICE PRIORITIES.
   5. THE COUNCIL SHALL MEET REGULARLY AND SHALL SUBMIT A REPORT  ON  ITS
 ACTIVITIES  TO  THE  GOVERNOR AND THE LEGISLATURE NO LATER THAN DECEMBER
 THIRTY-FIRST, TWO THOUSAND TWENTY-FIVE AND ANNUALLY THEREAFTER.
   § 2. This act shall take effect immediately.
 
                                  PART X
 
   Intentionally Omitted.
 
                                  PART Y
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   Section 1. Section 7 of part R2 of 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, as amended by  section
 1  of  part  W  of chapter 57 of the laws of 2021, is amended to read as
 follows:
   § 7. This act shall take effect immediately [and  shall  expire  March
 31,  2024 when upon such date the provisions of this act shall be deemed
 repealed].
   § 2. This act shall take effect immediately.
 
                                  PART Z
 
   Section 1. Section 2 of 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, as amended by section 1
 of part V of chapter 57 of the laws of  2021,  is  amended  to  read  as
 follows:
   §  2.  This act shall take effect immediately [and shall expire and be
 deemed repealed March 31, 2024].
   § 2. This act shall take effect immediately.

                                  PART AA
 
   Section 1. Paragraph 31 of subsection  (i)  of  section  3216  of  the
 insurance  law  is  amended  by adding a new subparagraph (J) to read as
 follows:
   (J) THIS SUBPARAGRAPH SHALL APPLY TO FACILITIES IN THIS STATE THAT ARE
 LICENSED, CERTIFIED, OR OTHERWISE AUTHORIZED BY THE OFFICE OF  ADDICTION
 SERVICES  AND SUPPORTS FOR THE PROVISION OF OUTPATIENT, INTENSIVE OUTPA-
 TIENT, OUTPATIENT REHABILITATION AND OPIOID TREATMENT THAT  ARE  PARTIC-
 IPATING  IN  THE  INSURER'S  PROVIDER NETWORK. REIMBURSEMENT FOR COVERED
 OUTPATIENT TREATMENT PROVIDED BY SUCH FACILITIES SHALL BE AT A RATE THAT
 IS NOT LESS THAN THE RATE THAT WOULD BE PAID FOR SUCH TREATMENT PURSUANT
 TO THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE  OF
 THE SOCIAL SERVICES LAW.
   §  2.  Paragraph 35 of subsection (i) of section 3216 of the insurance
 law is amended by adding a new subparagraph (K) to read as follows:
   (K) THIS SUBPARAGRAPH SHALL APPLY TO OUTPATIENT TREATMENT PROVIDED  IN
 A FACILITY ISSUED AN OPERATING CERTIFICATE BY THE COMMISSIONER OF MENTAL
 HEALTH  PURSUANT  TO  THE PROVISIONS OF ARTICLE THIRTY-ONE OF THE MENTAL
 HYGIENE LAW, OR IN A FACILITY OPERATED BY THE OFFICE OF  MENTAL  HEALTH,
 OR  IN  A CRISIS STABILIZATION CENTER LICENSED PURSUANT TO SECTION 36.01
 OF THE MENTAL HYGIENE  LAW,  THAT  IS  PARTICIPATING  IN  THE  INSURER'S
 PROVIDER   NETWORK.   REIMBURSEMENT  FOR  COVERED  OUTPATIENT  TREATMENT
 PROVIDED BY SUCH A FACILITY SHALL BE AT A RATE THAT IS NOT LESS THAN THE
 RATE THAT WOULD BE PAID FOR  SUCH  TREATMENT  PURSUANT  TO  THE  MEDICAL
 ASSISTANCE  PROGRAM  UNDER  TITLE  ELEVEN  OF ARTICLE FIVE OF THE SOCIAL
 SERVICES LAW.
   § 3. Paragraph 5 of subsection (l) of section 3221  of  the  insurance
 law is amended by adding a new subparagraph (K) to read as follows:
   (K)  THIS SUBPARAGRAPH SHALL APPLY TO OUTPATIENT TREATMENT PROVIDED IN
 A FACILITY ISSUED AN OPERATING CERTIFICATE BY THE COMMISSIONER OF MENTAL
 S. 8307--A                         147                        A. 8807--A
 
 HEALTH PURSUANT TO THE PROVISIONS OF ARTICLE THIRTY-ONE  OF  THE  MENTAL
 HYGIENE  LAW,  OR IN A FACILITY OPERATED BY THE OFFICE OF MENTAL HEALTH,
 OR IN A CRISIS STABILIZATION CENTER LICENSED PURSUANT TO  SECTION  36.01
 OF  THE  MENTAL  HYGIENE  LAW,  THAT  IS  PARTICIPATING IN THE INSURER'S
 PROVIDER  NETWORK.  REIMBURSEMENT  FOR  COVERED   OUTPATIENT   TREATMENT
 PROVIDED BY SUCH A FACILITY SHALL BE AT A RATE THAT IS NOT LESS THAN THE
 RATE  THAT  WOULD  BE  PAID  FOR  SUCH TREATMENT PURSUANT TO THE MEDICAL
 ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF  ARTICLE  FIVE  OF  THE  SOCIAL
 SERVICES LAW.
   §  4.  Paragraph  7 of subsection (l) of section 3221 of the insurance
 law is amended by adding a new subparagraph (J) to read as follows:
   (J) THIS SUBPARAGRAPH SHALL APPLY TO FACILITIES IN THIS STATE THAT ARE
 LICENSED, CERTIFIED, OR OTHERWISE AUTHORIZED BY THE OFFICE OF  ADDICTION
 SERVICES  AND SUPPORTS FOR THE PROVISION OF OUTPATIENT, INTENSIVE OUTPA-
 TIENT, OUTPATIENT REHABILITATION AND OPIOID TREATMENT THAT  ARE  PARTIC-
 IPATING  IN  THE  INSURER'S  PROVIDER NETWORK. REIMBURSEMENT FOR COVERED
 OUTPATIENT TREATMENT PROVIDED BY SUCH FACILITIES SHALL BE AT A RATE THAT
 IS NOT LESS THAN THE RATE THAT WOULD BE PAID FOR SUCH TREATMENT PURSUANT
 TO THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE  OF
 THE SOCIAL SERVICES LAW.
   § 5. Subsection (g) of section 4303 of the insurance law is amended by
 adding a new paragraph 12 to read as follows:
   (12)  THIS PARAGRAPH SHALL APPLY TO OUTPATIENT TREATMENT PROVIDED IN A
 FACILITY ISSUED AN OPERATING CERTIFICATE BY THE COMMISSIONER  OF  MENTAL
 HEALTH  PURSUANT  TO  THE PROVISIONS OF ARTICLE THIRTY-ONE OF THE MENTAL
 HYGIENE LAW, OR IN A FACILITY OPERATED BY THE OFFICE OF  MENTAL  HEALTH,
 OR  IN  A CRISIS STABILIZATION CENTER LICENSED PURSUANT TO SECTION 36.01
 OF THE MENTAL HYGIENE LAW, THAT IS PARTICIPATING  IN  THE  CORPORATION'S
 PROVIDER   NETWORK.   REIMBURSEMENT  FOR  COVERED  OUTPATIENT  TREATMENT
 PROVIDED BY SUCH FACILITY SHALL BE AT A RATE THAT IS NOT LESS  THAN  THE
 RATE  THAT  WOULD  BE  PAID  FOR  SUCH TREATMENT PURSUANT TO THE MEDICAL
 ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF  ARTICLE  FIVE  OF  THE  SOCIAL
 SERVICES LAW.
   § 6. Subsection (l) of section 4303 of the insurance law is amended by
 adding a new paragraph 10 to read as follows:
   (10)  THIS  PARAGRAPH SHALL APPLY TO FACILITIES IN THIS STATE THAT ARE
 LICENSED, CERTIFIED, OR OTHERWISE AUTHORIZED BY THE OFFICE OF  ADDICTION
 SERVICES  AND SUPPORTS FOR THE PROVISION OF OUTPATIENT, INTENSIVE OUTPA-
 TIENT, OUTPATIENT REHABILITATION AND OPIOID TREATMENT THAT  ARE  PARTIC-
 IPATING IN THE CORPORATION'S PROVIDER NETWORK. REIMBURSEMENT FOR COVERED
 OUTPATIENT TREATMENT PROVIDED BY SUCH FACILITIES SHALL BE AT A RATE THAT
 IS NOT LESS THAN THE RATE THAT WOULD BE PAID FOR SUCH TREATMENT PURSUANT
 TO  THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE OF
 THE SOCIAL SERVICES LAW.
   § 7. This act shall take effect January 1, 2025  and  shall  apply  to
 policies and contracts issued, renewed, modified, altered, or amended on
 and after such date.
 
                                  PART BB

   Section  1.  Sections  19  and  21  of chapter 723 of the laws of 1989
 amending the mental hygiene law and other laws relating to comprehensive
 psychiatric emergency programs, as amended by section 1 of part  PPP  of
 chapter 58 of the laws of 2020, are amended to read as follows:
   §  19. Notwithstanding any other provision of law, the commissioner of
 mental health shall[, until July 1, 2024,] be solely authorized, in  his
 S. 8307--A                         148                        A. 8807--A
 
 or  her  discretion, to designate those general hospitals, local govern-
 mental units and voluntary agencies which may apply  and  be  considered
 for  the  approval  and issuance of an operating certificate pursuant to
 article  31  of the mental hygiene law for the operation of a comprehen-
 sive psychiatric emergency program.
   § 21. This act shall take effect immediately[, and sections  one,  two
 and  four  through  twenty  of  this  act shall remain in full force and
 effect, until July 1, 2024, at which time the amendments  and  additions
 made  by  such  sections of this act shall be deemed to be repealed, and
 any provision of law amended by any of such sections of this  act  shall
 revert  to  its  text  as it existed prior to the effective date of this
 act].
   § 2. This act shall take effect immediately.
 
                                  PART CC
 
   Section 1. Subdivision 2 of section 493 of the social services law, as
 added by section 1 of part B of chapter 501 of  the  laws  of  2012,  is
 amended to read as follows:
   2.  For  substantiated  reports  of  abuse or neglect in facilities or
 provider agencies in receipt of medical  assistance  AND  WHICH  ARE  NO
 LONGER  SUBJECT  TO AMENDMENT OR APPEAL PURSUANT TO SECTION FOUR HUNDRED
 NINETY-FOUR OF THIS ARTICLE, such information shall also be forwarded by
 the justice center to the office of the Medicaid inspector general  when
 such abuse or neglect may [be relevant to an investigation of unaccepta-
 ble  practices as such practices are defined] RESULT in [regulations of]
 POSSIBLE EXCLUSION OR OTHER SANCTION  BY  the  office  of  the  Medicaid
 inspector  general  AS DETERMINED IN CONSULTATION WITH THE OFFICE OF THE
 MEDICAID INSPECTOR GENERAL.
   § 2. This act shall take effect immediately.
 
                                  PART DD

   Section 1. Section 3 of part A of 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, as amended by
 section  1  of  part  T of chapter 57 of the laws of 2021, is amended to
 read as follows:
   § 3. This act shall take effect immediately[; and shall expire and  be
 deemed repealed June 30, 2024].
   § 2. This act shall take effect immediately.
 
                                  PART EE
 
   Section  1.  Subparagraph  (v)  of  paragraph  (a) of subdivision 1 of
 section 6908 of the education law is renumbered subparagraph (vi) and  a
 new subparagraph (v) is added to read as follows:
   (V)  TASKS  PROVIDED  BY  A DIRECT SUPPORT STAFF IN NON-FACILITY BASED
 PROGRAMS CERTIFIED, AUTHORIZED OR APPROVED BY THE OFFICE FOR PEOPLE WITH
 DEVELOPMENTAL DISABILITIES, SO LONG AS SUCH STAFF DOES NOT HOLD THEMSELF
 OUT AS ONE WHO ACCEPTS EMPLOYMENT SOLELY FOR PERFORMING SUCH  CARE,  AND
 WHERE  NURSING SERVICES ARE UNDER THE INSTRUCTION OF A SERVICE RECIPIENT
 OR FAMILY OR HOUSEHOLD MEMBER DETERMINED BY  A  REGISTERED  PROFESSIONAL
 NURSE  TO  BE  CAPABLE OF PROVIDING SUCH INSTRUCTION.  IN THE EVENT THAT
 THE REGISTERED NURSE DETERMINES THAT THE SERVICE RECIPIENT,  FAMILY,  OR
 S. 8307--A                         149                        A. 8807--A
 
 HOUSEHOLD  MEMBER  IS NOT CAPABLE OF PROVIDING SUCH INSTRUCTION, NURSING
 TASKS MAY BE PERFORMED BY DIRECT SUPPORT STAFF PURSUANT TO  SUBPARAGRAPH
 (VI) OF THIS PARAGRAPH SUBJECT TO THE REQUIREMENTS SET FORTH THEREIN; OR
   §  2.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART FF
 
   Section 1. 1. Subject to available appropriations and approval of  the
 director  of  the  budget,  the  commissioners  of  the office of mental
 health, office for people with  developmental  disabilities,  office  of
 addiction  services  and  supports,  office  of temporary and disability
 assistance, office of children and family services, and the state office
 for the aging shall establish a state  fiscal  year  2024-2025  cost  of
 living  adjustment  (COLA),  effective April 1, 2024, for projecting for
 the effects of inflation upon rates of payments, contracts, or any other
 form of reimbursement for the programs and services listed in paragraphs
 (i), (ii), (iii), (iv), (v),  and  (vi)  of  subdivision  four  of  this
 section. The COLA established herein shall be applied to the appropriate
 portion  of  reimbursable  costs or contract amounts. Where appropriate,
 transfers to the department of health (DOH) shall be made as  reimburse-
 ment for the state share of medical assistance.
   2.  Notwithstanding  any inconsistent provision of law, subject to the
 approval of the director of  the  budget  and  available  appropriations
 therefore,  for  the period of April 1, 2024 through March 31, 2025, the
 commissioners shall provide funding to support  a  one  and  five-tenths
 percent  (1.5%)  cost  of  living  adjustment under this section for all
 eligible programs and services as  determined  pursuant  to  subdivision
 four of this section.
   3.  Notwithstanding any inconsistent provision of law, and as approved
 by the director of the budget, the 1.5 percent cost of living adjustment
 (COLA) established herein shall be inclusive of all other cost of living
 type increases, inflation factors,  or  trend  factors  that  are  newly
 applied  effective  April  1,  2024.  Except for the 1.5 percent cost of
 living adjustment (COLA) established herein, for the  period  commencing
 on  April  1, 2024 and ending March 31, 2025 the commissioners shall not
 apply any other new cost of living adjustments for the purpose of estab-
 lishing rates of payments, contracts or any other form of reimbursement.
 The phrase "all other cost of living type increases, inflation  factors,
 or  trend  factors"  as  defined  in  this subdivision shall not include
 payments made pursuant to the American Rescue Plan Act or other  federal
 relief  programs  related  to  the  Coronavirus  Disease 2019 (COVID-19)
 pandemic public health emergency. This subdivision shall not prevent the
 office of children and family services from  applying  additional  trend
 factors  or  staff  retention  factors to eligible programs and services
 under paragraph (v) of subdivision four of this section.
   4. Eligible programs and services. (i) Programs and  services  funded,
 licensed, or certified by the office of mental health (OMH) eligible for
 the  cost  of  living  adjustment  established  herein,  pending federal
 approval where applicable, include: office  of  mental  health  licensed
 outpatient programs, pursuant to parts 587 and 599 of title 14 CRR-NY of
 the office of mental health regulations including clinic, continuing day
 treatment,  day  treatment,  intensive  outpatient  programs and partial
 hospitalization;  outreach;  crisis  residence;  crisis   stabilization,
 crisis/respite  beds;  mobile crisis, part 590 comprehensive psychiatric
 emergency program  services;  crisis  intervention;  home  based  crisis
 S. 8307--A                         150                        A. 8807--A
 
 intervention;  family  care;  supported single room occupancy; supported
 housing; supported housing  community  services;  treatment  congregate;
 supported   congregate;   community  residence  -  children  and  youth;
 treatment/apartment;  supported  apartment;  community  residence single
 room occupancy; on-site rehabilitation; employment programs; recreation;
 respite care; transportation;  psychosocial  club;  assertive  community
 treatment;  case  management;  care  coordination, including health home
 plus services; local  government  unit  administration;  monitoring  and
 evaluation;  children  and  youth  vocational  services; single point of
 access; school-based mental health program; family support children  and
 youth;  advocacy/support  services;  drop  in centers; recovery centers;
 transition management services; bridger; home and community based waiver
 services; behavioral health waiver services authorized pursuant  to  the
 section  1115  MRT waiver; self-help programs; consumer service dollars;
 conference of local mental hygiene directors; multicultural  initiative;
 ongoing  integrated  supported employment services; supported education;
 mentally  ill/chemical  abuse  (MICA)  network;  personalized   recovery
 oriented  services;  children and family treatment and support services;
 residential treatment facilities operating pursuant to part 584 of title
 14-NYCRR;  geriatric  demonstration  programs;  community-based   mental
 health  family  treatment  and  support;  coordinated children's service
 initiative; homeless services; and promises zone.
   (ii) Programs and services  funded,  licensed,  or  certified  by  the
 office  for  people with developmental disabilities (OPWDD) eligible for
 the cost  of  living  adjustment  established  herein,  pending  federal
 approval  where applicable, include: local/unified services; chapter 620
 services; voluntary operated community residential services; article  16
 clinics;  day  treatment  services;  family  support  services; 100% day
 training; epilepsy services; traumatic brain injury services;  hepatitis
 B  services;  independent  practitioner  services  for  individuals with
 intellectual and/or  developmental  disabilities;  crisis  services  for
 individuals  with intellectual and/or developmental disabilities; family
 care  residential  habilitation;  supervised  residential  habilitation;
 supportive residential habilitation; respite; day habilitation; prevoca-
 tional  services; supported employment; community habilitation; interme-
 diate care facility day and residential  services;  specialty  hospital;
 pathways to employment; intensive behavioral services; community transi-
 tion  services;  family  education  and  training;  fiscal intermediary;
 support broker; and personal resource accounts.
   (iii) Programs and services funded,  licensed,  or  certified  by  the
 office  of addiction services and supports (OASAS) eligible for the cost
 of living adjustment established herein, pending federal approval  where
 applicable, include: medically supervised withdrawal services - residen-
 tial;  medically  supervised withdrawal services - outpatient; medically
 managed detoxification; medically monitored withdrawal; inpatient  reha-
 bilitation  services;  outpatient  opioid  treatment; residential opioid
 treatment; KEEP units outpatient; residential opioid treatment to absti-
 nence; problem  gambling  treatment;  medically  supervised  outpatient;
 outpatient   rehabilitation;   specialized   services   substance  abuse
 programs; home and community based waiver services pursuant to  subdivi-
 sion  9  of  section 366 of the social services law; children and family
 treatment and support services; continuum of care rental assistance case
 management; NY/NY III post-treatment  housing;  NY/NY  III  housing  for
 persons  at  risk  for  homelessness; permanent supported housing; youth
 clubhouse; recovery community  centers;  recovery  community  organizing
 initiative; residential rehabilitation services for youth (RRSY); inten-
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 sive  residential; community residential; supportive living; residential
 services; job placement  initiative;  case  management;  family  support
 navigator;  local government unit administration; peer engagement; voca-
 tional   rehabilitation;   support   services;  HIV  early  intervention
 services; dual diagnosis coordinator; problem gambling resource centers;
 problem  gambling  prevention;  prevention  resource  centers;   primary
 prevention services; other prevention services; and community services.
   (iv)  Programs  and  services  funded,  licensed,  or certified by the
 office of temporary and disability assistance (OTDA)  eligible  for  the
 cost  of  living adjustment established herein, pending federal approval
 where applicable, include:  nutrition  outreach  and  education  program
 (NOEP).
   (v) Programs and services funded, licensed, or certified by the office
 of  children  and family services (OCFS) eligible for the cost of living
 adjustment established herein, pending federal approval  where  applica-
 ble,  include:  programs  for  which  the  office of children and family
 services establishes maximum state aid rates pursuant to  section  398-a
 of  the social services law and section 4003 of the education law; emer-
 gency foster homes; foster family boarding homes and therapeutic  foster
 homes;  supervised  settings  as  defined  by  subdivision twenty-two of
 section 371 of the  social  services  law;  adoptive  parents  receiving
 adoption subsidy pursuant to section 453 of the social services law; and
 congregate  and  scattered  supportive  housing  programs and supportive
 services provided under the NY/NY III supportive  housing  agreement  to
 young adults leaving or having recently left foster care.
   (vi) Programs and services funded, licensed, or certified by the state
 office  for  the aging (SOFA) eligible for the cost of living adjustment
 established herein, pending federal approval where applicable,  include:
 community  services  for  the elderly; expanded in-home services for the
 elderly; and supplemental nutrition assistance program.
   5. Each local government unit or direct  contract  provider  receiving
 funding  for  the  cost  of  living  adjustment established herein shall
 submit a written certification, in such form and at such  time  as  each
 commissioner  shall prescribe, attesting how such funding will be or was
 used to first promote the recruitment  and  retention  of  non-executive
 direct  care staff, non-executive direct support professionals, non-exe-
 cutive clinical staff, or respond to other critical non-personal service
 costs prior to supporting any salary increases or other compensation for
 executive level job titles.
   6. Notwithstanding any inconsistent provision of law to the  contrary,
 agency  commissioners shall be authorized to recoup funding from a local
 governmental unit or direct contract provider for  the  cost  of  living
 adjustment  established  herein determined to have been used in a manner
 inconsistent with the appropriation, or  any  other  provision  of  this
 section.  Such  agency  commissioners  shall be authorized to employ any
 legal mechanism to recoup such funds, including an offset of other funds
 that are owed to such local governmental unit or direct contract provid-
 er.
   § 2. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART GG
 
   Section 1. Subdivision 29 of section 364-j of the social services law,
 as  added  by section 49 of part C of chapter 60 of the laws of 2014, is
 amended to read as follows:
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   29. In the event  that  the  department  receives  approval  from  the
 Centers  for  Medicare  and  Medicaid  Services to amend its 1115 waiver
 [known as the Partnership Plan] or receives  approval  for  a  new  1115
 waiver  [for the purpose of reinvesting savings resulting from the rede-
 sign of the medical assistance program] PRIOR TO OR FOLLOWING THE EFFEC-
 TIVE  DATE  OF THIS SUBDIVISION, the commissioner is authorized to enter
 into contracts[, and/or] AND to amend the  terms  of  contracts  awarded
 prior to [the effective date of this subdivision] APRIL FIRST, TWO THOU-
 SAND  TWENTY-FOUR, for the purpose of assisting the department of health
 with  implementing  projects  authorized  under  such  waiver  approval.
 Notwithstanding  the  provisions  of sections one hundred twelve and one
 hundred sixty-three of the state finance law, or  sections  one  hundred
 forty-two  and  one hundred forty-three of the economic development law,
 or any contrary provision of law, contracts may be entered  or  contract
 amendments  may  be  made pursuant to this subdivision without a compet-
 itive bid or request for proposal process  [if  the  term  of  any  such
 contract  or  contract  amendment  does  not extend beyond March thirty-
 first, two thousand nineteen]; provided,  however,  in  the  case  of  a
 contract  entered  into  after  the  effective date of this subdivision,
 that:
   (a) The department of health shall post on its website, for  a  period
 of no less than thirty days:
   (i)  A description of the proposed services to be provided pursuant to
 the contract or contracts;
   (ii) The criteria for selection of a contractor or contractors;
   (iii) The period of time during which  a  prospective  contractor  may
 seek  selection,  which  shall  be  no  less than thirty days after such
 information is first posted on the website; and
   (iv) The manner by  which  a  prospective  contractor  may  seek  such
 selection, which may include submission by electronic means;
   (b)  All  reasonable and responsive submissions that are received from
 prospective contractors in timely  fashion  shall  be  reviewed  by  the
 commissioner of health; and
   (c)  The  commissioner  of  health  shall  select  such  contractor or
 contractors that, in [his or her] SUCH  COMMISSIONER'S  discretion,  are
 best suited to serve the purposes of this section.
   §  2.  This act shall take effect immediately; provided, however, that
 the amendments to section 364-j of  the  social  services  law  made  by
 section  one of this act shall not affect the repeal of such section and
 shall be deemed repealed therewith.
 
                                  PART HH
 
   Section 1. Subparagraphs (i) and (ii) of paragraph (a) of  subdivision
 4-a of section 365-f of the social services law, as amended by section 3
 of  part  G  of chapter 57 of the laws of 2019, the opening paragraph of
 subparagraph (i) as amended by section 2 of part PP of chapter 57 of the
 laws of 2022, are amended to read as follows:
   (i) "Fiscal intermediary" means an entity that provides fiscal  inter-
 mediary  services  and  has  a contract for providing such services with
 [the department of health and is selected through the procurement  proc-
 ess described in paragraphs (b), (b-1), (b-2) and (b-3) of this subdivi-
 sion. Eligible applicants for contracts shall be entities that are capa-
 ble  of appropriately providing fiscal intermediary services, performing
 the responsibilities of a fiscal intermediary, and complying  with  this
 section, including but not limited to entities that:
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   (A)  are  a  service  center  for independent living under section one
 thousand one hundred twenty-one of the education law; or
   (B)  have  been  established as fiscal intermediaries prior to January
 first, two thousand twelve and have  been  continuously  providing  such
 services for eligible individuals under this section.]:
   (A) A LOCAL DEPARTMENT OF SOCIAL SERVICES;
   (B)  AN  ORGANIZATION  LICENSED UNDER ARTICLE FORTY-FOUR OF THE PUBLIC
 HEALTH LAW; OR
   (C) AN ACCOUNTABLE CARE ORGANIZATION CERTIFIED UNDER  ARTICLE  TWENTY-
 NINE-E  OF  THE  PUBLIC  HEALTH  LAW  OR  AN  INTEGRATED DELIVERY SYSTEM
 COMPOSED PRIMARILY OF HEALTH CARE PROVIDERS RECOGNIZED BY THE DEPARTMENT
 AS A PERFORMING PROVIDER SYSTEM UNDER THE DELIVERY SYSTEM REFORM  INCEN-
 TIVE PAYMENT PROGRAM.
   (ii)   Fiscal   intermediary  services  shall  include  the  following
 services, performed on behalf of the consumer to facilitate [his or her]
 THE CONSUMER'S role as the employer:
   (A) wage and benefit processing for consumer directed personal assist-
 ants;
   (B) processing all income tax and other required wage withholdings;
   (C) complying with workers' compensation, disability and  unemployment
 requirements;
   (D)  maintaining personnel records for each consumer directed personal
 assistant, including time records and  other  documentation  needed  for
 wages  and  benefit  processing  and a copy of the medical documentation
 required pursuant to regulations established by the commissioner;
   (E) ensuring that the health status of each consumer directed personal
 assistant is assessed prior to service delivery pursuant to  regulations
 issued by the commissioner;
   (F) maintaining records of service authorizations or reauthorizations;
   (G) monitoring the consumer's or, if applicable, the designated repre-
 sentative's  continuing  ability  to fulfill the consumer's responsibil-
 ities under the program and promptly notifying the authorizing entity of
 any circumstance that may affect the consumer's or, if  applicable,  the
 designated representative's ability to fulfill such responsibilities;
   (H)  complying with regulations established by the commissioner speci-
 fying the responsibilities of fiscal intermediaries  providing  services
 under this title; AND
   (I)  entering  into  a department approved memorandum of understanding
 with the consumer that describes  the  parties'  responsibilities  under
 this program[; and
   (J) other related responsibilities which may include, as determined by
 the  commissioner, assisting consumers to perform the consumers' respon-
 sibilities under this section and department  regulations  in  a  manner
 that does not infringe upon the consumer's responsibilities and self-di-
 rection].
   § 2. Paragraphs (b) and (c) of subdivision 4-a of section 365-f of the
 social  services law are REPEALED and two new paragraphs (b) and (c) are
 added to read as follows:
   (B) AS OF JANUARY FIRST, TWO  THOUSAND  TWENTY-FIVE  NO  ENTITY  SHALL
 PROVIDE,  DIRECTLY  OR  THROUGH  CONTRACT,  FISCAL INTERMEDIARY SERVICES
 WITHOUT AN AUTHORIZATION AS A FISCAL INTERMEDIARY ISSUED BY THE  COMMIS-
 SIONER  IN  ACCORDANCE  WITH  THIS SUBDIVISION. IN ESTABLISHING AUTHORI-
 ZATION STANDARDS AND PROCESSES, THE  COMMISSIONER  MAY  CONSIDER  DEMON-
 STRATED  COMPLIANCE  WITH  ALL  APPLICABLE  FEDERAL  AND  STATE LAWS AND
 REGULATIONS, INCLUDING BUT NOT LIMITED TO,  MARKETING  AND  LABOR  PRAC-
 TICES,  COST  REPORTING, AND ELECTRONIC VISIT VERIFICATION REQUIREMENTS;
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 PROVIDED, HOWEVER, THAT THIS SHALL NOT BE CONSTRUED TO LIMIT THE COMMIS-
 SIONER'S  DISCRETION  IN  ESTABLISHING  SUCH  STANDARDS  AND  PROCESSES.
 NOTWITHSTANDING  THE  PRECEDING  REQUIREMENT FOR AUTHORIZATION, A FISCAL
 INTERMEDIARY  THAT  IS IN OPERATION PRIOR TO JANUARY FIRST, TWO THOUSAND
 TWENTY-FOUR MAY CONTINUE TO PROVIDE FISCAL INTERMEDIARY SERVICES WITHOUT
 AN AUTHORIZATION UNTIL SUCH TIME AS THE COMMISSIONER DETERMINES THAT THE
 CONTINUED PROVISION OF SERVICES  THROUGH  UNAUTHORIZED  FISCAL  INTERME-
 DIARIES IS NO LONGER NECESSARY TO ENSURE ACCESS TO SERVICES; SUCH DETER-
 MINATION MAY BE MADE ON A STATEWIDE, REGIONAL, OR COUNTY BASIS.
   (C)  THE COMMISSIONER IS AUTHORIZED TO DETERMINE THE MAXIMUM NUMBER OF
 FISCAL INTERMEDIARIES A LOCAL DEPARTMENT OF SOCIAL SERVICES OR AN ORGAN-
 IZATION LICENSED UNDER ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH  LAW,  OR
 AN  ACCOUNTABLE  CARE ORGANIZATION CERTIFIED UNDER ARTICLE TWENTY-NINE-E
 OF THE PUBLIC HEALTH LAW  OR  AN  INTEGRATED  DELIVERY  SYSTEM  COMPOSED
 PRIMARILY  OF  HEALTH  CARE  PROVIDERS RECOGNIZED BY THE DEPARTMENT AS A
 PERFORMING PROVIDER SYSTEM UNDER THE DELIVERY  SYSTEM  REFORM  INCENTIVE
 PAYMENT  PROGRAM MAY CONTRACT WITH, PROVIDED IT IS DETERMINED THAT THERE
 REMAINS ADEQUATE ACCESS TO SERVICES; SUCH DETERMINATION MAY BE MADE ON A
 STATEWIDE, REGIONAL OR COUNTY LEVEL BASIS.
   § 3. Paragraphs (b-1), (b-2) and (b-3) of subdivision 4-a  of  section
 365-f of the social services law are REPEALED.
   §  4.  Subdivision 4-b of section 365-f of the social services law, as
 amended by section 8 of part G of chapter 57 of the  laws  of  2019,  is
 amended to read as follows:
   4-b. Actions involving the authorization of a fiscal intermediary.
   (a)  [The  department  may  terminate a fiscal intermediary's contract
 under this section or suspend or limit the fiscal intermediary's  rights
 and  privileges  under  the contract upon thirty day's written notice to
 the fiscal intermediary, if  the  commissioner  finds  that  the  fiscal
 intermediary has failed to comply with the provisions of this section or
 regulations promulgated hereunder. The written notice shall include:
   (i)  A  description of the conduct and the issues related thereto that
 have been identified as failure of compliance; and
   (ii) the time frame of the conduct that  fails  compliance]  A  FISCAL
 INTERMEDIARY'S  AUTHORIZATION  MAY  BE  REVOKED,  SUSPENDED, LIMITED, OR
 ANNULLED UPON THIRTY DAYS' WRITTEN NOTICE TO THE FISCAL INTERMEDIARY, IF
 THE COMMISSIONER FINDS THAT THE FISCAL INTERMEDIARY HAS FAILED TO COMPLY
 WITH THE PROVISIONS OF THIS SUBDIVISION OR REGULATIONS PROMULGATED HERE-
 UNDER.
   (b) Notwithstanding the foregoing, upon determining  that  the  public
 health  or safety would be imminently endangered by the continued opera-
 tion or actions of the fiscal intermediary, the commissioner may [termi-
 nate]  REVOKE,  SUSPEND,  LIMIT,  OR  ANNUL  the  fiscal  intermediary's
 [contract or suspend or limit the fiscal intermediary's rights and priv-
 ileges  under  the  contract]  AUTHORIZATION  immediately  [upon written
 notice].
   (c) THE COMMISSIONER MAY ISSUE ORDERS AND TAKE OTHER ACTIONS AS NECES-
 SARY AND APPROPRIATE TO PROHIBIT AND PREVENT  THE  PROVISION  OF  FISCAL
 INTERMEDIARY SERVICES BY AN UNAUTHORIZED ENTITY.
   (D)  All  orders  or  determinations  under  this subdivision shall be
 subject to review as provided in  article  seventy-eight  of  the  civil
 practice law and rules.
   §  5.  Paragraph (c) of subdivision 4-d of section 365-f of the social
 services law, as added by section 7 of part G of chapter 57 of the  laws
 of 2019, is amended to read as follows:
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   (c)  Where  a  fiscal  intermediary is suspending or ceasing operation
 pursuant to an order under subdivision four-b of this  section,  or  has
 failed  to  [submit an offer for a contract] APPLY FOR AUTHORIZATION, or
 has been denied [a contract] AUTHORIZATION under this section,  all  the
 provisions  of  this  subdivision shall apply except subparagraph (i) of
 paragraph (a) of this subdivision, notice of which to all parties  shall
 be  provided  by the department, WITH THE ASSISTANCE OF ANY LOCAL SOCIAL
 SERVICES DISTRICTS OR MANAGED CARE PLANS WITH WHICH THE FISCAL  INTERME-
 DIARY CONTRACTS, as appropriate.
   §  6.  Paragraph (d) of subdivision 4-d of section 365-f of the social
 services law is REPEALED.
   § 7. Paragraph (b) of subdivision 5 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:
   (b) Notwithstanding any other provision of law,  the  commissioner  is
 authorized to waive any provision of section three hundred sixty-seven-b
 of this title related to payment and may promulgate regulations, INCLUD-
 ING  EMERGENCY REGULATIONS, necessary to carry out the objectives of the
 program INCLUDING MINIMUM SELECTION CRITERIA AND  TRAINING  REQUIREMENTS
 FOR  PERSONAL ASSISTANTS, THE ESTABLISHMENT OF LIMITATIONS ON THE NUMBER
 OF HOURS A PERSONAL ASSISTANT MAY WORK ON A DAILY AND WEEKLY BASIS,  and
 which  describe  the  responsibilities  of  the  eligible individuals in
 arranging and paying for services and the protections assured such indi-
 viduals if they are unable or  no  longer  desire  to  continue  in  the
 program,  THE  FISCAL INTERMEDIARY AUTHORIZATION PROCESS, STANDARDS, AND
 TIME FRAMES, AND THOSE REGULATIONS NECESSARY TO ENSURE  ADEQUATE  ACCESS
 TO  SERVICES,  INCLUDING BUT NOT LIMITED TO THE MAXIMUM NUMBER OF FISCAL
 INTERMEDIARIES A LOCAL DEPARTMENT OF SOCIAL SERVICES OR AN  ORGANIZATION
 LICENSED  UNDER  ARTICLE  FORTY-FOUR  OF  THE  PUBLIC  HEALTH LAW, OR AN
 ACCOUNTABLE CARE ORGANIZATION CERTIFIED UNDER ARTICLE  TWENTY-NINE-E  OF
 THE  PUBLIC HEALTH LAW OR INTEGRATED DELIVERY SYSTEMS COMPOSED PRIMARILY
 OF HEALTH CARE PROVIDERS RECOGNIZED BY THE DEPARTMENT  AS  A  PERFORMING
 PROVIDER  SYSTEM  UNDER  THE  DELIVERY  SYSTEM  REFORM INCENTIVE PAYMENT
 PROGRAM MAY CONTRACT WITH; SUCH DETERMINATION MAY BE MADE  ON  A  STATE-
 WIDE, REGIONAL, OR COUNTY BASIS.
   §  8. Paragraphs (e) and (f) of subdivision 2 of section 3605-c of the
 public health law, as added by section 10 of part MM of  chapter  56  of
 the  laws  of 2020, are amended and a new paragraph (g) is added to read
 as follows:
   (e) the commissioner may institute a  continuous  recruitment  process
 provided  that  the  information  required  under  paragraph (a) of this
 subdivision remains on the department's website for the entire  duration
 of  the  recruitment  process,  until  such date as the commissioner may
 determine upon no less than ten days notice being posted on the website;
 [and]
   (f) the commissioner may reoffer contracts under  the  same  terms  of
 this  subdivision,  if  determined  necessary  by the commissioner, on a
 statewide or regional basis[.]; AND
   (G) ON AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-FOUR, THE DEPARTMENT
 SHALL NOT ALLOW THE ENROLLMENT OR RE-ENROLLMENT  OF  A  LHCSA  INTO  THE
 MEDICAL  ASSISTANCE PROGRAM IF SUCH LHCSA IS MAJORITY OWNED BY A COMPANY
 WHICH PROVIDES FISCAL INTERMEDIARY SERVICES, OR IS MAJORITY OWNED  BY  A
 COMPANY  WHICH  ALSO HAS MAJORITY OWNERSHIP OVER A COMPANY THAT PROVIDES
 FISCAL INTERMEDIARY SERVICES, OR  ITSELF  PROVIDES  FISCAL  INTERMEDIARY
 SERVICES  IN THE STATE CONSUMER DIRECTED PERSONAL ASSISTANCE PROGRAM, OR
 IS THE MAJORITY OWNER OF A COMPANY  THAT  PROVIDES  FISCAL  INTERMEDIARY
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 SERVICES, AS DEFINED IN SECTION THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL
 SERVICES  LAW.    FOR  THE PURPOSES OF THIS SECTION, "MAJORITY OWNED" OR
 "MAJORITY OWNERSHIP" SHALL BE  DEFINED  AS  CONTROLLING  INTEREST  IN  A
 COMPANY,  OR  BEING  THE  LARGEST HOLDER OF THE COMMON STOCK OR ORDINARY
 SHARES OF A COMPANY.
   § 9. Paragraphs (g) and (h) of subdivision 1 of section  4403  of  the
 public  health law, paragraph (g) as added by chapter 938 of the laws of
 1976 and paragraph (h) as amended by chapter 805 of the  laws  of  1984,
 are  amended  and  two  new  paragraphs (i) and (j) are added to read as
 follows:
   (g) approved mechanisms exist to  resolve  complaints  and  grievances
 initiated by any enrolled member; [and]
   (h)  the  contract  between the enrollee and the organization meet the
 requirements of the superintendent as set forth  in  section  forty-four
 hundred  six of this article, as to the provisions contained therein for
 health services, the procedures for offering, renewing,  converting  and
 terminating  contracts  to  enrollees,  and the rates for such contracts
 including but not limited to, compliance with the provisions of  section
 one thousand one hundred nine of the insurance law[.];
   (I) THAT THE APPLICANT IS NOT CONTROLLED, AS DEFINED UNDER REGULATION,
 BY  AN  ENTITY  WHICH  PROVIDES  FISCAL  INTERMEDIARY  SERVICES,  IS NOT
 CONTROLLED BY AN ENTITY WHICH ALSO  HAS  CONTROL  OVER  AN  ENTITY  THAT
 PROVIDES  FISCAL  INTERMEDIARY  SERVICES, DOES NOT ITSELF PROVIDE FISCAL
 INTERMEDIARY SERVICES IN THE STATE CONSUMER DIRECTED PERSONAL ASSISTANCE
 PROGRAM, AND DOES NOT CONTROL AN ENTITY THAT  PROVIDES  FISCAL  INTERME-
 DIARY  SERVICES, AS DEFINED IN SECTION THREE HUNDRED SIXTY-FIVE-F OF THE
 SOCIAL SERVICES LAW; AND
   (J) THAT THE APPLICANT IS NOT CONTROLLED, AS DEFINED UNDER REGULATION,
 BY AN  ENTITY  WHICH  PROVIDES  LICENSED  HOME  CARE  SERVICES,  IS  NOT
 CONTROLLED  BY  AN  ENTITY  WHICH  ALSO  HAS CONTROL OVER A COMPANY THAT
 PROVIDES LICENSED HOME CARE SERVICES, DOES NOT ITSELF  PROVIDE  LICENSED
 HOME  CARE  SERVICES,  AND  DOES  NOT  CONTROL  AN  ENTITY THAT PROVIDES
 LICENSED HOME CARE SERVICES.
   § 10. Section 4403 of the public health law is amended by adding a new
 subdivision 1-a to read as follows:
   1-A. (A) BY APRIL FIRST, TWO THOUSAND TWENTY-FIVE, ANY HEALTH  MAINTE-
 NANCE  ORGANIZATION  WHICH  PROVIDES  FISCAL  INTERMEDIARY  SERVICES  OR
 LICENSED HOME CARE SERVICES, IS CONTROLLED BY AN ENTITY  WHICH  PROVIDES
 FISCAL INTERMEDIARY SERVICES OR LICENSED HOME CARE SERVICES, HAS CONTROL
 OVER  AN  ENTITY WHICH PROVIDES FISCAL INTERMEDIARY SERVICES OR LICENSED
 HOME CARE SERVICES, OR IS CONTROLLED BY AN ENTITY WHICH ALSO HAS CONTROL
 OVER AN ENTITY THAT PROVIDES FISCAL INTERMEDIARY  SERVICES  OR  LICENSED
 HOME  CARE  SERVICES, SHALL BE REQUIRED TO RESUBMIT AN APPLICATION FOR A
 CERTIFICATE OF AUTHORITY PURSUANT TO SECTION FOUR THOUSAND FOUR  HUNDRED
 TWO OF THIS ARTICLE.
   (B) AFTER APRIL FIRST, TWO THOUSAND TWENTY-FIVE, NO HEALTH MAINTENANCE
 ORGANIZATION  WHICH  PROVIDES  FISCAL  INTERMEDIARY SERVICES OR LICENSED
 HOME CARE SERVICES, IS CONTROLLED BY AN  ENTITY  WHICH  PROVIDES  FISCAL
 INTERMEDIARY  SERVICES  OR LICENSED HOME CARE SERVICES, HAS CONTROL OVER
 AN ENTITY WHICH PROVIDES FISCAL INTERMEDIARY SERVICES OR  LICENSED  HOME
 CARE SERVICES, OR IS CONTROLLED BY AN ENTITY WHICH ALSO HAS CONTROL OVER
 AN  ENTITY  THAT  PROVIDES FISCAL INTERMEDIARY SERVICES OR LICENSED HOME
 CARE SERVICES, MAY MAINTAIN CERTIFICATION TO OPERATE AS A HEALTH MAINTE-
 NANCE ORGANIZATION.
    (C) FOR THE PURPOSES OF THIS SUBDIVISION, "CONTROL" SHALL BE  DEFINED
 IN REGULATION.
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   § 11. Paragraphs (h) and (i) of subdivision 3 of section 4403-f of the
 public health law, as amended by section 41-a of part H of chapter 59 of
 the  laws  of  2011,  are amended and two new paragraphs (j) and (k) are
 added to read as follows:
   (h) that the contractual arrangements for providers of health and long
 term  care  services in the benefit package are sufficient to ensure the
 availability and accessibility of such services to the proposed enrolled
 population consistent with guidelines established by  the  commissioner;
 with respect to individuals in receipt of such services prior to enroll-
 ment,  such  guidelines shall require the managed long term care plan to
 contract with agencies currently providing such services,  in  order  to
 promote  continuity  of care. In addition, such guidelines shall require
 managed long term care  plans  to  offer  and  cover  consumer  directed
 personal  assistance  services  for  eligible individuals who elect such
 services pursuant to section three hundred sixty-five-f  of  the  social
 services law; [and]
   (i)  that the applicant is financially responsible and may be expected
 to meet its obligations to its enrolled members[.];
   (J) THAT THE APPLICANT IS NOT CONTROLLED, AS DEFINED UNDER REGULATION,
 BY AN  ENTITY  WHICH  PROVIDES  FISCAL  INTERMEDIARY  SERVICES,  IS  NOT
 CONTROLLED  BY  AN  ENTITY  WHICH  ALSO  HAS CONTROL OVER AN ENTITY THAT
 PROVIDES FISCAL INTERMEDIARY SERVICES, DOES NOT  ITSELF  PROVIDE  FISCAL
 INTERMEDIARY SERVICES IN THE STATE CONSUMER DIRECTED PERSONAL ASSISTANCE
 PROGRAM,  AND  DOES  NOT CONTROL AN ENTITY THAT PROVIDES FISCAL INTERME-
 DIARY SERVICES, AS DEFINED IN SECTION THREE HUNDRED SIXTY-FIVE-F OF  THE
 SOCIAL SERVICES LAW; AND
   (K) THAT THE APPLICANT IS NOT CONTROLLED, AS DEFINED UNDER REGULATION,
 BY  AN  ENTITY  WHICH  PROVIDES  LICENSED  HOME  CARE  SERVICES,  IS NOT
 CONTROLLED BY AN ENTITY WHICH ALSO  HAS  CONTROL  OVER  A  COMPANY  THAT
 PROVIDES  LICENSED  HOME CARE SERVICES, DOES NOT ITSELF PROVIDE LICENSED
 HOME CARE SERVICES,  AND  DOES  NOT  CONTROL  AN  ENTITY  THAT  PROVIDES
 LICENSED HOME CARE SERVICES.
   §  12.  Section 4403-f of the public health law is amended by adding a
 new subdivision 3-a to read as follows:
   3-A. (A) BY APRIL FIRST, TWO THOUSAND TWENTY-FIVE,  ANY  MANAGED  LONG
 TERM  CARE  PLAN WHICH PROVIDES FISCAL INTERMEDIARY SERVICES OR LICENSED
 HOME CARE SERVICES, IS CONTROLLED BY AN  ENTITY  WHICH  PROVIDES  FISCAL
 INTERMEDIARY  SERVICES  OR LICENSED HOME CARE SERVICES, HAS CONTROL OVER
 AN ENTITY WHICH PROVIDES FISCAL INTERMEDIARY SERVICES OR  LICENSED  HOME
 CARE SERVICES, OR IS CONTROLLED BY AN ENTITY WHICH ALSO HAS CONTROL OVER
 AN  ENTITY  THAT  PROVIDES FISCAL INTERMEDIARY SERVICES OR LICENSED HOME
 CARE SERVICES, SHALL BE  REQUIRED  TO  RESUBMIT  AN  APPLICATION  FOR  A
 CERTIFICATE OF AUTHORITY PURSUANT TO SUBDIVISION TWO OF THIS SECTION.
   (B)  AFTER APRIL FIRST, TWO THOUSAND TWENTY-FIVE, NO MANAGED LONG TERM
 CARE PLAN WHICH PROVIDES FISCAL INTERMEDIARY SERVICES OR  LICENSED  HOME
 CARE SERVICES, IS CONTROLLED BY AN ENTITY WHICH PROVIDES FISCAL INTERME-
 DIARY SERVICES OR LICENSED HOME CARE SERVICES, HAS CONTROL OVER AN ENTI-
 TY  WHICH  PROVIDES  FISCAL  INTERMEDIARY SERVICES OR LICENSED HOME CARE
 SERVICES, OR IS CONTROLLED BY AN ENTITY WHICH ALSO HAS CONTROL  OVER  AN
 ENTITY  THAT PROVIDES FISCAL INTERMEDIARY SERVICES OR LICENSED HOME CARE
 SERVICES, MAY MAINTAIN CERTIFICATION TO OPERATE AS A MANAGED  LONG  TERM
 CARE PLAN.
   (C)  FOR  THE  PURPOSES  OF THIS SUBDIVISION, "CONTROL" SHALL HAVE THE
 SAME MEANING AS DEFINED IN REGULATION.
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   § 13. Subparagraphs (v) and (vi) of paragraph (e) of subdivision 2  of
 section  365-a  of  the social services law are renumbered subparagraphs
 (vi) and (vii) and a new subparagraph (v) is added to read as follows:
   (V)  THE COMMISSIONER OF HEALTH MAY ISSUE REGULATIONS, INCLUDING EMER-
 GENCY REGULATIONS, TO ESTABLISH THE MAXIMUM DAILY AND WEEKLY  HOURS  ANY
 INDIVIDUAL  AIDE  PROVIDING PERSONAL CARE SERVICES AVAILABLE PURSUANT TO
 THIS PARAGRAPH SHALL WORK;
   § 14. Paragraph (c) of subdivision 2 of section 365-f  of  the  social
 services  law,  as  amended by section 3 of part MM of chapter 56 of the
 laws of 2020, is amended to read as follows:
   (c) has been determined by the social services district,  pursuant  to
 an assessment of the person's appropriateness for the program, conducted
 with an appropriate long term home health care program, a certified home
 health  agency, or an AIDS home care program or pursuant to the personal
 care program, as being in need of home care  services  or  private  duty
 nursing  and as needing at least limited assistance with physical maneu-
 vering with more than two activities of daily  living,  or  for  persons
 with  a  dementia  or  Alzheimer's diagnosis, as needing at least super-
 vision with more than one activity of daily living,  provided  that  the
 provisions related to activities of daily living in this paragraph shall
 only  apply to persons who initially seek eligibility for the program on
 or after October first, two thousand twenty, and who is able and willing
 [or has a designated representative, including a legal guardian able and
 willing] to make informed choices, [or a designated  relative  or  other
 adult  who is able and willing to assist in making informed choices,] as
 to the type and quality of services, including but not limited  to  such
 services  as  nursing  care,  personal  care, transportation and respite
 services; and
   § 15. Subdivision 3 of section 365-f of the social  services  law,  as
 amended  by  section  9 of part QQ of chapter 56 of the laws of 2020, is
 amended to read as follows:
   3. Division of responsibilities. (A) Eligible individuals who elect to
 participate in the program assume the responsibility for services  under
 such  program  as  mutually  agreed  to  by  the eligible individual and
 provider and as documented in the eligible individual's record,  includ-
 ing,  but  not  limited  to,  recruiting,  hiring  and supervising their
 personal assistants. [For the purposes of this section,]
   (B) A personal assistant  [shall  mean],  FOR  THE  PURPOSES  OF  THIS
 SECTION, IS an adult who:
   (1)  has obtained an individual unique identifier from the state by or
 before a date determined by the commissioner of health  in  consultation
 with the Medicaid inspector general[,]; and
   (2)  provides  services  under this section to the eligible individual
 under the eligible individual's instruction, supervision, and  direction
 [or  under  the  instruction,  supervision and direction of the eligible
 individual's designated representative, provided that a].
   (C) A person legally responsible for an eligible individual's care and
 support, an eligible individual's spouse [or designated representative],
 may not be the personal assistant for the eligible individual;  however,
 a  personal assistant may include any other adult relative of the eligi-
 ble individual, provided, however, that the program determines that  the
 services  provided  by such relative are consistent with an individual's
 plan of care and that the aggregate cost  for  such  services  does  not
 exceed the aggregate costs for equivalent services provided by a non-re-
 lative personal assistant.
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   (D) Any personal information submitted to obtain [such] A unique iden-
 tifier UNDER THIS SUBDIVISION shall be maintained as confidential pursu-
 ant to article six-A of the public officers law ("New York state privacy
 protection law"). Such individuals shall be assisted as appropriate with
 service coverage, supervision, advocacy and management.
   (E)  Providers shall not be liable for fulfillment of responsibilities
 agreed to be undertaken by the eligible  individual.  This  subdivision,
 however,  shall  not diminish the participating provider's liability for
 failure to exercise reasonable care in properly carrying out its respon-
 sibilities under this program, which shall include monitoring such indi-
 vidual's continuing ability to fulfill those responsibilities documented
 in his or her records. Failure of the individual to carry out his or her
 agreed to responsibilities may be considered in determining  such  indi-
 vidual's continued appropriateness for the program.
   §  16. Clause (G) of subparagraph (ii) of paragraph (a) of subdivision
 4-a of section 365-f of the social services law, as amended by section 3
 of part G of chapter 57 of the laws of  2019,  is  amended  to  read  as
 follows:
   (G)  monitoring  the  consumer's  [or,  if  applicable, the designated
 representative's] continuing ability to fulfill the consumer's responsi-
 bilities under the program and promptly notifying the authorizing entity
 of any circumstance that may affect the consumer's [or,  if  applicable,
 the  designated  representative's]  ability to fulfill such responsibil-
 ities;
   § 17. Subparagraph (iii) of paragraph (a) subdivision 4-a  of  section
 365-f  of  the  social  services law, as added by section 1 of part E of
 chapter 57 of the laws of 2017, is amended to read as follows:
   (iii) Fiscal intermediaries are not responsible for, and fiscal inter-
 mediary services shall not include, fulfillment of the  responsibilities
 of  the consumer [or, if applicable, the consumer's designated represen-
 tative] as established by  the  commissioner.  A  fiscal  intermediary's
 responsibilities  shall not include, and a fiscal intermediary shall not
 engage in: managing the plan of care including recruiting and  hiring  a
 sufficient  number  of  individuals  who meet the definition of consumer
 directed personal assistant, as such term is defined by the  commission-
 er,  to  provide authorized services that are included on the consumer's
 plan  of  care;  training,  supervising  and  scheduling  each  consumer
 directed  personal assistant; terminating the consumer directed personal
 assistant's employment; or assuring that each consumer directed personal
 assistant competently and safely performs the  personal  care  services,
 home health aide services and skilled nursing tasks that are included on
 the  consumer's  plan  of  care.  A  fiscal  intermediary shall exercise
 reasonable care in properly carrying out its responsibilities under  the
 program.
   §  18.  This  act shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024; provided,
 however, that sections thirteen, fourteen, fifteen, sixteen  and  seven-
 teen  of  this  act  shall  take  effect  October 1, 2024; and provided,
 further, that the amendments to section 4403-f of the public health  law
 made  by  sections  eleven  and  twelve of this act shall not affect the
 repeal of such section and shall be deemed repealed therewith.
   § 2. Severability clause. If any clause, sentence, paragraph, subdivi-
 sion, section or part of this act shall be  adjudged  by  any  court  of
 competent  jurisdiction  to  be invalid, such judgment shall not affect,
 impair, or invalidate the remainder thereof, but shall  be  confined  in
 its  operation  to the clause, sentence, paragraph, subdivision, section
 S. 8307--A                         160                        A. 8807--A
 
 or part thereof directly involved in the controversy in which such judg-
 ment shall have been rendered. It is hereby declared to be the intent of
 the legislature that this act would  have  been  enacted  even  if  such
 invalid provisions had not been included herein.
   §  3.  This  act shall take effect immediately provided, however, that
 the applicable effective date of Parts A through HH of this act shall be
 as specifically set forth in the last section of such Parts.

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
     S. 8307--C                                            A. 8807--C
 
                       S E N A T E - A S S E M B L Y
 
                             January 17, 2024
                                ___________
 
 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 -- committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to said committee  --  committee  discharged,  bill  amended,  ordered
   reprinted  as  amended  and recommitted to said committee -- committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to said committee
 
 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 --  committee  discharged,  bill  amended,
   ordered  reprinted  as  amended  and  recommitted to said committee --
   again reported from said committee with amendments, ordered  reprinted
   as  amended  and  recommitted to said committee -- again reported from
   said committee with  amendments,  ordered  reprinted  as  amended  and
   recommitted to said committee
 
 AN  ACT  to amend part H of chapter 59 of the laws of 2011, amending the
   public  health  law  and  other  laws  relating  to  general  hospital
   reimbursement  for  annual  rates,  in relation to known and projected
   department of health state fund medicaid  expenditures  (Part  A);  to
   amend  the  public  health  law,  in  relation  to  extending  certain
   provisions related to the issuance of  accountable  care  organization
   certifications  and  state oversight of antitrust provisions; to amend
   part D of chapter 56 of the laws of 2013 amending the social  services
   law  relating  to  eligibility  conditions, chapter 649 of the laws of
   1996 amending the public health law, the mental hygiene  law  and  the
   social  services  law  relating  to  authorizing  the establishment of
   special needs plans, part V of chapter 57 of the laws of 2022 amending
   the public health law and the insurance law relating to  reimbursement
   for  commercial and Medicaid services provided via telehealth, chapter
   659 of the laws of 1997 amending the public health law and other  laws
   relating  to  creation of continuing care retirement communities, part
   NN of chapter 57 of the laws of 2018 amending the  public  health  law
   and  the state finance law relating to enacting the opioid stewardship
   act, part II of chapter 54 of the laws of  2016  amending  part  C  of
   chapter  58 of the laws of 2005 relating to authorizing reimbursements
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD12671-05-4
 S. 8307--C                          2                         A. 8807--C
 
   for expenditures made by or on behalf of social services districts for
   medical assistance for needy persons and administration thereof,  part
   B  of  chapter 57 of the laws of 2015 amending the social services law
   and  other laws relating to energy audits and/or disaster preparedness
   reviews of residential healthcare facilities by the commissioner, part
   H of chapter 57 of the laws of 2019 amending  the  public  health  law
   relating to waiver of certain regulations, part Q of chapter 59 of the
   laws  of 2016, amending the mental hygiene law relating to the closure
   or transfer of a state-operated  individualized  residential  alterna-
   tive,  and chapter 769 of the laws of 2023, amending the public health
   law relating to the  adult  cystic  fibrosis  assistance  program,  in
   relation to the effectiveness thereof; and to amend chapter 670 of the
   laws of 2021, requiring the office for people with developmental disa-
   bilities  to  establish the care demonstration program, in relation to
   the establishment of a care demonstration program and  the  effective-
   ness  thereof  (Part  B);  to  amend the education law, in relation to
   removing the exemption for school psychologists to render early inter-
   vention services; and to amend chapter 217 of the laws of 2015, amend-
   ing the education law relating to certified school  psychologists  and
   special  education  services  and programs for preschool children with
   handicapping conditions, in  relation  to  the  effectiveness  thereof
   (Part  C); to amend the public health law, in relation to reducing the
   hospital capital rate add-on; to amend part ZZ of chapter  56  of  the
   laws  of 2020 amending the tax law and the  social services law relat-
   ing to certain Medicaid management, in relation to  the  effectiveness
   thereof;  to  amend part E of chapter 57 of the laws of 2015, amending
   the public health law relating to the payment  of  certain  funds  for
   uncompensated  care,  in  relation  to  certain payments being made as
   outpatient  upper  payment  limit  payments  for  outpatient  hospital
   services  during  certain  state  fiscal  years and calendar years; to
   amend part B of chapter 57 of the laws of 2015,  amending  the  social
   services  law relating to supplemental rebates, in relation to author-
   izing the department of health to increase operating cost component of
   rates of payment for general hospital outpatient services and  author-
   izing  the department of health to pay a public hospital adjustment to
   public general hospitals during certain state fiscal years and  calen-
   dar  years; to amend the public health law, in relation to authorizing
   the commissioner to make additional inpatient hospital payments during
   certain state fiscal years and calendar years; and to amend part B  of
   chapter  58  of the laws of 2010, amending the social services law and
   the public health law relating to prescription drug coverage for needy
   persons and health care initiatives pools, in relation to  authorizing
   the department of health to make Medicaid payment increases for county
   operated  free-standing  clinics during certain state fiscal years and
   calendar years (Part D); to amend the public health law,  in  relation
   to  freezing  the operating component of the rates for skilled nursing
   facilities, reducing the capital component of the  rates  for  skilled
   nursing  facilities  by an additional ten percent, and eligibility for
   admission to the New York state veterans' home (Part E); to amend  the
   social  services law, in relation to the special needs assisted living
   residence voucher program (Part F); intentionally omitted (Part G); to
   amend part I of chapter 57 of  the  laws  of  2022,  providing  a  one
   percent  across  the board payment increase to all qualifying fee-for-
   service Medicaid rates, in relation to  eliminating  the  one  percent
   rate  increase  to  managed  care organizations (Part H); to amend the
   social services law, in relation to copayments for drugs; to amend the
 S. 8307--C                          3                         A. 8807--C
 
   public health law, in relation to the preferred drug program; to amend
   the public health law, in relation to the Medicaid drug cap and  phar-
   macy cost reporting; and to amend the social services law, in relation
   to  coverage for drugs authorized by accelerated approval (Part I); to
   amend the social services law,  in  relation  to  renaming  the  basic
   health program to the essential plan; to amend part H of chapter 57 of
   the  laws of 2021, amending the social services law relating to elimi-
   nating consumer-paid premium payments in the basic health program,  in
   relation to the effectiveness thereof; to amend part BBB of chapter 56
   of  the  laws  of  2022, amending the public health law and other laws
   relating to permitting the commissioner of health to submit  a  waiver
   that  expands  eligibility  for  New  York's  basic health program and
   increases the federal poverty  limit  cap  for  basic  health  program
   eligibility  from    two  hundred  to  two  hundred  fifty percent, in
   relation to extending certain provisions related  to  providing  long-
   term  services and supports under the essential plan; and to amend the
   public health law, in relation to adding references to the 1332  state
   innovation  waiver,  providing  a new subsidy to assist low-income New
   Yorkers with the payment of premiums, cost-sharing or both through the
   marketplace, and adding the 1332 state innovation program to the func-
   tions of the marketplace (Part J); 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 insur-
   ance coverage paid for by funds from  the  hospital  excess  liability
   pool and extending the effectiveness of certain provisions thereof; 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,  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 K);
   intentionally omitted (Part L); to amend the social services  law  and
   the  public health law, in relation to authorizing continuous coverage
   in Medicaid and child health plus, for eligible children ages zero  to
   six  (Part  M);  intentionally  omitted  (Part N); to amend the public
   health law, in relation to  expanding  financial  assistance;  and  to
   amend  the  general  business  law, in relation to additional consumer
   protection for medical debt and restricting the applications  for  and
   use  of credit cards and medical financial products (Part O); to amend
   part C of chapter 57 of the laws of 2022 amending  the  public  health
   law  and  the education law relating to allowing pharmacists to direct
   limited service laboratories and order  and  administer  COVID-19  and
   influenza tests and modernizing nurse practitioners, and chapter 21 of
   the  laws  of  2011 amending the education law relating to authorizing
   pharmacists to perform  collaborative  drug  therapy  management  with
   physicians in certain settings, in relation to the effectiveness ther-
   eof  (Part  P);  intentionally omitted (Part Q); intentionally omitted
   (Part R); to amend the public health law, in relation to  establishing
   the  healthcare  safety  net  transformation  program (Part S); inten-
   tionally omitted (Part T);  intentionally  omitted  (Part  U);  inten-
   tionally  omitted  (Part  V);  intentionally  omitted (Part W); inten-
   tionally omitted (Part X); 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
 S. 8307--C                          4                         A. 8807--C
 
   program, the membership of subcommittees for mental health of communi-
   ty  services  boards and the duties of such subcommittees and creating
   the community mental health and  workforce  reinvestment  account,  in
   relation  to  the  effectiveness thereof (Part Y); to amend part NN of
   chapter 58 of the laws of 2015, amending the mental hygiene law relat-
   ing 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 Z); to amend
   the insurance law, in relation to setting  minimal  reimbursement  for
   behavioral  health  treatment  (Part  AA); to amend chapter 723 of the
   laws of 1989 amending the mental hygiene law and other  laws  relating
   to  comprehensive  psychiatric emergency programs, in  relation to the
   effectiveness of certain provisions thereof (Part  BB);  intentionally
   omitted  (Part CC); to amend part A of 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 DD); intentionally omitted (Part
   EE); to establish a cost of living  adjustment  for  designated  human
   services  programs  (Part  FF);  to  amend the social services law, in
   relation to providing contracting  flexibility  in  relation  to  1115
   medicaid  waivers  (Part  GG);  to  amend  the social services law, in
   relation to statewide fiscal intermediaries and a registration process
   for such intermediaries; to amend the social services law, in relation
   to the consumer directed personal assistance program;  and  to  repeal
   certain  provisions  of the social services law relating thereto (Part
   HH); to amend the public health law and  the  state  finance  law,  in
   relation to establishing a New York managed care organization provider
   tax (Part II); to amend the social services law, in relation to cover-
   age  for  services provided by school-based health centers for medical
   assistance recipients (Part JJ); to amend the public  health  law,  in
   relation to the creation of a community doula expansion grant program;
   and to repeal such program upon expiration thereof (Part KK); to amend
   the  public  health  law,  in  relation  to  reimbursement  rates  for
   medically fragile children  and  pediatric  diagnostic  and  treatment
   centers;  and  providing  for  the  repeal of such provisions upon the
   expiration thereof (Part LL); to amend the executive law, in  relation
   to establishing the community advisory board for the modernization and
   revitalization of SUNY downstate health sciences university (Part MM);
   and  to amend part I of chapter 57 of the laws of 2022 providing a one
   percent across the board payment increase to all  qualifying  fee-for-
   service  Medicaid rates, in relation to certain Medicaid payments made
   for hospital services (Part NN)
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  This  act enacts into law major components of legislation
 necessary to implement the state health and mental  hygiene  budget  for
 the  2024-2025  state  fiscal  year.  Each component is wholly contained
 within a Part identified as Parts A through NN. The effective  date  for
 each particular provision contained within such Part is set forth in the
 last section of such Part. Any provision in any section contained within
 a  Part,  including the effective date of the Part, which makes a refer-
 ence to a section "of this act",  when  used  in  connection  with  that
 S. 8307--C                          5                         A. 8807--C
 
 particular  component,  shall  be deemed to mean and refer to the corre-
 sponding section of the Part in which it is found. Section three of this
 act sets forth the general effective date of this act.
 
                                  PART A
 
   Section  1.  Paragraph (a) of subdivision 1 of section 92 of part H of
 chapter 59 of the laws of 2011, amending the public health law and other
 laws relating to general hospital reimbursement  for  annual  rates,  as
 amended  by  section  1  of part A of chapter 57 of the laws of 2023, is
 amended to read as follows:
   (a) For state fiscal years  2011-12  through  [2024-25]  2025-26,  the
 director  of the budget, in consultation with the commissioner of health
 referenced as "commissioner" for purposes of this section, shall  assess
 on  a  quarterly  basis,  as  reflected in quarterly reports pursuant to
 subdivision five of this  section  known  and  projected  department  of
 health  state  funds medicaid expenditures by category of service and by
 geographic regions, as defined by the commissioner.
   § 2. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART B
 
   Section  1. Subdivision p of section 76 of part D of chapter 56 of the
 laws of 2013 amending the social services law  relating  to  eligibility
 conditions,  as amended by section 2 of part E of chapter 57 of the laws
 of 2019, is amended to read as follows:
   p. the amendments to subparagraph 7 of paragraph (b) of subdivision  1
 of  section  366  of the social services law made by section one of this
 act shall expire and be deemed repealed October 1, [2024] 2029.
   § 2. Section 10 of chapter 649 of the laws of 1996 amending the public
 health law, the mental hygiene law and the social services law  relating
 to  authorizing  the establishment of special needs plans, as amended by
 section 21 of part E of chapter 57 of the laws of 2019,  is  amended  to
 read as follows:
   §  10.  This  act shall take effect immediately and shall be deemed to
 have been in full force and effect on and after July 1, 1996;  provided,
 however,  that  sections one, two and three of this act shall expire and
 be deemed repealed [on] March 31, [2025] 2030 provided, however that the
 amendments to section 364-j of the social services law made  by  section
 four  of  this  act  shall not affect the expiration of such section and
 shall be deemed to expire therewith  and  provided,  further,  that  the
 provisions  of  subdivisions  8,  9 and 10 of section 4401 of the public
 health law, as added by section one of this act; section 4403-d  of  the
 public health law as added by section two of this act and the provisions
 of  section seven of this act, except for the provisions relating to the
 establishment of no more than twelve  comprehensive  HIV  special  needs
 plans, shall expire and be deemed repealed on July 1, 2000.
   §  3.  Subdivision  3  of  section 2999-p of the public health law, as
 amended by section 8 of part BB of chapter 56 of the laws  of  2020,  is
 amended to read as follows:
   3.  The commissioner may issue a certificate of authority to an entity
 that meets conditions for ACO certification as set forth in  regulations
 made  by  the commissioner pursuant to section twenty-nine hundred nine-
 ty-nine-q of this article. The commissioner  shall  not  issue  any  new
 S. 8307--C                          6                         A. 8807--C
 
 certificate under this article after December thirty-first, two thousand
 [twenty-four] TWENTY-EIGHT.
   §  4.  Subdivision  1  of section 2999-aa of the public health law, as
 amended by section 9 of part S of chapter 57 of the  laws  of  2021,  is
 amended to read as follows:
   1.  In order to promote improved quality and efficiency of, and access
 to, health care services and to promote improved  clinical  outcomes  to
 the  residents  of  New  York,  it  shall  be the policy of the state to
 encourage, where appropriate, cooperative, collaborative and integrative
 arrangements including but not  limited  to,  mergers  and  acquisitions
 among  health  care  providers  or  among  others who might otherwise be
 competitors, under the active supervision of the  commissioner.  To  the
 extent  such arrangements, or the planning and negotiations that precede
 them, might be anti-competitive within the meaning  and  intent  of  the
 state and federal antitrust laws, the intent of the state is to supplant
 competition  with  such  arrangements  under  the active supervision and
 related administrative actions  of  the  commissioner  as  necessary  to
 accomplish  the  purposes  of  this article, and to provide state action
 immunity under the state and federal  antitrust  laws  with  respect  to
 activities  undertaken  by  health care providers and others pursuant to
 this article, where the benefits of such  active  supervision,  arrange-
 ments  and actions of the commissioner outweigh any disadvantages likely
 to result from a reduction of competition. The  commissioner  shall  not
 approve  an  arrangement for which state action immunity is sought under
 this article without first consulting with, and receiving a  recommenda-
 tion from, the public health and health planning council. No arrangement
 under  this  article  shall be approved after December thirty-first, two
 thousand [twenty-four] TWENTY-EIGHT.
   § 5. Section 7 of part V of chapter 57 of the laws  of  2022  amending
 the  public  health  law and the insurance law relating to reimbursement
 for commercial and Medicaid services provided via telehealth, is amended
 to read as follows:
   § 7. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2022; provided,
 however, this act shall expire and be deemed repealed on and after April
 1, [2024] 2026.
   § 6. Section 97 of chapter 659 of the laws of 1997 amending the public
 health  law  and  other  laws  relating  to  creation of continuing care
 retirement communities, as amended by section 11 of part Z of chapter 57
 of the laws of 2018, is amended to read as follows:
   § 97. This act shall take effect immediately, provided, however,  that
 the  amendments to subdivision 4 of section 854 of the general municipal
 law made by section seventy of this act shall not affect the  expiration
 of such subdivision and shall be deemed to expire therewith and provided
 further  that  sections  sixty-seven  and  sixty-eight of this act shall
 apply to taxable years  beginning  on  or  after  January  1,  1998  and
 provided  further  that sections eighty-one through eighty-seven of this
 act shall expire and be deemed repealed on December 31, [2024] 2029  and
 provided further, however, that the amendments to section ninety of this
 act  shall  take effect January 1, 1998 and shall apply to all policies,
 contracts, certificates, riders or other evidences of coverage  of  long
 term  care  insurance  issued,  renewed, altered or modified pursuant to
 section 3229 of the insurance law on or after such date.
   § 7. Section 5 of part NN of chapter 57 of the laws of  2018  amending
 the public health law and the state finance law relating to enacting the
 S. 8307--C                          7                         A. 8807--C
 
 opioid stewardship act, as amended by section 5 of part XX of chapter 59
 of the laws of 2019, is amended to read as follows:
   §  5.  This act shall take effect July 1, 2018 and shall expire and be
 deemed to be repealed on June 30, [2024] 2029, provided that,  effective
 immediately,  the addition, amendment and/or repeal of any rule or regu-
 lation necessary for the implementation of this  act  on  its  effective
 date are authorized to be made and completed on or before such effective
 date,  and,  provided  that  this  act  shall  only apply to the sale or
 distribution of opioids in the state of New York on or  before  December
 31, 2018.
   §  8.  Section 2 of part II of chapter 54 of the laws of 2016 amending
 part C of chapter 58  of  the  laws  of  2005  relating  to  authorizing
 reimbursements  for expenditures made by or on behalf of social services
 districts for medical assistance for needy  persons  and  administration
 thereof, as amended by section 6 of part CC of chapter 57 of the laws of
 2022, is amended to read as follows:
   §  2.  This  act shall take effect immediately and shall expire and be
 deemed repealed March 31, [2024] 2026.
   § 9. Subdivision 5 of section 60 of part B of chapter 57 of  the  laws
 of  2015  amending  the  social  services law and other laws relating to
 energy  audits  and/or  disaster  preparedness  reviews  of  residential
 healthcare  facilities by the commissioner, as amended by chapter 125 of
 the laws of 2021, is amended to read as follows:
   5. section thirty-eight  of  this  act  shall  expire  and  be  deemed
 repealed July 1, [2024] 2027;
   §  10. Section 7 of part H of chapter 57 of the laws of 2019, amending
 the public health law relating to  waiver  of  certain  regulations,  as
 amended  by  section  1 of part GG of chapter 57 of the laws of 2022, is
 amended to read as follows:
   § 7. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2019, provided,
 however,  that  section  two of this act shall expire on April 1, [2024]
 2026.
   § 11. Section 2 of part Q of chapter 59 of the laws of 2016,  amending
 the  mental  hygiene law relating to the closure or transfer of a state-
 operated individualized residential alternative, as amended  by  chapter
 176 of the laws of 2022, is amended to read as follows:
   §  2.  This  act shall take effect immediately and shall expire and be
 deemed repealed March 31, [2024] 2026.
   § 12. Subdivision (a) of section 1 of chapter 670 of the laws of 2021,
 requiring the office  for  people  with  developmental  disabilities  to
 establish the care demonstration program, is amended to read as follows:
   (a) The commissioner of the office for people with developmental disa-
 bilities  [shall]  MAY,  AT  THEIR DISCRETION, establish the care demon-
 stration program, to utilize the state workforce  to  provide  community
 based care to individuals with developmental disabilities.
   §  13.  Section  3  of  chapter 670 of the laws of 2021, requiring the
 office for people with developmental disabilities to establish the  care
 demonstration program, is amended to read as follows:
   §  3.  This  act shall take effect immediately and shall expire and be
 deemed repealed March 31, [2024] 2026.
   § 14. Section 2 of chapter 769 of  the  laws  of  2023,  amending  the
 public  health  law  relating  to  the  adult cystic fibrosis assistance
 program, as amended by chapter 31 of the laws of  2024,  is  amended  to
 read as follows:
 S. 8307--C                          8                         A. 8807--C
 
   § 2. This act shall take effect immediately and shall expire March 31,
 [2024]  2025  when  upon  such  date the provisions of this act shall be
 deemed repealed.
   §  15.  This  act shall take effect immediately and shall be deemed to
 have been in full force and effect on and after March 31, 2024.
 
                                  PART C
 
   Section 1. Paragraph d of subdivision 6 of section 4410 of the  educa-
 tion  law,  as amended by chapter 217 of the laws of 2015, is amended to
 read as follows:
   d. Notwithstanding any other provision of law  to  the  contrary,  the
 exemption in subdivision one of section seventy-six hundred five of this
 chapter  shall  apply  to  persons  employed on a full-time or part-time
 salary basis, which may include on an hourly, weekly, or monthly  basis,
 or  on  a fee for evaluation services basis provided that such person is
 employed by and under the dominion and control of a center-based program
 approved pursuant to subdivision nine of this  section  as  a  certified
 school psychologist to provide activities, services and use of the title
 psychologist to students enrolled in such approved center-based program;
 and  to  certified school psychologists employed on a full-time or part-
 time salary basis, which may include on an hourly,  weekly,  or  monthly
 basis,  or  on  a  fee  for  evaluation services basis provided that the
 school psychologist is employed by and under the dominion and control of
 a program that has been approved pursuant to paragraph b of  subdivision
 nine  of this section, or subdivision nine-a of this section, to conduct
 a multi-disciplinary evaluation of a preschool child having or suspected
 of having a disability where authorized by paragraph a [or b] of  subdi-
 vision  six  of section sixty-five hundred three-b of this chapter[; and
 to certified school psychologists employed on a full-time  or  part-time
 salary  basis, which may include on an hourly, weekly, or monthly basis,
 or on a fee for evaluation services basis provided  that  such  psychol-
 ogist  is  employed  by  and under the dominion and control of an agency
 approved in accordance with title two-A of article  twenty-five  of  the
 public  health  law to deliver early intervention program multidiscipli-
 nary evaluations, service coordination services and  early  intervention
 program  services,  where  authorized by paragraph a or b of subdivision
 six of section sixty-five hundred three-b of this chapter, each], in the
 course of their employment. Nothing in this section shall  be  construed
 to  authorize  a  certified  school psychologist or group of such school
 psychologists to engage in independent practice or practice  outside  of
 an employment relationship.
   § 2. Subdivision 1 of section 7605 of the education law, as amended by
 chapter 217 of the laws of 2015, is amended to read as follows:
   1.  The activities, services, and use of the title of psychologist, or
 any derivation thereof, on the part of a  person  in  the  employ  of  a
 federal,  state, county or municipal agency, or other political subdivi-
 sion, or a chartered elementary or secondary school  or  degree-granting
 educational  institution  insofar  as such activities and services are a
 part of the duties of [his] SUCH salaried position; or on the part of  a
 person  in  the employ as a certified school psychologist on a full-time
 or part-time salary basis, which may include on an  hourly,  weekly,  or
 monthly  basis,  or on a fee for evaluation services basis provided that
 such person employed as a certified school psychologist is  employed  by
 and  under  the  dominion  and  control of a preschool special education
 program approved pursuant to paragraph b of subdivision nine or subdivi-
 S. 8307--C                          9                         A. 8807--C

 sion nine-a of section forty-four hundred ten of this chapter to provide
 activities, services and to use the  title  "certified  school  psychol-
 ogist",  so long as this shall not be construed to permit the use of the
 title  "licensed  psychologist",  to  students enrolled in such approved
 program or to conduct a  multidisciplinary  evaluation  of  a  preschool
 child  having  or suspected of having a disability[; or on the part of a
 person in the employ as a certified school psychologist on  a  full-time
 or  part-time  salary  basis,  which may include on an hourly, weekly or
 monthly basis, or on a fee for evaluation services basis  provided  that
 such  person  employed as a certified school psychologist is employed by
 and under the dominion and control of an agency approved  in  accordance
 with  title  two-A  of  article  twenty-five of the public health law to
 deliver  early  intervention  program   multidisciplinary   evaluations,
 service  coordination services and early intervention program services],
 where each such preschool special education  program  [or  early  inter-
 vention provider] is authorized by paragraph a [or b] of subdivision six
 of  section  sixty-five hundred [three] THREE-B of this title[, each] in
 the course of their employment. Nothing in  this  subdivision  shall  be
 construed  to authorize a certified school psychologist or group of such
 school psychologists to  engage  in  independent  practice  or  practice
 outside of an employment relationship.
   § 3. Section 3 of chapter 217 of the laws of 2015, amending the educa-
 tion  law  relating to certified school psychologists and special educa-
 tion services and programs  for  preschool  children  with  handicapping
 conditions, as amended by chapter 339 of the laws of 2022, is amended to
 read as follows:
   §  3.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after July 1, 2014,  provided,
 however  that  the  provisions  of  this  act shall expire and be deemed
 repealed June 30, [2024] 2026.
   § 4. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024; provided,
 however,  that  sections one and two of this act shall take effect April
 1, 2025; provided further, however, that the amendments to  paragraph  d
 of  subdivision  6  of section 4410 of the education law made by section
 one of this act shall not affect the expiration of  such  paragraph  and
 shall be deemed to expire therewith; and provided further, however, that
 the  amendments  to  subdivision  1 of section 7605 of the education law
 made by section two of this act shall not affect the expiration of  such
 subdivision and shall be deemed to expire therewith.
 
                                  PART D
 
   Section  1.  Paragraph  (c)  of subdivision 8 of section 2807-c of the
 public health law, as amended by section 1 of part D of  chapter  57  of
 the laws of 2021, is amended to read as follows:
   (c)  In order to reconcile capital related inpatient expenses included
 in rates of payment based on a budget to actual expenses and  statistics
 for  the  rate  period  for  a  general hospital, rates of payment for a
 general hospital shall be adjusted to reflect the dollar  value  of  the
 difference  between  capital  related inpatient expenses included in the
 computation of rates of payment for a prior rate period based on a budg-
 et and actual capital related inpatient expenses  for  such  prior  rate
 period,  each  as  determined  in  accordance with paragraph (a) of this
 subdivision, adjusted to reflect increases or  decreases  in  volume  of
 service  in  such  prior  rate  period compared to statistics applied in
 S. 8307--C                         10                         A. 8807--C
 
 determining the capital related inpatient expenses component of rates of
 payment based on a budget for such prior rate period.
   For  rates  effective  April  first, two thousand twenty through March
 thirty-first, two  thousand  twenty-one,  the  budgeted  capital-related
 expenses add-on as described in paragraph (a) of this subdivision, based
 on  a  budget  submitted in accordance to paragraph (a) of this subdivi-
 sion, shall be reduced by five percent relative to the rate in effect on
 such date; and the actual capital expenses add-on as described in  para-
 graph  (a)  of this subdivision, based on actual expenses and statistics
 through appropriate audit procedures in accordance with paragraph (a) of
 this subdivision shall be reduced by five percent relative to  the  rate
 in effect on such date.
   For  rates  effective [on and after] April first, two thousand twenty-
 one THROUGH SEPTEMBER THIRTIETH, TWO THOUSAND TWENTY-FOUR, the  budgeted
 capital-related  expenses  add-on  as described in paragraph (a) of this
 subdivision, based on a budget submitted in accordance to paragraph  (a)
 of  this  subdivision,  shall  be reduced by ten percent relative to the
 rate in effect on such date; and the actual capital expenses  add-on  as
 described in paragraph (a) of this subdivision, based on actual expenses
 and  statistics  through appropriate audit procedures in accordance with
 paragraph (a) of this subdivision shall be reduced by ten percent  rela-
 tive to the rate in effect on such date.
   FOR  RATES  EFFECTIVE ON AND AFTER OCTOBER FIRST, TWO THOUSAND TWENTY-
 FOUR, THE BUDGETED CAPITAL-RELATED EXPENSES ADD-ON AS DESCRIBED IN PARA-
 GRAPH (A) OF THIS SUBDIVISION, BASED ON A BUDGET SUBMITTED IN ACCORDANCE
 WITH PARAGRAPH (A) OF THIS  SUBDIVISION,  SHALL  BE  REDUCED  BY  TWENTY
 PERCENT  RELATIVE  TO  THE  RATE  IN EFFECT ON SUCH DATE; AND THE ACTUAL
 CAPITAL EXPENSES ADD-ON AS DESCRIBED IN PARAGRAPH (A) OF  THIS  SUBDIVI-
 SION  SHALL  BE REDUCED BY TWENTY PERCENT RELATIVE TO THE RATE IN EFFECT
 ON SUCH DATE.
   For any rate year, all reconciliation add-on  amounts  calculated  [on
 and  after]  FOR  THE PERIOD OF April first, two thousand twenty THROUGH
 SEPTEMBER THIRTIETH, TWO THOUSAND TWENTY-FOUR shall be  reduced  by  ten
 percent,  and  all  reconciliation  recoupment amounts calculated [on or
 after] FOR THE PERIOD  OF  April  first,  two  thousand  twenty  THROUGH
 SEPTEMBER  THIRTIETH,  TWO  THOUSAND  TWENTY-FOUR  shall increase by ten
 percent.
   FOR ANY RATE YEAR, ALL RECONCILIATION ADD-ON AMOUNTS CALCULATED ON AND
 AFTER OCTOBER FIRST, TWO THOUSAND TWENTY-FOUR SHALL BE REDUCED BY TWENTY
 PERCENT, AND ALL RECONCILIATION  RECOUPMENT  AMOUNTS  CALCULATED  ON  OR
 AFTER  OCTOBER  FIRST, TWO THOUSAND TWENTY-FOUR SHALL INCREASE BY TWENTY
 PERCENT.
   Notwithstanding any inconsistent  provision  of  subparagraph  (i)  of
 paragraph (e) of subdivision nine of this section, capital related inpa-
 tient  expenses  of  a  general  hospital included in the computation of
 rates of payment based on a budget shall not be included in the computa-
 tion of a volume adjustment made in accordance with  such  subparagraph.
 Adjustments  to rates of payment for a general hospital made pursuant to
 this paragraph shall be made in accordance with paragraph (c) of  subdi-
 vision  eleven  of  this  section. Such adjustments shall not be carried
 forward except for such  volume  adjustment  as  may  be  authorized  in
 accordance with subparagraph (i) of paragraph (e) of subdivision nine of
 this section for such general hospital.
   §  2.  Section 5 of part ZZ of chapter 56 of the laws of 2020 amending
 the tax law and the social services law  relating  to  certain  Medicaid
 S. 8307--C                         11                         A. 8807--C
 
 management, as amended by section 3 of part RR of chapter 57 of the laws
 of 2022, is amended to read as follows:
   §  5.  This  act  shall  take  effect  immediately and shall be deemed
 repealed [five] EIGHT years after such effective date.
   § 3. Section 2 of part E of chapter 57 of the laws of  2015,  amending
 the  public  health  law  relating  to  the payment of certain funds for
 uncompensated care, is amended to read as follows:
   § 2. Notwithstanding any inconsistent provision of law, rule or  regu-
 lation  to  the  contrary,  and  subject  to the availability of federal
 financial participation pursuant to title  XIX  of  the  federal  social
 security  act,  effective  for  [periods on and after] EACH STATE FISCAL
 YEAR FROM April 1, 2015, THROUGH DECEMBER 31, 2024; AND FOR THE CALENDAR
 YEAR JANUARY 1, 2025 THROUGH DECEMBER 31, 2025; AND  FOR  EACH  CALENDAR
 YEAR THEREAFTER, payments pursuant to paragraph (i) of subdivision 35 of
 section  2807-c of the public health law may be made as outpatient upper
 payment limit payments for outpatient hospital services, not  to  exceed
 an  amount of three hundred thirty-nine million dollars annually between
 payments authorized under this section and such section  of  the  public
 health  law.  Such payments shall be made as medical assistance payments
 for outpatient services pursuant to title 11 of article 5 of the  social
 services  law  for patients eligible for federal financial participation
 under title XIX of the federal social security act for general  hospital
 outpatient  services and general hospital emergency room services issued
 pursuant to paragraph (g) of subdivision 2 of section 2807 of the public
 health law to general hospitals, other than major public general  hospi-
 tals,  providing emergency room services and including safety net hospi-
 tals, which shall, for the purpose of  this  paragraph,  be  defined  as
 having  either:  a Medicaid share of total inpatient hospital discharges
 of at least thirty-five  percent,  including  both  fee-for-service  and
 managed  care  discharges  for  acute and exempt services; or a Medicaid
 share of total discharges of at least  thirty  percent,  including  both
 fee-for-service  and  managed  care  discharges  for  acute  and  exempt
 services, and also  providing  obstetrical  services.    Eligibility  to
 receive  such additional payments shall be based on data from the period
 two years prior to the rate year, as reported on the institutional  cost
 report submitted to the department as of October first of the prior rate
 year.  No  eligible general hospital's annual payment amount pursuant to
 this section shall exceed the lower of the sum of the annual amounts due
 that hospital pursuant  to  section  twenty-eight  hundred  seven-k  and
 section  twenty-eight  hundred  seven-w of the public health law; or the
 hospital's facility specific projected disproportionate  share  hospital
 payment  ceiling established pursuant to federal law, provided, however,
 that payment amounts to eligible hospitals in excess  of  the  lower  of
 such  sum  or payment ceiling shall be reallocated to eligible hospitals
 that do not have excess payment amounts.  Such  reallocations  shall  be
 proportional  to  each such hospital's aggregate payment amount pursuant
 to paragraph (i) of subdivision 35  of  section  2807-c  of  the  public
 health law and this section to the total of all payment amounts for such
 eligible  hospitals.  Such  adjustment  payment may be added to rates of
 payment or made as aggregate  payments  to  eligible  general  hospitals
 other  than  major  public general hospitals.   The distribution of such
 payments shall be pursuant to a methodology approved by the commissioner
 of health in regulation.
   § 4. Section 21 of part B of chapter 57 of the laws of 2015,  amending
 the  social services law relating to supplemental rebates, is amended to
 read as follows:
 S. 8307--C                         12                         A. 8807--C
 
   § 21. Notwithstanding any inconsistent provision of law, rule or regu-
 lation to the contrary, and  subject  to  the  availability  of  federal
 financial  participation  pursuant  to  title  XIX of the federal social
 security act, effective for [the period] EACH  STATE  FISCAL  YEAR  FROM
 April  1, 2011 through [March 31, 2012, and state fiscal years] DECEMBER
 31, 2024; AND FOR THE CALENDAR YEAR JANUARY 1, 2025 THROUGH DECEMBER 31,
 2025; AND FOR EACH CALENDAR YEAR thereafter, the department of health is
 authorized to increase the operating cost component of rates of  payment
 for  general hospital outpatient services and general hospital emergency
 room services issued pursuant to  paragraph  (g)  of  subdivision  2  of
 section  2807  of the public health law for public general hospitals, as
 defined in subdivision 10 of section 2801  of  the  public  health  law,
 other  than those operated by the state of New York or the state univer-
 sity of New York, and located in a  city  with  a  population  over  one
 million,  up  to  two  hundred  eighty-seven million dollars annually as
 medical assistance payments for outpatient services pursuant to title 11
 of article 5 of the social services law for patients eligible for feder-
 al financial participation under title XIX of the federal social securi-
 ty act based on such criteria and methodologies as the commissioner  may
 from time to time set through a memorandum of understanding with the New
 York  city  health and hospitals corporation, and such adjustments shall
 be paid by means of one or more estimated payments, with such  estimated
 payments  to be reconciled to the commissioner of health's final adjust-
 ment determinations after the disproportionate  share  hospital  payment
 adjustment  caps  have  been  calculated  for such period under sections
 1923(f) and (g) of the federal  social  security  act.  Such  adjustment
 payment  may  be added to rates of payment or made as aggregate payments
 to eligible public general hospitals.
   § 5. The opening paragraph of subparagraph (i)  of  paragraph  (i)  of
 subdivision 35 of section 2807-c of the public health law, as amended by
 section  4  of  part  C of chapter 56 of the laws of 2013, is amended to
 read as follows:
   Notwithstanding any inconsistent provision of this subdivision or  any
 other  contrary  provision  of  law  and  subject to the availability of
 federal financial participation, for [the period] EACH STATE FISCAL YEAR
 FROM July first, two thousand ten through [March thirty-first, two thou-
 sand eleven,] DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-FOUR; and [each
 state fiscal year period] FOR THE CALENDAR YEAR JANUARY FIRST, TWO THOU-
 SAND TWENTY-FIVE THROUGH DECEMBER  THIRTY-FIRST,  TWO  THOUSAND  TWENTY-
 FIVE; AND FOR EACH CALENDAR YEAR thereafter, the commissioner shall make
 additional inpatient hospital payments up to the aggregate upper payment
 limit for inpatient hospital services after all other medical assistance
 payments, but not to exceed two hundred thirty-five million five hundred
 thousand  dollars  for  the  period July first, two thousand ten through
 March thirty-first, two thousand eleven, three hundred fourteen  million
 dollars  for  each state fiscal year beginning April first, two thousand
 eleven, through March thirty-first, two thousand thirteen, and  no  less
 than  three  hundred  thirty-nine  million dollars for each state fiscal
 year [thereafter] UNTIL DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-FOUR;
 AND THEN FROM CALENDAR YEAR  JANUARY  FIRST,  TWO  THOUSAND  TWENTY-FIVE
 THROUGH  DECEMBER  THIRTY-FIRST,  TWO THOUSAND TWENTY-FIVE; AND FOR EACH
 CALENDAR YEAR THEREAFTER, to general hospitals, other than major  public
 general hospitals, providing emergency room services and including safe-
 ty  net  hospitals,  which  shall, for the purpose of this paragraph, be
 defined as having either: a Medicaid share of total  inpatient  hospital
 discharges  of at least thirty-five percent, including both fee-for-ser-
 S. 8307--C                         13                         A. 8807--C
 
 vice and managed care discharges for acute and  exempt  services;  or  a
 Medicaid share of total discharges of at least thirty percent, including
 both  fee-for-service  and  managed care discharges for acute and exempt
 services,  and  also  providing  obstetrical  services.  Eligibility  to
 receive such additional payments shall be based on data from the  period
 two  years prior to the rate year, as reported on the institutional cost
 report submitted to the department as of October first of the prior rate
 year. Such payments shall be made as  medical  assistance  payments  for
 fee-for-service  inpatient hospital services pursuant to title eleven of
 article five of the social services law for patients eligible for feder-
 al financial participation under title XIX of the federal social securi-
 ty act and in accordance with the following:
   § 6. Section 18 of part B of chapter 57 of the laws of 2015,  amending
 the  social services law relating to supplemental rebates, is amended to
 read as follows:
   § 18. Notwithstanding any inconsistent provision of law or  regulation
 to  the  contrary,  and subject to the availability of federal financial
 participation pursuant to title XIX of the federal social security  act,
 effective  for  [the  period] EACH STATE FISCAL YEAR FROM April 1, 2012,
 through [March 31, 2013, and state fiscal years] DECEMBER 31, 2024;  AND
 FOR  THE  CALENDAR  YEAR FROM JANUARY 1, 2025 THROUGH DECEMBER 31, 2025;
 AND FOR EACH CALENDAR YEAR  thereafter,  the  department  of  health  is
 authorized  to pay a public hospital adjustment to public general hospi-
 tals, as defined in subdivision 10 of section 2801 of the public  health
 law,  other  than  those  operated by the state of New York or the state
 university of New York, and located in a city with a population of  over
 1  million,  of  up  to  one  billion eighty million dollars annually as
 medical assistance payments for inpatient services pursuant to title  11
 of article 5 of the social services law for patients eligible for feder-
 al financial participation under title XIX of the federal social securi-
 ty  act based on such criteria and methodologies as the commissioner may
 from time to time set through a memorandum of understanding with the New
 York city health and hospitals corporation, and such  adjustments  shall
 be  paid by means of one or more estimated payments, with such estimated
 payments to be reconciled to the commissioner of health's final  adjust-
 ment  determinations  after  the disproportionate share hospital payment
 adjustment caps have been calculated  for  such  period  under  sections
 1923(f)  and  (g)  of  the  federal social security act. Such adjustment
 payment may be added to rates of payment or made as  aggregate  payments
 to eligible public general hospitals.
   §  7. Subdivision 1 of section 3-a of part B of chapter 58 of the laws
 of 2010, amending the social services law  and  the  public  health  law
 relating to prescription drug coverage for needy persons and health care
 initiatives pools, is amended to read as follows:
   1.  Notwithstanding  any  inconsistent provision of law, rule or regu-
 lation to the contrary, and  subject  to  the  availability  of  federal
 financial  participation,  effective  for [the period] EACH STATE FISCAL
 YEAR FROM August 1, 2010 through [March 31, 2011, and each state  fiscal
 year]  DECEMBER 31, 2024; AND FOR THE CALENDAR YEAR FROM JANUARY 1, 2025
 THROUGH DECEMBER 31, 2025; AND FOR EACH CALENDAR  YEAR  thereafter,  the
 department  of  health  is authorized to make Medicaid payment increases
 for diagnostic and treatment centers (DTC) services issued  pursuant  to
 section  2807  of  the public health law for public DTCs operated by the
 New York City Health and Hospitals Corporation, at the election  of  the
 social services district in which an eligible DTC is physically located,
 of  up  to  twelve million six hundred thousand dollars on an annualized
 S. 8307--C                         14                         A. 8807--C
 
 basis for DTC services pursuant to title 11 of article 5 of  the  social
 services  law  for patients eligible for federal financial participation
 under title XIX of the federal social security act based  on  each  such
 DTC's proportionate share of the sum of all clinic visits for all facil-
 ities  eligible  for an adjustment pursuant to this section for the base
 year two years prior to the rate year. Such proportionate share payments
 may be added to rates of payment or made as aggregate payments to eligi-
 ble DTCs.
   § 8. Subdivision 1 of section 3-b of part B of chapter 58 of the  laws
 of  2010,  amending  the  social  services law and the public health law
 relating to prescription drug coverage for needy persons and health care
 initiatives pools, is amended to read as follows:
   1. Notwithstanding any inconsistent provision of law,  rule  or  regu-
 lation  to  the  contrary,  and  subject  to the availability of federal
 financial participation, effective for [the period]  EACH  STATE  FISCAL
 YEAR  FROM August 1, 2010 through [March 31, 2011, and each state fiscal
 year] DECEMBER 31, 2024; AND FOR THE CALENDAR YEAR FROM JANUARY 1,  2025
 THROUGH  DECEMBER  31,  2025; AND FOR EACH CALENDAR YEAR thereafter, the
 department of health, is authorized to make Medicaid  payment  increases
 for  county  operated  diagnostic  and  treatment centers (DTC) services
 issued pursuant to section  2807  of  the  public  health  law  and  for
 services  provided  by  county  operated  free-standing clinics licensed
 pursuant to articles 31 and 32  of  the  mental  hygiene  law,  but  not
 including  facilities operated by the New York City Health and Hospitals
 Corporation, of up to five million four hundred thousand dollars  on  an
 annualized  basis for such services pursuant to title 11 of article 5 of
 the social services law for  patients  eligible  for  federal  financial
 participation  under title XIX of the federal social security act. Local
 social services districts may decline such increased payments  to  their
 sponsored  DTCs and free-standing clinics, provided they provide written
 notification to the commissioner of health, within thirty days following
 receipt of notification of a payment pursuant to this section.  Distrib-
 utions pursuant to this  section  shall  be  based  on  each  facility's
 proportionate  share  of  the  sum  of all DTC and clinic visits for all
 facilities receiving payments pursuant to this section for the base year
 two years prior to the rate year. Such proportionate share payments  may
 be  added  to rates or payment or made as aggregate payments to eligible
 facilities.
   § 9. Paragraph (e-1) of subdivision 12 of section 2808 of  the  public
 health law, as amended by section 15 of part B of chapter 57 of the laws
 of 2023, is amended to read as follows:
   (e-1) Notwithstanding any inconsistent provision of law or regulation,
 the  commissioner  shall  provide,  in  addition to payments established
 pursuant to this article prior to application  of  this  section,  addi-
 tional  payments  under the medical assistance program pursuant to title
 eleven of article five of the social services law for non-state operated
 public residential health care facilities, including public  residential
 health  care  facilities  located in the county of Nassau, the county of
 Westchester and the county of Erie,  but  excluding  public  residential
 health  care  facilities  operated by a town or city within a county, in
 aggregate annual amounts of up to one hundred fifty million  dollars  in
 additional payments for the state fiscal year beginning April first, two
 thousand  six  and  for the state fiscal year beginning April first, two
 thousand seven and for the state fiscal year beginning April first,  two
 thousand eight and of up to three hundred million dollars in such aggre-
 gate  annual  additional  payments  for  the state fiscal year beginning
 S. 8307--C                         15                         A. 8807--C
 
 April first, two thousand nine, and for the state fiscal year  beginning
 April  first,  two  thousand ten and for the state fiscal year beginning
 April first, two thousand eleven, and for the state fiscal years  begin-
 ning  April  first,  two  thousand  twelve and April first, two thousand
 thirteen, and of up to five hundred million dollars  in  such  aggregate
 annual  additional  payments  for the state fiscal years beginning April
 first, two thousand fourteen, April  first,  two  thousand  fifteen  and
 April  first,  two  thousand  sixteen  and of up to five hundred million
 dollars in such aggregate  annual  additional  payments  for  the  state
 fiscal years beginning April first, two thousand seventeen, April first,
 two thousand eighteen, and April first, two thousand nineteen, and of up
 to  five  hundred  million  dollars  in such aggregate annual additional
 payments for the state fiscal years beginning April first, two  thousand
 twenty, April first, two thousand twenty-one, and April first, two thou-
 sand  twenty-two,  and  of  up  to  five hundred million dollars in such
 aggregate annual additional payments for the state fiscal  years  begin-
 ning  April  first, two thousand twenty-three, AND FROM April first, two
 thousand twenty-four UNTIL DECEMBER THIRTY-FIRST, TWO  THOUSAND  TWENTY-
 FOUR,  and [April first, two thousand twenty-five] FOR THE CALENDAR YEAR
 JANUARY FIRST, TWO THOUSAND TWENTY-FIVE THROUGH  DECEMBER  THIRTY-FIRST,
 TWO  THOUSAND  TWENTY-FIVE,  AND FOR EACH CALENDAR YEAR THEREAFTER.  The
 amount allocated to each eligible public residential health care facili-
 ty for this period shall be computed in accordance with  the  provisions
 of  paragraph  (f)  of this subdivision, provided, however, that patient
 days shall be utilized for such computation reflecting  actual  reported
 data  for  two thousand three and each representative succeeding year as
 applicable, and provided further, however, that,  in  consultation  with
 impacted providers, of the funds allocated for distribution in the state
 fiscal  year beginning April first, two thousand thirteen, up to thirty-
 two million dollars may be allocated in accordance with paragraph  (f-1)
 of this subdivision.
   §  10.  This  act  shall  take  effect immediately; provided, however,
 section one of this act shall take effect October 1, 2024; and provided,
 further, that sections three, four, five, six, seven, eight and nine  of
 this act shall take effect January 1, 2025.
 
                                  PART E
 
   Section  1.  Subparagraph  (ii) of paragraph (b) of subdivision 2-b of
 section 2808 of the public health law, as added by section 47 of part  C
 of chapter 109 of the laws of 2006, is amended to read as follows:
   (ii) (A) The operating component of rates shall be subject to case mix
 adjustment  through  application  of  the  relative resource utilization
 groups system of patient classification (RUG-III) employed by the feder-
 al government with regard to  payments  to  skilled  nursing  facilities
 pursuant  to  title XVIII of the federal social security act (Medicare),
 as revised by regulation to reflect New  York  state  wages  and  fringe
 benefits,  provided,  however,  that  such RUG-III classification system
 weights shall be increased in the following amounts  for  the  following
 categories  of  residents:  [(A)]  (1)  thirty  minutes for the impaired
 cognition A category, [(B)] (2) forty minutes for the impaired cognition
 B category, and [(C)] (3) twenty-five minutes for the  reduced  physical
 functions  B  category.    Such adjustments shall be made in January and
 July of each calendar year. Such adjustments and related patient classi-
 fications in each facility shall be subject to audit review  in  accord-
 ance with regulations promulgated by the commissioner.
 S. 8307--C                         16                         A. 8807--C
 
   (B)  EFFECTIVE  APRIL  FIRST,  TWO  THOUSAND TWENTY-FOUR, THE CASE MIX
 ADJUSTMENT FROM THE OPERATING COMPONENT OF THE RATES FOR SKILLED NURSING
 FACILITIES SHALL REMAIN UNCHANGED FROM THE  JULY  TWO  THOUSAND  TWENTY-
 THREE  RATES  DURING  THE DEVELOPMENT AND UNTIL FULL IMPLEMENTATION OF A
 CASE MIX METHODOLOGY USING THE PATIENT DRIVEN PAYMENT MODEL.
   §  2. Subparagraph (iv) of paragraph (b) of subdivision 2-b of section
 2808 of the public health law, as amended by section 1  of  part  NN  of
 chapter 56 of the laws of 2020, is amended to read as follows:
   (iv)  The  capital cost component of rates on and after January first,
 two thousand nine shall: (A) fully reflect the cost  of  local  property
 taxes  and payments made in lieu of local property taxes, as reported in
 each facility's cost report submitted for the year two  years  prior  to
 the  rate  year; (B) provided, however, notwithstanding any inconsistent
 provision of this article, commencing April first, two  thousand  twenty
 for  rates  of  payment for patients eligible for payments made by state
 governmental agencies, the capital cost component determined in  accord-
 ance  with  this  subparagraph  and  inclusive of any shared savings for
 eligible facilities that elect to refinance their mortgage loans  pursu-
 ant  to  paragraph  (d)  of  subdivision two-a of this section, shall be
 reduced by the commissioner by five percent; AND (C) PROVIDED,  HOWEVER,
 NOTWITHSTANDING  ANY  INCONSISTENT PROVISION OF THIS ARTICLE, COMMENCING
 APRIL FIRST, TWO THOUSAND TWENTY-FOUR FOR RATES OF PAYMENT FOR  PATIENTS
 ELIGIBLE  FOR  PAYMENTS MADE BY STATE GOVERNMENTAL AGENCIES, THE CAPITAL
 COST COMPONENT DETERMINED  IN  ACCORDANCE  WITH  THIS  SUBPARAGRAPH  AND
 INCLUSIVE  OF  ANY  SHARED SAVINGS FOR ELIGIBLE FACILITIES THAT ELECT TO
 REFINANCE THEIR MORTGAGE LOANS PURSUANT TO PARAGRAPH (D) OF  SUBDIVISION
 TWO-A  OF THIS SECTION, SHALL BE REDUCED BY THE COMMISSIONER BY AN ADDI-
 TIONAL TEN PERCENT, PROVIDED, HOWEVER, THAT  SUCH  REDUCTION  SHALL  NOT
 APPLY  TO  RATES OF PAYMENT FOR PATIENTS IN PEDIATRIC RESIDENTIAL HEALTH
 CARE FACILITIES AS DEFINED  IN  PARAGRAPH  (C)  OF  SUBDIVISION  TWO  OF
 SECTION TWENTY-EIGHT HUNDRED EIGHT-E OF THIS ARTICLE.
   §  3.  Paragraph  (h)  of  subdivision 1 of section 2632 of the public
 health law, as amended by chapter 414 of the laws of 2015, is amended to
 read as follows:
   (h) in the Persian Gulf conflict from the second day of August,  nine-
 teen  hundred  ninety  to  the  end  of such conflict including military
 service in Operation Enduring Freedom, Operation Iraqi  Freedom,  Opera-
 tion New Dawn or Operation Inherent Resolve and was the recipient of the
 global  war  on terrorism expeditionary medal or the Iraq campaign medal
 or the Afghanistan campaign medal; and who was a resident of  the  state
 of New York at the time of entry upon such active duty or who shall have
 been  a  resident of this state for [one year] SIX MONTHS next preceding
 the application for admission shall be entitled  to  admission  to  said
 home  after  the  approval  of the application by the board of visitors,
 subject to the provisions of this article and to the conditions, limita-
 tions and penalties prescribed by the regulations of the department. Any
 such veteran or dependent, who otherwise fulfills the  requirements  set
 forth  in  this section, may be admitted directly to the skilled nursing
 facility or the health related facility provided such veteran or depend-
 ent is certified by a physician designated or approved by the department
 to require the type of care provided by such facilities.
   § 4. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART F
 S. 8307--C                         17                         A. 8807--C
 
   Section  1.  Paragraph  (n)  of  subdivision 3 of section 461-l of the
 social services law, as amended by section 2 of part B of chapter 57  of
 the laws of 2018, is amended to read as follows:
   (n)  The  commissioner  of health is authorized to create a program to
 subsidize the cost of assisted living for those individuals living  with
 Alzheimer's  disease  and  dementia  who  are  not  eligible for medical
 assistance pursuant to title eleven of article five of this chapter  AND
 RESIDE  IN  A  SPECIAL  NEEDS  ASSISTED LIVING RESIDENCE CERTIFIED UNDER
 SECTION FORTY-SIX HUNDRED FIFTY-FIVE OF THE PUBLIC HEALTH  LAW.    [The]
 SUBJECT  TO  APPROPRIATIONS,  THE  program  shall  authorize  [up to two
 hundred] vouchers to individuals through an application process and  pay
 for  up  to  seventy-five percent of the average private pay rate in the
 respective region. The commissioner of  health  may  propose  rules  and
 regulations to effectuate this provision.
   §  2.    This act shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART G
 
                           Intentionally Omitted
 
                                  PART H

   Section 1. Section 1 of part I of chapter 57  of  the  laws  of  2022,
 providing  a one percent across the board payment increase to all quali-
 fying fee-for-service Medicaid rates,  is  amended  by  adding  two  new
 subdivisions 3 and 4 to read as follows:
   3. FOR THE STATE FISCAL YEARS BEGINNING APRIL 1, 2024, AND THEREAFTER,
 ALL DEPARTMENT OF HEALTH MEDICAID PAYMENTS MADE TO MEDICAID MANAGED CARE
 ORGANIZATIONS  WILL NO LONGER BE SUBJECT TO THE UNIFORM RATE INCREASE IN
 SUBDIVISION 1 OF THIS SECTION.
   4. RATE ADJUSTMENTS MADE PURSUANT TO SUBDIVISIONS 1 THROUGH 3 OF  THIS
 SECTION  SHALL NOT BE SUBJECT TO THE NOTIFICATION REQUIREMENTS SET FORTH
 IN SUBDIVISION 7 OF SECTION 2807 OF THE PUBLIC HEALTH LAW.
   § 2. This act shall take effect immediately.

                                  PART I
 
   Section 1. Paragraph (a) of subdivision 4  of  section  365-a  of  the
 social  services  law, as amended by chapter 493 of the laws of 2010, is
 amended to read as follows:
   (a) drugs which may be dispensed without a prescription as required by
 section sixty-eight hundred ten of the education law; provided, however,
 that the state commissioner of health may by regulation specify  certain
 of  such  drugs which may be reimbursed as an item of medical assistance
 in accordance with the price schedule established by such  commissioner.
 Notwithstanding any other provision of law, [additions] MODIFICATIONS to
 the  list  of  drugs  reimbursable  under this paragraph may be filed as
 regulations by the commissioner  of  health  without  prior  notice  and
 comment; PROVIDED, HOWEVER, THAT THE DEPARTMENT WILL NOTIFY ENROLLEES OF
 ANY  ELIMINATIONS TO THE LIST OF DRUGS REIMBURSABLE UNDER THIS PARAGRAPH
 AT LEAST SIXTY DAYS PRIOR TO THE REMOVAL OF SUCH DRUG. SUCH ELIMINATIONS
 SHALL BE REFERRED TO  THE  DRUG  UTILIZATION  REVIEW  BOARD  ESTABLISHED
 PURSUANT  TO  SECTION  THREE  HUNDRED  SIXTY-NINE-BB OF THIS ARTICLE FOR
 RECOMMENDATION PRIOR TO ELIMINATION FROM THE LIST;
 S. 8307--C                         18                         A. 8807--C
 
   § 1-a. Subdivision 7 of section 272  of  the  public  health  law,  as
 amended  by  section  16 of part A of chapter 56 of the laws of 2013, is
 amended to read as follows:
   7.  The  commissioner  shall  provide thirty days public notice on the
 department's website prior to any meeting of the board to develop recom-
 mendations concerning the preferred drug program AND ANY PROPOSED ELIMI-
 NATIONS TO THE LIST OF DRUGS  REIMBURSABLE  UNDER  SUBDIVISION  FOUR  OF
 SECTION  THREE  HUNDRED  SIXTY-FIVE-A  OF THE SOCIAL SERVICES LAW.  Such
 notice regarding meetings of the board shall include  a  description  of
 the  proposed  therapeutic  class  to  be  reviewed,  a  listing of drug
 products in the therapeutic class, and the proposals to be considered by
 the board.  The board shall allow interested parties a reasonable oppor-
 tunity to make an oral presentation to the board related  to  the  prior
 authorization  of  the therapeutic class to be reviewed. The board shall
 consider any information provided by any  interested  party,  including,
 but  not  limited  to,  prescribers, dispensers, patients, consumers and
 manufacturers of the drug in developing their recommendations.
   § 2. Subdivision 8 of section 272 of the public health law, as amended
 by section 16 of part A of chapter 56 of the laws of 2013, is amended to
 read as follows:
   8. The commissioner shall provide notice of any recommendations devel-
 oped by the board regarding the preferred drug program OR ELIMINATION TO
 THE LIST OF DRUGS REIMBURSABLE UNDER SUBDIVISION FOUR OF  SECTION  THREE
 HUNDRED  SIXTY-FIVE-A  OF  THE  SOCIAL  SERVICES LAW, at least five days
 before any final determination  by  the  commissioner,  by  making  such
 information  available  on  the department's website. Such public notice
 may include: a summary of the deliberations of the board; a  summary  of
 the  positions of those making public comments at meetings of the board;
 the response of the board to those comments, if any;  and  the  findings
 and recommendations of the board.
   § 3. Subdivision 9 of section 272 of the public health law, as amended
 by section 16 of part A of chapter 56 of the laws of 2013, is amended to
 read as follows:
   9.  Within  ten  days of a final determination regarding the preferred
 drug program OR ELIMINATION TO THE  LIST  OF  DRUGS  REIMBURSABLE  UNDER
 SUBDIVISION  FOUR  OF  SECTION  THREE HUNDRED SIXTY-FIVE-A OF THE SOCIAL
 SERVICES LAW, the  commissioner  shall  provide  public  notice  on  the
 department's  website  of  such determinations, including: the nature of
 the determination; and analysis of  the  impact  of  the  commissioner's
 determination on state public health plan populations and providers; and
 the  projected fiscal impact to the state public health plan programs of
 the commissioner's determination.
   § 4. Section 280 of the public health law, as amended by section 8  of
 part D of chapter 57 of the laws of 2018, paragraph (b) of subdivision 2
 as  amended  by  section 5, subdivision 3 as amended by section 6, para-
 graph (a) of subdivision 5 as amended by section 7,  subparagraph  (iii)
 of paragraph (e) of subdivision 5 as amended by section 6-a and subdivi-
 sion  8  as  amended by section 9 of part B of chapter 57 of the laws of
 2019,  paragraphs (c) and (d) of subdivision 2 as amended and  paragraph
 (e)  of subdivision 2 as added by section 2 of part FFF of chapter 56 of
 the laws of 2020, the opening paragraph of paragraph (a) of  subdivision
 6  and  paragraph  (a)  of subdivision 7 as amended by sections 3 and 4,
 respectively, of part GG of chapter 56 of the laws of 2020,  is  amended
 to read as follows:
   § 280. Medicaid drug cap. 1. The legislature hereby finds and declares
 that  there is a significant public interest for the Medicaid program to
 S. 8307--C                         19                         A. 8807--C
 
 manage drug costs in a manner that ensures patient access while  provid-
 ing  financial  stability  for  the  state  and participating providers.
 Since two thousand eleven, the state  has  taken  significant  steps  to
 contain  costs  in the Medicaid program by imposing a statutory limit on
 annual growth. Drug expenditures,  however,  continually  outpace  other
 cost  components  causing  significant pressure on the state, providers,
 and patient access operating under the Medicaid global cap. It is there-
 fore intended that the department establish a [Medicaid drug  cap  as  a
 separate  component  within the Medicaid global cap] SUPPLEMENTAL REBATE
 PROGRAM as part of a focused and sustained effort to balance the  growth
 of drug expenditures with the growth of total Medicaid expenditures.
   2.  The  commissioner shall [establish a year to year] REVIEW AT LEAST
 ANNUALLY THE department of health state funds Medicaid drug [expenditure
 growth target as follows:
   (a) for state fiscal year two thousand seventeen--two  thousand  eigh-
 teen,  be  limited to the ten-year rolling average of the medical compo-
 nent of the consumer price index plus five percent and minus a  pharmacy
 savings target of fifty-five million dollars; and
   (b)  for  state  fiscal year two thousand eighteen--two thousand nine-
 teen, be limited to the ten-year rolling average of the  medical  compo-
 nent  of the consumer price index plus four percent and minus a pharmacy
 savings target of eighty-five million dollars;
   (c) for state fiscal year two thousand nineteen--two thousand  twenty,
 be  limited  to the ten-year rolling average of the medical component of
 the consumer price index plus four percent and minus a pharmacy  savings
 target of eighty-five million dollars;
   (d)  for  state  fiscal year two thousand twenty--two thousand twenty-
 one, be limited to the ten-year rolling average of the medical component
 of the consumer price index plus two percent; and
   (e) for state fiscal year two thousand twenty-one--two thousand  twen-
 ty-two and fiscal years thereafter, be limited in accordance with subdi-
 vision  one of section ninety-one of part H of chapter fifty-nine of the
 laws of two thousand eleven, as amended] EXPENDITURES TO IDENTIFY  DRUGS
 IN  THE  EIGHTIETH PERCENTILE OR HIGHER OF TOTAL SPEND, NET OF REBATE OR
 IN THE EIGHTIETH PERCENTILE OR HIGHER BASED ON COST PER  CLAIM,  NET  OF
 REBATE.
   3.  (A) The [department and the division of the budget shall assess on
 a quarterly basis the projected total amount to be expended in the  year
 on a cash basis by the Medicaid program for each drug, and the projected
 annual  amount of state funds Medicaid drug expenditures on a cash basis
 for all drugs, which shall be a component of the projected department of
 health state funds Medicaid  expenditures  calculated  for  purposes  of
 sections  ninety-one  and  ninety-two of part H of chapter fifty-nine of
 the laws of two thousand eleven. For purposes  of  this  section,  state
 funds  Medicaid  drug expenditures include amounts expended for drugs in
 both the Medicaid fee-for-service  program  and  Medicaid  managed  care
 programs,  minus  the  amount  of  any drug rebates or supplemental drug
 rebates received by the department, including rebates pursuant to subdi-
 vision five of this section with respect to rebate targets. The  depart-
 ment  and  the  division  of the budget shall report in December of each
 year, for the prior April  through  October,  to  the  drug  utilization
 review  board  the  projected  state  funds  Medicaid  drug expenditures
 including the amounts, in aggregate thereof,  attributable  to  the  net
 cost  of:  changes  in  the utilization of drugs by Medicaid recipients;
 changes in the number of Medicaid recipients; changes  to  the  cost  of
 brand  name drugs and changes to the cost of generic drugs. The informa-
 S. 8307--C                         20                         A. 8807--C

 tion contained in the report shall not be publicly released in a  manner
 that allows for the identification of an individual drug or manufacturer
 or  that  is likely to compromise the financial competitive, or proprie-
 tary nature of the information.
   (a) In the event the director of the budget determines, based on Medi-
 caid drug expenditures for the previous quarter or other relevant infor-
 mation,  that  the  total department of health state funds Medicaid drug
 expenditure is projected to exceed the annual growth limitation  imposed
 by  subdivision  two of this section, the] commissioner may identify and
 refer drugs IN THE EIGHTIETH PERCENTILE OR HIGHER OF TOTAL SPEND, NET OF
 REBATE OR IN THE EIGHTIETH PERCENTILE OR HIGHER BASED ON COST PER CLAIM,
 NET OF REBATE, to the  drug  utilization  review  board  established  by
 section  three  hundred  sixty-nine-bb  of the social services law for a
 recommendation as to  whether  a  target  supplemental  Medicaid  rebate
 should be paid by the manufacturer of the drug to the department and the
 target amount of the rebate.
   (b)  If the department intends to refer a drug to the drug utilization
 review board pursuant to paragraph (a) of this subdivision, the  depart-
 ment  shall  notify  the  manufacturer of such drug and shall attempt to
 reach agreement with the manufacturer on a rebate for the drug prior  to
 referring  the  drug  to  the  drug utilization review board for review.
 Such rebate may be based on evidence-based research, including, but  not
 limited  to,  such  research operated or conducted by or for other state
 governments, the federal government, the governments of  other  nations,
 and  third party payers or multi-state coalitions, provided however that
 the department shall account for the effectiveness of the drug in treat-
 ing the conditions  for  which  it  is  prescribed  or  in  improving  a
 patient's  health,  quality of life, or overall health outcomes, and the
 likelihood that use of the drug will reduce the need for  other  medical
 care, including hospitalization.
   (c)  In  the  event  that  the  commissioner and the manufacturer have
 previously agreed to a supplemental rebate for a drug pursuant to  para-
 graph  (b)  of this subdivision or paragraph (e) of subdivision seven of
 section three hundred sixty-seven-a of the social services law, the drug
 shall not be referred to the  drug  utilization  review  board  for  any
 further  supplemental  rebate  for  the  duration of the previous rebate
 agreement, provided however, the commissioner may refer a  drug  to  the
 drug  utilization  review board if the commissioner determines there are
 significant  and  substantiated  utilization  or  market  changes,   new
 evidence-based research, or statutory or federal regulatory changes that
 warrant  additional  rebates. In such cases, the department shall notify
 the manufacturer and provide evidence of the changes  or  research  that
 would  warrant  additional rebates, and shall attempt to reach agreement
 with the manufacturer on a rebate for the drug prior  to  referring  the
 drug to the drug utilization review board for review.
   (d)  The  department shall consider a drug's actual cost to the state,
 including current rebate amounts, prior to seeking an additional  rebate
 pursuant to paragraph (b) or (c) of this subdivision.
   (e)  [The  commissioner  shall  be  authorized  to  take  the  actions
 described in this section only so long as total Medicaid  drug  expendi-
 tures  are  projected  to exceed the annual growth limitation imposed by
 subdivision two of this section.] IF THE COMMISSIONER IS UNSUCCESSFUL IN
 ENTERING INTO A REBATE ARRANGEMENT WITH THE  MANUFACTURER  OF  THE  DRUG
 SATISFACTORY  TO  THE  DEPARTMENT,  THE DRUG MANUFACTURER SHALL, IN THAT
 EVENT BE REQUIRED TO PROVIDE TO THE DEPARTMENT, ON A STANDARD  REPORTING
 FORM DEVELOPED BY THE DEPARTMENT, THE FOLLOWING INFORMATION:
 S. 8307--C                         21                         A. 8807--C

   (I) THE ACTUAL COST OF DEVELOPING, MANUFACTURING, PRODUCING (INCLUDING
 THE COST PER DOSE OF PRODUCTION), AND DISTRIBUTING THE DRUG;
   (II) RESEARCH AND DEVELOPMENT COSTS OF THE DRUG, INCLUDING PAYMENTS TO
 PREDECESSOR  ENTITIES  CONDUCTING  RESEARCH  AND  DEVELOPMENT,  SUCH  AS
 BIOTECHNOLOGY COMPANIES, UNIVERSITIES AND MEDICAL SCHOOLS,  AND  PRIVATE
 RESEARCH INSTITUTIONS;
   (III)  ADMINISTRATIVE,  MARKETING, AND ADVERTISING COSTS FOR THE DRUG,
 APPORTIONED BY MARKETING ACTIVITIES  THAT  ARE  DIRECTED  TO  CONSUMERS,
 MARKETING  ACTIVITIES  THAT  ARE  DIRECTED TO PRESCRIBERS, AND THE TOTAL
 COST OF ALL MARKETING AND ADVERTISING  THAT  IS  DIRECTED  PRIMARILY  TO
 CONSUMERS  AND  PRESCRIBERS  IN  NEW  YORK, INCLUDING BUT NOT LIMITED TO
 PRESCRIBER DETAILING, COPAYMENT DISCOUNT PROGRAMS, AND DIRECT-TO-CONSUM-
 ER MARKETING;
   (IV) THE EXTENT OF UTILIZATION OF THE DRUG;
   (V) PRICES FOR THE DRUG THAT ARE CHARGED  TO  PURCHASERS  OUTSIDE  THE
 UNITED STATES;
   (VI)  PRICES CHARGED TO TYPICAL PURCHASERS IN THE STATE, INCLUDING BUT
 NOT LIMITED TO PHARMACIES, PHARMACY  CHAINS,  PHARMACY  WHOLESALERS,  OR
 OTHER DIRECT PURCHASERS;
   (VII) THE AVERAGE REBATES AND DISCOUNTS PROVIDED PER PAYER TYPE IN THE
 STATE; AND
   (VIII) THE AVERAGE PROFIT MARGIN OF EACH DRUG OVER THE PRIOR FIVE-YEAR
 PERIOD AND THE PROJECTED PROFIT MARGIN ANTICIPATED FOR SUCH DRUG.
   (F) ALL INFORMATION DISCLOSED PURSUANT TO PARAGRAPH (E) OF THIS SUBDI-
 VISION  SHALL  BE  CONSIDERED CONFIDENTIAL AND SHALL NOT BE DISCLOSED BY
 THE DEPARTMENT IN A FORM THAT  IDENTIFIES  A  SPECIFIC  MANUFACTURER  OR
 PRICES CHARGED FOR DRUGS BY SUCH MANUFACTURER.
   4.  In  determining  whether to recommend a target supplemental rebate
 for a drug, the drug utilization review board shall consider the  actual
 cost  of  the  drug to the Medicaid program, including federal and state
 rebates, and may consider, among other things:
   (a) the drug's impact on [the] Medicaid drug spending [growth target],
 and the adequacy of capitation rates of participating  Medicaid  managed
 care  plans,  and  the  drug's  affordability  and value to the Medicaid
 program; or
   (b) significant and unjustified increases in the price of the drug; or
   (c) whether the drug may be priced disproportionately to its therapeu-
 tic benefits.
   5. (a) If the drug utilization review board recommends a target rebate
 amount on a drug referred by  the  commissioner,  the  department  shall
 negotiate  with  the drug's manufacturer for a supplemental rebate to be
 paid by the manufacturer in an amount not to exceed such  target  rebate
 amount.  [A  rebate requirement shall apply beginning with the first day
 of the state fiscal year during which the rebate  was  required  without
 regard  to the date the department enters into the rebate agreement with
 the manufacturer.]
   (b) The supplemental rebate required by paragraph (a) of this subdivi-
 sion shall apply to drugs dispensed to enrollees of managed care provid-
 ers pursuant  to  section  three  hundred  sixty-four-j  of  the  social
 services  law  and to drugs dispensed to Medicaid recipients who are not
 enrollees of such providers.
   (c) [If the drug utilization review board recommends a  target  rebate
 amount  for  a  drug  and the department is unable to negotiate a rebate
 from the manufacturer in an amount that is at least seventy-five percent
 of the target rebate amount, the commissioner is authorized to waive the
 provisions of paragraph (b) of subdivision three of section two  hundred
 S. 8307--C                         22                         A. 8807--C

 seventy-three  of  this article and the provisions of subdivisions twen-
 ty-five and twenty-five-a of section three hundred sixty-four-j  of  the
 social  services  law  with  respect  to such drug; however, this waiver
 shall  not be implemented in situations where it would prevent access by
 a Medicaid recipient to a drug which is the only treatment for a partic-
 ular disease or condition. Under no circumstances shall the commissioner
 be authorized to waive such provisions with respect  to  more  than  two
 drugs in a given time.
   (d)]  Where  the  department  and  a  manufacturer enter into a rebate
 agreement pursuant to this section, which may be in addition to existing
 rebate agreements entered into by the manufacturer with respect  to  the
 same  drug,  no  additional  rebates shall be required to be paid by the
 manufacturer to a managed care provider or any of a managed care provid-
 er's agents, including but not limited to any pharmacy benefit  manager,
 while the department is collecting the rebate pursuant to this section.
   [(e)]  (D)  In formulating a recommendation concerning a target rebate
 amount for a drug, the drug utilization review board may consider:
   (i) publicly available information relevant  to  the  pricing  of  the
 drug;
   (ii) information supplied by the department relevant to the pricing of
 the drug;
   (iii)  information  relating to value-based pricing provided, however,
 if the department directly invites any third party to  provide  cost-ef-
 fectiveness analysis or research related to value-based pricing, and the
 department  receives  and considers such analysis or research for use by
 the board, such third party shall disclose any  funding  sources.    The
 department  shall,  if  reasonably possible, make publicly available the
 following documents in its possession that it  relies  upon  to  provide
 cost  effectiveness analyses or research related to value-based pricing:
 (A) descriptions of underlying methodologies; (B) assumptions and  limi-
 tations  of  research findings; and (C) if available, data that presents
 results in a way that reflects different outcomes for affected  subpopu-
 lations;
   (iv)  the  seriousness and prevalence of the disease or condition that
 is treated by the drug;
   (v) the extent of utilization of the drug;
   (vi) the effectiveness of the drug  in  treating  the  conditions  for
 which  it  is prescribed, or in improving a patient's health, quality of
 life, or overall health outcomes;
   (vii) the likelihood that use of the drug will  reduce  the  need  for
 other medical care, including hospitalization;
   (viii) the average wholesale price, wholesale acquisition cost, retail
 price  of  the  drug,  and  the cost of the drug to the Medicaid program
 minus rebates received by the state;
   (ix) in the case  of  generic  drugs,  the  number  of  pharmaceutical
 manufacturers that produce the drug;
   (x) whether there are pharmaceutical equivalents to the drug; and
   (xi)  information supplied by the manufacturer, if any, explaining the
 relationship between the pricing of the drug and the cost of development
 of the drug and/or the therapeutic benefit  of  the  drug,  or  that  is
 otherwise  pertinent  to  the  manufacturer's pricing decision; any such
 information, INCLUDING THE INFORMATION ON THE  STANDARD  REPORTING  FORM
 REQUIREMENT  IN  PARAGRAPH  (E)  OF  SUBDIVISION  THREE OF THIS SECTION,
 provided shall be considered confidential and shall not be disclosed  by
 the  drug  utilization review board in a form that identifies a specific
 manufacturer or prices charged for drugs by such manufacturer.
 S. 8307--C                         23                         A. 8807--C
 
   6. [(a) If the drug  utilization  review  board  recommends  a  target
 rebate  amount  or  if the commissioner identifies a drug as a high cost
 drug pursuant to subparagraph (vii) of paragraph (e) of subdivision 7 of
 section three hundred sixty-seven-a of the social services law  and  the
 department  is  unsuccessful  in entering into a rebate arrangement with
 the manufacturer of the drug satisfactory to the  department,  the  drug
 manufacturer  shall  in that event be required to provide to the depart-
 ment, on a standard reporting form  developed  by  the  department,  the
 following information:
   (i) the actual cost of developing, manufacturing, producing (including
 the cost per dose of production), and distributing the drug;
   (ii) research and development costs of the drug, including payments to
 predecessor  entities  conducting  research  and  development,  such  as
 biotechnology companies, universities and medical schools,  and  private
 research institutions;
   (iii)  administrative,  marketing, and advertising costs for the drug,
 apportioned by marketing activities  that  are  directed  to  consumers,
 marketing  activities  that  are  directed to prescribers, and the total
 cost of all marketing and advertising  that  is  directed  primarily  to
 consumers  and  prescribers  in  New  York, including but not limited to
 prescriber detailing, copayment discount programs, and direct-to-consum-
 er marketing;
   (iv) the extent of utilization of the drug;
   (v) prices for the drug that are charged  to  purchasers  outside  the
 United States;
   (vi)  prices charged to typical purchasers in the state, including but
 not limited to pharmacies, pharmacy  chains,  pharmacy  wholesalers,  or
 other direct purchasers;
   (vii) the average rebates and discounts provided per payer type in the
 State; and
   (viii) the average profit margin of each drug over the prior five-year
 period and the projected profit margin anticipated for such drug.
   (b) All information disclosed pursuant to paragraph (a) of this subdi-
 vision  shall  be  considered confidential and shall not be disclosed by
 the department in a form that  identifies  a  specific  manufacturer  or
 prices charged for drugs by such manufacturer.
   7.]  (a) [If, after] AFTER taking into account all rebates and supple-
 mental rebates received by the department, including rebates received to
 date pursuant to this section[, total  Medicaid  drug  expenditures  are
 still projected to exceed the annual growth limitation imposed by subdi-
 vision two of this section], the commissioner may: subject any drug of a
 manufacturer  referred  to  the drug utilization review board under this
 section to prior approval in  accordance  with  existing  processes  and
 procedures  when  such  manufacturer has not entered into a supplemental
 rebate arrangement as required by this section; direct  a  managed  care
 plan  to  limit or reduce reimbursement for a drug provided by a medical
 practitioner if the drug utilization review board  recommends  a  target
 rebate  amount  for  such  drug and the manufacturer has failed to enter
 into a rebate arrangement required by this section; direct managed  care
 plans  to remove from their Medicaid formularies any drugs of a manufac-
 turer who has a drug that the drug utilization review board recommends a
 target rebate amount for and the manufacturer has failed to enter into a
 rebate arrangement required by this section; promote  the  use  of  cost
 effective  and  clinically  appropriate  drugs  other  than  those  of a
 manufacturer who has a drug  that  the  drug  utilization  review  board
 recommends  a  target  rebate  amount and the manufacturer has failed to
 S. 8307--C                         24                         A. 8807--C
 
 enter into a rebate arrangement required by this section; allow manufac-
 turers to accelerate rebate payments under  existing  rebate  contracts;
 and  such  other  actions  as  authorized by law. The commissioner shall
 provide  written notice to the legislature AT LEAST thirty days prior to
 taking action pursuant to this paragraph[, unless action is necessary in
 the fourth quarter of a fiscal  year  to  prevent  total  Medicaid  drug
 expenditures from exceeding the limitation imposed by subdivision two of
 this  section,  in which case such notice to the legislature may be less
 than thirty days].
   (b) The commissioner shall be authorized to take the actions described
 in paragraph (a) of this subdivision [only so  long  as  total  Medicaid
 drug  expenditures  are projected to exceed the annual growth limitation
 imposed by subdivision two  of  this  section].  In  addition,  no  such
 actions  shall be deemed to supersede the provisions of paragraph (b) of
 subdivision three of section two hundred seventy-three of  this  article
 or  the  provisions  of  subdivisions  twenty-five  and twenty-five-a of
 section three hundred sixty-four-j of the social services  law[,  except
 as  allowed  by  paragraph  (c)  of  subdivision  five of this section];
 provided further that nothing in this section shall prevent access by  a
 Medicaid  recipient  to a drug which is the only treatment for a partic-
 ular disease or condition.
   [8.] 7. The commissioner shall PROVIDE A report by July first annually
 to the drug utilization review board, THE GOVERNOR, THE SPEAKER  OF  THE
 ASSEMBLY,  AND THE TEMPORARY PRESIDENT OF THE SENATE on savings achieved
 through the [drug cap] SUPPLEMENTAL REBATE PROGRAMS in the  last  fiscal
 year.  Such  report  shall  provide  data  on what savings were achieved
 through actions pursuant to subdivisions three, five and [seven] SIX  of
 this section, respectively, and what savings were achieved through other
 means and how such savings were calculated and implemented.
   §  5.  The  opening  paragraph  of  paragraph  (e) of subdivision 7 of
 section 367-a of the social services law, as amended by  section  24  of
 part B of chapter 57 of the laws of 2023, is amended to read as follows:
   During the period from April first, two thousand fifteen through March
 thirty-first,  two thousand twenty-six, the commissioner may, in lieu of
 a managed care provider or pharmacy benefit manager, negotiate  directly
 and enter into an arrangement with a pharmaceutical manufacturer for the
 provision of supplemental rebates relating to pharmaceutical utilization
 by enrollees of managed care providers pursuant to section three hundred
 sixty-four-j  of  this  title  and may also negotiate directly and enter
 into such an agreement relating to pharmaceutical utilization by medical
 assistance recipients not so enrolled. Such rebate arrangements shall be
 limited to the following: antiretrovirals approved by the  FDA  for  the
 treatment  of  HIV/AIDS, ACCELERATED APPROVAL DRUGS ESTABLISHED PURSUANT
 TO THIS PARAGRAPH, opioid dependence agents and opioid antagonists list-
 ed in a statewide formulary established pursuant to  subparagraph  (vii)
 of  this  paragraph, hepatitis C agents, high cost drugs as provided for
 in subparagraph (viii) of this paragraph, gene therapies as provided for
 in subparagraph (ix) of this paragraph, and  any  other  class  or  drug
 designated by the commissioner for which the pharmaceutical manufacturer
 has  in effect a rebate arrangement with the federal secretary of health
 and human services pursuant to 42 U.S.C. § 1396r-8, and  for  which  the
 state  has  established standard clinical criteria. No agreement entered
 into pursuant to this  paragraph  shall  have  an  initial  term  or  be
 extended  beyond  the  expiration  or  repeal  of  this paragraph.   FOR
 PURPOSES OF THIS PARAGRAPH, AN  "ACCELERATED  APPROVAL"  IS  A  DRUG  OR
 LABELED  INDICATION  OF  A DRUG AUTHORIZED BY THE FEDERAL FOOD, DRUG AND
 S. 8307--C                         25                         A. 8807--C
 
 COSMETIC ACT FOR DRUGS APPROVED UNDER SUBPART H OF 21 CFR PART  314  AND
 SUBPART  E  OF 21 CFR PART 601 FOR SERIOUS CONDITIONS THAT FILL AN UNMET
 MEDICAL NEED BASED ON WHETHER THE DRUG HAS  AN  EFFECT  ON  A  SURROGATE
 CLINICAL  ENDPOINT,  AND  IS PENDING VERIFICATION OF CLINICAL BENEFIT IN
 CONFIRMATORY TRIALS.
   § 6. Paragraphs (a), (b) and (c) of subdivision 9 of section 367-a  of
 the social services law, paragraphs (a) and (c) as amended by chapter 19
 of  the laws of 1998, paragraph (b) as amended by section 3 of part C of
 chapter 58 of the laws of 2004, subparagraphs (i) and (ii) of  paragraph
 (b) as amended by section 7 of part D of chapter 57 of the laws of 2017,
 and subparagraph (iii) of paragraph (b) as added by section 29 of part E
 of chapter 63 of the laws of 2005, are amended to read as follows:
   (a) for drugs provided by medical practitioners and claimed separately
 by  the  practitioners[, the actual cost of the drugs to the practition-
 ers; and] THE LOWER OF:
   (I) (1) AN AMOUNT EQUAL TO THE NATIONAL AVERAGE DRUG ACQUISITION  COST
 SET  BY  THE  FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES FOR THE
 DRUG, IF ANY, OR IF SUCH AMOUNT IS NOT AVAILABLE, THE WHOLESALE ACQUISI-
 TION COST OF THE DRUG BASED ON  THE  PACKAGE  SIZE  DISPENSED  FROM,  AS
 REPORTED  BY  THE  PRESCRIPTION DRUG PRICING SERVICE USED BY THE DEPART-
 MENT, (2) THE FEDERAL UPPER LIMIT, IF ANY, ESTABLISHED  BY  THE  FEDERAL
 CENTERS FOR MEDICARE AND MEDICAID SERVICES; (3) THE STATE MAXIMUM ACQUI-
 SITION  COST,  IF  ANY,  ESTABLISHED  PURSUANT  TO PARAGRAPH (E) OF THIS
 SUBDIVISION; OR (4) THE ACTUAL COST OF THE DRUG TO THE PRACTITIONER.
   (II) NOTWITHSTANDING SUBPARAGRAPH (I) OF THIS PARAGRAPH AND  PARAGRAPH
 (E)  OF THIS SUBDIVISION, FOR THE MEDICAID FEE-FOR-SERVICE PROGRAM, IF A
 DRUG HAS BEEN PURCHASED FROM A MANUFACTURER BY A COVERED ENTITY PURSUANT
 TO SECTION 340B OF THE FEDERAL PUBLIC HEALTH  SERVICE  ACT  (42  USCA  §
 256B),  THE  ACTUAL  AMOUNT PAID BY SUCH COVERED ENTITY. FOR PURPOSES OF
 THIS SUBPARAGRAPH, A "COVERED  ENTITY"  IS  AN  ENTITY  THAT  MEETS  THE
 REQUIREMENTS  OF  PARAGRAPH FOUR OF SUBDIVISION (A) OF SUCH SECTION THAT
 ELECTS TO PARTICIPATE IN THE PROGRAM ESTABLISHED BY  SUCH  SECTION,  AND
 THAT CAUSES CLAIMS FOR PAYMENT FOR DRUGS COVERED BY THIS SUBPARAGRAPH TO
 BE  SUBMITTED  TO  THE  MEDICAL  ASSISTANCE  PROGRAM, EITHER DIRECTLY OR
 THROUGH AN AUTHORIZED CONTRACT PHARMACY. NO MEDICAL ASSISTANCE  PAYMENTS
 MAY BE MADE TO A COVERED ENTITY OR TO AN AUTHORIZED CONTRACT PHARMACY OF
 A  COVERED  ENTITY  FOR  DRUGS  THAT ARE ELIGIBLE FOR PURCHASE UNDER THE
 SECTION 340B PROGRAM  AND  ARE  DISPENSED  ON  AN  OUTPATIENT  BASIS  TO
 PATIENTS  OF THE COVERED ENTITY, OTHER THAN UNDER THE PROVISIONS OF THIS
 SUBPARAGRAPH.  MEDICAL PRACTITIONERS SUBMITTING CLAIMS FOR REIMBURSEMENT
 OF DRUGS PURCHASED PURSUANT TO SECTION 340B OF THE PUBLIC HEALTH SERVICE
 ACT SHALL NOTIFY THE DEPARTMENT THAT THE CLAIM IS ELIGIBLE FOR  PURCHASE
 UNDER  THE 340B PROGRAM, CONSISTENT WITH CLAIMING INSTRUCTIONS ISSUED BY
 THE DEPARTMENT TO IDENTIFY SUCH CLAIMS.
   (III) IN NO EVENT SHALL A MEDICAL PRACTITIONER  BE  REIMBURSED  AT  AN
 AMOUNT  THAT  IS  LOWER  THAN THE STATE MAXIMUM ACQUISITION COST, OR FOR
 DRUGS THAT DO NOT HAVE A STATE MAXIMUM ACQUISITION COST,  THE  WHOLESALE
 ACQUISITION COST OF THE DRUG BASED ON THE PACKAGE SIZE.
   (b) for drugs dispensed by pharmacies:
   (i)  (A)  if  the  drug  dispensed is a generic prescription drug, the
 lower of: (1) an amount equal to the national average  drug  acquisition
 cost  set  by the federal centers for medicare and medicaid services for
 the drug, if any, or if such amount  if  not  available,  the  wholesale
 acquisition  cost  of the drug based on the package size dispensed from,
 as reported by the prescription drug pricing service used by the depart-
 ment, less seventeen and one-half percent thereof; (2) the federal upper
 S. 8307--C                         26                         A. 8807--C
 
 limit, if any, established by the federal centers for medicare and medi-
 caid services; (3) the state maximum acquisition cost,  if  any,  estab-
 lished  pursuant  to  paragraph  (e)  of  this  subdivision;  or (4) the
 dispensing  pharmacy's  usual and customary price charged to the general
 public; (B) if the drug dispensed is available without a prescription as
 required by section sixty-eight hundred ten of the education law but  is
 reimbursed as an item of medical assistance pursuant to paragraph (a) of
 subdivision  four  of  section three hundred sixty-five-a of this title,
 the lower of (1) an amount equal to the national average  drug  acquisi-
 tion  cost set by the federal centers for medicare and medicaid services
 for the drug, if any, or if such amount is not available, the  wholesale
 acquisition  cost  of the drug based on the package size dispensed from,
 as reported by the prescription drug pricing service used by the depart-
 ment, (2) the federal upper limit, if any, established  by  the  federal
 centers for medicare and medicaid services; (3) the state maximum acqui-
 sition cost if any, established pursuant to paragraph (e) of this subdi-
 vision;  or  (4)  the  dispensing  pharmacy's  usual and customary price
 charged to the general public;
   (ii) if the drug dispensed is  a  brand-name  prescription  drug,  the
 lower of:
   (A)  an amount equal to the national average drug acquisition cost set
 by the federal centers for medicare and medicaid services for the  drug,
 if  any,  or  if such amount is not available, the wholesale acquisition
 cost of the drug based on the package size dispensed from,  as  reported
 by  the  prescription drug pricing service used by the department[, less
 three and three-tenths percent thereof]; or (B) the  dispensing  pharma-
 cy's usual and customary price charged to the general public; and
   (iii) notwithstanding subparagraphs (i) and (ii) of this paragraph and
 paragraphs  (d)  and (e) of this subdivision, if the drug dispensed is a
 drug that has been purchased from a manufacturer  by  a  covered  entity
 pursuant  to  section  340B of the federal public health service act (42
 USCA § 256b), the actual amount paid by such covered entity pursuant  to
 such section, plus the reasonable administrative costs, as determined by
 the  commissioner,  incurred  by  the covered entity or by an authorized
 contract pharmacy in connection with the purchase and dispensing of such
 drug and the tracking of such transactions. For purposes of this subpar-
 agraph, a "covered entity" is an entity that meets the  requirements  of
 paragraph four of subsection (a) of such section, that elects to partic-
 ipate in the program established by such section, and that causes claims
 for  payment  for  drugs covered by this subparagraph to be submitted to
 the medical assistance program, either directly or through an authorized
 contract pharmacy. No medical assistance  payments  may  be  made  to  a
 covered entity or to an authorized contract pharmacy of a covered entity
 for  drugs that are eligible for purchase under the section 340B program
 and are dispensed on an outpatient basis  to  patients  of  the  covered
 entity, other than under the provisions of this subparagraph. Pharmacies
 submitting  claims  for  reimbursement  of  drugs  purchased pursuant to
 section 340B of the public health service act shall notify  the  depart-
 ment  that  the  claim  is eligible for purchase under the 340B program,
 consistent with claiming instructions issued by the department to  iden-
 tify such claims.
   (c) Notwithstanding subparagraph (i) of paragraph (b) of this subdivi-
 sion, if a qualified prescriber certifies "brand medically necessary" or
 "brand  necessary" in his or her own handwriting directly on the face of
 a prescription, OR IN THE CASE OF ELECTRONIC PRESCRIPTIONS,  INSERTS  AN
 ELECTRONIC  DIRECTION  TO  CLARIFY "BRAND MEDICALLY NECESSARY" OR "BRAND
 S. 8307--C                         27                         A. 8807--C
 
 NECESSARY", for a multiple source drug for which a specific upper  limit
 of reimbursement has been established by the federal agency, in addition
 to  writing  "d  a  w"  in  the  box  provided  for  such purpose on the
 prescription  form,  payment under this title for such drug must be made
 under the provisions of subparagraph (ii) of such paragraph.
   § 7. This act  shall  take  effect  October  1,  2024;  provided  that
 the amendments to paragraph (e) of subdivision 7 of section 367-a of the
 social services law made by section five of this act  shall  not  affect
 the repeal of such paragraph and shall be deemed repealed therewith; and
 provided  further, that the amendments to subdivision 9 of section 367-a
 of the social services law made by section six of  this  act  shall  not
 affect the expiration of such subdivision pursuant to section 4 of chap-
 ter 19 of the laws of 1998, as amended, and shall expire therewith.
 
                                  PART J
 
   Section  1. The title heading of title 11-D of article 5 of the social
 services law, as amended by section 1 of part H of  chapter  57  of  the
 laws of 2021, is amended to read as follows:
                    [BASIC HEALTH PROGRAM] ESSENTIAL PLAN
   §  2.  Section 3 of part H of chapter 57 of the laws of 2021, amending
 the social services law relating to  eliminating  consumer-paid  premium
 payments in the basic health program, is amended to read as follows:
   § 3. This act shall take effect June 1, 2021 [and]; PROVIDED, HOWEVER,
 SECTION  TWO  OF  THIS  ACT  shall  expire and be deemed repealed should
 federal approval be withdrawn or 42 U.S.C. 18051 be  repealed;  provided
 that the commissioner of health shall notify the legislative bill draft-
 ing  commission upon the withdrawal of federal approval or the repeal of
 42 U.S.C. 18051 in order that the commission may  maintain  an  accurate
 and  timely  effective data base of the official text of the laws of the
 state of New York in  furtherance  of  effectuating  the  provisions  of
 section  44  of the legislative law and section 70-b of the public offi-
 cers law.
   § 3. Subdivisions (b) and (c) of section 8 of part BBB of  chapter  56
 of  the  laws  of  2022,  amending  the public health law and other laws
 relating to permitting the commissioner of health  to  submit  a  waiver
 that  expands  eligibility  for  New  York's  basic  health  program and
 increases the federal poverty limit cap for basic health  program eligi-
 bility from  two hundred to two hundred  fifty percent, are  amended  to
 read as follows:
   (b)  section  four  of  this  act  shall expire and be deemed repealed
 December 31, [2024] 2025; provided, however, the amendments to paragraph
 (c) of subdivision 1 of section 369-gg of the social services  law  made
 by  such  section  of  this  act  shall be subject to the expiration and
 reversion of such paragraph pursuant to section 2 of part H  of  chapter
 57  of  the  laws of 2021 when upon such date, the provisions of section
 five of this act shall take effect; provided, however, the amendments to
 such paragraph made by section five of this  act  shall  expire  and  be
 deemed repealed December 31, [2024] 2025;
   (c)  section six of this act shall take effect January 1, [2025] 2026;
 provided, however, the amendments to paragraph (c) of subdivision  1  of
 section  369-gg  of the social services law made by such section of this
 act shall be subject to the expiration and reversion of  such  paragraph
 pursuant  to  section 2 of part H of chapter 57 of the laws of 2021 when
 upon such date, the provisions of section seven of this act  shall  take
 effect; and
 S. 8307--C                         28                         A. 8807--C

   §  4.  Paragraph  (a)  of subdivision 1 of section 268-c of the public
 health law, as added by section 2 of part T of chapter 57 of the laws of
 2019, is amended to read as follows:
   (a) Perform eligibility determinations for federal and state insurance
 affordability  programs  including medical assistance in accordance with
 section three hundred sixty-six of the social services law, child health
 plus in accordance with section twenty-five hundred eleven of this chap-
 ter, the basic health program in accordance with section  three  hundred
 sixty-nine-gg  of  the  social  services  law, THE 1332 STATE INNOVATION
 PROGRAM IN ACCORDANCE WITH SECTION THREE HUNDRED  SIXTY-NINE-II  OF  THE
 SOCIAL SERVICES LAW, premium tax credits and cost-sharing reductions and
 qualified  health  plans  in  accordance  with  applicable law and other
 health insurance programs as determined by the commissioner;
   § 5. Subdivision 16 of section 268-c of  the  public  health  law,  as
 added  by  section  2  of  part  T of chapter 57 of the laws of 2019, is
 amended to read as follows:
   16. In accordance with applicable federal and state law, inform  indi-
 viduals of eligibility requirements for the Medicaid program under title
 XIX  of  the  social security act and the social services law, the chil-
 dren's health insurance program (CHIP) under title  XXI  of  the  social
 security  act  and  this chapter, the basic health program under section
 three hundred sixty-nine-gg of the social services law, THE  1332  STATE
 INNOVATION  PROGRAM IN ACCORDANCE WITH SECTION THREE HUNDRED SIXTY-NINE-
 II OF THE SOCIAL SERVICES LAW, or any applicable state or  local  public
 health insurance program and if, through screening of the application by
 the  Marketplace,  the  Marketplace determines that such individuals are
 eligible for any such program, enroll such individuals in such program.
   § 6. Section 268-c of the public health law is amended by adding a new
 subdivision 26 to read as follows:
   26. SUBJECT TO FEDERAL APPROVAL IF REQUIRED, THE USE  OF  STATE  FUNDS
 AND  THE AVAILABILITY OF FUNDS IN THE 1332 STATE INNOVATION PROGRAM FUND
 ESTABLISHED PURSUANT TO SECTION NINETY-EIGHT-D OF THE STATE FINANCE LAW,
 THE COMMISSIONER SHALL HAVE THE AUTHORITY  TO  ESTABLISH  A  PROGRAM  TO
 PROVIDE  SUBSIDIES FOR THE PAYMENT OF PREMIUM OR COST SHARING OR BOTH TO
 ASSIST INDIVIDUALS WHO ARE ELIGIBLE TO PURCHASE QUALIFIED  HEALTH  PLANS
 THROUGH  THE  MARKETPLACE,  OR  TAKE SUCH OTHER ACTION AS APPROPRIATE TO
 REDUCE OR ELIMINATE QUALIFIED HEALTH PLAN PREMIUMS  OR  COST-SHARING  OR
 BOTH.
   §  7.  Subparagraph  (i)  of paragraph (a) of subdivision 4 of section
 268-e of the public health law, as added by section 2 of part T of chap-
 ter 57 of the laws of 2019, is amended to read as follows:
   (i) An initial determination of eligibility, including:
   (A) eligibility to enroll in a qualified health plan;
   (B) eligibility for Medicaid;
   (C) eligibility for Child Health Plus;
   (D) eligibility for the Basic Health Program;
   (E) ELIGIBILITY FOR THE 1332 STATE INNOVATION PROGRAM;
   (F) the amount of advance payments of the premium tax credit and level
 of cost-sharing reductions;
   [(F)] (G) the amount of any other subsidy that may be available  under
 law; and
   [(G)]  (H)  eligibility  for  such  other health insurance programs as
 determined by the commissioner; and
   § 8. Section 268 of the public health law, as added by  section  2  of
 part T of chapter 57 of the laws of 2019, is amended to read as follows:
 S. 8307--C                         29                         A. 8807--C
 
   § 268. Statement of policy and purposes.  The purpose of this title is
 to  codify the establishment of the health benefit exchange in New York,
 known as NY State  of  Health,  The  Official  Health  Plan  Marketplace
 (Marketplace),  in  conformance  with  Executive Order 42 (Cuomo) issued
 April  12,  2012.  The Marketplace shall continue to perform eligibility
 determinations for federal and state  insurance  affordability  programs
 including  medical  assistance  in accordance with section three hundred
 sixty-six of the social services law, child health  plus  in  accordance
 with  section  twenty-five  hundred  eleven  of  this chapter, the basic
 health program in accordance with section three hundred sixty-nine-gg of
 the social services law, THE 1332 STATE INNOVATION PROGRAM IN ACCORDANCE
 WITH SECTION THREE HUNDRED SIXTY-NINE-II OF THE SOCIAL SERVICE LAW,  and
 premium  tax credits and cost-sharing reductions, together with perform-
 ing eligibility determinations for qualified health plans and such other
 health insurance programs as determined by the commissioner. The Market-
 place  shall  also  facilitate  enrollment  in  insurance  affordability
 programs,  qualified health plans and other health insurance programs as
 determined by the commissioner,  the  purchase  and  sale  of  qualified
 health  plans  and/or  other or additional health plans certified by the
 Marketplace pursuant to this title,  and  shall  continue  to  have  the
 authority to operate a small business health options program ("SHOP") to
 assist  eligible  small  employers  in  selecting qualified health plans
 and/or other or additional health plans certified by the Marketplace and
 to determine small employer eligibility for purposes of  small  employer
 tax  credits.  It  is  the  intent  of the legislature, by codifying the
 Marketplace in state statute, to continue to promote quality and afford-
 able health coverage and care, reduce the number of  uninsured  persons,
 provide a transparent marketplace, educate consumers and assist individ-
 uals  with  access to coverage, premium assistance tax credits and cost-
 sharing reductions. In addition, the  legislature  declares  the  intent
 that  the  Marketplace continue to be properly integrated with insurance
 affordability programs, including Medicaid, child health  plus  and  the
 basic  health program, THE 1332 STATE INNOVATION PROGRAM, and such other
 health insurance programs as determined by the commissioner.
   § 9. Subdivision 8 of section 268-a of the public health law, as added
 by section 1 of part PP of chapter 57 of the laws of 2021, is amended to
 read as follows:
   8. "Insurance affordability  program"  means  Medicaid,  child  health
 plus, the basic health program, THE 1332 STATE INNOVATION PROGRAM, post-
 partum  extended coverage and any other health insurance subsidy program
 designated as such by the commissioner.
   § 10. This act shall take effect immediately and shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024; provided,
 however,  that  section  six of this act shall only take effect upon the
 commissioner of health obtaining and maintaining all necessary approvals
 from the secretary of health and human services and the secretary of the
 treasury based on an amended application for a waiver  for  state  inno-
 vation pursuant to section 1332 of the patient protection and affordable
 care  act  (P.L.  111-148)  and  subdivision  25 of section 268-c of the
 public health law; and  provided,  further,  that  the  commissioner  of
 health  shall  notify  the legislative bill drafting commission upon the
 occurrence of the enactment of the legislation provided for  in  section
 six  of  this  act in order that the commission may maintain an accurate
 and timely effective data base of the official text of the laws  of  the
 state  of  New  York  in  furtherance  of effectuating the provisions of
 S. 8307--C                         30                         A. 8807--C
 
 section 44 of the legislative law and section 70-b of the  public  offi-
 cers law.
 
                                  PART K
 
   Section 1. Paragraph (a) of subdivision 1 of section 18 of chapter 266
 of the laws of 1986, amending the civil practice law and rules and other
 laws  relating  to  malpractice  and  professional  medical  conduct, as
 amended by section 1 of part F of chapter 57 of the  laws  of  2023,  is
 amended to read as follows:
   (a)  The  superintendent of financial services and the commissioner of
 health or their designee shall, from funds  available  in  the  hospital
 excess liability pool created pursuant to subdivision 5 of this section,
 purchase  a policy or policies for excess insurance coverage, as author-
 ized by paragraph 1 of subsection (e) of section 5502 of  the  insurance
 law; or from an insurer, other than an insurer described in section 5502
 of the insurance law, duly authorized to write such coverage and actual-
 ly  writing  medical  malpractice  insurance  in  this  state;  or shall
 purchase equivalent excess coverage in a form previously approved by the
 superintendent of financial services for purposes  of  providing  equiv-
 alent  excess  coverage  in accordance with section 19 of chapter 294 of
 the laws of 1985, for medical or dental malpractice occurrences  between
 July  1, 1986 and June 30, 1987, between July 1, 1987 and June 30, 1988,
 between July 1, 1988 and June 30, 1989, between July 1,  1989  and  June
 30,  1990,  between July 1, 1990 and June 30, 1991, between July 1, 1991
 and June 30, 1992, between July 1, 1992 and June 30, 1993, between  July
 1,  1993  and  June  30,  1994,  between July 1, 1994 and June 30, 1995,
 between July 1, 1995 and June 30, 1996, between July 1,  1996  and  June
 30,  1997,  between July 1, 1997 and June 30, 1998, between July 1, 1998
 and June 30, 1999, between July 1, 1999 and June 30, 2000, between  July
 1,  2000  and  June  30,  2001,  between July 1, 2001 and June 30, 2002,
 between July 1, 2002 and June 30, 2003, between July 1,  2003  and  June
 30,  2004,  between July 1, 2004 and June 30, 2005, between July 1, 2005
 and June 30, 2006, between July 1, 2006 and June 30, 2007, between  July
 1,  2007  and  June  30,  2008,  between July 1, 2008 and June 30, 2009,
 between July 1, 2009 and June 30, 2010, between July 1,  2010  and  June
 30,  2011,  between July 1, 2011 and June 30, 2012, between July 1, 2012
 and June 30, 2013, between July 1, 2013 and June 30, 2014, between  July
 1,  2014  and  June  30,  2015,  between July 1, 2015 and June 30, 2016,
 between July 1, 2016 and June 30, 2017, between July 1,  2017  and  June
 30,  2018,  between July 1, 2018 and June 30, 2019, between July 1, 2019
 and June 30, 2020, between July 1, 2020 and June 30, 2021, between  July
 1, 2021 and June 30, 2022, between July 1, 2022 and June 30, 2023, [and]
 between  July  1,  2023  and June 30, 2024, AND BETWEEN JULY 1, 2024 AND
 JUNE 30, 2025 or reimburse the hospital  where  the  hospital  purchases
 equivalent  excess  coverage as defined in subparagraph (i) of paragraph
 (a) of subdivision 1-a of this section for medical or dental malpractice
 occurrences between July 1, 1987 and June 30, 1988, between July 1, 1988
 and June 30, 1989, between July 1, 1989 and June 30, 1990, between  July
 1,  1990  and  June  30,  1991,  between July 1, 1991 and June 30, 1992,
 between July 1, 1992 and June 30, 1993, between July 1,  1993  and  June
 30,  1994,  between July 1, 1994 and June 30, 1995, between July 1, 1995
 and June 30, 1996, between July 1, 1996 and June 30, 1997, between  July
 1,  1997  and  June  30,  1998,  between July 1, 1998 and June 30, 1999,
 between July 1, 1999 and June 30, 2000, between July 1,  2000  and  June
 30,  2001,  between July 1, 2001 and June 30, 2002, between July 1, 2002
 S. 8307--C                         31                         A. 8807--C
 
 and June 30, 2003, between July 1, 2003 and June 30, 2004, between  July
 1,  2004  and  June  30,  2005,  between July 1, 2005 and June 30, 2006,
 between July 1, 2006 and June 30, 2007, between July 1,  2007  and  June
 30,  2008,  between July 1, 2008 and June 30, 2009, between July 1, 2009
 and June 30, 2010, between July 1, 2010 and June 30, 2011, between  July
 1,  2011  and  June  30,  2012,  between July 1, 2012 and June 30, 2013,
 between July 1, 2013 and June 30, 2014, between July 1,  2014  and  June
 30,  2015,  between July 1, 2015 and June 30, 2016, between July 1, 2016
 and June 30, 2017, between July 1, 2017 and June 30, 2018, between  July
 1,  2018  and  June  30,  2019,  between July 1, 2019 and June 30, 2020,
 between July 1, 2020 and June 30, 2021, between July 1,  2021  and  June
 30,  2022, between July 1, 2022 and June 30, 2023, [and] between July 1,
 2023 and June 30, 2024, AND BETWEEN JULY 1, 2024 AND JUNE 30,  2025  for
 physicians  or  dentists  certified  as eligible for each such period or
 periods pursuant to subdivision 2 of this section by a general  hospital
 licensed  pursuant to article 28 of the public health law; provided that
 no single insurer shall write more  than  fifty  percent  of  the  total
 excess premium for a given policy year; and provided, however, that such
 eligible physicians or dentists must have in force an individual policy,
 from  an insurer licensed in this state of primary malpractice insurance
 coverage in amounts of no less than one million three  hundred  thousand
 dollars  for  each  claimant  and  three  million  nine hundred thousand
 dollars for all claimants under that policy during the  period  of  such
 excess  coverage  for  such  occurrences  or  be  endorsed as additional
 insureds under a hospital professional liability policy which is offered
 through a voluntary attending physician ("channeling") program previous-
 ly permitted by the superintendent  of  financial  services  during  the
 period of such excess coverage for such occurrences. During such period,
 such  policy  for  excess  coverage  or  such equivalent excess coverage
 shall, when combined with the physician's or dentist's primary  malprac-
 tice insurance coverage or coverage provided through a voluntary attend-
 ing  physician  ("channeling")  program, total an aggregate level of two
 million three hundred thousand dollars for each claimant and six million
 nine hundred thousand dollars for all claimants from all  such  policies
 with  respect to occurrences in each of such years provided, however, if
 the cost of primary malpractice insurance  coverage  in  excess  of  one
 million  dollars,  but  below  the  excess medical malpractice insurance
 coverage provided pursuant to this act, exceeds the rate of nine percent
 per annum, then the required  level  of  primary  malpractice  insurance
 coverage  in excess of one million dollars for each claimant shall be in
 an amount of not less than the dollar amount of such coverage  available
 at  nine  percent per annum; the required level of such coverage for all
 claimants under that policy shall be in an amount not  less  than  three
 times the dollar amount of coverage for each claimant; and excess cover-
 age,  when  combined  with  such primary malpractice insurance coverage,
 shall increase the aggregate level for  each  claimant  by  one  million
 dollars  and  three  million  dollars  for  all  claimants; and provided
 further, that, with respect to policies of primary  medical  malpractice
 coverage  that  include  occurrences  between April 1, 2002 and June 30,
 2002, such requirement that coverage be in  amounts  no  less  than  one
 million  three  hundred  thousand  dollars  for  each claimant and three
 million nine hundred thousand dollars for all claimants for such  occur-
 rences shall be effective April 1, 2002.
   §  2.  Subdivision 3 of section 18 of chapter 266 of the laws of 1986,
 amending the civil practice law and rules and  other  laws  relating  to
 S. 8307--C                         32                         A. 8807--C
 
 malpractice and professional medical conduct, as amended by section 2 of
 part F of chapter 57 of the laws of 2023, is amended to read as follows:
   (3)(a)  The  superintendent  of financial services shall determine and
 certify to each general hospital and to the commissioner of  health  the
 cost  of  excess malpractice insurance for medical or dental malpractice
 occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988
 and June 30, 1989, between July 1, 1989 and June 30, 1990, between  July
 1,  1990  and  June  30,  1991,  between July 1, 1991 and June 30, 1992,
 between July 1, 1992 and June 30, 1993, between July 1,  1993  and  June
 30,  1994,  between July 1, 1994 and June 30, 1995, between July 1, 1995
 and June 30, 1996, between July 1, 1996 and June 30, 1997, between  July
 1,  1997  and  June  30,  1998,  between July 1, 1998 and June 30, 1999,
 between July 1, 1999 and June 30, 2000, between July 1,  2000  and  June
 30,  2001,  between July 1, 2001 and June 30, 2002, between July 1, 2002
 and June 30, 2003, between July 1, 2003 and June 30, 2004, between  July
 1,  2004  and  June  30,  2005,  between July 1, 2005 and June 30, 2006,
 between July 1, 2006 and June 30, 2007, between July 1,  2007  and  June
 30,  2008,  between July 1, 2008 and June 30, 2009, between July 1, 2009
 and June 30, 2010, between July 1, 2010 and June 30, 2011, between  July
 1,  2011  and  June  30,  2012,  between July 1, 2012 and June 30, 2013,
 between July 1, 2013 and June 30, 2014, between July 1,  2014  and  June
 30,  2015,  between July 1, 2015 and June 30, 2016, between July 1, 2016
 and June 30, 2017, between July 1, 2017 and June 30, 2018, between  July
 1,  2018  and  June  30,  2019,  between July 1, 2019 and June 30, 2020,
 between July 1, 2020 and June 30, 2021, between July 1,  2021  and  June
 30,  2022, between July 1, 2022 and June 30, 2023, [and] between July 1,
 2023 and June 30, 2024, AND BETWEEN JULY 1, 2024 AND JUNE 30, 2025 allo-
 cable to each general hospital for physicians or dentists  certified  as
 eligible  for purchase of a policy for excess insurance coverage by such
 general hospital in accordance with subdivision 2 of this  section,  and
 may amend such determination and certification as necessary.
   (b)  The  superintendent  of  financial  services  shall determine and
 certify to each general hospital and to the commissioner of  health  the
 cost  of  excess malpractice insurance or equivalent excess coverage for
 medical or dental malpractice occurrences between July 1, 1987 and  June
 30,  1988,  between July 1, 1988 and June 30, 1989, between July 1, 1989
 and June 30, 1990, between July 1, 1990 and June 30, 1991, between  July
 1,  1991  and  June  30,  1992,  between July 1, 1992 and June 30, 1993,
 between July 1, 1993 and June 30, 1994, between July 1,  1994  and  June
 30,  1995,  between July 1, 1995 and June 30, 1996, between July 1, 1996
 and June 30, 1997, between July 1, 1997 and June 30, 1998, between  July
 1,  1998  and  June  30,  1999,  between July 1, 1999 and June 30, 2000,
 between July 1, 2000 and June 30, 2001, between July 1,  2001  and  June
 30,  2002,  between July 1, 2002 and June 30, 2003, between July 1, 2003
 and June 30, 2004, between July 1, 2004 and June 30, 2005, between  July
 1,  2005  and  June  30,  2006,  between July 1, 2006 and June 30, 2007,
 between July 1, 2007 and June 30, 2008, between July 1,  2008  and  June
 30,  2009,  between July 1, 2009 and June 30, 2010, between July 1, 2010
 and June 30, 2011, between July 1, 2011 and June 30, 2012, between  July
 1,  2012  and  June  30,  2013,  between July 1, 2013 and June 30, 2014,
 between July 1, 2014 and June 30, 2015, between July 1,  2015  and  June
 30,  2016,  between July 1, 2016 and June 30, 2017, between July 1, 2017
 and June 30, 2018, between July 1, 2018 and June 30, 2019, between  July
 1,  2019  and  June  30,  2020,  between July 1, 2020 and June 30, 2021,
 between July 1, 2021 and June 30, 2022, between July 1,  2022  and  June
 30, 2023, [and] between July 1, 2023 and June 30, 2024, AND BETWEEN JULY
 S. 8307--C                         33                         A. 8807--C
 
 1,  2024 AND JUNE 30, 2025 allocable to each general hospital for physi-
 cians or dentists certified as eligible for purchase  of  a  policy  for
 excess  insurance coverage or equivalent excess coverage by such general
 hospital in accordance with subdivision 2 of this section, and may amend
 such determination and certification as necessary. The superintendent of
 financial  services shall determine and certify to each general hospital
 and to the commissioner of health the ratable share of such cost alloca-
 ble to the period July 1, 1987 to December 31, 1987, to the period Janu-
 ary 1, 1988 to June 30, 1988, to the period July 1, 1988 to December 31,
 1988, to the period January 1, 1989 to June 30, 1989, to the period July
 1, 1989 to December 31, 1989, to the period January 1, 1990 to June  30,
 1990,  to  the  period  July 1, 1990 to December 31, 1990, to the period
 January 1, 1991 to June 30, 1991, to the period July 1, 1991 to December
 31, 1991, to the period January 1, 1992 to June 30, 1992, to the  period
 July 1, 1992 to December 31, 1992, to the period January 1, 1993 to June
 30, 1993, to the period July 1, 1993 to December 31, 1993, to the period
 January 1, 1994 to June 30, 1994, to the period July 1, 1994 to December
 31,  1994, to the period January 1, 1995 to June 30, 1995, to the period
 July 1, 1995 to December 31, 1995, to the period January 1, 1996 to June
 30, 1996, to the period July 1, 1996 to December 31, 1996, to the period
 January 1, 1997 to June 30, 1997, to the period July 1, 1997 to December
 31, 1997, to the period January 1, 1998 to June 30, 1998, to the  period
 July 1, 1998 to December 31, 1998, to the period January 1, 1999 to June
 30, 1999, to the period July 1, 1999 to December 31, 1999, to the period
 January 1, 2000 to June 30, 2000, to the period July 1, 2000 to December
 31,  2000, to the period January 1, 2001 to June 30, 2001, to the period
 July 1, 2001 to June 30, 2002, to the period July 1, 2002  to  June  30,
 2003, to the period July 1, 2003 to June 30, 2004, to the period July 1,
 2004  to June 30, 2005, to the period July 1, 2005 and June 30, 2006, to
 the period July 1, 2006 and June 30, 2007, to the period  July  1,  2007
 and  June 30, 2008, to the period July 1, 2008 and June 30, 2009, to the
 period July 1, 2009 and June 30, 2010, to the period July  1,  2010  and
 June  30,  2011,  to  the  period July 1, 2011 and June 30, 2012, to the
 period July 1, 2012 and June 30, 2013, to the period July  1,  2013  and
 June  30,  2014,  to  the  period July 1, 2014 and June 30, 2015, to the
 period July 1, 2015 and June 30, 2016, to the period July  1,  2016  and
 June 30, 2017, to the period July 1, 2017 to June 30, 2018, to the peri-
 od July 1, 2018 to June 30, 2019, to the period July 1, 2019 to June 30,
 2020, to the period July 1, 2020 to June 30, 2021, to the period July 1,
 2021  to  June  30,  2022,  to the period July 1, 2022 to June 30, 2023,
 [and] to the period July 1, 2023 to June 30, 2024,  AND  TO  THE  PERIOD
 JULY 1, 2024 TO JUNE 30, 2025.
   § 3. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
 18  of  chapter 266 of the laws of 1986, amending the civil practice law
 and rules and  other  laws  relating  to  malpractice  and  professional
 medical  conduct, as amended by section 3 of part F of chapter 57 of the
 laws of 2023, are amended to read as follows:
   (a) To the extent funds available to  the  hospital  excess  liability
 pool  pursuant to subdivision 5 of this section as amended, and pursuant
 to section 6 of part J of chapter 63 of the laws of 2001,  as  may  from
 time  to  time  be amended, which amended this subdivision, are insuffi-
 cient to meet the costs  of  excess  insurance  coverage  or  equivalent
 excess  coverage  for coverage periods during the period July 1, 1992 to
 June 30, 1993, during the period July 1, 1993 to June 30,  1994,  during
 the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
 to  June  30,  1996,  during  the  period July 1, 1996 to June 30, 1997,
 S. 8307--C                         34                         A. 8807--C
 
 during the period July 1, 1997 to June 30, 1998, during the period  July
 1,  1998  to  June  30, 1999, during the period July 1, 1999 to June 30,
 2000, during the period July 1, 2000 to June 30, 2001, during the period
 July  1,  2001  to  October 29, 2001, during the period April 1, 2002 to
 June 30, 2002, during the period July 1, 2002 to June 30,  2003,  during
 the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
 to  June  30,  2005,  during  the  period July 1, 2005 to June 30, 2006,
 during the period July 1, 2006 to June 30, 2007, during the period  July
 1,  2007  to  June  30, 2008, during the period July 1, 2008 to June 30,
 2009, during the period July 1, 2009 to June 30, 2010, during the period
 July 1, 2010 to June 30, 2011, during the period July 1,  2011  to  June
 30,  2012,  during  the period July 1, 2012 to June 30, 2013, during the
 period July 1, 2013 to June 30, 2014, during the period July 1, 2014  to
 June  30,  2015, during the period July 1, 2015 to June 30, 2016, during
 the period July 1, 2016 to June 30, 2017, during the period July 1, 2017
 to June 30, 2018, during the period July  1,  2018  to  June  30,  2019,
 during  the period July 1, 2019 to June 30, 2020, during the period July
 1, 2020 to June 30, 2021, during the period July 1,  2021  to  June  30,
 2022,  during the period July 1, 2022 to June 30, 2023, [and] during the
 period July 1, 2023 to June 30, 2024, AND DURING THE PERIOD JULY 1, 2024
 TO JUNE 30, 2025 allocated or reallocated in accordance  with  paragraph
 (a) of subdivision 4-a of this section to rates of payment applicable to
 state governmental agencies, each physician or dentist for whom a policy
 for excess insurance coverage or equivalent excess coverage is purchased
 for  such  period  shall  be  responsible for payment to the provider of
 excess insurance coverage or equivalent excess coverage of an  allocable
 share  of  such  insufficiency,  based on the ratio of the total cost of
 such coverage for such physician to the sum of the total  cost  of  such
 coverage for all physicians applied to such insufficiency.
   (b)  Each  provider  of excess insurance coverage or equivalent excess
 coverage covering the period July 1, 1992 to June 30, 1993, or  covering
 the period July 1, 1993 to June 30, 1994, or covering the period July 1,
 1994  to  June 30, 1995, or covering the period July 1, 1995 to June 30,
 1996, or covering the period July 1, 1996 to June 30, 1997, or  covering
 the period July 1, 1997 to June 30, 1998, or covering the period July 1,
 1998  to  June 30, 1999, or covering the period July 1, 1999 to June 30,
 2000, or covering the period July 1, 2000 to June 30, 2001, or  covering
 the  period  July  1,  2001  to October 29, 2001, or covering the period
 April 1, 2002 to June 30, 2002, or covering the period July 1,  2002  to
 June  30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
 covering the period July 1, 2004 to June 30, 2005, or covering the peri-
 od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
 June 30, 2007, or covering the period July 1, 2007 to June 30, 2008,  or
 covering the period July 1, 2008 to June 30, 2009, or covering the peri-
 od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
 June  30, 2011, or covering the period July 1, 2011 to June 30, 2012, or
 covering the period July 1, 2012 to June 30, 2013, or covering the peri-
 od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to
 June 30, 2015, or covering the period July 1, 2015 to June 30, 2016,  or
 covering the period July 1, 2016 to June 30, 2017, or covering the peri-
 od July 1, 2017 to June 30, 2018, or covering the period July 1, 2018 to
 June  30, 2019, or covering the period July 1, 2019 to June 30, 2020, or
 covering the period July 1, 2020 to June 30, 2021, or covering the peri-
 od July 1, 2021 to June 30, 2022, or covering the period July 1, 2022 to
 June 30, 2023, or covering the period July 1, 2023 to June 30, 2024,  OR
 COVERING THE PERIOD JULY 1, 2024 TO JUNE 30, 2025 shall notify a covered
 S. 8307--C                         35                         A. 8807--C

 physician  or  dentist  by mail, mailed to the address shown on the last
 application for excess insurance coverage or equivalent excess coverage,
 of the amount due to such provider from such physician  or  dentist  for
 such coverage period determined in accordance with paragraph (a) of this
 subdivision.  Such amount shall be due from such physician or dentist to
 such provider of excess insurance coverage or equivalent excess coverage
 in a time and manner  determined  by  the  superintendent  of  financial
 services.
   (c)  If  a physician or dentist liable for payment of a portion of the
 costs of excess insurance coverage or equivalent excess coverage  cover-
 ing  the  period  July  1, 1992 to June 30, 1993, or covering the period
 July 1, 1993 to June 30, 1994, or covering the period July  1,  1994  to
 June  30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
 covering the period July 1, 1996 to June 30, 1997, or covering the peri-
 od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
 June 30, 1999, or covering the period July 1, 1999 to June 30, 2000,  or
 covering the period July 1, 2000 to June 30, 2001, or covering the peri-
 od  July  1,  2001  to October 29, 2001, or covering the period April 1,
 2002 to June 30, 2002, or covering the period July 1, 2002 to  June  30,
 2003,  or covering the period July 1, 2003 to June 30, 2004, or covering
 the period July 1, 2004 to June 30, 2005, or covering the period July 1,
 2005 to June 30, 2006, or covering the period July 1, 2006 to  June  30,
 2007,  or covering the period July 1, 2007 to June 30, 2008, or covering
 the period July 1, 2008 to June 30, 2009, or covering the period July 1,
 2009 to June 30, 2010, or covering the period July 1, 2010 to  June  30,
 2011,  or covering the period July 1, 2011 to June 30, 2012, or covering
 the period July 1, 2012 to June 30, 2013, or covering the period July 1,
 2013 to June 30, 2014, or covering the period July 1, 2014 to  June  30,
 2015,  or covering the period July 1, 2015 to June 30, 2016, or covering
 the period July 1, 2016 to June 30, 2017, or covering the period July 1,
 2017 to June 30, 2018, or covering the period July 1, 2018 to  June  30,
 2019,  or covering the period July 1, 2019 to June 30, 2020, or covering
 the period July 1, 2020 to June 30, 2021, or covering the period July 1,
 2021 to June 30, 2022, or covering the period July 1, 2022 to  June  30,
 2023,  or covering the period July 1, 2023 to June 30, 2024, OR COVERING
 THE PERIOD JULY 1, 2024 TO JUNE 30, 2025 determined in  accordance  with
 paragraph  (a)  of  this  subdivision fails, refuses or neglects to make
 payment to the provider  of  excess  insurance  coverage  or  equivalent
 excess coverage in such time and manner as determined by the superinten-
 dent  of  financial  services pursuant to paragraph (b) of this subdivi-
 sion, excess insurance coverage or equivalent excess coverage  purchased
 for  such  physician or dentist in accordance with this section for such
 coverage period shall be cancelled and shall be null and void as of  the
 first  day  on  or  after  the commencement of a policy period where the
 liability for payment pursuant to this subdivision has not been met.
   (d) Each provider of excess insurance coverage  or  equivalent  excess
 coverage  shall  notify the superintendent of financial services and the
 commissioner of health or their designee of each physician  and  dentist
 eligible  for  purchase  of  a  policy  for excess insurance coverage or
 equivalent excess coverage covering the period July 1, 1992 to June  30,
 1993,  or covering the period July 1, 1993 to June 30, 1994, or covering
 the period July 1, 1994 to June 30, 1995, or covering the period July 1,
 1995 to June 30, 1996, or covering the period July 1, 1996 to  June  30,
 1997,  or covering the period July 1, 1997 to June 30, 1998, or covering
 the period July 1, 1998 to June 30, 1999, or covering the period July 1,
 1999 to June 30, 2000, or covering the period July 1, 2000 to  June  30,
 S. 8307--C                         36                         A. 8807--C
 
 2001, or covering the period July 1, 2001 to October 29, 2001, or cover-
 ing  the  period  April 1, 2002 to June 30, 2002, or covering the period
 July 1, 2002 to June 30, 2003, or covering the period July  1,  2003  to
 June  30, 2004, or covering the period July 1, 2004 to June 30, 2005, or
 covering the period July 1, 2005 to June 30, 2006, or covering the peri-
 od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to
 June 30, 2008, or covering the period July 1, 2008 to June 30, 2009,  or
 covering the period July 1, 2009 to June 30, 2010, or covering the peri-
 od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to
 June  30, 2012, or covering the period July 1, 2012 to June 30, 2013, or
 covering the period July 1, 2013 to June 30, 2014, or covering the peri-
 od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to
 June 30, 2016, or covering the period July 1, 2016 to June 30, 2017,  or
 covering the period July 1, 2017 to June 30, 2018, or covering the peri-
 od July 1, 2018 to June 30, 2019, or covering the period July 1, 2019 to
 June  30, 2020, or covering the period July 1, 2020 to June 30, 2021, or
 covering the period July 1, 2021 to June 30, 2022, or covering the peri-
 od July 1, 2022 to June 30, 2023, or covering the period July 1, 2023 to
 June 30, 2024, OR COVERING THE PERIOD JULY 1, 2024 TO JUNE 30, 2025 that
 has made payment to such provider of excess insurance coverage or equiv-
 alent excess coverage in accordance with paragraph (b) of this  subdivi-
 sion  and  of  each  physician  and  dentist  who has failed, refused or
 neglected to make such payment.
   (e) A provider of  excess  insurance  coverage  or  equivalent  excess
 coverage  shall  refund to the hospital excess liability pool any amount
 allocable to the period July 1, 1992 to June 30, 1993, and to the period
 July 1, 1993 to June 30, 1994, and to the period July 1,  1994  to  June
 30,  1995,  and  to the period July 1, 1995 to June 30, 1996, and to the
 period July 1, 1996 to June 30, 1997, and to the period July 1, 1997  to
 June  30,  1998, and to the period July 1, 1998 to June 30, 1999, and to
 the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
 to June 30, 2001, and to the period July 1, 2001 to  October  29,  2001,
 and to the period April 1, 2002 to June 30, 2002, and to the period July
 1,  2002  to  June  30, 2003, and to the period July 1, 2003 to June 30,
 2004, and to the period July 1, 2004 to June 30, 2005, and to the period
 July 1, 2005 to June 30, 2006, and to the period July 1,  2006  to  June
 30,  2007,  and  to the period July 1, 2007 to June 30, 2008, and to the
 period July 1, 2008 to June 30, 2009, and to the period July 1, 2009  to
 June  30,  2010, and to the period July 1, 2010 to June 30, 2011, and to
 the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
 to June 30, 2013, and to the period July 1, 2013 to June 30,  2014,  and
 to  the  period July 1, 2014 to June 30, 2015, and to the period July 1,
 2015 to June 30, 2016, to the period July 1, 2016 to June 30, 2017,  and
 to  the  period July 1, 2017 to June 30, 2018, and to the period July 1,
 2018 to June 30, 2019, and to the period July 1, 2019 to June 30,  2020,
 and  to the period July 1, 2020 to June 30, 2021, and to the period July
 1, 2021 to June 30, 2022, and to the period July 1,  2022  to  June  30,
 2023, and to the period July 1, 2023 to June 30, 2024, AND TO THE PERIOD
 JULY  1, 2024 TO JUNE 30, 2025 received from the hospital excess liabil-
 ity pool for purchase of excess insurance coverage or equivalent  excess
 coverage covering the period July 1, 1992 to June 30, 1993, and covering
 the  period  July 1, 1993 to June 30, 1994, and covering the period July
 1, 1994 to June 30, 1995, and covering the period July 1, 1995  to  June
 30,  1996,  and  covering  the period July 1, 1996 to June 30, 1997, and
 covering the period July 1, 1997 to June  30,  1998,  and  covering  the
 period  July  1,  1998 to June 30, 1999, and covering the period July 1,
 S. 8307--C                         37                         A. 8807--C
 
 1999 to June 30, 2000, and covering the period July 1, 2000 to June  30,
 2001,  and  covering  the  period  July 1, 2001 to October 29, 2001, and
 covering the period April 1, 2002 to June 30,  2002,  and  covering  the
 period  July  1,  2002 to June 30, 2003, and covering the period July 1,
 2003 to June 30, 2004, and covering the period July 1, 2004 to June  30,
 2005,  and covering the period July 1, 2005 to June 30, 2006, and cover-
 ing the period July 1, 2006 to June 30, 2007, and  covering  the  period
 July  1,  2007 to June 30, 2008, and covering the period July 1, 2008 to
 June 30, 2009, and covering the period July 1, 2009 to  June  30,  2010,
 and  covering the period July 1, 2010 to June 30, 2011, and covering the
 period July 1, 2011 to June 30, 2012, and covering the  period  July  1,
 2012  to June 30, 2013, and covering the period July 1, 2013 to June 30,
 2014, and covering the period July 1, 2014 to June 30, 2015, and  cover-
 ing  the  period  July 1, 2015 to June 30, 2016, and covering the period
 July 1, 2016 to June 30, 2017, and covering the period July 1,  2017  to
 June  30,  2018,  and covering the period July 1, 2018 to June 30, 2019,
 and covering the period July 1, 2019 to June 30, 2020, and covering  the
 period  July  1,  2020 to June 30, 2021, and covering the period July 1,
 2021 to June 30, 2022, and covering the period July 1, 2022 to June  30,
 2023  for,  and  covering  the period July 1, 2023 to June 30, 2024, AND
 COVERING THE PERIOD JULY 1, 2024 TO JUNE 30, 2025 a physician or dentist
 where such excess insurance coverage or equivalent  excess  coverage  is
 cancelled in accordance with paragraph (c) of this subdivision.
   § 4. Section 40 of chapter 266 of the laws of 1986, amending the civil
 practice  law  and  rules  and  other  laws  relating to malpractice and
 professional medical conduct, as amended by section 4 of part F of chap-
 ter 57 of the laws of 2023, is amended to read as follows:
   § 40. The superintendent of financial services shall  establish  rates
 for  policies  providing  coverage  for  physicians and surgeons medical
 malpractice for the periods commencing July 1, 1985 and ending June  30,
 [2024] 2025; provided, however, that notwithstanding any other provision
 of  law,  the superintendent shall not establish or approve any increase
 in rates for the period commencing July 1,  2009  and  ending  June  30,
 2010.  The  superintendent shall direct insurers to establish segregated
 accounts for premiums, payments, reserves and investment income  attrib-
 utable to such premium periods and shall require periodic reports by the
 insurers  regarding  claims and expenses attributable to such periods to
 monitor whether such accounts will be sufficient to meet incurred claims
 and expenses. On or after July 1, 1989, the superintendent shall  impose
 a  surcharge  on  premiums  to  satisfy  a  projected deficiency that is
 attributable to the premium levels established pursuant to this  section
 for  such  periods;  provided, however, that such annual surcharge shall
 not exceed eight percent of the established rate until  July  1,  [2024]
 2025, at which time and thereafter such surcharge shall not exceed twen-
 ty-five  percent  of  the  approved  adequate rate, and that such annual
 surcharges shall continue for such period of time as shall be sufficient
 to satisfy such deficiency. The superintendent  shall  not  impose  such
 surcharge  during the period commencing July 1, 2009 and ending June 30,
 2010. On and after July  1,  1989,  the  surcharge  prescribed  by  this
 section  shall  be  retained by insurers to the extent that they insured
 physicians and surgeons during the July 1, 1985 through June 30,  [2024]
 2025  policy  periods;  in  the  event  and to the extent physicians and
 surgeons were insured by another insurer during such periods, all  or  a
 pro  rata  share of the surcharge, as the case may be, shall be remitted
 to such other insurer in accordance with rules  and  regulations  to  be
 promulgated by the superintendent.  Surcharges collected from physicians
 S. 8307--C                         38                         A. 8807--C
 
 and  surgeons  who  were not insured during such policy periods shall be
 apportioned among all insurers in proportion to the premium  written  by
 each  insurer  during such policy periods; if a physician or surgeon was
 insured by an insurer subject to rates established by the superintendent
 during  such  policy  periods,  and  at  any time thereafter a hospital,
 health maintenance organization, employer or institution is  responsible
 for  responding in damages for liability arising out of such physician's
 or surgeon's practice of medicine, such responsible  entity  shall  also
 remit  to  such  prior  insurer the equivalent amount that would then be
 collected as a surcharge if the physician or surgeon  had  continued  to
 remain  insured  by  such  prior  insurer. In the event any insurer that
 provided coverage during such policy  periods  is  in  liquidation,  the
 property/casualty  insurance  security fund shall receive the portion of
 surcharges to which the insurer in liquidation would have been entitled.
 The surcharges authorized herein shall be deemed to be income earned for
 the purposes of section 2303 of the insurance law.  The  superintendent,
 in  establishing  adequate  rates and in determining any projected defi-
 ciency pursuant to the requirements of this section  and  the  insurance
 law,  shall  give  substantial  weight, determined in his discretion and
 judgment, to the  prospective  anticipated  effect  of  any  regulations
 promulgated  and  laws  enacted  and the public benefit of   stabilizing
 malpractice rates and minimizing rate level fluctuation during the peri-
 od of time necessary for the development of  more  reliable  statistical
 experience  as  to  the  efficacy of such laws and regulations affecting
 medical, dental or podiatric malpractice enacted or promulgated in 1985,
 1986, by this act and at any other time.  Notwithstanding any  provision
 of the insurance law, rates already established and to be established by
 the  superintendent pursuant to this section are deemed adequate if such
 rates would be adequate when taken together with the maximum  authorized
 annual  surcharges to be imposed for a reasonable period of time whether
 or not any such annual surcharge has been actually  imposed  as  of  the
 establishment of such rates.
   §  5. Section 5 and subdivisions (a) and (e) of section 6 of 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, as amended by section 5
 of part F of chapter 57 of the laws of 2023,  are  amended  to  read  as
 follows:
   §  5. The superintendent of financial services and the commissioner of
 health shall determine, no later than June 15, 2002, June 15, 2003, June
 15, 2004, June 15, 2005, June 15, 2006, June 15, 2007,  June  15,  2008,
 June  15,  2009,  June  15, 2010, June 15, 2011, June 15, 2012, June 15,
 2013, June 15, 2014, June 15, 2015, June 15, 2016, June 15,  2017,  June
 15,  2018,  June  15, 2019, June 15, 2020, June 15, 2021, June 15, 2022,
 June 15, 2023, [and] June 15, 2024, AND JUNE  15,  2025  the  amount  of
 funds  available in the hospital excess liability pool, created pursuant
 to section 18 of chapter 266 of the laws of 1986, and whether such funds
 are sufficient for purposes of purchasing excess insurance coverage  for
 eligible participating physicians and dentists during the period July 1,
 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003
 to  June  30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to
 June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007 to June
 30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to June  30,
 2010,  or  July  1,  2010  to June 30, 2011, or July 1, 2011 to June 30,
 2012, or July 1, 2012 to June 30, 2013, or July  1,  2013  to  June  30,
 2014,  or  July  1,  2014  to June 30, 2015, or July 1, 2015 to June 30,
 S. 8307--C                         39                         A. 8807--C
 
 2016, or July 1, 2016 to June 30, 2017, or July  1,  2017  to  June  30,
 2018,  or  July  1,  2018  to June 30, 2019, or July 1, 2019 to June 30,
 2020, or July 1, 2020 to June 30, 2021, or July  1,  2021  to  June  30,
 2022,  or  July  1,  2022  to June 30, 2023, or July 1, 2023 to June 30,
 2024, OR JULY 1, 2024 TO JUNE 30, 2025 as applicable.
   (a) This section shall be effective only upon a determination,  pursu-
 ant  to  section  five  of  this act, by the superintendent of financial
 services and the commissioner of health, and  a  certification  of  such
 determination  to  the  state  director  of the budget, the chair of the
 senate committee on finance and the chair of the assembly  committee  on
 ways  and means, that the amount of funds in the hospital excess liabil-
 ity pool, created pursuant to section 18 of chapter 266 of the  laws  of
 1986, is insufficient for purposes of purchasing excess insurance cover-
 age for eligible participating physicians and dentists during the period
 July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July
 1,  2003  to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1,
 2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007
 to June 30, 2008, or July 1, 2008 to June 30, 2009, or July 1,  2009  to
 June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June
 30,  2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30,
 2014, or July 1, 2014 to June 30, 2015, or July  1,  2015  to  June  30,
 2016,  or  July  1,  2016  to June 30, 2017, or July 1, 2017 to June 30,
 2018, or July 1, 2018 to June 30, 2019, or July  1,  2019  to  June  30,
 2020,  or  July  1,  2020  to June 30, 2021, or July 1, 2021 to June 30,
 2022, or July 1, 2022 to June 30, 2023, or July  1,  2023  to  June  30,
 2024, OR JULY 1, 2024 TO JUNE 30, 2025 as applicable.
   (e)  The  commissioner  of  health  shall  transfer for deposit to the
 hospital excess liability pool created pursuant to section 18 of chapter
 266 of the laws of 1986 such amounts as directed by  the  superintendent
 of  financial  services  for  the purchase of excess liability insurance
 coverage for eligible participating  physicians  and  dentists  for  the
 policy  year  July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30,
 2003, or July 1, 2003 to June 30, 2004, or July  1,  2004  to  June  30,
 2005,  or  July  1,  2005  to June 30, 2006, or July 1, 2006 to June 30,
 2007, as applicable, and the cost of administering the  hospital  excess
 liability pool for such applicable policy year,  pursuant to the program
 established  in  chapter  266  of the laws of 1986, as amended, no later
 than June 15, 2002, June 15, 2003, June 15, 2004, June  15,  2005,  June
 15,  2006,  June  15, 2007, June 15, 2008, June 15, 2009, June 15, 2010,
 June 15, 2011, June 15, 2012, June 15, 2013, June  15,  2014,  June  15,
 2015,  June  15, 2016, June 15, 2017, June 15, 2018, June 15, 2019, June
 15, 2020, June 15, 2021, June 15, 2022, June 15, 2023,  [and]  June  15,
 2024, AND JUNE 15, 2025 as applicable.
   §  6. Section 20 of 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 thereto, as amended by section 6 of part F
 of chapter 57 of the laws of 2023, is amended to read as follows:
   § 20. Notwithstanding any law, rule or  regulation  to  the  contrary,
 only  physicians  or dentists who were eligible, and for whom the super-
 intendent of financial services and the commissioner of health, or their
 designee, purchased, with funds available in the hospital excess liabil-
 ity pool, a full or partial policy for  excess  coverage  or  equivalent
 excess  coverage  for  the coverage period ending the thirtieth of June,
 two thousand [twenty-three] TWENTY-FOUR, shall be eligible to apply  for
 such  coverage  for the coverage period beginning the first of July, two
 thousand [twenty-three] TWENTY-FOUR; provided,  however,  if  the  total
 S. 8307--C                         40                         A. 8807--C
 
 number of physicians or dentists for whom such excess coverage or equiv-
 alent excess coverage was purchased for the policy year ending the thir-
 tieth of June, two thousand [twenty-three] TWENTY-FOUR exceeds the total
 number  of physicians or dentists certified as eligible for the coverage
 period beginning the first of July, two thousand [twenty-three]  TWENTY-
 FOUR,  then the general hospitals may certify additional eligible physi-
 cians or dentists in a number equal to such general  hospital's  propor-
 tional  share  of  the  total  number of physicians or dentists for whom
 excess coverage or equivalent excess coverage was purchased  with  funds
 available  in  the hospital excess liability pool as of the thirtieth of
 June, two thousand [twenty-three] TWENTY-FOUR, as applied to the differ-
 ence between the number of eligible physicians or dentists  for  whom  a
 policy  for  excess coverage or equivalent excess coverage was purchased
 for the coverage period ending  the  thirtieth  of  June,  two  thousand
 [twenty-three] TWENTY-FOUR and the number of such eligible physicians or
 dentists  who  have  applied  for  excess  coverage or equivalent excess
 coverage for the coverage period beginning the first of July, two  thou-
 sand [twenty-three] TWENTY-FOUR.
   §  7.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART L
 
                           Intentionally Omitted

                                  PART M
 
   Section 1. Subparagraph 3 of paragraph (b) of subdivision 4 of section
 366 of the social services law, as added by section 2 of part D of chap-
 ter 56 of the laws of 2013, is amended to read as follows:
   (3) (A) A child [under] BETWEEN the [age] AGES of SIX AND nineteen who
 is determined eligible for medical assistance under  the  provisions  of
 this  section,  shall,  consistent with applicable federal requirements,
 remain eligible for such assistance until [the earlier of:
   (i)] the last day of the month which is twelve  months  following  the
 determination  [or  redetermination]  OR RENEWAL of eligibility for such
 assistance[; or
   (ii) the last day of the month in which the child reaches the  age  of
 nineteen].
   (B)  A  CHILD  UNDER  THE  AGE  OF  SIX WHO IS DETERMINED ELIGIBLE FOR
 MEDICAL ASSISTANCE UNDER THE PROVISIONS OF THIS SECTION, SHALL, CONSIST-
 ENT WITH APPLICABLE FEDERAL REQUIREMENTS, REMAIN  CONTINUOUSLY  ELIGIBLE
 FOR MEDICAL ASSISTANCE COVERAGE UNTIL THE LATER OF:
   (I)  THE  LAST DAY OF THE TWELFTH MONTH FOLLOWING THE DETERMINATION OR
 RENEWAL OF ELIGIBILITY FOR SUCH ASSISTANCE; OR
   (II) THE LAST DAY OF THE MONTH IN WHICH THE CHILD REACHES THE  AGE  OF
 SIX.
   § 2. Subdivision 6 of section 2510 of the public health law is amended
 by adding a new paragraph (e) to read as follows:
   (E)  AN  ELIGIBLE  CHILD UNDER SIX YEARS OF AGE SHALL, CONSISTENT WITH
 APPLICABLE FEDERAL REQUIREMENTS, REMAIN CONTINUOUSLY ENROLLED UNTIL  THE
 LATER OF:
   (I) THE LAST DAY OF THE TWELFTH MONTH FOLLOWING THE DATE OF ENROLLMENT
 OR RECERTIFICATION IN THE CHILD HEALTH INSURANCE PLAN; OR
 S. 8307--C                         41                         A. 8807--C
 
   (II)  THE  LAST DAY OF THE MONTH IN WHICH THE CHILD REACHES THE AGE OF
 SIX.
   § 3. This act shall take effect January 1, 2025.
 
                                  PART N
 
                           Intentionally Omitted
 
                                  PART O
 
   Section 1. Subdivision 1 of section 2807-k of the public health law is
 amended by adding a new paragraph (h) to read as follows:
   (H) "UNDERINSURED" SHALL MEAN AN INDIVIDUAL WITH OUT OF POCKET MEDICAL
 COSTS ACCUMULATED IN THE PAST TWELVE MONTHS THAT AMOUNT TO MORE THAN TEN
 PERCENT OF SUCH INDIVIDUAL'S GROSS ANNUAL INCOME.
   §  2.  Subdivision  9  of  section 2807-k of the public health law, as
 amended by section 1 of subpart C of part Y of chapter 57 of the laws of
 2023, is amended to read as follows:
   9. In order for a general hospital to participate in the  distribution
 of  funds  from  the  pool,  the general hospital must implement minimum
 collection policies and procedures approved by the commissioner, utiliz-
 ing only a uniform financial assistance form developed and  provided  by
 the  department.  ALL  GENERAL  HOSPITALS THAT DO NOT PARTICIPATE IN THE
 INDIGENT CARE POOL SHALL ALSO UTILIZE ONLY THE UNIFORM FINANCIAL ASSIST-
 ANCE FORM AND OTHERWISE COMPLY WITH SUBDIVISION NINE-A OF  THIS  SECTION
 GOVERNING  THE PROVISION OF FINANCIAL ASSISTANCE AND HOSPITAL COLLECTION
 PROCEDURES.
   § 3. Subdivision 9-a of section 2807-k of the public  health  law,  as
 added  by  section  39-a of part A of chapter 57 of the laws of 2006 and
 paragraph (k) as added by section 43 of part B of chapter 58 of the laws
 of 2008, is amended to read as follows:
   9-a. (a) [As a  condition  for  participation  in  pool  distributions
 authorized  pursuant  to  this  section and section twenty-eight hundred
 seven-w of this article for] FOR periods on and after January first, two
 thousand nine, general hospitals shall, effective  for  periods  on  and
 after  January  first, two thousand seven, establish financial aid poli-
 cies and procedures, in accordance with the provisions of this  subdivi-
 sion,  for  reducing charges otherwise applicable to low-income individ-
 uals without health insurance OR UNDERINSURED INDIVIDUALS, or  who  have
 exhausted  their  health  insurance benefits, and who can demonstrate an
 inability to pay full charges, and also, at the  hospital's  discretion,
 for  reducing  or  discounting  the collection of co-pays and deductible
 payments from those individuals who can demonstrate an inability to  pay
 such  amounts.  IMMIGRATION STATUS SHALL NOT BE AN ELIGIBILITY CRITERION
 FOR THE PURPOSE OF DETERMINING FINANCIAL ASSISTANCE UNDER THIS SECTION.
   (b) Such reductions from charges for [uninsured] patients with incomes
 below at least [three] FOUR hundred percent of the federal poverty level
 shall result in a charge to such individuals that does not  exceed  [the
 greater  of]  the amount that would have been paid for the same services
 [by the "highest volume payor" for such general hospital as  defined  in
 subparagraph (v) of this paragraph, or for services provided pursuant to
 title  XVIII  of  the  federal  social  security  act (medicare), or for
 services] provided pursuant to title XIX of the federal social  security
 act (medicaid), and provided further that such amounts shall be adjusted
 according to income level as follows:
 S. 8307--C                         42                         A. 8807--C

   (i) For patients with incomes [at or] below at least [one] TWO hundred
 percent  of  the  federal  poverty level, the hospital shall [collect no
 more than a nominal payment amount, consistent  with  guidelines  estab-
 lished  by the commissioner] WAIVE ALL CHARGES. NO NOMINAL PAYMENT SHALL
 BE COLLECTED;
   (ii)  For  patients  with  incomes  between at least [one] TWO hundred
 [one] percent and [one] UP TO  THREE  hundred  [fifty]  percent  of  the
 federal  poverty  level,  the  hospital  shall  collect no more than the
 amount identified after application of a proportional sliding fee sched-
 ule under which patients with lower incomes shall pay the lowest amount.
 Such schedule shall provide that the amount the hospital may collect for
 such patients increases [from the nominal amount described  in  subpara-
 graph  (i)  of  this paragraph] in equal increments as the income of the
 patient increases, up to a  maximum  of  [twenty]  TEN  percent  of  the
 [greater  of the] amount that would have been paid for the same services
 [by the "highest volume payor" for such general hospital, as defined  in
 subparagraph (v) of this paragraph, or for services provided pursuant to
 title  XVIII  of  the  federal  social  security  act  (medicare) or for
 services] provided pursuant to title XIX of the federal social  security
 act  (medicaid),  OR  FOR  UNDERINSURED PATIENTS, UP TO A MAXIMUM OF TEN
 PERCENT OF THE AMOUNT  THAT  WOULD  HAVE  BEEN  PAID  PURSUANT  TO  SUCH
 PATIENT'S INSURANCE COST SHARING;
   (iii)  For  patients with incomes between at least [one] THREE hundred
 [fifty-one] ONE percent and [two] FOUR hundred [fifty]  percent  of  the
 federal  poverty  level,  the  hospital  shall  collect no more than the
 amount identified after application of a proportional sliding fee sched-
 ule under which patients with lower income shall pay the lowest amounts.
 Such schedule shall provide that the amount the hospital may collect for
 such patients increases from the [twenty] TEN percent  figure  described
 in subparagraph (ii) of this paragraph in equal increments as the income
 of  the  patient  increases,  up  to  a  maximum of [the greater] TWENTY
 PERCENT of the amount that would have been paid for  the  same  services
 [by  the "highest volume payor" for such general hospital, as defined in
 subparagraph (v) of this paragraph, or for services provided pursuant to
 title XVIII of  the  federal  social  security  act  (medicare)  or  for
 services]  provided pursuant to title XIX of the federal social security
 act (medicaid), OR FOR UNDERINSURED PATIENTS, UP TO A MAXIMUM OF  TWENTY
 PERCENT  OF  THE  AMOUNT  THAT  WOULD  HAVE  BEEN  PAID PURSUANT TO SUCH
 PATIENT'S INSURANCE COST SHARING; [and
   (iv) For patients with incomes between at least two hundred  fifty-one
 percent  and  three  hundred  percent  of the federal poverty level, the
 hospital shall collect no more than the greater of the amount that would
 have been paid for the same services by the "highest volume  payor"  for
 such  general hospital as defined in subparagraph (v) of this paragraph,
 or for services provided pursuant to title XVIII of the  federal  social
 security  act (medicare), or for services provided pursuant to title XIX
 of the federal social security act (medicaid).
   (v) For the purposes of this paragraph, "highest volume  payor"  shall
 mean  the  insurer,  corporation  or organization licensed, organized or
 certified pursuant to article thirty-two, forty-two  or  forty-three  of
 the insurance law or article forty-four of this chapter, or other third-
 party  payor,  which  has  a  contract  or  agreement  to pay claims for
 services provided by the  general  hospital  and  incurred  the  highest
 volume of claims in the previous calendar year.
   (vi)  A  hospital may implement policies and procedures to permit, but
 not require, consideration on a case-by-case basis of exceptions to  the
 S. 8307--C                         43                         A. 8807--C

 requirements  described  in subparagraphs (i) and (ii) of this paragraph
 based upon the existence of significant assets owned by the patient that
 should be taken into account  in  determining  the  appropriate  payment
 amount  for  that  patient's care, provided, however, that such proposed
 policies and procedures  shall  be  subject  to  the  prior  review  and
 approval  of the commissioner and, if approved, shall be included in the
 hospital's financial assistance  policy  established  pursuant  to  this
 section,  and  provided  further  that, if such approval is granted, the
 maximum amount that may be collected shall not exceed the greater of the
 amount that would have been paid for the same services by  the  "highest
 volume  payor"  for such general hospital as defined in subparagraph (v)
 of this paragraph, or for services provided pursuant to title  XVIII  of
 the  federal  social  security  act (medicare), or for services provided
 pursuant to title XIX of the federal social security act (medicaid).  In
 the  event  that a general hospital reviews a patient's assets in deter-
 mining payment  adjustments  such  policies  and  procedures  shall  not
 consider  as assets a patient's primary residence, assets held in a tax-
 deferred or  comparable  retirement  savings  account,  college  savings
 accounts,  or  cars  used  regularly  by  a  patient or immediate family
 members.
   (vii)] (IV) Nothing in this paragraph shall be construed  to  limit  a
 hospital's   ability   to  establish  patient  eligibility  for  payment
 discounts at income levels higher than those specified herein and/or  to
 provide  greater  payment  discounts  for  eligible  patients than those
 required by this paragraph.
   (c) Such policies and procedures shall be  clear,  understandable,  in
 writing and publicly available in summary form and each general hospital
 participating  in the pool shall ensure that every patient is made aware
 of the existence of such policies and procedures and is provided,  in  a
 timely  manner,  with  a  summary  of such policies and procedures [upon
 request]. Any summary provided to patients shall, at a minimum,  include
 specific  information  as to income levels used to determine eligibility
 for assistance, a description of the primary service area of the  hospi-
 tal and the means of applying for assistance. For general hospitals with
 twenty-four  hour  emergency  departments,  such policies and procedures
 shall require the WRITTEN notification of patients during the intake and
 registration process, AND DURING DISCHARGE OF THE PATIENT,  AND  through
 the  conspicuous  posting  of  language-appropriate  information  in the
 general hospital, and  information  on  bills  and  statements  sent  to
 patients,  that financial aid may be available to qualified patients and
 how to obtain further information. For specialty hospitals without twen-
 ty-four hour emergency departments, such notification shall  take  place
 through  written  materials  provided  to patients during the intake and
 registration process prior to the provision of any health care  services
 or procedures, AND DURING DISCHARGE OF THE PATIENT, and through informa-
 tion on bills and statements sent to patients, that financial aid may be
 available  to  qualified patients and how to obtain further information.
 Application materials shall include  a  notice  to  patients  that  upon
 submission  of  a  completed  application,  including any information or
 documentation needed to determine the patient's eligibility pursuant  to
 the  hospital's  financial  assistance policy, the patient may disregard
 any bills until the hospital has rendered a decision on the  application
 in accordance with this paragraph.
   (d) Such policies and procedures shall include clear, objective crite-
 ria  for  determining  a patient's ability to pay and for providing such
 adjustments to payment requirements as are  necessary.  In  addition  to
 S. 8307--C                         44                         A. 8807--C
 
 adjustment  mechanisms  such  as  sliding fee schedules and discounts to
 fixed standards, such policies and procedures shall also provide for the
 use of installment plans for the  payment  of  outstanding  balances  by
 patients  pursuant  to  the  provisions  of  the  [hospital's] financial
 assistance policy. The monthly payment  under  such  a  plan  shall  not
 exceed  [ten]  FIVE percent of the gross monthly income of the patient[,
 provided, however, that if patient assets are considered  under  such  a
 policy,  then  patient  assets which are not excluded assets pursuant to
 subparagraph (vi) of paragraph (b) of this subdivision may be considered
 in addition to the limit on monthly  payments].  The  rate  of  interest
 charged  to  the patient on the unpaid balance, if any, shall not exceed
 [the rate for a ninety-day security issued by the United States  Depart-
 ment  of  Treasury,  plus  .5]  TWO percent and no plan shall include an
 accelerator or similar clause under which a higher rate of  interest  is
 triggered upon a missed payment. If such policies and procedures include
 a  requirement  of  a deposit prior to non-emergent, medically-necessary
 care, such deposit must be included as part of any financial aid consid-
 eration. Such policies and procedures shall be applied  consistently  to
 all eligible patients.
   (e)  Such  policies  and procedures shall permit patients to apply for
 assistance [within at least ninety days of the date of discharge or date
 of service and provide at least twenty days for  patients  to  submit  a
 completed  application] AT ANY TIME DURING THE COLLECTION PROCESS.  Such
 policies and  procedures  may  require  that  patients  seeking  payment
 adjustments  provide appropriate financial information and documentation
 in support of their application, provided, however, that  such  applica-
 tion  process  shall not be unduly burdensome or complex. General hospi-
 tals shall, upon request, assist patients in  understanding  the  hospi-
 tal's  policies  and procedures and in applying for payment adjustments.
 Application forms  shall  be  printed  in  the  "primary  languages"  of
 patients  served by the general hospital. For the purposes of this para-
 graph, "primary languages" shall include any language that is either (i)
 used to communicate, during at least five percent of patient visits in a
 year, by patients who  cannot  speak,  read,  write  or  understand  the
 English  language  at  the  level of proficiency necessary for effective
 communication with health care providers, or (ii) spoken by  non-English
 speaking  individuals  comprising  more  than one percent of the primary
 hospital service area population, as calculated using demographic infor-
 mation available from the United States Bureau of  the  Census,  supple-
 mented  by  data  from school systems. Decisions regarding such applica-
 tions shall be made  within  thirty  days  of  receipt  of  a  completed
 application.  Such policies and procedures shall require that the hospi-
 tal issue any denial/approval of such application in writing with infor-
 mation on how to appeal the denial and shall  require  the  hospital  to
 establish  an appeals process under which it will evaluate the denial of
 an application. Nothing in this  subdivision  shall  be  interpreted  as
 prohibiting a hospital from making the availability of financial assist-
 ance contingent upon the patient first applying for coverage under title
 XIX of the social security act (medicaid) or another PUBLICLY SUBSIDIZED
 insurance  program  if, in the judgment of the hospital, the patient may
 be eligible  for  medicaid  or  another  PUBLICLY  SUBSIDIZED  insurance
 program,  and  upon  the  patient's cooperation in following the [hospi-
 tal's] financial  assistance  application  requirements,  including  the
 provision of information needed to make a determination on the patient's
 application in accordance with the hospital's financial assistance poli-
 cy,  PROVIDED,  HOWEVER,  THAT  THIS  REQUIREMENT SHALL NOT APPLY TO ANY
 S. 8307--C                         45                         A. 8807--C
 
 PATIENT THAT WOULD OTHERWISE NOT QUALIFY FOR  COVERAGE  BASED  ON  THEIR
 IMMIGRATION STATUS.
   (f)  Such  policies  and  procedures  shall provide that patients with
 incomes below [three] FOUR hundred percent of the federal poverty  level
 are  deemed  presumptively  eligible  for  payment adjustments and shall
 conform to the requirements set forth in paragraph (b) of this  subdivi-
 sion,  provided,  however,  that  nothing  in  this subdivision shall be
 interpreted as precluding hospitals from extending such payment  adjust-
 ments  to  other  patients, either generally or on a case-by-case basis.
 Such policies and procedures shall provide financial aid  for  emergency
 hospital services, including emergency transfers pursuant to the federal
 emergency  medical  treatment  and  active labor act (42 USC 1395dd), to
 patients who reside in New York state and for medically necessary hospi-
 tal services for patients who reside in the hospital's  primary  service
 area  as determined according to criteria established by the commission-
 er. In developing such criteria, the  commissioner  shall  consult  with
 representatives of the hospital industry, health care consumer advocates
 and local public health officials. Such criteria shall be made available
 to  the public no less than thirty days prior to the date of implementa-
 tion and shall, at a minimum:
   (i) prohibit a  hospital  from  developing  or  altering  its  primary
 service  area in a manner designed to avoid medically underserved commu-
 nities or communities with high percentages of uninsured residents;
   (ii) ensure that every geographic area of the state is included in  at
 least  one  general  hospital's  primary  service  area so that eligible
 patients may access care and financial assistance; and
   (iii) require the hospital to notify the commissioner upon making  any
 change  to its primary service area, and to include a description of its
 primary service area in  the  hospital's  annual  implementation  report
 filed  pursuant  to  subdivision  three  of section twenty-eight hundred
 three-l of this article.
   (g) Nothing in this subdivision shall  be  interpreted  as  precluding
 hospitals  from  extending  payment  adjustments for medically necessary
 non-emergency hospital services to patients outside  of  the  hospital's
 primary  service area. For patients determined to be eligible for finan-
 cial aid under the terms of a  hospital's  financial  aid  policy,  such
 policies  and procedures shall prohibit any limitations on financial aid
 for services based on the medical condition of the applicant, other than
 typical limitations or exclusions based  on  medical  necessity  or  the
 clinical or therapeutic benefit of a procedure or treatment.
   (h)  SUCH  POLICIES AND PROCEDURES SHALL PROHIBIT THE DENIAL OF ADMIS-
 SION OR DENIAL OF TREATMENT FOR SERVICES THAT ARE REASONABLY ANTICIPATED
 TO BE MEDICALLY NECESSARY BECAUSE THE  PATIENT  HAS  AN  UNPAID  MEDICAL
 BILL.  Such  policies  and  procedures  shall  [not permit] PROHIBIT the
 forced sale or foreclosure of a patient's primary residence in order  to
 collect  an  outstanding  medical bill and shall require the hospital to
 refrain from sending an account to collection if the patient has submit-
 ted a completed application for financial aid,  including  any  required
 supporting  documentation,  while  the hospital determines the patient's
 eligibility for such aid. SUCH POLICIES AND  PROCEDURES  SHALL  PROHIBIT
 THE SALE OF MEDICAL DEBT ACCUMULATED PURSUANT TO THIS SECTION TO A THIRD
 PARTY,  UNLESS THE THIRD PARTY EXPLICITLY PURCHASES SUCH MEDICAL DEBT IN
 ORDER TO RELIEVE THE DEBT OF THE PATIENT. Such policies  and  procedures
 shall provide for written notification, which shall include notification
 on  a  patient bill, to a patient not less than thirty days prior to the
 referral of debts for collection and shall require that  the  collection
 S. 8307--C                         46                         A. 8807--C
 
 agency obtain the hospital's written consent prior to commencing a legal
 action.  SUCH  POLICIES  AND  PROCEDURES  SHALL PROHIBIT A HOSPITAL FROM
 COMMENCING A LEGAL ACTION RELATED TO THE RECOVERY  OF  MEDICAL  DEBT  OR
 UNPAID BILLS AGAINST PATIENTS WITH INCOMES BELOW FOUR HUNDRED PERCENT OF
 THE  FEDERAL  POVERTY LEVEL. IN ANY LEGAL ACTION RELATED TO THE RECOVERY
 OF MEDICAL DEBT OR UNPAID BILLS BY OR  ON  BEHALF  OF  A  HOSPITAL,  THE
 COMPLAINT  SHALL  BE ACCOMPANIED BY AN AFFIDAVIT BY THE HOSPITAL'S CHIEF
 FINANCIAL OFFICER STATING THAT  BASED  UPON  THE  HOSPITAL'S  REASONABLE
 EFFORT  TO  DETERMINE  THE  PATIENT'S  INCOME, THE PATIENT WHOM THEY ARE
 TAKING LEGAL ACTION AGAINST DOES NOT HAVE AN INCOME BELOW  FOUR  HUNDRED
 PERCENT OF THE FEDERAL POVERTY LEVEL. Such policies and procedures shall
 require  all  general  hospital staff who interact with patients or have
 responsibility for billing and collections to be trained in  such  poli-
 cies  and  procedures, and require the implementation of a mechanism for
 the general hospital to measure its compliance with  such  policies  and
 procedures.   Such  policies  and  procedures  shall  require  that  any
 collection agency  under  contract  with  a  general  hospital  for  the
 collection  of  debts follow the hospital's financial assistance policy,
 including providing information to patients on how to apply  for  finan-
 cial  assistance  where  appropriate. Such policies and procedures shall
 prohibit collections from a patient who is determined to be eligible for
 medical assistance pursuant to title XIX of the federal social  security
 act  at  the time services were rendered and for which services medicaid
 payment is available.
   (i) Reports required to be submitted to the department by each general
 hospital as a condition  for  participation  in  the  pools,  and  which
 contain, in accordance with applicable regulations, a certification from
 an  independent  certified  public  accountant  or  independent licensed
 public accountant or an attestation from a senior official of the hospi-
 tal that the hospital is in compliance with conditions of  participation
 in  the  pools,  shall  also contain, for reporting periods on and after
 January first, two thousand seven:
   (i) a report on hospital costs incurred  and  uncollected  amounts  in
 providing  services  to  eligible patients without insurance[, including
 the amount of care provided for a nominal payment  amount,]  during  the
 period covered by the report;
   (ii)  hospital  costs incurred and uncollected amounts for deductibles
 and coinsurance for eligible patients with insurance or other third-par-
 ty payor coverage;
   (iii) the number of patients, organized  according  to  United  States
 postal  service  zip code, who applied for financial assistance pursuant
 to the hospital's financial assistance policy, and the number, organized
 according to United States postal service zip code,  whose  applications
 were approved and whose applications were denied;
   (iv)  THE  NUMBER  OF  PATIENTS, INCLUDING THEIR AGE, RACE, ETHNICITY,
 GENDER AND INSURANCE STATUS, WHO APPLIED FOR FINANCIAL ASSISTANCE  UNDER
 THE  HOSPITAL'S FINANCIAL ASSISTANCE POLICY, AND THE NUMBER OF PATIENTS,
 INCLUDING THEIR AGE, RACE, ETHNICITY, GENDER AND INSURANCE STATUS, WHOSE
 APPLICATIONS WERE APPROVED AND DENIED;
   (V) the reimbursement received for indigent care from the pool  estab-
 lished pursuant to this section;
   [(v)] (VI) the amount of funds that have been expended on charity care
 from  charitable  bequests made or trusts established for the purpose of
 providing financial assistance to patients who are eligible  in  accord-
 ance with the terms of such bequests or trusts;
 S. 8307--C                         47                         A. 8807--C
 
   [(vi)]  (VII)  for  hospitals  located in social services districts in
 which the district allows hospitals to assist patients with such  appli-
 cations,  the  number of applications for eligibility under title XIX of
 the social security act (medicaid) that the hospital  assisted  patients
 in completing and the number denied and approved; AND
   [(vii)] (VIII) the hospital's financial losses resulting from services
 provided under medicaid[; and
   (viii)  the  number  of  liens  placed  on  the  primary residences of
 patients through the collection process used by a hospital].
   (j) Within ninety days of the effective date of this subdivision  each
 hospital  shall submit to the commissioner a written report on its poli-
 cies and procedures for financial assistance to patients which are  used
 by  the  hospital on the effective date of this subdivision. Such report
 shall include copies of its policies and procedures, including  material
 which  is  distributed  to patients, and a description of the hospital's
 financial aid policies and procedures. Such  description  shall  include
 the  income levels of patients on which eligibility is based, the finan-
 cial aid eligible patients receive and the  means  of  calculating  such
 aid,  and  the  service  area, if any, used by the hospital to determine
 eligibility.
   (k) [In the event it is determined by the commissioner that the  state
 will  be unable to secure all necessary federal approvals to include, as
 part of the state's approved state plan  under  title  nineteen  of  the
 federal  social  security  act, a requirement, as set forth in paragraph
 one of this subdivision, that compliance  with  this  subdivision  is  a
 condition  of participation in pool distributions authorized pursuant to
 this section and section twenty-eight hundred seven-w of  this  article,
 then  such condition of participation shall be deemed null and void and,
 notwithstanding] NOTWITHSTANDING section twelve of this chapter, failure
 to comply with the provisions of this subdivision by a hospital  on  and
 after the date of such determination shall make such hospital liable for
 a  civil  penalty  not  to  exceed  ten  thousand  dollars for each such
 violation. The imposition of such civil penalties shall  be  subject  to
 the provisions of section twelve-a of this chapter.
   (L)  A  HOSPITAL  OR  ITS  COLLECTION AGENT SHALL NOT COMMENCE A CIVIL
 ACTION AGAINST A PATIENT OR DELEGATE A COLLECTION  ACTIVITY  TO  A  DEBT
 COLLECTOR  FOR NONPAYMENT FOR AT LEAST ONE HUNDRED EIGHTY DAYS AFTER THE
 FIRST POST-SERVICE BILL IS ISSUED AND UNTIL A HOSPITAL HAS MADE  REASON-
 ABLE  EFFORTS  TO  DETERMINE  WHETHER  A PATIENT QUALIFIES FOR FINANCIAL
 ASSISTANCE.
   § 4. The public health law is amended by adding a new section 18-c  to
 read as follows:
   §  18-C. SEPARATE PATIENT CONSENT FOR TREATMENT AND PAYMENT FOR HEALTH
 CARE SERVICES. INFORMED CONSENT FROM A PATIENT TO PROVIDE ANY TREATMENT,
 PROCEDURE, EXAMINATION OR OTHER DIRECT HEALTH  CARE  SERVICES  SHALL  BE
 OBTAINED SEPARATELY FROM SUCH PATIENT'S CONSENT TO PAY FOR THE SERVICES.
 CONSENT  TO  PAY  FOR ANY HEALTH CARE SERVICES BY A PATIENT SHALL NOT BE
 GIVEN PRIOR TO THE PATIENT RECEIVING SUCH SERVICES AND DISCUSSING TREAT-
 MENT COSTS. FOR PURPOSES OF THIS  SECTION,  "CONSENT"  MEANS  AN  ACTION
 WHICH:  (A)  CLEARLY  AND  CONSPICUOUSLY  COMMUNICATES  THE INDIVIDUAL'S
 AUTHORIZATION OF AN ACT OR PRACTICE; (B) IS MADE IN THE ABSENCE  OF  ANY
 MECHANISM  IN  THE  USER  INTERFACE  THAT HAS THE PURPOSE OR SUBSTANTIAL
 EFFECT OF OBSCURING, SUBVERTING, OR IMPAIRING DECISION-MAKING OR  CHOICE
 TO OBTAIN CONSENT; AND (C) CANNOT BE INFERRED FROM INACTION.
   §  5.  The  general business law is amended by adding two new sections
 349-g and 519-a to read as follows:
 S. 8307--C                         48                         A. 8807--C
 
   § 349-G.  RESTRICTIONS ON APPLICATIONS FOR AND USE OF CREDIT CARDS AND
 MEDICAL FINANCIAL PRODUCTS. 1. FOR PURPOSES OF THIS SECTION, THE FOLLOW-
 ING TERMS SHALL HAVE THE FOLLOWING MEANINGS:
   (A)  "MEDICAL  FINANCIAL PRODUCTS" SHALL MEAN MEDICAL CREDIT CARDS AND
 THIRD-PARTY MEDICAL INSTALLMENT LOANS.
   (B) "HEALTH CARE PROVIDER"  SHALL  MEAN  A  HEALTH  CARE  PROFESSIONAL
 LICENSED,  REGISTERED OR CERTIFIED PURSUANT TO TITLE EIGHT OF THE EDUCA-
 TION LAW.
   (C) "MEDICAL CREDIT CARD" SHALL MEAN A CREDIT  CARD  ISSUED  UNDER  AN
 OPEN-END  OR  CLOSED-END  PLAN  OFFERED  SPECIFICALLY FOR THE PAYMENT OF
 HEALTH CARE SERVICES, PRODUCTS, OR DEVICES PROVIDED TO A PERSON.
   2. IT SHALL BE PROHIBITED FOR ANY HOSPITAL OR HEALTH CARE PROVIDER, OR
 EMPLOYEE OR AGENT OF A HOSPITAL OR HEALTH CARE PROVIDER, TO COMPLETE ANY
 PORTION OF AN APPLICATION FOR MEDICAL FINANCIAL PRODUCTS FOR THE PATIENT
 OR OTHERWISE ARRANGE  FOR  OR  ESTABLISH  AN  APPLICATION  THAT  IS  NOT
 COMPLETELY FILLED OUT BY THE PATIENT.
   §  519-A.  CREDIT  CARDS  AND PAYMENT FOR HEALTH CARE SERVICES. 1. FOR
 PURPOSES OF THIS SECTION, THE TERM "CREDIT CARD"  SHALL  HAVE  THE  SAME
 MEANING AS IN SECTION FIVE HUNDRED ELEVEN OF THIS ARTICLE.
   2.  NO HOSPITAL OR HEALTH CARE PROVIDER SHALL REQUIRE CREDIT CARD PRE-
 AUTHORIZATION NOR REQUIRE THE PATIENT TO HAVE  A  CREDIT  CARD  ON  FILE
 PRIOR  TO PROVIDING EMERGENCY OR MEDICALLY NECESSARY MEDICAL SERVICES TO
 SUCH PATIENT.
   3. HOSPITALS AND HEALTH CARE PROVIDERS SHALL NOTIFY ALL PATIENTS ABOUT
 THE RISKS OF PAYING FOR  MEDICAL  SERVICES  WITH  A  CREDIT  CARD.  SUCH
 NOTIFICATION SHALL HIGHLIGHT THE FACT THAT BY USING A CREDIT CARD TO PAY
 FOR  MEDICAL  SERVICES,  THE  PATIENT  IS  FORGOING  STATE  AND  FEDERAL
 PROTECTIONS THAT REGARD MEDICAL DEBT.  THE COMMISSIONER OF HEALTH  SHALL
 HAVE  THE  AUTHORITY  AND  SOLE  DISCRETION  TO SET REQUIREMENTS FOR THE
 CONTENTS OF SUCH NOTICES.
   § 6. This act shall take effect six months after it shall have  become
 a  law;  provided,  however, that if section 1 of subpart C of part Y of
 chapter 57 of the laws of 2023 shall not have taken effect on or  before
 such  date  then  section  two of this act shall take effect on the same
 date and in the same manner as such chapter of the laws  of  2023  takes
 effect.  Effective immediately, the addition, amendment and/or repeal of
 any  rule  or regulation necessary for the implementation of this act on
 its effective date are authorized to be made and completed on or  before
 such effective date.
 
                                  PART P
 
   Section  1.  Section  8  of  part  C of chapter 57 of the laws of 2022
 amending the public health law and the education law relating to  allow-
 ing  pharmacists  to  direct  limited service laboratories and order and
 administer COVID-19 and influenza tests and  modernizing  nurse  practi-
 tioners, is amended to read as follows:
   §  8.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2022; provided,
 however, that sections one, two, three, four, six and seven of this  act
 shall  expire  and  be  deemed  repealed  [two years after it shall have
 become a law] JULY 1, 2026.
   § 2. Section 5 of chapter 21 of the laws of 2011 amending  the  educa-
 tion  law  relating  to authorizing pharmacists to perform collaborative
 drug therapy management with physicians in certain settings, as  amended
 S. 8307--C                         49                         A. 8807--C
 
 by section 5 of part CC of chapter 57 of the laws of 2022, is amended to
 read as follows:
   § 5. This act shall take effect on the one hundred twentieth day after
 it  shall  have  become a law, provided, however, that the provisions of
 sections two, three, and four of this act shall  expire  and  be  deemed
 repealed  July 1, [2024] 2026; provided, however, that the amendments to
 subdivision 1 of section 6801 of the education law made by  section  one
 of  this  act  shall  be subject to the expiration and reversion of such
 subdivision pursuant to section 8 of chapter 563 of the  laws  of  2008,
 when  upon  such  date the provisions of section one-a of this act shall
 take effect; provided, further, that effective  immediately,  the  addi-
 tion,  amendment  and/or  repeal of any rule or regulation necessary for
 the implementation of this act on its effective date are authorized  and
 directed to be made and completed on or before such effective date.
   §  3.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART Q
 
                           Intentionally Omitted
 
                                  PART R
 
                           Intentionally Omitted
 
                                  PART S
 
   Section 1. (a) The public health  law  is  amended  by  adding  a  new
 section 2825-i to read as follows:
   §  2825-I.  HEALTHCARE  SAFETY  NET  TRANSFORMATION  PROGRAM. 1. (A) A
 STATEWIDE HEALTHCARE SAFETY NET TRANSFORMATION PROGRAM SHALL  BE  ESTAB-
 LISHED WITHIN THE DEPARTMENT FOR THE PURPOSE OF SUPPORTING THE TRANSFOR-
 MATION  OF  SAFETY NET HOSPITALS TO IMPROVE ACCESS, EQUITY, QUALITY, AND
 OUTCOMES WHILE INCREASING THE FINANCIAL  SUSTAINABILITY  OF  SAFETY  NET
 HOSPITALS.  SUCH  PROGRAM MAY PROVIDE OR UTILIZE NEW OR EXISTING CAPITAL
 FUNDING, OR OPERATING SUBSIDIES,  OR  BOTH.  ANY  APPLICATION  FOR  THIS
 PROGRAM  MUST BE JOINTLY SUBMITTED BY A SAFETY NET HOSPITAL AND AT LEAST
 ONE PARTNER ORGANIZATION.
   (B) ALL APPLICATIONS SHALL DEMONSTRATE HOW THE REQUESTED  FUNDING  AND
 REGULATORY  FLEXIBILITIES  ARE NECESSARY TO ACHIEVE THE PROGRAM GOALS OF
 IMPROVING THE SAFETY NET  HOSPITAL'S  FINANCIAL  OUTLOOK  AND  IMPROVING
 HEALTH  OUTCOMES  FOR  THE COMMUNITIES IT SERVES. THE COMMISSIONER SHALL
 DEVELOP AN APPLICATION FOR THIS PROGRAM THAT INCLUDES BUT IS NOT LIMITED
 TO THE FOLLOWING INFORMATION:
   (I)  KEY  ORGANIZATIONAL  INFORMATION,  INCLUDING  THE  ORGANIZATIONAL
 STRUCTURE OF THE SAFETY NET HOSPITAL AND PARTNER ORGANIZATION (INCLUDING
 ANY  PARENT  OR  SUBSIDIARY,  AND THE INTERRELATIONSHIP BETWEEN ALL SUCH
 ORGANIZATIONS) AND THE NAME, BUSINESS ADDRESS,  AND  BIOGRAPHY  OF  EACH
 DIRECTOR  AND OFFICER OF THE SAFETY NET HOSPITAL, THE PARTNER, AND OTHER
 ORGANIZATIONS WITHIN EITHER THE SAFETY NET HOSPITAL'S OR  THE  PARTNER'S
 ORGANIZATIONAL STRUCTURE;
   (II)  THE  TYPE  OF  COLLABORATIVE  MODEL  PROPOSED, INCLUDING BUT NOT
 LIMITED TO A MERGER, ACQUISITION, MANAGEMENT SERVICES CONTRACT, OR CLIN-
 ICAL INTEGRATION;
 S. 8307--C                         50                         A. 8807--C
 
   (III) A DETAILED DESCRIPTION OF THE PROPOSED TRANSFORMATION PLAN  THAT
 INCLUDES,  AT  A  MINIMUM,  A  FIVE-YEAR  STRATEGIC AND OPERATIONAL PLAN
 OUTLINING THE ROLES AND RESPONSIBILITIES OF THE SAFETY NET HOSPITAL  AND
 PARTNER ORGANIZATION;
   (IV) A TIMELINE OF KEY METRICS AND GOALS;
   (V)  ANY  REGULATORY  FLEXIBILITIES  REQUIRED  TO IMPLEMENT SUCH PLAN,
 INCLUDING THE JUSTIFICATION FOR WHY SUCH FLEXIBILITIES ARE NECESSARY FOR
 THE TRANSFORMATION PLAN TO ACHIEVE AN IMPROVED FINANCIAL OUTLOOK FOR THE
 SAFETY NET HOSPITAL AND IMPROVED HEALTH OUTCOMES FOR THE COMMUNITIES  IT
 SERVES;
   (VI)  THE  AMOUNT  OF  FUNDING  REQUESTED FOR THE FIRST FIVE YEARS AND
 PROJECTED NEEDS THEREAFTER, INCLUDING THE RATIONALE FOR WHY SUCH FUNDING
 IS NECESSARY FOR THE TRANSFORMATION PLAN TO ACHIEVE AN  IMPROVED  FINAN-
 CIAL  OUTLOOK  FOR  THE SAFETY NET HOSPITAL AND IMPROVED HEALTH OUTCOMES
 FOR THE COMMUNITIES IT SERVES; AND
   (VII) DETAILED PLANS FOR ANY OPERATIONAL SURPLUS AFTER REACHING FINAN-
 CIAL SUSTAINABILITY.
   2. THE COMMISSIONER SHALL ENTER AN AGREEMENT WITH THE PRESIDENT OF THE
 DORMITORY AUTHORITY OF THE STATE OF NEW YORK PURSUANT TO SECTION SIXTEEN
 HUNDRED EIGHTY-R OF THE PUBLIC AUTHORITIES LAW, AS REQUIRED, WHICH SHALL
 APPLY TO THIS AGREEMENT, SUBJECT TO THE APPROVAL OF THE DIRECTOR OF  THE
 DIVISION  OF THE BUDGET, FOR THE PURPOSES OF THE DISTRIBUTION AND ADMIN-
 ISTRATION OF AVAILABLE FUNDS PURSUANT TO SUCH AGREEMENT AND MADE  AVAIL-
 ABLE  PURSUANT  TO THIS SECTION AND SUBJECT TO APPROPRIATION. SUCH FUNDS
 MAY BE AWARDED AND DISTRIBUTED BY THE DEPARTMENT TO  SAFETY  NET  HOSPI-
 TALS,  OR A PARTNER ORGANIZATION, IN THE FORM OF GRANTS. TO QUALIFY AS A
 SAFETY NET HOSPITAL FOR PURPOSES OF THIS SECTION, A HOSPITAL SHALL:
   (A) BE EITHER A PUBLIC HOSPITAL, A RURAL EMERGENCY HOSPITAL,  CRITICAL
 ACCESS HOSPITAL OR SOLE COMMUNITY HOSPITAL;
   (B)  HAVE  AT LEAST THIRTY PERCENT OF ITS INPATIENT DISCHARGES MADE UP
 OF MEDICAL ASSISTANCE PROGRAM ELIGIBLE INDIVIDUALS,  UNINSURED  INDIVID-
 UALS  OR  MEDICAL  ASSISTANCE PROGRAM DUALLY ELIGIBLE INDIVIDUALS AND AT
 LEAST THIRTY-FIVE PERCENT OF ITS OUTPATIENT VISITS MADE  UP  OF  MEDICAL
 ASSISTANCE   PROGRAM  ELIGIBLE  INDIVIDUALS,  UNINSURED  INDIVIDUALS  OR
 MEDICAL ASSISTANCE PROGRAM DUALLY-ELIGIBLE INDIVIDUALS;
   (C) SERVE AT LEAST THIRTY PERCENT OF THE RESIDENTS OF A  COUNTY  OR  A
 MULTI-COUNTY  AREA  WHO ARE MEDICAL ASSISTANCE PROGRAM ELIGIBLE INDIVID-
 UALS, UNINSURED INDIVIDUALS OR MEDICAL ASSISTANCE PROGRAM  DUALLY-ELIGI-
 BLE INDIVIDUALS; OR
   (D)  IN  THE DISCRETION OF THE COMMISSIONER, SERVE A SIGNIFICANT POPU-
 LATION OF MEDICAL ASSISTANCE  PROGRAM  ELIGIBLE  INDIVIDUALS,  UNINSURED
 INDIVIDUALS OR MEDICAL ASSISTANCE PROGRAM DUALLY-ELIGIBLE INDIVIDUALS.
   3.  PARTNER  ORGANIZATIONS MAY INCLUDE, BUT ARE NOT LIMITED TO, HEALTH
 SYSTEMS, HOSPITALS, HEALTH PLANS, RESIDENTIAL  HEALTH  CARE  FACILITIES,
 PHYSICIAN  GROUPS,  COMMUNITY-BASED  ORGANIZATION,  OR  OTHER HEALTHCARE
 ENTITIES WHO CAN SERVE AS PARTNERS IN THE TRANSFORMATION OF  THE  SAFETY
 NET HOSPITAL.
   4.    NOTWITHSTANDING  SECTION  ONE  HUNDRED  SIXTY-THREE OF THE STATE
 FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND ONE HUNDRED  FORTY-THREE
 OF THE ECONOMIC DEVELOPMENT LAW OR ANY INCONSISTENT PROVISIONS OF LAW TO
 THE  CONTRARY,  AWARDS  MAY  BE  PROVIDED  WITHOUT  A COMPETITIVE BID OR
 REQUEST FOR PROPOSAL PROCESS TO SAFETY NET HOSPITALS OR  PARTNER  ORGAN-
 IZATIONS  FOR  PURPOSES OF INCREASING ACCESS, EQUITY, QUALITY, OUTCOMES,
 AND LONG-TERM FINANCIAL SUSTAINABILITY OF SUCH SAFETY NET HOSPITALS.
   5. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY,  THE  COMMIS-
 SIONER  MAY  WAIVE  REGULATORY  REQUIREMENTS TO ALLOW APPLICANTS TO MORE
 S. 8307--C                         51                         A. 8807--C
 
 EFFECTIVELY  OR  EFFICIENTLY  IMPLEMENT  PROJECTS  AWARDED  THROUGH  THE
 HEALTHCARE  SAFETY  NET  TRANSFORMATION PROGRAM, PROVIDED, HOWEVER, THAT
 REGULATIONS PERTAINING TO MINIMUM STANDARDS FOR  HOSPITALS  FOR  PATIENT
 SAFETY,  PATIENT  AUTONOMY,  PATIENT PRIVACY, PATIENT RIGHTS, QUALITY OF
 CARE, SAFE STAFFING, ADVERSE EVENT  REPORTING,  DUE  PROCESS,  SCOPE  OF
 PRACTICE,  PROFESSIONAL  LICENSURE, ENVIRONMENTAL PROTECTIONS, INFECTION
 CONTROL, PROVIDER REIMBURSEMENT METHODOLOGIES, CHARACTER AND COMPETENCE,
 OR OCCUPATIONAL STANDARDS AND EMPLOYEE RIGHTS SHALL NOT BE  WAIVED,  NOR
 SHALL  ANY REGULATIONS BE WAIVED IF SUCH WAIVER WOULD RISK PATIENT SAFE-
 TY. SUCH WAIVER SHALL NOT EXCEED THE LIFE OF THE PROJECT OR SUCH SHORTER
 TIME PERIODS AS THE COMMISSIONER MAY DETERMINE.  ANY  REGULATORY  RELIEF
 GRANTED PURSUANT TO THIS SUBDIVISION SHALL BE SPECIFICALLY DESCRIBED AND
 REQUESTED WITHIN EACH PROJECT APPLICATION AND BE REVIEWED BY THE COMMIS-
 SIONER.
   6.  CONTINUED  SUPPORT  UNDER THE PROGRAM SHALL BE CONTINGENT UPON THE
 IMPLEMENTATION OF THE APPROVED PLAN AND KEY MILESTONES.
   7. THE RELEASE OF ANY FUNDING WILL BE CONTINGENT UPON COMPLIANCE  WITH
 THE TRANSFORMATION PLAN AND A DETERMINATION THAT ACCEPTABLE PROGRESS HAS
 BEEN MADE WITH SUCH PLAN. IF KEY MILESTONES AND GOALS ARE NOT MET, ADDI-
 TIONAL  FINANCIAL  RESOURCES  MAY  BE  WITHHELD AND REDIRECTED, UPON THE
 RECOMMENDATION OF THE COMMISSIONER AND APPROVAL BY THE DIRECTOR OF BUDG-
 ET.
   8. THE COMMISSIONER SHALL PROVIDE A REPORT ON AN ANNUAL BASIS  TO  THE
 SPEAKER  OF  THE  ASSEMBLY,  THE  TEMPORARY PRESIDENT OF THE SENATE, THE
 CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE, THE CHAIR OF THE  SENATE
 FINANCE  COMMITTEE,  AND  THE DIRECTOR OF THE DIVISION OF BUDGET, ON ANY
 TRANSFORMATION PLAN APPROVED UNDER THIS SECTION,  INCLUDING  INFORMATION
 ON  PARTNERSHIP AGREEMENTS, AND ANY AMENDMENTS THERETO. THE REPORT SHALL
 ALSO INCLUDE FOR EACH AWARD, THE NAME OF THE HOSPITAL AND  PARTNER,  THE
 CORPORATE  STRUCTURE  OF  ANY PARTNER ORGANIZATION, A DESCRIPTION OF THE
 PROJECT AND ITS PURPOSE, THE AMOUNT OF THE AWARD  AND  THE  DISBURSEMENT
 DATE,  THE REGULATIONS WAIVED FOR EACH PROJECT AND THE JUSTIFICATION FOR
 SUCH WAIVER, AND THE STATUS OF ACHIEVEMENT OF  PERFORMANCE  METRICS  AND
 MILESTONES. SUCH REPORT SHALL BE PROVIDED UNTIL SUCH TIME AS THE DEPART-
 MENT  DETERMINES THAT THE PROJECTS THAT RECEIVE FUNDING PURSUANT TO THIS
 SECTION ARE SUBSTANTIALLY COMPLETE.
   § 2. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART T
 
                           Intentionally Omitted

                                  PART U
 
                           Intentionally Omitted
 
                                  PART V
 
                           Intentionally Omitted
 
                                  PART W
 S. 8307--C                         52                         A. 8807--C
 
                           Intentionally Omitted
 
                                  PART X
 
                          Intentionally Omitted.
 
                                  PART Y
 
   Section  1.  Section  7  of part R2 of 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, as amended by  section
 1  of  part  W  of chapter 57 of the laws of 2021, is amended to read as
 follows:
   § 7. This act shall take effect immediately and shall expire March 31,
 [2024] 2027 when upon such date the provisions  of  this  act  shall  be
 deemed repealed.
   §  2.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART Z
 
   Section 1. Section 2 of 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, as amended by section 1
 of part V of chapter 57 of the laws of  2021,  is  amended  to  read  as
 follows:
   §  2.  This  act shall take effect immediately and shall expire and be
 deemed repealed March 31, [2024] 2025.
   § 2. This act shall take effect immediately.
 
                                  PART AA
 
   Section 1. Paragraph 31 of subsection  (i)  of  section  3216  of  the
 insurance  law  is  amended  by adding a new subparagraph (J) to read as
 follows:
   (J) THIS SUBPARAGRAPH SHALL APPLY TO FACILITIES IN THIS STATE THAT ARE
 LICENSED, CERTIFIED, OR OTHERWISE AUTHORIZED BY THE OFFICE OF  ADDICTION
 SERVICES  AND SUPPORTS FOR THE PROVISION OF OUTPATIENT, INTENSIVE OUTPA-
 TIENT, OUTPATIENT REHABILITATION AND OPIOID TREATMENT THAT  ARE  PARTIC-
 IPATING  IN  THE  INSURER'S  PROVIDER NETWORK. REIMBURSEMENT FOR COVERED
 OUTPATIENT TREATMENT PROVIDED BY SUCH FACILITIES SHALL BE AT RATES NEGO-
 TIATED BETWEEN THE INSURER AND THE PARTICIPATING FACILITY, PROVIDED THAT
 SUCH RATES ARE NOT LESS THAN THE RATES  THAT  WOULD  BE  PAID  FOR  SUCH
 TREATMENT  PURSUANT TO THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE ELEVEN
 OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW. FOR  THE  PURPOSES  OF  THIS
 SUBPARAGRAPH,  THE  RATES THAT WOULD BE PAID FOR SUCH TREATMENT PURSUANT
 TO THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE  OF
 THE  SOCIAL  SERVICES  LAW  SHALL BE THE RATES WITH AN EFFECTIVE DATE OF
 APRIL FIRST OF THE PRECEDING YEAR, WHICH SHALL BE ESTABLISHED  PRIOR  TO
 OCTOBER FIRST OF THE PRECEDING CALENDAR YEAR. PRIOR TO THE SUBMISSION OF
 S. 8307--C                         53                         A. 8807--C
 
 PREMIUM RATE FILINGS AND APPLICATIONS, THE SUPERINTENDENT SHALL  PROVIDE
 INSURERS WITH  GUIDANCE ON FACTORS TO CONSIDER IN CALCULATING THE IMPACT
 OF  RATE CHANGES FOR THE PURPOSES OF SUBMITTING PREMIUM RATE FILINGS AND
 APPLICATIONS  TO  THE  SUPERINTENDENT FOR THE SUBSEQUENT POLICY YEAR. TO
 THE EXTENT THAT THE RATES WITH AN EFFECTIVE DATE OF APRIL  FIRST  DIFFER
 FROM  THE  ESTIMATED  RATES  INCORPORATED  IN   PREMIUM RATE FILINGS AND
 APPLICATIONS, INSURERS MAY ACCOUNT  FOR  SUCH  DIFFERENCES    IN  FUTURE
 PREMIUM  RATE  FILINGS  AND APPLICATIONS SUBMITTED TO THE SUPERINTENDENT
 FOR APPROVAL.
   § 2. Paragraph 35 of subsection (i) of section 3216 of  the  insurance
 law is amended by adding a new subparagraph (K) to read as follows:
   (K)  THIS SUBPARAGRAPH SHALL APPLY TO OUTPATIENT TREATMENT PROVIDED IN
 A FACILITY ISSUED AN OPERATING CERTIFICATE BY THE COMMISSIONER OF MENTAL
 HEALTH PURSUANT TO THE PROVISIONS OF ARTICLE THIRTY-ONE  OF  THE  MENTAL
 HYGIENE  LAW,  OR IN A FACILITY OPERATED BY THE OFFICE OF MENTAL HEALTH,
 OR IN A CRISIS STABILIZATION CENTER LICENSED PURSUANT TO  SECTION  36.01
 OF  THE  MENTAL  HYGIENE  LAW,  THAT  IS  PARTICIPATING IN THE INSURER'S
 PROVIDER  NETWORK.  REIMBURSEMENT  FOR  COVERED   OUTPATIENT   TREATMENT
 PROVIDED  BY  SUCH  A  FACILITY SHALL BE AT RATES NEGOTIATED BETWEEN THE
 INSURER AND THE PARTICIPATING FACILITY, PROVIDED THAT SUCH RATES ARE NOT
 LESS THAN THE RATES THAT WOULD BE PAID FOR SUCH  TREATMENT  PURSUANT  TO
 THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE OF THE
 SOCIAL  SERVICES  LAW.  FOR THE PURPOSES OF THIS SUBPARAGRAPH, THE RATES
 THAT WOULD BE PAID FOR SUCH TREATMENT PURSUANT TO THE MEDICAL ASSISTANCE
 PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE OF THE  SOCIAL  SERVICES  LAW
 SHALL BE THE RATES WITH AN EFFECTIVE DATE OF  APRIL FIRST OF THE PRECED-
 ING  YEAR,  WHICH  SHALL  BE  ESTABLISHED  PRIOR TO OCTOBER FIRST OF THE
 PRECEDING CALENDAR YEAR. PRIOR TO THE SUBMISSION OF PREMIUM RATE FILINGS
 AND APPLICATIONS, THE SUPERINTENDENT SHALL  PROVIDE INSURERS WITH  GUID-
 ANCE ON  FACTORS TO CONSIDER IN CALCULATING THE IMPACT OF  RATE  CHANGES
 FOR  THE PURPOSES OF SUBMITTING PREMIUM RATE FILINGS AND APPLICATIONS TO
 THE SUPERINTENDENT FOR THE SUBSEQUENT POLICY YEAR. TO  THE  EXTENT  THAT
 THE  RATES  WITH  AN EFFECTIVE DATE OF APRIL FIRST DIFFER FROM THE ESTI-
 MATED RATES INCORPORATED IN   PREMIUM  RATE  FILINGS  AND  APPLICATIONS,
 INSURERS  MAY  ACCOUNT  FOR  SUCH  DIFFERENCES    IN FUTURE PREMIUM RATE
 FILINGS AND APPLICATIONS  SUBMITTED TO THE SUPERINTENDENT FOR APPROVAL.
   § 3. Paragraph 5 of subsection (l) of section 3221  of  the  insurance
 law is amended by adding a new subparagraph (K) to read as follows:
   (K)  THIS SUBPARAGRAPH SHALL APPLY TO OUTPATIENT TREATMENT PROVIDED IN
 A FACILITY ISSUED AN OPERATING CERTIFICATE BY THE COMMISSIONER OF MENTAL
 HEALTH PURSUANT TO THE PROVISIONS OF ARTICLE THIRTY-ONE  OF  THE  MENTAL
 HYGIENE  LAW,  OR IN A FACILITY OPERATED BY THE OFFICE OF MENTAL HEALTH,
 OR IN A CRISIS STABILIZATION CENTER LICENSED PURSUANT TO  SECTION  36.01
 OF  THE  MENTAL  HYGIENE  LAW,  THAT  IS  PARTICIPATING IN THE INSURER'S
 PROVIDER  NETWORK.  REIMBURSEMENT  FOR  COVERED   OUTPATIENT   TREATMENT
 PROVIDED  BY  SUCH  A  FACILITY SHALL BE AT RATES NEGOTIATED BETWEEN THE
 INSURER AND THE PARTICIPATING FACILITY, PROVIDED THAT SUCH RATES ARE NOT
 LESS THAN THE RATES THAT WOULD BE PAID FOR SUCH  TREATMENT  PURSUANT  TO
 THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE OF THE
 SOCIAL  SERVICES  LAW.  FOR THE PURPOSES OF THIS SUBPARAGRAPH, THE RATES
 THAT WOULD BE PAID FOR SUCH TREATMENT PURSUANT TO THE MEDICAL ASSISTANCE
 PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE OF THE  SOCIAL  SERVICES  LAW
 SHALL BE THE RATES WITH AN EFFECTIVE DATE OF  APRIL FIRST OF THE PRECED-
 ING  YEAR,  WHICH  SHALL  BE  ESTABLISHED  PRIOR TO OCTOBER FIRST OF THE
 PRECEDING CALENDAR YEAR. PRIOR TO THE SUBMISSION OF PREMIUM RATE FILINGS
 AND APPLICATIONS, THE SUPERINTENDENT SHALL  PROVIDE INSURERS WITH  GUID-
 S. 8307--C                         54                         A. 8807--C
 
 ANCE  ON  FACTORS  TO CONSIDER IN CALCULATING THE IMPACT OF RATE CHANGES
 FOR THE PURPOSES OF SUBMITTING PREMIUM RATE FILINGS AND APPLICATIONS  TO
 THE  SUPERINTENDENT  FOR  THE SUBSEQUENT POLICY YEAR. TO THE EXTENT THAT
 THE  RATES  WITH  AN EFFECTIVE DATE OF APRIL FIRST DIFFER FROM THE ESTI-
 MATED RATES INCORPORATED IN   PREMIUM  RATE  FILINGS  AND  APPLICATIONS,
 INSURERS  MAY  ACCOUNT  FOR  SUCH  DIFFERENCES    IN FUTURE PREMIUM RATE
 FILINGS AND APPLICATIONS  SUBMITTED TO THE SUPERINTENDENT FOR APPROVAL.
   § 4. Paragraph 7 of subsection (l) of section 3221  of  the  insurance
 law is amended by adding a new subparagraph (J) to read as follows:
   (J) THIS SUBPARAGRAPH SHALL APPLY TO FACILITIES IN THIS STATE THAT ARE
 LICENSED,  CERTIFIED, OR OTHERWISE AUTHORIZED BY THE OFFICE OF ADDICTION
 SERVICES AND SUPPORTS FOR THE PROVISION OF OUTPATIENT, INTENSIVE  OUTPA-
 TIENT,  OUTPATIENT  REHABILITATION AND OPIOID TREATMENT THAT ARE PARTIC-
 IPATING IN THE INSURER'S PROVIDER  NETWORK.  REIMBURSEMENT  FOR  COVERED
 OUTPATIENT TREATMENT PROVIDED BY SUCH FACILITIES SHALL BE AT RATES NEGO-
 TIATED BETWEEN THE INSURER AND THE PARTICIPATING FACILITY, PROVIDED THAT
 SUCH  RATES  ARE  NOT  LESS  THAN  THE RATES THAT WOULD BE PAID FOR SUCH
 TREATMENT PURSUANT TO THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE  ELEVEN
 OF  ARTICLE  FIVE  OF  THE SOCIAL SERVICES LAW. FOR THE PURPOSES OF THIS
 SUBPARAGRAPH, THE RATES THAT WOULD BE PAID FOR SUCH  TREATMENT  PURSUANT
 TO  THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE OF
 THE SOCIAL SERVICES LAW SHALL BE THE RATES WITH  AN  EFFECTIVE  DATE  OF
 APRIL  FIRST  OF THE PRECEDING YEAR, WHICH SHALL BE ESTABLISHED PRIOR TO
 OCTOBER FIRST OF THE PRECEDING CALENDAR YEAR. PRIOR TO THE SUBMISSION OF
 PREMIUM RATE FILINGS AND APPLICATIONS, THE SUPERINTENDENT SHALL  PROVIDE
 INSURERS WITH  GUIDANCE ON FACTORS TO CONSIDER IN CALCULATING THE IMPACT
 OF RATE CHANGES FOR THE PURPOSES OF SUBMITTING PREMIUM RATE FILINGS  AND
 APPLICATIONS  TO  THE  SUPERINTENDENT FOR THE SUBSEQUENT POLICY YEAR. TO
 THE EXTENT THAT THE RATES WITH AN EFFECTIVE DATE OF APRIL  FIRST  DIFFER
 FROM  THE  ESTIMATED  RATES  INCORPORATED  IN   PREMIUM RATE FILINGS AND
 APPLICATIONS, INSURERS MAY ACCOUNT  FOR  SUCH  DIFFERENCES    IN  FUTURE
 PREMIUM  RATE  FILINGS  AND APPLICATIONS SUBMITTED TO THE SUPERINTENDENT
 FOR APPROVAL.
   § 5. Subsection (g) of section 4303 of the insurance law is amended by
 adding a new paragraph 12 to read as follows:
   (12) THIS PARAGRAPH SHALL APPLY TO OUTPATIENT TREATMENT PROVIDED IN  A
 FACILITY  ISSUED  AN OPERATING CERTIFICATE BY THE COMMISSIONER OF MENTAL
 HEALTH PURSUANT TO THE PROVISIONS OF ARTICLE THIRTY-ONE  OF  THE  MENTAL
 HYGIENE  LAW,  OR IN A FACILITY OPERATED BY THE OFFICE OF MENTAL HEALTH,
 OR IN A CRISIS STABILIZATION CENTER LICENSED PURSUANT TO  SECTION  36.01
 OF  THE  MENTAL  HYGIENE LAW, THAT IS PARTICIPATING IN THE CORPORATION'S
 PROVIDER  NETWORK.  REIMBURSEMENT  FOR  COVERED   OUTPATIENT   TREATMENT
 PROVIDED  BY  SUCH  FACILITY  SHALL  BE  AT RATES NEGOTIATED BETWEEN THE
 CORPORATION  AND THE PARTICIPATING FACILITY, PROVIDED  THAT  SUCH  RATES
 ARE NOT LESS THAN THE RATES THAT WOULD BE PAID FOR SUCH TREATMENT PURSU-
 ANT TO THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE
 OF  THE  SOCIAL  SERVICES  LAW.  FOR THE PURPOSES OF THIS PARAGRAPH, THE
 RATES THAT WOULD BE PAID FOR SUCH  TREATMENT  PURSUANT  TO  THE  MEDICAL
 ASSISTANCE  PROGRAM  UNDER  TITLE  ELEVEN  OF ARTICLE FIVE OF THE SOCIAL
 SERVICES LAW SHALL BE THE RATES WITH AN EFFECTIVE DATE OF APRIL FIRST OF
 THE PRECEDING YEAR, WHICH SHALL BE ESTABLISHED PRIOR TO OCTOBER FIRST OF
 THE PRECEDING CALENDAR YEAR. PRIOR TO THE  SUBMISSION  OF  PREMIUM  RATE
 FILINGS AND APPLICATIONS, THE SUPERINTENDENT SHALL  PROVIDE CORPORATIONS
 WITH  GUIDANCE ON  FACTORS TO CONSIDER IN CALCULATING THE IMPACT OF RATE
 CHANGES FOR THE PURPOSES OF SUBMITTING PREMIUM RATE FILINGS AND APPLICA-
 TIONS TO THE SUPERINTENDENT FOR  THE  SUBSEQUENT  POLICY  YEAR.  TO  THE
 S. 8307--C                         55                         A. 8807--C
 
 EXTENT  THAT THE RATES WITH AN EFFECTIVE DATE OF APRIL FIRST DIFFER FROM
 THE ESTIMATED RATES INCORPORATED IN  PREMIUM RATE FILINGS  AND  APPLICA-
 TIONS,  CORPORATIONS MAY ACCOUNT FOR SUCH DIFFERENCES  IN FUTURE PREMIUM
 RATE  FILINGS  AND  APPLICATIONS    SUBMITTED  TO THE SUPERINTENDENT FOR
 APPROVAL.
   § 6. Subsection (l) of section 4303 of the insurance law is amended by
 adding a new paragraph 10 to read as follows:
   (10) THIS PARAGRAPH SHALL APPLY TO FACILITIES IN THIS STATE  THAT  ARE
 LICENSED,  CERTIFIED, OR OTHERWISE AUTHORIZED BY THE OFFICE OF ADDICTION
 SERVICES AND SUPPORTS FOR THE PROVISION OF OUTPATIENT, INTENSIVE  OUTPA-
 TIENT,  OUTPATIENT  REHABILITATION AND OPIOID TREATMENT THAT ARE PARTIC-
 IPATING IN THE CORPORATION'S PROVIDER NETWORK. REIMBURSEMENT FOR COVERED
 OUTPATIENT TREATMENT PROVIDED BY SUCH FACILITIES SHALL BE AT RATES NEGO-
 TIATED BETWEEN THE CORPORATION AND THE PARTICIPATING FACILITY,  PROVIDED
 THAT  SUCH RATES ARE NOT LESS THAN THE RATES THAT WOULD BE PAID FOR SUCH
 TREATMENT PURSUANT TO THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE  ELEVEN
 OF  ARTICLE  FIVE  OF  THE SOCIAL SERVICES LAW. FOR THE PURPOSES OF THIS
 PARAGRAPH, THE RATES THAT WOULD BE PAID FOR SUCH TREATMENT  PURSUANT  TO
 THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE OF THE
 SOCIAL  SERVICES  LAW SHALL BE THE RATES WITH AN EFFECTIVE DATE OF APRIL
 FIRST OF THE PRECEDING YEAR, WHICH SHALL BE ESTABLISHED PRIOR TO OCTOBER
 FIRST OF THE PRECEDING CALENDAR YEAR. PRIOR TO THE SUBMISSION OF PREMIUM
 RATE FILINGS AND APPLICATIONS, THE SUPERINTENDENT SHALL  PROVIDE  CORPO-
 RATIONS  WITH  GUIDANCE ON FACTORS TO CONSIDER IN CALCULATING THE IMPACT
 OF RATE CHANGES FOR THE PURPOSES OF SUBMITTING PREMIUM RATE FILINGS  AND
 APPLICATIONS  TO  THE SUPERINTENDENT FOR THE SUBSEQUENT POLICY YEAR.  TO
 THE EXTENT THAT THE RATES WITH AN EFFECTIVE DATE OF APRIL  FIRST  DIFFER
 FROM  THE  ESTIMATED  RATES  INCORPORATED  IN   PREMIUM RATE FILINGS AND
 APPLICATIONS, CORPORATIONS MAY ACCOUNT FOR SUCH DIFFERENCES   IN  FUTURE
 PREMIUM  RATE  FILINGS AND APPLICATIONS  SUBMITTED TO THE SUPERINTENDENT
 FOR APPROVAL.
   § 7. This act shall take effect January 1, 2025  and  shall  apply  to
 policies and contracts issued, renewed, modified, altered, or amended on
 and after such date.
 
                                  PART BB
 
   Section  1.  Sections  19  and  21  of chapter 723 of the laws of 1989
 amending the mental hygiene law and other laws relating to comprehensive
 psychiatric emergency programs, as amended by section 1 of part  PPP  of
 chapter 58 of the laws of 2020, are amended to read as follows:
   §  19. Notwithstanding any other provision of law, the commissioner of
 mental health shall, until July 1, [2024] 2027, be solely authorized, in
 [his or her] SUCH COMMISSIONER'S discretion, to designate those  general
 hospitals,  local  governmental  units  and voluntary agencies which may
 apply and be considered for the approval and issuance  of  an  operating
 certificate  pursuant  to  article  31 of the mental hygiene law for the
 operation of a comprehensive psychiatric emergency program.
   § 21. This act shall take effect immediately, and  sections  one,  two
 and  four  through  twenty  of  this  act shall remain in full force and
 effect, until July 1, [2024] 2027, at  which  time  the  amendments  and
 additions  made  by  such  sections  of  this  act shall be deemed to be
 repealed, and any provision of law amended by any of  such  sections  of
 this  act  shall revert to its text as it existed prior to the effective
 date of this act.
   § 2. This act shall take effect immediately.
 S. 8307--C                         56                         A. 8807--C
 
                                  PART CC
 
                           Intentionally Omitted
 
                                  PART DD
 
   Section  1.  Section  3  of  part A of 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, as amended by
 section 1 of part T of chapter 57 of the laws of  2021,  is  amended  to
 read as follows:
   §  3.  This act shall take effect immediately; and shall expire and be
 deemed repealed June 30, [2024] 2027.
   § 2. This act shall take effect immediately.
 
                                  PART EE
 
                           Intentionally Omitted
 
                                  PART FF
 
   Section 1. 1. Subject to available appropriations and approval of  the
 director  of  the  budget,  the  commissioners  of  the office of mental
 health, office for people with  developmental  disabilities,  office  of
 addiction  services  and  supports,  office  of temporary and disability
 assistance, office of children and family services, and the state office
 for the aging (hereinafter "the commissioners") shall establish a  state
 fiscal  year 2024-2025 cost of living adjustment (COLA), effective April
 1, 2024, for projecting for the  effects  of  inflation  upon  rates  of
 payments, contracts, or any other form of reimbursement for the programs
 and services listed in subdivision five of this section. The COLA estab-
 lished  herein shall be applied to the appropriate portion of reimbursa-
 ble costs or contract  amounts.  Where  appropriate,  transfers  to  the
 department  of health (DOH) shall be made as reimbursement for the state
 share of medical assistance.
   2. Notwithstanding any inconsistent provision of law, subject  to  the
 approval  of  the  director  of  the budget and available appropriations
 therefore, for the period of April 1, 2024 through March 31,  2025,  the
 commissioners  shall  provide  funding to support a two and eight-tenths
 and four-hundredths percent (2.84%) cost of living adjustment under this
 section for all eligible programs and services as determined pursuant to
 subdivision five of this section.
   3. Notwithstanding any inconsistent provision of law, and as  approved
 by  the  director of the budget, the 2.84 percent cost of living adjust-
 ment (COLA) established herein shall be inclusive of all other  cost  of
 living  type  increases,  inflation  factors,  or trend factors that are
 newly applied effective April 1, 2024. Except for the 2.84 percent  cost
 of  living adjustment (COLA) established herein, for the period commenc-
 ing on April 1, 2024 and ending March 31, 2025 the  commissioners  shall
 not  apply  any  other new cost of living adjustments for the purpose of
 establishing  rates  of  payments,  contracts  or  any  other  form   of
 reimbursement.  The  phrase  "all  other  cost of living type increases,
 inflation factors, or trend factors"  as  defined  in  this  subdivision
 S. 8307--C                         57                         A. 8807--C
 
 shall not include payments made pursuant to the American Rescue Plan Act
 or other federal relief programs related to the Coronavirus Disease 2019
 (COVID-19)  pandemic public health emergency. This subdivision shall not
 prevent  the  office of children and family services from applying addi-
 tional trend factors or staff retention factors to eligible programs and
 services under paragraph (v) of subdivision five of this section.
   4. Each local government unit or direct  contract  provider  receiving
 the  cost of living adjustment established herein shall use such funding
 to provide a targeted salary increase of at least one  and  seven-tenths
 percent  (1.7%)  to  eligible individuals in accordance with subdivision
 six of this section.  Notwithstanding any inconsistent provision of law,
 the commissioners shall develop guidelines for  local  government  units
 and  direct contract providers on implementation of such targeted salary
 increase.
   5. Eligible programs and services. (i) Programs and  services  funded,
 licensed, or certified by the office of mental health (OMH) eligible for
 the  cost  of  living  adjustment  established  herein,  pending federal
 approval where applicable, include: office  of  mental  health  licensed
 outpatient programs, pursuant to parts 587 and 599 of title 14 CRR-NY of
 the office of mental health regulations including clinic, continuing day
 treatment,  day  treatment,  intensive  outpatient  programs and partial
 hospitalization;  outreach;  crisis  residence;  crisis   stabilization,
 crisis/respite  beds;  mobile crisis, part 590 comprehensive psychiatric
 emergency program  services;  crisis  intervention;  home  based  crisis
 intervention;  family  care;  supported single room occupancy; supported
 housing; supported housing  community  services;  treatment  congregate;
 supported   congregate;   community  residence  -  children  and  youth;
 treatment/apartment; supported  apartment;  community  residence  single
 room occupancy; on-site rehabilitation; employment programs; recreation;
 respite  care;  transportation;  psychosocial  club; assertive community
 treatment; case management; care  coordination,  including  health  home
 plus  services;  local  government  unit  administration; monitoring and
 evaluation; children and youth  vocational  services;  single  point  of
 access;  school-based mental health program; family support children and
 youth; advocacy/support services; drop  in  centers;  recovery  centers;
 transition management services; bridger; home and community based waiver
 services;  behavioral  health waiver services authorized pursuant to the
 section 1115 MRT waiver; self-help programs; consumer  service  dollars;
 conference  of local mental hygiene directors; multicultural initiative;
 ongoing integrated supported employment services;  supported  education;
 mentally   ill/chemical  abuse  (MICA)  network;  personalized  recovery
 oriented services; children and family treatment and  support  services;
 residential treatment facilities operating pursuant to part 584 of title
 14-NYCRR;   geriatric  demonstration  programs;  community-based  mental
 health family treatment  and  support;  coordinated  children's  service
 initiative; homeless services; and promises zone.
   (ii)  Programs  and  services  funded,  licensed,  or certified by the
 office for people with developmental disabilities (OPWDD)  eligible  for
 the  cost  of  living  adjustment  established  herein,  pending federal
 approval where applicable, include: local/unified services; chapter  620
 services;  voluntary operated community residential services; article 16
 clinics; day treatment  services;  family  support  services;  100%  day
 training;  epilepsy services; traumatic brain injury services; hepatitis
 B services;  independent  practitioner  services  for  individuals  with
 intellectual  and/or  developmental  disabilities;  crisis  services for
 individuals with intellectual and/or developmental disabilities;  family
 S. 8307--C                         58                         A. 8807--C

 care  residential  habilitation;  supervised  residential  habilitation;
 supportive residential habilitation; respite; day habilitation; prevoca-
 tional services; supported employment; community habilitation;  interme-
 diate  care  facility  day and residential services; specialty hospital;
 pathways to employment; intensive behavioral services; community transi-
 tion services;  family  education  and  training;  fiscal  intermediary;
 support broker; and personal resource accounts.
   (iii)  Programs  and  services  funded,  licensed, or certified by the
 office of addiction services and supports (OASAS) eligible for the  cost
 of  living adjustment established herein, pending federal approval where
 applicable, include: medically supervised withdrawal services - residen-
 tial; medically supervised withdrawal services -  outpatient;  medically
 managed  detoxification; medically monitored withdrawal; inpatient reha-
 bilitation services; outpatient  opioid  treatment;  residential  opioid
 treatment; KEEP units outpatient; residential opioid treatment to absti-
 nence;  problem  gambling  treatment;  medically  supervised outpatient;
 outpatient  rehabilitation;   specialized   services   substance   abuse
 programs;  home and community based waiver services pursuant to subdivi-
 sion 9 of section 366 of the social services law;  children  and  family
 treatment and support services; continuum of care rental assistance case
 management;  NY/NY  III  post-treatment  housing;  NY/NY III housing for
 persons at risk for homelessness;  permanent  supported  housing;  youth
 clubhouse;  recovery  community  centers;  recovery community organizing
 initiative; residential rehabilitation services for youth (RRSY); inten-
 sive residential; community residential; supportive living;  residential
 services;  job  placement  initiative;  case  management; family support
 navigator; local government unit administration; peer engagement;  voca-
 tional   rehabilitation;   support   services;  HIV  early  intervention
 services; dual diagnosis coordinator; problem gambling resource centers;
 problem  gambling  prevention;  prevention  resource  centers;   primary
 prevention services; other prevention services; and community services.
   (iv)  Programs  and  services  funded,  licensed,  or certified by the
 office of temporary and disability assistance (OTDA)  eligible  for  the
 cost  of  living adjustment established herein, pending federal approval
 where applicable, include:  nutrition  outreach  and  education  program
 (NOEP).
   (v) Programs and services funded, licensed, or certified by the office
 of  children  and family services (OCFS) eligible for the cost of living
 adjustment established herein, pending federal approval  where  applica-
 ble,  include:  programs  for  which  the  office of children and family
 services establishes maximum state aid rates pursuant to  section  398-a
 of  the social services law and section 4003 of the education law; emer-
 gency foster homes; foster family boarding homes and therapeutic  foster
 homes;  supervised  settings  as  defined  by  subdivision twenty-two of
 section 371 of the  social  services  law;  adoptive  parents  receiving
 adoption subsidy pursuant to section 453 of the social services law; and
 congregate  and  scattered  supportive  housing  programs and supportive
 services provided under the NY/NY III supportive  housing  agreement  to
 young adults leaving or having recently left foster care.
   (vi) Programs and services funded, licensed, or certified by the state
 office  for  the aging (SOFA) eligible for the cost of living adjustment
 established herein, pending federal approval where applicable,  include:
 community  services  for  the elderly; expanded in-home services for the
 elderly; and wellness in nutrition program.
   6. Eligible individuals.  Support staff, direct care  staff,  clinical
 staff,  and  non-executive administrative staff in programs and services
 S. 8307--C                         59                         A. 8807--C
 
 listed in subdivision five of this section shall  be  eligible  for  the
 1.7%  targeted  salary increase established pursuant to subdivision four
 of this section.
   (a)  For  the office of mental health, office for people with develop-
 mental disabilities, and office  of  addiction  services  and  supports,
 support  staff  shall  mean  individuals employed in consolidated fiscal
 report position title codes ranging from 100 to 199; direct  care  staff
 shall  mean  individuals employed in consolidated fiscal report position
 title codes ranging from 200 to 299; clinical staff shall mean  individ-
 uals employed in consolidated fiscal report position title codes ranging
 from 300 to 399; and non-executive administrative staff shall mean indi-
 viduals employed in consolidated fiscal report position title codes 400,
 500  to 599, 605 to 699, and 703 to 799. Individuals employed in consol-
 idated fiscal report position title codes 601 to 604, 701 and 702  shall
 be ineligible for the 1.7% targeted salary increase established herein.
   (b)  For  the office of temporary and disability assistance, office of
 children and family services, and the state office for the aging, eligi-
 ble support staff, direct care staff, clinical staff, and  non-executive
 administrative staff titles shall be determined by each agency's commis-
 sioner.
   7.  Each  local  government unit or direct contract provider receiving
 funding for the cost  of  living  adjustment  established  herein  shall
 submit  a  written  certification, in such form and at such time as each
 commissioner shall prescribe, attesting how such funding will be or  was
 used  to  first  promote the recruitment and retention of support staff,
 direct care staff, clinical staff, non-executive  administrative  staff,
 or  respond  to  other  critical  non-personal  service  costs  prior to
 supporting any salary increases  or  other  compensation  for  executive
 level job titles.
   8.  Notwithstanding any inconsistent provision of law to the contrary,
 agency commissioners shall be authorized to recoup funding from a  local
 governmental  unit  or  direct  contract provider for the cost of living
 adjustment established herein determined to have been used in  a  manner
 inconsistent  with  the  appropriation,  or  any other provision of this
 section. Such agency commissioners shall be  authorized  to  employ  any
 legal mechanism to recoup such funds, including an offset of other funds
 that are owed to such local governmental unit or direct contract provid-
 er.
   §  2.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART GG
 
   Section 1. Subdivision 29 of section 364-j of the social services law,
 as added by section 49 of part C of chapter 60 of the laws of  2014,  is
 amended to read as follows:
   29.  In  the  event  that  the  department  receives approval from the
 Centers for Medicare and Medicaid Services  to  amend  its  1115  waiver
 [known  as  the  Partnership  Plan]  or receives approval for a new 1115
 waiver [for the purpose of reinvesting savings resulting from the  rede-
 sign of the medical assistance program] PRIOR TO OR FOLLOWING THE EFFEC-
 TIVE  DATE  OF  THE CHAPTER OF THE LAWS OF TWO THOUSAND TWENTY-FOUR THAT
 AMENDED THIS SUBDIVISION, the commissioner is authorized to  enter  into
 contracts[, and/or] AND to amend the terms of contracts awarded prior to
 the  effective  date  of THE CHAPTER OF THE LAWS OF TWO THOUSAND TWENTY-
 FOUR THAT AMENDED this subdivision, for the  purpose  of  assisting  the
 S. 8307--C                         60                         A. 8807--C
 
 department  of  health  with implementing projects authorized under such
 waiver approval. Notwithstanding the provisions of sections one  hundred
 twelve and one hundred sixty-three of the state finance law, or sections
 one hundred forty-two and one hundred forty-three of the economic devel-
 opment  law,  or any contrary provision of law, contracts may be entered
 or contract amendments may be made pursuant to  this  subdivision  UNTIL
 MARCH  THIRTY-FIRST, TWO THOUSAND TWENTY-SEVEN without a competitive bid
 or request for proposal process [if the term of  any  such  contract  or
 contract  amendment does not extend beyond March thirty-first, two thou-
 sand nineteen]; provided, however, in the case  of  a  contract  entered
 into after the effective date of this subdivision, that:
   (a)  The  department of health shall post on its website, for a period
 of no less than thirty days:
   (i) A description of the proposed services to be provided pursuant  to
 the contract or contracts;
   (ii) The criteria for selection of a contractor or contractors;
   (iii)  The  period  of  time during which a prospective contractor may
 seek selection, which shall be no  less  than  thirty  days  after  such
 information is first posted on the website; and
   (iv)  The  manner  by  which  a  prospective  contractor may seek such
 selection, which may include submission by electronic means;
   (b) All reasonable and responsive submissions that are  received  from
 prospective  contractors  in  timely  fashion  shall  be reviewed by the
 commissioner of health; and
   (c) The  commissioner  of  health  shall  select  such  contractor  or
 contractors  that,  in  [his or her] SUCH COMMISSIONER'S discretion, are
 best suited to serve the purposes of this section.
   § 2. This act shall take effect immediately; provided,  however,  that
 the  amendments  to  section  364-j  of  the social services law made by
 section one of this act shall not affect the repeal of such section  and
 shall be deemed repealed therewith.
 
                                  PART HH
 
   Section  1. Subparagraphs (i) and (ii) of paragraph (a) of subdivision
 4-a of section 365-f of the social services law, as amended by section 3
 of part G of chapter 57 of the laws of 2019, the  opening  paragraph  of
 subparagraph (i) as amended by section 2 of part PP of chapter 57 of the
 laws  of  2022,  are amended, and three new subparagraphs (ii-a), (ii-b)
 and (ii-c) are added to read as follows:
   (i) "[Fiscal] STATEWIDE FISCAL  intermediary"  means  an  entity  that
 provides  fiscal  intermediary services and has a contract for providing
 such services with the department of health and is selected through  the
 procurement  process  described  in  [paragraphs] PARAGRAPH (b)[, (b-1),
 (b-2) and (b-3)] of this subdivision. [Eligible applicants for contracts
 shall be entities that are capable  of  appropriately  providing  fiscal
 intermediary  services,  performing  the  responsibilities  of  a fiscal
 intermediary, and complying with this section, including but not limited
 to entities that:
   (A) are a service center for  independent  living  under  section  one
 thousand one hundred twenty-one of the education law; or
   (B)  have  been  established as fiscal intermediaries prior to January
 first, two thousand twelve and have  been  continuously  providing  such
 services for eligible individuals under this section.]
 S. 8307--C                         61                         A. 8807--C
 
   (ii)   Fiscal   intermediary  services  shall  include  the  following
 services, performed on behalf of the consumer to facilitate [his or her]
 THE CONSUMER'S role as the employer:
   (A) wage and benefit processing for consumer directed personal assist-
 ants;
   (B) processing all income tax and other required wage withholdings;
   (C)  complying with workers' compensation, disability and unemployment
 requirements;
   (D) maintaining personnel records for each consumer directed  personal
 assistant,  including  time  records  and other documentation needed for
 wages and benefit processing and a copy  of  the  medical  documentation
 required pursuant to regulations established by the commissioner;
   (E) ensuring that the health status of each consumer directed personal
 assistant  is assessed prior to service delivery pursuant to regulations
 issued by the commissioner;
   (F) maintaining records of service authorizations or reauthorizations;
   (G) monitoring the consumer's or, if applicable, the designated repre-
 sentative's continuing ability to fulfill  the  consumer's  responsibil-
 ities under the program and promptly notifying the authorizing entity of
 any  circumstance  that may affect the consumer's or, if applicable, the
 designated representative's ability to fulfill such responsibilities;
   (H) complying with regulations established by the commissioner  speci-
 fying  the  responsibilities of fiscal intermediaries providing services
 under this title;
   (I) entering into a department approved  memorandum  of  understanding
 with  the  consumer  that  describes the parties' responsibilities under
 this program; and
   (J) other related responsibilities which may include, as determined by
 the commissioner, assisting consumers to perform the consumers'  respon-
 sibilities  under  this  section  and department regulations in a manner
 that does not infringe upon the consumer's responsibilities and self-di-
 rection.
   (II-A) THE COMMISSIONER SHALL REQUIRE ANY MANAGED CARE PLANS,  MANAGED
 LONG-TERM  CARE  PLANS, LOCAL SOCIAL SERVICE DISTRICTS, AND OTHER APPRO-
 PRIATE LONG-TERM SERVICE PROGRAMS OFFERING  CONSUMER  DIRECTED  PERSONAL
 ASSISTANCE  SERVICES  TO CONTRACT WITH THE STATEWIDE FISCAL INTERMEDIARY
 SET FORTH IN SUBPARAGRAPH (I) OF THIS PARAGRAPH TO  PROVIDE  ALL  FISCAL
 INTERMEDIARY SERVICES TO CONSUMERS.
   (II-B)  THE STATEWIDE FISCAL INTERMEDIARY SHALL SUBCONTRACT TO FACILI-
 TATE THE DELIVERY OF FISCAL INTERMEDIARY SERVICES TO AN ENTITY THAT IS A
 SERVICE CENTER FOR INDEPENDENT LIVING UNDER  SECTION  ONE  THOUSAND  ONE
 HUNDRED  TWENTY-ONE  OF THE EDUCATION LAW THAT HAS BEEN PROVIDING FISCAL
 INTERMEDIARY SERVICES SINCE JANUARY FIRST, TWO THOUSAND  TWENTY-FOUR  OR
 EARLIER.  THE STATEWIDE FISCAL INTERMEDIARY SHALL FURTHER SUBCONTRACT TO
 FACILITATE THE DELIVERY OF FISCAL INTERMEDIARY SERVICES  WITH  AT  LEAST
 ONE  ENTITY PER RATE SETTING REGION THAT HAS A PROVEN RECORD OF DELIVER-
 ING SERVICES TO INDIVIDUALS WITH DISABILITIES AND THE SENIOR POPULATION,
 AND HAS BEEN PROVIDING FISCAL INTERMEDIARY SERVICES SINCE JANUARY FIRST,
 TWO THOUSAND TWELVE; PROVIDED THAT SUCH SUBCONTRACTOR SHALL BE  REQUIRED
 TO  PROVIDE ANY DELEGATED FISCAL INTERMEDIARY SERVICES WITH CULTURAL AND
 LINGUISTIC COMPETENCY SPECIFIC TO THE POPULATION OF CONSUMERS AND  THOSE
 OF  THE  AVAILABLE WORKFORCE, AND SHALL COMPLY WITH THE REQUIREMENTS FOR
 REGISTRATION AS A FISCAL INTERMEDIARY SET FORTH IN  SUBDIVISION  FOUR-A-
 ONE  OF  THIS  SECTION.  FOR PURPOSES OF THIS SECTION, "DELEGATED FISCAL
 INTERMEDIARY SERVICES" ARE DEFINED AS FISCAL  INTERMEDIARY  SERVICES  AS
 SET FORTH IN SUBPARAGRAPH (II) OF PARAGRAPH (A) OF THIS SUBDIVISION THAT
 S. 8307--C                         62                         A. 8807--C
 
 THE  STATEWIDE  FISCAL  INTERMEDIARY INCLUDES IN A SUBCONTRACT AND WHICH
 SHALL INCLUDE SERVICES DESIGNED TO MEET THE NEEDS OF  CONSUMERS  OF  THE
 PROGRAM,  WHICH  MAY  INCLUDE ASSISTING CONSUMERS WITH NAVIGATION OF THE
 PROGRAM BY PROVIDING INDIVIDUAL CONSUMER ASSISTANCE AND SUPPORT AS NEED-
 ED,  CONSUMER  PEER  SUPPORT, AND EDUCATION AND TRAINING TO CONSUMERS ON
 THEIR DUTIES UNDER THE PROGRAM.
   (II-C) THE STATEWIDE FISCAL  INTERMEDIARY  SHALL  BE  RESPONSIBLE  FOR
 PAYMENT  TO  SUBCONTRACTORS  FOR DELEGATED FISCAL INTERMEDIARY SERVICES.
 THE PAYMENT SHALL NOT REQUIRE A CERTIFICATION  BY  THE  COMMISSIONER  IF
 PAYMENTS  ARE  REASONABLY  RELATED TO THE COSTS OF EFFICIENT DELIVERY OF
 SUCH SERVICES.
   § 2. Paragraph (b) of subdivision 4-a of section 365-f of  the  social
 services  law,  as  amended  by section 4 of part G of chapter 57 of the
 laws of 2019 and subparagraph (vi) as amended by section 1 of part LL of
 chapter 57 of the laws of 2021, is amended to read as follows:
   (b)  Notwithstanding  [any  inconsistent  provision  of]  section  one
 hundred sixty-three of the state finance law, SECTION ONE HUNDRED TWELVE
 OF  THE  STATE  FINANCE  LAW,  or  section  one hundred forty-two of the
 economic development law the commissioner shall enter into [contracts] A
 CONTRACT under this subdivision with AN eligible [contractors]  CONTRAC-
 TOR  that  [submit]  SUBMITS an offer for a contract, provided, however,
 that:
   (i) the department shall post on its website:
   (A) a  description  of  the  proposed  STATEWIDE  FISCAL  INTERMEDIARY
 services to be provided pursuant to [contracts] A CONTRACT in accordance
 with this subdivision;
   (B)  [that  the  selection  of  contractors shall be based on criteria
 reasonably related to the contractors' ability to provide fiscal  inter-
 mediary  services including but not limited to: ability to appropriately
 serve individuals participating in the program, geographic  distribution
 that  would  ensure  access in rural and underserved areas, demonstrated
 cultural and language competencies specific to the population of consum-
 ers and those of the available  workforce,  ability  to  provide  timely
 consumer  assistance,  experience serving individuals with disabilities,
 the availability of consumer peer support, and  demonstrated  compliance
 with  all  applicable  federal and state laws and regulations, including
 but not limited to those relating to wages and labor] THE  CRITERIA  FOR
 SELECTION OF THE STATEWIDE FISCAL INTERMEDIARY, WHICH SHALL INCLUDE AT A
 MINIMUM  THAT THE ELIGIBLE CONTRACTOR IS CAPABLE OF PERFORMING STATEWIDE
 FISCAL INTERMEDIARY SERVICES WITH  DEMONSTRATED  CULTURAL  AND  LANGUAGE
 COMPETENCIES  SPECIFIC  TO  THE POPULATION OF CONSUMERS AND THOSE OF THE
 AVAILABLE WORKFORCE, HAS EXPERIENCE SERVING INDIVIDUALS  WITH  DISABILI-
 TIES,  AND  AS  OF  APRIL  FIRST,  TWO THOUSAND TWENTY-FOUR IS PROVIDING
 SERVICES AS A FISCAL INTERMEDIARY ON A STATEWIDE BASIS WITH AT LEAST ONE
 OTHER STATE;
   (C)  the  manner  by  which  prospective  contractors  may  seek  such
 selection, which may include submission by electronic means;
   (ii)  all  [reasonable  and  responsive] offers that are received from
 prospective contractors in A timely fashion AND THAT MEET  THE  CRITERIA
 SET  FORTH  IN CLAUSE (B) OF SUBPARAGRAPH (I) OF THIS PARAGRAPH shall be
 reviewed by the commissioner; AND
   (iii) the commissioner shall award such [contracts]  CONTRACT  to  the
 [contractors]  CONTRACTOR  that  [best  meet]  MEETS  the  criteria  for
 selection and [are best suited to serve the purposes of] OFFERS THE BEST
 VALUE FOR PROVIDING THE SERVICES REQUIRED PURSUANT TO this  section  and
 the needs of consumers[;
 S. 8307--C                         63                         A. 8807--C

   (iv)  all entities providing fiscal intermediary services on or before
 April first, two thousand nineteen, shall submit an offer for a contract
 under this section within sixty days after  the  commissioner  publishes
 the  initial  offer  on the department's website. Such entities shall be
 deemed  authorized to provide such services unless: (A) the entity fails
 to submit an offer for a contract under this section  within  the  sixty
 days;  or  (B)  the  entity's offer for a contract under this section is
 denied;
   (v) all decisions made and approaches taken pursuant to this paragraph
 shall be documented in a procurement record as defined  in  section  one
 hundred sixty-three of the state finance law; and
   (vi)  the  commissioner  is  authorized to either reoffer contracts or
 utilize the previous offer,  to  ensure  that  all  provisions  of  this
 section are met].
   §  3.  Section 365-f of the social services law is amended by adding a
 new subdivision 4-a-1 to read as follows:
   4-A-1.  (A) FISCAL INTERMEDIARY REGISTRATION. EXCEPT FOR THE STATEWIDE
 FISCAL INTERMEDIARY AND ITS SUBCONTRACTORS, AS OF APRIL FIRST, TWO THOU-
 SAND TWENTY-FIVE, NO ENTITY SHALL PROVIDE, DIRECTLY OR THROUGH CONTRACT,
 FISCAL INTERMEDIARY SERVICES.    ALL  SUBCONTRACTORS  OF  THE  STATEWIDE
 FISCAL  INTERMEDIARY,  SHALL  REGISTER WITH THE DEPARTMENT WITHIN THIRTY
 DAYS OF BEING SELECTED AS A SUBCONTRACTOR.
   (B) IN SELECTING ITS SUBCONTRACTORS, THE STATEWIDE FISCAL INTERMEDIARY
 SHALL CONSIDER DEMONSTRATED COMPLIANCE WITH ALL APPLICABLE  FEDERAL  AND
 STATE  LAWS AND REGULATIONS, INCLUDING BUT NOT LIMITED TO, MARKETING AND
 LABOR PRACTICES,  COST  REPORTING,  AND  ELECTRONIC  VISIT  VERIFICATION
 REQUIREMENTS.
   §  4.  Paragraphs (b-1), (b-2) and (b-3) of subdivision 4-a of section
 365-f of the social services law are REPEALED.
   § 5. Subdivision 4-b of section 365-f of the social services  law,  as
 amended  by  section  8  of part G of chapter 57 of the laws of 2019, is
 amended to read as follows:
   4-b. Actions involving the [authorization] REGISTRATION  of  a  fiscal
 intermediary.
   (a)  [The  department  may  terminate a fiscal intermediary's contract
 under this section or suspend or limit the fiscal intermediary's  rights
 and  privileges  under  the contract upon thirty day's written notice to
 the fiscal intermediary, if  the  commissioner  finds  that  the  fiscal
 intermediary has failed to comply with the provisions of this section or
 regulations promulgated hereunder. The written notice shall include:
   (i)  A  description of the conduct and the issues related thereto that
 have been identified as failure of compliance; and
   (ii) the time frame of the conduct that  fails  compliance]  A  FISCAL
 INTERMEDIARY'S  REGISTRATION  MAY  BE  REVOKED,  SUSPENDED,  LIMITED, OR
 ANNULLED BY THE COMMISSIONER UPON THIRTY DAYS'  WRITTEN  NOTICE  TO  THE
 FISCAL  INTERMEDIARY, IF THE COMMISSIONER FINDS THAT THE FISCAL INTERME-
 DIARY HAS FAILED TO COMPLY WITH THE PROVISIONS OF THIS SECTION OR  REGU-
 LATIONS PROMULGATED HEREUNDER.
   (b)  [Notwithstanding  the foregoing, upon determining that the public
 health or safety would be imminently endangered by the continued  opera-
 tion  or actions of the fiscal intermediary, the commissioner may termi-
 nate the fiscal intermediary's contract or suspend or limit  the  fiscal
 intermediary's rights and privileges under the contract immediately upon
 written  notice.]  THE  COMMISSIONER  MAY  ISSUE  ORDERS  AND TAKE OTHER
 ACTIONS AS  NECESSARY  AND  APPROPRIATE  TO  PROHIBIT  AND  PREVENT  THE
 PROVISION OF FISCAL INTERMEDIARY SERVICES BY AN UNREGISTERED ENTITY.
 S. 8307--C                         64                         A. 8807--C
 
   (c)  All  orders  or  determinations  under  this subdivision shall be
 subject to review as provided in  article  seventy-eight  of  the  civil
 practice law and rules.
   §  6.  Paragraph (d) of subdivision 4-d of section 365-f of the social
 services law is REPEALED.
   § 7. Paragraph (b) of subdivision 5 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:
   (b) Notwithstanding any other provision of law,  the  commissioner  is
 authorized to waive any provision of section three hundred sixty-seven-b
 of  this  title related to payment and may promulgate regulations neces-
 sary to carry out the objectives of the program INCLUDING MINIMUM  SAFE-
 TY,  AND  HEALTH AND IMMUNIZATION CRITERIA AND TRAINING REQUIREMENTS FOR
 PERSONAL ASSISTANTS, and which  describe  the  responsibilities  of  the
 eligible  individuals  in  arranging  and  paying  for  services and the
 protections assured such individuals if they are  unable  or  no  longer
 desire  to continue in the program, THE FISCAL INTERMEDIARY REGISTRATION
 PROCESS, STANDARDS, AND TIME FRAMES, AND THOSE REGULATIONS NECESSARY  TO
 ENSURE ADEQUATE ACCESS TO SERVICES.
   §  8.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART II
 
   Section 1. The public health law is amended by adding  a  new  section
 2807-ff to read as follows:
   §  2807-FF.  NEW  YORK MANAGED CARE ORGANIZATION PROVIDER TAX.  1. THE
 COMMISSIONER, SUBJECT TO THE APPROVAL OF THE  DIRECTOR  OF  THE  BUDGET,
 SHALL:  APPLY  FOR A WAIVER OR WAIVERS OF THE BROAD-BASED AND UNIFORMITY
 REQUIREMENTS RELATED TO THE ESTABLISHMENT OF A  NEW  YORK  MANAGED  CARE
 ORGANIZATION  PROVIDER  TAX  (THE "MCO PROVIDER TAX") IN ORDER TO SECURE
 FEDERAL FINANCIAL PARTICIPATION FOR THE COSTS OF THE MEDICAL  ASSISTANCE
 PROGRAM;  ISSUE  REGULATIONS  TO  IMPLEMENT  THE  MCO PROVIDER TAX; AND,
 SUBJECT TO APPROVAL BY THE CENTERS FOR MEDICARE AND  MEDICAID  SERVICES,
 IMPOSE THE MCO PROVIDER TAX AS AN ASSESSMENT UPON INSURERS, HEALTH MAIN-
 TENANCE  ORGANIZATIONS,  AND  MANAGED  CARE  ORGANIZATIONS  OFFERING THE
 FOLLOWING PLANS OR PRODUCTS:
   (A) MEDICAL ASSISTANCE  PROGRAM  COVERAGE  PROVIDED  BY  MANAGED  CARE
 PROVIDERS  PURSUANT  TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THE SOCIAL
 SERVICES LAW;
   (B) A CHILD HEALTH INSURANCE PLAN CERTIFIED PURSUANT TO SECTION  TWEN-
 TY-FIVE HUNDRED ELEVEN OF THIS CHAPTER;
   (C)  ESSENTIAL  PLAN  COVERAGE  CERTIFIED  PURSUANT  TO  SECTION THREE
 HUNDRED SIXTY-NINE-GG OF THE SOCIAL SERVICES LAW;
   (D) COVERAGE PURCHASED ON THE NEW YORK INSURANCE EXCHANGE  ESTABLISHED
 PURSUANT TO SECTION TWO HUNDRED SIXTY-EIGHT-B OF THIS CHAPTER; OR
   (E)  ANY  OTHER COMPREHENSIVE COVERAGE SUBJECT TO ARTICLES THIRTY-TWO,
 FORTY-TWO AND FORTY-THREE OF THE INSURANCE LAW, OR ARTICLE FORTY-FOUR OF
 THIS CHAPTER.
   2. THE MCO PROVIDER TAX SHALL COMPLY WITH ALL RELEVANT  PROVISIONS  OF
 FEDERAL LAWS, RULES AND REGULATIONS.
   § 2. The state finance law is amended by adding a new section 99-rr to
 read as follows:
   §  99-RR. HEALTHCARE STABILITY FUND. 1. THERE IS HEREBY ESTABLISHED IN
 THE JOINT CUSTODY OF THE STATE COMPTROLLER AND THE COMMISSIONER OF TAXA-
 S. 8307--C                         65                         A. 8807--C
 
 TION AND FINANCE A SPECIAL FUND TO BE KNOWN AS THE "HEALTHCARE STABILITY
 FUND" ("FUND").
   2.  THE  FUND  SHALL CONSIST OF MONIES RECEIVED FROM THE IMPOSITION OF
 THE CENTERS FOR MEDICARE AND MEDICAID SERVICES-APPROVED MCO PROVIDER TAX
 ESTABLISHED PURSUANT TO SECTION TWENTY-EIGHT  HUNDRED  SEVEN-FF  OF  THE
 PUBLIC  HEALTH  LAW,  AND  ALL  OTHER  MONIES APPROPRIATED, CREDITED, OR
 TRANSFERRED THERETO FROM ANY OTHER FUND OR SOURCE PURSUANT TO LAW.
   3. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY AND SUBJECT TO
 AVAILABLE LEGISLATIVE APPROPRIATION AND APPROVAL OF THE DIRECTOR OF  THE
 BUDGET, MONIES OF THE FUND MAY BE AVAILABLE FOR:
   (A)  FUNDING THE NON-FEDERAL SHARE OF INCREASED CAPITATION PAYMENTS TO
 MANAGED CARE PROVIDERS, AS DEFINED IN SECTION THREE HUNDRED SIXTY-FOUR-J
 OF THE SOCIAL SERVICES LAW, FOR THE MEDICAL ASSISTANCE PROGRAM, PURSUANT
 TO A PLAN DEVELOPED AND APPROVED BY THE DIRECTOR OF THE BUDGET;
   (B) FUNDING THE NON-FEDERAL SHARE OF THE MEDICAL  ASSISTANCE  PROGRAM,
 INCLUDING  SUPPLEMENTAL SUPPORT FOR THE DELIVERY OF HEALTH CARE SERVICES
 TO MEDICAL ASSISTANCE PROGRAM ENROLLEES AND QUALITY INCENTIVE PROGRAMS;
   (C) REIMBURSEMENT TO THE GENERAL FUND FOR EXPENDITURES INCURRED IN THE
 MEDICAL ASSISTANCE PROGRAM, INCLUDING, BUT NOT LIMITED TO, REIMBURSEMENT
 PURSUANT TO A SAVINGS ALLOCATION PLAN  ESTABLISHED  IN  ACCORDANCE  WITH
 SECTION  NINETY-TWO  OF  PART H OF CHAPTER FIFTY-NINE OF THE LAWS OF TWO
 THOUSAND ELEVEN, AS AMENDED; AND
   (D) TRANSFER TO THE  CAPITAL  PROJECTS  FUND,  OR  ANY  OTHER  CAPITAL
 PROJECTS  FUND  OF  THE  STATE  TO  SUPPORT  THE DELIVERY OF HEALTH CARE
 SERVICES.
   4. MONIES DISBURSED FROM THE FUND SHALL BE EXEMPT FROM THE CALCULATION
 OF DEPARTMENT OF HEALTH STATE FUNDS MEDICAID EXPENDITURES UNDER SUBDIVI-
 SION ONE OF SECTION NINETY-TWO OF PART H OF CHAPTER  FIFTY-NINE  OF  THE
 LAWS OF TWO THOUSAND ELEVEN, AS AMENDED.
   5.  MONIES  IN  SUCH FUND SHALL BE KEPT SEPARATE FROM AND SHALL NOT BE
 COMMINGLED WITH ANY OTHER MONIES IN THE CUSTODY OF  THE  COMPTROLLER  OR
 THE  COMMISSIONER  OF  TAXATION  AND FINANCE. ANY MONIES OF THE FUND NOT
 REQUIRED FOR IMMEDIATE USE MAY, AT THE DISCRETION OF THE COMPTROLLER, IN
 CONSULTATION WITH THE DIRECTOR OF THE BUDGET, BE INVESTED BY  THE  COMP-
 TROLLER  IN  OBLIGATIONS  OF  THE UNITED STATES OR THE STATE. ANY INCOME
 EARNED BY THE INVESTMENT OF SUCH MONIES SHALL BE ADDED TO AND  BECOME  A
 PART OF AND SHALL BE USED FOR THE PURPOSES OF SUCH FUND.
   6.  THE  DIRECTOR OF THE BUDGET SHALL PROVIDE QUARTERLY REPORTS TO THE
 SPEAKER OF THE ASSEMBLY, THE TEMPORARY  PRESIDENT  OF  THE  SENATE,  THE
 CHAIR OF THE SENATE FINANCE COMMITTEE AND THE CHAIR OF THE ASSEMBLY WAYS
 AND MEANS COMMITTEE, ON THE RECEIPTS AND DISTRIBUTIONS OF THE HEALTHCARE
 STABILITY  FUND, INCLUDING AN ITEMIZATION OF SUCH RECEIPTS AND DISBURSE-
 MENTS, THE HISTORICAL AND PROJECTED EXPENDITURES, AND THE PROJECTED FUND
 BALANCE.
   § 3. Paragraphs (g) and (h) of subdivision 1 of section 2807-y of  the
 public health law, as added by section 67 of part B of chapter 58 of the
 laws  of  2005,  are amended and a new paragraph (i) is added to read as
 follows:
   (g) section thirty-six hundred fourteen-a of this chapter; [and]
   (h) section three hundred sixty-seven-i of the social services law[.];
 AND
   (I) SECTION TWENTY-EIGHT HUNDRED SEVEN-FF OF THIS ARTICLE.
   § 4. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024.
 
                                  PART JJ
 S. 8307--C                         66                         A. 8807--C
 
   Section  1.  Subdivision 3 of section 364-j of the social services law
 is amended by adding a new paragraph (d-3) to read as follows:
   (D-3)  SERVICES  PROVIDED  IN SCHOOL-BASED HEALTH CENTERS SHALL NOT BE
 PROVIDED TO MEDICAL ASSISTANCE RECIPIENTS THROUGH MANAGED CARE  PROGRAMS
 ESTABLISHED  PURSUANT  TO  THIS  SECTION UNTIL AT LEAST APRIL FIRST, TWO
 THOUSAND TWENTY-FIVE.
   § 2. This act shall take effect immediately; provided,  however,  that
 the  amendments to section 364-j of the social services law made by this
 act shall not affect the repeal of such  section  and  shall  be  deemed
 repealed therewith.
 
                                  PART KK
 
   Section  1.    Paragraph  (d)  of  subdivision 4 of section 206 of the
 public health law, as added by chapter 602  of  the  laws  of  2007,  is
 amended and a new paragraph (e) is added to read as follows:
   (d)  assess  civil  penalties  against  a  public  water  system which
 provides water to the public for  human  consumption  through  pipes  or
 other  constructed conveyances, as further defined in the state sanitary
 code or, in the case  of  mass  gatherings,  the  person  who  holds  or
 promotes  the  mass  gathering as defined in subdivision five of section
 two hundred twenty-five of this article not to exceed twenty-five  thou-
 sand  dollars  per  day, for each violation of or failure to comply with
 any term or provision of the state sanitary code as it relates to public
 water systems that serve a population of five thousand or  more  persons
 or any mass gatherings, which penalty may be assessed after a hearing or
 an opportunity to be heard[.];
   (E)  ISSUE  A  NON-PATIENT  SPECIFIC  STATEWIDE STANDING ORDER FOR THE
 PROVISION OF DOULA SERVICES FOR PREGNANT, BIRTHING, AND POSTPARTUM INDI-
 VIDUALS THROUGH TWELVE MONTHS POSTPARTUM.
   § 2. Article 25 of the public health law is amended by  adding  a  new
 title 3-A to read as follows:
                                TITLE III-A
                     COMMUNITY DOULA EXPANSION PROGRAM
 SECTION 2560. COMMUNITY DOULA EXPANSION GRANT PROGRAM.
         2561. DEFINITIONS.
         2562. RULES.
         2563. REPORT.
   § 2560. COMMUNITY  DOULA  EXPANSION GRANT PROGRAM. THE COMMUNITY DOULA
 EXPANSION GRANT PROGRAM IS ESTABLISHED WITHIN THE DEPARTMENT.
   § 2561. DEFINITIONS. AS USED IN THIS TITLE:
   1.  "ELIGIBLE  PROVIDERS"  SHALL  MEAN  COMMUNITY-BASED  ORGANIZATIONS
 PROVIDING  FOR  THE  RECRUITMENT,  TRAINING,  CERTIFICATION, SUPPORTING,
 AND/OR MENTORING OF COMMUNITY-BASED DOULAS.
   2. "COMMUNITY-BASED DOULA" SHALL MEAN A CERTIFIED DOULA THAT  PROVIDES
 CULTURALLY  SENSITIVE  PREGNANCY AND CHILDBIRTH EDUCATION, EARLY LINKAGE
 TO HEALTH CARE, AND AIDS BIRTHING PERSONS IN NAVIGATING  OTHER  SERVICES
 AND SUPPORTS THAT THEY MAY NEED TO BE HEALTHY.
   §  2562.  RULES. 1. THE COMMISSIONER SHALL ESTABLISH A COMMUNITY DOULA
 EXPANSION GRANT PROGRAM FOR ELIGIBLE PROVIDERS TO RECEIVE FUNDING IN THE
 PERFORMANCE OF RECRUITMENT, TRAINING, CERTIFICATION, SUPPORTING,  AND/OR
 MENTORING  OF COMMUNITY-BASED DOULAS. SUCH ELIGIBLE PROVIDERS SHALL MEET
 PROFESSIONALLY RECOGNIZED TRAINING  STANDARDS,  COMPLY  WITH  APPLICABLE
 STATE  LAW AND REGULATIONS, AND SHALL BE CAPABLE OF PROVIDING CULTURALLY
 CONGRUENT CARE.
 S. 8307--C                         67                         A. 8807--C
 
   2. THE COMMISSIONER IS AUTHORIZED,  WITHIN  AMOUNTS  APPROPRIATED  FOR
 SUCH  PURPOSE,  TO MAKE GRANTS IN ACCORDANCE WITH THIS SUBDIVISION. SUCH
 GRANTS MAY BE USED FOR BUT NOT LIMITED TO  THE  ADMINISTRATION,  FACULTY
 RECRUITMENT AND DEVELOPMENT, START-UP COSTS AND OTHER COSTS INCURRED FOR
 PROVIDING   RECRUITMENT,  TRAINING,  CERTIFICATION,  SUPPORTING,  AND/OR
 MENTORING OF COMMUNITY-BASED DOULAS.
   3. THERE SHALL BE AN EMPHASIS  OF  APPROPRIATING  GRANTS  TO  ELIGIBLE
 PROVIDERS  THAT  SPECIFICALLY  TRAIN,  RECRUIT,  AND  EMPLOY DOULAS FROM
 HISTORICALLY VULNERABLE COMMUNITIES, AND BILINGUAL  DOULAS.    THIS  MAY
 INCLUDE GRANTS FOR DOULA APPRENTICE PROGRAMS.
   4. INFORMATION ABOUT THE COMMUNITY DOULA EXPANSION GRANT PROGRAM SHALL
 BE POSTED ON THE DEPARTMENT'S WEBSITE.
   §  2563.  REPORT.    UPON  EXPIRATION OF THE PROGRAM, THE COMMISSIONER
 SHALL POST A FINAL REPORT ON  THE  DEPARTMENT'S  WEBSITE  OUTLINING  THE
 TOTAL  NUMBER OF GRANTS AWARDED, THE NAMES OF ELIGIBLE PROVIDERS AWARDED
 FUNDS PURSUANT TO THE PROGRAM, AND THE AMOUNT  OF  FUNDING  RECEIVED  BY
 EACH.
   §  3.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024; provided,
 however, that the provisions of section two of  this  act  shall  expire
 March  31, 2025 when upon such date the provisions of such section shall
 be deemed repealed.
 
                                  PART LL
 
   Section 1. Paragraph (g) of subdivision  2  of  section  2807  of  the
 public  health law is amended by adding a new subparagraph (iii) to read
 as follows:
   (III) (A) FOR PURPOSES OF THIS SUBPARAGRAPH:
   (1) "CHILDREN WITH MEDICAL FRAGILITY" SHALL MEAN AN INDIVIDUAL WHO  IS
 UNDER  TWENTY-ONE  YEARS OF AGE AND HAS A CHRONIC DEBILITATING CONDITION
 OR CONDITIONS, WHO MAY OR MAY NOT BE HOSPITALIZED OR  INSTITUTIONALIZED,
 AND  WHO MEETS ONE OR MORE OF THE FOLLOWING CRITERIA: (I) IS TECHNOLOGY-
 DEPENDENT FOR LIFE OR HEALTH SUSTAINING FUNCTIONS; (II) REQUIRES COMPLEX
 MEDICATION REGIMENS OR MEDICAL INTERVENTIONS TO MAINTAIN OR  TO  IMPROVE
 THEIR HEALTH STATUS; OR (III) IS IN NEED OF ONGOING ASSESSMENT OR INTER-
 VENTION  TO  PREVENT  SERIOUS  DETERIORATION  OF  THEIR HEALTH STATUS OR
 MEDICAL COMPLICATIONS THAT PLACE THEIR LIFE, HEALTH  OR  DEVELOPMENT  AT
 RISK.
   (2)  "PEDIATRIC  RESIDENTIAL  HEALTH CARE FACILITY" SHALL MEAN A FREE-
 STANDING FACILITY OR DISCRETE UNIT WITHIN A FACILITY AUTHORIZED  BY  THE
 COMMISSIONER  TO  PROVIDE EXTENSIVE NURSING, MEDICAL, PSYCHOLOGICAL, AND
 COUNSELING SUPPORT SERVICES SOLELY TO CHILDREN UNDER THE AGE OF  TWENTY-
 ONE.
   (3)  "PEDIATRIC DIAGNOSTIC AND TREATMENT CENTER" SHALL MEAN A DIAGNOS-
 TIC AND TREATMENT CENTER ESTABLISHED PURSUANT TO THIS ARTICLE, WHICH  AS
 OF  APRIL FIRST, TWO THOUSAND TWENTY-FOUR, HAS BEEN PARTICIPATING IN THE
 DEMONSTRATION PROGRAM AUTHORIZED UNDER SUBDIVISION ONE OF SECTION  TWEN-
 TY-EIGHT  HUNDRED  EIGHT-E  OF  THIS  ARTICLE, FOR WHICH AT LEAST EIGHTY
 PERCENT OF ITS TOTAL MEDICAID FEE-FOR-SERVICE REIMBURSEMENTS DERIVE FROM
 THE PROVISION OF SERVICES TO CHILDREN UNDER THE AGE OF  TWENTY-ONE  WITH
 MEDICAL  FRAGILITY AND IS AFFILIATED WITH A PEDIATRIC RESIDENTIAL HEALTH
 CARE FACILITY.
   (B) (1) NOTWITHSTANDING ANY LAW, RULE, OR REGULATION TO THE  CONTRARY,
 THE  COMMISSIONER  SHALL  ESTABLISH RATES OF REIMBURSEMENT FOR PEDIATRIC
 DIAGNOSTIC AND TREATMENT CENTERS FOR ALL SERVICES PROVIDED ON  OR  AFTER
 S. 8307--C                         68                         A. 8807--C
 
 APRIL  FIRST, TWO THOUSAND TWENTY-FOUR, TO CHILDREN ELIGIBLE FOR MEDICAL
 ASSISTANCE THAT REFLECT THE COSTS NECESSARY TO PROVIDE CARE AND SERVICES
 TO CHILDREN WITH MEDICAL FRAGILITY BEING TREATED AT SUCH PEDIATRIC DIAG-
 NOSTIC AND TREATMENT CENTER.
   (2)  FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-FOUR, TO DECEMBER
 THIRTY-FIRST, TWO THOUSAND TWENTY-FOUR, AND UNTIL SUCH TIME AS A  CERTI-
 FIED  ANNUAL COST REPORT FOR SUCH PERIOD IS RECEIVED AND VERIFIED BY THE
 DEPARTMENT, THE OPERATING COMPONENT OF SUCH RATE SHALL REFLECT  BUDGETED
 COSTS  FOR  THE  PERIOD JANUARY FIRST, TWO THOUSAND TWENTY-FOUR, THROUGH
 DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-FOUR,  AS  SUBMITTED  TO  THE
 DEPARTMENT  AND  ADJUSTED  AS  THE  COMMISSIONER DEEMS APPROPRIATE. UPON
 SUBMISSION AND SUBSEQUENT VERIFICATION OF THE COST REPORT, THE OPERATING
 COMPONENT OF THE RATE SHALL BE REFLECTIVE OF ACTUAL COSTS FOR THE PERIOD
 JANUARY FIRST, TWO THOUSAND TWENTY-FOUR, THROUGH DECEMBER  THIRTY-FIRST,
 TWO  THOUSAND TWENTY-FOUR, SUBJECT TO FURTHER ADJUSTMENTS AS THE COMMIS-
 SIONER DEEMS APPROPRIATE. THEREAFTER, THE BASE PERIOD REPORTED OPERATING
 COSTS USED TO ESTABLISH RATES PURSUANT TO  THIS  SUBPARAGRAPH  SHALL  BE
 UPDATED NO LESS FREQUENTLY THAN EVERY TWO YEARS. IN ADDITION TO REQUIRED
 ANNUAL  COST  REPORTS,  PEDIATRIC  DIAGNOSTIC  AND TREATMENT CENTERS, AS
 DEFINED BY THIS  SUBPARAGRAPH,  SHALL  SUBMIT  ADDITIONAL  DATA  AS  THE
 COMMISSIONER REQUIRES.
   (3)  NOTWITHSTANDING  ANY  LAW,  RULE,  OR REGULATION TO THE CONTRARY,
 PEDIATRIC DIAGNOSTIC AND  TREATMENT  CENTERS  SHALL  BE  REIMBURSED  FOR
 SERVICES PROVIDED TO CHILDREN ENROLLED IN MEDICAID MANAGED CARE PLANS AT
 THE RATES OF REIMBURSEMENT PROMULGATED PURSUANT TO THIS SUBPARAGRAPH.
   (4)  THE  CAPITAL COMPONENT OF THE RATE SHALL REFLECT ACTUAL BASE YEAR
 COSTS.
   (5) ALL RATES ESTABLISHED UNDER THIS SUBPARAGRAPH SHALL BE SUBJECT  TO
 THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION.
   (6)  THE  COMMISSIONER  MAY  PROMULGATE  OR  AMEND  REGULATIONS AS THE
 COMMISSIONER DETERMINES APPROPRIATE AND NECESSARY TO ESTABLISH THE RATES
 PROVIDED FOR IN THIS SUBPARAGRAPH AND/OR EXEMPT PEDIATRIC DIAGNOSTIC AND
 TREATMENT CENTERS FROM THE AMBULATORY PAYMENT GROUP REIMBURSEMENT  METH-
 ODOLOGY APPLICABLE TO DIAGNOSTIC AND TREATMENT CENTERS.
   §  2.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2024; provided,
 however, that the provisions of this act  shall  expire  and  be  deemed
 repealed April 1, 2027.
 
                                  PART MM

   Section  1.  The executive law is amended by adding a new article 49-C
 to read as follows:
                               ARTICLE 49-C
   COMMUNITY ADVISORY BOARD FOR THE MODERNIZATION AND REVITALIZATION OF
                 SUNY DOWNSTATE HEALTH SCIENCES UNIVERSITY
 § 996. COMMUNITY ADVISORY BOARD FOR THE MODERNIZATION AND REVITALIZATION
          OF SUNY DOWNSTATE HEALTH SCIENCES UNIVERSITY.
   § 996. COMMUNITY ADVISORY BOARD FOR THE MODERNIZATION AND  REVITALIZA-
 TION  OF  SUNY  DOWNSTATE  HEALTH SCIENCES UNIVERSITY. 1. ADVISORY BOARD
 ESTABLISHED. (A) THERE SHALL BE ESTABLISHED THE ADVISORY BOARD  FOR  THE
 MODERNIZATION AND REVITALIZATION OF SUNY DOWNSTATE (HEREINAFTER REFERRED
 TO AS "THE ADVISORY BOARD"). THE ADVISORY BOARD SHALL REVIEW AND EXAMINE
 A  VARIETY  OF  OPTIONS  TO STRENGTHEN SUNY DOWNSTATE AND PROMOTE LONGER
 TERM VIABILITY  FOR  ITS  DUAL  EDUCATION  AND  HEALTHCARE  MISSION.  IN
 S. 8307--C                         69                         A. 8807--C
 
 CONDUCTING  ITS  STUDY,  THE  ADVISORY BOARD WILL CONSIDER THE FOLLOWING
 FACTORS:
   (I) OVERALL HEALTHCARE SERVICE DELIVERY TRENDS AND MODELS;
    (II)  HISTORIC  AND  PROJECTED  FINANCIALS  FOR  THE HOSPITAL AND THE
 CAMPUS;
   (III) CURRENT STATE OF BUILDING INFRASTRUCTURE AND CAPITAL NEEDS;
   (IV) COMMUNITY HEALTHCARE NEEDS, OUTCOMES, AND HEALTH DISPARITIES;
   (V) EXISTING INPATIENT AND OUTPATIENT  SERVICE  OFFERINGS  AND  HEALTH
 OUTCOMES;
   (VI) CAPACITY AND AVAILABILITY OF INPATIENT AND OUTPATIENT SERVICES IN
 THE BROADER PRIMARY AND SECONDARY SERVICE AREAS;
   (VII)  EFFICIENCY  OF  OPERATIONS  AND  QUALITY OF HEALTHCARE SERVICES
 BENCHMARKING; AND
   (VIII) TRAINING NEEDS FOR STUDENTS AND EMPLOYMENT OUTCOMES.
   2. ADVISORY BOARD MEMBERS. THE ADVISORY BOARD  SHALL  CONSIST  OF  THE
 FOLLOWING MEMBERS: (A) THE COMMISSIONER OF THE DEPARTMENT OF HEALTH; (B)
 ONE  REPRESENTATIVE  OF  ORGANIZED  LABOR  REPRESENTING EMPLOYEES AT THE
 STATE UNIVERSITY OF NEW YORK PURSUANT TO ARTICLE FOURTEEN OF  THE  CIVIL
 SERVICE  LAW, WHO SHALL BE APPOINTED BY THE GOVERNOR UPON RECOMMENDATION
 OF THE PRESIDENT OF  THE  UNION  REPRESENTING  THE  GREATEST  NUMBER  OF
 EMPLOYEES  AT  SUNY DOWNSTATE; (C) ONE MEMBER APPOINTED BY THE TEMPORARY
 PRESIDENT OF THE SENATE; (D) ONE MEMBER APPOINTED BY THE SPEAKER OF  THE
 ASSEMBLY;  (E)  THREE  MEMBERS APPOINTED BY THE GOVERNOR; (F) ONE MEMBER
 APPOINTED BY THE GOVERNOR UPON  THE  JOINT  RECOMMENDATION  OF  BROOKLYN
 COMMUNITY BOARDS 9 AND 17; AND (G) THE CHANCELLOR OF THE STATE UNIVERSI-
 TY OF NEW YORK.
   3.  OUTREACH.  THE  ADVISORY  BOARD SHALL SOLICIT RECOMMENDATIONS FROM
 HEALTHCARE EXPERTS, COUNTY HEALTH DEPARTMENTS, COMMUNITY-BASED ORGANIZA-
 TIONS,  STATE  AND  REGIONAL  HEALTHCARE  INDUSTRY  ASSOCIATIONS,  LABOR
 UNIONS,  EXPERTS  IN  HOSPITAL OPERATIONS, AND OTHER INTERESTED PARTIES.
 THE ADVISORY BOARD SHALL HOLD NO LESS THAN THREE  PUBLIC  HEARINGS  WITH
 REQUISITE  PUBLIC  NOTICE  TO SOLICIT INPUT AND RECOMMENDATIONS FROM ANY
 INTERESTED PARTY.
   4. COMPENSATION. THE MEMBERS OF THE ADVISORY BOARD  SHALL  RECEIVE  NO
 COMPENSATION  FOR  THEIR  SERVICE AS MEMBERS, BUT SHALL BE ALLOWED THEIR
 ACTUAL AND NECESSARY EXPENSES  INCURRED  IN  THE  PERFORMANCE  OF  THEIR
 DUTIES.
   5. RECOMMENDATIONS AND REPORT. (A) THE ADVISORY BOARD SHALL COMPLETE A
 STUDY  AND  PROVIDE  WRITTEN  RECOMMENDATIONS  TO  PRIORITIZE HEALTHCARE
 SERVICES PROVIDED IN THE SUNY  DOWNSTATE  SERVICE  AREA.    THE  WRITTEN
 RECOMMENDATIONS  SHALL  INCLUDE  A  REASONABLE,  SCALABLE  AND  FISCALLY
 RESPONSIBLE PLAN FOR THE FINANCIAL HEALTH, VIABILITY AND  SUSTAINABILITY
 OF  SUNY  DOWNSTATE; PROVIDED, HOWEVER, THAT SUCH PLAN SHALL INCORPORATE
 UTILIZATION OF ALL AVAILABLE STATE AND FEDERALLY AVAILABLE  APPROPRIATED
 AMOUNTS,  AND  SHALL  NOT  EXCEED MORE THAN TWO HUNDRED FIFTY PERCENT OF
 SUCH AMOUNTS.
   (B) A REPORT OF THE ADVISORY BOARD'S RECOMMENDATIONS SHALL BE PROVIDED
 TO THE GOVERNOR, THE TEMPORARY PRESIDENT OF THE SENATE, AND THE  SPEAKER
 OF THE ASSEMBLY NO LATER THAN APRIL FIRST, TWO THOUSAND TWENTY-FIVE.
   6.  CERTIFICATE OF NEED. THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL
 AND THE COMMISSIONER OF HEALTH ARE PROHIBITED FROM REVIEWING OR  APPROV-
 ING  ANY CERTIFICATE OF NEED APPLICATION RELATED TO A REDUCTION IN INPA-
 TIENT SERVICES PURSUANT TO ANY ARTICLE OF LAW  OR  REGULATION  THAT  MAY
 AFFECT  A CHANGE TO INPATIENT SERVICES AT SUNY DOWNSTATE HEALTH SCIENCES
 UNIVERSITY UNTIL AT LEAST APRIL FIRST, TWO THOUSAND TWENTY-FIVE.
   § 2. This act shall take effect immediately.
 S. 8307--C                         70                         A. 8807--C
 
                                  PART NN
 
   Section  1.  Section  1-a  of part I of chapter 57 of the laws of 2022
 providing a one percent across the board payment increase to all  quali-
 fying fee-for-service Medicaid rates, as added by section 8 of part E of
 chapter 57 of the laws of 2023, is amended to read as follows:
   §  1-a.  Notwithstanding any provision of law to the contrary, for the
 state fiscal years beginning April 1,  2023,  and  thereafter,  Medicaid
 payments made for the operating component of hospital inpatient services
 shall  be  subject  to  a  uniform  rate  increase of seven and one-half
 percent in addition to the increase contained in  section  one  of  this
 act,  subject  to  the  approval  of  the commissioner of health and the
 director of the budget.   Notwithstanding any provision of  law  to  the
 contrary, for the state fiscal years beginning April 1, 2023, and there-
 after,  Medicaid  payments  made for the operating component of hospital
 outpatient services shall be subject to a uniform rate increase  of  six
 and  one-half  percent  in addition to the increase contained in section
 one of this act, subject to the approval of the commissioner  of  health
 and the director of the budget.  NOTWITHSTANDING ANY PROVISION OF LAW TO
 THE  CONTRARY, FOR THE PERIOD APRIL 1, 2024 THROUGH MARCH 31, 2025 MEDI-
 CAID PAYMENTS MADE FOR HOSPITAL SERVICES SHALL BE INCREASED BY AN AGGRE-
 GATE AMOUNT OF UP TO $525,000,000 IN ADDITION TO THE INCREASE  CONTAINED
 IN  SECTIONS  ONE  AND  ONE-B OF THIS ACT SUBJECT TO THE APPROVAL OF THE
 COMMISSIONER OF HEALTH  AND  THE  DIRECTOR  OF  THE  BUDGET.  Such  rate
 [increase]  INCREASES  shall  be  subject  to  federal financial partic-
 ipation.
   § 2. Section 1-a of part I of chapter 57 of the laws of 2022 providing
 a one percent across the board payment increase to all  qualifying  fee-
 for-service  Medicaid  rates, as added by section 7 of part I of chapter
 57 of the laws of 2023, is amended to read as follows:
   § [1-a] 1-B.  Notwithstanding any provision of law  to  the  contrary,
 for  the  state  fiscal  years  beginning April 1, 2023, and thereafter,
 Medicaid payments made for the operating component of residential health
 care facilities services shall be subject to a uniform rate increase  of
 6.5  percent  in  addition to the increase contained in subdivision 1 of
 section 1 of this part, subject to the approval of the  commissioner  of
 the department of health and the director of the division of the budget;
 provided,  however,  that  such  Medicaid payments shall be subject to a
 uniform rate increase of up to 7.5 percent in addition to  the  increase
 contained  in  subdivision  1  of section 1 of this part contingent upon
 approval of the commissioner of the department of health,  the  director
 of the division of the budget, and the Centers for Medicare and Medicaid
 Services.  NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, FOR THE
 PERIOD  APRIL  1, 2024 THROUGH MARCH 31, 2025 MEDICAID PAYMENTS MADE FOR
 NURSING HOME SERVICES SHALL BE INCREASED BY AN AGGREGATE AMOUNT OF UP TO
 $285,000,000 IN ADDITION TO THE INCREASE CONTAINED IN SECTIONS  ONE  AND
 ONE-C  OF THIS ACT SUBJECT TO THE APPROVAL OF THE COMMISSIONER OF HEALTH
 AND THE DIRECTOR OF THE BUDGET. Such rate [increase] INCREASES shall  be
 subject to federal financial participation.
   § 3. Section 1-b of part I of chapter 57 of the laws of 2022 providing
 a  one  percent across the board payment increase to all qualifying fee-
 for-service Medicaid rates, as added by section 7 of part I  of  chapter
 57 of the laws of 2023, is amended to read as follows:
   § [1-b] 1-C. Notwithstanding any provision of law to the contrary, for
 the state fiscal years beginning April 1, 2023, and thereafter, Medicaid
 payments made for the operating component of assisted living programs as
 S. 8307--C                         71                         A. 8807--C
 
 defined  by  paragraph  (a)  of  subdivision one of section 461-l of the
 social services law shall be subject to a uniform rate increase  of  6.5
 percent  in  addition  to  the increase contained in section one of this
 part,  subject  to the approval of the commissioner of the department of
 health and the director of division of the budget.  NOTWITHSTANDING  ANY
 PROVISION  OF  LAW TO THE CONTRARY, FOR THE PERIOD APRIL 1, 2024 THROUGH
 MARCH 31, 2025, MEDICAID PAYMENTS FOR ASSISTED LIVING PROGRAMS SHALL  BE
 INCREASED  BY UP TO $15,000,000 IN ADDITION TO THE INCREASE CONTAINED IN
 THIS SECTION SUBJECT TO THE APPROVAL OF THE COMMISSIONER OF  HEALTH  AND
 THE  DIRECTOR  OF  THE  BUDGET.  Such rate [increase] INCREASES shall be
 subject to federal financial participation.
   § 4. Part I of chapter 57 of the laws of 2022 providing a one  percent
 across  the  board  payment  increase  to all qualifying fee-for-service
 Medicaid rates, is amended by adding  a  new  section  1-d  to  read  as
 follows:
   § 1-D. SUCH INCREASES AS ADDED BY THE CHAPTER OF THE LAWS OF 2024 THAT
 ADDED  THIS  SECTION  MAY TAKE THE FORM OF INCREASED RATES OF PAYMENT IN
 MEDICAID  FEE-FOR-SERVICE  AND/OR  MEDICAID  MANAGED  CARE,   LUMP   SUM
 PAYMENTS,  OR  STATE  DIRECTED PAYMENTS UNDER 42 CFR 438.6(C). SUCH RATE
 INCREASES SHALL BE SUBJECT TO FEDERAL FINANCIAL PARTICIPATION.
   § 5. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2024.
   § 2. Severability clause. If any clause, sentence, paragraph, subdivi-
 sion,  section  or  part  of  this act shall be adjudged by any court of
 competent jurisdiction to be invalid, such judgment  shall  not  affect,
 impair,  or  invalidate  the remainder thereof, but shall be confined in
 its operation to the clause, sentence, paragraph,  subdivision,  section
 or part thereof directly involved in the controversy in which such judg-
 ment shall have been rendered. It is hereby declared to be the intent of
 the  legislature  that  this  act  would  have been enacted even if such
 invalid provisions had not been included herein.
   § 3. This act shall take effect immediately  provided,  however,  that
 the applicable effective date of Parts A through NN of this act shall be
 as specifically set forth in the last section of such Parts.