Senate Bill S2990

2009-2010 Legislative Session

Provides for increasing the applicability of brand name and generic prescription drug and other medical services co-payments for medicaid recipients

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Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Feb 17, 2010	print number 2990a
Feb 17, 2010	amend and recommit to health
Jan 06, 2010	referred to health
May 13, 2009	committee discharged and committed to health
Mar 09, 2009	referred to social services

Bill Amendments

Original

A (Active)

co-Sponsors

2009-S2990 - Details

Current Committee:: Senate Health
Law Section:: Social Services Law
Laws Affected:: Amd §367-a, Soc Serv L
Versions Introduced in Other Legislative Sessions:: 2011-2012: S3221
2013-2014: S1436
2015-2016: S4290

2009-S2990 - Summary

Provides for increasing the applicability of brand name and generic prescription drug and other medical services, except diagnostic services, co-payments for medicaid recipients.

2009-S2990 - Sponsor Memo

                                 BILL NUMBER:  S2990

 TITLE OF BILL :

An act to amend the social services law, in relation to medicaid
co-payments for prescription drugs and other services

 PURPOSE OF THE BILL :

This bill provides for increasing brand name and generic prescription
drug and other medical services co-payments for Medicaid recipients
and requires prepayment.

 SUMMARY OF SPECIFIC PROVISIONS :

§ 1- Amends paragraph (b) of subdivision 6 of § 367-a of the Social
Services Law to redefine those persons not subject to co-payments for
services.

§ 2- Amends the opening paragraph of paragraph (d) of subdivision 6 of
§ 367-a of the Social Services Law to require that co-payments shall
apply to all services covered by the title, except diagnostic
services, and to require that co-payments must be pre-paid at the time
when services are rendered.

§ 3- Authorizes the Commissioner of Health to promulgate or adopt any

rules or regulations necessary to implement the provisions of this
Act.

§ 4- Effective date.

 JUSTIFICATION :

The rising cost of the Medicaid program is threatening the ability for
the State and its counties to maintain the current program. Just as
private health insurance requires co-payments for services in order to
rein in costs of health care, New York State should implement the same
model to rein in costs and ensure that the cost of the Medicaid
program can be sustained. In an effort to modernize the Medicaid
program so that it is similar to private health insurance, this
legislation institutes co-payments for all services, except diagnostic
services. To ensure that co-payments to the providers of the services
are received, prepayment of the co-payments must be made when the
services are rendered. Currently, the law does not allow for providers
to withhold services if the recipient states that he or she can not
pay the copayment. However, abuse of this provision has become
increasingly apparent, and therefore steps must be taken to ensure
that providers receive their payments for the services that they
provide to the consumers.

 PRIOR LEGISLATIVE HISTORY :

2005-2006: A.5466-C/S.3578-B.
2007-2008: S.3292/A.4676 -- HEALTH/Health

 FISCAL IMPLICATIONS :

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

 EFFECTIVE DATE :
This act shall take effect immediately.

2009-S2990 - Bill Text download pdf

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

                                  2990

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                              March 9, 2009
                               ___________

Introduced  by  Sens. RANZENHOFER, LARKIN, PADAVAN, VOLKER -- read twice
  and ordered printed, and when printed to be committed to the Committee
  on Social Services

AN ACT to amend the social services law, in relation to medicaid co-pay-
  ments for prescription drugs and other services

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

  Section  1.  Paragraph  (b)  of  subdivision 6 of section 367-a of the
social services law, as added by chapter 41 of the laws of 1992, subpar-
agraph (iii) as amended by chapter 843 of the laws of 1992 and  subpara-
graph  (iv) as amended by section 40 of part C of chapter 58 of the laws
of 2005, is amended to read as follows:
  (b) Co-payments shall apply to all eligible persons for  the  services
defined in paragraph (d) of this subdivision with the exception of:
  (i) [individuals under twenty-one years of age;
  (ii) pregnant women;
  (iii)]  individuals  who are inpatients in a medical facility who have
been required to spend all of their  income  for  medical  care,  except
their  personal needs allowance or residents of community based residen-
tial facilities licensed by the office of mental health or the office of
mental retardation and developmental disabilities who have been required
to spend all of their income, except their personal needs allowance;
  [(iv) individuals enrolled  in  health  maintenance  organizations  or
other  entities  which  provide  comprehensive health services, or other
managed care programs for services covered by such programs, except that
such persons, other than persons  otherwise  exempted  from  co-payments
pursuant  to  subparagraphs  (i), (ii), (iii) and (v) of this paragraph,
and other than those persons  enrolled  in  a  managed  long  term  care
program,  shall  be  subject to co-payments as described in subparagraph
(v) of paragraph (d) of this subdivision;] and

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03979-01-9

S. 2990                             2

  [(v)] (II) any other individuals required to be  excluded  by  federal
law or regulations.
  S  2.  The  opening  paragraph  of  paragraph  (d) of subdivision 6 of
section 367-a of the social services law, as added by chapter 41 of  the
laws of 1992, is amended to read as follows:
  Co-payments  shall  apply  to  [the following] ALL services COVERED BY
THIS TITLE, EXCEPT DIAGNOSTIC SERVICES, AND SHALL  BE  PRE-PAID  AT  THE
TIME  WHEN  SUCH  SERVICES  ARE RENDERED, subject to such exceptions for
subcategories of these services as recognized  by  the  commissioner  OF
HEALTH in regulations, provided in accordance with section three hundred
sixty-five-a  of this [article] TITLE and the regulations of the depart-
ment, to the extent permitted by title XIX of the federal social securi-
ty act:
  S 3. The commissioner of health is authorized to promulgate  or  adopt
any  rules  or regulations necessary to implement the provisions of this
act and any co-payments, procedures, forms,  or  instructions  necessary
for such implementation may be adopted and issued on or after the effec-
tive date of this act. Notwithstanding any inconsistent provision of the
state  administrative  procedure act or any other provision of law, rule
or regulation, the commissioner of  health  and  the  superintendent  of
insurance  and  any appropriate council are authorized to adopt or amend
or promulgate on an emergency basis any regulation he  or  she  or  such
council  determines  necessary to implement any provision of this act on
its effective date.
  S 4. This act shall take effect immediately and  shall  be  deemed  to
have been in full force and effect on and after April 1, 2006, provided,
however,  that the amendments to paragraphs (b) and (d) of subdivision 6
of section 367-a of the social services law made by sections one and two
of this act shall not affect the repeal of such paragraphs and shall  be
deemed repealed therewith.

co-Sponsors

2009-S2990A (ACTIVE) - Details

Current Committee:: Senate Health
Law Section:: Social Services Law
Laws Affected:: Amd §367-a, Soc Serv L
Versions Introduced in Other Legislative Sessions:: 2011-2012: S3221
2013-2014: S1436
2015-2016: S4290

2009-S2990A (ACTIVE) - Summary

Provides for increasing the applicability of brand name and generic prescription drug and other medical services, except diagnostic services, co-payments for medicaid recipients.

2009-S2990A (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S2990A

 TITLE OF BILL :
An act to amend the social services law, in relation to medicaid
co-payments for prescription drugs and other services


 PURPOSE OF THE BILL :
This bill provides for increasing brand name and generic prescription
drug and other medical services co-payments for Medicaid recipients
and requires prepayment.

 SUMMARY OF SPECIFIC PROVISIONS :
 SECTION 1  - Amends paragraph (b) of subdivision 6 of § 367-a of the
Social Services Law to redefine those persons not subject to
co-payments for services.

 SECTION 2  - Amends the opening paragraph of paragraph (d) of
subdivision 6 of § 367-a of the Social Services Law to require that
co-payments shall apply to all services covered by the title, except
diagnostic services, and to require that co-payments must be pre-paid
at the time when services are rendered.

 SECTION 3  - Authorizes the Commissioner of Health to promulgate or
adopt any rules or regulations necessary to implement the provisions
of this Act.

 SECTION 4  - Effective date.

 JUSTIFICATION :
The rising cost of the Medicaid program is threatening the ability for
the State and its counties to maintain the current program. Just as
private health insurance requires co-payments for services in order to
rein in costs of health care, New York State should implement the same
model to rein in costs and ensure that the cost of the Medicaid
program can be sustained. In an effort to modernize the Medicaid
program so that it is similar to private health insurance, this
legislation institutes co-payments for all services, except diagnostic
services. To ensure that co-payments to the providers of the services
are received, prepayment of the co-payments must be made when the
services are rendered. Currently, the law does not allow for providers
to withhold services if the recipient states that he or she can not
pay the copayment.  However, abuse of this provision has become
increasingly apparent, and therefore steps must be taken to ensure
that providers receive their payments for the services that they
provide to the consumers.

 PRIOR LEGISLATIVE HISTORY :
2005-06 - S.3578-B/A.5466-C
2007-08 - S.3292/A.4676 -- HEALTH/Health
2009 - S.2990 -- HEALTH

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

 EFFECTIVE DATE :
This act shall take effect immediately provided, however, that the
amendments to paragraphs (b) of subdivision 6 of section 367-a of the
social services law made by sections one and two of this act shall not
affect the repeal of such paragraphs and shall be deemed repealed
therewith.

2009-S2990A (ACTIVE) - Bill Text download pdf

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

                                 2990--A

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                              March 9, 2009
                               ___________

Introduced  by  Sens. RANZENHOFER, LARKIN, PADAVAN, VOLKER -- read twice
  and ordered printed, and when printed to be committed to the Committee
  on Social Services --  recommitted  to  the  Committee  on  Health  in
  accordance  with  Senate  Rule 6, sec. 8 -- committee discharged, bill
  amended, ordered reprinted as amended and recommitted to said  commit-
  tee

AN ACT to amend the social services law, in relation to medicaid co-pay-
  ments for prescription drugs and other services

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

  Section 1. Paragraph (b) of subdivision 6  of  section  367-a  of  the
social services law, as added by chapter 41 of the laws of 1992, subpar-
agraph  (iii) as amended by chapter 843 of the laws of 1992 and subpara-
graph (iv) as amended by section 40 of part C of chapter 58 of the  laws
of 2005, is amended to read as follows:
  (b)  Co-payments  shall apply to all eligible persons for the services
defined in paragraph (d) of this subdivision with the exception of:
  (i) [individuals under twenty-one years of age;
  (ii) pregnant women;
  (iii)] individuals who are inpatients in a medical facility  who  have
been  required  to  spend  all  of their income for medical care, except
their personal needs allowance or residents of community based  residen-
tial facilities licensed by the office of mental health or the office of
mental retardation and developmental disabilities who have been required
to spend all of their income, except their personal needs allowance;
  [(iv)  individuals  enrolled  in  health  maintenance organizations or
other entities which provide comprehensive  health  services,  or  other
managed care programs for services covered by such programs, except that
such  persons,  other  than  persons otherwise exempted from co-payments
pursuant to subparagraphs (i), (ii), (iii) and (v)  of  this  paragraph,
and  other  than  those  persons  enrolled  in  a managed long term care

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03979-03-0

S. 2990--A                          2

program, shall be subject to co-payments as  described  in  subparagraph
(v) of paragraph (d) of this subdivision;] and
  [(v)]  (II)  any  other individuals required to be excluded by federal
law or regulations.
  S 2. The opening paragraph  of  paragraph  (d)  of  subdivision  6  of
section  367-a of the social services law, as added by chapter 41 of the
laws of 1992, is amended to read as follows:
  Co-payments shall apply to [the following]  ALL  services  COVERED  BY
THIS  TITLE,  EXCEPT  DIAGNOSTIC  SERVICES, AND SHALL BE PRE-PAID AT THE
TIME WHEN SUCH SERVICES ARE RENDERED, subject  to  such  exceptions  for
subcategories  of  these  services  as recognized by the commissioner OF
HEALTH in regulations, provided in accordance with section three hundred
sixty-five-a of this [article] TITLE and the regulations of the  depart-
ment, to the extent permitted by title XIX of the federal social securi-
ty act:
  S  3.  The commissioner of health is authorized to promulgate or adopt
any rules or regulations necessary to implement the provisions  of  this
act  and  any  co-payments, procedures, forms, or instructions necessary
for such implementation may be adopted and issued on or after the effec-
tive date of this act. Notwithstanding any inconsistent provision of the
state administrative procedure act or any other provision of  law,  rule
or  regulation,  the  commissioner  of  health and the superintendent of
insurance and any appropriate council are authorized to adopt  or  amend
or  promulgate  on  an  emergency basis any regulation he or she or such
council determines necessary to implement any provision of this  act  on
its effective date.
  S  4.  This act shall take effect immediately; provided, however, that
the amendments to paragraphs (b) and (d) of  subdivision  6  of  section
367-a  of  the  social services law made by sections one and two of this
act shall not affect the repeal of such paragraphs and shall  be  deemed
repealed therewith.

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Senate Bill S2990

Sponsored By

Archive: Last Bill Status - In Senate Committee Health Committee

Actions

Bill Amendments

co-Sponsors

2009-S2990 - Details

2009-S2990 - Summary

2009-S2990 - Sponsor Memo

2009-S2990 - Bill Text download pdf

co-Sponsors

2009-S2990A (ACTIVE) - Details

2009-S2990A (ACTIVE) - Summary

2009-S2990A (ACTIVE) - Sponsor Memo

2009-S2990A (ACTIVE) - Bill Text download pdf

Comments

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Sponsored By

Michael H. Ranzenhofer

Archive: Last Bill Status - In Senate Committee Health Committee

Actions

Bill Amendments

co-Sponsors

William Larkin

Frank Padavan

Dale M. Volker

2009-S2990 - Details

2009-S2990 - Summary

2009-S2990 - Sponsor Memo

2009-S2990 - Bill Text download pdf

co-Sponsors

William Larkin

Frank Padavan

Dale M. Volker

2009-S2990A (ACTIVE) - Details

2009-S2990A (ACTIVE) - Summary

2009-S2990A (ACTIVE) - Sponsor Memo

2009-S2990A (ACTIVE) - Bill Text download pdf

Comments