S T A T E O F N E W Y O R K
________________________________________________________________________
6405
2009-2010 Regular Sessions
I N A S S E M B L Y
March 3, 2009
___________
Introduced by M. of A. ORTIZ, COLTON, EDDINGTON, ESPAILLAT, GREENE,
V. LOPEZ, J. RIVERA -- Multi-Sponsored by -- M. of A. CAHILL, COOK,
DIAZ, FARRELL, MAGEE, McENENY, PEOPLES, PERRY, SWEENEY, TOWNS, WEISEN-
BERG -- read once and referred to the Committee on Aging
AN ACT in relation to increasing access to pharmaceuticals for needy
seniors and the disabled through the expansion of eligibility for the
medicaid program
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. This act shall be known and may be cited as the "medicaid
prescription senior eligibility expansion program".
S 2. Legislative findings and intent. The legislature finds and
declares that states are looking for solutions to improve the access of
needy seniors to prescription medicines. Nearly thirty percent of medi-
care enrollees in the state have no coverage for pharmaceuticals, with
nearly a quarter of such enrollees living below the federal poverty
level. Furthermore, millions more elderly and disabled medicare enrol-
lees are underinsured for prescription drugs. A federal 1115 medicaid
waiver to extend prescription drug coverage to qualified medicare bene-
ficiaries and special low-income medicare beneficiaries would provide
meaningful access to prescription drugs for the state's poor and near-
poor senior population. The legislature further finds that a federal
1115 medicaid waiver enables the state to benefit from the well estab-
lished state-federal partnership in medicaid through access to federal
matching funds in addition to state funds.
S 3. Definitions. As used in this act:
1. "Department" means the department of health;
2. "Qualified medicare beneficiaries" means medicare beneficiaries
with incomes equal to or below one hundred percent of the federal pover-
ty level who are eligible for medicaid assistance for the Part A and
Part B medicare premiums and for medicare deductibles and co-insurance
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD09921-01-9
A. 6405 2
requirements as set forth in section 1905(p)(1) of title XIX of the
social security act; and
3. "Specified low-income medicare beneficiaries" means medicare bene-
ficiaries who have incomes greater than one hundred percent of the
federal poverty level and less than and equal to one hundred twenty
percent of the federal poverty level and meet the requirements set forth
in section 1902(a)(10) (E)(iii) of title XIX of the social security act.
S 4. Medicaid prescription senior eligibility expansion program. 1.
There is hereby established a medicaid prescription senior eligibility
expansion program. In order to become eligible for the program, an indi-
vidual must meet the following requirements:
a. be a United States citizen or a lawfully admitted alien;
b. be a state resident;
c. be at least sixty-five years of age or an individual between the
ages of nineteen and sixty-four who is otherwise eligible for benefits
under title II of the social security act;
d. meet the definition of a qualified medicare beneficiary or a speci-
fied low-income medicare beneficiary as set forth in section three of
this act; and
e. be ineligible for and/or not receiving a prescription drug benefit
through a medicare supplemental policy or any other third party payer
prescription benefit.
2. Individuals eligible for the medicaid prescription senior eligibil-
ity expansion program shall be entitled to the medicaid prescription
drug coverage as provided to medicaid recipients as set forth in title
XIX of the social security act.
S 5. Program administration. 1. The department shall administer the
medicaid prescription senior eligibility expansion program.
2. The department shall apply for a federal medicare 1115 demon-
stration waiver from the federal secretary of health and human services
to expand medicaid eligibility for the purposes of prescription drug
coverage to qualified medicare beneficiaries and specified low-income
medicare beneficiaries under the medicaid prescription senior eligibil-
ity expansion program.
3. The department shall promulgate and adopt rules and regulations as
are necessary to implement the provisions of the medicaid prescription
senior eligibility expansion program in a cost effective manner that are
consistent with the purposes of such program.
S 6. Annual report. The department shall submit an annual report to
the legislature beginning one year from the date of implementation of
the medicaid prescription senior eligibility expansion program.
S 7. This act shall take effect immediately.