NY State Assembly Bill 2009-A8977

Assembly Bill A8977

Signed By Governor

2009-2010 Legislative Session

Establishes definitions for "cash medical support", "reasonable in cost" and "reasonably accessible"; repealer

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Archive: Last Bill Status - Signed by Governor

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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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jul 11, 2009	signed chap.215
Jul 10, 2009	delivered to governor
Jul 09, 2009	returned to assembly repassed senate vote reconsidered - restored to third reading
Jun 30, 2009	passed senate 3rd reading cal.665 substituted for s4214b
Jun 22, 2009	referred to rules delivered to senate passed assembly ordered to third reading rules cal.622 rules report cal.622 reported reported referred to rules
Jun 18, 2009	reported referred to codes
Jun 17, 2009	referred to judiciary

Votes

- Jul 9, 2009 - Floor Vote
  A8977
  
  62
  
  Aye
  
  0
  
  Nay
  
  0
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  - - Floor Vote: Jul 9, 2009
      
      aye (62)
      
      Adams
      
      Addabbo Jr.
      
      Alesi
      
      Aubertine
      
      Bonacic
      
      Breslin
      
      DeFrancisco
      
      Diaz
      
      Dilan
      
      Duane
      
      Espada
      
      Farley
      
      Flanagan
      
      Foley
      
      Fuschillo
      
      Golden
      
      Griffo
      
      Hannon
      
      Hassell-Thompson
      
      Huntley
      
      Johnson
      
      Johnson
      
      Klein
      
      Krueger
      
      Kruger
      
      LaValle
      
      Lanza
      
      Larkin
      
      Leibell
      
      Libous
      
      Little
      
      Marcellino
      
      Maziarz
      
      McDonald
      
      Monserrate
      
      Montgomery
      
      Morahan
      
      Nozzolio
      
      Onorato
      
      Oppenheimer
      
      Padavan
      
      Parker
      
      Perkins
      
      Ranzenhofer
      
      Robach
      
      Saland
      
      Sampson
      
      Savino
      
      Schneiderman
      
      Serrano
      
      Seward
      
      Skelos
      
      Smith
      
      Squadron
      
      Stachowski
      
      Stavisky
      
      Stewart-Cousins
      
      Thompson
      
      Valesky
      
      Volker
      
      Winner
      
      Young

2009-A8977 (ACTIVE) - Details

See Senate Version of this Bill:: S4214
Law Section:: Family Court Act
Laws Affected:: Rpld & add §413 sub 1 ¶(c) sub¶ 5, §416 sub (f), amd §§514 & 545, Fam Ct Act; rpld & add §240 sub 1-b ¶(c) sub¶ 5, sub 1 ¶(d), Dom Rel L; amd §5241, CPLR

2009-A8977 (ACTIVE) - Summary

Establishes definitions for "cash medical support", "reasonable in cost" and "reasonably accessible"; amends the priority for deductions via an income execution.

2009-A8977 (ACTIVE) - Sponsor Memo

                                BILL NUMBER:A8977                REVISED 6/22/09

TITLE OF BILL:  An act to amend the family court act and the domestic
relations law, in relation to establishing definitions for "cash medical
support", and when health insurance benefits are "reasonable in cost"
and "reasonably accessible"; to amend the civil practice law and rules,
in relation to amending the priority for deductions via an income
execution; and to repeal certain provisions of the family court act and
the domestic relations law relating thereto

PURPOSE OF BILL:  This bill would enact federal mandates set forth in
the final medical support regulations for the child support enforcement
program, released by the federal Department of Health and Human Services
on July 21, 2008. The federal regulations require each state to define
when private health insurance benefits, an element of support, are
"reasonable in cost" and when such health insurance shall be considered
"reasonably accessible."

SUMMARY OF PROVISIONS:  Sections 1 and 2 of the bill would amend section
413 of the Family Court Act (FCA) and section 240 of the Domestic
Relations Law (DRL), respectively, to require the court to determine the
availability of private health insurance benefits, define the term "cash
medical support," and provide an income-based numeric standard for
determining when cash medical support should be ordered and the amount
of each parent's contribution. For children enrolled in the State Child
Health Insurance Program (SCHT), the portion of cash medical support

attributable to public coverage is the pro rata share of the family
contribution under the State's child health insurance plan. For children
enrolled in the Medical Assistance (MA) program, the non-custodial
parent's obligation for the portion of cash medical support attributable
to public benefits is the lesser of (1) the amount that would be
required under SCRIP using the combined income of the parents as if the
child(ren) were in a two-parent household; or, (2) the actual amount
expended by the MA program. For children enrolled in either program, the
total cash medical support obligation for costs attributable to public
coverage or benefits shall not exceed 5% of the non-custodial parent's
income or reduce the parent's income below the self-support reserve.

Sections 3 and 4 of the bill would amend section 416 of the FCA and
section 240 of the DRL, respectively, to define the terms "reasonable in
cost" and "reasonably accessible," to aid the court in determining
whether private health insurance benefits are available to a child.

Sections 5 and 6 of the bill would amend section 416(e)(2)(iii) of the
FCA and section 240(1)(c)(2)(iii) of the DRL. These sections provide
that when private health insurance benefits are unavailable, the custo-
dial parent must be directed to apply for SCRIP or MA. The current
language allowing the court to apportion the cost of any premium, family
contribution, or health expense associated with participation in such
plan or program is deleted.

Sections 7 and 8 of the bill would amend section 416(f) of the FCA and
section 240(1)(d) of the DRL. These sections currently provide for the
proration of costs between the parties where private health insurance is
ordered. The subdivisions are amended to state that the cost of private
health insurance, or the cost of any premium, family contribution, or
health expense incurred as a result of enrollment in SCRIP or the MA
program shall be deemed cash medical support and each parent's contrib-
ution will be determined under the amended provisions in sections 1 and
2 of this bill.

Sections 9 and 10 of the bill would amend sections 514 and 545 of the
FCA, respectively, to provide that the necessary expenses incurred by or
for the mother in connection with her pregnancy, confinement and recov-
ery shall be deemed a cash medical support obligation and the court
shall determine the obligation of either or both parties to contribute
to the cost pursuant to section 413 of the FCA, the Child Support Stand-
ards Act.

Section 11 of the bill would amend section 5241(b)(2)(i) of the Civil
Practice Law and Rules (CPLR) to correct a statutory reference.

Section 12 of the bill would amend section 5241(h) of the CPLR to revise
the priority of deductions made by an employer or income payor in
response to an income execution, medical support execution or income
deduction order. Under this bill, the employer will first deduct the
amount due for current child support obligations, then the cost of
health insurance premiums, then the additional amount to reduce support
arrears.

Section 13 of the bill would provide that the amendments would be effec-
tive on the ninetieth day after it shall become law and apply to any
proceeding to establish or modify a child support obligation, including
a medical support obligation, commenced on or after that date.

EXISTING LAW:  Various sections of the FCA, the DRL and the Social
Services Law (SSL) contain provisions concerning the obligation of
parents to support their children and provide procedures for the estab-
lishment of paternity and the establishment, enforcement and modifica-
tion of child support obligations, including the cost of health insur-
ance coverage and other health care expenses. Section 5241 of the CPLR
contains the procedure associated with utilizing income executions and
medical support executions for support enforcement.

JUSTIFICATION:  The provision of health insurance benefits and medical
support is an important component of child support. This bill would
allow New York to comply with the federal final rules (45 CFR 302.56;
303.31) pertaining to medical support, which requires states to define
the terms "reasonable in cost" and "reasonably accessible" in relation
to the availability of private health insurance, and also the federal
mandate to set a reasonable income-based numeric standard for determin-
ing when cash medical support should be ordered.

Under federal regulations, private health insurance is considered
"available" when it is reasonable in cost and reasonably accessible as
those terms are defined by a state. In the event that private health
insurance is not "available", the regulations mandate that states seek
an order for "cash medical support" until such time as private health
insurance becomes available. Additionally, the final medical support
regulations allow states to define when it is appropriate to seek cash
medical support in addition to private health insurance benefits.

This bill would define "cash medical support" under the child support
standards as the amount to be paid for the cost of health insurance
provided by a public entity or by a parent through an employer or organ-
ization, and/or for other health care costs not covered by insurance. It
sets out the method of apportioning the cost of the different types of
cash medical support, such as private health insurance premiums, bene-
fits provided by the SCHIP and the MA program, as well as health care
expenses not covered by health insurance. The bill also limits the
establishment of cash medical support obligations in support orders so
that the non-custodial parent's income will not be reduced below the
self-support reserve (135% of the federal poverty income guidelines for
a single person).

This bill would adopt the federal option for the State definition of
cash medical support and provide a method for the court to determine the
parties' obligation to provide each of the three types of cash medical
support. First, if private health insurance benefits are determined by a
court to be "available" (i.e., the cost of securing such benefits is 5%
or less of the parties' gross income), the court must order the non-cus-
todial parent to pay his or her pro rata share of the health insurance
premium. The primary goal of these provisions is to ensure that private
health insurance is utilized when available at reasonable cost. The use
of private health insurance may reduce the cost of health care for the
child expended by the parents and the public.

Second, if the child covered by private health insurance incurs addi-
tional unreimbursed health care expenses, the court shall order the
non-custodial parent to pay his or her pro rata share of the reasonable
cash medical support expenses. Orders requiring the non-custodial parent
to pay his or her share of unreimbursed health care expenses are
currently a mandatory provision under the Child Support Standards Act.
The bill continues this obligation. When combined with the cost to the
parent for private health insurance or public coverage, the total
payment ordered by the court for cash medical support may not cause his
or her income to fall below the self-support reserve.

Third, where private health insurance benefits are determined by the
court not to be "available," the custodial parent will be ordered, in
accordance with current law, to apply for SCHIP or MA. If the child is
determined eligible for SCHIP, the portion of cash medical support asso-
ciated with public coverage or benefits is the prorated share of the
family contribution under SCHIP. For children, enrolled in MA (regard-
less of whether it is managed care or fee-for-service), the non-custodi-

al parent's obligation towards the portion of cash medical support for
public coverage or benefits is the lesser of the amount that would be
required under SCHIP using the combined income of the parents as if the
children) were in a two-parent household, or the actual amount expended
by the MA program. In managed care cases, the court will order a monthly
obligation for the portion of cash medical support associated with
public coverage. In fee-for-service cases, for the portion of cash
medical support associated with public coverage, the court will set
forth in the order the maximum annual cash support obligation based on
the amount that would be required under SCHIP in a two-parent household.

For children enrolled in either program, in no case shall the cash
medical support obligation for public coverage or benefits exceed 5% of
the non-custodial patent's gross income, or the difference between the
non-custodial parent's income and the self-support reserve, whichever is
less.

The bill would also define two terms that are considered by courts in
determining whether private health insurance benefits are available to a
child. Private health insurance benefits must be "reasonable in cost"
and "reasonably accessible" in order to be deemed available.

The first term, "reasonable in cost," is defined in this bill to mean
that the cost of premiums and deductibles for private health insurance
attributable to the child(ren) does not exceed five percent of the
combined parental gross income. However, no benefits will be considered
"reasonable in cost" if the cost to a parent of extending coverage to
the child(ren) would reduce the income of that parent below the self-
support reserve. In addition, upon a finding of the court that the cost
borne by a parent is unjust or inappropriate, the presumption of cost
reasonableness may be rebutted.

Pursuant to the federal regulations, where the child(ren) will be added
to existing benefits, the "cost" to be considered in determining reason-
ableness is the cost of adding the child who is the subject of the
order. However, the "cost" to be considered in determining reasonable-
ness is the difference between self-only (individual) benefits and
health insurance benefits which extend to all the children who are the
subject of the order. This would include determining the portion of any
deductible attributable to the child(ren) which should be considered for
purposes of this analysis.  Only the incremental increase in the deduct-
ible associated with adding the child(ren) to existing coverage or, the
incremental difference between the deductible for self-only coverage and
coverage extending to the child, is to be considered.

"Reasonably accessible" is defined to mean that the child lives within
the geographic area covered by the plan or lives within thirty minutes
or thirty miles of services covered by the health insurance benefits or
through benefits provided under a reciprocal agreement.  The presumption
of accessibility may be rebutted for good cause shown which may include,
but is not limited to, a consideration of the special health needs of
the subject child.

In addition to complying with the federal mandate, these provisions will
improve child support orders. Currently, the courts do not have a stand-
ard definition of reasonable cost. Different courts apply different
standards, and even calculate the cost of health insurance differently.
Greater consistency in determining whether health insurance is available
- that is, reasonable in cost and reasonably accessible - is anticipated
as a result of this bill. In addition, the court is given flexibility to
address the parties' individual circumstances and set an order that is
just and appropriate.

The bill would also clarify that the cost of private health insurance
premiums or any premium, family contribution, or health expense associ-
ated with enrollment of a child in SCRIP or MA is cash medical support.
The proposed amendments refer the court to the Child Support Standards
Act to calculate the amount of each parties' contribution to the cost of
these expenses.

The bill would further clarify that the necessary expenses incurred by
or for the mother in connection with her pregnancy, confinement and
recovery are a cash medical support obligation to the father. Where
these expenses were paid under the MA program on the mother's behalf,
the father's liability to the social services district and the State
will be subject to the same cap and low income protections as cash
medical support for other MA expenses.

Finally, the bill amends the priorities for income withholding by an
employer or other income payor. Consistent with the goal of providing
private health insurance benefits whenever possible, deductions to
satisfy support obligations will have the following priority:
(1)current support obligations (2) health insurance premiums; (3)
arrears.

LEGISLATIVE HISTORY:  In the 2008 Legislative Session, provisions simi-
lar to sections three and four of this bill were part of S.8340, but
S.8340 was not reported from the Senate Rules Committee.

FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:  Failure to pass
this bill will put the State out of IV-D Plan compliance and subject the
State to elimination of federal reimbursement.

EFFECTIVE DATE:  The bill would take effect on the ninetieth day after
it shall become law and apply to any proceeding to establish or modify a
child support obligation, including a medical support obligation,
commenced on or after that date.

2009-A8977 (ACTIVE) - Bill Text download pdf

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

                                  8977

                       2009-2010 Regular Sessions

                          I N  A S S E M B L Y

                              June 17, 2009
                               ___________

Introduced  by M. of A. WEINSTEIN -- (at request of the Office of Tempo-
  rary and Disability Assistance) --  read  once  and  referred  to  the
  Committee on Judiciary

AN  ACT to amend the family court act and the domestic relations law, in
  relation to establishing definitions for "cash medical  support",  and
  when  health  insurance benefits are "reasonable in cost" and "reason-
  ably accessible"; to amend  the  civil  practice  law  and  rules,  in
  relation  to  amending  the  priority  for  deductions  via  an income
  execution; and to repeal certain provisions of the  family  court  act
  and the domestic relations law relating thereto

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

  Section 1. Subparagraph 5 of paragraph (c) of subdivision 1 of section
413 of the family court act is REPEALED and  a  new  subparagraph  5  is
added to read as follows:
  (5)  THE  COURT  SHALL  DETERMINE  THE  PARTIES' OBLIGATION TO PROVIDE
HEALTH INSURANCE BENEFITS PURSUANT TO SECTION FOUR  HUNDRED  SIXTEEN  OF
THIS PART AND TO PAY CASH MEDICAL SUPPORT AS PROVIDED UNDER THIS SUBPAR-
AGRAPH.
  (I)  "CASH  MEDICAL SUPPORT" MEANS AN AMOUNT ORDERED TO BE PAID TOWARD
THE COST OF HEALTH INSURANCE PROVIDED BY A PUBLIC ENTITY OR BY A  PARENT
THROUGH  AN EMPLOYER OR ORGANIZATION, INCLUDING SUCH EMPLOYERS OR ORGAN-
IZATIONS WHICH ARE SELF  INSURED,  OR  THROUGH  OTHER  AVAILABLE  HEALTH
INSURANCE  OR  HEALTH  CARE COVERAGE PLANS, AND/OR FOR OTHER HEALTH CARE
EXPENSES NOT COVERED BY INSURANCE.
  (II) WHERE HEALTH INSURANCE BENEFITS PURSUANT  TO  PARAGRAPH  ONE  AND
SUBPARAGRAPHS  (I)  AND  (II)  OF  PARAGRAPH  TWO  OF SUBDIVISION (E) OF
SECTION FOUR HUNDRED SIXTEEN OF THIS PART ARE DETERMINED BY THE COURT TO
BE AVAILABLE, THE COST OF PROVIDING HEALTH INSURANCE BENEFITS  SHALL  BE
PRORATED  BETWEEN  THE  PARTIES  IN THE SAME PROPORTION AS EACH PARENT'S
INCOME IS TO THE COMBINED PARENTAL INCOME. IF THE  CUSTODIAL  PARENT  IS

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD07704-07-9

A. 8977                             2

ORDERED  TO  PROVIDE  SUCH BENEFITS, THE NON-CUSTODIAL PARENT'S PRO RATA
SHARE OF SUCH COSTS SHALL BE ADDED TO THE BASIC SUPPORT  OBLIGATION.  IF
THE NON-CUSTODIAL PARENT IS ORDERED TO PROVIDE SUCH BENEFITS, THE CUSTO-
DIAL  PARENT'S  PRO  RATA SHARE OF SUCH COSTS SHALL BE DEDUCTED FROM THE
BASIC SUPPORT OBLIGATION.
  (III) WHERE HEALTH INSURANCE BENEFITS PURSUANT TO  PARAGRAPH  ONE  AND
SUBPARAGRAPHS  (I)  AND  (II)  OF  PARAGRAPH  TWO  OF SUBDIVISION (E) OF
SECTION FOUR HUNDRED SIXTEEN OF THIS PART ARE DETERMINED BY THE COURT TO
BE UNAVAILABLE, IF THE CHILD OR CHILDREN  ARE  DETERMINED  ELIGIBLE  FOR
COVERAGE  UNDER  THE  MEDICAL ASSISTANCE PROGRAM ESTABLISHED PURSUANT TO
TITLE ELEVEN OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW, THE COURT SHALL
ORDER THE NON-CUSTODIAL PARENT TO PAY CASH MEDICAL SUPPORT AS FOLLOWS:
  (A) IN THE CASE OF A CHILD OR CHILDREN  AUTHORIZED  FOR  MANAGED  CARE
COVERAGE  UNDER THE MEDICAL ASSISTANCE PROGRAM, THE LESSER OF THE AMOUNT
THAT WOULD BE REQUIRED AS A FAMILY CONTRIBUTION UNDER THE STATE'S  CHILD
HEALTH  INSURANCE PLAN PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-FIVE OF
THE PUBLIC HEALTH LAW FOR THE CHILD  OR  CHILDREN  IF  THEY  WERE  IN  A
TWO-PARENT  HOUSEHOLD  WITH  INCOME  EQUAL TO THE COMBINED INCOME OF THE
NON-CUSTODIAL AND CUSTODIAL PARENTS OR THE PREMIUM PAID BY  THE  MEDICAL
ASSISTANCE  PROGRAM  ON  BEHALF  OF THE CHILD OR CHILDREN TO THE MANAGED
CARE PLAN. THE COURT SHALL SEPARATELY STATE THE  NON-CUSTODIAL  PARENT'S
MONTHLY  OBLIGATION.  THE  NON-CUSTODIAL  PARENT'S  CASH MEDICAL SUPPORT
OBLIGATION UNDER THIS CLAUSE SHALL NOT EXCEED FIVE PERCENT OF HIS OR HER
GROSS INCOME, OR  THE  DIFFERENCE  BETWEEN  THE  NON-CUSTODIAL  PARENT'S
INCOME AND THE SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (B)  IN THE CASE OF A CHILD OR CHILDREN AUTHORIZED FOR FEE-FOR-SERVICE
COVERAGE UNDER THE MEDICAL ASSISTANCE PROGRAM  OTHER  THAN  A  CHILD  OR
CHILDREN DESCRIBED IN ITEM (A) OF THIS CLAUSE, THE COURT SHALL DETERMINE
THE  NON-CUSTODIAL  PARENT'S  MAXIMUM  ANNUAL CASH MEDICAL SUPPORT OBLI-
GATION, WHICH SHALL BE EQUAL TO THE LESSER OF THE  MONTHLY  AMOUNT  THAT
WOULD  BE  REQUIRED  AS  A  FAMILY  CONTRIBUTION UNDER THE STATE'S CHILD
HEALTH INSURANCE PLAN PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-FIVE  OF
THE  PUBLIC  HEALTH  LAW  FOR  THE  CHILD  OR CHILDREN IF THEY WERE IN A
TWO-PARENT HOUSEHOLD WITH INCOME EQUAL TO THE  COMBINED  INCOME  OF  THE
NON-CUSTODIAL AND CUSTODIAL PARENTS TIMES TWELVE MONTHS OR THE NUMBER OF
MONTHS  THAT  THE  CHILD  OR CHILDREN ARE AUTHORIZED FOR FEE-FOR-SERVICE
COVERAGE DURING ANY YEAR. THE COURT SHALL SEPARATELY STATE IN THE  ORDER
THE  NON-CUSTODIAL  PARENT'S  MAXIMUM  ANNUAL CASH MEDICAL SUPPORT OBLI-
GATION AND, UPON PROOF TO THE COURT THAT THE NON-CUSTODIAL PARENT, AFTER
NOTICE OF THE AMOUNT DUE, HAS  FAILED  TO  PAY  THE  PUBLIC  ENTITY  FOR
INCURRED  HEALTH  CARE EXPENSES, THE COURT SHALL ORDER THE NON-CUSTODIAL
PARENT TO PAY SUCH INCURRED HEALTH CARE EXPENSES UP TO THE MAXIMUM ANNU-
AL CASH MEDICAL  SUPPORT  OBLIGATION.  SUCH  AMOUNTS  SHALL  BE  SUPPORT
ARREARS/PAST  DUE  SUPPORT  AND  SHALL  BE  SUBJECT  TO  ANY REMEDIES AS
PROVIDED BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE SUPPORT.
THE TOTAL ANNUAL AMOUNT THAT THE NON-CUSTODIAL PARENT IS ORDERED TO  PAY
UNDER  THIS  CLAUSE  SHALL  NOT  EXCEED FIVE PERCENT OF HIS OR HER GROSS
INCOME OR THE DIFFERENCE BETWEEN THE NON-CUSTODIAL PARENT'S  INCOME  AND
THE SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (C)  THE COURT SHALL ORDER CASH MEDICAL SUPPORT TO BE PAID BY THE NON-
CUSTODIAL PARENT FOR HEALTH CARE EXPENSES OF THE CHILD OR CHILDREN  PAID
BY  THE  MEDICAL ASSISTANCE PROGRAM PRIOR TO THE ISSUANCE OF THE COURT'S
ORDER. THE AMOUNT OF SUCH SUPPORT SHALL BE CALCULATED AS PROVIDED  UNDER
ITEM  (A)  OR  (B)  OF  THIS  CLAUSE,  PROVIDED THAT THE AMOUNT THAT THE
NON-CUSTODIAL PARENT IS ORDERED TO PAY UNDER THIS ITEM SHALL NOT  EXCEED
FIVE  PERCENT  OF  HIS OR HER GROSS INCOME OR THE DIFFERENCE BETWEEN THE

A. 8977                             3

NON-CUSTODIAL PARENT'S INCOME AND THE SELF-SUPPORT RESERVE, WHICHEVER IS
LESS, FOR THE YEAR WHEN THE EXPENSE WAS INCURRED. SUCH AMOUNTS SHALL  BE
SUPPORT ARREARS/PAST DUE SUPPORT AND SHALL BE SUBJECT TO ANY REMEDIES AS
PROVIDED BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE SUPPORT.
  (IV)  WHERE  HEALTH  INSURANCE  BENEFITS PURSUANT TO PARAGRAPH ONE AND
SUBPARAGRAPHS (I) AND (II)  OF  PARAGRAPH  TWO  OF  SUBDIVISION  (E)  OF
SECTION FOUR HUNDRED SIXTEEN OF THIS PART ARE DETERMINED BY THE COURT TO
BE  UNAVAILABLE,  AND  THE CHILD OR CHILDREN ARE DETERMINED ELIGIBLE FOR
COVERAGE UNDER THE STATE'S CHILD HEALTH INSURANCE PLAN PURSUANT TO TITLE
ONE-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW, THE  COURT  SHALL
PRORATE  EACH  PARENT'S  SHARE  OF  THE  COST OF THE FAMILY CONTRIBUTION
REQUIRED UNDER SUCH CHILD HEALTH INSURANCE PLAN IN THE  SAME  PROPORTION
AS  EACH  PARENT'S  INCOME IS TO THE COMBINED PARENTAL INCOME, AND STATE
THE AMOUNT OF THE NON-CUSTODIAL PARENT'S SHARE IN THE ORDER.  THE  TOTAL
AMOUNT  OF CASH MEDICAL SUPPORT THAT THE NON-CUSTODIAL PARENT IS ORDERED
TO PAY UNDER THIS CLAUSE SHALL NOT EXCEED FIVE PERCENT  OF  HIS  OR  HER
GROSS  INCOME,  OR  THE  DIFFERENCE  BETWEEN  THE NON-CUSTODIAL PARENT'S
INCOME AND THE SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (V) IN ADDITION TO THE AMOUNTS ORDERED UNDER CLAUSE  (II),  (III),  OR
(IV)  OF THIS SUBPARAGRAPH, THE COURT SHALL PRO RATE EACH PARENT'S SHARE
OF REASONABLE HEALTH CARE EXPENSES NOT REIMBURSED OR PAID BY  INSURANCE,
THE  MEDICAL  ASSISTANCE PROGRAM ESTABLISHED PURSUANT TO TITLE ELEVEN OF
ARTICLE FIVE OF THE SOCIAL SERVICES LAW, OR  THE  STATE'S  CHILD  HEALTH
INSURANCE  PLAN  PURSUANT  TO  TITLE ONE-A OF ARTICLE TWENTY-FIVE OF THE
PUBLIC HEALTH LAW, IN THE SAME PROPORTION AS EACH PARENT'S INCOME IS  TO
THE COMBINED PARENTAL INCOME, AND STATE THE NON-CUSTODIAL PARENT'S SHARE
AS  A PERCENTAGE IN THE ORDER. THE NON-CUSTODIAL PARENT'S PRO RATA SHARE
OF SUCH HEALTH CARE EXPENSES DETERMINED BY THE COURT TO BE DUE AND OWING
SHALL BE SUPPORT ARREARS/PAST DUE SUPPORT AND SHALL BE  SUBJECT  TO  ANY
REMEDIES PROVIDED BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE
SUPPORT.  IN  ADDITION,  THE  COURT  MAY  DIRECT  THAT THE NON-CUSTODIAL
PARENT'S PRO RATA SHARE OF SUCH HEALTH CARE EXPENSES BE PAID IN ONE  SUM
OR IN PERIODIC SUMS, INCLUDING DIRECT PAYMENT TO THE HEALTH CARE PROVID-
ER.
  (VI)  UPON PROOF BY EITHER PARTY THAT CASH MEDICAL SUPPORT PURSUANT TO
CLAUSE (II), (III), (IV) OR (V) OF THIS SUBPARAGRAPH WOULD BE UNJUST  OR
INAPPROPRIATE  PURSUANT  TO  PARAGRAPH  (F)  OF  SUBDIVISION ONE OF THIS
SECTION, THE COURT SHALL:
  (A) ORDER THE PARTIES TO PAY CASH MEDICAL SUPPORT AS THE  COURT  FINDS
JUST AND APPROPRIATE, CONSIDERING THE BEST INTERESTS OF THE CHILD; AND
  (B)  SET  FORTH  IN  THE  ORDER  THE FACTORS IT CONSIDERED, THE AMOUNT
CALCULATED UNDER THIS SUBPARAGRAPH, THE REASON OR REASONS THE COURT  DID
NOT ORDER SUCH AMOUNT, AND THE BASIS FOR THE AMOUNT AWARDED.
  S 2. Subparagraph 5 of paragraph (c) of subdivision 1-b of section 240
of  the  domestic  relations law is REPEALED and a new subparagraph 5 is
added to read as follows:
  (5) THE COURT SHALL  DETERMINE  THE  PARTIES'  OBLIGATION  TO  PROVIDE
HEALTH  INSURANCE  BENEFITS  PURSUANT  TO  THIS  SECTION AND TO PAY CASH
MEDICAL SUPPORT AS PROVIDED UNDER THIS SUBPARAGRAPH.
  (I) "CASH MEDICAL SUPPORT" MEANS AN AMOUNT ORDERED TO BE  PAID  TOWARD
THE  COST OF HEALTH INSURANCE PROVIDED BY A PUBLIC ENTITY OR BY A PARENT
THROUGH AN EMPLOYER OR ORGANIZATION, INCLUDING SUCH EMPLOYERS OR  ORGAN-
IZATIONS  WHICH  ARE  SELF  INSURED,  OR  THROUGH OTHER AVAILABLE HEALTH
INSURANCE OR HEALTH CARE COVERAGE PLANS, AND/OR FOR  OTHER  HEALTH  CARE
EXPENSES NOT COVERED BY INSURANCE.

A. 8977                             4

  (II)  WHERE HEALTH INSURANCE BENEFITS PURSUANT TO SUBPARAGRAPH ONE AND
CLAUSES (I) AND (II) OF SUBPARAGRAPH TWO OF PARAGRAPH (C) OF SUBDIVISION
ONE OF THIS SECTION ARE DETERMINED BY THE COURT  TO  BE  AVAILABLE,  THE
COST  OF  PROVIDING  HEALTH INSURANCE BENEFITS SHALL BE PRORATED BETWEEN
THE  PARTIES  IN  THE  SAME PROPORTION AS EACH PARENT'S INCOME IS TO THE
COMBINED PARENTAL INCOME. IF THE CUSTODIAL PARENT IS ORDERED TO  PROVIDE
SUCH  BENEFITS,  THE NON-CUSTODIAL PARENT'S PRO RATA SHARE OF SUCH COSTS
SHALL BE ADDED TO THE BASIC SUPPORT  OBLIGATION.  IF  THE  NON-CUSTODIAL
PARENT  IS  ORDERED TO PROVIDE SUCH BENEFITS, THE CUSTODIAL PARENT'S PRO
RATA SHARE OF SUCH COSTS SHALL BE DEDUCTED FROM THE BASIC SUPPORT  OBLI-
GATION.
  (III) WHERE HEALTH INSURANCE BENEFITS PURSUANT TO SUBPARAGRAPH ONE AND
CLAUSES (I) AND (II) OF SUBPARAGRAPH TWO OF PARAGRAPH (C) OF SUBDIVISION
ONE  OF  THIS  SECTION ARE DETERMINED BY THE COURT TO BE UNAVAILABLE, IF
THE CHILD OR CHILDREN ARE DETERMINED ELIGIBLE  FOR  COVERAGE  UNDER  THE
MEDICAL ASSISTANCE PROGRAM ESTABLISHED PURSUANT TO TITLE ELEVEN OF ARTI-
CLE  FIVE OF THE SOCIAL SERVICES LAW, THE COURT SHALL ORDER THE NON-CUS-
TODIAL PARENT TO PAY CASH MEDICAL SUPPORT AS FOLLOWS:
  (A) IN THE CASE OF A CHILD OR CHILDREN  AUTHORIZED  FOR  MANAGED  CARE
COVERAGE  UNDER THE MEDICAL ASSISTANCE PROGRAM, THE LESSER OF THE AMOUNT
THAT WOULD BE REQUIRED AS A FAMILY CONTRIBUTION UNDER THE STATE'S  CHILD
HEALTH  INSURANCE PLAN PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-FIVE OF
THE PUBLIC HEALTH LAW FOR THE CHILD  OR  CHILDREN  IF  THEY  WERE  IN  A
TWO-PARENT  HOUSEHOLD  WITH  INCOME  EQUAL TO THE COMBINED INCOME OF THE
NON-CUSTODIAL AND CUSTODIAL PARENTS OR THE PREMIUM PAID BY  THE  MEDICAL
ASSISTANCE  PROGRAM  ON  BEHALF  OF THE CHILD OR CHILDREN TO THE MANAGED
CARE PLAN. THE COURT SHALL SEPARATELY STATE THE  NON-CUSTODIAL  PARENT'S
MONTHLY  OBLIGATION.  THE  NON-CUSTODIAL  PARENT'S  CASH MEDICAL SUPPORT
OBLIGATION UNDER THIS CLAUSE SHALL NOT EXCEED FIVE PERCENT OF HIS OR HER
GROSS INCOME, OR  THE  DIFFERENCE  BETWEEN  THE  NON-CUSTODIAL  PARENT'S
INCOME AND THE SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (B)  IN THE CASE OF A CHILD OR CHILDREN AUTHORIZED FOR FEE-FOR-SERVICE
COVERAGE UNDER THE MEDICAL ASSISTANCE PROGRAM  OTHER  THAN  A  CHILD  OR
CHILDREN DESCRIBED IN ITEM (A) OF THIS CLAUSE, THE COURT SHALL DETERMINE
THE  NON-CUSTODIAL  PARENT'S  MAXIMUM  ANNUAL CASH MEDICAL SUPPORT OBLI-
GATION, WHICH SHALL BE EQUAL TO THE LESSER OF THE  MONTHLY  AMOUNT  THAT
WOULD  BE  REQUIRED  AS  A  FAMILY  CONTRIBUTION UNDER THE STATE'S CHILD
HEALTH INSURANCE PLAN PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-FIVE  OF
THE  PUBLIC  HEALTH  LAW  FOR  THE  CHILD  OR CHILDREN IF THEY WERE IN A
TWO-PARENT HOUSEHOLD WITH INCOME EQUAL TO THE  COMBINED  INCOME  OF  THE
NON-CUSTODIAL AND CUSTODIAL PARENTS TIMES TWELVE MONTHS OR THE NUMBER OF
MONTHS  THAT  THE  CHILD  OR CHILDREN ARE AUTHORIZED FOR FEE-FOR-SERVICE
COVERAGE DURING ANY YEAR. THE COURT SHALL SEPARATELY STATE IN THE  ORDER
THE  NON-CUSTODIAL  PARENT'S  MAXIMUM  ANNUAL CASH MEDICAL SUPPORT OBLI-
GATION AND, UPON PROOF TO THE COURT THAT THE NON-CUSTODIAL PARENT, AFTER
NOTICE OF THE AMOUNT DUE, HAS  FAILED  TO  PAY  THE  PUBLIC  ENTITY  FOR
INCURRED  HEALTH  CARE EXPENSES, THE COURT SHALL ORDER THE NON-CUSTODIAL
PARENT TO PAY SUCH INCURRED HEALTH CARE EXPENSES UP TO THE MAXIMUM ANNU-
AL CASH MEDICAL  SUPPORT  OBLIGATION.  SUCH  AMOUNTS  SHALL  BE  SUPPORT
ARREARS/PAST  DUE  SUPPORT  AND  SHALL  BE  SUBJECT  TO  ANY REMEDIES AS
PROVIDED BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE SUPPORT.
THE TOTAL ANNUAL AMOUNT THAT THE NON-CUSTODIAL PARENT IS ORDERED TO  PAY
UNDER  THIS  CLAUSE  SHALL  NOT  EXCEED FIVE PERCENT OF HIS OR HER GROSS
INCOME OR THE DIFFERENCE BETWEEN THE NON-CUSTODIAL PARENT'S  INCOME  AND
THE SELF-SUPPORT RESERVE, WHICHEVER IS LESS.

A. 8977                             5

  (C)  THE COURT SHALL ORDER CASH MEDICAL SUPPORT TO BE PAID BY THE NON-
CUSTODIAL PARENT FOR HEALTH CARE EXPENSES OF THE CHILD OR CHILDREN  PAID
BY  THE  MEDICAL ASSISTANCE PROGRAM PRIOR TO THE ISSUANCE OF THE COURT'S
ORDER. THE AMOUNT OF SUCH SUPPORT SHALL BE CALCULATED AS PROVIDED  UNDER
ITEM  (A)  OR  (B)  OF  THIS  CLAUSE,  PROVIDED THAT THE AMOUNT THAT THE
NON-CUSTODIAL PARENT IS ORDERED TO PAY UNDER THIS ITEM SHALL NOT  EXCEED
FIVE  PERCENT  OF  HIS OR HER GROSS INCOME OR THE DIFFERENCE BETWEEN THE
NON-CUSTODIAL PARENT'S INCOME AND THE SELF-SUPPORT RESERVE, WHICHEVER IS
LESS, FOR THE YEAR WHEN THE EXPENSE WAS INCURRED. SUCH AMOUNTS SHALL  BE
SUPPORT ARREARS/PAST DUE SUPPORT AND SHALL BE SUBJECT TO ANY REMEDIES AS
PROVIDED BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE SUPPORT.
  (IV)  WHERE HEALTH INSURANCE BENEFITS PURSUANT TO SUBPARAGRAPH ONE AND
CLAUSES (I) AND (II) OF SUBPARAGRAPH TWO OF PARAGRAPH (C) OF SUBDIVISION
ONE OF THIS SECTION ARE DETERMINED BY THE COURT TO BE  UNAVAILABLE,  AND
THE  CHILD  OR  CHILDREN  ARE DETERMINED ELIGIBLE FOR COVERAGE UNDER THE
STATE'S CHILD HEALTH INSURANCE PLAN PURSUANT TO TITLE ONE-A  OF  ARTICLE
TWENTY-FIVE  OF  THE  PUBLIC  HEALTH  LAW,  THE COURT SHALL PRORATE EACH
PARENT'S SHARE OF THE COST OF THE  FAMILY  CONTRIBUTION  REQUIRED  UNDER
SUCH CHILD HEALTH INSURANCE PLAN IN THE SAME PROPORTION AS EACH PARENT'S
INCOME  IS  TO THE COMBINED PARENTAL INCOME, AND STATE THE AMOUNT OF THE
NON-CUSTODIAL PARENT'S SHARE IN THE ORDER.  THE  TOTAL  AMOUNT  OF  CASH
MEDICAL  SUPPORT  THAT  THE NON-CUSTODIAL PARENT IS ORDERED TO PAY UNDER
THIS CLAUSE SHALL NOT EXCEED FIVE PERCENT OF HIS OR HER GROSS INCOME, OR
THE  DIFFERENCE  BETWEEN  THE  NON-CUSTODIAL  PARENT'S  INCOME  AND  THE
SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (V)  IN  ADDITION  TO THE AMOUNTS ORDERED UNDER CLAUSE (II), (III), OR
(IV), THE COURT SHALL PRO RATE EACH PARENT'S SHARE OF REASONABLE  HEALTH
CARE  EXPENSES  NOT REIMBURSED OR PAID BY INSURANCE, THE MEDICAL ASSIST-
ANCE PROGRAM ESTABLISHED PURSUANT TO TITLE ELEVEN OF ARTICLE FIVE OF THE
SOCIAL SERVICES LAW, OR THE STATE'S CHILD HEALTH INSURANCE PLAN PURSUANT
TO TITLE ONE-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW,  IN  THE
SAME  PROPORTION  AS  EACH  PARENT'S  INCOME IS TO THE COMBINED PARENTAL
INCOME, AND STATE THE NON-CUSTODIAL PARENT'S SHARE AS  A  PERCENTAGE  IN
THE ORDER. THE NON-CUSTODIAL PARENT'S PRO RATA SHARE OF SUCH HEALTH CARE
EXPENSES  DETERMINED  BY  THE COURT TO BE DUE AND OWING SHALL BE SUPPORT
ARREARS/PAST DUE SUPPORT AND SHALL BE SUBJECT TO ANY  REMEDIES  PROVIDED
BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE SUPPORT. IN ADDI-
TION,  THE  COURT  MAY  DIRECT  THAT THE NON-CUSTODIAL PARENT'S PRO RATA
SHARE OF SUCH HEALTH CARE EXPENSES BE PAID IN ONE  SUM  OR  IN  PERIODIC
SUMS, INCLUDING DIRECT PAYMENT TO THE HEALTH CARE PROVIDER.
  (VI)  UPON PROOF BY EITHER PARTY THAT CASH MEDICAL SUPPORT PURSUANT TO
CLAUSE (II), (III), (IV), OR (V) OF THIS SUBPARAGRAPH WOULD BE UNJUST OR
INAPPROPRIATE PURSUANT TO PARAGRAPH (F) OF THIS SUBDIVISION,  THE  COURT
SHALL:
  (A)  ORDER  THE PARTIES TO PAY CASH MEDICAL SUPPORT AS THE COURT FINDS
JUST AND APPROPRIATE, CONSIDERING THE BEST INTERESTS OF THE CHILD; AND
  (B) SET FORTH IN THE ORDER  THE  FACTORS  IT  CONSIDERED,  THE  AMOUNT
CALCULATED  UNDER THIS SUBPARAGRAPH, THE REASON OR REASONS THE COURT DID
NOT ORDER SUCH AMOUNT, AND THE BASIS FOR THE AMOUNT AWARDED.
  S 3. Subdivision (d) of section 416 of the family court act is amended
by adding a new paragraph 3 to read as follows:
  (3) WHEN THE PERSON ON WHOSE BEHALF THE PETITION IS BROUGHT IS A CHILD
IN ACCORDANCE WITH SUBDIVISION (E) OF  THIS  SECTION,  HEALTH  INSURANCE
BENEFITS  SHALL BE CONSIDERED "REASONABLE IN COST" IF THE COST OF HEALTH
INSURANCE BENEFITS DOES NOT EXCEED FIVE PERCENT OF THE COMBINED PARENTAL
GROSS INCOME.  THE COST OF HEALTH INSURANCE BENEFITS SHALL REFER TO  THE

A. 8977                             6

COST  OF  THE PREMIUM AND DEDUCTIBLE ATTRIBUTABLE TO ADDING THE CHILD OR
CHILDREN TO EXISTING COVERAGE OR THE DIFFERENCE BETWEEN SUCH  COSTS  FOR
SELF-ONLY  AND  FAMILY COVERAGE. PROVIDED, HOWEVER, THE PRESUMPTION THAT
THE  HEALTH  INSURANCE  BENEFITS  ARE REASONABLE IN COST MAY BE REBUTTED
UPON A FINDING THAT THE COST IS UNJUST OR  INAPPROPRIATE  WHICH  FINDING
SHALL BE BASED ON THE CIRCUMSTANCES OF THE CASE, THE COST AND COMPREHEN-
SIVENESS  OF  THE HEALTH INSURANCE BENEFITS FOR WHICH THE CHILD OR CHIL-
DREN MAY OTHERWISE BE ELIGIBLE, AND THE BEST INTERESTS OF THE  CHILD  OR
CHILDREN.   IN NO INSTANCE SHALL HEALTH INSURANCE BENEFITS BE CONSIDERED
"REASONABLE IN COST" IF A PARENT'S SHARE OF THE COST OF  EXTENDING  SUCH
COVERAGE  WOULD  REDUCE THE INCOME OF THAT PARENT BELOW THE SELF-SUPPORT
RESERVE. HEALTH INSURANCE BENEFITS ARE "REASONABLY  ACCESSIBLE"  IF  THE
CHILD  LIVES  WITHIN  THE  GEOGRAPHIC  AREA COVERED BY THE PLAN OR LIVES
WITHIN THIRTY MINUTES OR THIRTY MILES OF TRAVEL TIME  FROM  THE  CHILD'S
RESIDENCE  TO  THE  SERVICES COVERED BY THE HEALTH INSURANCE BENEFITS OR
THROUGH BENEFITS PROVIDED UNDER A RECIPROCAL AGREEMENT; PROVIDED, HOWEV-
ER, THIS PRESUMPTION MAY BE REBUTTED FOR GOOD CAUSE SHOWN INCLUDING, BUT
NOT LIMITED TO, THE SPECIAL HEALTH NEEDS OF THE CHILD.  THE COURT  SHALL
SET FORTH SUCH FINDING AND THE REASONS THEREFOR IN THE ORDER OF SUPPORT.
  S  4.  Paragraph  (b)  of subdivision 1 of section 240 of the domestic
relations law is amended by adding a  new  subparagraph  3  to  read  as
follows:
  (3) WHEN THE PERSON ON WHOSE BEHALF THE PETITION IS BROUGHT IS A CHILD
IN  ACCORDANCE  WITH PARAGRAPH (C) OF THIS SUBDIVISION, HEALTH INSURANCE
BENEFITS SHALL BE CONSIDERED "REASONABLE IN COST" IF THE COST OF  HEALTH
INSURANCE BENEFITS DOES NOT EXCEED FIVE PERCENT OF THE COMBINED PARENTAL
GROSS  INCOME.  THE COST OF HEALTH INSURANCE BENEFITS SHALL REFER TO THE
COST OF THE PREMIUM AND DEDUCTIBLE ATTRIBUTABLE TO ADDING THE  CHILD  OR
CHILDREN  TO  EXISTING COVERAGE OR THE DIFFERENCE BETWEEN SUCH COSTS FOR
SELF-ONLY AND FAMILY COVERAGE. PROVIDED, HOWEVER, THE  PRESUMPTION  THAT
THE  HEALTH  INSURANCE  BENEFITS  ARE REASONABLE IN COST MAY BE REBUTTED
UPON A FINDING THAT THE COST IS UNJUST OR  INAPPROPRIATE  WHICH  FINDING
SHALL BE BASED ON THE CIRCUMSTANCES OF THE CASE, THE COST AND COMPREHEN-
SIVENESS  OF  THE HEALTH INSURANCE BENEFITS FOR WHICH THE CHILD OR CHIL-
DREN MAY OTHERWISE BE ELIGIBLE, AND THE BEST INTERESTS OF THE  CHILD  OR
CHILDREN.   IN NO INSTANCE SHALL HEALTH INSURANCE BENEFITS BE CONSIDERED
"REASONABLE IN COST" IF A PARENT'S SHARE OF THE COST OF  EXTENDING  SUCH
COVERAGE  WOULD  REDUCE THE INCOME OF THAT PARENT BELOW THE SELF-SUPPORT
RESERVE. HEALTH INSURANCE BENEFITS ARE "REASONABLY  ACCESSIBLE"  IF  THE
CHILD  LIVES  WITHIN  THE  GEOGRAPHIC  AREA COVERED BY THE PLAN OR LIVES
WITHIN THIRTY MINUTES OR THIRTY MILES OF TRAVEL TIME  FROM  THE  CHILD'S
RESIDENCE  TO  THE  SERVICES COVERED BY THE HEALTH INSURANCE BENEFITS OR
THROUGH BENEFITS PROVIDED UNDER A RECIPROCAL AGREEMENT; PROVIDED, HOWEV-
ER, THIS PRESUMPTION MAY BE REBUTTED FOR GOOD CAUSE SHOWN INCLUDING, BUT
NOT LIMITED TO, THE SPECIAL HEALTH NEEDS OF THE CHILD.  THE COURT  SHALL
SET FORTH SUCH FINDING AND THE REASONS THEREFOR IN THE ORDER OF SUPPORT.
  S  5.  Subparagraph (iii) of paragraph 2 of subdivision (e) of section
416 of the family court act, as added by chapter  624  of  the  laws  of
2002, is amended to read as follows:
  (iii)  If  neither parent has available health insurance benefits, the
court shall direct in the order of support  that  the  custodial  parent
apply  for  the  state's  child  health insurance plan pursuant to title
one-A of article twenty-five of the public health law  and  the  medical
assistance  program established pursuant to title eleven of article five
of the social services law. [If eligible for such  coverage,  the  court
shall  prorate the cost of any premium or family contribution in accord-

A. 8977                             7

ance with subdivision (f) of this section.]  A  direction  issued  under
this  subdivision shall not limit or alter either parent's obligation to
obtain health insurance benefits at such time as they  become  available
as  required  pursuant  to  subdivision (c) of this section.  NOTHING IN
THIS SUBDIVISION SHALL ALTER OR  LIMIT  THE  AUTHORITY  OF  THE  MEDICAL
ASSISTANCE  PROGRAM TO DETERMINE WHEN IT IS CONSIDERED COST EFFECTIVE TO
REQUIRE A CUSTODIAL PARENT TO ENROLL  A  CHILD  IN  AN  AVAILABLE  GROUP
HEALTH  INSURANCE PLAN PURSUANT TO PARAGRAPHS (B) AND (C) OF SUBDIVISION
ONE OF SECTION THREE HUNDRED SIXTY-SEVEN-A OF THE SOCIAL SERVICES LAW.
  S 6. Clause (iii) of subparagraph 2 of paragraph (c) of subdivision  1
of  section 240 of the domestic relations law, as amended by chapter 624
of the laws of 2002, is amended to read as follows:
  (iii) If neither parent has available health insurance  benefits,  the
court  shall  direct  in  the order of support that the custodial parent
apply for the state's child health  insurance  plan  pursuant  to  title
one-A  of  article  twenty-five of the public health law and the medical
assistance program established pursuant to title eleven of article  five
of  the  social  services law. [If eligible for such coverage, the court
shall prorate the cost of any premium or family contribution in  accord-
ance  with  paragraph (d) of this subdivision.] A direction issued under
this subdivision shall not limit or alter either parent's obligation  to
obtain  health insurance benefits at such time as they become available,
as required pursuant to paragraph (a) of this subdivision.   NOTHING  IN
THIS  SUBDIVISION  SHALL  ALTER  OR  LIMIT  THE AUTHORITY OF THE MEDICAL
ASSISTANCE PROGRAM TO DETERMINE WHEN IT IS CONSIDERED COST EFFECTIVE  TO
REQUIRE  A  CUSTODIAL  PARENT  TO  ENROLL  A CHILD IN AN AVAILABLE GROUP
HEALTH INSURANCE PLAN PURSUANT TO PARAGRAPHS (B) AND (C)  OF SUBDIVISION
ONE OF SECTION THREE HUNDRED SIXTY-SEVEN-A OF THE SOCIAL SERVICES LAW.
  S 7. Subdivision (f) of  section  416  of  the  family  court  act  is
REPEALED and a new subdivision (f) is added to read as follows:
  (F)  THE COST OF PROVIDING HEALTH INSURANCE BENEFITS OR BENEFITS UNDER
THE STATE'S CHILD  HEALTH  INSURANCE  PLAN  OR  THE  MEDICAL  ASSISTANCE
PROGRAM,  PURSUANT  TO  SUBDIVISION (E) OF THIS SECTION, SHALL BE DEEMED
CASH MEDICAL SUPPORT, AND THE COURT SHALL DETERMINE  THE  OBLIGATION  OF
EITHER  OR  BOTH  PARENTS  TO CONTRIBUTE TO THE COST THEREOF PURSUANT TO
SUBPARAGRAPH FIVE OF PARAGRAPH (C) OF SUBDIVISION ONE  OF  SECTION  FOUR
HUNDRED THIRTEEN OF THIS PART.
  S  8.  Paragraph  (d)  of subdivision 1 of section 240 of the domestic
relations law is REPEALED and a new paragraph (d) is added  to  read  as
follows:
  (D)  THE COST OF PROVIDING HEALTH INSURANCE BENEFITS OR BENEFITS UNDER
THE STATE'S CHILD  HEALTH  INSURANCE  PLAN  OR  THE  MEDICAL  ASSISTANCE
PROGRAM,  PURSUANT TO PARAGRAPH (C) OF THIS SUBDIVISION, SHALL BE DEEMED
CASH MEDICAL SUPPORT, AND THE COURT SHALL DETERMINE  THE  OBLIGATION  OF
EITHER  OR  BOTH  PARENTS  TO CONTRIBUTE TO THE COST THEREOF PURSUANT TO
SUBPARAGRAPH FIVE OF PARAGRAPH (C) OF SUBDIVISION ONE-B OF THIS SECTION.
  S 9. Section 514 of the family court act, as amended by chapter 81  of
the laws of 1995, is amended to read as follows:
  S  514.  Liability  of father to mother. The father is liable [to pay]
FOR the reasonable expenses of the mother's confinement and recovery and
such reasonable expenses in connection with her pregnancy as  DETERMINED
BY  the  court  [in  its discretion may deem proper]; provided, however,
where the mother's confinement, recovery and expenses in connection with
her pregnancy were paid under the  medical  assistance  program  on  the
mother's  behalf,  the  father  may  be  liable  to  the social services
district furnishing such medical assistance and to the state  department

A. 8977                             8

of  [social services] HEALTH for [the full amount of] medical assistance
so expended[, as the court in its discretion may  deem  proper].    SUCH
EXPENSES, INCLUDING SUCH EXPENSES PAID BY THE MEDICAL ASSISTANCE PROGRAM
ON  THE  MOTHER'S  BEHALF,  SHALL BE DEEMED CASH MEDICAL SUPPORT AND THE
COURT SHALL DETERMINE THE OBLIGATION OF THE PARTIES TO CONTRIBUTE TO THE
COST THEREOF PURSUANT TO SUBPARAGRAPH FIVE OF PARAGRAPH (C) OF  SUBDIVI-
SION ONE OF SECTION FOUR HUNDRED THIRTEEN OF THIS ACT.
  S 10. Subdivision 1 of section 545 of the family court act, as amended
by chapter 214 of the laws of 1998, is amended to read as follows:
  1.  In a proceeding in which the court has made an order of filiation,
the court shall direct the parent or  parents  possessed  of  sufficient
means or able to earn such means to pay weekly or at other fixed periods
a  fair  and  reasonable  sum according to their respective means as the
court may determine and apportion for such child's  support  and  educa-
tion,  until the child is twenty-one. The order shall be effective as of
the earlier of the date of the application for an  order  of  filiation,
or,  if the children for whom support is sought are in receipt of public
assistance, the date for which their eligibility for  public  assistance
was  effective. Any retroactive amount of child support shall be support
arrears/past-due support and shall be paid in one sum or  periodic  sums
as  the  court shall direct, taking into account any amount of temporary
support which has been paid. In addition, such retroactive child support
shall be enforceable in any manner provided by law  including,  but  not
limited to, an execution for support enforcement pursuant to subdivision
(b) of section fifty-two hundred forty-one of the civil practice law and
rules.   The court shall direct such parent to make his or her residence
known at all times should he or she move from the address last known  to
the court by reporting such change to the support collection unit desig-
nated  by  the  appropriate  social  services  district. The order shall
contain the social security numbers of the named parents. The order  may
also  direct each parent to pay an amount as the court may determine and
apportion for the support of the child prior to the making of the  order
of  filiation,  and may direct each parent to pay an amount as the court
may determine and apportion for [(i)] the funeral expenses if the  child
has  died[;  (ii)  the].  THE  necessary expenses incurred by or for the
mother in connection with her confinement and  recovery[;]  and  [(iii)]
such  expenses  in  connection  with the pregnancy of the mother [as the
court may deem proper] SHALL BE DEEMED CASH  MEDICAL  SUPPORT,  AND  THE
COURT  SHALL  DETERMINE  THE  OBLIGATION  OF  EITHER  OR BOTH PARENTS TO
CONTRIBUTE TO THE COST THEREOF PURSUANT TO SUBPARAGRAPH  FIVE  OF  PARA-
GRAPH  (C)  OF  SUBDIVISION ONE OF SECTION FOUR HUNDRED THIRTEEN OF THIS
ACT.  In addition, the court shall make provisions for health  insurance
benefits  in  accordance  with  the requirements of section four hundred
sixteen of this act.
  S 11. Subparagraph (i) of paragraph 2 of subdivision  (b)  of  section
5241  of  the civil practice law and rules, as amended by chapter 533 of
the laws of 1999, is amended to read as follows:
  (i) Where the court orders the  debtor  to  provide  health  insurance
benefits  for  specified  dependents,  an  execution for medical support
enforcement may, except as provided for herein, be issued by the support
collection unit, or by the sheriff, the clerk of court or  the  attorney
for  the  creditor  as  an officer of the court; provided, however, that
when the court issues an order of child support or  combined  child  and
spousal  support  on  behalf  of  persons other than those in receipt of
public assistance or in receipt of  services  pursuant  to  section  one
hundred  eleven-g  of  the  social  services law, such medical execution

A. 8977                             9

shall be in the form of a separate qualified medical child support order
as provided by subdivision [(f)] (J) of section four hundred sixteen  of
the  family  court  act  and  paragraph  [(f)] (H) of subdivision one of
section  two hundred forty of the domestic relations law. Such execution
for medical support  enforcement  may  require  the  debtor's  employer,
organization or group health plan administrator to purchase on behalf of
the  debtor  and the debtor's dependents such available health insurance
benefits. Such execution shall  direct  the  employer,  organization  or
group  health  plan  administrator to provide to the dependents for whom
such benefits are required to be provided or such dependents'  custodial
parent  or  legal  guardian  or  social  services  district on behalf of
persons applying for or in receipt of public assistance any  identifica-
tion  cards  and  benefit  claim forms and to withhold from the debtor's
income the employee's share of the cost of such health  insurance  bene-
fits,  and to provide written confirmation of such enrollment indicating
the date such benefits were or become available or  that  such  benefits
are  not  available  and  the  reasons  therefor  to  the  issuer of the
execution. An  execution  for  medical  support  enforcement  shall  not
require  a debtor's employer, organization or group health plan adminis-
trator to purchase or  otherwise  acquire  health  insurance  or  health
insurance  benefits  that would not otherwise be available to the debtor
by reason of his or her employment or membership. Nothing  herein  shall
be  deemed  to  obligate or otherwise hold any employer, organization or
group health plan administrator responsible for an option  exercised  by
the  debtor  in  selecting  medical insurance coverage by an employee or
member.
  S 12. Subdivision (h) of section 5241 of the civil  practice  law  and
rules, as amended by chapter 398 of the laws of 1997, is amended to read
as follows:
  (h)  Priority.  A levy pursuant to this section or an income deduction
order pursuant to section 5242 of this chapter shall take priority  over
any other assignment, levy or process. If an employer or income payor is
served with more than one execution pursuant to this section, or with an
execution pursuant to this section and also an order pursuant to section
5242 of this chapter, and if the combined total amount of the deductions
to  be  withheld exceeds the limits set forth in subdivision (g) of this
section, the employer or income payor shall withhold the maximum  amount
permitted thereby and pay to each creditor that proportion thereof which
such  creditor's  claim  bears  to  the  combined  total. Any additional
deduction authorized by subdivision (g) of this section to be applied to
the reduction of arrears shall be applied to such arrears in  proportion
to  the  amount  of  arrears due to each creditor. Deductions to satisfy
CURRENT  support  obligations[,  including  any  additional   deductions
authorized by subdivision (g) of this section,] shall have priority over
deductions  for  the  debtor's  share of health insurance premiums WHICH
SHALL HAVE PRIORITY OVER ANY ADDITIONAL DEDUCTION AUTHORIZED BY SUBDIVI-
SION (G) OF THIS SECTION.
  S 13. This act shall take effect on the ninetieth day after  it  shall
have  become  a  law  and  shall apply to any proceeding to establish or
modify a child support obligation, including  a  medical  support  obli-
gation, commenced on or after such date.

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