NY State Senate Bill 2009-S5644

Archive: Last Bill Status - In Senate Committee Aging Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
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Delivered to Governor
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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 06, 2010	referred to aging
May 26, 2009	referred to aging

2009-S5644 (ACTIVE) - Details

Current Committee:: Senate Aging
Law Section:: Elder Law
Laws Affected:: Amd §§242 & 248, Eld L

2009-S5644 (ACTIVE) - Summary

Relates to eligibility levels in the elderly pharmaceutical insurance coverage program.

2009-S5644 (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S5644

 TITLE OF BILL :
An act to amend the elder law, in relation to eligibility levels in
the elderly pharmaceutical insurance coverage program


 PURPOSE OR GENERAL IDEA OF BILL :
To permit individuals with severe and permanent disabilities to
participate in the EIPC program and raise the income eligibility for
those currently in the EPIC program.

 SUMMARY OF SPECIFIC PROVISIONS :
Section 1: Makes individuals who are eligible for or are receiving
social security disability insurance (SSDI) eligible to participate in
the EPIC program. Expands coverage for elderly individuals by
providing coverage for those who are at least 65 years of age and
whose income is less than fifty-thousand dollars annually for an
unmarried person, and less than seventy-five thousand dollars annually
for a married couple.

Section 2 Establishes deductibles based on income for unmarried
individuals and married couples.

Section 3: Establishes co-payments based on income for unmarried
individuals and married couples.

Section 4: Immediate effective date.

 JUSTIFICATION :
While EPIC is now limited to people age 65 and over, people with
severe and permanent disabilities under this age have needs similar to
New York's seniors. They, too, almost invariably live on fixed incomes
and often have significant prescription drug needs. On aver age,
disabled Medicare beneficiaries have lower incomes and much poorer
physical, mental and functional levels than their elderly
counterparts. Disabled beneficiaries are more than twice as likely to
report being in fair or poor health than the elderly (59% vs. 23%) and
are twice as likely to have trouble performing at least one "activity
of daily living."

The combination of poor health status, high drug utilization and low
income makes paying for prescription medications particularly
burdensome for people with disabilities. A Kaiser Foundation national
survey in December 2003 found that nine out often people with
disabilities used at least one prescription medication on a regular
basis. Almost a third of them (32%) identified cost as a barrier to
obtaining necessary prescription drugs, more than the share who
reported problems with any other medical benefit. Among the uninsured,
60 percent skipped doses, split pills, or did not fill a prescription
due to cost. Not surprisingly, "improving prescription drug coverage"
was named by 41 percent of respondents as the "most important
disability-related issue for government to address."

The Part D drug benefit introduced in the Medicare program in 2006
does not adequately meet the needs of adults with disabilities.  Some
non-elderly adults with disabilities are not eligible for Part D
because they are in the two-year waiting period for Medicare and those
already receiving Medicare often find themselves in the Part D
coverage gap or "donut hole" in the beginning of the calendar year due
to their use of multiple costly medications.

While EPIC is one of New York's great success stories, its exclusion
of people with disabilities must be corrected. At least 15 other
states, including Massachusetts, New Jersey, and Connecticut, have
implemented pharmacy assistance programs that cover non-elderly adults
with disabilities. EPIC expansion would provide desperately needed
coverage to many New Yorkers and help correct and equalize our
patchwork health and prescription drug coverage system.

This legislation would also raise the income eligibility for those
currently in the EPIC program as well as those who would become
eligible as a result of this bill. This income eligibility expansion
would allow thousands of seniors and people with disabilities to have
access to the medications they desperately need to remain healthy.

 PRIOR LEGISLATIVE HISTORY :
This is a new bill

 FISCAL IMPLICATIONS :
To be determined.

 EFFECTIVE DATE :
Immediate effective date.

2009-S5644 (ACTIVE) - Bill Text download pdf

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

                                  5644

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                              May 26, 2009
                               ___________

Introduced  by  Sen.  DUANE  -- read twice and ordered printed, and when
  printed to be committed to the Committee on Aging

AN ACT to amend the elder law, in relation to eligibility levels in  the
  elderly pharmaceutical insurance coverage program

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

  Section 1. Subdivisions 1 and 2 of section 242 of the elder law, para-
graph (b) of subdivision 1 and paragraphs (a) and (b) of  subdivision  2
as  amended  by  section 14 of part B of chapter 57 of the laws of 2006,
are amended to read as follows:
  1. Persons eligible  for  comprehensive  coverage  under  section  two
hundred forty-seven of this title shall include:
  (a) any unmarried resident who is at least sixty-five years of age, OR
ELIGIBLE  FOR  OR  RECEIVING SOCIAL SECURITY DISABILITY INSURANCE (SSDI)
BENEFITS, and whose income for the calendar year  immediately  preceding
the  effective  date of the annual coverage period beginning on or after
January first, two thousand [five] TEN, is less than or equal to  twenty
thousand  dollars.  After the initial determination of eligibility, each
eligible individual must be redetermined eligible at least  every  twen-
ty-four months; and
  (b)  any  married resident who is at least sixty-five years of age, OR
ELIGIBLE FOR OR RECEIVING SOCIAL SECURITY  DISABILITY  INSURANCE  (SSDI)
BENEFITS,  and  whose income for the calendar year immediately preceding
the effective date of the annual coverage period when combined with  the
income  in the same calendar year of such married person's spouse begin-
ning on or after January first, two thousand [one] TEN, is less than  or
equal to twenty-six thousand dollars. After the initial determination of
eligibility,  each  eligible individual must be redetermined eligible at
least every twenty-four months.
  2. Persons  eligible  for  catastrophic  coverage  under  section  two
hundred forty-eight of this title shall include:
  (a) any unmarried resident who is at least sixty-five years of age, OR
ELIGIBLE  FOR  OR  RECEIVING SOCIAL SECURITY DISABILITY INSURANCE (SSDI)
BENEFITS, and whose income for the calendar year  immediately  preceding

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD14014-01-9

S. 5644                             2

the  effective  date of the annual coverage period beginning on or after
January first, two thousand [one] TEN, is more than twenty thousand  and
less  than  or  equal to [thirty-five] FIFTY thousand dollars. After the
initial  determination  of eligibility, each eligible individual must be
redetermined eligible at least every twenty-four months; and
  (b) any married resident who is at least sixty-five years of  age,  OR
ELIGIBLE  FOR  OR  RECEIVING SOCIAL SECURITY DISABILITY INSURANCE (SSDI)
BENEFITS, and whose income for the calendar year  immediately  preceding
the  effective date of the annual coverage period when combined with the
income in the same calendar year of such married person's spouse  begin-
ning  on  or  after  January first, two thousand [one] TEN, is more than
twenty-six  thousand  dollars  and  less  than  or  equal   to   [fifty]
SEVENTY-FIVE thousand dollars. After the initial determination of eligi-
bility,  each eligible individual must be redetermined eligible at least
every twenty-four months.
  S 2. Paragraphs (a) and (b) of subdivision 2 of  section  248  of  the
elder law are amended to read as follows:
  (a) Annual personal covered drug expenditures for unmarried individual
eligible program participants:
individual income of $20,001 to $21,000.......................... $530
individual income of $21,001 to $22,000.......................... $550
individual income of $22,001 to $23,000.......................... $580
individual income of $23,001 to $24,000.......................... $720
individual income of $24,001 to $25,000.......................... $750
individual income of $25,001 to $26,000.......................... $780
individual income of $26,001 to $27,000.......................... $810
individual income of $27,001 to $28,000.......................... $840
individual income of $28,001 to $29,000.......................... $870
individual income of $29,001 to $30,000.......................... $900
individual income of $30,001 to $31,000.......................... $930
individual income of $31,001 to $32,000.......................... $960
individual income of $32,001 to $33,000........................ $1,160
individual income of $33,001 to $34,000........................ $1,190
individual income of $34,001 to [$35,000]
                                 $50,000 ...................... $1,230
  (b)  Annual  personal covered drug expenditures for each married indi-
vidual eligible program participant:
joint income of $26,001 to $27,000............................... $650
joint income of $27,001 to $28,000............................... $675
joint income of $28,001 to $29,000............................... $700
joint income of $29,001 to $30,000............................... $725
joint income of $30,001 to $31,000............................... $900
joint income of $31,001 to $32,000............................... $930
joint income of $32,001 to $33,000............................... $960
joint income of $33,001 to $34,000............................... $990
joint income of $34,001 to $35,000............................. $1,020
joint income of $35,001 to $36,000............................. $1,050
joint income of $36,001 to $37,000............................. $1,080
joint income of $37,001 to $38,000............................. $1,110
joint income of $38,001 to $39,000............................. $1,140
joint income of $39,001 to $40,000............................. $1,170
joint income of $40,001 to $41,000............................. $1,200
joint income of $41,001 to $42,000............................. $1,230
joint income of $42,001 to $43,000............................. $1,260
joint income of $43,001 to $44,000............................. $1,290
joint income of $44,001 to $45,000............................. $1,320

S. 5644                             3

joint income of $45,001 to $46,000............................. $1,575
joint income of $46,001 to $47,000............................. $1,610
joint income of $47,001 to $48,000............................. $1,645
joint income of $48,001 to $49,000............................. $1,680
joint income of $49,001 to [$50,000]
                            $75,000 ........................... $1,715
  S  3.  Paragraphs  (a)  and (b) of subdivision 4 of section 248 of the
elder law are amended to read as follows:
  (a) Limits on co-payments by  unmarried  individual  eligible  program
participants:
individual income of $20,001 to $21,000........... no more than $1,050
individual income of $21,001 to $22,000........... no more than $1,100
individual income of $22,001 to $23,000........... no more than $1,150
individual income of $23,001 to $24,000........... no more than $1,200
individual income of $24,001 to $25,000........... no more than $1,250
individual income of $25,001 to $26,000........... no more than $1,300
individual income of $26,001 to $27,000........... no more than $1,350
individual income of $27,001 to $28,000........... no more than $1,400
individual income of $28,001 to $29,000........... no more than $1,450
individual income of $29,001 to $30,000........... no more than $1,500
individual income of $30,001 to $31,000........... no more than $1,550
individual income of $31,001 to $32,000........... no more than $1,600
individual income of $32,001 to $33,000........... no more than $1,650
individual income of $33,001 to $34,000........... no more than $1,700
individual income of $34,001 to [$35,000]
                              $50,000 ............ no more than $1,750
  (b)  Limits on co-payments by each married individual eligible program
participant:
joint income of $26,001 to $27,000................ no more than $1,080
joint income of $27,001 to $28,000................ no more than $1,120
joint income of $28,001 to $29,000................ no more than $1,160
joint income of $29,001 to $30,000................ no more than $1,200
joint income of $30,001 to $31,000................ no more than $1,240
joint income of $31,001 to $32,000................ no more than $1,280
joint income of $32,001 to $33,000................ no more than $1,320
joint income of $33,001 to $34,000................ no more than $1,360
joint income of $34,001 to $35,000................ no more than $1,400
joint income of $35,001 to $36,000................ no more than $1,440
joint income of $36,001 to $37,000................ no more than $1,480
joint income of $37,001 to $38,000................ no more than $1,520
joint income of $38,001 to $39,000................ no more than $1,560
joint income of $39,001 to $40,000................ no more than $1,600
joint income of $40,001 to $41,000................ no more than $1,640
joint income of $41,001 to $42,000................ no more than $1,680
joint income of $42,001 to $43,000................ no more than $1,720
joint income of $43,001 to $44,000................ no more than $1,760
joint income of $44,001 to $45,000................ no more than $1,800
joint income of $45,001 to $46,000................ no more than $1,840
joint income of $46,001 to $47,000................ no more than $1,880
joint income of $47,001 to $48,000................ no more than $1,920
joint income of $48,001 to $49,000................ no more than $1,960
joint income of $49,001 to [$50,000]
                            $75,000 ............... no more than $2,000
  S 4. This act shall take effect immediately.

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Senate Bill S5644

Sponsored By

Archive: Last Bill Status - In Senate Committee Aging Committee

Actions

2009-S5644 (ACTIVE) - Details

2009-S5644 (ACTIVE) - Summary

2009-S5644 (ACTIVE) - Sponsor Memo

2009-S5644 (ACTIVE) - Bill Text download pdf

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Sponsored By

Thomas K. Duane

Archive: Last Bill Status - In Senate Committee Aging Committee

Actions

2009-S5644 (ACTIVE) - Details

2009-S5644 (ACTIVE) - Summary

2009-S5644 (ACTIVE) - Sponsor Memo

2009-S5644 (ACTIVE) - Bill Text download pdf

Comments