NY State Senate Bill 2011-S2684

Senate Bill S2684

2011-2012 Legislative Session

Modifies medicaid services' availability to bring them more in line with those of private health insurance coverage

download bill text pdf

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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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 17, 2012	print number 2684a
Jan 17, 2012	amend and recommit to health
Jan 04, 2012	referred to health
Jan 28, 2011	referred to health

Bill Amendments

Original

A (Active)

co-Sponsors

2011-S2684 - Details

Current Committee:: Senate Health
Law Section:: Social Services Law
Laws Affected:: Amd §§365-a & 265-a, rpld §365-a sub 2 ¶(n), Soc Serv L
Versions Introduced in Other Legislative Sessions:: 2009-2010: S7950
2013-2014: S1212
2015-2016: S4137

2011-S2684 - Summary

Modifies medicaid services' availability to bring them more in line with those of private health insurance coverage.

2011-S2684 - Sponsor Memo

                                BILL NUMBER:S2684

TITLE OF BILL:
An act
to amend the social services law, in relation to the character and
adequacy of Medicaid assistance and to repeal paragraph (n) of
subdivision 2 of section 365-a of the social services law relating to
the care and services of audiologists

PURPOSE OF THE BILL:
Modifies the availability of Medicaid services to
bring them more in line with those of private health insurance
coverage.

SUMMARY OF SPECIFIC PROVISIONS:
§ 1- Amends paragraph (a) of
subdivision 2 of § 365-a of the Social Services Law to remove
dentists, nurses, and private duty nursing from those services
authorized under the subdivision. However, nurse midwives and nurse
practitioners are added.

§ 2- Amends paragraph (t) of subdivision 2 of § 365-a of the Social
Services Law to specify that coverage for preventive, prophylactic
and other routine dental care, services and supplies will be
authorized only when provided in a hospital outpatient or clinic
facility. § 3- Amends paragraph (g) of subdivision 2 of

§ 365-a of the Social Services Law to remove dental prosthetic
appliances from those services authorized under the subdivision and
to authorize the Commissioner of Health to require prior approval of
any prescription drug that is prescribed for a resident of a nursing
home that is not reimbursed as part of the nursing home's Medicaid
rate.

§ 4- Amends paragraph (1) of subdivision 2 of § 365-a of the Social
Services Law to add clinical psychologists, nurses and audiologists,
including such care and services provided in a hospital outpatient or
clinic facility, and dentists in those services and care provided in
accordance with the program of early and periodic screening and
diagnosis.

§ 5- Repeals paragraph (n) of subdivision 2 of § 365-a of the Social
Services Law which relates to services provided by audiologists.

§ 6- Allows the Commissioner of Health to promulgate or adopt any
rules or regulations necessary to implement the provisions of the bill.

§ 7- Effective date.

JUSTIFICATION:
The ultimate goal of this legislation is to bring
Medicaid coverage more in line with private health insurance
coverage. The costs associated with "optional" services, those
allowed for but not required by the federal government but required
by New York State, have increased substantially, causing fiscal
strife for many of the state's counties. These costs are often passed


along to the citizens of the state through higher property taxes or
other tax increases. This legislation in no way suggests that
monetary concerns outweigh the care of individuals. However, it is
unfair and inappropriate to ask working families to pay for services
covered under "optional" Medicaid coverage that they themselves may
not be able to afford or obtain under their own private health
insurance plan.

PRIOR LEGISLATIVE HISTORY:
2007-2008: A.4674
2005-2006: A.5465-A
2009-2010: S.7950/A.6677 -- HEALTH/Health

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

EFFECTIVE DATE:
On the one hundred eightieth day after it shall have
become a law.

2011-S2684 - Bill Text download pdf

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

                                  2684

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                            January 28, 2011
                               ___________

Introduced  by  Sens.  RANZENHOFER,  MAZIARZ  --  read twice and ordered
  printed, and when printed to be committed to the Committee on Health

AN ACT to amend the social services law, in relation  to  the  character
  and  adequacy  of  Medicaid  assistance and to repeal paragraph (n) of
  subdivision 2 of section 365-a of the social services law relating  to
  the care and services of audiologists

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

  Section 1. Paragraph (a) of subdivision 2  of  section  365-a  of  the
social  services  law,  as amended by chapter 47 of the laws of 1996, is
amended to read as follows:
  (a) services of qualified physicians, [dentists, nurses,  and  private
duty  nursing  services  shall  be  further subject to the provisions of
section three hundred  sixty-seven-o  of  this  chapter,]  optometrists,
NURSE  MIDWIVES,  NURSE  PRACTITIONERS,  and  other related professional
personnel;
  S 2. Paragraph (f) of subdivision 2 of section  365-a  of  the  social
services  law, as added by chapter 184 of the laws of 1969 and as relet-
tered by chapter 478 of the laws of 1980, is amended to read as follows:
  (f) preventive, prophylactic and other routine dental  care,  services
and  supplies  ONLY  WHEN  PROVIDED  IN  A HOSPITAL OUTPATIENT OR CLINIC
FACILITY REFERRED TO IN PARAGRAPH (C) OF THIS SUBDIVISION;
  S 3. Paragraph (g) of subdivision 2 of section  365-a  of  the  social
services  law,  as  amended by section 1 of part F of chapter 497 of the
laws of 2008, is amended to read as follows:
  (g) sickroom supplies,  eyeglasses,  AND  prosthetic  appliances  [and
dental  prosthetic  appliances]  furnished  in accordance with the regu-
lations of the department, provided that 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  glucometers and test strips, and may subject non-pre-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02430-01-1

S. 2684                             2

ferred manufacturers' glucometers and test strips to prior authorization
under section two hundred seventy-three of the public health law;  drugs
provided  on  an  in-patient  basis,  those  drugs contained on the list
established  by  regulation  of  the  commissioner of health pursuant to
subdivision four of this section, and  those  drugs  which  may  not  be
dispensed  without  a  prescription  as  required by section sixty-eight
hundred ten of the education law and which the  commissioner  of  health
shall determine to be reimbursable based upon such factors as the avail-
ability  of  such  drugs  or  alternatives at low cost if purchased by a
medicaid recipient, or the essential nature of such drugs  as  described
by such commissioner in regulations, provided, however, that such drugs,
exclusive  of long-term maintenance drugs, shall be dispensed in quanti-
ties no greater than a thirty day supply or one hundred doses, whichever
is greater; provided further that the commissioner of health is  author-
ized  to  require  prior  authorization for any refill of a prescription
when less than seventy-five percent of the previously  dispensed  amount
per  fill  should have been used were the product used as normally indi-
cated, AND PROVIDED FURTHER THAT  SUCH  COMMISSIONER  IS  AUTHORIZED  TO
REQUIRE PRIOR APPROVAL OF ANY PRESCRIPTION DRUG THAT IS PRESCRIBED FOR A
RESIDENT  OF  A  NURSING  HOME AND THAT IS NOT REIMBURSED AS PART OF THE
NURSING HOME'S MEDICAID RATE; medical assistance shall not  include  any
drug provided on other than an in-patient basis for which a recipient is
charged or a claim is made in the case of a prescription drug, in excess
of  the  maximum  reimbursable  amounts  to be established by department
regulations in accordance with standards established by the secretary of
the United States department of health and human services,  or,  in  the
case  of  a  drug not requiring a prescription, in excess of the maximum
reimbursable amount established by the commissioner of  health  pursuant
to paragraph (a) of subdivision four of this section;
  S  4.  Paragraph  (l)  of subdivision 2 of section 365-a of the social
services law, as amended by chapter 81 of the laws of 1995,  is  amended
to read as follows:
  (l)  care  and services of podiatrists, CLINICAL PSYCHOLOGISTS, NURSES
AND AUDIOLOGISTS, INCLUDING SUCH CARE AND SERVICES PROVIDED IN A  HOSPI-
TAL  OUT-PATIENT OR CLINIC FACILITY REFERRED TO IN PARAGRAPH (C) OF THIS
SUBDIVISION, AND  DENTISTS,  which  care  and  services  shall  only  be
provided  upon  referral by a physician, nurse practitioner or certified
nurse midwife in accordance with  the  program  of  early  and  periodic
screening  and  diagnosis  established  pursuant to subdivision three of
this section or to persons eligible for benefits under  title  XVIII  of
the  federal  social security act as qualified medicare beneficiaries in
accordance with federal requirements therefor [and private  duty  nurses
which  care and services shall only be provided in accordance with regu-
lations of the department of health;  provided,  however,  that  private
duty  nursing  services  shall  not be restricted when such services are
more appropriate and cost-effective than nursing services provided by  a
home health agency pursuant to section three hundred sixty-seven-l];
  S  5.  Paragraph  (n)  of subdivision 2 of section 365-a of the social
services law, as added by chapter 556 of the laws of 1986, is REPEALED.
  S 6. The commissioner of health is authorized to promulgate  or  adopt
any  rules  or regulations necessary to implement the provisions of this
act and any procedures, forms, or instructions necessary for such imple-
mentation may be adopted and issued on or after the  effective  date  of
this act. Notwithstanding any inconsistent provision of the state admin-
istrative  procedure  act  or  any other provision of law, rule or regu-
lation, the commissioner of health and the superintendent  of  insurance

S. 2684                             3

and  any  appropriate council is authorized to adopt or amend or promul-
gate 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 7. This act shall take effect on the one hundred eightieth day after
it shall have become a law.

co-Sponsors

2011-S2684A (ACTIVE) - Details

Current Committee:: Senate Health
Law Section:: Social Services Law
Laws Affected:: Amd §§365-a & 265-a, rpld §365-a sub 2 ¶(n), Soc Serv L
Versions Introduced in Other Legislative Sessions:: 2009-2010: S7950
2013-2014: S1212
2015-2016: S4137

2011-S2684A (ACTIVE) - Summary

Modifies medicaid services' availability to bring them more in line with those of private health insurance coverage.

2011-S2684A (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S2684A

TITLE OF BILL:
An act
to amend the social services law, in relation to the character and
adequacy of Medicaid assistance and to repeal paragraph (n) of
subdivision 2 of section 365-a of the social services law relating to
the care and services of audiologists

PURPOSE OF THE BILL:
Modifies the availability of Medicaid services to
bring them more in line with those of private health insurance
coverage.

SUMMARY OF SPECIFIC PROVISIONS:
§ 1- Amends paragraph (a) of
subdivision 2 of § 365-a of the Social Services Law to remove
dentists, nurses, and private duty nursing from those services
authorized under the subdivision. However, nurse midwives and nurse
practitioners are added.

§ 2- Amends paragraph (t) of subdivision 2 of § 365-a of the Social
Services Law to specify that coverage for preventive, prophylactic
and other routine dental care, services and supplies will be
authorized only when provided in a hospital outpatient or clinic
facility.

§ 3- Amends paragraph (g) of subdivision 2 of
§ 365-a of the Social Services Law to remove dental prosthetic
appliances from those services authorized under the subdivision and
to authorize the Commissioner of Health to require prior approval of
any prescription drug that is prescribed for a resident of a nursing
home that is not reimbursed as part of the nursing home's Medicaid
rate.

§ 4- Amends paragraph (1) of subdivision 2 of § 365-a of the Social
Services Law to add clinical psychologists, nurses and audiologists,
including such care and services provided in a hospital outpatient or
clinic facility, and dentists in those services and care provided in
accordance with the program of early and periodic screening and
diagnosis.

§ 5- Repeals paragraph (n) of subdivision 2 of § 365-a of the Social
Services Law which relates to services provided by audiologists.

§ 6- Allows the Commissioner of Health to promulgate or adopt any
rules or regulations necessary to implement the provisions of the bill.

§ 7- Effective date.

JUSTIFICATION:

The ultimate goal of this legislation is to bring
Medicaid coverage more in line with private health insurance
coverage. The costs associated with "optional" services, those
allowed for but not required by the federal government but required
by New York State, have increased substantially, causing fiscal
strife for many of the state's counties. These costs are often passed
along to the citizens of the state through higher property taxes or
other tax increases. This legislation in no way suggests that
monetary concerns outweigh the care of individuals. However, it is
unfair and inappropriate to ask working families to pay for services
covered under "optional" Medicaid coverage that they themselves may
not be able to afford or obtain under their own private health
insurance plan.

PRIOR LEGISLATIVE HISTORY:
2007-2008: A.4674
2005-2006: A.5465A
2009-2010: S.7950/A.6677 -- HEALTH/Health
2011:      S.2684 -- HEALTH

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

EFFECTIVE DATE:
On the one hundred eightieth day after it shall have
become a law.

2011-S2684A (ACTIVE) - Bill Text download pdf

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

                                 2684--A

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                            January 28, 2011
                               ___________

Introduced  by  Sens.  RANZENHOFER,  MAZIARZ,  LARKIN  -- read twice and
  ordered printed, and when printed to be committed to the Committee  on
  Health  --  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 committee

AN  ACT  to  amend the social services law, in relation to the character
  and adequacy of Medicaid assistance and to  repeal  paragraph  (n)  of
  subdivision  2 of section 365-a of the social services law relating to
  the care and services of audiologists

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

  Section  1.  Paragraph  (a)  of  subdivision 2 of section 365-a of the
social services law, as amended by chapter 47 of the laws  of  1996,  is
amended to read as follows:
  (a)  services  of qualified physicians, [dentists, nurses, and private
duty nursing services shall be further  subject  to  the  provisions  of
section  three  hundred  sixty-seven-o  of  this chapter,] optometrists,
NURSE MIDWIVES, NURSE  PRACTITIONERS,  and  other  related  professional
personnel;
  S  2.  Paragraph  (f)  of subdivision 2 of section 365-a of the social
services law, as added by chapter 184 of the laws of 1969 and as  relet-
tered by chapter 478 of the laws of 1980, is amended to read as follows:
  (f)  preventive,  prophylactic and other routine dental care, services
and supplies ONLY WHEN PROVIDED  IN  A  HOSPITAL  OUTPATIENT  OR  CLINIC
FACILITY REFERRED TO IN PARAGRAPH (C) OF THIS SUBDIVISION;
  S  3.  Paragraph  (g)  of subdivision 2 of section 365-a of the social
services law, as amended by section 23 of part H of chapter  59  of  the
laws of 2011, is amended to read as follows:
  (g)  sickroom  supplies,  eyeglasses,  AND  prosthetic appliances [and
dental prosthetic appliances] furnished in  accordance  with  the  regu-
lations  of  the department; provided further that: (i) the commissioner

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02430-02-2

S. 2684--A                          2

of health is authorized to implement a preferred diabetic supply program
wherein the department of health  will  receive  enhanced  rebates  from
preferred  manufacturers of glucometers and test strips, and may subject
non-preferred  manufacturers'  glucometers  and  test  strips  to  prior
authorization under section two  hundred  seventy-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 or for treatment of an inborn  metabolic  disorder,  or  to
address  growth and development problems in children; (iii) prescription
footwear and inserts are limited to coverage only when used as an  inte-
gral  part  of  a  lower  limb orthotic appliance, as part of a diabetic
treatment plan, or to address growth and development problems  in  chil-
dren; [and] (iv) compression and support stockings are limited to cover-
age only for pregnancy or treatment of venous stasis ulcers; AND (V) THE
COMMISSIONER  OF  HEALTH  IS AUTHORIZED TO REQUIRE PRIOR APPROVAL OF ANY
PRESCRIPTION DRUG THAT IS PRESCRIBED FOR A RESIDENT OF  A  NURSING  HOME
AND THAT IS NOT REIMBURSED AS PART OF THE NURSING HOME'S MEDICAID RATE;
  S  4.  Paragraph  (l)  of subdivision 2 of section 365-a of the social
services law, as amended by chapter 81 of the laws of 1995,  is  amended
to read as follows:
  (l)  care  and services of podiatrists, CLINICAL PSYCHOLOGISTS, NURSES
AND AUDIOLOGISTS, INCLUDING SUCH CARE AND SERVICES PROVIDED IN A  HOSPI-
TAL  OUT-PATIENT OR CLINIC FACILITY REFERRED TO IN PARAGRAPH (C) OF THIS
SUBDIVISION, AND  DENTISTS,  which  care  and  services  shall  only  be
provided  upon  referral by a physician, nurse practitioner or certified
nurse midwife in accordance with  the  program  of  early  and  periodic
screening  and  diagnosis  established  pursuant to subdivision three of
this section or to persons eligible for benefits under  title  XVIII  of
the  federal  social security act as qualified medicare beneficiaries in
accordance with federal requirements therefor [and private  duty  nurses
which  care and services shall only be provided in accordance with regu-
lations of the department of health;  provided,  however,  that  private
duty  nursing  services  shall  not be restricted when such services are
more appropriate and cost-effective than nursing services provided by  a
home health agency pursuant to section three hundred sixty-seven-l];
  S  5.  Paragraph  (n)  of subdivision 2 of section 365-a of the social
services law, as added by chapter 556 of the laws of 1986, is REPEALED.
  S 6. The commissioner of health is authorized to promulgate  or  adopt
any  rules  or regulations necessary to implement the provisions of this
act and any procedures, forms, or instructions necessary for such imple-
mentation may be adopted and issued on or after the  effective  date  of
this act. Notwithstanding any inconsistent provision of the state admin-
istrative  procedure  act  or  any other provision of law, rule or regu-
lation, the commissioner of health and the superintendent  of  insurance
and  any  appropriate council is authorized to adopt or amend or promul-
gate 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 7. This act shall take effect on the one hundred eightieth day after
it shall have become a law.

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Senate Bill S2684

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Sponsored By

Michael H. Ranzenhofer

Archive: Last Bill Status - In Senate Committee Health Committee

Bill Amendments

co-Sponsors

George D. Maziarz

William Larkin

2011-S2684 - Details

2011-S2684 - Summary

2011-S2684 - Sponsor Memo

2011-S2684 - Bill Text download pdf

co-Sponsors

George D. Maziarz

William Larkin

2011-S2684A (ACTIVE) - Details

2011-S2684A (ACTIVE) - Summary

2011-S2684A (ACTIVE) - Sponsor Memo

2011-S2684A (ACTIVE) - Bill Text download pdf

Comments