senate Bill S2809D

Signed By Governor
2011-2012 Legislative Session

Enacts into law major components of legislation necessary to implement the health and mental hygiene budget for the 2011-2012 state fiscal plan

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Archive: Last Bill Status - Signed by Governor


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed by Governor

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Actions

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Mar 31, 2011 signed chap.59
Mar 30, 2011 delivered to governor
returned to senate
passed assembly
message of necessity - 3 day message
motion to amend lost
ordered to third reading rules cal.17
substituted for a4009d
referred to ways and means
delivered to assembly
passed senate
message of necessity
ordered to third reading cal.295
print number 2809d
amend (t) and recommit to finance
Mar 12, 2011 print number 2809c
amend (t) and recommit to finance
Mar 04, 2011 print number 2809b
amend (t) and recommit to finance
Feb 25, 2011 print number 2809a
amend (t) and recommit to finance
Feb 01, 2011 referred to finance

Votes

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Bill Amendments

Original
A
B
C
D (Active)
Original
A
B
C
D (Active)

S2809 - Bill Details

See Assembly Version of this Bill:
A4009D
Law Section:
Budget Bills
Laws Affected:
Amd Various Laws, generally

S2809 - Bill Texts

view summary

Relates to Medicare part D; relates to early intervention services; relates to tobacco control and insurance initiatives pool distributions; relates to clinical laboratories; relates to the distribution of HEAL NY capital grants; extends numerous provisions of law; repeals provisions of law relating to elderly pharmaceutical insurance; relates to rates of payment and medical assistance; relates to the distribution of pool allocations and graduate medical education; relates to health care initiative pool distributions; extends payment provisions for general hospitals; extends access to community health care services in rural areas; continues the priority restoration adjustment; relates to medical and professional malpractice insurance; relates to the liquidation of domestic insurers; relates to rates of payment for personal care service providers, residential health care facilities and diagnostic and treatment centers; relates to payments to residential health care facilities and other reimbursements; authorizes bad debt and charity care allowances for certified home health agencies; relates to capital related inpatient expenses; relates to rates of payment for long term home health care programs; relates to the effectiveness of the child health insurance plan; relates to the suspension of eligibility for medical assistance; foregoes certain adjustments during the 2011-2012 state fiscal year; relates to the closure and the reduction in size of certain facilities serving persons with mental illness; relates to general hospital inpatient reimbursement for annual rates; establishes ceiling limitations for certain rates of payment; repeals certain provisions of the social services law relating to prescription drug payments; initiates a study to determine costs incurred by public school districts for certain medical care, services and supplies; relates to the calculation of capital costs; relates to the HIV special needs plan; relates to the pharmacy and therapeutics committee and the preferred drug program; relates to covered part D drugs, limited coverage for formula therapy, prescription footwear, speech therapy, physical therapy and occupational therapy, payment for home health care nursing services, and coverage for smoking cessation counseling services, the furnishing of medical assistance to applicants with responsible relatives, and mail order prescriptions; relates to the commissioner of health's authority to negotiate agreements resolving multiple pending rate appeals; relates to diagnostic care centers; relates to temporary operator certificates for general hospitals or diagnostic and treatment centers; relates to health home services; relates to managed long term care plans and residential health care facilities; relates to insurance co-payments; provides palliative care support for patients with advanced life limiting conditions and illnesses; relates to the provision of home health care services; establishes a workgroup to develop a plan and draft legislation for the purpose of operating and managing public nursing homes; encourages cooperative, collaborative and integrative arrangements between health care providers, payers, and others; relates to the definition of estate; relates to the New York state medical indemnity fund and the New York state hospital quality initiative; requires compliance with operational standards by hospitals and providers of services in hospitals; creates an accountable care organization demonstration program; limits the reporting of death by the operator of an adult home or residence; requires preclaim review for participating providers of medical assistance program items and services; relates to seeking federal approvals to establish payment methodologies with accountable care organizations; relates to medical assistance for needy persons; relates to the character and adequacy of assistance; relates to residential health care facility supplemental payments, non-capital components of rates, and temporary nursing home stability contributions; authorizes the commissioner of health to enter into contracts for purposes of the Early Innovator federal grant award; and relates to applications for orders of rehabilitation or liquidation.

view sponsor memo
BILL NUMBER:S2809

TITLE OF BILL:

An act
to amend the elder law, in relation to Medicare part D; to amend
the public health law and the insurance law, in relation to early
intervention services;
to amend the public health law and the elder law, in relation to
creating local competitive performance grant programs for priority
health initiatives and initiatives in aging; to amend the
public health law,
in relation to tobacco control and insurance initiatives pool
distributions;
to amend the public health law, in relation
to clinical laboratories;
to amend the public health law, in relation to distribution of
HEAL NY capital grants;
to amend section 32 of part A of chapter 58 of
the laws of 2008, amending the elder law and other laws relating to
reimbursement to particular provider pharmacies and prescription drug
coverage, in relation to the effectiveness thereof; to amend section 4
of part X2 of chapter 62 of the laws of 2003, amending the public health
law relating to allowing for the use of funds of the office of
professional medical conduct for activities of the patient health
information and quality improvement act of 2000, in relation to the
effectiveness thereof; to amend paragraph b of subdivision 1 of section
76 of chapter 731 of the laws of 1993, amending the public health law
and other laws relating to reimbursement, delivery and capital costs of
ambulatory health care services and inpatient hospital services, in
relation to the effectiveness thereof; to amend section 4 of chapter 505
of the laws of 1995, amending the public health law relating to the
operation of department of health facilities, in relation to the
effectiveness thereof; to amend section 3 of chapter 303 of the laws of
1999, amending the New York state medical care
facilities finance agency act
relating to financing health facilities, in relation to the
effectiveness thereof;
to repeal
subdivisions 4 and 5 of section 2545 of the public health law, relating
to IFSP; to repeal paragraph (b) of subdivision 2 of section 605 of the
public health law, relating to state aid for basic services;
to repeal subdivision 2, and paragraphs (c), (d)
and (g)
of subdivision 3 of section 242 of the elder law, relating to
eligibility for comprehensive coverage for elderly pharmaceutical
insurance; to repeal section 244 of the elder law, relating to the
elderly pharmaceutical insurance coverage panel; to repeal subdivisions
1, 2 and 4 of section 247 of the elder law, relating to cost-sharing
responsibilities of participants in the elderly pharmaceutical insurance
coverage program; and to repeal section 248 of the elder law, relating to
cost-sharing responsibilities of participants in the elderly
catastrophic insurance program (Part A);
to amend the
public health law, in relation
to rates of payment and medical assistance;
and to amend chapter 58 of the laws


of 2009,
amending the public health law and other laws relating to Medicaid
reimbursements to residential health care facilities, in relation to
adjustments to Medicaid ratio of payment for inpatient services (Part B);
to amend the New York Health Care Reform Act of 1996, in relation to
extending certain provisions relating thereto; to amend the New York
Health Care Reform Act of 2000, in relation to extending the
effectiveness of provisions thereof; to amend the public health law, in
relation to the distribution of pool allocations and graduate medical
education;
to amend chapter 62 of the laws of 2003 amending the general
business law and other laws relating to enacting major components
necessary to implement the state fiscal plan for the 2003-04 state
fiscal year, in relation to the deposit of certain
funds; to amend the public health law, in relation to health care
initiative pool distributions; to amend the public
authorities law, in relation to the transfer of certain funds;
to amend the social services law, in relation to extending payment
provisions for general hospitals; to amend chapter 600 of the laws of
1986 amending the public health law relating to the development of pilot
reimbursement programs for ambulatory care services, in relation to the
effectiveness of such chapter;
to amend
chapter 520 of the
laws of 1978 relating to providing for a comprehensive survey of health
care financing, education and illness prevention and creating councils
for the conduct thereof, in relation to extending the effectiveness of
portions thereof; to amend the public health law, in relation to
extending access to community health care services in rural areas;
to amend the public health law, in relation to
continuing the priority restoration adjustment;
to amend chapter
266 of the laws of 1986 amending the civil practice law and rules and
other laws relating to malpractice and professional medical conduct, in
relation to extending the applicability of certain provisions thereof;
to amend the insurance law, in relation to liquidation of domestic
insurers; to amend chapter 63 of the laws of 2001 amending chapter 20 of
the laws of 2001 amending the military law and other laws relating to
making appropriations for the support of government, in relation to
extending the applicability of certain provisions thereof;
to amend chapter 904 of the laws of 1984, amending the public health law
and the social services law relating to encouraging comprehensive health
services, in relation to the effectiveness thereof;
to amend the social services law and the
public health law, in relation to
rates of payment for personal care service providers, residential health
care facilities and diagnostic and treatment centers; and to amend
chapter 495 of the laws of 2004
amending the insurance law and the public health law relating to the New
York state health insurance continuation assistance demonstration
project, in relation to the effectiveness of such provisions (Part C);
to amend the public health law, in relation to payments to
residential health care
facilities; to amend chapter 474 of the laws of 1996, amending the
education law and
other laws relating to rates for residential healthcare facilities, in
relation to


reimbursements; to amend chapter 884 of the laws of 1990, amending the
public health
law relating to authorizing bad debt and charity care allowances for
certified home health
agencies, in relation to the effectiveness thereof; to amend chapter
81 of the laws of 1995,
amending the public health law and other laws relating to medical
reimbursement
and welfare reform, in relation to reimbursements and the
effectiveness thereof; to
amend the public health law, in relation to capital related inpatient
expenses;
to amend part C of chapter 58 of
the laws of 2007,
amending the social services law and other laws relating to enacting
the major
components of legislation necessary to implement the health and mental
hygiene
budget for the 2007-2008 state fiscal year, in relation to rates of
payment by state
governmental agencies;
to amend
chapter 451 of the
laws of 2007, amending the public health law, the social services law
and the insurance
law, relating to providing enhanced consumer and provider protections,
in relation to
extending the effectiveness of certain provisions thereof; to amend
the public health law,
in relation to rates of payment for long term home health care
programs; to amend
chapter 2 of the laws of 1998,
amending the public health law and other
laws
relating to expanding the child health insurance plan, in relation to
the effectiveness of
certain provisions thereof; to amend chapter 649 of the laws of 1996,
amending the
public health law, the mental hygiene law and the social services law
relating to
authorizing the establishment of special needs plans, in relation to
the effectiveness
thereof; to amend chapter 58 of the laws of 2008, amending the social
services law and
the public health law relating to adjustments of rates, in relation to
the effectiveness of certain provisions thereof;
to amend chapter 535 of the laws of 1983, amending the
social services law
relating to eligibility of certain enrollees for medical assistance,
in relation to the
effectiveness thereof;
to amend chapter 19 of the laws
of 1998, amending
the social services law relating to limiting the method of payment for
prescription
drugs under the medical assistance program, in relation to the
effectiveness thereof;


to amend chapter 710 of the laws of 1988, amending the social
services law and the education law relating to medical assistance
eligibility of certain persons and providing for managed medical
care demonstration programs,
in relation to the effectiveness thereof; to amend chapter
165 of the laws of
1991,
amending the public health law and other laws relating to
establishing payments
for medical assistance, in relation to the effectiveness thereof;
to repeal certain provisions of the public health law relating
to capital related inpatient expenses; and to repeal certain
provisions of chapter 41 of the laws of 1992, amending the
public health law and other laws relating to health care providers
relating to the effectiveness of certain provisions
thereof (Part D);
to amend the social services law,
in relation to suspension of
eligibility for medical assistance (Part E);
to amend chapter 57 of the laws of 2006, relating to
establishing a cost of living
adjustment for designated human services programs, in relation to
foregoing such adjustment during the 2011-2012 state fiscal
year (Part F); and
to amend the mental hygiene law, in relation to the closure and the
reduction in size of certain facilities serving persons with mental
illness; and to repeal certain provisions of such law relating thereto
(Part G)

PURPOSE:

This bill contains provisions needed to
implement the Health
and Mental Hygiene portions of the 2011-12 Executive Budget.

This memorandum describes Parts A through G of the bill which are
described wholly within the parts listed below.

Part A - Improve public health services and achieve savings by
modifying Elderly Pharmaceutical Insurance Coverage, Early
Intervention, and General Public Health Work, and implementing
various other changes.

PURPOSE:

This bill contains provisions needed to implement the 2011-12
Executive Budget through cost savings and various other changes in
the Department of Health (DOH) and the State Office for the Aging
(SOFA).

STATEMENT IN SUPPORT. SUMMARY OF PROVISIONS, EXISTING LAW, AND
PRIOR LEGISLATIVE HISTORY:

This bill generates State Financial Plan savings by modifying the
Elderly Pharmaceutical Insurance Coverage (EPIC), Early


Intervention (EI) and General Public Health Work (GPHW) programs, and
implementing various other changes.

Section 1 of the bill amends Elder Law § 242(3) to eliminate the Part
D premium assistance payment and deductible credit currently provided
by EPIC.

Section 2 of the bill amends Elder Law § 241 to eliminate references
to the EPIC application fee and deductible credit and define the
"coverage gap period" and "Medicare Part D excluded drug classes."

Sections 3 of the bill through 3-n amend Elder Law §§ 242, 243, 244,
247, 248, 250 and 254 to provide for EPIC coverage only while a
participant is in the Medicare Part D coverage gap and to streamline
the program through measures such as the elimination of transitional
assistance, financial hardship exemptions, the EPIC panel, the EPIC
registration fee, and catastrophic drug coverage.

Section 4 of the bill provides for a 10 percent across-the-board
reduction in rates for the EI program.

Section 5 of the bill amends public Health Law § 2559 to require
providers who receive more than $500,000 from Medicaid for EI
services each year to seek reimbursement directly from Medicaid prior
to seeking payment from municipalities for these services.

Sections 6 through 10 of the bill are intentionally omitted.

Section 11 of the bill amends Insurance Law § 3235-a to prohibit
Insurance companies from denying claims for medical services normally
covered under the terms of a policy based on prior authorization
requirements, the location where services are provided, the duration
of the condition, the likelihood of significant improvement, or the
network status of the service provider.

Section 12 of the bill amends Public Health Law § 2545 to eliminate
the requirement that a child's parents and an El official agree on
the child's initial Individualized Family Service Plan (IFSP) before
the EI official can authorize EI services. This change complies with
Federal regulations which only require parental consent on services
prior to authorization.

Section 13 of the bill amend s Public Health Law § 605 to eliminate
reimbursement for optional services for the GPHW program.

Section 14 of the bill adds a new Public Health Law § 212 to establish a
Local Competitive Performance Grant program for priority health
initiatives by authorizing the commissioner of Health to make grants
and enter into contracts (within amounts appropriated) with public,
non-profit or private entities.

Section 15 of the bill adds a new Elder Law § 224 to establish a Local
Competitive Performance Grant program for priority initiatives in
aging by authorizing the Director of SOFA to make grants and enter
into contracts (within amounts appropriated) with public, non-profit
or private entities.


Section 16 of the bill makes a technical amendment to Public Health
Law § 2807-v to delink the funding for the Empire State Stem Cell
Fund authorized by the Health Care Reform Act (HCRA) from any
potential conversion proceeds to allow for spending from current HCRA
resources.

Section 17 of the bill is intentionally omitted.

Sections 18 of the bill through 21 amend Public Health Law §§ 571,575,
576 and 577 to update and clarify the cost components of the
methodology used to determine fees that support DOH's oversight
system for clinical laboratories and blood banks.

Sections 22 through 25 of the bill are intentionally omitted.

Section 25-a of the bill amends Public Health Law § 2818 to authorize
the Commissioner of Health to distribute funds available under the
Health Care Efficiency and Affordability Law for New Yorkers
(HEAL-NY) program through grants to general hospitals and nursing
homes, without a competitive bid or request for proposal process, to
facilitate closures, mergers and restructuring of such facilities for
the purpose of promoting access to essential health care services.

Section 26 of the bill amends Chapter 58 of the Laws of 2008 to make
permanent an increase in certain maximum monetary penalties for
violations of the Public Health or its associated regulations and the
dedication of revenue generated from such increase to the support of
the Patient Safety Center.

Section 27 of the bill amends Chapter 62 of the Laws of 2003 to extend
for two years a provision allowing the use Office of Professional
Medical Conduct (OPMC) funds for activities that support patient
safety initiatives.

Section 28 of the bill amends Chapter 731 of the Laws of 1993 to
provide a three year extension of the health occupation development
and work place demonstration programs.

Section 29 of the bill amends Chapter 505 of the Laws of 1995 to make
permanent the statute authorizing a streamlined process for contracts
for the purchase of goods and services for State hospitals operated
by DOH up threshold amounts.

Section 30 of the bill amends Chapter 303 of the Laws of 1999 to make
permanent the statute permitting the Dormitory Authority of the State
of New York to bundle Primary Care Development Corporation projects
and refinance them at lower cost.

Section 31 of the bill sets effective dates for these provisions and
authorizes the Commissioner of Health to promulgate emergency
regulations if necessary to implement the provisions of sections 18
through 21 of the bill.

BUDGET IMPLICATIONS:


Enactment of this bill is necessary to implement the 2011-2012
Executive Budget, which recommends State Financial Plan savings of
$75.8 million in 2011-12 and $187.5 million in 2012-13 as follows:

* $58.4 million in savings in 2011-12 ($93.2 million in 2012-13)
associated with reforming the EPIC program.

* $11.6 million in savings in 2011-12 ($50.8 million in 2012-13)
associated with modifying the EI program.

* $10.5 million in savings in 2011-12 ($52.8 million in 2012-13)
associated with eliminating optional services under the GPHW program.

* $3.9 million in costs in 2011-12 ($7.7 million in 2012-13)
associated with establishing a Local Competitive Performance Grant
Program for DOH.

* $0.8 million in costs in 2011-12 ($1.6 million in 2012-13)
associated with establishing a Local Competitive Performance Grant
Program for SOFA.

EFFECTIVE DATE:

This bill takes effect April 1, 2011, with the following exceptions:

* Section 1 takes effect July 1, 2011;

* Sections 2 through 3-n take effect January 1, 2012; and

* Section 13 takes. effect on July 1, 2011.

Part B - Suspend implementation of a new nursing home reimbursement
method and extend the reimbursement cap, authorize certain Medicaid
payments and extend authorization to collect nursing home assessment
revenue.

PURPOSE:

This bill is necessary to suspend the implementation of a new nursing
home reimbursement methodology and extend the existing nursing home
reimbursement cap and authorization to collect nursing home
assessment revenue. In addition, this bill authorizes certain
Medicaid payments to State University of New York (SUNY) hospitals,
AIDS Adult Day Health Care (ADHC) providers and providers treating
Huntington's disease.

STATEMENT IN SUPPORT, SUMMARY OF PROVISIONS, EXISTING LAW, AND
PRIOR LEGISLATIVE HISTORY:

Section 1 of the bill authorizes supplemental Medicaid payments for
professional services provided by physicians, nurse practitioners,
and physician assistants participating in practice plans affiliated
with SUNY hospitals.

Section 2 of the bill amends Public Health Law § 2807-c to require
hospitals to submit additional data to the Department of Health for


the purpose of calculating provider specific disproportionate share
hospital caps, in accordance with Federal requirements.

Section 3 of the bill amends Public Health Law § 2808 to suspend
implementation of the nursing home rebasing methodology until July 1,
2011.

Section 4 of the bill amends Chapter 58 of the Laws of 2009 to extend
the $210 million (gross) annual cap on nursing home rate increases
through March 31,2012.

Section 5 of the bill authorizes Medicaid payments for nursing homes
with discrete units for treating patients with Huntington's disease.

Sections 6 and 7 of the bill allow prior year Medicaid payments to be
made to adult day health care providers treating patients with AIDS.

Section 8 of the bill amends Public Health Law § 2807 -d to
permanently extend authorization to collect nursing home gross
receipts assessments.

Section 9 of the bill provides that the State shall not take any
administrative or statutory action that would cause the state share
of Medicaid spending to grow at an annual rate that exceeds a
10-year rolling average of the medical component of the Consumer Price
Index.

Sections 10, 11, 12 and 13 of the bill set forth provisions pertaining
to statutory references, time frames for notice, severability and
effective dates.

BUDGET IMPLICATIONS:

Enactment of this bill is necessary to implement the 2011-2012
Executive Budget by authorizing the collection of $556 million in
annual revenues and the payment of funds as assumed in the State's
Financial Plan.

EFFECTIVE DATE:

This bill takes effect April 1, 2011.

Part C - Extend the Health Care Reform Act (HCRA) for three years.

PURPOSE:

This bill extends the provisions of the Health Care Reform Act (HCRA)
governing the financing of health care. services through March
31, 2014. Currently, HCRA is scheduled to sunset on March 31, 2011.

SUMMARY OF PROVISIONS, EXISTING LAW, PRIOR LEGISLATIVE HISTORY,
STATEMENT IN SUPPORT:

In 1996, New York enacted the Health Care Reform Act (HCRA), which
replaced the hospital reimbursement system in existence since 1983
with a deregulated system.
This Act was designed to improve the fiscal health of hospitals and


support critical
public health programs. It was subsequently extended and modified
several times, most recently by Chapter 58 of the Laws of 2008, which
reauthorized HCRA through March 31, 2011.

This bill extends HCRA through March 31, 2014 and amends provisions in
order to maximize the use of available revenue sources, modify
programs and secure the fiscal viability of HCRA through its proposed
extension period. Specifically:

Sections 1 through 3 of the bill amend various provisions to extend
effective dates through March 31, 2014. These provisions include the
continuation of the Medicaid inpatient hospital reimbursement.
methodology as well as the collection and allocation of HCRA
surcharges.

Section 4 of the bill provides funding for various administrative
costs of the Department of Health to assist in the implementation of
HCRA programs.

Sections 5, 5-a, 5-b and 6 of the bill amend Public Health Law
§ 2807-s to extend authorization for the collection of the Covered Lives
Assessment through March 31, 2014.

Sections 7 and 8 of the bill amend Public Health Law §§ 2807-1 and
2807-v to extend the Health Care Initiatives and Tobacco Control and
Insurance Initiatives Pools.

Section 9 of the bill amends Public Authorities Law § 1680-j to modify
and extend the authority to transfer funds from HCRA to the General
Fund for purposes related to subsidizing Health Care Efficiency and
Affordability Law for New Yorkers (HEAL-NY) capital grants and debt
service costs.

Sections 10 through 12 of the bill extend the authorization for
certain provisions historically extended with HCRA (ie.; timely
hospital admission billing payments, uniform fiscal intermediary
billing requirements, the Council on Health Care Financing, and the
Ambulatory Care Pilot Program).

Sections 13 and 14 of the bill amend Public Health Law §§ 2952 and
2958 to extend provisions regarding funding for the Rural Health
Network and Access Development Programs.

Sections 15 through 20 of the bill extend the Physician's Excess
Medical Malpractice Program through June 30, 2014.

Sections 21 through 25 of the bill amend various provisions to extend
the Primary Care Case Management Program, the Upstate Personal Care
and Home Care Workforce Recruitment and Retention Programs, and the
Entertainment Industry Worker Insurance Demonstration Program through
March 31, 2014.

Section 26 and 26-a of the bill amend Public Health Law § 2807-m to
extend the authorization for Area Health Education Centers (AHEC),
the Empire Clinical Research Investigator Program (ECRIP) and the


Doctors Across New York program, including programs such as the
Physician Loan Repayment and Practice Support Programs.

Section 27 of the bill amends Public Health Law § 2807-p to extend
authorization for State-only grant payments for clinic bad debt and
charity care.

Sections 28 and 29 of the bill amend Public Health Law §§ 2807-k and
2807-w to extend hospital indigent care payments through December
31, 2014.

Sections 30 and 31 of the bill amend Public Health Law § 2807-j to
clarify that, similar to physicians employed by a hospital, private
practice physicians who bill discretely in a hospital or clinic are
not required to pay HCRA surcharges.
Sections 32 through 35 of the bill pertain to waiver authority, time
frames for notice, severability and effective dates.

BUDGET IMPLICATIONS:

Enactment of this bill is necessary to implement the 2011-12 Executive
Budget and the State's multi-year Financial Plan, which reflects the
continuation of HCRA funding for a number of important health
programs and revenue sources.

EFFECTIVE DATE:

This bill takes effect April 1, 2011.

Part D - Extend various provisions of the Public Health, Social
Services and Mental Hygiene laws, including continued authorization
of previously enacted Medicaid savings initiatives.

PURPOSE:

This bill is necessary to maintain Financial Plan savings by
continuing various previously enacted Medicaid cost containment
actions authorized in the Public Health, Social Services and Mental
Hygiene Laws.

STATEMENT IN SUPPORT, SUMMARY OF PROVISIONS, EXISTING LAW, AND
PRIOR LEGISLATIVE HISTORY:

Section 1 of the bill permanently extends authorization for up to $300
million annually for nursing home "upper payment limit" (UPL)
payments for non-state operated public nursing homes.

Section 2 of the bill permanently extends unconsolidated law
authorizing "intergovernmental transfer" (IGT) payments to non-New
York City "disproportionate share hospitals" (DSH).

Section 3 of the bill extends authorization for bad debt and charity
care allowances for certified home health agencies through 2013.

Sections 4 through 8 of the bill permanently extend provisions
relating to Medicaid capital cost reimbursement and remove references
to Medicare that are no longer relevant.


Section 9 of the bill permanently continues the exclusion of the
1996-97 trend factor from nursing home and inpatient rates.

Section 10 of the bill permanently continues the 0.25 percent trend
factor reduction for hospitals and nursing homes.

Sections 11 through 14 and 14-a of the bill extend the requirement
that nursing homes, hospitals, certified home health care and long
term home health care providers maximize Medicare revenues through
February 1, 2013.

Sections 15 and 16 of the bill remove a $1.5 million reconciliation
limit for the certified home health care agency administrative and
general cap.

Section 17 of the bill extends the requirement that parties to a
contract between a hospital and a managed care organization (MCO)
continue to abide by the terms of the contract for two months from
the effective date of contract termination or non-renewal, unless
certain circumstances are met, through June 30, 2013.

Section 18 of the bill permanently extends a limitation on the
reimbursement of the long term home health care program
administrative and general costs to a statewide average.

Section 19 of the bill permanently extends certain income and benefit
expansions relating to Child Health Plus and facilitated enrollment.

Section 20 of the bill permanently extends authorization for partially
capitated managed care plans to provide primary care and preventive
services to Medicaid recipients as well as HIV special needs plans.

Section 21 of the bill extends authorization for the Commissioner of
Health to establish utilization thresholds for Medicaid services
through July 1, 2014.

Section 22 of the bill permanently extends authorization for the
Medicaid program, subject to the availability of Federal financial
participation, to cover Medicaid Managed
Care (MMC) premiums for the six-month period beginning with enrollment
in a MMC plan, even if the enrollee loses eligibility for Medicaid
before the end of such period.

Section 23 of the bill continues the statutory requirement that
establishes limited licensed home care service agencies in adult
homes or enriched housing programs as providers of personal care and
limited medical services.

Section 24 of the bill extends the managed care pharmacy carve-out
through March 31, 2014.

Section 25 of the bill permanently extends the Medicaid managed care
program.

Sections 26 and 26-a of the bill permanently extend Medicaid
co-payments.


BUDGET IMPLICATIONS:

Enactment of this bill is necessary to implement the 2011-12 Executive
Budget because it ensures the continuation of previously enacted
State Financial Plan savings totaling $221.6 million annually.

EFFECTIVE DATE:

This bill takes effect April 1, 2011.

Part E - Amend the Medicaid eligibility status of individuals served
in Institutions for Mental Diseases (IMD).

PURPOSE:

This bill is designed to allow the Office of Mental Health
(OMH) to suspend, rather than terminate, Medicaid. (MA) eligibility
for individuals who are served in Institutions for Mental Disease
(IMD), thereby preventing a delay in their receipt of needed services
after discharge from the institution, and also preventing significant
loss of Federal MA funding to the State.

STATEMENT IN SUPPORT, SUMMARY OF PROVISIONS, EXISTING LAW, AND
PRIOR LEGISLATIVE HISTORY:

Currently, the State terminates MA eligibility for individuals between
the ages of 22 and 64 when they are admitted to a psychiatric
hospital, or other facility classified by the Federal government as
an IMD, since services provided to such individuals in such
facilities are not eligible for Federal Financial Participation (FFP)
under MA law and regulations. However, upon discharge from and IMD
facility such individuals are required to re-enroll in MA in order to
receive reimbursable services. Although technically eligible for MA
upon discharge, there is usually a lag until eligibility is
re-established.

This delay in eligibility can negatively impact post-discharge
continuity of care, because individuals are unable to timely access
needed care, which in turn leads to increases in relapse rates,
emergency care reliance and otherwise avoidable hospitalizations.
Service providers and State and local governments are also more likely
to bear the full cost of their care, without the Federal assistance
such services would generate under MA. If eligibility is suspended
rather than terminated upon admission to an IMD facility, individuals
will be better served upon discharge, with immediate access to health
and mental health services that provide continuity of care and
ongoing support that can reduce recidivism and avoid more costly
services.

Furthermore, the Federal Centers for Medicare and MA Services (CMS)
has recommended that States suspend rather than terminate eligibility
for such individuals.
In 2010 CMS also issued guidance indicating that the costs of
providing inpatient services for individuals in IMDs whose MA has
been terminated will no longer be counted in calculating an IMD's MA
"disproportionate share" (DSH) payments, whereas the costs of such
patients with suspended eligibility will be countable. Additionally,


many OMH inpatients between 22 and 64 years of age are dually
eligible for Medicare and MA when admitted. However, because current
State policy results in removal of these individuals from the MA
rolls, CMS views them as receiving Medicare only, which is considered
third party coverage and therefore ineligible for DSH payments. By
suspending instead of terminating eligibility, such individuals
would still be on the MA roll, thereby making their uncompensated
costs DSH eligible.

Chapter 355 of the Laws of 2007 similarly amended Social Services Law
§ 366 to authorize State and local correctional facilities to suspend
rather than terminate MA eligibility for inmates during an
individual's incarceration. As a result of this bill, if such an
inmate is released from a correctional facility and immediately
admitted to an IMD facility, the former inmate's MA eligibility would
continue to be suspended until his or her discharge to the community.

BUDGET IMPLICATIONS:

Enactment of this bill is necessary to implement the 2011-2012
Executive Budget because it would preserve roughly $200 million in
annual DSH revenues that would otherwise be subject to Federal
disallowances.

EFFECTIVE DATE:

This bill takes effect April 1, 2011.

Part F - Establish a one-year deferral of the Human Services Cost of
living Adjustment.

PURPOSE:

This bill defers the Human Services Cost-of-Living Adjustment (COLA)
for 2011-12 and extends the adjustment for an additional year,
through March 31, 2015.

STATEMENT IN SUPPORT, SUMMARY OF PROVISIONS, EXISTING LAW, AND
PRIOR LEGISLATIVE HISTORY:

This bill defers the 2011-12 COLA for designated Human Services
programs under the auspices of several State agencies, including the
Office for People with Developmental Disabilities, Office of Mental
Health, Office of Alcoholism and Substance Abuse Services, Department
of Health, State Office for the Aging, and Office of Children and
Family Services.

Additionally, this bill seeks to honor the State's commitment to
support the COLA for three years by continuing the adjustment for one
additional year, through SFY 2014-15.

BUDGET IMPLICATIONS:

Eliminating the formula for the 2011-12 Human Services COLA will
result in a savings of $49 million annually to the State.

EFFECTIVE DATE:


This bill takes effect immediately.

Part G - Ensure the efficient and cost-effective delivery of programs
and services operated by the Office of Mental Health.

PURPOSE:

This bill ensures that reforms intended to facilitate the cost
effective and efficient operation of hospitals, facilities and
programs run by the Office of Mental Health (OMH) can be effectuated
by the Commissioner. Currently, such reforms are subject to a one year
period of delay before they can be implemented.

STATEMENT IN SUPPORTS, SUMMARY OF PROVISIONS, EXISTING LAW, AND
PRIOR LEGISLATIVE HISTORY:

This bill provides the OMH Commissioner with the flexibility to
determine the most appropriate and effective way to deliver
State-operated services, including which facilities and programs
should be closed, consolidated, downsized, redesigned or
transferred based on a variety of factors, including fiscal and
programmatic needs, clinical assessments, and current census figures.

The bill permanently repeals Mental Hygiene Law § 7.17(e), which
currently requires a one-year notice for significant service
reductions, and notwithstands subdivision (b) that delineates
individual State Psychiatric Centers. For 2011-12, the bill also
allows the OMH Commissioner to the flexibility to consolidate,
reduce, transfer, close or redesign facilities and services
notwithstanding MHL Section 41.55, which requires that all savings
realized from the closure of hospitals or beds be reinvested into
community services.

The approach facilitated by this bill is part of a longstanding effort
to have individuals served in the community rather than in
institutions, which can be a more appropriate and less costly setting
for many individuals.

BUDGET IMPLICATIONS:

Enactment of this bill is necessary to implement the 2011-12 Executive
Budget and generate savings associated with a ten percent cut in
State operational costs.

EFFECTIVE DATE:

This bill takes effect April 1, 2011.

The provisions of this act shall take effect immediately, provided,
however, that the applicable effective date of each part of this act
shall be as specifically set forth in the last section of such part.

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

    S. 2809                                                  A. 4009

                      S E N A T E - A S S E M B L Y

                            February 1, 2011
                               ___________

IN  SENATE -- A BUDGET BILL, submitted by the Governor pursuant to arti-
  cle seven of the Constitution -- read twice and ordered  printed,  and
  when printed to be committed to the Committee on Finance

IN  ASSEMBLY  --  A  BUDGET  BILL, submitted by the Governor pursuant to
  article seven of the Constitution -- read once  and  referred  to  the
  Committee on Ways and Means

AN  ACT to amend the elder law, in relation to Medicare part D; to amend
  the public health law and the insurance  law,  in  relation  to  early
  intervention  services;  to  amend the public health law and the elder
  law, in relation  to  creating  local  competitive  performance  grant
  programs  for priority health initiatives and initiatives in aging; to
  amend the public health law, in relation to tobacco control and insur-
  ance initiatives pool distributions; to amend the public  health  law,
  in  relation to clinical laboratories; to amend the public health law,
  in relation to distribution  of  HEAL  NY  capital  grants;  to  amend
  section  32  of part A of chapter 58 of the laws of 2008, amending the
  elder law and other  laws  relating  to  reimbursement  to  particular
  provider pharmacies and prescription drug coverage, in relation to the
  effectiveness  thereof; to amend section 4 of part X2 of chapter 62 of
  the laws of 2003, amending the public health law relating to  allowing
  for the use of funds of the office of professional medical conduct for
  activities  of  the patient health information and quality improvement
  act of 2000, in relation to the effectiveness thereof; to amend  para-
  graph  b  of subdivision 1 of section 76 of chapter 731 of the laws of
  1993, amending the public  health  law  and  other  laws  relating  to
  reimbursement,  delivery  and  capital costs of ambulatory health care
  services and inpatient hospital services, in relation  to  the  effec-
  tiveness  thereof;  to  amend  section 4 of chapter 505 of the laws of
  1995, amending the public health law  relating  to  the  operation  of
  department  of  health  facilities,  in  relation to the effectiveness
  thereof; to amend section 3 of chapter 303 of the laws of 1999, amend-
  ing the New York state medical  care  facilities  finance  agency  act
  relating to financing health facilities, in relation to the effective-
  ness  thereof;  to  repeal subdivisions 4 and 5 of section 2545 of the
  public health law, relating to IFSP; to repeal paragraph (b) of subdi-
  vision 2 of section 605 of the public health law,  relating  to  state

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD12571-01-1

S. 2809                             2                            A. 4009

  aid  for  basic services; to repeal subdivision 2, and paragraphs (c),
  (d) and (g) of subdivision 3 of section 242 of the elder law, relating
  to eligibility for comprehensive coverage for  elderly  pharmaceutical
  insurance;  to  repeal  section  244 of the elder law, relating to the
  elderly pharmaceutical insurance coverage panel;  to  repeal  subdivi-
  sions  1,  2  and 4 of section 247 of the elder law, relating to cost-
  sharing responsibilities of participants in the elderly pharmaceutical
  insurance coverage program; and to repeal section  248  of  the  elder
  law,  relating to cost-sharing responsibilities of participants in the
  elderly catastrophic insurance program (Part A); to amend  the  public
  health  law,  in  relation to rates of payment and medical assistance;
  and to amend chapter 58 of the  laws  of  2009,  amending  the  public
  health law and other laws relating to Medicaid reimbursements to resi-
  dential health care facilities, in relation to adjustments to Medicaid
  ratio  of  payment  for  inpatient services (Part B); to amend the New
  York Health Care Reform Act of 1996, in relation to extending  certain
  provisions  relating thereto; to amend the New York Health Care Reform
  Act of 2000, in relation to extending the effectiveness of  provisions
  thereof;  to  amend the public health law, in relation to the distrib-
  ution of pool allocations and graduate  medical  education;  to  amend
  chapter  62  of the laws of 2003 amending the general business law and
  other laws relating to enacting major components necessary  to  imple-
  ment  the  state  fiscal  plan  for  the 2003-04 state fiscal year, in
  relation to the deposit of certain funds; to amend the  public  health
  law,  in  relation  to  health  care initiative pool distributions; to
  amend the public authorities law,  in  relation  to  the  transfer  of
  certain  funds;  to  amend  the  social  services  law, in relation to
  extending payment provisions for general hospitals; to  amend  chapter
  600 of the laws of 1986 amending the public health law relating to the
  development  of  pilot  reimbursement  programs  for  ambulatory  care
  services, in relation to the effectiveness of such chapter;  to  amend
  chapter 520 of the laws of 1978 relating to providing for a comprehen-
  sive survey of health care financing, education and illness prevention
  and  creating councils for the conduct thereof, in relation to extend-
  ing the effectiveness of portions thereof; to amend the public  health
  law, in relation to extending access to community health care services
  in rural areas; to amend the public health law, in relation to contin-
  uing  the priority restoration adjustment; to amend chapter 266 of the
  laws of 1986 amending the civil practice law and rules and other  laws
  relating  to malpractice and professional medical conduct, in relation
  to extending the applicability of certain provisions thereof; to amend
  the insurance law, in relation to liquidation of domestic insurers; to
  amend chapter 63 of the laws of 2001 amending chapter 20 of  the  laws
  of  2001  amending  the military law and other laws relating to making
  appropriations for the support of government, in relation to extending
  the applicability of certain provisions thereof; to amend chapter  904
  of  the  laws  of  1984, amending the public health law and the social
  services law relating to encouraging comprehensive health services, in
  relation to the effectiveness thereof; to amend  the  social  services
  law  and  the  public  health law, in relation to rates of payment for
  personal care service providers, residential  health  care  facilities
  and  diagnostic and treatment centers; and to amend chapter 495 of the
  laws of 2004 amending the insurance law  and  the  public  health  law
  relating  to  the New York state health insurance continuation assist-
  ance demonstration project, in relation to the effectiveness  of  such
  provisions  (Part  C);  to amend the public health law, in relation to

S. 2809                             3                            A. 4009

  payments to residential health care facilities; to amend  chapter  474
  of  the laws of 1996, amending the education law and other laws relat-
  ing to rates for residential healthcare  facilities,  in  relation  to
  reimbursements; to amend chapter 884 of the laws of 1990, amending the
  public  health  law  relating to authorizing bad debt and charity care
  allowances for certified home health  agencies,  in  relation  to  the
  effectiveness thereof; to amend chapter 81 of the laws of 1995, amend-
  ing  the  public  health  law  and  other  laws  relating  to  medical
  reimbursement and welfare reform, in relation  to  reimbursements  and
  the effectiveness thereof; to amend the public health law, in relation
  to  capital  related inpatient expenses; to amend part C of chapter 58
  of the laws of 2007, amending the social services law and  other  laws
  relating  to enacting the major components of legislation necessary to
  implement the health and mental hygiene budget for the 2007-2008 state
  fiscal year, in relation to rates of  payment  by  state  governmental
  agencies;  to  amend  chapter  451  of  the laws of 2007, amending the
  public health law, the social services  law  and  the  insurance  law,
  relating  to  providing enhanced consumer and provider protections, in
  relation to extending the effectiveness of certain provisions thereof;
  to amend the public health law, in relation to rates  of  payment  for
  long term home health care programs; to amend chapter 2 of the laws of
  1998,  amending  the  public  health  law  and  other laws relating to
  expanding the child health insurance plan, in relation to  the  effec-
  tiveness  of  certain  provisions thereof; to amend chapter 649 of the
  laws of 1996, amending the public health law, the mental  hygiene  law
  and  the social services law relating to authorizing the establishment
  of special needs plans, in relation to the effectiveness  thereof;  to
  amend chapter 58 of the laws of 2008, amending the social services law
  and  the  public  health  law  relating  to  adjustments  of rates, in
  relation to the effectiveness of certain provisions thereof; to  amend
  chapter  535  of  the  laws  of 1983, amending the social services law
  relating to eligibility of certain enrollees for  medical  assistance,
  in  relation  to the effectiveness thereof; to amend chapter 19 of the
  laws of 1998, amending the social services law  relating  to  limiting
  the method of payment for prescription drugs under the medical assist-
  ance program, in relation to the effectiveness thereof; to amend chap-
  ter  710 of the laws of 1988, amending the social services law and the
  education law relating to medical assistance  eligibility  of  certain
  persons and providing for managed medical care demonstration programs,
  in  relation to the effectiveness thereof; to amend chapter 165 of the
  laws of 1991, amending the public health law and other  laws  relating
  to  establishing  payments  for medical assistance, in relation to the
  effectiveness thereof; to repeal  certain  provisions  of  the  public
  health  law  relating  to  capital  related inpatient expenses; and to
  repeal certain provisions of chapter 41 of the laws of 1992,  amending
  the public health law and other laws relating to health care providers
  relating  to the effectiveness of certain provisions thereof (Part D);
  to amend the social services law, in relation to suspension of  eligi-
  bility  for  medical  assistance  (Part E); to amend chapter 57 of the
  laws of 2006, relating to establishing a cost of living adjustment for
  designated human services programs,  in  relation  to  foregoing  such
  adjustment  during  the  2011-2012  state fiscal year (Part F); and to
  amend the mental hygiene law, in  relation  to  the  closure  and  the
  reduction  in  size  of certain facilities serving persons with mental
  illness; and to repeal certain provisions of such law relating thereto
  (Part G)

S. 2809                             4                            A. 4009

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

  Section  1.  This  act enacts into law major components of legislation
which are necessary to implement the state fiscal plan for the 2011-2012
state fiscal year. Each component is  wholly  contained  within  a  Part
identified  as Parts A through G. The effective date for each particular
provision contained within such Part is set forth in the last section of
such Part. Any provision in any section contained within a Part, includ-
ing the effective date of the Part, which makes a reference to a section
"of this act", when used in connection with that  particular  component,
shall  be  deemed  to mean and refer to the corresponding section of the
Part in which it is found. Section three of  this  act  sets  forth  the
general effective date of this act.

                                 PART A

  Section  1. Paragraph (f) of subdivision 3 of section 242 of the elder
law, as added by section 3 of part B of chapter 58 of the laws of  2007,
is amended to read as follows:
  (f)  As  a  condition of continued eligibility for benefits under this
title, if a program participant is eligible for  Medicare  part  D  drug
coverage  under  section  1860D  of the federal social security act, the
participant is required to enroll in Medicare part D at the first avail-
able enrollment period and to maintain such enrollment. This requirement
shall be waived if such enrollment would  result  in  significant  addi-
tional financial liability by the participant, including, but not limit-
ed to, individuals in a Medicare advantage plan whose cost sharing would
be  increased,  or  if  such  enrollment would result in the loss of any
health coverage through a union or employer plan  for  the  participant,
the  participant's  spouse  or other dependent.  [The elderly pharmaceu-
tical insurance coverage program shall provide  premium  assistance  for
all participants enrolled in Medicare part D as follows:
  (i)  for  participants  with  comprehensive coverage under section two
hundred forty-seven of this title, the elderly pharmaceutical  insurance
coverage program shall pay for the portion of the part D monthly premium
that  is  the  responsibility  of the participant. Such payment shall be
limited to the low-income benchmark premium amount  established  by  the
federal  centers for Medicare and Medicaid services and any other amount
which such agency establishes  under  its  de  minimus  premium  policy,
except  that  such payments made on behalf of participants enrolled in a
Medicare advantage plan may  exceed  the  low-income  benchmark  premium
amount if determined to be cost effective to the program.
  (ii)  for  participants  with  catastrophic coverage under section two
hundred forty-eight of this title, the elderly pharmaceutical  insurance
coverage  program shall credit the participant's annual personal covered
drug expenditure amount required under this title by an amount equal  to
the  annual  low-income  benchmark  premium  amount  established  by the
centers for Medicare and Medicaid services, prorated for  the  remaining
portion  of  the participant's elderly pharmaceutical insurance coverage
program coverage period. The elderly pharmaceutical  insurance  coverage
program   shall,   at   appropriate   times,  notify  participants  with
catastrophic coverage under section  two  hundred  forty-seven  of  this
title  of their right to coordinate the annual coverage period with that
of Medicare part D, along with the possible advantages and disadvantages
of doing so.]

S. 2809                             5                            A. 4009

  S 2. Subdivision 6 of section 241 of the elder law is amended and  two
new subdivisions 8 and 9 are added to read as follows:
  6.  "Annual  coverage  period" shall mean the period of twelve consec-
utive calendar months for which an eligible program participant has  met
the  [application fee or deductible requirements, as the case may be, of
sections two hundred forty-seven and two hundred  forty-eight]  REQUIRE-
MENTS OF SECTION TWO HUNDRED FORTY-TWO of this title.
  8.  "COVERAGE GAP PERIOD" SHALL MEAN THE PERIOD BETWEEN THE END OF THE
MEDICARE  PART D INITIAL COVERAGE PHASE AND THE START OF MEDICARE PART D
CATASTROPHIC COVERAGE.
  9. "MEDICARE PART D EXCLUDED DRUG CLASSES" SHALL  MEAN  ANY  DRUGS  OR
CLASSES  OF DRUGS, OR THEIR MEDICAL USES, WHICH ARE DESCRIBED IN SECTION
1927(D)(2) OR 1927(D)(3) OF THE FEDERAL SOCIAL SECURITY  ACT,  WITH  THE
EXCEPTION OF SMOKING CESSATION AGENTS.
  S  3.  Subdivision 1 of section 242 of the elder law, paragraph (b) as
amended by section 14 of part B of chapter 57 of the laws  of  2006,  is
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,
WHO  IS  ENROLLED  IN MEDICARE PART D, 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, is less
than or equal to [twenty]  THIRTY-FIVE  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,  WHO
IS  ENROLLED  IN MEDICARE PART D, 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 beginning on or after January first, two  thousand  one,
is  less than or equal to [twenty-six] FIFTY thousand dollars. After the
initial determination of eligibility, each eligible individual  must  be
redetermined eligible at least every twenty-four months.
  S 3-a. Subdivision 2 of section 242 of the elder law is REPEALED.
  S  3-b. Paragraph (c) of subdivision 3 of section 242 of the elder law
is REPEALED and a new paragraph (c) is added to read as follows:
  (C) FOR PERSONS WHO MEET THE ELIGIBILITY REQUIREMENTS  TO  PARTICIPATE
IN  THE  ELDERLY  PHARMACEUTICAL INSURANCE COVERAGE PROGRAM, THE PROGRAM
WILL PAY FOR A DRUG COVERED BY THE PERSON'S MEDICARE PART D  PLAN  OR  A
DRUG IN A MEDICARE PART D EXCLUDED DRUG CLASS, AS DEFINED IN SUBDIVISION
NINE OF SECTION TWO HUNDRED FORTY-ONE OF THIS TITLE, DURING THE COVERAGE
GAP, AS DEFINED IN SUBDIVISION EIGHT OF SECTION TWO HUNDRED FORTY-ONE OF
THIS  TITLE,  PROVIDED  THAT  SUCH DRUG IS A COVERED DRUG, AS DEFINED IN
SUBDIVISION ONE OF SECTION TWO HUNDRED FORTY-ONE OF THIS TITLE, AND THAT
THE PARTICIPANT COMPLIES WITH THE POINT OF SALE CO-PAYMENT  REQUIREMENTS
SET FORTH IN SECTION TWO HUNDRED FORTY-SEVEN OF THIS TITLE.
  S  3-c. Paragraph (d) of subdivision 3 of section 242 of the elder law
is REPEALED.
  S 3-d. Paragraphs (e) and (f) of subdivision 3 of section 242  of  the
elder  law, paragraph (e) as amended by section 112 of part C of chapter
58 of the laws of 2009, paragraph (f) as added by section 3 of part B of
chapter 58 of the laws of 2007, are amended to read as follows:
  (e) As a condition of [continued] eligibility for benefits under  this
title,  if a program participant's income indicates that the participant
could be eligible for an income-related subsidy under  section  1860D-14

S. 2809                             6                            A. 4009

of  the  federal social security act by either applying for such subsidy
or by enrolling in a medicare savings program as  a  qualified  medicare
beneficiary  (QMB),  a specified low-income medicare beneficiary (SLMB),
or  a  qualifying  individual (QI), a program participant is required to
provide, and to authorize the elderly pharmaceutical insurance  coverage
program  to  obtain, any information or documentation required to estab-
lish the participant's eligibility for such subsidy,  and  to  authorize
the elderly pharmaceutical insurance coverage program to apply on behalf
of  the participant for the subsidy or the medicare savings program. The
elderly pharmaceutical insurance coverage program shall make  a  reason-
able  effort  to  notify  the  program participant of his or her need to
provide any of the above required information. After a reasonable effort
has been made to contact the participant, a participant shall  be  noti-
fied  in  writing that he or she has sixty days to provide such required
information. If such information is not provided within  the  sixty  day
period, the participant's coverage may be terminated.
  (f)  As a condition of [continued] eligibility for benefits under this
title, [if] a program participant is [eligible for Medicare part D  drug
coverage  under  section  1860D  of the federal social security act, the
participant is] required to [enroll] BE ENROLLED in Medicare part D  [at
the  first available enrollment period] and to maintain such enrollment.
[This requirement shall be waived if such  enrollment  would  result  in
significant  additional  financial liability by the participant, includ-
ing, but not limited to, individuals in a Medicare advantage plan  whose
cost  sharing  would be increased, or if such enrollment would result in
the loss of any health coverage through a union or employer plan for the
participant, the participant's spouse or other dependent.   The  elderly
pharmaceutical  insurance coverage program shall provide premium assist-
ance for all participants enrolled in Medicare part D as follows:
  (i) for participants with comprehensive  coverage  under  section  two
hundred  forty-seven of this title, the elderly pharmaceutical insurance
coverage program shall pay for the portion of the part D monthly premium
that is the responsibility of the participant.  Such  payment  shall  be
limited  to  the  low-income benchmark premium amount established by the
federal centers for Medicare and Medicaid services and any other  amount
which  such  agency  establishes  under  its  de minimus premium policy,
except that such payments made on behalf of participants enrolled  in  a
Medicare  advantage  plan  may  exceed  the low-income benchmark premium
amount if determined to be cost effective to the program.
  (ii) for participants with catastrophic  coverage  under  section  two
hundred  forty-eight of this title, the elderly pharmaceutical insurance
coverage program shall credit the participant's annual personal  covered
drug  expenditure amount required under this title by an amount equal to
the annual  low-income  benchmark  premium  amount  established  by  the
centers  for  Medicare and Medicaid services, prorated for the remaining
portion of the participant's elderly pharmaceutical  insurance  coverage
program  coverage  period. The elderly pharmaceutical insurance coverage
program  shall,  at  appropriate   times,   notify   participants   with
catastrophic  coverage  under  section  two  hundred forty-seven of this
title of their right to coordinate the annual coverage period with  that
of Medicare part D, along with the possible advantages and disadvantages
of doing so.]
  S  3-e. Paragraph (g) of subdivision 3 of section 242 of the elder law
is REPEALED.

S. 2809                             7                            A. 4009

  S 3-f. Paragraph (h) of subdivision 3 of section 242 of the elder law,
as added by section 3 of part B of chapter 58 of the laws  of  2007,  is
amended to read as follows:
  (h)  [In  order  to maximize prescription drug coverage under Medicare
part D, the] THE elderly pharmaceutical insurance  coverage  program  is
authorized  to  represent  program participants under this title [in the
pursuit of such] WITH RESPECT TO THEIR MEDICARE PART D  coverage.  [Such
representation shall not result in any additional financial liability on
behalf of such program participants and shall include, but not be limit-
ed to, the following actions:
  (i)  application  for the premium and cost-sharing subsidies on behalf
of eligible program participants;
  (ii) enrollment in a prescription drug plan or MA-PD plan; the elderly
pharmaceutical insurance coverage program shall provide program  partic-
ipants with prior written notice of, and the opportunity to decline such
facilitated  enrollment subject, however, to the provisions of paragraph
(f) of this subdivision;
  (iii) pursuit of appeals, grievances, or coverage determinations.]
  S 3-g. Section 243 of the elder law is amended to read as follows:
  S 243. Pharmaceutical insurance contract. 1. The  [elderly  pharmaceu-
tical  insurance  coverage  panel,  established  pursuant to section two
hundred forty-four of this title] COMMISSIONER OF HEALTH shall,  subject
to  the  approval  of  the director of the budget, enter into a contract
with one or more contractors to assist in carrying out the provisions of
this title. Such contractual arrangements shall be  made  subject  to  a
competitive  process  pursuant to the state finance law and shall ensure
that state  payments  for  the  contractor's  necessary  and  legitimate
expenses  for  the  administration  of  this  program are limited to the
amount specified in advance, and that such payments shall not exceed the
amount appropriated therefor in any fiscal year. The [panel] COMMISSION-
ER shall[, at each of its  regularly  scheduled  meetings,]  review  the
contract  pricing  provisions  to  assure  that  the  level  of contract
payments are in the best interest of the state, giving consideration  to
the total level of participant enrollment achieved, the volume of claims
processed, and such other factors as may be relevant in order to contain
state  expenditures.  In  the event that the [panel] COMMISSIONER deter-
mines that the contract payment provisions do not protect  the  interest
of  the  state,  the  [executive  director]  COMMISSIONER shall initiate
contract negotiations for the purpose  of  modifying  contract  payments
and/or scope requirements.
  2.  The  responsibilities  of  the  contractor  or  contractors  shall
include, but need not be limited to:
  (a) providing for a method of determining, on an annual basis and upon
their application therefor,  the  eligibility  of  persons  pursuant  to
section  two  hundred forty-two of this title within a reasonable period
of time, including alternative methods for such determination of  eligi-
bility, such as through the mail or home visits, where reasonable and/or
necessary,  and  for  notifying  applicants of such eligibility determi-
nations;
  (b) notifying each eligible program participant in  writing  upon  the
commencement  of  the annual coverage period of such participant's cost-
sharing responsibilities pursuant  to  [sections]  SECTION  two  hundred
forty-seven  [and two hundred forty-eight] of this title. The contractor
shall also notify each eligible program participant of any adjustment of
the co-payment schedule by mail no less than thirty days  prior  to  the

S. 2809                             8                            A. 4009

effective  date  of  such  adjustments  and  shall  inform such eligible
program participants of the date such adjustments shall take effect;
  (c)  issuing  an  identification card to each ELIGIBLE program partic-
ipant [who is eligible to  purchase  prescribed  covered  drugs  for  an
amount  specified  pursuant  to subdivision three of section two hundred
forty-seven or subdivision three of section two hundred  forty-eight  of
this  title.  The dates of the annual coverage period shall be imprinted
on the card. When an  eligible  program  participant  meets  the  annual
limits  on  point  of  sale co-payments set forth in subdivision four of
section two hundred forty-seven  or  subdivision  four  of  section  two
hundred forty-eight of this title, either new identification cards shall
be  issued  to  such  participant  indicating  waiver of such co-payment
requirements for the remainder of the  annual  coverage  period  or  the
contractor  shall  develop and implement an alternative method to permit
the purchase of covered drugs without a co-payment requirement];
  (d) [developing and implementing  the  system  for  those  individuals
electing  the  deductible  option  to record their personal covered drug
expenditures in accordance with subdivision three of section two hundred
forty-eight of this title. Such recordkeeping system shall  be  provided
to  each  such participant at a nominal charge which shall be subject to
the approval of the panel. The contractor shall also  reimburse  partic-
ipants  for  personal  covered drug expenditures made in excess of their
deductible requirements, less the co-payments  required  by  subdivision
four  of  section  two  hundred forty-eight of this title, made prior to
their receipt of an identification card issued in accordance with  para-
graph (c) of this subdivision;
  (e)]  processing of claims for reimbursement to participating provider
pharmacies pursuant to section two hundred fifty of this title;
  [(f)] (E) performing or causing to be  performed  utilization  reviews
for  such  purposes  as  may  be required by the [elderly pharmaceutical
insurance coverage panel] COMMISSIONER OF HEALTH;
  [(g)] (F) conducting audits  and  surveys  of  participating  provider
pharmacies  as  specified  pursuant  to  the terms and conditions of the
contract; and
  [(h)] (G) coordinating coverage with  insurance  companies  and  other
public and private organizations offering such coverage for those eligi-
ble  program  participants  having  partial  coverage  for covered drugs
through third-party sources, and providing for recoupment of any  dupli-
cate  reimbursement paid by the state on behalf of such eligible program
participants.
  3. The contractor or contractors shall be  required  to  provide  such
reports as may be deemed necessary by the [elderly pharmaceutical insur-
ance  coverage panel] COMMISSIONER OF HEALTH and shall maintain files in
a manner and format approved by the [executive director] COMMISSIONER.
  4. The contractor or contractors may contract  with  private  not-for-
profit or proprietary corporations, or with entities of local government
within  the  state  of  New  York,  to  perform  such obligations of the
contractor or  contractors  as  the  [elderly  pharmaceutical  insurance
coverage panel] COMMISSIONER OF HEALTH shall permit.
  S  3-h. Section 244 of the elder law is REPEALED and a new section 244
is added to read as follows:
  S 244. POWERS OF THE COMMISSIONER  OF  HEALTH.    THE  POWERS  OF  THE
COMMISSIONER  OF  HEALTH  IN  ADMINISTERING  THE  ELDERLY PHARMACEUTICAL
INSURANCE COVERAGE PROGRAM SHALL INCLUDE  BUT  NOT  BE  LIMITED  TO  THE
FOLLOWING:

S. 2809                             9                            A. 4009

  1. SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE BUDGET, PROMULGATING
PROGRAM  REGULATIONS  PURSUANT  TO SECTION TWO HUNDRED FORTY-SIX OF THIS
TITLE;
  2. DETERMINING THE ANNUAL SCHEDULE OF COST-SHARING RESPONSIBILITIES OF
ELIGIBLE PROGRAM PARTICIPANTS PURSUANT TO SECTION TWO HUNDRED FORTY-SEV-
EN OF THIS TITLE;
  3. ENTERING INTO CONTRACTS PURSUANT TO SECTION TWO HUNDRED FORTY-THREE
OF THIS TITLE;
  4. IMPLEMENTING ALTERNATIVE PROGRAM IMPROVEMENTS FOR THE EFFICIENT AND
EFFECTIVE  OPERATION OF THE PROGRAM IN ACCORDANCE WITH THE PROVISIONS OF
THIS TITLE;
  5. ESTABLISHING OR  CONTRACTING  FOR  A  THERAPEUTIC  DRUG  MONITORING
PROGRAM,  FOR THE PURPOSE OF MONITORING THERAPEUTIC DRUG USE BY ELIGIBLE
PROGRAM PARTICIPANTS IN AN EFFORT TO PREVENT THE INCORRECT  OR  UNNECES-
SARY CONSUMPTION OF SUCH THERAPEUTIC DRUGS.
  S  3-i. The section heading of section 247 of the elder law is amended
to read as follows:
  Cost-sharing responsibilities of eligible  program  participants  [for
comprehensive coverage].
  S 3-j. Subdivision 1 of section 247 of the elder law is REPEALED and a
new subdivision 1 is added to read as follows:
  1.  AS  A  CONDITION  OF  ELIGIBILITY  FOR  BENEFITS UNDER THIS TITLE,
PARTICIPANTS MUST MAINTAIN MEDICARE PART  D  COVERAGE  AND  PAY  MONTHLY
PREMIUMS TO THEIR MEDICARE PART D DRUG PLAN.
  S  3-k.  Subdivisions  2  and  4  of  section 247 of the elder law are
REPEALED and subdivision 3 is renumbered subdivision 2 and paragraph (a)
is amended to read as follows:
  (a) [Upon satisfaction  of  the  registration  fee  pursuant  to  this
section  an  eligible]  A  program  participant must pay a point of sale
co-payment as set forth in paragraph (b) of this subdivision at the time
of each purchase of a [covered] drug prescribed for such individual THAT
IS DESCRIBED IN PARAGRAPH  (C)  OF  SUBDIVISION  THREE  OF  SECTION  TWO
HUNDRED  FORTY-TWO  OF THIS TITLE.  [Such co-payment shall not be waived
or reduced in whole or in part, subject to the limits provided by subdi-
vision four of this section.]
  S 3-l. Section 248 of the elder law is REPEALED.
  S 3-m. Section 250 of the elder law, paragraph (a) of subdivision 1 as
amended by section 6-a and subparagraph l of paragraph (b)  of  subdivi-
sion  1  as  amended by section 1 of part A of chapter 58 of the laws of
2008, paragraph (b) of subdivision 1 as amended by section 17 of part  A
of  chapter  58  of the laws of 2004, subparagraph 1 of paragraph (a) of
subdivision 3 and subdivision 5 as amended by section 19 of  part  B  of
chapter 57 of the laws of 2006, subdivision 6 as amended by section 19-a
of  part  A  of  chapter  109 of the laws of 2010, is amended to read as
follows:
  S 250. Reimbursement to  participating  provider  pharmacies.  1.  The
amount  of  reimbursement  which shall be paid by the state to a partic-
ipating provider pharmacy [for any covered drug filled or  refilled  for
any  eligible  program  participant] FILLING OR REFILLING A PRESCRIPTION
FOR A DRUG THAT IS DESCRIBED IN PARAGRAPH (C) OF  SUBDIVISION  THREE  OF
SECTION  TWO  HUNDRED  FORTY-TWO  OF  THIS  TITLE  shall be equal to the
allowed amount defined as follows, minus the point of sale co-payment as
required by [sections] SECTION two hundred forty-seven [and two  hundred
forty-eight] of this title:

S. 2809                            10                            A. 4009

  (a)  Multiple  source  covered drugs. Except for brand name drugs that
are required by the prescriber to be dispensed as written,  the  allowed
amount for a multiple source covered drug shall equal the lower of:
  (1)  The  pharmacy's usual and customary charge to the general public,
taking into consideration any quantity and promotional discounts to  the
general public at the time of purchase, or
  (2) The upper limit, if any, set by the centers for medicare and medi-
caid services for such multiple source drug, or
  (3) Average wholesale price discounted by twenty-five percent, or
  (4) The maximum allowable cost, if any, established by the commission-
er  of  health  pursuant to paragraph (e) of subdivision nine of section
three hundred sixty-seven-a of the social services law.
  Plus a dispensing fee for drugs reimbursed pursuant  to  subparagraphs
two,  three,  and four of this paragraph, as defined in paragraph (c) of
this subdivision.
  (b) Other covered drugs. The  allowed  amount  for  brand  name  drugs
required  by  the  prescriber to be dispensed as written and for covered
drugs other than multiple source drugs shall be determined  by  applying
the lower of:
  (1)  Average wholesale price discounted by sixteen and twenty-five one
hundredths percent, plus a dispensing fee as defined in paragraph (c) of
this subdivision, or
  (2) The pharmacy's usual and customary charge to the  general  public,
taking  into consideration any quantity and promotional discounts to the
general public at the time of purchase.
  (c) As required by paragraphs (a)  and  (b)  of  this  subdivision,  a
dispensing  fee  of four dollars fifty cents will apply to generic drugs
and a dispensing fee of three dollars fifty cents will  apply  to  brand
name drugs.
  2. For purposes of determining the amount of reimbursement which shall
be  paid  to a participating provider pharmacy, the [panel] COMMISSIONER
OF HEALTH shall determine or cause to be determined, through  a  statis-
tically  valid  survey, the quantities of each covered drug that partic-
ipating provider pharmacies buy most frequently.  Using  the  result  of
this  survey,  the contractor shall update every thirty days the list of
average wholesale prices upon which  such  reimbursement  is  determined
using  nationally  recognized  and  most  recently revised sources. Such
price revisions shall be made available to  all  participating  provider
pharmacies.  The  pharmacist  shall  be reimbursed based on the price in
effect at the time the covered drug is dispensed.
  3. [(a) Notwithstanding any inconsistent provision of law, the program
for  elderly  pharmaceutical  insurance  coverage  shall  reimburse  for
covered  drugs which are dispensed under the program by a provider phar-
macy only pursuant to the  terms  of  a  rebate  agreement  between  the
program  and  the  manufacturer  (as  defined  under section 1927 of the
federal social security act) of such covered drugs;  provided,  however,
that:
  (1)  any agreement between the program and a manufacturer entered into
before August first, nineteen hundred ninety-one,  shall  be  deemed  to
have  been entered into on April first, nineteen hundred ninety-one; and
provided further, that if a manufacturer has not entered into an  agree-
ment  with  the department before August first, nineteen hundred ninety-
one, such agreement shall not be effective until April  first,  nineteen
hundred  ninety-two, unless such agreement provides that rebates will be
retroactively calculated as if the agreement had been in effect on April
first, nineteen hundred ninety-one; and

S. 2809                            11                            A. 4009

  (2) the program may reimburse for any covered drugs pursuant to subdi-
visions one and two of this section, for which a rebate  agreement  does
not  exist and which are determined by the elderly pharmaceutical insur-
ance coverage panel to be essential to the health of persons participat-
ing in the program; and likely to provide effective therapy or diagnosis
for  a  disease not adequately treated or diagnosed by any other covered
drug; and which are recommended  for  reimbursement  by  the  panel  and
approved by the commissioner of health.
  (b) The rebate agreement between such manufacturer and the program for
elderly  pharmaceutical  insurance  coverage  shall  utilize for covered
drugs the identical formula used to determine  the  rebate  for  federal
financial  participation  for  drugs, pursuant to section 1927(c) of the
federal social security act, to  determine  the  amount  of  the  rebate
pursuant to this subdivision.
  (c) The amount of rebate pursuant to paragraph (b) of this subdivision
shall  be  calculated by multiplying the required rebate formulas by the
total number of units of each dosage form and  strength  dispensed.  The
rebate  agreement shall also provide for periodic payment of the rebate,
provision of information to the program, audits, verification  of  data,
damages to the program for any delay or non-production of necessary data
by the manufacturer and for the confidentiality of information.
  (d)  The  program  in providing utilization data to a manufacturer (as
provided for under section 1927 (b) of the federal social security  act)
shall  provide  such  data  by zip code, if requested, for the top three
hundred most commonly used drugs by volume covered under a rebate agree-
ment.
  (e) Any funds collected pursuant to any rebate agreements entered into
with a manufacturer pursuant to this  subdivision,  shall  be  deposited
into  the  elderly  pharmaceutical  insurance  coverage  program premium
account.
  4.] Notwithstanding any other provision of law, entities  which  offer
insurance  coverage for provision of and/or reimbursement for pharmaceu-
tical   expenses,   including   but    not    limited    to,    entities
licensed/certified  pursuant  to  article  thirty-two, forty-two, forty-
three or forty-four of the insurance law (employees  welfare  funds)  or
article  forty-four  of  the  public  health law, shall participate in a
benefit recovery  program  with  the  elderly  pharmaceutical  insurance
coverage  (EPIC)  program which includes, but is not limited to, a semi-
annual match of EPIC's file of enrollees against the  entity's  file  of
insured  to identify individuals enrolled in both plans with claims paid
within the twenty-four months preceding the date the entity receives the
match request information from EPIC. Such entity shall indicate if phar-
maceutical coverage  is  available  from  the  entity  for  the  insured
persons,  list the copayment or other payment obligations of the insured
persons applicable to the pharmaceutical coverage, and (after  receiving
necessary claim information from EPIC) list the amounts which the entity
would have paid for the pharmaceutical claims for those identified indi-
viduals  and the entity shall reimburse EPIC for pharmaceutical expenses
paid by EPIC that are covered under the contract between the entity  and
its  insured  in  only  those instances where the entity has not already
made payment of the claim.  Reimbursement  of  the  net  amount  payable
(after rebates and discounts) that would have been paid under the cover-
age issued by the entity will be made by the entity to EPIC within sixty
days  of  receipt  from  EPIC  of the standard data in electronic format
necessary for the entity to adjudicate the claim  and  if  the  standard
data  is  provided  to the entity by EPIC in paper format payment by the

S. 2809                            12                            A. 4009

entity shall be made within one hundred eighty days.   After  completing
at  least  one  match  process with EPIC in electronic format, an entity
shall be entitled to elect a monthly or bi-monthly match process  rather
than a semi-annual match process.
  [5.]  4.  Notwithstanding  any  other  provision  of  law, the [panel]
COMMISSIONER OF HEALTH shall maximize the coordination of  benefits  for
persons  enrolled  under  Title XVIII of the federal social security act
(medicare) and enrolled under this title in order to facilitate medicare
payment of claims. The [panel] COMMISSIONER  OF  HEALTH  may  select  an
independent  contractor,  through  a  request-for-proposal  process,  to
implement a centralized  coordination  of  benefits  system  under  this
subdivision for individuals qualified in both the elderly pharmaceutical
insurance  coverage  (EPIC)  program  and  medicare programs who receive
medications or other covered products from a pharmacy provider currently
enrolled  in  the  elderly  pharmaceutical  insurance  coverage   (EPIC)
program.
  [6.  (a)]  5.  The  EPIC program shall be the payor of last resort for
individuals qualified in both the EPIC program and title  XVIII  of  the
federal  social  security  act  (Medicare).  [For  such  individuals, no
reimbursement shall be available under EPIC for  covered  drug  expenses
except:
  (i) where a prescription drug plan authorized by Part D of the federal
social  security act (referred to in this subdivision as a Medicare Part
D plan) has approved coverage and EPIC  has  an  obligation  under  this
title  to pay a portion of the participant's cost-sharing responsibility
under Medicare Part D; or
  (ii) where the provider pharmacy has certified that a Medicare Part  D
plan has denied coverage.
  (b)  If  the  provider pharmacy certifies as set forth in subparagraph
(ii) of paragraph (a) of this subdivision, the EPIC  program  shall  pay
for  the drug as the primary payor upon a showing of compliance with the
notification and appeal provisions of subparagraph two of paragraph  (c)
of subdivision three of section two hundred forty-two of this title.]
  S 3-n. Section 254 of the elder law is amended to read as follows:
  S  254.  Cost  of living adjustment. [1.] Within amounts appropriated,
the [panel] COMMISSIONER OF HEALTH shall adjust the program  eligibility
standards  set  forth  in  subdivision  [two] ONE of section two hundred
forty-two of this title to account for increases in the cost of living.
  [2. The panel shall further adjust individual and joint income catego-
ries set forth in subdivisions two  and  four  of  section  two  hundred
forty-eight of this title to conform to the adjustments made pursuant to
subdivision one of this section.]
  S  4. Notwithstanding any contrary provision of law, rates established
pursuant to section 69-4.30 of Title 10 of the New York Codes, Rules and
Regulations for approved services rendered on and after  April  1,  2011
shall be reduced by ten percent.
  S  5.  Paragraph  (a)  of  subdivision 3 of section 2559 of the public
health law, as amended by chapter 231 of the laws of 1993, is amended to
read as follows:
  (a) [Providers] EXCEPT AS PROVIDED IN SUBPARAGRAPH (I) OF  THIS  PARA-
GRAPH,  PROVIDERS  of  early  intervention  services  and transportation
services shall in the first instance and where applicable, seek  payment
from  all  third  party  payors including governmental agencies prior to
claiming payment from a given  municipality  for  services  rendered  to
eligible  children,  provided  that,  for the purpose of seeking payment
from the medical assistance program or from other  third  party  payors,

S. 2809                            13                            A. 4009

the municipality shall be deemed the provider of such early intervention
services  to  the extent that the provider has promptly furnished to the
municipality adequate and complete information necessary to support  the
municipality  billing,  and provided further that the obligation to seek
payment shall not apply to a payment from a third party payor who is not
prohibited from applying such payment, and will apply such  payment,  to
an annual or lifetime limit specified in the insured's policy.
  (I)  EARLY INTERVENTION PROGRAM PROVIDERS WHO RECEIVED PAYMENT OF FIVE
HUNDRED THOUSAND DOLLARS OR MORE AS DETERMINED PURSUANT TO  SUBPARAGRAPH
(II)  OF  THIS  PARAGRAPH  FOR  EARLY  INTERVENTION SERVICES PROVIDED TO
ELIGIBLE CHILDREN THAT WERE COVERED SERVICES UNDER THE  MEDICAL  ASSIST-
ANCE  PROGRAM,  SHALL  IN  THE  FIRST INSTANCE AND WHERE AVAILABLE, SEEK
PAYMENT FROM THE MEDICAL ASSISTANCE PROGRAM OR AN  INSURANCE  POLICY  OR
HEALTH  BENEFIT  PLAN  FOR THOSE CHILDREN COVERED UNDER BOTH THE MEDICAL
ASSISTANCE PROGRAM AND AN INSURANCE POLICY OR HEALTH BENEFIT PLAN, PRIOR
TO CLAIMING PAYMENT FROM A MUNICIPALITY FOR SERVICES  RENDERED  TO  SUCH
CHILDREN;
  (II) THE COMMISSIONER SHALL DETERMINE WHICH PROVIDERS RECEIVED PAYMENT
OF FIVE HUNDRED THOUSAND DOLLARS OR MORE FOR EARLY INTERVENTION SERVICES
THAT  WERE  COVERED  UNDER THE MEDICAL ASSISTANCE PROGRAM BASED UPON THE
MOST RECENT YEAR FOR WHICH COMPLETE INFORMATION EXISTS. THE COMMISSIONER
SHALL NOTIFY A PROVIDER AT LEAST THIRTY  DAYS  PRIOR  TO  THE  DATE  THE
PROVIDER  SHALL  BE  REQUIRED  TO  BILL  FOR SERVICES IN ACCORDANCE WITH
SUBPARAGRAPH (I) OF THIS PARAGRAPH.
  (III) PARENTS SHALL PROVIDE AND THE MUNICIPALITY SHALL OBTAIN INFORMA-
TION ON ANY PLAN OF INSURANCE UNDER WHICH AN ELIGIBLE CHILD  HAS  COVER-
AGE.
  S 6. Intentionally omitted.
  S 7. Intentionally omitted.
  S 8. Intentionally omitted.
  S 9. Intentionally omitted.
  S 10. Intentionally omitted.
  S  11.  Section  3235-a of the insurance law, as added by section 3 of
part C of chapter 1 of the laws of 2002, is amended to read as follows:
  S 3235-a. Payment for early intervention services. (a)  No  policy  of
accident  and  health  insurance, including contracts issued pursuant to
article forty-three of this chapter, shall exclude coverage  for  other-
wise  covered  services solely on the basis that the services constitute
early intervention program services under title two-A of  article  twen-
ty-five of the public health law.
  (b)  Where  a  policy  of  accident  and health insurance, including a
contract  issued  pursuant  to  article  forty-three  of  this  chapter,
provides  coverage  for  [an]  A  SERVICE THAT IS PROVIDED TO AN INSURED
UNDER THE early intervention program service, such coverage shall not be
applied against any maximum annual or lifetime monetary limits set forth
in such policy or contract. Visit limitations and other terms and condi-
tions of the policy will continue to apply to COVERED SERVICES  PROVIDED
UNDER  THE  early  intervention  [services] PROGRAM. However, any visits
used for early intervention program services shall not reduce the number
of visits otherwise available under the  policy  or  contract  for  such
services.  WHERE A SERVICE PROVIDED TO AN INSURED UNDER THE EARLY INTER-
VENTION  PROGRAM  IS  A  COVERED  SERVICE  UNDER THE INSURER'S POLICY OR
CONTRACT, THE INDIVIDUALIZED FAMILY SERVICES PLAN AS DEFINED IN  SECTION
TWENTY-FIVE  HUNDRED FORTY-ONE OF THE PUBLIC HEALTH LAW AND CERTIFIED BY
THE EARLY INTERVENTION OFFICIAL OR SUCH OFFICIAL'S  DESIGNEE,  SHALL  BE
DEEMED TO MEET ANY PRECERTIFICATION, PREAUTHORIZATION AND MEDICAL NECES-

S. 2809                            14                            A. 4009

SITY  REQUIREMENTS  IMPOSED  ON  BENEFITS  UNDER THE POLICY OR CONTRACT,
PROVIDED, HOWEVER, THAT THE EARLY INTERVENTION OFFICIAL SHALL REMOVE  OR
REDACT  ANY INFORMATION CONTAINED ON THE INSURED'S INDIVIDUALIZED FAMILY
SERVICE  PLAN  THAT IS NOT REQUIRED BY THE INSURER FOR PAYMENT PURPOSES.
PAYMENT FOR A SERVICE COVERED UNDER  THE  POLICY  OR  CONTRACT  THAT  IS
PROVIDED  UNDER  THE EARLY INTERVENTION PROGRAM SHALL BE AT RATES ESTAB-
LISHED BY THE COMMISSIONER OF HEALTH FOR SUCH SERVICE PURSUANT TO  REGU-
LATIONS.
  (c)  NO  INSURER, INCLUDING A HEALTH MAINTENANCE ORGANIZATION ISSUED A
CERTIFICATE OF AUTHORITY UNDER ARTICLE FORTY-FOUR OF THE  PUBLIC  HEALTH
LAW  AND A CORPORATION ORGANIZED UNDER ARTICLE FORTY-THREE OF THIS CHAP-
TER SHALL DENY PAYMENT OF A CLAIM SUBMITTED FOR A SERVICE COVERED  UNDER
THE  INSURER'S  POLICY  OR  CONTRACT AND PROVIDED UNDER THE EARLY INTER-
VENTION PROGRAM BASED UPON THE FOLLOWING:
  (I) THE LOCATION WHERE SERVICES ARE PROVIDED;
  (II) THE DURATION OF THE INSURED'S CONDITION  OR  THAT  THE  INSURED'S
CONDITION  IS  NOT  AMENABLE TO SIGNIFICANT IMPROVEMENT WITHIN A CERTAIN
PERIOD OF TIME AS SPECIFIED IN THE POLICY OR CONTRACT;
  (III) THAT THE PROVIDER OF SERVICES IS NOT A PARTICIPATING PROVIDER IN
THE INSURER'S NETWORK; OR
  (IV) THE ABSENCE OF A PRIMARY CARE REFERRAL.
  (D) Any right of subrogation to benefits which a municipality is enti-
tled in accordance with paragraph (d) of subdivision  three  of  section
twenty-five  hundred  fifty-nine of the public health law shall be valid
and enforceable to the extent benefits are available under any  accident
and health insurance policy. The right of subrogation does not attach to
insurance benefits paid or provided under any accident and health insur-
ance  policy  prior to receipt by the insurer of written notice from the
municipality.  UPON THE INSURER'S RECEIPT OF  WRITTEN  NOTICE  FROM  THE
MUNICIPALITY THE INSURER SHALL PROVIDE THE MUNICIPALITY WITH INFORMATION
ON THE EXTENT OF BENEFITS AVAILABLE TO AN INSURED UNDER THE POLICY.
  [(d)]  (E)  No  insurer,  including  a health maintenance organization
issued a certificate of authority under article forty-four of the public
health law and a corporation organized under article forty-three of this
chapter, shall refuse to issue an accident and health  insurance  policy
or  contract  or refuse to renew an accident and health insurance policy
or contract  solely  because  the  applicant  or  insured  is  receiving
services under the early intervention program.
  S  12.  Subdivisions  4 and 5 of section 2545 of the public health law
are REPEALED and subdivisions 6, 7, 8 and 9 are renumbered  subdivisions
4, 5, 6 and 7.
  S  13.  Paragraph  (b)  of  subdivision 2 of section 605 of the public
health law is REPEALED.
  S 14. The public health law is amended by adding a new section 212  to
read as follows:
  S 212. LOCAL COMPETITIVE PERFORMANCE GRANT PROGRAM FOR PRIORITY HEALTH
INITIATIVES.  1.  THERE  IS HEREBY ESTABLISHED WITHIN THE DEPARTMENT THE
LOCAL COMPETITIVE PERFORMANCE GRANT PROGRAM FOR PRIORITY  HEALTH  INITI-
ATIVES  TO  ADDRESS EMERGING OR ONGOING PUBLIC HEALTH MATTERS AND PURSUE
INNOVATIONS IN PUBLIC HEALTH.
  2. WITHIN AMOUNTS APPROPRIATED THEREFOR, THE COMMISSIONER  IS  AUTHOR-
IZED  TO MAKE GRANTS TO AND ENTER INTO CONTRACTS WITH PUBLIC, NON-PROFIT
OR PRIVATE ENTITIES FOR PURPOSES WHICH MAY INCLUDE, BUT ARE NOT  LIMITED
TO,  MINORITY  HEALTH-RELATED INITIATIVES, REPRODUCTIVE HEALTH SERVICES,
DISEASE-SPECIFIC PURPOSES, AND OTHER HEALTH-RELATED  RESEARCH,  OUTREACH
AND  EDUCATION PURPOSES. SUCH GRANTS SHALL BE AWARDED UNDER THIS SECTION

S. 2809                            15                            A. 4009

ON A COMPETITIVE BASIS PURSUANT TO A  REQUEST  FOR  APPLICATION/PROPOSAL
PROCESS, IN THE NUMBER, AMOUNTS AND MANNER DETERMINED BY THE COMMISSION-
ER, PURSUANT TO CRITERIA DETERMINED BY THE COMMISSIONER.
  3.  THE COMMISSIONER MAY PROMULGATE REGULATIONS, INCLUDING ON AN EMER-
GENCY BASIS, AS NECESSARY TO IMPLEMENT THE PROVISIONS OF THIS SECTION.
  S 15. The elder law is amended by adding a new section 224 to read  as
follows:
  S 224. LOCAL COMPETITIVE PERFORMANCE GRANT PROGRAM FOR PRIORITY INITI-
ATIVES  IN  AGING.  1. THERE IS HEREBY ESTABLISHED WITHIN THE OFFICE THE
LOCAL COMPETITIVE PERFORMANCE GRANT PROGRAM FOR PRIORITY INITIATIVES  IN
AGING  TO  ADDRESS  EMERGING OR ONGOING MATTERS THAT AFFECT OLDER ADULTS
AND PURSUING INNOVATIONS IN ASSISTING OLDER ADULTS.
  2. WITHIN AMOUNTS APPROPRIATED THEREFOR, THE DIRECTOR IS AUTHORIZED TO
MAKE GRANTS TO AND ENTER  INTO  CONTRACTS  WITH  PUBLIC,  NON-PROFIT  OR
PRIVATE  ENTITIES.  SUCH GRANTS SHALL BE AWARDED UNDER THIS SECTION ON A
COMPETITIVE BASIS PURSUANT TO A REQUEST FOR  APPLICATION/PROPOSAL  PROC-
ESS,  IN  THE  NUMBER,  AMOUNTS  AND  MANNER DETERMINED BY THE DIRECTOR,
PURSUANT TO CRITERIA DETERMINED BY THE DIRECTOR.
  3. THE DIRECTOR MAY PROMULGATE REGULATIONS, INCLUDING ON AN  EMERGENCY
BASIS, AS NECESSARY TO IMPLEMENT THE PROVISIONS OF THIS SECTION.
  S 16. Paragraph (fff) of subdivision 1 of section 2807-v of the public
health  law, as amended by section 5 of part B of chapter 58 of the laws
of 2008, is amended to read as follows:
  (fff) Funds shall be made available to the empire state stem cell fund
established by section ninety-nine-p of the state finance law [from  the
public  asset  as  defined in section four thousand three hundred one of
the insurance law and accumulated from the conversion  of  one  or  more
article forty-three corporations and its or their not-for-profit subsid-
iaries  occurring  on  or after January first, two thousand seven.  Such
funds shall be made available] within amounts appropriated up  to  fifty
million  dollars  annually  and  shall  not  exceed five hundred million
dollars in total.
  S 17.  Intentionally Omitted.
  S 18. Subdivision 3 of section  571  of  the  public  health  law,  as
amended  by  chapter  436  of  the  laws  of 1993, is amended to read as
follows:
  3. "Reference system" means a system of [periodic testing]  ASSESSMENT
of  methods, procedures and materials of clinical laboratories and blood
banks, including, but not  limited  to,  ONGOING  VALIDATION  WHICH  MAY
INCLUDE  DIRECT  TESTING  AND  EXPERIMENTATION BY THE DEPARTMENT OF SUCH
METHODS, PROCEDURES AND  MATERIALS,  the  distribution  of  [manuals  of
approved  methods]  STANDARDS  AND GUIDELINES, inspection of facilities,
[cooperative research, and] periodic submission of  test  specimens  for
examination,  AND RESEARCH CONDUCTED BY THE DEPARTMENT THAT INVOLVES THE
STUDY OF NEW OR EXISTING METHODS, PROCEDURES AND MATERIALS IN THE  FIELD
OF CLINICAL LABORATORY MEDICINE, AND SUCH OTHER ACTIVITIES AS MAY BE SET
FORTH IN REGULATION.
  S 19. Subdivisions 1, 2 and 6 of section 575 of the public health law,
as  amended  by  chapter 436 of the laws of 1993, are amended to read as
follows:
  1. Application for a permit shall be made by the owner and the  direc-
tor of the clinical laboratory or blood bank [upon forms provided by the
department]  IN  A  MANNER  AND FORMAT PRESCRIBED BY THE DEPARTMENT. The
application shall contain the name of the owner, the name of the  direc-
tor,  the  procedures  or categories of procedures or services for which
the permit is sought, the location or locations and physical description

S. 2809                            16                            A. 4009

of the facility or location or  locations  at  which  tests  are  to  be
performed  or  at  which  a blood bank is to be operated, and such other
information as the department may require.
  2.  A  permit  OR  PERMIT  CATEGORY shall not be issued unless a valid
certificate of qualification in the category of procedures for which the
permit is sought has  been  issued  to  the  director  pursuant  to  the
provisions  of  section  five hundred seventy-three of this title, [and]
unless ALL FEES AND OUTSTANDING PENALTIES, IF ANY, HAVE BEEN  PAID,  AND
the  department  finds  that  the  clinical  laboratory or blood bank is
competently staffed and properly equipped, and will be operated  in  the
manner required by this title.
  6.  A  permit shall become void by a change in the director, owner, or
location. A CATEGORY ON A PERMIT SHALL BECOME VOID BY A  CHANGE  IN  THE
DIRECTOR  FOR THAT CATEGORY. The department may, pursuant to regulations
adopted under this title, extend the date on which a permit OR  CATEGORY
ON A PERMIT shall become void for a period not to exceed sixty days from
the date of a change of the director, owner or location.  An application
for  a  NEW  permit  [may]  MUST  be  made  [at any time,] in the manner
provided by this section.
  S 20. Subdivision 3 and paragraphs (a), (b), (c) and (e)  of  subdivi-
sion  4  of  section 576 of the public health law, as amended by chapter
436 of the laws of 1993, are amended to read as follows:
  3. The department shall operate a reference system and shall prescribe
standards for the PROPER OPERATION OF CLINICAL  LABORATORIES  AND  BLOOD
BANKS  AND  FOR  THE examination of specimens. As part of such reference
system, the department may REVIEW AND APPROVE TESTING METHODS  DEVELOPED
OR  MODIFIED BY CLINICAL LABORATORIES AND BLOOD BANKS PRIOR TO THE TEST-
ING METHODS BEING OFFERED IN THIS STATE, AND MAY require clinical  labo-
ratories  and  blood  banks  to  analyze  test  samples submitted by the
department and to report on the results of such analyses. The rules  and
regulations  of  the department shall prescribe the REQUIREMENTS FOR THE
PROPER OPERATION OF  A  CLINICAL  LABORATORY  OR  BLOOD  BANK,  FOR  THE
APPROVAL  OF  METHODS  AND  THE  manner  in which proficiency testing or
analyses of samples shall be performed and reports submitted. Failure to
meet department standards FOR THE PROPER OPERATION OF A CLINICAL LABORA-
TORY OR BLOOD BANK, INCLUDING THE CRITERIA FOR APPROVAL OF  METHODS,  OR
FAILURE  TO  MAINTAIN  SATISFACTORY  PERFORMANCE  in proficiency testing
shall result in termination of the permit in the category or  categories
of testing established by the department in regulation until remediation
is  achieved.  Such  standards shall be at least as stringent as federal
standards promulgated under the federal clinical laboratory  improvement
[act]  AMENDMENTS  of  nineteen  hundred  eighty-eight. Such failure and
termination shall be subject to review in  accordance  with  regulations
adopted by the department.
  (a) The department may adopt and amend rules and regulations to effec-
tuate  the  provisions  and purposes of this title. Such rules and regu-
lations shall establish [inspection and  reference]  fees  for  clinical
laboratories  and  blood  banks in amounts not exceeding the cost of the
[inspection and] reference [program] SYSTEM  for  clinical  laboratories
and  blood banks and shall be subject to the approval of the director of
the budget.  THE COMMISSIONER SHALL DETERMINE THE PROPER COST ALLOCATION
METHOD TO UTILIZE TO DETERMINE THE COST OF THE REFERENCE SYSTEM. THE FEE
PAID BY THE DEPARTMENT TO MAINTAIN AN EXEMPTION FOR  CLINICAL  LABORATO-
RIES AND BLOOD BANKS FROM THE REQUIREMENTS OF THE FEDERAL CLINICAL LABO-
RATORY  IMPROVEMENT AMENDMENTS OF NINETEEN HUNDRED EIGHTY-EIGHT SHALL BE
DEEMED A COST OF THE REFERENCE SYSTEM.

S. 2809                            17                            A. 4009

  (b) In determining the fee charges  to  be  assessed,  the  department
shall,  on  or before May first of each year, compute the [total actual]
costs for the preceding state fiscal year which were expended to operate
and administer the duties of the department pursuant to this title.  The
department  shall,  at such time or times and pursuant to such procedure
as it shall determine by regulation, bill and collect from each clinical
laboratory and blood bank an amount computed by multiplying  such  total
computed  operating expenses of the department by a fraction the numera-
tor of which is the gross annual receipts of such clinical laboratory or
blood bank during such twelve month period preceding the date of  compu-
tation  as the department shall designate by regulation, and the denomi-
nator of which is the total gross annual receipts of all clinical  labo-
ratories or blood banks operating in the state during such period.
  (c)  Each  such clinical laboratory and blood bank shall submit to the
department, in such form  and  at  such  times  as  the  department  may
require,  a  report  containing  information  regarding its gross annual
receipts [from the performance of tests or examination of specimens] FOR
ALL ACTIVITIES PERFORMED pursuant to a permit issued by  the  department
in  accordance  with the provisions of section five hundred seventy-five
of this title. The department may  require  additional  information  and
audit and review such information to verify its accuracy.
  (e)  On  or  before  September  fifteenth of each year, the department
shall [recompute the actual] RECONCILE ITS costs and  expenses  [of  the
department] FOR THE REFERENCE SYSTEM for the preceding state fiscal year
and  shall, on or before October fifteenth send to each clinical labora-
tory and blood bank, a statement setting forth the amount due and  paya-
ble by, or the amount computed to the credit of, such clinical laborato-
ry  or  blood  bank,  computed on the basis of the above stated formula,
except that for the purposes of such computation the fraction  shall  be
multiplied against the total recomputed [actual] expenses of the depart-
ment  for  such  fiscal  year. Any amount due shall be payable not later
than thirty days following the date of such statement. Any credit  shall
be applied against any succeeding payment due.
  S 21. Subdivision 1 of section 577 of the public health law is amended
by adding a new paragraph (i) to read as follows:
  (I)  HAS BEEN FOUND UPON INSPECTION BY THE DEPARTMENT TO BE IN NONCOM-
PLIANCE WITH A PROVISION OR PROVISIONS OF THIS TITLE OR  THE  RULES  AND
REGULATIONS  PROMULGATED HEREUNDER, AND HAS FAILED TO ADDRESS SUCH FIND-
INGS AS REQUIRED BY THE DEPARTMENT.
  S 22.  Intentionally Omitted.
  S 23.  Intentionally Omitted.
  S 24.  Intentionally Omitted.
  S 25.  Intentionally Omitted.
  S 25-a. Section 2818 of the public health law is amended by  adding  a
new subdivision 6 to read as follows:
  6.  NOTWITHSTANDING  ANY  CONTRARY PROVISION OF THIS SECTION, SECTIONS
ONE HUNDRED TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW,
OR ANY OTHER CONTRARY PROVISION OF LAW, SUBJECT TO  AVAILABLE  APPROPRI-
ATIONS,  FUNDS AVAILABLE FOR EXPENDITURE PURSUANT TO THIS SECTION MAY BE
DISTRIBUTED BY THE COMMISSIONER WITHOUT A COMPETITIVE BID OR REQUEST FOR
PROPOSAL PROCESS FOR GRANTS TO GENERAL HOSPITALS AND RESIDENTIAL  HEALTH
CARE  FACILITIES  FOR  THE PURPOSE OF FACILITATING CLOSURES, MERGERS AND
RESTRUCTURING OF SUCH FACILITIES IN  ORDER  TO  STRENGTHEN  AND  PROTECT
CONTINUED ACCESS TO ESSENTIAL HEALTH CARE RESOURCES.
  S 26. Section 32 of part A of chapter 58 of the laws of 2008, amending
the  elder  law  and  other laws relating to reimbursement to particular

S. 2809                            18                            A. 4009

provider pharmacies  and  prescription  drug  coverage,  as  amended  by
section  20  of part OO of chapter 57 of the laws of 2008, is amended to
read as follows:
  S  32.  This  act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2008;  provided
however,  that  sections  one, six-a, nineteen, twenty, twenty-four, and
twenty-five of this act shall take effect July 1, 2008; [provided howev-
er that sections sixteen, seventeen  and  eighteen  of  this  act  shall
expire  April  1,  2011;] provided, however, that the amendments made by
section twenty-eight of this act shall take effect on the same  date  as
section  1  of  chapter  281  of the laws of 2007 takes effect; provided
further, that sections twenty-nine, thirty, and thirty-one of  this  act
shall  take effect October 1, 2008; provided further, that section twen-
ty-seven of this act shall take effect January  1,  2009;  and  provided
further,  that  section  twenty-seven  of  this  act shall expire and be
deemed repealed March 31, 2011; and provided, further, however, that the
amendments to subdivision 1 of section 241 of the education law made  by
section  twenty-nine of this act shall not affect the expiration of such
subdivision and shall be deemed to expire therewith  and  provided  that
the  amendments  to section 272 of the public health law made by section
thirty of this act shall not affect the repeal of such section and shall
be deemed repealed therewith.
  S 27. Section 4 of part X2 of chapter 62 of the laws of 2003, amending
the public health law relating to allowing for the use of funds  of  the
office  of  professional  medical  conduct for activities of the patient
health information and quality improvement act of 2000,  as  amended  by
chapter 21 of the laws of 2010, is amended to read as follows:
  S  4.  This  act  shall  take  effect  immediately;  provided that the
provisions of section one of this act shall be deemed to  have  been  in
full force and effect on and after April 1, 2003, and shall expire March
31, [2011] 2013 when upon such date the provisions of such section shall
be deemed repealed.
  S  28.  Paragraph (b) of subdivision 1 of section 76 of chapter 731 of
the laws of 1993, amending the public health law and other laws relating
to reimbursement, delivery and capital cost of  ambulatory  health  care
services  and  inpatient  hospital services, as amended by section 14 of
part A of chapter 58 of the laws of 2007, is amended to read as follows:
  (b) sections fifteen through nineteen and  subdivision  3  of  section
2807-e  of  the public health law as added by section twenty of this act
shall expire on [July 1, 2011] JULY 1, 2014, and section seventy-four of
this act shall expire on July 1, 2007;
  S 29. Section 4 of chapter 505 of  the  laws  of  1995,  amending  the
public  health  law  relating  to  the operation of department of health
facilities, as amended by chapter 609 of the laws of 2007, is amended to
read as follows:
  S 4. This act shall take effect immediately[; provided, however,  that
the provisions of paragraph (b) of subdivision 4 of section 409-c of the
public  health  law,  as  added by section three of this act, shall take
effect January 1, 1996 and shall expire and be deemed  repealed  sixteen
years from the effective date thereof].
  S  30.  Section 3 of chapter 303 of the laws of 1999, amending the New
York state medical  care  facilities  finance  agency  act  relating  to
financing  health  facilities,  as amended by chapter 607 of the laws of
2007, is amended to read as follows:
  S 3. This act shall take effect immediately[, provided, however,  that
subdivision 15-a of section 5 of section 1 of chapter 392 of the laws of

S. 2809                            19                            A. 4009

1973,  as  added  by section one of this act, shall expire and be deemed
repealed June 30, 2011; and provided further, however, that the  expira-
tion  and  repeal of such subdivision 15-a shall not affect or impair in
any  manner any health facilities bonds issued, or any lease or purchase
of a health facility executed, pursuant to such subdivision  15-a  prior
to  its  expiration  and repeal and that, with respect to any such bonds
issued and outstanding as of June  30,  2011,  the  provisions  of  such
subdivision  15-a  as  they existed immediately prior to such expiration
and repeal shall continue to apply through the latest maturity  date  of
any  such bonds, or their earlier retirement or redemption, for the sole
purpose of authorizing the issuance of refunding bonds to  refund  bonds
previously issued pursuant thereto].
  S  31.  This  act  shall  take effect April 1, 2011, provided, however
that:
  (a) section one of this act shall take effect July 1, 2011;
  (b) sections two through three-n of this act shall take effect January
1, 2012;
  (c) section thirteen of this act shall take effect July 1, 2011; and
  (d) related to sections eighteen, nineteen, twenty and  twenty-one  of
this  act, the commissioner of health is authorized to promulgate, on an
emergency basis, any regulations necessary to implement any provision of
such sections upon their effective date.

                                 PART B

  Section 1.   (a) Notwithstanding any inconsistent  provision  of  law,
rule  or  regulation to the contrary, and subject to the availability of
federal financial participation, effective for the period April 1,  2011
through  March  31,  2012,  and  each  state fiscal year thereafter, the
department  of  health  is  authorized  to  make  supplemental  Medicaid
payments for professional services provided by physicians, nurse practi-
tioners and physician assistants who are participating in a plan for the
management  of clinical practice at the State University of New York, in
accordance with title 11 of article 5 of the  social  services  law  for
patients eligible for federal financial participation under title XIX of
the  federal social security act, in amounts that will increase fees for
such professional services to an amount equal to the average  commercial
rate that would otherwise be received for such services rendered by such
physicians,  nurse  practitioners  and  physician assistants. The calcu-
lation of such supplemental fee payments shall  be  made  in  accordance
with  applicable  federal law and regulation and subject to the approval
of the division of the budget. Such supplemental Medicaid  fee  payments
may  be  added  to  the professional fees paid under the fee schedule or
made as aggregate lump sum payments to eligible clinical practice  plans
authorized to receive professional fees.
  (b) The affiliated State University of New York health science centers
shall  be responsible for payment of one hundred percent of the non-fed-
eral share of such  supplemental  Medicaid  payments  for  all  services
provided by physicians, nurse practitioners and physician assistants who
are  participating in a plan for the management of clinical practice, in
accordance with section 365-a of the social services law, regardless  of
whether another social services district or the department of health may
otherwise be responsible for furnishing medical assistance to the eligi-
ble persons receiving such services.
  S  2.    Subdivision  21 of section 2807-c of the public health law is
amended by adding a new paragraph (e-1) to read as follows:

S. 2809                            20                            A. 4009

  (E-1) FOR PERIODS ON AND AFTER JANUARY FIRST, TWO THOUSAND ELEVEN, FOR
PURPOSES OF CALCULATIONS PURSUANT TO PARAGRAPHS  (B)  AND  (C)  OF  THIS
SUBDIVISION  OF MAXIMUM DISPROPORTIONATE SHARE PAYMENT DISTRIBUTIONS FOR
A RATE YEAR OR PART  THEREOF,  COSTS  INCURRED  OF  FURNISHING  HOSPITAL
SERVICES NET OF MEDICAL ASSISTANCE PAYMENTS, OTHER THAN DISPROPORTIONATE
SHARE  PAYMENTS,  AND  PAYMENTS  BY UNINSURED PATIENTS SHALL FOR THE TWO
THOUSAND ELEVEN CALENDAR YEAR, SHALL BE DETERMINED  INITIALLY  BASED  ON
EACH  HOSPITAL'S  SUBMISSION  OF  A  FULLY  COMPLETED TWO THOUSAND EIGHT
DISPROPORTIONATE SHARE HOSPITAL DATA COLLECTION TOOL, WHICH IS  REQUIRED
TO  BE  SUBMITTED  TO THE DEPARTMENT BY MARCH THIRTY-FIRST, TWO THOUSAND
ELEVEN, AND SHALL BE SUBSEQUENTLY REVISED  TO  REFLECT  EACH  HOSPITAL'S
SUBMISSION OF A FULLY COMPLETED TWO THOUSAND NINE DISPROPORTIONATE SHARE
HOSPITAL  DATA COLLECTION TOOL, WHICH IS REQUIRED TO BE SUBMITTED TO THE
DEPARTMENT BY OCTOBER FIRST, TWO THOUSAND ELEVEN.
  FOR CALENDAR YEARS ON AND AFTER  TWO  THOUSAND  TWELVE,  SUCH  INITIAL
DETERMINATIONS  SHALL  REFLECT  SUBMISSION  OF  DATA  AS REQUIRED BY THE
COMMISSIONER ON A SPECIFIED DATE.  ALL SUCH INITIAL DETERMINATIONS SHALL
SUBSEQUENTLY BE REVISED TO REFLECT ANNUAL RATE PERIOD DATA  AND  STATIS-
TICS. INDIGENT CARE PAYMENTS WILL BE WITHHELD IN INSTANCES WHEN A HOSPI-
TAL  HAS  NOT SUBMITTED REQUIRED INFORMATION BY THE DUE DATES PRESCRIBED
IN THIS PARAGRAPH, PROVIDED, HOWEVER, THAT SUCH PAYMENTS SHALL  BE  MADE
UPON  SUBMISSION  OF  SUCH  REQUIRED  DATA. FOR PURPOSES OF CALCULATIONS
PURSUANT TO PARAGRAPH (D) OF THIS SUBDIVISION OF ELIGIBILITY TO  RECEIVE
DISPROPORTIONATE  SHARE  PAYMENTS  FOR  A RATE YEAR OR PART THEREOF, THE
HOSPITAL INPATIENT UTILIZATION RATE SHALL BE  DETERMINED  BASED  ON  THE
BASE  YEAR  STATISTICS IN ACCORDANCE WITH THE METHODOLOGY ESTABLISHED BY
THE COMMISSIONER, AND COSTS INCURRED  OF  FURNISHING  HOSPITAL  SERVICES
SHALL  BE DETERMINED IN ACCORDANCE WITH A METHODOLOGY ESTABLISHED BY THE
COMMISSIONER CONSISTENT  WITH  REQUIREMENTS  OF  THE  SECRETARY  OF  THE
DEPARTMENT  OF  HEALTH AND HUMAN SERVICES FOR PURPOSES OF FEDERAL FINAN-
CIAL PARTICIPATION PURSUANT TO THE TITLE XIX OF THE FEDERAL SOCIAL SECU-
RITY ACT IN DISPROPORTIONATE SHARE PAYMENTS.
  S 3. Subparagraph (i) of paragraph (b) of subdivision 2-b  of  section
2808  of  the  public  health  law, as amended by section 1 of part D of
chapter 58 of the laws of 2010, is amended to read as follows:
  (i) Subject to the provisions of subparagraphs (ii) through  (xiv)  of
this  paragraph, for periods on and after April first, two thousand nine
through June thirtieth, two thousand eleven the operating cost component
of rates of payment shall reflect allowable operating costs as  reported
in  each  facility's cost report for the two thousand two calendar year,
as adjusted for inflation on an annual  basis  in  accordance  with  the
methodology  set  forth  in  paragraph (c) of subdivision ten of section
twenty-eight hundred seven-c of this article,  provided,  however,  that
for  those  facilities which do not receive a per diem add-on adjustment
pursuant to subparagraph (ii) of  paragraph  (a)  of  this  subdivision,
rates shall be further adjusted to include the proportionate benefit, as
determined  by  the commissioner, of the expiration of the opening para-
graph and paragraph (a) of subdivision sixteen of this  section  and  of
paragraph  (a)  of  subdivision  fourteen  of this section, and provided
further that the operating cost component of rates of payment for  those
facilities  which  did  not  receive a per diem adjustment in accordance
with subparagraph (ii) of paragraph (a) of this subdivision shall not be
less than the operating component such facilities received  in  the  two
thousand eight rate period, as adjusted for inflation on an annual basis
in  accordance with the methodology set forth in paragraph (c) of subdi-
vision ten of section twenty-eight hundred seven-c of this  article  and

S. 2809                            21                            A. 4009

further  provided,  however,  that  rates for facilities whose operating
cost component reflects base year costs subsequent to January first, two
thousand two shall have rates computed in  accordance  with  this  para-
graph,  utilizing  allowable  operating costs as reported in such subse-
quent base year period, and trended forward to the rate year in  accord-
ance  with  applicable inflation factors, AND PROVIDED FURTHER, HOWEVER,
THAT NOTWITHSTANDING ANY INCONSISTENT  PROVISION  OF  THIS  SUBDIVISION,
RATE  ADJUSTMENTS AS DESCRIBED IN THIS SUBPARAGRAPH AND AS EFFECTIVE FOR
RATE PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND  NINE  THROUGH  JUNE
THIRTIETH,  TWO THOUSAND ELEVEN, SHALL NOT BE IMPLEMENTED AND PAID PRIOR
TO JULY FIRST, TWO THOUSAND ELEVEN.
  S 4. Section 2 of part D of chapter 58 of the laws of  2009,  amending
the public health law and other laws relating to Medicaid reimbursements
to residential health care facilities, as amended by section 3 of Part D
of chapter 58 of the laws of 2010, is amended to read as follows:
  S  2. Notwithstanding paragraph (b) of subdivision 2-b of section 2808
of the public health law or any other contrary provision  of  law,  with
regard  to  adjustments  to  medicaid  rates  of  payment  for inpatient
services provided by residential health care facilities for  the  period
April  1, 2009 through March 31, 2010, made pursuant to paragraph (b) of
subdivision 2-b of section 2808 of the public health  law,  the  commis-
sioner  of  health and the director of the budget shall, upon a determi-
nation that such adjustments, including the application  of  adjustments
authorized  by  the  provisions  of  paragraph (g) of subdivision 2-b of
section 2808 of the public health law,  shall  result  in  an  aggregate
increase  in  total Medicaid rates of payment for such services for such
period that is less than or more than two hundred  ten  million  dollars
($210,000,000),  make such proportional adjustments to such rates as are
necessary to result in an increase of such aggregate expenditures of two
hundred ten million dollars ($210,000,000), and provided further, howev-
er, that notwithstanding section 2808 of the public health  law  or  any
other contrary provision of law, with regard to adjustments to inpatient
rates  of payment made pursuant to section 2808 of the public health law
for inpatient services provided by residential  health  care  facilities
for the period April 1, 2010 through [June 30, 2011] MARCH 31, 2012, the
commissioner  of  health  and  the  director of the budget shall, upon a
determination by such commissioner and  such  director  that  such  rate
adjustments shall, prior to the application of any applicable adjustment
for  inflation,  result in an aggregate increase in total Medicaid rates
of payment for  such  services,  including  payments  made  pursuant  to
subparagraph  (i) of paragraph (d) of subdivision 2-c of section 2808 of
the public health law, make such proportional adjustments to such  rates
as  are  necessary  to reduce such total aggregate rate adjustments such
that the aggregate total reflects no  such  increase  or  decrease,  and
provided further, however, the case mix adjustments as otherwise author-
ized by subparagraph (ii) of paragraph (b) of subdivision 2-b of section
2808 of the public health law and as scheduled for January of 2011 shall
not  be  made.    Adjustments made pursuant to this section shall not be
subject to subsequent correction or reconciliation.
  S 5. Notwithstanding any contrary provision of law and subject to  the
availability  of  federal  financial  participation,  for periods on and
after July 1, 2011, Medicaid rates of payments  for  inpatient  services
provided  by  residential health care facilities which, as of the effec-
tive date of this section, operate discrete units for treatment of resi-
dents with huntington's disease, shall be increased  by  a  rate  add-on
amount. The aggregate amount of such rate add-ons for the period July 1,

S. 2809                            22                            A. 4009

2011  through  December  31,  2011 shall be eight hundred fifty thousand
dollars ($850,000), and shall be  one  million  seven  hundred  thousand
dollars ($1,700,000) for the 2012 calendar year and each year thereafter
and  such amounts shall be allocated to each eligible residential health
care facility proportionally, based on the number of beds in each facil-
ity's discrete unit for treatment of huntington's  disease  relative  to
the total number of such beds in all such units. Such rate add-ons shall
be computed utilizing reported Medicaid days from certified cost reports
as  submitted  to  the department of health for the calendar year period
two years prior to the applicable rate  year  and,  further,  such  rate
add-ons shall not be subject to subsequent adjustment or reconciliation.
  S  6.  Notwithstanding  section 448 of chapter 170 of the laws of 1994
and section 4 of chapter 81 of the laws of 1995,  as  amended,  and  any
other  inconsistent  provision  of  law or regulation and subject to the
availability of federal financial participation, for the period April 1,
2011 through June 30, 2011, medical assistance rates of payment to resi-
dential health care facilities and diagnostic treatment centers licensed
under article 28 of the public health law  for  adult  day  health  care
services provided to registrants with acquired immunodeficiency syndrome
(AIDS)  or  other  human immunodeficiency virus (HIV) related illnesses,
shall be increased by an aggregate amount of one million  eight  hundred
sixty-seven  thousand  dollars  ($1,867,000). Such amount shall be allo-
cated proportionally among such providers based on the  medical  assist-
ance  visits  reported  by  each provider in the most recently available
cost report, as submitted to the department  of  health  by  January  1,
2011, and shall be included as adjustments to each provider's daily rate
of  payment  for such services. Such adjustments shall not be subject to
subsequent adjustment or reconciliation.
  S 7. Notwithstanding any contrary provision of law or  regulation  and
subject  to  availability  of  federal  financial participation, for the
period April 1, 2011 through June 30, 2011, rates of payment by  govern-
mental agencies to residential health care facilities and diagnostic and
treatment centers licensed under article 28 of the public health law for
adult  day  health  care  services provided to registrants with acquired
immunodeficiency syndrome (AIDS) or other human  immunodeficiency  virus
(HIV)  related  illnesses,  shall reflect an adjustment to such rates of
payments in an aggregate  amount  of  two  hundred  thirty-six  thousand
dollars ($236,000) and distributed proportionally as rate add-ons, based
on  each eligible providers' Medicaid visits as reported in such provid-
er's most recently available cost report as submitted to the  department
of  health prior to January 1, 2011, and provided further, however, that
such adjustments shall not be subject to subsequent adjustment or recon-
ciliation.
  S 8. Subparagraph (vi) of paragraph (b) of subdivision  2  of  section
2807-d  of  the public health law, as amended by section 37 of part C of
chapter 58 of the laws of 2007, is amended to read as follows:
  (vi) Notwithstanding any contrary provision of this paragraph  or  any
other  provision  of  law or regulation to the contrary, for residential
health care facilities the assessment shall be six percent of each resi-
dential health care facility's gross receipts received from all  patient
care  services and other operating income on a cash basis for the period
April first, two thousand two through March thirty-first,  two  thousand
three  for  hospital  or  health-related  services,  including adult day
services; provided, however, that residential  health  care  facilities'
gross receipts attributable to payments received pursuant to title XVIII
of the federal social security act (medicare) shall be excluded from the

S. 2809                            23                            A. 4009

assessment; provided, however, that for all such gross receipts received
on  or after April first, two thousand three through March thirty-first,
two thousand five, such assessment shall be five  percent,  and  further
provided  that  for  all  such gross receipts received on or after April
first, two thousand five through March thirty-first, two thousand  nine,
and  on  or  after  April first, two thousand nine through March thirty-
first, two thousand eleven such assessment shall  be  six  percent,  AND
FURTHER  PROVIDED  THAT FOR ALL SUCH GROSS RECEIPTS RECEIVED ON OR AFTER
APRIL FIRST, TWO THOUSAND ELEVEN SUCH ASSESSMENT SHALL BE SIX PERCENT.
  S 9. Notwithstanding any inconsistent provision of state law, rule  or
regulation to the contrary, subject to federal approval, the state shall
not take any administrative or statutory action that would result in the
year  to  year  rate  of growth of state share Medicaid spending, in the
aggregate, to exceed the ten year rolling average of the medical  compo-
nent  of  the  consumer  price  index  as published by the United States
department of labor, bureau of labor statistics for  the  preceding  ten
years.
  S 10. Notwithstanding any inconsistent provision of law, rule or regu-
lation, for purposes of implementing the provisions of the public health
law and the social services law, references to titles XIX and XXI of the
federal  social  security  act  in  the public health law and the social
services law shall be deemed to include and also to mean  any  successor
titles thereto under the federal social security act.
  S 11. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the  public health law, section 18 of chapter 2 of the laws of 1988, and
18 NYCRR 505.14(h), as they relate to time frames for  notice,  approval
or  certification  of rates of payment, are hereby suspended and without
force or effect for purposes of implementing the provisions of this act.
  S 12. Severability clause. If any clause, sentence, paragraph,  subdi-
vision,  section  or  part of this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment  shall  not  affect,
impair or invalidate the remainder thereof, but shall be confined in its
operation  to  the  clause, sentence, paragraph, subdivision, section or
part thereof directly involved in the controversy in  which  such  judg-
ment shall have been rendered. It is hereby declared to be the intent of
the  legislature  that  this  act  would  have been enacted even if such
invalid provisions had not been included herein.
  S 13. This act shall take effect immediately and shall  be  deemed  to
have been in full force and effect on and after April 1, 2011; provided,
however, that:
  (a)  any rules or regulations necessary to implement the provisions of
this act may be promulgated and any procedures, forms,  or  instructions
necessary  for such implementation may be adopted and issued on or after
the date this act shall have become a law;
  (b) this act shall not be construed to alter, change,  affect,  impair
or defeat any rights, obligations, duties or interests accrued, incurred
or conferred prior to the effective date of this act;
  (c) the commissioner of health and the superintendent of insurance and
any  appropriate  council may take any steps necessary to implement this
act prior to its effective date;
  (d) notwithstanding any inconsistent provision of the  state  adminis-
trative procedure act or any other provision of law, rule or regulation,
the  commissioner  of health and the superintendent of insurance and any
appropriate council is authorized to adopt or amend or promulgate on  an
emergency  basis  any  regulation  he  or she or such council determines

S. 2809                            24                            A. 4009

necessary to implement any provision of this act on its effective  date;
and
  (e)  the provisions of this act shall become effective notwithstanding
the failure of the commissioner  of  health  or  the  superintendent  of
insurance  or  any  council  to adopt or amend or promulgate regulations
implementing this act.

                                 PART C

  Section 1. Subdivision 5 of section 168 of chapter 639 of the laws  of
1996,  constituting  the  New  York  Health  Care Reform Act of 1996, as
amended by section 1 of part B of chapter 58 of the  laws  of  2008,  is
amended to read as follows:
  5.  sections  2807-c,  2807-j,  2807-s and 2807-t of the public health
law, as amended or as added by this act, shall expire  on  December  31,
[2011]  2014,  and  shall be thereafter effective only in respect to any
act done on or before such date or action or proceeding arising  out  of
such  act  including continued collections of funds from assessments and
allowances and  surcharges  established  pursuant  to  sections  2807-c,
2807-j,  2807-s  and 2807-t of the public health law, and administration
and distributions of funds from pools established pursuant  to  sections
2807-c,  2807-j, 2807-k, 2807-l, 2807-m, 2807-s and 2807-t of the public
health law related to patient  services  provided  before  December  31,
[2011]  2014, and continued expenditure of funds authorized for programs
and grants until the exhaustion of funds therefor;
  S 2. Subdivision 1 of section 138 of chapter 1 of the  laws  of  1999,
constituting  the New York Health Care Reform Act of 2000, as amended by
section 1-a of part B of chapter 58 of the laws of 2008, is  amended  to
read as follows:
  1.  sections  2807-c,  2807-j, 2807-s, and 2807-t of the public health
law, as amended by this act, shall expire on December 31,  [2011]  2014,
and shall be thereafter effective only in respect to any act done before
such  date  or  action  or  proceeding arising out of such act including
continued collections of  funds  from  assessments  and  allowances  and
surcharges  established  pursuant to sections 2807-c, 2807-j, 2807-s and
2807-t of the public health law, and administration and distributions of
funds from  pools  established  pursuant  to  sections  2807-c,  2807-j,
2807-k,  2807-l, 2807-m, 2807-s, 2807-t, 2807-v and 2807-w of the public
health law, as amended or added by this act, related to patient services
provided before December 31, [2011] 2014, and continued  expenditure  of
funds  authorized  for programs and grants until the exhaustion of funds
therefor;
  S 3. Paragraph (a) of subdivision 9 of section 2807-j  of  the  public
health  law, as amended by section 2 of part B of chapter 58 of the laws
of 2008, is amended to read as follows:
  (a) funds shall be deposited and credited to a  special  revenue-other
fund  to  be established by the comptroller or to the health care reform
act (HCRA) resources fund established pursuant to section  ninety-two-dd
of  the  state  finance  law,  whichever is applicable. To the extent of
funds appropriated therefore, the commissioner shall  make  payments  to
general  hospitals  related  to  bad  debt  and charity care pursuant to
section twenty-eight hundred seven-k of this  article.  Funds  shall  be
deposited in the following amounts:
  (i) fifty-seven and thirty-three-hundredths percent of the funds accu-
mulated  for  the  period  January  first, nineteen hundred ninety-seven
through December thirty-first, nineteen hundred ninety-seven,

S. 2809                            25                            A. 4009

  (ii) fifty-seven and one-hundredths percent of the  funds  accumulated
for  the  period  January  first,  nineteen hundred ninety-eight through
December thirty-first, nineteen hundred ninety-eight,
  (iii)  fifty-five and thirty-two-hundredths percent of the funds accu-
mulated for the  period  January  first,  nineteen  hundred  ninety-nine
through December thirty-first, nineteen hundred ninety-nine, and
  (iv)  seven  hundred  sixty-five million dollars annually of the funds
accumulated for the periods January first, two thousand through December
thirty-first, two thousand [ten] THIRTEEN, and
  (v) one hundred ninety-one million two hundred fifty thousand  dollars
of  the  funds  accumulated  for  the period January first, two thousand
[eleven] FOURTEEN through  March  thirty-first,  two  thousand  [eleven]
FOURTEEN.
  S 4. Section 34 of part A3 of chapter 62 of the laws of 2003, amending
the  general  business  law  and  other  laws relating to enacting major
components necessary to implement the state fiscal plan for the  2003-04
state  fiscal  year,  as amended by section 3 of part B of chapter 58 of
the laws of 2008, is amended to read as follows:
  S 34. (1) Notwithstanding any inconsistent provision of law,  rule  or
regulation  and  effective  April 1, 2008 through March 31, [2011] 2014,
the commissioner of health is authorized to transfer and the state comp-
troller is authorized and directed to receive for deposit to the  credit
of  the department of health's special revenue fund - other, health care
reform act (HCRA) resources fund - 061, provider  collection  monitoring
account,  within  amounts  appropriated each year, those funds collected
and accumulated pursuant to section 2807-v of  the  public  health  law,
including  income  from  invested  funds, for the purpose of payment for
administrative costs of the department of  health  related  to  adminis-
tration  of  statutory  duties  for  the  collections  and distributions
authorized by section 2807-v of the public health law.
  (2) Notwithstanding any inconsistent provision of law, rule  or  regu-
lation  and  effective  April 1, 2008 through March 31, [2011] 2014, the
commissioner of health is authorized to transfer  and  the  state  comp-
troller  is authorized and directed to receive for deposit to the credit
of the department of health's special revenue fund - other, health  care
reform  act  (HCRA) resources fund - 061, provider collection monitoring
account, within amounts appropriated each year,  those  funds  collected
and  accumulated  and interest earned through surcharges on payments for
health care services pursuant to section 2807-s of the public health law
and from assessments pursuant to section 2807-t of the public health law
for the purpose of payment for administrative costs of the department of
health related to administration of statutory duties for the collections
and distributions authorized by sections 2807-s, 2807-t, and  2807-m  of
the public health law.
  (3)  Notwithstanding  any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31,  [2011]  2014,  the
commissioner  of health is authorized to transfer and the comptroller is
authorized to deposit, within  amounts  appropriated  each  year,  those
funds  authorized  for distribution in accordance with the provisions of
paragraph (a) of subdivision 1 of section 2807-l of  the  public  health
law  for the purposes of payment for administrative costs of the depart-
ment of health related  to  the  child  health  insurance  plan  program
authorized  pursuant to title 1-A of article 25 of the public health law
into the special revenue funds - other, health care  reform  act  (HCRA)
resources fund - 061, child health insurance account, established within
the department of health.

S. 2809                            26                            A. 4009

  (4)  Notwithstanding  any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31,  [2011]  2014,  the
commissioner  of health is authorized to transfer and the comptroller is
authorized to deposit, within  amounts  appropriated  each  year,  those
funds  authorized  for distribution in accordance with the provisions of
paragraph (e) of subdivision 1 of section 2807-l of  the  public  health
law  for  the purpose of payment for administrative costs of the depart-
ment of health related to the health occupation  development  and  work-
place  demonstration  program established pursuant to section 2807-h and
the health workforce retraining program established pursuant to  section
2807-g  of the public health law into the special revenue funds - other,
health care reform act (HCRA) resources fund -  061,  health  occupation
development  and  workplace  demonstration  program account, established
within the department of health.
  (5) Notwithstanding any inconsistent provision of law, rule  or  regu-
lation  and  effective  April 1, 2008 through March 31, [2011] 2014, the
commissioner of health is authorized to transfer and the comptroller  is
authorized  to  deposit,  within  amounts  appropriated each year, those
funds allocated pursuant to paragraph (j) of subdivision  1  of  section
2807-v  of the public health law for the purpose of payment for adminis-
trative costs of the department of health related to  administration  of
the state's tobacco control programs and cancer services provided pursu-
ant  to  sections  2807-r and 1399-ii of the public health law into such
accounts established within the department of health for such purposes.
  (6) Notwithstanding any inconsistent provision of law, rule  or  regu-
lation  and  effective  April 1, 2008 through March 31, [2011] 2014, the
commissioner of health is authorized to transfer and the comptroller  is
authorized  to deposit, within amounts appropriated each year, the funds
authorized for distribution in accordance with the provisions of section
2807-l of the public health law for the purposes of payment for adminis-
trative costs of the department of health related to the programs funded
pursuant to section 2807-l of the public health  law  into  the  special
revenue  funds  -  other, health care reform act (HCRA) resources fund -
061, pilot health insurance account, established within  the  department
of health.
  (7)  Notwithstanding  any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31,  [2011]  2014,  the
commissioner  of health is authorized to transfer and the comptroller is
authorized to deposit, within  amounts  appropriated  each  year,  those
funds  authorized  for distribution in accordance with the provisions of
subparagraph (ii) of paragraph (f) of subdivision 19 of  section  2807-c
of  the public health law from monies accumulated and interest earned in
the bad debt and charity care and capital  statewide  pools  through  an
assessment  charged  to  general hospitals pursuant to the provisions of
subdivision 18 of section 2807-c of the  public  health  law  and  those
funds  authorized  for distribution in accordance with the provisions of
section 2807-l of the public health law for the purposes of payment  for
administrative  costs  of  the  department of health related to programs
funded under section 2807-l of the public health law  into  the  special
revenue  funds  -  other, health care reform act (HCRA) resources fund -
061, primary care initiatives account, established within the department
of health.
  (8) Notwithstanding any inconsistent provision of law, rule  or  regu-
lation  and  effective  April 1, 2008 through March 31, [2011] 2014, the
commissioner of health is authorized to transfer and the comptroller  is
authorized  to  deposit,  within  amounts  appropriated each year, those

S. 2809                            27                            A. 4009

funds authorized for distribution in accordance with section  2807-l  of
the  public  health  law  for the purposes of payment for administrative
costs of the department of  health  related  to  programs  funded  under
section 2807-l of the public health law into the special revenue funds -
other,  health  care reform act (HCRA) resources fund - 061, health care
delivery administration account, established within  the  department  of
health.
  (9)  Notwithstanding  any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31,  [2011]  2014,  the
commissioner  of health is authorized to transfer and the comptroller is
authorized to deposit, within  amounts  appropriated  each  year,  those
funds  authorized  pursuant to sections 2807-d, 3614-a and 3614-b of the
public health law and section 367-i of the social services law  and  for
distribution  in  accordance  with  the  provisions  of subdivision 9 of
section 2807-j of the public health law for the purpose of  payment  for
administration of statutory duties for the collections and distributions
authorized  by  sections  2807-c, 2807-d, 2807-j, 2807-k, 2807-l, 3614-a
and 3614-b of the public health law and  section  367-i  of  the  social
services  law into the special revenue funds - other, health care reform
act (HCRA) resources fund - 061, provider collection monitoring account,
established within the department of health.
  S 5. Subparagraphs (xiv) and (xv) of paragraph (a) of subdivision 6 of
section 2807-s of the public health law, as amended by section 4 of part
I of chapter 2 of the laws of 2009, are amended to read as follows:
  (xiv) A gross annual statewide amount for the  period  January  first,
two  thousand  nine  through  December  thirty-first, two thousand [ten]
THIRTEEN,  shall  be  nine  hundred  [thirty-nine]  FORTY-FOUR   million
dollars.
  (xv)  A gross statewide amount for the period January first, two thou-
sand [eleven] FOURTEEN through March thirty-first, two thousand [eleven]
FOURTEEN, shall be two hundred [thirty-four] THIRTY-SIX  million  [seven
hundred fifty thousand] dollars.
  S 5-a. Subparagraphs (iv) and (v) of paragraph (c) of subdivision 6 of
section  2807-s  of  the  public health law, as amended by section 12 of
part B of chapter 58 of the  laws  of  2008,  are  amended  to  read  as
follows:
  (iv)  A  further  gross  annual statewide amount for two thousand, two
thousand one, two thousand two, two thousand three, two  thousand  four,
two  thousand  five,  two thousand six, two thousand seven, two thousand
eight, two thousand nine [and], two thousand ten, TWO  THOUSAND  ELEVEN,
TWO  THOUSAND  TWELVE  AND  TWO  THOUSAND  THIRTEEN shall be eighty-nine
million dollars.
  (v) A further gross statewide amount for the period January first, two
thousand [eleven] FOURTEEN  through  March  thirty-first,  two  thousand
[eleven]  FOURTEEN,  shall be twenty-two million two hundred fifty thou-
sand dollars.
  S 5-b. Subparagraphs (i) and (ii) of paragraph (e) of subdivision 6 of
section 2807-s of the public health law, as amended  by  section  13  of
part  B  of  chapter  58  of  the  laws  of 2008, are amended to read as
follows:
  (i) A further gross annual statewide amount shall  be  twelve  million
dollars  for  each  period prior to January first, two thousand [eleven]
FOURTEEN.
  (ii) A further gross statewide amount for the  period  January  first,
two  thousand [eleven] FOURTEEN through March thirty-first, two thousand
[eleven] FOURTEEN shall be three million dollars.

S. 2809                            28                            A. 4009

  S 6. Subparagraphs (x), (xi), (xii), (xiii) and (xiv) of paragraph (a)
of subdivision 7 of section 2807-s of the public health law, as  amended
by  section 100 of part C of chapter 58 of the laws of 2009, are amended
to read as follows:
  (x)  forty-seven million two hundred ten thousand dollars on an annual
basis for the periods January first, two thousand nine through  December
thirty-first, two thousand ten; [and]
  (xi)  eleven  million  eight  hundred  thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven;
  (xii) TWENTY-THREE MILLION EIGHT HUNDRED THIRTY-SIX  THOUSAND  DOLLARS
EACH  STATE  FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN;
  (XIII) provided, however, for periods  prior  to  January  first,  two
thousand nine, amounts set forth in this paragraph may be reduced by the
commissioner  in  an amount to be approved by the director of the budget
to reflect the amount received from the  federal  government  under  the
state's  1115 waiver which is directed under its terms and conditions to
the graduate medical education program established pursuant  to  section
twenty-eight hundred seven-m of this article;
  [(xiii)]  (XIV)  provided  further, however, for periods prior to July
first, two thousand nine, amounts set forth in this paragraph  shall  be
reduced  by  an amount equal to the total actual distribution reductions
for all facilities pursuant to paragraph (e)  of  subdivision  three  of
section twenty-eight hundred seven-m of this article; and
  [(xiv)]  (XV)  provided  further,  however,  for periods prior to July
first, two thousand nine, amounts set forth in this paragraph  shall  be
reduced by an amount equal to the actual distribution reductions for all
facilities pursuant to paragraph (s) of subdivision one of section twen-
ty-eight hundred seven-m of this article.
  S  7. Section 2807-l of the public health law, as amended by section 4
of part B of chapter 58 of the laws of 2008, clause (A) of  subparagraph
(i) of paragraph (b) of subdivision 1 as amended by section 51 of part B
and  paragraph (n) of subdivision 1 as amended by section 9 of part C of
chapter 58 of the laws of 2009, subparagraph (iv) of  paragraph  (c)  of
subdivision  1  as amended by section 13 of part B of chapter 109 of the
laws of 2010, is amended to read as follows:
  S 2807-l. Health care initiatives pool distributions. 1. Funds accumu-
lated in the health care initiatives pools pursuant to paragraph (b)  of
subdivision  nine  of section twenty-eight hundred seven-j of this arti-
cle, or the health care reform act  (HCRA)  resources  fund  established
pursuant to section ninety-two-dd of the state finance law, whichever is
applicable,  including  income from invested funds, shall be distributed
or retained by the commissioner or by the state comptroller, as applica-
ble, in accordance with the following.
  (a) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of distributions to programs to provide health care coverage  for  unin-
sured  or underinsured children pursuant to sections twenty-five hundred
ten and twenty-five hundred eleven of this chapter from  the  respective
health  care  initiatives pools established for the following periods in
the following amounts:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
up to one hundred twenty million six hundred thousand dollars;

S. 2809                            29                            A. 4009

  (ii)  from  the  pool  for  the period January first, nineteen hundred
ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
eight,  up  to  one  hundred  sixty-four  million  five hundred thousand
dollars;
  (iii)  from  the  pool  for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
up to one hundred eighty-one million dollars;
  (iv) from the pool for the period January first, two thousand  through
December thirty-first, two thousand, two hundred seven million dollars;
  (v)  from  the  pool  for  the  period January first, two thousand one
through December thirty-first, two thousand one, two hundred thirty-five
million dollars;
  (vi) from the pool for the period  January  first,  two  thousand  two
through  December  thirty-first, two thousand two, three hundred twenty-
four million dollars;
  (vii) from the pool for the period January first, two  thousand  three
through  December  thirty-first,  two thousand three, up to four hundred
fifty million three hundred thousand dollars;
  (viii) from the pool for the period January first, two  thousand  four
through  December  thirty-first,  two  thousand four, up to four hundred
sixty million nine hundred thousand dollars;
  (ix) from the pool or the health  care  reform  act  (HCRA)  resources
fund,  whichever  is applicable, for the period January first, two thou-
sand five through December thirty-first, two thousand five,  up  to  one
hundred fifty-three million eight hundred thousand dollars;
  (x)  from  the  health  care  reform act (HCRA) resources fund for the
period January first, two thousand six  through  December  thirty-first,
two  thousand  six, up to three hundred twenty-five million four hundred
thousand dollars;
  (xi) from the health care reform act (HCRA)  resources  fund  for  the
period  January first, two thousand seven through December thirty-first,
two thousand seven, up to four hundred twenty-eight  million  fifty-nine
thousand dollars;
  (xii)  from  the  health care reform act (HCRA) resources fund for the
period January first, two thousand eight through December  thirty-first,
two  thousand  ten,  up  to four hundred fifty-three million six hundred
seventy-four thousand dollars annually; [and]
  (xiii) from the health care reform act (HCRA) resources fund  for  the
period  January  first, two thousand eleven, through March thirty-first,
two thousand eleven, up to one hundred  thirteen  million  four  hundred
eighteen thousand dollars[.];
  (XIV)  FROM  THE  HEALTH CARE REFORM ACT (HCRA) RESOURCES FUND FOR THE
PERIOD APRIL FIRST, TWO THOUSAND ELEVEN, THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND TWELVE, UP TO THREE HUNDRED TWENTY-FOUR MILLION  SEVEN  HUNDRED
FORTY-FOUR THOUSAND DOLLARS;
  (XV)  FROM  THE  HEALTH  CARE REFORM ACT (HCRA) RESOURCES FUND FOR THE
PERIOD APRIL FIRST, TWO THOUSAND TWELVE, THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND THIRTEEN, UP TO THREE HUNDRED FORTY-SIX  MILLION  FOUR  HUNDRED
FORTY-FOUR THOUSAND DOLLARS; AND
  (XVI)  FROM  THE  HEALTH CARE REFORM ACT (HCRA) RESOURCES FUND FOR THE
PERIOD APRIL FIRST, TWO THOUSAND THIRTEEN, THROUGH  MARCH  THIRTY-FIRST,
TWO  THOUSAND  FOURTEEN, UP TO THREE HUNDRED SEVENTY MILLION SIX HUNDRED
NINETY-FIVE THOUSAND DOLLARS.
  (b) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of distributions for health  insurance  programs  under  the  individual

S. 2809                            30                            A. 4009

subsidy programs established pursuant to the expanded health care cover-
age  act of nineteen hundred eighty-eight as amended, and for evaluation
of such programs from the respective health care  initiatives  pools  or
the  health care reform act (HCRA) resources fund, whichever is applica-
ble, established for the following periods in the following amounts:
  (i) (A) an amount not to exceed six million dollars on  an  annualized
basis  for  the  periods  January  first,  nineteen hundred ninety-seven
through December thirty-first, nineteen hundred ninety-nine; up  to  six
million  dollars  for  the  period  January  first, two thousand through
December thirty-first, two thousand; up to five million dollars for  the
period  January  first,  two thousand one through December thirty-first,
two thousand one; up to four million  dollars  for  the  period  January
first, two thousand two through December thirty-first, two thousand two;
up  to  two  million six hundred thousand dollars for the period January
first, two thousand three through December  thirty-first,  two  thousand
three;  up  to one million three hundred thousand dollars for the period
January first, two thousand  four  through  December  thirty-first,  two
thousand four; up to six hundred seventy thousand dollars for the period
January  first,  two  thousand five through June thirtieth, two thousand
five; up to one million three hundred thousand dollars  for  the  period
April  first,  two thousand six through March thirty-first, two thousand
seven; and up to one million three hundred thousand dollars annually for
the period April first, two thousand seven through  March  thirty-first,
two  thousand  nine,  shall be allocated to individual subsidy programs;
and
  (B) an amount not to exceed seven million  dollars  on  an  annualized
basis  for the periods during the period January first, nineteen hundred
ninety-seven through December thirty-first, nineteen hundred ninety-nine
and four million dollars annually for the  periods  January  first,  two
thousand  through  December  thirty-first,  two  thousand two, and three
million dollars for the period January first, two thousand three through
December thirty-first, two thousand three, and two million  dollars  for
the  period  January  first,  two thousand four through December thirty-
first, two thousand four, and two million dollars for the period January
first, two thousand five through June thirtieth, two thousand five shall
be allocated to the catastrophic health care expense program.
  (ii) Notwithstanding any law to the contrary, the characterizations of
the New York state small business health insurance  partnership  program
as  in  effect  prior  to  June  thirtieth,  two thousand three, voucher
program as in effect prior to December thirty-first, two  thousand  one,
individual  subsidy  program  as  in effect prior to June thirtieth, two
thousand five, and catastrophic  health  care  expense  program,  as  in
effect prior to June thirtieth, two thousand five, may, for the purposes
of  identifying  matching funds for the community health care conversion
demonstration project described in a waiver of the provisions  of  title
XIX  of the federal social security act granted to the state of New York
and dated July fifteenth, nineteen hundred ninety-seven, may continue to
be used to characterize the insurance programs in sections four thousand
three hundred twenty-one-a, four thousand  three  hundred  twenty-two-a,
four  thousand  three hundred twenty-six and four thousand three hundred
twenty-seven of the insurance law, which are successor programs to these
programs.
  (c) Up to seventy-eight million dollars shall be reserved and  accumu-
lated  from  year  to  year  from the pool for the period January first,
nineteen hundred ninety-seven through  December  thirty-first,  nineteen
hundred  ninety-seven,  for  purposes  of  public health programs, up to

S. 2809                            31                            A. 4009

seventy-six million dollars shall be reserved and accumulated from  year
to  year  from the pools for the periods January first, nineteen hundred
ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
eight  and  January first, nineteen hundred ninety-nine through December
thirty-first, nineteen hundred ninety-nine, up  to  eighty-four  million
dollars  shall  be  reserved  and accumulated from year to year from the
pools for the period January first, two thousand through December  thir-
ty-first,  two  thousand,  up  to  eighty-five  million dollars shall be
reserved and accumulated from year to year from the pools for the period
January first, two thousand one through December thirty-first, two thou-
sand one, up to eighty-six million dollars shall be reserved and accumu-
lated from year to year from the pools for the period January first, two
thousand two through December thirty-first,  two  thousand  two,  up  to
eighty-six  million one hundred fifty thousand dollars shall be reserved
and accumulated from year to year from the pools for the period  January
first,  two  thousand  three through December thirty-first, two thousand
three, up to fifty-eight million seven hundred eighty  thousand  dollars
shall  be  reserved and accumulated from year to year from the pools for
the period January first, two thousand  four  through  December  thirty-
first, two thousand four, up to sixty-eight million seven hundred thirty
thousand  dollars  shall  be  reserved and accumulated from year to year
from the pools or the health care  reform  act  (HCRA)  resources  fund,
whichever is applicable, for the period January first, two thousand five
through  December  thirty-first,  two  thousand  five, up to ninety-four
million three hundred fifty thousand dollars shall be reserved and accu-
mulated from year to  year  from  the  health  care  reform  act  (HCRA)
resources  fund  for  the period January first, two thousand six through
December thirty-first, two thousand six,  up  to  seventy  million  nine
hundred  thirty-nine  thousand dollars shall be reserved and accumulated
from year to year from the health care reform act (HCRA) resources  fund
for  the period January first, two thousand seven through December thir-
ty-first, two thousand seven,  up  to  fifty-five  million  six  hundred
eighty-nine  thousand dollars annually shall be reserved and accumulated
from year to year from the health care reform act (HCRA) resources  fund
for  the period January first, two thousand eight through December thir-
ty-first, two thousand ten, [and] up to thirteen  million  nine  hundred
twenty-two  thousand dollars shall be reserved and accumulated from year
to year from the health care reform act (HCRA) resources  fund  for  the
period  January  first,  two thousand eleven through March thirty-first,
two thousand eleven, AND FOR PERIODS ON AND AFTER APRIL FIRST, TWO THOU-
SAND ELEVEN, UP TO FUNDING AMOUNTS SPECIFIED BELOW and shall  be  avail-
able, including income from invested funds, for:
  (i)  deposit by the commissioner, within amounts appropriated, and the
state comptroller is hereby  authorized  and  directed  to  receive  for
deposit  to, to the credit of the department of health's special revenue
fund - other, hospital based grants program account or the  health  care
reform  act (HCRA) resources fund, whichever is applicable, for purposes
of services  and  expenses  related  to  general  hospital  based  grant
programs,  up  to  twenty-two million dollars annually from the nineteen
hundred ninety-seven pool, nineteen hundred ninety-eight pool,  nineteen
hundred  ninety-nine  pool, two thousand pool, two thousand one pool and
two thousand two pool, respectively, up to  twenty-two  million  dollars
from  the  two  thousand  three  pool, up to ten million dollars for the
period January first, two thousand four through  December  thirty-first,
two  thousand  four, up to eleven million dollars for the period January
first, two thousand five through  December  thirty-first,  two  thousand

S. 2809                            32                            A. 4009

five, up to twenty-two million dollars for the period January first, two
thousand  six  through  December  thirty-first,  two thousand six, up to
twenty-two million ninety-seven thousand dollars annually for the period
January  first,  two  thousand  seven through December thirty-first, two
thousand ten, [and] up to five million five hundred twenty-four thousand
dollars for the period January first, two thousand eleven through  March
thirty-first,  two  thousand eleven, UP TO THIRTEEN MILLION FOUR HUNDRED
FORTY-FIVE THOUSAND DOLLARS FOR THE PERIOD  APRIL  FIRST,  TWO  THOUSAND
ELEVEN  THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE, AND UP TO THIR-
TEEN MILLION THREE HUNDRED  SEVENTY-FIVE  THOUSAND  DOLLARS  EACH  STATE
FISCAL  YEAR  FOR  THE  PERIOD  APRIL FIRST, TWO THOUSAND TWELVE THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN;
  (ii) deposit by the commissioner, within amounts appropriated, and the
state comptroller is hereby  authorized  and  directed  to  receive  for
deposit  to,  to  the  credit of the emergency medical services training
account established in section ninety-seven-q of the state  finance  law
or the health care reform act (HCRA) resources fund, whichever is appli-
cable,  up  to  sixteen  million  dollars on an annualized basis for the
periods January first, nineteen hundred  ninety-seven  through  December
thirty-first, nineteen hundred ninety-nine, up to twenty million dollars
for  the  period  January  first,  two thousand through December thirty-
first, two thousand, up to twenty-one million  dollars  for  the  period
January first, two thousand one through December thirty-first, two thou-
sand one, up to twenty-two million dollars for the period January first,
two  thousand two through December thirty-first, two thousand two, up to
twenty-two million five hundred fifty thousand dollars  for  the  period
January  first,  two  thousand  three through December thirty-first, two
thousand three, up to nine million six hundred eighty  thousand  dollars
for  the  period January first, two thousand four through December thir-
ty-first, two thousand four, up to twelve  million  one  hundred  thirty
thousand dollars for the period January first, two thousand five through
December  thirty-first, two thousand five, up to twenty-four million two
hundred fifty thousand dollars for the period January first,  two  thou-
sand  six  through December thirty-first, two thousand six, up to twenty
million four hundred ninety-two thousand dollars annually for the period
January first, two thousand seven  through  December  thirty-first,  two
thousand ten, [and] up to five million one hundred twenty-three thousand
dollars  for the period January first, two thousand eleven through March
thirty-first, two thousand eleven, UP TO EIGHTEEN MILLION THREE  HUNDRED
FIFTY  THOUSAND  DOLLARS FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE, UP TO EIGHTEEN  MILLION
NINE  HUNDRED  FIFTY  THOUSAND  DOLLARS  FOR THE PERIOD APRIL FIRST, TWO
THOUSAND TWELVE THROUGH MARCH THIRTY-FIRST, TWO THOUSAND  THIRTEEN,  AND
UP  TO  NINETEEN  MILLION FOUR HUNDRED NINETEEN THOUSAND DOLLARS FOR THE
PERIOD APRIL FIRST, TWO THOUSAND THIRTEEN  THROUGH  MARCH  THIRTY-FIRST,
TWO THOUSAND FOURTEEN;
  (iii)  priority  distributions  by  the  commissioner up to thirty-two
million dollars on an annualized basis for the period January first, two
thousand through December thirty-first, two thousand four, up  to  thir-
ty-eight  million  dollars on an annualized basis for the period January
first, two thousand five through  December  thirty-first,  two  thousand
six,  up  to eighteen million two hundred fifty thousand dollars for the
period January first, two thousand seven through December  thirty-first,
two  thousand seven, up to three million dollars annually for the period
January first, two thousand eight  through  December  thirty-first,  two
thousand  ten,  [and] up to seven hundred fifty thousand dollars for the

S. 2809                            33                            A. 4009

period January first, two thousand eleven  through  March  thirty-first,
two thousand eleven, AND UP TO TWO MILLION NINE HUNDRED THOUSAND DOLLARS
EACH  STATE  FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN
THROUGH  MARCH  THIRTY-FIRST,  TWO THOUSAND FOURTEEN to be allocated (A)
for the purposes established pursuant to subparagraph (ii) of  paragraph
(f)  of  subdivision nineteen of section twenty-eight hundred seven-c of
this article as in effect on  December  thirty-first,  nineteen  hundred
ninety-six  and  as  may  thereafter  be  amended, up to fifteen million
dollars annually for the periods January  first,  two  thousand  through
December  thirty-first,  two  thousand  four,  up  to twenty-one million
dollars annually for the period January first, two thousand five through
December thirty-first, two thousand six, and up to  seven  million  five
hundred  thousand  dollars  for  the  period January first, two thousand
seven through March thirty-first, two thousand seven;
  (B) pursuant to a memorandum of  understanding  entered  into  by  the
commissioner,  the  majority leader of the senate and the speaker of the
assembly, for the purposes outlined in such memorandum upon  the  recom-
mendation  of  the  majority  leader  of the senate, up to eight million
five hundred thousand dollars annually for the period January first, two
thousand through December thirty-first, two thousand six, and up to four
million two hundred fifty thousand dollars for the period January first,
two thousand seven through June thirtieth, two thousand seven,  and  for
the  purposes outlined in such memorandum upon the recommendation of the
speaker of the assembly, up  to  eight  million  five  hundred  thousand
dollars  annually  for  the  periods January first, two thousand through
December thirty-first, two thousand six, and  up  to  four  million  two
hundred  fifty  thousand dollars for the period January first, two thou-
sand seven through June thirtieth, two thousand seven; and
  (C) for services and expenses, including grants, related to  emergency
assistance  distributions  as  designated by the commissioner.  Notwith-
standing section one hundred twelve or one hundred  sixty-three  of  the
state  finance law or any other contrary provision of law, such distrib-
utions shall be limited to providers or programs where, as determined by
the commissioner, emergency assistance is vital to protect the  life  or
safety  of  patients,  to ensure the retention of facility caregivers or
other staff, or in instances where health facility operations are  jeop-
ardized,  or  where  the public health is jeopardized or other emergency
situations exist, up to three million dollars annually  for  the  period
April first, two thousand seven through March thirty-first, two thousand
eleven,  AND  UP TO TWO MILLION NINE HUNDRED THOUSAND DOLLARS EACH STATE
FISCAL YEAR FOR THE PERIOD APRIL  FIRST,  TWO  THOUSAND  ELEVEN  THROUGH
MARCH  THIRTY-FIRST,  TWO  THOUSAND FOURTEEN.   Upon any distribution of
such funds, the commissioner shall  immediately  notify  the  chair  and
ranking  minority  member  of the senate finance committee, the assembly
ways and means committee, the senate committee on health, and the assem-
bly committee on health;
  (iv) distributions by  the  commissioner  related  to  poison  control
centers  pursuant  to subdivision seven of section twenty-five hundred-d
of this chapter, up to five  million  dollars  for  the  period  January
first,  nineteen  hundred  ninety-seven  through  December thirty-first,
nineteen hundred ninety-seven, up to three million dollars on an annual-
ized basis for the periods during the  period  January  first,  nineteen
hundred  ninety-eight  through  December  thirty-first, nineteen hundred
ninety-nine, up to five million dollars annually for the periods January
first, two thousand through December thirty-first, two thousand two,  up
to  four  million  six hundred thousand dollars annually for the periods

S. 2809                            34                            A. 4009

January first, two thousand three  through  December  thirty-first,  two
thousand  four,  up to five million one hundred thousand dollars for the
period January first, two thousand five through  December  thirty-first,
two  thousand  six  annually,  up  to  five million one hundred thousand
dollars annually for  the  period  January  first,  two  thousand  seven
through  December  thirty-first,  two thousand nine, up to three million
six hundred thousand dollars for the period January first, two  thousand
ten  through  December thirty-first, two thousand ten, [and] up to seven
hundred seventy-five thousand dollars for the period January first,  two
thousand  eleven through March thirty-first, two thousand eleven, AND UP
TO TWO MILLION FIVE HUNDRED THOUSAND DOLLARS EACH STATE FISCAL YEAR  FOR
THE  PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST,
TWO THOUSAND FOURTEEN; and
  (v) deposit by the commissioner, within amounts appropriated, and  the
state  comptroller  is  hereby  authorized  and  directed to receive for
deposit to, to the credit of the department of health's special  revenue
fund  -  other,  miscellaneous  special  revenue fund - 339 maternal and
child HIV  services  account  or  the  health  care  reform  act  (HCRA)
resources  fund,  whichever  is  applicable,  for  purposes of a special
program for HIV services for [infants and pregnant] women AND  CHILDREN,
INCLUDING  ADOLESCENTS pursuant to section [seventy-one of chapter seven
hundred thirty-one of the laws of nineteen hundred ninety-three,  amend-
ing]  TWENTY-FIVE HUNDRED-F-ONE OF the public health law [and other laws
relating to reimbursement, delivery  and  capital  costs  of  ambulatory
health  care  services  and  inpatient  hospital  services],  up to five
million dollars annually for the periods  January  first,  two  thousand
through  December  thirty-first,  two  thousand  two, up to five million
dollars for the period January first, two thousand three through  Decem-
ber  thirty-first,  two  thousand  three, up to two million five hundred
thousand dollars for the period January first, two thousand four through
December thirty-first, two thousand four, up to two million five hundred
thousand dollars for the period January first, two thousand five through
December thirty-first, two thousand five, up to five million dollars for
the period January first, two  thousand  six  through  December  thirty-
first,  two  thousand  six,  up to five million dollars annually for the
period January first, two thousand seven through December  thirty-first,
two  thousand  ten,  [and]  up to one million two hundred fifty thousand
dollars for the period January first, two thousand eleven through  March
thirty-first,  two  thousand eleven, AND UP TO FIVE MILLION DOLLARS EACH
STATE FISCAL YEAR FOR  THE  PERIOD  APRIL  FIRST,  TWO  THOUSAND  ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN;
  (d)  (i)  An  amount  of up to twenty million dollars annually for the
period January first, two thousand through  December  thirty-first,  two
thousand  six,  up  to ten million dollars for the period January first,
two thousand seven through June thirtieth, two  thousand  seven,  up  to
twenty  million dollars annually for the period January first, two thou-
sand eight through December thirty-first, two thousand ten, [and] up  to
five  million  dollars for the period January first, two thousand eleven
through March thirty-first, two thousand  eleven,  AND  UP  TO  NINETEEN
MILLION  SIX  HUNDRED  THOUSAND  DOLLARS  EACH STATE FISCAL YEAR FOR THE
PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST,  TWO
THOUSAND  FOURTEEN, shall be transferred to the health facility restruc-
turing pool established pursuant to section twenty-eight hundred fifteen
of this article;
  (ii) provided, however, amounts transferred pursuant  to  subparagraph
(i)  of this paragraph may be reduced in an amount to be approved by the

S. 2809                            35                            A. 4009

director of the budget to reflect the amount received from  the  federal
government  under  the  state's  1115 waiver which is directed under its
terms and conditions to the health facility restructuring program.
  (e)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available,  including income from invested funds, for  purposes
of  distributions  to  organizations  to  support  the  health workforce
retraining program established pursuant to section twenty-eight  hundred
seven-g  of  this   article  from the respective health care initiatives
pools established for the following periods  in  the  following  amounts
from  the  pools  or  the  health care reform act (HCRA) resources fund,
whichever is applicable,  during  the  period  January  first,  nineteen
hundred  ninety-seven  through  December  thirty-first, nineteen hundred
ninety-nine, up to fifty million dollars on an annualized basis,  up  to
thirty  million  dollars  for  the  period  January  first, two thousand
through December thirty-first, two thousand, up to forty million dollars
for the period January first, two thousand one through December  thirty-
first,  two  thousand  one,  up  to fifty million dollars for the period
January first, two thousand two through December thirty-first, two thou-
sand two, up to forty-one million one hundred fifty thousand dollars for
the period January first, two thousand three  through  December  thirty-
first,  two  thousand  three,  up to forty-one million one hundred fifty
thousand dollars for the period January first, two thousand four through
December thirty-first, two thousand  four,  up  to  fifty-eight  million
three  hundred  sixty thousand dollars for the period January first, two
thousand five through December thirty-first, two thousand  five,  up  to
fifty-two  million  three  hundred sixty thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six, up to thirty-five million four hundred thousand dollars  annu-
ally  for  the period January first, two thousand seven through December
thirty-first, two thousand ten [and], up to eight million eight  hundred
fifty thousand dollars for the period January first, two thousand eleven
through  March thirty-first, two thousand eleven, AND UP TO TWENTY-EIGHT
MILLION FOUR HUNDRED THOUSAND DOLLARS EACH STATE  FISCAL  YEAR  FOR  THE
PERIOD  APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND FOURTEEN, less the amount of funds  available  for  allocations
for  rate  adjustments  for  workforce training programs for payments by
state governmental agencies for inpatient hospital services.
  (f) Funds shall be accumulated and transferred from as follows:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
(A)  thirty-four  million   six hundred thousand dollars shall be trans-
ferred to funds reserved and accumulated pursuant to  paragraph  (b)  of
subdivision  nineteen  of  section  twenty-eight hundred seven-c of this
article, and (B) eighty-two million dollars  shall  be  transferred  and
deposited  and  credited to the credit of the state general fund medical
assistance local assistance account;
  (ii) from the pool for the  period  January  first,  nineteen  hundred
ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
eight, eighty-two million dollars shall be transferred and deposited and
credited to the credit of the  state  general  fund  medical  assistance
local assistance account;
  (iii)  from  the  pool  for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
eighty-two million dollars shall be transferred and deposited and  cred-
ited  to  the  credit of the state general fund medical assistance local
assistance account;

S. 2809                            36                            A. 4009

  (iv) from the pool or the health  care  reform  act  (HCRA)  resources
fund,  whichever  is applicable, for the period January first, two thou-
sand  through  December  thirty-first,  two  thousand  four,  eighty-two
million dollars annually, and for the period January first, two thousand
five  through  December  thirty-first,  two  thousand  five,  eighty-two
million dollars, and for the period  January  first,  two  thousand  six
through  December  thirty-first,  two  thousand  six, eighty-two million
dollars, and for the period January first, two  thousand  seven  through
December  thirty-first,  two thousand seven, eighty-two million dollars,
and for the period January first, two thousand  eight  through  December
thirty-first,  two thousand eight, ninety million seven hundred thousand
dollars shall be deposited by the  commissioner,  and  the  state  comp-
troller  is hereby authorized and directed to receive for deposit to the
credit of the state special revenue fund - other,  HCRA  transfer  fund,
medical assistance account;
  (v)  from  the  health  care  reform act (HCRA) resources fund for the
period January first, two thousand nine through  December  thirty-first,
two  thousand  nine, one hundred eight million nine hundred seventy-five
thousand dollars, and for the period January  first,  two  thousand  ten
through  December thirty-first, two thousand ten, one hundred twenty-six
million one hundred thousand  dollars,  [and]  for  the  period  January
first,  two  thousand  eleven  through  March thirty-first, two thousand
eleven, twenty million five hundred thousand dollars, AND FOR EACH STATE
FISCAL YEAR FOR THE PERIOD APRIL  FIRST,  TWO  THOUSAND  ELEVEN  THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN, ONE HUNDRED FORTY-SIX MILLION
FOUR  HUNDRED  THOUSAND DOLLARS, shall be deposited by the commissioner,
and the state comptroller is hereby authorized and directed  to  receive
for  deposit,  to  the credit of the state special revenue fund - other,
HCRA transfer fund, medical assistance account.
  (g) Funds shall be transferred to primary health care  services  pools
created  by  the  commissioner, and shall be available, including income
from invested funds, for distributions in accordance with former section
twenty-eight hundred seven-bb of this article from the respective health
care initiatives pools  for  the  following  periods  in  the  following
percentage  amounts  of  funds remaining after allocations in accordance
with paragraphs (a) through (f) of this subdivision:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
fifteen and eighty-seven-hundredths percent;
  (ii)  from  the  pool  for  the period January first, nineteen hundred
ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
eight, fifteen and eighty-seven-hundredths percent; and
  (iii)  from  the  pool  for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
sixteen and thirteen-hundredths percent.
  (h) Funds shall be reserved and accumulated from year to year  by  the
commissioner  and  shall  be  available,  including income from invested
funds, for purposes of primary care education and training  pursuant  to
article nine of this chapter from the respective health care initiatives
pools  established for the following periods in the following percentage
amounts of funds remaining after allocations in  accordance  with  para-
graphs  (a)  through  (f) of this subdivision and shall be available for
distributions as follows:
  (i) funds shall be reserved and accumulated:

S. 2809                            37                            A. 4009

  (A) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
six and thirty-five-hundredths percent;
  (B) from the pool for the period January first, nineteen hundred nine-
ty-eight  through  December thirty-first, nineteen hundred ninety-eight,
six and thirty-five-hundredths percent; and
  (C) from the pool for the period January first, nineteen hundred nine-
ty-nine through December thirty-first, nineteen hundred ninety-nine, six
and forty-five-hundredths percent;
  (ii) funds shall be available for distributions including income  from
invested funds as follows:
  (A)  for purposes of the primary care physician loan repayment program
in accordance with section nine hundred three of  this  chapter,  up  to
five million dollars on an annualized basis;
  (B)  for purposes of the primary care practitioner scholarship program
in accordance with section nine hundred four of this chapter, up to  two
million dollars on an annualized basis;
  (C) for purposes of minority participation in medical education grants
in  accordance  with section nine hundred six of this chapter, up to one
million dollars on an annualized basis; and
  (D) provided, however, that the commissioner may reallocate any  funds
remaining  or unallocated for distributions for the primary care practi-
tioner scholarship program in accordance with section nine hundred  four
of this chapter.
  (i)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  distrib-
utions  in  accordance  with  section  twenty-nine hundred fifty-two and
section twenty-nine hundred fifty-eight of this chapter for rural health
care delivery development and  rural  health  care  access  development,
respectively,  from  the respective health care initiatives pools or the
health care reform act (HCRA) resources fund, whichever  is  applicable,
for  the  following periods in the following percentage amounts of funds
remaining after allocations in accordance with  paragraphs  (a)  through
(f) of this subdivision, and for periods on and after January first, two
thousand, in the following amounts:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
thirteen and forty-nine-hundredths percent;
  (ii) from the pool for the  period  January  first,  nineteen  hundred
ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
eight, thirteen and forty-nine-hundredths percent;
  (iii) from the pool for the period  January  first,  nineteen  hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
thirteen and seventy-one-hundredths percent;
  (iv) from the pool for the periods January first, two thousand through
December thirty-first, two thousand two, seventeen million dollars annu-
ally,  and  for  the  period  January  first, two thousand three through
December thirty-first, two thousand three, up to fifteen  million  eight
hundred fifty thousand dollars;
  (v) from the pool or the health care reform act (HCRA) resources fund,
whichever is applicable, for the period January first, two thousand four
through  December thirty-first, two thousand four, up to fifteen million
eight hundred fifty thousand dollars, and for the period January  first,
two  thousand  five through December thirty-first, two thousand five, up
to nineteen million two hundred thousand dollars,  and  for  the  period
January first, two thousand six through December thirty-first, two thou-

S. 2809                            38                            A. 4009

sand  six,  up to nineteen million two hundred thousand dollars, for the
period January first, two thousand seven through December  thirty-first,
two  thousand  ten,  up  to  eighteen million one hundred fifty thousand
dollars annually, [and] for the period January first, two thousand elev-
en  through  March thirty-first, two thousand eleven, up to four million
five hundred thirty-eight thousand dollars, AND FOR  EACH  STATE  FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIR-
TY-FIRST, TWO THOUSAND FOURTEEN, UP TO SIXTEEN MILLION TWO HUNDRED THOU-
SAND DOLLARS.
  (j)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  distributions  related to health information and health care quality
improvement pursuant to former section twenty-eight hundred  seven-n  of
this  article  from  the respective health care initiatives pools estab-
lished for the following periods in the following percentage amounts  of
funds  remaining  after  allocations  in  accordance with paragraphs (a)
through (f) of this subdivision:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
six and thirty-five-hundredths percent;
  (ii)  from  the  pool  for  the period January first, nineteen hundred
ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
eight, six and thirty-five-hundredths percent; and
  (iii)  from  the  pool  for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
six and forty-five-hundredths percent.
  (k) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available,  including  income  from invested funds, for allo-
cations  and  distributions  in  accordance  with  section  twenty-eight
hundred  seven-p  of  this  article  for diagnostic and treatment center
uncompensated care from the respective health care initiatives pools  or
the  health care reform act (HCRA) resources fund, whichever is applica-
ble, for the following periods in the following percentage   amounts  of
funds  remaining  after  allocations  in  accordance with paragraphs (a)
through (f) of this subdivision, and for periods on  and  after  January
first, two thousand, in the following amounts:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
thirty-eight and one-tenth percent;
  (ii) from the pool for the  period  January  first,  nineteen  hundred
ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
eight, thirty-eight and one-tenth percent;
  (iii) from the pool for the period  January  first,  nineteen  hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
thirty-eight and seventy-one-hundredths percent;
  (iv) from the pool for the periods January first, two thousand through
December  thirty-first,  two  thousand  two, forty-eight million dollars
annually, and for the period January first, two thousand  three  through
June thirtieth, two thousand three, twenty-four million dollars;
  (v)  (A)  from the pool or the health care reform act (HCRA) resources
fund, whichever is applicable, for the period July first,  two  thousand
three  through  December  thirty-first,  two  thousand  three, up to six
million dollars, for the period January first, two thousand four through
December thirty-first, two thousand six, up to  twelve  million  dollars
annually,  for  the  period  January  first,  two thousand seven through
December thirty-first, two thousand [ten] THIRTEEN,  up  to  forty-eight

S. 2809                            39                            A. 4009

million dollars annually, and for the period January first, two thousand
[eleven]  FOURTEEN  through  March  thirty-first,  two thousand [eleven]
FOURTEEN, up to twelve million dollars;
  (B)  from  the  health  care  reform act (HCRA) resources fund for the
period January first, two thousand six  through  December  thirty-first,
two  thousand  six,  an  additional  seven million five hundred thousand
dollars, for the period January first, two thousand seven through Decem-
ber thirty-first, two  thousand  [ten]  THIRTEEN,  an  additional  seven
million five hundred thousand dollars annually, and for the period Janu-
ary  first,  two  thousand [eleven] FOURTEEN through March thirty-first,
two thousand [eleven] FOURTEEN, an additional one million eight  hundred
seventy-five  thousand  dollars, for voluntary non-profit diagnostic and
treatment center  uncompensated  care  in  accordance  with  subdivision
four-c of section twenty-eight hundred seven-p of this article; and
  (vi)  funds  reserved  and  accumulated pursuant to this paragraph for
periods on and after July first, two thousand three, shall be  deposited
by  the  commissioner,  within amounts appropriated, and the state comp-
troller is hereby authorized and directed to receive for deposit to  the
credit  of  the state special revenue funds - other, HCRA transfer fund,
medical assistance account, for purposes of funding the state  share  of
rate  adjustments  made pursuant to section twenty-eight hundred seven-p
of this article, provided, however, that in the event federal  financial
participation  is  not  available  for rate adjustments made pursuant to
paragraph (b) of subdivision one of section twenty-eight hundred seven-p
of this article, funds shall be distributed pursuant to paragraph (a) of
subdivision one of section twenty-eight hundred seven-p of this  article
from  the  respective  health  care initiatives pools or the health care
reform act (HCRA) resources fund, whichever is applicable.
  (l) Funds shall be reserved and accumulated from year to year  by  the
commissioner  and  shall  be  available,  including income from invested
funds, for transfer to and allocation  for services and expenses for the
payment of benefits to recipients of  drugs under the AIDS drug  assist-
ance  program  (ADAP)  -  HIV  uninsured care program as administered by
Health Research Incorporated from the  respective   health  care  initi-
atives pools or the health care reform act (HCRA) resources fund, which-
ever is applicable, established for the following periods in the follow-
ing   percentage   amounts  of  funds  remaining  after  allocations  in
accordance with paragraphs (a) through (f) of this subdivision, and  for
periods  on  and  after  January  first,  two thousand, in the following
amounts:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
nine and fifty-two-hundredths percent;
  (ii)  from  the  pool  for  the period January first, nineteen hundred
ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
eight, nine and fifty-two-hundredths percent;
  (iii)  from  the  pool  for the period January first, nineteen hundred
ninety-nine and December  thirty-first,  nineteen  hundred  ninety-nine,
nine and sixty-eight-hundredths percent;
  (iv) from the pool for the periods January first, two thousand through
December  thirty-first,  two  thousand two, up to twelve million dollars
annually, and for the period January first, two thousand  three  through
December  thirty-first, two thousand three, up to forty million dollars;
and
  (v) from the pool or the health care reform act (HCRA) resources fund,
whichever is applicable, for the periods  January  first,  two  thousand

S. 2809                            40                            A. 4009

four  through  December thirty-first, two thousand four, up to fifty-six
million dollars, for the period January first, two thousand five through
December thirty-first, two thousand six, up  to  sixty  million  dollars
annually,  for  the  period  January  first,  two thousand seven through
December thirty-first, two thousand ten, up  to  sixty  million  dollars
annually,  [and]  for  the  period  January  first,  two thousand eleven
through March thirty-first, two thousand eleven, up to  fifteen  million
dollars,  AND  EACH  STATE  FISCAL  YEAR FOR THE PERIOD APRIL FIRST, TWO
THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN, UP TO
FORTY-TWO MILLION THREE HUNDRED THOUSAND DOLLARS.
  (m) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of distributions pursuant to section  twenty-eight  hundred  seven-r  of
this article for cancer related services from the respective health care
initiatives  pools  or the health care reform act (HCRA) resources fund,
whichever is applicable, established for the following  periods  in  the
following  percentage  amounts  of  funds remaining after allocations in
accordance with paragraphs (a) through (f) of this subdivision, and  for
periods  on  and  after  January  first,  two thousand, in the following
amounts:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
seven and ninety-four-hundredths percent;
  (ii)  from  the  pool  for  the period January first, nineteen hundred
ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
eight, seven and ninety-four-hundredths percent;
  (iii)  from  the  pool  for the period January first, nineteen hundred
ninety-nine and December thirty-first, nineteen hundred ninety-nine, six
and forty-five-hundredths percent;
  (iv) from the pool for the period January first, two thousand  through
December thirty-first, two thousand two, up to ten million dollars on an
annual basis;
  (v)  from  the  pool  for the period January first, two thousand three
through December thirty-first, two thousand four, up  to  eight  million
nine hundred fifty thousand dollars on an annual basis;
  (vi)  from  the  pool  or  the health care reform act (HCRA) resources
fund, whichever is applicable, for the period January first,  two  thou-
sand  five  through  December  thirty-first, two thousand six, up to ten
million fifty thousand dollars on an annual basis, for the period  Janu-
ary  first,  two thousand seven through December thirty-first, two thou-
sand ten, up to nineteen million dollars annually, and  for  the  period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven, up to four million seven hundred fifty thousand dollars.
  (n)  Funds  shall  be accumulated and transferred from the health care
reform act (HCRA) resources fund as follows: for the period April first,
two thousand seven through March thirty-first, two thousand  eight,  and
on  an  annual  basis  for  the  periods April first, two thousand eight
through November thirtieth, two  thousand  nine,  funds  within  amounts
appropriated  shall  be  transferred  and  deposited and credited to the
credit of the state special revenue funds - other, HCRA  transfer  fund,
medical  assistance  account, for purposes of funding the state share of
rate adjustments made to public and voluntary  hospitals  in  accordance
with  paragraphs  (i) and (j) of subdivision one of section twenty-eight
hundred seven-c of this article.
  2. Notwithstanding any inconsistent provision of law,  rule  or  regu-
lation,  any  funds  accumulated  in  the  health care initiatives pools

S. 2809                            41                            A. 4009

pursuant to paragraph (b) of subdivision nine  of  section  twenty-eight
hundred  seven-j of this article, as a result of surcharges, assessments
or other obligations during the periods January first, nineteen  hundred
ninety-seven  through  December  thirty-first,  nineteen hundred ninety-
nine, which are unused or uncommitted for distributions pursuant to this
section shall be reserved and accumulated  from  year  to  year  by  the
commissioner and, within amounts appropriated, transferred and deposited
into  the  special  revenue funds - other, miscellaneous special revenue
fund - 339, child health insurance account  or  any  successor  fund  or
account,  for  purposes  of  distributions to implement the child health
insurance program established pursuant to sections  twenty-five  hundred
ten  and  twenty-five  hundred eleven of this chapter for periods on and
after January first, two thousand one; provided, however, funds reserved
and accumulated for  priority  distributions  pursuant  to  subparagraph
(iii)  of  paragraph (c) of subdivision one of this section shall not be
transferred and deposited into such account pursuant  to  this  subdivi-
sion; and provided further, however, that any unused or uncommitted pool
funds accumulated and allocated pursuant to paragraph (j) of subdivision
one  of  this  section  shall  be distributed for purposes of the health
information and quality improvement act of 2000.
  3. Revenue from distributions pursuant to this section  shall  not  be
included  in  gross  revenue  received  for  purposes of the assessments
pursuant to subdivision eighteen of section twenty-eight hundred seven-c
of this article, subject to the provisions of paragraph (e) of  subdivi-
sion  eighteen  of section twenty-eight hundred seven-c of this article,
and shall not be included in gross revenue received for purposes of  the
assessments  pursuant  to  section  twenty-eight hundred seven-d of this
article, subject to the provisions  of  subdivision  twelve  of  section
twenty-eight hundred seven-d of this article.
  S  8.  Subdivision  1  of  section 2807-v of the public health law, as
amended by section 5 of part B of chapter 58 of the laws of 2008,  para-
graphs  (g),  (h),  (i)  and  (i-1) as amended by section 5 of part I of
chapter 2 of the laws of 2009, subparagraphs (xi) and (xii) of paragraph
(j) as amended by section 12, paragraph (jj) as amended by  section  10,
subparagraph  (vii)  of  paragraph  (qq)  as  amended  by section 11 and
subparagraph (vii) of paragraph (uu) as amended by section 9 of  part  B
of  chapter 109 of the laws of 2010, paragraph (s) as amended by section
8, paragraphs (x) and (y) as amended by section  6,  paragraph  (kk)  as
amended  by  section 124, subparagraph (vi) of paragraph (uu) as amended
by section 120, paragraph (xx) as amended by section 10  and  paragraphs
(ggg)  and  (hhh) as amended by section 7 of part C of chapter 58 of the
laws of 2009, is amended to read as follows:
  1. Funds accumulated in the tobacco control and insurance  initiatives
pool  or in the health care reform act (HCRA) resources fund established
pursuant to section ninety-two-dd of the state finance law, whichever is
applicable, including income from invested funds, shall  be  distributed
or retained by the commissioner or by the state comptroller, as applica-
ble, in accordance with the following:
  (a)  Funds  shall  be  deposited  by  the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medicaid  fraud  hotline  and
medicaid  administration  account, or any successor fund or account, for
purposes of services and expenses  related  to  the  toll-free  medicaid
fraud hotline established pursuant to section one hundred eight of chap-
ter  one  of  the  laws of nineteen hundred ninety-nine from the tobacco

S. 2809                            42                            A. 4009

control and insurance initiatives pool  established  for  the  following
periods in the following amounts: four hundred thousand dollars annually
for  the  periods  January  first, two thousand through December thirty-
first,  two  thousand  two,  up to four hundred thousand dollars for the
period January first, two thousand three through December  thirty-first,
two  thousand  three, up to four hundred thousand dollars for the period
January first, two thousand  four  through  December  thirty-first,  two
thousand  four, up to four hundred thousand dollars for the period Janu-
ary first, two thousand five through December thirty-first, two thousand
five, up to four hundred thousand dollars for the period January  first,
two  thousand six through December thirty-first, two thousand six, up to
four hundred thousand dollars for the period January first, two thousand
seven through December thirty-first, two  thousand  seven,  up  to  four
hundred  thousand  dollars  for  the  period January first, two thousand
eight through December thirty-first, two  thousand  eight,  up  to  four
hundred thousand dollars for the period January first, two thousand nine
through  December  thirty-first,  two  thousand nine, up to four hundred
thousand dollars for the period January first, two thousand ten  through
December  thirty-first,  two thousand ten, [and] up to one hundred thou-
sand dollars for the period January first, two thousand  eleven  through
March  thirty-first, two thousand eleven AND WITHIN AMOUNTS APPROPRIATED
ON AND AFTER APRIL FIRST, TWO THOUSAND ELEVEN.
  (b) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of payment of audits or audit contracts necessary to determine payor and
provider compliance with requirements set forth in sections twenty-eight
hundred seven-j, twenty-eight hundred seven-s and  twenty-eight  hundred
seven-t  of  this article [and hospital compliance with paragraph six of
subdivision (a) of section 405.4 of title 10 of the official compilation
of codes, rules and regulations of the state of New York  in  accordance
with  subdivision  nine  of  section  twenty-eight hundred three of this
article] from the tobacco control and insurance initiatives pool  estab-
lished  for the following periods in the following amounts: five million
six hundred thousand dollars annually for the periods January first, two
thousand through December thirty-first, two thousand  two,  up  to  five
million dollars for the period January first, two thousand three through
December  thirty-first,  two  thousand three, up to five million dollars
for the period January first, two thousand four through  December  thir-
ty-first,  two  thousand four, up to five million dollars for the period
January first, two thousand five  through  December  thirty  first,  two
thousand  five, up to five million dollars for the period January first,
two thousand six through December thirty-first, two thousand six, up  to
seven  million  eight  hundred  thousand  dollars for the period January
first, two thousand seven through December  thirty-first,  two  thousand
seven,  and  up  to  eight  million  three  hundred twenty-five thousand
dollars for the period January first, two thousand eight through  Decem-
ber  thirty-first,  two thousand eight, up to eight million five hundred
thousand dollars for the period January first, two thousand nine through
December thirty-first, two thousand  nine,  up  to  eight  million  five
hundred  thousand dollars for the period January first, two thousand ten
through December thirty-first, two thousand ten, [and] up to two million
one hundred twenty-five thousand dollars for the period  January  first,
two thousand eleven through March thirty-first, two thousand eleven, AND
UP  TO FOURTEEN MILLION SEVEN HUNDRED THOUSAND DOLLARS EACH STATE FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIR-
TY-FIRST, TWO THOUSAND FOURTEEN.

S. 2809                            43                            A. 4009

  (c) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, enhanced community services
account,  or  any  successor fund or account, for mental health services
programs for case management services for adults and children; supported
housing; home and community based waiver services; family  based  treat-
ment;  family support services; mobile mental health teams; transitional
housing; and community oversight, established pursuant to articles seven
and forty-one of the mental hygiene law and subdivision nine of  section
three  hundred  sixty-six of the social services law; and for comprehen-
sive care centers for eating disorders pursuant to  THE  FORMER  section
twenty-seven  hundred  ninety-nine-l  of  this chapter, provided however
that, for such centers, funds in the amount  of  five  hundred  thousand
dollars  on  an  annualized basis shall be transferred from the enhanced
community services account, or any successor fund or account, and depos-
ited into the fund established by section  ninety-five-e  of  the  state
finance  law;  from  the  tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
  (i) forty-eight million dollars to be reserved, to be retained or  for
distribution  pursuant to a chapter of the laws of two thousand, for the
period January first, two thousand through  December  thirty-first,  two
thousand;
  (ii)  eighty-seven  million  dollars to be reserved, to be retained or
for distribution pursuant to a chapter of the laws of two thousand  one,
for  the period January first, two thousand one through December thirty-
first, two thousand one;
  (iii) eighty-seven million dollars to be reserved, to be  retained  or
for  distribution pursuant to a chapter of the laws of two thousand two,
for the period January first, two thousand two through December  thirty-
first, two thousand two;
  (iv)  eighty-eight  million  dollars to be reserved, to be retained or
for distribution pursuant to a chapter  of  the  laws  of  two  thousand
three, for the period January first, two thousand three through December
thirty-first, two thousand three;
  (v)  eighty-eight million dollars, plus five hundred thousand dollars,
to be reserved, to be retained or for distribution pursuant to a chapter
of the laws of two thousand four, and pursuant  to  THE  FORMER  section
twenty-seven hundred ninety-nine-l of this chapter, for the period Janu-
ary first, two thousand four through December thirty-first, two thousand
four;
  (vi) eighty-eight million dollars, plus five hundred thousand dollars,
to be reserved, to be retained or for distribution pursuant to a chapter
of  the  laws  of  two thousand five, and pursuant to THE FORMER section
twenty-seven hundred ninety-nine-l of this chapter, for the period Janu-
ary first, two thousand five through December thirty-first, two thousand
five;
  (vii)  eighty-eight  million  dollars,  plus  five  hundred   thousand
dollars,  to be reserved, to be retained or for distribution pursuant to
a chapter of the laws of two thousand six, and pursuant to section twen-
ty-seven hundred ninety-nine-l of this chapter, for the  period  January
first, two thousand six through December thirty-first, two thousand six;
  (viii)  eighty-six  million  four  hundred thousand dollars, plus five
hundred thousand dollars, to be reserved, to be retained or for distrib-
ution pursuant to a chapter of the laws of two thousand seven and pursu-
ant to THE FORMER section twenty-seven  hundred  ninety-nine-l  of  this

S. 2809                            44                            A. 4009

chapter, for the period January first, two thousand seven through Decem-
ber thirty-first, two thousand seven; and
  (ix)  twenty-two  million nine hundred thirteen thousand dollars, plus
one hundred twenty-five thousand dollars, to be reserved, to be retained
or for distribution pursuant to a chapter of the laws  of  two  thousand
eight  and  pursuant  to THE FORMER section twenty-seven hundred ninety-
nine-l of this chapter, for the period January first, two thousand eight
through March thirty-first, two thousand eight.
  (d) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share of services and expenses related to the family health plus program
including up to two and one-half million dollars annually for the period
January  first, two thousand through December thirty-first, two thousand
two, for administration and marketing costs associated with such program
established pursuant to clause (A) of subparagraph (v) of paragraph  (a)
of  subdivision two of section three hundred sixty-nine-ee of the social
services law from the tobacco control  and  insurance  initiatives  pool
established for the following periods in the following amounts:
  (i) three million five hundred thousand dollars for the period January
first, two thousand through December thirty-first, two thousand;
  (ii)  twenty-seven  million  dollars for the period January first, two
thousand one through December thirty-first, two thousand one; and
  (iii) fifty-seven million dollars for the period  January  first,  two
thousand two through December thirty-first, two thousand two.
  (e)  Funds  shall  be  deposited  by  the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of services and expenses related to the family health plus program
including up to two and one-half million dollars annually for the period
January first, two thousand through December thirty-first, two  thousand
two  for administration and marketing costs associated with such program
established pursuant to clause (B) of subparagraph (v) of paragraph  (a)
of  subdivision two of section three hundred sixty-nine-ee of the social
services law from the tobacco control  and  insurance  initiatives  pool
established for the following periods in the following amounts:
  (i)  two  million five hundred thousand dollars for the period January
first, two thousand through December thirty-first, two thousand;
  (ii) thirty million five hundred thousand dollars for the period Janu-
ary first, two thousand one through December thirty-first, two  thousand
one; and
  (iii)  sixty-six  million  dollars  for  the period January first, two
thousand two through December thirty-first, two thousand two.
  (f) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  -  other, HCRA transfer fund, medicaid fraud hotline and
medicaid administration account, or any successor fund or  account,  for
purposes of payment of administrative expenses of the department related
to  the family health plus program established pursuant to section three
hundred sixty-nine-ee of  the  social  services  law  from  the  tobacco
control  and  insurance  initiatives  pool established for the following

S. 2809                            45                            A. 4009

periods in the following amounts: five hundred thousand  dollars  on  an
annual  basis for the periods January first, two thousand through Decem-
ber thirty-first, two thousand six, five hundred  thousand  dollars  for
the  period  January  first, two thousand seven through December thirty-
first, two thousand seven, and five hundred  thousand  dollars  for  the
period  January first, two thousand eight through December thirty-first,
two thousand eight, five hundred thousand dollars for the period January
first, two thousand nine through  December  thirty-first,  two  thousand
nine,  five  hundred  thousand dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten, [and]  one
hundred  twenty-five  thousand dollars for the period January first, two
thousand eleven through March  thirty-first,  two  thousand  eleven  AND
WITHIN AMOUNTS APPROPRIATED ON AND AFTER APRIL FIRST, TWO THOUSAND ELEV-
EN.
  (g)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  services and expenses related to the health maintenance organization
direct pay market program established pursuant to  sections  forty-three
hundred  twenty-one-a and forty-three hundred twenty-two-a of the insur-
ance law from the tobacco control and insurance initiatives pool  estab-
lished for the following periods in the following amounts:
  (i)  up  to  thirty-five million dollars for the period January first,
two thousand through December thirty-first, two thousand of which  fifty
percentum  shall  be  allocated  to the program pursuant to section four
thousand three hundred twenty-one-a  of  the  insurance  law  and  fifty
percentum to the program pursuant to section four thousand three hundred
twenty-two-a of the insurance law;
  (ii)  up  to  thirty-six million dollars for the period January first,
two thousand one through December  thirty-first,  two  thousand  one  of
which  fifty  percentum  shall  be  allocated to the program pursuant to
section four thousand three hundred twenty-one-a of  the  insurance  law
and  fifty  percentum  to  the program pursuant to section four thousand
three hundred twenty-two-a of the insurance law;
  (iii) up to thirty-nine million dollars for the period January  first,
two  thousand  two  through  December  thirty-first, two thousand two of
which fifty percentum shall be allocated  to  the  program  pursuant  to
section  four  thousand  three hundred twenty-one-a of the insurance law
and fifty percentum to the program pursuant  to  section  four  thousand
three hundred twenty-two-a of the insurance law;
  (iv)  up  to  forty  million dollars for the period January first, two
thousand three through December  thirty-first,  two  thousand  three  of
which  fifty  percentum  shall  be  allocated to the program pursuant to
section four thousand three hundred twenty-one-a of  the  insurance  law
and  fifty  percentum  to  the program pursuant to section four thousand
three hundred twenty-two-a of the insurance law;
  (v) up to forty million dollars for  the  period  January  first,  two
thousand  four through December thirty-first, two thousand four of which
fifty percentum shall be allocated to the program  pursuant  to  section
four  thousand three hundred twenty-one-a of the insurance law and fifty
percentum to the program pursuant to section four thousand three hundred
twenty-two-a of the insurance law;
  (vi) up to forty million dollars for the  period  January  first,  two
thousand  five through December thirty-first, two thousand five of which
fifty percentum shall be allocated to the program  pursuant  to  section
four  thousand three hundred twenty-one-a of the insurance law and fifty

S. 2809                            46                            A. 4009

percentum to the program pursuant to section four thousand three hundred
twenty-two-a of the insurance law;
  (vii)  up  to  forty million dollars for the period January first, two
thousand six through December thirty-first, two thousand  six  of  which
fifty  percentum  shall  be allocated to the program pursuant to section
four thousand three hundred twenty-one-a of the insurance law and  fifty
percentum  shall  be  allocated  to the program pursuant to section four
thousand three hundred twenty-two-a of the insurance law;
  (viii) up to forty million dollars for the period January  first,  two
thousand  seven  through  December  thirty-first,  two thousand seven of
which fifty percentum shall be allocated  to  the  program  pursuant  to
section  four  thousand  three hundred twenty-one-a of the insurance law
and fifty percentum shall  be  allocated  to  the  program  pursuant  to
section  four  thousand three hundred twenty-two-a of the insurance law;
and
  (ix) up to forty million dollars for the  period  January  first,  two
thousand  eight  through  December  thirty-first,  two thousand eight of
which fifty per centum shall be allocated to  the  program  pursuant  to
section  four  thousand  three hundred twenty-one-a of the insurance law
and fifty per centum shall be  allocated  to  the  program  pursuant  to
section four thousand three hundred twenty-two-a of the insurance law.
  (h)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  services  and  expenses  related  to the healthy New York individual
program established pursuant to sections  four  thousand  three  hundred
twenty-six and four thousand three hundred twenty-seven of the insurance
law  from the tobacco control and insurance initiatives pool established
for the following periods in the following amounts:
  (i) up to six million dollars for the period January first, two  thou-
sand one through December thirty-first, two thousand one;
  (ii)  up  to twenty-nine million dollars for the period January first,
two thousand two through December thirty-first, two thousand two;
  (iii) up to five million one hundred thousand dollars for  the  period
January  first,  two  thousand  three through December thirty-first, two
thousand three;
  (iv) up to twenty-four million six hundred thousand  dollars  for  the
period  January  first, two thousand four through December thirty-first,
two thousand four;
  (v) up to thirty-four million six hundred  thousand  dollars  for  the
period  January  first, two thousand five through December thirty-first,
two thousand five;
  (vi) up to fifty-four million eight hundred thousand dollars  for  the
period  January  first,  two thousand six through December thirty-first,
two thousand six;
  (vii) up to sixty-one million seven hundred thousand dollars  for  the
period  January first, two thousand seven through December thirty-first,
two thousand seven; and
  (viii) up to one hundred three million seven  hundred  fifty  thousand
dollars  for the period January first, two thousand eight through Decem-
ber thirty-first, two thousand eight.
  (i) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of services and expenses related to the healthy New York  group  program
established  pursuant to sections four thousand three hundred twenty-six
and four thousand three hundred twenty-seven of the insurance  law  from

S. 2809                            47                            A. 4009

the  tobacco  control and insurance initiatives pool established for the
following periods in the following amounts:
  (i)  up  to  thirty-four million dollars for the period January first,
two thousand one through December thirty-first, two thousand one;
  (ii) up to seventy-seven million dollars for the period January first,
two thousand two through December thirty-first, two thousand two;
  (iii) up to ten million five hundred thousand dollars for  the  period
January  first,  two  thousand  three through December thirty-first, two
thousand three;
  (iv) up to twenty-four million six hundred thousand  dollars  for  the
period  January  first, two thousand four through December thirty-first,
two thousand four;
  (v) up to thirty-four million six hundred  thousand  dollars  for  the
period  January  first, two thousand five through December thirty-first,
two thousand five;
  (vi) up to fifty-four million eight hundred thousand dollars  for  the
period  January  first,  two thousand six through December thirty-first,
two thousand six;
  (vii) up to sixty-one million seven hundred thousand dollars  for  the
period  January first, two thousand seven through December thirty-first,
two thousand seven; and
  (viii) up to one hundred three million seven  hundred  fifty  thousand
dollars  for the period January first, two thousand eight through Decem-
ber thirty-first, two thousand eight.
  (i-1) Notwithstanding the provisions of paragraphs (h) and (i) of this
subdivision, the commissioner shall reserve and  accumulate  up  to  two
million  five  hundred thousand dollars annually for the periods January
first, two thousand four through  December  thirty-first,  two  thousand
six,  one  million  four hundred thousand dollars for the period January
first, two thousand seven through December  thirty-first,  two  thousand
seven,  two  million  dollars for the period January first, two thousand
eight through December thirty-first,  two  thousand  eight,  from  funds
otherwise  available  for  distribution  under  such  paragraphs for the
services and expenses related to the  pilot  program  for  entertainment
industry  employees  included  in subsection (b) of section one thousand
one hundred twenty-two of the insurance law,  and  an  additional  seven
hundred  thousand  dollars  annually  for the periods January first, two
thousand four through December thirty-first, two thousand six, an  addi-
tional  three hundred thousand dollars for the period January first, two
thousand seven through June thirtieth, two thousand seven  for  services
and expenses related to the pilot program for displaced workers included
in  subsection (c) of section one thousand one hundred twenty-two of the
insurance law.
  (j) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of services and expenses related  to  the  tobacco  use  prevention  and
control  program established pursuant to sections thirteen hundred nine-
ty-nine-ii and thirteen hundred ninety-nine-jj of this chapter, from the
tobacco control and  insurance  initiatives  pool  established  for  the
following periods in the following amounts:
  (i)  up  to  thirty  million dollars for the period January first, two
thousand through December thirty-first, two thousand;
  (ii) up to forty million dollars for the  period  January  first,  two
thousand one through December thirty-first, two thousand one;
  (iii)  up  to  forty million dollars for the period January first, two
thousand two through December thirty-first, two thousand two;

S. 2809                            48                            A. 4009

  (iv) up to thirty-six million nine hundred fifty thousand dollars  for
the  period  January  first, two thousand three through December thirty-
first, two thousand three;
  (v)  up  to thirty-six million nine hundred fifty thousand dollars for
the period January first, two thousand  four  through  December  thirty-
first, two thousand four;
  (vi)  up  to forty million six hundred thousand dollars for the period
January first, two thousand  five  through  December  thirty-first,  two
thousand five;
  (vii)  up  to eighty-one million nine hundred thousand dollars for the
period January first, two thousand six  through  December  thirty-first,
two thousand six, provided, however, that within amounts appropriated, a
portion  of  such  funds  may  be transferred to the Roswell Park Cancer
Institute Corporation to support costs associated with cancer research;
  (viii) up to ninety-four million one hundred  fifty  thousand  dollars
for  the period January first, two thousand seven through December thir-
ty-first, two thousand seven, provided,  however,  that  within  amounts
appropriated,  a portion of such funds may be transferred to the Roswell
Park Cancer Institute  Corporation  to  support  costs  associated  with
cancer research;
  (ix)  up to ninety-four million one hundred fifty thousand dollars for
the period January first, two thousand eight  through  December  thirty-
first, two thousand eight;
  (x)  up  to ninety-four million one hundred fifty thousand dollars for
the period January first, two thousand  nine  through  December  thirty-
first, two thousand nine;
  (xi)  up  to  eighty-seven million seven hundred seventy-five thousand
dollars for the period January first, two thousand ten through  December
thirty-first, two thousand ten; [and]
  (xii)  up  to  twenty-one million four hundred twelve thousand dollars
for the period January first, two thousand eleven through March  thirty-
first, two thousand eleven[.]; AND
  (XIII) UP TO FIFTY-TWO MILLION ONE HUNDRED THOUSAND DOLLARS EACH STATE
FISCAL  YEAR  FOR  THE  PERIOD  APRIL FIRST, TWO THOUSAND ELEVEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN.
  (k) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  fund - other, HCRA transfer fund, health care services account,
or any successor fund or account, for purposes of services and  expenses
related  to public health programs, including comprehensive care centers
for eating disorders pursuant to THE FORMER section twenty-seven hundred
ninety-nine-l of this chapter, provided however that, for such  centers,
funds  in  the  amount of five hundred thousand dollars on an annualized
basis shall be transferred from the health care services account, or any
successor fund or account, and deposited into the  fund  established  by
section  ninety-five-e  of  the  state  finance law FOR PERIODS PRIOR TO
MARCH THIRTY-FIRST, TWO THOUSAND ELEVEN, from the  tobacco  control  and
insurance  initiatives pool established for the following periods in the
following amounts:
  (i) up to thirty-one million dollars for the period January first, two
thousand through December thirty-first, two thousand;
  (ii) up to forty-one million dollars for the period January first, two
thousand one through December thirty-first, two thousand one;
  (iii) up to eighty-one million dollars for the period  January  first,
two thousand two through December thirty-first, two thousand two;

S. 2809                            49                            A. 4009

  (iv)  one hundred twenty-two million five hundred thousand dollars for
the period January first, two thousand three  through  December  thirty-
first, two thousand three;
  (v)  one  hundred  eight  million  five  hundred seventy-five thousand
dollars, plus an additional five hundred thousand dollars, for the peri-
od January first, two thousand four through December  thirty-first,  two
thousand four;
  (vi)  ninety-one million eight hundred thousand dollars, plus an addi-
tional five hundred thousand dollars, for the period January first,  two
thousand five through December thirty-first, two thousand five;
  (vii) one hundred fifty-six million six hundred thousand dollars, plus
an  additional  five  hundred  thousand  dollars, for the period January
first, two thousand six through December thirty-first, two thousand six;
  (viii) one hundred fifty-one million four  hundred  thousand  dollars,
plus an additional five hundred thousand dollars, for the period January
first,  two  thousand  seven through December thirty-first, two thousand
seven;
  (ix) one hundred sixteen  million  nine  hundred  forty-nine  thousand
dollars, plus an additional five hundred thousand dollars, for the peri-
od  January first, two thousand eight through December thirty-first, two
thousand eight;
  (x) one hundred  sixteen  million  nine  hundred  forty-nine  thousand
dollars, plus an additional five hundred thousand dollars, for the peri-
od  January  first, two thousand nine through December thirty-first, two
thousand nine;
  (xi) one hundred sixteen  million  nine  hundred  forty-nine  thousand
dollars, plus an additional five hundred thousand dollars, for the peri-
od  January  first,  two thousand ten through December thirty-first, two
thousand ten; [and]
  (xii)  twenty-nine  million  two  hundred  thirty-seven  thousand  two
hundred  fifty dollars, plus an additional one hundred twenty-five thou-
sand dollars, for the period January first, two thousand eleven  through
March thirty-first, two thousand eleven[.];
  (XIII)  ONE  HUNDRED  TWENTY MILLION THIRTY-EIGHT THOUSAND DOLLARS FOR
THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH  THIRTY-FIRST,
TWO THOUSAND TWELVE; AND
  (XIV) ONE HUNDRED NINETEEN MILLION FOUR HUNDRED SEVEN THOUSAND DOLLARS
EACH  STATE  FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWELVE
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN.
  (l) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share  of the personal care and certified home health agency rate or fee
increases established pursuant to subdivision  three  of  section  three
hundred  sixty-seven-o  of  the  social  services  law  from the tobacco
control and insurance initiatives pool  established  for  the  following
periods in the following amounts:
  (i)  twenty-three  million two hundred thousand dollars for the period
January first, two thousand through December thirty-first, two thousand;
  (ii) twenty-three million two hundred thousand dollars for the  period
January first, two thousand one through December thirty-first, two thou-
sand one;

S. 2809                            50                            A. 4009

  (iii) twenty-three million two hundred thousand dollars for the period
January first, two thousand two through December thirty-first, two thou-
sand two;
  (iv)  up  to  sixty-five  million two hundred thousand dollars for the
period January first, two thousand three through December  thirty-first,
two thousand three;
  (v)  up  to  sixty-five  million  two hundred thousand dollars for the
period January first, two thousand four through  December  thirty-first,
two thousand four;
  (vi)  up  to  sixty-five  million two hundred thousand dollars for the
period January first, two thousand five through  December  thirty-first,
two thousand five;
  (vii)  up  to  sixty-five million two hundred thousand dollars for the
period January first, two thousand six  through  December  thirty-first,
two thousand six;
  (viii)  up  to sixty-five million two hundred thousand dollars for the
period January first, two thousand seven through December  thirty-first,
two thousand seven; and
  (ix)  up  to  sixteen  million  three hundred thousand dollars for the
period January first, two thousand eight through March thirty-first, two
thousand eight.
  (m) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share  of  services  and expenses related to home care workers insurance
pilot demonstration programs established pursuant to subdivision two  of
section  three hundred sixty-seven-o of the social services law from the
tobacco control and  insurance  initiatives  pool  established  for  the
following periods in the following amounts:
  (i)  three million eight hundred thousand dollars for the period Janu-
ary first, two thousand through December thirty-first, two thousand;
  (ii) three million eight hundred thousand dollars for the period Janu-
ary first, two thousand one through December thirty-first, two  thousand
one;
  (iii)  three  million  eight  hundred  thousand dollars for the period
January first, two thousand two through December thirty-first, two thou-
sand two;
  (iv) up to three million eight hundred thousand dollars for the period
January first, two thousand three  through  December  thirty-first,  two
thousand three;
  (v)  up to three million eight hundred thousand dollars for the period
January first, two thousand  four  through  December  thirty-first,  two
thousand four;
  (vi) up to three million eight hundred thousand dollars for the period
January  first,  two  thousand  five  through December thirty-first, two
thousand five;
  (vii) up to three million eight hundred thousand dollars for the peri-
od January first, two thousand six through  December  thirty-first,  two
thousand six;
  (viii)  up  to  three  million  eight hundred thousand dollars for the
period January first, two thousand seven through December  thirty-first,
two thousand seven; and

S. 2809                            51                            A. 4009

  (ix)  up to nine hundred fifty thousand dollars for the period January
first, two thousand  eight  through  March  thirty-first,  two  thousand
eight.
  (n) Funds shall be transferred by the commissioner and shall be depos-
ited  to  the credit of the special revenue funds - other, miscellaneous
special revenue fund - 339, elderly  pharmaceutical  insurance  coverage
program  premium  account authorized pursuant to the provisions of title
three of article two of the elder law, or any successor fund or account,
for funding state expenses relating to  the  program  from  the  tobacco
control  and  insurance  initiatives  pool established for the following
periods in the following amounts:
  (i) one hundred seven million dollars for the  period  January  first,
two thousand through December thirty-first, two thousand;
  (ii)  one  hundred  sixty-four  million dollars for the period January
first, two thousand one through December thirty-first, two thousand one;
  (iii) three hundred twenty-two million seven hundred thousand  dollars
for  the period January first, two thousand two through December thirty-
first, two thousand two;
  (iv) four hundred thirty-three million three hundred thousand  dollars
for  the period January first, two thousand three through December thir-
ty-first, two thousand three;
  (v) five hundred four million one hundred fifty thousand  dollars  for
the  period  January  first,  two thousand four through December thirty-
first, two thousand four;
  (vi) five hundred sixty-six million eight hundred thousand dollars for
the period January first, two thousand  five  through  December  thirty-
first, two thousand five;
  (vii) six hundred three million one hundred fifty thousand dollars for
the  period  January  first,  two  thousand six through December thirty-
first, two thousand six;
  (viii) six hundred sixty million eight hundred  thousand  dollars  for
the  period  January  first, two thousand seven through December thirty-
first, two thousand seven;
  (ix) three hundred sixty-seven million four hundred sixty-three  thou-
sand  dollars  for  the period January first, two thousand eight through
December thirty-first, two thousand eight;
  (x) three hundred thirty-four million eight hundred twenty-five  thou-
sand  dollars  for  the  period January first, two thousand nine through
December thirty-first, two thousand nine;
  (xi) three hundred forty-four million nine  hundred  thousand  dollars
for  the period January first, two thousand ten through December thirty-
first, two thousand ten; [and]
  (xii) eighty-seven million seven hundred eighty-eight thousand dollars
for the period January first, two thousand eleven through March  thirty-
first, two thousand eleven[.];
  (XIII)  ONE  HUNDRED  FORTY-THREE  MILLION  ONE HUNDRED FIFTY THOUSAND
DOLLARS FOR THE PERIOD APRIL FIRST, TWO THOUSAND  ELEVEN  THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND TWELVE;
  (XIV)  ONE  HUNDRED TWENTY MILLION NINE HUNDRED FIFTY THOUSAND DOLLARS
FOR  THE  PERIOD  APRIL  FIRST,  TWO  THOUSAND  TWELVE   THROUGH   MARCH
THIRTY-FIRST, TWO THOUSAND THIRTEEN; AND
  (XV)  ONE  HUNDRED  TWENTY-EIGHT  MILLION EIGHT HUNDRED FIFTY THOUSAND
DOLLARS FOR THE PERIOD APRIL FIRST, TWO THOUSAND THIRTEEN THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND FOURTEEN.
  (o)  Funds  shall be reserved and accumulated and shall be transferred
to the Roswell Park  Cancer  Institute  Corporation,  from  the  tobacco

S. 2809                            52                            A. 4009

control  and  insurance  initiatives  pool established for the following
periods in the following amounts:
  (i)  up  to  ninety  million dollars for the period January first, two
thousand through December thirty-first, two thousand;
  (ii) up to sixty million dollars for the  period  January  first,  two
thousand one through December thirty-first, two thousand one;
  (iii)  up to eighty-five million dollars for the period January first,
two thousand two through December thirty-first, two thousand two;
  (iv) eighty-five million two hundred fifty thousand  dollars  for  the
period  January first, two thousand three through December thirty-first,
two thousand three;
  (v) seventy-eight million dollars for the period  January  first,  two
thousand four through December thirty-first, two thousand four;
  (vi)  seventy-eight  million dollars for the period January first, two
thousand five through December thirty-first, two thousand five;
  (vii) ninety-one million dollars for the  period  January  first,  two
thousand six through December thirty-first, two thousand six;
  (viii) seventy-eight million dollars for the period January first, two
thousand seven through December thirty-first, two thousand seven;
  (ix)  seventy-eight  million dollars for the period January first, two
thousand eight through December thirty-first, two thousand eight;
  (x) seventy-eight million dollars for the period  January  first,  two
thousand nine through December thirty-first, two thousand nine;
  (xi)  seventy-eight  million dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten; [and]
  (xii) nineteen million five hundred thousand dollars  for  the  period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven[.]; AND
  (XIII)  SIXTY-NINE  MILLION  EIGHT HUNDRED FORTY THOUSAND DOLLARS EACH
STATE FISCAL YEAR FOR  THE  PERIOD  APRIL  FIRST,  TWO  THOUSAND  ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN.
  (p)  Funds  shall  be  deposited  by  the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, indigent care fund - 068, indigent care  account,
or  any  successor fund or account, for purposes of providing a medicaid
disproportionate share payment from the high need indigent care  adjust-
ment  pool  established pursuant to section twenty-eight hundred seven-w
of this article, from the tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
  (i) eighty-two million dollars annually for the periods January first,
two thousand through December thirty-first, two thousand two;
  (ii) up to eighty-two million dollars for the  period  January  first,
two thousand three through December thirty-first, two thousand three;
  (iii)  up  to eighty-two million dollars for the period January first,
two thousand four through December thirty-first, two thousand four;
  (iv) up to eighty-two million dollars for the  period  January  first,
two thousand five through December thirty-first, two thousand five;
  (v) up to eighty-two million dollars for the period January first, two
thousand six through December thirty-first, two thousand six;
  (vi)  up  to  eighty-two million dollars for the period January first,
two thousand seven through December thirty-first, two thousand seven;
  (vii) up to eighty-two million dollars for the period  January  first,
two thousand eight through December thirty-first, two thousand eight;
  (viii)  up to eighty-two million dollars for the period January first,
two thousand nine through December thirty-first, two thousand nine;

S. 2809                            53                            A. 4009

  (ix) up to eighty-two million dollars for the  period  January  first,
two thousand ten through December thirty-first, two thousand ten; [and]
  (x)  up to twenty million five hundred thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven; AND
  (XI) UP TO EIGHTY-TWO MILLION DOLLARS EACH STATE FISCAL YEAR  FOR  THE
PERIOD  APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND FOURTEEN.
  (q) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of providing distributions  to  eligible  school  based  health  centers
established  pursuant to section eighty-eight of chapter one of the laws
of nineteen hundred ninety-nine, from the tobacco control and  insurance
initiatives  pool established for the following periods in the following
amounts:
  (i) seven million dollars annually for the period January  first,  two
thousand through December thirty-first, two thousand two;
  (ii)  up  to  seven  million dollars for the period January first, two
thousand three through December thirty-first, two thousand three;
  (iii) up to seven million dollars for the period  January  first,  two
thousand four through December thirty-first, two thousand four;
  (iv)  up  to  seven  million dollars for the period January first, two
thousand five through December thirty-first, two thousand five;
  (v) up to seven million dollars for  the  period  January  first,  two
thousand six through December thirty-first, two thousand six;
  (vi)  up  to  seven  million dollars for the period January first, two
thousand seven through December thirty-first, two thousand seven;
  (vii) up to seven million dollars for the period  January  first,  two
thousand eight through December thirty-first, two thousand eight;
  (viii)  up  to seven million dollars for the period January first, two
thousand nine through December thirty-first, two thousand nine;
  (ix) up to seven million dollars for the  period  January  first,  two
thousand ten through December thirty-first, two thousand ten; [and]
  (x)  up  to  one  million seven hundred fifty thousand dollars for the
period January first, two thousand eleven  through  March  thirty-first,
two thousand eleven; AND
  (XI) UP TO FIVE MILLION SIX HUNDRED THOUSAND DOLLARS EACH STATE FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIR-
TY-FIRST, TWO THOUSAND FOURTEEN.
  (r) Funds shall be deposited by the commissioner within amounts appro-
priated,  and the state comptroller is hereby authorized and directed to
receive for deposit to the credit of the state special revenue  funds  -
other,  HCRA transfer fund, medical assistance account, or any successor
fund or account, for purposes of providing distributions for  supplemen-
tary   medical  insurance  for  Medicare  part  B  premiums,  physicians
services, outpatient services, medical  equipment,  supplies  and  other
health services, from the tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
  (i)  forty-three  million  dollars  for  the period January first, two
thousand through December thirty-first, two thousand;
  (ii) sixty-one million dollars for the period January first, two thou-
sand one through December thirty-first, two thousand one;
  (iii) sixty-five million dollars for the  period  January  first,  two
thousand two through December thirty-first, two thousand two;

S. 2809                            54                            A. 4009

  (iv)  sixty-seven million five hundred thousand dollars for the period
January first, two thousand three  through  December  thirty-first,  two
thousand three;
  (v)  sixty-eight  million  dollars  for  the period January first, two
thousand four through December thirty-first, two thousand four;
  (vi) sixty-eight million dollars for the  period  January  first,  two
thousand five through December thirty-first, two thousand five;
  (vii)  sixty-eight  million  dollars for the period January first, two
thousand six through December thirty-first, two thousand six;
  (viii) seventeen million five hundred thousand dollars for the  period
January  first,  two  thousand  seven through December thirty-first, two
thousand seven;
  (ix) sixty-eight million dollars for the  period  January  first,  two
thousand eight through December thirty-first, two thousand eight;
  (x)  sixty-eight  million  dollars  for  the period January first, two
thousand nine through December thirty-first, two thousand nine;
  (xi) sixty-eight million dollars for the  period  January  first,  two
thousand ten through December thirty-first, two thousand ten; [and]
  (xii)  seventeen  million  dollars  for  the period January first, two
thousand eleven through March thirty-first, two thousand eleven[.]; AND
  (XIII) SIXTY-EIGHT MILLION DOLLARS EACH  STATE  FISCAL  YEAR  FOR  THE
PERIOD  APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND FOURTEEN.
  (s) Funds shall be deposited by the commissioner within amounts appro-
priated, and the state comptroller is hereby authorized and directed  to
receive  for  deposit to the credit of the state special revenue funds -
other, HCRA transfer fund, medical assistance account, or any  successor
fund  or  account,  for  purposes of providing distributions pursuant to
paragraphs (s-5), (s-6),  (s-7)  and  (s-8)  of  subdivision  eleven  of
section  twenty-eight  hundred  seven-c of this article from the tobacco
control and insurance initiatives pool  established  for  the  following
periods in the following amounts:
  (i)  eighteen  million dollars for the period January first, two thou-
sand through December thirty-first, two thousand;
  (ii) twenty-four million dollars  annually  for  the  periods  January
first, two thousand one through December thirty-first, two thousand two;
  (iii)  up to twenty-four million dollars for the period January first,
two thousand three through December thirty-first, two thousand three;
  (iv) up to twenty-four million dollars for the period  January  first,
two thousand four through December thirty-first, two thousand four;
  (v)  up  to  twenty-four million dollars for the period January first,
two thousand five through December thirty-first, two thousand five;
  (vi) up to twenty-four million dollars for the period  January  first,
two thousand six through December thirty-first, two thousand six;
  (vii)  up to twenty-four million dollars for the period January first,
two thousand seven through December thirty-first, two thousand seven;
  (viii) up to twenty-four million dollars for the period January first,
two thousand eight through December thirty-first,  two  thousand  eight;
and
  (ix)  up  to  twenty-two million dollars for the period January first,
two thousand nine through November thirtieth, two thousand nine.
  (t) Funds shall be reserved and accumulated from year to year  by  the
commissioner and shall be made available, including income from invested
funds:
  (i)  For  the  purpose  of making grants to a state owned and operated
medical school which does not have a state owned and  operated  hospital

S. 2809                            55                            A. 4009

on  site  and  available for teaching purposes. Notwithstanding sections
one hundred twelve and one hundred sixty-three of the state finance law,
such grants shall be made in the amount of up to five  hundred  thousand
dollars  for  the  period  January  first, two thousand through December
thirty-first, two thousand;
  (ii) For the purpose of making grants to medical schools  pursuant  to
section  eighty-six-a  of  chapter  one  of the laws of nineteen hundred
ninety-nine in the sum of up to four  million  dollars  for  the  period
January first, two thousand through December thirty-first, two thousand;
and
  (iii)  The  funds  disbursed pursuant to subparagraphs (i) and (ii) of
this paragraph from the tobacco control and insurance  initiatives  pool
are  contingent upon meeting all funding amounts established pursuant to
paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n),  (p),  (q),  (r)
and  (s)  of  this  subdivision,  paragraph  (a)  of subdivision nine of
section twenty-eight hundred seven-j of  this  article,  and  paragraphs
(a),  (i)  and  (k)  of  subdivision one of section twenty-eight hundred
seven-l of this article.
  (u) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share  of  services  and  expenses  related  to the nursing home quality
improvement demonstration program established pursuant to section  twen-
ty-eight  hundred  eight-d  of this article from the tobacco control and
insurance initiatives pool established for the following periods in  the
following amounts:
  (i)  up  to twenty-five million dollars for the period beginning April
first, two thousand two and ending December thirty-first,  two  thousand
two,  and  on  an  annualized  basis,  for each annual period thereafter
beginning January first, two thousand three and ending December  thirty-
first, two thousand four;
  (ii)  up  to eighteen million seven hundred fifty thousand dollars for
the period January first, two thousand  five  through  December  thirty-
first, two thousand five; and
  (iii)  up  to  fifty-six million five hundred thousand dollars for the
period January first, two thousand six  through  December  thirty-first,
two thousand six.
  (v) Funds shall be transferred by the commissioner and shall be depos-
ited  to the credit of the hospital excess liability pool created pursu-
ant to section eighteen of chapter two hundred sixty-six of the laws  of
nineteen  hundred  eighty-six,  or  any  successor  fund or account, for
purposes of expenses related to the purchase of excess medical  malprac-
tice  insurance and the cost of administrating the pool, including costs
associated with the risk  management  program  established  pursuant  to
section  forty-two  of part A of chapter one of the laws of two thousand
two required by paragraph (a) of subdivision one of section eighteen  of
chapter two hundred sixty-six of the laws of nineteen hundred eighty-six
as may be amended from time to time, from the tobacco control and insur-
ance  initiatives  pool  established  for  the  following periods in the
following amounts:
  (i) up to fifty million dollars or so much as is needed for the period
January first, two thousand two through December thirty-first, two thou-
sand two;

S. 2809                            56                            A. 4009

  (ii) up to seventy-six million seven hundred thousand dollars for  the
period  January first, two thousand three through December thirty-first,
two thousand three;
  (iii)  up  to sixty-five million dollars for the period January first,
two thousand four through December thirty-first, two thousand four;
  (iv) up to sixty-five million dollars for the  period  January  first,
two thousand five through December thirty-first, two thousand five;
  (v)  up to one hundred thirteen million eight hundred thousand dollars
for the period January first, two thousand six through December  thirty-
first, two thousand six;
  (vi)  up  to one hundred thirty million dollars for the period January
first, two thousand seven through December  thirty-first,  two  thousand
seven;
  (vii)  up to one hundred thirty million dollars for the period January
first, two thousand eight through December  thirty-first,  two  thousand
eight;
  (viii) up to one hundred thirty million dollars for the period January
first,  two  thousand  nine  through December thirty-first, two thousand
nine;
  (ix) up to one hundred thirty million dollars for the  period  January
first, two thousand ten through December thirty-first, two thousand ten;
[and]
  (x)  up  to  thirty-two  million five hundred thousand dollars for the
period January first, two thousand eleven  through  March  thirty-first,
two thousand eleven[.]; AND
  (XI)  UP  TO  ONE  HUNDRED  TWENTY-SEVEN MILLION FOUR HUNDRED THOUSAND
DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND
ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN.
  (w)  Funds  shall  be  deposited  by  the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of the treatment of breast and cervical cancer pursuant  to  para-
graph  (v) of subdivision four of section three hundred sixty-six of the
social services law, from the tobacco control and insurance  initiatives
pool established for the following periods in the following amounts:
  (i)  up  to four hundred fifty thousand dollars for the period January
first, two thousand two through December thirty-first, two thousand two;
  (ii) up to two million one hundred thousand  dollars  for  the  period
January  first,  two  thousand  three through December thirty-first, two
thousand three;
  (iii) up to two million one hundred thousand dollars  for  the  period
January  first,  two  thousand  four  through December thirty-first, two
thousand four;
  (iv) up to two million one hundred thousand  dollars  for  the  period
January  first,  two  thousand  five  through December thirty-first, two
thousand five;
  (v) up to two million one hundred  thousand  dollars  for  the  period
January first, two thousand six through December thirty-first, two thou-
sand six;
  (vi)  up  to  two  million one hundred thousand dollars for the period
January first, two thousand seven  through  December  thirty-first,  two
thousand seven;

S. 2809                            57                            A. 4009

  (vii)  up  to  two million one hundred thousand dollars for the period
January first, two thousand eight  through  December  thirty-first,  two
thousand eight;
  (viii)  up  to two million one hundred thousand dollars for the period
January first, two thousand  nine  through  December  thirty-first,  two
thousand nine;
  (ix)  up  to  two  million one hundred thousand dollars for the period
January first, two thousand ten through December thirty-first, two thou-
sand ten; [and]
  (x) up to five hundred twenty-five thousand  dollars  for  the  period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven[.]; AND
  (XI)  UP TO TWO MILLION ONE HUNDRED THOUSAND DOLLARS EACH STATE FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIR-
TY-FIRST, TWO THOUSAND FOURTEEN.
  (x) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share of the non-public general hospital rates increases for recruitment
and retention of health care workers from the tobacco control and insur-
ance  initiatives  pool  established  for  the  following periods in the
following amounts:
  (i) twenty-seven million one hundred thousand dollars on an annualized
basis for the period January first, two thousand  two  through  December
thirty-first, two thousand two;
  (ii)  fifty  million  eight  hundred thousand dollars on an annualized
basis for the period January first, two thousand three through  December
thirty-first, two thousand three;
  (iii)  sixty-nine million three hundred thousand dollars on an annual-
ized basis for the period  January  first,  two  thousand  four  through
December thirty-first, two thousand four;
  (iv)  sixty-nine million three hundred thousand dollars for the period
January first, two thousand  five  through  December  thirty-first,  two
thousand five;
  (v)  sixty-nine  million three hundred thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six;
  (vi) sixty-five million three hundred thousand dollars for the  period
January  first,  two  thousand  seven through December thirty-first, two
thousand seven;
  (vii) sixty-one million one hundred fifty  thousand  dollars  for  the
period  January first, two thousand eight through December thirty-first,
two thousand eight; and
  (viii) forty-eight million seven hundred twenty-one  thousand  dollars
for the period January first, two thousand nine through November thirti-
eth, two thousand nine.
  (y)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  grants  to public general hospitals for recruitment and retention of
health care workers pursuant to paragraph (b) of subdivision  thirty  of
section  twenty-eight  hundred  seven-c of this article from the tobacco
control and insurance initiatives pool  established  for  the  following
periods in the following amounts:

S. 2809                            58                            A. 4009

  (i)  eighteen  million  five hundred thousand dollars on an annualized
basis for the period January first, two thousand  two  through  December
thirty-first, two thousand two;
  (ii)  thirty-seven million four hundred thousand dollars on an annual-
ized basis for the period January  first,  two  thousand  three  through
December thirty-first, two thousand three;
  (iii)  fifty-two million two hundred thousand dollars on an annualized
basis for the period January first, two thousand four  through  December
thirty-first, two thousand four;
  (iv)  fifty-two  million  two  hundred thousand dollars for the period
January first, two thousand  five  through  December  thirty-first,  two
thousand five;
  (v)  fifty-two  million  two  hundred  thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six;
  (vi) forty-nine million dollars for  the  period  January  first,  two
thousand seven through December thirty-first, two thousand seven;
  (vii)  forty-nine  million  dollars  for the period January first, two
thousand eight through December thirty-first, two thousand eight; and
  (viii) twelve million two hundred fifty thousand dollars for the peri-
od January first, two thousand  nine  through  March  thirty-first,  two
thousand nine.
  Provided,  however,  amounts pursuant to this paragraph may be reduced
in an amount to be approved by the director of  the  budget  to  reflect
amounts  received  from  the  federal  government under the state's 1115
waiver which are directed under its terms and conditions to  the  health
workforce recruitment and retention program.
  (z)  Funds  shall  be  deposited  by  the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of the non-public residential health care facility rate  increases
for  recruitment  and retention of health care workers pursuant to para-
graph (a) of subdivision eighteen of section twenty-eight hundred  eight
of  this article from the tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
  (i) twenty-one million five hundred thousand dollars on an  annualized
basis  for  the  period January first, two thousand two through December
thirty-first, two thousand two;
  (ii) thirty-three million three hundred thousand dollars on an annual-
ized basis for the period January  first,  two  thousand  three  through
December thirty-first, two thousand three;
  (iii)  forty-six  million three hundred thousand dollars on an annual-
ized basis for the period  January  first,  two  thousand  four  through
December thirty-first, two thousand four;
  (iv)  forty-six  million three hundred thousand dollars for the period
January first, two thousand  five  through  December  thirty-first,  two
thousand five;
  (v)  forty-six  million  three hundred thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six;
  (vi) thirty million nine hundred thousand dollars for the period Janu-
ary first, two thousand seven through December thirty-first,  two  thou-
sand seven;

S. 2809                            59                            A. 4009

  (vii) twenty-four million seven hundred thousand dollars for the peri-
od  January first, two thousand eight through December thirty-first, two
thousand eight;
  (viii)  twelve million three hundred seventy-five thousand dollars for
the period January first, two thousand  nine  through  December  thirty-
first, two thousand nine;
  (ix)  nine million three hundred thousand dollars for the period Janu-
ary first, two thousand ten through December thirty-first, two  thousand
ten; and
  (x)  two  million  three  hundred twenty-five thousand dollars for the
period January first, two thousand eleven  through  March  thirty-first,
two thousand eleven.
  (aa)  Funds  shall  be  reserved and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  grants  to public residential health care facilities for recruitment
and retention of health care workers pursuant to paragraph (b) of subdi-
vision eighteen of section twenty-eight hundred eight  of  this  article
from  the tobacco control and insurance initiatives pool established for
the following periods in the following amounts:
  (i) seven million five hundred thousand dollars on an annualized basis
for the period January first, two thousand two through December  thirty-
first, two thousand two;
  (ii)  eleven  million  seven hundred thousand dollars on an annualized
basis for the period January first, two thousand three through  December
thirty-first, two thousand three;
  (iii)  sixteen  million  two hundred thousand dollars on an annualized
basis for the period January first, two thousand four  through  December
thirty-first, two thousand four;
  (iv) sixteen million two hundred thousand dollars for the period Janu-
ary first, two thousand five through December thirty-first, two thousand
five;
  (v)  sixteen million two hundred thousand dollars for the period Janu-
ary first, two thousand six through December thirty-first, two  thousand
six;
  (vi) ten million eight hundred thousand dollars for the period January
first,  two  thousand  seven through December thirty-first, two thousand
seven;
  (vii) six million seven hundred fifty thousand dollars for the  period
January  first,  two  thousand  eight through December thirty-first, two
thousand eight; and
  (viii) one million three hundred fifty thousand dollars for the period
January first, two thousand  nine  through  December  thirty-first,  two
thousand nine.
  (bb)(i)  Funds  shall be deposited by the commissioner, within amounts
appropriated, and subject  to  the  availability  of  federal  financial
participation,  and  the  state  comptroller  is  hereby  authorized and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  the  purpose  of  supporting  the
state  share  of  adjustments  to Medicaid rates of payment for personal
care services provided pursuant to paragraph (e) of subdivision  two  of
section three hundred sixty-five-a of the social services law, for local
social  service districts which include a city with a population of over
one million persons and computed  and  distributed  in  accordance  with
memorandums of understanding to be entered into between the state of New
York and such local social service districts for the purpose of support-

S. 2809                            60                            A. 4009

ing  the  recruitment  and retention of personal care service workers or
any worker with direct patient care  responsibility,  from  the  tobacco
control  and  insurance  initiatives  pool established for the following
periods and the following amounts:
  (A) forty-four million dollars, on an annualized basis, for the period
April  first,  two thousand two through December thirty-first, two thou-
sand two;
  (B) seventy-four million dollars, on  an  annualized  basis,  for  the
period  January first, two thousand three through December thirty-first,
two thousand three;
  (C) one hundred four million dollars, on an annualized basis, for  the
period  January  first, two thousand four through December thirty-first,
two thousand four;
  (D) one hundred thirty-six million dollars, on  an  annualized  basis,
for  the  period January first, two thousand five through December thir-
ty-first, two thousand five;
  (E) one hundred thirty-six million dollars, on  an  annualized  basis,
for  the period January first, two thousand six through December thirty-
first, two thousand six;
  (F) one hundred thirty-six million  dollars  for  the  period  January
first,  two  thousand  seven through December thirty-first, two thousand
seven;
  (G) one hundred thirty-six million  dollars  for  the  period  January
first,  two  thousand  eight through December thirty-first, two thousand
eight;
  (H) one hundred thirty-six million  dollars  for  the  period  January
first,  two  thousand  nine  through December thirty-first, two thousand
nine;
  (I) one hundred thirty-six million  dollars  for  the  period  January
first, two thousand ten through December thirty-first, two thousand ten;
[and]
  (J)  thirty-four  million  dollars  for  the period January first, two
thousand eleven through March thirty-first, two thousand eleven[.]; AND
  (K) ONE HUNDRED THIRTY-SIX MILLION DOLLARS EACH STATE FISCAL YEAR  FOR
THE  PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST,
TWO THOUSAND FOURTEEN.
  (ii) Adjustments to Medicaid rates made  pursuant  to  this  paragraph
shall  not, in aggregate, exceed the following amounts for the following
periods:
  (A) for the period April first,  two  thousand  two  through  December
thirty-first, two thousand two, one hundred ten million dollars;
  (B)  for the period January first, two thousand three through December
thirty-first,  two  thousand  three,  one  hundred  eighty-five  million
dollars;
  (C)  for  the period January first, two thousand four through December
thirty-first, two thousand four, two hundred sixty million dollars;
  (D) for the period January first, two thousand five  through  December
thirty-first, two thousand five, three hundred forty million dollars;
  (E)  for  the  period January first, two thousand six through December
thirty-first, two thousand six, three hundred forty million dollars;
  (F) for the period January first, two thousand seven through  December
thirty-first, two thousand seven, three hundred forty million dollars;
  (G)  for the period January first, two thousand eight through December
thirty-first, two thousand eight, three hundred forty million dollars;
  (H) for the period January first, two thousand nine  through  December
thirty-first, two thousand nine, three hundred forty million dollars;

S. 2809                            61                            A. 4009

  (I)  for  the  period January first, two thousand ten through December
thirty-first, two thousand ten, three  hundred  forty  million  dollars;
[and]
  (J)  for  the  period January first, two thousand eleven through March
thirty-first, two thousand eleven, eighty-five million dollars[.]; AND
  (K) FOR EACH STATE FISCAL YEAR WITHIN  THE  PERIOD  APRIL  FIRST,  TWO
THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN, THREE
HUNDRED FORTY MILLION DOLLARS.
  (iii)  Personal care service providers which have their rates adjusted
pursuant to this paragraph shall use  such  funds  for  the  purpose  of
recruitment  and  retention  of  non-supervisory  personal care services
workers or any worker with direct patient care responsibility  only  and
are  prohibited  from  using such funds for any other purpose. Each such
personal care services provider shall submit, at a time and in a  manner
to  be determined by the commissioner, a written certification attesting
that such funds will be used solely for the purpose of  recruitment  and
retention of non-supervisory personal care services workers or any work-
er  with direct patient care responsibility. The commissioner is author-
ized to audit each such provider to ensure compliance with  the  written
certification  required  by  this subdivision and shall recoup any funds
determined to have been used for purposes  other  than  recruitment  and
retention of non-supervisory personal care services workers or any work-
er  with direct patient care responsibility. Such recoupment shall be in
addition to any other penalties provided by law.
  (cc) Funds shall be deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  the  purpose  of  supporting  the
state  share  of  adjustments  to Medicaid rates of payment for personal
care services provided pursuant to paragraph (e) of subdivision  two  of
section three hundred sixty-five-a of the social services law, for local
social  service  districts  which  shall not include a city with a popu-
lation of over one million persons for the  purpose  of  supporting  the
personal  care  services  worker  recruitment  and  retention program as
established pursuant to  section  three  hundred  sixty-seven-q  of  the
social  services law, from the tobacco control and insurance initiatives
pool established for the following periods and the following amounts:
  (i) two million eight hundred thousand dollars for  the  period  April
first, two thousand two through December thirty-first, two thousand two;
  (ii)  five  million  six  hundred  thousand  dollars, on an annualized
basis, for the period January first, two thousand three through December
thirty-first, two thousand three;
  (iii) eight million four hundred thousand dollars,  on  an  annualized
basis,  for the period January first, two thousand four through December
thirty-first, two thousand four;
  (iv) ten million eight hundred  thousand  dollars,  on  an  annualized
basis,  for the period January first, two thousand five through December
thirty-first, two thousand five;
  (v) ten million eight  hundred  thousand  dollars,  on  an  annualized
basis,  for  the period January first, two thousand six through December
thirty-first, two thousand six;
  (vi) eleven million two hundred thousand dollars for the period  Janu-
ary  first,  two thousand seven through December thirty-first, two thou-
sand seven;

S. 2809                            62                            A. 4009

  (vii) eleven million two hundred thousand dollars for the period Janu-
ary first, two thousand eight through December thirty-first,  two  thou-
sand eight;
  (viii)  eleven  million  two  hundred  thousand dollars for the period
January first, two thousand  nine  through  December  thirty-first,  two
thousand nine;
  (ix)  eleven million two hundred thousand dollars for the period Janu-
ary first, two thousand ten through December thirty-first, two  thousand
ten; [and]
  (x)  two million eight hundred thousand dollars for the period January
first, two thousand eleven  through  March  thirty-first,  two  thousand
eleven[.]; AND
  (XI)  ELEVEN  MILLION  TWO  HUNDRED THOUSAND DOLLARS EACH STATE FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIR-
TY-FIRST, TWO THOUSAND FOURTEEN.
  (dd) Funds shall be deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any  successor  fund or account, for purposes of funding the state share
of Medicaid expenditures for physician services from the tobacco control
and insurance initiatives pool established for the following periods  in
the following amounts:
  (i)  up to fifty-two million dollars for the period January first, two
thousand two through December thirty-first, two thousand two;
  (ii) eighty-one million two hundred thousand dollars  for  the  period
January  first,  two  thousand  three through December thirty-first, two
thousand three;
  (iii) eighty-five million two hundred thousand dollars for the  period
January  first,  two  thousand  four  through December thirty-first, two
thousand four;
  (iv) eighty-five million two hundred thousand dollars for  the  period
January  first,  two  thousand  five  through December thirty-first, two
thousand five;
  (v) eighty-five million two hundred thousand dollars  for  the  period
January first, two thousand six through December thirty-first, two thou-
sand six;
  (vi) [eight-five] EIGHTY-FIVE million two hundred thousand dollars for
the  period  January  first, two thousand seven through December thirty-
first, two thousand seven;
  (vii) eighty-five million two hundred thousand dollars for the  period
January  first,  two  thousand  eight through December thirty-first, two
thousand eight;
  (viii) eighty-five million two hundred thousand dollars for the period
January first, two thousand  nine  through  December  thirty-first,  two
thousand nine;
  (ix)  eighty-five  million two hundred thousand dollars for the period
January first, two thousand ten through December thirty-first, two thou-
sand ten; [and]
  (x) twenty-one million three hundred thousand dollars for  the  period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven[.]; AND
  (XI)  EIGHTY-FIVE  MILLION  TWO  HUNDRED  THOUSAND  DOLLARS EACH STATE
FISCAL YEAR FOR THE PERIOD APRIL  FIRST,  TWO  THOUSAND  ELEVEN  THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN.

S. 2809                            63                            A. 4009

  (ee)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any  successor  fund or account, for purposes of funding the state share
of the free-standing diagnostic and treatment center rate increases  for
recruitment and retention of health care workers pursuant to subdivision
seventeen of section twenty-eight hundred seven of this article from the
tobacco  control  and  insurance  initiatives  pool  established for the
following periods in the following amounts:
  (i) three million two hundred fifty thousand dollars  for  the  period
April  first,  two thousand two through December thirty-first, two thou-
sand two;
  (ii) three million two hundred fifty thousand dollars on an annualized
basis for the period January first, two thousand three through  December
thirty-first, two thousand three;
  (iii)  three  million two hundred fifty thousand dollars on an annual-
ized basis for the period  January  first,  two  thousand  four  through
December thirty-first, two thousand four;
  (iv)  three  million two hundred fifty thousand dollars for the period
January first, two thousand  five  through  December  thirty-first,  two
thousand five;
  (v)  three  million  two hundred fifty thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six;
  (vi) three million two hundred fifty thousand dollars for  the  period
January  first,  two  thousand  seven through December thirty-first, two
thousand seven;
  (vii) three million four hundred thirty-eight thousand dollars for the
period January first, two thousand eight through December  thirty-first,
two thousand eight;
  (viii)  two million four hundred fifty thousand dollars for the period
January first, two thousand  nine  through  December  thirty-first,  two
thousand nine;
  (ix)  one million five hundred thousand dollars for the period January
first, two thousand ten through December thirty-first, two thousand ten;
and
  (x) three hundred twenty-five thousand dollars for the period  January
first,  two  thousand  eleven  through  March thirty-first, two thousand
eleven.
  (ff) Funds shall be deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any  successor  fund or account, for purposes of funding the state share
of Medicaid expenditures for disabled persons as authorized pursuant  to
subparagraphs twelve and thirteen of paragraph (a) of subdivision one of
section  three  hundred  sixty-six  of  the social services law from the
tobacco control and  insurance  initiatives  pool  established  for  the
following periods in the following amounts:
  (i)  one  million  eight hundred thousand dollars for the period April
first, two thousand two through December thirty-first, two thousand two;
  (ii) sixteen million four hundred thousand dollars  on  an  annualized
basis  for the period January first, two thousand three through December
thirty-first, two thousand three;

S. 2809                            64                            A. 4009

  (iii) eighteen million seven hundred thousand dollars on an annualized
basis for the period January first, two thousand four  through  December
thirty-first, two thousand four;
  (iv)  thirty million six hundred thousand dollars for the period Janu-
ary first, two thousand five through December thirty-first, two thousand
five;
  (v) thirty million six hundred thousand dollars for the period January
first, two thousand six through December thirty-first, two thousand six;
  (vi) thirty million six hundred thousand dollars for the period  Janu-
ary  first,  two thousand seven through December thirty-first, two thou-
sand seven;
  (vii) fifteen million dollars for the period January first, two  thou-
sand eight through December thirty-first, two thousand eight;
  (viii) fifteen million dollars for the period January first, two thou-
sand nine through December thirty-first, two thousand nine;
  (ix)  fifteen  million dollars for the period January first, two thou-
sand ten through December thirty-first, two thousand ten; [and]
  (x) three million seven hundred fifty thousand dollars for the  period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven[.]; AND
  (XI)  FIFTEEN  MILLION  DOLLARS  EACH STATE FISCAL YEAR FOR THE PERIOD
APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST,  TWO  THOU-
SAND FOURTEEN.
  (gg)  Funds  shall  be  reserved and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  grants  to non-public general hospitals pursuant to paragraph (c) of
subdivision thirty of section twenty-eight hundred seven-c of this arti-
cle from the tobacco control and insurance initiatives pool  established
for the following periods in the following amounts:
  (i)  up to one million three hundred thousand dollars on an annualized
basis for the period January first, two thousand  two  through  December
thirty-first, two thousand two;
  (ii) up to three million two hundred thousand dollars on an annualized
basis  for the period January first, two thousand three through December
thirty-first, two thousand three;
  (iii) up to five million six hundred thousand dollars on an annualized
basis for the period January first, two thousand four  through  December
thirty-first, two thousand four;
  (iv)  up  to eight million six hundred thousand dollars for the period
January first, two thousand  five  through  December  thirty-first,  two
thousand five;
  (v)  up to eight million six hundred thousand dollars on an annualized
basis for the period January first, two thousand  six  through  December
thirty-first, two thousand six;
  (vi)  up  to  two  million six hundred thousand dollars for the period
January first, two thousand seven  through  December  thirty-first,  two
thousand seven;
  (vii)  up  to  two million six hundred thousand dollars for the period
January first, two thousand eight  through  December  thirty-first,  two
thousand eight;
  (viii)  up  to two million six hundred thousand dollars for the period
January first, two thousand  nine  through  December  thirty-first,  two
thousand nine;
  (ix)  up  to  two  million six hundred thousand dollars for the period
January first, two thousand ten through December thirty-first, two thou-
sand ten; and

S. 2809                            65                            A. 4009

  (x) up to six hundred fifty thousand dollars for  the  period  January
first,  two  thousand  eleven  through  March thirty-first, two thousand
eleven.
  (hh)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit to the credit of the special revenue
fund -  other,  HCRA  transfer  fund,  medical  assistance  account  for
purposes  of  providing  financial assistance to residential health care
facilities pursuant to subdivisions nineteen and twenty-one  of  section
twenty-eight hundred eight of this article, from the tobacco control and
insurance  initiatives pool established for the following periods in the
following amounts:
  (i) for the period April first,  two  thousand  two  through  December
thirty-first, two thousand two, ten million dollars;
  (ii) for the period January first, two thousand three through December
thirty-first,  two thousand three, nine million four hundred fifty thou-
sand dollars;
  (iii) for the period January first, two thousand four through December
thirty-first, two thousand four, nine million three hundred fifty  thou-
sand dollars;
  (iv)  up  to fifteen million dollars for the period January first, two
thousand five through December thirty-first, two thousand five;
  (v) up to fifteen million dollars for the period  January  first,  two
thousand six through December thirty-first, two thousand six;
  (vi)  up  to fifteen million dollars for the period January first, two
thousand seven through December thirty-first, two thousand seven;
  (vii) up to fifteen million dollars for the period January first,  two
thousand eight through December thirty-first, two thousand eight;
  (viii) up to fifteen million dollars for the period January first, two
thousand nine through December thirty-first, two thousand nine;
  (ix)  up  to fifteen million dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten; [and]
  (x) up to three million seven hundred fifty thousand dollars  for  the
period  January  first,  two thousand eleven through March thirty-first,
two thousand eleven[.]; AND
  (XI) FIFTEEN MILLION DOLLARS EACH STATE FISCAL  YEAR  FOR  THE  PERIOD
APRIL  FIRST,  TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND FOURTEEN.
  (ii) Funds shall be deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  the  purpose  of  supporting  the
state  share of Medicaid expenditures for disabled persons as authorized
by sections 1619 (a) and (b) of the federal social security act pursuant
to the tobacco control and insurance initiatives  pool  established  for
the following periods in the following amounts:
  (i)  six  million  four  hundred thousand dollars for the period April
first, two thousand two through December thirty-first, two thousand two;
  (ii) eight million five hundred thousand dollars, for the period Janu-
ary first, two thousand three through December thirty-first,  two  thou-
sand three;
  (iii) eight million five hundred thousand dollars for the period Janu-
ary first, two thousand four through December thirty-first, two thousand
four;

S. 2809                            66                            A. 4009

  (iv)  eight million five hundred thousand dollars for the period Janu-
ary first, two thousand five through December thirty-first, two thousand
five;
  (v) eight million five hundred thousand dollars for the period January
first, two thousand six through December thirty-first, two thousand six;
  (vi) eight million six hundred thousand dollars for the period January
first,  two  thousand  seven through December thirty-first, two thousand
seven;
  (vii) eight million five hundred thousand dollars for the period Janu-
ary first, two thousand eight through December thirty-first,  two  thou-
sand eight;
  (viii)  eight  million  five  hundred  thousand dollars for the period
January first, two thousand  nine  through  December  thirty-first,  two
thousand nine;
  (ix)  eight million five hundred thousand dollars for the period Janu-
ary first, two thousand ten through December thirty-first, two  thousand
ten; [and]
  (x) two million one hundred twenty-five thousand dollars for the peri-
od  January  first,  two thousand eleven through March thirty-first, two
thousand eleven; AND
  (XI) EIGHT MILLION FIVE HUNDRED THOUSAND  DOLLARS  EACH  STATE  FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIR-
TY-FIRST, TWO THOUSAND FOURTEEN.
  (jj)  Funds  shall  be  reserved and accumulated from year to year and
shall be available,  including  income  from  invested  funds,  for  the
purposes  of  a grant program to improve access to infertility services,
treatments and procedures, from the tobacco control and insurance initi-
atives pool established for the period January first, two  thousand  two
through  December  thirty-first,  two thousand two in the amount of nine
million one hundred seventy-five thousand dollars, for the period  April
first,  two  thousand six through March thirty-first, two thousand seven
in the amount of five million dollars, for the period April  first,  two
thousand  seven  through  March  thirty-first, two thousand eight in the
amount of five million dollars, for the period April first, two thousand
eight through March thirty-first, two thousand nine  in  the  amount  of
five  million dollars, and for the period April first, two thousand nine
through March thirty-first, two thousand  ten  in  the  amount  of  five
million  dollars,  [and]  for  the  period April first, two thousand ten
through March thirty-first, two thousand eleven in  the  amount  of  two
million  two  hundred  thousand dollars, AND FOR THE PERIOD APRIL FIRST,
TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND  TWELVE  UP
TO ONE MILLION ONE HUNDRED THOUSAND DOLLARS.
  (kk)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds -- other, HCRA transfer fund, medical assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of  Medical  Assistance  Program  expenditures  from  the  tobacco
control  and  insurance  initiatives  pool established for the following
periods in the following amounts:
  (i) thirty-eight million eight hundred thousand dollars for the period
January first, two thousand two through December thirty-first, two thou-
sand two;
  (ii) up to two hundred ninety-five  million  dollars  for  the  period
January  first,  two  thousand  three through December thirty-first, two
thousand three;

S. 2809                            67                            A. 4009

  (iii) up to four hundred seventy-two million dollars  for  the  period
January  first,  two  thousand  four  through December thirty-first, two
thousand four;
  (iv)  up to nine hundred million dollars for the period January first,
two thousand five through December thirty-first, two thousand five;
  (v) up to eight  hundred  sixty-six  million  three  hundred  thousand
dollars  for the period January first, two thousand six through December
thirty-first, two thousand six;
  (vi) up to six hundred sixteen million seven hundred thousand  dollars
for  the period January first, two thousand seven through December thir-
ty-first, two thousand seven;
  (vii) up to five hundred seventy-eight million  nine  hundred  twenty-
five  thousand  dollars for the period January first, two thousand eight
through December thirty-first, two thousand eight; and
  (viii) within amounts appropriated on and  after  January  first,  two
thousand nine.
  (ll)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds -- other, HCRA transfer fund, medical assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of Medicaid expenditures related to the city of New York from  the
tobacco  control  and  insurance  initiatives  pool  established for the
following periods in the following amounts:
  (i) eighty-two million seven hundred thousand dollars for  the  period
January first, two thousand two through December thirty-first, two thou-
sand two;
  (ii)  one hundred twenty-four million six hundred thousand dollars for
the period January first, two thousand three  through  December  thirty-
first, two thousand three;
  (iii)  one  hundred twenty-four million seven hundred thousand dollars
for the period January first, two thousand four through  December  thir-
ty-first, two thousand four;
  (iv)  one  hundred  twenty-four million seven hundred thousand dollars
for the period January first, two thousand five through  December  thir-
ty-first, two thousand five;
  (v) one hundred twenty-four million seven hundred thousand dollars for
the  period  January  first,  two  thousand six through December thirty-
first, two thousand six;
  (vi) one hundred twenty-four million seven  hundred  thousand  dollars
for  the period January first, two thousand seven through December thir-
ty-first, two thousand seven;
  (vii) one hundred twenty-four million seven hundred  thousand  dollars
for  the period January first, two thousand eight through December thir-
ty-first, two thousand eight;
  (viii) one hundred twenty-four million seven hundred thousand  dollars
for  the  period January first, two thousand nine through December thir-
ty-first, two thousand nine;
  (ix) one hundred twenty-four million seven  hundred  thousand  dollars
for  the period January first, two thousand ten through December thirty-
first, two thousand ten; [and]
  (x) thirty-one million one hundred seventy-five thousand  dollars  for
the  period  January  first,  two  thousand eleven through March thirty-
first, two thousand eleven[.]; AND

S. 2809                            68                            A. 4009

  (XI) ONE HUNDRED TWENTY-FOUR MILLION SEVEN  HUNDRED  THOUSAND  DOLLARS
EACH  STATE  FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN.
  (mm)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding specified
percentages of the state share of services and expenses related  to  the
family health plus program in accordance with the following schedule:
  (i)  (A)  for  the  period  January  first, two thousand three through
December thirty-first, two thousand four, one  hundred  percent  of  the
state share;
  (B)  for  the period January first, two thousand five through December
thirty-first, two thousand  five,  seventy-five  percent  of  the  state
share; and,
  (C)  for  periods  beginning  on and after January first, two thousand
six, fifty percent of the state share.
  (ii) Funding for the family health plus program  will  include  up  to
five million dollars annually for the period January first, two thousand
three  through  December  thirty-first,  two  thousand  six,  up to five
million dollars for the period January first, two thousand seven through
December thirty-first, two thousand  seven,  up  to  seven  million  two
hundred  thousand  dollars  for  the  period January first, two thousand
eight through December thirty-first, two thousand  eight,  up  to  seven
million  two  hundred thousand dollars for the period January first, two
thousand nine through December thirty-first, two thousand  nine,  up  to
seven million two hundred thousand dollars for the period January first,
two  thousand ten through December thirty-first, two thousand ten, [and]
up to one million eight hundred thousand dollars for the period  January
first,  two  thousand  eleven  through  March thirty-first, two thousand
eleven, UP TO SIX MILLION FORTY-NINE THOUSAND  DOLLARS  FOR  THE  PERIOD
APRIL  FIRST,  TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND TWELVE, UP TO SIX MILLION TWO HUNDRED EIGHTY-NINE THOUSAND  DOLLARS
FOR   THE   PERIOD  APRIL  FIRST,  TWO  THOUSAND  TWELVE  THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND THIRTEEN, AND UP TO SIX MILLION FOUR  HUNDRED
SIXTY-ONE  THOUSAND  DOLLARS  FOR  THE  PERIOD APRIL FIRST, TWO THOUSAND
THIRTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN, for adminis-
tration and marketing costs associated  with  such  program  established
pursuant  to clauses (A) and (B) of subparagraph (v) of paragraph (a) of
subdivision two of section three hundred  sixty-nine-ee  of  the  social
services  law  from  the  tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
  (A) one hundred ninety million six hundred thousand  dollars  for  the
period  January first, two thousand three through December thirty-first,
two thousand three;
  (B) three hundred seventy-four million dollars for the period  January
first,  two  thousand  four  through December thirty-first, two thousand
four;
  (C) five hundred thirty-eight million four  hundred  thousand  dollars
for  the  period January first, two thousand five through December thir-
ty-first, two thousand five;
  (D) three hundred eighteen million seven hundred seventy-five thousand
dollars for the period January first, two thousand six through  December
thirty-first, two thousand six;

S. 2809                            69                            A. 4009

  (E) four hundred eighty-two million eight hundred thousand dollars for
the  period  January  first, two thousand seven through December thirty-
first, two thousand seven;
  (F)  five hundred seventy million twenty-five thousand dollars for the
period January first, two thousand eight through December  thirty-first,
two thousand eight;
  (G) six hundred ten million seven hundred twenty-five thousand dollars
for  the  period January first, two thousand nine through December thir-
ty-first, two thousand nine;
  (H) six hundred twenty-seven million two hundred seventy-five thousand
dollars for the period January first, two thousand ten through  December
thirty-first, two thousand ten; [and]
  (I)  one  hundred fifty-seven million eight hundred seventy-five thou-
sand dollars for the period January first, two thousand  eleven  through
March thirty-first, two thousand eleven[.];
  (J) SIX HUNDRED TWENTY-EIGHT MILLION FOUR HUNDRED THOUSAND DOLLARS FOR
THE  PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST,
TWO THOUSAND TWELVE;
  (K) SIX HUNDRED FIFTY MILLION FOUR HUNDRED THOUSAND  DOLLARS  FOR  THE
PERIOD  APRIL FIRST, TWO THOUSAND TWELVE THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND THIRTEEN; AND
  (L) SIX HUNDRED FIFTY MILLION FOUR HUNDRED THOUSAND  DOLLARS  FOR  THE
PERIOD  APRIL  FIRST,  TWO THOUSAND THIRTEEN THROUGH MARCH THIRTY-FIRST,
TWO THOUSAND FOURTEEN.
  (nn) Funds shall be deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  fund - other, HCRA transfer fund, health care services account,
or any successor fund or account, for purposes  related  to  adult  home
initiatives  for  medicaid  eligible residents of residential facilities
licensed pursuant to section four hundred sixty-b of the social services
law from the tobacco control and insurance initiatives pool  established
for the following periods in the following amounts:
  (i) up to four million dollars for the period January first, two thou-
sand three through December thirty-first, two thousand three;
  (ii) up to six million dollars for the period January first, two thou-
sand four through December thirty-first, two thousand four;
  (iii)  up  to  eight million dollars for the period January first, two
thousand  five  through  December  thirty-first,  two   thousand   five,
provided,  however,  that  up to five million two hundred fifty thousand
dollars of such funds shall be received by the comptroller and deposited
to the credit of the special revenue fund - other / aid  to  localities,
HCRA  transfer  fund - 061, enhanced community services account - 05, or
any successor fund or account, for the purposes set forth in this  para-
graph;
  (iv)  up  to  eight  million dollars for the period January first, two
thousand six through December thirty-first, two thousand six,  provided,
however,  that  up to five million two hundred fifty thousand dollars of
such funds shall be received by the comptroller  and  deposited  to  the
credit  of  the  special  revenue fund - other / aid to localities, HCRA
transfer fund - 061, enhanced community services account -  05,  or  any
successor fund or account, for the purposes set forth in this paragraph;
  (v)  up  to  eight  million  dollars for the period January first, two
thousand  seven  through  December  thirty-first,  two  thousand  seven,
provided,  however,  that  up to five million two hundred fifty thousand
dollars of such funds shall be received by the comptroller and deposited

S. 2809                            70                            A. 4009

to the credit of the special revenue fund - other / aid  to  localities,
HCRA  transfer  fund - 061, enhanced community services account - 05, or
any successor fund or account, for the purposes set forth in this  para-
graph;
  (vi)  up  to  two million seven hundred fifty thousand dollars for the
period January first, two thousand eight through December  thirty-first,
two thousand eight;
  (vii)  up  to two million seven hundred fifty thousand dollars for the
period January first, two thousand nine through  December  thirty-first,
two thousand nine;
  (viii)  up to two million seven hundred fifty thousand dollars for the
period January first, two thousand ten  through  December  thirty-first,
two thousand ten; and
  (ix)  up  to  six hundred eighty-eight thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven.
  (oo) Funds shall be reserved and accumulated from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of grants to non-public general hospitals pursuant to paragraph  (e)  of
subdivision  twenty-five of section twenty-eight hundred seven-c of this
article from the tobacco control and insurance initiatives  pool  estab-
lished for the following periods in the following amounts:
  (i)  up  to five million dollars on an annualized basis for the period
January first, two thousand  four  through  December  thirty-first,  two
thousand four;
  (ii)  up  to  five  million  dollars for the period January first, two
thousand five through December thirty-first, two thousand five;
  (iii) up to five million dollars for the  period  January  first,  two
thousand six through December thirty-first, two thousand six;
  (iv)  up  to  five  million  dollars for the period January first, two
thousand seven through December thirty-first, two thousand seven; and
  (v) up to five million dollars for the period January first, two thou-
sand eight through December thirty-first, two thousand eight;
  (vi) up to five million dollars for  the  period  January  first,  two
thousand nine through December thirty-first, two thousand nine;
  (vii)  up  to  five  million dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten; and
  (viii) up to one million two hundred fifty thousand  dollars  for  the
period  January  first,  two thousand eleven through March thirty-first,
two thousand eleven.
  (pp) Funds shall be reserved and accumulated from  year  to  year  and
shall  be  available,  including  income  from  invested  funds, for the
purpose of supporting the provision of tax credits for  long  term  care
insurance  pursuant  to subdivision one of section one hundred ninety of
the tax law, paragraph (a) of subdivision twenty-five-a of  section  two
hundred  ten  of such law, subsection (aa) of section six hundred six of
such law, paragraph one of subsection (k) of  section  fourteen  hundred
fifty-six  of  such  law and paragraph one of subdivision (m) of section
fifteen hundred eleven of such law, in the following amounts:
  (i) ten million dollars for the period  January  first,  two  thousand
four through December thirty-first, two thousand four;
  (ii)  ten  million  dollars for the period January first, two thousand
five through December thirty-first, two thousand five;
  (iii) ten million dollars for the period January first,  two  thousand
six through December thirty-first, two thousand six; and

S. 2809                            71                            A. 4009

  (iv)  five  million dollars for the period January first, two thousand
seven through June thirtieth, two thousand seven.
  (qq)  Funds  shall  be  reserved and accumulated from year to year and
shall be available,  including  income  from  invested  funds,  for  the
purpose  of  supporting  the  long-term  care  insurance  education  and
outreach program established pursuant to section two hundred seventeen-a
of the elder law for the following periods in the following amounts:
  (i) up to five million dollars for the period January first, two thou-
sand four through December thirty-first,  two  thousand  four;  of  such
funds  one  million  nine  hundred  fifty thousand dollars shall be made
available to the department for the purpose of developing,  implementing
and  administering  the  long-term care insurance education and outreach
program and three million fifty thousand dollars shall be  deposited  by
the  commissioner,  within  amounts appropriated, and the comptroller is
hereby authorized and directed to receive for deposit to the  credit  of
the  special  revenue  funds - other, HCRA transfer fund, long term care
insurance resource center account of the state office for the  aging  or
any  future  account designated for the purpose of implementing the long
term care insurance education and outreach  program  and  providing  the
long  term  care insurance resource centers with the necessary resources
to carry out their operations;
  (ii) up to five million dollars for  the  period  January  first,  two
thousand  five through December thirty-first, two thousand five; of such
funds one million nine hundred fifty  thousand  dollars  shall  be  made
available  to the department for the purpose of developing, implementing
and administering the long-term care insurance  education  and  outreach
program  and  three million fifty thousand dollars shall be deposited by
the commissioner, within amounts appropriated, and  the  comptroller  is
hereby  authorized  and directed to receive for deposit to the credit of
the special revenue funds - other, HCRA transfer fund,  long  term  care
insurance  resource  center account of the state office for the aging or
any future account designated for the purpose of implementing  the  long
term  care  insurance  education  and outreach program and providing the
long term care insurance resource centers with the  necessary  resources
to carry out their operations;
  (iii)  up  to  five  million dollars for the period January first, two
thousand six through December thirty-first, two thousand  six;  of  such
funds  one  million  nine  hundred  fifty thousand dollars shall be made
available to the department for the purpose of developing,  implementing
and  administering  the  long-term care insurance education and outreach
program and three million fifty thousand dollars shall be made available
to the office for the aging for the purpose of providing the  long  term
care  insurance  resource  centers with the necessary resources to carry
out their operations;
  (iv) up to five million dollars for  the  period  January  first,  two
thousand  seven  through  December  thirty-first, two thousand seven; of
such funds one million nine hundred fifty thousand dollars shall be made
available to the department for the purpose of developing,  implementing
and  administering  the  long-term care insurance education and outreach
program and three million fifty thousand dollars shall be made available
to the office for the aging for the purpose of providing the  long  term
care  insurance  resource  centers with the necessary resources to carry
out their operations;
  (v) up to five million dollars for the period January first, two thou-
sand eight through December thirty-first, two thousand  eight;  of  such
funds  one  million  nine  hundred  fifty thousand dollars shall be made

S. 2809                            72                            A. 4009

available to the department for the purpose of developing,  implementing
and  administering  the  long term care insurance education and outreach
program and three million fifty thousand dollars shall be made available
to  the  office for the aging for the purpose of providing the long term
care insurance resource centers with the necessary  resources  to  carry
out their operations;
  (vi)  up  to  five  million  dollars for the period January first, two
thousand nine through December thirty-first, two thousand nine; of  such
funds  one  million  nine  hundred  fifty thousand dollars shall be made
available to the department for the purpose of developing,  implementing
and  administering  the  long-term care insurance education and outreach
program and three million fifty thousand dollars shall be made available
to the office for the aging for the purpose of providing  the  long-term
care  insurance  resource  centers with the necessary resources to carry
out their operations;
  (vii) up to four hundred eighty-eight thousand dollars for the  period
January first, two thousand ten through March thirty-first, two thousand
ten;  of  such funds four hundred eighty-eight thousand dollars shall be
made available to the department for the purpose of  developing,  imple-
menting  and  administering  the  long-term care insurance education and
outreach program.
  (rr) Funds shall be reserved and accumulated from the tobacco  control
and  insurance initiatives pool and shall be available, including income
from invested funds, for the purpose of supporting expenses  related  to
implementation  of  the provisions of title III of article twenty-nine-D
of this chapter, for the following periods and in the following amounts:
  (i) up to ten million dollars for the period January first, two  thou-
sand six through December thirty-first, two thousand six;
  (ii) up to ten million dollars for the period January first, two thou-
sand seven through December thirty-first, two thousand seven;
  (iii)  up  to  ten  million  dollars for the period January first, two
thousand eight through December thirty-first, two thousand eight;
  (iv) up to ten million dollars for the period January first, two thou-
sand nine through December thirty-first, two thousand nine;
  (v) up to ten million dollars for the period January first, two  thou-
sand ten through December thirty-first, two thousand ten; and
  (vi)  up  to  two million five hundred thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven.
  (ss) Funds shall be reserved and accumulated from the tobacco  control
and  insurance initiatives pool and used for a health care stabilization
program established by the commissioner for the purposes of  stabilizing
critical health care providers and health care programs whose ability to
continue  to provide appropriate services are threatened by financial or
other challenges, in the amount of up to  twenty-eight  million  dollars
for the period July first, two thousand four through June thirtieth, two
thousand  five.  Notwithstanding  the  provisions of section one hundred
twelve of the state finance law or any other inconsistent  provision  of
the state finance law or any other law, funds available for distribution
pursuant  to  this  paragraph  may  be  allocated and distributed by the
commissioner, or the state comptroller as applicable without  a  compet-
itive bid or request for proposal process. Considerations relied upon by
the commissioner in determining the allocation and distribution of these
funds  shall  include,  but  not  be  limited to, the following: (i) the
importance of the provider or program in meeting  critical  health  care
needs  in  the  community  in  which  it  operates; (ii) the provider or

S. 2809                            73                            A. 4009

program provision of care to under-served populations; (iii) the quality
of the care or services the provider or program delivers; (iv) the abil-
ity of the provider or program to continue  to  deliver  an  appropriate
level  of  care or services if additional funding is made available; (v)
the ability of the provider or program to access, in  a  timely  manner,
alternative  sources  of  funding, including other sources of government
funding; (vi) the ability of other providers or programs in the communi-
ty to meet the community health care needs; (vii) whether  the  provider
or  program  has an appropriate plan to improve its financial condition;
and (viii) whether additional  funding  would  permit  the  provider  or
program  to  consolidate,  relocate, or close programs or services where
such actions would result in greater stability  and  efficiency  in  the
delivery of needed health care services or programs.
  (tt)  Funds  shall  be  reserved and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  providing  grants  for  two  long  term  care demonstration projects
designed to test new models for the delivery of long term care  services
established  pursuant  to  section  twenty-eight hundred seven-x of this
chapter, for the following periods and in the following amounts:
  (i) up to five hundred thousand dollars for the period January  first,
two thousand four through December thirty-first, two thousand four;
  (ii) up to five hundred thousand dollars for the period January first,
two thousand five through December thirty-first, two thousand five;
  (iii)  up  to  five  hundred  thousand  dollars for the period January
first, two thousand six through December thirty-first, two thousand six;
  (iv) up to one million dollars for the period January first, two thou-
sand seven through December thirty-first, two thousand seven; and
  (v) up to two hundred fifty thousand dollars for  the  period  January
first,  two  thousand  eight  through  March  thirty-first, two thousand
eight.
  (uu) Funds shall be reserved and accumulated from  year  to  year  and
shall  be  available,  including  income  from  invested  funds, for the
purpose of supporting disease management and telemedicine  demonstration
programs  authorized  pursuant  to [sections] SECTION twenty-one hundred
eleven [and thirty-six hundred twenty-one] of this chapter[, respective-
ly,] for the following periods in the following amounts:
  (i) five million dollars for the period January  first,  two  thousand
four  through  December  thirty-first, two thousand four, of which three
million dollars shall be available for disease management  demonstration
programs  and  two  million  dollars shall be available for telemedicine
demonstration programs;
  (ii) five million dollars for the period January first,  two  thousand
five  through  December  thirty-first, two thousand five, of which three
million dollars shall be available for disease management  demonstration
programs  and  two  million  dollars shall be available for telemedicine
demonstration programs;
  (iii) nine million five hundred thousand dollars for the period  Janu-
ary  first, two thousand six through December thirty-first, two thousand
six, of which seven million  five  hundred  thousand  dollars  shall  be
available  for disease management demonstration programs and two million
dollars shall be available for telemedicine demonstration programs;
  (iv) nine million five hundred thousand dollars for the period January
first, two thousand seven through December  thirty-first,  two  thousand
seven,  of  which  seven  million five hundred thousand dollars shall be
available for disease management demonstration programs and one  million
dollars shall be available for telemedicine demonstration programs;

S. 2809                            74                            A. 4009

  (v)  nine million five hundred thousand dollars for the period January
first, two thousand eight through December  thirty-first,  two  thousand
eight,  of  which  seven  million five hundred thousand dollars shall be
available for disease management demonstration programs and two  million
dollars shall be available for telemedicine demonstration programs;
  (vi)  seven  million eight hundred thirty-three thousand three hundred
thirty-three dollars for the period January  first,  two  thousand  nine
through December thirty-first, two thousand nine, of which seven million
five  hundred thousand dollars shall be available for disease management
demonstration programs and three  hundred  thirty-three  thousand  three
hundred  thirty-three dollars shall be available for telemedicine demon-
stration programs for  the  period  January  first,  two  thousand  nine
through March first, two thousand nine;
  (vii)  one million eight hundred seventy-five thousand dollars for the
period January first, two thousand ten through March  thirty-first,  two
thousand  ten  shall  be  available for disease management demonstration
programs.
  (ww) Funds shall be deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for the deposit to the credit of the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share  of  the  general  hospital  rates  increases  for recruitment and
retention of health care workers pursuant to paragraph (e)  of  subdivi-
sion thirty of section twenty-eight hundred seven-c of this article from
the  tobacco  control and insurance initiatives pool established for the
following periods in the following amounts:
  (i) sixty million five hundred thousand dollars for the period January
first, two thousand five through  December  thirty-first,  two  thousand
five; and
  (ii)  sixty million five hundred thousand dollars for the period Janu-
ary first, two thousand six through December thirty-first, two  thousand
six.
  (xx)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive for the deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of the general hospital rates increases for rural hospitals pursu-
ant to subdivision thirty-two of section twenty-eight hundred seven-c of
this article from the tobacco control  and  insurance  initiatives  pool
established for the following periods in the following amounts:
  (i) three million five hundred thousand dollars for the period January
first,  two  thousand  five  through December thirty-first, two thousand
five;
  (ii) three million five hundred thousand dollars for the period  Janu-
ary  first, two thousand six through December thirty-first, two thousand
six;
  (iii) three million five hundred thousand dollars for the period Janu-
ary first, two thousand seven through December thirty-first,  two  thou-
sand seven;
  (iv)  three million five hundred thousand dollars for the period Janu-
ary first, two thousand eight through December thirty-first,  two  thou-
sand eight; and

S. 2809                            75                            A. 4009

  (v)  three  million  two hundred eight thousand dollars for the period
January first, two thousand nine through November thirtieth,  two  thou-
sand nine.
  (yy)  Funds  shall  be  reserved and accumulated from year to year and
shall be available,  within  amounts  appropriated  and  notwithstanding
section  one  hundred  twelve  of  the  state  finance law and any other
contrary provision of law, for the purpose of supporting grants  not  to
exceed  five  million  dollars  to be made by the commissioner without a
competitive bid or request for  proposal  process,  in  support  of  the
delivery  of  critically  needed  health  care  services, to health care
providers located in the counties of Erie and Niagara which  executed  a
memorandum of closing and conducted a merger closing in escrow on Novem-
ber  twenty-fourth, nineteen hundred ninety-seven and which entered into
a settlement dated December thirtieth, two thousand four for a  loss  on
disposal  of  assets  under the provisions of title XVIII of the federal
social security act applicable to mergers occurring  prior  to  December
first, nineteen hundred ninety-seven.
  (zz)  Funds  shall  be  reserved and accumulated from year to year and
shall be available, within amounts  appropriated,  for  the  purpose  of
supporting  expenditures  authorized  pursuant  to  section twenty-eight
hundred eighteen of this article from the tobacco control and  insurance
initiatives  pool established for the following periods in the following
amounts:
  (i) six million five hundred thousand dollars for the  period  January
first,  two  thousand  five  through December thirty-first, two thousand
five;
  (ii) one hundred eight million three hundred thousand dollars for  the
period  January  first,  two thousand six through December thirty-first,
two thousand six, provided, however, that within amounts appropriated in
the two thousand six through two thousand seven  state  fiscal  year,  a
portion  of  such  funds  may  be transferred to the Roswell Park Cancer
Institute Corporation to fund capital costs;
  (iii) one hundred seventy-one million dollars for the  period  January
first,  two  thousand  seven through December thirty-first, two thousand
seven, provided, however, that within amounts appropriated  in  the  two
thousand  six through two thousand seven state fiscal year, a portion of
such funds may be transferred  to  the  Roswell  Park  Cancer  Institute
Corporation to fund capital costs;
  (iv) one hundred seventy-one million five hundred thousand dollars for
the  period  January  first, two thousand eight through December thirty-
first, two thousand eight;
  (v) one hundred twenty-eight  million  seven  hundred  fifty  thousand
dollars for the period January first, two thousand nine through December
thirty-first, two thousand nine;
  (vi)  one  hundred thirty-one million three hundred seventy-five thou-
sand dollars for the period January  first,  two  thousand  ten  through
December thirty-first, two thousand ten; [and]
  (vii)  thirty-four  million two hundred fifty thousand dollars for the
period January first, two thousand eleven  through  March  thirty-first,
two thousand eleven[.];
  (VIII) FOUR HUNDRED THIRTY-THREE MILLION THREE HUNDRED SIXTY-SIX THOU-
SAND  DOLLARS  FOR  THE  PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND TWELVE;
  (IX) ONE HUNDRED FIFTY MILLION EIGHT HUNDRED SIX THOUSAND DOLLARS  FOR
THE  PERIOD APRIL FIRST, TWO THOUSAND TWELVE THROUGH MARCH THIRTY-FIRST,
TWO THOUSAND THIRTEEN; AND

S. 2809                            76                            A. 4009

  (X) SEVENTY-EIGHT MILLION SEVENTY-ONE THOUSAND DOLLARS FOR THE  PERIOD
APRIL FIRST, TWO THOUSAND THIRTEEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND FOURTEEN.
  (aaa)  Funds  shall  be reserved and accumulated from year to year and
shall be available, including income from invested funds,  for  services
and  expenses related to school based health centers, in an amount up to
three million five hundred thousand dollars for the period April  first,
two  thousand  six through March thirty-first, two thousand seven, up to
three million five hundred thousand dollars for the period April  first,
two thousand seven through March thirty-first, two thousand eight, up to
three  million five hundred thousand dollars for the period April first,
two thousand eight through March thirty-first, two thousand nine, up  to
three  million five hundred thousand dollars for the period April first,
two thousand nine through March thirty-first, two thousand ten, [and] up
to three million five hundred thousand  dollars  for  the  period  April
first, two thousand ten through March thirty-first, two thousand eleven,
AND  UP  TO TWO MILLION EIGHT HUNDRED THOUSAND DOLLARS EACH STATE FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIR-
TY-FIRST, TWO THOUSAND FOURTEEN.   The total amount  of  funds  provided
herein shall be distributed as grants based on the ratio of each provid-
er's  total  enrollment  for  all  sites  to the total enrollment of all
providers. This formula shall be applied to the  total  amount  provided
herein.
  (bbb)  Funds  shall  be reserved and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  awarding  grants  to  operators  of  adult  homes,  enriched housing
programs and residences through the enhancing abilities and life experi-
ence (EnAbLe) program to provide for  the  installation,  operation  and
maintenance  of air conditioning in resident rooms, consistent with this
paragraph, in an amount up to two million dollars for the  period  April
first,  two thousand six through March thirty-first, two thousand seven,
up to three million eight hundred thousand dollars for the period  April
first,  two  thousand  seven  through  March  thirty-first, two thousand
eight, up to three million eight hundred thousand dollars for the period
April first, two thousand eight through March thirty-first, two thousand
nine, up to three million eight hundred thousand dollars for the  period
April  first, two thousand nine through March thirty-first, two thousand
ten, and up to three million eight  hundred  thousand  dollars  for  the
period  April  first,  two  thousand ten through March thirty-first, two
thousand eleven. Residents shall not be charged utility cost for the use
of air conditioners supplied under the  EnAbLe  program.  All  such  air
conditioners must be operated in occupied resident rooms consistent with
requirements applicable to common areas.
  (ccc)  Funds  shall  be  deposited by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive for the deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of increases in the rates for certified home health agencies, long
term home  health  care  programs,  AIDS  home  care  programs,  hospice
programs and managed long term care plans and approved managed long term
care  operating  demonstrations as defined in section forty-four hundred
three-f of this chapter for recruitment and  retention  of  health  care
workers  pursuant  to  subdivisions  nine  and ten of section thirty-six
hundred fourteen of this chapter from the tobacco control and  insurance

S. 2809                            77                            A. 4009

initiatives  pool established for the following periods in the following
amounts:
  (i)  twenty-five  million dollars for the period June first, two thou-
sand six through December thirty-first, two thousand six;
  (ii) fifty million dollars for the period January first, two  thousand
seven through December thirty-first, two thousand seven;
  (iii) fifty million dollars for the period January first, two thousand
eight through December thirty-first, two thousand eight;
  (iv)  fifty million dollars for the period January first, two thousand
nine through December thirty-first, two thousand nine;
  (v) fifty million dollars for the period January first,  two  thousand
ten through December thirty-first, two thousand ten; [and]
  (vi) twelve million five hundred thousand dollars for the period Janu-
ary  first, two thousand eleven through March thirty-first, two thousand
eleven[.]; AND
  (VII) FIFTY MILLION DOLLARS EACH STATE  FISCAL  YEAR  FOR  THE  PERIOD
APRIL  FIRST,  TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND FOURTEEN.
  (ddd) Funds shall be deposited by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for the deposit to the credit of the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share  of  increases  in  the medical assistance rates for providers for
purposes of enhancing the provision, quality and/or efficiency  of  home
care  services  pursuant  to  subdivision  eleven  of section thirty-six
hundred fourteen of this chapter from the tobacco control and  insurance
initiatives  pool  established for the following period in the amount of
eight million dollars for the  period  April  first,  two  thousand  six
through December thirty-first, two thousand six.
  (eee)  Funds  shall  be reserved and accumulated from year to year and
shall be available, including income from invested funds, to the  Center
for  Functional  Genomics at the State University of New York at Albany,
for the purposes of the Adirondack  network  for  cancer  education  and
research  in rural communities grant program to improve access to health
care and shall be made available from the tobacco control and  insurance
initiatives  pool  established for the following period in the amount of
up to five million dollars for the period January  first,  two  thousand
six through December thirty-first, two thousand six.
  (fff) Funds shall be made available to the empire state stem cell fund
established  by  section ninety-nine-p of the state finance law from the
public asset as defined in section four thousand three  hundred  one  of
the  insurance  law  and  accumulated from the conversion of one or more
article forty-three corporations and its or their not-for-profit subsid-
iaries occurring on or after January first, two thousand  seven.    Such
funds  shall  be  made available within amounts appropriated up to fifty
million dollars annually and  shall  not  exceed  five  hundred  million
dollars in total.
  (ggg)  Funds  shall  be  deposited by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any successor fund or account, for the purpose of supporting  the  state
share  of  Medicaid  expenditures  for  hospital translation services as
authorized pursuant to paragraph (k) of subdivision one of section twen-
ty-eight hundred seven-c of this article from the  tobacco  control  and

S. 2809                            78                            A. 4009

initiatives  pool established for the following periods in the following
amounts:
  (i)  sixteen  million  dollars for the period July first, two thousand
eight through December thirty-first, two thousand eight; and
  (ii) fourteen million seven hundred thousand dollars  for  the  period
January  first,  two thousand nine through November thirtieth, two thou-
sand nine.
  (hhh) Funds shall be deposited by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any  successor  fund or account, for the purpose of supporting the state
share of Medicaid expenditures for adjustments  to  inpatient  rates  of
payment  for  general  hospitals  located  in the counties of Nassau and
Suffolk as authorized pursuant to paragraph (l) of  subdivision  one  of
section  twenty-eight  hundred  seven-c of this article from the tobacco
control and initiatives pool established for the  following  periods  in
the following amounts:
  (i)  two  million  five  hundred thousand dollars for the period April
first, two thousand eight through December  thirty-first,  two  thousand
eight; and
  (ii) two million two hundred ninety-two thousand dollars for the peri-
od  January  first,  two  thousand  nine through November thirtieth, two
thousand nine.
  S 9. Subdivision 3 of section 1680-j of the public authorities law, as
amended by section 34 of part C of chapter 58 of the laws  of  2009,  is
amended to read as follows:
  3.  Notwithstanding  any  law  to the contrary, and in accordance with
section four of the state finance law, the comptroller is hereby author-
ized and directed to transfer from the health  care  reform  act  (HCRA)
resources fund (061) to the general fund, upon the request of the direc-
tor of the budget, up to $6,500,000 on or before March 31, 2006, and the
comptroller  is  further hereby authorized and directed to transfer from
the healthcare reform act (HCRA); Resources fund (061)  to  the  Capital
Projects  Fund,  upon  the  request  of  the  director  of budget, up to
$139,000,000 for the period April 1, 2006 through March 31, 2007, up  to
$171,100,000  for the period April 1, 2007 through March 31, 2008, up to
$208,100,000 for the period April 1, 2008 through March 31, 2009, up  to
$151,600,000  for the period April 1, 2009 through March 31, 2010, [and]
up to [$238,000,000] $215,743,000 for the period April 1,  2010  through
March  31, 2011, UP TO $433,366,000 FOR THE PERIOD APRIL 1, 2011 THROUGH
MARCH 31, 2012, UP TO $150,806,000 FOR THE PERIOD APRIL 1, 2012  THROUGH
MARCH  31,  2013, UP TO $78,071,000 FOR THE PERIOD APRIL 1, 2013 THROUGH
MARCH 31, 2014, AND UP TO $86,005,000  FOR  THE  PERIOD  APRIL  1,  2014
THROUGH MARCH 31, 2015.
  S  10.  Paragraph (a) of subdivision 12 of section 367-b of the social
services law, as amended by section 8 of part B of  chapter  58  of  the
laws of 2008, is amended to read as follows:
  (a) For the purpose of regulating cash flow for general hospitals, the
department  shall develop and implement a payment methodology to provide
for timely payments for inpatient hospital services  eligible  for  case
based  payments per discharge based on diagnosis-related groups provided
during the period January first, nineteen hundred  eighty-eight  through
March  thirty-first  two  thousand  [eleven] FOURTEEN, by such hospitals
which elect to participate in the system.

S. 2809                            79                            A. 4009

  S 11. Section 2 of chapter 600 of  the  laws  of  1986,  amending  the
public  health  law  relating  to the development of pilot reimbursement
programs for ambulatory care services, as amended by section 9 of part B
of chapter 58 of the laws of 2008, is amended to read as follows:
  S  2.  This  act  shall  take effect immediately, except that this act
shall expire and be of no further force and effect on and after April 1,
[2011] 2014; provided, however, that the commissioner  of  health  shall
submit a report to the governor and the legislature detailing the objec-
tive,  impact, design and computation of any pilot reimbursement program
established pursuant to this act, on or before March 31, 1994 and  annu-
ally  thereafter.  Such report shall include an assessment of the finan-
cial impact of such payment system on providers, as well as  the  impact
of such system on access to care.
  S  12. Paragraph (i) of subdivision (b) of section 1 of chapter 520 of
the laws of 1978, relating to providing for a  comprehensive  survey  of
health  care  financing,  education  and illness prevention and creating
councils for the conduct thereof, as amended by section 11 of part B  of
chapter 58 of the laws of 2008, is amended to read as follows:
  (i)  oversight  and  evaluation  of  the inpatient financing system in
place for 1988 through March 31, [2011] 2014,  and  the  appropriateness
and effectiveness of the bad debt and charity care financing provisions;
  S  13. The opening paragraph of section 2952 of the public health law,
as amended by section 21 of part B of chapter 58 of the laws of 2008, is
amended to read as follows:
  To the extent of funds available therefor, the sum  of  seven  million
dollars  shall annually be available for periods prior to January first,
two thousand three, and up to six million five hundred  thirty  thousand
dollars  annually  for  the  period  January  first,  two thousand three
through December thirty-first, two thousand four, up  to  seven  million
sixty-two  thousand  dollars  for the period January first, two thousand
five through December thirty-first, two thousand  six  annually,  up  to
seven million sixty-two thousand dollars annually for the period January
first,  two  thousand  seven through December thirty-first, two thousand
ten, [and] up to one million seven hundred  sixty-six  thousand  dollars
for  the period January first, two thousand eleven through March thirty-
first, two thousand eleven, AND WITHIN  AMOUNTS  APPROPRIATED  FOR  EACH
STATE  FISCAL  YEAR ON AND AFTER APRIL FIRST, TWO THOUSAND ELEVEN, shall
be available to the commissioner from funds made available  pursuant  to
section twenty-eight hundred seven-l of this chapter for grants pursuant
to this section.
  S  14.  Subdivision  1  of  section  2958 of the public health law, as
amended by section 22 of part B of chapter 58 of the laws  of  2008,  is
amended to read as follows:
  1.  To  the extent of funds available therefor, the sum of ten million
dollars shall annually be made available for periods  prior  to  January
first,  two  thousand three, and up to nine million three hundred twenty
thousand dollars for  the  period  January  first,  two  thousand  three
through  December  thirty-first,  two thousand three, up to nine million
three hundred twenty thousand dollars for the period January first,  two
thousand  four  through  December thirty-first, two thousand four, up to
twelve million eighty-eight thousand  dollars  for  the  period  January
first,  two  thousand  five  through December thirty-first, two thousand
five, up to twelve million eighty-eight thousand dollars for the  period
January first, two thousand six through December thirty-first, two thou-
sand  six,  up  to eleven million eighty-eight thousand dollars annually
for the period January first, two thousand seven through December  thir-

S. 2809                            80                            A. 4009

ty-first, two thousand ten, [and] up to two million seven hundred seven-
ty-two thousand dollars for the period January first, two thousand elev-
en  through  March thirty-first, two thousand eleven, AND WITHIN AMOUNTS
APPROPRIATED  FOR  EACH  STATE FISCAL YEAR ON AND AFTER APRIL FIRST, TWO
THOUSAND ELEVEN, shall be  available  to  the  commissioner  from  funds
pursuant  to  section  twenty-eight  hundred  seven-l of this chapter to
provide assistance to general hospitals classified as a  rural  hospital
for  purposes  of determining payment for inpatient services provided to
beneficiaries of title XVIII of the federal social security  act  (Medi-
care)  or  under  state  regulations, in recognition of the unique costs
incurred by these facilities to provide hospital services in  remote  or
sparsely populated areas pursuant to subdivision two of this section.
  S  15.  Paragraph (a) of subdivision 1 of section 18 of chapter 266 of
the laws of 1986, amending the civil practice law and  rules  and  other
laws  relating  to  malpractice  and  professional  medical  conduct, as
amended by section 23 of part B of chapter 58 of the laws  of  2008,  is
amended to read as follows:
  (a)  The superintendent of insurance and the commissioner of health or
their designee shall,  from  funds  available  in  the  hospital  excess
liability  pool created pursuant to subdivision [(5)] 5 of this section,
purchase a policy or policies for excess insurance coverage, as  author-
ized  by  paragraph  [(1)]  1  of  subsection (e) of section 5502 of the
insurance law; or from an insurer, other than an  insurer  described  in
section  5502 of the insurance law, duly authorized to write such cover-
age and actually writing medical malpractice insurance in this state; or
shall purchase equivalent excess coverage in a form previously  approved
by  the superintendent of insurance for purposes of providing equivalent
excess coverage in accordance with section 19 of chapter 294 of the laws
of 1985, for medical or dental malpractice occurrences between  July  1,
1986  and June 30, 1987, between July 1, 1987 and June 30, 1988, between
July 1, 1988 and June 30, 1989, between July 1, 1989 and June 30,  1990,
between  July  1,  1990 and June 30, 1991, between July 1, 1991 and June
30, 1992, between July 1, 1992 and June 30, 1993, between July  1,  1993
and  June 30, 1994, between July 1, 1994 and June 30, 1995, between July
1, 1995 and June 30, 1996, between July  1,  1996  and  June  30,  1997,
between  July  1,  1997 and June 30, 1998, between July 1, 1998 and June
30, 1999, between July 1, 1999 and June 30, 2000, between July  1,  2000
and  June 30, 2001, between July 1, 2001 and June 30, 2002, between July
1, 2002 and June 30, 2003, between July  1,  2003  and  June  30,  2004,
between  July  1,  2004 and June 30, 2005, between July 1, 2005 and June
30, 2006, between July 1, 2006 and June 30, 2007, between July  1,  2007
and  June 30, 2008, between July 1, 2008 and June 30, 2009, between July
1, 2009 and June 30, 2010, [and] between July 1, 2010 and June 30, 2011,
BETWEEN JULY 1, 2011 AND JUNE 30, 2012, BETWEEN JULY 1,  2012  AND  JUNE
30,  2013  AND  BETWEEN  JULY 1, 2013 AND JUNE 30, 2014 or reimburse the
hospital where the hospital  purchases  equivalent  excess  coverage  as
defined  in subparagraph (i) of paragraph (a) of subdivision [(1-a)] 1-A
of this section for medical or dental  malpractice  occurrences  between
July  1, 1987 and June 30, 1988, between July 1, 1988 and June 30, 1989,
between July 1, 1989 and June 30, 1990, between July 1,  1990  and  June
30,  1991,  between July 1, 1991 and June 30, 1992, between July 1, 1992
and June 30, 1993, between July 1, 1993 and June 30, 1994, between  July
1,  1994  and  June  30,  1995,  between July 1, 1995 and June 30, 1996,
between July 1, 1996 and June 30, 1997, between July 1,  1997  and  June
30,  1998,  between July 1, 1998 and June 30, 1999, between July 1, 1999
and June 30, 2000, between July 1, 2000 and June 30, 2001, between  July

S. 2809                            81                            A. 4009

1,  2001  and  June  30,  2002,  between July 1, 2002 and June 30, 2003,
between July 1, 2003 and June 30, 2004, between July 1,  2004  and  June
30,  2005,  between July 1, 2005 and June 30, 2006, between July 1, 2006
and  June 30, 2007, between July 1, 2007 and June 30, 2008, between July
1, 2008 and June 30, 2009, between July 1, 2009 and June 30, 2010, [and]
between July 1, 2010 and June 30, 2011, BETWEEN JULY 1,  2011  AND  JUNE
30,  2012,  BETWEEN  JULY  1, 2012 AND JUNE 30, 2013 AND BETWEEN JULY 1,
2013 AND JUNE 30, 2014 for physicians or dentists certified as  eligible
for  each such period or periods pursuant to subdivision [(2)] 2 of this
section by a general hospital licensed pursuant to  article  28  of  the
public health law; provided that no single insurer shall write more than
fifty  percent  of the total excess premium for a given policy year; and
provided, however, that such eligible physicians or dentists  must  have
in force an individual policy, from an insurer licensed in this state of
primary  malpractice  insurance  coverage in amounts of no less than one
million three hundred thousand  dollars  for  each  claimant  and  three
million nine hundred thousand dollars for all claimants under that poli-
cy  during the period of such excess coverage for such occurrences or be
endorsed as additional insureds under a hospital professional  liability
policy  which is offered through a voluntary attending physician ("chan-
neling") program previously permitted by the superintendent of insurance
during the period of such excess coverage for such  occurrences.  During
such  period,  such policy for excess coverage or such equivalent excess
coverage shall, when combined with the physician's or dentist's  primary
malpractice  insurance coverage or coverage provided through a voluntary
attending physician ("channeling") program, total an aggregate level  of
two  million  three  hundred  thousand dollars for each claimant and six
million nine hundred thousand dollars for all claimants  from  all  such
policies  with  respect  to  occurrences in each of such years provided,
however, if the cost of primary malpractice insurance coverage in excess
of one million dollars, but below the excess medical malpractice  insur-
ance  coverage  provided  pursuant to this act, exceeds the rate of nine
percent per annum, then the required level of primary malpractice insur-
ance coverage in excess of one million dollars for each  claimant  shall
be  in  an  amount  of  not less than the dollar amount of such coverage
available at nine percent per annum; the required level of such coverage
for all claimants under that policy shall be in an amount not less  than
three  times the dollar amount of coverage for each claimant; and excess
coverage, when combined with such primary malpractice  insurance  cover-
age, shall increase the aggregate level for each claimant by one million
dollars  and  three  million  dollars  for  all  claimants; and provided
further, that, with respect to policies of primary  medical  malpractice
coverage  that  include  occurrences  between April 1, 2002 and June 30,
2002, such requirement that coverage be in  amounts  no  less  than  one
million  three  hundred  thousand  dollars  for  each claimant and three
million nine hundred thousand dollars for all claimants for such  occur-
rences shall be effective April 1, 2002.
  S  16. Subdivision 3 of section 18 of chapter 266 of the laws of 1986,
amending the civil practice law and rules and  other  laws  relating  to
malpractice  and  professional medical conduct, as amended by section 24
of part B of chapter 58 of the laws of  2008,  is  amended  to  read  as
follows:
  (3)(a)  The superintendent of insurance shall determine and certify to
each general hospital and to the commissioner  of  health  the  cost  of
excess  malpractice  insurance  for medical or dental malpractice occur-
rences between July 1, 1986 and June 30, 1987, between July 1, 1988  and

S. 2809                            82                            A. 4009

June  30,  1989, between July 1, 1989 and June 30, 1990, between July 1,
1990 and June 30, 1991, between July 1, 1991 and June 30, 1992,  between
July  1, 1992 and June 30, 1993, between July 1, 1993 and June 30, 1994,
between  July  1,  1994 and June 30, 1995, between July 1, 1995 and June
30, 1996, between July 1, 1996 and June 30, 1997, between July  1,  1997
and  June 30, 1998, between July 1, 1998 and June 30, 1999, between July
1, 1999 and June 30, 2000, between July  1,  2000  and  June  30,  2001,
between  July  1,  2001 and June 30, 2002, between July 1, 2002 and June
30, 2003, between July 1, 2003 and June 30, 2004, between July  1,  2004
and  June 30, 2005, between July 1, 2005 and June 30, 2006, between July
1, 2006 and June 30, 2007, between July  1,  2007  and  June  30,  2008,
between  July  1,  2008 and June 30, 2009, between July 1, 2009 and June
30, 2010, [and] between July 1, 2010 and June 30, 2011, BETWEEN JULY  1,
2011  AND  JUNE  30,  2012,  BETWEEN JULY 1, 2012 AND JUNE 30, 2013, AND
BETWEEN JULY 1, 2013 AND JUNE 30, 2014 allocable to each general  hospi-
tal  for  physicians or dentists certified as eligible for purchase of a
policy for excess insurance coverage by such general hospital in accord-
ance with subdivision [(2)] 2 of this section, and may amend such deter-
mination and certification as necessary.
  (b) The superintendent of insurance shall  determine  and  certify  to
each  general  hospital  and  to  the commissioner of health the cost of
excess malpractice insurance or equivalent excess coverage  for  medical
or  dental  malpractice  occurrences  between  July 1, 1987 and June 30,
1988, between July 1, 1988 and June 30, 1989, between July 1,  1989  and
June  30,  1990, between July 1, 1990 and June 30, 1991, between July 1,
1991 and June 30, 1992, between July 1, 1992 and June 30, 1993,  between
July  1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995,
between July 1, 1995 and June 30, 1996, between July 1,  1996  and  June
30,  1997,  between July 1, 1997 and June 30, 1998, between July 1, 1998
and June 30, 1999, between July 1, 1999 and June 30, 2000, between  July
1,  2000  and  June  30,  2001,  between July 1, 2001 and June 30, 2002,
between July 1, 2002 and June 30, 2003, between July 1,  2003  and  June
30,  2004,  between July 1, 2004 and June 30, 2005, between July 1, 2005
and June 30, 2006, between July 1, 2006 and June 30, 2007, between  July
1,  2007  and  June  30,  2008,  between July 1, 2008 and June 30, 2009,
between July 1, 2009 and June 30, 2010, [and] between July 1,  2010  and
June  30,  2011, BETWEEN JULY 1, 2011 AND JUNE 30, 2012, BETWEEN JULY 1,
2012 AND JUNE 30, 2013, AND BETWEEN JULY 1, 2013 AND JUNE 30, 2014 allo-
cable to each general hospital for physicians or dentists  certified  as
eligible  for  purchase  of  a  policy  for excess insurance coverage or
equivalent excess coverage by such general hospital in  accordance  with
subdivision  [(2)]  2  of this section, and may amend such determination
and certification as necessary. The superintendent  of  insurance  shall
determine  and  certify to each general hospital and to the commissioner
of health the ratable share of such cost allocable to the period July 1,
1987 to December 31, 1987, to the period January 1,  1988  to  June  30,
1988,  to  the  period  July 1, 1988 to December 31, 1988, to the period
January 1, 1989 to June 30, 1989, to the period July 1, 1989 to December
31, 1989, to the period January 1, 1990 to June 30, 1990, to the  period
July 1, 1990 to December 31, 1990, to the period January 1, 1991 to June
30, 1991, to the period July 1, 1991 to December 31, 1991, to the period
January 1, 1992 to June 30, 1992, to the period July 1, 1992 to December
31,  1992, to the period January 1, 1993 to June 30, 1993, to the period
July 1, 1993 to December 31, 1993, to the period January 1, 1994 to June
30, 1994, to the period July 1, 1994 to December 31, 1994, to the period
January 1, 1995 to June 30, 1995, to the period July 1, 1995 to December

S. 2809                            83                            A. 4009

31, 1995, to the period January 1, 1996 to June 30, 1996, to the  period
July 1, 1996 to December 31, 1996, to the period January 1, 1997 to June
30, 1997, to the period July 1, 1997 to December 31, 1997, to the period
January 1, 1998 to June 30, 1998, to the period July 1, 1998 to December
31,  1998, to the period January 1, 1999 to June 30, 1999, to the period
July 1, 1999 to December 31, 1999, to the period January 1, 2000 to June
30, 2000, to the period July 1, 2000 to December 31, 2000, to the period
January 1, 2001 to June 30, 2001, to the period July 1, 2001 to June 30,
2002, to the period July 1, 2002 to June 30, 2003, to the period July 1,
2003 to June 30, 2004, to the period July 1, 2004 to June 30,  2005,  to
the  period  July  1, 2005 and June 30, 2006, to the period July 1, 2006
and June 30, 2007, to the period July 1, 2007 and June 30, 2008, to  the
period  July  1,  2008 and June 30, 2009, to the period July 1, 2009 and
June 30, 2010, [and] to the period July 1, 2010 and June  30,  2011,  TO
THE  PERIOD  JULY  1, 2011 AND JUNE 30, 2012, TO THE PERIOD JULY 1, 2012
AND JUNE 30, 2013, AND TO THE PERIOD JULY 1, 2013 AND JUNE 30, 2014.
  S 17. Paragraphs (a), (b), (c),  (d)  and  (e)  of  subdivision  8  of
section  18 of chapter 266 of the laws of 1986, amending the civil prac-
tice law and rules and other laws relating to  malpractice  and  profes-
sional medical conduct, as amended by section 25 of part B of chapter 58
of the laws of 2008, are amended to read as follows:
  (a)  To  the  extent  funds available to the hospital excess liability
pool pursuant to subdivision [(5)] 5 of this  section  as  amended,  and
pursuant  to  section  6 of part J of chapter 63 of the laws of 2001, as
may from time to time be amended, which amended  this  subdivision,  are
insufficient  to  meet  the costs of excess insurance coverage or equiv-
alent excess coverage for coverage periods during  the  period  July  1,
1992  to June 30, 1993, during the period July 1, 1993 to June 30, 1994,
during the period July 1, 1994 to June 30, 1995, during the period  July
1,  1995  to  June  30, 1996, during the period July 1, 1996 to June 30,
1997, during the period July 1, 1997 to June 30, 1998, during the period
July 1, 1998 to June 30, 1999, during the period July 1,  1999  to  June
30,  2000,  during  the period July 1, 2000 to June 30, 2001, during the
period July 1, 2001 to October 29, 2001, during the period April 1, 2002
to June 30, 2002, during the period July  1,  2002  to  June  30,  2003,
during  the period July 1, 2003 to June 30, 2004, during the period July
1, 2004 to June 30, 2005, during the period July 1,  2005  to  June  30,
2006, during the period July 1, 2006 to June 30, 2007, during the period
July  1,  2007  to June 30, 2008, during the period July 1, 2008 to June
30, 2009, during the period July 1, 2009 to June 30, 2010 [and],  during
the period July 1, 2010 to June 30, 2011, DURING THE PERIOD JULY 1, 2011
TO  JUNE  30, 2012, DURING THE PERIOD JULY 1, 2012 TO JUNE 30, 2013, AND
DURING THE PERIOD JULY 1, 2013 TO JUNE 30, 2014 allocated or reallocated
in accordance with paragraph (a) of  subdivision  [(4-a)]  4-A  of  this
section  to  rates of payment applicable to state governmental agencies,
each physician or dentist for whom a policy for excess insurance  cover-
age  or equivalent excess coverage is purchased for such period shall be
responsible for payment to the provider of excess insurance coverage  or
equivalent  excess coverage of an allocable share of such insufficiency,
based on the ratio of the total cost of such coverage for such physician
to the sum of the total cost of such coverage for all physicians applied
to such insufficiency.
  (b) Each provider of excess insurance coverage  or  equivalent  excess
coverage  covering the period July 1, 1992 to June 30, 1993, or covering
the period July 1, 1993 to June 30, 1994, or covering the period July 1,
1994 to June 30, 1995, or covering the period July 1, 1995 to  June  30,

S. 2809                            84                            A. 4009

1996,  or covering the period July 1, 1996 to June 30, 1997, or covering
the period July 1, 1997 to June 30, 1998, or covering the period July 1,
1998 to June 30, 1999, or covering the period July 1, 1999 to  June  30,
2000,  or covering the period July 1, 2000 to June 30, 2001, or covering
the period July 1, 2001 to October 29,  2001,  or  covering  the  period
April  1,  2002 to June 30, 2002, or covering the period July 1, 2002 to
June 30, 2003, or covering the period July 1, 2003 to June 30, 2004,  or
covering the period July 1, 2004 to June 30, 2005, or covering the peri-
od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
June  30, 2007, or covering the period July 1, 2007 to June 30, 2008, or
covering the period July 1, 2008 to June 30, 2009, or covering the peri-
od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
June 30, 2011, OR COVERING THE PERIOD JULY 1, 2011 TO JUNE 30, 2012,  OR
COVERING THE PERIOD JULY 1, 2012 TO JUNE 30, 2013, OR COVERING THE PERI-
OD  JULY  1,  2013  TO JUNE 30, 2014 shall notify a covered physician or
dentist by mail, mailed to the address shown on the last application for
excess insurance coverage or equivalent excess coverage, of  the  amount
due  to  such  provider from such physician or dentist for such coverage
period determined in accordance with paragraph (a) of this  subdivision.
Such amount shall be due from such physician or dentist to such provider
of excess insurance coverage or equivalent excess coverage in a time and
manner determined by the superintendent of insurance.
  (c)  If  a physician or dentist liable for payment of a portion of the
costs of excess insurance coverage or equivalent excess coverage  cover-
ing  the  period  July  1, 1992 to June 30, 1993, or covering the period
July 1, 1993 to June 30, 1994, or covering the period July  1,  1994  to
June  30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
covering the period July 1, 1996 to June 30, 1997, or covering the peri-
od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
June 30, 1999, or covering the period July 1, 1999 to June 30, 2000,  or
covering the period July 1, 2000 to June 30, 2001, or covering the peri-
od  July  1,  2001  to October 29, 2001, or covering the period April 1,
2002 to June 30, 2002, or covering the period July 1, 2002 to  June  30,
2003,  or covering the period July 1, 2003 to June 30, 2004, or covering
the period July 1, 2004 to June 30, 2005, or covering the period July 1,
2005 to June 30, 2006, or covering the period July 1, 2006 to  June  30,
2007,  or covering the period July 1, 2007 to June 30, 2008, or covering
the period July 1, 2008 to June 30, 2009, or covering the period July 1,
2009 to June 30, 2010, or covering the period July 1, 2010 to  June  30,
2011,  OR COVERING THE PERIOD JULY 1, 2011 TO JUNE 30, 2012, OR COVERING
THE PERIOD JULY 1, 2012 TO JUNE 30, 2013, OR COVERING THE PERIOD JULY 1,
2013 TO JUNE 30, 2014 determined in accordance  with  paragraph  (a)  of
this  subdivision  fails,  refuses  or  neglects  to make payment to the
provider of excess insurance coverage or equivalent excess  coverage  in
such  time  and  manner as determined by the superintendent of insurance
pursuant to paragraph (b) of this subdivision, excess insurance coverage
or equivalent excess coverage purchased for such physician or dentist in
accordance with this section for such coverage period shall be cancelled
and shall be null and void as of the first day on or after the commence-
ment of a policy period where the liability for payment pursuant to this
subdivision has not been met.
  (d) Each provider of excess insurance coverage  or  equivalent  excess
coverage  shall  notify  the superintendent of insurance and the commis-
sioner of health or their designee of each physician and dentist  eligi-
ble for purchase of a policy for excess insurance coverage or equivalent
excess  coverage  covering  the period July 1, 1992 to June 30, 1993, or

S. 2809                            85                            A. 4009

covering the period July 1, 1993 to June 30, 1994, or covering the peri-
od July 1, 1994 to June 30, 1995, or covering the period July 1, 1995 to
June 30, 1996, or covering the period July 1, 1996 to June 30, 1997,  or
covering the period July 1, 1997 to June 30, 1998, or covering the peri-
od July 1, 1998 to June 30, 1999, or covering the period July 1, 1999 to
June  30, 2000, or covering the period July 1, 2000 to June 30, 2001, or
covering the period July 1, 2001 to October 29, 2001,  or  covering  the
period  April  1,  2002 to June 30, 2002, or covering the period July 1,
2002 to June 30, 2003, or covering the period July 1, 2003 to  June  30,
2004,  or covering the period July 1, 2004 to June 30, 2005, or covering
the period July 1, 2005 to June 30, 2006, or covering the period July 1,
2006 to June 30, 2007, or covering the period July 1, 2007 to  June  30,
2008,  or covering the period July 1, 2008 to June 30, 2009, or covering
the period July 1, 2009 to June 30, 2010, or covering the period July 1,
2010 to June 30, 2011, OR COVERING THE PERIOD JULY 1, 2011 TO  JUNE  30,
2012,  OR COVERING THE PERIOD JULY 1, 2012 TO JUNE 30, 2013, OR COVERING
THE PERIOD JULY 1, 2013 TO JUNE 30, 2014 that has made payment  to  such
provider  of  excess insurance coverage or equivalent excess coverage in
accordance with paragraph (b) of this subdivision and of each  physician
and dentist who has failed, refused or neglected to make such payment.
  (e)  A  provider  of  excess  insurance  coverage or equivalent excess
coverage shall refund to the hospital excess liability pool  any  amount
allocable to the period July 1, 1992 to June 30, 1993, and to the period
July  1,  1993  to June 30, 1994, and to the period July 1, 1994 to June
30, 1995, and to the period July 1, 1995 to June 30, 1996,  and  to  the
period  July 1, 1996 to June 30, 1997, and to the period July 1, 1997 to
June 30, 1998, and to the period July 1, 1998 to June 30, 1999,  and  to
the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
to  June  30,  2001, and to the period July 1, 2001 to October 29, 2001,
and to the period April 1, 2002 to June 30, 2002, and to the period July
1, 2002 to June 30, 2003, and to the period July 1,  2003  to  June  30,
2004, and to the period July 1, 2004 to June 30, 2005, and to the period
July  1,  2005  to June 30, 2006, and to the period July 1, 2006 to June
30, 2007, and to the period July 1, 2007 to June 30, 2008,  and  to  the
period  July 1, 2008 to June 30, 2009, and to the period July 1, 2009 to
June 30, 2010, and to the period July 1, 2010 to June 30, 2011,  AND  TO
THE PERIOD JULY 1, 2011 TO JUNE 30, 2012, AND TO THE PERIOD JULY 1, 2012
TO  JUNE  30,  2013,  AND  TO  THE  PERIOD JULY 1, 2013 TO JUNE 30, 2014
received from the hospital excess liability pool for purchase of  excess
insurance  coverage  or  equivalent  excess coverage covering the period
July 1, 1992 to June 30, 1993, and covering the period July 1,  1993  to
June  30,  1994,  and covering the period July 1, 1994 to June 30, 1995,
and covering the period July 1, 1995 to June 30, 1996, and covering  the
period  July  1,  1996 to June 30, 1997, and covering the period July 1,
1997 to June 30, 1998, and covering the period July 1, 1998 to June  30,
1999,  and covering the period July 1, 1999 to June 30, 2000, and cover-
ing the period July 1, 2000 to June 30, 2001, and  covering  the  period
July  1, 2001 to October 29, 2001, and covering the period April 1, 2002
to June 30, 2002, and covering the period July 1, 2002 to June 30, 2003,
and covering the period July 1, 2003 to June 30, 2004, and covering  the
period  July  1,  2004 to June 30, 2005, and covering the period July 1,
2005 to June 30, 2006, and covering the period July 1, 2006 to June  30,
2007,  and covering the period July 1, 2007 to June 30, 2008, and cover-
ing the period July 1, 2008 to June 30, 2009, and  covering  the  period
July  1,  2009 to June 30, 2010, and covering the period July 1, 2010 to
June 30, 2011, AND COVERING THE PERIOD JULY 1, 2011 TO  JUNE  30,  2012,

S. 2809                            86                            A. 4009

AND  COVERING THE PERIOD JULY 1, 2012 TO JUNE 30, 2013, AND COVERING THE
PERIOD JULY 1, 2013 TO JUNE 30, 2014 for a physician  or  dentist  where
such   excess  insurance  coverage  or  equivalent  excess  coverage  is
cancelled in accordance with paragraph (c) of this subdivision.
  S  18.  Section  40  of  chapter 266 of the laws of 1986, amending the
civil practice law and rules and other laws relating to malpractice  and
professional  medical  conduct, as amended by chapter 216 of the laws of
2009, is amended to read as follows:
  S 40. The superintendent of insurance shall establish rates for  poli-
cies  providing coverage for physicians and surgeons medical malpractice
for the periods commencing July 1, 1985 and ending June 30, [2011] 2014;
provided, however, that notwithstanding any other provision of law,  the
superintendent  shall not establish or approve any increase in rates for
the period commencing July 1, 2009 and ending June 30, 2010. The  super-
intendent  shall  direct  insurers  to establish segregated accounts for
premiums, payments, reserves and investment income attributable to  such
premium  periods  and  shall  require  periodic  reports by the insurers
regarding claims and expenses attributable to such  periods  to  monitor
whether  such  accounts  will  be sufficient to meet incurred claims and
expenses. On or after July 1, 1989, the superintendent  shall  impose  a
surcharge  on premiums to satisfy a projected deficiency that is attrib-
utable to the premium levels established pursuant to  this  section  for
such  periods;  provided,  however, that such annual surcharge shall not
exceed eight percent of the established rate until July 1, [2011]  2014,
at which time and thereafter such surcharge shall not exceed twenty-five
percent  of  the approved adequate rate, and that such annual surcharges
shall continue for such period of time as shall be sufficient to satisfy
such deficiency. The superintendent  shall  not  impose  such  surcharge
during  the period commencing July 1, 2009 and ending June 30, 2010.  On
and after July 1, 1989, the surcharge prescribed by this  section  shall
be  retained  by insurers to the extent that they insured physicians and
surgeons during the July 1, 1985 through June  30,  [2011]  2014  policy
periods;  in  the  event  and to the extent physicians and surgeons were
insured by another insurer during such periods, all or a pro rata  share
of  the  surcharge,  as the case may be, shall be remitted to such other
insurer in accordance with rules and regulations to  be  promulgated  by
the  superintendent.   Surcharges collected from physicians and surgeons
who were not insured during such policy  periods  shall  be  apportioned
among  all insurers in proportion to the premium written by each insurer
during such policy periods; if a physician or surgeon was insured by  an
insurer  subject  to rates established by the superintendent during such
policy periods, and at any time thereafter a  hospital,  health  mainte-
nance  organization, employer or institution is responsible for respond-
ing in  damages  for  liability  arising  out  of  such  physician's  or
surgeon's practice of medicine, such responsible entity shall also remit
to such prior insurer the equivalent amount that would then be collected
as  a  surcharge  if  the  physician  or surgeon had continued to remain
insured by such prior insurer. In the event any  insurer  that  provided
coverage   during   such   policy   periods   is   in  liquidation,  the
property/casualty insurance security fund shall receive the  portion  of
surcharges to which the insurer in liquidation would have been entitled.
The surcharges authorized herein shall be deemed to be income earned for
the  purposes of section 2303 of the insurance law.  The superintendent,
in establishing adequate rates and in determining  any  projected  defi-
ciency  pursuant  to  the requirements of this section and the insurance
law, shall give substantial weight, determined  in  his  discretion  and

S. 2809                            87                            A. 4009

judgment,  to  the  prospective  anticipated  effect  of any regulations
promulgated and laws enacted and the public benefit  of    stabilizing
malpractice rates and minimizing rate level fluctuation during the peri-
od  of  time  necessary for the development of more reliable statistical
experience as to the efficacy of such  laws  and  regulations  affecting
medical, dental or podiatric malpractice enacted or promulgated in 1985,
1986,  by this act and at any other time.  Notwithstanding any provision
of the insurance law, rates already established and to be established by
the superintendent pursuant to this section are deemed adequate if  such
rates  would be adequate when taken together with the maximum authorized
annual surcharges to be imposed for a reasonable period of time  whether
or  not  any  such  annual surcharge has been actually imposed as of the
establishment of such rates.
  S 19. Subsection (c) of section 2343 of the insurance law, as  amended
by section 27 of part B of chapter 58 of the laws of 2008, is amended to
read as follows:
  (c)  Notwithstanding  any other provision of this chapter, no applica-
tion for an order of rehabilitation or liquidation of a domestic insurer
whose primary liability arises from the business of medical  malpractice
insurance,  as  that  term  is defined in subsection (b) of section five
thousand five hundred one of this chapter, shall be made on the  grounds
specified  in  subsection  (a)  or  (c)  of  section seven thousand four
hundred two of this chapter at any time prior  to  June  thirtieth,  two
thousand [eleven] FOURTEEN.
  S 20. Section 5 and subdivisions (a) and (e) of section 6 of part J of
chapter  63 of the laws of 2001, amending chapter 20 of the laws of 2001
amending the military law and other laws relating  to  making  appropri-
ations for the support of government, as amended by section 28 of part B
of chapter 58 of the laws of 2008, are amended to read as follows:
  S  5.  The  superintendent of insurance and the commissioner of health
shall determine, no later than June 15, 2002, June 15,  2003,  June  15,
2004,  June  15, 2005, June 15, 2006, June 15, 2007, June 15, 2008, June
15, 2009, June 15, 2010, [and] June 15, 2011, JUNE 15,  2012,  JUNE  15,
2013,  AND  JUNE 15, 2014, the amount of funds available in the hospital
excess liability pool, created pursuant to section 18 of chapter 266  of
the  laws of 1986, and whether such funds are sufficient for purposes of
purchasing excess insurance coverage for eligible  participating  physi-
cians  and  dentists during the period July 1, 2001 to June 30, 2002, or
July 1, 2002 to June 30, 2003, or July 1, 2003 to June 30, 2004, or July
1, 2004 to June 30, 2005, or July 1, 2005 to June 30, 2006, or  July  1,
2006 to June 30, 2007, or July 1, 2007 to June 30, 2008, or July 1, 2008
to  June  30, 2009, or July 1, 2009 to June 30, 2010, or July 1, 2010 to
June 30, 2011, OR JULY 1, 2011 TO JUNE 30, 2012, OR JULY 1, 2012 TO JUNE
30, 2013, OR JULY 1, 2013 TO JUNE 30, 2014, as applicable.
  (a) This section shall be effective only upon a determination,  pursu-
ant  to section five of this act, by the superintendent of insurance and
the commissioner of health, and a certification of such determination to
the state director of the budget, the chair of the senate  committee  on
finance  and the chair of the assembly committee on ways and means, that
the amount of funds in  the  hospital  excess  liability  pool,  created
pursuant  to  section 18 of chapter 266 of the laws of 1986, is insuffi-
cient for purposes of purchasing excess insurance coverage for  eligible
participating  physicians and dentists during the period July 1, 2001 to
June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003 to June
30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to June  30,
2006,  or  July  1,  2006  to June 30, 2007, or July 1, 2007 to June 30,

S. 2809                            88                            A. 4009

2008, or July 1, 2008 to June 30, 2009, or July  1,  2009  to  June  30,
2010,  or  July  1,  2010  to June 30, 2011, OR JULY 1, 2011 TO JUNE 30,
2012, OR JULY 1, 2012 TO JUNE 30, 2013, OR JULY  1,  2013  TO  JUNE  30,
2014, as applicable.
  (e)  The  commissioner  of  health  shall  transfer for deposit to the
hospital excess liability pool created pursuant to section 18 of chapter
266 of the laws of 1986 such amounts as directed by  the  superintendent
of insurance for the purchase of excess liability insurance coverage for
eligible  participating physicians and dentists for the policy year July
1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or  July  1,
2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005
to  June  30, 2006, or July 1, 2006 to June 30, 2007, as applicable, and
the cost of administering the hospital excess liability  pool  for  such
applicable  policy year,  pursuant to the program established in chapter
266 of the laws of 1986, as amended, no later than June 15,  2002,  June
15,  2003,  June  15, 2004, June 15, 2005, June 15, 2006, June 15, 2007,
June 15, 2008, June 15, 2009, June 15, 2010, [and] June 15,  2011,  JUNE
15, 2012, JUNE 15, 2013, AND JUNE 15, 2014, as applicable.
  S  21.  Section  18  of  chapter 904 of the laws of 1984, amending the
public health law and the social services law  relating  to  encouraging
comprehensive  health  services,  as  amended by section 64 of part C of
chapter 58 of the laws of 2008, is amended to read as follows:
  S 18. This act shall take effect  immediately,  except  that  sections
six,  nine, ten and eleven of this act shall take effect on the sixtieth
day after it shall have become a law, sections two, three, four and nine
of this act shall expire and be of no further  force  or  effect  on  or
after  March  31, [2012] 2014, section two of this act shall take effect
on April 1, 1985 or seventy-five days following the  submission  of  the
report  required  by  section  one  of this act, whichever is later, and
sections eleven and thirteen of this act  shall  expire  and  be  of  no
further force or effect on or after March 31, 1988.
  S 22.  Paragraphs (i) and (j) of subdivision 1 of section 367-q of the
social services law, as added by section 22-d of part B of chapter 58 of
the  laws of 2008, are amended and three new paragraphs (k), (l) and (m)
are added to read as follows:
  (i) for the period April first, two thousand nine through March  thir-
ty-first,  two  thousand ten, twenty-eight million five hundred thousand
dollars; [and]
  (j) for the period April first, two thousand ten through  March  thir-
ty-first,  two  thousand eleven, twenty-eight million five hundred thou-
sand dollars[.];
  (K) FOR THE PERIOD APRIL FIRST,  TWO  THOUSAND  ELEVEN  THROUGH  MARCH
THIRTY-FIRST,  TWO  THOUSAND  TWELVE,  TWENTY-EIGHT MILLION FIVE HUNDRED
THOUSAND DOLLARS;
  (L) FOR THE PERIOD APRIL FIRST,  TWO  THOUSAND  TWELVE  THROUGH  MARCH
THIRTY-FIRST,  TWO  THOUSAND THIRTEEN, TWENTY-EIGHT MILLION FIVE HUNDRED
THOUSAND DOLLARS; AND
  (M) FOR THE PERIOD APRIL FIRST, TWO THOUSAND  THIRTEEN  THROUGH  MARCH
THIRTY-FIRST,  TWO  THOUSAND FOURTEEN, TWENTY-EIGHT MILLION FIVE HUNDRED
THOUSAND DOLLARS.
  S 23. Paragraph (f) of subdivision 9 of section  3614  of  the  public
health law, as added by section 22-e of part B of chapter 58 of the laws
of  2008, is amended and three new paragraphs (g), (h) and (i) are added
to read as follows:
  (f) for the period April first, two thousand ten through  March  thir-
ty-first, two thousand eleven, up to one hundred million dollars[.];

S. 2809                            89                            A. 4009

  (G)  FOR  THE  PERIOD  APRIL  FIRST, TWO THOUSAND ELEVEN THROUGH MARCH
THIRTY-FIRST, TWO THOUSAND TWELVE, UP TO ONE HUNDRED MILLION DOLLARS;
  (H)  FOR  THE  PERIOD  APRIL  FIRST, TWO THOUSAND TWELVE THROUGH MARCH
THIRTY-FIRST, TWO THOUSAND THIRTEEN, UP TO ONE HUNDRED MILLION DOLLARS;
  (I) FOR THE PERIOD APRIL FIRST, TWO THOUSAND  THIRTEEN  THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND FOURTEEN, UP TO ONE HUNDRED MILLION DOLLARS.
  S  24.  Paragraph  (a) of subdivision 10 of section 3614 of the public
health law, as amended by section 5 of part C of chapter 109 of the laws
of 2006, is amended to read as follows:
  (a) Such adjustments to rates of payments shall be  allocated  propor-
tionally  based  on  each certified home health agency's, long term home
health care program, AIDS home care and hospice  program's  home  health
aide  or  other  direct  care  services  total  annual  hours of service
provided to medicaid patients, as reported in each  such  agency's  most
[recent]  RECENTLY  AVAILABLE cost report as submitted to the department
[prior to November first, two thousand five] or for the purpose  of  the
managed long term care program a suitable proxy developed by the depart-
ment in consultation with the interested parties. Payments made pursuant
to  this section shall not be subject to subsequent adjustment or recon-
ciliation.
  S 25. Section 4 of chapter 495 of  the  laws  of  2004,  amending  the
insurance  law  and the public health law relating to the New York state
health  insurance  continuation  assistance  demonstration  project,  as
amended  by  section  29 of part B of chapter 58 of the laws of 2008, is
amended to read as follows:
  S 4. This act shall take effect on the sixtieth  day  after  it  shall
have  become  a  law;  provided,  however, that this act shall remain in
effect until July 1, [2011] 2014 when upon such date the  provisions  of
this  act shall expire and be deemed repealed; provided, further, that a
displaced worker shall be eligible for continuation assistance  retroac-
tive to July 1, 2004.
  S  26. The opening paragraph of paragraph (b) and paragraphs (c), (d),
(e), (f) and (g) of subdivision 5-a of  section  2807-m  of  the  public
health law, the opening paragraph of paragraph (b) as amended by section
4  of part B of chapter 109 of the laws of 2010, paragraphs (c), (f) and
(g) and the opening paragraphs of paragraphs (d) and (e) as  amended  by
section  98  of  part C of chapter 58 of the laws of 2009 and paragraphs
(d) and (e) as added by section 75-c of part C of chapter 58 of the laws
of 2008, are amended to read as follows:
  Nine million one hundred twenty  thousand  dollars  annually  for  the
period  January  first, two thousand nine through December thirty-first,
two thousand ten, and two million two hundred  eighty  thousand  dollars
for  the period January first, two thousand eleven, AND NINE MILLION ONE
HUNDRED TWENTY THOUSAND DOLLARS EACH STATE FISCAL YEAR  FOR  THE  PERIOD
APRIL  FIRST,  TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND FOURTEEN, through March thirty-first, two thousand eleven, shall be
set aside and reserved by  the  commissioner  from  the  regional  pools
established  pursuant to subdivision two of this section to be allocated
regionally with two-thirds of the available funding going  to  New  York
city  and  one-third  of  the available funding going to the rest of the
state and shall be available for distribution as follows:
  (c) Ambulatory care  training.  Four  million  nine  hundred  thousand
dollars  for the period January first, two thousand eight through Decem-
ber thirty-first, two thousand eight, four million nine hundred thousand
dollars for the period January first, two thousand nine through December
thirty-first, two thousand nine,  four  million  nine  hundred  thousand

S. 2809                            90                            A. 4009

dollars  for the period January first, two thousand ten through December
thirty-first, two thousand ten, [and] one million  two  hundred  twenty-
five  thousand dollars for the period January first, two thousand eleven
through  March thirty-first, two thousand eleven, AND FOUR MILLION THREE
HUNDRED THOUSAND DOLLARS EACH STATE FISCAL YEAR  FOR  THE  PERIOD  APRIL
FIRST,  TWO  THOUSAND  ELEVEN  THROUGH  MARCH THIRTY-FIRST, TWO THOUSAND
FOURTEEN, shall be set aside and reserved by the commissioner  from  the
regional  pools  established pursuant to subdivision two of this section
and shall be available for distributions to sponsoring  institutions  to
be  directed  to support clinical training of medical students and resi-
dents in free-standing ambulatory  care  settings,  including  community
health  centers  and  private practices. Such funding shall be allocated
regionally with two-thirds of the available funding going  to  New  York
city  and  one-third  of  the available funding going to the rest of the
state and shall be distributed to sponsoring institutions in each region
pursuant to a request for application or request  for  proposal  process
with  preference  being  given  to sponsoring institutions which provide
training in sites located in underserved rural or inner-city  areas  and
those that include medical students in such training.
  (d)  Physician loan repayment program.  One million nine hundred sixty
thousand dollars for  the  period  January  first,  two  thousand  eight
through  December  thirty-first,  two  thousand  eight, one million nine
hundred sixty thousand dollars for the period January first,  two  thou-
sand  nine through December thirty-first, two thousand nine, one million
nine hundred sixty thousand dollars for the period  January  first,  two
thousand ten through December thirty-first, two thousand ten, [and] four
hundred  ninety thousand dollars for the period January first, two thou-
sand eleven through March thirty-first, two  thousand  eleven,  AND  ONE
MILLION  SEVEN  HUNDRED  THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR THE
PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST,  TWO
THOUSAND  FOURTEEN,  shall be set aside and reserved by the commissioner
from the regional pools established pursuant to subdivision two of  this
section  and shall be available for purposes of physician loan repayment
in accordance with subdivision ten of this section. Such  funding  shall
be  allocated  regionally with one-third of available funds going to New
York city and two-thirds of available funds going to  the  rest  of  the
state  and  shall  be  distributed  in  a manner to be determined by the
commissioner as follows:
  (i) Funding shall first be awarded to repay loans of up to twenty-five
physicians who train in primary care or  specialty  tracks  in  teaching
general hospitals, and who enter and remain in primary care or specialty
practices in underserved communities, as determined by the commissioner.
  (ii)  After  distributions in accordance with subparagraph (i) of this
paragraph, all remaining funds shall be awarded to repay loans of physi-
cians who enter and remain in primary care  or  specialty  practices  in
underserved  communities,  as  determined by the commissioner, including
but not limited to physicians working in  general  hospitals,  or  other
health care facilities.
  (iii)  In no case shall less than fifty percent of the funds available
pursuant to this paragraph be distributed in  accordance  with  subpara-
graphs (i) and (ii) of this paragraph to physicians identified by gener-
al hospitals.
  (e)  Physician  practice support.   Four million nine hundred thousand
dollars for the period January first, two thousand eight through  Decem-
ber thirty-first, two thousand eight, four million nine hundred thousand
dollars annually for the period January first, two thousand nine through

S. 2809                            91                            A. 4009

December  thirty-first,  two thousand ten, [and] one million two hundred
twenty-five thousand dollars for the period January first, two  thousand
eleven through March thirty-first, two thousand eleven, AND FOUR MILLION
THREE  HUNDRED  THOUSAND  DOLLARS  EACH STATE FISCAL YEAR FOR THE PERIOD
APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST,  TWO  THOU-
SAND  FOURTEEN, shall be set aside and reserved by the commissioner from
the regional pools established  pursuant  to  subdivision  two  of  this
section  and  shall  be  available  for  purposes  of physician practice
support. Such funding shall be allocated regionally  with  one-third  of
available funds going to New York city and two-thirds of available funds
going  to  the rest of the state and shall be distributed in a manner to
be determined by the commissioner as follows:
  (i) Preference in funding shall first be accorded to teaching  general
hospitals  for  up  to  twenty-five awards, to support costs incurred by
physicians trained in primary or specialty tracks who thereafter  estab-
lish  or join practices in underserved communities, as determined by the
commissioner.
  (ii) After distributions in accordance with subparagraph (i)  of  this
paragraph, all remaining funds shall be awarded to physicians to support
the  cost  of  establishing or joining practices in underserved communi-
ties, as determined by the commissioner,  and  to  hospitals  and  other
health  care  providers to recruit new physicians to provide services in
underserved communities, as determined by the commissioner.
  (iii) In no case shall less than fifty percent of the funds  available
pursuant  to  this  paragraph  be  distributed  to  general hospitals in
accordance with subparagraphs (i) and (ii) of this paragraph.
  (f) Study on physician workforce. Five hundred ninety thousand dollars
annually for the period January first, two thousand eight through Decem-
ber thirty-first, two thousand ten, [and] one hundred forty-eight  thou-
sand  dollars  for the period January first, two thousand eleven through
March thirty-first, two thousand eleven, AND FIVE HUNDRED SIXTEEN  THOU-
SAND  DOLLARS  EACH  STATE  FISCAL  YEAR FOR THE PERIOD APRIL FIRST, TWO
THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN, shall
be set aside and reserved by the commissioner from  the  regional  pools
established  pursuant  to  subdivision  two of this section and shall be
available to fund a study of physician  workforce  needs  and  solutions
including,  but  not  limited  to, an analysis of residency programs and
projected physician workforce  and  community  needs.  The  commissioner
shall  enter  into  agreements with one or more organizations to conduct
such study based on a request for proposal process.
  (g) Diversity in medicine/post-baccalaureate program.  Notwithstanding
any  inconsistent provision of section one hundred twelve or one hundred
sixty-three of the state finance law or any other law, one million  nine
hundred  sixty  thousand  dollars annually for the period January first,
two thousand eight through  December  thirty-first,  two  thousand  ten,
[and] four hundred ninety thousand dollars for the period January first,
two thousand eleven through March thirty-first, two thousand eleven, AND
ONE  MILLION  SEVEN  HUNDRED THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR
THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH  THIRTY-FIRST,
TWO  THOUSAND  FOURTEEN,  shall be set aside and reserved by the commis-
sioner from the regional pools established pursuant to  subdivision  two
of  this section and shall be available for distributions to the Associ-
ated Medical Schools of New York to fund its diversity program including
existing and new post-baccalaureate programs for  minority  and  econom-
ically  disadvantaged  students  and  encourage  participation  from all
medical schools in New York. The associated medical schools of New  York

S. 2809                            92                            A. 4009

shall report to the commissioner on an annual basis regarding the use of
funds  for  such  purpose  in  such  form and manner as specified by the
commissioner.
  S  26-a.  Subdivision 7 of section 2807-m of the public health law, as
amended by section 99 of part C of chapter 58 of the laws  of  2009,  is
amended to read as follows:
  7.  Notwithstanding  any inconsistent provision of section one hundred
twelve or one hundred sixty-three of the state finance law or any  other
law,  up  to one million dollars for the period January first, two thou-
sand through  December  thirty-first,  two  thousand,  one  million  six
hundred  thousand  dollars  annually  for the periods January first, two
thousand one through December  thirty-first,  two  thousand  eight,  one
million  five  hundred thousand dollars annually for the periods January
first, two thousand nine through  December  thirty-first,  two  thousand
ten,  [and]  three  hundred seventy-five thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven, AND ONE MILLION THREE HUNDRED TWENTY THOUSAND DOLLARS  EACH
STATE  FISCAL  YEAR  FOR  THE  PERIOD  APRIL  FIRST, TWO THOUSAND ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN, shall  be  set  aside
and  reserved  by  the  commissioner from the regional pools established
pursuant to subdivision two of this section and shall be  available  for
distributions to the New York state area health education center program
for  the  purpose  of  expanding  community-based  training  of  medical
students. In addition, one million dollars annually for the period Janu-
ary first, two thousand eight through December thirty-first,  two  thou-
sand  ten, [and] two hundred fifty thousand dollars for the period Janu-
ary first, two thousand eleven through March thirty-first, two  thousand
eleven, AND EIGHT HUNDRED EIGHTY THOUSAND DOLLARS EACH STATE FISCAL YEAR
FOR   THE   PERIOD  APRIL  FIRST,  TWO  THOUSAND  ELEVEN  THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND FOURTEEN, shall be set aside and reserved  by
the  commissioner from the regional pools established pursuant to subdi-
vision two of this section and shall be available for  distributions  to
the  New York state area health education center program for the purpose
of post-secondary training of health care professionals who will achieve
specific program outcomes within the New York state area  health  educa-
tion  center  program.  The  New York state area health education center
program shall report to the commissioner on an  annual  basis  regarding
the  use  of funds for each purpose in such form and manner as specified
by the commissioner.
  S 27. Subdivision 4-c of section 2807-p of the public health  law,  as
amended  by section 13-c of Part C of chapter 58 of the laws of 2009, is
amended to read as follows:
  4-c. Notwithstanding any provision of law to the contrary, the commis-
sioner shall make additional payments for uncompensated care  to  volun-
tary  non-profit  diagnostic and treatment centers that are eligible for
distributions under subdivision four of this section  in  the  following
amounts:  for  the  period June first, two thousand six through December
thirty-first, two thousand six, in the  amount  of  seven  million  five
hundred  thousand  dollars,  for  the period January first, two thousand
seven through December thirty-first, two thousand seven,  seven  million
five  hundred  thousand dollars, for the period January first, two thou-
sand eight through December  thirty-first,  two  thousand  eight,  seven
million five hundred thousand dollars, for the period January first, two
thousand  nine through December thirty-first, two thousand nine, fifteen
million five hundred thousand dollars, for the period January first, two
thousand ten through December  thirty-first,  two  thousand  ten,  seven

S. 2809                            93                            A. 4009

million five hundred thousand dollars, FOR THE PERIOD JANUARY FIRST, TWO
THOUSAND ELEVEN THOUGH DECEMBER THIRTY-FIRST, TWO THOUSAND ELEVEN, SEVEN
MILLION FIVE HUNDRED THOUSAND DOLLARS, FOR THE PERIOD JANUARY FIRST, TWO
THOUSAND  TWELVE  THROUGH  DECEMBER  THIRTY-FIRST,  TWO THOUSAND TWELVE,
SEVEN MILLION FIVE HUNDRED THOUSAND  DOLLARS,  FOR  THE  PERIOD  JANUARY
FIRST, TWO THOUSAND THIRTEEN THROUGH DECEMBER THIRTY-FIRST, TWO THOUSAND
THIRTEEN, SEVEN MILLION FIVE HUNDRED THOUSAND DOLLARS, and for the peri-
od  January  first, two thousand [eleven] FOURTEEN through March thirty-
first, two thousand [eleven] FOURTEEN, in  the  amount  of  one  million
eight hundred seventy-five thousand dollars, provided, however, that for
periods  on and after January first, two thousand eight, such additional
payments shall be distributed to voluntary,  non-profit  diagnostic  and
treatment  centers  and  to  public  diagnostic and treatment centers in
accordance with paragraph (g) of subdivision four of  this  section.  In
the  event  that  federal  financial participation is available for rate
adjustments pursuant to this section, the commissioner shall  make  such
payments  as  additional  adjustments  to rates of payment for voluntary
non-profit diagnostic  and  treatment  centers  that  are  eligible  for
distributions  under subdivision four-a of this section in the following
amounts: for the period June first, two thousand  six  through  December
thirty-first,  two  thousand  six, fifteen million dollars in the aggre-
gate, and for the period January first, two thousand seven through  June
thirtieth,  two  thousand  seven,  seven  million  five hundred thousand
dollars in the aggregate. The amounts allocated pursuant to  this  para-
graph  shall  be  aggregated  with  and distributed pursuant to the same
methodology applicable to the amounts allocated to such  diagnostic  and
treatment  centers for such periods pursuant to subdivision four of this
section if federal financial participation is not available, or pursuant
to subdivision four-a of this section if federal financial participation
is available.  Notwithstanding section three  hundred  sixty-eight-a  of
the  social  services  law,  there  shall be no local share in a medical
assistance payment adjustment under this subdivision.
  S 28. Subdivision 3 and paragraph (a)  of  subdivision  4  of  section
2807-k  of  the public health law, as amended by section 15 of part C of
chapter 58 of the laws of 2010, are amended to read as follows:
  3. Each major public general hospital shall be allocated for  distrib-
ution  from the pools established pursuant to this section for each year
through December thirty-first, two thousand [eleven] FOURTEEN, an amount
equal to the amount allocated to such major public general hospital from
the regional pool  established  pursuant  to  subdivision  seventeen  of
section  twenty-eight  hundred  seven-c  of  this article for the period
January first, nineteen  hundred  ninety-six  through  December  thirty-
first,  nineteen hundred ninety-six, provided, however, that payments on
and after January first, two thousand  nine  shall  be  subject  to  the
provisions of subdivision five-a of this section.
  (a)  From  funds in the pool for each year, thirty-six million dollars
shall be reserved on an annual basis through December thirty-first,  two
thousand [eleven] FOURTEEN, for distribution as high need adjustments in
accordance with subdivision six of this section, provided, however, that
payments  on and after January first, two thousand nine shall be subject
to the provisions of subdivision five-a of this section.
  S 29. The opening paragraph, paragraph (a) of subdivision 1 and subdi-
vision 2 of section 2807-w of the  public  health  law,  as  amended  by
section  14  of part C of chapter 58 of the laws of 2010, are amended to
read as follows:

S. 2809                            94                            A. 4009

  Funds allocated pursuant  to  paragraph  (p)  of  subdivision  one  of
section twenty-eight hundred seven-v of this article, shall be deposited
as  authorized  and  used  for the purpose of making medicaid dispropor-
tionate share payments of up to eighty-two million dollars on an annual-
ized  basis  pursuant  to subdivision twenty-one of section twenty-eight
hundred seven-c of this article, for the period January first, two thou-
sand through March thirty-first,  two  thousand  [eleven]  FOURTEEN,  in
accordance with the following:
  (a) Each eligible rural hospital shall receive one hundred forty thou-
sand  dollars  on an annualized basis for the periods January first, two
thousand through December thirty-first, two thousand [eleven]  FOURTEEN,
provided as a disproportionate share payment; provided, however, that if
such  payment pursuant to this paragraph exceeds a hospital's applicable
disproportionate share limit, then the total amount in  excess  of  such
limit  shall  be  provided as a nondisproportionate share payment in the
form of a grant directly  from  this  pool  without  allocation  to  the
special  revenue funds - other, indigent care fund - 068, or any succes-
sor fund or account, and provided further that payments for  periods  on
and  after  January  first,  two  thousand  nine shall be subject to the
provisions of subdivision five-a of section twenty-eight hundred seven-k
of this article;
  2. From the funds in the pool each year, thirty-six million dollars on
an annualized basis for the periods January first, two thousand  through
December  thirty-first, two thousand [eleven] FOURTEEN, of the funds not
distributed in accordance with subdivision one of this section, shall be
distributed in accordance with the formula set forth in subdivision  six
of  section  twenty-eight  hundred  seven-k  of  this article, provided,
however, that payments for periods on and after January first, two thou-
sand nine shall be subject to the provisions of  subdivision  five-a  of
section twenty-eight hundred seven-k of this article.
  S  30.  Subparagraph  (v) of paragraph (a) of subdivision 3 of section
2807-j of the public health law, as added by chapter 639 of the laws  of
1996, is amended to read as follows:
  (v)  revenue received from physician practice or faculty practice plan
discrete billings for [private practicing] physician services;
  S 31. Clause (D) of subparagraph (ii) of paragraph (b) of  subdivision
3 of section 2807-j of the public health law, as added by chapter 639 of
the laws of 1996, is amended to read as follows:
  (D)  revenue received from physician practice or faculty practice plan
discrete billings for [private practicing] physician services;
  S 32. Notwithstanding any inconsistent provision of law, rule or regu-
lation, for purposes of implementing the provisions of the public health
law and the social services law, references to titles XIX and XXI of the
federal social security act in the public  health  law  and  the  social
services  law  shall be deemed to include and also to mean any successor
titles thereto under the federal social security act.
  S 33. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the public health law, section 18 of chapter 2 of the laws of 1988,  and
18  NYCRR  505.14(h), as they relate to time frames for notice, approval
or certification of rates of payment, are hereby suspended  and  without
force or effect for purposes of implementing the provisions of this act.
  S 34.  Severability clause. If any clause, sentence, paragraph, subdi-
vision,  section  or  part of this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgement shall  not  affect,
impair or invalidate the remainder thereof, but shall be confined in its

S. 2809                            95                            A. 4009

operation  to  the  clause, sentence, paragraph, subdivision, section or
part thereof directly involved in the controversy in which  such  judge-
ment shall have been rendered. It is hereby declared to be the intent of
the  legislature  that  this  act  would  have been enacted even if such
invalid provisions had not been included herein.
  S 35. This act shall take effect immediately and shall  be  deemed  to
have  been in full force and effect on and after April 1, 2011, provided
that:
  (a) any rules or regulations necessary to implement the provisions  of
this  act  may be promulgated and any procedures, forms, or instructions
necessary for such implementation may be adopted and issued on or  after
the date this act shall have become a law;
  (b)  this  act shall not be construed to alter, change, affect, impair
or defeat any rights, obligations, duties or interests accrued, incurred
or conferred prior to the effective date of this act;
  (c) the commissioner of health and the superintendent of insurance and
any appropriate council may take any steps necessary to  implement  this
act prior to its effective date;
  (d)  notwithstanding  any inconsistent provision of the state adminis-
trative procedure act or any other provision of law, rule or regulation,
the commissioner of health and the superintendent of insurance  and  any
appropriate  council is authorized to adopt or amend or promulgate on an
emergency basis any regulation he or  she  or  such  council  determines
necessary to implement any provision of this act on its effective date;
  (e)  the provisions of this act shall become effective notwithstanding
the failure of the commissioner  of  health  or  the  superintendent  of
insurance  or  any  council  to adopt or amend or promulgate regulations
implementing this act;
  (f) the amendments to sections 2807-j and 2807-s of the public  health
law  made by sections three, five, five-a, five-b, six, thirty and thir-
ty-one, respectively, of this act shall not  affect  the  expiration  of
such sections and shall expire therewith; and
  (g)  the  amendments  to  paragraph  (i-l) of subdivision 1 of section
2807-v of the public health law made by section eight of this act  shall
not  affect  the  repeal  of such paragraph and shall be deemed repealed
therewith.

                                 PART D

  Section 1. Paragraph (e-1) of subdivision 12 of section  2808  of  the
public  health  law,  as  separately amended by section 11 of part B and
section 21 of part D of chapter 58 of the laws of 2009,  is  amended  to
read as follows:
  (e-1) Notwithstanding any inconsistent provision of law or regulation,
the  commissioner  shall  provide,  in  addition to payments established
pursuant to this article prior to application  of  this  section,  addi-
tional  payments  under the medical assistance program pursuant to title
eleven of article five of the social services law for non-state operated
public residential health care facilities, including public  residential
health  care  facilities  located in the county of Nassau, the county of
Westchester and the county of Erie,  but  excluding  public  residential
health  care  facilities  operated by a town or city within a county, in
aggregate annual amounts of up to one hundred fifty million  dollars  in
additional payments for the state fiscal year beginning April first, two
thousand  six  and  for the state fiscal year beginning April first, two
thousand seven and for the state fiscal year beginning April first,  two

S. 2809                            96                            A. 4009

thousand eight and of up to three hundred million dollars in such aggre-
gate  annual  additional  payments  for  the state fiscal year beginning
April first, two thousand nine, and for the state fiscal year  beginning
April  first,  two  thousand ten and for the state fiscal year beginning
April first, two thousand eleven, AND EACH STATE FISCAL YEAR THEREAFTER.
The amount allocated to each eligible  public  residential  health  care
facility  for  this  period  shall  be  computed  in accordance with the
provisions of paragraph (f) of this subdivision, provided, however, that
patient days shall be utilized for such  computation  reflecting  actual
reported  data for two thousand three and each representative succeeding
year as applicable.
  S 2. Paragraph (a) of subdivision 1 of section 212 of chapter  474  of
the  laws of 1996, amending the education law and other laws relating to
rates for residential healthcare facilities, as amended by section 2  of
part B of chapter 58 of the laws of 2010, is amended to read as follows:
  (a) Notwithstanding any inconsistent provision of law or regulation to
the  contrary,  effective beginning August 1, 1996, for the period April
1, 1997 through March 31, 1998, April 1, 1998 for the  period  April  1,
1998  through  March  31,  1999, August 1, 1999, for the period April 1,
1999 through March 31, 2000, April 1, 2000, for the period April 1, 2000
through March 31, 2001, April 1, 2001, for  the  period  April  1,  2001
through  March  31,  2002,  April  1, 2002, for the period April 1, 2002
through March 31, 2003, and for the state fiscal year beginning April 1,
2005 through March 31, 2006, and for the  state  fiscal  year  beginning
April  1,  2006  through  March  31, 2007, and for the state fiscal year
beginning April 1, 2007 through March 31, 2008, and for the state fiscal
year beginning April 1, 2008 through March 31, 2009, and for  the  state
fiscal  year beginning April 1, 2009 through March 31, 2010, and for the
state fiscal year beginning April 1, 2010 through March  31,  2011,  AND
FOR  EACH  STATE  FISCAL  YEAR  THEREAFTER,  the department of health is
authorized to pay public general hospitals, as defined in subdivision 10
of section 2801 of the public health law, operated by the state  of  New
York  or by the state university of New York or by a county, which shall
not include a city with a population of over one million, of  the  state
of New York, and those public general hospitals located in the county of
Westchester,  the  county  of  Erie  or the county of Nassau, additional
payments for inpatient hospital services as medical assistance  payments
pursuant  to  title  11  of  article  5  of  the social services law for
patients eligible for federal financial participation under title XIX of
the federal social security act in medical assistance  pursuant  to  the
federal  laws  and regulations governing disproportionate share payments
to hospitals up to one hundred  percent  of  each  such  public  general
hospital's  medical  assistance  and  uninsured patient losses after all
other medical assistance, including disproportionate share  payments  to
such  public  general  hospital  for  1996,  1997, 1998, and 1999, based
initially for 1996 on reported 1994 reconciled data  as  further  recon-
ciled  to  actual  reported  1996  reconciled  data,  and for 1997 based
initially on reported 1995 reconciled  data  as  further  reconciled  to
actual  reported  1997  reconciled  data,  for  1998  based initially on
reported 1995 reconciled data as further reconciled to  actual  reported
1998  reconciled  data, for 1999 based initially on reported 1995 recon-
ciled data as further reconciled  to  actual  reported  1999  reconciled
data,  for  2000  based  initially  on  reported 1995 reconciled data as
further reconciled to actual reported 2000 data, for 2001 based initial-
ly on reported 1995 reconciled data  as  further  reconciled  to  actual
reported 2001 data, for 2002 based initially on reported 2000 reconciled

S. 2809                            97                            A. 4009

data  as  further reconciled to actual reported 2002 data, and for state
fiscal years beginning on April 1, 2005,  based  initially  on  reported
2000  reconciled  data as further reconciled to actual reported data for
2005,  and  for  state  fiscal  years  beginning on April 1, 2006, based
initially on reported 2000 reconciled  data  as  further  reconciled  to
actual  reported  data for 2006, for state fiscal years beginning on and
after April 1, 2007 through March 31, 2009, based initially on  reported
2000  reconciled  data as further reconciled to actual reported data for
2007 and 2008, respectively, for state fiscal  years  beginning  on  and
after  April  1, 2009, based initially on reported 2007 reconciled data,
adjusted for authorized Medicaid rate changes applicable  to  the  state
fiscal year, and as further reconciled to actual reported data for 2009,
for  state  fiscal  years  beginning  on  and after April 1, 2010, based
initially on reported reconciled data from the base year two years prior
to the payment year,  adjusted  for  authorized  Medicaid  rate  changes
applicable  to  the  state fiscal year, and further reconciled to actual
reported data from such payment year, and to actual  reported  data  for
each  respective succeeding year.  The payments may be added to rates of
payment or made as aggregate payments  to  an  eligible  public  general
hospital.
  S  3.  Section  11  of  chapter  884 of the laws of 1990, amending the
public health law relating to authorizing  bad  debt  and  charity  care
allowances  for certified home health agencies, as amended by section 14
of part B of chapter 58 of the laws of  2009,  is  amended  to  read  as
follows:
  S 11. This act shall take effect immediately and:
  (a) sections one and three shall expire on December 31, 1996,
  (b)  sections  four  through ten shall expire on June 30, [2011] 2013,
and
  (c) provided that the amendment to section 2807-b of the public health
law by section two of this act shall not affect the expiration  of  such
section  2807-b  as  otherwise  provided  by  law and shall be deemed to
expire therewith.
  S 4. Subdivision 2 of section 246 of chapter 81 of the laws  of  1995,
amending  the  public  health  law  and  other  laws relating to medical
reimbursement and welfare reform, as amended by section 15 of part B  of
chapter 58 of the laws of 2009, is amended to read as follows:
  2.  Sections  five,  seven  through nine, twelve through fourteen, and
eighteen of this act shall be deemed to have  been  in  full  force  and
effect  on  and  after  April  1, 1995 through March 31, 1999 and on and
after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
through March 31, 2003 and on and after April 1, 2003 through March  31,
2006  and  on  and after April 1, 2006 through March 31, 2007 and on and
after April 1, 2007 through March 31, 2009 and on  and  after  April  1,
2009  through  March 31, 2011 AND SECTIONS TWELVE, THIRTEEN AND FOURTEEN
OF THIS ACT SHALL BE DEEMED TO BE IN FULL FORCE AND EFFECT ON AND  AFTER
APRIL 1, 2011;
  S 5. Intentionally omitted.
  S 6. Intentionally omitted.
  S  7. Paragraphs (a) and (e) of subdivision 8 of section 2807-c of the
public health law, paragraph (a) as amended by chapter 731 of  the  laws
of  1993  and  paragraph (e) as added by chapter 81 of the laws of 1995,
are amended to read as follows:
  (a) Capital related inpatient expenses including but  not  limited  to
straight  line  depreciation  on  buildings  and  non-movable equipment,
accelerated depreciation on major movable equipment if requested by  the

S. 2809                            98                            A. 4009

hospital,  rentals  and  interest  on  capital  debt  (or  for hospitals
financed pursuant  to  article  twenty-eight-B  of  this  chapter,  such
expenses,  including amortization in lieu of depreciation, as determined
pursuant  to  the reimbursement regulations promulgated pursuant to such
article and article twenty-eight of this chapter), [and excluding  costs
related  to  services  provided  to  beneficiaries of title XVIII of the
federal social security act (medicare),] shall be included in  rates  of
payment  determined pursuant to this section based on a budget for capi-
tal related inpatient expenses and  subsequently  reconciled  to  actual
expenses  and  statistics  through appropriate audit procedures. General
hospitals shall submit to the commissioner, at least one hundred  twenty
days  prior  to  the  commencement  of  each year, a schedule of capital
related inpatient expenses for the forthcoming year. Any capital expend-
iture which requires or required approval pursuant to this article  must
have received such approval for any capital related expense generated by
such  capital  expenditure to be included in rates of payment. The basis
for determining capital related inpatient expenses shall be  the  lesser
of  actual  cost  or  the  final  amount  specifically  approved for the
construction of the capital asset. The submitted budget may include  the
capital  related  inpatient  expenses for all existing capital assets as
well as estimates of capital  related  inpatient  expenses  for  capital
assets  to be acquired or placed in use prior to the commencement of the
rate year or during the rate year provided all required  approvals  have
been obtained.
  The  council shall adopt, with the approval of the commissioner, regu-
lations to:
  (i) identify by type the eligible capital related inpatient expenses;
  (ii) safeguard the future financial viability of voluntary, non-profit
general hospitals by requiring  funding  of  inpatient  depreciation  on
building and fixed and movable equipment;
  (iii)  provide  authorization  to  adjust inpatient rates by advancing
payment of depreciation as needed, in instances of capital debt  related
financial distress of voluntary, non-profit general hospitals; and
  (iv) provide a methodology for the reimbursement treatment of sales.
  (e)  Notwithstanding  any  inconsistent provision of this subdivision,
commencing April first, nineteen hundred ninety-five, when a factor  for
reconciliation  of budgeted capital related inpatient expenses to actual
capital related inpatient expenses [excluding costs related to  services
provided  to beneficiaries of title XVIII of the federal social security
act (medicare)] for a prior year is  included  in  the  capital  related
inpatient  expenses  component of rates of payment, such capital related
inpatient expenses component of rates of payment shall be reduced by the
commissioner by the difference between the  reconciled  capital  related
inpatient expenses included in rates of payment determined in accordance
with paragraphs (a), (b) and (c) of this subdivision for such prior year
and  capital  related  inpatient expenses for such prior year calculated
[based on a determination of costs related to services provided to bene-
ficiaries of title XVIII of the federal social security act  (medicare)]
based  on  the  hospital's  average  capital  related inpatient expenses
computed on a per diem basis.
  S 8. Paragraph (d) of subdivision 8 of section 2807-c  of  the  public
health law is REPEALED.
  S  9.  Section  194  of  chapter 474 of the laws of 1996, amending the
education law and other laws relating to rates  for  residential  health
care facilities, as amended by section 24 of part B of chapter 58 of the
laws of 2009, is amended to read as follows:

S. 2809                            99                            A. 4009

  S  194.  1. Notwithstanding any inconsistent provision of law or regu-
lation, the trend factors used to project reimbursable  operating  costs
to the rate period for purposes of determining rates of payment pursuant
to  article  28  of  the  public  health law for residential health care
facilities  for reimbursement of inpatient services provided to patients
eligible for payments made by state governmental agencies on  and  after
April  1, 1996 through March 31, 1999 and for payments made on and after
July 1, 1999 through March 31, 2000 and  on  and  after  April  1,  2000
through  March 31, 2003 and on and after April 1, 2003 through March 31,
2007 and on and after April 1, 2007 through March 31, 2009  and  on  and
after  April  1,  2009  through March 31, 2011 AND ON AND AFTER APRIL 1,
2011 shall reflect no trend factor projections or  adjustments  for  the
period April 1, 1996, through March 31, 1997.
  2.  The  commissioner  of health shall adjust such rates of payment to
reflect the exclusion pursuant to this section of such  specified  trend
factor projections or adjustments.
  S  10.  Subdivision  1  of section 89-a of part C of chapter 58 of the
laws of 2007, amending the social services law and other  laws  relating
to  enacting  the major components of legislation necessary to implement
the health and mental hygiene budget  for  the  2007-2008  state  fiscal
year,  as  amended  by section 25 of part B of chapter 58 of the laws of
2009, is amended to read as follows:
  1. Notwithstanding paragraph (c) of subdivision 10 of  section  2807-c
of  the  public  health  law  and section 21 of chapter 1 of the laws of
1999, as amended, and any other inconsistent provision of law  or  regu-
lation  to  the  contrary,  in  determining  rates  of payments by state
governmental agencies effective for services provided beginning April 1,
2006, through March 31, 2009, and on and after  April  1,  2009  through
March  31, 2011, AND ON AND AFTER APRIL 1, 2011 for inpatient and outpa-
tient services provided by general hospitals and for inpatient  services
and  outpatient  adult  day health care services provided by residential
health care facilities pursuant to article 28 of the public health  law,
the  commissioner of health shall apply a trend factor projection of two
and twenty-five hundredths percent attributable to the period January 1,
2006 through December 31, 2006,  and  on  and  after  January  1,  2007,
provided,  however,  that on reconciliation of such trend factor for the
period January 1, 2006 through December 31, 2006 pursuant  to  paragraph
(c)  of  subdivision 10 of section 2807-c of the public health law, such
trend factor shall be the final US Consumer Price Index  (CPI)  for  all
urban  consumers,  as published by the US Department of Labor, Bureau of
Labor Statistics less twenty-five hundredths of a percentage point.
  S 11. Paragraph (f) of subdivision 1 of section 64 of  chapter  81  of
the laws of 1995, amending the public health law and other laws relating
to medical reimbursement and welfare reform, as amended by section 26 of
part B of chapter 58 of the laws of 2009, is amended to read as follows:
  (f)  Prior  to  February  1, 2001, February 1, 2002, February 1, 2003,
February 1, 2004, February 1, 2005, February 1, 2006, February 1,  2007,
February  1, 2008, February 1, 2009, February 1, 2010, [and] February 1,
2011, FEBRUARY 1, 2012, AND FEBRUARY 1, 2013 the commissioner of  health
shall  calculate the result of the statewide total of residential health
care facility days of care provided to beneficiaries of title  XVIII  of
the  federal  social security act (medicare), divided by the sum of such
days of care plus days  of  care  provided  to  residents  eligible  for
payments  pursuant  to  title 11 of article 5 of the social services law
minus the number of days provided to residents receiving  hospice  care,
expressed  as a percentage, for the period commencing January 1, through

S. 2809                            100                           A. 4009

November 30, of the prior year respectively, based on such data for such
period. This value shall be called the 2000,  2001,  2002,  2003,  2004,
2005, 2006, 2007, 2008, 2009, 2010 [and], 2011, 2012, AND 2013 statewide
target percentage respectively.
  S  12.  Subparagraph (ii) of paragraph (b) of subdivision 3 of section
64 of chapter 81 of the laws of 1995, amending the public health law and
other laws relating to medical  reimbursement  and  welfare  reform,  as
amended  by  section  27 of part B of chapter 58 of the laws of 2009, is
amended to read as follows:
  (ii) If the 1997, 1998, 2000, 2001,  2002,  2003,  2004,  2005,  2006,
2007,  2008,  2009,  2010  [and],  2011, 2012, AND 2013 statewide target
percentages are not for each year at least three percentage points high-
er than the statewide base percentage, the commissioner of health  shall
determine  the  percentage  by which the statewide target percentage for
each year is not at least three percentage points higher than the state-
wide base percentage. The percentage calculated pursuant to  this  para-
graph  shall  be  called  the  1997, 1998, 2000, 2001, 2002, 2003, 2004,
2005, 2006, 2007, 2008, 2009, 2010 [and], 2011, 2012, AND 2013 statewide
reduction percentage respectively. If the 1997, 1998, 2000, 2001,  2002,
2003,  2004,  2005,  2006, 2007, 2008, 2009, 2010 [and], 2011, 2012, AND
2013 statewide target percentage for the respective  year  is  at  least
three  percentage  points higher than the statewide base percentage, the
statewide reduction percentage for the respective year shall be zero.
  S 13.  Subparagraph (iii) of paragraph (b) of subdivision 4 of section
64 of chapter 81 of the laws of 1995, amending the public health law and
other laws relating to medical  reimbursement  and  welfare  reform,  as
amended  by  section  28 of part B of chapter 58 of the laws of 2009, is
amended to read as follows:
  (iii) The 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007,  2008,
2009,  2010  [and],  2011, 2012, AND 2013 statewide reduction percentage
shall be multiplied by one hundred two million dollars  respectively  to
determine  the  1998,  2000,  2001,  2002, 2003, 2004, 2005, 2006, 2007,
2008, 2009,  2010  [and],  2011,  2012,  AND  2013  statewide  aggregate
reduction  amount.  If  the  1998  and the 2000, 2001, 2002, 2003, 2004,
2005, 2006, 2007, 2008, 2009, 2010 [and], 2011, 2012, AND 2013 statewide
reduction percentage shall be zero respectively, there shall be no 1998,
2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010  [and],
2011, 2012, AND 2013 reduction amount.
  S  14.  Paragraph  (b) of subdivision 5 of section 64 of chapter 81 of
the laws of 1995, amending the public health law and other laws relating
to medical reimbursement and welfare reform, as amended by section 29 of
part B of chapter 58 of the laws of 2009, is amended to read as follows:
  (b) The 1996, 1997, 1998, 1999, 2000, 2001, 2002,  2003,  2004,  2005,
2006,  2007,  2008,  2009,  2010  [and],  2011, 2012, AND 2013 statewide
aggregate reduction amounts shall for each  year  be  allocated  by  the
commissioner of health among residential health care facilities that are
eligible  to  provide  services  to  beneficiaries of title XVIII of the
federal social  security  act  (medicare)  and  residents  eligible  for
payments pursuant to title 11 of article 5 of the social services law on
the  basis  of  the  extent  of each facility's failure to achieve a two
percentage points increase  in  the  1996  target  percentage,  a  three
percentage  point  increase  in  the 1997, 1998, 2000, 2001, 2002, 2003,
2004, 2005, 2006, 2007, 2008, 2009, 2010 [and],  2011,  2012,  AND  2013
target percentage and a two and one-quarter percentage point increase in
the  1999 target percentage for each year, compared to the base percent-
age, calculated on a facility specific basis for this purpose,  compared

S. 2809                            101                           A. 4009

to  the  statewide  total  of  the  extent of each facility's failure to
achieve a two percentage  points  increase  in  the  1996  and  a  three
percentage  point  increase  in  the  1997  and a three percentage point
increase in the 1998 and a two and one-quarter percentage point increase
in  the  1999 target percentage and a three percentage point increase in
the 2000, 2001, 2002, 2003, 2004, 2005, 2006,  2007,  2008,  2009,  2010
[and],  2011,  2012,  AND  2013  target  percentage compared to the base
percentage. These amounts shall be called the 1996,  1997,  1998,  1999,
2000,  2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010 [and],
2011, 2012, AND 2013 facility specific reduction amounts respectively.
  S 14-a. Section 228 of chapter 474 of the laws of 1996,  amending  the
education  law  and  other laws relating to rates for residential health
care facilities, as amended by section 30 of part B of chapter 58 of the
laws of 2009, is amended to read as follows:
  S 228. 1. Definitions. (a) Regions,  for  purposes  of  this  section,
shall  mean  a downstate region to consist of Kings, New York, Richmond,
Queens, Bronx, Nassau and Suffolk counties  and  an  upstate  region  to
consist  of  all  other New York state counties. A certified home health
agency or long term home health care program shall  be  located  in  the
same county utilized by the commissioner of health for the establishment
of rates pursuant to article 36 of the public health law.
  (b)  Certified  home  health  agency  (CHHA)  shall  mean such term as
defined in section 3602 of the public health law.
  (c) Long term home health care program (LTHHCP) shall mean  such  term
as defined in subdivision 8 of section 3602 of the public health law.
  (d) Regional group shall mean all those CHHAs and LTHHCPs, respective-
ly, located within a region.
  (e)  Medicaid  revenue percentage, for purposes of this section, shall
mean CHHA and LTHHCP  revenues  attributable  to  services  provided  to
persons  eligible  for payments pursuant to title 11 of article 5 of the
social services law divided by such revenues plus CHHA and LTHHCP reven-
ues attributable to services provided to beneficiaries of Title XVIII of
the federal social security act (medicare).
  (f) Base period, for purposes of this  section,  shall  mean  calendar
year 1995.
  (g) Target period. For purposes of this section, the 1996 target peri-
od  shall  mean  August  1, 1996 through March 31, 1997, the 1997 target
period shall mean January 1, 1997 through November 30,  1997,  the  1998
target  period shall mean January 1, 1998 through November 30, 1998, the
1999 target period shall mean January 1, 1999 through November 30, 1999,
the 2000 target period shall mean January 1, 2000 through  November  30,
2000, the 2001 target period shall mean January 1, 2001 through November
30,  2001,  the  2002  target  period shall mean January 1, 2002 through
November 30, 2002, the 2003 target period shall  mean  January  1,  2003
through  November 30, 2003, the 2004 target period shall mean January 1,
2004 through November 30, 2004, and the 2005 target  period  shall  mean
January  1, 2005 through November 30, 2005, the 2006 target period shall
mean January 1, 2006 through November 30,  2006,  and  the  2007  target
period shall mean January 1, 2007 through November 30, 2007 and the 2008
target  period shall mean January 1, 2008 through November 30, 2008, and
the 2009 target period shall mean January 1, 2009 through  November  30,
2009  and  the  2010  target  period  shall mean January 1, 2010 through
November 30, 2010 and the 2011 target period shall mean January 1,  2011
through  November 30, 2011 AND THE 2012 TARGET PERIOD SHALL MEAN JANUARY
1, 2012 THROUGH NOVEMBER 30, 2012 AND THE 2013 TARGET PERIOD SHALL  MEAN
JANUARY 1, 2013 THROUGH NOVEMBER 30, 2013.

S. 2809                            102                           A. 4009

  2.  (a) Prior to February 1, 1997, for each regional group the commis-
sioner of health shall calculate the 1996 medicaid  revenue  percentages
for the period commencing August 1, 1996 to the last date for which such
data is available and reasonably accurate.
  (b)  Prior  to  February  1, 1998, prior to February 1, 1999, prior to
February 1, 2000, prior to February 1, 2001, prior to February 1,  2002,
prior  to February 1, 2003, prior to February 1, 2004, prior to February
1, 2005, prior to February 1, 2006, prior to February 1, 2007, prior  to
February  1,  2008, prior to February 1, 2009, prior to February 1, 2010
[and], prior to February 1, 2011, PRIOR TO FEBRUARY 1, 2012 AND PRIOR TO
FEBRUARY 1, 2013 for each regional  group  the  commissioner  of  health
shall  calculate  the  prior year's medicaid revenue percentages for the
period commencing January 1 through November 30 of such prior year.
  3. By September 15, 1996, for each regional group the commissioner  of
health shall calculate the base period medicaid revenue percentage.
  4.  (a)  For  each  regional  group,  the 1996 target medicaid revenue
percentage shall be calculated by subtracting the 1996 medicaid  revenue
reduction percentages from the base period medicaid revenue percentages.
The  1996  medicaid  revenue  reduction  percentage, taking into account
regional and program differences in utilization of medicaid and medicare
services, for the following regional groups shall be equal to:
  (i) one and one-tenth percentage points for CHHAs located  within  the
downstate region;
  (ii)  six-tenths  of one percentage point for CHHAs located within the
upstate region;
  (iii) one and eight-tenths percentage points for LTHHCPs located with-
in the downstate region; and
  (iv) one and seven-tenths percentage points for LTHHCPs located within
the upstate region.
  (b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004,  2005,  2006,  2007,
2008,  2009,  2010  [and], 2011, 2012, AND 2013 for each regional group,
the target medicaid revenue percentage for the respective year shall  be
calculated   by  subtracting  the  respective  year's  medicaid  revenue
reduction percentage from the base period medicaid  revenue  percentage.
The  medicaid  revenue reduction percentages for 1997, 1998, 2000, 2001,
2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010 [and], 2011,  2012,
AND  2013 taking into account regional and program differences in utili-
zation of medicaid and medicare services,  for  the  following  regional
groups shall be equal to for each such year:
  (i)  one  and one-tenth percentage points for CHHAs located within the
downstate region;
  (ii) six-tenths of one percentage point for CHHAs located  within  the
upstate region;
  (iii) one and eight-tenths percentage points for LTHHCPs located with-
in the downstate region; and
  (iv) one and seven-tenths percentage points for LTHHCPs located within
the upstate region.
  (c) For each regional group, the 1999 target medicaid revenue percent-
age  shall  be  calculated  by  subtracting  the  1999  medicaid revenue
reduction percentage from the base period medicaid  revenue  percentage.
The  1999  medicaid  revenue  reduction percentages, taking into account
regional and program differences in utilization of medicaid and medicare
services, for the following regional groups shall be equal to:
  (i) eight hundred twenty-five thousandths  (.825)  of  one  percentage
point for CHHAs located within the downstate region;

S. 2809                            103                           A. 4009

  (ii)  forty-five  hundredths  (.45)  of one percentage point for CHHAs
located within the upstate region;
  (iii)  one  and  thirty-five  hundredths  percentage points (1.35) for
LTHHCPs located within the downstate region; and
  (iv) one and two hundred seventy-five  thousandths  percentage  points
(1.275) for LTHHCPs located within the upstate region.
  5.  (a) For each regional group, if the 1996 medicaid revenue percent-
age is not equal to or  less  than  the  1996  target  medicaid  revenue
percentage,  the  commissioner of health shall compare the 1996 medicaid
revenue percentage to the 1996 target  medicaid  revenue  percentage  to
determine  the  amount  of the shortfall which, when divided by the 1996
medicaid  revenue  reduction  percentage,  shall  be  called  the   1996
reduction  factor.  These  amounts, expressed as a percentage, shall not
exceed one hundred percent. If the 1996 medicaid revenue  percentage  is
equal  to  or less than the 1996 target medicaid revenue percentage, the
1996 reduction factor shall be zero.
  (b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003,  2004,  2005,  2006,
2007,  2008,  2009,  2010  [and], 2011, 2012, AND 2013 for each regional
group, if the medicaid revenue percentage for the respective year is not
equal to or less than the target medicaid revenue  percentage  for  such
respective  year,  the commissioner of health shall compare such respec-
tive year's medicaid revenue percentage to such respective year's target
medicaid revenue percentage to determine the  amount  of  the  shortfall
which,  when divided by the respective year's medicaid revenue reduction
percentage, shall be called the reduction  factor  for  such  respective
year.  These  amounts,  expressed  as a percentage, shall not exceed one
hundred percent. If the medicaid revenue  percentage  for  a  particular
year is equal to or less than the target medicaid revenue percentage for
that year, the reduction factor for that year shall be zero.
  6.  (a)  For  each  regional group, the 1996 reduction factor shall be
multiplied by the following amounts to determine each  regional  group's
applicable 1996 state share reduction amount:
  (i) two million three hundred ninety thousand dollars ($2,390,000) for
CHHAs located within the downstate region;
  (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
within the upstate region;
  (iii)  one  million  two hundred seventy thousand dollars ($1,270,000)
for LTHHCPs located within the downstate region; and
  (iv) five hundred  ninety  thousand  dollars  ($590,000)  for  LTHHCPs
located within the upstate region.
  For  each regional group reduction, if the 1996 reduction factor shall
be zero, there shall be no 1996 state share reduction amount.
  (b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004,  2005,  2006,  2007,
2008,  2009,  2010  [and], 2011, 2012, AND 2013 for each regional group,
the reduction factor for the respective year shall be multiplied by  the
following  amounts  to  determine each regional group's applicable state
share reduction amount for such respective year:
  (i) two million three hundred ninety thousand dollars ($2,390,000) for
CHHAs located within the downstate region;
  (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
within the upstate region;
  (iii) one million two hundred seventy  thousand  dollars  ($1,270,000)
for LTHHCPs located within the downstate region; and
  (iv)  five  hundred  ninety  thousand  dollars  ($590,000) for LTHHCPs
located within the upstate region.

S. 2809                            104                           A. 4009

  For each regional group reduction,  if  the  reduction  factor  for  a
particular  year  shall be zero, there shall be no state share reduction
amount for such year.
  (c) For each regional group, the 1999 reduction factor shall be multi-
plied by the following amounts to determine each regional group's appli-
cable 1999 state share reduction amount:
  (i) one million seven hundred ninety-two thousand five hundred dollars
($1,792,500) for CHHAs located within the downstate region;
  (ii)  five  hundred sixty-two thousand five hundred dollars ($562,500)
for CHHAs located within the upstate region;
  (iii) nine hundred fifty-two thousand five hundred dollars  ($952,500)
for LTHHCPs located within the downstate region; and
  (iv)  four  hundred forty-two thousand five hundred dollars ($442,500)
for LTHHCPs located within the upstate region.
  For each regional group reduction, if the 1999 reduction factor  shall
be zero, there shall be no 1999 state share reduction amount.
  7.  (a) For each regional group, the 1996 state share reduction amount
shall be allocated by the commissioner of health among CHHAs and LTHHCPs
on the basis of the extent  of  each  CHHA's  and  LTHHCP's  failure  to
achieve  the  1996  target  medicaid revenue percentage, calculated on a
provider specific basis utilizing revenues for this  purpose,  expressed
as  a  proportion  of  the  total of each CHHA's and LTHHCP's failure to
achieve the 1996 target medicaid revenue percentage within the  applica-
ble  regional group. This proportion shall be multiplied by the applica-
ble 1996 state share reduction amount calculation pursuant to  paragraph
(a)  of  subdivision  6 of this section. This amount shall be called the
1996 provider specific state share reduction amount.
  (b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003,  2004,  2005,  2006,
2007,  2008,  2009,  2010  [and], 2011, 2012, AND 2013 for each regional
group, the state share reduction amount for the respective year shall be
allocated by the commissioner of health among CHHAs and LTHHCPs  on  the
basis  of  the extent of each CHHA's and LTHHCP's failure to achieve the
target medicaid revenue percentage for the applicable  year,  calculated
on  a  provider  specific  basis  utilizing  revenues  for this purpose,
expressed as a proportion of the total of each CHHA's and LTHHCP's fail-
ure to achieve the target medicaid revenue percentage for the applicable
year within the applicable regional  group.  This  proportion  shall  be
multiplied  by the applicable year's state share reduction amount calcu-
lation pursuant to paragraph  (b)  or  (c)  of  subdivision  6  of  this
section.  This  amount shall be called the provider specific state share
reduction amount for the applicable year.
  8. (a) The 1996 provider specific state share reduction  amount  shall
be due to the state from each CHHA and LTHHCP and may be recouped by the
state  by  March  31, 1997 in a lump sum amount or amounts from payments
due to the CHHA and LTHHCP pursuant to title 11  of  article  5  of  the
social services law.
  (b) The provider specific state share reduction amount for 1997, 1998,
1999,  2000,  2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010
[and], 2011, 2012, AND 2013 respectively, shall be due to the state from
each CHHA and LTHHCP and each year the amount due for such year  may  be
recouped  by  the  state by March 31 of the following year in a lump sum
amount or amounts from payments due to the CHHA and LTHHCP  pursuant  to
title 11 of article 5 of the social services law.
  9.  CHHAs  and  LTHHCPs shall submit such data and information at such
times as the commissioner of health may require  for  purposes  of  this

S. 2809                            105                           A. 4009

section.  The  commissioner of health may use data available from third-
party payors.
  10. On or about June 1, 1997, for each regional group the commissioner
of  health  shall  calculate for the period August 1, 1996 through March
31, 1997 a medicaid revenue percentage,  a  reduction  factor,  a  state
share  reduction  amount,  and a provider specific state share reduction
amount in accordance with the methodology provided in paragraph  (a)  of
subdivision 2, paragraph (a) of subdivision 5, paragraph (a) of subdivi-
sion  6 and paragraph (a) of subdivision 7 of this section. The provider
specific state share reduction amount calculated in accordance with this
subdivision shall be compared to the 1996 provider specific state  share
reduction amount calculated in accordance with paragraph (a) of subdivi-
sion 7 of this section. Any amount in excess of the amount determined in
accordance  with paragraph (a) of subdivision 7 of this section shall be
due to the state from each CHHA  and  LTHHCP  and  may  be  recouped  in
accordance  with  paragraph (a) of subdivision 8 of this section. If the
amount is less than the amount determined in accordance  with  paragraph
(a)  of  subdivision 7 of this section, the difference shall be refunded
to the CHHA and LTHHCP by the state no later than July 15,  1997.  CHHAs
and  LTHHCPs  shall  submit  data  for the period August 1, 1996 through
March 31, 1997 to the commissioner of health by April 15, 1997.
  11. If a CHHA or LTHHCP  fails  to  submit  data  and  information  as
required for purposes of this section:
  (a) such CHHA or LTHHCP shall be presumed to have no decrease in medi-
caid  revenue  percentage  between  the  applicable  base period and the
applicable target period for purposes of the  calculations  pursuant  to
this section; and
  (b)  the  commissioner of health shall reduce the current rate paid to
such CHHA and such LTHHCP by state  governmental  agencies  pursuant  to
article  36  of the public health law by one percent for a period begin-
ning on the first day of the calendar month following the applicable due
date as established by the commissioner of health and  continuing  until
the last day of the calendar month in which the required data and infor-
mation are submitted.
  12. The commissioner of health shall inform in writing the director of
the  budget  and the chair of the senate finance committee and the chair
of the assembly ways and means committee of the results  of  the  calcu-
lations pursuant to this section.
  S  15.  Subdivision  5-a  of  section 246 of chapter 81 of the laws of
1995, amending the public health law and other laws relating to  medical
reimbursement  and welfare reform, as amended by section 32 of part B of
chapter 58 of the laws of 2009, is amended to read as follows:
  5-a. Section sixty-four-a of this act shall be deemed to have been  in
full  force and effect on and after April 1, 1995 through March 31, 1999
and on and after July 1, 1999 through March 31, 2000 and  on  and  after
April  1,  2000  through  March  31, 2003 and on and after April 1, 2003
through March 31, 2007, and on and after April 1, 2007 through March 31,
2009, and on and after April 1, 2009 through March 31, 2011, AND ON  AND
AFTER APRIL 1, 2011;
  S  16.  Section  64-b  of chapter 81 of the laws of 1995, amending the
public health law and other laws relating to medical  reimbursement  and
welfare  reform, as amended by section 33 of part B of chapter 58 of the
laws of 2009, is amended to read as follows:
  S  64-b.  Notwithstanding  any  inconsistent  provision  of  law,  the
provisions of subdivision 7 of section 3614 of the public health law, as
amended,  shall  remain and be in full force and effect on April 1, 1995

S. 2809                            106                           A. 4009

through March 31, 1999 and on July 1, 1999 through March 31, 2000 and on
and after April 1, 2000 through March 31, 2003 and on and after April 1,
2003 through March 31, 2007, and on and  after  April  1,  2007  through
March  31,  2009, and on and after April 1, 2009 through March 31, 2011,
AND ON AND AFTER APRIL 1, 2011.
  S 17. Subdivision 1 of section 20 of chapter 451 of the laws of  2007,
amending  the  public health law, the social services law and the insur-
ance  law,  relating  to  providing  enhanced  consumer   and   provider
protections,  as  amended  by  section 38 of part B of chapter 58 of the
laws of 2009, is amended to read as follows:
  1. sections four, eleven and thirteen  of this act shall  take  effect
immediately  and  shall  expire  and  be deemed repealed June 30, [2011]
2013;
  S 18. The opening paragraph of subdivision 7-a of section 3614 of  the
public  health  law, as amended by section 46 of part B of chapter 58 of
the laws of 2009, is amended to read as follows:
  Notwithstanding any inconsistent provision of law or  regulation,  for
the  purposes  of establishing rates of payment by governmental agencies
for long term home health care programs for the period April first,  two
thousand five, through December thirty-first, two thousand five, and for
the  period  January first, two thousand six through March thirty-first,
two thousand seven, and on and after April  first,  two  thousand  seven
through  March  thirty-first,  two thousand nine, and on and after April
first, two thousand nine through March thirty-first, two thousand  elev-
en,  AND ON AND AFTER APRIL FIRST, TWO THOUSAND ELEVEN, the reimbursable
base year administrative and general costs of  a  provider  of  services
shall  not  exceed the statewide average of total reimbursable base year
administrative and general costs of such providers of services.
  S 19. Subdivisions 3, 4 and 5 of section 47 of chapter 2 of  the  laws
of  1998,  amending  the  public  health  law and other laws relating to
expanding the child health insurance plan, as amended by section  24  of
part  A  of  chapter  58  of  the  laws  of 2007, are amended to read as
follows:
  3. section six  of  this  act  shall  take  effect  January  1,  1999;
[provided, however, that subparagraph (iii) of paragraph (c) of subdivi-
sion  9  of section 2510 of the public health law, as added by this act,
shall expire on July 1, 2011;]
  4. sections two, three, four, seven, eight, nine,  fourteen,  fifteen,
sixteen,  eighteen,  eighteen-a,  twenty-three, twenty-four, and twenty-
nine of this act shall take effect January 1, 1999 [and shall expire  on
July  1,  2011];  section  twenty-five  of this act shall take effect on
January 1, 1999 and shall expire on April 1, 2005;
  5. section twelve of this act  shall  take  effect  January  1,  1999;
[provided,  however,  paragraphs (g) and (h) of subdivision 2 of section
2511 of the public health law, as added by such section, shall expire on
July 1, 2011;]
  S 20. Section 10 of chapter 649 of the  laws  of  1996,  amending  the
public  health  law,  the mental hygiene law and the social services law
relating to authorizing the establishment of  special  needs  plans,  as
amended  by  section  63 of part C of chapter 58 of the laws of 2008, is
amended to read as follows:
  S 10. This act shall take effect immediately and shall  be  deemed  to
have been in full force and effect on and after July 1, 1996; [provided,
however,  that  sections one, two and three of this act shall expire and
be deemed repealed on March 31, 2012] provided, however that the  amend-
ments  to  section 364-j of the social services law made by section four

S. 2809                            107                           A. 4009

of this act shall not affect the expiration of such section and shall be
deemed to expire therewith and provided, further, that the provisions of
subdivisions 8, 9 and 10 of section 4401 of the public  health  law,  as
added  by  section  one of this act; section 4403-d of the public health
law as added by section two of this act and the  provisions  of  section
seven  of this act, except for the provisions relating to the establish-
ment of no more than twelve comprehensive HIV special needs plans, shall
expire and be deemed repealed on July 1, 2000.
  S 21. Subdivision (i-1) of section 79 of part C of chapter 58  of  the
laws of 2008, amending the social services law and the public health law
relating to adjustments of rates, is amended to read as follows:
  (i-1)  section  thirty-one-a of this act shall be deemed repealed July
1, [2011] 2014;
  S 22. Section 2 of chapter 535 of  the  laws  of  1983,  amending  the
social  services  law  relating  to eligibility of certain enrollees for
medical assistance, as amended by section 69 of part C of chapter 58  of
the laws of 2008, is amended to read as follows:
  S  2. This act shall take effect immediately [and shall remain in full
force and effect through March 31, 2012].
  S 23. Subdivision 12 of section 246 of chapter 81 of the laws of 1995,
amending the public health  law  and  other  laws  relating  to  medical
reimbursement  and welfare reform, as amended by section 56 of part C of
chapter 58 of the laws of 2008, is amended to read as follows:
  12. Sections one hundred five-b through one hundred five-f of this act
shall expire March 31, [2011] 2013.
  S 24. Section 4 of chapter 19 of the laws of 1998, amending the social
services law relating to limiting the method of payment for prescription
drugs under the medical assistance program, as amended by section 68  of
part C of chapter 58 of the laws of 2008, is amended to read as follows:
  S  4. This act shall take effect 120 days after it shall have become a
law and shall expire and be deemed repealed March 31, [2012] 2014.
  S 25. Section 11 of chapter 710 of the  laws  of  1988,  amending  the
social services law and the education law relating to medical assistance
eligibility  of  certain  persons and providing for managed medical care
demonstration programs, as amended by section 66 of part C of chapter 58
of the laws of 2008, is amended to read as follows:
  S 11.  This  act  shall  take  effect  immediately;  except  that  the
provisions  of sections one, two, three, four, eight and ten of this act
shall take effect on the ninetieth day after it shall have become a law;
and except that the provisions of sections five, six and seven  of  this
act  shall  take effect January 1, 1989; and except that effective imme-
diately, the addition, amendment and/or repeal of any rule or regulation
necessary for the implementation of this act on its effective  date  are
authorized  and  directed  to  be  made  and completed on or before such
effective date; provided, however, that [the provisions of section 364-j
of the social services law, as added by section one of  this  act  shall
expire  and  be  deemed  repealed  on  and  after  March  31, 2012,] the
provisions of section 364-k of the social  services  law,  as  added  by
section  two  of  this act, except subdivision 10 of such section, shall
expire and be deemed repealed on and after  January  1,  1994,  and  the
provisions  of  subdivision  10  of section 364-k of the social services
law, as added by section two of this act, shall  expire  and  be  deemed
repealed on January 1, 1995.
  S  26.  Subdivision  (c)  of  section 62 of chapter 165 of the laws of
1991, amending the public health law and other laws relating  to  estab-

S. 2809                            108                           A. 4009

lishing  payments  for  medical  assistance, as amended by section 67 of
part C of chapter 58 of the laws of 2008, is amended to read as follows:
  (c)  [section  364-j of the social services law, as amended by section
eight of this act and subdivision 6  of  section  367-a  of  the  social
services  law as added by section twelve of this act shall expire and be
deemed repealed on March 31, 2012 and provided further, that] the amend-
ments to the provisions of section 364-j of the social services law MADE
BY SECTION EIGHT OF THIS ACT shall only apply to managed  care  programs
approved on or after the effective date of this act;
  S  26-a.  Subdivision  (x) of section 165 of chapter 41 of the laws of
1992, amending the public health law and other laws relating  to  health
care providers, is REPEALED.
  S 27. Notwithstanding any inconsistent provision of law, rule or regu-
lation, for purposes of implementing the provisions of the public health
law and the social services law, references to titles XIX and XXI of the
federal  social  security  act  in  the public health law and the social
services law shall be deemed to include and also to mean  any  successor
titles thereto under the federal social security act.
  S 28. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the  public health law, section 18 of chapter 2 of the laws of 1988, and
18 NYCRR 505.14(h), as they relate to time frames for  notice,  approval
or  certification  of rates of payment, are hereby suspended and without
force or effect for purposes of implementing the provisions of this act.
  S 29. Severability clause. If any clause, sentence, paragraph,  subdi-
vision,  section  or  part of this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment  shall  not  affect,
impair or invalidate the remainder thereof, but shall be confined in its
operation  to  the  clause, sentence, paragraph, subdivision, section or
part thereof directly involved in the controversy in which  such  judge-
ment shall have been rendered. It is hereby declared to be the intent of
the  legislature  that  this  act  would  have been enacted even if such
invalid provisions had not been included herein.
  S 30. This act shall take effect immediately and shall  be  deemed  to
have been in full force and effect on and after April 1, 2011.

                                 PART E

  Section 1. Section 366 of the social services law is amended by adding
a new subdivision 1-b to read as follows:
  1-B.  NOTWITHSTANDING  ANY OTHER PROVISION OF LAW, IN THE EVENT THAT A
PERSON WHO IS AN INPATIENT IN AN INSTITUTION  FOR  MENTAL  DISEASES,  AS
DEFINED  BY  FEDERAL  LAW  AND  REGULATIONS,  AND  WHO WAS IN RECEIPT OF
MEDICAL ASSISTANCE PURSUANT TO THIS TITLE  IMMEDIATELY  PRIOR  TO  BEING
ADMITTED TO SUCH FACILITY, OR WHO WAS DIRECTLY ADMITTED TO SUCH FACILITY
AFTER  BEING AN INPATIENT IN ANOTHER INSTITUTION FOR MENTAL DISEASES AND
WHO WAS IN RECEIPT OF MEDICAL ASSISTANCE  PRIOR  TO  ADMISSION  TO  SUCH
TRANSFERRING  INSTITUTION, SUCH PERSON SHALL REMAIN ELIGIBLE FOR MEDICAL
ASSISTANCE WHILE AN INPATIENT IN SUCH FACILITY; PROVIDED, HOWEVER,  THAT
NO  MEDICAL ASSISTANCE SHALL BE FURNISHED PURSUANT TO THIS TITLE FOR ANY
CARE, SERVICES, OR SUPPLIES PROVIDED DURING THE TIME THAT SUCH PERSON IS
AN INPATIENT, EXCEPT TO THE EXTENT THAT FEDERAL FINANCIAL  PARTICIPATION
IS  AVAILABLE  FOR  THE  COSTS OF SUCH CARE, SERVICES, OR SUPPLIES. UPON
RELEASE FROM SUCH FACILITY, SUCH PERSON SHALL CONTINUE  TO  BE  ELIGIBLE
FOR RECEIPT OF MEDICAL ASSISTANCE FURNISHED PURSUANT TO THIS TITLE UNTIL
SUCH  TIME  AS  THE  PERSON  IS  DETERMINED TO NO LONGER BE ELIGIBLE FOR

S. 2809                            109                           A. 4009

RECEIPT OF SUCH ASSISTANCE. TO THE EXTENT PERMITTED BY FEDERAL LAW,  THE
TIME  DURING  WHICH  SUCH  PERSON  IS AN INPATIENT IN AN INSTITUTION FOR
MENTAL DISEASES SHALL NOT BE INCLUDED IN ANY  CALCULATION  OF  WHEN  THE
PERSON  MUST  RECERTIFY HIS OR HER ELIGIBILITY FOR MEDICAL ASSISTANCE IN
ACCORDANCE WITH THIS ARTICLE.
  S 2. Paragraph (c) of subdivision 1  of  section  366  of  the  social
services  law, as amended by chapter 355 of the laws of 2007, is amended
to read as follows:
  (c) except as provided in subparagraph six of paragraph  (a)  of  this
subdivision  or  subdivision one-a OR SUBDIVISION ONE-B of this section,
is not an inmate or  patient  in  an  institution  or  facility  wherein
medical  assistance  for needy persons may not be provided in accordance
with applicable federal or state requirements; and
  S 3. This act shall take effect  April  1,  2011;  provided  that  all
actions  necessary  for the timely implementation of this act, including
revisions to  information,  eligibility  and  benefit  computer  systems
utilized by social services districts and administered by the department
of  health of the state of New York, shall be taken prior to such effec-
tive date so that the provisions of this act may be implemented on  such
date.

                                 PART F

  Section  1. Subdivisions 3-b and 3-c of section 1 of part C of chapter
57 of the laws of 2006,  relating  to  establishing  a  cost  of  living
adjustment for designated human services programs, as amended by section
1  of  part F of chapter 111 of the laws of 2010, are amended to read as
follows:
  3-b. Notwithstanding any  inconsistent  provision  of  law,  beginning
April  1, 2009 and ending March 31, [2011] 2012, the commissioners shall
not include a COLA for the purpose of establishing  rates  of  payments,
contracts or any other form of reimbursement.
  3-c.  Notwithstanding  any  inconsistent  provision  of law, beginning
April 1, [2011] 2012 and ending March 31, [2014] 2015, the commissioners
shall develop the COLA under this section using the actual U.S. consumer
price index for all urban consumers  (CPI-U)  published  by  the  United
States  department  of  labor, bureau of labor statistics for the twelve
month period ending in July of the  budget  year  prior  to  such  state
fiscal  year,  for  the  purpose  of  establishing  rates  of  payments,
contracts or any other form of reimbursement.
  S 2. Section 4 of part C of chapter 57 of the laws of  2006,  relating
to  establishing  a  cost  of  living  adjustment  for  designated human
services programs, as amended by section 2 of part F of chapter  111  of
the laws of 2010, is amended to read as follows:
  S  4.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2006;  provided
section  one  of  this  act shall expire and be deemed repealed April 1,
[2014] 2015; provided, further, that sections two and three of this  act
shall expire and be deemed repealed December 31, 2009.
  S  3.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2011; provided,
however, that the amendments to section 1 of part C of chapter 57 of the
laws of 2006 made by section one of this act shall not affect the repeal
of such section and shall be deemed repealed therewith.

                                 PART G

S. 2809                            110                           A. 4009

  Section 1. Subdivision (b) of section 7.17 of the mental hygiene  law,
as  amended by section 1 of part J of chapter 58 of the laws of 2005, is
amended to read as follows:
  (b)  There  shall  be  in the office the hospitals named below for the
care, treatment and rehabilitation of [the  mentally  disabled]  PERSONS
WITH  MENTAL  ILLNESS  and  for research and teaching in the science and
skills required for the  care,  treatment  and  rehabilitation  of  such
[mentally disabled] PERSONS WITH MENTAL ILLNESS.
  Greater Binghamton Health Center
  Bronx Psychiatric Center
  Buffalo Psychiatric Center
  Capital District Psychiatric Center
  Central New York Psychiatric Center
  Creedmoor Psychiatric Center
  Elmira Psychiatric Center
  Hudson River Psychiatric Center
  Kingsboro Psychiatric Center
  Kirby Forensic Psychiatric Center
  Manhattan Psychiatric Center
  Mid-Hudson Forensic Psychiatric Center
  Mohawk Valley Psychiatric Center
  Nathan S. Kline Institute for Psychiatric Research
  New York State Psychiatric Institute
  Pilgrim Psychiatric Center
  Richard H. Hutchings Psychiatric Center
  Rochester Psychiatric Center
  Rockland Psychiatric Center
  St. Lawrence Psychiatric Center
  South Beach Psychiatric Center
  Bronx Children's Psychiatric Center
  Brooklyn Children's [Psychiatric] Center
  Queens Children's Psychiatric Center
  Rockland Children's Psychiatric Center
  Sagamore Children's Psychiatric Center
  Western New York Children's Psychiatric Center
  The  New  York  State  Psychiatric  Institute  and The Nathan S. Kline
Institute for Psychiatric Research are designated as institutes for  the
conduct  of medical research and other scientific investigation directed
towards furthering knowledge of the etiology, diagnosis,  treatment  and
prevention  of  mental  illness.    THE  BROOKLYN CHILDREN'S CENTER IS A
FACILITY OPERATED BY THE OFFICE TO PROVIDE COMMUNITY-BASED MENTAL HEALTH
SERVICES FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCES.
  S 2. Subdivision (e) of section 7.17 of  the  mental  hygiene  law  is
REPEALED and subdivision (f) is relettered subdivision (e).
  S  3. (a) Notwithstanding the provisions of subdivision (b) of section
7.17 of the mental hygiene law, section 41.55 of the mental hygiene law,
or any other law to the contrary, the office of mental health is author-
ized in state fiscal year 2011-12 to close, consolidate, reduce,  trans-
fer  or  otherwise  redesign services of hospitals, other facilities and
programs operated by the office  of  mental  health,  and  to  implement
significant  service  reductions and reconfigurations as shall be deter-
mined by the commissioner of mental health to be necessary for the cost-
effective and efficient operation of such  hospitals,  other  facilities
and programs.
  (b)  The  office of mental health shall provide notice upon its public
website and to the legislature as soon as possible, but  no  later  than

S. 2809                            111                           A. 4009

two  weeks  prior to the anticipated closure, consolidation, or transfer
of inpatient wards.
  (c)  Any  transfers of inpatient capacity or any resulting transfer of
functions shall be authorized to be made by the commissioner  of  mental
health  and  any transfer of personnel upon such transfer of capacity or
transfer of functions shall  be  accomplished  in  accordance  with  the
provisions of section 70 of the civil service law.
  S 4. Severability clause. If any clause, sentence, paragraph, subdivi-
sion,  section  or  part  of  this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment  shall  not  affect,
impair,  or  invalidate  the remainder thereof, but shall be confined in
its operation to the clause, sentence, paragraph,  subdivision,  section
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the  legislature  that  this  act  would  have been enacted even if such
invalid provisions had not been included herein.
  S 5. This act shall take effect  April  1,  2011;  provided  that  the
amendments  to subdivision (f) of section 7.17 of the mental hygiene law
made by section two of this act shall not  affect  the  repeal  of  such
subdivision and shall be deemed repealed therewith.
  S 2. Severability clause. If any clause, sentence, paragraph, subdivi-
sion,  section  or  part  of  this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment  shall  not  affect,
impair,  or  invalidate  the remainder thereof, but shall be confined in
its operation to the clause, sentence, paragraph,  subdivision,  section
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the  legislature  that  this  act  would  have been enacted even if such
invalid provisions had not been included herein.
  S 3. This act shall take effect immediately  provided,  however,  that
the  applicable effective date of Parts A through G of this act shall be
as specifically set forth in the last section of such Parts.

S2809A - Bill Details

See Assembly Version of this Bill:
A4009D
Law Section:
Budget Bills
Laws Affected:
Amd Various Laws, generally

S2809A - Bill Texts

view summary

Relates to Medicare part D; relates to early intervention services; relates to tobacco control and insurance initiatives pool distributions; relates to clinical laboratories; relates to the distribution of HEAL NY capital grants; extends numerous provisions of law; repeals provisions of law relating to elderly pharmaceutical insurance; relates to rates of payment and medical assistance; relates to the distribution of pool allocations and graduate medical education; relates to health care initiative pool distributions; extends payment provisions for general hospitals; extends access to community health care services in rural areas; continues the priority restoration adjustment; relates to medical and professional malpractice insurance; relates to the liquidation of domestic insurers; relates to rates of payment for personal care service providers, residential health care facilities and diagnostic and treatment centers; relates to payments to residential health care facilities and other reimbursements; authorizes bad debt and charity care allowances for certified home health agencies; relates to capital related inpatient expenses; relates to rates of payment for long term home health care programs; relates to the effectiveness of the child health insurance plan; relates to the suspension of eligibility for medical assistance; foregoes certain adjustments during the 2011-2012 state fiscal year; relates to the closure and the reduction in size of certain facilities serving persons with mental illness; relates to general hospital inpatient reimbursement for annual rates; establishes ceiling limitations for certain rates of payment; repeals certain provisions of the social services law relating to prescription drug payments; initiates a study to determine costs incurred by public school districts for certain medical care, services and supplies; relates to the calculation of capital costs; relates to the HIV special needs plan; relates to the pharmacy and therapeutics committee and the preferred drug program; relates to covered part D drugs, limited coverage for formula therapy, prescription footwear, speech therapy, physical therapy and occupational therapy, payment for home health care nursing services, and coverage for smoking cessation counseling services, the furnishing of medical assistance to applicants with responsible relatives, and mail order prescriptions; relates to the commissioner of health's authority to negotiate agreements resolving multiple pending rate appeals; relates to diagnostic care centers; relates to temporary operator certificates for general hospitals or diagnostic and treatment centers; relates to health home services; relates to managed long term care plans and residential health care facilities; relates to insurance co-payments; provides palliative care support for patients with advanced life limiting conditions and illnesses; relates to the provision of home health care services; establishes a workgroup to develop a plan and draft legislation for the purpose of operating and managing public nursing homes; encourages cooperative, collaborative and integrative arrangements between health care providers, payers, and others; relates to the definition of estate; relates to the New York state medical indemnity fund and the New York state hospital quality initiative; requires compliance with operational standards by hospitals and providers of services in hospitals; creates an accountable care organization demonstration program; limits the reporting of death by the operator of an adult home or residence; requires preclaim review for participating providers of medical assistance program items and services; relates to seeking federal approvals to establish payment methodologies with accountable care organizations; relates to medical assistance for needy persons; relates to the character and adequacy of assistance; relates to residential health care facility supplemental payments, non-capital components of rates, and temporary nursing home stability contributions; authorizes the commissioner of health to enter into contracts for purposes of the Early Innovator federal grant award; and relates to applications for orders of rehabilitation or liquidation.

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

    S. 2809--A                                            A. 4009--A

                      S E N A T E - A S S E M B L Y

                            February 1, 2011
                               ___________

IN  SENATE -- A BUDGET BILL, submitted by the Governor pursuant to arti-
  cle seven of the Constitution -- read twice and ordered  printed,  and
  when  printed to be committed to the Committee on Finance -- committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

IN ASSEMBLY -- A BUDGET BILL, submitted  by  the  Governor  pursuant  to
  article  seven  of  the  Constitution -- read once and referred to the
  Committee on Ways and Means --  committee  discharged,  bill  amended,
  ordered reprinted as amended and recommitted to said committee

AN  ACT to amend the elder law, in relation to Medicare part D; to amend
  the public health law and the insurance  law,  in  relation  to  early
  intervention  services;  to  amend the public health law and the elder
  law, in relation  to  creating  local  competitive  performance  grant
  programs  for priority health initiatives and initiatives in aging; to
  amend the public health law, in relation to tobacco control and insur-
  ance initiatives pool distributions; to amend the public  health  law,
  in  relation to clinical laboratories; to amend the public health law,
  in relation to distribution  of  HEAL  NY  capital  grants;  to  amend
  section  32  of part A of chapter 58 of the laws of 2008, amending the
  elder law and other  laws  relating  to  reimbursement  to  particular
  provider pharmacies and prescription drug coverage, in relation to the
  effectiveness  thereof; to amend section 4 of part X2 of chapter 62 of
  the laws of 2003, amending the public health law relating to  allowing
  for the use of funds of the office of professional medical conduct for
  activities  of  the patient health information and quality improvement
  act of 2000, in relation to the effectiveness thereof; to amend  para-
  graph  b  of subdivision 1 of section 76 of chapter 731 of the laws of
  1993, amending the public  health  law  and  other  laws  relating  to
  reimbursement,  delivery  and  capital costs of ambulatory health care
  services and inpatient hospital services, in relation  to  the  effec-
  tiveness  thereof;  to  amend  section 4 of chapter 505 of the laws of
  1995, amending the public health law  relating  to  the  operation  of
  department  of  health  facilities,  in  relation to the effectiveness
  thereof; to amend section 3 of chapter 303 of the laws of 1999, amend-
  ing the New York state medical  care  facilities  finance  agency  act
  relating to financing health facilities, in relation to the effective-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD12571-02-1

S. 2809--A                          2                         A. 4009--A

  ness thereof; to repeal subdivision 2, and paragraphs (c), (d) and (g)
  of  subdivision  3 of section 242 of the elder law, relating to eligi-
  bility for comprehensive coverage for  elderly  pharmaceutical  insur-
  ance;  to repeal section 244 of the elder law, relating to the elderly
  pharmaceutical insurance coverage panel; to repeal subdivisions  1,  2
  and  4  of  section  247  of  the  elder law, relating to cost-sharing
  responsibilities of participants in the elderly pharmaceutical  insur-
  ance  coverage  program;  and  to repeal section 248 of the elder law,
  relating to  cost-sharing  responsibilities  of  participants  in  the
  elderly  catastrophic  insurance program (Part A); to amend the public
  health law, in relation to rates of payment  and  medical  assistance;
  and  to  amend  chapter  58  of  the laws of 2009, amending the public
  health law and other laws relating to Medicaid reimbursements to resi-
  dential health care facilities, in relation to adjustments to Medicaid
  ratio of payment for inpatient services (Part B);  to  amend  the  New
  York  Health Care Reform Act of 1996, in relation to extending certain
  provisions relating thereto; to amend the New York Health Care  Reform
  Act  of 2000, in relation to extending the effectiveness of provisions
  thereof; to amend the public health law, in relation to  the  distrib-
  ution  of  pool  allocations  and graduate medical education; to amend
  chapter 62 of the laws of 2003 amending the general business  law  and
  other  laws  relating to enacting major components necessary to imple-
  ment the state fiscal plan for  the  2003-04  state  fiscal  year,  in
  relation  to  the deposit of certain funds; to amend the public health
  law, in relation to health  care  initiative  pool  distributions;  to
  amend  the  public  authorities  law,  in  relation to the transfer of
  certain funds; to amend  the  social  services  law,  in  relation  to
  extending  payment  provisions for general hospitals; to amend chapter
  600 of the laws of 1986 amending the public health law relating to the
  development  of  pilot  reimbursement  programs  for  ambulatory  care
  services,  in  relation to the effectiveness of such chapter; to amend
  chapter 520 of the laws of 1978 relating to providing for a comprehen-
  sive survey of health care financing, education and illness prevention
  and creating councils for the conduct thereof, in relation to  extend-
  ing  the effectiveness of portions thereof; to amend the public health
  law, in relation to extending access to community health care services
  in rural areas; to amend the public health law, in relation to contin-
  uing the priority restoration adjustment; to amend chapter 266 of  the
  laws  of 1986 amending the civil practice law and rules and other laws
  relating to malpractice and professional medical conduct, in  relation
  to extending the applicability of certain provisions thereof; to amend
  the insurance law, in relation to liquidation of domestic insurers; to
  amend  chapter  63 of the laws of 2001 amending chapter 20 of the laws
  of 2001 amending the military law and other laws  relating  to  making
  appropriations for the support of government, in relation to extending
  the  applicability of certain provisions thereof; to amend chapter 904
  of the laws of 1984, amending the public health  law  and  the  social
  services law relating to encouraging comprehensive health services, in
  relation  to  the  effectiveness thereof; to amend the social services
  law and the public health law, in relation to  rates  of  payment  for
  personal  care  service  providers, residential health care facilities
  and diagnostic and treatment centers; and to amend chapter 495 of  the
  laws  of  2004  amending  the  insurance law and the public health law
  relating to the New York state health insurance  continuation  assist-
  ance  demonstration  project, in relation to the effectiveness of such
  provisions (Part C); to amend the public health law,  in  relation  to

S. 2809--A                          3                         A. 4009--A

  payments  to  residential health care facilities; to amend chapter 474
  of the laws of 1996, amending the education law and other laws  relat-
  ing  to  rates  for  residential healthcare facilities, in relation to
  reimbursements; to amend chapter 884 of the laws of 1990, amending the
  public  health  law  relating to authorizing bad debt and charity care
  allowances for certified home health  agencies,  in  relation  to  the
  effectiveness thereof; to amend chapter 81 of the laws of 1995, amend-
  ing  the  public  health  law  and  other  laws  relating  to  medical
  reimbursement and welfare reform, in relation  to  reimbursements  and
  the effectiveness thereof; to amend the public health law, in relation
  to  capital  related inpatient expenses; to amend part C of chapter 58
  of the laws of 2007, amending the social services law and  other  laws
  relating  to enacting the major components of legislation necessary to
  implement the health and mental hygiene budget for the 2007-2008 state
  fiscal year, in relation to rates of  payment  by  state  governmental
  agencies;  to  amend  chapter  451  of  the laws of 2007, amending the
  public health law, the social services  law  and  the  insurance  law,
  relating  to  providing enhanced consumer and provider protections, in
  relation to extending the effectiveness of certain provisions thereof;
  to amend the public health law, in relation to rates  of  payment  for
  long term home health care programs; to amend chapter 2 of the laws of
  1998,  amending  the  public  health  law  and  other laws relating to
  expanding the child health insurance plan, in relation to  the  effec-
  tiveness  of  certain  provisions thereof; to amend chapter 649 of the
  laws of 1996, amending the public health law, the mental  hygiene  law
  and  the social services law relating to authorizing the establishment
  of special needs plans, in relation to the effectiveness  thereof;  to
  amend chapter 58 of the laws of 2008, amending the social services law
  and  the  public  health  law  relating  to  adjustments  of rates, in
  relation to the effectiveness of certain provisions thereof; to  amend
  chapter  535  of  the  laws  of 1983, amending the social services law
  relating to eligibility of certain enrollees for  medical  assistance,
  in  relation  to the effectiveness thereof; to amend chapter 19 of the
  laws of 1998, amending the social services law  relating  to  limiting
  the method of payment for prescription drugs under the medical assist-
  ance program, in relation to the effectiveness thereof; to amend chap-
  ter  710 of the laws of 1988, amending the social services law and the
  education law relating to medical assistance  eligibility  of  certain
  persons and providing for managed medical care demonstration programs,
  in  relation to the effectiveness thereof; to amend chapter 165 of the
  laws of 1991, amending the public health law and other  laws  relating
  to  establishing  payments  for medical assistance, in relation to the
  effectiveness thereof; to repeal  certain  provisions  of  the  public
  health  law  relating  to  capital  related inpatient expenses; and to
  repeal certain provisions of chapter 41 of the laws of 1992,  amending
  the public health law and other laws relating to health care providers
  relating  to the effectiveness of certain provisions thereof (Part D);
  to amend the social services law, in relation to suspension of  eligi-
  bility  for  medical  assistance  (Part E); to amend chapter 57 of the
  laws of 2006, relating to establishing a cost of living adjustment for
  designated human services programs,  in  relation  to  foregoing  such
  adjustment  during  the  2011-2012  state fiscal year (Part F); and to
  amend the mental hygiene law, in  relation  to  the  closure  and  the
  reduction  in  size  of certain facilities serving persons with mental
  illness; and to repeal certain provisions of such law relating thereto
  (Part G)

S. 2809--A                          4                         A. 4009--A

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

  Section  1.  This  act enacts into law major components of legislation
which are necessary to implement the state fiscal plan for the 2011-2012
state fiscal year. Each component is  wholly  contained  within  a  Part
identified  as Parts A through G. The effective date for each particular
provision contained within such Part is set forth in the last section of
such Part. Any provision in any section contained within a Part, includ-
ing the effective date of the Part, which makes a reference to a section
"of this act", when used in connection with that  particular  component,
shall  be  deemed  to mean and refer to the corresponding section of the
Part in which it is found. Section three of  this  act  sets  forth  the
general effective date of this act.

                                 PART A

  Section  1. Paragraph (f) of subdivision 3 of section 242 of the elder
law, as added by section 3 of part B of chapter 58 of the laws of  2007,
is amended to read as follows:
  (f)  As  a  condition of continued eligibility for benefits under this
title, if a program participant is eligible for  Medicare  part  D  drug
coverage  under  section  1860D  of the federal social security act, the
participant is required to enroll in Medicare part D at the first avail-
able enrollment period and to maintain such enrollment. This requirement
shall be waived if such enrollment would  result  in  significant  addi-
tional financial liability by the participant, including, but not limit-
ed to, individuals in a Medicare advantage plan whose cost sharing would
be  increased,  or  if  such  enrollment would result in the loss of any
health coverage through a union or employer plan  for  the  participant,
the  participant's  spouse  or other dependent.  [The elderly pharmaceu-
tical insurance coverage program shall provide  premium  assistance  for
all participants enrolled in Medicare part D as follows:
  (i)  for  participants  with  comprehensive coverage under section two
hundred forty-seven of this title, the elderly pharmaceutical  insurance
coverage program shall pay for the portion of the part D monthly premium
that  is  the  responsibility  of the participant. Such payment shall be
limited to the low-income benchmark premium amount  established  by  the
federal  centers for Medicare and Medicaid services and any other amount
which such agency establishes  under  its  de  minimus  premium  policy,
except  that  such payments made on behalf of participants enrolled in a
Medicare advantage plan may  exceed  the  low-income  benchmark  premium
amount if determined to be cost effective to the program.
  (ii)  for  participants  with  catastrophic coverage under section two
hundred forty-eight of this title, the elderly pharmaceutical  insurance
coverage  program shall credit the participant's annual personal covered
drug expenditure amount required under this title by an amount equal  to
the  annual  low-income  benchmark  premium  amount  established  by the
centers for Medicare and Medicaid services, prorated for  the  remaining
portion  of  the participant's elderly pharmaceutical insurance coverage
program coverage period. The elderly pharmaceutical  insurance  coverage
program   shall,   at   appropriate   times,  notify  participants  with
catastrophic coverage under section  two  hundred  forty-seven  of  this
title  of their right to coordinate the annual coverage period with that
of Medicare part D, along with the possible advantages and disadvantages
of doing so.]

S. 2809--A                          5                         A. 4009--A

  S 2. Subdivision 6 of section 241 of the elder law is amended and  two
new subdivisions 8 and 9 are added to read as follows:
  6.  "Annual  coverage  period" shall mean the period of twelve consec-
utive calendar months for which an eligible program participant has  met
the  [application fee or deductible requirements, as the case may be, of
sections two hundred forty-seven and two hundred  forty-eight]  REQUIRE-
MENTS OF SECTION TWO HUNDRED FORTY-TWO of this title.
  8.  "COVERAGE GAP PERIOD" SHALL MEAN THE PERIOD BETWEEN THE END OF THE
MEDICARE  PART D INITIAL COVERAGE PHASE AND THE START OF MEDICARE PART D
CATASTROPHIC COVERAGE.
  9. "MEDICARE PART D EXCLUDED DRUG CLASSES" SHALL  MEAN  ANY  DRUGS  OR
CLASSES  OF DRUGS, OR THEIR MEDICAL USES, WHICH ARE DESCRIBED IN SECTION
1927(D)(2) OR 1927(D)(3) OF THE FEDERAL SOCIAL SECURITY  ACT,  WITH  THE
EXCEPTION OF SMOKING CESSATION AGENTS.
  S  3.  Subdivision 1 of section 242 of the elder law, paragraph (b) as
amended by section 14 of part B of chapter 57 of the laws  of  2006,  is
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,
WHO  IS  ENROLLED  IN MEDICARE PART D, 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, is less
than or equal to [twenty]  THIRTY-FIVE  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,  WHO
IS  ENROLLED  IN MEDICARE PART D, 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 beginning on or after January first, two  thousand  one,
is  less than or equal to [twenty-six] FIFTY thousand dollars. After the
initial determination of eligibility, each eligible individual  must  be
redetermined eligible at least every twenty-four months.
  S 3-a. Subdivision 2 of section 242 of the elder law is REPEALED.
  S  3-b. Paragraph (c) of subdivision 3 of section 242 of the elder law
is REPEALED and a new paragraph (c) is added to read as follows:
  (C) FOR PERSONS WHO MEET THE ELIGIBILITY REQUIREMENTS  TO  PARTICIPATE
IN  THE  ELDERLY  PHARMACEUTICAL INSURANCE COVERAGE PROGRAM, THE PROGRAM
WILL PAY FOR A DRUG COVERED BY THE PERSON'S MEDICARE PART D  PLAN  OR  A
DRUG IN A MEDICARE PART D EXCLUDED DRUG CLASS, AS DEFINED IN SUBDIVISION
NINE OF SECTION TWO HUNDRED FORTY-ONE OF THIS TITLE, DURING THE COVERAGE
GAP, AS DEFINED IN SUBDIVISION EIGHT OF SECTION TWO HUNDRED FORTY-ONE OF
THIS  TITLE,  PROVIDED  THAT  SUCH DRUG IS A COVERED DRUG, AS DEFINED IN
SUBDIVISION ONE OF SECTION TWO HUNDRED FORTY-ONE OF THIS TITLE, AND THAT
THE PARTICIPANT COMPLIES WITH THE POINT OF SALE CO-PAYMENT  REQUIREMENTS
SET FORTH IN SECTION TWO HUNDRED FORTY-SEVEN OF THIS TITLE.
  S  3-c. Paragraph (d) of subdivision 3 of section 242 of the elder law
is REPEALED.
  S 3-d. Paragraphs (e) and (f) of subdivision 3 of section 242  of  the
elder  law, paragraph (e) as amended by section 112 of part C of chapter
58 of the laws of 2009, paragraph (f) as amended by section one of  this
act, are amended to read as follows:
  (e)  As a condition of [continued] eligibility for benefits under this
title, if a program participant's income indicates that the  participant
could  be  eligible for an income-related subsidy under section 1860D-14

S. 2809--A                          6                         A. 4009--A

of the federal social security act by either applying for  such  subsidy
or  by  enrolling  in a medicare savings program as a qualified medicare
beneficiary (QMB), a specified low-income medicare  beneficiary  (SLMB),
or  a  qualifying  individual (QI), a program participant is required to
provide, and to authorize the elderly pharmaceutical insurance  coverage
program  to  obtain, any information or documentation required to estab-
lish the participant's eligibility for such subsidy,  and  to  authorize
the elderly pharmaceutical insurance coverage program to apply on behalf
of  the participant for the subsidy or the medicare savings program. The
elderly pharmaceutical insurance coverage program shall make  a  reason-
able  effort  to  notify  the  program participant of his or her need to
provide any of the above required information. After a reasonable effort
has been made to contact the participant, a participant shall  be  noti-
fied  in  writing that he or she has sixty days to provide such required
information. If such information is not provided within  the  sixty  day
period, the participant's coverage may be terminated.
  (f)  As a condition of [continued] eligibility for benefits under this
title, [if] a program participant is [eligible for Medicare part D  drug
coverage  under  section  1860D  of the federal social security act, the
participant is] required to [enroll] BE ENROLLED in Medicare part D  [at
the  first available enrollment period] and to maintain such enrollment.
[This requirement shall be waived if such  enrollment  would  result  in
significant  additional  financial liability by the participant, includ-
ing, but not limited to, individuals in a Medicare advantage plan  whose
cost  sharing  would be increased, or if such enrollment would result in
the loss of any health coverage through a union or employer plan for the
participant, the participant's spouse or other dependent.]
  S 3-e. Paragraph (g) of subdivision 3 of section 242 of the elder  law
is REPEALED.
  S 3-f. Paragraph (h) of subdivision 3 of section 242 of the elder law,
as  added  by  section 3 of part B of chapter 58 of the laws of 2007, is
amended to read as follows:
  (h) [In order to maximize prescription drug  coverage  under  Medicare
part  D,  the]  THE elderly pharmaceutical insurance coverage program is
authorized to represent program participants under this  title  [in  the
pursuit  of  such] WITH RESPECT TO THEIR MEDICARE PART D coverage. [Such
representation shall not result in any additional financial liability on
behalf of such program participants and shall include, but not be limit-
ed to, the following actions:
  (i) application for the premium and cost-sharing subsidies  on  behalf
of eligible program participants;
  (ii) enrollment in a prescription drug plan or MA-PD plan; the elderly
pharmaceutical  insurance coverage program shall provide program partic-
ipants with prior written notice of, and the opportunity to decline such
facilitated enrollment subject, however, to the provisions of  paragraph
(f) of this subdivision;
  (iii) pursuit of appeals, grievances, or coverage determinations.]
  S 3-g. Section 243 of the elder law is amended to read as follows:
  S  243.  Pharmaceutical insurance contract. 1. The [elderly pharmaceu-
tical insurance coverage panel,  established  pursuant  to  section  two
hundred  forty-four of this title] COMMISSIONER OF HEALTH shall, subject
to the approval of the director of the budget,  enter  into  a  contract
with one or more contractors to assist in carrying out the provisions of
this  title.  Such  contractual  arrangements shall be made subject to a
competitive process pursuant to the state finance law and  shall  ensure
that  state  payments  for  the  contractor's  necessary  and legitimate

S. 2809--A                          7                         A. 4009--A

expenses for the administration of  this  program  are  limited  to  the
amount specified in advance, and that such payments shall not exceed the
amount appropriated therefor in any fiscal year. The [panel] COMMISSION-
ER  shall[,  at  each  of  its regularly scheduled meetings,] review the
contract pricing  provisions  to  assure  that  the  level  of  contract
payments  are in the best interest of the state, giving consideration to
the total level of participant enrollment achieved, the volume of claims
processed, and such other factors as may be relevant in order to contain
state expenditures. In the event that the  [panel]  COMMISSIONER  deter-
mines  that  the contract payment provisions do not protect the interest
of the state,  the  [executive  director]  COMMISSIONER  shall  initiate
contract  negotiations  for  the  purpose of modifying contract payments
and/or scope requirements.
  2.  The  responsibilities  of  the  contractor  or  contractors  shall
include, but need not be limited to:
  (a) providing for a method of determining, on an annual basis and upon
their  application  therefor,  the  eligibility  of  persons pursuant to
section two hundred forty-two of this title within a  reasonable  period
of  time, including alternative methods for such determination of eligi-
bility, such as through the mail or home visits, where reasonable and/or
necessary, and for notifying applicants  of  such  eligibility  determi-
nations;
  (b)  notifying  each  eligible program participant in writing upon the
commencement of the annual coverage period of such  participant's  cost-
sharing  responsibilities  pursuant  to  [sections]  SECTION two hundred
forty-seven [and two hundred forty-eight] of this title. The  contractor
shall also notify each eligible program participant of any adjustment of
the  co-payment  schedule  by mail no less than thirty days prior to the
effective date of  such  adjustments  and  shall  inform  such  eligible
program participants of the date such adjustments shall take effect;
  (c)  issuing  an  identification card to each ELIGIBLE program partic-
ipant [who is eligible to  purchase  prescribed  covered  drugs  for  an
amount  specified  pursuant  to subdivision three of section two hundred
forty-seven or subdivision three of section two hundred  forty-eight  of
this  title.  The dates of the annual coverage period shall be imprinted
on the card. When an  eligible  program  participant  meets  the  annual
limits  on  point  of  sale co-payments set forth in subdivision four of
section two hundred forty-seven  or  subdivision  four  of  section  two
hundred forty-eight of this title, either new identification cards shall
be  issued  to  such  participant  indicating  waiver of such co-payment
requirements for the remainder of the  annual  coverage  period  or  the
contractor  shall  develop and implement an alternative method to permit
the purchase of covered drugs without a co-payment requirement];
  (d) [developing and implementing  the  system  for  those  individuals
electing  the  deductible  option  to record their personal covered drug
expenditures in accordance with subdivision three of section two hundred
forty-eight of this title. Such recordkeeping system shall  be  provided
to  each  such participant at a nominal charge which shall be subject to
the approval of the panel. The contractor shall also  reimburse  partic-
ipants  for  personal  covered drug expenditures made in excess of their
deductible requirements, less the co-payments  required  by  subdivision
four  of  section  two  hundred forty-eight of this title, made prior to
their receipt of an identification card issued in accordance with  para-
graph (c) of this subdivision;
  (e)]  processing of claims for reimbursement to participating provider
pharmacies pursuant to section two hundred fifty of this title;

S. 2809--A                          8                         A. 4009--A

  [(f)] (E) performing or causing to be  performed  utilization  reviews
for  such  purposes  as  may  be required by the [elderly pharmaceutical
insurance coverage panel] COMMISSIONER OF HEALTH;
  [(g)]  (F)  conducting  audits  and  surveys of participating provider
pharmacies as specified pursuant to the  terms  and  conditions  of  the
contract; and
  [(h)]  (G)  coordinating  coverage  with insurance companies and other
public and private organizations offering such coverage for those eligi-
ble program participants  having  partial  coverage  for  covered  drugs
through  third-party sources, and providing for recoupment of any dupli-
cate reimbursement paid by the state on behalf of such eligible  program
participants.
  3.  The  contractor  or  contractors shall be required to provide such
reports as may be deemed necessary by the [elderly pharmaceutical insur-
ance coverage panel] COMMISSIONER OF HEALTH and shall maintain files  in
a manner and format approved by the [executive director] COMMISSIONER.
  4.  The  contractor  or contractors may contract with private not-for-
profit or proprietary corporations, or with entities of local government
within the state of  New  York,  to  perform  such  obligations  of  the
contractor  or  contractors  as  the  [elderly  pharmaceutical insurance
coverage panel] COMMISSIONER OF HEALTH shall permit.
  S 3-h. Section 244 of the elder law is REPEALED and a new section  244
is added to read as follows:
  S  244.  POWERS  OF  THE  COMMISSIONER  OF HEALTH.   THE POWERS OF THE
COMMISSIONER OF  HEALTH  IN  ADMINISTERING  THE  ELDERLY  PHARMACEUTICAL
INSURANCE  COVERAGE  PROGRAM  SHALL  INCLUDE  BUT  NOT BE LIMITED TO THE
FOLLOWING:
  1. SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE BUDGET, PROMULGATING
PROGRAM REGULATIONS PURSUANT TO SECTION TWO HUNDRED  FORTY-SIX  OF  THIS
TITLE;
  2. DETERMINING THE ANNUAL SCHEDULE OF COST-SHARING RESPONSIBILITIES OF
ELIGIBLE PROGRAM PARTICIPANTS PURSUANT TO SECTION TWO HUNDRED FORTY-SEV-
EN OF THIS TITLE;
  3. ENTERING INTO CONTRACTS PURSUANT TO SECTION TWO HUNDRED FORTY-THREE
OF THIS TITLE;
  4. IMPLEMENTING ALTERNATIVE PROGRAM IMPROVEMENTS FOR THE EFFICIENT AND
EFFECTIVE  OPERATION OF THE PROGRAM IN ACCORDANCE WITH THE PROVISIONS OF
THIS TITLE;
  5. ESTABLISHING OR  CONTRACTING  FOR  A  THERAPEUTIC  DRUG  MONITORING
PROGRAM,  FOR THE PURPOSE OF MONITORING THERAPEUTIC DRUG USE BY ELIGIBLE
PROGRAM PARTICIPANTS IN AN EFFORT TO PREVENT THE INCORRECT  OR  UNNECES-
SARY CONSUMPTION OF SUCH THERAPEUTIC DRUGS.
  S  3-i. The section heading of section 247 of the elder law is amended
to read as follows:
  Cost-sharing responsibilities of eligible  program  participants  [for
comprehensive coverage].
  S 3-j. Subdivision 1 of section 247 of the elder law is REPEALED and a
new subdivision 1 is added to read as follows:
  1.  AS  A  CONDITION  OF  ELIGIBILITY  FOR  BENEFITS UNDER THIS TITLE,
PARTICIPANTS MUST MAINTAIN MEDICARE PART  D  COVERAGE  AND  PAY  MONTHLY
PREMIUMS TO THEIR MEDICARE PART D DRUG PLAN.
  S  3-k.  Subdivisions  2  and  4  of  section 247 of the elder law are
REPEALED and subdivision 3 is renumbered subdivision 2 and paragraph (a)
is amended to read as follows:
  (a) [Upon satisfaction  of  the  registration  fee  pursuant  to  this
section  an  eligible]  A  program  participant must pay a point of sale

S. 2809--A                          9                         A. 4009--A

co-payment as set forth in paragraph (b) of this subdivision at the time
of each purchase of a [covered] drug prescribed for such individual THAT
IS DESCRIBED IN PARAGRAPH  (C)  OF  SUBDIVISION  THREE  OF  SECTION  TWO
HUNDRED  FORTY-TWO  OF THIS TITLE.  [Such co-payment shall not be waived
or reduced in whole or in part, subject to the limits provided by subdi-
vision four of this section.]
  S 3-l. Section 248 of the elder law is REPEALED.
  S 3-m. Section 250 of the elder law, paragraph (a) of subdivision 1 as
amended by section 6-a and subparagraph l of paragraph (b)  of  subdivi-
sion  1  as  amended by section 1 of part A of chapter 58 of the laws of
2008, paragraph (b) of subdivision 1 as amended by section 17 of part  A
of  chapter  58  of the laws of 2004, subparagraph 1 of paragraph (a) of
subdivision 3 and subdivision 5 as amended by section 19 of  part  B  of
chapter 57 of the laws of 2006, subdivision 6 as amended by section 19-a
of  part  A  of  chapter  109 of the laws of 2010, is amended to read as
follows:
  S 250. Reimbursement to  participating  provider  pharmacies.  1.  The
amount  of  reimbursement  which shall be paid by the state to a partic-
ipating provider pharmacy [for any covered drug filled or  refilled  for
any  eligible  program  participant] FILLING OR REFILLING A PRESCRIPTION
FOR A DRUG THAT IS DESCRIBED IN PARAGRAPH (C) OF  SUBDIVISION  THREE  OF
SECTION  TWO  HUNDRED  FORTY-TWO  OF  THIS  TITLE  shall be equal to the
allowed amount defined as follows, minus the point of sale co-payment as
required by [sections] SECTION two hundred forty-seven [and two  hundred
forty-eight] of this title:
  (a)  Multiple  source  covered drugs. Except for brand name drugs that
are required by the prescriber to be dispensed as written,  the  allowed
amount for a multiple source covered drug shall equal the lower of:
  (1)  The  pharmacy's usual and customary charge to the general public,
taking into consideration any quantity and promotional discounts to  the
general public at the time of purchase, or
  (2) The upper limit, if any, set by the centers for medicare and medi-
caid services for such multiple source drug, or
  (3) Average wholesale price discounted by twenty-five percent, or
  (4) The maximum allowable cost, if any, established by the commission-
er  of  health  pursuant to paragraph (e) of subdivision nine of section
three hundred sixty-seven-a of the social services law.
  Plus a dispensing fee for drugs reimbursed pursuant  to  subparagraphs
two,  three,  and four of this paragraph, as defined in paragraph (c) of
this subdivision.
  (b) Other covered drugs. The  allowed  amount  for  brand  name  drugs
required  by  the  prescriber to be dispensed as written and for covered
drugs other than multiple source drugs shall be determined  by  applying
the lower of:
  (1)  Average wholesale price discounted by sixteen and twenty-five one
hundredths percent, plus a dispensing fee as defined in paragraph (c) of
this subdivision, or
  (2) The pharmacy's usual and customary charge to the  general  public,
taking  into consideration any quantity and promotional discounts to the
general public at the time of purchase.
  (c) As required by paragraphs (a)  and  (b)  of  this  subdivision,  a
dispensing  fee  of four dollars fifty cents will apply to generic drugs
and a dispensing fee of three dollars fifty cents will  apply  to  brand
name drugs.
  2. For purposes of determining the amount of reimbursement which shall
be  paid  to a participating provider pharmacy, the [panel] COMMISSIONER

S. 2809--A                         10                         A. 4009--A

OF HEALTH shall determine or cause to be determined, through  a  statis-
tically  valid  survey, the quantities of each covered drug that partic-
ipating provider pharmacies buy most frequently.  Using  the  result  of
this  survey,  the contractor shall update every thirty days the list of
average wholesale prices upon which  such  reimbursement  is  determined
using  nationally  recognized  and  most  recently revised sources. Such
price revisions shall be made available to  all  participating  provider
pharmacies.  The  pharmacist  shall  be reimbursed based on the price in
effect at the time the covered drug is dispensed.
  3. [(a) Notwithstanding any inconsistent provision of law, the program
for  elderly  pharmaceutical  insurance  coverage  shall  reimburse  for
covered  drugs which are dispensed under the program by a provider phar-
macy only pursuant to the  terms  of  a  rebate  agreement  between  the
program  and  the  manufacturer  (as  defined  under section 1927 of the
federal social security act) of such covered drugs;  provided,  however,
that:
  (1)  any agreement between the program and a manufacturer entered into
before August first, nineteen hundred ninety-one,  shall  be  deemed  to
have  been entered into on April first, nineteen hundred ninety-one; and
provided further, that if a manufacturer has not entered into an  agree-
ment  with  the department before August first, nineteen hundred ninety-
one, such agreement shall not be effective until April  first,  nineteen
hundred  ninety-two, unless such agreement provides that rebates will be
retroactively calculated as if the agreement had been in effect on April
first, nineteen hundred ninety-one; and
  (2) the program may reimburse for any covered drugs pursuant to subdi-
visions one and two of this section, for which a rebate  agreement  does
not  exist and which are determined by the elderly pharmaceutical insur-
ance coverage panel to be essential to the health of persons participat-
ing in the program; and likely to provide effective therapy or diagnosis
for a disease not adequately treated or diagnosed by any  other  covered
drug;  and  which  are  recommended  for  reimbursement by the panel and
approved by the commissioner of health.
  (b) The rebate agreement between such manufacturer and the program for
elderly pharmaceutical insurance  coverage  shall  utilize  for  covered
drugs  the  identical  formula  used to determine the rebate for federal
financial participation for drugs, pursuant to section  1927(c)  of  the
federal  social  security  act,  to  determine  the amount of the rebate
pursuant to this subdivision.
  (c) The amount of rebate pursuant to paragraph (b) of this subdivision
shall be calculated by multiplying the required rebate formulas  by  the
total  number  of  units of each dosage form and strength dispensed. The
rebate agreement shall also provide for periodic payment of the  rebate,
provision  of  information to the program, audits, verification of data,
damages to the program for any delay or non-production of necessary data
by the manufacturer and for the confidentiality of information.
  (d) The program in providing utilization data to  a  manufacturer  (as
provided  for under section 1927 (b) of the federal social security act)
shall provide such data by zip code, if requested,  for  the  top  three
hundred most commonly used drugs by volume covered under a rebate agree-
ment.
  (e) Any funds collected pursuant to any rebate agreements entered into
with  a  manufacturer  pursuant  to this subdivision, shall be deposited
into the  elderly  pharmaceutical  insurance  coverage  program  premium
account.

S. 2809--A                         11                         A. 4009--A

  4.]  Notwithstanding  any other provision of law, entities which offer
insurance coverage for provision of and/or reimbursement for  pharmaceu-
tical    expenses,    including    but    not   limited   to,   entities
licensed/certified pursuant to  article  thirty-two,  forty-two,  forty-
three  or  forty-four  of the insurance law (employees welfare funds) or
article forty-four of the public health  law,  shall  participate  in  a
benefit  recovery  program  with  the  elderly  pharmaceutical insurance
coverage (EPIC) program which includes, but is not limited to,  a  semi-
annual  match  of  EPIC's file of enrollees against the entity's file of
insured to identify individuals enrolled in both plans with claims  paid
within the twenty-four months preceding the date the entity receives the
match request information from EPIC. Such entity shall indicate if phar-
maceutical  coverage  is  available  from  the  entity  for  the insured
persons, list the copayment or other payment obligations of the  insured
persons  applicable to the pharmaceutical coverage, and (after receiving
necessary claim information from EPIC) list the amounts which the entity
would have paid for the pharmaceutical claims for those identified indi-
viduals and the entity shall reimburse EPIC for pharmaceutical  expenses
paid  by EPIC that are covered under the contract between the entity and
its insured in only those instances where the  entity  has  not  already
made  payment  of  the  claim.  Reimbursement  of the net amount payable
(after rebates and discounts) that would have been paid under the cover-
age issued by the entity will be made by the entity to EPIC within sixty
days of receipt from EPIC of the  standard  data  in  electronic  format
necessary  for  the  entity  to adjudicate the claim and if the standard
data is provided to the entity by EPIC in paper format  payment  by  the
entity  shall  be made within one hundred eighty days.  After completing
at least one match process with EPIC in  electronic  format,  an  entity
shall  be entitled to elect a monthly or bi-monthly match process rather
than a semi-annual match process.
  [5.] 4. Notwithstanding  any  other  provision  of  law,  the  [panel]
COMMISSIONER  OF  HEALTH shall maximize the coordination of benefits for
persons enrolled under Title XVIII of the federal  social  security  act
(medicare) and enrolled under this title in order to facilitate medicare
payment  of  claims.  The  [panel]  COMMISSIONER OF HEALTH may select an
independent  contractor,  through  a  request-for-proposal  process,  to
implement  a  centralized  coordination  of  benefits  system under this
subdivision for individuals qualified in both the elderly pharmaceutical
insurance coverage (EPIC) program  and  medicare  programs  who  receive
medications or other covered products from a pharmacy provider currently
enrolled   in  the  elderly  pharmaceutical  insurance  coverage  (EPIC)
program.
  [6. (a)] 5. The EPIC program shall be the payor  of  last  resort  for
individuals  qualified  in  both the EPIC program and title XVIII of the
federal social  security  act  (Medicare).  [For  such  individuals,  no
reimbursement  shall  be  available under EPIC for covered drug expenses
except:
  (i) where a prescription drug plan authorized by Part D of the federal
social security act (referred to in this subdivision as a Medicare  Part
D  plan)  has  approved  coverage  and EPIC has an obligation under this
title to pay a portion of the participant's cost-sharing  responsibility
under Medicare Part D; or
  (ii)  where the provider pharmacy has certified that a Medicare Part D
plan has denied coverage.
  (b) If the provider pharmacy certifies as set  forth  in  subparagraph
(ii)  of  paragraph  (a) of this subdivision, the EPIC program shall pay

S. 2809--A                         12                         A. 4009--A

for the drug as the primary payor upon a showing of compliance with  the
notification  and appeal provisions of subparagraph two of paragraph (c)
of subdivision three of section two hundred forty-two of this title.]
  S 3-n. Section 254 of the elder law is amended to read as follows:
  S  254.  Cost  of living adjustment. [1.] Within amounts appropriated,
the [panel] COMMISSIONER OF HEALTH shall adjust the program  eligibility
standards  set  forth  in  subdivision  [two] ONE of section two hundred
forty-two of this title to account for increases in the cost of living.
  [2. The panel shall further adjust individual and joint income catego-
ries set forth in subdivisions two  and  four  of  section  two  hundred
forty-eight of this title to conform to the adjustments made pursuant to
subdivision one of this section.]
  S  4. Notwithstanding any contrary provision of law, rates established
pursuant to section 69-4.30 of Title 10 of the New York Codes, Rules and
Regulations for approved services rendered on and after  April  1,  2011
shall be reduced by ten percent.
  S  5.  Paragraph  (a)  of  subdivision 3 of section 2559 of the public
health law, as amended by chapter 231 of the laws of 1993, is amended to
read as follows:
  (a) [Providers] EXCEPT AS PROVIDED IN SUBPARAGRAPH (I) OF  THIS  PARA-
GRAPH,  PROVIDERS  of  early  intervention  services  and transportation
services shall in the first instance and where applicable, seek  payment
from  all  third  party  payors including governmental agencies prior to
claiming payment from a given  municipality  for  services  rendered  to
eligible  children,  provided  that,  for the purpose of seeking payment
from the medical assistance program or from other  third  party  payors,
the municipality shall be deemed the provider of such early intervention
services  to  the extent that the provider has promptly furnished to the
municipality adequate and complete information necessary to support  the
municipality  billing,  and provided further that the obligation to seek
payment shall not apply to a payment from a third party payor who is not
prohibited from applying such payment, and will apply such  payment,  to
an annual or lifetime limit specified in the insured's policy.
  (I)  EARLY INTERVENTION PROGRAM PROVIDERS WHO RECEIVED PAYMENT OF FIVE
HUNDRED THOUSAND DOLLARS OR MORE AS DETERMINED PURSUANT TO  SUBPARAGRAPH
(II)  OF  THIS  PARAGRAPH  FOR  EARLY  INTERVENTION SERVICES PROVIDED TO
ELIGIBLE CHILDREN THAT WERE COVERED SERVICES UNDER THE  MEDICAL  ASSIST-
ANCE  PROGRAM,  SHALL  IN  THE  FIRST INSTANCE AND WHERE AVAILABLE, SEEK
PAYMENT FROM THE MEDICAL ASSISTANCE PROGRAM OR AN  INSURANCE  POLICY  OR
HEALTH  BENEFIT  PLAN  FOR THOSE CHILDREN COVERED UNDER BOTH THE MEDICAL
ASSISTANCE PROGRAM AND AN INSURANCE POLICY OR HEALTH BENEFIT PLAN, PRIOR
TO CLAIMING PAYMENT FROM A MUNICIPALITY FOR SERVICES  RENDERED  TO  SUCH
CHILDREN;
  (II) THE COMMISSIONER SHALL DETERMINE WHICH PROVIDERS RECEIVED PAYMENT
OF FIVE HUNDRED THOUSAND DOLLARS OR MORE FOR EARLY INTERVENTION SERVICES
THAT  WERE  COVERED  UNDER THE MEDICAL ASSISTANCE PROGRAM BASED UPON THE
MOST RECENT YEAR FOR WHICH COMPLETE INFORMATION EXISTS. THE COMMISSIONER
SHALL NOTIFY A PROVIDER AT LEAST THIRTY  DAYS  PRIOR  TO  THE  DATE  THE
PROVIDER  SHALL  BE  REQUIRED  TO  BILL  FOR SERVICES IN ACCORDANCE WITH
SUBPARAGRAPH (I) OF THIS PARAGRAPH.
  (III) PARENTS SHALL PROVIDE AND THE MUNICIPALITY SHALL OBTAIN INFORMA-
TION ON ANY PLAN OF INSURANCE UNDER WHICH AN ELIGIBLE CHILD  HAS  COVER-
AGE.
  S 6. Intentionally omitted.
  S 7. Intentionally omitted.
  S 8. Intentionally omitted.

S. 2809--A                         13                         A. 4009--A

  S 9. Intentionally omitted.
  S 10. Intentionally omitted.
  S  11.  Section  3235-a of the insurance law, as added by section 3 of
part C of chapter 1 of the laws of 2002, is amended to read as follows:
  S 3235-a. Payment for early intervention services. (a)  No  policy  of
accident  and  health  insurance, including contracts issued pursuant to
article forty-three of this chapter, shall exclude coverage  for  other-
wise  covered  services solely on the basis that the services constitute
early intervention program services under title two-A of  article  twen-
ty-five of the public health law.
  (b)  Where  a  policy  of  accident  and health insurance, including a
contract  issued  pursuant  to  article  forty-three  of  this  chapter,
provides  coverage  for  [an]  A  SERVICE THAT IS PROVIDED TO AN INSURED
UNDER THE early intervention program service, such coverage shall not be
applied against any maximum annual or lifetime monetary limits set forth
in such policy or contract. Visit limitations and other terms and condi-
tions of the policy will continue to apply to COVERED SERVICES  PROVIDED
UNDER  THE  early  intervention  [services] PROGRAM. However, any visits
used for early intervention program services shall not reduce the number
of visits otherwise available under the  policy  or  contract  for  such
services.  WHERE A SERVICE PROVIDED TO AN INSURED UNDER THE EARLY INTER-
VENTION  PROGRAM  IS  A  COVERED  SERVICE  UNDER THE INSURER'S POLICY OR
CONTRACT, THE INDIVIDUALIZED FAMILY SERVICES PLAN AS DEFINED IN  SECTION
TWENTY-FIVE  HUNDRED FORTY-ONE OF THE PUBLIC HEALTH LAW AND CERTIFIED BY
THE EARLY INTERVENTION OFFICIAL OR SUCH OFFICIAL'S  DESIGNEE,  SHALL  BE
DEEMED TO MEET ANY PRECERTIFICATION, PREAUTHORIZATION AND MEDICAL NECES-
SITY  REQUIREMENTS  IMPOSED  ON  BENEFITS  UNDER THE POLICY OR CONTRACT,
PROVIDED, HOWEVER, THAT THE EARLY INTERVENTION OFFICIAL SHALL REMOVE  OR
REDACT  ANY INFORMATION CONTAINED ON THE INSURED'S INDIVIDUALIZED FAMILY
SERVICE PLAN THAT IS NOT REQUIRED BY THE INSURER FOR  PAYMENT  PURPOSES.
PAYMENT  FOR  A  SERVICE  COVERED  UNDER  THE POLICY OR CONTRACT THAT IS
PROVIDED UNDER THE EARLY INTERVENTION PROGRAM SHALL BE AT  RATES  ESTAB-
LISHED  BY THE COMMISSIONER OF HEALTH FOR SUCH SERVICE PURSUANT TO REGU-
LATIONS.
  (c) NO INSURER, INCLUDING A HEALTH MAINTENANCE ORGANIZATION  ISSUED  A
CERTIFICATE  OF  AUTHORITY UNDER ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH
LAW AND A CORPORATION ORGANIZED UNDER ARTICLE FORTY-THREE OF THIS  CHAP-
TER  SHALL DENY PAYMENT OF A CLAIM SUBMITTED FOR A SERVICE COVERED UNDER
THE INSURER'S POLICY OR CONTRACT AND PROVIDED  UNDER  THE  EARLY  INTER-
VENTION PROGRAM BASED UPON THE FOLLOWING:
  (I) THE LOCATION WHERE SERVICES ARE PROVIDED;
  (II)  THE  DURATION  OF  THE INSURED'S CONDITION OR THAT THE INSURED'S
CONDITION IS NOT AMENABLE TO SIGNIFICANT IMPROVEMENT  WITHIN  A  CERTAIN
PERIOD OF TIME AS SPECIFIED IN THE POLICY OR CONTRACT;
  (III) THAT THE PROVIDER OF SERVICES IS NOT A PARTICIPATING PROVIDER IN
THE INSURER'S NETWORK; OR
  (IV) THE ABSENCE OF A PRIMARY CARE REFERRAL.
  (D) Any right of subrogation to benefits which a municipality is enti-
tled  in  accordance  with paragraph (d) of subdivision three of section
twenty-five hundred fifty-nine of the public health law shall  be  valid
and  enforceable to the extent benefits are available under any accident
and health insurance policy. The right of subrogation does not attach to
insurance benefits paid or provided under any accident and health insur-
ance policy prior to receipt by the insurer of written notice  from  the
municipality.    UPON  THE  INSURER'S RECEIPT OF WRITTEN NOTICE FROM THE

S. 2809--A                         14                         A. 4009--A

MUNICIPALITY THE INSURER SHALL PROVIDE THE MUNICIPALITY WITH INFORMATION
ON THE EXTENT OF BENEFITS AVAILABLE TO AN INSURED UNDER THE POLICY.
  [(d)]  (E)  No  insurer,  including  a health maintenance organization
issued a certificate of authority under article forty-four of the public
health law and a corporation organized under article forty-three of this
chapter, shall refuse to issue an accident and health  insurance  policy
or  contract  or refuse to renew an accident and health insurance policy
or contract  solely  because  the  applicant  or  insured  is  receiving
services under the early intervention program.
  S  12.  Subdivisions 4 and 5 of section 2545 of the public health law,
as added by section 2 of chapter 428 of the laws of 1992, are amended to
read as follows:
  4. If the IFSP TEAM MEMBERS, INCLUDING THE early intervention official
and the parent agree on the IFSP, the IFSP shall be deemed final and the
service coordinator shall be authorized to implement the plan.
  5. If the IFSP TEAM MEMBERS, INCLUDING THE early intervention official
and the parent do not agree on an IFSP, the  service  coordinator  shall
implement the sections of the proposed IFSP that are not in dispute, and
the  parent shall have the due process rights set forth in section twen-
ty-five hundred forty-nine of this title.
  S 13. Subdivision 2 of section  605  of  the  public  health  law,  as
amended  by  section  7  of part B of chapter 57 of the laws of 2006, is
amended to read as follows:
  2. State aid reimbursement for public health services  provided  by  a
municipality under this title, shall be made [as follows:
  (a)]  if the municipality is providing some or all of the basic public
health services identified in paragraph  (b)  of  subdivision  three  of
section  six hundred two of this title, pursuant to an approved plan, at
a rate of no less than thirty-six per centum of the  difference  between
the  amount  of  moneys  expended  by the municipality for public health
services required by paragraph (b) of subdivision three of  section  six
hundred  two  of  this  title  during the fiscal year and the base grant
provided pursuant to subdivision one of this section. No such reimburse-
ment shall be provided for services if they are not approved in  a  plan
or if no plan is submitted for such services.
  [(b)  if  the  municipality  is providing other public health services
within limits to be prescribed by  regulation  by  the  commissioner  in
addition  to some or all of the public health services required in para-
graph (b) of subdivision three of section six hundred two of this title,
pursuant to an approved plan, at a rate of not less than thirty-six  per
centum  of  the  moneys  expended  by  the  municipality  for such other
services. No such reimbursement shall be provided for services  if  they
are  not  approved  in  a  plan  or  if  no  plan  is submitted for such
services.]
  S 14. The public health law is amended by adding a new section 212  to
read as follows:
  S 212. LOCAL COMPETITIVE PERFORMANCE GRANT PROGRAM FOR PRIORITY HEALTH
INITIATIVES.  1.  THERE  IS HEREBY ESTABLISHED WITHIN THE DEPARTMENT THE
LOCAL COMPETITIVE PERFORMANCE GRANT PROGRAM FOR PRIORITY  HEALTH  INITI-
ATIVES  TO  ADDRESS EMERGING OR ONGOING PUBLIC HEALTH MATTERS AND PURSUE
INNOVATIONS IN PUBLIC HEALTH.
  2. WITHIN AMOUNTS APPROPRIATED THEREFOR, THE COMMISSIONER  IS  AUTHOR-
IZED  TO MAKE GRANTS TO AND ENTER INTO CONTRACTS WITH PUBLIC, NON-PROFIT
OR PRIVATE ENTITIES FOR PURPOSES WHICH MAY INCLUDE, BUT ARE NOT  LIMITED
TO,  MINORITY  HEALTH-RELATED INITIATIVES, REPRODUCTIVE HEALTH SERVICES,
DISEASE-SPECIFIC PURPOSES, AND OTHER HEALTH-RELATED  RESEARCH,  OUTREACH

S. 2809--A                         15                         A. 4009--A

AND  EDUCATION PURPOSES. SUCH GRANTS SHALL BE AWARDED UNDER THIS SECTION
ON A COMPETITIVE BASIS PURSUANT TO A  REQUEST  FOR  APPLICATION/PROPOSAL
PROCESS, IN THE NUMBER, AMOUNTS AND MANNER DETERMINED BY THE COMMISSION-
ER, PURSUANT TO CRITERIA DETERMINED BY THE COMMISSIONER.
  3.  THE COMMISSIONER MAY PROMULGATE REGULATIONS, INCLUDING ON AN EMER-
GENCY BASIS, AS NECESSARY TO IMPLEMENT THE PROVISIONS OF THIS SECTION.
  S 15. The elder law is amended by adding a new section 224 to read  as
follows:
  S 224. LOCAL COMPETITIVE PERFORMANCE GRANT PROGRAM FOR PRIORITY INITI-
ATIVES  IN  AGING.  1. THERE IS HEREBY ESTABLISHED WITHIN THE OFFICE THE
LOCAL COMPETITIVE PERFORMANCE GRANT PROGRAM FOR PRIORITY INITIATIVES  IN
AGING  TO  ADDRESS  EMERGING OR ONGOING MATTERS THAT AFFECT OLDER ADULTS
AND PURSUING INNOVATIONS IN ASSISTING OLDER ADULTS.
  2. WITHIN AMOUNTS APPROPRIATED THEREFOR, THE DIRECTOR IS AUTHORIZED TO
MAKE GRANTS TO AND ENTER  INTO  CONTRACTS  WITH  PUBLIC,  NON-PROFIT  OR
PRIVATE  ENTITIES.  SUCH GRANTS SHALL BE AWARDED UNDER THIS SECTION ON A
COMPETITIVE BASIS PURSUANT TO A REQUEST FOR  APPLICATION/PROPOSAL  PROC-
ESS,  IN  THE  NUMBER,  AMOUNTS  AND  MANNER DETERMINED BY THE DIRECTOR,
PURSUANT TO CRITERIA DETERMINED BY THE DIRECTOR.
  3. THE DIRECTOR MAY PROMULGATE REGULATIONS, INCLUDING ON AN  EMERGENCY
BASIS, AS NECESSARY TO IMPLEMENT THE PROVISIONS OF THIS SECTION.
  S 16. Paragraph (fff) of subdivision 1 of section 2807-v of the public
health  law, as amended by section 5 of part B of chapter 58 of the laws
of 2008, is amended to read as follows:
  (fff) Funds shall be made available to the empire state stem cell fund
established by section ninety-nine-p of the state finance law [from  the
public  asset  as  defined in section four thousand three hundred one of
the insurance law and accumulated from the conversion  of  one  or  more
article forty-three corporations and its or their not-for-profit subsid-
iaries  occurring  on  or after January first, two thousand seven.  Such
funds shall be made available] within amounts appropriated up  to  fifty
million  dollars  annually  and  shall  not  exceed five hundred million
dollars in total.
  S 17.  Intentionally Omitted.
  S 18. Subdivision 3 of section  571  of  the  public  health  law,  as
amended  by  chapter  436  of  the  laws  of 1993, is amended to read as
follows:
  3. "Reference system" means a system of [periodic testing]  ASSESSMENT
of  methods, procedures and materials of clinical laboratories and blood
banks, including, but not  limited  to,  ONGOING  VALIDATION  WHICH  MAY
INCLUDE  DIRECT  TESTING  AND  EXPERIMENTATION BY THE DEPARTMENT OF SUCH
METHODS, PROCEDURES AND  MATERIALS,  the  distribution  of  [manuals  of
approved  methods]  STANDARDS  AND GUIDELINES, inspection of facilities,
[cooperative research, and] periodic submission of  test  specimens  for
examination,  AND RESEARCH CONDUCTED BY THE DEPARTMENT THAT INVOLVES THE
STUDY OF NEW OR EXISTING METHODS, PROCEDURES AND MATERIALS IN THE  FIELD
OF CLINICAL LABORATORY MEDICINE, AND SUCH OTHER ACTIVITIES AS MAY BE SET
FORTH IN REGULATION.
  S 19. Subdivisions 1, 2 and 6 of section 575 of the public health law,
as  amended  by  chapter 436 of the laws of 1993, are amended to read as
follows:
  1. Application for a permit shall be made by the owner and the  direc-
tor of the clinical laboratory or blood bank [upon forms provided by the
department]  IN  A  MANNER  AND FORMAT PRESCRIBED BY THE DEPARTMENT. The
application shall contain the name of the owner, the name of the  direc-
tor,  the  procedures  or categories of procedures or services for which

S. 2809--A                         16                         A. 4009--A

the permit is sought, the location or locations and physical description
of the facility or location or  locations  at  which  tests  are  to  be
performed  or  at  which  a blood bank is to be operated, and such other
information as the department may require.
  2.  A  permit  OR  PERMIT  CATEGORY shall not be issued unless a valid
certificate of qualification in the category of procedures for which the
permit is sought has  been  issued  to  the  director  pursuant  to  the
provisions  of  section  five hundred seventy-three of this title, [and]
unless ALL FEES AND OUTSTANDING PENALTIES, IF ANY, HAVE BEEN  PAID,  AND
the  department  finds  that  the  clinical  laboratory or blood bank is
competently staffed and properly equipped, and will be operated  in  the
manner required by this title.
  6.  A  permit shall become void by a change in the director, owner, or
location. A CATEGORY ON A PERMIT SHALL BECOME VOID BY A  CHANGE  IN  THE
DIRECTOR  FOR THAT CATEGORY. The department may, pursuant to regulations
adopted under this title, extend the date on which a permit OR  CATEGORY
ON A PERMIT shall become void for a period not to exceed sixty days from
the date of a change of the director, owner or location.  An application
for  a  NEW  permit  [may]  MUST  be  made  [at any time,] in the manner
provided by this section.
  S 20. Subdivision 3 and paragraphs (a), (b), (c) and (e)  of  subdivi-
sion  4  of  section 576 of the public health law, as amended by chapter
436 of the laws of 1993, are amended to read as follows:
  3. The department shall operate a reference system and shall prescribe
standards for the PROPER OPERATION OF CLINICAL  LABORATORIES  AND  BLOOD
BANKS  AND  FOR  THE examination of specimens. As part of such reference
system, the department may REVIEW AND APPROVE TESTING METHODS  DEVELOPED
OR  MODIFIED BY CLINICAL LABORATORIES AND BLOOD BANKS PRIOR TO THE TEST-
ING METHODS BEING OFFERED IN THIS STATE, AND MAY require clinical  labo-
ratories  and  blood  banks  to  analyze  test  samples submitted by the
department and to report on the results of such analyses. The rules  and
regulations  of  the department shall prescribe the REQUIREMENTS FOR THE
PROPER OPERATION OF  A  CLINICAL  LABORATORY  OR  BLOOD  BANK,  FOR  THE
APPROVAL  OF  METHODS  AND  THE  manner  in which proficiency testing or
analyses of samples shall be performed and reports submitted. Failure to
meet department standards FOR THE PROPER OPERATION OF A CLINICAL LABORA-
TORY OR BLOOD BANK, INCLUDING THE CRITERIA FOR APPROVAL OF  METHODS,  OR
FAILURE  TO  MAINTAIN  SATISFACTORY  PERFORMANCE  in proficiency testing
shall result in termination of the permit in the category or  categories
of testing established by the department in regulation until remediation
is  achieved.  Such  standards shall be at least as stringent as federal
standards promulgated under the federal clinical laboratory  improvement
[act]  AMENDMENTS  of  nineteen  hundred  eighty-eight. Such failure and
termination shall be subject to review in  accordance  with  regulations
adopted by the department.
  (a) The department may adopt and amend rules and regulations to effec-
tuate  the  provisions  and purposes of this title. Such rules and regu-
lations shall establish [inspection and  reference]  fees  for  clinical
laboratories  and  blood  banks in amounts not exceeding the cost of the
[inspection and] reference [program] SYSTEM  for  clinical  laboratories
and  blood banks and shall be subject to the approval of the director of
the budget.  THE COMMISSIONER SHALL DETERMINE THE PROPER COST ALLOCATION
METHOD TO UTILIZE TO DETERMINE THE COST OF THE REFERENCE SYSTEM. THE FEE
PAID BY THE DEPARTMENT TO MAINTAIN AN EXEMPTION FOR  CLINICAL  LABORATO-
RIES AND BLOOD BANKS FROM THE REQUIREMENTS OF THE FEDERAL CLINICAL LABO-

S. 2809--A                         17                         A. 4009--A

RATORY  IMPROVEMENT AMENDMENTS OF NINETEEN HUNDRED EIGHTY-EIGHT SHALL BE
DEEMED A COST OF THE REFERENCE SYSTEM.
  (b)  In  determining  the  fee  charges to be assessed, the department
shall, on or before May first of each year, compute the  [total  actual]
costs for the preceding state fiscal year which were expended to operate
and  administer the duties of the department pursuant to this title. The
department shall, at such time or times and pursuant to  such  procedure
as it shall determine by regulation, bill and collect from each clinical
laboratory  and  blood bank an amount computed by multiplying such total
computed operating expenses of the department by a fraction the  numera-
tor of which is the gross annual receipts of such clinical laboratory or
blood  bank during such twelve month period preceding the date of compu-
tation as the department shall designate by regulation, and the  denomi-
nator  of which is the total gross annual receipts of all clinical labo-
ratories or blood banks operating in the state during such period.
  (c) Each such clinical laboratory and blood bank shall submit  to  the
department,  in  such  form  and  at  such  times  as the department may
require, a report containing  information  regarding  its  gross  annual
receipts [from the performance of tests or examination of specimens] FOR
ALL  ACTIVITIES  PERFORMED pursuant to a permit issued by the department
in accordance with the provisions of section five  hundred  seventy-five
of  this  title.  The  department may require additional information and
audit and review such information to verify its accuracy.
  (e) On or before September fifteenth  of  each  year,  the  department
shall  [recompute  the  actual] RECONCILE ITS costs and expenses [of the
department] FOR THE REFERENCE SYSTEM for the preceding state fiscal year
and shall, on or before October fifteenth send to each clinical  labora-
tory  and blood bank, a statement setting forth the amount due and paya-
ble by, or the amount computed to the credit of, such clinical laborato-
ry or blood bank, computed on the basis of  the  above  stated  formula,
except  that  for the purposes of such computation the fraction shall be
multiplied against the total recomputed [actual] expenses of the depart-
ment for such fiscal year. Any amount due shall  be  payable  not  later
than  thirty days following the date of such statement. Any credit shall
be applied against any succeeding payment due.
  S 21. Subdivision 1 of section 577 of the public health law is amended
by adding a new paragraph (i) to read as follows:
  (I) HAS BEEN FOUND UPON INSPECTION BY THE DEPARTMENT TO BE IN  NONCOM-
PLIANCE  WITH  A  PROVISION OR PROVISIONS OF THIS TITLE OR THE RULES AND
REGULATIONS PROMULGATED HEREUNDER, AND HAS FAILED TO ADDRESS SUCH  FIND-
INGS AS REQUIRED BY THE DEPARTMENT.
  S 22.  Intentionally Omitted.
  S 23.  Intentionally Omitted.
  S 24.  Intentionally Omitted.
  S 25.  Intentionally Omitted.
  S  25-a.  Section 2818 of the public health law is amended by adding a
new subdivision 6 to read as follows:
  6. NOTWITHSTANDING ANY CONTRARY PROVISION OF  THIS  SECTION,  SECTIONS
ONE HUNDRED TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW,
OR  ANY  OTHER CONTRARY PROVISION OF LAW, SUBJECT TO AVAILABLE APPROPRI-
ATIONS, FUNDS AVAILABLE FOR EXPENDITURE PURSUANT TO THIS SECTION MAY  BE
DISTRIBUTED BY THE COMMISSIONER WITHOUT A COMPETITIVE BID OR REQUEST FOR
PROPOSAL  PROCESS FOR GRANTS TO GENERAL HOSPITALS AND RESIDENTIAL HEALTH
CARE FACILITIES FOR THE PURPOSE OF FACILITATING  CLOSURES,  MERGERS  AND
RESTRUCTURING  OF  SUCH  FACILITIES  IN  ORDER TO STRENGTHEN AND PROTECT
CONTINUED ACCESS TO ESSENTIAL HEALTH CARE RESOURCES.

S. 2809--A                         18                         A. 4009--A

  S 26. Section 32 of part A of chapter 58 of the laws of 2008, amending
the elder law and other laws relating  to  reimbursement  to  particular
provider  pharmacies  and  prescription  drug  coverage,  as  amended by
section 20 of part OO of chapter 57 of the laws of 2008, is  amended  to
read as follows:
  S  32.  This  act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2008;  provided
however,  that  sections  one, six-a, nineteen, twenty, twenty-four, and
twenty-five of this act shall take effect July 1, 2008; [provided howev-
er that sections sixteen, seventeen  and  eighteen  of  this  act  shall
expire  April  1,  2011;] provided, however, that the amendments made by
section twenty-eight of this act shall take effect on the same  date  as
section  1  of  chapter  281  of the laws of 2007 takes effect; provided
further, that sections twenty-nine, thirty, and thirty-one of  this  act
shall  take effect October 1, 2008; provided further, that section twen-
ty-seven of this act shall take effect January  1,  2009;  and  provided
further,  that  section  twenty-seven  of  this  act shall expire and be
deemed repealed March 31, 2011; and provided, further, however, that the
amendments to subdivision 1 of section 241 of the education law made  by
section  twenty-nine of this act shall not affect the expiration of such
subdivision and shall be deemed to expire therewith  and  provided  that
the  amendments  to section 272 of the public health law made by section
thirty of this act shall not affect the repeal of such section and shall
be deemed repealed therewith.
  S 27. Section 4 of part X2 of chapter 62 of the laws of 2003, amending
the public health law relating to allowing for the use of funds  of  the
office  of  professional  medical  conduct for activities of the patient
health information and quality improvement act of 2000,  as  amended  by
chapter 21 of the laws of 2010, is amended to read as follows:
  S  4.  This  act  shall  take  effect  immediately;  provided that the
provisions of section one of this act shall be deemed to  have  been  in
full force and effect on and after April 1, 2003, and shall expire March
31, [2011] 2013 when upon such date the provisions of such section shall
be deemed repealed.
  S  28.  Paragraph (b) of subdivision 1 of section 76 of chapter 731 of
the laws of 1993, amending the public health law and other laws relating
to reimbursement, delivery and capital cost of  ambulatory  health  care
services  and  inpatient  hospital services, as amended by section 14 of
part A of chapter 58 of the laws of 2007, is amended to read as follows:
  (b) sections fifteen through nineteen and  subdivision  3  of  section
2807-e  of  the public health law as added by section twenty of this act
shall expire on [July 1, 2011] JULY 1, 2014, and section seventy-four of
this act shall expire on July 1, 2007;
  S 29. Section 4 of chapter 505 of  the  laws  of  1995,  amending  the
public  health  law  relating  to  the operation of department of health
facilities, as amended by chapter 609 of the laws of 2007, is amended to
read as follows:
  S 4. This act shall take effect immediately[; provided, however,  that
the provisions of paragraph (b) of subdivision 4 of section 409-c of the
public  health  law,  as  added by section three of this act, shall take
effect January 1, 1996 and shall expire and be deemed  repealed  sixteen
years from the effective date thereof].
  S  30.  Section 3 of chapter 303 of the laws of 1999, amending the New
York state medical  care  facilities  finance  agency  act  relating  to
financing  health  facilities,  as amended by chapter 607 of the laws of
2007, is amended to read as follows:

S. 2809--A                         19                         A. 4009--A

  S 3. This act shall take effect immediately[, provided, however,  that
subdivision 15-a of section 5 of section 1 of chapter 392 of the laws of
1973,  as  added  by section one of this act, shall expire and be deemed
repealed June 30, 2011; and provided further, however, that the  expira-
tion  and  repeal of such subdivision 15-a shall not affect or impair in
any manner any health facilities bonds issued, or any lease or  purchase
of  a  health facility executed, pursuant to such subdivision 15-a prior
to its expiration and repeal and that, with respect to  any  such  bonds
issued  and  outstanding  as  of  June  30, 2011, the provisions of such
subdivision 15-a as they existed immediately prior  to  such  expiration
and  repeal  shall continue to apply through the latest maturity date of
any such bonds, or their earlier retirement or redemption, for the  sole
purpose  of  authorizing the issuance of refunding bonds to refund bonds
previously issued pursuant thereto].
  S 31. This act shall take effect  April  1,  2011,  provided,  however
that:
  (a) section one of this act shall take effect July 1, 2011;
  (b) sections two through three-n of this act shall take effect January
1, 2012;
  (c) section thirteen of this act shall take effect July 1, 2011; and
  (d)  related  to sections eighteen, nineteen, twenty and twenty-one of
this act, the commissioner of health is authorized to promulgate, on  an
emergency basis, any regulations necessary to implement any provision of
such sections upon their effective date.

                                 PART B

  Section  1.    (a)  Notwithstanding any inconsistent provision of law,
rule or regulation to the contrary, and subject to the  availability  of
federal  financial participation, effective for the period April 1, 2011
through March 31, 2012, and  each  state  fiscal  year  thereafter,  the
department  of  health  is  authorized  to  make  supplemental  Medicaid
payments for professional services provided by physicians, nurse practi-
tioners and physician assistants who are participating in a plan for the
management of clinical practice at the State University of New York,  in
accordance  with  title  11  of article 5 of the social services law for
patients eligible for federal financial participation under title XIX of
the federal social security act, in amounts that will increase fees  for
such  professional services to an amount equal to the average commercial
rate that would otherwise be received for such services rendered by such
physicians, nurse practitioners and  physician  assistants.  The  calcu-
lation  of  such  supplemental  fee payments shall be made in accordance
with applicable federal law and regulation and subject to  the  approval
of  the  division of the budget. Such supplemental Medicaid fee payments
may be added to the professional fees paid under  the  fee  schedule  or
made  as aggregate lump sum payments to eligible clinical practice plans
authorized to receive professional fees.
  (b) The affiliated State University of New York health science centers
shall be responsible for payment of one hundred percent of the  non-fed-
eral  share  of  such  supplemental  Medicaid  payments for all services
provided by physicians, nurse practitioners and physician assistants who
are participating in a plan for the management of clinical practice,  in
accordance  with section 365-a of the social services law, regardless of
whether another social services district or the department of health may
otherwise be responsible for furnishing medical assistance to the eligi-
ble persons receiving such services.

S. 2809--A                         20                         A. 4009--A

  S 2.  Subdivision 21 of section 2807-c of the  public  health  law  is
amended by adding a new paragraph (e-1) to read as follows:
  (E-1) FOR PERIODS ON AND AFTER JANUARY FIRST, TWO THOUSAND ELEVEN, FOR
PURPOSES  OF  CALCULATIONS  PURSUANT  TO  PARAGRAPHS (B) AND (C) OF THIS
SUBDIVISION OF MAXIMUM DISPROPORTIONATE SHARE PAYMENT DISTRIBUTIONS  FOR
A  RATE  YEAR  OR  PART  THEREOF,  COSTS INCURRED OF FURNISHING HOSPITAL
SERVICES NET OF MEDICAL ASSISTANCE PAYMENTS, OTHER THAN DISPROPORTIONATE
SHARE PAYMENTS, AND PAYMENTS BY UNINSURED PATIENTS  SHALL  FOR  THE  TWO
THOUSAND  ELEVEN  CALENDAR  YEAR, SHALL BE DETERMINED INITIALLY BASED ON
EACH HOSPITAL'S SUBMISSION OF  A  FULLY  COMPLETED  TWO  THOUSAND  EIGHT
DISPROPORTIONATE  SHARE HOSPITAL DATA COLLECTION TOOL, WHICH IS REQUIRED
TO BE SUBMITTED TO THE DEPARTMENT BY MARCH  THIRTY-FIRST,  TWO  THOUSAND
ELEVEN,  AND  SHALL  BE  SUBSEQUENTLY REVISED TO REFLECT EACH HOSPITAL'S
SUBMISSION OF A FULLY COMPLETED TWO THOUSAND NINE DISPROPORTIONATE SHARE
HOSPITAL DATA COLLECTION TOOL, WHICH IS REQUIRED TO BE SUBMITTED TO  THE
DEPARTMENT BY OCTOBER FIRST, TWO THOUSAND ELEVEN.
  FOR  CALENDAR  YEARS  ON  AND  AFTER TWO THOUSAND TWELVE, SUCH INITIAL
DETERMINATIONS SHALL REFLECT SUBMISSION  OF  DATA  AS  REQUIRED  BY  THE
COMMISSIONER ON A SPECIFIED DATE.  ALL SUCH INITIAL DETERMINATIONS SHALL
SUBSEQUENTLY  BE  REVISED TO REFLECT ANNUAL RATE PERIOD DATA AND STATIS-
TICS. INDIGENT CARE PAYMENTS WILL BE WITHHELD IN INSTANCES WHEN A HOSPI-
TAL HAS NOT SUBMITTED REQUIRED INFORMATION BY THE DUE  DATES  PRESCRIBED
IN  THIS  PARAGRAPH, PROVIDED, HOWEVER, THAT SUCH PAYMENTS SHALL BE MADE
UPON SUBMISSION OF SUCH REQUIRED  DATA.  FOR  PURPOSES  OF  CALCULATIONS
PURSUANT  TO PARAGRAPH (D) OF THIS SUBDIVISION OF ELIGIBILITY TO RECEIVE
DISPROPORTIONATE SHARE PAYMENTS FOR A RATE YEAR  OR  PART  THEREOF,  THE
HOSPITAL  INPATIENT  UTILIZATION  RATE  SHALL BE DETERMINED BASED ON THE
BASE YEAR STATISTICS IN ACCORDANCE WITH THE METHODOLOGY  ESTABLISHED  BY
THE  COMMISSIONER,  AND  COSTS  INCURRED OF FURNISHING HOSPITAL SERVICES
SHALL BE DETERMINED IN ACCORDANCE WITH A METHODOLOGY ESTABLISHED BY  THE
COMMISSIONER  CONSISTENT  WITH  REQUIREMENTS  OF  THE  SECRETARY  OF THE
DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR PURPOSES OF  FEDERAL  FINAN-
CIAL PARTICIPATION PURSUANT TO THE TITLE XIX OF THE FEDERAL SOCIAL SECU-
RITY ACT IN DISPROPORTIONATE SHARE PAYMENTS.
  S  3.  Subparagraph (i) of paragraph (b) of subdivision 2-b of section
2808 of the public health law, as amended by section  1  of  part  D  of
chapter 58 of the laws of 2010, is amended to read as follows:
  (i)  Subject  to the provisions of subparagraphs (ii) through (xiv) of
this paragraph, for periods on and after April first, two thousand  nine
through June thirtieth, two thousand eleven the operating cost component
of  rates of payment shall reflect allowable operating costs as reported
in each facility's cost report for the two thousand two  calendar  year,
as  adjusted  for  inflation  on  an annual basis in accordance with the
methodology set forth in paragraph (c) of  subdivision  ten  of  section
twenty-eight  hundred  seven-c  of this article, provided, however, that
for those facilities which do not receive a per diem  add-on  adjustment
pursuant  to  subparagraph  (ii)  of  paragraph (a) of this subdivision,
rates shall be further adjusted to include the proportionate benefit, as
determined by the commissioner, of the expiration of the  opening  para-
graph  and  paragraph  (a) of subdivision sixteen of this section and of
paragraph (a) of subdivision fourteen  of  this  section,  and  provided
further  that the operating cost component of rates of payment for those
facilities which did not receive a per  diem  adjustment  in  accordance
with subparagraph (ii) of paragraph (a) of this subdivision shall not be
less  than  the  operating component such facilities received in the two
thousand eight rate period, as adjusted for inflation on an annual basis

S. 2809--A                         21                         A. 4009--A

in accordance with the methodology set forth in paragraph (c) of  subdi-
vision  ten  of section twenty-eight hundred seven-c of this article and
further provided, however, that rates  for  facilities  whose  operating
cost component reflects base year costs subsequent to January first, two
thousand  two  shall  have  rates computed in accordance with this para-
graph, utilizing allowable operating costs as reported  in  such  subse-
quent  base year period, and trended forward to the rate year in accord-
ance with applicable inflation factors, AND PROVIDED  FURTHER,  HOWEVER,
THAT  NOTWITHSTANDING  ANY  INCONSISTENT  PROVISION OF THIS SUBDIVISION,
RATE ADJUSTMENTS AS DESCRIBED IN THIS SUBPARAGRAPH AND AS EFFECTIVE  FOR
RATE  PERIODS  ON  AND AFTER APRIL FIRST, TWO THOUSAND NINE THROUGH JUNE
THIRTIETH, TWO THOUSAND ELEVEN, SHALL NOT BE IMPLEMENTED AND PAID  PRIOR
TO JULY FIRST, TWO THOUSAND ELEVEN.
  S  4.  Section 2 of part D of chapter 58 of the laws of 2009, amending
the public health law and other laws relating to Medicaid reimbursements
to residential health care facilities, as amended by section 3 of Part D
of chapter 58 of the laws of 2010, is amended to read as follows:
  S 2. Notwithstanding paragraph (b) of subdivision 2-b of section  2808
of  the  public  health law or any other contrary provision of law, with
regard to  adjustments  to  medicaid  rates  of  payment  for  inpatient
services  provided  by residential health care facilities for the period
April 1, 2009 through March 31, 2010, made pursuant to paragraph (b)  of
subdivision  2-b  of  section 2808 of the public health law, the commis-
sioner of health and the director of the budget shall, upon  a  determi-
nation  that  such adjustments, including the application of adjustments
authorized by the provisions of paragraph  (g)  of  subdivision  2-b  of
section  2808  of  the  public  health law, shall result in an aggregate
increase in total Medicaid rates of payment for such services  for  such
period  that  is  less than or more than two hundred ten million dollars
($210,000,000), make such proportional adjustments to such rates as  are
necessary to result in an increase of such aggregate expenditures of two
hundred ten million dollars ($210,000,000), and provided further, howev-
er,  that  notwithstanding  section 2808 of the public health law or any
other contrary provision of law, with regard to adjustments to inpatient
rates of payment made pursuant to section 2808 of the public health  law
for  inpatient  services  provided by residential health care facilities
for the period April 1, 2010 through [June 30, 2011] MARCH 31, 2012, the
commissioner of health and the director of  the  budget  shall,  upon  a
determination  by  such  commissioner  and  such director that such rate
adjustments shall, prior to the application of any applicable adjustment
for inflation, result in an aggregate increase in total  Medicaid  rates
of  payment  for  such  services,  including  payments  made pursuant to
subparagraph (i) of paragraph (d) of subdivision 2-c of section 2808  of
the  public health law, make such proportional adjustments to such rates
as are necessary to reduce such total aggregate  rate  adjustments  such
that  the  aggregate  total  reflects  no such increase or decrease, and
provided further, however, the case mix adjustments as otherwise author-
ized by subparagraph (ii) of paragraph (b) of subdivision 2-b of section
2808 of the public health law and as scheduled for January of 2011 shall
not be made.  Adjustments made pursuant to this  section  shall  not  be
subject to subsequent correction or reconciliation.
  S  5. Notwithstanding any contrary provision of law and subject to the
availability of federal financial  participation,  for  periods  on  and
after  July  1,  2011, Medicaid rates of payments for inpatient services
provided by residential health care facilities which, as of  the  effec-
tive date of this section, operate discrete units for treatment of resi-

S. 2809--A                         22                         A. 4009--A

dents  with  huntington's  disease,  shall be increased by a rate add-on
amount. The aggregate amount of such rate add-ons for the period July 1,
2011 through December 31, 2011 shall be  eight  hundred  fifty  thousand
dollars  ($850,000),  and  shall  be  one million seven hundred thousand
dollars ($1,700,000) for the 2012 calendar year and each year thereafter
and such amounts shall be allocated to each eligible residential  health
care facility proportionally, based on the number of beds in each facil-
ity's  discrete  unit  for treatment of huntington's disease relative to
the total number of such beds in all such units. Such rate add-ons shall
be computed utilizing reported Medicaid days from certified cost reports
as submitted to the department of health for the  calendar  year  period
two  years  prior  to  the  applicable rate year and, further, such rate
add-ons shall not be subject to subsequent adjustment or reconciliation.
  S 6. Notwithstanding section 448 of chapter 170 of the  laws  of  1994
and  section  4  of  chapter 81 of the laws of 1995, as amended, and any
other inconsistent provision of law or regulation  and  subject  to  the
availability of federal financial participation, for the period April 1,
2011 through June 30, 2011, medical assistance rates of payment to resi-
dential health care facilities and diagnostic treatment centers licensed
under  article  28  of  the  public health law for adult day health care
services provided to registrants with acquired immunodeficiency syndrome
(AIDS) or other human immunodeficiency virus  (HIV)  related  illnesses,
shall  be  increased by an aggregate amount of one million eight hundred
sixty-seven thousand dollars ($1,867,000). Such amount  shall  be  allo-
cated  proportionally  among such providers based on the medical assist-
ance visits reported by each provider in  the  most  recently  available
cost  report,  as  submitted  to  the department of health by January 1,
2011, and shall be included as adjustments to each provider's daily rate
of payment for such services. Such adjustments shall not be  subject  to
subsequent adjustment or reconciliation.
  S  7.  Notwithstanding any contrary provision of law or regulation and
subject to availability of  federal  financial  participation,  for  the
period  April 1, 2011 through June 30, 2011, rates of payment by govern-
mental agencies to residential health care facilities and diagnostic and
treatment centers licensed under article 28 of the public health law for
adult day health care services provided  to  registrants  with  acquired
immunodeficiency  syndrome  (AIDS) or other human immunodeficiency virus
(HIV) related illnesses, shall reflect an adjustment to  such  rates  of
payments  in  an  aggregate  amount  of  two hundred thirty-six thousand
dollars ($236,000) and distributed proportionally as rate add-ons, based
on each eligible providers' Medicaid visits as reported in such  provid-
er's  most recently available cost report as submitted to the department
of health prior to January 1, 2011, and provided further, however,  that
such adjustments shall not be subject to subsequent adjustment or recon-
ciliation.
  S  8.  Subparagraph  (vi) of paragraph (b) of subdivision 2 of section
2807-d of the public health law, as amended by section 37 of part  C  of
chapter 58 of the laws of 2007, is amended to read as follows:
  (vi)  Notwithstanding  any contrary provision of this paragraph or any
other provision of law or regulation to the  contrary,  for  residential
health care facilities the assessment shall be six percent of each resi-
dential  health care facility's gross receipts received from all patient
care services and other operating income on a cash basis for the  period
April  first,  two thousand two through March thirty-first, two thousand
three for hospital  or  health-related  services,  including  adult  day
services;  provided,  however,  that residential health care facilities'

S. 2809--A                         23                         A. 4009--A

gross receipts attributable to payments received pursuant to title XVIII
of the federal social security act (medicare) shall be excluded from the
assessment; provided, however, that for all such gross receipts received
on  or after April first, two thousand three through March thirty-first,
two thousand five, such assessment shall be five  percent,  and  further
provided  that  for  all  such gross receipts received on or after April
first, two thousand five through March thirty-first, two thousand  nine,
and  on  or  after  April first, two thousand nine through March thirty-
first, two thousand eleven such assessment shall  be  six  percent,  AND
FURTHER  PROVIDED  THAT FOR ALL SUCH GROSS RECEIPTS RECEIVED ON OR AFTER
APRIL FIRST, TWO THOUSAND ELEVEN SUCH ASSESSMENT SHALL BE SIX PERCENT.
  S 9. Notwithstanding any inconsistent provision of state law, rule  or
regulation to the contrary, subject to federal approval, the state shall
not take any administrative or statutory action that would result in the
year  to  year  rate  of growth of state share Medicaid spending, in the
aggregate, to exceed the ten year rolling average of the medical  compo-
nent  of  the  consumer  price  index  as published by the United States
department of labor, bureau of labor statistics for  the  preceding  ten
years.
  S 10. Notwithstanding any inconsistent provision of law, rule or regu-
lation, for purposes of implementing the provisions of the public health
law and the social services law, references to titles XIX and XXI of the
federal  social  security  act  in  the public health law and the social
services law shall be deemed to include and also to mean  any  successor
titles thereto under the federal social security act.
  S 11. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the  public health law, section 18 of chapter 2 of the laws of 1988, and
18 NYCRR 505.14(h), as they relate to time frames for  notice,  approval
or  certification  of rates of payment, are hereby suspended and without
force or effect for purposes of implementing the provisions of this act.
  S 12. Severability clause. If any clause, sentence, paragraph,  subdi-
vision,  section  or  part of this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment  shall  not  affect,
impair or invalidate the remainder thereof, but shall be confined in its
operation  to  the  clause, sentence, paragraph, subdivision, section or
part thereof directly involved in the controversy in  which  such  judg-
ment shall have been rendered. It is hereby declared to be the intent of
the  legislature  that  this  act  would  have been enacted even if such
invalid provisions had not been included herein.
  S 13. This act shall take effect immediately and shall  be  deemed  to
have been in full force and effect on and after April 1, 2011; provided,
however, that:
  (a)  any rules or regulations necessary to implement the provisions of
this act may be promulgated and any procedures, forms,  or  instructions
necessary  for such implementation may be adopted and issued on or after
the date this act shall have become a law;
  (b) this act shall not be construed to alter, change,  affect,  impair
or defeat any rights, obligations, duties or interests accrued, incurred
or conferred prior to the effective date of this act;
  (c) the commissioner of health and the superintendent of insurance and
any  appropriate  council may take any steps necessary to implement this
act prior to its effective date;
  (d) notwithstanding any inconsistent provision of the  state  adminis-
trative procedure act or any other provision of law, rule or regulation,
the  commissioner  of health and the superintendent of insurance and any

S. 2809--A                         24                         A. 4009--A

appropriate council is authorized to adopt or amend or promulgate on  an
emergency  basis  any  regulation  he  or she or such council determines
necessary to implement any provision of this act on its effective  date;
and
  (e)  the provisions of this act shall become effective notwithstanding
the failure of the commissioner  of  health  or  the  superintendent  of
insurance  or  any  council  to adopt or amend or promulgate regulations
implementing this act.

                                 PART C

  Section 1. Subdivision 5 of section 168 of chapter 639 of the laws  of
1996,  constituting  the  New  York  Health  Care Reform Act of 1996, as
amended by section 1 of part B of chapter 58 of the  laws  of  2008,  is
amended to read as follows:
  5.  sections  2807-c,  2807-j,  2807-s and 2807-t of the public health
law, as amended or as added by this act, shall expire  on  December  31,
[2011]  2014,  and  shall be thereafter effective only in respect to any
act done on or before such date or action or proceeding arising  out  of
such  act  including continued collections of funds from assessments and
allowances and  surcharges  established  pursuant  to  sections  2807-c,
2807-j,  2807-s  and 2807-t of the public health law, and administration
and distributions of funds from pools established pursuant  to  sections
2807-c,  2807-j, 2807-k, 2807-l, 2807-m, 2807-s and 2807-t of the public
health law related to patient  services  provided  before  December  31,
[2011]  2014, and continued expenditure of funds authorized for programs
and grants until the exhaustion of funds therefor;
  S 2. Subdivision 1 of section 138 of chapter 1 of the  laws  of  1999,
constituting  the New York Health Care Reform Act of 2000, as amended by
section 1-a of part B of chapter 58 of the laws of 2008, is  amended  to
read as follows:
  1.  sections  2807-c,  2807-j, 2807-s, and 2807-t of the public health
law, as amended by this act, shall expire on December 31,  [2011]  2014,
and shall be thereafter effective only in respect to any act done before
such  date  or  action  or  proceeding arising out of such act including
continued collections of  funds  from  assessments  and  allowances  and
surcharges  established  pursuant to sections 2807-c, 2807-j, 2807-s and
2807-t of the public health law, and administration and distributions of
funds from  pools  established  pursuant  to  sections  2807-c,  2807-j,
2807-k,  2807-l, 2807-m, 2807-s, 2807-t, 2807-v and 2807-w of the public
health law, as amended or added by this act, related to patient services
provided before December 31, [2011] 2014, and continued  expenditure  of
funds  authorized  for programs and grants until the exhaustion of funds
therefor;
  S 3. Paragraph (a) of subdivision 9 of section 2807-j  of  the  public
health  law, as amended by section 2 of part B of chapter 58 of the laws
of 2008, is amended to read as follows:
  (a) funds shall be deposited and credited to a  special  revenue-other
fund  to  be established by the comptroller or to the health care reform
act (HCRA) resources fund established pursuant to section  ninety-two-dd
of  the  state  finance  law,  whichever is applicable. To the extent of
funds appropriated therefore, the commissioner shall  make  payments  to
general  hospitals  related  to  bad  debt  and charity care pursuant to
section twenty-eight hundred seven-k of this  article.  Funds  shall  be
deposited in the following amounts:

S. 2809--A                         25                         A. 4009--A

  (i) fifty-seven and thirty-three-hundredths percent of the funds accu-
mulated  for  the  period  January  first, nineteen hundred ninety-seven
through December thirty-first, nineteen hundred ninety-seven,
  (ii)  fifty-seven  and one-hundredths percent of the funds accumulated
for the period January  first,  nineteen  hundred  ninety-eight  through
December thirty-first, nineteen hundred ninety-eight,
  (iii)  fifty-five and thirty-two-hundredths percent of the funds accu-
mulated for the  period  January  first,  nineteen  hundred  ninety-nine
through December thirty-first, nineteen hundred ninety-nine, and
  (iv)  seven  hundred  sixty-five million dollars annually of the funds
accumulated for the periods January first, two thousand through December
thirty-first, two thousand [ten] THIRTEEN, and
  (v) one hundred ninety-one million two hundred fifty thousand  dollars
of  the  funds  accumulated  for  the period January first, two thousand
[eleven] FOURTEEN through  March  thirty-first,  two  thousand  [eleven]
FOURTEEN.
  S 4. Section 34 of part A3 of chapter 62 of the laws of 2003, amending
the  general  business  law  and  other  laws relating to enacting major
components necessary to implement the state fiscal plan for the  2003-04
state  fiscal  year,  as amended by section 3 of part B of chapter 58 of
the laws of 2008, is amended to read as follows:
  S 34. (1) Notwithstanding any inconsistent provision of law,  rule  or
regulation  and  effective  April 1, 2008 through March 31, [2011] 2014,
the commissioner of health is authorized to transfer and the state comp-
troller is authorized and directed to receive for deposit to the  credit
of  the department of health's special revenue fund - other, health care
reform act (HCRA) resources fund - 061, provider  collection  monitoring
account,  within  amounts  appropriated each year, those funds collected
and accumulated pursuant to section 2807-v of  the  public  health  law,
including  income  from  invested  funds, for the purpose of payment for
administrative costs of the department of  health  related  to  adminis-
tration  of  statutory  duties  for  the  collections  and distributions
authorized by section 2807-v of the public health law.
  (2) Notwithstanding any inconsistent provision of law, rule  or  regu-
lation  and  effective  April 1, 2008 through March 31, [2011] 2014, the
commissioner of health is authorized to transfer  and  the  state  comp-
troller  is authorized and directed to receive for deposit to the credit
of the department of health's special revenue fund - other, health  care
reform  act  (HCRA) resources fund - 061, provider collection monitoring
account, within amounts appropriated each year,  those  funds  collected
and  accumulated  and interest earned through surcharges on payments for
health care services pursuant to section 2807-s of the public health law
and from assessments pursuant to section 2807-t of the public health law
for the purpose of payment for administrative costs of the department of
health related to administration of statutory duties for the collections
and distributions authorized by sections 2807-s, 2807-t, and  2807-m  of
the public health law.
  (3)  Notwithstanding  any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31,  [2011]  2014,  the
commissioner  of health is authorized to transfer and the comptroller is
authorized to deposit, within  amounts  appropriated  each  year,  those
funds  authorized  for distribution in accordance with the provisions of
paragraph (a) of subdivision 1 of section 2807-l of  the  public  health
law  for the purposes of payment for administrative costs of the depart-
ment of health related  to  the  child  health  insurance  plan  program
authorized  pursuant to title 1-A of article 25 of the public health law

S. 2809--A                         26                         A. 4009--A

into the special revenue funds - other, health care  reform  act  (HCRA)
resources fund - 061, child health insurance account, established within
the department of health.
  (4)  Notwithstanding  any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31,  [2011]  2014,  the
commissioner  of health is authorized to transfer and the comptroller is
authorized to deposit, within  amounts  appropriated  each  year,  those
funds  authorized  for distribution in accordance with the provisions of
paragraph (e) of subdivision 1 of section 2807-l of  the  public  health
law  for  the purpose of payment for administrative costs of the depart-
ment of health related to the health occupation  development  and  work-
place  demonstration  program established pursuant to section 2807-h and
the health workforce retraining program established pursuant to  section
2807-g  of the public health law into the special revenue funds - other,
health care reform act (HCRA) resources fund -  061,  health  occupation
development  and  workplace  demonstration  program account, established
within the department of health.
  (5) Notwithstanding any inconsistent provision of law, rule  or  regu-
lation  and  effective  April 1, 2008 through March 31, [2011] 2014, the
commissioner of health is authorized to transfer and the comptroller  is
authorized  to  deposit,  within  amounts  appropriated each year, those
funds allocated pursuant to paragraph (j) of subdivision  1  of  section
2807-v  of the public health law for the purpose of payment for adminis-
trative costs of the department of health related to  administration  of
the state's tobacco control programs and cancer services provided pursu-
ant  to  sections  2807-r and 1399-ii of the public health law into such
accounts established within the department of health for such purposes.
  (6) Notwithstanding any inconsistent provision of law, rule  or  regu-
lation  and  effective  April 1, 2008 through March 31, [2011] 2014, the
commissioner of health is authorized to transfer and the comptroller  is
authorized  to deposit, within amounts appropriated each year, the funds
authorized for distribution in accordance with the provisions of section
2807-l of the public health law for the purposes of payment for adminis-
trative costs of the department of health related to the programs funded
pursuant to section 2807-l of the public health  law  into  the  special
revenue  funds  -  other, health care reform act (HCRA) resources fund -
061, pilot health insurance account, established within  the  department
of health.
  (7)  Notwithstanding  any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31,  [2011]  2014,  the
commissioner  of health is authorized to transfer and the comptroller is
authorized to deposit, within  amounts  appropriated  each  year,  those
funds  authorized  for distribution in accordance with the provisions of
subparagraph (ii) of paragraph (f) of subdivision 19 of  section  2807-c
of  the public health law from monies accumulated and interest earned in
the bad debt and charity care and capital  statewide  pools  through  an
assessment  charged  to  general hospitals pursuant to the provisions of
subdivision 18 of section 2807-c of the  public  health  law  and  those
funds  authorized  for distribution in accordance with the provisions of
section 2807-l of the public health law for the purposes of payment  for
administrative  costs  of  the  department of health related to programs
funded under section 2807-l of the public health law  into  the  special
revenue  funds  -  other, health care reform act (HCRA) resources fund -
061, primary care initiatives account, established within the department
of health.

S. 2809--A                         27                         A. 4009--A

  (8) Notwithstanding any inconsistent provision of law, rule  or  regu-
lation  and  effective  April 1, 2008 through March 31, [2011] 2014, the
commissioner of health is authorized to transfer and the comptroller  is
authorized  to  deposit,  within  amounts  appropriated each year, those
funds  authorized  for distribution in accordance with section 2807-l of
the public health law for the purposes  of  payment  for  administrative
costs  of  the  department  of  health  related to programs funded under
section 2807-l of the public health law into the special revenue funds -
other, health care reform act (HCRA) resources fund - 061,  health  care
delivery  administration  account,  established within the department of
health.
  (9) Notwithstanding any inconsistent provision of law, rule  or  regu-
lation  and  effective  April 1, 2008 through March 31, [2011] 2014, the
commissioner of health is authorized to transfer and the comptroller  is
authorized  to  deposit,  within  amounts  appropriated each year, those
funds authorized pursuant to sections 2807-d, 3614-a and 3614-b  of  the
public  health  law and section 367-i of the social services law and for
distribution in accordance with  the  provisions  of  subdivision  9  of
section  2807-j  of the public health law for the purpose of payment for
administration of statutory duties for the collections and distributions
authorized by sections 2807-c, 2807-d, 2807-j,  2807-k,  2807-l,  3614-a
and  3614-b  of  the  public  health law and section 367-i of the social
services law into the special revenue funds - other, health care  reform
act (HCRA) resources fund - 061, provider collection monitoring account,
established within the department of health.
  S 5. Subparagraphs (xiv) and (xv) of paragraph (a) of subdivision 6 of
section 2807-s of the public health law, as amended by section 4 of part
I of chapter 2 of the laws of 2009, are amended to read as follows:
  (xiv)  A  gross  annual statewide amount for the period January first,
two thousand nine through  December  thirty-first,  two  thousand  [ten]
THIRTEEN,   shall  be  nine  hundred  [thirty-nine]  FORTY-FOUR  million
dollars.
  (xv) A gross statewide amount for the period January first, two  thou-
sand [eleven] FOURTEEN through March thirty-first, two thousand [eleven]
FOURTEEN,  shall  be two hundred [thirty-four] THIRTY-SIX million [seven
hundred fifty thousand] dollars.
  S 5-a. Subparagraphs (iv) and (v) of paragraph (c) of subdivision 6 of
section 2807-s of the public health law, as amended  by  section  12  of
part  B  of  chapter  58  of  the  laws  of 2008, are amended to read as
follows:
  (iv) A further gross annual statewide amount  for  two  thousand,  two
thousand  one,  two thousand two, two thousand three, two thousand four,
two thousand five, two thousand six, two thousand  seven,  two  thousand
eight,  two  thousand nine [and], two thousand ten, TWO THOUSAND ELEVEN,
TWO THOUSAND TWELVE AND  TWO  THOUSAND  THIRTEEN  shall  be  eighty-nine
million dollars.
  (v) A further gross statewide amount for the period January first, two
thousand  [eleven]  FOURTEEN  through  March  thirty-first, two thousand
[eleven] FOURTEEN, shall be twenty-two million two hundred  fifty  thou-
sand dollars.
  S 5-b. Subparagraphs (i) and (ii) of paragraph (e) of subdivision 6 of
section  2807-s  of  the  public health law, as amended by section 13 of
part B of chapter 58 of the  laws  of  2008,  are  amended  to  read  as
follows:

S. 2809--A                         28                         A. 4009--A

  (i)  A  further  gross annual statewide amount shall be twelve million
dollars for each period prior to January first,  two  thousand  [eleven]
FOURTEEN.
  (ii)  A  further  gross statewide amount for the period January first,
two thousand [eleven] FOURTEEN through March thirty-first, two  thousand
[eleven] FOURTEEN shall be three million dollars.
  S 6. Subparagraphs (x), (xi), (xii), (xiii) and (xiv) of paragraph (a)
of  subdivision 7 of section 2807-s of the public health law, as amended
by section 100 of part C of chapter 58 of the laws of 2009, are  amended
to read as follows:
  (x)  forty-seven million two hundred ten thousand dollars on an annual
basis for the periods January first, two thousand nine through  December
thirty-first, two thousand ten; [and]
  (xi)  eleven  million  eight  hundred  thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven;
  (xii) TWENTY-THREE MILLION EIGHT HUNDRED THIRTY-SIX  THOUSAND  DOLLARS
EACH  STATE  FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN;
  (XIII) provided, however, for periods  prior  to  January  first,  two
thousand nine, amounts set forth in this paragraph may be reduced by the
commissioner  in  an amount to be approved by the director of the budget
to reflect the amount received from the  federal  government  under  the
state's  1115 waiver which is directed under its terms and conditions to
the graduate medical education program established pursuant  to  section
twenty-eight hundred seven-m of this article;
  [(xiii)]  (XIV)  provided  further, however, for periods prior to July
first, two thousand nine, amounts set forth in this paragraph  shall  be
reduced  by  an amount equal to the total actual distribution reductions
for all facilities pursuant to paragraph (e)  of  subdivision  three  of
section twenty-eight hundred seven-m of this article; and
  [(xiv)]  (XV)  provided  further,  however,  for periods prior to July
first, two thousand nine, amounts set forth in this paragraph  shall  be
reduced by an amount equal to the actual distribution reductions for all
facilities pursuant to paragraph (s) of subdivision one of section twen-
ty-eight hundred seven-m of this article.
  S  7. Section 2807-l of the public health law, as amended by section 4
of part B of chapter 58 of the laws of 2008, clause (A) of  subparagraph
(i) of paragraph (b) of subdivision 1 as amended by section 51 of part B
and  paragraph (n) of subdivision 1 as amended by section 9 of part C of
chapter 58 of the laws of 2009, subparagraph (iv) of  paragraph  (c)  of
subdivision  1  as amended by section 13 of part B of chapter 109 of the
laws of 2010, is amended to read as follows:
  S 2807-l. Health care initiatives pool distributions. 1. Funds accumu-
lated in the health care initiatives pools pursuant to paragraph (b)  of
subdivision  nine  of section twenty-eight hundred seven-j of this arti-
cle, or the health care reform act  (HCRA)  resources  fund  established
pursuant to section ninety-two-dd of the state finance law, whichever is
applicable,  including  income from invested funds, shall be distributed
or retained by the commissioner or by the state comptroller, as applica-
ble, in accordance with the following.
  (a) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of distributions to programs to provide health care coverage  for  unin-
sured  or underinsured children pursuant to sections twenty-five hundred
ten and twenty-five hundred eleven of this chapter from  the  respective

S. 2809--A                         29                         A. 4009--A

health  care  initiatives pools established for the following periods in
the following amounts:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
up to one hundred twenty million six hundred thousand dollars;
  (ii) from the pool for the  period  January  first,  nineteen  hundred
ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
eight, up to  one  hundred  sixty-four  million  five  hundred  thousand
dollars;
  (iii)  from  the  pool  for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
up to one hundred eighty-one million dollars;
  (iv) from the pool for the period January first, two thousand  through
December thirty-first, two thousand, two hundred seven million dollars;
  (v)  from  the  pool  for  the  period January first, two thousand one
through December thirty-first, two thousand one, two hundred thirty-five
million dollars;
  (vi) from the pool for the period  January  first,  two  thousand  two
through  December  thirty-first, two thousand two, three hundred twenty-
four million dollars;
  (vii) from the pool for the period January first, two  thousand  three
through  December  thirty-first,  two thousand three, up to four hundred
fifty million three hundred thousand dollars;
  (viii) from the pool for the period January first, two  thousand  four
through  December  thirty-first,  two  thousand four, up to four hundred
sixty million nine hundred thousand dollars;
  (ix) from the pool or the health  care  reform  act  (HCRA)  resources
fund,  whichever  is applicable, for the period January first, two thou-
sand five through December thirty-first, two thousand five,  up  to  one
hundred fifty-three million eight hundred thousand dollars;
  (x)  from  the  health  care  reform act (HCRA) resources fund for the
period January first, two thousand six  through  December  thirty-first,
two  thousand  six, up to three hundred twenty-five million four hundred
thousand dollars;
  (xi) from the health care reform act (HCRA)  resources  fund  for  the
period  January first, two thousand seven through December thirty-first,
two thousand seven, up to four hundred twenty-eight  million  fifty-nine
thousand dollars;
  (xii)  from  the  health care reform act (HCRA) resources fund for the
period January first, two thousand eight through December  thirty-first,
two  thousand  ten,  up  to four hundred fifty-three million six hundred
seventy-four thousand dollars annually; [and]
  (xiii) from the health care reform act (HCRA) resources fund  for  the
period  January  first, two thousand eleven, through March thirty-first,
two thousand eleven, up to one hundred  thirteen  million  four  hundred
eighteen thousand dollars[.];
  (XIV)  FROM  THE  HEALTH CARE REFORM ACT (HCRA) RESOURCES FUND FOR THE
PERIOD APRIL FIRST, TWO THOUSAND ELEVEN, THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND TWELVE, UP TO THREE HUNDRED TWENTY-FOUR MILLION  SEVEN  HUNDRED
FORTY-FOUR THOUSAND DOLLARS;
  (XV)  FROM  THE  HEALTH  CARE REFORM ACT (HCRA) RESOURCES FUND FOR THE
PERIOD APRIL FIRST, TWO THOUSAND TWELVE, THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND THIRTEEN, UP TO THREE HUNDRED FORTY-SIX  MILLION  FOUR  HUNDRED
FORTY-FOUR THOUSAND DOLLARS; AND
  (XVI)  FROM  THE  HEALTH CARE REFORM ACT (HCRA) RESOURCES FUND FOR THE
PERIOD APRIL FIRST, TWO THOUSAND THIRTEEN, THROUGH  MARCH  THIRTY-FIRST,

S. 2809--A                         30                         A. 4009--A

TWO  THOUSAND  FOURTEEN, UP TO THREE HUNDRED SEVENTY MILLION SIX HUNDRED
NINETY-FIVE THOUSAND DOLLARS.
  (b)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  distributions  for  health  insurance  programs under the individual
subsidy programs established pursuant to the expanded health care cover-
age act of nineteen hundred eighty-eight as amended, and for  evaluation
of  such  programs  from the respective health care initiatives pools or
the health care reform act (HCRA) resources fund, whichever is  applica-
ble, established for the following periods in the following amounts:
  (i)  (A)  an amount not to exceed six million dollars on an annualized
basis for the  periods  January  first,  nineteen  hundred  ninety-seven
through  December  thirty-first, nineteen hundred ninety-nine; up to six
million dollars for the  period  January  first,  two  thousand  through
December  thirty-first, two thousand; up to five million dollars for the
period January first, two thousand one  through  December  thirty-first,
two  thousand  one;  up  to  four million dollars for the period January
first, two thousand two through December thirty-first, two thousand two;
up to two million six hundred thousand dollars for  the  period  January
first,  two  thousand  three through December thirty-first, two thousand
three; up to one million three hundred thousand dollars for  the  period
January  first,  two  thousand  four  through December thirty-first, two
thousand four; up to six hundred seventy thousand dollars for the period
January first, two thousand five through June  thirtieth,  two  thousand
five;  up  to  one million three hundred thousand dollars for the period
April first, two thousand six through March thirty-first,  two  thousand
seven; and up to one million three hundred thousand dollars annually for
the  period  April first, two thousand seven through March thirty-first,
two thousand nine, shall be allocated to  individual  subsidy  programs;
and
  (B)  an  amount  not  to exceed seven million dollars on an annualized
basis for the periods during the period January first, nineteen  hundred
ninety-seven through December thirty-first, nineteen hundred ninety-nine
and  four  million  dollars  annually for the periods January first, two
thousand through December thirty-first,  two  thousand  two,  and  three
million dollars for the period January first, two thousand three through
December  thirty-first,  two thousand three, and two million dollars for
the period January first, two thousand  four  through  December  thirty-
first, two thousand four, and two million dollars for the period January
first, two thousand five through June thirtieth, two thousand five shall
be allocated to the catastrophic health care expense program.
  (ii) Notwithstanding any law to the contrary, the characterizations of
the  New  York state small business health insurance partnership program
as in effect prior  to  June  thirtieth,  two  thousand  three,  voucher
program  as  in effect prior to December thirty-first, two thousand one,
individual subsidy program as in effect prior  to  June  thirtieth,  two
thousand  five,  and  catastrophic  health  care  expense program, as in
effect prior to June thirtieth, two thousand five, may, for the purposes
of identifying matching funds for the community health  care  conversion
demonstration  project  described in a waiver of the provisions of title
XIX of the federal social security act granted to the state of New  York
and dated July fifteenth, nineteen hundred ninety-seven, may continue to
be used to characterize the insurance programs in sections four thousand
three  hundred  twenty-one-a,  four thousand three hundred twenty-two-a,
four thousand three hundred twenty-six and four thousand  three  hundred

S. 2809--A                         31                         A. 4009--A

twenty-seven of the insurance law, which are successor programs to these
programs.
  (c)  Up to seventy-eight million dollars shall be reserved and accumu-
lated from year to year from the pool  for  the  period  January  first,
nineteen  hundred  ninety-seven  through December thirty-first, nineteen
hundred ninety-seven, for purposes of  public  health  programs,  up  to
seventy-six  million dollars shall be reserved and accumulated from year
to year from the pools for the periods January first,  nineteen  hundred
ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
eight and January first, nineteen hundred ninety-nine  through  December
thirty-first,  nineteen  hundred  ninety-nine, up to eighty-four million
dollars shall be reserved and accumulated from year  to  year  from  the
pools  for the period January first, two thousand through December thir-
ty-first, two thousand, up  to  eighty-five  million  dollars  shall  be
reserved and accumulated from year to year from the pools for the period
January first, two thousand one through December thirty-first, two thou-
sand one, up to eighty-six million dollars shall be reserved and accumu-
lated from year to year from the pools for the period January first, two
thousand  two  through  December  thirty-first,  two thousand two, up to
eighty-six million one hundred fifty thousand dollars shall be  reserved
and  accumulated from year to year from the pools for the period January
first, two thousand three through December  thirty-first,  two  thousand
three,  up  to fifty-eight million seven hundred eighty thousand dollars
shall be reserved and accumulated from year to year from the  pools  for
the  period  January  first,  two thousand four through December thirty-
first, two thousand four, up to sixty-eight million seven hundred thirty
thousand dollars shall be reserved and accumulated  from  year  to  year
from  the  pools  or  the  health care reform act (HCRA) resources fund,
whichever is applicable, for the period January first, two thousand five
through December thirty-first, two  thousand  five,  up  to  ninety-four
million three hundred fifty thousand dollars shall be reserved and accu-
mulated  from  year  to  year  from  the  health  care reform act (HCRA)
resources fund for the period January first, two  thousand  six  through
December  thirty-first,  two  thousand  six,  up to seventy million nine
hundred thirty-nine thousand dollars shall be reserved  and  accumulated
from  year to year from the health care reform act (HCRA) resources fund
for the period January first, two thousand seven through December  thir-
ty-first,  two  thousand  seven,  up  to  fifty-five million six hundred
eighty-nine thousand dollars annually shall be reserved and  accumulated
from  year to year from the health care reform act (HCRA) resources fund
for the period January first, two thousand eight through December  thir-
ty-first,  two  thousand  ten, [and] up to thirteen million nine hundred
twenty-two thousand dollars shall be reserved and accumulated from  year
to  year  from  the health care reform act (HCRA) resources fund for the
period January first, two thousand eleven  through  March  thirty-first,
two thousand eleven, AND FOR PERIODS ON AND AFTER APRIL FIRST, TWO THOU-
SAND  ELEVEN,  UP TO FUNDING AMOUNTS SPECIFIED BELOW and shall be avail-
able, including income from invested funds, for:
  (i) deposit by the commissioner, within amounts appropriated, and  the
state  comptroller  is  hereby  authorized  and  directed to receive for
deposit to, to the credit of the department of health's special  revenue
fund  -  other, hospital based grants program account or the health care
reform act (HCRA) resources fund, whichever is applicable, for  purposes
of  services  and  expenses  related  to  general  hospital  based grant
programs, up to twenty-two million dollars annually  from  the  nineteen
hundred  ninety-seven pool, nineteen hundred ninety-eight pool, nineteen

S. 2809--A                         32                         A. 4009--A

hundred ninety-nine pool, two thousand pool, two thousand one  pool  and
two  thousand  two  pool, respectively, up to twenty-two million dollars
from the two thousand three pool, up to  ten  million  dollars  for  the
period  January  first, two thousand four through December thirty-first,
two thousand four, up to eleven million dollars for the  period  January
first,  two  thousand  five  through December thirty-first, two thousand
five, up to twenty-two million dollars for the period January first, two
thousand six through December thirty-first,  two  thousand  six,  up  to
twenty-two million ninety-seven thousand dollars annually for the period
January  first,  two  thousand  seven through December thirty-first, two
thousand ten, [and] up to five million five hundred twenty-four thousand
dollars for the period January first, two thousand eleven through  March
thirty-first,  two  thousand eleven, UP TO THIRTEEN MILLION FOUR HUNDRED
FORTY-FIVE THOUSAND DOLLARS FOR THE PERIOD  APRIL  FIRST,  TWO  THOUSAND
ELEVEN  THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE, AND UP TO THIR-
TEEN MILLION THREE HUNDRED  SEVENTY-FIVE  THOUSAND  DOLLARS  EACH  STATE
FISCAL  YEAR  FOR  THE  PERIOD  APRIL FIRST, TWO THOUSAND TWELVE THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN;
  (ii) deposit by the commissioner, within amounts appropriated, and the
state comptroller is hereby  authorized  and  directed  to  receive  for
deposit  to,  to  the  credit of the emergency medical services training
account established in section ninety-seven-q of the state  finance  law
or the health care reform act (HCRA) resources fund, whichever is appli-
cable,  up  to  sixteen  million  dollars on an annualized basis for the
periods January first, nineteen hundred  ninety-seven  through  December
thirty-first, nineteen hundred ninety-nine, up to twenty million dollars
for  the  period  January  first,  two thousand through December thirty-
first, two thousand, up to twenty-one million  dollars  for  the  period
January first, two thousand one through December thirty-first, two thou-
sand one, up to twenty-two million dollars for the period January first,
two  thousand two through December thirty-first, two thousand two, up to
twenty-two million five hundred fifty thousand dollars  for  the  period
January  first,  two  thousand  three through December thirty-first, two
thousand three, up to nine million six hundred eighty  thousand  dollars
for  the  period January first, two thousand four through December thir-
ty-first, two thousand four, up to twelve  million  one  hundred  thirty
thousand dollars for the period January first, two thousand five through
December  thirty-first, two thousand five, up to twenty-four million two
hundred fifty thousand dollars for the period January first,  two  thou-
sand  six  through December thirty-first, two thousand six, up to twenty
million four hundred ninety-two thousand dollars annually for the period
January first, two thousand seven  through  December  thirty-first,  two
thousand ten, [and] up to five million one hundred twenty-three thousand
dollars  for the period January first, two thousand eleven through March
thirty-first, two thousand eleven, UP TO EIGHTEEN MILLION THREE  HUNDRED
FIFTY  THOUSAND  DOLLARS FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE, UP TO EIGHTEEN  MILLION
NINE  HUNDRED  FIFTY  THOUSAND  DOLLARS  FOR THE PERIOD APRIL FIRST, TWO
THOUSAND TWELVE THROUGH MARCH THIRTY-FIRST, TWO THOUSAND  THIRTEEN,  AND
UP  TO  NINETEEN  MILLION FOUR HUNDRED NINETEEN THOUSAND DOLLARS FOR THE
PERIOD APRIL FIRST, TWO THOUSAND THIRTEEN  THROUGH  MARCH  THIRTY-FIRST,
TWO THOUSAND FOURTEEN;
  (iii)  priority  distributions  by  the  commissioner up to thirty-two
million dollars on an annualized basis for the period January first, two
thousand through December thirty-first, two thousand four, up  to  thir-
ty-eight  million  dollars on an annualized basis for the period January

S. 2809--A                         33                         A. 4009--A

first, two thousand five through  December  thirty-first,  two  thousand
six,  up  to eighteen million two hundred fifty thousand dollars for the
period January first, two thousand seven through December  thirty-first,
two  thousand seven, up to three million dollars annually for the period
January first, two thousand eight  through  December  thirty-first,  two
thousand  ten,  [and] up to seven hundred fifty thousand dollars for the
period January first, two thousand eleven  through  March  thirty-first,
two thousand eleven, AND UP TO TWO MILLION NINE HUNDRED THOUSAND DOLLARS
EACH  STATE  FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN to  be  allocated  (A)
for  the purposes established pursuant to subparagraph (ii) of paragraph
(f) of subdivision nineteen of section twenty-eight hundred  seven-c  of
this  article  as  in  effect on December thirty-first, nineteen hundred
ninety-six and as may thereafter  be  amended,  up  to  fifteen  million
dollars  annually  for  the  periods January first, two thousand through
December thirty-first, two  thousand  four,  up  to  twenty-one  million
dollars annually for the period January first, two thousand five through
December  thirty-first,  two  thousand six, and up to seven million five
hundred thousand dollars for the  period  January  first,  two  thousand
seven through March thirty-first, two thousand seven;
  (B)  pursuant  to  a  memorandum  of understanding entered into by the
commissioner, the majority leader of the senate and the speaker  of  the
assembly,  for  the purposes outlined in such memorandum upon the recom-
mendation of the majority leader  of the senate,  up  to  eight  million
five hundred thousand dollars annually for the period January first, two
thousand through December thirty-first, two thousand six, and up to four
million two hundred fifty thousand dollars for the period January first,
two  thousand  seven through June thirtieth, two thousand seven, and for
the purposes outlined in such memorandum upon the recommendation of  the
speaker  of  the  assembly,  up  to  eight million five hundred thousand
dollars annually for the periods January  first,  two  thousand  through
December  thirty-first,  two  thousand  six,  and up to four million two
hundred fifty thousand dollars for the period January first,  two  thou-
sand seven through June thirtieth, two thousand seven; and
  (C)  for services and expenses, including grants, related to emergency
assistance distributions as designated by the  commissioner.    Notwith-
standing  section  one  hundred twelve or one hundred sixty-three of the
state finance law or any other contrary provision of law, such  distrib-
utions shall be limited to providers or programs where, as determined by
the  commissioner,  emergency assistance is vital to protect the life or
safety of patients, to ensure the retention of  facility  caregivers  or
other  staff, or in instances where health facility operations are jeop-
ardized, or where the public health is jeopardized  or  other  emergency
situations  exist,  up  to three million dollars annually for the period
April first, two thousand seven through March thirty-first, two thousand
eleven, AND UP TO TWO MILLION NINE HUNDRED THOUSAND DOLLARS  EACH  STATE
FISCAL  YEAR  FOR  THE  PERIOD  APRIL FIRST, TWO THOUSAND ELEVEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN.   Upon  any  distribution  of
such  funds,  the  commissioner  shall  immediately notify the chair and
ranking minority member of the senate finance  committee,  the  assembly
ways and means committee, the senate committee on health, and the assem-
bly committee on health;
  (iv)  distributions  by  the  commissioner  related  to poison control
centers pursuant to subdivision seven of section  twenty-five  hundred-d
of  this  chapter,  up  to  five  million dollars for the period January
first, nineteen  hundred  ninety-seven  through  December  thirty-first,

S. 2809--A                         34                         A. 4009--A

nineteen hundred ninety-seven, up to three million dollars on an annual-
ized  basis  for  the  periods during the period January first, nineteen
hundred ninety-eight through  December  thirty-first,  nineteen  hundred
ninety-nine, up to five million dollars annually for the periods January
first,  two thousand through December thirty-first, two thousand two, up
to four million six hundred thousand dollars annually  for  the  periods
January  first,  two  thousand  three through December thirty-first, two
thousand four, up to five million one hundred thousand dollars  for  the
period  January  first, two thousand five through December thirty-first,
two thousand six annually, up  to  five  million  one  hundred  thousand
dollars  annually  for  the  period  January  first,  two thousand seven
through December thirty-first, two thousand nine, up  to  three  million
six  hundred thousand dollars for the period January first, two thousand
ten through December thirty-first, two thousand ten, [and] up  to  seven
hundred  seventy-five thousand dollars for the period January first, two
thousand eleven through March thirty-first, two thousand eleven, AND  UP
TO  TWO MILLION FIVE HUNDRED THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR
THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH  THIRTY-FIRST,
TWO THOUSAND FOURTEEN; and
  (v)  deposit by the commissioner, within amounts appropriated, and the
state comptroller is hereby  authorized  and  directed  to  receive  for
deposit  to, to the credit of the department of health's special revenue
fund - other, miscellaneous special revenue  fund  -  339  maternal  and
child  HIV  services  account  or  the  health  care  reform  act (HCRA)
resources fund, whichever is  applicable,  for  purposes  of  a  special
program  for HIV services for [infants and pregnant] women AND CHILDREN,
INCLUDING ADOLESCENTS pursuant to section [seventy-one of chapter  seven
hundred  thirty-one of the laws of nineteen hundred ninety-three, amend-
ing] TWENTY-FIVE HUNDRED-F-ONE OF the public health law [and other  laws
relating  to  reimbursement,  delivery  and  capital costs of ambulatory
health care services  and  inpatient  hospital  services],  up  to  five
million  dollars  annually  for  the periods January first, two thousand
through December thirty-first, two thousand  two,  up  to  five  million
dollars  for the period January first, two thousand three through Decem-
ber thirty-first, two thousand three, up to  two  million  five  hundred
thousand dollars for the period January first, two thousand four through
December thirty-first, two thousand four, up to two million five hundred
thousand dollars for the period January first, two thousand five through
December thirty-first, two thousand five, up to five million dollars for
the  period  January  first,  two  thousand six through December thirty-
first, two thousand six, up to five million  dollars  annually  for  the
period  January first, two thousand seven through December thirty-first,
two thousand ten, [and] up to one million  two  hundred  fifty  thousand
dollars  for the period January first, two thousand eleven through March
thirty-first, two thousand eleven, AND UP TO FIVE MILLION  DOLLARS  EACH
STATE  FISCAL  YEAR  FOR  THE  PERIOD  APRIL  FIRST, TWO THOUSAND ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN;
  (d) (i) An amount of up to twenty million  dollars  annually  for  the
period  January  first,  two thousand through December thirty-first, two
thousand six, up to ten million dollars for the  period  January  first,
two  thousand  seven  through  June thirtieth, two thousand seven, up to
twenty million dollars annually for the period January first, two  thou-
sand  eight through December thirty-first, two thousand ten, [and] up to
five million dollars for the period January first, two  thousand  eleven
through  March  thirty-first,  two  thousand  eleven, AND UP TO NINETEEN
MILLION SIX HUNDRED THOUSAND DOLLARS EACH  STATE  FISCAL  YEAR  FOR  THE

S. 2809--A                         35                         A. 4009--A

PERIOD  APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND FOURTEEN, shall be transferred to the health facility  restruc-
turing pool established pursuant to section twenty-eight hundred fifteen
of this article;
  (ii)  provided,  however, amounts transferred pursuant to subparagraph
(i) of this paragraph may be reduced in an amount to be approved by  the
director  of  the budget to reflect the amount received from the federal
government under the state's 1115 waiver which  is  directed  under  its
terms and conditions to the health facility restructuring program.
  (e)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available,  including income from invested funds, for  purposes
of  distributions  to  organizations  to  support  the  health workforce
retraining program established pursuant to section twenty-eight  hundred
seven-g  of  this   article  from the respective health care initiatives
pools established for the following periods  in  the  following  amounts
from  the  pools  or  the  health care reform act (HCRA) resources fund,
whichever is applicable,  during  the  period  January  first,  nineteen
hundred  ninety-seven  through  December  thirty-first, nineteen hundred
ninety-nine, up to fifty million dollars on an annualized basis,  up  to
thirty  million  dollars  for  the  period  January  first, two thousand
through December thirty-first, two thousand, up to forty million dollars
for the period January first, two thousand one through December  thirty-
first,  two  thousand  one,  up  to fifty million dollars for the period
January first, two thousand two through December thirty-first, two thou-
sand two, up to forty-one million one hundred fifty thousand dollars for
the period January first, two thousand three  through  December  thirty-
first,  two  thousand  three,  up to forty-one million one hundred fifty
thousand dollars for the period January first, two thousand four through
December thirty-first, two thousand  four,  up  to  fifty-eight  million
three  hundred  sixty thousand dollars for the period January first, two
thousand five through December thirty-first, two thousand  five,  up  to
fifty-two  million  three  hundred sixty thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six, up to thirty-five million four hundred thousand dollars  annu-
ally  for  the period January first, two thousand seven through December
thirty-first, two thousand ten [and], up to eight million eight  hundred
fifty thousand dollars for the period January first, two thousand eleven
through  March thirty-first, two thousand eleven, AND UP TO TWENTY-EIGHT
MILLION FOUR HUNDRED THOUSAND DOLLARS EACH STATE  FISCAL  YEAR  FOR  THE
PERIOD  APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND FOURTEEN, less the amount of funds  available  for  allocations
for  rate  adjustments  for  workforce training programs for payments by
state governmental agencies for inpatient hospital services.
  (f) Funds shall be accumulated and transferred from as follows:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
(A)  thirty-four  million   six hundred thousand dollars shall be trans-
ferred to funds reserved and accumulated pursuant to  paragraph  (b)  of
subdivision  nineteen  of  section  twenty-eight hundred seven-c of this
article, and (B) eighty-two million dollars  shall  be  transferred  and
deposited  and  credited to the credit of the state general fund medical
assistance local assistance account;
  (ii) from the pool for the  period  January  first,  nineteen  hundred
ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
eight, eighty-two million dollars shall be transferred and deposited and

S. 2809--A                         36                         A. 4009--A

credited to the credit of the  state  general  fund  medical  assistance
local assistance account;
  (iii)  from  the  pool  for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
eighty-two million dollars shall be transferred and deposited and  cred-
ited  to  the  credit of the state general fund medical assistance local
assistance account;
  (iv) from the pool or the health  care  reform  act  (HCRA)  resources
fund,  whichever  is applicable, for the period January first, two thou-
sand  through  December  thirty-first,  two  thousand  four,  eighty-two
million dollars annually, and for the period January first, two thousand
five  through  December  thirty-first,  two  thousand  five,  eighty-two
million dollars, and for the period  January  first,  two  thousand  six
through  December  thirty-first,  two  thousand  six, eighty-two million
dollars, and for the period January first, two  thousand  seven  through
December  thirty-first,  two thousand seven, eighty-two million dollars,
and for the period January first, two thousand  eight  through  December
thirty-first,  two thousand eight, ninety million seven hundred thousand
dollars shall be deposited by the  commissioner,  and  the  state  comp-
troller  is hereby authorized and directed to receive for deposit to the
credit of the state special revenue fund - other,  HCRA  transfer  fund,
medical assistance account;
  (v)  from  the  health  care  reform act (HCRA) resources fund for the
period January first, two thousand nine through  December  thirty-first,
two  thousand  nine, one hundred eight million nine hundred seventy-five
thousand dollars, and for the period January  first,  two  thousand  ten
through  December thirty-first, two thousand ten, one hundred twenty-six
million one hundred thousand  dollars,  [and]  for  the  period  January
first,  two  thousand  eleven  through  March thirty-first, two thousand
eleven, twenty million five hundred thousand dollars, AND FOR EACH STATE
FISCAL YEAR FOR THE PERIOD APRIL  FIRST,  TWO  THOUSAND  ELEVEN  THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN, ONE HUNDRED FORTY-SIX MILLION
FOUR  HUNDRED  THOUSAND DOLLARS, shall be deposited by the commissioner,
and the state comptroller is hereby authorized and directed  to  receive
for  deposit,  to  the credit of the state special revenue fund - other,
HCRA transfer fund, medical assistance account.
  (g) Funds shall be transferred to primary health care  services  pools
created  by  the  commissioner, and shall be available, including income
from invested funds, for distributions in accordance with former section
twenty-eight hundred seven-bb of this article from the respective health
care initiatives pools  for  the  following  periods  in  the  following
percentage  amounts  of  funds remaining after allocations in accordance
with paragraphs (a) through (f) of this subdivision:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
fifteen and eighty-seven-hundredths percent;
  (ii)  from  the  pool  for  the period January first, nineteen hundred
ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
eight, fifteen and eighty-seven-hundredths percent; and
  (iii)  from  the  pool  for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
sixteen and thirteen-hundredths percent.
  (h) Funds shall be reserved and accumulated from year to year  by  the
commissioner  and  shall  be  available,  including income from invested
funds, for purposes of primary care education and training  pursuant  to
article nine of this chapter from the respective health care initiatives

S. 2809--A                         37                         A. 4009--A

pools  established for the following periods in the following percentage
amounts of funds remaining after allocations in  accordance  with  para-
graphs  (a)  through  (f) of this subdivision and shall be available for
distributions as follows:
  (i) funds shall be reserved and accumulated:
  (A) from the pool for the period January first, nineteen hundred nine-
ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
six and thirty-five-hundredths percent;
  (B) from the pool for the period January first, nineteen hundred nine-
ty-eight through December thirty-first, nineteen  hundred  ninety-eight,
six and thirty-five-hundredths percent; and
  (C) from the pool for the period January first, nineteen hundred nine-
ty-nine through December thirty-first, nineteen hundred ninety-nine, six
and forty-five-hundredths percent;
  (ii)  funds shall be available for distributions including income from
invested funds as follows:
  (A) for purposes of the primary care physician loan repayment  program
in  accordance  with  section  nine hundred three of this chapter, up to
five million dollars on an annualized basis;
  (B) for purposes of the primary care practitioner scholarship  program
in  accordance with section nine hundred four of this chapter, up to two
million dollars on an annualized basis;
  (C) for purposes of minority participation in medical education grants
in accordance with section nine hundred six of this chapter, up  to  one
million dollars on an annualized basis; and
  (D)  provided, however, that the commissioner may reallocate any funds
remaining or unallocated for distributions for the primary care  practi-
tioner  scholarship program in accordance with section nine hundred four
of this chapter.
  (i) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available, including income from invested funds, for distrib-
utions in accordance with  section  twenty-nine  hundred  fifty-two  and
section twenty-nine hundred fifty-eight of this chapter for rural health
care  delivery  development  and  rural  health care access development,
respectively, from the respective health care initiatives pools  or  the
health  care  reform act (HCRA) resources fund, whichever is applicable,
for the following periods in the following percentage amounts  of  funds
remaining  after  allocations  in accordance with paragraphs (a) through
(f) of this subdivision, and for periods on and after January first, two
thousand, in the following amounts:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
thirteen and forty-nine-hundredths percent;
  (ii)  from  the  pool  for  the period January first, nineteen hundred
ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
eight, thirteen and forty-nine-hundredths percent;
  (iii)  from  the  pool  for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
thirteen and seventy-one-hundredths percent;
  (iv) from the pool for the periods January first, two thousand through
December thirty-first, two thousand two, seventeen million dollars annu-
ally, and for the period  January  first,  two  thousand  three  through
December  thirty-first,  two thousand three, up to fifteen million eight
hundred fifty thousand dollars;
  (v) from the pool or the health care reform act (HCRA) resources fund,
whichever is applicable, for the period January first, two thousand four

S. 2809--A                         38                         A. 4009--A

through December thirty-first, two thousand four, up to fifteen  million
eight  hundred fifty thousand dollars, and for the period January first,
two thousand five through December thirty-first, two thousand  five,  up
to  nineteen  million  two  hundred thousand dollars, and for the period
January first, two thousand six through December thirty-first, two thou-
sand six, up to nineteen million two hundred thousand dollars,  for  the
period  January first, two thousand seven through December thirty-first,
two thousand ten, up to eighteen  million  one  hundred  fifty  thousand
dollars annually, [and] for the period January first, two thousand elev-
en  through  March thirty-first, two thousand eleven, up to four million
five hundred thirty-eight thousand dollars, AND FOR  EACH  STATE  FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIR-
TY-FIRST, TWO THOUSAND FOURTEEN, UP TO SIXTEEN MILLION TWO HUNDRED THOU-
SAND DOLLARS.
  (j)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  distributions  related to health information and health care quality
improvement pursuant to former section twenty-eight hundred  seven-n  of
this  article  from  the respective health care initiatives pools estab-
lished for the following periods in the following percentage amounts  of
funds  remaining  after  allocations  in  accordance with paragraphs (a)
through (f) of this subdivision:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
six and thirty-five-hundredths percent;
  (ii)  from  the  pool  for  the period January first, nineteen hundred
ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
eight, six and thirty-five-hundredths percent; and
  (iii)  from  the  pool  for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
six and forty-five-hundredths percent.
  (k) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available,  including  income  from invested funds, for allo-
cations  and  distributions  in  accordance  with  section  twenty-eight
hundred  seven-p  of  this  article  for diagnostic and treatment center
uncompensated care from the respective health care initiatives pools  or
the  health care reform act (HCRA) resources fund, whichever is applica-
ble, for the following periods in the following percentage   amounts  of
funds  remaining  after  allocations  in  accordance with paragraphs (a)
through (f) of this subdivision, and for periods on  and  after  January
first, two thousand, in the following amounts:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
thirty-eight and one-tenth percent;
  (ii) from the pool for the  period  January  first,  nineteen  hundred
ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
eight, thirty-eight and one-tenth percent;
  (iii) from the pool for the period  January  first,  nineteen  hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
thirty-eight and seventy-one-hundredths percent;
  (iv) from the pool for the periods January first, two thousand through
December  thirty-first,  two  thousand  two, forty-eight million dollars
annually, and for the period January first, two thousand  three  through
June thirtieth, two thousand three, twenty-four million dollars;
  (v)  (A)  from the pool or the health care reform act (HCRA) resources
fund, whichever is applicable, for the period July first,  two  thousand

S. 2809--A                         39                         A. 4009--A

three  through  December  thirty-first,  two  thousand  three, up to six
million dollars, for the period January first, two thousand four through
December thirty-first, two thousand six, up to  twelve  million  dollars
annually,  for  the  period  January  first,  two thousand seven through
December thirty-first, two thousand [ten] THIRTEEN,  up  to  forty-eight
million dollars annually, and for the period January first, two thousand
[eleven]  FOURTEEN  through  March  thirty-first,  two thousand [eleven]
FOURTEEN, up to twelve million dollars;
  (B) from the health care reform act  (HCRA)  resources  fund  for  the
period  January  first,  two thousand six through December thirty-first,
two thousand six, an additional  seven  million  five  hundred  thousand
dollars, for the period January first, two thousand seven through Decem-
ber  thirty-first,  two  thousand  [ten]  THIRTEEN,  an additional seven
million five hundred thousand dollars annually, and for the period Janu-
ary first, two thousand [eleven] FOURTEEN  through  March  thirty-first,
two  thousand [eleven] FOURTEEN, an additional one million eight hundred
seventy-five thousand dollars, for voluntary non-profit  diagnostic  and
treatment  center  uncompensated  care  in  accordance  with subdivision
four-c of section twenty-eight hundred seven-p of this article; and
  (vi) funds reserved and accumulated pursuant  to  this  paragraph  for
periods  on and after July first, two thousand three, shall be deposited
by the commissioner, within amounts appropriated, and  the  state  comp-
troller  is hereby authorized and directed to receive for deposit to the
credit of the state special revenue funds - other, HCRA  transfer  fund,
medical  assistance  account, for purposes of funding the state share of
rate adjustments made pursuant to section twenty-eight  hundred  seven-p
of  this article, provided, however, that in the event federal financial
participation is not available for rate  adjustments  made  pursuant  to
paragraph (b) of subdivision one of section twenty-eight hundred seven-p
of this article, funds shall be distributed pursuant to paragraph (a) of
subdivision  one of section twenty-eight hundred seven-p of this article
from the respective health care initiatives pools  or  the  health  care
reform act (HCRA) resources fund, whichever is applicable.
  (l)  Funds  shall be reserved and accumulated from year to year by the
commissioner and shall be  available,  including  income  from  invested
funds, for transfer to and allocation  for services and expenses for the
payment  of benefits to recipients of  drugs under the AIDS drug assist-
ance program (ADAP) - HIV uninsured  care  program  as  administered  by
Health  Research  Incorporated  from  the respective  health care initi-
atives pools or the health care reform act (HCRA) resources fund, which-
ever is applicable, established for the following periods in the follow-
ing  percentage  amounts  of  funds  remaining  after   allocations   in
accordance  with paragraphs (a) through (f) of this subdivision, and for
periods on and after January  first,  two  thousand,  in  the  following
amounts:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
nine and fifty-two-hundredths percent;
  (ii) from the pool for the  period  January  first,  nineteen  hundred
ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
eight, nine and fifty-two-hundredths percent;
  (iii) from the pool for the period  January  first,  nineteen  hundred
ninety-nine  and  December  thirty-first,  nineteen hundred ninety-nine,
nine and sixty-eight-hundredths percent;
  (iv) from the pool for the periods January first, two thousand through
December thirty-first, two thousand two, up to  twelve  million  dollars

S. 2809--A                         40                         A. 4009--A

annually,  and  for the period January first, two thousand three through
December thirty-first, two thousand three, up to forty million  dollars;
and
  (v) from the pool or the health care reform act (HCRA) resources fund,
whichever  is  applicable,  for  the periods January first, two thousand
four through December thirty-first, two thousand four, up  to  fifty-six
million dollars, for the period January first, two thousand five through
December  thirty-first,  two  thousand  six, up to sixty million dollars
annually, for the period  January  first,  two  thousand  seven  through
December  thirty-first,  two  thousand  ten, up to sixty million dollars
annually, [and] for  the  period  January  first,  two  thousand  eleven
through  March  thirty-first, two thousand eleven, up to fifteen million
dollars, AND EACH STATE FISCAL YEAR FOR  THE  PERIOD  APRIL  FIRST,  TWO
THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN, UP TO
FORTY-TWO MILLION THREE HUNDRED THOUSAND DOLLARS.
  (m)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  distributions  pursuant  to  section twenty-eight hundred seven-r of
this article for cancer related services from the respective health care
initiatives pools or the health care reform act (HCRA)  resources  fund,
whichever  is  applicable,  established for the following periods in the
following percentage amounts of funds  remaining  after  allocations  in
accordance  with paragraphs (a) through (f) of this subdivision, and for
periods on and after January  first,  two  thousand,  in  the  following
amounts:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
seven and ninety-four-hundredths percent;
  (ii) from the pool for the  period  January  first,  nineteen  hundred
ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
eight, seven and ninety-four-hundredths percent;
  (iii) from the pool for the period  January  first,  nineteen  hundred
ninety-nine and December thirty-first, nineteen hundred ninety-nine, six
and forty-five-hundredths percent;
  (iv)  from the pool for the period January first, two thousand through
December thirty-first, two thousand two, up to ten million dollars on an
annual basis;
  (v) from the pool for the period January  first,  two  thousand  three
through  December  thirty-first,  two thousand four, up to eight million
nine hundred fifty thousand dollars on an annual basis;
  (vi) from the pool or the health  care  reform  act  (HCRA)  resources
fund,  whichever  is applicable, for the period January first, two thou-
sand five through December thirty-first, two thousand  six,  up  to  ten
million  fifty thousand dollars on an annual basis, for the period Janu-
ary first, two thousand seven through December thirty-first,  two  thou-
sand  ten,  up  to nineteen million dollars annually, and for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven, up to four million seven hundred fifty thousand dollars.
  (n) Funds shall be accumulated and transferred from  the  health  care
reform act (HCRA) resources fund as follows: for the period April first,
two  thousand  seven through March thirty-first, two thousand eight, and
on an annual basis for the  periods  April  first,  two  thousand  eight
through  November  thirtieth,  two  thousand  nine, funds within amounts
appropriated shall be transferred and  deposited  and  credited  to  the
credit  of  the state special revenue funds - other, HCRA transfer fund,
medical assistance account, for purposes of funding the state  share  of

S. 2809--A                         41                         A. 4009--A

rate  adjustments  made  to public and voluntary hospitals in accordance
with paragraphs (i) and (j) of subdivision one of  section  twenty-eight
hundred seven-c of this article.
  2.  Notwithstanding  any  inconsistent provision of law, rule or regu-
lation, any funds accumulated  in  the  health  care  initiatives  pools
pursuant  to  paragraph  (b) of subdivision nine of section twenty-eight
hundred seven-j of this article, as a result of surcharges,  assessments
or  other obligations during the periods January first, nineteen hundred
ninety-seven through December  thirty-first,  nineteen  hundred  ninety-
nine, which are unused or uncommitted for distributions pursuant to this
section  shall  be  reserved  and  accumulated  from year to year by the
commissioner and, within amounts appropriated, transferred and deposited
into the special revenue funds - other,  miscellaneous  special  revenue
fund  -  339,  child  health  insurance account or any successor fund or
account, for purposes of distributions to  implement  the  child  health
insurance  program  established pursuant to sections twenty-five hundred
ten and twenty-five hundred eleven of this chapter for  periods  on  and
after January first, two thousand one; provided, however, funds reserved
and  accumulated  for  priority  distributions  pursuant to subparagraph
(iii) of paragraph (c) of subdivision one of this section shall  not  be
transferred  and  deposited  into such account pursuant to this subdivi-
sion; and provided further, however, that any unused or uncommitted pool
funds accumulated and allocated pursuant to paragraph (j) of subdivision
one of this section shall be distributed  for  purposes  of  the  health
information and quality improvement act of 2000.
  3.  Revenue  from  distributions pursuant to this section shall not be
included in gross revenue  received  for  purposes  of  the  assessments
pursuant to subdivision eighteen of section twenty-eight hundred seven-c
of  this article, subject to the provisions of paragraph (e) of subdivi-
sion eighteen of section twenty-eight hundred seven-c of  this  article,
and  shall not be included in gross revenue received for purposes of the
assessments pursuant to section twenty-eight  hundred  seven-d  of  this
article,  subject  to  the  provisions  of subdivision twelve of section
twenty-eight hundred seven-d of this article.
  S 8. Subdivision 1 of section 2807-v of  the  public  health  law,  as
amended  by section 5 of part B of chapter 58 of the laws of 2008, para-
graphs (g), (h), (i) and (i-1) as amended by section  5  of  part  I  of
chapter 2 of the laws of 2009, subparagraphs (xi) and (xii) of paragraph
(j)  as  amended by section 12, paragraph (jj) as amended by section 10,
subparagraph (vii) of paragraph  (qq)  as  amended  by  section  11  and
subparagraph  (vii)  of paragraph (uu) as amended by section 9 of part B
of chapter 109 of the laws of 2010, paragraph (s) as amended by  section
8,  paragraphs  (x)  and  (y) as amended by section 6, paragraph (kk) as
amended by section 124, subparagraph (vi) of paragraph (uu)  as  amended
by  section  120, paragraph (xx) as amended by section 10 and paragraphs
(ggg) and (hhh) as amended by section 7 of part C of chapter 58  of  the
laws of 2009, is amended to read as follows:
  1.  Funds accumulated in the tobacco control and insurance initiatives
pool or in the health care reform act (HCRA) resources fund  established
pursuant to section ninety-two-dd of the state finance law, whichever is
applicable,  including  income from invested funds, shall be distributed
or retained by the commissioner or by the state comptroller, as applica-
ble, in accordance with the following:
  (a) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special

S. 2809--A                         42                         A. 4009--A

revenue  funds  -  other, HCRA transfer fund, medicaid fraud hotline and
medicaid administration account, or any successor fund or  account,  for
purposes  of  services  and  expenses  related to the toll-free medicaid
fraud hotline established pursuant to section one hundred eight of chap-
ter  one  of  the  laws of nineteen hundred ninety-nine from the tobacco
control and insurance initiatives pool  established  for  the  following
periods in the following amounts: four hundred thousand dollars annually
for  the  periods  January  first, two thousand through December thirty-
first, two thousand two, up to four hundred  thousand  dollars  for  the
period  January first, two thousand three through December thirty-first,
two thousand three, up to four hundred thousand dollars for  the  period
January  first,  two  thousand  four  through December thirty-first, two
thousand four, up to four hundred thousand dollars for the period  Janu-
ary first, two thousand five through December thirty-first, two thousand
five,  up to four hundred thousand dollars for the period January first,
two thousand six through December thirty-first, two thousand six, up  to
four hundred thousand dollars for the period January first, two thousand
seven  through  December  thirty-first,  two  thousand seven, up to four
hundred thousand dollars for the  period  January  first,  two  thousand
eight  through  December  thirty-first,  two  thousand eight, up to four
hundred thousand dollars for the period January first, two thousand nine
through December thirty-first, two thousand nine,  up  to  four  hundred
thousand  dollars for the period January first, two thousand ten through
December thirty-first, two thousand ten, [and] up to one  hundred  thou-
sand  dollars  for the period January first, two thousand eleven through
March thirty-first, two thousand eleven AND WITHIN AMOUNTS  APPROPRIATED
ON AND AFTER APRIL FIRST, TWO THOUSAND ELEVEN.
  (b)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of payment of audits or audit contracts necessary to determine payor and
provider compliance with requirements set forth in sections twenty-eight
hundred  seven-j,  twenty-eight hundred seven-s and twenty-eight hundred
seven-t of this article [and hospital compliance with paragraph  six  of
subdivision (a) of section 405.4 of title 10 of the official compilation
of  codes,  rules and regulations of the state of New York in accordance
with subdivision nine of section  twenty-eight  hundred  three  of  this
article]  from the tobacco control and insurance initiatives pool estab-
lished for the following periods in the following amounts: five  million
six hundred thousand dollars annually for the periods January first, two
thousand  through  December  thirty-first,  two thousand two, up to five
million dollars for the period January first, two thousand three through
December thirty-first, two thousand three, up to  five  million  dollars
for  the  period January first, two thousand four through December thir-
ty-first, two thousand four, up to five million dollars for  the  period
January  first,  two  thousand  five  through December thirty first, two
thousand five, up to five million dollars for the period January  first,
two  thousand six through December thirty-first, two thousand six, up to
seven million eight hundred thousand  dollars  for  the  period  January
first,  two  thousand  seven through December thirty-first, two thousand
seven, and up  to  eight  million  three  hundred  twenty-five  thousand
dollars  for the period January first, two thousand eight through Decem-
ber thirty-first, two thousand eight, up to eight million  five  hundred
thousand dollars for the period January first, two thousand nine through
December  thirty-first,  two  thousand  nine,  up  to eight million five
hundred thousand dollars for the period January first, two thousand  ten
through December thirty-first, two thousand ten, [and] up to two million

S. 2809--A                         43                         A. 4009--A

one  hundred  twenty-five thousand dollars for the period January first,
two thousand eleven through March thirty-first, two thousand eleven, AND
UP TO FOURTEEN MILLION SEVEN HUNDRED THOUSAND DOLLARS EACH STATE  FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIR-
TY-FIRST, TWO THOUSAND FOURTEEN.
  (c)  Funds  shall  be  deposited  by  the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, enhanced  community  services
account,  or  any  successor fund or account, for mental health services
programs for case management services for adults and children; supported
housing; home and community based waiver services; family  based  treat-
ment;  family support services; mobile mental health teams; transitional
housing; and community oversight, established pursuant to articles seven
and forty-one of the mental hygiene law and subdivision nine of  section
three  hundred  sixty-six of the social services law; and for comprehen-
sive care centers for eating disorders pursuant to  THE  FORMER  section
twenty-seven  hundred  ninety-nine-l  of  this chapter, provided however
that, for such centers, funds in the amount  of  five  hundred  thousand
dollars  on  an  annualized basis shall be transferred from the enhanced
community services account, or any successor fund or account, and depos-
ited into the fund established by section  ninety-five-e  of  the  state
finance  law;  from  the  tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
  (i) forty-eight million dollars to be reserved, to be retained or  for
distribution  pursuant to a chapter of the laws of two thousand, for the
period January first, two thousand through  December  thirty-first,  two
thousand;
  (ii)  eighty-seven  million  dollars to be reserved, to be retained or
for distribution pursuant to a chapter of the laws of two thousand  one,
for  the period January first, two thousand one through December thirty-
first, two thousand one;
  (iii) eighty-seven million dollars to be reserved, to be  retained  or
for  distribution pursuant to a chapter of the laws of two thousand two,
for the period January first, two thousand two through December  thirty-
first, two thousand two;
  (iv)  eighty-eight  million  dollars to be reserved, to be retained or
for distribution pursuant to a chapter  of  the  laws  of  two  thousand
three, for the period January first, two thousand three through December
thirty-first, two thousand three;
  (v)  eighty-eight million dollars, plus five hundred thousand dollars,
to be reserved, to be retained or for distribution pursuant to a chapter
of the laws of two thousand four, and pursuant  to  THE  FORMER  section
twenty-seven hundred ninety-nine-l of this chapter, for the period Janu-
ary first, two thousand four through December thirty-first, two thousand
four;
  (vi) eighty-eight million dollars, plus five hundred thousand dollars,
to be reserved, to be retained or for distribution pursuant to a chapter
of  the  laws  of  two thousand five, and pursuant to THE FORMER section
twenty-seven hundred ninety-nine-l of this chapter, for the period Janu-
ary first, two thousand five through December thirty-first, two thousand
five;
  (vii)  eighty-eight  million  dollars,  plus  five  hundred   thousand
dollars,  to be reserved, to be retained or for distribution pursuant to
a chapter of the laws of two thousand six, and pursuant to section twen-

S. 2809--A                         44                         A. 4009--A

ty-seven hundred ninety-nine-l of this chapter, for the  period  January
first, two thousand six through December thirty-first, two thousand six;
  (viii)  eighty-six  million  four  hundred thousand dollars, plus five
hundred thousand dollars, to be reserved, to be retained or for distrib-
ution pursuant to a chapter of the laws of two thousand seven and pursu-
ant to THE FORMER section twenty-seven  hundred  ninety-nine-l  of  this
chapter, for the period January first, two thousand seven through Decem-
ber thirty-first, two thousand seven; and
  (ix)  twenty-two  million nine hundred thirteen thousand dollars, plus
one hundred twenty-five thousand dollars, to be reserved, to be retained
or for distribution pursuant to a chapter of the laws  of  two  thousand
eight  and  pursuant  to THE FORMER section twenty-seven hundred ninety-
nine-l of this chapter, for the period January first, two thousand eight
through March thirty-first, two thousand eight.
  (d) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share of services and expenses related to the family health plus program
including up to two and one-half million dollars annually for the period
January  first, two thousand through December thirty-first, two thousand
two, for administration and marketing costs associated with such program
established pursuant to clause (A) of subparagraph (v) of paragraph  (a)
of  subdivision two of section three hundred sixty-nine-ee of the social
services law from the tobacco control  and  insurance  initiatives  pool
established for the following periods in the following amounts:
  (i) three million five hundred thousand dollars for the period January
first, two thousand through December thirty-first, two thousand;
  (ii)  twenty-seven  million  dollars for the period January first, two
thousand one through December thirty-first, two thousand one; and
  (iii) fifty-seven million dollars for the period  January  first,  two
thousand two through December thirty-first, two thousand two.
  (e)  Funds  shall  be  deposited  by  the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of services and expenses related to the family health plus program
including up to two and one-half million dollars annually for the period
January first, two thousand through December thirty-first, two  thousand
two  for administration and marketing costs associated with such program
established pursuant to clause (B) of subparagraph (v) of paragraph  (a)
of  subdivision two of section three hundred sixty-nine-ee of the social
services law from the tobacco control  and  insurance  initiatives  pool
established for the following periods in the following amounts:
  (i)  two  million five hundred thousand dollars for the period January
first, two thousand through December thirty-first, two thousand;
  (ii) thirty million five hundred thousand dollars for the period Janu-
ary first, two thousand one through December thirty-first, two  thousand
one; and
  (iii)  sixty-six  million  dollars  for  the period January first, two
thousand two through December thirty-first, two thousand two.
  (f) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special

S. 2809--A                         45                         A. 4009--A

revenue  funds  -  other, HCRA transfer fund, medicaid fraud hotline and
medicaid administration account, or any successor fund or  account,  for
purposes of payment of administrative expenses of the department related
to  the family health plus program established pursuant to section three
hundred sixty-nine-ee of  the  social  services  law  from  the  tobacco
control  and  insurance  initiatives  pool established for the following
periods in the following amounts: five hundred thousand  dollars  on  an
annual  basis for the periods January first, two thousand through Decem-
ber thirty-first, two thousand six, five hundred  thousand  dollars  for
the  period  January  first, two thousand seven through December thirty-
first, two thousand seven, and five hundred  thousand  dollars  for  the
period  January first, two thousand eight through December thirty-first,
two thousand eight, five hundred thousand dollars for the period January
first, two thousand nine through  December  thirty-first,  two  thousand
nine,  five  hundred  thousand dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten, [and]  one
hundred  twenty-five  thousand dollars for the period January first, two
thousand eleven through March  thirty-first,  two  thousand  eleven  AND
WITHIN AMOUNTS APPROPRIATED ON AND AFTER APRIL FIRST, TWO THOUSAND ELEV-
EN.
  (g)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  services and expenses related to the health maintenance organization
direct pay market program established pursuant to  sections  forty-three
hundred  twenty-one-a and forty-three hundred twenty-two-a of the insur-
ance law from the tobacco control and insurance initiatives pool  estab-
lished for the following periods in the following amounts:
  (i)  up  to  thirty-five million dollars for the period January first,
two thousand through December thirty-first, two thousand of which  fifty
percentum  shall  be  allocated  to the program pursuant to section four
thousand three hundred twenty-one-a  of  the  insurance  law  and  fifty
percentum to the program pursuant to section four thousand three hundred
twenty-two-a of the insurance law;
  (ii)  up  to  thirty-six million dollars for the period January first,
two thousand one through December  thirty-first,  two  thousand  one  of
which  fifty  percentum  shall  be  allocated to the program pursuant to
section four thousand three hundred twenty-one-a of  the  insurance  law
and  fifty  percentum  to  the program pursuant to section four thousand
three hundred twenty-two-a of the insurance law;
  (iii) up to thirty-nine million dollars for the period January  first,
two  thousand  two  through  December  thirty-first, two thousand two of
which fifty percentum shall be allocated  to  the  program  pursuant  to
section  four  thousand  three hundred twenty-one-a of the insurance law
and fifty percentum to the program pursuant  to  section  four  thousand
three hundred twenty-two-a of the insurance law;
  (iv)  up  to  forty  million dollars for the period January first, two
thousand three through December  thirty-first,  two  thousand  three  of
which  fifty  percentum  shall  be  allocated to the program pursuant to
section four thousand three hundred twenty-one-a of  the  insurance  law
and  fifty  percentum  to  the program pursuant to section four thousand
three hundred twenty-two-a of the insurance law;
  (v) up to forty million dollars for  the  period  January  first,  two
thousand  four through December thirty-first, two thousand four of which
fifty percentum shall be allocated to the program  pursuant  to  section
four  thousand three hundred twenty-one-a of the insurance law and fifty

S. 2809--A                         46                         A. 4009--A

percentum to the program pursuant to section four thousand three hundred
twenty-two-a of the insurance law;
  (vi)  up  to  forty  million dollars for the period January first, two
thousand five through December thirty-first, two thousand five of  which
fifty  percentum  shall  be allocated to the program pursuant to section
four thousand three hundred twenty-one-a of the insurance law and  fifty
percentum to the program pursuant to section four thousand three hundred
twenty-two-a of the insurance law;
  (vii)  up  to  forty million dollars for the period January first, two
thousand six through December thirty-first, two thousand  six  of  which
fifty  percentum  shall  be allocated to the program pursuant to section
four thousand three hundred twenty-one-a of the insurance law and  fifty
percentum  shall  be  allocated  to the program pursuant to section four
thousand three hundred twenty-two-a of the insurance law;
  (viii) up to forty million dollars for the period January  first,  two
thousand  seven  through  December  thirty-first,  two thousand seven of
which fifty percentum shall be allocated  to  the  program  pursuant  to
section  four  thousand  three hundred twenty-one-a of the insurance law
and fifty percentum shall  be  allocated  to  the  program  pursuant  to
section  four  thousand three hundred twenty-two-a of the insurance law;
and
  (ix) up to forty million dollars for the  period  January  first,  two
thousand  eight  through  December  thirty-first,  two thousand eight of
which fifty per centum shall be allocated to  the  program  pursuant  to
section  four  thousand  three hundred twenty-one-a of the insurance law
and fifty per centum shall be  allocated  to  the  program  pursuant  to
section four thousand three hundred twenty-two-a of the insurance law.
  (h)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  services  and  expenses  related  to the healthy New York individual
program established pursuant to sections  four  thousand  three  hundred
twenty-six and four thousand three hundred twenty-seven of the insurance
law  from the tobacco control and insurance initiatives pool established
for the following periods in the following amounts:
  (i) up to six million dollars for the period January first, two  thou-
sand one through December thirty-first, two thousand one;
  (ii)  up  to twenty-nine million dollars for the period January first,
two thousand two through December thirty-first, two thousand two;
  (iii) up to five million one hundred thousand dollars for  the  period
January  first,  two  thousand  three through December thirty-first, two
thousand three;
  (iv) up to twenty-four million six hundred thousand  dollars  for  the
period  January  first, two thousand four through December thirty-first,
two thousand four;
  (v) up to thirty-four million six hundred  thousand  dollars  for  the
period  January  first, two thousand five through December thirty-first,
two thousand five;
  (vi) up to fifty-four million eight hundred thousand dollars  for  the
period  January  first,  two thousand six through December thirty-first,
two thousand six;
  (vii) up to sixty-one million seven hundred thousand dollars  for  the
period  January first, two thousand seven through December thirty-first,
two thousand seven; and
  (viii) up to one hundred three million seven  hundred  fifty  thousand
dollars  for the period January first, two thousand eight through Decem-
ber thirty-first, two thousand eight.

S. 2809--A                         47                         A. 4009--A

  (i) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of services and expenses related to the healthy New York  group  program
established  pursuant to sections four thousand three hundred twenty-six
and  four  thousand three hundred twenty-seven of the insurance law from
the tobacco control and insurance initiatives pool established  for  the
following periods in the following amounts:
  (i)  up  to  thirty-four million dollars for the period January first,
two thousand one through December thirty-first, two thousand one;
  (ii) up to seventy-seven million dollars for the period January first,
two thousand two through December thirty-first, two thousand two;
  (iii) up to ten million five hundred thousand dollars for  the  period
January  first,  two  thousand  three through December thirty-first, two
thousand three;
  (iv) up to twenty-four million six hundred thousand  dollars  for  the
period  January  first, two thousand four through December thirty-first,
two thousand four;
  (v) up to thirty-four million six hundred  thousand  dollars  for  the
period  January  first, two thousand five through December thirty-first,
two thousand five;
  (vi) up to fifty-four million eight hundred thousand dollars  for  the
period  January  first,  two thousand six through December thirty-first,
two thousand six;
  (vii) up to sixty-one million seven hundred thousand dollars  for  the
period  January first, two thousand seven through December thirty-first,
two thousand seven; and
  (viii) up to one hundred three million seven  hundred  fifty  thousand
dollars  for the period January first, two thousand eight through Decem-
ber thirty-first, two thousand eight.
  (i-1) Notwithstanding the provisions of paragraphs (h) and (i) of this
subdivision, the commissioner shall reserve and  accumulate  up  to  two
million  five  hundred thousand dollars annually for the periods January
first, two thousand four through  December  thirty-first,  two  thousand
six,  one  million  four hundred thousand dollars for the period January
first, two thousand seven through December  thirty-first,  two  thousand
seven,  two  million  dollars for the period January first, two thousand
eight through December thirty-first,  two  thousand  eight,  from  funds
otherwise  available  for  distribution  under  such  paragraphs for the
services and expenses related to the  pilot  program  for  entertainment
industry  employees  included  in subsection (b) of section one thousand
one hundred twenty-two of the insurance law,  and  an  additional  seven
hundred  thousand  dollars  annually  for the periods January first, two
thousand four through December thirty-first, two thousand six, an  addi-
tional  three hundred thousand dollars for the period January first, two
thousand seven through June thirtieth, two thousand seven  for  services
and expenses related to the pilot program for displaced workers included
in  subsection (c) of section one thousand one hundred twenty-two of the
insurance law.
  (j) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of services and expenses related  to  the  tobacco  use  prevention  and
control  program established pursuant to sections thirteen hundred nine-
ty-nine-ii and thirteen hundred ninety-nine-jj of this chapter, from the
tobacco control and  insurance  initiatives  pool  established  for  the
following periods in the following amounts:

S. 2809--A                         48                         A. 4009--A

  (i)  up  to  thirty  million dollars for the period January first, two
thousand through December thirty-first, two thousand;
  (ii)  up  to  forty  million dollars for the period January first, two
thousand one through December thirty-first, two thousand one;
  (iii) up to forty million dollars for the period  January  first,  two
thousand two through December thirty-first, two thousand two;
  (iv)  up to thirty-six million nine hundred fifty thousand dollars for
the period January first, two thousand three  through  December  thirty-
first, two thousand three;
  (v)  up  to thirty-six million nine hundred fifty thousand dollars for
the period January first, two thousand  four  through  December  thirty-
first, two thousand four;
  (vi)  up  to forty million six hundred thousand dollars for the period
January first, two thousand  five  through  December  thirty-first,  two
thousand five;
  (vii)  up  to eighty-one million nine hundred thousand dollars for the
period January first, two thousand six  through  December  thirty-first,
two thousand six, provided, however, that within amounts appropriated, a
portion  of  such  funds  may  be transferred to the Roswell Park Cancer
Institute Corporation to support costs associated with cancer research;
  (viii) up to ninety-four million one hundred  fifty  thousand  dollars
for  the period January first, two thousand seven through December thir-
ty-first, two thousand seven, provided,  however,  that  within  amounts
appropriated,  a portion of such funds may be transferred to the Roswell
Park Cancer Institute  Corporation  to  support  costs  associated  with
cancer research;
  (ix)  up to ninety-four million one hundred fifty thousand dollars for
the period January first, two thousand eight  through  December  thirty-
first, two thousand eight;
  (x)  up  to ninety-four million one hundred fifty thousand dollars for
the period January first, two thousand  nine  through  December  thirty-
first, two thousand nine;
  (xi)  up  to  eighty-seven million seven hundred seventy-five thousand
dollars for the period January first, two thousand ten through  December
thirty-first, two thousand ten; [and]
  (xii)  up  to  twenty-one million four hundred twelve thousand dollars
for the period January first, two thousand eleven through March  thirty-
first, two thousand eleven[.]; AND
  (XIII) UP TO FIFTY-TWO MILLION ONE HUNDRED THOUSAND DOLLARS EACH STATE
FISCAL  YEAR  FOR  THE  PERIOD  APRIL FIRST, TWO THOUSAND ELEVEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN.
  (k) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  fund - other, HCRA transfer fund, health care services account,
or any successor fund or account, for purposes of services and  expenses
related  to public health programs, including comprehensive care centers
for eating disorders pursuant to THE FORMER section twenty-seven hundred
ninety-nine-l of this chapter, provided however that, for such  centers,
funds  in  the  amount of five hundred thousand dollars on an annualized
basis shall be transferred from the health care services account, or any
successor fund or account, and deposited into the  fund  established  by
section  ninety-five-e  of  the  state  finance law FOR PERIODS PRIOR TO
MARCH THIRTY-FIRST, TWO THOUSAND ELEVEN, from the  tobacco  control  and
insurance  initiatives pool established for the following periods in the
following amounts:

S. 2809--A                         49                         A. 4009--A

  (i) up to thirty-one million dollars for the period January first, two
thousand through December thirty-first, two thousand;
  (ii) up to forty-one million dollars for the period January first, two
thousand one through December thirty-first, two thousand one;
  (iii)  up  to eighty-one million dollars for the period January first,
two thousand two through December thirty-first, two thousand two;
  (iv) one hundred twenty-two million five hundred thousand dollars  for
the  period  January  first, two thousand three through December thirty-
first, two thousand three;
  (v) one hundred  eight  million  five  hundred  seventy-five  thousand
dollars, plus an additional five hundred thousand dollars, for the peri-
od  January  first, two thousand four through December thirty-first, two
thousand four;
  (vi) ninety-one million eight hundred thousand dollars, plus an  addi-
tional  five hundred thousand dollars, for the period January first, two
thousand five through December thirty-first, two thousand five;
  (vii) one hundred fifty-six million six hundred thousand dollars, plus
an additional five hundred thousand  dollars,  for  the  period  January
first, two thousand six through December thirty-first, two thousand six;
  (viii)  one  hundred  fifty-one million four hundred thousand dollars,
plus an additional five hundred thousand dollars, for the period January
first, two thousand seven through December  thirty-first,  two  thousand
seven;
  (ix)  one  hundred  sixteen  million  nine hundred forty-nine thousand
dollars, plus an additional five hundred thousand dollars, for the peri-
od January first, two thousand eight through December thirty-first,  two
thousand eight;
  (x)  one  hundred  sixteen  million  nine  hundred forty-nine thousand
dollars, plus an additional five hundred thousand dollars, for the peri-
od January first, two thousand nine through December  thirty-first,  two
thousand nine;
  (xi)  one  hundred  sixteen  million  nine hundred forty-nine thousand
dollars, plus an additional five hundred thousand dollars, for the peri-
od January first, two thousand ten through  December  thirty-first,  two
thousand ten; [and]
  (xii)  twenty-nine  million  two  hundred  thirty-seven  thousand  two
hundred fifty dollars, plus an additional one hundred twenty-five  thou-
sand  dollars, for the period January first, two thousand eleven through
March thirty-first, two thousand eleven[.];
  (XIII) ONE HUNDRED TWENTY MILLION THIRTY-EIGHT  THOUSAND  DOLLARS  FOR
THE  PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST,
TWO THOUSAND TWELVE; AND
  (XIV) ONE HUNDRED NINETEEN MILLION FOUR HUNDRED SEVEN THOUSAND DOLLARS
EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  TWELVE
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN.
  (l)  Funds  shall  be  deposited  by  the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of the personal care and certified home health agency rate or  fee
increases  established  pursuant  to  subdivision three of section three
hundred sixty-seven-o of  the  social  services  law  from  the  tobacco
control  and  insurance  initiatives  pool established for the following
periods in the following amounts:

S. 2809--A                         50                         A. 4009--A

  (i) twenty-three million two hundred thousand dollars for  the  period
January first, two thousand through December thirty-first, two thousand;
  (ii)  twenty-three million two hundred thousand dollars for the period
January first, two thousand one through December thirty-first, two thou-
sand one;
  (iii) twenty-three million two hundred thousand dollars for the period
January first, two thousand two through December thirty-first, two thou-
sand two;
  (iv) up to sixty-five million two hundred  thousand  dollars  for  the
period  January first, two thousand three through December thirty-first,
two thousand three;
  (v) up to sixty-five million two  hundred  thousand  dollars  for  the
period  January  first, two thousand four through December thirty-first,
two thousand four;
  (vi) up to sixty-five million two hundred  thousand  dollars  for  the
period  January  first, two thousand five through December thirty-first,
two thousand five;
  (vii) up to sixty-five million two hundred thousand  dollars  for  the
period  January  first,  two thousand six through December thirty-first,
two thousand six;
  (viii) up to sixty-five million two hundred thousand dollars  for  the
period  January first, two thousand seven through December thirty-first,
two thousand seven; and
  (ix) up to sixteen million three  hundred  thousand  dollars  for  the
period January first, two thousand eight through March thirty-first, two
thousand eight.
  (m)  Funds  shall  be  deposited  by  the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of services and expenses related to home  care  workers  insurance
pilot  demonstration programs established pursuant to subdivision two of
section three hundred sixty-seven-o of the social services law from  the
tobacco  control  and  insurance  initiatives  pool  established for the
following periods in the following amounts:
  (i) three million eight hundred thousand dollars for the period  Janu-
ary first, two thousand through December thirty-first, two thousand;
  (ii) three million eight hundred thousand dollars for the period Janu-
ary  first, two thousand one through December thirty-first, two thousand
one;
  (iii) three million eight hundred  thousand  dollars  for  the  period
January first, two thousand two through December thirty-first, two thou-
sand two;
  (iv) up to three million eight hundred thousand dollars for the period
January  first,  two  thousand  three through December thirty-first, two
thousand three;
  (v) up to three million eight hundred thousand dollars for the  period
January  first,  two  thousand  four  through December thirty-first, two
thousand four;
  (vi) up to three million eight hundred thousand dollars for the period
January first, two thousand  five  through  December  thirty-first,  two
thousand five;
  (vii) up to three million eight hundred thousand dollars for the peri-
od  January  first,  two thousand six through December thirty-first, two
thousand six;

S. 2809--A                         51                         A. 4009--A

  (viii) up to three million eight  hundred  thousand  dollars  for  the
period  January first, two thousand seven through December thirty-first,
two thousand seven; and
  (ix)  up to nine hundred fifty thousand dollars for the period January
first, two thousand  eight  through  March  thirty-first,  two  thousand
eight.
  (n) Funds shall be transferred by the commissioner and shall be depos-
ited  to  the credit of the special revenue funds - other, miscellaneous
special revenue fund - 339, elderly  pharmaceutical  insurance  coverage
program  premium  account authorized pursuant to the provisions of title
three of article two of the elder law, or any successor fund or account,
for funding state expenses relating to  the  program  from  the  tobacco
control  and  insurance  initiatives  pool established for the following
periods in the following amounts:
  (i) one hundred seven million dollars for the  period  January  first,
two thousand through December thirty-first, two thousand;
  (ii)  one  hundred  sixty-four  million dollars for the period January
first, two thousand one through December thirty-first, two thousand one;
  (iii) three hundred twenty-two million seven hundred thousand  dollars
for  the period January first, two thousand two through December thirty-
first, two thousand two;
  (iv) four hundred thirty-three million three hundred thousand  dollars
for  the period January first, two thousand three through December thir-
ty-first, two thousand three;
  (v) five hundred four million one hundred fifty thousand  dollars  for
the  period  January  first,  two thousand four through December thirty-
first, two thousand four;
  (vi) five hundred sixty-six million eight hundred thousand dollars for
the period January first, two thousand  five  through  December  thirty-
first, two thousand five;
  (vii) six hundred three million one hundred fifty thousand dollars for
the  period  January  first,  two  thousand six through December thirty-
first, two thousand six;
  (viii) six hundred sixty million eight hundred  thousand  dollars  for
the  period  January  first, two thousand seven through December thirty-
first, two thousand seven;
  (ix) three hundred sixty-seven million four hundred sixty-three  thou-
sand  dollars  for  the period January first, two thousand eight through
December thirty-first, two thousand eight;
  (x) three hundred thirty-four million eight hundred twenty-five  thou-
sand  dollars  for  the  period January first, two thousand nine through
December thirty-first, two thousand nine;
  (xi) three hundred forty-four million nine  hundred  thousand  dollars
for  the period January first, two thousand ten through December thirty-
first, two thousand ten; [and]
  (xii) eighty-seven million seven hundred eighty-eight thousand dollars
for the period January first, two thousand eleven through March  thirty-
first, two thousand eleven[.];
  (XIII)  ONE  HUNDRED  FORTY-THREE  MILLION  ONE HUNDRED FIFTY THOUSAND
DOLLARS FOR THE PERIOD APRIL FIRST, TWO THOUSAND  ELEVEN  THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND TWELVE;
  (XIV)  ONE  HUNDRED TWENTY MILLION NINE HUNDRED FIFTY THOUSAND DOLLARS
FOR  THE  PERIOD  APRIL  FIRST,  TWO  THOUSAND  TWELVE   THROUGH   MARCH
THIRTY-FIRST, TWO THOUSAND THIRTEEN; AND

S. 2809--A                         52                         A. 4009--A

  (XV)  ONE  HUNDRED  TWENTY-EIGHT  MILLION EIGHT HUNDRED FIFTY THOUSAND
DOLLARS FOR THE PERIOD APRIL FIRST, TWO THOUSAND THIRTEEN THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND FOURTEEN.
  (o)  Funds  shall be reserved and accumulated and shall be transferred
to the Roswell Park  Cancer  Institute  Corporation,  from  the  tobacco
control  and  insurance  initiatives  pool established for the following
periods in the following amounts:
  (i) up to ninety million dollars for the  period  January  first,  two
thousand through December thirty-first, two thousand;
  (ii)  up  to  sixty  million dollars for the period January first, two
thousand one through December thirty-first, two thousand one;
  (iii) up to eighty-five million dollars for the period January  first,
two thousand two through December thirty-first, two thousand two;
  (iv)  eighty-five  million  two hundred fifty thousand dollars for the
period January first, two thousand three through December  thirty-first,
two thousand three;
  (v)  seventy-eight  million  dollars for the period January first, two
thousand four through December thirty-first, two thousand four;
  (vi) seventy-eight million dollars for the period January  first,  two
thousand five through December thirty-first, two thousand five;
  (vii)  ninety-one  million  dollars  for the period January first, two
thousand six through December thirty-first, two thousand six;
  (viii) seventy-eight million dollars for the period January first, two
thousand seven through December thirty-first, two thousand seven;
  (ix) seventy-eight million dollars for the period January  first,  two
thousand eight through December thirty-first, two thousand eight;
  (x)  seventy-eight  million  dollars for the period January first, two
thousand nine through December thirty-first, two thousand nine;
  (xi) seventy-eight million dollars for the period January  first,  two
thousand ten through December thirty-first, two thousand ten; [and]
  (xii)  nineteen  million  five hundred thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven[.]; AND
  (XIII) SIXTY-NINE MILLION EIGHT HUNDRED FORTY  THOUSAND  DOLLARS  EACH
STATE  FISCAL  YEAR  FOR  THE  PERIOD  APRIL  FIRST, TWO THOUSAND ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN.
  (p) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds - other, indigent care fund - 068, indigent care account,
or any successor fund or account, for purposes of providing  a  medicaid
disproportionate  share payment from the high need indigent care adjust-
ment pool established pursuant to section twenty-eight  hundred  seven-w
of this article, from the tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
  (i) eighty-two million dollars annually for the periods January first,
two thousand through December thirty-first, two thousand two;
  (ii)  up  to  eighty-two million dollars for the period January first,
two thousand three through December thirty-first, two thousand three;
  (iii) up to eighty-two million dollars for the period  January  first,
two thousand four through December thirty-first, two thousand four;
  (iv)  up  to  eighty-two million dollars for the period January first,
two thousand five through December thirty-first, two thousand five;
  (v) up to eighty-two million dollars for the period January first, two
thousand six through December thirty-first, two thousand six;

S. 2809--A                         53                         A. 4009--A

  (vi) up to eighty-two million dollars for the  period  January  first,
two thousand seven through December thirty-first, two thousand seven;
  (vii)  up  to eighty-two million dollars for the period January first,
two thousand eight through December thirty-first, two thousand eight;
  (viii) up to eighty-two million dollars for the period January  first,
two thousand nine through December thirty-first, two thousand nine;
  (ix)  up  to  eighty-two million dollars for the period January first,
two thousand ten through December thirty-first, two thousand ten; [and]
  (x) up to twenty million five hundred thousand dollars for the  period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven; AND
  (XI)  UP  TO EIGHTY-TWO MILLION DOLLARS EACH STATE FISCAL YEAR FOR THE
PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST,  TWO
THOUSAND FOURTEEN.
  (q)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  providing  distributions  to  eligible  school  based health centers
established pursuant to section eighty-eight of chapter one of the  laws
of  nineteen hundred ninety-nine, from the tobacco control and insurance
initiatives pool established for the following periods in the  following
amounts:
  (i)  seven  million dollars annually for the period January first, two
thousand through December thirty-first, two thousand two;
  (ii) up to seven million dollars for the  period  January  first,  two
thousand three through December thirty-first, two thousand three;
  (iii)  up  to  seven million dollars for the period January first, two
thousand four through December thirty-first, two thousand four;
  (iv) up to seven million dollars for the  period  January  first,  two
thousand five through December thirty-first, two thousand five;
  (v)  up  to  seven  million  dollars for the period January first, two
thousand six through December thirty-first, two thousand six;
  (vi) up to seven million dollars for the  period  January  first,  two
thousand seven through December thirty-first, two thousand seven;
  (vii)  up  to  seven million dollars for the period January first, two
thousand eight through December thirty-first, two thousand eight;
  (viii) up to seven million dollars for the period January  first,  two
thousand nine through December thirty-first, two thousand nine;
  (ix)  up  to  seven  million dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten; [and]
  (x) up to one million seven hundred fifty  thousand  dollars  for  the
period  January  first,  two thousand eleven through March thirty-first,
two thousand eleven; AND
  (XI) UP TO FIVE MILLION SIX HUNDRED THOUSAND DOLLARS EACH STATE FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIR-
TY-FIRST, TWO THOUSAND FOURTEEN.
  (r) Funds shall be deposited by the commissioner within amounts appro-
priated, and the state comptroller is hereby authorized and directed  to
receive  for  deposit to the credit of the state special revenue funds -
other, HCRA transfer fund, medical assistance account, or any  successor
fund  or account, for purposes of providing distributions for supplemen-
tary  medical  insurance  for  Medicare  part  B  premiums,   physicians
services,  outpatient  services,  medical  equipment, supplies and other
health services, from the tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
  (i) forty-three million dollars for  the  period  January  first,  two
thousand through December thirty-first, two thousand;

S. 2809--A                         54                         A. 4009--A

  (ii) sixty-one million dollars for the period January first, two thou-
sand one through December thirty-first, two thousand one;
  (iii)  sixty-five  million  dollars  for the period January first, two
thousand two through December thirty-first, two thousand two;
  (iv) sixty-seven million five hundred thousand dollars for the  period
January  first,  two  thousand  three through December thirty-first, two
thousand three;
  (v) sixty-eight million dollars for  the  period  January  first,  two
thousand four through December thirty-first, two thousand four;
  (vi)  sixty-eight  million  dollars  for the period January first, two
thousand five through December thirty-first, two thousand five;
  (vii) sixty-eight million dollars for the period  January  first,  two
thousand six through December thirty-first, two thousand six;
  (viii)  seventeen million five hundred thousand dollars for the period
January first, two thousand seven  through  December  thirty-first,  two
thousand seven;
  (ix)  sixty-eight  million  dollars  for the period January first, two
thousand eight through December thirty-first, two thousand eight;
  (x) sixty-eight million dollars for  the  period  January  first,  two
thousand nine through December thirty-first, two thousand nine;
  (xi)  sixty-eight  million  dollars  for the period January first, two
thousand ten through December thirty-first, two thousand ten; [and]
  (xii) seventeen million dollars for  the  period  January  first,  two
thousand eleven through March thirty-first, two thousand eleven[.]; AND
  (XIII)  SIXTY-EIGHT  MILLION  DOLLARS  EACH  STATE FISCAL YEAR FOR THE
PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST,  TWO
THOUSAND FOURTEEN.
  (s) Funds shall be deposited by the commissioner within amounts appro-
priated,  and the state comptroller is hereby authorized and directed to
receive for deposit to the credit of the state special revenue  funds  -
other,  HCRA transfer fund, medical assistance account, or any successor
fund or account, for purposes of  providing  distributions  pursuant  to
paragraphs  (s-5),  (s-6),  (s-7)  and  (s-8)  of  subdivision eleven of
section twenty-eight hundred seven-c of this article  from  the  tobacco
control  and  insurance  initiatives  pool established for the following
periods in the following amounts:
  (i) eighteen million dollars for the period January first,  two  thou-
sand through December thirty-first, two thousand;
  (ii)  twenty-four  million  dollars  annually  for the periods January
first, two thousand one through December thirty-first, two thousand two;
  (iii) up to twenty-four million dollars for the period January  first,
two thousand three through December thirty-first, two thousand three;
  (iv)  up  to twenty-four million dollars for the period January first,
two thousand four through December thirty-first, two thousand four;
  (v) up to twenty-four million dollars for the  period  January  first,
two thousand five through December thirty-first, two thousand five;
  (vi)  up  to twenty-four million dollars for the period January first,
two thousand six through December thirty-first, two thousand six;
  (vii) up to twenty-four million dollars for the period January  first,
two thousand seven through December thirty-first, two thousand seven;
  (viii) up to twenty-four million dollars for the period January first,
two  thousand  eight  through December thirty-first, two thousand eight;
and
  (ix) up to twenty-two million dollars for the  period  January  first,
two thousand nine through November thirtieth, two thousand nine.

S. 2809--A                         55                         A. 4009--A

  (t)  Funds  shall be reserved and accumulated from year to year by the
commissioner and shall be made available, including income from invested
funds:
  (i)  For  the  purpose  of making grants to a state owned and operated
medical school which does not have a state owned and  operated  hospital
on  site  and  available for teaching purposes. Notwithstanding sections
one hundred twelve and one hundred sixty-three of the state finance law,
such grants shall be made in the amount of up to five  hundred  thousand
dollars  for  the  period  January  first, two thousand through December
thirty-first, two thousand;
  (ii) For the purpose of making grants to medical schools  pursuant  to
section  eighty-six-a  of  chapter  one  of the laws of nineteen hundred
ninety-nine in the sum of up to four  million  dollars  for  the  period
January first, two thousand through December thirty-first, two thousand;
and
  (iii)  The  funds  disbursed pursuant to subparagraphs (i) and (ii) of
this paragraph from the tobacco control and insurance  initiatives  pool
are  contingent upon meeting all funding amounts established pursuant to
paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n),  (p),  (q),  (r)
and  (s)  of  this  subdivision,  paragraph  (a)  of subdivision nine of
section twenty-eight hundred seven-j of  this  article,  and  paragraphs
(a),  (i)  and  (k)  of  subdivision one of section twenty-eight hundred
seven-l of this article.
  (u) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share  of  services  and  expenses  related  to the nursing home quality
improvement demonstration program established pursuant to section  twen-
ty-eight  hundred  eight-d  of this article from the tobacco control and
insurance initiatives pool established for the following periods in  the
following amounts:
  (i)  up  to twenty-five million dollars for the period beginning April
first, two thousand two and ending December thirty-first,  two  thousand
two,  and  on  an  annualized  basis,  for each annual period thereafter
beginning January first, two thousand three and ending December  thirty-
first, two thousand four;
  (ii)  up  to eighteen million seven hundred fifty thousand dollars for
the period January first, two thousand  five  through  December  thirty-
first, two thousand five; and
  (iii)  up  to  fifty-six million five hundred thousand dollars for the
period January first, two thousand six  through  December  thirty-first,
two thousand six.
  (v) Funds shall be transferred by the commissioner and shall be depos-
ited  to the credit of the hospital excess liability pool created pursu-
ant to section eighteen of chapter two hundred sixty-six of the laws  of
nineteen  hundred  eighty-six,  or  any  successor  fund or account, for
purposes of expenses related to the purchase of excess medical  malprac-
tice  insurance and the cost of administrating the pool, including costs
associated with the risk  management  program  established  pursuant  to
section  forty-two  of part A of chapter one of the laws of two thousand
two required by paragraph (a) of subdivision one of section eighteen  of
chapter two hundred sixty-six of the laws of nineteen hundred eighty-six
as may be amended from time to time, from the tobacco control and insur-

S. 2809--A                         56                         A. 4009--A

ance  initiatives  pool  established  for  the  following periods in the
following amounts:
  (i) up to fifty million dollars or so much as is needed for the period
January first, two thousand two through December thirty-first, two thou-
sand two;
  (ii)  up to seventy-six million seven hundred thousand dollars for the
period January first, two thousand three through December  thirty-first,
two thousand three;
  (iii)  up  to sixty-five million dollars for the period January first,
two thousand four through December thirty-first, two thousand four;
  (iv) up to sixty-five million dollars for the  period  January  first,
two thousand five through December thirty-first, two thousand five;
  (v)  up to one hundred thirteen million eight hundred thousand dollars
for the period January first, two thousand six through December  thirty-
first, two thousand six;
  (vi)  up  to one hundred thirty million dollars for the period January
first, two thousand seven through December  thirty-first,  two  thousand
seven;
  (vii)  up to one hundred thirty million dollars for the period January
first, two thousand eight through December  thirty-first,  two  thousand
eight;
  (viii) up to one hundred thirty million dollars for the period January
first,  two  thousand  nine  through December thirty-first, two thousand
nine;
  (ix) up to one hundred thirty million dollars for the  period  January
first, two thousand ten through December thirty-first, two thousand ten;
[and]
  (x)  up  to  thirty-two  million five hundred thousand dollars for the
period January first, two thousand eleven  through  March  thirty-first,
two thousand eleven[.]; AND
  (XI)  UP  TO  ONE  HUNDRED  TWENTY-SEVEN MILLION FOUR HUNDRED THOUSAND
DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND
ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN.
  (w)  Funds  shall  be  deposited  by  the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of the treatment of breast and cervical cancer pursuant  to  para-
graph  (v) of subdivision four of section three hundred sixty-six of the
social services law, from the tobacco control and insurance  initiatives
pool established for the following periods in the following amounts:
  (i)  up  to four hundred fifty thousand dollars for the period January
first, two thousand two through December thirty-first, two thousand two;
  (ii) up to two million one hundred thousand  dollars  for  the  period
January  first,  two  thousand  three through December thirty-first, two
thousand three;
  (iii) up to two million one hundred thousand dollars  for  the  period
January  first,  two  thousand  four  through December thirty-first, two
thousand four;
  (iv) up to two million one hundred thousand  dollars  for  the  period
January  first,  two  thousand  five  through December thirty-first, two
thousand five;
  (v) up to two million one hundred  thousand  dollars  for  the  period
January first, two thousand six through December thirty-first, two thou-
sand six;

S. 2809--A                         57                         A. 4009--A

  (vi)  up  to  two  million one hundred thousand dollars for the period
January first, two thousand seven  through  December  thirty-first,  two
thousand seven;
  (vii)  up  to  two million one hundred thousand dollars for the period
January first, two thousand eight  through  December  thirty-first,  two
thousand eight;
  (viii)  up  to two million one hundred thousand dollars for the period
January first, two thousand  nine  through  December  thirty-first,  two
thousand nine;
  (ix)  up  to  two  million one hundred thousand dollars for the period
January first, two thousand ten through December thirty-first, two thou-
sand ten; [and]
  (x) up to five hundred twenty-five thousand  dollars  for  the  period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven[.]; AND
  (XI)  UP TO TWO MILLION ONE HUNDRED THOUSAND DOLLARS EACH STATE FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIR-
TY-FIRST, TWO THOUSAND FOURTEEN.
  (x) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share of the non-public general hospital rates increases for recruitment
and retention of health care workers from the tobacco control and insur-
ance  initiatives  pool  established  for  the  following periods in the
following amounts:
  (i) twenty-seven million one hundred thousand dollars on an annualized
basis for the period January first, two thousand  two  through  December
thirty-first, two thousand two;
  (ii)  fifty  million  eight  hundred thousand dollars on an annualized
basis for the period January first, two thousand three through  December
thirty-first, two thousand three;
  (iii)  sixty-nine million three hundred thousand dollars on an annual-
ized basis for the period  January  first,  two  thousand  four  through
December thirty-first, two thousand four;
  (iv)  sixty-nine million three hundred thousand dollars for the period
January first, two thousand  five  through  December  thirty-first,  two
thousand five;
  (v)  sixty-nine  million three hundred thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six;
  (vi) sixty-five million three hundred thousand dollars for the  period
January  first,  two  thousand  seven through December thirty-first, two
thousand seven;
  (vii) sixty-one million one hundred fifty  thousand  dollars  for  the
period  January first, two thousand eight through December thirty-first,
two thousand eight; and
  (viii) forty-eight million seven hundred twenty-one  thousand  dollars
for the period January first, two thousand nine through November thirti-
eth, two thousand nine.
  (y)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  grants  to public general hospitals for recruitment and retention of
health care workers pursuant to paragraph (b) of subdivision  thirty  of
section  twenty-eight  hundred  seven-c of this article from the tobacco

S. 2809--A                         58                         A. 4009--A

control and insurance initiatives pool  established  for  the  following
periods in the following amounts:
  (i)  eighteen  million  five hundred thousand dollars on an annualized
basis for the period January first, two thousand  two  through  December
thirty-first, two thousand two;
  (ii)  thirty-seven million four hundred thousand dollars on an annual-
ized basis for the period January  first,  two  thousand  three  through
December thirty-first, two thousand three;
  (iii)  fifty-two million two hundred thousand dollars on an annualized
basis for the period January first, two thousand four  through  December
thirty-first, two thousand four;
  (iv)  fifty-two  million  two  hundred thousand dollars for the period
January first, two thousand  five  through  December  thirty-first,  two
thousand five;
  (v)  fifty-two  million  two  hundred  thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six;
  (vi) forty-nine million dollars for  the  period  January  first,  two
thousand seven through December thirty-first, two thousand seven;
  (vii)  forty-nine  million  dollars  for the period January first, two
thousand eight through December thirty-first, two thousand eight; and
  (viii) twelve million two hundred fifty thousand dollars for the peri-
od January first, two thousand  nine  through  March  thirty-first,  two
thousand nine.
  Provided,  however,  amounts pursuant to this paragraph may be reduced
in an amount to be approved by the director of  the  budget  to  reflect
amounts  received  from  the  federal  government under the state's 1115
waiver which are directed under its terms and conditions to  the  health
workforce recruitment and retention program.
  (z)  Funds  shall  be  deposited  by  the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of the non-public residential health care facility rate  increases
for  recruitment  and retention of health care workers pursuant to para-
graph (a) of subdivision eighteen of section twenty-eight hundred  eight
of  this article from the tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
  (i) twenty-one million five hundred thousand dollars on an  annualized
basis  for  the  period January first, two thousand two through December
thirty-first, two thousand two;
  (ii) thirty-three million three hundred thousand dollars on an annual-
ized basis for the period January  first,  two  thousand  three  through
December thirty-first, two thousand three;
  (iii)  forty-six  million three hundred thousand dollars on an annual-
ized basis for the period  January  first,  two  thousand  four  through
December thirty-first, two thousand four;
  (iv)  forty-six  million three hundred thousand dollars for the period
January first, two thousand  five  through  December  thirty-first,  two
thousand five;
  (v)  forty-six  million  three hundred thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six;

S. 2809--A                         59                         A. 4009--A

  (vi) thirty million nine hundred thousand dollars for the period Janu-
ary first, two thousand seven through December thirty-first,  two  thou-
sand seven;
  (vii) twenty-four million seven hundred thousand dollars for the peri-
od  January first, two thousand eight through December thirty-first, two
thousand eight;
  (viii) twelve million three hundred seventy-five thousand dollars  for
the  period  January  first,  two thousand nine through December thirty-
first, two thousand nine;
  (ix) nine million three hundred thousand dollars for the period  Janu-
ary  first, two thousand ten through December thirty-first, two thousand
ten; and
  (x) two million three hundred twenty-five  thousand  dollars  for  the
period  January  first,  two thousand eleven through March thirty-first,
two thousand eleven.
  (aa) Funds shall be reserved and accumulated from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of grants to public residential health care facilities  for  recruitment
and retention of health care workers pursuant to paragraph (b) of subdi-
vision  eighteen  of  section twenty-eight hundred eight of this article
from the tobacco control and insurance initiatives pool established  for
the following periods in the following amounts:
  (i) seven million five hundred thousand dollars on an annualized basis
for  the period January first, two thousand two through December thirty-
first, two thousand two;
  (ii) eleven million seven hundred thousand dollars  on  an  annualized
basis  for the period January first, two thousand three through December
thirty-first, two thousand three;
  (iii) sixteen million two hundred thousand dollars  on  an  annualized
basis  for  the period January first, two thousand four through December
thirty-first, two thousand four;
  (iv) sixteen million two hundred thousand dollars for the period Janu-
ary first, two thousand five through December thirty-first, two thousand
five;
  (v) sixteen million two hundred thousand dollars for the period  Janu-
ary  first, two thousand six through December thirty-first, two thousand
six;
  (vi) ten million eight hundred thousand dollars for the period January
first, two thousand seven through December  thirty-first,  two  thousand
seven;
  (vii)  six million seven hundred fifty thousand dollars for the period
January first, two thousand eight  through  December  thirty-first,  two
thousand eight; and
  (viii) one million three hundred fifty thousand dollars for the period
January  first,  two  thousand  nine  through December thirty-first, two
thousand nine.
  (bb)(i) Funds shall be deposited by the commissioner,  within  amounts
appropriated,  and  subject  to  the  availability  of federal financial
participation, and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for the purpose of supporting the
state share of adjustments to Medicaid rates  of  payment  for  personal
care  services  provided pursuant to paragraph (e) of subdivision two of
section three hundred sixty-five-a of the social services law, for local
social service districts which include a city with a population of  over

S. 2809--A                         60                         A. 4009--A

one  million  persons  and  computed  and distributed in accordance with
memorandums of understanding to be entered into between the state of New
York and such local social service districts for the purpose of support-
ing  the  recruitment  and retention of personal care service workers or
any worker with direct patient care  responsibility,  from  the  tobacco
control  and  insurance  initiatives  pool established for the following
periods and the following amounts:
  (A) forty-four million dollars, on an annualized basis, for the period
April first, two thousand two through December thirty-first,  two  thou-
sand two;
  (B)  seventy-four  million  dollars,  on  an annualized basis, for the
period January first, two thousand three through December  thirty-first,
two thousand three;
  (C)  one hundred four million dollars, on an annualized basis, for the
period January first, two thousand four through  December  thirty-first,
two thousand four;
  (D)  one  hundred  thirty-six million dollars, on an annualized basis,
for the period January first, two thousand five through  December  thir-
ty-first, two thousand five;
  (E)  one  hundred  thirty-six million dollars, on an annualized basis,
for the period January first, two thousand six through December  thirty-
first, two thousand six;
  (F)  one  hundred  thirty-six  million  dollars for the period January
first, two thousand seven through December  thirty-first,  two  thousand
seven;
  (G)  one  hundred  thirty-six  million  dollars for the period January
first, two thousand eight through December  thirty-first,  two  thousand
eight;
  (H)  one  hundred  thirty-six  million  dollars for the period January
first, two thousand nine through  December  thirty-first,  two  thousand
nine;
  (I)  one  hundred  thirty-six  million  dollars for the period January
first, two thousand ten through December thirty-first, two thousand ten;
[and]
  (J) thirty-four million dollars for  the  period  January  first,  two
thousand eleven through March thirty-first, two thousand eleven[.]; AND
  (K)  ONE HUNDRED THIRTY-SIX MILLION DOLLARS EACH STATE FISCAL YEAR FOR
THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH  THIRTY-FIRST,
TWO THOUSAND FOURTEEN.
  (ii)  Adjustments  to  Medicaid  rates made pursuant to this paragraph
shall not, in aggregate, exceed the following amounts for the  following
periods:
  (A)  for  the  period  April  first, two thousand two through December
thirty-first, two thousand two, one hundred ten million dollars;
  (B) for the period January first, two thousand three through  December
thirty-first,  two  thousand  three,  one  hundred  eighty-five  million
dollars;
  (C) for the period January first, two thousand four  through  December
thirty-first, two thousand four, two hundred sixty million dollars;
  (D)  for  the period January first, two thousand five through December
thirty-first, two thousand five, three hundred forty million dollars;
  (E) for the period January first, two thousand  six  through  December
thirty-first, two thousand six, three hundred forty million dollars;
  (F)  for the period January first, two thousand seven through December
thirty-first, two thousand seven, three hundred forty million dollars;

S. 2809--A                         61                         A. 4009--A

  (G) for the period January first, two thousand eight through  December
thirty-first, two thousand eight, three hundred forty million dollars;
  (H)  for  the period January first, two thousand nine through December
thirty-first, two thousand nine, three hundred forty million dollars;
  (I) for the period January first, two thousand  ten  through  December
thirty-first,  two  thousand  ten,  three hundred forty million dollars;
[and]
  (J) for the period January first, two thousand  eleven  through  March
thirty-first, two thousand eleven, eighty-five million dollars[.]; AND
  (K)  FOR  EACH  STATE  FISCAL  YEAR WITHIN THE PERIOD APRIL FIRST, TWO
THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN, THREE
HUNDRED FORTY MILLION DOLLARS.
  (iii) Personal care service providers which have their rates  adjusted
pursuant  to  this  paragraph  shall  use  such funds for the purpose of
recruitment and retention  of  non-supervisory  personal  care  services
workers  or  any worker with direct patient care responsibility only and
are prohibited from using such funds for any other  purpose.  Each  such
personal  care services provider shall submit, at a time and in a manner
to be determined by the commissioner, a written certification  attesting
that  such  funds will be used solely for the purpose of recruitment and
retention of non-supervisory personal care services workers or any work-
er with direct patient care responsibility. The commissioner is  author-
ized  to  audit each such provider to ensure compliance with the written
certification required by this subdivision and shall  recoup  any  funds
determined  to  have  been  used for purposes other than recruitment and
retention of non-supervisory personal care services workers or any work-
er with direct patient care responsibility. Such recoupment shall be  in
addition to any other penalties provided by law.
  (cc)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for the purpose of supporting the
state share of adjustments to Medicaid rates  of  payment  for  personal
care  services  provided pursuant to paragraph (e) of subdivision two of
section three hundred sixty-five-a of the social services law, for local
social service districts which shall not include a  city  with  a  popu-
lation  of  over  one  million persons for the purpose of supporting the
personal care services  worker  recruitment  and  retention  program  as
established  pursuant  to  section  three  hundred  sixty-seven-q of the
social services law, from the tobacco control and insurance  initiatives
pool established for the following periods and the following amounts:
  (i)  two  million  eight hundred thousand dollars for the period April
first, two thousand two through December thirty-first, two thousand two;
  (ii) five million six  hundred  thousand  dollars,  on  an  annualized
basis, for the period January first, two thousand three through December
thirty-first, two thousand three;
  (iii)  eight  million  four hundred thousand dollars, on an annualized
basis, for the period January first, two thousand four through  December
thirty-first, two thousand four;
  (iv)  ten  million  eight  hundred  thousand dollars, on an annualized
basis, for the period January first, two thousand five through  December
thirty-first, two thousand five;
  (v)  ten  million  eight  hundred  thousand  dollars, on an annualized
basis, for the period January first, two thousand six  through  December
thirty-first, two thousand six;

S. 2809--A                         62                         A. 4009--A

  (vi)  eleven million two hundred thousand dollars for the period Janu-
ary first, two thousand seven through December thirty-first,  two  thou-
sand seven;
  (vii) eleven million two hundred thousand dollars for the period Janu-
ary  first,  two thousand eight through December thirty-first, two thou-
sand eight;
  (viii) eleven million two hundred  thousand  dollars  for  the  period
January  first,  two  thousand  nine  through December thirty-first, two
thousand nine;
  (ix) eleven million two hundred thousand dollars for the period  Janu-
ary  first, two thousand ten through December thirty-first, two thousand
ten; [and]
  (x) two million eight hundred thousand dollars for the period  January
first,  two  thousand  eleven  through  March thirty-first, two thousand
eleven[.]; AND
  (XI) ELEVEN MILLION TWO HUNDRED THOUSAND  DOLLARS  EACH  STATE  FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIR-
TY-FIRST, TWO THOUSAND FOURTEEN.
  (dd)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any successor fund or account, for purposes of funding the  state  share
of Medicaid expenditures for physician services from the tobacco control
and  insurance initiatives pool established for the following periods in
the following amounts:
  (i) up to fifty-two million dollars for the period January first,  two
thousand two through December thirty-first, two thousand two;
  (ii)  eighty-one  million  two hundred thousand dollars for the period
January first, two thousand three  through  December  thirty-first,  two
thousand three;
  (iii)  eighty-five million two hundred thousand dollars for the period
January first, two thousand  four  through  December  thirty-first,  two
thousand four;
  (iv)  eighty-five  million two hundred thousand dollars for the period
January first, two thousand  five  through  December  thirty-first,  two
thousand five;
  (v)  eighty-five  million  two hundred thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six;
  (vi) [eight-five] EIGHTY-FIVE million two hundred thousand dollars for
the period January first, two thousand seven  through  December  thirty-
first, two thousand seven;
  (vii)  eighty-five million two hundred thousand dollars for the period
January first, two thousand eight  through  December  thirty-first,  two
thousand eight;
  (viii) eighty-five million two hundred thousand dollars for the period
January  first,  two  thousand  nine  through December thirty-first, two
thousand nine;
  (ix) eighty-five million two hundred thousand dollars for  the  period
January first, two thousand ten through December thirty-first, two thou-
sand ten; [and]
  (x)  twenty-one  million three hundred thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven[.]; AND

S. 2809--A                         63                         A. 4009--A

  (XI) EIGHTY-FIVE MILLION  TWO  HUNDRED  THOUSAND  DOLLARS  EACH  STATE
FISCAL  YEAR  FOR  THE  PERIOD  APRIL FIRST, TWO THOUSAND ELEVEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN.
  (ee)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any successor fund or account, for purposes of funding the  state  share
of  the free-standing diagnostic and treatment center rate increases for
recruitment and retention of health care workers pursuant to subdivision
seventeen of section twenty-eight hundred seven of this article from the
tobacco control and  insurance  initiatives  pool  established  for  the
following periods in the following amounts:
  (i)  three  million  two hundred fifty thousand dollars for the period
April first, two thousand two through December thirty-first,  two  thou-
sand two;
  (ii) three million two hundred fifty thousand dollars on an annualized
basis  for the period January first, two thousand three through December
thirty-first, two thousand three;
  (iii) three million two hundred fifty thousand dollars on  an  annual-
ized  basis  for  the  period  January  first, two thousand four through
December thirty-first, two thousand four;
  (iv) three million two hundred fifty thousand dollars for  the  period
January  first,  two  thousand  five  through December thirty-first, two
thousand five;
  (v) three million two hundred fifty thousand dollars  for  the  period
January first, two thousand six through December thirty-first, two thou-
sand six;
  (vi)  three  million two hundred fifty thousand dollars for the period
January first, two thousand seven  through  December  thirty-first,  two
thousand seven;
  (vii) three million four hundred thirty-eight thousand dollars for the
period  January first, two thousand eight through December thirty-first,
two thousand eight;
  (viii) two million four hundred fifty thousand dollars for the  period
January  first,  two  thousand  nine  through December thirty-first, two
thousand nine;
  (ix) one million five hundred thousand dollars for the period  January
first, two thousand ten through December thirty-first, two thousand ten;
and
  (x)  three hundred twenty-five thousand dollars for the period January
first, two thousand eleven  through  March  thirty-first,  two  thousand
eleven.
  (ff)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any successor fund or account, for purposes of funding the  state  share
of  Medicaid expenditures for disabled persons as authorized pursuant to
subparagraphs twelve and thirteen of paragraph (a) of subdivision one of
section three hundred sixty-six of the  social  services  law  from  the
tobacco  control  and  insurance  initiatives  pool  established for the
following periods in the following amounts:
  (i) one million eight hundred thousand dollars for  the  period  April
first, two thousand two through December thirty-first, two thousand two;

S. 2809--A                         64                         A. 4009--A

  (ii)  sixteen  million  four hundred thousand dollars on an annualized
basis for the period January first, two thousand three through  December
thirty-first, two thousand three;
  (iii) eighteen million seven hundred thousand dollars on an annualized
basis  for  the period January first, two thousand four through December
thirty-first, two thousand four;
  (iv) thirty million six hundred thousand dollars for the period  Janu-
ary first, two thousand five through December thirty-first, two thousand
five;
  (v) thirty million six hundred thousand dollars for the period January
first, two thousand six through December thirty-first, two thousand six;
  (vi)  thirty million six hundred thousand dollars for the period Janu-
ary first, two thousand seven through December thirty-first,  two  thou-
sand seven;
  (vii)  fifteen million dollars for the period January first, two thou-
sand eight through December thirty-first, two thousand eight;
  (viii) fifteen million dollars for the period January first, two thou-
sand nine through December thirty-first, two thousand nine;
  (ix) fifteen million dollars for the period January first,  two  thou-
sand ten through December thirty-first, two thousand ten; [and]
  (x)  three million seven hundred fifty thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven[.]; AND
  (XI) FIFTEEN MILLION DOLLARS EACH STATE FISCAL  YEAR  FOR  THE  PERIOD
APRIL  FIRST,  TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND FOURTEEN.
  (gg) Funds shall be reserved and accumulated from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of grants to non-public general hospitals pursuant to paragraph  (c)  of
subdivision thirty of section twenty-eight hundred seven-c of this arti-
cle  from the tobacco control and insurance initiatives pool established
for the following periods in the following amounts:
  (i) up to one million three hundred thousand dollars on an  annualized
basis  for  the  period January first, two thousand two through December
thirty-first, two thousand two;
  (ii) up to three million two hundred thousand dollars on an annualized
basis for the period January first, two thousand three through  December
thirty-first, two thousand three;
  (iii) up to five million six hundred thousand dollars on an annualized
basis  for  the period January first, two thousand four through December
thirty-first, two thousand four;
  (iv) up to eight million six hundred thousand dollars for  the  period
January  first,  two  thousand  five  through December thirty-first, two
thousand five;
  (v) up to eight million six hundred thousand dollars on an  annualized
basis  for  the  period January first, two thousand six through December
thirty-first, two thousand six;
  (vi) up to two million six hundred thousand  dollars  for  the  period
January  first,  two  thousand  seven through December thirty-first, two
thousand seven;
  (vii) up to two million six hundred thousand dollars  for  the  period
January  first,  two  thousand  eight through December thirty-first, two
thousand eight;
  (viii) up to two million six hundred thousand dollars for  the  period
January  first,  two  thousand  nine  through December thirty-first, two
thousand nine;

S. 2809--A                         65                         A. 4009--A

  (ix) up to two million six hundred thousand  dollars  for  the  period
January first, two thousand ten through December thirty-first, two thou-
sand ten; and
  (x)  up  to  six hundred fifty thousand dollars for the period January
first, two thousand eleven  through  March  thirty-first,  two  thousand
eleven.
  (hh)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit to the credit of the special revenue
fund -  other,  HCRA  transfer  fund,  medical  assistance  account  for
purposes  of  providing  financial assistance to residential health care
facilities pursuant to subdivisions nineteen and twenty-one  of  section
twenty-eight hundred eight of this article, from the tobacco control and
insurance  initiatives pool established for the following periods in the
following amounts:
  (i) for the period April first,  two  thousand  two  through  December
thirty-first, two thousand two, ten million dollars;
  (ii) for the period January first, two thousand three through December
thirty-first,  two thousand three, nine million four hundred fifty thou-
sand dollars;
  (iii) for the period January first, two thousand four through December
thirty-first, two thousand four, nine million three hundred fifty  thou-
sand dollars;
  (iv)  up  to fifteen million dollars for the period January first, two
thousand five through December thirty-first, two thousand five;
  (v) up to fifteen million dollars for the period  January  first,  two
thousand six through December thirty-first, two thousand six;
  (vi)  up  to fifteen million dollars for the period January first, two
thousand seven through December thirty-first, two thousand seven;
  (vii) up to fifteen million dollars for the period January first,  two
thousand eight through December thirty-first, two thousand eight;
  (viii) up to fifteen million dollars for the period January first, two
thousand nine through December thirty-first, two thousand nine;
  (ix)  up  to fifteen million dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten; [and]
  (x) up to three million seven hundred fifty thousand dollars  for  the
period  January  first,  two thousand eleven through March thirty-first,
two thousand eleven[.]; AND
  (XI) FIFTEEN MILLION DOLLARS EACH STATE FISCAL  YEAR  FOR  THE  PERIOD
APRIL  FIRST,  TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND FOURTEEN.
  (ii) Funds shall be deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  the  purpose  of  supporting  the
state  share of Medicaid expenditures for disabled persons as authorized
by sections 1619 (a) and (b) of the federal social security act pursuant
to the tobacco control and insurance initiatives  pool  established  for
the following periods in the following amounts:
  (i)  six  million  four  hundred thousand dollars for the period April
first, two thousand two through December thirty-first, two thousand two;
  (ii) eight million five hundred thousand dollars, for the period Janu-
ary first, two thousand three through December thirty-first,  two  thou-
sand three;

S. 2809--A                         66                         A. 4009--A

  (iii) eight million five hundred thousand dollars for the period Janu-
ary first, two thousand four through December thirty-first, two thousand
four;
  (iv)  eight million five hundred thousand dollars for the period Janu-
ary first, two thousand five through December thirty-first, two thousand
five;
  (v) eight million five hundred thousand dollars for the period January
first, two thousand six through December thirty-first, two thousand six;
  (vi) eight million six hundred thousand dollars for the period January
first, two thousand seven through December  thirty-first,  two  thousand
seven;
  (vii) eight million five hundred thousand dollars for the period Janu-
ary  first,  two thousand eight through December thirty-first, two thou-
sand eight;
  (viii) eight million five hundred  thousand  dollars  for  the  period
January  first,  two  thousand  nine  through December thirty-first, two
thousand nine;
  (ix) eight million five hundred thousand dollars for the period  Janu-
ary  first, two thousand ten through December thirty-first, two thousand
ten; [and]
  (x) two million one hundred twenty-five thousand dollars for the peri-
od January first, two thousand eleven through  March  thirty-first,  two
thousand eleven; AND
  (XI)  EIGHT  MILLION  FIVE  HUNDRED THOUSAND DOLLARS EACH STATE FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIR-
TY-FIRST, TWO THOUSAND FOURTEEN.
  (jj) Funds shall be reserved and accumulated from  year  to  year  and
shall  be  available,  including  income  from  invested  funds, for the
purposes of a grant program to improve access to  infertility  services,
treatments and procedures, from the tobacco control and insurance initi-
atives  pool  established for the period January first, two thousand two
through December thirty-first, two thousand two in the  amount  of  nine
million  one hundred seventy-five thousand dollars, for the period April
first, two thousand six through March thirty-first, two  thousand  seven
in  the  amount of five million dollars, for the period April first, two
thousand seven through March thirty-first, two  thousand  eight  in  the
amount of five million dollars, for the period April first, two thousand
eight  through  March  thirty-first,  two thousand nine in the amount of
five million dollars, and for the period April first, two thousand  nine
through  March  thirty-first,  two  thousand  ten  in the amount of five
million dollars, [and] for the period  April  first,  two  thousand  ten
through  March  thirty-first,  two  thousand eleven in the amount of two
million two hundred thousand dollars, AND FOR THE  PERIOD  APRIL  FIRST,
TWO  THOUSAND  ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE UP
TO ONE MILLION ONE HUNDRED THOUSAND DOLLARS.
  (kk) Funds shall be deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds -- other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share  of  Medical  Assistance  Program  expenditures  from  the tobacco
control and insurance initiatives pool  established  for  the  following
periods in the following amounts:
  (i) thirty-eight million eight hundred thousand dollars for the period
January first, two thousand two through December thirty-first, two thou-
sand two;

S. 2809--A                         67                         A. 4009--A

  (ii)  up  to  two  hundred  ninety-five million dollars for the period
January first, two thousand three  through  December  thirty-first,  two
thousand three;
  (iii)  up  to  four hundred seventy-two million dollars for the period
January first, two thousand  four  through  December  thirty-first,  two
thousand four;
  (iv)  up to nine hundred million dollars for the period January first,
two thousand five through December thirty-first, two thousand five;
  (v) up to eight  hundred  sixty-six  million  three  hundred  thousand
dollars  for the period January first, two thousand six through December
thirty-first, two thousand six;
  (vi) up to six hundred sixteen million seven hundred thousand  dollars
for  the period January first, two thousand seven through December thir-
ty-first, two thousand seven;
  (vii) up to five hundred seventy-eight million  nine  hundred  twenty-
five  thousand  dollars for the period January first, two thousand eight
through December thirty-first, two thousand eight; and
  (viii) within amounts appropriated on and  after  January  first,  two
thousand nine.
  (ll)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds -- other, HCRA transfer fund, medical assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of Medicaid expenditures related to the city of New York from  the
tobacco  control  and  insurance  initiatives  pool  established for the
following periods in the following amounts:
  (i) eighty-two million seven hundred thousand dollars for  the  period
January first, two thousand two through December thirty-first, two thou-
sand two;
  (ii)  one hundred twenty-four million six hundred thousand dollars for
the period January first, two thousand three  through  December  thirty-
first, two thousand three;
  (iii)  one  hundred twenty-four million seven hundred thousand dollars
for the period January first, two thousand four through  December  thir-
ty-first, two thousand four;
  (iv)  one  hundred  twenty-four million seven hundred thousand dollars
for the period January first, two thousand five through  December  thir-
ty-first, two thousand five;
  (v) one hundred twenty-four million seven hundred thousand dollars for
the  period  January  first,  two  thousand six through December thirty-
first, two thousand six;
  (vi) one hundred twenty-four million seven  hundred  thousand  dollars
for  the period January first, two thousand seven through December thir-
ty-first, two thousand seven;
  (vii) one hundred twenty-four million seven hundred  thousand  dollars
for  the period January first, two thousand eight through December thir-
ty-first, two thousand eight;
  (viii) one hundred twenty-four million seven hundred thousand  dollars
for  the  period January first, two thousand nine through December thir-
ty-first, two thousand nine;
  (ix) one hundred twenty-four million seven  hundred  thousand  dollars
for  the period January first, two thousand ten through December thirty-
first, two thousand ten; [and]

S. 2809--A                         68                         A. 4009--A

  (x) thirty-one million one hundred seventy-five thousand  dollars  for
the  period  January  first,  two  thousand eleven through March thirty-
first, two thousand eleven[.]; AND
  (XI)  ONE  HUNDRED  TWENTY-FOUR MILLION SEVEN HUNDRED THOUSAND DOLLARS
EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN.
  (mm)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding specified
percentages of the state share of services and expenses related  to  the
family health plus program in accordance with the following schedule:
  (i)  (A)  for  the  period  January  first, two thousand three through
December thirty-first, two thousand four, one  hundred  percent  of  the
state share;
  (B)  for  the period January first, two thousand five through December
thirty-first, two thousand  five,  seventy-five  percent  of  the  state
share; and,
  (C)  for  periods  beginning  on and after January first, two thousand
six, fifty percent of the state share.
  (ii) Funding for the family health plus program  will  include  up  to
five million dollars annually for the period January first, two thousand
three  through  December  thirty-first,  two  thousand  six,  up to five
million dollars for the period January first, two thousand seven through
December thirty-first, two thousand  seven,  up  to  seven  million  two
hundred  thousand  dollars  for  the  period January first, two thousand
eight through December thirty-first, two thousand  eight,  up  to  seven
million  two  hundred thousand dollars for the period January first, two
thousand nine through December thirty-first, two thousand  nine,  up  to
seven million two hundred thousand dollars for the period January first,
two  thousand ten through December thirty-first, two thousand ten, [and]
up to one million eight hundred thousand dollars for the period  January
first,  two  thousand  eleven  through  March thirty-first, two thousand
eleven, UP TO SIX MILLION FORTY-NINE THOUSAND  DOLLARS  FOR  THE  PERIOD
APRIL  FIRST,  TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND TWELVE, UP TO SIX MILLION TWO HUNDRED EIGHTY-NINE THOUSAND  DOLLARS
FOR   THE   PERIOD  APRIL  FIRST,  TWO  THOUSAND  TWELVE  THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND THIRTEEN, AND UP TO SIX MILLION FOUR  HUNDRED
SIXTY-ONE  THOUSAND  DOLLARS  FOR  THE  PERIOD APRIL FIRST, TWO THOUSAND
THIRTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN, for adminis-
tration and marketing costs associated  with  such  program  established
pursuant  to clauses (A) and (B) of subparagraph (v) of paragraph (a) of
subdivision two of section three hundred  sixty-nine-ee  of  the  social
services  law  from  the  tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
  (A) one hundred ninety million six hundred thousand  dollars  for  the
period  January first, two thousand three through December thirty-first,
two thousand three;
  (B) three hundred seventy-four million dollars for the period  January
first,  two  thousand  four  through December thirty-first, two thousand
four;
  (C) five hundred thirty-eight million four  hundred  thousand  dollars
for  the  period January first, two thousand five through December thir-
ty-first, two thousand five;

S. 2809--A                         69                         A. 4009--A

  (D) three hundred eighteen million seven hundred seventy-five thousand
dollars for the period January first, two thousand six through  December
thirty-first, two thousand six;
  (E) four hundred eighty-two million eight hundred thousand dollars for
the  period  January  first, two thousand seven through December thirty-
first, two thousand seven;
  (F) five hundred seventy million twenty-five thousand dollars for  the
period  January first, two thousand eight through December thirty-first,
two thousand eight;
  (G) six hundred ten million seven hundred twenty-five thousand dollars
for the period January first, two thousand nine through  December  thir-
ty-first, two thousand nine;
  (H) six hundred twenty-seven million two hundred seventy-five thousand
dollars  for the period January first, two thousand ten through December
thirty-first, two thousand ten; [and]
  (I) one hundred fifty-seven million eight hundred  seventy-five  thou-
sand  dollars  for the period January first, two thousand eleven through
March thirty-first, two thousand eleven[.];
  (J) SIX HUNDRED TWENTY-EIGHT MILLION FOUR HUNDRED THOUSAND DOLLARS FOR
THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH  THIRTY-FIRST,
TWO THOUSAND TWELVE;
  (K)  SIX  HUNDRED  FIFTY MILLION FOUR HUNDRED THOUSAND DOLLARS FOR THE
PERIOD APRIL FIRST, TWO THOUSAND TWELVE THROUGH MARCH THIRTY-FIRST,  TWO
THOUSAND THIRTEEN; AND
  (L)  SIX  HUNDRED  FIFTY MILLION FOUR HUNDRED THOUSAND DOLLARS FOR THE
PERIOD APRIL FIRST, TWO THOUSAND THIRTEEN  THROUGH  MARCH  THIRTY-FIRST,
TWO THOUSAND FOURTEEN.
  (nn)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue fund - other, HCRA transfer fund, health care services  account,
or  any  successor  fund  or account, for purposes related to adult home
initiatives for medicaid eligible residents  of  residential  facilities
licensed pursuant to section four hundred sixty-b of the social services
law  from the tobacco control and insurance initiatives pool established
for the following periods in the following amounts:
  (i) up to four million dollars for the period January first, two thou-
sand three through December thirty-first, two thousand three;
  (ii) up to six million dollars for the period January first, two thou-
sand four through December thirty-first, two thousand four;
  (iii) up to eight million dollars for the period  January  first,  two
thousand   five   through  December  thirty-first,  two  thousand  five,
provided, however, that up to five million two  hundred  fifty  thousand
dollars of such funds shall be received by the comptroller and deposited
to  the  credit of the special revenue fund - other / aid to localities,
HCRA transfer fund - 061, enhanced community services account -  05,  or
any  successor fund or account, for the purposes set forth in this para-
graph;
  (iv) up to eight million dollars for the  period  January  first,  two
thousand  six through December thirty-first, two thousand six, provided,
however, that up to five million two hundred fifty thousand  dollars  of
such  funds  shall  be  received by the comptroller and deposited to the
credit of the special revenue fund - other /  aid  to  localities,  HCRA
transfer  fund  -  061, enhanced community services account - 05, or any
successor fund or account, for the purposes set forth in this paragraph;

S. 2809--A                         70                         A. 4009--A

  (v) up to eight million dollars for  the  period  January  first,  two
thousand  seven  through  December  thirty-first,  two  thousand  seven,
provided, however, that up to five million two  hundred  fifty  thousand
dollars of such funds shall be received by the comptroller and deposited
to  the  credit of the special revenue fund - other / aid to localities,
HCRA transfer fund - 061, enhanced community services account -  05,  or
any  successor fund or account, for the purposes set forth in this para-
graph;
  (vi) up to two million seven hundred fifty thousand  dollars  for  the
period  January first, two thousand eight through December thirty-first,
two thousand eight;
  (vii) up to two million seven hundred fifty thousand dollars  for  the
period  January  first, two thousand nine through December thirty-first,
two thousand nine;
  (viii) up to two million seven hundred fifty thousand dollars for  the
period  January  first,  two thousand ten through December thirty-first,
two thousand ten; and
  (ix) up to six hundred eighty-eight thousand dollars  for  the  period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven.
  (oo)  Funds  shall  be  reserved and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  grants  to non-public general hospitals pursuant to paragraph (e) of
subdivision twenty-five of section twenty-eight hundred seven-c of  this
article  from  the tobacco control and insurance initiatives pool estab-
lished for the following periods in the following amounts:
  (i) up to five million dollars on an annualized basis for  the  period
January  first,  two  thousand  four  through December thirty-first, two
thousand four;
  (ii) up to five million dollars for  the  period  January  first,  two
thousand five through December thirty-first, two thousand five;
  (iii)  up  to  five  million dollars for the period January first, two
thousand six through December thirty-first, two thousand six;
  (iv) up to five million dollars for  the  period  January  first,  two
thousand seven through December thirty-first, two thousand seven; and
  (v) up to five million dollars for the period January first, two thou-
sand eight through December thirty-first, two thousand eight;
  (vi)  up  to  five  million  dollars for the period January first, two
thousand nine through December thirty-first, two thousand nine;
  (vii) up to five million dollars for the  period  January  first,  two
thousand ten through December thirty-first, two thousand ten; and
  (viii)  up  to  one million two hundred fifty thousand dollars for the
period January first, two thousand eleven  through  March  thirty-first,
two thousand eleven.
  (pp)  Funds  shall  be  reserved and accumulated from year to year and
shall be available,  including  income  from  invested  funds,  for  the
purpose  of  supporting  the provision of tax credits for long term care
insurance pursuant to subdivision one of section one hundred  ninety  of
the  tax  law, paragraph (a) of subdivision twenty-five-a of section two
hundred ten of such law, subsection (aa) of section six hundred  six  of
such  law,  paragraph  one of subsection (k) of section fourteen hundred
fifty-six of such law and paragraph one of subdivision  (m)  of  section
fifteen hundred eleven of such law, in the following amounts:
  (i)  ten  million  dollars  for the period January first, two thousand
four through December thirty-first, two thousand four;

S. 2809--A                         71                         A. 4009--A

  (ii) ten million dollars for the period January  first,  two  thousand
five through December thirty-first, two thousand five;
  (iii)  ten  million dollars for the period January first, two thousand
six through December thirty-first, two thousand six; and
  (iv) five million dollars for the period January first,  two  thousand
seven through June thirtieth, two thousand seven.
  (qq)  Funds  shall  be  reserved and accumulated from year to year and
shall be available,  including  income  from  invested  funds,  for  the
purpose  of  supporting  the  long-term  care  insurance  education  and
outreach program established pursuant to section two hundred seventeen-a
of the elder law for the following periods in the following amounts:
  (i) up to five million dollars for the period January first, two thou-
sand four through December thirty-first,  two  thousand  four;  of  such
funds  one  million  nine  hundred  fifty thousand dollars shall be made
available to the department for the purpose of developing,  implementing
and  administering  the  long-term care insurance education and outreach
program and three million fifty thousand dollars shall be  deposited  by
the  commissioner,  within  amounts appropriated, and the comptroller is
hereby authorized and directed to receive for deposit to the  credit  of
the  special  revenue  funds - other, HCRA transfer fund, long term care
insurance resource center account of the state office for the  aging  or
any  future  account designated for the purpose of implementing the long
term care insurance education and outreach  program  and  providing  the
long  term  care insurance resource centers with the necessary resources
to carry out their operations;
  (ii) up to five million dollars for  the  period  January  first,  two
thousand  five through December thirty-first, two thousand five; of such
funds one million nine hundred fifty  thousand  dollars  shall  be  made
available  to the department for the purpose of developing, implementing
and administering the long-term care insurance  education  and  outreach
program  and  three million fifty thousand dollars shall be deposited by
the commissioner, within amounts appropriated, and  the  comptroller  is
hereby  authorized  and directed to receive for deposit to the credit of
the special revenue funds - other, HCRA transfer fund,  long  term  care
insurance  resource  center account of the state office for the aging or
any future account designated for the purpose of implementing  the  long
term  care  insurance  education  and outreach program and providing the
long term care insurance resource centers with the  necessary  resources
to carry out their operations;
  (iii)  up  to  five  million dollars for the period January first, two
thousand six through December thirty-first, two thousand  six;  of  such
funds  one  million  nine  hundred  fifty thousand dollars shall be made
available to the department for the purpose of developing,  implementing
and  administering  the  long-term care insurance education and outreach
program and three million fifty thousand dollars shall be made available
to the office for the aging for the purpose of providing the  long  term
care  insurance  resource  centers with the necessary resources to carry
out their operations;
  (iv) up to five million dollars for  the  period  January  first,  two
thousand  seven  through  December  thirty-first, two thousand seven; of
such funds one million nine hundred fifty thousand dollars shall be made
available to the department for the purpose of developing,  implementing
and  administering  the  long-term care insurance education and outreach
program and three million fifty thousand dollars shall be made available
to the office for the aging for the purpose of providing the  long  term

S. 2809--A                         72                         A. 4009--A

care  insurance  resource  centers with the necessary resources to carry
out their operations;
  (v) up to five million dollars for the period January first, two thou-
sand  eight  through  December thirty-first, two thousand eight; of such
funds one million nine hundred fifty  thousand  dollars  shall  be  made
available  to the department for the purpose of developing, implementing
and administering the long term care insurance  education  and  outreach
program and three million fifty thousand dollars shall be made available
to  the  office for the aging for the purpose of providing the long term
care insurance resource centers with the necessary  resources  to  carry
out their operations;
  (vi)  up  to  five  million  dollars for the period January first, two
thousand nine through December thirty-first, two thousand nine; of  such
funds  one  million  nine  hundred  fifty thousand dollars shall be made
available to the department for the purpose of developing,  implementing
and  administering  the  long-term care insurance education and outreach
program and three million fifty thousand dollars shall be made available
to the office for the aging for the purpose of providing  the  long-term
care  insurance  resource  centers with the necessary resources to carry
out their operations;
  (vii) up to four hundred eighty-eight thousand dollars for the  period
January first, two thousand ten through March thirty-first, two thousand
ten;  of  such funds four hundred eighty-eight thousand dollars shall be
made available to the department for the purpose of  developing,  imple-
menting  and  administering  the  long-term care insurance education and
outreach program.
  (rr) Funds shall be reserved and accumulated from the tobacco  control
and  insurance initiatives pool and shall be available, including income
from invested funds, for the purpose of supporting expenses  related  to
implementation  of  the provisions of title III of article twenty-nine-D
of this chapter, for the following periods and in the following amounts:
  (i) up to ten million dollars for the period January first, two  thou-
sand six through December thirty-first, two thousand six;
  (ii) up to ten million dollars for the period January first, two thou-
sand seven through December thirty-first, two thousand seven;
  (iii)  up  to  ten  million  dollars for the period January first, two
thousand eight through December thirty-first, two thousand eight;
  (iv) up to ten million dollars for the period January first, two thou-
sand nine through December thirty-first, two thousand nine;
  (v) up to ten million dollars for the period January first, two  thou-
sand ten through December thirty-first, two thousand ten; and
  (vi)  up  to  two million five hundred thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven.
  (ss) Funds shall be reserved and accumulated from the tobacco  control
and  insurance initiatives pool and used for a health care stabilization
program established by the commissioner for the purposes of  stabilizing
critical health care providers and health care programs whose ability to
continue  to provide appropriate services are threatened by financial or
other challenges, in the amount of up to  twenty-eight  million  dollars
for the period July first, two thousand four through June thirtieth, two
thousand  five.  Notwithstanding  the  provisions of section one hundred
twelve of the state finance law or any other inconsistent  provision  of
the state finance law or any other law, funds available for distribution
pursuant  to  this  paragraph  may  be  allocated and distributed by the
commissioner, or the state comptroller as applicable without  a  compet-

S. 2809--A                         73                         A. 4009--A

itive bid or request for proposal process. Considerations relied upon by
the commissioner in determining the allocation and distribution of these
funds  shall  include,  but  not  be  limited to, the following: (i) the
importance  of  the  provider or program in meeting critical health care
needs in the community in  which  it  operates;  (ii)  the  provider  or
program provision of care to under-served populations; (iii) the quality
of the care or services the provider or program delivers; (iv) the abil-
ity  of  the  provider  or program to continue to deliver an appropriate
level of care or services if additional funding is made  available;  (v)
the  ability  of  the provider or program to access, in a timely manner,
alternative sources of funding, including other  sources  of  government
funding; (vi) the ability of other providers or programs in the communi-
ty  to  meet the community health care needs; (vii) whether the provider
or program has an appropriate plan to improve its  financial  condition;
and  (viii)  whether  additional  funding  would  permit the provider or
program to consolidate, relocate, or close programs  or  services  where
such  actions  would  result  in greater stability and efficiency in the
delivery of needed health care services or programs.
  (tt) Funds shall be reserved and accumulated from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of providing grants  for  two  long  term  care  demonstration  projects
designed  to test new models for the delivery of long term care services
established pursuant to section twenty-eight  hundred  seven-x  of  this
chapter, for the following periods and in the following amounts:
  (i)  up to five hundred thousand dollars for the period January first,
two thousand four through December thirty-first, two thousand four;
  (ii) up to five hundred thousand dollars for the period January first,
two thousand five through December thirty-first, two thousand five;
  (iii) up to five hundred  thousand  dollars  for  the  period  January
first, two thousand six through December thirty-first, two thousand six;
  (iv) up to one million dollars for the period January first, two thou-
sand seven through December thirty-first, two thousand seven; and
  (v)  up  to  two hundred fifty thousand dollars for the period January
first, two thousand  eight  through  March  thirty-first,  two  thousand
eight.
  (uu)  Funds  shall  be  reserved and accumulated from year to year and
shall be available,  including  income  from  invested  funds,  for  the
purpose  of supporting disease management and telemedicine demonstration
programs authorized pursuant to [sections]  SECTION  twenty-one  hundred
eleven [and thirty-six hundred twenty-one] of this chapter[, respective-
ly,] for the following periods in the following amounts:
  (i)  five  million  dollars for the period January first, two thousand
four through December thirty-first, two thousand four,  of  which  three
million  dollars shall be available for disease management demonstration
programs and two million dollars shall  be  available  for  telemedicine
demonstration programs;
  (ii)  five  million dollars for the period January first, two thousand
five through December thirty-first, two thousand five,  of  which  three
million  dollars shall be available for disease management demonstration
programs and two million dollars shall  be  available  for  telemedicine
demonstration programs;
  (iii)  nine million five hundred thousand dollars for the period Janu-
ary first, two thousand six through December thirty-first, two  thousand
six,  of  which  seven  million  five  hundred thousand dollars shall be
available for disease management demonstration programs and two  million
dollars shall be available for telemedicine demonstration programs;

S. 2809--A                         74                         A. 4009--A

  (iv) nine million five hundred thousand dollars for the period January
first,  two  thousand  seven through December thirty-first, two thousand
seven, of which seven million five hundred  thousand  dollars  shall  be
available  for disease management demonstration programs and one million
dollars shall be available for telemedicine demonstration programs;
  (v)  nine million five hundred thousand dollars for the period January
first, two thousand eight through December  thirty-first,  two  thousand
eight,  of  which  seven  million five hundred thousand dollars shall be
available for disease management demonstration programs and two  million
dollars shall be available for telemedicine demonstration programs;
  (vi)  seven  million eight hundred thirty-three thousand three hundred
thirty-three dollars for the period January  first,  two  thousand  nine
through December thirty-first, two thousand nine, of which seven million
five  hundred thousand dollars shall be available for disease management
demonstration programs and three  hundred  thirty-three  thousand  three
hundred  thirty-three dollars shall be available for telemedicine demon-
stration programs for  the  period  January  first,  two  thousand  nine
through March first, two thousand nine;
  (vii)  one million eight hundred seventy-five thousand dollars for the
period January first, two thousand ten through March  thirty-first,  two
thousand  ten  shall  be  available for disease management demonstration
programs.
  (ww) Funds shall be deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for the deposit to the credit of the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share  of  the  general  hospital  rates  increases  for recruitment and
retention of health care workers pursuant to paragraph (e)  of  subdivi-
sion thirty of section twenty-eight hundred seven-c of this article from
the  tobacco  control and insurance initiatives pool established for the
following periods in the following amounts:
  (i) sixty million five hundred thousand dollars for the period January
first, two thousand five through  December  thirty-first,  two  thousand
five; and
  (ii)  sixty million five hundred thousand dollars for the period Janu-
ary first, two thousand six through December thirty-first, two  thousand
six.
  (xx)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive for the deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of the general hospital rates increases for rural hospitals pursu-
ant to subdivision thirty-two of section twenty-eight hundred seven-c of
this article from the tobacco control  and  insurance  initiatives  pool
established for the following periods in the following amounts:
  (i) three million five hundred thousand dollars for the period January
first,  two  thousand  five  through December thirty-first, two thousand
five;
  (ii) three million five hundred thousand dollars for the period  Janu-
ary  first, two thousand six through December thirty-first, two thousand
six;
  (iii) three million five hundred thousand dollars for the period Janu-
ary first, two thousand seven through December thirty-first,  two  thou-
sand seven;

S. 2809--A                         75                         A. 4009--A

  (iv)  three million five hundred thousand dollars for the period Janu-
ary first, two thousand eight through December thirty-first,  two  thou-
sand eight; and
  (v)  three  million  two hundred eight thousand dollars for the period
January first, two thousand nine through November thirtieth,  two  thou-
sand nine.
  (yy)  Funds  shall  be  reserved and accumulated from year to year and
shall be available,  within  amounts  appropriated  and  notwithstanding
section  one  hundred  twelve  of  the  state  finance law and any other
contrary provision of law, for the purpose of supporting grants  not  to
exceed  five  million  dollars  to be made by the commissioner without a
competitive bid or request for  proposal  process,  in  support  of  the
delivery  of  critically  needed  health  care  services, to health care
providers located in the counties of Erie and Niagara which  executed  a
memorandum of closing and conducted a merger closing in escrow on Novem-
ber  twenty-fourth, nineteen hundred ninety-seven and which entered into
a settlement dated December thirtieth, two thousand four for a  loss  on
disposal  of  assets  under the provisions of title XVIII of the federal
social security act applicable to mergers occurring  prior  to  December
first, nineteen hundred ninety-seven.
  (zz)  Funds  shall  be  reserved and accumulated from year to year and
shall be available, within amounts  appropriated,  for  the  purpose  of
supporting  expenditures  authorized  pursuant  to  section twenty-eight
hundred eighteen of this article from the tobacco control and  insurance
initiatives  pool established for the following periods in the following
amounts:
  (i) six million five hundred thousand dollars for the  period  January
first,  two  thousand  five  through December thirty-first, two thousand
five;
  (ii) one hundred eight million three hundred thousand dollars for  the
period  January  first,  two thousand six through December thirty-first,
two thousand six, provided, however, that within amounts appropriated in
the two thousand six through two thousand seven  state  fiscal  year,  a
portion  of  such  funds  may  be transferred to the Roswell Park Cancer
Institute Corporation to fund capital costs;
  (iii) one hundred seventy-one million dollars for the  period  January
first,  two  thousand  seven through December thirty-first, two thousand
seven, provided, however, that within amounts appropriated  in  the  two
thousand  six through two thousand seven state fiscal year, a portion of
such funds may be transferred  to  the  Roswell  Park  Cancer  Institute
Corporation to fund capital costs;
  (iv) one hundred seventy-one million five hundred thousand dollars for
the  period  January  first, two thousand eight through December thirty-
first, two thousand eight;
  (v) one hundred twenty-eight  million  seven  hundred  fifty  thousand
dollars for the period January first, two thousand nine through December
thirty-first, two thousand nine;
  (vi)  one  hundred thirty-one million three hundred seventy-five thou-
sand dollars for the period January  first,  two  thousand  ten  through
December thirty-first, two thousand ten; [and]
  (vii)  thirty-four  million two hundred fifty thousand dollars for the
period January first, two thousand eleven  through  March  thirty-first,
two thousand eleven[.];
  (VIII) FOUR HUNDRED THIRTY-THREE MILLION THREE HUNDRED SIXTY-SIX THOU-
SAND  DOLLARS  FOR  THE  PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND TWELVE;

S. 2809--A                         76                         A. 4009--A

  (IX) ONE HUNDRED FIFTY MILLION EIGHT HUNDRED SIX THOUSAND DOLLARS  FOR
THE  PERIOD APRIL FIRST, TWO THOUSAND TWELVE THROUGH MARCH THIRTY-FIRST,
TWO THOUSAND THIRTEEN; AND
  (X)  SEVENTY-EIGHT MILLION SEVENTY-ONE THOUSAND DOLLARS FOR THE PERIOD
APRIL FIRST, TWO THOUSAND THIRTEEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND FOURTEEN.
  (aaa) Funds shall be reserved and accumulated from year  to  year  and
shall  be  available, including income from invested funds, for services
and expenses related to school based health centers, in an amount up  to
three  million five hundred thousand dollars for the period April first,
two thousand six through March thirty-first, two thousand seven,  up  to
three  million five hundred thousand dollars for the period April first,
two thousand seven through March thirty-first, two thousand eight, up to
three million five hundred thousand dollars for the period April  first,
two  thousand eight through March thirty-first, two thousand nine, up to
three million five hundred thousand dollars for the period April  first,
two thousand nine through March thirty-first, two thousand ten, [and] up
to  three  million  five  hundred  thousand dollars for the period April
first, two thousand ten through March thirty-first, two thousand eleven,
AND UP TO TWO MILLION EIGHT HUNDRED THOUSAND DOLLARS EACH  STATE  FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIR-
TY-FIRST,  TWO  THOUSAND  FOURTEEN.   The total amount of funds provided
herein shall be distributed as grants based on the ratio of each provid-
er's total enrollment for all sites  to  the  total  enrollment  of  all
providers.  This  formula  shall be applied to the total amount provided
herein.
  (bbb) Funds shall be reserved and accumulated from year  to  year  and
shall  be  available, including income from invested funds, for purposes
of awarding  grants  to  operators  of  adult  homes,  enriched  housing
programs and residences through the enhancing abilities and life experi-
ence  (EnAbLe)  program  to  provide for the installation, operation and
maintenance of air conditioning in resident rooms, consistent with  this
paragraph,  in  an amount up to two million dollars for the period April
first, two thousand six through March thirty-first, two thousand  seven,
up  to three million eight hundred thousand dollars for the period April
first, two thousand  seven  through  March  thirty-first,  two  thousand
eight, up to three million eight hundred thousand dollars for the period
April first, two thousand eight through March thirty-first, two thousand
nine,  up to three million eight hundred thousand dollars for the period
April first, two thousand nine through March thirty-first, two  thousand
ten,  and  up  to  three  million eight hundred thousand dollars for the
period April first, two thousand ten  through  March  thirty-first,  two
thousand eleven. Residents shall not be charged utility cost for the use
of  air  conditioners  supplied  under  the EnAbLe program. All such air
conditioners must be operated in occupied resident rooms consistent with
requirements applicable to common areas.
  (ccc) Funds shall be deposited by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for the deposit to the credit of the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share of increases in the rates for certified home health agencies, long
term  home  health  care  programs,  AIDS  home  care  programs, hospice
programs and managed long term care plans and approved managed long term
care operating demonstrations as defined in section  forty-four  hundred
three-f  of  this  chapter  for recruitment and retention of health care

S. 2809--A                         77                         A. 4009--A

workers pursuant to subdivisions nine  and  ten  of  section  thirty-six
hundred  fourteen of this chapter from the tobacco control and insurance
initiatives pool established for the following periods in the  following
amounts:
  (i)  twenty-five  million dollars for the period June first, two thou-
sand six through December thirty-first, two thousand six;
  (ii) fifty million dollars for the period January first, two  thousand
seven through December thirty-first, two thousand seven;
  (iii) fifty million dollars for the period January first, two thousand
eight through December thirty-first, two thousand eight;
  (iv)  fifty million dollars for the period January first, two thousand
nine through December thirty-first, two thousand nine;
  (v) fifty million dollars for the period January first,  two  thousand
ten through December thirty-first, two thousand ten; [and]
  (vi) twelve million five hundred thousand dollars for the period Janu-
ary  first, two thousand eleven through March thirty-first, two thousand
eleven[.]; AND
  (VII) FIFTY MILLION DOLLARS EACH STATE  FISCAL  YEAR  FOR  THE  PERIOD
APRIL  FIRST,  TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND FOURTEEN.
  (ddd) Funds shall be deposited by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for the deposit to the credit of the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share  of  increases  in  the medical assistance rates for providers for
purposes of enhancing the provision, quality and/or efficiency  of  home
care  services  pursuant  to  subdivision  eleven  of section thirty-six
hundred fourteen of this chapter from the tobacco control and  insurance
initiatives  pool  established for the following period in the amount of
eight million dollars for the  period  April  first,  two  thousand  six
through December thirty-first, two thousand six.
  (eee)  Funds  shall  be reserved and accumulated from year to year and
shall be available, including income from invested funds, to the  Center
for  Functional  Genomics at the State University of New York at Albany,
for the purposes of the Adirondack  network  for  cancer  education  and
research  in rural communities grant program to improve access to health
care and shall be made available from the tobacco control and  insurance
initiatives  pool  established for the following period in the amount of
up to five million dollars for the period January  first,  two  thousand
six through December thirty-first, two thousand six.
  (fff) Funds shall be made available to the empire state stem cell fund
established  by  section ninety-nine-p of the state finance law from the
public asset as defined in section four thousand three  hundred  one  of
the  insurance  law  and  accumulated from the conversion of one or more
article forty-three corporations and its or their not-for-profit subsid-
iaries occurring on or after January first, two thousand  seven.    Such
funds  shall  be  made available within amounts appropriated up to fifty
million dollars annually and  shall  not  exceed  five  hundred  million
dollars in total.
  (ggg)  Funds  shall  be  deposited by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any successor fund or account, for the purpose of supporting  the  state
share  of  Medicaid  expenditures  for  hospital translation services as

S. 2809--A                         78                         A. 4009--A

authorized pursuant to paragraph (k) of subdivision one of section twen-
ty-eight hundred seven-c of this article from the  tobacco  control  and
initiatives  pool established for the following periods in the following
amounts:
  (i)  sixteen  million  dollars for the period July first, two thousand
eight through December thirty-first, two thousand eight; and
  (ii) fourteen million seven hundred thousand dollars  for  the  period
January  first,  two thousand nine through November thirtieth, two thou-
sand nine.
  (hhh) Funds shall be deposited by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any  successor  fund or account, for the purpose of supporting the state
share of Medicaid expenditures for adjustments  to  inpatient  rates  of
payment  for  general  hospitals  located  in the counties of Nassau and
Suffolk as authorized pursuant to paragraph (l) of  subdivision  one  of
section  twenty-eight  hundred  seven-c of this article from the tobacco
control and initiatives pool established for the  following  periods  in
the following amounts:
  (i)  two  million  five  hundred thousand dollars for the period April
first, two thousand eight through December  thirty-first,  two  thousand
eight; and
  (ii) two million two hundred ninety-two thousand dollars for the peri-
od  January  first,  two  thousand  nine through November thirtieth, two
thousand nine.
  S 9. Subdivision 3 of section 1680-j of the public authorities law, as
amended by section 34 of part C of chapter 58 of the laws  of  2009,  is
amended to read as follows:
  3.  Notwithstanding  any  law  to the contrary, and in accordance with
section four of the state finance law, the comptroller is hereby author-
ized and directed to transfer from the health  care  reform  act  (HCRA)
resources fund (061) to the general fund, upon the request of the direc-
tor of the budget, up to $6,500,000 on or before March 31, 2006, and the
comptroller  is  further hereby authorized and directed to transfer from
the healthcare reform act (HCRA); Resources fund (061)  to  the  Capital
Projects  Fund,  upon  the  request  of  the  director  of budget, up to
$139,000,000 for the period April 1, 2006 through March 31, 2007, up  to
$171,100,000  for the period April 1, 2007 through March 31, 2008, up to
$208,100,000 for the period April 1, 2008 through March 31, 2009, up  to
$151,600,000  for the period April 1, 2009 through March 31, 2010, [and]
up to [$238,000,000] $215,743,000 for the period April 1,  2010  through
March  31, 2011, UP TO $433,366,000 FOR THE PERIOD APRIL 1, 2011 THROUGH
MARCH 31, 2012, UP TO $150,806,000 FOR THE PERIOD APRIL 1, 2012  THROUGH
MARCH  31,  2013, UP TO $78,071,000 FOR THE PERIOD APRIL 1, 2013 THROUGH
MARCH 31, 2014, AND UP TO $86,005,000  FOR  THE  PERIOD  APRIL  1,  2014
THROUGH MARCH 31, 2015.
  S  10.  Paragraph (a) of subdivision 12 of section 367-b of the social
services law, as amended by section 8 of part B of  chapter  58  of  the
laws of 2008, is amended to read as follows:
  (a) For the purpose of regulating cash flow for general hospitals, the
department  shall develop and implement a payment methodology to provide
for timely payments for inpatient hospital services  eligible  for  case
based  payments per discharge based on diagnosis-related groups provided
during the period January first, nineteen hundred  eighty-eight  through

S. 2809--A                         79                         A. 4009--A

March  thirty-first  two  thousand  [eleven] FOURTEEN, by such hospitals
which elect to participate in the system.
  S  11.  Section  2  of  chapter  600 of the laws of 1986, amending the
public health law relating to the  development  of  pilot  reimbursement
programs for ambulatory care services, as amended by section 9 of part B
of chapter 58 of the laws of 2008, is amended to read as follows:
  S  2.  This  act  shall  take effect immediately, except that this act
shall expire and be of no further force and effect on and after April 1,
[2011] 2014; provided, however, that the commissioner  of  health  shall
submit a report to the governor and the legislature detailing the objec-
tive,  impact, design and computation of any pilot reimbursement program
established pursuant to this act, on or before March 31, 1994 and  annu-
ally  thereafter.  Such report shall include an assessment of the finan-
cial impact of such payment system on providers, as well as  the  impact
of such system on access to care.
  S  12. Paragraph (i) of subdivision (b) of section 1 of chapter 520 of
the laws of 1978, relating to providing for a  comprehensive  survey  of
health  care  financing,  education  and illness prevention and creating
councils for the conduct thereof, as amended by section 11 of part B  of
chapter 58 of the laws of 2008, is amended to read as follows:
  (i)  oversight  and  evaluation  of  the inpatient financing system in
place for 1988 through March 31, [2011] 2014,  and  the  appropriateness
and effectiveness of the bad debt and charity care financing provisions;
  S  13. The opening paragraph of section 2952 of the public health law,
as amended by section 21 of part B of chapter 58 of the laws of 2008, is
amended to read as follows:
  To the extent of funds available therefor, the sum  of  seven  million
dollars  shall annually be available for periods prior to January first,
two thousand three, and up to six million five hundred  thirty  thousand
dollars  annually  for  the  period  January  first,  two thousand three
through December thirty-first, two thousand four, up  to  seven  million
sixty-two  thousand  dollars  for the period January first, two thousand
five through December thirty-first, two thousand  six  annually,  up  to
seven million sixty-two thousand dollars annually for the period January
first,  two  thousand  seven through December thirty-first, two thousand
ten, [and] up to one million seven hundred  sixty-six  thousand  dollars
for  the period January first, two thousand eleven through March thirty-
first, two thousand eleven, AND WITHIN  AMOUNTS  APPROPRIATED  FOR  EACH
STATE  FISCAL  YEAR ON AND AFTER APRIL FIRST, TWO THOUSAND ELEVEN, shall
be available to the commissioner from funds made available  pursuant  to
section twenty-eight hundred seven-l of this chapter for grants pursuant
to this section.
  S  14.  Subdivision  1  of  section  2958 of the public health law, as
amended by section 22 of part B of chapter 58 of the laws  of  2008,  is
amended to read as follows:
  1.  To  the extent of funds available therefor, the sum of ten million
dollars shall annually be made available for periods  prior  to  January
first,  two  thousand three, and up to nine million three hundred twenty
thousand dollars for  the  period  January  first,  two  thousand  three
through  December  thirty-first,  two thousand three, up to nine million
three hundred twenty thousand dollars for the period January first,  two
thousand  four  through  December thirty-first, two thousand four, up to
twelve million eighty-eight thousand  dollars  for  the  period  January
first,  two  thousand  five  through December thirty-first, two thousand
five, up to twelve million eighty-eight thousand dollars for the  period
January first, two thousand six through December thirty-first, two thou-

S. 2809--A                         80                         A. 4009--A

sand  six,  up  to eleven million eighty-eight thousand dollars annually
for the period January first, two thousand seven through December  thir-
ty-first, two thousand ten, [and] up to two million seven hundred seven-
ty-two thousand dollars for the period January first, two thousand elev-
en  through  March thirty-first, two thousand eleven, AND WITHIN AMOUNTS
APPROPRIATED FOR EACH STATE FISCAL YEAR ON AND AFTER  APRIL  FIRST,  TWO
THOUSAND  ELEVEN,  shall  be  available  to  the commissioner from funds
pursuant to section twenty-eight hundred  seven-l  of  this  chapter  to
provide  assistance  to general hospitals classified as a rural hospital
for purposes of determining payment for inpatient services  provided  to
beneficiaries  of  title XVIII of the federal social security act (Medi-
care) or under state regulations, in recognition  of  the  unique  costs
incurred  by  these facilities to provide hospital services in remote or
sparsely populated areas pursuant to subdivision two of this section.
  S 15. Paragraph (a) of subdivision 1 of section 18 of chapter  266  of
the  laws  of  1986, amending the civil practice law and rules and other
laws relating  to  malpractice  and  professional  medical  conduct,  as
amended  by  section  23 of part B of chapter 58 of the laws of 2008, is
amended to read as follows:
  (a) The superintendent of insurance and the commissioner of health  or
their  designee  shall,  from  funds  available  in  the hospital excess
liability pool created pursuant to subdivision [(5)] 5 of this  section,
purchase  a policy or policies for excess insurance coverage, as author-
ized by paragraph [(1)] 1 of subsection  (e)  of  section  5502  of  the
insurance  law;  or  from an insurer, other than an insurer described in
section 5502 of the insurance law, duly authorized to write such  cover-
age and actually writing medical malpractice insurance in this state; or
shall  purchase equivalent excess coverage in a form previously approved
by the superintendent of insurance for purposes of providing  equivalent
excess coverage in accordance with section 19 of chapter 294 of the laws
of  1985,  for medical or dental malpractice occurrences between July 1,
1986 and June 30, 1987, between July 1, 1987 and June 30, 1988,  between
July  1, 1988 and June 30, 1989, between July 1, 1989 and June 30, 1990,
between July 1, 1990 and June 30, 1991, between July 1,  1991  and  June
30,  1992,  between July 1, 1992 and June 30, 1993, between July 1, 1993
and June 30, 1994, between July 1, 1994 and June 30, 1995, between  July
1,  1995  and  June  30,  1996,  between July 1, 1996 and June 30, 1997,
between July 1, 1997 and June 30, 1998, between July 1,  1998  and  June
30,  1999,  between July 1, 1999 and June 30, 2000, between July 1, 2000
and June 30, 2001, between July 1, 2001 and June 30, 2002, between  July
1,  2002  and  June  30,  2003,  between July 1, 2003 and June 30, 2004,
between July 1, 2004 and June 30, 2005, between July 1,  2005  and  June
30,  2006,  between July 1, 2006 and June 30, 2007, between July 1, 2007
and June 30, 2008, between July 1, 2008 and June 30, 2009, between  July
1, 2009 and June 30, 2010, [and] between July 1, 2010 and June 30, 2011,
BETWEEN  JULY  1,  2011 AND JUNE 30, 2012, BETWEEN JULY 1, 2012 AND JUNE
30, 2013 AND BETWEEN JULY 1, 2013 AND JUNE 30,  2014  or  reimburse  the
hospital  where  the  hospital  purchases  equivalent excess coverage as
defined in subparagraph (i) of paragraph (a) of subdivision [(1-a)]  1-A
of  this  section  for medical or dental malpractice occurrences between
July 1, 1987 and June 30, 1988, between July 1, 1988 and June 30,  1989,
between  July  1,  1989 and June 30, 1990, between July 1, 1990 and June
30, 1991, between July 1, 1991 and June 30, 1992, between July  1,  1992
and  June 30, 1993, between July 1, 1993 and June 30, 1994, between July
1, 1994 and June 30, 1995, between July  1,  1995  and  June  30,  1996,
between  July  1,  1996 and June 30, 1997, between July 1, 1997 and June

S. 2809--A                         81                         A. 4009--A

30, 1998, between July 1, 1998 and June 30, 1999, between July  1,  1999
and  June 30, 2000, between July 1, 2000 and June 30, 2001, between July
1, 2001 and June 30, 2002, between July  1,  2002  and  June  30,  2003,
between  July  1,  2003 and June 30, 2004, between July 1, 2004 and June
30, 2005, between July 1, 2005 and June 30, 2006, between July  1,  2006
and  June 30, 2007, between July 1, 2007 and June 30, 2008, between July
1, 2008 and June 30, 2009, between July 1, 2009 and June 30, 2010, [and]
between July 1, 2010 and June 30, 2011, BETWEEN JULY 1,  2011  AND  JUNE
30,  2012,  BETWEEN  JULY  1, 2012 AND JUNE 30, 2013 AND BETWEEN JULY 1,
2013 AND JUNE 30, 2014 for physicians or dentists certified as  eligible
for  each such period or periods pursuant to subdivision [(2)] 2 of this
section by a general hospital licensed pursuant to  article  28  of  the
public health law; provided that no single insurer shall write more than
fifty  percent  of the total excess premium for a given policy year; and
provided, however, that such eligible physicians or dentists  must  have
in force an individual policy, from an insurer licensed in this state of
primary  malpractice  insurance  coverage in amounts of no less than one
million three hundred thousand  dollars  for  each  claimant  and  three
million nine hundred thousand dollars for all claimants under that poli-
cy  during the period of such excess coverage for such occurrences or be
endorsed as additional insureds under a hospital professional  liability
policy  which is offered through a voluntary attending physician ("chan-
neling") program previously permitted by the superintendent of insurance
during the period of such excess coverage for such  occurrences.  During
such  period,  such policy for excess coverage or such equivalent excess
coverage shall, when combined with the physician's or dentist's  primary
malpractice  insurance coverage or coverage provided through a voluntary
attending physician ("channeling") program, total an aggregate level  of
two  million  three  hundred  thousand dollars for each claimant and six
million nine hundred thousand dollars for all claimants  from  all  such
policies  with  respect  to  occurrences in each of such years provided,
however, if the cost of primary malpractice insurance coverage in excess
of one million dollars, but below the excess medical malpractice  insur-
ance  coverage  provided  pursuant to this act, exceeds the rate of nine
percent per annum, then the required level of primary malpractice insur-
ance coverage in excess of one million dollars for each  claimant  shall
be  in  an  amount  of  not less than the dollar amount of such coverage
available at nine percent per annum; the required level of such coverage
for all claimants under that policy shall be in an amount not less  than
three  times the dollar amount of coverage for each claimant; and excess
coverage, when combined with such primary malpractice  insurance  cover-
age, shall increase the aggregate level for each claimant by one million
dollars  and  three  million  dollars  for  all  claimants; and provided
further, that, with respect to policies of primary  medical  malpractice
coverage  that  include  occurrences  between April 1, 2002 and June 30,
2002, such requirement that coverage be in  amounts  no  less  than  one
million  three  hundred  thousand  dollars  for  each claimant and three
million nine hundred thousand dollars for all claimants for such  occur-
rences shall be effective April 1, 2002.
  S  16. Subdivision 3 of section 18 of chapter 266 of the laws of 1986,
amending the civil practice law and rules and  other  laws  relating  to
malpractice  and  professional medical conduct, as amended by section 24
of part B of chapter 58 of the laws of  2008,  is  amended  to  read  as
follows:
  (3)(a)  The superintendent of insurance shall determine and certify to
each general hospital and to the commissioner  of  health  the  cost  of

S. 2809--A                         82                         A. 4009--A

excess  malpractice  insurance  for medical or dental malpractice occur-
rences between July 1, 1986 and June 30, 1987, between July 1, 1988  and
June  30,  1989, between July 1, 1989 and June 30, 1990, between July 1,
1990  and June 30, 1991, between July 1, 1991 and June 30, 1992, between
July 1, 1992 and June 30, 1993, between July 1, 1993 and June 30,  1994,
between  July  1,  1994 and June 30, 1995, between July 1, 1995 and June
30, 1996, between July 1, 1996 and June 30, 1997, between July  1,  1997
and  June 30, 1998, between July 1, 1998 and June 30, 1999, between July
1, 1999 and June 30, 2000, between July  1,  2000  and  June  30,  2001,
between  July  1,  2001 and June 30, 2002, between July 1, 2002 and June
30, 2003, between July 1, 2003 and June 30, 2004, between July  1,  2004
and  June 30, 2005, between July 1, 2005 and June 30, 2006, between July
1, 2006 and June 30, 2007, between July  1,  2007  and  June  30,  2008,
between  July  1,  2008 and June 30, 2009, between July 1, 2009 and June
30, 2010, [and] between July 1, 2010 and June 30, 2011, BETWEEN JULY  1,
2011  AND  JUNE  30,  2012,  BETWEEN JULY 1, 2012 AND JUNE 30, 2013, AND
BETWEEN JULY 1, 2013 AND JUNE 30, 2014 allocable to each general  hospi-
tal  for  physicians or dentists certified as eligible for purchase of a
policy for excess insurance coverage by such general hospital in accord-
ance with subdivision [(2)] 2 of this section, and may amend such deter-
mination and certification as necessary.
  (b) The superintendent of insurance shall  determine  and  certify  to
each  general  hospital  and  to  the commissioner of health the cost of
excess malpractice insurance or equivalent excess coverage  for  medical
or  dental  malpractice  occurrences  between  July 1, 1987 and June 30,
1988, between July 1, 1988 and June 30, 1989, between July 1,  1989  and
June  30,  1990, between July 1, 1990 and June 30, 1991, between July 1,
1991 and June 30, 1992, between July 1, 1992 and June 30, 1993,  between
July  1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995,
between July 1, 1995 and June 30, 1996, between July 1,  1996  and  June
30,  1997,  between July 1, 1997 and June 30, 1998, between July 1, 1998
and June 30, 1999, between July 1, 1999 and June 30, 2000, between  July
1,  2000  and  June  30,  2001,  between July 1, 2001 and June 30, 2002,
between July 1, 2002 and June 30, 2003, between July 1,  2003  and  June
30,  2004,  between July 1, 2004 and June 30, 2005, between July 1, 2005
and June 30, 2006, between July 1, 2006 and June 30, 2007, between  July
1,  2007  and  June  30,  2008,  between July 1, 2008 and June 30, 2009,
between July 1, 2009 and June 30, 2010, [and] between July 1,  2010  and
June  30,  2011, BETWEEN JULY 1, 2011 AND JUNE 30, 2012, BETWEEN JULY 1,
2012 AND JUNE 30, 2013, AND BETWEEN JULY 1, 2013 AND JUNE 30, 2014 allo-
cable to each general hospital for physicians or dentists  certified  as
eligible  for  purchase  of  a  policy  for excess insurance coverage or
equivalent excess coverage by such general hospital in  accordance  with
subdivision  [(2)]  2  of this section, and may amend such determination
and certification as necessary. The superintendent  of  insurance  shall
determine  and  certify to each general hospital and to the commissioner
of health the ratable share of such cost allocable to the period July 1,
1987 to December 31, 1987, to the period January 1,  1988  to  June  30,
1988,  to  the  period  July 1, 1988 to December 31, 1988, to the period
January 1, 1989 to June 30, 1989, to the period July 1, 1989 to December
31, 1989, to the period January 1, 1990 to June 30, 1990, to the  period
July 1, 1990 to December 31, 1990, to the period January 1, 1991 to June
30, 1991, to the period July 1, 1991 to December 31, 1991, to the period
January 1, 1992 to June 30, 1992, to the period July 1, 1992 to December
31,  1992, to the period January 1, 1993 to June 30, 1993, to the period
July 1, 1993 to December 31, 1993, to the period January 1, 1994 to June

S. 2809--A                         83                         A. 4009--A

30, 1994, to the period July 1, 1994 to December 31, 1994, to the period
January 1, 1995 to June 30, 1995, to the period July 1, 1995 to December
31, 1995, to the period January 1, 1996 to June 30, 1996, to the  period
July 1, 1996 to December 31, 1996, to the period January 1, 1997 to June
30, 1997, to the period July 1, 1997 to December 31, 1997, to the period
January 1, 1998 to June 30, 1998, to the period July 1, 1998 to December
31,  1998, to the period January 1, 1999 to June 30, 1999, to the period
July 1, 1999 to December 31, 1999, to the period January 1, 2000 to June
30, 2000, to the period July 1, 2000 to December 31, 2000, to the period
January 1, 2001 to June 30, 2001, to the period July 1, 2001 to June 30,
2002, to the period July 1, 2002 to June 30, 2003, to the period July 1,
2003 to June 30, 2004, to the period July 1, 2004 to June 30,  2005,  to
the  period  July  1, 2005 and June 30, 2006, to the period July 1, 2006
and June 30, 2007, to the period July 1, 2007 and June 30, 2008, to  the
period  July  1,  2008 and June 30, 2009, to the period July 1, 2009 and
June 30, 2010, [and] to the period July 1, 2010 and June  30,  2011,  TO
THE  PERIOD  JULY  1, 2011 AND JUNE 30, 2012, TO THE PERIOD JULY 1, 2012
AND JUNE 30, 2013, AND TO THE PERIOD JULY 1, 2013 AND JUNE 30, 2014.
  S 17. Paragraphs (a), (b), (c),  (d)  and  (e)  of  subdivision  8  of
section  18 of chapter 266 of the laws of 1986, amending the civil prac-
tice law and rules and other laws relating to  malpractice  and  profes-
sional medical conduct, as amended by section 25 of part B of chapter 58
of the laws of 2008, are amended to read as follows:
  (a)  To  the  extent  funds available to the hospital excess liability
pool pursuant to subdivision [(5)] 5 of this  section  as  amended,  and
pursuant  to  section  6 of part J of chapter 63 of the laws of 2001, as
may from time to time be amended, which amended  this  subdivision,  are
insufficient  to  meet  the costs of excess insurance coverage or equiv-
alent excess coverage for coverage periods during  the  period  July  1,
1992  to June 30, 1993, during the period July 1, 1993 to June 30, 1994,
during the period July 1, 1994 to June 30, 1995, during the period  July
1,  1995  to  June  30, 1996, during the period July 1, 1996 to June 30,
1997, during the period July 1, 1997 to June 30, 1998, during the period
July 1, 1998 to June 30, 1999, during the period July 1,  1999  to  June
30,  2000,  during  the period July 1, 2000 to June 30, 2001, during the
period July 1, 2001 to October 29, 2001, during the period April 1, 2002
to June 30, 2002, during the period July  1,  2002  to  June  30,  2003,
during  the period July 1, 2003 to June 30, 2004, during the period July
1, 2004 to June 30, 2005, during the period July 1,  2005  to  June  30,
2006, during the period July 1, 2006 to June 30, 2007, during the period
July  1,  2007  to June 30, 2008, during the period July 1, 2008 to June
30, 2009, during the period July 1, 2009 to June 30, 2010 [and],  during
the period July 1, 2010 to June 30, 2011, DURING THE PERIOD JULY 1, 2011
TO  JUNE  30, 2012, DURING THE PERIOD JULY 1, 2012 TO JUNE 30, 2013, AND
DURING THE PERIOD JULY 1, 2013 TO JUNE 30, 2014 allocated or reallocated
in accordance with paragraph (a) of  subdivision  [(4-a)]  4-A  of  this
section  to  rates of payment applicable to state governmental agencies,
each physician or dentist for whom a policy for excess insurance  cover-
age  or equivalent excess coverage is purchased for such period shall be
responsible for payment to the provider of excess insurance coverage  or
equivalent  excess coverage of an allocable share of such insufficiency,
based on the ratio of the total cost of such coverage for such physician
to the sum of the total cost of such coverage for all physicians applied
to such insufficiency.
  (b) Each provider of excess insurance coverage  or  equivalent  excess
coverage  covering the period July 1, 1992 to June 30, 1993, or covering

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the period July 1, 1993 to June 30, 1994, or covering the period July 1,
1994 to June 30, 1995, or covering the period July 1, 1995 to  June  30,
1996,  or covering the period July 1, 1996 to June 30, 1997, or covering
the period July 1, 1997 to June 30, 1998, or covering the period July 1,
1998  to  June 30, 1999, or covering the period July 1, 1999 to June 30,
2000, or covering the period July 1, 2000 to June 30, 2001, or  covering
the  period  July  1,  2001  to October 29, 2001, or covering the period
April 1, 2002 to June 30, 2002, or covering the period July 1,  2002  to
June  30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
covering the period July 1, 2004 to June 30, 2005, or covering the peri-
od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
June 30, 2007, or covering the period July 1, 2007 to June 30, 2008,  or
covering the period July 1, 2008 to June 30, 2009, or covering the peri-
od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
June  30, 2011, OR COVERING THE PERIOD JULY 1, 2011 TO JUNE 30, 2012, OR
COVERING THE PERIOD JULY 1, 2012 TO JUNE 30, 2013, OR COVERING THE PERI-
OD JULY 1, 2013 TO JUNE 30, 2014 shall notify  a  covered  physician  or
dentist by mail, mailed to the address shown on the last application for
excess  insurance  coverage or equivalent excess coverage, of the amount
due to such provider from such physician or dentist  for  such  coverage
period  determined in accordance with paragraph (a) of this subdivision.
Such amount shall be due from such physician or dentist to such provider
of excess insurance coverage or equivalent excess coverage in a time and
manner determined by the superintendent of insurance.
  (c) If a physician or dentist liable for payment of a portion  of  the
costs  of excess insurance coverage or equivalent excess coverage cover-
ing the period July 1, 1992 to June 30, 1993,  or  covering  the  period
July  1,  1993  to June 30, 1994, or covering the period July 1, 1994 to
June 30, 1995, or covering the period July 1, 1995 to June 30, 1996,  or
covering the period July 1, 1996 to June 30, 1997, or covering the peri-
od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
June  30, 1999, or covering the period July 1, 1999 to June 30, 2000, or
covering the period July 1, 2000 to June 30, 2001, or covering the peri-
od July 1, 2001 to October 29, 2001, or covering  the  period  April  1,
2002  to  June 30, 2002, or covering the period July 1, 2002 to June 30,
2003, or covering the period July 1, 2003 to June 30, 2004, or  covering
the period July 1, 2004 to June 30, 2005, or covering the period July 1,
2005  to  June 30, 2006, or covering the period July 1, 2006 to June 30,
2007, or covering the period July 1, 2007 to June 30, 2008, or  covering
the period July 1, 2008 to June 30, 2009, or covering the period July 1,
2009  to  June 30, 2010, or covering the period July 1, 2010 to June 30,
2011, OR COVERING THE PERIOD JULY 1, 2011 TO JUNE 30, 2012, OR  COVERING
THE PERIOD JULY 1, 2012 TO JUNE 30, 2013, OR COVERING THE PERIOD JULY 1,
2013  TO  JUNE  30,  2014 determined in accordance with paragraph (a) of
this subdivision fails, refuses or  neglects  to  make  payment  to  the
provider  of  excess insurance coverage or equivalent excess coverage in
such time and manner as determined by the  superintendent  of  insurance
pursuant to paragraph (b) of this subdivision, excess insurance coverage
or equivalent excess coverage purchased for such physician or dentist in
accordance with this section for such coverage period shall be cancelled
and shall be null and void as of the first day on or after the commence-
ment of a policy period where the liability for payment pursuant to this
subdivision has not been met.
  (d)  Each  provider  of excess insurance coverage or equivalent excess
coverage shall notify the superintendent of insurance  and  the  commis-
sioner  of health or their designee of each physician and dentist eligi-

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ble for purchase of a policy for excess insurance coverage or equivalent
excess coverage covering the period July 1, 1992 to June  30,  1993,  or
covering the period July 1, 1993 to June 30, 1994, or covering the peri-
od July 1, 1994 to June 30, 1995, or covering the period July 1, 1995 to
June  30, 1996, or covering the period July 1, 1996 to June 30, 1997, or
covering the period July 1, 1997 to June 30, 1998, or covering the peri-
od July 1, 1998 to June 30, 1999, or covering the period July 1, 1999 to
June 30, 2000, or covering the period July 1, 2000 to June 30, 2001,  or
covering  the  period  July 1, 2001 to October 29, 2001, or covering the
period April 1, 2002 to June 30, 2002, or covering the  period  July  1,
2002  to  June 30, 2003, or covering the period July 1, 2003 to June 30,
2004, or covering the period July 1, 2004 to June 30, 2005, or  covering
the period July 1, 2005 to June 30, 2006, or covering the period July 1,
2006  to  June 30, 2007, or covering the period July 1, 2007 to June 30,
2008, or covering the period July 1, 2008 to June 30, 2009, or  covering
the period July 1, 2009 to June 30, 2010, or covering the period July 1,
2010  to  June 30, 2011, OR COVERING THE PERIOD JULY 1, 2011 TO JUNE 30,
2012, OR COVERING THE PERIOD JULY 1, 2012 TO JUNE 30, 2013, OR  COVERING
THE  PERIOD  JULY 1, 2013 TO JUNE 30, 2014 that has made payment to such
provider of excess insurance coverage or equivalent excess  coverage  in
accordance  with paragraph (b) of this subdivision and of each physician
and dentist who has failed, refused or neglected to make such payment.
  (e) A provider of  excess  insurance  coverage  or  equivalent  excess
coverage  shall  refund to the hospital excess liability pool any amount
allocable to the period July 1, 1992 to June 30, 1993, and to the period
July 1, 1993 to June 30, 1994, and to the period July 1,  1994  to  June
30,  1995,  and  to the period July 1, 1995 to June 30, 1996, and to the
period July 1, 1996 to June 30, 1997, and to the period July 1, 1997  to
June  30,  1998, and to the period July 1, 1998 to June 30, 1999, and to
the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
to June 30, 2001, and to the period July 1, 2001 to  October  29,  2001,
and to the period April 1, 2002 to June 30, 2002, and to the period July
1,  2002  to  June  30, 2003, and to the period July 1, 2003 to June 30,
2004, and to the period July 1, 2004 to June 30, 2005, and to the period
July 1, 2005 to June 30, 2006, and to the period July 1,  2006  to  June
30,  2007,  and  to the period July 1, 2007 to June 30, 2008, and to the
period July 1, 2008 to June 30, 2009, and to the period July 1, 2009  to
June  30,  2010, and to the period July 1, 2010 to June 30, 2011, AND TO
THE PERIOD JULY 1, 2011 TO JUNE 30, 2012, AND TO THE PERIOD JULY 1, 2012
TO JUNE 30, 2013, AND TO THE PERIOD  JULY  1,  2013  TO  JUNE  30,  2014
received  from the hospital excess liability pool for purchase of excess
insurance coverage or equivalent excess  coverage  covering  the  period
July  1,  1992 to June 30, 1993, and covering the period July 1, 1993 to
June 30, 1994, and covering the period July 1, 1994 to  June  30,  1995,
and  covering the period July 1, 1995 to June 30, 1996, and covering the
period July 1, 1996 to June 30, 1997, and covering the  period  July  1,
1997  to June 30, 1998, and covering the period July 1, 1998 to June 30,
1999, and covering the period July 1, 1999 to June 30, 2000, and  cover-
ing  the  period  July 1, 2000 to June 30, 2001, and covering the period
July 1, 2001 to October 29, 2001, and covering the period April 1,  2002
to June 30, 2002, and covering the period July 1, 2002 to June 30, 2003,
and  covering the period July 1, 2003 to June 30, 2004, and covering the
period July 1, 2004 to June 30, 2005, and covering the  period  July  1,
2005  to June 30, 2006, and covering the period July 1, 2006 to June 30,
2007, and covering the period July 1, 2007 to June 30, 2008, and  cover-
ing  the  period  July 1, 2008 to June 30, 2009, and covering the period

S. 2809--A                         86                         A. 4009--A

July 1, 2009 to June 30, 2010, and covering the period July 1,  2010  to
June  30,  2011,  AND COVERING THE PERIOD JULY 1, 2011 TO JUNE 30, 2012,
AND COVERING THE PERIOD JULY 1, 2012 TO JUNE 30, 2013, AND COVERING  THE
PERIOD  JULY  1,  2013 TO JUNE 30, 2014 for a physician or dentist where
such  excess  insurance  coverage  or  equivalent  excess  coverage   is
cancelled in accordance with paragraph (c) of this subdivision.
  S  18.  Section  40  of  chapter 266 of the laws of 1986, amending the
civil practice law and rules and other laws relating to malpractice  and
professional  medical  conduct, as amended by chapter 216 of the laws of
2009, is amended to read as follows:
  S 40. The superintendent of insurance shall establish rates for  poli-
cies  providing coverage for physicians and surgeons medical malpractice
for the periods commencing July 1, 1985 and ending June 30, [2011] 2014;
provided, however, that notwithstanding any other provision of law,  the
superintendent  shall not establish or approve any increase in rates for
the period commencing July 1, 2009 and ending June 30, 2010. The  super-
intendent  shall  direct  insurers  to establish segregated accounts for
premiums, payments, reserves and investment income attributable to  such
premium  periods  and  shall  require  periodic  reports by the insurers
regarding claims and expenses attributable to such  periods  to  monitor
whether  such  accounts  will  be sufficient to meet incurred claims and
expenses. On or after July 1, 1989, the superintendent  shall  impose  a
surcharge  on premiums to satisfy a projected deficiency that is attrib-
utable to the premium levels established pursuant to  this  section  for
such  periods;  provided,  however, that such annual surcharge shall not
exceed eight percent of the established rate until July 1, [2011]  2014,
at which time and thereafter such surcharge shall not exceed twenty-five
percent  of  the approved adequate rate, and that such annual surcharges
shall continue for such period of time as shall be sufficient to satisfy
such deficiency. The superintendent  shall  not  impose  such  surcharge
during  the period commencing July 1, 2009 and ending June 30, 2010.  On
and after July 1, 1989, the surcharge prescribed by this  section  shall
be  retained  by insurers to the extent that they insured physicians and
surgeons during the July 1, 1985 through June  30,  [2011]  2014  policy
periods;  in  the  event  and to the extent physicians and surgeons were
insured by another insurer during such periods, all or a pro rata  share
of  the  surcharge,  as the case may be, shall be remitted to such other
insurer in accordance with rules and regulations to  be  promulgated  by
the  superintendent.   Surcharges collected from physicians and surgeons
who were not insured during such policy  periods  shall  be  apportioned
among  all insurers in proportion to the premium written by each insurer
during such policy periods; if a physician or surgeon was insured by  an
insurer  subject  to rates established by the superintendent during such
policy periods, and at any time thereafter a  hospital,  health  mainte-
nance  organization, employer or institution is responsible for respond-
ing in  damages  for  liability  arising  out  of  such  physician's  or
surgeon's practice of medicine, such responsible entity shall also remit
to such prior insurer the equivalent amount that would then be collected
as  a  surcharge  if  the  physician  or surgeon had continued to remain
insured by such prior insurer. In the event any  insurer  that  provided
coverage   during   such   policy   periods   is   in  liquidation,  the
property/casualty insurance security fund shall receive the  portion  of
surcharges to which the insurer in liquidation would have been entitled.
The surcharges authorized herein shall be deemed to be income earned for
the  purposes of section 2303 of the insurance law.  The superintendent,
in establishing adequate rates and in determining  any  projected  defi-

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ciency  pursuant  to  the requirements of this section and the insurance
law, shall give substantial weight, determined  in  his  discretion  and
judgment,  to  the  prospective  anticipated  effect  of any regulations
promulgated  and  laws  enacted  and the public benefit of  stabilizing
malpractice rates and minimizing rate level fluctuation during the peri-
od of time necessary for the development of  more  reliable  statistical
experience  as  to  the  efficacy of such laws and regulations affecting
medical, dental or podiatric malpractice enacted or promulgated in 1985,
1986, by this act and at any other time.  Notwithstanding any  provision
of the insurance law, rates already established and to be established by
the  superintendent pursuant to this section are deemed adequate if such
rates would be adequate when taken together with the maximum  authorized
annual  surcharges to be imposed for a reasonable period of time whether
or not any such annual surcharge has been actually  imposed  as  of  the
establishment of such rates.
  S  19. Subsection (c) of section 2343 of the insurance law, as amended
by section 27 of part B of chapter 58 of the laws of 2008, is amended to
read as follows:
  (c) Notwithstanding any other provision of this chapter,  no  applica-
tion for an order of rehabilitation or liquidation of a domestic insurer
whose  primary liability arises from the business of medical malpractice
insurance, as that term is defined in subsection  (b)  of  section  five
thousand  five hundred one of this chapter, shall be made on the grounds
specified in subsection (a)  or  (c)  of  section  seven  thousand  four
hundred  two  of  this  chapter at any time prior to June thirtieth, two
thousand [eleven] FOURTEEN.
  S 20. Section 5 and subdivisions (a) and (e) of section 6 of part J of
chapter 63 of the laws of 2001, amending chapter 20 of the laws of  2001
amending  the  military  law and other laws relating to making appropri-
ations for the support of government, as amended by section 28 of part B
of chapter 58 of the laws of 2008, are amended to read as follows:
  S 5. The superintendent of insurance and the  commissioner  of  health
shall  determine,  no  later than June 15, 2002, June 15, 2003, June 15,
2004, June 15, 2005, June 15, 2006, June 15, 2007, June 15,  2008,  June
15,  2009,  June  15, 2010, [and] June 15, 2011, JUNE 15, 2012, JUNE 15,
2013, AND JUNE 15, 2014, the amount of funds available in  the  hospital
excess  liability pool, created pursuant to section 18 of chapter 266 of
the laws of 1986, and whether such funds are sufficient for purposes  of
purchasing  excess  insurance coverage for eligible participating physi-
cians and dentists during the period July 1, 2001 to June 30,  2002,  or
July 1, 2002 to June 30, 2003, or July 1, 2003 to June 30, 2004, or July
1,  2004  to June 30, 2005, or July 1, 2005 to June 30, 2006, or July 1,
2006 to June 30, 2007, or July 1, 2007 to June 30, 2008, or July 1, 2008
to June 30, 2009, or July 1, 2009 to June 30, 2010, or July 1,  2010  to
June 30, 2011, OR JULY 1, 2011 TO JUNE 30, 2012, OR JULY 1, 2012 TO JUNE
30, 2013, OR JULY 1, 2013 TO JUNE 30, 2014, as applicable.
  (a)  This section shall be effective only upon a determination, pursu-
ant to section five of this act, by the superintendent of insurance  and
the commissioner of health, and a certification of such determination to
the  state  director of the budget, the chair of the senate committee on
finance and the chair of the assembly committee on ways and means,  that
the  amount  of  funds  in  the  hospital excess liability pool, created
pursuant to section 18 of chapter 266 of the laws of 1986,  is  insuffi-
cient  for purposes of purchasing excess insurance coverage for eligible
participating physicians and dentists during the period July 1, 2001  to
June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003 to June

S. 2809--A                         88                         A. 4009--A

30,  2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to June 30,
2006, or July 1, 2006 to June 30, 2007, or July  1,  2007  to  June  30,
2008,  or  July  1,  2008  to June 30, 2009, or July 1, 2009 to June 30,
2010,  or  July  1,  2010  to June 30, 2011, OR JULY 1, 2011 TO JUNE 30,
2012, OR JULY 1, 2012 TO JUNE 30, 2013, OR JULY  1,  2013  TO  JUNE  30,
2014, as applicable.
  (e)  The  commissioner  of  health  shall  transfer for deposit to the
hospital excess liability pool created pursuant to section 18 of chapter
266 of the laws of 1986 such amounts as directed by  the  superintendent
of insurance for the purchase of excess liability insurance coverage for
eligible  participating physicians and dentists for the policy year July
1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or  July  1,
2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005
to  June  30, 2006, or July 1, 2006 to June 30, 2007, as applicable, and
the cost of administering the hospital excess liability  pool  for  such
applicable  policy year,  pursuant to the program established in chapter
266 of the laws of 1986, as amended, no later than June 15,  2002,  June
15,  2003,  June  15, 2004, June 15, 2005, June 15, 2006, June 15, 2007,
June 15, 2008, June 15, 2009, June 15, 2010, [and] June 15,  2011,  JUNE
15, 2012, JUNE 15, 2013, AND JUNE 15, 2014, as applicable.
  S  21.  Section  18  of  chapter 904 of the laws of 1984, amending the
public health law and the social services law  relating  to  encouraging
comprehensive  health  services,  as  amended by section 64 of part C of
chapter 58 of the laws of 2008, is amended to read as follows:
  S 18. This act shall take effect  immediately,  except  that  sections
six,  nine, ten and eleven of this act shall take effect on the sixtieth
day after it shall have become a law, sections two, three, four and nine
of this act shall expire and be of no further  force  or  effect  on  or
after  March  31, [2012] 2014, section two of this act shall take effect
on April 1, 1985 or seventy-five days following the  submission  of  the
report  required  by  section  one  of this act, whichever is later, and
sections eleven and thirteen of this act  shall  expire  and  be  of  no
further force or effect on or after March 31, 1988.
  S 22.  Paragraphs (i) and (j) of subdivision 1 of section 367-q of the
social services law, as added by section 22-d of part B of chapter 58 of
the  laws of 2008, are amended and three new paragraphs (k), (l) and (m)
are added to read as follows:
  (i) for the period April first, two thousand nine through March  thir-
ty-first,  two  thousand ten, twenty-eight million five hundred thousand
dollars; [and]
  (j) for the period April first, two thousand ten through  March  thir-
ty-first,  two  thousand eleven, twenty-eight million five hundred thou-
sand dollars[.];
  (K) FOR THE PERIOD APRIL FIRST,  TWO  THOUSAND  ELEVEN  THROUGH  MARCH
THIRTY-FIRST,  TWO  THOUSAND  TWELVE,  TWENTY-EIGHT MILLION FIVE HUNDRED
THOUSAND DOLLARS;
  (L) FOR THE PERIOD APRIL FIRST,  TWO  THOUSAND  TWELVE  THROUGH  MARCH
THIRTY-FIRST,  TWO  THOUSAND THIRTEEN, TWENTY-EIGHT MILLION FIVE HUNDRED
THOUSAND DOLLARS; AND
  (M) FOR THE PERIOD APRIL FIRST, TWO THOUSAND  THIRTEEN  THROUGH  MARCH
THIRTY-FIRST,  TWO  THOUSAND FOURTEEN, TWENTY-EIGHT MILLION FIVE HUNDRED
THOUSAND DOLLARS.
  S 23. Paragraph (f) of subdivision 9 of section  3614  of  the  public
health law, as added by section 22-e of part B of chapter 58 of the laws
of  2008, is amended and three new paragraphs (g), (h) and (i) are added
to read as follows:

S. 2809--A                         89                         A. 4009--A

  (f) for the period April first, two thousand ten through  March  thir-
ty-first, two thousand eleven, up to one hundred million dollars[.];
  (G)  FOR  THE  PERIOD  APRIL  FIRST, TWO THOUSAND ELEVEN THROUGH MARCH
THIRTY-FIRST, TWO THOUSAND TWELVE, UP TO ONE HUNDRED MILLION DOLLARS;
  (H) FOR THE PERIOD APRIL FIRST,  TWO  THOUSAND  TWELVE  THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND THIRTEEN, UP TO ONE HUNDRED MILLION DOLLARS;
  (I)  FOR  THE  PERIOD APRIL FIRST, TWO THOUSAND THIRTEEN THROUGH MARCH
THIRTY-FIRST, TWO THOUSAND FOURTEEN, UP TO ONE HUNDRED MILLION DOLLARS.
  S 24. Paragraph (a) of subdivision 10 of section 3614  of  the  public
health law, as amended by section 5 of part C of chapter 109 of the laws
of 2006, is amended to read as follows:
  (a)  Such  adjustments to rates of payments shall be allocated propor-
tionally based on each certified home health agency's,  long  term  home
health  care  program,  AIDS home care and hospice program's home health
aide or other  direct  care  services  total  annual  hours  of  service
provided  to  medicaid  patients, as reported in each such agency's most
[recent] RECENTLY AVAILABLE cost report as submitted to  the  department
[prior  to  November first, two thousand five] or for the purpose of the
managed long term care program a suitable proxy developed by the depart-
ment in consultation with the interested parties. Payments made pursuant
to this section shall not be subject to subsequent adjustment or  recon-
ciliation.
  S  25.  Section  4  of  chapter  495 of the laws of 2004, amending the
insurance law and the public health law relating to the New  York  state
health  insurance  continuation  assistance  demonstration  project,  as
amended by section 29 of part B of chapter 58 of the laws  of  2008,  is
amended to read as follows:
  S  4.  This  act  shall take effect on the sixtieth day after it shall
have become a law; provided, however, that  this  act  shall  remain  in
effect  until  July 1, [2011] 2014 when upon such date the provisions of
this act shall expire and be deemed repealed; provided, further, that  a
displaced  worker shall be eligible for continuation assistance retroac-
tive to July 1, 2004.
  S 26. The opening paragraph of paragraph (b) and paragraphs (c),  (d),
(e),  (f)  and  (g)  of  subdivision 5-a of section 2807-m of the public
health law, the opening paragraph of paragraph (b) as amended by section
4 of part B of chapter 109 of the laws of 2010, paragraphs (c), (f)  and
(g)  and  the opening paragraphs of paragraphs (d) and (e) as amended by
section 98 of part C of chapter 58 of the laws of  2009  and  paragraphs
(d) and (e) as added by section 75-c of part C of chapter 58 of the laws
of 2008, are amended to read as follows:
  Nine  million  one  hundred  twenty  thousand dollars annually for the
period January first, two thousand nine through  December  thirty-first,
two  thousand  ten,  and two million two hundred eighty thousand dollars
for the period January first, two thousand eleven, AND NINE MILLION  ONE
HUNDRED  TWENTY  THOUSAND  DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD
APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST,  TWO  THOU-
SAND FOURTEEN, through March thirty-first, two thousand eleven, shall be
set  aside  and  reserved  by  the  commissioner from the regional pools
established pursuant to subdivision two of this section to be  allocated
regionally  with  two-thirds  of the available funding going to New York
city and one-third of the available funding going to  the  rest  of  the
state and shall be available for distribution as follows:
  (c)  Ambulatory  care  training.  Four  million  nine hundred thousand
dollars for the period January first, two thousand eight through  Decem-
ber thirty-first, two thousand eight, four million nine hundred thousand

S. 2809--A                         90                         A. 4009--A

dollars for the period January first, two thousand nine through December
thirty-first,  two  thousand  nine,  four  million nine hundred thousand
dollars for the period January first, two thousand ten through  December
thirty-first,  two  thousand  ten, [and] one million two hundred twenty-
five thousand dollars for the period January first, two thousand  eleven
through  March thirty-first, two thousand eleven, AND FOUR MILLION THREE
HUNDRED THOUSAND DOLLARS EACH STATE FISCAL YEAR  FOR  THE  PERIOD  APRIL
FIRST,  TWO  THOUSAND  ELEVEN  THROUGH  MARCH THIRTY-FIRST, TWO THOUSAND
FOURTEEN, shall be set aside and reserved by the commissioner  from  the
regional  pools  established pursuant to subdivision two of this section
and shall be available for distributions to sponsoring  institutions  to
be  directed  to support clinical training of medical students and resi-
dents in free-standing ambulatory  care  settings,  including  community
health  centers  and  private practices. Such funding shall be allocated
regionally with two-thirds of the available funding going  to  New  York
city  and  one-third  of  the available funding going to the rest of the
state and shall be distributed to sponsoring institutions in each region
pursuant to a request for application or request  for  proposal  process
with  preference  being  given  to sponsoring institutions which provide
training in sites located in underserved rural or inner-city  areas  and
those that include medical students in such training.
  (d)  Physician loan repayment program.  One million nine hundred sixty
thousand dollars for  the  period  January  first,  two  thousand  eight
through  December  thirty-first,  two  thousand  eight, one million nine
hundred sixty thousand dollars for the period January first,  two  thou-
sand  nine through December thirty-first, two thousand nine, one million
nine hundred sixty thousand dollars for the period  January  first,  two
thousand ten through December thirty-first, two thousand ten, [and] four
hundred  ninety thousand dollars for the period January first, two thou-
sand eleven through March thirty-first, two  thousand  eleven,  AND  ONE
MILLION  SEVEN  HUNDRED  THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR THE
PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST,  TWO
THOUSAND  FOURTEEN,  shall be set aside and reserved by the commissioner
from the regional pools established pursuant to subdivision two of  this
section  and shall be available for purposes of physician loan repayment
in accordance with subdivision ten of this section. Such  funding  shall
be  allocated  regionally with one-third of available funds going to New
York city and two-thirds of available funds going to  the  rest  of  the
state  and  shall  be  distributed  in  a manner to be determined by the
commissioner as follows:
  (i) Funding shall first be awarded to repay loans of up to twenty-five
physicians who train in primary care or  specialty  tracks  in  teaching
general hospitals, and who enter and remain in primary care or specialty
practices in underserved communities, as determined by the commissioner.
  (ii)  After  distributions in accordance with subparagraph (i) of this
paragraph, all remaining funds shall be awarded to repay loans of physi-
cians who enter and remain in primary care  or  specialty  practices  in
underserved  communities,  as  determined by the commissioner, including
but not limited to physicians working in  general  hospitals,  or  other
health care facilities.
  (iii)  In no case shall less than fifty percent of the funds available
pursuant to this paragraph be distributed in  accordance  with  subpara-
graphs (i) and (ii) of this paragraph to physicians identified by gener-
al hospitals.
  (e)  Physician  practice support.   Four million nine hundred thousand
dollars for the period January first, two thousand eight through  Decem-

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ber thirty-first, two thousand eight, four million nine hundred thousand
dollars annually for the period January first, two thousand nine through
December  thirty-first,  two thousand ten, [and] one million two hundred
twenty-five  thousand dollars for the period January first, two thousand
eleven through March thirty-first, two thousand eleven, AND FOUR MILLION
THREE HUNDRED THOUSAND DOLLARS EACH STATE FISCAL  YEAR  FOR  THE  PERIOD
APRIL  FIRST,  TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND FOURTEEN, shall be set aside and reserved by the commissioner  from
the  regional  pools  established  pursuant  to  subdivision two of this
section and shall  be  available  for  purposes  of  physician  practice
support.  Such  funding  shall be allocated regionally with one-third of
available funds going to New York city and two-thirds of available funds
going to the rest of the state and shall be distributed in a  manner  to
be determined by the commissioner as follows:
  (i)  Preference in funding shall first be accorded to teaching general
hospitals for up to twenty-five awards, to  support  costs  incurred  by
physicians  trained in primary or specialty tracks who thereafter estab-
lish or join practices in underserved communities, as determined by  the
commissioner.
  (ii)  After  distributions in accordance with subparagraph (i) of this
paragraph, all remaining funds shall be awarded to physicians to support
the cost of establishing or joining practices  in  underserved  communi-
ties,  as  determined  by  the  commissioner, and to hospitals and other
health care providers to recruit new physicians to provide  services  in
underserved communities, as determined by the commissioner.
  (iii)  In no case shall less than fifty percent of the funds available
pursuant to this  paragraph  be  distributed  to  general  hospitals  in
accordance with subparagraphs (i) and (ii) of this paragraph.
  (f) Study on physician workforce. Five hundred ninety thousand dollars
annually for the period January first, two thousand eight through Decem-
ber  thirty-first, two thousand ten, [and] one hundred forty-eight thou-
sand dollars for the period January first, two thousand  eleven  through
March  thirty-first, two thousand eleven, AND FIVE HUNDRED SIXTEEN THOU-
SAND DOLLARS EACH STATE FISCAL YEAR FOR  THE  PERIOD  APRIL  FIRST,  TWO
THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN, shall
be  set  aside  and reserved by the commissioner from the regional pools
established pursuant to subdivision two of this  section  and  shall  be
available  to  fund  a  study of physician workforce needs and solutions
including, but not limited to, an analysis  of  residency  programs  and
projected  physician  workforce  and  community  needs. The commissioner
shall enter into agreements with one or more  organizations  to  conduct
such study based on a request for proposal process.
  (g)  Diversity in medicine/post-baccalaureate program. Notwithstanding
any inconsistent provision of section one hundred twelve or one  hundred
sixty-three  of the state finance law or any other law, one million nine
hundred sixty thousand dollars annually for the  period  January  first,
two  thousand  eight  through  December  thirty-first, two thousand ten,
[and] four hundred ninety thousand dollars for the period January first,
two thousand eleven through March thirty-first, two thousand eleven, AND
ONE MILLION SEVEN HUNDRED THOUSAND DOLLARS EACH STATE  FISCAL  YEAR  FOR
THE  PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST,
TWO THOUSAND FOURTEEN, shall be set aside and reserved  by  the  commis-
sioner  from  the regional pools established pursuant to subdivision two
of this section and shall be available for distributions to the  Associ-
ated Medical Schools of New York to fund its diversity program including
existing  and  new  post-baccalaureate programs for minority and econom-

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ically disadvantaged  students  and  encourage  participation  from  all
medical  schools in New York. The associated medical schools of New York
shall report to the commissioner on an annual basis regarding the use of
funds  for  such  purpose  in  such  form and manner as specified by the
commissioner.
  S 26-a. Subdivision 7 of section 2807-m of the public health  law,  as
amended  by  section  99 of part C of chapter 58 of the laws of 2009, is
amended to read as follows:
  7. Notwithstanding any inconsistent provision of section  one  hundred
twelve  or one hundred sixty-three of the state finance law or any other
law, up to one million dollars for the period January first,  two  thou-
sand  through  December  thirty-first,  two  thousand,  one  million six
hundred thousand dollars annually for the  periods  January  first,  two
thousand  one  through  December  thirty-first,  two thousand eight, one
million five hundred thousand dollars annually for the  periods  January
first,  two  thousand  nine  through December thirty-first, two thousand
ten, [and] three hundred seventy-five thousand dollars  for  the  period
January first, two thousand eleven through March thirty-first, two thou-
sand  eleven, AND ONE MILLION THREE HUNDRED TWENTY THOUSAND DOLLARS EACH
STATE FISCAL YEAR FOR  THE  PERIOD  APRIL  FIRST,  TWO  THOUSAND  ELEVEN
THROUGH  MARCH  THIRTY-FIRST,  TWO THOUSAND FOURTEEN, shall be set aside
and reserved by the commissioner from  the  regional  pools  established
pursuant  to  subdivision two of this section and shall be available for
distributions to the New York state area health education center program
for  the  purpose  of  expanding  community-based  training  of  medical
students. In addition, one million dollars annually for the period Janu-
ary  first,  two thousand eight through December thirty-first, two thou-
sand ten, [and] two hundred fifty thousand dollars for the period  Janu-
ary  first, two thousand eleven through March thirty-first, two thousand
eleven, AND EIGHT HUNDRED EIGHTY THOUSAND DOLLARS EACH STATE FISCAL YEAR
FOR  THE  PERIOD  APRIL  FIRST,  TWO  THOUSAND  ELEVEN   THROUGH   MARCH
THIRTY-FIRST,  TWO THOUSAND FOURTEEN, shall be set aside and reserved by
the commissioner from the regional pools established pursuant to  subdi-
vision  two  of this section and shall be available for distributions to
the New York state area health education center program for the  purpose
of post-secondary training of health care professionals who will achieve
specific  program  outcomes within the New York state area health educa-
tion center program. The New York state  area  health  education  center
program  shall  report  to the commissioner on an annual basis regarding
the use of funds for each purpose in such form and manner  as  specified
by the commissioner.
  S  27.  Subdivision 4-c of section 2807-p of the public health law, as
amended by section 13-c of Part C of chapter 58 of the laws of 2009,  is
amended to read as follows:
  4-c. Notwithstanding any provision of law to the contrary, the commis-
sioner  shall  make additional payments for uncompensated care to volun-
tary non-profit diagnostic and treatment centers that are  eligible  for
distributions  under  subdivision  four of this section in the following
amounts: for the period June first, two thousand  six  through  December
thirty-first,  two  thousand  six,  in  the amount of seven million five
hundred thousand dollars, for the period  January  first,  two  thousand
seven  through  December thirty-first, two thousand seven, seven million
five hundred thousand dollars, for the period January first,  two  thou-
sand  eight  through  December  thirty-first,  two thousand eight, seven
million five hundred thousand dollars, for the period January first, two
thousand nine through December thirty-first, two thousand nine,  fifteen

S. 2809--A                         93                         A. 4009--A

million five hundred thousand dollars, for the period January first, two
thousand  ten  through  December  thirty-first,  two thousand ten, seven
million five hundred thousand dollars, FOR THE PERIOD JANUARY FIRST, TWO
THOUSAND ELEVEN THOUGH DECEMBER THIRTY-FIRST, TWO THOUSAND ELEVEN, SEVEN
MILLION FIVE HUNDRED THOUSAND DOLLARS, FOR THE PERIOD JANUARY FIRST, TWO
THOUSAND  TWELVE  THROUGH  DECEMBER  THIRTY-FIRST,  TWO THOUSAND TWELVE,
SEVEN MILLION FIVE HUNDRED THOUSAND  DOLLARS,  FOR  THE  PERIOD  JANUARY
FIRST, TWO THOUSAND THIRTEEN THROUGH DECEMBER THIRTY-FIRST, TWO THOUSAND
THIRTEEN, SEVEN MILLION FIVE HUNDRED THOUSAND DOLLARS, and for the peri-
od  January  first, two thousand [eleven] FOURTEEN through March thirty-
first, two thousand [eleven] FOURTEEN, in  the  amount  of  one  million
eight hundred seventy-five thousand dollars, provided, however, that for
periods  on and after January first, two thousand eight, such additional
payments shall be distributed to voluntary,  non-profit  diagnostic  and
treatment  centers  and  to  public  diagnostic and treatment centers in
accordance with paragraph (g) of subdivision four of  this  section.  In
the  event  that  federal  financial participation is available for rate
adjustments pursuant to this section, the commissioner shall  make  such
payments  as  additional  adjustments  to rates of payment for voluntary
non-profit diagnostic  and  treatment  centers  that  are  eligible  for
distributions  under subdivision four-a of this section in the following
amounts: for the period June first, two thousand  six  through  December
thirty-first,  two  thousand  six, fifteen million dollars in the aggre-
gate, and for the period January first, two thousand seven through  June
thirtieth,  two  thousand  seven,  seven  million  five hundred thousand
dollars in the aggregate. The amounts allocated pursuant to  this  para-
graph  shall  be  aggregated  with  and distributed pursuant to the same
methodology applicable to the amounts allocated to such  diagnostic  and
treatment  centers for such periods pursuant to subdivision four of this
section if federal financial participation is not available, or pursuant
to subdivision four-a of this section if federal financial participation
is available.  Notwithstanding section three  hundred  sixty-eight-a  of
the  social  services  law,  there  shall be no local share in a medical
assistance payment adjustment under this subdivision.
  S 28. Subdivision 3 and paragraph (a)  of  subdivision  4  of  section
2807-k  of  the public health law, as amended by section 15 of part C of
chapter 58 of the laws of 2010, are amended to read as follows:
  3. Each major public general hospital shall be allocated for  distrib-
ution  from the pools established pursuant to this section for each year
through December thirty-first, two thousand [eleven] FOURTEEN, an amount
equal to the amount allocated to such major public general hospital from
the regional pool  established  pursuant  to  subdivision  seventeen  of
section  twenty-eight  hundred  seven-c  of  this article for the period
January first, nineteen  hundred  ninety-six  through  December  thirty-
first,  nineteen hundred ninety-six, provided, however, that payments on
and after January first, two thousand  nine  shall  be  subject  to  the
provisions of subdivision five-a of this section.
  (a)  From  funds in the pool for each year, thirty-six million dollars
shall be reserved on an annual basis through December thirty-first,  two
thousand [eleven] FOURTEEN, for distribution as high need adjustments in
accordance with subdivision six of this section, provided, however, that
payments  on and after January first, two thousand nine shall be subject
to the provisions of subdivision five-a of this section.
  S 29. The opening paragraph, paragraph (a) of subdivision 1 and subdi-
vision 2 of section 2807-w of the  public  health  law,  as  amended  by

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section  14  of part C of chapter 58 of the laws of 2010, are amended to
read as follows:
  Funds  allocated  pursuant  to  paragraph  (p)  of  subdivision one of
section twenty-eight hundred seven-v of this article, shall be deposited
as authorized and used for the purpose  of  making  medicaid  dispropor-
tionate share payments of up to eighty-two million dollars on an annual-
ized  basis  pursuant  to subdivision twenty-one of section twenty-eight
hundred seven-c of this article, for the period January first, two thou-
sand through March thirty-first,  two  thousand  [eleven]  FOURTEEN,  in
accordance with the following:
  (a) Each eligible rural hospital shall receive one hundred forty thou-
sand  dollars  on an annualized basis for the periods January first, two
thousand through December thirty-first, two thousand [eleven]  FOURTEEN,
provided as a disproportionate share payment; provided, however, that if
such  payment pursuant to this paragraph exceeds a hospital's applicable
disproportionate share limit, then the total amount in  excess  of  such
limit  shall  be  provided as a nondisproportionate share payment in the
form of a grant directly  from  this  pool  without  allocation  to  the
special  revenue funds - other, indigent care fund - 068, or any succes-
sor fund or account, and provided further that payments for  periods  on
and  after  January  first,  two  thousand  nine shall be subject to the
provisions of subdivision five-a of section twenty-eight hundred seven-k
of this article;
  2. From the funds in the pool each year, thirty-six million dollars on
an annualized basis for the periods January first, two thousand  through
December  thirty-first, two thousand [eleven] FOURTEEN, of the funds not
distributed in accordance with subdivision one of this section, shall be
distributed in accordance with the formula set forth in subdivision  six
of  section  twenty-eight  hundred  seven-k  of  this article, provided,
however, that payments for periods on and after January first, two thou-
sand nine shall be subject to the provisions of  subdivision  five-a  of
section twenty-eight hundred seven-k of this article.
  S  30.  Subparagraph  (v) of paragraph (a) of subdivision 3 of section
2807-j of the public health law, as added by chapter 639 of the laws  of
1996, is amended to read as follows:
  (v)  revenue received from physician practice or faculty practice plan
discrete billings for [private practicing] physician services;
  S 31. Clause (D) of subparagraph (ii) of paragraph (b) of  subdivision
3 of section 2807-j of the public health law, as added by chapter 639 of
the laws of 1996, is amended to read as follows:
  (D)  revenue received from physician practice or faculty practice plan
discrete billings for [private practicing] physician services;
  S 32. Notwithstanding any inconsistent provision of law, rule or regu-
lation, for purposes of implementing the provisions of the public health
law and the social services law, references to titles XIX and XXI of the
federal social security act in the public  health  law  and  the  social
services  law  shall be deemed to include and also to mean any successor
titles thereto under the federal social security act.
  S 33. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the public health law, section 18 of chapter 2 of the laws of 1988,  and
18  NYCRR  505.14(h), as they relate to time frames for notice, approval
or certification of rates of payment, are hereby suspended  and  without
force or effect for purposes of implementing the provisions of this act.
  S 34.  Severability clause. If any clause, sentence, paragraph, subdi-
vision,  section  or  part of this act shall be adjudged by any court of

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competent jurisdiction to be invalid, such judgement shall  not  affect,
impair or invalidate the remainder thereof, but shall be confined in its
operation  to  the  clause, sentence, paragraph, subdivision, section or
part  thereof  directly involved in the controversy in which such judge-
ment shall have been rendered. It is hereby declared to be the intent of
the legislature that this act would  have  been  enacted  even  if  such
invalid provisions had not been included herein.
  S  35.  This  act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2011,  provided
that:
  (a)  any rules or regulations necessary to implement the provisions of
this act may be promulgated and any procedures, forms,  or  instructions
necessary  for such implementation may be adopted and issued on or after
the date this act shall have become a law;
  (b) this act shall not be construed to alter, change,  affect,  impair
or defeat any rights, obligations, duties or interests accrued, incurred
or conferred prior to the effective date of this act;
  (c) the commissioner of health and the superintendent of insurance and
any  appropriate  council may take any steps necessary to implement this
act prior to its effective date;
  (d) notwithstanding any inconsistent provision of the  state  adminis-
trative procedure act or any other provision of law, rule or regulation,
the  commissioner  of health and the superintendent of insurance and any
appropriate council is authorized to adopt or amend or promulgate on  an
emergency  basis  any  regulation  he  or she or such council determines
necessary to implement any provision of this act on its effective date;
  (e) the provisions of this act shall become effective  notwithstanding
the  failure  of  the  commissioner  of  health or the superintendent of
insurance or any council to adopt or  amend  or  promulgate  regulations
implementing this act;
  (f)  the amendments to sections 2807-j and 2807-s of the public health
law made by sections three, five, five-a, five-b, six, thirty and  thir-
ty-one,  respectively,  of  this  act shall not affect the expiration of
such sections and shall expire therewith; and
  (g) the amendments to paragraph (i-l)  of  subdivision  1  of  section
2807-v  of the public health law made by section eight of this act shall
not affect the repeal of such paragraph and  shall  be  deemed  repealed
therewith.

                                 PART D

  Section  1.  Paragraph  (e-1) of subdivision 12 of section 2808 of the
public health law, as separately amended by section 11  of  part  B  and
section  21  of  part D of chapter 58 of the laws of 2009, is amended to
read as follows:
  (e-1) Notwithstanding any inconsistent provision of law or regulation,
the commissioner shall provide,  in  addition  to  payments  established
pursuant  to  this  article  prior to application of this section, addi-
tional payments under the medical assistance program pursuant  to  title
eleven of article five of the social services law for non-state operated
public  residential health care facilities, including public residential
health care facilities located in the county of Nassau,  the  county  of
Westchester  and  the  county  of Erie, but excluding public residential
health care facilities operated by a town or city within  a  county,  in
aggregate  annual  amounts of up to one hundred fifty million dollars in
additional payments for the state fiscal year beginning April first, two

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thousand six and for the state fiscal year beginning  April  first,  two
thousand  seven and for the state fiscal year beginning April first, two
thousand eight and of up to three hundred million dollars in such aggre-
gate  annual  additional  payments  for  the state fiscal year beginning
April first, two thousand nine, and for the state fiscal year  beginning
April  first,  two  thousand ten and for the state fiscal year beginning
April first, two thousand eleven, AND EACH STATE FISCAL YEAR THEREAFTER.
The amount allocated to each eligible  public  residential  health  care
facility  for  this  period  shall  be  computed  in accordance with the
provisions of paragraph (f) of this subdivision, provided, however, that
patient days shall be utilized for such  computation  reflecting  actual
reported  data for two thousand three and each representative succeeding
year as applicable.
  S 2. Paragraph (a) of subdivision 1 of section 212 of chapter  474  of
the  laws of 1996, amending the education law and other laws relating to
rates for residential healthcare facilities, as amended by section 2  of
part B of chapter 58 of the laws of 2010, is amended to read as follows:
  (a) Notwithstanding any inconsistent provision of law or regulation to
the  contrary,  effective beginning August 1, 1996, for the period April
1, 1997 through March 31, 1998, April 1, 1998 for the  period  April  1,
1998  through  March  31,  1999, August 1, 1999, for the period April 1,
1999 through March 31, 2000, April 1, 2000, for the period April 1, 2000
through March 31, 2001, April 1, 2001, for  the  period  April  1,  2001
through  March  31,  2002,  April  1, 2002, for the period April 1, 2002
through March 31, 2003, and for the state fiscal year beginning April 1,
2005 through March 31, 2006, and for the  state  fiscal  year  beginning
April  1,  2006  through  March  31, 2007, and for the state fiscal year
beginning April 1, 2007 through March 31, 2008, and for the state fiscal
year beginning April 1, 2008 through March 31, 2009, and for  the  state
fiscal  year beginning April 1, 2009 through March 31, 2010, and for the
state fiscal year beginning April 1, 2010 through March  31,  2011,  AND
FOR  EACH  STATE  FISCAL  YEAR  THEREAFTER,  the department of health is
authorized to pay public general hospitals, as defined in subdivision 10
of section 2801 of the public health law, operated by the state  of  New
York  or by the state university of New York or by a county, which shall
not include a city with a population of over one million, of  the  state
of New York, and those public general hospitals located in the county of
Westchester,  the  county  of  Erie  or the county of Nassau, additional
payments for inpatient hospital services as medical assistance  payments
pursuant  to  title  11  of  article  5  of  the social services law for
patients eligible for federal financial participation under title XIX of
the federal social security act in medical assistance  pursuant  to  the
federal  laws  and regulations governing disproportionate share payments
to hospitals up to one hundred  percent  of  each  such  public  general
hospital's  medical  assistance  and  uninsured patient losses after all
other medical assistance, including disproportionate share  payments  to
such  public  general  hospital  for  1996,  1997, 1998, and 1999, based
initially for 1996 on reported 1994 reconciled data  as  further  recon-
ciled  to  actual  reported  1996  reconciled  data,  and for 1997 based
initially on reported 1995 reconciled  data  as  further  reconciled  to
actual  reported  1997  reconciled  data,  for  1998  based initially on
reported 1995 reconciled data as further reconciled to  actual  reported
1998  reconciled  data, for 1999 based initially on reported 1995 recon-
ciled data as further reconciled  to  actual  reported  1999  reconciled
data,  for  2000  based  initially  on  reported 1995 reconciled data as
further reconciled to actual reported 2000 data, for 2001 based initial-

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ly on reported 1995 reconciled data  as  further  reconciled  to  actual
reported 2001 data, for 2002 based initially on reported 2000 reconciled
data  as  further reconciled to actual reported 2002 data, and for state
fiscal  years  beginning  on  April 1, 2005, based initially on reported
2000 reconciled data as further reconciled to actual reported  data  for
2005,  and  for  state  fiscal  years  beginning on April 1, 2006, based
initially on reported 2000 reconciled  data  as  further  reconciled  to
actual  reported  data for 2006, for state fiscal years beginning on and
after April 1, 2007 through March 31, 2009, based initially on  reported
2000  reconciled  data as further reconciled to actual reported data for
2007 and 2008, respectively, for state fiscal  years  beginning  on  and
after  April  1, 2009, based initially on reported 2007 reconciled data,
adjusted for authorized Medicaid rate changes applicable  to  the  state
fiscal year, and as further reconciled to actual reported data for 2009,
for  state  fiscal  years  beginning  on  and after April 1, 2010, based
initially on reported reconciled data from the base year two years prior
to the payment year,  adjusted  for  authorized  Medicaid  rate  changes
applicable  to  the  state fiscal year, and further reconciled to actual
reported data from such payment year, and to actual  reported  data  for
each  respective succeeding year.  The payments may be added to rates of
payment or made as aggregate payments  to  an  eligible  public  general
hospital.
  S  3.  Section  11  of  chapter  884 of the laws of 1990, amending the
public health law relating to authorizing  bad  debt  and  charity  care
allowances  for certified home health agencies, as amended by section 14
of part B of chapter 58 of the laws of  2009,  is  amended  to  read  as
follows:
  S 11. This act shall take effect immediately and:
  (a) sections one and three shall expire on December 31, 1996,
  (b)  sections  four  through ten shall expire on June 30, [2011] 2013,
and
  (c) provided that the amendment to section 2807-b of the public health
law by section two of this act shall not affect the expiration  of  such
section  2807-b  as  otherwise  provided  by  law and shall be deemed to
expire therewith.
  S 4. Subdivision 2 of section 246 of chapter 81 of the laws  of  1995,
amending  the  public  health  law  and  other  laws relating to medical
reimbursement and welfare reform, as amended by section 15 of part B  of
chapter 58 of the laws of 2009, is amended to read as follows:
  2.  Sections  five,  seven  through nine, twelve through fourteen, and
eighteen of this act shall be deemed to have  been  in  full  force  and
effect  on  and  after  April  1, 1995 through March 31, 1999 and on and
after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
through March 31, 2003 and on and after April 1, 2003 through March  31,
2006  and  on  and after April 1, 2006 through March 31, 2007 and on and
after April 1, 2007 through March 31, 2009 and on  and  after  April  1,
2009  through  March 31, 2011 AND SECTIONS TWELVE, THIRTEEN AND FOURTEEN
OF THIS ACT SHALL BE DEEMED TO BE IN FULL FORCE AND EFFECT ON AND  AFTER
APRIL 1, 2011;
  S 5. Intentionally omitted.
  S 6. Intentionally omitted.
  S  7. Paragraphs (a) and (e) of subdivision 8 of section 2807-c of the
public health law, paragraph (a) as amended by chapter 731 of  the  laws
of  1993  and  paragraph (e) as added by chapter 81 of the laws of 1995,
are amended to read as follows:

S. 2809--A                         98                         A. 4009--A

  (a) Capital related inpatient expenses including but  not  limited  to
straight  line  depreciation  on  buildings  and  non-movable equipment,
accelerated depreciation on major movable equipment if requested by  the
hospital,  rentals  and  interest  on  capital  debt  (or  for hospitals
financed  pursuant  to  article  twenty-eight-B  of  this  chapter, such
expenses, including amortization in lieu of depreciation, as  determined
pursuant  to  the reimbursement regulations promulgated pursuant to such
article and article twenty-eight of this chapter), [and excluding  costs
related  to  services  provided  to  beneficiaries of title XVIII of the
federal social security act (medicare),] shall be included in  rates  of
payment  determined pursuant to this section based on a budget for capi-
tal related inpatient expenses and  subsequently  reconciled  to  actual
expenses  and  statistics  through appropriate audit procedures. General
hospitals shall submit to the commissioner, at least one hundred  twenty
days  prior  to  the  commencement  of  each year, a schedule of capital
related inpatient expenses for the forthcoming year. Any capital expend-
iture which requires or required approval pursuant to this article  must
have received such approval for any capital related expense generated by
such  capital  expenditure to be included in rates of payment. The basis
for determining capital related inpatient expenses shall be  the  lesser
of  actual  cost  or  the  final  amount  specifically  approved for the
construction of the capital asset. The submitted budget may include  the
capital  related  inpatient  expenses for all existing capital assets as
well as estimates of capital  related  inpatient  expenses  for  capital
assets  to be acquired or placed in use prior to the commencement of the
rate year or during the rate year provided all required  approvals  have
been obtained.
  The  council shall adopt, with the approval of the commissioner, regu-
lations to:
  (i) identify by type the eligible capital related inpatient expenses;
  (ii) safeguard the future financial viability of voluntary, non-profit
general hospitals by requiring  funding  of  inpatient  depreciation  on
building and fixed and movable equipment;
  (iii)  provide  authorization  to  adjust inpatient rates by advancing
payment of depreciation as needed, in instances of capital debt  related
financial distress of voluntary, non-profit general hospitals; and
  (iv) provide a methodology for the reimbursement treatment of sales.
  (e)  Notwithstanding  any  inconsistent provision of this subdivision,
commencing April first, nineteen hundred ninety-five, when a factor  for
reconciliation  of budgeted capital related inpatient expenses to actual
capital related inpatient expenses [excluding costs related to  services
provided  to beneficiaries of title XVIII of the federal social security
act (medicare)] for a prior year is  included  in  the  capital  related
inpatient  expenses  component of rates of payment, such capital related
inpatient expenses component of rates of payment shall be reduced by the
commissioner by the difference between the  reconciled  capital  related
inpatient expenses included in rates of payment determined in accordance
with paragraphs (a), (b) and (c) of this subdivision for such prior year
and  capital  related  inpatient expenses for such prior year calculated
[based on a determination of costs related to services provided to bene-
ficiaries of title XVIII of the federal social security act  (medicare)]
based  on  the  hospital's  average  capital  related inpatient expenses
computed on a per diem basis.
  S 8. Paragraph (d) of subdivision 8 of section 2807-c  of  the  public
health law is REPEALED.

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  S  9.  Section  194  of  chapter 474 of the laws of 1996, amending the
education law and other laws relating to rates  for  residential  health
care facilities, as amended by section 24 of part B of chapter 58 of the
laws of 2009, is amended to read as follows:
  S  194.  1. Notwithstanding any inconsistent provision of law or regu-
lation, the trend factors used to project reimbursable  operating  costs
to the rate period for purposes of determining rates of payment pursuant
to  article  28  of  the  public  health law for residential health care
facilities for reimbursement of inpatient services provided to  patients
eligible  for  payments made by state governmental agencies on and after
April 1, 1996 through March 31, 1999 and for payments made on and  after
July  1,  1999  through  March  31,  2000 and on and after April 1, 2000
through March 31, 2003 and on and after April 1, 2003 through March  31,
2007  and  on  and after April 1, 2007 through March 31, 2009 and on and
after April 1, 2009 through March 31, 2011 AND ON  AND  AFTER  APRIL  1,
2011  shall  reflect  no trend factor projections or adjustments for the
period April 1, 1996, through March 31, 1997.
  2. The commissioner of health shall adjust such rates  of  payment  to
reflect  the  exclusion pursuant to this section of such specified trend
factor projections or adjustments.
  S 10. Subdivision 1 of section 89-a of part C of  chapter  58  of  the
laws  of  2007, amending the social services law and other laws relating
to enacting the major components of legislation necessary  to  implement
the  health  and  mental  hygiene  budget for the 2007-2008 state fiscal
year, as amended by section 25 of part B of chapter 58 of  the  laws  of
2009, is amended to read as follows:
  1.  Notwithstanding  paragraph (c) of subdivision 10 of section 2807-c
of the public health law and section 21 of chapter  1  of  the  laws  of
1999,  as  amended, and any other inconsistent provision of law or regu-
lation to the contrary,  in  determining  rates  of  payments  by  state
governmental agencies effective for services provided beginning April 1,
2006,  through  March  31,  2009, and on and after April 1, 2009 through
March 31, 2011, AND ON AND AFTER APRIL 1, 2011 for inpatient and  outpa-
tient  services provided by general hospitals and for inpatient services
and outpatient adult day health care services  provided  by  residential
health  care facilities pursuant to article 28 of the public health law,
the commissioner of health shall apply a trend factor projection of  two
and twenty-five hundredths percent attributable to the period January 1,
2006  through  December  31,  2006,  and  on  and after January 1, 2007,
provided, however, that on reconciliation of such trend factor  for  the
period  January  1, 2006 through December 31, 2006 pursuant to paragraph
(c) of subdivision 10 of section 2807-c of the public health  law,  such
trend  factor  shall  be the final US Consumer Price Index (CPI) for all
urban consumers, as published by the US Department of Labor,  Bureau  of
Labor Statistics less twenty-five hundredths of a percentage point.
  S  11.  Paragraph  (f) of subdivision 1 of section 64 of chapter 81 of
the laws of 1995, amending the public health law and other laws relating
to medical reimbursement and welfare reform, as amended by section 26 of
part B of chapter 58 of the laws of 2009, is amended to read as follows:
  (f) Prior to February 1, 2001, February 1,  2002,  February  1,  2003,
February  1, 2004, February 1, 2005, February 1, 2006, February 1, 2007,
February 1, 2008, February 1, 2009, February 1, 2010, [and] February  1,
2011,  FEBRUARY 1, 2012, AND FEBRUARY 1, 2013 the commissioner of health
shall calculate the result of the statewide total of residential  health
care  facility  days of care provided to beneficiaries of title XVIII of
the federal social security act (medicare), divided by the sum  of  such

S. 2809--A                         100                        A. 4009--A

days  of  care  plus  days  of  care  provided to residents eligible for
payments pursuant to title 11 of article 5 of the  social  services  law
minus  the  number of days provided to residents receiving hospice care,
expressed  as a percentage, for the period commencing January 1, through
November 30, of the prior year respectively, based on such data for such
period. This value shall be called the 2000,  2001,  2002,  2003,  2004,
2005, 2006, 2007, 2008, 2009, 2010 [and], 2011, 2012, AND 2013 statewide
target percentage respectively.
  S  12.  Subparagraph (ii) of paragraph (b) of subdivision 3 of section
64 of chapter 81 of the laws of 1995, amending the public health law and
other laws relating to medical  reimbursement  and  welfare  reform,  as
amended  by  section  27 of part B of chapter 58 of the laws of 2009, is
amended to read as follows:
  (ii) If the 1997, 1998, 2000, 2001,  2002,  2003,  2004,  2005,  2006,
2007,  2008,  2009,  2010  [and],  2011, 2012, AND 2013 statewide target
percentages are not for each year at least three percentage points high-
er than the statewide base percentage, the commissioner of health  shall
determine  the  percentage  by which the statewide target percentage for
each year is not at least three percentage points higher than the state-
wide base percentage. The percentage calculated pursuant to  this  para-
graph  shall  be  called  the  1997, 1998, 2000, 2001, 2002, 2003, 2004,
2005, 2006, 2007, 2008, 2009, 2010 [and], 2011, 2012, AND 2013 statewide
reduction percentage respectively. If the 1997, 1998, 2000, 2001,  2002,
2003,  2004,  2005,  2006, 2007, 2008, 2009, 2010 [and], 2011, 2012, AND
2013 statewide target percentage for the respective  year  is  at  least
three  percentage  points higher than the statewide base percentage, the
statewide reduction percentage for the respective year shall be zero.
  S 13.  Subparagraph (iii) of paragraph (b) of subdivision 4 of section
64 of chapter 81 of the laws of 1995, amending the public health law and
other laws relating to medical  reimbursement  and  welfare  reform,  as
amended  by  section  28 of part B of chapter 58 of the laws of 2009, is
amended to read as follows:
  (iii) The 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007,  2008,
2009,  2010  [and],  2011, 2012, AND 2013 statewide reduction percentage
shall be multiplied by one hundred two million dollars  respectively  to
determine  the  1998,  2000,  2001,  2002, 2003, 2004, 2005, 2006, 2007,
2008, 2009,  2010  [and],  2011,  2012,  AND  2013  statewide  aggregate
reduction  amount.  If  the  1998  and the 2000, 2001, 2002, 2003, 2004,
2005, 2006, 2007, 2008, 2009, 2010 [and], 2011, 2012, AND 2013 statewide
reduction percentage shall be zero respectively, there shall be no 1998,
2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010  [and],
2011, 2012, AND 2013 reduction amount.
  S  14.  Paragraph  (b) of subdivision 5 of section 64 of chapter 81 of
the laws of 1995, amending the public health law and other laws relating
to medical reimbursement and welfare reform, as amended by section 29 of
part B of chapter 58 of the laws of 2009, is amended to read as follows:
  (b) The 1996, 1997, 1998, 1999, 2000, 2001, 2002,  2003,  2004,  2005,
2006,  2007,  2008,  2009,  2010  [and],  2011, 2012, AND 2013 statewide
aggregate reduction amounts shall for each  year  be  allocated  by  the
commissioner of health among residential health care facilities that are
eligible  to  provide  services  to  beneficiaries of title XVIII of the
federal social  security  act  (medicare)  and  residents  eligible  for
payments pursuant to title 11 of article 5 of the social services law on
the  basis  of  the  extent  of each facility's failure to achieve a two
percentage points increase  in  the  1996  target  percentage,  a  three
percentage  point  increase  in  the 1997, 1998, 2000, 2001, 2002, 2003,

S. 2809--A                         101                        A. 4009--A

2004, 2005, 2006, 2007, 2008, 2009, 2010 [and],  2011,  2012,  AND  2013
target percentage and a two and one-quarter percentage point increase in
the  1999 target percentage for each year, compared to the base percent-
age,  calculated on a facility specific basis for this purpose, compared
to the statewide total of the  extent  of  each  facility's  failure  to
achieve  a  two  percentage  points  increase  in  the  1996 and a three
percentage point increase in the  1997  and  a  three  percentage  point
increase in the 1998 and a two and one-quarter percentage point increase
in  the  1999 target percentage and a three percentage point increase in
the 2000, 2001, 2002, 2003, 2004, 2005, 2006,  2007,  2008,  2009,  2010
[and],  2011,  2012,  AND  2013  target  percentage compared to the base
percentage. These amounts shall be called the 1996,  1997,  1998,  1999,
2000,  2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010 [and],
2011, 2012, AND 2013 facility specific reduction amounts respectively.
  S 14-a. Section 228 of chapter 474 of the laws of 1996,  amending  the
education  law  and  other laws relating to rates for residential health
care facilities, as amended by section 30 of part B of chapter 58 of the
laws of 2009, is amended to read as follows:
  S 228. 1. Definitions. (a) Regions,  for  purposes  of  this  section,
shall  mean  a downstate region to consist of Kings, New York, Richmond,
Queens, Bronx, Nassau and Suffolk counties  and  an  upstate  region  to
consist  of  all  other New York state counties. A certified home health
agency or long term home health care program shall  be  located  in  the
same county utilized by the commissioner of health for the establishment
of rates pursuant to article 36 of the public health law.
  (b)  Certified  home  health  agency  (CHHA)  shall  mean such term as
defined in section 3602 of the public health law.
  (c) Long term home health care program (LTHHCP) shall mean  such  term
as defined in subdivision 8 of section 3602 of the public health law.
  (d) Regional group shall mean all those CHHAs and LTHHCPs, respective-
ly, located within a region.
  (e)  Medicaid  revenue percentage, for purposes of this section, shall
mean CHHA and LTHHCP  revenues  attributable  to  services  provided  to
persons  eligible  for payments pursuant to title 11 of article 5 of the
social services law divided by such revenues plus CHHA and LTHHCP reven-
ues attributable to services provided to beneficiaries of Title XVIII of
the federal social security act (medicare).
  (f) Base period, for purposes of this  section,  shall  mean  calendar
year 1995.
  (g) Target period. For purposes of this section, the 1996 target peri-
od  shall  mean  August  1, 1996 through March 31, 1997, the 1997 target
period shall mean January 1, 1997 through November 30,  1997,  the  1998
target  period shall mean January 1, 1998 through November 30, 1998, the
1999 target period shall mean January 1, 1999 through November 30, 1999,
the 2000 target period shall mean January 1, 2000 through  November  30,
2000, the 2001 target period shall mean January 1, 2001 through November
30,  2001,  the  2002  target  period shall mean January 1, 2002 through
November 30, 2002, the 2003 target period shall  mean  January  1,  2003
through  November 30, 2003, the 2004 target period shall mean January 1,
2004 through November 30, 2004, and the 2005 target  period  shall  mean
January  1, 2005 through November 30, 2005, the 2006 target period shall
mean January 1, 2006 through November 30,  2006,  and  the  2007  target
period shall mean January 1, 2007 through November 30, 2007 and the 2008
target  period shall mean January 1, 2008 through November 30, 2008, and
the 2009 target period shall mean January 1, 2009 through  November  30,
2009  and  the  2010  target  period  shall mean January 1, 2010 through

S. 2809--A                         102                        A. 4009--A

November 30, 2010 and the 2011 target period shall mean January 1,  2011
through  November 30, 2011 AND THE 2012 TARGET PERIOD SHALL MEAN JANUARY
1, 2012 THROUGH NOVEMBER 30, 2012 AND THE 2013 TARGET PERIOD SHALL  MEAN
JANUARY 1, 2013 THROUGH NOVEMBER 30, 2013.
  2.  (a) Prior to February 1, 1997, for each regional group the commis-
sioner of health shall calculate the 1996 medicaid  revenue  percentages
for the period commencing August 1, 1996 to the last date for which such
data is available and reasonably accurate.
  (b)  Prior  to  February  1, 1998, prior to February 1, 1999, prior to
February 1, 2000, prior to February 1, 2001, prior to February 1,  2002,
prior  to February 1, 2003, prior to February 1, 2004, prior to February
1, 2005, prior to February 1, 2006, prior to February 1, 2007, prior  to
February  1,  2008, prior to February 1, 2009, prior to February 1, 2010
[and], prior to February 1, 2011, PRIOR TO FEBRUARY 1, 2012 AND PRIOR TO
FEBRUARY 1, 2013 for each regional  group  the  commissioner  of  health
shall  calculate  the  prior year's medicaid revenue percentages for the
period commencing January 1 through November 30 of such prior year.
  3. By September 15, 1996, for each regional group the commissioner  of
health shall calculate the base period medicaid revenue percentage.
  4.  (a)  For  each  regional  group,  the 1996 target medicaid revenue
percentage shall be calculated by subtracting the 1996 medicaid  revenue
reduction percentages from the base period medicaid revenue percentages.
The  1996  medicaid  revenue  reduction  percentage, taking into account
regional and program differences in utilization of medicaid and medicare
services, for the following regional groups shall be equal to:
  (i) one and one-tenth percentage points for CHHAs located  within  the
downstate region;
  (ii)  six-tenths  of one percentage point for CHHAs located within the
upstate region;
  (iii) one and eight-tenths percentage points for LTHHCPs located with-
in the downstate region; and
  (iv) one and seven-tenths percentage points for LTHHCPs located within
the upstate region.
  (b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004,  2005,  2006,  2007,
2008,  2009,  2010  [and], 2011, 2012, AND 2013 for each regional group,
the target medicaid revenue percentage for the respective year shall  be
calculated   by  subtracting  the  respective  year's  medicaid  revenue
reduction percentage from the base period medicaid  revenue  percentage.
The  medicaid  revenue reduction percentages for 1997, 1998, 2000, 2001,
2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010 [and], 2011,  2012,
AND  2013 taking into account regional and program differences in utili-
zation of medicaid and medicare services,  for  the  following  regional
groups shall be equal to for each such year:
  (i)  one  and one-tenth percentage points for CHHAs located within the
downstate region;
  (ii) six-tenths of one percentage point for CHHAs located  within  the
upstate region;
  (iii) one and eight-tenths percentage points for LTHHCPs located with-
in the downstate region; and
  (iv) one and seven-tenths percentage points for LTHHCPs located within
the upstate region.
  (c) For each regional group, the 1999 target medicaid revenue percent-
age  shall  be  calculated  by  subtracting  the  1999  medicaid revenue
reduction percentage from the base period medicaid  revenue  percentage.
The  1999  medicaid  revenue  reduction percentages, taking into account

S. 2809--A                         103                        A. 4009--A

regional and program differences in utilization of medicaid and medicare
services, for the following regional groups shall be equal to:
  (i)  eight  hundred  twenty-five  thousandths (.825) of one percentage
point for CHHAs located within the downstate region;
  (ii) forty-five hundredths (.45) of one  percentage  point  for  CHHAs
located within the upstate region;
  (iii)  one  and  thirty-five  hundredths  percentage points (1.35) for
LTHHCPs located within the downstate region; and
  (iv) one and two hundred seventy-five  thousandths  percentage  points
(1.275) for LTHHCPs located within the upstate region.
  5.  (a) For each regional group, if the 1996 medicaid revenue percent-
age is not equal to or  less  than  the  1996  target  medicaid  revenue
percentage,  the  commissioner of health shall compare the 1996 medicaid
revenue percentage to the 1996 target  medicaid  revenue  percentage  to
determine  the  amount  of the shortfall which, when divided by the 1996
medicaid  revenue  reduction  percentage,  shall  be  called  the   1996
reduction  factor.  These  amounts, expressed as a percentage, shall not
exceed one hundred percent. If the 1996 medicaid revenue  percentage  is
equal  to  or less than the 1996 target medicaid revenue percentage, the
1996 reduction factor shall be zero.
  (b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003,  2004,  2005,  2006,
2007,  2008,  2009,  2010  [and], 2011, 2012, AND 2013 for each regional
group, if the medicaid revenue percentage for the respective year is not
equal to or less than the target medicaid revenue  percentage  for  such
respective  year,  the commissioner of health shall compare such respec-
tive year's medicaid revenue percentage to such respective year's target
medicaid revenue percentage to determine the  amount  of  the  shortfall
which,  when divided by the respective year's medicaid revenue reduction
percentage, shall be called the reduction  factor  for  such  respective
year.  These  amounts,  expressed  as a percentage, shall not exceed one
hundred percent. If the medicaid revenue  percentage  for  a  particular
year is equal to or less than the target medicaid revenue percentage for
that year, the reduction factor for that year shall be zero.
  6.  (a)  For  each  regional group, the 1996 reduction factor shall be
multiplied by the following amounts to determine each  regional  group's
applicable 1996 state share reduction amount:
  (i) two million three hundred ninety thousand dollars ($2,390,000) for
CHHAs located within the downstate region;
  (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
within the upstate region;
  (iii)  one  million  two hundred seventy thousand dollars ($1,270,000)
for LTHHCPs located within the downstate region; and
  (iv) five hundred  ninety  thousand  dollars  ($590,000)  for  LTHHCPs
located within the upstate region.
  For  each regional group reduction, if the 1996 reduction factor shall
be zero, there shall be no 1996 state share reduction amount.
  (b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004,  2005,  2006,  2007,
2008,  2009,  2010  [and], 2011, 2012, AND 2013 for each regional group,
the reduction factor for the respective year shall be multiplied by  the
following  amounts  to  determine each regional group's applicable state
share reduction amount for such respective year:
  (i) two million three hundred ninety thousand dollars ($2,390,000) for
CHHAs located within the downstate region;
  (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
within the upstate region;

S. 2809--A                         104                        A. 4009--A

  (iii) one million two hundred seventy  thousand  dollars  ($1,270,000)
for LTHHCPs located within the downstate region; and
  (iv)  five  hundred  ninety  thousand  dollars  ($590,000) for LTHHCPs
located within the upstate region.
  For each regional group reduction,  if  the  reduction  factor  for  a
particular  year  shall be zero, there shall be no state share reduction
amount for such year.
  (c) For each regional group, the 1999 reduction factor shall be multi-
plied by the following amounts to determine each regional group's appli-
cable 1999 state share reduction amount:
  (i) one million seven hundred ninety-two thousand five hundred dollars
($1,792,500) for CHHAs located within the downstate region;
  (ii) five hundred sixty-two thousand five hundred  dollars  ($562,500)
for CHHAs located within the upstate region;
  (iii)  nine hundred fifty-two thousand five hundred dollars ($952,500)
for LTHHCPs located within the downstate region; and
  (iv) four hundred forty-two thousand five hundred  dollars  ($442,500)
for LTHHCPs located within the upstate region.
  For  each regional group reduction, if the 1999 reduction factor shall
be zero, there shall be no 1999 state share reduction amount.
  7. (a) For each regional group, the 1996 state share reduction  amount
shall be allocated by the commissioner of health among CHHAs and LTHHCPs
on  the  basis  of  the  extent  of  each CHHA's and LTHHCP's failure to
achieve the 1996 target medicaid revenue  percentage,  calculated  on  a
provider  specific  basis utilizing revenues for this purpose, expressed
as a proportion of the total of each  CHHA's  and  LTHHCP's  failure  to
achieve  the 1996 target medicaid revenue percentage within the applica-
ble regional group. This proportion shall be multiplied by the  applica-
ble  1996 state share reduction amount calculation pursuant to paragraph
(a) of subdivision 6 of this section. This amount shall  be  called  the
1996 provider specific state share reduction amount.
  (b)  For  1997,  1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
2007, 2008, 2009, 2010 [and], 2011, 2012, AND  2013  for  each  regional
group, the state share reduction amount for the respective year shall be
allocated  by  the commissioner of health among CHHAs and LTHHCPs on the
basis of the extent of each CHHA's and LTHHCP's failure to  achieve  the
target  medicaid  revenue percentage for the applicable year, calculated
on a provider  specific  basis  utilizing  revenues  for  this  purpose,
expressed as a proportion of the total of each CHHA's and LTHHCP's fail-
ure to achieve the target medicaid revenue percentage for the applicable
year  within  the  applicable  regional  group. This proportion shall be
multiplied by the applicable year's state share reduction amount  calcu-
lation  pursuant  to  paragraph  (b)  or  (c)  of  subdivision 6 of this
section. This amount shall be called the provider specific  state  share
reduction amount for the applicable year.
  8.  (a)  The 1996 provider specific state share reduction amount shall
be due to the state from each CHHA and LTHHCP and may be recouped by the
state by March 31, 1997 in a lump sum amount or  amounts  from  payments
due  to  the  CHHA  and  LTHHCP pursuant to title 11 of article 5 of the
social services law.
  (b) The provider specific state share reduction amount for 1997, 1998,
1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008,  2009,  2010
[and], 2011, 2012, AND 2013 respectively, shall be due to the state from
each  CHHA  and LTHHCP and each year the amount due for such year may be
recouped by the state by March 31 of the following year in  a  lump  sum

S. 2809--A                         105                        A. 4009--A

amount  or  amounts from payments due to the CHHA and LTHHCP pursuant to
title 11 of article 5 of the social services law.
  9.  CHHAs  and  LTHHCPs shall submit such data and information at such
times as the commissioner of health may require  for  purposes  of  this
section.  The  commissioner of health may use data available from third-
party payors.
  10. On or about June 1, 1997, for each regional group the commissioner
of health shall calculate for the period August 1,  1996  through  March
31,  1997  a  medicaid  revenue  percentage, a reduction factor, a state
share reduction amount, and a provider specific  state  share  reduction
amount  in  accordance with the methodology provided in paragraph (a) of
subdivision 2, paragraph (a) of subdivision 5, paragraph (a) of subdivi-
sion 6 and paragraph (a) of subdivision 7 of this section. The  provider
specific state share reduction amount calculated in accordance with this
subdivision  shall be compared to the 1996 provider specific state share
reduction amount calculated in accordance with paragraph (a) of subdivi-
sion 7 of this section. Any amount in excess of the amount determined in
accordance with paragraph (a) of subdivision 7 of this section shall  be
due  to  the  state  from  each  CHHA  and LTHHCP and may be recouped in
accordance with paragraph (a) of subdivision 8 of this section.  If  the
amount  is  less than the amount determined in accordance with paragraph
(a) of subdivision 7 of this section, the difference shall  be  refunded
to  the  CHHA and LTHHCP by the state no later than July 15, 1997. CHHAs
and LTHHCPs shall submit data for the  period  August  1,  1996  through
March 31, 1997 to the commissioner of health by April 15, 1997.
  11.  If  a  CHHA  or  LTHHCP  fails  to submit data and information as
required for purposes of this section:
  (a) such CHHA or LTHHCP shall be presumed to have no decrease in medi-
caid revenue percentage between  the  applicable  base  period  and  the
applicable  target  period  for purposes of the calculations pursuant to
this section; and
  (b) the commissioner of health shall reduce the current rate  paid  to
such  CHHA  and  such  LTHHCP by state governmental agencies pursuant to
article 36 of the public health law by one percent for a  period  begin-
ning on the first day of the calendar month following the applicable due
date  as  established by the commissioner of health and continuing until
the last day of the calendar month in which the required data and infor-
mation are submitted.
  12. The commissioner of health shall inform in writing the director of
the budget and the chair of the senate finance committee and  the  chair
of  the  assembly  ways and means committee of the results of the calcu-
lations pursuant to this section.
  S 15. Subdivision 5-a of section 246 of chapter  81  of  the  laws  of
1995,  amending the public health law and other laws relating to medical
reimbursement and welfare reform, as amended by section 32 of part B  of
chapter 58 of the laws of 2009, is amended to read as follows:
  5-a.  Section sixty-four-a of this act shall be deemed to have been in
full force and effect on and after April 1, 1995 through March 31,  1999
and  on  and  after July 1, 1999 through March 31, 2000 and on and after
April 1, 2000 through March 31, 2003 and on  and  after  April  1,  2003
through March 31, 2007, and on and after April 1, 2007 through March 31,
2009,  and on and after April 1, 2009 through March 31, 2011, AND ON AND
AFTER APRIL 1, 2011;
  S 16. Section 64-b of chapter 81 of the laws  of  1995,  amending  the
public  health  law and other laws relating to medical reimbursement and

S. 2809--A                         106                        A. 4009--A

welfare reform, as amended by section 33 of part B of chapter 58 of  the
laws of 2009, is amended to read as follows:
  S  64-b.  Notwithstanding  any  inconsistent  provision  of  law,  the
provisions of subdivision 7 of section 3614 of the public health law, as
amended, shall remain and be in full force and effect on April  1,  1995
through March 31, 1999 and on July 1, 1999 through March 31, 2000 and on
and after April 1, 2000 through March 31, 2003 and on and after April 1,
2003  through  March  31,  2007,  and on and after April 1, 2007 through
March 31, 2009, and on and after April 1, 2009 through March  31,  2011,
AND ON AND AFTER APRIL 1, 2011.
  S  17. Subdivision 1 of section 20 of chapter 451 of the laws of 2007,
amending the public health law, the social services law and  the  insur-
ance   law,   relating  to  providing  enhanced  consumer  and  provider
protections, as amended by section 38 of part B of  chapter  58  of  the
laws of 2009, is amended to read as follows:
  1.  sections  four, eleven and thirteen  of this act shall take effect
immediately and shall expire and be  deemed  repealed  June  30,  [2011]
2013;
  S  18. The opening paragraph of subdivision 7-a of section 3614 of the
public health law, as amended by section 46 of part B of chapter  58  of
the laws of 2009, is amended to read as follows:
  Notwithstanding  any  inconsistent provision of law or regulation, for
the purposes of establishing rates of payment by  governmental  agencies
for  long term home health care programs for the period April first, two
thousand five, through December thirty-first, two thousand five, and for
the period January first, two thousand six through  March  thirty-first,
two  thousand  seven,  and  on and after April first, two thousand seven
through March thirty-first, two thousand nine, and on  and  after  April
first,  two thousand nine through March thirty-first, two thousand elev-
en, AND ON AND AFTER APRIL FIRST, TWO THOUSAND ELEVEN, the  reimbursable
base  year  administrative  and  general costs of a provider of services
shall not exceed the statewide average of total reimbursable  base  year
administrative and general costs of such providers of services.
  S  19.  Subdivisions 3, 4 and 5 of section 47 of chapter 2 of the laws
of 1998, amending the public health  law  and  other  laws  relating  to
expanding  the  child health insurance plan, as amended by section 24 of
part A of chapter 58 of the  laws  of  2007,  are  amended  to  read  as
follows:
  3.  section  six  of  this  act  shall  take  effect  January 1, 1999;
[provided, however, that subparagraph (iii) of paragraph (c) of subdivi-
sion 9 of section 2510 of the public health law, as added by  this  act,
shall expire on July 1, 2011;]
  4.  sections  two, three, four, seven, eight, nine, fourteen, fifteen,
sixteen, eighteen, eighteen-a, twenty-three,  twenty-four,  and  twenty-
nine  of this act shall take effect January 1, 1999 [and shall expire on
July 1, 2011]; section twenty-five of this  act  shall  take  effect  on
January 1, 1999 and shall expire on April 1, 2005;
  5.  section  twelve  of  this  act  shall take effect January 1, 1999;
[provided, however, paragraphs (g) and (h) of subdivision 2  of  section
2511 of the public health law, as added by such section, shall expire on
July 1, 2011;]
  S  20.  Section  10  of  chapter 649 of the laws of 1996, amending the
public health law, the mental hygiene law and the  social  services  law
relating  to  authorizing  the  establishment of special needs plans, as
amended by section 63 of part C of chapter 58 of the laws  of  2008,  is
amended to read as follows:

S. 2809--A                         107                        A. 4009--A

  S  10.  This  act shall take effect immediately and shall be deemed to
have been in full force and effect on and after July 1, 1996; [provided,
however, that sections one, two and three of this act shall  expire  and
be  deemed repealed on March 31, 2012] provided, however that the amend-
ments  to  section 364-j of the social services law made by section four
of this act shall not affect the expiration of such section and shall be
deemed to expire therewith and provided, further, that the provisions of
subdivisions 8, 9 and 10 of section 4401 of the public  health  law,  as
added  by  section  one of this act; section 4403-d of the public health
law as added by section two of this act and the  provisions  of  section
seven  of this act, except for the provisions relating to the establish-
ment of no more than twelve comprehensive HIV special needs plans, shall
expire and be deemed repealed on July 1, 2000.
  S 21. Subdivision (i-1) of section 79 of part C of chapter 58  of  the
laws of 2008, amending the social services law and the public health law
relating to adjustments of rates, is amended to read as follows:
  (i-1)  section  thirty-one-a of this act shall be deemed repealed July
1, [2011] 2014;
  S 22. Section 2 of chapter 535 of  the  laws  of  1983,  amending  the
social  services  law  relating  to eligibility of certain enrollees for
medical assistance, as amended by section 69 of part C of chapter 58  of
the laws of 2008, is amended to read as follows:
  S  2. This act shall take effect immediately [and shall remain in full
force and effect through March 31, 2012].
  S 23. Subdivision 12 of section 246 of chapter 81 of the laws of 1995,
amending the public health  law  and  other  laws  relating  to  medical
reimbursement  and welfare reform, as amended by section 56 of part C of
chapter 58 of the laws of 2008, is amended to read as follows:
  12. Sections one hundred five-b through one hundred five-f of this act
shall expire March 31, [2011] 2013.
  S 24. Section 4 of chapter 19 of the laws of 1998, amending the social
services law relating to limiting the method of payment for prescription
drugs under the medical assistance program, as amended by section 68  of
part C of chapter 58 of the laws of 2008, is amended to read as follows:
  S  4. This act shall take effect 120 days after it shall have become a
law and shall expire and be deemed repealed March 31, [2012] 2014.
  S 25. Section 11 of chapter 710 of the  laws  of  1988,  amending  the
social services law and the education law relating to medical assistance
eligibility  of  certain  persons and providing for managed medical care
demonstration programs, as amended by section 66 of part C of chapter 58
of the laws of 2008, is amended to read as follows:
  S 11.  This  act  shall  take  effect  immediately;  except  that  the
provisions  of sections one, two, three, four, eight and ten of this act
shall take effect on the ninetieth day after it shall have become a law;
and except that the provisions of sections five, six and seven  of  this
act  shall  take effect January 1, 1989; and except that effective imme-
diately, the addition, amendment and/or repeal of any rule or regulation
necessary for the implementation of this act on its effective  date  are
authorized  and  directed  to  be  made  and completed on or before such
effective date; provided, however, that [the provisions of section 364-j
of the social services law, as added by section one of  this  act  shall
expire  and  be  deemed  repealed  on  and  after  March  31, 2012,] the
provisions of section 364-k of the social  services  law,  as  added  by
section  two  of  this act, except subdivision 10 of such section, shall
expire and be deemed repealed on and after  January  1,  1994,  and  the
provisions  of  subdivision  10  of section 364-k of the social services

S. 2809--A                         108                        A. 4009--A

law, as added by section two of this act, shall  expire  and  be  deemed
repealed on January 1, 1995.
  S  26.  Subdivision  (c)  of  section 62 of chapter 165 of the laws of
1991, amending the public health law and other laws relating  to  estab-
lishing  payments  for  medical  assistance, as amended by section 67 of
part C of chapter 58 of the laws of 2008, is amended to read as follows:
  (c) [section 364-j of the social services law, as amended  by  section
eight  of  this  act  and  subdivision  6 of section 367-a of the social
services law as added by section twelve of this act shall expire and  be
deemed repealed on March 31, 2012 and provided further, that] the amend-
ments to the provisions of section 364-j of the social services law MADE
BY  SECTION  EIGHT OF THIS ACT shall only apply to managed care programs
approved on or after the effective date of this act;
  S 26-a. Subdivision (x) of section 165 of chapter 41 of  the  laws  of
1992,  amending  the public health law and other laws relating to health
care providers, is REPEALED.
  S 27. Notwithstanding any inconsistent provision of law, rule or regu-
lation, for purposes of implementing the provisions of the public health
law and the social services law, references to titles XIX and XXI of the
federal social security act in the public  health  law  and  the  social
services  law  shall be deemed to include and also to mean any successor
titles thereto under the federal social security act.
  S 28. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the public health law, section 18 of chapter 2 of the laws of 1988,  and
18  NYCRR  505.14(h), as they relate to time frames for notice, approval
or certification of rates of payment, are hereby suspended  and  without
force or effect for purposes of implementing the provisions of this act.
  S  29. Severability clause. If any clause, sentence, paragraph, subdi-
vision, section or part of this act shall be adjudged by  any  court  of
competent  jurisdiction  to  be invalid, such judgment shall not affect,
impair or invalidate the remainder thereof, but shall be confined in its
operation to the clause, sentence, paragraph,  subdivision,  section  or
part  thereof  directly involved in the controversy in which such judge-
ment shall have been rendered. It is hereby declared to be the intent of
the legislature that this act would  have  been  enacted  even  if  such
invalid provisions had not been included herein.
  S  30.  This  act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2011.

                                 PART E

  Section 1. Section 366 of the social services law is amended by adding
a new subdivision 1-b to read as follows:
  1-B. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, IN THE EVENT  THAT  A
PERSON  WHO  IS  AN  INPATIENT IN AN INSTITUTION FOR MENTAL DISEASES, AS
DEFINED BY FEDERAL LAW AND  REGULATIONS,  AND  WHO  WAS  IN  RECEIPT  OF
MEDICAL  ASSISTANCE  PURSUANT  TO  THIS TITLE IMMEDIATELY PRIOR TO BEING
ADMITTED TO SUCH FACILITY, OR WHO WAS DIRECTLY ADMITTED TO SUCH FACILITY
AFTER BEING AN INPATIENT IN ANOTHER INSTITUTION FOR MENTAL DISEASES  AND
WHO  WAS  IN  RECEIPT  OF  MEDICAL ASSISTANCE PRIOR TO ADMISSION TO SUCH
TRANSFERRING INSTITUTION, SUCH PERSON SHALL REMAIN ELIGIBLE FOR  MEDICAL
ASSISTANCE  WHILE AN INPATIENT IN SUCH FACILITY; PROVIDED, HOWEVER, THAT
NO MEDICAL ASSISTANCE SHALL BE FURNISHED PURSUANT TO THIS TITLE FOR  ANY
CARE, SERVICES, OR SUPPLIES PROVIDED DURING THE TIME THAT SUCH PERSON IS
AN  INPATIENT, EXCEPT TO THE EXTENT THAT FEDERAL FINANCIAL PARTICIPATION

S. 2809--A                         109                        A. 4009--A

IS AVAILABLE FOR THE COSTS OF SUCH CARE,  SERVICES,  OR  SUPPLIES.  UPON
RELEASE  FROM  SUCH  FACILITY, SUCH PERSON SHALL CONTINUE TO BE ELIGIBLE
FOR RECEIPT OF MEDICAL ASSISTANCE FURNISHED PURSUANT TO THIS TITLE UNTIL
SUCH  TIME  AS  THE  PERSON  IS  DETERMINED TO NO LONGER BE ELIGIBLE FOR
RECEIPT OF SUCH ASSISTANCE. TO THE EXTENT PERMITTED BY FEDERAL LAW,  THE
TIME  DURING  WHICH  SUCH  PERSON  IS AN INPATIENT IN AN INSTITUTION FOR
MENTAL DISEASES SHALL NOT BE INCLUDED IN ANY  CALCULATION  OF  WHEN  THE
PERSON  MUST  RECERTIFY HIS OR HER ELIGIBILITY FOR MEDICAL ASSISTANCE IN
ACCORDANCE WITH THIS ARTICLE.
  S 2. Paragraph (c) of subdivision 1  of  section  366  of  the  social
services  law, as amended by chapter 355 of the laws of 2007, is amended
to read as follows:
  (c) except as provided in subparagraph six of paragraph  (a)  of  this
subdivision  or  subdivision one-a OR SUBDIVISION ONE-B of this section,
is not an inmate or  patient  in  an  institution  or  facility  wherein
medical  assistance  for needy persons may not be provided in accordance
with applicable federal or state requirements; and
  S 3. This act shall take effect  April  1,  2011;  provided  that  all
actions  necessary  for the timely implementation of this act, including
revisions to  information,  eligibility  and  benefit  computer  systems
utilized by social services districts and administered by the department
of  health of the state of New York, shall be taken prior to such effec-
tive date so that the provisions of this act may be implemented on  such
date.

                                 PART F

  Section  1. Subdivisions 3-b and 3-c of section 1 of part C of chapter
57 of the laws of 2006,  relating  to  establishing  a  cost  of  living
adjustment for designated human services programs, as amended by section
1  of  part F of chapter 111 of the laws of 2010, are amended to read as
follows:
  3-b. Notwithstanding any  inconsistent  provision  of  law,  beginning
April  1, 2009 and ending March 31, [2011] 2012, the commissioners shall
not include a COLA for the purpose of establishing  rates  of  payments,
contracts or any other form of reimbursement.
  3-c.  Notwithstanding  any  inconsistent  provision  of law, beginning
April 1, [2011] 2012 and ending March 31, [2014] 2015, the commissioners
shall develop the COLA under this section using the actual U.S. consumer
price index for all urban consumers  (CPI-U)  published  by  the  United
States  department  of  labor, bureau of labor statistics for the twelve
month period ending in July of the  budget  year  prior  to  such  state
fiscal  year,  for  the  purpose  of  establishing  rates  of  payments,
contracts or any other form of reimbursement.
  S 2. Section 4 of part C of chapter 57 of the laws of  2006,  relating
to  establishing  a  cost  of  living  adjustment  for  designated human
services programs, as amended by section 2 of part F of chapter  111  of
the laws of 2010, is amended to read as follows:
  S  4.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2006;  provided
section  one  of  this  act shall expire and be deemed repealed April 1,
[2014] 2015; provided, further, that sections two and three of this  act
shall expire and be deemed repealed December 31, 2009.
  S  3.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2011; provided,
however, that the amendments to section 1 of part C of chapter 57 of the

S. 2809--A                         110                        A. 4009--A

laws of 2006 made by section one of this act shall not affect the repeal
of such section and shall be deemed repealed therewith.

                                 PART G

  Section  1. Subdivision (b) of section 7.17 of the mental hygiene law,
as amended by section 1 of part J of chapter 58 of the laws of 2005,  is
amended to read as follows:
  (b)  There  shall  be  in the office the hospitals named below for the
care, treatment and rehabilitation of [the  mentally  disabled]  PERSONS
WITH  MENTAL  ILLNESS  and  for research and teaching in the science and
skills required for the  care,  treatment  and  rehabilitation  of  such
[mentally disabled] PERSONS WITH MENTAL ILLNESS.
  Greater Binghamton Health Center
  Bronx Psychiatric Center
  Buffalo Psychiatric Center
  Capital District Psychiatric Center
  Central New York Psychiatric Center
  Creedmoor Psychiatric Center
  Elmira Psychiatric Center
  Hudson River Psychiatric Center
  Kingsboro Psychiatric Center
  Kirby Forensic Psychiatric Center
  Manhattan Psychiatric Center
  Mid-Hudson Forensic Psychiatric Center
  Mohawk Valley Psychiatric Center
  Nathan S. Kline Institute for Psychiatric Research
  New York State Psychiatric Institute
  Pilgrim Psychiatric Center
  Richard H. Hutchings Psychiatric Center
  Rochester Psychiatric Center
  Rockland Psychiatric Center
  St. Lawrence Psychiatric Center
  South Beach Psychiatric Center
  Bronx Children's Psychiatric Center
  Brooklyn Children's [Psychiatric] Center
  Queens Children's Psychiatric Center
  Rockland Children's Psychiatric Center
  Sagamore Children's Psychiatric Center
  Western New York Children's Psychiatric Center
  The  New  York  State  Psychiatric  Institute  and The Nathan S. Kline
Institute for Psychiatric Research are designated as institutes for  the
conduct  of medical research and other scientific investigation directed
towards furthering knowledge of the etiology, diagnosis,  treatment  and
prevention  of  mental  illness.    THE  BROOKLYN CHILDREN'S CENTER IS A
FACILITY OPERATED BY THE OFFICE TO PROVIDE COMMUNITY-BASED MENTAL HEALTH
SERVICES FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCES.
  S 2. Subdivision (e) of section 7.17 of  the  mental  hygiene  law  is
REPEALED and subdivision (f) is relettered subdivision (e).
  S  3. (a) Notwithstanding the provisions of subdivision (b) of section
7.17 of the mental hygiene law, section 41.55 of the mental hygiene law,
or any other law to the contrary, the office of mental health is author-
ized in state fiscal year 2011-12 to close, consolidate, reduce,  trans-
fer  or  otherwise  redesign services of hospitals, other facilities and
programs operated by the office  of  mental  health,  and  to  implement
significant  service  reductions and reconfigurations as shall be deter-

S. 2809--A                         111                        A. 4009--A

mined by the commissioner of mental health to be necessary for the cost-
effective and efficient operation of such  hospitals,  other  facilities
and programs.
  (b)  The  office of mental health shall provide notice upon its public
website and to the legislature as soon as possible, but  no  later  than
two  weeks  prior to the anticipated closure, consolidation, or transfer
of inpatient wards.
  (c) Any transfers of inpatient capacity or any resulting  transfer  of
functions  shall  be authorized to be made by the commissioner of mental
health and any transfer of personnel upon such transfer of  capacity  or
transfer  of  functions  shall  be  accomplished  in accordance with the
provisions of section 70 of the civil service law.
  S 4. Severability clause. If any clause, sentence, paragraph, subdivi-
sion, section or part of this act shall be  adjudged  by  any  court  of
competent  jurisdiction  to  be invalid, such judgment shall not affect,
impair, or invalidate the remainder thereof, but shall  be  confined  in
its  operation  to the clause, sentence, paragraph, subdivision, section
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the legislature that this act would  have  been  enacted  even  if  such
invalid provisions had not been included herein.
  S  5.  This  act  shall  take  effect April 1, 2011; provided that the
amendments to subdivision (f) of section 7.17 of the mental hygiene  law
made  by  section  two  of  this act shall not affect the repeal of such
subdivision and shall be deemed repealed therewith.
  S 2. Severability clause. If any clause, sentence, paragraph, subdivi-
sion, section or part of this act shall be  adjudged  by  any  court  of
competent  jurisdiction  to  be invalid, such judgment shall not affect,
impair, or invalidate the remainder thereof, but shall  be  confined  in
its  operation  to the clause, sentence, paragraph, subdivision, section
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the legislature that this act would  have  been  enacted  even  if  such
invalid provisions had not been included herein.
  S  3.  This  act shall take effect immediately provided, however, that
the applicable effective date of Parts A through G of this act shall  be
as specifically set forth in the last section of such Parts.

S2809B - Bill Details

See Assembly Version of this Bill:
A4009D
Law Section:
Budget Bills
Laws Affected:
Amd Various Laws, generally

S2809B - Bill Texts

view summary

Relates to Medicare part D; relates to early intervention services; relates to tobacco control and insurance initiatives pool distributions; relates to clinical laboratories; relates to the distribution of HEAL NY capital grants; extends numerous provisions of law; repeals provisions of law relating to elderly pharmaceutical insurance; relates to rates of payment and medical assistance; relates to the distribution of pool allocations and graduate medical education; relates to health care initiative pool distributions; extends payment provisions for general hospitals; extends access to community health care services in rural areas; continues the priority restoration adjustment; relates to medical and professional malpractice insurance; relates to the liquidation of domestic insurers; relates to rates of payment for personal care service providers, residential health care facilities and diagnostic and treatment centers; relates to payments to residential health care facilities and other reimbursements; authorizes bad debt and charity care allowances for certified home health agencies; relates to capital related inpatient expenses; relates to rates of payment for long term home health care programs; relates to the effectiveness of the child health insurance plan; relates to the suspension of eligibility for medical assistance; foregoes certain adjustments during the 2011-2012 state fiscal year; relates to the closure and the reduction in size of certain facilities serving persons with mental illness; relates to general hospital inpatient reimbursement for annual rates; establishes ceiling limitations for certain rates of payment; repeals certain provisions of the social services law relating to prescription drug payments; initiates a study to determine costs incurred by public school districts for certain medical care, services and supplies; relates to the calculation of capital costs; relates to the HIV special needs plan; relates to the pharmacy and therapeutics committee and the preferred drug program; relates to covered part D drugs, limited coverage for formula therapy, prescription footwear, speech therapy, physical therapy and occupational therapy, payment for home health care nursing services, and coverage for smoking cessation counseling services, the furnishing of medical assistance to applicants with responsible relatives, and mail order prescriptions; relates to the commissioner of health's authority to negotiate agreements resolving multiple pending rate appeals; relates to diagnostic care centers; relates to temporary operator certificates for general hospitals or diagnostic and treatment centers; relates to health home services; relates to managed long term care plans and residential health care facilities; relates to insurance co-payments; provides palliative care support for patients with advanced life limiting conditions and illnesses; relates to the provision of home health care services; establishes a workgroup to develop a plan and draft legislation for the purpose of operating and managing public nursing homes; encourages cooperative, collaborative and integrative arrangements between health care providers, payers, and others; relates to the definition of estate; relates to the New York state medical indemnity fund and the New York state hospital quality initiative; requires compliance with operational standards by hospitals and providers of services in hospitals; creates an accountable care organization demonstration program; limits the reporting of death by the operator of an adult home or residence; requires preclaim review for participating providers of medical assistance program items and services; relates to seeking federal approvals to establish payment methodologies with accountable care organizations; relates to medical assistance for needy persons; relates to the character and adequacy of assistance; relates to residential health care facility supplemental payments, non-capital components of rates, and temporary nursing home stability contributions; authorizes the commissioner of health to enter into contracts for purposes of the Early Innovator federal grant award; and relates to applications for orders of rehabilitation or liquidation.

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

    S. 2809--B                                            A. 4009--B

                      S E N A T E - A S S E M B L Y

                            February 1, 2011
                               ___________

IN  SENATE -- A BUDGET BILL, submitted by the Governor pursuant to arti-
  cle seven of the Constitution -- read twice and ordered  printed,  and
  when  printed to be committed to the Committee on Finance -- committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee  --  committee  discharged,  bill  amended,  ordered
  reprinted as amended and recommitted to said committee

IN  ASSEMBLY  --  A  BUDGET  BILL, submitted by the Governor pursuant to
  article seven of the Constitution -- read once  and  referred  to  the
  Committee  on  Ways  and  Means -- committee discharged, bill amended,
  ordered reprinted as amended and  recommitted  to  said  committee  --
  again  reported from said committee with amendments, ordered reprinted
  as amended and recommitted to said committee

AN ACT to amend the elder law, in relation to Medicare part D; to  amend
  the  public  health  law  and  the insurance law, in relation to early
  intervention services; to amend the public health law  and  the  elder
  law,  in  relation  to  creating  local  competitive performance grant
  programs for priority health initiatives and initiatives in aging;  to
  amend the public health law, in relation to tobacco control and insur-
  ance  initiatives  pool distributions; to amend the public health law,
  in relation to clinical laboratories; to amend the public health  law,
  in  relation  to  distribution  of  HEAL  NY  capital grants; to amend
  section 32 of part A of chapter 58 of the laws of 2008,  amending  the
  elder  law  and  other  laws  relating  to reimbursement to particular
  provider pharmacies and prescription drug coverage, in relation to the
  effectiveness thereof; to amend section 4 of part X2 of chapter 62  of
  the  laws of 2003, amending the public health law relating to allowing
  for the use of funds of the office of professional medical conduct for
  activities of the patient health information and  quality  improvement
  act  of 2000, in relation to the effectiveness thereof; to amend para-
  graph b of subdivision 1 of section 76 of chapter 731 of the  laws  of
  1993,  amending  the  public  health  law  and  other laws relating to
  reimbursement, delivery and capital costs of  ambulatory  health  care
  services  and  inpatient  hospital services, in relation to the effec-
  tiveness thereof; to amend section 4 of chapter 505  of  the  laws  of
  1995,  amending  the  public  health  law relating to the operation of
  department of health facilities,  in  relation  to  the  effectiveness

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD12571-03-1

S. 2809--B                          2                         A. 4009--B

  thereof; to amend section 3 of chapter 303 of the laws of 1999, amend-
  ing  the  New  York  state  medical care facilities finance agency act
  relating to financing health facilities, in relation to the effective-
  ness thereof; to repeal subdivision 2, and paragraphs (c), (d) and (g)
  of  subdivision  3 of section 242 of the elder law, relating to eligi-
  bility for comprehensive coverage for  elderly  pharmaceutical  insur-
  ance;  to repeal section 244 of the elder law, relating to the elderly
  pharmaceutical insurance coverage panel; to repeal subdivisions  1,  2
  and  4  of  section  247  of  the  elder law, relating to cost-sharing
  responsibilities of participants in the elderly pharmaceutical  insur-
  ance  coverage  program;  and  to repeal section 248 of the elder law,
  relating to  cost-sharing  responsibilities  of  participants  in  the
  elderly  catastrophic  insurance program (Part A); to amend the public
  health law, in relation to rates of payment  and  medical  assistance;
  and  to  amend  chapter  58  of  the laws of 2009, amending the public
  health law and other laws relating to Medicaid reimbursements to resi-
  dential health care facilities, in relation to adjustments to Medicaid
  ratio of payment for inpatient services (Part B);  to  amend  the  New
  York  Health Care Reform Act of 1996, in relation to extending certain
  provisions relating thereto; to amend the New York Health Care  Reform
  Act  of 2000, in relation to extending the effectiveness of provisions
  thereof; to amend the public health law, in relation to  the  distrib-
  ution  of  pool  allocations  and graduate medical education; to amend
  chapter 62 of the laws of 2003 amending the general business  law  and
  other  laws  relating to enacting major components necessary to imple-
  ment the state fiscal plan for  the  2003-04  state  fiscal  year,  in
  relation  to  the deposit of certain funds; to amend the public health
  law, in relation to health  care  initiative  pool  distributions;  to
  amend  the  public  authorities  law,  in  relation to the transfer of
  certain funds; to amend  the  social  services  law,  in  relation  to
  extending  payment  provisions for general hospitals; to amend chapter
  600 of the laws of 1986 amending the public health law relating to the
  development  of  pilot  reimbursement  programs  for  ambulatory  care
  services,  in  relation to the effectiveness of such chapter; to amend
  chapter 520 of the laws of 1978 relating to providing for a comprehen-
  sive survey of health care financing, education and illness prevention
  and creating councils for the conduct thereof, in relation to  extend-
  ing  the effectiveness of portions thereof; to amend the public health
  law, in relation to extending access to community health care services
  in rural areas; to amend the public health law, in relation to contin-
  uing the priority restoration adjustment; to amend chapter 266 of  the
  laws  of 1986 amending the civil practice law and rules and other laws
  relating to malpractice and professional medical conduct, in  relation
  to extending the applicability of certain provisions thereof; to amend
  the insurance law, in relation to liquidation of domestic insurers; to
  amend  chapter  63 of the laws of 2001 amending chapter 20 of the laws
  of 2001 amending the military law and other laws  relating  to  making
  appropriations for the support of government, in relation to extending
  the  applicability of certain provisions thereof; to amend chapter 904
  of the laws of 1984, amending the public health  law  and  the  social
  services law relating to encouraging comprehensive health services, in
  relation  to  the  effectiveness thereof; to amend the social services
  law and the public health law, in relation to  rates  of  payment  for
  personal  care  service  providers, residential health care facilities
  and diagnostic and treatment centers; and to amend chapter 495 of  the
  laws  of  2004  amending  the  insurance law and the public health law

S. 2809--B                          3                         A. 4009--B

  relating to the New York state health insurance  continuation  assist-
  ance  demonstration  project, in relation to the effectiveness of such
  provisions (Part C); to amend the public health law,  in  relation  to
  payments  to  residential health care facilities; to amend chapter 474
  of the laws of 1996, amending the education law and other laws  relat-
  ing  to  rates  for  residential healthcare facilities, in relation to
  reimbursements; to amend chapter 884 of the laws of 1990, amending the
  public health law relating to authorizing bad debt  and  charity  care
  allowances  for  certified  home  health  agencies, in relation to the
  effectiveness thereof; to amend chapter 81 of the laws of 1995, amend-
  ing  the  public  health  law  and  other  laws  relating  to  medical
  reimbursement  and  welfare  reform, in relation to reimbursements and
  the effectiveness thereof; to amend the public health law, in relation
  to capital related inpatient expenses; to amend part C of  chapter  58
  of  the  laws of 2007, amending the social services law and other laws
  relating to enacting the major components of legislation necessary  to
  implement the health and mental hygiene budget for the 2007-2008 state
  fiscal  year,  in  relation  to rates of payment by state governmental
  agencies; to amend chapter 451 of  the  laws  of  2007,  amending  the
  public  health  law,  the  social  services law and the insurance law,
  relating to providing enhanced consumer and provider  protections,  in
  relation to extending the effectiveness of certain provisions thereof;
  to  amend  the  public health law, in relation to rates of payment for
  long term home health care programs; to amend chapter 2 of the laws of
  1998, amending the public  health  law  and  other  laws  relating  to
  expanding  the  child health insurance plan, in relation to the effec-
  tiveness of certain provisions thereof; to amend chapter  649  of  the
  laws  of  1996, amending the public health law, the mental hygiene law
  and the social services law relating to authorizing the  establishment
  of  special  needs plans, in relation to the effectiveness thereof; to
  amend chapter 58 of the laws of 2008, amending the social services law
  and the public  health  law  relating  to  adjustments  of  rates,  in
  relation  to the effectiveness of certain provisions thereof; to amend
  chapter 535 of the laws of 1983,  amending  the  social  services  law
  relating  to  eligibility of certain enrollees for medical assistance,
  in relation to the effectiveness thereof; to amend chapter 19  of  the
  laws  of  1998,  amending the social services law relating to limiting
  the method of payment for prescription drugs under the medical assist-
  ance program, in relation to the effectiveness thereof; to amend chap-
  ter 710 of the laws of 1988, amending the social services law and  the
  education  law  relating  to medical assistance eligibility of certain
  persons and providing for managed medical care demonstration programs,
  in relation to the effectiveness thereof; to amend chapter 165 of  the
  laws  of  1991, amending the public health law and other laws relating
  to establishing payments for medical assistance, in  relation  to  the
  effectiveness  thereof;  to  repeal  certain  provisions of the public
  health law relating to capital  related  inpatient  expenses;  and  to
  repeal  certain provisions of chapter 41 of the laws of 1992, amending
  the public health law and other laws relating to health care providers
  relating to the effectiveness of certain provisions thereof (Part  D);
  to  amend the social services law, in relation to suspension of eligi-
  bility for medical assistance (Part E); to amend  chapter  57  of  the
  laws of 2006, relating to establishing a cost of living adjustment for
  designated  human  services  programs,  in  relation to foregoing such
  adjustment during the 2011-2012 state fiscal year (Part F);  to  amend
  the  mental  hygiene law, in relation to the closure and the reduction

S. 2809--B                          4                         A. 4009--B

  in size of certain facilities serving persons with mental illness; and
  to repeal certain provisions of such law relating thereto (Part G)  to
  amend the public health law, in relation to general hospital inpatient
  reimbursement for annual rates; to amend chapter 1 of the laws of 1999
  amending the public health law and other laws relating to enacting the
  New  York  Health  Care  Reform  Act  of 2000, in relation to rates of
  payment for residential health care facilities; to  amend  the  public
  health  law,  in  relation  to  establishing  ceiling  limitations for
  certain rates of payment; to repeal certain provisions of  the  social
  services  law  relating  to  prescription  drug payments; to amend the
  social services law,  in  relation  to  a  study  to  determine  costs
  incurred by public school districts for certain medical care, services
  and  supplies;  to  amend the public health law, in relation to calcu-
  lation of capital costs and to repeal certain provisions of  such  law
  relating thereto; to amend the education law, in relation to immuniza-
  tions; to amend the public health law, in relation to the pharmacy and
  therapeutics  committee  and the preferred drug program; and to repeal
  certain provisions of such law relating thereto; to amend  the  social
  services  law and the public health law, in relation to covered part D
  drugs, limited coverage for formula  therapy,  prescription  footwear,
  speech therapy, physical therapy and occupational therapy, payment for
  home  health care nursing services, and coverage for smoking cessation
  counseling services, the furnishing of medical  assistance  to  appli-
  cants  with  responsible  relatives,  and the commissioner of health's
  authority to negotiate  agreements  resolving  multiple  pending  rate
  appeals;  to repeal subdivision 12 of section 272 of the public health
  law relating to authorization under the  preferred  drug  program  for
  anti-psychotics,  anti-depressants,  anti-rejection  drugs  for trans-
  plants and anti-retrovirals used in the treatment of HIV and AIDS;  to
  amend the public health law, in relation to temporary operator certif-
  icates  for  general hospitals or diagnostic and treatment centers; to
  amend the social services law, in relation to health home services; to
  amend the public health law, in relation to  managed  long  term  care
  plans;  to  amend  the  social  services law, in relation to insurance
  co-payments; to amend the public health law, in relation to  providing
  palliative  care  support  for  patients  with  advanced life limiting
  conditions and  illnesses;  to  amend  the  social  services  law,  in
  relation  to  provisions  of home health care services, to establish a
  workgroup to develop a plan and draft legislation for the  purpose  of
  operating  and  managing  public  nursing  homes;  to amend the public
  health law, in relation to encouraging cooperative, collaborative  and
  integrative  arrangements  between  health care providers, payers, and
  others; to amend the social services law, in relation to definition of
  estate; to amend the civil practice law  and  rules,  in  relation  to
  damage  awards  and  to repeal certain provisions of such law relating
  thereto; to amend the mental hygiene law, in  relation  to  compliance
  with  operational  standards by hospitals and providers of services in
  hospitals; to amend the public health  law,  in  relation  to  serious
  event  reporting;  to  amend the general municipal law, in relation to
  including a hospital and continuing care retirement  community  within
  the  definition  of project and defining hospital; to amend chapter 66
  of the laws of 1994, amending  the  public  health  law,  the  general
  municipal  law and the insurance law relating to the financing of life
  care communities, in relation to repealing  the  application  deadline
  for  eligibility for assistance from an industrial development agency;
  to amend the social services law, in relation to limiting the  report-

S. 2809--B                          5                         A. 4009--B

  ing  of death by the operator of an adult home or residence, to define
  certain terms as used in the  social  services  law,  and  to  require
  preclaim  review  for  participating  providers  of medical assistance
  program items and services; to amend the public health law, and part B
  of chapter 58 of the laws of 2010, amending chapter 474 of the laws of
  1996  amending  the education law and other laws relating to rates for
  residential healthcare facilities and other laws relating to  Medicaid
  payments,  in  relation  to  seeking  federal  approvals  to establish
  payment methodologies with  accountable  care  organizations,  and  to
  amend  the  mental hygiene law, in relation to entities subject to the
  visitation, examination, inspection, and investigation; to  amend  the
  social  services  law,  in  relation  to  medical assistance for needy
  persons and to repeal certain provisions of such law relating thereto;
  to amend the tax law, in relation to increasing credits for  long-term
  care  insurance;  to amend the social services law, in relation to the
  character and adequacy of assistance; and providing for the repeal  of
  certain provisions upon expiration thereof (Part H)

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

  Section 1. This act enacts into law major  components  of  legislation
which are necessary to implement the state fiscal plan for the 2011-2012
state  fiscal  year.  Each  component  is wholly contained within a Part
identified as Parts A through H. The effective date for each  particular
provision contained within such Part is set forth in the last section of
such Part. Any provision in any section contained within a Part, includ-
ing the effective date of the Part, which makes a reference to a section
"of  this  act", when used in connection with that particular component,
shall be deemed to mean and refer to the corresponding  section  of  the
Part  in  which  it  is  found. Section three of this act sets forth the
general effective date of this act.

                                 PART A

  Section 1. Paragraph (f) of subdivision 3 of section 242 of the  elder
law,  as added by section 3 of part B of chapter 58 of the laws of 2007,
is amended to read as follows:
  (f) As a condition of continued eligibility for  benefits  under  this
title,  if  a  program  participant is eligible for Medicare part D drug
coverage under section 1860D of the federal  social  security  act,  the
participant is required to enroll in Medicare part D at the first avail-
able enrollment period and to maintain such enrollment. This requirement
shall  be  waived  if  such enrollment would result in significant addi-
tional financial liability by the participant, including, but not limit-
ed to, individuals in a Medicare advantage plan whose cost sharing would
be increased, or if such enrollment would result  in  the  loss  of  any
health  coverage  through  a union or employer plan for the participant,
the participant's spouse or other dependent.   [The  elderly  pharmaceu-
tical  insurance  coverage  program shall provide premium assistance for
all participants enrolled in Medicare part D as follows:
  (i) for participants with comprehensive  coverage  under  section  two
hundred  forty-seven of this title, the elderly pharmaceutical insurance
coverage program shall pay for the portion of the part D monthly premium
that is the responsibility of the participant.  Such  payment  shall  be

S. 2809--B                          6                         A. 4009--B

limited  to  the  low-income benchmark premium amount established by the
federal centers for Medicare and Medicaid services and any other  amount
which  such  agency  establishes  under  its  de minimus premium policy,
except  that  such payments made on behalf of participants enrolled in a
Medicare advantage plan may  exceed  the  low-income  benchmark  premium
amount if determined to be cost effective to the program.
  (ii)  for  participants  with  catastrophic coverage under section two
hundred forty-eight of this title, the elderly pharmaceutical  insurance
coverage  program shall credit the participant's annual personal covered
drug expenditure amount required under this title by an amount equal  to
the  annual  low-income  benchmark  premium  amount  established  by the
centers for Medicare and Medicaid services, prorated for  the  remaining
portion  of  the participant's elderly pharmaceutical insurance coverage
program coverage period. The elderly pharmaceutical  insurance  coverage
program   shall,   at   appropriate   times,  notify  participants  with
catastrophic coverage under section  two  hundred  forty-seven  of  this
title  of their right to coordinate the annual coverage period with that
of Medicare part D, along with the possible advantages and disadvantages
of doing so.]
  S 2. Subdivision 6 of section 241 of the elder law is amended and  two
new subdivisions 8 and 9 are added to read as follows:
  6.  "Annual  coverage  period" shall mean the period of twelve consec-
utive calendar months for which an eligible program participant has  met
the  [application fee or deductible requirements, as the case may be, of
sections two hundred forty-seven and two hundred  forty-eight]  REQUIRE-
MENTS OF SECTION TWO HUNDRED FORTY-TWO of this title.
  8.  "COVERAGE GAP PERIOD" SHALL MEAN THE PERIOD BETWEEN THE END OF THE
MEDICARE  PART D INITIAL COVERAGE PHASE AND THE START OF MEDICARE PART D
CATASTROPHIC COVERAGE.
  9. "MEDICARE PART D EXCLUDED DRUG CLASSES" SHALL  MEAN  ANY  DRUGS  OR
CLASSES  OF DRUGS, OR THEIR MEDICAL USES, WHICH ARE DESCRIBED IN SECTION
1927(D)(2) OR 1927(D)(3) OF THE FEDERAL SOCIAL SECURITY  ACT,  WITH  THE
EXCEPTION OF SMOKING CESSATION AGENTS.
  S  3.  Subdivision 1 of section 242 of the elder law, paragraph (b) as
amended by section 14 of part B of chapter 57 of the laws  of  2006,  is
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,
WHO  IS  ENROLLED  IN MEDICARE PART D, 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, is less
than or equal to [twenty]  THIRTY-FIVE  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,  WHO
IS  ENROLLED  IN MEDICARE PART D, 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 beginning on or after January first, two  thousand  one,
is  less than or equal to [twenty-six] FIFTY thousand dollars. After the
initial determination of eligibility, each eligible individual  must  be
redetermined eligible at least every twenty-four months.
  S 3-a. Subdivision 2 of section 242 of the elder law is REPEALED.
  S  3-b. Paragraph (c) of subdivision 3 of section 242 of the elder law
is REPEALED and a new paragraph (c) is added to read as follows:

S. 2809--B                          7                         A. 4009--B

  (C) FOR PERSONS WHO MEET THE ELIGIBILITY REQUIREMENTS  TO  PARTICIPATE
IN  THE  ELDERLY  PHARMACEUTICAL INSURANCE COVERAGE PROGRAM, THE PROGRAM
WILL PAY FOR A DRUG COVERED BY THE PERSON'S MEDICARE PART D  PLAN  OR  A
DRUG IN A MEDICARE PART D EXCLUDED DRUG CLASS, AS DEFINED IN SUBDIVISION
NINE OF SECTION TWO HUNDRED FORTY-ONE OF THIS TITLE, DURING THE COVERAGE
GAP, AS DEFINED IN SUBDIVISION EIGHT OF SECTION TWO HUNDRED FORTY-ONE OF
THIS  TITLE,  PROVIDED  THAT  SUCH DRUG IS A COVERED DRUG, AS DEFINED IN
SUBDIVISION ONE OF SECTION TWO HUNDRED FORTY-ONE OF THIS TITLE, AND THAT
THE PARTICIPANT COMPLIES WITH THE POINT OF SALE CO-PAYMENT  REQUIREMENTS
SET FORTH IN SECTION TWO HUNDRED FORTY-SEVEN OF THIS TITLE.
  S  3-c. Paragraph (d) of subdivision 3 of section 242 of the elder law
is REPEALED.
  S 3-d. Paragraphs (e) and (f) of subdivision 3 of section 242  of  the
elder  law, paragraph (e) as amended by section 112 of part C of chapter
58 of the laws of 2009, paragraph (f) as amended by section one of  this
act, are amended to read as follows:
  (e)  As a condition of [continued] eligibility for benefits under this
title, if a program participant's income indicates that the  participant
could  be  eligible for an income-related subsidy under section 1860D-14
of the federal social security act by either applying for  such  subsidy
or  by  enrolling  in a medicare savings program as a qualified medicare
beneficiary (QMB), a specified low-income medicare  beneficiary  (SLMB),
or  a  qualifying  individual (QI), a program participant is required to
provide, and to authorize the elderly pharmaceutical insurance  coverage
program  to  obtain, any information or documentation required to estab-
lish the participant's eligibility for such subsidy,  and  to  authorize
the elderly pharmaceutical insurance coverage program to apply on behalf
of  the participant for the subsidy or the medicare savings program. The
elderly pharmaceutical insurance coverage program shall make  a  reason-
able  effort  to  notify  the  program participant of his or her need to
provide any of the above required information. After a reasonable effort
has been made to contact the participant, a participant shall  be  noti-
fied  in  writing that he or she has sixty days to provide such required
information. If such information is not provided within  the  sixty  day
period, the participant's coverage may be terminated.
  (f)  As a condition of [continued] eligibility for benefits under this
title, [if] a program participant is [eligible for Medicare part D  drug
coverage  under  section  1860D  of the federal social security act, the
participant is] required to [enroll] BE ENROLLED in Medicare part D  [at
the  first available enrollment period] and to maintain such enrollment.
[This requirement shall be waived if such  enrollment  would  result  in
significant  additional  financial liability by the participant, includ-
ing, but not limited to, individuals in a Medicare advantage plan  whose
cost  sharing  would be increased, or if such enrollment would result in
the loss of any health coverage through a union or employer plan for the
participant, the participant's spouse or other dependent.]
  S 3-e. Paragraph (g) of subdivision 3 of section 242 of the elder  law
is REPEALED.
  S 3-f. Paragraph (h) of subdivision 3 of section 242 of the elder law,
as  added  by  section 3 of part B of chapter 58 of the laws of 2007, is
amended to read as follows:
  (h) [In order to maximize prescription drug  coverage  under  Medicare
part  D,  the]  THE elderly pharmaceutical insurance coverage program is
authorized to represent program participants under this  title  [in  the
pursuit  of  such] WITH RESPECT TO THEIR MEDICARE PART D coverage. [Such
representation shall not result in any additional financial liability on

S. 2809--B                          8                         A. 4009--B

behalf of such program participants and shall include, but not be limit-
ed to, the following actions:
  (i)  application  for the premium and cost-sharing subsidies on behalf
of eligible program participants;
  (ii) enrollment in a prescription drug plan or MA-PD plan; the elderly
pharmaceutical insurance coverage program shall provide program  partic-
ipants with prior written notice of, and the opportunity to decline such
facilitated  enrollment subject, however, to the provisions of paragraph
(f) of this subdivision;
  (iii) pursuit of appeals, grievances, or coverage determinations.]
  S 3-g. Section 243 of the elder law is amended to read as follows:
  S 243. Pharmaceutical insurance contract. 1. The  [elderly  pharmaceu-
tical  insurance  coverage  panel,  established  pursuant to section two
hundred forty-four of this title] COMMISSIONER OF HEALTH shall,  subject
to  the  approval  of  the director of the budget, enter into a contract
with one or more contractors to assist in carrying out the provisions of
this title. Such contractual arrangements shall be  made  subject  to  a
competitive  process  pursuant to the state finance law and shall ensure
that state  payments  for  the  contractor's  necessary  and  legitimate
expenses  for  the  administration  of  this  program are limited to the
amount specified in advance, and that such payments shall not exceed the
amount appropriated therefor in any fiscal year. The [panel] COMMISSION-
ER shall[, at each of its  regularly  scheduled  meetings,]  review  the
contract  pricing  provisions  to  assure  that  the  level  of contract
payments are in the best interest of the state, giving consideration  to
the total level of participant enrollment achieved, the volume of claims
processed, and such other factors as may be relevant in order to contain
state  expenditures.  In  the event that the [panel] COMMISSIONER deter-
mines that the contract payment provisions do not protect  the  interest
of  the  state,  the  [executive  director]  COMMISSIONER shall initiate
contract negotiations for the purpose  of  modifying  contract  payments
and/or scope requirements.
  2.  The  responsibilities  of  the  contractor  or  contractors  shall
include, but need not be limited to:
  (a) providing for a method of determining, on an annual basis and upon
their application therefor,  the  eligibility  of  persons  pursuant  to
section  two  hundred forty-two of this title within a reasonable period
of time, including alternative methods for such determination of  eligi-
bility, such as through the mail or home visits, where reasonable and/or
necessary,  and  for  notifying  applicants of such eligibility determi-
nations;
  (b) notifying each eligible program participant in  writing  upon  the
commencement  of  the annual coverage period of such participant's cost-
sharing responsibilities pursuant  to  [sections]  SECTION  two  hundred
forty-seven  [and two hundred forty-eight] of this title. The contractor
shall also notify each eligible program participant of any adjustment of
the co-payment schedule by mail no less than thirty days  prior  to  the
effective  date  of  such  adjustments  and  shall  inform such eligible
program participants of the date such adjustments shall take effect;
  (c) issuing an identification card to each  ELIGIBLE  program  partic-
ipant  [who  is  eligible  to  purchase  prescribed covered drugs for an
amount specified pursuant to subdivision three of  section  two  hundred
forty-seven  or  subdivision three of section two hundred forty-eight of
this title. The dates of the annual coverage period shall  be  imprinted
on  the  card.  When  an  eligible  program participant meets the annual
limits on point of sale co-payments set forth  in  subdivision  four  of

S. 2809--B                          9                         A. 4009--B

section  two  hundred  forty-seven  or  subdivision  four of section two
hundred forty-eight of this title, either new identification cards shall
be issued to such  participant  indicating  waiver  of  such  co-payment
requirements  for  the  remainder  of  the annual coverage period or the
contractor shall develop and implement an alternative method  to  permit
the purchase of covered drugs without a co-payment requirement];
  (d)  [developing  and  implementing  the  system for those individuals
electing the deductible option to record  their  personal  covered  drug
expenditures in accordance with subdivision three of section two hundred
forty-eight  of  this title. Such recordkeeping system shall be provided
to each such participant at a nominal charge which shall be  subject  to
the  approval  of the panel. The contractor shall also reimburse partic-
ipants for personal covered drug expenditures made in  excess  of  their
deductible  requirements,  less  the co-payments required by subdivision
four of section two hundred forty-eight of this  title,  made  prior  to
their  receipt of an identification card issued in accordance with para-
graph (c) of this subdivision;
  (e)] processing of claims for reimbursement to participating  provider
pharmacies pursuant to section two hundred fifty of this title;
  [(f)]  (E)  performing  or causing to be performed utilization reviews
for such purposes as may be  required  by  the  [elderly  pharmaceutical
insurance coverage panel] COMMISSIONER OF HEALTH;
  [(g)]  (F)  conducting  audits  and  surveys of participating provider
pharmacies as specified pursuant to the  terms  and  conditions  of  the
contract; and
  [(h)]  (G)  coordinating  coverage  with insurance companies and other
public and private organizations offering such coverage for those eligi-
ble program participants  having  partial  coverage  for  covered  drugs
through  third-party sources, and providing for recoupment of any dupli-
cate reimbursement paid by the state on behalf of such eligible  program
participants.
  3.  The  contractor  or  contractors shall be required to provide such
reports as may be deemed necessary by the [elderly pharmaceutical insur-
ance coverage panel] COMMISSIONER OF HEALTH and shall maintain files  in
a manner and format approved by the [executive director] COMMISSIONER.
  4.  The  contractor  or contractors may contract with private not-for-
profit or proprietary corporations, or with entities of local government
within the state of  New  York,  to  perform  such  obligations  of  the
contractor  or  contractors  as  the  [elderly  pharmaceutical insurance
coverage panel] COMMISSIONER OF HEALTH shall permit.
  S 3-h. Section 244 of the elder law is REPEALED and a new section  244
is added to read as follows:
  S  244.  POWERS  OF  THE  COMMISSIONER  OF HEALTH.   THE POWERS OF THE
COMMISSIONER OF  HEALTH  IN  ADMINISTERING  THE  ELDERLY  PHARMACEUTICAL
INSURANCE  COVERAGE  PROGRAM  SHALL  INCLUDE  BUT  NOT BE LIMITED TO THE
FOLLOWING:
  1. SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE BUDGET, PROMULGATING
PROGRAM REGULATIONS PURSUANT TO SECTION TWO HUNDRED  FORTY-SIX  OF  THIS
TITLE;
  2. DETERMINING THE ANNUAL SCHEDULE OF COST-SHARING RESPONSIBILITIES OF
ELIGIBLE PROGRAM PARTICIPANTS PURSUANT TO SECTION TWO HUNDRED FORTY-SEV-
EN OF THIS TITLE;
  3. ENTERING INTO CONTRACTS PURSUANT TO SECTION TWO HUNDRED FORTY-THREE
OF THIS TITLE;

S. 2809--B                         10                         A. 4009--B

  4. IMPLEMENTING ALTERNATIVE PROGRAM IMPROVEMENTS FOR THE EFFICIENT AND
EFFECTIVE  OPERATION OF THE PROGRAM IN ACCORDANCE WITH THE PROVISIONS OF
THIS TITLE;
  5.  ESTABLISHING  OR  CONTRACTING  FOR  A  THERAPEUTIC DRUG MONITORING
PROGRAM, FOR THE PURPOSE OF MONITORING THERAPEUTIC DRUG USE BY  ELIGIBLE
PROGRAM  PARTICIPANTS  IN AN EFFORT TO PREVENT THE INCORRECT OR UNNECES-
SARY CONSUMPTION OF SUCH THERAPEUTIC DRUGS.
  S 3-i. The section heading of section 247 of the elder law is  amended
to read as follows:
  Cost-sharing  responsibilities  of  eligible program participants [for
comprehensive coverage].
  S 3-j. Subdivision 1 of section 247 of the elder law is REPEALED and a
new subdivision 1 is added to read as follows:
  1. AS A CONDITION  OF  ELIGIBILITY  FOR  BENEFITS  UNDER  THIS  TITLE,
PARTICIPANTS  MUST  MAINTAIN  MEDICARE  PART  D COVERAGE AND PAY MONTHLY
PREMIUMS TO THEIR MEDICARE PART D DRUG PLAN.
  S 3-k. Subdivisions 2 and 4 of  section  247  of  the  elder  law  are
REPEALED and subdivision 3 is renumbered subdivision 2 and paragraph (a)
is amended to read as follows:
  (a)  [Upon  satisfaction  of  the  registration  fee  pursuant to this
section an eligible] A program participant must  pay  a  point  of  sale
co-payment as set forth in paragraph (b) of this subdivision at the time
of each purchase of a [covered] drug prescribed for such individual THAT
IS  DESCRIBED  IN  PARAGRAPH  (C)  OF  SUBDIVISION  THREE OF SECTION TWO
HUNDRED FORTY-TWO OF THIS TITLE.  [Such co-payment shall not  be  waived
or reduced in whole or in part, subject to the limits provided by subdi-
vision four of this section.]
  S 3-l. Section 248 of the elder law is REPEALED.
  S 3-m. Section 250 of the elder law, paragraph (a) of subdivision 1 as
amended  by  section 6-a and subparagraph l of paragraph (b) of subdivi-
sion 1 as amended by section 1 of part A of chapter 58 of  the  laws  of
2008,  paragraph (b) of subdivision 1 as amended by section 17 of part A
of chapter 58 of the laws of 2004, subparagraph 1 of  paragraph  (a)  of
subdivision  3  and  subdivision 5 as amended by section 19 of part B of
chapter 57 of the laws of 2006, subdivision 6 as amended by section 19-a
of part A of chapter 109 of the laws of 2010,  is  amended  to  read  as
follows:
  S  250.  Reimbursement  to  participating  provider pharmacies. 1. The
amount of reimbursement which shall be paid by the state  to  a  partic-
ipating  provider  pharmacy [for any covered drug filled or refilled for
any eligible program participant] FILLING OR  REFILLING  A  PRESCRIPTION
FOR  A  DRUG  THAT IS DESCRIBED IN PARAGRAPH (C) OF SUBDIVISION THREE OF
SECTION TWO HUNDRED FORTY-TWO OF  THIS  TITLE  shall  be  equal  to  the
allowed amount defined as follows, minus the point of sale co-payment as
required  by [sections] SECTION two hundred forty-seven [and two hundred
forty-eight] of this title:
  (a) Multiple source covered drugs. Except for brand  name  drugs  that
are  required  by the prescriber to be dispensed as written, the allowed
amount for a multiple source covered drug shall equal the lower of:
  (1) The pharmacy's usual and customary charge to the  general  public,
taking  into consideration any quantity and promotional discounts to the
general public at the time of purchase, or
  (2) The upper limit, if any, set by the centers for medicare and medi-
caid services for such multiple source drug, or
  (3) Average wholesale price discounted by twenty-five percent, or

S. 2809--B                         11                         A. 4009--B

  (4) The maximum allowable cost, if any, established by the commission-
er of health pursuant to paragraph (e) of subdivision  nine  of  section
three hundred sixty-seven-a of the social services law.
  Plus  a  dispensing fee for drugs reimbursed pursuant to subparagraphs
two, three, and four of this paragraph, as defined in paragraph  (c)  of
this subdivision.
  (b)  Other  covered  drugs.  The  allowed  amount for brand name drugs
required by the prescriber to be dispensed as written  and  for  covered
drugs  other  than multiple source drugs shall be determined by applying
the lower of:
  (1) Average wholesale price discounted by sixteen and twenty-five  one
hundredths percent, plus a dispensing fee as defined in paragraph (c) of
this subdivision, or
  (2)  The  pharmacy's usual and customary charge to the general public,
taking into consideration any quantity and promotional discounts to  the
general public at the time of purchase.
  (c)  As  required  by  paragraphs  (a)  and (b) of this subdivision, a
dispensing fee of four dollars fifty cents will apply to  generic  drugs
and  a  dispensing  fee of three dollars fifty cents will apply to brand
name drugs.
  2. For purposes of determining the amount of reimbursement which shall
be paid to a participating provider pharmacy, the  [panel]  COMMISSIONER
OF  HEALTH  shall determine or cause to be determined, through a statis-
tically valid survey, the quantities of each covered drug  that  partic-
ipating  provider  pharmacies  buy  most frequently. Using the result of
this survey, the contractor shall update every thirty days the  list  of
average  wholesale  prices  upon  which such reimbursement is determined
using nationally recognized and  most  recently  revised  sources.  Such
price  revisions  shall  be made available to all participating provider
pharmacies. The pharmacist shall be reimbursed based  on  the  price  in
effect at the time the covered drug is dispensed.
  3. [(a) Notwithstanding any inconsistent provision of law, the program
for  elderly  pharmaceutical  insurance  coverage  shall  reimburse  for
covered drugs which are dispensed under the program by a provider  phar-
macy  only  pursuant  to  the  terms  of  a rebate agreement between the
program and the manufacturer (as  defined  under  section  1927  of  the
federal  social  security act) of such covered drugs; provided, however,
that:
  (1) any agreement between the program and a manufacturer entered  into
before  August  first,  nineteen  hundred ninety-one, shall be deemed to
have been entered into on April first, nineteen hundred ninety-one;  and
provided  further, that if a manufacturer has not entered into an agree-
ment with the department before August first, nineteen  hundred  ninety-
one,  such  agreement shall not be effective until April first, nineteen
hundred ninety-two, unless such agreement provides that rebates will  be
retroactively calculated as if the agreement had been in effect on April
first, nineteen hundred ninety-one; and
  (2) the program may reimburse for any covered drugs pursuant to subdi-
visions  one  and two of this section, for which a rebate agreement does
not exist and which are determined by the elderly pharmaceutical  insur-
ance coverage panel to be essential to the health of persons participat-
ing in the program; and likely to provide effective therapy or diagnosis
for  a  disease not adequately treated or diagnosed by any other covered
drug; and which are recommended  for  reimbursement  by  the  panel  and
approved by the commissioner of health.

S. 2809--B                         12                         A. 4009--B

  (b) The rebate agreement between such manufacturer and the program for
elderly  pharmaceutical  insurance  coverage  shall  utilize for covered
drugs the identical formula used to determine  the  rebate  for  federal
financial  participation  for  drugs, pursuant to section 1927(c) of the
federal  social  security  act,  to  determine  the amount of the rebate
pursuant to this subdivision.
  (c) The amount of rebate pursuant to paragraph (b) of this subdivision
shall be calculated by multiplying the required rebate formulas  by  the
total  number  of  units of each dosage form and strength dispensed. The
rebate agreement shall also provide for periodic payment of the  rebate,
provision  of  information to the program, audits, verification of data,
damages to the program for any delay or non-production of necessary data
by the manufacturer and for the confidentiality of information.
  (d) The program in providing utilization data to  a  manufacturer  (as
provided  for under section 1927 (b) of the federal social security act)
shall provide such data by zip code, if requested,  for  the  top  three
hundred most commonly used drugs by volume covered under a rebate agree-
ment.
  (e) Any funds collected pursuant to any rebate agreements entered into
with  a  manufacturer  pursuant  to this subdivision, shall be deposited
into the  elderly  pharmaceutical  insurance  coverage  program  premium
account.
  4.]  Notwithstanding  any other provision of law, entities which offer
insurance coverage for provision of and/or reimbursement for  pharmaceu-
tical    expenses,    including    but    not   limited   to,   entities
licensed/certified pursuant to  article  thirty-two,  forty-two,  forty-
three  or  forty-four  of the insurance law (employees welfare funds) or
article forty-four of the public health  law,  shall  participate  in  a
benefit  recovery  program  with  the  elderly  pharmaceutical insurance
coverage (EPIC) program which includes, but is not limited to,  a  semi-
annual  match  of  EPIC's file of enrollees against the entity's file of
insured to identify individuals enrolled in both plans with claims  paid
within the twenty-four months preceding the date the entity receives the
match request information from EPIC. Such entity shall indicate if phar-
maceutical  coverage  is  available  from  the  entity  for  the insured
persons, list the copayment or other payment obligations of the  insured
persons  applicable to the pharmaceutical coverage, and (after receiving
necessary claim information from EPIC) list the amounts which the entity
would have paid for the pharmaceutical claims for those identified indi-
viduals and the entity shall reimburse EPIC for pharmaceutical  expenses
paid  by EPIC that are covered under the contract between the entity and
its insured in only those instances where the  entity  has  not  already
made  payment  of  the  claim.  Reimbursement  of the net amount payable
(after rebates and discounts) that would have been paid under the cover-
age issued by the entity will be made by the entity to EPIC within sixty
days of receipt from EPIC of the  standard  data  in  electronic  format
necessary  for  the  entity  to adjudicate the claim and if the standard
data is provided to the entity by EPIC in paper format  payment  by  the
entity  shall  be made within one hundred eighty days.  After completing
at least one match process with EPIC in  electronic  format,  an  entity
shall  be entitled to elect a monthly or bi-monthly match process rather
than a semi-annual match process.
  [5.] 4. Notwithstanding  any  other  provision  of  law,  the  [panel]
COMMISSIONER  OF  HEALTH shall maximize the coordination of benefits for
persons enrolled under Title XVIII of the federal  social  security  act
(medicare) and enrolled under this title in order to facilitate medicare

S. 2809--B                         13                         A. 4009--B

payment  of  claims.  The  [panel]  COMMISSIONER OF HEALTH may select an
independent  contractor,  through  a  request-for-proposal  process,  to
implement  a  centralized  coordination  of  benefits  system under this
subdivision for individuals qualified in both the elderly pharmaceutical
insurance  coverage  (EPIC)  program  and  medicare programs who receive
medications or other covered products from a pharmacy provider currently
enrolled  in  the  elderly  pharmaceutical  insurance  coverage   (EPIC)
program.
  [6.  (a)]  5.  The  EPIC program shall be the payor of last resort for
individuals qualified in both the EPIC program and title  XVIII  of  the
federal  social  security  act  (Medicare).  [For  such  individuals, no
reimbursement shall be available under EPIC for  covered  drug  expenses
except:
  (i) where a prescription drug plan authorized by Part D of the federal
social  security act (referred to in this subdivision as a Medicare Part
D plan) has approved coverage and EPIC  has  an  obligation  under  this
title  to pay a portion of the participant's cost-sharing responsibility
under Medicare Part D; or
  (ii) where the provider pharmacy has certified that a Medicare Part  D
plan has denied coverage.
  (b)  If  the  provider pharmacy certifies as set forth in subparagraph
(ii) of paragraph (a) of this subdivision, the EPIC  program  shall  pay
for  the drug as the primary payor upon a showing of compliance with the
notification and appeal provisions of subparagraph two of paragraph  (c)
of subdivision three of section two hundred forty-two of this title.]
  S 3-n. Section 254 of the elder law is amended to read as follows:
  S  254.  Cost  of living adjustment. [1.] Within amounts appropriated,
the [panel] COMMISSIONER OF HEALTH shall adjust the program  eligibility
standards  set  forth  in  subdivision  [two] ONE of section two hundred
forty-two of this title to account for increases in the cost of living.
  [2. The panel shall further adjust individual and joint income catego-
ries set forth in subdivisions two  and  four  of  section  two  hundred
forty-eight of this title to conform to the adjustments made pursuant to
subdivision one of this section.]
  S  4. Notwithstanding any contrary provision of law, rates established
pursuant to section 69-4.30 of Title 10 of the New York Codes, Rules and
Regulations for approved services rendered on and after  April  1,  2011
shall be reduced by ten percent.
  S  5.  Paragraph  (a)  of  subdivision 3 of section 2559 of the public
health law, as amended by chapter 231 of the laws of 1993, is amended to
read as follows:
  (a) [Providers] EXCEPT AS PROVIDED IN SUBPARAGRAPH (I) OF  THIS  PARA-
GRAPH,  PROVIDERS  of  early  intervention  services  and transportation
services shall in the first instance and where applicable, seek  payment
from  all  third  party  payors including governmental agencies prior to
claiming payment from a given  municipality  for  services  rendered  to
eligible  children,  provided  that,  for the purpose of seeking payment
from the medical assistance program or from other  third  party  payors,
the municipality shall be deemed the provider of such early intervention
services  to  the extent that the provider has promptly furnished to the
municipality adequate and complete information necessary to support  the
municipality  billing,  and provided further that the obligation to seek
payment shall not apply to a payment from a third party payor who is not
prohibited from applying such payment, and will apply such  payment,  to
an annual or lifetime limit specified in the insured's policy.

S. 2809--B                         14                         A. 4009--B

  (I)  EARLY INTERVENTION PROGRAM PROVIDERS WHO RECEIVED PAYMENT OF FIVE
HUNDRED THOUSAND DOLLARS OR MORE AS DETERMINED PURSUANT TO  SUBPARAGRAPH
(II)  OF  THIS  PARAGRAPH  FOR  EARLY  INTERVENTION SERVICES PROVIDED TO
ELIGIBLE CHILDREN THAT WERE COVERED SERVICES UNDER THE  MEDICAL  ASSIST-
ANCE  PROGRAM,  SHALL  IN  THE  FIRST INSTANCE AND WHERE AVAILABLE, SEEK
PAYMENT FROM THE MEDICAL ASSISTANCE PROGRAM OR AN  INSURANCE  POLICY  OR
HEALTH  BENEFIT  PLAN  FOR THOSE CHILDREN COVERED UNDER BOTH THE MEDICAL
ASSISTANCE PROGRAM AND AN INSURANCE POLICY OR HEALTH BENEFIT PLAN, PRIOR
TO CLAIMING PAYMENT FROM A MUNICIPALITY FOR SERVICES  RENDERED  TO  SUCH
CHILDREN;
  (II) THE COMMISSIONER SHALL DETERMINE WHICH PROVIDERS RECEIVED PAYMENT
OF FIVE HUNDRED THOUSAND DOLLARS OR MORE FOR EARLY INTERVENTION SERVICES
THAT  WERE  COVERED  UNDER THE MEDICAL ASSISTANCE PROGRAM BASED UPON THE
MOST RECENT YEAR FOR WHICH COMPLETE INFORMATION EXISTS. THE COMMISSIONER
SHALL NOTIFY A PROVIDER AT LEAST THIRTY  DAYS  PRIOR  TO  THE  DATE  THE
PROVIDER  SHALL  BE  REQUIRED  TO  BILL  FOR SERVICES IN ACCORDANCE WITH
SUBPARAGRAPH (I) OF THIS PARAGRAPH.
  (III) PARENTS SHALL PROVIDE AND THE MUNICIPALITY SHALL OBTAIN INFORMA-
TION ON ANY PLAN OF INSURANCE UNDER WHICH AN ELIGIBLE CHILD  HAS  COVER-
AGE.
  S 6. Intentionally omitted.
  S 7. Intentionally omitted.
  S 8. Intentionally omitted.
  S 9. Intentionally omitted.
  S 10. Intentionally omitted.
  S  11.  Section  3235-a of the insurance law, as added by section 3 of
part C of chapter 1 of the laws of 2002, is amended to read as follows:
  S 3235-a. Payment for early intervention services. (a)  No  policy  of
accident  and  health  insurance, including contracts issued pursuant to
article forty-three of this chapter, shall exclude coverage  for  other-
wise  covered  services solely on the basis that the services constitute
early intervention program services under title two-A of  article  twen-
ty-five of the public health law.
  (b)  Where  a  policy  of  accident  and health insurance, including a
contract  issued  pursuant  to  article  forty-three  of  this  chapter,
provides  coverage  for  [an]  A  SERVICE THAT IS PROVIDED TO AN INSURED
UNDER THE early intervention program service, such coverage shall not be
applied against any maximum annual or lifetime monetary limits set forth
in such policy or contract. Visit limitations and other terms and condi-
tions of the policy will continue to apply to COVERED SERVICES  PROVIDED
UNDER  THE  early  intervention  [services] PROGRAM. However, any visits
used for early intervention program services shall not reduce the number
of visits otherwise available under the  policy  or  contract  for  such
services.  WHERE A SERVICE PROVIDED TO AN INSURED UNDER THE EARLY INTER-
VENTION  PROGRAM  IS  A  COVERED  SERVICE  UNDER THE INSURER'S POLICY OR
CONTRACT, THE INDIVIDUALIZED FAMILY SERVICES PLAN AS DEFINED IN  SECTION
TWENTY-FIVE  HUNDRED FORTY-ONE OF THE PUBLIC HEALTH LAW AND CERTIFIED BY
THE EARLY INTERVENTION OFFICIAL OR SUCH OFFICIAL'S  DESIGNEE,  SHALL  BE
DEEMED TO MEET ANY PRECERTIFICATION, PREAUTHORIZATION AND MEDICAL NECES-
SITY  REQUIREMENTS  IMPOSED  ON  BENEFITS  UNDER THE POLICY OR CONTRACT,
PROVIDED, HOWEVER, THAT THE EARLY INTERVENTION OFFICIAL SHALL REMOVE  OR
REDACT  ANY INFORMATION CONTAINED ON THE INSURED'S INDIVIDUALIZED FAMILY
SERVICE PLAN THAT IS NOT REQUIRED BY THE INSURER FOR  PAYMENT  PURPOSES.
PAYMENT  FOR  A  SERVICE  COVERED  UNDER  THE POLICY OR CONTRACT THAT IS
PROVIDED UNDER THE EARLY INTERVENTION PROGRAM SHALL BE AT  RATES  ESTAB-

S. 2809--B                         15                         A. 4009--B

LISHED  BY THE COMMISSIONER OF HEALTH FOR SUCH SERVICE PURSUANT TO REGU-
LATIONS.
  (c)  NO  INSURER, INCLUDING A HEALTH MAINTENANCE ORGANIZATION ISSUED A
CERTIFICATE OF AUTHORITY UNDER ARTICLE FORTY-FOUR OF THE  PUBLIC  HEALTH
LAW  AND A CORPORATION ORGANIZED UNDER ARTICLE FORTY-THREE OF THIS CHAP-
TER SHALL DENY PAYMENT OF A CLAIM SUBMITTED FOR A SERVICE COVERED  UNDER
THE  INSURER'S  POLICY  OR  CONTRACT AND PROVIDED UNDER THE EARLY INTER-
VENTION PROGRAM BASED UPON THE FOLLOWING:
  (I) THE LOCATION WHERE SERVICES ARE PROVIDED;
  (II) THE DURATION OF THE INSURED'S CONDITION  OR  THAT  THE  INSURED'S
CONDITION  IS  NOT  AMENABLE TO SIGNIFICANT IMPROVEMENT WITHIN A CERTAIN
PERIOD OF TIME AS SPECIFIED IN THE POLICY OR CONTRACT;
  (III) THAT THE PROVIDER OF SERVICES IS NOT A PARTICIPATING PROVIDER IN
THE INSURER'S NETWORK; OR
  (IV) THE ABSENCE OF A PRIMARY CARE REFERRAL.
  (D) Any right of subrogation to benefits which a municipality is enti-
tled in accordance with paragraph (d) of subdivision  three  of  section
twenty-five  hundred  fifty-nine of the public health law shall be valid
and enforceable to the extent benefits are available under any  accident
and health insurance policy. The right of subrogation does not attach to
insurance benefits paid or provided under any accident and health insur-
ance  policy  prior to receipt by the insurer of written notice from the
municipality.  UPON THE INSURER'S RECEIPT OF  WRITTEN  NOTICE  FROM  THE
MUNICIPALITY THE INSURER SHALL PROVIDE THE MUNICIPALITY WITH INFORMATION
ON THE EXTENT OF BENEFITS AVAILABLE TO AN INSURED UNDER THE POLICY.
  [(d)]  (E)  No  insurer,  including  a health maintenance organization
issued a certificate of authority under article forty-four of the public
health law and a corporation organized under article forty-three of this
chapter, shall refuse to issue an accident and health  insurance  policy
or  contract  or refuse to renew an accident and health insurance policy
or contract  solely  because  the  applicant  or  insured  is  receiving
services under the early intervention program.
  S  12.  Subdivisions 4 and 5 of section 2545 of the public health law,
as added by section 2 of chapter 428 of the laws of 1992, are amended to
read as follows:
  4. If the IFSP TEAM MEMBERS, INCLUDING THE early intervention official
and the parent agree on the IFSP, the IFSP shall be deemed final and the
service coordinator shall be authorized to implement the plan.
  5. If the IFSP TEAM MEMBERS, INCLUDING THE early intervention official
and the parent do not agree on an IFSP, the  service  coordinator  shall
implement the sections of the proposed IFSP that are not in dispute, and
the  parent shall have the due process rights set forth in section twen-
ty-five hundred forty-nine of this title.
  S 13. Subdivision 2 of section  605  of  the  public  health  law,  as
amended  by  section  7  of part B of chapter 57 of the laws of 2006, is
amended to read as follows:
  2. State aid reimbursement for public health services  provided  by  a
municipality under this title, shall be made [as follows:
  (a)]  if the municipality is providing some or all of the basic public
health services identified in paragraph  (b)  of  subdivision  three  of
section  six hundred two of this title, pursuant to an approved plan, at
a rate of no less than thirty-six per centum of the  difference  between
the  amount  of  moneys  expended  by the municipality for public health
services required by paragraph (b) of subdivision three of  section  six
hundred  two  of  this  title  during the fiscal year and the base grant
provided pursuant to subdivision one of this section. No such reimburse-

S. 2809--B                         16                         A. 4009--B

ment shall be provided for services if they are not approved in  a  plan
or if no plan is submitted for such services.
  [(b)  if  the  municipality  is providing other public health services
within limits to be prescribed by  regulation  by  the  commissioner  in
addition  to some or all of the public health services required in para-
graph (b) of subdivision three of section six hundred two of this title,
pursuant to an approved plan, at a rate of not less than thirty-six  per
centum  of  the  moneys  expended  by  the  municipality  for such other
services. No such reimbursement shall be provided for services  if  they
are  not  approved  in  a  plan  or  if  no  plan  is submitted for such
services.]
  S 14. The public health law is amended by adding a new section 212  to
read as follows:
  S 212. LOCAL COMPETITIVE PERFORMANCE GRANT PROGRAM FOR PRIORITY HEALTH
INITIATIVES.  1.  THERE  IS HEREBY ESTABLISHED WITHIN THE DEPARTMENT THE
LOCAL COMPETITIVE PERFORMANCE GRANT PROGRAM FOR PRIORITY  HEALTH  INITI-
ATIVES  TO  ADDRESS EMERGING OR ONGOING PUBLIC HEALTH MATTERS AND PURSUE
INNOVATIONS IN PUBLIC HEALTH.
  2. WITHIN AMOUNTS APPROPRIATED THEREFOR, THE COMMISSIONER  IS  AUTHOR-
IZED  TO MAKE GRANTS TO AND ENTER INTO CONTRACTS WITH PUBLIC, NON-PROFIT
OR PRIVATE ENTITIES FOR PURPOSES WHICH MAY INCLUDE, BUT ARE NOT  LIMITED
TO,  MINORITY  HEALTH-RELATED INITIATIVES, REPRODUCTIVE HEALTH SERVICES,
DISEASE-SPECIFIC PURPOSES, AND OTHER HEALTH-RELATED  RESEARCH,  OUTREACH
AND  EDUCATION PURPOSES. SUCH GRANTS SHALL BE AWARDED UNDER THIS SECTION
ON A COMPETITIVE BASIS PURSUANT TO A  REQUEST  FOR  APPLICATION/PROPOSAL
PROCESS, IN THE NUMBER, AMOUNTS AND MANNER DETERMINED BY THE COMMISSION-
ER, PURSUANT TO CRITERIA DETERMINED BY THE COMMISSIONER.
  3.  THE COMMISSIONER MAY PROMULGATE REGULATIONS, INCLUDING ON AN EMER-
GENCY BASIS, AS NECESSARY TO IMPLEMENT THE PROVISIONS OF THIS SECTION.
  S 15. The elder law is amended by adding a new section 224 to read  as
follows:
  S 224. LOCAL COMPETITIVE PERFORMANCE GRANT PROGRAM FOR PRIORITY INITI-
ATIVES  IN  AGING.  1. THERE IS HEREBY ESTABLISHED WITHIN THE OFFICE THE
LOCAL COMPETITIVE PERFORMANCE GRANT PROGRAM FOR PRIORITY INITIATIVES  IN
AGING  TO  ADDRESS  EMERGING OR ONGOING MATTERS THAT AFFECT OLDER ADULTS
AND PURSUING INNOVATIONS IN ASSISTING OLDER ADULTS.
  2. WITHIN AMOUNTS APPROPRIATED THEREFOR, THE DIRECTOR IS AUTHORIZED TO
MAKE GRANTS TO AND ENTER  INTO  CONTRACTS  WITH  PUBLIC,  NON-PROFIT  OR
PRIVATE  ENTITIES.  SUCH GRANTS SHALL BE AWARDED UNDER THIS SECTION ON A
COMPETITIVE BASIS PURSUANT TO A REQUEST FOR  APPLICATION/PROPOSAL  PROC-
ESS,  IN  THE  NUMBER,  AMOUNTS  AND  MANNER DETERMINED BY THE DIRECTOR,
PURSUANT TO CRITERIA DETERMINED BY THE DIRECTOR.
  3. THE DIRECTOR MAY PROMULGATE REGULATIONS, INCLUDING ON AN  EMERGENCY
BASIS, AS NECESSARY TO IMPLEMENT THE PROVISIONS OF THIS SECTION.
  S 16. Paragraph (fff) of subdivision 1 of section 2807-v of the public
health  law, as amended by section 5 of part B of chapter 58 of the laws
of 2008, is amended to read as follows:
  (fff) Funds shall be made available to the empire state stem cell fund
established by section ninety-nine-p of the state finance law [from  the
public  asset  as  defined in section four thousand three hundred one of
the insurance law and accumulated from the conversion  of  one  or  more
article forty-three corporations and its or their not-for-profit subsid-
iaries  occurring  on  or after January first, two thousand seven.  Such
funds shall be made available] within amounts appropriated up  to  fifty
million  dollars  annually  and  shall  not  exceed five hundred million
dollars in total.

S. 2809--B                         17                         A. 4009--B

  S 17.  Intentionally Omitted.
  S  18.  Subdivision  3  of  section  571  of the public health law, as
amended by chapter 436 of the laws  of  1993,  is  amended  to  read  as
follows:
  3.  "Reference system" means a system of [periodic testing] ASSESSMENT
of methods, procedures and materials of clinical laboratories and  blood
banks,  including,  but  not  limited  to,  ONGOING VALIDATION WHICH MAY
INCLUDE DIRECT TESTING AND EXPERIMENTATION BY  THE  DEPARTMENT  OF  SUCH
METHODS,  PROCEDURES  AND  MATERIALS,  the  distribution  of [manuals of
approved methods] STANDARDS AND GUIDELINES,  inspection  of  facilities,
[cooperative  research,  and]  periodic submission of test specimens for
examination, AND RESEARCH CONDUCTED BY THE DEPARTMENT THAT INVOLVES  THE
STUDY  OF NEW OR EXISTING METHODS, PROCEDURES AND MATERIALS IN THE FIELD
OF CLINICAL LABORATORY MEDICINE, AND SUCH OTHER ACTIVITIES AS MAY BE SET
FORTH IN REGULATION.
  S 19. Subdivisions 1, 2 and 6 of section 575 of the public health law,
as amended by chapter 436 of the laws of 1993, are amended  to  read  as
follows:
  1.  Application for a permit shall be made by the owner and the direc-
tor of the clinical laboratory or blood bank [upon forms provided by the
department] IN A MANNER AND FORMAT PRESCRIBED  BY  THE  DEPARTMENT.  The
application  shall contain the name of the owner, the name of the direc-
tor, the procedures or categories of procedures or  services  for  which
the permit is sought, the location or locations and physical description
of  the  facility  or  location  or  locations  at which tests are to be
performed or at which a blood bank is to be  operated,  and  such  other
information as the department may require.
  2.  A  permit  OR  PERMIT  CATEGORY shall not be issued unless a valid
certificate of qualification in the category of procedures for which the
permit is sought has  been  issued  to  the  director  pursuant  to  the
provisions  of  section  five hundred seventy-three of this title, [and]
unless ALL FEES AND OUTSTANDING PENALTIES, IF ANY, HAVE BEEN  PAID,  AND
the  department  finds  that  the  clinical  laboratory or blood bank is
competently staffed and properly equipped, and will be operated  in  the
manner required by this title.
  6.  A  permit shall become void by a change in the director, owner, or
location. A CATEGORY ON A PERMIT SHALL BECOME VOID BY A  CHANGE  IN  THE
DIRECTOR  FOR THAT CATEGORY. The department may, pursuant to regulations
adopted under this title, extend the date on which a permit OR  CATEGORY
ON A PERMIT shall become void for a period not to exceed sixty days from
the date of a change of the director, owner or location.  An application
for  a  NEW  permit  [may]  MUST  be  made  [at any time,] in the manner
provided by this section.
  S 20. Subdivision 3 and paragraphs (a), (b), (c) and (e)  of  subdivi-
sion  4  of  section 576 of the public health law, as amended by chapter
436 of the laws of 1993, are amended to read as follows:
  3. The department shall operate a reference system and shall prescribe
standards for the PROPER OPERATION OF CLINICAL  LABORATORIES  AND  BLOOD
BANKS  AND  FOR  THE examination of specimens. As part of such reference
system, the department may REVIEW AND APPROVE TESTING METHODS  DEVELOPED
OR  MODIFIED BY CLINICAL LABORATORIES AND BLOOD BANKS PRIOR TO THE TEST-
ING METHODS BEING OFFERED IN THIS STATE, AND MAY require clinical  labo-
ratories  and  blood  banks  to  analyze  test  samples submitted by the
department and to report on the results of such analyses. The rules  and
regulations  of  the department shall prescribe the REQUIREMENTS FOR THE
PROPER OPERATION OF  A  CLINICAL  LABORATORY  OR  BLOOD  BANK,  FOR  THE

S. 2809--B                         18                         A. 4009--B

APPROVAL  OF  METHODS  AND  THE  manner  in which proficiency testing or
analyses of samples shall be performed and reports submitted. Failure to
meet department standards FOR THE PROPER OPERATION OF A CLINICAL LABORA-
TORY  OR  BLOOD BANK, INCLUDING THE CRITERIA FOR APPROVAL OF METHODS, OR
FAILURE TO MAINTAIN  SATISFACTORY  PERFORMANCE  in  proficiency  testing
shall  result in termination of the permit in the category or categories
of testing established by the department in regulation until remediation
is achieved. Such standards shall be at least as  stringent  as  federal
standards  promulgated under the federal clinical laboratory improvement
[act] AMENDMENTS of nineteen  hundred  eighty-eight.  Such  failure  and
termination  shall  be  subject to review in accordance with regulations
adopted by the department.
  (a) The department may adopt and amend rules and regulations to effec-
tuate the provisions and purposes of this title. Such  rules  and  regu-
lations  shall  establish  [inspection  and reference] fees for clinical
laboratories and blood banks in amounts not exceeding the  cost  of  the
[inspection  and]  reference  [program] SYSTEM for clinical laboratories
and blood banks and shall be subject to the approval of the director  of
the budget.  THE COMMISSIONER SHALL DETERMINE THE PROPER COST ALLOCATION
METHOD TO UTILIZE TO DETERMINE THE COST OF THE REFERENCE SYSTEM. THE FEE
PAID  BY  THE DEPARTMENT TO MAINTAIN AN EXEMPTION FOR CLINICAL LABORATO-
RIES AND BLOOD BANKS FROM THE REQUIREMENTS OF THE FEDERAL CLINICAL LABO-
RATORY IMPROVEMENT AMENDMENTS OF NINETEEN HUNDRED EIGHTY-EIGHT SHALL  BE
DEEMED A COST OF THE REFERENCE SYSTEM.
  (b)  In  determining  the  fee  charges to be assessed, the department
shall, on or before May first of each year, compute the  [total  actual]
costs for the preceding state fiscal year which were expended to operate
and  administer the duties of the department pursuant to this title. The
department shall, at such time or times and pursuant to  such  procedure
as it shall determine by regulation, bill and collect from each clinical
laboratory  and  blood bank an amount computed by multiplying such total
computed operating expenses of the department by a fraction the  numera-
tor of which is the gross annual receipts of such clinical laboratory or
blood  bank during such twelve month period preceding the date of compu-
tation as the department shall designate by regulation, and the  denomi-
nator  of which is the total gross annual receipts of all clinical labo-
ratories or blood banks operating in the state during such period.
  (c) Each such clinical laboratory and blood bank shall submit  to  the
department,  in  such  form  and  at  such  times  as the department may
require, a report containing  information  regarding  its  gross  annual
receipts [from the performance of tests or examination of specimens] FOR
ALL  ACTIVITIES  PERFORMED pursuant to a permit issued by the department
in accordance with the provisions of section five  hundred  seventy-five
of  this  title.  The  department may require additional information and
audit and review such information to verify its accuracy.
  (e) On or before September fifteenth  of  each  year,  the  department
shall  [recompute  the  actual] RECONCILE ITS costs and expenses [of the
department] FOR THE REFERENCE SYSTEM for the preceding state fiscal year
and shall, on or before October fifteenth send to each clinical  labora-
tory  and blood bank, a statement setting forth the amount due and paya-
ble by, or the amount computed to the credit of, such clinical laborato-
ry or blood bank, computed on the basis of  the  above  stated  formula,
except  that  for the purposes of such computation the fraction shall be
multiplied against the total recomputed [actual] expenses of the depart-
ment for such fiscal year. Any amount due shall  be  payable  not  later

S. 2809--B                         19                         A. 4009--B

than  thirty days following the date of such statement. Any credit shall
be applied against any succeeding payment due.
  S 21. Subdivision 1 of section 577 of the public health law is amended
by adding a new paragraph (i) to read as follows:
  (I)  HAS BEEN FOUND UPON INSPECTION BY THE DEPARTMENT TO BE IN NONCOM-
PLIANCE WITH A PROVISION OR PROVISIONS OF THIS TITLE OR  THE  RULES  AND
REGULATIONS  PROMULGATED HEREUNDER, AND HAS FAILED TO ADDRESS SUCH FIND-
INGS AS REQUIRED BY THE DEPARTMENT.
  S 22.  Intentionally Omitted.
  S 23.  Intentionally Omitted.
  S 24.  Intentionally Omitted.
  S 25.  Intentionally Omitted.
  S 25-a. Section 2818 of the public health law is amended by  adding  a
new subdivision 6 to read as follows:
  6.  NOTWITHSTANDING  ANY  CONTRARY PROVISION OF THIS SECTION, SECTIONS
ONE HUNDRED TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW,
OR ANY OTHER CONTRARY PROVISION OF LAW, SUBJECT TO  AVAILABLE  APPROPRI-
ATIONS,  FUNDS AVAILABLE FOR EXPENDITURE PURSUANT TO THIS SECTION MAY BE
DISTRIBUTED BY THE COMMISSIONER WITHOUT A COMPETITIVE BID OR REQUEST FOR
PROPOSAL PROCESS FOR GRANTS TO GENERAL HOSPITALS AND RESIDENTIAL  HEALTH
CARE  FACILITIES  FOR  THE PURPOSE OF FACILITATING CLOSURES, MERGERS AND
RESTRUCTURING OF SUCH FACILITIES IN  ORDER  TO  STRENGTHEN  AND  PROTECT
CONTINUED ACCESS TO ESSENTIAL HEALTH CARE RESOURCES.
  S 26. Section 32 of part A of chapter 58 of the laws of 2008, amending
the  elder  law  and  other laws relating to reimbursement to particular
provider pharmacies  and  prescription  drug  coverage,  as  amended  by
section  20  of part OO of chapter 57 of the laws of 2008, is amended to
read as follows:
  S 32. This act shall take effect immediately and shall  be  deemed  to
have  been in full force and effect on and after April 1, 2008; provided
however, that sections one, six-a, nineteen,  twenty,  twenty-four,  and
twenty-five of this act shall take effect July 1, 2008; [provided howev-
er  that  sections  sixteen,  seventeen  and  eighteen of this act shall
expire April 1, 2011;] provided, however, that the  amendments  made  by
section  twenty-eight  of this act shall take effect on the same date as
section 1 of chapter 281 of the laws  of  2007  takes  effect;  provided
further,  that  sections twenty-nine, thirty, and thirty-one of this act
shall take effect October 1, 2008; provided further, that section  twen-
ty-seven  of  this  act  shall take effect January 1, 2009; and provided
further, that section twenty-seven of  this  act  shall  expire  and  be
deemed repealed March 31, 2011; and provided, further, however, that the
amendments  to subdivision 1 of section 241 of the education law made by
section twenty-nine of this act shall not affect the expiration of  such
subdivision  and  shall  be deemed to expire therewith and provided that
the amendments to section 272 of the public health law made  by  section
thirty of this act shall not affect the repeal of such section and shall
be deemed repealed therewith.
  S 27. Section 4 of part X2 of chapter 62 of the laws of 2003, amending
the  public  health law relating to allowing for the use of funds of the
office of professional medical conduct for  activities  of  the  patient
health  information  and  quality improvement act of 2000, as amended by
chapter 21 of the laws of 2010, is amended to read as follows:
  S 4. This  act  shall  take  effect  immediately;  provided  that  the
provisions  of  section  one of this act shall be deemed to have been in
full force and effect on and after April 1, 2003, and shall expire March

S. 2809--B                         20                         A. 4009--B

31, [2011] 2013 when upon such date the provisions of such section shall
be deemed repealed.
  S  28.  Paragraph (b) of subdivision 1 of section 76 of chapter 731 of
the laws of 1993, amending the public health law and other laws relating
to reimbursement, delivery and capital cost of  ambulatory  health  care
services  and  inpatient  hospital services, as amended by section 14 of
part A of chapter 58 of the laws of 2007, is amended to read as follows:
  (b) sections fifteen through nineteen and  subdivision  3  of  section
2807-e  of  the public health law as added by section twenty of this act
shall expire on [July 1, 2011] JULY 1, 2014, and section seventy-four of
this act shall expire on July 1, 2007;
  S 29. Section 4 of chapter 505 of  the  laws  of  1995,  amending  the
public  health  law  relating  to  the operation of department of health
facilities, as amended by chapter 609 of the laws of 2007, is amended to
read as follows:
  S 4. This act shall take effect immediately[; provided, however,  that
the provisions of paragraph (b) of subdivision 4 of section 409-c of the
public  health  law,  as  added by section three of this act, shall take
effect January 1, 1996 and shall expire and be deemed  repealed  sixteen
years from the effective date thereof].
  S  30.  Section 3 of chapter 303 of the laws of 1999, amending the New
York state medical  care  facilities  finance  agency  act  relating  to
financing  health  facilities,  as amended by chapter 607 of the laws of
2007, is amended to read as follows:
  S 3. This act shall take effect immediately[, provided, however,  that
subdivision 15-a of section 5 of section 1 of chapter 392 of the laws of
1973,  as  added  by section one of this act, shall expire and be deemed
repealed June 30, 2011; and provided further, however, that the  expira-
tion  and  repeal of such subdivision 15-a shall not affect or impair in
any manner any health facilities bonds issued, or any lease or  purchase
of  a  health facility executed, pursuant to such subdivision 15-a prior
to its expiration and repeal and that, with respect to  any  such  bonds
issued  and  outstanding  as  of  June  30, 2011, the provisions of such
subdivision 15-a as they existed immediately prior  to  such  expiration
and  repeal  shall continue to apply through the latest maturity date of
any such bonds, or their earlier retirement or redemption, for the  sole
purpose  of  authorizing the issuance of refunding bonds to refund bonds
previously issued pursuant thereto].
  S 31. This act shall take effect  April  1,  2011,  provided,  however
that:
  (a) section one of this act shall take effect July 1, 2011;
  (b) sections two through three-n of this act shall take effect January
1, 2012;
  (c) section thirteen of this act shall take effect July 1, 2011; and
  (d)  related  to sections eighteen, nineteen, twenty and twenty-one of
this act, the commissioner of health is authorized to promulgate, on  an
emergency basis, any regulations necessary to implement any provision of
such sections upon their effective date.

                                 PART B

  Section  1.    (a)  Notwithstanding any inconsistent provision of law,
rule or regulation to the contrary, and subject to the  availability  of
federal  financial participation, effective for the period April 1, 2011
through March 31, 2012, and  each  state  fiscal  year  thereafter,  the
department  of  health  is  authorized  to  make  supplemental  Medicaid

S. 2809--B                         21                         A. 4009--B

payments for professional services provided by physicians, nurse practi-
tioners and physician assistants who are participating in a plan for the
management of clinical practice at the State University of New York,  in
accordance  with  title  11  of article 5 of the social services law for
patients eligible for federal financial participation under title XIX of
the federal social security act, in amounts that will increase fees  for
such  professional services to an amount equal to the average commercial
rate that would otherwise be received for such services rendered by such
physicians, nurse practitioners and  physician  assistants.  The  calcu-
lation  of  such  supplemental  fee payments shall be made in accordance
with applicable federal law and regulation and subject to  the  approval
of  the  division of the budget. Such supplemental Medicaid fee payments
may be added to the professional fees paid under  the  fee  schedule  or
made  as aggregate lump sum payments to eligible clinical practice plans
authorized to receive professional fees.
  (b) The affiliated State University of New York health science centers
shall be responsible for payment of one hundred percent of the  non-fed-
eral  share  of  such  supplemental  Medicaid  payments for all services
provided by physicians, nurse practitioners and physician assistants who
are participating in a plan for the management of clinical practice,  in
accordance  with section 365-a of the social services law, regardless of
whether another social services district or the department of health may
otherwise be responsible for furnishing medical assistance to the eligi-
ble persons receiving such services.
  S 2.  Subdivision 21 of section 2807-c of the  public  health  law  is
amended by adding a new paragraph (e-1) to read as follows:
  (E-1) FOR PERIODS ON AND AFTER JANUARY FIRST, TWO THOUSAND ELEVEN, FOR
PURPOSES  OF  CALCULATIONS  PURSUANT  TO  PARAGRAPHS (B) AND (C) OF THIS
SUBDIVISION OF MAXIMUM DISPROPORTIONATE SHARE PAYMENT DISTRIBUTIONS  FOR
A  RATE  YEAR  OR  PART  THEREOF,  COSTS INCURRED OF FURNISHING HOSPITAL
SERVICES NET OF MEDICAL ASSISTANCE PAYMENTS, OTHER THAN DISPROPORTIONATE
SHARE PAYMENTS, AND PAYMENTS BY UNINSURED PATIENTS  SHALL  FOR  THE  TWO
THOUSAND  ELEVEN  CALENDAR  YEAR, SHALL BE DETERMINED INITIALLY BASED ON
EACH HOSPITAL'S SUBMISSION OF  A  FULLY  COMPLETED  TWO  THOUSAND  EIGHT
DISPROPORTIONATE  SHARE HOSPITAL DATA COLLECTION TOOL, WHICH IS REQUIRED
TO BE SUBMITTED TO THE DEPARTMENT BY MARCH  THIRTY-FIRST,  TWO  THOUSAND
ELEVEN,  AND  SHALL  BE  SUBSEQUENTLY REVISED TO REFLECT EACH HOSPITAL'S
SUBMISSION OF A FULLY COMPLETED TWO THOUSAND NINE DISPROPORTIONATE SHARE
HOSPITAL DATA COLLECTION TOOL, WHICH IS REQUIRED TO BE SUBMITTED TO  THE
DEPARTMENT BY OCTOBER FIRST, TWO THOUSAND ELEVEN.
  FOR  CALENDAR  YEARS  ON  AND  AFTER TWO THOUSAND TWELVE, SUCH INITIAL
DETERMINATIONS SHALL REFLECT SUBMISSION  OF  DATA  AS  REQUIRED  BY  THE
COMMISSIONER ON A SPECIFIED DATE.  ALL SUCH INITIAL DETERMINATIONS SHALL
SUBSEQUENTLY  BE  REVISED TO REFLECT ANNUAL RATE PERIOD DATA AND STATIS-
TICS. INDIGENT CARE PAYMENTS WILL BE WITHHELD IN INSTANCES WHEN A HOSPI-
TAL HAS NOT SUBMITTED REQUIRED INFORMATION BY THE DUE  DATES  PRESCRIBED
IN  THIS  PARAGRAPH, PROVIDED, HOWEVER, THAT SUCH PAYMENTS SHALL BE MADE
UPON SUBMISSION OF SUCH REQUIRED  DATA.  FOR  PURPOSES  OF  CALCULATIONS
PURSUANT  TO PARAGRAPH (D) OF THIS SUBDIVISION OF ELIGIBILITY TO RECEIVE
DISPROPORTIONATE SHARE PAYMENTS FOR A RATE YEAR  OR  PART  THEREOF,  THE
HOSPITAL  INPATIENT  UTILIZATION  RATE  SHALL BE DETERMINED BASED ON THE
BASE YEAR STATISTICS IN ACCORDANCE WITH THE METHODOLOGY  ESTABLISHED  BY
THE  COMMISSIONER,  AND  COSTS  INCURRED OF FURNISHING HOSPITAL SERVICES
SHALL BE DETERMINED IN ACCORDANCE WITH A METHODOLOGY ESTABLISHED BY  THE
COMMISSIONER  CONSISTENT  WITH  REQUIREMENTS  OF  THE  SECRETARY  OF THE
DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR PURPOSES OF  FEDERAL  FINAN-

S. 2809--B                         22                         A. 4009--B

CIAL PARTICIPATION PURSUANT TO THE TITLE XIX OF THE FEDERAL SOCIAL SECU-
RITY ACT IN DISPROPORTIONATE SHARE PAYMENTS.
  S  3.  Subparagraph (i) of paragraph (b) of subdivision 2-b of section
2808 of the public health law, as amended by section  1  of  part  D  of
chapter 58 of the laws of 2010, is amended to read as follows:
  (i)  Subject  to the provisions of subparagraphs (ii) through (xiv) of
this paragraph, for periods on and after April first, two thousand  nine
through June thirtieth, two thousand eleven the operating cost component
of  rates of payment shall reflect allowable operating costs as reported
in each facility's cost report for the two thousand two  calendar  year,
as  adjusted  for  inflation  on  an annual basis in accordance with the
methodology set forth in paragraph (c) of  subdivision  ten  of  section
twenty-eight  hundred  seven-c  of this article, provided, however, that
for those facilities which do not receive a per diem  add-on  adjustment
pursuant  to  subparagraph  (ii)  of  paragraph (a) of this subdivision,
rates shall be further adjusted to include the proportionate benefit, as
determined by the commissioner, of the expiration of the  opening  para-
graph  and  paragraph  (a) of subdivision sixteen of this section and of
paragraph (a) of subdivision fourteen  of  this  section,  and  provided
further  that the operating cost component of rates of payment for those
facilities which did not receive a per  diem  adjustment  in  accordance
with subparagraph (ii) of paragraph (a) of this subdivision shall not be
less  than  the  operating component such facilities received in the two
thousand eight rate period, as adjusted for inflation on an annual basis
in accordance with the methodology set forth in paragraph (c) of  subdi-
vision  ten  of section twenty-eight hundred seven-c of this article and
further provided, however, that rates  for  facilities  whose  operating
cost component reflects base year costs subsequent to January first, two
thousand  two  shall  have  rates computed in accordance with this para-
graph, utilizing allowable operating costs as reported  in  such  subse-
quent  base year period, and trended forward to the rate year in accord-
ance with applicable inflation factors, AND PROVIDED  FURTHER,  HOWEVER,
THAT  NOTWITHSTANDING  ANY  INCONSISTENT  PROVISION OF THIS SUBDIVISION,
RATE ADJUSTMENTS AS DESCRIBED IN THIS SUBPARAGRAPH AND AS EFFECTIVE  FOR
RATE  PERIODS  ON  AND AFTER APRIL FIRST, TWO THOUSAND NINE THROUGH JUNE
THIRTIETH, TWO THOUSAND ELEVEN, SHALL NOT BE IMPLEMENTED AND PAID  PRIOR
TO JULY FIRST, TWO THOUSAND ELEVEN.
  S  4.  Section 2 of part D of chapter 58 of the laws of 2009, amending
the public health law and other laws relating to Medicaid reimbursements
to residential health care facilities, as amended by section 3 of Part D
of chapter 58 of the laws of 2010, is amended to read as follows:
  S 2. Notwithstanding paragraph (b) of subdivision 2-b of section  2808
of  the  public  health law or any other contrary provision of law, with
regard to  adjustments  to  medicaid  rates  of  payment  for  inpatient
services  provided  by residential health care facilities for the period
April 1, 2009 through March 31, 2010, made pursuant to paragraph (b)  of
subdivision  2-b  of  section 2808 of the public health law, the commis-
sioner of health and the director of the budget shall, upon  a  determi-
nation  that  such adjustments, including the application of adjustments
authorized by the provisions of paragraph  (g)  of  subdivision  2-b  of
section  2808  of  the  public  health law, shall result in an aggregate
increase in total Medicaid rates of payment for such services  for  such
period  that  is  less than or more than two hundred ten million dollars
($210,000,000), make such proportional adjustments to such rates as  are
necessary to result in an increase of such aggregate expenditures of two
hundred ten million dollars ($210,000,000), and provided further, howev-

S. 2809--B                         23                         A. 4009--B

er,  that  notwithstanding  section 2808 of the public health law or any
other contrary provision of law, with regard to adjustments to inpatient
rates of payment made pursuant to section 2808 of the public health  law
for  inpatient  services  provided by residential health care facilities
for the period April 1, 2010 through [June 30, 2011] MARCH 31, 2012, the
commissioner of health and the director of  the  budget  shall,  upon  a
determination  by  such  commissioner  and  such director that such rate
adjustments shall, prior to the application of any applicable adjustment
for inflation, result in an aggregate increase in total  Medicaid  rates
of  payment  for  such  services,  including  payments  made pursuant to
subparagraph (i) of paragraph (d) of subdivision 2-c of section 2808  of
the  public health law, make such proportional adjustments to such rates
as are necessary to reduce such total aggregate  rate  adjustments  such
that  the  aggregate  total  reflects  no such increase or decrease, and
provided further, however, the case mix adjustments as otherwise author-
ized by subparagraph (ii) of paragraph (b) of subdivision 2-b of section
2808 of the public health law and as scheduled for January of 2011 shall
not be made.  Adjustments made pursuant to this  section  shall  not  be
subject to subsequent correction or reconciliation.
  S4-a.  Subdivision  2-c  of  section  2808 of the public health law is
REPEALED and a new subdivision 2-c is added, to read as follows:
  2-C. (A) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS SECTION OR
ANY OTHER CONTRARY PROVISION OF LAW AND SUBJECT TO THE  AVAILABILITY  OF
FEDERAL  FINANCIAL  PARTICIPATION, THE NON-CAPITAL COMPONENT OF RATES OF
PAYMENT BY GOVERNMENTAL AGENCIES  FOR  INPATIENT  SERVICES  PROVIDED  BY
RESIDENTIAL HEALTH CARE FACILITIES ON AND AFTER JULY FIRST, TWO THOUSAND
ELEVEN  SHALL  REFLECT  A DIRECT STATEWIDE PRICE COMPONENT, AND INDIRECT
STATEWIDE PRICE COMPONENT, AND A FACILITY SPE