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

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  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

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  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.]

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  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

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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

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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;

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  [(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

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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-

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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

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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

S. 2809--A                         84                         A. 4009--A

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-

S. 2809--A                         85                         A. 4009--A

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

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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:

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  (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-

S. 2809--A                         91                         A. 4009--A

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:

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  (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

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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,

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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

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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

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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;

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  (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

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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.

                            
                    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 SPECIFIC NON-COMPARABLE COMPO-
NENT, UTILIZING ALLOWABLE OPERATING COSTS FOR A BASE YEAR AS  DETERMINED
BY THE COMMISSIONER BY REGULATION.
  (B)  THE  DIRECT  AND  INDIRECT  STATEWIDE  PRICE  COMPONENTS SHALL BE
ADJUSTED BY A WAGE EQUALIZATION FACTOR AND THE  DIRECT  STATEWIDE  PRICE
COMPONENT  SHALL  BE  SUBJECT  TO  A  CASE  MIX ADJUSTMENT UTILIZING THE
PATIENTS THAT ARE ELIGIBLE FOR MEDICAL ASSISTANCE PURSUANT TO TILE ELEV-
EN OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW.
  (C) THE NON-CAPITAL COMPONENT OF THE RATES FOR (I) AIDS FACILITIES  OR
DISCRETE AIDS UNITS WITHIN FACILITIES, (II) DISCRETE UNITS FOR RESIDENTS
RECEIVING CARE IN A LONG-TERM INPATIENT REHABILITATION PROGRAM FOR TRAU-
MATIC  BRAIN INJURED PERSONS, (III) DISCRETE UNITS PROVIDING SPECIALIZED
PROGRAMS FOR RESIDENTS REQUIRING BEHAVIORAL INTERVENTIONS, (IV) DISCRETE
UNITS FOR LONG-TERM VENTILATOR DEPENDENT RESIDENTS, AND  (V)  FACILITIES
OR  DISCRETE  UNITS  WITHIN  FACILITIES  THAT PROVIDE EXTENSIVE NURSING,
MEDICAL, PSYCHOLOGICAL AND COUNSELING SUPPORT SERVICES SOLELY  TO  CHIL-
DREN  SHALL  BE ESTABLISHED PURSUANT TO REGULATIONS PROMULGATED PURSUANT
TO THIS SUBDIVISION.
  (D) THE COMMISSIONER SHALL PROMULGATE REGULATIONS, AND MAY  PROMULGATE
EMERGENCY  REGULATIONS,  TO IMPLEMENT THE PROVISIONS OF THIS SUBDIVISION
AND SUCH REGULATIONS MAY ALSO INCLUDE, BUT NOT BE LIMITED TO, PROVISIONS
FOR RATE ADJUSTMENTS OR PAYMENT ENHANCEMENTS TO FACILITATE  THE  TRANSI-
TION  OF  FACILITIES TO THE RATE-SETTING METHODOLOGY ESTABLISHED BY THIS
SUBDIVISION AND FOR FACILITATING  QUALITY  IMPROVEMENTS  IN  RESIDENTIAL
HEALTH CARE FACILITIES.
  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-

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

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,
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

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

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
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. Intentionally omitted.
  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
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

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

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,
  (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,

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

  (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.
  (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

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

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
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

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

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 6. Intentionally omitted.
  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

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

(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;
  (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;

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

  (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
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-

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

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
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

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

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
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-

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

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
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

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

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
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

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

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
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

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

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;
  (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

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

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:
  (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:

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

  (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-
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)

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

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
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-

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

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
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;

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

  (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
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

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

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
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-

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

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.
  (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;

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

  (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
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,

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

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
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

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

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
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;

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

  (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
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

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

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;
  (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

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

  (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;
  (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-

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

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;
  (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;

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

  (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
  (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;

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

  (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
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

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

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;
  (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]

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

  (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;
  (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;

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

  (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
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;

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

  (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;
  (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-

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

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;
  (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;

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

  (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:
  (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:

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

  (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;
  (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;

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

  (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-
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.

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

  (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;
  (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

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

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;
  (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;

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

  (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.
  (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

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

  (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;
  (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;

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

  (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
  (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.

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

  (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;
  (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

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

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;
  (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;

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

  (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
  (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

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

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;
  (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,

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

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
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

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

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
  (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

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

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
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

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

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
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;

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

  (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;
  (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

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

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
  (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;

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

  (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
  (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

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

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
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

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

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
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

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

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 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:

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

  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-
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,

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

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
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,

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

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
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

S. 2809--B                         84                         A. 4009--B

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
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

S. 2809--B                         85                         A. 4009--B

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,
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

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

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
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

S. 2809--B                         87                         A. 4009--B

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,
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-

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

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
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

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

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,
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[.];

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

  (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[.];
  (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,

S. 2809--B                         91                         A. 4009--B

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
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

S. 2809--B                         92                         A. 4009--B

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
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.

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

  (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
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. 2809--B                         94                         A. 4009--B

  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
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

S. 2809--B                         95                         A. 4009--B

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:
  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. 2809--B                         96                         A. 4009--B

  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
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

S. 2809--B                         97                         A. 4009--B

  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
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

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

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
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

S. 2809--B                         99                         A. 4009--B

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
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

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

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 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

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

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
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. 2809--B                         102                        A. 4009--B

  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
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

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

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.
  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-

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

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;
  (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

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

  (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.
  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

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

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
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

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

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
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

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

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
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. Intentionally omitted.
  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

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

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-
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

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

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
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

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

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

  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. 2809--B                         112                        A. 4009--B

  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
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.

                                 PART H

  Section 1. Subparagraph 1  of  paragraph  (c)  of  subdivision  10  of
section  2807-c  of  the public health law, as amended by chapter 419 of
the laws of 2000, is amended to read as follows:
  (1) For rate periods on and after April first,  two  thousand  THROUGH
MARCH  THIRTY-FIRST,  TWO THOUSAND ELEVEN, the commissioner shall estab-
lish trend factors for rates of payment for state governmental  agencies
to  project  for the effects of inflation except that such trend factors
shall not be applied to services for which rates of payment  are  estab-
lished  by  the  commissioners  of the department of mental hygiene. The
factors shall be applied to  the  appropriate  portion  of  reimbursable
costs.
  S  2.  Section 21 of 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, as amended by section 18 of part D of chapter 58 of
the laws of 2009, is amended to read as follows:
  S 21. Notwithstanding any inconsistent provision of law, effective FOR
RATE PERIODS April 1, 2000 THROUGH MARCH 31, 2011, in determining  rates
of  payment  for  residential health care facilities pursuant to section
2808 of the public health law, hospital outpatient services and diagnos-
tic and treatment centers pursuant to section 2807 of the public  health
law,  unless  otherwise  subject to the limits set forth in section 4 of

S. 2809--B                         113                        A. 4009--B

chapter 81 of the laws of 1995, as amended by this act,  certified  home
health  agencies  and  long  term  home health care programs pursuant to
section 3614-a of the public  health  law  and  personal  care  services
pursuant to section 367-i of the social services law, and for periods on
and  after  April  1,  2009,  adult day health care services provided to
patients diagnosed with AIDS as defined by applicable  regulations,  the
commissioner  of  health shall apply trend factors using the methodology
described in paragraph (c) of subdivision 10 of section  2807-c  of  the
public  health  law, except that such trend factors shall not be applied
to services for which rates of payment are established  by  the  commis-
sioners of the department of mental hygiene.  Nothing in this section is
intended  to reduce a change in any existing provision of law establish-
ing maximum reimbursement rates.
  S 2-a. Notwithstanding any contrary provision of law,  rule  or  regu-
lation, for Medicaid rates of payment for services provided on and after
April  1,  2011  the  commissioner of health is authorized to promulgate
regulations, including  emergency  regulations,  with  regard  to  trend
factor  adjustments  for inflation which may be applied to such rates of
payment with regard to hospice services provided pursuant to article  40
of  the  public  health  law,  assisted living program services provided
pursuant to section 461-1  of  the  social  services  law,  foster  care
services  provided  pursuant  to  article  6 of the social services law,
adult day health care services provided pursuant to article  28  of  the
public  health  law  or  personal  care services provided in those local
social services districts, including  New  York  city,  whose  rates  of
payment  for  such  services  is  established  by  such  social services
districts pursuant to a rate-setting exemption issued by the commission-
er of health to such local social services districts in accordance  with
applicable regulations.
  S  3. Section 3614 of the public health law is amended by adding a new
subdivision 12 to read as follows:
  12. (A) NOTWITHSTANDING ANY INCONSISTENT PROVISION  OF  LAW  OR  REGU-
LATION  AND  SUBJECT  TO  THE  AVAILABILITY OF FEDERAL FINANCIAL PARTIC-
IPATION, EFFECTIVE ON AND AFTER APRIL FIRST, TWO THOUSAND ELEVEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND TWELVE, RATES OF PAYMENT BY  GOVERNMENT
AGENCIES FOR SERVICES PROVIDED BY CERTIFIED HOME HEALTH AGENCIES, EXCEPT
FOR  SUCH  SERVICES PROVIDED TO CHILDREN UNDER EIGHTEEN YEARS OF AGE AND
OTHER DISCRETE GROUPS AS MAY BE DETERMINED BY THE COMMISSIONER  PURSUANT
TO  REGULATIONS, SHALL REFLECT CEILING LIMITATIONS DETERMINED IN ACCORD-
ANCE WITH THIS SUBDIVISION, PROVIDED, HOWEVER, THAT AT THE DISCRETION OF
THE COMMISSIONER SUCH CEILINGS MAY, AS AN  ALTERNATIVE,  BE  APPLIED  TO
PAYMENTS  FOR  SERVICES  PROVIDED ON AND AFTER APRIL FIRST, TWO THOUSAND
ELEVEN, EXCEPT FOR SUCH SERVICES PROVIDED TO CHILDREN AND OTHER DISCRETE
GROUPS AS MAY BE DETERMINED BY THE COMMISSIONER PURSUANT TO REGULATIONS.
IN DETERMINING SUCH PAYMENTS OR RATES OF PAYMENT, AGENCY CEILINGS  SHALL
BE  ESTABLISHED.  SUCH CEILINGS SHALL BE APPLIED TO PAYMENTS OR RATES OF
PAYMENT FOR CERTIFIED HOME HEALTH AGENCY SERVICES AS ESTABLISHED  PURSU-
ANT  TO THIS SECTION AND APPLICABLE REGULATIONS. CEILINGS SHALL BE BASED
ON A BLEND OF: (I) AN AGENCY'S TWO THOUSAND  NINE  AVERAGE  PER  PATIENT
MEDICAID  CLAIMS,  WEIGHTED AT A PERCENTAGE AS DETERMINED BY THE COMMIS-
SIONER; AND (II) THE TWO THOUSAND NINE  STATEWIDE  AVERAGE  PER  PATIENT
MEDICAID  CLAIMS  ADJUSTED BY A REGIONAL WAGE INDEX FACTOR AND AN AGENCY
PATIENT CASE MIX INDEX, WEIGHTED AT A PERCENTAGE AS  DETERMINED  BY  THE
COMMISSIONER.  SUCH CEILINGS WILL BE EFFECTIVE APRIL FIRST, TWO THOUSAND
ELEVEN THROUGH MARCH  THIRTY-FIRST,  TWO  THOUSAND  TWELVE.  AN  INTERIM
PAYMENT  OR  RATE OF PAYMENT ADJUSTMENT EFFECTIVE APRIL FIRST, TWO THOU-

S. 2809--B                         114                        A. 4009--B

SAND ELEVEN, SHALL BE APPLIED TO AGENCIES  WITH  PROJECTED  AVERAGE  PER
PATIENT  MEDICAID  CLAIMS, AS DETERMINED BY THE COMMISSIONER, TO BE OVER
THEIR CEILINGS. SUCH AGENCIES SHALL HAVE  THEIR  PAYMENTS  OR  RATES  OF
PAYMENT  REDUCED TO REFLECT THE AMOUNT BY WHICH SUCH CLAIMS EXCEED THEIR
CEILINGS.
  (B) CEILING LIMITATIONS DETERMINED PURSUANT TO PARAGRAPH (A)  OF  THIS
SUBDIVISION  SHALL  BE SUBJECT TO RECONCILIATION. IN DETERMINING PAYMENT
OR RATE OF PAYMENT ADJUSTMENTS BASED ON  SUCH  RECONCILIATION,  ADJUSTED
AGENCY  CEILINGS  SHALL BE ESTABLISHED.  SUCH ADJUSTED CEILINGS SHALL BE
BASED ON A BLEND OF: (I) AN  AGENCY'S  TWO  THOUSAND  NINE  AVERAGE  PER
PATIENT  MEDICAID  CLAIMS  ADJUSTED  BY  THE  PERCENTAGE  OF INCREASE OR
DECREASE IN SUCH AGENCY'S PATIENT CASE MIX FROM THE  TWO  THOUSAND  NINE
CALENDAR  YEAR  TO  THE  ANNUAL  PERIOD APRIL FIRST, TWO THOUSAND ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE, WEIGHTED AT A  PERCENT-
AGE  AS  DETERMINED  BY THE COMMISSIONER; AND (II) THE TWO THOUSAND NINE
STATEWIDE AVERAGE PER PATIENT MEDICAID CLAIMS  ADJUSTED  BY  A  REGIONAL
WAGE INDEX FACTOR AND THE AGENCY'S PATIENT CASE MIX INDEX FOR THE ANNUAL
PERIOD  APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND TWELVE, WEIGHTED AT A PERCENTAGE AS DETERMINED BY  THE  COMMIS-
SIONER.  SUCH  ADJUSTED AGENCY CEILING SHALL BE COMPARED TO ACTUAL MEDI-
CAID PAID CLAIMS FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND TWELVE.  IN  THOSE  INSTANCES  WHEN  AN
AGENCY'S ACTUAL PER PATIENT MEDICAID CLAIMS ARE DETERMINED TO EXCEED THE
AGENCY'S  ADJUSTED  CEILING, THE AMOUNT OF SUCH EXCESS SHALL BE DUE FROM
EACH SUCH AGENCY TO THE STATE AND MAY BE RECOUPED BY THE DEPARTMENT IN A
LUMP SUM AMOUNT OR THROUGH REDUCTIONS IN THE MEDICAID  PAYMENTS  DUE  TO
THE  AGENCY.  IN  THOSE  INSTANCES  WHERE  AN INTERIM PAYMENT OR RATE OF
PAYMENT ADJUSTMENT WAS APPLIED TO AN AGENCY IN ACCORDANCE WITH PARAGRAPH
(A) OF THIS SUBDIVISION, AND SUCH AGENCY'S ACTUAL PER  PATIENT  MEDICAID
CLAIMS ARE DETERMINED TO BE LESS THAN THE AGENCY'S ADJUSTED CEILING, THE
AMOUNT BY WHICH SUCH MEDICAID CLAIMS ARE LESS THAN THE AGENCY'S ADJUSTED
CEILING  SHALL  BE  REMITTED  TO EACH SUCH AGENCY BY THE DEPARTMENT IN A
LUMP SUM AMOUNT OR THROUGH AN INCREASE IN THE MEDICAID PAYMENTS  DUE  TO
THE AGENCY.
  (C)  INTERIM  PAYMENT  OR RATE OF PAYMENT ADJUSTMENTS PURSUANT TO THIS
SUBDIVISION SHALL BE BASED ON MEDICAID PAID CLAIMS, AS DETERMINED BY THE
COMMISSIONER, FOR SERVICES PROVIDED BY AGENCIES IN  THE  BASE  YEAR  TWO
THOUSAND  NINE.  AMOUNTS  DUE FROM RECONCILING RATE ADJUSTMENTS SHALL BE
BASED ON MEDICAID PAID CLAIMS, AS DETERMINED BY  THE  COMMISSIONER,  FOR
SERVICES  PROVIDED  BY  AGENCIES  IN THE BASE YEAR TWO THOUSAND NINE AND
MEDICAID PAID CLAIMS, AS DETERMINED BY THE  COMMISSIONER,  FOR  SERVICES
PROVIDED BY AGENCIES IN THE RECONCILIATION PERIOD APRIL FIRST, TWO THOU-
SAND  ELEVEN  THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE. IN DETER-
MINING CASE MIX, EACH PATIENT SHALL BE CLASSIFIED USING A  SYSTEM  BASED
ON MEASURES WHICH MAY INCLUDE, BUT NOT BE LIMITED TO, CLINICAL AND FUNC-
TIONAL  MEASURES,  AS  REPORTED  ON  THE  FEDERAL OUTCOME AND ASSESSMENT
INFORMATION SET (OASIS), AS MAY BE AMENDED.
  (D) THE COMMISSIONER MAY REQUIRE AGENCIES TO COLLECT  AND  SUBMIT  ANY
DATA  REQUIRED  TO  IMPLEMENT  THE  PROVISIONS  OF THIS SUBDIVISION. THE
COMMISSIONER  MAY  PROMULGATE  REGULATIONS,  INCLUDING  EMERGENCY  REGU-
LATIONS, TO IMPLEMENT THE PROVISIONS OF THIS SUBDIVISION.
  (E)  PAYMENTS  OR  RATE  OF PAYMENT ADJUSTMENTS DETERMINED PURSUANT TO
THIS SUBDIVISION SHALL, FOR THE PERIOD APRIL FIRST, TWO THOUSAND  ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE, BE RETROACTIVELY RECON-
CILED UTILIZING THE METHODOLOGY IN PARAGRAPH (B) OF THIS SUBDIVISION AND
UTILIZING ACTUAL PAID CLAIMS FROM SUCH PERIOD.

S. 2809--B                         115                        A. 4009--B

  (F)  NOTWITHSTANDING  ANY  INCONSISTENT PROVISION OF THIS SUBDIVISION,
PAYMENTS OR RATE OF PAYMENT ADJUSTMENTS MADE PURSUANT TO  THIS  SUBDIVI-
SION  SHALL  NOT  RESULT  IN  AN  AGGREGATE  ANNUAL DECREASE IN MEDICAID
PAYMENTS TO PROVIDERS SUBJECT TO THIS SUBDIVISION THAT IS IN  EXCESS  OF
TWO  HUNDRED  MILLION DOLLARS, AS DETERMINED BY THE COMMISSIONER AND NOT
SUBJECT TO SUBSEQUENT ADJUSTMENT, AND THE COMMISSIONER SHALL  MAKE  SUCH
ADJUSTMENTS  TO  SUCH  PAYMENTS  OR RATES OF PAYMENT AS ARE NECESSARY TO
ENSURE THAT SUCH AGGREGATE LIMITS ON PAYMENT DECREASES ARE NOT EXCEEDED.
  S 4. Section 3614 of the public health law is amended by adding a  new
subdivision 13 to read as follows:
  13.  (A)  NOTWITHSTANDING  ANY  INCONSISTENT PROVISION OF LAW OR REGU-
LATION AND SUBJECT TO THE  AVAILABILITY  OF  FEDERAL  FINANCIAL  PARTIC-
IPATION, EFFECTIVE APRIL FIRST, TWO THOUSAND TWELVE, PAYMENTS BY GOVERN-
MENT  AGENCIES  FOR SERVICES PROVIDED BY CERTIFIED HOME HEALTH AGENCIES,
EXCEPT FOR SUCH SERVICES PROVIDED TO CHILDREN UNDER  EIGHTEEN  YEARS  OF
AGE  AND  OTHER DISCREET GROUPS AS MAY BE DETERMINED BY THE COMMISSIONER
PURSUANT TO REGULATIONS, SHALL BE BASED ON EPISODIC PAYMENTS. IN  ESTAB-
LISHING  SUCH  PAYMENTS, A STATEWIDE BASE PRICE SHALL BE ESTABLISHED FOR
EACH SIXTY DAY EPISODE OF CARE AND ADJUSTED BY  A  REGIONAL  WAGE  INDEX
FACTOR  AND AN INDIVIDUAL PATIENT CASE MIX INDEX. SUCH EPISODIC PAYMENTS
MAY BE FURTHER ADJUSTED FOR LOW  UTILIZATION  CASES  AND  TO  REFLECT  A
PERCENTAGE LIMITATION OF THE COST FOR HIGH-UTILIZATION CASES THAT EXCEED
OUTLIER THRESHOLDS OF SUCH PAYMENTS.
  (B)  INITIAL  BASE  YEAR  EPISODIC PAYMENTS SHALL BE BASED ON MEDICAID
PAID CLAIMS, AS DETERMINED AND ADJUSTED BY THE COMMISSIONER  TO  ACHIEVE
SAVINGS COMPARABLE TO THE PRIOR STATE FISCAL YEAR, FOR SERVICES PROVIDED
BY  ALL  CERTIFIED  HOME  HEALTH  AGENCIES IN THE BASE YEAR TWO THOUSAND
NINE. SUBSEQUENT BASE YEAR EPISODIC PAYMENTS MAY BE  BASED  ON  MEDICAID
PAID  CLAIMS FOR SERVICES PROVIDED BY ALL CERTIFIED HOME HEALTH AGENCIES
IN A BASE YEAR SUBSEQUENT TO TWO THOUSAND NINE,  AS  DETERMINED  BY  THE
COMMISSIONER, PROVIDED, HOWEVER, THAT SUCH BASE YEAR ADJUSTMENT SHALL BE
MADE  NOT  LESS  FREQUENTLY THAN EVERY THREE YEARS.  IN DETERMINING CASE
MIX, EACH PATIENT SHALL BE CLASSIFIED USING A SYSTEM BASED  ON  MEASURES
WHICH MAY INCLUDE, BUT NOT LIMITED TO, CLINICAL AND FUNCTIONAL MEASURES,
AS  REPORTED  ON  THE  FEDERAL  OUTCOME  AND  ASSESSMENT INFORMATION SET
(OASIS), AS MAY BE AMENDED.
  (C) THE COMMISSIONER MAY REQUIRE AGENCIES TO COLLECT  AND  SUBMIT  ANY
DATA  REQUIRED  TO  IMPLEMENT  THIS  SUBDIVISION.  THE  COMMISSIONER MAY
PROMULGATE REGULATIONS, INCLUDING EMERGENCY  REGULATIONS,  TO  IMPLEMENT
THE PROVISIONS OF THIS SUBDIVISION.
  S  5.  Sections  365-i  and  369-dd  of  the  social  services law are
REPEALED.
  S 5-a. Subparagraph (v) of paragraph (e) of subdivision 1 and subdivi-
sion 2-b of section 369-ee of the social services law, subparagraph  (v)
of  paragraph (e) of subdivision 1 as amended by section 1 of part C and
subdivision 2-b as added by section 2 of part C of  chapter  58  of  the
laws of 2008, are amended to read as follows:
  (v)  prescription  drugs [as defined in section two hundred seventy of
the public health law, which shall be provided pursuant  to  subdivision
two-b  of this section,] and non-prescription smoking cessation products
or devices;
  2-b. Prescription drug payments. [(a) Subject to paragraph (b) of this
subdivision, payment for  drugs,  except  for  such  drugs  provided  by
medical  practitioners,  and for which payment is authorized pursuant to
paragraph (e) of subdivision one of this section, shall be made pursuant
to subdivision nine of section three hundred sixty-seven-a of this arti-

S. 2809--B                         116                        A. 4009--B

cle and article two-A of the public health law and subdivision  four  of
section  three  hundred  sixty-five-a  of this article. Payment for such
drugs provided by medical practitioners shall be included in the capita-
tion  payment  for services or supplies provided to persons eligible for
health care services under this title.
  (b)] Payment for drugs for which payment  is  authorized  pursuant  to
paragraph (e) of subdivision one of this section[, and that are provided
by  an  employer  partnership  for family health plus plan authorized by
section three hundred sixty-nine-ff of this title,] shall be included in
the capitation payment for services  or  supplies  provided  to  persons
eligible for health care services under [such] A FAMILY HEALTH INSURANCE
plan.
  S  6.  Section  368-d  of the social services law is amended by adding
three new subdivisions 4, 5 and 6 to read as follows:
  4.  THE COMMISSIONER OF HEALTH IS AUTHORIZED TO CONTRACT WITH  ONE  OR
MORE ENTITIES TO CONDUCT A STUDY TO DETERMINE ACTUAL DIRECT AND INDIRECT
COSTS  INCURRED  BY  PUBLIC  SCHOOL  DISTRICTS  AND STATE OPERATED/STATE
SUPPORTED SCHOOLS WHICH OPERATE PURSUANT TO ARTICLE EIGHTY-FIVE,  EIGHT-
Y-SEVEN  OR EIGHTY-EIGHT OF THE EDUCATION LAW FOR MEDICAL CARE, SERVICES
AND SUPPLIES, INCLUDING RELATED SPECIAL EDUCATION SERVICES  AND  SPECIAL
TRANSPORTATION, FURNISHED TO CHILDREN WITH HANDICAPPING CONDITIONS.
  5.  NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR  SECTION
ONE HUNDRED FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR ANY OTHER LAW,
THE  COMMISSIONER  OF  HEALTH  IS AUTHORIZED TO ENTER INTO A CONTRACT OR
CONTRACTS UNDER SUBDIVISION FOUR OF THIS SECTION WITHOUT  A  COMPETITIVE
BID OR REQUEST FOR PROPOSAL PROCESS, PROVIDED, HOWEVER, THAT:
  (A)  THE  DEPARTMENT OF HEALTH SHALL POST ON ITS WEBSITE, FOR A PERIOD
OF NO LESS THAN THIRTY DAYS:
  (I) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT  TO
THE CONTRACT OR CONTRACTS;
  (II) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (III)  THE  PERIOD  OF  TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY
SEEK SELECTION, WHICH SHALL BE NO  LESS  THAN  THIRTY  DAYS  AFTER  SUCH
INFORMATION IS FIRST POSTED ON THE WEBSITE; AND
  (IV)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (B) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE  RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
COMMISSIONER OF HEALTH; AND
  (C) THE  COMMISSIONER  OF  HEALTH  SHALL  SELECT  SUCH  CONTRACTOR  OR
CONTRACTORS THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE
PURPOSES OF THIS SECTION.
  6.  THE COMMISSIONER SHALL EVALUATE THE RESULTS OF THE STUDY CONDUCTED
PURSUANT TO SUBDIVISION FOUR OF THIS SECTION TO DETERMINE,  AFTER  IDEN-
TIFICATION OF ACTUAL DIRECT AND INDIRECT COSTS INCURRED BY PUBLIC SCHOOL
DISTRICTS  AND  STATE  OPERATED/STATE  SUPPORTED  SCHOOLS, WHETHER IT IS
ADVISABLE TO CLAIM FEDERAL REIMBURSEMENT  FOR  EXPENDITURES  UNDER  THIS
SECTION  AS  CERTIFIED PUBLIC EXPENDITURES. IN THE EVENT SUCH CLAIMS ARE
SUBMITTED,  IF  FEDERAL  REIMBURSEMENT  RECEIVED  FOR  CERTIFIED  PUBLIC
EXPENDITURES ON BEHALF OF MEDICAL ASSISTANCE RECIPIENTS WHOSE ASSISTANCE
AND  CARE ARE THE RESPONSIBILITY OF A SOCIAL SERVICES DISTRICT IN A CITY
WITH A POPULATION OF OVER TWO MILLION, RESULTS  IN  A  DECREASE  IN  THE
STATE  SHARE  OF  ANNUAL  EXPENDITURES PURSUANT TO THIS SECTION FOR SUCH
RECIPIENTS, THEN TO THE EXTENT THAT THE AMOUNT OF ANY SUCH DECREASE WHEN
COMBINED WITH ANY DECREASE IN THE STATE  SHARE  OF  ANNUAL  EXPENDITURES

S. 2809--B                         117                        A. 4009--B

DESCRIBED  IN SUBDIVISION FIVE OF SECTION THREE HUNDRED SIXTY-EIGHT-E OF
THIS TITLE EXCEEDS FIFTY MILLION DOLLARS, THE  EXCESS  AMOUNT  SHALL  BE
TRANSFERRED  TO  SUCH CITY. ANY SUCH EXCESS AMOUNT TRANSFERRED SHALL NOT
BE  CONSIDERED  A  REVENUE  RECEIVED BY SUCH SOCIAL SERVICES DISTRICT IN
DETERMINING THE DISTRICT'S ACTUAL MEDICAL  ASSISTANCE  EXPENDITURES  FOR
PURPOSES  OF  PARAGRAPH  (B)  OF  SECTION  ONE  OF  PART  C  OF  CHAPTER
FIFTY-EIGHT OF THE LAWS OF TWO THOUSAND FIVE.
  S 7. Section 368-e of the social services law  is  amended  by  adding
three new subdivisions 3, 4 and 5 to read as follows:
  3.    THE COMMISSIONER OF HEALTH IS AUTHORIZED TO CONTRACT WITH ONE OR
MORE ENTITIES TO CONDUCT A STUDY TO DETERMINE ACTUAL DIRECT AND INDIRECT
COSTS INCURRED BY COUNTIES FOR  MEDICAL  CARE,  SERVICES  AND  SUPPLIES,
INCLUDING RELATED SPECIAL EDUCATION SERVICES AND SPECIAL TRANSPORTATION,
FURNISHED TO PRE-SCHOOL CHILDREN WITH HANDICAPPING CONDITIONS.
  4.  NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR  SECTION
ONE HUNDRED FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR ANY OTHER LAW,
THE  COMMISSIONER  OF  HEALTH  IS AUTHORIZED TO ENTER INTO A CONTRACT OR
CONTRACTS UNDER SUBDIVISION THREE OF THIS SECTION WITHOUT A  COMPETITIVE
BID OR REQUEST FOR PROPOSAL PROCESS, PROVIDED, HOWEVER, THAT:
  (A)  THE  DEPARTMENT OF HEALTH SHALL POST ON ITS WEBSITE, FOR A PERIOD
OF NO LESS THAN THIRTY DAYS:
  (I) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT  TO
THE CONTRACT OR CONTRACTS;
  (II) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (III)  THE  PERIOD  OF  TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY
SEEK SELECTION, WHICH SHALL BE NO  LESS  THAN  THIRTY  DAYS  AFTER  SUCH
INFORMATION IS FIRST POSTED ON THE WEBSITE; AND
  (IV)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (B) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE  RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
COMMISSIONER OF HEALTH; AND
  (C) THE  COMMISSIONER  OF  HEALTH  SHALL  SELECT  SUCH  CONTRACTOR  OR
CONTRACTORS THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE
PURPOSES OF THIS SECTION.
  5.  THE COMMISSIONER SHALL EVALUATE THE RESULTS OF THE STUDY CONDUCTED
PURSUANT TO SUBDIVISION THREE OF THIS SECTION TO DETERMINE, AFTER  IDEN-
TIFICATION  OF ACTUAL DIRECT AND INDIRECT COSTS INCURRED BY COUNTIES FOR
MEDICAL CARE, SERVICES, AND SUPPLIES FURNISHED  TO  PRE-SCHOOL  CHILDREN
WITH  HANDICAPPING  CONDITIONS, WHETHER IT IS ADVISABLE TO CLAIM FEDERAL
REIMBURSEMENT FOR EXPENDITURES UNDER THIS SECTION  AS  CERTIFIED  PUBLIC
EXPENDITURES.    IN  THE  EVENT  SUCH  CLAIMS  ARE SUBMITTED, IF FEDERAL
REIMBURSEMENT RECEIVED FOR CERTIFIED PUBLIC EXPENDITURES  ON  BEHALF  OF
MEDICAL  ASSISTANCE RECIPIENTS WHOSE ASSISTANCE AND CARE ARE THE RESPON-
SIBILITY OF A SOCIAL SERVICES DISTRICT IN A CITY WITH  A  POPULATION  OF
OVER  TWO  MILLION,  RESULTS  IN A DECREASE IN THE STATE SHARE OF ANNUAL
EXPENDITURES PURSUANT TO THIS SECTION FOR SUCH RECIPIENTS, THEN  TO  THE
EXTENT  THAT  THE  AMOUNT  OF  ANY  SUCH DECREASE WHEN COMBINED WITH ANY
DECREASE IN THE STATE SHARE OF ANNUAL EXPENDITURES DESCRIBED IN SUBDIVI-
SION SIX OF SECTION THREE HUNDRED SIXTY-EIGHT-D OF  THIS  TITLE  EXCEEDS
FIFTY  MILLION  DOLLARS,  THE EXCESS AMOUNT SHALL BE TRANSFERRED TO SUCH
CITY. ANY SUCH EXCESS AMOUNT  TRANSFERRED  SHALL  NOT  BE  CONSIDERED  A
REVENUE  RECEIVED  BY  SUCH  SOCIAL SERVICES DISTRICT IN DETERMINING THE
DISTRICT'S ACTUAL MEDICAL ASSISTANCE EXPENDITURES FOR PURPOSES OF  PARA-

S. 2809--B                         118                        A. 4009--B

GRAPH (B) OF SECTION ONE OF PART C OF CHAPTER FIFTY-EIGHT OF THE LAWS OF
TWO THOUSAND FIVE.
  S  8.  Paragraph  d  of  subdivision  20 of section 2808 of the public
health law is REPEALED and a  new  paragraph  d  is  added  to  read  as
follows:
  D.  NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW, RULE OR REGULATION,
FOR  RATE  PERIODS  ON  AND  AFTER APRIL FIRST, TWO THOUSAND ELEVEN, THE
CAPITAL COST  COMPONENT  OF  MEDICAID  RATES  OF  PAYMENT  FOR  SERVICES
PROVIDED  BY  RESIDENTIAL  HEALTH  CARE FACILITIES SHALL NOT INCLUDE ANY
PAYMENT FACTOR FOR RETURN ON OR RETURN OF EQUITY.
  S 9. Paragraph (b) of subdivision 11 of  section  272  of  the  public
health  law,  as added by section 36 of part C of chapter 58 of the laws
of 2009, is amended to read as follows:
  (b) The commissioner may designate a  pharmaceutical  manufacturer  as
one  with  whom  the  commissioner  is  negotiating  or has negotiated a
manufacturer agreement, and all of the drugs it manufactures or  markets
shall  be  included  in the preferred drug program. The commissioner may
negotiate directly with a pharmaceutical manufacturer for rebates relat-
ing to any or all of the drugs it manufactures or markets. A manufactur-
er agreement shall designate any or all of  the  drugs  manufactured  or
marketed  by  the  pharmaceutical manufacturer as being preferred or non
preferred drugs. When a pharmaceutical manufacturer has been  designated
by  the  commissioner  under this paragraph but THE COMMISSIONER has not
reached a manufacturer agreement with the  pharmaceutical  manufacturer,
then  THE  COMMISSIONER  MAY DESIGNATE SOME OR all of the drugs manufac-
tured or marketed by the pharmaceutical manufacturer [shall be]  AS  non
preferred  drugs. However, notwithstanding this paragraph, any drug that
is selected to be on the preferred drug  list  under  paragraph  (b)  of
subdivision ten of this section on grounds that it is significantly more
clinically effective and safer than other drugs in its therapeutic class
shall be a preferred drug.
  S  10.  Paragraphs (a), (b), (c), (d), (e) and (f) of subdivision 9 of
section 367-a of the social services law are REPEALED,  paragraphs  (g),
(h)  and  (i) are relettered paragraphs (b), (c) and (d) and the opening
paragraph of subdivision 9, as amended by chapter  19  of  the  laws  of
1998, is amended to read as follows:
  (A) Notwithstanding any inconsistent provision of law or regulation to
the  contrary,  for  those  drugs  which  may not be dispensed without a
prescription as required by  section  sixty-eight  hundred  ten  of  the
education  law and for which payment is authorized pursuant to paragraph
(g) of subdivision two of section three  hundred  sixty-five-a  of  this
title,  payments  FOR  SUCH  DRUGS  AND DISPENSING FEES under this title
shall be made at [the following] amounts[:] ESTABLISHED BY  THE  COMMIS-
SIONER.
  S 11. Intentionally Omitted.
  S 12. Subdivision 22 of section 6802 of the education law, as added by
chapter 563 of the laws of 2008, is amended to read as follows:
  22.  "Administer",  for the purpose of section sixty-eight hundred one
of this article, means the direct application of an immunizing agent  to
[adults]  PERSONS  ELEVEN  YEARS  OF AGE OR OLDER, whether by injection,
ingestion or any other means, pursuant to a patient  specific  order  or
non-patient specific regimen prescribed or ordered issued by a physician
or certified nurse practitioner who has a practice site in the county in
which the immunization is administered.  However if the county where the
immunization  is  to  be  administered  has a population of seventy-five
thousand or less, then the licensed physician or certified nurse practi-

S. 2809--B                         119                        A. 4009--B

tioner may be in an  adjoining  county.  Such  administration  shall  be
limited  to  immunizing  agents  [to  prevent  influenza or pneumococcal
disease] RECOMMENDED BY THE FEDERAL  CENTERS  FOR  DISEASE  CONTROL  AND
PREVENTION FOR PERSONS WHO ARE ELEVEN YEARS OF AGE OR OLDER, and medica-
tions required for emergency treatment of anaphylaxis.
  S  13. Subdivision 1 of section 271 of the public health law, as added
by section 10 of part C of chapter 58 of the laws of 2005, is amended to
read as follows:
  1. There is hereby established in the department a pharmacy and thera-
peutics committee. The committee shall consist of  [seventeen]  EIGHTEEN
members,  who shall be appointed by the commissioner and who shall serve
three year terms; except  that  for  the  initial  appointments  to  the
committee,  five  members  shall serve one year terms, seven shall serve
two year terms, and five shall serve three year terms. Committee members
may be reappointed upon the completion of their  terms.  [No]  WITH  THE
EXCEPTION  OF  THE  CHAIRPERSON,  NO member of the committee shall be an
employee of the state or any subdivision of the state,  other  than  for
his  or  her membership on the committee, except for employees of health
care facilities or universities operated by the state, a public  benefit
corporation, the State University of New York or municipalities.
  S  14.  Paragraphs  (d) and (e) of subdivision 2 of section 271 of the
public health law, as added by section 10 of part C of chapter 58 of the
laws of 2005, are amended, and a new paragraph (f) is added to  read  as
follows:
  (d) one person with expertise in drug utilization review who is either
a  health  care professional licensed under title eight of the education
law, is a pharmacologist or has a doctorate in pharmacology; [and]
  (e) three persons who shall be consumers or representatives of  organ-
izations  with  a  regional  or statewide constituency and who have been
involved in activities related to health care consumer advocacy, includ-
ing issues affecting Medicaid or EPIC recipients[.]; AND
  (F) A CHAIRPERSON DESIGNATED PURSUANT  TO  SUBDIVISION  FOUR  OF  THIS
SECTION.
  S  15.  Subdivision  4  of  section  271  of  the public health law is
REPEALED and a new subdivision 4 is added to read as follows:
  4. THE COMMISSIONER SHALL DESIGNATE A  MEMBER  OF  THE  DEPARTMENT  TO
SERVE AS CHAIRPERSON OF THE COMMITTEE.
  S  16. Subdivision 3 of section 272 of the public health law, as added
by section 10 of part C of chapter 58 of the laws of 2005, is amended to
read as follows:
  3. The commissioner shall  establish  performance  standards  for  the
program  that,  at a minimum, ensure that the preferred drug program and
the clinical drug review program provide  sufficient  technical  support
and  timely  responses  to  consumers, prescribers and pharmacists.  THE
COMMISSIONER MAY DESIGNATE A MEMBER OF THE  DEPARTMENT  TO  PERFORM  ANY
ACTIONS OF THE COMMISSIONER AUTHORIZED OR REQUIRED BY THIS SECTION.
  S  17.  Subdivision  10  of  section  272  of the public health law is
amended by adding a new paragraph (d) to read as follows:
  (D) NOTWITHSTANDING ANY PROVISION OF THIS SECTION TO THE CONTRARY, THE
COMMISSIONER MAY DESIGNATE THERAPEUTIC CLASSES OF  DRUGS  OR  INDIVIDUAL
DRUGS  AS  PREFERRED  PRIOR  TO  ANY REVIEW THAT MAY BE CONDUCTED BY THE
COMMITTEE PURSUANT TO THIS SECTION.
  S 18. Paragraphs (b) and (c) of subdivision 3 of section  273  of  the
public health law, as added by section 10 of part C of chapter 58 of the
laws of 2005, are amended to read as follows:

S. 2809--B                         120                        A. 4009--B

  (b)  In the event that the patient does not meet the criteria in para-
graph (a) of this subdivision, the  prescriber  may  provide  additional
information  to  the  program  to justify the use of a prescription drug
that is not on the preferred drug list.  The  program  shall  provide  a
reasonable opportunity for a prescriber to reasonably present his or her
justification  of  prior authorization. [If, after consultation with the
program, the prescriber, in his or her reasonable professional judgment,
determines that the use of a  prescription  drug  that  is  not  on  the
preferred  drug  list is warranted, the prescriber's determination shall
be final.]
  (c) [If a prescriber meets the requirements of paragraph (a) or (b) of
this subdivision, the prescriber shall be  granted  prior  authorization
under this section] PRIOR AUTHORIZATION FOR THE NON-PREFERRED DRUG SHALL
BE  DENIED IF THE PRESCRIBER FAILS TO MEET THE REQUIREMENTS OF PARAGRAPH
(A) OF THIS SUBDIVISION OR, IF AFTER CONSULTATION WITH  THE  PROGRAM  AS
DESCRIBED  IN  PARAGRAPH (B) OF THIS SUBDIVISION, THE PROGRAM DETERMINES
THAT THE USE OF THE PRESCRIBED DRUG THAT IS NOT ON  THE  PREFERRED  DRUG
LIST IS NOT WARRANTED.
  S 19. Intentionally Omitted.
  S  20.   Paragraph (g) of subdivision 4 of section 365-a of the social
services law, as amended by section 61 of part C of chapter  58  of  the
laws of 2007, is amended to read as follows:
  (g)  for  eligible  persons who are also beneficiaries under part D of
title XVIII of the federal social security act, drugs which are  denomi-
nated  as  "covered part D drugs" under section 1860D-2(e) of such act[;
provided however that, for purposes of this paragraph, "covered  part  D
drugs"  shall not mean atypical anti-psychotics, anti-depressants, anti-
retrovirals used in the treatment of HIV/AIDS, or  anti-rejection  drugs
used for the treatment of organ and tissue transplants].
  S  21.  Subdivision  12  of  section  272  of the public health law is
REPEALED.
  S 22. Intentionally Omitted.
  S 23. Paragraph (g) of subdivision 2 of section 365-a  of  the  social
services  law,  as  amended by section 1 of part F of chapter 497 of the
laws of 2008, is amended to read as follows:
  (g) sickroom supplies, eyeglasses, prosthetic  appliances  and  dental
prosthetic  appliances  furnished  in accordance with the regulations of
the department[,]; provided FURTHER that: (I) the commissioner of health
is authorized to implement a preferred diabetic supply  program  wherein
the  department  of  health will receive enhanced rebates from preferred
manufacturers of glucometers and test strips, and may  subject  non-pre-
ferred manufacturers' glucometers and test strips to prior authorization
under  section  two hundred seventy-three of the public health law; (II)
ENTERAL FORMULA THERAPY IS LIMITED TO  COVERAGE  ONLY  FOR  NASOGASTRIC,
JEJUNOSTOMY,  OR  GASTROSTOMY TUBE FEEDING OR FOR TREATMENT OF AN INBORN
ERROR OF METABOLISM; OTHER NUTRITIONAL OR DIETARY  SUPPLEMENTS  ARE  NOT
COVERED; (III) PRESCRIPTION FOOTWEAR AND INSERTS ARE LIMITED TO COVERAGE
ONLY  WHEN  USED AS AN INTEGRAL PART OF A LOWER LIMB ORTHOTIC APPLIANCE,
AS PART OF A DIABETIC TREATMENT PLAN, OR TO ADDRESS GROWTH AND  DEVELOP-
MENT  PROBLEMS  IN  CHILDREN; AND (IV) COMPRESSION AND SUPPORT STOCKINGS
ARE LIMITED TO COVERAGE ONLY FOR PREGNANCY OR TREATMENT OF VENOUS STASIS
ULCERS;
  (G-1) drugs provided on an in-patient basis, those drugs contained  on
the  list established by regulation of the commissioner of health pursu-
ant to subdivision four of this section, and those drugs which  may  not
be  dispensed  without a prescription as required by section sixty-eight

S. 2809--B                         121                        A. 4009--B

hundred ten of the education law and which the  commissioner  of  health
shall determine to be reimbursable based upon such factors as the avail-
ability  of  such  drugs  or  alternatives at low cost if purchased by a
medicaid  recipient,  or the essential nature of such drugs as described
by such commissioner in regulations, provided, however, that such drugs,
exclusive of long-term maintenance drugs, shall be dispensed in  quanti-
ties no greater than a thirty day supply or one hundred doses, whichever
is  greater; provided further that the commissioner of health is author-
ized to require prior authorization for any  refill  of  a  prescription
when  less  than seventy-five percent of the previously dispensed amount
per fill should have been used were the product used as  normally  indi-
cated; PROVIDED FURTHER THAT THE COMMISSIONER OF HEALTH IS AUTHORIZED TO
REQUIRE  PRIOR  AUTHORIZATION  OF  PRESCRIPTIONS OF OPIOID ANALGESICS IN
EXCESS OF FOUR PRESCRIPTIONS IN A THIRTY-DAY PERIOD; medical  assistance
shall  not  include  any drug provided on other than an in-patient basis
for which a recipient is charged or a claim is made in  the  case  of  a
prescription  drug,  in excess of the maximum reimbursable amounts to be
established by  department  regulations  in  accordance  with  standards
established  by  the secretary of the United States department of health
and human  services,  or,  in  the  case  of  a  drug  not  requiring  a
prescription,  in  excess of the maximum reimbursable amount established
by the commissioner of health pursuant to paragraph (a)  of  subdivision
four of this section;
  S  24.  Paragraph  (a)  of  subdivision 3 of section 366 of the social
services law, as amended by chapter 110 of the laws of 1971, is  amended
to read as follows:
  (a)  Medical  assistance  shall  be  furnished  to applicants in cases
where, although such applicant has a responsible  relative  with  suffi-
cient  income  and resources to provide medical assistance as determined
by the regulations of the department, the income and  resources  of  the
responsible  relative are not available to such applicant because of the
absence of such relative [or] AND the refusal or failure of such  ABSENT
relative  to  provide the necessary care and assistance.  In such cases,
however, the furnishing of  such  assistance  shall  create  an  implied
contract  with such relative, and the cost thereof may be recovered from
such relative in accordance with title six  of  article  three  OF  THIS
CHAPTER and other applicable provisions of law.
  S  25.  Paragraph  (b) of subdivision 17 of section 2808 of the public
health law, as added by section 30 of part B of chapter 109 of the  laws
of 2010, is amended and a new paragraph (c) is added to read as follows:
  (b) Notwithstanding any inconsistent provision of law or regulation to
the contrary, for the state fiscal year beginning April first, two thou-
sand  ten  and ending March thirty-first, two thousand [eleven] FIFTEEN,
the commissioner shall not be required  to  revise  certified  rates  of
payment  established  pursuant to this article for rate periods prior to
April first, two thousand [eleven] FIFTEEN, based  on  consideration  of
rate  appeals  filed by residential health care facilities or based upon
adjustments to capital cost reimbursement as a result of approval by the
commissioner of an application for construction  under  section  twenty-
eight  hundred  two  of  this  article, in excess of an aggregate annual
amount of eighty million dollars for EACH such  state  fiscal  year.  In
revising such rates within such fiscal limit, the commissioner shall, in
prioritizing  such  rate appeals, include consideration of which facili-
ties the commissioner determines are facing significant financial  hard-
ship  as  well  as  such  other considerations as the commissioner deems
appropriate and, further, the commissioner is authorized to  enter  into

S. 2809--B                         122                        A. 4009--B

agreements  with such facilities or any other facility to resolve multi-
ple pending rate appeals based upon a negotiated  aggregate  amount  and
may offset such negotiated aggregate amounts against any amounts owed by
the  facility  to the department, including, but not limited to, amounts
owed pursuant to section twenty-eight hundred seven-d of  this  article;
PROVIDED,  HOWEVER,  THAT THE COMMISSIONER'S AUTHORITY TO NEGOTIATE SUCH
AGREEMENTS RESOLVING  MULTIPLE  PENDING  RATE  APPEALS  AS  HEREINBEFORE
DESCRIBED SHALL CONTINUE ON AND AFTER APRIL FIRST, TWO THOUSAND FIFTEEN.
Rate adjustments made pursuant to this paragraph remain fully subject to
approval by the director of the budget in accordance with the provisions
of  subdivision  two of section twenty-eight hundred seven of this arti-
cle.
  (C) NOTWITHSTANDING ANY OTHER CONTRARY PROVISION OF LAW, RULE OR REGU-
LATION, FOR PERIODS ON AND AFTER APRIL FIRST, TWO  THOUSAND  ELEVEN  THE
COMMISSIONER  SHALL PROMULGATE REGULATIONS, AND MAY PROMULGATE EMERGENCY
REGULATIONS, ESTABLISHING PRIORITIES AND TIME FRAMES FOR PROCESSING RATE
APPEALS, INCLUDING RATE APPEALS FILED PRIOR TO APRIL FIRST, TWO THOUSAND
ELEVEN, WITHIN AVAILABLE ADMINISTRATIVE  RESOURCES;  PROVIDED,  HOWEVER,
THAT  SUCH  REGULATIONS SHALL NOT BE INCONSISTENT WITH THE PROVISIONS OF
PARAGRAPH (B) OF THIS SUBDIVISION.
  S 26. Notwithstanding any provision of law to the contrary and subject
to the availability of federal financial participation, for  periods  on
and  after  April 1, 2011, clinics certified pursuant to articles 16, 31
or 32 of the mental hygiene law shall be subject  to  targeted  Medicaid
reimbursement  rate reductions in accordance with the provisions of this
section. Such reductions shall be based on utilization thresholds  which
may  be  established  either  as  provider-specific  or patient-specific
thresholds. Provider-specific  thresholds  shall  be  based  on  average
patient  utilization  for a given provider in comparison to a peer based
standard to be determined for each service.  When applying  a  provider-
specific  threshold,  rates will be reduced on a prospective basis based
on the amount any provider  is  over  the  determined  threshold  level.
Patient-specific  thresholds  will  be based on annual thresholds deter-
mined for each service over which the per visit payment for  each  visit
in  excess of the standard during a twelve month period shall be reduced
by a pre-determined amount. The thresholds, peer based standards and the
payment reductions shall be determined by the department of health, with
the approval of the division of the budget, and in consultation with the
office of mental health, the office for people with developmental  disa-
bilities  and the office of alcoholism and substance abuse services, and
any such resulting rates shall be subject to certification by the appro-
priate commissioners pursuant to subdivision (a) of section 43.02 of the
mental hygiene law. The base period used  to  establish  the  thresholds
shall  be  the  2009  calendar  year.  The total annualized reduction in
payments shall be no less than $10,900,000 for Article  31  clinics,  no
less   than  $2,400,000  for  Article  16  clinics,  and  no  less  than
$13,250,000 for Article 32  clinics.  The  commissioner  of  health  may
promulgate  regulations,  including  emergency regulations, to implement
the provisions of this section.
  S 27. Paragraph (h) of subdivision 2 of section 365-a  of  the  social
services  law,  as  amended  by  chapter  444 of the laws of 1979 and as
relettered by chapter 478 of the laws of 1980, is  amended  to  read  as
follows:
  (h)  SPEECH THERAPY, AND WHEN PROVIDED AT THE DIRECTION OF A PHYSICIAN
OR NURSE PRACTITIONER, physical therapy [and relative] INCLUDING RELATED
rehabilitative services [when provided at the direction of a  physician]

S. 2809--B                         123                        A. 4009--B

AND  OCCUPATIONAL THERAPY; PROVIDED, HOWEVER, THAT SPEECH THERAPY, PHYS-
ICAL THERAPY AND OCCUPATIONAL THERAPY EACH SHALL BE LIMITED TO  COVERAGE
OF  TWENTY  VISITS  PER YEAR; SUCH LIMITATION SHALL NOT APPLY TO PERSONS
WITH DEVELOPMENTAL DISABILITIES;
  S 28. Section 3614 of the public health law is amended by adding a new
subdivision 2-a to read as follows:
  2-A.  NOTWITHSTANDING  ANY  CONTRARY LAW, RULE OR REGULATION, FOR RATE
PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND ELEVEN, MEDICAID RATES OF
PAYMENTS FOR SERVICES PROVIDED BY CERTIFIED  HOME  HEALTH  AGENCIES,  BY
LONG  TERM  HOME  HEALTH  CARE  PROGRAMS OR BY AN AIDS HOME CARE PROGRAM
SHALL NOT REFLECT A SEPARATE PAYMENT  FOR  HOME  CARE  NURSING  SERVICES
PROVIDED  TO PATIENTS DIAGNOSED WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME
(AIDS).
  S 29. Paragraph (h) of subdivision 5-a of section 2807-m of the public
health law is relettered paragraph (i) and a new paragraph (h) is  added
to read as follows:
  (H)  PUBLIC  HEALTH SERVICES CORPS (PHSC). ONE MILLION DOLLARS FOR THE
PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST,  TWO
THOUSAND  TWELVE, AND TWO MILLION DOLLARS EACH STATE FISCAL YEAR FOR THE
PERIOD APRIL FIRST, TWO THOUSAND TWELVE 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 AWARDS MADE PURSUANT TO A COMPET-
ITIVE REQUEST FOR PROPOSAL OR REQUEST FOR APPLICATION PROCESS TO SUPPORT
WELL-TRAINED,  HIGHLY QUALIFIED NON-PHYSICIAN HEALTH PROFESSIONALS DEDI-
CATED TO DELIVERING PUBLIC HEALTH AND HEALTH  CARE  SERVICES  TO  UNDER-
SERVED  COMMUNITIES  OUTSIDE  THEIR  REGULARLY  SCHEDULED  EMPLOYMENT IN
ACCORDANCE WITH THE FOLLOWING:
  (I) PHSC MEMBERS SHALL BE NON-PHYSICIAN CLINICAL SERVICE PROVIDERS WHO
MAY INCLUDE, BUT NOT BE LIMITED TO, THE FOLLOWING  HEALTH  CARE  PROFES-
SIONALS: MENTAL HEALTH SPECIALISTS, INCLUDING CLINICAL PSYCHOLOGISTS AND
CLINICAL  SOCIAL  WORKERS, DENTISTS AND DENTAL HYGIENISTS, NURSE PRACTI-
TIONERS AND PHYSICIAN ASSISTANTS, DIETICIANS, PUBLIC HEALTH  NURSES  AND
OTHER  REGISTERED NURSES, BACHELOR OF SCIENCE NURSES, LICENSED PRACTICAL
NURSES, EPIDEMIOLOGISTS, PUBLIC HEALTH EDUCATORS AND  GRADUATE  STUDENTS
IN  PUBLIC  HEALTH WHO WANT TO PROVIDE SERVICE TO STATE AND LOCAL HEALTH
DEPARTMENTS VIA AN INTERNSHIP.
  (II) PHSC MEMBERS GRANTED AWARDS  PURSUANT  TO  THIS  PARAGRAPH  SHALL
RECEIVE  UP  TO FIFTEEN THOUSAND DOLLARS ANNUALLY ON AN INDIVIDUAL BASIS
TO PROVIDE CLINICAL, HEALTH PROMOTION AND  DISEASE  PREVENTION  INVESTI-
GATION,  ANALYSIS  AND  SERVICES  TO  MEDICALLY INDIGENT POPULATIONS AND
COMMUNITIES IN NEW YORK STATE AS DETERMINED BY THE COMMISSIONER AND  MAY
INCLUDE, BUT NOT BE LIMITED TO, ANY NUMBER OF THE FOLLOWING ACTIVITIES:
  (A)  CLINICAL  TREATMENT  IN UNDERSERVED AREAS INCLUDING VACCINATIONS,
PHYSICALS AND DENTAL CHECKUPS;
  (B) PUBLIC HEALTH EMERGENCY RESPONSE AS DIRECTED BY THE GOVERNOR;
  (C) PUBLIC HEALTH EDUCATION WORKSHOPS INCLUDING CLASSES ON  NUTRITION,
FAMILY PLANNING, ALCOHOL AND DRUG ABUSE AND ELDER CARE;
  (D)  COMMUNITY  HEALTH  EVALUATION  STUDIES  INCLUDING ASSISTANCE WITH
EPIDEMIOLOGIC STUDIES IN A PARTICULAR COMMUNITY;
  (E) DISEASE OUTBREAK INVESTIGATIONS; AND
  (F) CAREER DEVELOPMENT INSTRUCTION IN DESIGNATED SCHOOLS.
  (III) PHSC MEMBERS  SHALL:  PROVIDE  UP  TO  THREE  HUNDRED  HOURS  OF
SERVICES;  DELIVER  SERVICES  IN  EXISTING  VENUES  SUCH  AS  HOSPITALS,
FREE-STANDING  CLINICS,  COUNTY  HEALTH  DEPARTMENTS,  SCHOOLS,  NURSING
HOMES, TOWN HALLS AND ANY OTHER VENUE IN A RURAL OR INNER-CITY AREA; AND

S. 2809--B                         124                        A. 4009--B

ATTEND  ANNUAL  TRAINING  PROVIDED  IN  DESIGNATED LOCATIONS IN NEW YORK
STATE WHICH SHALL ADDRESS HEALTH SYSTEM  CONCERNS  SUCH  AS  PREVENTABLE
EVENTS, PATIENT WITH MULTIPLE DIAGNOSES AND MEDICAL HOME MODELS.
  (IV) UP TO FIFTEEN PERCENT OF FUNDING AVAILABLE PURSUANT TO THIS PARA-
GRAPH  SHALL  BE  USED FOR ADMINISTRATION OF THE PHSC PROGRAM, INCLUDING
PHSC MEMBER TRAINING, TRAVEL AND PLACEMENT.
  S 30.  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-FOUR MILLION EIGHT HUNDRED  THIRTY-SIX  THOUSAND  DOLLARS
FOR   THE   PERIOD  APRIL  FIRST,  TWO  THOUSAND  ELEVEN  THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND TWELVE;
  (XIII) TWENTY-FIVE MILLION EIGHT HUNDRED THIRTY-SIX  THOUSAND  DOLLARS
EACH  STATE  FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWELVE
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN;
  (XIV) provided, however, for periods prior to January first, two thou-
sand 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)]  (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 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)]  (XVI)  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  31.  Paragraph  (s) of subdivision 2 of section 365-a of the social
services law, as amended by section 46 of part B of chapter  58  of  the
laws of 2010, is amended to read as follows:
  (s)  smoking  cessation counseling services [for pregnant women on any
day of pregnancy through the end of the month in which the  one  hundred
eightieth  day  following  the end of the pregnancy occurs, and children
and adolescents ten to twenty years of age, during a medical visit  when
provided  by a general hospital outpatient department or a free-standing
clinic, or by a physician, registered physician's assistant,  registered
nurse  practitioner  or  licensed  midwife  in  office-based  settings];
provided, however, that the provisions of this  paragraph  [relating  to
smoking  cessation counseling services] shall not take effect unless all
necessary approvals under federal law and regulation have been  obtained
to  receive  federal  financial  participation  in  the  costs  of  such
services.

S. 2809--B                         125                        A. 4009--B

  S 32. Subparagraph (i) of paragraph (b-1) of subdivision 1 of  section
2807-c  of  the public health law, as amended by section 10 of part C of
chapter 58 of the laws of 2010, is amended to read as follows:
  (i)  For  patients  discharged  on  and  after January first, nineteen
hundred ninety-seven and prior to January first, two thousand and on and
after January first, two thousand, payments  to  general  hospitals  for
reimbursement of inpatient hospital services provided to patients eligi-
ble  for  payments pursuant to the workers' compensation law, the volun-
teer firefighters' benefit law, the volunteer ambulance workers' benefit
law, and the comprehensive motor vehicle insurance reparations act shall
be at the rates of payment determined pursuant to this section for state
governmental agencies, excluding  adjustments  pursuant  to  subdivision
fourteen-f  of this section and subdivision thirty-three of this section
[and], excluding such further reductions to such payments as are enacted
as part of the state budget for the state fiscal year  commencing  April
first,  two  thousand  ten AND EXCLUDING SUCH FURTHER REDUCTIONS TO SUCH
PAYMENTS AS ARE ENACTED AS PART OF THE STATE  BUDGET  FOR  STATE  FISCAL
YEARS COMMENCING ON AND AFTER APRIL FIRST, TWO THOUSAND ELEVEN.
  S  33. The public health law is amended by adding a new section 3614-c
to read as follows:
  S 3614-C. HOME CARE WORKER WAGE PARITY. 1. AS USED  IN  THIS  SECTION,
THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANING:
  (A)  "LIVING WAGE LAW" MEANS ANY LAW ENACTED BY A MUNICIPAL GOVERNMENT
IN THE STATE OF NEW YORK WHICH ESTABLISHES A MINIMUM WAGE  FOR  SOME  OR
ALL EMPLOYEES WHO PERFORM WORK ON MUNICIPAL GOVERNMENT CONTRACTS.
  (B)  "SOCIAL  SERVICES  DISTRICT"  MEANS  ANY SOCIAL SERVICES DISTRICT
RECOGNIZED BY THE DEPARTMENT ON JANUARY FIRST, TWO THOUSAND ELEVEN.
  (C) "MUNICIPAL GOVERNMENT" MEANS ANY CITY OR COUNTY GOVERNMENT.
  (D) "TOTAL COMPENSATION" MEANS ALL WAGES AND OTHER DIRECT COMPENSATION
PAID TO OR PROVIDED ON BEHALF OF THE EMPLOYEE INCLUDING, BUT NOT LIMITED
TO, WAGES, HEALTH, EDUCATION OR PENSION BENEFITS, SUPPLEMENTS IN LIEU OF
BENEFITS AND COMPENSATED TIME OFF,  EXCEPT  THAT  IT  DOES  NOT  INCLUDE
EMPLOYER  TAXES  OR EMPLOYER PORTION OF PAYMENTS FOR STATUTORY BENEFITS,
INCLUDING BUT NOT LIMITED TO FICA,  DISABILITY  INSURANCE,  UNEMPLOYMENT
INSURANCE AND WORKERS' COMPENSATION.
  (E)  "PREVAILING  RATE OF TOTAL COMPENSATION" MEANS THE AVERAGE HOURLY
AMOUNT OF TOTAL COMPENSATION PAID TO ALL  HOME  CARE  AIDES  COVERED  BY
WHATEVER  COLLECTIVELY BARGAINED AGREEMENT COVERS THE GREATEST NUMBER OF
HOME CARE AIDES IN A SOCIAL SERVICES DISTRICT. THE PREVAILING RATE SHALL
BE CALCULATED SEPARATELY FOR EACH  SOCIAL  SERVICES  DISTRICT,  PROVIDED
THAT  THE  SOCIAL  SERVICES  DISTRICT IS COTERMINOUS WITH THE GEOGRAPHIC
BOUNDARIES OF A MUNICIPAL GOVERNMENT WHICH HAS  ENACTED  A  LIVING  WAGE
LAW.  FOR PURPOSES OF THIS DEFINITION, ANY SET OF COLLECTIVELY BARGAINED
AGREEMENTS IN A SOCIAL SERVICES DISTRICT  WITH  SUBSTANTIALLY  THE  SAME
TERMS  AND CONDITIONS RELATING TO TOTAL COMPENSATION SHALL BE CONSIDERED
AS A SINGLE COLLECTIVELY BARGAINED AGREEMENT.
  (F) "HOME CARE AIDE" MEANS A HOME HEALTH  AIDE,  PERSONAL  CARE  AIDE,
HOME  ATTENDANT  OR  OTHER  LICENSED  OR UNLICENSED PERSON WHOSE PRIMARY
RESPONSIBILITY INCLUDES THE PROVISION OF IN-HOME ASSISTANCE WITH  ACTIV-
ITIES  OF  DAILY  LIVING  INSTRUMENTAL  ACTIVITIES  OF  DAILY  LIVING OR
HEALTH-RELATED TASKS.
  (G) "MANAGED CARE PLAN" MEANS ANY MANAGED CARE  PROGRAM,  ORGANIZATION
OR  DEMONSTRATION  COVERING  PERSONAL CARE OR HOME HEALTH AIDE SERVICES,
AND WHICH RECEIVES PREMIUMS FUNDED, IN WHOLE OR IN PART, BY THE NEW YORK
STATE MEDICAL ASSISTANCE PROGRAM, INCLUDING BUT NOT LIMITED TO ALL MEDI-
CAID MANAGED CARE, MEDICAID MANAGED LONG TERM CARE, MEDICAID  ADVANTAGE,

S. 2809--B                         126                        A. 4009--B

AND MEDICAID ADVANTAGE PLUS PLANS AND ALL PROGRAMS OF ALL-INCLUSIVE CARE
FOR THE ELDERLY.
  (H)  "EPISODE  OF CARE" MEANS ANY SERVICE UNIT REIMBURSED, IN WHOLE OR
IN PART, BY THE NEW  YORK  STATE  MEDICAL  ASSISTANCE  PROGRAM,  WHETHER
THROUGH  DIRECT REIMBURSEMENT OR COVERED BY A PREMIUM PAYMENT, AND WHICH
COVERS, IN WHOLE OR IN PART, ANY SERVICE PROVIDED BY A HOME  CARE  AIDE,
INCLUDING BUT NOT LIMITED TO ALL SERVICE UNITS DEFINED AS VISITS, HOURS,
DAYS, MONTHS OR EPISODES.
  2.  NOTWITHSTANDING  ANY  INCONSISTENT PROVISION OF LAW, RULE OR REGU-
LATION, EFFECTIVE JANUARY FIRST, TWO THOUSAND  TWELVE,  NO  PAYMENTS  BY
GOVERNMENT  AGENCIES  SHALL  BE  MADE TO CERTIFIED HOME HEALTH AGENCIES,
LONG TERM HOME HEALTH CARE  PROGRAMS  OR  MANAGED  CARE  PLANS  FOR  ANY
EPISODE  OF  CARE  FURNISHED, IN WHOLE OR IN PART, BY ANY HOME CARE AIDE
WHO IS COMPENSATED AT AMOUNTS LESS THAN THE APPLICABLE MINIMUM  RATE  OF
HOME  CARE AIDE TOTAL COMPENSATION ESTABLISHED PURSUANT TO THIS SECTION,
PROVIDED THAT THE EPISODE OF CARE  IS  PROVIDED  IN  A  SOCIAL  SERVICES
DISTRICT  COTERMINOUS  WITH  THE  GEOGRAPHIC BOUNDARIES OF ANY MUNICIPAL
GOVERNMENT WHICH HAS ENACTED A LIVING WAGE LAW.
  3. THE MINIMUM RATE OF HOME CARE AIDE TOTAL COMPENSATION SHALL BE:
  (A) FOR THE PERIOD MARCH FIRST, TWO THOUSAND TWELVE  THROUGH  FEBRUARY
TWENTY-EIGHTH,  TWO  THOUSAND  THIRTEEN,  NINETY  PERCENT  OF  THE TOTAL
COMPENSATION MANDATED BY THE LIVING WAGE LAW OF THE MUNICIPAL GOVERNMENT
WHOSE GEOGRAPHIC BOUNDARIES ARE COTERMINOUS  WITH  THE  SOCIAL  SERVICES
DISTRICT IN WHICH THE EPISODE OF CARE IS PROVIDED;
  (B) FOR THE PERIOD MARCH FIRST, TWO THOUSAND THIRTEEN THROUGH FEBRUARY
TWENTY-EIGHTH,  TWO  THOUSAND FOURTEEN, NINETY-FIVE PERCENT OF THE TOTAL
COMPENSATION MANDATED BY THE LIVING WAGE LAW OF THE MUNICIPAL GOVERNMENT
WHOSE GEOGRAPHIC BOUNDARIES ARE COTERMINOUS  WITH  THE  SOCIAL  SERVICES
DISTRICT IN WHICH THE EPISODE OF CARE IS PROVIDED;
  (C)  FOR  ALL PERIODS ON AND AFTER MARCH FIRST, TWO THOUSAND FOURTEEN,
NO LESS THAN THE PREVAILING RATE OF TOTAL  COMPENSATION  AS  OF  JANUARY
FIRST,  TWO  THOUSAND  ELEVEN, OR THE TOTAL COMPENSATION MANDATED BY THE
LIVING WAGE LAW OF THE MUNICIPAL GOVERNMENT WHOSE GEOGRAPHIC  BOUNDARIES
ARE  COTERMINOUS  WITH THE SOCIAL SERVICES DISTRICT IN WHICH THE EPISODE
OF CARE IS PROVIDED, WHICHEVER IS GREATER.
  4.  ANY PORTION OF THE MINIMUM RATE OF HOME CARE  AIDE  TOTAL  COMPEN-
SATION  ATTRIBUTABLE  TO  HEALTH  BENEFIT  COSTS  OR PAYMENTS IN LIEU OF
HEALTH BENEFITS, AND PAID TIME OFF, AS ESTABLISHED PURSUANT TO  SUBDIVI-
SION  THREE  OF  THIS  SECTION  SHALL  BE SUPERSEDED BY THE TERMS OF ANY
EMPLOYER BONA FIDE COLLECTIVE BARGAINING AGREEMENT IN EFFECT AS OF JANU-
ARY FIRST, TWO THOUSAND ELEVEN, OR A SUCCESSOR TO SUCH AGREEMENT,  WHICH
PROVIDES FOR HOME CARE AIDES' HEALTH BENEFITS THROUGH PAYMENTS TO JOINT-
LY ADMINISTERED LABOR-MANAGEMENT FUNDS.
  5.  THE TERMS OF THIS SECTION SHALL APPLY EQUALLY TO SERVICES PROVIDED
BY HOME CARE AIDES WHO WORK ON EPISODES OF CARE AS DIRECT  EMPLOYEES  OF
CERTIFIED  HOME HEALTH AGENCIES, LONG TERM HOME HEALTH CARE PROGRAMS, OR
MANAGED CARE PLANS, OR AS EMPLOYEES OF LICENSED HOME CARE SERVICES AGEN-
CIES, LIMITED LICENSED HOME CARE SERVICES AGENCIES, OR UNDER  ANY  OTHER
ARRANGEMENT.
  6.  NO PAYMENTS BY GOVERNMENT AGENCIES SHALL BE MADE TO CERTIFIED HOME
HEALTH AGENCIES, LONG TERM HOME HEALTH CARE PROGRAMS,  OR  MANAGED  CARE
PLANS  FOR ANY EPISODE OF CARE WITHOUT THE CERTIFIED HOME HEALTH AGENCY,
LONG TERM HOME HEALTH CARE PROGRAM, OR MANAGED CARE PLAN  HAVING  DELIV-
ERED  PRIOR WRITTEN CERTIFICATION TO THE COMMISSIONER, ON FORMS PREPARED
BY THE DEPARTMENT IN CONSULTATION WITH THE DEPARTMENT OF LABOR, THAT ALL
SERVICES PROVIDED UNDER EACH EPISODE OF CARE ARE IN FULL COMPLIANCE WITH

S. 2809--B                         127                        A. 4009--B

THE TERMS OF THIS SECTION AND ANY REGULATIONS  PROMULGATED  PURSUANT  TO
THIS SECTION.
  7.  IF  A  CERTIFIED  HOME HEALTH AGENCY OR LONG TERM HOME HEALTH CARE
PROGRAM ELECTS TO PROVIDE HOME CARE AIDE SERVICES THROUGH CONTRACTS WITH
LICENSED HOME CARE SERVICES AGENCIES OR  THROUGH  OTHER  THIRD  PARTIES,
PROVIDED  THAT  THE EPISODE OF CARE ON WHICH THE HOME CARE AIDE WORKS IS
COVERED UNDER THE TERMS OF THIS SECTION, THE CERTIFIED HOME HEALTH AGEN-
CY, LONG TERM HOME HEALTH CARE PROGRAM, OR MANAGED CARE PLAN MUST OBTAIN
A WRITTEN CERTIFICATION FROM THE LICENSED HOME CARE SERVICES  AGENCY  OR
OTHER  THIRD  PARTY, ON FORMS PREPARED BY THE DEPARTMENT IN CONSULTATION
WITH THE DEPARTMENT OF LABOR, WHICH ATTESTS TO THE  LICENSED  HOME  CARE
SERVICES  AGENCY'S  OR  OTHER THIRD PARTY'S COMPLIANCE WITH THE TERMS OF
THIS SECTION. SUCH CERTIFICATIONS SHALL ALSO OBLIGATE THE CERTIFIED HOME
HEALTH AGENCY, LONG TERM HOME HEALTH CARE PROGRAM, OR MANAGED CARE  PLAN
TO  OBTAIN,  ON NO LESS THAN A QUARTERLY BASIS, ALL INFORMATION FROM THE
LICENSED HOME CARE SERVICES AGENCY OR OTHER THIRD PARTIES  NECESSARY  TO
VERIFY  COMPLIANCE  WITH THE TERMS OF THIS SECTION.  SUCH CERTIFICATIONS
AND THE INFORMATION EXCHANGED PURSUANT TO THEM SHALL BE RETAINED BY  ALL
CERTIFIED  HOME HEALTH AGENCIES, LONG TERM HOME HEALTH CARE PROGRAMS, OR
MANAGED CARE PLANS, AND ALL LICENSED HOME  CARE  SERVICES  AGENCIES,  OR
OTHER  THIRD  PARTIES  FOR  A PERIOD OF NO LESS THAN TEN YEARS, AND MADE
AVAILABLE TO THE DEPARTMENT UPON REQUEST.
  8. THE COMMISSIONER SHALL DISTRIBUTE  TO  ALL  CERTIFIED  HOME  HEALTH
AGENCIES,  LONG  TERM  HOME HEALTH CARE PROGRAMS, AND MANAGED CARE PLANS
OFFICIAL NOTICE OF THE MINIMUM RATES OF HOME CARE AIDE  COMPENSATION  AT
LEAST  ONE HUNDRED TWENTY DAYS PRIOR TO THE EFFECTIVE DATE OF EACH MINI-
MUM RATE FOR EACH SOCIAL SERVICES DISTRICT COVERED BY THE TERMS OF  THIS
SECTION.
  9.  THE  COMMISSIONER IS AUTHORIZED TO PROMULGATE REGULATIONS, AND MAY
PROMULGATE EMERGENCY REGULATIONS, TO IMPLEMENT THE  PROVISIONS  OF  THIS
SECTION.
  10.  NOTHING  IN THIS SECTION SHOULD BE CONSTRUED AS APPLICABLE TO ANY
SERVICE PROVIDED BY CERTIFIED  HOME  HEALTH  AGENCIES,  LONG  TERM  HOME
HEALTH  CARE  PROGRAMS, OR MANAGED CARE PLANS EXCEPT FOR ALL EPISODES OF
CARE REIMBURSED IN WHOLE OR IN PART BY THE NEW YORK MEDICAID PROGRAM.
  11. NO CERTIFIED HOME HEALTH AGENCY, MANAGED CARE PLAN  OR  LONG  TERM
HOME  HEALTH CARE PROGRAM SHALL BE LIABLE FOR RECOUPMENT OF PAYMENTS FOR
SERVICES PROVIDED THROUGH A LICENSED HOME CARE SERVICES AGENCY OR  OTHER
THIRD  PARTY WITH WHICH THE CERTIFIED HOME HEALTH AGENCY, LONG TERM HOME
HEALTH CARE PROGRAM, OR MANAGED CARE PLAN HAS  A  CONTRACT  BECAUSE  THE
LICENSED  AGENCY  OR  OTHER  THIRD  PARTY  FAILED  TO  COMPLY  WITH  THE
PROVISIONS OF THIS SECTION IF THE CERTIFIED  HOME  HEALTH  AGENCY,  LONG
TERM  HOME  HEALTH CARE PROGRAM, OR MANAGED CARE PLAN HAS REASONABLY AND
IN GOOD FAITH COLLECTED  CERTIFICATIONS  AND  ALL  INFORMATION  REQUIRED
PURSUANT TO SUBDIVISIONS SIX AND SEVEN OF THIS SECTION.
  S  33-a.  The  social  services law is amended by adding a new section
364-J-3 to read as follows:
  S 364-J-3. PROVISION OF HOME CARE SERVICES TO MANAGED CARE  ENROLLEES.
1.  FOR  ALL  BENEFICIARIES NEWLY ENROLLING IN MANAGED CARE PLANS IN NEW
YORK CITY ON OR AFTER APRIL FIRST, TWO  THOUSAND  TWELVE,  AND  FOR  ALL
BENEFICIARIES  ENROLLED  IN  MANAGED  CARE  PLANS IN NEW YORK CITY ON OR
AFTER APRIL FIRST, TWO THOUSAND  FOURTEEN,  AND  FOR  ALL  BENEFICIARIES
MANDATED  TO ENROLL IN MANAGED CARE PLANS, MANAGED CARE PLANS SHALL ONLY
COVER HOME CARE SERVICES IF DELIVERED UNDER CONTRACT TO  PROVIDERS  THAT
HAVE BEEN EXPRESSLY APPROVED BY THE DEPARTMENT OF HEALTH OR ITS DESIGNEE
TO  PROVIDE  HOME  CARE  SERVICES  TO  MANAGED CARE BENEFICIARIES IN THE

S. 2809--B                         128                        A. 4009--B

SOCIAL SERVICES DISTRICT WHERE THE BENEFICIARY RESIDES. THIS REQUIREMENT
SHALL APPLY TO ALL BENEFICIARIES WHOSE  MANAGED  CARE  IS  FINANCED,  IN
WHOLE OR IN PART, BY THE MEDICAL ASSISTANCE PROGRAM OF NEW YORK STATE.
  2.  APPROVAL  FOR ELIGIBILITY TO PROVIDE HOME CARE SERVICES TO MANAGED
CARE BENEFICIARIES SHALL TAKE THE FORM OF A CERTIFIED PROVIDER AGREEMENT
ENTERED INTO BETWEEN THE PROVIDER OF HOME CARE SERVICES AND THE  DEPART-
MENT  OF  HEALTH OR ITS DESIGNEE, SPECIFYING THE TERMS OF THE PROVIDER'S
ELIGIBILITY TO PROVIDE HOME CARE SERVICES TO MANAGED CARE BENEFICIARIES,
ITS RIGHTS AND OBLIGATIONS IN RELATION TO THE MANAGED CARE PLAN  AUTHOR-
IZING  SUCH SERVICES, AND ANY CONTINGENCIES NECESSARY TO ENSURE THAT THE
PROVIDER  OF  HOME  CARE  SERVICES  DELIVERS  SATISFACTORY   PERFORMANCE
THROUGHOUT  THE  DURATION  OF THE AGREEMENT. THE DEPARTMENT OF HEALTH OR
ITS DESIGNEE SHALL HAVE RESPONSIBILITY FOR OVERSEEING ALL APPROVED AGEN-
CIES' COMPLIANCE WITH THE TERMS AND CONDITIONS OF THEIR PROVIDER  AGREE-
MENTS ON AN ONGOING BASIS.
  3. NO PROVIDER AGREEMENT SHALL BE VALID FOR PERIODS GREATER THAN THREE
YEARS. NO LIMIT SHALL BE PLACED ON THE NUMBER OF TIMES A PROVIDER MAY BE
REAPPROVED  FOR  ELIGIBILITY  TO  SERVE  MANAGED CARE BENEFICIARIES. THE
DEPARTMENT OF HEALTH OR ITS DESIGNEE SHALL RESERVE THE RIGHT  TO  REVOKE
ANY APPROVAL TO PROVIDE HOME CARE SERVICES TO MANAGED CARE BENEFICIARIES
AT  ANY TIME IN INSTANCES WHERE THE APPROVED AGENCY HAS BEEN IN MATERIAL
NON-COMPLIANCE WITH THE TERMS OF THE CERTIFIED PROVIDER AGREEMENT.
  4. NO PROVIDER OF HOME CARE SERVICES SHALL BE APPROVED FOR ELIGIBILITY
TO SERVE MANAGED CARE BENEFICIARIES UNLESS THE  PROVIDER  OF  HOME  CARE
SERVICES MEETS AT LEAST ONE OF THE FOLLOWING MINIMUM CRITERIA:
  (A)  THE PROVIDER, OR AN AFFILIATE OF THE PROVIDER, HAS AN ESTABLISHED
RECORD OF PROVIDING HOME CARE SERVICES TO  THE  MEDICAID  PERSONAL  CARE
PROGRAM  AND  UNDER  CONTRACT WITH THE HUMAN RESOURCES ADMINISTRATION IN
NEW YORK CITY;
  (B) THE PROVIDER IS AFFILIATED WITH  A  LONG  TERM  HOME  HEALTH  CARE
PROGRAM OR MANAGED LONG TERM CARE PLAN; OR
  (C)  THE  PROVIDER OR ITS AFFILIATE HAS AN EXCEPTIONAL PRIOR RECORD OF
INVESTING IN THE QUALITY AND SUSTAINABILITY OF THE LONG TERM CARE  WORK-
FORCE,  INCLUDING, BUT NOT LIMITED TO, THE PROVISION OF TRAINING THROUGH
A DEPARTMENT OF HEALTH APPROVED TRAINING PROGRAM AND  THE  PROVISION  OF
HEALTH AND EDUCATION BENEFITS TO EMPLOYEES.
  5.  EXCEPT  FOR  MATERIAL  INSTANCES  OF  NON-COMPLIANCE  WITH PROGRAM
REQUIREMENTS, ALL PROVIDERS  OF  HOME  CARE  SERVICES  TO  THE  MEDICAID
PERSONAL  CARE  PROGRAM UNDER CONTRACT WITH THE HUMAN RESOURCES ADMINIS-
TRATION AS OF JANUARY FIRST, TWO THOUSAND ELEVEN, SHALL BE APPROVED  FOR
ELIGIBILITY  TO  SUBCONTRACT  WITH  MANAGED  CARE PLANS IN NEW YORK CITY
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FIFTEEN.
  6. NO PROVIDER SHALL BE APPROVED AS  ELIGIBLE  TO  PROVIDE  HOME  CARE
SERVICES  TO  MANAGED  CARE  BENEFICIARIES UNLESS IT COMPENSATES ALL ITS
HOME CARE EMPLOYEES IN COMPLIANCE WITH THE PROVISIONS OF  SECTION  THIR-
TY-SIX HUNDRED FOURTEEN-C OF THE PUBLIC HEALTH LAW.
  7.  FOR  THE NEW YORK CITY SOCIAL SERVICES DISTRICT, NO PROVIDER SHALL
BE APPROVED UNLESS THE TOTAL DOLLAR VALUE OF ALL  EMPLOYEE  COMPENSATION
PAID  BY  THE  PROVIDER TO ITS HOME CARE EMPLOYEES WHO WERE EMPLOYEES IN
THE MEDICAID PERSONAL CARE PROGRAM AS OF  JANUARY  FIRST,  TWO  THOUSAND
ELEVEN,  INCLUSIVE OF WAGES, BENEFITS, PAYMENTS IN LIEU OF BENEFITS, AND
PAID TIME OFF, CALCULATED ON AN AVERAGE HOURLY BASIS, IS  NO  LESS  THAN
THE MOST COMMON PREVAILING LEVEL OF TOTAL COMPENSATION PAID TO EMPLOYEES
BY  AGENCIES  PROVIDING  MEDICAID  PERSONAL  CARE PROGRAM SERVICES UNDER
CONTRACT WITH THE HUMAN RESOURCES ADMINISTRATION AS  OF  JANUARY  FIRST,

S. 2809--B                         129                        A. 4009--B

TWO  THOUSAND  ELEVEN,  AS  DETERMINED  BY  THE HUMAN RESOURCES ADMINIS-
TRATION.
  8.  PROVIDERS  OF  HOME CARE SERVICES TO MORE THAN THREE HUNDRED FIFTY
MANAGED LONG TERM CARE OR LONG TERM HOME HEALTH CARE BENEFICIARIES AS OF
JANUARY FIRST, TWO THOUSAND ELEVEN, MUST BE AFFORDED AN  OPPORTUNITY  TO
APPLY  FOR  APPROVAL  TO PROVIDE HOME CARE SERVICES TO MANAGED LONG TERM
CARE BENEFICIARIES FOR PERIODS BEGINNING NO LATER THAN APRIL FIRST,  TWO
THOUSAND  TWELVE,  PROVIDED  THAT  ALL  SUCH  APPLICANTS  SHALL STILL BE
CONSIDERED FOR APPROVAL IN  ACCORDANCE  WITH  ALL  OTHERWISE  APPLICABLE
PROVISIONS OF THIS SECTION.
  9.  ALL  APPROVED PROVIDERS, AS WELL AS ALL PROVIDERS SEEKING APPROVAL
TO PROVIDE HOME  CARE  SERVICES  TO  MANAGED  CARE  BENEFICIARIES  SHALL
FURNISH TO THE DEPARTMENT OF HEALTH OR ITS DESIGNEE, UPON THEIR REQUEST,
ALL INFORMATION NECESSARY TO IMPLEMENT ANY PROVISION OF THIS SECTION.
  10. FOR PURPOSES OF THIS SECTION:
  (A) HOME CARE SERVICES SHALL MEAN ALL SERVICES PROVIDED BY HOME HEALTH
AIDES,  PERSONAL  CARE AIDES, HOME ATTENDANTS OR OTHER LICENSED OR UNLI-
CENSED PERSONNEL WHOSE PRIMARY RESPONSIBILITIES INCLUDE THE PROVISION OF
IN HOME ASSISTANCE WITH ACTIVITIES OF DAILY LIVING, INSTRUMENTAL  ACTIV-
ITIES OF DAILY LIVING, OR HEALTH RELATED TASKS.
  (B)  PROVIDERS  OF  HOME  CARE  SERVICES SHALL MEAN LICENSED HOME CARE
SERVICES AGENCIES, CONSUMER DIRECTED  PERSONAL  ASSISTANCE  PROGRAMS  OR
ENTITIES  PROVIDING  HOME  CARE  SERVICES  TO THE MEDICAID PERSONAL CARE
PROGRAM UNDER CONTRACT WITH THE HUMAN RESOURCES  ADMINISTRATION  IN  NEW
YORK CITY AS OF JANUARY FIRST, TWO THOUSAND ELEVEN.
  (C)  THE  MEDICAID  PERSONAL  CARE  PROGRAM SHALL INCLUDE ALL SERVICES
PROVIDED UNDER NEW YORK STATE'S MEDICAL ASSISTANCE PROGRAM IN  NEW  YORK
CITY,  INCLUDING  BOTH  THE  HOME  ATTENDANT  PROGRAM  AND  THE CONSUMER
DIRECTED PERSONAL ASSISTANCE PROGRAM.
  (D) "MANAGED CARE PLAN" MEANS  ANY  MANAGED  CARE  PROGRAM  OR  DEMON-
STRATION  COVERING PERSONAL CARE OR HOME HEALTH AIDE SERVICES, AND WHICH
RECEIVES PREMIUMS FUNDED, IN WHOLE OR IN PART, BY  THE  NEW  YORK  STATE
MEDICAL  ASSISTANCE  PROGRAM,  INCLUDING BUT NOT LIMITED TO ALL MEDICAID
MANAGED CARE, MEDICAID MANAGED LONG TERM CARE, MEDICAID  ADVANTAGE,  AND
MEDICAID  ADVANTAGE  PLUS  PLANS, AND ALL PROGRAMS OF ALL INCLUSIVE CARE
FOR THE ELDERLY.
  S 34. The public health law is amended by adding a new section  2806-a
to read as follows:
  S  2806-A.  TEMPORARY OPERATOR.   1. FOR THE PURPOSES OF THIS SECTION:
(A) THE TERM "ESTABLISHED OPERATOR" SHALL MEAN THE OPERATOR OF A GENERAL
HOSPITAL OR A DIAGNOSTIC AND TREATMENT CENTER THAT HAS BEEN  ESTABLISHED
AND  ISSUED  AN  OPERATING CERTIFICATE AS SUCH PURSUANT TO THIS ARTICLE;
AND (B) THE TERM "TEMPORARY OPERATOR" SHALL MEAN ANY  PERSON  OR  ENTITY
THAT:
  (I)  AGREES TO OPERATE THE GENERAL HOSPITAL OR A DIAGNOSTIC AND TREAT-
MENT CENTER ON A TEMPORARY BASIS IN THE BEST INTERESTS OF  THE  PATIENTS
AND  THE  COMMUNITY  SERVED BY THE GENERAL HOSPITAL OR BY THE DIAGNOSTIC
AND TREATMENT CENTER; AND
  (II) HAS DEMONSTRATED THAT HE OR SHE HAS THE CHARACTER, COMPETENCE AND
FINANCIAL ABILITY TO OPERATE THE GENERAL HOSPITAL OR THE DIAGNOSTIC  AND
TREATMENT CENTER IN COMPLIANCE WITH APPLICABLE STANDARDS.
  2. (A) WHEN A STATEMENT OF DEFICIENCIES HAS BEEN ISSUED BY THE DEPART-
MENT  AND  UPON  A  DETERMINATION  BY  THE COMMISSIONER THAT THERE EXIST
SIGNIFICANT MANAGEMENT FAILURES, INCLUDING BUT NOT LIMITED  TO  ADMINIS-
TRATIVE,  OPERATIONAL OR CLINICAL DEFICIENCIES OR FINANCIAL INSTABILITY,
IN A GENERAL HOSPITAL OR IN A DIAGNOSTIC AND TREATMENT CENTER  THAT  (I)

S. 2809--B                         130                        A. 4009--B

SERIOUSLY  ENDANGER THE LIFE, HEALTH OR SAFETY OF PATIENTS OR (II) JEOP-
ARDIZE EXISTING OR CONTINUED ACCESS TO  NECESSARY  SERVICES  WITHIN  THE
COMMUNITY,  HE  OR SHE SHALL APPOINT A TEMPORARY OPERATOR TO ASSUME SOLE
CONTROL  OVER AND SOLE RESPONSIBILITY FOR THE OPERATIONS OF THAT GENERAL
HOSPITAL OR DIAGNOSTIC AND TREATMENT CENTER. THE APPOINTMENT OF A TEMPO-
RARY OPERATOR SHALL BE IN ADDITION TO ANY  OTHER  REMEDIES  PROVIDED  BY
LAW.
  (B) THE ESTABLISHED OPERATOR OF A GENERAL HOSPITAL OR A DIAGNOSTIC AND
TREATMENT  CENTER  MAY AT ANY TIME REQUEST THE COMMISSIONER TO APPOINT A
TEMPORARY OPERATOR. UPON RECEIVING SUCH A REQUEST, THE COMMISSIONER MAY,
IF HE OR SHE DETERMINES THAT SUCH AN ACTION IS NECESSARY TO  RESTORE  OR
ENSURE  THE  PROVISION  OF  QUALITY  CARE TO THE PATIENTS, ENTER INTO AN
AGREEMENT WITH THE ESTABLISHED OPERATOR FOR THE APPOINTMENT OF A  TEMPO-
RARY  OPERATOR  TO  ASSUME SOLE CONTROL OVER AND SOLE RESPONSIBILITY FOR
THE OPERATIONS OF THAT GENERAL  HOSPITAL  OR  DIAGNOSTIC  AND  TREATMENT
CENTER.
  3.  A  TEMPORARY OPERATOR APPOINTED PURSUANT TO THIS SECTION SHALL USE
HIS OR HER BEST  EFFORTS  TO  CORRECT  OR  ELIMINATE  ANY  DEFICIENCIES,
MANAGEMENT  FAILURES OR FINANCIAL INSTABILITY IN THE GENERAL HOSPITAL OR
DIAGNOSTIC AND TREATMENT CENTER. SUCH CORRECTION OR ELIMINATION OF DEFI-
CIENCIES, MANAGEMENT FAILURES OR FINANCIAL INSTABILITY SHALL NOT INCLUDE
MAJOR ALTERATIONS OF THE PHYSICAL STRUCTURE OF THE FACILITY. DURING  THE
TERM  OF  HIS  OR HER APPOINTMENT, THE TEMPORARY OPERATOR SHALL HAVE THE
AUTHORITY TO DIRECT THE MANAGEMENT OF THE GENERAL HOSPITAL OR DIAGNOSTIC
AND TREATMENT CENTER IN ALL ASPECTS OF OPERATION AND SHALL  BE  AFFORDED
FULL  ACCESS  TO THE ACCOUNTS AND RECORDS OF THE FACILITY. THE TEMPORARY
OPERATOR SHALL, DURING THIS PERIOD,  OPERATE  THE  GENERAL  HOSPITAL  OR
DIAGNOSTIC AND TREATMENT CENTER IN SUCH A MANNER AS TO ENSURE SAFETY AND
THE  QUALITY  OF  HEALTH  CARE  FOR THE PATIENTS. THE TEMPORARY OPERATOR
SHALL HAVE THE POWER TO LET CONTRACTS  THEREFOR  OR  INCUR  EXPENSES  ON
BEHALF  OF  THE  GENERAL  HOSPITAL  OR  DIAGNOSTIC AND TREATMENT CENTER,
PROVIDED  THAT  WHERE  INDIVIDUAL  ITEMS  OF  REPAIRS,  IMPROVEMENTS  OR
SUPPLIES  EXCEED  TEN  THOUSAND  DOLLARS,  THE  TEMPORARY OPERATOR SHALL
OBTAIN PRICE QUOTATIONS FROM  AT  LEAST  THREE  REPUTABLE  SOURCES.  THE
TEMPORARY  OPERATOR  SHALL NOT BE REQUIRED TO FILE ANY BOND. NO SECURITY
INTEREST IN ANY REAL OR PERSONAL PROPERTY  COMPRISING  THE  FACILITY  OR
CONTAINED  WITHIN THE FACILITY, OR IN ANY FIXTURE OF THE FACILITY, SHALL
BE IMPAIRED OR DIMINISHED IN PRIORITY BY THE TEMPORARY OPERATOR. NEITHER
THE TEMPORARY OPERATOR NOR THE DEPARTMENT SHALL ENGAGE IN  ANY  ACTIVITY
THAT  CONSTITUTES A CONFISCATION OF PROPERTY WITHOUT THE PAYMENT OF FAIR
COMPENSATION.
  4. THE TEMPORARY OPERATOR SHALL BE ENTITLED TO A  REASONABLE  FEE,  AS
DETERMINED  BY  THE COMMISSIONER, AND NECESSARY EXPENSES INCURRED DURING
HIS OR HER PERFORMANCE AS TEMPORARY OPERATOR, TO BE PAID FROM THE REVEN-
UE OF THE GENERAL HOSPITAL OR DIAGNOSTIC  AND  TREATMENT  CENTER.    THE
TEMPORARY  OPERATOR SHALL COLLECT INCOMING PAYMENTS FROM ALL SOURCES AND
APPLY THEM FIRST TO THE REASONABLE FEE AND  TO  COSTS  INCURRED  IN  THE
PERFORMANCE OF HIS OR HER FUNCTIONS AS TEMPORARY OPERATOR. THE TEMPORARY
OPERATOR SHALL BE LIABLE ONLY IN HIS OR HER CAPACITY AS TEMPORARY OPERA-
TOR  FOR  INJURY  TO  PERSON AND PROPERTY BY REASON OF CONDITIONS OF THE
GENERAL HOSPITAL OR DIAGNOSTIC AND TREATMENT CENTER IN A CASE  WHERE  AN
ESTABLISHED  OPERATOR  WOULD  HAVE BEEN LIABLE; HE OR SHE SHALL NOT HAVE
ANY LIABILITY IN HIS OR HER PERSONAL CAPACITY, EXCEPT FOR  GROSS  NEGLI-
GENCE AND INTENTIONAL ACTS.
  5. THE INITIAL TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR SHALL
NOT  EXCEED  ONE  HUNDRED  TWENTY DAYS. ADDITIONAL APPOINTMENTS OF UP TO

S. 2809--B                         131                        A. 4009--B

NINETY DAYS MAY BE MADE WHEN THE COMMISSIONER DETERMINES THAT ADDITIONAL
TERMS ARE NECESSARY TO CORRECT THE DEFICIENCIES, MANAGEMENT FAILURES  OR
FINANCIAL  INSTABILITY  THAT  REQUIRED  THE APPOINTMENT OF THE TEMPORARY
OPERATOR.  WITHIN FOURTEEN DAYS PRIOR TO THE TERMINATION OF EACH TERM OF
THE APPOINTMENT OF THE TEMPORARY OPERATOR, THE TEMPORARY OPERATOR  SHALL
SUBMIT  TO THE COMMISSIONER A REPORT DESCRIBING THE ACTIONS TAKEN DURING
THE APPOINTMENT TO ADDRESS SUCH DEFICIENCIES, MANAGEMENT FAILURES AND/OR
FINANCIAL INSTABILITY. THE REPORT SHALL REFLECT BEST EFFORTS TO  PRODUCE
A FULL AND COMPLETE ACCOUNTING.
  6.  THE  COMMISSIONER  SHALL, UPON MAKING A DETERMINATION TO APPOINT A
TEMPORARY OPERATOR PURSUANT TO PARAGRAPH (A) OF SUBDIVISION TWO OF  THIS
SECTION, CAUSE THE ESTABLISHED OPERATOR OF THE GENERAL HOSPITAL OR DIAG-
NOSTIC  AND  TREATMENT  CENTER  TO  BE  NOTIFIED OF THE DETERMINATION BY
REGISTERED OR CERTIFIED MAIL ADDRESSED TO THE PRINCIPAL  OFFICE  OF  THE
ESTABLISHED OPERATOR. UPON RECEIPT OF SUCH NOTIFICATION AT THE PRINCIPAL
OFFICE OF THE ESTABLISHED OPERATOR AND BEFORE THE EXPIRATION OF TEN DAYS
THEREAFTER, THE ESTABLISHED OPERATOR MAY REQUEST AN ADMINISTRATIVE HEAR-
ING  ON  THE  DETERMINATION TO BE HELD NO LATER THAN SIXTY DAYS FROM THE
DATE OF THE APPOINTMENT OF THE  TEMPORARY  OPERATOR.  ANY  SUCH  HEARING
SHALL  BE  STRICTLY LIMITED TO THE ISSUE OF WHETHER THE DETERMINATION OF
THE COMMISSIONER IS SUPPORTED BY SUBSTANTIAL EVIDENCE.
  7. NO PROVISION CONTAINED IN THIS SECTION SHALL BE DEEMED  TO  RELIEVE
THE  ESTABLISHED  OPERATOR  OR ANY OTHER PERSON OF ANY CIVIL OR CRIMINAL
LIABILITY INCURRED, OR ANY DUTY IMPOSED BY LAW, BY  REASON  OF  ACTS  OR
OMISSIONS  OF  THE ESTABLISHED OPERATOR OR ANY OTHER PERSON PRIOR TO THE
APPOINTMENT OF ANY TEMPORARY  OPERATOR  HEREUNDER;  NOR  SHALL  ANYTHING
CONTAINED IN THIS SECTION BE CONSTRUED TO SUSPEND DURING THE TERM OF THE
APPOINTMENT  OF THE TEMPORARY OPERATOR ANY OBLIGATION OF THE ESTABLISHED
OPERATOR OR ANY OTHER PERSON FOR THE PAYMENT OF TAXES OR OTHER OPERATING
AND MAINTENANCE EXPENSES OF THE FACILITY NOR OF THE ESTABLISHED OPERATOR
OR ANY OTHER PERSON FOR THE PAYMENT OF MORTGAGES OR LIENS.
  S 35. The public health law is amended by adding a new  article  29-AA
to read as follows:
                              ARTICLE 29-AA
                     PATIENT CENTERED MEDICAL HOMES
SECTION 2959-A. MULTIPAYOR PATIENT CENTERED MEDICAL HOME PROGRAM.
  S  2959-A.  MULTIPAYOR  PATIENT  CENTERED  MEDICAL  HOME PROGRAM.   1.
NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW, THE  COMMISSIONER  IS
AUTHORIZED  TO ESTABLISH A PROGRAM WHEREBY ENHANCED PAYMENTS ARE MADE TO
CLINICIANS AND CLINICS STATEWIDE THAT ARE CERTIFIED AS MEDICAL HOMES FOR
THE PURPOSE OF IMPROVING HEALTH CARE  OUTCOMES  AND  EFFICIENCY  THROUGH
PATIENT CARE CONTINUITY AND COORDINATION OF HEALTH SERVICES.
  2.  MEDICAL  HOMES  CERTIFIED  PURSUANT  TO  THIS  SECTION MAY PROVIDE
SERVICES TO:   RECIPIENTS ELIGIBLE FOR MEDICAL  ASSISTANCE  PURSUANT  TO
TITLE  ELEVEN OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW ("MEDICAID FEE-
FOR-SERVICE"); ENROLLEES ELIGIBLE FOR  MEDICAL  ASSISTANCE  PURSUANT  TO
SUCH  TITLE AND ENROLLED IN APPROVED MANAGED CARE ORGANIZATIONS PURSUANT
TO SECTION THREE HUNDRED SIXTY-FOUR-J OF SUCH TITLE  ("MEDICAID  MANAGED
CARE");  ENROLLEES  ELIGIBLE  FOR  FAMILY  HEALTH  PLUS  AND ENROLLED IN
APPROVED ORGANIZATIONS PURSUANT TO TITLE ELEVEN-D OF ARTICLE FIVE OF THE
SOCIAL SERVICES LAW ("FAMILY HEALTH PLUS"); ENROLLEES ELIGIBLE  FOR  THE
CHILD  HEALTH  INSURANCE  PROGRAM AND ENROLLED IN APPROVED ORGANIZATIONS
PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-FIVE OF THIS  CHAPTER  ("CHILD
HEALTH  PLUS  PROGRAM"); ENROLLEES AND SUBSCRIBERS OF COMMERCIAL MANAGED
CARE PLANS OPERATING  IN  ACCORDANCE  WITH  THE  PROVISIONS  OF  ARTICLE
FORTY-FOUR OF THIS CHAPTER OR BY HEALTH MAINTENANCE ORGANIZATIONS ORGAN-

S. 2809--B                         132                        A. 4009--B

IZED  AND OPERATING IN ACCORDANCE WITH ARTICLE FORTY-THREE OF THE INSUR-
ANCE LAW;  ENROLLEES  AND  SUBSCRIBERS  OF  OTHER  COMMERCIAL  INSURANCE
PRODUCTS; AND EMPLOYEES OF EMPLOYER-SPONSORED SELF-INSURED PLANS.
  3.  (A) IN ORDER TO PROMOTE IMPROVED QUALITY OF, AND ACCESS TO, HEALTH
CARE SERVICES AND PROMOTE IMPROVED CLINICAL OUTCOMES, IT IS  THE  POLICY
OF  THE  STATE  TO  ENCOURAGE COOPERATIVE, COLLABORATIVE AND INTEGRATIVE
ARRANGEMENTS AMONG PAYORS  OF  HEALTH  CARE  SERVICES  AND  HEALTH  CARE
SERVICES  PROVIDERS WHO MIGHT OTHERWISE BE COMPETITORS, UNDER THE ACTIVE
SUPERVISION OF THE COMMISSIONER. IT  IS  THE  INTENT  OF  THE  STATE  TO
SUPPLANT COMPETITION WITH SUCH ARRANGEMENTS ONLY TO THE EXTENT NECESSARY
TO  ACCOMPLISH THE PURPOSES OF THIS ARTICLE, AND TO PROVIDE STATE ACTION
IMMUNITY UNDER THE STATE AND FEDERAL ANTITRUST LAWS TO PAYORS OF  HEALTH
CARE  SERVICES  AND  HEALTH  CARE SERVICES PROVIDERS WITH RESPECT TO THE
PLANNING,  IMPLEMENTATION  AND  OPERATION  OF  THE  MULTIPAYOR   PATIENT
CENTERED MEDICAL HOME PROGRAM.
  (B)  THE COMMISSIONER OR HIS OR HER DULY AUTHORIZED REPRESENTATIVE MAY
ENGAGE IN APPROPRIATE  STATE  SUPERVISION  NECESSARY  TO  PROMOTE  STATE
ACTION  IMMUNITY  UNDER  THE  STATE  AND FEDERAL ANTITRUST LAWS, AND MAY
INSPECT OR REQUEST ADDITIONAL DOCUMENTATION FROM PAYORS OF  HEALTH  CARE
SERVICES AND HEALTH CARE SERVICES PROVIDERS TO VERIFY THAT MEDICAL HOMES
CERTIFIED PURSUANT TO THIS SECTION OPERATE IN ACCORDANCE WITH ITS INTENT
AND PURPOSE.
  4.  THE  COMMISSIONER IS AUTHORIZED TO PARTICIPATE IN, ACTIVELY SUPER-
VISE, FACILITATE AND APPROVE MULTIPLE PRIMARY CARE MEDICAL HOME COLLABO-
RATIVES AROUND THE STATE WITH HEALTH CARE SERVICES PROVIDERS, WHICH  MAY
INCLUDE  HOSPITALS,  DIAGNOSTIC AND TREATMENT CENTERS, AND PRIVATE PRAC-
TICES, AND PAYORS OF HEALTH CARE SERVICES, INCLUDING  EMPLOYERS,  HEALTH
PLANS AND INSURERS, TO ESTABLISH: (A) THE BOUNDARIES OF EACH PROGRAM AND
THE  PROVIDERS  ELIGIBLE TO PARTICIPATE; (B) PRACTICE STANDARDS FOR EACH
MEDICAL HOME PROGRAM CONSISTENT WITH  EXISTING  STANDARDS  DEVELOPED  BY
NATIONAL  ACCREDITING  AND PROFESSIONAL ORGANIZATIONS, INCLUDING BUT NOT
LIMITED TO THE JOINT PRINCIPLES OF THE AMERICAN  COLLEGE  OF  PHYSICIANS
("ACP"),  THE AMERICAN ACADEMY OF FAMILY PHYSICIANS ("AAFP"), THE AMERI-
CAN ACADEMY OF PEDIATRICS ("AAP"), AND THE AMERICAN OSTEOPATHIC  ASSOCI-
ATION  ("AOA"),  AND  STANDARDS  DEVELOPED BY THE NATIONAL COMMITTEE FOR
QUALITY ASSURANCE ("NCQA");  (C)  METHODOLOGIES  BY  WHICH  PAYORS  WILL
PROVIDE  ENHANCED  RATES  OF PAYMENT TO CERTIFIED MEDICAL HOMES; AND (D)
METHODOLOGIES TO PAY ADDITIONAL AMOUNTS  FOR  MEDICAL  HOMES  THAT  MEET
SPECIFIC  PROCESS  OR  OUTCOME  STANDARDS ESTABLISHED BY EACH MULTIPAYOR
PATIENT CENTERED MEDICAL HOME COLLABORATIVE.
  5. THE COMMISSIONER IS AUTHORIZED TO ESTABLISH AN  ADVISORY  GROUP  OF
STATE  AGENCIES AND STAKEHOLDERS, SUCH AS PROFESSIONAL ORGANIZATIONS AND
ASSOCIATIONS, TO IDENTIFY LEGAL AND/OR ADMINISTRATIVE  BARRIERS  TO  THE
SHARING  OF CARE MANAGEMENT AND CARE COORDINATION SERVICES AMONG PARTIC-
IPATING HEALTH CARE SERVICES PROVIDERS AND TO MAKE  RECOMMENDATIONS  FOR
STATUTORY AND/OR REGULATORY CHANGES TO ADDRESS SUCH BARRIERS.
  6.  PATIENT,  PAYOR AND HEALTH CARE SERVICES PROVIDER PARTICIPATION IN
THE MULTIPAYOR PATIENT CENTERED MEDICAL  HOME  PROGRAM  SHALL  BE  ON  A
VOLUNTARY BASIS.
  7.  CLINICS  AND CLINICIANS PARTICIPATING UNDER THE ADIRONDACK MEDICAL
HOME MULTIPAYOR DEMONSTRATION PROGRAM ESTABLISHED  PURSUANT  TO  SECTION
TWENTY-NINE HUNDRED FIFTY-NINE OF THIS CHAPTER, OR THE STATEWIDE PATIENT
CENTERED  MEDICAL  HOME  PROGRAM  ESTABLISHED  PURSUANT TO SECTION THREE
HUNDRED SIXTY-FOUR-M OF THE SOCIAL SERVICES LAW, ARE  NOT  ELIGIBLE  FOR
ENHANCED PAYMENTS PURSUANT TO THIS SECTION.

S. 2809--B                         133                        A. 4009--B

  8.  SUBJECT  TO  THE  AVAILABILITY  OF  FUNDING  AND FEDERAL FINANCIAL
PARTICIPATION, THE COMMISSIONER IS AUTHORIZED:
  (A)  TO  PAY ENHANCED RATES OF PAYMENT UNDER MEDICAID FEE-FOR-SERVICE,
MEDICAID MANAGED CARE, FAMILY HEALTH PLUS AND CHILD HEALTH PLUS TO CLIN-
ICS AND CLINICIANS THAT ARE CERTIFIED AS PATIENT CENTERED MEDICAL  HOMES
UNDER THIS TITLE;
  (B)  TO  PAY  ADDITIONAL  AMOUNTS FOR MEDICAL HOMES THAT MEET SPECIFIC
PROCESS OR OUTCOME STANDARDS SPECIFIED BY THE COMMISSIONER IN  CONSULTA-
TION  WITH  EACH MULTIPAYOR PATIENT CENTERED MEDICAL HOME COLLABORATIVE;
AND
  (C) TO TEST NEW MODELS OF PAYMENT TO HIGH VOLUME MEDICAID PRIMARY CARE
MEDICAL HOME PRACTICES THAT INCORPORATE RISK  ADJUSTED  GLOBAL  PAYMENTS
COMBINED WITH CARE MANAGEMENT AND PAY FOR PERFORMANCE ADJUSTMENTS.
  9.  (A)  THE  COMMISSIONER  IS AUTHORIZED TO CONTRACT WITH ONE OR MORE
ENTITIES TO ASSIST THE STATE IN  IMPLEMENTING  THE  PROVISIONS  OF  THIS
SECTION.  SUCH  ENTITY  OR ENTITIES SHALL BE THE SAME ENTITY OR ENTITIES
CHOSEN TO ASSIST IN THE IMPLEMENTATION OF THE HEALTH HOME PROVISIONS  OF
SECTION  THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW.  RESPON-
SIBILITIES OF THE CONTRACTOR SHALL INCLUDE BUT NOT BE LIMITED TO: DEVEL-
OPING RECOMMENDATIONS WITH RESPECT  TO  PROGRAM  POLICY,  REIMBURSEMENT,
SYSTEM  REQUIREMENTS,  REPORTING REQUIREMENTS, EVALUATION PROTOCOLS, AND
PROVIDER AND  PATIENT  ENROLLMENT;  PROVIDING  TECHNICAL  ASSISTANCE  TO
POTENTIAL  MEDICAL HOME AND HEALTH HOME PROVIDERS; DATA COLLECTION; DATA
SHARING; PROGRAM EVALUATION, AND PREPARATION OF REPORTS.
  (B) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR  SECTION
ONE HUNDRED FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR ANY OTHER LAW,
THE  COMMISSIONER  IS  AUTHORIZED  TO ENTER INTO A CONTRACT OR CONTRACTS
UNDER PARAGRAPH (A) OF THIS SUBDIVISION WITHOUT  A  COMPETITIVE  BID  OR
REQUEST FOR PROPOSAL PROCESS, PROVIDED, HOWEVER, THAT:
  (I)  THE DEPARTMENT SHALL POST ON ITS WEBSITE, FOR A PERIOD OF NO LESS
THAN THIRTY DAYS:
  (1) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT  TO
THE CONTRACT OR CONTRACTS;
  (2) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (3)  THE PERIOD OF TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY SEEK
SELECTION, WHICH SHALL BE NO LESS THAN THIRTY DAYS AFTER  SUCH  INFORMA-
TION IS FIRST POSTED ON THE WEBSITE; AND
  (4)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR  MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (II) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
COMMISSIONER; AND
  (III) THE COMMISSIONER SHALL SELECT  SUCH  CONTRACTOR  OR  CONTRACTORS
THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE PURPOSES OF
THIS SECTION.
  S  36. Subparagraph (xi) of paragraph (b) of subdivision 35 of section
2807-c of the public health law, as added by section  2  of  part  C  of
chapter  58  of the laws of 2009, is amended and three new subparagraphs
(xii), (xiii) and (xiv) are added to read as follows:
  (xi) Rates for teaching general hospitals shall include  reimbursement
for direct and indirect graduate medical education as defined and calcu-
lated  pursuant to such regulations. In addition, such regulations shall
specify the reports and information  required  by  the  commissioner  to
assess  the  cost, quality and health system needs for medical education
provided[.];

S. 2809--B                         134                        A. 4009--B

  (XII)  SUCH  REGULATIONS  MAY  INCORPORATE  QUALITY  RELATED  MEASURES
PERTAINING  TO  POTENTIALLY  PREVENTABLE  CONDITIONS  AND COMPLICATIONS,
INCLUDING, BUT  NOT  LIMITED  TO,  DISEASES  OR  COMPLICATIONS  OF  CARE
ACQUIRED IN THE HOSPITAL AND INJURIES SUSTAINED IN THE HOSPITAL;
  (XIII)  SUCH  REGULATIONS  MAY  INCORPORATE  QUALITY  RELATED MEASURES
PERTAINING TO THE  INAPPROPRIATE  USE  OF  CERTAIN  MEDICAL  PROCEDURES,
INCLUDING,  BUT  NOT  LIMITED  TO,  CESAREAN DELIVERIES, CORONARY ARTERY
BYPASS GRAFTS AND PERCUTANEOUS CORONARY INTERVENTIONS;
  (XIV) SUCH REGULATIONS MAY IMPOSE A FEE ON GENERAL HOSPITAL SUFFICIENT
TO COVER THE COSTS OF AUDITING THE INSTITUTIONAL COST REPORTS  SUBMITTED
BY GENERAL HOSPITALS.
  S 37. The social services law is amended by adding a new section 365-l
to read as follows:
  S 365-L. HEALTH HOMES.  1. NOTWITHSTANDING ANY LAW, RULE OR REGULATION
TO  THE CONTRARY, THE COMMISSIONER OF HEALTH IS AUTHORIZED, IN CONSULTA-
TION WITH THE COMMISSIONERS OF THE OFFICE OF MENTAL  HEALTH,  OFFICE  OF
ALCOHOLISM  AND  SUBSTANCE  ABUSE  SERVICES,  AND OFFICE FOR PEOPLE WITH
DEVELOPMENTAL DISABILITIES, TO (A) ESTABLISH, IN ACCORDANCE WITH  APPLI-
CABLE FEDERAL LAW AND REGULATIONS, STANDARDS FOR THE PROVISION OF HEALTH
HOME  SERVICES TO MEDICAID ENROLLEES WITH CHRONIC CONDITIONS, (B) ESTAB-
LISH PAYMENT METHODOLOGIES FOR HEALTH HOME  SERVICES  BASED  ON  FACTORS
INCLUDING  BUT NOT LIMITED TO THE COMPLEXITY OF THE CONDITIONS PROVIDERS
WILL BE MANAGING, THE ANTICIPATED AMOUNT OF PATIENT  CONTACT  NEEDED  TO
MANAGE  SUCH  CONDITIONS,  AND  THE HEALTH CARE COST SAVINGS REALIZED BY
PROVISION OF HEALTH HOME SERVICES,  (C)  ESTABLISH  THE  CRITERIA  UNDER
WHICH  A MEDICAID ENROLLEE WILL BE DESIGNATED AS BEING AN ELIGIBLE INDI-
VIDUAL WITH CHRONIC CONDITIONS FOR PURPOSES OF THIS PROGRAM, (D)  ASSIGN
ANY  MEDICAID ENROLLEE DESIGNATED AS AN ELIGIBLE INDIVIDUAL WITH CHRONIC
CONDITIONS TO A PROVIDER OF HEALTH HOME SERVICES.
  2. IN ADDITION TO PAYMENTS MADE FOR HEALTH HOME SERVICES  PURSUANT  TO
SUBDIVISION  ONE  OF THIS SECTION, THE COMMISSIONER IS AUTHORIZED TO PAY
ADDITIONAL AMOUNTS TO PROVIDERS OF HEALTH HOME SERVICES THAT MEET  PROC-
ESS OR OUTCOME STANDARDS SPECIFIED BY THE COMMISSIONER.
  3.  UNTIL  SUCH  TIME AS THE COMMISSIONER OBTAINS NECESSARY WAIVERS OF
THE FEDERAL SOCIAL SECURITY ACT, MEDICAID ENROLLEES ASSIGNED TO  PROVID-
ERS OF HEALTH HOME SERVICES WILL BE ALLOWED TO OPT OUT OF SUCH SERVICES.
  4.  PAYMENTS  AUTHORIZED  PURSUANT  TO  THIS SECTION WILL BE MADE WITH
STATE FUNDS ONLY, TO THE EXTENT THAT SUCH FUNDS ARE APPROPRIATED  THERE-
FORE, UNTIL SUCH TIME AS FEDERAL FINANCIAL PARTICIPATION IN THE COSTS OF
SUCH SERVICES IS AVAILABLE.
  5.  THE  COMMISSIONER  IS AUTHORIZED TO SUBMIT AMENDMENTS TO THE STATE
PLAN FOR MEDICAL ASSISTANCE AND/OR SUBMIT ONE OR MORE  APPLICATIONS  FOR
WAIVERS  OF THE FEDERAL SOCIAL SECURITY ACT, TO OBTAIN FEDERAL FINANCIAL
PARTICIPATION IN THE COSTS OF HEALTH HOME SERVICES PROVIDED PURSUANT  TO
THIS SECTION, AND AS PROVIDED IN SUBDIVISION THREE OF THIS SECTION.
  6.  NOTWITHSTANDING  ANY  LIMITATIONS IMPOSED BY SECTION THREE HUNDRED
SIXTY-FOUR-L OF THIS TITLE ON ENTITIES  PARTICIPATING  IN  DEMONSTRATION
PROJECTS  ESTABLISHED  PURSUANT  TO  SUCH  SECTION,  THE COMMISSIONER IS
AUTHORIZED TO ALLOW SUCH ENTITIES WHICH MEET THE  REQUIREMENTS  OF  THIS
SECTION TO PROVIDE HEALTH HOME SERVICES.
  7.  NOTWITHSTANDING  ANY LAW, RULE, OR REGULATION TO THE CONTRARY, THE
COMMISSIONERS OF THE DEPARTMENT OF HEALTH, THE OFFICE OF MENTAL  HEALTH,
THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, AND THE OFFICE OF
ALCOHOLISM AND SUBSTANCE ABUSE SERVICES ARE AUTHORIZED TO JOINTLY ESTAB-
LISH  A  SINGLE SET OF OPERATING AND REPORTING REQUIREMENTS AND A SINGLE
SET OF CONSTRUCTION AND SURVEY REQUIREMENTS FOR ENTITIES THAT:

S. 2809--B                         135                        A. 4009--B

  (A) CAN DEMONSTRATE EXPERIENCE IN THE DELIVERY OF HEALTH,  AND  MENTAL
HEALTH  AND/OR  ALCOHOL  AND SUBSTANCE ABUSE SERVICES AND/OR SERVICES TO
PERSONS WITH DEVELOPMENTAL DISABILITIES, AND THE CAPACITY TO OFFER INTE-
GRATED DELIVERY OF SUCH  SERVICES  IN  EACH  LOCATION  APPROVED  BY  THE
COMMISSIONER; AND
  (B) MEET THE STANDARDS ESTABLISHED PURSUANT TO SUBDIVISION ONE OF THIS
SECTION  FOR  PROVIDING  AND RECEIVING PAYMENT FOR HEALTH HOME SERVICES;
PROVIDED, HOWEVER, THAT AN  ENTITY  MEETING  THE  STANDARDS  ESTABLISHED
PURSUANT  TO SUBDIVISION ONE OF THIS SECTION SHALL NOT BE REQUIRED TO BE
AN INTEGRATED SERVICE PROVIDER PURSUANT TO THIS SUBDIVISION.
  IN ESTABLISHING A SINGLE SET OF OPERATING AND  REPORTING  REQUIREMENTS
AND  A  SINGLE  SET OF CONSTRUCTION AND SURVEY REQUIREMENTS FOR ENTITIES
DESCRIBED IN THIS SUBDIVISION, THE COMMISSIONERS OF  THE  DEPARTMENT  OF
HEALTH, THE OFFICE OF MENTAL HEALTH, THE OFFICE FOR PEOPLE WITH DEVELOP-
MENTAL  DISABILITIES,  AND  THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE
SERVICES ARE AUTHORIZED TO WAIVE  ANY  REGULATORY  REQUIREMENTS  AS  ARE
NECESSARY  TO  AVOID  DUPLICATION OF REQUIREMENTS AND TO ALLOW THE INTE-
GRATED DELIVERY OF SERVICES IN A RATIONAL AND EFFICIENT MANNER.
  8. (A) THE COMMISSIONER OF HEALTH IS AUTHORIZED TO CONTRACT  WITH  ONE
OR  MORE  ENTITIES TO ASSIST THE STATE IN IMPLEMENTING THE PROVISIONS OF
THIS SECTION. SUCH ENTITY OR ENTITIES SHALL BE THE SAME ENTITY OR  ENTI-
TIES  CHOSEN  TO  ASSIST IN THE IMPLEMENTATION OF THE MULTIPAYOR PATIENT
CENTERED MEDICAL HOME PROGRAM PURSUANT TO  SECTION  TWENTY-NINE  HUNDRED
FIFTY-NINE-A  OF THE PUBLIC HEALTH LAW. RESPONSIBILITIES OF THE CONTRAC-
TOR SHALL INCLUDE BUT NOT BE LIMITED TO: DEVELOPING RECOMMENDATIONS WITH
RESPECT TO PROGRAM POLICY, REIMBURSEMENT, SYSTEM REQUIREMENTS, REPORTING
REQUIREMENTS, EVALUATION PROTOCOLS, AND PROVIDER AND PATIENT ENROLLMENT;
PROVIDING TECHNICAL ASSISTANCE TO POTENTIAL MEDICAL HOME AND HEALTH HOME
PROVIDERS; DATA COLLECTION; DATA SHARING; PROGRAM EVALUATION, AND PREPA-
RATION OF REPORTS.
  (B) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR  SECTION
ONE HUNDRED FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR ANY OTHER LAW,
THE  COMMISSIONER  OF  HEALTH  IS AUTHORIZED TO ENTER INTO A CONTRACT OR
CONTRACTS UNDER PARAGRAPH (A) OF THIS SUBDIVISION WITHOUT A  COMPETITIVE
BID OR REQUEST FOR PROPOSAL PROCESS, PROVIDED, HOWEVER, THAT:
  (I)  THE  DEPARTMENT OF HEALTH SHALL POST ON ITS WEBSITE, FOR A PERIOD
OF NO LESS THAN THIRTY DAYS:
  (1) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT  TO
THE CONTRACT OR CONTRACTS;
  (2) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (3)  THE PERIOD OF TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY SEEK
SELECTION, WHICH SHALL BE NO LESS THAN THIRTY DAYS AFTER  SUCH  INFORMA-
TION IS FIRST POSTED ON THE WEBSITE; AND
  (4)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR  MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (II) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
COMMISSIONER OF HEALTH; AND
  (III) THE COMMISSIONER OF  HEALTH  SHALL  SELECT  SUCH  CONTRACTOR  OR
CONTRACTORS THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE
PURPOSES OF THIS SECTION.
  S 38. Intentionally Omitted.
  S 39. Intentionally Omitted.

S. 2809--B                         136                        A. 4009--B

  S  40.  Paragraph  (u) of subdivision 2 of section 365-a of the social
services law, as amended by section 42 of part B of chapter  58  of  the
laws of 2010, is amended to read as follows:
  (u)  screening,  brief  intervention,  and  referral  to treatment [in
hospital outpatient and emergency departments and free-standing diagnos-
tic and treatment centers] of individuals at risk  for  substance  abuse
including  referral  to the appropriate level of intervention and treat-
ment in a community setting; provided, however, that the  provisions  of
this  paragraph  relating to screening, brief intervention, and referral
to treatment  services  shall  not  take  effect  unless  all  necessary
approvals under federal law and regulation have been obtained to receive
federal financial participation in such costs.
  S  41.  Paragraphs (d) and (e) of subdivision 1 and paragraphs (c) and
(d) of subdivision 2 of section 4403-f of the public health  law,  para-
graph  (d) of subdivision 1 as amended by section 6 of part C of chapter
58 of the laws of 2007, paragraph (e) of subdivision  1  as  amended  by
section  65-d of part A of chapter 57 of the laws of 2006, paragraph (c)
of subdivision 2 as added by chapter 659 of the laws of 1997  and  para-
graph  (d) of subdivision 2 as amended by section 9 of part C of chapter
58 of the laws of 2007, and paragraphs (d) and (e) of subdivision  1  as
relettered by section 7 of part C of chapter 58 of the laws of 2007, are
amended to read as follows:
  (d)  ["Approved  managed long term care demonstration" means the sites
approved by the commissioner to participate in the  "Evaluated  Medicaid
Long Term Care Capitation Program".
  (e)]  "Health  and  long term care services" means services including,
but not limited to [primary care, acute care,] home and  community-based
and  institution-based long term care and ancillary services (that shall
include medical supplies and nutritional supplements) that are necessary
to meet the needs of persons whom the plan is authorized to enroll.  THE
MANAGED LONG TERM CARE PLAN MAY ALSO COVER PRIMARY CARE AND  ACUTE  CARE
IF SO AUTHORIZED.
  (c)  [a  description  that  demonstrates the cost-effectiveness of the
program as compared to the cost of services clients would otherwise have
received;
  (d)] adequate  documentation  of  the  appropriate  licenses,  certif-
ications  or  approvals  to provide care as planned, including contracts
with such providers as may be necessary to provide the  full  complement
of services required to be provided under this section.
  S  41-a.  Subdivision 3 of section 4403-f of the public health law, as
amended by chapter 627 of the laws  of  2008,  is  amended  to  read  as
follows:
  3.  Certificate  of  authority;  approval.  The commissioner shall not
approve an application for a certificate of authority unless the  appli-
cant demonstrates to the commissioner's satisfaction:
  (a) [the relative cost effectiveness to the medical assistance program
when  compared to other managed long term care plans proposing to serve,
or serving, comparable populations;
  (b)] that it will have in  place  acceptable  quality-assurance  mech-
anisms, grievance procedures, mechanisms to protect the rights of enrol-
lees  and case management services to ensure continuity, quality, appro-
priateness and coordination of care;
  [(c)] (B) that it will  include  an  enrollment  process  which  shall
ensure  that enrollment in the plan is informed [and voluntary by enrol-
lees or their representatives and a  voluntary  disenrollment  process].
The  application  shall [include the specific grounds that would warrant

S. 2809--B                         137                        A. 4009--B

involuntary disenrollment provided, however,] DESCRIBE THE DISENROLLMENT
PROCESS, WHICH SHALL PROVIDE THAT an otherwise eligible  enrollee  shall
not be involuntarily disenrolled on the basis of health status;
  [(d)] (C) satisfactory evidence of the character and competence of the
proposed  operators  and  reasonable  assurance  that the applicant will
provide high quality services to an enrolled population;
  [(e)] (D) sufficient management systems capacity to meet the  require-
ments of this section and the ability to efficiently process payment for
covered services;
  [(f)]  (E)  readiness  and  capability to [achieve full capitation for
services reimbursed pursuant to title XVIII of the federal social  secu-
rity  act or, for an applicant designated as an eligible applicant prior
to April first, two thousand seven pursuant to paragraph (d) of subdivi-
sion six of this section that has its principal  place  of  business  in
Bronx  county  and  is unable to achieve such full capitation, readiness
and capability to achieve full capitation  on  a  scheduled  basis  for]
MAXIMIZE REIMBURSEMENT OF AND COORDINATE services reimbursed pursuant to
title XVIII of the federal social security act [or capability and proto-
cols  for  benefit coordination for services reimbursed pursuant to such
title] and all other applicable benefits, with such benefit coordination
including, but not limited to, measures to support sound clinical  deci-
sions,  reduce administrative complexity, coordinate access to services,
maximize benefits available pursuant  to  such  title  and  ensure  that
necessary care is provided;
  [(g)]  (F)  readiness  and capability to [achieve full capitation for]
ARRANGE AND MANAGE COVERED SERVICES AND COORDINATE OTHER services  reim-
bursed pursuant to title XIX of the federal social security act;
  [(h)] (G) willingness and capability of taking, or cooperating in, all
steps necessary to secure and integrate any potential sources of funding
for services provided by the managed long term care plan, including, but
not limited to, funding available under titles XVI, XVIII, XIX and XX of
the  federal  social  security  act,  the federal older Americans act of
nineteen hundred sixty-five, as amended,  or  any  successor  provisions
subject  to  approval of the director of the state office for aging, and
through financing options such as those authorized pursuant  to  section
three hundred sixty-seven-f of the social services law;
  [(i)]  (H)  that  the CONTRACTUAL arrangements for PROVIDERS OF health
and long term care services IN THE BENEFIT  PACKAGE  ARE  SUFFICIENT  TO
ensure  the  availability  and  accessibility  of  such  services to the
proposed enrolled population CONSISTENT WITH GUIDELINES  ESTABLISHED  BY
THE  COMMISSIONER;  WITH  RESPECT  TO  INDIVIDUALS  IN  RECEIPT  OF SUCH
SERVICES PRIOR TO ENROLLMENT, SUCH GUIDELINES SHALL REQUIRE THE  MANAGED
LONG  TERM  CARE PLAN TO CONTRACT WITH AGENCIES CURRENTLY PROVIDING SUCH
SERVICES, IN ORDER TO PROMOTE CONTINUITY OF CARE; and
  [(j)] (I) that the applicant is financially  responsible  and  may  be
expected to meet its obligations to its enrolled members.
  S  41-b.  Subdivisions  5, 6, 7 and 10 of section 4403-f of the public
health law, subdivision 5 as amended by section 15 of part C of  chapter
58  of the laws of 2007, subdivisions 6 and 7 as added by chapter 659 of
the laws of 1997, paragraphs (a),  (b)  and  (c)  of  subdivision  6  as
amended  by section 6 of part C of chapter 58 of the laws of 2010, para-
graph (d) of subdivision 6 as amended by section 17 of part C of chapter
58 of the laws of 2007, paragraphs (c)  and  (d)  of  subdivision  7  as
amended by section 18 of part C of chapter 58 of the laws of 2007, para-
graphs  (e) and (g) of subdivision 7 as relettered by section 20 of part
C of chapter 58 of the laws of 2007, paragraph (h) of subdivision  7  as

S. 2809--B                         138                        A. 4009--B

added by section 65-c of part A of chapter 57 of the laws of 2006, para-
graph  (i)  as added by section 65-f of part A of chapter 57 of the laws
of 2006, and such paragraphs (h) and (i) as relettered by section 20  of
part C of chapter 58 of the laws of 2007, paragraph (f) of subdivision 7
as  amended  by  section  7 of part C of chapter 58 of the laws of 2010,
subparagraph (iii) of paragraph (h)  of  subdivision  7  as  amended  by
section  19  of part C of chapter 58 of the laws of 2007, subdivision 10
as amended by chapter 192 of the laws of 2006 and renumbered by  section
22  of  part C of chapter 58 of the laws of 2007, are amended to read as
follows:
  5. Applicability of other laws. A managed  long  term  care  plan  [or
approved  managed  long term care demonstration] shall be subject to the
provisions of the insurance law and  regulations  applicable  to  health
maintenance  organizations,  this  article  and  regulations promulgated
pursuant thereto. To the extent that the provisions of this section  are
inconsistent  with  the  provisions of this chapter or the provisions of
the insurance law, the provisions of this section shall prevail.
  6. Approval authority.  (a) An applicant shall be issued a certificate
of authority as a managed long term care plan upon  a  determination  by
the commissioner that the applicant complies with the operating require-
ments  for a managed long term care plan under this section. The commis-
sioner shall issue no more than  [fifty]  SEVENTY-FIVE  certificates  of
authority to managed long term care plans pursuant to this section. [For
purposes  of  issuance  of no more than fifty certificates of authority,
such certificates shall include those certificates  issued  pursuant  to
paragraphs (b) and (c) of this subdivision.]
  (b)  An  operating  demonstration  shall  be  issued  a certificate of
authority as a managed long term care plan upon a determination  by  the
commissioner   that  such  demonstration  complies  with  the  operating
requirements for a managed long  term  care  plan  under  this  section.
[Except  as  otherwise  expressly  provided in paragraphs (d) and (e) of
subdivision seven of this section,  nothing]  NOTHING  in  this  section
shall be construed to affect the continued legal authority of an operat-
ing demonstration to operate its previously approved program.
  [(c)  An approved managed long term care demonstration shall be issued
a certificate of authority as a managed  long  term  care  plan  upon  a
determination  by the commissioner that such demonstration complies with
the operating requirements for a managed long term care plan under  this
section.  Notwithstanding  any  inconsistent  provision  of  law  to the
contrary, all authority for the operation of approved managed long  term
care demonstrations which have not been issued a certificate of authori-
ty  as  a  managed  long term care plan, shall expire one year after the
adoption of regulations implementing managed long term care plans.
  (d) The majority leader of the senate and the speaker of the  assembly
may each designate in writing up to fifteen eligible applicants to apply
to  be  approved  managed  long  term  care demonstrations or plans. The
commissioner may designate in writing up to eleven  eligible  applicants
to apply to be approved managed long term care demonstrations or plans.]
  7. Program oversight and administration. (a)(i) The commissioner shall
promulgate regulations to implement this section and to ensure the qual-
ity,  appropriateness and cost-effectiveness of the services provided by
managed long term care plans. The commissioner may waive rules and regu-
lations of the department, including but not limited to, those  pertain-
ing  to  duplicative  requirements  concerning record keeping, boards of
directors, staffing and reporting, when such  waiver  will  promote  the
efficient  delivery of appropriate, quality, cost-effective services and

S. 2809--B                         139                        A. 4009--B

when the health, safety and general welfare of  enrollees  will  not  be
impaired  as  a  result of such waiver. In order to achieve managed long
term care plan system efficiencies and coordination and to  promote  the
objectives  of  high  quality,  integrated  and cost effective care, the
commissioner may establish a single  coordinated  surveillance  process,
allow for a comprehensive quality improvement and review process to meet
component  quality  requirements, and require a uniform cost report. The
commissioner shall require managed long term care plans to utilize qual-
ity improvement measures, based on health outcomes  data,  for  internal
quality  assessment  processes  and may utilize such measures as part of
the single coordinated surveillance process.
  (ii) Notwithstanding any inconsistent provision of the social services
law to the contrary, the commissioner  shall,  pursuant  to  regulation,
determine  whether  and the extent to which the applicable provisions of
the social services law or regulations relating to approvals and author-
izations of, and utilization limitations on, health and long  term  care
services reimbursed pursuant to title XIX of the federal social security
act,  including, but not limited to, fiscal assessment requirements, are
inconsistent with the flexibility necessary for the  efficient  adminis-
tration  of  managed  long  term  care  plans and such regulations shall
provide that such provisions shall not be  applicable  to  enrollees  or
managed  long  term  care  plans,  provided that such determinations are
consistent with applicable federal law and regulation.
  (b) The commissioner shall, to the extent necessary, submit the appro-
priate waivers, including, but not limited to, those authorized pursuant
to sections eleven hundred fifteen and nineteen hundred fifteen  of  the
federal  social  security  act,  or  successor provisions, and any other
waivers necessary to achieve the purposes of high  quality,  integrated,
and  cost  effective  care and integrated financial eligibility policies
under the medical assistance program or pursuant to title XVIII  of  the
federal social security act. IN ADDITION, THE COMMISSIONER IS AUTHORIZED
TO  SUBMIT  THE  APPROPRIATE WAIVERS, INCLUDING BUT NOT LIMITED TO THOSE
AUTHORIZED PURSUANT TO SECTIONS  ELEVEN  HUNDRED  FIFTEEN  AND  NINETEEN
HUNDRED  FIFTEEN  OF  THE  FEDERAL  SOCIAL  SECURITY  ACT  OR  SUCCESSOR
PROVISIONS, AND ANY OTHER WAIVERS NECESSARY TO REQUIRE  MEDICAL  ASSIST-
ANCE RECIPIENTS WHO ARE TWENTY-ONE YEARS OF AGE OR OLDER AND WHO REQUIRE
COMMUNITY-BASED LONG TERM CARE SERVICES, AS SPECIFIED BY THE COMMISSION-
ER,  FOR MORE THAN ONE HUNDRED AND TWENTY DAYS, TO RECEIVE SUCH SERVICES
THROUGH AN AVAILABLE PLAN CERTIFIED PURSUANT TO THIS  SECTION  OR  OTHER
CARE  COORDINATION PROGRAM SPECIFIED BY THE COMMISSIONER. Copies of such
original waiver applications shall be provided to the  chairman  of  the
senate finance committee and the chairman of the assembly ways and means
committee  simultaneously  with  their submission to the federal govern-
ment.  THE COMMISSIONER SHALL DEVELOP A WORKGROUP  TO  FURTHER  EVALUATE
AND  PROMOTE THE TRANSITION OF PERSONS IN RECEIPT OF HOME AND COMMUNITY-
BASED LONG TERM CARE SERVICES INTO MANAGED  LONG  TERM  CARE  PLANS  AND
OTHER CARE COORDINATION MODELS.
  (c)(i)  A managed long term care plan shall not use deceptive or coer-
cive marketing methods to encourage participants to  enroll.  A  managed
long  term  care plan shall not distribute marketing materials to poten-
tial enrollees before such materials have been approved by  the  commis-
sioner.
  (ii)  The  commissioner  shall  ensure,  through  periodic  reviews of
managed long term care plans, that enrollment was [a voluntary  and]  AN
informed  choice; such plan has only enrolled persons whom it is author-
ized to enroll, and plan services are promptly  available  to  enrollees

S. 2809--B                         140                        A. 4009--B

when appropriate. Such periodic reviews shall be made according to stan-
dards as determined by the commissioner in regulations.
  (d)  Notwithstanding  any  provision of law, rule or regulation to the
contrary, the commissioner may issue a request for  proposals  to  carry
out reviews of enrollment and assessment activities in managed long term
care plans and operating demonstrations with respect to enrollees eligi-
ble  to  receive services under title XIX of the federal social security
act to determine if enrollment meets the  requirements  of  subparagraph
(ii)  of paragraph (c) of this subdivision; and that assessments of such
enrollees' health, functional and  other  status,  for  the  purpose  of
adjusting  premiums,  were  accurate.  [Evaluations  shall  address each
bidder's ability to ensure that enrollments in such plans  are  promptly
reviewed  and  that medical assistance required to be furnished pursuant
to title eleven of article five of  the  social  services  law  will  be
appropriately furnished to the recipients for whom the local commission-
ers are responsible pursuant to section three hundred sixty-five of such
title  and  that  plan implementation will be consistent with the proper
and efficient administration  of  the  medical  assistance  program  and
managed long term care plans.]
  (e)  The commissioner may, in his or her discretion for the purpose of
protection of enrollees, impose measures including, but not limited  to,
bans  on  further  enrollments  and  requirements  for use of enrollment
brokers until any identified problems are resolved to  the  satisfaction
of the commissioner.
  (f)  Continuation  of  a  certificate  of  authority issued under this
section shall be contingent upon satisfactory performance by the managed
long term care plan in the  delivery,  continuity,  accessibility,  cost
effectiveness  and  quality of the services to enrolled members; compli-
ance with applicable provisions of this  section  and  rules  and  regu-
lations  promulgated  thereunder;  the continuing fiscal solvency of the
organization; and, federal financial participation in payments on behalf
of enrollees who are eligible to receive services under title XIX of the
federal social security act.
  (g) [The commissioner shall ensure that (i) a process exists  for  the
resolution  of disputes concerning the accuracy of assessments performed
pursuant to paragraphs (d) and (e) of this  subdivision;  and  (ii)  the
tasks  described  in  paragraphs  (d)  and  (e)  of this subdivision are
consistently administered.
  (h)] (i) Managed long term care plans and  demonstrations  may  enroll
eligible  persons  in the plan or demonstration upon the completion of a
comprehensive assessment that shall include, but not be limited  to,  an
evaluation  of  the  medical,  social  and  environmental  needs of each
prospective enrollee in such program. This assessment shall  also  serve
as the basis for the development and provision of an appropriate plan of
care  for  the  [prospective] enrollee. UPON APPROVAL OF FEDERAL WAIVERS
PURSUANT TO PARAGRAPH (B) OF  THIS  SUBDIVISION  WHICH  REQUIRE  MEDICAL
ASSISTANCE   RECIPIENTS  WHO  REQUIRE  COMMUNITY-BASED  LONG  TERM  CARE
SERVICES TO ENROLL IN A PLAN, AND UPON APPROVAL OF THE  COMMISSIONER,  A
PLAN  MAY ENROLL AN APPLICANT WHO IS CURRENTLY RECEIVING HOME AND COMMU-
NITY-BASED SERVICES AND COMPLETE  THE  COMPREHENSIVE  ASSESSMENT  WITHIN
THIRTY  DAYS  OF  ENROLLMENT  PROVIDED  THAT THE PLAN CONTINUES TO COVER
TRANSITIONAL CARE UNTIL SUCH TIME AS THE ASSESSMENT IS COMPLETED.
  (ii) The assessment shall be completed  by  a  representative  of  the
managed  long  term care plan or demonstration, in consultation with the
prospective enrollee's health  care  practitioner  AS  NECESSARY.    The

S. 2809--B                         141                        A. 4009--B

commissioner  shall prescribe the forms on which the assessment shall be
made.
  (iii)  The  [completed assessment and documentation of the] enrollment
APPLICATION shall be submitted by the managed long  term  care  plan  or
demonstration  to  the  [local  department  of  social services, or to a
contractor selected pursuant to  paragraph  (d)  of  this  subdivision,]
ENTITY  DESIGNATED  BY  THE  DEPARTMENT  prior  to  the  commencement of
services under the managed long term care  plan  or  demonstration.  For
purposes  of  reimbursement of the managed long term care plan or demon-
stration, if the [completed assessment and documentation are] ENROLLMENT
APPLICATION IS submitted on or before the twentieth day  of  the  month,
the  enrollment  shall  commence on the first day of the month following
the completion and submission  and  if  the  [completed  assessment  and
documentation are] ENROLLMENT APPLICATION IS submitted after the twenti-
eth  day of the month, the enrollment shall commence on the first day of
the second month following submission.  Enrollments conducted by a  plan
or  demonstration shall be subject to review and audit by the department
[and by the local social services district]  or  a  contractor  selected
pursuant to paragraph (d) of this subdivision.
  (iv)  Continued  enrollment in a managed long term care plan or demon-
stration paid for by government funds shall be based upon  a  comprehen-
sive  assessment  of  the medical, social and environmental needs of the
recipient of the services. Such assessment shall be performed  at  least
[annually]  EVERY  SIX MONTHS by the managed long term care plan serving
the enrollee.  The commissioner shall prescribe the forms on  which  the
assessment will be made.
  [(i)]  (H) The commissioner shall, upon request by a managed long term
care plan[, approved managed long term care demonstration,] or operating
demonstration,  and  consistent  with  federal  regulations  promulgated
pursuant  to  the  Health  Insurance Portability and Accountability Act,
share with such plan or demonstration the following data if it is avail-
able:
  (i) information concerning utilization of services  and  providers  by
each  of its enrollees prior to and during enrollment, including but not
limited to utilization of emergency  department  services,  prescription
drugs, and hospital and nursing facility admissions.
  (ii) aggregate data concerning utilization and costs for enrollees and
for  comparable  cohorts  served  through  the  Medicaid fee-for-service
program.
  10. [The] NOTWITHSTANDING ANY INCONSISTENT PROVISION TO THE  CONTRARY,
THE  ENROLLMENT  AND  DISENROLLMENT  PROCESS  AND  services  provided or
arranged by all operating demonstrations or any  program  that  receives
designation as a Program of All-Inclusive Care for the Elderly (PACE) as
authorized  by  federal public law 105-33, subtitle I of title IV of the
Balanced Budget Act of 1997, MUST MEET ALL APPLICABLE  FEDERAL  REQUIRE-
MENTS.  SERVICES may include, but need not be limited to, housing, inpa-
tient and outpatient hospital services, nursing home care,  home  health
care,  adult  day  care, assisted living services provided in accordance
with article forty-six-B of this chapter, adult care facility  services,
enriched  housing program services, hospice care, respite care, personal
care, homemaker services, diagnostic  laboratory  services,  therapeutic
and  diagnostic radiologic services, emergency services, emergency alarm
systems, home delivered meals,  physical  adaptations  to  the  client's
home,  physician  care  (including  consultant  and  referral services),
ancillary  services,  case  management  services,  transportation,   and
related medical services.

S. 2809--B                         142                        A. 4009--B

  S 42. The social services law is amended by adding a new section 365-m
to read as follows:
  S  365-M. ADMINISTRATION AND MANAGEMENT OF BEHAVIORAL HEALTH SERVICES.
1. THE COMMISSIONERS OF THE OFFICE OF MENTAL HEALTH AND  THE  OFFICE  OF
ALCOHOLISM  AND  SUBSTANCE  ABUSE  SERVICES,  IN  CONSULTATION  WITH THE
COMMISSIONER OF HEALTH AND WITH THE APPROVAL  OF  THE  DIVISION  OF  THE
BUDGET, SHALL HAVE RESPONSIBILITY FOR JOINTLY DESIGNATING REGIONAL ENTI-
TIES  TO PROVIDE ADMINISTRATIVE AND MANAGEMENT SERVICES FOR THE PURPOSES
OF PRIOR APPROVING AND COORDINATING THE PROVISION OF  BEHAVIORAL  HEALTH
SERVICES,  AND  INTEGRATING  SUCH  BEHAVIORAL HEALTH SERVICES WITH OTHER
SERVICES AVAILABLE UNDER THIS TITLE, FOR RECIPIENTS OF  MEDICAL  ASSIST-
ANCE  WHO ARE NOT ENROLLED IN MANAGED CARE, AND FOR SUCH APPROVAL, COOR-
DINATION, AND INTEGRATION OF BEHAVIORAL HEALTH  SERVICES  THAT  ARE  NOT
PROVIDED  THROUGH MANAGED CARE PROGRAMS UNDER THIS TITLE FOR INDIVIDUALS
REGARDLESS OF WHETHER OR NOT SUCH INDIVIDUALS ARE  ENROLLED  IN  MANAGED
CARE  PROGRAMS.  SUCH  REGIONAL  ENTITIES  SHALL ALSO BE RESPONSIBLE FOR
SAFEGUARDING AGAINST UNNECESSARY UTILIZATION OF SUCH CARE  AND  SERVICES
AND ASSURING THAT PAYMENTS ARE CONSISTENT WITH THE EFFICIENT AND ECONOM-
ICAL DELIVERY OF QUALITY CARE.
  2.  IN EXERCISING THIS RESPONSIBILITY, THE COMMISSIONERS OF THE OFFICE
OF MENTAL HEALTH AND  THE  OFFICE  OF  ALCOHOLISM  AND  SUBSTANCE  ABUSE
SERVICES ARE AUTHORIZED TO CONTRACT, AFTER CONSULTATION WITH THE COMMIS-
SIONER OF HEALTH, WITH REGIONAL BEHAVIORAL HEALTH ORGANIZATIONS OR OTHER
ENTITIES. SUCH CONTRACTS MAY INCLUDE RESPONSIBILITY FOR RECEIPT, REVIEW,
AND  DETERMINATION OF PRIOR AUTHORIZATION REQUESTS FOR BEHAVIORAL HEALTH
CARE AND SERVICES, CONSISTENT WITH CRITERIA ESTABLISHED OR  APPROVED  BY
THE  COMMISSIONERS  OF  MENTAL HEALTH AND ALCOHOLISM AND SUBSTANCE ABUSE
SERVICES, AND AUTHORIZATION OF APPROPRIATE CARE AND  SERVICES  BASED  ON
DOCUMENTED PATIENT MEDICAL NEED.
  3.  NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR  SECTION
ONE  HUNDRED FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR ANY OTHER LAW
TO THE CONTRARY, THE COMMISSIONERS OF THE OFFICE OF  MENTAL  HEALTH  AND
THE  OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES ARE AUTHORIZED TO
ENTER INTO A CONTRACT OR CONTRACTS UNDER SUBDIVISIONS  ONE  AND  TWO  OF
THIS  SECTION WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS,
PROVIDED, HOWEVER, THAT:
  (A) THE OFFICE OF MENTAL HEALTH  AND  THE  OFFICE  OF  ALCOHOLISM  AND
SUBSTANCE  ABUSE  SERVICES SHALL POST ON THEIR WEBSITES, FOR A PERIOD OF
NO LESS THAN THIRTY DAYS:
  (I) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT  TO
THE CONTRACTOR CONTRACTS;
  (II) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (III)  THE  PERIOD  OF  TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY
SEEK SELECTION, WHICH SHALL BE NO  LESS  THAN  THIRTY  DAYS  AFTER  SUCH
INFORMATION IS FIRST POSTED ON THE WEBSITE; AND
  (IV)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (B) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE  RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
COMMISSIONERS; AND
  (C) THE COMMISSIONERS OF THE OFFICE OF MENTAL HEALTH AND THE OFFICE OF
ALCOHOLISM AND  SUBSTANCE  ABUSE  SERVICES,  IN  CONSULTATION  WITH  THE
COMMISSIONER  OF  HEALTH,  SHALL  SELECT  SUCH CONTRACTOR OR CONTRACTORS
THAT, IN THEIR DISCRETION, HAVE DEMONSTRATED THE ABILITY TO EFFECTIVELY,
EFFICIENTLY, AND ECONOMICALLY INTEGRATE  BEHAVIORAL  HEALTH  AND  HEALTH

S. 2809--B                         143                        A. 4009--B

SERVICES;  HAVE  THE  REQUISITE  EXPERTISE AND FINANCIAL RESOURCES; HAVE
DEMONSTRATED THAT THEIR DIRECTORS, SPONSORS, MEMBERS, MANAGERS, PARTNERS
OR OPERATORS HAVE THE REQUISITE CHARACTER, COMPETENCE  AND  STANDING  IN
THE  COMMUNITY,  AND  ARE  BEST  SUITED  TO  SERVE  THE PURPOSES OF THIS
SECTION.
  4. THE COMMISSIONERS OF THE OFFICE OF MENTAL  HEALTH,  THE  OFFICE  OF
ALCOHOLISM  AND  SUBSTANCE  ABUSE SERVICES AND THE DEPARTMENT OF HEALTH,
SHALL HAVE THE RESPONSIBILITY FOR  JOINTLY  DESIGNATING  ON  A  REGIONAL
BASIS,  AFTER  CONSULTATION  WITH  THE  CITY  OF NEW YORK'S LOCAL SOCIAL
SERVICES DISTRICT AND LOCAL GOVERNMENTAL UNIT, AS SUCH TERM  IS  DEFINED
IN  THE  MENTAL  HYGIENE  LAW,  AND AFTER CONSULTATION OF OTHER AFFECTED
COUNTIES, A LIMITED NUMBER OF SPECIALIZED MANAGED  CARE  PLANS,  SPECIAL
NEED  MANAGED  CARE  PLANS,  AND/OR  INTEGRATED  PHYSICAL AND BEHAVIORAL
HEALTH PROVIDER SYSTEMS CAPABLE OF MANAGING THE BEHAVIORAL AND  PHYSICAL
HEALTH NEEDS OF MEDICAL ASSISTANCE ENROLLEES WITH SIGNIFICANT BEHAVIORAL
HEALTH  NEEDS.  INITIAL  DESIGNATIONS  OF SUCH PLANS OR PROVIDER SYSTEMS
SHOULD BE MADE  NO  LATER  THAN  APRIL  FIRST,  TWO  THOUSAND  THIRTEEN,
PROVIDED, HOWEVER, SUCH DESIGNATIONS SHALL BE CONTINGENT UPON A DETERMI-
NATION  BY  SUCH  STATE COMMISSIONERS THAT THE ENTITIES TO BE DESIGNATED
HAVE THE CAPACITY AND FINANCIAL ABILITY  TO  PROVIDE  SERVICES  IN  SUCH
PLANS  OR  PROVIDER  SYSTEMS, AND THAT THE REGION HAS A SUFFICIENT POPU-
LATION AND SERVICE BASE TO SUPPORT SUCH PLANS AND SYSTEMS.  ONCE  DESIG-
NATED, THE COMMISSIONER OF HEALTH SHALL MAKE ARRANGEMENTS TO ENROLL SUCH
ENROLLEES  IN  SUCH PLANS OR INTEGRATED PROVIDER SYSTEMS AND TO PAY SUCH
PLANS OR PROVIDER SYSTEMS ON A CAPITATED OR OTHER BASIS TO MANAGE, COOR-
DINATE, AND PAY FOR BEHAVIORAL AND PHYSICAL  HEALTH  MEDICAL  ASSISTANCE
SERVICES FOR SUCH ENROLLEES.  NOTWITHSTANDING ANY INCONSISTENT PROVISION
OF  SECTION  ONE HUNDRED TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE
FINANCE LAW, AND SECTION ONE HUNDRED FORTY-TWO OF THE ECONOMIC  DEVELOP-
MENT  LAW,  OR  ANY  OTHER LAW TO THE CONTRARY, THE DESIGNATIONS OF SUCH
PLANS AND PROVIDER SYSTEMS, AND ANY RESULTING CONTRACTS WITH SUCH PLANS,
PROVIDERS OR PROVIDER SYSTEMS ARE AUTHORIZED TO BE ENTERED INTO BY  SUCH
STATE  COMMISSIONERS  WITHOUT  A COMPETITIVE BID OR REQUEST FOR PROPOSAL
PROCESS. OVERSIGHT OF SUCH  CONTRACTS  WITH  SUCH  PLANS,  PROVIDERS  OR
PROVIDER SYSTEMS SHALL BE THE JOINT RESPONSIBILITY OF SUCH STATE COMMIS-
SIONERS, AND FOR CONTRACTS AFFECTING THE CITY OF NEW YORK, ALSO WITH THE
CITY'S  LOCAL  SOCIAL  SERVICES DISTRICT AND LOCAL GOVERNMENTAL UNIT, AS
SUCH TERM IS DEFINED IN THE MENTAL HYGIENE LAW.
  S 43. Paragraph (c) of subdivision 6 of section 367-a  of  the  social
services  law, as amended by chapter 41 of the laws of 1992 and subpara-
graph (iii) as amended by section 47 of part C of chapter 58 of the laws
of 2009, is amended to read as follows:
  (c) (i) Co-payments charged pursuant to this subdivision  for  non-in-
stitutional  services  shall  not  exceed the following table, provided,
however, that the department  may  establish  standard  co-payments  for
services based upon the average or typical payment for that service:

    State's payment                  Maximum co-payment
    for the services               chargeable to recipient
      $10 or less                           $[.50] .60
      $10.01 to $25                        $[1.00] 1.15
      $25.01 to $50                        $[2.00] 2.30
      $50.01 or more                       $[3.00] 3.40

  (ii)  co-payments  charged  pursuant  to  this  subdivision  for  each
discharge for inpatient care shall be [twenty-five] THIRTY dollars.

S. 2809--B                         144                        A. 4009--B

  (iii) Notwithstanding any  other  provision  of  this  paragraph,  co-
payments  charged  for each generic prescription drug dispensed shall be
one dollar AND FIFTEEN CENTS and for each brand name  prescription  drug
dispensed  shall  be  three  dollars AND FORTY CENTS; provided, however,
that  the  co-payments  charged for each brand name prescription drug on
the preferred drug list established  pursuant  to  section  two  hundred
seventy-two  of  the  public  health law and the co-payments charged for
each brand name prescription drug reimbursed  pursuant  to  subparagraph
(ii)  of  paragraph  (a-1)  of subdivision four of section three hundred
sixty-five-a of this title shall be one dollar AND FIFTEEN CENTS.
  (IV) THE CO-PAYMENT FOR EMERGENCY ROOM SERVICES PROVIDED  FOR  NON-UR-
GENT OR NON-EMERGENCY MEDICAL CARE SHALL BE SIX DOLLARS AND FORTY CENTS;
PROVIDED  HOWEVER  THAT  CO-PAYMENTS PURSUANT TO THIS SUBPARAGRAPH SHALL
NOT BE REQUIRED WITH RESPECT TO EMERGENCY SERVICES  OR  FAMILY  PLANNING
SERVICES AND SUPPLIES.
  S  44.  Paragraph  (d) of subdivision 6 of section 367-a of the social
services law is amended by adding six new subparagraphs (ix), (x), (xi),
(xii), (xiii), and (xiv) to read as follows:
  (IX) VISION CARE;
  (X) DENTAL SERVICES;
  (XI) AUDIOLOGY SERVICES;
  (XII) PHYSICIAN SERVICES;
  (XIII) NURSE PRACTITIONER SERVICES;
  (XIV) REHABILITATION SERVICES INCLUDING OCCUPATIONAL THERAPY; PHYSICAL
THERAPY AND SPEECH THERAPY;
  S 45. Subparagraph (ii) of paragraph (f) of subdivision 6  of  section
367-a  of the social services law, as amended by section 42 of part C of
chapter 58 of the laws of 2005, is amended and a new subparagraph  (iii)
is added to read as follows:
  (ii)  In  the  year  commencing April first, two thousand five and for
each year thereafter, AND ENDING IN THE YEAR CONCLUDING ON  MARCH  THIR-
TY-FIRST,  TWO  THOUSAND  ELEVEN,  no recipient shall be required to pay
more than a total of two hundred dollars in co-payments required by this
subdivision, nor shall reductions  in  payments  as  a  result  of  such
co-payments exceed two hundred dollars for any recipient.
  (III)  IN THE YEAR COMMENCING APRIL FIRST, TWO THOUSAND ELEVEN AND FOR
EACH YEAR THEREAFTER, NO RECIPIENT SHALL BE REQUIRED TO PAY MORE THAN  A
TOTAL  OF THREE HUNDRED DOLLARS IN CO-PAYMENTS REQUIRED BY THIS SUBDIVI-
SION, NOR SHALL REDUCTIONS IN PAYMENTS AS A RESULT OF  SUCH  CO-PAYMENTS
EXCEED THREE HUNDRED DOLLARS FOR ANY RECIPIENT.
  S 46. Subdivision 2-a of section 369-ee of the social services law, as
amended  by  section  26 of part E of chapter 63 of the laws of 2005, is
amended to read as follows:
  2-a. Co-payments. Subject to federal approval pursuant to  subdivision
six of this section, persons receiving family health plus coverage under
this section shall be responsible to make co-payments in accordance with
the  terms  of subdivision six of section three hundred sixty-seven-a of
this article, including those individuals  who  are  otherwise  exempted
under  the  provisions of subparagraph (iv) of paragraph (b) of subdivi-
sion six  of  section  three  hundred  sixty-seven-a  of  this  article,
provided  however, that notwithstanding the provisions of paragraphs (c)
and (d) of such subdivision:
  (i) co-payments charged for each generic prescription  drug  dispensed
shall  be  three  dollars  and  for  each  brand  name prescription drug
dispensed shall be six dollars;

S. 2809--B                         145                        A. 4009--B

  (ii) the co-payment charged for each dental  service  visit  shall  be
five  dollars,  provided  that no enrollee shall be required to pay more
than twenty-five dollars per year in co-payments  for  dental  services;
[and]
  (iii)  the  co-payment  for clinic services [and], physician services,
AND NURSE PRACTITIONER SERVICES shall be five dollars; AND
  (IV) THE CO-PAYMENT FOR EMERGENCY ROOM SERVICES PROVIDED  FOR  NON-UR-
GENT OR NON-EMERGENCY MEDICAL CARE SHALL BE SIX DOLLARS AND FORTY CENTS;
PROVIDED  HOWEVER  THAT CO-PAYMENTS PURSUANT TO THIS PARAGRAPH SHALL NOT
BE REQUIRED WITH  RESPECT  TO  EMERGENCY  SERVICES  OR  FAMILY  PLANNING
SERVICES AND SUPPLIES;
and  provided  further  that  the  limitations  in paragraph (f) of such
subdivision shall not apply.
  S 47. Section 2510 of the public health law is amended by adding a new
subdivision 13 to read as follows:
  13. "CO-PAYMENT" MEANS A PAYMENT MADE ON BEHALF OF AN  ELIGIBLE  CHILD
TO  A HEALTH CARE PROVIDER FOR A COVERED HEALTH CARE SERVICE PROVIDED TO
SUCH CHILD IN AN AMOUNT TO BE DETERMINED BY THE COMMISSIONER  CONSISTENT
WITH FEDERAL STANDARDS AND SPECIFIED IN APPLICABLE CONTRACTS.  AGGREGATE
CO-PAYMENT  AMOUNTS  COLLECTED BY HEALTH CARE PROVIDERS PURSUANT TO THIS
SUBDIVISION SHALL NOT EXCEED THREE HUNDRED DOLLARS PER YEAR PER ELIGIBLE
CHILD.
  S 47-a. Subdivision 8 of section 2511 of  the  public  health  law  is
amended  by  adding  three  new  paragraphs  (f), (g) and (h) to read as
follows:
  (F) THE COMMISSIONER SHALL ADJUST SUBSIDY PAYMENTS  MADE  TO  APPROVED
ORGANIZATIONS  ON  AND  AFTER  APRIL  FIRST, TWO THOUSAND ELEVEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND TWELVE, SO THAT THE AMOUNT OF EACH SUCH
PAYMENT IS REDUCED BY ONE AND SEVEN-TENTHS PERCENT.
  (G) EFFECTIVE OCTOBER FIRST, TWO  THOUSAND  ELEVEN,  THE  COMMISSIONER
SHALL  REDUCE SUBSIDY PAYMENTS MADE TO APPROVED ORGANIZATIONS TO REFLECT
ESTIMATED COLLECTIONS OF CO-PAYMENT AMOUNTS IMPOSED PURSUANT TO SUBDIVI-
SION THIRTEEN OF SECTION TWENTY-FIVE HUNDRED TEN OF THIS  TITLE  AND  AS
SPECIFIED  IN APPLICABLE CONTRACTS BASED ON THE NUMBER OF COVERED HEALTH
CARE SERVICE VISITS REPORTED BY AN APPROVED ORGANIZATION ON THE MEDICAID
MANAGED CARE OPERATING REPORT SUBMITTED TO THE DEPARTMENT FOR THE CALEN-
DAR YEAR ENDING DECEMBER THIRTY-FIRST, TWO  THOUSAND  TEN  AND  ADJUSTED
ANNUALLY  ON JULY FIRST TO REFLECT THE VISITS REPORTED FOR THE PRECEDING
CALENDAR YEAR.
  (H) THE COMMISSIONER MAY INCREASE SUBSIDY PAYMENTS  MADE  TO  APPROVED
ORGANIZATIONS  THAT  VOLUNTARILY  PARTICIPATE IN THE MULTI-PAYOR PATIENT
CENTERED MEDICAL HOME PROGRAM TO  REFLECT  ADDITIONAL  COSTS  ASSOCIATED
WITH  ENHANCED  PAYMENTS  MADE  TO  CERTIFIED  MEDICAL HOMES BY APPROVED
ORGANIZATIONS AS REQUIRED BY ARTICLE TWENTY-NINE-AA OF THIS CHAPTER.
  S 48. The public health law is amended by adding a new section  2997-d
to read as follows:
  S  2997-D.  HOSPITAL,  NURSING HOME, HOME CARE, SPECIAL NEEDS ASSISTED
LIVING RESIDENCES AND ENHANCED  ASSISTED  LIVING  RESIDENCES  PALLIATIVE
CARE  SUPPORT.    1.  (A) "PALLIATIVE CARE" MEANS HEALTH CARE TREATMENT,
INCLUDING INTERDISCIPLINARY  END-OF-LIFE  CARE,  AND  CONSULTATION  WITH
PATIENTS  AND  FAMILY  MEMBERS, TO PREVENT OR RELIEVE PAIN AND SUFFERING
AND TO ENHANCE THE PATIENT'S QUALITY OF  LIFE,  INCLUDING  HOSPICE  CARE
UNDER ARTICLE FORTY OF THIS CHAPTER.
  (B) "APPROPRIATE" HAS THE SAME MEANING AS PARAGRAPH (A) OF SUBDIVISION
ONE OF SECTION TWENTY-NINE HUNDRED NINETY-SEVEN-C OF THIS TITLE.

S. 2809--B                         146                        A. 4009--B

  2.  GENERAL HOSPITALS, NURSING HOMES, ORGANIZATIONS LICENSED OR CERTI-
FIED PURSUANT TO ARTICLE THIRTY-SIX OF THIS CHAPTER,  AND  ORGANIZATIONS
LICENSED  AS  SPECIAL  NEEDS  ASSISTED  LIVING  RESIDENCES  OR  ENHANCED
ASSISTED LIVING RESIDENCES PURSUANT TO ARTICLE FORTY-SIX-B OF THIS CHAP-
TER  SHALL  ESTABLISH  POLICIES  AND PROCEDURES TO PROVIDE PATIENTS WITH
ADVANCED LIFE LIMITING CONDITIONS AND ILLNESSES WHO MIGHT  BENEFIT  FROM
PALLIATIVE  CARE AND PAIN MANAGEMENT SERVICES WITH ACCESS TO INFORMATION
AND COUNSELING REGARDING PALLIATIVE CARE  AND  PAIN  MANAGEMENT  OPTIONS
APPROPRIATE  TO  THE  PATIENT.    POLICIES  MUST  INCLUDE  PROVISION FOR
PATIENTS WHO LACK CAPACITY TO MAKE MEDICAL DECISIONS, SO THAT ACCESS  TO
SUCH INFORMATION AND COUNSELING SHALL BE PROVIDED TO THE PERSONS WHO ARE
LEGALLY AUTHORIZED TO MAKE MEDICAL DECISIONS ON BEHALF OF SUCH PATIENTS.
  3.  GENERAL HOSPITALS, NURSING HOMES, ORGANIZATIONS LICENSED OR CERTI-
FIED PURSUANT TO ARTICLE THIRTY-SIX OF THIS CHAPTER,  AND  ORGANIZATIONS
LICENSED  AS  SPECIAL  NEEDS  ASSISTED  LIVING  RESIDENCES  OR  ENHANCED
ASSISTED LIVING RESIDENCES PURSUANT TO ARTICLE FORTY-SIX-B OF THIS CHAP-
TER SHALL FACILITATE ACCESS TO  APPROPRIATE  PALLIATIVE  CARE  AND  PAIN
MANAGEMENT  CONSULTATIONS  AND  SERVICES  INCLUDING  BUT  NOT LIMITED TO
REFERRALS CONSISTENT WITH PATIENT NEEDS AND PREFERENCES.
  S 49.    The  commissioner  of  health  shall  establish  a  workgroup
comprised  of  county  officials,  representatives  of  the nursing home
industry, representatives of  organized  labor  unions,  representatives
from  the department of health and the division of budget, and any other
interested individuals or representatives to  develop  a  plan  and  the
necessary  legislation to establish a public benefit corporation for the
purpose of operating and managing public nursing homes.
  The workgroup shall prepare and submit a report and draft  legislation
to the governor and the legislature no later than November 1, 2011.
  S  50. Legislative findings. Legislative intent. The legislature finds
that integration and coordination of health care services  is  essential
to  the  improvement  of  health  care  quality,  efficiency, access and
outcomes. The federal Patient Protection and Affordable Care Act creates
several health system demonstration  and  pilot  programs,  intended  to
promote  and  assess  delivery  system and payment reforms, that require
integration of services, coordination among providers, or a  combination
of  the two. Expanding these programs to include non-governmental payers
may strengthen  their  impact,  but  will  require  collaboration  among
competing  payers.  In  addition,  collaborative  arrangements among, or
consolidation of, providers may  be  necessary  to  preserve  access  to
essential  services  in some communities, while improving the quality of
the services they provide and the efficiency  of  their  operations,  as
well as minimizing unnecessary increases in the cost of care.
  Federal  and  state  antitrust  laws  may  prohibit or discourage such
collaboration or consolidation  beneficial  to  residents  of  New  York
state,  given  their potential for, or actual, reduction in competition.
The legislature finds that  such  agreements  should  be  permitted  and
encouraged. Under these circumstances, competition as currently mandated
by federal and state antitrust laws should be supplanted by a regulatory
program  to permit and encourage cooperative, collaborative and integra-
tive agreements between health care providers, payers, and others,  that
are  beneficial  to  New York residents when the benefits of such agree-
ments outweigh any disadvantages caused by  their  potential  or  actual
adverse  effects  on  competition. Regulatory oversight of such arrange-
ments should be provided to ensure that the benefits of such  agreements
outweigh  any disadvantages attributable to any reduction in competition
that may  result  from  the  agreements.  Accordingly,  the  legislature

S. 2809--B                         147                        A. 4009--B

intends  to  authorize  a regulatory program to permit and oversee inte-
gration,  consolidation,  collaboration,  and  coordination  among   and
between providers and payers, where necessary to assure access to essen-
tial  health care services, to improve health care quality and outcomes,
to enhance efficiency, or to minimize the cost of health care.
  S 51. The public health law is amended by adding a new article 29-E to
read as follows:
                              ARTICLE 29-E
            IMPROVED INTEGRATION OF HEALTH CARE AND FINANCING
SECTION 2999-AA. ANTITRUST PROVISIONS, STATE OVERSIGHT.
        2999-BB. DEPARTMENT AUTHORITY.
  S 2999-AA. ANTITRUST PROVISIONS, STATE OVERSIGHT.    1.  IN  ORDER  TO
PROMOTE  IMPROVED  QUALITY AND EFFICIENCY OF, AND ACCESS TO, HEALTH CARE
SERVICES AND TO PROMOTE IMPROVED CLINICAL OUTCOMES TO THE  RESIDENTS  OF
NEW  YORK, IT SHALL BE THE POLICY OF THE STATE TO ENCOURAGE COOPERATIVE,
COLLABORATIVE AND INTEGRATIVE ARRANGEMENTS BETWEEN HEALTH  CARE  PROVID-
ERS,  PAYERS  AND  OTHERS  WHO MIGHT OTHERWISE BE COMPETITORS, UNDER THE
ACTIVE SUPERVISION OF THE COMMISSIONER. TO THE EXTENT SUCH  ARRANGEMENTS
MIGHT BE ANTI-COMPETITIVE WITHIN THE MEANING AND INTENT OF THE STATE AND
FEDERAL  ANTITRUST LAWS, THE INTENT OF THE STATE IS TO SUPPLANT COMPETI-
TION WITH SUCH ARRANGEMENTS AS NECESSARY TO ACCOMPLISH THE  PURPOSES  OF
THIS  ARTICLE,  AND TO PROVIDE STATE ACTION IMMUNITY UNDER THE STATE AND
FEDERAL ANTITRUST LAWS WITH RESPECT TO ACTIVITIES UNDERTAKEN  BY  HEALTH
CARE  PROVIDERS  AND OTHERS PURSUANT TO THIS ARTICLE, WHERE THE BENEFITS
OF SUCH ARRANGEMENTS OUTWEIGH ANY DISADVANTAGES LIKELY TO RESULT FROM  A
REDUCTION OF COMPETITION.
  2.  THE  COMMISSIONER OR HIS OR HER DULY AUTHORIZED REPRESENTATIVE MAY
ALSO ENGAGE IN APPROPRIATE STATE SUPERVISION NECESSARY TO PROMOTE  STATE
ACTION IMMUNITY UNDER THE STATE AND FEDERAL ANTITRUST LAWS.
  S  2999-BB.  DEPARTMENT  AUTHORITY.    THE DEPARTMENT SHALL PROMULGATE
REGULATIONS TO IMPLEMENT THIS ARTICLE.  THE DEPARTMENT SHALL FURTHER  BE
AUTHORIZED  TO  IMPOSE FEES AS APPROPRIATE TO FACILITATE THE IMPLEMENTA-
TION OF THIS ARTICLE. THIS ARTICLE IS NOT INTENDED TO LIMIT THE AUTHORI-
TY OF THE ATTORNEY GENERAL OF THE STATE OF NEW YORK.
  S 52. Article 29-D of the public health law is amended by adding a new
title 4 to read as follows:
                                  TITLE 4
                  NEW YORK STATE MEDICAL INDEMNITY FUND
SECTION 2999-G. PURPOSE OF THIS ARTICLE.
        2999-H. DEFINITIONS.
        2999-I. CUSTODY AND ADMINISTRATION OF THE FUND.
        2999-J. PAYMENTS FROM THE FUND.
        2999-L. RULES AND REGULATIONS.
  S 2999-G. PURPOSE OF THIS ARTICLE.   CREATION OF THE  NEW  YORK  STATE
MEDICAL  INDEMNITY  FUND.  THERE  IS  HEREBY  CREATED THE NEW YORK STATE
MEDICAL INDEMNITY FUND (THE "FUND").   THE PURPOSE OF  THE  FUND  IS  TO
PROVIDE A FUNDING SOURCE FOR CERTAIN COSTS ASSOCIATED WITH BIRTH RELATED
NEUROLOGICAL  INJURIES,  IN  ORDER  TO  REDUCE PREMIUM COSTS FOR MEDICAL
MALPRACTICE INSURANCE COVERAGE.
  S 2999-H. DEFINITIONS. AS USED IN THIS TITLE, UNLESS  THE  CONTEXT  OR
SUBJECT MATTER REQUIRES OTHERWISE:
  (A)  "BIRTH  RELATED NEUROLOGICAL INJURY" MEANS AN INJURY TO THE BRAIN
OR SPINAL CORD OF A LIVE INFANT CAUSED BY THE DEPRIVATION OF  OXYGEN  OR
MECHANICAL INJURY OCCURRING IN THE COURSE OF LABOR, DELIVERY OR RESUSCI-
TATION  OR  BY  OTHER  MEDICAL  SERVICES PROVIDED OR NOT PROVIDED DURING
DELIVERY ADMISSION  THAT  RENDERED  THE  INFANT  WITH  A  PERMANENT  AND

S. 2809--B                         148                        A. 4009--B

SUBSTANTIAL  MOTOR IMPAIRMENT OR WITH A DEVELOPMENTAL DISABILITY AS THAT
TERM IS DEFINED BY SECTION 1.03 OF THE MENTAL HYGIENE  LAW.  THIS  DEFI-
NITION SHALL APPLY TO LIVE BIRTHS ONLY.
  (B) "FUND" MEANS THE NEW YORK STATE MEDICAL INDEMNITY FUND.
  (C)  "MEDICALLY NECESSARY HEALTH CARE COSTS" MEANS THE FUTURE MEDICAL,
DENTAL,  REHABILITATION,  CUSTODIAL,  DURABLE  MEDICAL  EQUIPMENT,  HOME
MODIFICATIONS, ASSISTIVE TECHNOLOGY, VEHICLE MODIFICATIONS, PRESCRIPTION
AND  NON-PRESCRIPTION  MEDICATIONS, AND OTHER HEALTH CARE COSTS ACTUALLY
INCURRED FOR SERVICES RENDERED TO AND  SUPPLIES  UTILIZED  BY  QUALIFIED
PLAINTIFFS, WHICH ARE MEDICALLY NECESSARY AS THAT TERM IS DEFINED BY THE
COMMISSIONER IN REGULATION.
  (D)  "QUALIFIED  PLAINTIFFS"  MEANS THOSE PLAINTIFFS WHO (I) HAVE BEEN
FOUND BY A JURY OR COURT TO HAVE SUSTAINED A BIRTH-RELATED  NEUROLOGICAL
INJURY  AS  THE  RESULT OF MEDICAL MALPRACTICE, OR (II) HAVE SUSTAINED A
BIRTH-RELATED NEUROLOGICAL INJURY AS THE RESULT OF ALLEGED MEDICAL MALP-
RACTICE, AND HAVE SETTLED THEIR LAWSUITS THEREFOR.
  S 2999-I. CUSTODY AND ADMINISTRATION OF THE FUND.  (A) THE COMMISSION-
ER OF TAXATION AND FINANCE SHALL BE  THE  CUSTODIAN  OF  THE  FUND.  ALL
PAYMENTS FROM THE FUND SHALL BE MADE BY THE COMMISSIONER OF TAXATION AND
FINANCE  UPON  CERTIFICATES  SIGNED  BY  THE SUPERINTENDENT OF FINANCIAL
REGULATION, OR HIS OR HER DESIGNEE, AS HEREINAFTER  PROVIDED.  THE  FUND
SHALL BE SEPARATE AND APART FROM ANY OTHER FUND AND FROM ALL OTHER STATE
MONIES.  NO MONIES FROM THE FUND SHALL BE TRANSFERRED TO ANY OTHER FUND,
NOR SHALL ANY SUCH MONIES BE APPLIED TO THE MAKING OF  ANY  PAYMENT  FOR
ANY PURPOSE OTHER THAN THE PURPOSE SET FORTH IN THIS TITLE.
  (B)  THE FUND SHALL BE ADMINISTERED BY THE SUPERINTENDENT OF FINANCIAL
REGULATION OR HIS OR HER DESIGNEE IN ACCORDANCE WITH THE  PROVISIONS  OF
THIS ARTICLE.
  (C)  THE  EXPENSE  OF  ADMINISTERING  THE FUND, INCLUDING THE EXPENSES
INCURRED BY THE DEPARTMENT, SHALL BE PAID FROM THE FUND.
  (D) MONIES FOR THE FUND WILL BE PROVIDED PURSUANT TO THIS CHAPTER.
  (E) BEGINNING APRIL FIRST, TWO THOUSAND TWELVE AND ANNUALLY  THEREAFT-
ER,  THE SUPERINTENDENT OF FINANCIAL REGULATION SHALL CAUSE TO BE DEPOS-
ITED INTO THE FUND, SUBJECT TO AVAILABLE APPROPRIATIONS, AN AMOUNT EQUAL
TO THE DIFFERENCE BETWEEN THE AMOUNT APPROPRIATED TO  THE  FUND  IN  THE
PRECEDING  YEAR, AS INCREASED BY THE ADJUSTMENT FACTOR DEFINED IN SUBDI-
VISION (G) OF THIS SECTION, AND THE ASSETS OF THE FUND AT THE CONCLUSION
OF THAT FISCAL YEAR.
  (F) FOLLOWING THE  DEPOSIT  REFERENCED  IN  SUBDIVISION  (E)  OF  THIS
SECTION,  THE  SUPERINTENDENT  OF  FINANCIAL REGULATION SHALL CONDUCT AN
ACTUARIAL CALCULATION OF THE ESTIMATED LIABILITIES OF THE FUND  FOR  THE
COMING  YEAR  RESULTING  FROM  THE  QUALIFIED PLAINTIFFS ENROLLED IN THE
FUND. THE ADMINISTRATOR SHALL FROM TIME TO TIME ADJUST SUCH CALCULATION.
IF THE TOTAL OF ALL  CURRENT  ESTIMATES  OF  LIABILITIES  EQUALS  EIGHTY
PERCENT  OF  THE  FUND'S  ASSETS, THEN THE FUND SHALL NOT ACCEPT ANY NEW
ENROLLMENTS UNTIL A NEW DEPOSIT HAS BEEN MADE  PURSUANT  TO  SUBDIVISION
(E)  OF  THIS SECTION. WHEN, AS A RESULT OF SUCH NEW DEPOSIT, THE FUND'S
LIABILITIES NO LONGER EXCEED THE FUND'S ASSETS, THE  FUND  ADMINISTRATOR
SHALL  ENROLL  NEW QUALIFIED PLAINTIFFS IN THE ORDER THAT AN APPLICATION
FOR ENROLLMENT HAS BEEN SUBMITTED IN ACCORDANCE WITH SUBDIVISION SIX  OF
SECTION TWENTY-NINE HUNDRED NINETY-NINE-J OF THIS TITLE.
  (G)  FOR PURPOSES OF THIS SECTION, THE ADJUSTMENT FACTOR REFERENCED IN
THIS SECTION SHALL BE THE TEN YEAR ROLLING AVERAGE MEDICAL COMPONENT  OF
THE CONSUMER PRICE INDEX AS PUBLISHED BY THE UNITED STATES DEPARTMENT OF
LABOR, BUREAU OF LABOR STATISTICS, FOR THE PRECEDING TEN YEARS.

S. 2809--B                         149                        A. 4009--B

  S  2999-J.  PAYMENTS  FROM THE FUND.  1. THE FUND SHALL BE USED TO PAY
THE (I) MEDICALLY NECESSARY HEALTH CARE COSTS OF  QUALIFIED  PLAINTIFFS,
(II) EXISTING MEDICAID LIENS ASSERTED AGAINST THE PROCEEDS OF ANY RECOV-
ERY FOR THE BIRTH RELATED NEUROLOGICAL INJURIES SUSTAINED BY SUCH QUALI-
FIED  PLAINTIFFS,  AND  (III)  THE  PORTION OF THE FEES OF THE QUALIFIED
PLAINTIFFS' ATTORNEYS DEEMED TO BE ATTRIBUTABLE TO SUCH LIEN  AMOUNT  OR
AMOUNTS.
  2.  IN DETERMINING THE AMOUNT OF MEDICALLY NECESSARY HEALTH CARE COSTS
TO BE PAID FROM THE FUND, ANY SUCH COST OR EXPENSE  THAT  WAS  OR  WILL,
WITH  REASONABLE  CERTAINTY,  BE  PAID, REPLACED OR INDEMNIFIED FROM ANY
COLLATERAL SOURCE AS PROVIDED BY SUBDIVISION (A) OF  SECTION  FORTY-FIVE
HUNDRED FORTY-FIVE OF THE CIVIL PRACTICE LAW AND RULES SHALL NOT CONSTI-
TUTE  A  MEDICALLY NECESSARY HEALTH CARE COST AND SHALL NOT BE PAID FROM
THE FUND. FOR PURPOSES OF THIS  TITLE,  "COLLATERAL  SOURCE"  SHALL  NOT
INCLUDE MEDICARE OR MEDICAID.
  3.  IN DETERMINING THE AMOUNT OF MEDICALLY NECESSARY HEALTH CARE COSTS
TO BE PAID FROM THE FUND, THERE SHALL BE PROPORTIONATELY  DEDUCTED  FROM
EACH  CLAIM  SUBMITTED  TO THE FUND THE AMOUNTS NECESSARY FOR PAYMENT OF
THE SET-OFFS, ADJUSTMENTS AND DEDUCTIONS AS SET FORTH IN SUBDIVISION (E)
OF SECTION FIVE THOUSAND THIRTY-ONE OF THE CIVIL PRACTICE LAW AND RULES.
  4. THE AMOUNT OF MEDICALLY NECESSARY HEALTH CARE COSTS TO BE PAID FROM
THE FUND  SHALL  BE  CALCULATED  ON  THE  BASIS  OF  MEDICAID  RATES  OF
REIMBURSEMENT  OR,  WHERE NO SUCH RATES ARE AVAILABLE, AS DEFINED BY THE
COMMISSIONER IN REGULATION. ANY  DISPUTE  AS  TO  WHETHER  ANY  COST  IS
MEDICALLY NECESSARY SHALL BE DETERMINED BY THE COMMISSIONER.
  5. ON A FORM TO BE PRESCRIBED AND FURNISHED BY THE FUND, THE QUALIFIED
PLAINTIFF  SHALL FILE WITH THE FUND CLAIMS FOR THE PAYMENT FROM THE FUND
OF MEDICALLY NECESSARY HEALTH CARE COSTS, ANY EXISTING  MEDICAID  LIENS,
AND  THE PORTION OF THE FEE OF THE QUALIFIED PLAINTIFF'S ATTORNEY DEEMED
TO BE ATTRIBUTABLE TO SUCH LIEN AMOUNT OR AMOUNTS.
  6. A QUALIFIED PLAINTIFF SHALL BE ENROLLED WHEN (A) SUCH PLAINTIFF, OR
ANY OF THE DEFENDANTS IN REGARD  TO  THE  PLAINTIFF'S  CLAIM,  MAKES  AN
APPLICATION  FOR  ENROLLMENT  BY PROVIDING THE FUND ADMINISTRATOR WITH A
CERTIFIED COPY OF THE JUDGMENT  OR  OF  THE  COURT  APPROVED  SETTLEMENT
AGREEMENT;  AND  (B) THE FUND ADMINISTRATOR DETERMINES UPON THE BASIS OF
SUCH JUDGMENT OR SETTLEMENT AGREEMENT AND ANY ADDITIONAL INFORMATION THE
FUND ADMINISTRATOR SHALL REQUEST  THAT  THE  PLAINTIFF  IS  A  QUALIFIED
PLAINTIFF;  PROVIDED  THAT  NO  ENROLLMENT  SHALL OCCUR WHEN THE FUND IS
CLOSED TO ENROLLMENT PURSUANT TO SUBDIVISION (F) OF SECTION  TWENTY-NINE
HUNDRED NINETY-NINE-I OF THIS TITLE.
  6-A. AS TO ALL CLAIMS, THE FUND ADMINISTRATOR SHALL:
  (A)  DETERMINE WHICH OF SUCH COSTS ARE MEDICALLY NECESSARY HEALTH CARE
COSTS TO BE PAID FROM THE FUND; AND
  (B) THEREUPON CERTIFY TO THE  COMMISSIONER  OF  TAXATION  AND  FINANCE
THOSE  COSTS  THAT HAVE BEEN DETERMINED TO BE MEDICALLY NECESSARY HEALTH
CARE COSTS TO BE PAID FROM THE FUND.
  7. THE QUALIFIED PLAINTIFF'S CLAIM FOR THE  PAYMENT  OF  ANY  EXISTING
MEDICAID  LIENS  SHALL BE ACCOMPANIED BY EVIDENCE OF ANY SUCH LIENS AND,
AS TO SUCH CLAIM, THE FUND ADMINISTRATOR SHALL:
  (A) CONFIRM THE EXISTENCE AND AMOUNT OF SUCH LIENS; AND
  (B) ACCEPT AND PROCESS CLAIMS FOR PAYMENT OF SUCH LIENS; AND
  (C) THEREUPON CERTIFY TO THE  COMMISSIONER  OF  TAXATION  AND  FINANCE
THOSE  LIENS  THAT  HAVE  BEEN  DETERMINED TO BE EXISTING VALID MEDICAID
LIENS TO BE PAID FROM THE FUND.
  WITH REGARD TO THE QUALIFIED PLAINTIFF'S CLAIM FOR THE PAYMENT OF  THE
PORTION  OF  THE  FEE OF THE QUALIFIED PLAINTIFF'S ATTORNEY DEEMED TO BE

S. 2809--B                         150                        A. 4009--B

ATTRIBUTABLE TO THE EXISTING  MEDICAID  LIENS,  THE  FUND  ADMINISTRATOR
SHALL  ACCEPT  AND PROCESS CLAIMS FOR PAYMENT OF SUCH FEE, ASSUMING THAT
THE EXISTING MEDICAID LIEN IS THE LAST  COMPONENT  OF  THE  JUDGMENT  OR
SETTLEMENT SUM TO BE PAID.
  8.  ANY DISPUTE CONCERNING ANY DETERMINATION BY THE FUND ADMINISTRATOR
WITH REGARD TO THAT PORTION OF THE ATTORNEY'S FEE SHALL BE  REFERRED  TO
THE COMMISSIONER.
  9.  PAYMENTS  FROM THE FUND SHALL BE MADE BY THE COMMISSIONER OF TAXA-
TION AND FINANCE ON THE SAID CERTIFICATE OF THE SUPERINTENDENT OF FINAN-
CIAL REGULATION. NO PAYMENT SHALL BE MADE BY THE COMMISSIONER  OF  TAXA-
TION  AND  FINANCE  IN  EXCESS  OF  THE  AMOUNT CERTIFIED. PROMPTLY UPON
RECEIPT OF THE SAID CERTIFICATE OF THE SUPERINTENDENT OF FINANCIAL REGU-
LATION, THE COMMISSIONER OF TAXATION AND FINANCE SHALL PAY (I) THE QUAL-
IFIED PLAINTIFF'S HEALTH CARE PROVIDER OR REIMBURSE THE QUALIFIED PLAIN-
TIFF THE AMOUNT SO CERTIFIED  FOR  PAYMENT,  (II)  THE  LIEN  AMOUNT  OR
AMOUNTS  SO  CERTIFIED  FOR PAYMENT, AND (III) THE QUALIFIED PLAINTIFF'S
ATTORNEY THE PORTION OF THE FEE SO CERTIFIED FOR PAYMENT.
  10. PAYMENT FROM THE FUND SHALL NOT GIVE THE FUND ANY RIGHT OF  RECOV-
ERY AGAINST ANY QUALIFIED PLAINTIFF OR SUCH QUALIFIED PLAINTIFF'S ATTOR-
NEY EXCEPT IN THE CASE OF FRAUD OR MISTAKE.
  11.  ALL  HEALTH CARE PROVIDERS SHALL ACCEPT FROM QUALIFIED PLAINTIFFS
ASSIGNMENTS OF THE RIGHT TO RECEIVE PAYMENTS FROM THE FUND FOR MEDICALLY
NECESSARY HEALTH CARE COSTS.
  12. HEALTH INSURERS (OTHER THAN MEDICARE AND MEDICAID)  SHALL  BE  THE
PRIMARY  PAYERS  OF  MEDICALLY  NECESSARY HEALTH CARE COSTS OF QUALIFIED
PLAINTIFFS. SUCH COSTS SHALL BE PAID FROM THE FUND ONLY  TO  THE  EXTENT
THAT HEALTH INSURERS OR OTHER COLLATERAL SOURCES ARE NOT OTHERWISE OBLI-
GATED  TO MAKE PAYMENTS THEREFOR. HEALTH INSURERS THAT MAKE PAYMENTS FOR
MEDICALLY NECESSARY HEALTH CARE COSTS  TO  OR  ON  BEHALF  OF  QUALIFIED
PLAINTIFFS  SHALL  HAVE  NO  RIGHT OF RECOVERY AGAINST AND SHALL HAVE NO
LIEN UPON THE FUND OR ANY PERSON OR ENTITY NOR SHALL THE FUND CONSTITUTE
AN ADDITIONAL PAYMENT SOURCE TO OFFSET THE PAYMENTS OTHERWISE CONTRACTU-
ALLY REQUIRED TO BE MADE BY SUCH HEALTH INSURERS.
  13. EXCEPT AS PROVIDED FOR BY THIS TITLE, NO PAYMENT SHALL BE REQUIRED
TO BE MADE BY ANY DEFENDANT OR SUCH DEFENDANT'S  INSURER  FOR  MEDICALLY
NECESSARY  HEALTH CARE COSTS, OR FOR THE EXISTING MEDICAID LIEN AMOUNTS,
OR FOR THE PORTION OF THE FEE  OF  THE  QUALIFIED  PLAINTIFF'S  ATTORNEY
DEEMED TO BE ATTRIBUTABLE TO SUCH LIEN AMOUNTS, AND NO JUDGMENT SHALL BE
MADE OR ENTERED REQUIRING THAT ANY SUCH PAYMENT BE MADE BY ANY DEFENDANT
OR SUCH DEFENDANT'S INSURER.
  14.  THE  DETERMINATION  OF  THE  QUALIFIED PLAINTIFF'S ATTORNEY'S FEE
SHALL BE BASED UPON THE ENTIRE SUM AWARDED BY THE JURY OR THE  COURT  OR
THE  FULL  SUM OF THE SETTLEMENT, AS THE CASE MAY BE. THE PORTION OF THE
QUALIFIED PLAINTIFF'S ATTORNEY'S FEE DEEMED TO BE  ATTRIBUTABLE  TO  THE
EXISTING  MEDICAID  LIEN  SHALL  BE  PAID IN ACCORDANCE WITH SUBDIVISION
SEVEN OF THIS SECTION AND SHALL NOT BE PAID OUT  OF  THE  MEDICAID  LIEN
AMOUNT.  THE PORTION OF THE QUALIFIED PLAINTIFF'S ATTORNEY'S FEE THAT IS
ALLOCATED TO ALL OTHER ELEMENTS OF DAMAGES SHALL BE PAID IN A  LUMP  SUM
BY  THE  DEFENDANTS  AND THEIR INSURERS PURSUANT TO SECTION FOUR HUNDRED
SEVENTY-FOUR-A OF THE JUDICIARY LAW; PROVIDED HOWEVER THAT  THE  PORTION
OF  THE  ATTORNEY  FEE  THAT  IS  ALLOCATED  TO THE NON-FUND ELEMENTS OF
DAMAGES SHALL BE DEDUCTED FROM THE NON-FUND PORTION OF THE  AWARD  IN  A
PROPORTIONAL MANNER.
  15.  THE  COMMISSIONER  OF  HEALTH AND THE SUPERINTENDENT OF FINANCIAL
REGULATION SHALL PROMULGATE, AMEND AND ENFORCE ALL REASONABLE RULES  AND
REGULATIONS  NECESSARY  FOR  THE  PROPER  ADMINISTRATION  OF THE FUND IN

S. 2809--B                         151                        A. 4009--B

ACCORDANCE WITH THE PROVISIONS  OF  THIS  SECTION,  INCLUDING,  BUT  NOT
LIMITED  TO,  THOSE  CONCERNING THE PAYMENT OF CLAIMS AND CONCERNING THE
ACTUARIAL CALCULATIONS  NECESSARY  TO  DETERMINE,  ANNUALLY,  THE  TOTAL
AMOUNT  TO  BE  PAID  INTO THE FUND AS PROVIDED HEREIN, AND AS OTHERWISE
NEEDED TO IMPLEMENT THIS TITLE.
  S 52-a. Article 29-D of the public health law is amended by  adding  a
new title 5 to read as follows:
                                  TITLE 5
               NEW YORK STATE HOSPITAL QUALITY INITIATIVE
SECTION 2999-M. NEW YORK STATE HOSPITAL QUALITY INITIATIVE.
  S  2999-M.  NEW  YORK STATE HOSPITAL QUALITY INITIATIVE.  THE NEW YORK
STATE HOSPITAL QUALITY INITIATIVE, INCLUDING THE NEW YORK STATE  OBSTET-
RICAL  PATIENT  SAFETY  WORKGROUP,  WILL BE CREATED IN THE DEPARTMENT OF
HEALTH TO BE COMPRISED OF MEDICAL, HOSPITAL  AND  ACADEMIC  EXPERTS  AND
OTHER STAKEHOLDERS CHOSEN BY THE COMMISSIONER.
  THE NEW YORK STATE QUALITY INITIATIVE WILL OVERSEE THE GENERAL DISSEM-
INATION  OF  INITIATIVES, GUIDANCE, AND BEST PRACTICES TO GENERAL HOSPI-
TALS. ACTIVITIES WILL INCLUDE BUT NOT BE LIMITED TO:  BUILDING  CULTURES
OF  PATIENT SAFETY AND IMPLEMENTING EVIDENCE BASED CARE IN TARGET AREAS.
THE WORKGROUP WILL UNDERTAKE COLLABORATIVE WORK TO  IMPROVE  OBSTETRICAL
CARE OUTCOMES AND QUALITY OF CARE, BASED ON IDENTIFYING AND IMPLEMENTING
EVIDENCE  BASED  PRACTICES, AND CLINICAL PROTOCOLS THAT CAN BE STANDARD-
IZED AND ADOPTED BY HOSPITALS INCLUDING BUT NOT LIMITED TO:
  (A)  SURVEYING,  REVIEWING  AND  ANALYZING  CURRENT  "BEST"  PRACTICES
EMPLOYED  IN  OBSTETRICAL CASES, INCLUDING EXPLORING THE USE OF "VIRTUAL
GRAND ROUNDS";
  (B) UNDERTAKING A REVIEW OF "CLOSED CLAIMS" IN AN EFFORT TO DEVELOP  A
SET OF "STANDARD BEST PRACTICES" FOR DELIVERIES IN NEW YORK STATE;
  (C)  FORMULATING  AND  RECOMMENDING  TO THE COMMISSIONER BEST PRACTICE
STANDARDS AND DESIGNING NEW PROGRAMS  FOR  IMPLEMENTATION  AND  IMPROVED
OUTCOMES, INCLUDING BUT NOT LIMITED TO, CLINICAL BUNDLES FOR HIGH PRIOR-
ITY  CONDITIONS, ELECTRONIC FETAL MONITORING TRAINING AND CERTIFICATION,
AND TEAM TRAINING; AND
  (D)  ENGAGING  THE  EXISTING  REGIONAL  PERINATAL  CENTER  NETWORK  IN
DIALOGUES  REGARDING  THE  ABOVE  TOPICS  AND  MAKING RECOMMENDATIONS TO
IMPROVE AND/OR UPGRADE ASSISTANCE AND COMMUNICATION  TO  SMALLER  HOSPI-
TALS.
  S  52-b.  Subdivision  1 of section 2807-v of the public health law is
amended by adding a new paragraph (iii) to read as follows:
  (III) FUNDS SHALL BE RESERVED AND SET ASIDE AND ACCUMULATED FROM  YEAR
TO  YEAR  AND  SHALL BE MADE AVAILABLE, INCLUDING INCOME FROM INVESTMENT
FUNDS, FOR THE PURPOSE OF SUPPORTING THE NEW YORK STATE  MEDICAL  INDEM-
NITY  FUND AS AUTHORIZED PURSUANT TO TITLE FOUR OF ARTICLE TWENTY-NINE-D
OF THIS CHAPTER, FOR THE FOLLOWING PERIODS AND IN THE FOLLOWING AMOUNTS,
PROVIDED, HOWEVER, THAT THE COMMISSIONER IS AUTHORIZED  TO  SEEK  WAIVER
AUTHORITY  FROM  THE  FEDERAL  CENTERS FOR MEDICARE AND MEDICAID FOR THE
PURPOSE OF SECURING MEDICAID FEDERAL FINANCIAL  PARTICIPATION  FOR  SUCH
PROGRAM, IN WHICH CASE THE FUNDING AUTHORIZED PURSUANT TO THIS PARAGRAPH
SHALL BE UTILIZED AS THE NON-FEDERAL SHARE FOR SUCH PAYMENTS:
  ONE  HUNDRED  MILLION DOLLARS FOR THE PERIOD APRIL FIRST, TWO THOUSAND
ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE.
  S 52-c. The public health law is  amended  by  adding  a  new  section
2807-d-1 to read as follows:
  S  2807-D-1.  HOSPITAL QUALITY CONTRIBUTIONS.   1. NOTWITHSTANDING ANY
CONTRARY PROVISION OF LAW AND SUBJECT TO THE RECEIPT  OF  ALL  NECESSARY
FEDERAL  APPROVALS  OR WAIVERS, FOR PERIODS ON AND AFTER JULY FIRST, TWO

S. 2809--B                         152                        A. 4009--B

THOUSAND ELEVEN, A QUALITY CONTRIBUTION SHALL BE IMPOSED  ON  THE  INPA-
TIENT  REVENUE  OF  EACH  GENERAL  HOSPITAL EQUAL TO THREE TENTHS OF ONE
PERCENT OF SUCH REVENUE, AS DEFINED IN ACCORDANCE WITH PARAGRAPH (A)  OF
SUBDIVISION  THREE OF SECTION TWENTY-EIGHT HUNDRED SEVEN-D OF THIS ARTI-
CLE, AND PROVIDED FURTHER, HOWEVER, THAT ON AND AFTER  JULY  FIRST,  TWO
THOUSAND  ELEVEN,  AN  ADDITIONAL  QUALITY  CONTRIBUTION  EQUAL  TO FOUR
PERCENT OF SUCH INPATIENT REVENUE SHALL BE IMPOSED WITH  REGARD  TO  ALL
SUCH  INPATIENT  REVENUE THAT IS RECEIVED FOR THE PROVISION OF INPATIENT
OBSTETRICAL PATIENT CARE SERVICES, PROVIDED, HOWEVER,  THAT  SUCH  ADDI-
TIONAL  QUALITY  CONTRIBUTION  IS  SUBJECT  TO  RECEIPT OF ALL NECESSARY
FEDERAL APPROVALS OR WAIVERS, AS DETERMINED AS NECESSARY BY THE  COMMIS-
SIONER, AND PROVIDED FURTHER, HOWEVER, THAT IN THE EVENT THE COMMISSION-
ER,  IN  CONSULTATION  WITH  THE DIRECTOR OF THE BUDGET, DETERMINES THAT
SUCH QUALITY CONTRIBUTION AND SUCH ADDITIONAL QUALITY CONTRIBUTION SHALL
RAISE LESS THAN OR MORE THAN THE TOTAL  QUALITY  COLLECTION  AMOUNT  SET
FORTH IN SUBDIVISION TWO OF THIS SECTION, THEN IN THAT EVENT THE COMMIS-
SIONER,  IN CONSULTATION WITH THE DIRECTOR OF THE BUDGET, MAY PROMULGATE
REGULATIONS, AND MAY PROMULGATE  EMERGENCY  REGULATIONS,  INCREASING  OR
DECREASING  SUCH  QUALITY  CONTRIBUTIONS BY AMOUNTS SUFFICIENT TO ENSURE
THE COLLECTION OF SUCH ANNUAL QUALITY CONTRIBUTION AMOUNT AND TO  ENSURE
THAT FIFTY-FIVE PERCENT OF SUCH AGGREGATE AMOUNT IS RAISED BY SUCH QUAL-
ITY  CONTRIBUTION  AND  FORTY-FIVE  PERCENT IS RAISED BY SUCH ADDITIONAL
QUALITY CONTRIBUTION.
  2. THE ANNUAL QUALITY CONTRIBUTION AMOUNT  REFERENCED  IN  SUBDIVISION
ONE OF THIS SECTION SHALL BE ONE HUNDRED SEVENTY MILLION DOLLARS FOR THE
STATE  FISCAL  YEAR  BEGINNING APRIL FIRST, TWO THOUSAND ELEVEN, AND FOR
EACH SUBSEQUENT STATE FISCAL YEAR THEREAFTER IT SHALL BE THE  AMOUNT  OF
THE  PRECEDING  YEAR AS INCREASED BY THE TEN YEAR ROLLING AVERAGE OF THE
MEDICAL COMPONENT OF THE CONSUMER PRICE INDEX AS PUBLISHED BY THE UNITED
STATES DEPARTMENT OF LABOR, BUREAU OF LABOR STATISTICS, FOR THE  PRECED-
ING TEN YEARS.
  3. THE QUALITY CONTRIBUTIONS DESCRIBED IN THIS SECTION SHALL BE ADMIN-
ISTERED IN ACCORDANCE WITH AND SUBJECT TO THE PROVISIONS OF SUBDIVISIONS
FOUR, FIVE, SIX, SEVEN, EIGHT AND TWELVE OF SECTION TWENTY-EIGHT HUNDRED
SEVEN-D  OF  THIS ARTICLE, PROVIDED, HOWEVER, THAT SUCH QUALITY CONTRIB-
UTIONS SHALL BE DEPOSITED IN THE  HCRA  RESOURCES  FUND  AS  ESTABLISHED
PURSUANT TO SECTION NINETY-TWO-DD OF THE STATE FINANCE LAW; AND PROVIDED
FURTHER, HOWEVER, THAT SUCH CONTRIBUTIONS SHALL NOT BE AN ALLOWABLE COST
IN THE DETERMINATION OF REIMBURSEMENT RATES OF PAYMENT COMPUTED PURSUANT
TO THIS ARTICLE.
  4.  THE  COLLECTION  OF  THE  QUALITY  CONTRIBUTIONS DESCRIBED IN THIS
SECTION SHALL BE SUSPENDED AND THE AMOUNTS ALREADY PAID FOR THAT  FISCAL
YEAR  SHALL  BE  REFUNDED  PROPORTIONATELY  TO EACH CONTRIBUTOR IF A TWO
HUNDRED FIFTY THOUSAND DOLLAR LIMITATION FOR NON-ECONOMIC DAMAGES PURSU-
ANT TO ARTICLE FIFTY-C OF THE CIVIL PRACTICE LAW AND  RULES  IS  NOT  IN
PLACE.
  S 52-d. Section 3012-a of the civil practice law and rules, as amended
by chapter 507 of the laws of 1987, is amended to read as follows:
  S  3012-a. Certificate of merit in medical, dental and podiatric malp-
ractice actions.  (a) In any action for  medical,  dental  or  podiatric
malpractice,  the  complaint  shall  be  accompanied  by  a certificate,
executed by the attorney for the plaintiff, declaring that:
  (1) the attorney has reviewed the facts of the case and has  consulted
AS TO EACH NAMED DEFENDANT, with at least one physician in medical malp-
ractice  actions,  at least one dentist in dental malpractice actions or
at least one podiatrist in podiatric malpractice actions who is licensed

S. 2809--B                         153                        A. 4009--B

to practice in this state or any other state, WHO IS CURRENTLY IN ACTIVE
PRACTICE IN THE SAME SPECIALTY AS THE DEFENDANT, and  who  the  attorney
reasonably  believes is knowledgeable in the relevant issues involved in
the  particular action, and that the attorney has concluded on the basis
of such review and consultation that there is a reasonable basis for the
commencement  of  such  action  AGAINST  EACH  DEFENDANT  NAMED  IN  THE
COMPLAINT; or
  (2)  the  attorney  was  unable to obtain the consultation required by
paragraph one of this subdivision because a limitation of  time,  estab-
lished by article two of this chapter, would bar the action and that the
certificate  required  by  paragraph  one  of this subdivision could not
reasonably be obtained before such time expired.  If  a  certificate  is
executed  pursuant to this subdivision, the certificate required by this
section  shall  be  filed  within  ninety  days  after  service  of  the
complaint[; or
  (3)  the  attorney  was  unable to obtain the consultation required by
paragraph one of this subdivision because the attorney  had  made  three
separate good faith attempts with three separate physicians, dentists or
podiatrists,  in accordance with the provisions of paragraph one of this
subdivision to obtain such consultation  and  none  of  those  contacted
would agree to such a consultation].
  (b) Where a certificate is required pursuant to this section, a single
certificate shall be filed for each DEFENDANT NAMED IN THE action[, even
if  more  than  one defendant has been named in the complaint or is] AND
FOR EACH DEFENDANT WHO IS subsequently named.
  (c) Where the attorney intends to rely solely on the doctrine of  "res
ipsa  loquitur", this section shall be inapplicable.  In such cases, the
complaint shall be accompanied by a certificate, executed by the  attor-
ney, declaring that the attorney is solely relying on such doctrine and,
for that reason, is not filing a certificate required by this section.
  (d)  If  a request by the plaintiff for the records of the plaintiff's
medical or dental treatment by the defendants has  been  made  and  such
records  have  not been produced, the plaintiff shall not be required to
serve the certificate required by this section until ninety  days  after
such records have been produced.
  (e)  For  purposes  of  this section, and subject to the provisions of
section thirty-one hundred one of this chapter, an attorney who  submits
a  certificate as required by paragraph one or two of subdivision (a) of
this section and the physician, dentist  or  podiatrist  with  whom  the
attorney consulted shall not be required to disclose the identity of the
physician,  dentist  or  podiatrist  consulted  and the contents of such
consultation; provided, however, that when the attorney  makes  a  claim
under  paragraph  three  of  subdivision (a) of this section that he was
unable to obtain the required consultation with the  physician,  dentist
or podiatrist, the court may, upon the request of a defendant made prior
to compliance by the plaintiff with the provisions of section thirty-one
hundred  of  this  chapter, require the attorney to divulge to the court
the names of physicians, dentists or podiatrists refusing such consulta-
tion.
  (f) The provisions of this section shall not be applicable to a plain-
tiff who is not represented by an attorney.
  (g) The plaintiff may, in lieu of serving the certificate required  by
this  section,  provide the defendant or defendants with the information
required by paragraph one  of  subdivision  (d)  of  section  thirty-one
hundred one of this chapter within the period of time prescribed by this
section.

S. 2809--B                         154                        A. 4009--B

  S  52-e.  Subparagraphs (i) and (ii) of paragraph 1 of subdivision (d)
of section 3101 of the civil practice law and rules, subparagraph (i) as
amended by chapter 184 of the laws of 1988,  and  subparagraph  (ii)  as
amended  by  chapter  165  of  the  laws of 1991, are amended to read as
follows:
  (i) Upon request, each party shall identify each person whom the party
expects  to  call  as  an  expert witness at trial and shall disclose in
reasonable detail the subject matter on which each expert is expected to
testify, the substance of the facts and opinions on which each expert is
expected to testify, the qualifications of each  expert  witness  and  a
summary of the grounds for each expert's opinion. However, where a party
for  good  cause  shown retains an expert an insufficient period of time
before the commencement of trial to give appropriate notice thereof, the
party shall not thereupon be precluded  from  introducing  the  expert's
testimony  at  the  trial  solely  on grounds of noncompliance with this
paragraph. In that instance, upon motion of any party, made before or at
trial, or on its own initiative, the court may make whatever  order  may
be  just.  [In an action for medical, dental or podiatric malpractice, a
party, in responding to a request, may omit the names of medical, dental
or podiatric experts but shall be required to disclose all other  infor-
mation concerning such experts otherwise required by this paragraph.]
  (ii)  In  an action for medical, dental or podiatric malpractice, [any
party may, by written offer made to and served upon  all  other  parties
and  filed  with  the  court, offer to disclose the name of, and to make
available for examination upon oral deposition,  any  person  the  party
making  the  offer expects to call as an expert witness at trial. Within
twenty days of service of the offer, a party shall accept or reject  the
offer  by  serving  a  written  reply upon all parties and filing a copy
thereof with the court. Failure to serve a reply within twenty  days  of
service  of  the  offer shall be deemed a rejection of the offer. If all
parties accept the offer, each party shall be required to produce his or
her expert witness for examination upon oral deposition upon receipt  of
a  notice  to  take  oral  deposition in accordance with rule thirty-one
hundred seven of this chapter. If any party, having made or accepted the
offer, fails to make that party's expert available for oral  deposition,
that  party  shall  be  precluded  from offering expert testimony at the
trial of the action] A PARTY SHALL BE REQUIRED TO PRODUCE EACH PERSON SO
IDENTIFIED BY SUCH PARTY AS AN EXPERT WITNESS FOR EXAMINATION UPON  ORAL
DEPOSITION  UPON  RECEIPT OF A NOTICE TO TAKE ORAL DEPOSITION AFTER SUCH
TIME AS THE PRODUCING PARTY COMPLIES WITH SUBPARAGRAPH (I) OF THIS PARA-
GRAPH.
  S 52-f. The civil practice law and rules is amended by  adding  a  new
rule 3409 to read as follows:
  RULE  3409.  SETTLEMENT  CONFERENCE  IN  DENTAL, PODIATRIC AND MEDICAL
MALPRACTICE ACTIONS.  IN EVERY DENTAL, PODIATRIC OR MEDICAL  MALPRACTICE
ACTION,  THE  COURT  SHALL HOLD A MANDATORY SETTLEMENT CONFERENCE WITHIN
FORTY-FIVE DAYS AFTER THE FILING OF THE NOTE OF ISSUE AND CERTIFICATE OF
READINESS OR, IF A PARTY MOVES TO VACATE THE NOTE OF ISSUE  AND  CERTIF-
ICATE  OF  READINESS,  WITHIN  FORTY-FIVE  DAYS AFTER THE DENIAL OF SUCH
MOTION. WHERE PARTIES ARE REPRESENTED BY COUNSEL, ONLY  ATTORNEYS  FULLY
FAMILIAR  WITH  THE  ACTION  AND  AUTHORIZED  TO DISPOSE OF THE CASE, OR
ACCOMPANIED BY A PERSON EMPOWERED TO ACT ON BEHALF OF THE PARTY  REPRES-
ENTED, WILL BE PERMITTED TO APPEAR AT THE CONFERENCE. WHERE APPROPRIATE,
THE COURT MAY ORDER PARTIES, REPRESENTATIVES OF PARTIES, REPRESENTATIVES
OF INSURANCE CARRIERS OR PERSONS HAVING AN INTEREST IN ANY SETTLEMENT TO
ALSO  ATTEND  IN  PERSON OR TELEPHONICALLY AT THE SETTLEMENT CONFERENCE.

S. 2809--B                         155                        A. 4009--B

THE CHIEF ADMINISTRATIVE JUDGE SHALL BY RULE ADOPT PROCEDURES TO  IMPLE-
MENT SUCH SETTLEMENT CONFERENCE.
  S 52-g. Intentionally omitted.
  S  52-h.  Subdivision 2 of section 2805-m of the public health law, as
amended by chapter 808 of the laws  of  1987,  is  amended  to  read  as
follows:
  2.  Notwithstanding  any other provisions of law, none of the records,
documentation or committee  actions  or  records  required  pursuant  to
sections  twenty-eight hundred five-j and twenty-eight hundred five-k of
this article, the reports  required  pursuant  to  section  twenty-eight
hundred  five-l  of this article nor any incident reporting requirements
imposed upon diagnostic and treatment centers pursuant to the provisions
of this chapter shall be subject to disclosure under article six of  the
public  officers law or article thirty-one of the civil practice law and
rules, except [as hereinafter provided or]  as  provided  by  any  other
provision  of  law.  No  person  in  attendance at a meeting of any such
committee shall be required to testify as to  what  transpired  thereat.
[The  prohibition  relating to discovery of testimony shall not apply to
the statements made by any person in attendance at such a meeting who is
a party to an action or proceeding  the  subject  matter  of  which  was
reviewed at such meeting.]
  S  52-i.  The  civil practice law and rules is amended by adding a new
article 50-C to read as follows:
                               ARTICLE 50-C
                              DAMAGE AWARDS
SECTION 5051. DEFINITION.
        5052. DAMAGE AWARDS.
  S 5051. DEFINITION. AS USED IN  THIS  ARTICLE,  "NONECONOMIC  DAMAGES"
MEANS  NONPECUNIARY  DAMAGES  ARISING  FROM  PAIN AND SUFFERING, LOSS OF
SERVICES, LOSS OF CONSORTIUM, OR OTHER NONPECUNIARY DAMAGES.
  S 5052. DAMAGE AWARDS. IN ANY MEDICAL, DENTAL, OR  PODIATRIC  MALPRAC-
TICE ACTION, THE PREVAILING PLAINTIFF MAY BE AWARDED:
  (A) ECONOMIC AND PECUNIARY DAMAGES; AND
  (B)  NONECONOMIC  DAMAGES  SUFFERED  BY  THE INJURED PLAINTIFF, NOT TO
EXCEED TWO HUNDRED FIFTY THOUSAND DOLLARS, PROVIDED, HOWEVER, THAT  SUCH
LIMITATION SHALL BE ADJUSTED IN ACCORDANCE WITH THE CONSUMER PRICE INDEX
FOR  ALL  URBAN  CONSUMERS  (CPI-U), AS PUBLISHED ANNUALLY BY THE UNITED
STATES DEPARTMENT OF LABOR, BUREAU OF LABOR STATISTICS.
  S 52-j. Subdivision (c) of section 5031 of the civil practice law  and
rules is REPEALED and subdivisions (d), (e), (f), (g) and (h) are relet-
tered subdivisions (c), (d), (e), (f) and (g).
  S  52-k.  Subdivisions  (c),  (d),  (e) and (f) of section 5031 of the
civil practice law and rules, as added by chapter 86 of the laws of 2003
and as relettered by section fifty-two-j of this  act,  are  amended  to
read as follows:
  (c)  The  findings  of future economic and pecuniary damages except in
wrongful death actions AND IN ACTIONS SUBJECT TO TITLE 4 OF ARTICLE 29-D
OF THE PUBLIC HEALTH LAW,  shall  be  used  to  determine  a  stream  of
payments  for each such item of damages by applying (i) the growth rate,
to the (ii) annual amount in current dollars, for the  (iii)  period  of
years,  all  of  such items as determined by the finder of fact for each
such item of damages. The court shall determine the present value of the
stream of payments for each such item of damages by applying a  discount
rate  to  the stream of payments. After determining the present value of
the stream of payments for future economic and pecuniary damages,  thir-
ty-five  percent  of that present value shall be paid in a lump sum, and

S. 2809--B                         156                        A. 4009--B

the stream of payments for future economic and pecuniary  damages  shall
be  adjusted  accordingly  by  proportionately reducing each item of the
remaining stream of payments for future economic and  pecuniary  damages
and  paying those amounts over time in the form of an annuity in accord-
ance with the provisions set forth in  subdivision  [(g)]  (F)  of  this
section, subject to the adjustments and deductions specified in subdivi-
sion [(f)](E) of this section.
  (d)  The  discount rate to be used in determining the present value of
all streams of payments for periods of up to twenty years shall  be  the
rate  in effect for the ten-year United States Treasury Bond on the date
of the verdict. As to any streams of payments for which  the  period  of
years  exceeds twenty years, the discount rate to be used in determining
the present value shall be calculated by averaging, on an annual  basis,
the  rate  in effect for the ten-year United States Treasury Bond on the
date of the verdict for the first twenty years and two percentage points
above the rate in effect for the ten-year United States Treasury Bond on
the date of the verdict for the years after twenty years.
  (e) After making the applicable calculations set forth above:
  (1) The court shall apply any set-offs for comparative negligence  and
settlements  by  deducting  them  proportionately  from each item of the
damages awards, including the lump sum payments  specified  in  subdivi-
sions  (b)[,  (c),] and [(d)] (C) of this section, and the present value
of the streams of payments specified in [such subdivisions]  SUBDIVISION
(c) [and (d)].  After such deductions, the streams of payments specified
in [such subdivisions] SUBDIVISION (c) [and (d)] and their present value
shall be adjusted accordingly.
  (2)  The  court  shall  then  deduct  the  litigation  expenses of the
plaintiff's attorney proportionately from each  remaining  item  of  the
damages  awards,  including the remaining lump sum payments specified in
such subdivisions (b)[, (c),] and [(d)] (C), and the  present  value  of
the  remaining  streams  of  payments  specified  in [such subdivisions]
SUBDIVISION (c) [and (d)], and such expenses shall be  paid  in  a  lump
sum.  After  said deductions, the streams of payments specified in [such
subdivisions] SUBDIVISION (c) [and (d)] and their present value shall be
adjusted accordingly.
  (3) The court shall then determine the attorney's fees based upon  the
remaining  damages  awards,  including  the  remaining lump sum payments
specified in such subdivisions (b)[, (c),] and [(d)] (C), and the  pres-
ent value of the remaining streams of payments specified in [such subdi-
visions]  SUBDIVISION  (c)  [and  (d)].    The  attorney's fees shall be
deducted proportionately from each item of the remaining damages awards,
including the remaining lump sum payments specified in such subdivisions
(B) AND (c)[, and (d),] and the present value of the  remaining  streams
of  payments specified in [such subdivisions] SUBDIVISION (c) [and (d)],
and such fees shall be paid in a lump sum.  After said  deductions,  the
stream of payments specified in [such subdivisions] SUBDIVISION (c) [and
(d)] and their present value shall be adjusted accordingly.
  (4)  Any  liens  which  are not the subject of a separate award by the
finder of fact shall then be deducted proportionately from each item  of
the  remaining damages awards, including the remaining lump sum payments
specified in such subdivisions (b)[, (c),] and [(d)] (C), and the  pres-
ent value of the remaining streams of payments specified in [such subdi-
visions]  SUBDIVISION  (c)  [and (d)], and such liens shall be paid in a
lump sum. After said deductions, the stream  of  payments  specified  in
[such  subdivisions]  SUBDIVISION  (c) [and (d)] and their present value
shall be adjusted accordingly.

S. 2809--B                         157                        A. 4009--B

  (f) The defendants and their insurance carriers shall be  required  to
offer  and  to guarantee the purchase and payment of an annuity contract
to make annual payments in equal monthly installments of  the  remaining
streams  of  payments  specified  in [such subdivisions] SUBDIVISION (c)
[and  (d)],  after  making  the deductions and adjustments prescribed in
subdivision [(f)] (E)  of  this  section.  The  annuity  contract  shall
provide that the payments shall run from the date of the verdict (unless
some  other  date  is  specified in the verdict) for the period of years
determined by the finder of fact (except  the  stream  of  payments  for
future  pain  and  suffering, which shall not exceed eight years) or the
life of the plaintiff, whichever is shorter, except that:
  (1) awards for lost earnings shall be paid for the full  term  of  the
award determined by the finder of fact; and
  (2)  awards  for any item of economic or pecuniary damages as to which
the finder of fact found that the loss or item of damage  is  permanent,
the  payments for that item shall continue to run for the entire life of
the plaintiff, increasing each year beyond the period  of  years  deter-
mined by the finder of fact at the same growth rate as determined by the
finder of fact.
  S  52-l.  Section 5034 of the civil practice law and rules, as amended
by chapter 446 of the laws of 1999, is amended to read as follows:
  S 5034. Failure to make payment. If at any  time  following  entry  of
judgment,  a judgment debtor fails for any reason to make a payment in a
timely fashion according to the terms  of  this  article,  the  judgment
creditor may petition the court which rendered the original judgment for
an  order  requiring  payment  by the judgment debtor of the outstanding
payments in a lump sum. In calculating the amount of the lump sum  judg-
ment,  the  court  shall  total  the remaining periodic payments due and
owing to the judgment creditor, as calculated  pursuant  to  subdivision
[(e)] (D) of section five thousand thirty-one of this article, and shall
not  convert  these  amounts  to their present value. The court may also
require the payment of interest on the outstanding judgment.
  S 52-m. The creation and continuation of the New  York  State  Medical
Indemnity  Fund  established  pursuant to title 4 of article 29-D of the
public health law, as added by section fifty-two of this act, is contin-
gent upon the application of a two hundred fifty thousand dollar limita-
tion for non-economic damages, defined in  article  50-C  of  the  civil
practice  law  and  rules,  as  added  by section fifty-two of this act;
provided, however, that payments  pursuant  to  section  2999-j  of  the
public  health  law,  as  added  by  section fifty-two of this act shall
continue to be made as set forth in such section  with  respect  to  any
qualified  plaintiff  enrolled  in  such fund prior to any suspension of
such limitation for non-economic damages.
  S 53. Subdivision 6 of section 369 of  the  social  services  law,  as
added by chapter 170 of the laws of 1994, is amended to read as follows:
  6.  For  purposes of this section, [the term] AN INDIVIDUAL'S "estate"
[means] INCLUDES all OF THE INDIVIDUAL'S real and personal property  and
other assets [included within the individual's estate and] passing under
the  terms of a valid will or by intestacy.  AN INDIVIDUAL'S ESTATE ALSO
INCLUDES ANY OTHER PROPERTY IN WHICH THE INDIVIDUAL HAS ANY LEGAL  TITLE
OR  INTEREST  AT  THE  TIME  OF  DEATH, INCLUDING JOINTLY HELD PROPERTY,
RETAINED LIFE ESTATES, AND INTERESTS IN TRUSTS, TO THE  EXTENT  OF  SUCH
INTERESTS;  PROVIDED,  HOWEVER, THAT A CLAIM AGAINST A RECIPIENT OF SUCH
PROPERTY BY DISTRIBUTION OR SURVIVAL SHALL BE LIMITED TO  THE  VALUE  OF
THE  PROPERTY  RECEIVED  OR  THE  AMOUNT  OF MEDICAL ASSISTANCE BENEFITS
OTHERWISE RECOVERABLE PURSUANT TO THIS SECTION, WHICHEVER IS LESS.

S. 2809--B                         158                        A. 4009--B

  S 54.  Subparagraph 12 of paragraph (a) of subdivision  1  of  section
366  of the social services law, as amended by section 42-a of part C of
chapter 58 of the laws of 2008, is amended to read as follows:
  (12) is a disabled person at least sixteen years of age, but under the
age of sixty-five, who: would be eligible for benefits under the supple-
mental  security income program but for earnings in excess of the allow-
able limit; has net available income that does not  exceed  two  hundred
fifty percent of the applicable federal income official poverty line, as
defined  and updated by the United States department of health and human
services, for a one-person or two-person household, as  defined  by  the
commissioner in regulation; has household resources, as defined in para-
graph  (e)  of  subdivision  two of section three hundred sixty-six-c of
this title, OTHER THAN RETIREMENT ACCOUNTS,  that  do  not  exceed  [the
amount  described  in  subparagraph four of paragraph (a) of subdivision
two of this section] TWENTY THOUSAND DOLLARS for a one-person  HOUSEHOLD
or THIRTY THOUSAND DOLLARS FOR A two-person household, as defined by the
commissioner  in  regulation;  and  contributes  to  the cost of medical
assistance provided pursuant to this  subparagraph  in  accordance  with
subdivision twelve of section three hundred sixty-seven-a of this title;
for  purposes  of  this  subparagraph, disabled means having a medically
determinable impairment of sufficient severity and duration  to  qualify
for benefits under section 1902(a)(10)(A)(ii)(xv) of the social security
act; or
  S  55. The mental hygiene law is amended by adding a new section 31.08
to read as follows:
S 31.08 COMPLIANCE WITH OPERATIONAL STANDARDS BY HOSPITALS.
  (A) NOTWITHSTANDING THE PROVISIONS OF SECTION 31.07 OF THIS ARTICLE, A
HOSPITAL AS DEFINED IN SECTION 1.03 OF THIS CHAPTER, WHICH  IS  A  WARD,
WING,  UNIT,  OR  OTHER  PART  OF  A  HOSPITAL,  AS  DEFINED  IN ARTICLE
TWENTY-EIGHT OF THE PUBLIC  HEALTH  LAW,  WHICH  PROVIDES  SERVICES  FOR
PERSONS  WITH MENTAL ILLNESS PURSUANT TO AN OPERATING CERTIFICATE ISSUED
BY THE COMMISSIONER OF MENTAL HEALTH, MAY BE DEEMED TO BE IN  COMPLIANCE
WITH  APPLICABLE  PROVISIONS  OF THIS CHAPTER AND OTHER APPLICABLE LAWS,
RULES AND REGULATIONS, PROVIDED THAT SUCH HOSPITAL HAS  BEEN  ACCREDITED
BY  THE JOINT COMMISSION, OR ANY OTHER HOSPITAL ACCREDITING ORGANIZATION
TO WHICH THE CENTERS FOR MEDICARE  AND  MEDICAID  SERVICES  HAS  GRANTED
DEEMING  STATUS,  AND WHICH THE COMMISSIONER OF MENTAL HEALTH SHALL HAVE
DETERMINED HAS ACCREDITING STANDARDS SUFFICIENT TO  ASSURE  THE  COMMIS-
SIONER  THAT  HOSPITALS  SO  ACCREDITED  ARE  IN  COMPLIANCE  WITH  SUCH
PROVISIONS OF LAW, RULES AND REGULATIONS. THE  COMMISSIONER  MAY  EXEMPT
ANY SUCH HOSPITAL FROM THE ANNUAL INSPECTION AND VISITATION REQUIREMENTS
ESTABLISHED IN SECTION 31.07 OF THIS ARTICLE, PROVIDED THAT:
  1.  SUCH  HOSPITAL HAS A HISTORY OF COMPLIANCE WITH SUCH PROVISIONS OF
LAW, RULES AND REGULATIONS AND A RECORD OF PROVIDING GOOD QUALITY  CARE,
AS DETERMINED BY THE COMMISSIONER;
  2. A COPY OF THE SURVEY REPORT AND THE CERTIFICATE OF ACCREDITATION OF
THE  JOINT  COMMISSION  OR  OTHER  APPROVED  ACCREDITING ORGANIZATION IS
SUBMITTED BY THE ACCREDITING BODY OR THE HOSPITAL TO  THE  COMMISSIONER,
WITHIN SEVEN DAYS OF ISSUANCE TO THE HOSPITAL;
  3.  THE  JOINT COMMISSION OR OTHER ACCREDITING ORGANIZATION HAS AGREED
TO AND DOES EVALUATE, AS PART OF ITS ACCREDITATION SURVEY,  ANY  MINIMAL
OPERATIONAL STANDARDS ESTABLISHED BY THE COMMISSIONER WHICH ARE IN ADDI-
TION  TO THE MINIMAL OPERATIONAL STANDARDS OF ACCREDITATION OF THE JOINT
COMMISSION OR OTHER ACCREDITING ORGANIZATION; AND
  4. THERE ARE NO CONSTRAINTS PLACED UPON ACCESS BY THE COMMISSIONER  TO
THE  JOINT  COMMISSION OR OTHER APPROVED ACCREDITING ORGANIZATION SURVEY

S. 2809--B                         159                        A. 4009--B

REPORTS, PLANS OF CORRECTION, INTERIM SELF-EVALUATION  REPORTS,  NOTICES
OF  NONCOMPLIANCE, PROGRESS REPORTS ON CORRECTION OF AREAS OF NONCOMPLI-
ANCE, OR ANY OTHER RELATED REPORTS, INFORMATION, COMMUNICATIONS OR MATE-
RIALS REGARDING SUCH HOSPITAL.
  (B) ANY HOSPITAL GOVERNED BY THE PROVISIONS OF SUBDIVISION (A) OF THIS
SECTION SHALL AT ALL TIMES BE SUBJECT TO INSPECTION OR VISITATION BY THE
COMMISSIONER  TO  DETERMINE COMPLIANCE WITH APPLICABLE LAW, REGULATIONS,
STANDARDS OR CONDITIONS AS DEEMED NECESSARY BY THE  COMMISSIONER.    ANY
SUCH  HOSPITAL  SHALL BE SUBJECT TO THE FULL RANGE OF LICENSING ENFORCE-
MENT AUTHORITY OF THE COMMISSIONER.
  (C) ANY HOSPITAL GOVERNED BY THE PROVISIONS OF SUBDIVISION (A) OF THIS
SECTION SHALL NOTIFY THE COMMISSIONER IMMEDIATELY UPON RECEIPT OF NOTICE
BY THE JOINT COMMISSION OR OTHER APPROVED ACCREDITING  ORGANIZATION,  OR
ANY  COMMUNICATION  THE HOSPITAL MAY RECEIVE THAT SUCH ORGANIZATION WILL
BE RECOMMENDING THAT SUCH HOSPITAL  NOT  BE  ACCREDITED,  NOT  HAVE  ITS
ACCREDITATION  RENEWED,  OR  HAVE  ITS ACCREDITATION TERMINATED, OR UPON
RECEIPT OF NOTICE OR OTHER COMMUNICATION FROM THE CENTERS  FOR  MEDICARE
AND  MEDICAID  SERVICES REGARDING A DETERMINATION THAT THE HOSPITAL WILL
BE TERMINATED FROM PARTICIPATION IN THE MEDICARE PROGRAM BECAUSE  IT  IS
NOT  IN  COMPLIANCE WITH ONE OR MORE CONDITIONS OF PARTICIPATION IN SUCH
PROGRAM, OR HAS DEFICIENCIES THAT EITHER INDIVIDUALLY OR IN  COMBINATION
JEOPARDIZE THE HEALTH AND SAFETY OF PATIENTS OR ARE OF SUCH CHARACTER AS
TO SERIOUSLY LIMIT THE PROVIDER'S CAPACITY TO RENDER ADEQUATE CARE.
  S 56.  The mental hygiene law is amended by adding a new section 32.14
to read as follows:
S  32.14  COMPLIANCE WITH OPERATIONAL STANDARDS BY PROVIDERS OF SERVICES
          IN HOSPITALS.
  (A) NOTWITHSTANDING THE PROVISIONS OF SECTION 32.13 OF THIS ARTICLE, A
PROVIDER OF SERVICES AS DEFINED IN SECTION 1.03  OF  THIS  CHAPTER  THAT
OCCUPIES  A WARD, WING, UNIT, OR OTHER PART OF A HOSPITAL, AS DEFINED IN
ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW, WHICH  PROVIDES  SERVICES
FOR  PERSONS  WITH  MENTAL DISABILITIES PURSUANT TO AN OPERATING CERTIF-
ICATE ISSUED BY THE COMMISSIONER, MAY BE DEEMED TO BE IN COMPLIANCE WITH
APPLICABLE PROVISIONS OF THIS CHAPTER AND OTHER APPLICABLE  LAWS,  RULES
AND  REGULATIONS IN REGARD TO SERVICES PROVIDED AT SUCH WARD, WING, UNIT
OR OTHER PART OF A  HOSPITAL,  PROVIDED  THAT  SUCH  HOSPITAL  HAS  BEEN
ACCREDITED  BY  THE JOINT COMMISSION, OR ANY OTHER ACCREDITING ORGANIZA-
TION TO WHICH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES HAS GRANTED
DEEMING STATUS, AND WHICH THE COMMISSIONER  SHALL  HAVE  DETERMINED  HAS
ACCREDITING STANDARDS SUFFICIENT TO ASSURE THE COMMISSIONER THAT PROVID-
ERS  OF  SERVICES  OCCUPYING  A  WARD,  WING, UNIT OR OTHER PART OF SUCH
HOSPITAL SO ACCREDITED ARE IN COMPLIANCE WITH SUCH  PROVISIONS  OF  LAW,
RULES AND REGULATIONS IN REGARD TO SERVICES PROVIDED AT SUCH WARD, WING,
UNIT  OR OTHER PART OF A HOSPITAL.  THE COMMISSIONER MAY EXEMPT ANY SUCH
PROVIDER OF SERVICES, IN REGARD TO SERVICES PROVIDED AT SUCH WARD, WING,
UNIT OR OTHER PART OF A HOSPITAL, FROM THE ANNUAL INSPECTION AND VISITA-
TION REQUIREMENTS ESTABLISHED IN SECTION 32.13 OF THIS ARTICLE, PROVIDED
THAT:
  1. SUCH PROVIDER OF SERVICES HAS A HISTORY  OF  COMPLIANCE  WITH  SUCH
PROVISIONS  OF LAW, RULES AND REGULATIONS AND A RECORD OF PROVIDING GOOD
QUALITY CARE, AS DETERMINED BY THE COMMISSIONER;
  2. A COPY OF THE SURVEY REPORT AND THE CERTIFICATE OF ACCREDITATION OF
THE JOINT COMMISSION  OR  OTHER  APPROVED  ACCREDITING  ORGANIZATION  IS
SUBMITTED  BY  THE  ACCREDITING  BODY OR THE PROVIDER OF SERVICES TO THE
COMMISSIONER,  WITHIN  SEVEN  DAYS  OF  ISSUANCE  TO  SUCH  PROVIDER  OF
SERVICES;

S. 2809--B                         160                        A. 4009--B

  3. THE JOINT COMMISSION OR OTHER APPROVED ACCREDITING ORGANIZATION HAS
AGREED  TO  AND  DOES EVALUATE, AS PART OF ITS ACCREDITATION SURVEY, ANY
MINIMAL OPERATIONAL STANDARDS ESTABLISHED BY THE COMMISSIONER WHICH  ARE
IN ADDITION TO THE MINIMAL OPERATIONAL STANDARDS OF ACCREDITATION OF THE
JOINT COMMISSION OR OTHER ACCREDITING ORGANIZATION; AND
  4.  THERE ARE NO CONSTRAINTS PLACED UPON ACCESS BY THE COMMISSIONER TO
THE JOINT COMMISSION OR OTHER APPROVED ACCREDITING  ORGANIZATION  SURVEY
REPORTS,  PLANS  OF CORRECTION, INTERIM SELF-EVALUATION REPORTS, NOTICES
OF NONCOMPLIANCE, PROGRESS REPORTS ON CORRECTION OF AREAS OF  NONCOMPLI-
ANCE, OR ANY OTHER RELATED REPORTS, INFORMATION, COMMUNICATIONS OR MATE-
RIALS REGARDING SUCH PROVIDER OF SERVICES.
  (B) ANY PROVIDER OF SERVICES GOVERNED BY THE PROVISIONS OF SUBDIVISION
(A) OF THIS SECTION SHALL AT ALL TIMES BE SUBJECT TO INSPECTION OR VISI-
TATION  BY THE COMMISSIONER TO DETERMINE COMPLIANCE WITH APPLICABLE LAW,
REGULATIONS, STANDARDS OR CONDITIONS AS DEEMED NECESSARY BY THE  COMMIS-
SIONER. ANY SUCH PROVIDER OF SERVICES SHALL BE SUBJECT TO THE FULL RANGE
OF CERTIFICATION ENFORCEMENT AUTHORITY OF THE COMMISSIONER.
  (C) ANY PROVIDER OF SERVICES GOVERNED BY THE PROVISIONS OF SUBDIVISION
(A)  OF  THIS  SECTION  SHALL  NOTIFY  THE COMMISSIONER IMMEDIATELY UPON
RECEIPT OF NOTICE BY THE JOINT COMMISSION OR OTHER APPROVED  ACCREDITING
ORGANIZATION,  OR ANY COMMUNICATION THE PROVIDER OF SERVICES MAY RECEIVE
THAT SUCH ORGANIZATION  WILL  BE  RECOMMENDING  THAT  SUCH  PROVIDER  OF
SERVICES  NOT BE ACCREDITED, NOT HAVE ITS ACCREDITATION RENEWED, OR HAVE
ITS ACCREDITATION TERMINATED, OR UPON RECEIPT OF NOTICE OR OTHER  COMMU-
NICATION FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES REGARDING A
DETERMINATION  THAT  THE  PROVIDER  OF  SERVICES WILL BE TERMINATED FROM
PARTICIPATION IN THE MEDICARE OR MEDICAID PROGRAM BECAUSE IT IS  NOT  IN
COMPLIANCE WITH ONE OR MORE CONDITIONS OF PARTICIPATION IN SUCH PROGRAM,
OR  HAS DEFICIENCIES THAT EITHER INDIVIDUALLY OR IN COMBINATION JEOPARD-
IZE THE HEALTH AND SAFETY OF PATIENTS OR ARE OF  SUCH  CHARACTER  AS  TO
SERIOUSLY LIMIT THE PROVIDER'S CAPACITY TO RENDER ADEQUATE CARE.
  S  57. Notwithstanding any other provision of law to the contrary, the
requirements set forth in section 2805-t of the public  health  law  are
hereby suspended until October 1, 2012.
  S 58. Section 2805-l of the public health law, as added by chapter 266
of the laws of 1986, subdivision 3 as amended by chapter 542 of the laws
of 2000, subdivision 4 as added and subdivision 5 as renumbered by chap-
ter 632 of the laws of 2006, is amended to read as follows:
  S  2805-l.  [Incident] SERIOUS EVENT reporting. 1. (A) All hospitals[,
as defined in subdivision ten of section  twenty-eight  hundred  one  of
this  article,] shall be required to report [incidents] EVENTS described
by subdivision two of this section to the department  in  a  manner  and
within time periods as may be specified by regulation of the department.
  (B)  FOR PURPOSES OF THIS SECTION, "HOSPITAL" MEANS ANY GENERAL HOSPI-
TAL OR DIAGNOSTIC AND TREATMENT CENTER.
  2. The following [incidents] EVENTS shall be reported to  the  depart-
ment:
  (a)  patients'  deaths  or  impairments of bodily functions in circum-
stances other than those related  to  the  natural  course  of  illness,
disease  or  proper  treatment  in  accordance  with  generally accepted
medical standards;
  (b) fires in the hospital which disrupt the provision of patient  care
services or cause harm to patients or staff;
  (c)  equipment  malfunction during treatment or diagnosis of a patient
which did or could have adversely affected a patient or hospital person-
nel;

S. 2809--B                         161                        A. 4009--B

  (d) poisoning occurring within the hospital;
  (e) strikes by hospital staff;
  (f)  disasters  or other emergency situations external to the hospital
environment which affect hospital operations; and
  (g) termination of any services vital to the continued safe  operation
of  the hospital or to the health and safety of its patients and person-
nel, including but not limited to the anticipated or actual  termination
of telephone, electric, gas, fuel, water, heat, air conditioning, rodent
or pest control, laundry services, food or contract services.
  3.  NOTWITHSTANDING ANY PROVISION OF THIS SECTION TO THE CONTRARY, THE
COMMISSIONER IS AUTHORIZED TO  MODIFY,  BY  REGULATION,  THE  REPORTABLE
EVENTS  REQUIRED  BY  THIS  SECTION,  CONSISTENT WITH NATIONAL CONSENSUS
STANDARDS.
  4. The hospital shall conduct an investigation of  [incidents]  EVENTS
described  in  paragraphs  (a)  through  (d)  of subdivision two of this
section within thirty days of obtaining  knowledge  of  any  information
which  reasonably  appears  to  show  that  such an [incident] EVENT has
occurred, provided that, if the hospital reasonably expects such  inves-
tigation  to  extend  beyond  such thirty day period, the hospital shall
notify the department of such expectation and the reason  therefor,  and
shall  inform  the  department  of  the  expected completion date of the
investigation. The hospital shall provide to the department  a  copy  of
the investigation report within twenty-four hours of completion. Nothing
herein  shall limit the authority of the department to conduct an inves-
tigation of [incidents] EVENTS occurring in [general] hospitals.
  5. THE DEPARTMENT SHALL:
  (A) ANALYZE EVENT REPORTS, FINDINGS OF THE INVESTIGATIONS, THEIR  ROOT
CAUSE  ANALYSES,  AND  CORRECTIVE  ACTION PLANS TO DETERMINE PATTERNS OF
SYSTEMIC FAILURE IN THE HEALTH CARE SYSTEM AND IDENTIFY SUCCESSFUL METH-
ODS TO CORRECT THESE FAILURES; AND
  (B) COMMUNICATE TO FACILITIES THE DEPARTMENT'S  CONCLUSIONS,  IF  ANY,
REGARDING  EVENT  REPORTS, PATTERNS OF SYSTEMIC FAILURE, AND RECOMMENDA-
TIONS FOR CORRECTIVE ACTION RESULTING FROM THE ANALYSIS  OF  SUBMISSIONS
FROM FACILITIES.
  [4]  6.    The  commissioner  shall  establish  protocols for hospital
personnel where a patient under the age of eighteen  years  dies  during
transportation  to  the hospital or while at the hospital, under circum-
stances other than those related  to  the  natural  course  of  illness,
disease  or  proper  treatment  in  accordance  with  generally accepted
medical standards. Such protocols shall address matters  including,  but
not limited to, the following:
  (a) medical and social history, and examination of the patient;
  (b) preservation of evidence and chain of custody;
  (c)  questioning  of  the  patient's  family,  guardian  or  person in
parental authority;
  (d) circumstances surrounding the injury resulting in death;
  (e) determination of the cause of death;
  (f) notification of law enforcement personnel; and
  (g) reporting requirements under title  six  of  article  six  of  the
social services law.
  In  developing such protocols, the commissioner shall consult with the
office of children and family  services,  local  departments  of  social
services, coordinators of child fatality review teams established pursu-
ant to section four hundred twenty-two-b of the social services law, law
enforcement  agencies,  pediatricians  preferably  with expertise in the

S. 2809--B                         162                        A. 4009--B

area of child abuse and maltreatment or forensic  pediatrics,  and  such
other persons as the commissioner deems necessary.
  [5]  7.    The  commissioner shall make, adopt, promulgate and enforce
such rules and regulations as he may deem appropriate to effectuate  the
purposes of this section.
  S  59.  Subdivision  4 of section 854 of the general municipal law, as
amended by chapter 541 of the laws  of  1982,  is  amended  to  read  as
follows:
  (4)  "Project"  -  shall mean any land, any building or other improve-
ment, and all real and personal properties located within the  state  of
New York and within or outside or partially within and partially outside
the  municipality  for  whose benefit the agency was created, including,
but not limited to, machinery, equipment  and  other  facilities  deemed
necessary  or  desirable in connection therewith, or incidental thereto,
whether or not now in existence or under construction,  which  shall  be
suitable  for manufacturing, warehousing, research, commercial or indus-
trial purposes or  other  economically  sound  purposes  identified  and
called  for  to implement a state designated urban cultural park manage-
ment plan as provided in title G of the parks, recreation  and  historic
preservation  law  and which may include or mean an industrial pollution
control facility, a recreation facility, educational or cultural facili-
ty, A HOSPITAL, A CONTINUING CARE RETIREMENT COMMUNITY, a  horse  racing
facility  or a railroad facility, provided, however, no agency shall use
its funds in respect of any project  wholly  or  partially  outside  the
municipality  for whose benefit the agency was created without the prior
consent thereto by the governing body or bodies of all the other munici-
palities in which a part or parts of  the  project  is,  or  is  to  be,
located.
  S  60. Section 854 of the general municipal law is amended by adding a
new subdivision 13 to read as follows:
  (13) "HOSPITAL" - SHALL MEAN A FACILITY AUTHORIZED TO  CONDUCT  ACTIV-
ITIES  IN  THIS  STATE,  PURSUANT  TO ARTICLE TWENTY-EIGHT OF THE PUBLIC
HEALTH LAW. NOTHING IN THIS ARTICLE SHALL BE DEEMED TO WAIVE ANY  APPLI-
CABLE  REQUIREMENT FOR AN OPERATING FACILITY CERTIFICATE, CONSENT OR ANY
OTHER APPROVAL AS PROVIDED BY LAW.
  S 61. Section 15 of 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, as amended by chapter 381 of the
laws of 2007, is amended to read as follows:
  S  15.  This act shall take effect immediately, provided, however that
the amendment made to subdivision 4 of section 854 of the general munic-
ipal law by section eight of this act shall not affect the reversion  of
such  subdivision as provided by section 5 of chapter 905 of the laws of
1986, as amended and that where the continuing care retirement community
council is authorized to promulgate regulations by this act, it is here-
by authorized to implement the provisions of this act in advance of such
regulations[; and provided further  that  sections  one,  three,  seven,
eight, nine, ten, eleven, twelve and thirteen of this act, and paragraph
m of subdivision 2 of section 4602 of the public health law, as added by
section  two  of  this act, shall apply only to applicants for a certif-
icate of authority pursuant to article 46 of the public health law  that
have  been  approved  to  receive  and have received such certificate of
authority on or before January 31, 2008].
  S 62. Section 461-m of the social services law, as amended by  chapter
462 of the laws of 1996, is amended to read as follows:

S. 2809--B                         163                        A. 4009--B

  S  461-m.  Death and felony crime reporting.  The operator of an adult
home or residence for adults shall have an affirmative  duty  to  report
any  death  INVOLVING  CIRCUMSTANCES  OTHER  THAN  THOSE  RELATED TO THE
NATURAL COURSE  OF  ILLNESS  OR  DISEASE,  or  attempted  suicide  of  a
resident,  to  the  department  within twenty-four hours of [its] occur-
rence, and shall also have an affirmative duty to report to an appropri-
ate law enforcement authority if it is believed that a felony crime  may
have  been  committed  against  a  resident  of such facility as soon as
possible, or in any event within forty-eight hours.   In  addition,  the
operator shall send any reports involving a resident who had at any time
received  services  from  a mental hygiene service provider to the state
commission on quality of care [for the mentally disabled]  AND  ADVOCACY
FOR PERSONS WITH DISABILITIES.
  S  63.  Subdivision  38  of  section  2  of the social services law is
amended by adding four new paragraphs (f), (g), (h) and (i) to  read  as
follows:
  (F)  "VERIFICATION ORGANIZATION" MEANS AN ENTITY WHICH USES ELECTRONIC
MEANS INCLUDING BUT NOT LIMITED TO CONTEMPORANEOUS  TELEPHONE  VERIFICA-
TION  OR  CONTEMPORANEOUS  VERIFIED  ELECTRONIC DATA TO VERIFY WHETHER A
SERVICE OR ITEM WAS PROVIDED TO AN ELIGIBLE MEDICAID RECIPIENT. FOR EACH
SERVICE OR ITEM THE VERIFICATION ORGANIZATION SHALL CAPTURE:
  (I) THE IDENTITY OF THE INDIVIDUAL PROVIDING SERVICES OR ITEMS TO  THE
MEDICAID RECIPIENT;
  (II) THE IDENTITY OF THE MEDICAID RECIPIENT; AND
  (III) THE DATE, TIME, DURATION, LOCATION AND TYPE OF SERVICE OR ITEM.
  A LIST OF VERIFICATION ORGANIZATIONS SHALL BE JOINTLY DEVELOPED BY THE
DEPARTMENT OF HEALTH AND THE OFFICE OF THE MEDICAID INSPECTOR GENERAL.
  (G)  "EXCEPTION  REPORT" MEANS AN ELECTRONIC REPORT CONTAINING ALL THE
DATA FIELDS IN PARAGRAPH (F) OF THIS SUBDIVISION FOR  CONFLICTS  BETWEEN
SERVICES  OR  ITEMS ON THE BASIS OF THE IDENTITY OF THE PERSON PROVIDING
THE SERVICE OR ITEM TO THE MEDICAID RECIPIENT, THE IDENTITY OF THE MEDI-
CAID RECIPIENT, AND/OR TIME, DATE, DURATION OR LOCATION OF SERVICE;
  (H) "CONFLICT REPORT" MEANS AN ELECTRONIC REPORT CONTAINING ALL OF THE
DATA FIELDS IN PARAGRAPH (F) OF THIS SUBDIVISION DETAILING INCONGRUITIES
IN SERVICES OR ITEMS BETWEEN SCHEDULING AND/OR LOCATION OF SERVICE  WHEN
COMPARED TO A DUTY ROSTER.
  (I)  "PARTICIPATING  PROVIDER"  MEANS  A CERTIFIED HOME HEALTH AGENCY,
LONG TERM HOME HEALTH AGENCY OR PERSONAL CARE PROVIDER WITH TOTAL  MEDI-
CAID REIMBURSEMENTS EXCEEDING FIFTEEN MILLION DOLLARS PER CALENDAR YEAR.
  S 64. The social services law is amended by adding a new section 363-e
to read as follows:
  S  363-E.  PRECLAIM  REVIEW  FOR  PARTICIPATING  PROVIDERS  OF MEDICAL
ASSISTANCE PROGRAM SERVICES AND ITEMS. EVERY SERVICE OR  ITEM  WITHIN  A
CLAIM  SUBMITTED BY A PARTICIPATING PROVIDER SHALL BE REVIEWED AND VERI-
FIED BY A VERIFICATION ORGANIZATION PRIOR TO SUBMISSION OF  A  CLAIM  TO
THE  DEPARTMENT  OF  HEALTH. THE VERIFICATION ORGANIZATION SHALL DECLARE
EACH SERVICE OR ITEM TO BE VERIFIED OR  UNVERIFIED.  EACH  PARTICIPATING
PROVIDER SHALL RECEIVE AND MAINTAIN REPORTS FROM THE VERIFICATION ORGAN-
IZATION WHICH SHALL CONTAIN DATA ON:
  1. VERIFIED SERVICES OR ITEMS, INCLUDING WHETHER A SERVICE APPEARED ON
A CONFLICT OR EXCEPTION REPORT BEFORE VERIFICATION AND HOW THAT CONFLICT
OR EXCEPTION WAS RESOLVED; AND
  2.  SERVICES  OR  ITEMS THAT WERE NOT VERIFIED, INCLUDING CONFLICT AND
EXCEPTION REPORT DATA FOR THESE SERVICES.

S. 2809--B                         164                        A. 4009--B

  S 65. Subparagraph (iii) of paragraph (d) of subdivision 1 of  section
367-a  of the social services law, as amended by section 53 of part C of
chapter 58 of the laws of 2008, is amended to read as follows:
  (iii)  When  payment under part B of title XVIII of the federal social
security act for items and services provided to eligible persons who are
also beneficiaries under part B of title XVIII  of  the  federal  social
security  act  and for items and services provided to qualified medicare
beneficiaries under part B of title XVIII of the federal social security
act would exceed the amount that otherwise  would  be  made  under  this
title  if provided to an eligible person other than a person who is also
a beneficiary under part B or is a qualified medicare  beneficiary,  the
amount  payable  FOR  SERVICES  COVERED under this title shall be twenty
percent of the amount of any co-insurance  liability  of  such  eligible
persons  pursuant  to  federal  law  were  they not eligible for medical
assistance or  were  they  not  qualified  medicare  beneficiaries  with
respect  to  such benefits under such part B; provided, however, amounts
payable under this title for items and  services  provided  to  eligible
persons who are also beneficiaries under part B or to qualified medicare
beneficiaries  by an ambulance service under the authority of an operat-
ing certificate issued pursuant to article thirty of the  public  health
law,  a  psychologist  licensed under article one hundred fifty-three of
the education law, or a facility under the  authority  of  an  operating
certificate issued pursuant to article sixteen, thirty-one or thirty-two
of  the  mental hygiene law [and with respect to outpatient hospital and
clinic items and services provided by a facility under the authority  of
an  operating certificate issued pursuant to article twenty-eight of the
public health law], shall not be less than the amount  of  any  co-insu-
rance  liability  of  such  eligible  persons or such qualified medicare
beneficiaries, or for which such  eligible  persons  or  such  qualified
medicare  beneficiaries  would be liable under federal law were they not
eligible for medical assistance or  were  they  not  qualified  medicare
beneficiaries with respect to such benefits under part B.
  S  65-a.  Subdivision 1 of section 367-a of the social services law is
amended by adding a new paragraph (g) to read as follows:
  (G) NOTWITHSTANDING ANY PROVISION OF THIS  SECTION  TO  THE  CONTRARY,
AMOUNTS  PAYABLE  UNDER THIS TITLE FOR MEDICAL ASSISTANCE IN THE FORM OF
HOSPITAL OUTPATIENT SERVICES OR DIAGNOSTIC AND TREATMENT CENTER SERVICES
PURSUANT TO ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH  LAW  PROVIDED  TO
ELIGIBLE  PERSONS WHO ARE ALSO BENEFICIARIES UNDER PART B OF TITLE XVIII
OF THE FEDERAL SOCIAL SECURITY ACT SHALL NOT EXCEED THE APPROVED MEDICAL
ASSISTANCE PAYMENT LEVEL LESS THE AMOUNT PAYABLE UNDER PART B.
  S 66. Section 2807 of the public health law is amended by adding a new
subdivision 20 to read as follows:
  20.  FOR PERIODS ON OR AFTER OCTOBER FIRST, TWO THOUSAND  ELEVEN,  THE
COMMISSIONER  IS  AUTHORIZED  TO SEEK ALL NECESSARY FEDERAL APPROVALS TO
ESTABLISH PAYMENT METHODOLOGIES WITH  "ACCOUNTABLE  CARE  ORGANIZATIONS"
("ACO")  AS  DESCRIBED  IN  SECTION  EIGHTEEN HUNDRED NINETY-NINE OF THE
FEDERAL SOCIAL SECURITY ACT FOR THE PURPOSE OF  IMPROVING  THE  QUALITY,
COORDINATION   AND  ACCOUNTABILITY  OF  SERVICES  PROVIDED  TO  MEDICAID
FEE-FOR-SERVICE PATIENTS IN NEW YORK. THE  COMMISSIONER  MAY  PROMULGATE
REGULATIONS,  INCLUDING  EMERGENCY REGULATIONS, PERTAINING TO ACOS. SUCH
REGULATIONS SHALL INCLUDE, BUT NOT BE LIMITED TO,  ESTABLISHING  QUALITY
STANDARDS  FOR  ACOS AND ESTABLISHING MECHANISMS FOR RELATING REIMBURSE-
MENT TO THE ACHIEVING OF SUCH QUALITY STANDARDS.
  S 67. Section 18 of part B of chapter 58 of the laws of 2010, amending
chapter 474 of the laws of 1996, amending the education  law  and  other

S. 2809--B                         165                        A. 4009--B

laws  relating  to rates for residential healthcare facilities and other
laws relating to Medicaid payments, is amended to read as follows:
  S  18.  Notwithstanding  any contrary provision of law, surcharges and
assessments due and owing pursuant to sections 2807-j, 2807-s and 2807-t
of the public health law for any period prior to January 1, [2010] 2011,
which are paid and accompanied by all required  reports  and  which  are
received  on  or before December 31, [2010] 2011 shall not be subject to
interest or penalties as otherwise provided in such sections,  provided,
however,  that  such  reports  may  be  based on estimates by payors and
designated providers of services of the amounts owed, subject to  subse-
quent  audit  by the commissioner of health or the commissioner's desig-
nee, and provided further, however, with regard to all principal, inter-
est and penalty amounts collected by the commissioner of health prior to
the effective date of this  act,  the  penalty  provisions  of  sections
2807-j,  2807-s and 2807-t of the public health law shall remain in full
force and effect and such amounts collected  shall  not  be  subject  to
further  adjustment  pursuant  to  this  section,  and provided further,
however, that payments of principal amounts of  surcharges  and  assess-
ments  which  were paid late and received prior to the effective date of
this provision, and in regard to which interest and penalty amounts have
not been collected, shall not be subject to such interest and penalties,
and provided, further, however, that  the  provisions  of  this  section
shall  not  apply  to delinquent amounts which have been referred by the
commissioner  of  health  for  recoupment  or   collection   proceeding.
Furthermore,  the  provisions  of  this  section  shall not apply to any
surcharge or assessment payments made in response to a final audit find-
ing issued by the commissioner of health or the commissioner's designee.
  S 68. Section 2807-j of the public health law is amended by  adding  a
new subdivision 13 to read as follows:
  13. (A) NOTWITHSTANDING ANY INCONSISTENT PROVISIONS OF THIS SECTION OR
ANY OTHER CONTRARY PROVISION OF LAW, FOR PERIODS ON OR AFTER JULY FIRST,
TWO  THOUSAND  ELEVEN,  EACH THIRD PARTY PAYOR WHICH HAS ENTERED INTO AN
ELECTION AGREEMENT WITH THE COMMISSIONER PURSUANT TO SUBDIVISION FIVE OF
THIS SECTION MAY, AS A CONDITION OF SUCH ELECTION, BE  REQUIRED  BY  THE
COMMISSIONER  TO PAY TO THE COMMISSIONER OR THE COMMISSIONER'S DESIGNEE,
A PERCENTAGE SURCHARGE EQUAL TO THE SURCHARGE PERCENT SET FORTH IN PARA-
GRAPH (C) OF SUBDIVISION TWO OF THIS SECTION FOR  THE  SAME  PERIOD  AND
APPLIED TO ALL PAYMENTS MADE BY SUCH THIRD PARTY PAYORS FOR PATIENT CARE
SERVICES  PROVIDED  WITHIN THE STATE OF NEW YORK BY PHYSICIANS IN PHYSI-
CIAN OFFICES OR  IN  URGENT  CARE  FACILITIES  THAT  ARE  NOT  OTHERWISE
LICENSED  PURSUANT  TO  THIS  ARTICLE AND WHICH ARE BILLED AS SURGERY OR
RADIOLOGY SERVICES IN ACCORDANCE WITH THE CURRENT PROCEDURE TERMINOLOGY,
FOURTH EDITION, AS PUBLISHED BY THE AMERICAN MEDICAL ASSOCIATION.
  (B) SUCH PAYMENTS SHALL BE MADE AND REPORTED AT THE SAME TIME  AND  IN
THE  SAME MANNER AS THE PAYMENTS AND REPORTS WHICH ARE OTHERWISE SUBMIT-
TED BY EACH THIRD PARTY PAYOR TO THE COMMISSIONER OR THE  COMMISSIONER'S
DESIGNEE IN ACCORDANCE WITH THIS SECTION. SUCH PAYMENTS SHALL BE SUBJECT
TO  AUDIT  BY  THE COMMISSIONER IN THE SAME MANNER AS THE OTHER PAYMENTS
OTHERWISE SUBMITTED AND REPORTED PURSUANT TO THIS SECTION.  THE  COMMIS-
SIONER MAY TAKE ALL MEASURES TO COLLECT DELINQUENT PAYMENTS DUE PURSUANT
TO THIS SUBDIVISION AS ARE OTHERWISE PERMITTED WITH REGARD TO DELINQUENT
PAYMENTS DUE PURSUANT TO OTHER SUBDIVISIONS OF THIS SECTION.
  (C)  SURCHARGES  PURSUANT  TO  THIS  SUBDIVISION  SHALL  NOT  APPLY TO
PAYMENTS MADE BY THIRD PARTY PAYORS FOR SERVICES  PROVIDED  TO  PATIENTS
INSURED  BY  MEDICAID  OR  BY  THE  CHILD  HEALTH PLUS PROGRAM OR TO ANY

S. 2809--B                         166                        A. 4009--B

PATIENT IN A CATEGORY THAT IS EXEMPT FROM SURCHARGE OBLIGATIONS ASSESSED
PURSUANT TO SUBDIVISIONS ONE THROUGH TWELVE OF THIS SECTION.
  S 69. Subparagraph (iii) of paragraph (b) of subdivision 25 of section
2808 of the public health law, as added by section 31 of part B of chap-
ter  109  of the laws of 2010, is amended and a new subparagraph (iv) is
added to read as follows:
  (iii) payment to a facility for reserved bed days provided  on  behalf
of  such person for non-hospitalization leaves of absence may not exceed
ten days in any twelve month period[.]; AND
  (IV) PAYMENTS FOR RESERVED BED  DAYS  FOR  TEMPORARY  HOSPITALIZATIONS
SHALL  ONLY  BE  MADE  TO A RESIDENTIAL HEALTH CARE FACILITY IF AT LEAST
FIFTY PERCENT OF THE FACILITY'S RESIDENTS ELIGIBLE TO PARTICIPATE  IN  A
MEDICARE MANAGED CARE PLAN ARE ENROLLED IN SUCH A PLAN.
  S 70. Subdivision 1 of section 2801 of the public health law, as sepa-
rately  amended  by chapters 297 and 416 of the laws of 1983, is amended
to read as follows:
  1. "Hospital" means a facility or institution engaged  principally  in
providing services by or under the supervision of a physician or, in the
case  of  a  dental  clinic  or dental dispensary, of a dentist, for the
prevention, diagnosis or  treatment  of  human  disease,  pain,  injury,
deformity or physical condition, including, but not limited to, a gener-
al  hospital, public health center, diagnostic center, treatment center,
dental clinic, dental dispensary, rehabilitation  center  other  than  a
facility used solely for vocational rehabilitation, nursing home, tuber-
culosis  hospital,  chronic disease hospital, maternity hospital, lying-
in-asylum, out-patient department, out-patient lodge, dispensary  and  a
laboratory  or  central service facility serving one or more such insti-
tutions, but the term hospital shall not include an  institution,  sani-
tarium  or  other facility engaged principally in providing services for
the prevention, diagnosis or treatment of mental disability and which is
subject to [the powers of visitation, examination, inspection and inves-
tigation of the department of mental hygiene except for  those  distinct
parts of] LICENSURE UNDER THE MENTAL HYGIENE LAW, ALTHOUGH such a facil-
ity  which  [provide] ALSO PROVIDES hospital service SHALL BE SUBJECT TO
THE POWERS OF VISITATION, EXAMINATION, INSPECTION AND  INVESTIGATION  OF
THE  DEPARTMENT.  The  provisions  of  this article shall not apply to a
facility or institution engaged principally in providing services by  or
under the supervision of the bona fide members and adherents of a recog-
nized religious organization whose teachings include reliance on spirit-
ual  means through prayer alone for healing in the practice of the reli-
gion of such organization and where services are provided in  accordance
with those teachings.
  S  71.  Subdivision (a) of section 16.03 of the mental hygiene law, as
added by chapter 786 of the laws of 1983,  paragraph  3  as  amended  by
chapter 555 of the laws of 1993, is amended to read as follows:
  (a)  No  provider  of  services  shall  engage in any of the following
activities without an operating certificate issued by  the  commissioner
pursuant to this article:
  (1)  Operation of a residential facility for the care and treatment of
the mentally retarded or developmentally  disabled  including  a  family
care home.
  (2)  [Operation  of  any  distinct part of a general hospital or other
facility possessing an operating certificate, pursuant to article  twen-
ty-eight  of  the public health law, operated for the primary purpose of
providing residential  or  non-residential  services  for  the  mentally
retarded or developmentally disabled.

S. 2809--B                         167                        A. 4009--B

  (3)]  Operation  of  a  facility established or maintained by a public
agency, board, or commission, or by a corporation or  voluntary  associ-
ation  for  the rendition of out-patient or non-residential services for
the mentally retarded or developmentally  disabled;  provided,  however,
that  such  operation  shall  not  be deemed to include (i) professional
practice, within the scope of  a  professional  license  or  certificate
issued  by an agency of the state, by an individual practitioner or by a
partnership of such individuals or by a professional service corporation
duly incorporated pursuant to the  business  corporation  law  or  by  a
university  faculty  practice  corporation duly incorporated pursuant to
the not-for-profit corporation  law  or  (ii)  non-residential  services
which  are  licensed,  supervised,  or operated by another agency of the
state, PROVIDED, HOWEVER, THAT SUCH OPERATION SHALL BE SUBJECT TO  VISI-
TATION,  EXAMINATION,  INSPECTION AND INVESTIGATION OF THE COMMISSIONER,
and non-residential services which are chartered or issued a certificate
of incorporation pursuant to the education law or (iii)  pastoral  coun-
seling  by a clergyman or minister, including those defined as clergyman
or minister by section two of the religious corporations law.
  S 72. Subdivision (a) of section 31.02 of the mental hygiene  law,  as
amended  by  chapter  804 of the laws of 1975 and such section as renum-
bered by chapter 978 of the laws of 1977,  paragraph  3  as  amended  by
chapter  555 of the laws of 1993, paragraph 4 as added by chapter 947 of
the laws of 1981, paragraph 5 as added by chapter 351  of  the  laws  of
1985,  and  paragraph  6 as added by chapter 723 of the laws of 1989, is
amended to read as follows:
  (a) Except as provided in subdivision (b) of this section no  provider
of  services  shall engage in any of the following activities without an
operating certificate issued by the commissioner pursuant to this  arti-
cle:
  1.  operation  of  a  residential facility or institution, including a
community residence, for the care, custody, or treatment of the mentally
disabled; provided, however, that giving domestic care and comfort to  a
person in the home shall not constitute such an operation.
  2.  [operation  of  any  part of a general hospital for the purpose of
providing residential or non-residential services for the mentally disa-
bled.
  3.] operation of a facility established  or  maintained  by  a  public
agency,  board,  or commission, or by a corporation for the rendition of
out-patient or  non-residential  services  for  the  mentally  disabled;
provided,  however,  that  such operation shall not be deemed to include
(i) professional practice, within the scope of a professional license or
certificate issued by an agency of the state, by an  individual  practi-
tioner  or  by  a  partnership  of such individuals or by a professional
service corporation duly incorporated pursuant to  the  business  corpo-
ration law or by a university faculty practice corporation duly incorpo-
rated  pursuant  to the not-for-profit corporation law or (ii) non-resi-
dential services which are licensed, supervised, or operated by  another
agency  of  the  state,  PROVIDED, HOWEVER, THAT SUCH OPERATION SHALL BE
SUBJECT TO VISITATION, EXAMINATION, INSPECTION AND INVESTIGATION OF  THE
COMMISSIONER,  and nonresidential services which are chartered or issued
a certificate of incorporation pursuant to the education  law  or  (iii)
pastoral  counseling by a clergyman or minister, including those defined
as clergyman or minister by section two of  the  religious  corporations
law.
  [4.] 3. operation of a residential treatment facility for children and
youth.

S. 2809--B                         168                        A. 4009--B

  [5.] 4. operation of a residential care center for adults.
  [6.] 5. operation of a comprehensive psychiatric emergency program.
  S  73.  Subdivision (a) of section 32.05 of the mental hygiene law, as
added by chapter 558 of the laws of 1999, is amended to read as follows:
  (a) Except as provided in subdivision (b) of this section no  provider
of  services  shall engage in any of the following activities without an
operating certificate issued by the commissioner pursuant to this  arti-
cle:
  1. operation of a residential program, including a community residence
for  the  care, custody, or treatment of persons suffering from chemical
abuse or dependence; provided, however, that giving  domestic  care  and
comfort  to a person in the home shall not constitute such an operation;
OR
  2. [operation of a discrete unit  of  a  hospital  or  other  facility
possessing  an operating certificate pursuant to article twenty-eight of
the public health law for the purpose of providing residential  or  non-
residential chemical dependence services; or
  3.]  operation of a program established or maintained by a provider of
services for the rendition of out-patient  or  non-residential  chemical
dependence services; provided, however, that such operation shall not be
deemed  to  include  (i)  professional  practice,  within the scope of a
professional license or certificate issued by an agency of the state, by
an appropriately licensed individual or by a partnership of  such  indi-
viduals,  or  by  a  professional  service corporation duly incorporated
pursuant to the business corporation law wherein all professionals  bear
the  same  professional license, or a university faculty practice corpo-
ration duly incorporated pursuant to the not-for-profit corporation law,
unless more than fifty percent of such practice by  either  such  corpo-
ration  consists  of  the  rendering of chemical dependence services; or
(ii) non-residential services which are chartered or  issued  a  certif-
icate  of incorporation pursuant to the education law; or (iii) pastoral
counseling by a clergyman or minister, including those defined as  cler-
gyman  or  minister by section two of the religious corporations law; or
(iv) services which are exclusively prevention strategies and approaches
as defined in section 1.03 of this chapter.
  S 74. Section 366 of the social services law is amended  by  adding  a
new subdivision 14 to read as follows:
  14.  THE  COMMISSIONER  OF HEALTH MAY MAKE ANY AVAILABLE AMENDMENTS TO
THE STATE PLAN FOR MEDICAL  ASSISTANCE  SUBMITTED  PURSUANT  TO  SECTION
THREE  HUNDRED  SIXTY-THREE-A  OF THIS TITLE, OR, IF AN AMENDMENT IS NOT
POSSIBLE, DEVELOP AND SUBMIT AN APPLICATION FOR ANY WAIVER  OR  APPROVAL
UNDER THE FEDERAL SOCIAL SECURITY ACT THAT MAY BE NECESSARY TO DISREGARD
OR EXEMPT AN AMOUNT OF INCOME, FOR THE PURPOSE OF ASSISTING WITH HOUSING
COSTS,  FOR  INDIVIDUALS RECEIVING COVERAGE OF NURSING FACILITY SERVICES
UNDER THIS TITLE WHO ARE: (I) DISCHARGED FROM THE  NURSING  FACILITY  TO
THE  COMMUNITY;  (II)  ENROLLED  IN A PLAN CERTIFIED PURSUANT TO SECTION
FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW; AND (III) WHILE  SO
ENROLLED,  NOT  CONSIDERED AN "INSTITUTIONALIZED SPOUSE" FOR PURPOSES OF
SECTION THREE HUNDRED SIXTY-SIX-C OF THIS TITLE.
  S 75. Intentionally Omitted.
  S 76. Subdivision 6 of section 364-i of the  social  services  law  is
amended by adding a new paragraph (a-2) to read as follows:
  (A-2)  AT THE TIME OF APPLICATION FOR PRESUMPTIVE ELIGIBILITY PURSUANT
TO THIS SUBDIVISION, A PREGNANT WOMAN WHO RESIDES IN A  SOCIAL  SERVICES
DISTRICT  THAT HAS IMPLEMENTED THE STATE'S MANAGED CARE PROGRAM PURSUANT
TO SECTION THREE HUNDRED  SIXTY-FOUR-J  OF  THIS  TITLE  MUST  CHOOSE  A

S. 2809--B                         169                        A. 4009--B

MANAGED  CARE  PROVIDER. IF A MANAGED CARE PROVIDER IS NOT CHOSEN AT THE
TIME OF APPLICATION, THE PREGNANT WOMAN WILL BE ASSIGNED  TO  A  MANAGED
CARE PROVIDER IN ACCORDANCE WITH SUBPARAGRAPHS (II), (III), (IV) AND (V)
OF   PARAGRAPH   (F)  OF  SUBDIVISION  FOUR  OF  SECTION  THREE  HUNDRED
SIXTY-FOUR-J OF THIS TITLE.
  S 77. Paragraphs (b), (c), (d) and (f) of  subdivision  3  of  section
364-j  of  the social services law are REPEALED, paragraph (e) is relet-
tered paragraph (d), and two new paragraphs (b) and  (c)  are  added  to
read as follows:
  (B)  THE FOLLOWING MEDICAL ASSISTANCE RECIPIENTS SHALL NOT BE REQUIRED
TO PARTICIPATE IN A MANAGED CARE PROGRAM ESTABLISHED  PURSUANT  TO  THIS
SECTION:
  (I) INDIVIDUALS WITH A CHRONIC MEDICAL CONDITION WHO ARE BEING TREATED
BY  A  SPECIALIST  PHYSICIAN  THAT IS NOT ASSOCIATED WITH A MANAGED CARE
PROVIDER IN THE INDIVIDUAL'S SOCIAL SERVICES DISTRICT MAY DEFER  PARTIC-
IPATION  IN  THE MANAGED CARE PROGRAM FOR SIX MONTHS OR UNTIL THE COURSE
OF TREATMENT IS COMPLETE, WHICHEVER OCCURS FIRST; AND
  (II) NATIVE AMERICANS.
  (C) THE FOLLOWING MEDICAL ASSISTANCE RECIPIENTS SHALL NOT BE  ELIGIBLE
TO  PARTICIPATE  IN  A MANAGED CARE PROGRAM ESTABLISHED PURSUANT TO THIS
SECTION:
  (I) A PERSON ELIGIBLE FOR MEDICARE PARTICIPATING IN A CAPITATED DEMON-
STRATION PROGRAM FOR LONG TERM CARE;
  (II) AN INFANT LIVING WITH AN INCARCERATED MOTHER IN A STATE OR  LOCAL
CORRECTIONAL FACILITY AS DEFINED IN SECTION TWO OF THE CORRECTION LAW;
  (III)  A  PERSON WHO IS EXPECTED TO BE ELIGIBLE FOR MEDICAL ASSISTANCE
FOR LESS THAN SIX MONTHS;
  (IV) A PERSON WHO IS ELIGIBLE FOR  MEDICAL  ASSISTANCE  BENEFITS  ONLY
WITH RESPECT TO TUBERCULOSIS-RELATED SERVICES;
  (V) INDIVIDUALS RECEIVING HOSPICE SERVICES AT TIME OF ENROLLMENT;
  (VI)  A  PERSON WHO HAS PRIMARY MEDICAL OR HEALTH CARE COVERAGE AVAIL-
ABLE FROM OR UNDER A  THIRD-PARTY  PAYOR  WHICH  MAY  BE  MAINTAINED  BY
PAYMENT,  OR  PART PAYMENT, OF THE PREMIUM OR COST SHARING AMOUNTS, WHEN
PAYMENT OF SUCH PREMIUM OR COST SHARING AMOUNTS WOULD BE COST-EFFECTIVE,
AS DETERMINED BY THE LOCAL SOCIAL SERVICES DISTRICT;
  (VII) A PERSON RECEIVING FAMILY PLANNING SERVICES PURSUANT TO SUBPARA-
GRAPH ELEVEN OF PARAGRAPH  (A)  OF  SUBDIVISION  ONE  OF  SECTION  THREE
HUNDRED SIXTY-SIX OF THIS TITLE;
  (VIII)  A  PERSON  WHO  IS ELIGIBLE FOR MEDICAL ASSISTANCE PURSUANT TO
PARAGRAPH (V) OF SUBDIVISION FOUR OF SECTION THREE HUNDRED SIXTY-SIX  OF
THIS TITLE; AND
  (IX)  A PERSON WHO IS MEDICARE/MEDICAID DUALLY ELIGIBLE AND WHO IS NOT
ENROLLED IN A MEDICARE MANAGED CARE PLAN.
  S 77-a. Paragraph (g) of subdivision 3 of section 364-j of the  social
services law, as amended by chapter 649 of the laws of 1996, and subpar-
agraph  (i) as amended by section 30 of part C of chapter 58 of the laws
of 2008, is amended to read as follows:
  [(g)] (E) The following categories of individuals [will  not]  MAY  be
required  to  enroll  with  a  managed care program [until] WHEN program
features and reimbursement rates are approved  by  the  commissioner  of
health  and,  as  appropriate,  the  [commissioner] COMMISSIONERS of THE
DEPARTMENT OF mental health, THE OFFICE FOR PERSONS  WITH  DEVELOPMENTAL
DISABILITIES, AND THE OFFICE OF ALCOHOL AND SUBSTANCE ABUSE SERVICES:
  (i)  an individual dually eligible for medical assistance and benefits
under the federal Medicare program and enrolled in  a  Medicare  managed
care  plan  offered  by  an entity that is also a managed care provider;

S. 2809--B                         170                        A. 4009--B

provided that (notwithstanding paragraph (g) of subdivision four of this
section):
  (a) if the individual changes his or her Medicare managed care plan as
authorized  by  title  XVIII  of  the  federal  social security act, and
enrolls in another Medicare managed care plan that  is  also  a  managed
care  provider, the individual shall be (if required by the commissioner
under this paragraph) enrolled in that managed care provider;
  (b) if the individual changes his or her Medicare managed care plan as
authorized by title XVIII  of  the  federal  social  security  act,  but
enrolls in another Medicare managed care plan that is not also a managed
care provider, the individual shall be disenrolled from the managed care
provider  in  which he or she was enrolled and withdraw from the managed
care program;
  (c) if the individual disenrolls from his or her Medicare managed care
plan as authorized by title XVIII of the federal  social  security  act,
and  does not enroll in another Medicare managed care plan, the individ-
ual shall be disenrolled from the managed care provider in which  he  or
she was enrolled and withdraw from the managed care program;
  (d)  nothing  herein shall require an individual enrolled in a managed
long term care plan, pursuant to section forty-four hundred  three-f  of
the public health law, to disenroll from such program.
  (ii) an individual eligible for supplemental security income;
  (iii) HIV positive individuals; [and]
  (iv)  persons with serious mental illness and children and adolescents
with serious emotional disturbances, as defined  in  section  forty-four
hundred one of the public health law[.];
  (V)  A  PERSON RECEIVING SERVICES PROVIDED BY A RESIDENTIAL ALCOHOL OR
SUBSTANCE ABUSE PROGRAM OR FACILITY FOR THE MENTALLY RETARDED;
  (VI) A PERSON RECEIVING SERVICES  PROVIDED  BY  AN  INTERMEDIATE  CARE
FACILITY  FOR THE MENTALLY RETARDED OR WHO HAS CHARACTERISTICS AND NEEDS
SIMILAR TO SUCH PERSONS;
  (VII) A  PERSON  WITH  A  DEVELOPMENTAL  OR  PHYSICAL  DISABILITY  WHO
RECEIVES  HOME  AND  COMMUNITY-BASED  SERVICES  OR CARE-AT-HOME SERVICES
THROUGH EXISTING WAIVERS UNDER SECTION NINETEEN HUNDRED FIFTEEN  (C)  OF
THE  FEDERAL  SOCIAL  SECURITY  ACT OR WHO HAS CHARACTERISTICS AND NEEDS
SIMILAR TO SUCH PERSONS;
  (VIII) A PERSON WHO IS ELIGIBLE FOR  MEDICAL  ASSISTANCE  PURSUANT  TO
SUBPARAGRAPH  TWELVE OR SUBPARAGRAPH THIRTEEN OF PARAGRAPH (A) OF SUBDI-
VISION ONE OF SECTION THREE HUNDRED SIXTY-SIX OF THIS TITLE;
  (IX) A PERSON RECEIVING SERVICES PROVIDED BY A LONG TERM  HOME  HEALTH
CARE  PROGRAM, OR A PERSON RECEIVING INPATIENT SERVICES IN A STATE-OPER-
ATED PSYCHIATRIC FACILITY OR A RESIDENTIAL TREATMENT FACILITY FOR  CHIL-
DREN AND YOUTH;
  (X)  CERTIFIED  BLIND  OR  DISABLED  CHILDREN LIVING OR EXPECTED TO BE
LIVING SEPARATE AND APART FROM THE PARENT FOR THIRTY DAYS OR MORE;
  (XI) RESIDENTS OF NURSING FACILITIES;
  (XII) A FOSTER CHILD IN THE PLACEMENT OF A VOLUNTARY AGENCY OR IN  THE
DIRECT CARE OF THE LOCAL SOCIAL SERVICES DISTRICT;
  (XIII) A PERSON OR FAMILY THAT IS HOMELESS; AND
  (XIV)  INDIVIDUALS  FOR  WHOM A MANAGED CARE PROVIDER IS NOT GEOGRAPH-
ICALLY ACCESSIBLE SO AS TO REASONABLY PROVIDE SERVICES TO THE PERSON.  A
MANAGED  CARE  PROVIDER  IS  NOT GEOGRAPHICALLY ACCESSIBLE IF THE PERSON
CANNOT ACCESS THE  PROVIDER'S  SERVICES  IN  A  TIMELY  FASHION  DUE  TO
DISTANCE OR TRAVEL TIME.

S. 2809--B                         171                        A. 4009--B

  S  78.  Subparagraph  (v) of paragraph (e) of subdivision 4 of section
364-j of the social services law, as amended by section 14 of part C  of
chapter 58 of the laws of 2004, is amended to read as follows:
  (v)  Upon  delivery  of  the  pre-enrollment  information,  the  local
district or the enrollment organization shall certify the  participant's
receipt  of such information. Upon verification that the participant has
received  the  pre-enrollment  education  information,  a  managed  care
provider,  a  local district or the enrollment organization may enroll a
participant into a managed care provider. Managed  care  providers  must
submit enrollment forms to the local department of social services. Upon
enrollment,  participants  will  sign an attestation that they have been
informed that: participants have a choice  of  managed  care  providers;
participants have a choice of primary care practitioners; and, except as
otherwise  provided  in  this  section, including but not limited to the
exceptions listed in subparagraph (iii) of paragraph (a) of this  subdi-
vision, participants must exclusively use their primary care practition-
ers and plan providers. The commissioner of health [or with respect to a
managed  care  plan  serving participants in a city with a population of
over two million, the local department of social services in such city,]
may suspend or curtail enrollment or impose  sanctions  for  failure  to
appropriately notify clients as required in this subparagraph.
  S  79.  Subparagraph  (i) of paragraph (f) of subdivision 4 of section
364-j of the social services law, as amended by section 14 of part C  of
chapter 58 of the laws of 2004, is amended to read as follows:
  (i)  Participants  SHALL CHOOSE A MANAGED CARE PROVIDER AT THE TIME OF
APPLICATION FOR MEDICAL ASSISTANCE; IF THE PARTICIPANT DOES  NOT  CHOOSE
SUCH  A  PROVIDER  THE  COMMISSIONER  SHALL ASSIGN SUCH PARTICIPANT TO A
MANAGED CARE PROVIDER IN ACCORDANCE WITH SUBPARAGRAPHS (II), (III), (IV)
AND (V) OF THIS PARAGRAPH. PARTICIPANTS ALREADY IN  RECEIPT  OF  MEDICAL
ASSISTANCE  shall  have  no  less than [sixty] THIRTY days from the date
selected by the district to enroll in the managed care program to select
a managed care provider, and as appropriate,  a  mental  health  special
needs  plan,  and shall be provided with information to make an informed
choice. Where a participant has not selected such a provider  or  mental
health  special needs plan, the commissioner of health shall assign such
participant to a managed care provider, and as appropriate, to a  mental
health  special  needs plan, taking into account capacity and geographic
accessibility. The commissioner may after the period of time established
in subparagraph (ii) of this paragraph assign participants to a  managed
care provider taking into account quality performance criteria and cost.
Provided however, cost criteria shall not be of greater value than qual-
ity criteria in assigning participants.
  S  80.  Paragraphs (d), (e), and (f) of subdivision 5 of section 364-j
of the social services law, as added by section 15 of part C of  chapter
58 of the laws of 2004, are amended to read as follows:
  (d)  Notwithstanding  any  inconsistent  provision  of  this title and
section one hundred sixty-three of the state finance  law,  the  commis-
sioner  of  health [or the local department of social services in a city
with a population of over two million] may contract  with  managed  care
providers  approved  under  paragraph (b) of this subdivision, without a
competitive bid or request for proposal process, to provide coverage for
participants pursuant to this title.
  (e) Notwithstanding any  inconsistent  provision  of  this  title  and
section  one  hundred  forty-three  of  the economic development law, no
notice in the procurement opportunities newsletter shall be required for
contracts awarded by the commissioner of health [or the local department

S. 2809--B                         172                        A. 4009--B

of social services in a city with a population of over two million],  to
qualified managed care providers pursuant to this section.
  (f)  The  care  and  services  described  in  subdivision four of this
section will be furnished by a managed care  provider  pursuant  to  the
provisions  of  this section when such services are furnished in accord-
ance with an agreement with the  department  of  health  [or  the  local
department  of  social  services in a city with a population of over two
million], and meet applicable federal law and regulations.
  S 81. Paragraph (k) of subdivision 2 of section 365-a  of  the  social
services  law, as amended by chapter 659 of the laws of 1997, is amended
to read as follows:
  (k) care and services furnished by an entity offering a  comprehensive
health  services  plan,  including an entity that has received a certif-
icate of  authority  pursuant  to  sections  forty-four  hundred  three,
forty-four  hundred  three-a or forty-four hundred eight-a of the public
health law (as added by chapter six hundred thirty-nine of the  laws  of
nineteen  hundred  ninety-six)  or  a  health  maintenance  organization
authorized under article forty-three of the insurance law,  to  eligible
individuals  residing in the geographic area served by such entity, when
such services are furnished in accordance with an agreement approved  by
the  department  which  meets  the requirements of federal law and regu-
lations [provided, that  no  such  agreement  shall  allow  for  medical
assistance payments on a capitated basis for nursing facility, home care
or  other  long  term  care  services of a duration and scope defined in
regulations of the department of health promulgated pursuant to  section
forty-four  hundred three-f of the public health law, unless such entity
has received a certificate of authority as a managed long term care plan
or is an operating demonstration or is an  approved  managed  long  term
care demonstration, pursuant to such section].
  S  82.  Paragraph  (a) of subdivision 1 of section 367-f of the social
services law, as amended by section 37 of part D of chapter  58  of  the
laws of 2009, is amended to read as follows:
  (a)  "Medicaid  extended  coverage" shall mean eligibility for medical
assistance (i) without regard to the resource  requirements  of  section
three  hundred  sixty-six of this title, or in the case of an individual
covered under an insurance policy or certificate described  in  subdivi-
sion two of this section that provided a residential health care facili-
ty  benefit  less  than [three] TWO years in duration, without consider-
ation of an amount of resources equivalent  to  the  value  of  benefits
received  by  the individual under such policy or certificate, as deter-
mined under the rules of the partnership  for  long-term  care  program;
(ii)  without  regard  to  the  recovery  of medical assistance from the
estates of individuals and the imposition  of  liens  on  the  homes  of
persons pursuant to section three hundred sixty-nine of this title, with
respect  to resources exempt from consideration pursuant to subparagraph
(i) of this paragraph; provided, however, that nothing in  this  section
shall  prevent  the imposition of a lien or recovery against property of
an individual on account of medical  assistance  incorrectly  paid;  and
(iii)  based on an income eligibility standard for married couples equal
to the amount of the minimum monthly maintenance needs allowance defined
in paragraph (h) of subdivision two of section three hundred sixty-six-c
of this title, and for single individuals  equal  to  one-half  of  such
amount;  provided, however, that the commissioner of health shall not be
required to implement the provisions of this subparagraph if the use  of
such  income  eligibility  standards  will  result  in a loss of federal
financial participation in  the  costs  of  Medicaid  extended  coverage

S. 2809--B                         173                        A. 4009--B

furnished  in  accordance  with subparagraphs (i) and (ii) of this para-
graph.
  S  83.  Subdivision  1  of  section  190 of the tax law, as amended by
section 17 of part B of chapter 58 of the laws of 2004,  is  amended  to
read as follows:
  1.  General.  A  taxpayer  shall  be  allowed a credit against the tax
imposed by this article, other  than  the  taxes  and  fees  imposed  by
sections  one hundred eighty and one hundred eighty-one of this article,
equal to [twenty] FORTY percent of the premium paid during  the  taxable
year  for long-term care insurance. In order to qualify for such credit,
the taxpayer's premium payment must  be  for  the  purchase  of  or  for
continuing  coverage under a long-term care insurance policy that quali-
fies for such credit pursuant to section one thousand one hundred seven-
teen of the insurance law.
  S 84. Paragraph (a) of subdivision 25-a of section 210 of the tax law,
as amended by section 18 of part B of chapter 58 of the laws of 2004, is
amended to read as follows:
  (a) A taxpayer shall be allowed a credit against the  tax  imposed  by
this  article equal to [twenty] FORTY percent of the premium paid during
the taxable year for long-term care insurance. In order to  qualify  for
such  credit, the taxpayer's premium payment must be for the purchase of
or for continuing coverage under a long-term care insurance policy  that
qualifies  for  such credit pursuant to section one thousand one hundred
seventeen of the insurance law.
  S 85. Paragraph 1 of subsection (aa) of section 606 of the tax law, as
amended by section 1 of part P of chapter 61 of the  laws  of  2005,  is
amended to read as follows:
  (1)  Residents.  A  taxpayer shall be allowed a credit against the tax
imposed by this article equal to [twenty] FORTY percent of  the  premium
paid  during  the taxable year for long-term care insurance. In order to
qualify for such credit, the taxpayer's premium payment must be for  the
purchase  of or for continuing coverage under a long-term care insurance
policy that qualifies for such credit pursuant to section  one  thousand
one  hundred seventeen of the insurance law. If the amount of the credit
allowable under this subsection for any taxable year  shall  exceed  the
taxpayer's  tax  for  such  year,  the excess may be carried over to the
following year or years and may be deducted from the taxpayer's tax  for
such year or years.
  S 86. Paragraph 1 of subsection (k) of section 1456 of the tax law, as
amended  by  section  20 of part B of chapter 58 of the laws of 2004, is
amended to read as follows:
  (1) A taxpayer shall be allowed a credit against the  tax  imposed  by
this  article equal to [twenty] FORTY percent of the premium paid during
the taxable year for long-term care insurance. In order to  qualify  for
such  credit, the taxpayer's premium payment must be for the purchase of
or for continuing coverage under a long-term care insurance policy  that
qualifies  for  such credit pursuant to section one thousand one hundred
seventeen of the insurance law.
  S 87. Paragraph 1 of subdivision (m) of section 1511 of the  tax  law,
as amended by section 21 of part B of chapter 58 of the laws of 2004, is
amended to read as follows:
  (1)  A  taxpayer  shall be allowed a credit against the tax imposed by
this article equal to [twenty] FORTY percent of the premium paid  during
the  taxable  year for long-term care insurance. In order to qualify for
such credit, the taxpayer's premium payment must be for the purchase  of
or  for continuing coverage under a long-term care insurance policy that

S. 2809--B                         174                        A. 4009--B

qualifies for such credit pursuant to section one thousand  one  hundred
seventeen of the insurance law.
  S 88. Subparagraph 11 of paragraph (a) of subdivision 1 of section 366
of the social services law, as amended by section 1-h of part C of chap-
ter 58 of the laws of 2007, is amended to read as follows:
  (11)  for  purposes of receiving family planning services eligible for
reimbursement by the federal government at a rate of ninety percent,  is
not  otherwise  eligible  for medical assistance and whose income is two
hundred percent or less of the comparable federal income official pover-
ty line (as defined and annually revised by the United States department
of health and human  services);  provided,  however,  that  such  ninety
percent  limitation  shall not apply to those services identified by the
commissioner of health as services,  including  treatment  for  sexually
transmitted  diseases,  generally performed as part of or as a follow-up
to a service eligible for such ninety  percent  reimbursement;  PROVIDED
FURTHER  THAT  THE  COMMISSIONER  OF  HEALTH  IS AUTHORIZED TO ESTABLISH
CRITERIA FOR PRESUMPTIVE ELIGIBILITY FOR SERVICES PROVIDED  PURSUANT  TO
THIS  SUBPARAGRAPH  IN  ACCORDANCE  WITH  ALL APPLICABLE REQUIREMENTS OF
FEDERAL LAW OR REGULATION PERTAINING TO SUCH  ELIGIBILITY.  The  commis-
sioner  of  health  shall  submit whatever waiver applications as may be
necessary  to  receive  federal  financial  participation  for  services
provided under this subparagraph and the provisions of this subparagraph
shall  be  effective  if  and  so long as such federal financial partic-
ipation shall be available; or
  S 89. Paragraph (e) of subdivision 2 of section 365-a  of  the  social
services  law, as amended by chapter 170 of the laws of 1994, is amended
to read as follows:
  (e) (I) personal care services, including personal emergency  response
services,  shared aide and an individual aide, SUBJECT TO THE PROVISIONS
OF SUBPARAGRAPHS (II), (III), AND (IV) OF THIS PARAGRAPH,  furnished  to
an individual who is not an inpatient or resident of a hospital, nursing
facility,  intermediate  care  facility  for  the  mentally retarded, or
institution for mental disease, as determined to  meet  the  recipient's
needs  for assistance when cost effective and appropriate [in accordance
with section three  hundred  sixty-seven-k  and  section  three  hundred
sixty-seven-o  of  this  title],  and when prescribed by a physician, in
accordance with the recipient's plan of treatment and provided by  indi-
viduals  who  are qualified to provide such services, who are supervised
by a registered nurse and who are not members of the recipient's family,
and furnished in the recipient's home or other location;
  (II) THE  COMMISSIONER  IS  AUTHORIZED  TO  ADOPT  STANDARDS  FOR  THE
PROVISION  AND MANAGEMENT OF SERVICES AVAILABLE UNDER THIS PARAGRAPH FOR
INDIVIDUALS WHOSE NEED FOR SUCH SERVICES EXCEEDS A SPECIFIED LEVEL TO BE
DETERMINED BY THE COMMISSIONER;
  (III) THE COMMISSIONER IS AUTHORIZED TO PROVIDE ASSISTANCE TO  PERSONS
RECEIVING SERVICES UNDER THIS PARAGRAPH WHO ARE TRANSITIONING TO RECEIV-
ING  CARE  FROM  A  MANAGED  LONG  TERM  CARE PLAN CERTIFIED PURSUANT TO
SECTION FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW;
  (IV) PERSONAL CARE SERVICES AVAILABLE PURSUANT TO THIS PARAGRAPH SHALL
NOT EXCEED EIGHT HOURS PER WEEK FOR INDIVIDUALS WHOSE NEEDS ARE  LIMITED
TO NUTRITIONAL AND ENVIRONMENTAL SUPPORT FUNCTIONS;
  S 90.  (a) Notwithstanding any other provision of law to the contrary,
for  the state fiscal year period beginning April 1, 2011 and each state
fiscal year thereafter, all Medicaid payments made for services provided
on and after April 1, 2011, shall, except as  hereinafter  provided,  be
subject  to  a uniform two percent reduction and such reduction shall be

S. 2809--B                         175                        A. 4009--B

applied, to the extent practicable, in equal amounts during  the  fiscal
year, provided, however, that an alternative method may be considered at
the  discretion  of  the  commissioner of health and the director of the
budget  based  upon consultation with the health care industry including
but not limited to, a uniform reduction in Medicaid rates of payments or
other reductions provided that any method selected achieves no less than
$345,000,000 in Medicaid state share savings annually, except as herein-
after provided, for services provided on and after April 1, 2011 through
March 31, 2012 and each state fiscal year thereafter.
  (b) The  following  types  of  appropriations  shall  be  exempt  from
reductions pursuant to this section:
  (i)  any  reductions that would violate federal law including, but not
limited to, payments required pursuant to the federal Medicare program;
  (ii) any reductions related to payments pursuant to article 32,  arti-
cle 31 and article 16 of the mental hygiene law;
  (iii) payments the state is obligated to make pursuant to court orders
or judgments;
  (iv)  payments  for  which  the non-federal share does not reflect any
state funding; and
  (v) at the discretion of the commissioner of health and  the  director
of  the  budget,  payments  with regard to which it is determined by the
commissioner of health and the director of the budget  that  application
of  reductions  pursuant  to  this section would result, by operation of
federal law, in a lower federal medical assistance percentage applicable
to such payments.
  (c) Reductions to Medicaid payments or Medicaid rates of payments made
pursuant to this section shall be subject to the receipt of  all  neces-
sary federal approvals.
  S  91.   Notwithstanding any inconsistent provision of state law, rule
or regulation to the contrary, subject to federal approval, the year  to
year  rate  of growth of department of health state funds spending shall
not exceed the ten year rolling average of the medical component of  the
consumer  price  index  as  published by the United States department of
labor, bureau of labor statistics, for the preceding ten years.
  S 92.  The director of the budget, in consultation  with  the  commis-
sioner  of health, shall periodically assess known and projected depart-
ment of health state funds medicaid expenditures, and if the director of
the budget determines that such expenditures are expected to cause medi-
caid disbursements for such period to exceed the projected department of
health medicaid state funds disbursements in the enacted  budget  finan-
cial  plan  pursuant to subdivision 3 of section 23 of the state finance
law, the commissioner of health, in consultation with  the  director  of
the  budget,  shall  develop a medicaid savings allocation plan to limit
such spending to the aggregate limit  level  specified  in  the  enacted
budget  financial  plan,  provided,  however,  such  projections  may be
adjusted by the director of the budget to account for any changes in the
New York state federal medical assistance percentage amount  established
pursuant  to the federal social security act, changes in provider reven-
ues, and beginning April 1, 2012 the operational costs of the  New  York
state medical indemnity fund.
  1.  Such medicaid savings allocation plan shall be designed, to reduce
the disbursements authorized by the appropriations herein in  compliance
with  the  following guidelines: (1) reductions shall be made in compli-
ance with applicable  federal  law,  including  the  provisions  of  the
Patient  Protection and Affordable Care Act, Public Law No. 111-148, and
the Health Care and Education Reconciliation Act of 2010, Public Law No.

S. 2809--B                         176                        A. 4009--B

111-152 (collectively "Affordable Care Act") and any  subsequent  amend-
ments  thereto  or  regulations  promulgated  thereunder; (2) reductions
shall be made in a manner that complies with  the  state  Medicaid  plan
approved  by  the  federal  centers  for medicare and medicaid services,
provided, however, that the commissioner  of  health  is  authorized  to
submit  any state plan amendment or seek other federal approval, includ-
ing waiver authority,  to  implement  the  provisions  of  the  medicaid
savings  allocation plan that meets the other criteria set forth herein;
(3) reductions shall be made in a manner that maximizes  federal  finan-
cial  participation,  to  the  extent practicable, including any federal
financial participation that is available or is reasonably  expected  to
become available, in the discretion of the commissioner of health, under
the  Affordable  Care  Act; (4) reductions shall be made uniformly among
categories of services, to the extent practicable,  and  shall  be  made
uniformly  within  a  category  of  service,  to the extent practicable,
except where the commissioner of health determines that there are suffi-
cient grounds for non-uniformity, including  but  not  limited  to:  the
extent  to  which specific categories of services contributed to depart-
ment of health medicaid state funds spending in  excess  of  the  limits
specified  herein;  the  need  to maintain safety net services in under-
served communities; the need to encourage or discourage  certain  activ-
ities  by  providers  of  particular  health  care  services in order to
improve quality of and access to care;  or  the  potential  benefits  of
pursuing  innovative  payment models contemplated by the Affordable Care
Act, in which case such grounds shall  be  set  forth  in  the  medicaid
savings  allocation  plan;  and (5) reductions shall be made in a manner
that does not unnecessarily create administrative  burdens  to  Medicaid
applicants and recipients or providers.
  2.  In  accordance  with  the  medicaid  savings  allocation plan, the
commissioner of the department of  health  shall  reduce  department  of
health state funds medicaid disbursements by the amount of the projected
overspending through, actions including, but not limited to modifying or
suspending reimbursement methods, including but not limited to all fees,
premium  levels  and  rates of payment, notwithstanding any provision of
law that sets a specific amount or methodology for any such payments  or
rates  of payment; modifying or discontinuing Medicaid program benefits;
seeking all necessary Federal approvals, including, but not  limited  to
waivers,  waiver  amendments;  and  suspending  time  frames for notice,
approval or certification  of  rate  requirements,  notwithstanding  any
provision  of law, rule or regulation to the contrary, including but not
limited to 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).
  S 93. 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 94. 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 95. Severability clause. If any clause, sentence, paragraph,  subdi-
vision,  section  or  part of this act shall be adjudged by any court of

S. 2809--B                         177                        A. 4009--B

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 judgment
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  96.  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) the amendment to subparagraph 1 of paragraph (c) of subdivision 10
of  section  2807-c of the public health law made by section one of this
act shall not affect the  expiration  of  such  subparagraph  and  shall
expire and be deemed repealed therewith;
  (b)  the  amendments  to section 272 of the public health law, made by
sections nine, sixteen and seventeen of this act shall  not  affect  the
repeal  of  such  section and shall expire and be deemed repealed there-
with;
  (b-1) the amendments to subdivision 9 of section 367-a of  the  social
services  law made by section ten of this act shall not affect the expi-
ration of such subdivision and shall be deemed to expire therewith;
  (c) the amendments to subdivision 22 of section 6802 of the  education
law,  made  by section twelve of this act shall not affect the repeal of
such subdivision and shall expire and be deemed repealed therewith;
  (d) the amendments to section 271 of the public health  law,  made  by
sections thirteen, fourteen and fifteen of this act shall not affect the
repeal  of  such  section and shall expire and be deemed repealed there-
with;
  (e) the amendments to subparagraph (i) of paragraph (b-1) of  subdivi-
sion  1 of section 2807-c of the public health law made by section thir-
ty-two of this act shall not affect the expiration of such paragraph and
shall be deemed to expire therewith;
  (f) the amendments to section 4403-f of the public health law made  by
sections  forty-one,  forty-one-a  and forty-one-b of this act shall not
affect the repeal of such section and shall be  deemed  repealed  there-
with;
  (g)  the  amendments  to  subdivision 6 of section 367-a of the social
services law, made by sections forty-three, forty-four and forty-five of
this act shall not affect the  repeal  of  such  subdivision  and  shall
expire and be deemed repealed therewith;
  (h)  sections thirty-six, fifty, fifty-one and sixty-eight of this act
shall take effect on the ninetieth day after it shall have become a law;
  (i) the amendments to section 2807-j of the public health law made  by
section  sixty-eight of this act shall not affect the expiration of such
section and shall be deemed to expire therewith;
  (j) sections  five,  twenty,  twenty-one,  twenty-four,  twenty-seven,
forty-one,  forty-one-a,  forty-one-b,  forty-three,  forty-four, forty-
five, forty-six, forty-eight, fifty-four, fifty-eight,  seventy,  seven-
ty-one,  seventy-two  and seventy-three of this act shall take effect on
the one hundred eightieth day after it shall have become a law;
  (k) section forty-seven of this act shall take effect  on  October  1,
2011;
  (l)  the amendments to paragraph 6 of subdivision (a) of section 31.02
of the mental hygiene law made by section seventy-two of this act  shall
not  affect  the  repeal  of  such  paragraph  and shall be deemed to be
repealed therewith;

S. 2809--B                         178                        A. 4009--B

  (m) the amendments to section 364-j of the social services law made by
sections seventy-seven, seventy-seven-a, seventy-eight, seventy-nine and
eighty of this act shall not affect the repeal of such section and shall
be deemed repealed therewith;
  (n)  the amendments to paragraph (k) of subdivision 2 of section 365-a
of the social services law made by section eighty-one of this act  shall
not  affect  the  expiration  of such subdivision and shall be deemed to
expire therewith;
  (o) section twelve of this act shall take effect August 1, 2011;
  (p) sections thirteen, fourteen, fifteen, sixteen, seventeen and eigh-
teen shall take effect May 1, 2011;
  (q) section twenty-three of this act shall  take  effect  December  1,
2011;
  (r) section forty of this act shall take effect September 1, 2011;
  (s) sections sixty-nine, eighty-two, eighty-three, eighty-four, eight-
y-five,  eighty-six,  and  eighty-seven of this act shall take effect on
January 1, 2012 and shall apply to taxable years beginning on  or  after
January 1, 2012;
  (t)  section  thirty-five  of  this  act  shall  expire  and be deemed
repealed April 1, 2015;
  (u) section ninety-one of this act shall take effect April 1, 2012;
  (v) 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, provided that the department
of health may promulgate regulations including on  an  emergency  basis,
necessary to implement this act, prior to its effective date;
  (w)  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;
  (x) 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;
  (y)  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;
  (z)  sections  fifty-two  through  fifty-two-m  of this act shall take
effect on the ninetieth day after it shall  have  become  law,  provided
that  it  shall  apply  to birth-related neurological injury lawsuits in
existence as of the date of enactment and to all birth-related neurolog-
ical injury lawsuits commenced subsequently to the  date  of  enactment,
and provided further that the commissioner of health and the superinten-
dent  of  financial  regulations  shall  be authorized to promulgate any
regulations as necessary to implement such sections prior to such effec-
tive date, including on an emergency basis; and
  (aa) 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.
  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

S. 2809--B                         179                        A. 4009--B

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 H of this act shall be
as specifically set forth in the last section of such Parts.

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

                                 2809--C

                            I N  S E N A T E

                            February 1, 2011
                               ___________

A  BUDGET  BILL,  submitted by the Governor pursuant to article 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  --  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, in relation to early intervention services; 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  the
  public  health law, in relation to the scope of the statewide planning
  and research cooperative  system;  to  amend  the  insurance  law,  in
  relation  to  exemptions; to amend 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 part X2 of chapter  62
  of the laws of 2003, amending the public health law relating to allow-
  ing for the use of funds of the office of professional medical conduct
  for  activities of the patient health information and quality improve-
  ment act of 2000, in relation to the effectiveness thereof;  to  amend
  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  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 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  certain  provisions  of  the  insurance  law  relating  to
  exemptions;  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-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                      [ ] is old law to be omitted.
                                                           LBD12571-05-1

S. 2809--C                          2

  ance; 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 responsibil-
  ities 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; to amend chapter 58  of  the  laws  of
  2009,  amending the public health law and other laws relating to Medi-
  caid reimbursements to residential health care facilities, in relation
  to adjustments to Medicaid ratio of payment  for  inpatient  services;
  and  to  amend  the social services law, in relation to allowing local
  social services  districts  discretion  to  provide  certain  medicaid
  services  and  to cover certain categories of eligibility (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  effec-
  tiveness  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 gener-
  al  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 distrib-
  utions; to amend the public authorities law, in relation to the trans-
  fer 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
  payments  to  residential health care facilities; to amend chapter 474
  of the laws of 1996, amending the education law and other laws  relat-

S. 2809--C                          3

  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; and to repeal certain provisions of the public
  health law relating to capital related inpatient expenses;  (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
  in size of certain facilities  serving  persons  with  mental  illness
  (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 amend the social services

S. 2809--C                          4

  law,  in  relation  to  a  study to determine costs incurred by public
  school districts for certain medical care, services and  supplies;  to
  amend  part  B  of  chapter 58 of the laws of 2010 amending the public
  health  law  relating  to duties of the department and cardiac service
  information, in relation to making technical corrections  thereto;  to
  amend  the  public  health  law, in relation to calculation of capital
  costs; to amend the education law, in relation  to  immunizations;  to
  amend the public health law, in relation to the pharmacy and therapeu-
  tics  committee  and  the preferred drug program and to repeal certain
  provisions of the social services 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 foot-
  wear, speech  therapy,  physical  therapy  and  occupational  therapy,
  payment  for home health care nursing services, and coverage for smok-
  ing cessation counseling services, the furnishing of  medical  assist-
  ance to applicants with responsible relatives, and the commissioner of
  health's  authority to negotiate agreements resolving multiple pending
  rate appeals; to amend the education law, in relation to the  adminis-
  tration  of certain immunizing agents to persons eighteen years of age
  or older; 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-
  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

S. 2809--C                          5

  residential healthcare facilities and other laws relating to  Medicaid
  payments,  in  relation  to  seeking  federal  approvals  to establish
  payment methodologies with accountable care  organizations;  to  amend
  the mental hygiene law, in relation to entities subject to the visita-
  tion,  examination, inspection, and investigation; to amend the social
  services law, providing for the  repeal  of  certain  provisions  upon
  expiration  thereof,  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; to amend the public health  law,
  in  relation  to accountable care organizations; to amend the tax law,
  in relation to long-term care insurance tax credits; and to amend  the
  social  services  law  and the insurance law, in relation to directing
  the department of health to  submit  an  amendment  to  the  plan  for
  medical assistance; and to direct the department of insurance to adopt
  any  necessary conforming amendments to regulations or other rules and
  providing for the repeal of certain provisions upon expiration  there-
  of; (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

S. 2809--C                          6

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 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. 2809--C                          7

  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
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

S. 2809--C                          8

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 shall, subject to the approval  of  the
director  of the budget, enter into a contract with one or more contrac-
tors 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 adminis-
tration 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 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 deter-
mines that the contract payment provisions do not protect  the  interest
of  the  state,  the  executive director shall initiate contract negoti-
ations 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

S. 2809--C                          9

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;
  [(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 and shall maintain files  in  a  manner  and  format
approved by the executive director.
  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 cover-
age panel shall permit.
  S 3-h. Intentionally omitted.
  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--C                         10

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 shall determine

S. 2809--C                         11

or cause to be determined, through a  statistically  valid  survey,  the
quantities  of  each covered drug that participating 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 avail-
able 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--C                         12

  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  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
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

S. 2809--C                         13

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 shall adjust the program eligibility standards set forth in subdi-
vision [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 9. Intentionally omitted.

S. 2809--C                         14

  S 10. Intentionally omitted.
  S 11. Intentionally omitted.
  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 13-a.  Task force on the implementation  of  an  expanded  statewide
research and cooperative system. 1. The task force on an expanded state-
wide research and cooperative system is hereby created to examine, eval-
uate,  and  determine current quality reporting initiatives across state
agencies and departments and develop a streamlined reporting process  to
consolidate  information  and  develop  initiative  to  utilize reported
information in an efficient way with the goal of creating an  all  payer
claims database in New York State. The task force shall consider:
  (i)  confidentiality provisions related to patient-identifiable infor-
mation
  (ii) initiatives relative to accuracy and completeness of reporting
  (iii) administrative burdens on  institutional  and  non-institutional
health  care providers and third-party health care payers as a result of
an enhanced reporting system
  (iv) capacity and existing resources within New York State to  provide
for such a database
  (v)  the  effectiveness  of intervention programs in developing health
outcomes

S. 2809--C                         15

  (vi) current program and the need for  future  programs  that  provide
information to consumers and purchasers of health care
  (vii) information relative to health disparities in New York State
  (viii)  consistency  in reporting across the continuum of care and New
York State agencies
  (ix) elimination of duplicative or inconsistent reporting requirements
  2. Such task force shall consist of eighteen members,  each  to  serve
until  April  first,  two thousand twelve. Ten members of the task force
shall be appointed by the governor, provided however that two  shall  be
on nomination for the temporary president of the senate; one shall be on
nomination  of  the minority leader of the senate; two shall be on nomi-
nation of the speaker of the assembly; one shall be on nomination of the
minority leader of the assembly; and two shall be on nomination  of  the
Commissioner  of  Health.    Appointments  shall  be made prior to April
first, two thousand eleven.  Vacancies in the task force shall be filled
in the manner provided for the original appointments.
  3. All appointees  shall  have  expertise  in  fields  or  disciplines
related to health care, hospital administration, and public health.
  4. The task force shall be chaired by a member appointed by the major-
ity of the task force. The task force shall elect a vice-chair and other
necessary officers from among all appointed members.
  5.  Notwithstanding  any  other  provision  of  law, a majority of the
members of the task force then in office shall constitute a  quorum  for
the  transaction of business or the exercise of any power or function of
the task force. An act, determination or decision of the majority of the
members of the task force shall be held to be the act, determination, or
decision of the task force.
  6. The task force shall meet at least every six months at the call  of
the chair. Meetings may be held via teleconference. Special meetings may
be  called  by  the chair at the request of a majority of the members of
the task force.
  7. Members of the task force shall receive no compensation  for  their
services  but  shall be reimbursed for their actual expenses incurred in
the performance of their duties in the work of the task force.
  8. The task force shall submit a report to  the  Legislature  and  the
Executive  on  December  1,  2012  with  recommendations for an enhanced
statewide research and cooperative system which shall include:
  (i) recommendations on the form and manner of enhanced reporting
  (ii) recommendations on the use of unique patient and provider identi-
fiers
  (iii) recommendations specifying a uniform coding system that reflects
all health care utilization and costs for health care services
  (iv) recommendations related  to  reporting  health  care  claims  and
enrollment  data, reports, schedules, statistics, or other data relating
to health care costs, prices, quality,  utilization  or  resources,  and
data  related  to  race,  ethnicity,  sex,  age,  and  primary  language
collected in a manner consistent with established national standards.
  (v) considerations for complying with privacy and security laws
  (vi) recommendations for implementation guidelines
  (vii) recommendations for the use such information including  but  not
limited to distribution, analysis, and disclosure.
  S 14. Intentionally omitted.
  S 15. Intentionally omitted.
  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:

S. 2809--C                         16

  (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
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:

S. 2809--C                         17

  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.
  (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.

S. 2809--C                         18

  (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. Section 1325 of the insurance law is REPEALED  and a new section
1325 is added to read as follows:
  S 1325. EXEMPTION. (A) FOR THE PURPOSES OF EXEMPTING CERTAIN INSURANCE
COMPANIES FROM THE PROVISION OF SECTION ONE THOUSAND THREE HUNDRED TWEN-
TY-FOUR  OF THIS ARTICLE, THE SUPERINTENDENT SHALL EXEMPT THROUGH DECEM-
BER THIRTY-FIRST, TWO THOUSAND FOURTEEN THOSE STOCK AND NON-STOCK INSUR-
ANCE COMPANIES TO WHICH SUBPARAGRAPH (B) OF PARAGRAPH TWO OF  SUBSECTION
(B) OF SUCH SECTION APPLIES.
  (B)  THE  SUPERINTENDENT SHALL NO LATER THAN JUNE THIRTIETH, TWO THOU-
SAND TWELVE PROMULGATE,  FOR  APPLICATION  DURING  THE  NEXT  SUCCEEDING
CALENDAR  YEAR,  AND  AFTER CONSULTATION WITH THE COMMISSIONER OF HEALTH
AND DOMESTIC MEDICAL MALPRACTICE INSURERS  WRITING  MEDICAL  MALPRACTICE
INSURANCE  IN  THIS STATE, A REGULATION WHICH PROVIDES A SEPARATE FINAN-
CIAL SECURITY STANDARD AND  FOR  THOSE  STOCK  AND  NON-STOCK  INSURANCE
COMPANIES  TO  WHICH SUBPARAGRAPH (B) OF PARAGRAPH TWO OF SUBSECTION (B)
OF SECTION ONE THOUSAND THREE HUNDRED TWENTY-FOUR OF THIS CHAPTER APPLY.
SUCH STANDARD SHALL BE SUFFICIENTLY DISTINCT FROM THAT PROVIDED  FOR  IN
THIS  CHAPTER OR RELATED REGULATION OR UTILIZED BY THE SUPERINTENDENT IN
THE EXAMINATION OF PROPERTY AND CASUALTY CARRIERS SO AS TO  REFLECT  THE
UNIQUE  MARKET,  FINANCIAL  AND  LEGAL  OBLIGATIONS IMPOSED UPON MEDICAL
MALPRACTICE INSURANCE CARRIERS. FURTHER, THE  REGULATION  SHALL  INCLUDE
NEW  STATUTORY  FINANCIAL  STATEMENT  BLANKS  AND  EXAMINATION PROTOCOLS
CONSISTENT WITH THE NEW STANDARD.
  S 24-a. The insurance law is amended by adding a new section  1326  to
read as follows:
  S 1326. STATUTORY ASSOCIATION MEMBERSHIP; OBLIGATIONS. FOR THOSE STOCK
AND  NON-STOCK  COMPANIES  TO WHICH SUBPARAGRAPH (B) OF PARAGRAPH TWO OF
SUBSECTION (B) OF SECTION ONE THOUSAND THREE HUNDRED TWENTY-FOUR OF THIS
ARTICLE APPLIES, NO LIABILITIES ARISING FROM THE OBLIGATIONS OF AN ASSO-
CIATION AUTHORIZED PURSUANT TO SUBPARAGRAPH  (D)  OF  PARAGRAPH  TWO  OF
SUBSECTION (C) OF SECTION FIVE THOUSAND FIVE HUNDRED TWO OF THIS CHAPTER
SHALL  BE  DUE AND OWING FROM SUCH COMPANIES UNLESS AND UNTIL SUCH OBLI-
GATIONS CAN ONLY BE SATISFIED, AFTER CONSIDERATION OF ALL  RESOURCES  OF
THE ASSOCIATION, INCLUDING BUT NOT LIMITED TO CURRENT PREMIUM INCOME, BY
A  CONTRIBUTION  FROM  SUCH  COMPANIES AND THE COMPANIES ARE NOTIFIED OF
SAME BY SUCH ASSOCIATION NOT LESS THAN  THREE  HUNDRED  SIXTY-FIVE  DAYS

S. 2809--C                         19

PRIOR  TO  THE  DATE UPON WHICH SUCH OBLIGATIONS SHALL BE DUE AND OWING,
AND SHALL ONLY RELATE TO OBLIGATIONS OF THE ASSOCIATION THAT ARE ACTUAL-
LY DUE AND OWING BY THE ASSOCIATION IN THAT YEAR IN  WHICH  CONTRIBUTION
IS TO BE MADE BY THE COMPANIES. SUCH OBLIGATIONS SHALL NOT BE AGGREGATED
FOR ANY OTHER YEAR EXCEPT THAT IN WHICH CONTRIBUTION IS DUE AND OWING OR
PREVIOUS  YEARS IN WHICH CONTRIBUTIONS HAVE NOT BEEN SATISFIED; FURTHER,
SUCH LIABILITIES AND THE CONTRIBUTIONS THEREFOR SHALL  NOT  INCLUDE  ANY
CONTINGENT  LIABILITIES  OF  THE  ASSOCIATION  FOR  THE  YEAR  FOR WHICH
CONTRIBUTIONS ARE REQUESTED; PROVIDED,  HOWEVER,  THAT  COMPANIES  SHALL
MAINTAIN  AT  ALL  TIMES A RESERVE OF NOT LESS THAN TEN PERCENT OF THEIR
RESPECTIVE AND PROPORTIONATE LIABILITIES OF THE AGGREGATE DEFICIT OF THE
ASSOCIATION, AS SUCH RESPECTIVE AND  PROPORTIONATE  LIABILITIES  OF  THE
AGGREGATE  DEFICIT  ARE  REPORTED BY THE ASSOCIATION CONSISTENT WITH THE
PROVISIONS OF THIS SECTION.
  S 24-b. 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] DECEM-
BER THIRTY-FIRST, two thousand [eleven] FOURTEEN.
  S  25.  Subsection (i) of section 3216 of the insurance law is amended
by adding a new paragraph 28 to read as follows:
  (28) EACH POLICY WHICH PROVIDES COVERAGE FOR  PRESCRIBED  DRUGS  SHALL
AUTHORIZE  THE  INSURED  AT  THEIR  OPTION TO PURCHASE SUCH DRUGS FROM A
NETWORK MAIL ORDER PHARMACY OR FROM A NON-MAIL ORDER PHARMACY THAT IS  A
NETWORK  PROVIDER,  PROVIDED THAT THE NON-MAIL ORDER PHARMACY WILL OFFER
SUCH DRUGS AT A PRICE THAT IS COMPARABLE TO THAT  OF  THE  NETWORK  MAIL
ORDER  PHARMACY.  SUCH POLICY SHALL NOT IMPOSE A CO-PAYMENT FEE OR OTHER
CONDITION ON ANY INSURED WHO ELECTS TO PURCHASE DRUGS FROM OTHER THAN  A
MAIL  ORDER  PHARMACY  WHICH IS NOT ALSO IMPOSED ON INSUREDS ELECTING TO
PURCHASE DRUGS FROM A DESIGNATED MAIL ORDER PHARMACY; PROVIDED, HOWEVER,
THAT THE PROVISIONS OF THIS SECTION SHALL NOT SUPERSEDE THE TERMS  OF  A
COLLECTIVE  BARGAINING AGREEMENT OR APPLY TO A POLICY THAT IS THE RESULT
OF A COLLECTIVE BARGAINING AGREEMENT BETWEEN AN EMPLOYER  AND  A  RECOG-
NIZED  OR  CERTIFIED  EMPLOYEE  ORGANIZATION.  NOTHING IN THIS PARAGRAPH
SHALL ALTER ANY PROVISIONS OF SECTIONS THIRTEEN AND  THIRTEEN-O  OF  THE
WORKERS'  COMPENSATION  LAW REGARDING THE PURCHASE OF PRESCRIPTION DRUGS
AND THE USE OF MAIL ORDER PHARMACY.
  S 25-a. Subsection (1) of section 3221 of the insurance law is amended
by adding a new paragraph 18 to read as follows:
  (18) EACH INSURER DELIVERING A GROUP OR BLANKET POLICY  OR  ISSUING  A
GROUP OR BLANKET POLICY FOR DELIVERY IN THIS STATE WHICH PROVIDES COVER-
AGE  FOR PRESCRIBED DRUGS SHALL AUTHORIZE THE INSURED AT THEIR OPTION TO
PURCHASE SUCH DRUGS FROM  A  NETWORK  MAIL  ORDER  PHARMACY  OR  FROM  A
NON-MAIL  ORDER  PHARMACY  THAT IS A NETWORK PROVIDER, PROVIDED THAT THE
NON-MAIL ORDER PHARMACY WILL OFFER SUCH DRUG AT A PRICE THAT IS COMPARA-
BLE TO THAT OF THE NETWORK MAIL ORDER PHARMACY.  SUCH POLICY  SHALL  NOT
MANDATE  THAT  THE  SAME  BE  PURCHASED BY THE INSURED FROM A MAIL ORDER
PHARMACY, NOR MAY SUCH POLICY IMPOSE A CO-PAYMENT FEE OR OTHER CONDITION
ON ANY INSURED WHO ELECTS TO PURCHASE DRUGS FROM OTHER THAN A MAIL ORDER
PHARMACY WHICH IS NOT ALSO IMPOSED  ON  INSUREDS  ELECTING  TO  PURCHASE

S. 2809--C                         20

DRUGS FROM A DESIGNATED MAIL ORDER PHARMACY; PROVIDED, HOWEVER, THAT THE
PROVISIONS OF THIS SECTION SHALL NOT SUPERSEDE THE TERMS OF A COLLECTIVE
BARGAINING  AGREEMENT  OR  APPLY  TO  A  POLICY  THAT IS THE RESULT OF A
COLLECTIVE  BARGAINING AGREEMENT BETWEEN AN EMPLOYER AND A RECOGNIZED OR
CERTIFIED EMPLOYEE ORGANIZATION. NOTHING IN THIS PARAGRAPH  SHALL  ALTER
ANY  PROVISIONS  OF  SECTIONS  THIRTEEN  AND  THIRTEEN-O OF THE WORKERS'
COMPENSATION LAW REGARDING THE PURCHASE OF PRESCRIPTION  DRUGS  AND  THE
USE OF MAIL ORDER PHARMACY.
  S  25-b.  Section 4303 of the insurance law is amended by adding a new
subsection (hh) to read as follows:
  (HH) EACH POLICY ISSUED BY A MEDICAL EXPENSE INDEMNITY CORPORATION,  A
HOSPITAL  SERVICE  CORPORATION  OR  A  HEALTH SERVICES CORPORATION WHICH
PROVIDES COVERAGE FOR PRESCRIBED DRUGS SHALL AUTHORIZE  THE  INSURED  AT
THEIR  OPTION  TO PURCHASE SUCH DRUGS FROM A NETWORK MAIL ORDER PHARMACY
OR FROM A NON-MAIL ORDER PHARMACY THAT IS A NETWORK  PROVIDER,  PROVIDED
THAT  THE  NON-MAIL ORDER PHARMACY WILL OFFER SUCH DRUGS AT A PRICE THAT
IS COMPARABLE TO THAT OF THE NETWORK MAIL ORDER PHARMACY.   SUCH  POLICY
SHALL  NOT MANDATE THAT THE SAME BE PURCHASED BY THE INSURED FROM A MAIL
ORDER PHARMACY, NOR MAY SUCH POLICY IMPOSE A  CO-PAYMENT  FEE  OR  OTHER
CONDITION  ON ANY INSURED WHO ELECTS TO PURCHASE DRUGS FROM OTHER THAN A
MAIL ORDER PHARMACY WHICH IS NOT ALSO IMPOSED ON  INSUREDS  ELECTING  TO
PURCHASE DRUGS FROM A DESIGNATED MAIL ORDER PHARMACY; PROVIDED, HOWEVER,
THAT  THE  PROVISIONS OF THIS SECTION SHALL NOT SUPERSEDE THE TERMS OF A
COLLECTIVE BARGAINING AGREEMENT OR APPLY TO A POLICY THAT IS THE  RESULT
OF  A  COLLECTIVE  BARGAINING AGREEMENT BETWEEN AN EMPLOYER AND A RECOG-
NIZED OR CERTIFIED EMPLOYEE ORGANIZATION.  NOTHING  IN  THIS  SUBSECTION
SHALL  ALTER  ANY  PROVISIONS OF SECTIONS THIRTEEN AND THIRTEEN-O OF THE
WORKERS' COMPENSATION LAW REGARDING THE PURCHASE OF  PRESCRIPTION  DRUGS
AND THE USE OF MAIL ORDER PHARMACY.
  S  25-c.  The  opening  paragraph of paragraph 25 of subsection (b) of
section 4322 of the insurance law, as amended by chapter 554 of the laws
of 2002, is amended to read as follows:
  Prescription drugs, including contraceptive drugs or devices  approved
by  the  federal  food  and  drug  administration or generic equivalents
approved as substitutes by such food and drug administration and  nutri-
tional supplements (formulas) for the therapeutic treatment of phenylke-
tonuria,  branched-chain  ketonuria,  galactosemia  and  homocystinuria,
obtained at a participating pharmacy under a prescription written by  an
in-plan  or  out-of-plan  provider. Health maintenance organizations, in
addition to providing coverage for prescription drugs at a participating
pharmacy, may utilize a mail order prescription drug program.   HOWEVER,
EACH  HEALTH  MAINTENANCE  ORGANIZATION  SHALL  AUTHORIZE THE INSURED AT
THEIR OPTION TO PURCHASE SUCH DRUGS FROM A NETWORK MAIL  ORDER  PHARMACY
OR  FROM  A NON-MAIL ORDER PHARMACY THAT IS A NETWORK PROVIDER, PROVIDED
THAT THE NON-MAIL ORDER PHARMACY WILL OFFER SUCH DRUGS AT A  PRICE  THAT
IS COMPARABLE TO THAT OF THE NETWORK MAIL ORDER PHARMACY. THE PROVISIONS
OF THIS SECTION SHALL NOT SUPERSEDE THE TERMS OF A COLLECTIVE BARGAINING
AGREEMENT  OR  APPLY  TO  A  POLICY  THAT  IS THE RESULT OF A COLLECTIVE
BARGAINING AGREEMENT BETWEEN AN EMPLOYER AND A RECOGNIZED  OR  CERTIFIED
EMPLOYEE  ORGANIZATION.  NOTHING  IN  THIS  PARAGRAPH  SHALL  ALTER  ANY
PROVISIONS OF SECTIONS THIRTEEN AND THIRTEEN-O OF THE  WORKERS'  COMPEN-
SATION  LAW  REGARDING THE PURCHASE OF PRESCRIPTION DRUGS AND THE USE OF
MAIL  ORDER  PHARMACY.  Health  maintenance  organizations  may  provide
prescription drugs pursuant to a drug formulary; however, health mainte-
nance organizations must implement an appeals process so that the use of

S. 2809--C                         21

non-formulary  prescription  drugs  may  be  requested by a physician or
other provider.
  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 however
that  sections  sixteen, seventeen and eighteen of this act shall expire
April 1, [2011] 2014; 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]
TWENTY 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

S. 2809--C                         22

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] 2015; and provided further, however, that the
expiration 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] 2015, 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 redemp-
tion, 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;
  (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; and
  (e) sections twenty-five,  twenty-five-a,  twenty-five-b  and  twenty-
five-c of this act shall take effect on the thirtieth day after this act
shall  have  become  a law and shall apply to all policies and contracts
issued, renewed, modified, altered, or amended on or after  such  effec-
tive 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-

S. 2809--C                         23

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 1-a. 1. 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 profes-
sional services provided by physicians, nurse practitioners  and  physi-
cian  assistants  who  are employed by non-state operated public general
hospitals operated by a public benefit corporation located in a city  of
more than one million persons or who are providing professional services
at  a facility of such public benefit corporation as a member of a prac-
tice plan under contract to provide  services  to  patients  of  such  a
public  benefit corporation, 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 either the Medicare rate or the average commercial rate
that would otherwise be received for  such  services  rendered  by  such
physicians,  nurse  practitioners  and  physician  assistants, provided,
however, that such supplemental fee payments shall not be available with
regard to services provided at facilities participating in the  Medicare
Teaching  Election  Amendment.  The calculation 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 sump payments
to entities authorized to receive professional fees.
  2. Public general hospitals as described in subdivision  one  of  this
section shall, notwithstanding the social services district Medicaid cap
provisions  of  Part C of Chapter 58 of the laws of 2005, be responsible
for payment of one hundred percent of  the  non-federal  share  of  such
supplemental  Medicaid payments for all services provided by physicians,
nurse practitioners and physician assistants who are  employed  by  such
public general hospitals, 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  eligible  persons receiving such services.
Social services district funding of the non-federal share  of  any  such
payments  shall  be deemed to be voluntary for purposes of the increased
federal medical assistance percentage provisions of the American  Recov-
ery  and  Reinvestment Act of 2009, provided, however, that in the event
the federal Centers for Medicare and Medicaid Services  determines  that
such  non-federal share payments are not voluntary payments for purposes
of such Act, the provisions of this section shall be null and void.
  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

S. 2809--C                         24

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 2-a. Paragraph (c) of subdivision 8 of section 2807  of  the  public
health law, as added by section 28 of part B of chapter 1 of the laws of
2002, is amended to read as follows:
  (c)  Rates  of payments to facilities which first qualify as federally
qualified health centers or rural health centers  on  or  after  October
first,  two thousand shall be computed in accordance with the provisions
of paragraph (b) of subdivision two of this section, provided,  however,
that the operating cost component of such rates shall reflect an average
of  the  operating  cost  component of rates of payments issued to other
facilities subject to this subdivision  during  the  same  rate  period,
located  in the same geographic region and with a similar case load, and
further provided that the capital cost component  of  such  rates  shall
reflect the most recently available capital cost data as reported to the
department.  For  each  twelve month period following the rate period in
which such facilities commence operation, the operating  cost  component
of  rates of payment for such facilities shall be computed in accordance
with paragraph (b) of this subdivision.   IN CALCULATING  THE  OPERATING
COST  COMPONENT  OF  SUCH  RATES  FOR  FACILITIES WHICH FIRST QUALIFY AS
FEDERALLY QUALIFIED HEALTH CARE CENTERS ON OR AFTER OCTOBER  FIRST,  TWO
THOUSAND,  THE  COUNTIES COMPRISING THE GEOGRAPHIC REGION KNOWN AS DOWN-
STATE SHALL BE THE SAME AS THE COUNTIES COMPRISING THE DOWNSTATE  REGION
FOR PURPOSES OF REIMBURSING DIAGNOSTIC AND TREATMENT CENTERS UNDER AMBU-
LATORY  PATIENT  GROUPS, WHICH COUNTIES ARE SPECIFIED IN THE REGULATIONS
ADOPTED BY THE COMMISSIONER IMPLEMENTING SECTION 18 OF PART C OF CHAPTER
FIFTY-EIGHT OF THE LAWS OF TWO THOUSAND EIGHT.
  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:

S. 2809--C                         25

  (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] TWELVE 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 calen-
dar 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 adjust-
ment 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 FOR RATE  PERIODS  ON
AND  AFTER  APRIL  FIRST,  TWO THOUSAND NINE THROUGH JUNE THIRTIETH, TWO
THOUSAND ELEVEN, SHALL BE IMPLEMENTED AND PAID PRIOR TO JULY FIRST,  TWO
THOUSAND  ELEVEN  AND SHALL CONTINUE TO BE IMPLEMENTED AND PAID FOR RATE
PERIODS ON AND AFTER JULY SECOND,  TWO  THOUSAND  ELEVEN,  THROUGH  JUNE
THIRTIETH, TWO THOUSAND TWELVE.
  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

S. 2809--C                         26

for  inpatient  services  provided by residential health care facilities
for the period April 1, 2010 through June 30, [2011] 2012,  the  commis-
sioner  of  health and the director of the budget shall, upon a determi-
nation 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 subpara-
graph (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  authorized  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 4-a. The opening paragraph and subparagraph (vi) of paragraph (a) of
subdivision 2-c of section 2808 of the public health  law,  the  opening
paragraph  as  added by section 5 of part D of chapter 58 of the laws of
2010 and subparagraph (vi) of paragraph (a) as amended by section  2  of
part  D  of  chapter  58  of  the  laws  of 2010, are amended to read as
follows:
  Notwithstanding any inconsistent provision  of  this  section  or  any
other  contrary  provision  of  law  and  subject to the availability of
federal financial participation, the operating costs of rates of payment
by governmental agencies for inpatient services provided by  residential
health  care  facilities  on and after July first, two thousand [eleven]
TWELVE shall be determined in accordance with the following:
  (vi) Notwithstanding subparagraph (i) of this paragraph, the operating
cost component of the rates, effective July first, two thousand [eleven]
TWELVE for the following categories of facilities, as established pursu-
ant to applicable regulations, shall reflect the  rates  in  effect  for
such  facilities  on  June  thirtieth,  two thousand [eleven] TWELVE, as
adjusted for inflation in accordance with applicable statutes: (A)  AIDS
facilities  or discrete AIDS units within facilities, (B) discrete units
for residents receiving care in  a  long-term  inpatient  rehabilitation
program  for traumatic brain injured persons, (C) discrete units provid-
ing specialized  programs  for  residents  requiring  behavioral  inter-
ventions,  (D)  discrete  units for long-term ventilator dependent resi-
dents, and (E) facilities  or  discrete  units  within  facilities  that
provide extensive nursing, medical, psychological and counseling support
services  solely to children. Such rate shall remain in effect until the
department, in consultation with representatives  of  the  nursing  home
industry,  as  selected by the commissioner, develops a regional pricing
or alternative methodology for determining such rates.
  S 4-b. The opening paragraph and subparagraph (vi) of paragraph (a) of
subdivision 2-c of section 2808 of the public health law, as amended  by
section  2  of  part  D of chapter 58 of the laws of 2010, is amended to
read as follows:
  Notwithstanding any inconsistent provision  of  this  section  or  any
other  contrary  provision  of  law  and  subject to the availability of
federal financial participation, the operating costs of rates of payment
by governmental agencies for inpatient services provided by  residential
health  care  facilities  on and after July first, two thousand [eleven]
TWELVE shall be determined in accordance with the following:

S. 2809--C                         27

  (vi) Notwithstanding subparagraph (i) of this paragraph, the operating
cost component of the rates, effective July first, two thousand [eleven]
TWELVE for the following categories of facilities, as established pursu-
ant to applicable regulations, shall reflect the  rates  in  effect  for
such  facilities  on  June  thirtieth,  two thousand [eleven] TWELVE, as
adjusted for inflation in accordance with applicable statutes: (A)  AIDS
facilities  or discrete AIDS units within facilities, (B) discrete units
for residents receiving care in  a  long-term  inpatient  rehabilitation
program  for traumatic brain injured persons, (C) discrete units provid-
ing specialized  programs  for  residents  requiring  behavioral  inter-
ventions,  (D)  discrete  units for long-term ventilator dependent resi-
dents, and (E) facilities  or  discrete  units  within  facilities  that
provide extensive nursing, medical, psychological and counseling support
services  solely to children. Such rate shall remain in effect until the
department, in consultation with representatives  of  the  nursing  home
industry,  as  selected by the commissioner, develops a regional pricing
or alternative methodology for determining such rates.
  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,
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

S. 2809--C                         28

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
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, AND ON OR AFTER APRIL  FIRST,  TWO  THOUSAND
ELEVEN  THROUGH  MARCH THIRTY-FIRST, TWO THOUSAND THIRTEEN, such assess-
ment shall be six percent.
  S 8-a. Section 365-a of the social services law is amended by adding a
new subdivision 10 to read as follows:
  10. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS SECTION  OR  OF
ANY  OTHER  PROVISION  OF  THIS  CHAPTER OR OTHER LAW, EACH LOCAL SOCIAL
SERVICES DISTRICT IS HEREBY  AUTHORIZED  TO  DETERMINE  WHICH,  IF  ANY,
SERVICES  IT  CHOOSES  TO  PROVIDE TO ELIGIBLE PERSONS OF THOSE SERVICES
OTHERWISE REQUIRED TO BE  PROVIDED  BY  APPLICABLE  STATE  LAW  BUT  NOT
REQUIRED TO BE PROVIDED BY FEDERAL LAW.
  S  8-b.  Section 366 of the social services law is amended by adding a
new subdivision 10 to read as follows:
  10. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS SECTION  OR  OF
ANY  OTHER  PROVISION  OF  THIS  CHAPTER OR OTHER LAW, EACH LOCAL SOCIAL
SERVICES DISTRICT IS HEREBY AUTHORIZED TO DETERMINE WHICH, IF ANY, CATE-
GORIES OF ELIGIBILITY IT CHOOSES TO PROVIDE MEDICAL ASSISTANCE OTHERWISE
REQUIRED TO BE PROVIDED BY APPLICABLE STATE LAW BUT NOT REQUIRED  TO  BE
PROVIDED BY FEDERAL LAW.
  S 8-c. The commissioner of health:
  1.   is authorized and directed to apply for any and all federal waiv-
ers required to implement the provisions of subdivision  10  of  section
365-a and subdivision 10 of section 366 of the social services law;
  2.  shall  promulgate  any  and all rules and regulations and take any
other measures necessary to implement this act, including but not limit-
ed to developing a services and eligibility plan  and  distributing  the

S. 2809--C                         29

same  to local social services districts whereby such districts may make
such choices as are authorized by subdivision 10 of  section  365-a  and
subdivision  10  of  section 366 of the social services law, as added by
sections  one and two, respectively, of this act, and applicable federal
waivers; and
  3. shall specify dates by which such services  and  eligibility  plans
must  be returned to said commissioner for review and approval to imple-
ment such plans. A district that does not have an approved plan  by  the
deadline set therefor by the commissioner shall provide all services and
categories  of eligibility required under the state plan as in effect at
that time.
  S 9. Intentionally omitted.
  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
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; and

S. 2809--C                         30

  (f) the provisions of section two-a of this act shall take  effect  on
January  1,  2012 and shall apply to the rates established for federally
qualified health centers for all fiscal years  beginning  on  and  after
October 1, 2012.

                                 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--C                         31

  (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--C                         32

  (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--C                         33

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--C                         34

  S 6. Intentionally omitted.
  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;
  (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;

S. 2809--C                         35

  (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
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

S. 2809--C                         36

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
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

S. 2809--C                         37

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 THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN, UP TO FUNDING AMOUNTS
SPECIFIED BELOW and shall be available, 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
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

S. 2809--C                         38

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
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

S. 2809--C                         39

  (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
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-

S. 2809--C                         40

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
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-

S. 2809--C                         41

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;
  (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

S. 2809--C                         42

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:
  (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,

S. 2809--C                         43

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-
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

S. 2809--C                         44

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
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.

S. 2809--C                         45

  (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
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;

S. 2809--C                         46

  (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
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

S. 2809--C                         47

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
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

S. 2809--C                         48

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.
  (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,

S. 2809--C                         49

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
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

S. 2809--C                         50

  (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
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

S. 2809--C                         51

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
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

S. 2809--C                         52

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
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

S. 2809--C                         53

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;
  (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;

S. 2809--C                         54

  (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;
  (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;

S. 2809--C                         55

  (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;
  (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

S. 2809--C                         56

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
  (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;

S. 2809--C                         57

  (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
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]

S. 2809--C                         58

  (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;
  (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;

S. 2809--C                         59

  (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;
  (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

S. 2809--C                         60

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
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

S. 2809--C                         61

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;
  (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

S. 2809--C                         62

  (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;
  (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;

S. 2809--C                         63

  (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:
  (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.

S. 2809--C                         64

  (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;
  (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;

S. 2809--C                         65

  (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-
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;

S. 2809--C                         66

  (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;
  (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,

S. 2809--C                         67

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;
  (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;

S. 2809--C                         68

  (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.
  (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;

S. 2809--C                         69

  (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;
  (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:

S. 2809--C                         70

  (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
  (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;

S. 2809--C                         71

  (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;
  (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

S. 2809--C                         72

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;
  (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;

S. 2809--C                         73

  (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
  (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]

S. 2809--C                         74

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;
  (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

S. 2809--C                         75

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
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;

S. 2809--C                         76

  (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
  (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

S. 2809--C                         77

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
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;

S. 2809--C                         78

  (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
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.

S. 2809--C                         79

  (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;
  (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

S. 2809--C                         80

  (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
  (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;

S. 2809--C                         81

  (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
  (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

S. 2809--C                         82

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
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,

S. 2809--C                         83

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
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

S. 2809--C                         84

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 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

S. 2809--C                         85

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-
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

S. 2809--C                         86

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
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

S. 2809--C                         87

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
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

S. 2809--C                         88

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
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

S. 2809--C                         89

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,
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

S. 2809--C                         90

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
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

S. 2809--C                         91

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,
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

S. 2809--C                         92

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
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

S. 2809--C                         93

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,
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

S. 2809--C                         94

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[.];
  (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

S. 2809--C                         95

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
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

S. 2809--C                         96

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
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

S. 2809--C                         97

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
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

S. 2809--C                         98

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
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. 2809--C                         99

  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:
  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:

S. 2809--C                         100

  (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
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

S. 2809--C                         101

  (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
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 APRIL FIRST, TWO THOUSAND TWELVE.
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  THE  STATE  FISCAL  YEAR  BEGINNING APRIL 1, 2011 THROUGH MARCH 31,
2012, the department of health  is  authorized  to  pay  public  general
hospitals,  as  defined  in subdivision 10 of section 2801 of the public

S. 2809--C                         102

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  popu-
lation  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  govern-
ing  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 reconciled 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 reconciled data as further reconciled to  actual  reported
1999  reconciled  data, for 2000 based initially on reported 1995 recon-
ciled data as further reconciled to actual reported 2000 data, for  2001
based  initially  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

S. 2809--C                         103

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 ON AND AFTER APRIL 1, 2011 THROUGH MARCH
31, 2012;
  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
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;

S. 2809--C                         104

  (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  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  THROUGH  MARCH 31, 2013, 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 THROUGH MARCH  31,  2013,
for  inpatient and outpatient services provided by general hospitals and

S. 2809--C                         105

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
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:

S. 2809--C                         106

  (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
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.

S. 2809--C                         107

  (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.
  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

S. 2809--C                         108

  (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;
  (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

S. 2809--C                         109

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.
  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.

S. 2809--C                         110

  (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
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

S. 2809--C                         111

  (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 THROUGH MARCH 31, 2013;
  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
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 THROUGH MARCH 31, 2013.
  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  THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND THIRTEEN, the reimbursable base year adminis-
trative and general costs of a provider of services shall not exceed the

S. 2809--C                         112

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] 2014;
  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] 2014; 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] 2014;
  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] 2016 provided, however that the
amendments 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
establishment 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] 2016.
  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. Intentionally omitted.

S. 2809--C                         113

  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] 2016, 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-
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] 2016 and provided further, that the
amendments 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. Intentionally omitted.
  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. 2809--C                         114

  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; provided,
however,  that  the amendments made to paragraph (e) of subdivision 8 of
section 2807-c of the public health law by section  seven  of  this  act
shall not affect the expiration of such paragraph and shall expire ther-
ewith.

                                 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
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:

S. 2809--C                         115

  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

  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

S. 2809--C                         116

  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 FACIL-
ITY  OPERATED  BY  THE  OFFICE  TO PROVIDE COMMUNITY-BASED MENTAL HEALTH
SERVICES FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCES.
  S 2. Notwithstanding any other provision of law to the  contrary,  the
requirements  set forth in subdivision (e) of section 7.17 of the mental
hygiene law are hereby suspended until April 1, 2012.
  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  according  to  this
section  as  shall be determined by the commissioner of mental health to
be necessary for the cost-effective  and  efficient  operation  of  such
hospitals, other facilities and programs.
  (b)  Determinations  concerning the closure, consolidation or of beds,
wards and hospitals in fiscal year 2010-11 shall be made by  the  office
of  mental  health based on: (1) data related to inpatient census, indi-
cating nonutilization or under utilization of beds; (2) the  maintenance
of an adequate level of patient care, including the proximity and capac-
ity  of similar such facilities; (3) the availability and sufficiency of
community mental health services; and (4)  the  efficient  operation  of
facilities.
  (c)  Facility  closures. At least one hundred eighty days prior to the
anticipated closure of any hospital named in subdivision (b) of  section
7.17  of the mental hygiene law, the office of mental health shall:  (1)
notify the president pro tempore of  the  senate,  the  speaker  of  the
assembly, and the chief executive officer of the county located in which
the  facility  to be closed is located; (2) provide written notification
to the legal guardians of patients of the facility to be closed; (3) and
provide notice of closure on the public website of the office of  mental
health.
  (d) Bed and ward closures. At least two weeks prior to the anticipated
closure or the consolidation or transfer of inpatient beds or wards, the
office  of mental health shall:  (1) notify the president pro tempore of
the senate, the speaker of the assembly, and the chief executive officer
of the county located in which the facility to be closed is located; (2)
provide written notification to the legal guardians of patients  of  the
facility  to  be closed; (3) and provide notice of closure on the public
website of the office of mental health.
  (e) 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

S. 2809--C                         117

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, 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 5. This act shall take effect April 1, 2011.

                                 PART H

  Section  1.  Subparagraph  1  of  paragraph  (c)  of subdivision 10 of
section 2807-c of the public health law, as amended by  chapter  419  of
the laws of 2000, is amended to read as follows:
  (1)  (I)  For  rate  periods  on  and  after April first, two thousand
THROUGH MARCH THIRTY-FIRST,  TWO  THOUSAND  FOURTEEN,  the  commissioner
shall  establish  trend  factors  for rates of payment for state govern-
mental agencies to project for the effects of inflation except that such
trend factors shall not be  applied  to  services  for  which  rates  of
payment are established by the commissioners of the department of mental
hygiene.  The  factors  shall  be  applied to the appropriate portion of
reimbursable costs.
  (II) NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE  CONTRARY,  THE
PROVISIONS  SET  FORTH  IN  THIS  SUBPARAGRAPH ARE HEREBY SUSPENDED FROM
APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST,  TWO  THOU-
SAND THIRTEEN.
  S  2.  Section 21 of 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, as amended by section 18 of part D of chapter 58 of
the laws of 2009, is amended to read as follows:
  S 21. Notwithstanding any inconsistent provision of law, effective FOR
RATE PERIODS April 1, 2000 THROUGH MARCH 31, 2014, in determining  rates
of  payment  for  residential health care facilities pursuant to section
2808 of the public health law, hospital outpatient services and diagnos-
tic and treatment centers pursuant to section 2807 of the public  health
law,  unless  otherwise  subject to the limits set forth in section 4 of
chapter 81 of the laws of 1995, as amended by this act,  certified  home
health  agencies  and  long  term  home health care programs pursuant to
section 3614-a of the public  health  law  and  personal  care  services
pursuant to section 367-i of the social services law, and for periods on
and  after  April  1,  2009,  adult day health care services provided to
patients diagnosed with AIDS as defined by applicable  regulations,  the
commissioner  of  health shall apply trend factors using the methodology
described in paragraph (c) of subdivision 10 of section  2807-c  of  the
public  health  law, except that such trend factors shall not be applied
to services for which rates of payment are established  by  the  commis-
sioners of the department of mental hygiene.  Nothing in this section is
intended  to reduce a change in any existing provision of law establish-
ing maximum reimbursement rates.
  S 2-a. Notwithstanding any contrary provision of law,  rule  or  regu-
lation, for Medicaid rates of payment for services provided on and after
April  1,  2011  the  commissioner of health is authorized to promulgate

S. 2809--C                         118

regulations, including  emergency  regulations,  with  regard  to  trend
factor  adjustments  for inflation which may be applied to such rates of
payment with regard to hospice services provided pursuant to article  40
of  the  public  health  law,  assisted living program services provided
pursuant to section 461-1  of  the  social  services  law,  foster  care
services  provided  pursuant  to  article  6 of the social services law,
adult day health care services provided pursuant to article  28  of  the
public  health  law  or  personal  care services provided in those local
social services districts, including  New  York  city,  whose  rates  of
payment  for  such  services  is  established  by  such  social services
districts pursuant to a rate-setting exemption issued by the commission-
er of health to such local social services districts in accordance  with
applicable regulations.
  S  3. Section 3614 of the public health law is amended by adding a new
subdivision 12 to read as follows:
  12. (A) NOTWITHSTANDING ANY INCONSISTENT PROVISION  OF  LAW  OR  REGU-
LATION  AND  SUBJECT  TO  THE  AVAILABILITY OF FEDERAL FINANCIAL PARTIC-
IPATION, EFFECTIVE ON AND AFTER APRIL FIRST, TWO THOUSAND ELEVEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND TWELVE, RATES OF PAYMENT BY  GOVERNMENT
AGENCIES FOR SERVICES PROVIDED BY CERTIFIED HOME HEALTH AGENCIES, EXCEPT
FOR  SUCH  SERVICES PROVIDED TO CHILDREN UNDER EIGHTEEN YEARS OF AGE AND
OTHER DISCRETE GROUPS AS MAY BE DETERMINED BY THE COMMISSIONER  PURSUANT
TO  REGULATIONS, SHALL REFLECT CEILING LIMITATIONS DETERMINED IN ACCORD-
ANCE WITH THIS SUBDIVISION, PROVIDED, HOWEVER, THAT AT THE DISCRETION OF
THE COMMISSIONER SUCH CEILINGS MAY, AS AN  ALTERNATIVE,  BE  APPLIED  TO
PAYMENTS  FOR  SERVICES  PROVIDED ON AND AFTER APRIL FIRST, TWO THOUSAND
ELEVEN, EXCEPT FOR SUCH SERVICES PROVIDED TO CHILDREN AND OTHER DISCRETE
GROUPS AS MAY BE DETERMINED BY THE COMMISSIONER PURSUANT TO REGULATIONS.
IN DETERMINING SUCH PAYMENTS OR RATES OF PAYMENT, AGENCY CEILINGS  SHALL
BE  ESTABLISHED.  SUCH CEILINGS SHALL BE APPLIED TO PAYMENTS OR RATES OF
PAYMENT FOR CERTIFIED HOME HEALTH AGENCY SERVICES AS ESTABLISHED  PURSU-
ANT  TO THIS SECTION AND APPLICABLE REGULATIONS. CEILINGS SHALL BE BASED
ON A BLEND OF: (I) AN AGENCY'S TWO THOUSAND  NINE  AVERAGE  PER  PATIENT
MEDICAID  CLAIMS,  WEIGHTED AT A PERCENTAGE AS DETERMINED BY THE COMMIS-
SIONER; AND (II) THE TWO THOUSAND NINE  STATEWIDE  AVERAGE  PER  PATIENT
MEDICAID  CLAIMS  ADJUSTED BY A REGIONAL WAGE INDEX FACTOR AND AN AGENCY
PATIENT CASE MIX INDEX, WEIGHTED AT A PERCENTAGE AS  DETERMINED  BY  THE
COMMISSIONER.  SUCH CEILINGS WILL BE EFFECTIVE APRIL FIRST, TWO THOUSAND
ELEVEN THROUGH MARCH  THIRTY-FIRST,  TWO  THOUSAND  TWELVE.  AN  INTERIM
PAYMENT  OR  RATE OF PAYMENT ADJUSTMENT EFFECTIVE APRIL FIRST, TWO THOU-
SAND ELEVEN, SHALL BE APPLIED TO AGENCIES  WITH  PROJECTED  AVERAGE  PER
PATIENT  MEDICAID  CLAIMS, AS DETERMINED BY THE COMMISSIONER, TO BE OVER
THEIR CEILINGS. SUCH AGENCIES SHALL HAVE  THEIR  PAYMENTS  OR  RATES  OF
PAYMENT  REDUCED TO REFLECT THE AMOUNT BY WHICH SUCH CLAIMS EXCEED THEIR
CEILINGS.
  (B) CEILING LIMITATIONS DETERMINED PURSUANT TO PARAGRAPH (A)  OF  THIS
SUBDIVISION  SHALL  BE SUBJECT TO RECONCILIATION. IN DETERMINING PAYMENT
OR RATE OF PAYMENT ADJUSTMENTS BASED ON  SUCH  RECONCILIATION,  ADJUSTED
AGENCY  CEILINGS  SHALL BE ESTABLISHED.  SUCH ADJUSTED CEILINGS SHALL BE
BASED ON A BLEND OF: (I) AN  AGENCY'S  TWO  THOUSAND  NINE  AVERAGE  PER
PATIENT  MEDICAID  CLAIMS  ADJUSTED  BY  THE  PERCENTAGE  OF INCREASE OR
DECREASE IN SUCH AGENCY'S PATIENT CASE MIX FROM THE  TWO  THOUSAND  NINE
CALENDAR  YEAR  TO  THE  ANNUAL  PERIOD APRIL FIRST, TWO THOUSAND ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE, WEIGHTED AT A  PERCENT-
AGE  AS  DETERMINED  BY THE COMMISSIONER; AND (II) THE TWO THOUSAND NINE
STATEWIDE AVERAGE PER PATIENT MEDICAID CLAIMS  ADJUSTED  BY  A  REGIONAL

S. 2809--C                         119

WAGE INDEX FACTOR AND THE AGENCY'S PATIENT CASE MIX INDEX FOR THE ANNUAL
PERIOD  APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND TWELVE, WEIGHTED AT A PERCENTAGE AS DETERMINED BY  THE  COMMIS-
SIONER.  SUCH  ADJUSTED AGENCY CEILING SHALL BE COMPARED TO ACTUAL MEDI-
CAID PAID CLAIMS FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND TWELVE.  IN  THOSE  INSTANCES  WHEN  AN
AGENCY'S ACTUAL PER PATIENT MEDICAID CLAIMS ARE DETERMINED TO EXCEED THE
AGENCY'S  ADJUSTED  CEILING, THE AMOUNT OF SUCH EXCESS SHALL BE DUE FROM
EACH SUCH AGENCY TO THE STATE AND MAY BE RECOUPED BY THE DEPARTMENT IN A
LUMP SUM AMOUNT OR THROUGH REDUCTIONS IN THE MEDICAID  PAYMENTS  DUE  TO
THE  AGENCY.  IN  THOSE  INSTANCES  WHERE  AN INTERIM PAYMENT OR RATE OF
PAYMENT ADJUSTMENT WAS APPLIED TO AN AGENCY IN ACCORDANCE WITH PARAGRAPH
(A) OF THIS SUBDIVISION, AND SUCH AGENCY'S ACTUAL PER  PATIENT  MEDICAID
CLAIMS ARE DETERMINED TO BE LESS THAN THE AGENCY'S ADJUSTED CEILING, THE
AMOUNT BY WHICH SUCH MEDICAID CLAIMS ARE LESS THAN THE AGENCY'S ADJUSTED
CEILING  SHALL  BE  REMITTED  TO EACH SUCH AGENCY BY THE DEPARTMENT IN A
LUMP SUM AMOUNT OR THROUGH AN INCREASE IN THE MEDICAID PAYMENTS  DUE  TO
THE AGENCY.
  (C)  INTERIM  PAYMENT  OR RATE OF PAYMENT ADJUSTMENTS PURSUANT TO THIS
SUBDIVISION SHALL BE BASED ON MEDICAID PAID CLAIMS, AS DETERMINED BY THE
COMMISSIONER, FOR SERVICES PROVIDED BY AGENCIES IN  THE  BASE  YEAR  TWO
THOUSAND  NINE.  AMOUNTS  DUE FROM RECONCILING RATE ADJUSTMENTS SHALL BE
BASED ON MEDICAID PAID CLAIMS, AS DETERMINED BY  THE  COMMISSIONER,  FOR
SERVICES  PROVIDED  BY  AGENCIES  IN THE BASE YEAR TWO THOUSAND NINE AND
MEDICAID PAID CLAIMS, AS DETERMINED BY THE  COMMISSIONER,  FOR  SERVICES
PROVIDED BY AGENCIES IN THE RECONCILIATION PERIOD APRIL FIRST, TWO THOU-
SAND  ELEVEN  THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE. IN DETER-
MINING CASE MIX, EACH PATIENT SHALL BE CLASSIFIED USING A  SYSTEM  BASED
ON MEASURES WHICH MAY INCLUDE, BUT NOT BE LIMITED TO, CLINICAL AND FUNC-
TIONAL  MEASURES,  AS  REPORTED  ON  THE  FEDERAL OUTCOME AND ASSESSMENT
INFORMATION SET (OASIS), AS MAY BE AMENDED.
  (D) THE COMMISSIONER MAY REQUIRE AGENCIES TO COLLECT  AND  SUBMIT  ANY
DATA  REQUIRED  TO  IMPLEMENT  THE  PROVISIONS  OF THIS SUBDIVISION. THE
COMMISSIONER MAY PROMULGATE REGULATIONS TO IMPLEMENT THE  PROVISIONS  OF
THIS SUBDIVISION.
  (E)  PAYMENTS  OR  RATE  OF PAYMENT ADJUSTMENTS DETERMINED PURSUANT TO
THIS SUBDIVISION SHALL, FOR THE PERIOD APRIL FIRST, TWO THOUSAND  ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE, BE RETROACTIVELY RECON-
CILED UTILIZING THE METHODOLOGY IN PARAGRAPH (B) OF THIS SUBDIVISION AND
UTILIZING ACTUAL PAID CLAIMS FROM SUCH PERIOD.
  (F)  NOTWITHSTANDING  ANY  INCONSISTENT PROVISION OF THIS SUBDIVISION,
PAYMENTS OR RATE OF PAYMENT ADJUSTMENTS MADE PURSUANT TO  THIS  SUBDIVI-
SION  SHALL  NOT  RESULT  IN  AN  AGGREGATE  ANNUAL DECREASE IN MEDICAID
PAYMENTS TO PROVIDERS SUBJECT TO THIS SUBDIVISION THAT IS IN  EXCESS  OF
TWO  HUNDRED  MILLION DOLLARS, AS DETERMINED BY THE COMMISSIONER AND NOT
SUBJECT TO SUBSEQUENT ADJUSTMENT, AND THE COMMISSIONER SHALL  MAKE  SUCH
ADJUSTMENTS  TO  SUCH  PAYMENTS  OR RATES OF PAYMENT AS ARE NECESSARY TO
ENSURE THAT SUCH AGGREGATE LIMITS ON PAYMENT DECREASES ARE NOT EXCEEDED.
  (G)  THE  COMMISSIONER  SHALL  ALSO  MAKE  SUCH  ADJUSTMENTS  TO  SUCH
PAYMENTS,  RATES  OF  PAYMENT AND THE PAYMENT METHODOLOGY TO ENSURE THAT
AGENCIES THAT HAVE CONSISTENTLY MAINTAINED UTILIZATION BELOW SUCH LIMITS
ARE NOT PENALIZED BY THE UTILIZATION OF THE FOREGOING METHODOLOGY.
  S 4. Section 3614 of the public health law is amended by adding a  new
subdivision 13 to read as follows:
  13.  (A)  NOTWITHSTANDING  ANY  INCONSISTENT PROVISION OF LAW OR REGU-
LATION AND SUBJECT TO THE  AVAILABILITY  OF  FEDERAL  FINANCIAL  PARTIC-

S. 2809--C                         120

IPATION,  EFFECTIVE APRIL FIRST, TWO THOUSAND TWELVE THROUGH MARCH THIR-
TY-FIRST, TWO THOUSAND THIRTEEN, PAYMENTS  BY  GOVERNMENT  AGENCIES  FOR
SERVICES  PROVIDED  BY  CERTIFIED  HOME HEALTH AGENCIES, EXCEPT FOR SUCH
SERVICES  PROVIDED  TO  CHILDREN  UNDER  EIGHTEEN YEARS OF AGE AND OTHER
DISCREET GROUPS AS MAY BE DETERMINED BY  THE  COMMISSIONER  PURSUANT  TO
REGULATIONS,  SHALL  BE BASED ON EPISODIC PAYMENTS. IN ESTABLISHING SUCH
PAYMENTS, A STATEWIDE BASE PRICE SHALL BE ESTABLISHED FOR EACH SIXTY DAY
EPISODE OF CARE AND ADJUSTED BY A REGIONAL  WAGE  INDEX  FACTOR  AND  AN
INDIVIDUAL PATIENT CASE MIX INDEX. SUCH EPISODIC PAYMENTS MAY BE FURTHER
ADJUSTED  FOR  LOW UTILIZATION CASES AND TO REFLECT A PERCENTAGE LIMITA-
TION OF THE COST FOR HIGH-UTILIZATION CASES THAT EXCEED OUTLIER  THRESH-
OLDS OF SUCH PAYMENTS.
  (B)  INITIAL  BASE  YEAR  EPISODIC PAYMENTS SHALL BE BASED ON MEDICAID
PAID CLAIMS, AS DETERMINED AND ADJUSTED BY THE COMMISSIONER  TO  ACHIEVE
SAVINGS COMPARABLE TO THE PRIOR STATE FISCAL YEAR, FOR SERVICES PROVIDED
BY  ALL  CERTIFIED  HOME  HEALTH  AGENCIES IN THE BASE YEAR TWO THOUSAND
NINE. SUBSEQUENT BASE YEAR EPISODIC PAYMENTS MAY BE  BASED  ON  MEDICAID
PAID  CLAIMS FOR SERVICES PROVIDED BY ALL CERTIFIED HOME HEALTH AGENCIES
IN A BASE YEAR SUBSEQUENT TO TWO THOUSAND NINE,  AS  DETERMINED  BY  THE
COMMISSIONER, PROVIDED, HOWEVER, THAT SUCH BASE YEAR ADJUSTMENT SHALL BE
MADE  NOT  LESS  FREQUENTLY THAN EVERY THREE YEARS.  IN DETERMINING CASE
MIX, EACH PATIENT SHALL BE CLASSIFIED USING A SYSTEM BASED  ON  MEASURES
WHICH MAY INCLUDE, BUT NOT LIMITED TO, CLINICAL AND FUNCTIONAL MEASURES,
AS  REPORTED  ON  THE  FEDERAL  OUTCOME  AND  ASSESSMENT INFORMATION SET
(OASIS), AS MAY BE AMENDED.
  (C) THE COMMISSIONER MAY REQUIRE AGENCIES TO COLLECT  AND  SUBMIT  ANY
DATA  REQUIRED  TO  IMPLEMENT  THIS  SUBDIVISION.  THE  COMMISSIONER MAY
PROMULGATE REGULATIONS TO IMPLEMENT THE PROVISIONS OF THIS SUBDIVISION.
  S 5. Intentionally omitted.
  S 6. Section 368-d of the social services law is amended by adding two
new subdivisions 4 and 5 to read as follows:
  4.  THE COMMISSIONER OF HEALTH IS AUTHORIZED TO CONTRACT WITH  ONE  OR
MORE ENTITIES TO CONDUCT A STUDY TO DETERMINE ACTUAL DIRECT AND INDIRECT
COSTS  INCURRED  BY  PUBLIC  SCHOOL  DISTRICTS  AND STATE OPERATED/STATE
SUPPORTED SCHOOLS WHICH OPERATE PURSUANT TO ARTICLE EIGHTY-FIVE,  EIGHT-
Y-SEVEN  OR EIGHTY-EIGHT OF THE EDUCATION LAW FOR MEDICAL CARE, SERVICES
AND SUPPLIES, INCLUDING RELATED SPECIAL EDUCATION SERVICES  AND  SPECIAL
TRANSPORTATION, FURNISHED TO CHILDREN WITH HANDICAPPING CONDITIONS.
  5.  THE COMMISSIONER SHALL EVALUATE THE RESULTS OF THE STUDY CONDUCTED
PURSUANT TO SUBDIVISION FOUR OF THIS SECTION TO DETERMINE,  AFTER  IDEN-
TIFICATION OF ACTUAL DIRECT AND INDIRECT COSTS INCURRED BY PUBLIC SCHOOL
DISTRICTS  AND  STATE  OPERATED/STATE  SUPPORTED  SCHOOLS, WHETHER IT IS
ADVISABLE TO CLAIM FEDERAL REIMBURSEMENT  FOR  EXPENDITURES  UNDER  THIS
SECTION  AS  CERTIFIED PUBLIC EXPENDITURES. IN THE EVENT SUCH CLAIMS ARE
SUBMITTED,  IF  FEDERAL  REIMBURSEMENT  RECEIVED  FOR  CERTIFIED  PUBLIC
EXPENDITURES ON BEHALF OF MEDICAL ASSISTANCE RECIPIENTS WHOSE ASSISTANCE
AND  CARE ARE THE RESPONSIBILITY OF A SOCIAL SERVICES DISTRICT IN A CITY
WITH A POPULATION OF OVER TWO MILLION, RESULTS  IN  A  DECREASE  IN  THE
STATE  SHARE  OF  ANNUAL  EXPENDITURES PURSUANT TO THIS SECTION FOR SUCH
RECIPIENTS, THEN TO THE EXTENT THAT THE AMOUNT OF ANY SUCH DECREASE WHEN
COMBINED WITH ANY DECREASE IN THE STATE  SHARE  OF  ANNUAL  EXPENDITURES
DESCRIBED  IN SUBDIVISION FIVE OF SECTION THREE HUNDRED SIXTY-EIGHT-E OF
THIS TITLE EXCEEDS FIFTY MILLION DOLLARS, THE  EXCESS  AMOUNT  SHALL  BE
TRANSFERRED  TO  SUCH CITY. ANY SUCH EXCESS AMOUNT TRANSFERRED SHALL NOT
BE CONSIDERED A REVENUE RECEIVED BY SUCH  SOCIAL  SERVICES  DISTRICT  IN
DETERMINING  THE  DISTRICT'S  ACTUAL MEDICAL ASSISTANCE EXPENDITURES FOR

S. 2809--C                         121

PURPOSES  OF  PARAGRAPH  (B)  OF  SECTION  ONE  OF  PART  C  OF  CHAPTER
FIFTY-EIGHT OF THE LAWS OF TWO THOUSAND FIVE.
  S 7. Section 368-e of the social services law is amended by adding two
new subdivisions 3 and 4 to read as follows:
  3.    THE COMMISSIONER OF HEALTH IS AUTHORIZED TO CONTRACT WITH ONE OR
MORE ENTITIES TO CONDUCT A STUDY TO DETERMINE ACTUAL DIRECT AND INDIRECT
COSTS INCURRED BY COUNTIES FOR  MEDICAL  CARE,  SERVICES  AND  SUPPLIES,
INCLUDING RELATED SPECIAL EDUCATION SERVICES AND SPECIAL TRANSPORTATION,
FURNISHED TO PRE-SCHOOL CHILDREN WITH HANDICAPPING CONDITIONS.
  4.  THE COMMISSIONER SHALL EVALUATE THE RESULTS OF THE STUDY CONDUCTED
PURSUANT TO SUBDIVISION THREE OF THIS SECTION TO DETERMINE, AFTER  IDEN-
TIFICATION  OF ACTUAL DIRECT AND INDIRECT COSTS INCURRED BY COUNTIES FOR
MEDICAL CARE, SERVICES, AND SUPPLIES FURNISHED  TO  PRE-SCHOOL  CHILDREN
WITH  HANDICAPPING  CONDITIONS, WHETHER IT IS ADVISABLE TO CLAIM FEDERAL
REIMBURSEMENT FOR EXPENDITURES UNDER THIS SECTION  AS  CERTIFIED  PUBLIC
EXPENDITURES.    IN  THE  EVENT  SUCH  CLAIMS  ARE SUBMITTED, IF FEDERAL
REIMBURSEMENT RECEIVED FOR CERTIFIED PUBLIC EXPENDITURES  ON  BEHALF  OF
MEDICAL  ASSISTANCE RECIPIENTS WHOSE ASSISTANCE AND CARE ARE THE RESPON-
SIBILITY OF A SOCIAL SERVICES DISTRICT IN A CITY WITH  A  POPULATION  OF
OVER  TWO  MILLION,  RESULTS  IN A DECREASE IN THE STATE SHARE OF ANNUAL
EXPENDITURES PURSUANT TO THIS SECTION FOR SUCH RECIPIENTS, THEN  TO  THE
EXTENT  THAT  THE  AMOUNT  OF  ANY  SUCH DECREASE WHEN COMBINED WITH ANY
DECREASE IN THE STATE SHARE OF ANNUAL EXPENDITURES DESCRIBED IN SUBDIVI-
SION SIX OF SECTION THREE HUNDRED SIXTY-EIGHT-D OF  THIS  TITLE  EXCEEDS
FIFTY  MILLION  DOLLARS,  THE EXCESS AMOUNT SHALL BE TRANSFERRED TO SUCH
CITY. ANY SUCH EXCESS AMOUNT  TRANSFERRED  SHALL  NOT  BE  CONSIDERED  A
REVENUE  RECEIVED  BY  SUCH  SOCIAL SERVICES DISTRICT IN DETERMINING THE
DISTRICT'S ACTUAL MEDICAL ASSISTANCE EXPENDITURES FOR PURPOSES OF  PARA-
GRAPH (B) OF SECTION ONE OF PART C OF CHAPTER FIFTY-EIGHT OF THE LAWS OF
TWO THOUSAND FIVE.
  S  7-a.  Subdivision  1  of section 3-d of part B of chapter 58 of the
laws of 2010, amending the public health law relating to duties  of  the
department  and  cardiac  service  information,  is  amended  to read as
follows:
  1. Notwithstanding any provision of law, rule  or  regulation  to  the
contrary,  and  subject to the availability of federal financial partic-
ipation, for periods on and  after  April  1,  2010,  payments  made  to
managed care providers sponsored by a public benefit corporation located
in a city of more than one million persons which provide coverage prima-
rily  to  Medicaid patients in accordance with sections 364-j and 369-ee
of the social services law may, at the election of the  social  services
district,  be  increased up to an annual aggregate amount of two hundred
million dollars; provided,  however  that,  notwithstanding  the  social
services district Medicaid cap provisions of part C of chapter 58 of the
laws  of  2005,  such  social services district shall be responsible for
payment of  one  hundred  percent  of  the  non-federal  share  of  such
increase,  and  provided  further,  however, that such payment increases
shall not be applied to  payments  related  to  the  Medicaid  advantage
program  [or the HIV special needs plan]. Social services district fund-
ing of the non-federal share of any such payments shall be deemed to  be
voluntary  for  purposes  of  the  increased  federal medical assistance
percentage provisions of the American Recovery and Reinvestment  Act  of
2009;  provided however that, in the event the federal Centers for Medi-
care and  Medicaid  Services  determines  that  such  non-federal  share
payments  are  not  voluntary  payments  for  purposes  of such Act, the
provisions of this section shall be null and void.

S. 2809--C                         122

  S 8. Paragraph d of subdivision 20  of  section  2808  of  the  public
health  law  is  amended  by  adding  a  new  paragraph (iii) to read as
follows:
  (III)  NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRARY, THE
PROVISIONS SET FORTH IN THIS  PARAGRAPH  ARE  HEREBY  SUSPENDED  THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND TWELVE.
  S  9.  Paragraph  (b)  of  subdivision 11 of section 272 of the public
health law, as added by section 36 of part C of chapter 58 of  the  laws
of 2009, is amended to read as follows:
  (b)  The  commissioner  may designate a pharmaceutical manufacturer as
one with whom the  commissioner  is  negotiating  or  has  negotiated  a
manufacturer  agreement, and all of the drugs it manufactures or markets
shall be included in the preferred drug program.  The  commissioner  may
negotiate directly with a pharmaceutical manufacturer for rebates relat-
ing to any or all of the drugs it manufactures or markets. A manufactur-
er  agreement  shall  designate  any or all of the drugs manufactured or
marketed by the pharmaceutical manufacturer as being  preferred  or  non
preferred  drugs. When a pharmaceutical manufacturer has been designated
by the commissioner under this paragraph but THE  COMMISSIONER  has  not
reached  a  manufacturer agreement with the pharmaceutical manufacturer,
then THE COMMISSIONER MAY DESIGNATE SOME OR all of  the  drugs  manufac-
tured  or  marketed by the pharmaceutical manufacturer [shall be] AS non
preferred drugs. However, notwithstanding this paragraph, any drug  that
is  selected  to  be  on  the preferred drug list under paragraph (b) of
subdivision ten of this section on grounds that it is significantly more
clinically effective and safer than other drugs in its therapeutic class
shall be a preferred drug.
  S 10. Intentionally omitted.
  S 11. Intentionally Omitted.
  S 12. Subdivision 22 of section 6802 of the education law, as added by
chapter 563 of the laws of 2008, is amended to read as follows:
  22. "Administer", for the purpose of section sixty-eight  hundred  one
of  this article, means the direct application of an immunizing agent to
[adults] PERSONS EIGHTEEN YEARS OF AGE OR OLDER, whether  by  injection,
ingestion  or  any  other means, pursuant to a patient specific order or
non-patient specific regimen prescribed or ordered issued by a physician
or certified nurse practitioner who has a practice site in the county in
which the immunization is administered.  However if the county where the
immunization is to be administered  has  a  population  of  seventy-five
thousand or less, then the licensed physician or certified nurse practi-
tioner  may  be  in  an  adjoining  county. Such administration shall be
limited to immunizing  agents  [to  prevent  influenza  or  pneumococcal
disease]  RECOMMENDED  BY  THE  FEDERAL  CENTERS FOR DISEASE CONTROL AND
PREVENTION FOR PERSONS WHO ARE EIGHTEEN YEARS OF AGE OR OLDER, and medi-
cations required for emergency treatment of anaphylaxis.
  S 13. Subdivision 1 of section 271 of the public health law, as  added
by section 10 of part C of chapter 58 of the laws of 2005, is amended to
read as follows:
  1. There is hereby established in the department a pharmacy and thera-
peutics  committee.  The committee shall consist of [seventeen] EIGHTEEN
members, who shall be appointed by the commissioner and who shall  serve
three  year  terms;  except  that  for  the  initial appointments to the
committee, five members shall serve one year terms,  seven  shall  serve
two year terms, and five shall serve three year terms. Committee members
may  be  reappointed  upon  the completion of their terms. [No] WITH THE
EXCEPTION OF THE CHAIRPERSON, NO member of the  committee  shall  be  an

S. 2809--C                         123

employee  of  the  state or any subdivision of the state, other than for
his or her membership on the committee, except for employees  of  health
care  facilities or universities operated by the state, a public benefit
corporation, the State University of New York or municipalities.
  S  14.  Paragraphs  (d) and (e) of subdivision 2 of section 271 of the
public health law, as added by section 10 of part C of chapter 58 of the
laws of 2005, are amended, and a new paragraph (f) is added to  read  as
follows:
  (d) one person with expertise in drug utilization review who is either
a  health  care professional licensed under title eight of the education
law, is a pharmacologist or has a doctorate in pharmacology; [and]
  (e) three persons who shall be consumers or representatives of  organ-
izations  with  a  regional  or statewide constituency and who have been
involved in activities related to health care consumer advocacy, includ-
ing issues affecting Medicaid or EPIC recipients[.]; AND
  (F) A CHAIRPERSON DESIGNATED PURSUANT  TO  SUBDIVISION  FOUR  OF  THIS
SECTION.
  S  15.  Subdivision  4  of  section  271  of  the public health law is
REPEALED and a new subdivision 4 is added to read as follows:
  4. THE COMMISSIONER SHALL DESIGNATE A  MEMBER  OF  THE  DEPARTMENT  TO
SERVE AS CHAIRPERSON OF THE COMMITTEE.
  S  16. Subdivision 3 of section 272 of the public health law, as added
by section 10 of part C of chapter 58 of the laws of 2005, is amended to
read as follows:
  3. The commissioner shall  establish  performance  standards  for  the
program  that,  at a minimum, ensure that the preferred drug program and
the clinical drug review program provide  sufficient  technical  support
and  timely  responses  to  consumers, prescribers and pharmacists.  THE
COMMISSIONER MAY DESIGNATE A MEMBER OF THE  DEPARTMENT  TO  PERFORM  ANY
ACTIONS OF THE COMMISSIONER AUTHORIZED OR REQUIRED BY THIS SECTION.
  S  17.  Subdivision  10  of  section  272  of the public health law is
amended by adding a new paragraph (d) to read as follows:
  (D) NOTWITHSTANDING ANY PROVISION OF THIS SECTION TO THE CONTRARY, THE
COMMISSIONER MAY DESIGNATE THERAPEUTIC CLASSES OF  DRUGS  OR  INDIVIDUAL
DRUGS  AS  PREFERRED  PRIOR  TO  ANY REVIEW THAT MAY BE CONDUCTED BY THE
COMMITTEE PURSUANT TO THIS SECTION.
  S 18. Intentionally omitted.
  S 19. Intentionally omitted.
  S 20.  Paragraph (g) of subdivision 4 of section 365-a of  the  social
services  law,  as  amended by section 61 of part C of chapter 58 of the
laws of 2007, is amended to read as follows:
  (g) for eligible persons who are also beneficiaries under  part  D  of
title  XVIII of the federal social security act, drugs which are denomi-
nated as "covered part D drugs" under section 1860D-2(e) of  such  act[;
provided  however  that, for purposes of this paragraph, "covered part D
drugs" shall not mean atypical anti-psychotics, anti-depressants,  anti-
retrovirals  used  in the treatment of HIV/AIDS, or anti-rejection drugs
used for the treatment of organ and tissue transplants].
  S 21. Subdivision 12 of section  272  of  the  public  health  law  is
REPEALED.
  S 22. Intentionally omitted.
  S  23.  Paragraph  (g) of subdivision 2 of section 365-a of the social
services law, as amended by section 1 of part F of chapter  497  of  the
laws of 2008, is amended to read as follows:
  (g)  sickroom  supplies,  eyeglasses, prosthetic appliances and dental
prosthetic appliances furnished in accordance with  the  regulations  of

S. 2809--C                         124

the department[,]; provided FURTHER that: (I) the commissioner of health
is  authorized  to implement a preferred diabetic supply program wherein
the department of health will receive enhanced  rebates  from  preferred
manufacturers  of  glucometers and test strips, and may subject non-pre-
ferred manufacturers' glucometers and test strips to prior authorization
under section two hundred seventy-three of the public health  law;  (II)
ENTERAL  FORMULA  THERAPY  IS  LIMITED TO COVERAGE ONLY FOR NASOGASTRIC,
JEJUNOSTOMY, OR GASTROSTOMY TUBE FEEDING OR FOR TREATMENT OF  AN  INBORN
ERROR OF METABOLISM; (III) PRESCRIPTION FOOTWEAR AND INSERTS ARE LIMITED
TO  COVERAGE ONLY WHEN USED AS AN INTEGRAL PART OF A LOWER LIMB ORTHOTIC
APPLIANCE, AS PART OF A DIABETIC TREATMENT PLAN, OR  TO  ADDRESS  GROWTH
AND  DEVELOPMENT  PROBLEMS IN CHILDREN; AND (IV) COMPRESSION AND SUPPORT
STOCKINGS ARE LIMITED TO COVERAGE ONLY FOR  PREGNANCY  OR  TREATMENT  OF
VENOUS STASIS ULCERS;
  (G-1)  drugs provided on an in-patient basis, those drugs contained on
the list established by regulation of the commissioner of health  pursu-
ant  to  subdivision four of this section, and those drugs which may not
be dispensed without a prescription as required by  section  sixty-eight
hundred  ten  of  the education law and which the commissioner of health
shall determine to be reimbursable based upon such factors as the avail-
ability of such drugs or alternatives at low  cost  if  purchased  by  a
medicaid  recipient,  or the essential nature of such drugs as described
by such commissioner in regulations, provided, however, that such drugs,
exclusive of long-term maintenance drugs, shall be dispensed in  quanti-
ties no greater than a thirty day supply or one hundred doses, whichever
is  greater; provided further that the commissioner of health is author-
ized to require prior authorization for any  refill  of  a  prescription
when  less  than seventy-five percent of the previously dispensed amount
per fill should have been used were the product used as  normally  indi-
cated; PROVIDED FURTHER THAT THE COMMISSIONER OF HEALTH IS AUTHORIZED TO
REQUIRE  PRIOR  AUTHORIZATION  OF  PRESCRIPTIONS OF OPIOID ANALGESICS IN
EXCESS OF FOUR PRESCRIPTIONS IN A THIRTY-DAY PERIOD; medical  assistance
shall  not  include  any drug provided on other than an in-patient basis
for which a recipient is charged or a claim is made in  the  case  of  a
prescription  drug,  in excess of the maximum reimbursable amounts to be
established by  department  regulations  in  accordance  with  standards
established  by  the secretary of the United States department of health
and human  services,  or,  in  the  case  of  a  drug  not  requiring  a
prescription,  in  excess of the maximum reimbursable amount established
by the commissioner of health pursuant to paragraph (a)  of  subdivision
four of this section;
  S 24. Intentionally omitted.
  S  25.  Paragraph  (b) of subdivision 17 of section 2808 of the public
health law, as added by section 30 of part B of chapter 109 of the  laws
of 2010, is amended and a new paragraph (c) is added to read as follows:
  (b) Notwithstanding any inconsistent provision of law or regulation to
the contrary, for the state fiscal year beginning April first, two thou-
sand  ten  and ending March thirty-first, two thousand [eleven] FIFTEEN,
the commissioner shall not be required  to  revise  certified  rates  of
payment  established  pursuant to this article for rate periods prior to
April first, two thousand [eleven] FIFTEEN, based  on  consideration  of
rate  appeals  filed by residential health care facilities or based upon
adjustments to capital cost reimbursement as a result of approval by the
commissioner of an application for construction  under  section  twenty-
eight  hundred  two  of  this  article, in excess of an aggregate annual
amount of eighty million dollars for EACH such  state  fiscal  year.  In

S. 2809--C                         125

revising such rates within such fiscal limit, the commissioner shall, in
prioritizing  such  rate appeals, include consideration of which facili-
ties the commissioner determines are facing significant financial  hard-
ship  as  well  as  such  other considerations as the commissioner deems
appropriate and, further, the commissioner is authorized to  enter  into
agreements  with such facilities or any other facility to resolve multi-
ple pending rate appeals based upon a negotiated  aggregate  amount  and
may offset such negotiated aggregate amounts against any amounts owed by
the  facility  to the department, including, but not limited to, amounts
owed pursuant to section twenty-eight hundred seven-d of  this  article;
PROVIDED,  HOWEVER,  THAT THE COMMISSIONER'S AUTHORITY TO NEGOTIATE SUCH
AGREEMENTS RESOLVING  MULTIPLE  PENDING  RATE  APPEALS  AS  HEREINBEFORE
DESCRIBED SHALL CONTINUE ON AND AFTER APRIL FIRST, TWO THOUSAND FIFTEEN.
Rate adjustments made pursuant to this paragraph remain fully subject to
approval by the director of the budget in accordance with the provisions
of  subdivision  two of section twenty-eight hundred seven of this arti-
cle.
  (C) NOTWITHSTANDING ANY OTHER CONTRARY PROVISION OF LAW, RULE OR REGU-
LATION, FOR PERIODS ON AND AFTER APRIL FIRST, TWO  THOUSAND  ELEVEN  THE
COMMISSIONER  SHALL PROMULGATE REGULATIONS, AND MAY PROMULGATE EMERGENCY
REGULATIONS, ESTABLISHING PRIORITIES AND TIME FRAMES FOR PROCESSING RATE
APPEALS, INCLUDING RATE APPEALS FILED PRIOR TO APRIL FIRST, TWO THOUSAND
ELEVEN, WITHIN AVAILABLE ADMINISTRATIVE  RESOURCES;  PROVIDED,  HOWEVER,
THAT  SUCH  REGULATIONS SHALL NOT BE INCONSISTENT WITH THE PROVISIONS OF
PARAGRAPH (B) OF THIS SUBDIVISION.
  S 26. Notwithstanding any provision of law to the contrary and subject
to the availability of federal financial participation, for  periods  on
and  after  April 1, 2011, clinics certified pursuant to articles 16, 31
or 32 of the mental hygiene law shall be subject  to  targeted  Medicaid
reimbursement  rate reductions in accordance with the provisions of this
section. Such reductions shall be based on utilization thresholds  which
may  be  established  either  as  provider-specific  or patient-specific
thresholds. Provider-specific  thresholds  shall  be  based  on  average
patient  utilization  for a given provider in comparison to a peer based
standard to be determined for each service.  When applying  a  provider-
specific  threshold,  rates will be reduced on a prospective basis based
on the amount any provider  is  over  the  determined  threshold  level.
Patient-specific  thresholds  will  be based on annual thresholds deter-
mined for each service over which the per visit payment for  each  visit
in  excess of the standard during a twelve month period shall be reduced
by a pre-determined amount. The thresholds, peer based standards and the
payment reductions shall be determined by the department of health, with
the approval of the division of the budget, and in consultation with the
office of mental health, the office for people with developmental  disa-
bilities  and the office of alcoholism and substance abuse services, and
any such resulting rates shall be subject to certification by the appro-
priate commissioners pursuant to subdivision (a) of section 43.02 of the
mental hygiene law. The base period used  to  establish  the  thresholds
shall  be  the  2009  calendar  year.  The total annualized reduction in
payments shall be not more than $10,900,000 for Article 31 clinics,  not
more  than  $2,400,000  for  Article  16  clinics,  and  not  more  than
$13,250,000 for Article 32  clinics.  The  commissioner  of  health  may
promulgate regulations to implement the provisions of this section.
  S  27.  Paragraph  (h) of subdivision 2 of section 365-a of the social
services law, as amended by chapter 444 of  the  laws  of  1979  and  as

S. 2809--C                         126

relettered  by  chapter  478  of the laws of 1980, is amended to read as
follows:
  (h)  SPEECH THERAPY, AND WHEN PROVIDED AT THE DIRECTION OF A PHYSICIAN
OR NURSE PRACTITIONER, physical therapy [and relative] INCLUDING RELATED
rehabilitative services [when provided at the direction of a  physician]
AND  OCCUPATIONAL THERAPY; PROVIDED, HOWEVER, THAT SPEECH THERAPY, PHYS-
ICAL THERAPY AND OCCUPATIONAL THERAPY EACH SHALL BE LIMITED TO  COVERAGE
OF  TWENTY  VISITS  PER YEAR; SUCH LIMITATION SHALL NOT APPLY TO PERSONS
WITH DEVELOPMENTAL DISABILITIES;
  S 28. Section 3614 of the public health law is amended by adding a new
subdivision 2-a to read as follows:
  2-A. NOTWITHSTANDING ANY CONTRARY LAW, RULE OR  REGULATION,  FOR  RATE
PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND ELEVEN, MEDICAID RATES OF
PAYMENTS  FOR  SERVICES  PROVIDED  BY CERTIFIED HOME HEALTH AGENCIES, BY
LONG TERM HOME HEALTH CARE PROGRAMS OR BY  AN  AIDS  HOME  CARE  PROGRAM
SHALL  NOT  REFLECT  A  SEPARATE  PAYMENT FOR HOME CARE NURSING SERVICES
PROVIDED TO PATIENTS DIAGNOSED WITH ACQUIRED IMMUNE DEFICIENCY  SYNDROME
(AIDS).
  S 29. Intentionally omitted.
  S 30. Intentionally omitted.
  S 31. Intentionally omitted.
  S  32. Subparagraph (i) of paragraph (b-1) of subdivision 1 of section
2807-c of the public health law, as amended by section 10 of part  C  of
chapter 58 of the laws of 2010, is amended to read as follows:
  (i)  For  patients  discharged  on  and  after January first, nineteen
hundred ninety-seven and prior to January first, two thousand and on and
after January first, two thousand, payments  to  general  hospitals  for
reimbursement of inpatient hospital services provided to patients eligi-
ble  for  payments pursuant to the workers' compensation law, the volun-
teer firefighters' benefit law, the volunteer ambulance workers' benefit
law, and the comprehensive motor vehicle insurance reparations act shall
be at the rates of payment determined pursuant to this section for state
governmental agencies, excluding  adjustments  pursuant  to  subdivision
fourteen-f  of this section and subdivision thirty-three of this section
[and], excluding such further reductions to such payments as are enacted
as part of the state budget for the state fiscal year  commencing  April
first,  two  thousand  ten AND EXCLUDING SUCH FURTHER REDUCTIONS TO SUCH
PAYMENTS AS ARE ENACTED AS PART OF THE STATE  BUDGET  FOR  STATE  FISCAL
YEARS COMMENCING ON AND AFTER APRIL FIRST, TWO THOUSAND ELEVEN.
  S 33. Intentionally omitted.
  S  34. The public health law is amended by adding a new section 2806-a
to read as follows:
  S 2806-A. TEMPORARY OPERATOR.  1. FOR THE PURPOSES  OF  THIS  SECTION:
(A) THE TERM "ESTABLISHED OPERATOR" SHALL MEAN THE OPERATOR OF A GENERAL
HOSPITAL  OR A DIAGNOSTIC AND TREATMENT CENTER THAT HAS BEEN ESTABLISHED
AND ISSUED AN OPERATING CERTIFICATE AS SUCH PURSUANT  TO  THIS  ARTICLE;
AND  (B)  THE  TERM "TEMPORARY OPERATOR" SHALL MEAN ANY PERSON OR ENTITY
THAT:
  (I) AGREES TO OPERATE THE GENERAL HOSPITAL OR A DIAGNOSTIC AND  TREAT-
MENT  CENTER  ON A TEMPORARY BASIS IN THE BEST INTERESTS OF THE PATIENTS
AND THE COMMUNITY SERVED BY THE GENERAL HOSPITAL OR  BY  THE  DIAGNOSTIC
AND TREATMENT CENTER; AND
  (II) HAS DEMONSTRATED THAT HE OR SHE HAS THE CHARACTER, COMPETENCE AND
FINANCIAL  ABILITY TO OPERATE THE GENERAL HOSPITAL OR THE DIAGNOSTIC AND
TREATMENT CENTER IN COMPLIANCE WITH APPLICABLE STANDARDS.

S. 2809--C                         127

  2. (A) WHEN A STATEMENT OF DEFICIENCIES HAS BEEN ISSUED BY THE DEPART-
MENT AND UPON A DETERMINATION  BY  THE  COMMISSIONER  THAT  THERE  EXIST
SIGNIFICANT  MANAGEMENT  FAILURES, INCLUDING BUT NOT LIMITED TO ADMINIS-
TRATIVE, OPERATIONAL OR CLINICAL DEFICIENCIES OR FINANCIAL  INSTABILITY,
IN  A  GENERAL HOSPITAL OR IN A DIAGNOSTIC AND TREATMENT CENTER THAT (I)
SERIOUSLY ENDANGER THE LIFE, HEALTH OR SAFETY OF PATIENTS OR (II)  JEOP-
ARDIZE  EXISTING  OR  CONTINUED  ACCESS TO NECESSARY SERVICES WITHIN THE
COMMUNITY, HE OR SHE SHALL APPOINT A TEMPORARY OPERATOR TO  ASSUME  SOLE
CONTROL  OVER AND SOLE RESPONSIBILITY FOR THE OPERATIONS OF THAT GENERAL
HOSPITAL OR DIAGNOSTIC AND TREATMENT CENTER. THE APPOINTMENT OF A TEMPO-
RARY OPERATOR SHALL BE IN ADDITION TO ANY  OTHER  REMEDIES  PROVIDED  BY
LAW.
  (B) THE ESTABLISHED OPERATOR OF A GENERAL HOSPITAL OR A DIAGNOSTIC AND
TREATMENT  CENTER  MAY AT ANY TIME REQUEST THE COMMISSIONER TO APPOINT A
TEMPORARY OPERATOR. UPON RECEIVING SUCH A REQUEST, THE COMMISSIONER MAY,
IF HE OR SHE DETERMINES THAT SUCH AN ACTION IS NECESSARY TO  RESTORE  OR
ENSURE  THE  PROVISION  OF  QUALITY  CARE TO THE PATIENTS, ENTER INTO AN
AGREEMENT WITH THE ESTABLISHED OPERATOR FOR THE APPOINTMENT OF A  TEMPO-
RARY  OPERATOR  TO  ASSUME SOLE CONTROL OVER AND SOLE RESPONSIBILITY FOR
THE OPERATIONS OF THAT GENERAL  HOSPITAL  OR  DIAGNOSTIC  AND  TREATMENT
CENTER.
  3.  A  TEMPORARY OPERATOR APPOINTED PURSUANT TO THIS SECTION SHALL USE
HIS OR HER BEST  EFFORTS  TO  CORRECT  OR  ELIMINATE  ANY  DEFICIENCIES,
MANAGEMENT  FAILURES OR FINANCIAL INSTABILITY IN THE GENERAL HOSPITAL OR
DIAGNOSTIC AND TREATMENT CENTER. SUCH CORRECTION OR ELIMINATION OF DEFI-
CIENCIES, MANAGEMENT FAILURES OR FINANCIAL INSTABILITY SHALL NOT INCLUDE
MAJOR ALTERATIONS OF THE PHYSICAL STRUCTURE OF THE FACILITY. DURING  THE
TERM  OF  HIS  OR HER APPOINTMENT, THE TEMPORARY OPERATOR SHALL HAVE THE
AUTHORITY TO DIRECT THE MANAGEMENT OF THE GENERAL HOSPITAL OR DIAGNOSTIC
AND TREATMENT CENTER IN ALL ASPECTS OF OPERATION AND SHALL  BE  AFFORDED
FULL  ACCESS  TO THE ACCOUNTS AND RECORDS OF THE FACILITY. THE TEMPORARY
OPERATOR SHALL, DURING THIS PERIOD,  OPERATE  THE  GENERAL  HOSPITAL  OR
DIAGNOSTIC AND TREATMENT CENTER IN SUCH A MANNER AS TO ENSURE SAFETY AND
THE  QUALITY  OF  HEALTH  CARE  FOR THE PATIENTS. THE TEMPORARY OPERATOR
SHALL HAVE THE POWER TO LET CONTRACTS  THEREFOR  OR  INCUR  EXPENSES  ON
BEHALF  OF  THE  GENERAL  HOSPITAL  OR  DIAGNOSTIC AND TREATMENT CENTER,
PROVIDED  THAT  WHERE  INDIVIDUAL  ITEMS  OF  REPAIRS,  IMPROVEMENTS  OR
SUPPLIES  EXCEED  TEN  THOUSAND  DOLLARS,  THE  TEMPORARY OPERATOR SHALL
OBTAIN PRICE QUOTATIONS FROM  AT  LEAST  THREE  REPUTABLE  SOURCES.  THE
TEMPORARY  OPERATOR  SHALL NOT BE REQUIRED TO FILE ANY BOND. NO SECURITY
INTEREST IN ANY REAL OR PERSONAL PROPERTY  COMPRISING  THE  FACILITY  OR
CONTAINED  WITHIN THE FACILITY, OR IN ANY FIXTURE OF THE FACILITY, SHALL
BE IMPAIRED OR DIMINISHED IN PRIORITY BY THE TEMPORARY OPERATOR. NEITHER
THE TEMPORARY OPERATOR NOR THE DEPARTMENT SHALL ENGAGE IN  ANY  ACTIVITY
THAT  CONSTITUTES A CONFISCATION OF PROPERTY WITHOUT THE PAYMENT OF FAIR
COMPENSATION.
  4. THE TEMPORARY OPERATOR SHALL BE ENTITLED TO A  REASONABLE  FEE,  AS
DETERMINED  BY  THE COMMISSIONER, AND NECESSARY EXPENSES INCURRED DURING
HIS OR HER PERFORMANCE AS TEMPORARY OPERATOR, TO BE PAID FROM THE REVEN-
UE OF THE GENERAL HOSPITAL OR DIAGNOSTIC  AND  TREATMENT  CENTER.    THE
TEMPORARY  OPERATOR SHALL COLLECT INCOMING PAYMENTS FROM ALL SOURCES AND
APPLY THEM FIRST TO THE REASONABLE FEE AND  TO  COSTS  INCURRED  IN  THE
PERFORMANCE OF HIS OR HER FUNCTIONS AS TEMPORARY OPERATOR. THE TEMPORARY
OPERATOR SHALL BE LIABLE ONLY IN HIS OR HER CAPACITY AS TEMPORARY OPERA-
TOR  FOR  INJURY  TO  PERSON AND PROPERTY BY REASON OF CONDITIONS OF THE
GENERAL HOSPITAL OR DIAGNOSTIC AND TREATMENT CENTER IN A CASE  WHERE  AN

S. 2809--C                         128

ESTABLISHED  OPERATOR  WOULD  HAVE BEEN LIABLE; HE OR SHE SHALL NOT HAVE
ANY LIABILITY IN HIS OR HER PERSONAL CAPACITY, EXCEPT FOR  GROSS  NEGLI-
GENCE AND INTENTIONAL ACTS.
  5. THE INITIAL TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR SHALL
NOT  EXCEED NINETY DAYS. ONE ADDITIONAL APPOINTMENT OF UP TO NINETY DAYS
MAY BE MADE IF THE COMMISSIONER DETERMINES  THAT  ADDITIONAL  TERMS  ARE
NECESSARY  TO CORRECT THE DEFICIENCIES, MANAGEMENT FAILURES OR FINANCIAL
INSTABILITY THAT REQUIRED THE APPOINTMENT  OF  THE  TEMPORARY  OPERATOR.
WITHIN  FOURTEEN  DAYS  PRIOR  TO  THE  TERMINATION  OF EACH TERM OF THE
APPOINTMENT OF THE TEMPORARY  OPERATOR,  THE  TEMPORARY  OPERATOR  SHALL
SUBMIT  TO THE COMMISSIONER A REPORT DESCRIBING THE ACTIONS TAKEN DURING
THE APPOINTMENT TO ADDRESS SUCH DEFICIENCIES, MANAGEMENT FAILURES AND/OR
FINANCIAL INSTABILITY. THE REPORT SHALL REFLECT BEST EFFORTS TO  PRODUCE
A FULL AND COMPLETE ACCOUNTING.
  6.  THE  COMMISSIONER  SHALL, UPON MAKING A DETERMINATION TO APPOINT A
TEMPORARY OPERATOR PURSUANT TO PARAGRAPH (A) OF SUBDIVISION TWO OF  THIS
SECTION, CAUSE THE ESTABLISHED OPERATOR OF THE GENERAL HOSPITAL OR DIAG-
NOSTIC  AND  TREATMENT  CENTER  TO  BE  NOTIFIED OF THE DETERMINATION BY
REGISTERED OR CERTIFIED MAIL ADDRESSED TO THE PRINCIPAL  OFFICE  OF  THE
ESTABLISHED OPERATOR. UPON RECEIPT OF SUCH NOTIFICATION AT THE PRINCIPAL
OFFICE OF THE ESTABLISHED OPERATOR AND BEFORE THE EXPIRATION OF TEN DAYS
THEREAFTER, THE ESTABLISHED OPERATOR MAY REQUEST AN ADMINISTRATIVE HEAR-
ING  ON  THE  DETERMINATION TO BE HELD NO LATER THAN SIXTY DAYS FROM THE
DATE OF THE APPOINTMENT OF THE  TEMPORARY  OPERATOR.  ANY  SUCH  HEARING
SHALL  BE  STRICTLY LIMITED TO THE ISSUE OF WHETHER THE DETERMINATION OF
THE COMMISSIONER IS SUPPORTED BY SUBSTANTIAL EVIDENCE.
  7. NO PROVISION CONTAINED IN THIS SECTION SHALL BE DEEMED  TO  RELIEVE
THE  ESTABLISHED  OPERATOR  OR ANY OTHER PERSON OF ANY CIVIL OR CRIMINAL
LIABILITY INCURRED, OR ANY DUTY IMPOSED BY LAW, BY  REASON  OF  ACTS  OR
OMISSIONS  OF  THE ESTABLISHED OPERATOR OR ANY OTHER PERSON PRIOR TO THE
APPOINTMENT OF ANY TEMPORARY  OPERATOR  HEREUNDER;  NOR  SHALL  ANYTHING
CONTAINED IN THIS SECTION BE CONSTRUED TO SUSPEND DURING THE TERM OF THE
APPOINTMENT  OF THE TEMPORARY OPERATOR ANY OBLIGATION OF THE ESTABLISHED
OPERATOR OR ANY OTHER PERSON FOR THE PAYMENT OF TAXES OR OTHER OPERATING
AND MAINTENANCE EXPENSES OF THE FACILITY NOR OF THE ESTABLISHED OPERATOR
OR ANY OTHER PERSON FOR THE PAYMENT OF MORTGAGES OR LIENS.
  S 34-a. Subdivision 2 of section 364-m of the social services law,  as
added  by  section  25  of  part C of chapter 58 of the laws of 2009, is
amended to read as follows:
  2. By December first, two thousand nine, the  commissioner  of  health
shall  develop  and  implement  standards  of  certification for patient
centered medical homes for Medicaid fee-for-service and Medicaid managed
care, Family Health Plus and Child Health Plus programs.  In  developing
such  standards, the commissioner of health shall: (a) consider existing
standards developed by national accrediting and  professional  organiza-
tions;  and (b) consult with national and local organizations working on
medical home models, physicians, hospitals, clinics,  health  plans  and
consumers  and  their  representatives.    ON AND AFTER APRIL FIRST, TWO
THOUSAND ELEVEN, THE COMMISSIONER OF HEALTH SHALL ALLOW PATIENT CENTERED
MEDICAL HOME PROGRAMS TO BE CERTIFIED USING EXISTING STANDARDS DEVELOPED
BY NATIONAL ACCREDITING AND PROFESSIONAL  ORGANIZATIONS,  INCLUDING  BUT
NOT  LIMITED  TO: THE JOINT PRINCIPLES OF THE AMERICAN COLLEGE OF PHYSI-
CIANS ("ACP"); THE AMERICAN ACADEMY OF FAMILY PHYSICIANS  ("AAFP");  THE
AMERICAN  ACADEMY  OF  PEDIATRICS  ("AAP"); AND THE AMERICAN OSTEOPATHIC
ASSOCIATION ("AOA"); AND STANDARDS DEVELOPED BY THE  NATIONAL  COMMITTEE
FOR QUALITY ASSURANCE ("NCQA").

S. 2809--C                         129

  S  35.  The public health law is amended by adding a new article 29-AA
to read as follows:
                              ARTICLE 29-AA
                     PATIENT CENTERED MEDICAL HOMES
SECTION 2959-A. MULTIPAYOR PATIENT CENTERED MEDICAL HOME PROGRAM.
  S  2959-A.  MULTIPAYOR  PATIENT  CENTERED  MEDICAL  HOME PROGRAM.   1.
NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW, THE  COMMISSIONER  IS
AUTHORIZED  TO ESTABLISH A PROGRAM WHEREBY ENHANCED PAYMENTS ARE MADE TO
CLINICIANS AND CLINICS STATEWIDE THAT ARE CERTIFIED AS MEDICAL HOMES FOR
THE PURPOSE OF IMPROVING HEALTH CARE  OUTCOMES  AND  EFFICIENCY  THROUGH
PATIENT CARE CONTINUITY AND COORDINATION OF HEALTH SERVICES.
  2.  MEDICAL  HOMES  CERTIFIED  PURSUANT  TO  THIS  SECTION MAY PROVIDE
SERVICES TO:   RECIPIENTS ELIGIBLE FOR MEDICAL  ASSISTANCE  PURSUANT  TO
TITLE  ELEVEN OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW ("MEDICAID FEE-
FOR-SERVICE"); ENROLLEES ELIGIBLE FOR  MEDICAL  ASSISTANCE  PURSUANT  TO
SUCH  TITLE AND ENROLLED IN APPROVED MANAGED CARE ORGANIZATIONS PURSUANT
TO SECTION THREE HUNDRED SIXTY-FOUR-J OF SUCH TITLE  ("MEDICAID  MANAGED
CARE");  ENROLLEES  ELIGIBLE  FOR  FAMILY  HEALTH  PLUS  AND ENROLLED IN
APPROVED ORGANIZATIONS PURSUANT TO TITLE ELEVEN-D OF ARTICLE FIVE OF THE
SOCIAL SERVICES LAW ("FAMILY HEALTH PLUS"); ENROLLEES ELIGIBLE  FOR  THE
CHILD  HEALTH  INSURANCE  PROGRAM AND ENROLLED IN APPROVED ORGANIZATIONS
PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-FIVE OF THIS  CHAPTER  ("CHILD
HEALTH  PLUS  PROGRAM"); ENROLLEES AND SUBSCRIBERS OF COMMERCIAL MANAGED
CARE PLANS OPERATING  IN  ACCORDANCE  WITH  THE  PROVISIONS  OF  ARTICLE
FORTY-FOUR OF THIS CHAPTER OR BY HEALTH MAINTENANCE ORGANIZATIONS ORGAN-
IZED  AND OPERATING IN ACCORDANCE WITH ARTICLE FORTY-THREE OF THE INSUR-
ANCE LAW;  ENROLLEES  AND  SUBSCRIBERS  OF  OTHER  COMMERCIAL  INSURANCE
PRODUCTS; AND EMPLOYEES OF EMPLOYER-SPONSORED SELF-INSURED PLANS.
  3.  (A) IN ORDER TO PROMOTE IMPROVED QUALITY OF, AND ACCESS TO, HEALTH
CARE SERVICES AND PROMOTE IMPROVED CLINICAL OUTCOMES, IT IS  THE  POLICY
OF  THE  STATE  TO  ENCOURAGE COOPERATIVE, COLLABORATIVE AND INTEGRATIVE
ARRANGEMENTS AMONG PAYORS  OF  HEALTH  CARE  SERVICES  AND  HEALTH  CARE
SERVICES  PROVIDERS WHO MIGHT OTHERWISE BE COMPETITORS, UNDER THE ACTIVE
SUPERVISION OF THE COMMISSIONER. IT  IS  THE  INTENT  OF  THE  STATE  TO
SUPPLANT COMPETITION WITH SUCH ARRANGEMENTS ONLY TO THE EXTENT NECESSARY
TO  ACCOMPLISH THE PURPOSES OF THIS ARTICLE, AND TO PROVIDE STATE ACTION
IMMUNITY UNDER THE STATE AND FEDERAL ANTITRUST LAWS TO PAYORS OF  HEALTH
CARE  SERVICES  AND  HEALTH  CARE SERVICES PROVIDERS WITH RESPECT TO THE
PLANNING,  IMPLEMENTATION  AND  OPERATION  OF  THE  MULTIPAYOR   PATIENT
CENTERED MEDICAL HOME PROGRAM.
  (B)  THE COMMISSIONER OR HIS OR HER DULY AUTHORIZED REPRESENTATIVE MAY
ENGAGE IN APPROPRIATE  STATE  SUPERVISION  NECESSARY  TO  PROMOTE  STATE
ACTION  IMMUNITY  UNDER  THE  STATE  AND FEDERAL ANTITRUST LAWS, AND MAY
INSPECT OR REQUEST ADDITIONAL DOCUMENTATION FROM PAYORS OF  HEALTH  CARE
SERVICES AND HEALTH CARE SERVICES PROVIDERS TO VERIFY THAT MEDICAL HOMES
CERTIFIED PURSUANT TO THIS SECTION OPERATE IN ACCORDANCE WITH ITS INTENT
AND PURPOSE.
  4.  THE  COMMISSIONER IS AUTHORIZED TO PARTICIPATE IN, ACTIVELY SUPER-
VISE, FACILITATE AND APPROVE MULTIPLE PRIMARY CARE MEDICAL HOME COLLABO-
RATIVES AROUND THE STATE WITH HEALTH CARE SERVICES PROVIDERS, WHICH  MAY
INCLUDE  HOSPITALS,  DIAGNOSTIC AND TREATMENT CENTERS, AND PRIVATE PRAC-
TICES, AND PAYORS OF HEALTH CARE SERVICES, INCLUDING  EMPLOYERS,  HEALTH
PLANS AND INSURERS, TO ESTABLISH: (A) THE BOUNDARIES OF EACH PROGRAM AND
THE  PROVIDERS  ELIGIBLE TO PARTICIPATE; (B) PRACTICE STANDARDS FOR EACH
MEDICAL HOME PROGRAM CONSISTENT WITH  EXISTING  STANDARDS  DEVELOPED  BY
NATIONAL  ACCREDITING  AND PROFESSIONAL ORGANIZATIONS, INCLUDING BUT NOT

S. 2809--C                         130

LIMITED TO THE JOINT PRINCIPLES OF THE AMERICAN  COLLEGE  OF  PHYSICIANS
("ACP"),  THE AMERICAN ACADEMY OF FAMILY PHYSICIANS ("AAFP"), THE AMERI-
CAN ACADEMY OF PEDIATRICS ("AAP"), AND THE AMERICAN OSTEOPATHIC  ASSOCI-
ATION  ("AOA"),  AND  STANDARDS  DEVELOPED BY THE NATIONAL COMMITTEE FOR
QUALITY ASSURANCE ("NCQA");  (C)  METHODOLOGIES  BY  WHICH  PAYORS  WILL
PROVIDE  ENHANCED  RATES  OF PAYMENT TO CERTIFIED MEDICAL HOMES; AND (D)
METHODOLOGIES TO PAY ADDITIONAL AMOUNTS  FOR  MEDICAL  HOMES  THAT  MEET
SPECIFIC  PROCESS  OR  OUTCOME  STANDARDS ESTABLISHED BY EACH MULTIPAYOR
PATIENT CENTERED MEDICAL HOME COLLABORATIVE.
  5. THE COMMISSIONER IS AUTHORIZED TO ESTABLISH AN  ADVISORY  GROUP  OF
STATE  AGENCIES AND STAKEHOLDERS, SUCH AS PROFESSIONAL ORGANIZATIONS AND
ASSOCIATIONS, TO IDENTIFY LEGAL AND/OR ADMINISTRATIVE  BARRIERS  TO  THE
SHARING  OF CARE MANAGEMENT AND CARE COORDINATION SERVICES AMONG PARTIC-
IPATING HEALTH CARE SERVICES PROVIDERS AND TO MAKE  RECOMMENDATIONS  FOR
STATUTORY AND/OR REGULATORY CHANGES TO ADDRESS SUCH BARRIERS.
  6.  PATIENT,  PAYOR AND HEALTH CARE SERVICES PROVIDER PARTICIPATION IN
THE MULTIPAYOR PATIENT CENTERED MEDICAL  HOME  PROGRAM  SHALL  BE  ON  A
VOLUNTARY BASIS.
  7.  CLINICS  AND CLINICIANS PARTICIPATING UNDER THE ADIRONDACK MEDICAL
HOME MULTIPAYOR DEMONSTRATION PROGRAM ESTABLISHED  PURSUANT  TO  SECTION
TWENTY-NINE HUNDRED FIFTY-NINE OF THIS CHAPTER, OR THE STATEWIDE PATIENT
CENTERED  MEDICAL  HOME  PROGRAM  ESTABLISHED  PURSUANT TO SECTION THREE
HUNDRED SIXTY-FOUR-M OF THE SOCIAL SERVICES LAW, ARE  NOT  ELIGIBLE  FOR
ENHANCED PAYMENTS PURSUANT TO THIS SECTION.
  8.  SUBJECT  TO  THE  AVAILABILITY  OF  FUNDING  AND FEDERAL FINANCIAL
PARTICIPATION, THE COMMISSIONER IS AUTHORIZED:
  (A) TO PAY ENHANCED RATES OF PAYMENT UNDER  MEDICAID  FEE-FOR-SERVICE,
MEDICAID MANAGED CARE, FAMILY HEALTH PLUS AND CHILD HEALTH PLUS TO CLIN-
ICS  AND CLINICIANS THAT ARE CERTIFIED AS PATIENT CENTERED MEDICAL HOMES
UNDER THIS TITLE;
  (B) TO PAY ADDITIONAL AMOUNTS FOR MEDICAL  HOMES  THAT  MEET  SPECIFIC
PROCESS  OR OUTCOME STANDARDS SPECIFIED BY THE COMMISSIONER IN CONSULTA-
TION WITH EACH MULTIPAYOR PATIENT CENTERED MEDICAL  HOME  COLLABORATIVE;
AND
  (C) TO TEST NEW MODELS OF PAYMENT TO HIGH VOLUME MEDICAID PRIMARY CARE
MEDICAL  HOME  PRACTICES  THAT INCORPORATE RISK ADJUSTED GLOBAL PAYMENTS
COMBINED WITH CARE MANAGEMENT AND PAY FOR PERFORMANCE ADJUSTMENTS.
  9. (A) THE COMMISSIONER IS AUTHORIZED TO CONTRACT  WITH  ONE  OR  MORE
ENTITIES  TO  ASSIST  THE  STATE  IN IMPLEMENTING THE PROVISIONS OF THIS
SECTION. SUCH ENTITY OR ENTITIES SHALL BE THE SAME  ENTITY  OR  ENTITIES
CHOSEN  TO ASSIST IN THE IMPLEMENTATION OF THE HEALTH HOME PROVISIONS OF
SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW.   RESPON-
SIBILITIES OF THE CONTRACTOR SHALL INCLUDE BUT NOT BE LIMITED TO: DEVEL-
OPING  RECOMMENDATIONS  WITH  RESPECT  TO PROGRAM POLICY, REIMBURSEMENT,
SYSTEM REQUIREMENTS, REPORTING REQUIREMENTS, EVALUATION  PROTOCOLS,  AND
PROVIDER  AND  PATIENT  ENROLLMENT;  PROVIDING  TECHNICAL  ASSISTANCE TO
POTENTIAL MEDICAL HOME AND HEALTH HOME PROVIDERS; DATA COLLECTION;  DATA
SHARING; PROGRAM EVALUATION, AND PREPARATION OF REPORTS.
  (B) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE HUNDRED
TWELVE  AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTION
ONE HUNDRED FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR ANY OTHER LAW,
THE COMMISSIONER IS AUTHORIZED TO ENTER INTO  A  CONTRACT  OR  CONTRACTS
UNDER  PARAGRAPH  (A)  OF  THIS SUBDIVISION WITHOUT A COMPETITIVE BID OR
REQUEST FOR PROPOSAL PROCESS, PROVIDED, HOWEVER, THAT:
  (I) THE DEPARTMENT SHALL POST ON ITS WEBSITE, FOR A PERIOD OF NO  LESS
THAN THIRTY DAYS:

S. 2809--C                         131

  (1)  A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT TO
THE CONTRACT OR CONTRACTS;
  (2) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (3)  THE PERIOD OF TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY SEEK
SELECTION, WHICH SHALL BE NO LESS THAN THIRTY DAYS AFTER  SUCH  INFORMA-
TION IS FIRST POSTED ON THE WEBSITE; AND
  (4)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR  MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (II) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
COMMISSIONER; AND
  (III) THE COMMISSIONER SHALL SELECT  SUCH  CONTRACTOR  OR  CONTRACTORS
THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE PURPOSES OF
THIS SECTION.
  S  35-a.  Subparagraph  (v)  of  subparagraph (b) of subdivision 35 of
section 2807-c of the public health law is amended to read as follows:
  (v) FOR THE PERIOD JULY FIRST, TWO THOUSAND TEN THROUGH MARCH  THIRTY-
FIRST TWO THOUSAND TWELVE, [S] Such regulations shall incorporate quali-
ty  related measures pertaining to potentially preventable complications
and re-admissions (PPRs) and provide for  rate  adjustments  or  payment
disallowances  related  to PPRs, which shall be calculated in accordance
with methodologies as determined by the commissioner, provided, however,
that such methodologies shall be based on a risk adjusted comparison  of
the  actual and the expected number of PPRs in a given hospital and with
benchmarks established by the commissioner  and  provided  further  that
such rate adjustments or payment disallowances shall result in an aggre-
gate  reduction in Medicaid payments of no less than thirty-five million
dollars for the period July first, two thousand ten through March  thir-
ty-first,  two  thousand  eleven  and  no  less than forty-seven million
dollars for the period April first, two thousand  eleven  through  March
thirty-first,  two thousand twelve, PROVIDED FURTHER THAT SUCH AGGREGATE
REDUCTIONS SHALL BE OFFSET BY MEDICAID PAYMENT REDUCTIONS OCCURRING AS A
RESULT OF DECREASED READMISSIONS DURING THE PERIOD JULY FIRST, TWO THOU-
SAND TEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND ELEVEN AND THE  PERIOD
APRIL  FIRST,  TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND TWELVE,; and provided  further  that  the  regulations  promulgated
pursuant  to  this  subparagraph  shall  be  effective on and after July
first, two thousand ten, and provided further,  however,  that  for  the
period  July  first,  two  thousand  ten through March thirty-first, two
thousand twelve, such rate adjustments or  payment  disallowances  shall
not apply to behavioral health PPRs; or to readmissions that occur on or
after  fifteen  days  following  an  initial admission. By no later than
April first, two thousand  eleven  the  commissioner  shall  enter  into
consultations with representatives of the health care facilities subject
to  this section regarding potential prospective revisions to applicable
methodologies and benchmarks set forth in regulations issued pursuant to
this subparagraph;
  S 36. Subparagraph (xi) of paragraph (b) of subdivision 35 of  section
2807-c  of  the  public  health  law, as added by section 2 of part C of
chapter 58 of the laws of 2009, is amended and three  new  subparagraphs
(xii), (xiii) and (xiv) are added to read as follows:
  (xi)  Rates for teaching general hospitals shall include reimbursement
for direct and indirect graduate medical education as defined and calcu-
lated pursuant to such regulations. In addition, such regulations  shall
specify  the  reports  and  information  required by the commissioner to

S. 2809--C                         132

assess the cost, quality and health system needs for  medical  education
provided[.];
  (XII)  SUCH  REGULATIONS  MAY  INCORPORATE  QUALITY  RELATED  MEASURES
PERTAINING TO  POTENTIALLY  PREVENTABLE  CONDITIONS  AND  COMPLICATIONS,
INCLUDING,  BUT  NOT  LIMITED  TO,  DISEASES  OR  COMPLICATIONS  OF CARE
ACQUIRED IN THE HOSPITAL AND INJURIES SUSTAINED IN THE HOSPITAL;
  (XIII) SUCH  REGULATIONS  MAY  INCORPORATE  QUALITY  RELATED  MEASURES
PERTAINING  TO  THE  INAPPROPRIATE  USE  OF  CERTAIN MEDICAL PROCEDURES,
INCLUDING, BUT NOT LIMITED  TO,  CESAREAN  DELIVERIES,  CORONARY  ARTERY
BYPASS GRAFTS AND PERCUTANEOUS CORONARY INTERVENTIONS;
  (XIV) SUCH REGULATIONS MAY IMPOSE A FEE ON GENERAL HOSPITAL SUFFICIENT
TO  COVER THE COSTS OF AUDITING THE INSTITUTIONAL COST REPORTS SUBMITTED
BY GENERAL HOSPITALS.
  S 37. The social services law is amended by adding a new section 365-l
to read as follows:
  S 365-L. HEALTH HOMES.  1. NOTWITHSTANDING ANY LAW, RULE OR REGULATION
TO THE CONTRARY, THE COMMISSIONER OF HEALTH IS AUTHORIZED, IN  CONSULTA-
TION  WITH  THE  COMMISSIONERS OF THE OFFICE OF MENTAL HEALTH, OFFICE OF
ALCOHOLISM AND SUBSTANCE ABUSE SERVICES,  AND  OFFICE  FOR  PEOPLE  WITH
DEVELOPMENTAL  DISABILITIES, TO (A) ESTABLISH, IN ACCORDANCE WITH APPLI-
CABLE FEDERAL LAW AND REGULATIONS, STANDARDS FOR THE PROVISION OF HEALTH
HOME SERVICES TO MEDICAID ENROLLEES WITH CHRONIC CONDITIONS, (B)  ESTAB-
LISH  PAYMENT  METHODOLOGIES  FOR  HEALTH HOME SERVICES BASED ON FACTORS
INCLUDING BUT NOT LIMITED TO THE COMPLEXITY OF THE CONDITIONS  PROVIDERS
WILL  BE  MANAGING,  THE ANTICIPATED AMOUNT OF PATIENT CONTACT NEEDED TO
MANAGE SUCH CONDITIONS, AND THE HEALTH CARE  COST  SAVINGS  REALIZED  BY
PROVISION  OF  HEALTH  HOME  SERVICES,  (C) ESTABLISH THE CRITERIA UNDER
WHICH A MEDICAID ENROLLEE WILL BE DESIGNATED AS BEING AN ELIGIBLE  INDI-
VIDUAL  WITH CHRONIC CONDITIONS FOR PURPOSES OF THIS PROGRAM, (D) ASSIGN
ANY MEDICAID ENROLLEE DESIGNATED AS AN ELIGIBLE INDIVIDUAL WITH  CHRONIC
CONDITIONS TO A PROVIDER OF HEALTH HOME SERVICES.
  2.  IN  ADDITION TO PAYMENTS MADE FOR HEALTH HOME SERVICES PURSUANT TO
SUBDIVISION ONE OF THIS SECTION, THE COMMISSIONER IS AUTHORIZED  TO  PAY
ADDITIONAL  AMOUNTS TO PROVIDERS OF HEALTH HOME SERVICES THAT MEET PROC-
ESS OR OUTCOME STANDARDS SPECIFIED BY THE COMMISSIONER.
  3. UNTIL SUCH TIME AS THE COMMISSIONER OBTAINS  NECESSARY  WAIVERS  OF
THE  FEDERAL SOCIAL SECURITY ACT, MEDICAID ENROLLEES ASSIGNED TO PROVID-
ERS OF HEALTH HOME SERVICES WILL BE ALLOWED TO OPT OUT OF SUCH SERVICES.
  4. PAYMENTS AUTHORIZED PURSUANT TO THIS  SECTION  WILL  BE  MADE  WITH
STATE  FUNDS ONLY, TO THE EXTENT THAT SUCH FUNDS ARE APPROPRIATED THERE-
FORE, UNTIL SUCH TIME AS FEDERAL FINANCIAL PARTICIPATION IN THE COSTS OF
SUCH SERVICES IS AVAILABLE.
  5. THE COMMISSIONER IS AUTHORIZED TO SUBMIT AMENDMENTS  TO  THE  STATE
PLAN  FOR  MEDICAL ASSISTANCE AND/OR SUBMIT ONE OR MORE APPLICATIONS FOR
WAIVERS OF THE FEDERAL SOCIAL SECURITY ACT, TO OBTAIN FEDERAL  FINANCIAL
PARTICIPATION  IN THE COSTS OF HEALTH HOME SERVICES PROVIDED PURSUANT TO
THIS SECTION, AND AS PROVIDED IN SUBDIVISION THREE OF THIS SECTION.
  6. NOTWITHSTANDING ANY LIMITATIONS IMPOSED BY  SECTION  THREE  HUNDRED
SIXTY-FOUR-L  OF  THIS  TITLE ON ENTITIES PARTICIPATING IN DEMONSTRATION
PROJECTS ESTABLISHED PURSUANT  TO  SUCH  SECTION,  THE  COMMISSIONER  IS
AUTHORIZED  TO  ALLOW  SUCH ENTITIES WHICH MEET THE REQUIREMENTS OF THIS
SECTION TO PROVIDE HEALTH HOME SERVICES.
  7. NOTWITHSTANDING ANY LAW, RULE, OR REGULATION TO THE  CONTRARY,  THE
COMMISSIONERS  OF THE DEPARTMENT OF HEALTH, THE OFFICE OF MENTAL HEALTH,
THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, AND THE OFFICE OF
ALCOHOLISM AND SUBSTANCE ABUSE SERVICES ARE AUTHORIZED TO JOINTLY ESTAB-

S. 2809--C                         133

LISH A SINGLE SET OF OPERATING AND REPORTING REQUIREMENTS AND  A  SINGLE
SET OF CONSTRUCTION AND SURVEY REQUIREMENTS FOR ENTITIES THAT:
  (A)  CAN  DEMONSTRATE EXPERIENCE IN THE DELIVERY OF HEALTH, AND MENTAL
HEALTH AND/OR ALCOHOL AND SUBSTANCE ABUSE SERVICES  AND/OR  SERVICES  TO
PERSONS WITH DEVELOPMENTAL DISABILITIES, AND THE CAPACITY TO OFFER INTE-
GRATED  DELIVERY  OF  SUCH  SERVICES  IN  EACH  LOCATION APPROVED BY THE
COMMISSIONER; AND
  (B) MEET THE STANDARDS ESTABLISHED PURSUANT TO SUBDIVISION ONE OF THIS
SECTION FOR PROVIDING AND RECEIVING PAYMENT FOR  HEALTH  HOME  SERVICES;
PROVIDED,  HOWEVER,  THAT  AN  ENTITY  MEETING THE STANDARDS ESTABLISHED
PURSUANT TO SUBDIVISION ONE OF THIS SECTION SHALL NOT BE REQUIRED TO  BE
AN INTEGRATED SERVICE PROVIDER PURSUANT TO THIS SUBDIVISION.
  IN  ESTABLISHING  A SINGLE SET OF OPERATING AND REPORTING REQUIREMENTS
AND A SINGLE SET OF CONSTRUCTION AND SURVEY  REQUIREMENTS  FOR  ENTITIES
DESCRIBED  IN  THIS  SUBDIVISION, THE COMMISSIONERS OF THE DEPARTMENT OF
HEALTH, THE OFFICE OF MENTAL HEALTH, THE OFFICE FOR PEOPLE WITH DEVELOP-
MENTAL DISABILITIES, AND THE OFFICE OF ALCOHOLISM  AND  SUBSTANCE  ABUSE
SERVICES  ARE  AUTHORIZED  TO  WAIVE  ANY REGULATORY REQUIREMENTS AS ARE
NECESSARY TO AVOID DUPLICATION OF REQUIREMENTS AND TO  ALLOW  THE  INTE-
GRATED DELIVERY OF SERVICES IN A RATIONAL AND EFFICIENT MANNER.
  8.  (A)  THE COMMISSIONER OF HEALTH IS AUTHORIZED TO CONTRACT WITH ONE
OR MORE ENTITIES TO ASSIST THE STATE IN IMPLEMENTING THE  PROVISIONS  OF
THIS  SECTION. SUCH ENTITY OR ENTITIES SHALL BE THE SAME ENTITY OR ENTI-
TIES CHOSEN TO ASSIST IN THE IMPLEMENTATION OF  THE  MULTIPAYOR  PATIENT
CENTERED  MEDICAL  HOME  PROGRAM PURSUANT TO SECTION TWENTY-NINE HUNDRED
FIFTY-NINE-A OF THE PUBLIC HEALTH LAW. RESPONSIBILITIES OF THE  CONTRAC-
TOR SHALL INCLUDE BUT NOT BE LIMITED TO: DEVELOPING RECOMMENDATIONS WITH
RESPECT TO PROGRAM POLICY, REIMBURSEMENT, SYSTEM REQUIREMENTS, REPORTING
REQUIREMENTS, EVALUATION PROTOCOLS, AND PROVIDER AND PATIENT ENROLLMENT;
PROVIDING TECHNICAL ASSISTANCE TO POTENTIAL MEDICAL HOME AND HEALTH HOME
PROVIDERS; DATA COLLECTION; DATA SHARING; PROGRAM EVALUATION, AND PREPA-
RATION OF REPORTS.
  (B) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE HUNDRED
TWELVE  AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTION
ONE HUNDRED FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR ANY OTHER LAW,
THE COMMISSIONER OF HEALTH IS AUTHORIZED TO ENTER  INTO  A  CONTRACT  OR
CONTRACTS  UNDER PARAGRAPH (A) OF THIS SUBDIVISION WITHOUT A COMPETITIVE
BID OR REQUEST FOR PROPOSAL PROCESS, PROVIDED, HOWEVER, THAT:
  (I) THE DEPARTMENT OF HEALTH SHALL POST ON ITS WEBSITE, FOR  A  PERIOD
OF NO LESS THAN THIRTY DAYS:
  (1)  A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT TO
THE CONTRACT OR CONTRACTS;
  (2) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (3) THE PERIOD OF TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY  SEEK
SELECTION,  WHICH  SHALL BE NO LESS THAN THIRTY DAYS AFTER SUCH INFORMA-
TION IS FIRST POSTED ON THE WEBSITE; AND
  (4) THE MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR  MAY  SEEK  SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (II)  ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE RECEIVED FROM
PROSPECTIVE CONTRACTORS IN TIMELY  FASHION  SHALL  BE  REVIEWED  BY  THE
COMMISSIONER OF HEALTH; AND
  (III)  THE  COMMISSIONER  OF  HEALTH  SHALL  SELECT SUCH CONTRACTOR OR
CONTRACTORS THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE
PURPOSES OF THIS SECTION.
  S 38. Intentionally omitted.
  S 39. Intentionally omitted.

S. 2809--C                         134

  S 40. Paragraph (u) of subdivision 2 of section 365-a  of  the  social
services  law,  as  amended by section 42 of part B of chapter 58 of the
laws of 2010, is amended to read as follows:
  (u)  screening,  brief  intervention,  and  referral  to treatment [in
hospital outpatient and emergency departments and free-standing diagnos-
tic and treatment centers] of individuals at risk  for  substance  abuse
including  referral  to the appropriate level of intervention and treat-
ment in a community setting; provided, however, that the  provisions  of
this  paragraph  relating to screening, brief intervention, and referral
to treatment  services  shall  not  take  effect  unless  all  necessary
approvals under federal law and regulation have been obtained to receive
federal financial participation in such costs.
  S  41.  Paragraphs (d) and (e) of subdivision 1 and paragraphs (c) and
(d) of subdivision 2 of section 4403-f of the public health  law,  para-
graph  (d) of subdivision 1 as amended by section 6 of part C of chapter
58 of the laws of 2007, paragraph (e) of subdivision  1  as  amended  by
section  65-d of part A of chapter 57 of the laws of 2006, paragraph (c)
of subdivision 2 as added by chapter 659 of the laws of 1997  and  para-
graph  (d) of subdivision 2 as amended by section 9 of part C of chapter
58 of the laws of 2007, and paragraphs (d) and (e) of subdivision  1  as
relettered by section 7 of part C of chapter 58 of the laws of 2007, are
amended to read as follows:
  (d)  ["Approved  managed long term care demonstration" means the sites
approved by the commissioner to participate in the  "Evaluated  Medicaid
Long Term Care Capitation Program".
  (e)]  "Health  and  long term care services" means services including,
but not limited to [primary care, acute care,] home and  community-based
and  institution-based long term care and ancillary services (that shall
include medical supplies and nutritional supplements) that are necessary
to meet the needs of persons whom the plan is authorized to enroll.  THE
MANAGED LONG TERM CARE PLAN MAY ALSO COVER PRIMARY CARE AND  ACUTE  CARE
IF SO AUTHORIZED.
  (c)  [a  description  that  demonstrates the cost-effectiveness of the
program as compared to the cost of services clients would otherwise have
received;
  (d)] adequate  documentation  of  the  appropriate  licenses,  certif-
ications  or  approvals  to provide care as planned, including contracts
with such providers as may be necessary to provide the  full  complement
of services required to be provided under this section.
  S  41-a.  Subdivision 3 of section 4403-f of the public health law, as
amended by chapter 627 of the laws  of  2008,  is  amended  to  read  as
follows:
  3.  Certificate  of  authority;  approval.  The commissioner shall not
approve an application for a certificate of authority unless the  appli-
cant demonstrates to the commissioner's satisfaction:
  (a) [the relative cost effectiveness to the medical assistance program
when  compared to other managed long term care plans proposing to serve,
or serving, comparable populations;
  (b)] that it will have in  place  acceptable  quality-assurance  mech-
anisms, grievance procedures, mechanisms to protect the rights of enrol-
lees  and case management services to ensure continuity, quality, appro-
priateness and coordination of care;
  [(c)] (B) that it will  include  an  enrollment  process  which  shall
ensure  that enrollment in the plan is informed [and voluntary by enrol-
lees or their representatives and a  voluntary  disenrollment  process].
The  application  shall [include the specific grounds that would warrant

S. 2809--C                         135

involuntary disenrollment provided, however,] DESCRIBE THE DISENROLLMENT
PROCESS, WHICH SHALL PROVIDE THAT an otherwise eligible  enrollee  shall
not be involuntarily disenrolled on the basis of health status;
  [(d)] (C) satisfactory evidence of the character and competence of the
proposed  operators  and  reasonable  assurance  that the applicant will
provide high quality services to an enrolled population;
  [(e)] (D) sufficient management systems capacity to meet the  require-
ments of this section and the ability to efficiently process payment for
covered services;
  [(f)]  (E)  readiness  and  capability to [achieve full capitation for
services reimbursed pursuant to title XVIII of the federal social  secu-
rity  act or, for an applicant designated as an eligible applicant prior
to April first, two thousand seven pursuant to paragraph (d) of subdivi-
sion six of this section that has its principal  place  of  business  in
Bronx  county  and  is unable to achieve such full capitation, readiness
and capability to achieve full capitation  on  a  scheduled  basis  for]
MAXIMIZE REIMBURSEMENT OF AND COORDINATE services reimbursed pursuant to
title XVIII of the federal social security act [or capability and proto-
cols  for  benefit coordination for services reimbursed pursuant to such
title] and all other applicable benefits, with such benefit coordination
including, but not limited to, measures to support sound clinical  deci-
sions,  reduce administrative complexity, coordinate access to services,
maximize benefits available pursuant  to  such  title  and  ensure  that
necessary care is provided;
  [(g)]  (F)  readiness  and capability to [achieve full capitation for]
ARRANGE AND MANAGE COVERED SERVICES AND COORDINATE OTHER services  reim-
bursed pursuant to title XIX of the federal social security act;
  [(h)] (G) willingness and capability of taking, or cooperating in, all
steps necessary to secure and integrate any potential sources of funding
for services provided by the managed long term care plan, including, but
not limited to, funding available under titles XVI, XVIII, XIX and XX of
the  federal  social  security  act,  the federal older Americans act of
nineteen hundred sixty-five, as amended,  or  any  successor  provisions
subject  to  approval of the director of the state office for aging, and
through financing options such as those authorized pursuant  to  section
three hundred sixty-seven-f of the social services law;
  [(i)]  (H)  that  the CONTRACTUAL arrangements for PROVIDERS OF health
and long term care services IN THE BENEFIT  PACKAGE  ARE  SUFFICIENT  TO
ensure  the  availability  and  accessibility  of  such  services to the
proposed enrolled population CONSISTENT WITH GUIDELINES  ESTABLISHED  BY
THE  COMMISSIONER;  WITH  RESPECT  TO  INDIVIDUALS  IN  RECEIPT  OF SUCH
SERVICES PRIOR TO ENROLLMENT, SUCH GUIDELINES SHALL REQUIRE THE  MANAGED
LONG  TERM  CARE PLAN TO CONTRACT WITH AGENCIES CURRENTLY PROVIDING SUCH
SERVICES, IN ORDER TO PROMOTE CONTINUITY OF CARE; and
  [(j)] (I) that the applicant is financially  responsible  and  may  be
expected to meet its obligations to its enrolled members.
  S  41-b.  Subdivisions  5, 6, 7 and 10 of section 4403-f of the public
health law, subdivision 5 as amended by section 15 of part C of  chapter
58  of the laws of 2007, subdivisions 6 and 7 as added by chapter 659 of
the laws of 1997, paragraphs (a),  (b)  and  (c)  of  subdivision  6  as
amended  by section 6 of part C of chapter 58 of the laws of 2010, para-
graph (d) of subdivision 6 as amended by section 17 of part C of chapter
58 of the laws of 2007, paragraphs (c)  and  (d)  of  subdivision  7  as
amended by section 18 of part C of chapter 58 of the laws of 2007, para-
graphs  (e) and (g) of subdivision 7 as relettered by section 20 of part
C of chapter 58 of the laws of 2007, paragraph (h) of subdivision  7  as

S. 2809--C                         136

added by section 65-c of part A of chapter 57 of the laws of 2006, para-
graph  (i)  as added by section 65-f of part A of chapter 57 of the laws
of 2006, and such paragraphs (h) and (i) as relettered by section 20  of
part C of chapter 58 of the laws of 2007, paragraph (f) of subdivision 7
as  amended  by  section  7 of part C of chapter 58 of the laws of 2010,
subparagraph (iii) of paragraph (h)  of  subdivision  7  as  amended  by
section  19  of part C of chapter 58 of the laws of 2007, subdivision 10
as amended by chapter 192 of the laws of 2006 and renumbered by  section
22  of  part C of chapter 58 of the laws of 2007, are amended to read as
follows:
  5. Applicability of other laws. A managed  long  term  care  plan  [or
approved  managed  long term care demonstration] shall be subject to the
provisions of the insurance law and  regulations  applicable  to  health
maintenance  organizations,  this  article  and  regulations promulgated
pursuant thereto. To the extent that the provisions of this section  are
inconsistent  with  the  provisions of this chapter or the provisions of
the insurance law, the provisions of this section shall prevail.
  6. Approval authority.  (a) An applicant shall be issued a certificate
of authority as a managed long term care plan upon  a  determination  by
the commissioner that the applicant complies with the operating require-
ments  for a managed long term care plan under this section. The commis-
sioner shall issue no more than  [fifty]  SEVENTY-FIVE  certificates  of
authority to managed long term care plans pursuant to this section. [For
purposes  of  issuance  of no more than fifty certificates of authority,
such certificates shall include those certificates  issued  pursuant  to
paragraphs (b) and (c) of this subdivision.]
  (b)  An  operating  demonstration  shall  be  issued  a certificate of
authority as a managed long term care plan upon a determination  by  the
commissioner   that  such  demonstration  complies  with  the  operating
requirements for a managed long  term  care  plan  under  this  section.
[Except  as  otherwise  expressly  provided in paragraphs (d) and (e) of
subdivision seven of this section,  nothing]  NOTHING  in  this  section
shall be construed to affect the continued legal authority of an operat-
ing demonstration to operate its previously approved program.
  [(c)  An approved managed long term care demonstration shall be issued
a certificate of authority as a managed  long  term  care  plan  upon  a
determination  by the commissioner that such demonstration complies with
the operating requirements for a managed long term care plan under  this
section.  Notwithstanding  any  inconsistent  provision  of  law  to the
contrary, all authority for the operation of approved managed long  term
care demonstrations which have not been issued a certificate of authori-
ty  as  a  managed  long term care plan, shall expire one year after the
adoption of regulations implementing managed long term care plans.
  (d) The majority leader of the senate and the speaker of the  assembly
may each designate in writing up to fifteen eligible applicants to apply
to  be  approved  managed  long  term  care demonstrations or plans. The
commissioner may designate in writing up to eleven  eligible  applicants
to apply to be approved managed long term care demonstrations or plans.]
  7. Program oversight and administration. (a)(i) The commissioner shall
promulgate regulations to implement this section and to ensure the qual-
ity,  appropriateness and cost-effectiveness of the services provided by
managed long term care plans. The commissioner may waive rules and regu-
lations of the department, including but not limited to, those  pertain-
ing  to  duplicative  requirements  concerning record keeping, boards of
directors, staffing and reporting, when such  waiver  will  promote  the
efficient  delivery of appropriate, quality, cost-effective services and

S. 2809--C                         137

when the health, safety and general welfare of  enrollees  will  not  be
impaired  as  a  result of such waiver. In order to achieve managed long
term care plan system efficiencies and coordination and to  promote  the
objectives  of  high  quality,  integrated  and cost effective care, the
commissioner may establish a single  coordinated  surveillance  process,
allow for a comprehensive quality improvement and review process to meet
component  quality  requirements, and require a uniform cost report. The
commissioner shall require managed long term care plans to utilize qual-
ity improvement measures, based on health outcomes  data,  for  internal
quality  assessment  processes  and may utilize such measures as part of
the single coordinated surveillance process.
  (ii) Notwithstanding any inconsistent provision of the social services
law to the contrary, the commissioner  shall,  pursuant  to  regulation,
determine  whether  and the extent to which the applicable provisions of
the social services law or regulations relating to approvals and author-
izations of, and utilization limitations on, health and long  term  care
services reimbursed pursuant to title XIX of the federal social security
act,  including, but not limited to, fiscal assessment requirements, are
inconsistent with the flexibility necessary for the  efficient  adminis-
tration  of  managed  long  term  care  plans and such regulations shall
provide that such provisions shall not be  applicable  to  enrollees  or
managed  long  term  care  plans,  provided that such determinations are
consistent with applicable federal law and regulation.
  (b) The commissioner shall, to the extent necessary, submit the appro-
priate waivers, including, but not limited to, those authorized pursuant
to sections eleven hundred fifteen and nineteen hundred fifteen  of  the
federal  social  security  act,  or  successor provisions, and any other
waivers necessary to achieve the purposes of high  quality,  integrated,
and  cost  effective  care and integrated financial eligibility policies
under the medical assistance program or pursuant to title XVIII  of  the
federal social security act. IN ADDITION, THE COMMISSIONER IS AUTHORIZED
TO  SUBMIT  THE  APPROPRIATE WAIVERS, INCLUDING BUT NOT LIMITED TO THOSE
AUTHORIZED PURSUANT TO SECTIONS  ELEVEN  HUNDRED  FIFTEEN  AND  NINETEEN
HUNDRED  FIFTEEN  OF  THE  FEDERAL  SOCIAL  SECURITY  ACT  OR  SUCCESSOR
PROVISIONS, AND ANY OTHER WAIVERS NECESSARY TO REQUIRE  MEDICAL  ASSIST-
ANCE RECIPIENTS WHO ARE TWENTY-ONE YEARS OF AGE OR OLDER AND WHO REQUIRE
COMMUNITY-BASED LONG TERM CARE SERVICES, AS SPECIFIED BY THE COMMISSION-
ER,  FOR MORE THAN ONE HUNDRED AND TWENTY DAYS, TO RECEIVE SUCH SERVICES
THROUGH AN AVAILABLE PLAN CERTIFIED PURSUANT TO THIS  SECTION  OR  OTHER
CARE  COORDINATION PROGRAM SPECIFIED BY THE COMMISSIONER. Copies of such
original waiver applications shall be provided to the  chairman  of  the
senate finance committee and the chairman of the assembly ways and means
committee  simultaneously  with  their submission to the federal govern-
ment.  THE COMMISSIONER SHALL DEVELOP A WORKGROUP  TO  FURTHER  EVALUATE
AND  PROMOTE THE TRANSITION OF PERSONS IN RECEIPT OF HOME AND COMMUNITY-
BASED LONG TERM CARE SERVICES INTO MANAGED  LONG  TERM  CARE  PLANS  AND
OTHER CARE COORDINATION MODELS.
  (c)(i)  A managed long term care plan shall not use deceptive or coer-
cive marketing methods to encourage participants to  enroll.  A  managed
long  term  care plan shall not distribute marketing materials to poten-
tial enrollees before such materials have been approved by  the  commis-
sioner.
  (ii)  The  commissioner  shall  ensure,  through  periodic  reviews of
managed long term care plans, that enrollment was [a voluntary  and]  AN
informed  choice; such plan has only enrolled persons whom it is author-
ized to enroll, and plan services are promptly  available  to  enrollees

S. 2809--C                         138

when appropriate. Such periodic reviews shall be made according to stan-
dards as determined by the commissioner in regulations.
  (d)  Notwithstanding  any  provision of law, rule or regulation to the
contrary, the commissioner may issue a request for  proposals  to  carry
out reviews of enrollment and assessment activities in managed long term
care plans and operating demonstrations with respect to enrollees eligi-
ble  to  receive services under title XIX of the federal social security
act to determine if enrollment meets the  requirements  of  subparagraph
(ii)  of paragraph (c) of this subdivision; and that assessments of such
enrollees' health, functional and  other  status,  for  the  purpose  of
adjusting  premiums,  were  accurate.  [Evaluations  shall  address each
bidder's ability to ensure that enrollments in such plans  are  promptly
reviewed  and  that medical assistance required to be furnished pursuant
to title eleven of article five of  the  social  services  law  will  be
appropriately furnished to the recipients for whom the local commission-
ers are responsible pursuant to section three hundred sixty-five of such
title  and  that  plan implementation will be consistent with the proper
and efficient administration  of  the  medical  assistance  program  and
managed long term care plans.]
  (e)  The commissioner may, in his or her discretion for the purpose of
protection of enrollees, impose measures including, but not limited  to,
bans  on  further  enrollments  and  requirements  for use of enrollment
brokers until any identified problems are resolved to  the  satisfaction
of the commissioner.
  (f)  Continuation  of  a  certificate  of  authority issued under this
section shall be contingent upon satisfactory performance by the managed
long term care plan in the  delivery,  continuity,  accessibility,  cost
effectiveness  and  quality of the services to enrolled members; compli-
ance with applicable provisions of this  section  and  rules  and  regu-
lations  promulgated  thereunder;  the continuing fiscal solvency of the
organization; and, federal financial participation in payments on behalf
of enrollees who are eligible to receive services under title XIX of the
federal social security act.
  (g) [The commissioner shall ensure that (i) a process exists  for  the
resolution  of disputes concerning the accuracy of assessments performed
pursuant to paragraphs (d) and (e) of this  subdivision;  and  (ii)  the
tasks  described  in  paragraphs  (d)  and  (e)  of this subdivision are
consistently administered.
  (h)] (i) Managed long term care plans and  demonstrations  may  enroll
eligible  persons  in the plan or demonstration upon the completion of a
comprehensive assessment that shall include, but not be limited  to,  an
evaluation  of  the  medical,  social  and  environmental  needs of each
prospective enrollee in such program. This assessment shall  also  serve
as the basis for the development and provision of an appropriate plan of
care  for  the  [prospective] enrollee. UPON APPROVAL OF FEDERAL WAIVERS
PURSUANT TO PARAGRAPH (B) OF  THIS  SUBDIVISION  WHICH  REQUIRE  MEDICAL
ASSISTANCE   RECIPIENTS  WHO  REQUIRE  COMMUNITY-BASED  LONG  TERM  CARE
SERVICES TO ENROLL IN A PLAN, AND UPON APPROVAL OF THE  COMMISSIONER,  A
PLAN  MAY ENROLL AN APPLICANT WHO IS CURRENTLY RECEIVING HOME AND COMMU-
NITY-BASED SERVICES AND COMPLETE  THE  COMPREHENSIVE  ASSESSMENT  WITHIN
THIRTY  DAYS  OF  ENROLLMENT  PROVIDED  THAT THE PLAN CONTINUES TO COVER
TRANSITIONAL CARE UNTIL SUCH TIME AS THE ASSESSMENT IS COMPLETED.
  (ii) The assessment shall be completed  by  a  representative  of  the
managed  long  term care plan or demonstration, in consultation with the
prospective enrollee's health  care  practitioner  AS  NECESSARY.    The

S. 2809--C                         139

commissioner  shall prescribe the forms on which the assessment shall be
made.
  (iii)  The  [completed assessment and documentation of the] enrollment
APPLICATION shall be submitted by the managed long  term  care  plan  or
demonstration  to  the  [local  department  of  social services, or to a
contractor selected pursuant to  paragraph  (d)  of  this  subdivision,]
ENTITY  DESIGNATED  BY  THE  DEPARTMENT  prior  to  the  commencement of
services under the managed long term care  plan  or  demonstration.  For
purposes  of  reimbursement of the managed long term care plan or demon-
stration, if the [completed assessment and documentation are] ENROLLMENT
APPLICATION IS submitted on or before the twentieth day  of  the  month,
the  enrollment  shall  commence on the first day of the month following
the completion and submission  and  if  the  [completed  assessment  and
documentation are] ENROLLMENT APPLICATION IS submitted after the twenti-
eth  day of the month, the enrollment shall commence on the first day of
the second month following submission.  Enrollments conducted by a  plan
or  demonstration shall be subject to review and audit by the department
[and by the local social services district]  or  a  contractor  selected
pursuant to paragraph (d) of this subdivision.
  (iv)  Continued  enrollment in a managed long term care plan or demon-
stration paid for by government funds shall be based upon  a  comprehen-
sive  assessment  of  the medical, social and environmental needs of the
recipient of the services. Such assessment shall be performed  at  least
[annually]  EVERY  SIX MONTHS by the managed long term care plan serving
the enrollee.  The commissioner shall prescribe the forms on  which  the
assessment will be made.
  [(i)]  (H) The commissioner shall, upon request by a managed long term
care plan[, approved managed long term care demonstration,] or operating
demonstration,  and  consistent  with  federal  regulations  promulgated
pursuant  to  the  Health  Insurance Portability and Accountability Act,
share with such plan or demonstration the following data if it is avail-
able:
  (i) information concerning utilization of services  and  providers  by
each  of its enrollees prior to and during enrollment, including but not
limited to utilization of emergency  department  services,  prescription
drugs, and hospital and nursing facility admissions.
  (ii) aggregate data concerning utilization and costs for enrollees and
for  comparable  cohorts  served  through  the  Medicaid fee-for-service
program.
  10. [The] NOTWITHSTANDING ANY INCONSISTENT PROVISION TO THE  CONTRARY,
THE  ENROLLMENT  AND  DISENROLLMENT  PROCESS  AND  services  provided or
arranged by all operating demonstrations or any  program  that  receives
designation as a Program of All-Inclusive Care for the Elderly (PACE) as
authorized  by  federal public law 105-33, subtitle I of title IV of the
Balanced Budget Act of 1997, MUST MEET ALL APPLICABLE  FEDERAL  REQUIRE-
MENTS.  SERVICES may include, but need not be limited to, housing, inpa-
tient and outpatient hospital services, nursing home care,  home  health
care,  adult  day  care, assisted living services provided in accordance
with article forty-six-B of this chapter, adult care facility  services,
enriched  housing program services, hospice care, respite care, personal
care, homemaker services, diagnostic  laboratory  services,  therapeutic
and  diagnostic radiologic services, emergency services, emergency alarm
systems, home delivered meals,  physical  adaptations  to  the  client's
home,  physician  care  (including  consultant  and  referral services),
ancillary  services,  case  management  services,  transportation,   and
related medical services.

S. 2809--C                         140

  S 42. The social services law is amended by adding a new section 365-m
to read as follows:
  S  365-M. ADMINISTRATION AND MANAGEMENT OF BEHAVIORAL HEALTH SERVICES.
1. THE COMMISSIONERS OF THE OFFICE OF MENTAL HEALTH AND  THE  OFFICE  OF
ALCOHOLISM  AND  SUBSTANCE  ABUSE  SERVICES,  IN  CONSULTATION  WITH THE
COMMISSIONER OF HEALTH AND WITH THE APPROVAL  OF  THE  DIVISION  OF  THE
BUDGET, SHALL HAVE RESPONSIBILITY FOR JOINTLY DESIGNATING REGIONAL ENTI-
TIES  TO PROVIDE ADMINISTRATIVE AND MANAGEMENT SERVICES FOR THE PURPOSES
OF PRIOR APPROVING AND COORDINATING THE PROVISION OF  BEHAVIORAL  HEALTH
SERVICES,  AND  INTEGRATING  SUCH  BEHAVIORAL HEALTH SERVICES WITH OTHER
SERVICES AVAILABLE UNDER THIS TITLE, FOR RECIPIENTS OF  MEDICAL  ASSIST-
ANCE  WHO ARE NOT ENROLLED IN MANAGED CARE, AND FOR SUCH APPROVAL, COOR-
DINATION, AND INTEGRATION OF BEHAVIORAL HEALTH  SERVICES  THAT  ARE  NOT
PROVIDED  THROUGH MANAGED CARE PROGRAMS UNDER THIS TITLE FOR INDIVIDUALS
REGARDLESS OF WHETHER OR NOT SUCH INDIVIDUALS ARE  ENROLLED  IN  MANAGED
CARE  PROGRAMS.  SUCH  REGIONAL  ENTITIES  SHALL ALSO BE RESPONSIBLE FOR
SAFEGUARDING AGAINST UNNECESSARY UTILIZATION OF SUCH CARE  AND  SERVICES
AND ASSURING THAT PAYMENTS ARE CONSISTENT WITH THE EFFICIENT AND ECONOM-
ICAL DELIVERY OF QUALITY CARE.
  2.  IN EXERCISING THIS RESPONSIBILITY, THE COMMISSIONERS OF THE OFFICE
OF MENTAL HEALTH AND  THE  OFFICE  OF  ALCOHOLISM  AND  SUBSTANCE  ABUSE
SERVICES ARE AUTHORIZED TO CONTRACT, AFTER CONSULTATION WITH THE COMMIS-
SIONER OF HEALTH, WITH REGIONAL BEHAVIORAL HEALTH ORGANIZATIONS OR OTHER
ENTITIES. SUCH CONTRACTS MAY INCLUDE RESPONSIBILITY FOR RECEIPT, REVIEW,
AND  DETERMINATION OF PRIOR AUTHORIZATION REQUESTS FOR BEHAVIORAL HEALTH
CARE AND SERVICES, CONSISTENT WITH CRITERIA ESTABLISHED OR  APPROVED  BY
THE  COMMISSIONERS  OF  MENTAL HEALTH AND ALCOHOLISM AND SUBSTANCE ABUSE
SERVICES, AND AUTHORIZATION OF APPROPRIATE CARE AND  SERVICES  BASED  ON
DOCUMENTED PATIENT MEDICAL NEED.
  3.  NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR  SECTION
ONE  HUNDRED FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR ANY OTHER LAW
TO THE CONTRARY, THE COMMISSIONERS OF THE OFFICE OF  MENTAL  HEALTH  AND
THE  OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES ARE AUTHORIZED TO
ENTER INTO A CONTRACT OR CONTRACTS UNDER SUBDIVISIONS  ONE  AND  TWO  OF
THIS  SECTION WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS,
PROVIDED, HOWEVER, THAT:
  (A) THE OFFICE OF MENTAL HEALTH  AND  THE  OFFICE  OF  ALCOHOLISM  AND
SUBSTANCE  ABUSE  SERVICES SHALL POST ON THEIR WEBSITES, FOR A PERIOD OF
NO LESS THAN THIRTY DAYS:
  (I) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT  TO
THE CONTRACTOR CONTRACTS;
  (II) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (III)  THE  PERIOD  OF  TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY
SEEK SELECTION, WHICH SHALL BE NO  LESS  THAN  THIRTY  DAYS  AFTER  SUCH
INFORMATION IS FIRST POSTED ON THE WEBSITE; AND
  (IV)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (B) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE  RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
COMMISSIONERS; AND
  (C) THE COMMISSIONERS OF THE OFFICE OF MENTAL HEALTH AND THE OFFICE OF
ALCOHOLISM AND  SUBSTANCE  ABUSE  SERVICES,  IN  CONSULTATION  WITH  THE
COMMISSIONER  OF  HEALTH,  SHALL  SELECT  SUCH CONTRACTOR OR CONTRACTORS
THAT, IN THEIR DISCRETION, HAVE DEMONSTRATED THE ABILITY TO EFFECTIVELY,
EFFICIENTLY, AND ECONOMICALLY INTEGRATE  BEHAVIORAL  HEALTH  AND  HEALTH

S. 2809--C                         141

SERVICES;  HAVE  THE  REQUISITE  EXPERTISE AND FINANCIAL RESOURCES; HAVE
DEMONSTRATED THAT THEIR DIRECTORS, SPONSORS, MEMBERS, MANAGERS, PARTNERS
OR OPERATORS HAVE THE REQUISITE CHARACTER, COMPETENCE  AND  STANDING  IN
THE  COMMUNITY,  AND  ARE  BEST  SUITED  TO  SERVE  THE PURPOSES OF THIS
SECTION.
  4. THE COMMISSIONERS OF THE OFFICE OF MENTAL  HEALTH,  THE  OFFICE  OF
ALCOHOLISM  AND  SUBSTANCE  ABUSE SERVICES AND THE DEPARTMENT OF HEALTH,
SHALL HAVE THE RESPONSIBILITY FOR  JOINTLY  DESIGNATING  ON  A  REGIONAL
BASIS,  AFTER  CONSULTATION  WITH  THE  CITY  OF NEW YORK'S LOCAL SOCIAL
SERVICES DISTRICT AND LOCAL GOVERNMENTAL UNIT, AS SUCH TERM  IS  DEFINED
IN  THE  MENTAL  HYGIENE  LAW,  AND AFTER CONSULTATION OF OTHER AFFECTED
COUNTIES, A LIMITED NUMBER OF SPECIALIZED MANAGED  CARE  PLANS,  SPECIAL
NEED  MANAGED  CARE  PLANS,  AND/OR  INTEGRATED  PHYSICAL AND BEHAVIORAL
HEALTH PROVIDER SYSTEMS CAPABLE OF MANAGING THE BEHAVIORAL AND  PHYSICAL
HEALTH NEEDS OF MEDICAL ASSISTANCE ENROLLEES WITH SIGNIFICANT BEHAVIORAL
HEALTH  NEEDS.  INITIAL  DESIGNATIONS  OF SUCH PLANS OR PROVIDER SYSTEMS
SHOULD BE MADE  NO  LATER  THAN  APRIL  FIRST,  TWO  THOUSAND  THIRTEEN,
PROVIDED, HOWEVER, SUCH DESIGNATIONS SHALL BE CONTINGENT UPON A DETERMI-
NATION  BY  SUCH  STATE COMMISSIONERS THAT THE ENTITIES TO BE DESIGNATED
HAVE THE CAPACITY AND FINANCIAL ABILITY  TO  PROVIDE  SERVICES  IN  SUCH
PLANS  OR  PROVIDER  SYSTEMS, AND THAT THE REGION HAS A SUFFICIENT POPU-
LATION AND SERVICE BASE TO SUPPORT SUCH PLANS AND SYSTEMS.  ONCE  DESIG-
NATED, THE COMMISSIONER OF HEALTH SHALL MAKE ARRANGEMENTS TO ENROLL SUCH
ENROLLEES  IN  SUCH PLANS OR INTEGRATED PROVIDER SYSTEMS AND TO PAY SUCH
PLANS OR PROVIDER SYSTEMS ON A CAPITATED OR OTHER BASIS TO MANAGE, COOR-
DINATE, AND PAY FOR BEHAVIORAL AND PHYSICAL  HEALTH  MEDICAL  ASSISTANCE
SERVICES FOR SUCH ENROLLEES.  NOTWITHSTANDING ANY INCONSISTENT PROVISION
OF  SECTION  ONE HUNDRED TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE
FINANCE LAW, AND SECTION ONE HUNDRED FORTY-TWO OF THE ECONOMIC  DEVELOP-
MENT  LAW,  OR  ANY  OTHER LAW TO THE CONTRARY, THE DESIGNATIONS OF SUCH
PLANS AND PROVIDER SYSTEMS, AND ANY RESULTING CONTRACTS WITH SUCH PLANS,
PROVIDERS OR PROVIDER SYSTEMS ARE AUTHORIZED TO BE ENTERED INTO BY  SUCH
STATE  COMMISSIONERS  WITHOUT  A COMPETITIVE BID OR REQUEST FOR PROPOSAL
PROCESS. OVERSIGHT OF SUCH  CONTRACTS  WITH  SUCH  PLANS,  PROVIDERS  OR
PROVIDER SYSTEMS SHALL BE THE JOINT RESPONSIBILITY OF SUCH STATE COMMIS-
SIONERS, AND FOR CONTRACTS AFFECTING THE CITY OF NEW YORK, ALSO WITH THE
CITY'S  LOCAL  SOCIAL  SERVICES DISTRICT AND LOCAL GOVERNMENTAL UNIT, AS
SUCH TERM IS DEFINED IN THE MENTAL HYGIENE LAW.
  S 43. Paragraph (c) of subdivision 6 of section 367-a  of  the  social
services  law, as amended by chapter 41 of the laws of 1992 and subpara-
graph (iii) as amended by section 47 of part C of chapter 58 of the laws
of 2009, is amended to read as follows:
  (c) (i) Co-payments charged pursuant to this subdivision  for  non-in-
stitutional  services  shall  not  exceed the following table, provided,
however, that the department  may  establish  standard  co-payments  for
services based upon the average or typical payment for that service:

    State's payment                  Maximum co-payment
    for the services               chargeable to recipient
      $10 or less                           $[.50] .60
      $10.01 to $25                        $[1.00] 1.15
      $25.01 to $50                        $[2.00] 2.30
      $50.01 or more                       $[3.00] 3.40

  (ii)  co-payments  charged  pursuant  to  this  subdivision  for  each
discharge for inpatient care shall be [twenty-five] THIRTY dollars.

S. 2809--C                         142

  (iii) Notwithstanding any  other  provision  of  this  paragraph,  co-
payments  charged  for each generic prescription drug dispensed shall be
one dollar AND FIFTEEN CENTS and for each brand name  prescription  drug
dispensed  shall  be  three  dollars AND FORTY CENTS; provided, however,
that  the  co-payments  charged for each brand name prescription drug on
the preferred drug list established  pursuant  to  section  two  hundred
seventy-two  of  the  public  health law and the co-payments charged for
each brand name prescription drug reimbursed  pursuant  to  subparagraph
(ii)  of  paragraph  (a-1)  of subdivision four of section three hundred
sixty-five-a of this title shall be one dollar AND FIFTEEN CENTS.
  (IV) THE CO-PAYMENT FOR EMERGENCY ROOM SERVICES PROVIDED  FOR  NON-UR-
GENT OR NON-EMERGENCY MEDICAL CARE SHALL BE SIX DOLLARS AND FORTY CENTS;
PROVIDED  HOWEVER  THAT  CO-PAYMENTS PURSUANT TO THIS SUBPARAGRAPH SHALL
NOT BE REQUIRED WITH RESPECT TO EMERGENCY SERVICES  OR  FAMILY  PLANNING
SERVICES AND SUPPLIES.
  S  44.  Paragraph  (d) of subdivision 6 of section 367-a of the social
services law is amended by adding six new subparagraphs (ix), (x), (xi),
(xii), (xiii), and (xiv) to read as follows:
  (IX) VISION CARE;
  (X) DENTAL SERVICES;
  (XI) AUDIOLOGY SERVICES;
  (XII) PHYSICIAN SERVICES;
  (XIII) NURSE PRACTITIONER SERVICES;
  (XIV) REHABILITATION SERVICES INCLUDING OCCUPATIONAL THERAPY; PHYSICAL
THERAPY AND SPEECH THERAPY;
  S 45. Subparagraph (ii) of paragraph (f) of subdivision 6  of  section
367-a  of the social services law, as amended by section 42 of part C of
chapter 58 of the laws of 2005, is amended and a new subparagraph  (iii)
is added to read as follows:
  (ii)  In  the  year  commencing April first, two thousand five and for
each year thereafter, AND ENDING IN THE YEAR CONCLUDING ON  MARCH  THIR-
TY-FIRST,  TWO  THOUSAND  ELEVEN,  no recipient shall be required to pay
more than a total of two hundred dollars in co-payments required by this
subdivision, nor shall reductions  in  payments  as  a  result  of  such
co-payments exceed two hundred dollars for any recipient.
  (III)  IN THE YEAR COMMENCING APRIL FIRST, TWO THOUSAND ELEVEN AND FOR
EACH YEAR THEREAFTER, NO RECIPIENT SHALL BE REQUIRED TO PAY MORE THAN  A
TOTAL  OF THREE HUNDRED DOLLARS IN CO-PAYMENTS REQUIRED BY THIS SUBDIVI-
SION, NOR SHALL REDUCTIONS IN PAYMENTS AS A RESULT OF  SUCH  CO-PAYMENTS
EXCEED THREE HUNDRED DOLLARS FOR ANY RECIPIENT.
  S 46. Subdivision 2-a of section 369-ee of the social services law, as
amended  by  section  26 of part E of chapter 63 of the laws of 2005, is
amended to read as follows:
  2-a. Co-payments. Subject to federal approval pursuant to  subdivision
six of this section, persons receiving family health plus coverage under
this section shall be responsible to make co-payments in accordance with
the  terms  of subdivision six of section three hundred sixty-seven-a of
this article, including those individuals  who  are  otherwise  exempted
under  the  provisions of subparagraph (iv) of paragraph (b) of subdivi-
sion six  of  section  three  hundred  sixty-seven-a  of  this  article,
provided  however, that notwithstanding the provisions of paragraphs (c)
and (d) of such subdivision:
  (i) co-payments charged for each generic prescription  drug  dispensed
shall  be  three  dollars  and  for  each  brand  name prescription drug
dispensed shall be six dollars;

S. 2809--C                         143

  (ii) the co-payment charged for each dental  service  visit  shall  be
five  dollars,  provided  that no enrollee shall be required to pay more
than twenty-five dollars per year in co-payments  for  dental  services;
[and]
  (iii)  the  co-payment  for clinic services [and], physician services,
AND NURSE PRACTITIONER SERVICES shall be five dollars; AND
  (IV) THE CO-PAYMENT FOR EMERGENCY ROOM SERVICES PROVIDED  FOR  NON-UR-
GENT OR NON-EMERGENCY MEDICAL CARE SHALL BE SIX DOLLARS AND FORTY CENTS;
PROVIDED  HOWEVER  THAT CO-PAYMENTS PURSUANT TO THIS PARAGRAPH SHALL NOT
BE REQUIRED WITH  RESPECT  TO  EMERGENCY  SERVICES  OR  FAMILY  PLANNING
SERVICES AND SUPPLIES;
and  provided  further  that  the  limitations  in paragraph (f) of such
subdivision shall not apply.
  S 47. Section 2510 of the public health law is amended by adding a new
subdivision 13 to read as follows:
  13. "CO-PAYMENT" MEANS A PAYMENT MADE ON BEHALF OF AN  ELIGIBLE  CHILD
TO  A HEALTH CARE PROVIDER FOR A COVERED HEALTH CARE SERVICE PROVIDED TO
SUCH CHILD IN AN AMOUNT TO BE DETERMINED BY THE COMMISSIONER  CONSISTENT
WITH FEDERAL STANDARDS AND SPECIFIED IN APPLICABLE CONTRACTS.  AGGREGATE
CO-PAYMENT  AMOUNTS  COLLECTED BY HEALTH CARE PROVIDERS PURSUANT TO THIS
SUBDIVISION SHALL NOT EXCEED THREE HUNDRED DOLLARS PER YEAR PER ELIGIBLE
CHILD.
  S 47-a. Subdivision 8 of section 2511 of  the  public  health  law  is
amended  by  adding  three  new  paragraphs  (f), (g) and (h) to read as
follows:
  (F) THE COMMISSIONER SHALL ADJUST SUBSIDY PAYMENTS  MADE  TO  APPROVED
ORGANIZATIONS  ON  AND  AFTER  APRIL  FIRST, TWO THOUSAND ELEVEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND TWELVE, SO THAT THE AMOUNT OF EACH SUCH
PAYMENT IS REDUCED BY ONE AND SEVEN-TENTHS PERCENT.
  (G) EFFECTIVE OCTOBER FIRST, TWO  THOUSAND  ELEVEN,  THE  COMMISSIONER
SHALL  REDUCE SUBSIDY PAYMENTS MADE TO APPROVED ORGANIZATIONS TO REFLECT
ESTIMATED COLLECTIONS OF CO-PAYMENT AMOUNTS IMPOSED PURSUANT TO SUBDIVI-
SION THIRTEEN OF SECTION TWENTY-FIVE HUNDRED TEN OF THIS  TITLE  AND  AS
SPECIFIED  IN APPLICABLE CONTRACTS BASED ON THE NUMBER OF COVERED HEALTH
CARE SERVICE VISITS REPORTED BY AN APPROVED ORGANIZATION ON THE MEDICAID
MANAGED CARE OPERATING REPORT SUBMITTED TO THE DEPARTMENT FOR THE CALEN-
DAR YEAR ENDING DECEMBER THIRTY-FIRST, TWO  THOUSAND  TEN  AND  ADJUSTED
ANNUALLY  ON JULY FIRST TO REFLECT THE VISITS REPORTED FOR THE PRECEDING
CALENDAR YEAR.
  (H) THE COMMISSIONER MAY INCREASE SUBSIDY PAYMENTS  MADE  TO  APPROVED
ORGANIZATIONS  THAT  VOLUNTARILY  PARTICIPATE IN THE MULTI-PAYOR PATIENT
CENTERED MEDICAL HOME PROGRAM TO  REFLECT  ADDITIONAL  COSTS  ASSOCIATED
WITH  ENHANCED  PAYMENTS  MADE  TO  CERTIFIED  MEDICAL HOMES BY APPROVED
ORGANIZATIONS AS REQUIRED BY ARTICLE TWENTY-NINE-AA OF THIS CHAPTER.
  S 48. The public health law is amended by adding a new section  2997-d
to read as follows:
  S  2997-D.  HOSPITAL,  NURSING HOME, HOME CARE, SPECIAL NEEDS ASSISTED
LIVING RESIDENCES AND ENHANCED  ASSISTED  LIVING  RESIDENCES  PALLIATIVE
CARE  SUPPORT.    1.  (A) "PALLIATIVE CARE" MEANS HEALTH CARE TREATMENT,
INCLUDING INTERDISCIPLINARY  END-OF-LIFE  CARE,  AND  CONSULTATION  WITH
PATIENTS  AND  FAMILY  MEMBERS, TO PREVENT OR RELIEVE PAIN AND SUFFERING
AND TO ENHANCE THE PATIENT'S QUALITY OF  LIFE,  INCLUDING  HOSPICE  CARE
UNDER ARTICLE FORTY OF THIS CHAPTER.
  (B) "APPROPRIATE" HAS THE SAME MEANING AS PARAGRAPH (A) OF SUBDIVISION
ONE OF SECTION TWENTY-NINE HUNDRED NINETY-SEVEN-C OF THIS TITLE.

S. 2809--C                         144

  2.  GENERAL HOSPITALS, NURSING HOMES, ORGANIZATIONS LICENSED OR CERTI-
FIED PURSUANT TO ARTICLE THIRTY-SIX OF THIS CHAPTER,  AND  ORGANIZATIONS
LICENSED  AS  SPECIAL  NEEDS  ASSISTED  LIVING  RESIDENCES  OR  ENHANCED
ASSISTED LIVING RESIDENCES PURSUANT TO ARTICLE FORTY-SIX-B OF THIS CHAP-
TER  SHALL  ESTABLISH  POLICIES  AND PROCEDURES TO PROVIDE PATIENTS WITH
ADVANCED LIFE LIMITING CONDITIONS AND ILLNESSES WHO MIGHT  BENEFIT  FROM
PALLIATIVE  CARE  INCLUDING  ASSOCIATED  PAIN  MANAGEMENT  SERVICES WITH
ACCESS TO INFORMATION AND COUNSELING REGARDING SUCH OPTIONS  APPROPRIATE
TO  THE PATIENT.   POLICIES MUST INCLUDE PROVISION FOR PATIENTS WHO LACK
CAPACITY TO MAKE MEDICAL DECISIONS, SO THAT ACCESS TO  SUCH  INFORMATION
AND  COUNSELING SHALL BE PROVIDED TO THE PERSONS WHO ARE LEGALLY AUTHOR-
IZED TO MAKE MEDICAL DECISIONS ON BEHALF OF SUCH PATIENTS.
  3. GENERAL HOSPITALS, NURSING HOMES, ORGANIZATIONS LICENSED OR  CERTI-
FIED  PURSUANT  TO ARTICLE THIRTY-SIX OF THIS CHAPTER, AND ORGANIZATIONS
LICENSED  AS  SPECIAL  NEEDS  ASSISTED  LIVING  RESIDENCES  OR  ENHANCED
ASSISTED LIVING RESIDENCES PURSUANT TO ARTICLE FORTY-SIX-B OF THIS CHAP-
TER  SHALL  FACILITATE  ACCESS  TO APPROPRIATE PALLIATIVE CARE INCLUDING
ASSOCIATED PAIN MANAGEMENT CONSULTATIONS AND SERVICES INCLUDING BUT  NOT
LIMITED TO REFERRALS CONSISTENT WITH PATIENT NEEDS AND PREFERENCES.  THE
DEPARTMENT  WILL  TAKE  INTO  ACCOUNT ACCESS AND PROXIMITY OF PALLIATIVE
CARE SERVICES, INCLUDING THE ABILITY  OF  HOSPICE  AND  PALLIATIVE  CARE
BOARD   CERTIFIED  PRACTITIONERS  AND  OTHER  RELATED  WORKFORCE  STAFF,
GEOGRAPHIC FACTORS, AND FACILITY SIZE THAT  MAY  IMPACT  DEVELOPMENT  OF
PALLIATIVE CARE SERVICES.
  S 49. Intentionally omitted.
  S  50. Legislative findings. Legislative intent. The legislature finds
that integration and coordination of health care services  is  essential
to  the  improvement  of  health  care  quality,  efficiency, access and
outcomes. The federal Patient Protection and Affordable Care Act creates
several health system demonstration  and  pilot  programs,  intended  to
promote  and  assess  delivery  system and payment reforms, that require
integration of services, coordination among providers, or a  combination
of  the two. Expanding these programs to include non-governmental payers
may strengthen  their  impact,  but  will  require  collaboration  among
competing  payers.  In  addition,  collaborative  arrangements among, or
consolidation of, providers may  be  necessary  to  preserve  access  to
essential  services  in some communities, while improving the quality of
the services they provide and the efficiency  of  their  operations,  as
well as minimizing unnecessary increases in the cost of care.
  Federal  and  state  antitrust  laws  may  prohibit or discourage such
collaboration or consolidation  beneficial  to  residents  of  New  York
state,  given  their potential for, or actual, reduction in competition.
The legislature finds that  such  agreements  should  be  permitted  and
encouraged. Under these circumstances, competition as currently mandated
by federal and state antitrust laws should be supplanted by a regulatory
program  to permit and encourage cooperative, collaborative and integra-
tive agreements between health care providers, payers, and others,  that
are  beneficial  to  New York residents when the benefits of such agree-
ments outweigh any disadvantages caused by  their  potential  or  actual
adverse  effects  on  competition. Regulatory oversight of such arrange-
ments should be provided to ensure that the benefits of such  agreements
outweigh  any disadvantages attributable to any reduction in competition
that may  result  from  the  agreements.  Accordingly,  the  legislature
intends  to  authorize  a regulatory program to permit and oversee inte-
gration,  consolidation,  collaboration,  and  coordination  among   and
between providers and payers, where necessary to assure access to essen-

S. 2809--C                         145

tial  health care services, to improve health care quality and outcomes,
to enhance efficiency, or to minimize the cost of health care.
  S 51. The public health law is amended by adding a new article 29-E to
read as follows:
                              ARTICLE 29-E
            IMPROVED INTEGRATION OF HEALTH CARE AND FINANCING
SECTION 2999-AA. ANTITRUST PROVISIONS, STATE OVERSIGHT.
        2999-BB. DEPARTMENT AUTHORITY.
  S  2999-AA.  ANTITRUST  PROVISIONS,  STATE OVERSIGHT.   1. IN ORDER TO
PROMOTE IMPROVED QUALITY AND EFFICIENCY OF, AND ACCESS TO,  HEALTH  CARE
SERVICES  AND  TO PROMOTE IMPROVED CLINICAL OUTCOMES TO THE RESIDENTS OF
NEW YORK, IT SHALL BE THE POLICY OF THE STATE TO ENCOURAGE  COOPERATIVE,
COLLABORATIVE  AND  INTEGRATIVE ARRANGEMENTS BETWEEN HEALTH CARE PROVID-
ERS, PAYERS AND OTHERS WHO MIGHT OTHERWISE  BE  COMPETITORS,  UNDER  THE
ACTIVE  SUPERVISION OF THE COMMISSIONER. TO THE EXTENT SUCH ARRANGEMENTS
MIGHT BE ANTI-COMPETITIVE WITHIN THE MEANING AND INTENT OF THE STATE AND
FEDERAL ANTITRUST LAWS, THE INTENT OF THE STATE IS TO SUPPLANT  COMPETI-
TION  WITH  SUCH ARRANGEMENTS AS NECESSARY TO ACCOMPLISH THE PURPOSES OF
THIS ARTICLE, AND TO PROVIDE STATE ACTION IMMUNITY UNDER THE  STATE  AND
FEDERAL  ANTITRUST  LAWS WITH RESPECT TO ACTIVITIES UNDERTAKEN BY HEALTH
CARE PROVIDERS AND OTHERS PURSUANT TO THIS ARTICLE, WHERE  THE  BENEFITS
OF  SUCH ARRANGEMENTS OUTWEIGH ANY DISADVANTAGES LIKELY TO RESULT FROM A
REDUCTION OF COMPETITION.
  2. THE COMMISSIONER OR HIS OR HER DULY AUTHORIZED  REPRESENTATIVE  MAY
ALSO  ENGAGE IN APPROPRIATE STATE SUPERVISION NECESSARY TO PROMOTE STATE
ACTION IMMUNITY UNDER THE STATE AND FEDERAL ANTITRUST LAWS.
  S 2999-BB. DEPARTMENT AUTHORITY.    THE  DEPARTMENT  SHALL  PROMULGATE
REGULATIONS  TO IMPLEMENT THIS ARTICLE.  THE DEPARTMENT SHALL FURTHER BE
AUTHORIZED TO IMPOSE FEES AS APPROPRIATE TO FACILITATE  THE  IMPLEMENTA-
TION OF THIS ARTICLE. THIS ARTICLE IS NOT INTENDED TO LIMIT THE AUTHORI-
TY OF THE ATTORNEY GENERAL OF THE STATE OF NEW YORK.
  S 52. Article 29-D of the public health law is amended by adding a new
title 4 to read as follows:
                                  TITLE 4
                  NEW YORK STATE MEDICAL INDEMNITY FUND
SECTION 2999-G. PURPOSE OF THIS ARTICLE.
        2999-H. DEFINITIONS.
        2999-I. CUSTODY AND ADMINISTRATION OF THE FUND.
        2999-J. PAYMENTS FROM THE FUND.
        2999-L. RULES AND REGULATIONS.
  S  2999-G.  PURPOSE  OF THIS ARTICLE.   CREATION OF THE NEW YORK STATE
MEDICAL INDEMNITY FUND. THERE IS  HEREBY  CREATED  THE  NEW  YORK  STATE
MEDICAL  INDEMNITY  FUND  (THE  "FUND").   THE PURPOSE OF THE FUND IS TO
PROVIDE A FUNDING SOURCE FOR CERTAIN COSTS ASSOCIATED WITH BIRTH RELATED
NEUROLOGICAL INJURIES, IN ORDER TO  REDUCE  PREMIUM  COSTS  FOR  MEDICAL
MALPRACTICE INSURANCE COVERAGE.
  S  2999-H.  DEFINITIONS.  AS USED IN THIS TITLE, UNLESS THE CONTEXT OR
SUBJECT MATTER REQUIRES OTHERWISE:
  (A) "BIRTH RELATED NEUROLOGICAL INJURY" MEANS AN INJURY TO  THE  BRAIN
OR  SPINAL  CORD OF A LIVE INFANT CAUSED BY THE DEPRIVATION OF OXYGEN OR
MECHANICAL INJURY OCCURRING IN THE COURSE OF LABOR, DELIVERY OR RESUSCI-
TATION OR BY OTHER MEDICAL SERVICES  PROVIDED  OR  NOT  PROVIDED  DURING
DELIVERY  ADMISSION  THAT  RENDERED  THE  INFANT  WITH  A  PERMANENT AND
SUBSTANTIAL MOTOR IMPAIRMENT OR WITH A DEVELOPMENTAL DISABILITY AS  THAT
TERM  IS  DEFINED  BY SECTION 1.03 OF THE MENTAL HYGIENE LAW. THIS DEFI-
NITION SHALL APPLY TO LIVE BIRTHS ONLY.

S. 2809--C                         146

  (B) "FUND" MEANS THE NEW YORK STATE MEDICAL INDEMNITY FUND.
  (C)  "MEDICALLY NECESSARY HEALTH CARE COSTS" MEANS THE FUTURE MEDICAL,
DENTAL,  REHABILITATION,  CUSTODIAL,  DURABLE  MEDICAL  EQUIPMENT,  HOME
MODIFICATIONS, ASSISTIVE TECHNOLOGY, VEHICLE MODIFICATIONS, PRESCRIPTION
AND  NON-PRESCRIPTION  MEDICATIONS, AND OTHER HEALTH CARE COSTS ACTUALLY
INCURRED FOR SERVICES RENDERED TO AND  SUPPLIES  UTILIZED  BY  QUALIFIED
PLAINTIFFS, WHICH ARE MEDICALLY NECESSARY AS THAT TERM IS DEFINED BY THE
COMMISSIONER IN REGULATION.
  (D)  "QUALIFIED  PLAINTIFFS"  MEANS THOSE PLAINTIFFS WHO (I) HAVE BEEN
FOUND BY A JURY OR COURT TO HAVE SUSTAINED A BIRTH-RELATED  NEUROLOGICAL
INJURY  AS  THE  RESULT OF MEDICAL MALPRACTICE, OR (II) HAVE SUSTAINED A
BIRTH-RELATED NEUROLOGICAL INJURY AS THE RESULT OF ALLEGED MEDICAL MALP-
RACTICE, AND HAVE SETTLED THEIR LAWSUITS THEREFOR.
  S 2999-I. CUSTODY AND ADMINISTRATION OF THE FUND.  (A) THE COMMISSION-
ER OF TAXATION AND FINANCE SHALL BE  THE  CUSTODIAN  OF  THE  FUND.  ALL
PAYMENTS FROM THE FUND SHALL BE MADE BY THE COMMISSIONER OF TAXATION AND
FINANCE  UPON  CERTIFICATES  SIGNED  BY  THE SUPERINTENDENT OF FINANCIAL
REGULATION, OR HIS OR HER DESIGNEE, AS HEREINAFTER  PROVIDED.  THE  FUND
SHALL BE SEPARATE AND APART FROM ANY OTHER FUND AND FROM ALL OTHER STATE
MONIES.  NO MONIES FROM THE FUND SHALL BE TRANSFERRED TO ANY OTHER FUND,
NOR SHALL ANY SUCH MONIES BE APPLIED TO THE MAKING OF  ANY  PAYMENT  FOR
ANY PURPOSE OTHER THAN THE PURPOSE SET FORTH IN THIS TITLE.
  (B)  THE FUND SHALL BE ADMINISTERED BY THE SUPERINTENDENT OF FINANCIAL
REGULATION OR HIS OR HER DESIGNEE IN ACCORDANCE WITH THE  PROVISIONS  OF
THIS ARTICLE.
  (C)  THE  EXPENSE  OF  ADMINISTERING  THE FUND, INCLUDING THE EXPENSES
INCURRED BY THE DEPARTMENT, SHALL BE PAID FROM THE FUND.
  (D) MONIES FOR THE FUND WILL BE PROVIDED PURSUANT TO THIS CHAPTER.
  (E) BEGINNING APRIL FIRST, TWO THOUSAND TWELVE AND ANNUALLY  THEREAFT-
ER,  THE SUPERINTENDENT OF FINANCIAL REGULATION SHALL CAUSE TO BE DEPOS-
ITED INTO THE FUND, SUBJECT TO AVAILABLE APPROPRIATIONS, AN AMOUNT EQUAL
TO THE DIFFERENCE BETWEEN THE AMOUNT APPROPRIATED TO  THE  FUND  IN  THE
PRECEDING  YEAR, AS INCREASED BY THE ADJUSTMENT FACTOR DEFINED IN SUBDI-
VISION (G) OF THIS SECTION, AND THE ASSETS OF THE FUND AT THE CONCLUSION
OF THAT FISCAL YEAR.
  (F) FOLLOWING THE  DEPOSIT  REFERENCED  IN  SUBDIVISION  (E)  OF  THIS
SECTION,  THE  SUPERINTENDENT  OF  FINANCIAL REGULATION SHALL CONDUCT AN
ACTUARIAL CALCULATION OF THE ESTIMATED LIABILITIES OF THE FUND  FOR  THE
COMING  YEAR  RESULTING  FROM  THE  QUALIFIED PLAINTIFFS ENROLLED IN THE
FUND. THE ADMINISTRATOR SHALL FROM TIME TO TIME ADJUST SUCH CALCULATION.
IF THE TOTAL OF ALL  CURRENT  ESTIMATES  OF  LIABILITIES  EQUALS  EIGHTY
PERCENT  OF  THE  FUND'S  ASSETS, THEN THE FUND SHALL NOT ACCEPT ANY NEW
ENROLLMENTS UNTIL A NEW DEPOSIT HAS BEEN MADE  PURSUANT  TO  SUBDIVISION
(E)  OF  THIS SECTION. WHEN, AS A RESULT OF SUCH NEW DEPOSIT, THE FUND'S
LIABILITIES NO LONGER EXCEED THE FUND'S ASSETS, THE  FUND  ADMINISTRATOR
SHALL  ENROLL  NEW QUALIFIED PLAINTIFFS IN THE ORDER THAT AN APPLICATION
FOR ENROLLMENT HAS BEEN SUBMITTED IN ACCORDANCE WITH SUBDIVISION SIX  OF
SECTION TWENTY-NINE HUNDRED NINETY-NINE-J OF THIS TITLE.
  (G)  FOR PURPOSES OF THIS SECTION, THE ADJUSTMENT FACTOR REFERENCED IN
THIS SECTION SHALL BE THE TEN YEAR ROLLING AVERAGE MEDICAL COMPONENT  OF
THE CONSUMER PRICE INDEX AS PUBLISHED BY THE UNITED STATES DEPARTMENT OF
LABOR, BUREAU OF LABOR STATISTICS, FOR THE PRECEDING TEN YEARS.
  S  2999-J.  PAYMENTS  FROM THE FUND.  1. THE FUND SHALL BE USED TO PAY
THE (I) MEDICALLY NECESSARY HEALTH CARE COSTS OF  QUALIFIED  PLAINTIFFS,
(II) EXISTING MEDICAID LIENS ASSERTED AGAINST THE PROCEEDS OF ANY RECOV-
ERY FOR THE BIRTH RELATED NEUROLOGICAL INJURIES SUSTAINED BY SUCH QUALI-

S. 2809--C                         147

FIED  PLAINTIFFS,  AND  (III)  THE  PORTION OF THE FEES OF THE QUALIFIED
PLAINTIFFS' ATTORNEYS DEEMED TO BE ATTRIBUTABLE TO SUCH LIEN  AMOUNT  OR
AMOUNTS.
  2.  IN DETERMINING THE AMOUNT OF MEDICALLY NECESSARY HEALTH CARE COSTS
TO BE PAID FROM THE FUND, ANY SUCH COST OR EXPENSE  THAT  WAS  OR  WILL,
WITH  REASONABLE  CERTAINTY,  BE  PAID, REPLACED OR INDEMNIFIED FROM ANY
COLLATERAL SOURCE AS PROVIDED BY SUBDIVISION (A) OF  SECTION  FORTY-FIVE
HUNDRED FORTY-FIVE OF THE CIVIL PRACTICE LAW AND RULES SHALL NOT CONSTI-
TUTE  A  MEDICALLY NECESSARY HEALTH CARE COST AND SHALL NOT BE PAID FROM
THE FUND. FOR PURPOSES OF THIS  TITLE,  "COLLATERAL  SOURCE"  SHALL  NOT
INCLUDE MEDICARE OR MEDICAID.
  3.  IN DETERMINING THE AMOUNT OF MEDICALLY NECESSARY HEALTH CARE COSTS
TO BE PAID FROM THE FUND, THERE SHALL BE PROPORTIONATELY  DEDUCTED  FROM
EACH  CLAIM  SUBMITTED  TO THE FUND THE AMOUNTS NECESSARY FOR PAYMENT OF
THE SET-OFFS, ADJUSTMENTS AND DEDUCTIONS AS SET FORTH IN SUBDIVISION (E)
OF SECTION FIVE THOUSAND THIRTY-ONE OF THE CIVIL PRACTICE LAW AND RULES.
  4. THE AMOUNT OF MEDICALLY NECESSARY HEALTH CARE COSTS TO BE PAID FROM
THE FUND  SHALL  BE  CALCULATED  ON  THE  BASIS  OF  MEDICAID  RATES  OF
REIMBURSEMENT  OR,  WHERE NO SUCH RATES ARE AVAILABLE, AS DEFINED BY THE
COMMISSIONER IN REGULATION. ANY  DISPUTE  AS  TO  WHETHER  ANY  COST  IS
MEDICALLY NECESSARY SHALL BE DETERMINED BY THE COMMISSIONER.
  5. ON A FORM TO BE PRESCRIBED AND FURNISHED BY THE FUND, THE QUALIFIED
PLAINTIFF  SHALL FILE WITH THE FUND CLAIMS FOR THE PAYMENT FROM THE FUND
OF MEDICALLY NECESSARY HEALTH CARE COSTS, ANY EXISTING  MEDICAID  LIENS,
AND  THE PORTION OF THE FEE OF THE QUALIFIED PLAINTIFF'S ATTORNEY DEEMED
TO BE ATTRIBUTABLE TO SUCH LIEN AMOUNT OR AMOUNTS.
  6. A QUALIFIED PLAINTIFF SHALL BE ENROLLED WHEN (A) SUCH PLAINTIFF, OR
ANY OF THE DEFENDANTS IN REGARD  TO  THE  PLAINTIFF'S  CLAIM,  MAKES  AN
APPLICATION  FOR  ENROLLMENT  BY PROVIDING THE FUND ADMINISTRATOR WITH A
CERTIFIED COPY OF THE JUDGMENT  OR  OF  THE  COURT  APPROVED  SETTLEMENT
AGREEMENT;  AND  (B) THE FUND ADMINISTRATOR DETERMINES UPON THE BASIS OF
SUCH JUDGMENT OR SETTLEMENT AGREEMENT AND ANY ADDITIONAL INFORMATION THE
FUND ADMINISTRATOR SHALL REQUEST  THAT  THE  PLAINTIFF  IS  A  QUALIFIED
PLAINTIFF;  PROVIDED  THAT  NO  ENROLLMENT  SHALL OCCUR WHEN THE FUND IS
CLOSED TO ENROLLMENT PURSUANT TO SUBDIVISION (F) OF SECTION  TWENTY-NINE
HUNDRED NINETY-NINE-I OF THIS TITLE.
  6-A. AS TO ALL CLAIMS, THE FUND ADMINISTRATOR SHALL:
  (A)  DETERMINE WHICH OF SUCH COSTS ARE MEDICALLY NECESSARY HEALTH CARE
COSTS TO BE PAID FROM THE FUND; AND
  (B) THEREUPON CERTIFY TO THE  COMMISSIONER  OF  TAXATION  AND  FINANCE
THOSE  COSTS  THAT HAVE BEEN DETERMINED TO BE MEDICALLY NECESSARY HEALTH
CARE COSTS TO BE PAID FROM THE FUND.
  7. THE QUALIFIED PLAINTIFF'S CLAIM FOR THE  PAYMENT  OF  ANY  EXISTING
MEDICAID  LIENS  SHALL BE ACCOMPANIED BY EVIDENCE OF ANY SUCH LIENS AND,
AS TO SUCH CLAIM, THE FUND ADMINISTRATOR SHALL:
  (A) CONFIRM THE EXISTENCE AND AMOUNT OF SUCH LIENS; AND
  (B) ACCEPT AND PROCESS CLAIMS FOR PAYMENT OF SUCH LIENS; AND
  (C) THEREUPON CERTIFY TO THE  COMMISSIONER  OF  TAXATION  AND  FINANCE
THOSE  LIENS  THAT  HAVE  BEEN  DETERMINED TO BE EXISTING VALID MEDICAID
LIENS TO BE PAID FROM THE FUND.
  WITH REGARD TO THE QUALIFIED PLAINTIFF'S CLAIM FOR THE PAYMENT OF  THE
PORTION  OF  THE  FEE OF THE QUALIFIED PLAINTIFF'S ATTORNEY DEEMED TO BE
ATTRIBUTABLE TO THE EXISTING  MEDICAID  LIENS,  THE  FUND  ADMINISTRATOR
SHALL  ACCEPT  AND PROCESS CLAIMS FOR PAYMENT OF SUCH FEE, ASSUMING THAT
THE EXISTING MEDICAID LIEN IS THE LAST  COMPONENT  OF  THE  JUDGMENT  OR
SETTLEMENT SUM TO BE PAID.

S. 2809--C                         148

  8.  ANY DISPUTE CONCERNING ANY DETERMINATION BY THE FUND ADMINISTRATOR
WITH REGARD TO THAT PORTION OF THE ATTORNEY'S FEE SHALL BE  REFERRED  TO
THE COMMISSIONER.
  9.  PAYMENTS  FROM THE FUND SHALL BE MADE BY THE COMMISSIONER OF TAXA-
TION AND FINANCE ON THE SAID CERTIFICATE OF THE SUPERINTENDENT OF FINAN-
CIAL REGULATION. NO PAYMENT SHALL BE MADE BY THE COMMISSIONER  OF  TAXA-
TION  AND  FINANCE  IN  EXCESS  OF  THE  AMOUNT CERTIFIED. PROMPTLY UPON
RECEIPT OF THE SAID CERTIFICATE OF THE SUPERINTENDENT OF FINANCIAL REGU-
LATION, THE COMMISSIONER OF TAXATION AND FINANCE SHALL PAY (I) THE QUAL-
IFIED PLAINTIFF'S HEALTH CARE PROVIDER OR REIMBURSE THE QUALIFIED PLAIN-
TIFF THE AMOUNT SO CERTIFIED  FOR  PAYMENT,  (II)  THE  LIEN  AMOUNT  OR
AMOUNTS  SO  CERTIFIED  FOR PAYMENT, AND (III) THE QUALIFIED PLAINTIFF'S
ATTORNEY THE PORTION OF THE FEE SO CERTIFIED FOR PAYMENT.
  10. PAYMENT FROM THE FUND SHALL NOT GIVE THE FUND ANY RIGHT OF  RECOV-
ERY AGAINST ANY QUALIFIED PLAINTIFF OR SUCH QUALIFIED PLAINTIFF'S ATTOR-
NEY EXCEPT IN THE CASE OF FRAUD OR MISTAKE.
  11.  ALL  HEALTH CARE PROVIDERS SHALL ACCEPT FROM QUALIFIED PLAINTIFFS
ASSIGNMENTS OF THE RIGHT TO RECEIVE PAYMENTS FROM THE FUND FOR MEDICALLY
NECESSARY HEALTH CARE COSTS.
  12. HEALTH INSURERS (OTHER THAN MEDICARE AND MEDICAID)  SHALL  BE  THE
PRIMARY  PAYERS  OF  MEDICALLY  NECESSARY HEALTH CARE COSTS OF QUALIFIED
PLAINTIFFS. SUCH COSTS SHALL BE PAID FROM THE FUND ONLY  TO  THE  EXTENT
THAT HEALTH INSURERS OR OTHER COLLATERAL SOURCES ARE NOT OTHERWISE OBLI-
GATED  TO MAKE PAYMENTS THEREFOR. HEALTH INSURERS THAT MAKE PAYMENTS FOR
MEDICALLY NECESSARY HEALTH CARE COSTS  TO  OR  ON  BEHALF  OF  QUALIFIED
PLAINTIFFS  SHALL  HAVE  NO  RIGHT OF RECOVERY AGAINST AND SHALL HAVE NO
LIEN UPON THE FUND OR ANY PERSON OR ENTITY NOR SHALL THE FUND CONSTITUTE
AN ADDITIONAL PAYMENT SOURCE TO OFFSET THE PAYMENTS OTHERWISE CONTRACTU-
ALLY REQUIRED TO BE MADE BY SUCH HEALTH INSURERS.
  13. EXCEPT AS PROVIDED FOR BY THIS TITLE, NO PAYMENT SHALL BE REQUIRED
TO BE MADE BY ANY DEFENDANT OR SUCH DEFENDANT'S  INSURER  FOR  MEDICALLY
NECESSARY  HEALTH CARE COSTS, OR FOR THE EXISTING MEDICAID LIEN AMOUNTS,
OR FOR THE PORTION OF THE FEE  OF  THE  QUALIFIED  PLAINTIFF'S  ATTORNEY
DEEMED TO BE ATTRIBUTABLE TO SUCH LIEN AMOUNTS, AND NO JUDGMENT SHALL BE
MADE OR ENTERED REQUIRING THAT ANY SUCH PAYMENT BE MADE BY ANY DEFENDANT
OR SUCH DEFENDANT'S INSURER.
  14.  THE  DETERMINATION  OF  THE  QUALIFIED PLAINTIFF'S ATTORNEY'S FEE
SHALL BE BASED UPON THE ENTIRE SUM AWARDED BY THE JURY OR THE  COURT  OR
THE  FULL  SUM OF THE SETTLEMENT, AS THE CASE MAY BE. THE PORTION OF THE
QUALIFIED PLAINTIFF'S ATTORNEY'S FEE DEEMED TO BE  ATTRIBUTABLE  TO  THE
EXISTING  MEDICAID  LIEN  SHALL  BE  PAID IN ACCORDANCE WITH SUBDIVISION
SEVEN OF THIS SECTION AND SHALL NOT BE PAID OUT  OF  THE  MEDICAID  LIEN
AMOUNT.  THE PORTION OF THE QUALIFIED PLAINTIFF'S ATTORNEY'S FEE THAT IS
ALLOCATED TO ALL OTHER ELEMENTS OF DAMAGES SHALL BE PAID IN A  LUMP  SUM
BY  THE  DEFENDANTS  AND THEIR INSURERS PURSUANT TO SECTION FOUR HUNDRED
SEVENTY-FOUR-A OF THE JUDICIARY LAW; PROVIDED HOWEVER THAT  THE  PORTION
OF  THE  ATTORNEY  FEE  THAT  IS  ALLOCATED  TO THE NON-FUND ELEMENTS OF
DAMAGES SHALL BE DEDUCTED FROM THE NON-FUND PORTION OF THE  AWARD  IN  A
PROPORTIONAL MANNER.
  15.  THE  COMMISSIONER  OF  HEALTH AND THE SUPERINTENDENT OF FINANCIAL
REGULATION SHALL PROMULGATE, AMEND AND ENFORCE ALL REASONABLE RULES  AND
REGULATIONS  NECESSARY  FOR  THE  PROPER  ADMINISTRATION  OF THE FUND IN
ACCORDANCE WITH THE PROVISIONS  OF  THIS  SECTION,  INCLUDING,  BUT  NOT
LIMITED  TO,  THOSE  CONCERNING THE PAYMENT OF CLAIMS AND CONCERNING THE
ACTUARIAL CALCULATIONS  NECESSARY  TO  DETERMINE,  ANNUALLY,  THE  TOTAL

S. 2809--C                         149

AMOUNT  TO  BE  PAID  INTO THE FUND AS PROVIDED HEREIN, AND AS OTHERWISE
NEEDED TO IMPLEMENT THIS TITLE.
  S  52-a.  Article 29-D of the public health law is amended by adding a
new title 5 to read as follows:
                                  TITLE 5
               NEW YORK STATE HOSPITAL QUALITY INITIATIVE
SECTION 2999-M. NEW YORK STATE HOSPITAL QUALITY INITIATIVE.
  S 2999-M. NEW YORK STATE HOSPITAL QUALITY INITIATIVE.   THE  NEW  YORK
STATE  HOSPITAL QUALITY INITIATIVE, INCLUDING THE NEW YORK STATE OBSTET-
RICAL PATIENT SAFETY WORKGROUP, WILL BE CREATED  IN  THE  DEPARTMENT  OF
HEALTH  TO  BE  COMPRISED  OF MEDICAL, HOSPITAL AND ACADEMIC EXPERTS AND
OTHER STAKEHOLDERS CHOSEN BY THE COMMISSIONER.
  THE NEW YORK STATE QUALITY INITIATIVE WILL OVERSEE THE GENERAL DISSEM-
INATION OF INITIATIVES, GUIDANCE, AND BEST PRACTICES TO  GENERAL  HOSPI-
TALS.  ACTIVITIES  WILL INCLUDE BUT NOT BE LIMITED TO: BUILDING CULTURES
OF PATIENT SAFETY AND IMPLEMENTING EVIDENCE BASED CARE IN TARGET  AREAS.
THE  WORKGROUP  WILL UNDERTAKE COLLABORATIVE WORK TO IMPROVE OBSTETRICAL
CARE OUTCOMES AND QUALITY OF CARE, BASED ON IDENTIFYING AND IMPLEMENTING
EVIDENCE BASED PRACTICES, AND CLINICAL PROTOCOLS THAT CAN  BE  STANDARD-
IZED AND ADOPTED BY HOSPITALS INCLUDING BUT NOT LIMITED TO:
  (A)  SURVEYING,  REVIEWING  AND  ANALYZING  CURRENT  "BEST"  PRACTICES
EMPLOYED IN OBSTETRICAL CASES, INCLUDING EXPLORING THE USE  OF  "VIRTUAL
GRAND ROUNDS";
  (B)  UNDERTAKING A REVIEW OF "CLOSED CLAIMS" IN AN EFFORT TO DEVELOP A
SET OF "STANDARD BEST PRACTICES" FOR DELIVERIES IN NEW YORK STATE;
  (C) FORMULATING AND RECOMMENDING TO  THE  COMMISSIONER  BEST  PRACTICE
STANDARDS  AND  DESIGNING  NEW  PROGRAMS FOR IMPLEMENTATION AND IMPROVED
OUTCOMES, INCLUDING BUT NOT LIMITED TO, CLINICAL BUNDLES FOR HIGH PRIOR-
ITY CONDITIONS, ELECTRONIC FETAL MONITORING TRAINING AND  CERTIFICATION,
AND TEAM TRAINING; AND
  (D)  ENGAGING  THE  EXISTING  REGIONAL  PERINATAL  CENTER  NETWORK  IN
DIALOGUES REGARDING THE  ABOVE  TOPICS  AND  MAKING  RECOMMENDATIONS  TO
IMPROVE  AND/OR  UPGRADE  ASSISTANCE AND COMMUNICATION TO SMALLER HOSPI-
TALS.
  S 52-b. Subdivision 1 of section 2807-v of the public  health  law  is
amended by adding a new paragraph (iii) to read as follows:
  (III)  FUNDS SHALL BE RESERVED AND SET ASIDE AND ACCUMULATED FROM YEAR
TO YEAR AND SHALL BE MADE AVAILABLE, INCLUDING  INCOME  FROM  INVESTMENT
FUNDS,  FOR  THE PURPOSE OF SUPPORTING THE NEW YORK STATE MEDICAL INDEM-
NITY FUND AS AUTHORIZED PURSUANT TO TITLE FOUR OF ARTICLE  TWENTY-NINE-D
OF THIS CHAPTER, FOR THE FOLLOWING PERIODS AND IN THE FOLLOWING AMOUNTS,
PROVIDED,  HOWEVER,  THAT  THE COMMISSIONER IS AUTHORIZED TO SEEK WAIVER
AUTHORITY FROM THE FEDERAL CENTERS FOR MEDICARE  AND  MEDICAID  FOR  THE
PURPOSE  OF  SECURING  MEDICAID FEDERAL FINANCIAL PARTICIPATION FOR SUCH
PROGRAM, IN WHICH CASE THE FUNDING AUTHORIZED PURSUANT TO THIS PARAGRAPH
SHALL BE UTILIZED AS THE NON-FEDERAL SHARE FOR SUCH PAYMENTS:
  ONE HUNDRED MILLION DOLLARS FOR THE PERIOD APRIL FIRST,  TWO  THOUSAND
ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE.
  S  52-c.  The  public  health  law  is amended by adding a new section
2807-d-1 to read as follows:
  S 2807-D-1. HOSPITAL QUALITY CONTRIBUTIONS.   1.  NOTWITHSTANDING  ANY
CONTRARY  PROVISION  OF  LAW AND SUBJECT TO THE RECEIPT OF ALL NECESSARY
FEDERAL APPROVALS OR WAIVERS, FOR PERIODS ON AND AFTER JULY  FIRST,  TWO
THOUSAND  ELEVEN,  A  QUALITY CONTRIBUTION SHALL BE IMPOSED ON THE INPA-
TIENT REVENUE OF EACH GENERAL HOSPITAL EQUAL  TO  THREE  TENTHS  OF  ONE
PERCENT  OF SUCH REVENUE, AS DEFINED IN ACCORDANCE WITH PARAGRAPH (A) OF

S. 2809--C                         150

SUBDIVISION THREE OF SECTION TWENTY-EIGHT HUNDRED SEVEN-D OF THIS  ARTI-
CLE,  AND  PROVIDED  FURTHER, HOWEVER, THAT ON AND AFTER JULY FIRST, TWO
THOUSAND ELEVEN,  AN  ADDITIONAL  QUALITY  CONTRIBUTION  EQUAL  TO  FOUR
PERCENT  OF  SUCH  INPATIENT REVENUE SHALL BE IMPOSED WITH REGARD TO ALL
SUCH INPATIENT REVENUE THAT IS RECEIVED FOR THE PROVISION  OF  INPATIENT
OBSTETRICAL  PATIENT  CARE  SERVICES, PROVIDED, HOWEVER, THAT SUCH ADDI-
TIONAL QUALITY CONTRIBUTION IS  SUBJECT  TO  RECEIPT  OF  ALL  NECESSARY
FEDERAL  APPROVALS OR WAIVERS, AS DETERMINED AS NECESSARY BY THE COMMIS-
SIONER, AND PROVIDED FURTHER, HOWEVER, THAT IN THE EVENT THE COMMISSION-
ER, IN CONSULTATION WITH THE DIRECTOR OF  THE  BUDGET,  DETERMINES  THAT
SUCH QUALITY CONTRIBUTION AND SUCH ADDITIONAL QUALITY CONTRIBUTION SHALL
RAISE  LESS  THAN  OR  MORE THAN THE TOTAL QUALITY COLLECTION AMOUNT SET
FORTH IN SUBDIVISION TWO OF THIS SECTION, THEN IN THAT EVENT THE COMMIS-
SIONER, IN CONSULTATION WITH THE DIRECTOR OF THE BUDGET, MAY  PROMULGATE
REGULATIONS,  AND  MAY  PROMULGATE  EMERGENCY REGULATIONS, INCREASING OR
DECREASING SUCH QUALITY CONTRIBUTIONS BY AMOUNTS  SUFFICIENT  TO  ENSURE
THE  COLLECTION OF SUCH ANNUAL QUALITY CONTRIBUTION AMOUNT AND TO ENSURE
THAT FIFTY-FIVE PERCENT OF SUCH AGGREGATE AMOUNT IS RAISED BY SUCH QUAL-
ITY CONTRIBUTION AND FORTY-FIVE PERCENT IS  RAISED  BY  SUCH  ADDITIONAL
QUALITY CONTRIBUTION.
  2.  THE  ANNUAL  QUALITY CONTRIBUTION AMOUNT REFERENCED IN SUBDIVISION
ONE OF THIS SECTION SHALL BE ONE HUNDRED SEVENTY MILLION DOLLARS FOR THE
STATE FISCAL YEAR BEGINNING APRIL FIRST, TWO THOUSAND  ELEVEN,  AND  FOR
EACH  SUBSEQUENT  STATE FISCAL YEAR THEREAFTER IT SHALL BE THE AMOUNT OF
THE PRECEDING YEAR AS INCREASED BY THE TEN YEAR ROLLING AVERAGE  OF  THE
MEDICAL COMPONENT OF THE CONSUMER PRICE INDEX AS PUBLISHED BY THE UNITED
STATES  DEPARTMENT OF LABOR, BUREAU OF LABOR STATISTICS, FOR THE PRECED-
ING TEN YEARS.
  3. THE QUALITY CONTRIBUTIONS DESCRIBED IN THIS SECTION SHALL BE ADMIN-
ISTERED IN ACCORDANCE WITH AND SUBJECT TO THE PROVISIONS OF SUBDIVISIONS
FOUR, FIVE, SIX, SEVEN, EIGHT AND TWELVE OF SECTION TWENTY-EIGHT HUNDRED
SEVEN-D OF THIS ARTICLE, PROVIDED, HOWEVER, THAT SUCH  QUALITY  CONTRIB-
UTIONS  SHALL  BE  DEPOSITED  IN  THE HCRA RESOURCES FUND AS ESTABLISHED
PURSUANT TO SECTION NINETY-TWO-DD OF THE STATE FINANCE LAW; AND PROVIDED
FURTHER, HOWEVER, THAT SUCH CONTRIBUTIONS SHALL NOT BE AN ALLOWABLE COST
IN THE DETERMINATION OF REIMBURSEMENT RATES OF PAYMENT COMPUTED PURSUANT
TO THIS ARTICLE.
  4. THIS SECTION SHALL  EXPIRE,  AND  THE  COLLECTION  OF  THE  QUALITY
CONTRIBUTIONS  DESCRIBED  IN  THIS  SECTION  SHALL  BE SUSPENDED AND THE
AMOUNTS ALREADY PAID FOR THAT FISCAL YEAR SHALL BE REFUNDED  PROPORTION-
ATELY  TO EACH CONTRIBUTOR, IF A TWO HUNDRED FIFTY THOUSAND DOLLAR LIMI-
TATION FOR NON-ECONOMIC DAMAGES PURSUANT TO ARTICLE FIFTY-C OF THE CIVIL
PRACTICE LAW AND RULES IS NOT IN PLACE.
  S 52-d. Section 3012-a of the civil practice law and rules, as amended
by chapter 507 of the laws of 1987, is amended to read as follows:
  S 3012-a. Certificate of merit in medical, dental and podiatric  malp-
ractice  actions.    (a)  In any action for medical, dental or podiatric
malpractice, the  complaint  shall  be  accompanied  by  a  certificate,
executed by the attorney for the plaintiff, declaring that:
  (1)  the attorney has reviewed the facts of the case and has consulted
AS TO EACH NAMED DEFENDANT, with at least one physician in medical malp-
ractice actions, at least one dentist in dental malpractice  actions  or
at least one podiatrist in podiatric malpractice actions who is licensed
to practice in this state or any other state, WHO IS CURRENTLY IN ACTIVE
PRACTICE  IN  THE  SAME SPECIALTY AS THE DEFENDANT, and who the attorney
reasonably believes is knowledgeable in the relevant issues involved  in

S. 2809--C                         151

the  particular action, and that the attorney has concluded on the basis
of such review and consultation that there is a reasonable basis for the
commencement  of  such  action  AGAINST  EACH  DEFENDANT  NAMED  IN  THE
COMPLAINT; or
  (2)  the  attorney  was  unable to obtain the consultation required by
paragraph one of this subdivision because a limitation of  time,  estab-
lished by article two of this chapter, would bar the action and that the
certificate  required  by  paragraph  one  of this subdivision could not
reasonably be obtained before such time expired.  If  a  certificate  is
executed  pursuant to this subdivision, the certificate required by this
section  shall  be  filed  within  ninety  days  after  service  of  the
complaint[; or
  (3)  the  attorney  was  unable to obtain the consultation required by
paragraph one of this subdivision because the attorney  had  made  three
separate good faith attempts with three separate physicians, dentists or
podiatrists,  in accordance with the provisions of paragraph one of this
subdivision to obtain such consultation  and  none  of  those  contacted
would agree to such a consultation].
  (b) Where a certificate is required pursuant to this section, a single
certificate shall be filed for each DEFENDANT NAMED IN THE action[, even
if  more  than  one defendant has been named in the complaint or is] AND
FOR EACH DEFENDANT WHO IS subsequently named.
  (c) Where the attorney intends to rely solely on the doctrine of  "res
ipsa  loquitur", this section shall be inapplicable.  In such cases, the
complaint shall be accompanied by a certificate, executed by the  attor-
ney, declaring that the attorney is solely relying on such doctrine and,
for that reason, is not filing a certificate required by this section.
  (d)  If  a request by the plaintiff for the records of the plaintiff's
medical or dental treatment by the defendants has  been  made  and  such
records  have  not been produced, the plaintiff shall not be required to
serve the certificate required by this section until ninety  days  after
such records have been produced.
  (e)  For  purposes  of  this section, and subject to the provisions of
section thirty-one hundred one of this chapter, an attorney who  submits
a  certificate as required by paragraph one or two of subdivision (a) of
this section and the physician, dentist  or  podiatrist  with  whom  the
attorney consulted shall not be required to disclose the identity of the
physician,  dentist  or  podiatrist  consulted  and the contents of such
consultation; provided, however, that when the attorney  makes  a  claim
under  paragraph  three  of  subdivision (a) of this section that he was
unable to obtain the required consultation with the  physician,  dentist
or podiatrist, the court may, upon the request of a defendant made prior
to compliance by the plaintiff with the provisions of section thirty-one
hundred  of  this  chapter, require the attorney to divulge to the court
the names of physicians, dentists or podiatrists refusing such consulta-
tion.
  (f) The provisions of this section shall not be applicable to a plain-
tiff who is not represented by an attorney.
  (g) The plaintiff may, in lieu of serving the certificate required  by
this  section,  provide the defendant or defendants with the information
required by paragraph one  of  subdivision  (d)  of  section  thirty-one
hundred one of this chapter within the period of time prescribed by this
section.
  S  52-e.  Subparagraphs (i) and (ii) of paragraph 1 of subdivision (d)
of section 3101 of the civil practice law and rules, subparagraph (i) as
amended by chapter 184 of the laws of 1988,  and  subparagraph  (ii)  as

S. 2809--C                         152

amended  by  chapter  165  of  the  laws of 1991, are amended to read as
follows:
  (i) Upon request, each party shall identify each person whom the party
expects  to  call  as  an  expert witness at trial and shall disclose in
reasonable detail the subject matter on which each expert is expected to
testify, the substance of the facts and opinions on which each expert is
expected to testify, the qualifications of each  expert  witness  and  a
summary of the grounds for each expert's opinion. However, where a party
for  good  cause  shown retains an expert an insufficient period of time
before the commencement of trial to give appropriate notice thereof, the
party shall not thereupon be precluded  from  introducing  the  expert's
testimony  at  the  trial  solely  on grounds of noncompliance with this
paragraph. In that instance, upon motion of any party, made before or at
trial, or on its own initiative, the court may make whatever  order  may
be  just.  [In an action for medical, dental or podiatric malpractice, a
party, in responding to a request, may omit the names of medical, dental
or podiatric experts but shall be required to disclose all other  infor-
mation concerning such experts otherwise required by this paragraph.]
  (ii)  In  an action for medical, dental or podiatric malpractice, [any
party may, by written offer made to and served upon  all  other  parties
and  filed  with  the  court, offer to disclose the name of, and to make
available for examination upon oral deposition,  any  person  the  party
making  the  offer expects to call as an expert witness at trial. Within
twenty days of service of the offer, a party shall accept or reject  the
offer  by  serving  a  written  reply upon all parties and filing a copy
thereof with the court. Failure to serve a reply within twenty  days  of
service  of  the  offer shall be deemed a rejection of the offer. If all
parties accept the offer, each party shall be required to produce his or
her expert witness for examination upon oral deposition upon receipt  of
a  notice  to  take  oral  deposition in accordance with rule thirty-one
hundred seven of this chapter. If any party, having made or accepted the
offer, fails to make that party's expert available for oral  deposition,
that  party  shall  be  precluded  from offering expert testimony at the
trial of the action] A PARTY SHALL BE REQUIRED TO PRODUCE EACH PERSON SO
IDENTIFIED BY SUCH PARTY AS AN EXPERT WITNESS FOR EXAMINATION UPON  ORAL
DEPOSITION  UPON  RECEIPT OF A NOTICE TO TAKE ORAL DEPOSITION AFTER SUCH
TIME AS THE PRODUCING PARTY COMPLIES WITH SUBPARAGRAPH (I) OF THIS PARA-
GRAPH.
  S 52-f. The civil practice law and rules is amended by  adding  a  new
rule 3409 to read as follows:
  RULE  3409.  SETTLEMENT  CONFERENCE  IN  DENTAL, PODIATRIC AND MEDICAL
MALPRACTICE ACTIONS.  IN EVERY DENTAL, PODIATRIC OR MEDICAL  MALPRACTICE
ACTION,  THE  COURT  SHALL HOLD A MANDATORY SETTLEMENT CONFERENCE WITHIN
FORTY-FIVE DAYS AFTER THE FILING OF THE NOTE OF ISSUE AND CERTIFICATE OF
READINESS OR, IF A PARTY MOVES TO VACATE THE NOTE OF ISSUE  AND  CERTIF-
ICATE  OF  READINESS,  WITHIN  FORTY-FIVE  DAYS AFTER THE DENIAL OF SUCH
MOTION. WHERE PARTIES ARE REPRESENTED BY COUNSEL, ONLY  ATTORNEYS  FULLY
FAMILIAR  WITH  THE  ACTION  AND  AUTHORIZED  TO DISPOSE OF THE CASE, OR
ACCOMPANIED BY A PERSON EMPOWERED TO ACT ON BEHALF OF THE PARTY  REPRES-
ENTED, WILL BE PERMITTED TO APPEAR AT THE CONFERENCE. WHERE APPROPRIATE,
THE COURT MAY ORDER PARTIES, REPRESENTATIVES OF PARTIES, REPRESENTATIVES
OF INSURANCE CARRIERS OR PERSONS HAVING AN INTEREST IN ANY SETTLEMENT TO
ALSO  ATTEND  IN  PERSON OR TELEPHONICALLY AT THE SETTLEMENT CONFERENCE.
THE CHIEF ADMINISTRATIVE JUDGE SHALL BY RULE ADOPT PROCEDURES TO  IMPLE-
MENT SUCH SETTLEMENT CONFERENCE.
  S 52-g. Intentionally omitted.

S. 2809--C                         153

  S  52-h.  Subdivision 2 of section 2805-m of the public health law, as
amended by chapter 808 of the laws  of  1987,  is  amended  to  read  as
follows:
  2.  Notwithstanding  any other provisions of law, none of the records,
documentation or committee  actions  or  records  required  pursuant  to
sections  twenty-eight hundred five-j and twenty-eight hundred five-k of
this article, the reports  required  pursuant  to  section  twenty-eight
hundred  five-l  of this article nor any incident reporting requirements
imposed upon diagnostic and treatment centers pursuant to the provisions
of this chapter shall be subject to disclosure under article six of  the
public  officers law or article thirty-one of the civil practice law and
rules, except [as hereinafter provided or]  as  provided  by  any  other
provision  of  law.  No  person  in  attendance at a meeting of any such
committee shall be required to testify as to  what  transpired  thereat.
[The  prohibition  relating to discovery of testimony shall not apply to
the statements made by any person in attendance at such a meeting who is
a party to an action or proceeding  the  subject  matter  of  which  was
reviewed at such meeting.]
  S  52-i.  The  civil practice law and rules is amended by adding a new
article 50-C to read as follows:
                               ARTICLE 50-C
                              DAMAGE AWARDS
SECTION 5051. DEFINITION.
        5052. DAMAGE AWARDS.
  S 5051. DEFINITION. AS USED IN  THIS  ARTICLE,  "NONECONOMIC  DAMAGES"
MEANS  NONPECUNIARY  DAMAGES  ARISING  FROM  PAIN AND SUFFERING, LOSS OF
SERVICES, LOSS OF CONSORTIUM, OR OTHER NONPECUNIARY DAMAGES.
  S 5052. DAMAGE AWARDS. IN ANY MEDICAL, DENTAL, OR  PODIATRIC  MALPRAC-
TICE ACTION, THE PREVAILING PLAINTIFF MAY BE AWARDED:
  (A) ECONOMIC AND PECUNIARY DAMAGES; AND
  (B)  NONECONOMIC  DAMAGES  SUFFERED  BY  THE INJURED PLAINTIFF, NOT TO
EXCEED TWO HUNDRED FIFTY THOUSAND DOLLARS, PROVIDED, HOWEVER, THAT  SUCH
LIMITATION SHALL BE ADJUSTED IN ACCORDANCE WITH THE CONSUMER PRICE INDEX
FOR  ALL  URBAN  CONSUMERS  (CPI-U), AS PUBLISHED ANNUALLY BY THE UNITED
STATES DEPARTMENT OF LABOR, BUREAU OF LABOR STATISTICS.
  S 52-j. Subdivision (c) of section 5031 of the civil practice law  and
rules is REPEALED and subdivisions (d), (e), (f), (g) and (h) are relet-
tered subdivisions (c), (d), (e), (f) and (g).
  S  52-k.  Subdivisions  (c),  (d),  (e) and (f) of section 5031 of the
civil practice law and rules, as added by chapter 86 of the laws of 2003
and as relettered by section fifty-two-j of this  act,  are  amended  to
read as follows:
  (c)  The  findings  of future economic and pecuniary damages except in
wrongful death actions AND IN ACTIONS SUBJECT TO TITLE 4 OF ARTICLE 29-D
OF THE PUBLIC HEALTH LAW,  shall  be  used  to  determine  a  stream  of
payments  for each such item of damages by applying (i) the growth rate,
to the (ii) annual amount in current dollars, for the  (iii)  period  of
years,  all  of  such items as determined by the finder of fact for each
such item of damages. The court shall determine the present value of the
stream of payments for each such item of damages by applying a  discount
rate  to  the stream of payments. After determining the present value of
the stream of payments for future economic and pecuniary damages,  thir-
ty-five  percent  of that present value shall be paid in a lump sum, and
the stream of payments for future economic and pecuniary  damages  shall
be  adjusted  accordingly  by  proportionately reducing each item of the
remaining stream of payments for future economic and  pecuniary  damages

S. 2809--C                         154

and  paying those amounts over time in the form of an annuity in accord-
ance with the provisions set forth in  subdivision  [(g)]  (F)  of  this
section, subject to the adjustments and deductions specified in subdivi-
sion [(f)](E) of this section.
  (d)  The  discount rate to be used in determining the present value of
all streams of payments for periods of up to twenty years shall  be  the
rate  in effect for the ten-year United States Treasury Bond on the date
of the verdict. As to any streams of payments for which  the  period  of
years  exceeds twenty years, the discount rate to be used in determining
the present value shall be calculated by averaging, on an annual  basis,
the  rate  in effect for the ten-year United States Treasury Bond on the
date of the verdict for the first twenty years and two percentage points
above the rate in effect for the ten-year United States Treasury Bond on
the date of the verdict for the years after twenty years.
  (e) After making the applicable calculations set forth above:
  (1) The court shall apply any set-offs for comparative negligence  and
settlements  by  deducting  them  proportionately  from each item of the
damages awards, including the lump sum payments  specified  in  subdivi-
sions  (b)[,  (c),] and [(d)] (C) of this section, and the present value
of the streams of payments specified in [such subdivisions]  SUBDIVISION
(c) [and (d)].  After such deductions, the streams of payments specified
in [such subdivisions] SUBDIVISION (c) [and (d)] and their present value
shall be adjusted accordingly.
  (2)  The  court  shall  then  deduct  the  litigation  expenses of the
plaintiff's attorney proportionately from each  remaining  item  of  the
damages  awards,  including the remaining lump sum payments specified in
such subdivisions (b)[, (c),] and [(d)] (C), and the  present  value  of
the  remaining  streams  of  payments  specified  in [such subdivisions]
SUBDIVISION (c) [and (d)], and such expenses shall be  paid  in  a  lump
sum.  After  said deductions, the streams of payments specified in [such
subdivisions] SUBDIVISION (c) [and (d)] and their present value shall be
adjusted accordingly.
  (3) The court shall then determine the attorney's fees based upon  the
remaining  damages  awards,  including  the  remaining lump sum payments
specified in such subdivisions (b)[, (c),] and [(d)] (C), and the  pres-
ent value of the remaining streams of payments specified in [such subdi-
visions]  SUBDIVISION  (c)  [and  (d)].    The  attorney's fees shall be
deducted proportionately from each item of the remaining damages awards,
including the remaining lump sum payments specified in such subdivisions
(B) AND (c)[, and (d),] and the present value of the  remaining  streams
of  payments specified in [such subdivisions] SUBDIVISION (c) [and (d)],
and such fees shall be paid in a lump sum.  After said  deductions,  the
stream of payments specified in [such subdivisions] SUBDIVISION (c) [and
(d)] and their present value shall be adjusted accordingly.
  (4)  Any  liens  which  are not the subject of a separate award by the
finder of fact shall then be deducted proportionately from each item  of
the  remaining damages awards, including the remaining lump sum payments
specified in such subdivisions (b)[, (c),] and [(d)] (C), and the  pres-
ent value of the remaining streams of payments specified in [such subdi-
visions]  SUBDIVISION  (c)  [and (d)], and such liens shall be paid in a
lump sum. After said deductions, the stream  of  payments  specified  in
[such  subdivisions]  SUBDIVISION  (c) [and (d)] and their present value
shall be adjusted accordingly.
  (f) The defendants and their insurance carriers shall be  required  to
offer  and  to guarantee the purchase and payment of an annuity contract
to make annual payments in equal monthly installments of  the  remaining

S. 2809--C                         155

streams  of  payments  specified  in [such subdivisions] SUBDIVISION (c)
[and (d)], after making the deductions  and  adjustments  prescribed  in
subdivision  [(f)]  (E)  of  this  section.  The  annuity contract shall
provide that the payments shall run from the date of the verdict (unless
some  other  date  is  specified in the verdict) for the period of years
determined by the finder of fact (except  the  stream  of  payments  for
future  pain  and  suffering, which shall not exceed eight years) or the
life of the plaintiff, whichever is shorter, except that:
  (1) awards for lost earnings shall be paid for the full  term  of  the
award determined by the finder of fact; and
  (2)  awards  for any item of economic or pecuniary damages as to which
the finder of fact found that the loss or item of damage  is  permanent,
the  payments for that item shall continue to run for the entire life of
the plaintiff, increasing each year beyond the period  of  years  deter-
mined by the finder of fact at the same growth rate as determined by the
finder of fact.
  S  52-l.  Section 5034 of the civil practice law and rules, as amended
by chapter 446 of the laws of 1999, is amended to read as follows:
  S 5034. Failure to make payment. If at any  time  following  entry  of
judgment,  a judgment debtor fails for any reason to make a payment in a
timely fashion according to the terms  of  this  article,  the  judgment
creditor may petition the court which rendered the original judgment for
an  order  requiring  payment  by the judgment debtor of the outstanding
payments in a lump sum. In calculating the amount of the lump sum  judg-
ment,  the  court  shall  total  the remaining periodic payments due and
owing to the judgment creditor, as calculated  pursuant  to  subdivision
[(e)] (D) of section five thousand thirty-one of this article, and shall
not  convert  these  amounts  to their present value. The court may also
require the payment of interest on the outstanding judgment.
  S 52-m. The creation and continuation of the New  York  State  Medical
Indemnity  Fund  established  pursuant to title 4 of article 29-D of the
public health law, as added by section fifty-two of this act, is contin-
gent upon the application of a two hundred fifty thousand dollar limita-
tion for non-economic damages, defined in  article  50-C  of  the  civil
practice  law  and  rules,  as  added  by section fifty-two of this act;
provided, however, that payments  pursuant  to  section  2999-j  of  the
public  health  law,  as  added  by  section fifty-two of this act shall
continue to be made as set forth in such section  with  respect  to  any
qualified  plaintiff  enrolled  in  such fund prior to any suspension of
such limitation for non-economic damages.
  S 53. Subdivision 6 of section 369 of  the  social  services  law,  as
added by chapter 170 of the laws of 1994, is amended to read as follows:
  6.  For  purposes of this section, [the term] AN INDIVIDUAL'S "estate"
[means] INCLUDES all OF THE INDIVIDUAL'S real and personal property  and
other assets [included within the individual's estate and] passing under
the  terms of a valid will or by intestacy.  AN INDIVIDUAL'S ESTATE ALSO
INCLUDES ANY OTHER PROPERTY IN WHICH THE INDIVIDUAL HAS ANY LEGAL  TITLE
OR  INTEREST  AT  THE  TIME  OF  DEATH, INCLUDING JOINTLY HELD PROPERTY,
RETAINED LIFE ESTATES, AND INTERESTS IN TRUSTS, TO THE  EXTENT  OF  SUCH
INTERESTS;  PROVIDED,  HOWEVER, THAT A CLAIM AGAINST A RECIPIENT OF SUCH
PROPERTY BY DISTRIBUTION OR SURVIVAL SHALL BE LIMITED TO  THE  VALUE  OF
THE  PROPERTY  RECEIVED  OR  THE  AMOUNT  OF MEDICAL ASSISTANCE BENEFITS
OTHERWISE RECOVERABLE PURSUANT TO THIS SECTION, WHICHEVER IS LESS.
  S 54.  Subparagraph 12 of paragraph (a) of subdivision  1  of  section
366  of the social services law, as amended by section 42-a of part C of
chapter 58 of the laws of 2008, is amended to read as follows:

S. 2809--C                         156

  (12) is a disabled person at least sixteen years of age, but under the
age of sixty-five, who: would be eligible for benefits under the supple-
mental security income program but for earnings in excess of the  allow-
able  limit;  has  net available income that does not exceed two hundred
fifty percent of the applicable federal income official poverty line, as
defined  and updated by the United States department of health and human
services, for a one-person or two-person household, as  defined  by  the
commissioner in regulation; has household resources, as defined in para-
graph  (e)  of  subdivision  two of section three hundred sixty-six-c of
this title, OTHER THAN RETIREMENT ACCOUNTS,  that  do  not  exceed  [the
amount  described  in  subparagraph four of paragraph (a) of subdivision
two of this section] TWENTY THOUSAND DOLLARS for a one-person  HOUSEHOLD
or THIRTY THOUSAND DOLLARS FOR A two-person household, as defined by the
commissioner  in  regulation;  and  contributes  to  the cost of medical
assistance provided pursuant to this  subparagraph  in  accordance  with
subdivision twelve of section three hundred sixty-seven-a of this title;
for  purposes  of  this  subparagraph, disabled means having a medically
determinable impairment of sufficient severity and duration  to  qualify
for benefits under section 1902(a)(10)(A)(ii)(xv) of the social security
act; or
  S  55. The mental hygiene law is amended by adding a new section 31.08
to read as follows:
S 31.08 COMPLIANCE WITH OPERATIONAL STANDARDS BY HOSPITALS.
  (A) NOTWITHSTANDING THE PROVISIONS OF SECTION 31.07 OF THIS ARTICLE, A
HOSPITAL AS DEFINED IN SECTION 1.03 OF THIS CHAPTER, WHICH  IS  A  WARD,
WING,  UNIT,  OR  OTHER  PART  OF  A  HOSPITAL,  AS  DEFINED  IN ARTICLE
TWENTY-EIGHT OF THE PUBLIC  HEALTH  LAW,  WHICH  PROVIDES  SERVICES  FOR
PERSONS  WITH MENTAL ILLNESS PURSUANT TO AN OPERATING CERTIFICATE ISSUED
BY THE COMMISSIONER OF MENTAL HEALTH, MAY BE DEEMED TO BE IN  COMPLIANCE
WITH  APPLICABLE  PROVISIONS  OF THIS CHAPTER AND OTHER APPLICABLE LAWS,
RULES AND REGULATIONS, PROVIDED THAT SUCH HOSPITAL HAS  BEEN  ACCREDITED
BY  THE JOINT COMMISSION, OR ANY OTHER HOSPITAL ACCREDITING ORGANIZATION
TO WHICH THE CENTERS FOR MEDICARE  AND  MEDICAID  SERVICES  HAS  GRANTED
DEEMING  STATUS,  AND WHICH THE COMMISSIONER OF MENTAL HEALTH SHALL HAVE
DETERMINED HAS ACCREDITING STANDARDS SUFFICIENT TO  ASSURE  THE  COMMIS-
SIONER  THAT  HOSPITALS  SO  ACCREDITED  ARE  IN  COMPLIANCE  WITH  SUCH
PROVISIONS OF LAW, RULES AND REGULATIONS. THE  COMMISSIONER  MAY  EXEMPT
ANY SUCH HOSPITAL FROM THE ANNUAL INSPECTION AND VISITATION REQUIREMENTS
ESTABLISHED IN SECTION 31.07 OF THIS ARTICLE, PROVIDED THAT:
  1.  SUCH  HOSPITAL HAS A HISTORY OF COMPLIANCE WITH SUCH PROVISIONS OF
LAW, RULES AND REGULATIONS AND A RECORD OF PROVIDING GOOD QUALITY  CARE,
AS DETERMINED BY THE COMMISSIONER;
  2. A COPY OF THE SURVEY REPORT AND THE CERTIFICATE OF ACCREDITATION OF
THE  JOINT  COMMISSION  OR  OTHER  APPROVED  ACCREDITING ORGANIZATION IS
SUBMITTED BY THE ACCREDITING BODY OR THE HOSPITAL TO  THE  COMMISSIONER,
WITHIN SEVEN DAYS OF ISSUANCE TO THE HOSPITAL;
  3.  THE  JOINT COMMISSION OR OTHER ACCREDITING ORGANIZATION HAS AGREED
TO AND DOES EVALUATE, AS PART OF ITS ACCREDITATION SURVEY,  ANY  MINIMAL
OPERATIONAL STANDARDS ESTABLISHED BY THE COMMISSIONER WHICH ARE IN ADDI-
TION  TO THE MINIMAL OPERATIONAL STANDARDS OF ACCREDITATION OF THE JOINT
COMMISSION OR OTHER ACCREDITING ORGANIZATION; AND
  4. THERE ARE NO CONSTRAINTS PLACED UPON ACCESS BY THE COMMISSIONER  TO
THE  JOINT  COMMISSION OR OTHER APPROVED ACCREDITING ORGANIZATION SURVEY
REPORTS, PLANS OF CORRECTION, INTERIM SELF-EVALUATION  REPORTS,  NOTICES
OF  NONCOMPLIANCE, PROGRESS REPORTS ON CORRECTION OF AREAS OF NONCOMPLI-

S. 2809--C                         157

ANCE, OR ANY OTHER RELATED REPORTS, INFORMATION, COMMUNICATIONS OR MATE-
RIALS REGARDING SUCH HOSPITAL.
  (B) ANY HOSPITAL GOVERNED BY THE PROVISIONS OF SUBDIVISION (A) OF THIS
SECTION SHALL AT ALL TIMES BE SUBJECT TO INSPECTION OR VISITATION BY THE
COMMISSIONER  TO  DETERMINE COMPLIANCE WITH APPLICABLE LAW, REGULATIONS,
STANDARDS OR CONDITIONS AS DEEMED NECESSARY BY THE  COMMISSIONER.    ANY
SUCH  HOSPITAL  SHALL BE SUBJECT TO THE FULL RANGE OF LICENSING ENFORCE-
MENT AUTHORITY OF THE COMMISSIONER.
  (C) ANY HOSPITAL GOVERNED BY THE PROVISIONS OF SUBDIVISION (A) OF THIS
SECTION SHALL NOTIFY THE COMMISSIONER IMMEDIATELY UPON RECEIPT OF NOTICE
BY THE JOINT COMMISSION OR OTHER APPROVED ACCREDITING  ORGANIZATION,  OR
ANY  COMMUNICATION  THE HOSPITAL MAY RECEIVE THAT SUCH ORGANIZATION WILL
BE RECOMMENDING THAT SUCH HOSPITAL  NOT  BE  ACCREDITED,  NOT  HAVE  ITS
ACCREDITATION  RENEWED,  OR  HAVE  ITS ACCREDITATION TERMINATED, OR UPON
RECEIPT OF NOTICE OR OTHER COMMUNICATION FROM THE CENTERS  FOR  MEDICARE
AND  MEDICAID  SERVICES REGARDING A DETERMINATION THAT THE HOSPITAL WILL
BE TERMINATED FROM PARTICIPATION IN THE MEDICARE PROGRAM BECAUSE  IT  IS
NOT  IN  COMPLIANCE WITH ONE OR MORE CONDITIONS OF PARTICIPATION IN SUCH
PROGRAM, OR HAS DEFICIENCIES THAT EITHER INDIVIDUALLY OR IN  COMBINATION
JEOPARDIZE THE HEALTH AND SAFETY OF PATIENTS OR ARE OF SUCH CHARACTER AS
TO SERIOUSLY LIMIT THE PROVIDER'S CAPACITY TO RENDER ADEQUATE CARE.
  S 56.  The mental hygiene law is amended by adding a new section 32.14
to read as follows:
S  32.14  COMPLIANCE WITH OPERATIONAL STANDARDS BY PROVIDERS OF SERVICES
          IN HOSPITALS.
  (A) NOTWITHSTANDING THE PROVISIONS OF SECTION 32.13 OF THIS ARTICLE, A
PROVIDER OF SERVICES AS DEFINED IN SECTION 1.03  OF  THIS  CHAPTER  THAT
OCCUPIES  A WARD, WING, UNIT, OR OTHER PART OF A HOSPITAL, AS DEFINED IN
ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW, WHICH  PROVIDES  SERVICES
FOR  PERSONS  WITH  MENTAL DISABILITIES PURSUANT TO AN OPERATING CERTIF-
ICATE ISSUED BY THE COMMISSIONER, MAY BE DEEMED TO BE IN COMPLIANCE WITH
APPLICABLE PROVISIONS OF THIS CHAPTER AND OTHER APPLICABLE  LAWS,  RULES
AND  REGULATIONS IN REGARD TO SERVICES PROVIDED AT SUCH WARD, WING, UNIT
OR OTHER PART OF A  HOSPITAL,  PROVIDED  THAT  SUCH  HOSPITAL  HAS  BEEN
ACCREDITED  BY  THE JOINT COMMISSION, OR ANY OTHER ACCREDITING ORGANIZA-
TION TO WHICH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES HAS GRANTED
DEEMING STATUS, AND WHICH THE COMMISSIONER  SHALL  HAVE  DETERMINED  HAS
ACCREDITING STANDARDS SUFFICIENT TO ASSURE THE COMMISSIONER THAT PROVID-
ERS  OF  SERVICES  OCCUPYING  A  WARD,  WING, UNIT OR OTHER PART OF SUCH
HOSPITAL SO ACCREDITED ARE IN COMPLIANCE WITH SUCH  PROVISIONS  OF  LAW,
RULES AND REGULATIONS IN REGARD TO SERVICES PROVIDED AT SUCH WARD, WING,
UNIT  OR OTHER PART OF A HOSPITAL.  THE COMMISSIONER MAY EXEMPT ANY SUCH
PROVIDER OF SERVICES, IN REGARD TO SERVICES PROVIDED AT SUCH WARD, WING,
UNIT OR OTHER PART OF A HOSPITAL, FROM THE ANNUAL INSPECTION AND VISITA-
TION REQUIREMENTS ESTABLISHED IN SECTION 32.13 OF THIS ARTICLE, PROVIDED
THAT:
  1. SUCH PROVIDER OF SERVICES HAS A HISTORY  OF  COMPLIANCE  WITH  SUCH
PROVISIONS  OF LAW, RULES AND REGULATIONS AND A RECORD OF PROVIDING GOOD
QUALITY CARE, AS DETERMINED BY THE COMMISSIONER;
  2. A COPY OF THE SURVEY REPORT AND THE CERTIFICATE OF ACCREDITATION OF
THE JOINT COMMISSION  OR  OTHER  APPROVED  ACCREDITING  ORGANIZATION  IS
SUBMITTED  BY  THE  ACCREDITING  BODY OR THE PROVIDER OF SERVICES TO THE
COMMISSIONER,  WITHIN  SEVEN  DAYS  OF  ISSUANCE  TO  SUCH  PROVIDER  OF
SERVICES;
  3. THE JOINT COMMISSION OR OTHER APPROVED ACCREDITING ORGANIZATION HAS
AGREED  TO  AND  DOES EVALUATE, AS PART OF ITS ACCREDITATION SURVEY, ANY

S. 2809--C                         158

MINIMAL OPERATIONAL STANDARDS ESTABLISHED BY THE COMMISSIONER WHICH  ARE
IN ADDITION TO THE MINIMAL OPERATIONAL STANDARDS OF ACCREDITATION OF THE
JOINT COMMISSION OR OTHER ACCREDITING ORGANIZATION; AND
  4.  THERE ARE NO CONSTRAINTS PLACED UPON ACCESS BY THE COMMISSIONER TO
THE JOINT COMMISSION OR OTHER APPROVED ACCREDITING  ORGANIZATION  SURVEY
REPORTS,  PLANS  OF CORRECTION, INTERIM SELF-EVALUATION REPORTS, NOTICES
OF NONCOMPLIANCE, PROGRESS REPORTS ON CORRECTION OF AREAS OF  NONCOMPLI-
ANCE, OR ANY OTHER RELATED REPORTS, INFORMATION, COMMUNICATIONS OR MATE-
RIALS REGARDING SUCH PROVIDER OF SERVICES.
  (B) ANY PROVIDER OF SERVICES GOVERNED BY THE PROVISIONS OF SUBDIVISION
(A) OF THIS SECTION SHALL AT ALL TIMES BE SUBJECT TO INSPECTION OR VISI-
TATION  BY THE COMMISSIONER TO DETERMINE COMPLIANCE WITH APPLICABLE LAW,
REGULATIONS, STANDARDS OR CONDITIONS AS DEEMED NECESSARY BY THE  COMMIS-
SIONER. ANY SUCH PROVIDER OF SERVICES SHALL BE SUBJECT TO THE FULL RANGE
OF CERTIFICATION ENFORCEMENT AUTHORITY OF THE COMMISSIONER.
  (C) ANY PROVIDER OF SERVICES GOVERNED BY THE PROVISIONS OF SUBDIVISION
(A)  OF  THIS  SECTION  SHALL  NOTIFY  THE COMMISSIONER IMMEDIATELY UPON
RECEIPT OF NOTICE BY THE JOINT COMMISSION OR OTHER APPROVED  ACCREDITING
ORGANIZATION,  OR ANY COMMUNICATION THE PROVIDER OF SERVICES MAY RECEIVE
THAT SUCH ORGANIZATION  WILL  BE  RECOMMENDING  THAT  SUCH  PROVIDER  OF
SERVICES  NOT BE ACCREDITED, NOT HAVE ITS ACCREDITATION RENEWED, OR HAVE
ITS ACCREDITATION TERMINATED, OR UPON RECEIPT OF NOTICE OR OTHER  COMMU-
NICATION FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES REGARDING A
DETERMINATION  THAT  THE  PROVIDER  OF  SERVICES WILL BE TERMINATED FROM
PARTICIPATION IN THE MEDICARE OR MEDICAID PROGRAM BECAUSE IT IS  NOT  IN
COMPLIANCE WITH ONE OR MORE CONDITIONS OF PARTICIPATION IN SUCH PROGRAM,
OR  HAS DEFICIENCIES THAT EITHER INDIVIDUALLY OR IN COMBINATION JEOPARD-
IZE THE HEALTH AND SAFETY OF PATIENTS OR ARE OF  SUCH  CHARACTER  AS  TO
SERIOUSLY LIMIT THE PROVIDER'S CAPACITY TO RENDER ADEQUATE CARE.
  S  57. Notwithstanding any other provision of law to the contrary, the
requirements set forth in section 2805-t of the public  health  law  are
hereby suspended until October 1, 2012.
  S 58. Section 2805-l of the public health law, as added by chapter 266
of the laws of 1986, subdivision 3 as amended by chapter 542 of the laws
of 2000, subdivision 4 as added and subdivision 5 as renumbered by chap-
ter 632 of the laws of 2006, is amended to read as follows:
  S  2805-l.  [Incident] SERIOUS EVENT reporting. 1. (A) All hospitals[,
as defined in subdivision ten of section  twenty-eight  hundred  one  of
this  article,] shall be required to report [incidents] EVENTS described
by subdivision two of this section to the department  in  a  manner  and
within time periods as may be specified by regulation of the department.
  (B)  FOR PURPOSES OF THIS SECTION, "HOSPITAL" MEANS ANY GENERAL HOSPI-
TAL OR DIAGNOSTIC AND TREATMENT CENTER.
  2. The following [incidents] EVENTS shall be reported to  the  depart-
ment:
  (a)  patients'  deaths  or  impairments of bodily functions in circum-
stances other than those related  to  the  natural  course  of  illness,
disease  or  proper  treatment  in  accordance  with  generally accepted
medical standards;
  (b) fires in the hospital which disrupt the provision of patient  care
services or cause harm to patients or staff;
  (c)  equipment  malfunction during treatment or diagnosis of a patient
which did or could have adversely affected a patient or hospital person-
nel;
  (d) poisoning occurring within the hospital;
  (e) strikes by hospital staff;

S. 2809--C                         159

  (f) disasters or other emergency situations external to  the  hospital
environment which affect hospital operations; and
  (g)  termination of any services vital to the continued safe operation
of the hospital or to the health and safety of its patients and  person-
nel,  including but not limited to the anticipated or actual termination
of telephone, electric, gas, fuel, water, heat, air conditioning, rodent
or pest control, laundry services, food or contract services.
  3. NOTWITHSTANDING ANY PROVISION OF THIS SECTION TO THE CONTRARY,  THE
COMMISSIONER  IS  AUTHORIZED  TO  MODIFY,  BY REGULATION, THE REPORTABLE
EVENTS REQUIRED BY THIS  SECTION,  CONSISTENT  WITH  NATIONAL  CONSENSUS
STANDARDS.
  4.  The  hospital shall conduct an investigation of [incidents] EVENTS
described in paragraphs (a) through  (d)  of  subdivision  two  of  this
section  within  thirty  days  of obtaining knowledge of any information
which reasonably appears to show  that  such  an  [incident]  EVENT  has
occurred,  provided that, if the hospital reasonably expects such inves-
tigation to extend beyond such thirty day  period,  the  hospital  shall
notify  the  department of such expectation and the reason therefor, and
shall inform the department of  the  expected  completion  date  of  the
investigation.  The  hospital  shall provide to the department a copy of
the investigation report within twenty-four hours of completion. Nothing
herein shall limit the authority of the department to conduct an  inves-
tigation of [incidents] EVENTS occurring in [general] hospitals.
  5. THE DEPARTMENT SHALL:
  (A)  ANALYZE EVENT REPORTS, FINDINGS OF THE INVESTIGATIONS, THEIR ROOT
CAUSE ANALYSES, AND CORRECTIVE ACTION PLANS  TO  DETERMINE  PATTERNS  OF
SYSTEMIC FAILURE IN THE HEALTH CARE SYSTEM AND IDENTIFY SUCCESSFUL METH-
ODS TO CORRECT THESE FAILURES; AND
  (B)  COMMUNICATE  TO  FACILITIES THE DEPARTMENT'S CONCLUSIONS, IF ANY,
REGARDING EVENT REPORTS, PATTERNS OF SYSTEMIC FAILURE,  AND  RECOMMENDA-
TIONS  FOR  CORRECTIVE ACTION RESULTING FROM THE ANALYSIS OF SUBMISSIONS
FROM FACILITIES.
  [4] 6.   The  commissioner  shall  establish  protocols  for  hospital
personnel  where  a  patient under the age of eighteen years dies during
transportation to the hospital or while at the hospital,  under  circum-
stances  other  than  those  related  to  the natural course of illness,
disease or  proper  treatment  in  accordance  with  generally  accepted
medical  standards.  Such protocols shall address matters including, but
not limited to, the following:
  (a) medical and social history, and examination of the patient;
  (b) preservation of evidence and chain of custody;
  (c) questioning  of  the  patient's  family,  guardian  or  person  in
parental authority;
  (d) circumstances surrounding the injury resulting in death;
  (e) determination of the cause of death;
  (f) notification of law enforcement personnel; and
  (g)  reporting  requirements  under  title  six  of article six of the
social services law.
  In developing such protocols, the commissioner shall consult with  the
office  of  children  and  family  services, local departments of social
services, coordinators of child fatality review teams established pursu-
ant to section four hundred twenty-two-b of the social services law, law
enforcement agencies, pediatricians preferably  with  expertise  in  the
area  of  child  abuse and maltreatment or forensic pediatrics, and such
other persons as the commissioner deems necessary.

S. 2809--C                         160

  [5] 7.  The commissioner shall make,  adopt,  promulgate  and  enforce
such  rules and regulations as he may deem appropriate to effectuate the
purposes of this section.
  S  59.  Subdivision  4 of section 854 of the general municipal law, as
amended by chapter 541 of the laws  of  1982,  is  amended  to  read  as
follows:
  (4)  "Project"  -  shall mean any land, any building or other improve-
ment, and all real and personal properties located within the  state  of
New York and within or outside or partially within and partially outside
the  municipality  for  whose benefit the agency was created, including,
but not limited to, machinery, equipment  and  other  facilities  deemed
necessary  or  desirable in connection therewith, or incidental thereto,
whether or not now in existence or under construction,  which  shall  be
suitable  for manufacturing, warehousing, research, commercial or indus-
trial purposes or  other  economically  sound  purposes  identified  and
called  for  to implement a state designated urban cultural park manage-
ment plan as provided in title G of the parks, recreation  and  historic
preservation  law  and which may include or mean an industrial pollution
control facility, a recreation facility, educational or cultural facili-
ty, A HOSPITAL, A CONTINUING CARE RETIREMENT COMMUNITY, a  horse  racing
facility  or a railroad facility, provided, however, no agency shall use
its funds in respect of any project  wholly  or  partially  outside  the
municipality  for whose benefit the agency was created without the prior
consent thereto by the governing body or bodies of all the other munici-
palities in which a part or parts of  the  project  is,  or  is  to  be,
located.
  S  60. Section 854 of the general municipal law is amended by adding a
new subdivision 13 to read as follows:
  (13) "HOSPITAL" - SHALL MEAN A FACILITY AUTHORIZED TO  CONDUCT  ACTIV-
ITIES  IN  THIS  STATE,  PURSUANT  TO ARTICLE TWENTY-EIGHT OF THE PUBLIC
HEALTH LAW. NOTHING IN THIS ARTICLE SHALL BE DEEMED TO WAIVE ANY  APPLI-
CABLE  REQUIREMENT FOR AN OPERATING FACILITY CERTIFICATE, CONSENT OR ANY
OTHER APPROVAL AS PROVIDED BY LAW.
  S 61. Section 15 of 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, as amended by chapter 381 of the
laws of 2007, is amended to read as follows:
  S  15.  This act shall take effect immediately, provided, however that
the amendment made to subdivision 4 of section 854 of the general munic-
ipal law by section eight of this act shall not affect the reversion  of
such  subdivision as provided by section 5 of chapter 905 of the laws of
1986, as amended and that where the continuing care retirement community
council is authorized to promulgate regulations by this act, it is here-
by authorized to implement the provisions of this act in advance of such
regulations[; and provided further  that  sections  one,  three,  seven,
eight, nine, ten, eleven, twelve and thirteen of this act, and paragraph
m of subdivision 2 of section 4602 of the public health law, as added by
section  two  of  this act, shall apply only to applicants for a certif-
icate of authority pursuant to article 46 of the public health law  that
have  been  approved  to  receive  and have received such certificate of
authority on or before January 31, 2008].
  S 62. Section 461-m of the social services law, as amended by  chapter
462 of the laws of 1996, is amended to read as follows:
  S  461-m.  Death and felony crime reporting.  The operator of an adult
home or residence for adults shall have an affirmative  duty  to  report
any  death  INVOLVING  CIRCUMSTANCES  OTHER  THAN  THOSE  RELATED TO THE

S. 2809--C                         161

NATURAL COURSE  OF  ILLNESS  OR  DISEASE,  or  attempted  suicide  of  a
resident,  to  the  department  within twenty-four hours of [its] occur-
rence, and shall also have an affirmative duty to report to an appropri-
ate  law enforcement authority if it is believed that a felony crime may
have been committed against a resident  of  such  facility  as  soon  as
possible,  or  in  any event within forty-eight hours.  In addition, the
operator shall send any reports involving a resident who had at any time
received services from a mental hygiene service provider  to  the  state
commission  on  quality of care [for the mentally disabled] AND ADVOCACY
FOR PERSONS WITH DISABILITIES.
  S 63. Subdivision 38 of section  2  of  the  social  services  law  is
amended  by  adding four new paragraphs (f), (g), (h) and (i) to read as
follows:
  (F) "VERIFICATION ORGANIZATION" MEANS AN ENTITY WHICH USES  ELECTRONIC
MEANS  INCLUDING  BUT NOT LIMITED TO CONTEMPORANEOUS TELEPHONE VERIFICA-
TION OR CONTEMPORANEOUS VERIFIED ELECTRONIC DATA  TO  VERIFY  WHETHER  A
SERVICE OR ITEM WAS PROVIDED TO AN ELIGIBLE MEDICAID RECIPIENT. FOR EACH
SERVICE OR ITEM THE VERIFICATION ORGANIZATION SHALL CAPTURE:
  (I)  THE IDENTITY OF THE INDIVIDUAL PROVIDING SERVICES OR ITEMS TO THE
MEDICAID RECIPIENT;
  (II) THE IDENTITY OF THE MEDICAID RECIPIENT; AND
  (III) THE DATE, TIME, DURATION, LOCATION AND TYPE OF SERVICE OR ITEM.
  A LIST OF VERIFICATION ORGANIZATIONS SHALL BE JOINTLY DEVELOPED BY THE
DEPARTMENT OF HEALTH AND THE OFFICE OF THE MEDICAID INSPECTOR GENERAL.
  (G) "EXCEPTION REPORT" MEANS AN ELECTRONIC REPORT CONTAINING  ALL  THE
DATA  FIELDS  IN PARAGRAPH (F) OF THIS SUBDIVISION FOR CONFLICTS BETWEEN
SERVICES OR ITEMS ON THE BASIS OF THE IDENTITY OF THE  PERSON  PROVIDING
THE SERVICE OR ITEM TO THE MEDICAID RECIPIENT, THE IDENTITY OF THE MEDI-
CAID RECIPIENT, AND/OR TIME, DATE, DURATION OR LOCATION OF SERVICE;
  (H) "CONFLICT REPORT" MEANS AN ELECTRONIC REPORT CONTAINING ALL OF THE
DATA FIELDS IN PARAGRAPH (F) OF THIS SUBDIVISION DETAILING INCONGRUITIES
IN  SERVICES OR ITEMS BETWEEN SCHEDULING AND/OR LOCATION OF SERVICE WHEN
COMPARED TO A DUTY ROSTER.
  (I) "PARTICIPATING PROVIDER" MEANS A  CERTIFIED  HOME  HEALTH  AGENCY,
LONG  TERM HOME HEALTH AGENCY OR PERSONAL CARE PROVIDER WITH TOTAL MEDI-
CAID REIMBURSEMENTS EXCEEDING FIFTEEN MILLION DOLLARS PER CALENDAR YEAR.
  S 64. The social services law is amended by adding a new section 363-e
to read as follows:
  S 363-E.  PRECLAIM  REVIEW  FOR  PARTICIPATING  PROVIDERS  OF  MEDICAL
ASSISTANCE  PROGRAM  SERVICES  AND ITEMS. EVERY SERVICE OR ITEM WITHIN A
CLAIM SUBMITTED BY A PARTICIPATING PROVIDER SHALL BE REVIEWED AND  VERI-
FIED  BY  A  VERIFICATION ORGANIZATION PRIOR TO SUBMISSION OF A CLAIM TO
THE DEPARTMENT OF HEALTH. THE VERIFICATION  ORGANIZATION  SHALL  DECLARE
EACH  SERVICE  OR  ITEM TO BE VERIFIED OR UNVERIFIED. EACH PARTICIPATING
PROVIDER SHALL RECEIVE AND MAINTAIN REPORTS FROM THE VERIFICATION ORGAN-
IZATION WHICH SHALL CONTAIN DATA ON:
  1. VERIFIED SERVICES OR ITEMS, INCLUDING WHETHER A SERVICE APPEARED ON
A CONFLICT OR EXCEPTION REPORT BEFORE VERIFICATION AND HOW THAT CONFLICT
OR EXCEPTION WAS RESOLVED; AND
  2. SERVICES OR ITEMS THAT WERE NOT VERIFIED,  INCLUDING  CONFLICT  AND
EXCEPTION REPORT DATA FOR THESE SERVICES.
  S  65. Subparagraph (iii) of paragraph (d) of subdivision 1 of section
367-a of the social services law, as amended by section 53 of part C  of
chapter 58 of the laws of 2008, is amended to read as follows:
  (iii)  When  payment under part B of title XVIII of the federal social
security act for items and services provided to eligible persons who are

S. 2809--C                         162

also beneficiaries under part B of title XVIII  of  the  federal  social
security  act  and for items and services provided to qualified medicare
beneficiaries under part B of title XVIII of the federal social security
act  would  exceed  the  amount  that otherwise would be made under this
title if provided to an eligible person other than a person who is  also
a  beneficiary  under part B or is a qualified medicare beneficiary, the
amount payable FOR SERVICES COVERED under this  title  shall  be  twenty
percent  of  the  amount  of any co-insurance liability of such eligible
persons pursuant to federal law  were  they  not  eligible  for  medical
assistance  or  were  they  not  qualified  medicare  beneficiaries with
respect to such benefits under such part B; provided,  however,  amounts
payable  under  this  title  for items and services provided to eligible
persons who are also beneficiaries under part B or to qualified medicare
beneficiaries by an ambulance service under the authority of an  operat-
ing  certificate  issued pursuant to article thirty of the public health
law, a psychologist licensed under article one  hundred  fifty-three  of
the  education  law,  or  a facility under the authority of an operating
certificate issued pursuant to article sixteen, thirty-one or thirty-two
of the mental hygiene law [and with respect to outpatient  hospital  and
clinic  items and services provided by a facility under the authority of
an operating certificate issued pursuant to article twenty-eight of  the
public  health  law],  shall not be less than the amount of any co-insu-
rance liability of such eligible  persons  or  such  qualified  medicare
beneficiaries,  or  for  which  such  eligible persons or such qualified
medicare beneficiaries would be liable under federal law were  they  not
eligible  for  medical  assistance  or  were they not qualified medicare
beneficiaries with respect to such benefits under part B.
  S 65-a. Subdivision 1 of section 367-a of the social services  law  is
amended by adding a new paragraph (g) to read as follows:
  (G)  NOTWITHSTANDING  ANY  PROVISION  OF THIS SECTION TO THE CONTRARY,
AMOUNTS PAYABLE UNDER THIS TITLE FOR MEDICAL ASSISTANCE IN THE  FORM  OF
HOSPITAL OUTPATIENT SERVICES OR DIAGNOSTIC AND TREATMENT CENTER SERVICES
PURSUANT  TO  ARTICLE  TWENTY-EIGHT OF THE PUBLIC HEALTH LAW PROVIDED TO
ELIGIBLE PERSONS WHO ARE ALSO BENEFICIARIES UNDER PART B OF TITLE  XVIII
OF THE FEDERAL SOCIAL SECURITY ACT SHALL NOT EXCEED THE APPROVED MEDICAL
ASSISTANCE PAYMENT LEVEL LESS THE AMOUNT PAYABLE UNDER PART B.
  S 66. The public health law is amended by adding a new article 29-E to
read as follows:
                              ARTICLE 29-E
                      ACCOUNTABLE CARE ORGANIZATION
SECTION 2999-G. DEFINITIONS.
        2999-H. AUTHORITY GRANTED TO THE COMMISSIONER.
        2999-I. CERTIFICATION AS AN ACCOUNTABLE CARE ORGANIZATION.
        2999-J. NEW  YORK STATE'S MEDICAID ACCOUNTABLE CARE ORGANIZATION
                  PROGRAM.
        2999-K. SHARED SAVINGS UNDER NEW YORK STATE'S MEDICAID  ACCOUNT-
                  ABLE CARE ORGANIZATION PROGRAM.
  S  2999-G. DEFINITIONS. 1. AN "ACCOUNTABLE CARE ORGANIZATION" OR "ACO"
SHALL BE A CLINICALLY INTEGRATED NETWORK OF PROVIDERS CERTIFIED  BY  THE
COMMISSIONER  THAT IS CLINICALLY AND FISCALLY ACCOUNTABLE FOR THE ENTIRE
CONTINUUM OF CARE THAT A GIVEN POPULATION OF PATIENTS MAY NEED.  AN  ACO
MAY  INCLUDE  OTHER ENTITIES THAT PROVIDE TECHNICAL ASSISTANCE, INFORMA-
TION SYSTEMS AND SERVICES,  CARE  COORDINATION  AND  OTHER  SERVICES  TO
HEALTH CARE PROVIDERS AND PATIENTS.

S. 2809--C                         163

  2.  "CERTIFICATE  OF AUTHORITY" SHALL MEAN A CERTIFICATE ISSUED BY THE
COMMISSIONER AUTHORIZING AN ENTITY TO OPERATE AS AN ACO UNDER THIS ARTI-
CLE.
  3. (A) "CLINICALLY INTEGRATED" REFERS TO AN ACTIVE AND ONGOING PROGRAM
TO EVALUATE AND MODIFY PRACTICE PATTERNS BY A NETWORK'S PROVIDER PARTIC-
IPANTS AND CREATE A HIGH DEGREE OF INTERDEPENDENCE AND COOPERATION AMONG
THE  PROVIDERS  TO  CONTROL  COSTS  AND  ENSURE QUALITY. THE PROGRAM MAY
INCLUDE:
  (I) ESTABLISHING MECHANISMS TO  MONITOR  AND  CONTROL  UTILIZATION  OF
HEALTH CARE SERVICES THAT ARE DESIGNED TO CONTROL COSTS AND ASSURE QUAL-
ITY OF CARE;
  (II)  SELECTIVELY CHOOSING NETWORK PROVIDERS WHO ARE LIKELY TO FURTHER
THESE EFFICIENCY OBJECTIVES; AND
  (III) THE SIGNIFICANT INVESTMENT OF CAPITAL, BOTH MONETARY AND  HUMAN,
IN  THE  NECESSARY  INFRASTRUCTURE AND CAPABILITY TO REALIZE THE CLAIMED
EFFICIENCIES.
  (B) PROVIDER NON-PARTICIPATION IN THE ACTIVITIES IDENTIFIED  IN  PARA-
GRAPH  (A)  OF  THIS  SUBDIVISION  SHALL NOT BE EVIDENCE THAT A CLINICAL
INTEGRATION PROGRAM DOES NOT EXIST.
  4. "HEALTH CARE PROVIDER" OR  "PROVIDER"  SHALL  MEAN  A  HEALTH  CARE
PROVIDER LICENSED, CERTIFIED, OR AUTHORIZED BY THE COMMISSIONER PURSUANT
TO  ARTICLE TWENTY-EIGHT, THIRTY-SIX, OR FORTY OF THIS CHAPTER; A PHYSI-
CIAN, NURSE, PHYSICAL THERAPIST, SOCIAL WORKER, OR HEALTH  CARE  PROFES-
SIONAL  CERTIFIED  UNDER  TITLE EIGHT OF THE EDUCATION LAW; OR AN ENTITY
LICENSED OR CERTIFIED UNDER ARTICLE SIXTEEN, THIRTY-ONE,  OR  THIRTY-TWO
OF THE MENTAL HYGIENE LAW.
  5.  (A)  "INNOVATIVE  PAYMENT"  SHALL MEAN A METHOD OR ARRANGEMENT FOR
PAYMENT THAT REWARDS HIGH QUALITY CARE AND PERMITS  THE  DEVELOPMENT  OF
MORE EFFECTIVE WAYS OF DELIVERING CARE.
  (B)  INNOVATIVE PAYMENTS MAY INCLUDE BUNDLED PAYMENTS, PARTIAL CAPITA-
TION PAYMENTS, FULL CAPITATION PAYMENTS, GAIN  SHARING  ARRANGEMENTS  OR
SHARED SAVINGS PROGRAM, AND OTHER METHODS OF PAYMENT NOT OTHERWISE SPEC-
IFIED  IN  THIS  SECTION. SUCH PAYMENT METHODS MAY BE ELIGIBLE FOR STATE
AND FEDERAL FINANCIAL PARTICIPATION.
  (C) INNOVATIVE PAYMENT METHODOLOGIES FOR ACOS MAY BE BASED ON  FACTORS
INCLUDING,  BUT NOT LIMITED TO, THE COMPLEXITY OF THE CONDITIONS PROVID-
ERS WILL BE MANAGING, THE ANTICIPATED AMOUNT OF PATIENT  CONTACT  NEEDED
TO MANAGE SUCH CONDITIONS, AND THE HEALTH CARE COST SAVINGS REALIZED.
  6. "MEDICARE" SHALL MEAN TITLE EIGHTEEN OF THE FEDERAL SOCIAL SECURITY
ACT AND THE PROGRAMS THEREUNDER.
  7.  "MEDICAL  ASSISTANCE  PROGRAM" OR "MAP" SHALL MEAN TITLE ELEVEN OF
ARTICLE FIVE OF THE SOCIAL SERVICES LAW  AND  THE  PROGRAMS  THEREUNDER,
OTHERWISE KNOWN AS THE NEW YORK STATE MEDICAID PROGRAM.
  8.  "PAYORS  OF  HEALTH  CARE SERVICES" OR "PAYORS" SHALL MEAN MEDICAL
ASSISTANCE PROVIDERS AUTHORIZED PURSUANT TO TITLE ELEVEN OF ARTICLE FIVE
OF THE SOCIAL SERVICES LAW; MANAGED CARE ORGANIZATIONS AUTHORIZED PURSU-
ANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THE  SOCIAL  SERVICES  LAW;
ORGANIZATIONS APPROVED PURSUANT TO TITLE ELEVEN-D OF ARTICLE FIVE OF THE
SOCIAL  SERVICES  LAW; ORGANIZATIONS APPROVED PURSUANT TO TITLE ONE-A OF
ARTICLE TWENTY-FIVE OF THIS CHAPTER; COMMERCIAL MANAGED CARE PLANS OPER-
ATING IN ACCORDANCE WITH THE PROVISIONS OF ARTICLE  FORTY-FOUR  OF  THIS
CHAPTER  OR  HEALTH MAINTENANCE ORGANIZATIONS ORGANIZED AND OPERATING IN
ACCORDANCE WITH ARTICLE FORTY-THREE OF THE INSURANCE LAW; OTHER  COMMER-
CIAL INSURANCE PRODUCTS; AND EMPLOYER-SPONSORED SELF-INSURED PLANS.
  S  2999-H.  AUTHORITY GRANTED TO THE COMMISSIONER. 1. THE COMMISSIONER
SHALL ISSUE A CERTIFICATE OF AUTHORITY TO AN ENTITY  THAT  MEETS  CONDI-

S. 2809--C                         164

TIONS FOR ACO CERTIFICATION AS SET FORTH UNDER SECTION TWO THOUSAND NINE
HUNDRED NINETY-NINE-I OF THIS ARTICLE.
  2.  THE COMMISSIONER MAY LIMIT, SUSPEND, OR TERMINATE A CERTIFICATE OF
AUTHORITY IF AN ACO IS NOT OPERATING IN ACCORDANCE WITH THIS ARTICLE.
  3. IT IS THE POLICY OF THE STATE TO PERMIT AND ENCOURAGE  COOPERATIVE,
COLLABORATIVE  AND INTEGRATIVE ARRANGEMENTS AMONG PAYORS AND HEALTH CARE
PROVIDERS WHO MIGHT OTHERWISE BE COMPETITORS  UNDER  THE  ACTIVE  SUPER-
VISION OF THE COMMISSIONER. TO THE EXTENT THAT IT IS NECESSARY TO ACCOM-
PLISH  THE  PURPOSES  OF THIS ARTICLE, COMPETITION MAY BE SUPPLANTED AND
THE STATE MAY PROVIDE STATE ACTION  IMMUNITY  UNDER  STATE  AND  FEDERAL
ANTITRUST LAWS TO PAYORS AND HEALTH CARE PROVIDERS.
  (A)  WITH  RESPECT  TO  THE PLANNING, IMPLEMENTATION, AND OPERATION OF
ACOS, THE COMMISSIONER SHALL BE AUTHORIZED TO EXEMPT  AN  ACO  FROM  THE
PROVISIONS AND PENALTIES OF:
  (I)  ARTICLE  TWENTY-TWO  OF  THE  GENERAL  BUSINESS  LAW  RELATING TO
ARRANGEMENTS AND AGREEMENTS IN RESTRAINT OF TRADE;
  (II) ARTICLE ONE HUNDRED THIRTY-ONE-A OF THE EDUCATION LAW RELATING TO
FEE-SPLITTING ARRANGEMENTS;
  (III) TITLE TWO-D OF ARTICLE TWO OF THIS CHAPTER  RELATING  TO  HEALTH
CARE PRACTITIONER REFERRALS; AND
  (IV)  ARTICLE  ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW RELATING TO
CORPORATE PRACTICE OF MEDICINE.
  (B) WITH RESPECT TO THE PLANNING,  IMPLEMENTATION,  AND  OPERATION  OF
ACOS,  THE COMMISSIONER SHALL BE AUTHORIZED TO APPLY FOR FEDERAL WAIVERS
TO EXEMPT ACOS FROM THE PROVISIONS AND PENALTIES OF:
  (I) 42 U.S.C. S 1320-7A AND 42 U.S.C. S 1320-7B RELATING TO THE FEDER-
AL CIVIL MONETARY PENALTY AND THE ANTI-KICKBACK STATUTE; AND
  (II) 42 U.S.C. S 1395NN RELATING TO  FEDERAL  PHYSICIAN  SELF-REFERRAL
LAW.
  (C)  THE COMMISSIONER MAY ENGAGE IN STATE SUPERVISION TO PROMOTE STATE
ACTION IMMUNITY UNDER STATE AND FEDERAL ANTITRUST LAWS. SUCH SUPERVISION
SHALL BE LIMITED TO SPECIFIC REQUESTS FOR DOCUMENTATION FROM PAYORS  AND
PROVIDERS TO VERIFY THAT ACOS CERTIFIED PURSUANT TO SECTION TWO THOUSAND
NINE HUNDRED NINETY-NINE-I OF THIS ARTICLE ARE PLANNED, IMPLEMENTED, AND
OPERATE IN ACCORDANCE WITH ITS INTENT AND PURPOSES.
  4.  THE  COMMISSIONER IS AUTHORIZED TO SEEK FEDERAL GRANTS, APPROVALS,
AND WAIVERS TO  IMPLEMENT  THIS  ARTICLE,  INCLUDING  FEDERAL  FINANCIAL
PARTICIPATION FOR ACOS.
  S  2999-I.  CERTIFICATION  AS AN ACCOUNTABLE CARE ORGANIZATION. 1. THE
COMMISSIONER SHALL CERTIFY AN ENTITY AS AN ACO IF IT HAS  THE  FOLLOWING
CHARACTERISTICS:
  (A)  THE  ABILITY TO BE ACCOUNTABLE FOR THE QUALITY, COST, AND OVERALL
CARE OF ITS PATIENTS;
  (B) A FORMAL LEGAL STRUCTURE THAT ALLOWS IT TO RECEIVE AND  DISTRIBUTE
INNOVATIVE PAYMENTS;
  (C)  A  LEADERSHIP AND MANAGEMENT STRUCTURE THAT SUPPORTS CLINICAL AND
ADMINISTRATIVE SYSTEMS;
  (D) PROCESSES TO PROMOTE EVIDENCE-BASED MEDICINE, COLLECT  INFORMATION
ON QUALITY AND COST MEASURES, AND COORDINATE CARE; AND
  (E) A CLINICALLY INTEGRATED NETWORK OF PROVIDERS.
  2.  ACOS  CERTIFIED  PURSUANT  TO THIS SECTION MAY PROVIDE SERVICES TO
RECIPIENTS OF BENEFITS PROVIDED BY  PAYORS  AS  DEFINED  IN  SUBDIVISION
EIGHT OF SECTION TWENTY-NINE HUNDRED NINETY-NINE-G OF THIS ARTICLE.
  S  2999-J.  NEW  YORK  STATE'S  MEDICAID ACCOUNTABLE CARE ORGANIZATION
PROGRAM. 1. THE COMMISSIONER SHALL ESTABLISH  AN  ACO  PROGRAM  FOR  THE
PURPOSE  OF  IMPROVING  THE  QUALITY, COORDINATION AND ACCOUNTABILITY OF

S. 2809--C                         165

SERVICES PROVIDED TO MEDICAL ASSISTANCE  PROGRAM  RECIPIENTS.  THE  CARE
PROVIDED  TO INDIVIDUALS IN THE MEDICAL ASSISTANCE PROGRAM PARTICIPATING
IN AN ACO SHOULD NOT BE LESS THAN THE QUALITY OF CARE  THAT  WOULD  HAVE
OTHERWISE BEEN PROVIDED TO THOSE INDIVIDUALS.
  2.  THE  COMMISSIONER SHALL HAVE THE AUTHORITY TO ISSUE REGULATIONS TO
IMPLEMENT THE MEDICAID ACCOUNTABLE CARE ORGANIZATION PROGRAM. SUCH REGU-
LATIONS SHALL  CONFORM,  WHERE  POSSIBLE,  TO  REGULATIONS  ON  MEDICAID
ACCOUNTABLE  CARE  ORGANIZATIONS PROMULGATED BY THE CENTERS FOR MEDICARE
AND MEDICAID SERVICES AND OTHER FEDERAL AGENCIES.
  3. AN ENTITY MUST BE ISSUED A CERTIFICATE OF AUTHORITY TO  PARTICIPATE
IN THE MEDICAID ACCOUNTABLE CARE ORGANIZATION PROGRAM.
  4. AN ACO THAT PARTICIPATES IN THE MEDICAID ACCOUNTABLE CARE ORGANIZA-
TION  PROGRAM  SHALL ENTER AN AGREEMENT WITH THE COMMISSIONER TO PARTIC-
IPATE IN THE PROGRAM FOR NOT LESS THAN THREE YEARS.
  5. THE COMMISSIONER SHALL SET FORTH BY REGULATION THE  MINIMUM  NUMBER
OF MAP RECIPIENTS THAT THE ACO MUST PROVIDE CARE TO.
  6. AN ACO THAT PARTICIPATES IN THE MEDICAID ACCOUNTABLE CARE ORGANIZA-
TION PROGRAM MAY BE ELIGIBLE TO SHARE SAVINGS WITH THE MAP.
  7. AN ACO THAT PARTICIPATES IN THE MEDICAID ACCOUNTABLE CARE ORGANIZA-
TION PROGRAM MAY ALSO AGREE TO BE REIMBURSED USING AN INNOVATIVE PAYMENT
METHODOLOGY,  AS  DESCRIBED  IN  SUBDIVISION FIVE OF SECTION TWENTY-NINE
HUNDRED NINETY-NINE-G OF THIS ARTICLE.
  S 2999-K. SHARED SAVINGS UNDER NEW YORK STATE'S  MEDICAID  ACCOUNTABLE
CARE  ORGANIZATION  PROGRAM. 1. AN ACO THAT PARTICIPATES IN THE MEDICAID
ACCOUNTABLE CARE ORGANIZATION PROGRAM AND ACHIEVES SAVINGS GREATER  THAN
THE  ANNUAL  MINIMUM SAVINGS LEVEL ESTABLISHED BY THE COMMISSIONER SHALL
RECEIVE AN INCENTIVE PAYMENT FOR SUCH YEAR EQUAL TO  A  PORTION  OF  THE
EXCESS AMOUNT OF SUCH SAVINGS.
  2.  THE  COMMISSIONER SHALL SET FORTH BY REGULATION THE ANNUAL MINIMUM
SAVINGS LEVEL THAT ACOS MUST ACHIEVE TO SHARE SAVINGS UNDER THE MEDICAID
ACCOUNTABLE CARE ORGANIZATION PROGRAM.
  3. THE COMMISSIONER SHALL SET FORTH BY REGULATION THE PORTION  OF  THE
EXCESS  AMOUNT  OF  SAVINGS THAT AN ACO MAY BE ENTITLED TO COLLECT UNDER
THE MEDICAID ACCOUNTABLE CARE ORGANIZATION PROGRAM.
  S 67. Section 18 of 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, is amended to read as follows:
  S 18. Notwithstanding any contrary provision of  law,  surcharges  and
assessments due and owing pursuant to sections 2807-j, 2807-s and 2807-t
of the public health law for any period prior to January 1, [2010] 2011,
which  are  paid  and  accompanied by all required reports and which are
received on or before December 31, [2010] 2011 shall not be  subject  to
interest  or penalties as otherwise provided in such sections, provided,
however, that such reports may be  based  on  estimates  by  payors  and
designated  providers of services of the amounts owed, subject to subse-
quent audit by the commissioner of health or the  commissioner's  desig-
nee, and provided further, however, with regard to all principal, inter-
est and penalty amounts collected by the commissioner of health prior to
the  effective  date  of  this  act,  the penalty provisions of sections
2807-j, 2807-s and 2807-t of the public health law shall remain in  full
force  and  effect  and  such  amounts collected shall not be subject to
further adjustment pursuant  to  this  section,  and  provided  further,
however,  that  payments  of principal amounts of surcharges and assess-
ments which were paid late and received prior to the effective  date  of
this provision, and in regard to which interest and penalty amounts have

S. 2809--C                         166

not been collected, shall not be subject to such interest and penalties,
and  provided,  further,  however,  that  the provisions of this section
shall not apply to delinquent amounts which have been  referred  by  the
commissioner   of   health  for  recoupment  or  collection  proceeding.
Furthermore, the provisions of this  section  shall  not  apply  to  any
surcharge or assessment payments made in response to a final audit find-
ing issued by the commissioner of health or the commissioner's designee.
  S 68.  Intentionally omitted.
  S 69. Subparagraph (iii) of paragraph (b) of subdivision 25 of section
2808 of the public health law, as added by section 31 of part B of chap-
ter  109  of the laws of 2010, is amended and a new subparagraph (iv) is
added to read as follows:
  (iii) payment to a facility for reserved bed days provided  on  behalf
of  such person for non-hospitalization leaves of absence may not exceed
ten days in any twelve month period[.]; AND
  (IV) PAYMENTS FOR RESERVED BED  DAYS  FOR  TEMPORARY  HOSPITALIZATIONS
SHALL  ONLY  BE  MADE  TO A RESIDENTIAL HEALTH CARE FACILITY IF AT LEAST
FIFTY PERCENT OF THE FACILITY'S RESIDENTS ELIGIBLE TO PARTICIPATE  IN  A
MEDICARE MANAGED CARE PLAN ARE ENROLLED IN SUCH A PLAN.
  S 70. Subdivision 1 of section 2801 of the public health law, as sepa-
rately  amended  by chapters 297 and 416 of the laws of 1983, is amended
to read as follows:
  1. "Hospital" means a facility or institution engaged  principally  in
providing services by or under the supervision of a physician or, in the
case  of  a  dental  clinic  or dental dispensary, of a dentist, for the
prevention, diagnosis or  treatment  of  human  disease,  pain,  injury,
deformity or physical condition, including, but not limited to, a gener-
al  hospital, public health center, diagnostic center, treatment center,
dental clinic, dental dispensary, rehabilitation  center  other  than  a
facility used solely for vocational rehabilitation, nursing home, tuber-
culosis  hospital,  chronic disease hospital, maternity hospital, lying-
in-asylum, out-patient department, out-patient lodge, dispensary  and  a
laboratory  or  central service facility serving one or more such insti-
tutions, but the term hospital shall not include an  institution,  sani-
tarium  or  other facility engaged principally in providing services for
the prevention, diagnosis or treatment of mental disability and which is
subject to [the powers of visitation, examination, inspection and inves-
tigation of the department of mental hygiene except for  those  distinct
parts of] LICENSURE UNDER THE MENTAL HYGIENE LAW, ALTHOUGH such a facil-
ity  which  [provide] ALSO PROVIDES hospital service SHALL BE SUBJECT TO
THE POWERS OF VISITATION, EXAMINATION, INSPECTION AND  INVESTIGATION  OF
THE  DEPARTMENT.  The  provisions  of  this article shall not apply to a
facility or institution engaged principally in providing services by  or
under the supervision of the bona fide members and adherents of a recog-
nized religious organization whose teachings include reliance on spirit-
ual  means through prayer alone for healing in the practice of the reli-
gion of such organization and where services are provided in  accordance
with those teachings.
  S  71.  Subdivision (a) of section 16.03 of the mental hygiene law, as
added by chapter 786 of the laws of 1983,  paragraph  3  as  amended  by
chapter 555 of the laws of 1993, is amended to read as follows:
  (a)  No  provider  of  services  shall  engage in any of the following
activities without an operating certificate issued by  the  commissioner
pursuant to this article:

S. 2809--C                         167

  (1)  Operation of a residential facility for the care and treatment of
the mentally retarded or developmentally  disabled  including  a  family
care home.
  (2)  [Operation  of  any  distinct part of a general hospital or other
facility possessing an operating certificate, pursuant to article  twen-
ty-eight  of  the public health law, operated for the primary purpose of
providing residential  or  non-residential  services  for  the  mentally
retarded or developmentally disabled.
  (3)]  Operation  of  a  facility established or maintained by a public
agency, board, or commission, or by a corporation or  voluntary  associ-
ation  for  the rendition of out-patient or non-residential services for
the mentally retarded or developmentally  disabled;  provided,  however,
that  such  operation  shall  not  be deemed to include (i) professional
practice, within the scope of  a  professional  license  or  certificate
issued  by an agency of the state, by an individual practitioner or by a
partnership of such individuals or by a professional service corporation
duly incorporated pursuant to the  business  corporation  law  or  by  a
university  faculty  practice  corporation duly incorporated pursuant to
the not-for-profit corporation  law  or  (ii)  non-residential  services
which  are  licensed,  supervised,  or operated by another agency of the
state, PROVIDED, HOWEVER, THAT SUCH OPERATION SHALL BE SUBJECT TO  VISI-
TATION,  EXAMINATION,  INSPECTION AND INVESTIGATION OF THE COMMISSIONER,
and non-residential services which are chartered or issued a certificate
of incorporation pursuant to the education law or (iii)  pastoral  coun-
seling  by a clergyman or minister, including those defined as clergyman
or minister by section two of the religious corporations law.
  S 72. Subdivision (a) of section 31.02 of the mental hygiene  law,  as
amended  by  chapter  804 of the laws of 1975 and such section as renum-
bered by chapter 978 of the laws of 1977,  paragraph  3  as  amended  by
chapter  555 of the laws of 1993, paragraph 4 as added by chapter 947 of
the laws of 1981, paragraph 5 as added by chapter 351  of  the  laws  of
1985,  and  paragraph  6 as added by chapter 723 of the laws of 1989, is
amended to read as follows:
  (a) Except as provided in subdivision (b) of this section no  provider
of  services  shall engage in any of the following activities without an
operating certificate issued by the commissioner pursuant to this  arti-
cle:
  1.  operation  of  a  residential facility or institution, including a
community residence, for the care, custody, or treatment of the mentally
disabled; provided, however, that giving domestic care and comfort to  a
person in the home shall not constitute such an operation.
  2.  [operation  of  any  part of a general hospital for the purpose of
providing residential or non-residential services for the mentally disa-
bled.
  3.] operation of a facility established  or  maintained  by  a  public
agency,  board,  or commission, or by a corporation for the rendition of
out-patient or  non-residential  services  for  the  mentally  disabled;
provided,  however,  that  such operation shall not be deemed to include
(i) professional practice, within the scope of a professional license or
certificate issued by an agency of the state, by an  individual  practi-
tioner  or  by  a  partnership  of such individuals or by a professional
service corporation duly incorporated pursuant to  the  business  corpo-
ration law or by a university faculty practice corporation duly incorpo-
rated  pursuant  to the not-for-profit corporation law or (ii) non-resi-
dential services which are licensed, supervised, or operated by  another
agency  of  the  state,  PROVIDED, HOWEVER, THAT SUCH OPERATION SHALL BE

S. 2809--C                         168

SUBJECT TO VISITATION, EXAMINATION, INSPECTION AND INVESTIGATION OF  THE
COMMISSIONER,  and nonresidential services which are chartered or issued
a certificate of incorporation pursuant to the education  law  or  (iii)
pastoral  counseling by a clergyman or minister, including those defined
as clergyman or minister by section two of  the  religious  corporations
law.
  [4.] 3. operation of a residential treatment facility for children and
youth.
  [5.] 4. operation of a residential care center for adults.
  [6.] 5. operation of a comprehensive psychiatric emergency program.
  S  73.  Subdivision (a) of section 32.05 of the mental hygiene law, as
added by chapter 558 of the laws of 1999, is amended to read as follows:
  (a) Except as provided in subdivision (b) of this section no  provider
of  services  shall engage in any of the following activities without an
operating certificate issued by the commissioner pursuant to this  arti-
cle:
  1. operation of a residential program, including a community residence
for  the  care, custody, or treatment of persons suffering from chemical
abuse or dependence; provided, however, that giving  domestic  care  and
comfort  to a person in the home shall not constitute such an operation;
OR
  2. [operation of a discrete unit  of  a  hospital  or  other  facility
possessing  an operating certificate pursuant to article twenty-eight of
the public health law for the purpose of providing residential  or  non-
residential chemical dependence services; or
  3.]  operation of a program established or maintained by a provider of
services for the rendition of out-patient  or  non-residential  chemical
dependence services; provided, however, that such operation shall not be
deemed  to  include  (i)  professional  practice,  within the scope of a
professional license or certificate issued by an agency of the state, by
an appropriately licensed individual or by a partnership of  such  indi-
viduals,  or  by  a  professional  service corporation duly incorporated
pursuant to the business corporation law wherein all professionals  bear
the  same  professional license, or a university faculty practice corpo-
ration duly incorporated pursuant to the not-for-profit corporation law,
unless more than fifty percent of such practice by  either  such  corpo-
ration  consists  of  the  rendering of chemical dependence services; or
(ii) non-residential services which are chartered or  issued  a  certif-
icate  of incorporation pursuant to the education law; or (iii) pastoral
counseling by a clergyman or minister, including those defined as  cler-
gyman  or  minister by section two of the religious corporations law; or
(iv) services which are exclusively prevention strategies and approaches
as defined in section 1.03 of this chapter.
  S 74. Section 366 of the social services law is amended  by  adding  a
new subdivision 14 to read as follows:
  14.  THE  COMMISSIONER  OF HEALTH MAY MAKE ANY AVAILABLE AMENDMENTS TO
THE STATE PLAN FOR MEDICAL  ASSISTANCE  SUBMITTED  PURSUANT  TO  SECTION
THREE  HUNDRED  SIXTY-THREE-A  OF THIS TITLE, OR, IF AN AMENDMENT IS NOT
POSSIBLE, DEVELOP AND SUBMIT AN APPLICATION FOR ANY WAIVER  OR  APPROVAL
UNDER THE FEDERAL SOCIAL SECURITY ACT THAT MAY BE NECESSARY TO DISREGARD
OR EXEMPT AN AMOUNT OF INCOME, FOR THE PURPOSE OF ASSISTING WITH HOUSING
COSTS,  FOR  INDIVIDUALS RECEIVING COVERAGE OF NURSING FACILITY SERVICES
UNDER THIS TITLE WHO ARE: (I) DISCHARGED FROM THE  NURSING  FACILITY  TO
THE  COMMUNITY;  (II)  ENROLLED  IN A PLAN CERTIFIED PURSUANT TO SECTION
FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW; AND (III) WHILE  SO

S. 2809--C                         169

ENROLLED,  NOT  CONSIDERED AN "INSTITUTIONALIZED SPOUSE" FOR PURPOSES OF
SECTION THREE HUNDRED SIXTY-SIX-C OF THIS TITLE.
  S 75. Intentionally omitted.
  S  76.  Subdivision  6  of section 364-i of the social services law is
amended by adding a new paragraph (a-2) to read as follows:
  (A-2) AT THE TIME OF APPLICATION FOR PRESUMPTIVE ELIGIBILITY  PURSUANT
TO  THIS  SUBDIVISION, A PREGNANT WOMAN WHO RESIDES IN A SOCIAL SERVICES
DISTRICT THAT HAS IMPLEMENTED THE STATE'S MANAGED CARE PROGRAM  PURSUANT
TO  SECTION  THREE  HUNDRED  SIXTY-FOUR-J  OF  THIS  TITLE MUST CHOOSE A
MANAGED CARE PROVIDER. IF A MANAGED CARE PROVIDER IS NOT CHOSEN  AT  THE
TIME  OF  APPLICATION,  THE PREGNANT WOMAN WILL BE ASSIGNED TO A MANAGED
CARE PROVIDER IN ACCORDANCE WITH SUBPARAGRAPHS (II), (III), (IV) AND (V)
OF  PARAGRAPH  (F)  OF  SUBDIVISION  FOUR  OF  SECTION   THREE   HUNDRED
SIXTY-FOUR-J OF THIS TITLE.
  S  77.  Paragraphs  (b),  (c), (d) and (f) of subdivision 3 of section
364-j of the social services law are REPEALED, paragraph (e)  is  relet-
tered  paragraph  (d),  and  two new paragraphs (b) and (c) are added to
read as follows:
  (B) THE FOLLOWING MEDICAL ASSISTANCE RECIPIENTS SHALL NOT BE  REQUIRED
TO  PARTICIPATE  IN  A MANAGED CARE PROGRAM ESTABLISHED PURSUANT TO THIS
SECTION:
  (I) INDIVIDUALS WITH A CHRONIC MEDICAL CONDITION WHO ARE BEING TREATED
BY A SPECIALIST PHYSICIAN THAT IS NOT ASSOCIATED  WITH  A  MANAGED  CARE
PROVIDER  IN THE INDIVIDUAL'S SOCIAL SERVICES DISTRICT MAY DEFER PARTIC-
IPATION IN THE MANAGED CARE PROGRAM FOR SIX MONTHS OR UNTIL  THE  COURSE
OF TREATMENT IS COMPLETE, WHICHEVER OCCURS FIRST; AND
  (II) NATIVE AMERICANS.
  (C)  THE FOLLOWING MEDICAL ASSISTANCE RECIPIENTS SHALL NOT BE ELIGIBLE
TO PARTICIPATE IN A MANAGED CARE PROGRAM ESTABLISHED  PURSUANT  TO  THIS
SECTION:
  (I) A PERSON ELIGIBLE FOR MEDICARE PARTICIPATING IN A CAPITATED DEMON-
STRATION PROGRAM FOR LONG TERM CARE;
  (II)  AN INFANT LIVING WITH AN INCARCERATED MOTHER IN A STATE OR LOCAL
CORRECTIONAL FACILITY AS DEFINED IN SECTION TWO OF THE CORRECTION LAW;
  (III) A PERSON WHO IS EXPECTED TO BE ELIGIBLE FOR  MEDICAL  ASSISTANCE
FOR LESS THAN SIX MONTHS;
  (IV)  A  PERSON  WHO  IS ELIGIBLE FOR MEDICAL ASSISTANCE BENEFITS ONLY
WITH RESPECT TO TUBERCULOSIS-RELATED SERVICES;
  (V) INDIVIDUALS RECEIVING HOSPICE SERVICES AT TIME OF ENROLLMENT;
  (VI) A PERSON WHO HAS PRIMARY MEDICAL OR HEALTH CARE  COVERAGE  AVAIL-
ABLE  FROM  OR  UNDER  A  THIRD-PARTY  PAYOR  WHICH MAY BE MAINTAINED BY
PAYMENT, OR PART PAYMENT, OF THE PREMIUM OR COST SHARING  AMOUNTS,  WHEN
PAYMENT OF SUCH PREMIUM OR COST SHARING AMOUNTS WOULD BE COST-EFFECTIVE,
AS DETERMINED BY THE LOCAL SOCIAL SERVICES DISTRICT;
  (VII) A PERSON RECEIVING FAMILY PLANNING SERVICES PURSUANT TO SUBPARA-
GRAPH  ELEVEN  OF  PARAGRAPH  (A)  OF  SUBDIVISION  ONE OF SECTION THREE
HUNDRED SIXTY-SIX OF THIS TITLE;
  (VIII) A PERSON WHO IS ELIGIBLE FOR  MEDICAL  ASSISTANCE  PURSUANT  TO
PARAGRAPH  (V) OF SUBDIVISION FOUR OF SECTION THREE HUNDRED SIXTY-SIX OF
THIS TITLE; AND
  (IX) A PERSON WHO IS MEDICARE/MEDICAID DUALLY ELIGIBLE AND WHO IS  NOT
ENROLLED IN A MEDICARE MANAGED CARE PLAN.
  S  77-a. Paragraph (g) of subdivision 3 of section 364-j of the social
services law, as amended by chapter 649 of the laws of 1996, and subpar-
agraph (i) as amended by section 30 of part C of chapter 58 of the  laws
of 2008, is amended to read as follows:

S. 2809--C                         170

  [(g)]  (E)  The  following categories of individuals [will not] MAY be
required to enroll with a managed  care  program  [until]  WHEN  program
features  and  reimbursement  rates  are approved by the commissioner of
health and, as appropriate,  the  [commissioner]  COMMISSIONERS  of  THE
DEPARTMENT  OF  mental health, THE OFFICE FOR PERSONS WITH DEVELOPMENTAL
DISABILITIES, AND THE OFFICE OF ALCOHOL AND SUBSTANCE ABUSE SERVICES:
  (i) an individual dually eligible for medical assistance and  benefits
under  the  federal  Medicare program and enrolled in a Medicare managed
care plan offered by an entity that is also  a  managed  care  provider;
provided that (notwithstanding paragraph (g) of subdivision four of this
section):
  (a) if the individual changes his or her Medicare managed care plan as
authorized  by  title  XVIII  of  the  federal  social security act, and
enrolls in another Medicare managed care plan that  is  also  a  managed
care  provider, the individual shall be (if required by the commissioner
under this paragraph) enrolled in that managed care provider;
  (b) if the individual changes his or her Medicare managed care plan as
authorized by title XVIII  of  the  federal  social  security  act,  but
enrolls in another Medicare managed care plan that is not also a managed
care provider, the individual shall be disenrolled from the managed care
provider  in  which he or she was enrolled and withdraw from the managed
care program;
  (c) if the individual disenrolls from his or her Medicare managed care
plan as authorized by title XVIII of the federal  social  security  act,
and  does not enroll in another Medicare managed care plan, the individ-
ual shall be disenrolled from the managed care provider in which  he  or
she was enrolled and withdraw from the managed care program;
  (d)  nothing  herein shall require an individual enrolled in a managed
long term care plan, pursuant to section forty-four hundred  three-f  of
the public health law, to disenroll from such program.
  (ii) an individual eligible for supplemental security income;
  (iii) HIV positive individuals; [and]
  (iv)  persons with serious mental illness and children and adolescents
with serious emotional disturbances, as defined  in  section  forty-four
hundred one of the public health law[.];
  (V)  A  PERSON RECEIVING SERVICES PROVIDED BY A RESIDENTIAL ALCOHOL OR
SUBSTANCE ABUSE PROGRAM OR FACILITY FOR THE MENTALLY RETARDED;
  (VI) A PERSON RECEIVING SERVICES  PROVIDED  BY  AN  INTERMEDIATE  CARE
FACILITY  FOR THE MENTALLY RETARDED OR WHO HAS CHARACTERISTICS AND NEEDS
SIMILAR TO SUCH PERSONS;
  (VII) A  PERSON  WITH  A  DEVELOPMENTAL  OR  PHYSICAL  DISABILITY  WHO
RECEIVES  HOME  AND  COMMUNITY-BASED  SERVICES  OR CARE-AT-HOME SERVICES
THROUGH EXISTING WAIVERS UNDER SECTION NINETEEN HUNDRED FIFTEEN  (C)  OF
THE  FEDERAL  SOCIAL  SECURITY  ACT OR WHO HAS CHARACTERISTICS AND NEEDS
SIMILAR TO SUCH PERSONS;
  (VIII) A PERSON WHO IS ELIGIBLE FOR  MEDICAL  ASSISTANCE  PURSUANT  TO
SUBPARAGRAPH  TWELVE OR SUBPARAGRAPH THIRTEEN OF PARAGRAPH (A) OF SUBDI-
VISION ONE OF SECTION THREE HUNDRED SIXTY-SIX OF THIS TITLE;
  (IX) A PERSON RECEIVING SERVICES PROVIDED BY A LONG TERM  HOME  HEALTH
CARE  PROGRAM, OR A PERSON RECEIVING INPATIENT SERVICES IN A STATE-OPER-
ATED PSYCHIATRIC FACILITY OR A RESIDENTIAL TREATMENT FACILITY FOR  CHIL-
DREN AND YOUTH;
  (X)  CERTIFIED  BLIND  OR  DISABLED  CHILDREN LIVING OR EXPECTED TO BE
LIVING SEPARATE AND APART FROM THE PARENT FOR THIRTY DAYS OR MORE;
  (XI) RESIDENTS OF NURSING FACILITIES;

S. 2809--C                         171

  (XII) A FOSTER CHILD IN THE PLACEMENT OF A VOLUNTARY AGENCY OR IN  THE
DIRECT CARE OF THE LOCAL SOCIAL SERVICES DISTRICT;
  (XIII) A PERSON OR FAMILY THAT IS HOMELESS; AND
  (XIV)  INDIVIDUALS  FOR  WHOM A MANAGED CARE PROVIDER IS NOT GEOGRAPH-
ICALLY ACCESSIBLE SO AS TO REASONABLY PROVIDE SERVICES TO THE PERSON.  A
MANAGED  CARE  PROVIDER  IS  NOT GEOGRAPHICALLY ACCESSIBLE IF THE PERSON
CANNOT ACCESS THE  PROVIDER'S  SERVICES  IN  A  TIMELY  FASHION  DUE  TO
DISTANCE OR TRAVEL TIME.
  S  78.  Subparagraph  (v) of paragraph (e) of subdivision 4 of section
364-j of the social services law, as amended by section 14 of part C  of
chapter 58 of the laws of 2004, is amended to read as follows:
  (v)  Upon  delivery  of  the  pre-enrollment  information,  the  local
district or the enrollment organization shall certify the  participant's
receipt  of such information. Upon verification that the participant has
received  the  pre-enrollment  education  information,  a  managed  care
provider,  a  local district or the enrollment organization may enroll a
participant into a managed care provider. Managed  care  providers  must
submit enrollment forms to the local department of social services. Upon
enrollment,  participants  will  sign an attestation that they have been
informed that: participants have a choice  of  managed  care  providers;
participants have a choice of primary care practitioners; and, except as
otherwise  provided  in  this  section, including but not limited to the
exceptions listed in subparagraph (iii) of paragraph (a) of this  subdi-
vision, participants must exclusively use their primary care practition-
ers and plan providers. The commissioner of health [or with respect to a
managed  care  plan  serving participants in a city with a population of
over two million, the local department of social services in such city,]
may suspend or curtail enrollment or impose  sanctions  for  failure  to
appropriately notify clients as required in this subparagraph.
  S  79.  Subparagraph  (i) of paragraph (f) of subdivision 4 of section
364-j of the social services law, as amended by section 14 of part C  of
chapter 58 of the laws of 2004, is amended to read as follows:
  (i)  Participants  SHALL CHOOSE A MANAGED CARE PROVIDER AT THE TIME OF
APPLICATION FOR MEDICAL ASSISTANCE; IF THE PARTICIPANT DOES  NOT  CHOOSE
SUCH  A  PROVIDER  THE  COMMISSIONER  SHALL ASSIGN SUCH PARTICIPANT TO A
MANAGED CARE PROVIDER IN ACCORDANCE WITH SUBPARAGRAPHS (II), (III), (IV)
AND (V) OF THIS PARAGRAPH. PARTICIPANTS ALREADY IN  RECEIPT  OF  MEDICAL
ASSISTANCE  shall  have  no  less than [sixty] THIRTY days from the date
selected by the district to enroll in the managed care program to select
a managed care provider, and as appropriate,  a  mental  health  special
needs  plan,  and shall be provided with information to make an informed
choice. Where a participant has not selected such a provider  or  mental
health  special needs plan, the commissioner of health shall assign such
participant to a managed care provider, and as appropriate, to a  mental
health  special  needs plan, taking into account capacity and geographic
accessibility. The commissioner may after the period of time established
in subparagraph (ii) of this paragraph assign participants to a  managed
care provider taking into account quality performance criteria and cost.
Provided however, cost criteria shall not be of greater value than qual-
ity criteria in assigning participants.
  S  80.  Paragraphs (d), (e), and (f) of subdivision 5 of section 364-j
of the social services law, as added by section 15 of part C of  chapter
58 of the laws of 2004, are amended to read as follows:
  (d)  Notwithstanding  any  inconsistent  provision  of  this title and
section one hundred sixty-three of the state finance  law,  the  commis-
sioner  of  health [or the local department of social services in a city

S. 2809--C                         172

with a population of over two million] may contract  with  managed  care
providers  approved  under  paragraph (b) of this subdivision, without a
competitive bid or request for proposal process, to provide coverage for
participants pursuant to this title.
  (e)  Notwithstanding  any  inconsistent  provision  of  this title and
section one hundred forty-three of  the  economic  development  law,  no
notice in the procurement opportunities newsletter shall be required for
contracts awarded by the commissioner of health [or the local department
of  social services in a city with a population of over two million], to
qualified managed care providers pursuant to this section.
  (f) The care and  services  described  in  subdivision  four  of  this
section  will  be  furnished  by a managed care provider pursuant to the
provisions of this section when such services are furnished  in  accord-
ance  with  an  agreement  with  the  department of health [or the local
department of social services in a city with a population  of  over  two
million], and meet applicable federal law and regulations.
  S  81.  Paragraph  (k) of subdivision 2 of section 365-a of the social
services law, as amended by chapter 659 of the laws of 1997, is  amended
to read as follows:
  (k)  care and services furnished by an entity offering a comprehensive
health services plan, including an entity that has  received  a  certif-
icate  of  authority  pursuant  to  sections  forty-four  hundred three,
forty-four hundred three-a or forty-four hundred eight-a of  the  public
health  law  (as added by chapter six hundred thirty-nine of the laws of
nineteen  hundred  ninety-six)  or  a  health  maintenance  organization
authorized  under  article forty-three of the insurance law, to eligible
individuals residing in the geographic area served by such entity,  when
such  services are furnished in accordance with an agreement approved by
the department which meets the requirements of  federal  law  and  regu-
lations  [provided,  that  no  such  agreement  shall  allow for medical
assistance payments on a capitated basis for nursing facility, home care
or other long term care services of a  duration  and  scope  defined  in
regulations  of the department of health promulgated pursuant to section
forty-four hundred three-f of the public health law, unless such  entity
has received a certificate of authority as a managed long term care plan
or  is  an  operating  demonstration or is an approved managed long term
care demonstration, pursuant to such section].
  S 82. Paragraph (a) of subdivision 1 of section 367-f  of  the  social
services  law,  as  amended by section 37 of part D of chapter 58 of the
laws of 2009, is amended to read as follows:
  (a) "Medicaid extended coverage" shall mean  eligibility  for  medical
assistance  (i)  without  regard to the resource requirements of section
three hundred sixty-six of this title, or in the case of  an  individual
covered  under  an insurance policy or certificate described in subdivi-
sion two of this section that provided a residential health care facili-
ty benefit less than [three] TWO years in  duration,  without  consider-
ation  of  an  amount  of  resources equivalent to the value of benefits
received by the individual under such policy or certificate,  as  deter-
mined  under  the  rules  of the partnership for long-term care program;
(ii) without regard to the  recovery  of  medical  assistance  from  the
estates  of  individuals  and  the  imposition  of liens on the homes of
persons pursuant to section three hundred sixty-nine of this title, with
respect to resources exempt from consideration pursuant to  subparagraph
(i)  of  this paragraph; provided, however, that nothing in this section
shall prevent the imposition of a lien or recovery against  property  of
an  individual  on  account  of medical assistance incorrectly paid; and

S. 2809--C                         173

(iii) based on an income eligibility standard for married couples  equal
to the amount of the minimum monthly maintenance needs allowance defined
in paragraph (h) of subdivision two of section three hundred sixty-six-c
of  this  title,  and  for  single individuals equal to one-half of such
amount; provided, however, that the commissioner of health shall not  be
required  to implement the provisions of this subparagraph if the use of
such income eligibility standards will  result  in  a  loss  of  federal
financial  participation  in  the  costs  of  Medicaid extended coverage
furnished in accordance with subparagraphs (i) and (ii)  of  this  para-
graph.
  S 83.  Intentionally omitted.
  S 84.  Intentionally omitted.
  S 85.  Intentionally omitted.
  S 86.  Intentionally omitted.
  S  87.  Subdivision  1  of  section  190 of the tax law, as amended by
section 17 of part B of chapter 58 of the laws of 2004,  is  amended  to
read as follows:
  1.  General.  A  taxpayer  shall  be  allowed a credit against the tax
imposed by this article, other  than  the  taxes  and  fees  imposed  by
sections  one hundred eighty and one hundred eighty-one of this article,
equal to [twenty] SEVENTY-FIVE percent of the premium  paid  during  the
taxable  year [for] IN WHICH THE long-term care insurance WAS PURCHASED,
FIFTY PERCENT OF THE PREMIUM PAID IN THE FOLLOWING YEAR AND  TWENTY-FIVE
PERCENT  OF  THE PREMIUM PAID IN THE THIRD YEAR. In order to qualify for
such credit, the taxpayer's premium payment must be for the purchase  of
or  for continuing coverage under a long-term care insurance policy that
qualifies for such credit pursuant to section one thousand  one  hundred
seventeen of the insurance law.
  S  87-a. Paragraph 1 of subsection (aa) of section 606 of the tax law,
as amended by section 1 of part P of chapter 61 of the laws of 2005,  is
amended to read as follows:
  (1)  Residents.  A  taxpayer shall be allowed a credit against the tax
imposed by this article equal to [twenty] SEVENTY-FIVE  percent  of  the
premium  paid  during the taxable year [for] IN WHICH THE long-term care
insurance WAS PURCHASED, FIFTY  PERCENT  OF  THE  PREMIUM  PAID  IN  THE
FOLLOWING  YEAR AND TWENTY-FIVE PERCENT OF THE PREMIUM PAID IN THE THIRD
YEAR.   In order to qualify for  such  credit,  the  taxpayer's  premium
payment  must  be for the purchase of or for continuing coverage under a
long-term care insurance policy that qualifies for such credit  pursuant
to  section  one thousand one hundred seventeen of the insurance law. If
the amount of the credit allowable under this subsection for any taxable
year shall exceed the taxpayer's tax for such year, the  excess  may  be
carried over to the following year or years and may be deducted from the
taxpayer's tax for such year or years.
  S  87-b. Paragraph 1 of subsection (k) of section 1456 of the tax law,
as amended by section 20 of part B of chapter 58 of the laws of 2004, is
amended to read as follows:
  (1) A taxpayer shall be allowed a credit against the  tax  imposed  by
this  article equal to [twenty] SEVENTY-FIVE percent of the premium paid
during the taxable year [for] IN WHICH THE long-term care insurance  WAS
PURCHASED,  FIFTY  PERCENT OF THE PREMIUM PAID IN THE FOLLOWING YEAR AND
TWENTY-FIVE PERCENT OF THE PREMIUM PAID IN THE THIRD YEAR.  In order  to
qualify  for such credit, the taxpayer's premium payment must be for the
purchase of or for continuing coverage under a long-term care  insurance
policy  that  qualifies for such credit pursuant to section one thousand
one hundred seventeen of the insurance law.

S. 2809--C                         174

  S 87-c. Paragraph 1 of subdivision (m) of section 1511 of the tax law,
as amended by section 21 of part B of chapter 58 of the laws of 2004, is
amended to read as follows:
  (1)  A  taxpayer  shall be allowed a credit against the tax imposed by
this article equal to [twenty] SEVENTY-FIVE percent of the premium  paid
during  the taxable year [for] IN WHICH THE long-term care insurance WAS
PURCHASED, FIFTY PERCENT OF THE PREMIUM PAID IN THE FOLLOWING  YEAR  AND
TWENTY-FIVE  PERCENT OF THE PREMIUM PAID IN THE THIRD YEAR.  In order to
qualify for such credit, the taxpayer's premium payment must be for  the
purchase  of or for continuing coverage under a long-term care insurance
policy that qualifies for such credit pursuant to section  one  thousand
one hundred seventeen of the insurance law.
  S  87-d.   Paragraph (a) of subdivision 25-a of section 210 of the tax
law, as amended by section 18 of part B of chapter 58  of  the  laws  of
2004, is amended to read as follows:
  (a)  A  taxpayer  shall be allowed a credit against the tax imposed by
this article equal to [twenty] SEVENTY-FIVE percent of the premium  paid
during  the taxable year [for] IN WHICH THE long-term care insurance WAS
PURCHASED, FIFTY PERCENT OF THE PREMIUM PAID IN THE FOLLOWING  YEAR  AND
TWENTY-FIVE  PERCENT OF THE PREMIUM PAID IN THE THIRD YEAR.  In order to
qualify for such credit, the taxpayer's premium payment must be for  the
purchase  of or for continuing coverage under a long-term care insurance
policy that qualifies for such credit pursuant to section  one  thousand
one hundred seventeen of the insurance law.
  S  87-e. Section 367-f of the social services law is amended by adding
a new subdivision 4 to read as follows:
  4. THE DEPARTMENT OF HEALTH  IS  HEREBY  AUTHORIZED  AND  DIRECTED  TO
SUBMIT  TO THE FEDERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES A REQUEST
FOR THE AMENDMENT OF THE PLAN FOR MEDICAL  ASSISTANCE,  WHICH  IS  MAIN-
TAINED  IN  ACCORDANCE  WITH  TITLE  XIX, OR ANY SUCCESSOR TITLE, OF THE
FEDERAL SOCIAL SECURITY ACT, TO ADOPT ANY AND ALL STANDARDS THAT MAY  BE
DEVELOPED  BY THE FEDERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES PURSU-
ANT TO SECTION 6021(B) OF THE FEDERAL DEFICIT REDUCTION ACT OF 2005, FOR
UNIFORM RECIPROCAL RECOGNITION  OF  LONG-TERM  CARE  INSURANCE  POLICIES
PURCHASED  UNDER  STATE  LONG-TERM  CARE  INSURANCE PARTNERSHIPS.   SUCH
REQUEST SHALL BE MADE WITHIN SIX MONTHS  OF  THE  PROMULGATION  OF  SUCH
STANDARDS  BY  THE FEDERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES, AND,
EXCEPT AS REQUIRED BY SUCH STANDARDS, SUCH UNIFORM  RECIPROCAL  RECOGNI-
TION  OF LONG-TERM CARE INSURANCE POLICIES SHALL APPLY WITHOUT REGARD TO
WHEN A POLICY IS ISSUED.
  S 87-f. Section 3229 of the insurance law is amended by adding  a  new
subsection (c) to read as follows:
  (C) THE SUPERINTENDENT SHALL ADOPT SUCH RULES OR REGULATIONS, OR AMEND
SUCH  RULES  AND  REGULATIONS,  AS  MAY  BE  NECESSARY TO CONFORM TO THE
REQUIREMENTS OF ANY AMENDMENT TO THE PLAN FOR MEDICAL ASSISTANCE,  WHICH
IS  MAINTAINED  IN ACCORDANCE WITH TITLE XIX, OR ANY SUCCESSOR TITLE, OF
THE FEDERAL SOCIAL SECURITY ACT, MADE PURSUANT TO  SUBDIVISION  FOUR  OF
SECTION THREE HUNDRED SIXTY-SEVEN-F OF THE SOCIAL SERVICES LAW.
  S 88. Subparagraph 11 of paragraph (a) of subdivision 1 of section 366
of the social services law, as amended by section 1-h of part C of chap-
ter 58 of the laws of 2007, is amended to read as follows:
  (11)  for  purposes of receiving family planning services eligible for
reimbursement by the federal government at a rate of ninety percent,  is
not  otherwise  eligible  for medical assistance and whose income is two
hundred percent or less of the comparable federal income official pover-
ty line (as defined and annually revised by the United States department

S. 2809--C                         175

of health and human  services);  provided,  however,  that  such  ninety
percent  limitation  shall not apply to those services identified by the
commissioner of health as services,  including  treatment  for  sexually
transmitted  diseases,  generally performed as part of or as a follow-up
to a service eligible for such ninety  percent  reimbursement;  PROVIDED
FURTHER  THAT  THE  COMMISSIONER  OF  HEALTH  IS AUTHORIZED TO ESTABLISH
CRITERIA FOR PRESUMPTIVE ELIGIBILITY FOR SERVICES PROVIDED  PURSUANT  TO
THIS  SUBPARAGRAPH  IN  ACCORDANCE  WITH  ALL APPLICABLE REQUIREMENTS OF
FEDERAL LAW OR REGULATION PERTAINING TO SUCH  ELIGIBILITY.  The  commis-
sioner  of  health  shall  submit whatever waiver applications as may be
necessary  to  receive  federal  financial  participation  for  services
provided under this subparagraph and the provisions of this subparagraph
shall  be  effective  if  and  so long as such federal financial partic-
ipation shall be available; or
  S 89. Paragraph (e) of subdivision 2 of section 365-a  of  the  social
services  law, as amended by chapter 170 of the laws of 1994, is amended
to read as follows:
  (e) (I) personal care services, including personal emergency  response
services,  shared aide and an individual aide, SUBJECT TO THE PROVISIONS
OF SUBPARAGRAPHS (II), (III), AND (IV) OF THIS PARAGRAPH,  furnished  to
an individual who is not an inpatient or resident of a hospital, nursing
facility,  intermediate  care  facility  for  the  mentally retarded, or
institution for mental disease, as determined to  meet  the  recipient's
needs  for assistance when cost effective and appropriate [in accordance
with section three  hundred  sixty-seven-k  and  section  three  hundred
sixty-seven-o  of  this  title],  and when prescribed by a physician, in
accordance with the recipient's plan of treatment and provided by  indi-
viduals  who  are qualified to provide such services, who are supervised
by a registered nurse and who are not members of the recipient's family,
and furnished in the recipient's home or other location;
  (II) THE  COMMISSIONER  IS  AUTHORIZED  TO  ADOPT  STANDARDS  FOR  THE
PROVISION  AND MANAGEMENT OF SERVICES AVAILABLE UNDER THIS PARAGRAPH FOR
INDIVIDUALS WHOSE NEED FOR SUCH SERVICES EXCEEDS A SPECIFIED LEVEL TO BE
DETERMINED BY THE COMMISSIONER;
  (III) THE COMMISSIONER IS AUTHORIZED TO PROVIDE ASSISTANCE TO  PERSONS
RECEIVING SERVICES UNDER THIS PARAGRAPH WHO ARE TRANSITIONING TO RECEIV-
ING  CARE  FROM  A  MANAGED  LONG  TERM  CARE PLAN CERTIFIED PURSUANT TO
SECTION FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW;
  (IV) PERSONAL CARE SERVICES AVAILABLE PURSUANT TO THIS PARAGRAPH SHALL
NOT EXCEED EIGHT HOURS PER WEEK FOR INDIVIDUALS WHOSE NEEDS ARE  LIMITED
TO NUTRITIONAL AND ENVIRONMENTAL SUPPORT FUNCTIONS;
  S 90.  (a) Notwithstanding any other provision of law to the contrary,
for  the  state fiscal year periods beginning April 1, 2011 and April 1,
2012, all Medicaid payments made for  services  provided  on  and  after
April  1,  2011,  through  March  31, 2013, shall, except as hereinafter
provided, be subject  to  a  uniform  two  percent  reduction  and  such
reduction  shall be applied, to the extent practicable, in equal amounts
during  the  fiscal  year.    Reductions  shall  achieve  no  more  than
$345,000,000 in Medicaid state share savings annually, except as herein-
after provided, for services provided on and after April 1, 2011 through
March 31, 2013.
  (b)  The  following  types  of  appropriations  shall  be  exempt from
reductions pursuant to this section:
  (i) any reductions that would violate federal law including,  but  not
limited to, payments required pursuant to the federal Medicare program;

S. 2809--C                         176

  (ii)  any reductions related to payments pursuant to article 32, arti-
cle 31 and article 16 of the mental hygiene law;
  (iii) payments the state is obligated to make pursuant to court orders
or judgments;
  (iv)  payments  for  which  the non-federal share does not reflect any
state funding; and
  (v) payments with regard to which it is determined by the commissioner
of health and the director of the budget that application of  reductions
pursuant to this section would result, by operation of federal law, in a
lower federal medical assistance percentage applicable to such payments.
  (c) Reductions to Medicaid payments or Medicaid rates of payments made
pursuant  to  this section shall be subject to the receipt of all neces-
sary federal approvals.
  S 91.  Notwithstanding any inconsistent provision of state  law,  rule
or  regulation to the contrary, subject to federal approval, the year to
year rate of growth of department of health state funds spending for the
period April 1, 2011, through March 31, 2013, shall not exceed  the  ten
year  rolling  average  of  the  medical component of the consumer price
index as published by the United States department of labor,  bureau  of
labor statistics, for the preceding ten years.
  S  92.    The  director  of  the  budget, and the chairs of the senate
finance and assembly  ways  and  means  committees,  shall  periodically
assess  known  and  projected  department of health state funds medicaid
expenditures.  Such assessment shall include an assessment  of  expendi-
tures  by  category  of  service  and geographic region of the state, as
defined pursuant to chapter 63 of the laws of 2005.  If it is determined
by the director of the budget, and the chairs of the senate finance  and
assembly  ways  and means committees that such expenditures are expected
to cause medicaid disbursements for such period to exceed the  projected
department  of  health medicaid state funds disbursements in the enacted
budget financial plan pursuant to subdivision 3 of  section  23  of  the
state  finance law, the commissioner of health, in consultation with the
director of the budget, shall develop a medicaid savings allocation plan
to limit such spending to the aggregate limit  level  specified  in  the
enacted  budget  financial plan, provided, however, such projections may
be adjusted by the director of the budget to account for any changes  in
the  New  York state federal medical assistance percentage amount estab-
lished pursuant to the federal social security act, changes in  provider
revenues,  and  beginning April 1, 2012 the operational costs of the New
York state medical indemnity fund.
  1. Such medicaid savings allocation plan shall be designed  to  reduce
the  disbursements  authorized by the appropriations herein and may take
into consideration that:   (1) reductions shall be  made  in  compliance
with  applicable  federal  law,  including the provisions of the Patient
Protection and Affordable Care Act, Public  Law  No.  111-148,  and  the
Health  Care  and  Education  Reconciliation Act of 2010, Public Law No.
111-152 (collectively "Affordable Care Act") and any  subsequent  amend-
ments  thereto  or  regulations  promulgated  thereunder; (2) reductions
shall be made in a manner that complies with  the  state  Medicaid  plan
approved  by  the  federal  centers  for medicare and medicaid services,
provided, however, that the commissioner  of  health  is  authorized  to
submit  any state plan amendment or seek other federal approval, includ-
ing waiver authority,  to  implement  the  provisions  of  the  medicaid
savings  allocation plan that meets the other criteria set forth herein;
(3) reductions shall be made in a manner that maximizes  federal  finan-
cial  participation,  to  the  extent practicable, including any federal

S. 2809--C                         177

financial participation that is available or is reasonably  expected  to
become available, in the discretion of the commissioner of health, under
the  Affordable  Care Act; (4) reductions shall be made in a manner that
does  not unnecessarily create administrative burdens to Medicaid appli-
cants and recipients or providers; and  (5)  reductions  shall  be  made
uniformly  within  the  specific  categories  of services, to the extent
practicable and according to  the  requirements  of  this  subparagraph,
which  contributed to department of health Medicaid state funds spending
in excess of the limits specified herein, provided however  the  commis-
sioner  of  health  shall  take  into consideration the need to maintain
safety net services in underserved communities or the potential benefits
of pursuing innovative payment models  contemplated  by  the  Affordable
Care  Act, in which case such grounds shall be set forth in the Medicaid
savings allocation plan.
  2. The medicaid savings allocation plan shall state  how  the  commis-
sioner  of  the  department  of health would reduce department of health
state funds medicaid disbursements by the amount of the projected  over-
spending  through,  actions  including,  but not limited to modifying or
suspending reimbursement methods, including but not limited to all fees,
premium levels and rates of payment, modifying or discontinuing Medicaid
program benefits; seeking all necessary  Federal  approvals,  including,
but not limited to waivers, waiver amendments.
  3.  The  Medicaid  savings  allocation  plan shall be submitted to the
legislature for their consideration and approval prior to implementation
of this plan.
  S 93. 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 94. 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  95. 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 judgment
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  96.  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) the amendment to subparagraph 1 of paragraph (c) of subdivision 10
of  section  2807-c of the public health law made by section one of this
act shall not affect the  expiration  of  such  subparagraph  and  shall
expire and be deemed repealed therewith;
  (b)  the  amendments  to section 272 of the public health law, made by
sections nine, sixteen and seventeen of this act shall  not  affect  the

S. 2809--C                         178

repeal  of  such  section and shall expire and be deemed repealed there-
with;
  (b-1)  the  amendments to subdivision 9 of section 367-a of the social
services law made by section ten of this act shall not affect the  expi-
ration of such subdivision and shall be deemed to expire therewith;
  (c)  the amendments to subdivision 22 of section 6802 of the education
law, made by section twelve of this act shall not affect the  repeal  of
such subdivision and shall expire and be deemed repealed therewith;
  (d)  the  amendments  to section 271 of the public health law, made by
sections thirteen, fourteen and fifteen of this act shall not affect the
repeal of such section and shall expire and be  deemed  repealed  there-
with;
  (e)  the amendments to subparagraph (i) of paragraph (b-1) of subdivi-
sion 1 of section 2807-c of the public health law made by section  thir-
ty-two of this act shall not affect the expiration of such paragraph and
shall be deemed to expire therewith;
  (e-1)  the  amendments to subdivision 2 of section 364-m of the social
services law made by section thirty-four-a of this act shall not  affect
the repeal of such section and shall be deemed repealed therewith;
  (f)  sections forty-one, forty-one-a and forty-one-b of this act shall
take effect on April 1, 2012; and the amendments to  section  4403-f  of
the  public  health law made therein shall not affect the repeal of such
section and shall be deemed repealed therewith;
  (g) the amendments to subdivision 6 of section  367-a  of  the  social
services law, made by sections forty-three, forty-four and forty-five of
this  act  shall  not  affect  the  repeal of such subdivision and shall
expire and be deemed repealed therewith;
  (h) sections thirty-six, fifty and fifty-one of this  act  shall  take
effect on the ninetieth day after it shall have become a law;
  (i) sections twenty, twenty-one, twenty-seven, forty-one, forty-one-a,
forty-one-b,  forty-three,  forty-four,  forty-five,  forty-six,  forty-
eight, fifty-four, fifty-eight, seventy,  seventy-one,  seventy-two  and
seventy-three of this act shall take effect on the one hundred eightieth
day after it shall have become a law;
  (j)  section  forty-seven  of this act shall take effect on October 1,
2011;
  (k) the amendments to paragraph 6 of subdivision (a) of section  31.02
of  the mental hygiene law made by section seventy-two of this act shall
not affect the repeal of such  paragraph  and  shall  be  deemed  to  be
repealed therewith;
  (l) the amendments to section 364-j of the social services law made by
sections seventy-seven, seventy-seven-a, seventy-eight, seventy-nine and
eighty of this act shall not affect the repeal of such section and shall
be deemed repealed therewith;
  (m)  the amendments to paragraph (k) of subdivision 2 of section 365-a
of the social services law made by section eighty-one of this act  shall
not  affect  the  expiration  of such subdivision and shall be deemed to
expire therewith;
  (n) section twelve of this act shall take effect August 1, 2011;
  (o) sections thirteen, fourteen, fifteen, sixteen, and seventeen shall
take effect May 1, 2011;
  (p) section twenty-three of this act shall  take  effect  December  1,
2011;
  (q) section forty of this act shall take effect September 1, 2011;

S. 2809--C                         179

  (r)  sections  sixty-nine and eighty-two of this act shall take effect
on January 1, 2012 and shall apply to  taxable  years  beginning  on  or
after January 1, 2012;
  (s)  section  thirty-five  of  this  act  shall  expire  and be deemed
repealed April 1, 2015;
  (s-1) sections eighty-seven through eighty-seven-d of this  act  shall
apply to long term care insurance contracts purchased or entered into on
or after January 1, 2012;
  (t) section ninety-one of this act shall take effect April 1, 2012;
  (u)  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, provided that the  department
of  health  may  promulgate regulations including on an emergency basis,
necessary to implement this act, prior to its effective date;
  (v) 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;
  (w) 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;
  (x) 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;
  (y) sections fifty-two through fifty-two-m  of  this  act  shall  take
effect  on  the  ninetieth  day after it shall have become law, provided
that it shall apply to birth-related  neurological  injury  lawsuits  in
existence as of the date of enactment and to all birth-related neurolog-
ical  injury  lawsuits  commenced subsequently to the date of enactment,
and provided further that the commissioner of health and the superinten-
dent of financial regulations shall  be  authorized  to  promulgate  any
regulations as necessary to implement such sections prior to such effec-
tive date, including on an emergency basis; and
  (z)  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.
  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 H of this act shall  be
as specifically set forth in the last section of such Parts.

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

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

                      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 -- 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 --  again  reported  from
  said  committee  with  amendments,  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, in relation to early intervention services; 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

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                      [ ] is old law to be omitted.
                                                           LBD12571-06-1

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

  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 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
  (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  ambu-
  latory  care  services, in relation to the effectiveness of such chap-
  ter; 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 liqui-
  dation 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  encour-
  aging  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

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

  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 author-
  izing  the  establishment  of  special needs plans, in relation to the
  effectiveness thereof; to amend chapter 58 of the laws of 2008, amend-
  ing 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 assist-
  ance, in relation to the  effectiveness  thereof;  to  repeal  certain
  provisions  of the public health law relating to capital related inpa-
  tient 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); to amend the mental hygiene law, in relation to

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

  the closure and the reduction in size of  certain  facilities  serving
  persons  with  mental illness; and providing for the repeal of certain
  provisions upon expiration thereof (Part G); and to amend  the  public
  health  law,  in  relation to general hospital inpatient reimbursement
  for annual rates; 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 calculation of capital costs and
  to repeal certain provisions of such law relating  thereto;  to  amend
  chapter  58  of  the  laws  of 2010 amending the public health law and
  other laws relating to Medicaid  payments,  in  relation  to  the  HIV
  special needs plan; 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 occupa-
  tional 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,  mail
  order  prescriptions,  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 transplants and anti-retro-
  virals  used  in  the  treatment  of HIV and AIDS; to amend the public
  health law, in relation to  diagnostic  care  centers;  to  amend  the
  public  health law, in relation to temporary operator certificates 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 statewide planning and research
  cooperative systems; to amend the public health law,  in  relation  to
  managed  long  term care plans and residential health care facilities;
  to amend the social services law, in  relation  to  insurance  co-pay-
  ments; to amend the public health law, in relation to providing palli-
  ative 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 public health law, in relation to the New York state medical
  indemnity  fund and the New York state hospital quality initiative; to
  amend the mental hygiene law, in relation to  compliance  with  opera-
  tional  standards by hospitals and providers of services in hospitals;
  to amend the public health law, in relation to serious  event  report-
  ing;  to  amend  the  public  health  law  in  relation to creating an
  accountable care organization  demonstration  program;  to  amend  the
  social services law, in relation to limiting the reporting 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

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

  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  methodol-
  ogies  with  accountable  care  organizations,  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 social services law, in relation to the character and adequacy  of
  assistance;  to  amend the public health law, in relation to operating
  costs and rates of payment and repealing certain  provisions  of  such
  law  relating thereto; to amend chapter 58 of the laws of 2009, amend-
  ing the  public  health  law  and  other  laws  relating  to  Medicaid
  reimbursements  to  residential health care facilities, in relation to
  such reimbursements; and to amend the public health law,  in  relation
  to residential health care facility supplemental payments, non-capital
  components  of  rates, temporary nursing home stability contributions,
  authorizes commissioner of health to enter into contracts for purposes
  of the Early Innovator federal grant award; to amend  chapter  385  of
  the  laws  of 2008 amending the insurance law relating to an exemption
  to certain provisions  of  law  relating  to  risk-based  capital  for
  property/casualty  insurance  companies, in relation to the effective-
  ness thereof; and to amend the insurance law, in relation to  applica-
  tions for orders of rehabilitation or liquidation; 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 extending the effectiveness
  thereof  and providing for the repeal of certain provisions upon expi-
  ration 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-

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

able enrollment period and to maintain such enrollment.  [This  require-
ment  shall  be  waived  if  such enrollment would result in significant
additional financial liability by the participant,  including,  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 partic-
ipant, the participant's spouse or other dependent.  The elderly pharma-
ceutical 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] FOR UNMARRIED PARTICIPANTS WITH INDI-
VIDUAL ANNUAL INCOME LESS THAN OR EQUAL TO TWENTY-THREE THOUSAND DOLLARS
AND  MARRIED PARTICIPANTS WITH JOINT ANNUAL INCOME LESS THAN OR EQUAL TO
TWENTY-NINE  THOUSAND  DOLLARS,  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 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

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

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
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.

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

[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
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

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

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;
  [(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

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

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
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

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

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
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

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

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.
  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

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

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
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 five percent.
  S 5. Intentionally omitted.
  S 6. Intentionally omitted.
  S 7. Intentionally omitted.
  S 8. Intentionally omitted.

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

  S 9. Intentionally omitted.
  S 10. Intentionally omitted.
  S 11. Intentionally omitted.
  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. Intentionally omitted.
  S 15. Intentionally omitted.
  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.  Subdivision  2  of  section  2407 of the public health law, as
amended by chapter 430 of the laws  of  2005,  is  amended  to  read  as
follows:

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

  2.  The advisory council shall be responsible for advising the commis-
sioner with respect to the implementation of this article and shall make
recommendations as to [the selection of approved organizations and]  the
standards  to  be  established  by  the commissioner pursuant to section
twenty-four  hundred  six of this title. [The commissioner shall consult
with the advisory council prior to  developing  standards  for  approved
organizations,  selecting  approved organizations, making grants to such
organizations and implementing the breast and cervical cancer  detection
and education program.]
  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 RELATED TO
THE QUALITY OF CLINICAL LABORATORY MEDICINE.
  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

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

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.  FOR THE PURPOSES OF THIS  SUBDIVISION,  STANDARD  FEDERALLY
ESTABLISHED  GOVERNMENTAL COST ALLOCATION PRACTICES SHALL BE USED BY THE
COMMISSIONER TO DETERMINE THE COST OF THE REFERENCE SYSTEM. THE  DEPART-
MENT  SHALL  MAKE AVAILABLE, ON THE DEPARTMENT'S WEBSITE, INFORMATION ON
THE COSTS INCLUDED IN DETERMINING THE PERMITTED LABORATORIES' FEES.  THE
DEPARTMENT  SHALL NOT DEEM AS COSTS OF THE REFERENCE SYSTEM, COSTS ASSO-
CIATED WITH FEDERAL GRANTS AND PATENTS WHICH  ARE  NOT  RELATED  TO  THE
REFERENCE  SYSTEM.    THE  FEE  PAID  BY  THE  DEPARTMENT TO MAINTAIN AN
EXEMPTION FOR CLINICAL LABORATORIES AND BLOOD BANKS  FROM  THE  REQUIRE-
MENTS OF THE FEDERAL CLINICAL LABORATORY IMPROVEMENT AMENDMENTS OF NINE-
TEEN  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

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

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.   PRIOR TO AN
AWARDED BEING GRANTED TO AN ELIGIBLE APPLICANT WITHOUT A COMPETITIVE BID
OR REQUEST FOR PROPOSAL PROCESS, THE COMMISSIONER SHALL NOTIFY THE CHAIR
OF THE SENATE FINANCE COMMITTEE, THE CHAIR  OF  THE  ASSEMBLY  WAYS  AND
MEANS COMMITTEE AND THE DIRECTOR OF THE DIVISION OF BUDGET OF THE INTENT
TO  GRANT SUCH AN AWARD. SUCH NOTICE SHALL INCLUDE INFORMATION REGARDING
HOW THE ELIGIBLE APPLICANT MEETS CRITERIA ESTABLISHED PURSUANT  TO  THIS
SECTION.
  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 however
that  sections  sixteen, seventeen and eighteen of this act shall expire
April 1, [2011] 2014; 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

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

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] 2014; 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]
TWENTY 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] 2015; and provided further, however,  that  the
expiration  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]  2015,  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  redemp-
tion,  for  the  sole  purpose  of authorizing the issuance of refunding
bonds to refund bonds previously issued pursuant thereto.

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

  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
or Medicare rate that would otherwise  be  received  for  such  services
rendered  by  such physicians, nurse practitioners and physician assist-
ants. The calculation 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 sched-
ule 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

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

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 ACTUAL 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. Intentionally omitted.
  S 4. Intentionally omitted.
  S4-a. Intentionally omitted.
  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,
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

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

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. Intentionally omitted.
  S 9. Intentionally omitted.
  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--D                         22                         A. 4009--D

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--D                         23                         A. 4009--D

  (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--D                         24                         A. 4009--D

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--D                         25                         A. 4009--D

  (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--D                         26                         A. 4009--D

  (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. Intentionally omitted.
  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;
  (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-

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

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
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,

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

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
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

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

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 THROUGH MARCH THIRTY-FIRST, TWO  THOUSAND  FOURTEEN,  UP  TO
FUNDING AMOUNTS SPECIFIED BELOW and shall be available, 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
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

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

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
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

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

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
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-

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

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
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

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

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;
  (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

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

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:
  (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.

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

  (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-
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

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

  (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
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

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

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
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;

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

  (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
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

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

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
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.

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

  (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.
  (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

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

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
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:

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

  (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
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:

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

  (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
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.

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

  (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
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

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

  (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;
  (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;

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

  (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;
  (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-

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

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;
  (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.

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

  (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
  (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;

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

  (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
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;

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

  (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;
  (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;

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

  (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;
  (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. 2809--D                         52                         A. 4009--D

  (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
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

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

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;
  (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]

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

  (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;
  (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:

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

  (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:
  (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

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

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;
  (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;

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

  (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-
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;

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

  (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;
  (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.

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

  (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;
  (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;

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

  (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.
  (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;

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

  (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;
  (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

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

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
  (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;

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

  (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;
  (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-

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

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;
  (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;

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

  (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
  (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]

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

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;
  (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

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

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
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;

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

  (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
  (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

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

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
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;

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

  (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
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.

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

  (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;
  (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

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

  (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
  (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;

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

  (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
  (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

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

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
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,

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

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
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

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

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 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

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

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-
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

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

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
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

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

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
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

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

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
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

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

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,
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

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

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
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

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

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,
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

S. 2809--D                         84                         A. 4009--D

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
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

S. 2809--D                         85                         A. 4009--D

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,
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

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

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[.];
  (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 and clauses (C), (D) and (G) of subpara-
graph (i) of paragraph (b) and paragraphs (c), (d), (e), (f) and (g)  of

S. 2809--D                         87                         A. 4009--D

subdivision  5-a of section 2807-m of the public health law, the opening
paragraph and clauses (C), (D) and (G) of subparagraph (i) 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 para-
graphs (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)  If  the  dollar  amount for the total number of clinical research
positions in the region  calculated  pursuant  to  clause  (B)  of  this
subparagraph  exceeds  [thirty percent of the funding available pursuant
to] THE TOTAL AMOUNT APPROPRIATED FOR PURPOSES OF this paragraph, [or an
amount equal to the sum of one clinical research position  per  teaching
general  hospital  in the region, whichever is greater,] including clin-
ical research positions that continue from  and  were  funded  in  prior
distribution  periods,  the commissioner shall eliminate one-half of the
clinical research positions submitted by  each  consortium  or  teaching
general  hospital  rounded  down  to  the  nearest  one  position.  Such
reduction shall be repeated until the dollar amount for the total number
of clinical research positions in the region  does  not  exceed  [thirty
percent of the regional pool, or an amount equal to the sum of one clin-
ical  research  position  per  teaching  general hospital in the region,
whichever is greater] THE TOTAL AMOUNT APPROPRIATED FOR PURPOSES OF THIS
PARAGRAPH. IF THE REPEATED REDUCTION OF THE  TOTAL  NUMBER  OF  CLINICAL
RESEARCH  POSITIONS  IN  THE  REGION BY ONE-HALF DOES NOT RENDER A TOTAL
FUNDING AMOUNT THAT IS EQUAL TO OR LESS THAN THE TOTAL  AMOUNT  RESERVED
FOR  THAT REGION WITHIN THE APPROPRIATION, THE FUNDING FOR EACH CLINICAL
RESEARCH POSITION IN THAT REGION SHALL BE REDUCED PROPORTIONALLY IN  ONE
THOUSAND  DOLLAR  INCREMENTS UNTIL THE TOTAL DOLLAR AMOUNT FOR THE TOTAL
NUMBER OF CLINICAL RESEARCH POSITIONS IN THAT REGION DOES NOT EXCEED THE
TOTAL AMOUNT RESERVED FOR THAT  REGION  WITHIN  THE  APPROPRIATION.  ANY
REDUCTION  IN  FUNDING  WILL BE EFFECTIVE FOR THE DURATION OF THE AWARD.
No clinical research positions that continue from  and  were  funded  in
prior  distribution  periods  shall  be  eliminated  OR  REDUCED by such
[reduction] METHODOLOGY.
  (D) Each consortium or teaching general hospital shall receive  [fifty
percent  of  its  annual distribution amount calculated pursuant to this
subparagraph once the requirements set  forth  in  clause  (G)  of  this
subparagraph  have  been met. The remaining distribution amount shall be
disbursed subsequent to the submission of information required  pursuant
to  clause  (G)  of this subparagraph] ITS ANNUAL DISTRIBUTION AMOUNT IN
ACCORDANCE WITH THE FOLLOWING:
  (I) EACH CONSORTIUM OR TEACHING GENERAL HOSPITAL WITH A ONE-YEAR ECRIP
AWARD  SHALL  RECEIVE  ITS  ANNUAL  DISTRIBUTION  AMOUNT  IN  FULL  UPON

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

COMPLETION OF THE REQUIREMENTS SET FORTH IN ITEMS (I) AND (II) OF CLAUSE
(G)  OF  THIS SUBPARAGRAPH. THE REQUIREMENTS SET FORTH IN ITEMS (IV) AND
(V) OF CLAUSE (G) OF THIS SUBPARAGRAPH MUST BE COMPLETED BY THE  CONSOR-
TIUM  OR TEACHING GENERAL HOSPITAL IN ORDER FOR THE CONSORTIUM OR TEACH-
ING GENERAL HOSPITAL TO BE ELIGIBLE TO APPLY FOR ECRIP  FUNDING  IN  ANY
SUBSEQUENT FUNDING CYCLE.
  (II)  EACH  CONSORTIUM  OR  TEACHING  GENERAL HOSPITAL WITH A TWO-YEAR
ECRIP AWARD SHALL RECEIVE ITS FIRST ANNUAL DISTRIBUTION AMOUNT  IN  FULL
UPON  COMPLETION  OF THE REQUIREMENTS SET FORTH IN ITEMS (I) AND (II) OF
CLAUSE (G) OF THIS SUBPARAGRAPH. EACH  CONSORTIUM  OR  TEACHING  GENERAL
HOSPITAL WILL RECEIVE ITS SECOND ANNUAL DISTRIBUTION AMOUNT IN FULL UPON
COMPLETION  OF THE REQUIREMENTS SET FORTH IN ITEM (III) OF CLAUSE (G) OF
THIS SUBPARAGRAPH. THE REQUIREMENTS SET FORTH IN ITEMS (IV) AND  (V)  OF
CLAUSE  (G)  OF THIS SUBPARAGRAPH MUST BE COMPLETED BY THE CONSORTIUM OR
TEACHING GENERAL HOSPITAL IN ORDER FOR THE CONSORTIUM OR TEACHING GENER-
AL HOSPITAL TO BE ELIGIBLE TO APPLY FOR ECRIP FUNDING IN ANY  SUBSEQUENT
FUNDING CYCLE.
  (G) In order to be eligible for distributions pursuant to this subpar-
agraph,  each  consortium and teaching general hospital shall provide to
the commissioner by July first of each distribution period, the  follow-
ing  data  and  information  on a hospital-specific basis. Such data and
information shall be certified as to accuracy and  completeness  by  the
chief executive officer, chief financial officer or chair of the consor-
tium  governing body of each consortium or teaching general hospital and
shall be maintained by each consortium and teaching general hospital for
five years from the date of submission:
  (I) For each clinical research  position,  information  on  the  type,
scope,  training  objectives,  institutional  support, clinical research
experience of the sponsor-mentor, plans for submitting research outcomes
to peer reviewed journals and at scientific meetings, including a  meet-
ing  sponsored by the department, the name of a principal contact person
responsible for tracking the career development of researchers placed in
clinical research positions, as defined in paragraph (c) of  subdivision
one of this section, and who is authorized to certify to the commission-
er  that  all  the requirements of the clinical research training objec-
tives set forth in this subparagraph shall be  met.  Such  certification
shall be provided by July first of each distribution period;
  (II)  For  each  clinical  research position, information on the name,
citizenship status, medical education and training, and medical  license
number  of  the researcher, if applicable, shall be provided by December
thirty-first of the calendar year following the distribution period;
  (III) Information on the status of the clinical research plan,  accom-
plishments, changes in research activities, progress, and performance of
the researcher shall be provided [six months after the clinical research
position  has  commenced and every six months thereafter for a full-time
position and for a half-time  position,  one  year  after  the  clinical
research   position  has  commenced  and  every  year  thereafter]  UPON
COMPLETION OF ONE-HALF OF THE AWARD TERM;
  (IV) A final report detailing training  experiences,  accomplishments,
activities  and  performance of the clinical researcher, and data, meth-
ods, results and  analyses  of  the  clinical  research  plan  shall  be
provided three months after the clinical research position ends; and
  (V)  TRACKING  INFORMATION  CONCERNING PAST RESEARCHERS, INCLUDING BUT
NOT LIMITED TO (A) BACKGROUND INFORMATION, (B) EMPLOYMENT  HISTORY,  (C)
RESEARCH  STATUS,  (D) CURRENT RESEARCH ACTIVITIES, (E) PUBLICATIONS AND

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

PRESENTATIONS, (F) RESEARCH  SUPPORT,  AND  (G)  ANY  OTHER  INFORMATION
NECESSARY TO TRACK THE RESEARCHER; AND
  (VI)  Any  other  data  or information required by the commissioner to
implement this subparagraph.
  (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
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

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

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
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,

S. 2809--D                         91                         A. 4009--D

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
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

S. 2809--D                         92                         A. 4009--D

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
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.

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

  (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:
  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. 2809--D                         94                         A. 4009--D

  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
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-

S. 2809--D                         95                         A. 4009--D

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
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 FOR THE STATE FISCAL YEARS  BEGIN-
NING  APRIL  FIRST,  TWO  THOUSAND  TWELVE AND APRIL FIRST, TWO THOUSAND
THIRTEEN. 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  repre-
sentative 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] 2013,
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 hospi-
tals 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  partic-
ipation  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 dispropor-
tionate share payments to such public general hospital for  1996,  1997,
1998,  and  1999,  based  initially for 1996 on reported 1994 reconciled

S. 2809--D                         96                         A. 4009--D

data as further reconciled 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  reconciled data as further reconciled to actual reported
1999 reconciled data, for 2000 based initially on reported  1995  recon-
ciled  data as further reconciled to actual reported 2000 data, for 2001
based initially 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

S. 2809--D                         97                         A. 4009--D

OF  THIS ACT SHALL BE DEEMED TO BE IN FULL FORCE AND EFFECT ON AND AFTER
APRIL 1, 2011 THROUGH MARCH 31, 2013;
  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
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

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

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  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 THROUGH MARCH 31, 2013 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 THROUGH MARCH 31, 2013
for inpatient and outpatient 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

S. 2809--D                         99                         A. 4009--D

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
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:

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

  (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
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

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

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.
  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;

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  (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;
  (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.

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

  (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.
  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

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

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
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

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

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 THROUGH MARCH 31, 2013;
  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
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 THROUGH MARCH 31, 2013.
  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  THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND THIRTEEN, the reimbursable base year adminis-
trative 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] 2014;
  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] 2014; section twenty-five of this act shall  take  effect
on January 1, 1999 and shall expire on April 1, 2005;

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

  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] 2014;
  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] 2016 provided, however  that  the
amendments  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
establishment  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] 2016.
  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. Intentionally omitted.
  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]  2016,  the

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

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-
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] 2015 and provided further, that the
amendments 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; provided,
however,  that  the  amendments  to  paragraph  (e)  of subdivision 8 of
section 2807-c of the public health law made by section  seven  of  this
act  shall  not  affect  the  expiration  of such paragraph and shall be
deemed to expire therewith.

                                 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

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

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
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. 2809--D                         109                        A. 4009--D

  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

  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 FACIL-
ITY OPERATED BY THE OFFICE  TO  PROVIDE  COMMUNITY-BASED  MENTAL  HEALTH
SERVICES FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCES.

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

  S  2.  Notwithstanding  the  provisions of subdivisions (b) and (e) 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 authorized in state fiscal year 2011-12 to close, consolidate,
reduce,  transfer  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 according
to this section as shall be determined by  the  commissioner  of  mental
health to be necessary for the cost-effective and efficient operation of
such hospitals, other facilities and programs.
  (a) In addition to the closure, consolidation or merger of one or more
facilities,  the  commissioner of mental health is authorized to perform
any significant service  reductions  that  would  reduce  inpatient  bed
capacity  by  up  to 600 beds, which shall include but not be limited to
closures of wards at a state-operated psychiatric center or the  conver-
sion  of  beds  to  transitional  placement  programs, provided that the
commissioner provide at least 30 days notice of such reductions  to  the
temporary  president  of  the senate and the speaker of the assembly and
simultaneously post such notice upon its public  website.  In  assessing
which  significant  service  reductions  to  undertake, the commissioner
shall consider data related to inpatient census, indicating  nonutiliza-
tion or under utilization of beds, and the efficient operation of facil-
ities.
  (b)  At  least  sixty  days  prior to the anticipated closure, consol-
idation or merger of any hospitals named in subdivision (b)  of  section
7.17  of the mental hygiene law, the commissioner of mental health shall
provide notice of such closure, consolidation or merger to the temporary
president of the senate and speaker of the assembly, the chief executive
officer of the county in which the facility is located, and  shall  post
such  notice  upon its public website. The commissioner shall be author-
ized to conduct any and all preparatory actions which may be required to
effectuate such closures during such  sixty  day  period.  In  assessing
which  of  such  hospitals to close, the commissioner shall consider the
following factors: (1) the size, scope and type of services provided  by
the  hospital;  (2)  the  current and anticipated long-term need for the
types of services provided by the facility within  its  catchment  area,
which  may  include, but not be limited to, services for adults or chil-
dren, or other specialized services, such as forensic services; (3)  the
availability  of staff sufficient to address the current and anticipated
long term service needs; (4) the long term capital  investment  required
to  ensure that the facility meets relevant state and federal regulatory
and capital construction requirements, and national accreditation stand-
ards; (5) the proximity of the facility to other facilities  with  space
that could accommodate anticipated need, the relative cost of any neces-
sary  renovations  of such space, the relative potential operating effi-
ciency of such facilities, and the size, scope  and  types  of  services
provided  by  the  other  facilities; (6) anticipated savings based upon
economies of  scale  or  other  factors;  (7)  community  mental  health
services  available  in  the  facility catchment area and the ability of
such community mental health services  to  meet  the  behavioral  health
needs  of  the impacted consumers; and (8) the anticipated impact of the
closure on access to mental health services.
  (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

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

transfer  of  functions  shall  be  accomplished  in accordance with the
provisions of section 70 of the civil service law.
  S 3. 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 4. This act shall take effect April 1, 2011; provided  that  section
two of this act shall expire and be deemed repealed March 31, 2012.

                                 PART H

  Section 1.  Notwithstanding paragraph (c) of subdivision 10 of section
2807-c  of the public health law, section 21 of chapter 1 of the laws of
1999, or any other contrary provision of law, in  determining  rates  of
payments  by state governmental agencies effective for services provided
on and after April  1,  2011,  for  inpatient  and  outpatient  services
provided  by  general  hospitals,  for  inpatient services and adult day
health care outpatient services  provided  by  residential  health  care
facilities  pursuant  to article 28 of the public health law, except for
residential health care facilities or  units  of  such  facilities  that
provide  services  primarily  to children under twenty-one years of age,
for home health care services provided pursuant to  article  36  of  the
public  health  law  by  certified  home health agencies, long term home
health care programs and AIDS home care programs, and for personal  care
services  provided pursuant to section 365-a of the social services law,
the commissioner of health  shall  apply  no  greater  than  zero  trend
factors  attributable  to the 2011 and 2012 calendar years in accordance
with paragraph (c) of subdivision 10 of section  2807-c  of  the  public
health  law,  provided,  however,  that  such no greater than zero trend
factors for such 2011 and 2012 calendar years shall also be  applied  to
rates  of  payment  for  personal  care services provided in those local
social service districts,  including  New  York  City,  whose  rates  of
payment  for  such services are established by such local social service
districts pursuant to a rate-setting exemption issued by the commission-
er of health to such local social services districts in accordance  with
applicable regulations, and provided further, however, that for rates of
payment for assisted living program services provided on and after April
1,  2011, trend factors attributable to the 2011 and 2012 calendar years
shall be established at no greater than zero percent.
  S 2. Notwithstanding paragraph (c) of subdivision 10 of section 2807-c
of the public health law, section 21 of chapter 1 of the laws  of  1999,
or any other contrary provision of law, in determining rates of payments
by  state  governmental  agencies effective for services provided on and
after January 1, 2013 through March 31, 2013, for inpatient  and  outpa-
tient services provided by general hospitals, for inpatient services and
adult day health care outpatient services provided by residential health
care  facilities pursuant to article 28 of the public health law, except
for residential health care facilities or units of such facilities  that
provide  services  primarily  to children under twenty-one years of age,
for home health care services provided pursuant to  article  36  of  the
public  health  law,  by  certified home health agencies, long term home

S. 2809--D                         112                        A. 4009--D

health care programs and AIDS home care programs, and for personal  care
services  provided pursuant to section 365-a of the social services law,
the commissioner of health  shall  apply  no  greater  than  zero  trend
factors  attributable to the 2013 calendar year in accordance with para-
graph (c) of subdivision 10 of section 2807-c of the public health  law,
provided, however, that such no greater than zero trend factors for such
2013  calendar  year  shall  also  be  applied  to  rates of payment for
personal care services provided in those local social service districts,
including New York city, whose rates of payment for  such  services  are
established  by  such local social service districts pursuant to a rate-
setting exemption issued by the commissioner of  health  to  such  local
social  service districts in accordance with applicable regulations, and
provided further, however, that for rates of payment for assisted living
program services provided on and after January 1, 2013 through March 31,
2013, trend factors attributable to the  2013  calendar  year  shall  be
established at no greater than zero percent.
  S 2-a. Intentionally omitted.
  S  3. Section 3614 of the public health law is amended by adding a new
subdivision 12 to read as follows:
  12. (A) NOTWITHSTANDING ANY INCONSISTENT PROVISION  OF  LAW  OR  REGU-
LATION  AND  SUBJECT  TO  THE  AVAILABILITY OF FEDERAL FINANCIAL PARTIC-
IPATION, EFFECTIVE ON AND AFTER APRIL FIRST, TWO THOUSAND ELEVEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND TWELVE, RATES OF PAYMENT BY  GOVERNMENT
AGENCIES FOR SERVICES PROVIDED BY CERTIFIED HOME HEALTH AGENCIES, EXCEPT
FOR  SUCH  SERVICES PROVIDED TO CHILDREN UNDER EIGHTEEN YEARS OF AGE AND
OTHER DISCRETE GROUPS AS MAY BE DETERMINED BY THE COMMISSIONER  PURSUANT
TO  REGULATIONS, SHALL REFLECT CEILING LIMITATIONS DETERMINED IN ACCORD-
ANCE WITH THIS SUBDIVISION, PROVIDED, HOWEVER, THAT AT THE DISCRETION OF
THE COMMISSIONER SUCH CEILINGS MAY, AS AN  ALTERNATIVE,  BE  APPLIED  TO
PAYMENTS  FOR  SERVICES  PROVIDED ON AND AFTER APRIL FIRST, TWO THOUSAND
ELEVEN, EXCEPT FOR SUCH SERVICES PROVIDED TO CHILDREN AND OTHER DISCRETE
GROUPS AS MAY BE DETERMINED BY THE COMMISSIONER PURSUANT TO REGULATIONS.
IN DETERMINING SUCH PAYMENTS OR RATES OF PAYMENT, AGENCY CEILINGS  SHALL
BE  ESTABLISHED.  SUCH CEILINGS SHALL BE APPLIED TO PAYMENTS OR RATES OF
PAYMENT FOR CERTIFIED HOME HEALTH AGENCY SERVICES AS ESTABLISHED  PURSU-
ANT  TO THIS SECTION AND APPLICABLE REGULATIONS. CEILINGS SHALL BE BASED
ON A BLEND OF: (I) AN AGENCY'S TWO THOUSAND  NINE  AVERAGE  PER  PATIENT
MEDICAID  CLAIMS,  WEIGHTED AT A PERCENTAGE AS DETERMINED BY THE COMMIS-
SIONER; AND (II) THE TWO THOUSAND NINE  STATEWIDE  AVERAGE  PER  PATIENT
MEDICAID  CLAIMS  ADJUSTED BY A REGIONAL WAGE INDEX FACTOR AND AN AGENCY
PATIENT CASE MIX INDEX, WEIGHTED AT A PERCENTAGE AS  DETERMINED  BY  THE
COMMISSIONER.  SUCH CEILINGS WILL BE EFFECTIVE APRIL FIRST, TWO THOUSAND
ELEVEN THROUGH MARCH  THIRTY-FIRST,  TWO  THOUSAND  TWELVE.  AN  INTERIM
PAYMENT  OR  RATE OF PAYMENT ADJUSTMENT EFFECTIVE APRIL FIRST, TWO THOU-
SAND ELEVEN, SHALL BE APPLIED TO AGENCIES  WITH  PROJECTED  AVERAGE  PER
PATIENT  MEDICAID  CLAIMS, AS DETERMINED BY THE COMMISSIONER, TO BE OVER
THEIR CEILINGS. SUCH AGENCIES SHALL HAVE  THEIR  PAYMENTS  OR  RATES  OF
PAYMENT  REDUCED TO REFLECT THE AMOUNT BY WHICH SUCH CLAIMS EXCEED THEIR
CEILINGS.
  (B) CEILING LIMITATIONS DETERMINED PURSUANT TO PARAGRAPH (A)  OF  THIS
SUBDIVISION  SHALL  BE SUBJECT TO RECONCILIATION. IN DETERMINING PAYMENT
OR RATE OF PAYMENT ADJUSTMENTS BASED ON  SUCH  RECONCILIATION,  ADJUSTED
AGENCY  CEILINGS  SHALL BE ESTABLISHED.  SUCH ADJUSTED CEILINGS SHALL BE
BASED ON A BLEND OF: (I) AN  AGENCY'S  TWO  THOUSAND  NINE  AVERAGE  PER
PATIENT  MEDICAID  CLAIMS  ADJUSTED  BY  THE  PERCENTAGE  OF INCREASE OR
DECREASE IN SUCH AGENCY'S PATIENT CASE MIX FROM THE  TWO  THOUSAND  NINE

S. 2809--D                         113                        A. 4009--D

CALENDAR  YEAR  TO  THE  ANNUAL  PERIOD APRIL FIRST, TWO THOUSAND ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE, WEIGHTED AT A  PERCENT-
AGE  AS  DETERMINED  BY THE COMMISSIONER; AND (II) THE TWO THOUSAND NINE
STATEWIDE  AVERAGE  PER  PATIENT  MEDICAID CLAIMS ADJUSTED BY A REGIONAL
WAGE INDEX FACTOR AND THE AGENCY'S PATIENT CASE MIX INDEX FOR THE ANNUAL
PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST,  TWO
THOUSAND  TWELVE,  WEIGHTED AT A PERCENTAGE AS DETERMINED BY THE COMMIS-
SIONER. SUCH ADJUSTED AGENCY CEILING SHALL BE COMPARED TO  ACTUAL  MEDI-
CAID PAID CLAIMS FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH
MARCH  THIRTY-FIRST,  TWO  THOUSAND  TWELVE.  IN THOSE INSTANCES WHEN AN
AGENCY'S ACTUAL PER PATIENT MEDICAID CLAIMS ARE DETERMINED TO EXCEED THE
AGENCY'S ADJUSTED CEILING, THE AMOUNT OF SUCH EXCESS SHALL BE  DUE  FROM
EACH SUCH AGENCY TO THE STATE AND MAY BE RECOUPED BY THE DEPARTMENT IN A
LUMP  SUM  AMOUNT  OR THROUGH REDUCTIONS IN THE MEDICAID PAYMENTS DUE TO
THE AGENCY. IN THOSE INSTANCES WHERE  AN  INTERIM  PAYMENT  OR  RATE  OF
PAYMENT ADJUSTMENT WAS APPLIED TO AN AGENCY IN ACCORDANCE WITH PARAGRAPH
(A)  OF  THIS SUBDIVISION, AND SUCH AGENCY'S ACTUAL PER PATIENT MEDICAID
CLAIMS ARE DETERMINED TO BE LESS THAN THE AGENCY'S ADJUSTED CEILING, THE
AMOUNT BY WHICH SUCH MEDICAID CLAIMS ARE LESS THAN THE AGENCY'S ADJUSTED
CEILING SHALL BE REMITTED TO EACH SUCH AGENCY BY  THE  DEPARTMENT  IN  A
LUMP  SUM  AMOUNT OR THROUGH AN INCREASE IN THE MEDICAID PAYMENTS DUE TO
THE AGENCY.
  (C) INTERIM PAYMENT OR RATE OF PAYMENT ADJUSTMENTS  PURSUANT  TO  THIS
SUBDIVISION SHALL BE BASED ON MEDICAID PAID CLAIMS, AS DETERMINED BY THE
COMMISSIONER,  FOR  SERVICES  PROVIDED  BY AGENCIES IN THE BASE YEAR TWO
THOUSAND NINE. AMOUNTS DUE FROM RECONCILING RATE  ADJUSTMENTS  SHALL  BE
BASED  ON  MEDICAID  PAID CLAIMS, AS DETERMINED BY THE COMMISSIONER, FOR
SERVICES PROVIDED BY AGENCIES IN THE BASE YEAR  TWO  THOUSAND  NINE  AND
MEDICAID  PAID  CLAIMS,  AS DETERMINED BY THE COMMISSIONER, FOR SERVICES
PROVIDED BY AGENCIES IN THE RECONCILIATION PERIOD APRIL FIRST, TWO THOU-
SAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE.  IN  DETER-
MINING  CASE  MIX, EACH PATIENT SHALL BE CLASSIFIED USING A SYSTEM BASED
ON MEASURES WHICH MAY INCLUDE, BUT NOT BE LIMITED TO, CLINICAL AND FUNC-
TIONAL MEASURES, AS REPORTED  ON  THE  FEDERAL  OUTCOME  AND  ASSESSMENT
INFORMATION SET (OASIS), AS MAY BE AMENDED.
  (D)  THE  COMMISSIONER  MAY REQUIRE AGENCIES TO COLLECT AND SUBMIT ANY
DATA REQUIRED TO IMPLEMENT  THE  PROVISIONS  OF  THIS  SUBDIVISION.  THE
COMMISSIONER  MAY  PROMULGATE REGULATIONS TO IMPLEMENT THE PROVISIONS OF
THIS SUBDIVISION.
  (E) PAYMENTS OR RATE OF PAYMENT  ADJUSTMENTS  DETERMINED  PURSUANT  TO
THIS  SUBDIVISION SHALL, FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE, BE RETROACTIVELY RECON-
CILED UTILIZING THE METHODOLOGY IN PARAGRAPH (B) OF THIS SUBDIVISION AND
UTILIZING ACTUAL PAID CLAIMS FROM SUCH PERIOD.
  (F) NOTWITHSTANDING ANY INCONSISTENT PROVISION  OF  THIS  SUBDIVISION,
PAYMENTS  OR  RATE OF PAYMENT ADJUSTMENTS MADE PURSUANT TO THIS SUBDIVI-
SION SHALL NOT RESULT  IN  AN  AGGREGATE  ANNUAL  DECREASE  IN  MEDICAID
PAYMENTS  TO  PROVIDERS SUBJECT TO THIS SUBDIVISION THAT IS IN EXCESS OF
TWO HUNDRED MILLION DOLLARS, AS DETERMINED BY THE COMMISSIONER  AND  NOT
SUBJECT  TO  SUBSEQUENT ADJUSTMENT, AND THE COMMISSIONER SHALL MAKE SUCH
ADJUSTMENTS TO SUCH PAYMENTS OR RATES OF PAYMENT  AS  ARE  NECESSARY  TO
ENSURE THAT SUCH AGGREGATE LIMITS ON PAYMENT DECREASES ARE NOT EXCEEDED.
  S  4. Section 3614 of the public health law is amended by adding a new
subdivision 13 to read as follows:
  13. (A) NOTWITHSTANDING ANY INCONSISTENT PROVISION  OF  LAW  OR  REGU-
LATION  AND  SUBJECT  TO  THE  AVAILABILITY OF FEDERAL FINANCIAL PARTIC-

S. 2809--D                         114                        A. 4009--D

IPATION, EFFECTIVE APRIL FIRST, TWO THOUSAND TWELVE THROUGH MARCH  THIR-
TY-FIRST,  TWO  THOUSAND  FIFTEEN,  PAYMENTS  BY GOVERNMENT AGENCIES FOR
SERVICES PROVIDED BY CERTIFIED HOME HEALTH  AGENCIES,  EXCEPT  FOR  SUCH
SERVICES  PROVIDED  TO  CHILDREN  UNDER  EIGHTEEN YEARS OF AGE AND OTHER
DISCREET GROUPS AS MAY BE DETERMINED BY  THE  COMMISSIONER  PURSUANT  TO
REGULATIONS,  SHALL  BE BASED ON EPISODIC PAYMENTS. IN ESTABLISHING SUCH
PAYMENTS, A STATEWIDE BASE PRICE SHALL BE ESTABLISHED FOR EACH SIXTY DAY
EPISODE OF CARE AND ADJUSTED BY A REGIONAL  WAGE  INDEX  FACTOR  AND  AN
INDIVIDUAL PATIENT CASE MIX INDEX. SUCH EPISODIC PAYMENTS MAY BE FURTHER
ADJUSTED  FOR  LOW UTILIZATION CASES AND TO REFLECT A PERCENTAGE LIMITA-
TION OF THE COST FOR HIGH-UTILIZATION CASES THAT EXCEED OUTLIER  THRESH-
OLDS OF SUCH PAYMENTS.
  (B)  INITIAL  BASE  YEAR  EPISODIC PAYMENTS SHALL BE BASED ON MEDICAID
PAID CLAIMS, AS DETERMINED AND ADJUSTED BY THE COMMISSIONER  TO  ACHIEVE
SAVINGS COMPARABLE TO THE PRIOR STATE FISCAL YEAR, FOR SERVICES PROVIDED
BY  ALL  CERTIFIED  HOME  HEALTH  AGENCIES IN THE BASE YEAR TWO THOUSAND
NINE. SUBSEQUENT BASE YEAR EPISODIC PAYMENTS MAY BE  BASED  ON  MEDICAID
PAID  CLAIMS FOR SERVICES PROVIDED BY ALL CERTIFIED HOME HEALTH AGENCIES
IN A BASE YEAR SUBSEQUENT TO TWO THOUSAND NINE,  AS  DETERMINED  BY  THE
COMMISSIONER, PROVIDED, HOWEVER, THAT SUCH BASE YEAR ADJUSTMENT SHALL BE
MADE  NOT  LESS  FREQUENTLY THAN EVERY THREE YEARS.  IN DETERMINING CASE
MIX, EACH PATIENT SHALL BE CLASSIFIED USING A SYSTEM BASED  ON  MEASURES
WHICH MAY INCLUDE, BUT NOT LIMITED TO, CLINICAL AND FUNCTIONAL MEASURES,
AS  REPORTED  ON  THE  FEDERAL  OUTCOME  AND  ASSESSMENT INFORMATION SET
(OASIS), AS MAY BE AMENDED.
  (C) THE COMMISSIONER MAY REQUIRE AGENCIES TO COLLECT  AND  SUBMIT  ANY
DATA  REQUIRED  TO  IMPLEMENT  THIS  SUBDIVISION.  THE  COMMISSIONER MAY
PROMULGATE REGULATIONS TO IMPLEMENT THE PROVISIONS OF THIS SUBDIVISION.
  S 5. Sections  365-i  and  369-dd  of  the  social  services  law  are
REPEALED.
  S 5-a. Subparagraph (v) of paragraph (e) of subdivision 1 and subdivi-
sion  2-b of section 369-ee of the social services law, subparagraph (v)
of paragraph (e) of subdivision 1 as amended by section 1 of part C  and
subdivision  2-b  as  added  by section 2 of part C of chapter 58 of the
laws of 2008, are amended to read as follows:
  (v) prescription drugs [as defined in section two hundred  seventy  of
the  public  health law, which shall be provided pursuant to subdivision
two-b of this section,] and non-prescription smoking cessation  products
or devices;
  2-b. Prescription drug payments. [(a) Subject to paragraph (b) of this
subdivision,  payment  for  drugs,  except  for  such  drugs provided by
medical practitioners, and for which payment is authorized  pursuant  to
paragraph (e) of subdivision one of this section, shall be made pursuant
to subdivision nine of section three hundred sixty-seven-a of this arti-
cle  and  article two-A of the public health law and subdivision four of
section three hundred sixty-five-a of this  article.  Payment  for  such
drugs provided by medical practitioners shall be included in the capita-
tion  payment  for services or supplies provided to persons eligible for
health care services under this title.
  (b)] Payment for drugs for which payment  is  authorized  pursuant  to
paragraph (e) of subdivision one of this section[, and that are provided
by  an  employer  partnership  for family health plus plan authorized by
section three hundred sixty-nine-ff of this title,] shall be included in
the capitation payment for services  or  supplies  provided  to  persons
eligible for health care services under [such] A FAMILY HEALTH INSURANCE
plan.

S. 2809--D                         115                        A. 4009--D

  S  6.  Section  368-d  of the social services law is amended by adding
three new subdivisions 4, 5 and 6 to read as follows:
  4.    THE COMMISSIONER OF HEALTH IS AUTHORIZED TO CONTRACT WITH ONE OR
MORE ENTITIES TO CONDUCT A STUDY TO DETERMINE ACTUAL DIRECT AND INDIRECT
COSTS INCURRED BY  PUBLIC  SCHOOL  DISTRICTS  AND  STATE  OPERATED/STATE
SUPPORTED  SCHOOLS WHICH OPERATE PURSUANT TO ARTICLE EIGHTY-FIVE, EIGHT-
Y-SEVEN OR EIGHTY-EIGHT OF THE EDUCATION LAW FOR MEDICAL CARE,  SERVICES
AND  SUPPLIES,  INCLUDING RELATED SPECIAL EDUCATION SERVICES AND SPECIAL
TRANSPORTATION, FURNISHED TO CHILDREN WITH HANDICAPPING CONDITIONS.
  5. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE  HUNDRED
TWELVE  AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTION
ONE HUNDRED FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR ANY OTHER LAW,
THE COMMISSIONER OF HEALTH IS AUTHORIZED TO ENTER  INTO  A  CONTRACT  OR
CONTRACTS  UNDER  SUBDIVISION FOUR OF THIS SECTION WITHOUT A COMPETITIVE
BID OR REQUEST FOR PROPOSAL PROCESS, PROVIDED, HOWEVER, THAT:
  (A) THE DEPARTMENT OF HEALTH SHALL POST ON ITS WEBSITE, FOR  A  PERIOD
OF NO LESS THAN THIRTY DAYS:
  (I)  A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT TO
THE CONTRACT OR CONTRACTS;
  (II) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (III) THE PERIOD OF TIME DURING WHICH  A  PROSPECTIVE  CONTRACTOR  MAY
SEEK  SELECTION,  WHICH  SHALL  BE  NO  LESS THAN THIRTY DAYS AFTER SUCH
INFORMATION IS FIRST POSTED ON THE WEBSITE; AND
  (IV) THE MANNER BY  WHICH  A  PROSPECTIVE  CONTRACTOR  MAY  SEEK  SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (B)  ALL  REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE RECEIVED FROM
PROSPECTIVE CONTRACTORS IN TIMELY  FASHION  SHALL  BE  REVIEWED  BY  THE
COMMISSIONER OF HEALTH; AND
  (C)  THE  COMMISSIONER  OF  HEALTH  SHALL  SELECT  SUCH  CONTRACTOR OR
CONTRACTORS THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE
PURPOSES OF THIS SECTION.
  (D) UPON SELECTION OF A CONTRACTOR OR CONTRACTORS, THE  DEPARTMENT  OF
HEALTH SHALL PROVIDE WRITTEN NOTIFICATION OF SUCH SELECTION AND A SUMMA-
RY OF THE CRITERIA EMPLOYED IN SUCH SELECTION TO THE CHAIR OF THE SENATE
FINANCE  COMMITTEE  AND THE CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMIT-
TEE.
  6. THE COMMISSIONER SHALL EVALUATE THE RESULTS OF THE STUDY  CONDUCTED
PURSUANT  TO  SUBDIVISION FOUR OF THIS SECTION TO DETERMINE, AFTER IDEN-
TIFICATION OF ACTUAL DIRECT AND INDIRECT COSTS INCURRED BY PUBLIC SCHOOL
DISTRICTS AND STATE OPERATED/STATE  SUPPORTED  SCHOOLS,  WHETHER  IT  IS
ADVISABLE  TO  CLAIM  FEDERAL  REIMBURSEMENT FOR EXPENDITURES UNDER THIS
SECTION AS CERTIFIED PUBLIC EXPENDITURES. IN THE EVENT SUCH  CLAIMS  ARE
SUBMITTED,  IF  FEDERAL  REIMBURSEMENT  RECEIVED  FOR  CERTIFIED  PUBLIC
EXPENDITURES ON BEHALF OF MEDICAL ASSISTANCE RECIPIENTS WHOSE ASSISTANCE
AND CARE ARE THE RESPONSIBILITY OF A SOCIAL SERVICES DISTRICT IN A  CITY
WITH  A  POPULATION  OF  OVER  TWO MILLION, RESULTS IN A DECREASE IN THE
STATE SHARE OF ANNUAL EXPENDITURES PURSUANT TO  THIS  SECTION  FOR  SUCH
RECIPIENTS, THEN TO THE EXTENT THAT THE AMOUNT OF ANY SUCH DECREASE WHEN
COMBINED  WITH  ANY  DECREASE  IN THE STATE SHARE OF ANNUAL EXPENDITURES
DESCRIBED IN SUBDIVISION FIVE OF SECTION THREE HUNDRED SIXTY-EIGHT-E  OF
THIS  TITLE  EXCEEDS  FIFTY  MILLION DOLLARS, THE EXCESS AMOUNT SHALL BE
TRANSFERRED TO SUCH CITY. ANY SUCH EXCESS AMOUNT TRANSFERRED  SHALL  NOT
BE  CONSIDERED  A  REVENUE  RECEIVED BY SUCH SOCIAL SERVICES DISTRICT IN
DETERMINING THE DISTRICT'S ACTUAL MEDICAL  ASSISTANCE  EXPENDITURES  FOR
PURPOSES  OF  PARAGRAPH  (B)  OF  SECTION  ONE  OF  PART  C  OF  CHAPTER
FIFTY-EIGHT OF THE LAWS OF TWO THOUSAND FIVE.

S. 2809--D                         116                        A. 4009--D

  S 7. Section 368-e of the social services law  is  amended  by  adding
three new subdivisions 3, 4 and 5 to read as follows:
  3.    THE COMMISSIONER OF HEALTH IS AUTHORIZED TO CONTRACT WITH ONE OR
MORE ENTITIES TO CONDUCT A STUDY TO DETERMINE ACTUAL DIRECT AND INDIRECT
COSTS INCURRED BY COUNTIES FOR  MEDICAL  CARE,  SERVICES  AND  SUPPLIES,
INCLUDING RELATED SPECIAL EDUCATION SERVICES AND SPECIAL TRANSPORTATION,
FURNISHED TO PRE-SCHOOL CHILDREN WITH HANDICAPPING CONDITIONS.
  4.  NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR  SECTION
ONE HUNDRED FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR ANY OTHER LAW,
THE  COMMISSIONER  OF  HEALTH  IS AUTHORIZED TO ENTER INTO A CONTRACT OR
CONTRACTS UNDER SUBDIVISION THREE OF THIS SECTION WITHOUT A  COMPETITIVE
BID OR REQUEST FOR PROPOSAL PROCESS, PROVIDED, HOWEVER, THAT:
  (A)  THE  DEPARTMENT OF HEALTH SHALL POST ON ITS WEBSITE, FOR A PERIOD
OF NO LESS THAN THIRTY DAYS:
  (I) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT  TO
THE CONTRACT OR CONTRACTS;
  (II) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (III)  THE  PERIOD  OF  TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY
SEEK SELECTION, WHICH SHALL BE NO  LESS  THAN  THIRTY  DAYS  AFTER  SUCH
INFORMATION IS FIRST POSTED ON THE WEBSITE; AND
  (IV)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (B) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE  RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
COMMISSIONER OF HEALTH; AND
  (C) THE  COMMISSIONER  OF  HEALTH  SHALL  SELECT  SUCH  CONTRACTOR  OR
CONTRACTORS THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE
PURPOSES OF THIS SECTION.
  (D)  UPON  SELECTION OF A CONTRACTOR OR CONTRACTORS, THE DEPARTMENT OF
HEALTH SHALL PROVIDE WRITTEN NOTIFICATION OF SUCH SELECTION AND A SUMMA-
RY OF THE CRITERIA EMPLOYED IN SUCH SELECTION TO THE CHAIR OF THE SENATE
FINANCE COMMITTEE AND THE CHAIR OF THE ASSEMBLY WAYS AND  MEANS  COMMIT-
TEE.
  5.  THE COMMISSIONER SHALL EVALUATE THE RESULTS OF THE STUDY CONDUCTED
PURSUANT TO SUBDIVISION THREE OF THIS SECTION TO DETERMINE, AFTER  IDEN-
TIFICATION  OF ACTUAL DIRECT AND INDIRECT COSTS INCURRED BY COUNTIES FOR
MEDICAL CARE, SERVICES, AND SUPPLIES FURNISHED  TO  PRE-SCHOOL  CHILDREN
WITH  HANDICAPPING  CONDITIONS, WHETHER IT IS ADVISABLE TO CLAIM FEDERAL
REIMBURSEMENT FOR EXPENDITURES UNDER THIS SECTION  AS  CERTIFIED  PUBLIC
EXPENDITURES.    IN  THE  EVENT  SUCH  CLAIMS  ARE SUBMITTED, IF FEDERAL
REIMBURSEMENT RECEIVED FOR CERTIFIED PUBLIC EXPENDITURES  ON  BEHALF  OF
MEDICAL  ASSISTANCE RECIPIENTS WHOSE ASSISTANCE AND CARE ARE THE RESPON-
SIBILITY OF A SOCIAL SERVICES DISTRICT IN A CITY WITH  A  POPULATION  OF
OVER  TWO  MILLION,  RESULTS  IN A DECREASE IN THE STATE SHARE OF ANNUAL
EXPENDITURES PURSUANT TO THIS SECTION FOR SUCH RECIPIENTS, THEN  TO  THE
EXTENT  THAT  THE  AMOUNT  OF  ANY  SUCH DECREASE WHEN COMBINED WITH ANY
DECREASE IN THE STATE SHARE OF ANNUAL EXPENDITURES DESCRIBED IN SUBDIVI-
SION SIX OF SECTION THREE HUNDRED SIXTY-EIGHT-D OF  THIS  TITLE  EXCEEDS
FIFTY  MILLION  DOLLARS,  THE EXCESS AMOUNT SHALL BE TRANSFERRED TO SUCH
CITY. ANY SUCH EXCESS AMOUNT  TRANSFERRED  SHALL  NOT  BE  CONSIDERED  A
REVENUE  RECEIVED  BY  SUCH  SOCIAL SERVICES DISTRICT IN DETERMINING THE
DISTRICT'S ACTUAL MEDICAL ASSISTANCE EXPENDITURES FOR PURPOSES OF  PARA-
GRAPH (B) OF SECTION ONE OF PART C OF CHAPTER FIFTY-EIGHT OF THE LAWS OF
TWO THOUSAND FIVE.

S. 2809--D                         117                        A. 4009--D

  S  8.  Paragraph  d  of  subdivision  20 of section 2808 of the public
health law is REPEALED and a  new  paragraph  d  is  added  to  read  as
follows:
  D.  NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW, RULE OR REGULATION,
FOR  RATE  PERIODS  ON  AND  AFTER APRIL FIRST, TWO THOUSAND ELEVEN, THE
COMMISSIONER MAY REDUCE OR ELIMINATE THE PAYMENT FACTOR FOR RETURN ON OR
RETURN OF EQUITY IN THE CAPITAL COST  COMPONENT  OF  MEDICAID  RATES  OF
PAYMENT FOR SERVICES PROVIDED BY RESIDENTIAL HEALTH CARE FACILITIES.
  S  9.  Paragraph  (b)  of  subdivision 11 of section 272 of the public
health law, as added by section 36 of part C of chapter 58 of  the  laws
of 2009, is amended to read as follows:
  (b)  The  commissioner  may designate a pharmaceutical manufacturer as
one with whom the  commissioner  is  negotiating  or  has  negotiated  a
manufacturer  agreement, and all of the drugs it manufactures or markets
shall be included in the preferred drug program.  The  commissioner  may
negotiate directly with a pharmaceutical manufacturer for rebates relat-
ing to any or all of the drugs it manufactures or markets. A manufactur-
er  agreement  shall  designate  any or all of the drugs manufactured or
marketed by the pharmaceutical manufacturer as being  preferred  or  non
preferred  drugs. When a pharmaceutical manufacturer has been designated
by the commissioner under this paragraph but THE  COMMISSIONER  has  not
reached  a  manufacturer agreement with the pharmaceutical manufacturer,
then THE COMMISSIONER MAY DESIGNATE SOME OR all of  the  drugs  manufac-
tured  or  marketed by the pharmaceutical manufacturer [shall be] AS non
preferred drugs. However, notwithstanding this paragraph, any drug  that
is  selected  to  be  on  the preferred drug list under paragraph (b) of
subdivision ten of this section on grounds that it is significantly more
clinically effective and safer than other drugs in its therapeutic class
shall be a preferred drug.
  S 10.  Subparagraphs (i) and (ii) of paragraph (b) of subdivision 9 of
section 367-a of the social services law, subparagraph (i) as amended by
section 10 and subparagraph (ii) as amended by section 4 of  part  C  of
chapter 58 of the laws of 2008, are amended to read as follows:
  (i)  if  the drug dispensed is a multiple source prescription drug for
which an upper limit has been set by the federal  centers  for  medicare
and medicaid services, the lower of: (A) an amount equal to the specific
upper  limit  set  by  such  federal  agency  for  the  multiple  source
prescription drug; (B) the estimated acquisition cost of  such  drug  to
pharmacies  which,  for  purposes  of  this subparagraph, shall mean the
average wholesale price of a prescription drug based on the package size
dispensed from, as reported by the  prescription  drug  pricing  service
used  by the department, less twenty-five percent thereof; (C) the maxi-
mum acquisition cost, if any, established pursuant to paragraph  (e)  of
this subdivision; [or] (D) the dispensing pharmacy's usual and customary
price  charged  to the general public[,]; OR (E) THE AVERAGE ACQUISITION
COST IF AVAILABLE; and
  (ii) if the drug dispensed is a multiple source prescription drug or a
brand-name prescription drug for which no specific upper limit has  been
set  by such federal agency, the lower of the estimated acquisition cost
of such drug to pharmacies, THE AVERAGE ACQUISITION COST IF AVAILABLE or
the dispensing pharmacy's usual  and  customary  price  charged  to  the
general public. For sole and multiple source brand name drugs, estimated
acquisition  cost  means  the  average wholesale price of a prescription
drug based upon the package size dispensed  from,  as  reported  by  the
prescription  drug pricing service used by the department, less [sixteen
and twenty-five one hundredths] SEVENTEEN percent thereof OR THE  WHOLE-

S. 2809--D                         118                        A. 4009--D

SALE  ACQUISITION  COST  OF  A PRESCRIPTION DRUG BASED UPON PACKAGE SIZE
DISPENSED FROM, AS REPORTED BY THE  PRESCRIPTION  DRUG  PRICING  SERVICE
USED  BY  THE  DEPARTMENT,  MINUS  ZERO AND FORTY-ONE HUNDREDTHS PERCENT
THEREOF,  and  updated monthly by the department[; or, for a specialized
HIV pharmacy, as defined in paragraph (f) of this subdivision,  acquisi-
tion cost means the average wholesale price of a prescription drug based
upon  the  package  size dispensed from, as reported by the prescription
drug pricing service used by the department, less twelve percent  there-
of,  and updated monthly by the department]. For multiple source generic
drugs, estimated acquisition cost means the lower of THE AVERAGE  ACQUI-
SITION COST, the average wholesale price of a prescription drug based on
the  package  size  dispensed from, as reported by the prescription drug
pricing service used by the department, less twenty-five percent  there-
of,  or  the  maximum  acquisition cost, if any, established pursuant to
paragraph (e) of this subdivision[; or, for a specialized HIV  pharmacy,
as  defined in paragraph (f) of this subdivision, acquisition cost means
the lower of the average wholesale price of a prescription drug based on
the package size dispensed from, as reported by  the  prescription  drug
pricing  service used by the department, less twelve percent thereof, or
the maximum acquisition cost, if any, established pursuant to  paragraph
(e) of this subdivision].
  S  10-a. Subparagraph (i) of paragraph (d) of subdivision 9 of section
367-a of the social services law, as amended by chapter 19 of  the  laws
of 1998, is amended to read as follows:
  (i)  for prescription drugs categorized as generic by the prescription
drug pricing service used by the department, [four]  THREE  dollars  and
fifty cents per prescription; and
  S  10-b. Paragraph (f) of subdivision 9 of section 367-a of the social
services law is REPEALED and a new paragraph (f) is  added  to  read  as
follows:
  (F) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW OR REGULATION TO
THE CONTRARY, THE COMMISSIONER SHALL HAVE THE AUTHORITY TO ESTABLISH THE
AMOUNT  OF PAYMENTS AND DISPENSING FEES UNDER THIS TITLE FOR THOSE DRUGS
WHICH MAY NOT BE DISPENSED WITHOUT A PRESCRIPTION AS REQUIRED BY SECTION
SIXTY-EIGHT HUNDRED TEN OF THE EDUCATION LAW AND FOR  WHICH  PAYMENT  IS
AUTHORIZED PURSUANT TO PARAGRAPH (G) OF SUBDIVISION TWO OF SECTION THREE
HUNDRED  SIXTY-FIVE-A  OF  THIS TITLE. THE COMMISSIONER SHALL NOT CHANGE
THE AMOUNTS OF OR METHOD FOR SUCH PAYMENTS  OR  DISPENSING  FEES  ON  OR
AFTER APRIL FIRST, TWO THOUSAND ELEVEN UNLESS NOTICE IS GIVEN SIXTY DAYS
IN  ADVANCE  OF  SUCH  CHANGE  TO THE CHAIRS OF THE COMMITTEES ON SENATE
FINANCE, ASSEMBLY WAYS AND MEANS, SENATE HEALTH, AND ASSEMBLY HEALTH.
  S 11. Subdivision 1 of section 3-d of part B of chapter 58 of the laws
of 2010 amending the public health law and other laws relating to  Medi-
caid payments, is amended to read as follows;
  1.  Notwithstanding  any  provision  of law, rule or regulation to the
contrary, and subject to the availability of federal  financial  partic-
ipation,  for  periods  on  and  after  April  1, 2010, payments made to
managed care providers sponsored by a public benefit corporation located
in a city of more than one million persons which provide coverage prima-
rily to Medicaid patients in accordance with sections 364-j  and  369-ee
of  the  social services law may, at the election of the social services
district, be increased up to an annual aggregate amount of  two  hundred
million  dollars;  provided,  however  that,  notwithstanding the social
services district Medicaid cap provisions of part C of chapter 58 of the
laws of 2005, such social services district  shall  be  responsible  for
payment  of  one  hundred  percent  of  the  non-federal  share  of such

S. 2809--D                         119                        A. 4009--D

increase, and provided further, however,  that  such  payment  increases
shall  not  be  applied  to  payments  related to the Medicaid advantage
program [or the HIV special needs plan]. Social services district  fund-
ing  of the non-federal share of any such payments shall be deemed to be
voluntary for purposes  of  the  increased  federal  medical  assistance
percentage  provisions  of the American Recovery and Reinvestment Act of
2009; provided however that, in the event the federal Centers for  Medi-
care  and  Medicaid  Services  determines  that  such  non-federal share
payments are not voluntary  payments  for  purposes  of  such  Act,  the
provisions of this section shall be null and void.
  S 12. Intentionally omitted.
  S  13. Subdivision 1 of section 271 of the public health law, as added
by section 10 of part C of chapter 58 of the laws of 2005, is amended to
read as follows:
  1. There is hereby established in the department a pharmacy and thera-
peutics committee. The committee shall consist of  [seventeen]  EIGHTEEN
members,  who shall be appointed by the commissioner and who shall serve
three year terms; except  that  for  the  initial  appointments  to  the
committee,  five  members  shall serve one year terms, seven shall serve
two year terms, and five shall serve three year terms. Committee members
may be reappointed upon the completion of their  terms.  [No]  WITH  THE
EXCEPTION  OF  THE  CHAIRPERSON,  NO member of the committee shall be an
employee of the state or any subdivision of the state,  other  than  for
his  or  her membership on the committee, except for employees of health
care facilities or universities operated by the state, a public  benefit
corporation, the State University of New York or municipalities.
  S  14.  Paragraphs  (d) and (e) of subdivision 2 of section 271 of the
public health law, as added by section 10 of part C of chapter 58 of the
laws of 2005, are amended, and a new paragraph (f) is added to  read  as
follows:
  (d) one person with expertise in drug utilization review who is either
a  health  care professional licensed under title eight of the education
law, is a pharmacologist or has a doctorate in pharmacology; [and]
  (e) three persons who shall be consumers or representatives of  organ-
izations  with  a  regional  or statewide constituency and who have been
involved in activities related to health care consumer advocacy, includ-
ing issues affecting Medicaid or EPIC recipients[.]; AND
  (F) A CHAIRPERSON DESIGNATED PURSUANT  TO  SUBDIVISION  FOUR  OF  THIS
SECTION.
  S  15.  Subdivision  4  of  section  271  of  the public health law is
REPEALED and a new subdivision 4 is added to read as follows:
  4. THE COMMISSIONER SHALL DESIGNATE A  MEMBER  OF  THE  DEPARTMENT  TO
SERVE AS CHAIRPERSON OF THE COMMITTEE.
  S 16. Intentionally omitted.
  S  17.  Subdivision  10  of  section  272  of the public health law is
amended by adding a new paragraph (d) to read as follows:
  (D) NOTWITHSTANDING ANY PROVISION OF THIS SECTION TO THE CONTRARY, THE
COMMISSIONER MAY  DESIGNATE  THERAPEUTIC  CLASSES  OF  DRUGS,  INCLUDING
CLASSES  WITH  ONLY  ONE DRUG, AS ALL PREFERRED PRIOR TO ANY REVIEW THAT
MAY BE CONDUCTED BY THE COMMITTEE PURSUANT TO THIS SECTION.
  S 18. Intentionally omitted.
  S 19.  Subdivision 4 of section 364-j of the social  services  law  is
amended by adding a new paragraph (u) to read as follows:
  (U)  A  MANAGED  CARE PROVIDER THAT PROVIDES COVERAGE FOR PRESCRIPTION
DRUGS SHALL PERMIT EACH PARTICIPANT  TO  FILL  ANY  MAIL  ORDER  COVERED
PRESCRIPTION,  AT  HIS  OR  HER  OPTION,  AT  ANY MAIL ORDER PHARMACY OR

S. 2809--D                         120                        A. 4009--D

NON-MAIL-ORDER RETAIL PHARMACY IN THE MANAGED CARE PROVIDER NETWORK,  IF
THE  NON-MAIL-ORDER  RETAIL  PHARMACY  OFFERS  TO ACCEPT A PRICE THAT IS
COMPARABLE TO THAT OF THE MAIL ORDER PHARMACY.
  S  20.   Paragraph (g) of subdivision 4 of section 365-a of the social
services law, as amended by section 61 of part C of chapter  58  of  the
laws of 2007, is amended to read as follows:
  (g)  for  eligible  persons who are also beneficiaries under part D of
title XVIII of the federal social security act, drugs which are  denomi-
nated  as  "covered part D drugs" under section 1860D-2(e) of such act[;
provided however that, for purposes of this paragraph, "covered  part  D
drugs"  shall not mean atypical anti-psychotics, anti-depressants, anti-
retrovirals used in the treatment of HIV/AIDS, or  anti-rejection  drugs
used for the treatment of organ and tissue transplants].
  S  21.  Subdivision  12  of  section  272  of the public health law is
REPEALED.
  S 22. Paragraph (c) of subdivision 8 of section  2807  of  the  public
health law, as added by section 28 of part B of chapter 1 of the laws of
2002, is amended to read as follows:
  (c)  Rates  of payments to facilities which first qualify as federally
qualified health centers or rural health centers  on  or  after  October
first,  two thousand shall be computed in accordance with the provisions
of paragraph (b) of subdivision two of this section, provided,  however,
that the operating cost component of such rates shall reflect an average
of  the  operating  cost  component of rates of payments issued to other
facilities subject to this subdivision  during  the  same  rate  period,
located  in the same geographic region and with a similar case load, and
further provided that the capital cost component  of  such  rates  shall
reflect the most recently available capital cost data as reported to the
department.  For  each  twelve month period following the rate period in
which such facilities commence operation, the operating  cost  component
of  rates of payment for such facilities shall be computed in accordance
with paragraph (b) of this subdivision.   IN CALCULATING  THE  OPERATING
COST  COMPONENT  OF  SUCH  RATES  FOR  FACILITIES WHICH FIRST QUALIFY AS
FEDERALLY QUALIFIED HEALTH CARE CENTERS ON OR AFTER OCTOBER  FIRST,  TWO
THOUSAND,  THE  COUNTIES COMPRISING THE GEOGRAPHIC REGION KNOWN AS DOWN-
STATE SHALL BE THE SAME AS THE COUNTIES COMPRISING THE DOWNSTATE  REGION
FOR PURPOSES OF REIMBURSING DIAGNOSTIC AND TREATMENT CENTERS UNDER AMBU-
LATORY  PATIENT  GROUPS, WHICH COUNTIES ARE SPECIFIED IN THE REGULATIONS
ADOPTED BY THE COMMISSIONER IMPLEMENTING SECTION 18 OF PART C OF CHAPTER
FIFTY-EIGHT OF THE LAWS OF TWO THOUSAND EIGHT.
  S 23. Paragraph (g) of subdivision 2 of section 365-a  of  the  social
services  law,  as  amended by section 1 of part F of chapter 497 of the
laws of 2008, is amended to read as follows:
  (g) sickroom supplies, eyeglasses, prosthetic  appliances  and  dental
prosthetic  appliances  furnished  in accordance with the regulations of
the department[,]; provided FURTHER that: (I) the commissioner of health
is authorized to implement a preferred diabetic supply  program  wherein
the  department  of  health will receive enhanced rebates from preferred
manufacturers of glucometers and test strips, and may  subject  non-pre-
ferred manufacturers' glucometers and test strips to prior authorization
under  section  two hundred seventy-three of the public health law; (II)
ENTERAL FORMULA THERAPY  AND  NUTRITIONAL  SUPPLEMENTS  ARE  LIMITED  TO
COVERAGE  ONLY FOR NASOGASTRIC, JEJUNOSTOMY, OR GASTROSTOMY TUBE FEEDING
OR FOR TREATMENT OF AN INBORN METABOLIC DISORDER, OR TO  ADDRESS  GROWTH
AND  DEVELOPMENT  PROBLEMS  IN CHILDREN; (III) PRESCRIPTION FOOTWEAR AND
INSERTS ARE LIMITED TO COVERAGE ONLY WHEN USED AS AN INTEGRAL PART OF  A

S. 2809--D                         121                        A. 4009--D

LOWER  LIMB ORTHOTIC APPLIANCE, AS PART OF A DIABETIC TREATMENT PLAN, OR
TO ADDRESS  GROWTH  AND  DEVELOPMENT  PROBLEMS  IN  CHILDREN;  AND  (IV)
COMPRESSION AND SUPPORT STOCKINGS ARE LIMITED TO COVERAGE ONLY FOR PREG-
NANCY OR TREATMENT OF VENOUS STASIS ULCERS;
  (G-1)  drugs provided on an in-patient basis, those drugs contained on
the list established by regulation of the commissioner of health  pursu-
ant  to  subdivision four of this section, and those drugs which may not
be dispensed without a prescription as required by  section  sixty-eight
hundred  ten  of  the education law and which the commissioner of health
shall determine to be reimbursable based upon such factors as the avail-
ability of such drugs or alternatives at low  cost  if  purchased  by  a
medicaid  recipient,  or the essential nature of such drugs as described
by such commissioner in regulations, provided, however, that such drugs,
exclusive of long-term maintenance drugs, shall be dispensed in  quanti-
ties no greater than a thirty day supply or one hundred doses, whichever
is  greater; provided further that the commissioner of health is author-
ized to require prior authorization for any  refill  of  a  prescription
when  less  than seventy-five percent of the previously dispensed amount
per fill should have been used were the product used as  normally  indi-
cated; PROVIDED FURTHER THAT THE COMMISSIONER OF HEALTH IS AUTHORIZED TO
REQUIRE  PRIOR  AUTHORIZATION  OF  PRESCRIPTIONS OF OPIOID ANALGESICS IN
EXCESS OF FOUR PRESCRIPTIONS IN A THIRTY-DAY PERIOD IN  ACCORDANCE  WITH
SECTION  TWO  HUNDRED  SEVENTY-THREE  OF  THE PUBLIC HEALTH LAW; medical
assistance shall not include any drug provided on other than  an  in-pa-
tient  basis  for which a recipient is charged or a claim is made in the
case of a prescription drug,  in  excess  of  the  maximum  reimbursable
amounts  to  be established by department regulations in accordance with
standards established by the secretary of the United  States  department
of  health and human services, or, in the case of a drug not requiring a
prescription, in excess of the maximum reimbursable  amount  established
by  the  commissioner of health pursuant to paragraph (a) of subdivision
four of this section;
  S 24. Intentionally omitted.
  S 25. Section 367-w of the social services law is REPEALED.
  S 26. Notwithstanding any provision of law to the contrary and subject
to the availability of federal financial participation, for  periods  on
and  after  April 1, 2011, clinics certified pursuant to articles 16, 31
or 32 of the mental hygiene law shall be subject  to  targeted  Medicaid
reimbursement  rate reductions in accordance with the provisions of this
section. Such reductions shall be based on utilization thresholds  which
may  be  established  either  as  provider-specific  or patient-specific
thresholds. Provider-specific  thresholds  shall  be  based  on  average
patient  utilization  for a given provider in comparison to a peer based
standard to be determined for each service.   The commissioners  of  the
office of mental health, the office for persons with developmental disa-
bilities,  and the office of alcoholism and substance abuse services, in
consultation with the commissioner of health, are  authorized  to  waive
utilization  thresholds  for  patients  of clinics certified pursuant to
article 16, 31, or 32 of the mental hygiene  law  who  are  enrolled  in
specific  treatment programs or otherwise meet criteria as may be speci-
fied by such commissioners.  When applying a  provider-specific  thresh-
old,  rates  will  be reduced on a prospective basis based on the amount
any provider is over the determined  threshold  level.  Patient-specific
thresholds  will  be  based  on  annual  thresholds  determined for each
service over which the per visit payment for each visit in excess of the
standard during a twelve month period shall be reduced by  a  pre-deter-

S. 2809--D                         122                        A. 4009--D

mined  amount.  The  thresholds,  peer  based  standards and the payment
reductions shall be determined by the department  of  health,  with  the
approval  of  the  division  of the budget, and in consultation with the
office  of mental health, the office for people with developmental disa-
bilities and the office of alcoholism and substance abuse services,  and
any such resulting rates shall be subject to certification by the appro-
priate commissioners pursuant to subdivision (a) of section 43.02 of the
mental  hygiene  law.  The  base period used to establish the thresholds
shall be the 2009 calendar  year.  The  total  annualized  reduction  in
payments  shall be not more than $10,900,000 for Article 31 clinics, not
more  than  $2,400,000  for  Article  16  clinics,  and  not  more  than
$13,250,000  for  Article  32  clinics.  The  commissioner of health may
promulgate regulations to implement the provisions of this section.
  S 27. Paragraph (h) of subdivision 2 of section 365-a  of  the  social
services  law,  as  amended  by  chapter  444 of the laws of 1979 and as
relettered by chapter 478 of the laws of 1980, is  amended  to  read  as
follows:
  (h)  SPEECH THERAPY, AND WHEN PROVIDED AT THE DIRECTION OF A PHYSICIAN
OR NURSE PRACTITIONER, physical therapy [and relative] INCLUDING RELATED
rehabilitative services [when provided at the direction of a  physician]
AND  OCCUPATIONAL THERAPY; PROVIDED, HOWEVER, THAT SPEECH THERAPY, PHYS-
ICAL THERAPY AND OCCUPATIONAL THERAPY EACH SHALL BE LIMITED TO  COVERAGE
OF  TWENTY  VISITS  PER YEAR; SUCH LIMITATION SHALL NOT APPLY TO PERSONS
WITH DEVELOPMENTAL DISABILITIES;
  S 28. Section 3614 of the public health law is amended by adding a new
subdivision 2-a to read as follows:
  2-A. NOTWITHSTANDING ANY CONTRARY LAW, RULE OR  REGULATION,  FOR  RATE
PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND ELEVEN, MEDICAID RATES OF
PAYMENTS  FOR  SERVICES  PROVIDED  BY CERTIFIED HOME HEALTH AGENCIES, BY
LONG TERM HOME HEALTH CARE PROGRAMS OR BY  AN  AIDS  HOME  CARE  PROGRAM
SHALL  NOT  REFLECT  A  SEPARATE  PAYMENT FOR HOME CARE NURSING SERVICES
PROVIDED TO PATIENTS DIAGNOSED WITH ACQUIRED IMMUNE DEFICIENCY  SYNDROME
(AIDS).
  S 29. Intentionally omitted.
  S  30.   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
FOR  THE  PERIOD  APRIL  FIRST,  TWO  THOUSAND  ELEVEN   THROUGH   MARCH
THIRTY-FIRST, TWO THOUSAND TWELVE;
  (XIII)  TWENTY-THREE MILLION EIGHT HUNDRED THIRTY-SIX THOUSAND DOLLARS
EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  TWELVE
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN;
  (XIV) provided, however, for periods prior to January first, two thou-
sand  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

S. 2809--D                         123                        A. 4009--D

the  graduate  medical education program established pursuant to section
twenty-eight hundred seven-m of this article;
  [(xiii)]  (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 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)]  (XVI)  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  31.  Paragraph  (s) of subdivision 2 of section 365-a of the social
services law, as amended by section 46 of part B of chapter  58  of  the
laws of 2010, is amended to read as follows:
  (s)  smoking  cessation counseling services [for pregnant women on any
day of pregnancy through the end of the month in which the  one  hundred
eightieth  day  following  the end of the pregnancy occurs, and children
and adolescents ten to twenty years of age, during a medical visit  when
provided  by a general hospital outpatient department or a free-standing
clinic, or by a physician, registered physician's assistant,  registered
nurse  practitioner  or  licensed  midwife  in  office-based  settings];
provided, however, that the provisions of this  paragraph  [relating  to
smoking  cessation counseling services] shall not take effect unless all
necessary approvals under federal law and regulation have been  obtained
to  receive  federal  financial  participation  in  the  costs  of  such
services.
  S 32. Subparagraph (i) of paragraph (b-1) of subdivision 1 of  section
2807-c  of  the public health law, as amended by section 10 of part C of
chapter 58 of the laws of 2010, is amended to read as follows:
  (i) For patients discharged  on  and  after  January  first,  nineteen
hundred ninety-seven and prior to January first, two thousand and on and
after  January  first,  two  thousand, payments to general hospitals for
reimbursement of inpatient hospital services provided to patients eligi-
ble for payments pursuant to the workers' compensation law,  the  volun-
teer firefighters' benefit law, the volunteer ambulance workers' benefit
law, and the comprehensive motor vehicle insurance reparations act shall
be at the rates of payment determined pursuant to this section for state
governmental  agencies,  excluding  adjustments  pursuant to subdivision
fourteen-f of this section and subdivision thirty-three of this  section
[and], excluding such further reductions to such payments as are enacted
as  part  of the state budget for the state fiscal year commencing April
first, two thousand ten AND EXCLUDING SUCH FURTHER  REDUCTIONS  TO  SUCH
PAYMENTS  AS  ARE  ENACTED  AS PART OF THE STATE BUDGET FOR STATE FISCAL
YEARS COMMENCING ON AND AFTER APRIL FIRST, TWO THOUSAND ELEVEN.
  S 33. The public health law is amended by adding a new section  3614-c
to read as follows:
  S  3614-C.  HOME  CARE WORKER WAGE PARITY. 1. AS USED IN THIS SECTION,
THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANING:
  (A) "LIVING WAGE LAW" MEANS ANY LAW  ENACTED  BY  NASSAU,  SUFFOLK  OR
WESTCHESTER  COUNTY  OR  A CITY WITH A POPULATION OF ONE MILLION OR MORE
WHICH ESTABLISHES A MINIMUM WAGE FOR SOME OR ALL EMPLOYEES  WHO  PERFORM
WORK ON CONTRACTS WITH SUCH COUNTY OR CITY.
  (B) "TOTAL COMPENSATION" MEANS ALL WAGES AND OTHER DIRECT COMPENSATION
PAID TO OR PROVIDED ON BEHALF OF THE EMPLOYEE INCLUDING, BUT NOT LIMITED
TO, WAGES, HEALTH, EDUCATION OR PENSION BENEFITS, SUPPLEMENTS IN LIEU OF

S. 2809--D                         124                        A. 4009--D

BENEFITS  AND  COMPENSATED  TIME  OFF,  EXCEPT  THAT IT DOES NOT INCLUDE
EMPLOYER TAXES OR EMPLOYER PORTION OF PAYMENTS FOR  STATUTORY  BENEFITS,
INCLUDING  BUT  NOT  LIMITED TO FICA, DISABILITY INSURANCE, UNEMPLOYMENT
INSURANCE AND WORKERS' COMPENSATION.
  (C)  "PREVAILING  RATE OF TOTAL COMPENSATION" MEANS THE AVERAGE HOURLY
AMOUNT OF TOTAL COMPENSATION PAID TO ALL  HOME  CARE  AIDES  COVERED  BY
WHATEVER  COLLECTIVELY BARGAINED AGREEMENT COVERS THE GREATEST NUMBER OF
HOME CARE AIDES IN A CITY WITH A POPULATION OF ONE MILLION OR MORE.  FOR
PURPOSES OF THIS DEFINITION, ANY SET OF  COLLECTIVELY  BARGAINED  AGREE-
MENTS  IN  SUCH  CITY  WITH  SUBSTANTIALLY THE SAME TERMS AND CONDITIONS
RELATING TO TOTAL COMPENSATION SHALL BE CONSIDERED AS A  SINGLE  COLLEC-
TIVELY BARGAINED AGREEMENT.
  (D)  "HOME  CARE  AIDE"  MEANS A HOME HEALTH AIDE, PERSONAL CARE AIDE,
HOME ATTENDANT OR OTHER LICENSED  OR  UNLICENSED  PERSON  WHOSE  PRIMARY
RESPONSIBILITY  INCLUDES THE PROVISION OF IN-HOME ASSISTANCE WITH ACTIV-
ITIES OF DAILY  LIVING,  INSTRUMENTAL  ACTIVITIES  OF  DAILY  LIVING  OR
HEALTH-RELATED  TASKS;  PROVIDED,  HOWEVER, THAT HOME CARE AIDE DOES NOT
INCLUDE ANY INDIVIDUAL (I) WORKING ON A CASUAL BASIS, OR (II) WHO  IS  A
RELATIVE  THROUGH  BLOOD,  MARRIAGE OR ADOPTION OF: (1) THE EMPLOYER; OR
(2) THE PERSON FOR WHOM THE  WORKER  IS  DELIVERING  SERVICES,  UNDER  A
PROGRAM FUNDED OR ADMINISTERED BY FEDERAL, STATE OR LOCAL GOVERNMENT.
  (E)  "MANAGED  CARE PLAN" MEANS ANY MANAGED CARE PROGRAM, ORGANIZATION
OR DEMONSTRATION COVERING PERSONAL CARE OR HOME  HEALTH  AIDE  SERVICES,
AND WHICH RECEIVES PREMIUMS FUNDED, IN WHOLE OR IN PART, BY THE NEW YORK
STATE MEDICAL ASSISTANCE PROGRAM, INCLUDING BUT NOT LIMITED TO ALL MEDI-
CAID  MANAGED CARE, MEDICAID MANAGED LONG TERM CARE, MEDICAID ADVANTAGE,
AND MEDICAID ADVANTAGE PLUS PLANS AND ALL PROGRAMS OF ALL-INCLUSIVE CARE
FOR THE ELDERLY.
  (F) "EPISODE OF CARE" MEANS ANY SERVICE UNIT REIMBURSED, IN  WHOLE  OR
IN  PART,  BY  THE  NEW  YORK  STATE MEDICAL ASSISTANCE PROGRAM, WHETHER
THROUGH DIRECT REIMBURSEMENT OR COVERED BY A PREMIUM PAYMENT, AND  WHICH
COVERS,  IN  WHOLE OR IN PART, ANY SERVICE PROVIDED BY A HOME CARE AIDE,
INCLUDING BUT NOT LIMITED TO ALL SERVICE UNITS DEFINED AS VISITS, HOURS,
DAYS, MONTHS OR EPISODES.
  2. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW,  RULE  OR  REGU-
LATION,  NO  PAYMENTS  BY GOVERNMENT AGENCIES SHALL BE MADE TO CERTIFIED
HOME HEALTH AGENCIES, LONG TERM HOME HEALTH  CARE  PROGRAMS  OR  MANAGED
CARE  PLANS  FOR  ANY EPISODE OF CARE FURNISHED, IN WHOLE OR IN PART, BY
ANY HOME CARE AIDE WHO IS COMPENSATED AT AMOUNTS LESS THAN THE  APPLICA-
BLE MINIMUM RATE OF HOME CARE AIDE TOTAL COMPENSATION ESTABLISHED PURSU-
ANT TO THIS SECTION.
  3. (A) THE MINIMUM RATE OF HOME CARE AIDE TOTAL COMPENSATION IN A CITY
WITH A POPULATION OF ONE MILLION OR MORE SHALL BE:
  (I)  FOR  THE PERIOD MARCH FIRST, TWO THOUSAND TWELVE THROUGH FEBRUARY
TWENTY-EIGHTH, TWO  THOUSAND  THIRTEEN,  NINETY  PERCENT  OF  THE  TOTAL
COMPENSATION MANDATED BY THE LIVING WAGE LAW OF SUCH CITY;
  (II)  FOR THE PERIOD MARCH FIRST, TWO THOUSAND THIRTEEN THROUGH FEBRU-
ARY TWENTY-EIGHTH, TWO THOUSAND FOURTEEN,  NINETY-FIVE  PERCENT  OF  THE
TOTAL COMPENSATION MANDATED BY THE LIVING WAGE LAW OF SUCH CITY;
  (III) FOR ALL PERIODS ON AND AFTER MARCH FIRST, TWO THOUSAND FOURTEEN,
NO  LESS  THAN  THE  PREVAILING RATE OF TOTAL COMPENSATION AS OF JANUARY
FIRST, TWO THOUSAND ELEVEN, OR THE TOTAL COMPENSATION  MANDATED  BY  THE
LIVING WAGE LAW OF SUCH CITY, WHICHEVER IS GREATER.
  (B) THE MINIMUM RATE OF HOME CARE AIDE TOTAL COMPENSATION IN THE COUN-
TIES OF NASSAU, SUFFOLK AND WESTCHESTER SHALL BE:

S. 2809--D                         125                        A. 4009--D

  (I) FOR THE PERIOD MARCH FIRST, TWO THOUSAND THIRTEEN THROUGH FEBRUARY
TWENTY-EIGHTH,  TWO  THOUSAND  FOURTEEN,  NINETY  PERCENT  OF  THE TOTAL
COMPENSATION MANDATED BY THE LIVING WAGE LAW AS SET ON MARCH FIRST,  TWO
THOUSAND THIRTEEN OF A CITY WITH A POPULATION OF A MILLION OR MORE;
  (II)  FOR THE PERIOD MARCH FIRST, TWO THOUSAND FOURTEEN THROUGH FEBRU-
ARY TWENTY-EIGHTH, TWO THOUSAND  FIFTEEN,  NINETY-FIVE  PERCENT  OF  THE
TOTAL  COMPENSATION  MANDATED  BY  THE  LIVING  WAGE LAW AS SET ON MARCH
FIRST, TWO THOUSAND FOURTEEN OF A CITY WITH A POPULATION OF A MILLION OR
MORE;
  (III) FOR THE PERIOD MARCH FIRST, TWO THOUSAND FIFTEEN, THROUGH FEBRU-
ARY TWENTY-EIGHTH, TWO THOUSAND SIXTEEN,  ONE  HUNDRED  PERCENT  OF  THE
TOTAL  COMPENSATION  MANDATED  BY  THE  LIVING  WAGE LAW AS SET ON MARCH
FIRST, TWO THOUSAND FIFTEEN OF A CITY WITH A POPULATION OF A MILLION  OR
MORE;
  (IV)  FOR  ALL  PERIODS ON OR AFTER MARCH FIRST, TWO THOUSAND SIXTEEN,
THE LESSER OF (I) ONE HUNDRED AND FIFTEEN PERCENT OF THE  TOTAL  COMPEN-
SATION  MANDATED  BY  THE  LIVING WAGE LAW AS SET ON MARCH FIRST OF EACH
SUCCEEDING YEAR OF A CITY WITH A POPULATION OF ONE MILLION OR  MORE  OR;
(II)  THE  TOTAL COMPENSATION MANDATED BY THE LIVING WAGE LAW OF NASSAU,
SUFFOLK OR WESTCHESTER COUNTY, BASED ON THE LOCATION OF THE  EPISODE  OF
CARE
  4.    ANY  PORTION OF THE MINIMUM RATE OF HOME CARE AIDE TOTAL COMPEN-
SATION ATTRIBUTABLE TO HEALTH BENEFIT  COSTS  OR  PAYMENTS  IN  LIEU  OF
HEALTH  BENEFITS, AND PAID TIME OFF, AS ESTABLISHED PURSUANT TO SUBDIVI-
SION THREE OF THIS SECTION SHALL BE  SUPERSEDED  BY  THE  TERMS  OF  ANY
EMPLOYER BONA FIDE COLLECTIVE BARGAINING AGREEMENT IN EFFECT AS OF JANU-
ARY  FIRST, TWO THOUSAND ELEVEN, OR A SUCCESSOR TO SUCH AGREEMENT, WHICH
PROVIDES FOR HOME CARE AIDES' HEALTH BENEFITS THROUGH PAYMENTS TO JOINT-
LY ADMINISTERED LABOR-MANAGEMENT FUNDS.
  5. THE TERMS OF THIS SECTION SHALL APPLY EQUALLY TO SERVICES  PROVIDED
BY  HOME  CARE AIDES WHO WORK ON EPISODES OF CARE AS DIRECT EMPLOYEES OF
CERTIFIED HOME HEALTH AGENCIES, LONG TERM HOME HEALTH CARE PROGRAMS,  OR
MANAGED CARE PLANS, OR AS EMPLOYEES OF LICENSED HOME CARE SERVICES AGEN-
CIES,  LIMITED  LICENSED HOME CARE SERVICES AGENCIES, OR UNDER ANY OTHER
ARRANGEMENT.
  6. NO PAYMENTS BY GOVERNMENT AGENCIES SHALL BE MADE TO CERTIFIED  HOME
HEALTH  AGENCIES,  LONG  TERM HOME HEALTH CARE PROGRAMS, OR MANAGED CARE
PLANS FOR ANY EPISODE OF CARE WITHOUT THE CERTIFIED HOME HEALTH  AGENCY,
LONG  TERM  HOME HEALTH CARE PROGRAM, OR MANAGED CARE PLAN HAVING DELIV-
ERED PRIOR WRITTEN CERTIFICATION TO THE COMMISSIONER, ON FORMS  PREPARED
BY THE DEPARTMENT IN CONSULTATION WITH THE DEPARTMENT OF LABOR, THAT ALL
SERVICES PROVIDED UNDER EACH EPISODE OF CARE ARE IN FULL COMPLIANCE WITH
THE  TERMS  OF  THIS SECTION AND ANY REGULATIONS PROMULGATED PURSUANT TO
THIS SECTION.
  7. IF A CERTIFIED HOME HEALTH AGENCY OR LONG  TERM  HOME  HEALTH  CARE
PROGRAM ELECTS TO PROVIDE HOME CARE AIDE SERVICES THROUGH CONTRACTS WITH
LICENSED  HOME  CARE  SERVICES  AGENCIES OR THROUGH OTHER THIRD PARTIES,
PROVIDED THAT THE EPISODE OF CARE ON WHICH THE HOME CARE AIDE  WORKS  IS
COVERED UNDER THE TERMS OF THIS SECTION, THE CERTIFIED HOME HEALTH AGEN-
CY, LONG TERM HOME HEALTH CARE PROGRAM, OR MANAGED CARE PLAN MUST OBTAIN
A  WRITTEN  CERTIFICATION FROM THE LICENSED HOME CARE SERVICES AGENCY OR
OTHER THIRD PARTY, ON FORMS PREPARED BY THE DEPARTMENT  IN  CONSULTATION
WITH  THE  DEPARTMENT  OF LABOR, WHICH ATTESTS TO THE LICENSED HOME CARE
SERVICES AGENCY'S OR OTHER THIRD PARTY'S COMPLIANCE WITH  THE  TERMS  OF
THIS SECTION. SUCH CERTIFICATIONS SHALL ALSO OBLIGATE THE CERTIFIED HOME
HEALTH  AGENCY, LONG TERM HOME HEALTH CARE PROGRAM, OR MANAGED CARE PLAN

S. 2809--D                         126                        A. 4009--D

TO OBTAIN, ON NO LESS THAN A QUARTERLY BASIS, ALL INFORMATION  FROM  THE
LICENSED  HOME  CARE SERVICES AGENCY OR OTHER THIRD PARTIES NECESSARY TO
VERIFY COMPLIANCE WITH THE TERMS OF THIS SECTION.   SUCH  CERTIFICATIONS
AND  THE INFORMATION EXCHANGED PURSUANT TO THEM SHALL BE RETAINED BY ALL
CERTIFIED HOME HEALTH AGENCIES, LONG TERM HOME HEALTH CARE PROGRAMS,  OR
MANAGED  CARE  PLANS,  AND  ALL LICENSED HOME CARE SERVICES AGENCIES, OR
OTHER THIRD PARTIES FOR A PERIOD OF NO LESS THAN  TEN  YEARS,  AND  MADE
AVAILABLE TO THE DEPARTMENT UPON REQUEST.
  8.  THE  COMMISSIONER  SHALL  DISTRIBUTE  TO ALL CERTIFIED HOME HEALTH
AGENCIES, LONG TERM HOME HEALTH CARE PROGRAMS, AND  MANAGED  CARE  PLANS
OFFICIAL  NOTICE  OF THE MINIMUM RATES OF HOME CARE AIDE COMPENSATION AT
LEAST ONE HUNDRED TWENTY DAYS PRIOR TO THE EFFECTIVE DATE OF EACH  MINI-
MUM  RATE FOR EACH SOCIAL SERVICES DISTRICT COVERED BY THE TERMS OF THIS
SECTION.
  9. THE COMMISSIONER IS AUTHORIZED TO PROMULGATE REGULATIONS,  AND  MAY
PROMULGATE  EMERGENCY  REGULATIONS,  TO IMPLEMENT THE PROVISIONS OF THIS
SECTION.
  10. NOTHING IN THIS SECTION SHOULD BE CONSTRUED AS APPLICABLE  TO  ANY
SERVICE  PROVIDED  BY  CERTIFIED  HOME  HEALTH  AGENCIES, LONG TERM HOME
HEALTH CARE PROGRAMS, OR MANAGED CARE PLANS EXCEPT FOR ALL  EPISODES  OF
CARE REIMBURSED IN WHOLE OR IN PART BY THE NEW YORK MEDICAID PROGRAM.
  11.  NO  CERTIFIED  HOME HEALTH AGENCY, MANAGED CARE PLAN OR LONG TERM
HOME HEALTH CARE PROGRAM SHALL BE LIABLE FOR RECOUPMENT OF PAYMENTS  FOR
SERVICES  PROVIDED THROUGH A LICENSED HOME CARE SERVICES AGENCY OR OTHER
THIRD PARTY WITH WHICH THE CERTIFIED HOME HEALTH AGENCY, LONG TERM  HOME
HEALTH  CARE  PROGRAM,  OR  MANAGED CARE PLAN HAS A CONTRACT BECAUSE THE
LICENSED  AGENCY  OR  OTHER  THIRD  PARTY  FAILED  TO  COMPLY  WITH  THE
PROVISIONS  OF  THIS  SECTION  IF THE CERTIFIED HOME HEALTH AGENCY, LONG
TERM HOME HEALTH CARE PROGRAM, OR MANAGED CARE PLAN HAS  REASONABLY  AND
IN  GOOD  FAITH  COLLECTED  CERTIFICATIONS  AND ALL INFORMATION REQUIRED
PURSUANT TO SUBDIVISIONS SIX AND SEVEN OF THIS SECTION.
  S 33-a. Intentionally omitted.
  S 34.  Subdivision 22-a of section 2808 of the public  health  law  is
amended by adding a new paragraph (d) to read as follows:
  (D)  (I)  NOTWITHSTANDING  ANY INCONSISTENT PROVISIONS OF SUBDIVISIONS
TWO-B OR TWO-C OF THIS SECTION OR ANY OTHER CONTRARY PROVISION  OF  LAW,
AND  SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION, FOR
INPATIENT SERVICES PROVIDED BY RESIDENTIAL HEALTH CARE FACILITIES ON AND
AFTER APRIL FIRST, TWO THOUSAND ELEVEN, THE COMMISSIONER MAY, SUBJECT TO
THE APPROVAL OF THE DIRECTOR OF THE BUDGET, GRANT APPROVAL OF  A  TEMPO-
RARY ADJUSTMENT TO MEDICAID RATES FOR ELIGIBLE FACILITIES, AS DETERMINED
IN ACCORDANCE WITH THIS PARAGRAPH.
  (II) ELIGIBLE FACILITIES SHALL BE THOSE RESIDENTIAL HEALTH CARE FACIL-
ITIES  WHICH,  AS  DETERMINED  BY  THE  COMMISSIONER, REQUIRE SHORT-TERM
ASSISTANCE TO ACCOMMODATE ADDITIONAL PATIENT SERVICES REQUIREMENTS STEM-
MING FROM THE CLOSURE OF OTHER FACILITIES IN THE  AREA,  INCLUDING,  BUT
NOT  LIMITED  TO, ADDITIONAL STAFF, SERVICE RECONFIGURATION AND ENHANCED
INFORMATION TECHNOLOGY CAPABILITY.
  (III) ELIGIBLE FACILITIES SHALL SUBMIT WRITTEN PROPOSALS DEMONSTRATING
THE NEED FOR ADDITIONAL SHORT-TERM RESOURCES  AND  HOW  SUCH  ADDITIONAL
RESOURCES WILL RESULT IN IMPROVEMENTS TO:
  (A) THE COST EFFECTIVENESS OF SERVICE DELIVERY;
  (B) QUALITY OF CARE; AND
  (C) OTHER FACTORS DEEMED APPROPRIATE BY THE COMMISSIONER.
  (IV)  SUCH  WRITTEN  PROPOSALS SHALL BE SUBMITTED TO THE DEPARTMENT AT
LEAST SIXTY DAYS PRIOR TO THE REQUESTED EFFECTIVE DATE OF THE  TEMPORARY

S. 2809--D                         127                        A. 4009--D

RATE  ADJUSTMENT. THE TEMPORARY RATE ADJUSTMENT SHALL BE IN EFFECT FOR A
SPECIFIED PERIOD OF TIME AS DETERMINED BY THE COMMISSIONER. AT  THE  END
OF  THE  SPECIFIED TIMEFRAME, THE FACILITY WILL BE REIMBURSED IN ACCORD-
ANCE  WITH  OTHERWISE APPLICABLE RATE-SETTING METHODOLOGIES. THE COMMIS-
SIONER MAY ESTABLISH, AS A CONDITION OF RECEIVING SUCH A TEMPORARY  RATE
ADJUSTMENT,  BENCHMARKS  AND GOALS TO BE ACHIEVED IN ACCORDANCE WITH THE
FACILITY'S APPROVED PROPOSALS AND MAY ALSO  REQUIRE  THAT  THE  FACILITY
SUBMIT  SUCH  PERIODIC REPORTS CONCERNING THE ACHIEVEMENT OF SUCH BENCH-
MARKS AND GOALS AS THE COMMISSIONER DEEMS NECESSARY. FAILURE TO  ACHIEVE
SATISFACTORY PROGRESS, AS DETERMINED BY THE COMMISSIONER, IN ACCOMPLISH-
ING SUCH BENCHMARKS AND GOALS SHALL BE A BASIS FOR ENDING THE FACILITY'S
TEMPORARY RATE ADJUSTMENT PRIOR TO THE END OF THE SPECIFIED TIMEFRAME.
  S  35.  The public health law is amended by adding a new article 29-AA
to read as follows:
                              ARTICLE 29-AA
                     PATIENT CENTERED MEDICAL HOMES
SECTION 2959-A. MULTIPAYOR PATIENT CENTERED MEDICAL HOME PROGRAM.
  S 2959-A. MULTIPAYOR PATIENT CENTERED MEDICAL HOME PROGRAM.    1.  (A)
THE  COMMISSIONER  IS  AUTHORIZED  TO  ESTABLISH MEDICAL HOME MULTIPAYOR
PROGRAMS (REFERRED TO IN THIS SECTION AS A "PROGRAM")  WHEREBY  ENHANCED
PAYMENTS  ARE MADE TO PRIMARY CARE CLINICIANS AND CLINICS STATEWIDE THAT
ARE CERTIFIED AS MEDICAL HOMES FOR THE PURPOSE OF IMPROVING HEALTH  CARE
OUTCOMES AND EFFICIENCY THROUGH IMPROVED ACCESS, PATIENT CARE CONTINUITY
AND COORDINATION OF HEALTH SERVICES.
  (B) AS USED IN THIS SECTION:
  (I)  "CLINIC"  MEANS  A  GENERAL HOSPITAL PROVIDING OUTPATIENT CARE OR
DIAGNOSTIC AND TREATMENT CENTER, LICENSED UNDER ARTICLE TWENTY-EIGHT  OF
THIS CHAPTER; AND
  (II)  "PRIMARY  CARE CLINICIAN" MEANS A PHYSICIAN, NURSE PRACTITIONER,
OR MIDWIFE ACTING WITHIN HIS OR HER LAWFUL SCOPE OF PRACTICE UNDER TITLE
EIGHT OF THE EDUCATION LAW AND WHO  IS  PRACTICING  IN  A  PRIMARY  CARE
SPECIALTY.
  (III)  "PRIMARY  CARE  MEDICAL  HOME  COLLABORATIVE"  MEANS  AN ENTITY
APPROVED BY THE COMMISSIONER WHICH SHALL INCLUDE BUT NOT BE  LIMITED  TO
HEALTH  CARE  PROVIDERS,  WHICH MAY INCLUDE BUT NOT BE LIMITED TO HOSPI-
TALS, DIAGNOSTIC AND TREATMENT CENTERS, PRIVATE PRACTICES AND  INDEPEND-
ENT PRACTICE ASSOCIATIONS, AND PAYORS OF HEALTH CARE SERVICES, WHICH MAY
INCLUDE BUT NOT BE LIMITED TO EMPLOYERS, HEALTH PLANS AND INSURERS.
  2.  (A) IN ORDER TO PROMOTE IMPROVED QUALITY OF, AND ACCESS TO, HEALTH
CARE SERVICES AND PROMOTE IMPROVED CLINICAL OUTCOMES, IT IS  THE  POLICY
OF  THE  STATE  TO  ENCOURAGE COOPERATIVE, COLLABORATIVE AND INTEGRATIVE
ARRANGEMENTS AMONG PAYORS  OF  HEALTH  CARE  SERVICES  AND  HEALTH  CARE
SERVICES  PROVIDERS WHO MIGHT OTHERWISE BE COMPETITORS, UNDER THE ACTIVE
SUPERVISION OF THE COMMISSIONER. IT  IS  THE  INTENT  OF  THE  STATE  TO
SUPPLANT  COMPETITION  WITH SUCH ARRANGEMENTS AND REGULATION ONLY TO THE
EXTENT NECESSARY TO ACCOMPLISH THE PURPOSES  OF  THIS  ARTICLE,  AND  TO
PROVIDE STATE ACTION IMMUNITY UNDER THE STATE AND FEDERAL ANTITRUST LAWS
TO  PAYORS  OF  HEALTH  CARE SERVICES AND HEALTH CARE SERVICES PROVIDERS
WITH RESPECT TO THE PLANNING, IMPLEMENTATION AND OPERATION OF THE MULTI-
PAYOR PATIENT CENTERED MEDICAL HOME PROGRAM.
  (B) THE COMMISSIONER OR HIS OR HER DULY AUTHORIZED REPRESENTATIVE  MAY
ENGAGE  IN  APPROPRIATE  STATE  SUPERVISION  NECESSARY  TO PROMOTE STATE
ACTION IMMUNITY UNDER THE STATE AND  FEDERAL  ANTITRUST  LAWS,  AND  MAY
INSPECT  OR  REQUEST ADDITIONAL DOCUMENTATION FROM PAYORS OF HEALTH CARE
SERVICES AND HEALTH CARE SERVICES PROVIDERS TO VERIFY THAT MEDICAL HOMES

S. 2809--D                         128                        A. 4009--D

CERTIFIED PURSUANT TO THIS SECTION OPERATE IN ACCORDANCE WITH ITS INTENT
AND PURPOSE.
  3.  THE  COMMISSIONER IS AUTHORIZED TO PARTICIPATE IN, ACTIVELY SUPER-
VISE, FACILITATE AND APPROVE A PRIMARY CARE MEDICAL  HOME  COLLABORATIVE
FOR  EACH  PROGRAM  AROUND THE STATE TO ESTABLISH: (A) THE BOUNDARIES OF
EACH PROGRAM AND THE PROVIDERS ELIGIBLE TO  PARTICIPATE,  PROVIDED  THAT
THE  BOUNDARIES OF PROGRAMS MAY OVERLAP; (B) PRACTICE STANDARDS FOR EACH
MEDICAL HOME PROGRAM ADOPTED WITH CONSIDERATION  OF  EXISTING  STANDARDS
DEVELOPED  BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE ("NCQA"), THE
JOINT COMMISSION OF ACCREDITATION OF HEALTHCARE ORGANIZATIONS  ("JCAHCO"
OR THE "JOINT COMMISSION"), AMERICAN ACCREDITATION HEALTHCARE COMMISSION
("URAC"), AMERICAN COLLEGE OF PHYSICIANS, THE AMERICAN ACADEMY OF FAMILY
PHYSICIANS,  THE AMERICAN ACADEMY OF PEDIATRICS, AND THE AMERICAN OSTEO-
PATHIC ASSOCIATION; THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, AND THE
AMERICAN COLLEGE OF NURSE PRACTITIONERS; (C) STANDARDS  FOR  IMPLEMENTA-
TION  AND  USE OF HEALTH INFORMATION TECHNOLOGY, INCLUDING PARTICIPATION
IN HEALTH INFORMATION EXCHANGES THROUGH THE STATEWIDE HEALTH INFORMATION
NETWORK; (D) METHODOLOGIES BY WHICH PAYORS WILL PROVIDE  ENHANCED  RATES
OF  PAYMENT  TO CERTIFIED MEDICAL HOMES; (E) REQUIREMENTS FOR COLLECTING
DATA RELATING TO THE PROVIDING AND PAYING FOR HEALTH CARE SERVICES UNDER
THE PROGRAM AND PROVIDING OF DATA TO THE COMMISSIONER, PAYORS AND HEALTH
CARE PROVIDERS UNDER THE PROGRAM, TO PROMOTE THE EFFECTIVE OPERATION AND
EVALUATION OF THE PROGRAM, CONSISTENT WITH PROTECTION OF  THE  CONFIDEN-
TIALITY  OF  INDIVIDUAL  PATIENT  INFORMATION;  AND (F) PROVISIONS UNDER
WHICH THE COMMISSIONER MAY TERMINATE THE PROGRAM.
  3-A.  THE COMMISSIONER MAY DEVELOP OR APPROVE (A) METHODOLOGIES TO PAY
ADDITIONAL AMOUNTS FOR MEDICAL  HOMES  THAT  MEET  SPECIFIC  PROCESS  OR
OUTCOME  STANDARDS  ESTABLISHED  BY  EACH  MULTIPAYOR  PATIENT  CENTERED
MEDICAL HOME COLLABORATIVE; (B) ALTERNATIVE METHODOLOGIES FOR PAYORS  OF
HEALTH  CARE  SERVICES  TO  HEALTH CARE PROVIDERS UNDER THE PROGRAM; (C)
PROVISIONS FOR PAYMENTS TO PROVIDERS THAT MAY VARY BY SIZE  OR  FORM  OF
ORGANIZATION  OF  THE  PROVIDER,  OR  PATIENT  CASE  MIX, TO ACCOMMODATE
DIFFERENT LEVELS OF RESOURCES AND DIFFICULTY TO MEET  THE  STANDARDS  OF
THE  PROGRAM;  (D)  PROVISIONS  FOR  PAYMENTS  TO  ENTITIES THAT PROVIDE
SERVICES TO HEALTH CARE PROVIDERS TO ASSIST THEM IN MEETING MEDICAL HOME
STANDARDS UNDER THE PROGRAM SUCH AS THE  SERVICES  OF  COMMUNITY  HEALTH
WORKERS.
  4.  THE  COMMISSIONER  IS AUTHORIZED TO ESTABLISH AN ADVISORY GROUP OF
STATE AGENCIES AND STAKEHOLDERS, SUCH AS PROFESSIONAL ORGANIZATIONS  AND
ASSOCIATIONS,  AND  CONSUMERS,  TO  IDENTIFY LEGAL AND/OR ADMINISTRATIVE
BARRIERS TO  THE  SHARING  OF  CARE  MANAGEMENT  AND  CARE  COORDINATION
SERVICES  AMONG PARTICIPATING HEALTH CARE SERVICES PROVIDERS AND TO MAKE
RECOMMENDATIONS FOR STATUTORY AND/OR REGULATORY CHANGES TO ADDRESS  SUCH
BARRIERS.
  5.  PATIENT,  PAYOR AND HEALTH CARE SERVICES PROVIDER PARTICIPATION IN
THE MULTIPAYOR PATIENT CENTERED MEDICAL  HOME  PROGRAM  SHALL  BE  ON  A
VOLUNTARY BASIS.
  6.  CLINICS AND PRIMARY CARE CLINICIANS PARTICIPATING IN A PROGRAM ARE
NOT ELIGIBLE FOR ADDITIONAL ENHANCEMENTS OR BONUSES UNDER THE  STATEWIDE
PATIENT  CENTERED  MEDICAL  HOME PROGRAM ESTABLISHED PURSUANT TO SECTION
THREE HUNDRED SIXTY-FOUR-M OF THE SOCIAL SERVICES LAW.  THE COMMISSIONER
SHALL DEVELOP OR APPROVE  A  METHOD  FOR  DETERMINING  PAYMENT  UNDER  A
PROGRAM  WHERE  A  PROVIDER  PARTICIPATES, OR A PATIENT IS SERVED, IN AN
AREA WHERE PROGRAM BOUNDARIES OVERLAP.
  7. SUBJECT TO  THE  AVAILABILITY  OF  FUNDING  AND  FEDERAL  FINANCIAL
PARTICIPATION, THE COMMISSIONER IS AUTHORIZED:

S. 2809--D                         129                        A. 4009--D

  (A)  TO  PAY ENHANCED RATES OF PAYMENT UNDER MEDICAID FEE-FOR-SERVICE,
MEDICAID MANAGED CARE, FAMILY HEALTH PLUS AND CHILD HEALTH PLUS TO CLIN-
ICS AND CLINICIANS THAT ARE CERTIFIED AS PATIENT CENTERED MEDICAL  HOMES
UNDER THIS TITLE;
  (B)  TO  PAY  ADDITIONAL  AMOUNTS FOR MEDICAL HOMES THAT MEET SPECIFIC
PROCESS OR OUTCOME STANDARDS SPECIFIED BY THE COMMISSIONER IN  CONSULTA-
TION WITH EACH MULTIPAYOR PATIENT CENTERED MEDICAL HOME COLLABORATIVE;
  (C)  TO  AUTHORIZE  ALTERNATIVE  PAYMENT  METHODOLOGIES UNDER MEDICAID
FEE-FOR-SERVICE, MEDICAID MANAGED CARE, FAMILY  HEALTH  PLUS  AND  CHILD
HEALTH  PLUS  FOR HEALTH CARE PROVIDERS AND TO SERVE THE PURPOSES OF THE
PROGRAM, INCLUDING PAYMENTS TO ENTITIES UNDER PARAGRAPH (G) OF  SUBDIVI-
SION THREE OF THIS SECTION; AND
  (D) TO TEST NEW MODELS OF PAYMENT TO HIGH VOLUME MEDICAID PRIMARY CARE
MEDICAL  HOME  PRACTICES  THAT INCORPORATE RISK ADJUSTED GLOBAL PAYMENTS
COMBINED WITH CARE MANAGEMENT AND PAY FOR PERFORMANCE ADJUSTMENTS.
  8. (A) THE COMMISSIONER IS AUTHORIZED TO CONTRACT  WITH  ONE  OR  MORE
ENTITIES  TO  ASSIST  THE  STATE  IN IMPLEMENTING THE PROVISIONS OF THIS
SECTION. SUCH ENTITY OR ENTITIES SHALL BE THE SAME  ENTITY  OR  ENTITIES
CHOSEN  TO ASSIST IN THE IMPLEMENTATION OF THE HEALTH HOME PROVISIONS OF
SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW.   RESPON-
SIBILITIES OF THE CONTRACTOR SHALL INCLUDE BUT NOT BE LIMITED TO: DEVEL-
OPING  RECOMMENDATIONS  WITH  RESPECT  TO PROGRAM POLICY, REIMBURSEMENT,
SYSTEM REQUIREMENTS, REPORTING REQUIREMENTS, EVALUATION  PROTOCOLS,  AND
PROVIDER  AND  PATIENT  ENROLLMENT;  PROVIDING  TECHNICAL  ASSISTANCE TO
POTENTIAL MEDICAL HOME AND HEALTH HOME PROVIDERS; DATA COLLECTION;  DATA
SHARING; PROGRAM EVALUATION, AND PREPARATION OF REPORTS.
  (B) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE HUNDRED
TWELVE  AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTION
ONE HUNDRED FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR ANY OTHER LAW,
THE COMMISSIONER IS AUTHORIZED TO ENTER INTO  A  CONTRACT  OR  CONTRACTS
UNDER  PARAGRAPH  (A) OF THIS SUBDIVISION WITHOUT A REQUEST FOR PROPOSAL
PROCESS, PROVIDED, HOWEVER, THAT:
  (I) THE DEPARTMENT SHALL POST ON ITS WEBSITE, FOR A PERIOD OF NO  LESS
THAN THIRTY DAYS:
  (1)  A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT TO
THE CONTRACT OR CONTRACTS;
  (2) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (3) THE PERIOD OF TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY  SEEK
SELECTION,  WHICH  SHALL BE NO LESS THAN THIRTY DAYS AFTER SUCH INFORMA-
TION IS FIRST POSTED ON THE WEBSITE; AND
  (4) THE MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR  MAY  SEEK  SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (II)  ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE RECEIVED FROM
PROSPECTIVE CONTRACTORS IN TIMELY  FASHION  SHALL  BE  REVIEWED  BY  THE
COMMISSIONER; AND
  (III)  THE  COMMISSIONER  SHALL  SELECT SUCH CONTRACTOR OR CONTRACTORS
THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE PURPOSES OF
THIS SECTION.
  9. THE COMMISSIONER MAY DIRECTLY, OR BY CONTRACT, PROVIDE:
  (A) TECHNICAL ASSISTANCE TO A PRIMARY CARE MEDICAL HOME  COLLABORATIVE
IN RELATION TO ESTABLISHING AND OPERATING A PROGRAM;
  (B)  CONSUMER  ASSISTANCE TO PATIENTS PARTICIPATING IN A PROGRAM AS TO
MATTERS RELATING TO THE PROGRAM;
  (C) TECHNICAL AND OTHER ASSISTANCE TO HEALTH  CARE  PROVIDERS  PARTIC-
IPATING  IN  A  PROGRAM AS TO MATTERS RELATING TO THE PROGRAM, INCLUDING
ACHIEVING MEDICAL HOME STANDARDS;

S. 2809--D                         130                        A. 4009--D

  (D) CARE COORDINATION PROVIDER TECHNICAL AND OTHER ASSISTANCE TO INDI-
VIDUALS AND ENTITIES PROVIDING CARE COORDINATION SERVICES TO HEALTH CARE
PROVIDERS UNDER A PROGRAM; AND
  (E) INFORMATION SHARING AND OTHER ASSISTANCE AMONG PROGRAMS TO IMPROVE
THE  OPERATION  OF PROGRAMS, CONSISTENT WITH APPLICABLE LAWS RELATING TO
PATIENT CONFIDENTIALITY.
  10. THE COMMISSIONER SHALL, TO THE EXTENT NECESSARY FOR THE PURPOSE OF
THIS SECTION, SUBMIT THE APPROPRIATE  WAIVERS  AND  OTHER  APPLICATIONS,
INCLUDING,  BUT  NOT  LIMITED  TO, THOSE AUTHORIZED PURSUANT TO SECTIONS
ELEVEN HUNDRED FIFTEEN AND  NINETEEN  HUNDRED  FIFTEEN  OF  THE  FEDERAL
SOCIAL  SECURITY  ACT, OR SUCCESSOR PROVISIONS, AND ANY OTHER WAIVERS OR
APPLICATIONS NECESSARY TO ACHIEVE THE PURPOSES OF  HIGH  QUALITY,  INTE-
GRATED,  AND  COST  EFFECTIVE  CARE AND INTEGRATED FINANCIAL ELIGIBILITY
POLICIES UNDER MEDICAID, FAMILY HEALTH PLUS AND  CHILD  HEALTH  PLUS  OR
MEDICARE. COPIES OF SUCH ORIGINAL WAIVER AND OTHER APPLICATIONS SHALL BE
PROVIDED  TO THE CHAIRMAN OF THE SENATE FINANCE COMMITTEE AND THE CHAIR-
MAN OF THE ASSEMBLY WAYS AND MEANS COMMITTEE SIMULTANEOUSLY  WITH  THEIR
SUBMISSION TO THE FEDERAL GOVERNMENT.
  11.  THE  ADIRONDACK  MEDICAL  HOME  MULTIPAYOR  DEMONSTRATION PROGRAM
(INCLUDING THE ADIRONDACK MEDICAL HOME COLLABORATIVE) PREVIOUSLY  ESTAB-
LISHED  UNDER  SECTION TWENTY-NINE HUNDRED FIFTY-NINE OF THIS CHAPTER IS
CONTINUED AND SHALL BE DEEMED TO BE A PROGRAM UNDER THIS SECTION.
  12. THE COMMISSIONER SHALL ANNUALLY REPORT TO  THE  GOVERNOR  AND  THE
LEGISLATURE  ON THE OPERATION OF THE PROGRAMS AND THEIR EFFECTIVENESS IN
ACHIEVING THE PURPOSES OF THIS SECTION, WITH PARTICULAR REFERENCE TO THE
QUALITY, COST, AND OUTCOMES FOR ENROLLEES IN  MEDICAID  FEE-FOR-SERVICE,
MEDICAID MANAGED CARE, FAMILY HEALTH PLUS AND CHILD HEALTH PLUS.
  S 35-a. Subparagraph (v) of paragraph (b) of subdivision 35 of section
2807-c  of  the  public health law, as amended by section 2 of part B of
chapter 109 of the laws of 2010, is amended to read as follows:
  (v) [Such] SUCH regulations shall incorporate quality related measures
[pertaining to], INCLUDING, BUT NOT LIMITED TO, potentially  preventable
[complications  and]  re-admissions  (PPRs) and provide for rate adjust-
ments or payment disallowances related to  PPRs  AND  OTHER  POTENTIALLY
PREVENTABLE  NEGATIVE  OUTCOMES  (PPNOS),  which  shall be calculated in
accordance  with  methodologies  as  determined  by  the   commissioner,
provided,  however,  that  such  methodologies shall be based on a [risk
adjusted] comparison of the actual  and  [the]  RISK  ADJUSTED  expected
number  of  PPRs AND OTHER PPNOS in a given hospital and with benchmarks
established by the commissioner and  provided  further  that  such  rate
adjustments  or  payment  disallowances  shall  result  in  an aggregate
reduction in Medicaid payments  of  no  less  than  thirty-five  million
dollars  for the period July first, two thousand ten through March thir-
ty-first, two thousand eleven and no less than  [forty-seven]  FIFTY-ONE
million  dollars for the period April first, two thousand eleven through
March thirty-first, two thousand  twelve,  PROVIDED  FURTHER  THAT  SUCH
AGGREGATE  REDUCTIONS  SHALL  BE  OFFSET  BY MEDICAID PAYMENT REDUCTIONS
OCCURRING AS A RESULT OF DECREASED PPRS DURING THE  PERIOD  JULY  FIRST,
TWO THOUSAND TEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND ELEVEN AND THE
PERIOD  APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND TWELVE AND AS A RESULT OF DECREASED  PPNOS  DURING  THE  PERIOD
APRIL  FIRST,  TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND TWELVE; and provided  further  that  [the  regulations  promulgated
pursuant  to  this  subparagraph  shall  be  effective on and after July
first, two thousand ten, and provided further, however,  that]  for  the
period  July  first,  two  thousand  ten through March thirty-first, two

S. 2809--D                         131                        A. 4009--D

thousand twelve, such rate adjustments or  payment  disallowances  shall
not apply to behavioral health PPRs; or to readmissions that occur on or
after  fifteen  days  following  an  initial admission. By no later than
[April]  JULY  first,  two  thousand eleven the commissioner shall enter
into consultations with representatives of the  health  care  facilities
subject  to  this  section  regarding potential prospective revisions to
applicable methodologies and benchmarks set forth in regulations  issued
pursuant to this subparagraph;
  S  36. Subparagraph (xi) of paragraph (b) of subdivision 35 of section
2807-c of the public health law, as added by section  2  of  part  C  of
chapter  58  of  the  laws of 2009, is amended and two new subparagraphs
(xii) and (xiii) are added to read as follows:
  (xi) Rates for teaching general hospitals shall include  reimbursement
for direct and indirect graduate medical education as defined and calcu-
lated  pursuant to such regulations. In addition, such regulations shall
specify the reports and information  required  by  the  commissioner  to
assess  the  cost, quality and health system needs for medical education
provided[.];
  (XII)  SUCH  REGULATIONS  MAY  INCORPORATE  QUALITY  RELATED  MEASURES
PERTAINING  TO  THE  INAPPROPRIATE  USE  OF  CERTAIN MEDICAL PROCEDURES,
INCLUDING, BUT NOT LIMITED  TO,  CESAREAN  DELIVERIES,  CORONARY  ARTERY
BYPASS GRAFTS AND PERCUTANEOUS CORONARY INTERVENTIONS;
  (XIII)  SUCH  REGULATIONS  MAY IMPOSE A FEE ON GENERAL HOSPITAL SUFFI-
CIENT TO COVER THE COSTS OF  AUDITING  THE  INSTITUTIONAL  COST  REPORTS
SUBMITTED  BY  GENERAL HOSPITALS, WHICH SHALL BE DEPOSITED IN THE HEALTH
CARE REFORM ACT (HCRA) RESOURCES ACCOUNT.
  S 37. The social services law is amended by adding a new section 365-l
to read as follows:
  S 365-L. HEALTH HOMES.  1. NOTWITHSTANDING ANY LAW, RULE OR REGULATION
TO THE CONTRARY, THE COMMISSIONER OF HEALTH IS AUTHORIZED, IN  CONSULTA-
TION  WITH  THE  COMMISSIONERS OF THE OFFICE OF MENTAL HEALTH, OFFICE OF
ALCOHOLISM AND SUBSTANCE ABUSE SERVICES,  AND  OFFICE  FOR  PEOPLE  WITH
DEVELOPMENTAL  DISABILITIES, TO (A) ESTABLISH, IN ACCORDANCE WITH APPLI-
CABLE FEDERAL LAW AND REGULATIONS, STANDARDS FOR THE PROVISION OF HEALTH
HOME SERVICES TO MEDICAID ENROLLEES WITH CHRONIC CONDITIONS, (B)  ESTAB-
LISH  PAYMENT  METHODOLOGIES  FOR  HEALTH HOME SERVICES BASED ON FACTORS
INCLUDING BUT NOT LIMITED TO THE COMPLEXITY OF THE CONDITIONS  PROVIDERS
WILL  BE  MANAGING,  THE ANTICIPATED AMOUNT OF PATIENT CONTACT NEEDED TO
MANAGE SUCH CONDITIONS, AND THE HEALTH CARE  COST  SAVINGS  REALIZED  BY
PROVISION  OF  HEALTH  HOME  SERVICES,  (C) ESTABLISH THE CRITERIA UNDER
WHICH A MEDICAID ENROLLEE WILL BE DESIGNATED AS BEING AN ELIGIBLE  INDI-
VIDUAL  WITH CHRONIC CONDITIONS FOR PURPOSES OF THIS PROGRAM, (D) ASSIGN
ANY MEDICAID ENROLLEE DESIGNATED AS AN ELIGIBLE INDIVIDUAL WITH  CHRONIC
CONDITIONS TO A PROVIDER OF HEALTH HOME SERVICES.
  2.  IN  ADDITION TO PAYMENTS MADE FOR HEALTH HOME SERVICES PURSUANT TO
SUBDIVISION ONE OF THIS SECTION, THE COMMISSIONER IS AUTHORIZED  TO  PAY
ADDITIONAL  AMOUNTS TO PROVIDERS OF HEALTH HOME SERVICES THAT MEET PROC-
ESS OR OUTCOME STANDARDS SPECIFIED BY THE COMMISSIONER.
  3. UNTIL SUCH TIME  AS  THE  COMMISSIONER  OBTAINS  NECESSARY  WAIVERS
AND/OR  APPROVALS OF THE FEDERAL SOCIAL SECURITY ACT, MEDICAID ENROLLEES
ASSIGNED TO PROVIDERS OF HEALTH HOME SERVICES WILL BE ALLOWED TO OPT OUT
OF SUCH SERVICES.  IN ADDITION, UPON ENROLLMENT, AN  ENROLLEE  SHALL  BE
OFFERED  AN OPTION OF AT LEAST TWO PROVIDERS OF HEALTH HOME SERVICES, TO
THE EXTENT PRACTICABLE.
  4. PAYMENTS AUTHORIZED PURSUANT TO THIS  SECTION  WILL  BE  MADE  WITH
STATE  FUNDS ONLY, TO THE EXTENT THAT SUCH FUNDS ARE APPROPRIATED THERE-

S. 2809--D                         132                        A. 4009--D

FORE, UNTIL SUCH TIME AS FEDERAL FINANCIAL PARTICIPATION IN THE COSTS OF
SUCH SERVICES IS AVAILABLE.
  5.  THE  COMMISSIONER  IS AUTHORIZED TO SUBMIT AMENDMENTS TO THE STATE
PLAN FOR MEDICAL ASSISTANCE AND/OR SUBMIT ONE OR MORE  APPLICATIONS  FOR
WAIVERS  OF THE FEDERAL SOCIAL SECURITY ACT, TO OBTAIN FEDERAL FINANCIAL
PARTICIPATION IN THE COSTS OF HEALTH HOME SERVICES PROVIDED PURSUANT  TO
THIS SECTION, AND AS PROVIDED IN SUBDIVISION THREE OF THIS SECTION.
  6.  NOTWITHSTANDING  ANY  LIMITATIONS IMPOSED BY SECTION THREE HUNDRED
SIXTY-FOUR-L OF THIS TITLE ON ENTITIES  PARTICIPATING  IN  DEMONSTRATION
PROJECTS  ESTABLISHED  PURSUANT  TO  SUCH  SECTION,  THE COMMISSIONER IS
AUTHORIZED TO ALLOW SUCH ENTITIES WHICH MEET THE  REQUIREMENTS  OF  THIS
SECTION TO PROVIDE HEALTH HOME SERVICES.
  7.  NOTWITHSTANDING  ANY LAW, RULE, OR REGULATION TO THE CONTRARY, THE
COMMISSIONERS OF THE DEPARTMENT OF HEALTH, THE OFFICE OF MENTAL  HEALTH,
THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, AND THE OFFICE OF
ALCOHOLISM AND SUBSTANCE ABUSE SERVICES ARE AUTHORIZED TO JOINTLY ESTAB-
LISH  A  SINGLE SET OF OPERATING AND REPORTING REQUIREMENTS AND A SINGLE
SET OF CONSTRUCTION AND SURVEY REQUIREMENTS FOR ENTITIES THAT:
  (A) CAN DEMONSTRATE EXPERIENCE IN THE DELIVERY OF HEALTH,  AND  MENTAL
HEALTH  AND/OR  ALCOHOL  AND SUBSTANCE ABUSE SERVICES AND/OR SERVICES TO
PERSONS WITH DEVELOPMENTAL DISABILITIES, AND THE CAPACITY TO OFFER INTE-
GRATED DELIVERY OF SUCH  SERVICES  IN  EACH  LOCATION  APPROVED  BY  THE
COMMISSIONER; AND
  (B) MEET THE STANDARDS ESTABLISHED PURSUANT TO SUBDIVISION ONE OF THIS
SECTION  FOR  PROVIDING  AND RECEIVING PAYMENT FOR HEALTH HOME SERVICES;
PROVIDED, HOWEVER, THAT AN  ENTITY  MEETING  THE  STANDARDS  ESTABLISHED
PURSUANT  TO SUBDIVISION ONE OF THIS SECTION SHALL NOT BE REQUIRED TO BE
AN INTEGRATED SERVICE PROVIDER PURSUANT TO THIS SUBDIVISION.
  IN ESTABLISHING A SINGLE SET OF OPERATING AND  REPORTING  REQUIREMENTS
AND  A  SINGLE  SET OF CONSTRUCTION AND SURVEY REQUIREMENTS FOR ENTITIES
DESCRIBED IN THIS SUBDIVISION, THE COMMISSIONERS OF  THE  DEPARTMENT  OF
HEALTH, THE OFFICE OF MENTAL HEALTH, THE OFFICE FOR PEOPLE WITH DEVELOP-
MENTAL  DISABILITIES,  AND  THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE
SERVICES ARE AUTHORIZED TO WAIVE  ANY  REGULATORY  REQUIREMENTS  AS  ARE
NECESSARY  TO  AVOID  DUPLICATION OF REQUIREMENTS AND TO ALLOW THE INTE-
GRATED DELIVERY OF SERVICES IN A RATIONAL AND EFFICIENT MANNER.
  8. (A) THE COMMISSIONER OF HEALTH IS AUTHORIZED TO CONTRACT  WITH  ONE
OR  MORE  ENTITIES TO ASSIST THE STATE IN IMPLEMENTING THE PROVISIONS OF
THIS SECTION. SUCH ENTITY OR ENTITIES SHALL BE THE SAME ENTITY OR  ENTI-
TIES  CHOSEN  TO  ASSIST IN THE IMPLEMENTATION OF THE MULTIPAYOR PATIENT
CENTERED MEDICAL HOME PROGRAM PURSUANT TO  SECTION  TWENTY-NINE  HUNDRED
FIFTY-NINE-A  OF THE PUBLIC HEALTH LAW. RESPONSIBILITIES OF THE CONTRAC-
TOR SHALL INCLUDE BUT NOT BE LIMITED TO: DEVELOPING RECOMMENDATIONS WITH
RESPECT TO PROGRAM POLICY, REIMBURSEMENT, SYSTEM REQUIREMENTS, REPORTING
REQUIREMENTS, EVALUATION PROTOCOLS, AND PROVIDER AND PATIENT ENROLLMENT;
PROVIDING TECHNICAL ASSISTANCE TO POTENTIAL MEDICAL HOME AND HEALTH HOME
PROVIDERS; DATA COLLECTION; DATA SHARING; PROGRAM EVALUATION, AND PREPA-
RATION OF REPORTS.
  (B) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR  SECTION
ONE HUNDRED FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR ANY OTHER LAW,
THE  COMMISSIONER  OF  HEALTH  IS AUTHORIZED TO ENTER INTO A CONTRACT OR
CONTRACTS UNDER PARAGRAPH (A) OF THIS SUBDIVISION WITHOUT A  COMPETITIVE
BID OR REQUEST FOR PROPOSAL PROCESS, PROVIDED, HOWEVER, THAT:
  (I)  THE  DEPARTMENT OF HEALTH SHALL POST ON ITS WEBSITE, FOR A PERIOD
OF NO LESS THAN THIRTY DAYS:

S. 2809--D                         133                        A. 4009--D

  (1) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT  TO
THE CONTRACT OR CONTRACTS;
  (2) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (3)  THE PERIOD OF TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY SEEK
SELECTION, WHICH SHALL BE NO LESS THAN THIRTY DAYS AFTER  SUCH  INFORMA-
TION IS FIRST POSTED ON THE WEBSITE; AND
  (4)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR  MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (II) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
COMMISSIONER OF HEALTH; AND
  (III) THE COMMISSIONER OF  HEALTH  SHALL  SELECT  SUCH  CONTRACTOR  OR
CONTRACTORS THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE
PURPOSES OF THIS SECTION.
  S  38.  Section 2816 of the public health law, as added by chapter 225
of the laws of 2001, paragraph  (a)  of  subdivision  2  as  amended  by
section  19  of  part D of chapter 57 of the laws of 2006, is amended to
read as follows:
  S 2816. Statewide planning and research cooperative system.  1.    (A)
The statewide planning and research cooperative system in the department
is continued, as provided in AND SUBJECT TO this section, WITHIN AMOUNTS
APPROPRIATED  FOR  THAT  PURPOSE.   The [statewide planning and research
cooperative] system shall be developed and operated by the  commissioner
in  consultation  with the council, [and shall be comprised of such data
elements] as may be specified by regulation OF THE  COMMISSIONER.    ANY
COMPONENT  OR COMPONENTS OF THE SYSTEM MAY BE OPERATED UNDER A DIFFERENT
NAME OR NAMES, AND MAY BE STRUCTURED  AS  SEPARATE  SYSTEMS.  IN  MAKING
REGULATIONS  UNDER THIS SECTION, SUBSEQUENT TO APRIL FIRST, TWO THOUSAND
ELEVEN, THE COMMISSIONER SHALL CONSULT WITH THE SUPERINTENDENT OF INSUR-
ANCE OR THE HEAD OF ANY AGENCY THAT SUCCEEDS THE  INSURANCE  DEPARTMENT,
HEALTH  CARE  PROVIDERS,  THIRD-PARTY  HEALTH CARE PAYERS, AND ADVOCATES
REPRESENTING PATIENTS; PROTECT THE CONFIDENTIALITY OF PATIENT-IDENTIFIA-
BLE INFORMATION; PROMOTE THE ACCURACY AND COMPLETENESS OF REPORTING; AND
MINIMIZE THE BURDEN ON INSTITUTIONAL AND NON-INSTITUTIONAL  HEALTH  CARE
PROVIDERS AND THIRD-PARTY HEALTH CARE PAYERS.
  (B)  AS  USED  IN  THIS  SECTION,  UNLESS THE CONTEXT CLEARLY REQUIRES
OTHERWISE:
  (I)  "HEALTH  CARE"  MEANS  ANY  SERVICES,  SUPPLIES,  EQUIPMENT,   OR
PRESCRIPTION DRUGS REFERRED TO IN SUBDIVISION TWO OF THIS SECTION.
  (II)  "HEALTH CARE PROVIDER" INCLUDES, IN ADDITION TO ITS COMMON MEAN-
INGS, A CLINICAL LABORATORY, A PHARMACY, AN ENTITY THAT IS AN INTEGRATED
ORGANIZATION OF HEALTH CARE PROVIDERS, AND AN ACCOUNTABLE CARE ORGANIZA-
TION OF HEALTH CARE PROVIDERS.
  (III) "SYSTEM" MEANS THE STATEWIDE PLANNING AND  RESEARCH  COOPERATIVE
SYSTEM  UNDER  THIS SECTION, AND ANY SEPARATE SYSTEM UNDER THIS SUBDIVI-
SION.
  (IV) "THIRD-PARTY HEALTH CARE PAYER" INCLUDES, BUT IS NOT LIMITED  TO,
AN  INSURER,  ORGANIZATION OR CORPORATION LICENSED OR CERTIFIED PURSUANT
TO ARTICLE THIRTY-TWO, FORTY-THREE OR FORTY-SEVEN OF THE INSURANCE  LAW,
OR  ARTICLE  FORTY-FOUR OF THE PUBLIC HEALTH LAW; OR AN ENTITY SUCH AS A
PHARMACY  BENEFITS  MANAGER,  FISCAL  ADMINISTRATOR,  OR  ADMINISTRATIVE
SERVICES   PROVIDER   THAT  PARTICIPATES  IN  THE  ADMINISTRATION  OF  A
THIRD-PARTY HEALTH CARE PAYER SYSTEM.
  (V) "COVERED PERSON" IS A PERSON COVERED UNDER  A  THIRD-PARTY  HEALTH
CARE PAYER CONTRACT, AGREEMENT, OR ARRANGEMENT.

S. 2809--D                         134                        A. 4009--D

  2. [Regulations] NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY,
REGULATIONS  governing the [statewide planning and research cooperative]
system shall include, but not be limited to, the following:
  (a)  Specification  of patient, COVERED PERSON, CLAIMS, and other data
elements and format [to] WHICH SHALL be reported including data  related
to:
  (i) inpatient hospitalization data from general hospitals;
  (ii)  ambulatory  surgery  data from hospital-based ambulatory surgery
services and all other ambulatory surgery facilities licensed under this
article;
  (iii) emergency department data from general hospitals;
  (iv) outpatient [clinic], CLINICAL LABORATORY, AND PRESCRIPTION  DATA,
INCLUDING  BUT  NOT  LIMITED  TO  data  from  OR  RELATING  TO SERVICES,
SUPPLIES, EQUIPMENT, AND  PRESCRIPTION  DRUGS  PROVIDED  OR  ORDERED  BY
general  hospitals  and  diagnostic and treatment centers licensed under
this article, [provided, however, that notwithstanding  subdivision  one
of  this  section the commissioner, in consultation with the health care
industry, is authorized to promulgate or adopt any rules or  regulations
necessary  to implement the collection of data pursuant to this subpara-
graph] PHARMACIES, CLINICAL LABORATORIES, AND OTHER HEALTH CARE  PROVID-
ERS;
  (v) COVERED PERSON AND CLAIMS DATA; and
  (VI)  the data specified in this paragraph shall include the identifi-
cation of patients transferred, admitted  or  treated  subsequent  to  a
medical,  surgical  or  diagnostic  procedure  by a licensed health care
professional OR at a HEALTH CARE site  or  facility  [other  than  those
specified in subparagraph (i), (ii), (iii) or (iv) of this paragraph].
  (b)  Standards  to  assure  the  protection of patient privacy in data
collected [and], PUBLISHED, released  [under  this  section],  USED  AND
ACCESSED UNDER THIS SECTION, INCLUDING COMPLIANCE WITH APPLICABLE FEDER-
AL LAW.
  (c)  Standards  for  the  publication  [and],  release, AND USE of AND
ACCESS TO data reported in accordance with this section, INCLUDING  FEES
TO BE CHARGED.
  (D)   PROVISIONS   REQUIRING   SPECIFIED  HEALTH  CARE  PROVIDERS  AND
THIRD-PARTY HEALTH CARE PAYERS TO REPORT DATA TO THE SYSTEM, WITH  SPEC-
IFICATIONS  OF  THE  DATA,  CIRCUMSTANCES,  FORMAT,  TIME  AND METHOD OF
REPORTING.
  (E) PROVISIONS TO ACQUIRE DATA RELATING TO HEALTH CARE PROVIDED (I) TO
PATIENTS FOR WHOM THERE IS NO THIRD-PARTY HEALTH  CARE  PAYER  AND  (II)
UNDER ARRANGEMENTS THAT DO NOT INVOLVE FEE-FOR-SERVICE PAYMENT.
  (F) PHASED-IN IMPLEMENTATION OF THE SYSTEM.
  3.  THE COMMISSIONER MAY PROVIDE THAT THE SYSTEM MAY PARTICIPATE IN OR
COOPERATE WITH A SIMILAR SYSTEM OPERATED BY, OR RECEIVE INFORMATION FROM
OR PROVIDE INFORMATION TO, A REGIONAL  OR  NATIONAL  ENTITY  OR  ANOTHER
JURISDICTION,  INCLUDING  MAKING APPROPRIATE AGREEMENTS AND APPLYING FOR
APPROVALS, PROVIDED THAT THE  PROTECTIONS  FOR  HEALTH  CARE  PROVIDERS,
PATIENTS,  AND  THIRD-PARTY  HEALTH  CARE  PAYERS  IN  THIS  SECTION ARE
PRESERVED AND COMPARABLE PROVISIONS ARE INCLUDED IN THE OTHER SYSTEM.
  4. THE COMMISSIONER MAY PROVIDE FOR ACCESS TO DATA IN THE SYSTEM BY  A
HEALTH  CARE  PROVIDER RELATING TO A PATIENT BEING TREATED BY THE HEALTH
CARE PROVIDER, SUBJECT TO THIS SECTION AND APPLICABLE STATE AND  FEDERAL
LAW.
  5.  IN  OPERATING THE SYSTEM, THE COMMISSIONER SHALL CONSIDER NATIONAL
STANDARDS, INCLUDING BUT NOT LIMITED TO THOSE APPROVED BY  THE  NATIONAL
UNIFORM  BILLING  COMMITTEE (NUBC) OR REQUIRED UNDER NATIONAL ELECTRONIC

S. 2809--D                         135                        A. 4009--D

DATA INTERCHANGE (EDI)  STANDARDS  FOR  HEALTH  CARE  TRANSACTIONS.  THE
COMMISSIONER  SHALL ALSO CONSIDER THE USE OF THE STATEWIDE HEALTH INFOR-
MATION NETWORK FOR NEW YORK IN RELATION TO THE SYSTEM.
  6.  NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW TO THE CONTRARY,
INCLUDING BUT NOT LIMITED TO SECTION ONE HUNDRED TWO  OF  THE  EXECUTIVE
LAW,  SUCH RULES AND REGULATIONS MAY DESCRIBE DATA ELEMENTS BY REFERENCE
TO INFORMATION REASONABLY AVAILABLE TO REGULATED PARTIES, AS SUCH  MATE-
RIAL  MAY  BE AMENDED IN THE FUTURE, EVEN THOUGH SUCH MATERIAL CANNOT BE
PRECISELY IDENTIFIED TO THE EXTENT THAT IT IS  AMENDED  IN  THE  FUTURE;
PROVIDED,  HOWEVER,  THAT  THE COMMISSIONER SHALL PRECISELY IDENTIFY AND
PUBLISH SUCH DATA ELEMENTS.
  7. THE COMMISSIONER MAY CONTRACT WITH ONE OR MORE ENTITIES TO  OPERATE
ANY PART OF THE SYSTEM SUBJECT TO THIS SECTION.
  8.  THE COMMISSIONER MAY ACCEPT GRANTS AND ENTER INTO CONTRACTS AS MAY
BE NECESSARY TO PROVIDE FUNDING FOR THE SYSTEM.
  9. THE COMMISSIONER SHALL PUBLISH AN ANNUAL REPORT RELATING TO  HEALTH
CARE  UTILIZATION,  COST,  QUALITY, AND SAFETY, INCLUDING DATA ON HEALTH
DISPARITIES.
  S 38-a. Paragraph (b) of subdivision 18-a of section 206 of the public
health law, as added by section 11 of part A of chapter 58 of  the  laws
of 2010, is amended to read as follows:
  (b)  The  commissioner shall make such rules and regulations as may be
necessary to implement federal policies and disburse funds  as  required
by the American Recovery and Reinvestment Act of 2009 and to promote the
development  of  a  statewide  health  information  network  of New York
(SHIN-NY) to enable widespread interoperability among  disparate  health
information  systems,  including  electronic  health  records,  personal
health records, HEALTH CARE CLAIMS AND OTHER  ADMINISTRATIVE  DATA,  and
public  health information systems, while protecting privacy and securi-
ty. Such rules and regulations shall include, but  not  be  limited  to,
requirements  for  organizations covered by 42 U.S.C. 17938 or any other
organizations that exchange health information through the SHIN-NY.
  S 39. The social services law is amended by adding a new section 363-e
to read as follows:
  S 363-E. MEDICAID PLAN, APPLICATIONS FOR WAIVERS AND PLAN  AMENDMENTS;
PUBLIC  DISCLOSURE.    1.  THE  COMMISSIONER OF HEALTH SHALL POST ON THE
DEPARTMENT OF HEALTH INTERNET WEBSITE IN AS TIMELY A MANNER AS PRACTICAL
THE ENTIRETY OF THE STATE'S PLAN FOR MEDICAL ASSISTANCE AS  REQUIRED  BY
TITLE  XIX  OF  THE  FEDERAL  SOCIAL SECURITY ACT, OR ITS SUCCESSOR, AND
EVERY APPROVED AMENDMENT AND CHANGE TO THE PLAN.
  2. THE COMMISSIONER OF HEALTH SHALL POST ON THE DEPARTMENT  OF  HEALTH
INTERNET  WEBSITE IN AS TIMELY A MANNER AS PRACTICAL:  EVERY APPLICATION
FOR A FEDERAL WAIVER AND EVERY PROPOSED STATE PLAN  AMENDMENT,  RELATING
TO  THE  STATE'S  PLAN  FOR MEDICAL ASSISTANCE, SUBMITTED TO THE FEDERAL
DEPARTMENT OF HEALTH AND HUMAN SERVICES, OR ANY SUCCESSOR AGENCY OR PART
THEREOF.
  S 40. Paragraph (u) of subdivision 2 of section 365-a  of  the  social
services  law,  as  amended by section 42 of part B of chapter 58 of the
laws of 2010, is amended to read as follows:
  (u) screening, brief  intervention,  and  referral  to  treatment  [in
hospital outpatient and emergency departments and free-standing diagnos-
tic  and  treatment  centers] of individuals at risk for substance abuse
including referral to the appropriate level of intervention  and  treat-
ment  in  a community setting; provided, however, that the provisions of
this paragraph relating to screening, brief intervention,  and  referral
to  treatment  services  shall  not  take  effect  unless  all necessary

S. 2809--D                         136                        A. 4009--D

approvals under federal law and regulation have been obtained to receive
federal financial participation in such costs.
  S  41.  Paragraphs (d) and (e) of subdivision 1 and paragraphs (c) and
(d) of subdivision 2 of section 4403-f of the public health  law,  para-
graph  (d) of subdivision 1 as amended by section 6 of part C of chapter
58 of the laws of 2007, paragraph (e) of subdivision  1  as  amended  by
section  65-d of part A of chapter 57 of the laws of 2006, paragraph (c)
of subdivision 2 as added by chapter 659 of the laws of 1997  and  para-
graph  (d) of subdivision 2 as amended by section 9 of part C of chapter
58 of the laws of 2007, and paragraphs (d) and (e) of subdivision  1  as
relettered by section 7 of part C of chapter 58 of the laws of 2007, are
amended to read as follows:
  (d)  ["Approved  managed long term care demonstration" means the sites
approved by the commissioner to participate in the  "Evaluated  Medicaid
Long Term Care Capitation Program".
  (e)]  "Health  and  long term care services" means services including,
but not limited to [primary care, acute care,] home and  community-based
and  institution-based long term care and ancillary services (that shall
include medical supplies and nutritional supplements) that are necessary
to meet the needs of persons whom the plan is authorized to enroll.  THE
MANAGED LONG TERM CARE PLAN MAY ALSO COVER PRIMARY CARE AND  ACUTE  CARE
IF SO AUTHORIZED.
  (c)  [a  description  that  demonstrates the cost-effectiveness of the
program as compared to the cost of services clients would otherwise have
received;
  (d)] adequate  documentation  of  the  appropriate  licenses,  certif-
ications  or  approvals  to provide care as planned, including contracts
with such providers as may be necessary to provide the  full  complement
of services required to be provided under this section.
  S  41-a.  Subdivision 3 of section 4403-f of the public health law, as
amended by chapter 627 of the laws  of  2008,  is  amended  to  read  as
follows:
  3.  Certificate  of  authority;  approval.  The commissioner shall not
approve an application for a certificate of authority unless the  appli-
cant demonstrates to the commissioner's satisfaction:
  (a) [the relative cost effectiveness to the medical assistance program
when  compared to other managed long term care plans proposing to serve,
or serving, comparable populations;
  (b)] that it will have in  place  acceptable  quality-assurance  mech-
anisms, grievance procedures, mechanisms to protect the rights of enrol-
lees  and case management services to ensure continuity, quality, appro-
priateness and coordination of care;
  [(c)] (B) that it will  include  an  enrollment  process  which  shall
ensure  that enrollment in the plan is informed [and voluntary by enrol-
lees or their representatives and a  voluntary  disenrollment  process].
The  application  shall [include the specific grounds that would warrant
involuntary disenrollment provided, however,] DESCRIBE THE DISENROLLMENT
PROCESS, WHICH SHALL PROVIDE THAT an otherwise eligible  enrollee  shall
not be involuntarily disenrolled on the basis of health status;
  [(d)] (C) satisfactory evidence of the character and competence of the
proposed  operators  and  reasonable  assurance  that the applicant will
provide high quality services to an enrolled population;
  [(e)] (D) sufficient management systems capacity to meet the  require-
ments of this section and the ability to efficiently process payment for
covered services;

S. 2809--D                         137                        A. 4009--D

  [(f)]  (E)  readiness  and  capability to [achieve full capitation for
services reimbursed pursuant to title XVIII of the federal social  secu-
rity  act or, for an applicant designated as an eligible applicant prior
to April first, two thousand seven pursuant to paragraph (d) of subdivi-
sion  six  of  this  section that has its principal place of business in
Bronx county and is unable to achieve such  full  capitation,  readiness
and  capability  to  achieve  full  capitation on a scheduled basis for]
MAXIMIZE REIMBURSEMENT OF AND COORDINATE services reimbursed pursuant to
title XVIII of the federal social security act [or capability and proto-
cols for benefit coordination for services reimbursed pursuant  to  such
title] and all other applicable benefits, with such benefit coordination
including,  but not limited to, measures to support sound clinical deci-
sions, reduce administrative complexity, coordinate access to  services,
maximize  benefits  available  pursuant  to  such  title and ensure that
necessary care is provided;
  [(g)] (F) readiness and capability to [achieve  full  capitation  for]
ARRANGE  AND MANAGE COVERED SERVICES AND COORDINATE NON-COVERED SERVICES
WHICH COULD INCLUDE PRIMARY, SPECIALTY, AND ACUTE  CARE  services  reim-
bursed pursuant to title XIX of the federal social security act;
  [(h)] (G) willingness and capability of taking, or cooperating in, all
steps necessary to secure and integrate any potential sources of funding
for services provided by the managed long term care plan, including, but
not limited to, funding available under titles XVI, XVIII, XIX and XX of
the  federal  social  security  act,  the federal older Americans act of
nineteen hundred sixty-five, as amended,  or  any  successor  provisions
subject  to  approval of the director of the state office for aging, and
through financing options such as those authorized pursuant  to  section
three hundred sixty-seven-f of the social services law;
  [(i)]  (H)  that  the CONTRACTUAL arrangements for PROVIDERS OF health
and long term care services IN THE BENEFIT  PACKAGE  ARE  SUFFICIENT  TO
ensure  the  availability  and  accessibility  of  such  services to the
proposed enrolled population CONSISTENT WITH GUIDELINES  ESTABLISHED  BY
THE  COMMISSIONER;  WITH  RESPECT  TO  INDIVIDUALS  IN  RECEIPT  OF SUCH
SERVICES PRIOR TO ENROLLMENT, SUCH GUIDELINES SHALL REQUIRE THE  MANAGED
LONG  TERM  CARE PLAN TO CONTRACT WITH AGENCIES CURRENTLY PROVIDING SUCH
SERVICES, IN ORDER TO PROMOTE CONTINUITY OF CARE.    IN  ADDITION,  SUCH
GUIDELINES SHALL REQUIRE MANAGED LONG TERM CARE PLANS TO OFFER AND COVER
CONSUMER  DIRECTED PERSONAL ASSISTANCE SERVICES FOR ELIGIBLE INDIVIDUALS
WHO ELECT SUCH SERVICES PURSUANT TO SECTION THREE  HUNDRED  SIXTY-FIVE-F
OF THE SOCIAL SERVICES LAW; and
  [(j)]  (I)  that  the  applicant is financially responsible and may be
expected to meet its obligations to its enrolled members.
  S 41-b. Subdivisions 5, 6, 7 and 10 of section 4403-f  of  the  public
health  law, subdivision 5 as amended by section 15 of part C of chapter
58 of the laws of 2007, subdivisions 6 and 7 as added by chapter 659  of
the  laws  of  1997,  paragraphs  (a),  (b)  and (c) of subdivision 6 as
amended by section 6 of part C of chapter 58 of the laws of 2010,  para-
graph (d) of subdivision 6 as amended by section 17 of part C of chapter
58  of  the  laws  of  2007,  paragraphs (c) and (d) of subdivision 7 as
amended by section 18 of part C of chapter 58 of the laws of 2007, para-
graphs (e) and (g) of subdivision 7 as relettered by section 20 of  part
C  of  chapter 58 of the laws of 2007, paragraph (h) of subdivision 7 as
added by section 65-c of part A of chapter 57 of the laws of 2006, para-
graph (i) as added by section 65-f of part A of chapter 57 of  the  laws
of  2006, and such paragraphs (h) and (i) as relettered by section 20 of
part C of chapter 58 of the laws of 2007, paragraph (f) of subdivision 7

S. 2809--D                         138                        A. 4009--D

as amended by section 7 of part C of chapter 58 of  the  laws  of  2010,
subparagraph  (iii)  of  paragraph  (h)  of  subdivision 7 as amended by
section 19 of part C of chapter 58 of the laws of 2007,  subdivision  10
as  amended by chapter 192 of the laws of 2006 and renumbered by section
22 of part C of chapter 58 of the laws of 2007, are amended to  read  as
follows:
  5.  Applicability  of  other  laws.  A managed long term care plan [or
approved managed long term care demonstration] shall be subject  to  the
provisions  of  the  insurance  law and regulations applicable to health
maintenance organizations,  this  article  and  regulations  promulgated
pursuant  thereto. To the extent that the provisions of this section are
inconsistent with the provisions of this chapter or  the  provisions  of
the insurance law, the provisions of this section shall prevail.
  6. Approval authority.  (a) An applicant shall be issued a certificate
of  authority  as  a managed long term care plan upon a determination by
the commissioner that the applicant complies with the operating require-
ments for a managed long term care plan under this section. The  commis-
sioner  shall  issue  no  more than [fifty] SEVENTY-FIVE certificates of
authority to managed long term care plans pursuant to this section. [For
purposes of issuance of no more than fifty  certificates  of  authority,
such  certificates  shall  include those certificates issued pursuant to
paragraphs (b) and (c) of this subdivision.]
  (b) An operating  demonstration  shall  be  issued  a  certificate  of
authority  as  a managed long term care plan upon a determination by the
commissioner  that  such  demonstration  complies  with  the   operating
requirements  for  a  managed  long  term  care plan under this section.
[Except as otherwise expressly provided in paragraphs  (d)  and  (e)  of
subdivision  seven  of  this  section,  nothing] NOTHING in this section
shall be construed to affect the continued legal authority of an operat-
ing demonstration to operate its previously approved program.
  (c) [An approved managed long term care demonstration shall be  issued
a  certificate  of  authority  as  a  managed long term care plan upon a
determination by the commissioner that such demonstration complies  with
the  operating requirements for a managed long term care plan under this
section. Notwithstanding  any  inconsistent  provision  of  law  to  the
contrary,  all authority for the operation of approved managed long term
care demonstrations which have not been issued a certificate of authori-
ty as a managed long term care plan, shall expire  one  year  after  the
adoption of regulations implementing managed long term care plans.
  (d)  The majority leader of the senate and the speaker of the assembly
may each designate in writing up to fifteen eligible applicants to apply
to be approved managed long  term  care  demonstrations  or  plans.  The
commissioner  may  designate in writing up to eleven eligible applicants
to apply to be approved managed long term care demonstrations or plans.]
FOR THE PERIOD BEGINNING APRIL FIRST, TWO  THOUSAND  TWELVE  AND  ENDING
MARCH  THIRTY-FIRST,  TWO  THOUSAND  FIFTEEN, THE MAJORITY LEADER OF THE
SENATE AND THE SPEAKER OF THE ASSEMBLY MAY EACH RECOMMEND TO THE COMMIS-
SIONER, IN WRITING, UP TO FOUR ELIGIBLE  APPLICANTS  TO  CONVERT  TO  BE
APPROVED  MANAGED  LONG  TERM  CARE  PLANS.  AN  APPLICANT SHALL ONLY BE
APPROVED AND ISSUED A  CERTIFICATE  OF  AUTHORITY  IF  THE  COMMISSIONER
DETERMINES  THAT  THE  APPLICANT  MEETS  THE REQUIREMENTS OF SUBDIVISION
THREE OF THIS SECTION. THE MAJORITY LEADER OF THE SENATE OR THE  SPEAKER
OF  THE  ASSEMBLY  MAY  ASSIGN  THEIR AUTHORITY TO RECOMMEND ONE OR MORE
APPLICANTS UNDER THIS SECTION TO THE COMMISSIONER.
  7. Program oversight and administration. (a)(i) The commissioner shall
promulgate regulations to implement this section and to ensure the qual-

S. 2809--D                         139                        A. 4009--D

ity, appropriateness and cost-effectiveness of the services provided  by
managed long term care plans. The commissioner may waive rules and regu-
lations  of the department, including but not limited to, those pertain-
ing  to  duplicative  requirements  concerning record keeping, boards of
directors, staffing and reporting, when such  waiver  will  promote  the
efficient  delivery of appropriate, quality, cost-effective services and
when the health, safety and general welfare of  enrollees  will  not  be
impaired  as  a  result of such waiver. In order to achieve managed long
term care plan system efficiencies and coordination and to  promote  the
objectives  of  high  quality,  integrated  and cost effective care, the
commissioner may establish a single  coordinated  surveillance  process,
allow for a comprehensive quality improvement and review process to meet
component  quality  requirements, and require a uniform cost report. The
commissioner shall require managed long term care plans to utilize qual-
ity improvement measures, based on health outcomes  data,  for  internal
quality  assessment  processes  and may utilize such measures as part of
the single coordinated surveillance process.
  (ii) Notwithstanding any inconsistent provision of the social services
law to the contrary, the commissioner  shall,  pursuant  to  regulation,
determine  whether  and the extent to which the applicable provisions of
the social services law or regulations relating to approvals and author-
izations of, and utilization limitations on, health and long  term  care
services reimbursed pursuant to title XIX of the federal social security
act,  including, but not limited to, fiscal assessment requirements, are
inconsistent with the flexibility necessary for the  efficient  adminis-
tration  of  managed  long  term  care  plans and such regulations shall
provide that such provisions shall not be  applicable  to  enrollees  or
managed  long  term  care  plans,  provided that such determinations are
consistent with applicable federal law and regulation.
  (b) (I) The commissioner shall, to the extent  necessary,  submit  the
appropriate  waivers,  including,  but  not limited to, those authorized
pursuant to sections eleven hundred fifteen and nineteen hundred fifteen
of the federal social security act, or  successor  provisions,  and  any
other  waivers  necessary to achieve the purposes of high quality, inte-
grated, and cost effective care  and  integrated  financial  eligibility
policies under the medical assistance program or pursuant to title XVIII
of  the  federal  social  security act. IN ADDITION, THE COMMISSIONER IS
AUTHORIZED TO SUBMIT THE APPROPRIATE WAIVERS, INCLUDING BUT NOT  LIMITED
TO  THOSE  AUTHORIZED  PURSUANT  TO  SECTIONS ELEVEN HUNDRED FIFTEEN AND
NINETEEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT OR SUCCESSOR
PROVISIONS, AND ANY OTHER WAIVERS NECESSARY TO REQUIRE ON OR AFTER APRIL
FIRST, TWO THOUSAND TWELVE, MEDICAL ASSISTANCE RECIPIENTS WHO ARE  TWEN-
TY-ONE  YEARS  OF AGE OR OLDER AND WHO REQUIRE COMMUNITY-BASED LONG TERM
CARE SERVICES, AS SPECIFIED BY  THE  COMMISSIONER,  FOR  MORE  THAN  ONE
HUNDRED  AND  TWENTY DAYS, TO RECEIVE SUCH SERVICES THROUGH AN AVAILABLE
PLAN CERTIFIED PURSUANT TO THIS SECTION  OR  OTHER  PROGRAM  MODEL  THAT
MEETS GUIDELINES SPECIFIED BY THE COMMISSIONER THAT SUPPORT COORDINATION
AND  INTEGRATION OF SERVICES. SUCH GUIDELINES SHALL ADDRESS THE REQUIRE-
MENTS OF PARAGRAPHS (A), (B), (C), (D), (E), (F), (G), (H), AND  (I)  OF
SUBDIVISION THREE OF THIS SECTION AS WELL AS PAYMENT METHODS THAT ENSURE
PROVIDER  ACCOUNTABILITY FOR COST EFFECTIVE QUALITY OUTCOMES. SUCH OTHER
PROGRAM MODELS MAY INCLUDE LONG TERM  HOME  HEALTH  CARE  PROGRAMS  THAT
COMPLY WITH SUCH GUIDELINES. Copies of such original waiver applications
AND AMENDMENTS THERETO shall be provided to the [chairman] CHAIRS of the
senate  finance  committee  [and the chairman of], the assembly ways and

S. 2809--D                         140                        A. 4009--D

means committee AND THE SENATE AND ASSEMBLY HEALTH COMMITTEES simultane-
ously with their submission to the federal government.
  (II)  THE  COMMISSIONER, SHALL SEEK INPUT FROM REPRESENTATIVES OF HOME
AND COMMUNITY-BASED LONG TERM CARE SERVICES PROVIDERS,  RECIPIENTS,  AND
THE  MEDICAID  MANAGED  CARE  ADVISORY  REVIEW  PANEL,  AMONG OTHERS, TO
FURTHER EVALUATE AND PROMOTE THE TRANSITION OF  PERSONS  IN  RECEIPT  OF
HOME  AND COMMUNITY-BASED LONG TERM CARE SERVICES INTO MANAGED LONG TERM
CARE PLANS AND OTHER CARE COORDINATION MODELS AND TO DEVELOP  GUIDELINES
FOR SUCH CARE COORDINATION MODELS. THE GUIDELINES SHALL BE FINALIZED AND
POSTED  ON  THE DEPARTMENT'S WEBSITE NO LATER THAN NOVEMBER FIFTEEN, TWO
THOUSAND ELEVEN.
  (III) MEDICAL ASSISTANCE RECIPIENTS WHO ARE NATIVE AMERICANS SHALL NOT
BE REQUIRED TO ENROLL IN A MANAGED LONG TERM CARE  PLAN  OR  OTHER  CARE
COORDINATION MODEL PURSUANT TO THIS PARAGRAPH.
  (IV) THE FOLLOWING MEDICAL ASSISTANCE RECIPIENTS SHALL NOT BE ELIGIBLE
TO PARTICIPATE IN A MANAGED LONG TERM CARE PROGRAM OR OTHER CARE COORDI-
NATION MODEL ESTABLISHED PURSUANT TO THIS PARAGRAPH:
  (1) A PERSON WHO IS EXPECTED TO BE ELIGIBLE FOR MEDICAL ASSISTANCE FOR
LESS  THAN SIX MONTHS, FOR A REASON OTHER THAN THAT THE PERSON IS ELIGI-
BLE FOR MEDICAL ASSISTANCE ONLY THROUGH THE APPLICATION OF EXCESS INCOME
TOWARD THE COST OF MEDICAL CARE AND SERVICES;
  (2) A PERSON WHO IS ELIGIBLE FOR MEDICAL ASSISTANCE BENEFITS ONLY WITH
RESPECT TO TUBERCULOSIS-RELATED SERVICES;
  (3) A PERSON RECEIVING HOSPICE SERVICES AT TIME OF ENROLLMENT;
  (4) A PERSON WHO HAS PRIMARY MEDICAL OR HEALTH CARE COVERAGE AVAILABLE
FROM OR UNDER A THIRD-PARTY PAYOR WHICH MAY BE MAINTAINED BY PAYMENT, OR
PART PAYMENT, OF THE PREMIUM OR COST SHARING AMOUNTS,  WHEN  PAYMENT  OF
SUCH  PREMIUM OR COST SHARING AMOUNTS WOULD BE COST-EFFECTIVE, AS DETER-
MINED BY THE SOCIAL SERVICES DISTRICT;
  (5) A PERSON RECEIVING FAMILY PLANNING SERVICES PURSUANT  TO  SUBPARA-
GRAPH  ELEVEN  OF  PARAGRAPH  (A)  OF  SUBDIVISION  ONE OF SECTION THREE
HUNDRED SIXTY-SIX OF THE SOCIAL SERVICES LAW;
  (6) A PERSON WHO IS ELIGIBLE FOR MEDICAL ASSISTANCE PURSUANT TO  PARA-
GRAPH  (V) OF SUBDIVISION FOUR OF SECTION THREE HUNDRED SIXTY-SIX OF THE
SOCIAL SERVICES LAW.
  (V) THE FOLLOWING MEDICAL ASSISTANCE RECIPIENTS SHALL NOT BE  ELIGIBLE
TO PARTICIPATE IN A MANAGED LONG TERM CARE PROGRAM OR OTHER CARE COORDI-
NATION  MODEL  ESTABLISHED  PURSUANT  TO  THIS  PARAGRAPH  UNTIL PROGRAM
FEATURES AND REIMBURSEMENT RATES ARE APPROVED BY THE  COMMISSIONER  AND,
AS APPLICABLE, THE COMMISSIONER OF DEVELOPMENTAL DISABILITIES:
  (1) A PERSON ENROLLED IN A MANAGED CARE PLAN PURSUANT TO SECTION THREE
HUNDRED SIXTY-FOUR-J OF THE SOCIAL SERVICES LAW;
  (2) A PARTICIPANT IN THE TRAUMATIC BRAIN INJURY WAIVER PROGRAM;
  (3)  A PARTICIPANT IN THE NURSING HOME TRANSITION AND DIVERSION WAIVER
PROGRAM;
  (4) A PERSON ENROLLED IN THE ASSISTED LIVING PROGRAM;
  (5) A PERSON ENROLLED IN HOME  AND  COMMUNITY  BASED  WAIVER  PROGRAMS
ADMINISTERED BY THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES.
  (VI)  PERSONS REQUIRED TO ENROLL IN THE MANAGED LONG TERM CARE PROGRAM
OR OTHER CARE COORDINATION MODEL ESTABLISHED PURSUANT TO THIS  PARAGRAPH
SHALL  HAVE  NO LESS THAN THIRTY DAYS TO SELECT A MANAGED LONG TERM CARE
PROVIDER, AND SHALL BE PROVIDED WITH INFORMATION  TO  MAKE  AN  INFORMED
CHOICE.  WHERE  A  PARTICIPANT  HAS  NOT  SELECTED  SUCH A PROVIDER, THE
COMMISSIONER SHALL ASSIGN SUCH PARTICIPANT TO A MANAGED LONG  TERM  CARE
PROVIDER,  TAKING INTO ACCOUNT QUALITY, CAPACITY AND GEOGRAPHIC ACCESSI-
BILITY.

S. 2809--D                         141                        A. 4009--D

  (VII) MANAGED LONG TERM CARE PROVIDED AND  PLANS  CERTIFIED  OR  OTHER
CARE  COORDINATION  MODEL  ESTABLISHED  PURSUANT TO THIS PARAGRAPH SHALL
COMPLY WITH THE PROVISIONS OF PARAGRAPHS (D), (I), AND (T) AND  SUBPARA-
GRAPH  (III)  OF PARAGRAPH (A) AND SUBPARAGRAPH (IV) OF PARAGRAPH (E) OF
SUBDIVISION  FOUR  OF  SECTION  THREE HUNDRED SIXTY-FOUR-J OF THE SOCIAL
SERVICES LAW.
  (c)(i) A managed long term care plan shall not use deceptive or  coer-
cive  marketing  methods  to encourage participants to enroll. A managed
long term care plan shall not distribute marketing materials  to  poten-
tial  enrollees  before such materials have been approved by the commis-
sioner.
  (ii) The  commissioner  shall  ensure,  through  periodic  reviews  of
managed  long  term care plans, that enrollment was [a voluntary and] AN
informed choice; such plan has only enrolled persons whom it is  author-
ized  to  enroll,  and plan services are promptly available to enrollees
when appropriate. Such periodic reviews shall be made according to stan-
dards as determined by the commissioner in regulations.
  (d) Notwithstanding any provision of law, rule or  regulation  to  the
contrary,  the  commissioner  may issue a request for proposals to carry
out reviews of enrollment and assessment activities in managed long term
care plans and operating demonstrations with respect to enrollees eligi-
ble to receive services under title XIX of the federal  social  security
act  to  determine  if enrollment meets the requirements of subparagraph
(ii) of paragraph (c) of this subdivision; and that assessments of  such
enrollees'  health,  functional  and  other  status,  for the purpose of
adjusting premiums,  were  accurate.  [Evaluations  shall  address  each
bidder's  ability  to ensure that enrollments in such plans are promptly
reviewed and that medical assistance required to be  furnished  pursuant
to  title  eleven  of  article  five  of the social services law will be
appropriately furnished to the recipients for whom the local commission-
ers are responsible pursuant to section three hundred sixty-five of such
title and that plan implementation will be consistent  with  the  proper
and  efficient  administration  of  the  medical  assistance program and
managed long term care plans.]
  (e) The commissioner may, in his or her discretion for the purpose  of
protection  of enrollees, impose measures including, but not limited to,
bans on further enrollments  and  requirements  for  use  of  enrollment
brokers  until  any identified problems are resolved to the satisfaction
of the commissioner.
  (f) Continuation of a  certificate  of  authority  issued  under  this
section shall be contingent upon satisfactory performance by the managed
long  term  care  plan  in the delivery, continuity, accessibility, cost
effectiveness and quality of the services to enrolled  members;  compli-
ance  with  applicable  provisions  of  this section and rules and regu-
lations promulgated thereunder; the continuing fiscal  solvency  of  the
organization; and, federal financial participation in payments on behalf
of enrollees who are eligible to receive services under title XIX of the
federal social security act.
  (g)  [The  commissioner shall ensure that (i) a process exists for the
resolution of disputes concerning the accuracy of assessments  performed
pursuant  to  paragraphs  (d)  and (e) of this subdivision; and (ii) the
tasks described in paragraphs  (d)  and  (e)  of  this  subdivision  are
consistently administered.
  (h)]  (i)  Managed  long term care plans and demonstrations may enroll
eligible persons in the plan or demonstration upon the completion  of  a
comprehensive  assessment  that shall include, but not be limited to, an

S. 2809--D                         142                        A. 4009--D

evaluation of the  medical,  social  and  environmental  needs  of  each
prospective  enrollee  in such program. This assessment shall also serve
as the basis for the development and provision of an appropriate plan of
care  for  the  [prospective] enrollee. UPON APPROVAL OF FEDERAL WAIVERS
PURSUANT TO PARAGRAPH (B) OF  THIS  SUBDIVISION  WHICH  REQUIRE  MEDICAL
ASSISTANCE   RECIPIENTS  WHO  REQUIRE  COMMUNITY-BASED  LONG  TERM  CARE
SERVICES TO ENROLL IN A PLAN, AND UPON APPROVAL OF THE  COMMISSIONER,  A
PLAN  MAY ENROLL AN APPLICANT WHO IS CURRENTLY RECEIVING HOME AND COMMU-
NITY-BASED SERVICES AND COMPLETE  THE  COMPREHENSIVE  ASSESSMENT  WITHIN
THIRTY  DAYS  OF  ENROLLMENT  PROVIDED  THAT THE PLAN CONTINUES TO COVER
TRANSITIONAL CARE UNTIL SUCH TIME AS THE ASSESSMENT IS COMPLETED.
  (ii) The assessment shall be completed  by  a  representative  of  the
managed  long  term care plan or demonstration, in consultation with the
prospective enrollee's health  care  practitioner  AS  NECESSARY.    The
commissioner  shall prescribe the forms on which the assessment shall be
made.
  (iii) The [completed assessment and documentation of  the]  enrollment
APPLICATION  shall  be  submitted  by the managed long term care plan or
demonstration to the [local department  of  social  services,  or  to  a
contractor  selected  pursuant  to  paragraph  (d) of this subdivision,]
ENTITY DESIGNATED  BY  THE  DEPARTMENT  prior  to  the  commencement  of
services  under  the  managed  long term care plan or demonstration. For
purposes of reimbursement of the managed long term care plan  or  demon-
stration, if the [completed assessment and documentation are] ENROLLMENT
APPLICATION  IS  submitted  on or before the twentieth day of the month,
the enrollment shall commence on the first day of  the  month  following
the  completion  and  submission  and  if  the [completed assessment and
documentation are] ENROLLMENT APPLICATION IS submitted after the twenti-
eth day of the month, the enrollment shall commence on the first day  of
the  second month following submission.  Enrollments conducted by a plan
or demonstration shall be subject to review and audit by the  department
[and  by  the  local  social services district] or a contractor selected
pursuant to paragraph (d) of this subdivision.
  (iv) Continued enrollment in a managed long term care plan  or  demon-
stration  paid  for by government funds shall be based upon a comprehen-
sive assessment of the medical, social and environmental  needs  of  the
recipient  of  the services. Such assessment shall be performed at least
[annually] EVERY SIX MONTHS by the managed long term care  plan  serving
the  enrollee.   The commissioner shall prescribe the forms on which the
assessment will be made.
  [(i)] (H) The commissioner shall, upon request by a managed long  term
care plan[, approved managed long term care demonstration,] or operating
demonstration,  and  consistent  with  federal  regulations  promulgated
pursuant to the Health Insurance  Portability  and  Accountability  Act,
share with such plan or demonstration the following data if it is avail-
able:
  (i)  information  concerning  utilization of services and providers by
each of its enrollees prior to and during enrollment, including but  not
limited  to  utilization  of emergency department services, prescription
drugs, and hospital and nursing facility admissions.
  (ii) aggregate data concerning utilization and costs for enrollees and
for comparable  cohorts  served  through  the  Medicaid  fee-for-service
program.
  10.  [The] NOTWITHSTANDING ANY INCONSISTENT PROVISION TO THE CONTRARY,
THE ENROLLMENT  AND  DISENROLLMENT  PROCESS  AND  services  provided  or
arranged  by  all  operating demonstrations or any program that receives

S. 2809--D                         143                        A. 4009--D

designation as a Program of All-Inclusive Care for the Elderly (PACE) as
authorized by federal public law 105-33, subtitle I of title IV  of  the
Balanced  Budget  Act of 1997, MUST MEET ALL APPLICABLE FEDERAL REQUIRE-
MENTS.  SERVICES may include, but need not be limited to, housing, inpa-
tient and outpatient hospital services, nursing home care,  home  health
care,  adult  day  care, assisted living services provided in accordance
with article forty-six-B of this chapter, adult care facility  services,
enriched  housing program services, hospice care, respite care, personal
care, homemaker services, diagnostic  laboratory  services,  therapeutic
and  diagnostic radiologic services, emergency services, emergency alarm
systems, home delivered meals,  physical  adaptations  to  the  client's
home,  physician  care  (including  consultant  and  referral services),
ancillary  services,  case  management  services,  transportation,   and
related medical services.
  S  42.    Section 4401 of the public health law is amended by adding a
new subdivision 8 to read as follows:
  8. "SPECIAL NEEDS MANAGED CARE  PLAN"  OR  "SPECIALIZED  MANAGED  CARE
PLAN"  SHALL  MEAN A COMBINATION OF PERSONS NATURAL OR CORPORATE, OR ANY
GROUPS OF SUCH PERSONS, OR A COUNTY  OR  COUNTIES,  WHO  ENTER  INTO  AN
ARRANGEMENT,  AGREEMENT  OR PLAN, OR COMBINATION OF ARRANGEMENTS, AGREE-
MENTS OR PLANS, TO PROVIDE HEALTH  AND  BEHAVIORAL  HEALTH  SERVICES  TO
ENROLLEES WITH SIGNIFICANT BEHAVIORAL HEALTH NEEDS.
  S  42-a.  The  public  health  law  is amended by adding a new section
4403-d to read as follows:
  S 4403-D. SPECIAL NEEDS MANAGED CARE  PLANS  AND  SPECIALIZED  MANAGED
CARE  PLANS. NO PERSON, GROUP OF PERSONS, COUNTY OR COUNTIES MAY OPERATE
A SPECIAL NEEDS MANAGED CARE PLAN OR SPECIALIZED MANAGED CARE PLAN WITH-
OUT FIRST OBTAINING A CERTIFICATE OF AUTHORITY  FROM  THE  COMMISSIONER,
ISSUED  JOINTLY WITH THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH AND
THE COMMISSIONER  OF  THE  OFFICE  OF  ALCOHOLISM  AND  SUBSTANCE  ABUSE
SERVICES.
  S  42-b. Paragraph (m) of subdivision 1 of section 364-j of the social
services law, as amended by chapter 649 of the laws of 1996, is  amended
to read as follows:
  (m)  "[Mental  health  special]  SPECIAL  needs MANAGED CARE plan" AND
"SPECIALIZED MANAGED CARE PLAN"  shall  have  the  same  meaning  as  in
section forty-four hundred [three-d] ONE of the public health law.
  S  42-c.  Subdivision 2 of section 364-j of the social services law is
amended by adding a new paragraph (c) to read as follows:
  (C) THE COMMISSIONER OF  HEALTH,  JOINTLY  WITH  THE  COMMISSIONER  OF
MENTAL  HEALTH  AND  THE  COMMISSIONER OF ALCOHOLISM AND SUBSTANCE ABUSE
SERVICES SHALL BE AUTHORIZED TO ESTABLISH SPECIAL NEEDS MANAGED CARE AND
SPECIALIZED MANAGED CARE PLANS, UNDER THE MEDICAL ASSISTANCE PROGRAM, IN
ACCORDANCE WITH APPLICABLE FEDERAL LAW AND REGULATIONS. THE COMMISSIONER
OF HEALTH,  IN  COOPERATION  WITH  SUCH  COMMISSIONERS,  IS  AUTHORIZED,
SUBJECT  TO  THE APPROVAL OF THE DIRECTOR OF THE DIVISION OF THE BUDGET,
TO APPLY FOR FEDERAL WAIVERS WHEN SUCH  ACTION  WOULD  BE  NECESSARY  TO
ASSIST IN PROMOTING THE OBJECTIVES OF THIS SECTION.
  S  42-d.  The  social  services law is amended by adding a new section
365-m to read as follows:
  S 365-M. ADMINISTRATION AND MANAGEMENT OF BEHAVIORAL HEALTH  SERVICES.
1.  THE  COMMISSIONERS  OF THE OFFICE OF MENTAL HEALTH AND THE OFFICE OF
ALCOHOLISM AND  SUBSTANCE  ABUSE  SERVICES,  IN  CONSULTATION  WITH  THE
COMMISSIONER  OF  HEALTH, THE IMPACTED LOCAL GOVERNMENTAL UNITS AND WITH
THE APPROVAL OF THE DIVISION OF THE BUDGET,  SHALL  HAVE  RESPONSIBILITY
FOR  JOINTLY DESIGNATING REGIONAL ENTITIES TO PROVIDE ADMINISTRATIVE AND

S. 2809--D                         144                        A. 4009--D

MANAGEMENT SERVICES FOR THE PURPOSES OF PRIOR APPROVING AND COORDINATING
THE PROVISION OF BEHAVIORAL HEALTH SERVICES, FACILITATING THE CONTINUITY
OF POST-HOSPITALIZATION BEHAVIORAL HEALTH AND THE INTEGRATION OF  BEHAV-
IORAL  HEALTH  SERVICES  WITH OTHER SERVICES AVAILABLE UNDER THIS TITLE,
FOR RECIPIENTS OF MEDICAL ASSISTANCE WHO ARE  NOT  ENROLLED  IN  MANAGED
CARE,  AND  FOR SUCH APPROVAL, COORDINATION, FACILITATING CONTINUITY AND
INTEGRATION OF BEHAVIORAL HEALTH SERVICES THAT ARE NOT PROVIDED  THROUGH
MANAGED  CARE  PROGRAMS  UNDER  THIS TITLE FOR INDIVIDUALS REGARDLESS OF
WHETHER OR NOT SUCH INDIVIDUALS ARE ENROLLED IN MANAGED  CARE  PROGRAMS.
SUCH REGIONAL ENTITIES SHALL ALSO BE RESPONSIBLE FOR PROMOTING APPROPRI-
ATE  CARE AND SERVICE UTILIZATION WHILE SAFEGUARDING AGAINST UNNECESSARY
UTILIZATION OF SUCH CARE AND SERVICES AND  ASSURING  THAT  PAYMENTS  ARE
CONSISTENT WITH THE EFFICIENT AND ECONOMICAL DELIVERY OF QUALITY CARE.
  2.  IN EXERCISING THIS RESPONSIBILITY, THE COMMISSIONERS OF THE OFFICE
OF MENTAL HEALTH AND  THE  OFFICE  OF  ALCOHOLISM  AND  SUBSTANCE  ABUSE
SERVICES ARE AUTHORIZED TO CONTRACT, AFTER CONSULTATION WITH THE COMMIS-
SIONER  OF  HEALTH  AND  THE  IMPACTED  LOCAL  GOVERNMENTAL  UNITS, WITH
REGIONAL  BEHAVIORAL  HEALTH  ORGANIZATIONS  OR  OTHER  ENTITIES.   SUCH
CONTRACTS  MAY  INCLUDE RESPONSIBILITY FOR RECEIPT, REVIEW, AND DETERMI-
NATION OF PRIOR AUTHORIZATION REQUESTS FOR BEHAVIORAL  HEALTH  CARE  AND
SERVICES UNDER SUBDIVISION ONE OF THIS SECTION, CONSISTENT WITH CRITERIA
ESTABLISHED  OR APPROVED BY THE COMMISSIONERS OF MENTAL HEALTH AND ALCO-
HOLISM AND SUBSTANCE ABUSE SERVICES, AND  AUTHORIZATION  OF  APPROPRIATE
CARE AND SERVICES BASED ON DOCUMENTED PATIENT MEDICAL NEED.
  3.  NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR  SECTION
ONE  HUNDRED FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR ANY OTHER LAW
TO THE CONTRARY, THE COMMISSIONERS OF THE OFFICE OF  MENTAL  HEALTH  AND
THE  OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES ARE AUTHORIZED TO
ENTER INTO A CONTRACT OR CONTRACTS UNDER SUBDIVISIONS  ONE  AND  TWO  OF
THIS  SECTION WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS,
PROVIDED, HOWEVER, THAT:
  (A) THE OFFICE OF MENTAL HEALTH  AND  THE  OFFICE  OF  ALCOHOLISM  AND
SUBSTANCE  ABUSE  SERVICES SHALL POST ON THEIR WEBSITES, FOR A PERIOD OF
NO LESS THAN THIRTY DAYS:
  (I) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT  TO
THE CONTRACTOR CONTRACTS;
  (II) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (III)  THE  PERIOD  OF  TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY
SEEK SELECTION, WHICH SHALL BE NO  LESS  THAN  THIRTY  DAYS  AFTER  SUCH
INFORMATION IS FIRST POSTED ON THE WEBSITE; AND
  (IV)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (B) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE  RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
COMMISSIONERS; AND
  (C) THE COMMISSIONERS OF THE OFFICE OF MENTAL HEALTH AND THE OFFICE OF
ALCOHOLISM AND  SUBSTANCE  ABUSE  SERVICES,  IN  CONSULTATION  WITH  THE
COMMISSIONER  OF HEALTH AND THE IMPACTED LOCAL GOVERNMENTAL UNITS, SHALL
SELECT SUCH CONTRACTOR OR CONTRACTORS THAT, IN  THEIR  DISCRETION,  HAVE
DEMONSTRATED  THE  ABILITY TO EFFECTIVELY, EFFICIENTLY, AND ECONOMICALLY
INTEGRATE BEHAVIORAL HEALTH AND  HEALTH  SERVICES;  HAVE  THE  REQUISITE
EXPERTISE  AND  FINANCIAL RESOURCES; HAVE DEMONSTRATED THAT THEIR DIREC-
TORS, SPONSORS, MEMBERS, MANAGERS, PARTNERS OR OPERATORS HAVE THE REQUI-
SITE CHARACTER, COMPETENCE AND STANDING IN THE COMMUNITY, AND  ARE  BEST
SUITED TO SERVE THE PURPOSES OF THIS SECTION.

S. 2809--D                         145                        A. 4009--D

  4.  THE  COMMISSIONERS  OF  THE OFFICE OF MENTAL HEALTH, THE OFFICE OF
ALCOHOLISM AND SUBSTANCE ABUSE SERVICES AND THE  DEPARTMENT  OF  HEALTH,
SHALL  HAVE  THE  RESPONSIBILITY  FOR  JOINTLY DESIGNATING ON A REGIONAL
BASIS, AFTER CONSULTATION WITH THE LOCAL SOCIAL  SERVICES  DISTRICT  AND
LOCAL  GOVERNMENTAL  UNIT, AS SUCH TERM IS DEFINED IN THE MENTAL HYGIENE
LAW, OF A CITY WITH A POPULATION OF OVER ONE MILLION PERSONS, AND  AFTER
CONSULTATION OF OTHER AFFECTED COUNTIES, A LIMITED NUMBER OF SPECIALIZED
MANAGED  CARE  PLANS  UNDER  SECTION  THREE HUNDRED SIXTY-FOUR-J OF THIS
TITLE, SPECIAL NEED MANAGED  CARE  PLANS  UNDER  SECTION  THREE  HUNDRED
SIXTY-FOUR-J  OF  THIS  TITLE, AND/OR INTEGRATED PHYSICAL AND BEHAVIORAL
HEALTH PROVIDER SYSTEMS CERTIFIED UNDER  ARTICLE  TWENTY-NINE-E  OF  THE
PUBLIC HEALTH LAW CAPABLE OF MANAGING THE BEHAVIORAL AND PHYSICAL HEALTH
NEEDS OF MEDICAL ASSISTANCE ENROLLEES WITH SIGNIFICANT BEHAVIORAL HEALTH
NEEDS.  INITIAL DESIGNATIONS OF SUCH PLANS OR PROVIDER SYSTEMS SHOULD BE
MADE NO LATER THAN APRIL FIRST, TWO THOUSAND THIRTEEN, PROVIDED,  HOWEV-
ER,  SUCH  DESIGNATIONS SHALL BE CONTINGENT UPON A DETERMINATION BY SUCH
STATE COMMISSIONERS THAT THE ENTITIES TO BE DESIGNATED HAVE THE CAPACITY
AND FINANCIAL ABILITY TO PROVIDE SERVICES  IN  SUCH  PLANS  OR  PROVIDER
SYSTEMS,  AND  THAT  THE  REGION HAS A SUFFICIENT POPULATION AND SERVICE
BASE TO SUPPORT SUCH PLANS AND SYSTEMS. ONCE DESIGNATED, THE COMMISSION-
ER OF HEALTH SHALL MAKE ARRANGEMENTS TO ENROLL SUCH  ENROLLEES  IN  SUCH
PLANS  OR  INTEGRATED PROVIDER SYSTEMS AND TO PAY SUCH PLANS OR PROVIDER
SYSTEMS ON A CAPITATED OR OTHER BASIS TO MANAGE, COORDINATE, AND PAY FOR
BEHAVIORAL AND PHYSICAL HEALTH  MEDICAL  ASSISTANCE  SERVICES  FOR  SUCH
ENROLLEES.    NOTWITHSTANDING  ANY INCONSISTENT PROVISION OF SECTION ONE
HUNDRED TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, AND
SECTION ONE HUNDRED FORTY-TWO OF THE ECONOMIC DEVELOPMENT  LAW,  OR  ANY
OTHER  LAW  TO THE CONTRARY, THE DESIGNATIONS OF SUCH PLANS AND PROVIDER
SYSTEMS, AND ANY RESULTING  CONTRACTS  WITH  SUCH  PLANS,  PROVIDERS  OR
PROVIDER SYSTEMS ARE AUTHORIZED TO BE ENTERED INTO BY SUCH STATE COMMIS-
SIONERS  WITHOUT  A  COMPETITIVE  BID  OR  REQUEST FOR PROPOSAL PROCESS,
PROVIDED HOWEVER THAT:
  (A) THE DEPARTMENT OF HEALTH, THE OFFICE  OF  MENTAL  HEALTH  AND  THE
OFFICE  OF  ALCOHOLISM  AND SUBSTANCE ABUSE SERVICES SHALL POST ON THEIR
WEBSITES, FOR A PERIOD OF NOT LESS THAN THIRTY DAYS:
  (I) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED BY THE PLANS
OR SYSTEMS;
  (II) THE CRITERIA FOR SELECTION OF A PLAN OR SYSTEM;
  (III) THE PERIOD OF TIME DURING WHICH A PROSPECTIVE PLAN OR SYSTEM MAY
SEEK SELECTION, WHICH SHALL BE NO  LESS  THAN  THIRTY  DAYS  AFTER  SUCH
INFORMATION IS FIRST POSTED ON THE WEBSITE; AND
  (IV)  THE  MANNER  BY WHICH A PROSPECTIVE PLAN OR SYSTEM MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (B) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE  RECEIVED  FROM
PROSPECTIVE  PLANS OR SYSTEMS IN TIMELY FASHION SHALL BE REVIEWED BY THE
COMMISSIONERS; AND
  (C) THE COMMISSIONERS OF THE OFFICE OF MENTAL HEALTH AND THE OFFICE OF
ALCOHOLISM AND  SUBSTANCE  ABUSE  SERVICES,  IN  CONSULTATION  WITH  THE
COMMISSIONER  OF  HEALTH,  SHALL  SELECT  SUCH PLANS OR SYSTEMS THAT, IN
THEIR DISCRETION, HAVE DEMONSTRATED THE ABILITY  TO  EFFECTIVELY,  EFFI-
CIENTLY,  AND  ECONOMICALLY  MANAGE  THE  BEHAVIORAL AND PHYSICAL HEALTH
NEEDS OF MEDICAL ASSISTANCE ENROLLEES WITH SIGNIFICANT BEHAVIORAL HEALTH
NEEDS; HAVE THE REQUISITE EXPERTISE AND FINANCIAL RESOURCES; HAVE DEMON-
STRATED THAT THEIR DIRECTORS, SPONSORS, MEMBERS, MANAGERS,  PARTNERS  OR
OPERATORS  HAVE  THE REQUISITE CHARACTER, COMPETENCE AND STANDING IN THE
COMMUNITY, AND ARE BEST SUITED TO SERVE THE PURPOSES  OF  THIS  SECTION.

S. 2809--D                         146                        A. 4009--D

OVERSIGHT  OF  SUCH  CONTRACTS  WITH  SUCH  PLANS, PROVIDERS OR PROVIDER
SYSTEMS SHALL BE THE JOINT RESPONSIBILITY OF SUCH  STATE  COMMISSIONERS,
AND FOR CONTRACTS AFFECTING A CITY WITH A POPULATION OF OVER ONE MILLION
PERSONS,  ALSO  WITH THE CITY'S LOCAL SOCIAL SERVICES DISTRICT AND LOCAL
GOVERNMENTAL UNIT, AS SUCH TERM IS DEFINED IN THE MENTAL HYGIENE LAW.
  S 43. Intentionally omitted.
  S 44. Intentionally omitted.
  S 45. Intentionally omitted.
  S 46. Intentionally omitted.
  S 47. Intentionally omitted.
  S 47-a. Subdivision 8 of section 2511 of  the  public  health  law  is
amended by adding two new paragraphs (f) and (g) to read as follows:
  (F)  THE  COMMISSIONER  SHALL ADJUST SUBSIDY PAYMENTS MADE TO APPROVED
ORGANIZATIONS ON AND AFTER APRIL  FIRST,  TWO  THOUSAND  ELEVEN  THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND TWELVE, SO THAT THE AMOUNT OF EACH SUCH
PAYMENT IS REDUCED BY ONE AND SEVEN-TENTHS PERCENT.
  (G)  THE  COMMISSIONER  MAY INCREASE SUBSIDY PAYMENTS MADE TO APPROVED
ORGANIZATIONS THAT VOLUNTARILY PARTICIPATE IN  THE  MULTI-PAYOR  PATIENT
CENTERED  MEDICAL  HOME  PROGRAM  TO REFLECT ADDITIONAL COSTS ASSOCIATED
WITH ENHANCED PAYMENTS MADE  TO  CERTIFIED  MEDICAL  HOMES  BY  APPROVED
ORGANIZATIONS AS REQUIRED BY ARTICLE TWENTY-NINE-AA OF THIS CHAPTER.
  S  48. The public health law is amended by adding a new section 2997-d
to read as follows:
  S 2997-D. HOSPITAL, NURSING HOME, HOME CARE,  SPECIAL  NEEDS  ASSISTED
LIVING  RESIDENCES  AND  ENHANCED  ASSISTED LIVING RESIDENCES PALLIATIVE
CARE SUPPORT.  1. (A) "PALLIATIVE CARE"  MEANS  HEALTH  CARE  TREATMENT,
INCLUDING  INTERDISCIPLINARY  END-OF-LIFE  CARE,  AND  CONSULTATION WITH
PATIENTS AND FAMILY MEMBERS, TO PREVENT OR RELIEVE  PAIN  AND  SUFFERING
AND  TO  ENHANCE  THE  PATIENT'S QUALITY OF LIFE, INCLUDING HOSPICE CARE
UNDER ARTICLE FORTY OF THIS CHAPTER.
  (B) "APPROPRIATE" HAS THE SAME MEANING AS PARAGRAPH (A) OF SUBDIVISION
ONE OF SECTION TWENTY-NINE HUNDRED NINETY-SEVEN-C OF THIS TITLE.
  2. GENERAL HOSPITALS, NURSING HOMES, ORGANIZATIONS LICENSED OR  CERTI-
FIED  PURSUANT  TO ARTICLE THIRTY-SIX OF THIS CHAPTER, AND ORGANIZATIONS
LICENSED  AS  SPECIAL  NEEDS  ASSISTED  LIVING  RESIDENCES  OR  ENHANCED
ASSISTED LIVING RESIDENCES PURSUANT TO ARTICLE FORTY-SIX-B OF THIS CHAP-
TER  SHALL  ESTABLISH  POLICIES  AND PROCEDURES TO PROVIDE PATIENTS WITH
ADVANCED LIFE LIMITING CONDITIONS AND ILLNESSES WHO MIGHT  BENEFIT  FROM
PALLIATIVE  CARE,  INCLUDING  ASSOCIATED  PAIN MANAGEMENT, SERVICES WITH
ACCESS TO INFORMATION AND COUNSELING REGARDING SUCH OPTIONS  APPROPRIATE
TO  THE PATIENT.   POLICIES MUST INCLUDE PROVISION FOR PATIENTS WHO LACK
CAPACITY TO MAKE MEDICAL DECISIONS, SO THAT ACCESS TO  SUCH  INFORMATION
AND  COUNSELING SHALL BE PROVIDED TO THE PERSONS WHO ARE LEGALLY AUTHOR-
IZED TO MAKE MEDICAL DECISIONS ON BEHALF OF SUCH PATIENTS.
  3. GENERAL HOSPITALS, NURSING HOMES, ORGANIZATIONS LICENSED OR  CERTI-
FIED  PURSUANT  TO ARTICLE THIRTY-SIX OF THIS CHAPTER, AND ORGANIZATIONS
LICENSED  AS  SPECIAL  NEEDS  ASSISTED  LIVING  RESIDENCES  OR  ENHANCED
ASSISTED LIVING RESIDENCES PURSUANT TO ARTICLE FORTY-SIX-B OF THIS CHAP-
TER SHALL FACILITATE ACCESS TO APPROPRIATE PALLIATIVE CARE CONSULTATIONS
AND  SERVICES,  INCLUDING  ASSOCIATED  PAIN MANAGEMENT CONSULTATIONS AND
SERVICES, INCLUDING BUT NOT LIMITED TO REFERRALS CONSISTENT WITH PATIENT
NEEDS AND PREFERENCES.  THE DEPARTMENT SHALL TAKE  INTO  ACCOUNT  ACCESS
AND PROXIMITY OF PALLIATIVE CARE SERVICES, INCLUDING THE AVAILABILITY OF
HOSPICE  AND  PALLIATIVE  CARE  BOARD  CERTIFIED PRACTITIONERS AND OTHER
RELATED WORKFORCE STAFF, GEOGRAPHIC FACTORS, AND FACILITY SIZE THAT  MAY
IMPACT DEVELOPMENT OF PALLIATIVE CARE SERVICES.

S. 2809--D                         147                        A. 4009--D

  S 49. Intentionally omitted.
  S 50. Legislative findings. The legislature finds that integration and
coordination  of health care services is essential to the improvement of
health care  quality,  efficiency,  access  and  outcomes.  The  federal
Patient Protection and Affordable Care Act creates several health system
demonstration  and pilot programs, intended to promote and assess deliv-
ery system and payment reforms, that require  integration  of  services,
coordination among providers, or a combination of the two.  In addition,
collaborative  arrangements among, or consolidation, mergers or acquisi-
tion, of providers may be necessary  to  preserve  access  to  essential
services  in  some  communities, and improve the quality of the services
they provide and the efficiency of their operations, as well as minimize
unnecessary increases in the cost of care.
  Federal and state antitrust  laws  may  prohibit  or  discourage  such
collaboration  or  consolidation  beneficial  to  residents  of New York
state, given their potential for, or actual, reduction  in  competition.
The legislature finds that such agreements where they meet the standards
of this section, should be permitted and encouraged. Under these circum-
stances,  competition  as  currently mandated by federal and state anti-
trust laws should be supplanted by a regulatory program  to  permit  and
encourage  mergers,  acquisitions,  and  cooperative,  collaborative and
integrative agreements among health care providers, and others, that are
beneficial to New York residents when the benefits  of  such  agreements
outweigh  any  disadvantages caused by their potential or actual adverse
effects on competition. Regulatory oversight of such arrangements should
be provided to ensure that the benefits of such agreements outweigh  any
disadvantages  attributable  to  any  reduction  in competition that may
result from the agreements.  Accordingly,  the  legislature  intends  to
authorize  a  regulatory  program to permit and oversee merger, acquisi-
tion, integration, consolidation, collaboration, and coordination  among
providers,  where  necessary  to  assure access to essential health care
services, to improve health care quality and outcomes, to enhance  effi-
ciency, or to minimize the cost of health care.
  S 51. The public health law is amended by adding a new article 29-F to
read as follows:
                              ARTICLE 29-F
            IMPROVED INTEGRATION OF HEALTH CARE AND FINANCING
SECTION 2999-AA. ANTITRUST PROVISIONS, STATE OVERSIGHT.
        2999-BB. DEPARTMENT AUTHORITY.
  S  2999-AA.  ANTITRUST  PROVISIONS,  STATE OVERSIGHT.   1. IN ORDER TO
PROMOTE IMPROVED QUALITY AND EFFICIENCY OF, AND ACCESS TO,  HEALTH  CARE
SERVICES  AND  TO PROMOTE IMPROVED CLINICAL OUTCOMES TO THE RESIDENTS OF
NEW YORK, IT SHALL BE THE POLICY OF THE STATE TO ENCOURAGE, WHERE APPRO-
PRIATE, COOPERATIVE, COLLABORATIVE AND INTEGRATIVE ARRANGEMENTS  INCLUD-
ING  BUT  NOT  LIMITED  TO,  MERGERS  AND ACQUISITIONS AMONG HEALTH CARE
PROVIDERS OR AMONG OTHERS WHO MIGHT OTHERWISE BE COMPETITORS, UNDER  THE
ACTIVE SUPERVISION OF THE COMMISSIONER. TO THE EXTENT SUCH ARRANGEMENTS,
OR  THE  PLANNING AND NEGOTIATIONS THAT PRECEDE THEM, MIGHT BE ANTI-COM-
PETITIVE WITHIN THE MEANING AND INTENT OF THE STATE  AND  FEDERAL  ANTI-
TRUST LAWS, THE INTENT OF THE STATE IS TO SUPPLANT COMPETITION WITH SUCH
ARRANGEMENTS  UNDER  THE  ACTIVE  SUPERVISION AND RELATED ADMINISTRATIVE
ACTIONS OF THE COMMISSIONER AS NECESSARY TO ACCOMPLISH THE  PURPOSES  OF
THIS  ARTICLE,  AND TO PROVIDE STATE ACTION IMMUNITY UNDER THE STATE AND
FEDERAL ANTITRUST LAWS WITH RESPECT TO ACTIVITIES UNDERTAKEN  BY  HEALTH
CARE  PROVIDERS  AND OTHERS PURSUANT TO THIS ARTICLE, WHERE THE BENEFITS
OF SUCH ACTIVE SUPERVISION, ARRANGEMENTS AND ACTIONS OF THE COMMISSIONER

S. 2809--D                         148                        A. 4009--D

OUTWEIGH ANY DISADVANTAGES LIKELY TO RESULT FROM A REDUCTION OF COMPETI-
TION.  THE COMMISSIONER SHALL NOT APPROVE AN ARRANGEMENT FOR WHICH STATE
ACTION IMMUNITY IS SOUGHT UNDER THIS ARTICLE  WITHOUT  FIRST  CONSULTING
WITH,  AND RECEIVING A RECOMMENDATION FROM, THE PUBLIC HEALTH AND HEALTH
PLANNING COUNCIL. NO ARRANGEMENT UNDER THIS ARTICLE  SHALL  BE  APPROVED
AFTER DECEMBER THIRTY-FIRST, TWO THOUSAND SIXTEEN.
  2.  THE  COMMISSIONER OR HIS OR HER DULY AUTHORIZED REPRESENTATIVE MAY
ENGAGE IN APPROPRIATE  STATE  SUPERVISION  NECESSARY  TO  PROMOTE  STATE
ACTION IMMUNITY UNDER THE STATE AND FEDERAL ANTITRUST LAWS.
  S  2999-BB.  DEPARTMENT  AUTHORITY.    THE DEPARTMENT SHALL PROMULGATE
REGULATIONS TO IMPLEMENT THIS ARTICLE.  SUCH REGULATIONS  SHALL  PROVIDE
STANDARDS  FOR  DETERMINING WHICH PROPOSED COLLABORATIONS, INTEGRATIONS,
MERGERS OR ACQUISITIONS SHALL BE COVERED BY THIS ARTICLE AND THE  MANNER
BY  WHICH  THE  INTERESTS SET FORTH IN THE LEGISLATIVE FINDINGS SHALL BE
ADVANCED THROUGH REGULATORY OVERSIGHT.  THE DEPARTMENT SHALL FURTHER  BE
AUTHORIZED  TO  IMPOSE FEES AS APPROPRIATE TO FACILITATE THE IMPLEMENTA-
TION OF THIS ARTICLE. THIS ARTICLE IS NOT INTENDED TO LIMIT THE AUTHORI-
TY OF THE ATTORNEY GENERAL OF THE STATE OF NEW YORK.
  S 52. Article 29-D of the public health law is amended by adding a new
title 4 to read as follows:
                                  TITLE 4
                  NEW YORK STATE MEDICAL INDEMNITY FUND
SECTION 2999-G. PURPOSE OF THIS TITLE.
        2999-H. DEFINITIONS.
        2999-I. CUSTODY AND ADMINISTRATION OF THE FUND.
        2999-J. PAYMENTS FROM THE FUND.
  S 2999-G. PURPOSE OF THIS TITLE.   CREATION  OF  THE  NEW  YORK  STATE
MEDICAL  INDEMNITY  FUND.  THERE  IS  HEREBY  CREATED THE NEW YORK STATE
MEDICAL INDEMNITY FUND (THE "FUND").   THE PURPOSE OF  THE  FUND  IS  TO
PROVIDE  A  FUNDING  SOURCE FOR FUTURE HEALTH CARE COSTS ASSOCIATED WITH
BIRTH RELATED NEUROLOGICAL INJURIES, IN ORDER TO  REDUCE  PREMIUM  COSTS
FOR MEDICAL MALPRACTICE INSURANCE COVERAGE.
  S  2999-H.  DEFINITIONS.  AS USED IN THIS TITLE, UNLESS THE CONTEXT OR
SUBJECT MATTER REQUIRES OTHERWISE:
  1. "BIRTH-RELATED NEUROLOGICAL INJURY" MEANS AN INJURY TO THE BRAIN OR
SPINAL CORD OF A LIVE INFANT CAUSED BY  THE  DEPRIVATION  OF  OXYGEN  OR
MECHANICAL INJURY OCCURRING IN THE COURSE OF LABOR, DELIVERY OR RESUSCI-
TATION  OR  BY  OTHER  MEDICAL  SERVICES PROVIDED OR NOT PROVIDED DURING
DELIVERY ADMISSION  THAT  RENDERED  THE  INFANT  WITH  A  PERMANENT  AND
SUBSTANTIAL  MOTOR IMPAIRMENT OR WITH A DEVELOPMENTAL DISABILITY AS THAT
TERM IS DEFINED BY SECTION 1.03 OF THE MENTAL HYGIENE LAW, OR BOTH. THIS
DEFINITION SHALL APPLY TO LIVE BIRTHS ONLY.
  2. "FUND" MEANS THE NEW YORK STATE MEDICAL INDEMNITY FUND.
  3. "QUALIFYING HEALTH CARE COSTS" MEANS THE FUTURE MEDICAL,  HOSPITAL,
SURGICAL,  NURSING,  DENTAL,  REHABILITATION, CUSTODIAL, DURABLE MEDICAL
EQUIPMENT, HOME MODIFICATIONS, ASSISTIVE TECHNOLOGY,  VEHICLE  MODIFICA-
TIONS,  PRESCRIPTION  AND NON-PRESCRIPTION MEDICATIONS, AND OTHER HEALTH
CARE COSTS ACTUALLY INCURRED  FOR  SERVICES  RENDERED  TO  AND  SUPPLIES
UTILIZED  BY  QUALIFIED  PLAINTIFFS,  WHICH  ARE NECESSARY TO MEET THEIR
HEALTH CARE NEEDS AS DETERMINED BY THEIR TREATING PHYSICIANS,  PHYSICIAN
ASSISTANTS,  OR  NURSE  PRACTITIONERS  AND  AS  OTHERWISE DEFINED BY THE
COMMISSIONER IN REGULATION.
  4. "QUALIFIED PLAINTIFF" MEANS EVERY PLAINTIFF OR CLAIMANT WHO (I) HAS
BEEN FOUND BY A JURY OR COURT TO HAVE SUSTAINED A  BIRTH-RELATED  NEURO-
LOGICAL  INJURY  AS  THE  RESULT  OF  MEDICAL  MALPRACTICE,  OR (II) HAS
SUSTAINED A BIRTH-RELATED NEUROLOGICAL INJURY AS THE RESULT  OF  ALLEGED

S. 2809--D                         149                        A. 4009--D

MEDICAL  MALPRACTICE, AND HAS SETTLED HIS OR HER LAWSUIT OR CLAIM THERE-
FOR.
  5.  ANY  REFERENCE  TO  THE "DEPARTMENT OF FINANCIAL SERVICES" AND THE
"SUPERINTENDENT OF FINANCIAL SERVICES" IN THIS TITLE SHALL  MEAN,  PRIOR
TO  OCTOBER THIRD, TWO THOUSAND ELEVEN, RESPECTIVELY, THE "DEPARTMENT OF
INSURANCE" AND "SUPERINTENDENT OF INSURANCE."
  S 2999-I. CUSTODY AND ADMINISTRATION OF THE FUND.  1. THE COMMISSIONER
OF TAXATION AND FINANCE SHALL BE THE  CUSTODIAN  OF  THE  FUND  AND  THE
SPECIAL  ACCOUNT  ESTABLISHED  PURSUANT  TO SECTION NINETY-NINE-T OF THE
STATE FINANCE LAW.  ALL PAYMENTS FROM THE FUND  SHALL  BE  MADE  BY  THE
COMMISSIONER  OF  TAXATION  AND  FINANCE UPON CERTIFICATES SIGNED BY THE
SUPERINTENDENT OF FINANCIAL SERVICES, OR HIS OR HER DESIGNEE, AS HEREIN-
AFTER PROVIDED. THE FUND SHALL BE SEPARATE AND APART FROM ANY OTHER FUND
AND FROM ALL OTHER STATE MONIES. NO MONIES FROM THE FUND SHALL BE TRANS-
FERRED TO ANY OTHER FUND, NOR SHALL ANY SUCH MONIES BE  APPLIED  TO  THE
MAKING  OF  ANY PAYMENT FOR ANY PURPOSE OTHER THAN THE PURPOSE SET FORTH
IN THIS TITLE.
  2. (A) THE FUND SHALL BE ADMINISTERED BY THE SUPERINTENDENT OF  FINAN-
CIAL  SERVICES  OR HIS OR HER DESIGNEE IN ACCORDANCE WITH THE PROVISIONS
OF THIS ARTICLE.
  (B) THE SUPERINTENDENT OF FINANCIAL SERVICES  SHALL  HAVE  ALL  POWERS
NECESSARY AND PROPER TO CARRY OUT THE PURPOSES OF THE FUND.
  (C)  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, THE SUPERINTENDENT OF FINANCIAL
SERVICES IS AUTHORIZED TO ENTER INTO A CONTRACT OR CONTRACTS  WITHOUT  A
COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS FOR PURPOSES OF ADMINIS-
TERING  THE  FUND FOR THE FIRST YEAR OF ITS OPERATION AND IN PREPARATION
THEREFOR.
  (D) THE DEPARTMENT OF FINANCIAL SERVICES AND THE DEPARTMENT SHALL POST
ON THEIR WEBSITES INFORMATION ABOUT THE FUND, ELIGIBILITY FOR ENROLLMENT
IN THE FUND, AND THE PROCESS FOR ENROLLMENT IN THE FUND.
  3. THE EXPENSE OF  ADMINISTERING  THE  FUND,  INCLUDING  THE  EXPENSES
INCURRED BY THE DEPARTMENT, SHALL BE PAID FROM THE FUND.
  4. MONIES FOR THE FUND WILL BE PROVIDED PURSUANT TO THIS CHAPTER.
  5. FOR THE STATE FISCAL YEAR BEGINNING APRIL FIRST, TWO THOUSAND ELEV-
EN  AND ENDING MARCH THIRTY-FIRST, TWO THOUSAND TWELVE, THE STATE FISCAL
YEAR BEGINNING APRIL FIRST, TWO THOUSAND TWELVE AND ENDING  MARCH  THIR-
TY-FIRST,  TWO  THOUSAND  THIRTEEN,  AND THE STATE FISCAL YEAR BEGINNING
APRIL FIRST, TWO THOUSAND THIRTEEN AND ENDING  MARCH  THIRTY-FIRST,  TWO
THOUSAND  FOURTEEN, THE SUPERINTENDENT OF FINANCIAL SERVICES SHALL CAUSE
TO BE DEPOSITED INTO THE FUND FOR  EACH  SUCH  FISCAL  YEAR  THE  AMOUNT
APPROPRIATED  FOR  SUCH  PURPOSE.    BEGINNING APRIL FIRST, TWO THOUSAND
FOURTEEN  AND  ANNUALLY  THEREAFTER,  THE  SUPERINTENDENT  OF  FINANCIAL
SERVICES SHALL CAUSE TO BE DEPOSITED INTO THE FUND, SUBJECT TO AVAILABLE
APPROPRIATIONS,  AN  AMOUNT  EQUAL  TO THE DIFFERENCE BETWEEN THE AMOUNT
APPROPRIATED TO THE FUND IN THE PRECEDING FISCAL YEAR, AS  INCREASED  BY
THE  ADJUSTMENT FACTOR DEFINED IN SUBDIVISION SEVEN OF THIS SECTION, AND
THE ASSETS OF THE FUND AT THE CONCLUSION OF THAT FISCAL YEAR.
  6. (A) FOLLOWING THE DEPOSIT REFERENCED IN SUBDIVISION  FIVE  OF  THIS
SECTION, THE SUPERINTENDENT OF FINANCIAL SERVICES SHALL CONDUCT AN ACTU-
ARIAL  CALCULATION  OF  THE  ESTIMATED  LIABILITIES  OF THE FUND FOR THE
COMING YEAR RESULTING FROM THE  QUALIFIED  PLAINTIFFS  ENROLLED  IN  THE
FUND. THE ADMINISTRATOR SHALL FROM TIME TO TIME ADJUST SUCH CALCULATION.
IF  THE  TOTAL OF ALL ESTIMATES OF CURRENT LIABILITIES EQUALS OR EXCEEDS
EIGHTY PERCENT OF THE FUND'S ASSETS, THEN THE FUND SHALL NOT ACCEPT  ANY

S. 2809--D                         150                        A. 4009--D

NEW  ENROLLMENTS  UNTIL A NEW DEPOSIT HAS BEEN MADE PURSUANT TO SUBDIVI-
SION FIVE OF THIS SECTION. WHEN, AS A RESULT OF SUCH  NEW  DEPOSIT,  THE
FUND'S LIABILITIES NO LONGER EXCEED EIGHTY PERCENT OF THE FUND'S ASSETS,
THE  FUND  ADMINISTRATOR  SHALL  ENROLL  NEW QUALIFIED PLAINTIFFS IN THE
ORDER THAT AN APPLICATION FOR ENROLLMENT HAS BEEN SUBMITTED  IN  ACCORD-
ANCE WITH SUBDIVISION SEVEN OF SECTION TWENTY-NINE HUNDRED NINETY-NINE-J
OF THIS TITLE.
  (B) WHENEVER ENROLLMENT IS SUSPENDED PURSUANT TO PARAGRAPH (A) OF THIS
SUBDIVISION  AND  UNTIL SUCH TIME AS ENROLLMENT RESUMES PURSUANT TO SUCH
PARAGRAPH:  (I) NOTICE OF SUCH SUSPENSION SHALL BE  PROMPTLY  POSTED  ON
THE  DEPARTMENT'S WEBSITE AND ON THE WEBSITE OF THE DEPARTMENT OF FINAN-
CIAL SERVICES; (II) THE FUND ADMINISTRATOR SHALL DENY  EACH  APPLICATION
FOR ENROLLMENT THAT HAD BEEN RECEIVED BUT NOT ACCEPTED PRIOR TO THE DATE
OF  SUSPENSION  AND  EACH  APPLICATION FOR ENROLLMENT RECEIVED AFTER THE
DATE OF SUCH SUSPENSION; AND (III)  NOTIFICATION  OF  EACH  SUCH  DENIAL
SHALL  BE MADE TO THE PLAINTIFF OR CLAIMANT OR PERSONS AUTHORIZED TO ACT
ON BEHALF OF SUCH PLAINTIFF OR CLAIMANT AND ALL DEFENDANTS IN REGARD  TO
SUCH  PLAINTIFF  OR  CLAIMANT,  TO THE EXTENT THEY ARE KNOWN TO THE FUND
ADMINISTRATOR. JUDGMENTS AND SETTLEMENTS FOR PLAINTIFFS OR CLAIMANTS FOR
WHOM APPLICATIONS ARE DENIED UNDER THIS PARAGRAPH OR WHO ARE NOT  ELIGI-
BLE  FOR  ENROLLMENT DUE TO SUSPENSION PURSUANT TO PARAGRAPH (A) OF THIS
SUBDIVISION SHALL BE SATISFIED AS IF THIS TITLE HAD NOT BEEN ENACTED.
  (C) FOLLOWING A SUSPENSION, WHENEVER ENROLLMENT  RESUMES  PURSUANT  TO
PARAGRAPH  (A)  OF  THIS SUBDIVISION, NOTICE THAT ENROLLMENT HAS RESUMED
SHALL BE PROMPTLY POSTED ON THE DEPARTMENT'S WEBSITE AND ON THE  WEBSITE
OF THE DEPARTMENT OF FINANCIAL SERVICES.
  (D)  THE  SUSPENSION  OF  ENROLLMENT PURSUANT TO PARAGRAPH (A) OF THIS
SUBDIVISION SHALL NOT IMPACT PAYMENT UNDER THE FUND  FOR  ANY  QUALIFIED
PLAINTIFFS ALREADY ENROLLED IN THE FUND.
  7.  FOR  PURPOSES OF THIS SECTION, THE ADJUSTMENT FACTOR REFERENCED IN
THIS SECTION SHALL BE THE TEN YEAR ROLLING AVERAGE MEDICAL COMPONENT  OF
THE CONSUMER PRICE INDEX AS PUBLISHED BY THE UNITED STATES DEPARTMENT OF
LABOR, BUREAU OF LABOR STATISTICS, FOR THE PRECEDING TEN YEARS.
  S  2999-J.  PAYMENTS  FROM THE FUND.  1. THE FUND SHALL BE USED TO PAY
THE QUALIFYING HEALTH CARE COSTS OF QUALIFIED PLAINTIFFS.
  2. THE PROVISION OF QUALIFYING HEALTH CARE COSTS TO  QUALIFIED  PLAIN-
TIFFS  SHALL  NOT BE SUBJECT TO PRIOR AUTHORIZATION, EXCEPT AS DESCRIBED
BY THE COMMISSIONER IN REGULATION; PROVIDED, HOWEVER,  THAT  SUCH  REGU-
LATION  SHALL  NOT  PREVENT  QUALIFIED PLAINTIFFS FROM RECEIVING CARE OR
ASSISTANCE THAT WOULD, AT A MINIMUM, BE AUTHORIZED  UNDER  THE  MEDICAID
PROGRAM;  AND  PROVIDED,  FURTHER,  THAT  IF  ANY PRIOR AUTHORIZATION IS
REQUIRED BY SUCH REGULATION, THE REGULATION SHALL REQUIRE THAT  REQUESTS
FOR  PRIOR  AUTHORIZATION BE PROCESSED WITHIN A REASONABLY PROMPT PERIOD
OF TIME AND SHALL IDENTIFY A PROCESS FOR PROMPT ADMINISTRATIVE REVIEW OF
ANY DENIAL OF A REQUEST FOR PRIOR AUTHORIZATION.
  3. IN DETERMINING THE AMOUNT OF QUALIFYING HEALTH  CARE  COSTS  TO  BE
PAID  FROM  THE  FUND,  ANY  SUCH COST OR EXPENSE THAT WAS OR WILL, WITH
REASONABLE CERTAINTY, BE PAID, REPLACED OR INDEMNIFIED FROM ANY  COLLAT-
ERAL SOURCE AS PROVIDED BY SUBDIVISION (A) OF SECTION FORTY-FIVE HUNDRED
FORTY-FIVE  OF  THE  CIVIL PRACTICE LAW AND RULES SHALL NOT CONSTITUTE A
QUALIFYING HEALTH CARE COST AND SHALL NOT BE PAID  FROM  THE  FUND.  FOR
PURPOSES  OF  THIS TITLE, "COLLATERAL SOURCE" SHALL NOT INCLUDE MEDICARE
OR MEDICAID.
  4. THE AMOUNT OF QUALIFYING HEALTH CARE COSTS TO BE PAID FROM THE FUND
SHALL BE CALCULATED:  (A) WITH RESPECT TO SERVICES PROVIDED  IN  PRIVATE
PHYSICIAN PRACTICES ON THE BASIS OF ONE HUNDRED PERCENT OF THE USUAL AND

S. 2809--D                         151                        A. 4009--D

CUSTOMARY  RATES,  AS  DEFINED BY THE COMMISSIONER IN REGULATION; OR (B)
WITH RESPECT TO ALL OTHER SERVICES, ON THE BASIS OF  MEDICAID  RATES  OF
REIMBURSEMENT  OR,  WHERE NO SUCH RATES ARE AVAILABLE, AS DEFINED BY THE
COMMISSIONER IN REGULATION.
  5. CLAIMS FOR THE PAYMENT OR REIMBURSEMENT FROM THE FUND OF QUALIFYING
HEALTH  CARE  COSTS SHALL BE MADE UPON FORMS PRESCRIBED AND FURNISHED BY
THE FUND ADMINISTRATOR IN CONSULTATION  WITH  THE  COMMISSIONER  AND  IN
CONJUNCTION  WITH REGULATIONS ESTABLISHING A MECHANISM FOR SUBMISSION OF
CLAIMS BY HEALTH CARE PROVIDERS DIRECTLY TO THE FUND, WHERE PRACTICABLE.
  6. (A)  EVERY  SETTLEMENT  AGREEMENT  FOR  CLAIMS  ARISING  OUT  OF  A
PLAINTIFF'S  OR  CLAIMANT'S BIRTH RELATED NEUROLOGICAL INJURY SUBJECT TO
THIS TITLE, AND THAT PROVIDES FOR THE PAYMENT OF FUTURE MEDICAL EXPENSES
FOR THE PLAINTIFF OR CLAIMANT, SHALL  PROVIDE  THAT  IN  THE  EVENT  THE
ADMINISTRATOR OF THE FUND DETERMINES THAT THE PLAINTIFF OR CLAIMANT IS A
QUALIFIED  PLAINTIFF,  ALL PAYMENTS FOR FUTURE MEDICAL EXPENSES SHALL BE
PAID IN ACCORDANCE WITH THIS TITLE, IN  LIEU  OF  THAT  PORTION  OF  THE
SETTLEMENT  AGREEMENT  THAT  PROVIDES  FOR PAYMENT OF SUCH EXPENSES. THE
PLAINTIFF'S OR CLAIMANT'S FUTURE  MEDICAL  EXPENSES  SHALL  BE  PAID  IN
ACCORDANCE WITH THIS TITLE. WHEN SUCH A SETTLEMENT AGREEMENT DOES NOT SO
PROVIDE,  THE  COURT  SHALL  DIRECT THE MODIFICATION OF THE AGREEMENT TO
INCLUDE SUCH TERM AS A CONDITION OF COURT APPROVAL.
  (B) IN ANY CASE WHERE THE JURY OR COURT HAS MADE AN AWARD  FOR  FUTURE
MEDICAL EXPENSES ARISING OUT OF A BIRTH RELATED NEUROLOGICAL INJURY, ANY
PARTY TO SUCH ACTION OR PERSON AUTHORIZED TO ACT ON BEHALF OF SUCH PARTY
MAY  MAKE  APPLICATION  TO  THE COURT THAT THE JUDGMENT REFLECT THAT, IN
LIEU OF THAT PORTION OF THE AWARD THAT  PROVIDES  FOR  PAYMENT  OF  SUCH
EXPENSES,  AND  UPON  A DETERMINATION BY THE FUND ADMINISTRATOR THAT THE
PLAINTIFF IS A QUALIFIED PLAINTIFF, THE FUTURE MEDICAL EXPENSES  OF  THE
PLAINTIFF  SHALL  BE PAID OUT OF THE FUND IN ACCORDANCE WITH THIS TITLE.
UPON A FINDING BY THE COURT THAT THE APPLICANT HAS MADE  A  PRIMA  FACIE
SHOWING  THAT  THE  PLAINTIFF  IS A QUALIFIED PLAINTIFF, THE COURT SHALL
ENSURE THAT THE JUDGMENT SO PROVIDES.
  7. A QUALIFIED PLAINTIFF SHALL BE ENROLLED WHEN (A) SUCH PLAINTIFF  OR
PERSON  AUTHORIZED  TO  ACT ON BEHALF OF SUCH PERSON, UPON NOTICE TO ALL
DEFENDANTS, OR ANY OF THE DEFENDANTS IN REGARD TO THE PLAINTIFF'S CLAIM,
UPON NOTICE TO SUCH PLAINTIFF, MAKES AN APPLICATION  FOR  ENROLLMENT  BY
PROVIDING  THE  FUND ADMINISTRATOR WITH A CERTIFIED COPY OF THE JUDGMENT
OR OF THE COURT APPROVED SETTLEMENT AGREEMENT; AND (B) THE FUND ADMINIS-
TRATOR DETERMINES UPON THE BASIS OF SUCH JUDGMENT OR  SETTLEMENT  AGREE-
MENT AND ANY ADDITIONAL INFORMATION THE FUND ADMINISTRATOR SHALL REQUEST
THAT  THE  RELEVANT  PROVISIONS  OF SUBDIVISION SIX OF THIS SECTION HAVE
BEEN MET AND THAT THE PLAINTIFF IS A QUALIFIED PLAINTIFF; PROVIDED  THAT
NO ENROLLMENT SHALL OCCUR WHEN THE FUND IS CLOSED TO ENROLLMENT PURSUANT
TO  SUBDIVISION SIX OF SECTION TWENTY-NINE HUNDRED NINETY-NINE-I OF THIS
TITLE.
  8. AS TO ALL CLAIMS, THE FUND ADMINISTRATOR SHALL:
  (A) DETERMINE WHICH OF SUCH COSTS ARE QUALIFYING HEALTH CARE COSTS  TO
BE PAID FROM THE FUND; AND
  (B)  THEREUPON  CERTIFY  TO  THE  COMMISSIONER OF TAXATION AND FINANCE
THOSE COSTS THAT HAVE BEEN DETERMINED TO BE QUALIFYING HEALTH CARE COSTS
TO BE PAID FROM THE FUND.
  9. PAYMENTS FROM THE FUND SHALL BE MADE BY THE COMMISSIONER  OF  TAXA-
TION AND FINANCE ON THE SAID CERTIFICATE OF THE SUPERINTENDENT OF FINAN-
CIAL  SERVICES. NO PAYMENT SHALL BE MADE BY THE COMMISSIONER OF TAXATION
AND FINANCE IN EXCESS OF THE AMOUNT CERTIFIED. PROMPTLY UPON RECEIPT  OF
THE  SAID  CERTIFICATE  OF THE SUPERINTENDENT OF FINANCIAL SERVICES, THE

S. 2809--D                         152                        A. 4009--D

COMMISSIONER OF TAXATION AND FINANCE SHALL PAY THE QUALIFIED PLAINTIFF'S
HEALTH CARE PROVIDER OR REIMBURSE THE QUALIFIED PLAINTIFF THE AMOUNT  SO
CERTIFIED FOR PAYMENT.
  10.  PAYMENT FROM THE FUND SHALL NOT GIVE THE FUND ANY RIGHT OF RECOV-
ERY AGAINST ANY QUALIFIED PLAINTIFF OR SUCH QUALIFIED PLAINTIFF'S ATTOR-
NEY EXCEPT IN THE CASE OF FRAUD OR MISTAKE.
  11. ALL HEALTH CARE PROVIDERS SHALL ACCEPT FROM QUALIFIED  PLAINTIFF'S
OR  PERSONS  AUTHORIZED TO ACT ON BEHALF OF SUCH PLAINTIFF'S ASSIGNMENTS
OF THE RIGHT TO RECEIVE PAYMENTS FROM THE  FUND  FOR  QUALIFYING  HEALTH
CARE COSTS.
  12.  HEALTH  INSURERS  (OTHER THAN MEDICARE AND MEDICAID) SHALL BE THE
PRIMARY PAYERS OF QUALIFYING HEALTH CARE COSTS OF QUALIFIED  PLAINTIFFS.
SUCH  COSTS  SHALL  BE PAID FROM THE FUND ONLY TO THE EXTENT THAT HEALTH
INSURERS OR OTHER COLLATERAL SOURCES OR OTHER PERSONS ARE NOT  OTHERWISE
OBLIGATED  TO MAKE PAYMENTS THEREFOR. HEALTH INSURERS THAT MAKE PAYMENTS
FOR QUALIFYING HEALTH CARE COSTS TO OR ON BEHALF OF QUALIFIED PLAINTIFFS
SHALL HAVE NO RIGHT OF RECOVERY AGAINST AND SHALL HAVE NO LIEN UPON  THE
FUND OR ANY PERSON OR ENTITY NOR SHALL THE FUND CONSTITUTE AN ADDITIONAL
PAYMENT  SOURCE  TO OFFSET THE PAYMENTS OTHERWISE CONTRACTUALLY REQUIRED
TO BE MADE BY SUCH HEALTH INSURERS.   THE  SUPERINTENDENT  OF  FINANCIAL
SERVICES  SHALL  HAVE  THE  AUTHORITY  TO ENFORCE THE PROVISIONS OF THIS
SUBDIVISION.
  13. EXCEPT AS PROVIDED FOR BY THIS TITLE, WITH RESPECT TO A  QUALIFIED
PLAINTIFF,  NO  PAYMENT SHALL BE REQUIRED TO BE MADE BY ANY DEFENDANT OR
SUCH DEFENDANT'S INSURER FOR QUALIFYING HEALTH CARE COSTS AND  NO  JUDG-
MENT SHALL BE MADE OR ENTERED REQUIRING THAT ANY SUCH PAYMENT BE MADE BY
ANY DEFENDANT OR SUCH DEFENDANT'S INSURER FOR SUCH HEALTH CARE COSTS.
  14.  THE  DETERMINATION  OF  THE  QUALIFIED PLAINTIFF'S ATTORNEY'S FEE
SHALL BE BASED UPON THE ENTIRE SUM AWARDED BY THE JURY OR THE  COURT  OR
THE  FULL  SUM  OF  THE  SETTLEMENT, AS THE CASE MAY BE.   THE QUALIFIED
PLAINTIFF'S ATTORNEY'S FEE SHALL BE PAID IN A LUMP SUM BY THE DEFENDANTS
AND THEIR INSURERS PURSUANT TO SECTION FOUR  HUNDRED  SEVENTY-FOUR-A  OF
THE JUDICIARY LAW; PROVIDED HOWEVER THAT THE PORTION OF THE ATTORNEY FEE
THAT  IS ALLOCATED TO THE NON-FUND ELEMENTS OF DAMAGES SHALL BE DEDUCTED
FROM THE NON-FUND PORTION OF THE AWARD IN A PROPORTIONAL MANNER.
  15. THE COMMISSIONER,  IN  CONSULTATION  WITH  THE  SUPERINTENDENT  OF
FINANCIAL  SERVICES,  SHALL  PROMULGATE, AMEND AND ENFORCE ALL RULES AND
REGULATIONS NECESSARY FOR THE  PROPER  ADMINISTRATION  OF  THE  FUND  IN
ACCORDANCE  WITH  THE  PROVISIONS  OF  THIS  SECTION, INCLUDING, BUT NOT
LIMITED TO, THOSE CONCERNING THE PAYMENT OF CLAIMS  AND  CONCERNING  THE
ACTUARIAL  CALCULATIONS  NECESSARY  TO  DETERMINE,  ANNUALLY,  THE TOTAL
AMOUNT TO BE PAID INTO THE FUND AS PROVIDED  HEREIN,  AND  AS  OTHERWISE
NEEDED TO IMPLEMENT THIS TITLE.
  16.  THE  COMMISSIONER SHALL CONVENE A CONSUMER ADVISORY COMMITTEE FOR
THE PURPOSE OF PROVIDING INFORMATION, AS REQUESTED BY THE  COMMISSIONER,
IN  THE DEVELOPMENT OF THE REGULATIONS AUTHORIZED BY SUBDIVISION FIFTEEN
OF THIS SECTION.
  S 52-a. Article 29-D of the public health law is amended by  adding  a
new title 5 to read as follows:
                                  TITLE 5
               NEW YORK STATE HOSPITAL QUALITY INITIATIVE
SECTION 2999-M. NEW YORK STATE HOSPITAL QUALITY INITIATIVE.
  S  2999-M.  NEW  YORK STATE HOSPITAL QUALITY INITIATIVE.  THE NEW YORK
STATE HOSPITAL QUALITY INITIATIVE, INCLUDING THE NEW YORK STATE  OBSTET-
RICAL  PATIENT  SAFETY  WORKGROUP,  WILL BE CREATED IN THE DEPARTMENT OF

S. 2809--D                         153                        A. 4009--D

HEALTH TO BE COMPRISED OF MEDICAL, HOSPITAL  AND  ACADEMIC  EXPERTS  AND
OTHER STAKEHOLDERS CHOSEN BY THE COMMISSIONER.
  THE NEW YORK STATE QUALITY INITIATIVE WILL OVERSEE THE GENERAL DISSEM-
INATION  OF  INITIATIVES, GUIDANCE, AND BEST PRACTICES TO GENERAL HOSPI-
TALS. ACTIVITIES WILL INCLUDE BUT NOT BE LIMITED TO:  BUILDING  CULTURES
OF  PATIENT SAFETY AND IMPLEMENTING EVIDENCE BASED CARE IN TARGET AREAS.
THE WORKGROUP WILL UNDERTAKE COLLABORATIVE WORK TO  IMPROVE  OBSTETRICAL
CARE OUTCOMES AND QUALITY OF CARE, BASED ON IDENTIFYING AND IMPLEMENTING
EVIDENCE  BASED  PRACTICES, AND CLINICAL PROTOCOLS THAT CAN BE STANDARD-
IZED AND ADOPTED BY HOSPITALS INCLUDING BUT NOT LIMITED TO:
  (A)  SURVEYING,  REVIEWING  AND  ANALYZING  CURRENT  "BEST"  PRACTICES
EMPLOYED  IN  OBSTETRICAL CASES, INCLUDING EXPLORING THE USE OF "VIRTUAL
GRAND ROUNDS";
  (B) UNDERTAKING A REVIEW OF CLAIMS IN AN EFFORT TO DEVELOP  A  SET  OF
"STANDARD BEST PRACTICES" FOR DELIVERIES IN NEW YORK STATE;
  (C)  FORMULATING  AND  RECOMMENDING  TO THE COMMISSIONER BEST PRACTICE
STANDARDS AND DESIGNING NEW PROGRAMS  FOR  IMPLEMENTATION  AND  IMPROVED
OUTCOMES, INCLUDING BUT NOT LIMITED TO, CLINICAL BUNDLES FOR HIGH PRIOR-
ITY  CONDITIONS, ELECTRONIC FETAL MONITORING TRAINING AND CERTIFICATION,
AND TEAM TRAINING; AND
  (D)  ENGAGING  THE  EXISTING  REGIONAL  PERINATAL  CENTER  NETWORK  IN
DIALOGUES  REGARDING  THE  ABOVE  TOPICS  AND  MAKING RECOMMENDATIONS TO
IMPROVE AND/OR UPGRADE ASSISTANCE AND COMMUNICATION  TO  SMALLER  HOSPI-
TALS.
  S  52-b.  Subdivision  1 of section 2807-v of the public health law is
amended by adding a new paragraph (iii) to read as follows:
  (III) FUNDS SHALL BE RESERVED AND SET ASIDE AND ACCUMULATED FROM  YEAR
TO  YEAR  AND  SHALL BE MADE AVAILABLE, INCLUDING INCOME FROM INVESTMENT
FUNDS, FOR THE PURPOSE OF SUPPORTING THE NEW YORK STATE  MEDICAL  INDEM-
NITY  FUND AS AUTHORIZED PURSUANT TO TITLE FOUR OF ARTICLE TWENTY-NINE-D
OF THIS CHAPTER, FOR THE FOLLOWING PERIODS AND IN THE FOLLOWING AMOUNTS,
PROVIDED, HOWEVER, THAT THE COMMISSIONER IS AUTHORIZED  TO  SEEK  WAIVER
AUTHORITY  FROM  THE  FEDERAL  CENTERS FOR MEDICARE AND MEDICAID FOR THE
PURPOSE OF SECURING MEDICAID FEDERAL FINANCIAL  PARTICIPATION  FOR  SUCH
PROGRAM, IN WHICH CASE THE FUNDING AUTHORIZED PURSUANT TO THIS PARAGRAPH
SHALL BE UTILIZED AS THE NON-FEDERAL SHARE FOR SUCH PAYMENTS:
  THIRTY MILLION DOLLARS FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE.
  S  52-c.  The  public  health  law  is amended by adding a new section
2807-d-1 to read as follows:
  S 2807-D-1. HOSPITAL QUALITY CONTRIBUTIONS.   1.  NOTWITHSTANDING  ANY
CONTRARY  PROVISION  OF  LAW AND SUBJECT TO THE RECEIPT OF ALL NECESSARY
FEDERAL APPROVALS OR WAIVERS, FOR PERIODS ON AND AFTER JULY  FIRST,  TWO
THOUSAND  ELEVEN,  A  QUALITY CONTRIBUTION SHALL BE IMPOSED ON THE INPA-
TIENT REVENUE  OF  EACH  GENERAL  HOSPITAL  THAT  IS  RECEIVED  FOR  THE
PROVISION  OF  INPATIENT  OBSTETRICAL PATIENT CARE SERVICES IN AN AMOUNT
EQUAL TO ONE AND SIX-TENTHS PERCENT  OF  SUCH  REVENUE,  AS  DEFINED  IN
ACCORDANCE   WITH   PARAGRAPH   (A)  OF  SUBDIVISION  THREE  OF  SECTION
TWENTY-EIGHT HUNDRED SEVEN-D OF THIS ARTICLE, PROVIDED, HOWEVER, THAT IN
THE EVENT THE COMMISSIONER, IN CONSULTATION WITH  THE  DIRECTOR  OF  THE
BUDGET,  DETERMINES THAT SUCH QUALITY CONTRIBUTION SHALL RAISE LESS THAN
OR MORE THAN THE TOTAL QUALITY COLLECTION AMOUNT SET FORTH  IN  SUBDIVI-
SION  TWO  OF  THIS  SECTION, THE COMMISSIONER, IN CONSULTATION WITH THE
DIRECTOR OF THE BUDGET, MAY PROMULGATE REGULATIONS, AND  MAY  PROMULGATE
EMERGENCY  REGULATIONS,  INCREASING  OR DECREASING SUCH QUALITY CONTRIB-

S. 2809--D                         154                        A. 4009--D

UTIONS BY AMOUNTS SUFFICIENT TO ENSURE THE  COLLECTION  OF  SUCH  ANNUAL
QUALITY CONTRIBUTION AMOUNT.
  2.  THE  ANNUAL  QUALITY CONTRIBUTION AMOUNT REFERENCED IN SUBDIVISION
ONE OF THIS SECTION SHALL BE THIRTY MILLION DOLLARS FOR THE STATE FISCAL
YEAR BEGINNING APRIL FIRST, TWO THOUSAND ELEVEN, AND FOR EACH SUBSEQUENT
STATE FISCAL YEAR THEREAFTER IT SHALL BE THE  AMOUNT  OF  THE  PRECEDING
YEAR  AS INCREASED BY 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.
  3. THE QUALITY CONTRIBUTIONS DESCRIBED IN THIS SECTION SHALL BE ADMIN-
ISTERED IN ACCORDANCE WITH AND SUBJECT TO THE PROVISIONS OF SUBDIVISIONS
FOUR, FIVE, SIX, SEVEN, EIGHT AND TWELVE OF SECTION TWENTY-EIGHT HUNDRED
SEVEN-D OF THIS ARTICLE, PROVIDED, HOWEVER, THAT SUCH  QUALITY  CONTRIB-
UTIONS  SHALL  BE  DEPOSITED  IN  THE HCRA RESOURCES FUND AS ESTABLISHED
PURSUANT TO SECTION NINETY-TWO-DD OF THE STATE FINANCE LAW; AND PROVIDED
FURTHER, HOWEVER, THAT SUCH CONTRIBUTIONS SHALL NOT BE AN ALLOWABLE COST
IN THE DETERMINATION OF REIMBURSEMENT RATES OF PAYMENT COMPUTED PURSUANT
TO THIS ARTICLE.
  S 52-d. The civil practice law and rules is amended by  adding  a  new
rule 3409 to read as follows:
  RULE  3409.  SETTLEMENT  CONFERENCE  IN  DENTAL, PODIATRIC AND MEDICAL
MALPRACTICE ACTIONS.  IN EVERY DENTAL, PODIATRIC OR MEDICAL  MALPRACTICE
ACTION,  THE  COURT  SHALL HOLD A MANDATORY SETTLEMENT CONFERENCE WITHIN
FORTY-FIVE DAYS AFTER THE FILING OF THE NOTE OF ISSUE AND CERTIFICATE OF
READINESS OR, IF A PARTY MOVES TO VACATE THE NOTE OF ISSUE  AND  CERTIF-
ICATE  OF  READINESS,  WITHIN  FORTY-FIVE  DAYS AFTER THE DENIAL OF SUCH
MOTION. WHERE PARTIES ARE REPRESENTED BY COUNSEL, ONLY  ATTORNEYS  FULLY
FAMILIAR  WITH  THE  ACTION  AND  AUTHORIZED  TO DISPOSE OF THE CASE, OR
ACCOMPANIED BY A PERSON EMPOWERED TO ACT ON BEHALF OF THE PARTY  REPRES-
ENTED, WILL BE PERMITTED TO APPEAR AT THE CONFERENCE. WHERE APPROPRIATE,
THE COURT MAY ORDER PARTIES, REPRESENTATIVES OF PARTIES, REPRESENTATIVES
OF INSURANCE CARRIERS OR PERSONS HAVING AN INTEREST IN ANY SETTLEMENT TO
ALSO  ATTEND  IN  PERSON OR TELEPHONICALLY AT THE SETTLEMENT CONFERENCE.
THE CHIEF ADMINISTRATIVE JUDGE SHALL BY RULE ADOPT PROCEDURES TO  IMPLE-
MENT SUCH SETTLEMENT CONFERENCE.
  S  52-e. The state finance law is amended by adding a new section 99-t
to read as follows:
  S 99-T. NEW YORK STATE MEDICAL INDEMNITY FUND ACCOUNT.   1.  THERE  IS
HEREBY  ESTABLISHED  IN  THE CUSTODY OF THE COMMISSIONER OF TAXATION AND
FINANCE A SPECIAL ACCOUNT TO BE KNOWN AS THE  "NEW  YORK  STATE  MEDICAL
INDEMNITY FUND ACCOUNT".
  2.  ALL  MONEYS  RECEIVED BY THE NEW YORK STATE MEDICAL INDEMNITY FUND
PURSUANT TO TITLE FOUR OF ARTICLE TWENTY-NINE-D OF THE PUBLIC HEALTH LAW
FROM WHATEVER SOURCE DERIVED SHALL BE DEPOSITED TO THE EXCLUSIVE  CREDIT
OF  SUCH  FUND ACCOUNT. SAID MONEYS SHALL BE KEPT SEPARATE AND SHALL NOT
BE COMMINGLED WITH ANY OTHER MONEYS IN THE CUSTODY OF  THE  COMMISSIONER
OF TAXATION AND FINANCE.
  3.  THE MONEYS IN SAID ACCOUNT SHALL BE RETAINED BY THE FUND AND SHALL
BE RELEASED BY THE  COMMISSIONER  OF  TAXATION  AND  FINANCE  ONLY  UPON
CERTIFICATES  SIGNED  BY THE SUPERINTENDENT OF FINANCIAL SERVICES OR THE
HEAD OF ANY SUCCESSOR AGENCY TO THE DEPARTMENT OF INSURANCE  OR  HIS  OR
HER  DESIGNEE AND ONLY FOR THE PURPOSES SET FORTH IN TITLE FOUR OF ARTI-
CLE TWENTY-NINE-D OF THE PUBLIC HEALTH LAW.
  S 52-f. Part C of chapter 58 of the laws of 2005, amending the  public
health  law  and  other  laws relating to authorizing reimbursements for

S. 2809--D                         155                        A. 4009--D

expenditures made by social services districts for  medical  assistance,
is amended by adding a new section 5-a to read as follows:
  S  5-A.  NOTWITHSTANDING  ANY  PROVISION  OF  LAW TO THE CONTRARY, THE
COMMISSIONER OF HEALTH IS AUTHORIZED TO APPROVE SOCIAL SERVICES DISTRICT
DEMONSTRATION PROGRAMS FOR THE PURPOSE  OF  MAXIMIZING  MEDICAID  RECOV-
ERIES. THE COMMISSIONER SHALL EVALUATE THE RESULTS OF ANY SUCH PROGRAMS,
INCLUDING  ANY  SAVINGS  RESULTING  THEREFROM.  TEN  PERCENT OF ANY SUCH
SAVINGS, AFTER CERTIFICATION BY THE DIRECTOR  OF  THE  DIVISION  OF  THE
BUDGET,  SHALL BE SHARED WITH THE APPLICABLE SOCIAL SERVICES DISTRICT IN
A MANNER TO BE DETERMINED JOINTLY BY THE COMMISSIONER OF HEALTH AND  THE
DIRECTOR OF THE DIVISION OF THE BUDGET.
  S  52-g. Subdivision 1 of section 104-b of the social services law, as
amended by chapter 271 of the laws  of  1965,  is  amended  to  read  as
follows:
  1.  If a recipient of public assistance and care shall have a right of
action, suit, claim, counterclaim or demand against another  on  account
of  any  personal  injuries  suffered by such recipient, then the public
welfare official for the public welfare district providing such  assist-
ance  and  care shall have a lien for such amount as may be fixed by the
public welfare official not exceeding, however, the total amount of such
assistance and care furnished by such public  welfare  official  on  and
after  the  date  when  such injuries were incurred.  IN ALL SUCH CASES,
NOTICE OF THE COMMENCEMENT OF SUCH AN ACTION SHALL BE  SERVED  UPON  THE
PUBLIC  WELFARE  DISTRICT THAT HAS PROVIDED OR IS PROVIDING SUCH ASSIST-
ANCE AND CARE, OR UPON THE DEPARTMENT OF HEALTH.
  The [welfare] commissioner shall endeavor to  ascertain  whether  such
person,  firm or corporation alleged to be responsible for such injuries
is insured with a liability insurance company, as the case may  be,  and
the name thereof.
  S  52-h.  The  civil practice law and rules is amended by adding a new
section 306-c to read as follows:
  S 306-C. NOTICE OF COMMENCEMENT OF ACTION  FOR  PERSONAL  INJURIES  BY
RECIPIENT  OF  MEDICAL ASSISTANCE.  IN THE CASE OF AN INDIVIDUAL WHO HAS
SUFFERED PERSONAL INJURIES AND HAS RECEIVED MEDICAL ASSISTANCE  PURSUANT
TO TITLES ELEVEN AND ELEVEN-D OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW
ON  OR  AFTER  THE DATE OF SUCH INJURY, NOTICE OF THE COMMENCEMENT OF AN
ACTION BY OR ON BEHALF OF SUCH INDIVIDUAL  FOR  SUCH  PERSONAL  INJURIES
SHALL  BE  SENT  TO  THE SOCIAL SERVICES DISTRICT IN THE COUNTY IN WHICH
SUCH RECIPIENT RESIDES, OR TO THE DEPARTMENT  OF  HEALTH,  BY  CERTIFIED
MAIL,  RETURN  RECEIPT REQUESTED, OR ELECTRONICALLY IN ACCORD WITH REGU-
LATIONS PROMULGATED BY THE COMMISSIONER OF  THE  DEPARTMENT  OF  HEALTH,
WITHIN  SIXTY DAYS OF THE COMPLETION OF SERVICE UPON ALL PARTIES TO SUCH
ACTION.  PROOF OF SENDING SUCH NOTICE SHALL BE FILED WITH THE  COURT  IN
ACCORDANCE  WITH  RULE  THREE  HUNDRED SIX OF THIS ARTICLE. SENDING SUCH
NOTICE SHALL NOT  BE  A  JURISDICTIONAL  REQUIREMENT  TO  COMMENCING  AN
ACTION.
  S 52-i. Intentionally omitted.
  S 52-j. Intentionally omitted.
  S 52-k. Intentionally omitted.
  S 52-l. Intentionally omitted.
  S 52-m. Intentionally omitted.
  S  53.  Subdivision  6  of  section 369 of the social services law, as
added by chapter 170 of the laws of 1994, is amended to read as follows:
  6. For purposes of this section, [the term] AN  INDIVIDUAL'S  "estate"
[means]  INCLUDES all OF THE INDIVIDUAL'S real and personal property and
other assets [included within the individual's estate and] passing under

S. 2809--D                         156                        A. 4009--D

the terms of a valid will or by  intestacy.    PURSUANT  TO  REGULATIONS
ADOPTED  BY  THE  COMMISSIONER, WHICH MAY BE PROMULGATED ON AN EMERGENCY
BASIS, AN INDIVIDUAL'S ESTATE ALSO INCLUDES ANY OTHER PROPERTY IN  WHICH
THE  INDIVIDUAL  HAS  ANY  LEGAL TITLE OR INTEREST AT THE TIME OF DEATH,
INCLUDING JOINTLY HELD PROPERTY, RETAINED LIFE ESTATES, AND INTERESTS IN
TRUSTS, TO THE EXTENT OF SUCH INTERESTS; PROVIDED, HOWEVER, THAT A CLAIM
AGAINST A RECIPIENT OF SUCH PROPERTY BY DISTRIBUTION OR  SURVIVAL  SHALL
BE  LIMITED  TO  THE  VALUE  OF  THE  PROPERTY RECEIVED OR THE AMOUNT OF
MEDICAL ASSISTANCE  BENEFITS  OTHERWISE  RECOVERABLE  PURSUANT  TO  THIS
SECTION,  WHICHEVER  IS  LESS.    NOTHING  IN  THIS SUBDIVISION SHALL BE
CONSTRUED AS AUTHORIZING THE DEPARTMENT OR A SOCIAL SERVICES DISTRICT TO
IMPOSE LIENS OR MAKE RECOVERIES THAT  ARE  PROHIBITED  BY  FEDERAL  LAWS
GOVERNING THE MEDICAL ASSISTANCE PROGRAM.
  S 54. Subparagraph 12 of paragraph (a) of subdivision 1 of section 366
of  the  social  services  law,  as amended by section 42-a of part C of
chapter 58 of the laws of 2008, is amended to read as follows:
  (12) is a disabled person at least sixteen years of age, but under the
age of sixty-five, who: would be eligible for benefits under the supple-
mental security income program but for earnings in excess of the  allow-
able  limit;  has  net available income that does not exceed two hundred
fifty percent of the applicable federal income official poverty line, as
defined and updated by the United States department of health and  human
services,  for  a  one-person or two-person household, as defined by the
commissioner in regulation; has household resources, as defined in para-
graph (e) of subdivision two of section  three  hundred  sixty-six-c  of
this  title,  OTHER  THAN  RETIREMENT  ACCOUNTS, that do not exceed [the
amount described in subparagraph four of paragraph  (a)  of  subdivision
two  of this section] TWENTY THOUSAND DOLLARS for a one-person HOUSEHOLD
or THIRTY THOUSAND DOLLARS FOR A two-person household, as defined by the
commissioner in regulation; and  contributes  to  the  cost  of  medical
assistance  provided  pursuant  to  this subparagraph in accordance with
subdivision twelve of section three hundred sixty-seven-a of this title;
for purposes of this subparagraph, disabled  means  having  a  medically
determinable  impairment  of sufficient severity and duration to qualify
for benefits under section 1902(a)(10)(A)(ii)(xv) of the social security
act; or
  S 55. The mental hygiene law is amended by adding a new section  31.08
to read as follows:
S 31.08 COMPLIANCE WITH OPERATIONAL STANDARDS BY HOSPITALS.
  (A)  NOTWITHSTANDING  THE PROVISIONS OF SECTION 31.07 OF THIS ARTICLE,
WITH RESPECT TO A HOSPITAL AS DEFINED IN SECTION 1.03 OF  THIS  CHAPTER,
WHICH  IS A WARD, WING, UNIT, OR OTHER PART OF A HOSPITAL, AS DEFINED IN
ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW, WHICH  PROVIDES  SERVICES
FOR  PERSONS  WITH  MENTAL  ILLNESS PURSUANT TO AN OPERATING CERTIFICATE
ISSUED BY THE COMMISSIONER, THE REQUIREMENTS OF SECTION  31.07  OF  THIS
ARTICLE  MAY BE DEEMED TO BE MET IF SUCH HOSPITAL HAS BEEN ACCREDITED BY
THE JOINT COMMISSION, OR ANY OTHER HOSPITAL ACCREDITING ORGANIZATION  TO
WHICH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES HAS GRANTED DEEMING
STATUS, AND WHICH THE COMMISSIONER SHALL HAVE DETERMINED HAS ACCREDITING
STANDARDS  SUFFICIENT  TO  ASSURE  THE  COMMISSIONER  THAT  HOSPITALS SO
ACCREDITED ARE IN COMPLIANCE WITH THE PROVISIONS  OF  THIS  CHAPTER  AND
APPLICABLE LAWS, RULES AND REGULATIONS IN REGARD TO SERVICES PROVIDED AT
SUCH  WING,  WARD,  UNIT OR OTHER PART OF A HOSPITAL. SUCH ACCREDITATION
SHALL HAVE THE SAME LEGAL EFFECT AS A DETERMINATION BY THE  COMMISSIONER
UNDER  SECTION  31.07 OF THIS ARTICLE THAT THE HOSPITAL IS IN COMPLIANCE
WITH SUCH PROVISIONS.   THE COMMISSIONER MAY EXEMPT  ANY  SUCH  HOSPITAL

S. 2809--D                         157                        A. 4009--D

FROM  THE  ANNUAL  INSPECTION AND VISITATION REQUIREMENTS ESTABLISHED IN
SECTION 31.07 OF THIS ARTICLE, PROVIDED THAT:
  1.  SUCH  HOSPITAL HAS A HISTORY OF COMPLIANCE WITH SUCH PROVISIONS OF
LAW, RULES AND REGULATIONS AND A RECORD OF PROVIDING GOOD QUALITY  CARE,
AS DETERMINED BY THE COMMISSIONER;
  2. A COPY OF THE SURVEY REPORT AND THE CERTIFICATE OF ACCREDITATION OF
THE  JOINT  COMMISSION  OR  OTHER  APPROVED  ACCREDITING ORGANIZATION IS
SUBMITTED BY THE ACCREDITING BODY OR THE HOSPITAL TO  THE  COMMISSIONER,
WITHIN SEVEN DAYS OF ISSUANCE TO THE HOSPITAL;
  3.  THE  JOINT COMMISSION OR OTHER ACCREDITING ORGANIZATION HAS AGREED
TO AND DOES EVALUATE, AS PART OF ITS ACCREDITATION SURVEY,  ANY  MINIMAL
OPERATIONAL STANDARDS ESTABLISHED BY THE COMMISSIONER WHICH ARE IN ADDI-
TION  TO THE MINIMAL OPERATIONAL STANDARDS OF ACCREDITATION OF THE JOINT
COMMISSION OR OTHER ACCREDITING ORGANIZATION; AND
  4. THERE ARE NO CONSTRAINTS PLACED UPON ACCESS BY THE COMMISSIONER  TO
THE  JOINT  COMMISSION OR OTHER APPROVED ACCREDITING ORGANIZATION SURVEY
REPORTS, PLANS OF CORRECTION, INTERIM SELF-EVALUATION  REPORTS,  NOTICES
OF  NONCOMPLIANCE, PROGRESS REPORTS ON CORRECTION OF AREAS OF NONCOMPLI-
ANCE, OR ANY OTHER RELATED REPORTS, INFORMATION, COMMUNICATIONS OR MATE-
RIALS REGARDING SUCH HOSPITAL.
  (B) ANY HOSPITAL GOVERNED BY THE PROVISIONS OF SUBDIVISION (A) OF THIS
SECTION SHALL AT ALL TIMES BE SUBJECT TO INSPECTION OR VISITATION BY THE
COMMISSIONER TO DETERMINE COMPLIANCE WITH APPLICABLE  LAW,  REGULATIONS,
STANDARDS  OR  CONDITIONS  AS DEEMED NECESSARY BY THE COMMISSIONER.  ANY
SUCH HOSPITAL SHALL BE SUBJECT TO THE FULL RANGE OF  LICENSING  ENFORCE-
MENT AUTHORITY OF THE COMMISSIONER.
  (C) ANY HOSPITAL GOVERNED BY THE PROVISIONS OF SUBDIVISION (A) OF THIS
SECTION SHALL NOTIFY THE COMMISSIONER IMMEDIATELY UPON RECEIPT OF NOTICE
BY  THE  JOINT COMMISSION OR OTHER APPROVED ACCREDITING ORGANIZATION, OR
ANY COMMUNICATION THE HOSPITAL MAY RECEIVE THAT SUCH  ORGANIZATION  WILL
BE  RECOMMENDING  THAT  SUCH  HOSPITAL  NOT  BE ACCREDITED, NOT HAVE ITS
ACCREDITATION RENEWED, OR HAVE ITS  ACCREDITATION  TERMINATED,  OR  UPON
RECEIPT  OF  NOTICE OR OTHER COMMUNICATION FROM THE CENTERS FOR MEDICARE
AND MEDICAID SERVICES REGARDING A DETERMINATION THAT THE  HOSPITAL  WILL
BE  TERMINATED  FROM PARTICIPATION IN THE MEDICARE PROGRAM BECAUSE IT IS
NOT IN COMPLIANCE WITH ONE OR MORE CONDITIONS OF PARTICIPATION  IN  SUCH
PROGRAM,  OR HAS DEFICIENCIES THAT EITHER INDIVIDUALLY OR IN COMBINATION
JEOPARDIZE THE HEALTH AND SAFETY OF PATIENTS OR ARE OF SUCH CHARACTER AS
TO SERIOUSLY LIMIT THE PROVIDER'S CAPACITY TO RENDER ADEQUATE CARE.
  S 56.  The mental hygiene law is amended by adding a new section 32.14
to read as follows:
S 32.14 COMPLIANCE WITH OPERATIONAL STANDARDS BY PROVIDERS  OF  SERVICES
          IN HOSPITALS.
  (A)  NOTWITHSTANDING  THE PROVISIONS OF SECTION 32.13 OF THIS ARTICLE,
WITH RESPECT TO A PROVIDER OF SERVICES AS DEFINED  IN  SECTION  1.03  OF
THIS CHAPTER THAT OCCUPIES A WARD, WING, UNIT, OR OTHER PART OF A HOSPI-
TAL,  AS DEFINED IN ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW, WHICH
PROVIDES SERVICES FOR PERSONS WITH MENTAL DISABILITIES  PURSUANT  TO  AN
OPERATING  CERTIFICATE  ISSUED  BY THE COMMISSIONER, THE REQUIREMENTS OF
SECTION 32.13 OF THIS ARTICLE MAY BE DEEMED TO BE MET IF  SUCH  HOSPITAL
HAS  BEEN  ACCREDITED  BY THE JOINT COMMISSION, OR ANY OTHER ACCREDITING
ORGANIZATION TO WHICH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES HAS
GRANTED DEEMING STATUS, AND WHICH THE COMMISSIONER SHALL HAVE DETERMINED
HAS ACCREDITING STANDARDS SUFFICIENT TO  ASSURE  THE  COMMISSIONER  THAT
PROVIDERS OF SERVICES OCCUPYING A WARD, WING, UNIT OR OTHER PART OF SUCH
HOSPITAL  SO  ACCREDITED  ARE  IN COMPLIANCE WITH THE PROVISIONS OF THIS

S. 2809--D                         158                        A. 4009--D

CHAPTER AND APPLICABLE LAWS, RULES AND REGULATIONS IN REGARD TO SERVICES
PROVIDED AT SUCH WARD, WING, UNIT OR OTHER PART OF  A  HOSPITAL.    SUCH
ACCREDITATION SHALL HAVE THE SAME LEGAL EFFECT AS A DETERMINATION BY THE
COMMISSIONER  UNDER  SECTION  32.13 OF THIS ARTICLE THAT THE PROVIDER OF
SERVICES IS IN COMPLIANCE WITH SUCH PROVISIONS.   THE  COMMISSIONER  MAY
EXEMPT  ANY SUCH PROVIDER OF SERVICES, IN REGARD TO SERVICES PROVIDED AT
SUCH WARD, WING, UNIT OR OTHER PART  OF  A  HOSPITAL,  FROM  THE  ANNUAL
INSPECTION  AND  VISITATION REQUIREMENTS ESTABLISHED IN SECTION 32.13 OF
THIS ARTICLE, PROVIDED THAT:
  1. SUCH PROVIDER OF SERVICES HAS A HISTORY  OF  COMPLIANCE  WITH  SUCH
PROVISIONS  OF LAW, RULES AND REGULATIONS AND A RECORD OF PROVIDING GOOD
QUALITY CARE, AS DETERMINED BY THE COMMISSIONER;
  2. A COPY OF THE SURVEY REPORT AND THE CERTIFICATE OF ACCREDITATION OF
THE JOINT COMMISSION  OR  OTHER  APPROVED  ACCREDITING  ORGANIZATION  IS
SUBMITTED  BY  THE  ACCREDITING  BODY OR THE PROVIDER OF SERVICES TO THE
COMMISSIONER,  WITHIN  SEVEN  DAYS  OF  ISSUANCE  TO  SUCH  PROVIDER  OF
SERVICES;
  3. THE JOINT COMMISSION OR OTHER APPROVED ACCREDITING ORGANIZATION HAS
AGREED  TO  AND  DOES EVALUATE, AS PART OF ITS ACCREDITATION SURVEY, ANY
MINIMAL OPERATIONAL STANDARDS ESTABLISHED BY THE COMMISSIONER WHICH  ARE
IN ADDITION TO THE MINIMAL OPERATIONAL STANDARDS OF ACCREDITATION OF THE
JOINT COMMISSION OR OTHER ACCREDITING ORGANIZATION; AND
  4.  THERE ARE NO CONSTRAINTS PLACED UPON ACCESS BY THE COMMISSIONER TO
THE JOINT COMMISSION OR OTHER APPROVED ACCREDITING  ORGANIZATION  SURVEY
REPORTS,  PLANS  OF CORRECTION, INTERIM SELF-EVALUATION REPORTS, NOTICES
OF NONCOMPLIANCE, PROGRESS REPORTS ON CORRECTION OF AREAS OF  NONCOMPLI-
ANCE, OR ANY OTHER RELATED REPORTS, INFORMATION, COMMUNICATIONS OR MATE-
RIALS REGARDING SUCH PROVIDER OF SERVICES.
  (B) ANY PROVIDER OF SERVICES GOVERNED BY THE PROVISIONS OF SUBDIVISION
(A) OF THIS SECTION SHALL AT ALL TIMES BE SUBJECT TO INSPECTION OR VISI-
TATION  BY THE COMMISSIONER TO DETERMINE COMPLIANCE WITH APPLICABLE LAW,
REGULATIONS, STANDARDS OR CONDITIONS AS DEEMED NECESSARY BY THE  COMMIS-
SIONER. ANY SUCH PROVIDER OF SERVICES SHALL BE SUBJECT TO THE FULL RANGE
OF CERTIFICATION ENFORCEMENT AUTHORITY OF THE COMMISSIONER.
  (C) ANY PROVIDER OF SERVICES GOVERNED BY THE PROVISIONS OF SUBDIVISION
(A)  OF  THIS  SECTION  SHALL  NOTIFY  THE COMMISSIONER IMMEDIATELY UPON
RECEIPT OF NOTICE BY THE JOINT COMMISSION OR OTHER APPROVED  ACCREDITING
ORGANIZATION,  OR ANY COMMUNICATION THE PROVIDER OF SERVICES MAY RECEIVE
THAT SUCH ORGANIZATION  WILL  BE  RECOMMENDING  THAT  SUCH  PROVIDER  OF
SERVICES  NOT BE ACCREDITED, NOT HAVE ITS ACCREDITATION RENEWED, OR HAVE
ITS ACCREDITATION TERMINATED, OR UPON RECEIPT OF NOTICE OR OTHER  COMMU-
NICATION FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES REGARDING A
DETERMINATION  THAT  THE  PROVIDER  OF  SERVICES WILL BE TERMINATED FROM
PARTICIPATION IN THE MEDICARE OR MEDICAID PROGRAM BECAUSE IT IS  NOT  IN
COMPLIANCE WITH ONE OR MORE CONDITIONS OF PARTICIPATION IN SUCH PROGRAM,
OR  HAS DEFICIENCIES THAT EITHER INDIVIDUALLY OR IN COMBINATION JEOPARD-
IZE THE HEALTH AND SAFETY OF PATIENTS OR ARE OF  SUCH  CHARACTER  AS  TO
SERIOUSLY LIMIT THE PROVIDER'S CAPACITY TO RENDER ADEQUATE CARE.
  S 57. Intentionally omitted.
  S 58. Section 2805-l of the public health law, as added by chapter 266
of the laws of 1986, subdivision 3 as amended by chapter 542 of the laws
of 2000, subdivision 4 as added and subdivision 5 as renumbered by chap-
ter 632 of the laws of 2006, is amended to read as follows:
  S  2805-l.  [Incident] ADVERSE EVENT reporting. 1. (A) All hospitals[,
as defined in subdivision ten of section  twenty-eight  hundred  one  of
this  article,] shall be required to report [incidents] EVENTS described

S. 2809--D                         159                        A. 4009--D

by subdivision two of this section to the department  in  a  manner  and
within time periods as may be specified by regulation of the department.
  (B)  FOR PURPOSES OF THIS SECTION, "HOSPITAL" MEANS ANY GENERAL HOSPI-
TAL OR DIAGNOSTIC AND TREATMENT CENTER.
  2. The following [incidents] ADVERSE EVENTS shall be reported  to  the
department:
  (a)  patients'  deaths  or  impairments of bodily functions in circum-
stances other than those related  to  the  natural  course  of  illness,
disease  or  proper  treatment  in  accordance  with  generally accepted
medical standards;
  (b) fires in the hospital which disrupt the provision of patient  care
services or cause harm to patients or staff;
  (c)  equipment  malfunction during treatment or diagnosis of a patient
which did or could have adversely affected a patient or hospital person-
nel;
  (d) poisoning occurring within the hospital;
  (e) strikes by hospital staff;
  (f) disasters or other emergency situations external to  the  hospital
environment which affect hospital operations; and
  (g)  termination of any services vital to the continued safe operation
of the hospital or to the health and safety of its patients and  person-
nel,  including but not limited to the anticipated or actual termination
of telephone, electric, gas, fuel, water, heat, air conditioning, rodent
or pest control, laundry services, food or contract services.
  3.  NOTWITHSTANDING ANY PROVISION OF THIS SECTION TO THE CONTRARY, THE
COMMISSIONER IS AUTHORIZED, AS APPROPRIATE IN THE INTEREST OF  PROMOTING
PATIENT  SAFETY, AND AFTER CONSULTING WITH CLINICIANS, HOSPITAL ADMINIS-
TRATORS, RESEARCHERS, AND  CONSUMERS  WITH  EXPERTISE  IN  THE  AREA  OF
PATIENT  SAFETY AND QUALITY IMPROVEMENT, TO ADD, MODIFY OR ELIMINATE ONE
OR MORE ADVERSE EVENTS SET FORTH IN SUBDIVISION TWO OF THIS SECTION,  BY
REGULATION, CONSISTENT WITH NATIONAL CONSENSUS STANDARDS ENDORSED BY THE
CONSENSUS-BASED  ENTITY  SELECTED  FOR  THE  PURPOSE OF PURSUING CERTAIN
ACTIVITIES RELATING TO HEALTHCARE PERFORMANCE MEASUREMENT  BY  THE  U.S.
DEPARTMENT  OF  HEALTH  AND  HUMAN  SERVICES  PURSUANT  TO  THE MEDICARE
IMPROVEMENTS FOR PATIENTS AND PROVIDERS ACT (PUB. L. 110-275).
  4. The hospital shall conduct an investigation of  [incidents]  EVENTS
described  in  paragraphs  (a)  through  (d)  of subdivision two of this
section within thirty days of obtaining  knowledge  of  any  information
which  reasonably  appears  to  show  that  such an [incident] EVENT has
occurred, provided that, if the hospital reasonably expects such  inves-
tigation  to  extend  beyond  such thirty day period, the hospital shall
notify the department of such expectation and the reason  therefor,  and
shall  inform  the  department  of  the  expected completion date of the
investigation. The hospital shall provide to the department  a  copy  of
the investigation report within twenty-four hours of completion. Nothing
herein  shall limit the authority of the department to conduct an inves-
tigation of [incidents] EVENTS occurring in [general] hospitals.
  5. THE DEPARTMENT SHALL:
  (A) ANALYZE EVENT REPORTS, FINDINGS OF THE INVESTIGATIONS, THEIR  ROOT
CAUSE  ANALYSES,  AND  CORRECTIVE  ACTION PLANS TO DETERMINE PATTERNS OF
SYSTEMIC FAILURE IN THE HEALTH CARE SYSTEM AND IDENTIFY SUCCESSFUL METH-
ODS TO CORRECT THESE FAILURES; AND
  (B) COMMUNICATE TO FACILITIES THE DEPARTMENT'S  CONCLUSIONS,  IF  ANY,
REGARDING  EVENT  REPORTS, PATTERNS OF SYSTEMIC FAILURE, AND RECOMMENDA-
TIONS FOR CORRECTIVE ACTION RESULTING FROM THE ANALYSIS  OF  SUBMISSIONS
FROM  FACILITIES;  AND  MAY  RELEASE, IN A FORMAT THAT DOES NOT IDENTIFY

S. 2809--D                         160                        A. 4009--D

SPECIFIC PATIENTS AND DOES NOT PROVIDE REASONABLE BASIS TO BELIEVE  THAT
THE  INFORMATION  CAN  BE  USED  TO IDENTIFY A PATIENT; (I) ANALYSES AND
FINDINGS DERIVED FROM THE ADVERSE EVENT DATA TO HOSPITALS OR THE  PUBLIC
AND  (II)  ADVERSE EVENT DATA TO RESEARCHERS FOR PATIENT SAFETY RESEARCH
PROJECTS APPROVED BY THE COMMISSIONER, SUBJECT TO ANY TERMS  AND  CONDI-
TIONS  IMPOSED BY THE COMMISSIONER CONCERNING THE SECURITY AND CONFIDEN-
TIALITY OF THE DATA AND THEIR USE;  AND  PROVIDED  THAT  NO  SUCH  DATA,
RECORD,  DOCUMENTATION  OR  ACTION SUBJECT TO SUBDIVISION TWO OF SECTION
TWENTY-EIGHT HUNDRED FIVE-M OF THIS ARTICLE, SHALL BE SUBJECT TO DISCLO-
SURE UNDER ARTICLE SIX OF THE PUBLIC OFFICERS LAW NOR ARTICLE THIRTY-ONE
OF THE CIVIL PRACTICE LAW AND RULES.
  [4] 6.   The  commissioner  shall  establish  protocols  for  hospital
personnel  where  a  patient under the age of eighteen years dies during
transportation to the hospital or while at the hospital,  under  circum-
stances  other  than  those  related  to  the natural course of illness,
disease or  proper  treatment  in  accordance  with  generally  accepted
medical  standards.  Such protocols shall address matters including, but
not limited to, the following:
  (a) medical and social history, and examination of the patient;
  (b) preservation of evidence and chain of custody;
  (c) questioning  of  the  patient's  family,  guardian  or  person  in
parental authority;
  (d) circumstances surrounding the injury resulting in death;
  (e) determination of the cause of death;
  (f) notification of law enforcement personnel; and
  (g)  reporting  requirements  under  title  six  of article six of the
social services law.
  In developing such protocols, the commissioner shall consult with  the
office  of  children  and  family  services, local departments of social
services, coordinators of child fatality review teams established pursu-
ant to section four hundred twenty-two-b of the social services law, law
enforcement agencies, pediatricians preferably  with  expertise  in  the
area  of  child  abuse and maltreatment or forensic pediatrics, and such
other persons as the commissioner deems necessary.
  [5] 7.  The commissioner shall make,  adopt,  promulgate  and  enforce
such  rules and regulations as he may deem appropriate to effectuate the
purposes of this section.
  S 59. Intentionally omitted.
  S 60. Intentionally omitted.
  S 61. Intentionally omitted.
  S 62. Intentionally omitted.
  S 63. Subdivision 38 of section  2  of  the  social  services  law  is
amended  by  adding four new paragraphs (f), (g), (h) and (i) to read as
follows:
  (F) "VERIFICATION ORGANIZATION" MEANS AN ENTITY, OPERATING IN A MANNER
CONSISTENT WITH APPLICABLE FEDERAL AND STATE CONFIDENTIALITY AND PRIVACY
LAWS AND REGULATIONS, WHICH USES  ELECTRONIC  MEANS  INCLUDING  BUT  NOT
LIMITED  TO  CONTEMPORANEOUS  TELEPHONE  VERIFICATION OR CONTEMPORANEOUS
VERIFIED ELECTRONIC DATA  TO  VERIFY  WHETHER  A  SERVICE  OR  ITEM  WAS
PROVIDED TO AN ELIGIBLE MEDICAID RECIPIENT. FOR EACH SERVICE OR ITEM THE
VERIFICATION ORGANIZATION SHALL CAPTURE:
  (I)  THE IDENTITY OF THE INDIVIDUAL PROVIDING SERVICES OR ITEMS TO THE
MEDICAID RECIPIENT;
  (II) THE IDENTITY OF THE MEDICAID RECIPIENT; AND
  (III) THE DATE, TIME, DURATION, LOCATION AND TYPE OF SERVICE OR ITEM.

S. 2809--D                         161                        A. 4009--D

  A LIST OF VERIFICATION ORGANIZATIONS SHALL BE JOINTLY DEVELOPED BY THE
DEPARTMENT OF HEALTH AND THE OFFICE OF THE MEDICAID INSPECTOR GENERAL.
  (G)  "EXCEPTION  REPORT" MEANS AN ELECTRONIC REPORT CONTAINING ALL THE
DATA FIELDS IN PARAGRAPH (F) OF THIS SUBDIVISION FOR  CONFLICTS  BETWEEN
SERVICES  OR  ITEMS ON THE BASIS OF THE IDENTITY OF THE PERSON PROVIDING
THE SERVICE OR ITEM TO THE MEDICAID RECIPIENT, THE IDENTITY OF THE MEDI-
CAID RECIPIENT, AND/OR TIME, DATE, DURATION OR LOCATION OF SERVICE;
  (H) "CONFLICT REPORT" MEANS AN ELECTRONIC REPORT CONTAINING ALL OF THE
DATA FIELDS IN PARAGRAPH (F) OF THIS SUBDIVISION DETAILING INCONGRUITIES
IN SERVICES OR ITEMS BETWEEN SCHEDULING AND/OR LOCATION OF SERVICE  WHEN
COMPARED TO A DUTY ROSTER.
  (I)  "PARTICIPATING  PROVIDER"  MEANS  A CERTIFIED HOME HEALTH AGENCY,
LONG TERM HOME HEALTH AGENCY OR PERSONAL CARE PROVIDER WITH TOTAL  MEDI-
CAID REIMBURSEMENTS EXCEEDING FIFTEEN MILLION DOLLARS PER CALENDAR YEAR.
  S 64. The social services law is amended by adding a new section 363-e
to read as follows:
  S  363-E.  PRECLAIM  REVIEW  FOR  PARTICIPATING  PROVIDERS  OF MEDICAL
ASSISTANCE PROGRAM SERVICES AND ITEMS. EVERY SERVICE OR  ITEM  WITHIN  A
CLAIM  SUBMITTED BY A PARTICIPATING PROVIDER SHALL BE REVIEWED AND VERI-
FIED BY A VERIFICATION ORGANIZATION PRIOR TO SUBMISSION OF  A  CLAIM  TO
THE  DEPARTMENT  OF  HEALTH. THE VERIFICATION ORGANIZATION SHALL DECLARE
EACH SERVICE OR ITEM TO BE VERIFIED OR  UNVERIFIED.  EACH  PARTICIPATING
PROVIDER SHALL RECEIVE AND MAINTAIN REPORTS FROM THE VERIFICATION ORGAN-
IZATION WHICH SHALL CONTAIN DATA ON:
  1. VERIFIED SERVICES OR ITEMS, INCLUDING WHETHER A SERVICE APPEARED ON
A CONFLICT OR EXCEPTION REPORT BEFORE VERIFICATION AND HOW THAT CONFLICT
OR EXCEPTION WAS RESOLVED; AND
  2.  SERVICES  OR  ITEMS THAT WERE NOT VERIFIED, INCLUDING CONFLICT AND
EXCEPTION REPORT DATA FOR THESE SERVICES.
  S 65. Subparagraph (iii) of paragraph (d) of subdivision 1 of  section
367-a  of the social services law, as amended by section 53 of part C of
chapter 58 of the laws of 2008, is amended to read as follows:
  (iii) When payment under part B of title XVIII of the  federal  social
security act for items and services provided to eligible persons who are
also  beneficiaries  under  part  B of title XVIII of the federal social
security act and for items and services provided to  qualified  medicare
beneficiaries under part B of title XVIII of the federal social security
act  would  exceed  the  amount  that otherwise would be made under this
title if provided to an eligible person other than a person who is  also
a  beneficiary  under part B or is a qualified medicare beneficiary, the
amount payable FOR SERVICES COVERED under this  title  shall  be  twenty
percent  of  the  amount  of any co-insurance liability of such eligible
persons pursuant to federal law  were  they  not  eligible  for  medical
assistance  or  were  they  not  qualified  medicare  beneficiaries with
respect to such benefits under such part B; provided,  however,  amounts
payable  under  this  title  for items and services provided to eligible
persons who are also beneficiaries under part B or to qualified medicare
beneficiaries by an ambulance service under the authority of an  operat-
ing  certificate  issued pursuant to article thirty of the public health
law, a psychologist licensed under article one  hundred  fifty-three  of
the  education  law,  or  a facility under the authority of an operating
certificate issued pursuant to article sixteen, thirty-one or thirty-two
of the mental hygiene law and with respect to  outpatient  hospital  and
clinic  items and services provided by a facility under the authority of
an operating certificate issued pursuant to article twenty-eight of  the
public health law, shall not be less than the amount of any co-insurance

S. 2809--D                         162                        A. 4009--D

liability  of such eligible persons or such qualified medicare benefici-
aries, or for which such eligible persons  or  such  qualified  medicare
beneficiaries  would  be liable under federal law were they not eligible
for medical assistance or were they not qualified medicare beneficiaries
with respect to such benefits under part B.
  S  65-a.  Subdivision 1 of section 367-a of the social services law is
amended by adding a new paragraph (g) to read as follows:
  (G) NOTWITHSTANDING ANY PROVISION OF THIS  SECTION  TO  THE  CONTRARY,
AMOUNTS  PAYABLE  UNDER THIS TITLE FOR MEDICAL ASSISTANCE IN THE FORM OF
HOSPITAL OUTPATIENT SERVICES OR DIAGNOSTIC AND TREATMENT CENTER SERVICES
PURSUANT TO ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH  LAW  PROVIDED  TO
ELIGIBLE  PERSONS WHO ARE ALSO BENEFICIARIES UNDER PART B OF TITLE XVIII
OF THE FEDERAL SOCIAL SECURITY ACT SHALL NOT EXCEED THE APPROVED MEDICAL
ASSISTANCE PAYMENT LEVEL LESS THE AMOUNT PAYABLE UNDER PART B.
  S 66. The public health law is amended by adding a new article 29-E to
read as follows:
                              ARTICLE 29-E
          ACCOUNTABLE CARE ORGANIZATIONS DEMONSTRATION PROGRAM
SECTION 2999-N. ACCOUNTABLE CARE ORGANIZATIONS; FINDINGS; PURPOSE.
        2999-O. DEFINITIONS.
        2999-P. ESTABLISHMENT OF ACO DEMONSTRATION PROGRAM.
        2999-Q. ACCOUNTABLE CARE ORGANIZATIONS; REQUIREMENTS.
        2999-R. OTHER LAWS.
  S 2999-N.  ACCOUNTABLE  CARE  ORGANIZATIONS;  FINDINGS;  PURPOSE.  THE
LEGISLATURE  INTENDS  TO  TEST THE ABILITY OF ACCOUNTABLE CARE ORGANIZA-
TIONS TO ASSUME A ROLE IN DELIVERING AN ARRAY OF HEALTH  CARE  SERVICES,
FROM  PRIMARY  AND  PREVENTIVE CARE THROUGH ACUTE INPATIENT HOSPITAL AND
POST-HOSPITAL CARE. THE LEGISLATURE FINDS THAT THE FORMATION AND  OPERA-
TION  OF  ACCOUNTABLE CARE ORGANIZATIONS UNDER THIS ARTICLE, AND SUBJECT
TO APPROPRIATE REGULATION, CAN BE CONSISTENT WITH THE PURPOSES OF FEDER-
AL AND STATE ANTI-TRUST, ANTI-REFERRAL, AND  OTHER  STATUTES,  INCLUDING
REDUCING  OVER-UTILIZATION  AND EXPENDITURES. THE LEGISLATURE FINDS THAT
THE DEVELOPMENT OF ACCOUNTABLE CARE  ORGANIZATIONS  UNDER  THIS  ARTICLE
WILL  REDUCE  HEALTH  CARE COSTS, PROMOTE EFFECTIVE ALLOCATION OF HEALTH
CARE RESOURCES, AND ENHANCE THE  QUALITY  AND  ACCESSIBILITY  OF  HEALTH
CARE.  THE  LEGISLATURE  FINDS THAT THIS ARTICLE IS NECESSARY TO PROMOTE
THE FORMATION OF ACCOUNTABLE CARE ORGANIZATIONS AND PROTECT  THE  PUBLIC
INTEREST AND THE INTERESTS OF PATIENTS AND HEALTH CARE PROVIDERS.
  S  2999-O.  DEFINITIONS.  AS USED IN THIS ARTICLE, THE FOLLOWING TERMS
SHALL HAVE THE FOLLOWING MEANINGS, UNLESS THE CONTEXT  CLEARLY  REQUIRES
OTHERWISE:
  1.  "ACCOUNTABLE  CARE ORGANIZATION" OR "ACO" MEANS AN ORGANIZATION OF
CLINICALLY INTEGRATED HEALTH CARE PROVIDERS CERTIFIED BY THE COMMISSION-
ER UNDER THIS ARTICLE.
  2. "CERTIFICATE OF AUTHORITY" OR "CERTIFICATE" MEANS A CERTIFICATE  OF
AUTHORITY ISSUED BY THE COMMISSIONER UNDER THIS ARTICLE.
  3.  "HEALTH  CARE  PROVIDER"  INCLUDES BUT IS NOT LIMITED TO AN ENTITY
LICENSED OR CERTIFIED UNDER ARTICLE TWENTY-EIGHT OR THIRTY-SIX  OF  THIS
CHAPTER;  AN ENTITY LICENSED OR CERTIFIED UNDER ARTICLE SIXTEEN, THIRTY-
ONE OR THIRTY-TWO OF THE MENTAL HYGIENE LAW; OR A  HEALTH  CARE  PRACTI-
TIONER LICENSED OR CERTIFIED UNDER TITLE EIGHT OF THE EDUCATION LAW OR A
LAWFUL  COMBINATION  OF  SUCH  HEALTH  CARE  PRACTITIONERS; AND MAY ALSO
INCLUDE, TO THE EXTENT PROVIDED BY REGULATION OF THE COMMISSIONER, OTHER
ENTITIES THAT PROVIDE  TECHNICAL  ASSISTANCE,  INFORMATION  SYSTEMS  AND
SERVICES,  CARE COORDINATION AND OTHER SERVICES TO HEALTH CARE PROVIDERS
AND PATIENTS PARTICIPATING IN AN ACO.

S. 2809--D                         163                        A. 4009--D

  4. "PRIMARY CARE" MEANS THE HEALTH CARE  FIELDS  OF  FAMILY  PRACTICE,
GENERAL PEDIATRICS, PRIMARY CARE INTERNAL MEDICINE, PRIMARY CARE OBSTET-
RICS, OR PRIMARY CARE GYNECOLOGY, WITHOUT REGARD TO BOARD CERTIFICATION,
PROVIDED BY A HEALTH CARE PROVIDER ACTING WITHIN HIS, HER, OR ITS LAWFUL
SCOPE OF PRACTICE.
  5.  "THIRD-PARTY  HEALTH CARE PAYER" HAS ITS ORDINARY MEANINGS AND MAY
INCLUDE ANY ENTITIES PROVIDED FOR BY  REGULATION  OF  THE  COMMISSIONER,
WHICH  MAY INCLUDE AN ENTITY SUCH AS A PHARMACY BENEFITS MANAGER, FISCAL
ADMINISTRATOR, OR ADMINISTRATIVE SERVICES PROVIDER THAT PARTICIPATES  IN
THE ADMINISTRATION OF A THIRD-PARTY HEALTH CARE PAYER SYSTEM.
  6.  ANY  REFERENCES  TO THE "DEPARTMENT OF FINANCIAL SERVICES" AND THE
"SUPERINTENDENT OF FINANCIAL SERVICES" IN THIS ARTICLE SHALL MEAN, PRIOR
TO OCTOBER THIRD, TWO THOUSAND ELEVEN, RESPECTIVELY, THE "DEPARTMENT  OF
INSURANCE" AND THE "SUPERINTENDENT OF INSURANCE."
  S  2999-P.  ESTABLISHMENT OF ACO DEMONSTRATION PROGRAM. 1. AN ACCOUNT-
ABLE CARE ORGANIZATION: (A) IS AN ORGANIZATION OF CLINICALLY  INTEGRATED
HEALTH CARE PROVIDERS THAT WORK TOGETHER TO PROVIDE, MANAGE, AND COORDI-
NATE HEALTH CARE (INCLUDING PRIMARY CARE) FOR A DEFINED POPULATION; WITH
A  MECHANISM  FOR  SHARED GOVERNANCE; THE ABILITY TO NEGOTIATE, RECEIVE,
AND DISTRIBUTE PAYMENTS; AND ACCOUNTABILITY FOR THE QUALITY,  COST,  AND
DELIVERY  OF  HEALTH CARE TO THE ACO'S PATIENTS; IN ACCORDANCE WITH THIS
ARTICLE; AND (B) HAS BEEN ISSUED  A  CERTIFICATE  OF  AUTHORITY  BY  THE
COMMISSIONER UNDER THIS ARTICLE.
  2. THE COMMISSIONER SHALL ESTABLISH A DEMONSTRATION PROGRAM WITHIN THE
DEPARTMENT  TO  TEST  THE  ABILITY OF ACOS TO DELIVER AN ARRAY OF HEALTH
CARE SERVICES FOR THE PURPOSE OF IMPROVING THE QUALITY, COORDINATION AND
ACCOUNTABILITY OF SERVICES PROVIDED TO PATIENTS IN NEW YORK.
  3. THE COMMISSIONER MAY ISSUE A CERTIFICATE OF AUTHORITY TO AN  ENTITY
THAT  MEETS CONDITIONS FOR ACO CERTIFICATION AS SET FORTH IN REGULATIONS
PROMULGATED BY THE COMMISSIONER PURSUANT TO SECTION TWENTY-NINE  HUNDRED
NINETY-NINE-Q  OF  THIS  ARTICLE.  THE COMMISSIONER SHALL NOT ISSUE MORE
THAN SEVEN CERTIFICATES UNDER THIS ARTICLE, AND SHALL NOT ISSUE ANY  NEW
CERTIFICATE UNDER THIS ARTICLE AFTER DECEMBER THIRTY-FIRST, TWO THOUSAND
FIFTEEN.
  4.  THE COMMISSIONER MAY LIMIT, SUSPEND, OR TERMINATE A CERTIFICATE OF
AUTHORITY IF AN ACO IS NOT OPERATING IN ACCORDANCE WITH THIS ARTICLE.
  5. THE COMMISSIONER IS AUTHORIZED TO SEEK FEDERAL APPROVALS AND  WAIV-
ERS  TO  IMPLEMENT  THIS  ARTICLE,  INCLUDING  BUT  NOT LIMITED TO THOSE
APPROVALS OR WAIVERS  NECESSARY  TO  OBTAIN  FEDERAL  FINANCIAL  PARTIC-
IPATION.
  S 2999-Q. ACCOUNTABLE CARE ORGANIZATIONS; REQUIREMENTS. 1. THE COMMIS-
SIONER  SHALL  PROMULGATE  REGULATIONS ESTABLISHING CRITERIA FOR CERTIF-
ICATES OF AUTHORITY, QUALITY STANDARDS FOR ACOS, REPORTING  REQUIREMENTS
AND  OTHER  MATTERS DEEMED TO BE APPROPRIATE AND NECESSARY IN THE OPERA-
TION AND EVALUATION OF THE DEMONSTRATION PROGRAM. IN  PROMULGATING  SUCH
REGULATIONS,  THE  COMMISSIONER SHALL CONSULT WITH THE SUPERINTENDENT OF
FINANCIAL SERVICES,  HEALTH  CARE  PROVIDERS,  THIRD-PARTY  HEALTH  CARE
PAYERS, ADVOCATES REPRESENTING PATIENTS, AND OTHER APPROPRIATE PARTIES.
  2.  SUCH  REGULATIONS MAY, AND SHALL AS NECESSARY FOR PURPOSES OF THIS
ARTICLE, ADDRESS MATTERS INCLUDING BUT NOT LIMITED TO:
  (A) THE GOVERNANCE, LEADERSHIP AND MANAGEMENT STRUCTURE  OF  THE  ACO,
INCLUDING  THE  MANNER  IN WHICH CLINICAL AND ADMINISTRATIVE SYSTEMS AND
CLINICAL PARTICIPATION WILL BE MANAGED;
  (B) DEFINITION OF THE POPULATION PROPOSED TO BE  SERVED  BY  THE  ACO,
WHICH  MAY  INCLUDE REFERENCE TO A GEOGRAPHICAL AREA AND PATIENT CHARAC-
TERISTICS;

S. 2809--D                         164                        A. 4009--D

  (C) THE CHARACTER, COMPETENCE AND FISCAL RESPONSIBILITY AND  SOUNDNESS
OF AN ACO AND ITS PRINCIPALS, IF AND TO THE EXTENT DEEMED APPROPRIATE BY
THE COMMISSIONER;
  (D)  THE  ADEQUACY  OF  AN  ACO'S NETWORK OF PARTICIPATING HEALTH CARE
PROVIDERS, INCLUDING PRIMARY CARE HEALTH CARE PROVIDERS;
  (E) MECHANISMS BY WHICH AN ACO WILL PROVIDE,  MANAGE,  AND  COORDINATE
QUALITY  HEALTH  CARE FOR ITS PATIENTS AND PROVIDE ACCESS TO HEALTH CARE
PROVIDERS THAT ARE NOT PARTICIPANTS IN THE ACO;
  (F) MECHANISMS BY WHICH THE ACO SHALL RECEIVE AND DISTRIBUTE  PAYMENTS
TO  ITS PARTICIPATING HEALTH CARE PROVIDERS, WHICH MAY INCLUDE INCENTIVE
PAYMENTS OR MECHANISMS FOR POOLING PAYMENTS  RECEIVED  BY  PARTICIPATING
HEALTH CARE PROVIDERS FROM THIRD-PARTY PAYERS AND PATIENTS;
  (G)  MECHANISMS  AND  CRITERIA  FOR ACCEPTING HEALTH CARE PROVIDERS TO
PARTICIPATE IN THE ACO THAT ARE RELATED TO  THE  NEEDS  OF  THE  PATIENT
POPULATION  TO BE SERVED AND NEEDS AND PURPOSES OF THE ACO, AND PREVENT-
ING UNREASONABLE DISCRIMINATION;
  (H) MECHANISMS FOR QUALITY  ASSURANCE  AND  GRIEVANCE  PROCEDURES  FOR
PATIENTS OR HEALTH CARE PROVIDERS WHERE APPROPRIATE;
  (I)  MECHANISMS  THAT  PROMOTE  EVIDENCE-BASED  HEALTH  CARE,  PATIENT
ENGAGEMENT, COORDINATION OF CARE, ELECTRONIC HEALTH  RECORDS,  INCLUDING
PARTICIPATION  IN HEALTH INFORMATION EXCHANGES, AND OTHER ENABLING TECH-
NOLOGIES;
  (J) PERFORMANCE STANDARDS FOR, AND MEASURES TO ASSESS, THE QUALITY AND
UTILIZATION OF CARE PROVIDED BY AN ACO;
  (K) APPROPRIATE REQUIREMENTS FOR ACOS TO PROMOTE COMPLIANCE  WITH  THE
PURPOSES OF THIS ARTICLE;
  (L)  POSTING  ON  THE DEPARTMENT'S WEBSITE INFORMATION ABOUT ACOS THAT
WOULD BE USEFUL TO HEALTH CARE PROVIDERS AND PATIENTS;
  (M) REQUIREMENTS FOR THE SUBMISSION OF INFORMATION AND  DATA  BY  ACOS
AND  THEIR  PARTICIPATING AND AFFILIATED HEALTH CARE PROVIDERS AS NECES-
SARY FOR THE EVALUATION OF THE SUCCESS OF THE DEMONSTRATION PROGRAM;
  (N) PROTECTION OF PATIENT RIGHTS AS APPROPRIATE;
  (O) THE IMPACT OF THE ESTABLISHMENT AND OPERATION OF AN ACO ON  ACCESS
TO ANY HEALTH CARE SERVICE IN THE AREA SERVED; AND
  (P) ESTABLISHMENT OF STANDARDS, AS APPROPRIATE, TO PROMOTE THE ABILITY
OF AN ACO TO PARTICIPATE IN APPLICABLE FEDERAL PROGRAMS FOR ACOS.
  3.  (A)  SUBJECT  TO  REGULATIONS  OF THE COMMISSIONER: (I) AN ACO MAY
ENTER INTO ARRANGEMENTS WITH ONE OR MORE THIRD-PARTY HEALTH CARE  PAYERS
TO  ESTABLISH  PAYMENT  METHODOLOGIES  FOR  HEALTH CARE SERVICES FOR THE
THIRD-PARTY HEALTH CARE PAYER'S ENROLLEES PROVIDED BY  THE  ACO  OR  FOR
WHICH  THE  ACO  IS  RESPONSIBLE,  SUCH AS FULL OR PARTIAL CAPITATION OR
OTHER ARRANGEMENTS; (II) SUCH ARRANGEMENTS MAY INCLUDE PROVISION FOR THE
ACO TO RECEIVE AND DISTRIBUTE PAYMENTS TO THE ACO'S PARTICIPATING HEALTH
CARE PROVIDERS, INCLUDING INCENTIVE PAYMENTS  AND  PAYMENTS  FOR  HEALTH
CARE  SERVICES  FROM  THIRD-PARTY  HEALTH  CARE PAYERS AND PATIENTS; AND
(III) AN ACO MAY INCLUDE MECHANISMS FOR  POOLING  PAYMENTS  RECEIVED  BY
PARTICIPATING   HEALTH   CARE  PROVIDERS  FROM  THIRD-PARTY  PAYERS  AND
PATIENTS.
  (B) SUBJECT TO REGULATIONS OF THE COMMISSIONER, THE  COMMISSIONER,  IN
CONSULTATION  WITH THE SUPERINTENDENT OF FINANCIAL SERVICES, MAY AUTHOR-
IZE A THIRD-PARTY HEALTH CARE PAYER TO PARTICIPATE IN PAYMENT  METHODOL-
OGIES  WITH  AN ACO UNDER THIS SUBDIVISION, NOTWITHSTANDING ANY CONTRARY
PROVISION OF THIS CHAPTER, THE INSURANCE LAW, THE SOCIAL  SERVICES  LAW,
OR  THE ELDER LAW, ON FINDING THAT THE PAYMENT METHODOLOGY IS CONSISTENT
WITH THE PURPOSES OF THIS ARTICLE.

S. 2809--D                         165                        A. 4009--D

  4. THE PROVISION OF HEALTH CARE SERVICES DIRECTLY OR INDIRECTLY BY  AN
ACO  THROUGH  HEALTH CARE PROVIDERS SHALL NOT BE CONSIDERED THE PRACTICE
OF A PROFESSION UNDER TITLE EIGHT OF THE EDUCATION LAW BY THE ACO.
  S  2999-R.  OTHER LAWS. 1. (A) IT IS THE POLICY OF THE STATE TO PERMIT
AND ENCOURAGE COOPERATIVE, COLLABORATIVE  AND  INTEGRATIVE  ARRANGEMENTS
AMONG THIRD-PARTY HEALTH CARE PAYERS AND HEALTH CARE PROVIDERS WHO MIGHT
OTHERWISE BE COMPETITORS UNDER THE ACTIVE SUPERVISION OF THE COMMISSION-
ER.  TO  THE  EXTENT  THAT IT IS NECESSARY TO ACCOMPLISH THE PURPOSES OF
THIS ARTICLE, COMPETITION MAY BE SUPPLANTED AND THE  STATE  MAY  PROVIDE
STATE  ACTION  IMMUNITY UNDER STATE AND FEDERAL ANTITRUST LAWS TO PAYORS
AND HEALTH CARE PROVIDERS.
  (B) THE COMMISSIONER MAY ENGAGE IN STATE SUPERVISION TO PROMOTE  STATE
ACTION  IMMUNITY UNDER STATE AND FEDERAL ANTITRUST LAWS AND MAY INSPECT,
REQUIRE, OR REQUEST ADDITIONAL  DOCUMENTATION  AND  TAKE  OTHER  ACTIONS
UNDER  THIS  ARTICLE TO VERIFY AND MAKE SURE THAT THIS ARTICLE IS IMPLE-
MENTED IN ACCORDANCE WITH ITS INTENT AND PURPOSE.
  2. WITH RESPECT TO THE  PLANNING,  IMPLEMENTATION,  AND  OPERATION  OF
ACOS,  THE  COMMISSIONER, BY REGULATION, MAY SPECIFICALLY DELINEATE SAFE
HARBORS THAT EXEMPT ACOS FROM THE APPLICATION OF THE FOLLOWING STATUTES:
  (A) ARTICLE  TWENTY-TWO  OF  THE  GENERAL  BUSINESS  LAW  RELATING  TO
ARRANGEMENTS AND AGREEMENTS IN RESTRAINT OF TRADE;
  (B)  ARTICLE ONE HUNDRED THIRTY-ONE-A OF THE EDUCATION LAW RELATING TO
FEE-SPLITTING ARRANGEMENTS; AND
  (C) TITLE TWO-D OF ARTICLE TWO OF THIS CHAPTER RELATING TO HEALTH CARE
PRACTITIONER REFERRALS.
  3. FOR THE PURPOSES OF THIS ARTICLE, AN ACO SHALL BE DEEMED  TO  BE  A
HOSPITAL   FOR   PURPOSES   OF  SECTIONS  TWENTY-EIGHT  HUNDRED  FIVE-J,
TWENTY-EIGHT   HUNDRED   FIVE-K,   TWENTY-EIGHT   HUNDRED   FIVE-L   AND
TWENTY-EIGHT  HUNDRED  FIVE-M OF THIS CHAPTER AND SUBDIVISIONS THREE AND
FIVE OF SECTION SIXTY-FIVE HUNDRED TWENTY-SEVEN OF THE EDUCATION LAW.
  S 67. Section 18 of 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, is amended to read as follows:
  S 18. Notwithstanding any contrary provision of  law,  surcharges  and
assessments due and owing pursuant to sections 2807-j, 2807-s and 2807-t
of the public health law for any period prior to January 1, [2010] 2011,
which  are  paid  and  accompanied by all required reports and which are
received on or before December 31, [2010] 2011 shall not be  subject  to
interest  or penalties as otherwise provided in such sections, provided,
however, that such reports may be  based  on  estimates  by  payors  and
designated  providers of services of the amounts owed, subject to subse-
quent audit by the commissioner of health or the  commissioner's  desig-
nee, and provided further, however, with regard to all principal, inter-
est and penalty amounts collected by the commissioner of health prior to
the  effective  date  of  this  act,  the penalty provisions of sections
2807-j, 2807-s and 2807-t of the public health law shall remain in  full
force  and  effect  and  such  amounts collected shall not be subject to
further adjustment pursuant  to  this  section,  and  provided  further,
however,  that  payments  of principal amounts of surcharges and assess-
ments which were paid late and received prior to the effective  date  of
this provision, and in regard to which interest and penalty amounts have
not been collected, shall not be subject to such interest and penalties,
and  provided,  further,  however,  that  the provisions of this section
shall not apply to delinquent amounts which have been  referred  by  the
commissioner   of   health  for  recoupment  or  collection  proceeding.

S. 2809--D                         166                        A. 4009--D

Furthermore, the provisions of this  section  shall  not  apply  to  any
surcharge or assessment payments made in response to a final audit find-
ing issued by the commissioner of health or the commissioner's designee.
  S 68. Intentionally omitted.
  S 69. Subparagraph (iii) of paragraph (b) of subdivision 25 of section
2808 of the public health law, as added by section 31 of part B of chap-
ter  109  of the laws of 2010, is amended and a new subparagraph (iv) is
added to read as follows:
  (iii) payment to a facility for reserved bed days provided  on  behalf
of  such person for non-hospitalization leaves of absence may not exceed
ten days in any twelve month period[.]; AND
  (IV) PAYMENTS FOR RESERVED BED  DAYS  FOR  TEMPORARY  HOSPITALIZATIONS
SHALL  ONLY  BE  MADE  TO A RESIDENTIAL HEALTH CARE FACILITY IF AT LEAST
FIFTY PERCENT OF THE FACILITY'S RESIDENTS ELIGIBLE TO PARTICIPATE  IN  A
MEDICARE MANAGED CARE PLAN ARE ENROLLED IN SUCH A PLAN.
  S 70. Intentionally omitted.
  S 71. Intentionally omitted.
  S 72. Intentionally omitted.
  S 73. Intentionally omitted.
  S  74.  Section  366 of the social services law is amended by adding a
new subdivision 14 to read as follows:
  14. THE COMMISSIONER OF HEALTH MAY MAKE ANY  AVAILABLE  AMENDMENTS  TO
THE  STATE  PLAN  FOR  MEDICAL  ASSISTANCE SUBMITTED PURSUANT TO SECTION
THREE HUNDRED SIXTY-THREE-A OF THIS TITLE, OR, IF AN  AMENDMENT  IS  NOT
POSSIBLE,  DEVELOP  AND SUBMIT AN APPLICATION FOR ANY WAIVER OR APPROVAL
UNDER THE FEDERAL SOCIAL SECURITY ACT THAT MAY BE NECESSARY TO DISREGARD
OR EXEMPT AN AMOUNT OF INCOME, FOR THE PURPOSE OF ASSISTING WITH HOUSING
COSTS, FOR INDIVIDUALS RECEIVING COVERAGE OF NURSING  FACILITY  SERVICES
UNDER  THIS  TITLE  WHO ARE: (I) DISCHARGED FROM THE NURSING FACILITY TO
THE COMMUNITY; (II) ENROLLED IN A PLAN  CERTIFIED  PURSUANT  TO  SECTION
FORTY-FOUR  HUNDRED THREE-F OF THE PUBLIC HEALTH LAW; AND (III) WHILE SO
ENROLLED, NOT CONSIDERED AN "INSTITUTIONALIZED SPOUSE" FOR  PURPOSES  OF
SECTION THREE HUNDRED SIXTY-SIX-C OF THIS TITLE.
  S 75. Intentionally Omitted.
  S  76.  Subdivision  6  of section 364-i of the social services law is
amended by adding a new paragraph (a-2) to read as follows:
  (A-2) AT THE TIME OF APPLICATION FOR PRESUMPTIVE ELIGIBILITY  PURSUANT
TO  THIS  SUBDIVISION, A PREGNANT WOMAN WHO RESIDES IN A SOCIAL SERVICES
DISTRICT THAT HAS IMPLEMENTED THE STATE'S MANAGED CARE PROGRAM  PURSUANT
TO  SECTION  THREE  HUNDRED  SIXTY-FOUR-J  OF  THIS  TITLE MUST CHOOSE A
MANAGED CARE PROVIDER. IF A MANAGED CARE PROVIDER IS NOT CHOSEN  AT  THE
TIME  OF  APPLICATION,  THE PREGNANT WOMAN WILL BE ASSIGNED TO A MANAGED
CARE PROVIDER IN ACCORDANCE WITH SUBPARAGRAPHS (II), (III), (IV) AND (V)
OF  PARAGRAPH  (F)  OF  SUBDIVISION  FOUR  OF  SECTION   THREE   HUNDRED
SIXTY-FOUR-J OF THIS TITLE.
  S  77.  Paragraphs  (b),  (c), (d) and (f) of subdivision 3 of section
364-j of the social services law are REPEALED, paragraph (e)  is  relet-
tered  paragraph  (d),  and  two new paragraphs (b) and (c) are added to
read as follows:
  (B) THE FOLLOWING MEDICAL ASSISTANCE RECIPIENTS SHALL NOT BE  REQUIRED
TO  PARTICIPATE  IN  A MANAGED CARE PROGRAM ESTABLISHED PURSUANT TO THIS
SECTION:
  (I) INDIVIDUALS WITH A CHRONIC MEDICAL CONDITION WHO ARE BEING TREATED
BY A SPECIALIST PHYSICIAN THAT IS NOT ASSOCIATED  WITH  A  MANAGED  CARE
PROVIDER  IN THE INDIVIDUAL'S SOCIAL SERVICES DISTRICT MAY DEFER PARTIC-

S. 2809--D                         167                        A. 4009--D

IPATION IN THE MANAGED CARE PROGRAM FOR SIX MONTHS OR UNTIL  THE  COURSE
OF TREATMENT IS COMPLETE, WHICHEVER OCCURS FIRST; AND
  (II) NATIVE AMERICANS.
  (C)  THE FOLLOWING MEDICAL ASSISTANCE RECIPIENTS SHALL NOT BE ELIGIBLE
TO PARTICIPATE IN A MANAGED CARE PROGRAM ESTABLISHED  PURSUANT  TO  THIS
SECTION:
  (I) A PERSON ELIGIBLE FOR MEDICARE PARTICIPATING IN A CAPITATED DEMON-
STRATION PROGRAM FOR LONG TERM CARE;
  (II)  AN INFANT LIVING WITH AN INCARCERATED MOTHER IN A STATE OR LOCAL
CORRECTIONAL FACILITY AS DEFINED IN SECTION TWO OF THE CORRECTION LAW;
  (III) A PERSON WHO IS EXPECTED TO BE ELIGIBLE FOR  MEDICAL  ASSISTANCE
FOR LESS THAN SIX MONTHS;
  (IV)  A  PERSON  WHO  IS ELIGIBLE FOR MEDICAL ASSISTANCE BENEFITS ONLY
WITH RESPECT TO TUBERCULOSIS-RELATED SERVICES;
  (V) INDIVIDUALS RECEIVING HOSPICE SERVICES AT TIME OF ENROLLMENT;
  (VI) A PERSON WHO HAS PRIMARY MEDICAL OR HEALTH CARE  COVERAGE  AVAIL-
ABLE  FROM  OR  UNDER  A  THIRD-PARTY  PAYOR  WHICH MAY BE MAINTAINED BY
PAYMENT, OR PART PAYMENT, OF THE PREMIUM OR COST SHARING  AMOUNTS,  WHEN
PAYMENT OF SUCH PREMIUM OR COST SHARING AMOUNTS WOULD BE COST-EFFECTIVE,
AS DETERMINED BY THE LOCAL SOCIAL SERVICES DISTRICT;
  (VII) A PERSON RECEIVING FAMILY PLANNING SERVICES PURSUANT TO SUBPARA-
GRAPH  ELEVEN  OF  PARAGRAPH  (A)  OF  SUBDIVISION  ONE OF SECTION THREE
HUNDRED SIXTY-SIX OF THIS TITLE;
  (VIII) A PERSON WHO IS ELIGIBLE FOR  MEDICAL  ASSISTANCE  PURSUANT  TO
PARAGRAPH  (V) OF SUBDIVISION FOUR OF SECTION THREE HUNDRED SIXTY-SIX OF
THIS TITLE; AND
  (IX) A PERSON WHO IS MEDICARE/MEDICAID DUALLY ELIGIBLE AND WHO IS  NOT
ENROLLED IN A MEDICARE MANAGED CARE PLAN.
  S  77-a. Paragraph (g) of subdivision 3 of section 364-j of the social
services law, as amended by chapter 649 of the laws of 1996, and subpar-
agraph (i) as amended by section 30 of part C of chapter 58 of the  laws
of 2008, is amended to read as follows:
  [(g)]  (E)  The  following categories of individuals [will not] MAY be
required to enroll with a managed  care  program  [until]  WHEN  program
features  and  reimbursement  rates  are approved by the commissioner of
health and, as appropriate,  the  [commissioner]  COMMISSIONERS  of  THE
DEPARTMENT  OF  mental health, THE OFFICE FOR PERSONS WITH DEVELOPMENTAL
DISABILITIES, THE OFFICE OF CHILDREN AND FAMILY SERVICES, AND THE OFFICE
OF ALCOHOL AND SUBSTANCE ABUSE SERVICES:
  (i) an individual dually eligible for medical assistance and  benefits
under  the  federal  Medicare program and enrolled in a Medicare managed
care plan offered by an entity that is also  a  managed  care  provider;
provided that (notwithstanding paragraph (g) of subdivision four of this
section):
  (a) if the individual changes his or her Medicare managed care plan as
authorized  by  title  XVIII  of  the  federal  social security act, and
enrolls in another Medicare managed care plan that  is  also  a  managed
care  provider, the individual shall be (if required by the commissioner
under this paragraph) enrolled in that managed care provider;
  (b) if the individual changes his or her Medicare managed care plan as
authorized by title XVIII  of  the  federal  social  security  act,  but
enrolls in another Medicare managed care plan that is not also a managed
care provider, the individual shall be disenrolled from the managed care
provider  in  which he or she was enrolled and withdraw from the managed
care program;

S. 2809--D                         168                        A. 4009--D

  (c) if the individual disenrolls from his or her Medicare managed care
plan as authorized by title XVIII of the federal  social  security  act,
and  does not enroll in another Medicare managed care plan, the individ-
ual shall be disenrolled from the managed care provider in which  he  or
she was enrolled and withdraw from the managed care program;
  (d)  nothing  herein shall require an individual enrolled in a managed
long term care plan, pursuant to section forty-four hundred  three-f  of
the public health law, to disenroll from such program.
  (ii) an individual eligible for supplemental security income;
  (iii) HIV positive individuals; [and]
  (iv)  persons with serious mental illness and children and adolescents
with serious emotional disturbances, as defined  in  section  forty-four
hundred one of the public health law[.];
  (V)  A  PERSON RECEIVING SERVICES PROVIDED BY A RESIDENTIAL ALCOHOL OR
SUBSTANCE ABUSE PROGRAM OR FACILITY FOR THE MENTALLY RETARDED;
  (VI) A PERSON RECEIVING SERVICES  PROVIDED  BY  AN  INTERMEDIATE  CARE
FACILITY  FOR THE MENTALLY RETARDED OR WHO HAS CHARACTERISTICS AND NEEDS
SIMILAR TO SUCH PERSONS;
  (VII) A  PERSON  WITH  A  DEVELOPMENTAL  OR  PHYSICAL  DISABILITY  WHO
RECEIVES  HOME  AND  COMMUNITY-BASED  SERVICES  OR CARE-AT-HOME SERVICES
THROUGH EXISTING WAIVERS UNDER SECTION NINETEEN HUNDRED FIFTEEN  (C)  OF
THE  FEDERAL  SOCIAL  SECURITY  ACT OR WHO HAS CHARACTERISTICS AND NEEDS
SIMILAR TO SUCH PERSONS;
  (VIII) A PERSON WHO IS ELIGIBLE FOR  MEDICAL  ASSISTANCE  PURSUANT  TO
SUBPARAGRAPH  TWELVE OR SUBPARAGRAPH THIRTEEN OF PARAGRAPH (A) OF SUBDI-
VISION ONE OF SECTION THREE HUNDRED SIXTY-SIX OF THIS TITLE;
  (IX) A PERSON RECEIVING SERVICES PROVIDED BY A LONG TERM  HOME  HEALTH
CARE  PROGRAM, OR A PERSON RECEIVING INPATIENT SERVICES IN A STATE-OPER-
ATED PSYCHIATRIC FACILITY OR A RESIDENTIAL TREATMENT FACILITY FOR  CHIL-
DREN AND YOUTH;
  (X)  CERTIFIED  BLIND  OR  DISABLED  CHILDREN LIVING OR EXPECTED TO BE
LIVING SEPARATE AND APART FROM THE PARENT FOR THIRTY DAYS OR MORE;
  (XI) RESIDENTS OF NURSING FACILITIES;
  (XII) A FOSTER CHILD IN THE PLACEMENT OF A VOLUNTARY AGENCY OR IN  THE
DIRECT CARE OF THE LOCAL SOCIAL SERVICES DISTRICT;
  (XIII) A PERSON OR FAMILY THAT IS HOMELESS; AND
  (XIV)  INDIVIDUALS  FOR  WHOM A MANAGED CARE PROVIDER IS NOT GEOGRAPH-
ICALLY ACCESSIBLE SO AS TO REASONABLY PROVIDE SERVICES TO THE PERSON.  A
MANAGED  CARE  PROVIDER  IS  NOT GEOGRAPHICALLY ACCESSIBLE IF THE PERSON
CANNOT ACCESS THE  PROVIDER'S  SERVICES  IN  A  TIMELY  FASHION  DUE  TO
DISTANCE OR TRAVEL TIME.
  S  78.  Subparagraph  (v) of paragraph (e) of subdivision 4 of section
364-j of the social services law, as amended by section 14 of part C  of
chapter 58 of the laws of 2004, is amended to read as follows:
  (v)  Upon  delivery  of  the  pre-enrollment  information,  the  local
district or the enrollment organization shall certify the  participant's
receipt  of such information. Upon verification that the participant has
received  the  pre-enrollment  education  information,  a  managed  care
provider,  a  local district or the enrollment organization may enroll a
participant into a managed care provider. Managed  care  providers  must
submit enrollment forms to the local department of social services. Upon
enrollment,  participants  will  sign an attestation that they have been
informed that: participants have a choice  of  managed  care  providers;
participants have a choice of primary care practitioners; and, except as
otherwise  provided  in  this  section, including but not limited to the
exceptions listed in subparagraph (iii) of paragraph (a) of this  subdi-

S. 2809--D                         169                        A. 4009--D

vision, participants must exclusively use their primary care practition-
ers and plan providers. The commissioner of health [or with respect to a
managed  care  plan  serving participants in a city with a population of
over two million, the local department of social services in such city,]
may  suspend  or  curtail  enrollment or impose sanctions for failure to
appropriately notify clients as required in this subparagraph.
  S 79. Subparagraph (i) of paragraph (f) of subdivision  4  of  section
364-j  of the social services law, as amended by section 14 of part C of
chapter 58 of the laws of 2004, is amended to read as follows:
  (i) Participants SHALL CHOOSE A MANAGED CARE PROVIDER AT THE  TIME  OF
APPLICATION  FOR  MEDICAL ASSISTANCE; IF THE PARTICIPANT DOES NOT CHOOSE
SUCH A PROVIDER THE COMMISSIONER SHALL  ASSIGN  SUCH  PARTICIPANT  TO  A
MANAGED CARE PROVIDER IN ACCORDANCE WITH SUBPARAGRAPHS (II), (III), (IV)
AND  (V)  OF  THIS PARAGRAPH. PARTICIPANTS ALREADY IN RECEIPT OF MEDICAL
ASSISTANCE shall have no less than [sixty] THIRTY  days  from  the  date
selected by the district to enroll in the managed care program to select
a  managed  care  provider,  and as appropriate, a mental health special
needs plan, and shall be provided with information to make  an  informed
choice.  Where  a participant has not selected such a provider or mental
health special needs plan, the commissioner of health shall assign  such
participant  to a managed care provider, and as appropriate, to a mental
health special needs plan, taking into account capacity  and  geographic
accessibility. The commissioner may after the period of time established
in  subparagraph (ii) of this paragraph assign participants to a managed
care provider taking into account quality performance criteria and cost.
Provided however, cost criteria shall not be of greater value than qual-
ity criteria in assigning participants.
  S 80. Paragraphs (d), (e), and (f) of subdivision 5 of  section  364-j
of  the social services law, as added by section 15 of part C of chapter
58 of the laws of 2004, are amended to read as follows:
  (d) Notwithstanding any  inconsistent  provision  of  this  title  and
section  one  hundred  sixty-three of the state finance law, the commis-
sioner of health [or the local department of social services in  a  city
with  a  population  of over two million] may contract with managed care
providers approved under paragraph (b) of this  subdivision,  without  a
competitive bid or request for proposal process, to provide coverage for
participants pursuant to this title.
  (e)  Notwithstanding  any  inconsistent  provision  of  this title and
section one hundred forty-three of  the  economic  development  law,  no
notice in the procurement opportunities newsletter shall be required for
contracts awarded by the commissioner of health [or the local department
of  social services in a city with a population of over two million], to
qualified managed care providers pursuant to this section.
  (f) The care and  services  described  in  subdivision  four  of  this
section  will  be  furnished  by a managed care provider pursuant to the
provisions of this section when such services are furnished  in  accord-
ance  with  an  agreement  with  the  department of health [or the local
department of social services in a city with a population  of  over  two
million], and meet applicable federal law and regulations.
  S  81.  Paragraph  (k) of subdivision 2 of section 365-a of the social
services law, as amended by chapter 659 of the laws of 1997, is  amended
to read as follows:
  (k)  care and services furnished by an entity offering a comprehensive
health services plan, including an entity that has  received  a  certif-
icate  of  authority  pursuant  to  sections  forty-four  hundred three,
forty-four hundred three-a or forty-four hundred eight-a of  the  public

S. 2809--D                         170                        A. 4009--D

health  law  (as added by chapter six hundred thirty-nine of the laws of
nineteen  hundred  ninety-six)  or  a  health  maintenance  organization
authorized  under  article forty-three of the insurance law, to eligible
individuals  residing in the geographic area served by such entity, when
such services are furnished in accordance with an agreement approved  by
the  department  which  meets  the requirements of federal law and regu-
lations [provided, that  no  such  agreement  shall  allow  for  medical
assistance payments on a capitated basis for nursing facility, home care
or  other  long  term  care  services of a duration and scope defined in
regulations of the department of health promulgated pursuant to  section
forty-four  hundred three-f of the public health law, unless such entity
has received a certificate of authority as a managed long term care plan
or is an operating demonstration or is an  approved  managed  long  term
care demonstration, pursuant to such section].
  S  82.  Paragraph  (a) of subdivision 1 of section 367-f of the social
services law, as amended by section 37 of part D of chapter  58  of  the
laws of 2009, is amended to read as follows:
  (a)  "Medicaid  extended  coverage" shall mean eligibility for medical
assistance (i) without regard to the resource  requirements  of  section
three  hundred  sixty-six of this title, or in the case of an individual
covered under an insurance policy or certificate described  in  subdivi-
sion two of this section that provided a residential health care facili-
ty  benefit  less  than [three] TWO years in duration, without consider-
ation of an amount of resources equivalent  to  the  value  of  benefits
received  by  the individual under such policy or certificate, as deter-
mined under the rules of the partnership  for  long-term  care  program;
(ii)  without  regard  to  the  recovery  of medical assistance from the
estates of individuals and the imposition  of  liens  on  the  homes  of
persons pursuant to section three hundred sixty-nine of this title, with
respect  to resources exempt from consideration pursuant to subparagraph
(i) of this paragraph; provided, however, that nothing in  this  section
shall  prevent  the imposition of a lien or recovery against property of
an individual on account of medical  assistance  incorrectly  paid;  and
(iii)  based on an income eligibility standard for married couples equal
to the amount of the minimum monthly maintenance needs allowance defined
in paragraph (h) of subdivision two of section three hundred sixty-six-c
of this title, and for single individuals  equal  to  one-half  of  such
amount;  provided, however, that the commissioner of health shall not be
required to implement the provisions of this subparagraph if the use  of
such  income  eligibility  standards  will  result  in a loss of federal
financial participation in  the  costs  of  Medicaid  extended  coverage
furnished  in  accordance  with subparagraphs (i) and (ii) of this para-
graph.
  S 83. Intentionally omitted.
  S 84. Intentionally omitted.
  S 85. Intentionally omitted.
  S 86. Intentionally omitted.
  S 87. Intentionally omitted.
  S 88. Subparagraph 11 of paragraph (a) of subdivision 1 of section 366
of the social services law, as amended by section 1-h of part C of chap-
ter 58 of the laws of 2007, is amended to read as follows:
  (11) for purposes of receiving family planning services  eligible  for
reimbursement  by the federal government at a rate of ninety percent, is
not otherwise eligible for medical assistance and whose  income  is  two
hundred percent or less of the comparable federal income official pover-
ty line (as defined and annually revised by the United States department

S. 2809--D                         171                        A. 4009--D

of  health  and  human  services);  provided,  however, that such ninety
percent limitation shall not apply to those services identified  by  the
commissioner  of  health  as  services, including treatment for sexually
transmitted  diseases,  generally performed as part of or as a follow-up
to a service eligible for such ninety  percent  reimbursement;  PROVIDED
FURTHER  THAT  THE  COMMISSIONER  OF  HEALTH  IS AUTHORIZED TO ESTABLISH
CRITERIA FOR PRESUMPTIVE ELIGIBILITY FOR SERVICES PROVIDED  PURSUANT  TO
THIS  SUBPARAGRAPH  IN  ACCORDANCE  WITH  ALL APPLICABLE REQUIREMENTS OF
FEDERAL LAW OR REGULATION PERTAINING TO SUCH  ELIGIBILITY.  The  commis-
sioner  of  health  shall  submit whatever waiver applications as may be
necessary  to  receive  federal  financial  participation  for  services
provided under this subparagraph and the provisions of this subparagraph
shall  be  effective  if  and  so long as such federal financial partic-
ipation shall be available; or
  S 89. Paragraph (e) of subdivision 2 of section 365-a  of  the  social
services  law, as amended by chapter 170 of the laws of 1994, is amended
to read as follows:
  (e) (I) personal care services, including personal emergency  response
services,  shared aide and an individual aide, SUBJECT TO THE PROVISIONS
OF SUBPARAGRAPHS (II), (III), AND (IV) OF THIS PARAGRAPH,  furnished  to
an individual who is not an inpatient or resident of a hospital, nursing
facility,  intermediate  care  facility  for  the  mentally retarded, or
institution for mental disease, as determined to  meet  the  recipient's
needs  for assistance when cost effective and appropriate [in accordance
with section three  hundred  sixty-seven-k  and  section  three  hundred
sixty-seven-o  of  this  title],  and when prescribed by a physician, in
accordance with the recipient's plan of treatment and provided by  indi-
viduals  who  are qualified to provide such services, who are supervised
by a registered nurse and who are not members of the recipient's family,
and furnished in the recipient's home or other location;
  (II) THE COMMISSIONER IS AUTHORIZED TO ADOPT  STANDARDS,  PURSUANT  TO
EMERGENCY  REGULATION,  FOR  THE  PROVISION  AND  MANAGEMENT OF SERVICES
AVAILABLE UNDER THIS PARAGRAPH  FOR  INDIVIDUALS  WHOSE  NEED  FOR  SUCH
SERVICES EXCEEDS A SPECIFIED LEVEL TO BE DETERMINED BY THE COMMISSIONER;
  (III)  THE COMMISSIONER IS AUTHORIZED TO PROVIDE ASSISTANCE TO PERSONS
RECEIVING SERVICES UNDER THIS PARAGRAPH WHO ARE TRANSITIONING TO RECEIV-
ING CARE FROM A MANAGED  LONG  TERM  CARE  PLAN  CERTIFIED  PURSUANT  TO
SECTION FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW;
  (IV) PERSONAL CARE SERVICES AVAILABLE PURSUANT TO THIS PARAGRAPH SHALL
NOT  EXCEED EIGHT HOURS PER WEEK FOR INDIVIDUALS WHOSE NEEDS ARE LIMITED
TO NUTRITIONAL AND ENVIRONMENTAL SUPPORT FUNCTIONS;
  S 90.  (a) Notwithstanding any other provision of law to the contrary,
for the state fiscal years beginning April 1, 2011 and ending  on  March
31,  2013, all Medicaid payments made for services provided on and after
April 1, 2011, shall, except as hereinafter provided, be  subject  to  a
uniform  two  percent  reduction and such reduction shall be applied, to
the extent  practicable,  in  equal  amounts  during  the  fiscal  year,
provided,  however,  that an alternative method may be considered at the
discretion of the commissioner of health and the director of the  budget
based  upon consultation with the health care industry including but not
limited to, a uniform reduction in Medicaid rates of payments  or  other
reductions provided that any method selected achieves up to $345,000,000
in  Medicaid  state share savings in state fiscal year 2011-12 and up to
$357,000,000  in  state  fiscal  year  2012-13,  except  as  hereinafter
provided, for services provided on and after April 1, 2011 through March
31,  2013.  Any  alternative  methods  to  achieve the reduction must be

S. 2809--D                         172                        A. 4009--D

provided in writing and shall be filed with the senate finance committee
and the assembly ways and means committee  not  less  than  thirty  days
before the date on which implementation is expected to begin. Nothing in
this  section shall be deemed to prevent all or part of such alternative
reduction plan from taking effect retroactively, to the extent permitted
by the federal centers for medicare and medicaid services.
  (b) The  following  types  of  appropriations  shall  be  exempt  from
reductions pursuant to this section:
  (i)  any  reductions that would violate federal law including, but not
limited to, payments required pursuant to the federal Medicare program;
  (ii) any reductions related to payments pursuant to article 32,  arti-
cle 31 and article 16 of the mental hygiene law;
  (iii) payments the state is obligated to make pursuant to court orders
or judgments;
  (iv)  payments  for  which  the non-federal share does not reflect any
state funding; and
  (v) at the discretion of the commissioner of health and  the  director
of  the  budget,  payments  with regard to which it is determined by the
commissioner of health and the director of the budget  that  application
of  reductions  pursuant  to  this section would result, by operation of
federal law, in a lower federal medical assistance percentage applicable
to such payments.
  (c) Reductions to Medicaid payments or Medicaid rates of payments made
pursuant to this section shall be subject to the receipt of  all  neces-
sary federal approvals.
  (d) Not less than 30 days prior to the conclusion of each state fiscal
year  in  which  the provisions of this section apply, the department of
health shall prepare and transmit  a  report  to  the  legislature  that
details  the  actions  taken  to  implement  the  Medicaid  state  share
reductions established pursuant to this section. Such  report  shall  be
provided  to the chairman of the senate finance committee and the assem-
bly ways and means committee.
  S 91.  Notwithstanding any inconsistent provision of state  law,  rule
or  regulation to the contrary, subject to federal approval, the year to
year rate of growth of department of health state funds Medicaid  spend-
ing  shall not 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 92. 1. For state fiscal years 2011-12 and 2012-13, the  director  of
the  budget,  in consultation with the commissioner of health referenced
as "commissioner" for purposes of this section, shall assess on a month-
ly basis, as reflected in monthly reports pursuant to  subdivision  five
of  this  section  known  and projected department of health state funds
medicaid expenditures by category of service and by geographic  regions,
as defined by the commissioner, and if the director of the budget deter-
mines  that  such  expenditures are expected to cause medicaid disburse-
ments for such period to exceed the projected department of health medi-
caid state funds disbursements in  the  enacted  budget  financial  plan
pursuant  to  subdivision  3 of section 23 of the state finance law, the
commissioner of health, in consultation with the director of the budget,
shall develop a medicaid savings allocation plan to limit such  spending
to  the  aggregate limit level specified in the enacted budget financial
plan, provided, however, such projections may be adjusted by the  direc-
tor  of  the  budget  to  account  for any changes in the New York state
federal medical assistance percentage amount established pursuant to the

S. 2809--D                         173                        A. 4009--D

federal social security act, changes in provider revenues, and beginning
April 1, 2012 the operational costs of the New York state medical indem-
nity fund.
  2.  Such medicaid savings allocation plan shall be designed, to reduce
the disbursements authorized by the appropriations herein in  compliance
with  the  following guidelines: (1) reductions shall be made in compli-
ance with applicable  federal  law,  including  the  provisions  of  the
Patient  Protection and Affordable Care Act, Public Law No. 111-148, and
the Health Care and Education Reconciliation Act of 2010, Public Law No.
111-152 (collectively "Affordable Care Act") and any  subsequent  amend-
ments  thereto  or  regulations  promulgated  thereunder; (2) reductions
shall be made in a manner that complies with  the  state  Medicaid  plan
approved  by  the  federal  centers  for medicare and medicaid services,
provided, however, that the commissioner  of  health  is  authorized  to
submit  any state plan amendment or seek other federal approval, includ-
ing waiver authority,  to  implement  the  provisions  of  the  medicaid
savings  allocation plan that meets the other criteria set forth herein;
(3) reductions shall be made in a manner that maximizes  federal  finan-
cial  participation,  to  the  extent practicable, including any federal
financial participation that is available or is reasonably  expected  to
become available, in the discretion of the commissioner of health, under
the  Affordable  Care  Act; (4) reductions shall be made uniformly among
categories of services and geographic  regions  of  the  state,  to  the
extent  practicable,  and  shall  be made uniformly within a category of
service, to the extent practicable, except  where  the  commissioner  of
health  determines that there are sufficient grounds for non-uniformity,
including but not limited to: the extent to which specific categories of
services contributed to department of health medicaid state funds spend-
ing in excess of the limits specified herein; the need to maintain safe-
ty net services in underserved communities; or the potential benefits of
pursuing innovative payment models contemplated by the  Affordable  Care
Act,  in  which  case  such  grounds  shall be set forth in the medicaid
savings allocation plan; and (5) reductions shall be made  in  a  manner
that  does  not  unnecessarily create administrative burdens to Medicaid
applicants and recipients or providers.
  3. (a) The commissioner of health shall seek the input of the legisla-
ture, as well  as  organizations  representing  health  care  providers,
consumers,  businesses,  workers, health insurers, and others with rele-
vant expertise, in developing such medicaid savings allocation plan,  to
the  extent  that  all  or  part  of such plan, in the discretion of the
commissioner, is likely to have a material impact on the  overall  medi-
caid  program, particular categories of service or particular geographic
regions of the states.
  (b)(i) The commissioner of health  shall  post  the  medicaid  savings
allocation  plan on the department of health's website and shall provide
written copies of such plan to the chairs of the senate finance and  the
assembly  ways  and means committees at least 30 days before the date on
which implementation is expected to begin.
  (ii) The commissioner of health may revise the medicaid savings  allo-
cation plan subsequent to the provision of notice and prior to implemen-
tation  but  need  provide  a new notice pursuant to subparagraph (i) of
this paragraph only if  the  commissioner  determines,  in  his  or  her
discretion, that such revisions materially alter the plan.
  (c)  Notwithstanding  the provisions of paragraphs (a) and (b) of this
subdivision,  the  commissioner  of  health  need  not  seek  the  input
described  in paragraph (a) of this subdivision or provide notice pursu-

S. 2809--D                         174                        A. 4009--D

ant to paragraph (b) of this paragraph if,  in  the  discretion  of  the
commissioner,  expedited  development  and  implementation of a medicaid
savings allocation plan is necessary due to a public health emergency.
  For purposes of this section, a public health emergency is defined as:
(i)  a  disaster, natural or otherwise, that significantly increases the
immediate need for health care personnel in an area of the  state;  (ii)
an  event  or  condition that creates a widespread risk of exposure to a
serious communicable disease, or the potential for such widespread  risk
of  exposure;  or  (iii)  any other event or condition determined by the
commissioner to constitute an imminent threat to public health.
  (d) Nothing in this paragraph shall be deemed to prevent all  or  part
of such medical savings allocation plan from taking effect retroactively
to the extent permitted by the federal centers for medicare and medicaid
services.
  4.  In  accordance  with  the  medicaid  savings  allocation plan, the
commissioner of the department of  health  shall  reduce  department  of
health state funds medicaid disbursements by the amount of the projected
overspending through, actions including, but not limited to modifying or
suspending reimbursement methods, including but not limited to all fees,
premium  levels  and  rates of payment, notwithstanding any provision of
law that sets a specific amount or methodology for any such payments  or
rates  of  payment;  modifying  Medicaid  program  benefits; seeking all
necessary Federal approvals, including,  but  not  limited  to  waivers,
waiver  amendments;  and  suspending time frames for notice, approval or
certification of rate requirements,  notwithstanding  any  provision  of
law,  rule  or  regulation to the contrary, including but not limited to
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).
  5.  The department of health shall prepare a monthly report that  sets
forth:    (a) known and projected department of health medicaid expendi-
tures as described in subdivision one  of  this  section;  and  (b)  the
actions  taken  to implement any medicaid savings allocation plan imple-
mented pursuant to subdivision four of this section, including  informa-
tion  concerning  the impact of such actions on each category of service
and each geographic region of the state. Each such monthly report  shall
be  provided  to  the chairs of the senate finance and the assembly ways
and means committees and shall be posted on the department  of  health's
website in a timely manner.
  S  93.  1.  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  profes-
sional  services  provided by physicians, nurse practitioners and physi-
cian assistants who are employed by a public benefit  corporation  or  a
non-state  operated public general hospital operated by a public benefit
corporation or who are providing professional services at a facility  of
such public benefit corporation as either a member of a practice plan or
an  employee  of  a professional corporation or limited liability corpo-
ration under contract to provide services to patients of such  a  public
benefit  corporation,  in  accordance  with title 11 of article 5 of the
social services law for patients eligible for federal financial  partic-
ipation  under  title XIX of the federal social security act, in amounts
that will increase fees for such  professional  services  to  an  amount
equal  to  either  the Medicare rate or the average commercial rate that
would otherwise be received for such services rendered  by  such  physi-

S. 2809--D                         175                        A. 4009--D

cians,  nurse practitioners and physician assistants, provided, however,
that such supplemental fee payments shall not be available  with  regard
to  services provided at facilities participating in the Medicare Teach-
ing  Election  Amendment.  The  calculation  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 entities authorized to receive professional fees.
  2.  The  supplemental  Medicaid  payments  for  professional  services
authorized by subdivision one of this section may be made  only  at  the
election  of the public benefit corporation or the local social services
district in which the non-state  operated  public  general  hospital  is
located.  The  electing  public  benefit  corporation  or  local  social
services district shall, notwithstanding the  social  services  district
Medicaid  cap provisions of Part C of chapter 58 of the laws of 2005, be
responsible for payment of one hundred percent of the non-federal  share
of such supplemental Medicaid payments, 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 responsi-
ble for furnishing medical assistance to the eligible persons  receiving
such  services.  Social  services district or public benefit corporation
funding of the non-federal share of any such payments shall be deemed to
be voluntary for purposes of the increased  federal  medical  assistance
percentage  provisions  of the American Recovery and Reinvestment Act of
2009, provided, however, that in the event the federal Centers for Medi-
care and  Medicaid  Services  determines  that  such  non-federal  share
payments  are  not  voluntary  payments  for  purposes  of such act, the
provisions of this section shall be null and void.
  S 94. 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  compo-
nent  of  rates  of  payment  shall reflect allowable operating costs as
reported in each facility's cost report for the two thousand two  calen-
dar  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 adjust-
ment 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-

S. 2809--D                         176                        A. 4009--D

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.
  S  95.  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 OR AFTER OCTOBER FIRST, TWO THOU-
SAND ELEVEN, BUT NO LATER THAN JANUARY FIRST, TWO THOUSAND TWELVE, SHALL
REFLECT A DIRECT STATEWIDE PRICE COMPONENT, AND INDIRECT STATEWIDE PRICE
COMPONENT, AND A FACILITY SPECIFIC NON-COMPARABLE  COMPONENT,  UTILIZING
ALLOWABLE  OPERATING  COSTS FOR A BASE YEAR AS DETERMINED BY THE COMMIS-
SIONER BY REGULATION. SUCH RATE COMPONENTS SHALL BE PERIODICALLY UPDATED
TO REFLECT CHANGES IN OPERATING COSTS.
  (B) THE DIRECT  AND  INDIRECT  STATEWIDE  PRICE  COMPONENTS  SHALL  BE
ADJUSTED  BY A WAGE EQUALIZATION FACTOR AND SUCH OTHER FACTORS AS DETER-
MINED TO BE APPROPRIATE TO RECOGNIZE LEGITIMATE COST  DIFFERENTIALS  AND
THE  DIRECT  STATEWIDE  PRICE  COMPONENT  SHALL BE SUBJECT TO A CASE MIX
ADJUSTMENT UTILIZING THE PATIENTS THAT ARE ELIGIBLE FOR MEDICAL  ASSIST-
ANCE  PURSUANT  TO  TITLE  ELEVEN OF ARTICLE FIVE OF THE SOCIAL SERVICES
LAW. SUCH WAGE EQUALIZATION FACTOR  SHALL  BE  PERIODICALLY  UPDATED  TO
REFLECT CURRENT LABOR MARKET CONDITIONS.
  (C) THE NON-CAPITAL COMPONENT OF THE RATES FOR: (I) AIDS FACILITIES OR
DISCRETE AIDS UNITS WITHIN FACILITIES; (II) DISCRETE UNITS FOR RESIDENTS
RECEIVING CARE IN A LONG-TERM INPATIENT REHABILITATION PROGRAM FOR TRAU-
MATIC  BRAIN INJURED PERSONS; (III) DISCRETE UNITS PROVIDING SPECIALIZED
PROGRAMS FOR RESIDENTS REQUIRING BEHAVIORAL INTERVENTIONS; (IV) DISCRETE
UNITS FOR LONG-TERM VENTILATOR DEPENDENT RESIDENTS; AND  (V)  FACILITIES
OR  DISCRETE  UNITS  WITHIN  FACILITIES  THAT PROVIDE EXTENSIVE NURSING,
MEDICAL, PSYCHOLOGICAL AND COUNSELING SUPPORT SERVICES SOLELY  TO  CHIL-
DREN  SHALL  REFLECT  THE RATES IN EFFECT FOR SUCH FACILITIES ON JANUARY
FIRST, TWO THOUSAND NINE, AS ADJUSTED FOR INFLATION AND RATE APPEALS  IN
ACCORDANCE  WITH APPLICABLE STATUTES, PROVIDED, HOWEVER, THAT SUCH RATES
FOR FACILITIES DESCRIBED IN SUBPARAGRAPH (I)  OF  THIS  PARAGRAPH  SHALL
REFLECT THE APPLICATION OF THE PROVISIONS OF SECTION TWELVE OF PART D OF
CHAPTER  FIFTY-EIGHT  OF  THE  LAWS  OF  TWO THOUSAND NINE, AND PROVIDED
FURTHER, HOWEVER, THAT INSOFAR AS SUCH RATES REFLECT  TREND  ADJUSTMENTS
FOR  TREND  FACTORS ATTRIBUTABLE TO THE TWO THOUSAND EIGHT AND TWO THOU-
SAND NINE CALENDAR YEARS THE  AGGREGATE  AMOUNT  OF  SUCH  TREND  FACTOR
ADJUSTMENTS  SHALL BE SUBJECT TO THE PROVISIONS OF SECTION TWO OF PART D
OF CHAPTER FIFTY-EIGHT OF THE LAWS OF TWO THOUSAND NINE, AS AMENDED.
  (D) THE COMMISSIONER SHALL PROMULGATE REGULATIONS, AND MAY  PROMULGATE
EMERGENCY  REGULATIONS, TO IMPLEMENT THE PROVISIONS OF THIS SUBDIVISION.
SUCH REGULATIONS SHALL BE DEVELOPED IN  CONSULTATION  WITH  THE  NURSING
HOME  INDUSTRY  AND ADVOCATES FOR RESIDENTIAL HEALTH CARE FACILITY RESI-
DENTS AND, FURTHER, THE COMMISSIONER SHALL PROVIDE NOTIFICATION CONCERN-
ING SUCH REGULATIONS TO THE CHAIRS OF THE  SENATE  AND  ASSEMBLY  HEALTH
COMMITTEES,  THE  CHAIR OF THE SENATE FINANCE COMMITTEE AND THE CHAIR OF
THE ASSEMBLY WAYS AND MEANS COMMITTEE. SUCH  REGULATIONS  SHALL  INCLUDE
PROVISIONS  FOR RATE ADJUSTMENTS OR PAYMENT ENHANCEMENTS TO FACILITATE A
MINIMUM FOUR-YEAR TRANSITION OF FACILITIES TO THE RATE-SETTING METHODOL-
OGY ESTABLISHED BY THIS SUBDIVISION AND MAY ALSO  INCLUDE,  BUT  NOT  BE
LIMITED TO, PROVISIONS FOR FACILITATING QUALITY IMPROVEMENTS IN RESIDEN-
TIAL HEALTH CARE FACILITIES.

S. 2809--D                         177                        A. 4009--D

  S  96.  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 AND JULY of
2011 shall not be made.  Adjustments made pursuant to this section shall
not be subject to subsequent correction or reconciliation.
  S 97. Section 2808 of the public health law is amended by adding a new
subdivision 2-d to read as follows:
  2-D. RESIDENTIAL HEALTH CARE FACILITY SUPPLEMENTAL PAYMENTS.  NOTWITH-
STANDING ANY INCONSISTENT PROVISION  OF  LAW,  RULE  OR  REGULATION  AND
SUBJECT  TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION, FOR THE
PERIOD MAY FIRST, TWO THOUSAND  ELEVEN  THROUGH  MAY  THIRTY-FIRST,  TWO
THOUSAND  ELEVEN, THE COMMISSIONER SHALL ADJUST INPATIENT MEDICAID RATES
OF PAYMENT ESTABLISHED PURSUANT TO THIS ARTICLE FOR ELIGIBLE RESIDENTIAL
HEALTH CARE FACILITIES IN ACCORDANCE WITH THE FOLLOWING:
  (A) RATE ADJUSTMENTS MADE PURSUANT TO THIS SUBDIVISION SHALL BE IN THE
FORM OF RATE ADD-ONS AND SHALL NOT EXCEED AN  AGGREGATE  AMOUNT  OF  TWO
HUNDRED TWENTY-ONE MILLION THREE HUNDRED THOUSAND DOLLARS.
  (B)  ELIGIBLE  FACILITIES  ARE THOSE FACILITIES WHICH THE COMMISSIONER
DETERMINES HAVE EXPERIENCED A NET REDUCTION IN THEIR INPATIENT  MEDICAID
REIMBURSEMENT  FOR  THE  PERIOD  APRIL  FIRST, TWO THOUSAND NINE THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND ELEVEN AS A RESULT OF THE FOLLOWING:
  (I) INPATIENT RATE ADJUSTMENTS  MADE  PURSUANT  TO  PARAGRAPH  (B)  OF
SUBDIVISION TWO-B OF THIS SECTION;

S. 2809--D                         178                        A. 4009--D

  (II)  USE  OF  THE  CASE MIX METHODOLOGY DESCRIBED IN PARAGRAPH (G) OF
SUBDIVISION TWO-B OF THIS SECTION;
  (III)  INPATIENT RATE ADJUSTMENTS MADE PURSUANT TO SECTION TWO OF PART
D OF CHAPTER FIFTY-EIGHT OF THE LAWS OF TWO THOUSAND NINE, AS AMENDED.
  (C) THE FOLLOWING ELIGIBLE FACILITIES SHALL RECEIVE  RATE  ADJUSTMENTS
PURSUANT  TO  THIS SUBDIVISION EQUAL TO ONE HUNDRED PERCENT OF THEIR NET
REIMBURSEMENT REDUCTION AS COMPUTED BY THE  COMMISSIONER  IN  ACCORDANCE
WITH PARAGRAPH (B) OF THIS SUBDIVISION:
  (I)  FACILITIES THAT HAVE BEEN DETERMINED BY THE COMMISSIONER AS BEING
ELIGIBLE FOR DISTRIBUTIONS OF AMOUNTS AVAILABLE  FOR  THE  TWO  THOUSAND
NINE PERIOD AS PROVIDED IN SUBDIVISION TWENTY-ONE OF THIS SECTION;
  (II)  NON-PUBLIC  FACILITIES  WHOSE  TOTAL  OPERATING  LOSSES EQUAL OR
EXCEED FIVE PERCENT OF TOTAL OPERATING REVENUE AND WHOSE MEDICAID UTILI-
ZATION EQUALS OR EXCEEDS SEVENTY PERCENT,  BASED  ON  EITHER  THEIR  TWO
THOUSAND NINE COST REPORT OR BASED ON THE OTHERWISE MOST RECENTLY AVAIL-
ABLE COST REPORT, AS DETERMINED BY THE COMMISSIONER;
  (III)  FACILITIES  OR DISTINCT UNITS OF FACILITIES PROVIDING INPATIENT
SERVICES PRIMARILY TO CHILDREN UNDER THE AGE OF TWENTY-ONE.
  (D) ELIGIBLE FACILITIES, OTHER THAN ELIGIBLE FACILITIES  DESCRIBED  IN
PARAGRAPH (C) OF THIS SUBDIVISION, SHALL RECEIVE RATE ADJUSTMENTS PURSU-
ANT  TO  THIS SUBDIVISION EQUAL TO FIFTY PERCENT OF THEIR NET REIMBURSE-
MENT REDUCTION AS COMPUTED BY THE COMMISSIONER IN ACCORDANCE WITH  PARA-
GRAPH (B) OF THIS SUBDIVISION.
  (E) ELIGIBLE FACILITIES AS DESCRIBED IN PARAGRAPH (D) OF THIS SUBDIVI-
SION  WHICH, AS DETERMINED BY THE COMMISSIONER, AFTER APPLICATION OF THE
RATE ADJUSTMENTS AUTHORIZED BY PARAGRAPH (D) OF THIS SUBDIVISION, REMAIN
SUBJECT TO A NET REDUCTION IN THEIR INPATIENT MEDICAID REVENUE  THAT  IS
IN  EXCESS  OF  TWO  PERCENT, AS MEASURED WITH REGARD TO THE NON-CAPITAL
COMPONENTS OF FACILITY INPATIENT RATES IN EFFECT ON MARCH  THIRTY-FIRST,
TWO  THOUSAND  NINE AS COMPUTED PRIOR TO THE APPLICATION OF TREND FACTOR
ADJUSTMENTS ATTRIBUTABLE TO THE TWO THOUSAND EIGHT AND TWO THOUSAND NINE
CALENDAR YEARS, SHALL HAVE THEIR RATES FURTHER ADJUSTED SUCH  THAT  SUCH
NET REDUCTION DOES NOT EXCEED SUCH TWO PERCENT.
  (F) ELIGIBLE FACILITIES AS DESCRIBED IN PARAGRAPH (D) OF THIS SUBDIVI-
SION  WHICH,  AS  DETERMINED BY THE COMMISSIONER, HAVE EXPERIENCED A NET
REDUCTION IN THEIR INPATIENT RATES OF MORE THAN SIX MILLION DOLLARS AS A
RESULT OF THE APPLICATION OF THE FACTOR DESCRIBED IN SUBPARAGRAPH  (III)
OF  PARAGRAPH  (B)  OF  THIS  SUBDIVISION SHALL AFTER APPLICATION OF THE
PROVISIONS OF PARAGRAPH  (E)  OF  THIS  SUBDIVISION,  HAVE  THEIR  RATES
FURTHER  ADJUSTED  SUCH  THAT ANY SUCH NET REDUCTION REMAINING AFTER THE
APPLICATION OF THE OTHER PROVISIONS OF THIS SUBDIVISION  IS  REDUCED  TO
ZERO.
  (G)  IN COMPUTING NET REDUCTIONS OF MEDICAID REIMBURSEMENT PURSUANT TO
PARAGRAPH (B) OF THIS SUBDIVISION THE COMMISSIONER SHALL:
  (I) DISREGARD THE IMPACT OF CASE MIX ADJUSTMENTS AS  OTHERWISE  SCHED-
ULED FOR JULY FIRST, TWO THOUSAND TEN; AND,
  (II)  DISREGARD  THE IMPACT OF ANY RATE ADJUSTMENTS ISSUED ON OR AFTER
JANUARY FIRST, TWO THOUSAND ELEVEN, INCLUDING ADJUSTMENTS TO RATE  PERI-
ODS PRIOR TO JANUARY FIRST, TWO THOUSAND ELEVEN.
  (H) PAYMENTS MADE PURSUANT TO THIS SUBDIVISION SHALL NOT BE SUBJECT TO
SUBSEQUENT  ADJUSTMENT  OR  RECONCILIATION AND, FURTHER, THE COMPUTATION
AND APPLICATION OF LIMITATIONS ON MEDICAID RATES OF PAYMENT AS DESCRIBED
IN SECTION TWO OF PART D OF CHAPTER FIFTY-EIGHT OF THE LAWS OF TWO THOU-
SAND NINE, AS AMENDED, AND AS APPLICABLE TO THE RATE  PERIODS  DESCRIBED
IN  PARAGRAPH  (A)  OF  THIS  SUBDIVISION, SHALL DISREGARD PAYMENTS MADE
PURSUANT TO THIS SUBDIVISION.

S. 2809--D                         179                        A. 4009--D

  (I) ADDITIONAL RATE ADJUSTMENTS SHALL BE MADE PURSUANT TO THIS  SUBDI-
VISION TO ELIGIBLE FACILITIES IN THE FORM OF RATE ADD-ONS FOR THE PERIOD
MAY  FIRST,  TWO  THOUSAND ELEVEN THROUGH MAY THIRTY-FIRST, TWO THOUSAND
ELEVEN WHICH SHALL IN AGGREGATE BE EQUAL TO TWENTY-FIVE PERCENT  OF  THE
AGGREGATE  AMOUNT  DESCRIBED  IN  PARAGRAPH  (A) OF THIS SUBDIVISION AND
WHICH SHALL BE DISTRIBUTED TO EACH ELIGIBLE FACILITY IN THE SAME PROPOR-
TION AS THE TOTAL DISTRIBUTIONS  OTHERWISE  RECEIVED  BY  EACH  FACILITY
PURSUANT TO THIS SUBDIVISION.
  (J)  THE  COMMISSIONER  MAY,  WITH THE APPROVAL OF THE DIRECTOR OF THE
BUDGET, AND SUBJECT TO THE IDENTIFICATION  OF  SUFFICIENT  NURSING  HOME
RELATED  MEDICAID  SAVINGS TO OFFSET THE EXPENDITURES AUTHORIZED BY THIS
PARAGRAPH, MAKE ADDITIONAL RATE ADJUSTMENTS PURSUANT TO THIS SUBDIVISION
TO ELIGIBLE FACILITIES IN THE FORM OF RATE ADD-ONS FOR THE PERIOD DECEM-
BER FIRST, TWO THOUSAND ELEVEN THROUGH DECEMBER THIRTY-FIRST, TWO  THOU-
SAND  ELEVEN WHICH SHALL IN AGGREGATE BE EQUAL TO TWELVE AND FIVE-TENTHS
PERCENT OF THE AGGREGATE AMOUNT  DESCRIBED  IN  PARAGRAPH  (A)  OF  THIS
SUBDIVISION  AND WHICH SHALL BE DISTRIBUTED TO EACH ELIGIBLE FACILITY IN
THE SAME PROPORTION AS THE TOTAL  DISTRIBUTIONS  OTHERWISE  RECEIVED  BY
EACH FACILITY PURSUANT TO THIS SUBDIVISION.
  S  98.  Paragraph  (b) of subdivision 17 of section 2808 of the public
health law, as added by section 30 of part B of chapter 109 of the  laws
of 2010, is amended and a new paragraph (c) is added to read as follows:
  (b) Notwithstanding any inconsistent provision of law or regulation to
the contrary, for the state fiscal year beginning April first, two thou-
sand  ten  and ending March thirty-first, two thousand [eleven] FIFTEEN,
the commissioner shall not be required  to  revise  certified  rates  of
payment  established  pursuant to this article for rate periods prior to
April first, two thousand [eleven] FIFTEEN, based  on  consideration  of
rate  appeals  filed by residential health care facilities or based upon
adjustments to capital cost reimbursement as a result of approval by the
commissioner of an application for construction  under  section  twenty-
eight  hundred  two  of  this  article, in excess of an aggregate annual
amount of eighty  million  dollars  for  EACH  such  state  fiscal  year
PROVIDED,  HOWEVER, THAT FOR THE PERIOD APRIL FIRST, TWO THOUSAND ELEVEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWELVE  SUCH  AGGREGATE  ANNUAL
AMOUNT  SHALL  BE  FIFTY MILLION DOLLARS.  In revising such rates within
such fiscal limit, the commissioner shall,  in  prioritizing  such  rate
appeals,  include  consideration  of  which  facilities the commissioner
determines are facing significant financial hardship  as  well  as  such
other considerations as the commissioner deems appropriate and, further,
the commissioner is authorized to enter into agreements with such facil-
ities  or  any  other  facility to resolve multiple pending rate appeals
based upon a negotiated aggregate amount and may offset such  negotiated
aggregate  amounts  against  any  amounts  owed  by  the facility to the
department, including, but not limited  to,  amounts  owed  pursuant  to
section twenty-eight hundred seven-d of this article; PROVIDED, HOWEVER,
THAT THE COMMISSIONER'S AUTHORITY TO NEGOTIATE SUCH AGREEMENTS RESOLVING
MULTIPLE  PENDING  RATE APPEALS AS HEREINBEFORE DESCRIBED SHALL CONTINUE
ON AND AFTER APRIL FIRST, TWO THOUSAND FIFTEEN.  Rate  adjustments  made
pursuant  to  this  paragraph  remain  fully  subject to approval by the
director of the budget in accordance with the provisions of  subdivision
two of section twenty-eight hundred seven of this article.
  (C) NOTWITHSTANDING ANY OTHER CONTRARY PROVISION OF LAW, RULE OR REGU-
LATION,  FOR  PERIODS  ON AND AFTER APRIL FIRST, TWO THOUSAND ELEVEN THE
COMMISSIONER SHALL PROMULGATE REGULATIONS, AND MAY PROMULGATE  EMERGENCY
REGULATIONS, ESTABLISHING PRIORITIES AND TIME FRAMES FOR PROCESSING RATE

S. 2809--D                         180                        A. 4009--D

APPEALS, INCLUDING RATE APPEALS FILED PRIOR TO APRIL FIRST, TWO THOUSAND
ELEVEN,  WITHIN  AVAILABLE  ADMINISTRATIVE RESOURCES; PROVIDED, HOWEVER,
THAT SUCH REGULATIONS SHALL NOT BE INCONSISTENT WITH THE  PROVISIONS  OF
PARAGRAPH (B) OF THIS SUBDIVISION.
  S  99.  Subdivision  2-b  of  section 2808 of the public health law is
amended by adding a new paragraph (h) to read as follows:
  (H) NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW AND SUBJECT  TO  THE
AVAILABILITY  OF  FEDERAL  FINANCIAL PARTICIPATION, FOR THE PERIOD APRIL
FIRST, TWO THOUSAND ELEVEN THROUGH JUNE THIRTIETH, TWO THOUSAND  ELEVEN,
THE  NON-CAPITAL  COMPONENTS  OF  RATES  SHALL  BE  SUBJECT TO A UNIFORM
PERCENTAGE REDUCTION SUFFICIENT TO REDUCE SUCH  RATES  BY  AN  AGGREGATE
AMOUNT  OF  TWENTY-SEVEN  MILLION  ONE  HUNDRED  THOUSAND  DOLLARS,  AND
PROVIDED FURTHER, HOWEVER, THAT SUCH REDUCTIONS SHALL BE DISREGARDED  IN
COMPUTATIONS  MADE  PURSUANT  TO  SECTION  TWO  OF  PART  D  OF  CHAPTER
FIFTY-EIGHT OF THE LAWS OF TWO THOUSAND NINE, AS AMENDED.
  S 100. Paragraph (a) of subdivision 21 of section 2808 of  the  public
health  law, as amended by section 8 of part D of chapter 58 of the laws
of 2009, is amended to read as follows:
  (a) Notwithstanding any inconsistent provision of law or regulation to
the contrary, for the purposes specified in subdivision nineteen of this
section, the commissioner  shall  adjust  medical  assistance  rates  of
payment  established  pursuant  to this article for services provided on
and after October first, two  thousand  four  through  December  thirty-
first,  two  thousand four and annually thereafter for services provided
on and after January first, two thousand five THROUGH  APRIL  THIRTIETH,
TWO  THOUSAND ELEVEN AND ON AND AFTER MAY FIRST, TWO THOUSAND TWELVE, to
include a rate adjustment to assist qualifying  facilities  pursuant  to
this subdivision, provided, however, that public residential health care
facilities  shall  not be eligible for rate adjustments pursuant to this
subdivision for rate periods on and  after  April  first,  two  thousand
nine[.],  PROVIDED  FURTHER,  HOWEVER, THAT NOTWITHSTANDING ANY CONTRARY
PROVISION OF LAW AND SUBJECT TO THE AVAILABILITY  OF  FEDERAL  FINANCIAL
PARTICIPATION, EACH FACILITY THAT RECEIVES A RATE ADJUSTMENT PURSUANT TO
THIS  SUBDIVISION  FOR  THE  PERIOD  MAY FIRST, TWO THOUSAND TEN THROUGH
APRIL THIRTIETH, TWO THOUSAND  ELEVEN  SHALL  HAVE  ITS  MEDICAID  RATES
REDUCED  FOR THE RATE PERIOD DECEMBER FIRST, TWO THOUSAND ELEVEN THROUGH
DECEMBER THIRTY-FIRST, TWO THOUSAND ELEVEN BY AN AMOUNT EQUAL IN  AGGRE-
GATE  TO THE AGGREGATE AMOUNT OF THE FUNDS SUCH FACILITY RECEIVED PURSU-
ANT TO THIS SUBDIVISION FOR THE  PERIOD  MAY  FIRST,  TWO  THOUSAND  TEN
THROUGH APRIL THIRTIETH, TWO THOUSAND ELEVEN.
  S  101. The public health law is amended by adding a new section 2807-
dd to read as follows:
  S  2807-DD.  TEMPORARY  NURSING  HOME  STABILITY   CONTRIBUTIONS.   1.
NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW AND SUBJECT TO THE RECEIPT
OF  ALL NECESSARY FEDERAL APPROVALS OR WAIVERS, FOR PERIODS ON AND AFTER
APRIL FIRST, TWO THOUSAND ELEVEN, A  TEMPORARY  NURSING  HOME  STABILITY
CONTRIBUTION  SHALL BE IMPOSED ON THE GROSS RECEIPTS OF EACH RESIDENTIAL
HEALTH CARE FACILITY EQUAL  TO  FOUR  TENTHS  OF  ONE  PERCENT  OF  SUCH
RECEIPTS  AND  PROVIDED FURTHER, HOWEVER, THAT ON AND AFTER APRIL FIRST,
TWO THOUSAND TWELVE THROUGH OCTOBER THIRTY-FIRST,  TWO  THOUSAND  TWELVE
SUCH  CONTRIBUTIONS  SHALL  BE REDUCED TO TWO TENTHS OF ONE PERCENT, AND
PROVIDED FURTHER, HOWEVER, THAT ON AND AFTER NOVEMBER FIRST,  TWO  THOU-
SAND TWELVE, SUCH CONTRIBUTIONS SHALL BE REDUCED TO ZERO.
  2.  THE  GROSS RECEIPTS SUBJECT TO THIS SECTION SHALL BE AS DEFINED IN
PARAGRAPH (B) OF  SUBDIVISION  THREE  OF  SECTION  TWENTY-EIGHT  HUNDRED
SEVEN-D  OF  THIS ARTICLE AND SHALL INCLUDE INCOME FROM ALL PATIENT CARE

S. 2809--D                         181                        A. 4009--D

SERVICES AND OTHER OPERATING INCOME  ON  A  CASH  BASIS,  BUT  EXCLUDING
REVENUE  RECEIVED PURSUANT TO THE FEDERAL MEDICARE PROGRAM. THE CONTRIB-
UTIONS DESCRIBED IN THIS SECTION SHALL  BE  ADMINISTERED  IN  ACCORDANCE
WITH  AND  SUBJECT  TO  THE  PROVISIONS OF SUBDIVISIONS FOUR, FIVE, SIX,
SEVEN, EIGHT, NINE AND TWELVE OF SECTION TWENTY-EIGHT HUNDRED SEVEN-D OF
THIS ARTICLE, PROVIDED, HOWEVER, THAT SUCH CONTRIBUTIONS SHALL NOT BE AN
ALLOWABLE COST IN THE DETERMINATION OF REIMBURSEMENT  RATES  OF  PAYMENT
COMPUTED PURSUANT TO THIS ARTICLE.
  S  102. 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
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 THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND THIRTEEN SUCH ASSESSMENT SHALL BE SIX PERCENT.
  S 103. Paragraph (c) of subdivision 10 of section 2807-d of the public
health law, as amended by section 2 of part H of chapter 686 of the laws
of 2003, is amended to read as follows:
  (c) provided, however, that for the purposes of determining  rates  of
payment pursuant to this article for residential health care facilities,
the assessment imposed pursuant to subparagraph (vi) of paragraph (b) of
subdivision  two  of  this  section  shall  be a reimbursable cost to be
reflected as timely as practicable, and subsequently reconciled to actu-
al cost, in rates of payment applicable within  the  assessment  period,
PROVIDED  FURTHER, HOWEVER, THAT INSOFAR AS SUCH ASSESSMENT IS IN EXCESS
OF SIX PERCENT IT SHALL NOT BE DEEMED A REIMBURSABLE COST AND SHALL  NOT
BE REFLECTED IN SUCH RATES OF PAYMENT.
  S  104.  Subdivision 17-a of section 2808 of the public health law, as
amended by section 4 of part D of chapter 58 of the  laws  of  2009,  is
amended to read as follows:
  17-a.  Notwithstanding any inconsistent provision of law or regulation
to the contrary, for  purposes  of  establishing  rates  of  payment  by
governmental   agencies  for  residential  health  care  facilities  for
services provided on and after January first, nineteen  hundred  ninety-
eight,  the  regional direct and indirect input price adjustment factors
to be applied to any such facility's rate  calculation  shall  be  based
upon  the  utilization of either nineteen hundred eighty-three, nineteen
hundred eighty-seven or  nineteen  hundred  ninety-three  calendar  year
financial  and  statistical  data and for periods beginning April first,
two thousand four through March thirty-first, two thousand nine based on

S. 2809--D                         182                        A. 4009--D

either nineteen hundred  eighty-three,  nineteen  hundred  eighty-seven,
nineteen  hundred  ninety-three or two thousand one calendar year finan-
cial and statistical data; provided, however, the state share amount for
the  utilization of two thousand one calendar year data shall be no more
than twenty-two million dollars on a pro rata basis per  calendar  year.
The  determination  of  which  calendar  year's data to utilize shall be
based upon a methodology that ensures that the particular year chosen by
each facility results in a factor that yields no less  reimbursement  to
the  facility  than  would result from the use of any of the other three
years' data. Such methodology shall utilize the nineteen hundred  eight-
y-three  and  nineteen hundred eighty-seven regional direct and indirect
input price adjustment factor corridor percentages in existence on Janu-
ary first, nineteen hundred ninety-seven as  well  as  nineteen  hundred
ninety-three  regional direct and indirect input price adjustment factor
corridor percentage in existence on January first, two thousand four  as
well  as  a  two  thousand  one regional direct and indirect input price
adjustment factor corridor percentage calculated in the same  manner  as
the  nineteen  hundred  ninety-three  direct  and  indirect  input price
adjustment factor corridor percentages in existence  on  January  first,
two  thousand  four;  provided,  however,  for rate periods on and after
April first, two thousand nine,  the  regional  input  price  adjustment
factors shall be based on the case mix predicted staffing for registered
nurses,  licensed  practical  nurses, nurses' aides, licensed therapists
and therapist aides. For the rate  period  beginning  April  first,  two
thousand  nine  through  [March thirty-first, two thousand ten,] THE DAY
IMMEDIATELY PRIOR TO THE DAY THE PROVISIONS OF SUBDIVISION TWO-C OF THIS
SECTION TAKE EFFECT,  the  regional  direct  and  indirect  input  price
adjustment  factors to be applied to a facility's rate calculation shall
be based upon the utilization of two thousand two calendar  year  finan-
cial  and  statistical data. Such methodology shall utilize two thousand
two regional direct and indirect input price adjustment factor  corridor
percentages  calculated  in  the  same  manner  as  the two thousand one
regional direct and indirect  input  price  adjustment  factor  corridor
percentages  in  existence  on  December  thirty-first, two thousand six
except that every  region  shall  receive  a  corridor  to  reflect  the
region's  actual  variation subject to a maximum statewide average vari-
able corridor percentage of ten percent.
  S 105. Notwithstanding any inconsistent provision of sections 112  and
163 of the state finance law, or section 142 of the economic development
law, or any other law, the commissioner of health is authorized to enter
into  a contract without a competitive bid or request for proposal proc-
ess for the purposes set forth in  the  Early  Innovator  federal  grant
awarded  to the department of health by the federal centers for medicare
and medicaid services pursuant to the Patient Protection and  Affordable
Care Act (P.L. 111-148) and the Health Care and Education Reconciliation
Act of 2010 (P.L. 111-152), provided, however, that:
  (i)  the  department of health shall post on its website, for a period
of no less than thirty days:
  (1) a description of the proposed services to be provided pursuant  to
the contract or contracts;
  (2)  the  criteria  for selection of a contractor or contractors which
shall include but not be limited to the ability  of  the  contractor  to
meet the federal grant requirements;
  (3)  the period of time during which a prospective contractor may seek
selection, which shall be no less than thirty days after  such  informa-
tion is first posted on the website; and

S. 2809--D                         183                        A. 4009--D

  (4)  the  manner  by  which  a  prospective  contractor  may seek such
selection, which may include submission by electronic means;
  (ii)  all reasonable and responsive submissions that are received from
prospective contractors in timely  fashion  shall  be  reviewed  by  the
commissioner of health;
  (iii)  the  commissioner  of  health  shall  select such contractor or
contractors that, in his or her discretion, are best suited to carry out
the purposes set forth in the Early Innovator federal grant  awarded  to
the department of health; and
  (iv) prior to the execution of any resulting contract, the commission-
er  of health shall submit a copy to the office of the state comptroller
for review and approval.
  S 106. Section 2 of chapter 385 of  the  laws  of  2008  amending  the
insurance  law  relating  to  an  exemption to certain provisions of law
relating to risk-based capital for property/casualty insurance companies
is amended to read as follows:
  S 2. This act shall take effect immediately, and shall expire  and  be
deemed repealed [December 31, 2011] JUNE 30, 2014.
  S  106-a.    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  107.  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 108. Notwithstanding any inconsistent  provision  of  law,  rule  or
regulation,  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 109. Notwithstanding any inconsistent  provision  of  law,  rule  or
regulation,  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 110. 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 judgment
shall  have been rendered. It is hereby declared to be the intent of the

S. 2809--D                         184                        A. 4009--D

legislature that this act would have been enacted even if  such  invalid
provisions had not been included herein.
  S  111.  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)  regulations  retroactive  to April 1, 2011 may be promulgated for
the regulations authorized pursuant  to  sections  three,  ninety-eight,
twenty-six, thirty-six, thirty-five-a, and fifty of this act;
  (b)  the  amendments  to section 272 of the public health law, made by
sections nine and seventeen of this act shall not affect the  repeal  of
such section and shall expire and be deemed repealed therewith;
  (c)  the  amendments  to  subdivision 9 of section 367-a of the social
services law, made by sections ten, ten-a, and ten-b of this  act  shall
not  affect  the  expiration  of such subdivision and shall be deemed to
expire therewith;
  (d) the amendments to section 271 of the public health  law,  made  by
sections thirteen, fourteen and fifteen of this act shall not affect the
repeal  of  such  section and shall expire and be deemed repealed there-
with;
  (e) the amendments to subparagraph (i) of paragraph (b-1) of  subdivi-
sion 1 of section 2807-c of the public health law, made by section thir-
ty-two of this act shall not affect the expiration of such paragraph and
shall be deemed to expire therewith;
  (f) the amendments to section 4403-f of the public health law, made by
sections  forty-one,  forty-one-a  and forty-one-b of this act shall not
affect the repeal of such section and shall be  deemed  repealed  there-
with;
  (g)  sections fifty and fifty-one of this act shall take effect on the
ninetieth day after it shall have become a law;
  (h) sections  five,  twenty,  twenty-one,  twenty-seven,  thirty-nine,
forty-one,  forty-one-a, forty-one-b, forty-eight, fifty-four and fifty-
eight of this act shall take effect on the  one  hundred  eightieth  day
after it shall have become a law;
  (i)  the amendments to paragraph (b) and subparagraph (i) of paragraph
(g) of subdivision 7 of section 4403-f of the public health law made  by
section  forty-one-b  of  this act shall expire and be repealed April 1,
2015;
  (j) the amendments to section 364-j of the social services law made by
sections nineteen, forty-two-b, forty-two-c, seventy-seven, seventy-sev-
en-a, seventy-eight, seventy-nine and  eighty  of  this  act  shall  not
affect  the  repeal  of such section and shall be deemed repealed there-
with;
  (k) the amendments to paragraph (k) of subdivision 2 of section  365-a
of  the social services law made by section eighty-one of this act shall
not affect the expiration of such subdivision and  shall  be  deemed  to
expire therewith;
  (l)  sections  thirteen,  fourteen,  fifteen and seventeen of this act
shall take effect May 1, 2011;
  (m) section forty of this act shall take effect September 1, 2011;
  (n) sections sixty-nine and eighty-two of this act shall  take  effect
on  January  1,  2012 and, further, section eighty-two of this act shall
apply to taxable years beginning on or after January 1, 2012;
  (o) sections thirty-eight and thirty-eight-a of this act shall  expire
and be deemed repealed March 31, 2015;
  (p) section ninety-one of this act shall take effect April 1, 2012;

S. 2809--D                         185                        A. 4009--D

  (q) the operation of the fund established by section fifty-two of this
act  shall  commence  on  October  1,  2011; provided, however, that the
provisions of section fifty-two of this act shall apply to birth-related
neurological injury lawsuits as to which no judgment  has  been  entered
and  no settlement agreement has been entered into by the parties before
the date of  enactment;  provided,  however,  that  notwithstanding  any
inconsistent provision of law, nothing in this act shall be construed to
prevent a qualified plaintiff from obtaining medical care and assistance
through  the  medicaid program or services provided in private physician
practices on the basis of one hundred percent of the usual and customary
rates as defined by the commissioner of health in regulation during  the
period of time subsequent to the date of enactment of this act and prior
to the date upon which the operation of such fund commences and, if such
costs  are  qualifying  health costs as defined in this act, having such
costs paid from the fund; and provided, further, that  the  commissioner
of health shall be authorized to promulgate any regulations as necessary
to implement such sections prior to such effective date, including on an
emergency basis;
  (r)  sections  fifty-two-a  through fifty-two-h of this act shall take
effect on the ninetieth day after it shall have become law;
  (s) the amendments to subdivision 7 of section 2807-s  of  the  public
health law made by section thirty of this act shall not affect the expi-
ration of such section and shall be deemed to expire therewith;
  (t)  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, provided that the (i) commis-
sioner of health (ii) the superintendent of financial services or, prior
to October 3, 2011, the superintendent of insurance, or (iii) any appro-
priate council may promulgate  regulations  including  on  an  emergency
basis,  necessary to implement this act, prior to its effective date and
may take any steps necessary to implement this act prior to  its  effec-
tive date;
  (u)  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; and
  (v) the provisions of this act shall become effective  notwithstanding
the  failure of the commissioner of health, the superintendent of finan-
cial services or, prior to October 3, 2011, the superintendent of insur-
ance or any council to adopt or amend or promulgate  regulations  imple-
menting this act.
  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 H of this act shall be
as specifically set forth in the last section of such Parts.