senate Bill S4384D

2011-2012 Legislative Session

Establishes the Medicaid identification and anti-fraud biometric technology program

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Sponsored By

Archive: Last Bill Status - In Committee


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

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Actions

view actions (18)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Feb 08, 2012 print number 4384d
amend and recommit to health
Feb 01, 2012 print number 4384c
amend and recommit to health
Jan 04, 2012 referred to health
returned to senate
died in assembly
Jun 17, 2011 referred to health
delivered to assembly
passed senate
Jun 16, 2011 ordered to third reading cal.1340
committee discharged and committed to rules
Jun 07, 2011 reported and committed to finance
Jun 03, 2011 print number 4384b
amend (t) and recommit to health
Apr 13, 2011 print number 4384a
amend (t) and recommit to health
Apr 04, 2011 referred to health

Bill Amendments

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

S4384 - Bill Details

See Assembly Version of this Bill:
A6555F
Current Committee:
Law Section:
Public Health Law
Laws Affected:
Add Art 2-B §§290 - 293, Pub Health L; amd §367-b, Soc Serv L

S4384 - Bill Texts

view summary

Establishes the "Medicaid identification and anti-fraud biometric technology program", requiring the department of health, in consultation with the office of the medicaid inspector general and the office of the attorney general to implement a program requiring the use of biometric technology, as a means of identification and for use as an anti-fraud application in the Medicaid program.

view sponsor memo
BILL NUMBER:S4384

TITLE OF BILL:
An act
to amend the public health law, in relation to establishing the Medicaid
identification and anti-fraud biometric technology program

PURPOSE OR GENERAL IDEA OF THE BILL:
Establishes the Medicaid
identification and anti-fraud biometric technology program

SUMMARY OF SPECIFIC PROVISIONS:
Section 1: The public health law is
amended by adding a new article 2-B to read as follows; the Department
of Health shall implement a program requiring the use of biometric
technology in the form of scanners to be use by hospitals, clinics
and pharmacies for the purpose of patient identification and
anti-fraud in the Medicaid program.

Section 2: The department shall provide a report to the Legislature on
the cost and implementation of the Medicaid identification and
anti-fraud biometric technology program within 6 months of enactment.

JUSTIFICATION:
New York will spend over $54 billion dollars this
fiscal year (2011-2012) on Medicaid and experts estimate that 10% or
over $5 billion is fraudulent charges to the state's health insurance
for the poor, disabled and elderly. Before we start cutting billions
of dollars in vital services for our children and most infirmed
elderly, we need to cut out billions of dollars in fraud. This
legislation will implement a modern fraud prevention mechanism in
hospitals, clinics and pharmacies all across New York by relying on
biometric technology. This is relatively inexpensive software and
hardware that can save New York billions of dollars annually in fraud
prevention. It is estimated that for every one dollar investment in
fraud technology measures, New York will save 300 times that amount.
So we need a one-time and immediate investment of $20 million dollars
to save the annual stealing of over $5 billion of taxpayer funds. The
$20 million dollar one-time investment in the technology needed for
this anti-fraud measure can be raised by implementing a one-penny per
prescription charge for a 6 month period on each of the $4 billion
Medicaid prescriptions written each year (on average each Medicaid
recipient fills 100 prescriptions
per year and we have over 4 million Medicaid recipients in New York).

Biometrics is the science and technology of measuring and analyzing
biological data. In information technology, biometrics refers to
technologies that measure and analyze human body characteristics,
such as DNA, fingerprints, eye retinas and irises, voice patterns,
facial patterns and hand measurements, for authentication purposes.
The identification cards issued to Medicaid
recipients will contain coded and encrypted biometric markers for
verification. Each card will also contain a computer code that will
establish anti-fraud markers to prevent fraud on the front end of a
transaction instead of relying on law enforcement and court action to
recoup stolen Medicaid funding. Medicaid cards will be issued to


physicians, clinical staff performing service intake and auxiliary
medical services and pharmacy staff for the purpose of authenticating
patient visit and prescription orders.

A current example of the problems with the current Medicaid
identification system and lack of up-front fraud prevention is the
following: The previous administration of the New York State
Department of Health has failed New York taxpayers in a horrible way.
The State's Prescription Drug Monitoring Program requires pharmacists
to report the prescriptions issued each month.
However, DOH has no mechanism for informing pharmacies of multiple
prescriptions to the same patient, identify fraud, or requiring
doctors and pharmacists to check the DOH database for misuse of
prescription drugs. This is a major source of fraud and illegal drug
sales. This legislation will require the implementation ofbiometric
palm readers and software in all hospitals, health clinics, and
pharmacies. The technology would catch duplicate prescription
requests and medical services. Palm readers are considered the most
accurate of biometric technology.

PRIOR LEGISLATIVE HISTORY:
None.

FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENT:
Will generate a
savings of close to $5 billion annually by preventing health care
fraud. Purchase and implementation of technology to prevent fraud can
be paid via a one cent per prescription fee for a six month only
surcharge on each prescription paid by Medicaid.

EFFECTIVE DATE:
This act shall take effect immediately.

view full text
download pdf
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  4384

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                              April 4, 2011
                               ___________

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

AN ACT to amend the public health law, in relation to  establishing  the
  Medicaid identification and anti-fraud biometric technology program

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

  Section 1. The public health law is amended by adding  a  new  article
2-B to read as follows:
                                ARTICLE 2-B
            MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC
                           TECHNOLOGY PROGRAM
SECTION 290. MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
               PROGRAM.
        291. DEFINITIONS.
        292. BIOMETRIC TECHNOLOGY USE REQUIREMENT.
        293. REPORT.
        294. RULES AND REGULATIONS.
  S  290.  MEDICAID  IDENTIFICATION  AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
PROGRAM. THERE IS HEREBY ESTABLISHED  IN  THE  DEPARTMENT  THE  MEDICAID
IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY PROGRAM.
  S 291. DEFINITIONS. AS USED IN THIS ARTICLE:
  1.  "BIOMETRIC TECHNOLOGY" MEANS TECHNOLOGY THAT MEASURES AND ANALYZES
BIOLOGICAL DATA, INCLUDING HUMAN  BODY  CHARACTERISTICS,  SUCH  AS  DNA,
FINGERPRINTS, VASCULAR PATTERNS, EYE RETINAS AND IRISES, VOICE PATTERNS,
FACIAL PATTERNS AND HAND MEASUREMENTS, FOR AUTHENTICATION PURPOSES.
  2.  "PALM  SCANNER"  MEANS A DEVICE CAPABLE OF USING PALM-VEIN PATTERN
RECOGNITION OR VASCULAR RECOGNITION USING NEAR-INFRARED LIGHT TO CAPTURE
A PATIENT'S PALM VEIN PATTERN TO GENERATE A BIOMETRIC PATTERN.
  S 292. BIOMETRIC TECHNOLOGY USE REQUIREMENT.  1.  THE  DEPARTMENT,  IN
CONSULTATION  WITH  THE OFFICE OF THE MEDICAID INSPECTOR GENERAL AND THE
OFFICE OF THE ATTORNEY GENERAL, SHALL IMPLEMENT A PROGRAM REQUIRING  THE

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09573-02-1

S. 4384                             2

USE  OF  BIOMETRIC TECHNOLOGY IN THE FORM OF PALM SCANNERS TO BE USED BY
HOSPITALS, CLINICS AND PHARMACIES, FOR THE PURPOSES OF PATIENT IDENTIFI-
CATION AND FOR USE AS AN ANTI-FRAUD APPLICATION IN THE MEDICAID PROGRAM.
  2. (A) MEDICAID CARDS ISSUED BY THE STATE TO MEDICAID RECIPIENTS SHALL
BE ENCODED AND ENCRYPTED WITH THE BIOMETRIC PALM PRINT OF THE CARD HOLD-
ER ALONG WITH OTHER INFORMATION DEEMED NECESSARY BY THE COMMISSIONER AND
THE  OFFICE  OF  HEALTH INSURANCE PROGRAMS, PROVIDED, HOWEVER, THAT SUCH
INFORMATION SHALL NOT INCLUDE SOCIAL SECURITY NUMBERS AND SHALL  NOT  BE
STORED IN A CENTRAL DATA BANK. SUCH CARD HELD BY EACH MEDICAID RECIPIENT
WILL  BE  CAPABLE  OF  STORING BIOMETRIC MARKERS AND A LOG OF DOCTOR AND
PHARMACY VISITS FOR EACH SERVICE BILLED TO THE MEDICAID PROGRAM.
  (B) MEDICAID CARDS SHALL BE ISSUED TO THE ADMITTING  STAFF  OF  HEALTH
CARE FACILITIES, MEDICAL STAFF PROVIDING SERVICE TO MEDICAID RECIPIENTS,
AND TO PHARMACY STAFF. HEALTH CARE FACILITY ADMITTING STAFF, HEALTH CARE
PROVIDERS  AND  PHARMACY  STAFF  SHALL SWIPE THE MEDICAID CARD ISSUED TO
THEM PURSUANT TO THIS ARTICLE AND SHALL SCAN HIS OR HER PALM ON  A  PALM
READER,  UPON  ADMITTING, PROVIDING CARE OR PHARMACY SERVICES TO A MEDI-
CAID RECIPIENT, TO VERIFY THE LEGITIMACY OF  THE  CARE  BEING  PROVIDED.
SUCH  CARD  SHALL  MAINTAIN A LOG IDENTIFYING THE PERSON RESPONSIBLE FOR
PROVIDING CARE TO SUCH PERSON.
  (C) MEDICAID RECIPIENTS SHALL BE REQUIRED TO SWIPE HIS OR HER MEDICAID
BENEFIT CARD AT TIME OF EACH VISIT TO A DOCTORS OFFICE OR CLINIC AT  THE
POINT  OF  ACTUALLY BEING SEEN BY THE DOCTOR OR CLINICAL STAFF, AND UPON
LEAVING THE HEALTH CARE FACILITY.
  (D) MEDICAID CARDS SHALL BE USED AND PALM READERS SHALL BE  PLACED  IN
PHARMACIES  WHERE THE MEDICAID RECIPIENT SHALL SWIPE HIS OR HER CARD AND
SHALL HAVE HIS OR HER PALM SCANNED WHEN FILLING A PRESCRIPTION. PHARMACY
STAFF REGISTERING THE PRESCRIPTION ORDER SHALL SWIPE AND SCAN HIS OR HER
MEDICAID ISSUED CARD AT THE SAME TIME TO VERIFY THE TRANSACTION.
  (E) THE COMMISSIONER AND THE OFFICE OF HEALTH INSURANCE PROGRAMS SHALL
PROMULGATE RULES AND REGULATIONS THAT SHALL  BE  DIGITIZED  AND  ENCODED
INTO THE MEDICAID CARD TO COMBAT FRAUD. SUCH RULES SHALL INCLUDE BUT ARE
NOT  LIMITED  TO  ESTABLISHING  A  NUMBER OF POSSIBLE PATIENT VISITS PER
DOCTOR PER BUSINESS DAY, THE NUMBER  OF  TIMES  A  PRESCRIPTION  CAN  BE
FILLED  BY  EACH  MEDICAID  RECIPIENT  EACH MONTH, THE NUMBER OF MEDICAL
EXAMS THAT CAN BE ORDERED FOR EACH PATIENT EACH MONTH IN ORDER TO ELIMI-
NATE DUPLICATIVE, REDUNDANT AND UNNECESSARY EXAMS.
  (F) THE COMMISSIONER AND THE OFFICE OF HEALTH  INSURANCE  PROGRAMS  IN
CONSULTATION  WITH  THE OFFICE OF THE ATTORNEY GENERAL AND THE OFFICE OF
THE MEDICAID INSPECTOR GENERAL SHALL DEVELOP ALL OF THE FRAUD PREVENTION
MARKERS WHICH SHALL BE ENCODED INTO THE MEDICAID CARDS  ISSUED  TO  BOTH
MEDICAID RECIPIENTS AND MEDICAID SERVICE PROVIDERS.
  (G) FRAUD PREVENTION MARKERS INCORPORATED INTO SOFTWARE WHICH SHALL BE
USED  TO  OPERATE THE HARDWARE COMPONENT OF THE BIOMETRIC SCANNERS SHALL
PREVENT AND/OR REJECT THE PAYMENT BY THE MEDICAID PROGRAM  AT  POINT  OF
SERVICE IF FRAUD OR POTENTIAL FRAUD IS IDENTIFIED BY THE BIOMETRIC TECH-
NOLOGY SYSTEM.
  (H)  THE COMMISSIONER IN CONSULTATION WITH THE OFFICE OF HEALTH INSUR-
ANCE PROGRAMS AND THE OFFICE OF THE ATTORNEY GENERAL SHALL BE  RESPONSI-
BLE  FOR  PROMULGATING RULES AND REGULATIONS NECESSARY FOR THE OPERATION
OF THIS PROGRAM AND ENSURING THAT MEDICAID  RECIPIENTS  HAVE  ACCESS  TO
EMERGENCY  HEALTH  SERVICES IN THE CASE OF A BIOMETRIC TECHNOLOGY SYSTEM
MALFUNCTION OR FRAUD DETECTION ALARM.
  3. (A) SUCH BIOMETRIC TECHNOLOGY USE REQUIREMENT SHALL BE  IMPLEMENTED
WITHIN TWELVE MONTHS FROM THE EFFECTIVE DATE OF THIS ARTICLE.

S. 4384                             3

  (B)  IF THE DEPARTMENT FAILS TO MEET THE DEADLINE ESTABLISHED PURSUANT
TO PARAGRAPH (A) OF THIS SUBDIVISION, IT SHALL SUBMIT IN WRITING TO EACH
MEMBER OF THE LEGISLATURE ITS  FAILURE  TO  MEET  SUCH  DEADLINE  AND  A
DETAILED EXPLANATION OF WHEN SUCH TECHNOLOGY WILL BE IN PLACE.
  S  293.  REPORT.  1. THE DEPARTMENT SHALL REPORT TO EACH MEMBER OF THE
LEGISLATURE WITHIN SIX MONTHS OF THE EFFECTIVE DATE OF THIS ARTICLE, THE
ESTIMATED TOTAL NUMBER OF BIOMETRIC SOFTWARE LICENSES REQUIRED TO  PLACE
BIOMETRIC PALM SCANNERS IN ALL HOSPITALS, CLINICS AND PHARMACIES SERVING
MEDICAID RECIPIENTS.
  2. SUCH REPORT SHALL INCLUDE:
  (A)  AN  ESTIMATED  NUMBER OF PALM SCANNERS TO BE PLACED IN ALL HOSPI-
TALS, CLINICS AND PHARMACIES SERVING MEDICAID RECIPIENTS;
  (B) THE ESTIMATED COST OF THE MAIN SERVER THAT SHALL BE USED TO AGGRE-
GATE THE BIOMETRIC DATA; AND
  (C) THE ESTIMATED ANNUAL COST FOR  THE  MAINTENANCE  AND  UPGRADES  OF
HARDWARE AND SOFTWARE REQUIRED FOR THE EFFECTIVE USE OF THIS TECHNOLOGY.
  S  294.  RULES  AND  REGULATIONS.  THE  COMMISSIONER IS AUTHORIZED AND
DIRECTED TO PROMULGATE SUCH RULES AND REGULATIONS AS HE OR SHE MAY  DEEM
NECESSARY OR APPROPRIATE TO EFFECTUATE THE PURPOSES OF THIS ARTICLE.
  S 2. This act shall take effect immediately.

Co-Sponsors

S4384A - Bill Details

See Assembly Version of this Bill:
A6555F
Current Committee:
Law Section:
Public Health Law
Laws Affected:
Add Art 2-B §§290 - 293, Pub Health L; amd §367-b, Soc Serv L

S4384A - Bill Texts

view summary

Establishes the "Medicaid identification and anti-fraud biometric technology program", requiring the department of health, in consultation with the office of the medicaid inspector general and the office of the attorney general to implement a program requiring the use of biometric technology, as a means of identification and for use as an anti-fraud application in the Medicaid program.

view sponsor memo
BILL NUMBER:S4384A

TITLE OF BILL:
An act
to amend the public health law, in relation to establishing the Medicaid
identification and anti-fraud biometric technology program;
to amend the social services law, in relation to conforming medical
assistance identification cards with the Medicaid identification and
anti-fraud biometric technology program; and to amend the state finance
law, in relation to establishing the Medicaid identification and
anti-fraud biometric technology program trust fund

PURPOSE OR GENERAL IDEA OF THE BILL:
Establishes the Medicaid
identification and anti-fraud biometric technology program

SUMMARY OF SPECIFIC PROVISIONS:
Section 1: The public health law is
amended by adding a new article 2-b to read as follows; the
Department of Health shall implement a program requiring the use
of biometric technology in the form of scanners to be use by
hospitals, clinics and pharmacies for the purpose of patient
identification and anti-fraud in the Medicaid program.

Section 2: The department shall provide a report to the Legislature on
the cost and implementation of the Medicaid identification and
anti-fraud biometric technology program within 6 months of enactment.

JUSTIFICATION:
New York will spend over $54 billion dollars this
fiscal year (2011-2012) on Medicaid and experts estimate that 10% or
over $5 billion is fraudulent charges to the state's health insurance
for the poor, disabled and elderly. Before we start cutting billions
of dollars in vital services for our children and most infirmed
elderly, we need to cut out billions of dollars in fraud. This
legislation will implement a modem fraud prevention mechanism in
hospitals, clinics and pharmacies all across New York by relying on
biometric technology. This is relatively inexpensive software and
hardware that can save New York billions of dollars annually in fraud
prevention. It is estimated that for every one dollar investment in
fraud technology measures, New York will save 300 times that amount.
So we need a one-time and immediate investment of $20 million dollars
to save the annual stealing of over $5 billion of taxpayer funds. The
$20 million dollar one-time investment in the technology needed for
this anti-fraud measure can be raised by implementing a one-penny per
prescription charge for a 6 month period on each of the $4 billion
Medicaid prescriptions written each year (on average each Medicaid
recipient fills 100 prescriptions
per year and we have over 4 million Medicaid recipients in New York).

Biometrics is the science and technology of measuring and analyzing
biological data. In information technology, biometrics refers to
technologies that measure and analyze human body characteristics,
such as DNA, fingerprints, eye retinas and irises, voice patterns,
facial patterns and hand measurements, for authentication purposes.
The identification cards issued to Medicaid


recipients will contain coded and encrypted biometric markers for
verification. Each card will also contain a computer code that will
establish anti-fraud markers to prevent fraud on the front end of a
transaction instead of relying on law enforcement and court action to
recoup stolen Medicaid funding. Medicaid cards will be issued to
physicians, clinical staff performing service intake and auxiliary
medical services and pharmacy staff for the purpose of authenticating
patient visit and prescription orders.

A current example of the problems with the current Medicaid
identification system and lack of up-front fraud prevention is the
following: The previous administration of the New York State
Department of Health has failed New York taxpayers in a horrible way.
The State's Prescription Drug Monitoring Program requires pharmacists
to report the prescriptions issued each month.
However, DOH has no mechanism for informing pharmacies of multiple
prescriptions to the same patient, identify fraud, or requiring
doctors and pharmacists to check the DOH database for misuse of
prescription drugs. This is a major source of fraud and illegal drug
sales. This legislation will require the implementation of biometric
palm readers and software in all hospitals, health clinics, and
pharmacies. The technology would catch duplicate prescription
requests and medical services. Palm readers are considered the most
accurate of biometric technology.

PRIOR LEGISLATIVE HISTORY:
None.

FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENT:
Will generate a
savings of close to $5 billion annually by preventing health care
fraud. Purchase and implementation of technology to prevent fraud can
be paid via a one cent per prescription fee for a six month only
surcharge on each prescription paid by Medicaid.

EFFECTIVE DATE:
This act shall take effect immediately.

view full text
download pdf
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 4384--A

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                              April 4, 2011
                               ___________

Introduced  by  Sen.  RANZENHOFER -- read twice and ordered printed, and
  when printed to be committed to the Committee on Health  --  committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

AN  ACT  to amend the public health law, in relation to establishing the
  Medicaid identification and anti-fraud biometric  technology  program;
  to  amend  the  social services law, in relation to conforming medical
  assistance identification cards with the Medicaid  identification  and
  anti-fraud  biometric  technology  program;  and  to  amend  the state
  finance law, in relation to establishing the  Medicaid  identification
  and anti-fraud biometric technology program trust fund

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

  Section 1. The public health law is amended by adding  a  new  article
2-B to read as follows:
                                ARTICLE 2-B
            MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC
                           TECHNOLOGY PROGRAM
SECTION 290. MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
               PROGRAM.
        291. DEFINITIONS.
        292. BIOMETRIC TECHNOLOGY USE REQUIREMENT.
        293. REPORT.
        294. RULES AND REGULATIONS.
  S  290.  MEDICAID  IDENTIFICATION  AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
PROGRAM. THERE IS HEREBY ESTABLISHED  IN  THE  DEPARTMENT  THE  MEDICAID
IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY PROGRAM.
  S 291. DEFINITIONS. AS USED IN THIS ARTICLE:
  1.  "BIOMETRIC TECHNOLOGY" MEANS TECHNOLOGY THAT MEASURES AND ANALYZES
BIOLOGICAL DATA, INCLUDING HUMAN  BODY  CHARACTERISTICS,  SUCH  AS  DNA,

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09573-04-1

S. 4384--A                          2

FINGERPRINTS, VASCULAR PATTERNS, EYE RETINAS AND IRISES, VOICE PATTERNS,
FACIAL PATTERNS AND HAND MEASUREMENTS, FOR AUTHENTICATION PURPOSES.
  2.  "PALM  SCANNER"  MEANS A DEVICE CAPABLE OF USING PALM-VEIN PATTERN
RECOGNITION OR VASCULAR RECOGNITION USING NEAR-INFRARED LIGHT TO CAPTURE
A PATIENT'S PALM VEIN PATTERN TO GENERATE A BIOMETRIC PATTERN.
  S 292. BIOMETRIC TECHNOLOGY USE REQUIREMENT.  1.  THE  DEPARTMENT,  IN
CONSULTATION  WITH  THE OFFICE OF THE MEDICAID INSPECTOR GENERAL AND THE
OFFICE OF THE ATTORNEY GENERAL, SHALL IMPLEMENT A PROGRAM REQUIRING  THE
USE  OF  BIOMETRIC TECHNOLOGY IN THE FORM OF PALM SCANNERS TO BE USED BY
HOSPITALS, CLINICS AND PHARMACIES, FOR THE PURPOSES OF PATIENT IDENTIFI-
CATION AND FOR USE AS AN ANTI-FRAUD APPLICATION IN THE MEDICAID PROGRAM.
  2. (A) MEDICAID CARDS ISSUED BY THE STATE TO MEDICAID RECIPIENTS SHALL
BE ENCODED AND ENCRYPTED WITH THE BIOMETRIC PALM PRINT OF THE CARD HOLD-
ER ALONG WITH OTHER INFORMATION DEEMED NECESSARY BY THE COMMISSIONER AND
THE OFFICE OF HEALTH INSURANCE PROGRAMS, PROVIDED,  HOWEVER,  THAT  SUCH
INFORMATION  SHALL  NOT INCLUDE SOCIAL SECURITY NUMBERS AND SHALL NOT BE
STORED IN A CENTRAL DATA BANK. SUCH CARD HELD BY EACH MEDICAID RECIPIENT
WILL BE CAPABLE OF STORING BIOMETRIC MARKERS AND A  LOG  OF  DOCTOR  AND
PHARMACY VISITS FOR EACH SERVICE BILLED TO THE MEDICAID PROGRAM.
  (B)  MEDICAID  CARDS  SHALL BE ISSUED TO THE ADMITTING STAFF OF HEALTH
CARE FACILITIES, MEDICAL STAFF PROVIDING SERVICE TO MEDICAID RECIPIENTS,
AND TO PHARMACY STAFF. HEALTH CARE FACILITY ADMITTING STAFF, HEALTH CARE
PROVIDERS AND PHARMACY STAFF SHALL SWIPE THE  MEDICAID  CARD  ISSUED  TO
THEM  PURSUANT  TO THIS ARTICLE AND SHALL SCAN HIS OR HER PALM ON A PALM
READER, UPON ADMITTING, PROVIDING CARE OR PHARMACY SERVICES TO  A  MEDI-
CAID  RECIPIENT,  TO  VERIFY  THE LEGITIMACY OF THE CARE BEING PROVIDED.
SUCH CARD SHALL MAINTAIN A LOG IDENTIFYING THE  PERSON  RESPONSIBLE  FOR
PROVIDING CARE TO SUCH PERSON.
  (C) MEDICAID RECIPIENTS SHALL BE REQUIRED TO SWIPE HIS OR HER MEDICAID
BENEFIT  CARD AT TIME OF EACH VISIT TO A DOCTORS OFFICE OR CLINIC AT THE
POINT OF ACTUALLY BEING SEEN BY THE DOCTOR OR CLINICAL STAFF,  AND  UPON
LEAVING THE HEALTH CARE FACILITY.
  (D)  MEDICAID  CARDS SHALL BE USED AND PALM READERS SHALL BE PLACED IN
PHARMACIES WHERE THE MEDICAID RECIPIENT SHALL SWIPE HIS OR HER CARD  AND
SHALL HAVE HIS OR HER PALM SCANNED WHEN FILLING A PRESCRIPTION. PHARMACY
STAFF REGISTERING THE PRESCRIPTION ORDER SHALL SWIPE AND SCAN HIS OR HER
MEDICAID ISSUED CARD AT THE SAME TIME TO VERIFY THE TRANSACTION.
  (E) THE COMMISSIONER AND THE OFFICE OF HEALTH INSURANCE PROGRAMS SHALL
PROMULGATE  RULES  AND  REGULATIONS  THAT SHALL BE DIGITIZED AND ENCODED
INTO THE MEDICAID CARD TO COMBAT FRAUD. SUCH RULES SHALL INCLUDE BUT ARE
NOT LIMITED TO ESTABLISHING A NUMBER  OF  POSSIBLE  PATIENT  VISITS  PER
DOCTOR  PER  BUSINESS  DAY,  THE  NUMBER  OF TIMES A PRESCRIPTION CAN BE
FILLED BY EACH MEDICAID RECIPIENT EACH  MONTH,  THE  NUMBER  OF  MEDICAL
EXAMS THAT CAN BE ORDERED FOR EACH PATIENT EACH MONTH IN ORDER TO ELIMI-
NATE DUPLICATIVE, REDUNDANT AND UNNECESSARY EXAMS.
  (F)  THE  COMMISSIONER  AND THE OFFICE OF HEALTH INSURANCE PROGRAMS IN
CONSULTATION WITH THE OFFICE OF THE ATTORNEY GENERAL AND THE  OFFICE  OF
THE MEDICAID INSPECTOR GENERAL SHALL DEVELOP ALL OF THE FRAUD PREVENTION
MARKERS  WHICH  SHALL  BE ENCODED INTO THE MEDICAID CARDS ISSUED TO BOTH
MEDICAID RECIPIENTS AND MEDICAID SERVICE PROVIDERS.
  (G) FRAUD PREVENTION MARKERS INCORPORATED INTO SOFTWARE WHICH SHALL BE
USED TO OPERATE THE HARDWARE COMPONENT OF THE BIOMETRIC  SCANNERS  SHALL
PREVENT  AND/OR  REJECT  THE PAYMENT BY THE MEDICAID PROGRAM AT POINT OF
SERVICE IF FRAUD OR POTENTIAL FRAUD IS IDENTIFIED BY THE BIOMETRIC TECH-
NOLOGY SYSTEM.

S. 4384--A                          3

  (H) THE COMMISSIONER IN CONSULTATION WITH THE OFFICE OF HEALTH  INSUR-
ANCE  PROGRAMS AND THE OFFICE OF THE ATTORNEY GENERAL SHALL BE RESPONSI-
BLE FOR PROMULGATING RULES AND REGULATIONS NECESSARY FOR  THE  OPERATION
OF  THIS  PROGRAM  AND  ENSURING THAT MEDICAID RECIPIENTS HAVE ACCESS TO
EMERGENCY  HEALTH  SERVICES IN THE CASE OF A BIOMETRIC TECHNOLOGY SYSTEM
MALFUNCTION OR FRAUD DETECTION ALARM.
  3. (A) SUCH BIOMETRIC TECHNOLOGY USE REQUIREMENT SHALL BE  IMPLEMENTED
WITHIN TWELVE MONTHS FROM THE EFFECTIVE DATE OF THIS ARTICLE.
  (B)  IF THE DEPARTMENT FAILS TO MEET THE DEADLINE ESTABLISHED PURSUANT
TO PARAGRAPH (A) OF THIS SUBDIVISION, IT SHALL SUBMIT IN WRITING TO EACH
MEMBER OF THE LEGISLATURE ITS  FAILURE  TO  MEET  SUCH  DEADLINE  AND  A
DETAILED EXPLANATION OF WHEN SUCH TECHNOLOGY WILL BE IN PLACE.
  S  293.  REPORT.  1. THE DEPARTMENT SHALL REPORT TO EACH MEMBER OF THE
LEGISLATURE WITHIN SIX MONTHS OF THE EFFECTIVE DATE OF THIS ARTICLE, THE
ESTIMATED TOTAL NUMBER OF BIOMETRIC SOFTWARE LICENSES REQUIRED TO  PLACE
BIOMETRIC PALM SCANNERS IN ALL HOSPITALS, CLINICS AND PHARMACIES SERVING
MEDICAID RECIPIENTS.
  2. SUCH REPORT SHALL INCLUDE:
  (A)  AN  ESTIMATED  NUMBER OF PALM SCANNERS TO BE PLACED IN ALL HOSPI-
TALS, CLINICS AND PHARMACIES SERVING MEDICAID RECIPIENTS;
  (B) THE ESTIMATED COST OF THE MAIN SERVER THAT SHALL BE USED TO AGGRE-
GATE THE BIOMETRIC DATA; AND
  (C) THE ESTIMATED ANNUAL COST FOR  THE  MAINTENANCE  AND  UPGRADES  OF
HARDWARE AND SOFTWARE REQUIRED FOR THE EFFECTIVE USE OF THIS TECHNOLOGY.
  S  294.  RULES  AND  REGULATIONS.  THE  COMMISSIONER IS AUTHORIZED AND
DIRECTED TO PROMULGATE SUCH RULES AND REGULATIONS AS HE OR SHE MAY  DEEM
NECESSARY OR APPROPRIATE TO EFFECTUATE THE PURPOSES OF THIS ARTICLE.
  S  2.    Subdivision 1 of section 367-b of the social services law, as
added by chapter 639 of the laws of 1976, is amended to read as follows:
  1. The department shall  design  and  implement  a  statewide  medical
assistance  information and payments system for the purpose of providing
individual and aggregate data to social  services  districts  to  assist
them  in  making basic management decisions, to the department and other
state agencies to assist in the administration of the medical assistance
program, and to the governor and the legislature as may be necessary  to
assist  in  making  major  administrative and policy decisions affecting
such program.  Such system shall be designed so as to be capable of  the
following:
  a. receiving and processing information relating to the eligibility of
each  person  applying for medical assistance and [of issuing] REQUIRING
THE DEPARTMENT OF HEALTH TO ISSUE AND MAIL a  medical  assistance  iden-
tification  card,  CONFORMING TO THE REQUIREMENTS SET FORTH IN THE MEDI-
CAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY  PROGRAM  ESTAB-
LISHED  PURSUANT  TO  ARTICLE  TWO-B OF THE PUBLIC HEALTH LAW to persons
determined by a social services official to be eligible for such assist-
ance;
  A-1. ACTIVATING MEDICAL ASSISTANCE IDENTIFICATION CARDS  BY  REQUIRING
AN  APPLICANT  RECEIVING  SUCH  CARD  TO  HAVE  HIS OR HER PALM SCANNED,
ENCODED AND ENCRYPTED INTO SUCH  CARD  AT  A  SOCIAL  SERVICES  DISTRICT
OFFICE IN THE SOCIAL SERVICES DISTRICT IN WHICH THE APPLICANT RESIDES;
  b.  receiving  and  processing  information relating to each qualified
provider of medical assistance furnishing care, services or supplies for
which claims for payment are made pursuant to this title;
  c. receiving and processing, in a form and manner  prescribed  by  the
department,  all  claims  for  medical  care, services and supplies, and

S. 4384--A                          4

making payments for valid claims to providers of medical care,  services
and supplies on behalf of social services districts;
  d. maintaining information necessary to allow the department, consist-
ent  with  the  powers and duties of the department of health, to review
the appropriateness, scope and duration of medical  care,  services  and
supplies provided to any eligible person pursuant to this chapter; and
  e.  initiating  implementation  of  such  a  system  for  the district
comprising the city of New York, in a manner compatible  with  expansion
of  such system to districts other than the district comprising the city
of New York.
  S 3. The state finance law is amended by adding a new section 98-d  to
read as follows:
  S  98-D.  MEDICAID  IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
PROGRAM TRUST FUND. 1. THERE IS HEREBY ESTABLISHED IN THE JOINT  CUSTODY
OF  THE STATE COMPTROLLER AND THE COMMISSIONER OF TAXATION AND FINANCE A
FUND TO BE KNOWN AS THE MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC
TECHNOLOGY PROGRAM TRUST FUND.
  2. SUCH FUND SHALL CONSIST OF TWENTY PERCENT OF ALL  MONEYS  RECOVERED
BY  THE  OFFICE  OF  THE ATTORNEY GENERAL AND THE OFFICE OF THE MEDICAID
INSPECTOR GENERAL RELATING TO MEDICAID FRAUD. ANY INTEREST EARNED BY THE
INVESTMENT OF MONEYS IN SUCH FUND SHALL BE ADDED TO SUCH FUND, BECOME  A
PART OF SUCH FUND, AND BE USED FOR THE PURPOSE OF SUCH FUND.
  3.  MONEYS OF SUCH FUND SHALL BE AVAILABLE FOR APPROPRIATION AND ALLO-
CATION ONLY TO THE DEPARTMENT OF HEALTH FOR THE PURPOSES OF CARRYING OUT
THE PROVISIONS OF THE MEDICAID IDENTIFICATION AND  ANTI-FRAUD  BIOMETRIC
TECHNOLOGY  PROGRAM  TRUST FUND ESTABLISHED PURSUANT TO ARTICLE TWO-B OF
THE PUBLIC HEALTH LAW.
  4. THE MONEYS OF THE FUND SHALL BE PAID OUT ON THE AUDIT  AND  WARRANT
OF THE COMPTROLLER ON VOUCHERS CERTIFIED OR APPROVED BY THE COMMISSIONER
OF HEALTH OR HIS DULY DESIGNATED REPRESENTATIVE.
  S  4.  This act shall take effect immediately; provided, however, that
effective immediately, the addition, amendment and/or repeal of any rule
or regulation necessary for the implementation of this act on its effec-
tive date are authorized and directed to be made  and  completed  on  or
before such effective date.

Co-Sponsors

view additional co-sponsors

S4384B - Bill Details

See Assembly Version of this Bill:
A6555F
Current Committee:
Law Section:
Public Health Law
Laws Affected:
Add Art 2-B §§290 - 293, Pub Health L; amd §367-b, Soc Serv L

S4384B - Bill Texts

view summary

Establishes the "Medicaid identification and anti-fraud biometric technology program", requiring the department of health, in consultation with the office of the medicaid inspector general and the office of the attorney general to implement a program requiring the use of biometric technology, as a means of identification and for use as an anti-fraud application in the Medicaid program.

view sponsor memo
BILL NUMBER:S4384B

TITLE OF BILL:
An act
to amend the public health law, in relation to establishing the Medicaid
identification and anti-fraud biometric technology program;
and
to amend the social services law, in relation to conforming medical
assistance identification with the Medicaid identification and
anti-fraud biometric technology program

PURPOSE OR GENERAL IDEA OF THE BILL:
Establishes the Medicaid
Identification and Antifraud Biometric Technology Program.

SUMMARY OF SPECIFIC PROVISIONS:
The Public Health Law is amended by
adding a new article 2-b to provide that the Department of Health
shall develop a request for proposals to implement a program using
biometric technology in hospitals, clinics and pharmacies for the
purpose of patient and provider identification to fight fraud in the
Medicaid program; sets time frames for such request; and requires the
Department of Health to report to the Governor, Senate and Assembly
as to the progress of implementing a biometric identification program.

Section 2: Amends the Social Services Law to require the Social
Services Department to conform its systems with the new Medicaid
Identification and Antifraud Biometric Identification Program when
available.

Section 3: Provides that this act shall take effect immediately.

JUSTIFICATION:
New York will spend over $54 billion dollars this
fiscal year (2011-2012) on Medicaid and experts estimate that as much
as 10%, or over $5 billion, is spent on fraudulent services and
claims for Medicaid services. New York cannot afford to continue to
pay for such improper and fraudulent claims. Rather than reducing
payments for vital services for our children and most infirm elderly,
we should more aggressively address the billions of dollars lost to
fraud by utilizing modem and effective identification technology.
This legislation will require the Department of Health to develop
result-oriented guidelines and seek requests for proposals to
implement a modem fraud prevention program in hospitals, clinics and
pharmacies all across New York relying on biometric technology. There
are many companies offering various types of biometric identification
systems that are already in common use by private industry and
governmental agencies.

The request for proposals shall focus on results to be obtained,
rather than specific technology, to allow the State to consider the
many technologies that have been developed. These technologies can
use relatively inexpensive software and hardware that has already
been developed and proven to save New York billions of dollars
annually in fraud prevention. The request must also specify that any
proposal must be revenue neutral from inception, whereby program


costs are at least offset by savings from inception, and shall have
as a primary goal reduction in Medicaid expenditures through
elimination of fraud and abuse.

Biometrics is the science and technology of measuring and analyzing
biological data. In information technology, biometrics refers to
technologies that measure and analyze human body characteristics,
such as DNA, fingerprints, eye retinas and irises, voice patterns,
facial patterns and hand measurements, for authentication purposes.
The identification issued to Medicaid recipients and providers will
contain biometric markers for verification that a recipient is
eligible for the service requested, and confirm that the provider
actually provides the service. Such identification can be made at the
beginning and end of a transaction before payment is ever made,
instead of relying on the current system of "pay and chase" where law
enforcement and court action is required to recoup improper Medicaid
payments after they have been made.

PRIOR LEGISLATIVE HISTORY:
New bill.

FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENT:
Will generate
substantial savings, perhaps as much as $5 billion annually by
preventing health care fraud and improper payments.

EFFECTIVE DATE:
This act shall take effect immediately.

view full text
download pdf
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 4384--B

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                              April 4, 2011
                               ___________

Introduced  by Sens. RANZENHOFER, ADDABBO, DeFRANCISCO, YOUNG, ZELDIN --
  read twice and ordered printed, and when printed to  be  committed  to
  the Committee on Health -- 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 public health law, in relation to  establishing  the
  Medicaid  identification  and anti-fraud biometric technology program;
  and to amend the  social  services  law,  in  relation  to  conforming
  medical assistance identification with the Medicaid identification and
  anti-fraud biometric technology program

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

  Section 1. The public health law is amended by adding  a  new  article
2-B to read as follows:
                                ARTICLE 2-B
            MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC
                           TECHNOLOGY PROGRAM
SECTION 290. MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
               PROGRAM.
        291. DEFINITIONS.
        292. BIOMETRIC TECHNOLOGY USE REQUIREMENT.
        293. RULES AND REGULATIONS.
  S  290.  MEDICAID  IDENTIFICATION  AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
PROGRAM. THERE IS HEREBY ESTABLISHED  IN  THE  DEPARTMENT  THE  MEDICAID
IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY PROGRAM.
  S 291. DEFINITIONS. AS USED IN THIS ARTICLE:
  1.  "BIOMETRIC TECHNOLOGY" MEANS TECHNOLOGY THAT MEASURES AND ANALYZES
BIOLOGICAL DATA, INCLUDING BUT  NOT  LIMITED  TO  DNA,  FINGER  IMAGING,
VASCULAR  PATTERNS,  EYE  RETINAS  AND  IRISES,  VOICE  PATTERNS, FACIAL
PATTERNS AND HAND MEASUREMENTS, FOR AUTHENTICATION PURPOSES.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09573-07-1

S. 4384--B                          2

  2.  "BIOMETRIC VERIFICATION DEVICE" MEANS A DEVICE  CAPABLE  OF  USING
BIOMETRIC  VERIFICATION  TECHNOLOGY TO VERIFY THE IDENTITY OF A MEDICAID
RECIPIENT OR PROVIDER.
  S  292.  BIOMETRIC  TECHNOLOGY  USE REQUIREMENT. 1. THE DEPARTMENT, IN
CONSULTATION WITH THE OFFICE OF THE MEDICAID INSPECTOR GENERAL  AND  THE
OFFICE OF THE ATTORNEY GENERAL, SHALL DEVELOP A REQUEST FOR PROPOSALS TO
IMPLEMENT  A PROGRAM REQUIRING THE USE OF BIOMETRIC TECHNOLOGY BY HOSPI-
TALS, CLINICS AND PHARMACIES, FOR THE PURPOSES OF PATIENT  AND  PROVIDER
IDENTIFICATION  AND FOR USE AS AN ANTI-FRAUD APPLICATION IN THE MEDICAID
PROGRAM.
  2. SUCH REQUEST FOR PROPOSALS SHALL INCLUDE  AT  A  MINIMUM  THAT  (A)
MEDICAID RECIPIENTS AND PROVIDERS SHALL PROVIDE BIOMETRIC PROOF OF THEIR
IDENTITY  ALONG  WITH  OTHER INFORMATION DEEMED NECESSARY BY THE COMMIS-
SIONER.
  (B) SUCH PROGRAM WILL BE CAPABLE OF STORING BIOMETRIC  MARKERS  AND  A
LOG  OF  DOCTOR AND PHARMACY VISITS FOR EACH SERVICE BILLED TO THE MEDI-
CAID PROGRAM.
  (C) MEDICAID IDENTIFICATION SHALL BE ISSUED TO  AND  ACCEPTED  BY  THE
ADMITTING  STAFF  OF  HEALTH  CARE  FACILITIES,  MEDICAL STAFF PROVIDING
SERVICE TO MEDICAID RECIPIENTS AND PHARMACY STAFF.
  (D) MEDICAID RECIPIENTS SHALL BE REQUIRED TO PROVIDE  BIOMETRIC  PROOF
OF  IDENTIFY  AT THE TIME OF EACH VISIT TO A DOCTORS OFFICE OR CLINIC AT
THE POINT OF ACTUALLY BEING SEEN BY THE DOCTOR OR  CLINICAL  STAFF,  AND
SHALL  AGAIN  PROVIDE  PROOF  OF  IDENTITY  UPON  COMPLETION  OF CARE OR
SERVICES.
  (E) BIOMETRIC VERIFICATION DEVICES SHALL  BE  USED  IN  PHARMACIES  TO
VERIFY  THE  IDENTITY  OF THE MEDICAID RECIPIENT AND THE VALIDITY OF THE
MEDICAID  COVERAGE  PRIOR  TO  OR  IN   CONJUNCTION   WITH   FILLING   A
PRESCRIPTION.
  (F)   PROVISIONS   SHALL   BE   INCLUDED  FOR  EMERGENCY  SERVICES  OR
PRESCRIPTIONS AND ALTERNATE IDENTIFICATION METHODS FOR MEDICAID  RECIPI-
ENTS PHYSICALLY OR MENTALLY UNABLE TO PROVIDE BIOMETRIC IDENTIFICATION.
  (G) FRAUD PREVENTION MARKERS INCORPORATED INTO SOFTWARE WHICH SHALL BE
USED TO OPERATE THE HARDWARE COMPONENT OF THE BIOMETRIC TECHNOLOGY SHALL
PREVENT  AND/OR REJECT THE PAYMENT BY THE MEDICAID PROGRAM AND ALERT THE
SERVICE PROVIDER AT POINT OF SERVICE IF  FRAUD  OR  POTENTIAL  FRAUD  IS
IDENTIFIED BY THE BIOMETRIC TECHNOLOGY SYSTEM.
  (H)  PROVISIONS  SHALL  BE INCLUDED TO ENSURE THAT MEDICAID RECIPIENTS
HAVE ACCESS TO EMERGENCY HEALTH SERVICES IN  THE  CASE  OF  A  BIOMETRIC
TECHNOLOGY SYSTEM MALFUNCTION OR FRAUD DETECTION ALARM.
  3.  SUCH  REQUEST FOR PROPOSALS SHALL SET FORTH REQUIREMENTS AS TO THE
RESULTS AND GOALS TO BE ACHIEVED, RATHER THAN SPECIFIC TECHNICAL METHODS
OR SYSTEMS, TO ALLOW CONSIDERATION OF  THE  WIDEST  POSSIBLE  CHOICE  OF
AVAILABLE TECHNOLOGY.
  4.  SUCH REQUEST FOR PROPOSALS SHALL REQUIRE THAT THE PROGRAM SHALL BE
REVENUE NEUTRAL FROM INCEPTION, WHEREBY ANY PROGRAM COSTS ARE  AT  LEAST
OFFSET  BY  STATE  MEDICAID  SAVINGS,  AND  SHALL HAVE AS A PRIMARY GOAL
REDUCTION OF MEDICAID EXPENDITURES  THROUGH  ELIMINATION  OF  FRAUD  AND
ABUSE.
  5.  (A) SUCH REQUEST FOR PROPOSALS FOR THE IMPLEMENTATION OF A PROGRAM
FOR BIOMETRIC TECHNOLOGY USE SHALL BE PUBLISHED  ON  OR  BEFORE  JANUARY
FIFTEENTH,  TWO  THOUSAND TWELVE, AND SHALL PROVIDE THAT PROPOSALS SHALL
BE OPENED ON OR BEFORE MARCH FIRST, TWO THOUSAND TWELVE.
  (B) THE COMMISSIONER SHALL REPORT TO THE GOVERNOR, THE TEMPORARY PRES-
IDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON OR  BEFORE  MARCH
THIRTIETH,  TWO  THOUSAND TWELVE WITH REGARD TO THE PROGRESS MADE IN THE

S. 4384--B                          3

DEVELOPMENT OF CRITERIA FOR A PROGRAM OF BIOMETRIC IDENTIFICATION AND OF
THE IMPLEMENTATION OF SUCH PROGRAM.
  S  293.  RULES  AND  REGULATIONS.  THE  COMMISSIONER IS AUTHORIZED AND
DIRECTED TO PROMULGATE SUCH RULES AND REGULATIONS AS HE OR SHE MAY  DEEM
NECESSARY OR APPROPRIATE TO EFFECTUATE THE PURPOSES OF THIS ARTICLE.
  S  2.    Subdivision 1 of section 367-b of the social services law, as
added by chapter 639 of the laws of 1976, is amended to read as follows:
  1. The department, IN CONSULTATION WITH THE  COMMISSIONER  OF  HEALTH,
shall  design  and  implement a statewide medical assistance information
and payments system for the purpose of providing individual  and  aggre-
gate  data  to  social services districts to assist them in making basic
management decisions, to the department  and  other  state  agencies  to
assist  in  the administration of the medical assistance program, and to
the governor and the legislature as may be necessary to assist in making
major administrative and policy decisions affecting such program.   Such
system shall be designed so as to be capable of the following:
  a. receiving and processing information relating to the eligibility of
each  person  applying  for  medical assistance and of issuing a medical
assistance identification card, AND WHEN AVAILABLE UTILIZING THE  BIOME-
TRIC  IDENTIFICATION  ISSUED  BY THE DEPARTMENT OF HEALTH, CONFORMING TO
THE REQUIREMENTS SET FORTH IN THE MEDICAID IDENTIFICATION AND ANTI-FRAUD
BIOMETRIC TECHNOLOGY PROGRAM ESTABLISHED PURSUANT TO  ARTICLE  TWO-B  OF
THE  PUBLIC  HEALTH LAW to persons determined by a social services offi-
cial to be eligible for such assistance;
  b.   ACTIVATING MEDICAL  ASSISTANCE  IDENTIFICATION  BY  REQUIRING  AN
APPLICANT  RECEIVING  SUCH IDENTIFICATION FROM THE DEPARTMENT TO HAVE IT
VERIFIED AT A SOCIAL SERVICES DISTRICT OFFICE  IN  THE  SOCIAL  SERVICES
DISTRICT IN WHICH THE APPLICANT RESIDES;
  C.  receiving  and  processing  information relating to each qualified
provider of medical assistance furnishing care, services or supplies for
which claims for payment are made pursuant to this title;
  [c.] D. receiving and processing, in a form and manner  prescribed  by
the  department, all claims for medical care, services and supplies, and
making payments for valid claims to providers of medical care,  services
and supplies on behalf of social services districts; AND
  [d.]  E.  maintaining  information  necessary to allow the department,
consistent with the powers and duties of the department  of  health,  to
review the appropriateness, scope and duration of medical care, services
and  supplies provided to any eligible person pursuant to this chapter[;
and
  e. initiating  implementation  of  such  a  system  for  the  district
comprising  the  city of New York, in a manner compatible with expansion
of such system to districts other than the district comprising the  city
of New York].
  S 3.  This act shall take effect immediately.

Co-Sponsors

view additional co-sponsors

S4384C - Bill Details

See Assembly Version of this Bill:
A6555F
Current Committee:
Law Section:
Public Health Law
Laws Affected:
Add Art 2-B §§290 - 293, Pub Health L; amd §367-b, Soc Serv L

S4384C - Bill Texts

view summary

Establishes the "Medicaid identification and anti-fraud biometric technology program", requiring the department of health, in consultation with the office of the medicaid inspector general and the office of the attorney general to implement a program requiring the use of biometric technology, as a means of identification and for use as an anti-fraud application in the Medicaid program.

view sponsor memo
BILL NUMBER:S4384C

TITLE OF BILL:
An act
to amend the public health law, in relation to establishing the Medicaid
identification and anti-fraud biometric technology program;
and
to amend the social services law, in relation to conforming medical
assistance identification with the Medicaid identification and
anti-fraud biometric technology program

PURPOSE OR GENERAL IDEA OF THE BILL:
Establishes the Medicaid
Identification and Antifraud Biometric Technology Program.

SUMMARY OF SPECIFIC PROVISIONS:
The Public Health Law is amended by
adding a new article 2-b to provide that the Department of Health
shall develop a request for proposals to implement a program using
biometric technology in hospitals, clinics and pharmacies for the
purpose of patient and provider identification to fight fraud in the
Medicaid program; sets time frames for such request; and requires the
Department of Health to report to the Governor, Senate and Assembly
as to the progress of implementing a biometric identification program.

Section 2: Amends the Social Services Law to require the Social
Services Department to conform its systems with the new Medicaid
Identification and Antifraud Biometric Identification Program when
available.

Section 3: Provides that this act shall take effect immediately

JUSTIFICATION:
New York will spend over $54 billion dollars this
fiscal year (2011-2012) on Medicaid and experts estimate that as much
as 10%, or over $5 billion, is spent on fraudulent services and
claims for Medicaid services. New York cannot afford to continue to
pay for such improper and fraudulent claims. Rather than reducing
payments for vital services for our children and most infirm elderly,
we should more aggressively address the billions of dollars lost to
fraud by utilizing modem and effective identification technology.
This legislation will require the Department of Health to develop
result-oriented guidelines and seek requests for proposals to
implement a modem fraud prevention program in hospitals, clinics and
pharmacies all across New York relying on biometric technology. There
are many companies offering various types of biometric identification
systems that are already in common use by private industry and
governmental agencies.

The request for proposals shall focus on results to be obtained,
rather than specific technology, to allow the State to consider the

many technologies that have been developed. These technologies can
use relatively inexpensive software and hardware that has already
been developed and proven to save New York billions of dollars
annually in fraud prevention. The request must also specify that any
proposal must be revenue neutral from inception, whereby program
costs are at least offset by savings from inception, and shall have
as a primary goal reduction in Medicaid expenditures through
elimination of fraud and abuse.

Biometrics is the science and technology of measuring and analyzing
biological data. In information technology, biometrics refers to
technologies that measure and analyze human body characteristics,
such as DNA, fingerprints, eye retinas and irises, voice patterns,
facial patterns and hand measurements, for authentication purposes.
The identification issued to Medicaid recipients and providers will
contain biometric markers for verification that a recipient is
eligible for the service requested, and confirm that the provider
actually provides the service. Such identification can be made at the
beginning and end of a transaction before payment is ever made,
instead of relying on the current system of "pay and chase" where law
enforcement and court action is required to recoup improper Medicaid
payments after they have been made.

PRIOR LEGISLATIVE HISTORY:
2011 - S.4384-B/A.6555-B -- PASSED SENATE/Health

FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENT:
Will generate
substantial savings, perhaps as much as $5 billion annually by
preventing health care fraud and improper payments.

EFFECTIVE DATE:
This act shall take effect immediately.

view full text
download pdf
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 4384--C

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                              April 4, 2011
                               ___________

Introduced  by  Sens.  RANZENHOFER, ADDABBO, DeFRANCISCO, LARKIN, YOUNG,
  ZELDIN -- read twice and ordered  printed,  and  when  printed  to  be
  committed  to  the  Committee  on Health -- committee discharged, bill
  amended, ordered reprinted as amended and recommitted to said  commit-
  tee  --  committee  discharged,  bill  amended,  ordered  reprinted as
  amended and recommitted  to  said  committee  --  recommitted  to  the
  Committee  on  Health  in  accordance  with  Senate  Rule 6, sec. 8 --
  committee discharged, bill amended, ordered reprinted as  amended  and
  recommitted to said committee

AN  ACT  to amend the public health law, in relation to establishing the
  Medicaid identification and anti-fraud biometric  technology  program;
  and  to  amend  the  social  services  law,  in relation to conforming
  medical assistance identification with the Medicaid identification and
  anti-fraud biometric technology program

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

  Section  1.  The  public health law is amended by adding a new article
2-B to read as follows:
                                ARTICLE 2-B
            MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC
                           TECHNOLOGY PROGRAM
SECTION 290. MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
               PROGRAM.
        291. DEFINITIONS.
        292. BIOMETRIC TECHNOLOGY USE REQUIREMENT.
        293. RULES AND REGULATIONS.
  S 290. MEDICAID IDENTIFICATION  AND  ANTI-FRAUD  BIOMETRIC  TECHNOLOGY
PROGRAM.  THERE  IS  HEREBY  ESTABLISHED  IN THE DEPARTMENT THE MEDICAID
IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY PROGRAM.
  S 291. DEFINITIONS. AS USED IN THIS ARTICLE:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09573-10-2

S. 4384--C                          2

  1. "BIOMETRIC TECHNOLOGY" MEANS TECHNOLOGY THAT MEASURES AND  ANALYZES
BIOLOGICAL  DATA,  INCLUDING  BUT  NOT  LIMITED  TO DNA, FINGER IMAGING,
VASCULAR PATTERNS,  EYE  RETINAS  AND  IRISES,  VOICE  PATTERNS,  FACIAL
PATTERNS AND HAND MEASUREMENTS, FOR AUTHENTICATION PURPOSES.
  2.    "BIOMETRIC  VERIFICATION DEVICE" MEANS A DEVICE CAPABLE OF USING
BIOMETRIC VERIFICATION TECHNOLOGY TO VERIFY THE IDENTITY OF  A  MEDICAID
RECIPIENT OR PROVIDER.
  S  292.  BIOMETRIC  TECHNOLOGY  USE REQUIREMENT. 1. THE DEPARTMENT, IN
CONSULTATION WITH THE OFFICE OF THE MEDICAID INSPECTOR GENERAL  AND  THE
OFFICE OF THE ATTORNEY GENERAL, SHALL DEVELOP A REQUEST FOR PROPOSALS TO
IMPLEMENT  A PROGRAM REQUIRING THE USE OF BIOMETRIC TECHNOLOGY BY HOSPI-
TALS, CLINICS AND PHARMACIES, FOR THE PURPOSES OF PATIENT  AND  PROVIDER
IDENTIFICATION  AND FOR USE AS AN ANTI-FRAUD APPLICATION IN THE MEDICAID
PROGRAM.
  2. SUCH REQUEST FOR PROPOSALS SHALL INCLUDE  AT  A  MINIMUM  THAT  (A)
MEDICAID RECIPIENTS AND PROVIDERS SHALL PROVIDE BIOMETRIC PROOF OF THEIR
IDENTITY  ALONG  WITH  OTHER INFORMATION DEEMED NECESSARY BY THE COMMIS-
SIONER.
  (B) SUCH PROGRAM WILL BE CAPABLE OF STORING BIOMETRIC  MARKERS  AND  A
LOG  OF  DOCTOR AND PHARMACY VISITS FOR EACH SERVICE BILLED TO THE MEDI-
CAID PROGRAM.
  (C) MEDICAID IDENTIFICATION SHALL BE ISSUED TO  AND  ACCEPTED  BY  THE
ADMITTING  STAFF  OF  HEALTH  CARE  FACILITIES,  MEDICAL STAFF PROVIDING
SERVICE TO MEDICAID RECIPIENTS AND PHARMACY STAFF.
  (D) MEDICAID RECIPIENTS SHALL BE REQUIRED TO PROVIDE  BIOMETRIC  PROOF
OF  IDENTIFY  AT THE TIME OF EACH VISIT TO A DOCTORS OFFICE OR CLINIC AT
THE POINT OF ACTUALLY BEING SEEN BY THE DOCTOR OR  CLINICAL  STAFF,  AND
SHALL  AGAIN  PROVIDE  PROOF  OF  IDENTITY  UPON  COMPLETION  OF CARE OR
SERVICES.
  (E) BIOMETRIC VERIFICATION DEVICES SHALL  BE  USED  IN  PHARMACIES  TO
VERIFY  THE  IDENTITY  OF THE MEDICAID RECIPIENT AND THE VALIDITY OF THE
MEDICAID  COVERAGE  PRIOR  TO  OR  IN   CONJUNCTION   WITH   FILLING   A
PRESCRIPTION.
  (F)   PROVISIONS   SHALL   BE   INCLUDED  FOR  EMERGENCY  SERVICES  OR
PRESCRIPTIONS AND ALTERNATE IDENTIFICATION METHODS FOR MEDICAID  RECIPI-
ENTS PHYSICALLY OR MENTALLY UNABLE TO PROVIDE BIOMETRIC IDENTIFICATION.
  (G) FRAUD PREVENTION MARKERS INCORPORATED INTO SOFTWARE WHICH SHALL BE
USED TO OPERATE THE HARDWARE COMPONENT OF THE BIOMETRIC TECHNOLOGY SHALL
PREVENT  AND/OR REJECT THE PAYMENT BY THE MEDICAID PROGRAM AND ALERT THE
SERVICE PROVIDER AT POINT OF SERVICE IF  FRAUD  OR  POTENTIAL  FRAUD  IS
IDENTIFIED BY THE BIOMETRIC TECHNOLOGY SYSTEM.
  (H)  PROVISIONS  SHALL  BE INCLUDED TO ENSURE THAT MEDICAID RECIPIENTS
HAVE ACCESS TO EMERGENCY HEALTH SERVICES IN  THE  CASE  OF  A  BIOMETRIC
TECHNOLOGY SYSTEM MALFUNCTION OR FRAUD DETECTION ALARM.
  (I)  EVALUATION AND SELECTION OF AN IDENTIFY CREDENTIALING SYSTEM THAT
ADDRESSES THE REQUIREMENTS OF MEDICAID BENEFICIARIES AND PROVIDERS SHALL
BE BASED  ON  THE  FOLLOWING  CRITERIA:  SECURITY,  PRIVACY,  USABILITY,
PERFORMANCE,  HYGIENE,  BIOMETRIC  CAPTURE AND STORAGE REQUIREMENTS, AND
INTEROPERABILITY.
  3. SUCH REQUEST FOR PROPOSALS SHALL SET FORTH REQUIREMENTS AS  TO  THE
RESULTS AND GOALS TO BE ACHIEVED, RATHER THAN SPECIFIC TECHNICAL METHODS
OR  SYSTEMS,  TO  ALLOW  CONSIDERATION  OF THE WIDEST POSSIBLE CHOICE OF
AVAILABLE TECHNOLOGY.
  4. SUCH REQUEST FOR PROPOSALS SHALL REQUIRE THAT THE PROGRAM SHALL  BE
REVENUE  NEUTRAL  FROM INCEPTION, WHEREBY ANY PROGRAM COSTS ARE AT LEAST
OFFSET BY STATE MEDICAID SAVINGS, AND  SHALL  HAVE  AS  A  PRIMARY  GOAL

S. 4384--C                          3

REDUCTION  OF  MEDICAID  EXPENDITURES  THROUGH  ELIMINATION OF FRAUD AND
ABUSE.
  5.  (A) SUCH REQUEST FOR PROPOSALS FOR THE IMPLEMENTATION OF A PROGRAM
FOR BIOMETRIC TECHNOLOGY USE SHALL BE PUBLISHED  ON  OR  BEFORE  JANUARY
FIFTEENTH, TWO THOUSAND THIRTEEN, AND SHALL PROVIDE THAT PROPOSALS SHALL
BE OPENED ON OR BEFORE MARCH FIRST, TWO THOUSAND THIRTEEN.
  (B) THE COMMISSIONER SHALL REPORT TO THE GOVERNOR, THE TEMPORARY PRES-
IDENT  OF  THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON OR BEFORE MARCH
THIRTIETH, TWO THOUSAND THIRTEEN WITH REGARD TO THE PROGRESS MADE IN THE
DEVELOPMENT OF CRITERIA FOR A PROGRAM OF BIOMETRIC IDENTIFICATION AND OF
THE IMPLEMENTATION OF SUCH PROGRAM.
  S 293. RULES AND  REGULATIONS.  THE  COMMISSIONER  IS  AUTHORIZED  AND
DIRECTED  TO PROMULGATE SUCH RULES AND REGULATIONS AS HE OR SHE MAY DEEM
NECESSARY OR APPROPRIATE TO EFFECTUATE THE PURPOSES OF THIS ARTICLE.
  S 2.  Subdivision 1 of section 367-b of the social  services  law,  as
added by chapter 639 of the laws of 1976, is amended to read as follows:
  1.  The  department,  IN CONSULTATION WITH THE COMMISSIONER OF HEALTH,
shall design and implement a statewide  medical  assistance  information
and  payments  system for the purpose of providing individual and aggre-
gate data to social services districts to assist them  in  making  basic
management  decisions,  to  the  department  and other state agencies to
assist in the administration of the medical assistance program,  and  to
the governor and the legislature as may be necessary to assist in making
major  administrative and policy decisions affecting such program.  Such
system shall be designed so as to be capable of the following:
  a. receiving and processing information relating to the eligibility of
each person applying for medical assistance and  of  issuing  a  medical
assistance  identification card, AND WHEN AVAILABLE UTILIZING THE BIOME-
TRIC IDENTIFICATION ISSUED BY THE DEPARTMENT OF  HEALTH,  CONFORMING  TO
THE REQUIREMENTS SET FORTH IN THE MEDICAID IDENTIFICATION AND ANTI-FRAUD
BIOMETRIC  TECHNOLOGY  PROGRAM  ESTABLISHED PURSUANT TO ARTICLE TWO-B OF
THE PUBLIC HEALTH LAW to persons determined by a social  services  offi-
cial to be eligible for such assistance;
  b.    ACTIVATING  MEDICAL  ASSISTANCE  IDENTIFICATION  BY REQUIRING AN
APPLICANT RECEIVING SUCH IDENTIFICATION FROM THE DEPARTMENT TO  HAVE  IT
VERIFIED  AT  A  SOCIAL  SERVICES DISTRICT OFFICE IN THE SOCIAL SERVICES
DISTRICT IN WHICH THE APPLICANT RESIDES;
  C. receiving and processing information  relating  to  each  qualified
provider of medical assistance furnishing care, services or supplies for
which claims for payment are made pursuant to this title;
  [c.]  D.  receiving and processing, in a form and manner prescribed by
the department, all claims for medical care, services and supplies,  and
making  payments for valid claims to providers of medical care, services
and supplies on behalf of social services districts; AND
  [d.] E. maintaining information necessary  to  allow  the  department,
consistent  with  the  powers and duties of the department of health, to
review the appropriateness, scope and duration of medical care, services
and supplies provided to any eligible person pursuant to this  chapter[;
and
  e.  initiating  implementation  of  such  a  system  for  the district
comprising the city of New York, in a manner compatible  with  expansion
of  such system to districts other than the district comprising the city
of New York].
  S 3.  This act shall take effect immediately.

Co-Sponsors

view additional co-sponsors

S4384D (ACTIVE) - Bill Details

See Assembly Version of this Bill:
A6555F
Current Committee:
Law Section:
Public Health Law
Laws Affected:
Add Art 2-B §§290 - 293, Pub Health L; amd §367-b, Soc Serv L

S4384D (ACTIVE) - Bill Texts

view summary

Establishes the "Medicaid identification and anti-fraud biometric technology program", requiring the department of health, in consultation with the office of the medicaid inspector general and the office of the attorney general to implement a program requiring the use of biometric technology, as a means of identification and for use as an anti-fraud application in the Medicaid program.

view sponsor memo
BILL NUMBER:S4384D

TITLE OF BILL:
An act
to amend the public health law, in relation to establishing the Medicaid
identification and anti-fraud biometric technology program;
and
to amend the social services law, in relation to conforming medical
assistance identification with the Medicaid identification and
anti-fraud biometric technology program

PURPOSE OR GENERAL IDEA OF THE BILL:
Establishes the Medicaid
Identification and Antifraud Biometric Technology Program.

SUMMARY OF SPECIFIC PROVISIONS:
The Public Health Law is amended by
adding a new article 2-b to provide that the Department of Health
shall develop a request for proposals to implement a program using
biometric technology in hospitals, clinics and pharmacies for the
purpose of patient and provider identification to fight fraud in the
Medicaid program; sets time frames for such request; and requires the
Department of Health to report to the Governor, Senate and Assembly
as to the progress of implementing a biometric identification program.

Section 2: Amends the Social Services Law to require the Social
Services Department to conform its systems with the new Medicaid
Identification and Antifraud Biornetric Identification Program when
available.

Section 3: Provides that this act shall take effect immediately.

JUSTIFICATION:
New York will spend over $54 billion dollars this
fiscal year (2011-2012) on Medicaid and experts estimate that as much
as 10%, or over $5 billion, is spent on fraudulent services and
claims for Medicaid services. New York cannot afford to continue to
pay for such improper and fraudulent claims. Rather than reducing
payments for vital services for our children and most infirm elderly,
we should more aggressively address the billions of dollars lost to
fraud by utilizing modem and effective identification technology.
This legislation will require the Department of Health to develop
result-oriented guidelines and seek requests for proposals to
implement a modem fraud prevention program in hospitals, clinics and
pharmacies all across New York relying on biometric technology. There
are many companies offering various types of biometric identification
systems that are already in common use by private industry and
governmental agencies.

The request for proposals shall focus on results to be obtained,
rather than specific technology, to allow the State to consider the

many technologies that have been developed. These technologies can
use relatively inexpensive software and hardware that has already
been developed and proven to save New York billions of dollars
annually in fraud prevention. The request must also specify that any
proposal must be revenue neutral from inception, whereby program
costs are at least offset by savings from inception, and shall have
as a primary goal reduction in Medicaid expenditures through
elimination of fraud and abuse.

Biometrics is the science and technology of measuring and analyzing
biological data. In information technology, biometrics refers to
technologies that measure and analyze human body characteristics,
such as DNA, fingerprints, eye retinas and irises, voice patterns,
facial patterns and hand measurements, for authentication purposes.
The identification issued to Medicaid recipients and providers will
contain biometric markers for verification that a recipient is
eligible for the service requested, and confirm that the provider
actually provides the service. Such identification can be made at the
beginning and end of a transaction before payment is ever made,
instead of relying on the current system of "pay and chase" where law
enforcement and court action is required to recoup improper Medicaid
payments after they have been made.

PRIOR LEGISLATIVE HISTORY:
2011 - S.4384-B/A.6555-B -- PASSED SENATE/Health

FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENT:
Will generate
substantial savings, perhaps as much as $5 billion annually by
preventing health care fraud and improper payments.

EFFECTIVE DATE:
This act shall take effect immediately.

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

                                 4384--D

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                              April 4, 2011
                               ___________

Introduced  by  Sens.  RANZENHOFER, ADDABBO, DeFRANCISCO, LARKIN, YOUNG,
  ZELDIN -- read twice and ordered  printed,  and  when  printed  to  be
  committed  to  the  Committee  on Health -- committee discharged, bill
  amended, ordered reprinted as amended and recommitted to said  commit-
  tee  --  committee  discharged,  bill  amended,  ordered  reprinted as
  amended and recommitted  to  said  committee  --  recommitted  to  the
  Committee  on  Health  in  accordance  with  Senate  Rule 6, sec. 8 --
  committee discharged, bill amended, ordered reprinted as  amended  and
  recommitted  to  said committee -- committee discharged, bill amended,
  ordered reprinted as amended and recommitted to said committee

AN ACT to amend the public health law, in relation to  establishing  the
  Medicaid  identification  and anti-fraud biometric technology program;
  and to amend the  social  services  law,  in  relation  to  conforming
  medical assistance identification with the Medicaid identification and
  anti-fraud biometric technology program

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

  Section 1. The public health law is amended by adding  a  new  article
2-B to read as follows:
                                ARTICLE 2-B
            MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC
                           TECHNOLOGY PROGRAM
SECTION 290. MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
               PROGRAM.
        291. DEFINITIONS.
        292. BIOMETRIC TECHNOLOGY USE REQUIREMENT.
        293. RULES AND REGULATIONS.
  S  290.  MEDICAID  IDENTIFICATION  AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
PROGRAM. THERE IS HEREBY ESTABLISHED  IN  THE  DEPARTMENT  THE  MEDICAID
IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY PROGRAM.
  S 291. DEFINITIONS. AS USED IN THIS ARTICLE:
  1.  "BIOMETRIC TECHNOLOGY" MEANS TECHNOLOGY THAT MEASURES AND ANALYZES
BIOLOGICAL DATA, INCLUDING BUT  NOT  LIMITED  TO  DNA,  FINGER  IMAGING,

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09573-14-2

S. 4384--D                          2

VASCULAR  PATTERNS,  EYE  RETINAS  AND  IRISES,  VOICE  PATTERNS, FACIAL
PATTERNS AND HAND MEASUREMENTS, FOR AUTHENTICATION PURPOSES.
  2.    "BIOMETRIC  VERIFICATION DEVICE" MEANS A DEVICE CAPABLE OF USING
BIOMETRIC VERIFICATION TECHNOLOGY TO VERIFY THE IDENTITY OF  A  MEDICAID
RECIPIENT OR PROVIDER.
  S  292.  BIOMETRIC  TECHNOLOGY  USE REQUIREMENT. 1. THE DEPARTMENT, IN
CONSULTATION WITH THE OFFICE OF THE MEDICAID INSPECTOR GENERAL  AND  THE
OFFICE OF THE ATTORNEY GENERAL, SHALL DEVELOP A REQUEST FOR PROPOSALS TO
IMPLEMENT  A PROGRAM REQUIRING THE USE OF BIOMETRIC TECHNOLOGY BY HOSPI-
TALS, CLINICS AND PHARMACIES, FOR THE PURPOSES OF PATIENT  AND  PROVIDER
IDENTIFICATION  AND FOR USE AS AN ANTI-FRAUD APPLICATION IN THE MEDICAID
PROGRAM.
  2. SUCH REQUEST FOR PROPOSALS SHALL INCLUDE  AT  A  MINIMUM  THAT  (A)
MEDICAID RECIPIENTS AND PROVIDERS SHALL PROVIDE BIOMETRIC PROOF OF THEIR
IDENTITY  ALONG  WITH  OTHER INFORMATION DEEMED NECESSARY BY THE COMMIS-
SIONER.
  (B) SUCH PROGRAM WILL BE CAPABLE OF STORING BIOMETRIC  MARKERS  AND  A
LOG  OF  DOCTOR AND PHARMACY VISITS FOR EACH SERVICE BILLED TO THE MEDI-
CAID PROGRAM.
  (C) MEDICAID IDENTIFICATION SHALL BE ISSUED TO  AND  ACCEPTED  BY  THE
ADMITTING  STAFF  OF  HEALTH  CARE  FACILITIES,  MEDICAL STAFF PROVIDING
SERVICE TO MEDICAID RECIPIENTS AND PHARMACY STAFF.
  (D) MEDICAID RECIPIENTS SHALL BE REQUIRED TO PROVIDE  BIOMETRIC  PROOF
OF  IDENTIFY  AT THE TIME OF EACH VISIT TO A DOCTORS OFFICE OR CLINIC AT
THE POINT OF ACTUALLY BEING SEEN BY THE DOCTOR OR  CLINICAL  STAFF,  AND
SHALL  AGAIN  PROVIDE  PROOF  OF  IDENTITY  UPON  COMPLETION  OF CARE OR
SERVICES.
  (E) BIOMETRIC VERIFICATION DEVICES SHALL  BE  USED  IN  PHARMACIES  TO
VERIFY  THE  IDENTITY  OF THE MEDICAID RECIPIENT AND THE VALIDITY OF THE
MEDICAID  COVERAGE  PRIOR  TO  OR  IN   CONJUNCTION   WITH   FILLING   A
PRESCRIPTION.
  (F)   PROVISIONS   SHALL   BE   INCLUDED  FOR  EMERGENCY  SERVICES  OR
PRESCRIPTIONS AND ALTERNATE IDENTIFICATION METHODS FOR MEDICAID  RECIPI-
ENTS PHYSICALLY OR MENTALLY UNABLE TO PROVIDE BIOMETRIC IDENTIFICATION.
  (G) FRAUD PREVENTION MARKERS INCORPORATED INTO SOFTWARE WHICH SHALL BE
USED TO OPERATE THE HARDWARE COMPONENT OF THE BIOMETRIC TECHNOLOGY SHALL
PREVENT  AND/OR REJECT THE PAYMENT BY THE MEDICAID PROGRAM AND ALERT THE
SERVICE PROVIDER AT POINT OF SERVICE IF  FRAUD  OR  POTENTIAL  FRAUD  IS
IDENTIFIED BY THE BIOMETRIC TECHNOLOGY SYSTEM.
  (H)  PROVISIONS  SHALL  BE INCLUDED TO ENSURE THAT MEDICAID RECIPIENTS
HAVE ACCESS TO EMERGENCY HEALTH SERVICES IN  THE  CASE  OF  A  BIOMETRIC
TECHNOLOGY SYSTEM MALFUNCTION OR FRAUD DETECTION ALARM.
  (I)  EVALUATION AND SELECTION OF AN IDENTIFY CREDENTIALING SYSTEM THAT
ADDRESSES THE REQUIREMENTS OF MEDICAID BENEFICIARIES AND PROVIDERS SHALL
BE BASED  ON  THE  FOLLOWING  CRITERIA:  SECURITY,  PRIVACY,  USABILITY,
PERFORMANCE,  HYGIENE,  BIOMETRIC  CAPTURE AND STORAGE REQUIREMENTS, AND
INTEROPERABILITY.
  3. SUCH REQUEST FOR PROPOSALS SHALL SET FORTH REQUIREMENTS AS  TO  THE
RESULTS AND GOALS TO BE ACHIEVED, RATHER THAN SPECIFIC TECHNICAL METHODS
OR  SYSTEMS,  TO  ALLOW  CONSIDERATION  OF THE WIDEST POSSIBLE CHOICE OF
AVAILABLE TECHNOLOGY.
  4. SUCH REQUEST FOR PROPOSALS SHALL  REQUIRE:  (A)  THAT  THE  PROGRAM
SHALL  BE  REVENUE NEUTRAL FROM INCEPTION, WHEREBY ANY PROGRAM COSTS ARE
AT LEAST OFFSET BY STATE MEDICAID SAVINGS, AND SHALL HAVE AS  A  PRIMARY
GOAL REDUCTION OF MEDICAID EXPENDITURES THROUGH ELIMINATION OF FRAUD AND
ABUSE;  AND (B) THAT THE PROGRAM SHALL BE COST NEUTRAL TO PROVIDERS FROM

S. 4384--D                          3

INCEPTION, WHEREBY ANY PROVIDER COSTS ARE AT LEAST  OFFSET  BY  PROVIDER
SAVINGS,  AND  SHALL  HAVE  AS  A  PRIMARY GOAL PROVIDER SAVINGS THROUGH
INCREASED EFFICIENCIES.
  5.  (A) SUCH REQUEST FOR PROPOSALS FOR THE IMPLEMENTATION OF A PROGRAM
FOR BIOMETRIC TECHNOLOGY USE SHALL BE PUBLISHED  ON  OR  BEFORE  JANUARY
FIFTEENTH, TWO THOUSAND THIRTEEN, AND SHALL PROVIDE THAT PROPOSALS SHALL
BE OPENED ON OR BEFORE MARCH FIRST, TWO THOUSAND THIRTEEN.
  (B) THE COMMISSIONER SHALL REPORT TO THE GOVERNOR, THE TEMPORARY PRES-
IDENT  OF  THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON OR BEFORE MARCH
THIRTIETH, TWO THOUSAND THIRTEEN WITH REGARD TO THE PROGRESS MADE IN THE
DEVELOPMENT OF CRITERIA FOR A PROGRAM OF BIOMETRIC IDENTIFICATION AND OF
THE IMPLEMENTATION OF SUCH PROGRAM.
  S 293. RULES AND  REGULATIONS.  THE  COMMISSIONER  IS  AUTHORIZED  AND
DIRECTED  TO PROMULGATE SUCH RULES AND REGULATIONS AS HE OR SHE MAY DEEM
NECESSARY OR APPROPRIATE TO EFFECTUATE THE PURPOSES OF THIS ARTICLE.
  S 2.  Subdivision 1 of section 367-b of the social  services  law,  as
added by chapter 639 of the laws of 1976, is amended to read as follows:
  1.  The  department,  IN CONSULTATION WITH THE COMMISSIONER OF HEALTH,
shall design and implement a statewide  medical  assistance  information
and  payments  system for the purpose of providing individual and aggre-
gate data to social services districts to assist them  in  making  basic
management  decisions,  to  the  department  and other state agencies to
assist in the administration of the medical assistance program,  and  to
the governor and the legislature as may be necessary to assist in making
major  administrative and policy decisions affecting such program.  Such
system shall be designed so as to be capable of the following:
  a. receiving and processing information relating to the eligibility of
each person applying for medical assistance and  of  issuing  a  medical
assistance  identification card, AND WHEN AVAILABLE UTILIZING THE BIOME-
TRIC IDENTIFICATION ISSUED BY THE DEPARTMENT OF  HEALTH,  CONFORMING  TO
THE REQUIREMENTS SET FORTH IN THE MEDICAID IDENTIFICATION AND ANTI-FRAUD
BIOMETRIC  TECHNOLOGY  PROGRAM  ESTABLISHED PURSUANT TO ARTICLE TWO-B OF
THE PUBLIC HEALTH LAW to persons determined by a social  services  offi-
cial to be eligible for such assistance;
  b.    ACTIVATING  MEDICAL  ASSISTANCE  IDENTIFICATION  BY REQUIRING AN
APPLICANT RECEIVING SUCH IDENTIFICATION FROM THE DEPARTMENT TO  HAVE  IT
VERIFIED  AT  A  SOCIAL  SERVICES DISTRICT OFFICE IN THE SOCIAL SERVICES
DISTRICT IN WHICH THE APPLICANT RESIDES;
  C. receiving and processing information  relating  to  each  qualified
provider of medical assistance furnishing care, services or supplies for
which claims for payment are made pursuant to this title;
  [c.]  D.  receiving and processing, in a form and manner prescribed by
the department, all claims for medical care, services and supplies,  and
making  payments for valid claims to providers of medical care, services
and supplies on behalf of social services districts; AND
  [d.] E. maintaining information necessary  to  allow  the  department,
consistent  with  the  powers and duties of the department of health, to
review the appropriateness, scope and duration of medical care, services
and supplies provided to any eligible person pursuant to this  chapter[;
and
  e.  initiating  implementation  of  such  a  system  for  the district
comprising the city of New York, in a manner compatible  with  expansion
of  such system to districts other than the district comprising the city
of New York].
  S 3.  This act shall take effect immediately.

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