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

                                  4845

                       2013-2014 Regular Sessions

                          I N  A S S E M B L Y

                            February 11, 2013
                               ___________

Introduced by M. of A. GJONAJ -- read once and referred to the Committee
  on Insurance

AN  ACT to amend the insurance law, in relation to establishing a public
  awareness program on the availability of long term health care  insur-
  ance  and  the  tax credits therefor and accelerating payment of death
  benefits or a special surrender value pursuant  to  a  life  insurance
  policy  upon  receipt  of end of life or palliative care; to amend the
  tax law, in relation to credits for premiums paid for  long-term  care
  insurance  policies; and to amend the public health law, the insurance
  law and the social services law, in relation to the provision of home-
  maker services

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

  Section  1.   The insurance law is amended by adding a new section 342
to read as follows:
  S 342. PUBLIC AWARENESS OF LONG TERM CARE INSURANCE.  THE  DEPARTMENT,
DEPARTMENT  OF  HEALTH,  OFFICE FOR THE AGING AND DEPARTMENT OF TAXATION
AND FINANCE SHALL JOINTLY  ESTABLISH  AND  CONDUCT  A  PUBLIC  AWARENESS
PROGRAM  ON  THE  AVAILABILITY AND COVERAGE PROVIDED BY HEALTH INSURANCE
PLANS FOR LONG TERM CARE, AND THE  PROVISIONS  OF  VARIOUS  TAX  CREDITS
THEREFOR.
  S  2.  Paragraph  1 of subsection (a) of section 1113 of the insurance
law, as amended by chapter 563 of the laws of 2010, is amended  to  read
as follows:
  (1)  "Life  Insurance,"  means every insurance upon the lives of human
beings, and every insurance appertaining thereto, including the granting
of endowment benefits, additional benefits in  the  event  of  death  by
accident,  additional  benefits  to  safeguard  the contract from lapse,
accelerated payments of part or all of the death benefit  or  a  special
surrender value upon (A) diagnosis of terminal illness defined as a life
expectancy  of  twelve months or less, (B) diagnosis of a medical condi-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD07788-01-3
              

A. 4845                             2

tion requiring extraordinary medical care  or  treatment  regardless  of
life expectancy, (C) certification by a licensed health care practition-
er  of any condition which requires continuous care for the remainder of
the  insured's  life in an eligible facility or at home when the insured
is chronically ill as defined by Section 7702(B) of the Internal Revenue
Code and regulations thereunder, provided the accelerated payments qual-
ify under Section 101(g)(3) of the Internal Revenue Code and  all  other
applicable  sections  of  federal law in order to maintain favorable tax
treatment, (D) certification by a licensed health care practitioner that
the insured is chronically ill as defined by Section  7702  (B)  of  the
Internal  Revenue Code and regulations thereunder, provided the acceler-
ated payments qualify under Section 101(g)(3) of  the  Internal  Revenue
Code  and all other applicable sections of federal law in order to main-
tain favorable tax treatment and the insurer that issues such policy  is
a  qualified long term care insurance carrier under Section 4980c of the
Internal Revenue Code or provide a special surrender value,  upon  total
and  permanent  disability of the insured, and optional modes of settle-
ment of proceeds, [or] (E) the insured's having been  a  resident  of  a
nursing  home,  as  defined  in  section twenty-eight hundred one of the
public health law, for a period of three months or more, with an  expec-
tation  that such insured will remain a resident of a nursing home until
death, OR (F) THE INSURED'S HAVING BEEN THE RECIPIENT OF LONG TERM  HOME
HEALTH  CARE,  HOSPICE  OR  ADULT  DAY CARE SERVICES, OR OTHER SERVICES,
WHICH PROVIDE END OF LIFE OR PALLIATIVE CARE  TO  THE  INSURED.    "Life
insurance"  also  includes additional benefits to safeguard the contract
against lapse in the event of unemployment of  the  insured  or  in  the
event  the  insured  is  a  resident of a nursing home. Amounts paid the
insurer for life insurance and proceeds applied under optional modes  of
settlement  or under dividend options may be allocated by the insurer to
one or more separate accounts pursuant  to  section  four  thousand  two
hundred forty of this chapter.
  S  3.  Subparagraph  (A)  of paragraph 11 of subsection (c) of section
3201 of the insurance law, as amended by chapter  563  of  the  laws  of
2010, is amended to read as follows:
  (A) The superintendent shall not approve a life insurance policy which
provides  for accelerated payment of death benefits or special surrender
values pursuant to subparagraph (B), (C), (D) [or], (E) OR (F) of  para-
graph one of subsection (a) of section one thousand one hundred thirteen
of this chapter unless it also provides for such accelerated payments or
special  surrender  values pursuant to subparagraph (A) of paragraph one
of subsection (a) of such section.
  S 4. Subsection (f) of section 3230 of the insurance law,  as  amended
by chapter 563 of the laws of 2010, is amended to read as follows:
  (f)  This section shall apply to all life insurance policies or policy
riders or provisions thereof that provide  for  accelerated  payment  of
death  benefits  or  a  special surrender value pursuant to subparagraph
(A), (B), (C) [or], (E) OR (F) of paragraph one  of  subsection  (a)  of
section one thousand one hundred thirteen of this chapter.
  S  5.  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 percent] THE FOLLOWING PERCENTAGES of the premium  paid
during the taxable year for long-term care insurance:

A. 4845                             3

  (A)  FORTY  PERCENT  IF THE INSURED IS LESS THAN FORTY YEARS OF AGE AT
THE END OF THE TAX YEAR;
  (B) THIRTY PERCENT IF THE INSURED IS LESS THAN FIFTY YEARS OF AGE, BUT
FORTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR;
  (C)  TWENTY-FIVE  PERCENT IF THE INSURED IS LESS THAN FIFTY-FIVE YEARS
OF AGE, BUT FIFTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR; OR
  (D) TWENTY PERCENT IF THE INSURED IS FIFTY-FIVE OR MORE YEARS  OF  AGE
AT THE END OF THE TAX 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 6. 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 percent] THE FOLLOWING PERCENTAGES of  the
premium paid during the taxable year for long-term care insurance:
  (I)  FORTY  PERCENT  IF THE INSURED IS LESS THAN FORTY YEARS OF AGE AT
THE END OF THE TAX YEAR;
  (II) THIRTY PERCENT IF THE INSURED IS LESS THAN FIFTY  YEARS  OF  AGE,
BUT FORTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR;
  (III) TWENTY-FIVE PERCENT IF THE INSURED IS LESS THAN FIFTY-FIVE YEARS
OF AGE, BUT FIFTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR; OR
  (IV)  TWENTY PERCENT IF THE INSURED IS FIFTY-FIVE OR MORE YEARS OF AGE
AT THE END OF THE TAX 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  7. 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 percent] THE FOLLOWING PERCENT-
AGES of the premium paid during the  taxable  year  for  long-term  care
insurance:
  (A)  FORTY  PERCENT  IF THE INSURED IS LESS THAN FORTY YEARS OF AGE AT
THE END OF THE TAX YEAR;
  (B) THIRTY PERCENT IF THE INSURED IS LESS THAN FIFTY YEARS OF AGE, BUT
FORTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR;
  (C) TWENTY-FIVE PERCENT IF THE INSURED IS LESS THAN  FIFTY-FIVE  YEARS
OF AGE, BUT FIFTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR; OR
  (D)  TWENTY  PERCENT IF THE INSURED IS FIFTY-FIVE OR MORE YEARS OF AGE
AT THE END OF THE TAX 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 8. 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:

A. 4845                             4

  (1) A taxpayer shall be allowed a credit against the  tax  imposed  by
this  article equal to [twenty percent] THE FOLLOWING PERCENTAGES of the
premium paid during the taxable year for long-term care insurance:
  (A)  FORTY  PERCENT  IF THE INSURED IS LESS THAN FORTY YEARS OF AGE AT
THE END OF THE TAX YEAR;
  (B) THIRTY PERCENT IF THE INSURED IS LESS THAN FIFTY YEARS OF AGE, BUT
FORTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR;
  (C) TWENTY-FIVE PERCENT IF THE INSURED IS LESS THAN  FIFTY-FIVE  YEARS
OF AGE, BUT FIFTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR; OR
  (D)  TWENTY  PERCENT IF THE INSURED IS FIFTY-FIVE OR MORE YEARS OF AGE
AT THE END OF THE TAX 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 9. 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 percent] THE FOLLOWING PERCENTAGES of the
premium paid during the taxable year for long-term care insurance:
  (A) FORTY PERCENT IF THE INSURED IS LESS THAN FIFTY YEARS  OF  AGE  AT
THE END OF THE TAX YEAR;
  (B) THIRTY PERCENT IF THE INSURED IS LESS THAN FIFTY YEARS OF AGE, BUT
FORTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR;
  (C)  TWENTY-FIVE  PERCENT IF THE INSURED IS LESS THAN FIFTY-FIVE YEARS
OF AGE, BUT FIFTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR; OR
  (D) TWENTY PERCENT IF THE INSURED IS FIFTY-FIVE OR MORE YEARS  OF  AGE
AT THE END OF THE TAX 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 10. Subdivision 4 of section 3602  of  the  public  health  law,  as
amended  by  chapter  600  of  the  laws  of 2002, is amended to read as
follows:
  4. "Home  health  aide  services"  means  simple  health  care  tasks,
personal hygiene services, housekeeping tasks essential to the patient's
health  and  other  related  supportive services. Such services shall be
prescribed by a physician in accordance with a plan of treatment for the
patient and: (A) shall be under the supervision of a registered  profes-
sional  nurse  from a certified home health agency or, when appropriate,
from a provider of a long term home  health  care  program  and  of  the
appropriate professional therapist from such agency or provider when the
aide  carries  out simple procedures as an extension of physical, speech
or occupational therapy, OR (B) HOMEMAKER SERVICES WHICH CAN BE  ENGAGED
THROUGH A PRIVATE HOME AIDE, PROVIDED HOWEVER THAT SUCH AIDE HAS (1) MET
THE  STANDARDS  ESTABLISHED  BY THE DEPARTMENT OF FAMILY ASSISTANCE, AND
(2) SUCH SERVICES ARE REIMBURSABLE THROUGH THE PARTNERSHIP FOR LONG TERM
CARE PROGRAM PURSUANT TO SECTION  THREE  HUNDRED  SIXTY-SEVEN-F  OF  THE
SOCIAL SERVICES LAW.  Such services may also be prescribed or ordered by
a nurse practitioner to the extent authorized by law and consistent with
the  written practice agreement pursuant to subdivision three of section
six thousand nine hundred two of the education law and not prohibited by
federal law or regulation.

A. 4845                             5

  S 11. Subparagraph (A) of paragraph 6 of  subsection  (i)  of  section
3216  of  the  insurance  law,  as amended by chapter 557 of the laws of
2000, is amended to read as follows:
  (A)  Home care means the care and treatment of a covered person who is
under the care of a physician but only if hospitalization or confinement
in a nursing facility as defined in  subchapter  XVIII  of  the  federal
Social  Security  Act,  42 U.S.C. SS 1395 et [seq] SEQ., would otherwise
have been required if home care was not provided, and the plan  covering
the  home  health service is established and approved in writing by such
physician.  Home care shall be provided by  an  agency  [possessing]  OR
THROUGH A PRIVATE HOME AIDE SERVICE PURSUANT TO THIS SUBPARAGRAPH. WHERE
HOME  CARE  IS  PROVIDED  BY AN AGENCY SUCH AGENCY SHALL POSSESS a valid
certificate of approval or license issued pursuant to article thirty-six
of the public health law and shall consist of one or more of the follow-
ing:
  (i) Part-time or intermittent home nursing care by or under the super-
vision of a registered professional nurse (R.N.).
  (ii) Part-time or intermittent home health aide services which consist
primarily of caring for the patient.
  (iii) Physical, occupational or speech therapy if provided by the home
health service or agency.
  (iv) Medical supplies, drugs and medications prescribed  by  a  physi-
cian, and laboratory services by or on behalf of a certified home health
agency  or  licensed  home care services agency to the extent such items
would have been covered under the contract if  the  covered  person  had
been  hospitalized  or confined in a skilled nursing facility as defined
in [title] subchapter XVIII of  the  federal  Social  Security  Act,  42
U.S.C.  SS 1395 et seq.
  WHERE  HOMEMAKER  SERVICES  ARE  PROVIDED  THROUGH  PRIVATE  HOME AIDE
SERVICES SUCH CARE SHALL CONSIST OF ONE OR MORE OF THE FOLLOWING:
  (I) SUCH AIDE SHALL HAVE MET THE STANDARDS ESTABLISHED BY THE  DEPART-
MENT OF FAMILY ASSISTANCE.
  (II)  SUCH  SERVICES ARE REIMBURSABLE THROUGH THE PARTNERSHIP FOR LONG
TERM CARE PROGRAM PURSUANT TO SECTION THREE HUNDRED SIXTY-SEVEN-F OF THE
SOCIAL SERVICES LAW.
  (III) PART-TIME  OR  INTERMITTENT  HOMEMAKER  SERVICES  WHICH  CONSIST
PRIMARILY OF CARING FOR THE PATIENT.
  S  12.  Subparagraph  (D)  of paragraph 1 of subsection (k) of section
3221 of the insurance law, as amended by chapter  557  of  the  laws  of
2000, is amended to read as follows:
  (D) Home care shall be provided by an agency [possessing] OR THROUGH A
PRIVATE HOME AIDE SERVICE PURSUANT TO THIS SUBPARAGRAPH. WHERE HOME CARE
IS  PROVIDED  BY AN AGENCY SUCH AGENCY SHALL POSSESS a valid certificate
of approval or license issued pursuant  to  article  thirty-six  of  the
public health law and shall consist of one or more of the following:
  (i) Part-time or intermittent home nursing care by or under the super-
vision of a registered professional nurse (R.N.).
  (ii) Part-time or intermittent home health aide services which consist
primarily of caring for the patient.
  (iii) Physical, occupational or speech therapy if provided by the home
health service or agency.
  (iv)  Medical  supplies,  drugs and medications prescribed by a physi-
cian, and laboratory services by or on behalf of a certified home health
agency or licensed home care services agency to the  extent  such  items
would  have  been  covered  under the contract if the covered person had
been hospitalized or confined in a skilled nursing facility  as  defined

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in  subchapter  XVIII  of  the federal Social Security Act, 42 U.S.C. SS
1395 et seq.
  WHERE  HOMEMAKER  SERVICES  ARE  PROVIDED  THROUGH  PRIVATE  HOME AIDE
SERVICES SUCH CARE SHALL CONSIST OF ONE OR MORE OF THE FOLLOWING:
  (I) SUCH AIDE SHALL HAVE MET THE STANDARDS ESTABLISHED BY THE  DEPART-
MENT OF FAMILY ASSISTANCE.
  (II)  SUCH  SERVICES ARE REIMBURSABLE THROUGH THE PARTNERSHIP FOR LONG
TERM CARE PROGRAM PURSUANT TO SECTION THREE HUNDRED SIXTY-SEVEN-F OF THE
SOCIAL SERVICES LAW.
  (III) PART-TIME  OR  INTERMITTENT  HOMEMAKER  SERVICES  WHICH  CONSIST
PRIMARILY OF CARING FOR THE PATIENT.
  S  13.  Subparagraphs  (B) and (C) of paragraph 3 of subsection (a) of
section 4303 of the insurance law, as amended by chapter 557 of the laws
of 2000, are amended and a new subparagraph (C-1) is added  to  read  as
follows:
  (B) Home care shall be provided by an agency [possessing] OR THROUGH A
PRIVATE HOME AIDE SERVICE PURSUANT TO THIS PARAGRAPH. WHERE HOME CARE IS
PROVIDED  BY  AN AGENCY SUCH AGENCY SHALL POSSESS a valid certificate of
approval or license issued pursuant to article thirty-six of the  public
health law.
  (C)  Home  care  PROVIDED BY AN AGENCY shall consist of one or more of
the following:
  (i) part-time or intermittent home nursing care by or under the super-
vision of a registered professional nurse (R.N.),
  (ii) part-time or intermittent home health aide services which consist
primarily of caring for the patient,
  (iii) physical, occupational or speech therapy if provided by the home
health service or agency, and
  (iv) medical supplies, drugs and medications prescribed  by  a  physi-
cian, and laboratory services by or on behalf of a certified home health
agency  or  licensed  home care services agency to the extent such items
would have been covered or provided under the contract  if  the  covered
person  had  been hospitalized or confined in a skilled nursing facility
as defined in subchapter XVIII of the Social Security Act, 42 U.S.C. [S]
SS 1395 et seq.
  (C-1) HOMEMAKER SERVICES PROVIDED THROUGH A PRIVATE HOME AIDE  SERVICE
SHALL CONSIST OF ONE OR MORE OF THE FOLLOWING:
  (I)  SUCH AIDE SHALL HAVE MET THE STANDARDS ESTABLISHED BY THE DEPART-
MENT OF FAMILY ASSISTANCE.
  (II) SUCH SERVICES ARE REIMBURSABLE THROUGH THE PARTNERSHIP  FOR  LONG
TERM CARE PROGRAM PURSUANT TO SECTION THREE HUNDRED SIXTY-SEVEN-F OF THE
SOCIAL SERVICES LAW.
  (III)  PART-TIME  OR  INTERMITTENT  HOMEMAKER  SERVICES  WHICH CONSIST
PRIMARILY OF CARING FOR THE PATIENT.
  S 14. Paragraph (b) of subdivision 1 of section 367-f  of  the  social
services law, as added by chapter 659 of the laws of 1997, is amended to
read as follows:
  (b)  "Long  term  care  services" shall include, but not be limited to
care, treatment, maintenance, and services: provided in a nursing facil-
ity licensed under  article  twenty-eight  of  the  public  health  law;
provided by a home care services agency, certified home health agency or
long  term  home  health  care program, as defined in section thirty-six
hundred two of the public health law; provided by an  adult  day  health
care program in accordance with regulations of the department of health;
[or]  provided  by a personal care provider licensed or regulated by any
other state or local agency; OR HOMEMAKER SERVICES THROUGH PRIVATE  HOME

A. 4845                             7

AIDES  AS PROVIDED IN SUBDIVISION FOUR OF SECTION THIRTY-SIX HUNDRED TWO
OF THE PUBLIC HEALTH LAW; and such  other  services  for  which  medical
assistance  is  otherwise  available under this chapter which are desig-
nated as long term care services in law or regulations of the department
of health.
  S  15.  The department of financial services shall analyze and compare
expenditures, utilization rates, and utilization patterns for claims for
home care services covered by individual and group accident  and  health
insurance  for the period commencing two years immediately preceding the
effective date of this act and ending two  years  immediately  following
the  effective  date  of  this act. The department of financial services
shall report its findings to the governor, the  temporary  president  of
the senate, and the speaker of the assembly on or before April 1, 2015.
  S 16. This act shall take effect on the first of January next succeed-
ing  the  date  on  which  it shall have become a law and shall apply to
policies or contracts issued, renewed, modified, altered, or amended  on
or after such date.