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

                                 2714--A

                       2013-2014 Regular Sessions

                          I N  A S S E M B L Y

                            January 17, 2013
                               ___________

Introduced  by M. of A. SCHIMMINGER, GOODELL -- Multi-Sponsored by -- M.
  of A.  DIPIETRO, GIGLIO, HAWLEY, HOOPER, MAGEE, RIVERA  --  read  once
  and  referred to the Committee on Health -- recommitted to the Commit-
  tee on Health in accordance with Assembly Rule 3, sec. 2 --  committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

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

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

  Section  1.  Paragraph  (a)  of  subdivision 2 of section 365-a of the
social services law, as amended by chapter 47 of the laws  of  1996,  is
amended to read as follows:
  (a)  services  of qualified physicians, [dentists, nurses, and private
duty nursing services shall be further  subject  to  the  provisions  of
section  three  hundred  sixty-seven-o  of  this chapter,] optometrists,
NURSE MIDWIVES, NURSE  PRACTITIONERS,  and  other  related  professional
personnel;
  S  2.  Paragraph  (f)  of subdivision 2 of section 365-a of the social
services law, as added by chapter 184 of the laws of 1969 and as  relet-
tered by chapter 478 of the laws of 1980, is amended to read as follows:
  (f)  preventive,  prophylactic and other routine dental care, services
and supplies ONLY WHEN PROVIDED  IN  A  HOSPITAL  OUTPATIENT  OR  CLINIC
FACILITY REFERRED TO IN PARAGRAPH (C) OF THIS SUBDIVISION;
  S  3.  Paragraph  (g)  of subdivision 2 of section 365-a of the social
services law, as amended by section 21 of part A of chapter  56  of  the
laws of 2013, is amended to read as follows:
  (g)  sickroom  supplies,  eyeglasses,  AND  prosthetic appliances [and
dental prosthetic appliances] furnished in  accordance  with  the  regu-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04839-03-4
              

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lations  of  the department; provided further that: (i) the commissioner
of health is authorized to implement a preferred diabetic supply program
wherein the department of health  will  receive  enhanced  rebates  from
preferred  manufacturers of glucometers and test strips, and may subject
non-preferred  manufacturers'  glucometers  and  test  strips  to  prior
authorization  under  section  two  hundred  seventy-three of the public
health law; (ii) enteral formula therapy and nutritional supplements are
limited to coverage only for nasogastric,  jejunostomy,  or  gastrostomy
tube  feeding,  for  treatment  of  an  inborn metabolic disorder, or to
address growth and development problems  in  children,  or,  subject  to
standards  established by the commissioner, for persons with a diagnosis
of HIV infection, AIDS or HIV-related  illness  or  other  diseases  and
conditions;  (iii)  prescription  footwear  and  inserts  are limited to
coverage only when used as an integral part of  a  lower  limb  orthotic
appliance,  as  part  of a diabetic treatment plan, or to address growth
and development problems  in  children;  (iv)  compression  and  support
stockings  are  limited  to  coverage only for pregnancy or treatment of
venous stasis ulcers; and (v) the commissioner of health  is  authorized
to  implement  an  incontinence supply utilization management program to
reduce costs without  limiting  access  through  the  existing  provider
network,  including  but  not  limited  to  single  or  multiple  source
contracts or,  a  preferred  incontinence  supply  program  wherein  the
department  of  health  will  receive  enhanced  rebates  from preferred
manufacturers of incontinence supplies, and  may  subject  non-preferred
manufacturers' incontinence supplies to prior approval pursuant to regu-
lations of the department, provided any necessary approvals under feder-
al  law have been obtained to receive federal financial participation in
the costs of incontinence supplies provided pursuant  to  this  subpara-
graph;  AND  (VI)  THE  COMMISSIONER  OF HEALTH IS AUTHORIZED TO REQUIRE
PRIOR APPROVAL OF ANY PRESCRIPTION DRUG THAT IS PRESCRIBED FOR  A  RESI-
DENT OF A NURSING HOME AND THAT IS NOT REIMBURSED AS PART OF THE NURSING
HOME'S MEDICAID RATE;
  S  4.  Paragraph  (l)  of subdivision 2 of section 365-a of the social
services law, as amended by chapter 81 of the laws of 1995,  is  amended
to read as follows:
  (l)  care  and services of podiatrists, CLINICAL PSYCHOLOGISTS, NURSES
AND AUDIOLOGISTS, INCLUDING SUCH CARE AND SERVICES PROVIDED IN A  HOSPI-
TAL  OUT-PATIENT OR CLINIC FACILITY REFERRED TO IN PARAGRAPH (C) OF THIS
SUBDIVISION, AND  DENTISTS,  which  care  and  services  shall  only  be
provided  upon  referral by a physician, nurse practitioner or certified
nurse midwife in accordance with  the  program  of  early  and  periodic
screening  and  diagnosis  established  pursuant to subdivision three of
this section or to persons eligible for benefits under  title  XVIII  of
the  federal  social security act as qualified medicare beneficiaries in
accordance with federal requirements therefor [and private  duty  nurses
which  care and services shall only be provided in accordance with regu-
lations of the department of health;  provided,  however,  that  private
duty  nursing  services  shall  not be restricted when such services are
more appropriate and cost-effective than nursing services provided by  a
home health agency pursuant to section three hundred sixty-seven-l];
  S  5.  Paragraph  (n)  of subdivision 2 of section 365-a of the social
services law, as added by chapter 556 of the laws of 1986, is REPEALED.
  S 6. The commissioner of health is authorized to promulgate  or  adopt
any  rules  or regulations necessary to implement the provisions of this
act and any procedures, forms, or instructions necessary for such imple-
mentation may be adopted and issued on or after the  effective  date  of

A. 2714--A                          3

this act. Notwithstanding any inconsistent provision of the state admin-
istrative  procedure  act  or  any other provision of law, rule or regu-
lation, the commissioner of health and the superintendent  of  insurance
and  any  appropriate council is authorized to adopt or amend or promul-
gate on an emergency basis any regulation he  or  she  or  such  council
determines  necessary  to  implement  any  provision  of this act on its
effective date.
  S 7. This act shall take effect on the one hundred eightieth day after
it shall have become a law.