senate Bill S2504

2013-2014 Legislative Session

Relates to income eligibility for certain medical assistance programs; repealer

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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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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 08, 2014 referred to health
Jan 18, 2013 referred to health

S2504 - Bill Details

See Assembly Version of this Bill:
A2280
Current Committee:
Law Section:
Social Services Law
Laws Affected:
Amd §§366, 369-ee & 366-a, rpld §366 sub 1 ¶(a) sub¶ 5-a, Soc Serv L; amd Part B §23-a, Chap 436 of 1997
Versions Introduced in 2011-2012 Legislative Session:
S5402, A7816

S2504 - Bill Texts

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Relates to income eligibility for certain medical assistance programs; restores amendments made in 2009 to require resource testing for certain benefits.

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BILL NUMBER:S2504

TITLE OF BILL: An act to amend the social services law, in relation
to income eligibility; to amend chapter 436 of the laws of 1997,
constituting the welfare reform act of 1997, in relation to persons
who are subject to the photograph identification requirements
established by the commissioner of health for the medical assistance
program; and to repeal certain provisions of the social services law,
relating to income eligibility of certain persons

PURPOSE: To enhance cost savings and reduce Medicaid fraud by
reinstating the use of a resource asset test for Medicaid eligibility.
In addition, it reinstates the initial personal interview upon the
filing of an application for Medicaid.

SUMMARY OF PROVISIONS: Amends the social services law to reinstate
the resource test for Medicaid eligibility and make changes to conform
language to the provisions associated with such reinstatement. Also
amends the social services law to reinstate the requirements of a
personal interview when possible when applying for Medicaid.

EXISTING LAW: Existing law allows individuals to qualify for Medicaid
without reporting their resources. They only need to report income. In
addition, there are no requirements that a personal interview be
conducted by social services during the application process.

JUSTIFICATION: The 2009 State Budget included language that repealed
the resource asset test for Medicaid eligibility. This test,was part
of a social services district's procedures to ensure that people that
received Medicaid truly qualified for the service. It prevented people
from hiding their resources including houses, cars, and businesses.
There have been instances reported in the media in which individuals
had million dollar homes, luxury automobiles and successful
businesses, but because they were self employed, they were able to
hide their income and qualify for Medicaid, providing free health
insurance to their entire families. The Daily News reported a sweep by
the Manhattan District Attorney of nine- teen Medicaid cheats -
including some with luxury cars and million-dollar homes that
collected Medicaid benefits meant for the poor. The list included a
Hamptons homeowner who claimed to get by on $5,000 a year, an artist
who cried poverty despite owning two million dollar Manhattan
apartments.

Removing this safeguard was a poor policy-making decision at a time
when this State needs to be prudent with taxpayers' money. The
Medicaid system was designed as a safety net for low-income people who
could not afford health coverage, not for people who have the means
but simply do not want to pay for it. This legislation will put the
provisions of screening for Medicaid eligibility back into place
exactly as they existed prior to the 2009 legislation so the system
can provide the benefits for those most in need.

LEGISLATIVE HISTORY:

S.5402 of 2012 - Referred to Health 01/04/12


FISCAL IMPLICATIONS: Cost savings to the State.

LOCAL FISCAL IMPLICATIONS:

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
________________________________________________________________________

                                  2504

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 18, 2013
                               ___________

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

AN ACT to amend the social services law, in relation to income eligibil-
  ity; to amend chapter 436  of  the  laws  of  1997,  constituting  the
  welfare  reform act of 1997, in relation to persons who are subject to
  the photograph identification requirements established by the  commis-
  sioner  of  health  for  the medical assistance program; and to repeal
  certain provisions of the social  services  law,  relating  to  income
  eligibility of certain persons

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

  Section 1. Clauses (ii) and (iii) of subparagraph 1 and  subparagraphs
3  and  4 of paragraph (a) of subdivision 1 of section 366 of the social
services law, as amended by section 58 of part C of chapter  58  of  the
laws of 2009, are amended to read as follows:
  (ii)  such  person  [shall not be subject to a resource test] MAY HAVE
RESOURCES UP TO THE AMOUNT SPECIFIED IN SUBPARAGRAPH FOUR  OF  PARAGRAPH
(A) OF SUBDIVISION TWO OF THIS SECTION;
  (iii)  a person whose income [is] AND RESOURCES ARE within the [limit]
LIMITS set forth in [clause] CLAUSES (i) AND (II) of  this  subparagraph
shall  be  deemed  to  have  unmet needs for purposes of the eligibility
requirements of the safety net program as it existed on the first day of
November, nineteen hundred ninety-seven;
  (3) is a child under the age of twenty-one years  receiving  care  (A)
away  from  his  own home in accordance with title two of article six of
this chapter; (B) during the initial thirty days of placement  with  the
[division  for youth] OFFICE OF CHILDREN AND FAMILY SERVICES pursuant to
section 353.3 of the family court act; (C) in an authorized agency  when
placed pursuant to section seven hundred fifty-six or 353.3 of the fami-
ly  court act; or (D) in residence at a division foster family home or a
division contract home, and has not, according to the  criteria  promul-
gated  by  the  department,  sufficient  income AND RESOURCES, including
available support from his  parents,  to  meet  all  costs  of  required
medical care and services available under this title; or

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04076-01-3

S. 2504                             2

  (4) is receiving care, in the case of and in connection with the birth
of  an out of wedlock child, in accordance with title two of article six
of this chapter, and has not, according to the criteria  promulgated  by
the  department,  sufficient  income  AND RESOURCES, including available
support  from  responsible  relatives,  to  meet  all  costs of required
medical care and services available under this title; or
  S 2. Subparagraphs 5, 6 and 8 of paragraph (a)  of  subdivision  1  of
section 366 of the social services law, subparagraphs 5 and 6 as amended
by  section 59 of part C of chapter 58 of the laws of 2009, subparagraph
8 as separately amended by sections 59 and 63 of part C of chapter 58 of
the laws of 2009, are amended to read as follows:
  (5) although not receiving public assistance or care for  his  or  her
maintenance  under  other provisions of this chapter, has NOT, ACCORDING
TO THE CRITERIA AND STANDARDS ESTABLISHED BY THIS ARTICLE OR  BY  ACTION
OF  THE DEPARTMENT, SUFFICIENT income and resources, including available
support from responsible relatives, [that does not  exceed  the  amounts
set  forth in paragraph (a) of subdivision two of this section,] TO MEET
ALL THE COSTS OF MEDICAL CARE AND SERVICES AVAILABLE UNDER  THIS  TITLE,
and is (i) UNDER THE AGE OF TWENTY-ONE YEARS, OR sixty-five years of age
or older, or certified blind or certified disabled or (ii) A SPOUSE OF A
CASH PUBLIC ASSISTANCE RECIPIENT LIVING WITH HIM OR HER AND ESSENTIAL OR
NECESSARY  TO  HIS OR HER WELFARE AND WHOSE NEEDS ARE TAKEN INTO ACCOUNT
IN DETERMINING THE AMOUNT OF HIS  OR  HER  CASH  PAYMENT  OR  (III)  for
reasons  other  than income or resources[,]: (A) is eligible for federal
supplemental security income benefits and/or additional state  payments;
OR  (B)  WOULD MEET THE ELIGIBILITY REQUIREMENTS OF THE AID TO DEPENDENT
CHILDREN PROGRAM AS IT EXISTED ON THE SIXTEENTH DAY  OF  JULY,  NINETEEN
HUNDRED NINETY-SIX; or
  (6)  is  a resident of a home for adults operated by a social services
district or a residential care center for adults or community  residence
operated  or  certified  by  the  office  of mental health, and has not,
according to criteria promulgated by the department consistent with this
title, sufficient income[, or in the case of a person  sixty-five  years
of  age  or  older,  certified  blind, or certified disabled, sufficient
income] and resources,  including  available  support  from  responsible
relatives,  to  meet all the costs of required medical care and services
available under this title; or
  (8) is a member of a family which contains a  dependent  child  living
with  a  caretaker  relative, which has[: (i) subject to the approval of
the federal Centers for Medicare and Medicaid services, gross income not
in excess of one hundred percent of the federal income official  poverty
line  (as  defined and annually revised by the federal office of manage-
ment and budget) for a family of the same  size  as  the  families  that
include  the  children  or  (ii)  in  the absence of such approval,] net
available income not in excess of one  hundred  thirty  percent  of  the
highest  amount that ordinarily would have been paid to a person without
any income or resources  under  the  family  assistance  program  as  it
existed  on the first day of November, nineteen hundred ninety-seven, to
be increased annually by the same percentage as the percentage  increase
in  the  federal  consumer  price  index,  AND  WHICH  HAS NET AVAILABLE
RESOURCES NOT IN EXCESS OF THE AMOUNT SPECIFIED IN SUBPARAGRAPH FOUR  OF
PARAGRAPH  (A)  OF SUBDIVISION TWO OF THIS SECTION; for purposes of this
subparagraph, the net available income AND RESOURCES of a  family  shall
be  determined using the methodology of the family assistance program as
it exists on the first day of November, nineteen  hundred  ninety-seven,
except  that no part of the methodology of the family assistance program

S. 2504                             3

will be used which is more restrictive than the methodology of  the  aid
to  dependent  children  program  as  it existed on the sixteenth day of
July, nineteen hundred ninety-six; for purposes  of  this  subparagraph,
the  term  dependent  child means a person under twenty-one years of age
who is deprived of parental support or care  by  reason  of  the  death,
continued  absence,  or physical or mental incapacity of a parent, or by
reason of the unemployment of the parent, as defined by  the  department
of health; or
  S 3. Subparagraph 5-a of paragraph (a) of subdivision 1 of section 366
of the social services law is REPEALED.
  S  4. Subparagraph 10 of paragraph (a) of subdivision 1 of section 366
of the social services law, as amended by section  59-a  of  part  C  of
chapter 58 of the laws of 2009, is amended to read as follows:
  (10)  is  a  child  who  is  under twenty-one years of age, who is not
living with a caretaker relative, who has net available  income  not  in
excess  of  the  income standards of the family assistance program as it
existed on the first day of November, nineteen hundred ninety-seven, AND
WHO HAS NET AVAILABLE RESOURCES NOT IN EXCESS OF ONE  THOUSAND  DOLLARS;
for  purposes of this subparagraph, the child's net available income AND
RESOURCES shall be  determined  using  the  methodology  of  the  family
assistance  program as it existed on the first day of November, nineteen
hundred ninety-seven, except that: (I) THERE  SHALL  BE  DISREGARDED  AN
ADDITIONAL  AMOUNT  OF  RESOURCES  EQUAL  TO  THE DIFFERENCE BETWEEN THE
APPLICABLE RESOURCE STANDARD OF THE  FAMILY  ASSISTANCE  PROGRAM  AS  IT
EXISTS  ON  THE FIRST DAY OF NOVEMBER, NINETEEN HUNDRED NINETY-SEVEN AND
ONE THOUSAND DOLLARS AND (II) no part of the methodology of  the  family
assistance program will be used which is more restrictive than the meth-
odology  of  the  aid to dependent children program as it existed on the
sixteenth day of July, nineteen hundred ninety-six; or
  S 5. Subdivision 1 of section 369-ee of the  social  services  law  is
amended by adding a new paragraph (i) to read as follows:
  (I) "RESOURCES" FOR PURPOSES OF THIS TITLE SHALL HAVE THE SAME MEANING
AS  DETERMINED  IN  ACCORDANCE  WITH PARAGRAPH (A) OF SUBDIVISION TWO OF
SECTION THREE HUNDRED SIXTY-SIX OF THIS ARTICLE.
  S 6. Subdivision 2 of section 369-ee of the  social  services  law  is
amended by adding a new paragraph (c) to read as follows:
  (C)  FOR  THE  PURPOSES  OF THIS TITLE, THE DETERMINATION OF RESOURCES
SHALL BE IN ACCORDANCE WITH PARAGRAPHS (B) AND (C) OF SUBDIVISION TWO OF
SECTION THREE HUNDRED SIXTY-SIX-A OF THIS ARTICLE.
  S 7. The opening paragraph  of  paragraph  (b)  of  subdivision  2  of
section 369-ee of the social services law, as amended by section 59-c of
part C of chapter 58 of the laws of 2009, is amended to read as follows:
  Subject  to  the  provisions  of paragraph (d) of this subdivision, in
order to establish INCOME eligibility  under  this  subdivision,  [which
shall  be  determined  without regard to resources,] an individual shall
provide such documentation as is necessary and sufficient to  initially,
and annually thereafter, determine an applicant's eligibility for cover-
age  under  this  title.  Such  documentation  shall include, but not be
limited to the following, if needed to verify eligibility:
  S 8.  Subdivision 1 and paragraph (a)  of  subdivision  2  of  section
366-a  of the social services law, as amended by section 60 of part C of
chapter 58 of the laws of 2009, is amended to read as follows:
  1. Any person  requesting  medical  assistance  may  make  application
therefor  in  person, through another in his OR HER behalf or by mail to
the social services official of the county, city  or  town,  or  to  the
service officer of the city or town in which the applicant resides or is

S. 2504                             4

found.   In addition, in the case of a person who is sixty-five years of
age or older and is a patient in a state hospital  for  tuberculosis  or
for the mentally disabled, applications may be made to the department or
to a social services official designated as the agent of the department.
Notwithstanding any provision of law to the contrary, IN ACCORDANCE WITH
DEPARTMENT REGULATIONS, WHEN AND APPLICATION IS MADE BY MAIL, a personal
interview  SHALL  BE CONDUCTED with the applicant or with the person who
made application on his or her behalf [shall not be required as part  of
a  determination  of  initial or continuing eligibility pursuant to this
title] WHEN THE APPLICANT CANNOT BE INTERVIEWED DUE TO HIS OR HER  PHYS-
ICAL OR MENTAL CONDITION.
  (a)  Upon receipt of such application, the appropriate social services
official, or the department of health or its agent when the applicant is
a patient in a state hospital for the mentally  disabled,  shall  verify
the eligibility of such applicant. In accordance with the regulations of
the  department  of health, it shall be the responsibility of the appli-
cant to provide information and documentation necessary for the determi-
nation of initial and ongoing eligibility for medical assistance.  If an
applicant or recipient is unable to provide necessary documentation, the
public welfare official shall promptly  cause  an  investigation  to  be
made.  Where an investigation is necessary, sources of information other
than public records will be consulted only with permission of the appli-
cant or recipient. In the event that such permission is not  granted  by
the  applicant  or  recipient,  or  necessary  documentation  cannot  be
obtained, the social services official or the department  of  health  or
its  agent  may suspend or deny medical assistance until such time as it
may be satisfied as to the applicant's or recipient's eligibility there-
for.  TO THE EXTENT PRACTICABLE, ANY INTERVIEW CONDUCTED AS A RESULT  OF
AN  APPLICATION FOR MEDICAL ASSISTANCE SHALL BE CONDUCTED IN THE HOME OF
THE PERSON INTERVIEWED OR IN THE INSTITUTION IN  WHICH  SUCH  PERSON  IS
RECEIVING MEDICAL ASSISTANCE.
  S  9.  Paragraph (a) of  subdivision 5 of section 369-ee of the social
services law, as amended by section 61 of part C of chapter  58  of  the
laws of 2009, is amended to read as follows:
  (a)  [A  personal  interview with the applicant or with the person who
made application on his or her behalf shall not be required as part of a
determination of initial or  continuing  eligibility  pursuant  to  this
title.]   PERSONAL   INTERVIEWS,   PURSUANT  TO  SECTION  THREE  HUNDRED
SIXTY-SIX-A OF THIS CHAPTER, MAY BE REQUIRED  UPON  INITIAL  APPLICATION
ONLY  AND  MAY  BE  CONDUCTED  IN COMMUNITY SETTINGS. Recertification of
eligibility shall take place on no more than an annual basis  AND  SHALL
NOT  REQUIRE  A  PERSONAL  INTERVIEW.   Nothing herein shall abridge the
participant's obligation  to  report  changes  in  residency,  financial
circumstances or household composition.
  S  10.    Section  23-a  of part B of chapter 436 of the laws of 1997,
constituting the welfare reform act of 1997, as amended by section 62 of
part C of chapter 58 of the laws of 2009, is amended to read as follows:
  S 23-a. Notwithstanding any contrary provision thereof, section 266 of
chapter 83 of the laws of 1995 shall apply to applicants for or  recipi-
ents  of  public  assistance  and  care,  INCLUDING  MEDICAL ASSISTANCE;
provided, however, that [such section shall not apply to]  WITH  RESPECT
TO  MEDICAL ASSISTANCE, SUCH SECTION SHALL APPLY ONLY TO PERSONS WHO ARE
SUBJECT TO THE PHOTOGRAPH IDENTIFICATION REQUIREMENTS ESTABLISHED BY THE
COMMISSIONER OF HEALTH FOR the medical assistance program.
  S 11. This act shall take effect immediately.

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