The New York State Senate

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

    S. 6914                                                  A. 9205

                      S E N A T E - A S S E M B L Y

                             March 29, 2014
                               ___________

IN  SENATE -- A BUDGET BILL, submitted by the Governor pursuant to arti-
  cle seven of the Constitution -- read twice and ordered  printed,  and
  when printed to be committed to the Committee on Finance

IN  ASSEMBLY  --  A  BUDGET  BILL, submitted by the Governor pursuant to
  article seven of the Constitution -- read once  and  referred  to  the
  Committee on Ways and Means

AN  ACT to amend the public health law, in relation to prenatal clinical
  health care services; to amend the public health law, in  relation  to
  simplifying  consent  for HIV testing; to amend the public health law,
  in relation to authorization  for  data  sharing  with  providers  for
  purposes of patient linkage and retention in care; to amend the public
  health  law, in relation to biennial reports for the control of malig-
  nant diseases; to amend the state finance  law,  in  relation  to  the
  breast  cancer research and education fund; to amend the public health
  law, and the state finance law, in relation to  the  cancer  detection
  and education program advisory counsel; to amend the vehicle and traf-
  fic  law,  in  relation  to a distinctive "drive for the cure" license
  plate; to amend the tax law, in relation to the gift for prostate  and
  testicular  research and education; to amend the public health law, in
  relation to the capital restructuring financing program; to amend  the
  public  health  law,  in  relation to delivery system reform incentive
  payments; to amend the public health  law,  in  relation  to  eligible
  applicants  for  the  Medicaid redesign team initiatives; to amend the
  state finance law, in relation to the Alzheimer's  disease  assistance
  fund;  to  amend  the  public health law, in relation to participating
  borrowers; to amend the elder law, in relation to program  eligibility
  for catastrophic coverage; to amend the public health law, in relation
  to the primary care service corps practitioner loan repayment program;
  to  amend the public health law, in relation to evaluating the state's
  health information technology infrastructure and systems; to amend the
  public health law, in relation to the establishment  of  certain  free
  standing  clinics,  outpatient  health  care facilities and ambulatory
  health care centers in the county of Bronx; in  relation  to  payments
  submitted  by  early  intervention  providers  to  certain third party
  payors; to amend the public health  law  and  the  insurance  law,  in
  relation  to safe patient handling; to amend the public health law and

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

                      [ ] is old law to be omitted.
                                                           LBD12676-01-4

S. 6914                             2                            A. 9205

  the social services law, in relation to  review  of  criminal  history
  information  concerning  prospective  employees;  to  amend the public
  health law, in relation to the provision of contact information relat-
  ing  to  long  term care; to amend the public health law and the state
  finance law, in relation to the operation of the New York State donate
  life registry; to amend the social services law and the public  health
  law,  in  relation  to  streamlining the application process for adult
  care facilities and assisted living residences; to  amend  the  public
  health  law, in relation to the long term home health care program; to
  amend the public health law, in relation to resident  working  audits;
  to  amend  chapter  58  of the laws of 2008 amending the elder law and
  other laws relating to reimbursement to particular provider pharmacies
  and prescription drug coverage, in relation to the effectiveness ther-
  eof; and to repeal certain provisions of the public health law and the
  state finance law relating thereto (Part A); to  amend  the  New  York
  Health  Care  Reform  Act  of  1996,  in relation to extending certain
  provisions relating thereto; to amend the New York Health Care  Reform
  Act  of 2000, in relation to extending the effectiveness of provisions
  thereof; to amend the public health law, in relation to  the  distrib-
  ution  of  pool  allocations  and graduate medical education; to amend
  chapter 62 of the laws of 2003 amending the general business  law  and
  other  laws  relating to enacting major components necessary to imple-
  ment the state fiscal plan for  the  2003-04  state  fiscal  year,  in
  relation  to  the deposit of certain funds; to amend the public health
  law, in relation to health  care  initiative  pool  distributions;  to
  amend  the  social  services  law,  in  relation  to extending payment
  provisions for general hospitals; to amend chapter 600 of the laws  of
  1986  amending  the  public  health law relating to the development of
  pilot reimbursement programs for ambulatory care services, in relation
  to the effectiveness of such chapter; to amend chapter 520 of the laws
  of 1978 relating to providing for a  comprehensive  survey  of  health
  care financing, education and illness prevention and creating councils
  for the conduct thereof, in relation to extending the effectiveness of
  portions  thereof;  to  amend  the  public  health law, in relation to
  extending access to community health care services in rural areas;  to
  amend  the  public  health  law,  in  relation to rates of payment for
  personal care service providers; to amend the public  health  law,  in
  relation  to  the  assessment  on  covered  lives; to amend the public
  health law, in relation to the comprehensive diagnostic and  treatment
  centers  indigent  care  program;  to  amend the public health law, in
  relation to general hospital indigent pool and general hospital  inpa-
  tient  reimbursement  rates;  to amend chapter 266 of the laws of 1986
  amending the civil practice law and rules and other laws  relating  to
  malpractice and professional medical conduct, in relation to extending
  the  applicability of certain provisions thereof; and to amend chapter
  63 of the laws of 2001 amending chapter 20 of the laws of 2001  amend-
  ing  the military law and other laws relating to making appropriations
  for the support of government, in relation to extending  the  applica-
  bility  of  certain  provisions  thereof (Part B); to amend the social
  services law, in relation to eliminating prescriber prevails for brand
  name drugs with  generic  equivalents;  directing  the  department  of
  health to develop new methodology for pharmacy reimbursement; to amend
  the public health law, in relation to minimum supplemental rebates for
  pharmaceutical  manufacturers;  to  amend  the social services law, in
  relation to  early  refill  of  prescriptions;  to  amend  the  social
  services  law,  in relation to emergency and non-emergency transporta-

S. 6914                             3                            A. 9205

  tion; to amend section 45-c of part A of chapter 56  of  the  laws  of
  2013,  relating  to  the report on the transition of behavioral health
  services as a managed care benefit in the medical assistance  program,
  in  relation to reports on the transition of behavior health services;
  to amend the social services law, in relation to  the  integration  of
  behavioral  and  physical  health  clinic services; to amend part A of
  chapter 56 of the laws of 2013 amending chapter 59 of the laws of 2011
  amending the public health law and  other  laws  relating  to  general
  hospital  reimbursement  for annual rates relating to the cap on local
  Medicaid expenditures, in relation to  establishing  rate  protections
  for behavioral health essential providers and the effectiveness there-
  of;  to  amend section 1 of part H of chapter 111 of the laws of 2010,
  relating to increasing Medicaid payments to providers through  managed
  care organizations and providing equivalent fees through an ambulatory
  patient  group  methodology,  in relation to transfer of funds and the
  effectiveness thereof; to amend the social services law,  in  relation
  to spousal support for the costs of community-based long term care; to
  amend the social services law, in relation to fair hearings within the
  Fully  Integrated  Duals Advantage program; to amend the public health
  law, in relation to the establishment of a default  rate  for  nursing
  homes  under managed care; to amend the public health law, in relation
  to rates of payment for certified home health agencies and  long  term
  home health care programs; to amend social services law in relation to
  Community  First  Choice Option; to amend education law in relation to
  developing training curricula to educate certain home health aides; to
  amend public health law in relation to Development Disabilities  Indi-
  vidual  Care and Support Organization; to amend the public health law,
  in relation to rate setting methodologies for the ICD-10; to amend the
  public health law, in relation to inpatient psych base years; to amend
  the public health law, in relation to specialty inpatient base  years;
  to  amend  the  public health law, in relation to inpatient psych base
  years; to amend the public health law, in relation to  hospital  inpa-
  tient  base  years; to amend part H of chapter 59 of the laws of 2011,
  amending the public health law and other laws relating  to  known  and
  projected  department  of  health state fund medicaid expenditures, in
  relation to the determination of rates of payments  by  certain  state
  governmental agencies; to amend the social services law and the public
  health  law,  in relation to requiring the use of an enrollment broker
  for counties that are mandated Medicaid managed care and managed  long
  term care; to amend the public health law, in relation to establishing
  vital  access  pools for licensed home care service agencies; to amend
  the social services law, in relation to the expansion of the  Medicaid
  managed  care  advisory review panel; to amend part H of chapter 59 of
  the laws of 2011 amending the public health law  relating  to  general
  hospital  inpatient reimbursement for annual rates, in relation to the
  across the board reduction of 2011; to amend the social services  law,
  in  relation  to  establishing  a health homes criminal justice initi-
  ative; to amend the social services law, in relation to the transition
  of children in foster care  to  managed  care;  to  amend  the  social
  services  law and the state finance law, in relation to the establish-
  ment of a basic health plan; to amend  the  social  services  law,  in
  relation to hospital presumptive eligibility under the affordable care
  act;  to  amend  the  state finance law, in relation to a basic health
  program trust fund and a state  health  innovation  plan  account;  to
  amend the social services law, in relation to spending down procedures
  under  the  MAGI  system  of  eligibility  determination; to amend the

S. 6914                             4                            A. 9205

  public health law, in relation to moving rate setting for child health
  plus to the department of health; to amend the public health  law,  in
  relation to eliminating the existing child health plus waiting period;
  to amend chapter 2 of the laws of 1998, amending the public health law
  and  other laws relating to expanding the child health insurance plan,
  in relation to allowing for the permanent expansion  of  child  health
  plus  income and benefit provisions; to amend the public health law in
  relation to potentially preventable negative outcomes;  to  amend  the
  public  health law, in relation to a rural dentistry pilot program; to
  amend chapter 779 of the laws of 1986, amending  the  social  services
  law relating to authorizing services for non-residents in adult homes,
  residences  for  adults  and enriched housing programs, in relation to
  extending the authorization  of  non-resident  services  within  adult
  homes; to amend part C of chapter 58 of the laws of 2008, amending the
  social  services law and the public health law relating to adjustments
  of  rates,  in  relation  to  extending  the   utilization   threshold
  exemption;  to  amend  chapter  19  of  the laws of 1998, amending the
  social services law relating to limiting the  method  of  payment  for
  prescription  drugs  under the medical assistance program, in relation
  to extending provisions related  to  dispensing  fees;  to  amend  the
  public  health  law,  in  relation  to rates of payment to residential
  health care facilities; to amend chapter 731  of  the  laws  of  1993,
  amending  the  public health law and other laws relating to reimburse-
  ment, delivery and capital cost of ambulatory health care services and
  inpatient hospital services, in relation to the effectiveness thereof;
  to amend chapter 904 of the laws of 1984, amending the  public  health
  law  and the social services law relating to encouraging comprehensive
  health services, in relation to the effectiveness  thereof;  providing
  for  the  repeal of certain provisions relating to the availability of
  funds upon expiration thereof; providing for  the  repeal  of  certain
  provisions relating to the availability of funds upon expiration ther-
  eof;  and  to repeal certain provisions of the social services law and
  the public health law relating thereto (Part C); to amend  the  educa-
  tion  law  and  the  public health law, in relation to the practice of
  pharmacy and the compounding of drugs, and  establishing  requirements
  for the registration of outsourcing facilities in New York state (Part
  D);  to  amend  the mental hygiene law, in relation to establishing an
  integrated employment plan (Part E); directing a report by the  office
  for  people  with developmental disabilities on the establishment of a
  direct support professional credentialing pilot program (Part  F);  to
  amend the mental hygiene law and the state finance law, in relation to
  community  mental health support and workforce reinvestment funds; and
  to amend chapter 62 of the laws of 2003, amending the  mental  hygiene
  law  and the state finance law relating to the community mental health
  support and workforce reinvestment program, the membership of  subcom-
  mittees  for mental health of community services boards and the duties
  of such subcommittees and creating the  community  mental  health  and
  workforce   reinvestment   account,  in  relation  to  extending  such
  provisions relating thereto (Part G); to amend the insurance law,  the
  public  health  law  and  the  financial  services law, in relation to
  establishing protections to prevent surprise medical  bills  including
  network  adequacy  requirements, claim submission requirements, access
  to out-of-network care and prohibition of excessive emergency  charges
  (Part  H);  and  to  amend chapter 57 of the laws of 2006, relating to
  establishing a cost of living adjustment for designated human services

S. 6914                             5                            A. 9205

  programs, in relation to forgoing such adjustment during the 2014-2015
  state fiscal year (Part I)

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

  Section 1. This act enacts into law major  components  of  legislation
which are necessary to implement the state fiscal plan for the 2014-2015
state  fiscal  year.  Each  component  is wholly contained within a Part
identified as Parts A through I. The effective date for each  particular
provision contained within such Part is set forth in the last section of
such Part. Any provision in any section contained within a Part, includ-
ing the effective date of the Part, which makes a reference to a section
"of  this  act", when used in connection with that particular component,
shall be deemed to mean and refer to the corresponding  section  of  the
Part  in  which  it  is  found. Section three of this act sets forth the
general effective date of this act.

                                 PART A

  Section 1. Paragraph (a) of subdivision 1 of section 602 of the public
health law, as added by section 16 of part E of chapter 56 of  the  laws
of 2013, is amended to read as follows:
  (a)  Family  health, which shall include activities designed to reduce
perinatal, infant and maternal mortality and morbidity  and  to  promote
the health of infants, children, adolescents, and people of childbearing
age.  Such  activities  shall include family centered perinatal services
and other services appropriate to promote the birth of a healthy baby to
a healthy mother, and services to assure that infants,  young  children,
and  school  age  children  are enrolled in appropriate health insurance
programs and other health benefit programs for which they are  eligible,
and  that  the  parents  or guardians of such children are provided with
information concerning health care providers  in  their  area  that  are
willing  and able to provide health services to such children. Provision
of primary and preventive clinical health care services shall be  eligi-
ble  for  state  aid  for uninsured persons under the age of twenty-one,
provided that the municipality makes good faith efforts to  assist  such
persons with insurance enrollment and only until such time as enrollment
becomes  effective.  PROVISION OF PRENATAL CLINICAL HEALTH CARE SERVICES
SHALL BE ELIGIBLE FOR STATE AID FOR UNINSURED WOMEN OF ANY AGE, PROVIDED
THAT THE MUNICIPALITY MAKES GOOD FAITH EFFORTS TO ASSIST SUCH WOMEN WITH
INSURANCE ENROLLMENT AND ONLY UNTIL  SUCH  TIME  AS  ENROLLMENT  BECOMES
EFFECTIVE.
  S  2. Subdivisions 1, 2, 2-a, 2-b, 2-c, 3 and 4 of section 2781 of the
public health law, subdivisions 1, 2, 3 and 4 as  amended  and  subdivi-
sions  2-a, 2-b and 2-c as added by chapter 308 of the laws of 2010, are
amended to read as follows:
  1. Except as provided in section three thousand one hundred twenty-one
of the civil practice law and rules, or  unless  otherwise  specifically
authorized  or required by a state or federal law, no person shall order
the performance of an HIV related test  without  first  having  received
[the  written  or, where authorized by this subdivision, oral,] informed
consent of the subject of the test who has capacity to consent or,  when
the  subject  lacks capacity to consent, of a person authorized pursuant
to law to consent to health care for such individual.   [When  the  test

S. 6914                             6                            A. 9205

being ordered is a rapid HIV test, such informed consent may be obtained
orally  and  shall  be  documented  in the subject of the test's medical
record by the person ordering the performance of the test.] IN ORDER FOR
THERE  TO BE INFORMED CONSENT, THE PERSON ORDERING THE TEST SHALL, PRIOR
TO OBTAINING INFORMED CONSENT, AT A MINIMUM ADVISE THE  PROTECTED  INDI-
VIDUAL THAT AN HIV-RELATED TEST IS BEING PERFORMED.
  2.  [Except  where  subdivision  one  of this section permits informed
consent to be obtained orally, informed consent to HIV  related  testing
shall consist of a statement consenting to HIV related testing signed by
the subject of the test who has capacity to consent or, when the subject
lacks  capacity  to  consent,  by a person authorized pursuant to law to
consent to health care for the subject after the subject or  such  other
person  has  received  the information described in subdivision three of
this section.
  2-a. Where a written consent to HIV related testing is included  in  a
signed general consent to medical care for the subject of the test or in
a signed consent to any health care service for the subject of the test,
the  consent  form  shall  have  a  clearly marked place adjacent to the
signature where the subject of the test,  or,  when  the  subject  lacks
capacity  to  consent, a person authorized pursuant to law to consent to
health care for such  individual,  shall  be  given  an  opportunity  to
specifically  decline  in  writing  HIV  related testing on such general
consent.
  2-b. A written or oral informed]  INFORMED  consent  for  HIV  related
testing  pursuant  to this section shall be valid for such testing until
such consent is revoked [or expires by its terms]. Each time that an HIV
related test is ordered pursuant to informed consent in accordance  with
this  section,  the physician or other person authorized pursuant to law
to order the performance of the  HIV  related  test,  or  such  person's
representative, shall orally notify the subject of the test or, when the
subject  lacks  capacity to consent, a person authorized pursuant to law
to consent to health care for such individual, that an HIV related  test
will  be  conducted at such time, and shall note the notification in the
patient's record.
  [2-c.] 2-A. The provisions of this section regarding  [oral]  informed
consent  [for  a rapid HIV test] shall not apply to tests performed in a
facility operated under the correction law.   FOR TESTS CONDUCTED  IN  A
FACILITY  UNDER  THE  CORRECTION LAW, INDIVIDUAL CONSENT FOR HIV RELATED
TESTING MUST BE IN WRITING.
  3. [Prior to the execution of written, or  obtaining  and  documenting
oral,  informed  consent, a] A person ordering the performance of an HIV
related test shall provide either directly or through  a  representative
to  the subject of an HIV related test or, if the subject lacks capacity
to consent, to a person authorized pursuant to law to consent to  health
care for the subject, an explanation that:
  (a)  HIV  causes AIDS and can be transmitted through sexual activities
and needle-sharing, by pregnant women  to  their  fetuses,  and  through
breastfeeding infants;
  (b)  there is treatment for HIV that can help an individual stay heal-
thy;
  (c) individuals with HIV or AIDS can adopt safe practices  to  protect
uninfected  and infected people in their lives from becoming infected or
multiply infected with HIV;
  (d) testing is voluntary and can be done anonymously at a public test-
ing center;
  (e) the law protects the confidentiality of HIV related test results;

S. 6914                             7                            A. 9205

  (f) the law prohibits discrimination  based  on  an  individual's  HIV
status and services are available to help with such consequences; and
  (g)  the  law  allows an individual's informed consent for HIV related
testing to be valid for such testing until such consent  is  revoked  by
the subject of the HIV RELATED test [or expires by its terms].
  Protocols shall be in place to ensure compliance with this section.
  4.  A person authorized pursuant to law to order the performance of an
HIV related test shall provide directly or through a  representative  to
the person seeking such test, an opportunity to remain anonymous [and to
provide  written,  informed  consent  or authorize documentation of oral
informed consent,] through use of a coded  system  with  no  linking  of
individual  identity  to  the  test  request  or  results. A health care
provider who is not  authorized  by  the  commissioner  to  provide  HIV
related tests on an anonymous basis shall refer a person who requests an
anonymous  test to a test site which does provide anonymous testing. The
provisions of this subdivision shall not apply to a health care provider
ordering the performance  of  an  HIV  related  test  on  an  individual
proposed for insurance coverage.
  S  3. Section 2135 of the public health law, as amended by chapter 308
of the laws of 2010, is amended to read as follows:
  S 2135. Confidentiality. All reports or  information  secured  by  the
department,  municipal  health  commissioner  or district health officer
under the provisions of this title shall be confidential except: (a)  in
so  far  as  is necessary to carry out the provisions of this title; (b)
when used in the aggregate, without patient specific identifying  infor-
mation,  in programs approved by the commissioner for the improvement of
the quality of medical care provided to persons with HIV/AIDS; [or]  (c)
when  used  within the state or local health department by public health
disease programs to assess co-morbidity or completeness of reporting and
to direct program needs, in  which  case  patient  specific  identifying
information  shall  not  be  disclosed outside the state or local health
department; OR (D)  WHEN  USED  FOR  PURPOSES  OF  PATIENT  LINKAGE  AND
RETENTION IN CARE, PATIENT SPECIFIC IDENTIFIED INFORMATION MAY BE SHARED
BETWEEN  LOCAL  AND  STATE  HEALTH DEPARTMENTS AND HEALTH CARE PROVIDERS
CURRENTLY TREATING THE PATIENT AS APPROVED BY THE COMMISSIONER.
  S 4. Intentionally omitted.
  S 5. Subdivision 1 of section  2411  of  the  public  health  law,  as
amended  by chapter 219 of the laws of 1997, paragraph (e) as amended by
chapter 106 of the laws of 2013, and paragraph (h) as amended by chapter
638 of the laws of 2008, is amended to read as follows:
  1. The board shall:
  (a) Survey state agencies, boards, programs and  other  state  govern-
mental  entities  to  assess  what, if any, relevant data has been or is
being collected which may be of use to researchers engaged  in  breast[,
prostate or testicular] cancer research;
  (b)  Consistent with the survey conducted pursuant to paragraph (a) of
this subdivision, compile a list of data  collected  by  state  agencies
which  may  be of assistance to researchers engaged in breast[, prostate
or testicular] cancer research as  established  in  section  twenty-four
hundred twelve of this title;
  (c)  Consult  with the Centers for Disease Control and Prevention, the
National Institutes of Health, the Federal Agency For Health Care Policy
and Research, the National Academy of Sciences and  other  organizations
or  entities  which  may  be involved in cancer research to solicit both
information regarding breast[, prostate and testicular] cancer  research

S. 6914                             8                            A. 9205

projects  that  are  currently  being  conducted and recommendations for
future research projects;
  (d) Review requests made to the commissioner for access to information
pursuant  to paragraph b of subdivision one of section 33-1203 and para-
graph c of subdivision two  of  section  33-1205  of  the  environmental
conservation law for use in human health related research projects. Such
data  shall  only  be  provided  to  researchers engaged in human health
related research. The request made by such researchers shall  include  a
copy of the research proposal or the research protocol approved by their
institution and copies of their institution's Institutional Review Board
(IRB)  or equivalent review board approval of such proposal or protocol.
In the case of research conducted outside the auspices of an institution
by a researcher previously published in a peer-reviewed scientific jour-
nal, the board shall request copies of the research proposal  and  shall
deny  access to the site-specific and nine-digit zip code pesticide data
if the board determines that such  proposal  does  not  follow  accepted
scientific  practice  for  the  design  of a research project. The board
shall establish guidelines to restrict the dissemination by  researchers
of  the name, address or other information that would otherwise identify
a commercial applicator or private applicator or any person who receives
the services of a commercial applicator;
  (e) Solicit, receive, and review applications from public and  private
agencies  and  organizations  and  qualified  research  institutions for
grants from the breast  cancer  research  and  education  fund,  created
pursuant to section ninety-seven-yy of the state finance law, to conduct
research  or educational programs which focus on the causes, prevention,
screening, treatment and cure of breast cancer and may include, but  are
not  limited  to  mapping of breast cancer, and basic, behavioral, clin-
ical,  demographic,  environmental,   epidemiologic   and   psychosocial
research.  The board shall make recommendations to the commissioner, and
the commissioner shall, in his or  her  discretion,  grant  approval  of
applications  for  grants  from  those  applications  recommended by the
board. The board shall consult with the Centers for Disease Control  and
Prevention,  the  National  Institutes of Health, the Federal Agency For
Health Care Policy and  Research,  the  National  Academy  of  Sciences,
breast cancer advocacy groups, and other organizations or entities which
may  be  involved  in breast cancer research to solicit both information
regarding breast cancer  research  projects  that  are  currently  being
conducted  and  recommendations for future research projects. As used in
this section, "qualified  research  institution"  may  include  academic
medical  institutions,  state  or  local  government agencies, public or
private organizations within  this  state,  and  any  other  institution
approved by the department, which is conducting a breast cancer research
project or educational program. If a board member submits an application
for  a  grant  from the breast cancer research and education fund, he or
she shall be prohibited from reviewing and making  a  recommendation  on
the application;
  (f)  Consider, based on evolving scientific evidence, whether a corre-
lation exists between pesticide use and pesticide exposure. As  part  of
such  consideration the board shall make recommendations as to methodol-
ogies which may be utilized to establish such correlation;
  (g) After two years of implementation of pesticide reporting  pursuant
to  section  33-1205  of  the  environmental conservation law, the board
shall compare the percentage of agricultural crop production general use
pesticides being reported to the total amount of such  pesticides  being
used  in  this state as estimated by Cornell University, Cornell Cooper-

S. 6914                             9                            A. 9205

ative Extension, the department of environmental conservation,  and  the
Environmental Protection Agency;
  (h)  Meet  at least six times in the first year, at the request of the
chair and at any other time as the  chair  deems  necessary.  The  board
shall  meet  at  least [four] TWO times a year AND AS NEEDED thereafter.
Provided, however, that at least one such meeting  a  year  shall  be  a
public  hearing,  at  which  the general public may question and present
information and comments to the board with respect to the  operation  of
the health research science board, the breast cancer research and educa-
tion  fund[,  the  prostate and testicular cancer research and education
fund], and pesticide reporting established pursuant to sections  33-1205
and  33-1207 of the environmental conservation law. At such hearing, the
commissioner of the department of environmental conservation or  his  or
her  designee shall make a report to the board with respect to the effi-
ciency and  utility  of  pesticide  reporting  established  pursuant  to
sections  33-1205  and  33-1207  of  the environmental conservation law.
SHOULD THE EXISTING BYLAWS BE AMENDED BY THE BOARD, ANY SUCH  AMENDMENTS
SHALL BE CONSISTENT WITH THE REVISIONS OF THIS PARAGRAPH;
  S  5-a.  Section  2413 of the public health law, as amended by chapter
219 of the laws of 1997, is amended to read as follows:
  S 2413. Biennial report.  The commissioner shall submit a report on or
before January first commencing in  nineteen  hundred  ninety-nine,  and
biennially  thereafter,  to the governor, the temporary president of the
senate and the speaker of the assembly concerning the operation  of  the
health research science board. Such report shall include recommendations
from  the  health  research science board including, but not limited to,
the types of data that would be useful for breast[, prostate or testicu-
lar] cancer researchers and whether private citizen use  of  residential
pesticides  should  be  added  to the reporting requirements. The report
shall also include a summary of research requests granted or denied.  In
addition, such report shall include an evaluation by  the  commissioner,
the commissioner of the department of environmental conservation and the
health  research  science  board of the basis, efficiency and scientific
utility of the information derived from pesticide reporting pursuant  to
sections  33-1205  and 33-1207 of the environmental conservation law and
recommend whether such system  should  be  modified  or  continued.  The
report  shall  include  a  summary  of  the comments and recommendations
presented by the public at the board's public hearings.
  S 5-b. Section 97-yy of the state finance law is amended by  adding  a
new subdivision 2-b to read as follows:
  2-B. ON OR BEFORE THE FIRST DAY OF FEBRUARY EACH YEAR, THE COMMISSION-
ER  OF  HEALTH SHALL PROVIDE A WRITTEN REPORT TO THE TEMPORARY PRESIDENT
OF THE SENATE, SPEAKER OF THE ASSEMBLY,  CHAIR  OF  THE  SENATE  FINANCE
COMMITTEE,  CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE, CHAIR OF THE
SENATE COMMITTEE ON HEALTH, AND CHAIR OF THE ASSEMBLY HEALTH  COMMITTEE.
SUCH  REPORT  SHALL  INCLUDE  HOW  THE  MONIES OF THE FUND WERE UTILIZED
DURING THE PRECEDING CALENDAR YEAR, AND SHALL INCLUDE:
  (I) THE AMOUNT OF MONEY DISPERSED FROM THE FUND;
  (II) RECIPIENTS OF AWARDS FROM THE FUND;
  (III) THE AMOUNT AWARDED TO EACH; AND
  (IV) THE PURPOSES FOR WHICH SUCH AWARDS WERE GRANTED.
  S 6. Section 2409-a of the public health law, as added by  section  73
of  part  D  of  chapter  60  of the laws of 2012, is amended to read as
follows:
  S 2409-a. Advisory council. 1. There  is  hereby  established  in  the
department  the  [breast,  cervical  and  ovarian]  cancer detection and

S. 6914                            10                            A. 9205

education program advisory council, for  the  purpose  of  advising  the
commissioner   with  regards  to  providing  information  to  consumers,
patients, and health  care  providers  relating,  but  not  limited  to,
breast,  cervical,  PROSTATE,  TESTICULAR  and ovarian cancer, including
signs and symptoms, risk factors, the benefits of prevention  and  early
detection, guideline concordant cancer screening and disease management,
options  for  diagnostic  testing  and  treatment, new technologies, and
survivorship.
  2. The advisory council shall: (A) make recommendations to the depart-
ment regarding  the  promotion  and  implementation  of  programs  under
sections  twenty-four  hundred  six and twenty-four hundred nine of this
title; AND (B) PRIOR TO THE DEPARTMENT PROVIDING  GRANTS  FROM  THE  NEW
YORK  STATE  PROSTATE AND TESTICULAR CANCER RESEARCH AND EDUCATION FUND,
CREATED PURSUANT TO SECTION NINETY-FIVE-E  OF  THE  STATE  FINANCE  LAW,
ADVISE  THE  DEPARTMENT ON VARIOUS COMPONENTS OF THE DEPARTMENT'S SOLIC-
ITATION TO DISTRIBUTE SUCH FUNDS, INCLUDING  BUT  NOT  LIMITED  TO,  THE
POTENTIAL  USES OF THE FUNDS, THE ENTITIES THAT MAY BE ELIGIBLE TO APPLY
FOR THE  FUNDS,  THE  RECOMMENDED  CONTRACT  DELIVERABLES  FOR  ENTITIES
RECEIVING  THE  FUNDS,  THE  RECOMMENDED  GEOGRAPHIC DISTRIBUTION OF THE
FUNDS, AND THE RECOMMENDED AWARD AMOUNTS.
  3. The commissioner shall appoint  twenty-one  voting  members,  which
shall  include  representation  of health care professionals, consumers,
patients, ONE VOTING MEMBER WHO SHALL BE A PERSON WHO  HAS  OR  HAS  HAD
PROSTATE  OR  TESTICULAR CANCER, ONE VOTING MEMBER WHO SHALL BE A PERSON
WHO HAS OR HAS HAD BREAST, CERVICAL OR OVARIAN CANCER and  other  appro-
priate  [interest]  INTERESTS  reflective of the diversity of the state,
with expertise in breast, cervical, PROSTATE, TESTICULAR and/or  ovarian
cancer.  The commissioner shall appoint one member as a chairperson. The
members of the council shall receive no compensation for their services,
but shall be allowed their actual and  necessary  expenses  incurred  in
performance of their duties.
  4.  A  majority  of the appointed voting membership of the board shall
constitute quorum.
  5. The advisory council shall meet at  least  twice  a  year,  at  the
request of the department.
  S 7. Section 95-e of the state finance law, as added by chapter 273 of
the  laws  of  2004,  subdivision 2 as amended by section 1 of part A of
chapter 58 of the laws of 2004, is amended to read as follows:
  S  95-e.  New  York  [state]  STATE  prostate  AND  TESTICULAR  cancer
research[, detection] and education fund. 1. There is hereby established
in the joint custody of the commissioner of taxation and finance and the
comptroller,  a  special fund to be known as the "New York [state] STATE
prostate AND  TESTICULAR  cancer  research[,  detection]  and  education
fund".
  2.  Such  fund  shall consist of all revenues received pursuant to the
provisions of SECTION FOUR HUNDRED FOUR-Q OF  THE  VEHICLE  AND  TRAFFIC
LAW,  AS ADDED BY CHAPTER FIVE HUNDRED TWENTY-EIGHT OF THE LAWS OF NINE-
TEEN HUNDRED NINETY-NINE,  AND  sections  two  hundred  nine-E  and  six
hundred  thirty of the tax law, all revenues received pursuant to appro-
priations by the legislature, and all moneys appropriated, credited,  or
transferred  thereto  from any other fund or source pursuant to law. For
each state fiscal year, there shall be appropriated to the fund  by  the
state,  in  addition  to  all other moneys required to be deposited into
such fund, an amount equal to the amounts of monies collected and depos-
ited into the fund pursuant to SECTION FOUR HUNDRED FOUR-Q OF THE  VEHI-
CLE  AND  TRAFFIC  LAW, AS ADDED BY CHAPTER FIVE HUNDRED TWENTY-EIGHT OF

S. 6914                            11                            A. 9205

THE LAWS OF NINETEEN  HUNDRED  NINETY-NINE,  AND  sections  two  hundred
[nine-e] NINE-E and six hundred thirty of the tax law during the preced-
ing  calendar  year,  as certified by the comptroller. Nothing contained
herein  shall prevent the state from receiving grants, gifts or bequests
for the purposes of the fund as defined in this section  and  depositing
them  into the fund according to law. Any interest received by the comp-
troller on moneys on deposit in such  fund  shall  be  retained  in  and
become part of such fund.
  3. (A) Moneys of the fund [shall be expended only to provide grants to
the  New  York State Coalition to Cure Prostate Cancer, a not-for-profit
corporation established in this state which is incorporated],  FOLLOWING
APPROPRIATION  BY  THE LEGISLATURE AND ALLOCATION BY THE DIRECTOR OF THE
BUDGET, SHALL BE MADE AVAILABLE TO THE COMMISSIONER OF HEALTH TO PROVIDE
GRANTS for the purpose of advancing and financing prostate AND  TESTICU-
LAR   cancer   research,  [detection]  SUPPORT  PROGRAMS  and  education
projects. [To the extent practicable, the New York  State  Coalition  to
Cure Prostate Cancer shall cooperate and coordinate its efforts with the
prostate  and testicular cancer detection and education advisory council
established pursuant to  section  twenty-four  hundred  sixteen  of  the
public health law.]
  (B)  NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTION ONE HUNDRED
SIXTY-THREE OF THE STATE FINANCE LAW,  THE  COMMISSIONER  OF  HEALTH  IS
AUTHORIZED  TO ENTER INTO A CONTRACT OR CONTRACTS UNDER PARAGRAPH (A) OF
THIS SUBDIVISION WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROC-
ESS, PROVIDED, HOWEVER, THAT:
  (I) THE DEPARTMENT OF HEALTH SHALL POST ON ITS WEBSITE, FOR  A  PERIOD
OF NO LESS THAN THIRTY DAYS:
  (1)  A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT TO
THE CONTRACT OR CONTRACTS;
  (2) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (3) THE PERIOD OF TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY  SEEK
SELECTION,  WHICH  SHALL BE NO LESS THAN THIRTY DAYS AFTER SUCH INFORMA-
TION IS FIRST POSTED ON THE WEBSITE; AND
  (4) THE MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR  MAY  SEEK  SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (II)  ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE RECEIVED FROM
PROSPECTIVE CONTRACTORS IN TIMELY  FASHION  SHALL  BE  REVIEWED  BY  THE
COMMISSIONER OF HEALTH; AND
  (III)  THE  COMMISSIONER  OF  HEALTH  SHALL  SELECT SUCH CONTRACTOR OR
CONTRACTORS THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE
PURPOSES OF THIS SECTION.
  4. (A) On or before the first day of February  each  year,  the  comp-
troller  shall  certify  to  the  governor,  temporary  president of the
senate, speaker of the assembly, chair of the senate  finance  committee
and  chair of the assembly ways and means committee, the amount of money
deposited by source in the New York [state] STATE prostate AND  TESTICU-
LAR cancer research[, detection] and education fund during the preceding
calendar  year as the result of revenue derived pursuant to SECTION FOUR
HUNDRED FOUR-Q OF THE VEHICLE AND TRAFFIC LAW, AS ADDED BY CHAPTER  FIVE
HUNDRED  TWENTY-EIGHT  OF  THE LAWS OF NINETEEN HUNDRED NINETY-NINE, AND
sections two hundred nine-E and six hundred thirty of the  tax  law  and
from all other sources.
  (B) ON OR BEFORE THE FIRST DAY OF FEBRUARY EACH YEAR, THE COMMISSIONER
OF  HEALTH  SHALL PROVIDE A WRITTEN REPORT TO THE TEMPORARY PRESIDENT OF
THE SENATE, SPEAKER OF THE ASSEMBLY, CHAIR OF THE SENATE FINANCE COMMIT-
TEE, CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE, CHAIR OF THE SENATE

S. 6914                            12                            A. 9205

COMMITTEE ON HEALTH, AND CHAIR OF THE ASSEMBLY  HEALTH  COMMITTEE.  SUCH
REPORT  SHALL  INCLUDE  HOW  MONIES OF THE FUND WERE UTILIZED DURING THE
PRECEDING CALENDAR YEAR AND SHALL INCLUDE:
  (I) THE AMOUNT OF MONEY DISBURSED FROM THE FUND;
  (II) RECIPIENTS OF AWARDS FROM THE FUND;
  (III) THE AMOUNT AWARDED TO EACH; AND
  (IV) THE PURPOSES FOR WHICH SUCH AWARDS WERE GRANTED.
  5.  [As  a  condition  of receiving grants from the fund, the New York
State Coalition To Cure Prostate Cancer shall agree to issue  and  shall
issue,  on  or  before  the  first  day  of February each year, a report
including, but not limited to, financial statements,  financial  reports
and  reports  on the issuance of grants. Such reports shall be delivered
to the governor and the chairs of the senate finance committee  and  the
assembly  ways  and  means committee and shall also be made available to
the public.  Such financial statements and reports shall be audited by a
nationally recognized accounting firm.
  6.] Moneys shall be payable from the  fund  [to  the  New  York  State
Coalition to Cure Prostate Cancer] on the audit and warrant of the comp-
troller on vouchers approved by the comptroller.
  S  7-a. Subdivision 2 of section 404-q of the vehicle and traffic law,
as added by chapter 528 of the laws of  1999,  is  amended  to  read  as
follows:
  2. A distinctive "drive for the cure" license plate issued pursuant to
this  section  shall be issued in the same manner as other number plates
upon the payment of the regular registration fee prescribed  by  section
four  hundred one of this article, provided, however, that an additional
annual service charge of twenty-five dollars shall be charged  for  such
plate.  Twelve  dollars  and  fifty  cents from each twenty-five dollars
received as annual service charges under this section shall be deposited
to the credit of the breast cancer research and  education  fund  estab-
lished  pursuant to section ninety-seven-yy of the state finance law and
shall be used for research and education programs undertaken pursuant to
section twenty-four hundred ten of the public health law. Twelve dollars
and fifty cents from each twenty-five dollars received as annual service
charges under this section shall be deposited to the credit of  the  NEW
YORK  STATE  prostate  and testicular cancer research and education fund
established pursuant to section [ninety-seven-ccc] NINETY-FIVE-E of  the
state  finance law and shall be used for research and education programs
undertaken pursuant to section [ninety-seven-ccc] NINETY-FIVE-E  of  the
state  finance  law. Provided, however that one year after the effective
date of this section funds in the amount of six thousand dollars, or  so
much  thereof  as may be available, shall be allocated to the department
to offset costs associated with the production of such license plates.
  S 7-b. Section 97-ccc of the state finance law is REPEALED.
  S 7-c. Section  209-E of the tax law, as added by chapter 273  of  the
laws of 2004, is amended to read as follows:
  S 209-E. Gift for prostate AND TESTICULAR cancer research[, detection]
and  education.  Effective for any tax year commencing on or after Janu-
ary first, two thousand four, a taxpayer in any taxable year  may  elect
to  contribute to the support of the New York [state] STATE prostate AND
TESTICULAR  cancer  research[,  detection]  and  education  fund.   Such
contribution  shall  be  in any whole dollar amount and shall not reduce
the amount of the state tax owed  by  such  taxpayer.  The  commissioner
shall  include  space  on  the  corporate  income tax return to enable a
taxpayer to make such contribution.  Notwithstanding any other provision
of law, all revenues collected pursuant to this section shall be credit-

S. 6914                            13                            A. 9205

ed to  the  New  York  [state]  STATE  prostate  AND  TESTICULAR  cancer
research[,  detection]  and  education  fund  and shall be used only for
those purposes enumerated in section ninety-five-e of the state  finance
law.
  S 7-d. Section 630 of the tax law, as added by chapter 273 of the laws
of 2004, is amended to read as follows:
  S  630.  Gift for prostate AND TESTICULAR cancer research[, detection]
and education.  Effective for any tax year commencing on or after  Janu-
ary  first,  two  thousand  four,  an individual in any taxable year may
elect to contribute to the New York [state] STATE prostate AND  TESTICU-
LAR  cancer  research[, detection] and education fund. Such contribution
shall be in any whole dollar amount and shall not reduce the  amount  of
state  tax owed by such individual. The commissioner shall include space
on the personal income tax return to enable  a  taxpayer  to  make  such
contribution.  Notwithstanding  any  other provision of law all revenues
collected pursuant to this section shall be credited  to  the  New  York
[state]  STATE  prostate AND TESTICULAR cancer research[, detection] and
education fund and used only for those purposes  enumerated  in  section
ninety-five-e of the state finance law.
  S  8. The public health law is amended by adding a new section 2825 to
read as follows:
  S 2825. CAPITAL RESTRUCTURING FINANCING PROGRAM. 1. A CAPITAL RESTRUC-
TURING FINANCING PROGRAM IS HEREBY ESTABLISHED UNDER THE JOINT  ADMINIS-
TRATION OF THE COMMISSIONER AND THE PRESIDENT OF THE DORMITORY AUTHORITY
OF  THE  STATE  OF  NEW  YORK  FOR THE PURPOSE OF ENHANCING THE QUALITY,
FINANCIAL VIABILITY AND EFFICIENCY OF NEW YORK'S  HEALTH  CARE  DELIVERY
SYSTEM  BY TRANSFORMING THE SYSTEM INTO A MORE RATIONAL PATIENT-CENTERED
CARE SYSTEM THAT PROMOTES POPULATION HEALTH AND IMPROVED WELL-BEING  FOR
ALL  NEW  YORKERS.  THE  ISSUANCE  OF ANY BONDS OR NOTES HEREUNDER SHALL
FURTHER BE SUBJECT TO THE APPROVAL OF THE DIRECTOR OF  THE  DIVISION  OF
THE  BUDGET,  AND  ANY  PROJECTS FUNDED THROUGH THE ISSUANCE OF BONDS OR
NOTES HEREUNDER SHALL BE APPROVED BY THE NEW YORK STATE PUBLIC  AUTHORI-
TIES  CONTROL  BOARD,  AS REQUIRED UNDER SECTION FIFTY-ONE OF THE PUBLIC
AUTHORITIES LAW.
  2. FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  FOURTEEN  THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND TWENTY-ONE, FUNDS MADE AVAILABLE FOR EXPENDI-
TURE PURSUANT TO THIS SECTION MAY BE DISTRIBUTED BY THE COMMISSIONER AND
THE  PRESIDENT  OF THE AUTHORITY, IN CONSULTATION WITH THE COMMISSIONERS
OF THE OFFICE OF MENTAL HEALTH, OFFICE  FOR  PEOPLE  WITH  DEVELOPMENTAL
DISABILITIES  AND OFFICE FOR ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, AS
APPLICABLE, FOR:
  (A) CAPITAL GRANTS  TO  GENERAL  HOSPITALS,  RESIDENTIAL  HEALTH  CARE
FACILITIES,  DIAGNOSTICS  AND  TREATMENT  CENTERS,  AND CLINICS LICENSED
PURSUANT TO THIS CHAPTER OR THE  MENTAL  HYGIENE  LAW,  ASSISTED  LIVING
PROGRAMS,  PRIMARY  CARE PROVIDERS, AND HOME CARE PROVIDERS CERTIFIED OR
LICENSED PURSUANT TO ARTICLE THIRTY-SIX OF  THIS  CHAPTER  (COLLECTIVELY
"APPLICANTS") THAT QUALIFY FOR PAYMENTS UNDER THE DELIVERY SYSTEM REFORM
INCENTIVE  PAYMENT  PROGRAM  (DSRIP),  IN  WHICH CASE FUNDING UNDER THIS
PARAGRAPH SHALL BE REQUESTED IN SUCH APPLICANT'S DSRIP APPLICATION. SUCH
CAPITAL GRANT PROJECTS INCLUDE, BUT ARE NOT LIMITED TO; CLOSURES,  MERG-
ERS,  RESTRUCTURING,  IMPROVEMENTS  TO  INFRASTRUCTURE,  DEVELOPMENT  OF
PRIMARY CARE SERVICE CAPACITY, DEVELOPMENT OF TELEHEALTH INFRASTRUCTURE,
THE PROMOTION OF INTEGRATED DELIVERY SYSTEMS THAT STRENGTHEN AND PROTECT
CONTINUED ACCESS TO ESSENTIAL HEALTH CARE SERVICES AND OTHER TRANSFORMA-
TIONAL PROJECTS AS DETERMINED BY THE COMMISSIONER AND THE  PRESIDENT  OF
THE AUTHORITY.

S. 6914                            14                            A. 9205

  (B)  CAPITAL  GRANTS  TO  GENERAL  HOSPITALS,  RESIDENTIAL HEALTH CARE
FACILITIES, DIAGNOSTIC  AND  TREATMENT  CENTERS,  AND  CLINICS  LICENSED
PURSUANT  TO  THIS  CHAPTER  OR  THE MENTAL HYGIENE LAW, ASSISTED LIVING
PROGRAMS, PRIMARY CARE PROVIDERS,  HOME  CARE  PROVIDERS,  CERTIFIED  OR
LICENSED  PURSUANT  TO  ARTICLE THIRTY-SIX OF THIS CHAPTER (COLLECTIVELY
"APPLICANTS") THAT ARE NON-QUALIFYING AND  NON-PARTICIPATING  APPLICANTS
UNDER  PARAGRAPH  (A)  OF  THIS SUBDIVISION, FOR CAPITAL NON-OPERATIONAL
WORKS OR PURPOSES THAT SUPPORT THE PURPOSES SET FORTH IN  THIS  SECTION.
SUCH  CAPITAL  GRANT PROJECTS INCLUDE, BUT ARE NOT LIMITED TO; CLOSURES,
MERGERS, RESTRUCTURING, IMPROVEMENTS TO INFRASTRUCTURE,  DEVELOPMENT  OF
PRIMARY CARE SERVICE CAPACITY, DEVELOPMENT OF TELEHEALTH INFRASTRUCTURE,
THE PROMOTION OF INTEGRATED DELIVERY SYSTEMS THAT STRENGTHEN AND PROTECT
CONTINUED ACCESS TO ESSENTIAL HEALTH CARE SERVICES.
  3.  THE  COMMISSIONER  AND  THE PRESIDENT OF THE AUTHORITY SHALL ENTER
INTO AN AGREEMENT, SUBJECT TO APPROVAL BY THE DIRECTOR OF THE BUDGET AND
SUBJECT TO SECTION SIXTEEN HUNDRED EIGHTY-R OF  THE  PUBLIC  AUTHORITIES
LAW, AS ADDED BY A CHAPTER OF THE LAWS OF TWO THOUSAND FOURTEEN, FOR THE
PURPOSES  OF  AWARDING,  DISTRIBUTING,  AND ADMINISTERING THE FUNDS MADE
AVAILABLE PURSUANT TO THIS SECTION.
  (A) FOR CAPITAL GRANT PROJECTS UNDER PARAGRAPH (A) OF SUBDIVISION  TWO
OF  THIS  SECTION,  THE  EVALUATION  OF  APPLICATIONS SHALL BE SUBMITTED
PURSUANT TO THE PROCESS DESCRIBED IN PARAGRAPH (B) OF SUBDIVISION TWENTY
OF SECTION TWENTY-EIGHT HUNDRED SEVEN OF THIS ARTICLE; PROVIDED,  HOWEV-
ER,  THAT  SUCH CAPITAL GRANT PROJECTS SHALL NOT BE SUBJECT TO REVIEW BY
THE FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES.
  (B) FOR MONIES ALLOCATED UNDER PARAGRAPH (B)  OF  SUBDIVISION  TWO  OF
THIS SECTION:
  (I)  THE DEPARTMENT SHALL POST ON ITS WEBSITE, FOR A PERIOD OF NO LESS
THAN THIRTY DAYS:
  (A) THE PROCESS BY WHICH SUCH APPLICATIONS SHALL BE REVIEWED;
  (B) THE CRITERIA BY WHICH SUCH APPLICATIONS SHALL BE JUDGED; AND
  (C) A LIST OF APPROVED AND  DENIED  APPLICATIONS  SUBSEQUENT  TO  SUCH
DETERMINATION.
  (II)  THE  EVALUATION OF APPLICATIONS SHALL BE REVIEWED BY THE DEPART-
MENT, PURSUANT TO A PROCESS TO BE DETERMINED BY THE DEPARTMENT. APPLICA-
TIONS SHALL THEN BE SUBJECT TO REVIEW BY THE PANEL ESTABLISHED  PURSUANT
TO  PARAGRAPH  (B) OF SUBDIVISION TWENTY OF SECTION TWENTY-EIGHT HUNDRED
SEVEN OF THIS ARTICLE, WHICH SHALL SUBMIT  ITS  RECOMMENDATIONS  TO  THE
COMMISSIONER  FOR FINAL DETERMINATION. DETERMINATION OF AWARDS FOR FUNDS
ALLOCATED UNDER PARAGRAPH (B) OF SUBDIVISION TWO OF THIS SECTION,  SHALL
INCLUDE, BUT NOT BE LIMITED TO THE FOLLOWING CRITERIA:
  (A) ELIGIBILITY REQUIREMENTS FOR APPLICANTS;
  (B) STATEWIDE GEOGRAPHIC DISTRIBUTION OF FUNDS;
  (C)  MINIMUM  AND  MAXIMUM  AMOUNTS OF FUNDING TO BE AWARDED UNDER THE
PROGRAM;
  (D) THE RELATIONSHIP BETWEEN THE PROJECT PROPOSED BY AN APPLICANT  AND
IDENTIFIED COMMUNITY NEED;
  (E)  THE  EXTENT  TO  WHICH  THE  APPLICANT  HAS ACCESS TO ALTERNATIVE
FINANCING;
  (F) THE EXTENT TO WHICH THE PROPOSED PROJECT FURTHERS THE PURPOSES SET
FORTH IN THIS SECTION;
  (G) THE EXTENT THAT THE PROPOSED PROJECT FURTHERS THE  DEVELOPMENT  OF
PRIMARY CARE;
  (H)  THE EXTENT TO WHICH THE PROPOSED PROJECT BENEFITS MEDICAID ENROL-
LEES AND UNINSURED INDIVIDUALS;

S. 6914                            15                            A. 9205

  (I) THE EXTENT TO WHICH THE PROPOSED PROJECT ADDRESSES POTENTIAL  RISK
TO PATIENT SAFETY AND WELFARE;
  (J)  THE  EXTENT  THAT THE PROPOSED PROJECT INVOLVES AN APPLICANT THAT
RECEIVES OR HAS APPLIED FOR A  TEMPORARY  RATE  ADJUSTMENT  PURSUANT  TO
APPLICABLE REGULATIONS; AND
  (K)  THE  EXTENT  TO WHICH THE PROPOSED PROJECT WILL CONTRIBUTE TO THE
LONG TERM SUSTAINABILITY OF THE APPLICANT.
  THE COMMISSIONER SHALL PROVIDE A REPORT ON A QUARTERLY  BASIS  TO  THE
CHAIRS OF THE SENATE FINANCE, ASSEMBLY WAYS AND MEANS, SENATE HEALTH AND
ASSEMBLY  HEALTH  COMMITTEES.  SUCH  REPORTS SHALL BE SUBMITTED NO LATER
THAN SIXTY DAYS AFTER THE CLOSE OF THE QUARTER, AND SHALL CONFORM TO THE
REPORTING REQUIREMENTS OF SUBDIVISION  TWENTY  OF  SECTION  TWENTY-EIGHT
HUNDRED SEVEN OF THIS ARTICLE, AS APPLICABLE.
  S  8-a.  Subdivision  20  of section 2807 of the public health law, as
added by section 9 of part Q of chapter 56  of  the  laws  of  2013,  is
amended to read as follows:
  20.  (A)  Notwithstanding any contrary provision of law and subject to
the receipt of all necessary federal approvals and the  availability  of
federal financial participation, the commissioner is authorized to enter
into agreements with SUNY downstate medical center, other public general
hospitals,  and/or  with  the sponsoring local governments of such other
public general hospitals, under which such facilities and/or such  local
government  shall,  by  intergovernmental transfer, fund the non-federal
share of Medicaid funds made available for Delivery System Reform Incen-
tive Payments ("[DSRIPS] DSRIP") to such  facilities.  Such  non-federal
share  payments  shall  be  deemed voluntary and, further, such payments
shall be excluded from computations made pursuant to section one of part
C of chapter fifty-eight of the laws of two thousand five,  as  amended.
In  addition, the facilities, and/or the sponsoring local governments of
such facilities or the state may, by written notification to  the  other
parties to the agreement, cancel such agreement at any time prior to the
payment  of  the  DSRIP  funds.  THE  COMMISSIONER SHALL, TO THE MAXIMUM
DEGREE PRACTICABLE, AND TO THE EXTENT PERMITTED BY THE  FEDERAL  CENTERS
FOR  MEDICARE  AND  MEDICAID  SERVICES  ("CMS"),  ENSURE  THAT THE DSRIP
PROGRAM IS IMPLEMENTED THROUGHOUT THE ENTIRE STATE.
  (B) THE COMMISSIONER SHALL ESTABLISH  AN  ADVISORY  PANEL  TO  PROVIDE
ASSISTANCE  WITH REGARD TO THE DSRIP PROGRAM. THE PANEL SHALL BE CHARGED
WITH REVIEWING RECOMMENDATIONS FOR DSRIP FUNDING  MADE  BY  THE  STATE'S
CONTRACTED  DSRIP  ASSESSOR  AND ADVISING THE COMMISSIONER REGARDING THE
RESULTS OF SUCH REVIEW. SUCH PANEL SHALL ALSO REVIEW APPLICATIONS  UNDER
PARAGRAPH  (B)  OF SUBDIVISION TWO OF SECTION TWENTY-EIGHT HUNDRED TWEN-
TY-FIVE OF THIS ARTICLE. PANEL MEMBERSHIP SHALL BE COMPRISED OF INDIVID-
UALS WITH SIGNIFICANT HEALTH CARE SYSTEM EXPERIENCE. MEMBERS MAY NOT  BE
ELECTED OFFICIALS OR EMPLOYED BY PROVIDERS THAT WOULD BENEFIT FROM DSRIP
FUNDING,  AND  MUST NOT HAVE ANY CONFLICT OF INTEREST THAT WOULD PREVENT
THEM FROM PROVIDING AN IMPARTIAL REVIEW OF  DSRIP  ASSESSOR  RECOMMENDA-
TIONS.  THE PANEL SHALL CONSIST OF MEMBERS APPOINTED BY THE COMMISSIONER
AND SHALL IN ADDITION CONSIST OF ONE MEMBER APPOINTED  BY  THE  MAJORITY
LEADER  OF  THE  NEW  YORK STATE SENATE, AND ONE MEMBER APPOINTED BY THE
SPEAKER OF THE NEW YORK STATE ASSEMBLY. THE PANEL SHALL  CARRY  OUT  THE
REVIEW  OF  DSRIP RECOMMENDATIONS IN STRICT ACCORDANCE WITH ALL REQUIRE-
MENTS SET FORTH IN THE STATE'S FEDERAL  1115  MEDICAID  WAIVER  STANDARD
TERMS  AND CONDITIONS. THE PANEL SHALL SUBMIT ITS RECOMMENDATIONS TO THE
COMMISSIONER FOR FINAL DETERMINATION, IN ACCORDANCE  WITH  ALL  REQUIRE-
MENTS  SET  FORTH  IN  THE STATE'S FEDERAL 1115 MEDICAID WAIVER STANDARD
TERMS AND CONDITIONS. THE COMMISSIONER MAY MODIFY  THE  REQUIREMENTS  OF

S. 6914                            16                            A. 9205

THIS  PARAGRAPH  AND PARAGRAPH (C) OF THIS SUBDIVISION IF SUCH MODIFICA-
TIONS ARE REQUIRED BY THE FEDERAL CMS.
  (C)  FOR  PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND FOURTEEN, THE
COMMISSIONER SHALL PROVIDE A REPORT ON A QUARTERLY BASIS TO  THE  CHAIRS
OF THE SENATE FINANCE, ASSEMBLY WAYS AND MEANS, SENATE HEALTH AND ASSEM-
BLY  HEALTH  COMMITTEES  WITH REGARD TO THE STATUS OF THE DSRIP PROGRAM.
SUCH REPORTS SHALL BE SUBMITTED NO LATER THAN SIXTY DAYS AFTER THE CLOSE
OF THE QUARTER, AND SHALL INCLUDE THE MOST CURRENT INFORMATION SUBMITTED
BY PROVIDERS TO THE  STATE  AND  THE  FEDERAL  CMS.  THE  REPORTS  SHALL
INCLUDE:
  (I) ANALYSIS OF PROGRESS MADE TOWARD DSRIP GOALS;
  (II) THE IMPACT ON THE STATE'S HEALTH CARE DELIVERY SYSTEM;
  (III)  INFORMATION  ON  THE  NUMBER AND TYPES OF PROVIDERS WHO PARTIC-
IPATE;
  (IV) PLANS  AND  PROGRESS  FOR  MONITORING  PROVIDER  COMPLIANCE  WITH
REQUIREMENTS;
  (V) A STATUS UPDATE ON PROJECT MILESTONE PROGRESS;
  (VI) INFORMATION ON PROJECT SPENDING AND BUDGET;
  (VII) ANALYSIS OF IMPACT ON MEDICAID BENEFICIARIES SERVED;
  (VIII) A SUMMARY OF PUBLIC ENGAGEMENT AND PUBLIC COMMENTS RECEIVED;
  (IX) A DESCRIPTION OF DSRIP FUNDING APPLICATIONS THAT WERE DENIED;
  (X)  A  DESCRIPTION OF ALL REGULATION WAIVERS ISSUED PURSUANT TO PARA-
GRAPH (E) OF THIS SUBDIVISION; AND
  (XI) A SUMMARY OF THE STATEWIDE GEOGRAPHIC DISTRIBUTION OF FUNDS.
  (D) FOR PERIODS ON AND AFTER APRIL FIRST, TWO  THOUSAND  FOURTEEN  THE
COMMISSIONER  SHALL PROMPTLY MAKE ALL DSRIP GOVERNING DOCUMENTS, INCLUD-
ING 1115 WAIVER STANDARD TERMS AND  CONDITIONS,  SUPPORTING  ATTACHMENTS
AND  DETAILED  PROJECT DESCRIPTIONS, AND ALL MATERIALS MADE AVAILABLE TO
THE LEGISLATURE PURSUANT TO PARAGRAPH (C) OF THIS SUBDIVISION, AVAILABLE
ON THE DEPARTMENT'S WEBSITE.  THE  COMMISSIONER  SHALL  ALSO  PROVIDE  A
DETAILED  OVERVIEW  ON THE DEPARTMENT'S WEBSITE OF THE OPPORTUNITIES FOR
PUBLIC COMMENT ON THE DSRIP PROGRAM.
  (E) NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, THE  COMMIS-
SIONERS  OF  THE  DEPARTMENT OF HEALTH, THE OFFICE OF MENTAL HEALTH, THE
OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES,  AND  THE  OFFICE  OF
ALCOHOLISM  AND  SUBSTANCE  ABUSE  SERVICES  ARE AUTHORIZED TO WAIVE ANY
REGULATORY REQUIREMENTS AS ARE  NECESSARY,  CONSISTENT  WITH  APPLICABLE
LAW,  TO  ALLOW  APPLICANTS  UNDER THIS SUBDIVISION AND PARAGRAPH (A) OF
SUBDIVISION TWO OF SECTION  TWENTY-EIGHT  HUNDRED  TWENTY-FIVE  OF  THIS
ARTICLE  TO AVOID DUPLICATION OF REQUIREMENTS AND TO ALLOW THE EFFICIENT
IMPLEMENTATION OF THE PROPOSED PROJECT; PROVIDED,  HOWEVER,  THAT  REGU-
LATIONS  PERTAINING  TO  PATIENT SAFETY MAY NOT BE WAIVED, NOR SHALL ANY
REGULATIONS BE WAIVED IF SUCH WAIVER WOULD  RISK  PATIENT  SAFETY.  SUCH
WAIVER  SHALL  NOT  EXCEED  THE LIFE OF THE PROJECT OR SUCH SHORTER TIME
PERIODS AS THE AUTHORIZING COMMISSIONER MAY  DETERMINE.  ANY  REGULATORY
RELIEF  GRANTED PURSUANT TO THIS SUBDIVISION SHALL BE DESCRIBED, INCLUD-
ING EACH REGULATIONS WAIVED AND THE PROJECT IT RELATES TO, IN THE REPORT
PROVIDED PURSUANT TO PARAGRAPH (C) OF THIS SUBDIVISION.
  S 8-b. Subdivision 21 of section 2807 of the  public  health  law,  as
added  by  section  10  of  part Q of chapter 56 of the laws of 2013, is
amended to read as follows:
  21. (A) Notwithstanding any contrary provision of law and  subject  to
the  receipt  of all necessary federal approvals and the availability of
federal financial participation, the commissioner is authorized to enter
into agreements with SUNY downstate medical center, other public general
hospitals, and/or with the sponsoring local governments  of  such  other

S. 6914                            17                            A. 9205

public  general hospitals, under which such facilities and/or such local
government shall, by intergovernmental transfer,  fund  the  non-federal
share  of  Medicaid  funds made available for implementation of Medicaid
Redesign  Team  initiatives.  Such  non-federal  share payments shall be
deemed voluntary and, further, such  payments  shall  be  excluded  from
computations  made  pursuant  to section one of part C of chapter fifty-
eight of the laws of two thousand five, as  amended.  In  addition,  the
facilities,  and/or  the sponsoring local governments of such facilities
or the state may, by written notification to the other  parties  to  the
agreement, cancel such agreement at any time prior to the payment of the
Medicaid Redesign Team initiatives funds.
  (B)  APPLICATIONS  BY  ELIGIBLE  APPLICANTS FOR MEDICAID REDESIGN TEAM
INITIATIVES FUNDED BY MONIES MADE AVAILABLE PURSUANT TO PARAGRAPH (A) OF
THIS SUBDIVISION SHALL BE SUBMITTED FOR REVIEW  TO  THE  ADVISORY  PANEL
ESTABLISHED  PURSUANT  TO  PARAGRAPH  (B)  OF SUBDIVISION TWENTY OF THIS
SECTION AND SUCH PANEL SHALL SUBMIT THEIR RECOMMENDATIONS TO THE COMMIS-
SIONER FOR FINAL DETERMINATION. FOR PERIODS ON AND  AFTER  APRIL  FIRST,
TWO  THOUSAND  FOURTEEN,  THE  COMMISSIONER  SHALL PROVIDE A REPORT ON A
QUARTERLY BASIS TO THE MAJORITY LEADER OF THE NEW YORK STATE SENATE  AND
TO  THE SPEAKER OF THE NEW YORK STATE ASSEMBLY WITH REGARD TO THE STATUS
OF SUCH APPLICATIONS  AND  APPROVED  PROJECTS.  SUCH  REPORTS  SHALL  BE
SUBMITTED  NO  LATER THAN SIXTY DAYS AFTER THE CLOSE OF THE QUARTER, AND
SHALL INCLUDE THE MOST CURRENT INFORMATION SUBMITTED  BY  APPLICANTS  TO
THE  STATE.  THE REPORTS SHALL BE SUBMITTED IN CONJUNCTION WITH AND AS A
PART OF THE REPORTS SUBMITTED PURSUANT TO PARAGRAPH (C)  OF  SUBDIVISION
TWENTY OF THIS SECTION AND SHALL INCLUDE:
  (I) ANALYSIS OF PROGRESS MADE TOWARD PROJECT GOALS;
  (II) THE IMPACT ON THE STATE'S HEALTH CARE DELIVERY SYSTEM;
  (III)  INFORMATION  ON  THE  NUMBER AND TYPES OF PROVIDERS WHO PARTIC-
IPATE;
  (IV) PLANS  AND  PROGRESS  FOR  MONITORING  PROVIDER  COMPLIANCE  WITH
REQUIREMENTS;
  (V) A STATUS UPDATE ON PROJECT MILESTONE PROGRESS;
  (VI) INFORMATION ON PROJECT SPENDING AND BUDGET;
  (VII) ANALYSIS OF IMPACT ON MEDICAID BENEFICIARIES SERVED;
  (VIII) A SUMMARY OF PUBLIC ENGAGEMENT AND PUBLIC COMMENTS RECEIVED;
  (IX) A DESCRIPTION OF APPLICATIONS THAT WERE DENIED;
  (X)  A  DESCRIPTION OF ALL REGULATION WAIVERS ISSUED PURSUANT TO PARA-
GRAPH (E) OF THIS SUBDIVISION; AND
  (XI) A SUMMARY OF THE STATEWIDE GEOGRAPHIC DISTRIBUTION OF FUNDS.
  (C) THE COMMISSIONER SHALL MAKE ALL REPORTS PREPARED PURSUANT TO PARA-
GRAPH (B) OF THIS SUBDIVISION AND ALL SUPPORTING ATTACHMENTS AND MATERI-
ALS AVAILABLE ON THE DEPARTMENT'S WEBSITE.
  (D) NOTWITHSTANDING ANY INCONSISTENT LAW TO THE CONTRARY, AND  SUBJECT
TO  FEDERAL FINANCIAL PARTICIPATION, AND SUBJECT TO AMOUNTS APPROPRIATED
FOR PURPOSES HEREIN, THE DEPARTMENT MAY DISTRIBUTE FUNDS  TO  MAKE  RATE
ADJUSTMENTS  FOR  HEALTH  HOME  PROVIDERS  AS DESCRIBED IN SECTION THREE
HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW FOR  MEMBER  ENGAGEMENT,
STAFF TRAINING AND RETRAINING, HEALTH INFORMATION TECHNOLOGY IMPLEMENTA-
TION,  JOINT GOVERNANCE TECHNICAL ASSISTANCE, AND OTHER SUCH PURPOSES AS
THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONERS OF  THE  OFFICE
OF  MENTAL  HEALTH  AND  THE  OFFICE  OF  ALCOHOLISM AND SUBSTANCE ABUSE
SERVICES DETERMINES.
  (E) NOTWITHSTANDING ANY PROVISIONS OF LAW TO THE CONTRARY, THE COMMIS-
SIONERS OF THE DEPARTMENT OF HEALTH, THE OFFICE OF  MENTAL  HEALTH,  THE
OFFICE  FOR  PEOPLE  WITH  DEVELOPMENTAL DISABILITIES, AND THE OFFICE OF

S. 6914                            18                            A. 9205

ALCOHOLISM AND SUBSTANCE ABUSE SERVICES  ARE  AUTHORIZED  TO  WAIVE  ANY
REGULATORY  REQUIREMENTS  AS  ARE  NECESSARY, CONSISTENT WITH APPLICABLE
LAW, TO ALLOW APPLICANTS UNDER THIS SUBDIVISION  AND  PARAGRAPH  (A)  OF
SUBDIVISION  TWO  OF  SECTION  TWENTY-EIGHT  HUNDRED TWENTY-FIVE OF THIS
ARTICLE TO AVOID DUPLICATION OF REQUIREMENTS AND TO ALLOW THE  EFFICIENT
IMPLEMENTATION  OF  THE  PROPOSED PROJECT; PROVIDED, HOWEVER, THAT REGU-
LATIONS PERTAINING TO PATIENT SAFETY MAY NOT BE WAIVED,  NOT  SHALL  ANY
REGULATION  BE  WAIVED  IF  SUCH  WAIVER WOULD RISK PATIENT SAFETY. SUCH
WAIVER SHALL NOT EXCEED THE LIFE OF THE PROJECT  OR  SUCH  SHORTER  TIME
PERIOD  AS  THE  AUTHORIZING  COMMISSIONER ANY DETERMINE. ANY REGULATORY
RELIEF GRANTED PURSUANT TO THIS SUBDIVISION SHALL BE DESCRIBED,  INCLUD-
ING  EACH REGULATION WAIVED AND THE PROJECT IT RELATES TO, IN THE REPORT
PROVIDED PURSUANT TO PARAGRAPH (B) OF THIS SUBDIVISION.
  S 9. Section 89-e of the state finance law is amended by adding a  new
subdivision 2-b to read as follows:
  (2-B)  ON  OR  BEFORE THE FIRST DAY OF FEBRUARY EACH YEAR, THE COMMIS-
SIONER OF HEALTH SHALL PROVIDE A WRITTEN REPORT TO THE TEMPORARY  PRESI-
DENT OF THE SENATE, SPEAKER OF THE ASSEMBLY, CHAIR OF THE SENATE FINANCE
COMMITTEE,  CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE, CHAIR OF THE
SENATE COMMITTEE ON HEALTH, AND CHAIR OF THE ASSEMBLY HEALTH  COMMITTEE.
SUCH  REPORT  SHALL  INCLUDE  HOW  THE  MONIES OF THE FUND WERE UTILIZED
DURING THE PRECEDING CALENDAR YEAR AND SHALL INCLUDE:
  (I) THE AMOUNT OF MONEY DISPERSED FROM THE FUND;
  (II) RECIPIENTS OF AWARDS FROM THE FUND;
  (III) THE AMOUNT AWARDED TO EACH; AND
  (IV) THE PURPOSES FOR WHICH SUCH AWARDS WERE GRANTED.
  S 10. Paragraph (c) of subdivision 1 of section  2815  of  the  public
health  law,  as added by chapter 639 of the laws of 1996, is amended to
read as follows:
  (c) "Participating [general hospital] BORROWER" shall mean a  not-for-
profit  general hospital, A NOT-FOR-PROFIT DIAGNOSTIC CENTER, A NOT-FOR-
PROFIT TREATMENT CENTER, A NOT-FOR-PROFIT RESIDENTIAL HEALTH CARE FACIL-
ITY OR  ANY  OTHER  NOT-FOR-PROFIT  ENTITY  IN  POSSESSION  OF  A  VALID
OPERATING  CERTIFICATE  ISSUED  PURSUANT TO THIS ARTICLE, EACH organized
under the laws of this state, which has been approved for  participation
in this program by the commissioner.
  S  11.  Paragraphs (b), (c), and (d) of subdivision 3 and subdivisions
3-a, 4, 5, and 6 of section 2815 of the public health law, as  added  by
chapter  639  of the laws of 1996, subdivision 3-a as added by chapter 1
of the laws of 1999, are amended to read as follows:
  (b) for the development  and  implementation  of  business  plans  for
participating  [general hospitals] BORROWERS, addressing the development
of service delivery strategies, including strategies for  the  formation
or  strengthening  of  networks, affiliations or other business combina-
tions, designed to provide  long-term  financial  stability  within  and
among participating [general hospitals] BORROWERS;
  (c)  for  the  expenditure  or loan of funds by the authority from the
restructuring pool to reimburse  the  authority  or  the  agency,  where
appropriate,  for  the costs of engaging management, legal or accounting
consultants to identify, develop and implement improved  strategies  for
one or more participating [general hospitals] BORROWERS for implementing
the  recommendations of such consultants, where appropriate, and for the
payment of debt service on bonds, notes or other obligations  issued  or
incurred  by  the  authority  or the agency to fund loans to one or more
participating [general hospitals] BORROWERS;

S. 6914                            19                            A. 9205

  (d) for assurances that participating  [general  hospitals]  BORROWERS
will  address  the  recommendations  of such consultants and furnish the
commissioner, the authority, and where applicable, the agency, with such
additional financial, management, legal and operational  information  as
each  may  deem  necessary to monitor the performance of a participating
[general hospital] BORROWER; and
  3-a. Any participating  [general  hospital]  BORROWER  may  apply  for
restructuring  pool  funds  to  the  extent  such funds are derived from
deposits made pursuant to paragraph (d) of subdivision  one  of  section
twenty-eight  hundred  seven-l of this article, provided, however, that,
in reviewing such applications, the commissioner and the authority shall
consider the extent to which  the  applicant  hospital  has  alternative
available  sources of funds, including, but not limited to, funds avail-
able through affiliation agreements with other hospitals OR ENTITIES.
  4. To the extent funds are available  from  a  participating  [general
hospital]  BORROWER  therefor,  expenditures from the restructuring pool
shall be repaid to the restructuring pool from  repayments  received  by
the  authority,  or  the  agency  where applicable, from a participating
[general hospital] BORROWER pursuant  to  the  terms  of  any  financing
agreement,  mortgage  or  loan document permitting the recovery from the
participating [general hospital]  BORROWER  of  such  expenditures.  The
authority shall record and account for all such payments, which shall be
deposited in the restructuring pool.
  5.  Loans  from  the  restructuring  pool shall be made pursuant to an
agreement with the participating [general hospital] BORROWER  specifying
the terms thereof, including repayment terms. The authority shall record
and  account  for  all  such repayments, which shall be deposited in the
restructuring pool. The authority shall notify the chair of  the  senate
finance  committee, the director of the division of budget, the chair of
the assembly ways and means committee, THE CHAIR OF THE SENATE COMMITTEE
ON HEALTH, AND THE CHAIR OF THE ASSEMBLY  HEALTH  COMMITTEE,  five  days
prior to the making of a loan from the restructuring pool. The authority
shall  also report quarterly to such chairpersons on the transactions in
the pool, including but not limited to RECEIPTS OR deposits to the pool,
DISBURSEMENTS OR loans made from the pool, investment  income,  and  the
balance on hand as of the end of the month for each such quarter.
  6. The commissioner is authorized, with the assistance and cooperation
of  the  authority,  to  provide  a  program  of technical assistance to
participating [general hospitals] BORROWERS.
  S 12. Subdivision 2 of section 242 of  the  elder  law,  as  added  by
section  5  of  part  T of chapter 56 of the laws of 2012, is amended to
read as follows:
  2. Persons  eligible  for  catastrophic  coverage  under  section  two
hundred forty-eight of this title shall include:
  (a) any unmarried resident who is at least sixty-five years of age and
whose  income  for the calendar year immediately preceding the effective
date of the annual coverage period beginning on or after January  first,
two thousand one, is more than twenty thousand and less than or equal to
[thirty-five]  SEVENTY-FIVE thousand dollars. After the initial determi-
nation of eligibility, each eligible  individual  must  be  redetermined
eligible at least every twenty-four months; and
  (b)  any  married resident who is at least sixty-five years of age and
whose income for the calendar year immediately preceding  the  effective
date  of the annual coverage period when combined with the income in the
same calendar year of such married person's spouse beginning on or after
January first, two  thousand  one,  is  more  than  twenty-six  thousand

S. 6914                            20                            A. 9205

dollars  and less than or equal to [fifty] ONE HUNDRED thousand dollars.
After the initial determination of eligibility, each eligible individual
must be redetermined eligible at least every twenty-four months.
  S  13.  Paragraphs  (a) and (b) of subdivision 2 of section 248 of the
elder law, as added by section 17 of part T of chapter 56 of the laws of
2012, are amended to read as follows:
  (a) Annual personal covered drug expenditures for unmarried individual
eligible program participants:
individual income of $20,001 to $21,000                $530
individual income of $21,001 to $22,000                $550
individual income of $22,001 to $23,000                $580
individual income of $23,001 to $24,000                $720
individual income of $24,001 to $25,000                $750
individual income of $25,001 to $26,000                $780
individual income of $26,001 to $27,000                $810
individual income of $27,001 to $28,000                $840
individual income of $28,001 to $29,000                $870
individual income of $29,001 to $30,000                $900
individual income of $30,001 to $31,000                $930
individual income of $31,001 to $32,000                $960
individual income of $32,001 to $33,000                $1,160
individual income of $33,001 to $34,000                $1,190
individual income of $34,001 to $35,000                $1,230
INDIVIDUAL INCOME OF $35,001 TO $36,000                $1,260
INDIVIDUAL INCOME OF $36,001 TO $37,000                $1,290
INDIVIDUAL INCOME OF $37,001 TO $38,000                $1,320
INDIVIDUAL INCOME OF $38,001 TO $39,000                $1,350
INDIVIDUAL INCOME OF $39,001 TO $40,000                $1,380
INDIVIDUAL INCOME OF $40,001 TO $41,000                $1,410
INDIVIDUAL INCOME OF $41,001 TO $42,000                $1,440
INDIVIDUAL INCOME OF $42,001 TO $43,000                $1,470
INDIVIDUAL INCOME OF $43,001 TO $44,000                $1,500
INDIVIDUAL INCOME OF $44,001 TO $45,000                $1,530
INDIVIDUAL INCOME OF $45,001 TO $46,000                $1,560
INDIVIDUAL INCOME OF $46,001 TO $47,000                $1,590
INDIVIDUAL INCOME OF $47,001 TO $48,000                $1,620
INDIVIDUAL INCOME OF $48,001 TO $49,000                $1,650
INDIVIDUAL INCOME OF $49,001 TO $50,000                $1,680
INDIVIDUAL INCOME OF $50,001 TO $51,000                $1,710
INDIVIDUAL INCOME OF $51,001 TO $52,000                $1,740
INDIVIDUAL INCOME OF $52,001 TO $53,000                $1,770
INDIVIDUAL INCOME OF $53,001 TO $54,000                $1,800
INDIVIDUAL INCOME OF $54,001 TO $55,000                $1,830
INDIVIDUAL INCOME OF $55,001 TO $56,000                $1,860
INDIVIDUAL INCOME OF $56,001 TO $57,000                $1,890
INDIVIDUAL INCOME OF $57,001 TO $58,000                $1,920
INDIVIDUAL INCOME OF $58,001 TO $59,000                $1,950
INDIVIDUAL INCOME OF $59,001 TO $60,000                $1,980
INDIVIDUAL INCOME OF $60,001 TO $61,000                $2,010
INDIVIDUAL INCOME OF $61,001 TO $62,000                $2,040
INDIVIDUAL INCOME OF $62,001 TO $63,000                $2,070
INDIVIDUAL INCOME OF $63,001 TO $64,000                $2,100
INDIVIDUAL INCOME OF $64,001 TO $65,000                $2,130
INDIVIDUAL INCOME OF $65,001 TO $66,000                $2,160
INDIVIDUAL INCOME OF $66,001 TO $67,000                $2,190
INDIVIDUAL INCOME OF $67,001 TO $68,000                $2,220

S. 6914                            21                            A. 9205

INDIVIDUAL INCOME OF $68,001 TO $69,000                $2,250
INDIVIDUAL INCOME OF $69,001 TO $70,000                $2,280
INDIVIDUAL INCOME OF $70,001 TO $71,000                $2,310
INDIVIDUAL INCOME OF $71,001 TO $72,000                $2,340
INDIVIDUAL INCOME OF $72,001 TO $73,000                $2,370
INDIVIDUAL INCOME OF $73,001 TO $74,000                $2,400
INDIVIDUAL INCOME OF $74,001 TO $75,000                $2,430
  (b) Annual personal covered drug expenditures for each married
individual eligible program participant:
joint income of $26,001 to $27,000                     $650
joint income of $27,001 to $28,000                     $675
joint income of $28,001 to $29,000                     $700
joint income of $29,001 to $30,000                     $725
joint income of $30,001 to $31,000                     $900
joint income of $31,001 to $32,000                     $930
joint income of $32,001 to $33,000                     $960
joint income of $33,001 to $34,000                     $990
joint income of $34,001 to $35,000                     $1,020
joint income of $35,001 to $36,000                     $1,050
joint income of $36,001 to $37,000                     $1,080
joint income of $37,001 to $38,000                     $1,110
joint income of $38,001 to $39,000                     $1,140
joint income of $39,001 to $40,000                     $1,170
joint income of $40,001 to $41,000                     $1,200
joint income of $41,001 to $42,000                     $1,230
joint income of $42,001 to $43,000                     $1,260
joint income of $43,001 to $44,000                     $1,290
joint income of $44,001 to $45,000                     $1,320
joint income of $45,001 to $46,000                     $1,575
joint income of $46,001 to $47,000                     $1,610
joint income of $47,001 to $48,000                     $1,645
joint income of $48,001 to $49,000                     $1,680
joint income of $49,001 to $50,000                     $1,715
JOINT INCOME OF $50,001 TO $51,000                     $1,745
JOINT INCOME OF $51,001 TO $52,000                     $1,775
JOINT INCOME OF $52,001 TO $53,000                     $1,805
JOINT INCOME OF $53,001 TO $54,000                     $1,835
JOINT INCOME OF $54,001 TO $55,000                     $1,865
JOINT INCOME OF $55,001 TO $56,000                     $1,895
JOINT INCOME OF $56,001 TO $57,000                     $1,925
JOINT INCOME OF $57,001 TO $58,000                     $1,955
JOINT INCOME OF $58,001 TO $59,000                     $1,985
JOINT INCOME OF $59,001 TO $60,000                     $2,015
JOINT INCOME OF $60,001 TO $61,000                     $2,045
JOINT INCOME OF $61,001 TO $62,000                     $2,075
JOINT INCOME OF $62,001 TO $63,000                     $2,105
JOINT INCOME OF $63,001 TO $64,000                     $2,135
JOINT INCOME OF $64,001 TO $65,000                     $2,165
JOINT INCOME OF $65,001 TO $66,000                     $2,195
JOINT INCOME OF $66,001 TO $67,000                     $2,225
JOINT INCOME OF $67,001 TO $68,000                     $2,255
JOINT INCOME OF $68,001 TO $69,000                     $2,285
JOINT INCOME OF $69,001 TO $70,000                     $2,315
JOINT INCOME OF $70,001 TO $71,000                     $2,345
JOINT INCOME OF $71,001 TO $72,000                     $2,375
JOINT INCOME OF $72,001 TO $73,000                     $2,405

S. 6914                            22                            A. 9205

JOINT INCOME OF $73,001 TO $74,000                     $2,435
JOINT INCOME OF $74,001 TO $75,000                     $2,465
JOINT INCOME OF $75,001 TO $76,000                     $2,495
JOINT INCOME OF $76,001 TO $77,000                     $2,525
JOINT INCOME OF $77,001 TO $78,000                     $2,555
JOINT INCOME OF $78,001 TO $79,000                     $2,585
JOINT INCOME OF $79,001 TO $80,000                     $2,615
JOINT INCOME OF $80,001 TO $81,000                     $2,645
JOINT INCOME OF $81,001 TO $82,000                     $2,675
JOINT INCOME OF $82,001 TO $83,000                     $2,705
JOINT INCOME OF $83,001 TO $84,000                     $2,735
JOINT INCOME OF $84,001 TO $85,000                     $2,765
JOINT INCOME OF $85,001 TO $86,000                     $2,795
JOINT INCOME OF $86,001 TO $87,000                     $2,825
JOINT INCOME OF $87,001 TO $88,000                     $2,855
JOINT INCOME OF $88,001 TO $89,000                     $2,885
JOINT INCOME OF $89,001 TO $90,000                     $2,915
JOINT INCOME OF $90,001 TO $91,000                     $2,945
JOINT INCOME OF $91,001 TO $92,000                     $2,975
JOINT INCOME OF $92,001 TO $93,000                     $3,005
JOINT INCOME OF $93,001 TO $94,000                     $3,035
JOINT INCOME OF $94,001 TO $95,000                     $3,065
JOINT INCOME OF $95,001 TO $96,000                     $3,095
JOINT INCOME OF $96,001 TO $97,000                     $3,125
JOINT INCOME OF $97,001 TO $98,000                     $3,155
JOINT INCOME OF $98,001 TO $99,000                     $3,185
JOINT INCOME OF $99,001 TO $100,000                    $3,215
  S  14.  Paragraphs  (a) and (b) of subdivision 4 of section 248 of the
elder law, as added by section 17 of part T of chapter 56 of the laws of
2012, are amended to read as follows:
  (a) Limits on co-payments by  unmarried  individual  eligible  program
participants:
individual income of $20,001 to $21,000           no more than $1,050
individual income of $21,001 to $22,000           no more than $1,100
individual income of $22,001 to $23,000           no more than $1,150
individual income of $23,001 to $24,000           no more than $1,200
individual income of $24,001 to $25,000           no more than $1,250
individual income of $25,001 to $26,000           no more than $1,300
individual income of $26,001 to $27,000           no more than $1,350
individual income of $27,001 to $28,000           no more than $1,400
individual income of $28,001 to $29,000           no more than $1,450
individual income of $29,001 to $30,000           no more than $1,500
individual income of $30,001 to $31,000           no more than $1,550
individual income of $31,001 to $32,000           no more than $1,600
individual income of $32,001 to $33,000           no more than $1,650
individual income of $33,001 to $34,000           no more than $1,700
individual income of $34,001 to                   no more than $1,750
  [$35,000] $75,000
  (b)  Limits on co-payments by each married individual eligible program
participant:
joint income of $26,001 to $27,000                no more than $1,080
joint income of $27,001 to $28,000                no more than $1,120
joint income of $28,001 to $29,000                no more than $1,160
joint income of $29,001 to $30,000                no more than $1,200
joint income of $30,001 to $31,000                no more than $1,240
joint income of $31,001 to $32,000                no more than $1,280

S. 6914                            23                            A. 9205

joint income of $32,001 to $33,000                no more than $1,320
joint income of $33,001 to $34,000                no more than $1,360
joint income of $34,001 to $35,000                no more than $1,400
joint income of $35,001 to $36,000                no more than $1,440
joint income of $36,001 to $37,000                no more than $1,480
joint income of $37,001 to $38,000                no more than $1,520
joint income of $38,001 to $39,000                no more than $1,560
joint income of $39,001 to $40,000                no more than $1,600
joint income of $40,001 to $41,000                no more than $1,640
joint income of $41,001 to $42,000                no more than $1,680
joint income of $42,001 to $43,000                no more than $1,720
joint income of $43,001 to $44,000                no more than $1,760
joint income of $44,001 to $45,000                no more than $1,800
joint income of $45,001 to $46,000                no more than $1,840
joint income of $46,001 to $47,000                no more than $1,880
joint income of $47,001 to $48,000                no more than $1,920
joint income of $48,001 to $49,000                no more than $1,960
joint income of $49,001 to                        no more than $2,000
  [$50,000] $100,000
  S  15. Subdivision 1 of section 924 of the public health law, as added
by section 23 of part D of chapter 56 of the laws of 2012, is amended to
read as follows:
  1. [The] NOTWITHSTANDING  ANY  CONTRARY  PROVISION  OF  THIS  SECTION,
SECTIONS  ONE  HUNDRED  TWELVE  AND ONE HUNDRED SIXTY-THREE OF THE STATE
FINANCE LAW, OR ANY OTHER CONTRARY PROVISION OF LAW, THE commissioner is
authorized, within amounts available therefor, to  make  loan  repayment
awards to eligible primary care service corps practitioners who agree to
practice  full-time in an underserved area in New York state, in amounts
to be determined by the commissioner, but not to exceed thirty-two thou-
sand dollars per year for any year in which such  practitioners  provide
full-time eligible obligated service, WITHOUT COMPETITIVE BID OR REQUEST
FOR PROPOSAL PROCESS.
  S  16.  Paragraph (b) of subdivision 18-a of section 206 of the public
health law, as amended by section 38-a of part H of chapter  59  of  the
laws of 2011, is amended and paragraph (c) is added to read as follows:
  (b) The commissioner shall:
  (I) CONVENE A WORKGROUP TO:
  (A)  EVALUATE THE STATE'S HEALTH INFORMATION TECHNOLOGY INFRASTRUCTURE
AND SYSTEMS, AS WELL AS OTHER RELATED PLANS  AND  PROJECTS  DESIGNED  TO
MAKE  IMPROVEMENTS  OR  MODIFICATIONS TO SUCH INFRASTRUCTURE AND SYSTEMS
INCLUDING, BUT NOT LIMITED TO, THE ALL PAYOR DATABASE (APD),  THE  STATE
PLANNING  AND  RESEARCH  COOPERATIVE  SYSTEM  (SPARCS),  REGIONAL HEALTH
INFORMATION ORGANIZATIONS  (RHIOS),  THE  STATEWIDE  HEALTH  INFORMATION
NETWORK  OF  NEW  YORK  (SHIN-NY)  AND  MEDICAL  ASSISTANCE  ELIGIBILITY
SYSTEMS; AND
  (B) DEVELOP RECOMMENDATIONS FOR THE STATE TO MOVE TOWARD A  COMPREHEN-
SIVE  HEALTH  CLAIMS AND CLINICAL DATABASE AIMED AT IMPROVING QUALITY OF
CARE, EFFICIENCY, COST OF CARE AND PATIENT SATISFACTION AVAILABLE  IN  A
SELF-SUSTAINABLE,  NON-DUPLICATIVE, INTERACTIVE AND INTEROPERABLE MANNER
THAT ENSURES SAFEGUARDS FOR PRIVACY, CONFIDENTIALITY AND SECURITY;
  (II) SUBMIT A REPORT TO THE GOVERNOR AND THE  TEMPORARY  PRESIDENT  OF
THE  SENATE  AND THE SPEAKER OF THE ASSEMBLY, WHICH SHALL FULLY CONSIDER
THE EVALUATION AND RECOMMENDATIONS OF THE WORKGROUP, ON OR BEFORE DECEM-
BER FIRST, TWO THOUSAND FOURTEEN.
  (C) THE MEMBERS OF THE WORKGROUP SHALL INCLUDE, AT  A  MINIMUM,  THREE
MEMBERS  WHO REPRESENT RHIOS, TWO MEMBERS EMPLOYED BY THE DEPARTMENT WHO

S. 6914                            24                            A. 9205

ARE INVOLVED IN THE DEVELOPMENT OF THE SHIN-NY AND THE APD, TWO  MEMBERS
WHO  REPRESENT  PHYSICIANS,  TWO  MEMBERS  WHO  REPRESENT HOSPITALS, ONE
MEMBER WHO REPRESENTS FEDERALLY QUALIFIED HEALTH CENTERS, THE  CHAIR  OF
THE  SENATE  HEALTH  COMMITTEE  OR HIS OR HER DESIGNEE, THE CHAIR OF THE
ASSEMBLY HEALTH COMMITTEE OR HIS OR HER DESIGNEE, AND OTHER  INDIVIDUALS
WITH EXPERTISE IN MATTERS RELEVANT TO THE CHARGE OF THE WORKGROUP.
  (D)  THE  COMMISSIONER  MAY  make such rules and regulations as may be
necessary to implement federal policies and disburse funds  as  required
by the American Recovery and Reinvestment Act of 2009 and to promote the
development  of  a  [statewide health information network of New York (]
SELF-SUFFICIENT SHIN-NY[)] to enable widespread, NON-DUPLICATIVE  inter-
operability  among disparate health information systems, including elec-
tronic health records, personal  health  records,  health  care  claims,
PAYMENT  and  other  administrative  data, and public health information
systems, while protecting privacy and security.  Such  rules  and  regu-
lations shall include, but not be limited to, requirements for organiza-
tions  covered  by  42  U.S.C.  17938  or  any  other organizations that
exchange health information through the SHIN-NY OR ANY  OTHER  STATEWIDE
HEALTH INFORMATION SYSTEM RECOMMENDED BY THE WORKGROUP. THE COMMISSIONER
SHALL CONSIDER THE RECOMMENDATIONS OF THE WORKGROUP. IF THE COMMISSIONER
ACTS IN A MANNER INCONSISTENT WITH THE RECOMMENDATIONS OF THE WORKGROUP,
HE OR SHE SHALL PROVIDE THE REASONS THEREFOR.
  S  17.  Section  2818 of the public health law is amended to add a new
subdivision 8 to read as follows:
  8. ON OR BEFORE DECEMBER FIRST, TWO THOUSAND FOURTEEN, THE  DEPARTMENT
SHALL  ISSUE  A  REPORT  TO THE GOVERNOR, THE TEMPORARY PRESIDENT OF THE
SENATE AND THE SPEAKER OF THE ASSEMBLY REGARDING GRANTS MADE PURSUANT TO
THIS SECTION TO SUPPORT HEALTH INFORMATION TECHNOLOGY.
  S 18. The public health law is amended by adding a new section  2801-h
to read as follows:
  S  2801-H.  COMMUNITY  FORUM ON ESTABLISHMENT OF CERTAIN FACILITIES IN
THE COUNTY OF BRONX. 1. FOR ANY PROPOSED FREE  STANDING  CLINIC,  OUTPA-
TIENT  HEALTH  CARE FACILITY OR AMBULATORY HEALTH CARE CENTER THAT:  (I)
IS TO BE OVER THREE STORIES IN HEIGHT OR TO CONTAIN OVER THIRTY THOUSAND
SQUARE FEET, (II) IS PROPOSED TO BE LOCATED IN THE COUNTY OF BRONX,  AND
(III)  IS  SPONSORED,  DIRECTLY  OR  INDIRECTLY, BY A HOSPITAL, THEN THE
SPONSORING HOSPITAL SHALL, PRIOR TO THE ESTABLISHMENT  OF  SUCH  CLINIC,
FACILITY  OR  CENTER,  FILE  A  NOTICE  THEREOF WITH THE DEPARTMENT, THE
EDUCATION DEPARTMENT AND THE COMMUNITY BOARD OF THE  LOCALITY  IN  WHICH
THE CLINIC, FACILITY OR CENTER IS TO BE ESTABLISHED.
  2.  NOT  LESS  THAN  ONE HUNDRED EIGHTY DAYS NOR MORE THAN TWO HUNDRED
SEVENTY DAYS AFTER RECEIPT OF A SPONSORING HOSPITAL'S NOTICE PURSUANT TO
SUBDIVISION ONE OF THIS SECTION, THE COMMISSIONER SHALL  HOLD  A  PUBLIC
COMMUNITY  FORUM FOR THE PURPOSE OF OBTAINING PUBLIC AND COMMUNITY BOARD
INPUT CONCERNING THE ANTICIPATED IMPACT OF THE ESTABLISHMENT OF  A  FREE
STANDING  CLINIC,  OUTPATIENT  HEALTH CARE FACILITY OR AMBULATORY HEALTH
CARE FACILITY. SUCH IMPACT MAY INCLUDE AND RELATE TO:  (I) THE APPROPRI-
ATENESS OF THE SIZE, HEIGHT, BULK DIMENSIONS AND SCOPE OF  SUCH  CLINIC,
FACILITY  OR CENTER WHEN COMPARED TO THE SURROUNDING PHYSICAL CHARACTER-
ISTICS AND SOCIAL FABRIC  OF  SUCH  COMMUNITY,  (II)  THE  PROVISION  OF
ADEQUATE  MOTOR  VEHICLE  PARKING TO ACCOMMODATE SUCH FACILITY NEEDS AND
WHICH DOES NOT DIMINISH THE CURRENT SUPPLY OF PARKING FOR  NEARBY  RESI-
DENTS  OR  INCREASE  TRAFFIC  CONGESTION  NEAR  SUCH FACILITY, (III) THE
CURRENT ACCESS TO APPROPRIATE MEDICAL FACILITIES  OR  THE  PROVISION  OF
ESSENTIAL MEDICAL SERVICES TO SUCH COMMUNITY, SERVICE AREA AND SURROUND-
ING  COMMUNITIES,  AND (IV) OPTIONS AND PROPOSALS TO AMELIORATE OR MITI-

S. 6914                            25                            A. 9205

GATE ANTICIPATED ADVERSE IMPACTS TO THE LOCAL COMMUNITY.    THE  COMMIS-
SIONER  SHALL  AFFORD  COMMUNITY  MEMBERS,  REPRESENTATIVES OF THE LOCAL
COMMUNITY BOARD, LOCAL BUSINESSES AND CONSUMERS A REASONABLE OPPORTUNITY
TO  SPEAK  ABOUT  RELEVANT  MATTERS AT SUCH COMMUNITY FORUM.  EVERY SUCH
FORUM SHALL BE HELD UPON  NOT  LESS  THAN  THIRTY  DAYS  NOTICE  TO  THE
AFFECTED COMMUNITY AND THE LOCAL COMMUNITY BOARD.
  3.  THE  COMMISSIONER  SHALL, PRIOR TO ESTABLISHING THE DATE, TIME AND
LOCATION OF THE PUBLIC COMMUNITY FORUM, CONSULT  WITH,  AND  OBTAIN  THE
ADVICE  AND CONSENT OF THE APPROPRIATE COMMUNITY BOARD, AS TO ESTABLISH-
ING A CONVENIENT DATE, TIME AND LOCATION TO CONDUCT THE  FORUM  FOR  THE
LOCALLY  IMPACTED  COMMUNITY.    SUCH  HEARING  LOCATION SHALL BE WITHIN
REASONABLE PROXIMITY TO THE PROPOSED CLINIC, FACILITY OR CENTER, AND  IN
SUITABLE FACILITIES THAT PROVIDE ADEQUATE ROOM AND ACCESS TO HEAR PUBLIC
COMMENTS PRESENTED.
  4.  NOT  LATER  THAN  NINETY  DAYS AFTER HOLDING A COMMUNITY FORUM THE
COMMISSIONER SHALL MAKE AVAILABLE TO  THE  PUBLIC  ON  THE  DEPARTMENT'S
WEBSITE  THE  REASONS  WHY  SUCH  FACILITY IS, BY A PREPONDERANCE OF THE
EVIDENCE, IN THE BEST INTERESTS OF  THOSE  WHO  LIVE  WITHIN  THE  LOCAL
COMMUNITY  AND  WITHIN  THE LOCAL SERVICE AREA AS IT RELATES TO: (I) THE
APPROPRIATENESS OF THE SIZE, HEIGHT, BULK DIMENSIONS AND SCOPE  OF  SUCH
CLINIC,  FACILITY  OR  CENTER  WHEN COMPARED TO THE SURROUNDING PHYSICAL
CHARACTERISTICS AND SOCIAL FABRIC OF SUCH COMMUNITY, (II) THE  PROVISION
OF ADEQUATE MOTOR VEHICLE PARKING TO ACCOMMODATE SUCH FACILITY NEEDS AND
WHICH  DOES  NOT DIMINISH THE CURRENT SUPPLY OF PARKING FOR NEARBY RESI-
DENTS OR INCREASE TRAFFIC CONGESTION NEAR SUCH FACILITY, AND  (III)  THE
CURRENT  ACCESS  TO  APPROPRIATE  MEDICAL FACILITIES OR THE PROVISION OF
ESSENTIAL MEDICAL SERVICES TO SUCH COMMUNITY, SERVICE AREA AND SURROUND-
ING COMMUNITIES.
  5. AFTER DUE CONSIDERATION OF THE COMMENTS AT THE COMMUNITY FORUM  AND
CONSULTATION  WITH  THE  EDUCATION  DEPARTMENT,  THE  COMMISSIONER SHALL
EITHER APPROVE, MODIFY OR DENY AUTHORIZATION FOR  THE  ESTABLISHMENT  OF
ANY SUCH CLINIC, FACILITY OR CENTER.
  S 19. For claims for payment submitted by early intervention providers
to  third  party  payors between the period April 1, 2013 until June 30,
2013 in accordance with title 2-A of article 25  of  the  public  health
law,  for  which the third party payor has not, on the effective date of
this section, made payment of the claim in whole or in part or  rendered
a  determination that it is not obligated to pay the claim, the provider
shall be authorized to seek payment of such claim from the municipality,
through the fiscal agent under contract with the department  of  health;
provided,  however,  that  the  provider  shall  continue  to render any
assistance  needed,  and  provide  any  information  and   documentation
requested  by  the  third party payor to facilitate payment of the claim
even if the provider has already received payment from the municipality.
If such third party payor makes payment of the claim after the  provider
has  received  payment  from  the  municipality, the third party payment
shall be reconciled against future payments due the  provider  from  the
municipality.  This  section  shall  only  apply  to claims submitted by
approved early intervention providers to third party payors  during  the
period  April 1, 2013 until June 30, 2013 for which no payment or deter-
mination has been made, as specified in this section, on April 1,  2014.
Payment  shall  be made on the forty-fifth day after this act shall take
effect. The provisions in subdivision 2 of section 2557  of  the  public
health  law  that  prohibit state reimbursement from being paid prior to
April first of the year in which the approved  costs  are  paid  by  the

S. 6914                            26                            A. 9205

municipality  shall  not apply to the municipal payments made under this
section.
  S 20. Article 29-D of the public health law is amended by adding a new
title 1-A to read as follows:
                                TITLE 1-A
                          SAFE PATIENT HANDLING
SECTION 2997-G. LEGISLATIVE INTENT.
        2997-H. DEFINITIONS.
        2997-I. SAFE PATIENT HANDLING WORKGROUP.
        2997-J. DISSEMINATION OF BEST PRACTICES, EXAMPLES OF SAMPLE SAFE
                 PATIENT  HANDLING  POLICIES  AND  OTHER  RESOURCES  AND
                 TOOLS.
        2997-K. SAFE PATIENT HANDLING COMMITTEES; PROGRAMS.
        2997-L. ACTIVITIES.
  S  2997-G.  LEGISLATIVE  INTENT.  THE  LEGISLATURE  HEREBY  FINDS  AND
DECLARES THAT IT IS IN THE PUBLIC INTEREST FOR HEALTH CARE FACILITIES TO
IMPLEMENT  SAFE  PATIENT HANDLING POLICIES. THERE ARE MANY BENEFITS THAT
CAN BE DERIVED FROM SAFE PATIENT  HANDLING  PROGRAMS.  PATIENTS  BENEFIT
THROUGH  IMPROVED  QUALITY  OF  CARE AND QUALITY OF LIFE BY REDUCING THE
RISK OF INJURY. CAREGIVERS ALSO BENEFIT FROM THE REDUCED RISK OF  CAREER
ENDING  AND  DEBILITATING INJURIES LEADING TO INCREASED MORALE, IMPROVED
JOB SATISFACTION, AND LONGEVITY IN THE PROFESSION. HEALTH  CARE  FACILI-
TIES  MAY  REALIZE A RETURN ON THEIR INVESTMENT THROUGH REDUCED WORKERS'
COMPENSATION MEDICAL AND INDEMNITY COSTS,  REDUCED  LOST  WORKDAYS,  AND
IMPROVED RECRUITMENT AND RETENTION OF CAREGIVERS. ALL OF THIS COULD LEAD
TO FISCAL IMPROVEMENT IN HEALTH CARE IN NEW YORK STATE.
  S 2997-H. DEFINITIONS. FOR THE PURPOSES OF THIS TITLE:
  1.  "HEALTH  CARE  FACILITY" SHALL MEAN GENERAL HOSPITALS, RESIDENTIAL
HEALTH CARE FACILITIES, DIAGNOSTIC AND TREATMENT  CENTERS,  AND  CLINICS
LICENSED  PURSUANT  TO  ARTICLE TWENTY-EIGHT OF THIS CHAPTER, FACILITIES
WHICH PROVIDE HEALTH CARE SERVICES AND ARE LICENSED OR OPERATED PURSUANT
TO ARTICLE EIGHT OF THE EDUCATION LAW, ARTICLE NINETEEN-G OF THE  EXECU-
TIVE  LAW  OR  THE  CORRECTION LAW, AND HOSPITALS AND SCHOOLS DEFINED IN
SECTION 1.03 OF THE MENTAL HYGIENE LAW.
  2. "NURSE" SHALL MEAN A REGISTERED PROFESSIONAL NURSE  OR  A  LICENSED
PRACTICAL  NURSE  AS  DEFINED  BY ARTICLE ONE HUNDRED THIRTY-NINE OF THE
EDUCATION LAW.
  3. "DIRECT CARE WORKER" SHALL MEAN  ANY  EMPLOYEE  OF  A  HEALTH  CARE
FACILITY  WHO  IS RESPONSIBLE FOR PATIENT HANDLING OR PATIENT ASSESSMENT
AS A REGULAR OR INCIDENTAL PART OF HIS OR HER EMPLOYMENT, INCLUDING  ANY
LICENSED OR UNLICENSED HEALTH CARE WORKER.
  4.  "EMPLOYEE  REPRESENTATIVE"  SHALL MEAN THE RECOGNIZED OR CERTIFIED
COLLECTIVE BARGAINING AGENT FOR NURSES  OR  DIRECT  CARE  WORKERS  OF  A
HEALTH CARE FACILITY.
  5. "SAFE PATIENT HANDLING" SHALL MEAN THE USE OF ENGINEERING CONTROLS,
LIFTING  AND TRANSFER AIDS, OR ASSISTIVE DEVICES BY STAFF TO PERFORM THE
ACTS OF LIFTING, TRANSFERRING AND REPOSITIONING HEALTH CARE PATIENTS AND
RESIDENTS.
  6. "MUSCULOSKELETAL DISORDERS" SHALL MEAN CONDITIONS THAT INVOLVE  THE
NERVES, TENDONS, MUSCLES AND SUPPORTING STRUCTURES OF THE BODY.
  S  2997-I.  SAFE PATIENT HANDLING WORKGROUP. 1. THE COMMISSIONER SHALL
ESTABLISH A SAFE PATIENT HANDLING WORKGROUP (REFERRED TO IN THIS SECTION
AS THE "WORKGROUP") WITHIN THE DEPARTMENT. THE WORKGROUP  SHALL  CONSIST
OF, AT THE MINIMUM, THE COMMISSIONER OR HIS OR HER DESIGNEE; THE COMMIS-
SIONER  OF  LABOR OR HIS OR HER DESIGNEE; REPRESENTATIVES OF HEALTH CARE
PROVIDER  ORGANIZATIONS;  REPRESENTATIVES  FROM  EMPLOYEE  ORGANIZATIONS

S. 6914                            27                            A. 9205

REPRESENTING  NURSES  AND  REPRESENTATIVES  FROM  EMPLOYEE ORGANIZATIONS
REPRESENTING DIRECT CARE WORKERS; REPRESENTATIVES OF  NURSE  EXECUTIVES;
REPRESENTATIVES WHO ARE CERTIFIED ERGONOMIST EVALUATION SPECIALISTS; AND
REPRESENTATIVES  WHO  HAVE  EXPERTISE IN FIELDS OF DISCIPLINE RELATED TO
HEALTH CARE OR OCCUPATIONAL SAFETY.
  2. WORKGROUP MEMBERS SHALL RECEIVE NO COMPENSATION FOR THEIR  SERVICES
AS  MEMBERS  OF  THE  WORKGROUP,  BUT SHALL BE REIMBURSED FOR ACTUAL AND
NECESSARY EXPENSES INCURRED IN THE PERFORMANCE OF THEIR DUTIES.
  3. THE WORKGROUP SHALL BE ESTABLISHED NO LATER THAN JANUARY FIRST, TWO
THOUSAND FIFTEEN.
  4. THE WORKGROUP SHALL:
  (A) REVIEW  EXISTING  SAFE  PATIENT  HANDLING  PROGRAMS  OR  POLICIES,
INCLUDING  DEMONSTRATION PROGRAMS PREVIOUSLY AUTHORIZED BY CHAPTER SEVEN
HUNDRED THIRTY-EIGHT OF THE LAWS OF TWO THOUSAND FIVE AND NATIONAL  DATA
AND RESULTS;
  (B)  CONSULT  WITH  ANY  ORGANIZATION,  EDUCATIONAL INSTITUTION, OTHER
GOVERNMENT ENTITY OR AGENCY OR PERSON THAT THE WORKGROUP DETERMINES  MAY
BE  ABLE  TO  PROVIDE  INFORMATION  AND EXPERTISE ON THE DEVELOPMENT AND
IMPLEMENTATION OF SAFE PATIENT HANDLING PROGRAMS;
  (C) IDENTIFY OR DEVELOP TRAINING MATERIALS FOR CONSIDERATION BY HEALTH
CARE FACILITIES; AND
  (D) SUBMIT A REPORT TO THE COMMISSIONER BY JULY  FIRST,  TWO  THOUSAND
FIFTEEN  IDENTIFYING  SAFE  PATIENT  HANDLING  PROGRAM  BEST  PRACTICES,
PROVIDING EXAMPLES OF SAMPLE POLICIES,  AND  IDENTIFYING  RESOURCES  AND
TOOLS  USEFUL  FOR  PROVIDERS TO MEET THE GOALS OF SAFE PATIENT HANDLING
POLICIES.
  5. ALL STATE DEPARTMENTS, COMMISSIONS, AGENCIES, AND  PUBLIC  AUTHORI-
TIES  SHALL  PROVIDE THE WORKGROUP WITH ANY REASONABLY REQUESTED ASSIST-
ANCE OR ADVICE IN A TIMELY MANNER.
  S 2997-J. DISSEMINATION OF BEST PRACTICES,  EXAMPLES  OF  SAMPLE  SAFE
PATIENT HANDLING POLICIES AND OTHER RESOURCES AND TOOLS. THE COMMISSION-
ER  SHALL  DISSEMINATE  BEST  PRACTICES, EXAMPLES OF SAMPLE SAFE PATIENT
HANDLING POLICIES, AND OTHER RESOURCES AND TOOLS TO HEALTH CARE  FACILI-
TIES,  TAKING INTO CONSIDERATION THE RECOMMENDATIONS OF THE SAFE PATIENT
HANDLING WORKGROUP. SUCH BEST PRACTICES, EXAMPLES OF SAMPLE SAFE PATIENT
HANDLING POLICIES, AND OTHER RESOURCES AND TOOLS SHALL BE MADE AVAILABLE
TO ALL FACILITIES COVERED BY THIS TITLE ON OR BEFORE JANUARY FIRST,  TWO
THOUSAND SIXTEEN.
  S  2997-K. SAFE PATIENT HANDLING COMMITTEES; PROGRAMS. 1. ON OR BEFORE
JANUARY FIRST, TWO THOUSAND SIXTEEN, EACH  HEALTH  CARE  FACILITY  SHALL
ESTABLISH A SAFE PATIENT HANDLING COMMITTEE (REFERRED TO IN THIS SECTION
AS  A  "COMMITTEE"  EXCEPT WHERE THE CONTEXT CLEARLY REQUIRES OTHERWISE)
EITHER BY CREATING A NEW COMMITTEE OR ASSIGNING THE FUNCTIONS OF A  SAFE
PATIENT  HANDLING  COMMITTEE TO AN EXISTING COMMITTEE, INCLUDING BUT NOT
LIMITED TO A SAFETY COMMITTEE OR QUALITY ASSURANCE COMMITTEE, OR SUBCOM-
MITTEE THEREOF. THE PURPOSE OF A COMMITTEE IS TO  DESIGN  AND  RECOMMEND
THE  PROCESS  FOR  IMPLEMENTING  A SAFE PATIENT HANDLING PROGRAM FOR THE
HEALTH CARE FACILITY.  THE  COMMITTEE  SHALL  INCLUDE  INDIVIDUALS  WITH
EXPERTISE  OR  EXPERIENCE  THAT  IS  RELEVANT  TO SAFE PATIENT HANDLING,
INCLUDING RISK MANAGEMENT, NURSING, PURCHASING, OR  OCCUPATIONAL  SAFETY
AND  HEALTH, AND IN FACILITIES WHERE THERE ARE EMPLOYEE REPRESENTATIVES,
AT LEAST ONE SHALL BE APPOINTED ON BEHALF OF NURSES  AND  AT  LEAST  ONE
SHALL  BE  APPOINTED  ON  BEHALF OF DIRECT CARE WORKERS. ONE HALF OF THE
MEMBERS OF THE COMMITTEE SHALL BE FRONTLINE NON-MANAGERIAL EMPLOYEES WHO
PROVIDE DIRECT CARE TO PATIENTS. AT LEAST ONE NON-MANAGERIAL  NURSE  AND
ONE  NON-MANAGERIAL  DIRECT  CARE  WORKER  SHALL  BE ON THE SAFE PATIENT

S. 6914                            28                            A. 9205

HANDLING COMMITTEE. IN HEALTH CARE FACILITIES WHERE A  RESIDENT  COUNCIL
IS  ESTABLISHED,  AND  WHERE  FEASIBLE,  AT LEAST ONE MEMBER OF THE SAFE
PATIENT HANDLING COMMITTEE SHALL BE A REPRESENTATIVE FROM  THE  RESIDENT
COUNCIL.    THE COMMITTEE SHALL HAVE TWO CO-CHAIRS WITH ONE FROM MANAGE-
MENT AND ONE FRONTLINE NON-MANAGERIAL NURSE OR DIRECT CARE WORKER.
  2. ON OR BEFORE JANUARY FIRST, TWO  THOUSAND  SEVENTEEN,  EACH  HEALTH
CARE  FACILITY,  IN  CONSULTATION  WITH THE COMMITTEE, SHALL ESTABLISH A
SAFE PATIENT HANDLING PROGRAM. AS PART OF THIS PROGRAM,  A  HEALTH  CARE
FACILITY SHALL:
  (A) IMPLEMENT A SAFE PATIENT HANDLING POLICY, CONSIDERING THE ELEMENTS
OF  THE SAMPLE SAFE PATIENT HANDLING POLICIES AND BEST PRACTICES DISSEM-
INATED BY THE COMMISSIONER, AS WELL AS THE  TYPE  OF  FACILITY  AND  ITS
SERVICES,  PATIENT  POPULATIONS AND CARE PLANS, TYPES OF CAREGIVERS, AND
PHYSICAL ENVIRONMENT, FOR ALL SHIFTS AND UNITS OF THE HEALTH CARE FACIL-
ITY.  IMPLEMENTATION OF THE SAFE PATIENT HANDLING POLICY MAY BE  PHASED-
IN;
  (B)  CONDUCT  A  PATIENT  HANDLING  HAZARD ASSESSMENT. THIS ASSESSMENT
SHOULD CONSIDER SUCH VARIABLES AS PATIENT-HANDLING TASKS, TYPES OF NURS-
ING UNITS, PATIENT POPULATIONS AND THE PHYSICAL ENVIRONMENT  OF  PATIENT
CARE AREAS;
  (C)  DEVELOP  A  PROCESS  TO  IDENTIFY THE APPROPRIATE USE OF THE SAFE
PATIENT HANDLING POLICY BASED ON  THE  PATIENT'S  PHYSICAL  AND  MEDICAL
CONDITION  AND  THE AVAILABILITY OF SAFE PATIENT HANDLING EQUIPMENT. THE
POLICY SHALL INCLUDE A MEANS TO ADDRESS  CIRCUMSTANCES  UNDER  WHICH  IT
WOULD  BE  CONTRAINDICATED  BASED  ON  A  PATIENT'S  PHYSICAL,  MEDICAL,
WEIGHT-BEARING, COGNITIVE AND/OR REHABILITATIVE STATUS TO USE LIFTING OR
TRANSFER AIDS OR ASSISTIVE DEVICES FOR PARTICULAR PATIENTS;
  (D) PROVIDE INITIAL AND ON-GOING YEARLY TRAINING AND EDUCATION ON SAFE
PATIENT HANDLING FOR CURRENT EMPLOYEES  AND  NEW  HIRES,  AND  ESTABLISH
PROCEDURES  TO ENSURE THAT RETRAINING FOR THOSE FOUND TO BE DEFICIENT IS
PROVIDED AS NEEDED;
  (E) SET UP AND UTILIZE A PROCESS FOR INCIDENT INVESTIGATION AND  POST-
INVESTIGATION  REVIEW  WHICH MAY INCLUDE A PLAN OF CORRECTION AND IMPLE-
MENTATION OF CONTROLS;
  (F) CONDUCT AN ANNUAL PERFORMANCE EVALUATION OF THE PROGRAM TO  DETER-
MINE  ITS  EFFECTIVENESS, WITH THE RESULTS OF THE EVALUATION REPORTED TO
THE COMMITTEE. THE EVALUATION SHALL DETERMINE THE EXTENT TO WHICH IMPLE-
MENTATION OF THE PROGRAM HAS RESULTED IN A  REDUCTION  IN  THE  RISK  OF
INJURY  TO  PATIENTS,  MUSCULOSKELETAL  DISORDER CLAIMS AND DAYS OF LOST
WORK ATTRIBUTABLE TO MUSCULOSKELETAL DISORDERS BY  EMPLOYEES  CAUSED  BY
PATIENT  HANDLING, AND INCLUDE RECOMMENDATIONS TO INCREASE THE PROGRAM'S
EFFECTIVENESS;
  (G) WHEN DEVELOPING ARCHITECTURAL PLANS FOR CONSTRUCTING OR REMODELING
A HEALTH CARE FACILITY OR A UNIT OF A  HEALTH  CARE  FACILITY  IN  WHICH
PATIENT HANDLING AND MOVEMENT OCCURS, CONSIDER THE FEASIBILITY OF INCOR-
PORATING   PATIENT   HANDLING   EQUIPMENT  OR  THE  PHYSICAL  SPACE  AND
CONSTRUCTION DESIGN NEEDED TO INCORPORATE  THAT  EQUIPMENT  AT  A  LATER
DATE; AND
  (H)  DEVELOP  A PROCESS BY WHICH EMPLOYEES MAY REFUSE TO PERFORM OR BE
INVOLVED IN PATIENT HANDLING OR MOVEMENT THAT  THE  EMPLOYEE  REASONABLY
BELIEVES  IN  GOOD  FAITH  WILL EXPOSE A PATIENT OR HEALTH CARE FACILITY
EMPLOYEE TO AN UNACCEPTABLE RISK OF INJURY. SUCH PROCESS  SHALL  REQUIRE
THAT  THE NURSE OR DIRECT CARE WORKER MAKE A GOOD FAITH EFFORT TO ENSURE
PATIENT SAFETY AND BRING THE MATTER TO THE ATTENTION OF THE FACILITY  IN
A  TIMELY  MANNER. A HEALTH CARE FACILITY EMPLOYEE WHO REASONABLY AND IN
GOOD FAITH FOLLOWS THE PROCESS DEVELOPED BY THE HEALTH CARE FACILITY  IN

S. 6914                            29                            A. 9205

ACCORDANCE  WITH  THIS SUBDIVISION SHALL NOT BE THE SUBJECT OF DISCIPLI-
NARY ACTION BY THE HEALTH CARE FACILITY FOR THE REFUSAL TO PERFORM OR BE
INVOLVED IN THE PATIENT HANDLING OR MOVEMENT.
  S 2997-L. ACTIVITIES. THE ACTIVITIES ENUMERATED IN SECTION TWENTY-NINE
HUNDRED NINETY-SEVEN-K OF THIS TITLE SHALL BE UNDERTAKEN CONSISTENT WITH
SECTION  TWENTY-EIGHT HUNDRED FIVE-J OF THIS CHAPTER BY A COVERED HEALTH
CARE PROVIDER  AND  SHALL  BE  DEEMED  ACTIVITIES  OF  SUCH  PROGRAM  AS
DESCRIBED  IN  SUCH  SECTION AND ANY AND ALL INFORMATION ATTRIBUTABLE TO
SUCH ACTIVITIES SHALL BE SUBJECT TO PROVISIONS OF  SECTION  TWENTY-EIGHT
HUNDRED   FIVE-M   OF   THIS  CHAPTER  AND  SECTION  SIXTY-FIVE  HUNDRED
TWENTY-SEVEN OF THE EDUCATION LAW.
  S 21. Section 2304 of the insurance law is amended  by  adding  a  new
subsection (j) to read as follows:
  (J)(1)  ON  OR BEFORE JULY FIRST, TWO THOUSAND SIXTEEN, THE DEPARTMENT
SHALL MAKE RULES ESTABLISHING REQUIREMENTS FOR HEALTH CARE FACILITIES TO
OBTAIN A REDUCED WORKER'S COMPENSATION RATE FOR  SAFE  PATIENT  HANDLING
PROGRAMS IMPLEMENTED PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-NINE-A OF
THE PUBLIC HEALTH LAW.
  (2)  THE DEPARTMENT SHALL COMPLETE AN EVALUATION OF THE RESULTS OF THE
REDUCED RATE, INCLUDING CHANGES IN CLAIM FREQUENCY AND COSTS, AND  SHALL
REPORT  TO  THE  APPROPRIATE  COMMITTEES OF THE LEGISLATURE ON OR BEFORE
DECEMBER FIRST, TWO THOUSAND EIGHTEEN AND AGAIN ON  OR  BEFORE  DECEMBER
FIRST, TWO THOUSAND TWENTY.
  S  22.  Subdivision  6  of  section  2899 of the public health law, as
amended by chapter 331 of the laws  of  2006,  is  amended  to  read  as
follows:
  6. "Provider" shall mean any residential health care facility licensed
under article twenty-eight of this chapter; or any certified home health
agency, licensed home care services agency or long term home health care
program certified under article thirty-six of this chapter; OR ANY ADULT
CARE FACILITY LICENSED UNDER ARTICLE SEVEN OF THE SOCIAL SERVICES LAW.
  S  23.  Paragraph (a) of subdivision 9 of section 2899-a of the public
health law, as amended by chapter 331 of the laws of 2006, is amended to
read as follows:
  (a) In the event that funds are appropriated in any given fiscal  year
for  the  reimbursement for the costs of providing such criminal history
information, reimbursement shall be made available in an  equitable  and
direct  manner for the projected cost of the fee established pursuant to
law by the division of criminal justice services for processing a crimi-
nal history information check, the fee imposed by the federal bureau  of
investigation  for  a national criminal history check, and costs associ-
ated with obtaining the fingerprints to all providers licensed, but  not
certified  under  article thirty-six of this chapter, AND ALL ADULT CARE
FACILITIES LICENSED UNDER ARTICLE SEVEN  OF  THE  SOCIAL  SERVICES  LAW,
including  those  that  are  subject  to  this article and are unable to
access direct reimbursement from  state  and/or  federal  funded  health
programs.
  S 24. The social services law is amended by adding a new section 461-t
to read as follows:
  S 461-T. REVIEW OF CRIMINAL HISTORY INFORMATION CONCERNING PROSPECTIVE
DIRECT  CARE EMPLOYEES. EVERY ADULT CARE FACILITY SHALL CONDUCT A CRIMI-
NAL HISTORY RECORD CHECK OF PROSPECTIVE DIRECT CARE EMPLOYEES  UTILIZING
THE  PROCEDURES AND STANDARDS SET FORTH IN ARTICLE TWENTY-EIGHT-E OF THE
PUBLIC HEALTH LAW.
  S 25. The public health law is amended by adding a new section  2997-e
to read as follows:

S. 6914                            30                            A. 9205

  S 2997-E. PROVISION OF CONTACT INFORMATION RELATING TO LONG TERM CARE.
WHENEVER  A  HEALTH CARE PROVIDER OR PRACTITIONER MAKES A RECOMMENDATION
REGARDING THE NECESSITY OF LONG TERM CARE SERVICES OR A REFERRAL FOR THE
RECEIPT OF LONG  TERM  CARE  SERVICES  TO  A  PATIENT,  THE  PATIENT  OR
PATIENT'S DESIGNATED REPRESENTATIVE SHALL BE PROVIDED BY THE HEALTH CARE
PROVIDER OR PRACTITIONER THE CONTACT INFORMATION FOR NY CONNECTS: CHOIC-
ES  FOR  LONG  TERM  CARE,  ESTABLISHED PURSUANT TO SUBDIVISION EIGHT OF
SECTION TWO HUNDRED THREE OF THE ELDER  LAW,  THAT  CORRESPONDS  TO  THE
PATIENT'S  COUNTY  OF RESIDENCE OR PROSPECTIVE COUNTY OF RESIDENCE BASED
ON THE PREFERENCE OF THE PATIENT.
  S 26. Intentionally omitted.
  S 27. Section 4310 of the public health law, as amended by chapter 639
of the laws of 2006, the section heading as separately amended by  chap-
ter  640 of the laws of 2006, subdivisions 1 and 3 as amended by chapter
158 of the laws of 2012, subdivision 2 as separately amended by chapters
158 and 465 of the laws of 2012, is amended to read as follows:
  S 4310. New York state donate life registry for organ, EYE and  tissue
donations.  1.  The department shall establish an organ, EYE, and tissue
donor registry, which shall be called and be referred to as the  "donate
life  registry", WHICH SHALL PROVIDE A MEANS TO MAKE AND REGISTER A GIFT
OF ORGANS, EYES AND TISSUES TO TAKE PLACE AFTER DEATH PURSUANT  TO  THIS
ARTICLE.  [Such] THE DONATE LIFE registry shall contain a listing of all
donors who have declared their consent to make an anatomical gift.
  2. THE COMMISSIONER MAY ENTER INTO A MULTI-YEAR CONTRACT FOR THE OPER-
ATION AND PROMOTION OF THE DONATE LIFE REGISTRY SUBJECT  TO  SUCH  TERMS
AND  CONDITIONS AS MAY BE CONTAINED WITHIN SUCH CONTRACT WITH A NOT-FOR-
PROFIT ORGANIZATION THAT HAS EXPERIENCE  WORKING  WITH  ORGAN,  EYE  AND
TISSUE PROCUREMENT ORGANIZATIONS, HAS EXPERTISE IN CONDUCTING ORGAN, EYE
AND  TISSUE  DONOR  PROMOTIONAL  CAMPAIGNS,  AND  IS AFFILIATED WITH THE
ORGAN, EYE AND TISSUE  DONATION  COMMUNITY  THROUGHOUT  THE  STATE.  THE
CONTRACTOR  MAY  SUBCONTRACT  AS NEEDED FOR THE EFFECTIVE PERFORMANCE OF
THE CONTRACT. ALL SUCH SUBCONTRACTORS AND THE TERMS OF SUCH SUBCONTRACTS
SHALL BE SUBJECT TO APPROVAL BY THE COMMISSIONER. ANY  APPLICABLE  STATE
AGENCY, INCLUDING, BUT NOT LIMITED TO, THE DEPARTMENT, THE DEPARTMENT OF
MOTOR  VEHICLES  AND  THE  BOARD  OF  ELECTIONS,  SHALL COOPERATE IN THE
COLLECTION AND TRANSFER OF REGISTRANT DATA TO THE DONATE LIFE REGISTRY.
  3. THE DUTIES OF THE CONTRACTOR SHALL INCLUDE, BUT NOT BE LIMITED  TO,
THE FOLLOWING:
  (A) THE DEVELOPMENT, IMPLEMENTATION AND MAINTENANCE OF THE DONATE LIFE
REGISTRY  THAT INCLUDES ONLINE, MAILED AND OTHER FORMS OF ORGAN, EYE AND
TISSUE DONOR REGISTRATION, VERIFICATION, AMENDMENT AND REVOCATION;
  (B) PREPARATION AND SUBMISSION OF A PLAN TO ENCOURAGE ORGAN,  EYE  AND
TISSUE DONATION THROUGH EDUCATION AND MARKETING EFFORTS AND OTHER RECOM-
MENDATIONS  THAT  WOULD STREAMLINE AND ENHANCE THE COST-EFFECTIVE OPERA-
TION OF THE DONATE LIFE REGISTRY;
  (C) PROVISION OF WRITTEN OR ELECTRONIC NOTIFICATION OF REGISTRATION IN
THE DONATE LIFE REGISTRY TO AN INDIVIDUAL ENROLLING IN THE  DONATE  LIFE
REGISTRY; AND
  (D)  PREPARATION  AND  SUBMISSION  OF  AN ANNUAL WRITTEN REPORT TO THE
DEPARTMENT. SUCH REPORT SHALL INCLUDE:
  (I) A PERFORMANCE MATRIX INCLUDING THE NUMBER OF  REGISTRANTS  ON  THE
DONATE  LIFE REGISTRY AND AN ANALYSIS OF THE REGISTRATION RATES, INCLUD-
ING BUT NOT LIMITED TO, LOCATION, METHOD OF  REGISTRATION,  DEMOGRAPHIC,
AND STATE COMPARISONS;
  (II)  THE CHARACTERISTICS OF REGISTRANTS AS DETERMINED FROM THE DONATE
LIFE REGISTRY INFORMATION;

S. 6914                            31                            A. 9205

  (III) THE ANNUAL DOLLAR AMOUNT OF VOLUNTARY CONTRIBUTIONS RECEIVED  BY
THE  CONTRACTOR FOR THE PURPOSES OF MAINTAINING THE DONATE LIFE REGISTRY
AND/OR EDUCATIONAL AND PROMOTIONAL CAMPAIGNS AND INITIATIVES;
  (IV) A DESCRIPTION OF THE PROMOTIONAL CAMPAIGNS AND INITIATIVES IMPLE-
MENTED DURING THE YEAR; AND
  (V)  ACCOUNTING  STATEMENTS  OF EXPENDITURES FOR THE PURPOSES OF MAIN-
TAINING THE DONATE LIFE REGISTRY AND PROMOTIONAL  CAMPAIGNS  AND  INITI-
ATIVES.
  4.    (A)  FOR  THE  PERIOD APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND FIFTEEN,  PAYMENTS  TO  THE  CONTRACTOR
SHALL BE PAID BY THE DEPARTMENT.
  (B)  FOR  THE  PERIOD  BEGINNING APRIL FIRST, TWO THOUSAND FIFTEEN AND
THEREAFTER, PAYMENTS TO THE CONTRACTOR SHALL BE PAID BY  THE  DEPARTMENT
FROM  FUNDS AVAILABLE FOR THESE PURPOSES, INCLUDING, BUT NOT LIMITED TO,
THE FUNDS DEPOSITED INTO THE LIFE PASS IT  ON  TRUST  FUND  PURSUANT  TO
SECTION NINETY-FIVE-D OF THE STATE FINANCE LAW.
  (C) IN ADDITION, THE CONTRACTOR MAY RECEIVE AND USE VOLUNTARY CONTRIB-
UTIONS.
  5.  (A)  Such ORGAN, EYE AND TISSUE registration of consent to make an
anatomical gift can be made through [(a)]: (I) indication  made  on  the
application or renewal form of a DRIVER'S license, [(b)] (II) indication
made  on  a  non-driver identification card application or renewal form,
[(c) enrolling in the registry website  maintained  by  the  department,
which may include using an electronic signature subject to article three
of  the  state  technology  law,  (d)]  (III) indication made on a voter
registration form pursuant to subdivision five of section 5-210  of  the
election  law, (IV) ENROLLMENT THROUGH THE DONATE LIFE REGISTRY WEBSITE,
(V) PAPER ENROLLMENT SUBMITTED TO THE DONATE  LIFE  REGISTRY,  or  [(e)]
(VI) through any other method identified by the commissioner.
  (B)(I)   Where  required  by  law  for  [consent]  REGISTRATION  forms
described in [paragraphs (a) and (b)]  SUBPARAGRAPHS  (I)  AND  (II)  of
PARAGRAPH  (A)  OF  this subdivision, the commissioner shall ensure that
space is provided on any [consent] REGISTRATION form so that the  appli-
cant  shall register or decline registration in the donate life registry
for organ, EYE and tissue donations under  this  section  and  that  the
following is stated on the form in clear and conspicuous type:
  "You  must  fill out the following section: Would you like to be added
to the Donate Life Registry? Check box for 'yes'  or  'skip  this  ques-
tion'."
  (II)  The  commissioner  shall  not maintain records of any person who
checks "skip this question". Failure to check a box shall not impair the
validity of an application, and failure to check "yes" or checking "skip
this question" shall not be construed to imply a wish not to donate.  In
the  case  of  an  applicant under eighteen years of age, checking "yes"
shall not constitute consent to make an anatomical gift or  registration
in the donate life registry. Where an applicant has previously consented
to  make  an  anatomical gift or registered in the donate life registry,
checking "skip this question" or failing to check a box shall not impair
that consent or registration.
  (C) ENROLLMENT OR AMENDMENT OR  REVOCATION  THROUGH  THE  DONATE  LIFE
REGISTRY WEBSITE THROUGH ANY OF THE MEANS LISTED IN THIS SUBDIVISION MAY
BE  SIGNED BY ELECTRONIC SIGNATURE, IN ACCORDANCE WITH THE PROVISIONS OF
ARTICLE THREE OF THE STATE TECHNOLOGY LAW, SUPPORTED BY THE USE OF SUIT-
ABLE MECHANISMS INCLUDING UNIQUE IDENTIFIERS TO  PROVIDE  CONFIDENCE  IN
THE  IDENTITY  OF  THE  PERSON  PROVIDING  THE ELECTRONIC SIGNATURE. The
registration shall take effect upon the provision of  written  or  elec-

S. 6914                            32                            A. 9205

tronic  notice  of the registration to the [person] INDIVIDUAL enrolling
in the DONATE LIFE registry.
  [3.  (a)  Information contained in the registry shall be accessible to
(i) federally designated organ procurement organizations, (ii)  eye  and
tissue   banks   licensed   by   the   department  pursuant  to  article
forty-three-B of this chapter,  and  (iii)  any  other  entity  formally
approved by the commissioner.
  (b) The information contained in the registry shall not be released to
any person except as expressly authorized by this section solely for the
purpose  of identifying potential organ and tissue donors at or near the
time of death.
  4. If the department had an established registry prior to  the  effec-
tive  date  of this section, it shall be deemed to meet the requirements
of this section.
  5. The registry shall provide  persons  enrolled  the  opportunity  to
specify which organs and tissues they want to donate and if the donation
can be used for transplantation, research, or both.]
  (D)  AMENDMENTS  OR REVOCATIONS FROM THE DONATE LIFE REGISTRY SHALL BE
MADE BY THE FOLLOWING, SUBJECT TO THE REQUIREMENTS OF THE COMMISSIONER:
  (I) REGISTRANTS SUBMITTING AN AMENDMENT OR REVOCATION  IN  WRITING  TO
THE DONATE LIFE REGISTRY; OR
  (II)  REGISTRANTS SUBMITTING AN AMENDMENT OR REVOCATION ELECTRONICALLY
THROUGH THE DONATE LIFE REGISTRY WEBSITE.
  (E) REMOVAL FROM THE DONATE  LIFE  REGISTRY  SHALL  NOT  BE  DEEMED  A
REFUSAL OF ANY OTHER OR FUTURE ANATOMICAL GIFT.
  (F)  THE  DONATE  LIFE REGISTRY SHALL PROVIDE INDIVIDUALS ENROLLED THE
OPPORTUNITY TO SPECIFY WHICH ORGANS,  EYES  AND  TISSUES  THEY  WANT  TO
DONATE AND IF THE DONATION MAY BE USED FOR TRANSPLANTATION, RESEARCH, OR
BOTH.
  6.  [A  person]  AN  INDIVIDUAL  registered  in the [organ and tissue]
DONATE LIFE registry before [the effective  date  of  this  subdivision]
JULY  TWENTY-THIRD, TWO THOUSAND EIGHT shall be deemed to have expressed
intent to donate, until and unless he or she files an amendment  to  his
or her registration or a new registration expressing consent to donate.
  7.  [The  commissioner shall contact each person registered before the
effective date of this subdivision in the organ and tissue  registry  in
writing  to inform him or her that at the time he or she registered, the
registry was that of intent and that the registry is now one of consent,
to explain in clear and  understandable  terms  the  difference  between
intent  and consent, and to provide opportunity for the person to change
his or her registration to  provide  consent  by  amending  his  or  her
current  registration  or  executing a new registration.] (A) THE DONATE
LIFE REGISTRY SHALL BE MAINTAINED IN  A  MANNER  THAT  ALLOWS  IMMEDIATE
ACCESS  TO  ORGAN,  EYE  AND TISSUE DONATION RECORDS TWENTY-FOUR HOURS A
DAY, SEVEN DAYS A WEEK TO  THE  CONTRACTOR,  THE  DEPARTMENT,  FEDERALLY
DESIGNATED  ORGAN  PROCUREMENT  ORGANIZATIONS,  LICENSED  EYE AND TISSUE
BANKS, AND SUCH OTHER ENTITIES WHICH MAY BE APPROVED BY  THE  DEPARTMENT
FOR  ACCESS.  ACCESS  SHALL  BE  AVAILABLE TO REGISTRANTS TO CONFIRM THE
ACCURACY AND VALIDITY OF THEIR REGISTRATION AND TO AMEND OR REVOKE THEIR
REGISTRATION, SUBJECT TO REASONABLE PROCEDURES TO VERIFY IDENTITY.
  (B) ACCESS TO THE DONATE LIFE REGISTRY SHALL  HAVE  SECURITY  MEASURES
SET  FORTH  IN THE CONTRACT TO PROTECT THE INTEGRITY OF THE IDENTIFIABLE
DATA IN THE DONATE LIFE REGISTRY, WHICH MAY  ONLY  BE  ACCESSED  BY  THE
PARTIES  DESCRIBED IN PARAGRAPH (A) OF THIS SUBDIVISION AND ONLY FOR THE
PURPOSES OF DETERMINING DONOR STATUS AT OR NEAR THE TIME OF DEATH OF  AN
INDIVIDUAL,  BY  THE  DEPARTMENT FOR ANY PURPOSE, BY THE CONTRACTOR ONLY

S. 6914                            33                            A. 9205

FOR PURPOSES OF QUALITY ASSESSMENT AND  IMPROVEMENT,  TECHNICAL  SUPPORT
AND  DONOR  SERVICES,  OR  BY INDIVIDUAL REGISTRANTS FOR THE PURPOSES OF
CONFIRMING THE ACCURACY AND VALIDITY OF THEIR  REGISTRATION  OR  MAKING,
AMENDING OR REVOKING THEIR REGISTRATION.
  (C)  DE-IDENTIFIED  INFORMATION MAY BE ACCESSED BY THE ENTITIES LISTED
IN PARAGRAPH (A) OF THIS SUBDIVISION OR THEIR DESIGNEES FOR PURPOSES  OF
ANALYSIS,   PROMOTION,  EDUCATION,  QUALITY  IMPROVEMENT  AND  TECHNICAL
SUPPORT FOR THE DONATE LIFE REGISTRY. THE INFORMATION CONTAINED  IN  THE
REGISTRY SHALL NOT BE RELEASED TO ANY PERSON EXCEPT AS EXPRESSLY AUTHOR-
IZED BY THIS SECTION, SOLELY FOR THE PURPOSES SO AUTHORIZED.
  8.  The commissioner is authorized to promulgate rules and regulations
necessary to implement the provisions of this section.
  9. AN INTERAGENCY  WORK  GROUP,  COMPOSED  OF  THE  COMMISSIONER,  THE
COMMISSIONER  OF  THE DEPARTMENT OF MOTOR VEHICLES, A CHAIR OF THE BOARD
OF ELECTIONS, OR THEIR DESIGNEES, AND SUCH OTHER INDIVIDUALS AS  MAY  BE
DESIGNATED  BY  THE  COMMISSIONER, SHALL BE ESTABLISHED TO MEET WITH THE
CONTRACTOR ANNUALLY AND AS NEEDED TO REVIEW THE  STATUS  OF  THE  DONATE
LIFE  REGISTRY,  TO EXAMINE THE STEPS THAT MIGHT BE TAKEN BY STATE AGEN-
CIES TO ENHANCE ITS PERFORMANCE  AND  TO  MAKE  RECOMMENDATIONS  TO  THE
CONTRACTOR.
  S 28. Intentionally omitted.
  S 29. Subdivision 3 of section 95-d of the state finance law, as added
by chapter 415 of the laws of 2003, is amended to read as follows:
  3.  Monies  of  the  fund  shall be expended only for organ transplant
research and education projects approved by the commissioner of  health,
or  to provide grants to not-for-profit corporations in this state which
are incorporated for the purpose of increasing and promoting  organ  and
tissue  donation awareness PROVIDED, HOWEVER, BEGINNING APRIL FIRST, TWO
THOUSAND FIFTEEN, ANY REVENUES  RECEIVED  OR  ANY  MONIES  APPROPRIATED,
CREDITED OR TRANSFERRED TO THE FUND ON AND AFTER MAY FIRST, TWO THOUSAND
FOURTEEN  MAY  ALSO BE EXPENDED TO SUPPORT THE MAINTENANCE AND OPERATION
OF THE DONATE LIFE REGISTRY IN ACCORDANCE WITH THE PROVISIONS OF SECTION
FORTY-THREE HUNDRED TEN OF THE PUBLIC HEALTH LAW.
  S 30. Section 461-b of the social services law is  amended  by  adding
two new subdivisions 9 and 10 to read as follows:
  9.  (A)  THE PRIOR WRITTEN APPROVAL OF THE DEPARTMENT IS REQUIRED FOR:
(I) ANY TRANSFER, ASSIGNMENT OR OTHER DISPOSITION OF TEN PERCENT OR MORE
OF AN INTEREST OR VOTING RIGHTS IN A PARTNERSHIP,  BUSINESS  CORPORATION
OR  LIMITED  LIABILITY  COMPANY  WHICH  IS THE OPERATOR OF AN ADULT CARE
FACILITY TO A NEW PARTNER, SHAREHOLDER OR MEMBER; OR (II) ANY  TRANSFER,
ASSIGNMENT  OR OTHER DISPOSITION OF INTEREST OR VOTING RIGHTS IN A PART-
NERSHIP, BUSINESS CORPORATION OR LIMITED LIABILITY COMPANY WHICH IS  THE
OPERATOR  OF  AN  ADULT  CARE FACILITY WHICH RESULTS IN THE OWNERSHIP OR
CONTROL OF MORE THAN TEN PERCENT OF THE INTEREST OR VOTING RIGHTS THERE-
UNDER BY ANY PERSON WHO HAS NOT BEEN PREVIOUSLY APPROVED BY THE  DEPART-
MENT FOR THAT OPERATOR.
  (B)  WITH  RESPECT  TO A TRANSFER, ASSIGNMENT OR DISPOSITION INVOLVING
LESS THAN TEN PERCENT OF AN INTEREST OR VOTING RIGHTS IN  SUCH  PARTNER-
SHIP,  BUSINESS  CORPORATION OR LIMITED LIABILITY COMPANY TO A NEW PART-
NER, SHAREHOLDER OR MEMBER, NO PRIOR APPROVAL OF THE DEPARTMENT SHALL BE
REQUIRED EXCEPT WHERE REQUIRED BY PARAGRAPH  (A)  OF  THIS  SUBDIVISION.
HOWEVER,  NO  SUCH TRANSACTION SHALL BE EFFECTIVE UNLESS AT LEAST NINETY
DAYS PRIOR TO THE INTENDED  EFFECTIVE  DATE  THEREOF,  THE  PARTNERSHIP,
BUSINESS  CORPORATION  OR  LIMITED LIABILITY COMPANY FULLY COMPLETES AND
FILES WITH THE DEPARTMENT NOTICE ON A  FORM,  TO  BE  DEVELOPED  BY  THE
DEPARTMENT,  WHICH  SHALL DISCLOSE SUCH INFORMATION AS MAY REASONABLY BE

S. 6914                            34                            A. 9205

NECESSARY FOR THE DEPARTMENT TO DETERMINE WHETHER IT SHOULD PROHIBIT THE
TRANSACTION. WITHIN NINETY DAYS FROM THE DATE OF RECEIPT OF SUCH NOTICE,
THE DEPARTMENT MAY PROHIBIT ANY SUCH TRANSACTION UNDER THIS SUBPARAGRAPH
IF  IT FINDS:   (I) THERE ARE REASONABLE GROUNDS TO BELIEVE THE PROPOSED
TRANSACTION DOES NOT SATISFY THE CHARACTER AND COMPETENCE REVIEW, AS MAY
BE APPROPRIATE; OR (II) IF THE TRANSACTION, TOGETHER WITH ALL OTHER SUCH
TRANSACTIONS DURING ANY  FIVE  YEAR  PERIOD,  WOULD  IN  THE  AGGREGATE,
INVOLVE  TWENTY-FIVE  PERCENT OR MORE OF THE INTEREST IN THE ENTITY THAT
CONSTITUTES THE  OPERATOR.  THE  DEPARTMENT  SHALL  STATE  THE  SPECIFIC
REASONS  FOR  PROHIBITING  ANY  TRANSACTION  UNDER THIS SUBPARAGRAPH AND
SHALL SO NOTIFY EACH PARTY TO THE PROPOSED TRANSACTION.
  (C) WITH RESPECT TO A TRANSFER, ASSIGNMENT OR DISPOSITION OF AN INTER-
EST OR VOTING RIGHTS IN A PARTNERSHIP, BUSINESS CORPORATION  OR  LIMITED
LIABILITY  COMPANY  TO  ANY  EXISTING PARTNER, SHAREHOLDER OR MEMBER, NO
PRIOR APPROVAL OF THE DEPARTMENT SHALL  BE  REQUIRED.  HOWEVER,  IF  THE
TRANSACTION  INVOLVES THE WITHDRAWAL OF THE TRANSFEROR FROM THE PARTNER-
SHIP, BUSINESS CORPORATION OR LIMITED LIABILITY COMPANY, NO SUCH  TRANS-
ACTION  SHALL  BE  EFFECTIVE  UNLESS  AT  LEAST NINETY DAYS PRIOR TO THE
INTENDED EFFECTIVE DATE THEREOF, THE PARTNERSHIP,  BUSINESS  CORPORATION
OR  LIMITED LIABILITY COMPANY FULLY COMPLETES AND FILES WITH THE DEPART-
MENT NOTICE OF SUCH TRANSACTION.  WITHIN NINETY DAYS FROM  THE  DATE  OF
RECEIPT OF SUCH NOTICE, THE DEPARTMENT MAY PROHIBIT ANY SUCH TRANSACTION
UNDER THIS PARAGRAPH IF THE EQUITY POSITION OF THE PARTNERSHIP, BUSINESS
CORPORATION  OR LIMITED LIABILITY COMPANY, DETERMINED IN ACCORDANCE WITH
GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, WOULD BE REDUCED AS  A  RESULT
OF  THE  TRANSFER, ASSIGNMENT OR DISPOSITION. THE DEPARTMENT SHALL STATE
THE SPECIFIC REASON FOR PROHIBITING ANY TRANSACTION UNDER THIS PARAGRAPH
AND SHALL SO NOTIFY EACH PARTY TO THE PROPOSED TRANSACTION.
  10. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, THE  DEPART-
MENT IS AUTHORIZED TO APPROVE A CERTIFICATE OF INCORPORATION OR ARTICLES
OF  ORGANIZATION FOR ESTABLISHMENT OF AN ADULT CARE FACILITY ON AN EXPE-
DITED BASIS WHERE: (A) THE CERTIFICATE OF INCORPORATION OR  ARTICLES  OF
ORGANIZATION REFLECTS SOLELY A CHANGE IN THE FORM OF THE BUSINESS ORGAN-
IZATION  OF AN EXISTING ENTITY WHICH HAD BEEN APPROVED BY THE DEPARTMENT
TO OPERATE AN ADULT CARE FACILITY; (B) EVERY INCORPORATOR,  STOCKHOLDER,
MEMBER AND DIRECTOR OF THE NEW ENTITY SHALL HAVE BEEN AN OWNER, PARTNER,
INCORPORATOR,  STOCKHOLDER,  MEMBER  OR DIRECTOR OF THE EXISTING ENTITY;
(C) THE DISTRIBUTION OF OWNERSHIP INTERESTS AND VOTING RIGHTS IN THE NEW
ENTITY SHALL BE THE SAME AS IN THE EXISTING ENTITY; AND (D) THERE  SHALL
BE  NO  CHANGE IN THE OPERATOR OF THE ADULT CARE FACILITY OTHER THAN THE
FORM OF ITS BUSINESS ORGANIZATION, AS A RESULT OF THE APPROVAL  OF  SUCH
CERTIFICATE   OF   INCORPORATION   OR  ARTICLES  OF  ORGANIZATION.  UPON
SUBMISSION, IF THE DEPARTMENT DOES NOT OBJECT  TO  THE  PROPOSAL  WITHIN
NINETY  DAYS OF THE RECEIPT OF A COMPLETE APPLICATION, THE PROPOSAL WILL
BE DEEMED ACCEPTABLE TO THE DEPARTMENT AND AN AMENDED OPERATING  CERTIF-
ICATE SHALL BE ISSUED.
  S  31.  Subdivisions  1  and 2 of section 461-k of the social services
law, as added by chapter 779 of the laws of 1986, are amended to read as
follows:
  1. (a) "Services for non-residents  in  adult  homes,  residences  for
adults and enriched housing programs" shall mean an organized program of
services  which  the  facility  is authorized to provide to residents of
such facility but which are provided to non-residents for the purpose of
restoring, maintaining or developing the capacity of  aged  or  disabled
persons  to  remain  in  or  return  to the community. Such services may
include but shall not be limited to day programs and temporary  residen-

S. 6914                            35                            A. 9205

tial  care  as  defined  herein.  A person participating in a program of
services for non-residents in an adult care facility shall be considered
a resident of the facility and shall be  afforded  all  the  rights  and
protections afforded residents of the facility under this chapter except
that  the  provisions  of  sections  four  hundred  sixty-one-g and four
hundred sixty-one-h of this title relating to termination  of  admission
agreements  shall not apply and that persons receiving services pursuant
to this section shall not be considered to be receiving residential care
as defined in section two hundred nine of this chapter for  purposes  of
determining  eligibility  for  and  the  amount of supplemental security
income benefits and additional state payments.
  (b) "Day programs" shall mean an organized program  for  non-residents
which  shall include personal care, supervision and other adult services
which the facility is authorized to provide to residents of such facili-
ty which may include but are not limited to, activities, meals, informa-
tion and referral, and transportation services,  provided  in  an  adult
home, residence for adults or enriched housing program.
  (c) "Temporary residential care" shall mean the provision of temporary
residential  care  of  frail  or  disabled adults on behalf of or in the
absence of the caregiver for up to [six weeks] ONE HUNDRED  TWENTY  DAYS
in  any  twelve  month  period, provided in an adult home, residence for
adults or enriched housing program.
  2. A program to provide services for non-residents in  an  adult  care
facility may be established and operated in an adult home, residence for
adults  or  enriched  housing  program provided that such facility has a
current operating certificate issued in  accordance  with  section  four
hundred sixty-one-b of this title. No operator may establish and operate
a  DAY  program  to  provide  services  for non-residents, AS DEFINED IN
SUBPARAGRAPH (B) OF SUBDIVISION ONE OF THIS SECTION, unless the operator
has received the prior written approval of the department.  The  depart-
ment  shall  grant  such approval TO OPERATE A DAY PROGRAM only to those
operators that are operating in compliance with applicable law and regu-
lations.  NO OPERATOR MAY PROVIDE TEMPORARY RESIDENTIAL CARE AS  DEFINED
IN SUBPARAGRAPH (C) OF SUBDIVISION ONE OF THIS SECTION, UNLESS THE OPER-
ATOR HAS NOTIFIED THE DEPARTMENT OF ITS INTENT TO DO SO.
  S 32. Intentionally omitted.
  S 33. Subdivision 4 of section 4656 of the public health law, as added
by chapter 2 of the laws of 2004, is amended to read as follows:
  4. The department shall develop an expedited review and approval proc-
ess  FOR  APPLICATIONS  FOR  UP  TO  NINE ADDITIONAL BEDS TO AN EXISTING
ENHANCED OR SPECIAL NEEDS ASSISTED LIVING CERTIFICATE QUALIFIED AS BEING
IN GOOD STANDING UNDER SECTION FORTY-SIX  HUNDRED  FIFTY-THREE  OF  THIS
ARTICLE.
  S  34.  Paragraph  (b)  of subdivision 5 of section 3610 of the public
health law is REPEALED.
  S 35. Subdivision 2 of section 3610  of  the  public  health  law,  as
amended  by  section  65 of part A of chapter 58 of the laws of 2010, is
amended to read as follows:
  2. A hospital, residential health care  facility,  or  certified  home
health  agency  seeking authorization to provide a long term home health
care program shall transmit to the commissioner an  application  setting
forth  the scope of the proposed program. Such application shall be in a
format and shall be submitted in a quantity determined  by  the  commis-
sioner.  The  commissioner  shall transmit the application to the public
health and health planning council and to the health systems agency,  if
any,  having  geographic  jurisdiction  of  the  area where the proposed

S. 6914                            36                            A. 9205

program is to be located.  The  application  shall  include  a  detailed
description  of  the proposed program including, but not limited to, the
following:
  (a) an outline of the institution's or agency's plans for the program;
  (b) the need for the proposed program;
  (c) the number and types of personnel to be employed;
  (d)  the  ability  of the agency, hospital, or facility to provide the
program;
  (e) the estimated number of visits to be provided;
  (f) the geographic  area  in  which  the  proposed  programs  will  be
provided;
  (g)  any  special  or  unusual  services, programs, or equipment to be
provided;
  (h) a demonstration that the proposed program is feasible and adequate
in terms of both short range and long range goals;
  (i) such other information as the commissioner may require.
  The health systems agency and the public health  and  health  planning
council shall review the application and submit their recommendations to
the  commissioner.  At  the time members of the public health and health
planning council are notified  that  an  application  is  scheduled  for
consideration,  the  applicant and the health systems agency shall be so
notified in writing. The health systems agency or the public health  and
health  planning council shall not recommend approval of the application
unless it is satisfied as to:
  (a) the public need for the program at the time and  place  and  under
the circumstances proposed;
  (b)  the  financial  resources of the provider of the proposed program
and its sources of future revenues;
  (c) the ability of the proposed program to meet those standards estab-
lished for participation as a home health agency under  title  XVIII  of
the federal Social Security Act; and
  (d) such other matters as it shall deem pertinent.
  After  receiving  and  considering  the  recommendations of the public
health and health planning council and the health  systems  agency,  the
commissioner shall make his or her determination. The commissioner shall
act  upon  an  application  after  the public health and health planning
council and the health systems agency have  had  a  reasonable  time  to
submit their recommendations. The commissioner shall not take any action
contrary  to  the  advice of either until he or she affords to either an
opportunity to request a public hearing and, if so requested,  a  public
hearing  shall  be held. The commissioner shall not approve the applica-
tion unless he or she is satisfied as to the detailed description of the
proposed program and
  (a) the public need for the existence of the program at the  time  and
place and under the circumstances proposed;
  (b)  the  financial  resources of the provider of the proposed program
and its sources of future revenues;
  (c) the ability of the proposed program to meet those standards estab-
lished for participation as a home health agency under  title  XVIII  of
the federal Social Security Act; and
  (d) such other matters as he or she shall deem pertinent.
  If  the application is approved, the applicant shall be so notified in
writing. The commissioner's written approval of  the  application  shall
constitute  authorization  to  provide  a  long  term  home  health care
program. [In making his or her  authorization,  the  commissioner  shall
stipulate  the maximum number of persons which a provider of a long term

S. 6914                            37                            A. 9205

home health care program may serve.] If  the  commissioner  proposes  to
disapprove  the  application,  he  or  she shall notify the applicant in
writing, stating his or her reasons  for  disapproval,  and  afford  the
applicant an opportunity for a public hearing.
  S 36. Intentionally omitted.
  S 37. Section 32 of part A of chapter 58 of the laws of 2008, amending
the  elder  law  and  other laws relating to reimbursement to particular
provider pharmacies  and  prescription  drug  coverage,  as  amended  by
section  26  of  part A of chapter 59 of the laws of 2011, is amended to
read as follows:
  S 32. This act shall take effect immediately and shall  be  deemed  to
have  been in full force and effect on and after April 1, 2008; provided
however, that sections one, six-a, nineteen,  twenty,  twenty-four,  and
twenty-five of this act shall take effect July 1, 2008; provided however
that  sections  sixteen, seventeen and eighteen of this act shall expire
April 1, [2014] 2017; provided, however, that  the  amendments  made  by
section  twenty-eight  of this act shall take effect on the same date as
section 1 of chapter 281 of the laws  of  2007  takes  effect;  provided
further,  that  sections twenty-nine, thirty, and thirty-one of this act
shall take effect October 1, 2008; provided further, that section  twen-
ty-seven  of  this  act  shall take effect January 1, 2009; and provided
further, that section twenty-seven of  this  act  shall  expire  and  be
deemed  repealed  March 31, [2014] 2015; and provided, further, however,
that the amendments to subdivision 1 of section 241 of the education law
made by section twenty-nine of this act shall not affect the  expiration
of such subdivision and shall be deemed to expire therewith and provided
that  the  amendments  to  section  272 of the public health law made by
section thirty of this act shall not affect the repeal of  such  section
and shall be deemed repealed therewith.
  S  38.  This  act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2014; provided,
however, that the amendments to subdivisions 1 and 2 of section 461-k of
the social services law made by section thirty-one of this act shall not
affect the expiration of such section and  shall  be  deemed  to  expire
therewith;  and provided, further, that the amendments made to paragraph
(b) of subdivision 18-a of section 206 of the public health law made  by
section  sixteen  of  this  act  shall not affect the expiration of such
paragraph and shall be deemed to expire therewith.

                                 PART B

  Section 1. Subdivision 5 of section 168 of chapter 639 of the laws  of
1996,  constituting  the  New  York  Health  Care Reform Act of 1996, as
amended by section 1 of part C of chapter 59 of the  laws  of  2011,  is
amended to read as follows:
  5.  sections  2807-c,  2807-j,  2807-s and 2807-t of the public health
law, as amended or as added by this act, shall expire  on  December  31,
[2014]  2017,  and  shall be thereafter effective only in respect to any
act done on or before such date or action or proceeding arising  out  of
such  act  including continued collections of funds from assessments and
allowances and  surcharges  established  pursuant  to  sections  2807-c,
2807-j,  2807-s  and 2807-t of the public health law, and administration
and distributions of funds from pools established pursuant  to  sections
2807-c,  2807-j, 2807-k, 2807-l, 2807-m, 2807-s and 2807-t of the public
health law related to patient  services  provided  before  December  31,

S. 6914                            38                            A. 9205

[2014]  2017, and continued expenditure of funds authorized for programs
and grants until the exhaustion of funds therefor;
  S  2.  Subdivision  1 of section 138 of chapter 1 of the laws of 1999,
constituting the New York Health Care Reform Act of 2000, as amended  by
section  2  of  part  C of chapter 59 of the laws of 2011, is amended to
read as follows:
  1. sections 2807-c, 2807-j, 2807-s, and 2807-t of  the  public  health
law,  as  amended by this act, shall expire on December 31, [2014] 2017,
and shall be thereafter effective only in respect to any act done before
such date or action or proceeding arising  out  of  such  act  including
continued  collections  of  funds  from  assessments  and allowances and
surcharges established pursuant to sections 2807-c, 2807-j,  2807-s  and
2807-t of the public health law, and administration and distributions of
funds  from  pools  established  pursuant  to  sections  2807-c, 2807-j,
2807-k, 2807-l, 2807-m, 2807-s, 2807-t, 2807-v and 2807-w of the  public
health law, as amended or added by this act, related to patient services
provided  before  December 31, [2014] 2017, and continued expenditure of
funds authorized for programs and grants until the exhaustion  of  funds
therefor;
  S  3.  The opening paragraph, subparagraph (xiv) and (xv) of paragraph
(a), subparagraph (v) of paragraph (c) and paragraph (e) of  subdivision
6  of  section 2807-s of the public health law, the opening paragraph as
amended by section 4 of part A3 of chapter  62  of  the  laws  of  2003,
subparagraphs (xiv) and (xv) of paragraph (a) as amended by section 5 of
part  C of chapter 59 of the laws of 2011, subparagraph (v) of paragraph
(c) as amended by section 5-a of part C of chapter 59  of  the  laws  of
2011  and paragraph (e) as amended by section 6 of part A3 of chapter 62
of the laws of 2003, subparagraphs (i) and  (ii)  of  paragraph  (e)  as
amended  by section 5-b of part C of chapter 59 of the laws of 2011, are
amended to read as follows:
  The amount allocated to each region for purposes  of  calculating  the
regional  allowance  percentage  pursuant  to this section for each year
during the period January first, nineteen hundred  ninety-seven  through
December  thirty-first,  nineteen  hundred  ninety-nine and the regional
assessments pursuant to section twenty-eight  hundred  seven-t  of  this
article  for each year during the period January first, nineteen hundred
ninety-seven through December thirty-first, nineteen hundred ninety-nine
and for each year on and after January first, two thousand, shall be the
sum of the factors computed in paragraphs  (b),  (d)  and  (f)  of  this
subdivision, IF SUCH FACTORS ARE APPLICABLE TO A GIVEN YEAR, as follows:
  (xiv)  A  gross  annual statewide amount for the period January first,
two thousand nine through December thirty-first, two thousand [thirteen]
FOURTEEN, shall be nine hundred forty-four million dollars.
  (xv) A gross ANNUAL statewide amount for the period January first, two
thousand [fourteen] FIFTEEN through [March] DECEMBER  thirty-first,  two
thousand  [fourteen]  SEVENTEEN,  shall  be [two hundred thirty-six] ONE
BILLION FORTY-FIVE million dollars.
  (v) A further gross ANNUAL statewide amount  for  the  period  January
first,  two thousand fourteen through [March] DECEMBER thirty-first, two
thousand  fourteen,  shall  be  [twenty-two]  EIGHTY-NINE  million  [two
hundred fifty thousand] dollars.
  (e)  [(i)]  A  further  gross  annual statewide amount shall be twelve
million dollars for each period prior to  January  first,  two  thousand
[fourteen] FIFTEEN.

S. 6914                            39                            A. 9205

  [(ii)  A  further gross statewide amount for the period January first,
two thousand fourteen through March thirty-first, two thousand  fourteen
shall be three million dollars.]
  S  4. Subparagraph (xiii) of paragraph (a) of subdivision 7 of section
2807-s of the public health law, as added by section 30  of  part  H  of
chapter 59 of the laws of 2011, is amended to read as follows:
  (xiii)  twenty-three million eight hundred thirty-six thousand dollars
each state fiscal year for the period April first, two  thousand  twelve
through March thirty-first, two thousand [fourteen] SEVENTEEN;
  S  5.  Subparagraphs (iv) and (v) of paragraph (a) of subdivision 9 of
section 2807-j of the public health law, as amended by section 3 of part
C of chapter 59 of the laws of 2011, are amended to read as follows:
  (iv) seven hundred sixty-five million dollars annually  of  the  funds
accumulated for the periods January first, two thousand through December
thirty-first, two thousand [thirteen] SIXTEEN, and
  (v)  one hundred ninety-one million two hundred fifty thousand dollars
of the funds accumulated for the  period  January  first,  two  thousand
[fourteen] SEVENTEEN through March thirty-first, two thousand [fourteen]
SEVENTEEN.
  S  6. Section 34 of part A3 of chapter 62 of the laws of 2003 amending
the general business law and  other  laws  relating  to  enacting  major
components  necessary to implement the state fiscal plan for the 2003-04
state fiscal year, as amended by section 4 of part C of  chapter  59  of
the laws of 2011, is amended to read as follows:
  S  34.  (1) Notwithstanding any inconsistent provision of law, rule or
regulation and effective April 1, 2008 through March  31,  [2014]  2017,
the commissioner of health is authorized to transfer and the state comp-
troller  is authorized and directed to receive for deposit to the credit
of the department of health's special revenue fund - other, health  care
reform  act  (HCRA) resources fund - 061, provider collection monitoring
account, within amounts appropriated each year,  those  funds  collected
and  accumulated  pursuant  to  section 2807-v of the public health law,
including income from invested funds, for the  purpose  of  payment  for
administrative  costs  of  the  department of health related to adminis-
tration of  statutory  duties  for  the  collections  and  distributions
authorized by section 2807-v of the public health law.
  (2)  Notwithstanding  any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31,  [2014]  2017,  the
commissioner  of  health  is  authorized to transfer and the state comp-
troller is authorized and directed to receive for deposit to the  credit
of  the department of health's special revenue fund - other, health care
reform act (HCRA) resources fund - 061, provider  collection  monitoring
account,  within  amounts  appropriated each year, those funds collected
and accumulated and interest earned through surcharges on  payments  for
health care services pursuant to section 2807-s of the public health law
and from assessments pursuant to section 2807-t of the public health law
for the purpose of payment for administrative costs of the department of
health related to administration of statutory duties for the collections
and  distributions  authorized by sections 2807-s, 2807-t, and 2807-m of
the public health law.
  (3) Notwithstanding any inconsistent provision of law, rule  or  regu-
lation  and  effective  April 1, 2008 through March 31, [2014] 2017, the
commissioner of health is authorized to transfer and the comptroller  is
authorized  to  deposit,  within  amounts  appropriated each year, those
funds authorized for distribution in accordance with the  provisions  of
paragraph  (a)  of  subdivision 1 of section 2807-l of the public health

S. 6914                            40                            A. 9205

law for the purposes of payment for administrative costs of the  depart-
ment  of  health  related  to  the  child  health insurance plan program
authorized pursuant to title 1-A of article 25 of the public health  law
into  the  special  revenue funds - other, health care reform act (HCRA)
resources fund - 061, child health insurance account, established within
the department of health.
  (4) Notwithstanding any inconsistent provision of law, rule  or  regu-
lation  and  effective  April 1, 2008 through March 31, [2014] 2017, the
commissioner of health is authorized to transfer and the comptroller  is
authorized  to  deposit,  within  amounts  appropriated each year, those
funds authorized for distribution in accordance with the  provisions  of
paragraph  (e)  of  subdivision 1 of section 2807-l of the public health
law for the purpose of payment for administrative costs of  the  depart-
ment  of  health  related to the health occupation development and work-
place demonstration program established pursuant to section  2807-h  and
the  health workforce retraining program established pursuant to section
2807-g of the public health law into the special revenue funds -  other,
health  care  reform  act (HCRA) resources fund - 061, health occupation
development and workplace  demonstration  program  account,  established
within the department of health.
  (5)  Notwithstanding  any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31,  [2014]  2017,  the
commissioner  of health is authorized to transfer and the comptroller is
authorized to deposit, within  amounts  appropriated  each  year,  those
funds  allocated  pursuant  to paragraph (j) of subdivision 1 of section
2807-v of the public health law for the purpose of payment for  adminis-
trative  costs  of the department of health related to administration of
the state's tobacco control programs and cancer services provided pursu-
ant to sections 2807-r and 1399-ii of the public health  law  into  such
accounts established within the department of health for such purposes.
  (6)  Notwithstanding  any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31,  [2014]  2017,  the
commissioner  of health is authorized to transfer and the comptroller is
authorized to deposit, within amounts appropriated each year, the  funds
authorized for distribution in accordance with the provisions of section
2807-l of the public health law for the purposes of payment for adminis-
trative costs of the department of health related to the programs funded
pursuant  to  section  2807-l  of the public health law into the special
revenue funds - other, health care reform act (HCRA)  resources  fund  -
061,  pilot  health insurance account, established within the department
of health.
  (7) Notwithstanding any inconsistent provision of law, rule  or  regu-
lation  and  effective  April 1, 2008 through March 31, [2014] 2017, the
commissioner of health is authorized to transfer and the comptroller  is
authorized  to  deposit,  within  amounts  appropriated each year, those
funds authorized for distribution in accordance with the  provisions  of
subparagraph  (ii)  of paragraph (f) of subdivision 19 of section 2807-c
of the public health law from monies accumulated and interest earned  in
the  bad  debt  and  charity care and capital statewide pools through an
assessment charged to general hospitals pursuant to  the  provisions  of
subdivision  18  of  section  2807-c  of the public health law and those
funds authorized for distribution in accordance with the  provisions  of
section  2807-l of the public health law for the purposes of payment for
administrative costs of the department of  health  related  to  programs
funded  under  section  2807-l of the public health law into the special
revenue funds - other, health care reform act (HCRA)  resources  fund  -

S. 6914                            41                            A. 9205

061, primary care initiatives account, established within the department
of health.
  (8)  Notwithstanding  any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31,  [2014]  2017,  the
commissioner  of health is authorized to transfer and the comptroller is
authorized to deposit, within  amounts  appropriated  each  year,  those
funds  authorized  for distribution in accordance with section 2807-l of
the public health law for the purposes  of  payment  for  administrative
costs  of  the  department  of  health  related to programs funded under
section 2807-l of the public health law into the special revenue funds -
other, health care reform act (HCRA) resources fund - 061,  health  care
delivery  administration  account,  established within the department of
health.
  (9) Notwithstanding any inconsistent provision of law, rule  or  regu-
lation  and  effective  April 1, 2008 through March 31, [2014] 2017, the
commissioner of health is authorized to transfer and the comptroller  is
authorized  to  deposit,  within  amounts  appropriated each year, those
funds authorized pursuant to sections 2807-d, 3614-a and 3614-b  of  the
public  health  law and section 367-i of the social services law and for
distribution in accordance with  the  provisions  of  subdivision  9  of
section  2807-j  of the public health law for the purpose of payment for
administration of statutory duties for the collections and distributions
authorized by sections 2807-c, 2807-d, 2807-j,  2807-k,  2807-l,  3614-a
and  3614-b  of  the  public  health law and section 367-i of the social
services law into the special revenue funds - other, health care  reform
act (HCRA) resources fund - 061, provider collection monitoring account,
established within the department of health.
  S  7. Section 2807-l of the public health law, as amended by section 7
of part C of chapter 59 of the laws of  2011,  is  amended  to  read  as
follows:
  S 2807-l. Health care initiatives pool distributions. 1. Funds accumu-
lated  in the health care initiatives pools pursuant to paragraph (b) of
subdivision nine of section twenty-eight hundred seven-j of  this  arti-
cle,  or  the  health  care reform act (HCRA) resources fund established
pursuant to section ninety-two-dd of the state finance law, whichever is
applicable, including income from invested funds, shall  be  distributed
or retained by the commissioner or by the state comptroller, as applica-
ble, in accordance with the following.
  (a)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  distributions  to programs to provide health care coverage for unin-
sured or underinsured children pursuant to sections twenty-five  hundred
ten  and  twenty-five hundred eleven of this chapter from the respective
health care initiatives pools established for the following  periods  in
the following amounts:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
up to one hundred twenty million six hundred thousand dollars;
  (ii) from the pool for the  period  January  first,  nineteen  hundred
ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
eight, up to  one  hundred  sixty-four  million  five  hundred  thousand
dollars;
  (iii)  from  the  pool  for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
up to one hundred eighty-one million dollars;

S. 6914                            42                            A. 9205

  (iv) from the pool for the period January first, two thousand  through
December thirty-first, two thousand, two hundred seven million dollars;
  (v)  from  the  pool  for  the  period January first, two thousand one
through December thirty-first, two thousand one, two hundred thirty-five
million dollars;
  (vi) from the pool for the period  January  first,  two  thousand  two
through  December  thirty-first, two thousand two, three hundred twenty-
four million dollars;
  (vii) from the pool for the period January first, two  thousand  three
through  December  thirty-first,  two thousand three, up to four hundred
fifty million three hundred thousand dollars;
  (viii) from the pool for the period January first, two  thousand  four
through  December  thirty-first,  two  thousand four, up to four hundred
sixty million nine hundred thousand dollars;
  (ix) from the pool or the health  care  reform  act  (HCRA)  resources
fund,  whichever  is applicable, for the period January first, two thou-
sand five through December thirty-first, two thousand five,  up  to  one
hundred fifty-three million eight hundred thousand dollars;
  (x)  from  the  health  care  reform act (HCRA) resources fund for the
period January first, two thousand six  through  December  thirty-first,
two  thousand  six, up to three hundred twenty-five million four hundred
thousand dollars;
  (xi) from the health care reform act (HCRA)  resources  fund  for  the
period  January first, two thousand seven through December thirty-first,
two thousand seven, up to four hundred twenty-eight  million  fifty-nine
thousand dollars;
  (xii)  from  the  health care reform act (HCRA) resources fund for the
period January first, two thousand eight through December  thirty-first,
two  thousand  ten,  up  to four hundred fifty-three million six hundred
seventy-four thousand dollars annually;
  (xiii) from the health care reform act (HCRA) resources fund  for  the
period  January  first, two thousand eleven, through March thirty-first,
two thousand eleven, up to one hundred  thirteen  million  four  hundred
eighteen thousand dollars;
  (xiv)  from  the  health care reform act (HCRA) resources fund for the
period April first, two thousand eleven, through March thirty-first, two
thousand twelve, up to three hundred twenty-four million  seven  hundred
forty-four thousand dollars;
  (xv)  from  the  health  care reform act (HCRA) resources fund for the
period April first, two thousand twelve, through March thirty-first, two
thousand thirteen, up to three hundred forty-six  million  four  hundred
forty-four thousand dollars; [and]
  (xvi)  from  the  health care reform act (HCRA) resources fund for the
period April first, two thousand thirteen, through  March  thirty-first,
two  thousand  fourteen, up to three hundred seventy million six hundred
ninety-five thousand dollars[.]; AND
  (XVII) FROM THE HEALTH CARE REFORM ACT (HCRA) RESOURCES FUND FOR  EACH
STATE  FISCAL  YEAR  FOR  PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND
FOURTEEN, WITHIN AMOUNTS APPROPRIATED.
  (b) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of distributions for health  insurance  programs  under  the  individual
subsidy programs established pursuant to the expanded health care cover-
age  act of nineteen hundred eighty-eight as amended, and for evaluation
of such programs from the respective health care  initiatives  pools  or

S. 6914                            43                            A. 9205

the  health care reform act (HCRA) resources fund, whichever is applica-
ble, established for the following periods in the following amounts:
  (i)  (A)  an amount not to exceed six million dollars on an annualized
basis for the  periods  January  first,  nineteen  hundred  ninety-seven
through  December  thirty-first, nineteen hundred ninety-nine; up to six
million dollars for the  period  January  first,  two  thousand  through
December  thirty-first, two thousand; up to five million dollars for the
period January first, two thousand one  through  December  thirty-first,
two  thousand  one;  up  to  four million dollars for the period January
first, two thousand two through December thirty-first, two thousand two;
up to two million six hundred thousand dollars for  the  period  January
first,  two  thousand  three through December thirty-first, two thousand
three; up to one million three hundred thousand dollars for  the  period
January  first,  two  thousand  four  through December thirty-first, two
thousand four; up to six hundred seventy thousand dollars for the period
January first, two thousand five through June  thirtieth,  two  thousand
five;  up  to  one million three hundred thousand dollars for the period
April first, two thousand six through March thirty-first,  two  thousand
seven; and up to one million three hundred thousand dollars annually for
the  period  April first, two thousand seven through March thirty-first,
two thousand nine, shall be allocated to  individual  subsidy  programs;
and
  (B)  an  amount  not  to exceed seven million dollars on an annualized
basis for the periods during the period January first, nineteen  hundred
ninety-seven through December thirty-first, nineteen hundred ninety-nine
and  four  million  dollars  annually for the periods January first, two
thousand through December thirty-first,  two  thousand  two,  and  three
million dollars for the period January first, two thousand three through
December  thirty-first,  two thousand three, and two million dollars for
the period January first, two thousand  four  through  December  thirty-
first, two thousand four, and two million dollars for the period January
first, two thousand five through June thirtieth, two thousand five shall
be allocated to the catastrophic health care expense program.
  (ii) Notwithstanding any law to the contrary, the characterizations of
the  New  York state small business health insurance partnership program
as in effect prior  to  June  thirtieth,  two  thousand  three,  voucher
program  as  in effect prior to December thirty-first, two thousand one,
individual subsidy program as in effect prior  to  June  thirtieth,  two
thousand  five,  and  catastrophic  health  care  expense program, as in
effect prior to June thirtieth, two thousand five, may, for the purposes
of identifying matching funds for the community health  care  conversion
demonstration  project  described in a waiver of the provisions of title
XIX of the federal social security act granted to the state of New  York
and dated July fifteenth, nineteen hundred ninety-seven, may continue to
be used to characterize the insurance programs in sections four thousand
three  hundred  twenty-one-a,  four thousand three hundred twenty-two-a,
four thousand three hundred twenty-six and four thousand  three  hundred
twenty-seven of the insurance law, which are successor programs to these
programs.
  (c)  Up to seventy-eight million dollars shall be reserved and accumu-
lated from year to year from the pool  for  the  period  January  first,
nineteen  hundred  ninety-seven  through December thirty-first, nineteen
hundred ninety-seven, for purposes of  public  health  programs,  up  to
seventy-six  million dollars shall be reserved and accumulated from year
to year from the pools for the periods January first,  nineteen  hundred
ninety-eight  through  December  thirty-first,  nineteen hundred ninety-

S. 6914                            44                            A. 9205

eight and January first, nineteen hundred ninety-nine  through  December
thirty-first,  nineteen  hundred  ninety-nine, up to eighty-four million
dollars shall be reserved and accumulated from year  to  year  from  the
pools  for the period January first, two thousand through December thir-
ty-first, two thousand, up  to  eighty-five  million  dollars  shall  be
reserved and accumulated from year to year from the pools for the period
January first, two thousand one through December thirty-first, two thou-
sand one, up to eighty-six million dollars shall be reserved and accumu-
lated from year to year from the pools for the period January first, two
thousand  two  through  December  thirty-first,  two thousand two, up to
eighty-six million one hundred fifty thousand dollars shall be  reserved
and  accumulated from year to year from the pools for the period January
first, two thousand three through December  thirty-first,  two  thousand
three,  up  to fifty-eight million seven hundred eighty thousand dollars
shall be reserved and accumulated from year to year from the  pools  for
the  period  January  first,  two thousand four through December thirty-
first, two thousand four, up to sixty-eight million seven hundred thirty
thousand dollars shall be reserved and accumulated  from  year  to  year
from  the  pools  or  the  health care reform act (HCRA) resources fund,
whichever is applicable, for the period January first, two thousand five
through December thirty-first, two  thousand  five,  up  to  ninety-four
million three hundred fifty thousand dollars shall be reserved and accu-
mulated  from  year  to  year  from  the  health  care reform act (HCRA)
resources fund for the period January first, two  thousand  six  through
December  thirty-first,  two  thousand  six,  up to seventy million nine
hundred thirty-nine thousand dollars shall be reserved  and  accumulated
from  year to year from the health care reform act (HCRA) resources fund
for the period January first, two thousand seven through December  thir-
ty-first,  two  thousand  seven,  up  to  fifty-five million six hundred
eighty-nine thousand dollars annually shall be reserved and  accumulated
from  year to year from the health care reform act (HCRA) resources fund
for the period January first, two thousand eight through December  thir-
ty-first,  two thousand ten, up to thirteen million nine hundred twenty-
two thousand dollars shall be reserved and accumulated from year to year
from the health care reform act (HCRA) resources  fund  for  the  period
January first, two thousand eleven through March thirty-first, two thou-
sand  eleven,  and  for  periods  on and after April first, two thousand
eleven [through March thirty-first, two thousand fourteen], up to  fund-
ing  amounts  specified  below  and shall be available, including income
from invested funds, for:
  (i) deposit by the commissioner, within amounts appropriated, and  the
state  comptroller  is  hereby  authorized  and  directed to receive for
deposit to, to the credit of the department of health's special  revenue
fund  -  other, hospital based grants program account or the health care
reform act (HCRA) resources fund, whichever is applicable, for  purposes
of  services  and  expenses  related  to  general  hospital  based grant
programs, up to twenty-two million dollars annually  from  the  nineteen
hundred  ninety-seven pool, nineteen hundred ninety-eight pool, nineteen
hundred ninety-nine pool, two thousand pool, two thousand one  pool  and
two  thousand  two  pool, respectively, up to twenty-two million dollars
from the two thousand three pool, up to  ten  million  dollars  for  the
period  January  first, two thousand four through December thirty-first,
two thousand four, up to eleven million dollars for the  period  January
first,  two  thousand  five  through December thirty-first, two thousand
five, up to twenty-two million dollars for the period January first, two
thousand six through December thirty-first,  two  thousand  six,  up  to

S. 6914                            45                            A. 9205

twenty-two million ninety-seven thousand dollars annually for the period
January  first,  two  thousand  seven through December thirty-first, two
thousand ten, up to  five  million  five  hundred  twenty-four  thousand
dollars  for the period January first, two thousand eleven through March
thirty-first, two thousand eleven, up to thirteen million  four  hundred
forty-five  thousand  dollars  for  the period April first, two thousand
eleven through March thirty-first, two thousand twelve, and up to  thir-
teen  million  three  hundred  seventy-five  thousand dollars each state
fiscal year for the period April  first,  two  thousand  twelve  through
March thirty-first, two thousand fourteen;
  (ii) deposit by the commissioner, within amounts appropriated, and the
state  comptroller  is  hereby  authorized  and  directed to receive for
deposit to, to the credit of the  emergency  medical  services  training
account  established  in section ninety-seven-q of the state finance law
or the health care reform act (HCRA) resources fund, whichever is appli-
cable, up to sixteen million dollars on  an  annualized  basis  for  the
periods  January  first,  nineteen hundred ninety-seven through December
thirty-first, nineteen hundred ninety-nine, up to twenty million dollars
for the period January first,  two  thousand  through  December  thirty-
first,  two  thousand,  up  to twenty-one million dollars for the period
January first, two thousand one through December thirty-first, two thou-
sand one, up to twenty-two million dollars for the period January first,
two thousand two through December thirty-first, two thousand two, up  to
twenty-two  million  five  hundred fifty thousand dollars for the period
January first, two thousand three  through  December  thirty-first,  two
thousand  three,  up to nine million six hundred eighty thousand dollars
for the period January first, two thousand four through  December  thir-
ty-first,  two  thousand  four,  up to twelve million one hundred thirty
thousand dollars for the period January first, two thousand five through
December thirty-first, two thousand five, up to twenty-four million  two
hundred  fifty  thousand dollars for the period January first, two thou-
sand six through December thirty-first, two thousand six, up  to  twenty
million four hundred ninety-two thousand dollars annually for the period
January  first,  two  thousand  seven through December thirty-first, two
thousand ten, up to  five  million  one  hundred  twenty-three  thousand
dollars  for the period January first, two thousand eleven through March
thirty-first, two thousand eleven, up to eighteen million three  hundred
fifty  thousand  dollars for the period April first, two thousand eleven
through March thirty-first, two thousand twelve, up to eighteen  million
nine  hundred  fifty  thousand  dollars  for the period April first, two
thousand twelve through March thirty-first, two thousand thirteen, [and]
up to nineteen million four hundred nineteen thousand  dollars  for  the
period  April  first,  two thousand thirteen through March thirty-first,
two thousand fourteen, AND UP TO NINETEEN MILLION SIX HUNDRED FIFTY-NINE
THOUSAND SEVEN HUNDRED DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD  OF
APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND SEVENTEEN;
  (iii)  priority  distributions  by  the  commissioner up to thirty-two
million dollars on an annualized basis for the period January first, two
thousand through December thirty-first, two thousand four, up  to  thir-
ty-eight  million  dollars on an annualized basis for the period January
first, two thousand five through  December  thirty-first,  two  thousand
six,  up  to eighteen million two hundred fifty thousand dollars for the
period January first, two thousand seven through December  thirty-first,
two  thousand seven, up to three million dollars annually for the period
January first, two thousand eight  through  December  thirty-first,  two

S. 6914                            46                            A. 9205

thousand  ten, up to seven hundred fifty thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven, [and] up to two million nine hundred thousand dollars  each
state  fiscal  year  for  the  period  April  first, two thousand eleven
through March thirty-first, two thousand fourteen, AND UP TO TWO MILLION
NINE HUNDRED THOUSAND DOLLARS EACH STATE  FISCAL  YEAR  FOR  THE  PERIOD
APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND SEVENTEEN to be allocated (A) for the purposes established pursuant
to subparagraph (ii) of paragraph (f) of subdivision nineteen of section
twenty-eight  hundred  seven-c  of this article as in effect on December
thirty-first, nineteen hundred  ninety-six  and  as  may  thereafter  be
amended,  up to fifteen million dollars annually for the periods January
first, two thousand through December thirty-first, two thousand four, up
to twenty-one million dollars annually for the period January first, two
thousand five through December thirty-first, two thousand six, and up to
seven million five hundred  thousand  dollars  for  the  period  January
first,  two  thousand  seven  through  March  thirty-first, two thousand
seven;
  (B) pursuant to a memorandum of  understanding  entered  into  by  the
commissioner,  the  majority leader of the senate and the speaker of the
assembly, for the purposes outlined in such memorandum upon  the  recom-
mendation  of  the  majority  leader  of the senate, up to eight million
five hundred thousand dollars annually for the period January first, two
thousand through December thirty-first, two thousand six, and up to four
million two hundred fifty thousand dollars for the period January first,
two thousand seven through June thirtieth, two thousand seven,  and  for
the  purposes outlined in such memorandum upon the recommendation of the
speaker of the assembly, up  to  eight  million  five  hundred  thousand
dollars  annually  for  the  periods January first, two thousand through
December thirty-first, two thousand six, and  up  to  four  million  two
hundred  fifty  thousand dollars for the period January first, two thou-
sand seven through June thirtieth, two thousand seven; and
  (C) for services and expenses, including grants, related to  emergency
assistance  distributions  as  designated by the commissioner.  Notwith-
standing section one hundred twelve or one hundred  sixty-three  of  the
state  finance law or any other contrary provision of law, such distrib-
utions shall be limited to providers or programs where, as determined by
the commissioner, emergency assistance is vital to protect the  life  or
safety  of  patients,  to ensure the retention of facility caregivers or
other staff, or in instances where health facility operations are  jeop-
ardized,  or  where  the public health is jeopardized or other emergency
situations exist, up to three million dollars annually  for  the  period
April first, two thousand seven through March thirty-first, two thousand
eleven, [and] up to two million nine hundred thousand dollars each state
fiscal  year  for  the  period  April first, two thousand eleven through
March thirty-first, two thousand fourteen, AND UP TO  TWO  MILLION  NINE
HUNDRED  THOUSAND  DOLLARS  EACH  STATE FISCAL YEAR FOR THE PERIOD APRIL
FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH  THIRTY-FIRST,  TWO  THOUSAND
SEVENTEEN.   Upon any distribution of such funds, the commissioner shall
immediately notify the chair and ranking minority member of  the  senate
finance  committee,  the  assembly  ways and means committee, the senate
committee on health, and the assembly committee on health;
  (iv) distributions by  the  commissioner  related  to  poison  control
centers  pursuant  to subdivision seven of section twenty-five hundred-d
of this chapter, up to five  million  dollars  for  the  period  January
first,  nineteen  hundred  ninety-seven  through  December thirty-first,

S. 6914                            47                            A. 9205

nineteen hundred ninety-seven, up to three million dollars on an annual-
ized basis for the periods during the  period  January  first,  nineteen
hundred  ninety-eight  through  December  thirty-first, nineteen hundred
ninety-nine, up to five million dollars annually for the periods January
first,  two thousand through December thirty-first, two thousand two, up
to four million six hundred thousand dollars annually  for  the  periods
January  first,  two  thousand  three through December thirty-first, two
thousand four, up to five million one hundred thousand dollars  for  the
period  January  first, two thousand five through December thirty-first,
two thousand six annually, up  to  five  million  one  hundred  thousand
dollars  annually  for  the  period  January  first,  two thousand seven
through December thirty-first, two thousand nine, up  to  three  million
six  hundred thousand dollars for the period January first, two thousand
ten through December thirty-first, two thousand ten, up to seven hundred
seventy-five thousand dollars for the period January first, two thousand
eleven through March thirty-first, two thousand eleven, [and] up to  two
million  five  hundred  thousand  dollars each state fiscal year for the
period April first, two thousand eleven through March thirty-first,  two
thousand  fourteen,  AND  UP  TO THREE MILLION DOLLARS EACH STATE FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  FOURTEEN  THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND SEVENTEEN; and
  (v)  deposit by the commissioner, within amounts appropriated, and the
state comptroller is hereby  authorized  and  directed  to  receive  for
deposit  to, to the credit of the department of health's special revenue
fund - other, miscellaneous special revenue  fund  -  339  maternal  and
child  HIV  services  account  or  the  health  care  reform  act (HCRA)
resources fund, whichever is  applicable,  for  purposes  of  a  special
program  for  HIV services for women and children, including adolescents
pursuant to section twenty-five hundred-f-one of [the public health law]
THIS CHAPTER, up to five million dollars annually for the periods  Janu-
ary first, two thousand through December thirty-first, two thousand two,
up  to  five  million dollars for the period January first, two thousand
three through December thirty-first,  two  thousand  three,  up  to  two
million  five hundred thousand dollars for the period January first, two
thousand four through December thirty-first, two thousand  four,  up  to
two  million five hundred thousand dollars for the period January first,
two thousand five through December thirty-first, two thousand  five,  up
to  five  million dollars for the period January first, two thousand six
through December thirty-first, two thousand  six,  up  to  five  million
dollars  annually  for  the  period  January  first,  two thousand seven
through December thirty-first, two thousand ten, up to one  million  two
hundred  fifty  thousand dollars for the period January first, two thou-
sand eleven through March thirty-first, two thousand eleven, and  up  to
five  million dollars each state fiscal year for the period April first,
two thousand eleven through March thirty-first, two thousand fourteen;
  (d) (i) An amount of up to twenty million  dollars  annually  for  the
period  January  first,  two thousand through December thirty-first, two
thousand six, up to ten million dollars for the  period  January  first,
two  thousand  seven  through  June thirtieth, two thousand seven, up to
twenty million dollars annually for the period January first, two  thou-
sand  eight  through December thirty-first, two thousand ten, up to five
million dollars for  the  period  January  first,  two  thousand  eleven
through  March  thirty-first,  two thousand eleven, [and] up to nineteen
million six hundred thousand dollars each  state  fiscal  year  for  the
period  April first, two thousand eleven through March thirty-first, two
thousand fourteen, AND UP  TO  NINETEEN  MILLION  SIX  HUNDRED  THOUSAND

S. 6914                            48                            A. 9205

DOLLARS  EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND
FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND  SEVENTEEN,  shall  be
transferred to the health facility restructuring pool established pursu-
ant to section twenty-eight hundred fifteen of this article;
  (ii)  provided,  however, amounts transferred pursuant to subparagraph
(i) of this paragraph may be reduced in an amount to be approved by  the
director  of  the budget to reflect the amount received from the federal
government under the state's 1115 waiver which  is  directed  under  its
terms and conditions to the health facility restructuring program.
  (e)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available,  including income from invested funds, for  purposes
of  distributions  to  organizations  to  support  the  health workforce
retraining program established pursuant to section twenty-eight  hundred
seven-g  of  this   article  from the respective health care initiatives
pools established for the following periods  in  the  following  amounts
from  the  pools  or  the  health care reform act (HCRA) resources fund,
whichever is applicable,  during  the  period  January  first,  nineteen
hundred  ninety-seven  through  December  thirty-first, nineteen hundred
ninety-nine, up to fifty million dollars on an annualized basis,  up  to
thirty  million  dollars  for  the  period  January  first, two thousand
through December thirty-first, two thousand, up to forty million dollars
for the period January first, two thousand one through December  thirty-
first,  two  thousand  one,  up  to fifty million dollars for the period
January first, two thousand two through December thirty-first, two thou-
sand two, up to forty-one million one hundred fifty thousand dollars for
the period January first, two thousand three  through  December  thirty-
first,  two  thousand  three,  up to forty-one million one hundred fifty
thousand dollars for the period January first, two thousand four through
December thirty-first, two thousand  four,  up  to  fifty-eight  million
three  hundred  sixty thousand dollars for the period January first, two
thousand five through December thirty-first, two thousand  five,  up  to
fifty-two  million  three  hundred sixty thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six, up to thirty-five million four hundred thousand dollars  annu-
ally  for  the period January first, two thousand seven through December
thirty-first, two thousand ten, up to eight million eight hundred  fifty
thousand  dollars  for  the  period  January  first, two thousand eleven
through March thirty-first, two thousand eleven,  [and]  up  to  twenty-
eight  million  four hundred thousand dollars each state fiscal year for
the period April first, two thousand eleven through March  thirty-first,
two thousand fourteen, AND UP TO TWENTY-SIX MILLION EIGHT HUNDRED SEVEN-
TEEN THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST,
TWO  THOUSAND  FOURTEEN  THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SEVEN-
TEEN, less the amount  of  funds  available  for  allocations  for  rate
adjustments  for  workforce  training  programs  for  payments  by state
governmental agencies for inpatient hospital services.
  (f) Funds shall be accumulated and transferred from as follows:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
(A)  thirty-four  million   six hundred thousand dollars shall be trans-
ferred to funds reserved and accumulated pursuant to  paragraph  (b)  of
subdivision  nineteen  of  section  twenty-eight hundred seven-c of this
article, and (B) eighty-two million dollars  shall  be  transferred  and
deposited  and  credited to the credit of the state general fund medical
assistance local assistance account;

S. 6914                            49                            A. 9205

  (ii) from the pool for the  period  January  first,  nineteen  hundred
ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
eight, eighty-two million dollars shall be transferred and deposited and
credited to the credit of the  state  general  fund  medical  assistance
local assistance account;
  (iii)  from  the  pool  for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
eighty-two million dollars shall be transferred and deposited and  cred-
ited  to  the  credit of the state general fund medical assistance local
assistance account;
  (iv) from the pool or the health  care  reform  act  (HCRA)  resources
fund,  whichever  is applicable, for the period January first, two thou-
sand  through  December  thirty-first,  two  thousand  four,  eighty-two
million dollars annually, and for the period January first, two thousand
five  through  December  thirty-first,  two  thousand  five,  eighty-two
million dollars, and for the period  January  first,  two  thousand  six
through  December  thirty-first,  two  thousand  six, eighty-two million
dollars, and for the period January first, two  thousand  seven  through
December  thirty-first,  two thousand seven, eighty-two million dollars,
and for the period January first, two thousand  eight  through  December
thirty-first,  two thousand eight, ninety million seven hundred thousand
dollars shall be deposited by the  commissioner,  and  the  state  comp-
troller  is hereby authorized and directed to receive for deposit to the
credit of the state special revenue fund - other,  HCRA  transfer  fund,
medical assistance account;
  (v)  from  the  health  care  reform act (HCRA) resources fund for the
period January first, two thousand nine through  December  thirty-first,
two  thousand  nine, one hundred eight million nine hundred seventy-five
thousand dollars, and for the period January  first,  two  thousand  ten
through  December thirty-first, two thousand ten, one hundred twenty-six
million one hundred thousand dollars, for the period January first,  two
thousand  eleven through March thirty-first, two thousand eleven, twenty
million five hundred thousand dollars, and for each  state  fiscal  year
for  the  period  April first, two thousand eleven through March thirty-
first, two thousand fourteen, one hundred forty-six million four hundred
thousand dollars, shall be deposited by the commissioner, and the  state
comptroller is hereby authorized and directed to receive for deposit, to
the  credit  of  the  state  special revenue fund - other, HCRA transfer
fund, medical assistance account.
  (g) Funds shall be transferred to primary health care  services  pools
created  by  the  commissioner, and shall be available, including income
from invested funds, for distributions in accordance with former section
twenty-eight hundred seven-bb of this article from the respective health
care initiatives pools  for  the  following  periods  in  the  following
percentage  amounts  of  funds remaining after allocations in accordance
with paragraphs (a) through (f) of this subdivision:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
fifteen and eighty-seven-hundredths percent;
  (ii)  from  the  pool  for  the period January first, nineteen hundred
ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
eight, fifteen and eighty-seven-hundredths percent; and
  (iii)  from  the  pool  for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
sixteen and thirteen-hundredths percent.

S. 6914                            50                            A. 9205

  (h) Funds shall be reserved and accumulated from year to year  by  the
commissioner  and  shall  be  available,  including income from invested
funds, for purposes of primary care education and training  pursuant  to
article nine of this chapter from the respective health care initiatives
pools  established for the following periods in the following percentage
amounts of funds remaining after allocations in  accordance  with  para-
graphs  (a)  through  (f) of this subdivision and shall be available for
distributions as follows:
  (i) funds shall be reserved and accumulated:
  (A) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
six and thirty-five-hundredths percent;
  (B) from the pool for the period January first, nineteen hundred nine-
ty-eight  through  December thirty-first, nineteen hundred ninety-eight,
six and thirty-five-hundredths percent; and
  (C) from the pool for the period January first, nineteen hundred nine-
ty-nine through December thirty-first, nineteen hundred ninety-nine, six
and forty-five-hundredths percent;
  (ii) funds shall be available for distributions including income  from
invested funds as follows:
  (A)  for purposes of the primary care physician loan repayment program
in accordance with section nine hundred three of  this  chapter,  up  to
five million dollars on an annualized basis;
  (B)  for purposes of the primary care practitioner scholarship program
in accordance with section nine hundred four of this chapter, up to  two
million dollars on an annualized basis;
  (C) for purposes of minority participation in medical education grants
in  accordance  with section nine hundred six of this chapter, up to one
million dollars on an annualized basis; and
  (D) provided, however, that the commissioner may reallocate any  funds
remaining  or unallocated for distributions for the primary care practi-
tioner scholarship program in accordance with section nine hundred  four
of this chapter.
  (i)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  distrib-
utions  in  accordance  with  section  twenty-nine hundred fifty-two and
section twenty-nine hundred fifty-eight of this chapter for rural health
care delivery development and  rural  health  care  access  development,
respectively,  from  the respective health care initiatives pools or the
health care reform act (HCRA) resources fund, whichever  is  applicable,
for  the  following periods in the following percentage amounts of funds
remaining after allocations in accordance with  paragraphs  (a)  through
(f) of this subdivision, and for periods on and after January first, two
thousand, in the following amounts:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
thirteen and forty-nine-hundredths percent;
  (ii) from the pool for the  period  January  first,  nineteen  hundred
ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
eight, thirteen and forty-nine-hundredths percent;
  (iii) from the pool for the period  January  first,  nineteen  hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
thirteen and seventy-one-hundredths percent;
  (iv) from the pool for the periods January first, two thousand through
December thirty-first, two thousand two, seventeen million dollars annu-
ally,  and  for  the  period  January  first, two thousand three through

S. 6914                            51                            A. 9205

December thirty-first, two thousand three, up to fifteen  million  eight
hundred fifty thousand dollars;
  (v) from the pool or the health care reform act (HCRA) resources fund,
whichever is applicable, for the period January first, two thousand four
through  December thirty-first, two thousand four, up to fifteen million
eight hundred fifty thousand  dollars,  [and]  for  the  period  January
first,  two  thousand  five  through December thirty-first, two thousand
five, up to nineteen million two hundred thousand dollars, [and] for the
period January first, two thousand six  through  December  thirty-first,
two  thousand  six, up to nineteen million two hundred thousand dollars,
for the period January first, two thousand seven through December  thir-
ty-first,  two  thousand  ten,  up to eighteen million one hundred fifty
thousand dollars annually, for the period January  first,  two  thousand
eleven  through  March  thirty-first,  two  thousand  eleven, up to four
million five hundred thirty-eight thousand dollars, [and] for each state
fiscal year for the period April  first,  two  thousand  eleven  through
March  thirty-first,  two  thousand  fourteen, up to sixteen million two
hundred thousand dollars, AND UP TO SIXTEEN MILLION TWO HUNDRED THOUSAND
DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND
FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
  (j)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  distributions  related to health information and health care quality
improvement pursuant to former section twenty-eight hundred  seven-n  of
this  article  from  the respective health care initiatives pools estab-
lished for the following periods in the following percentage amounts  of
funds  remaining  after  allocations  in  accordance with paragraphs (a)
through (f) of this subdivision:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
six and thirty-five-hundredths percent;
  (ii)  from  the  pool  for  the period January first, nineteen hundred
ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
eight, six and thirty-five-hundredths percent; and
  (iii)  from  the  pool  for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
six and forty-five-hundredths percent.
  (k) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available,  including  income  from invested funds, for allo-
cations  and  distributions  in  accordance  with  section  twenty-eight
hundred  seven-p  of  this  article  for diagnostic and treatment center
uncompensated care from the respective health care initiatives pools  or
the  health care reform act (HCRA) resources fund, whichever is applica-
ble, for the following periods in the following percentage   amounts  of
funds  remaining  after  allocations  in  accordance with paragraphs (a)
through (f) of this subdivision, and for periods on  and  after  January
first, two thousand, in the following amounts:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
thirty-eight and one-tenth percent;
  (ii) from the pool for the  period  January  first,  nineteen  hundred
ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
eight, thirty-eight and one-tenth percent;
  (iii) from the pool for the period  January  first,  nineteen  hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
thirty-eight and seventy-one-hundredths percent;

S. 6914                            52                            A. 9205

  (iv) from the pool for the periods January first, two thousand through
December  thirty-first,  two  thousand  two, forty-eight million dollars
annually, and for the period January first, two thousand  three  through
June thirtieth, two thousand three, twenty-four million dollars;
  (v)  (A)  from the pool or the health care reform act (HCRA) resources
fund, whichever is applicable, for the period July first,  two  thousand
three  through  December  thirty-first,  two  thousand  three, up to six
million dollars, for the period January first, two thousand four through
December thirty-first, two thousand six, up to  twelve  million  dollars
annually,  for  the  period  January  first,  two thousand seven through
December thirty-first, two thousand thirteen, up to forty-eight  million
dollars annually, [and] for the period January first, two thousand four-
teen  through  March  thirty-first,  two thousand fourteen, up to twelve
million dollars AND FOR THE PERIOD APRIL FIRST,  TWO  THOUSAND  FOURTEEN
THROUGH  MARCH  THIRTY-FIRST,  TWO THOUSAND SEVENTEEN, UP TO FORTY-EIGHT
MILLION DOLLARS ANNUALLY;
  (B) from the health care reform act  (HCRA)  resources  fund  for  the
period  January  first,  two thousand six through December thirty-first,
two thousand six, an additional  seven  million  five  hundred  thousand
dollars, for the period January first, two thousand seven through Decem-
ber  thirty-first,  two  thousand  thirteen, an additional seven million
five hundred thousand dollars annually, [and]  for  the  period  January
first,  two  thousand  fourteen through March thirty-first, two thousand
fourteen, an additional one million eight hundred seventy-five  thousand
dollars,  AND  FOR THE PERIOD APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN, AN ADDITIONAL SEVEN  MILLION
FIVE HUNDRED THOUSAND DOLLARS ANNUALLY for voluntary non-profit diagnos-
tic  and treatment center uncompensated care in accordance with subdivi-
sion four-c of section twenty-eight hundred seven-p of this article; and
  (vi) funds reserved and accumulated pursuant  to  this  paragraph  for
periods  on and after July first, two thousand three, shall be deposited
by the commissioner, within amounts appropriated, and  the  state  comp-
troller  is hereby authorized and directed to receive for deposit to the
credit of the state special revenue funds - other, HCRA  transfer  fund,
medical  assistance  account, for purposes of funding the state share of
rate adjustments made pursuant to section twenty-eight  hundred  seven-p
of  this article, provided, however, that in the event federal financial
participation is not available for rate  adjustments  made  pursuant  to
paragraph (b) of subdivision one of section twenty-eight hundred seven-p
of this article, funds shall be distributed pursuant to paragraph (a) of
subdivision  one of section twenty-eight hundred seven-p of this article
from the respective health care initiatives pools  or  the  health  care
reform act (HCRA) resources fund, whichever is applicable.
  (l)  Funds  shall be reserved and accumulated from year to year by the
commissioner and shall be  available,  including  income  from  invested
funds, for transfer to and allocation  for services and expenses for the
payment  of benefits to recipients of  drugs under the AIDS drug assist-
ance program (ADAP) - HIV uninsured  care  program  as  administered  by
Health  Research  Incorporated  from  the respective  health care initi-
atives pools or the health care reform act (HCRA) resources fund, which-
ever is applicable, established for the following periods in the follow-
ing  percentage  amounts  of  funds  remaining  after   allocations   in
accordance  with paragraphs (a) through (f) of this subdivision, and for
periods on and after January  first,  two  thousand,  in  the  following
amounts:

S. 6914                            53                            A. 9205

  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
nine and fifty-two-hundredths percent;
  (ii)  from  the  pool  for  the period January first, nineteen hundred
ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
eight, nine and fifty-two-hundredths percent;
  (iii)  from  the  pool  for the period January first, nineteen hundred
ninety-nine and December  thirty-first,  nineteen  hundred  ninety-nine,
nine and sixty-eight-hundredths percent;
  (iv) from the pool for the periods January first, two thousand through
December  thirty-first,  two  thousand two, up to twelve million dollars
annually, and for the period January first, two thousand  three  through
December  thirty-first, two thousand three, up to forty million dollars;
and
  (v) from the pool or the health care reform act (HCRA) resources fund,
whichever is applicable, for the periods  January  first,  two  thousand
four  through  December thirty-first, two thousand four, up to fifty-six
million dollars, for the period January first, two thousand five through
December thirty-first, two thousand six, up  to  sixty  million  dollars
annually,  for  the  period  January  first,  two thousand seven through
December thirty-first, two thousand ten, up  to  sixty  million  dollars
annually,  for  the  period  January  first, two thousand eleven through
March thirty-first, two thousand eleven, up to fifteen million  dollars,
[and]  each  state  fiscal year for the period April first, two thousand
eleven through March thirty-first, two thousand fourteen, up  to  forty-
two  million  three hundred thousand dollars AND UP TO FORTY-ONE MILLION
FIFTY THOUSAND DOLLARS EACH STATE  FISCAL  YEAR  FOR  THE  PERIOD  APRIL
FIRST,  TWO  THOUSAND  FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND
SEVENTEEN.
  (m) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of distributions pursuant to section  twenty-eight  hundred  seven-r  of
this article for cancer related services from the respective health care
initiatives  pools  or the health care reform act (HCRA) resources fund,
whichever is applicable, established for the following  periods  in  the
following  percentage  amounts  of  funds remaining after allocations in
accordance with paragraphs (a) through (f) of this subdivision, and  for
periods  on  and  after  January  first,  two thousand, in the following
amounts:
  (i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
seven and ninety-four-hundredths percent;
  (ii)  from  the  pool  for  the period January first, nineteen hundred
ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
eight, seven and ninety-four-hundredths percent;
  (iii)  from  the  pool  for the period January first, nineteen hundred
ninety-nine and December thirty-first, nineteen hundred ninety-nine, six
and forty-five-hundredths percent;
  (iv) from the pool for the period January first, two thousand  through
December thirty-first, two thousand two, up to ten million dollars on an
annual basis;
  (v)  from  the  pool  for the period January first, two thousand three
through December thirty-first, two thousand four, up  to  eight  million
nine hundred fifty thousand dollars on an annual basis;
  (vi)  from  the  pool  or  the health care reform act (HCRA) resources
fund, whichever is applicable, for the period January first,  two  thou-

S. 6914                            54                            A. 9205

sand  five  through  December  thirty-first, two thousand six, up to ten
million fifty thousand dollars on an annual basis, for the period  Janu-
ary  first,  two thousand seven through December thirty-first, two thou-
sand  ten,  up  to nineteen million dollars annually, and for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven, up to four million seven hundred fifty thousand dollars.
  (n) Funds shall be accumulated and transferred from  the  health  care
reform act (HCRA) resources fund as follows: for the period April first,
two  thousand  seven through March thirty-first, two thousand eight, and
on an annual basis for the  periods  April  first,  two  thousand  eight
through  November  thirtieth,  two  thousand  nine, funds within amounts
appropriated shall be transferred and  deposited  and  credited  to  the
credit  of  the state special revenue funds - other, HCRA transfer fund,
medical assistance account, for purposes of funding the state  share  of
rate  adjustments  made  to public and voluntary hospitals in accordance
with paragraphs (i) and (j) of subdivision one of  section  twenty-eight
hundred seven-c of this article.
  2.  Notwithstanding  any  inconsistent provision of law, rule or regu-
lation, any funds accumulated  in  the  health  care  initiatives  pools
pursuant  to  paragraph  (b) of subdivision nine of section twenty-eight
hundred seven-j of this article, as a result of surcharges,  assessments
or  other obligations during the periods January first, nineteen hundred
ninety-seven through December  thirty-first,  nineteen  hundred  ninety-
nine, which are unused or uncommitted for distributions pursuant to this
section  shall  be  reserved  and  accumulated  from year to year by the
commissioner and, within amounts appropriated, transferred and deposited
into the special revenue funds - other,  miscellaneous  special  revenue
fund  -  339,  child  health  insurance account or any successor fund or
account, for purposes of distributions to  implement  the  child  health
insurance  program  established pursuant to sections twenty-five hundred
ten and twenty-five hundred eleven of this chapter for  periods  on  and
after January first, two thousand one; provided, however, funds reserved
and  accumulated  for  priority  distributions  pursuant to subparagraph
(iii) of paragraph (c) of subdivision one of this section shall  not  be
transferred  and  deposited  into such account pursuant to this subdivi-
sion; and provided further, however, that any unused or uncommitted pool
funds accumulated and allocated pursuant to paragraph (j) of subdivision
one of this section shall be distributed  for  purposes  of  the  health
information and quality improvement act of 2000.
  3.  Revenue  from  distributions pursuant to this section shall not be
included in gross revenue  received  for  purposes  of  the  assessments
pursuant to subdivision eighteen of section twenty-eight hundred seven-c
of  this article, subject to the provisions of paragraph (e) of subdivi-
sion eighteen of section twenty-eight hundred seven-c of  this  article,
and  shall not be included in gross revenue received for purposes of the
assessments pursuant to section twenty-eight  hundred  seven-d  of  this
article,  subject  to  the  provisions  of subdivision twelve of section
twenty-eight hundred seven-d of this article.
  S 8. Section 2807-v of the public health law, as amended by section  5
of part B of chapter 58 of the laws of 2008, subdivision 1 as amended by
section  8  of  part  C of chapter 59 of the laws of 2011, clause (K) of
subparagraph (i) of paragraph  (bb)  of  subdivision  1  as  amended  by
section  35-a,  subparagraph  (xi) of paragraph (cc) of subdivision 1 as
amended by section 35-b and subparagraph (vii)  of  paragraph  (ccc)  of
subdivision  1 as amended by section 35-c of part D of chapter 56 of the
laws of 2012, paragraph (fff) of subdivision 1 as separately amended  by

S. 6914                            55                            A. 9205

section  16  of  part A of chapter 59 of the laws of 2011, and paragraph
(iii) of subdivision 1 as added by section 52-b of part H of chapter  59
of the laws of 2011, is amended to read as follows:
  S  2807-v.  Tobacco  control  and  insurance initiatives pool distrib-
utions.   1. Funds accumulated in  the  tobacco  control  and  insurance
initiatives  pool or in the health care reform act (HCRA) resources fund
established pursuant to section ninety-two-dd of the state finance  law,
whichever  is applicable, including income from invested funds, shall be
distributed or retained by the commissioner or by the state comptroller,
as applicable, in accordance with the following:
  (a) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  -  other, HCRA transfer fund, medicaid fraud hotline and
medicaid administration account, or any successor fund or  account,  for
purposes  of  services  and  expenses  related to the toll-free medicaid
fraud hotline established pursuant to section one hundred eight of chap-
ter one of the laws of nineteen hundred  ninety-nine  from  the  tobacco
control  and  insurance  initiatives  pool established for the following
periods in the following amounts: four hundred thousand dollars annually
for the periods January first, two  thousand  through  December  thirty-
first,  two  thousand  two,  up to four hundred thousand dollars for the
period January first, two thousand three through December  thirty-first,
two  thousand  three, up to four hundred thousand dollars for the period
January first, two thousand  four  through  December  thirty-first,  two
thousand  four, up to four hundred thousand dollars for the period Janu-
ary first, two thousand five through December thirty-first, two thousand
five, up to four hundred thousand dollars for the period January  first,
two  thousand six through December thirty-first, two thousand six, up to
four hundred thousand dollars for the period January first, two thousand
seven through December thirty-first, two  thousand  seven,  up  to  four
hundred  thousand  dollars  for  the  period January first, two thousand
eight through December thirty-first, two  thousand  eight,  up  to  four
hundred thousand dollars for the period January first, two thousand nine
through  December  thirty-first,  two  thousand nine, up to four hundred
thousand dollars for the period January first, two thousand ten  through
December  thirty-first,  two  thousand  ten,  up to one hundred thousand
dollars for the period January first, two thousand eleven through  March
thirty-first, two thousand eleven and within amounts appropriated on and
after April first, two thousand eleven.
  (b)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of payment of audits or audit contracts necessary to determine payor and
provider compliance with requirements set forth in sections twenty-eight
hundred  seven-j,  twenty-eight hundred seven-s and twenty-eight hundred
seven-t of this article from the tobacco control  and  insurance  initi-
atives  pool  established  for  the  following  periods in the following
amounts: five million six hundred  thousand  dollars  annually  for  the
periods  January  first, two thousand through December thirty-first, two
thousand two, up to five million dollars for the period  January  first,
two thousand three through December thirty-first, two thousand three, up
to  five million dollars for the period January first, two thousand four
through December thirty-first, two thousand four,  up  to  five  million
dollars for the period January first, two thousand five through December
thirty  first,  two  thousand  five,  up to five million dollars for the
period January first, two thousand six  through  December  thirty-first,

S. 6914                            56                            A. 9205

two thousand six, up to seven million eight hundred thousand dollars for
the  period  January  first, two thousand seven through December thirty-
first, two thousand seven, and up to eight million three  hundred  twen-
ty-five  thousand  dollars  for  the  period January first, two thousand
eight through December thirty-first, two thousand  eight,  up  to  eight
million  five hundred thousand dollars for the period January first, two
thousand nine through December thirty-first, two thousand  nine,  up  to
eight  million  five  hundred  thousand  dollars  for the period January
first, two thousand ten through December thirty-first, two thousand ten,
up to two million one hundred twenty-five thousand dollars for the peri-
od January first, two thousand eleven through  March  thirty-first,  two
thousand  eleven,  [and]  up  to fourteen million seven hundred thousand
dollars each state fiscal year for the period April first, two  thousand
eleven  through  March  thirty-first,  two  thousand fourteen, AND UP TO
ELEVEN MILLION ONE HUNDRED THOUSAND DOLLARS EACH STATE FISCAL  YEAR  FOR
THE   PERIOD   APRIL   FIRST,   TWO   THOUSAND  FOURTEEN  THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
  (c) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, enhanced community services
account, or any successor fund or account, for  mental  health  services
programs for case management services for adults and children; supported
housing;  home  and community based waiver services; family based treat-
ment; family support services; mobile mental health teams;  transitional
housing; and community oversight, established pursuant to articles seven
and  forty-one of the mental hygiene law and subdivision nine of section
three hundred sixty-six of the social services law; and  for  comprehen-
sive  care  centers  for eating disorders pursuant to the former section
twenty-seven hundred ninety-nine-l of  this  chapter,  provided  however
that,  for  such  centers,  funds in the amount of five hundred thousand
dollars on an annualized basis shall be transferred  from  the  enhanced
community services account, or any successor fund or account, and depos-
ited  into  the  fund  established by section ninety-five-e of the state
finance law; from the tobacco control  and  insurance  initiatives  pool
established for the following periods in the following amounts:
  (i)  forty-eight million dollars to be reserved, to be retained or for
distribution pursuant to a chapter of the laws of two thousand, for  the
period  January  first,  two thousand through December thirty-first, two
thousand;
  (ii) eighty-seven million dollars to be reserved, to  be  retained  or
for  distribution pursuant to a chapter of the laws of two thousand one,
for the period January first, two thousand one through December  thirty-
first, two thousand one;
  (iii)  eighty-seven  million dollars to be reserved, to be retained or
for distribution pursuant to a chapter of the laws of two thousand  two,
for  the period January first, two thousand two through December thirty-
first, two thousand two;
  (iv) eighty-eight million dollars to be reserved, to  be  retained  or
for  distribution  pursuant  to  a  chapter  of the laws of two thousand
three, for the period January first, two thousand three through December
thirty-first, two thousand three;
  (v) eighty-eight million dollars, plus five hundred thousand  dollars,
to be reserved, to be retained or for distribution pursuant to a chapter
of  the  laws  of  two thousand four, and pursuant to the former section
twenty-seven hundred ninety-nine-l of this chapter, for the period Janu-

S. 6914                            57                            A. 9205

ary first, two thousand four through December thirty-first, two thousand
four;
  (vi) eighty-eight million dollars, plus five hundred thousand dollars,
to be reserved, to be retained or for distribution pursuant to a chapter
of  the  laws  of  two thousand five, and pursuant to the former section
twenty-seven hundred ninety-nine-l of this chapter, for the period Janu-
ary first, two thousand five through December thirty-first, two thousand
five;
  (vii)  eighty-eight  million  dollars,  plus  five  hundred   thousand
dollars,  to be reserved, to be retained or for distribution pursuant to
a chapter of the laws of  two  thousand  six,  and  pursuant  to  FORMER
section  twenty-seven  hundred  ninety-nine-l  of  this chapter, for the
period January first, two thousand six  through  December  thirty-first,
two thousand six;
  (viii)  eighty-six  million  four  hundred thousand dollars, plus five
hundred thousand dollars, to be reserved, to be retained or for distrib-
ution pursuant to a chapter of the laws of two thousand seven and pursu-
ant to the former section twenty-seven  hundred  ninety-nine-l  of  this
chapter, for the period January first, two thousand seven through Decem-
ber thirty-first, two thousand seven; and
  (ix)  twenty-two  million nine hundred thirteen thousand dollars, plus
one hundred twenty-five thousand dollars, to be reserved, to be retained
or for distribution pursuant to a chapter of the laws  of  two  thousand
eight  and  pursuant  to the former section twenty-seven hundred ninety-
nine-l of this chapter, for the period January first, two thousand eight
through March thirty-first, two thousand eight.
  (d) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share of services and expenses related to the family health plus program
including up to two and one-half million dollars annually for the period
January  first, two thousand through December thirty-first, two thousand
two, for administration and marketing costs associated with such program
established pursuant to clause (A) of subparagraph (v) of paragraph  (a)
of  subdivision two of section three hundred sixty-nine-ee of the social
services law from the tobacco control  and  insurance  initiatives  pool
established for the following periods in the following amounts:
  (i) three million five hundred thousand dollars for the period January
first, two thousand through December thirty-first, two thousand;
  (ii)  twenty-seven  million  dollars for the period January first, two
thousand one through December thirty-first, two thousand one; and
  (iii) fifty-seven million dollars for the period  January  first,  two
thousand two through December thirty-first, two thousand two.
  (e)  Funds  shall  be  deposited  by  the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of services and expenses related to the family health plus program
including up to two and one-half million dollars annually for the period
January first, two thousand through December thirty-first, two  thousand
two  for administration and marketing costs associated with such program
established pursuant to clause (B) of subparagraph (v) of paragraph  (a)
of  subdivision two of section three hundred sixty-nine-ee of the social

S. 6914                            58                            A. 9205

services law from the tobacco control  and  insurance  initiatives  pool
established for the following periods in the following amounts:
  (i)  two  million five hundred thousand dollars for the period January
first, two thousand through December thirty-first, two thousand;
  (ii) thirty million five hundred thousand dollars for the period Janu-
ary first, two thousand one through December thirty-first, two  thousand
one; and
  (iii)  sixty-six  million  dollars  for  the period January first, two
thousand two through December thirty-first, two thousand two.
  (f) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  -  other, HCRA transfer fund, medicaid fraud hotline and
medicaid administration account, or any successor fund or  account,  for
purposes of payment of administrative expenses of the department related
to  the family health plus program established pursuant to section three
hundred sixty-nine-ee of  the  social  services  law  from  the  tobacco
control  and  insurance  initiatives  pool established for the following
periods in the following amounts: five hundred thousand  dollars  on  an
annual  basis for the periods January first, two thousand through Decem-
ber thirty-first, two thousand six, five hundred  thousand  dollars  for
the  period  January  first, two thousand seven through December thirty-
first, two thousand seven, and five hundred  thousand  dollars  for  the
period  January first, two thousand eight through December thirty-first,
two thousand eight, five hundred thousand dollars for the period January
first, two thousand nine through  December  thirty-first,  two  thousand
nine,  five  hundred  thousand dollars for the period January first, two
thousand ten  through  December  thirty-first,  two  thousand  ten,  one
hundred  twenty-five  thousand dollars for the period January first, two
thousand eleven through March  thirty-first,  two  thousand  eleven  and
within amounts appropriated on and after April first, two thousand elev-
en.
  (g)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  services and expenses related to the health maintenance organization
direct pay market program established pursuant to  sections  forty-three
hundred  twenty-one-a and forty-three hundred twenty-two-a of the insur-
ance law from the tobacco control and insurance initiatives pool  estab-
lished for the following periods in the following amounts:
  (i)  up  to  thirty-five million dollars for the period January first,
two thousand through December thirty-first, two thousand of which  fifty
percentum  shall  be  allocated  to the program pursuant to section four
thousand three hundred twenty-one-a  of  the  insurance  law  and  fifty
percentum to the program pursuant to section four thousand three hundred
twenty-two-a of the insurance law;
  (ii)  up  to  thirty-six million dollars for the period January first,
two thousand one through December  thirty-first,  two  thousand  one  of
which  fifty  percentum  shall  be  allocated to the program pursuant to
section four thousand three hundred twenty-one-a of  the  insurance  law
and  fifty  percentum  to  the program pursuant to section four thousand
three hundred twenty-two-a of the insurance law;
  (iii) up to thirty-nine million dollars for the period January  first,
two  thousand  two  through  December  thirty-first, two thousand two of
which fifty percentum shall be allocated  to  the  program  pursuant  to
section  four  thousand  three hundred twenty-one-a of the insurance law

S. 6914                            59                            A. 9205

and fifty percentum to the program pursuant  to  section  four  thousand
three hundred twenty-two-a of the insurance law;
  (iv)  up  to  forty  million dollars for the period January first, two
thousand three through December  thirty-first,  two  thousand  three  of
which  fifty  percentum  shall  be  allocated to the program pursuant to
section four thousand three hundred twenty-one-a of  the  insurance  law
and  fifty  percentum  to  the program pursuant to section four thousand
three hundred twenty-two-a of the insurance law;
  (v) up to forty million dollars for  the  period  January  first,  two
thousand  four through December thirty-first, two thousand four of which
fifty percentum shall be allocated to the program  pursuant  to  section
four  thousand three hundred twenty-one-a of the insurance law and fifty
percentum to the program pursuant to section four thousand three hundred
twenty-two-a of the insurance law;
  (vi) up to forty million dollars for the  period  January  first,  two
thousand  five through December thirty-first, two thousand five of which
fifty percentum shall be allocated to the program  pursuant  to  section
four  thousand three hundred twenty-one-a of the insurance law and fifty
percentum to the program pursuant to section four thousand three hundred
twenty-two-a of the insurance law;
  (vii) up to forty million dollars for the period  January  first,  two
thousand  six  through  December thirty-first, two thousand six of which
fifty percentum shall be allocated to the program  pursuant  to  section
four  thousand three hundred twenty-one-a of the insurance law and fifty
percentum shall be allocated to the program  pursuant  to  section  four
thousand three hundred twenty-two-a of the insurance law;
  (viii)  up  to forty million dollars for the period January first, two
thousand seven through December  thirty-first,  two  thousand  seven  of
which  fifty  percentum  shall  be  allocated to the program pursuant to
section four thousand three hundred twenty-one-a of  the  insurance  law
and  fifty  percentum  shall  be  allocated  to  the program pursuant to
section four thousand three hundred twenty-two-a of the  insurance  law;
and
  (ix)  up  to  forty  million dollars for the period January first, two
thousand eight through December  thirty-first,  two  thousand  eight  of
which  fifty  per  centum  shall be allocated to the program pursuant to
section four thousand three hundred twenty-one-a of  the  insurance  law
and  fifty  per  centum  shall  be  allocated to the program pursuant to
section four thousand three hundred twenty-two-a of the insurance law.
  (h) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of services and expenses related to  the  healthy  New  York  individual
program  established  pursuant  to  sections four thousand three hundred
twenty-six and four thousand three hundred twenty-seven of the insurance
law from the tobacco control and insurance initiatives pool  established
for the following periods in the following amounts:
  (i)  up to six million dollars for the period January first, two thou-
sand one through December thirty-first, two thousand one;
  (ii) up to twenty-nine million dollars for the period  January  first,
two thousand two through December thirty-first, two thousand two;
  (iii)  up  to five million one hundred thousand dollars for the period
January first, two thousand three  through  December  thirty-first,  two
thousand three;
  (iv)  up  to  twenty-four million six hundred thousand dollars for the
period January first, two thousand four through  December  thirty-first,
two thousand four;

S. 6914                            60                            A. 9205

  (v)  up  to  thirty-four  million six hundred thousand dollars for the
period January first, two thousand five through  December  thirty-first,
two thousand five;
  (vi)  up  to fifty-four million eight hundred thousand dollars for the
period January first, two thousand six  through  December  thirty-first,
two thousand six;
  (vii)  up  to sixty-one million seven hundred thousand dollars for the
period January first, two thousand seven through December  thirty-first,
two thousand seven; and
  (viii)  up  to  one hundred three million seven hundred fifty thousand
dollars for the period January first, two thousand eight through  Decem-
ber thirty-first, two thousand eight.
  (i)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  services  and expenses related to the healthy New York group program
established pursuant to sections four thousand three hundred  twenty-six
and  four  thousand three hundred twenty-seven of the insurance law from
the tobacco control and insurance initiatives pool established  for  the
following periods in the following amounts:
  (i)  up  to  thirty-four million dollars for the period January first,
two thousand one through December thirty-first, two thousand one;
  (ii) up to seventy-seven million dollars for the period January first,
two thousand two through December thirty-first, two thousand two;
  (iii) up to ten million five hundred thousand dollars for  the  period
January  first,  two  thousand  three through December thirty-first, two
thousand three;
  (iv) up to twenty-four million six hundred thousand  dollars  for  the
period  January  first, two thousand four through December thirty-first,
two thousand four;
  (v) up to thirty-four million six hundred  thousand  dollars  for  the
period  January  first, two thousand five through December thirty-first,
two thousand five;
  (vi) up to fifty-four million eight hundred thousand dollars  for  the
period  January  first,  two thousand six through December thirty-first,
two thousand six;
  (vii) up to sixty-one million seven hundred thousand dollars  for  the
period  January first, two thousand seven through December thirty-first,
two thousand seven; and
  (viii) up to one hundred three million seven  hundred  fifty  thousand
dollars  for the period January first, two thousand eight through Decem-
ber thirty-first, two thousand eight.
  (i-1) Notwithstanding the provisions of paragraphs (h) and (i) of this
subdivision, the commissioner shall reserve and  accumulate  up  to  two
million  five  hundred thousand dollars annually for the periods January
first, two thousand four through  December  thirty-first,  two  thousand
six,  one  million  four hundred thousand dollars for the period January
first, two thousand seven through December  thirty-first,  two  thousand
seven,  two  million  dollars for the period January first, two thousand
eight through December thirty-first,  two  thousand  eight,  from  funds
otherwise  available  for  distribution  under  such  paragraphs for the
services and expenses related to the  pilot  program  for  entertainment
industry  employees  included  in subsection (b) of section one thousand
one hundred twenty-two of the insurance law,  and  an  additional  seven
hundred  thousand  dollars  annually  for the periods January first, two
thousand four through December thirty-first, two thousand six, an  addi-
tional  three hundred thousand dollars for the period January first, two

S. 6914                            61                            A. 9205

thousand seven through June thirtieth, two thousand seven  for  services
and expenses related to the pilot program for displaced workers included
in  subsection (c) of section one thousand one hundred twenty-two of the
insurance law.
  (j)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  services  and  expenses  related  to  the tobacco use prevention and
control program established pursuant to sections thirteen hundred  nine-
ty-nine-ii and thirteen hundred ninety-nine-jj of this chapter, from the
tobacco  control  and  insurance  initiatives  pool  established for the
following periods in the following amounts:
  (i) up to thirty million dollars for the  period  January  first,  two
thousand through December thirty-first, two thousand;
  (ii)  up  to  forty  million dollars for the period January first, two
thousand one through December thirty-first, two thousand one;
  (iii) up to forty million dollars for the period  January  first,  two
thousand two through December thirty-first, two thousand two;
  (iv)  up to thirty-six million nine hundred fifty thousand dollars for
the period January first, two thousand three  through  December  thirty-
first, two thousand three;
  (v)  up  to thirty-six million nine hundred fifty thousand dollars for
the period January first, two thousand  four  through  December  thirty-
first, two thousand four;
  (vi)  up  to forty million six hundred thousand dollars for the period
January first, two thousand  five  through  December  thirty-first,  two
thousand five;
  (vii)  up  to eighty-one million nine hundred thousand dollars for the
period January first, two thousand six  through  December  thirty-first,
two thousand six, provided, however, that within amounts appropriated, a
portion  of  such  funds  may  be transferred to the Roswell Park Cancer
Institute Corporation to support costs associated with cancer research;
  (viii) up to ninety-four million one hundred  fifty  thousand  dollars
for  the period January first, two thousand seven through December thir-
ty-first, two thousand seven, provided,  however,  that  within  amounts
appropriated,  a portion of such funds may be transferred to the Roswell
Park Cancer Institute  Corporation  to  support  costs  associated  with
cancer research;
  (ix)  up to ninety-four million one hundred fifty thousand dollars for
the period January first, two thousand eight  through  December  thirty-
first, two thousand eight;
  (x)  up  to ninety-four million one hundred fifty thousand dollars for
the period January first, two thousand  nine  through  December  thirty-
first, two thousand nine;
  (xi)  up  to  eighty-seven million seven hundred seventy-five thousand
dollars for the period January first, two thousand ten through  December
thirty-first, two thousand ten;
  (xii)  up  to  twenty-one million four hundred twelve thousand dollars
for the period January first, two thousand eleven through March  thirty-
first, two thousand eleven; [and]
  (xiii) up to fifty-two million one hundred thousand dollars each state
fiscal  year  for  the  period  April first, two thousand eleven through
March thirty-first, two thousand fourteen; AND
  (XIV) UP TO SIX MILLION DOLLARS EACH STATE FISCAL YEAR FOR THE  PERIOD
APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND SEVENTEEN.

S. 6914                            62                            A. 9205

  (k)  Funds  shall  be  deposited  by  the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue fund - other, HCRA transfer fund, health care services  account,
or  any successor fund or account, for purposes of services and expenses
related to public health programs, including comprehensive care  centers
for eating disorders pursuant to the former section twenty-seven hundred
ninety-nine-l  of this chapter, provided however that, for such centers,
funds in the amount of five hundred thousand dollars  on  an  annualized
basis shall be transferred from the health care services account, or any
successor  fund  or  account, and deposited into the fund established by
section ninety-five-e of the state finance  law  for  periods  prior  to
March  thirty-first,  two  thousand eleven, from the tobacco control and
insurance initiatives pool established for the following periods in  the
following amounts:
  (i) up to thirty-one million dollars for the period January first, two
thousand through December thirty-first, two thousand;
  (ii) up to forty-one million dollars for the period January first, two
thousand one through December thirty-first, two thousand one;
  (iii)  up  to eighty-one million dollars for the period January first,
two thousand two through December thirty-first, two thousand two;
  (iv) one hundred twenty-two million five hundred thousand dollars  for
the  period  January  first, two thousand three through December thirty-
first, two thousand three;
  (v) one hundred  eight  million  five  hundred  seventy-five  thousand
dollars, plus an additional five hundred thousand dollars, for the peri-
od  January  first, two thousand four through December thirty-first, two
thousand four;
  (vi) ninety-one million eight hundred thousand dollars, plus an  addi-
tional  five hundred thousand dollars, for the period January first, two
thousand five through December thirty-first, two thousand five;
  (vii) one hundred fifty-six million six hundred thousand dollars, plus
an additional five hundred thousand  dollars,  for  the  period  January
first, two thousand six through December thirty-first, two thousand six;
  (viii)  one  hundred  fifty-one million four hundred thousand dollars,
plus an additional five hundred thousand dollars, for the period January
first, two thousand seven through December  thirty-first,  two  thousand
seven;
  (ix)  one  hundred  sixteen  million  nine hundred forty-nine thousand
dollars, plus an additional five hundred thousand dollars, for the peri-
od January first, two thousand eight through December thirty-first,  two
thousand eight;
  (x)  one  hundred  sixteen  million  nine  hundred forty-nine thousand
dollars, plus an additional five hundred thousand dollars, for the peri-
od January first, two thousand nine through December  thirty-first,  two
thousand nine;
  (xi)  one  hundred  sixteen  million  nine hundred forty-nine thousand
dollars, plus an additional five hundred thousand dollars, for the peri-
od January first, two thousand ten through  December  thirty-first,  two
thousand ten;
  (xii)  twenty-nine  million  two  hundred  thirty-seven  thousand  two
hundred fifty dollars, plus an additional one hundred twenty-five  thou-
sand  dollars, for the period January first, two thousand eleven through
March thirty-first, two thousand eleven;

S. 6914                            63                            A. 9205

  (xiii) one hundred twenty million thirty-eight  thousand  dollars  for
the  period April first, two thousand eleven through March thirty-first,
two thousand twelve; and
  (xiv) one hundred nineteen million four hundred seven thousand dollars
each  state  fiscal year for the period April first, two thousand twelve
through March thirty-first, two thousand fourteen.
  (l) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share  of the personal care and certified home health agency rate or fee
increases established pursuant to subdivision  three  of  section  three
hundred  sixty-seven-o  of  the  social  services  law  from the tobacco
control and insurance initiatives pool  established  for  the  following
periods in the following amounts:
  (i)  twenty-three  million two hundred thousand dollars for the period
January first, two thousand through December thirty-first, two thousand;
  (ii) twenty-three million two hundred thousand dollars for the  period
January first, two thousand one through December thirty-first, two thou-
sand one;
  (iii) twenty-three million two hundred thousand dollars for the period
January first, two thousand two through December thirty-first, two thou-
sand two;
  (iv)  up  to  sixty-five  million two hundred thousand dollars for the
period January first, two thousand three through December  thirty-first,
two thousand three;
  (v)  up  to  sixty-five  million  two hundred thousand dollars for the
period January first, two thousand four through  December  thirty-first,
two thousand four;
  (vi)  up  to  sixty-five  million two hundred thousand dollars for the
period January first, two thousand five through  December  thirty-first,
two thousand five;
  (vii)  up  to  sixty-five million two hundred thousand dollars for the
period January first, two thousand six  through  December  thirty-first,
two thousand six;
  (viii)  up  to sixty-five million two hundred thousand dollars for the
period January first, two thousand seven through December  thirty-first,
two thousand seven; and
  (ix)  up  to  sixteen  million  three hundred thousand dollars for the
period January first, two thousand eight through March thirty-first, two
thousand eight.
  (m) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share  of  services  and expenses related to home care workers insurance
pilot demonstration programs established pursuant to subdivision two  of
section  three hundred sixty-seven-o of the social services law from the
tobacco control and  insurance  initiatives  pool  established  for  the
following periods in the following amounts:
  (i)  three million eight hundred thousand dollars for the period Janu-
ary first, two thousand through December thirty-first, two thousand;

S. 6914                            64                            A. 9205

  (ii) three million eight hundred thousand dollars for the period Janu-
ary first, two thousand one through December thirty-first, two  thousand
one;
  (iii)  three  million  eight  hundred  thousand dollars for the period
January first, two thousand two through December thirty-first, two thou-
sand two;
  (iv) up to three million eight hundred thousand dollars for the period
January first, two thousand three  through  December  thirty-first,  two
thousand three;
  (v)  up to three million eight hundred thousand dollars for the period
January first, two thousand  four  through  December  thirty-first,  two
thousand four;
  (vi) up to three million eight hundred thousand dollars for the period
January  first,  two  thousand  five  through December thirty-first, two
thousand five;
  (vii) up to three million eight hundred thousand dollars for the peri-
od January first, two thousand six through  December  thirty-first,  two
thousand six;
  (viii)  up  to  three  million  eight hundred thousand dollars for the
period January first, two thousand seven through December  thirty-first,
two thousand seven; and
  (ix)  up to nine hundred fifty thousand dollars for the period January
first, two thousand  eight  through  March  thirty-first,  two  thousand
eight.
  (n) Funds shall be transferred by the commissioner and shall be depos-
ited  to  the credit of the special revenue funds - other, miscellaneous
special revenue fund - 339, elderly  pharmaceutical  insurance  coverage
program  premium  account authorized pursuant to the provisions of title
three of article two of the elder law, or any successor fund or account,
for funding state expenses relating to  the  program  from  the  tobacco
control  and  insurance  initiatives  pool established for the following
periods in the following amounts:
  (i) one hundred seven million dollars for the  period  January  first,
two thousand through December thirty-first, two thousand;
  (ii)  one  hundred  sixty-four  million dollars for the period January
first, two thousand one through December thirty-first, two thousand one;
  (iii) three hundred twenty-two million seven hundred thousand  dollars
for  the period January first, two thousand two through December thirty-
first, two thousand two;
  (iv) four hundred thirty-three million three hundred thousand  dollars
for  the period January first, two thousand three through December thir-
ty-first, two thousand three;
  (v) five hundred four million one hundred fifty thousand  dollars  for
the  period  January  first,  two thousand four through December thirty-
first, two thousand four;
  (vi) five hundred sixty-six million eight hundred thousand dollars for
the period January first, two thousand  five  through  December  thirty-
first, two thousand five;
  (vii) six hundred three million one hundred fifty thousand dollars for
the  period  January  first,  two  thousand six through December thirty-
first, two thousand six;
  (viii) six hundred sixty million eight hundred  thousand  dollars  for
the  period  January  first, two thousand seven through December thirty-
first, two thousand seven;

S. 6914                            65                            A. 9205

  (ix) three hundred sixty-seven million four hundred sixty-three  thou-
sand  dollars  for  the period January first, two thousand eight through
December thirty-first, two thousand eight;
  (x)  three hundred thirty-four million eight hundred twenty-five thou-
sand dollars for the period January first,  two  thousand  nine  through
December thirty-first, two thousand nine;
  (xi)  three  hundred  forty-four million nine hundred thousand dollars
for the period January first, two thousand ten through December  thirty-
first, two thousand ten;
  (xii) eighty-seven million seven hundred eighty-eight thousand dollars
for  the period January first, two thousand eleven through March thirty-
first, two thousand eleven;
  (xiii) one hundred forty-three  million  one  hundred  fifty  thousand
dollars  for  the  period April first, two thousand eleven through March
thirty-first, two thousand twelve;
  (xiv) one hundred twenty million nine hundred fifty  thousand  dollars
for  the  period  April first, two thousand twelve through March thirty-
first, two thousand thirteen; [and]
  (xv) one hundred twenty-eight million  eight  hundred  fifty  thousand
dollars  for the period April first, two thousand thirteen through March
thirty-first, two thousand fourteen[.]; AND
  (XVI) ONE HUNDRED TWENTY-SEVEN MILLION FOUR HUNDRED  SIXTEEN  THOUSAND
DOLLARS  EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND
FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
  (o) Funds shall be reserved and accumulated and shall  be  transferred
to  the  Roswell  Park  Cancer  Institute  Corporation, from the tobacco
control and insurance initiatives pool  established  for  the  following
periods in the following amounts:
  (i)  up  to  ninety  million dollars for the period January first, two
thousand through December thirty-first, two thousand;
  (ii) up to sixty million dollars for the  period  January  first,  two
thousand one through December thirty-first, two thousand one;
  (iii)  up to eighty-five million dollars for the period January first,
two thousand two through December thirty-first, two thousand two;
  (iv) eighty-five million two hundred fifty thousand  dollars  for  the
period  January first, two thousand three through December thirty-first,
two thousand three;
  (v) seventy-eight million dollars for the period  January  first,  two
thousand four through December thirty-first, two thousand four;
  (vi)  seventy-eight  million dollars for the period January first, two
thousand five through December thirty-first, two thousand five;
  (vii) ninety-one million dollars for the  period  January  first,  two
thousand six through December thirty-first, two thousand six;
  (viii) seventy-eight million dollars for the period January first, two
thousand seven through December thirty-first, two thousand seven;
  (ix)  seventy-eight  million dollars for the period January first, two
thousand eight through December thirty-first, two thousand eight;
  (x) seventy-eight million dollars for the period  January  first,  two
thousand nine through December thirty-first, two thousand nine;
  (xi)  seventy-eight  million dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten;
  (xii) nineteen million five hundred thousand dollars  for  the  period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven; [and]

S. 6914                            66                            A. 9205

  (xiii)  sixty-nine  million  eight hundred forty thousand dollars each
state fiscal year for  the  period  April  first,  two  thousand  eleven
through March thirty-first, two thousand fourteen[.]; AND
  (XIV) UP TO NINETY-SIX MILLION SIX HUNDRED THOUSAND DOLLARS EACH STATE
FISCAL  YEAR  FOR  THE PERIOD APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
  (p) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds - other, indigent care fund - 068, indigent care account,
or any successor fund or account, for purposes of providing  a  medicaid
disproportionate  share payment from the high need indigent care adjust-
ment pool established pursuant to section twenty-eight  hundred  seven-w
of this article, from the tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
  (i) eighty-two million dollars annually for the periods January first,
two thousand through December thirty-first, two thousand two;
  (ii)  up  to  eighty-two million dollars for the period January first,
two thousand three through December thirty-first, two thousand three;
  (iii) up to eighty-two million dollars for the period  January  first,
two thousand four through December thirty-first, two thousand four;
  (iv)  up  to  eighty-two million dollars for the period January first,
two thousand five through December thirty-first, two thousand five;
  (v) up to eighty-two million dollars for the period January first, two
thousand six through December thirty-first, two thousand six;
  (vi) up to eighty-two million dollars for the  period  January  first,
two thousand seven through December thirty-first, two thousand seven;
  (vii)  up  to eighty-two million dollars for the period January first,
two thousand eight through December thirty-first, two thousand eight;
  (viii) up to eighty-two million dollars for the period January  first,
two thousand nine through December thirty-first, two thousand nine;
  (ix)  up  to  eighty-two million dollars for the period January first,
two thousand ten through December thirty-first, two thousand ten;
  (x) up to twenty million five hundred thousand dollars for the  period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven; and
  (xi)  up  to eighty-two million dollars each state fiscal year for the
period April first, two thousand eleven through March thirty-first,  two
thousand fourteen.
  (q)  Funds  shall  be  reserved  and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  providing  distributions  to  eligible  school  based health centers
established pursuant to section eighty-eight of chapter one of the  laws
of  nineteen hundred ninety-nine, from the tobacco control and insurance
initiatives pool established for the following periods in the  following
amounts:
  (i)  seven  million dollars annually for the period January first, two
thousand through December thirty-first, two thousand two;
  (ii) up to seven million dollars for the  period  January  first,  two
thousand three through December thirty-first, two thousand three;
  (iii)  up  to  seven million dollars for the period January first, two
thousand four through December thirty-first, two thousand four;
  (iv) up to seven million dollars for the  period  January  first,  two
thousand five through December thirty-first, two thousand five;
  (v)  up  to  seven  million  dollars for the period January first, two
thousand six through December thirty-first, two thousand six;

S. 6914                            67                            A. 9205

  (vi) up to seven million dollars for the  period  January  first,  two
thousand seven through December thirty-first, two thousand seven;
  (vii)  up  to  seven million dollars for the period January first, two
thousand eight through December thirty-first, two thousand eight;
  (viii) up to seven million dollars for the period January  first,  two
thousand nine through December thirty-first, two thousand nine;
  (ix)  up  to  seven  million dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten;
  (x) up to one million seven hundred fifty  thousand  dollars  for  the
period  January  first,  two thousand eleven through March thirty-first,
two thousand eleven; [and]
  (xi) up to five million six hundred thousand dollars each state fiscal
year for the period April first, two thousand eleven through March thir-
ty-first, two thousand fourteen[.]; AND
  (XII) UP TO FIVE MILLION TWO HUNDRED  EIGHTY-EIGHTY  THOUSAND  DOLLARS
EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND FOURTEEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
  (r) Funds shall be deposited by the commissioner within amounts appro-
priated,  and the state comptroller is hereby authorized and directed to
receive for deposit to the credit of the state special revenue  funds  -
other,  HCRA transfer fund, medical assistance account, or any successor
fund or account, for purposes of providing distributions for  supplemen-
tary   medical  insurance  for  Medicare  part  B  premiums,  physicians
services, outpatient services, medical  equipment,  supplies  and  other
health services, from the tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
  (i)  forty-three  million  dollars  for  the period January first, two
thousand through December thirty-first, two thousand;
  (ii) sixty-one million dollars for the period January first, two thou-
sand one through December thirty-first, two thousand one;
  (iii) sixty-five million dollars for the  period  January  first,  two
thousand two through December thirty-first, two thousand two;
  (iv)  sixty-seven million five hundred thousand dollars for the period
January first, two thousand three  through  December  thirty-first,  two
thousand three;
  (v)  sixty-eight  million  dollars  for  the period January first, two
thousand four through December thirty-first, two thousand four;
  (vi) sixty-eight million dollars for the  period  January  first,  two
thousand five through December thirty-first, two thousand five;
  (vii)  sixty-eight  million  dollars for the period January first, two
thousand six through December thirty-first, two thousand six;
  (viii) seventeen million five hundred thousand dollars for the  period
January  first,  two  thousand  seven through December thirty-first, two
thousand seven;
  (ix) sixty-eight million dollars for the  period  January  first,  two
thousand eight through December thirty-first, two thousand eight;
  (x)  sixty-eight  million  dollars  for  the period January first, two
thousand nine through December thirty-first, two thousand nine;
  (xi) sixty-eight million dollars for the  period  January  first,  two
thousand ten through December thirty-first, two thousand ten;
  (xii)  seventeen  million  dollars  for  the period January first, two
thousand eleven through March thirty-first, two thousand eleven; and
  (xiii) sixty-eight million dollars each  state  fiscal  year  for  the
period  April first, two thousand eleven through March thirty-first, two
thousand fourteen.

S. 6914                            68                            A. 9205

  (s) Funds shall be deposited by the commissioner within amounts appro-
priated, and the state comptroller is hereby authorized and directed  to
receive  for  deposit to the credit of the state special revenue funds -
other, HCRA transfer fund, medical assistance account, or any  successor
fund  or  account,  for  purposes of providing distributions pursuant to
paragraphs (s-5), (s-6),  (s-7)  and  (s-8)  of  subdivision  eleven  of
section  twenty-eight  hundred  seven-c of this article from the tobacco
control and insurance initiatives pool  established  for  the  following
periods in the following amounts:
  (i)  eighteen  million dollars for the period January first, two thou-
sand through December thirty-first, two thousand;
  (ii) twenty-four million dollars  annually  for  the  periods  January
first, two thousand one through December thirty-first, two thousand two;
  (iii)  up to twenty-four million dollars for the period January first,
two thousand three through December thirty-first, two thousand three;
  (iv) up to twenty-four million dollars for the period  January  first,
two thousand four through December thirty-first, two thousand four;
  (v)  up  to  twenty-four million dollars for the period January first,
two thousand five through December thirty-first, two thousand five;
  (vi) up to twenty-four million dollars for the period  January  first,
two thousand six through December thirty-first, two thousand six;
  (vii)  up to twenty-four million dollars for the period January first,
two thousand seven through December thirty-first, two thousand seven;
  (viii) up to twenty-four million dollars for the period January first,
two thousand eight through December thirty-first,  two  thousand  eight;
and
  (ix)  up  to  twenty-two million dollars for the period January first,
two thousand nine through November thirtieth, two thousand nine.
  (t) Funds shall be reserved and accumulated from year to year  by  the
commissioner and shall be made available, including income from invested
funds:
  (i)  For  the  purpose  of making grants to a state owned and operated
medical school which does not have a state owned and  operated  hospital
on  site  and  available for teaching purposes. Notwithstanding sections
one hundred twelve and one hundred sixty-three of the state finance law,
such grants shall be made in the amount of up to five  hundred  thousand
dollars  for  the  period  January  first, two thousand through December
thirty-first, two thousand;
  (ii) For the purpose of making grants to medical schools  pursuant  to
section  eighty-six-a  of  chapter  one  of the laws of nineteen hundred
ninety-nine in the sum of up to four  million  dollars  for  the  period
January first, two thousand through December thirty-first, two thousand;
and
  (iii)  The  funds  disbursed pursuant to subparagraphs (i) and (ii) of
this paragraph from the tobacco control and insurance  initiatives  pool
are  contingent upon meeting all funding amounts established pursuant to
paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n),  (p),  (q),  (r)
and  (s)  of  this  subdivision,  paragraph  (a)  of subdivision nine of
section twenty-eight hundred seven-j of  this  article,  and  paragraphs
(a),  (i)  and  (k)  of  subdivision one of section twenty-eight hundred
seven-l of this article.
  (u) Funds shall be  deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state

S. 6914                            69                            A. 9205

share  of  services  and  expenses  related  to the nursing home quality
improvement demonstration program established pursuant to section  twen-
ty-eight  hundred  eight-d  of this article from the tobacco control and
insurance  initiatives pool established for the following periods in the
following amounts:
  (i) up to twenty-five million dollars for the period  beginning  April
first,  two  thousand two and ending December thirty-first, two thousand
two, and on an annualized  basis,  for  each  annual  period  thereafter
beginning  January first, two thousand three and ending December thirty-
first, two thousand four;
  (ii) up to eighteen million seven hundred fifty thousand  dollars  for
the  period  January  first,  two thousand five through December thirty-
first, two thousand five; and
  (iii) up to fifty-six million five hundred thousand  dollars  for  the
period  January  first,  two thousand six through December thirty-first,
two thousand six.
  (v) Funds shall be transferred by the commissioner and shall be depos-
ited to the credit of the hospital excess liability pool created  pursu-
ant  to section eighteen of chapter two hundred sixty-six of the laws of
nineteen hundred eighty-six, or  any  successor  fund  or  account,  for
purposes  of expenses related to the purchase of excess medical malprac-
tice insurance and the cost of administrating the pool, including  costs
associated  with  the  risk  management  program established pursuant to
section forty-two of part A of chapter one of the laws of  two  thousand
two  required by paragraph (a) of subdivision one of section eighteen of
chapter two hundred sixty-six of the laws of nineteen hundred eighty-six
as may be amended from time to time, from the tobacco control and insur-
ance initiatives pool established  for  the  following  periods  in  the
following amounts:
  (i) up to fifty million dollars or so much as is needed for the period
January first, two thousand two through December thirty-first, two thou-
sand two;
  (ii)  up to seventy-six million seven hundred thousand dollars for the
period January first, two thousand three through December  thirty-first,
two thousand three;
  (iii)  up  to sixty-five million dollars for the period January first,
two thousand four through December thirty-first, two thousand four;
  (iv) up to sixty-five million dollars for the  period  January  first,
two thousand five through December thirty-first, two thousand five;
  (v)  up to one hundred thirteen million eight hundred thousand dollars
for the period January first, two thousand six through December  thirty-
first, two thousand six;
  (vi)  up  to one hundred thirty million dollars for the period January
first, two thousand seven through December  thirty-first,  two  thousand
seven;
  (vii)  up to one hundred thirty million dollars for the period January
first, two thousand eight through December  thirty-first,  two  thousand
eight;
  (viii) up to one hundred thirty million dollars for the period January
first,  two  thousand  nine  through December thirty-first, two thousand
nine;
  (ix) up to one hundred thirty million dollars for the  period  January
first, two thousand ten through December thirty-first, two thousand ten;
  (x)  up  to  thirty-two  million five hundred thousand dollars for the
period January first, two thousand eleven  through  March  thirty-first,
two thousand eleven; [and]

S. 6914                            70                            A. 9205

  (xi)  up  to  one  hundred  twenty-seven million four hundred thousand
dollars each state fiscal year for the period April first, two  thousand
eleven through March thirty-first, two thousand fourteen[.]; AND
  (XII)  UP  TO  ONE  HUNDRED TWENTY-SEVEN MILLION FOUR HUNDRED THOUSAND
DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND
FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
  (w)  Funds  shall  be  deposited  by  the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of the treatment of breast and cervical cancer pursuant  to  para-
graph  (v) of subdivision four of section three hundred sixty-six of the
social services law, from the tobacco control and insurance  initiatives
pool established for the following periods in the following amounts:
  (i)  up  to four hundred fifty thousand dollars for the period January
first, two thousand two through December thirty-first, two thousand two;
  (ii) up to two million one hundred thousand  dollars  for  the  period
January  first,  two  thousand  three through December thirty-first, two
thousand three;
  (iii) up to two million one hundred thousand dollars  for  the  period
January  first,  two  thousand  four  through December thirty-first, two
thousand four;
  (iv) up to two million one hundred thousand  dollars  for  the  period
January  first,  two  thousand  five  through December thirty-first, two
thousand five;
  (v) up to two million one hundred  thousand  dollars  for  the  period
January first, two thousand six through December thirty-first, two thou-
sand six;
  (vi)  up  to  two  million one hundred thousand dollars for the period
January first, two thousand seven  through  December  thirty-first,  two
thousand seven;
  (vii)  up  to  two million one hundred thousand dollars for the period
January first, two thousand eight  through  December  thirty-first,  two
thousand eight;
  (viii)  up  to two million one hundred thousand dollars for the period
January first, two thousand  nine  through  December  thirty-first,  two
thousand nine;
  (ix)  up  to  two  million one hundred thousand dollars for the period
January first, two thousand ten through December thirty-first, two thou-
sand ten;
  (x) up to five hundred twenty-five thousand  dollars  for  the  period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven; [and]
  (xi)  up to two million one hundred thousand dollars each state fiscal
year for the period April first, two thousand eleven through March thir-
ty-first, two thousand fourteen[.]; AND
  (XII) UP TO TWO MILLION ONE HUNDRED THOUSAND DOLLARS EACH STATE FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  FOURTEEN  THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
  (x)  Funds  shall  be  deposited  by  the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of the non-public general hospital rates increases for recruitment

S. 6914                            71                            A. 9205

and retention of health care workers from the tobacco control and insur-
ance initiatives pool established  for  the  following  periods  in  the
following amounts:
  (i) twenty-seven million one hundred thousand dollars on an annualized
basis  for  the  period January first, two thousand two through December
thirty-first, two thousand two;
  (ii) fifty million eight hundred thousand  dollars  on  an  annualized
basis  for the period January first, two thousand three through December
thirty-first, two thousand three;
  (iii) sixty-nine million three hundred thousand dollars on an  annual-
ized  basis  for  the  period  January  first, two thousand four through
December thirty-first, two thousand four;
  (iv) sixty-nine million three hundred thousand dollars for the  period
January  first,  two  thousand  five  through December thirty-first, two
thousand five;
  (v) sixty-nine million three hundred thousand dollars for  the  period
January first, two thousand six through December thirty-first, two thou-
sand six;
  (vi)  sixty-five million three hundred thousand dollars for the period
January first, two thousand seven  through  December  thirty-first,  two
thousand seven;
  (vii)  sixty-one  million  one  hundred fifty thousand dollars for the
period January first, two thousand eight through December  thirty-first,
two thousand eight; and
  (viii)  forty-eight  million seven hundred twenty-one thousand dollars
for the period January first, two thousand nine through November thirti-
eth, two thousand nine.
  (y) Funds shall be reserved and accumulated  from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of grants to public general hospitals for recruitment and  retention  of
health  care  workers pursuant to paragraph (b) of subdivision thirty of
section twenty-eight hundred seven-c of this article  from  the  tobacco
control  and  insurance  initiatives  pool established for the following
periods in the following amounts:
  (i) eighteen million five hundred thousand dollars  on  an  annualized
basis  for  the  period January first, two thousand two through December
thirty-first, two thousand two;
  (ii) thirty-seven million four hundred thousand dollars on an  annual-
ized  basis  for  the  period  January first, two thousand three through
December thirty-first, two thousand three;
  (iii) fifty-two million two hundred thousand dollars on an  annualized
basis  for  the period January first, two thousand four through December
thirty-first, two thousand four;
  (iv) fifty-two million two hundred thousand  dollars  for  the  period
January  first,  two  thousand  five  through December thirty-first, two
thousand five;
  (v) fifty-two million two hundred  thousand  dollars  for  the  period
January first, two thousand six through December thirty-first, two thou-
sand six;
  (vi)  forty-nine  million  dollars  for  the period January first, two
thousand seven through December thirty-first, two thousand seven;
  (vii) forty-nine million dollars for the  period  January  first,  two
thousand eight through December thirty-first, two thousand eight; and
  (viii) twelve million two hundred fifty thousand dollars for the peri-
od  January  first,  two  thousand  nine through March thirty-first, two
thousand nine.

S. 6914                            72                            A. 9205

  Provided, however, amounts pursuant to this paragraph may  be  reduced
in  an  amount  to  be approved by the director of the budget to reflect
amounts received from the federal  government  under  the  state's  1115
waiver  which  are directed under its terms and conditions to the health
workforce recruitment and retention program.
  (z)  Funds  shall  be  deposited  by  the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of the non-public residential health care facility rate  increases
for  recruitment  and retention of health care workers pursuant to para-
graph (a) of subdivision eighteen of section twenty-eight hundred  eight
of  this article from the tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
  (i) twenty-one million five hundred thousand dollars on an  annualized
basis  for  the  period January first, two thousand two through December
thirty-first, two thousand two;
  (ii) thirty-three million three hundred thousand dollars on an annual-
ized basis for the period January  first,  two  thousand  three  through
December thirty-first, two thousand three;
  (iii)  forty-six  million three hundred thousand dollars on an annual-
ized basis for the period  January  first,  two  thousand  four  through
December thirty-first, two thousand four;
  (iv)  forty-six  million three hundred thousand dollars for the period
January first, two thousand  five  through  December  thirty-first,  two
thousand five;
  (v)  forty-six  million  three hundred thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six;
  (vi) thirty million nine hundred thousand dollars for the period Janu-
ary first, two thousand seven through December thirty-first,  two  thou-
sand seven;
  (vii) twenty-four million seven hundred thousand dollars for the peri-
od  January first, two thousand eight through December thirty-first, two
thousand eight;
  (viii) twelve million three hundred seventy-five thousand dollars  for
the  period  January  first,  two thousand nine through December thirty-
first, two thousand nine;
  (ix) nine million three hundred thousand dollars for the period  Janu-
ary  first, two thousand ten through December thirty-first, two thousand
ten; and
  (x) two million three hundred twenty-five  thousand  dollars  for  the
period  January  first,  two thousand eleven through March thirty-first,
two thousand eleven.
  (aa) Funds shall be reserved and accumulated from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of grants to public residential health care facilities  for  recruitment
and retention of health care workers pursuant to paragraph (b) of subdi-
vision  eighteen  of  section twenty-eight hundred eight of this article
from the tobacco control and insurance initiatives pool established  for
the following periods in the following amounts:
  (i) seven million five hundred thousand dollars on an annualized basis
for  the period January first, two thousand two through December thirty-
first, two thousand two;

S. 6914                            73                            A. 9205

  (ii) eleven million seven hundred thousand dollars  on  an  annualized
basis  for the period January first, two thousand three through December
thirty-first, two thousand three;
  (iii)  sixteen  million  two hundred thousand dollars on an annualized
basis for the period January first, two thousand four  through  December
thirty-first, two thousand four;
  (iv) sixteen million two hundred thousand dollars for the period Janu-
ary first, two thousand five through December thirty-first, two thousand
five;
  (v)  sixteen million two hundred thousand dollars for the period Janu-
ary first, two thousand six through December thirty-first, two  thousand
six;
  (vi) ten million eight hundred thousand dollars for the period January
first,  two  thousand  seven through December thirty-first, two thousand
seven;
  (vii) six million seven hundred fifty thousand dollars for the  period
January  first,  two  thousand  eight through December thirty-first, two
thousand eight; and
  (viii) one million three hundred fifty thousand dollars for the period
January first, two thousand  nine  through  December  thirty-first,  two
thousand nine.
  (bb)(i)  Funds  shall be deposited by the commissioner, within amounts
appropriated, and subject  to  the  availability  of  federal  financial
participation,  and  the  state  comptroller  is  hereby  authorized and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  the  purpose  of  supporting  the
state  share  of  adjustments  to Medicaid rates of payment for personal
care services provided pursuant to paragraph (e) of subdivision  two  of
section three hundred sixty-five-a of the social services law, for local
social  service districts which include a city with a population of over
one million persons and computed  and  distributed  in  accordance  with
memorandums of understanding to be entered into between the state of New
York and such local social service districts for the purpose of support-
ing  the  recruitment  and retention of personal care service workers or
any worker with direct patient care  responsibility,  from  the  tobacco
control  and  insurance  initiatives  pool established for the following
periods and the following amounts:
  (A) forty-four million dollars, on an annualized basis, for the period
April first, two thousand two through December thirty-first,  two  thou-
sand two;
  (B)  seventy-four  million  dollars,  on  an annualized basis, for the
period January first, two thousand three through December  thirty-first,
two thousand three;
  (C)  one hundred four million dollars, on an annualized basis, for the
period January first, two thousand four through  December  thirty-first,
two thousand four;
  (D)  one  hundred  thirty-six million dollars, on an annualized basis,
for the period January first, two thousand five through  December  thir-
ty-first, two thousand five;
  (E)  one  hundred  thirty-six million dollars, on an annualized basis,
for the period January first, two thousand six through December  thirty-
first, two thousand six;
  (F)  one  hundred  thirty-six  million  dollars for the period January
first, two thousand seven through December  thirty-first,  two  thousand
seven;

S. 6914                            74                            A. 9205

  (G)  one  hundred  thirty-six  million  dollars for the period January
first, two thousand eight through December  thirty-first,  two  thousand
eight;
  (H)  one  hundred  thirty-six  million  dollars for the period January
first, two thousand nine through  December  thirty-first,  two  thousand
nine;
  (I)  one  hundred  thirty-six  million  dollars for the period January
first, two thousand ten through December thirty-first, two thousand ten;
  (J) thirty-four million dollars for  the  period  January  first,  two
thousand eleven through March thirty-first, two thousand eleven; [and]
  (K)  up  to  one  hundred thirty-six million dollars each state fiscal
year for the period April first, two thousand eleven through March thir-
ty-first, two thousand fourteen[.]; AND
  (L) UP TO ONE HUNDRED THIRTY-SIX MILLION  DOLLARS  EACH  STATE  FISCAL
YEAR  FOR  THE  PERIOD MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN THROUGH
APRIL FIRST, TWO THOUSAND SEVENTEEN.
  (ii) Adjustments to Medicaid rates made  pursuant  to  this  paragraph
shall  not, in aggregate, exceed the following amounts for the following
periods:
  (A) for the period April first,  two  thousand  two  through  December
thirty-first, two thousand two, one hundred ten million dollars;
  (B)  for the period January first, two thousand three through December
thirty-first,  two  thousand  three,  one  hundred  eighty-five  million
dollars;
  (C)  for  the period January first, two thousand four through December
thirty-first, two thousand four, two hundred sixty million dollars;
  (D) for the period January first, two thousand five  through  December
thirty-first, two thousand five, three hundred forty million dollars;
  (E)  for  the  period January first, two thousand six through December
thirty-first, two thousand six, three hundred forty million dollars;
  (F) for the period January first, two thousand seven through  December
thirty-first, two thousand seven, three hundred forty million dollars;
  (G)  for the period January first, two thousand eight through December
thirty-first, two thousand eight, three hundred forty million dollars;
  (H) for the period January first, two thousand nine  through  December
thirty-first, two thousand nine, three hundred forty million dollars;
  (I)  for  the  period January first, two thousand ten through December
thirty-first, two thousand ten, three hundred forty million dollars;
  (J) for the period January first, two thousand  eleven  through  March
thirty-first, two thousand eleven, eighty-five million dollars; [and]
  (K)  for  each  state  fiscal  year within the period April first, two
thousand eleven through March thirty-first, two thousand fourteen, three
hundred forty million dollars[.]; AND
  (L) FOR EACH STATE FISCAL YEAR WITHIN  THE  PERIOD  APRIL  FIRST,  TWO
THOUSAND  FOURTEEN  THROUGH  MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN,
THREE HUNDRED FORTY MILLION DOLLARS.
  (iii) Personal care service providers which have their rates  adjusted
pursuant  to  this  paragraph  shall  use  such funds for the purpose of
recruitment and retention  of  non-supervisory  personal  care  services
workers  or  any worker with direct patient care responsibility only and
are prohibited from using such funds for any other  purpose.  Each  such
personal  care services provider shall submit, at a time and in a manner
to be determined by the commissioner, a written certification  attesting
that  such  funds will be used solely for the purpose of recruitment and
retention of non-supervisory personal care services workers or any work-
er with direct patient care responsibility. The commissioner is  author-

S. 6914                            75                            A. 9205

ized  to  audit each such provider to ensure compliance with the written
certification required by this subdivision and shall  recoup  any  funds
determined  to  have  been  used for purposes other than recruitment and
retention of non-supervisory personal care services workers or any work-
er  with direct patient care responsibility. Such recoupment shall be in
addition to any other penalties provided by law.
  (cc) Funds shall be deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  the  purpose  of  supporting  the
state  share  of  adjustments  to Medicaid rates of payment for personal
care services provided pursuant to paragraph (e) of subdivision  two  of
section three hundred sixty-five-a of the social services law, for local
social  service  districts  which  shall not include a city with a popu-
lation of over one million persons for the  purpose  of  supporting  the
personal  care  services  worker  recruitment  and  retention program as
established pursuant to  section  three  hundred  sixty-seven-q  of  the
social  services law, from the tobacco control and insurance initiatives
pool established for the following periods and the following amounts:
  (i) two million eight hundred thousand dollars for  the  period  April
first, two thousand two through December thirty-first, two thousand two;
  (ii)  five  million  six  hundred  thousand  dollars, on an annualized
basis, for the period January first, two thousand three through December
thirty-first, two thousand three;
  (iii) eight million four hundred thousand dollars,  on  an  annualized
basis,  for the period January first, two thousand four through December
thirty-first, two thousand four;
  (iv) ten million eight hundred  thousand  dollars,  on  an  annualized
basis,  for the period January first, two thousand five through December
thirty-first, two thousand five;
  (v) ten million eight  hundred  thousand  dollars,  on  an  annualized
basis,  for  the period January first, two thousand six through December
thirty-first, two thousand six;
  (vi) eleven million two hundred thousand dollars for the period  Janu-
ary  first,  two thousand seven through December thirty-first, two thou-
sand seven;
  (vii) eleven million two hundred thousand dollars for the period Janu-
ary first, two thousand eight through December thirty-first,  two  thou-
sand eight;
  (viii)  eleven  million  two  hundred  thousand dollars for the period
January first, two thousand  nine  through  December  thirty-first,  two
thousand nine;
  (ix)  eleven million two hundred thousand dollars for the period Janu-
ary first, two thousand ten through December thirty-first, two  thousand
ten;
  (x)  two million eight hundred thousand dollars for the period January
first, two thousand eleven  through  March  thirty-first,  two  thousand
eleven; [and]
  (xi)  up  to  eleven  million  two hundred thousand dollars each state
fiscal year for the period April  first,  two  thousand  eleven  through
March thirty-first, two thousand fourteen[.]; AND
  (XII)  UP  TO  ELEVEN  MILLION TWO HUNDRED THOUSAND DOLLARS EACH STATE
FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  FOURTEEN  THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN.

S. 6914                            76                            A. 9205

  (dd)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any  successor  fund or account, for purposes of funding the state share
of Medicaid expenditures for physician services from the tobacco control
and insurance initiatives pool established for the following periods  in
the following amounts:
  (i)  up to fifty-two million dollars for the period January first, two
thousand two through December thirty-first, two thousand two;
  (ii) eighty-one million two hundred thousand dollars  for  the  period
January  first,  two  thousand  three through December thirty-first, two
thousand three;
  (iii) eighty-five million two hundred thousand dollars for the  period
January  first,  two  thousand  four  through December thirty-first, two
thousand four;
  (iv) eighty-five million two hundred thousand dollars for  the  period
January  first,  two  thousand  five  through December thirty-first, two
thousand five;
  (v) eighty-five million two hundred thousand dollars  for  the  period
January first, two thousand six through December thirty-first, two thou-
sand six;
  (vi)  eighty-five  million two hundred thousand dollars for the period
January first, two thousand seven  through  December  thirty-first,  two
thousand seven;
  (vii)  eighty-five million two hundred thousand dollars for the period
January first, two thousand eight  through  December  thirty-first,  two
thousand eight;
  (viii) eighty-five million two hundred thousand dollars for the period
January  first,  two  thousand  nine  through December thirty-first, two
thousand nine;
  (ix) eighty-five million two hundred thousand dollars for  the  period
January first, two thousand ten through December thirty-first, two thou-
sand ten;
  (x)  twenty-one  million three hundred thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven; and
  (xi) eighty-five million  two  hundred  thousand  dollars  each  state
fiscal  year  for  the  period  April first, two thousand eleven through
March thirty-first, two thousand fourteen.
  (ee) Funds shall be deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any  successor  fund or account, for purposes of funding the state share
of the free-standing diagnostic and treatment center rate increases  for
recruitment and retention of health care workers pursuant to subdivision
seventeen of section twenty-eight hundred seven of this article from the
tobacco  control  and  insurance  initiatives  pool  established for the
following periods in the following amounts:
  (i) three million two hundred fifty thousand dollars  for  the  period
April  first,  two thousand two through December thirty-first, two thou-
sand two;
  (ii) three million two hundred fifty thousand dollars on an annualized
basis for the period January first, two thousand three through  December
thirty-first, two thousand three;

S. 6914                            77                            A. 9205

  (iii)  three  million two hundred fifty thousand dollars on an annual-
ized basis for the period  January  first,  two  thousand  four  through
December thirty-first, two thousand four;
  (iv)  three  million two hundred fifty thousand dollars for the period
January first, two thousand  five  through  December  thirty-first,  two
thousand five;
  (v)  three  million  two hundred fifty thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six;
  (vi) three million two hundred fifty thousand dollars for  the  period
January  first,  two  thousand  seven through December thirty-first, two
thousand seven;
  (vii) three million four hundred thirty-eight thousand dollars for the
period January first, two thousand eight through December  thirty-first,
two thousand eight;
  (viii)  two million four hundred fifty thousand dollars for the period
January first, two thousand  nine  through  December  thirty-first,  two
thousand nine;
  (ix)  one million five hundred thousand dollars for the period January
first, two thousand ten through December thirty-first, two thousand ten;
and
  (x) three hundred twenty-five thousand dollars for the period  January
first,  two  thousand  eleven  through  March thirty-first, two thousand
eleven.
  (ff) Funds shall be deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any  successor  fund or account, for purposes of funding the state share
of Medicaid expenditures for disabled persons as authorized pursuant  to
FORMER subparagraphs twelve and thirteen of paragraph (a) of subdivision
one  of  section three hundred sixty-six of the social services law from
the tobacco control and insurance initiatives pool established  for  the
following periods in the following amounts:
  (i)  one  million  eight hundred thousand dollars for the period April
first, two thousand two through December thirty-first, two thousand two;
  (ii) sixteen million four hundred thousand dollars  on  an  annualized
basis  for the period January first, two thousand three through December
thirty-first, two thousand three;
  (iii) eighteen million seven hundred thousand dollars on an annualized
basis for the period January first, two thousand four  through  December
thirty-first, two thousand four;
  (iv)  thirty million six hundred thousand dollars for the period Janu-
ary first, two thousand five through December thirty-first, two thousand
five;
  (v) thirty million six hundred thousand dollars for the period January
first, two thousand six through December thirty-first, two thousand six;
  (vi) thirty million six hundred thousand dollars for the period  Janu-
ary  first,  two thousand seven through December thirty-first, two thou-
sand seven;
  (vii) fifteen million dollars for the period January first, two  thou-
sand eight through December thirty-first, two thousand eight;
  (viii) fifteen million dollars for the period January first, two thou-
sand nine through December thirty-first, two thousand nine;
  (ix)  fifteen  million dollars for the period January first, two thou-
sand ten through December thirty-first, two thousand ten;

S. 6914                            78                            A. 9205

  (x) three million seven hundred fifty thousand dollars for the  period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven; [and]
  (xi)  fifteen  million  dollars  each state fiscal year for the period
April first, two thousand eleven through March thirty-first,  two  thou-
sand fourteen[.]; AND
  (XII)  FIFTEEN  MILLION  DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD
APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND SEVENTEEN.
  (gg) Funds shall be reserved and accumulated from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of grants to non-public general hospitals pursuant to paragraph  (c)  of
subdivision thirty of section twenty-eight hundred seven-c of this arti-
cle  from the tobacco control and insurance initiatives pool established
for the following periods in the following amounts:
  (i) up to one million three hundred thousand dollars on an  annualized
basis  for  the  period January first, two thousand two through December
thirty-first, two thousand two;
  (ii) up to three million two hundred thousand dollars on an annualized
basis for the period January first, two thousand three through  December
thirty-first, two thousand three;
  (iii) up to five million six hundred thousand dollars on an annualized
basis  for  the period January first, two thousand four through December
thirty-first, two thousand four;
  (iv) up to eight million six hundred thousand dollars for  the  period
January  first,  two  thousand  five  through December thirty-first, two
thousand five;
  (v) up to eight million six hundred thousand dollars on an  annualized
basis  for  the  period January first, two thousand six through December
thirty-first, two thousand six;
  (vi) up to two million six hundred thousand  dollars  for  the  period
January  first,  two  thousand  seven through December thirty-first, two
thousand seven;
  (vii) up to two million six hundred thousand dollars  for  the  period
January  first,  two  thousand  eight through December thirty-first, two
thousand eight;
  (viii) up to two million six hundred thousand dollars for  the  period
January  first,  two  thousand  nine  through December thirty-first, two
thousand nine;
  (ix) up to two million six hundred thousand  dollars  for  the  period
January first, two thousand ten through December thirty-first, two thou-
sand ten; and
  (x)  up  to  six hundred fifty thousand dollars for the period January
first, two thousand eleven  through  March  thirty-first,  two  thousand
eleven.
  (hh)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit to the credit of the special revenue
fund -  other,  HCRA  transfer  fund,  medical  assistance  account  for
purposes  of  providing  financial assistance to residential health care
facilities pursuant to subdivisions nineteen and twenty-one  of  section
twenty-eight hundred eight of this article, from the tobacco control and
insurance  initiatives pool established for the following periods in the
following amounts:
  (i) for the period April first,  two  thousand  two  through  December
thirty-first, two thousand two, ten million dollars;

S. 6914                            79                            A. 9205

  (ii) for the period January first, two thousand three through December
thirty-first,  two thousand three, nine million four hundred fifty thou-
sand dollars;
  (iii) for the period January first, two thousand four through December
thirty-first,  two thousand four, nine million three hundred fifty thou-
sand dollars;
  (iv) up to fifteen million dollars for the period January  first,  two
thousand five through December thirty-first, two thousand five;
  (v)  up  to  fifteen million dollars for the period January first, two
thousand six through December thirty-first, two thousand six;
  (vi) up to fifteen million dollars for the period January  first,  two
thousand seven through December thirty-first, two thousand seven;
  (vii)  up to fifteen million dollars for the period January first, two
thousand eight through December thirty-first, two thousand eight;
  (viii) up to fifteen million dollars for the period January first, two
thousand nine through December thirty-first, two thousand nine;
  (ix) up to fifteen million dollars for the period January  first,  two
thousand ten through December thirty-first, two thousand ten;
  (x)  up  to three million seven hundred fifty thousand dollars for the
period January first, two thousand eleven  through  March  thirty-first,
two thousand eleven; and
  (xi)  fifteen  million  dollars  each state fiscal year for the period
April first, two thousand eleven through March thirty-first,  two  thou-
sand fourteen.
  (ii)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for the purpose of supporting the
state share of Medicaid expenditures for disabled persons as  authorized
by sections 1619 (a) and (b) of the federal social security act pursuant
to  the  tobacco  control and insurance initiatives pool established for
the following periods in the following amounts:
  (i) six million four hundred thousand dollars  for  the  period  April
first, two thousand two through December thirty-first, two thousand two;
  (ii) eight million five hundred thousand dollars, for the period Janu-
ary  first,  two thousand three through December thirty-first, two thou-
sand three;
  (iii) eight million five hundred thousand dollars for the period Janu-
ary first, two thousand four through December thirty-first, two thousand
four;
  (iv) eight million five hundred thousand dollars for the period  Janu-
ary first, two thousand five through December thirty-first, two thousand
five;
  (v) eight million five hundred thousand dollars for the period January
first, two thousand six through December thirty-first, two thousand six;
  (vi) eight million six hundred thousand dollars for the period January
first,  two  thousand  seven through December thirty-first, two thousand
seven;
  (vii) eight million five hundred thousand dollars for the period Janu-
ary first, two thousand eight through December thirty-first,  two  thou-
sand eight;
  (viii)  eight  million  five  hundred  thousand dollars for the period
January first, two thousand  nine  through  December  thirty-first,  two
thousand nine;

S. 6914                            80                            A. 9205

  (ix)  eight million five hundred thousand dollars for the period Janu-
ary first, two thousand ten through December thirty-first, two  thousand
ten;
  (x) two million one hundred twenty-five thousand dollars for the peri-
od  January  first,  two thousand eleven through March thirty-first, two
thousand eleven; [and]
  (xi) eight million five hundred thousand  dollars  each  state  fiscal
year for the period April first, two thousand eleven through March thir-
ty-first, two thousand fourteen[.]; AND
  (XII)  EIGHT  MILLION  FIVE HUNDRED THOUSAND DOLLARS EACH STATE FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  FOURTEEN  THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
  (jj)  Funds  shall  be  reserved and accumulated from year to year and
shall be available,  including  income  from  invested  funds,  for  the
purposes  of  a grant program to improve access to infertility services,
treatments and procedures, from the tobacco control and insurance initi-
atives pool established for the period January first, two  thousand  two
through  December  thirty-first,  two thousand two in the amount of nine
million one hundred seventy-five thousand dollars, for the period  April
first,  two  thousand six through March thirty-first, two thousand seven
in the amount of five million dollars, for the period April  first,  two
thousand  seven  through  March  thirty-first, two thousand eight in the
amount of five million dollars, for the period April first, two thousand
eight through March thirty-first, two thousand nine  in  the  amount  of
five  million dollars, and for the period April first, two thousand nine
through March thirty-first, two thousand  ten  in  the  amount  of  five
million  dollars,  for  the period April first, two thousand ten through
March thirty-first, two thousand eleven in the amount of two million two
hundred thousand dollars, and for the period April first,  two  thousand
eleven through March thirty-first, two thousand twelve up to one million
one hundred thousand dollars.
  (kk)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds -- other, HCRA transfer fund, medical assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of  Medical  Assistance  Program  expenditures  from  the  tobacco
control  and  insurance  initiatives  pool established for the following
periods in the following amounts:
  (i) thirty-eight million eight hundred thousand dollars for the period
January first, two thousand two through December thirty-first, two thou-
sand two;
  (ii) up to two hundred ninety-five  million  dollars  for  the  period
January  first,  two  thousand  three through December thirty-first, two
thousand three;
  (iii) up to four hundred seventy-two million dollars  for  the  period
January  first,  two  thousand  four  through December thirty-first, two
thousand four;
  (iv) up to nine hundred million dollars for the period January  first,
two thousand five through December thirty-first, two thousand five;
  (v)  up  to  eight  hundred  sixty-six  million three hundred thousand
dollars for the period January first, two thousand six through  December
thirty-first, two thousand six;
  (vi)  up to six hundred sixteen million seven hundred thousand dollars
for the period January first, two thousand seven through December  thir-
ty-first, two thousand seven;

S. 6914                            81                            A. 9205

  (vii)  up  to  five hundred seventy-eight million nine hundred twenty-
five thousand dollars for the period January first, two  thousand  eight
through December thirty-first, two thousand eight; and
  (viii)  within  amounts  appropriated  on and after January first, two
thousand nine.
  (ll) Funds shall be deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  funds -- other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share  of Medicaid expenditures related to the city of New York from the
tobacco control and  insurance  initiatives  pool  established  for  the
following periods in the following amounts:
  (i)  eighty-two  million seven hundred thousand dollars for the period
January first, two thousand two through December thirty-first, two thou-
sand two;
  (ii) one hundred twenty-four million six hundred thousand dollars  for
the  period  January  first, two thousand three through December thirty-
first, two thousand three;
  (iii) one hundred twenty-four million seven hundred  thousand  dollars
for  the  period January first, two thousand four through December thir-
ty-first, two thousand four;
  (iv) one hundred twenty-four million seven  hundred  thousand  dollars
for  the  period January first, two thousand five through December thir-
ty-first, two thousand five;
  (v) one hundred twenty-four million seven hundred thousand dollars for
the period January first, two  thousand  six  through  December  thirty-
first, two thousand six;
  (vi)  one  hundred  twenty-four million seven hundred thousand dollars
for the period January first, two thousand seven through December  thir-
ty-first, two thousand seven;
  (vii)  one  hundred twenty-four million seven hundred thousand dollars
for the period January first, two thousand eight through December  thir-
ty-first, two thousand eight;
  (viii)  one hundred twenty-four million seven hundred thousand dollars
for the period January first, two thousand nine through  December  thir-
ty-first, two thousand nine;
  (ix)  one  hundred  twenty-four million seven hundred thousand dollars
for the period January first, two thousand ten through December  thirty-
first, two thousand ten;
  (x)  thirty-one  million one hundred seventy-five thousand dollars for
the period January first, two  thousand  eleven  through  March  thirty-
first, two thousand eleven; and
  (xi)  one  hundred  twenty-four million seven hundred thousand dollars
each state fiscal year for the period April first, two  thousand  eleven
through March thirty-first, two thousand fourteen.
  (mm)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding specified
percentages of the state share of services and expenses related  to  the
family health plus program in accordance with the following schedule:
  (i)  (A)  for  the  period  January  first, two thousand three through
December thirty-first, two thousand four, one  hundred  percent  of  the
state share;

S. 6914                            82                            A. 9205

  (B)  for  the period January first, two thousand five through December
thirty-first, two thousand  five,  seventy-five  percent  of  the  state
share; and,
  (C)  for  periods  beginning  on and after January first, two thousand
six, fifty percent of the state share.
  (ii) Funding for the family health plus program  will  include  up  to
five million dollars annually for the period January first, two thousand
three  through  December  thirty-first,  two  thousand  six,  up to five
million dollars for the period January first, two thousand seven through
December thirty-first, two thousand  seven,  up  to  seven  million  two
hundred  thousand  dollars  for  the  period January first, two thousand
eight through December thirty-first, two thousand  eight,  up  to  seven
million  two  hundred thousand dollars for the period January first, two
thousand nine through December thirty-first, two thousand  nine,  up  to
seven million two hundred thousand dollars for the period January first,
two  thousand ten through December thirty-first, two thousand ten, up to
one million eight hundred thousand dollars for the period January first,
two thousand eleven through March thirty-first, two thousand eleven,  up
to  six  million forty-nine thousand dollars for the period April first,
two thousand eleven through March thirty-first, two thousand twelve,  up
to  six  million two hundred eighty-nine thousand dollars for the period
April first, two thousand twelve through March thirty-first,  two  thou-
sand  thirteen,  and  up  to six million four hundred sixty-one thousand
dollars for the period April first, two thousand thirteen through  March
thirty-first,  two  thousand  fourteen, for administration and marketing
costs associated with such program established pursuant to  clauses  (A)
and  (B)  of  subparagraph  (v)  of  paragraph (a) of subdivision two of
section three hundred sixty-nine-ee of the social services law from  the
tobacco  control  and  insurance  initiatives  pool  established for the
following periods in the following amounts:
  (A) one hundred ninety million six hundred thousand  dollars  for  the
period  January first, two thousand three through December thirty-first,
two thousand three;
  (B) three hundred seventy-four million dollars for the period  January
first,  two  thousand  four  through December thirty-first, two thousand
four;
  (C) five hundred thirty-eight million four  hundred  thousand  dollars
for  the  period January first, two thousand five through December thir-
ty-first, two thousand five;
  (D) three hundred eighteen million seven hundred seventy-five thousand
dollars for the period January first, two thousand six through  December
thirty-first, two thousand six;
  (E) four hundred eighty-two million eight hundred thousand dollars for
the  period  January  first, two thousand seven through December thirty-
first, two thousand seven;
  (F) five hundred seventy million twenty-five thousand dollars for  the
period  January first, two thousand eight through December thirty-first,
two thousand eight;
  (G) six hundred ten million seven hundred twenty-five thousand dollars
for the period January first, two thousand nine through  December  thir-
ty-first, two thousand nine;
  (H) six hundred twenty-seven million two hundred seventy-five thousand
dollars  for the period January first, two thousand ten through December
thirty-first, two thousand ten;

S. 6914                            83                            A. 9205

  (I) one hundred fifty-seven million eight hundred  seventy-five  thou-
sand  dollars  for the period January first, two thousand eleven through
March thirty-first, two thousand eleven;
  (J) six hundred twenty-eight million four hundred thousand dollars for
the  period April first, two thousand eleven through March thirty-first,
two thousand twelve;
  (K) six hundred fifty million four hundred thousand  dollars  for  the
period  April first, two thousand twelve through March thirty-first, two
thousand thirteen; [and]
  (L) six hundred fifty million four hundred thousand  dollars  for  the
period  April  first,  two thousand thirteen through March thirty-first,
two thousand fourteen[.]; AND
  (M) UP TO THREE HUNDRED TEN MILLION FIVE HUNDRED NINETY-FIVE  THOUSAND
DOLLARS  FOR THE PERIOD APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH
THIRTY-FIRST, TWO THOUSAND FIFTEEN.
  (nn) Funds shall be deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for deposit to  the  credit  of  the  state  special
revenue  fund - other, HCRA transfer fund, health care services account,
or any successor fund or account, for purposes  related  to  adult  home
initiatives  for  medicaid  eligible residents of residential facilities
licensed pursuant to section four hundred sixty-b of the social services
law from the tobacco control and insurance initiatives pool  established
for the following periods in the following amounts:
  (i) up to four million dollars for the period January first, two thou-
sand three through December thirty-first, two thousand three;
  (ii) up to six million dollars for the period January first, two thou-
sand four through December thirty-first, two thousand four;
  (iii)  up  to  eight million dollars for the period January first, two
thousand  five  through  December  thirty-first,  two   thousand   five,
provided,  however,  that  up to five million two hundred fifty thousand
dollars of such funds shall be received by the comptroller and deposited
to the credit of the special revenue fund - other / aid  to  localities,
HCRA  transfer  fund - 061, enhanced community services account - 05, or
any successor fund or account, for the purposes set forth in this  para-
graph;
  (iv)  up  to  eight  million dollars for the period January first, two
thousand six through December thirty-first, two thousand six,  provided,
however,  that  up to five million two hundred fifty thousand dollars of
such funds shall be received by the comptroller  and  deposited  to  the
credit  of  the  special  revenue fund - other / aid to localities, HCRA
transfer fund - 061, enhanced community services account -  05,  or  any
successor fund or account, for the purposes set forth in this paragraph;
  (v)  up  to  eight  million  dollars for the period January first, two
thousand  seven  through  December  thirty-first,  two  thousand  seven,
provided,  however,  that  up to five million two hundred fifty thousand
dollars of such funds shall be received by the comptroller and deposited
to the credit of the special revenue fund - other / aid  to  localities,
HCRA  transfer  fund - 061, enhanced community services account - 05, or
any successor fund or account, for the purposes set forth in this  para-
graph;
  (vi)  up  to  two million seven hundred fifty thousand dollars for the
period January first, two thousand eight through December  thirty-first,
two thousand eight;

S. 6914                            84                            A. 9205

  (vii)  up  to two million seven hundred fifty thousand dollars for the
period January first, two thousand nine through  December  thirty-first,
two thousand nine;
  (viii)  up to two million seven hundred fifty thousand dollars for the
period January first, two thousand ten  through  December  thirty-first,
two thousand ten; and
  (ix)  up  to  six hundred eighty-eight thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven.
  (oo) Funds shall be reserved and accumulated from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of grants to non-public general hospitals pursuant to paragraph  (e)  of
subdivision  twenty-five of section twenty-eight hundred seven-c of this
article from the tobacco control and insurance initiatives  pool  estab-
lished for the following periods in the following amounts:
  (i)  up  to five million dollars on an annualized basis for the period
January first, two thousand  four  through  December  thirty-first,  two
thousand four;
  (ii)  up  to  five  million  dollars for the period January first, two
thousand five through December thirty-first, two thousand five;
  (iii) up to five million dollars for the  period  January  first,  two
thousand six through December thirty-first, two thousand six;
  (iv)  up  to  five  million  dollars for the period January first, two
thousand seven through December thirty-first, two thousand seven; [and]
  (v) up to five million dollars for the period January first, two thou-
sand eight through December thirty-first, two thousand eight;
  (vi) up to five million dollars for  the  period  January  first,  two
thousand nine through December thirty-first, two thousand nine;
  (vii)  up  to  five  million dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten; and
  (viii) up to one million two hundred fifty thousand  dollars  for  the
period  January  first,  two thousand eleven through March thirty-first,
two thousand eleven.
  (pp) Funds shall be reserved and accumulated from  year  to  year  and
shall  be  available,  including  income  from  invested  funds, for the
purpose of supporting the provision of tax credits for  long  term  care
insurance  pursuant  to subdivision one of section one hundred ninety of
the tax law, paragraph (a) of subdivision twenty-five-a of  section  two
hundred  ten  of such law, subsection (aa) of section six hundred six of
such law, paragraph one of subsection (k) of  section  fourteen  hundred
fifty-six  of  such  law and paragraph one of subdivision (m) of section
fifteen hundred eleven of such law, in the following amounts:
  (i) ten million dollars for the period  January  first,  two  thousand
four through December thirty-first, two thousand four;
  (ii)  ten  million  dollars for the period January first, two thousand
five through December thirty-first, two thousand five;
  (iii) ten million dollars for the period January first,  two  thousand
six through December thirty-first, two thousand six; and
  (iv)  five  million dollars for the period January first, two thousand
seven through June thirtieth, two thousand seven.
  (qq) Funds shall be reserved and accumulated from  year  to  year  and
shall  be  available,  including  income  from  invested  funds, for the
purpose  of  supporting  the  long-term  care  insurance  education  and
outreach program established pursuant to section two hundred seventeen-a
of the elder law for the following periods in the following amounts:

S. 6914                            85                            A. 9205

  (i) up to five million dollars for the period January first, two thou-
sand  four  through  December  thirty-first,  two thousand four; of such
funds one million nine hundred fifty  thousand  dollars  shall  be  made
available  to the department for the purpose of developing, implementing
and  administering  the  long-term care insurance education and outreach
program and three million fifty thousand dollars shall be  deposited  by
the  commissioner,  within  amounts appropriated, and the comptroller is
hereby authorized and directed to receive for deposit to the  credit  of
the  special  revenue  funds - other, HCRA transfer fund, long term care
insurance resource center account of the state office for the  aging  or
any  future  account designated for the purpose of implementing the long
term care insurance education and outreach  program  and  providing  the
long  term  care insurance resource centers with the necessary resources
to carry out their operations;
  (ii) up to five million dollars for  the  period  January  first,  two
thousand  five through December thirty-first, two thousand five; of such
funds one million nine hundred fifty  thousand  dollars  shall  be  made
available  to the department for the purpose of developing, implementing
and administering the long-term care insurance  education  and  outreach
program  and  three million fifty thousand dollars shall be deposited by
the commissioner, within amounts appropriated, and  the  comptroller  is
hereby  authorized  and directed to receive for deposit to the credit of
the special revenue funds - other, HCRA transfer fund,  long  term  care
insurance  resource  center account of the state office for the aging or
any future account designated for the purpose of implementing  the  long
term  care  insurance  education  and outreach program and providing the
long term care insurance resource centers with the  necessary  resources
to carry out their operations;
  (iii)  up  to  five  million dollars for the period January first, two
thousand six through December thirty-first, two thousand  six;  of  such
funds  one  million  nine  hundred  fifty thousand dollars shall be made
available to the department for the purpose of developing,  implementing
and  administering  the  long-term care insurance education and outreach
program and three million fifty thousand dollars shall be made available
to the office for the aging for the purpose of providing the  long  term
care  insurance  resource  centers with the necessary resources to carry
out their operations;
  (iv) up to five million dollars for  the  period  January  first,  two
thousand  seven  through  December  thirty-first, two thousand seven; of
such funds one million nine hundred fifty thousand dollars shall be made
available to the department for the purpose of developing,  implementing
and  administering  the  long-term care insurance education and outreach
program and three million fifty thousand dollars shall be made available
to the office for the aging for the purpose of providing the  long  term
care  insurance  resource  centers with the necessary resources to carry
out their operations;
  (v) up to five million dollars for the period January first, two thou-
sand eight through December thirty-first, two thousand  eight;  of  such
funds  one  million  nine  hundred  fifty thousand dollars shall be made
available to the department for the purpose of developing,  implementing
and  administering  the  long term care insurance education and outreach
program and three million fifty thousand dollars shall be made available
to the office for the aging for the purpose of providing the  long  term
care  insurance  resource  centers with the necessary resources to carry
out their operations;

S. 6914                            86                            A. 9205

  (vi) up to five million dollars for  the  period  January  first,  two
thousand  nine through December thirty-first, two thousand nine; of such
funds one million nine hundred fifty  thousand  dollars  shall  be  made
available  to the department for the purpose of developing, implementing
and  administering  the  long-term care insurance education and outreach
program and three million fifty thousand dollars shall be made available
to the office for the aging for the purpose of providing  the  long-term
care  insurance  resource  centers with the necessary resources to carry
out their operations;
  (vii) up to four hundred eighty-eight thousand dollars for the  period
January first, two thousand ten through March thirty-first, two thousand
ten;  of  such funds four hundred eighty-eight thousand dollars shall be
made available to the department for the purpose of  developing,  imple-
menting  and  administering  the  long-term care insurance education and
outreach program.
  (rr) Funds shall be reserved and accumulated from the tobacco  control
and  insurance initiatives pool and shall be available, including income
from invested funds, for the purpose of supporting expenses  related  to
implementation  of  the provisions of title III of article twenty-nine-D
of this chapter, for the following periods and in the following amounts:
  (i) up to ten million dollars for the period January first, two  thou-
sand six through December thirty-first, two thousand six;
  (ii) up to ten million dollars for the period January first, two thou-
sand seven through December thirty-first, two thousand seven;
  (iii)  up  to  ten  million  dollars for the period January first, two
thousand eight through December thirty-first, two thousand eight;
  (iv) up to ten million dollars for the period January first, two thou-
sand nine through December thirty-first, two thousand nine;
  (v) up to ten million dollars for the period January first, two  thou-
sand ten through December thirty-first, two thousand ten; and
  (vi)  up  to  two million five hundred thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven.
  (ss) Funds shall be reserved and accumulated from the tobacco  control
and  insurance initiatives pool and used for a health care stabilization
program established by the commissioner for the purposes of  stabilizing
critical health care providers and health care programs whose ability to
continue  to provide appropriate services are threatened by financial or
other challenges, in the amount of up to  twenty-eight  million  dollars
for the period July first, two thousand four through June thirtieth, two
thousand  five.  Notwithstanding  the  provisions of section one hundred
twelve of the state finance law or any other inconsistent  provision  of
the state finance law or any other law, funds available for distribution
pursuant  to  this  paragraph  may  be  allocated and distributed by the
commissioner, or the state comptroller as applicable without  a  compet-
itive bid or request for proposal process. Considerations relied upon by
the commissioner in determining the allocation and distribution of these
funds  shall  include,  but  not  be  limited to, the following: (i) the
importance of the provider or program in meeting  critical  health  care
needs  in  the  community  in  which  it  operates; (ii) the provider or
program provision of care to under-served populations; (iii) the quality
of the care or services the provider or program delivers; (iv) the abil-
ity of the provider or program to continue  to  deliver  an  appropriate
level  of  care or services if additional funding is made available; (v)
the ability of the provider or program to access, in  a  timely  manner,
alternative  sources  of  funding, including other sources of government

S. 6914                            87                            A. 9205

funding; (vi) the ability of other providers or programs in the communi-
ty to meet the community health care needs; (vii) whether  the  provider
or  program  has an appropriate plan to improve its financial condition;
and  (viii)  whether  additional  funding  would  permit the provider or
program to consolidate, relocate, or close programs  or  services  where
such  actions  would  result  in greater stability and efficiency in the
delivery of needed health care services or programs.
  (tt) Funds shall be reserved and accumulated from  year  to  year  and
shall  be  available, including income from invested funds, for purposes
of providing grants  for  two  long  term  care  demonstration  projects
designed  to test new models for the delivery of long term care services
established pursuant to section twenty-eight  hundred  seven-x  of  this
chapter, for the following periods and in the following amounts:
  (i)  up to five hundred thousand dollars for the period January first,
two thousand four through December thirty-first, two thousand four;
  (ii) up to five hundred thousand dollars for the period January first,
two thousand five through December thirty-first, two thousand five;
  (iii) up to five hundred  thousand  dollars  for  the  period  January
first, two thousand six through December thirty-first, two thousand six;
  (iv) up to one million dollars for the period January first, two thou-
sand seven through December thirty-first, two thousand seven; and
  (v)  up  to  two hundred fifty thousand dollars for the period January
first, two thousand  eight  through  March  thirty-first,  two  thousand
eight.
  (uu)  Funds  shall  be  reserved and accumulated from year to year and
shall be available,  including  income  from  invested  funds,  for  the
purpose  of supporting disease management and telemedicine demonstration
programs authorized pursuant to section  twenty-one  hundred  eleven  of
this chapter for the following periods in the following amounts:
  (i)  five  million  dollars for the period January first, two thousand
four through December thirty-first, two thousand four,  of  which  three
million  dollars shall be available for disease management demonstration
programs and two million dollars shall  be  available  for  telemedicine
demonstration programs;
  (ii)  five  million dollars for the period January first, two thousand
five through December thirty-first, two thousand five,  of  which  three
million  dollars shall be available for disease management demonstration
programs and two million dollars shall  be  available  for  telemedicine
demonstration programs;
  (iii)  nine million five hundred thousand dollars for the period Janu-
ary first, two thousand six through December thirty-first, two  thousand
six,  of  which  seven  million  five  hundred thousand dollars shall be
available for disease management demonstration programs and two  million
dollars shall be available for telemedicine demonstration programs;
  (iv) nine million five hundred thousand dollars for the period January
first,  two  thousand  seven through December thirty-first, two thousand
seven, of which seven million five hundred  thousand  dollars  shall  be
available  for disease management demonstration programs and one million
dollars shall be available for telemedicine demonstration programs;
  (v) nine million five hundred thousand dollars for the period  January
first,  two  thousand  eight through December thirty-first, two thousand
eight, of which seven million five hundred  thousand  dollars  shall  be
available  for disease management demonstration programs and two million
dollars shall be available for telemedicine demonstration programs;
  (vi) seven million eight hundred thirty-three thousand  three  hundred
thirty-three  dollars  for  the  period January first, two thousand nine

S. 6914                            88                            A. 9205

through December thirty-first, two thousand nine, of which seven million
five hundred thousand dollars shall be available for disease  management
demonstration  programs  and  three  hundred thirty-three thousand three
hundred  thirty-three dollars shall be available for telemedicine demon-
stration programs for  the  period  January  first,  two  thousand  nine
through March first, two thousand nine;
  (vii)  one million eight hundred seventy-five thousand dollars for the
period January first, two thousand ten through March  thirty-first,  two
thousand  ten  shall  be  available for disease management demonstration
programs.
  (ww) Funds shall be deposited  by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for the deposit to the credit of the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share  of  the  general  hospital  rates  increases  for recruitment and
retention of health care workers pursuant to paragraph (e)  of  subdivi-
sion thirty of section twenty-eight hundred seven-c of this article from
the  tobacco  control and insurance initiatives pool established for the
following periods in the following amounts:
  (i) sixty million five hundred thousand dollars for the period January
first, two thousand five through  December  thirty-first,  two  thousand
five; and
  (ii)  sixty million five hundred thousand dollars for the period Janu-
ary first, two thousand six through December thirty-first, two  thousand
six.
  (xx)  Funds  shall  be  deposited  by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive for the deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of the general hospital rates increases for rural hospitals pursu-
ant to subdivision thirty-two of section twenty-eight hundred seven-c of
this article from the tobacco control  and  insurance  initiatives  pool
established for the following periods in the following amounts:
  (i) three million five hundred thousand dollars for the period January
first,  two  thousand  five  through December thirty-first, two thousand
five;
  (ii) three million five hundred thousand dollars for the period  Janu-
ary  first, two thousand six through December thirty-first, two thousand
six;
  (iii) three million five hundred thousand dollars for the period Janu-
ary first, two thousand seven through December thirty-first,  two  thou-
sand seven;
  (iv)  three million five hundred thousand dollars for the period Janu-
ary first, two thousand eight through December thirty-first,  two  thou-
sand eight; and
  (v)  three  million  two hundred eight thousand dollars for the period
January first, two thousand nine through November thirtieth,  two  thou-
sand nine.
  (yy)  Funds  shall  be  reserved and accumulated from year to year and
shall be available,  within  amounts  appropriated  and  notwithstanding
section  one  hundred  twelve  of  the  state  finance law and any other
contrary provision of law, for the purpose of supporting grants  not  to
exceed  five  million  dollars  to be made by the commissioner without a
competitive bid or request for  proposal  process,  in  support  of  the

S. 6914                            89                            A. 9205

delivery  of  critically  needed  health  care  services, to health care
providers located in the counties of Erie and Niagara which  executed  a
memorandum of closing and conducted a merger closing in escrow on Novem-
ber  twenty-fourth, nineteen hundred ninety-seven and which entered into
a settlement dated December thirtieth, two thousand four for a  loss  on
disposal  of  assets  under the provisions of title XVIII of the federal
social security act applicable to mergers occurring  prior  to  December
first, nineteen hundred ninety-seven.
  (zz)  Funds  shall  be  reserved and accumulated from year to year and
shall be available, within amounts  appropriated,  for  the  purpose  of
supporting  expenditures  authorized  pursuant  to  section twenty-eight
hundred eighteen of this article from the tobacco control and  insurance
initiatives  pool established for the following periods in the following
amounts:
  (i) six million five hundred thousand dollars for the  period  January
first,  two  thousand  five  through December thirty-first, two thousand
five;
  (ii) one hundred eight million three hundred thousand dollars for  the
period  January  first,  two thousand six through December thirty-first,
two thousand six, provided, however, that within amounts appropriated in
the two thousand six through two thousand seven  state  fiscal  year,  a
portion  of  such  funds  may  be transferred to the Roswell Park Cancer
Institute Corporation to fund capital costs;
  (iii) one hundred seventy-one million dollars for the  period  January
first,  two  thousand  seven through December thirty-first, two thousand
seven, provided, however, that within amounts appropriated  in  the  two
thousand  six through two thousand seven state fiscal year, a portion of
such funds may be transferred  to  the  Roswell  Park  Cancer  Institute
Corporation to fund capital costs;
  (iv) one hundred seventy-one million five hundred thousand dollars for
the  period  January  first, two thousand eight through December thirty-
first, two thousand eight;
  (v) one hundred twenty-eight  million  seven  hundred  fifty  thousand
dollars for the period January first, two thousand nine through December
thirty-first, two thousand nine;
  (vi)  one  hundred thirty-one million three hundred seventy-five thou-
sand dollars for the period January  first,  two  thousand  ten  through
December thirty-first, two thousand ten;
  (vii)  thirty-four  million two hundred fifty thousand dollars for the
period January first, two thousand eleven  through  March  thirty-first,
two thousand eleven;
  (viii) four hundred thirty-three million three hundred sixty-six thou-
sand  dollars  for  the  period April first, two thousand eleven through
March thirty-first, two thousand twelve;
  (ix) one hundred fifty million eight hundred six thousand dollars  for
the  period April first, two thousand twelve through March thirty-first,
two thousand thirteen; [and]
  (x) seventy-eight million seventy-one thousand dollars for the  period
April first, two thousand thirteen through March thirty-first, two thou-
sand fourteen.
  (aaa)  Funds  shall  be reserved and accumulated from year to year and
shall be available, including income from invested funds,  for  services
and  expenses related to school based health centers, in an amount up to
three million five hundred thousand dollars for the period April  first,
two  thousand  six through March thirty-first, two thousand seven, up to
three million five hundred thousand dollars for the period April  first,

S. 6914                            90                            A. 9205

two thousand seven through March thirty-first, two thousand eight, up to
three  million five hundred thousand dollars for the period April first,
two thousand eight through March thirty-first, two thousand nine, up  to
three  million five hundred thousand dollars for the period April first,
two thousand nine through March thirty-first, two thousand  ten,  up  to
three  million five hundred thousand dollars for the period April first,
two thousand ten through March thirty-first, two thousand eleven,  [and]
up  to two million eight hundred thousand dollars each state fiscal year
for the period April first, two thousand eleven  through  March  thirty-
first,  two  thousand  fourteen,  AND  UP  TO  TWO  MILLION  SIX HUNDRED
FORTY-FOUR THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD  APRIL
FIRST,  TWO  THOUSAND  FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND
SEVENTEEN.  The total amount of funds provided herein shall be  distrib-
uted  as  grants  based on the ratio of each provider's total enrollment
for all sites to the total enrollment of  all  providers.  This  formula
shall be applied to the total amount provided herein.
  (bbb)  Funds  shall  be reserved and accumulated from year to year and
shall be available, including income from invested funds,  for  purposes
of  awarding  grants  to  operators  of  adult  homes,  enriched housing
programs and residences through the enhancing abilities and life experi-
ence (EnAbLe) program to provide for  the  installation,  operation  and
maintenance  of air conditioning in resident rooms, consistent with this
paragraph, in an amount up to two million dollars for the  period  April
first,  two thousand six through March thirty-first, two thousand seven,
up to three million eight hundred thousand dollars for the period  April
first,  two  thousand  seven  through  March  thirty-first, two thousand
eight, up to three million eight hundred thousand dollars for the period
April first, two thousand eight through March thirty-first, two thousand
nine, up to three million eight hundred thousand dollars for the  period
April  first, two thousand nine through March thirty-first, two thousand
ten, and up to three million eight  hundred  thousand  dollars  for  the
period  April  first,  two  thousand ten through March thirty-first, two
thousand eleven. Residents shall not be charged utility cost for the use
of air conditioners supplied under the  EnAbLe  program.  All  such  air
conditioners must be operated in occupied resident rooms consistent with
requirements applicable to common areas.
  (ccc)  Funds  shall  be  deposited by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive for the deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical  assistance  account,
or  any  successor  fund  or  account, for purposes of funding the state
share of increases in the rates for certified home health agencies, long
term home  health  care  programs,  AIDS  home  care  programs,  hospice
programs and managed long term care plans and approved managed long term
care  operating  demonstrations as defined in section forty-four hundred
three-f of this chapter for recruitment and  retention  of  health  care
workers  pursuant  to  subdivisions  nine  and ten of section thirty-six
hundred fourteen of this chapter from the tobacco control and  insurance
initiatives  pool established for the following periods in the following
amounts:
  (i) twenty-five million dollars for the period June first,  two  thou-
sand six through December thirty-first, two thousand six;
  (ii)  fifty million dollars for the period January first, two thousand
seven through December thirty-first, two thousand seven;
  (iii) fifty million dollars for the period January first, two thousand
eight through December thirty-first, two thousand eight;

S. 6914                            91                            A. 9205

  (iv) fifty million dollars for the period January first, two  thousand
nine through December thirty-first, two thousand nine;
  (v)  fifty  million dollars for the period January first, two thousand
ten through December thirty-first, two thousand ten;
  (vi) twelve million five hundred thousand dollars for the period Janu-
ary first, two thousand eleven through March thirty-first, two  thousand
eleven; [and]
  (vii) up to fifty million dollars each state fiscal year for the peri-
od  April  first,  two  thousand  eleven through March thirty-first, two
thousand fourteen[.]; AND
  (VIII) UP TO FIFTY MILLION DOLLARS EACH  STATE  FISCAL  YEAR  FOR  THE
PERIOD  APRIL  FIRST,  TWO THOUSAND FOURTEEN THROUGH MARCH THIRTY-FIRST,
TWO THOUSAND SEVENTEEN.
  (ddd) Funds shall be deposited by  the  commissioner,  within  amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed to receive for the deposit to the credit of the  state  special
revenue  funds  - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for  purposes  of  funding  the  state
share  of  increases  in  the medical assistance rates for providers for
purposes of enhancing the provision, quality and/or efficiency  of  home
care  services  pursuant  to  subdivision  eleven  of section thirty-six
hundred fourteen of this chapter from the tobacco control and  insurance
initiatives  pool  established for the following period in the amount of
eight million dollars for the  period  April  first,  two  thousand  six
through December thirty-first, two thousand six.
  (eee)  Funds  shall  be reserved and accumulated from year to year and
shall be available, including income from invested funds, to the  Center
for  Functional  Genomics at the State University of New York at Albany,
for the purposes of the Adirondack  network  for  cancer  education  and
research  in rural communities grant program to improve access to health
care and shall be made available from the tobacco control and  insurance
initiatives  pool  established for the following period in the amount of
up to five million dollars for the period January  first,  two  thousand
six through December thirty-first, two thousand six.
  (fff) Funds shall be made available to the empire state stem cell fund
established  by  section  ninety-nine-p  of the state finance law within
amounts appropriated up to fifty million dollars annually and shall  not
exceed five hundred million dollars in total.
  (ggg)  Funds  shall  be  deposited by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any successor fund or account, for the purpose of supporting  the  state
share  of  Medicaid  expenditures  for  hospital translation services as
authorized pursuant to paragraph (k) of subdivision one of section twen-
ty-eight hundred seven-c of this article from the  tobacco  control  and
initiatives  pool established for the following periods in the following
amounts:
  (i) sixteen million dollars for the period July  first,  two  thousand
eight through December thirty-first, two thousand eight; and
  (ii)  fourteen  million  seven hundred thousand dollars for the period
January first, two thousand nine through November thirtieth,  two  thou-
sand nine.
  (hhh)  Funds  shall  be  deposited by the commissioner, within amounts
appropriated,  and  the  state  comptroller  is  hereby  authorized  and
directed  to  receive  for  deposit  to  the credit of the state special

S. 6914                            92                            A. 9205

revenue fund - other, HCRA transfer fund, medical assistance account, or
any successor fund or account, for the purpose of supporting  the  state
share  of  Medicaid  expenditures  for adjustments to inpatient rates of
payment  for  general  hospitals  located  in the counties of Nassau and
Suffolk as authorized pursuant to paragraph (l) of  subdivision  one  of
section  twenty-eight  hundred  seven-c of this article from the tobacco
control and initiatives pool established for the  following  periods  in
the following amounts:
  (i)  two  million  five  hundred thousand dollars for the period April
first, two thousand eight through December  thirty-first,  two  thousand
eight; and
  (ii) two million two hundred ninety-two thousand dollars for the peri-
od  January  first,  two  thousand  nine through November thirtieth, two
thousand nine.
  (iii) Funds shall be reserved and set aside and accumulated from  year
to  year  and  shall be made available, including income from investment
funds, for the purpose of supporting the New York state  medical  indem-
nity  fund as authorized pursuant to title four of article twenty-nine-D
of this chapter, for the following periods and in the following amounts,
provided, however, that the commissioner is authorized  to  seek  waiver
authority  from  the  federal  centers for medicare and Medicaid for the
purpose of securing Medicaid federal financial  participation  for  such
program, in which case the funding authorized pursuant to this paragraph
shall be utilized as the non-federal share for such payments:
  Thirty million dollars for the period April first, two thousand eleven
through March thirty-first, two thousand twelve.
  2.  (a)  For  periods  prior  to January first, two thousand five, the
commissioner is authorized to  contract  with  the  article  forty-three
insurance law plans, or such other contractors as the commissioner shall
designate,  to receive and distribute funds from the tobacco control and
insurance initiatives pool established pursuant to this section. In  the
event  contracts  with  the  article  forty-three insurance law plans or
other commissioner's designees are effectuated, the  commissioner  shall
conduct annual audits of the receipt and distribution of such funds. The
reasonable  costs  and  expenses  of an administrator as approved by the
commissioner, not to exceed for personnel services on  an  annual  basis
five  hundred thousand dollars, for collection and distribution of funds
pursuant to this section shall be paid from such funds.
  (b) Notwithstanding any inconsistent provision of section one  hundred
twelve  or one hundred sixty-three of the state finance law or any other
law, at the discretion of the commissioner without a competitive bid  or
request  for proposal process, contracts in effect for administration of
pools established pursuant to  sections  twenty-eight  hundred  seven-k,
twenty-eight  hundred  seven-l  and twenty-eight hundred seven-m of this
article for the  period  January  first,  nineteen  hundred  ninety-nine
through  December  thirty-first,  nineteen  hundred  ninety-nine  may be
extended to provide for administration pursuant to this section and  may
be amended as may be necessary.
  S  9.  Subdivisions  5-a  and 7 of section 2807-m of the public health
law, as added by section 75-c of part C of chapter 58  of  the  laws  of
2008, the paragraph heading of paragraph (b) and the second undesignated
paragraph of paragraph (b) of subdivision 5-a as amended by section 4 of
part  B  of  chapter  109  of the laws of 2010, the opening paragraph of
paragraph (b), subparagraphs (C), (D) and  (G)  of  paragraph  (b),  and
paragraphs  (c), (f) and (g) of subdivision 5-a as amended by section 26
of part C of chapter 59 of the laws of 2011, subparagraph (H)  of  para-

S. 6914                            93                            A. 9205

graph (b) of subdivision 5-a as added by section 60 of part D of chapter
56  of  the  laws  of 2012, paragraphs (d) and (e) of subdivision 5-a as
amended by section 53 of part D of chapter 56 of the laws  of  2012  and
paragraph  (e-1)  of subdivision 5-a as added by section 54 of part D of
chapter 56 of the laws of 2012, and subdivision 7 as amended by  section
26-a of part C of chapter 59 of the laws of 2011, are amended to read as
follows:
  5-a.  Graduate  medical  education  innovations pool. (a) Supplemental
distributions. (i) Thirty-one million dollars  for  the  period  January
first,  two  thousand  eight through December thirty-first, two thousand
eight, shall be set aside and reserved  by  the  commissioner  from  the
regional  pools  established pursuant to subdivision two of this section
and shall be available for distributions pursuant to subdivision five of
this section and in accordance with section 86-1.89 of title 10  of  the
codes,  rules  and  regulations of the state of New York as in effect on
January first, two thousand eight; provided, however,  for  purposes  of
funding  the  empire  clinical research investigation program (ECRIP) in
accordance with paragraph eight of subdivision (e) and paragraph two  of
subdivision  (f)  of section 86-1.89 of title 10 of the codes, rules and
regulations of the state of New York, distributions shall be made  using
two  regions  defined as New York city and the rest of the state and the
dollar amount set forth in subparagraph (i) of paragraph two of subdivi-
sion (f) of section 86-1.89 of title 10 of the codes,  rules  and  regu-
lations  of the state of New York shall be increased from sixty thousand
dollars to seventy-five thousand dollars.
  (ii) For periods on  and  after  January  first,  two  thousand  nine,
supplemental  distributions pursuant to subdivision five of this section
and in accordance with section 86-1.89 of title 10 of the  codes,  rules
and regulations of the state of New York shall no longer be made and the
provisions  of section 86-1.89 of title 10 of the codes, rules and regu-
lations of the state of New York shall be null and void.
  (b) Empire clinical  research  investigator  program  (ECRIP).    Nine
million  one  hundred  twenty  thousand  dollars annually for the period
January first, two thousand  nine  through  December  thirty-first,  two
thousand  ten,  and  two million two hundred eighty thousand dollars for
the period January first, two thousand eleven, [and] THROUGH MARCH THIR-
TY-FIRST, TWO THOUSAND ELEVEN, nine million one hundred twenty  thousand
dollars  each state fiscal year for the period April first, two thousand
eleven through March thirty-first, two thousand fourteen, [through March
thirty-first, two thousand eleven,] AND UP TO EIGHT MILLION SIX  HUNDRED
TWELVE  THOUSAND  DOLLARS  EACH  STATE  FISCAL YEAR FOR THE PERIOD APRIL
FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH  THIRTY-FIRST,  TWO  THOUSAND
SEVENTEEN,  shall be set aside and reserved by the commissioner from the
regional pools established pursuant to subdivision two of  this  section
to  be  allocated  regionally  with  two-thirds of the available funding
going to New York city and one-third of the available funding  going  to
the  rest  of  the  state  and  shall  be  available for distribution as
follows:
  Distributions shall first be made to consortia  and  teaching  general
hospitals  for the empire clinical research investigator program (ECRIP)
to help secure federal funding for biomedical research,  train  clinical
researchers,  recruit national leaders as faculty to act as mentors, and
train residents and fellows  in  biomedical  research  skills  based  on
hospital-specific  data  submitted  to the commissioner by consortia and
teaching general hospitals in accordance with clause (G) of this subpar-

S. 6914                            94                            A. 9205

agraph. Such distributions shall be made in accordance with the  follow-
ing methodology:
  (A)  The  greatest  number  of clinical research positions for which a
consortium or teaching general hospital may be funded pursuant  to  this
subparagraph  shall  be  one  percent  of  the total number of residents
training at the consortium or teaching general hospital on  July  first,
two  thousand  eight  for  the  period  January first, two thousand nine
through December thirty-first, two thousand nine rounded up to the near-
est one position.
  (B) Distributions made to a consortium or  teaching  general  hospital
shall  equal  the product of the total number of clinical research posi-
tions submitted  by  a  consortium  or  teaching  general  hospital  and
accepted  by the commissioner as meeting the criteria set forth in para-
graph (b) of subdivision one of this section, subject to  the  reduction
calculation  set  forth  in  clause  (C) of this subparagraph, times one
hundred ten thousand dollars.
  (C) If the dollar amount for the total  number  of  clinical  research
positions  in  the  region  calculated  pursuant  to  clause (B) of this
subparagraph exceeds the total amount appropriated for purposes of  this
paragraph,  including clinical research positions that continue from and
were funded in prior distribution periods, the commissioner shall elimi-
nate one-half of the  clinical  research  positions  submitted  by  each
consortium  or teaching general hospital rounded down to the nearest one
position. Such reduction shall be repeated until the dollar  amount  for
the  total  number of clinical research positions in the region does not
exceed the total amount appropriated for purposes of this paragraph.  If
the  repeated  reduction  of the total number of clinical research posi-
tions in the region by one-half does not render a total  funding  amount
that  is equal to or less than the total amount reserved for that region
within the appropriation, the funding for each clinical  research  posi-
tion  in  that  region  shall  be reduced proportionally in one thousand
dollar increments until the total dollar amount for the total number  of
clinical  research  positions  in  that region does not exceed the total
amount reserved for that region within the appropriation. Any  reduction
in  funding will be effective for the duration of the award. No clinical
research positions that continue from and were funded in prior  distrib-
ution periods shall be eliminated or reduced by such methodology.
  (D)  Each  consortium  or  teaching general hospital shall receive its
annual distribution amount in accordance with the following:
  (I) Each consortium or teaching general hospital with a one-year ECRIP
award  shall  receive  its  annual  distribution  amount  in  full  upon
completion of the requirements set forth in items (I) and (II) of clause
(G)  of  this subparagraph. The requirements set forth in items (IV) and
(V) of clause (G) of this subparagraph must be completed by the  consor-
tium  or teaching general hospital in order for the consortium or teach-
ing general hospital to be eligible to apply for ECRIP  funding  in  any
subsequent funding cycle.
  (II)  Each  consortium  or  teaching  general hospital with a two-year
ECRIP award shall receive its first annual distribution amount  in  full
upon  completion  of the requirements set forth in items (I) and (II) of
clause (G) of this subparagraph. Each  consortium  or  teaching  general
hospital will receive its second annual distribution amount in full upon
completion  of the requirements set forth in item (III) of clause (G) of
this subparagraph. The requirements set forth in items (IV) and  (V)  of
clause  (G)  of this subparagraph must be completed by the consortium or
teaching general hospital in order for the consortium or teaching gener-

S. 6914                            95                            A. 9205

al hospital to be eligible to apply for ECRIP funding in any  subsequent
funding cycle.
  (E)  Each  consortium  or teaching general hospital receiving distrib-
utions pursuant to this subparagraph shall reserve seventy-five thousand
dollars to primarily fund salary and fringe  benefits  of  the  clinical
research  position  with  the remainder going to fund the development of
faculty who are involved in biomedical research, training  and  clinical
care.
  (F)  Undistributed  or  returned  funds  available  to  fund  clinical
research positions pursuant to this paragraph for a distribution  period
shall  be  available to fund clinical research positions in a subsequent
distribution period.
  (G) In order to be eligible for distributions pursuant to this subpar-
agraph, each consortium and teaching general hospital shall  provide  to
the  commissioner by July first of each distribution period, the follow-
ing data and information on a hospital-specific  basis.  Such  data  and
information  shall  be  certified as to accuracy and completeness by the
chief executive officer, chief financial officer or chair of the consor-
tium governing body of each consortium or teaching general hospital  and
shall be maintained by each consortium and teaching general hospital for
five years from the date of submission:
  (I)  For  each  clinical  research  position, information on the type,
scope, training objectives,  institutional  support,  clinical  research
experience of the sponsor-mentor, plans for submitting research outcomes
to  peer reviewed journals and at scientific meetings, including a meet-
ing sponsored by the department, the name of a principal contact  person
responsible for tracking the career development of researchers placed in
clinical  research positions, as defined in paragraph (c) of subdivision
one of this section, and who is authorized to certify to the commission-
er that all the requirements of the clinical  research  training  objec-
tives  set  forth  in this subparagraph shall be met. Such certification
shall be provided by July first of each distribution period;
  (II) For each clinical research position,  information  on  the  name,
citizenship  status, medical education and training, and medical license
number of the researcher, if applicable, shall be provided  by  December
thirty-first of the calendar year following the distribution period;
  (III)  Information on the status of the clinical research plan, accom-
plishments, changes in research activities, progress, and performance of
the researcher shall be provided upon  completion  of  one-half  of  the
award term;
  (IV)  A  final report detailing training experiences, accomplishments,
activities and performance of the clinical researcher, and  data,  meth-
ods,  results  and  analyses  of  the  clinical  research  plan shall be
provided three months after the clinical research position ends; and
  (V) Tracking information concerning past  researchers,  including  but
not  limited  to (A) background information, (B) employment history, (C)
research status, (D) current research activities, (E)  publications  and
presentations,  (F)  research  support,  and  (G)  any other information
necessary to track the researcher; and
  (VI) Any other data or information required  by  the  commissioner  to
implement this subparagraph.
  (H)  Notwithstanding  any  inconsistent provision of this subdivision,
for periods on and after April first, two thousand thirteen, ECRIP grant
awards shall be made in accordance with rules and regulations promulgat-
ed by the commissioner. Such regulations shall, at a minimum:

S. 6914                            96                            A. 9205

  (1) provide that ECRIP grant awards shall be made with  the  objective
of  securing  federal funding for biomedical research, training clinical
researchers, recruiting national leaders as faculty to act  as  mentors,
and training residents and fellows in biomedical research skills;
  (2)  provide that ECRIP grant applicants may include interdisciplinary
research teams comprised of teaching general hospitals acting in collab-
oration with entities including but  not  limited  to  medical  centers,
hospitals, universities and local health departments;
  (3) provide that applications for ECRIP grant awards shall be based on
such  information requested by the commissioner, which shall include but
not be limited to hospital-specific data;
  (4) establish the qualifications for  investigators  and  other  staff
required for grant projects eligible for ECRIP grant awards; and
  (5)  establish a methodology for the distribution of funds under ECRIP
grant awards.
  (c) Ambulatory care  training.  Four  million  nine  hundred  thousand
dollars  for the period January first, two thousand eight through Decem-
ber thirty-first, two thousand eight, four million nine hundred thousand
dollars for the period January first, two thousand nine through December
thirty-first, two thousand nine,  four  million  nine  hundred  thousand
dollars  for the period January first, two thousand ten through December
thirty-first, two thousand ten,  one  million  two  hundred  twenty-five
thousand  dollars  for  the  period  January  first, two thousand eleven
through March thirty-first, two  thousand  eleven,  [and]  four  million
three  hundred  thousand  dollars  each state fiscal year for the period
April first, two thousand eleven through March thirty-first,  two  thou-
sand  fourteen, AND UP TO FOUR MILLION SIXTY THOUSAND DOLLARS EACH STATE
FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  FOURTEEN  THROUGH
MARCH  THIRTY-FIRST,  TWO  THOUSAND  SEVENTEEN,  shall  be set aside and
reserved by the commissioner from the regional pools established  pursu-
ant  to  subdivision  two  of  this  section  and shall be available for
distributions to sponsoring institutions to be directed to support clin-
ical training of medical students and residents in free-standing ambula-
tory care settings, including community health centers and private prac-
tices. Such funding shall be allocated regionally with two-thirds of the
available funding going to New York city and one-third of the  available
funding going to the rest of the state and shall be distributed to spon-
soring institutions in each region pursuant to a request for application
or  request for proposal process with preference being given to sponsor-
ing institutions which provide training in sites located in  underserved
rural  or  inner-city  areas  and those that include medical students in
such training.
  (d) Physician loan repayment program. One million nine  hundred  sixty
thousand  dollars  for  the  period  January  first,  two thousand eight
through December thirty-first, two  thousand  eight,  one  million  nine
hundred  sixty  thousand dollars for the period January first, two thou-
sand nine through December thirty-first, two thousand nine, one  million
nine  hundred  sixty  thousand dollars for the period January first, two
thousand ten through  December  thirty-first,  two  thousand  ten,  four
hundred  ninety thousand dollars for the period January first, two thou-
sand eleven through March thirty-first, two thousand eleven,  [and]  one
million  seven  hundred  thousand dollars each state fiscal year for the
period April first, two thousand eleven through March thirty-first,  two
thousand  fourteen,  AND  UP  TO ONE MILLION SEVEN HUNDRED FIVE THOUSAND
DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND
FOURTEEN  THROUGH  MARCH  THIRTY-FIRST, TWO THOUSAND SEVENTEEN, shall be

S. 6914                            97                            A. 9205

set aside and reserved by  the  commissioner  from  the  regional  pools
established  pursuant  to  subdivision  two of this section and shall be
available for purposes of physician loan repayment  in  accordance  with
subdivision  ten of this section. Notwithstanding any contrary provision
of this section, sections one hundred twelve and one hundred sixty-three
of the state finance law, or any other contrary provision of  law,  such
funding  shall be allocated regionally with one-third of available funds
going to New York city and two-thirds of available funds  going  to  the
rest  of the state and shall be distributed in a manner to be determined
by the commissioner without a competitive bid or  request  for  proposal
process as follows:
  (i) Funding shall first be awarded to repay loans of up to twenty-five
physicians  who  train  in  primary care or specialty tracks in teaching
general hospitals, and who enter and remain in primary care or specialty
practices in underserved communities, as determined by the commissioner.
  (ii) After distributions in accordance with subparagraph (i)  of  this
paragraph, all remaining funds shall be awarded to repay loans of physi-
cians  who  enter  and  remain in primary care or specialty practices in
underserved communities, as determined by  the  commissioner,  including
but  not  limited  to  physicians working in general hospitals, or other
health care facilities.
  (iii) In no case shall less than fifty percent of the funds  available
pursuant  to  this  paragraph be distributed in accordance with subpara-
graphs (i) and (ii) of this paragraph to physicians identified by gener-
al hospitals.
  (e) Physician practice support. Four  million  nine  hundred  thousand
dollars  for the period January first, two thousand eight through Decem-
ber thirty-first, two thousand eight, four million nine hundred thousand
dollars annually for the period January first, two thousand nine through
December thirty-first, two thousand ten, one million two  hundred  twen-
ty-five  thousand  dollars  for  the  period January first, two thousand
eleven through March  thirty-first,  two  thousand  eleven,  [and]  four
million  three  hundred  thousand dollars each state fiscal year for the
period April first, two thousand eleven through March thirty-first,  two
thousand  fourteen,  AND UP TO FOUR MILLION THREE HUNDRED SIXTY THOUSAND
DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND
FOURTEEN  THROUGH  MARCH  THIRTY-FIRST, TWO THOUSAND SEVENTEEN, shall be
set aside and reserved by  the  commissioner  from  the  regional  pools
established  pursuant  to  subdivision  two of this section and shall be
available for purposes of physician  practice  support.  Notwithstanding
any  contrary provision of this section, sections one hundred twelve and
one hundred sixty-three of the state finance law, or any other  contrary
provision  of  law, such funding shall be allocated regionally with one-
third of available funds going to New York city and two-thirds of avail-
able funds going to the rest of the state and shall be distributed in  a
manner to be determined by the commissioner without a competitive bid or
request for proposal process as follows:
  (i)  Preference in funding shall first be accorded to teaching general
hospitals for up to twenty-five awards, to  support  costs  incurred  by
physicians  trained in primary or specialty tracks who thereafter estab-
lish or join practices in underserved communities, as determined by  the
commissioner.
  (ii)  After  distributions in accordance with subparagraph (i) of this
paragraph, all remaining funds shall be awarded to physicians to support
the cost of establishing or joining practices  in  underserved  communi-
ties,  as  determined  by  the  commissioner, and to hospitals and other

S. 6914                            98                            A. 9205

health care providers to recruit new physicians to provide  services  in
underserved communities, as determined by the commissioner.
  (iii)  In no case shall less than fifty percent of the funds available
pursuant to this  paragraph  be  distributed  to  general  hospitals  in
accordance with subparagraphs (i) and (ii) of this paragraph.
  (e-1) Work group. For funding available pursuant to paragraphs (d) and
(e) of this subdivision:
  (i)  The  department  shall  appoint a work group from recommendations
made by associations  representing  physicians,  general  hospitals  and
other  health care facilities to develop a streamlined application proc-
ess by June first, two thousand twelve.
  (ii) Subject to available funding, applications shall be accepted on a
continuous basis. The department shall provide technical  assistance  to
applicants  to facilitate their completion of applications. An applicant
shall be notified in writing  by  the  department  within  ten  days  of
receipt  of an application as to whether the application is complete and
if the application is incomplete, what information is  outstanding.  The
department  shall act on an application within thirty days of receipt of
a complete application.
  (f) Study on physician workforce. Five hundred ninety thousand dollars
annually for the period January first, two thousand eight through Decem-
ber thirty-first, two thousand ten,  one  hundred  forty-eight  thousand
dollars  for the period January first, two thousand eleven through March
thirty-first, two thousand eleven, [and] five hundred  sixteen  thousand
dollars  each state fiscal year for the period April first, two thousand
eleven through March thirty-first, two thousand fourteen, AND UP TO FOUR
HUNDRED EIGHTY-SEVEN THOUSAND DOLLARS EACH STATE  FISCAL  YEAR  FOR  THE
PERIOD  APRIL  FIRST,  TWO THOUSAND FOURTEEN THROUGH MARCH THIRTY-FIRST,
TWO THOUSAND SEVENTEEN, shall be set aside and reserved by  the  commis-
sioner  from  the regional pools established pursuant to subdivision two
of this section and shall be available to  fund  a  study  of  physician
workforce needs and solutions including, but not limited to, an analysis
of  residency  programs  and projected physician workforce and community
needs. The commissioner shall enter into agreements  with  one  or  more
organizations  to  conduct  such  study  based on a request for proposal
process.
  (g) Diversity in medicine/post-baccalaureate program.  Notwithstanding
any  inconsistent provision of section one hundred twelve or one hundred
sixty-three of the state finance law or any other law, one million  nine
hundred  sixty  thousand  dollars annually for the period January first,
two thousand eight through December thirty-first, two thousand ten, four
hundred ninety thousand dollars for the period January first, two  thou-
sand  eleven  through March thirty-first, two thousand eleven, [and] one
million seven hundred thousand dollars each state fiscal  year  for  the
period  April first, two thousand eleven through March thirty-first, two
thousand fourteen, AND UP TO  ONE  MILLION  SIX  HUNDRED  FIVE  THOUSAND
DOLLARS  EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND
FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND  SEVENTEEN,  shall  be
set  aside  and  reserved  by  the  commissioner from the regional pools
established pursuant to subdivision two of this  section  and  shall  be
available  for  distributions  to  the Associated Medical Schools of New
York to fund its diversity program including existing and new  post-bac-
calaureate programs for minority and economically disadvantaged students
and  encourage  participation  from all medical schools in New York. The
associated medical schools of New York shall report to the  commissioner

S. 6914                            99                            A. 9205

on  an  annual basis regarding the use of funds for such purpose in such
form and manner as specified by the commissioner.
  (h)  In  the  event  there are undistributed funds within amounts made
available for distributions pursuant to this subdivision, such funds may
be reallocated and distributed in  current  or  subsequent  distribution
periods  in  a manner determined by the commissioner for any purpose set
forth in this subdivision.
  7. Notwithstanding any inconsistent provision of section  one  hundred
twelve  or one hundred sixty-three of the state finance law or any other
law, up to one million dollars for the period January first,  two  thou-
sand  through  December  thirty-first,  two  thousand,  one  million six
hundred thousand dollars annually for the  periods  January  first,  two
thousand  one  through  December  thirty-first,  two thousand eight, one
million five hundred thousand dollars annually for the  periods  January
first,  two  thousand  nine  through December thirty-first, two thousand
ten, three hundred seventy-five thousand dollars for the period  January
first,  two  thousand  eleven  through  March thirty-first, two thousand
eleven, [and] one million three hundred  twenty  thousand  dollars  each
state  fiscal  year  for  the  period  April  first, two thousand eleven
through March thirty-first, two thousand fourteen, AND UP TO TWO MILLION
SEVENTY-SEVEN THOUSAND DOLLARS EACH STATE FISCAL  YEAR  FOR  THE  PERIOD
APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND SEVENTEEN, shall be set aside and reserved by the commissioner from
the  regional  pools  established  pursuant  to  subdivision two of this
section and shall be available for distributions to the New  York  state
area health education center program for the purpose of expanding commu-
nity-based  training  of  medical  students.  In  addition,  one million
dollars annually for  the  period  January  first,  two  thousand  eight
through December thirty-first, two thousand ten, two hundred fifty thou-
sand  dollars  for the period January first, two thousand eleven through
March thirty-first, two thousand eleven, and eight hundred eighty  thou-
sand  dollars  each  state  fiscal  year for the period April first, two
thousand eleven through March thirty-first, two thousand fourteen, shall
be set aside and reserved by the commissioner from  the  regional  pools
established  pursuant  to  subdivision  two of this section and shall be
available for distributions to the New York state area health  education
center program for the purpose of post-secondary training of health care
professionals  who will achieve specific program outcomes within the New
York state area health education center program. The New York state area
health education center program shall report to the commissioner  on  an
annual  basis  regarding  the use of funds for each purpose in such form
and manner as specified by the commissioner.
  S 10. Paragraph (a) of subdivision 12 of section 367-b of  the  social
services  law,  as  amended by section 10 of part C of chapter 59 of the
laws of 2011, is amended to read as follows:
  (a) For the purpose of regulating cash flow for general hospitals, the
department shall develop and implement a payment methodology to  provide
for  timely  payments  for inpatient hospital services eligible for case
based payments per discharge based on diagnosis-related groups  provided
during  the  period January first, nineteen hundred eighty-eight through
March thirty-first two thousand [fourteen] SEVENTEEN, by such  hospitals
which elect to participate in the system.
  S 11. Section 2 of chapter 600 of the laws of 1986 amending the public
health  law  relating to the development of pilot reimbursement programs
for ambulatory care services, as amended by section  11  of  part  C  of
chapter 59 of the laws of 2011, is amended to read as follows:

S. 6914                            100                           A. 9205

  S  2.  This  act  shall  take effect immediately, except that this act
shall expire and be of no further force and effect on and after April 1,
[2014] 2017; provided, however, that the commissioner  of  health  shall
submit a report to the governor and the legislature detailing the objec-
tive,  impact, design and computation of any pilot reimbursement program
established pursuant to this act, on or before March 31, 1994 and  annu-
ally  thereafter.  Such report shall include an assessment of the finan-
cial impact of such payment system on providers, as well as  the  impact
of such system on access to care.
  S  12. Paragraph (i) of subdivision (b) of section 1 of chapter 520 of
the laws of 1978, relating to providing for a  comprehensive  survey  of
health  care  financing,  education  and illness prevention and creating
councils for the conduct thereof, as amended by section 12 of part C  of
chapter 59 of the laws of 2011, is amended to read as follows:
  (i)  oversight  and  evaluation  of  the inpatient financing system in
place for 1988 through March 31, [2014] 2017,  and  the  appropriateness
and effectiveness of the bad debt and charity care financing provisions;
  S  13.    Paragraph (i) of subdivision 9 of section 3614 of the public
health law, as added by section 23 of part C of chapter 59 of  the  laws
of  2011, is amended and three new paragraphs (j), (k) and (l) are added
to read as follows:
  (i) for the period April first, two thousand  thirteen  through  March
thirty-first,   two   thousand  fourteen,  up  to  one  hundred  million
dollars[.];
  (J) FOR THE PERIOD APRIL FIRST, TWO THOUSAND  FOURTEEN  THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND FIFTEEN, UP TO ONE HUNDRED MILLION DOLLARS;
  (K)  FOR  THE  PERIOD  APRIL FIRST, TWO THOUSAND FIFTEEN THROUGH MARCH
THIRTY-FIRST, TWO THOUSAND SIXTEEN, UP TO ONE HUNDRED MILLION DOLLARS;
  (L) FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  SIXTEEN  THROUGH  MARCH
THIRTY-FIRST, TWO THOUSAND SEVENTEEN, UP TO ONE HUNDRED MILLION DOLLARS.
  S  14. Paragraphs (1) and (m) of subdivision 1 of section 367-q of the
social services law, as amended by section 35 of part D of chapter 56 of
the laws of 2012, are amended and three new paragraphs (n), (o) and  (p)
are added to read as follows:
  (l)  for  the  period  April  first, two thousand twelve through March
thirty-first, two thousand thirteen, up  to  twenty-eight  million  five
hundred thousand dollars; [and]
  (m)  for  the  period April first, two thousand thirteen through March
thirty-first, two thousand fourteen, up  to  twenty-eight  million  five
hundred thousand dollars[.];
  (N)  FOR  THE  PERIOD APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH
THIRTY-FIRST, TWO THOUSAND FIFTEEN,  UP  TO  TWENTY-EIGHT  MILLION  FIVE
HUNDRED THOUSAND DOLLARS;
  (O)  FOR  THE  PERIOD  APRIL FIRST, TWO THOUSAND FIFTEEN THROUGH MARCH
THIRTY-FIRST, TWO THOUSAND SIXTEEN,  UP  TO  TWENTY-EIGHT  MILLION  FIVE
HUNDRED THOUSAND DOLLARS; AND
  (P)  FOR  THE  PERIOD  APRIL FIRST, TWO THOUSAND SIXTEEN THROUGH MARCH
THIRTY-FIRST, TWO THOUSAND SEVENTEEN, UP TO  TWENTY-EIGHT  MILLION  FIVE
HUNDRED THOUSAND DOLLARS.
  S  15.  Subdivision  6  of section 2807-t of the public health law, as
added by chapter 639 of the laws of 1996, is amended to read as follows:
  6. Prospective adjustments. (A) The commissioner shall annually recon-
cile the sum of the actual payments made  to  the  commissioner  or  the
commissioner's designee for each region pursuant to section twenty-eight
hundred  seven-s  of  this  article and pursuant to this section for the
prior year with the regional allocation of the  gross  annual  statewide

S. 6914                            101                           A. 9205

amount  specified  in  subdivision  six  of section twenty-eight hundred
seven-s of this article for such prior year. The difference between  the
actual  amount  raised  for  a region and the regional allocation of the
specified  gross annual amount for such prior year shall be applied as a
prospective adjustment to the regional allocation of the specified gross
annual payment amount for such region for the year  next  following  the
calculation  of  the  reconciliation. The authorized dollar value of the
adjustments shall be the same as if calculated retrospectively.
  (B) NOTWITHSTANDING THE PROVISIONS OF PARAGRAPH (A) OF  THIS  SUBDIVI-
SION,  FOR  COVERED  LIVES  ASSESSMENT RATE PERIODS ON AND AFTER JANUARY
FIRST, TWO THOUSAND FIFTEEN THROUGH DECEMBER THIRTY-FIRST, TWO  THOUSAND
SEVENTEEN,  FOR  AMOUNTS  COLLECTED  IN  THE  AGGREGATE IN EXCESS OF ONE
BILLION FORTY-FIVE MILLION  DOLLARS  ON  AN  ANNUAL  BASIS,  PROSPECTIVE
ADJUSTMENTS  SHALL BE SUSPENDED IF THE ANNUAL RECONCILIATION CALCULATION
FROM THE PRIOR YEAR WOULD OTHERWISE RESULT IN A DECREASE TO THE REGIONAL
ALLOCATION OF THE SPECIFIED GROSS ANNUAL PAYMENT AMOUNT FOR THAT REGION,
PROVIDED, HOWEVER, THAT SUCH SUSPENSION SHALL BE LIFTED UPON A  DETERMI-
NATION  BY  THE  COMMISSIONER,  IN CONSULTATION WITH THE DIRECTOR OF THE
BUDGET, THAT SIXTY-FIVE MILLION DOLLARS IN AGGREGATE COLLECTIONS  ON  AN
ANNUAL BASIS OVER AND ABOVE ONE BILLION FORTY-FIVE MILLION DOLLARS ON AN
ANNUAL  BASIS  HAVE  BEEN RESERVED AND SET ASIDE FOR DEPOSIT IN THE HCRA
RESOURCES FUND. ANY AMOUNTS COLLECTED IN THE AGGREGATE AT OR  BELOW  ONE
BILLION  FORTY-FIVE MILLION DOLLARS ON AN ANNUAL BASIS, SHALL BE SUBJECT
TO REGIONAL ADJUSTMENTS RECONCILING ANY DECREASES OR  INCREASES  TO  THE
REGIONAL  ALLOCATION  IN  ACCORDANCE WITH PARAGRAPH (A) OF THIS SUBDIVI-
SION.
  S 16. Subdivision 4-c of section 2807-p of the public health  law,  as
amended  by  section  27 of part C of chapter 59 of the laws of 2011, is
amended to read as follows:
  4-c. Notwithstanding any provision of law to the contrary, the commis-
sioner shall make additional payments for uncompensated care  to  volun-
tary  non-profit  diagnostic and treatment centers that are eligible for
distributions under subdivision four of this section  in  the  following
amounts:  for  the  period June first, two thousand six through December
thirty-first, two thousand six, in the  amount  of  seven  million  five
hundred  thousand  dollars,  for  the period January first, two thousand
seven through December thirty-first, two thousand seven,  seven  million
five  hundred  thousand dollars, for the period January first, two thou-
sand eight through December  thirty-first,  two  thousand  eight,  seven
million five hundred thousand dollars, for the period January first, two
thousand  nine through December thirty-first, two thousand nine, fifteen
million five hundred thousand dollars, for the period January first, two
thousand ten through December  thirty-first,  two  thousand  ten,  seven
million five hundred thousand dollars, for the period January first, two
thousand eleven though December thirty-first, two thousand eleven, seven
million five hundred thousand dollars, for the period January first, two
thousand  twelve  through  December  thirty-first,  two thousand twelve,
seven million five hundred thousand  dollars,  for  the  period  January
first, two thousand thirteen through December thirty-first, two thousand
thirteen,  seven  million  five hundred thousand dollars, FOR THE PERIOD
JANUARY FIRST, TWO THOUSAND FOURTEEN THROUGH DECEMBER THIRTY-FIRST,  TWO
THOUSAND  FOURTEEN, SEVEN MILLION FIVE HUNDRED THOUSAND DOLLARS, FOR THE
PERIOD  JANUARY   FIRST,   TWO   THOUSAND   FIFTEEN   THROUGH   DECEMBER
THIRTY-FIRST,  TWO THOUSAND FIFTEEN, SEVEN MILLION FIVE HUNDRED THOUSAND
DOLLARS, FOR THE PERIOD  JANUARY  FIRST  TWO  THOUSAND  SIXTEEN  THROUGH
DECEMBER  THIRTY-FIRST, TWO THOUSAND SIXTEEN, SEVEN MILLION FIVE HUNDRED

S. 6914                            102                           A. 9205

THOUSAND DOLLARS, and for the period January first, two thousand  [four-
teen]  SEVENTEEN  through  March  thirty-first,  two thousand [fourteen]
SEVENTEEN, in the amount of one million [eight hundred seventy-five] SIX
HUNDRED  thousand  dollars,  provided,  however, that for periods on and
after January first, two thousand eight, such additional payments  shall
be distributed to voluntary, non-profit diagnostic and treatment centers
and  to public diagnostic and treatment centers in accordance with para-
graph (g) of subdivision four of this section. In the event that federal
financial participation is available for rate  adjustments  pursuant  to
this  section,  the  commissioner shall make such payments as additional
adjustments to rates of payment for voluntary non-profit diagnostic  and
treatment  centers that are eligible for distributions under subdivision
four-a of this section in the following amounts:  for  the  period  June
first, two thousand six through December thirty-first, two thousand six,
fifteen  million  dollars  in  the aggregate, and for the period January
first, two thousand seven through June thirtieth,  two  thousand  seven,
seven  million  five  hundred  thousand  dollars  in  the aggregate. The
amounts allocated pursuant to this paragraph shall  be  aggregated  with
and  distributed  pursuant  to  the  same  methodology applicable to the
amounts allocated to such diagnostic  and  treatment  centers  for  such
periods  pursuant  to subdivision four of this section if federal finan-
cial participation is not available, or pursuant to  subdivision  four-a
of  this  section  if  federal  financial  participation  is  available.
Notwithstanding  section  three  hundred  sixty-eight-a  of  the  social
services  law,  there  shall  be  no local share in a medical assistance
payment adjustment under this subdivision.
  S 17. Subdivision 9 of section 2807-k of the  public  health  law,  as
added by chapter 639 of the laws of 1996, is amended to read as follows:
  9.  In order for a general hospital to participate in the distribution
of funds from the pool, the  general  hospital  must  implement  minimum
collection  policies  and  procedures  approved by the commissioner [and
must be in compliance with bad debt and charity care reporting  require-
ments established pursuant to this article].
  S  17-a.  Paragraph  (d)  of  subdivision  16 of section 2807-c of the
public health law, as amended by chapter 731 of the  laws  of  1993,  is
amended to read as follows:
  (d) In order for a general hospital to participate in the distribution
of  funds from the pools, the general hospital must implement collection
policies and procedures approved by the commissioner  [and  must  be  in
compliance  with bad debt and charity care reporting requirements estab-
lished pursuant to this article].
  S 18. Paragraph (a) of subdivision 1 of section 18 of chapter  266  of
the  laws  of  1986, amending the civil practice law and rules and other
laws relating  to  malpractice  and  professional  medical  conduct,  as
amended  by  section  15 of part C of chapter 59 of the laws of 2011, is
amended to read as follows:
  (a) The superintendent of insurance and the commissioner of health  or
their  designee  shall,  from  funds  available  in  the hospital excess
liability pool created  pursuant  to  subdivision  5  of  this  section,
purchase  a policy or policies for excess insurance coverage, as author-
ized by paragraph 1 of subsection (e) of section 5502 of  the  insurance
law; or from an insurer, other than an insurer described in section 5502
of the insurance law, duly authorized to write such coverage and actual-
ly  writing  medical  malpractice  insurance  in  this  state;  or shall
purchase equivalent excess coverage in a form previously approved by the
superintendent of insurance for purposes of providing equivalent  excess

S. 6914                            103                           A. 9205

coverage  in  accordance  with  section 19 of chapter 294 of the laws of
1985, for medical or dental malpractice occurrences between July 1, 1986
and June 30, 1987, between July 1, 1987 and June 30, 1988, between  July
1,  1988  and  June  30,  1989,  between July 1, 1989 and June 30, 1990,
between July 1, 1990 and June 30, 1991, between July 1,  1991  and  June
30,  1992,  between July 1, 1992 and June 30, 1993, between July 1, 1993
and June 30, 1994, between July 1, 1994 and June 30, 1995, between  July
1,  1995  and  June  30,  1996,  between July 1, 1996 and June 30, 1997,
between July 1, 1997 and June 30, 1998, between July 1,  1998  and  June
30,  1999,  between July 1, 1999 and June 30, 2000, between July 1, 2000
and June 30, 2001, between July 1, 2001 and June 30, 2002, between  July
1,  2002  and  June  30,  2003,  between July 1, 2003 and June 30, 2004,
between July 1, 2004 and June 30, 2005, between July 1,  2005  and  June
30,  2006,  between July 1, 2006 and June 30, 2007, between July 1, 2007
and June 30, 2008, between July 1, 2008 and June 30, 2009, between  July
1,  2009  and  June  30,  2010,  between July 1, 2010 and June 30, 2011,
between July 1, 2011 and June 30, 2012, between July 1,  2012  and  June
30, 2013 [and], between July 1, 2013 and June 30, 2014, AND BETWEEN JULY
1,  2014  AND JUNE 30, 2015 or reimburse the hospital where the hospital
purchases equivalent excess coverage as defined in subparagraph  (i)  of
paragraph  (a)  of subdivision 1-a of this section for medical or dental
malpractice occurrences between July 1, 1987 and June 30, 1988,  between
July  1, 1988 and June 30, 1989, between July 1, 1989 and June 30, 1990,
between July 1, 1990 and June 30, 1991, between July 1,  1991  and  June
30,  1992,  between July 1, 1992 and June 30, 1993, between July 1, 1993
and June 30, 1994, between July 1, 1994 and June 30, 1995, between  July
1,  1995  and  June  30,  1996,  between July 1, 1996 and June 30, 1997,
between July 1, 1997 and June 30, 1998, between July 1,  1998  and  June
30,  1999,  between July 1, 1999 and June 30, 2000, between July 1, 2000
and June 30, 2001, between July 1, 2001 and June 30, 2002, between  July
1,  2002  and  June  30,  2003,  between July 1, 2003 and June 30, 2004,
between July 1, 2004 and June 30, 2005, between July 1,  2005  and  June
30,  2006,  between July 1, 2006 and June 30, 2007, between July 1, 2007
and June 30, 2008, between July 1, 2008 and June 30, 2009, between  July
1,  2009  and  June  30,  2010,  between July 1, 2010 and June 30, 2011,
between July 1, 2011 and June 30, 2012, between July 1,  2012  and  June
30, 2013 [and], between July 1, 2013 and June 30, 2014, AND BETWEEN JULY
1, 2014 AND JUNE 30, 2015 for physicians or dentists certified as eligi-
ble  for  each  such period or periods pursuant to subdivision 2 of this
section by a general hospital licensed pursuant to  article  28  of  the
public health law; provided that no single insurer shall write more than
fifty  percent  of the total excess premium for a given policy year; and
provided, however, that such eligible physicians or dentists  must  have
in force an individual policy, from an insurer licensed in this state of
primary  malpractice  insurance  coverage in amounts of no less than one
million three hundred thousand  dollars  for  each  claimant  and  three
million nine hundred thousand dollars for all claimants under that poli-
cy  during the period of such excess coverage for such occurrences or be
endorsed as additional insureds under a hospital professional  liability
policy  which is offered through a voluntary attending physician ("chan-
neling") program previously permitted by the superintendent of insurance
during the period of such excess coverage for such  occurrences.  During
such  period,  such policy for excess coverage or such equivalent excess
coverage shall, when combined with the physician's or dentist's  primary
malpractice  insurance coverage or coverage provided through a voluntary
attending physician ("channeling") program, total an aggregate level  of

S. 6914                            104                           A. 9205

two  million  three  hundred  thousand dollars for each claimant and six
million nine hundred thousand dollars for all claimants  from  all  such
policies  with  respect  to  occurrences in each of such years provided,
however, if the cost of primary malpractice insurance coverage in excess
of  one million dollars, but below the excess medical malpractice insur-
ance coverage provided pursuant to this act, exceeds the  rate  of  nine
percent per annum, then the required level of primary malpractice insur-
ance  coverage  in excess of one million dollars for each claimant shall
be in an amount of not less than the  dollar  amount  of  such  coverage
available at nine percent per annum; the required level of such coverage
for  all claimants under that policy shall be in an amount not less than
three times the dollar amount of coverage for each claimant; and  excess
coverage,  when  combined with such primary malpractice insurance cover-
age, shall increase the aggregate level for each claimant by one million
dollars and three  million  dollars  for  all  claimants;  and  provided
further,  that,  with respect to policies of primary medical malpractice
coverage that include occurrences between April 1,  2002  and  June  30,
2002,  such  requirement  that  coverage  be in amounts no less than one
million three hundred thousand  dollars  for  each  claimant  and  three
million  nine hundred thousand dollars for all claimants for such occur-
rences shall be effective April 1, 2002.
  S 19. Subdivision 3 of section 18 of chapter 266 of the laws of  1986,
amending  the  civil  practice  law and rules and other laws relating to
malpractice and professional medical conduct, as amended by  section  16
of  part  C  of  chapter  59  of the laws of 2011, is amended to read as
follows:
  (3)(a) The superintendent of insurance shall determine and certify  to
each  general  hospital  and  to  the commissioner of health the cost of
excess malpractice insurance for medical or  dental  malpractice  occur-
rences  between July 1, 1986 and June 30, 1987, between July 1, 1988 and
June 30, 1989, between July 1, 1989 and June 30, 1990, between  July  1,
1990  and June 30, 1991, between July 1, 1991 and June 30, 1992, between
July 1, 1992 and June 30, 1993, between July 1, 1993 and June 30,  1994,
between  July  1,  1994 and June 30, 1995, between July 1, 1995 and June
30, 1996, between July 1, 1996 and June 30, 1997, between July  1,  1997
and  June 30, 1998, between July 1, 1998 and June 30, 1999, between July
1, 1999 and June 30, 2000, between July  1,  2000  and  June  30,  2001,
between  July  1,  2001 and June 30, 2002, between July 1, 2002 and June
30, 2003, between July 1, 2003 and June 30, 2004, between July  1,  2004
and  June 30, 2005, between July 1, 2005 and June 30, 2006, between July
1, 2006 and June 30, 2007, between July  1,  2007  and  June  30,  2008,
between  July  1,  2008 and June 30, 2009, between July 1, 2009 and June
30, 2010, between July 1, 2010 and June 30, 2011, between July  1,  2011
and  June  30, 2012, between July 1, 2012 and June 30, 2013, and between
July 1, 2013 and June 30, 2014, AND BETWEEN JULY 1, 2014  AND  JUNE  30,
2015  allocable  to  each  general  hospital  for physicians or dentists
certified as eligible for purchase of  a  policy  for  excess  insurance
coverage  by  such  general hospital in accordance with subdivision 2 of
this section, and may amend  such  determination  and  certification  as
necessary.
  (b)  The  superintendent  of  insurance shall determine and certify to
each general hospital and to the commissioner  of  health  the  cost  of
excess  malpractice  insurance or equivalent excess coverage for medical
or dental malpractice occurrences between July  1,  1987  and  June  30,
1988,  between  July 1, 1988 and June 30, 1989, between July 1, 1989 and
June 30, 1990, between July 1, 1990 and June 30, 1991, between  July  1,

S. 6914                            105                           A. 9205

1991  and June 30, 1992, between July 1, 1992 and June 30, 1993, between
July 1, 1993 and June 30, 1994, between July 1, 1994 and June 30,  1995,
between  July  1,  1995 and June 30, 1996, between July 1, 1996 and June
30,  1997,  between July 1, 1997 and June 30, 1998, between July 1, 1998
and June 30, 1999, between July 1, 1999 and June 30, 2000, between  July
1,  2000  and  June  30,  2001,  between July 1, 2001 and June 30, 2002,
between July 1, 2002 and June 30, 2003, between July 1,  2003  and  June
30,  2004,  between July 1, 2004 and June 30, 2005, between July 1, 2005
and June 30, 2006, between July 1, 2006 and June 30, 2007, between  July
1,  2007  and  June  30,  2008,  between July 1, 2008 and June 30, 2009,
between July 1, 2009 and June 30, 2010, between July 1,  2010  and  June
30,  2011,  between July 1, 2011 and June 30, 2012, between July 1, 2012
and June 30, 2013, [and] between July 1, 2013 and  June  30,  2014,  AND
BETWEEN  JULY 1, 2014 AND JUNE 30, 2015 allocable to each general hospi-
tal for physicians or dentists certified as eligible for purchase  of  a
policy  for  excess  insurance coverage or equivalent excess coverage by
such general hospital in accordance with subdivision 2 of this  section,
and  may  amend  such  determination and certification as necessary. The
superintendent of insurance shall determine and certify to each  general
hospital  and  to  the  commissioner of health the ratable share of such
cost allocable to the period July 1, 1987 to December 31, 1987,  to  the
period  January  1, 1988 to June 30, 1988, to the period July 1, 1988 to
December 31, 1988, to the period January 1, 1989 to June  30,  1989,  to
the  period  July 1, 1989 to December 31, 1989, to the period January 1,
1990 to June 30, 1990, to the period July 1, 1990 to December 31,  1990,
to  the  period  January 1, 1991 to June 30, 1991, to the period July 1,
1991 to December 31, 1991, to the period January 1,  1992  to  June  30,
1992,  to  the  period  July 1, 1992 to December 31, 1992, to the period
January 1, 1993 to June 30, 1993, to the period July 1, 1993 to December
31, 1993, to the period January 1, 1994 to June 30, 1994, to the  period
July 1, 1994 to December 31, 1994, to the period January 1, 1995 to June
30, 1995, to the period July 1, 1995 to December 31, 1995, to the period
January 1, 1996 to June 30, 1996, to the period July 1, 1996 to December
31,  1996, to the period January 1, 1997 to June 30, 1997, to the period
July 1, 1997 to December 31, 1997, to the period January 1, 1998 to June
30, 1998, to the period July 1, 1998 to December 31, 1998, to the period
January 1, 1999 to June 30, 1999, to the period July 1, 1999 to December
31, 1999, to the period January 1, 2000 to June 30, 2000, to the  period
July 1, 2000 to December 31, 2000, to the period January 1, 2001 to June
30,  2001,  to  the  period July 1, 2001 to June 30, 2002, to the period
July 1, 2002 to June 30, 2003, to the period July 1, 2003  to  June  30,
2004, to the period July 1, 2004 to June 30, 2005, to the period July 1,
2005 and June 30, 2006, to the period July 1, 2006 and June 30, 2007, to
the  period  July  1, 2007 and June 30, 2008, to the period July 1, 2008
and June 30, 2009, to the period July 1, 2009 and June 30, 2010, to  the
period  July  1,  2010 and June 30, 2011, to the period July 1, 2011 and
June 30, 2012, to the period July 1, 2012 and June 30,  2013,  [and]  to
the  period  July  1,  2013 and June 30, 2014, AND TO THE PERIOD JULY 1,
2014 AND JUNE 30, 2015.
  S 20. Paragraphs (a), (b), (c),  (d)  and  (e)  of  subdivision  8  of
section  18 of chapter 266 of the laws of 1986, amending the civil prac-
tice law and rules and other laws relating to  malpractice  and  profes-
sional medical conduct, as amended by section 17 of part C of chapter 59
of the laws of 2011, are amended to read as follows:
  (a)  To  the  extent  funds available to the hospital excess liability
pool pursuant to subdivision 5 of this section as amended, and  pursuant

S. 6914                            106                           A. 9205

to  section  6  of part J of chapter 63 of the laws of 2001, as may from
time to time be amended, which amended this  subdivision,  are  insuffi-
cient  to  meet  the  costs  of  excess insurance coverage or equivalent
excess  coverage  for coverage periods during the period July 1, 1992 to
June 30, 1993, during the period July 1, 1993 to June 30,  1994,  during
the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
to  June  30,  1996,  during  the  period July 1, 1996 to June 30, 1997,
during the period July 1, 1997 to June 30, 1998, during the period  July
1,  1998  to  June  30, 1999, during the period July 1, 1999 to June 30,
2000, during the period July 1, 2000 to June 30, 2001, during the period
July 1, 2001 to October 29, 2001, during the period  April  1,  2002  to
June  30,  2002, during the period July 1, 2002 to June 30, 2003, during
the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
to June 30, 2005, during the period July  1,  2005  to  June  30,  2006,
during  the period July 1, 2006 to June 30, 2007, during the period July
1, 2007 to June 30, 2008, during the period July 1,  2008  to  June  30,
2009, during the period July 1, 2009 to June 30, 2010, during the period
July  1,  2010  to June 30, 2011, during the period July 1, 2011 to June
30, 2012, during the period July 1, 2012 to June 30, 2013, [and]  during
the  period July 1, 2013 to June 30, 2014, AND DURING THE PERIOD JULY 1,
2014 TO JUNE 30, 2015 allocated or reallocated in accordance with  para-
graph  (a) of subdivision 4-a of this section to rates of payment appli-
cable to state governmental agencies, each physician or dentist for whom
a policy for excess insurance coverage or equivalent excess coverage  is
purchased  for  such  period  shall  be  responsible  for payment to the
provider of excess insurance coverage or equivalent excess  coverage  of
an  allocable  share  of  such  insufficiency, based on the ratio of the
total cost of such coverage for such physician to the sum of  the  total
cost of such coverage for all physicians applied to such insufficiency.
  (b)  Each  provider  of excess insurance coverage or equivalent excess
coverage covering the period July 1, 1992 to June 30, 1993, or  covering
the period July 1, 1993 to June 30, 1994, or covering the period July 1,
1994  to  June 30, 1995, or covering the period July 1, 1995 to June 30,
1996, or covering the period July 1, 1996 to June 30, 1997, or  covering
the period July 1, 1997 to June 30, 1998, or covering the period July 1,
1998  to  June 30, 1999, or covering the period July 1, 1999 to June 30,
2000, or covering the period July 1, 2000 to June 30, 2001, or  covering
the  period  July  1,  2001  to October 29, 2001, or covering the period
April 1, 2002 to June 30, 2002, or covering the period July 1,  2002  to
June  30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
covering the period July 1, 2004 to June 30, 2005, or covering the peri-
od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
June 30, 2007, or covering the period July 1, 2007 to June 30, 2008,  or
covering the period July 1, 2008 to June 30, 2009, or covering the peri-
od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
June  30, 2011, or covering the period July 1, 2011 to June 30, 2012, or
covering the period July 1, 2012 to June 30, 2013, or covering the peri-
od July 1, 2013 to June 30, 2014, OR COVERING THE PERIOD JULY 1, 2014 TO
JUNE 30, 2015 shall notify a  covered  physician  or  dentist  by  mail,
mailed to the address shown on the last application for excess insurance
coverage  or  equivalent  excess  coverage,  of  the  amount due to such
provider from such physician or dentist for such coverage period  deter-
mined  in accordance with paragraph (a) of this subdivision. Such amount
shall be due from such physician or dentist to such provider  of  excess
insurance  coverage  or  equivalent excess coverage in a time and manner
determined by the superintendent of insurance.

S. 6914                            107                           A. 9205

  (c) If a physician or dentist liable for payment of a portion  of  the
costs  of excess insurance coverage or equivalent excess coverage cover-
ing the period July 1, 1992 to June 30, 1993,  or  covering  the  period
July  1,  1993  to June 30, 1994, or covering the period July 1, 1994 to
June  30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
covering the period July 1, 1996 to June 30, 1997, or covering the peri-
od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
June 30, 1999, or covering the period July 1, 1999 to June 30, 2000,  or
covering the period July 1, 2000 to June 30, 2001, or covering the peri-
od  July  1,  2001  to October 29, 2001, or covering the period April 1,
2002 to June 30, 2002, or covering the period July 1, 2002 to  June  30,
2003,  or covering the period July 1, 2003 to June 30, 2004, or covering
the period July 1, 2004 to June 30, 2005, or covering the period July 1,
2005 to June 30, 2006, or covering the period July 1, 2006 to  June  30,
2007,  or covering the period July 1, 2007 to June 30, 2008, or covering
the period July 1, 2008 to June 30, 2009, or covering the period July 1,
2009 to June 30, 2010, or covering the period July 1, 2010 to  June  30,
2011,  or covering the period July 1, 2011 to June 30, 2012, or covering
the period July 1, 2012 to June 30, 2013, or covering the period July 1,
2013 to June 30, 2014, OR COVERING THE PERIOD JULY 1, 2014 TO  JUNE  30,
2015  determined  in  accordance  with paragraph (a) of this subdivision
fails, refuses or neglects to make payment to  the  provider  of  excess
insurance coverage or equivalent excess coverage in such time and manner
as  determined  by the superintendent of insurance pursuant to paragraph
(b) of this subdivision, excess insurance coverage or equivalent  excess
coverage purchased for such physician or dentist in accordance with this
section  for  such  coverage period shall be cancelled and shall be null
and void as of the first day on or after the commencement  of  a  policy
period  where the liability for payment pursuant to this subdivision has
not been met.
  (d) Each provider of excess insurance coverage  or  equivalent  excess
coverage  shall  notify  the superintendent of insurance and the commis-
sioner of health or their designee of each physician and dentist  eligi-
ble for purchase of a policy for excess insurance coverage or equivalent
excess  coverage  covering  the period July 1, 1992 to June 30, 1993, or
covering the period July 1, 1993 to June 30, 1994, or covering the peri-
od July 1, 1994 to June 30, 1995, or covering the period July 1, 1995 to
June 30, 1996, or covering the period July 1, 1996 to June 30, 1997,  or
covering the period July 1, 1997 to June 30, 1998, or covering the peri-
od July 1, 1998 to June 30, 1999, or covering the period July 1, 1999 to
June  30, 2000, or covering the period July 1, 2000 to June 30, 2001, or
covering the period July 1, 2001 to October 29, 2001,  or  covering  the
period  April  1,  2002 to June 30, 2002, or covering the period July 1,
2002 to June 30, 2003, or covering the period July 1, 2003 to  June  30,
2004,  or covering the period July 1, 2004 to June 30, 2005, or covering
the period July 1, 2005 to June 30, 2006, or covering the period July 1,
2006 to June 30, 2007, or covering the period July 1, 2007 to  June  30,
2008,  or covering the period July 1, 2008 to June 30, 2009, or covering
the period July 1, 2009 to June 30, 2010, or covering the period July 1,
2010 to June 30, 2011, or covering the period July 1, 2011 to  June  30,
2012,  or covering the period July 1, 2012 to June 30, 2013, or covering
the period July 1, 2013 to June 30, 2014, OR COVERING THE PERIOD JULY 1,
2014 TO JUNE 30, 2015 that has made payment to such provider  of  excess
insurance  coverage  or  equivalent  excess  coverage in accordance with
paragraph (b) of this subdivision and of each physician and dentist  who
has failed, refused or neglected to make such payment.

S. 6914                            108                           A. 9205

  (e)  A  provider  of  excess  insurance  coverage or equivalent excess
coverage shall refund to the hospital excess liability pool  any  amount
allocable to the period July 1, 1992 to June 30, 1993, and to the period
July  1,  1993  to June 30, 1994, and to the period July 1, 1994 to June
30,  1995,  and  to the period July 1, 1995 to June 30, 1996, and to the
period July 1, 1996 to June 30, 1997, and to the period July 1, 1997  to
June  30,  1998, and to the period July 1, 1998 to June 30, 1999, and to
the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
to June 30, 2001, and to the period July 1, 2001 to  October  29,  2001,
and to the period April 1, 2002 to June 30, 2002, and to the period July
1,  2002  to  June  30, 2003, and to the period July 1, 2003 to June 30,
2004, and to the period July 1, 2004 to June 30, 2005, and to the period
July 1, 2005 to June 30, 2006, and to the period July 1,  2006  to  June
30,  2007,  and  to the period July 1, 2007 to June 30, 2008, and to the
period July 1, 2008 to June 30, 2009, and to the period July 1, 2009  to
June  30,  2010, and to the period July 1, 2010 to June 30, 2011, and to
the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
to June 30, 2013, and to the period July 1, 2013 to June 30,  2014,  AND
TO  THE  PERIOD JULY 1, 2014 TO JUNE 30, 2015 received from the hospital
excess liability pool for  purchase  of  excess  insurance  coverage  or
equivalent  excess coverage covering the period July 1, 1992 to June 30,
1993, and covering the period July 1, 1993 to June 30, 1994, and  cover-
ing  the  period  July 1, 1994 to June 30, 1995, and covering the period
July 1, 1995 to June 30, 1996, and covering the period July 1,  1996  to
June  30,  1997,  and covering the period July 1, 1997 to June 30, 1998,
and covering the period July 1, 1998 to June 30, 1999, and covering  the
period  July  1,  1999 to June 30, 2000, and covering the period July 1,
2000 to June 30, 2001, and covering the period July 1, 2001  to  October
29,  2001,  and  covering the period April 1, 2002 to June 30, 2002, and
covering the period July 1, 2002 to June  30,  2003,  and  covering  the
period  July  1,  2003 to June 30, 2004, and covering the period July 1,
2004 to June 30, 2005, and covering the period July 1, 2005 to June  30,
2006,  and covering the period July 1, 2006 to June 30, 2007, and cover-
ing the period July 1, 2007 to June 30, 2008, and  covering  the  period
July  1,  2008 to June 30, 2009, and covering the period July 1, 2009 to
June 30, 2010, and covering the period July 1, 2010 to  June  30,  2011,
and  covering the period July 1, 2011 to June 30, 2012, and covering the
period July 1, 2012 to June 30, 2013, and covering the  period  July  1,
2013  to June 30, 2014, AND COVERING THE PERIOD JULY 1, 2014 TO JUNE 30,
2015 for a physician or dentist where such excess insurance coverage  or
equivalent excess coverage is cancelled in accordance with paragraph (c)
of this subdivision.
  S  21.  Section  40  of  chapter 266 of the laws of 1986, amending the
civil practice law and rules and other laws relating to malpractice  and
professional  medical  conduct,  as  amended  by section 18 of part C of
chapter 59 of the laws of 2011, is amended to read as follows:
  S 40. The superintendent of insurance shall establish rates for  poli-
cies  providing coverage for physicians and surgeons medical malpractice
for the periods commencing July 1, 1985 and ending June 30, [2014] 2015;
provided, however, that notwithstanding any other provision of law,  the
superintendent  shall not establish or approve any increase in rates for
the period commencing July 1, 2009 and ending June 30, 2010. The  super-
intendent  shall  direct  insurers  to establish segregated accounts for
premiums, payments, reserves and investment income attributable to  such
premium  periods  and  shall  require  periodic  reports by the insurers
regarding claims and expenses attributable to such  periods  to  monitor

S. 6914                            109                           A. 9205

whether  such  accounts  will  be sufficient to meet incurred claims and
expenses. On or after July 1, 1989, the superintendent  shall  impose  a
surcharge  on premiums to satisfy a projected deficiency that is attrib-
utable  to  the  premium levels established pursuant to this section for
such periods; provided, however, that such annual  surcharge  shall  not
exceed  eight percent of the established rate until July 1, [2014] 2015,
at which time and thereafter such surcharge shall not exceed twenty-five
percent of the approved adequate rate, and that such  annual  surcharges
shall continue for such period of time as shall be sufficient to satisfy
such  deficiency.  The  superintendent  shall  not impose such surcharge
during the period commencing July 1, 2009 and ending June 30, 2010.   On
and  after  July 1, 1989, the surcharge prescribed by this section shall
be retained by insurers to the extent that they insured  physicians  and
surgeons  during  the  July  1, 1985 through June 30, [2014] 2015 policy
periods; in the event and to the extent  physicians  and  surgeons  were
insured  by another insurer during such periods, all or a pro rata share
of the surcharge, as the case may be, shall be remitted  to  such  other
insurer  in  accordance  with rules and regulations to be promulgated by
the superintendent.  Surcharges collected from physicians  and  surgeons
who  were  not  insured  during such policy periods shall be apportioned
among all insurers in proportion to the premium written by each  insurer
during  such policy periods; if a physician or surgeon was insured by an
insurer subject to rates established by the superintendent  during  such
policy  periods,  and  at any time thereafter a hospital, health mainte-
nance organization, employer or institution is responsible for  respond-
ing  in  damages  for  liability  arising  out  of  such  physician's or
surgeon's practice of medicine, such responsible entity shall also remit
to such prior insurer the equivalent amount that would then be collected
as a surcharge if the physician  or  surgeon  had  continued  to  remain
insured  by  such  prior insurer. In the event any insurer that provided
coverage  during  such   policy   periods   is   in   liquidation,   the
property/casualty  insurance  security fund shall receive the portion of
surcharges to which the insurer in liquidation would have been entitled.
The surcharges authorized herein shall be deemed to be income earned for
the purposes of section 2303 of the insurance law.  The  superintendent,
in  establishing  adequate  rates and in determining any projected defi-
ciency pursuant to the requirements of this section  and  the  insurance
law,  shall  give  substantial  weight, determined in his discretion and
judgment, to the  prospective  anticipated  effect  of  any  regulations
promulgated  and  laws  enacted  and the public benefit of   stabilizing
malpractice rates and minimizing rate level fluctuation during the peri-
od of time necessary for the development of  more  reliable  statistical
experience  as  to  the  efficacy of such laws and regulations affecting
medical, dental or podiatric malpractice enacted or promulgated in 1985,
1986, by this act and at any other time.  Notwithstanding any  provision
of the insurance law, rates already established and to be established by
the  superintendent pursuant to this section are deemed adequate if such
rates would be adequate when taken together with the maximum  authorized
annual  surcharges to be imposed for a reasonable period of time whether
or not any such annual surcharge has been actually  imposed  as  of  the
establishment of such rates.
  S 22. Section 5 and subdivisions (a) and (e) of section 6 of part J of
chapter  63 of the laws of 2001, amending chapter 20 of the laws of 2001
amending the military law and other laws relating  to  making  appropri-
ations for the support of government, as amended by section 20 of part C
of chapter 59 of the laws of 2011, are amended to read as follows:

S. 6914                            110                           A. 9205

  S  5.  The  superintendent of insurance and the commissioner of health
shall determine, no later than June 15, 2002, June 15,  2003,  June  15,
2004,  June  15, 2005, June 15, 2006, June 15, 2007, June 15, 2008, June
15, 2009, June 15, 2010, June 15, 2011, June 15, 2012,  June  15,  2013,
[and]  June 15, 2014, AND JUNE 15, 2015 the amount of funds available in
the hospital excess liability pool, created pursuant to  section  18  of
chapter  266  of the laws of 1986, and whether such funds are sufficient
for purposes  of  purchasing  excess  insurance  coverage  for  eligible
participating  physicians and dentists during the period July 1, 2001 to
June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003 to June
30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to June  30,
2006,  or  July  1,  2006  to June 30, 2007, or July 1, 2007 to June 30,
2008, or July 1, 2008 to June 30, 2009, or July  1,  2009  to  June  30,
2010,  or  July  1,  2010  to June 30, 2011, or July 1, 2011 to June 30,
2012, or July 1, 2012 to June 30, 2013, or July  1,  2013  to  June  30,
2014, OR JULY 1, 2014 TO JUNE 30, 2015, as applicable.
  (a)  This section shall be effective only upon a determination, pursu-
ant to section five of this act, by the superintendent of insurance  and
the commissioner of health, and a certification of such determination to
the  state  director of the budget, the chair of the senate committee on
finance and the chair of the assembly committee on ways and means,  that
the  amount  of  funds  in  the  hospital excess liability pool, created
pursuant to section 18 of chapter 266 of the laws of 1986,  is  insuffi-
cient  for purposes of purchasing excess insurance coverage for eligible
participating physicians and dentists during the period July 1, 2001  to
June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003 to June
30,  2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to June 30,
2006, or July 1, 2006 to June 30, 2007, or July  1,  2007  to  June  30,
2008,  or  July  1,  2008  to June 30, 2009, or July 1, 2009 to June 30,
2010, or July 1, 2010 to June 30, 2011, or July  1,  2011  to  June  30,
2012,  or  July  1,  2012  to June 30, 2013, or July 1, 2013 to June 30,
2014, OR JULY 1, 2014 TO JUNE 30, 2015, as applicable.
  (e) The commissioner of health  shall  transfer  for  deposit  to  the
hospital excess liability pool created pursuant to section 18 of chapter
266  of  the laws of 1986 such amounts as directed by the superintendent
of insurance for the purchase of excess liability insurance coverage for
eligible participating physicians and dentists for the policy year  July
1,  2001  to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1,
2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005
to June 30, 2006, or July 1, 2006 to June 30, 2007, as  applicable,  and
the  cost  of  administering the hospital excess liability pool for such
applicable policy year,  pursuant to the program established in  chapter
266  of  the laws of 1986, as amended, no later than June 15, 2002, June
15, 2003, June 15, 2004, June 15, 2005, June 15, 2006,  June  15,  2007,
June  15,  2008,  June  15, 2009, June 15, 2010, June 15, 2011, June 15,
2012, June 15, 2013, [and] June 15, 2014, AND JUNE 15, 2015, as applica-
ble.
  S 23. Notwithstanding any law, rule or  regulation  to  the  contrary,
only  physicians  or dentists who were eligible, and for whom the super-
intendent of financial services and the commissioner of health, or their
designee, purchased, with funds available in the hospital excess liabil-
ity pool, a full or partial policy for  excess  coverage  or  equivalent
excess  coverage  for  the coverage period ending the thirtieth of June,
two thousand fourteen, shall be eligible to apply for such coverage  for
the  coverage period beginning the first of July, two thousand fourteen;
provided, however, if the total number of  physicians  or  dentists  for

S. 6914                            111                           A. 9205

whom  such  excess  coverage or equivalent excess coverage was purchased
for the policy year ending the thirtieth of June, two thousand  fourteen
exceeds the total number of physicians or dentists certified as eligible
for  the coverage period beginning the first of July, two thousand four-
teen, then the general hospitals may certify additional eligible  physi-
cians  or  dentists in a number equal to such general hospital's propor-
tional share of the total number of  physicians  or  dentists  for  whom
excess  coverage  or equivalent excess coverage was purchased with funds
available in the hospital excess liability pool as of the  thirtieth  of
June,  two  thousand  fourteen, as applied to the difference between the
number of eligible physicians or dentists for whom a policy  for  excess
coverage  or  equivalent  excess coverage was purchased for the coverage
period ending the thirtieth of  June,  two  thousand  fourteen  and  the
number  of  such  eligible  physicians  or dentists who have applied for
excess coverage or equivalent excess coverage for  the  coverage  period
beginning the first of July, two thousand fourteen.
  S 24. Notwithstanding any inconsistent provision of law, rule or regu-
lation, for purposes of implementing the provisions of the public health
law and the social services law, references to titles XIX and XXI of the
federal  social  security  act  in  the public health law and the social
services law shall be deemed to include and also to mean  any  successor
titles thereto under the federal social security act.
  S 25. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the  public health law, section 18 of chapter 2 of the laws of 1988, and
18 NYCRR 505.14(h), as they relate to time frames for  notice,  approval
or  certification  of rates of payment, are hereby suspended and without
force or effect for purposes of implementing the provisions of this act.
  S 26. Severability clause. If any clause, sentence, paragraph,  subdi-
vision,  section  or  part of this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment  shall  not  affect,
impair or invalidate the remainder thereof, but shall be confined in its
operation  to  the  clause, sentence, paragraph, subdivision, section or
part thereof directly involved in the controversy in which such judgment
shall have been rendered. It is hereby declared to be the intent of  the
legislature  that  this act would have been enacted even if such invalid
provisions had not been included herein.
  S 27. This act shall take effect immediately and shall  be  deemed  to
have  been in full force and effect on and after April 1, 2014, provided
that:
  (a) any rules or regulations necessary to implement the provisions  of
this  act  may be promulgated and any procedures, forms, or instructions
necessary for such implementation may be adopted and issued on or  after
the date this act shall have become a law;
  (b)  this  act shall not be construed to alter, change, affect, impair
or defeat any right, obligations, duties or interests accrued,  incurred
or conferred prior to the effective date of this act;
  (c)  the  commissioner  of  health and the superintendent of financial
services and any appropriate council may take  any  steps  necessary  to
implement this act prior to its effective date;
  (d)  notwithstanding  any inconsistent provision of the state adminis-
trative procedure act or any other provision of law, rule or regulation,
the commissioner of health and the superintendent of financial  services
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

S. 6914                            112                           A. 9205

determines  necessary  to  implement  any  provision  of this act on its
effective date;
  (e)  the provisions of this act shall become effective notwithstanding
the failure of the commissioner  of  health  or  the  superintendent  of
financial  services or any council to adopt or amend or promulgate regu-
lations implementing this act;
  (f) the amendments to sections 2807-s and 2807-j of the public  health
law  made  by  sections  three, four and five, respectively, of this act
shall not affect the expiration of such sections and shall expire there-
with;
  (g) the amendments to paragraph (i-l)  of  subdivision  1  of  section
2807-v  of the public health law made by section eight of this act shall
not affect the repeal of such paragraph and  shall  be  deemed  repealed
therewith; and
  (h)  the  amendments  to subdivision 6 of section 2807-t of the public
health law made by section fifteen of this  act  shall  not  affect  the
expiration of such section and shall be deemed to expire therewith.

                                 PART C

  Section  1.  Notwithstanding any provision of law to the contrary, the
department of health is directed to consult with all  interested  stake-
holders,  for  the purpose of developing a new methodology of reimburse-
ment for pharmacies.  The department of health shall develop a transpar-
ent methodology that provides an adequate  level  of  reimbursement  for
pharmacies.
  S  2.  Subparagraphs (i) and (ii) of paragraph (b) of subdivision 9 of
section 367-a of the social services law, as amended by  section  10  of
part H of chapter 59 of the laws of 2011, is amended to read as follows:
  (i)  if  the drug dispensed is a multiple source prescription drug for
which an upper limit has been set by the federal  centers  for  medicare
and medicaid services, the lower of: (A) an amount equal to the specific
upper  limit  set  by  such  federal  agency  for  the  multiple  source
prescription drug; (B) the estimated acquisition cost of  such  drug  to
pharmacies  which,  for  purposes  of  this subparagraph, shall mean the
average wholesale price of a prescription drug based on the package size
dispensed from, as reported by the  prescription  drug  pricing  service
used  by the department, less twenty-five percent thereof; (C) the maxi-
mum acquisition cost, if any, established pursuant to paragraph  (e)  of
this  subdivision,  PROVIDED THAT THE METHODOLOGY USED BY THE DEPARTMENT
TO ESTABLISH A MAXIMUM ACQUISITION COST SHALL NOT INCLUDE AVERAGE ACQUI-
SITION COST AS DETERMINED BY DEPARTMENT SURVEYS; OR (D)  the  dispensing
pharmacy's  usual and customary price charged to the general public; [or
(E) the average acquisition cost if available;] and
  (ii) if the drug dispensed is a multiple source prescription drug or a
brand-name prescription drug for which no specific upper limit has  been
set  by such federal agency, the lower of the estimated acquisition cost
of such drug to pharmacies[, the average acquisition cost if  available]
or  the  dispensing  pharmacy's usual and customary price charged to the
general public. For sole and multiple source brand name drugs, estimated
acquisition cost means the average wholesale  price  of  a  prescription
drug  based  upon  the  package  size dispensed from, as reported by the
prescription drug pricing service used by the department, less seventeen
percent thereof or the wholesale acquisition cost of a prescription drug
based upon package size dispensed from, as reported by the  prescription
drug  pricing  service  used by the department, minus zero and forty-one

S. 6914                            113                           A. 9205

hundredths percent thereof, and updated monthly by the  department.  For
multiple  source  generic  drugs,  estimated  acquisition cost means the
lower of [the average acquisition cost,] the average wholesale price  of
a  prescription  drug  based  on  the  package  size  dispensed from, as
reported by the prescription drug pricing service used  by  the  depart-
ment, less twenty-five percent thereof, or the maximum acquisition cost,
if  any,  established  pursuant  to  paragraph  (e) of this subdivision,
PROVIDED THAT THE METHODOLOGY USED BY  THE  DEPARTMENT  TO  ESTABLISH  A
MAXIMUM  ACQUISITION  COST SHALL NOT INCLUDE AVERAGE ACQUISITION COST AS
DETERMINED BY DEPARTMENT SURVEYS.
  S 3. Paragraph (f) of subdivision 9 of section  367-a  of  the  social
services  law,  as  added by section 10-b of part H of chapter 59 of the
laws of 2011, is amended to read as follows:
  [(f) Notwithstanding any inconsistent provision of law  or  regulation
to  the contrary, the commissioner shall have the authority to establish
the amount of payments and dispensing fees under this  title  for  those
drugs  which  may not be dispensed without a prescription as required by
section sixty-eight hundred ten of  the  education  law  and  for  which
payment  is  authorized  pursuant to paragraph (g) of subdivision two of
section three hundred sixty-five-a of this title. The commissioner shall
not change the amounts of or method for such payments or dispensing fees
on or after April first, two thousand  eleven  unless  notice  is  given
sixty  days in advance of such change to the chairs of the committees on
senate finance, assembly ways and means,  senate  health,  and  assembly
health.]
  S 4. Intentionally omitted.
  S  5.  Paragraph (g-1) of subdivision 2 of section 365-a of the social
services law, as amended by section 23 of part H of chapter  59  of  the
laws of 2011, is amended to read as follows:
  (g-1)  drugs provided on an in-patient basis, those drugs contained on
the list established by regulation of the commissioner of health  pursu-
ant  to  subdivision four of this section, and those drugs which may not
be dispensed without a prescription as required by  section  sixty-eight
hundred  ten  of  the education law and which the commissioner of health
shall determine to be reimbursable based upon such factors as the avail-
ability of such drugs or alternatives at low  cost  if  purchased  by  a
medicaid  recipient,  or the essential nature of such drugs as described
by such commissioner in regulations, provided, however, that such drugs,
exclusive of long-term maintenance drugs, shall be dispensed in  quanti-
ties no greater than a thirty day supply or one hundred doses, whichever
is  greater; provided further that the commissioner of health is author-
ized to require prior authorization for any  refill  of  a  prescription
when  [less than seventy-five percent of the previously dispensed amount
per fill should have been used] MORE THAN A TEN DAY SUPPLY OF THE PREVI-
OUSLY DISPENSED AMOUNT SHOULD REMAIN were the product used  as  normally
indicated;  provided  further that the commissioner of health is author-
ized to require prior authorization of prescriptions of opioid  analges-
ics in excess of four prescriptions in a thirty-day period in accordance
with section two hundred seventy-three of the public health law; medical
assistance  shall  not include any drug provided on other than an in-pa-
tient basis for which a recipient is charged or a claim is made  in  the
case  of  a  prescription  drug,  in  excess of the maximum reimbursable
amounts to be established by department regulations in  accordance  with
standards  established  by the secretary of the United States department
of health and human services, or, in the case of a drug not requiring  a
prescription,  in  excess of the maximum reimbursable amount established

S. 6914                            114                           A. 9205

by the commissioner of health pursuant to paragraph (a)  of  subdivision
four of this section;
  S  6.  Paragraph  (i)  of subdivision 9 of section 367-a of the social
services law is REPEALED.
  S 7. Section 365-h of the social services law is amended by  adding  a
new subdivision 5 to read as follows:
  5.  NOTWITHSTANDING  ANY  CONTRARY  PROVISION  OF  LAW, AND SUBJECT TO
FEDERAL FINANCIAL PARTICIPATION, THE COMMISSIONER OF HEALTH  SHALL  MAKE
ADJUSTMENTS  TO PAYMENTS UNDER THIS SECTION, FOR THE PURPOSES OF PROVID-
ING INCREASED ACCESS TO MEDICAID NON-EMERGENCY TRANSPORTATION  IN  RURAL
COMMUNITIES.  UP  TO  TWO  MILLION  DOLLARS  SHALL BE AVAILABLE FOR SUCH
PURPOSES.
  S 8. The opening paragraph of  subdivision  1  and  subdivision  3  of
section  367-s  of  the social services law, as amended by section 38 of
part C of chapter 58 of the  laws  of  2008,  are  amended  to  read  as
follows:
  Notwithstanding  any  provision of law to the contrary, a supplemental
medical assistance payment shall be made on an annual basis to providers
of emergency medical transportation services in an aggregate amount  not
to exceed four million dollars for two thousand six, six million dollars
for  two  thousand  seven  [and],  six  million dollars for two thousand
eight, AND SIX MILLION DOLLARS FOR THE PERIOD MAY  FIRST,  TWO  THOUSAND
FOURTEEN  THROUGH  MARCH  THIRTY-FIRST, TWO THOUSAND FIFTEEN pursuant to
the following methodology:
  3. If all necessary approvals under federal law and regulation are not
obtained to receive federal  financial  participation  in  the  payments
authorized by this section, payments under this section shall be made in
an  aggregate  amount not to exceed two million dollars for two thousand
six, three million dollars for two thousand seven [and],  three  million
dollars  for two thousand eight AND THREE MILLION DOLLARS FOR THE PERIOD
MAY FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH THIRTY-FIRST,  TWO  THOU-
SAND  FIFTEEN.   In such case, the multiplier set forth in paragraph (b)
of subdivision one of this section shall be deemed  to  be  two  million
dollars or three million dollars as applicable to the annual period.
  S  9.  Subparagraph (iii) of paragraph (c) of subdivision 6 of section
367-a of the social services law, as amended by section 47 of part C  of
chapter 58 of the laws of 2009, is amended to read as follows:
  (iii)  Notwithstanding  any  other  provision  of  this paragraph, co-
payments charged for each generic prescription drug dispensed  shall  be
one  dollar and for each brand name prescription drug dispensed shall be
three dollars; provided, however, that the co-payments charged for  each
brand  name  prescription  drug  on  the preferred drug list established
pursuant to section two hundred seventy-two of the public health law OR,
FOR MANAGED CARE PROVIDERS OPERATING PURSUANT TO SECTION  THREE  HUNDRED
SIXTY-FOUR-J  OF  THIS TITLE, FOR EACH BRAND NAME PRESCRIPTION DRUG ON A
MANAGED CARE PROVIDER'S FORMULARY THAT SUCH PROVIDER HAS DESIGNATED AS A
PREFERRED  DRUG,  and  the  co-payments  charged  for  each  brand  name
prescription  drug reimbursed pursuant to subparagraph (ii) of paragraph
(a-1) of subdivision four of section three hundred sixty-five-a of  this
title shall be one dollar.
  S 10. Notwithstanding any inconsistent provision of law to the contra-
ry,  funds  shall be made available to the commissioner of the office of
mental health and the commissioner  of  the  office  of  alcoholism  and
substance  abuse  services,  in  consultation  with  the commissioner of
health and approved by the director  of  the  budget,  and  pursuant  to
appropriations  made therefor in an amount equal to the savings achieved

S. 6914                            115                           A. 9205

by the reductions described herein, to implement allocation plans devel-
oped by such commissioners, in consultation with the voluntary  agencies
providing  behavioral  health  services and local governmental units, as
defined  in  section  41.03  of  the  mental  hygiene  law, of the areas
impacted by reductions of  inpatient  behavioral  health  services,  and
which shall describe behavioral health services, including mental health
and  substance use disorder services, that are designed to amend service
needs resulting  from  the  reduction  of  inpatient  behavioral  health
services provided under the Medicaid program by programs licensed pursu-
ant  to  article  31  or 32 of the mental hygiene law. Such programs may
include programs that are licensed pursuant to both article  31  of  the
mental hygiene law and article 28 of the public health law, or certified
under  both  article  32 of the mental hygiene law and article 28 of the
public health law. The commissioner  of  health  shall  include  details
regarding  the  implementation of reinvestment allocation plans pursuant
to reductions of inpatient behavioral  health  services  in  the  annual
report  required  under section 45-c of part A of chapter 56 of the laws
of 2013.
  S 11. Section 365-m of the social services law is amended by adding  a
new subdivision 5 to read as follows:
  5. PURSUANT TO APPROPRIATIONS, THE DEPARTMENT OF HEALTH SHALL REINVEST
FUNDS  ALLOCATED  FOR BEHAVIORAL HEALTH SERVICES, WHICH ARE GENERAL FUND
SAVINGS DIRECTLY RELATED TO SAVINGS REALIZED THROUGH THE  TRANSITION  OF
POPULATIONS  COVERED  BY  THIS  SECTION  FROM  THE  APPLICABLE  MEDICAID
FEE-FOR-SERVICE SYSTEM  TO  A  MANAGED  CARE  MODEL,  INCLUDING  SAVINGS
RESULTING  FROM  THE  REDUCTION  OF  INPATIENT AND OUTPATIENT BEHAVIORAL
HEALTH SERVICES PROVIDED UNDER THE MEDICAID PROGRAMS LICENSED OR  CERTI-
FIED  PURSUANT TO ARTICLE THIRTY-ONE OR THIRTY-TWO OF THE MENTAL HYGIENE
LAW, OR PROGRAMS THAT ARE LICENSED PURSUANT TO BOTH  ARTICLE  THIRTY-ONE
OF  THE MENTAL HYGIENE LAW AND ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH
LAW, OR CERTIFIED UNDER BOTH ARTICLE THIRTY-TWO OF  THE  MENTAL  HYGIENE
LAW  AND  ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW, FOR THE PURPOSE
OF INCREASING INVESTMENT IN COMMUNITY BASED BEHAVIORAL HEALTH  SERVICES,
INCLUDING RESIDENTIAL SERVICES CERTIFIED BY THE OFFICE OF ALCOHOLISM AND
SUBSTANCE  ABUSE  SERVICES.  THE  METHODOLOGIES  USED  TO  CALCULATE THE
SAVINGS SHALL BE DEVELOPED BY THE COMMISSIONER OF HEALTH AND THE  DIREC-
TOR  OF  THE BUDGET IN CONSULTATION WITH THE COMMISSIONERS OF THE OFFICE
OF MENTAL HEALTH AND  THE  OFFICE  OF  ALCOHOLISM  AND  SUBSTANCE  ABUSE
SERVICES. IN NO EVENT SHALL THE FULL ANNUAL VALUE OF THE COMMUNITY BASED
BEHAVIORAL HEALTH SERVICE REINVESTMENT SAVINGS ATTRIBUTABLE TO THE TRAN-
SITION  TO  MANAGED CARE EXCEED THE TWELVE MONTH VALUE OF THE DEPARTMENT
OF HEALTH GENERAL FUND REDUCTIONS RESULTING FROM SUCH TRANSITION. WITHIN
ANY FISCAL YEAR WHERE APPROPRIATION INCREASES ARE RECOMMENDED FOR  REIN-
VESTMENT,  INSOFAR  AS  MANAGED  CARE TRANSITION SAVINGS DO NOT OCCUR AS
ESTIMATED, AND GENERAL FUND SAVINGS DO NOT  RESULT,  THEN  SPENDING  FOR
SUCH REINVESTMENT MAY BE REDUCED IN THE NEXT YEAR'S ANNUAL BUDGET ITEMI-
ZATION.  THE  COMMISSIONER  OF  HEALTH SHALL PROMULGATE REGULATIONS, AND
PRIOR TO OCTOBER FIRST, TWO THOUSAND FIFTEEN, MAY  PROMULGATE  EMERGENCY
REGULATIONS  AS  REQUIRED  TO DISTRIBUTE FUNDS PURSUANT TO THIS SUBDIVI-
SION; PROVIDED, HOWEVER,  THAT  ANY  EMERGENCY  REGULATIONS  PROMULGATED
PURSUANT   TO   THIS   SECTION  SHALL  EXPIRE  NO  LATER  THAN  DECEMBER
THIRTY-FIRST, TWO  THOUSAND  FIFTEEN.  THE  COMMISSIONER  SHALL  INCLUDE
DETAILED  DESCRIPTIONS  OF THE METHODOLOGY USED TO CALCULATE SAVINGS FOR
REINVESTMENT, THE RESULTS OF APPLYING SUCH  METHODOLOGIES,  THE  DETAILS
REGARDING  IMPLEMENTATION OF SUCH REINVESTMENT PURSUANT TO THIS SECTION,
AND ANY REGULATIONS PROMULGATED UNDER THIS SUBDIVISION,  IN  THE  ANNUAL

S. 6914                            116                           A. 9205

REPORT  REQUIRED  UNDER  SECTION  FORTY-FIVE-C  OF  PART  A  OF  CHAPTER
FIFTY-SIX OF THE LAWS OF TWO THOUSAND THIRTEEN.
  S  12.  Notwithstanding  any law, rule, or regulation to the contrary,
the commissioner of health, in consultation with the commissioner of the
office of mental health and the commissioner of the office of alcoholism
and substance abuse services, is authorized to  establish  an  evidence-
based,  collaborative  care  clinical delivery model in clinics licensed
under article 28 of the public health law, for the purpose of  improving
the  detection of depression and other diagnosed mental or substance use
disorders and the treatment of individuals with such  conditions  in  an
integrated  manner.    Such  commissioner shall be authorized to develop
criteria for the designation of clinics to be providers of collaborative
care services.   At a minimum, such  designated  clinics  shall  provide
screening  for depression and substance use disorders, medical diagnosis
of patients who screen  positive,  evidence-based  depression  care  and
substance  use disorder referrals, ongoing tracking of patient progress,
care management, and a designated  behavioral  health  practitioner  who
consults  with the care manager and primary care physician. The rates of
payment and billing rules for this service  will  be  developed  by  the
commissioner  of  health,  in  consultation with the commissioner of the
office of mental health and the commissioner of the office of alcoholism
and substance abuse services, and with the approval of the  director  of
the  budget.  Such commissioners are authorized to waive any duplicative
regulatory requirements as may be necessary to  allow  this  service  to
function  in  an effective and efficient manner; provided, however, that
regulations pertaining to patient safety may not be  waived,  nor  shall
any  regulation be waived if such waiver would risk patient safety. Such
waiver shall not exceed the life of the project, or  such  shorter  time
period  as  the authorizing commissioner may determine. The commissioner
of health shall include details  regarding  the  implementation  of  the
collaborative  care  clinical  delivery model, including any regulations
waived and the frequency and rationale for such waivers, in  the  annual
report under section 45-c of part A of chapter 56 of the laws of 2013.
  S  12-a. Paragraph (c) of subdivision 2 of section 365-a of the social
services law, as amended by section 24 of part A of chapter  56  of  the
laws of 2013, is amended to read as follows:
  (c)  out-patient hospital or clinic services in facilities operated in
compliance with applicable provisions of this chapter, the public health
law, the mental hygiene law and other  laws,  including  any  provisions
thereof requiring an operating certificate or license, including facili-
ties  authorized by the appropriate licensing authority to provide inte-
grated mental health services, and/or  alcoholism  and  substance  abuse
services,  and/or  physical  health services, and/or services to persons
with developmental disabilities, when such services are  provided  at  a
single  location  or  service  site,  or  where  such facilities are not
conveniently accessible, in any hospital located  [without]  WITHIN  the
state  and  care and services in a day treatment program operated by the
department of mental hygiene or by a voluntary agency under an agreement
with such department in that part of a public institution  operated  and
approved  pursuant  to  law as an intermediate care facility for persons
with developmental disabilities; AND PROVIDED, THAT THE COMMISSIONERS OF
HEALTH, MENTAL HEALTH, ALCOHOLISM AND SUBSTANCE ABUSE SERVICES  AND  THE
OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES MAY ISSUE REGULATIONS,
INCLUDING  EMERGENCY REGULATIONS PROMULGATED PRIOR TO OCTOBER FIRST, TWO
THOUSAND FIFTEEN THAT ARE REQUIRED TO FACILITATE  THE  ESTABLISHMENT  OF
INTEGRATED SERVICES CLINICS. ANY SUCH REGULATIONS PROMULGATED UNDER THIS

S. 6914                            117                           A. 9205

PARAGRAPH  SHALL  BE DESCRIBED IN THE ANNUAL REPORT REQUIRED PURSUANT TO
SECTION FORTY-FIVE-C OF PART A OF CHAPTER FIFTY-SIX OF THE LAWS  OF  TWO
THOUSAND THIRTEEN;
  S  13. Section 48-a of part A of chapter 56 of the laws of 2013 amend-
ing chapter 59 of the laws of 2011 amending the public  health  law  and
other  laws  relating to general hospital reimbursement for annual rates
relating to the cap on local Medicaid expenditures, is amended  to  read
as follows:
  S  48-a.  Notwithstanding  any contrary provision of law, the [commis-
sioner] COMMISSIONERS OF THE OFFICE of alcoholism  and  substance  abuse
services [is] AND THE OFFICE OF MENTAL HEALTH ARE authorized, subject to
the  approval  of the director of the budget, to transfer to the commis-
sioner of health state funds to be utilized as the state share  for  the
purpose  of  increasing  payments  under the medicaid program to managed
care organizations licensed under article 44 of the public health law or
under article 43 of the insurance law. Such managed  care  organizations
shall  utilize such funds for the purpose of reimbursing [hospital-based
and free-standing chemical dependence outpatient  and  opioid  treatment
clinics]  PROVIDERS licensed pursuant to article 28 of the public health
law or article 31 OR 32 of the mental hygiene law for [chemical  depend-
ency]  AMBULATORY  BEHAVIORAL  HEALTH  services,  as  determined  by the
commissioner of health, in consultation with the commissioner  of  alco-
holism  and  substance abuse services AND THE COMMISSIONER OF THE OFFICE
OF MENTAL  HEALTH,  provided  to  medicaid  eligible  outpatients.  Such
reimbursement  shall  be in the form of fees for such services which are
equivalent to the payments established for such services under the ambu-
latory patient group (APG) rate-setting methodology as utilized  by  the
department  of  health  [or  by], the office of alcoholism and substance
abuse  services,  OR  THE  OFFICE  OF  MENTAL  HEALTH  for  rate-setting
purposes;  provided,  however, that the increase to such fees that shall
result from the provisions of this section shall not, in  the  aggregate
and  as  determined  by the commissioner of health, in consultation with
the commissioner of alcoholism and  substance  abuse  services  AND  THE
COMMISSIONER  OF  THE  OFFICE  OF  MENTAL  HEALTH,  be  greater than the
increased funds made available pursuant to this section.   THE  INCREASE
OF  SUCH  AMBULATORY BEHAVIORAL HEALTH FEES TO PROVIDERS AVAILABLE UNDER
THIS SECTION SHALL BE FOR ALL RATE PERIODS ON AND  AFTER  THE  EFFECTIVE
DATE  OF  THE  CHAPTER  OF  THE  LAWS OF 2014 WHICH AMENDED THIS SECTION
THROUGH DECEMBER 31, 2016 FOR PATIENTS IN THE CITY OF NEW YORK, FOR  ALL
RATE  PERIODS ON AND AFTER THE EFFECTIVE DATE OF THE CHAPTER OF THE LAWS
OF 2014 WHICH AMENDED THIS SECTION THROUGH JUNE 30,  2017  FOR  PATIENTS
OUTSIDE  THE CITY OF NEW YORK, AND FOR ALL RATE PERIODS ON AND AFTER THE
EFFECTIVE DATE OF SUCH CHAPTER OF THE LAWS OF 2014  WHICH  AMENDED  THIS
SECTION  THROUGH  DECEMBER 31, 2017 FOR ALL SERVICES PROVIDED TO PERSONS
UNDER THE AGE OF TWENTY-ONE; PROVIDED, HOWEVER, THAT MANAGED CARE ORGAN-
IZATIONS AND PROVIDERS MAY NEGOTIATE  DIFFERENT  RATES  AND  METHODS  OF
PAYMENT  DURING SUCH PERIODS DESCRIBED ABOVE, SUBJECT TO THE APPROVAL OF
THE DEPARTMENT OF HEALTH. THE DEPARTMENT OF HEALTH  SHALL  CONSULT  WITH
THE  OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES AND THE OFFICE OF
MENTAL HEALTH IN DETERMINING WHETHER SUCH  ALTERNATIVE  RATES  SHALL  BE
APPROVED.  The  commissioner  of  health  may,  in consultation with the
commissioner of alcoholism and substance abuse services AND THE  COMMIS-
SIONER OF THE OFFICE OF MENTAL HEALTH, promulgate regulations, including
emergency  regulations PROMULGATED PRIOR TO OCTOBER 1, 2015 TO ESTABLISH
RATES FOR AMBULATORY BEHAVIORAL HEALTH SERVICES,  as  are  necessary  to
implement  the  provisions of this section. RATES PROMULGATED UNDER THIS

S. 6914                            118                           A. 9205

SECTION SHALL BE INCLUDED IN THE REPORT REQUIRED UNDER SECTION  45-C  OF
PART A OF THIS CHAPTER.
  S  14. Subdivision 8 of section 84 of part A of chapter 56 of the laws
of 2013, amending chapter 59 of the laws of  2011  amending  the  public
health law and other laws relating to general hospital reimbursement for
annual  rates  relating  to  the  cap on local Medicaid expenditures, is
amended to read as follows:
  8. section forty-eight-a of  this  act  shall  expire  and  be  deemed
repealed [March 31, 2016] JANUARY 1, 2018;
  S  15. Section 1 of part H of chapter 111 of the laws of 2010 relating
to increasing Medicaid payments to providers through managed care organ-
izations and providing equivalent fees  through  an  ambulatory  patient
group methodology, is amended to read as follows:
  Section  1.    Notwithstanding  any  contrary  provision  of  law, the
[commissioner] COMMISSIONERS of mental health [is]  AND  ALCOHOLISM  AND
SUBSTANCE  ABUSE SERVICES ARE authorized, subject to the approval of the
director of the budget, to transfer to the commissioner of health  state
funds  to  be  utilized as the state share for the purpose of increasing
payments under  the  medicaid  program  to  managed  care  organizations
licensed  under  article 44 of the public health law or under article 43
of the insurance law. Such managed care organizations shall utilize such
funds for the purpose of reimbursing [hospital-based  and  free-standing
clinics]  PROVIDERS licensed pursuant to article 28 of the public health
law, OR pursuant to article 31 OR ARTICLE 32 of the mental  hygiene  law
[or pursuant to both such provisions of law for outpatient mental health
services]  FOR  AMBULATORY  BEHAVIORAL HEALTH SERVICES, as determined by
the commissioner of health in  consultation  with  the  commissioner  of
mental  health  AND  COMMISSIONER  OF  ALCOHOLISM  AND  SUBSTANCE  ABUSE
SERVICES, provided to medicaid eligible outpatients. Such  reimbursement
shall  be  in the form of fees for such services which are equivalent to
the payments established for such services under the ambulatory  patient
group  (APG)  rate-setting  methodology as utilized by the department of
health or by the office of mental health OR  OFFICE  OF  ALCOHOLISM  AND
SUBSTANCE  ABUSE  SERVICES for rate-setting purposes; provided, however,
that the increase to such fees that shall result from the provisions  of
this  section  shall  not,  in  the  aggregate  and as determined by the
commissioner of health in consultation with the  [commissioner]  COMMIS-
SIONERS of mental health AND ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, be
greater  than  the  increased  funds  made  available  pursuant  to this
section. THE INCREASE OF SUCH BEHAVIORAL HEALTH FEES TO PROVIDERS AVAIL-
ABLE UNDER THIS SECTION SHALL BE FOR ALL RATE PERIODS ON AND  AFTER  THE
EFFECTIVE  DATE  OF  THE  CHAPTER OF THE LAWS OF 2014 WHICH AMENDED THIS
SECTION THROUGH DECEMBER 31, 2016 FOR PATIENTS IN THE CITY OF NEW  YORK,
FOR  ALL  RATE PERIODS ON AND AFTER THE EFFECTIVE DATE OF THE CHAPTER OF
THE LAWS OF 2014 WHICH AMENDED THIS SECTION THROUGH JUNE  30,  2017  FOR
PATIENTS  OUTSIDE  THE CITY OF NEW YORK, AND FOR ALL RATE PERIODS ON AND
AFTER THE EFFECTIVE DATE OF THE  CHAPTER  OF  THE  LAWS  OF  2014  WHICH
AMENDED THIS SECTION THROUGH DECEMBER 31, 2017 FOR ALL SERVICES PROVIDED
TO  PERSONS UNDER THE AGE OF TWENTY-ONE; PROVIDED, HOWEVER, THAT MANAGED
CARE ORGANIZATIONS AND PROVIDERS MAY NEGOTIATE DIFFERENT RATES AND METH-
ODS OF PAYMENT DURING SUCH PERIODS DESCRIBED, SUBJECT TO THE APPROVAL OF
THE DEPARTMENT OF HEALTH. THE DEPARTMENT OF HEALTH  SHALL  CONSULT  WITH
THE  OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES AND THE OFFICE OF
MENTAL HEALTH IN DETERMINING WHETHER SUCH  ALTERNATIVE  RATES  SHALL  BE
APPROVED.  The  commissioner  of  health  may,  in consultation with the
[commissioner]  COMMISSIONERS  of  mental  health  AND  ALCOHOLISM   AND

S. 6914                            119                           A. 9205

SUBSTANCE  ABUSE  SERVICES,  promulgate regulations, including emergency
regulations PROMULGATED PRIOR TO OCTOBER 1, 2013  THAT  ESTABLISH  RATES
FOR  BEHAVIORAL  HEALTH  SERVICES,  as  are  necessary  to implement the
provisions  of  this section. RATES PROMULGATED UNDER THIS SECTION SHALL
BE INCLUDED IN THE REPORT REQUIRED UNDER SECTION 45-C OF PART A OF CHAP-
TER 56 OF THE LAWS OF 2013.
  S 16. Section 2 of part H of chapter 111 of the laws of 2010, relating
to increasing Medicaid payments to providers through managed care organ-
izations and providing equivalent fees  through  an  ambulatory  patient
group  methodology,  as amended by section 49 of part A of chapter 56 of
the laws of 2013, is amended to read as follows:
  S 2. This act shall take effect immediately and  shall  be  deemed  to
have been in full force and effect on and after April 1, 2010, and shall
expire on [March 31, 2016] JANUARY 1, 2018.
  S  16-a.  Section  45-c  of  part A of chapter 56 of the laws of 2013,
relating to the report on the transition of behavioral  health  services
as  a managed care benefit in the medical assistance program, is amended
to read as follows:
  S 45-c. The commissioner of health in consultation  with  the  commis-
sioners  of the office of mental health and the office of alcoholism and
substance abuse SERVICES shall prepare a report  on  the  transition  of
behavioral  health  services  as  a  managed care benefit in the medical
assistance program.   Such report shall  examine  (i)  the  adequacy  of
rates;  (ii)  the  ability  of  managed care plans to arrange and manage
covered services for eligible enrollees; (iii) the  ability  of  managed
care plans to provide an adequate network of providers to meet the needs
of  enrollees;  (iv)  the  use  of evidence based tools or guidelines by
managed care plans when determining the appropriate  level  of  care  or
coverage for enrollees; (v) the ability of managed care plans to provide
eligible  enrollees  with  both  the  appropriate  amount  and  type  of
services; (vi) the quality assurance mechanisms  used  by  managed  care
plans,  including  processes  to ensure enrollee satisfaction; (vii) the
manner in which managed care plans address the cultural  and  linguistic
needs  of  enrollees;  [and]  (viii)  any other quality of care criteria
deemed appropriate by the commissioners to ensure the adequacy of rates,
continuity of care and the quality of life, health, and safety of enrol-
lees during the  transition  of  the  behavioral  health  benefit;  (IX)
DETAILS  REGARDING  THE  IMPLEMENTATION OF REINVESTMENT ALLOCATION PLANS
PURSUANT TO REDUCTIONS OF INPATIENT BEHAVIORAL HEALTH  SERVICES  INCLUD-
ING,  BUT  NOT  LIMITED, TO THE LOCATION AND SCOPE OF SERVICE REDUCTIONS
RESULTING FROM THE REDUCTION OR CLOSURE OF PROGRAMS LICENSED PURSUANT TO
ARTICLE 31 OR 32 OF THE MENTAL HYGIENE LAW AND A DESCRIPTION OF SERVICES
TO BE FUNDED PURSUANT TO ALLOCATION PLANS; (X) DETAILED DESCRIPTIONS  OF
THE  METHODOLOGY  USED TO CALCULATE THE AMOUNT OF SAVINGS RESULTING FROM
THE TRANSITION OF INDIVIDUALS INTO MANAGED CARE REALIZED UNDER  SUBDIVI-
SION  5  OF  SECTION 365-M OF THE SOCIAL SERVICES LAW, AND THE MANNER IN
WHICH THE REINVESTMENT WILL ADDRESS  THE  SERVICE  NEEDS;  (XI)  DETAILS
REGARDING THE IMPLEMENTATION OF THE COLLABORATIVE CARE CLINICAL DELIVERY
MODEL; (XII) A DESCRIPTION OF, AND RATIONALE FOR, ANY WAIVER OF EXISTING
REGULATIONS OR ANY PROMULGATION OF EMERGENCY REGULATIONS PURSUANT TO THE
BEHAVIORAL  HEALTH SERVICES TRANSITION AUTHORIZED BY SECTIONS 10 THROUGH
17 OF PART C OF A CHAPTER  OF  THE  LAWS  OF  2014  WHICH  AMENDED  THIS
SECTION, RELATING TO THE IMPLEMENTATION OF THE HEALTH AND MENTAL HYGIENE
BUDGET;  (XIII)  IMPLEMENTATION  OF  INFRASTRUCTURE  AND  ORGANIZATIONAL
MODIFICATIONS AND  INVESTMENTS  IN  HEALTH  INFORMATION  TECHNOLOGY  AND
TRAINING  AND  TECHNICAL  ASSISTANCE;  AND  (XIV)  DETAILS REGARDING THE

S. 6914                            120                           A. 9205

IMPLEMENTATION OF THE PLAN TO TRANSITION ADULT AND CHILDREN'S BEHAVIORAL
HEALTH PROVIDERS AND SERVICES INTO MANAGED CARE. [The  report  shall  be
submitted  no later than April first, two thousand sixteen to the gover-
nor, the temporary president of the senate, the speaker of the assembly,
the minority leader of the senate, and the minority leader of the assem-
bly.]  THE REPORT SHALL BE SUBMITTED ON AN ANNUAL BASIS TO THE GOVERNOR,
THE TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF THE ASSEMBLY,  THE
MINORITY  LEADER OF THE SENATE, THE MINORITY LEADER OF THE ASSEMBLY, AND
THE BEHAVIORAL HEALTH SUBCOMMITTEE OF THE  MEDICAID  REDESIGN  TEAM,  NO
LATER THAN JANUARY FIRST OF EACH YEAR.
  S 16-b. Section 84 of part A of chapter 56 of the laws of 2013, amend-
ing the public health law and other laws relating to state health mental
hygiene budget for the 2013-14 state fiscal year, is amended by adding a
new subdivision 7-a to read as follows:
  7-A.  SECTION  FORTY-FIVE-C  OF  THIS  ACT  SHALL EXPIRE AND BE DEEMED
REPEALED JANUARY 1, 2018;
  S 17. Subject to the availability of federal financial  participation,
the  commissioner  of health is authorized, within amounts appropriated,
to distribute funds to local governmental units, as defined  in  section
41.03  of  the mental hygiene law, to Medicaid managed care plans certi-
fied by the department  of  health,  health  homes  designated  by  such
department,  and  individual behavioral health providers and consortiums
of such providers licensed or certified by the office of  mental  health
or  the office of alcoholism and substance abuse services to prepare for
the transition of adult and children's behavioral health  providers  and
services  into  managed care. The use of such funds may include, but not
be limited  to,  infrastructure  and  organizational  modifications  and
investments  in health information technology and training and technical
assistance. Such funds shall be distributed pursuant to  a  plan  to  be
developed  by  the  commissioner  of  health,  in  consultation with the
commissioners of the office of mental health and the office of  alcohol-
ism  and substance abuse services. In developing such plan, such commis-
sioners may take into account the size and scope of  a  grantee's  oper-
ations  as a factor relevant to eligibility for, and the amount of, such
funds. The commissioner of health is authorized to audit  recipients  of
funds  under  this  section to ensure compliance and to recoup any funds
determined to have been used for purposes other than as described herein
or otherwise approved by such commissioners.   The  commissioners  shall
include  details  regarding the implementation of the plan to transition
adult and children's  behavioral  health  providers  and  services  into
managed  care in the annual report required under section 45-c of part A
of chapter 56 of the laws of 2013.
  S 18. The commissioner of health is authorized to establish a disabil-
ity clinician advisory group of experienced clinicians and clinic admin-
istrators who have an understanding of the comprehensive needs of people
with disabilities. Such group shall provide  the  commissioner  and  the
department  of  health  with information and data on the effect of poli-
cies,  including  proposed  regulations  or  statutes,  and  of   fiscal
proposals, including rate setting and appropriations, on the delivery of
supports  and  services  for individuals with disabilities including but
not limited to the role of specialty services.
  S 19. Paragraph (i) of subdivision 38  of  section  2  of  the  social
services law, as added by section 63 of part H of chapter 59 of the laws
of 2011, is amended to read as follows:
  (i)  "Participating  provider"  means  a certified home health agency,
long term home health agency or personal care provider with total  medi-

S. 6914                            121                           A. 9205

caid  reimbursements,  INCLUDING REIMBURSEMENTS THROUGH THE MANAGED CARE
PROGRAM ESTABLISHED PURSUANT TO SECTION THREE  HUNDRED  SIXTY-FOUR-J  OF
THIS CHAPTER, exceeding fifteen million dollars per calendar year.
  S  20.  The  opening paragraph of section 363-e of the social services
law, as added by section 64 of part H of chapter 59 of the laws of 2011,
is amended to read as follows:
  THE DEPARTMENT OF HEALTH AND THE  OFFICE  OF  THE  MEDICAID  INSPECTOR
GENERAL  SHALL  JOINTLY  DEVELOP REQUIREMENTS FOR PRECLAIM REVIEW. Every
service or item within a claim OR ENCOUNTER submitted by a participating
provider shall be reviewed and verified by a  verification  organization
prior  to submission of a claim OR ENCOUNTER to the department of health
OR TO A MANAGED CARE PROVIDER AS DEFINED IN PARAGRAPH (B) OF SUBDIVISION
ONE OF SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE.  The  verifica-
tion  organization  shall declare each service or item to be verified or
unverified. Each  participating  provider  shall  receive  and  maintain
reports from the verification organization which shall contain data on:
  S  21.  The  opening paragraph of subdivision 1 of section 20-c of the
social services law, as added by section 151 of part B of chapter 436 of
the laws of 1997, is amended to read as follows:
  (A) Except as otherwise specified  in  the  appropriation  for  system
support  and  information  services  program  in the office of temporary
disability assistance within the department of family assistance, OR  AS
AUTHORIZED  BY  SUBDIVISION TWO-A OF SECTION TWENTY-TWO OF THIS ARTICLE,
the department shall not enter into any contract with a  private  entity
under  which  that entity would perform any of the public assistance and
care eligibility determination functions, duties or obligations  of  the
department as set forth in this chapter.
  S 22. Section 22 of the social services law is amended by adding a new
subdivision 2-a to read as follows:
  2-A.  WITH  REGARD  TO  FAIR  HEARINGS HELD IN CONNECTION WITH APPEALS
UNDER THE FULLY INTEGRATED DUALS ADVANTAGE  DEMONSTRATION  PROGRAM,  THE
COMMISSIONER MAY CONTRACT FOR THE SOLE PURPOSE OF ASSISTING STAFF OF THE
OFFICE FOR SUCH PURPOSE.
  S  23.  Subdivision  2-c  of  section 2808 of the public health law is
amended by adding a new paragraph (e) to read as follows:
  (E) WITH THE EXCEPTION OF THOSE ENROLLEES COVERED UNDER A PAYMENT RATE
METHODOLOGY AGREEMENT NEGOTIATED WITH A RESIDENTIAL HEALTH CARE  FACILI-
TY,  PAYMENTS  FOR  INPATIENT  RESIDENTIAL HEALTH CARE FACILITY SERVICES
PROVIDED TO PATIENTS ELIGIBLE FOR MEDICAL ASSISTANCE PURSUANT  TO  TITLE
ELEVEN  OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW MADE BY ORGANIZATIONS
OPERATING IN ACCORDANCE WITH THE PROVISIONS  OF  ARTICLE  FORTY-FOUR  OF
THIS  CHAPTER OR BY HEALTH MAINTENANCE ORGANIZATIONS ORGANIZED AND OPER-
ATING IN ACCORDANCE WITH ARTICLE FORTY-THREE OF THE INSURANCE LAW, SHALL
BE THE RATES OF PAYMENT THAT WOULD BE PAID FOR SUCH PATIENTS  UNDER  THE
MEDICAL  ASSISTANCE  PROGRAM  AS DETERMINED PURSUANT TO THIS SECTION AND
SUBDIVISION TEN OF SECTION TWENTY-EIGHT HUNDRED SEVEN-D OF THIS  ARTICLE
AND AS IN EFFECT AT THE TIME SUCH SERVICES WERE PROVIDED. THE PROVISIONS
OF  THIS PARAGRAPH SHALL NOT APPLY TO PAYMENTS FOR PATIENTS WHOSE PLACE-
MENT IN A RESIDENTIAL HEALTH CARE FACILITY IS FOR THE PURPOSE OF RECEIV-
ING TIME-LIMITED REHABILITATION, TO BE FOLLOWED BY  DISCHARGE  FROM  THE
FACILITY, DURING THE PERIOD SUCH TIME-LIMITED SERVICES ARE PROVIDED.
  S  24. Section 365-f of the social services law is amended by adding a
new subdivision 9 to read as follows:
  9. NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW AND  SUBJECT  TO  THE
AVAILABILITY  OF  FEDERAL  FINANCIAL  PARTICIPATION,  FOR PERIODS ON AND
AFTER APRIL FIRST, TWO THOUSAND FOURTEEN, THE COMMISSIONER IS AUTHORIZED

S. 6914                            122                           A. 9205

TO MAKE TEMPORARY PERIODIC LUMP-SUM MEDICAID PAYMENTS TO FISCAL INTERME-
DIARIES PRINCIPALLY ENGAGED  IN  PROVIDING  CONSUMER  DIRECTED  PERSONAL
ASSISTANCE SERVICES TO MEDICAID PATIENTS, IN ACCORDANCE WITH THE FOLLOW-
ING:
  (A) ELIGIBLE FISCAL INTERMEDIARIES SHALL INCLUDE:
  (I)  PROVIDERS  UNDERGOING  CLOSURE  OR  SUBSTANTIAL  REDUCTION IN THE
VOLUME OF CARE;
  (II) PROVIDERS IMPACTED BY THE CLOSURE OF OTHER HEALTH CARE PROVIDERS;
  (III) PROVIDERS SUBJECT TO MERGERS,  ACQUISITIONS,  CONSOLIDATIONS  OR
RESTRUCTURING;
  (IV)  PROVIDERS  IMPACTED BY THE MERGER, ACQUISITION, CONSOLIDATION OR
RESTRUCTURING OF OTHER HEALTH CARE PROVIDERS;
  (V) PROVIDERS SEEKING TO ENSURE THAT ACCESS TO CARE IS  MAINTAINED  OR
INCREASED; OR
  (VI)  ON  OR  AFTER  JANUARY  FIRST,  TWO  THOUSAND FIFTEEN, PROVIDERS
IMPACTED BY CHANGES TO THE FAIR LABOR STANDARDS ACT  REQUIRING  OVERTIME
PAY FOR PERSONAL ASSISTANTS WORKING IN EXCESS OF FORTY HOURS PER WEEK.
  (B)  PROVIDERS  SEEKING MEDICAID PAYMENTS UNDER THIS SUBDIVISION SHALL
DEMONSTRATE THROUGH SUBMISSION OF A WRITTEN PROPOSAL TO THE COMMISSIONER
THAT THE ADDITIONAL RESOURCES PROVIDED BY SUCH  MEDICAID  PAYMENTS  WILL
ACHIEVE ONE OR MORE OF THE FOLLOWING:
  (I) PROTECT OR ENHANCE ACCESS TO CARE;
  (II) PROTECT OR ENHANCE QUALITY OF CARE;
  (III)  IMPROVE  THE  COST EFFECTIVENESS OF THE DELIVERY OF HEALTH CARE
SERVICES; OR
  (IV) OTHERWISE PROTECT OR ENHANCE THE HEALTH CARE DELIVERY SYSTEM,  AS
DETERMINED BY THE COMMISSIONER.
  (C)(I) SUCH WRITTEN PROPOSAL SHALL BE SUBMITTED TO THE COMMISSIONER AT
LEAST  SIXTY  DAYS  PRIOR TO THE REQUESTED COMMENCEMENT OF SUCH MEDICAID
PAYMENTS AND SHALL INCLUDE A PROPOSED BUDGET TO ACHIEVE THE GOALS OF THE
PROPOSAL. ANY MEDICAID PAYMENTS  ISSUED  PURSUANT  TO  THIS  SUBDIVISION
SHALL  BE  MADE  OVER  A  SPECIFIED PERIOD OF TIME, AS DETERMINED BY THE
COMMISSIONER, OF UP  TO  THREE  YEARS.  AT  THE  END  OF  THE  SPECIFIED
TIME-FRAME SUCH PAYMENTS SHALL CEASE. THE COMMISSIONER MAY ESTABLISH, AS
A CONDITION OF RECEIVING SUCH MEDICAID PAYMENTS, BENCHMARKS AND GOALS TO
BE  ACHIEVED  IN  CONFORMITY  WITH  THE  PROVIDER'S  WRITTEN PROPOSAL AS
APPROVED BY THE COMMISSIONER AND MAY  ALSO  REQUIRE  THAT  THE  PROVIDER
SUBMIT  SUCH  PERIODIC REPORTS CONCERNING THE ACHIEVEMENT OF SUCH BENCH-
MARKS AND GOALS AS THE COMMISSIONER DEEMS NECESSARY. FAILURE TO  ACHIEVE
SATISFACTORY PROGRESS, AS DETERMINED BY THE COMMISSIONER, IN ACCOMPLISH-
ING SUCH BENCHMARKS AND GOALS SHALL BE A BASIS FOR ENDING THE PROVIDER'S
MEDICAID PAYMENTS PRIOR TO THE END OF THE SPECIFIED TIMEFRAME.
  (II) THE COMMISSIONER MAY REQUIRE THAT APPLICATIONS SUBMITTED PURSUANT
TO THIS SUBDIVISION BE SUBMITTED IN RESPONSE TO AND IN ACCORDANCE WITH A
REQUEST  FOR  APPLICATIONS  OR  A  REQUEST  FOR  PROPOSALS ISSUED BY THE
COMMISSIONER.
  S 25. Section 3605 of the public health law is amended by adding a new
subdivision 14 to read as follows:
  14. NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW AND SUBJECT  TO  THE
AVAILABILITY  OF  FEDERAL  FINANCIAL  PARTICIPATION,  FOR PERIODS ON AND
AFTER APRIL FIRST, TWO THOUSAND FOURTEEN, THE COMMISSIONER IS AUTHORIZED
TO MAKE TEMPORARY PERIODIC LUMP-SUM MEDICAID PAYMENTS TO  LICENSED  HOME
CARE  SERVICE  AGENCIES  ("LHCSA") PRINCIPALLY ENGAGED IN PROVIDING HOME
HEALTH SERVICES TO MEDICAID PATIENTS, IN ACCORDANCE WITH THE FOLLOWING:
  (A) ELIGIBLE LHCSA PROVIDERS SHALL INCLUDE:
  (I) PROVIDERS UNDERGOING CLOSURE;

S. 6914                            123                           A. 9205

  (II) PROVIDERS IMPACTED BY THE CLOSURE OF OTHER HEALTH CARE PROVIDERS;
  (III)  PROVIDERS  SUBJECT  TO MERGERS, ACQUISITIONS, CONSOLIDATIONS OR
RESTRUCTURING;
  (IV) PROVIDERS IMPACTED BY THE MERGER, ACQUISITION,  CONSOLIDATION  OR
RESTRUCTURING OF OTHER HEALTH CARE PROVIDERS; OR
  (V) PROVIDERS SEEKING TO ENSURE THAT ACCESS TO CARE IS MAINTAINED.
  (B)  PROVIDERS  SEEKING MEDICAID PAYMENTS UNDER THIS SUBDIVISION SHALL
DEMONSTRATE THROUGH SUBMISSION OF A WRITTEN PROPOSAL TO THE COMMISSIONER
THAT THE ADDITIONAL RESOURCES PROVIDED BY SUCH  MEDICAID  PAYMENTS  WILL
ACHIEVE ONE OR MORE OF THE FOLLOWING:
  (I) PROTECT OR ENHANCE ACCESS TO CARE;
  (II) PROTECT OR ENHANCE QUALITY OF CARE;
  (III)  IMPROVE  THE  COST EFFECTIVENESS OF THE DELIVERY OF HEALTH CARE
SERVICES; OR
  (IV) OTHERWISE PROTECT OR ENHANCE THE HEALTH CARE DELIVERY SYSTEM,  AS
DETERMINED BY THE COMMISSIONER.
  (C)  (I)  SUCH WRITTEN PROPOSAL SHALL BE SUBMITTED TO THE COMMISSIONER
AT LEAST SIXTY DAYS PRIOR TO THE REQUESTED COMMENCEMENT OF SUCH MEDICAID
PAYMENTS AND SHALL INCLUDE A PROPOSED BUDGET TO ACHIEVE THE GOALS OF THE
PROPOSAL. ANY MEDICAID PAYMENTS  ISSUED  PURSUANT  TO  THIS  SUBDIVISION
SHALL  BE  MADE  OVER  A  SPECIFIED PERIOD OF TIME, AS DETERMINED BY THE
COMMISSIONER, OF UP TO THREE YEARS. AT THE END OF  THE  SPECIFIED  TIME-
FRAME  SUCH  PAYMENTS SHALL CEASE.  THE COMMISSIONER MAY ESTABLISH, AS A
CONDITION OF RECEIVING SUCH MEDICAID PAYMENTS, BENCHMARKS AND  GOALS  TO
BE  ACHIEVED  IN  CONFORMITY  WITH  THE  PROVIDER'S  WRITTEN PROPOSAL AS
APPROVED BY THE COMMISSIONER AND MAY  ALSO  REQUIRE  THAT  THE  PROVIDER
SUBMIT  SUCH  PERIODIC REPORTS CONCERNING THE ACHIEVEMENT OF SUCH BENCH-
MARKS AND GOALS AS THE COMMISSIONER DEEMS NECESSARY. FAILURE TO  ACHIEVE
SATISFACTORY PROGRESS, AS DETERMINED BY THE COMMISSIONER, IN ACCOMPLISH-
ING SUCH BENCHMARKS AND GOALS SHALL BE A BASIS FOR ENDING THE PROVIDER'S
MEDICAID PAYMENTS PRIOR TO THE END OF THE SPECIFIED TIMEFRAME.
  (II) THE COMMISSIONER MAY REQUIRE THAT APPLICATIONS SUBMITTED PURSUANT
TO THIS SUBDIVISION BE SUBMITTED IN RESPONSE TO AND IN ACCORDANCE WITH A
REQUEST  FOR  APPLICATIONS  OR  A  REQUEST  FOR  PROPOSALS ISSUED BY THE
COMMISSIONER.
  S 26. Section 3614 of the public health law is amended by adding a new
subdivision 14 to read as follows:
  14. (A) NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW AND  SUBJECT  TO
THE  AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION, FOR PERIODS ON AND
AFTER MARCH FIRST, TWO THOUSAND FOURTEEN THE COMMISSIONER  SHALL  ADJUST
MEDICAID RATES OF PAYMENT FOR SERVICES PROVIDED BY CERTIFIED HOME HEALTH
AGENCIES  TO  ADDRESS  COST  INCREASES  STEMMING FROM THE WAGE INCREASES
REQUIRED BY IMPLEMENTATION  OF  THE  PROVISIONS  OF  SECTION  THIRTY-SIX
HUNDRED FOURTEEN-C OF THIS ARTICLE. SUCH RATE ADJUSTMENTS SHALL BE BASED
ON  A  COMPARISON,  AS  DETERMINED  BY  THE  COMMISSIONER, OF THE HOURLY
COMPENSATION LEVELS FOR HOME HEALTH AIDES AND  PERSONAL  CARE  AIDES  AS
REFLECTED IN THE EXISTING MEDICAID RATES FOR CERTIFIED HOME HEALTH AGEN-
CIES TO THE HOURLY COMPENSATION LEVELS INCURRED AS A RESULT OF COMPLYING
WITH  THE  PROVISIONS  OF  SECTION THIRTY-SIX HUNDRED FOURTEEN-C OF THIS
ARTICLE.
  (B) NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW AND SUBJECT  TO  THE
AVAILABILITY  OF  FEDERAL  FINANCIAL  PARTICIPATION,  FOR PERIODS ON AND
AFTER MARCH FIRST, TWO THOUSAND FOURTEEN THE COMMISSIONER  SHALL  ADJUST
MEDICAID RATES OF PAYMENT FOR SERVICES PROVIDED BY LONG TERM HOME HEALTH
CARE PROGRAMS TO ADDRESS COST INCREASES STEMMING FROM THE WAGE INCREASES
REQUIRED  BY  IMPLEMENTATION  OF  THE  PROVISIONS  OF SECTION THIRTY-SIX

S. 6914                            124                           A. 9205

HUNDRED FOURTEEN-C OF THIS ARTICLE. SUCH RATE ADJUSTMENTS SHALL BE BASED
ON A COMPARISON, AS  DETERMINED  BY  THE  COMMISSIONER,  OF  THE  HOURLY
COMPENSATION  LEVELS  FOR  HOME  HEALTH AIDES AND PERSONAL CARE AIDES AS
REFLECTED  IN THE EXISTING MEDICAID RATES FOR LONG TERM HOME HEALTH CARE
PROGRAMS TO THE HOURLY COMPENSATION  LEVELS  INCURRED  AS  A  RESULT  OF
COMPLYING  WITH  THE PROVISIONS OF SECTION THIRTY-SIX HUNDRED FOURTEEN-C
OF THIS ARTICLE.
  S 26-a. Paragraph (d) of subdivision 2-c of section 2808 of the public
health law, as added by section 95 of part H of chapter 59 of  the  laws
of 2011, is amended to read as follows:
  (d)  The commissioner shall promulgate regulations, and may promulgate
emergency regulations, to implement the provisions of this  subdivision.
Such  regulations  shall  be  developed in consultation with the nursing
home industry and advocates for residential health care  facility  resi-
dents and, further, the commissioner shall provide notification concern-
ing  such  regulations  to  the chairs of the senate and assembly health
committees, the chair of the senate finance committee and the  chair  of
the  assembly  ways  and means committee. Such regulations shall include
provisions for rate adjustments or payment enhancements to facilitate  a
minimum four-year transition of facilities to the rate-setting methodol-
ogy  established  by  this  subdivision and may also include, but not be
limited to, provisions for facilitating quality improvements in residen-
tial health care facilities.    FOR  PURPOSES  OF  FACILITATING  QUALITY
IMPROVEMENTS  THROUGH  THE ESTABLISHMENT OF A NURSING HOME QUALITY POOL,
THOSE FACILITIES THAT CONTRIBUTE TO THE QUALITY  POOL,  BUT  ARE  DEEMED
INELIGIBLE  FOR QUALITY POOL PAYMENTS DUE EXCLUSIVELY TO A SPECIFIC CASE
OF EMPLOYEE MISCONDUCT, SHALL NEVERTHELESS BE  ELIGIBLE  FOR  A  QUALITY
POOL  PAYMENT  IF  THE  FACILITY PROPERLY REPORTED THE INCIDENT, DID NOT
RECEIVE A SURVEY CITATION FROM THE COMMISSIONER OR THE CENTERS FOR MEDI-
CARE AND MEDICAID SERVICES ESTABLISHING THE FACILITY'S CULPABILITY  WITH
REGARD  TO  SUCH  MISCONDUCT  AND, BUT FOR THE SPECIFIC CASE OF EMPLOYEE
MISCONDUCT, THE FACILITY WOULD HAVE OTHERWISE RECEIVED  A  QUALITY  POOL
PAYMENT.  REGULATIONS PERTAINING TO THE FACILITATION OF QUALITY IMPROVE-
MENT  MAY  BE MADE EFFECTIVE FOR PERIODS ON AND AFTER JANUARY FIRST, TWO
THOUSAND THIRTEEN.
  S 27. The public health law is amended by adding a new section 2826 to
read as follows:
  S 2826. TEMPORARY ADJUSTMENT TO REIMBURSEMENT  RATES.    (A)  NOTWITH-
STANDING ANY PROVISION OF LAW TO THE CONTRARY, WITHIN FUNDS APPROPRIATED
AND  SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION, THE
COMMISSIONER MAY GRANT APPROVAL OF A TEMPORARY ADJUSTMENT TO THE NON-CA-
PITAL COMPONENTS OF RATES, OR MAKE TEMPORARY LUMP-SUM MEDICAID PAYMENTS,
TO ELIGIBLE GENERAL HOSPITALS, SKILLED NURSING FACILITIES,  CLINICS  AND
HOME  CARE  PROVIDERS,  PROVIDED  HOWEVER, THAT SHOULD FEDERAL FINANCIAL
PARTICIPATION NOT BE AVAILABLE FOR ANY ELIGIBLE PROVIDER, THEN  PAYMENTS
PURSUANT  TO  THIS  SUBDIVISION  MAY  BE MADE AS GRANTS AND SHALL NOT BE
DEEMED TO BE MEDICAL ASSISTANCE PAYMENTS.
  (B) ELIGIBLE PROVIDERS SHALL INCLUDE:
  (I) PROVIDERS UNDERGOING CLOSURE;
  (II) PROVIDERS IMPACTED BY THE CLOSURE OF OTHER HEALTH CARE PROVIDERS;
  (III) PROVIDERS SUBJECT TO MERGERS,  ACQUISITIONS,  CONSOLIDATIONS  OR
RESTRUCTURING; OR
  (IV)  PROVIDERS  IMPACTED BY THE MERGER, ACQUISITION, CONSOLIDATION OR
RESTRUCTURING OF OTHER HEALTH CARE PROVIDERS.
  (C) PROVIDERS SEEKING TEMPORARY RATE ADJUSTMENTS  UNDER  THIS  SECTION
SHALL  DEMONSTRATE  THROUGH  SUBMISSION  OF  A  WRITTEN  PROPOSAL TO THE

S. 6914                            125                           A. 9205

COMMISSIONER THAT THE ADDITIONAL RESOURCES PROVIDED BY A TEMPORARY  RATE
ADJUSTMENT WILL ACHIEVE ONE OR MORE OF THE FOLLOWING:
  (I) PROTECT OR ENHANCE ACCESS TO CARE;
  (II) PROTECT OR ENHANCE QUALITY OF CARE;
  (III)  IMPROVE  THE  COST EFFECTIVENESS OF THE DELIVERY OF HEALTH CARE
SERVICES; OR
  (IV) OTHERWISE PROTECT OR ENHANCE THE HEALTH CARE DELIVERY SYSTEM,  AS
DETERMINED BY THE COMMISSIONER.
  (D) (I) SUCH  WRITTEN  PROPOSAL SHALL BE SUBMITTED TO THE COMMISSIONER
AT LEAST SIXTY DAYS PRIOR TO THE REQUESTED EFFECTIVE DATE OF THE  TEMPO-
RARY RATE ADJUSTMENT, AND SHALL INCLUDE A PROPOSED BUDGET TO ACHIEVE THE
GOALS  OF  THE  PROPOSAL.  ANY  MEDICAID PAYMENT ISSUED PURSUANT TO THIS
SECTION SHALL BE IN EFFECT FOR A SPECIFIED PERIOD OF TIME AS  DETERMINED
BY  THE  COMMISSIONER, OF UP TO THREE YEARS. AT THE END OF THE SPECIFIED
TIMEFRAME SUCH PAYMENTS OR ADJUSTMENTS TO THE NON-CAPITAL  COMPONENT  OF
RATES  SHALL  CEASE,  AND THE PROVIDER SHALL BE REIMBURSED IN ACCORDANCE
WITH THE OTHERWISE APPLICABLE RATE-SETTING METHODOLOGY AS SET  FORTH  IN
APPLICABLE  STATUTES AND REGULATIONS. THE COMMISSIONER MAY ESTABLISH, AS
A CONDITION OF RECEIVING SUCH  TEMPORARY  RATE  ADJUSTMENTS  OR  GRANTS,
BENCHMARKS  AND  GOALS  TO BE ACHIEVED IN CONFORMITY WITH THE PROVIDER'S
WRITTEN PROPOSAL AS APPROVED BY THE COMMISSIONER AND  MAY  ALSO  REQUIRE
THAT  THE  FACILITY SUBMIT SUCH PERIODIC REPORTS CONCERNING THE ACHIEVE-
MENT OF SUCH BENCHMARKS AND GOALS AS THE COMMISSIONER  DEEMS  NECESSARY.
FAILURE  TO  ACHIEVE SATISFACTORY PROGRESS, AS DETERMINED BY THE COMMIS-
SIONER, IN ACCOMPLISHING SUCH BENCHMARKS AND GOALS SHALL BE A BASIS  FOR
ENDING  THE  FACILITY'S  TEMPORARY RATE ADJUSTMENT OR GRANT PRIOR TO THE
END OF THE SPECIFIED TIMEFRAME. (II) THE COMMISSIONER MAY  REQUIRE  THAT
APPLICATIONS SUBMITTED PURSUANT TO THIS SECTION BE SUBMITTED IN RESPONSE
TO  AND  IN  ACCORDANCE WITH A REQUEST FOR APPLICATIONS OR A REQUEST FOR
PROPOSALS ISSUED BY THE COMMISSIONER.
  (E) NOTWITHSTANDING ANY LAW TO THE CONTRARY, GENERAL HOSPITALS DEFINED
AS CRITICAL ACCESS HOSPITALS PURSUANT TO  TITLE  XVIII  OF  THE  FEDERAL
SOCIAL SECURITY ACT SHALL BE ALLOCATED NO LESS THAN FIVE MILLION DOLLARS
ANNUALLY  PURSUANT  TO  THIS  SECTION.  THE  DEPARTMENT  OF HEALTH SHALL
PROVIDE A REPORT TO THE GOVERNOR AND LEGISLATURE NO LATER THAN  DECEMBER
FIRST,  TWO THOUSAND FOURTEEN PROVIDING RECOMMENDATIONS ON HOW TO ENSURE
THE FINANCIAL STABILITY OF, AND PRESERVE  PATIENT  ACCESS  TO,  CRITICAL
ACCESS HOSPITALS.
  S  27-a.  Subdivision 2 of section 365-a of the social services law is
amended by adding a new paragraph (bb) to read as follows:
  (BB) SUBJECT TO THE AVAILABILITY OF FEDERAL  FINANCIAL  PARTICIPATION,
SERVICES  AND  SUPPORTS  AUTHORIZED BY THE FEDERAL REGULATIONS GOVERNING
THE HOME AND COMMUNITY-BASED ATTENDANT SERVICES AND SUPPORTS STATE  PLAN
OPTION (COMMUNITY FIRST CHOICE) PURSUANT TO 42 U.S.C. S 1396N(K).
  S  27-b. Section 365-f of the social services law is amended by adding
a new subdivision 8 to read as follows:
  8. SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION, THE
PROVISIONS OF THIS SECTION GOVERNING CONSUMER DIRECTED PERSONAL  ASSIST-
ANCE  SERVICES  SHALL ALSO APPLY TO SUCH SERVICES WHEN OFFERED UNDER THE
HOME AND COMMUNITY-BASED ATTENDANT  SERVICES  AND  SUPPORTS  STATE  PLAN
OPTION (COMMUNITY FIRST CHOICE) PURSUANT TO 42 U.S.C. S 1396N(K).
  S  27-c. Subparagraph (iii) of paragraph a of subdivision 1 of section
6908 of the education law, as amended by chapter  160  of  the  laws  of
2003, is amended to read as follows:
  (iii)  the  providing  of  care  by  a person acting in the place of a
person exempt under clause (i) of this  paragraph,  but  who  does  hold

S. 6914                            126                           A. 9205

himself or herself out as one who accepts employment for performing such
care,  where  nursing  services  are under the instruction of a licensed
nurse, or under the instruction of a  patient  or  family  or  household
member  determined by a registered professional nurse to be self-direct-
ing and capable of providing such instruction, and [any remuneration is]
SERVICES ARE provided under section three hundred  sixty-five-f  of  the
social services law; or
  S 27-d. Intentionally omitted.
  S 27-e. Intentionally omitted.
  S 27-f. Intentionally omitted.
  S  27-h.  Section  57-c  of  part A of chapter 56 of the laws of 2013,
relating to establishing the home and community-based care  work  group,
is amended to read as follows:
  S  57-c.  Home and community based care workgroup. The commissioner of
health shall convene a home and community based care workgroup to  exam-
ine and make recommendations on issues which include, but are not limit-
ed to:
  a. State and federal regulatory requirements and related policy guide-
lines  (including the applicability of the federal conditions of partic-
ipation);
  b. Efficient home and community based care delivery,  including  tele-
health and hospice services; [and]
  c.  Alignment  of functions between managed care entities and home and
community based providers[.]; AND
  D. BEST PRACTICE FOR CLEAN CLAIMS AND RELATED DISPUTE RESOLUTION.
  The workgroup shall be 11 members. The members of the workgroup  shall
including  providers,  plans and representatives of consumers and direct
caregivers with relevant expertise.
  The commissioner of health, or his or her  designee  shall  chair  the
workgroup  and  department  of  health  and other executive agencies and
offices shall provide relevant data and other information as  is  neces-
sary for the group to perform its duties.
  The  commissioner  of  health  shall convene this workgroup by May 15,
[2013] 2014 and the group shall issue [a report] PERIODIC  REPORTS  with
recommendations  by  March  1,  2014, SEPTEMBER 1, 2014 AND FEBRUARY 28,
2015.
  S 28. Subdivision 35 of section 2807-c of the  public  health  law  is
amended by adding a new paragraph (j) to read as follows:
  (J)  NOTWITHSTANDING  ANY  CONTRARY  PROVISION  OF LAW, WITH REGARD TO
INPATIENT AND OUTPATIENT MEDICAID RATES OF PAYMENT FOR GENERAL  HOSPITAL
SERVICES,  THE  COMMISSIONER MAY MAKE SUCH ADJUSTMENTS TO SUCH RATES AND
TO THE METHODOLOGY FOR COMPUTING SUCH RATES AS IS NECESSARY  TO  ACHIEVE
NO  AGGREGATE, NET INCREASE OR DECREASE IN OVERALL MEDICAID EXPENDITURES
RELATED TO THE IMPLEMENTATION OF  THE  INTERNATIONAL  CLASSIFICATION  OF
DISEASES  VERSION  10  (ICD-10) CODING SYSTEM ON OR ABOUT OCTOBER FIRST,
TWO THOUSAND FOURTEEN, AS COMPARED TO SUCH AGGREGATE  EXPENDITURES  FROM
THE TWELVE-MONTH PERIOD IMMEDIATELY PRIOR TO SUCH IMPLEMENTATION.
  S  29. Subparagraph (i) of paragraph (e-1) of subdivision 4 of section
2807-c of the public health law, as amended by section 41 of part  B  of
chapter 58 of the laws of 2010, is amended to read as follows:
  (i)  For  rate periods on and after April first, two thousand ten, the
commissioner, in consultation with the commissioner  of  the  office  of
mental health, shall promulgate regulations, and may promulgate emergen-
cy regulations, establishing methodologies for determining the operating
cost  components  of  rates  of  payments for services described in this
paragraph. Such regulations shall utilize two  thousand  five  operating

S. 6914                            127                           A. 9205

costs  as  submitted to the department prior to July first, two thousand
nine and shall provide for methodologies establishing per diem inpatient
rates that utilize case  mix  adjustment  mechanisms.  Such  regulations
shall  contain  criteria for adjustments based on length of stay AND MAY
ALSO PROVIDE FOR A BASE YEAR UPDATE, PROVIDED, HOWEVER, THAT  SUCH  BASE
YEAR  UPDATE SHALL TAKE EFFECT NO EARLIER THAN APRIL FIRST, TWO THOUSAND
FIFTEEN, AND PROVIDED FURTHER, HOWEVER, THAT THE COMMISSIONER  MAY  MAKE
SUCH  ADJUSTMENTS TO SUCH UTILIZATION AND TO THE METHODOLOGY FOR COMPUT-
ING SUCH RATES AS IS NECESSARY TO ACHIEVE NO AGGREGATE,  NET  GROWTH  IN
OVERALL MEDICAID EXPENDITURES RELATED TO SUCH RATES, AS COMPARED TO SUCH
AGGREGATE  EXPENDITURES  FROM THE PRIOR YEAR. IN DETERMINING THE UPDATED
BASE YEAR TO BE UTILIZED PURSUANT TO THIS SUBPARAGRAPH, THE COMMISSIONER
SHALL TAKE INTO ACCOUNT THE BASE  YEAR  DETERMINED  IN  ACCORDANCE  WITH
PARAGRAPH (C) OF SUBDIVISION THIRTY-FIVE OF THIS SECTION.
  S  30.  Subparagraph  (vii)  of  paragraph  (e-2)  of subdivision 4 of
section 2807-c of the public health law, as added by section 13 of  part
C of chapter 58 of the laws of 2009, is amended to read as follows:
  (vii) The commissioner may promulgate regulations, including emergency
regulations,   implementing  the  provisions  of  this  paragraph,  AND,
FURTHER, SUCH REGULATIONS MAY PROVIDE FOR AN UPDATE  OF  THE  BASE  YEAR
COSTS AND STATISTICS USED TO COMPUTE SUCH RATES, PROVIDED, HOWEVER, THAT
SUCH BASE YEAR UPDATE SHALL TAKE EFFECT NO EARLIER THAN APRIL FIRST, TWO
THOUSAND  FIFTEEN,  AND PROVIDED FURTHER, HOWEVER, THAT THE COMMISSIONER
MAY MAKE SUCH ADJUSTMENTS TO SUCH UTILIZATION AND TO THE METHODOLOGY FOR
COMPUTING SUCH RATES AS IS NECESSARY TO ACHIEVE NO AGGREGATE, NET GROWTH
IN OVERALL MEDICAID EXPENDITURES RELATED TO SUCH RATES, AS  COMPARED  TO
SUCH  AGGREGATE  EXPENDITURES  FROM  THE  PRIOR YEAR. IN DETERMINING THE
UPDATED BASE YEAR TO BE UTILIZED  PURSUANT  TO  THIS  SUBPARAGRAPH,  THE
COMMISSIONER SHALL TAKE INTO ACCOUNT THE BASE YEAR DETERMINED IN ACCORD-
ANCE WITH PARAGRAPH (C) OF SUBDIVISION THIRTY-FIVE OF THIS SECTION.
  S  31.  Paragraph (l) of subdivision 4 of section 2807-c of the public
health law is amended by adding  a  new  subparagraph  (v)  to  read  as
follows:
  (V)  THE  COMMISSIONER MAY PROMULGATE REGULATIONS, INCLUDING EMERGENCY
REGULATIONS, PROVIDING FOR AN UPDATE OF THE BASE YEAR COSTS AND  STATIS-
TICS  USED  TO  COMPUTE  RATES  OF  PAYMENT  PURSUANT TO THIS PARAGRAPH,
PROVIDED, HOWEVER, THAT SUCH BASE  YEAR  UPDATE  SHALL  TAKE  EFFECT  NO
EARLIER  THAN  APRIL  FIRST, TWO THOUSAND FIFTEEN, AND PROVIDED FURTHER,
HOWEVER, THAT THE COMMISSIONER MAY MAKE SUCH ADJUSTMENTS TO SUCH  UTILI-
ZATION  AND  TO THE METHODOLOGY FOR COMPUTING SUCH RATES AS IS NECESSARY
TO ACHIEVE NO AGGREGATE, NET GROWTH  IN  OVERALL  MEDICAID  EXPENDITURES
RELATED  TO  SUCH RATES, AS COMPARED TO SUCH AGGREGATE EXPENDITURES FROM
THE PRIOR YEAR. IN DETERMINING THE UPDATED  BASE  YEAR  TO  BE  UTILIZED
PURSUANT  TO THIS SUBPARAGRAPH, THE COMMISSIONER SHALL TAKE INTO ACCOUNT
THE BASE YEAR DETERMINED IN ACCORDANCE WITH PARAGRAPH (C) OF SUBDIVISION
THIRTY-FIVE OF THIS SECTION.
  S 32.  Paragraph (c) of subdivision 35 of section 2807-c of the public
health law, as amended by section 26 of part A of chapter 56 of the laws
of 2013, is amended to read as follows:
  (c) The base period reported costs and statistics used  for  rate-set-
ting  for  operating  cost components, including the weights assigned to
diagnostic related groups, shall be  updated  no  less  frequently  than
every  four  years  and  the  new base period shall be no more than four
years prior to the first applicable rate period that utilizes  such  new
base  period provided, however, that the first updated base period shall

S. 6914                            128                           A. 9205

begin on [January] OR AFTER APRIL first, two thousand fourteen,  BUT  NO
LATER THAN JULY FIRST, TWO THOUSAND FOURTEEN.
  S 32-a. Notwithstanding any contrary provision of law, the commission-
er of health shall establish a workgroup to review and investigate Medi-
caid inpatient rate-setting methodologies with regard to hospitals whose
rates  are  governed by paragraphs (e-1), (e-2) and (l) of subdivision 4
of section 2807-c of the public health law and with particular regard to
the impact of the utilization of updated base years in  the  computation
of  such  rates.  The  workgroup  shall  contain designated staff of the
department of health, representatives of hospital associations and  such
other  interested  stakeholders  as  determined by the commissioner. The
commissioner shall consider the recommendations  of  such  workgroup  in
determining  proposed  revised  rates reflecting the utilization of such
updated base years and shall make such proposed revised rates  available
to  the chairs of the senate and assembly health committees no less than
thirty days prior to the effective date for  such  rates.  Such  updated
base  years  shall be implemented for rate periods commending no earlier
than April 1, 2015.
  S 33. Subdivision 1 of section 92 of part H of chapter 59 of the  laws
of 2011, amending the public health law and other laws relating to known
and  projected department of health state fund medicaid expenditures, as
amended by section 3 of part A of chapter 56 of the  laws  of  2013,  is
amended to read as follows:
  1.  For  state  fiscal  years  2011-12  through [2014-15] 2015-16, the
director of the budget, in consultation with the commissioner of  health
referenced  as "commissioner" for purposes of this section, shall assess
on a monthly basis, as reflected in monthly reports pursuant to subdivi-
sion five of this section known and projected department of health state
funds medicaid expenditures by category of  service  and  by  geographic
regions,  as  defined  by  the  commissioner, and if the director of the
budget determines that such expenditures are expected to cause  medicaid
disbursements  for  such  period  to  exceed the projected department of
health medicaid state funds disbursements in the enacted  budget  finan-
cial  plan  pursuant to subdivision 3 of section 23 of the state finance
law, the commissioner of health, in consultation with  the  director  of
the  budget,  shall  develop a medicaid savings allocation plan to limit
such spending to the aggregate limit  level  specified  in  the  enacted
budget  financial  plan,  provided,  however,  such  projections  may be
adjusted by the director of the budget to account for any changes in the
New York state federal medical assistance percentage amount  established
pursuant  to the federal social security act, changes in provider reven-
ues, reductions to local social  services  district  medical  assistance
administration, and beginning April 1, 2012 the operational costs of the
New York state medical indemnity fund.  Such projections may be adjusted
by  the  director  of  the  budget to account for increased or expedited
department of health state funds medicaid expenditures as a result of  a
natural  or other type of disaster, including a governmental declaration
of emergency.
  S 33-a. Subdivision 5 of section 92 of part H of  chapter  59  of  the
laws  of 2011, amending the public health law and other laws relating to
known and projected department of health state  fund  medicaid  expendi-
tures,  as  amended  by section 3 of part A of chapter 56 of the laws of
2013, is amended and three new subdivisions 6, 7, and  8  are  added  to
read as follows:

S. 6914                            129                           A. 9205

  5.  The [department of health] COMMISSIONER OF HEALTH, IN CONSULTATION
WITH  THE  DIRECTOR  OF BUDGET, shall prepare a monthly report that sets
forth:
  (a)  known and projected department of health medicaid expenditures as
described in subdivision one of this section,  and  factors  that  could
result  in  medicaid disbursements for the relevant state fiscal year to
exceed the projected department of health state funds  disbursements  in
the  enacted  budget financial plan pursuant to subdivision 3 of section
23 of the state finance law, including spending increases  or  decreases
due  to: enrollment fluctuations, rate changes, utilization changes, MRT
investments, and shift of beneficiaries to managed care; and  variations
in offline medicaid payments; [and]
  (b)  the  actions  taken  to implement any medicaid savings allocation
plan implemented pursuant to subdivision four of this section, including
information concerning the impact of such actions on  each  category  of
service  and  each  geographic  region  of the state. [Each such monthly
report shall be provided to the chairs of the  senate  finance  and  the
assembly ways and means committees and shall be posted on the department
of health's website in a timely manner.]
  (C) THE PRICE, TO INCLUDE THE BASE RATE PLUS ANY UPCOMING RATE ADJUST-
MENT;  UTILIZATION,  TO INCLUDE CURRENT ENROLLMENT, PROJECTED ENROLLMENT
CHANGES AND ACUITY; AND MEDICAID  REDESIGN  TEAM  INITIATIVES,  ONE-TIME
INITIATIVES  AND OTHER INITIATIVES DESCRIBING THE PROPOSED BUDGET ACTION
IMPACT, ANY PRIOR YEAR INITIATIVE WITH CURRENT AND FUTURE  YEAR  IMPACTS
FOR THE FOLLOWING CATEGORIES OF SPENDING:
  (I) INPATIENT;
  (II) OUTPATIENT;
  (III) EMERGENCY ROOM;
  (IV) CLINIC;
  (V) NURSING HOMES;
  (VI) OTHER LONG TERM CARE;
  (VII) MEDICAID MANAGED CARE;
  (VIII) FAMILY HEALTH PLUS;
  (IX) PHARMACY;
  (X) TRANSPORTATION;
  (XI) DENTAL;
  (XII) NON-INSTITUTIONAL AND ALL OTHER CATEGORIES;
  (XIII) AFFORDABLE HOUSING;
  (XIV) VITAL ACCESS PROVIDER SERVICES;
  (XV) BEHAVIORAL HEALTH VITAL ACCESS PROVIDER SERVICES;
  (XVI) HEALTH HOME ESTABLISHMENT GRANTS;
  (XVII) GRANTS FOR FACILITATING TRANSITION OF BEHAVIORAL HEALTH SERVICE
TO MANAGED CARE;
  (XVIII) FINGER LAKES HEALTH SERVICES AGENCY;
  (XIX) THE TRANSITION OF VULNERABLE POPULATIONS TO MANAGED CARE;
  (XX) AUDIT RECOVERIES AND SETTLEMENTS; AND
  (D)  WHERE  PRICE  AND UTILIZATION ARE NOT APPLICABLE, DETAIL SHALL BE
PROVIDED ON SPENDING, TO INCLUDE BUT NOT BE LIMITED TO:
  (I) DEMOGRAPHIC INFORMATION OF TARGETED RECIPIENTS;
  (II) NUMBER OF RECIPIENTS;
  (III) AWARD AMOUNTS;
  (IV) TIMING OF AWARDS; AND
  (V) THE IMPACT OF MEDICAID REDESIGN TEAM AND/OR ONE-TIME INITIATIVES.
  INFORMATION REQUIRED BY PARAGRAPHS (A) AND  (B)  OF  THIS  SUBDIVISION
SHALL  BE  PROVIDED TO THE CHAIRS OF THE SENATE FINANCE AND THE ASSEMBLY

S. 6914                            130                           A. 9205

WAYS AND MEANS COMMITTEES, AND SHALL BE  POSTED  ON  THE  DEPARTMENT  OF
HEALTH'S WEBSITE IN THE TIMELY MANNER.
  (E)  BEGINNING  ON  JULY  1,  2014, ADDITIONAL INFORMATION REQUIRED BY
PARAGRAPHS (C) AND (D) OF THIS SUBDIVISION  SHALL  BE  PROVIDED  TO  THE
GOVERNOR,  THE  TEMPORARY  PRESIDENT  OF  THE SENATE, THE SPEAKER OF THE
ASSEMBLY, THE CHAIR OF THE SENATE FINANCE COMMITTEE, THE  CHAIR  OF  THE
ASSEMBLY  WAYS  AND  MEANS  COMMITTEE,  AND THE CHAIRS OF THE SENATE AND
ASSEMBLY HEALTH COMMITTEES.
  (F) ANY PROJECTED MEDICAID SAVINGS DETERMINED BY THE  COMMISSIONER  OF
HEALTH  PURSUANT  TO  SECTION  34  OF PART C OF A CHAPTER OF THE LAWS OF
2014, RELATING TO THE IMPLEMENTATION OF THE HEALTH  AND  MENTAL  HYGIENE
BUDGET, AND THE PROPOSED ALLOCATION PLAN WITH REGARD TO SUCH SAVINGS.
  6.  THE  COMMISSIONER  OF  HEALTH AND THE DIRECTOR OF THE BUDGET SHALL
MAKE APPROPRIATE STAFF AVAILABLE TO MEET WITH THE CHAIRS OF  THE  HEALTH
COMMITTEES OF THE NEW YORK STATE SENATE AND THE NEW YORK STATE ASSEMBLY,
OR  THEIR  DESIGNEES,  UPON THEIR REQUEST AND WITH REASONABLE NOTICE, TO
REVIEW EACH MONTHLY REPORT, AS DESCRIBED IN THIS SUBDIVISION.
  7. THE COMMISSIONER OF HEALTH SHALL MAKE TRAINING AVAILABLE TO  DESIG-
NATED  LEGISLATIVE STAFF WITH REGARD TO THE SKILLS AND TECHNIQUES NEEDED
TO EFFECTIVELY ACCESS AND REVIEW RELEVANT MEDICAID DATA BASES UNDER  THE
CONTROL OF THE DEPARTMENT OF HEALTH, UPON THEIR REQUEST AND WITH REASON-
ABLE NOTICE.
  8.  THE  MONTHLY  REPORTS  AS  DESCRIBED  IN  SUBDIVISION FIVE OF THIS
SECTION AND RELATED DOCUMENTS PROVIDED TO THE NEW YORK STATE LEGISLATURE
SHALL BE POSTED ON THE WEBSITE MAINTAINED BY THE DEPARTMENT OF HEALTH.
  S 34. Notwithstanding any contrary provision of law and subject to the
availability of federal financial participation, for state fiscal  years
beginning  on  and  after  April 1, 2014, the commissioner of health, in
consultation with the director of the budget, shall,  prior  to  January
first  of  each  year,  determine  the  extent of savings that have been
achieved as a result of the application of the provisions of sections 91
and 92 of part H of chapter 59 of the laws  of  2011,  as  amended,  and
shall  further  determine  the availability of such savings for distrib-
ution during the last quarter of such state fiscal year. In  determining
such savings the commissioner of health, in consultation with the direc-
tor  of  the  budget,  may  exempt the medical assistance administration
program from distributions  under  this  section.  The  commissioner  of
health,  in consultation with the director of the budget, may distribute
funds up to an amount equal to such available savings in accordance with
an allocation plan that utilizes a  methodology  that  distributes  such
funds  proportionately  among providers and plans in New York's Medicaid
program. In developing such allocation plan the commissioner  of  health
shall  seek  the  input  of  the  legislature,  as well as organizations
representing health  care  providers,  consumers,  businesses,  workers,
health care insurers and others with relevant expertise. Such allocation
plan  shall  utilize  three years of the most recently available system-
wide expenditure data reflecting both MMIS and managed care  encounters.
Distributions to managed care plans shall be based on the administrative
outlays stemming from participation in the Medicaid program. The commis-
sioner  of  health  may  impose minimum threshold amounts in determining
provider eligibility for distributions pursuant to this section. No less
than fifty percent of the amount available  for  distribution  shall  be
made available for the purpose of assisting eligible providers utilizing
the  methodology  outlined  above.  The  remainder  of the distributions
pursuant to this section shall be made available  for  the  purposes  of
ensuring  a  minimum  level  of assistance to financially distressed and

S. 6914                            131                           A. 9205

critically needed providers  as  identified  by  the  commissioner.  The
commissioner  of  health shall post the Medicaid savings allocation plan
on the department of health's website and shall provide  written  copies
of  such  plan to the chairs of the senate finance and the assembly ways
and means committees at least 30 days before the date on which implemen-
tation is expected to begin. The commissioner of health is authorized to
seek such federal  approvals  as  may  be  required  to  effectuate  the
provisions  of  this  section,  including, but not limited to, to permit
payment of such distributions as lumps sums and to secure  waivers  from
otherwise  applicable  federal  upper payment limit restrictions on such
payments.  The provisions of this section are subject to  the  reporting
requirements  set  forth in paragraph (e) of subdivision 5 of section 92
of part H of chapter 59 of the laws of 2011, as amended by section  33-a
of  part  C of a chapter of the laws of 2014, relating to implementation
of the health and mental hygiene budget.
  S 34-a. Subdivision 1 of section 206  of  the  public  health  law  is
amended by adding a new paragraph (u) to read as follows:
  (U) THE COMMISSIONER SHALL PROVIDE A WRITTEN OR ELECTRONIC COPY OF ANY
STATE  PLAN AMENDMENT SUBMITTED TO THE CENTERS FOR MEDICARE AND MEDICAID
SERVICES TO THE CHAIR OF THE SENATE STANDING COMMITTEE ON HEALTH AND THE
CHAIR OF THE ASSEMBLY HEALTH COMMITTEE, NO LATER THAN FIVE BUSINESS DAYS
FROM THE DATE OF MAILING OR SUBMISSION.
  S 35. Subdivision 9 of section 365-l of the social  services  law,  as
added  by  section  6  of  part  A of chapter 56 of the laws of 2013, is
amended to read as follows:
  9. [Any] THE contract [or contracts] entered into by the  commissioner
of  health  prior  to  January  first, two thousand thirteen pursuant to
subdivision eight of this section may be amended or modified without the
need for a competitive bid or request for proposal process, and  without
regard  to the provisions of sections one hundred twelve and one hundred
sixty-three of the state finance law, section one hundred  forty-two  of
the  economic  development  law, or any other provision of law, to allow
the purchase of additional personnel and services, subject to  available
funding,  for  the limited purpose of assisting the department of health
with implementing the Balancing Incentive Program, the Fully  Integrated
Duals Advantage Program, the Vital Access Provider Program, the Medicaid
waiver amendment associated with the public hospital transformation, the
addition  of  behavioral health services as a managed care plan benefit,
THE DELIVERY SYSTEM REFORM INCENTIVE PAYMENT PLAN, ACTIVITIES TO FACILI-
TATE THE TRANSITION OF VULNERABLE POPULATIONS TO MANAGED CARE and/or any
workgroups required to be established by the chapter of the laws of  two
thousand thirteen that added this subdivision.
  S 36. Section 92 of part H of chapter 59 of the laws of 2011, amending
the  public  health  law  and other laws relating to known and projected
department of health state fund medicaid  expenditures,  is  amended  by
adding a new subdivision 6 to read as follows:
  6.  THE  COMMISSIONER  OF HEALTH, IN CONSULTATION WITH THE DIVISION OF
THE BUDGET SHALL, UPON SUBMISSION OF THE EXECUTIVE BUDGET TO THE  LEGIS-
LATURE,  PROVIDE  A DETAILED ACCOUNTING OF THE STATE MEDICAID GLOBAL CAP
ON THE CLOSE OUT OF THE PRIOR YEAR,  A  CURRENT  YEAR  RE-ESTIMATE,  THE
PROSPECTIVE TWO-YEAR ESTIMATE AND ANY OTHER INFORMATION DEEMED NECESSARY
AND APPROPRIATE.
  S  37.  Notwithstanding  any  provision  of  law  to the contrary, the
department of health and its designees, in consultation with the  assem-
bly  and the senate health committees and their designees, and the divi-
sion of budget and its designees,  shall  explore  the  feasibility  and

S. 6914                            132                           A. 9205

efficacy  of  codifying in consolidated law the provisions of section 92
of part H of chapter 59 of the laws of 2011, and other such related laws
and shall make such recommendations regarding codification by  no  later
than June 1, 2014.
  S  38.  Subdivision  (a)  of section 90 of part H of chapter 59 of the
laws of 2011, amending the public health law and other laws, relating to
general hospital inpatient reimbursement for annual rates, as amended by
section 1 of part A of chapter 56 of the laws of  2013,  is  amended  to
read as follows:
  (a)  (1)  Notwithstanding  any other provision of law to the contrary,
for the state fiscal years beginning April 1, 2011 and ending  on  March
31, [2015] 2014, all Medicaid payments made for services provided on and
after  April  1, 2011, shall, except as hereinafter provided, be subject
to a uniform two percent reduction and such reduction shall be  applied,
to  the  extent  practicable,  in  equal amounts during the fiscal year,
provided, however, that an alternative method may be considered  at  the
discretion  of the commissioner of health and the director of the budget
based upon consultation with the health care industry including but  not
limited  to,  a uniform reduction in Medicaid rates of payments or other
reductions provided that any method selected achieves up to $345,000,000
in Medicaid state share savings in state fiscal year 2011-12 and  up  to
$357,000,000  annually in state fiscal years 2012-13[,] AND 2013-14 [and
2014-15] except as hereinafter provided, for services  provided  on  and
after April 1, 2011 through March 31, [2015] 2014. Any alternative meth-
ods  to  achieve  the reduction must be provided in writing and shall be
filed with the senate finance committee and the assembly ways and  means
committee not less than thirty days before the date on which implementa-
tion  is  expected  to begin. Nothing in this section shall be deemed to
prevent all or part of  such  alternative  reduction  plan  from  taking
effect retroactively, to the extent permitted by the federal centers for
medicare and medicaid services.
  (2)  ALTERNATIVE  METHODS OF COST CONTAINMENT AS AUTHORIZED AND IMPLE-
MENTED PURSUANT TO PARAGRAPH ONE OF THIS SUBDIVISION SHALL  CONTINUE  TO
BE  APPLIED  AND  MAINTAINED  FOR  PERIODS  ON  AND AFTER APRIL 1, 2014,
PROVIDED, HOWEVER, THAT THE COMMISSIONER OF HEALTH, IN CONSULTATION WITH
THE DIRECTOR OF THE BUDGET, IS AUTHORIZED TO TERMINATE SUCH  ALTERNATIVE
METHODS  UPON  A  FINDING  THAT THEY ARE NO LONGER NECESSARY TO MAINTAIN
ESSENTIAL COST SAVINGS.
  S 39. Subdivisions (a)  and  (b)  of  section  364-jj  of  the  social
services  law, as amended by section 80-a of part A of chapter 56 of the
laws of 2013, are amended to read as follows:
  (a) There is hereby established a special  advisory  review  panel  on
Medicaid  managed  care.  The  panel  shall  consist of [twelve] SIXTEEN
members who shall be appointed as follows: [four] SIX by  the  governor,
one  of  which shall serve as the chair; [three] FOUR each by the tempo-
rary president of the senate and the speaker of the  assembly;  and  one
each by the minority leader of the senate and the minority leader of the
assembly.  At  least three members of such panel shall be members of the
joint advisory panel established  under  section  13.40  of  the  mental
hygiene law. THE PANEL SHALL INCLUDE A CONSUMER REPRESENTATIVE FOR INDI-
VIDUALS  WITH  BEHAVIORAL  HEALTH  NEEDS,  A CONSUMER REPRESENTATIVE FOR
INDIVIDUALS WHO ARE DUALLY ELIGIBLE FOR MEDICARE AND MEDICAID, A  REPRE-
SENTATIVE  OF  ENTITIES  THAT  PROVIDE  OR  ARRANGE FOR THE PROVISION OF
SERVICES TO INDIVIDUALS WITH BEHAVIORAL HEALTH NEEDS,  AND  A  REPRESEN-
TATIVE OF ENTITIES THAT PROVIDE OR ARRANGE FOR THE PROVISION OF SERVICES
TO  INDIVIDUALS  WHO  ARE  DUALLY  ELIGIBLE  FOR  MEDICARE AND MEDICAID.

S. 6914                            133                           A. 9205

Members shall serve without compensation but  shall  be  reimbursed  for
appropriate expenses.  The department shall provide technical assistance
and  access  to  data  as  is  required  for the panel to effectuate the
mission and purposes established herein.
  (b) The panel shall:
  (i)  determine  whether  there  is  sufficient  managed  care provider
participation in the Medicaid managed care program;
  (ii) determine whether managed care providers meet  proper  enrollment
targets  that  permit  as  many  Medicaid recipients as possible to make
their own health plan decisions, thus minimizing the number of automatic
assignments;
  (iii) review the phase-in schedule for  enrollment,  of  managed  care
providers under both the voluntary and mandatory programs;
  (iv)  assess the impact of managed care provider marketing and enroll-
ment strategies, and the public education campaign conducted in New York
city, on enrollees participation in Medicaid managed care plans;
  (v) evaluate the adequacy of managed care provider capacity by review-
ing established capacity measurements and monitoring  actual  access  to
plan practitioners;
  (vi)  examine  the  cost  implications  of  populations  excluded  and
exempted from Medicaid managed care;
  (vii) EVALUATE THE ADEQUACY AND APPROPRIATENESS OF PROGRAM MATERIALS;
  (VIII) EXAMINE TRENDS IN SERVICE DENIALS;
  (IX) ASSESS THE ACCESS TO CARE FOR PEOPLE WITH DISABILITIES;
  (X) in accordance with the recommendations of the joint advisory coun-
cil established pursuant to section 13.40 of  the  mental  hygiene  law,
advise  the  commissioners of health and developmental disabilities with
respect to the oversight of DISCOs and of health  maintenance  organiza-
tions  and  managed  long term care plans providing services authorized,
funded, approved or certified by the office  for  people  with  develop-
mental  disabilities,  and  review  all managed care options provided to
persons with developmental  disabilities,  including:  the  adequacy  of
support  for  habilitation  services;  the  record  of  compliance  with
requirements for person-centered planning, person-centered services  and
community  integration;  the  adequacy  of  rates  paid  to providers in
accordance with the provisions of paragraph 1  of  subdivision  four  of
section  forty-four  hundred  three  of the public health law, paragraph
(a-2) of subdivision eight of section forty-four hundred  three  of  the
public  health  law  or paragraph (a-2) of subdivision twelve of section
forty-four hundred three-f of the public health law; and the quality  of
life,  health, safety and community integration of persons with develop-
mental disabilities enrolled in managed care; and
  [(viii)] (XI) examine other issues as it deems appropriate.
  S 40. Subdivision 6 of section 368-d of the social  services  law,  as
amended  by  section  37 of part D of chapter 56 of the laws of 2012, is
amended to read as follows:
  6. The commissioner shall evaluate the results of the study  conducted
pursuant  to  subdivision four of this section to determine, after iden-
tification of actual direct and indirect costs incurred by public school
districts [and state operated and state supported schools for blind  and
deaf  students],  whether it is advisable to claim federal reimbursement
for expenditures under this section as certified public expenditures. In
the event such claims are submitted, if federal  reimbursement  received
for certified public expenditures on behalf of medical assistance recip-
ients  whose  assistance  and  care  are  the responsibility of a social
services district results in a decrease in the  state  share  of  annual

S. 6914                            134                           A. 9205

expenditures  pursuant  to this section for such recipients, then to the
extent that the amount of any  such  decrease  when  combined  with  any
decrease in the state share of annual expenditures described in subdivi-
sion  five  of section three hundred sixty-eight-e of this title exceeds
one hundred fifty million dollars for the period April 1,  2011  through
March  31,  2013, or exceeds one hundred million dollars in state fiscal
[year 2012-13 or any fiscal year thereafter] YEARS 2013-14 AND  2014-15,
the  excess  amount shall be transferred to such public school districts
[and state operated and state  supported  schools  for  blind  and  deaf
students]  in  amounts  proportional to their percentage contribution to
the statewide savings; AN AMOUNT EQUAL TO THIRTEEN AND  FIVE  HUNDREDTHS
PERCENT OF ANY DECREASE IN THE STATE SHARE OF ANNUAL EXPENDITURES PURSU-
ANT TO THIS SECTION FOR SUCH RECIPIENTS IN STATE FISCAL YEAR 2015-16 AND
ANY  FISCAL  YEAR  THEREAFTER SHALL BE TRANSFERRED TO SUCH PUBLIC SCHOOL
DISTRICTS IN AMOUNTS PROPORTIONAL TO THEIR  PERCENTAGE  CONTRIBUTION  TO
THE  STATEWIDE SAVINGS. Any [such excess] amount transferred PURSUANT TO
THIS SECTION shall not be considered a revenue received by  such  social
services  district  in determining the district's actual medical assist-
ance expenditures for purposes of paragraph (b) of section one of part C
of chapter fifty-eight of the laws of two thousand five.
  S 41. Subdivision 5 of section 368-e of the social  services  law,  as
amended  by  section  38 of part D of chapter 56 of the laws of 2012, is
amended to read as follows:
  5. The commissioner shall evaluate the results of the study  conducted
pursuant  to subdivision three of this section to determine, after iden-
tification of actual direct and indirect costs incurred by counties  for
medical  care,  services,  and supplies furnished to pre-school children
with handicapping conditions, whether it is advisable to  claim  federal
reimbursement  for  expenditures  under this section as certified public
expenditures. In  the  event  such  claims  are  submitted,  if  federal
reimbursement  received  for  certified public expenditures on behalf of
medical assistance recipients whose assistance and care are the  respon-
sibility  of  a  social  services district, results in a decrease in the
state share of annual expenditures pursuant to  this  section  for  such
recipients, then to the extent that the amount of any such decrease when
combined  with  any  decrease  in the state share of annual expenditures
described in subdivision six of section three hundred  sixty-eight-d  of
this  title  exceeds  one  hundred  fifty million dollars for the period
April 1, 2011 through March 31, 2013, or  exceeds  one  hundred  million
dollars  in  state  fiscal  [year 2012-13 or any fiscal year thereafter]
YEARS 2013-14 AND 2014-15, the excess amount  shall  be  transferred  to
such  counties  in amounts proportional to their percentage contribution
to  the  statewide  savings;  AN  AMOUNT  EQUAL  TO  THIRTEEN  AND  FIVE
HUNDREDTHS PERCENT OF ANY DECREASE IN THE STATE SHARE OF ANNUAL EXPENDI-
TURES  PURSUANT TO THIS SECTION FOR SUCH RECIPIENTS IN STATE FISCAL YEAR
2015-16 AND ANY FISCAL YEAR THEREAFTER  SHALL  BE  TRANSFERRED  TO  SUCH
COUNTIES IN AMOUNTS PROPORTIONAL TO THEIR PERCENTAGE CONTRIBUTION TO THE
STATEWIDE  SAVINGS.    Any  [such excess] amount transferred PURSUANT TO
THIS SECTION shall not be considered a revenue received by  such  social
services  district  in determining the district's actual medical assist-
ance expenditures for purposes of paragraph (b) of section one of part C
of chapter fifty-eight of the laws of two thousand five.
  S 42.  Subdivision 8 of section 365-a of the social services  law,  as
added  by  section  46-a of part B of chapter 58 of the laws of 2009, is
amended to read as follows:

S. 6914                            135                           A. 9205

  8. When a non-governmental entity  is  authorized  by  the  department
pursuant to contract or subcontract to make prior authorization or prior
approval  determinations  that  may  be required for any item of medical
assistance, a recipient may challenge any action taken or failure to act
in connection with a prior authorization or prior approval determination
as  if such determination were made by a government entity, and shall be
entitled to the same medical assistance benefits and  standards  and  to
the  same notice and procedural due process rights, including a right to
a fair hearing and aid continuing pursuant to section twenty-two of this
chapter, as if the prior authorization or prior  approval  determination
were  made  by  a government entity, WITHOUT REGARD TO EXPIRATION OF THE
PRIOR SERVICE AUTHORIZATION.
  S 43. Subparagraph (ii) of paragraph (a) of subdivision 7  of  section
4403-f of the public health law, as amended by section 41-b of part H of
chapter 59 of the laws of 2011, is amended to read as follows:
  (ii) Notwithstanding any inconsistent provision of the social services
law  to  the  contrary,  the commissioner shall, pursuant to regulation,
determine whether and the extent to which the applicable  provisions  of
the social services law or regulations relating to approvals and author-
izations  of,  and utilization limitations on, health and long term care
services reimbursed pursuant to title XIX of the federal social security
act, including, but not limited to, fiscal assessment requirements,  are
inconsistent  with  the flexibility necessary for the efficient adminis-
tration of managed long term  care  plans  and  such  regulations  shall
provide  that  such  provisions  shall not be applicable to enrollees or
managed long term care plans,  provided  that  such  determinations  are
consistent  with  applicable  federal law and regulation, AND SUBJECT TO
THE  PROVISIONS  OF  SUBDIVISION  EIGHT   OF   SECTION   THREE   HUNDRED
SIXTY-FIVE-A OF THE SOCIAL SERVICES LAW.
  S 44. The social services law is amended by adding a new section 398-b
to read as follows:
  S 398-B. TRANSITION TO MANAGED CARE. 1. NOTWITHSTANDING ANY INCONSIST-
ENT  PROVISION OF LAW TO THE CONTRARY AND SUBJECT TO THE AVAILABILITY OF
FEDERAL FINANCIAL PARTICIPATION, THE COMMISSIONER IS AUTHORIZED TO  MAKE
GRANTS  FROM  A  GROSS  AMOUNT OF FIVE MILLION DOLLARS TO FACILITATE THE
TRANSITION OF FOSTER CARE CHILDREN PLACED  WITH  VOLUNTARY  FOSTER  CARE
AGENCIES  TO  MANAGED  CARE. THE USE OF SUCH FUNDS MAY INCLUDE PROVIDING
TRAINING AND CONSULTING SERVICES TO VOLUNTARY AGENCIES TO  ACCESS  READ-
INESS  AND  MAKE  NECESSARY  INFRASTRUCTURE AND ORGANIZATIONAL MODIFICA-
TIONS, COLLECTING SERVICE UTILIZATION  AND  OTHER  DATA  FROM  VOLUNTARY
AGENCIES  AND  OTHER ENTITIES, AND MAKING INVESTMENTS IN HEALTH INFORMA-
TION TECHNOLOGY, INCLUDING THE INFRASTRUCTURE NECESSARY TO ESTABLISH AND
MAINTAIN ELECTRONIC HEALTH RECORDS.  SUCH  FUNDS  SHALL  BE  DISTRIBUTED
PURSUANT  TO A FORMULA TO BE DEVELOPED BY THE COMMISSIONER OF HEALTH, IN
CONSULTATION WITH THE COMMISSIONER OF THE OFFICE  OF  FAMILY  AND  CHILD
SERVICES.  IN  DEVELOPING  SUCH  FORMULA THE COMMISSIONERS MAY TAKE INTO
ACCOUNT SIZE AND SCOPE OF PROVIDER OPERATIONS AS A  FACTOR  RELEVANT  TO
ELIGIBILITY  FOR  SUCH  FUNDS.  EACH  RECIPIENT  OF  SUCH FUNDS SHALL BE
REQUIRED TO DOCUMENT AND DEMONSTRATE THE EFFECTIVE USE OF FUNDS DISTRIB-
UTED HEREIN.
  2. DATA PROVIDED BY VOLUNTARY FOSTER CARE AGENCIES SHALL BE  COMPLIANT
WITH  THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT, AND SHALL
BE TRANSMITTED SECURELY USING EMEDS OR OTHER MECHANISM TO BE  DETERMINED
BY  THE DEPARTMENT OF HEALTH. SUCH DATA MAY BE USED BY THE DEPARTMENT OF
HEALTH TO ESTABLISH RATES OF PAYMENT FOR MANAGED CARE ORGANIZATIONS  FOR
SERVICES PROVIDED TO CHILDREN IN FOSTER CARE. IN ESTABLISHING SUCH RATES

S. 6914                            136                           A. 9205

THE  COMMISSIONER  OF  HEALTH  SHALL ALSO TAKE INTO ACCOUNT CARE COORDI-
NATION SERVICES THAT WILL CONTINUE  TO  BE  PROVIDED  BY  THE  VOLUNTARY
FOSTER CARE AGENCIES.
  3.  THE  COMMISSIONER OF HEALTH SHALL ISSUE A REPORT TO BE MADE PUBLIC
ON THE DEPARTMENT OF HEALTH'S WEBSITE. SUCH REPORT SHALL CONFORM TO  THE
REQUIREMENTS  OF  SUBDIVISION  FIVE  OF  SECTION NINETY-TWO OF PART H OF
CHAPTER FIFTY-NINE OF THE LAWS OF TWO THOUSAND ELEVEN.
  S 45. Subdivision 3 of section 365-n of the social  services  law,  as
added  by  section  6  of  part  F of chapter 56 of the laws of 2012, is
amended to read as follows:
  3. Notwithstanding sections sixty-one, sixty-three, seventy,  seventy-
eight,  seventy-nine,  eighty-one  and [eight-one-a] EIGHTY-ONE-A of the
civil service law or any provisions to the  contrary  contained  in  any
general,  special,  or  local  laws,  all  lawful appointees of a county
performing the functions established in subdivision two of this  section
as of the effective date of this section OR ANY SUCH APPOINTEES WHO MEET
THE OPEN COMPETITIVE QUALIFICATIONS FOR POSITIONS ESTABLISHED TO PERFORM
THESE  FUNCTIONS  will be eligible for voluntary transfer to appropriate
positions, in the department, that are classified to perform such  func-
tions  without further examination, qualification, or probationary peri-
od; and, upon such transfer, will have all the rights and privileges  of
the  jurisdictional classification to which such positions are allocated
in the classified service of the state.
  S 46.  Section 365-n of the social services law is amended by adding a
new subdivision 5-a to read as follows:
  5-A. (A) THE COMMISSIONER MAY TAKE  NECESSARY  ACTION  TO  REVIEW  THE
ACCURACY  OF DETERMINATIONS OF INITIAL AND ONGOING ELIGIBILITY UNDER THE
MEDICAL ASSISTANCE PROGRAM, AND TO IDENTIFY AND ELIMINATE  INAPPROPRIATE
INSTANCES  OF  CONCURRENT  OR DUPLICATE BENEFITS AND AUTHORIZATIONS. THE
COMMISSIONER IS AUTHORIZED TO CONTRACT WITH  ONE  OR  MORE  ENTITIES  TO
ASSIST THE STATE IN IMPLEMENTING THE PROVISIONS OF THIS SUBDIVISION.
  (B)  NOTWITHSTANDING THE PROVISIONS OF SECTIONS ONE HUNDRED TWELVE AND
ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTION ONE HUNDRED
FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR ANY CONTRARY PROVISION  OF
LAW,  THE  COMMISSIONER  IS  AUTHORIZED  TO  ENTER  INTO  A  CONTRACT OR
CONTRACTS UNDER PARAGRAPH (A) OF THIS SUBDIVISION WITHOUT A  COMPETITIVE
BID OR REQUEST FOR PROPOSAL PROCESS, PROVIDED, HOWEVER, THAT:
  (I)  THE  DEPARTMENT OF HEALTH SHALL POST ON ITS WEBSITE, FOR A PERIOD
OF NO LESS THAN THIRTY DAYS:
  (1) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT  TO
THE CONTRACT OR CONTRACTS;
  (2) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (3)  THE PERIOD OF TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY SEEK
SELECTION, WHICH SHALL BE NO LESS THAN THIRTY DAYS AFTER  SUCH  INFORMA-
TION IS FIRST POSTED ON THE WEBSITE; AND
  (4)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR  MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (II) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
COMMISSIONER; AND
  (III) THE COMMISSIONER SHALL SELECT  SUCH  CONTRACTOR  OR  CONTRACTORS
THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE PURPOSES OF
THIS SECTION; AND
  (IV)  NO CONTRACT ENTERED PURSUANT TO THIS PARAGRAPH SHALL HAVE A TERM
THAT ENDS LATER THAN MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN.

S. 6914                            137                           A. 9205

  S 47.   Subparagraph (iv) of  paragraph  (e-2)  of  subdivision  4  of
section  2807-c  of  the  public  health  law is amended by adding a new
clause (E) to read as follows:
  (E) FOR FACILITIES SUBJECT TO THE PROVISIONS OF THIS SUBPARAGRAPH, THE
DEPARTMENT  SHALL EXAMINE THE FEASIBILITY OF REIMBURSING SUCH FACILITIES
FOR SERVICES PROVIDED TO CHILDREN ELIGIBLE FOR MEDICAL ASSISTANCE  ON  A
NON-FEE-FOR-SERVICE    BASIS.    FOR    PURPOSES    OF    THIS   CLAUSE,
"NON-FEE-FOR-SERVICE" SHALL BE DEFINED AS AN ALTERNATIVE PAYMENT  METHOD
TO  BUNDLE  CERTAIN  SERVICES RENDERED BY SUCH FACILITY, INCLUDING INPA-
TIENT, OUTPATIENT,  SPECIALTY  OUTPATIENT  AND  PHYSICIAN  SERVICES,  IN
AMOUNTS DETERMINED BY THE COMMISSIONER. THE DEPARTMENT SHALL EXAMINE:
  (A)  WHAT  SERVICES COULD BE PROVIDED PURSUANT TO THE NON-FEE-FOR-SER-
VICE BASIS;
  (B) HOW TO ENSURE, FOR CHILDREN ENROLLED  IN  MEDICAID  MANAGED  CARE,
THAT  THEIR  HEALTH  PLANS CAN CONTINUE TO ASSIST IN THE COORDINATION OF
THEIR CARE, PARTICULARLY UPON DISCHARGE FROM  INPATIENT,  OUTPATIENT  OR
SPECIALTY OUTPATIENT SERVICES; AND
  (C)  WHETHER  INCENTIVES  SHOULD  BE  INCORPORATED FOR MEETING QUALITY
BENCHMARKS OR ACHIEVING EFFICIENCIES IN THE DELIVERY AND COORDINATION OF
CARE OR WHETHER OTHER MEANS SHOULD BE CONSIDERED TO ACHIEVE THESE OBJEC-
TIVES.
  THE DEPARTMENT SHALL PROVIDE A REPORT OF ITS FINDINGS AND  RECOMMENDA-
TIONS  TO  THE  GOVERNOR  AND LEGISLATURE NO LATER THAN MARCH FIRST, TWO
THOUSAND FIFTEEN.
  S 48. Notwithstanding sections 112 and 163 of the state  finance  law,
or  any  other  contrary provision of law, the commissioner of health is
authorized to negotiate an  extension  of  the  terms  of  the  contract
executed  by  the  department  of  health  for  actuarial and consulting
services, on September 18, 2009, without a competitive  bid  or  request
for proposal process; provided, however, such extension shall not extend
beyond December 31, 2016.
  S 49.  Section 364-j of the social services law is amended by adding a
new subdivision 29 to read as follows:
  29.    IN  THE  EVENT  THAT  THE DEPARTMENT RECEIVES APPROVAL FROM THE
CENTERS FOR MEDICARE AND MEDICAID SERVICES  TO  AMEND  ITS  1115  WAIVER
KNOWN AS THE PARTNERSHIP PLAN OR RECEIVES APPROVAL FOR A NEW 1115 WAIVER
FOR  THE  PURPOSE  OF REINVESTING SAVINGS RESULTING FROM THE REDESIGN OF
THE MEDICAL ASSISTANCE PROGRAM, THE COMMISSIONER IS AUTHORIZED TO  ENTER
INTO  CONTRACTS, AND/OR TO AMEND THE TERMS OF CONTRACTS AWARDED PRIOR TO
THE EFFECTIVE DATE OF THIS SUBDIVISION, FOR THE PURPOSE OF ASSISTING THE
DEPARTMENT OF HEALTH WITH IMPLEMENTING PROJECTS  AUTHORIZED  UNDER  SUCH
WAIVER  APPROVAL. NOTWITHSTANDING THE PROVISIONS OF SECTIONS ONE HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTIONS
ONE HUNDRED FORTY-TWO AND ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVEL-
OPMENT LAW, OR ANY CONTRARY PROVISION OF LAW, CONTRACTS MAY  BE  ENTERED
OR  CONTRACT AMENDMENTS MAY BE MADE PURSUANT TO THIS SUBDIVISION WITHOUT
A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS IF  THE  TERM  OF  ANY
SUCH  CONTRACT  OR CONTRACT AMENDMENT DOES NOT EXTEND BEYOND MARCH THIR-
TY-FIRST, TWO THOUSAND NINETEEN; PROVIDED, HOWEVER, IN  THE  CASE  OF  A
CONTRACT  ENTERED  INTO  AFTER  THE  EFFECTIVE DATE OF THIS SUBDIVISION,
THAT:
  (A) THE DEPARTMENT OF HEALTH SHALL POST ON ITS WEBSITE, FOR  A  PERIOD
OF NO LESS THAN THIRTY DAYS:
  (I)  A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT TO
THE CONTRACT OR CONTRACTS;
  (II) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;

S. 6914                            138                           A. 9205

  (III) THE PERIOD OF TIME DURING WHICH  A  PROSPECTIVE  CONTRACTOR  MAY
SEEK  SELECTION,  WHICH  SHALL  BE  NO  LESS THAN THIRTY DAYS AFTER SUCH
INFORMATION IS FIRST POSTED ON THE WEBSITE; AND
  (IV)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (B) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE  RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
COMMISSIONER OF HEALTH; AND
  (C) THE  COMMISSIONER  OF  HEALTH  SHALL  SELECT  SUCH  CONTRACTOR  OR
CONTRACTORS THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE
PURPOSES OF THIS SECTION.
  S  50.  Subdivision  1  of  section  366 of the social services law is
amended by adding a new paragraph (g) to read as follows:
  (G) COVERAGE OF CERTAIN NONCITIZENS. (1) APPLICANTS AND RECIPIENTS WHO
ARE LAWFULLY ADMITTED FOR PERMANENT RESIDENCE, OR  WHO  ARE  PERMANENTLY
RESIDING  IN THE UNITED STATES UNDER COLOR OF LAW; WHO ARE MAGI ELIGIBLE
PURSUANT TO PARAGRAPH (B) OF THIS SUBDIVISION; AND WHO WOULD BE INELIGI-
BLE FOR MEDICAL ASSISTANCE COVERAGE UNDER SUBDIVISIONS ONE  AND  TWO  OF
SECTION  THREE  HUNDRED  SIXTY-FIVE-A  OF THIS TITLE SOLELY DUE TO THEIR
IMMIGRATION STATUS IF THE PROVISIONS OF SECTION ONE  HUNDRED  TWENTY-TWO
OF  THIS  CHAPTER  WERE  APPLIED,  SHALL ONLY BE ELIGIBLE FOR ASSISTANCE
UNDER THIS TITLE IF ENROLLED IN A STANDARD  HEALTH  PLAN  OFFERED  BY  A
BASIC  HEALTH  PROGRAM  ESTABLISHED  PURSUANT  TO  SECTION THREE HUNDRED
SIXTY-NINE-GG OF THIS ARTICLE IF SUCH PROGRAM IS ESTABLISHED AND OPERAT-
ING.
  (2) WITH RESPECT TO A PERSON DESCRIBED IN  SUBPARAGRAPH  ONE  OF  THIS
PARAGRAPH  WHO IS ENROLLED IN A STANDARD HEALTH PLAN, MEDICAL ASSISTANCE
COVERAGE SHALL MEAN:
  (I) PAYMENT OF REQUIRED PREMIUMS AND  OTHER  COST-SHARING  OBLIGATIONS
UNDER THE STANDARD HEALTH PLAN THAT EXCEED THE PERSON'S CO-PAYMENT OBLI-
GATION  UNDER  SUBDIVISION SIX OF SECTION THREE HUNDRED SIXTY-SEVEN-A OF
THIS TITLE; AND
  (II) PAYMENT FOR SERVICES AND SUPPLIES DESCRIBED IN SUBDIVISION ONE OR
TWO OF SECTION THREE HUNDRED SIXTY-FIVE-A OF THIS TITLE, AS  APPLICABLE,
BUT  ONLY  TO THE EXTENT THAT SUCH SERVICES AND SUPPLIES ARE NOT COVERED
BY THE STANDARD HEALTH PLAN.
  (3) NOTHING IN THIS SUBDIVISION SHALL PREVENT A  PERSON  DESCRIBED  IN
SUBPARAGRAPH  ONE  OF  THIS  PARAGRAPH  FROM QUALIFYING FOR OR RECEIVING
MEDICAL ASSISTANCE WHILE HIS OR HER ENROLLMENT IN A STANDARD HEALTH PLAN
IS PENDING, IN ACCORDANCE WITH APPLICABLE PROVISIONS OF THIS TITLE.
  S 51. The social services law is amended by adding a new section  369-
gg to read as follows:
  S  369-GG. BASIC HEALTH PROGRAM. 1. DEFINITIONS.  FOR PURPOSES OF THIS
SECTION:
  (A) "ELIGIBLE ORGANIZATION" MEANS  AN  INSURER  LICENSED  PURSUANT  TO
ARTICLE  THIRTY-TWO  OR FORTY-TWO OF THE INSURANCE LAW, A CORPORATION OR
AN ORGANIZATION UNDER ARTICLE FORTY-THREE OF THE INSURANCE  LAW,  OR  AN
ORGANIZATION  CERTIFIED  UNDER  ARTICLE  FORTY-FOUR OF THE PUBLIC HEALTH
LAW, INCLUDING PROVIDERS  CERTIFIED  UNDER  SECTION  FORTY-FOUR  HUNDRED
THREE-E OF THE PUBLIC HEALTH LAW;
  (B) "APPROVED ORGANIZATION" MEANS AN ELIGIBLE ORGANIZATION APPROVED BY
THE COMMISSIONER TO UNDERWRITE A BASIC HEALTH INSURANCE PLAN PURSUANT TO
THIS TITLE;
  (C)  "HEALTH CARE SERVICES" MEANS THE SERVICES AND SUPPLIES AS DEFINED
BY THE COMMISSIONER IN CONSULTATION WITH THE SUPERINTENDENT OF FINANCIAL
SERVICES, AND SHALL BE CONSISTENT WITH  AND  SUBJECT  TO  THE  ESSENTIAL

S. 6914                            139                           A. 9205

HEALTH  BENEFITS  AS  DEFINED BY THE COMMISSIONER IN ACCORDANCE WITH THE
PROVISIONS OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (P.L.  111-
148)  AND  CONSISTENT  WITH  THE BENEFITS PROVIDED BY THE REFERENCE PLAN
SELECTED BY THE COMMISSIONER FOR THE PURPOSES OF DEFINING SUCH BENEFITS;
  (D)  "QUALIFIED HEALTH PLAN" MEANS A HEALTH PLAN THAT MEETS THE CRITE-
RIA FOR CERTIFICATION DESCRIBED IN S 1311(C) OF THE  PATIENT  PROTECTION
AND  AFFORDABLE  CARE  ACT (P.L. 111-148), AND IS OFFERED TO INDIVIDUALS
THROUGH THE HEALTH INSURANCE EXCHANGE MARKETPLACE; AND
  (E) "BASIC HEALTH INSURANCE PLAN" MEANS A STANDARD HEALTH PLAN,  SEPA-
RATE  AND  APART  FROM  QUALIFIED  HEALTH  PLANS,  THAT  IS ISSUED BY AN
APPROVED ORGANIZATION AND CERTIFIED IN ACCORDANCE WITH THIS SECTION.
  2. AUTHORIZATION. IF IT IS IN THE FINANCIAL INTEREST OF THE  STATE  TO
DO  SO,  THE  COMMISSIONER OF HEALTH IS AUTHORIZED, WITH THE APPROVAL OF
THE DIRECTOR OF THE BUDGET, TO ESTABLISH A  BASIC  HEALTH  PROGRAM.  THE
COMMISSIONER'S  AUTHORITY  PURSUANT  TO  THIS SECTION IS CONTINGENT UPON
OBTAINING AND MAINTAINING ALL NECESSARY APPROVALS FROM THE SECRETARY  OF
HEALTH  AND HUMAN SERVICES TO OFFER A BASIC HEALTH PROGRAM IN ACCORDANCE
WITH 42 U.S.C. 18051. THE COMMISSIONER MAY  TAKE  ANY  AND  ALL  ACTIONS
NECESSARY TO OBTAIN SUCH APPROVALS.
  3.  ELIGIBILITY.  A  PERSON IS ELIGIBLE TO RECEIVE COVERAGE FOR HEALTH
CARE SERVICES PURSUANT TO THIS TITLE IF HE OR SHE:
  (A) RESIDES IN NEW YORK STATE AND IS UNDER SIXTY-FIVE YEARS OF AGE;
  (B) IS NOT ELIGIBLE FOR MEDICAL ASSISTANCE UNDER TITLE ELEVEN OF  THIS
ARTICLE  OR FOR THE CHILD HEALTH INSURANCE PLAN DESCRIBED IN TITLE ONE-A
OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW;
  (C) IS NOT ELIGIBLE FOR MINIMUM  ESSENTIAL  COVERAGE,  AS  DEFINED  IN
SECTION  5000A(F)  OF  THE  INTERNAL REVENUE SERVICE CODE OF 1986, OR IS
ELIGIBLE FOR AN EMPLOYER-SPONSORED  PLAN  THAT  IS  NOT  AFFORDABLE,  IN
ACCORDANCE WITH SECTION 5000A OF SUCH CODE; AND
  (D)  (I)  HAS  HOUSEHOLD INCOME AT OR BELOW TWO HUNDRED PERCENT OF THE
FEDERAL POVERTY LINE DEFINED AND ANNUALLY REVISED BY THE  UNITED  STATES
DEPARTMENT  OF  HEALTH  AND  HUMAN  SERVICES FOR A HOUSEHOLD OF THE SAME
SIZE;  AND  (II)  HAS  HOUSEHOLD  INCOME  THAT   EXCEEDS   ONE   HUNDRED
THIRTY-THREE  PERCENT  OF  THE FEDERAL POVERTY LINE DEFINED AND ANNUALLY
REVISED BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR
A HOUSEHOLD OF THE SAME SIZE; HOWEVER,  MAGI  ELIGIBLE  ALIENS  LAWFULLY
PRESENT  IN  THE  UNITED  STATES  WITH HOUSEHOLD INCOMES AT OR BELOW ONE
HUNDRED THIRTY-THREE PERCENT OF THE FEDERAL POVERTY LINE SHALL BE ELIGI-
BLE TO RECEIVE  COVERAGE  FOR  HEALTH  CARE  SERVICES  PURSUANT  TO  THE
PROVISIONS  OF  THIS TITLE IF SUCH ALIEN WOULD BE INELIGIBLE FOR MEDICAL
ASSISTANCE UNDER TITLE ELEVEN OF THIS ARTICLE DUE TO HIS  OR  HER  IMMI-
GRATION STATUS.
  AN  APPLICANT  WHO  FAILS  TO MAKE AN APPLICABLE PREMIUM PAYMENT SHALL
LOSE ELIGIBILITY TO RECEIVE COVERAGE FOR HEALTH CARE SERVICES IN ACCORD-
ANCE WITH TIME FRAMES AND PROCEDURES DETERMINED BY THE COMMISSIONER.
  4. ENROLLMENT. (A) SUBJECT TO FEDERAL APPROVAL,  THE  COMMISSIONER  IS
AUTHORIZED  TO  ESTABLISH  AN  APPLICATION  AND ENROLLMENT PROCEDURE FOR
PROSPECTIVE ENROLLEES.  SUCH  PROCEDURE  SHALL  INCLUDE  A  VERIFICATION
SYSTEM FOR APPLICANTS, WHICH SHALL BE CONSISTENT WITH 42 USC S 1320B-7.
  (B) SUCH PROCEDURE SHALL ALLOW FOR CONTINUOUS ENROLLMENT FOR ENROLLEES
TO THE BASIC HEALTH PROGRAM WHERE AN INDIVIDUAL MAY APPLY AND ENROLL FOR
COVERAGE AT ANY POINT.
  (C)  UPON  AN APPLICANT'S ENROLLMENT IN A BASIC HEALTH INSURANCE PLAN,
COVERAGE FOR HEALTH CARE SERVICES PURSUANT TO  THE  PROVISIONS  OF  THIS
TITLE  SHALL BE PROSPECTIVE. COVERAGE SHALL BEGIN IN A MANNER CONSISTENT
WITH THE REQUIREMENTS FOR QUALIFIED HEALTH  PLANS  OFFERED  THROUGH  THE

S. 6914                            140                           A. 9205

HEALTH  INSURANCE  EXCHANGE  MARKETPLACE, AS DELINEATED IN FEDERAL REGU-
LATION AT 42 CFR 155.420(B)(1) OR ANY SUCCESSOR REGULATION THEREOF.
  (D) A PERSON WHO HAS ENROLLED FOR COVERAGE PURSUANT TO THIS TITLE, AND
WHO LOSES ELIGIBILITY TO ENROLL IN THE BASIC HEALTH PROGRAM FOR A REASON
OTHER  THAN  CITIZENSHIP  STATUS,  LACK  OF  STATE RESIDENCE, FAILURE TO
PROVIDE A VALID SOCIAL SECURITY NUMBER, PROVIDING INACCURATE INFORMATION
THAT WOULD AFFECT ELIGIBILITY WHEN REQUESTING OR RENEWING HEALTH  COVER-
AGE  PURSUANT  TO  THIS  TITLE, OR FAILURE TO MAKE AN APPLICABLE PREMIUM
PAYMENT, BEFORE THE END OF A TWELVE MONTH PERIOD BEGINNING ON THE EFFEC-
TIVE DATE OF THE PERSON'S INITIAL ELIGIBILITY FOR  COVERAGE,  OR  BEFORE
THE END OF A TWELVE MONTH PERIOD BEGINNING ON THE DATE OF ANY SUBSEQUENT
DETERMINATION  OF  ELIGIBILITY,  SHALL  HAVE  HIS OR HER ELIGIBILITY FOR
COVERAGE CONTINUED UNTIL THE END OF SUCH TWELVE MONTH  PERIOD,  PROVIDED
THAT  THE STATE RECEIVES FEDERAL APPROVAL FOR USING FUNDS FROM THE BASIC
HEALTH PROGRAM TRUST FUND, ESTABLISHED  UNDER  SECTION  97-OOOO  OF  THE
STATE FINANCE LAW, FOR THE COSTS ASSOCIATED WITH SUCH ASSISTANCE.
  5.  PREMIUMS  AND  COST  SHARING. (A) SUBJECT TO FEDERAL APPROVAL, THE
COMMISSIONER SHALL ESTABLISH PREMIUM PAYMENTS  ENROLLEES  SHALL  PAY  TO
APPROVED  ORGANIZATIONS FOR COVERAGE OF HEALTH CARE SERVICES PURSUANT TO
THIS TITLE. SUCH PREMIUM PAYMENTS SHALL BE ESTABLISHED IN THE  FOLLOWING
MANNER:
  (I)  UP  TO  TWENTY DOLLARS MONTHLY FOR AN INDIVIDUAL WITH A HOUSEHOLD
INCOME ABOVE ONE HUNDRED AND FIFTY PERCENT OF THE FEDERAL  POVERTY  LINE
BUT  AT OR BELOW TWO HUNDRED PERCENT OF THE FEDERAL POVERTY LINE DEFINED
AND ANNUALLY REVISED BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN
SERVICES FOR A HOUSEHOLD OF THE SAME SIZE; AND
  (II) NO PAYMENT IS REQUIRED FOR INDIVIDUALS WITH A HOUSEHOLD INCOME AT
OR BELOW ONE HUNDRED AND FIFTY  PERCENT  OF  THE  FEDERAL  POVERTY  LINE
DEFINED  AND  ANNUALLY REVISED BY THE UNITED STATES DEPARTMENT OF HEALTH
AND HUMAN SERVICES FOR A HOUSEHOLD OF THE SAME SIZE.
  (B) THE COMMISSIONER SHALL  ESTABLISH  COST  SHARING  OBLIGATIONS  FOR
ENROLLEES, SUBJECT TO FEDERAL APPROVAL.
  6. ANY FUNDS TRANSFERRED BY THE SECRETARY OF HEALTH AND HUMAN SERVICES
TO THE STATE PURSUANT TO 42 U.S.C. 18051(D) SHALL BE DEPOSITED IN TRUST.
FUNDS FROM THE TRUST SHALL BE USED FOR PROVIDING HEALTH BENEFITS THROUGH
AN  APPROVED  ORGANIZATION, WHICH, AT A MINIMUM, SHALL INCLUDE ESSENTIAL
HEALTH BENEFITS AS DEFINED IN 42 U.S.C. 18022(B); TO REDUCE THE PREMIUMS
AND COST SHARING OF PARTICIPANTS IN THE BASIC  HEALTH  PROGRAM;  OR  FOR
SUCH  OTHER  PURPOSES  AS  MAY BE ALLOWED BY THE SECRETARY OF HEALTH AND
HUMAN SERVICES. HEALTH  BENEFITS  AVAILABLE  THROUGH  THE  BASIC  HEALTH
PROGRAM SHALL BE PROVIDED BY ONE OR MORE APPROVED ORGANIZATIONS PURSUANT
TO  AN  AGREEMENT  WITH  THE  DEPARTMENT  OF  HEALTH  AND SHALL MEET THE
REQUIREMENTS OF APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS.
  7. AN INDIVIDUAL WHO IS LAWFULLY ADMITTED FOR PERMANENT  RESIDENCE  OR
PERMANENTLY  RESIDING  IN  THE UNITED STATES UNDER COLOR OF LAW, AND WHO
WOULD BE INELIGIBLE FOR MEDICAL ASSISTANCE UNDER TITLE  ELEVEN  OF  THIS
ARTICLE  DUE  TO  HIS  OR  HER  IMMIGRATION  STATUS IF THE PROVISIONS OF
SECTION ONE HUNDRED TWENTY-TWO OF THIS CHAPTER WERE  APPLIED,  SHALL  BE
CONSIDERED TO BE INELIGIBLE FOR MEDICAL ASSISTANCE FOR PURPOSES OF PARA-
GRAPHS (B) AND (C) OF SUBDIVISION THREE OF THIS SECTION.
  S  52.  Subparagraph  2  of  paragraph (e) of subdivision 3 of section
367-a of the social services law, as added by section 16 of  part  D  of
chapter 56 of the laws of 2013, is amended to read as follows:
  (2)  Payment  pursuant  to  this  paragraph shall be for premium obli-
gations of the individual under the  qualified  health  plan  and  shall
continue  only  if  and  for  so long as the individual's MAGI household

S. 6914                            141                           A. 9205

income exceeds one hundred thirty-three percent, but does not exceed one
hundred fifty percent, of the federal poverty line  for  the  applicable
family  size,  OR,  IF  EARLIER,  UNTIL  THE  INDIVIDUAL IS ELIGIBLE FOR
ENROLLMENT  IN  A STANDARD HEALTH PLAN PURSUANT TO SECTION THREE HUNDRED
SIXTY-NINE-GG OF THIS ARTICLE.
  S 53. The state finance law is amended by adding a new section 97-oooo
to read as follows:
  S 97-OOOO. BASIC HEALTH PROGRAM TRUST FUND. 1. THERE IS HEREBY  ESTAB-
LISHED  IN  THE JOINT CUSTODY OF THE COMPTROLLER AND THE COMMISSIONER OF
TAXATION AND FINANCE A FUND, TO BE KNOWN AS THE  "BASIC  HEALTH  PROGRAM
TRUST FUND".
  2.  SUCH  FUND  SHALL  CONSIST  OF MONEYS TRANSFERRED FROM THE FEDERAL
GOVERNMENT PURSUANT TO 42 U.S.C. S 18051(D) FOR THE PURPOSE OF  REDUCING
THE  PREMIUMS  AND  COST-SHARING OF, OR PROVIDING BENEFITS FOR, ELIGIBLE
INDIVIDUALS ENROLLED IN THE BASIC HEALTH PROGRAM,  ESTABLISHED  PURSUANT
TO SECTION THREE HUNDRED SIXTY-NINE-GG OF THE SOCIAL SERVICES LAW.
  3.  UPON  FEDERAL  APPROVAL,  ALL MONIES IN SUCH FUND SHALL BE USED TO
IMPLEMENT AND OPERATE THE BASIC HEALTH PLAN, PURSUANT TO  SECTION  THREE
HUNDRED  SIXTY-NINE-GG  OF THE SOCIAL SERVICES LAW, EXCEPT TO THE EXTENT
THAT THE PROVISIONS OF SUCH SECTION CONFLICT OR  ARE  INCONSISTENT  WITH
FEDERAL  LAW,  IN  WHICH  CASE  THE PROVISIONS OF SUCH FEDERAL LAW SHALL
SUPERSEDE SUCH STATE LAW PROVISIONS.
  S 54. The state finance law is amended by adding a new section 97-xxxx
to read as follows:
  S 97-XXXX. STATE HEALTH INNOVATION PLAN ACCOUNT. 1.  THERE  IS  HEREBY
ESTABLISHED  IN  THE  JOINT  CUSTODY  OF  THE  STATE COMPTROLLER AND THE
COMMISSIONER OF THE DEPARTMENT OF HEALTH AN ACCOUNT OF THE MISCELLANEOUS
SPECIAL REVENUE FUND TO BE KNOWN AS THE  STATE  HEALTH  INNOVATION  PLAN
ACCOUNT.
  2.  NOTWITHSTANDING ANY OTHER LAW, RULE OR REGULATION TO THE CONTRARY,
THE STATE COMPTROLLER IS HEREBY AUTHORIZED AND DIRECTED TO  RECEIVE  FOR
DEPOSIT  TO  THE  CREDIT  OF  THE  STATE HEALTH INNOVATION PLAN ACCOUNT,
MONIES RECEIVED PURSUANT TO THE STATE INNOVATION MODEL  INITIATIVE  FROM
THE CENTERS FOR MEDICARE AND MEDICAID INNOVATION.
  3. MONEYS OF THIS ACCOUNT, FOLLOWING APPROPRIATION BY THE LEGISLATURE,
SHALL BE AVAILABLE TO THE DEPARTMENT OF HEALTH FOR SERVICES AND EXPENSES
OF THE STATE HEALTH INNOVATION PLAN.
  S  55. Section 364-i of the social services law is amended by adding a
new subdivision 8 to read as follows:
  8. (A) THE FOLLOWING INDIVIDUALS SHALL BE PRESUMED TO BE ELIGIBLE  FOR
MEDICAL  ASSISTANCE UNDER THIS TITLE BEGINNING ON THE DATE THAT A QUALI-
FIED HOSPITAL, AS DEFINED IN PARAGRAPH (B) OF THIS  SUBDIVISION,  DETER-
MINES, ON THE BASIS OF PRELIMINARY INFORMATION, THAT:
  (1)  A CHILD HAS MAGI HOUSEHOLD INCOME THAT DOES NOT EXCEED THE APPLI-
CABLE LEVEL FOR ELIGIBILITY AS PROVIDED FOR PURSUANT TO SUBPARAGRAPH TWO
OR THREE OF PARAGRAPH (B) OF SUBDIVISION ONE OF  SECTION  THREE  HUNDRED
SIXTY-SIX OF THIS TITLE;
  (2)  A  PREGNANT  WOMAN HAS MAGI HOUSEHOLD INCOME THAT DOES NOT EXCEED
THE MAGI-EQUIVALENT OF TWO HUNDRED PERCENT OF THE FEDERAL  POVERTY  LINE
FOR THE APPLICABLE FAMILY SIZE;
  (3) A PARENT OR CARETAKER RELATIVE HAS MAGI HOUSEHOLD INCOME THAT DOES
NOT  EXCEED  THE  MAGI-EQUIVALENT  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,  OR
HAS  NET  AVAILABLE INCOME, INCLUDING AVAILABLE SUPPORT FROM RESPONSIBLE

S. 6914                            142                           A. 9205

RELATIVES, THAT DOES NOT EXCEED THE AMOUNTS SET FORTH IN  PARAGRAPH  (A)
OF SUBDIVISION TWO OF SECTION THREE HUNDRED SIXTY-SIX OF THIS TITLE;
  (4)  AN INDIVIDUAL IN NEED OF TREATMENT OF BREAST, CERVICAL, COLON, OR
PROSTATE CANCER MEETS THE REQUIREMENTS OF PARAGRAPH (D) OR (E) OF SUBDI-
VISION FOUR OF SECTION THREE HUNDRED SIXTY-SIX OF THIS TITLE;
  (5) AN INDIVIDUAL AGE NINETEEN OR OLDER AND UNDER AGE SIXTY-FIVE MEETS
THE REQUIREMENTS OF SUBPARAGRAPH ONE OF PARAGRAPH (B) OF SUBDIVISION ONE
OF SECTION THREE HUNDRED SIXTY-SIX OF THIS TITLE;
  (6) AN INDIVIDUAL UNDER TWENTY-SIX YEARS OF AGE MEETS THE REQUIREMENTS
OF SUBPARAGRAPH NINE OF PARAGRAPH (C)  OF  SUBDIVISION  ONE  OF  SECTION
THREE HUNDRED SIXTY-SIX OF THIS TITLE; AND
  (7)  AN INDIVIDUAL HAS INCOME THAT DOES NOT EXCEED THE MAGI-EQUIVALENT
OF TWO HUNDRED PERCENT OF THE FEDERAL POVERTY LINE  FOR  THE  APPLICABLE
FAMILY  SIZE,  AND THE INDIVIDUAL MEETS THE REQUIREMENTS OF SUBPARAGRAPH
SIX OF PARAGRAPH (B) OF SUBDIVISION ONE OF SECTION THREE HUNDRED  SIXTY-
SIX  OF  THIS  TITLE;  COVERAGE  PURSUANT  TO THIS SUBPARAGRAPH SHALL BE
LIMITED TO FAMILY PLANNING SERVICES REIMBURSED BY THE FEDERAL GOVERNMENT
AT A RATE OF NINETY PERCENT.
  (B) FOR THE PURPOSES OF THIS SUBDIVISION, "QUALIFIED HOSPITAL" MEANS A
HOSPITAL THAT:
  (1) IS LICENSED AS A GENERAL HOSPITAL UNDER  ARTICLE  TWENTY-EIGHT  OF
THE PUBLIC HEALTH LAW;
  (2)  IS  ENROLLED  AS  A PROVIDER IN THE PROGRAM OF MEDICAL ASSISTANCE
UNDER THIS TITLE;
  (3) HAS NOTIFIED THE DEPARTMENT OF HEALTH  OF  ITS  ELECTION  TO  MAKE
PRESUMPTIVE  ELIGIBILITY  DETERMINATIONS  UNDER  THIS  SUBDIVISION,  AND
AGREES TO MAKE SUCH  DETERMINATIONS  IN  ACCORDANCE  WITH  POLICIES  AND
PROCEDURES ESTABLISHED BY THE DEPARTMENT;
  (4)  HAS  BEEN  DESIGNATED  BY THE DEPARTMENT OF HEALTH AS A CERTIFIED
APPLICATION COUNSELOR TO PROVIDE INFORMATION TO  INDIVIDUALS  CONCERNING
QUALIFIED  HEALTH  PLANS OFFERED THROUGH A HEALTH INSURANCE EXCHANGE AND
OTHER INSURANCE AFFORDABILITY PROGRAMS, ASSIST INDIVIDUALS TO APPLY  FOR
COVERAGE  THROUGH  A  QUALIFIED  HEALTH  PLAN OR INSURANCE AFFORDABILITY
PROGRAM, AND HELP FACILITATE THE ENROLLMENT OF ELIGIBLE  INDIVIDUALS  IN
SUCH PLANS OR PROGRAMS; AND
  (5)  HAS NOT BEEN DISQUALIFIED BY THE DEPARTMENT OF HEALTH PURSUANT TO
PARAGRAPH (C) OF THIS SUBDIVISION.
  (C) THE DEPARTMENT OF HEALTH MAY DISQUALIFY A HOSPITAL AS A  QUALIFIED
HOSPITAL IF THE DEPARTMENT DETERMINES THAT THE HOSPITAL IS NOT:
  (1)  MAKING,  OR  IS  NOT  CAPABLE  OF MAKING, PRESUMPTIVE ELIGIBILITY
DETERMINATIONS IN ACCORDANCE WITH THE  POLICIES  AND  PROCEDURES  ESTAB-
LISHED BY THE DEPARTMENT; OR
  (2)  MEETING  SUCH  STANDARDS  AS MAY BE ESTABLISHED BY THE DEPARTMENT
WITH RESPECT TO THE PROPORTION OF INDIVIDUALS  DETERMINED  PRESUMPTIVELY
ELIGIBLE BY THE HOSPITAL WHO ARE FOUND BY THE MEDICAL ASSISTANCE PROGRAM
TO  BE  ELIGIBLE  FOR  ONGOING  MEDICAL  ASSISTANCE AFTER THE END OF THE
PRESUMPTIVE ELIGIBILITY PERIOD.
  (D) CARE, SERVICES AND SUPPLIES, AS SET FORTH IN SECTION THREE HUNDRED
SIXTY-FIVE-A OF THIS TITLE, THAT ARE FURNISHED TO AN INDIVIDUAL DURING A
PRESUMPTIVE ELIGIBILITY PERIOD UNDER THIS SUBDIVISION BY AN ENTITY  THAT
IS  ELIGIBLE FOR PAYMENTS UNDER THIS TITLE SHALL BE DEEMED TO BE MEDICAL
ASSISTANCE FOR PURPOSES OF PAYMENT AND STATE REIMBURSEMENT.
  S 56. Subdivision 1 of section 366  of  the  social  services  law  is
amended by adding a new paragraph (f) to read as follows:
  (F)  NOTWITHSTANDING  ANY INCONSISTENT PROVISION OF THIS TITLE, FOR AN
INDIVIDUAL WHO HAS INCOME IN EXCESS OF AN APPLICABLE INCOME  ELIGIBILITY

S. 6914                            143                           A. 9205

STANDARD  AND  IS  ALLOWED TO ACHIEVE ELIGIBILITY FOR MEDICAL ASSISTANCE
UNDER THIS TITLE BY INCURRING MEDICAL EXPENSES EQUAL TO  THE  AMOUNT  OF
SUCH  EXCESS  INCOME,  THE  AMOUNT OF EXCESS INCOME MAY BE CALCULATED BY
COMPARING  THE INDIVIDUAL'S MAGI HOUSEHOLD INCOME TO THE MAGI-EQUIVALENT
OF THE APPLICABLE INCOME ELIGIBILITY STANDARD; PROVIDED,  HOWEVER,  THAT
MEDICAL  ASSISTANCE  SHALL  BE FURNISHED PURSUANT TO THIS PARAGRAPH ONLY
IF, FOR SO LONG AS, AND TO THE EXTENT  THAT  FEDERAL  FINANCIAL  PARTIC-
IPATION IS AVAILABLE THEREFOR. THE COMMISSIONER OF HEALTH SHALL MAKE ANY
AMENDMENTS  TO  THE  STATE PLAN FOR MEDICAL ASSISTANCE, OR APPLY FOR ANY
WAIVER OR APPROVAL UNDER THE FEDERAL SOCIAL SECURITY ACT THAT ARE NECES-
SARY TO CARRY OUT THE PROVISIONS OF THIS PARAGRAPH.
  S 56-a. Section 364-j of the social services law is amended by  adding
a new subdivision 30 to read as follows:
  30.  NOTWITHSTANDING THE PROVISIONS OF SECTION ONE HUNDRED SIXTY-THREE
OF THE STATE FINANCE LAW, OR SECTIONS  ONE  HUNDRED  FORTY-TWO  AND  ONE
HUNDRED  FORTY-THREE  OF  THE  ECONOMIC DEVELOPMENT LAW, OR ANY CONTRARY
PROVISION OF LAW, IN THE EVENT THAT THE STATE  RECEIVES  PRIOR  APPROVAL
AND  ENHANCED  FINANCIAL PARTICIPATION FROM THE CENTERS FOR MEDICAID AND
MEDICARE SERVICES, ADMINISTRATION FOR  CHILDREN  AND  FAMILIES  AND  THE
FEDERAL  FOOD  AND  NUTRITION  SERVICES FOR REIMBURSEMENT PURSUANT TO AN
A-87 COST ALLOCATION WAIVER FOR ENHANCED FUNDING FOR  INTEGRATED  ELIGI-
BILITY  SYSTEMS, THE STATE IS AUTHORIZED TO ENTER INTO CONTRACTS, AND/OR
TO AMEND THE TERMS OF CONTRACTS AWARDED PRIOR TO THE EFFECTIVE  DATE  OF
THIS  SUBDIVISION,  WITHOUT  A  COMPETITIVE  BID OR REQUEST FOR PROPOSAL
PROCESS, CONSISTENT WITH FEDERAL REQUIREMENTS, FOR THE PURPOSE OF IMPLE-
MENTING PROJECTS  AUTHORIZED  UNDER  SUCH  WAIVER  AMENDMENT;  PROVIDED,
HOWEVER, IN THE CASE OF A CONTRACT ENTERED INTO AFTER THE EFFECTIVE DATE
OF THIS SUBDIVISION, THAT:
  (A)  THE  OFFICE OF TEMPORARY AND DISABILITY ASSISTANCE AND THE OFFICE
OF GENERAL SERVICES, OR ANOTHER STATE AGENCY, SHALL POST ON ITS  WEBSITE
AND CONCURRENTLY PROVIDE TO THE CHAIR OF THE SENATE HEALTH COMMITTEE AND
THE CHAIR OF THE ASSEMBLY HEALTH COMMITTEE, FOR A PERIOD OF NO LESS THAN
THIRTY DAYS:
  (I)  A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT TO
THE CONTRACT OR CONTRACTS;
  (II) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (III) THE PERIOD OF TIME DURING WHICH  A  PROSPECTIVE  CONTRACTOR  MAY
SUBMIT  AN  OFFER,  WHICH  SHALL  BE NO LESS THAN THIRTY DAYS AFTER SUCH
INFORMATION IS FIRST POSTED ON THE WEBSITE; AND
  (IV) THE MANNER BY WHICH A PROSPECTIVE CONTRACTOR MAY SUBMIT AN OFFER,
WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (B) ALL RESPONSIVE  AND  REASONABLE  OFFERS  THAT  ARE  RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
COMMISSIONER OF TEMPORARY AND DISABILITY ASSISTANCE OR OTHER STATE AGEN-
CY; AND
  (C) THE COMMISSIONERS OF THE  DEPARTMENT  OF  HEALTH,  THE  OFFICE  OF
TEMPORARY AND DISABILITY ASSISTANCE AND THE OFFICE OF CHILDREN AND FAMI-
LY  SERVICES,  WORKING  IN  COOPERATION WITH THE STATE CHIEF INFORMATION
OFFICER AND THE OFFICE OF GENERAL SERVICES, SHALL AWARD SUCH CONTRACT TO
THE CONTRACTOR OR CONTRACTORS OFFER THAT PROVIDES THE BEST VALUE AS SUCH
TERM IS DEFINED IN SECTION ONE HUNDRED SIXTY-THREE OF THE STATE  FINANCE
LAW,  TO  THE  STATE.  AT  NOTIFICATION THE COMMISSIONER OF HEALTH SHALL
PROVIDE THIS INFORMATION TO THE CHAIR  OF  THE  SENATE  STANDING  HEALTH
COMMITTEE AND THE CHAIR OF THE ASSEMBLY HEALTH COMMITTEE.

S. 6914                            144                           A. 9205

  (D)  ALL DECISIONS MADE AND APPROACHES TAKEN PURSUANT TO THIS SUBDIVI-
SION SHALL BE DOCUMENTED IN A PROCUREMENT RECORD AS DEFINED  IN  SECTION
ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW.
  (E)  IN ACCORDANCE WITH ALL FEDERAL ADVANCE PLANNING DOCUMENT GUIDANCE
AND WITHIN THE PARAMETERS ESTABLISHED BY THE ENHANCED FINANCIAL  PARTIC-
IPATION  FROM  THE  CENTERS FOR MEDICAID AND MEDICARE SERVICES, ADMINIS-
TRATION FOR CHILDREN AND FAMILIES AND THE  FEDERAL  FOOD  AND  NUTRITION
SERVICES  FOR  REIMBURSEMENT  TO  AN  A-87  COST  ALLOCATION  WAIVER FOR
ENHANCED FUNDING  FOR  INTEGRATED  ELIGIBILITY  SYSTEMS,  PHASE  1  WILL
INCLUDE  FOUNDATIONAL  ALLOWABLE  SHARED  SERVICE COMPONENTS REQUIRED TO
SUCCESSFULLY MEET THE REQUIREMENTS  FOR  NON-MAGI  MEDICAID  SUCH  AS  A
COMMON  CLIENT  PORTAL,  DOCUMENT  MANAGEMENT,  RULES  ENGINES, WORKFLOW
MANAGEMENT TOOLS, CASE MANAGEMENT, NOTICES AND TRAINING.
  (F) THE CONTRACT WILL REQUIRE TRAINING TO BE PROVIDED AT  NO  COST  TO
THE SOCIAL SERVICES DISTRICTS.
  (G) THE CONTRACT SHALL REQUIRE THE COMPLETION OF SHARED SERVICE COMPO-
NENTS  BY  THE  TIMELINES  NECESSARY  TO  RECEIVE THE ENHANCED FINANCIAL
PARTICIPATION FROM THE  CENTERS  FOR  MEDICAID  AND  MEDICARE  SERVICES,
ADMINISTRATION FOR CHILDREN AND FAMILIES AND THE FEDERAL FOOD AND NUTRI-
TION SERVICES FOR REIMBURSEMENT TO AN A-87 COST ALLOCATION WAIVER.
  (H)  THE  COMMISSIONER  SHALL  PROVIDE, WITHIN THIRTY DAYS OF AWARD OF
SUCH CONTRACT OR CONTRACTS, THE CHAIR OF THE SENATE  STANDING  COMMITTEE
ON  HEALTH  AND THE CHAIR OF THE ASSEMBLY HEALTH COMMITTEE WITH A REPORT
OUTLINING THE PROCUREMENT AND AWARDS.
  S 57. Subdivision 8 of section  2511  of  the  public  health  law  is
amended by adding a new paragraph (h) to read as follows:
  (H) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS TITLE, ARTICLES
THIRTY-TWO  AND  FORTY-THREE  OF THE INSURANCE LAW AND SUBSECTION (E) OF
SECTION ELEVEN HUNDRED TWENTY OF THE INSURANCE LAW, FOR THE PERIOD APRIL
FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH  THIRTY-FIRST,  TWO  THOUSAND
FIFTEEN,  SUBSIDY  PAYMENTS  MADE  TO APPROVED ORGANIZATIONS SHALL BE AT
AMOUNTS APPROVED PRIOR TO APRIL FIRST, TWO THOUSAND FOURTEEN.
  S 58. Article 29-A of the public health law is amended by adding a new
title 1-A to read as follows:
                                TITLE 1-A
                      RURAL DENTISTRY PILOT PROGRAM
SECTION 2958-A. RURAL DENTISTRY PILOT PROGRAM.
  S 2958-A. RURAL DENTISTRY PILOT PROGRAM. 1.  THE  COMMISSIONER  SHALL,
WITHIN  MONIES APPROPRIATED THEREFORE, ESTABLISH A RURAL DENTISTRY PILOT
PROGRAM IN CHAUTAUQUA, ALLEGANY, AND CATTARAUGUS COUNTIES.  THE  COMMIS-
SIONER  SHALL,  IN COORDINATION WITH THE UNIVERSITY OF BUFFALO SCHOOL OF
DENTISTRY STUDY COST SAVINGS ACHIEVED THROUGH THE  PROVISION  OF  DENTAL
SERVICES  IN GEOGRAPHICALLY ISOLATED AND UNDERSERVED AREAS. SUCH A STUDY
SHALL DETERMINE:
  (I) THE QUALITY OF CARE  PROVIDED  THROUGH  A  MOBILE  DENTAL  SYSTEM,
INCLUDING  MINIMIZING  ANY  ADVERSE  EFFECTS ON DENTAL PRACTICES ALREADY
SERVING OR SEEKING  TO  ENTER  RURAL  OR  UNDERSERVED  COMMUNITIES,  THE
INVOLVEMENT OF DENTAL PRACTICES SERVING RURAL OR UNDERSERVED COMMUNITIES
IN  SUCH  A  MOBILE  DENTAL  SYSTEM,  AND  THE ESTABLISHMENT OF REFERRAL
SYSTEMS AND NETWORKS TO  EXISTING  DENTAL  PRACTICES  SERVING  RURAL  OR
UNDERSERVED COMMUNITIES FOR REGULAR ONGOING CARE OF PATIENTS;
  (II) COST SAVINGS ACHIEVED THROUGH TARGETED ORAL HEALTH INITIATIVES IN
RURAL AREAS;
  (III)  COROLLARIES  BETWEEN  PREVENTATIVE  DENTAL  CARE  AND  IMPROVED
PATIENT OUTCOMES IN RURAL AREAS;

S. 6914                            145                           A. 9205

  (IV) KNOWLEDGE, ATTITUDE, AND BEHAVIOR OUTCOMES AMONG DENTAL  STUDENTS
AND RECOMMENDATIONS FOR RURAL DENTAL HEALTH EDUCATION CURRICULUM;
  (V)  A  PROFILE OF THE PARTICIPANTS, THE NUMBER OF PERSONS SERVED, AND
HEALTH CARE DISPARITIES;
  (VI) A DESCRIPTION OF THE ACTIVITIES OF THE PROGRAM;
  (VII) GUIDANCE ON FACILITATED PARTICIPATION IN RURAL AREAS;
  (VIII) PROVIDER SHORTAGES IN RURAL AREAS;
  (IX) A DESCRIPTION OF THE IMPACT OF THE PROGRAMS ON THE COMMUNITY  AND
RECOMMENDATIONS FOR REPLICATION/IMPROVEMENT IN OTHER RURAL AREAS; AND
  (X)  SUCH  OTHER ACTIVITIES AS THE COMMISSIONER MAY DEEM NECESSARY AND
APPROPRIATE TO THIS SECTION.
  2. TWELVE MONTHS AFTER THE  APPROVAL  OF  THE  RURAL  DENTISTRY  PILOT
PROGRAM,  AND  ANNUALLY  THEREAFTER,  THE  PROGRAM  SHALL  REPORT TO THE
COMMISSIONER ON THE PROGRESS OF  THE  PROGRAM.  THE  COMMISSIONER  SHALL
EVALUATE  THE  FINDINGS  OF  THE  STUDY  AND REPORT TO THE GOVERNOR, THE
TEMPORARY PRESIDENT OF THE SENATE, THE  SPEAKER  OF  THE  ASSEMBLY,  THE
CHAIR  OF  THE  SENATE  STANDING  COMMITTEE  ON HEALTH, THE CHAIR OF THE
ASSEMBLY HEALTH COMMITTEE AND THE CHAIR OF THE LEGISLATIVE COMMISSION ON
RURAL RESOURCES ON ITS FINDINGS.
  3. ADDITIONALLY,  TO  THE  EXTENT  OF  FUNDS  APPROPRIATED  THEREFORE,
MEDICAL ASSISTANCE FUNDS, INCLUDING ANY FUNDING OR SHARED SAVINGS AS MAY
BECOME AVAILABLE THROUGH FEDERAL WAIVERS OR OTHERWISE UNDER TITLES EIGH-
TEEN  AND  NINETEEN  OF THE FEDERAL SOCIAL SECURITY ACT, MAY BE USED FOR
EXPENDITURES IN SUPPORT OF THE DEMONSTRATION PROGRAM.
  4. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW TO THE  CONTRARY,
THE   COMMISSIONER  IS  AUTHORIZED  TO  WAIVE,  MODIFY  OR  SUSPEND  THE
PROVISIONS OF RULES AND  REGULATIONS  PROMULGATED  PURSUANT  TO  ARTICLE
TWENTY-EIGHT  OF  THIS  CHAPTER IF THE COMMISSIONER DETERMINES THAT SUCH
WAIVER, MODIFICATION OR  SUSPENSION  IS  NECESSARY  FOR  THE  SUCCESSFUL
IMPLEMENTING OF THE RURAL DENTISTRY PILOT PROGRAM AUTHORIZED PURSUANT TO
THIS  SECTION  AND  PROVIDED  THAT  THE COMMISSIONER DETERMINES THAT THE
HEALTH, SAFETY AND GENERAL WELFARE OF PEOPLE RECEIVING HEALTH CARE UNDER
SUCH RURAL DENTISTRY PILOT PROGRAM WILL NOT BE IMPAIRED AS A  RESULT  OF
SUCH WAIVER, MODIFICATION, OR SUSPENSION.
  S  59.  Paragraph  (d)  of subdivision 2 of section 2511 of the public
health law is REPEALED.
  S 60.  Subparagraphs (iv) and (v) of paragraph (b) of subdivision 9 of
section 2511 of the public health law, subparagraph (iv) as  amended  by
section  33 of part D of chapter 56 of the laws of 2013 and subparagraph
(v) as amended by chapter 2 of the laws of 1998, are amended to read  as
follows:
  (iv) outstationing of persons who are authorized to provide assistance
to  families in completing the enrollment application process under this
title and title eleven of article five of the social  services  law,  in
locations, such as community settings, which are geographically accessi-
ble  to large numbers of children who may be eligible for benefits under
such titles, and at times, including evenings and weekends,  when  large
numbers  of  children who may be eligible for benefits under such titles
are likely to be encountered. Persons outstationed  in  accordance  with
this subparagraph shall be authorized to make determinations of presump-
tive  eligibility  in accordance with paragraph [(g)] (F) of subdivision
two of THIS section [two  thousand  five  hundred  and  eleven  of  this
title]; and
  (v)  notice  by  local social services districts to medical assistance
applicants of the availability of benefits under paragraph [(g)] (F)  of

S. 6914                            146                           A. 9205

subdivision two of THIS section [two thousand five hundred and eleven of
this title].
  S  61.  Subdivisions 3, 4 and 5 of section 47 of chapter 2 of the laws
of 1998, amending the public health  law  and  other  laws  relating  to
expanding  the  child health insurance plan, as amended by section 19 of
part D of chapter 59 of the  laws  of  2011,  are  amended  to  read  as
follows:
  3.  section  six  of  this  act  shall  take  effect  January 1, 1999;
provided, however, that subparagraph (iii) of paragraph (c) of  subdivi-
sion  9  of section 2510 of the public health law, as added by this act,
shall expire on July 1, [2014] 2017;
  4. sections two, three, four, seven, eight, nine,  fourteen,  fifteen,
sixteen,  eighteen, eighteen-a, [twenty-three,] twenty-four, and twenty-
nine of this act shall take effect January 1,  1999  and  SECTION  EIGH-
TEEN-A  shall  expire  on  July 1, 2014; section twenty-five of this act
shall take effect on January 1, 1999 and shall expire on April 1, 2005;
  5. section twelve of this act  shall  take  effect  January  1,  1999;
provided,  however,  paragraphs  (g) and (h) of subdivision 2 of section
2511 of the public health law, as added by such section, shall expire on
July 1, [2014] 2017;
  S 62. The opening paragraph of subparagraph (ii) of paragraph  (a)  of
subdivision  2  of section 369 of the social services law, as amended by
chapter 41 of the laws of 1992, is amended to read as follows:
  with respect to the real property of an individual who is an inpatient
in a nursing facility,  intermediate  care  facility  for  the  mentally
retarded,  or  other  medical  institution,  [and] who is not reasonably
expected to be discharged from the medical  institution  and  to  return
home,  AND WHO IS REQUIRED, AS A CONDITION OF RECEIVING SERVICES IN SUCH
INSTITUTION UNDER THE STATE PLAN FOR MEDICAL ASSISTANCE,  TO  SPEND  FOR
COSTS  OF  MEDICAL  CARE  ALL  BUT A MINIMAL AMOUNT OF HIS OR HER INCOME
REQUIRED FOR PERSONAL NEEDS;  provided,  however,  any  such  lien  will
dissolve  upon  the  individual's discharge from the medical institution
and return home; in addition, no such lien may be imposed on  the  indi-
vidual's  home  if  one of the following persons is lawfully residing in
the home:
  S 62-a. Subparagraph (i) of paragraph (b) of subdivision 2 of  section
369 of the social services law, as amended by chapter 170 of the laws of
1994, is amended to read as follows:
  (i)  Notwithstanding  any  inconsistent  provision  of this chapter or
other law, no adjustment or recovery may be made against the property of
any individual on account of any medical assistance correctly paid to or
on behalf of an individual under this title, except that recoveries must
be pursued:
  (A) upon the sale of the property subject to a lien imposed on account
of medical assistance paid to an individual described in clause (ii)  of
paragraph  (a)  of this subdivision, or from the estate of such individ-
ual; and
  (B) from the estate of an individual who was fifty-five years  of  age
or  older  when  he  or  she received such assistance, PROVIDED THAT FOR
INDIVIDUALS WHOSE ELIGIBILITY FOR MEDICAL ASSISTANCE WAS BASED ON  PARA-
GRAPH  (B) OF SUBDIVISION ONE OF SECTION THREE HUNDRED SIXTY-SIX OF THIS
TITLE, RECOVERY SHALL BE LIMITED TO  MEDICAL  ASSISTANCE  CONSISTING  OF
NURSING  FACILITY  SERVICES,  HOME  AND  COMMUNITY-BASED  SERVICES,  AND
RELATED HOSPITAL AND PRESCRIPTION DRUG SERVICES.
  S 63. Section 4 of chapter 779 of  the  laws  of  1986,  amending  the
social  services  law relating to authorizing services for non-residents

S. 6914                            147                           A. 9205

in adult homes, residences for adults and enriched housing programs,  as
amended  by  chapter  108  of  the  laws  of 2011, is amended to read as
follows:
  S 4. This act shall take effect on the one hundred twentieth day after
it  shall  have  become  a law and shall remain in full force and effect
until July 1, [2014] 2017, provided however, that effective immediately,
the addition, amendment and/or repeal of any rules or regulations neces-
sary for the implementation of the foregoing sections of this act on its
effective date are authorized and directed to be made and  completed  on
or before such effective date.
  S  64.  Subdivision (i-1) of section 79 of part C of chapter 58 of the
laws of 2008, amending the social services law and the public health law
relating to adjustments of rates, as amended by section 21 of part D  of
chapter 59 of the laws of 2011, is amended to read as follows:
  (i-1)  section  thirty-one-a of this act shall be deemed repealed July
1, [2014] 2017;
  S 65. Section 4 of chapter 19 of the laws of 1998, amending the social
services law relating to limiting the method of payment for prescription
drugs under the medical assistance program, as amended by section 107 of
part H of chapter 59 of the laws of 2011, is amended to read as follows:
  S 4. This act shall take effect 120 days after it shall have become  a
law and shall expire and be deemed repealed March 31, [2014] 2017.
  S  66. Paragraph (e-1) of subdivision 12 of section 2808 of the public
health law, as amended by section 63 of part A of chapter 56 of the laws
of 2013, is amended to read as follows:
  (e-1) Notwithstanding any inconsistent provision of law or regulation,
the commissioner shall provide,  in  addition  to  payments  established
pursuant  to  this  article  prior to application of this section, addi-
tional payments under the medical assistance program pursuant  to  title
eleven of article five of the social services law for non-state operated
public  residential health care facilities, including public residential
health care facilities located in the county of Nassau,  the  county  of
Westchester  and  the  county  of Erie, but excluding public residential
health care facilities operated by a town or city within  a  county,  in
aggregate  annual  amounts of up to one hundred fifty million dollars in
additional payments for the state fiscal year beginning April first, two
thousand six and for the state fiscal year beginning  April  first,  two
thousand  seven and for the state fiscal year beginning April first, two
thousand eight and of up to three hundred million dollars in such aggre-
gate annual additional payments for  the  state  fiscal  year  beginning
April  first, two thousand nine, and for the state fiscal year beginning
April first, two thousand ten and for the state  fiscal  year  beginning
April  first, two thousand eleven, and for the state fiscal years begin-
ning April first, two thousand twelve  and  April  first,  two  thousand
thirteen,  AND  OF  UP TO FIVE HUNDRED MILLION DOLLARS IN SUCH AGGREGATE
ANNUAL ADDITIONAL PAYMENTS FOR THE STATE FISCAL  YEARS  BEGINNING  APRIL
FIRST,  TWO  THOUSAND  FOURTEEN,  APRIL  FIRST, TWO THOUSAND FIFTEEN AND
APRIL FIRST, TWO THOUSAND SIXTEEN. The amount allocated to each eligible
public residential  health  care  facility  for  this  period  shall  be
computed  in  accordance  with  the  provisions of paragraph (f) of this
subdivision, provided, however, that patient days shall be utilized  for
such  computation reflecting actual reported data for two thousand three
and each representative succeeding  year  as  applicable,  and  provided
further,  however, that, in consultation with impacted providers, of the
funds allocated for distribution in  the  state  fiscal  year  beginning

S. 6914                            148                           A. 9205

April first, two thousand thirteen, up to thirty-two million dollars may
be allocated in accordance with paragraph (f-1) of this subdivision.
  S  67.  Paragraph  (i) of subdivision 3 of section 461-1 of the social
services law, as amended by section 4 of part D of  chapter  56  of  the
laws of 2012, is amended to read as follows:
  (i)  (A)  The  commissioner  of  health is authorized to add up to six
thousand assisted living program beds to the gross  number  of  assisted
living  program  beds having been determined to be available as of April
first, two thousand nine. Nothing herein shall be interpreted as prohib-
iting any eligible applicant from  submitting  an  application  for  any
assisted  living  program bed so added. The commissioner of health shall
not be required to review on a comparative basis applications  submitted
for  assisted  living  program beds made available under this paragraph.
The commissioner of health shall only  authorize  the  addition  of  six
thousand beds pursuant to a [five] SEVEN year plan ENDING PRIOR TO JANU-
ARY FIRST, TWO THOUSAND SEVENTEEN.
  (B)  THE COMMISSIONER OF HEALTH SHALL PROVIDE AN ANNUAL WRITTEN REPORT
TO THE CHAIR OF THE SENATE STANDING COMMITTEE ON HEALTH AND THE CHAIR OF
THE ASSEMBLY HEALTH COMMITTEE NO LATER THAN JANUARY FIRST OF EACH  YEAR.
SUCH REPORT SHALL INCLUDE, BUT NOT BE LIMITED TO, THE NUMBER OF ASSISTED
LIVING  PROGRAM  BEDS MADE AVAILABLE PURSUANT TO THIS SECTION BY COUNTY,
THE TOTAL NUMBER OF ASSISTED LIVING PROGRAM BEDS BY COUNTY,  THE  NUMBER
OF VACANT ASSISTED LIVING PROGRAM BEDS BY COUNTY, AND ANY OTHER INFORMA-
TION DEEMED NECESSARY AND APPROPRIATE.
  S 67-a. Subparagraph (v) of paragraph (b) of subdivision 35 of section
2807-c  of  the  public health law, as amended by section 7 of part B of
chapter 56 of the laws of 2013, is amended to read as follows:
  (v) such  regulations  shall  incorporate  quality  related  measures,
including,  but  not  limited  to, potentially preventable re-admissions
(PPRs) and provide for rate adjustments or payment disallowances related
to PPRs and other potentially  preventable  negative  outcomes  (PPNOs),
which shall be calculated in accordance with methodologies as determined
by the commissioner, provided, however, that such methodologies shall be
based on a comparison of the actual and risk adjusted expected number of
PPRs and other PPNOs in a given hospital and with benchmarks established
by  the  commissioner and provided further that such rate adjustments or
payment disallowances shall result in an aggregate reduction in Medicaid
payments of no less than thirty-five million dollars for the period July
first, two thousand ten through March thirty-first, two thousand  eleven
and  no less than fifty-one million dollars for annual periods beginning
April first, two thousand eleven through March thirty-first,  two  thou-
sand [fourteen] FIFTEEN, provided further that such aggregate reductions
shall  be offset by Medicaid payment reductions occurring as a result of
decreased PPRs during the period July first, two  thousand  ten  through
March  thirty-first, two thousand eleven and the period April first, two
thousand eleven through  March  thirty-first,  two  thousand  [fourteen]
FIFTEEN  and  as  a  result  of  decreased PPNOs during the period April
first, two thousand eleven  through  March  thirty-first,  two  thousand
[fourteen] FIFTEEN; and provided further that for the period July first,
two  thousand  ten  through  March thirty-first, two thousand [fourteen]
FIFTEEN, such rate adjustments or payment disallowances shall not  apply
to  behavioral  health  PPRs;  or to readmissions that occur on or after
fifteen days following an initial  admission.  By  no  later  than  July
first,  two  thousand eleven the commissioner shall enter into consulta-
tions with representatives of the health care facilities subject to this
section regarding potential prospective revisions to applicable  method-

S. 6914                            149                           A. 9205

ologies  and benchmarks set forth in regulations issued pursuant to this
subparagraph;
  S 67-b. Paragraph (b) of subdivision 1 of section 76 of chapter 731 of
the laws of 1993, amending the public health law and other laws relating
to  reimbursement,  delivery  and capital cost of ambulatory health care
services and inpatient hospital services, as amended by  section  28  of
part A of chapter 59 of the laws of 2011, is amended to read as follows:
  (b)  sections  fifteen  through  nineteen and subdivision 3 of section
2807-e of the public health law as added by section twenty of  this  act
shall  expire  on  July 1, [2014] 2017, and section seventy-four of this
act shall expire on July 1, 2007;
  S 67-c. Section 18 of chapter 904  the  laws  of  1984,  amending  the
public  health  law  and the social services law relating to encouraging
comprehensive health services, as amended by section 21  of  part  C  of
chapter 59 of the laws of 2011, is amended to read as follows:
  S  18.  This  act  shall take effect immediately, except that sections
six, nine, ten and eleven of this act shall take effect on the  sixtieth
day after it shall have become a law, sections two, three, four and nine
of  this  act  shall  expire  and be of no further force or effect on or
after March 31, [2014] 2017, section two of this act shall  take  effect
on  April  1,  1985 or seventy-five days following the submission of the
report required by section one of this  act,  whichever  is  later,  and
sections  eleven  and  thirteen  of  this  act shall expire and be of no
further force or effect on or after March 31, 1988.
  S 68. Notwithstanding any inconsistent provision of law, rule or regu-
lation, for purposes of implementing the provisions of the public health
law and the social services law, references to titles XIX and XXI of the
federal social security act in the public  health  law  and  the  social
services  law  shall be deemed to include and also to mean any successor
titles thereto under the federal social security act.
  S 69. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the public health law, section 18 of chapter 2 of the laws of 1988,  and
18  NYCRR  505.14(h), as they relate to time frames for notice, approval
or certification of rates of payment, are hereby suspended  and  without
force or effect for purposes of implementing the provisions of this act.
  S  70. Severability clause. If any clause, sentence, paragraph, subdi-
vision, section or part of this act shall be adjudged by  any  court  of
competent  jurisdiction  to  be invalid, such judgment shall not affect,
impair or invalidate the remainder thereof, but shall be confined in its
operation to the clause, sentence, paragraph,  subdivision,  section  or
part thereof directly involved in the controversy in which such judgment
shall  have been rendered. It is hereby declared to be the intent of the
legislature that this act would have been enacted even if  such  invalid
provisions had not been included herein.
  S  71.  This  act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1,  2014  provided
that:
  1.  sections  five, fifty-nine and sixty of this act shall take effect
July 1, 2014;
  2. section twenty-six of this act shall take effect immediately and be
deemed to have been in full force and effect on and after March 1, 2014;
  3. section nine of this act shall take effect May 1,  2014;  provided,
however,  that  the amendments to subparagraph (iii) of paragraph (c) of
subdivision 6 of section 367-a  of  the  social  services  law  made  by

S. 6914                            150                           A. 9205

section  nine  of this act shall not affect the repeal of such paragraph
and shall be deemed repealed therewith;
  3-a.  amendments made to section 365-h of the social services law made
by section seven of this act,  shall  not  affect  the  repeal  of  such
section and shall be deemed repealed therewith.
  3-b.  section  twenty-six-a  of  this act shall take effect October 1,
2014;
  3-c. sections fifty, fifty-one, fifty-two and fifty-three  shall  take
effect April 1, 2015;
  3-d. section fifty-five of this act shall take effect January 1, 2015;
  4.  the  amendments  to  subdivision  9  of section 2511 of the public
health law made by section sixty of this act shall not affect the  expi-
ration of such subdivision and shall expire therewith;
  4-a.  section  twenty-two of this act shall take effect April 1, 2014,
and shall be deemed expired January 1, 2017;
  4-b. the amendments to subdivisions (a) and (b) of section  364-jj  of
the  social  services  law made by section thirty-nine of this act shall
not affect the expiration of such section and shall be deemed to  expire
therewith;
  4-c.  the  amendments to section 364-j of the social services law made
by section forty-nine of this act shall not affect the  repeal  of  such
section and shall be deemed to repeal therewith;
  4-d.  the  amendments  to  section 48-a of part A of chapter 56 of the
laws of 2013 made by section thirteen of this act shall not  affect  the
expiration of such section and shall expire therewith;
  4-e.  the amendments to section 1 of part H of chapter 111 of the laws
of 2010 made by section fifteen of this act shall not affect the expira-
tion of such section and shall expire therewith;
  5. any rules or regulations necessary to implement the  provisions  of
this  act  may be promulgated and any procedures, forms, or instructions
necessary for such implementation may be adopted and issued on or  after
the date this act shall have become a law;
  6. this act shall not be construed to alter, change, affect, impair or
defeat any rights, obligations, duties or interests accrued, incurred or
conferred prior to the effective date of this act;
  7. the commissioner of health and the superintendent of the department
of  financial  services  and  any appropriate council may take any steps
necessary to implement this act prior to its effective date;
  8. notwithstanding any inconsistent provision of the state administra-
tive procedure act or any other provision of law,  rule  or  regulation,
the  commissioner  of health and the superintendent of the department of
financial services and any appropriate council is authorized to adopt or
amend or promulgate on an emergency basis any regulation he  or  she  or
such council determines necessary to implement any provision of this act
on its effective date; and
  9.  the  provisions of this act shall become effective notwithstanding
the failure of the commissioner of health or the superintendent  of  the
department  of  financial  services  or any council to adopt or amend or
promulgate regulations implementing this act.

                                 PART D

  Section 1. Section 6802 of the education  law  is  amended  by  adding
three new subdivisions 24, 25 and 26 to read as follows:
  24.  "COMPOUNDING"  MEANS  THE  COMBINING, ADMIXING, MIXING, DILUTING,
POOLING, RECONSTITUTING, OR OTHERWISE ALTERING OF A DRUG  OR  BULK  DRUG

S. 6914                            151                           A. 9205

SUBSTANCE TO CREATE A DRUG WITH RESPECT TO AN OUTSOURCING FACILITY UNDER
SECTION  503B  OF  THE  FEDERAL  FOOD, DRUG AND COSMETIC ACT AND FURTHER
DEFINED IN THIS SECTION.
  25. "OUTSOURCING FACILITY" MEANS A FACILITY THAT:
  (A) IS ENGAGED IN THE COMPOUNDING OF STERILE DRUGS;
  (B) IS CURRENTLY REGISTERED AS AN OUTSOURCING FACILITY WITH THE SECRE-
TARY OF HEALTH AND HUMAN SERVICES; AND
  (C)  COMPLIES  WITH  ALL  APPLICABLE REQUIREMENTS OF FEDERAL AND STATE
LAW, INCLUDING THE FEDERAL FOOD, DRUG AND COSMETIC ACT.
  26. "STERILE DRUG" MEANS A DRUG THAT IS INTENDED FOR PARENTERAL ADMIN-
ISTRATION, AN OPHTHALMIC OR ORAL INHALATION DRUG IN AQUEOUS FORMAT, OR A
DRUG THAT IS REQUIRED TO BE STERILE UNDER FEDERAL OR STATE LAW.
  S 2. Subdivision 1 of section 6808 of the education law, as  added  by
chapter 987 of the laws of 1971, is amended to read as follows:
  1.  No  person,  firm, corporation or association shall possess drugs,
prescriptions or poisons for the  purpose  of  compounding,  dispensing,
retailing,   wholesaling,   or  manufacturing,  or  shall  offer  drugs,
prescriptions or poisons for sale at retail or wholesale  unless  regis-
tered  by  the  department  as  a  pharmacy,  [store,]  wholesaler, [or]
manufacturer OR OUTSOURCING FACILITY.
  S 3. Subdivisions 5, 6 and 7 of section 6808 of the education law  are
renumbered  subdivisions  6, 7 and 8 and a new subdivision 5 is added to
read as follows:
  5. OUTSOURCING FACILITY'S REGISTRATION.
  A. OBTAINING A REGISTRATION. AN OUTSOURCING FACILITY SHALL  BE  REGIS-
TERED AS FOLLOWS:
  (1) AN APPLICATION FOR INITIAL REGISTRATION OR RENEWAL OF REGISTRATION
SHALL BE MADE ON A FORM PRESCRIBED BY THE DEPARTMENT.
  (2)  AN APPLICATION FOR INITIAL REGISTRATION SHALL BE ACCOMPANIED BY A
FEE OF EIGHT HUNDRED TWENTY-FIVE DOLLARS.
  B. RENEWAL OF REGISTRATION. ALL OUTSOURCING FACILITIES'  REGISTRATIONS
SHALL  BE  RENEWED ON A DATE SET BY THE DEPARTMENT. THE TRIENNIAL REGIS-
TRATION FEE SHALL BE FIVE HUNDRED TWENTY DOLLARS OR A PRO RATED  PORTION
THEREOF AS DETERMINED BY THE DEPARTMENT.
  C.  DISPLAY  OF  REGISTRATION.  THE  REGISTRATION  SHALL  BE DISPLAYED
CONSPICUOUSLY IN THE PLACE OF BUSINESS.
  D. CHANGE OF LOCATION. IN THE EVENT THAT THE LOCATION OF SUCH PLACE OF
BUSINESS SHALL BE CHANGED, THE OWNER SHALL APPLY TO THE  DEPARTMENT  FOR
INSPECTION  OF  THE NEW LOCATION AND ENDORSEMENT OF THE REGISTRATION FOR
THE NEW LOCATION. THE FEE FOR INSPECTION AND ENDORSEMENT  SHALL  BE  ONE
HUNDRED  SEVENTY-FIVE  DOLLARS, UNLESS IT APPEARS TO THE SATISFACTION OF
THE DEPARTMENT THAT THE CHANGE IN LOCATION IS OF A TEMPORARY NATURE  DUE
TO FIRE, FLOOD OR OTHER DISASTER.
  E.  REPORT.  UPON INITIALLY REGISTERING AS AN OUTSOURCING FACILITY AND
EVERY SIX MONTHS THEREAFTER, EACH OUTSOURCING FACILITY SHALL  SUBMIT  TO
THE EXECUTIVE SECRETARY OF THE STATE BOARD OF PHARMACY A REPORT:
  (1)  IDENTIFYING  THE  DRUGS  COMPOUNDED  BY SUCH OUTSOURCING FACILITY
DURING THE PREVIOUS 6-MONTH PERIOD; AND
  (2) WITH RESPECT TO EACH DRUG IDENTIFIED  UNDER  SUBPARAGRAPH  ONE  OF
THIS  PARAGRAPH,  PROVIDING  THE  ACTIVE  INGREDIENT; THE SOURCE OF SUCH
ACTIVE INGREDIENT; THE NATIONAL DRUG CODE NUMBER OF THE SOURCE  DRUG  OR
BULK  ACTIVE INGREDIENT, IF AVAILABLE; THE STRENGTH OF THE ACTIVE INGRE-
DIENT PER UNIT; THE DOSAGE FORM AND ROUTE OF ADMINISTRATION; THE PACKAGE
DESCRIPTION; THE NUMBER OF INDIVIDUAL UNITS PRODUCED; AND  THE  NATIONAL
DRUG CODE NUMBER OF THE FINAL PRODUCT, IF ASSIGNED.

S. 6914                            152                           A. 9205

  F.  CONDUCT  OF  OUTSOURCING  FACILITY.  EVERY OWNER OF AN OUTSOURCING
FACILITY IS RESPONSIBLE FOR THE STRENGTH, QUALITY, PURITY  AND  LABELING
THEREOF  OF  ALL COMPOUNDED DRUGS, SUBJECT TO THE GUARANTY PROVISIONS OF
THIS ARTICLE AND THE PUBLIC HEALTH LAW. EVERY OUTSOURCING FACILITY SHALL
BE  UNDER  THE  IMMEDIATE  SUPERVISION  AND  MANAGEMENT  OF A PHARMACIST
LICENSED TO PRACTICE IN NEW YORK STATE.
  G. APPLICANT FOR REGISTRATION.  AN APPLICANT FOR  REGISTRATION  OF  AN
OUTSOURCING  FACILITY SHALL BE OF GOOD MORAL CHARACTER, AS DETERMINED BY
THE DEPARTMENT. IN THE CASE OF A CORPORATE  APPLICANT,  THE  REQUIREMENT
SHALL EXTEND TO ALL OFFICERS AND DIRECTORS AND STAKEHOLDERS HAVING A TEN
PERCENT OR GREATER INTEREST IN THE CORPORATION.
  S  4.  Subdivisions  6  and 7 of section 6808 of the education law, as
added by chapter 987 of the laws of 1971, such  subdivisions  as  renum-
bered by section three of this act, are amended to read as follows:
  6.  Inspection.  The  state  board  of  pharmacy and the department of
education, and their employees designated  by  the  commissioner,  shall
have  the  right  to  enter  any pharmacy, wholesaler, manufacturer, [or
registered store,] OUTSOURCING FACILITY or vehicle and  to  inspect,  at
reasonable  times, such factory, warehouse, establishment or vehicle and
all records required by this article, pertinent equipment, finished  and
unfinished materials, containers, and labels.
  7.  [Revocation or suspension] PENALTIES.  A pharmacy, [store,] whole-
saler [or], manufacturer [registration may be revoked  or  suspended  by
the  committee on professional conduct of the state board of pharmacy in
accordance with  the  provisions  of  article  one  hundred  thirty]  OR
OUTSOURCING  FACILITY  REGISTERED  UNDER THIS SECTION SHALL BE UNDER THE
SUPERVISION OF THE BOARD OF REGENTS AND SHALL BE SUBJECT TO DISCIPLINARY
PROCEEDINGS AND PENALTIES IN ACCORDANCE WITH ARTICLE ONE HUNDRED  THIRTY
OF THIS CHAPTER IN THE SAME MANNER AND TO THE SAME EXTENT AS INDIVIDUALS
AND PROFESSIONAL SERVICE CORPORATIONS WITH RESPECT TO THEIR LICENSES AND
REGISTRATIONS,  PROVIDED THAT FAILURE TO COMPLY WITH THE REQUIREMENTS OF
THIS SECTION SHALL CONSTITUTE PROFESSIONAL MISCONDUCT.
  S 5. Subdivision 1 of section 6808-b of the education law, as  amended
by chapter 567 of the laws of 2002, is amended to read as follows:
  1.  Definition.    The term "nonresident establishment" shall mean any
pharmacy, manufacturer [or], wholesaler, OR OUTSOURCING FACILITY located
outside of the state that ships, mails or delivers prescription drugs or
devices to other establishments, authorized prescribers and/or  patients
residing  in  this  state. Such establishments shall include, but not be
limited to, pharmacies that transact business through  the  use  of  the
internet.
  S  6.  Paragraph f of subdivision 4 of section 6808-b of the education
law, as amended by chapter 567 of the laws of 2002, is amended  to  read
as follows:
  f. The application of establishments to be registered as a manufactur-
er  [or],  wholesaler  OR  OUTSOURCING  FACILITY of drugs and/or devices
shall be accompanied by a fee as provided in section sixty-eight hundred
eight of this article; and
  S 7. Section 6810 of the education law is  amended  by  adding  a  new
subdivision 14 to read as follows:
  14.  NOTWITHSTANDING  ANY  OTHER  PROVISION OF LAW TO THE CONTRARY, NO
OUTSOURCING FACILITY MAY DISTRIBUTE OR DISPENSE ANY DRUG TO  ANY  PERSON
PURSUANT TO A PRESCRIPTION UNLESS IT IS ALSO REGISTERED AS A PHARMACY IN
THIS  STATE  AND  MEETS ALL OTHER APPLICABLE REQUIREMENTS OF FEDERAL AND
STATE LAW.

S. 6914                            153                           A. 9205

  S 8. Section 6811 of the education law is  amended  by  adding  a  new
subdivision 26 to read as follows:
  26. ANY OUTSOURCING FACILITY TO SELL OR OFFER TO SELL ANY DRUG THAT IS
NOT BOTH COMPOUNDED UNDER THE PERSONAL SUPERVISION OF A LICENSED PHARMA-
CIST AND LABELED WITH THE FULL NAME OF THE OUTSOURCING FACILITY.
  S  9.  Subdivisions 1 and 2 of section 6811-a of the education law, as
added by chapter 729 of the  laws  of  1981,  are  amended  to  read  as
follows:
  1.  [No]  EXCEPT AS OTHERWISE AUTHORIZED IN THE FEDERAL FOOD, DRUG AND
COSMETIC ACT, NO drug for  which  a  prescription  is  required  by  the
provisions  of the Federal Food, Drug and Cosmetic Act or by the commis-
sioner of health may be manufactured or commercially distributed  within
this  state  in  tablet  or capsule form unless it has clearly marked or
imprinted on each such tablet or capsule in conformance with the  appli-
cable plan required by subdivision three of this section:
  (a)  an individual symbol, number, company name, words, letters, mark-
ing or National Drug Code (hereinafter referred to as N. D. C.)   number
identifying the manufacturer or distributor of the drug; and
  (b)  an  N.  D.  C.  number, symbol, number, letters, words or marking
identifying such drug or combination of drugs.
  2. [No] EXCEPT AS OTHERWISE AUTHORIZED IN THE FEDERAL FOOD,  DRUG  AND
COSMETIC  ACT,  NO  drug  for  which any prescription is required by the
provisions of the Federal Food, Drug and Cosmetic Act or by the  commis-
sioner  of  health  contained  within  a  bottle,  vial, carton or other
container, or in any way affixed or appended to  or  enclosed  within  a
package  of  any  kind,  and  designed  or intended for delivery in such
container or package to an ultimate consumer, shall be  manufactured  or
distributed  within  this  state  unless  such  container or package has
clearly and permanently marked or imprinted upon it in conformance  with
the applicable plan required by subdivision three of this section:
  (a)  an  individual  symbol,  N.  D.  C. number, company name, number,
letters, words or marking identifying the manufacturer or distributor of
the drug;
  (b) an N. D. C. number, symbol,  number,  letters,  words  or  marking
identifying such drug or combination of drugs; and
  (c) whenever the distributor of the prescription drug product does not
also  manufacture  the  product the names and places of business of both
shall appear on the label in words clearly distinguishing each.
  S 10. Subdivision 1 of section 6812 of the education law, as added  by
chapter 987 of the laws of 1971, is amended to read as follows:
  1. Where any pharmacy, MANUFACTURER, WHOLESALER OR OUTSOURCING FACILI-
TY  registered  by  the department is damaged by fire the board shall be
notified within a period of forty-eight hours, and the board shall  have
power to impound all drugs for analysis and condemnation, if found unfit
for   use.    Where  a  pharmacy  is  discontinued,  the  owner  of  its
prescription records shall notify the department as to  the  disposition
of  said  prescription  records, and in no case shall records be sold or
given away to a person who does not currently possess a registration  to
operate a pharmacy.
  S  11. Subdivision 1 of section 6817 of the education law, as added by
chapter 987 of the laws of 1971, is amended to read as follows:
  1. [No] EXCEPT AS OTHERWISE PROVIDED IN THE  FEDERAL  FOOD,  DRUG  AND
COSMETIC  ACT,  NO  person shall sell, deliver, offer for sale, hold for
sale, or give away any new drug, unless:
  a. an application with respect thereto has become effective, or in the
case of an investigational drug the sponsor has complied with the appli-

S. 6914                            154                           A. 9205

cable requirements, under the [federal food,  drug,  and  cosmetic  act]
FEDERAL FOOD, DRUG, AND COSMETIC ACT, or
  b. when not subject to such act, such drug has been tested and has not
been  found  to  be  unsafe  or ineffective for use under the conditions
prescribed, recommended or suggested in the labeling thereof, and, prior
to selling or offering for sale such drug, there has been filed with the
department an application setting forth
  (1) full reports of investigations which have been made to show wheth-
er or not such drug is safe and effective for use;
  (2) a full list of the ingredients used as components of such drug;
  (3) a full statement of the composition of such drug;
  (4) a full description of the methods used in, and the facilities  and
controls  used  for,  the  manufacture,  processing  and packing of such
drugs;
  (5) such samples of such drug and of the ingredients  used  as  compo-
nents thereof as the board or secretary may require; and
  (6) specimens of the labeling proposed to be used for such drug.
  S  12.  The  education  law is amended by adding a new section 6831 to
read as follows:
  S 6831. SPECIAL PROVISIONS RELATING TO  OUTSOURCING  FACILITIES.    1.
REGISTRATION.  ANY OUTSOURCING FACILITY THAT IS ENGAGED IN THE COMPOUND-
ING OF STERILE DRUGS IN THIS STATE SHALL BE REGISTERED AS AN OUTSOURCING
FACILITY UNDER THE FEDERAL FOOD, DRUG AND COSMETIC ACT AND BE REGISTERED
AS AN OUTSOURCING FACILITY PURSUANT TO THIS ARTICLE.
  2. NEW DRUGS. SECTIONS 502(F)(1), 505 AND 582  OF  THE  FEDERAL  FOOD,
DRUG  AND  COSMETIC  ACT  SHALL  NOT  APPLY  TO  A DRUG COMPOUNDED IN AN
OUTSOURCING FACILITY REGISTERED UNDER THE FEDERAL FOOD, DRUG AND COSMET-
IC ACT.
  3. PRESCRIPTIONS. NOTWITHSTANDING ANY OTHER PROVISION OF  LAW  TO  THE
CONTRARY, NO OUTSOURCING FACILITY MAY DISTRIBUTE OR DISPENSE ANY DRUG TO
ANY  PERSON PURSUANT TO A PRESCRIPTION UNLESS IT IS ALSO REGISTERED AS A
PHARMACY IN THIS STATE AND MEETS ALL OTHER  APPLICABLE  REQUIREMENTS  OF
FEDERAL AND STATE LAW.
  4.  RESTRICTIONS.  ANY  DRUGS  COMPOUNDED  IN  AN OUTSOURCING FACILITY
REGISTERED PURSUANT TO THIS ARTICLE SHALL BE  COMPOUNDED  IN  ACCORDANCE
WITH ALL APPLICABLE FEDERAL AND STATE LAWS.
  5. LABELING. NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRA-
RY,  THE  LABEL  OF ANY DRUG COMPOUNDED BY AN OUTSOURCING FACILITY SHALL
INCLUDE, BUT NOT BE LIMITED TO THE FOLLOWING:
  (A) A STATEMENT THAT THE DRUG IS A COMPOUNDED  DRUG  OR  A  REASONABLE
COMPARABLE ALTERNATIVE STATEMENT THAT PROMINENTLY IDENTIFIES THE DRUG AS
A COMPOUNDED DRUG;
  (B)  THE NAME, ADDRESS, AND PHONE NUMBER OF THE APPLICABLE OUTSOURCING
FACILITY; AND
  (C) WITH RESPECT TO THE DRUG:
  (I) THE LOT OR BATCH NUMBER;
  (II) THE ESTABLISHED NAME OF THE DRUG;
  (III) THE DOSAGE FORM AND STRENGTH;
  (IV) THE STATEMENT OF QUANTITY OR VOLUME, AS APPROPRIATE;
  (V) THE DATE THAT THE DRUG WAS COMPOUNDED;
  (VI) THE EXPIRATION DATE;
  (VII) STORAGE AND HANDLING INSTRUCTIONS;
  (VIII) THE NATIONAL DRUG CODE NUMBER, IF AVAILABLE;
  (IX) THE STATEMENT THAT THE DRUG IS NOT FOR RESALE, AND THE  STATEMENT
"OFFICE USE ONLY"; AND

S. 6914                            155                           A. 9205

  (X)  A  LIST  OF  THE  ACTIVE  AND INACTIVE INGREDIENTS, IDENTIFIED BY
ESTABLISHED NAME, AND THE QUANTITY OR PROPORTION OF EACH INGREDIENT.
  6.  CONTAINER.  THE  CONTAINER  FROM WHICH THE INDIVIDUAL UNITS OF THE
DRUG ARE REMOVED FOR DISPENSING OR FOR ADMINISTRATION (SUCH AS A PLASTIC
BAG CONTAINING INDIVIDUAL PRODUCT SYRINGES) SHALL INCLUDE:
  (A) A LIST OF ACTIVE AND INACTIVE INGREDIENTS,  IDENTIFIED  BY  ESTAB-
LISHED NAME, AND THE QUANTITY OR PROPORTION OF EACH INGREDIENT; AND
  (B)  ANY  OTHER INFORMATION REQUIRED BY REGULATIONS PROMULGATED BY THE
COMMISSIONER TO FACILITATE ADVERSE EVENT REPORTING  IN  ACCORDANCE  WITH
THE  REQUIREMENTS ESTABLISHED IN SECTION 310.305 OF TITLE 21 OF THE CODE
OF FEDERAL REGULATIONS.
  7. BULK DRUGS. A DRUG MAY ONLY BE COMPOUNDED IN AN OUTSOURCING FACILI-
TY THAT DOES NOT COMPOUND USING  BULK  DRUG  SUBSTANCES  AS  DEFINED  IN
SECTION  207.3(A)(4)  OF  TITLE 21 OF THE CODE OF FEDERAL REGULATIONS OR
ANY SUCCESSOR REGULATION UNLESS:
  (A) THE BULK DRUG SUBSTANCE APPEARS  ON  A  LIST  ESTABLISHED  BY  THE
SECRETARY  OF HEALTH AND HUMAN SERVICES IDENTIFYING BULK DRUG SUBSTANCES
FOR WHICH THERE IS A CLINICAL NEED;
  (B) THE DRUG IS COMPOUNDED FROM A BULK DRUG SUBSTANCE THAT APPEARS  ON
THE  FEDERAL  DRUG  SHORTAGE  LIST IN EFFECT AT THE TIME OF COMPOUNDING,
DISTRIBUTING, AND DISPENSING;
  (C) IF AN APPLICABLE MONOGRAPH EXISTS UNDER THE UNITED STATES  PHARMA-
COPEIA,  THE  NATIONAL  FORMULARY, OR ANOTHER COMPENDIUM OR PHARMACOPEIA
RECOGNIZED BY THE SECRETARY OF HEALTH AND HUMAN SERVICES  AND  THE  BULK
DRUG SUBSTANCES EACH COMPLY WITH THE MONOGRAPH;
  (D) THE BULK DRUG SUBSTANCES ARE EACH MANUFACTURED BY AN ESTABLISHMENT
THAT IS REGISTERED WITH THE FEDERAL GOVERNMENT.
  8.  INGREDIENTS.  IF  AN  OUTSOURCING FACILITY USES INGREDIENTS, OTHER
THAN BULK DRUG SUBSTANCES, SUCH INGREDIENTS MUST COMPLY WITH THE  STAND-
ARDS  OF THE APPLICABLE UNITED STATES PHARMACOPEIA OR NATIONAL FORMULARY
MONOGRAPH, IF SUCH MONOGRAPH EXISTS, OR OF ANOTHER COMPENDIUM OR PHARMA-
COPEIA RECOGNIZED BY THE SECRETARY OF  HEALTH  AND  HUMAN  SERVICES  FOR
PURPOSES OF THIS SUBDIVISION, IF ANY.
  9. UNSAFE OR INEFFECTIVE DRUGS. NO OUTSOURCING FACILITY MAY COMPOUND A
DRUG  THAT  APPEARS  ON  A LIST PUBLISHED BY THE SECRETARY OF HEALTH AND
HUMAN SERVICES THAT HAS  BEEN  WITHDRAWN  OR  REMOVED  FROM  THE  MARKET
BECAUSE  SUCH  DRUGS  OR  COMPONENTS OF SUCH DRUGS HAVE BEEN FOUND TO BE
UNSAFE OR NOT EFFECTIVE.
  10. PROHIBITION ON WHOLESALING. NO COMPOUNDED DRUG  WILL  BE  SOLD  OR
TRANSFERRED  BY  ANY  ENTITY  OTHER  THAN  THE OUTSOURCING FACILITY THAT
COMPOUNDED SUCH DRUG. THIS DOES NOT PROHIBIT  THE  ADMINISTRATION  OF  A
DRUG IN A HEALTH CARE SETTING OR DISPENSING A DRUG PURSUANT TO A PROPER-
LY EXECUTED PRESCRIPTION.
  11.  PROHIBITION  AGAINST  COPYING  AN  APPROVED  DRUG. NO OUTSOURCING
FACILITY MAY COMPOUND A DRUG THAT IS ESSENTIALLY A COPY OF ONE  OR  MORE
APPROVED DRUGS.
  12.  PROHIBITION  AGAINST  COMPOUNDING  DRUGS  PRESENTING DEMONSTRABLE
DIFFICULTIES. NO OUTSOURCING FACILITY MAY COMPOUND A DRUG:
  I. THAT IS IDENTIFIED, DIRECTLY OR AS PART OF A CATEGORY OF DRUGS,  ON
A  LIST  PUBLISHED  BY  THE  SECRETARY OF HEALTH AND HUMAN SERVICES THAT
PRESENT DEMONSTRABLE DIFFICULTIES FOR COMPOUNDING  THAT  ARE  REASONABLY
LIKELY  TO  LEAD  TO AN ADVERSE EFFECT ON THE SAFETY OR EFFECTIVENESS OF
THE DRUG OR CATEGORY OF DRUGS, TAKING INTO ACCOUNT THE RISKS  AND  BENE-
FITS TO PATIENTS; OR

S. 6914                            156                           A. 9205

  II.  THAT  IS  COMPOUNDED IN ACCORDANCE WITH ALL APPLICABLE CONDITIONS
IDENTIFIED ON THE DRUG LIST AS CONDITIONS THAT ARE NECESSARY TO  PREVENT
THE DRUG OR CATEGORY OF DRUGS FROM PRESENTING DEMONSTRABLE DIFFICULTIES.
  13.  ADVERSE EVENT REPORTS. OUTSOURCING FACILITIES SHALL SUBMIT A COPY
OF ALL ADVERSE EVENT REPORTS SUBMITTED TO THE SECRETARY  OF  HEALTH  AND
HUMAN  SERVICES  IN  ACCORDANCE WITH THE CONTENT AND FORMAT REQUIREMENTS
ESTABLISHED IN SECTION 310.305 OF TITLE 21 OF THE CODE OF FEDERAL  REGU-
LATIONS, OR ANY SUCCESSOR REGULATION, TO THE EXECUTIVE SECRETARY FOR THE
STATE BOARD OF PHARMACY.
  14.  REPORTS.  THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER
OF HEALTH, SHALL PREPARE AND SUBMIT A REPORT TO  THE  GOVERNOR  AND  THE
LEGISLATURE,  DUE  EIGHTEEN  MONTHS  FROM  THE  EFFECTIVE  DATE  OF THIS
SECTION, EVALUATING THE EFFECTIVENESS OF THE REGISTRATION AND  OVERSIGHT
OF OUTSOURCING FACILITIES RELATED TO COMPOUNDING.
  S  13.  Section 3302 of the public health law is amended by adding two
new subdivisions 42 and 43 to read as follows:
  42. "COMPOUNDING" MEANS THE  COMBINING,  ADMIXING,  MIXING,  DILUTING,
POOLING,  RECONSTITUTING,  OR  OTHERWISE ALTERING OF A DRUG OR BULK DRUG
SUBSTANCE TO CREATE A DRUG WITH RESPECT TO AN OUTSOURCING FACILITY UNDER
SECTION 503B OF THE FEDERAL FOOD, DRUG  AND  COSMETIC  ACT  AND  FURTHER
DEFINED IN THIS SECTION.
  43. "OUTSOURCING FACILITY" MEANS A FACILITY THAT:
  (A)  IS  ENGAGED  IN  THE  COMPOUNDING  OF STERILE DRUGS AS DEFINED IN
SECTION SIXTY-EIGHT HUNDRED TWO OF THE EDUCATION LAW;
  (B) IS CURRENTLY REGISTERED AS AN  OUTSOURCING  FACILITY  PURSUANT  TO
ARTICLE ONE HUNDRED THIRTY-SEVEN OF THE EDUCATION LAW; AND
  (C)  COMPLIES  WITH  ALL  APPLICABLE REQUIREMENTS OF FEDERAL AND STATE
LAW, INCLUDING THE FEDERAL FOOD, DRUG AND COSMETIC ACT.
  NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE  CONTRARY,  WHEN  AN
OUTSOURCING  FACILITY  DISTRIBUTES  OR  DISPENSES ANY DRUG TO ANY PERSON
PURSUANT TO A PRESCRIPTION, SUCH OUTSOURCING FACILITY SHALL BE DEEMED TO
BE PROVIDING PHARMACY SERVICES AND SHALL BE SUBJECT TO ALL  LAWS,  RULES
AND REGULATIONS GOVERNING PHARMACIES AND PHARMACY SERVICES.
  S  14.  The  opening paragraph of subdivision 2 of section 3318 of the
public health law, as added by chapter 878  of  the  laws  of  1972,  is
amended to read as follows:
  No  controlled  substance  contained  within a bottle, vial, carton or
other container, or in any way affixed or appended to or enclosed within
a package of any kind, and designed or intended  for  delivery  in  such
container  or  package  to  an ultimate consumer, shall be manufactured,
DELIVERED or distributed within this  state  unless  such  container  or
package has clearly and permanently marked or imprinted upon it:
  S 15. Subdivision 1 of section 3320 of the public health law, as added
by chapter 878 of the laws of 1972, is amended to read as follows:
  1. Controlled substances may be lawfully distributed within this state
only  to  licensed distributors or manufacturers, practitioners, pharma-
cists,  pharmacies,  institutional  dispensers,  REGISTERED  OUTSOURCING
FACILITIES, and laboratory, research or instructional facilities author-
ized by law to possess the particular substance distributed.
  S  16.  Paragraph  (a)  of subdivision 1 of section 3321 of the public
health law, as added by chapter 878 of the laws of 1972, is  amended  to
read as follows:
  (a)  the return of controlled substances to a manufacturer, REGISTERED
OUTSOURCING FACILITY or distributor by a practitioner or pharmacy;

S. 6914                            157                           A. 9205

  S 17. Section 3322 of the public health law, as added by  chapter  878
of the laws of 1972, subdivision 2 as amended by chapter 108 of the laws
of 1975, is amended to read as follows:
  S  3322.  Reports and records. 1. Persons licensed under this title OR
OPERATING A REGISTERED OUTSOURCING FACILITY shall  maintain  records  of
all  controlled  substances manufactured, COMPOUNDED, received, disposed
of, DELIVERED or distributed by them. The record shall show the date  of
receipt  or  delivery,  the name and address, and registration number of
the person from whom received or to whom DELIVERED OR  distributed,  the
kind  and  quantity  of substance received and DELIVERED OR distributed,
the kind and quantity of substance produced or removed from the  process
of manufacture and the date thereof.
  2.  Any  person  licensed  under  this title OR OPERATING A REGISTERED
OUTSOURCING FACILITY  shall  prepare  and  maintain  a  biennial  report
setting  forth the current inventory of controlled substances, the quan-
tities of controlled substances manufactured, COMPOUNDED,  DELIVERED  or
distributed within the state during the period covered by the report and
such  other  information  as  the  commissioner shall [be] BY regulation
prescribe. Maintaining for inspection a biennial inventory of controlled
substances prepared and maintained in compliance with  federal  statutes
and regulations shall be deemed in compliance with this section.
  3.  Any  person  licensed  under  this title OR OPERATING A REGISTERED
OUTSOURCING FACILITY shall forthwith notify the department of any  inci-
dent  involving  the  theft,  loss  or  possible diversion of controlled
substances manufactured, COMPOUNDED, DELIVERED  or  distributed  by  the
licensee OR OPERATOR.
  4. The records and reports required by this section shall be prepared,
preserved,  or filed in such manner and detail as the commissioner shall
by regulation prescribe.
  S 18. Paragraph (c) of subdivision 1 of section  3397  of  the  public
health law, as amended by chapter 547 of the laws of 1981, is amended to
read as follows:
  (c) falsely assume the title of, or represent himself to be a licensed
manufacturer, distributor, pharmacy, pharmacist, practitioner, research-
er,  approved institutional dispenser, OWNER OR EMPLOYEE OF A REGISTERED
OUTSOURCING FACILITY or other authorized  person,  for  the  purpose  of
obtaining a controlled substance;
  S  19.  This act shall take effect on the ninetieth day after it shall
have become a law.

                                 PART E

  Section 1. The mental hygiene law is amended by adding a  new  section
13.41 to read as follows:
S 13.41 INTEGRATED EMPLOYMENT PLAN.
  (A) THE COMMISSIONER, IN CONSULTATION WITH THE DEVELOPMENTAL DISABILI-
TIES  ADVISORY  COUNCIL,  SHALL  ESTABLISH A PLAN TO INCREASE EMPLOYMENT
OPPORTUNITIES FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES. THE PLAN SHALL
INCLUDE, BUT NOT BE LIMITED TO:
  (1) IDENTIFICATION OF STRATEGIES TO  INCREASE  COMPETITIVE  EMPLOYMENT
OPPORTUNITIES FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES, INCLUDING
STUDENTS TRANSITIONING FROM EDUCATIONAL PROGRAMS;
  (2) DATA CONCERNING JOB RETENTION AMONG INDIVIDUALS WITH DEVELOPMENTAL
DISABILITIES  AND  THE  IDENTIFICATION  OF  STRATEGIES  TO  INCREASE JOB
RETENTION;

S. 6914                            158                           A. 9205

  (3) IDENTIFICATION OF MODELS OF INTEGRATED  EMPLOYMENT  PROMOTING,  TO
THE  GREATEST  EXTENT POSSIBLE, INDIVIDUALS WITH DEVELOPMENTAL DISABILI-
TIES  WORKING  ALONGSIDE  INDIVIDUALS  WITHOUT  DISABILITIES,  INCLUDING
CONSIDERATIONS  OF  ABILITY LEVELS, CRITICAL LIFE TRANSITIONS AND APPRO-
PRIATE OPTIONS;
  (4)  STRATEGIES  FOR ASSISTING INDIVIDUALS IN TRANSITIONING FROM SHEL-
TERED WORKSHOP PROGRAMS TO COMPETITIVE EMPLOYMENT;
  (5) PARTNERSHIPS WITH BUSINESS  COMMUNITIES  AND  SENIOR  SERVICES  TO
ASSIST  IN  INCREASING  THE  AVAILABILITY  OF COMPETITIVE EMPLOYMENT FOR
OLDER ADULTS;
  (6) IDENTIFICATION OF MEANS TO  ASSIST  INDIVIDUALS  WITH  SIGNIFICANT
BEHAVIORAL  OR  MEDICAL  NEEDS IN PREPARING FOR AND MOVING TOWARDS INTE-
GRATED EMPLOYMENT;
  (7) TECHNICAL ASSISTANCE, COMPLIANCE AND TRANSITION ASSISTANCE  PROCE-
DURES  FOR  EXISTING  PROVIDERS  WHO  SEEK  TO TRANSITION TO COMPETITIVE
AND/OR INTEGRATED EMPLOYMENT MODELS; AND
  (8) ASSESSMENTS OF FUNDING AND NECESSARY SUPPORTS FOR INDIVIDUALS  AND
PROVIDERS.
  (B) THE COMMISSIONER, IN CONSULTATION WITH THE DEVELOPMENTAL DISABILI-
TIES ADVISORY COUNCIL, SHALL DEVELOP THE PLAN WITH INPUT FROM STAKEHOLD-
ERS,  INCLUDING INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES, PARENTS AND
GUARDIANS OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES, ADVOCATES  AND
PROVIDERS OF SERVICES FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES.
  (C)  THE PLAN REQUIRED PURSUANT TO THIS SECTION SHALL BE DEVELOPED AND
SUBMITTED TO THE TEMPORARY PRESIDENT OF THE SENATE AND  SPEAKER  OF  THE
ASSEMBLY  AND POSTED ON THE WEBSITE OF THE OFFICE FOR PEOPLE WITH DEVEL-
OPMENTAL DISABILITIES WITHIN ONE HUNDRED EIGHTY DAYS OF THE CENTERS  FOR
MEDICARE AND MEDICAID SERVICES' APPROVAL OF THE PLAN TO INCREASE COMPET-
ITIVE  EMPLOYMENT  OPPORTUNITIES FOR PEOPLE WITH DEVELOPMENTAL DISABILI-
TIES.
  S 2. This act shall take effect immediately.

                                 PART F

  Section 1. No later than January 1, 2016, the office for  people  with
developmental  disabilities  shall  issue  a report to the governor, the
temporary president of the  senate  and  the  speaker  of  the  assembly
setting  forth recommendations for the establishment of a direct support
professional  credentialing  pilot  program.  Recommendations  for   the
program  shall  be  based  on  a study to be conducted by the office for
people with developmental disabilities and shall  include  consideration
of:  (1) national and international models of direct support credential-
ing; (2) career ladders for direct support  professionals  and  supervi-
sors;  (3)  current  direct  support  professional salaries and training
requirements; (4) classroom and  on-the-job  training  requirements  for
existing  direct  support credentialing programs and the impact of these
requirements on operations of providers of  services;  (5)  ongoing  and
continuing  professional  education requirements for credentialed direct
support of professionals; (6) the fiscal impact of a credentialing pilot
program;  and  (7)  financial  incentives  for  those  who  successfully
complete the credentialing program.
  S 2. This act shall take effect immediately.

                                 PART G

S. 6914                            159                           A. 9205

  Section 1. Subdivision (e) of section 41.55 of the mental hygiene law,
as amended by section 3 of part C of chapter 111 of the laws of 2010, is
amended to read as follows:
  (e)  The amount of community mental health support and workforce rein-
vestment funds for the office of mental health shall  be  determined  in
the  annual  budget  and  shall include the amount of actual state oper-
ations general fund appropriation reductions, including personal service
savings and other than personal service savings directly  attributed  to
each  child  and  adult  non-geriatric  inpatient bed closure.   For the
purposes of this section a bed shall be considered to be closed upon the
elimination of funding for such beds  in  the  executive  budget.    The
appropriation  reductions as a result of inpatient bed closures shall be
no less than [seventy] ONE HUNDRED TEN thousand dollars  per  bed  on  a
full  annual basis, as annually recommended by the commissioner, subject
to the approval of the director of the budget, in the  executive  budget
request prior to the fiscal year for which the executive budget is being
submitted.  The  methodologies  used  to  calculate  the per bed closure
savings shall be developed by the commissioner and the director  of  the
budget.  In  no  event  shall  the full annual value of community mental
health support and workforce reinvestment programs attributable to  beds
closed  as  a  result  of net inpatient census decline exceed the twelve
month value of the office of mental health state operations general fund
reductions resulting from such census decline. Such reinvestment  amount
shall  be  made  available in the same proportion by which the office of
mental health's state operations general fund appropriations are reduced
each year as a result of child and  adult  non-geriatric  inpatient  bed
closures due to census decline.
  S  2.  Subdivision  2  of section 97-dddd of the state finance law, as
added by section 6 of part R2 of chapter 62 of  the  laws  of  2003,  is
amended to read as follows:
  2.  The  commissioner  of the office of mental health shall notify the
director of the budget when the number of children's psychiatric  center
beds  or  adult, non-geriatric psychiatric center beds closed in any one
year exceeds the number of beds projected to be closed by the office  of
mental  health  in  the  executive  budget request submitted in the year
prior to the fiscal year for which the executive budget is being submit-
ted. Notwithstanding any other law, rule or regulation to  the  contrary
the  director  of  the  budget  shall then transfer the amount of actual
state  operations  general  fund  appropriation  reductions,   including
personal  service  and  nonpersonal  service, directly attributed to the
closure of such beds, to the state comptroller  who  shall  then  credit
such appropriation reductions to the community mental health support and
workforce  reinvestment  account.  The  per  bed appropriation reduction
shall be no less than [seventy] ONE HUNDRED TEN thousand  dollars  on  a
full annual basis.
  S  3. Section 7 of part R2 of chapter 62 of the laws of 2003, amending
the mental hygiene law and the state finance law relating to the  commu-
nity  mental  health  support  and  workforce  reinvestment program, the
membership of subcommittees for  mental  health  of  community  services
boards  and  the duties of such subcommittees and creating the community
mental health and workforce reinvestment account, as amended by  section
3  of  part  H  of chapter 56 of the laws of 2013, is amended to read as
follows:
  S 7. This act shall take effect immediately and shall expire March 31,
[2015] 2018 when upon such date the provisions  of  this  act  shall  be
deemed repealed.

S. 6914                            160                           A. 9205

  S 4. This act shall take effect immediately; provided that:
  1.  the  amendments  to subdivision (e) of section 41.55 of the mental
hygiene law made by section one of this act shall not affect the  repeal
of such section and shall be deemed repealed therewith; and
  2.  the  amendments  to  subdivision 2 of section 97-dddd of the state
finance law made by section two of this act shall not affect the  repeal
of such section and shall be deemed repealed therewith.

                                 PART H

  Section  1.  Paragraphs 11, 12, 13, 14, 16 and 17 of subsection (a) of
section 3217-a of the insurance law, as added by chapter 705 of the laws
of 1996, are amended and four new paragraphs 16-a, 18,  19  and  20  are
added to read as follows:
  (11)  where  applicable,  notice that an insured enrolled in a managed
care product OR IN A COMPREHENSIVE POLICY THAT  UTILIZES  A  NETWORK  OF
PROVIDERS  offered  by  the insurer may obtain a referral [to] OR PREAU-
THORIZATION FOR a health care provider outside of the insurer's  network
or  panel  when  the insurer does not have a health care provider [with]
WHO IS GEOGRAPHICALLY ACCESSIBLE TO THE INSURED AND WHO HAS  THE  appro-
priate  training  and  experience  in  the  network or panel to meet the
particular health care needs of the insured and the procedure  by  which
the insured can obtain such referral OR PREAUTHORIZATION;
  (12)  where  applicable,  notice that an insured enrolled in a managed
care product OR A  COMPREHENSIVE  POLICY  THAT  UTILIZES  A  NETWORK  OF
PROVIDERS offered by the insurer with a condition which requires ongoing
care  from  a  specialist  may  request  a  standing  referral to such a
specialist and the procedure for requesting and obtaining such a  stand-
ing referral;
  (13)    where applicable, notice that an insured enrolled in a managed
care product OR A  COMPREHENSIVE  POLICY  THAT  UTILIZES  A  NETWORK  OF
PROVIDERS  offered  by  the  insurer  with  [(i)] (A) a life-threatening
condition or disease, or [(ii)] (B) a degenerative and disabling  condi-
tion  or disease, either of which requires specialized medical care over
a prolonged period of time may  request  a  specialist  responsible  for
providing  or  coordinating the insured's medical care and the procedure
for requesting and obtaining such a specialist;
  (14) where applicable, notice that an insured enrolled  in  a  managed
care  product  OR  A  COMPREHENSIVE  POLICY  THAT  UTILIZES A NETWORK OF
PROVIDERS offered by the  insurer  with  [(i)]  (A)  a  life-threatening
condition  or disease, or [(ii)] (B) a degenerative and disabling condi-
tion or disease, either of which requires specialized medical care  over
a  prolonged  period  of  time,  may  request access to a specialty care
center and the procedure by which such access may be obtained;
  (16) notice of all appropriate mailing addresses and telephone numbers
to be utilized by insureds seeking information or authorization; [and]
  (16-A) WHERE APPLICABLE, NOTICE THAT  AN  INSURED  SHALL  HAVE  DIRECT
ACCESS  TO  PRIMARY  AND  PREVENTIVE OBSTETRIC AND GYNECOLOGIC SERVICES,
INCLUDING ANNUAL EXAMINATIONS, CARE RESULTING FROM SUCH ANNUAL  EXAMINA-
TIONS,  AND  TREATMENT OF ACUTE GYNECOLOGIC CONDITIONS, FROM A QUALIFIED
PROVIDER OF SUCH SERVICES OF HER CHOICE FROM WITHIN THE PLAN OR FOR  ANY
CARE RELATED TO A PREGNANCY;
  (17) where applicable, a listing by specialty, which may be in a sepa-
rate  document that is updated annually, of the name, address, and tele-
phone number of all participating providers, including  facilities,  and
in   addition,  in  the  case  of  physicians,  board  certification[.],

S. 6914                            161                           A. 9205

LANGUAGES SPOKEN AND ANY AFFILIATIONS WITH PARTICIPATING HOSPITALS.  THE
LISTING  SHALL  ALSO  BE POSTED ON THE INSURER'S WEBSITE AND THE INSURER
SHALL UPDATE THE WEBSITE WITHIN FIFTEEN DAYS OF THE ADDITION  OR  TERMI-
NATION  OF A PROVIDER FROM THE INSURER'S NETWORK OR A CHANGE IN A PHYSI-
CIAN'S HOSPITAL AFFILIATION;
  (18) A DESCRIPTION OF THE METHOD BY WHICH  AN  INSURED  MAY  SUBMIT  A
CLAIM FOR HEALTH CARE SERVICES;
  (19) WITH RESPECT TO OUT-OF-NETWORK COVERAGE:
  (A)  A  CLEAR  DESCRIPTION  OF  THE METHODOLOGY USED BY THE INSURER TO
DETERMINE REIMBURSEMENT FOR OUT-OF-NETWORK HEALTH CARE SERVICES;
  (B) THE AMOUNT THAT THE INSURER WILL REIMBURSE UNDER  THE  METHODOLOGY
FOR OUT-OF-NETWORK HEALTH CARE SERVICES SET FORTH AS A PERCENTAGE OF THE
USUAL AND CUSTOMARY COST FOR OUT-OF-NETWORK HEALTH CARE SERVICES; AND
  (C)  EXAMPLES OF ANTICIPATED OUT-OF-POCKET COSTS FOR FREQUENTLY BILLED
OUT-OF-NETWORK HEALTH CARE SERVICES; AND
  (20) INFORMATION IN WRITING  AND  THROUGH  AN  INTERNET  WEBSITE  THAT
REASONABLY  PERMITS  AN  INSURED  OR PROSPECTIVE INSURED TO ESTIMATE THE
ANTICIPATED OUT-OF-POCKET COST FOR OUT-OF-NETWORK HEALTH  CARE  SERVICES
IN  A  GEOGRAPHICAL  AREA  OR ZIP CODE BASED UPON THE DIFFERENCE BETWEEN
WHAT THE INSURER WILL REIMBURSE FOR OUT-OF-NETWORK HEALTH CARE  SERVICES
AND  THE  USUAL  AND  CUSTOMARY  COST  FOR  OUT-OF-NETWORK  HEALTH  CARE
SERVICES.
  S 2. Paragraphs 11 and 12 of subsection (b) of section 3217-a  of  the
insurance  law, as added by chapter 705 of the laws of 1996, are amended
and two new paragraphs 13 and 14 are added to read as follows:
  (11) where applicable, provide the written application procedures  and
minimum  qualification  requirements  for  health  care  providers to be
considered by the insurer for participation in the insurer's network for
a managed care product; [and]
  (12) disclose such other information as required  by  the  superinten-
dent,  provided  that  such requirements are promulgated pursuant to the
state administrative procedure act[.];
  (13) DISCLOSE WHETHER A HEALTH CARE PROVIDER SCHEDULED  TO  PROVIDE  A
HEALTH CARE SERVICE IS AN IN-NETWORK PROVIDER; AND
  (14) WITH RESPECT TO OUT-OF-NETWORK COVERAGE, DISCLOSE THE APPROXIMATE
DOLLAR  AMOUNT  THAT  THE INSURER WILL PAY FOR A SPECIFIC OUT-OF-NETWORK
HEALTH CARE SERVICE.  THE INSURER SHALL ALSO INFORM THE INSURED  THROUGH
SUCH  DISCLOSURE  THAT  SUCH APPROXIMATION IS NOT BINDING ON THE INSURER
AND THAT THE APPROXIMATE DOLLAR AMOUNT THAT THE INSURER WILL PAY  FOR  A
SPECIFIC OUT-OF-NETWORK HEALTH CARE SERVICE MAY CHANGE.
  S  3.  Section  3217-a of the insurance law is amended by adding a new
subsection (f) to read as follows:
  (F) FOR PURPOSES OF THIS SECTION, "USUAL  AND  CUSTOMARY  COST"  SHALL
MEAN  THE  EIGHTIETH PERCENTILE OF ALL CHARGES FOR THE PARTICULAR HEALTH
CARE SERVICE PERFORMED BY A PROVIDER IN THE SAME  OR  SIMILAR  SPECIALTY
AND PROVIDED IN THE SAME GEOGRAPHICAL AREA AS REPORTED IN A BENCHMARKING
DATABASE  MAINTAINED BY A NONPROFIT ORGANIZATION SPECIFIED BY THE SUPER-
INTENDENT. THE NONPROFIT ORGANIZATION SHALL NOT BE  AFFILIATED  WITH  AN
INSURER, A CORPORATION SUBJECT TO ARTICLE FORTY-THREE OF THIS CHAPTER, A
MUNICIPAL  COOPERATIVE HEALTH BENEFIT PLAN CERTIFIED PURSUANT TO ARTICLE
FORTY-SEVEN OF THIS CHAPTER, OR A HEALTH MAINTENANCE ORGANIZATION CERTI-
FIED PURSUANT TO ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW.
  S 4. Section 3217-d of the insurance law is amended by  adding  a  new
subsection (d) to read as follows:
  (D)  AN  INSURER  THAT  ISSUES  A COMPREHENSIVE POLICY THAT UTILIZES A
NETWORK OF PROVIDERS AND IS NOT A MANAGED CARE HEALTH INSURANCE CONTRACT

S. 6914                            162                           A. 9205

AS DEFINED IN SUBSECTION (C) OF SECTION FOUR THOUSAND EIGHT HUNDRED  ONE
OF  THIS  CHAPTER,  SHALL  PROVIDE  ACCESS  TO  OUT-OF-NETWORK  SERVICES
CONSISTENT WITH THE REQUIREMENTS OF SUBSECTION (A) OF SECTION FOUR THOU-
SAND  EIGHT HUNDRED FOUR OF THIS CHAPTER, SUBSECTIONS (G-6) AND (G-7) OF
SECTION FOUR THOUSAND NINE HUNDRED OF THIS  CHAPTER,  SUBSECTIONS  (A-1)
AND  (A-2)  OF  SECTION FOUR THOUSAND NINE HUNDRED FOUR OF THIS CHAPTER,
PARAGRAPHS THREE AND FOUR OF SUBSECTION (B)  OF  SECTION  FOUR  THOUSAND
NINE HUNDRED TEN OF THIS CHAPTER, AND SUBPARAGRAPHS (C) AND (D) OF PARA-
GRAPH FOUR OF SUBSECTION (B) OF SECTION FOUR THOUSAND NINE HUNDRED FOUR-
TEEN OF THIS CHAPTER.
  S  5.  Section  3224-a of the insurance law is amended by adding a new
subsection (j) to read as follows:
  (J) AN INSURER OR AN ORGANIZATION OR CORPORATION LICENSED OR CERTIFIED
PURSUANT TO ARTICLE FORTY-THREE OR FORTY-SEVEN OF THIS CHAPTER OR  ARTI-
CLE  FORTY-FOUR OF THE PUBLIC HEALTH LAW OR A STUDENT HEALTH PLAN ESTAB-
LISHED OR MAINTAINED PURSUANT TO SECTION ONE THOUSAND ONE HUNDRED  TWEN-
TY-FOUR  OF THIS CHAPTER SHALL ACCEPT CLAIMS SUBMITTED BY A POLICYHOLDER
OR COVERED PERSON, IN WRITING, INCLUDING THROUGH THE INTERNET, BY  ELEC-
TRONIC MAIL OR BY FACSIMILE.
  S 6. The insurance law is amended by adding a new section 3241 to read
as follows:
  S  3241.    NETWORK  COVERAGE. (A) AN INSURER, A CORPORATION ORGANIZED
PURSUANT TO ARTICLE FORTY-THREE OF THIS CHAPTER, A MUNICIPAL COOPERATIVE
HEALTH BENEFIT PLAN CERTIFIED PURSUANT TO ARTICLE  FORTY-SEVEN  OF  THIS
CHAPTER,  OR A STUDENT HEALTH PLAN ESTABLISHED OR MAINTAINED PURSUANT TO
SECTION ONE THOUSAND ONE  HUNDRED  TWENTY-FOUR  OF  THIS  CHAPTER,  THAT
ISSUES  A  HEALTH  INSURANCE POLICY OR CONTRACT WITH A NETWORK OF HEALTH
CARE PROVIDERS SHALL ENSURE THAT THE NETWORK IS  ADEQUATE  TO  MEET  THE
HEALTH  NEEDS OF INSUREDS AND PROVIDE AN APPROPRIATE CHOICE OF PROVIDERS
SUFFICIENT TO RENDER THE SERVICES COVERED UNDER THE POLICY OR  CONTRACT.
THE SUPERINTENDENT SHALL REVIEW THE NETWORK OF HEALTH CARE PROVIDERS FOR
ADEQUACY  AT  THE  TIME  OF  THE  SUPERINTENDENT'S INITIAL APPROVAL OF A
HEALTH INSURANCE POLICY OR CONTRACT; AT LEAST EVERY THREE  YEARS  THERE-
AFTER; AND UPON APPLICATION FOR EXPANSION OF ANY SERVICE AREA ASSOCIATED
WITH  THE POLICY OR CONTRACT IN CONFORMANCE WITH THE STANDARDS SET FORTH
IN SUBDIVISION FIVE OF SECTION FOUR THOUSAND FOUR HUNDRED THREE  OF  THE
PUBLIC  HEALTH LAW.   TO THE EXTENT THAT THE NETWORK HAS BEEN DETERMINED
BY THE COMMISSIONER OF HEALTH TO MEET THE STANDARDS SET FORTH IN  SUBDI-
VISION  FIVE  OF  SECTION FOUR THOUSAND FOUR HUNDRED THREE OF THE PUBLIC
HEALTH LAW, SUCH NETWORK SHALL BE DEEMED ADEQUATE BY THE SUPERINTENDENT.
  (B)(1)(A) AN INSURER, A  CORPORATION  ORGANIZED  PURSUANT  TO  ARTICLE
FORTY-THREE OF THIS CHAPTER, A MUNICIPAL COOPERATIVE HEALTH BENEFIT PLAN
CERTIFIED  PURSUANT  TO  ARTICLE  FORTY-SEVEN  OF THIS CHAPTER, A HEALTH
MAINTENANCE ORGANIZATION CERTIFIED PURSUANT TO ARTICLE FORTY-FOUR OF THE
PUBLIC HEALTH LAW OR A STUDENT HEALTH  PLAN  ESTABLISHED  OR  MAINTAINED
PURSUANT  TO  SECTION ONE THOUSAND ONE HUNDRED TWENTY-FOUR OF THIS CHAP-
TER, THAT ISSUES A COMPREHENSIVE GROUP OR GROUP REMITTANCE HEALTH INSUR-
ANCE POLICY OR CONTRACT THAT COVERS OUT-OF-NETWORK HEALTH CARE  SERVICES
SHALL  MAKE AVAILABLE AND, IF REQUESTED BY THE POLICYHOLDER OR CONTRACT-
HOLDER, PROVIDE AT LEAST ONE OPTION FOR COVERAGE  FOR  AT  LEAST  EIGHTY
PERCENT  OF  THE  USUAL AND CUSTOMARY COST OF EACH OUT-OF-NETWORK HEALTH
CARE SERVICE AFTER IMPOSITION OF A DEDUCTIBLE OR ANY PERMISSIBLE BENEFIT
MAXIMUM.
  (B) IF THERE IS NO COVERAGE AVAILABLE PURSUANT TO SUBPARAGRAPH (A)  OF
THIS  PARAGRAPH  IN A RATING REGION, THEN THE SUPERINTENDENT MAY REQUIRE
AN INSURER, A CORPORATION ORGANIZED PURSUANT TO ARTICLE  FORTY-THREE  OF

S. 6914                            163                           A. 9205

THIS  CHAPTER,  A  MUNICIPAL  COOPERATIVE  HEALTH BENEFIT PLAN CERTIFIED
PURSUANT TO ARTICLE FORTY-SEVEN OF THIS CHAPTER,  A  HEALTH  MAINTENANCE
ORGANIZATION  CERTIFIED  PURSUANT  TO  ARTICLE  FORTY-FOUR OF THE PUBLIC
HEALTH  LAW, OR A STUDENT HEALTH PLAN ESTABLISHED OR MAINTAINED PURSUANT
TO SECTION ONE THOUSAND ONE HUNDRED TWENTY-FOUR OF THIS CHAPTER  ISSUING
A  COMPREHENSIVE  GROUP  OR  GROUP REMITTANCE HEALTH INSURANCE POLICY OR
CONTRACT IN THE RATING REGION, TO MAKE AVAILABLE AND,  IF  REQUESTED  BY
THE  POLICYHOLDER  OR  CONTRACTHOLDER,  PROVIDE  AT LEAST ONE OPTION FOR
COVERAGE OF EIGHTY PERCENT OF THE USUAL AND CUSTOMARY COST OF EACH  OUT-
OF-NETWORK  HEALTH  CARE  SERVICE  AFTER  IMPOSITION  OF ANY PERMISSIBLE
DEDUCTIBLE OR BENEFIT MAXIMUM.  THE  SUPERINTENDENT  MAY,  AFTER  GIVING
CONSIDERATION  TO THE PUBLIC INTEREST, PERMIT AN INSURER, A CORPORATION,
OR A HEALTH MAINTENANCE ORGANIZATION TO SATISFY THE REQUIREMENTS OF THIS
PARAGRAPH ON BEHALF OF ANOTHER INSURER, CORPORATION, OR  HEALTH  MAINTE-
NANCE ORGANIZATION WITHIN THE SAME HOLDING COMPANY SYSTEM, AS DEFINED IN
ARTICLE  FIFTEEN  OF THIS CHAPTER, INCLUDING A HEALTH MAINTENANCE ORGAN-
IZATION OPERATED AS A LINE OF BUSINESS OF A HEALTH  SERVICE  CORPORATION
ORGANIZED  PURSUANT  TO  ARTICLE FORTY-THREE OF THIS CHAPTER. THE SUPER-
INTENDENT MAY, UPON WRITTEN REQUEST, WAIVE THE REQUIREMENT FOR  COVERAGE
OF  OUT-OF-NETWORK HEALTH CARE SERVICES TO BE MADE AVAILABLE PURSUANT TO
THIS SUBPARAGRAPH IF THE SUPERINTENDENT DETERMINES THAT IT WOULD POSE AN
UNDUE HARDSHIP UPON AN INSURER,  A  CORPORATION  ORGANIZED  PURSUANT  TO
ARTICLE  FORTY-THREE  OF  THIS  CHAPTER,  A MUNICIPAL COOPERATIVE HEALTH
BENEFIT PLAN CERTIFIED PURSUANT TO ARTICLE FORTY-SEVEN OF THIS  CHAPTER,
A   HEALTH   MAINTENANCE  ORGANIZATION  CERTIFIED  PURSUANT  TO  ARTICLE
FORTY-FOUR OF THE PUBLIC HEALTH LAW, OR A  STUDENT  HEALTH  PLAN  ESTAB-
LISHED  OR MAINTAINED PURSUANT TO SECTION ONE THOUSAND ONE HUNDRED TWEN-
TY-FOUR OF THIS CHAPTER.
  (2) FOR THE PURPOSES OF THIS SUBSECTION, "USUAL  AND  CUSTOMARY  COST"
SHALL  MEAN  THE  EIGHTIETH PERCENTILE OF ALL CHARGES FOR THE PARTICULAR
HEALTH CARE SERVICE PERFORMED BY A  PROVIDER  IN  THE  SAME  OR  SIMILAR
SPECIALTY  AND  PROVIDED  IN THE SAME GEOGRAPHICAL AREA AS REPORTED IN A
BENCHMARKING DATABASE MAINTAINED BY A NONPROFIT  ORGANIZATION  SPECIFIED
BY  THE  SUPERINTENDENT.  THE NONPROFIT ORGANIZATION SHALL NOT BE AFFIL-
IATED WITH AN INSURER, A CORPORATION SUBJECT TO ARTICLE  FORTY-THREE  OF
THIS  CHAPTER,  A  MUNICIPAL  COOPERATIVE  HEALTH BENEFIT PLAN CERTIFIED
PURSUANT TO ARTICLE FORTY-SEVEN OF THIS CHAPTER,  A  HEALTH  MAINTENANCE
ORGANIZATION  CERTIFIED  PURSUANT  TO  ARTICLE  FORTY-FOUR OF THE PUBLIC
HEALTH LAW OR A STUDENT HEALTH PLAN ESTABLISHED OR  MAINTAINED  PURSUANT
TO SECTION ONE THOUSAND ONE HUNDRED TWENTY-FOUR OF THIS CHAPTER.
  (3)  THIS  SUBSECTION  SHALL  NOT  APPLY TO EMERGENCY CARE SERVICES IN
HOSPITAL FACILITIES OR PREHOSPITAL EMERGENCY MEDICAL SERVICES AS DEFINED
IN CLAUSE (I) OF SUBPARAGRAPH (E) OF PARAGRAPH TWENTY-FOUR OF SUBSECTION
(I) OF SECTION THREE THOUSAND TWO HUNDRED SIXTEEN OF  THIS  ARTICLE,  OR
CLAUSE (I) OF SUBPARAGRAPH (E) OF PARAGRAPH FIFTEEN OF SUBSECTION (L) OF
SECTION  THREE  THOUSAND  TWO  HUNDRED  TWENTY-ONE  OF  THIS CHAPTER, OR
SUBPARAGRAPH (A) OF PARAGRAPH FIVE OF SUBSECTION (AA)  OF  SECTION  FOUR
THOUSAND THREE HUNDRED THREE OF THIS CHAPTER.
  (4)  NOTHING  IN  THIS  SUBSECTION  SHALL  LIMIT  THE SUPERINTENDENT'S
AUTHORITY PURSUANT TO SECTION THREE THOUSAND TWO  HUNDRED  SEVENTEEN  OF
THIS  ARTICLE  TO  ESTABLISH MINIMUM STANDARDS FOR THE FORM, CONTENT AND
SALE OF ACCIDENT AND HEALTH INSURANCE POLICIES AND SUBSCRIBER CONTRACTS,
TO REQUIRE ADDITIONAL COVERAGE OPTIONS FOR OUT-OF-NETWORK  SERVICES,  OR
TO PROVIDE FOR STANDARDIZATION AND SIMPLIFICATION OF COVERAGE.
  (C)  WHEN  AN  INSURED  OR  ENROLLEE  UNDER  A CONTRACT OR POLICY THAT
PROVIDES COVERAGE FOR EMERGENCY SERVICES RECEIVES THE  SERVICES  FROM  A

S. 6914                            164                           A. 9205

HEALTH  CARE  PROVIDER THAT DOES NOT PARTICIPATE IN THE PROVIDER NETWORK
OF AN INSURER, A CORPORATION ORGANIZED PURSUANT TO  ARTICLE  FORTY-THREE
OF  THIS  CHAPTER, A MUNICIPAL COOPERATIVE HEALTH BENEFIT PLAN CERTIFIED
PURSUANT  TO  ARTICLE  FORTY-SEVEN OF THIS CHAPTER, A HEALTH MAINTENANCE
ORGANIZATION CERTIFIED PURSUANT TO  ARTICLE  FORTY-FOUR  OF  THE  PUBLIC
HEALTH  LAW, OR A STUDENT HEALTH PLAN ESTABLISHED OR MAINTAINED PURSUANT
TO SECTION ONE THOUSAND ONE HUNDRED TWENTY-FOUR OF THIS CHAPTER ("HEALTH
CARE PLAN"), THE HEALTH CARE PLAN  SHALL  ENSURE  THAT  THE  INSURED  OR
ENROLLEE  SHALL  INCUR  NO GREATER OUT-OF-POCKET COSTS FOR THE EMERGENCY
SERVICES THAN THE INSURED OR ENROLLEE WOULD HAVE INCURRED WITH A  HEALTH
CARE  PROVIDER  THAT  PARTICIPATES  IN  THE  HEALTH CARE PLAN'S PROVIDER
NETWORK. FOR THE PURPOSE OF THIS  SECTION,  "EMERGENCY  SERVICES"  SHALL
HAVE  THE  MEANING  SET  FORTH  IN SUBPARAGRAPH (D) OF PARAGRAPH NINE OF
SUBSECTION (I) OF SECTION THREE THOUSAND TWO  HUNDRED  SIXTEEN  OF  THIS
ARTICLE, SUBPARAGRAPH (D) OF PARAGRAPH FOUR OF SUBSECTION (K) OF SECTION
THREE  THOUSAND TWO HUNDRED TWENTY-ONE OF THIS ARTICLE, AND SUBPARAGRAPH
(D) OF PARAGRAPH TWO OF SUBSECTION (A) OF SECTION  FOUR  THOUSAND  THREE
HUNDRED THREE OF THIS CHAPTER.
  S  7.  Section  4306-c of the insurance law is amended by adding a new
subsection (d) to read as follows:
  (D) A CORPORATION, INCLUDING A MUNICIPAL  COOPERATIVE  HEALTH  BENEFIT
PLAN  CERTIFIED  PURSUANT  TO  ARTICLE FORTY-SEVEN OF THIS CHAPTER AND A
STUDENT HEALTH PLAN ESTABLISHED OR MAINTAINED PURSUANT  TO  SECTION  ONE
THOUSAND  ONE HUNDRED TWENTY-FOUR OF THIS CHAPTER, THAT ISSUES A COMPRE-
HENSIVE POLICY THAT UTILIZES A NETWORK OF PROVIDERS AND IS NOT A MANAGED
CARE HEALTH INSURANCE CONTRACT AS DEFINED IN SUBSECTION (C)  OF  SECTION
FOUR THOUSAND EIGHT HUNDRED ONE OF THIS CHAPTER, SHALL PROVIDE ACCESS TO
OUT-OF-NETWORK  SERVICES  CONSISTENT WITH THE REQUIREMENTS OF SUBSECTION
(A) OF SECTION  FOUR  THOUSAND  EIGHT  HUNDRED  FOUR  OF  THIS  CHAPTER,
SUBSECTIONS  (G-6)  AND  (G-7)  OF SECTION FOUR THOUSAND NINE HUNDRED OF
THIS CHAPTER, SUBSECTIONS (A-1) AND (A-2) OF SECTION FOUR THOUSAND  NINE
HUNDRED  FOUR  OF  THIS CHAPTER, PARAGRAPHS THREE AND FOUR OF SUBSECTION
(B) OF SECTION FOUR THOUSAND NINE  HUNDRED  TEN  OF  THIS  CHAPTER,  AND
SUBPARAGRAPHS (C) AND (D) OF PARAGRAPH FOUR OF SUBSECTION (B) OF SECTION
FOUR THOUSAND NINE HUNDRED FOURTEEN OF THIS CHAPTER.
  S  8. Paragraphs 11, 12, 13, 14, 16-a, 17, and 18 of subsection (a) of
section 4324 of the insurance law, paragraphs 11, 12, 13, 14, 17 and  18
as  added by chapter 705 of the laws of 1996, paragraph 16-a as added by
chapter 554 of the laws of 2002, are amended and  three  new  paragraphs
19, 20 and 21 are added to read as follows:
  (11)  where applicable, notice that a subscriber enrolled in a managed
care  product  OR IN A COMPREHENSIVE CONTRACT THAT UTILIZES A NETWORK OF
PROVIDERS offered by the corporation  may  obtain  a  referral  [to]  OR
PREAUTHORIZATION FOR a health care provider outside of the corporation's
network  or  panel  when  the  corporation  does  not have a health care
provider [with] WHO IS GEOGRAPHICALLY ACCESSIBLE TO THE INSURED AND  WHO
HAS  THE  appropriate training and experience in the network or panel to
meet the particular health care needs of the subscriber and  the  proce-
dure  by  which  the  subscriber can obtain such referral OR PREAUTHORI-
ZATION;
  (12) where applicable, notice that a subscriber enrolled in a  managed
care  product  OR  A  COMPREHENSIVE  CONTRACT THAT UTILIZES A NETWORK OF
PROVIDERS offered by the corporation with  a  condition  which  requires
ongoing care from a specialist may request a standing referral to such a
specialist  and the procedure for requesting and obtaining such a stand-
ing referral;

S. 6914                            165                           A. 9205

  (13) where applicable, notice that a subscriber enrolled in a  managed
care  product  OR  A  COMPREHENSIVE  CONTRACT THAT UTILIZES A NETWORK OF
PROVIDERS offered by the corporation with (i) a life-threatening  condi-
tion  or  disease,  or  (ii)  a  degenerative and disabling condition or
disease,  either  of  which  requires  specialized  medical  care over a
prolonged period of  time  may  request  a  specialist  responsible  for
providing  or  coordinating the subscriber's medical care and the proce-
dure for requesting and obtaining such a specialist;
  (14) where applicable, notice that a subscriber enrolled in a  managed
care  product  OR  A  COMPREHENSIVE  CONTRACT THAT UTILIZES A NETWORK OF
PROVIDERS offered by the corporation with [(i)] (A)  a  life-threatening
condition  or disease, or [(ii)] (B) a degenerative and disabling condi-
tion or disease, either of which requires specialized medical care  over
a prolonged period of time may request access to a specialty care center
and the procedure by which such access may be obtained;
  (16-a)  where  applicable,  notice  that an enrollee shall have direct
access to primary and preventive  obstetric  and  gynecologic  services,
INCLUDING  ANNUAL EXAMINATIONS, CARE RESULTING FROM SUCH ANNUAL EXAMINA-
TIONS, AND TREATMENT OF ACUTE GYNECOLOGIC CONDITIONS, from  a  qualified
provider  of  such  services  of her choice from within the plan [for no
fewer than two examinations annually for such services] or [to] FOR  any
care  related  to A pregnancy [and that additionally, the enrollee shall
have direct access to primary and preventive obstetric  and  gynecologic
services required as a result of such annual examinations or as a result
of an acute gynecologic condition];
  (17) where applicable, a listing by specialty, which may be in a sepa-
rate  document that is updated annually, of the name, address, and tele-
phone number of all participating providers, including  facilities,  and
in  addition,  in  the  case  of physicians, board certification[; and],
LANGUAGES SPOKEN AND ANY AFFILIATIONS WITH PARTICIPATING HOSPITALS.  THE
LISTING SHALL ALSO BE POSTED ON THE CORPORATION'S WEBSITE AND THE CORPO-
RATION SHALL UPDATE THE WEBSITE WITHIN FIFTEEN DAYS OF THE  ADDITION  OR
TERMINATION  OF A PROVIDER FROM THE CORPORATION'S NETWORK OR A CHANGE IN
A PHYSICIAN'S HOSPITAL AFFILIATION;
  (18) a description of the mechanisms by which subscribers may  partic-
ipate in the development of the policies of the corporation[.];
  (19)  THE  METHOD  BY WHICH A SUBSCRIBER MAY SUBMIT A CLAIM FOR HEALTH
CARE SERVICES;
  (20) WITH RESPECT TO OUT-OF-NETWORK COVERAGE:
  (A) A CLEAR DESCRIPTION OF THE METHODOLOGY USED BY THE CORPORATION  TO
DETERMINE REIMBURSEMENT FOR OUT-OF-NETWORK HEALTH CARE SERVICES;
  (B)  A  DESCRIPTION  OF THE AMOUNT THAT THE CORPORATION WILL REIMBURSE
UNDER THE METHODOLOGY FOR OUT-OF-NETWORK HEALTH CARE SERVICES SET  FORTH
AS  A  PERCENTAGE  OF  THE  USUAL  AND CUSTOMARY COST FOR OUT-OF-NETWORK
HEALTH CARE SERVICES; AND
  (C) EXAMPLES OF ANTICIPATED OUT-OF-POCKET COSTS FOR FREQUENTLY  BILLED
OUT-OF-NETWORK HEALTH CARE SERVICES; AND
  (21)  INFORMATION  IN  WRITING  AND  THROUGH  AN INTERNET WEBSITE THAT
REASONABLY PERMITS A SUBSCRIBER OR PROSPECTIVE  SUBSCRIBER  TO  ESTIMATE
THE  ANTICIPATED  OUT-OF-POCKET  COST  FOR  OUT-OF-NETWORK  HEALTH  CARE
SERVICES IN A GEOGRAPHICAL AREA OR ZIP CODE BASED  UPON  THE  DIFFERENCE
BETWEEN  WHAT  THE  CORPORATION WILL REIMBURSE FOR OUT-OF-NETWORK HEALTH
CARE SERVICES AND THE USUAL AND CUSTOMARY COST FOR OUT-OF-NETWORK HEALTH
CARE SERVICES.

S. 6914                            166                           A. 9205

  S 9. Paragraphs 11 and 12 of subsection (b) of  section  4324  of  the
insurance  law, as added by chapter 705 of the laws of 1996, are amended
and two new paragraphs 13 and 14 are added to read as follows:
  (11)  where applicable, provide the written application procedures and
minimum qualification requirements  for  health  care  providers  to  be
considered  by  the  corporation  for participation in the corporation's
network for a managed care product; [and]
  (12) disclose such other information as required  by  the  superinten-
dent,  provided  that  such requirements are promulgated pursuant to the
state administrative procedure act[.];
  (13) DISCLOSE WHETHER A HEALTH CARE PROVIDER SCHEDULED  TO  PROVIDE  A
HEALTH CARE SERVICE IS AN IN-NETWORK PROVIDER; AND
  (14) WITH RESPECT TO OUT-OF-NETWORK COVERAGE, DISCLOSE THE APPROXIMATE
DOLLAR  AMOUNT  THAT THE CORPORATION WILL PAY FOR A SPECIFIC OUT-OF-NET-
WORK HEALTH CARE SERVICE.  THE CORPORATION SHALL ALSO INFORM THE INSURED
THROUGH SUCH DISCLOSURE THAT SUCH APPROXIMATION IS NOT  BINDING  ON  THE
CORPORATION  AND THAT THE APPROXIMATE DOLLAR AMOUNT THAT THE CORPORATION
WILL PAY FOR A SPECIFIC OUT-OF-NETWORK HEALTH CARE SERVICE MAY CHANGE.
  S 10. Section 4324 of the insurance law is amended  by  adding  a  new
subsection (f) to read as follows:
  (F)  FOR  PURPOSES  OF  THIS SECTION, "USUAL AND CUSTOMARY COST" SHALL
MEAN THE EIGHTIETH PERCENTILE OF ALL CHARGES FOR THE  PARTICULAR  HEALTH
CARE  SERVICE  PERFORMED  BY A PROVIDER IN THE SAME OR SIMILAR SPECIALTY
AND PROVIDED IN THE SAME GEOGRAPHICAL AREA AS REPORTED IN A BENCHMARKING
DATABASE MAINTAINED BY A NONPROFIT ORGANIZATION SPECIFIED BY THE  SUPER-
INTENDENT.  THE  NONPROFIT  ORGANIZATION SHALL NOT BE AFFILIATED WITH AN
INSURER, A CORPORATION SUBJECT TO THIS ARTICLE, A MUNICIPAL  COOPERATIVE
HEALTH  BENEFIT  PLAN  CERTIFIED PURSUANT TO ARTICLE FORTY-SEVEN OF THIS
CHAPTER, OR A HEALTH  MAINTENANCE  ORGANIZATION  CERTIFIED  PURSUANT  TO
ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW.
  S  11.  Section  4900  of the insurance law is amended by adding a new
subsection (g-6-a) to read as follows:
  (G-6-A) "OUT-OF-NETWORK  REFERRAL  DENIAL"  MEANS  A  DENIAL  UNDER  A
MANAGED  CARE PRODUCT AS DEFINED IN SUBSECTION (C) OF SECTION FOUR THOU-
SAND EIGHT HUNDRED ONE OF THIS CHAPTER OF A REQUEST FOR AN AUTHORIZATION
OR REFERRAL TO AN OUT-OF-NETWORK PROVIDER ON THE BASIS THAT  THE  HEALTH
CARE  PLAN HAS A HEALTH CARE PROVIDER IN THE IN-NETWORK BENEFITS PORTION
OF ITS NETWORK WITH APPROPRIATE TRAINING  AND  EXPERIENCE  TO  MEET  THE
PARTICULAR  HEALTH  CARE NEEDS OF AN INSURED, AND WHO IS ABLE TO PROVIDE
THE REQUESTED HEALTH SERVICE. THE NOTICE OF AN  OUT-OF-NETWORK  REFERRAL
DENIAL  PROVIDED TO AN INSURED SHALL INCLUDE INFORMATION EXPLAINING WHAT
INFORMATION THE INSURED MUST SUBMIT IN ORDER TO APPEAL  THE  OUT-OF-NET-
WORK  REFERRAL DENIAL PURSUANT TO SUBSECTION (A-2) OF SECTION FOUR THOU-
SAND NINE HUNDRED FOUR  OF  THIS  ARTICLE.  AN  OUT-OF-NETWORK  REFERRAL
DENIAL  UNDER  THIS  SUBSECTION  DOES NOT CONSTITUTE AN ADVERSE DETERMI-
NATION AS DEFINED IN THIS ARTICLE.   AN OUT-OF-NETWORK  REFERRAL  DENIAL
SHALL NOT BE CONSTRUED TO INCLUDE AN OUT-OF-NETWORK DENIAL AS DEFINED IN
SUBSECTION (G-6) OF THIS SECTION.
  S  12. Subsection (b) of section 4903 of the insurance law, as amended
by chapter 514 of the laws of 2013, is amended to read as follows:
  (b) A utilization review agent shall make a utilization review  deter-
mination  involving health care services which require pre-authorization
and provide notice of a determination to the insured or insured's desig-
nee and the insured's health care provider by telephone and  in  writing
within  three  business days of receipt of the necessary information. To
the extent practicable, such  written  notification  to  the  enrollee's

S. 6914                            167                           A. 9205

health  care  provider  shall be transmitted electronically, in a manner
and in a form agreed upon by the parties.  THE NOTIFICATION SHALL  IDEN-
TIFY:  (1) WHETHER THE SERVICES ARE CONSIDERED IN-NETWORK OR OUT-OF-NET-
WORK; (2) WHETHER THE INSURED WILL BE HELD HARMLESS FOR THE SERVICES AND
NOT  BE  RESPONSIBLE  FOR ANY PAYMENT, OTHER THAN ANY APPLICABLE CO-PAY-
MENT, CO-INSURANCE OR DEDUCTIBLE; (3) AS APPLICABLE, THE  DOLLAR  AMOUNT
THE  HEALTH CARE PLAN WILL PAY IF THE SERVICE IS OUT-OF-NETWORK; AND (4)
AS APPLICABLE, INFORMATION EXPLAINING HOW AN INSURED MAY  DETERMINE  THE
ANTICIPATED  OUT-OF-POCKET  COST FOR OUT-OF-NETWORK HEALTH CARE SERVICES
IN A GEOGRAPHICAL AREA OR ZIP CODE BASED  UPON  THE  DIFFERENCE  BETWEEN
WHAT  THE HEALTH CARE PLAN WILL REIMBURSE FOR OUT-OF-NETWORK HEALTH CARE
SERVICES AND THE USUAL AND CUSTOMARY COST FOR OUT-OF-NETWORK HEALTH CARE
SERVICES.
  S 13. Section 4904 of the insurance law is amended  by  adding  a  new
subsection (a-2) to read as follows:
  (A-2)  AN  INSURED OR THE INSURED'S DESIGNEE MAY APPEAL AN OUT-OF-NET-
WORK REFERRAL DENIAL BY A HEALTH  CARE  PLAN  BY  SUBMITTING  A  WRITTEN
STATEMENT  FROM  THE  INSURED'S  ATTENDING  PHYSICIAN,  WHO  MUST  BE  A
LICENSED, BOARD CERTIFIED OR BOARD ELIGIBLE PHYSICIAN QUALIFIED TO PRAC-
TICE IN THE SPECIALTY AREA OF PRACTICE APPROPRIATE TO TREAT THE  INSURED
FOR  THE HEALTH SERVICE SOUGHT, PROVIDED THAT: (1) THE IN-NETWORK HEALTH
CARE PROVIDER OR PROVIDERS RECOMMENDED BY THE HEALTH CARE  PLAN  DO  NOT
HAVE  THE  APPROPRIATE  TRAINING  AND  EXPERIENCE TO MEET THE PARTICULAR
HEALTH CARE NEEDS OF THE INSURED FOR THE HEALTH SERVICE; AND (2)  RECOM-
MENDS AN OUT-OF-NETWORK PROVIDER WITH THE APPROPRIATE TRAINING AND EXPE-
RIENCE  TO MEET THE PARTICULAR HEALTH CARE NEEDS OF THE INSURED, AND WHO
IS ABLE TO PROVIDE THE REQUESTED HEALTH SERVICE.
  S 14. Subsection (b) of section 4910 of the insurance law  is  amended
by adding a new paragraph 4 to read as follows:
  (4)(A)  THE  INSURED  HAS HAD AN OUT-OF-NETWORK REFERRAL DENIED ON THE
GROUNDS THAT THE HEALTH CARE PLAN HAS A  HEALTH  CARE  PROVIDER  IN  THE
IN-NETWORK BENEFITS PORTION OF ITS NETWORK WITH APPROPRIATE TRAINING AND
EXPERIENCE  TO  MEET THE PARTICULAR HEALTH CARE NEEDS OF AN INSURED, AND
WHO IS ABLE TO PROVIDE THE REQUESTED HEALTH SERVICE.
  (B) THE INSURED'S ATTENDING PHYSICIAN, WHO SHALL BE A LICENSED,  BOARD
CERTIFIED  OR  BOARD  ELIGIBLE  PHYSICIAN  QUALIFIED  TO PRACTICE IN THE
SPECIALTY AREA OF PRACTICE APPROPRIATE TO  TREAT  THE  INSURED  FOR  THE
HEALTH SERVICE SOUGHT, CERTIFIES THAT THE IN-NETWORK HEALTH CARE PROVID-
ER  OR  PROVIDERS  RECOMMENDED  BY  THE HEALTH CARE PLAN DO NOT HAVE THE
APPROPRIATE TRAINING AND EXPERIENCE TO MEET THE PARTICULAR  HEALTH  CARE
NEEDS  OF AN INSURED, AND RECOMMENDS AN OUT-OF-NETWORK PROVIDER WITH THE
APPROPRIATE TRAINING AND EXPERIENCE TO MEET THE PARTICULAR  HEALTH  CARE
NEEDS  OF  AN  INSURED,  AND WHO IS ABLE TO PROVIDE THE REQUESTED HEALTH
SERVICE.
  S 15. Paragraph 4 of subsection (b) of section 4914 of  the  insurance
law is amended by adding a new subparagraph (D) to read as follows:
  (D)  FOR  EXTERNAL  APPEALS  REQUESTED  PURSUANT  TO PARAGRAPH FOUR OF
SUBSECTION (B) OF SECTION FOUR THOUSAND NINE HUNDRED TEN OF  THIS  TITLE
RELATING TO AN OUT-OF-NETWORK REFERRAL DENIAL, THE EXTERNAL APPEAL AGENT
SHALL  REVIEW THE UTILIZATION REVIEW AGENT'S FINAL ADVERSE DETERMINATION
AND, IN ACCORDANCE WITH THE PROVISIONS  OF  THIS  TITLE,  SHALL  MAKE  A
DETERMINATION AS TO WHETHER THE OUT-OF-NETWORK REFERRAL SHALL BE COVERED
BY THE HEALTH PLAN; PROVIDED THAT SUCH DETERMINATION SHALL:
  (I)  BE CONDUCTED ONLY BY ONE OR A GREATER ODD NUMBER OF CLINICAL PEER
REVIEWERS;
  (II) BE ACCOMPANIED BY A WRITTEN STATEMENT:

S. 6914                            168                           A. 9205

  (I) THAT THE OUT-OF-NETWORK REFERRAL SHALL BE COVERED  BY  THE  HEALTH
CARE PLAN EITHER WHEN THE REVIEWER OR A MAJORITY OF THE PANEL OF REVIEW-
ERS  DETERMINES,  UPON  REVIEW  OF  THE  TRAINING  AND EXPERIENCE OF THE
IN-NETWORK HEALTH CARE PROVIDER OR PROVIDERS PROPOSED BY THE  PLAN,  THE
TRAINING  AND  EXPERIENCE  OF THE REQUESTED OUT-OF-NETWORK PROVIDER, THE
CLINICAL STANDARDS OF THE PLAN, THE INFORMATION PROVIDED CONCERNING  THE
INSURED, THE ATTENDING PHYSICIAN'S RECOMMENDATION, THE INSURED'S MEDICAL
RECORD,  AND  ANY OTHER PERTINENT INFORMATION, THAT THE HEALTH PLAN DOES
NOT HAVE A PROVIDER WITH THE APPROPRIATE TRAINING AND EXPERIENCE TO MEET
THE PARTICULAR HEALTH CARE NEEDS OF AN INSURED WHO IS  ABLE  TO  PROVIDE
THE  REQUESTED  HEALTH SERVICE, AND THAT THE OUT-OF-NETWORK PROVIDER HAS
THE APPROPRIATE TRAINING AND EXPERIENCE TO MEET  THE  PARTICULAR  HEALTH
CARE  NEEDS  OF  AN  INSURED,  IS  ABLE  TO PROVIDE THE REQUESTED HEALTH
SERVICE, AND IS LIKELY TO PRODUCE A MORE CLINICALLY BENEFICIAL  OUTCOME;
OR
  (II) UPHOLDING THE HEALTH PLAN'S DENIAL OF COVERAGE;
  (III)  BE  SUBJECT TO THE TERMS AND CONDITIONS GENERALLY APPLICABLE TO
BENEFITS UNDER THE EVIDENCE OF COVERAGE UNDER THE HEALTH CARE PLAN;
  (IV) BE BINDING ON THE PLAN AND THE INSURED; AND
  (V) BE ADMISSIBLE IN ANY COURT PROCEEDING.
  S 16. The public health law is amended by adding a new section  23  to
read as follows:
  S  23.  CLAIM  FORMS.    A NON-PARTICIPATING PHYSICIAN SHALL INCLUDE A
CLAIM FORM FOR A THIRD-PARTY PAYOR WITH A PATIENT BILL FOR  HEALTH  CARE
SERVICES, OTHER THAN A BILL FOR THE PATIENT'S CO-PAYMENT, COINSURANCE OR
DEDUCTIBLE.
  S  17.  The public health law is amended by adding a new section 24 to
read as follows:
  S 24. DISCLOSURE.  1. A HEALTH CARE PROFESSIONAL, OR A GROUP  PRACTICE
OF  HEALTH  CARE  PROFESSIONALS,  A DIAGNOSTIC AND TREATMENT CENTER OR A
HEALTH CENTER DEFINED UNDER 42 U.S.C. S 254B ON BEHALF  OF  HEALTH  CARE
PROFESSIONALS  RENDERING  SERVICES AT THE GROUP PRACTICE, DIAGNOSTIC AND
TREATMENT CENTER  OR  HEALTH  CENTER,  SHALL  DISCLOSE  TO  PATIENTS  OR
PROSPECTIVE  PATIENTS  IN  WRITING  OR  THROUGH  AN INTERNET WEBSITE THE
HEALTH CARE PLANS IN WHICH THE HEALTH CARE PROFESSIONAL, GROUP PRACTICE,
DIAGNOSTIC AND TREATMENT CENTER OR HEALTH  CENTER,  IS  A  PARTICIPATING
PROVIDER  AND  THE  HOSPITALS WITH WHICH THE HEALTH CARE PROFESSIONAL IS
AFFILIATED PRIOR TO THE PROVISION OF NON-EMERGENCY SERVICES AND VERBALLY
AT THE TIME AN APPOINTMENT IS SCHEDULED.
  2. IF A HEALTH CARE PROFESSIONAL, OR A GROUP PRACTICE OF  HEALTH  CARE
PROFESSIONALS,  A  DIAGNOSTIC  AND  TREATMENT  CENTER OR A HEALTH CENTER
DEFINED UNDER 42 U.S.C. S 254B ON BEHALF OF  HEALTH  CARE  PROFESSIONALS
RENDERING  SERVICES  AT  THE  GROUP  PRACTICE,  DIAGNOSTIC AND TREATMENT
CENTER OR HEALTH CENTER, DOES  NOT  PARTICIPATE  IN  THE  NETWORK  OF  A
PATIENT'S  OR  PROSPECTIVE  PATIENT'S  HEALTH CARE PLAN, THE HEALTH CARE
PROFESSIONAL, GROUP PRACTICE, DIAGNOSTIC AND TREATMENT CENTER OR  HEALTH
CENTER,  SHALL:    (A) PRIOR TO THE PROVISION OF NON-EMERGENCY SERVICES,
INFORM A PATIENT OR PROSPECTIVE PATIENT THAT  THE  AMOUNT  OR  ESTIMATED
AMOUNT  THE  HEALTH  CARE  PROFESSIONAL WILL BILL THE PATIENT FOR HEALTH
CARE SERVICES IS AVAILABLE UPON REQUEST;  AND  (B)  UPON  RECEIPT  OF  A
REQUEST  FROM  A PATIENT OR PROSPECTIVE PATIENT, DISCLOSE TO THE PATIENT
OR PROSPECTIVE PATIENT IN WRITING THE AMOUNT  OR  ESTIMATED  AMOUNT  OR,
WITH  RESPECT  TO  A HEALTH CENTER, A SCHEDULE OF FEES PROVIDED UNDER 42
U.S.C. S 254B(K)(3)(G)(I), THAT  THE  HEALTH  CARE  PROFESSIONAL,  GROUP
PRACTICE,  DIAGNOSTIC  AND  TREATMENT CENTER OR HEALTH CENTER, WILL BILL
THE PATIENT OR PROSPECTIVE PATIENT FOR HEALTH CARE SERVICES PROVIDED  OR

S. 6914                            169                           A. 9205

ANTICIPATED  TO BE PROVIDED TO THE PATIENT OR PROSPECTIVE PATIENT ABSENT
UNFORESEEN MEDICAL CIRCUMSTANCES THAT MAY ARISE  WHEN  THE  HEALTH  CARE
SERVICES ARE PROVIDED.
  3.  A  HEALTH  CARE  PROFESSIONAL  WHO  IS A PHYSICIAN SHALL PROVIDE A
PATIENT OR PROSPECTIVE PATIENT WITH THE  NAME,  PRACTICE  NAME,  MAILING
ADDRESS,  AND  TELEPHONE NUMBER OF ANY HEALTH CARE PROVIDER SCHEDULED TO
PERFORM ANESTHESIOLOGY, LABORATORY, PATHOLOGY,  RADIOLOGY  OR  ASSISTANT
SURGEON  SERVICES  IN  CONNECTION WITH CARE TO BE PROVIDED IN THE PHYSI-
CIAN'S OFFICE FOR THE PATIENT OR COORDINATED OR REFERRED BY  THE  PHYSI-
CIAN  FOR  THE  PATIENT  AT  THE  TIME OF REFERRAL TO OR COORDINATION OF
SERVICES WITH SUCH PROVIDER.
  4.   A HEALTH CARE PROFESSIONAL  WHO  IS  A  PHYSICIAN  SHALL,  FOR  A
PATIENT'S  SCHEDULED HOSPITAL ADMISSION OR SCHEDULED OUTPATIENT HOSPITAL
SERVICES, PROVIDE A PATIENT AND THE HOSPITAL  WITH  THE  NAME,  PRACTICE
NAME,  MAILING ADDRESS AND TELEPHONE NUMBER OF ANY OTHER PHYSICIAN WHOSE
SERVICES WILL BE ARRANGED BY THE PHYSICIAN AND ARE SCHEDULED AT THE TIME
OF THE PRE-ADMISSION TESTING, REGISTRATION   OR ADMISSION  AT  THE  TIME
NON-EMERGENCY  SERVICES  ARE  SCHEDULED;  AND  INFORMATION  AS TO HOW TO
DETERMINE THE HEALTHCARE PLANS IN WHICH THE PHYSICIAN PARTICIPATES.
  5. A HOSPITAL SHALL ESTABLISH, UPDATE AND MAKE PUBLIC THROUGH  POSTING
ON THE HOSPITAL'S WEBSITE, TO THE EXTENT REQUIRED BY FEDERAL GUIDELINES,
A  LIST  OF  THE  HOSPITAL'S  STANDARD  CHARGES  FOR  ITEMS AND SERVICES
PROVIDED BY THE HOSPITAL, INCLUDING FOR DIAGNOSIS-RELATED GROUPS  ESTAB-
LISHED UNDER SECTION 1886(D)(4) OF THE FEDERAL SOCIAL SECURITY ACT.
  6.  A  HOSPITAL  SHALL POST ON THE HOSPITAL'S WEBSITE:  (A) THE HEALTH
CARE PLANS IN WHICH THE HOSPITAL IS  A  PARTICIPATING  PROVIDER;  (B)  A
STATEMENT  THAT  (I) PHYSICIAN SERVICES PROVIDED IN THE HOSPITAL ARE NOT
INCLUDED IN THE HOSPITAL'S CHARGES; (II) PHYSICIANS WHO PROVIDE SERVICES
IN THE HOSPITAL MAY OR MAY NOT PARTICIPATE WITH  THE  SAME  HEALTH  CARE
PLANS  AS  THE HOSPITAL, AND; (III) THE PROSPECTIVE PATIENT SHOULD CHECK
WITH THE PHYSICIAN ARRANGING FOR THE HOSPITAL SERVICES TO DETERMINE  THE
HEALTH  CARE  PLANS IN WHICH THE PHYSICIAN PARTICIPATES; (C) AS APPLICA-
BLE, THE NAME, MAILING ADDRESS AND TELEPHONE  NUMBER  OF  THE  PHYSICIAN
GROUPS THAT THE HOSPITAL HAS CONTRACTED WITH TO PROVIDE SERVICES INCLUD-
ING  ANESTHESIOLOGY,  PATHOLOGY  OR  RADIOLOGY,  AND INSTRUCTIONS HOW TO
CONTACT THESE GROUPS TO DETERMINE THE HEALTH CARE PLAN PARTICIPATION  OF
THE PHYSICIANS IN THESE GROUPS; AND (D) AS APPLICABLE, THE NAME, MAILING
ADDRESS, AND TELEPHONE NUMBER OF PHYSICIANS EMPLOYED BY THE HOSPITAL AND
WHOSE  SERVICES  MAY  BE  PROVIDED  AT THE HOSPITAL, AND THE HEALTH CARE
PLANS IN WHICH THEY PARTICIPATE.
  7. IN REGISTRATION OR ADMISSION MATERIALS PROVIDED IN ADVANCE OF  NON-
EMERGENCY HOSPITAL SERVICES, A HOSPITAL SHALL: (A) ADVISE THE PATIENT OR
PROSPECTIVE  PATIENT  TO CHECK WITH THE PHYSICIAN ARRANGING THE HOSPITAL
SERVICES TO DETERMINE: (I) THE NAME, PRACTICE NAME, MAILING ADDRESS  AND
TELEPHONE  NUMBER OF ANY OTHER PHYSICIAN WHOSE SERVICES WILL BE ARRANGED
BY THE PHYSICIAN; AND (II) WHETHER THE SERVICES OF  PHYSICIANS  WHO  ARE
EMPLOYED  OR  CONTRACTED  BY  THE HOSPITAL TO PROVIDE SERVICES INCLUDING
ANESTHESIOLOGY, PATHOLOGY AND/OR RADIOLOGY ARE REASONABLY ANTICIPATED TO
BE PROVIDED TO THE PATIENT; AND  (B)  PROVIDE  PATIENTS  OR  PROSPECTIVE
PATIENTS  WITH INFORMATION AS TO HOW TO TIMELY DETERMINE THE HEALTH CARE
PLANS PARTICIPATED IN BY PHYSICIANS WHO ARE  REASONABLY  ANTICIPATED  TO
PROVIDE  SERVICES  TO  THE PATIENT AT THE HOSPITAL, AS DETERMINED BY THE
PHYSICIAN ARRANGING THE PATIENT'S HOSPITAL SERVICES, AND WHO ARE EMPLOY-
EES OF THE HOSPITAL OR CONTRACTED BY THE HOSPITAL  TO  PROVIDE  SERVICES
INCLUDING ANESTHESIOLOGY, RADIOLOGY AND/OR PATHOLOGY.
  8. FOR PURPOSES OF THIS SECTION:

S. 6914                            170                           A. 9205

  (A)  "HEALTH  CARE  PLAN"  MEANS A HEALTH INSURER INCLUDING AN INSURER
LICENSED TO WRITE ACCIDENT AND HEALTH INSURANCE SUBJECT TO ARTICLE THIR-
TY-TWO OF THE INSURANCE LAW; A CORPORATION ORGANIZED PURSUANT TO ARTICLE
FORTY-THREE OF THE INSURANCE LAW; A MUNICIPAL COOPERATIVE HEALTH BENEFIT
PLAN  CERTIFIED  PURSUANT TO ARTICLE FORTY-SEVEN OF THE INSURANCE LAW; A
HEALTH MAINTENANCE ORGANIZATION CERTIFIED PURSUANT TO ARTICLE FORTY-FOUR
OF THIS CHAPTER; A STUDENT HEALTH PLAN ESTABLISHED OR MAINTAINED  PURSU-
ANT TO SECTION ONE THOUSAND ONE HUNDRED TWENTY-FOUR OF THE INSURANCE LAW
OR A SELF-FUNDED EMPLOYEE WELFARE BENEFIT PLAN.
  (B) "HEALTH CARE PROFESSIONAL" MEANS AN APPROPRIATELY LICENSED, REGIS-
TERED  OR  CERTIFIED HEALTH CARE PROFESSIONAL PURSUANT TO TITLE EIGHT OF
THE EDUCATION LAW.
  (C) "HOSPITAL" MEANS A GENERAL HOSPITAL AS DEFINED IN SUBDIVISION  TEN
OF SECTION TWO THOUSAND EIGHT HUNDRED ONE OF THIS CHAPTER.
  S  18.  Paragraphs (k), (p-1), (q) and (r) of subdivision 1 of section
4408 of the public health law, paragraphs (k), (q) and (r) as  added  by
chapter 705 of the laws of 1996, and paragraph (p-1) as added by chapter
554  of  the laws of 2002, are amended and three new paragraphs (s), (t)
and (u) are added to read as follows:
  (k) notice that an enrollee may obtain a referral  to  a  health  care
provider  outside  of  the  health maintenance organization's network or
panel when the health maintenance organization does not  have  a  health
care  provider  [with]  WHO IS GEOGRAPHICALLY ACCESSIBLE TO THE ENROLLEE
AND WHO HAS appropriate training and experience in the network or  panel
to  meet the particular health care needs of the enrollee and the proce-
dure by which the enrollee can obtain such referral;
  (p-1) notice that an enrollee shall have direct access to primary  and
preventive obstetric and gynecologic services, INCLUDING ANNUAL EXAMINA-
TIONS,  CARE  RESULTING  FROM SUCH ANNUAL EXAMINATIONS, AND TREATMENT OF
ACUTE GYNECOLOGIC CONDITIONS, from a qualified provider of such services
of her choice from within the plan [for no fewer than  two  examinations
annually  for such services] or [to] FOR any care related to A pregnancy
[and that additionally, the enrollee shall have direct access to primary
and preventive obstetric and gynecologic services required as  a  result
of  such  annual  examinations  or  as  a result of an acute gynecologic
condition];
  (q) notice of all appropriate mailing addresses and telephone  numbers
to be utilized by enrollees seeking information or authorization; [and]
  (r)  a  listing by specialty, which may be in a separate document that
is updated annually, of the name, address and telephone  number  of  all
participating  providers, including facilities, and, in addition, in the
case of physicians, board certification[.],  LANGUAGES  SPOKEN  AND  ANY
AFFILIATIONS  WITH  PARTICIPATING  HOSPITALS.  THE LISTING SHALL ALSO BE
POSTED ON THE HEALTH MAINTENANCE ORGANIZATION'S WEBSITE AND  THE  HEALTH
MAINTENANCE ORGANIZATION SHALL UPDATE THE WEBSITE WITHIN FIFTEEN DAYS OF
THE  ADDITION  OR  TERMINATION OF A PROVIDER FROM THE HEALTH MAINTENANCE
ORGANIZATION'S NETWORK OR A CHANGE  IN  A  PHYSICIAN'S  HOSPITAL  AFFIL-
IATION;
  (S) WHERE APPLICABLE, A DESCRIPTION OF THE METHOD BY WHICH AN ENROLLEE
MAY SUBMIT A CLAIM FOR HEALTH CARE SERVICES;
  (T) WITH RESPECT TO OUT-OF-NETWORK COVERAGE:
  (I)  A CLEAR DESCRIPTION OF THE METHODOLOGY USED BY THE HEALTH MAINTE-
NANCE ORGANIZATION TO DETERMINE REIMBURSEMENT FOR OUT-OF-NETWORK  HEALTH
CARE SERVICES;
  (II)  THE  AMOUNT  THAT THE HEALTH MAINTENANCE ORGANIZATION WILL REIM-
BURSE UNDER THE METHODOLOGY FOR OUT-OF-NETWORK HEALTH CARE SERVICES  SET

S. 6914                            171                           A. 9205

FORTH AS A PERCENTAGE OF THE USUAL AND CUSTOMARY COST FOR OUT-OF-NETWORK
HEALTH CARE SERVICES;
  (III)  EXAMPLES  OF  ANTICIPATED  OUT-OF-POCKET  COSTS  FOR FREQUENTLY
BILLED OUT-OF-NETWORK HEALTH CARE SERVICES; AND
  (U) INFORMATION IN  WRITING  AND  THROUGH  AN  INTERNET  WEBSITE  THAT
REASONABLY  PERMITS  AN ENROLLEE OR PROSPECTIVE ENROLLEE TO ESTIMATE THE
ANTICIPATED OUT-OF-POCKET COST FOR OUT-OF-NETWORK HEALTH  CARE  SERVICES
IN  A  GEOGRAPHICAL  AREA  OR ZIP CODE BASED UPON THE DIFFERENCE BETWEEN
WHAT THE HEALTH MAINTENANCE ORGANIZATION WILL REIMBURSE FOR  OUT-OF-NET-
WORK  HEALTH  CARE  SERVICES  AND  THE  USUAL  AND  CUSTOMARY  COST  FOR
OUT-OF-NETWORK HEALTH CARE SERVICES.
  S 19. Paragraphs (k) and (l) of subdivision 2 of section 4408  of  the
public  health  law,  as  added  by chapter 705 of the laws of 1996, are
amended and two new paragraphs (m) and (n) are added to read as follows:
  (k) provide the written application procedures and minimum  qualifica-
tion  requirements  for  health  care  providers to be considered by the
health maintenance organization; [and]
  (1) disclose  other  information  as  required  by  the  commissioner,
provided  that  such  requirements are promulgated pursuant to the state
administrative procedure act[.];
  (M) DISCLOSE WHETHER A HEALTH CARE PROVIDER  SCHEDULED  TO  PROVIDE  A
HEALTH CARE SERVICE IS AN IN-NETWORK PROVIDER; AND
  (N)  WITH RESPECT TO OUT-OF-NETWORK COVERAGE, DISCLOSE THE APPROXIMATE
DOLLAR AMOUNT THAT THE HEALTH MAINTENANCE ORGANIZATION WILL  PAY  FOR  A
SPECIFIC  OUT-OF-NETWORK  HEALTH  CARE  SERVICE.  THE HEALTH MAINTENANCE
ORGANIZATION SHALL ALSO INFORM AN ENROLLEE THROUGH SUCH DISCLOSURE  THAT
SUCH APPROXIMATION IS NOT BINDING ON THE HEALTH MAINTENANCE ORGANIZATION
AND  THAT  THE  APPROXIMATE  DOLLAR  AMOUNT  THAT THE HEALTH MAINTENANCE
ORGANIZATION WILL PAY FOR A SPECIFIC OUT-OF-NETWORK HEALTH CARE  SERVICE
MAY CHANGE.
  S 20. Section 4408 of the public health law is amended by adding a new
subdivision 7 to read as follows:
  7.    FOR  PURPOSES  OF THIS SECTION, "USUAL AND CUSTOMARY COST" SHALL
MEAN THE EIGHTIETH PERCENTILE OF ALL CHARGES FOR THE  PARTICULAR  HEALTH
CARE  SERVICE  PERFORMED  BY A PROVIDER IN THE SAME OR SIMILAR SPECIALTY
AND PROVIDED IN THE SAME GEOGRAPHICAL AREA AS REPORTED IN A BENCHMARKING
DATABASE MAINTAINED BY A NONPROFIT ORGANIZATION SPECIFIED BY THE  SUPER-
INTENDENT OF FINANCIAL SERVICES. THE NONPROFIT ORGANIZATION SHALL NOT BE
AFFILIATED WITH AN INSURER, A CORPORATION SUBJECT TO ARTICLE FORTY-THREE
OF THE INSURANCE LAW, A MUNICIPAL COOPERATIVE HEALTH BENEFIT PLAN CERTI-
FIED  PURSUANT  TO ARTICLE FORTY-SEVEN OF THE INSURANCE LAW, OR A HEALTH
MAINTENANCE ORGANIZATION CERTIFIED PURSUANT TO THIS ARTICLE.
  S 21. Section 4900 of the public health law is amended by adding a new
subdivision 7-f-1 to read as follows:
  7-F-1. "OUT-OF-NETWORK REFERRAL DENIAL" MEANS A DENIAL  OF  A  REQUEST
FOR  AN  AUTHORIZATION  OR REFERRAL TO AN OUT-OF-NETWORK PROVIDER ON THE
BASIS THAT THE HEALTH CARE PLAN  HAS  A  HEALTH  CARE  PROVIDER  IN  THE
IN-NETWORK BENEFITS PORTION OF ITS NETWORK WITH APPROPRIATE TRAINING AND
EXPERIENCE  TO MEET THE PARTICULAR HEALTH CARE NEEDS OF AN ENROLLEE, AND
WHO IS ABLE TO PROVIDE THE REQUESTED HEALTH SERVICE. THE  NOTICE  OF  AN
OUT-OF-NETWORK  REFERRAL  DENIAL  PROVIDED  TO AN ENROLLEE SHALL INCLUDE
INFORMATION EXPLAINING WHAT INFORMATION  THE  ENROLLEE  MUST  SUBMIT  IN
ORDER  TO APPEAL THE OUT-OF-NETWORK REFERRAL DENIAL PURSUANT TO SUBDIVI-
SION ONE-B OF SECTION FOUR THOUSAND NINE HUNDRED FOUR OF  THIS  ARTICLE.
AN  OUT-OF-NETWORK  REFERRAL  DENIAL  UNDER  THIS  SUBDIVISION  DOES NOT
CONSTITUTE AN ADVERSE DETERMINATION AS DEFINED IN THIS ARTICLE. AN  OUT-

S. 6914                            172                           A. 9205

OF-NETWORK  REFERRAL DENIAL SHALL NOT BE CONSTRUED TO INCLUDE AN OUT-OF-
NETWORK DENIAL AS DEFINED IN SUBDIVISION SEVEN-F OF THIS SECTION.
  S  22.  Subdivision  2  of  section  4903 of the public health law, as
amended by chapter 514 of the laws  of  2013,  is  amended  to  read  as
follows:
  2. A utilization review agent shall make a utilization review determi-
nation  involving  health  care services which require pre-authorization
and provide notice of a determination  to  the  enrollee  or  enrollee's
designee  and  the  enrollee's  health care provider by telephone and in
writing within three business days of receipt of the necessary  informa-
tion.  To  the  extent  practicable,  such  written  notification to the
enrollee's health care provider shall be transmitted electronically,  in
a  manner  and  in  a  form agreed upon by the parties. THE NOTIFICATION
SHALL IDENTIFY; (A) WHETHER THE SERVICES ARE  CONSIDERED  IN-NETWORK  OR
OUT-OF-NETWORK;  (B)  AND WHETHER THE ENROLLEE WILL BE HELD HARMLESS FOR
THE SERVICES AND NOT BE RESPONSIBLE FOR  ANY  PAYMENT,  OTHER  THAN  ANY
APPLICABLE  CO-PAYMENT  OR  CO-INSURANCE;  (C) AS APPLICABLE, THE DOLLAR
AMOUNT THE HEALTH CARE PLAN WILL PAY IF THE SERVICE  IS  OUT-OF-NETWORK;
AND (D) AS APPLICABLE, INFORMATION EXPLAINING HOW AN ENROLLEE MAY DETER-
MINE  THE  ANTICIPATED OUT-OF-POCKET COST FOR OUT-OF-NETWORK HEALTH CARE
SERVICES IN A GEOGRAPHICAL AREA OR ZIP CODE BASED  UPON  THE  DIFFERENCE
BETWEEN  WHAT  THE  HEALTH  CARE  PLAN WILL REIMBURSE FOR OUT-OF-NETWORK
HEALTH CARE SERVICES AND THE USUAL AND CUSTOMARY COST FOR OUT-OF-NETWORK
HEALTH CARE SERVICES.
  S 23. Section 4904 of the public health law is amended by adding a new
subdivision 1-b to read as follows:
  1-B. AN ENROLLEE OR THE ENROLLEE'S DESIGNEE MAY APPEAL A DENIAL OF  AN
OUT-OF-NETWORK  REFERRAL  BY  A HEALTH CARE PLAN BY SUBMITTING A WRITTEN
STATEMENT FROM  THE  ENROLLEE'S  ATTENDING  PHYSICIAN,  WHO  MUST  BE  A
LICENSED, BOARD CERTIFIED OR BOARD ELIGIBLE PHYSICIAN QUALIFIED TO PRAC-
TICE IN THE SPECIALTY AREA OF PRACTICE APPROPRIATE TO TREAT THE ENROLLEE
FOR  THE HEALTH SERVICE SOUGHT, PROVIDED THAT: (A) THE IN-NETWORK HEALTH
CARE PROVIDER OR PROVIDERS RECOMMENDED BY THE HEALTH CARE  PLAN  DO  NOT
HAVE  THE  APPROPRIATE  TRAINING  AND  EXPERIENCE TO MEET THE PARTICULAR
HEALTH CARE NEEDS OF THE ENROLLEE FOR THE HEALTH SERVICE; AND (B) RECOM-
MENDS AN OUT-OF-NETWORK PROVIDER WITH THE APPROPRIATE TRAINING AND EXPE-
RIENCE TO MEET THE PARTICULAR HEALTH CARE NEEDS OF THE ENROLLEE, AND WHO
IS ABLE TO PROVIDE THE REQUESTED HEALTH SERVICE.
  S 24. Subdivision 2 of section  4910  of  the  public  health  law  is
amended by adding a new paragraph (d) to read as follows:
  (D)(I)  THE  ENROLLEE HAS HAD AN OUT-OF-NETWORK REFERRAL DENIED ON THE
GROUNDS THAT THE HEALTH CARE PLAN HAS A  HEALTH  CARE  PROVIDER  IN  THE
IN-NETWORK BENEFITS PORTION OF ITS NETWORK WITH APPROPRIATE TRAINING AND
EXPERIENCE  TO MEET THE PARTICULAR HEALTH CARE NEEDS OF AN ENROLLEE, AND
WHO IS ABLE TO PROVIDE THE REQUESTED HEALTH SERVICE.
  (II) THE ENROLLEE'S ATTENDING PHYSICIAN,  WHO  SHALL  BE  A  LICENSED,
BOARD CERTIFIED OR BOARD ELIGIBLE PHYSICIAN QUALIFIED TO PRACTICE IN THE
SPECIALTY  AREA  OF  PRACTICE  APPROPRIATE TO TREAT THE ENROLLEE FOR THE
HEALTH SERVICE SOUGHT, CERTIFIES THAT THE IN-NETWORK HEALTH CARE PROVID-
ER OR PROVIDERS RECOMMENDED BY THE HEALTH CARE  PLAN  DO  NOT  HAVE  THE
APPROPRIATE  TRAINING  AND EXPERIENCE TO MEET THE PARTICULAR HEALTH CARE
NEEDS OF AN ENROLLEE, AND RECOMMENDS AN OUT-OF-NETWORK PROVIDER WITH THE
APPROPRIATE TRAINING AND EXPERIENCE TO MEET THE PARTICULAR  HEALTH  CARE
NEEDS  OF  AN  ENROLLEE, AND WHO IS ABLE TO PROVIDE THE REQUESTED HEALTH
SERVICE.

S. 6914                            173                           A. 9205

  S 25. Paragraph (d) of subdivision 2 of section  4914  of  the  public
health  law  is  amended  by  adding  a  new subparagraph (D) to read as
follows:
  (D) FOR EXTERNAL APPEALS REQUESTED PURSUANT TO PARAGRAPH (D) OF SUBDI-
VISION  TWO  OF  SECTION  FOUR  THOUSAND  NINE HUNDRED TEN OF THIS TITLE
RELATING TO AN OUT-OF-NETWORK REFERRAL DENIAL, THE EXTERNAL APPEAL AGENT
SHALL REVIEW THE UTILIZATION REVIEW AGENT'S FINAL ADVERSE  DETERMINATION
AND,  IN  ACCORDANCE  WITH  THE  PROVISIONS  OF THIS TITLE, SHALL MAKE A
DETERMINATION AS TO WHETHER THE OUT-OF-NETWORK REFERRAL SHALL BE COVERED
BY THE HEALTH PLAN; PROVIDED THAT SUCH DETERMINATION SHALL:
  (I) BE CONDUCTED ONLY BY ONE OR A GREATER ODD NUMBER OF CLINICAL  PEER
REVIEWERS;
  (II) BE ACCOMPANIED BY A WRITTEN STATEMENT:
  (1)  THAT  THE  OUT-OF-NETWORK REFERRAL SHALL BE COVERED BY THE HEALTH
CARE PLAN EITHER WHEN THE REVIEWER OR A MAJORITY OF THE PANEL OF REVIEW-
ERS DETERMINES, UPON REVIEW  OF  THE  TRAINING  AND  EXPERIENCE  OF  THE
IN-NETWORK  HEALTH  CARE PROVIDER OR PROVIDERS PROPOSED BY THE PLAN, THE
TRAINING AND EXPERIENCE OF THE REQUESTED  OUT-OF-NETWORK  PROVIDER,  THE
CLINICAL  STANDARDS OF THE PLAN, THE INFORMATION PROVIDED CONCERNING THE
ENROLLEE,  THE  ATTENDING  PHYSICIAN'S  RECOMMENDATION,  THE  ENROLLEE'S
MEDICAL  RECORD,  AND  ANY  OTHER PERTINENT INFORMATION, THAT THE HEALTH
PLAN DOES NOT HAVE A PROVIDER WITH THE APPROPRIATE TRAINING AND  EXPERI-
ENCE TO MEET THE PARTICULAR HEALTH CARE NEEDS OF AN ENROLLEE WHO IS ABLE
TO  PROVIDE  THE  REQUESTED  HEALTH SERVICE, AND THAT THE OUT-OF-NETWORK
PROVIDER HAS THE APPROPRIATE TRAINING AND EXPERIENCE TO MEET THE PARTIC-
ULAR HEALTH CARE NEEDS OF AN ENROLLEE, IS ABLE TO PROVIDE THE  REQUESTED
HEALTH  SERVICE,  AND  IS LIKELY TO PRODUCE A MORE CLINICALLY BENEFICIAL
OUTCOME; OR
  (2) UPHOLDING THE HEALTH PLAN'S DENIAL OF COVERAGE;
  (III) BE SUBJECT TO THE TERMS AND CONDITIONS GENERALLY  APPLICABLE  TO
BENEFITS UNDER THE EVIDENCE OF COVERAGE UNDER THE HEALTH CARE PLAN;
  (IV) BE BINDING ON THE PLAN AND THE ENROLLEE; AND
  (V) BE ADMISSIBLE IN ANY COURT PROCEEDING.
  S  26. The financial services law is amended by adding a new article 6
to read as follows:
                                 ARTICLE 6
              EMERGENCY MEDICAL SERVICES AND SURPRISE BILLS
SECTION 601. DISPUTE RESOLUTION PROCESS ESTABLISHED.
        602. APPLICABILITY.
        603. DEFINITIONS.
        604. CRITERIA FOR DETERMINING A REASONABLE FEE.
        605. DISPUTE RESOLUTION FOR EMERGENCY SERVICES.
        606. HOLD HARMLESS AND ASSIGNMENT OF BENEFITS FOR SURPRISE BILLS
               FOR INSUREDS.
        607. DISPUTE RESOLUTION FOR SURPRISE BILLS.
        608. PAYMENT FOR INDEPENDENT DISPUTE RESOLUTION ENTITY.
  S 601. DISPUTE  RESOLUTION  PROCESS  ESTABLISHED.  THE  SUPERINTENDENT
SHALL  ESTABLISH  A  DISPUTE RESOLUTION PROCESS BY WHICH A DISPUTE FOR A
BILL FOR EMERGENCY SERVICES OR A SURPRISE  BILL  MAY  BE  RESOLVED.  THE
SUPERINTENDENT  SHALL  HAVE THE POWER TO GRANT AND REVOKE CERTIFICATIONS
OF INDEPENDENT DISPUTE RESOLUTION ENTITIES TO CONDUCT THE DISPUTE RESOL-
UTION PROCESS. THE SUPERINTENDENT SHALL  PROMULGATE  REGULATIONS  ESTAB-
LISHING  STANDARDS FOR THE DISPUTE RESOLUTION PROCESS, INCLUDING A PROC-
ESS  FOR  CERTIFYING  AND  SELECTING  INDEPENDENT   DISPUTE   RESOLUTION
ENTITIES.  AN  INDEPENDENT  DISPUTE RESOLUTION ENTITY SHALL USE LICENSED
PHYSICIANS IN ACTIVE PRACTICE IN THE SAME OR SIMILAR  SPECIALTY  AS  THE

S. 6914                            174                           A. 9205

PHYSICIAN  PROVIDING  THE  SERVICE THAT IS SUBJECT TO THE DISPUTE RESOL-
UTION PROCESS OF THIS ARTICLE. TO THE EXTENT PRACTICABLE, THE  PHYSICIAN
SHALL BE LICENSED IN THIS STATE.
  S  602. APPLICABILITY. (A) THIS ARTICLE SHALL NOT APPLY TO HEALTH CARE
SERVICES, INCLUDING EMERGENCY SERVICES, WHERE PHYSICIAN FEES ARE SUBJECT
TO SCHEDULES OR OTHER MONETARY LIMITATIONS UNDER ANY OTHER LAW,  INCLUD-
ING THE WORKERS' COMPENSATION LAW AND ARTICLE FIFTY-ONE OF THE INSURANCE
LAW, AND SHALL NOT PREEMPT ANY SUCH LAW.
  (B)(1) WITH REGARD TO EMERGENCY SERVICES BILLED UNDER AMERICAN MEDICAL
ASSOCIATION  CURRENT  PROCEDURAL  TERMINOLOGY  (CPT) CODES 99281 THROUGH
99285, 99288, 99291 THROUGH 99292, 99217 THROUGH  99220,  99224  THROUGH
99226,  AND  99234  THROUGH 99236, THE DISPUTE RESOLUTION PROCESS ESTAB-
LISHED IN THIS ARTICLE SHALL NOT APPLY WHEN:
  (A) THE AMOUNT BILLED FOR ANY SUCH CPT CODE MEETS THE REQUIREMENTS SET
FORTH IN PARAGRAPH THREE OF THIS SUBSECTION, AFTER ANY APPLICABLE CO-IN-
SURANCE, CO-PAYMENT AND DEDUCTIBLE; AND
  (B) THE AMOUNT BILLED FOR ANY  SUCH  CPT  CODE  DOES  NOT  EXCEED  ONE
HUNDRED  TWENTY  PERCENT  OF  THE  USUAL AND CUSTOMARY COST FOR SUCH CPT
CODE.
  (2) THE HEALTH CARE PLAN SHALL ENSURE THAT AN INSURED SHALL NOT  INCUR
ANY  GREATER  OUT-OF-POCKET  COSTS FOR EMERGENCY SERVICES BILLED UNDER A
CPT CODE AS SET FORTH IN THIS SUBSECTION THAN  THE  INSURED  WOULD  HAVE
INCURRED  IF  SUCH  EMERGENCY  SERVICES WERE PROVIDED BY A PARTICIPATING
PHYSICIAN.
  (3) BEGINNING JANUARY FIRST, TWO THOUSAND  FIFTEEN  AND  EACH  JANUARY
FIRST  THEREAFTER,  THE  SUPERINTENDENT SHALL PUBLISH ON A WEBSITE MAIN-
TAINED BY THE DEPARTMENT OF FINANCIAL SERVICES, AND PROVIDE  IN  WRITING
TO EACH HEALTH CARE PLAN, A DOLLAR AMOUNT FOR WHICH BILLS FOR THE PROCE-
DURE  CODES  IDENTIFIED  IN  THIS  SUBSECTION  SHALL  BE EXEMPT FROM THE
DISPUTE RESOLUTION PROCESS ESTABLISHED  IN  THIS  ARTICLE.  SUCH  AMOUNT
SHALL  EQUAL  THE AMOUNT FROM THE PRIOR YEAR, BEGINNING WITH SIX HUNDRED
DOLLARS IN TWO THOUSAND FOURTEEN, ADJUSTED BY THE AVERAGE OF THE  ANNUAL
AVERAGE  INFLATION  RATES  FOR  THE MEDICAL CARE COMMODITIES AND MEDICAL
CARE SERVICES COMPONENTS OF THE CONSUMER PRICE INDEX. IN NO EVENT  SHALL
AN  AMOUNT EXCEEDING ONE THOUSAND TWO HUNDRED DOLLARS FOR A SPECIFIC CPT
CODE BILLED BE EXEMPT FROM THE DISPUTE RESOLUTION PROCESS ESTABLISHED IN
THIS ARTICLE.
  S 603. DEFINITIONS. FOR THE PURPOSES OF THIS ARTICLE:
  (A) "EMERGENCY CONDITION" MEANS A MEDICAL OR BEHAVIORAL CONDITION THAT
MANIFESTS ITSELF BY ACUTE SYMPTOMS  OF  SUFFICIENT  SEVERITY,  INCLUDING
SEVERE  PAIN, SUCH THAT A PRUDENT LAYPERSON, POSSESSING AN AVERAGE KNOW-
LEDGE OF MEDICINE AND HEALTH, COULD REASONABLY  EXPECT  THE  ABSENCE  OF
IMMEDIATE MEDICAL ATTENTION TO RESULT IN : (1) PLACING THE HEALTH OF THE
PERSON AFFLICTED WITH SUCH CONDITION IN SERIOUS JEOPARDY, OR IN THE CASE
OF A BEHAVIORAL CONDITION PLACING THE HEALTH OF SUCH PERSON OR OTHERS IN
SERIOUS  JEOPARDY;  (2) SERIOUS IMPAIRMENT TO SUCH PERSON'S BODILY FUNC-
TIONS; (3) SERIOUS DYSFUNCTION OF ANY  BODILY  ORGAN  OR  PART  OF  SUCH
PERSON;  (4)  SERIOUS  DISFIGUREMENT  OF SUCH PERSON; OR (5) A CONDITION
DESCRIBED IN CLAUSE (I), (II) OR (III) OF SECTION 1867(E)(1)(A)  OF  THE
SOCIAL SECURITY ACT 42 U.S.C. S 1395DD.
  (B)  "EMERGENCY  SERVICES"  MEANS, WITH RESPECT TO AN EMERGENCY CONDI-
TION: (1) A MEDICAL SCREENING EXAMINATION AS REQUIRED UNDER SECTION 1867
OF THE SOCIAL SECURITY ACT, 42 U.S.C. S  1395DD,  WHICH  IS  WITHIN  THE
CAPABILITY  OF  THE EMERGENCY DEPARTMENT OF A HOSPITAL, INCLUDING ANCIL-
LARY SERVICES ROUTINELY AVAILABLE TO THE EMERGENCY DEPARTMENT TO  EVALU-
ATE SUCH EMERGENCY MEDICAL CONDITION; AND (2) WITHIN THE CAPABILITIES OF

S. 6914                            175                           A. 9205

THE STAFF AND FACILITIES AVAILABLE AT THE HOSPITAL, SUCH FURTHER MEDICAL
EXAMINATION  AND  TREATMENT  AS  ARE  REQUIRED UNDER SECTION 1867 OF THE
SOCIAL SECURITY ACT, 42 U.S.C.  S 1395DD, TO STABILIZE THE PATIENT.
  (C) "HEALTH CARE PLAN" MEANS AN INSURER LICENSED TO WRITE ACCIDENT AND
HEALTH  INSURANCE PURSUANT TO ARTICLE THIRTY-TWO OF THE INSURANCE LAW; A
CORPORATION ORGANIZED PURSUANT TO ARTICLE FORTY-THREE OF  THE  INSURANCE
LAW;  A  MUNICIPAL COOPERATIVE HEALTH BENEFIT PLAN CERTIFIED PURSUANT TO
ARTICLE FORTY-SEVEN OF THE INSURANCE LAW; A HEALTH MAINTENANCE ORGANIZA-
TION CERTIFIED PURSUANT TO ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH  LAW;
OR  A  STUDENT HEALTH PLAN ESTABLISHED OR MAINTAINED PURSUANT TO SECTION
ONE THOUSAND ONE HUNDRED TWENTY-FOUR OF THE INSURANCE LAW.
  (D) "INSURED" MEANS A PATIENT COVERED UNDER A HEALTH CARE PLAN'S POLI-
CY OR CONTRACT.
  (E) "NON-PARTICIPATING" MEANS NOT HAVING A CONTRACT WITH A HEALTH CARE
PLAN TO PROVIDE HEALTH CARE SERVICES TO AN INSURED.
  (F) "PARTICIPATING" MEANS HAVING A CONTRACT WITH A HEALTH CARE PLAN TO
PROVIDE HEALTH CARE SERVICES TO AN INSURED.
  (G) "PATIENT" MEANS  A  PERSON  WHO  RECEIVES  HEALTH  CARE  SERVICES,
INCLUDING EMERGENCY SERVICES, IN THIS STATE.
  (H)  "SURPRISE BILL" MEANS A BILL FOR HEALTH CARE SERVICES, OTHER THAN
EMERGENCY SERVICES, RECEIVED BY:
  (1) AN INSURED FOR SERVICES RENDERED BY A NON-PARTICIPATING  PHYSICIAN
AT  A  PARTICIPATING  HOSPITAL  OR  AMBULATORY  SURGICAL CENTER, WHERE A
PARTICIPATING PHYSICIAN IS UNAVAILABLE OR A NON-PARTICIPATING  PHYSICIAN
RENDERS  SERVICES WITHOUT THE INSURED'S KNOWLEDGE, OR UNFORESEEN MEDICAL
SERVICES ARISE AT THE  TIME  THE  HEALTH  CARE  SERVICES  ARE  RENDERED;
PROVIDED,  HOWEVER,  THAT A SURPRISE BILL SHALL NOT MEAN A BILL RECEIVED
FOR HEALTH CARE SERVICES WHEN A PARTICIPATING PHYSICIAN IS AVAILABLE AND
THE INSURED HAS ELECTED TO  OBTAIN  SERVICES  FROM  A  NON-PARTICIPATING
PHYSICIAN;
  (2)  AN INSURED FOR SERVICES RENDERED BY A NON-PARTICIPATING PROVIDER,
WHERE THE SERVICES WERE REFERRED BY A PARTICIPATING PHYSICIAN TO A  NON-
PARTICIPATING  PROVIDER  WITHOUT EXPLICIT WRITTEN CONSENT OF THE INSURED
ACKNOWLEDGING THAT THE PARTICIPATING PHYSICIAN IS REFERRING THE  INSURED
TO  A  NON-PARTICIPATING  PROVIDER  AND  THAT THE REFERRAL MAY RESULT IN
COSTS NOT COVERED BY THE HEALTH CARE PLAN; OR
  (3) A PATIENT WHO IS NOT AN INSURED FOR SERVICES RENDERED BY A  PHYSI-
CIAN  AT A HOSPITAL OR AMBULATORY SURGICAL CENTER, WHERE THE PATIENT HAS
NOT TIMELY RECEIVED ALL OF THE DISCLOSURES REQUIRED PURSUANT TO  SECTION
TWENTY-FOUR OF THE PUBLIC HEALTH LAW.
  (I)  "USUAL  AND CUSTOMARY COST" MEANS THE EIGHTIETH PERCENTILE OF ALL
CHARGES FOR THE PARTICULAR HEALTH CARE SERVICE PERFORMED BY  A  PROVIDER
IN  THE  SAME OR SIMILAR SPECIALTY AND PROVIDED IN THE SAME GEOGRAPHICAL
AREA AS REPORTED IN A BENCHMARKING DATABASE MAINTAINED  BY  A  NONPROFIT
ORGANIZATION SPECIFIED BY THE SUPERINTENDENT. THE NONPROFIT ORGANIZATION
SHALL  NOT BE AFFILIATED WITH AN INSURER, A CORPORATION SUBJECT TO ARTI-
CLE FORTY-THREE OF THE INSURANCE LAW,  A  MUNICIPAL  COOPERATIVE  HEALTH
BENEFIT  PLAN CERTIFIED PURSUANT TO ARTICLE FORTY-SEVEN OF THE INSURANCE
LAW, OR A HEALTH MAINTENANCE ORGANIZATION CERTIFIED PURSUANT TO  ARTICLE
FORTY-FOUR OF THE PUBLIC HEALTH LAW.
  S  604.  CRITERIA FOR DETERMINING A REASONABLE FEE. IN DETERMINING THE
APPROPRIATE AMOUNT TO PAY FOR A  HEALTH  CARE  SERVICE,  AN  INDEPENDENT
DISPUTE  RESOLUTION  ENTITY SHALL CONSIDER ALL RELEVANT FACTORS, INCLUD-
ING:
  (A) WHETHER THERE IS A GROSS DISPARITY BETWEEN THE FEE CHARGED BY  THE
PHYSICIAN FOR SERVICES RENDERED AS COMPARED TO:

S. 6914                            176                           A. 9205

  (1) FEES PAID TO THE INVOLVED PHYSICIAN FOR THE SAME SERVICES RENDERED
BY  THE  PHYSICIAN  TO  OTHER PATIENTS IN HEALTH CARE PLANS IN WHICH THE
PHYSICIAN IS NOT PARTICIPATING, AND
  (2)  IN  THE CASE OF A DISPUTE INVOLVING A HEALTH CARE PLAN, FEES PAID
BY THE HEALTH CARE PLAN TO REIMBURSE SIMILARLY QUALIFIED PHYSICIANS  FOR
THE  SAME SERVICES IN THE SAME REGION WHO ARE NOT PARTICIPATING WITH THE
HEALTH CARE PLAN;
  (B) THE LEVEL OF TRAINING, EDUCATION AND EXPERIENCE OF THE PHYSICIAN;
  (C) THE PHYSICIAN'S USUAL CHARGE FOR COMPARABLE SERVICES  WITH  REGARD
TO  PATIENTS  IN HEALTH CARE PLANS IN WHICH THE PHYSICIAN IS NOT PARTIC-
IPATING;
  (D) THE CIRCUMSTANCES AND COMPLEXITY OF THE PARTICULAR CASE, INCLUDING
TIME AND PLACE OF THE SERVICE;
  (E) INDIVIDUAL PATIENT CHARACTERISTICS; AND
  (F) THE USUAL AND CUSTOMARY COST OF THE SERVICE.
  S 605.  DISPUTE  RESOLUTION  FOR  EMERGENCY  SERVICES.  (A)  EMERGENCY
SERVICES FOR AN INSURED. (1) WHEN A HEALTH CARE PLAN RECEIVES A BILL FOR
EMERGENCY  SERVICES  FROM A NON-PARTICIPATING PHYSICIAN, THE HEALTH CARE
PLAN SHALL PAY AN AMOUNT THAT IT DETERMINES IS REASONABLE FOR THE  EMER-
GENCY  SERVICES  RENDERED BY THE NON-PARTICIPATING PHYSICIAN, IN ACCORD-
ANCE WITH SECTION THREE THOUSAND TWO HUNDRED TWENTY-FOUR-A OF THE INSUR-
ANCE  LAW,  EXCEPT  FOR  THE  INSURED'S   CO-PAYMENT,   COINSURANCE   OR
DEDUCTIBLE,  IF  ANY,  AND  SHALL ENSURE THAT THE INSURED SHALL INCUR NO
GREATER OUT-OF-POCKET COSTS FOR THE EMERGENCY SERVICES THAN THE  INSURED
WOULD   HAVE   INCURRED  WITH  A  PARTICIPATING  PHYSICIAN  PURSUANT  TO
SUBSECTION (C) OF SECTION THREE THOUSAND TWO HUNDRED  FORTY-ONE  OF  THE
INSURANCE LAW.
  (2)  A  NON-PARTICIPATING PHYSICIAN OR A HEALTH CARE PLAN MAY SUBMIT A
DISPUTE REGARDING A FEE OR PAYMENT FOR EMERGENCY SERVICES FOR REVIEW  TO
AN INDEPENDENT DISPUTE RESOLUTION ENTITY.
  (3)  THE  INDEPENDENT  DISPUTE RESOLUTION ENTITY SHALL MAKE A DETERMI-
NATION WITHIN THIRTY DAYS OF RECEIPT OF THE DISPUTE FOR REVIEW.
  (4) IN DETERMINING A REASONABLE FEE  FOR  THE  SERVICES  RENDERED,  AN
INDEPENDENT  DISPUTE  RESOLUTION  ENTITY  SHALL SELECT EITHER THE HEALTH
CARE PLAN'S PAYMENT OR THE NON-PARTICIPATING PHYSICIAN'S FEE. THE  INDE-
PENDENT DISPUTE RESOLUTION ENTITY SHALL DETERMINE WHICH AMOUNT TO SELECT
BASED  UPON  THE CONDITIONS AND FACTORS SET FORTH IN SECTION SIX HUNDRED
FOUR OF THIS ARTICLE.   IF  AN  INDEPENDENT  DISPUTE  RESOLUTION  ENTITY
DETERMINES, BASED ON THE HEALTH CARE PLAN'S PAYMENT AND THE NON-PARTICI-
PATING  PHYSICIAN'S  FEE, THAT A SETTLEMENT BETWEEN THE HEALTH CARE PLAN
AND NON-PARTICIPATING PHYSICIAN IS REASONABLY LIKELY, OR THAT  BOTH  THE
HEALTH  CARE  PLAN'S  PAYMENT  AND THE NON-PARTICIPATING PHYSICIAN'S FEE
REPRESENT UNREASONABLE EXTREMES, THEN THE INDEPENDENT DISPUTE RESOLUTION
ENTITY MAY DIRECT BOTH PARTIES TO ATTEMPT A GOOD FAITH  NEGOTIATION  FOR
SETTLEMENT.  THE HEALTH CARE PLAN AND NON-PARTICIPATING PHYSICIAN MAY BE
GRANTED UP TO TEN BUSINESS DAYS FOR THIS NEGOTIATION,  WHICH  SHALL  RUN
CONCURRENTLY WITH THE THIRTY DAY PERIOD FOR DISPUTE RESOLUTION.
  (B)  EMERGENCY  SERVICES  FOR  A PATIENT THAT IS NOT AN INSURED. (1) A
PATIENT THAT IS NOT AN INSURED OR THE PATIENT'S PHYSICIAN MAY  SUBMIT  A
DISPUTE  REGARDING  A  FEE FOR EMERGENCY SERVICES FOR REVIEW TO AN INDE-
PENDENT DISPUTE RESOLUTION ENTITY UPON APPROVAL OF THE SUPERINTENDENT.
  (2) AN INDEPENDENT DISPUTE RESOLUTION ENTITY SHALL DETERMINE A REASON-
ABLE FEE FOR THE SERVICES BASED UPON THE SAME CONDITIONS AND FACTORS SET
FORTH IN SECTION SIX HUNDRED FOUR OF THIS ARTICLE.

S. 6914                            177                           A. 9205

  (3) A PATIENT THAT IS NOT AN INSURED SHALL NOT BE REQUIRED TO PAY  THE
PHYSICIAN'S FEE IN ORDER TO BE ELIGIBLE TO SUBMIT THE DISPUTE FOR REVIEW
TO AN INDEPENDENT DISPUTE RESOLUTION ENTITY.
  (C)  THE  DETERMINATION  OF  AN  INDEPENDENT DISPUTE RESOLUTION ENTITY
SHALL BE BINDING ON THE HEALTH CARE PLAN,  PHYSICIAN  AND  PATIENT,  AND
SHALL  BE  ADMISSIBLE  IN  ANY  COURT PROCEEDING BETWEEN THE HEALTH CARE
PLAN, PHYSICIAN OR PATIENT, OR IN ANY ADMINISTRATIVE PROCEEDING  BETWEEN
THIS STATE AND THE PHYSICIAN.
  S 606. HOLD HARMLESS AND ASSIGNMENT OF BENEFITS FOR SURPRISE BILLS FOR
INSUREDS.  WHEN AN INSURED ASSIGNS BENEFITS FOR A SURPRISE BILL IN WRIT-
ING TO A NON-PARTICIPATING PHYSICIAN THAT KNOWS THE INSURED  IS  INSURED
UNDER A HEALTH CARE PLAN, THE NON-PARTICIPATING PHYSICIAN SHALL NOT BILL
THE  INSURED EXCEPT FOR ANY APPLICABLE COPAYMENT, COINSURANCE OR DEDUCT-
IBLE THAT WOULD BE OWED IF THE INSURED UTILIZED A  PARTICIPATING  PHYSI-
CIAN.
  S  607.  DISPUTE  RESOLUTION  FOR  SURPRISE BILLS.   (A) SURPRISE BILL
RECEIVED BY AN INSURED WHO ASSIGNS BENEFITS.  (1) IF AN INSURED  ASSIGNS
BENEFITS  TO  A  NON-PARTICIPATING PHYSICIAN, THE HEALTH CARE PLAN SHALL
PAY THE NON-PARTICIPATING PHYSICIAN IN ACCORDANCE  WITH  PARAGRAPHS  TWO
AND THREE OF THIS SUBSECTION.
  (2)  THE NON-PARTICIPATING PHYSICIAN MAY BILL THE HEALTH CARE PLAN FOR
THE HEALTH CARE SERVICES RENDERED, AND THE HEALTH CARE  PLAN  SHALL  PAY
THE  NON-PARTICIPATING PHYSICIAN THE BILLED AMOUNT OR ATTEMPT TO NEGOTI-
ATE REIMBURSEMENT WITH THE NON-PARTICIPATING PHYSICIAN.
  (3) IF THE HEALTH CARE PLAN'S ATTEMPTS TO NEGOTIATE REIMBURSEMENT  FOR
HEALTH  CARE SERVICES PROVIDED BY A NON-PARTICIPATING PHYSICIAN DOES NOT
RESULT IN A RESOLUTION OF THE PAYMENT DISPUTE BETWEEN  THE  NON-PARTICI-
PATING  PHYSICIAN  AND  THE HEALTH CARE PLAN, THE HEALTH CARE PLAN SHALL
PAY THE NON-PARTICIPATING PHYSICIAN  AN  AMOUNT  THE  HEALTH  CARE  PLAN
DETERMINES  IS  REASONABLE FOR THE HEALTH CARE SERVICES RENDERED, EXCEPT
FOR THE INSURED'S COPAYMENT, COINSURANCE OR  DEDUCTIBLE,  IN  ACCORDANCE
WITH  SECTION  THREE THOUSAND TWO HUNDRED TWENTY-FOUR-A OF THE INSURANCE
LAW.
  (4) EITHER THE HEALTH CARE PLAN OR THE NON-PARTICIPATING PHYSICIAN MAY
SUBMIT THE DISPUTE REGARDING THE SURPRISE BILL FOR REVIEW  TO  AN  INDE-
PENDENT  DISPUTE  RESOLUTION  ENTITY,  PROVIDED HOWEVER, THE HEALTH CARE
PLAN MAY NOT SUBMIT THE DISPUTE UNLESS IT HAS COMPLIED WITH THE REQUIRE-
MENTS OF PARAGRAPHS ONE, TWO AND THREE OF THIS SUBSECTION.
  (5) THE INDEPENDENT DISPUTE RESOLUTION ENTITY SHALL  MAKE  A  DETERMI-
NATION WITHIN THIRTY DAYS OF RECEIPT OF THE DISPUTE FOR REVIEW.
  (6)  WHEN  DETERMINING A REASONABLE FEE FOR THE SERVICES RENDERED, THE
INDEPENDENT DISPUTE RESOLUTION ENTITY SHALL  SELECT  EITHER  THE  HEALTH
CARE  PLAN'S  PAYMENT OR THE NON-PARTICIPATING PHYSICIAN'S FEE. AN INDE-
PENDENT DISPUTE RESOLUTION ENTITY SHALL DETERMINE WHICH AMOUNT TO SELECT
BASED UPON THE CONDITIONS AND FACTORS SET FORTH IN SECTION  SIX  HUNDRED
FOUR  OF  THIS  ARTICLE.    IF  AN INDEPENDENT DISPUTE RESOLUTION ENTITY
DETERMINES, BASED ON THE HEALTH CARE PLAN'S PAYMENT AND THE NON-PARTICI-
PATING PHYSICIAN'S FEE, THAT A SETTLEMENT BETWEEN THE HEALTH  CARE  PLAN
AND  NON-PARTICIPATING  PHYSICIAN IS REASONABLY LIKELY, OR THAT BOTH THE
HEALTH CARE PLAN'S PAYMENT AND  THE  NON-PARTICIPATING  PHYSICIAN'S  FEE
REPRESENT UNREASONABLE EXTREMES, THEN THE INDEPENDENT DISPUTE RESOLUTION
ENTITY  MAY  DIRECT BOTH PARTIES TO ATTEMPT A GOOD FAITH NEGOTIATION FOR
SETTLEMENT. THE HEALTH CARE PLAN AND NON-PARTICIPATING PHYSICIAN MAY  BE
GRANTED  UP  TO  TEN BUSINESS DAYS FOR THIS NEGOTIATION, WHICH SHALL RUN
CONCURRENTLY WITH THE THIRTY DAY PERIOD FOR DISPUTE RESOLUTION.

S. 6914                            178                           A. 9205

  (B) SURPRISE BILL RECEIVED BY AN INSURED WHO DOES NOT ASSIGN  BENEFITS
OR  BY  A  PATIENT  WHO IS NOT AN INSURED.   (1) AN INSURED WHO DOES NOT
ASSIGN BENEFITS IN ACCORDANCE WITH SUBSECTION (A) OF THIS SECTION  OR  A
PATIENT  WHO  IS  NOT  AN  INSURED  AND WHO RECEIVES A SURPRISE BILL MAY
SUBMIT  A DISPUTE REGARDING THE SURPRISE BILL FOR REVIEW TO AN INDEPEND-
ENT DISPUTE RESOLUTION ENTITY.
  (2) THE  INDEPENDENT  DISPUTE  RESOLUTION  ENTITY  SHALL  DETERMINE  A
REASONABLE  FEE  FOR THE SERVICES RENDERED BASED UPON THE CONDITIONS AND
FACTORS SET FORTH IN SECTION SIX HUNDRED FOUR OF THIS ARTICLE.
  (3) A PATIENT OR INSURED WHO DOES NOT ASSIGN  BENEFITS  IN  ACCORDANCE
WITH  SUBSECTION  (A)  OF  THIS SECTION SHALL NOT BE REQUIRED TO PAY THE
PHYSICIAN'S FEE TO BE ELIGIBLE TO SUBMIT THE DISPUTE FOR REVIEW  TO  THE
INDEPENDENT DISPUTE ENTITY.
  (C)  THE  DETERMINATION  OF  AN  INDEPENDENT DISPUTE RESOLUTION ENTITY
SHALL BE BINDING ON THE PATIENT, PHYSICIAN AND  HEALTH  CARE  PLAN,  AND
SHALL  BE  ADMISSIBLE  IN  ANY  COURT  PROCEEDING BETWEEN THE PATIENT OR
INSURED, PHYSICIAN  OR  HEALTH  CARE  PLAN,  OR  IN  ANY  ADMINISTRATIVE
PROCEEDING BETWEEN THIS STATE AND THE PHYSICIAN.
  S  608.  PAYMENT  FOR  INDEPENDENT  DISPUTE RESOLUTION ENTITY. (A) FOR
DISPUTES INVOLVING AN INSURED, WHEN THE INDEPENDENT  DISPUTE  RESOLUTION
ENTITY  DETERMINES THE HEALTH CARE PLAN'S PAYMENT IS REASONABLE, PAYMENT
FOR THE DISPUTE RESOLUTION PROCESS SHALL BE THE  RESPONSIBILITY  OF  THE
NON-PARTICIPATING  PHYSICIAN.  WHEN  THE  INDEPENDENT DISPUTE RESOLUTION
ENTITY DETERMINES THE NON-PARTICIPATING PHYSICIAN'S FEE  IS  REASONABLE,
PAYMENT  FOR  THE DISPUTE RESOLUTION PROCESS SHALL BE THE RESPONSIBILITY
OF THE HEALTH CARE PLAN.  WHEN A GOOD FAITH NEGOTIATION DIRECTED BY  THE
INDEPENDENT  DISPUTE  RESOLUTION  ENTITY  PURSUANT  TO PARAGRAPH FOUR OF
SUBSECTION (A) OF SECTION SIX HUNDRED FIVE OF THIS ARTICLE, OR PARAGRAPH
SIX OF SUBSECTION (A) OF SECTION  SIX  HUNDRED  SEVEN  OF  THIS  ARTICLE
RESULTS IN A SETTLEMENT BETWEEN THE HEALTH CARE PLAN AND NON-PARTICIPAT-
ING  PHYSICIAN, THE HEALTH CARE PLAN AND THE NON-PARTICIPATING PHYSICIAN
SHALL EVENLY DIVIDE AND SHARE THE PRORATED COST FOR DISPUTE RESOLUTION.
  (B) FOR DISPUTES INVOLVING A PATIENT THAT IS NOT AN INSURED, WHEN  THE
INDEPENDENT  DISPUTE RESOLUTION ENTITY DETERMINES THE PHYSICIAN'S FEE IS
REASONABLE, PAYMENT FOR THE DISPUTE  RESOLUTION  PROCESS  SHALL  BE  THE
RESPONSIBILITY  OF THE PATIENT UNLESS PAYMENT FOR THE DISPUTE RESOLUTION
PROCESS WOULD POSE A HARDSHIP TO THE PATIENT. THE  SUPERINTENDENT  SHALL
PROMULGATE  A REGULATION TO DETERMINE PAYMENT FOR THE DISPUTE RESOLUTION
PROCESS IN CASES OF HARDSHIP. WHEN THE  INDEPENDENT  DISPUTE  RESOLUTION
ENTITY  DETERMINES  THE PHYSICIAN'S FEE IS UNREASONABLE, PAYMENT FOR THE
DISPUTE RESOLUTION PROCESS SHALL BE THE RESPONSIBILITY OF THE PHYSICIAN.
  S 27. Paragraphs 5 and 6 of subsection (a)  of  section  2601  of  the
insurance law, paragraph 5 as amended by chapter 547 of the laws of 1997
and  paragraph  6  as  amended  by  chapter 388 of the laws of 2008, are
amended and a new paragraph 7 is added to read as follows:
  (5) compelling policyholders to institute suits to recover amounts due
under its policies by offering substantially less than the amounts ulti-
mately recovered in suits brought by them; [or]
  (6) failing to promptly disclose coverage pursuant to  subsection  (d)
or  subparagraph (A) of paragraph two of subsection (f) of section three
thousand four hundred twenty of this chapter[.]; OR
  (7) SUBMITTING REASONABLY RENDERED CLAIMS TO THE  INDEPENDENT  DISPUTE
RESOLUTION  PROCESS  ESTABLISHED  UNDER  ARTICLE  SIX  OF  THE FINANCIAL
SERVICES LAW.
  S 28. 1. An  out-of-network  reimbursement  rate  workgroup  shall  be
convened  and  shall consist of 9 members appointed by the governor. Two

S. 6914                            179                           A. 9205

members shall be appointed on the recommendation of the speaker  of  the
assembly and two members shall be appointed on the recommendation of the
temporary  president  of the senate and shall consist of two physicians,
two  representatives  of  health plans, and three consumers and shall be
co-chaired by the superintendent of the department of financial services
and the commissioner of the department of health.  Such  representatives
of  the  workgroup  must  represent  different regions of the state. The
members shall receive no compensation for their services, but  shall  be
allowed  their actual and necessary expenses incurred in the performance
of their duties.
  2. The workgroup shall review the current out-of-network reimbursement
rates used by health insurers  licensed  under  the  insurance  law  and
health  maintenance  organizations certified under the public health law
and the rate methodology as required under the laws  of  2014  and  make
recommendations  regarding  an  alternative rate methodology taking into
consideration the following factors:
  a. current physician charges for out-of-network services;
  b. trends in medical care and the actual costs of medical care;
  c. regional differences regarding medical costs and trends;
  d. the current methodologies and levels of reimbursement  for  out-of-
network  services  currently  paid  by health plans, including insurers,
HMOs, Medicare, and Medicaid;
  e. the current in-network rates paid by health plans, including insur-
ers, HMOs, Medicare and Medicaid for the same service and  by  the  same
provider;
  f. the impact different rate methodologies would have on out-of-pocket
costs for consumers who access out-of-network services;
  g. the impact different rate methodologies would have on premium costs
in different regions of the state;
  h. reimbursement data from all health plans both public and private as
well  as  charge data from medical professionals and hospitals available
through the All Payer  Database  as  developed  and  maintained  by  the
department  of  health  including  data  provided  in  the annual report
published pursuant to section 2816 of the public health law; and
  i. other issues deemed appropriate by either the superintendent of the
department of financial services or the commissioner of  the  department
of health.
  3.  The workgroup shall review out-of-network coverage in the individ-
ual and small group  markets  and  make  recommendations  regarding  the
availability and adequacy of the coverage, taking into consideration the
following factors:
  a.  the  extent  to which out-of-network coverage is available in each
rating region in this state;
  b. the extent to which a significant level of out-of-network  benefits
is  available in every rating region in this state, including the preva-
lence of coverage based on the usual  and  customary  cost  as  well  as
coverage  based  on other set reimbursement methodologies, such as Medi-
care; and
  c. other issues deemed appropriate by either the superintendent of the
department of financial services or the commissioner of  the  department
of health.
  4.  The  workgroup  shall report its findings and make recommendations
for legislation and regulations to the  governor,  the  speaker  of  the
assembly,  the  senate  majority leader, the chairs of the insurance and
health committees in both the assembly and the senate,  and  the  super-

S. 6914                            180                           A. 9205

intendent  of the department of financial services no later than January
1, 2016.
  S 29. This act shall take effect one year after it shall have become a
law, provided, however, that:
  1.  if  the  amendments  by  chapter  514  of the laws of 2013 made to
subsection (b) of section 4903 of the insurance law and subdivision 2 of
section 4903 of the public health law, as amended by sections twelve and
twenty-two of this act, respectively, take effect after such date,  then
sections twelve and twenty-two of this act shall take effect on the same
date as chapter 514 of the laws of 2013 takes effect;
  2.  for  policies  renewed  on and after such date this act shall take
effect on the renewal date;
  3. sections twelve, sixteen, seventeen, twenty-two and  twenty-six  of
this  act shall apply to health care services provided on and after such
date;
  4. sections eleven, thirteen, fourteen, fifteen,  twenty-one,  twenty-
three,  twenty-four  and  twenty-five of this act shall apply to denials
issued on and after such date; and
  5. effective immediately, the superintendent of financial services may
promulgate any regulations  necessary  for  the  implementation  of  the
provisions  of  this  act  on its effective date, and may certify one or
more independent dispute resolution entities.

                                 PART I

  Section 1. Subdivisions 3-b and 3-c of section 1 and section 4 of part
C of chapter 57 of the laws of 2006, relating to establishing a cost  of
living  adjustment for designated human services programs, as amended by
section 1 of part N of chapter 56 of the laws of 2013,  are  amended  to
read as follows:
  3-b.  Notwithstanding  any  inconsistent  provision  of law, beginning
April 1, 2009 and ending March 31, [2014] 2016, the commissioners  shall
not  include  a  COLA for the purpose of establishing rates of payments,
contracts or any other form of reimbursement.
  3-c. Notwithstanding any  inconsistent  provision  of  law,  beginning
April 1, [2014] 2016 and ending March 31, [2017] 2019, the commissioners
shall develop the COLA under this section using the actual U.S. consumer
price  index  for  all  urban  consumers (CPI-U) published by the United
States department of labor, bureau of labor statistics  for  the  twelve
month  period  ending  in  July  of  the budget year prior to such state
fiscal  year,  for  the  purpose  of  establishing  rates  of  payments,
contracts or any other form of reimbursement.
  S  4.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2006;  provided
section  one  of  this  act shall expire and be deemed repealed April 1,
[2017] 2019; provided, further, that sections two and three of this  act
shall expire and be deemed repealed December 31, 2009.
  S  2.  Section 1 of part C of chapter 57 of the laws of 2006, relating
to establishing  a  cost  of  living  adjustment  for  designated  human
services programs, is amended by adding a new subdivision 3-d to read as
follows:
  3-D.  (I)  NOTWITHSTANDING  THE  PROVISIONS OF SUBDIVISION 3-B OF THIS
SECTION, AS AMENDED BY SECTION ONE OF A CHAPTER  OF  THE  LAWS  OF  2014
WHICH  ADDED  THIS  SUBDIVISION,  OR ANY OTHER INCONSISTENT PROVISION OF
LAW, AND SUBJECT TO THE AVAILABILITY OF THE APPROPRIATION THEREFOR,  FOR
THE  PROGRAMS  LISTED IN PARAGRAPHS (I), (II), (III), (IV), (V) AND (VI)

S. 6914                            181                           A. 9205

OF SUBDIVISION 4 OF THIS SECTION, THE COMMISSIONERS SHALL PROVIDE  FUND-
ING  TO  SUPPORT  (1)  A  TWO PERCENT (2%) INCREASE IN ANNUAL SALARY AND
SALARY-RELATED FRINGE BENEFITS FOR DIRECT CARE STAFF AND DIRECT  SUPPORT
PROFESSIONALS, AND IN PAYMENT TO FOSTER PARENTS AND ADOPTIVE PARENTS, AS
DEFINED  BY  THE  COMMISSIONER OF THE APPLICABLE STATE AGENCY SUBJECT TO
THE APPROVAL OF THE DIRECTOR OF THE BUDGET BEGINNING  JANUARY  1,  2015,
AND  (2) A TWO PERCENT (2%) INCREASE IN ANNUAL SALARY AND SALARY-RELATED
FRINGE BENEFITS FOR DIRECT CARE STAFF, DIRECT SUPPORT PROFESSIONALS  AND
CLINICAL  STAFF,  AND IN PAYMENT TO FOSTER PARENTS AND ADOPTIVE PARENTS,
AS DEFINED BY THE COMMISSIONER OF THE APPLICABLE STATE AGENCY SUBJECT TO
THE APPROVAL OF THE DIRECTOR OF THE BUDGET BEGINNING APRIL 1, 2015. SUCH
COMMISSIONERS SHALL USE THE CONSOLIDATED FISCAL REPORTING  MANUAL  AS  A
REFERENCE,  TO THE EXTENT THAT APPLICABLE JOB TITLES ARE LISTED THEREIN.
WHERE APPLICABLE, THE FUNDING PROVIDED UNDER THIS SUBDIVISION  SHALL  BE
APPLIED  TO  REIMBURSABLE  COSTS  OR  CONTRACT AMOUNTS TO SUPPORT SALARY
INCREASES AND SALARY-RELATED FRINGE BENEFITS OF ELIGIBLE  PERSONS,  THAT
TOOK EFFECT ON OR AFTER JANUARY 1, 2014. THE COMMISSIONERS SHALL PROVIDE
FUNDING  FOR  SUCH  SALARY  AND ASSOCIATED FRINGE BENEFIT INCREASES IN A
MANNER WHICH WILL RESULT IN A CONSISTENT METHODOLOGY AMONG PROGRAMS  AND
PROVIDER TYPES.
  (II)  THE  COMMISSIONERS  SHALL  DEVELOP  STANDARDS, INCLUDING BUT NOT
LIMITED TO, REQUIRING THAT A LOCAL GOVERNMENT UNIT  OR  PROVIDER  AGENCY
DEVELOP  A  PLAN OF IMPLEMENTATION TO ENSURE THAT SUCH FUNDING INCREASES
SHALL BE DIRECTED TO DIRECT CARE STAFF,  DIRECT  SUPPORT  PROFESSIONALS,
CLINICAL  STAFF,  FOSTER  PARENTS  AND ADOPTIVE PARENTS, AS APPROPRIATE,
PURSUANT TO PARAGRAPH (I) OF THIS  SUBDIVISION.  EACH  LOCAL  GOVERNMENT
UNIT  OR  DIRECT CONTRACT PROVIDER RECEIVING SUCH FUNDING SHALL SUBMIT A
WRITTEN CERTIFICATION, IN SUCH FORM AND AT SUCH TIME AS EACH COMMISSION-
ER SHALL PRESCRIBE, ATTESTING TO HOW SUCH FUNDING WILL BE  OR  WAS  USED
FOR  PURPOSES  ELIGIBLE  UNDER  THIS  SECTION.  FURTHER, PROVIDERS SHALL
SUBMIT A RESOLUTION FROM THEIR GOVERNING BODY TO THE APPROPRIATE COMMIS-
SIONER, ATTESTING THAT THE FUNDING  RECEIVED  WILL  BE  USED  SOLELY  TO
SUPPORT  SALARY  AND  SALARY-RELATED FRINGE BENEFIT INCREASES FOR DIRECT
CARE STAFF, DIRECT SUPPORT PROFESSIONALS, CLINICAL STAFF, FOSTER PARENTS
AND ADOPTIVE PARENTS, PURSUANT TO PARAGRAPH (I) OF THIS SUBDIVISION  AND
THE APPLICABLE STANDARDS ISSUED BY THE APPROPRIATE COMMISSIONER PURSUANT
TO THIS PARAGRAPH.  SUCH COMMISSIONERS SHALL BE AUTHORIZED TO RECOUP ANY
FUNDS  AS  APPROPRIATED  HEREIN DETERMINED TO HAVE BEEN USED IN A MANNER
INCONSISTENT WITH SUCH STANDARDS OR INCONSISTENT WITH THE PROVISIONS  OF
THIS  SUBDIVISION,  AND SUCH COMMISSIONERS SHALL BE AUTHORIZED TO EMPLOY
ANY LEGAL MECHANISM TO RECOUP SUCH FUNDS, INCLUDING AN OFFSET  OF  OTHER
FUNDS THAT ARE OWED TO SUCH LOCAL GOVERNMENTAL UNIT OR PROVIDER.
  (III)  WHERE  APPROPRIATE, TRANSFERS TO THE DEPARTMENT OF HEALTH SHALL
BE MADE AS REIMBURSEMENT FOR THE STATE SHARE OF MEDICAL ASSISTANCE.
  S 3. This act shall take effect immediately and  shall  be  deemed  to
have been in full force and effect on and after April 1, 2014; provided,
however, that the amendments to subdivisions 3-b and 3-c of section 1 of
part  C  of  chapter  57 of the laws of 2006, relating to establishing a
cost of living adjustment for designated human services programs made by
section one of this act shall not affect the repeal of such subdivisions
and shall be deemed repealed therewith.
  S 2. Severability clause. If any clause, sentence, paragraph, subdivi-
sion, section or part of this act shall be  adjudged  by  any  court  of
competent  jurisdiction  to  be invalid, such judgment shall not affect,
impair, or invalidate the remainder thereof, but shall  be  confined  in
its  operation  to the clause, sentence, paragraph, subdivision, section

S. 6914                            182                           A. 9205

or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the legislature that this act would  have  been  enacted  even  if  such
invalid provisions had not been included herein.
  S  3.  This  act shall take effect immediately provided, however, that
the applicable effective date of Parts A through I of this act shall  be
as specifically set forth in the last section of such Parts.