NY State Senate Bill 2013-S3071

Senate Bill S3071

2013-2014 Legislative Session

Makes various provisions to encourage the purchase of long term health care insurance coverage

download bill text pdf

Archive: Last Bill Status - In Senate Committee Insurance Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 08, 2014	referred to insurance
Jan 29, 2013	referred to insurance

2013-S3071 (ACTIVE) - Details

See Assembly Version of this Bill:: A4845
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Add §342, amd §§1113, 3201, 3216, 3221, 3230 & 4303, Ins L; amd §§190, 210, 606, 1456 & 1511, Tax L; amd §3602, Pub Health L; amd §367-f, Soc Serv L
Versions Introduced in 2011-2012 Legislative Session:: S5037

2013-S3071 (ACTIVE) - Summary

Makes various provisions to encourage the purchase of long term health care insurance coverage: directs the department of financial assistance to establish a public awareness program on the availability of long term health care insurance and the provision of tax credits for premiums paid therefor; accelerates payment of death benefits and special surrender values upon receipt of the insured of end of life or palliative care; enhances tax credits for premiums paid for long term health care insurance; provides homemaker services may be provided by private home aides, subject to certain requirements, not only certified home care agencies

2013-S3071 (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S3071

TITLE OF BILL:  An act to amend the insurance law, in relation to
establishing a public awareness program on the availability of long
term health care insurance and the tax credits therefor and
accelerating payment of death benefits or a special surrender value
pursuant to a life insurance policy upon receipt of end of life or
palliative care; to amend the tax law, in relation to credits for
premiums paid for long-term care insurance policies; and to amend the
public health law, the insurance law and the social services law, in
relation to the provision of homemaker services

PURPOSE OR GENERAL IDEA OF BILL:  The purpose of this bill is to
expand upon the provisions of Chapter 563 of the Laws of 2010, which
expanded the types of end of life care that can be financed by an
accelerated death benefit rider attached to a life insurance policy to
include persons who have resided in a nursing home for three months or
more. This bill expands such end of life care that can be financed by
a life insurance accelerated death benefit to include end of life care
provided for by long term home health care, hospice or adult day care
services or palliative care.  The bill also provides additional tax
credit inducements to encourage individuals to purchase long term care
insurance when they are younger.

SUMMARY OF SPECIFIC PROVISIONS:

Section 1: Adds Insurance Law section 342 to establish a coordinated
Public awareness program to encourage individuals to purchase long
term care (LTC) insurance. Such awareness program shall be a
collaborative effort between the Departments of Health, Insurance, and
Taxation & Finance, and the Office of the Aging.

Section 2: Amends Insurance Law section 1113(al to expand the types of
long term care (LTC) and end of life care that can be financed by an
accelerated death benefit payable from an individual's life insurance.
This accelerated death benefit would need to be purchased as an
additional rider attached to a life insurance contract. This
authorization for a new rider was done by expanding the definition of
life insurance.

Section 3: Amends Insurance Law section 3201(11) to add life insurance
policies that have a trigger for payment of benefit upon the recipient
receiving end of life care or palliative care via long term health
care, hospice or adult day care services, or other services as one of
the types of policies that the Insurance Department must approve the
policy form for before and insurer can begin to sell such policy
riders to the general public.

Section 4: Amends Insurance Law section 3230(f) to add the payment of
an accelerated payment of a death benefit or special surrender value
upon the insured requiring end of life care as provided for in
Insurance Law section 1113.

Section 5: Amends Tax Law section 190 to increase the tax credit for
purchasing long term care insurance. The tax credit increase from 20%
to 4096 if the insured is less than 40 years old. The bill provides


further a gradual increase in the tax credit based on age. For persons
less than 50 years old, the tax credit is 30%, for those less than 55
years old, the tax credit is 25%, and for those 55 years old or older,
the tax credit remains the same as it is now at 20%. The reason for
the increased tax credit for those under the age of 40, 50, and 55
years of age is to encourage younger persons to purchase long term
care insurance when the premium rate is cheaper. Over 80% of the New
York Partnership for Long Term Care Insurance policies are purchased
by persons over the age of 55. For persons over the age of 60 years,
the average cost of a Partnership for Long Term Care insurance policy
is between $3,000 and $6,000, for those under the age of 55, it is
approximately $2,300. Hence, even with the higher percentage tax
credit for the purchase of LTC Insurance, for younger persons the tax
subsidy will be less than it is for the average person over the age of
60. The goal of this bill is to encourage younger individuals to
purchase this kind of coverage.

Section 5: Amends Tax Law section 210 to add the new tax credit
incentives for the computation of the corporate franchise tax.

Section 7: Amends Tax Law section 606 to add the LTC tax credit for
personnel income tax calculations.

Section 8: Amends Tax Law section 1456 to add the LTC tax credit for
bank corporation taxes.

Section 9: Amends Tax Law section 1511 to add the LTC tax credit for
insurance corporation taxes.

Section 10: Amends the public Health Law section 3602(4) to broaden
the definition of "home health aide services" to include "homemaker
services" which can be engaged through a private home aide. Further,
that such services are reimbursable through the partnership for long
term care program for end of life expenses.

Section 11: Amends Insurance Law section 3216 that relates to the
provisions of individual health care contracts and expands coverage
under such individual health care policies to cover homemaker services
that are provided and reimbursed under the LTC Partnership program.

Section 12: Amends Insurance Law section 3221(k) that relates to the
provisions of small group health insurance policies to expand the
definition of home care to include the provision of such services
through a private home aide service as long as such service is
provided and reimbursed under the LTC partnership program.

Section 13: Amends Insurance Law section 4303(a) to expand the defi-
nition of home care to include the provision of such services through
a private home aide service as long as such service is provided and
reimbursed under the LTC Partnership program.

Section 14; Amends social Services Law section 367-f to expand the
definition of long term care services to include homemaker services
provided through private home aides that is reimbursed pursuant to the
LTC partnership


Section 15: Mandates that the Insurance Department analyze and compare
expenditures, utilization rates, and utilization patterns for claims
for home care services covered under individual and group accident
policies for the period commencing 2 years preceding the effective
date of this act.

JUSTIFICATION:  As the general population becomes older, more and more
individuals are looking for affordable ways to pay for the financing
of their nursing home and long term care needs. While there are
available policies that provide payment for long term care, more
products should be authorized under New York law so that consumers
will have more types of insurance coverage available to meet their
specific needs or the needs of their family.

In addition, encouraging more individuals to finance their own long
term care, will help to curtail future expenditures from the State's
Medicaid program, which currently finances the lion's share of the
provision of long term care in this State. This bill is a further
extension of new laws such as Chapter 563 of the Laws of 2010 which
are geared towards encouraging individuals to finance their own long
term care and nursing home care as we all get older.

PRIOR LEGISLATIVE HISTORY:  2011-2012 - S. 5037 - Referred to
Insurance

FISCAL IMPLICATIONS: It is the intent of this bill encourage the
increased use of Long Term Care insurance for the use as a financing
mechanism to finance end of life care. This, in the end, should help
to decrease State Medicaid expenditures.

EFFECTIVE DATE: This act shall take effect on January 1st of the year
next succeeding its date of enactment.

2013-S3071 (ACTIVE) - Bill Text download pdf

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

                                  3071

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 29, 2013
                               ___________

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

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

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

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

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

S. 3071                             2

tion  requiring  extraordinary  medical  care or treatment regardless of
life expectancy, (C) certification by a licensed health care practition-
er of any condition which requires continuous care for the remainder  of
the  insured's  life in an eligible facility or at home when the insured
is chronically ill as defined by Section 7702(B) of the Internal Revenue
Code and regulations thereunder, provided the accelerated payments qual-
ify under Section 101(g)(3) of the Internal Revenue Code and  all  other
applicable  sections  of  federal law in order to maintain favorable tax
treatment, (D) certification by a licensed health care practitioner that
the insured is chronically ill as defined by Section  7702  (B)  of  the
Internal  Revenue Code and regulations thereunder, provided the acceler-
ated payments qualify under Section 101(g)(3) of  the  Internal  Revenue
Code  and all other applicable sections of federal law in order to main-
tain favorable tax treatment and the insurer that issues such policy  is
a  qualified long term care insurance carrier under Section 4980c of the
Internal Revenue Code or provide a special surrender value,  upon  total
and  permanent  disability of the insured, and optional modes of settle-
ment of proceeds, [or] (E) the insured's having been  a  resident  of  a
nursing  home,  as  defined  in  section twenty-eight hundred one of the
public health law, for a period of three months or more, with an  expec-
tation  that such insured will remain a resident of a nursing home until
death, OR (F) THE INSURED'S HAVING BEEN THE RECIPIENT OF LONG TERM  HOME
HEALTH  CARE,  HOSPICE  OR  ADULT  DAY CARE SERVICES, OR OTHER SERVICES,
WHICH PROVIDE END OF LIFE OR PALLIATIVE CARE  TO  THE  INSURED.    "Life
insurance"  also  includes additional benefits to safeguard the contract
against lapse in the event of unemployment of  the  insured  or  in  the
event  the  insured  is  a  resident of a nursing home. Amounts paid the
insurer for life insurance and proceeds applied under optional modes  of
settlement  or under dividend options may be allocated by the insurer to
one or more separate accounts pursuant  to  section  four  thousand  two
hundred forty of this chapter.
  S  3.  Subparagraph  (A)  of paragraph 11 of subsection (c) of section
3201 of the insurance law, as amended by chapter  563  of  the  laws  of
2010, is amended to read as follows:
  (A) The superintendent shall not approve a life insurance policy which
provides  for accelerated payment of death benefits or special surrender
values pursuant to subparagraph (B), (C), (D) [or], (E) OR (F) of  para-
graph one of subsection (a) of section one thousand one hundred thirteen
of this chapter unless it also provides for such accelerated payments or
special  surrender  values pursuant to subparagraph (A) of paragraph one
of subsection (a) of such section.
  S 4. Subsection (f) of section 3230 of the insurance law,  as  amended
by chapter 563 of the laws of 2010, is amended to read as follows:
  (f)  This section shall apply to all life insurance policies or policy
riders or provisions thereof that provide  for  accelerated  payment  of
death  benefits  or  a  special surrender value pursuant to subparagraph
(A), (B), (C) [or], (E) OR (F) of paragraph one  of  subsection  (a)  of
section one thousand one hundred thirteen of this chapter.
  S  5.  Subdivision  1  of  section  190  of the tax law, as amended by
section 17 of part B of chapter 58 of the laws of 2004,  is  amended  to
read as follows:
  1.  General.  A  taxpayer  shall  be  allowed a credit against the tax
imposed by this article, other  than  the  taxes  and  fees  imposed  by
sections  one hundred eighty and one hundred eighty-one of this article,
equal to [twenty percent] THE FOLLOWING PERCENTAGES of the premium  paid
during the taxable year for long-term care insurance:

S. 3071                             3

  (A)  FORTY  PERCENT  IF THE INSURED IS LESS THAN FORTY YEARS OF AGE AT
THE END OF THE TAX YEAR;
  (B) THIRTY PERCENT IF THE INSURED IS LESS THAN FIFTY YEARS OF AGE, BUT
FORTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR;
  (C)  TWENTY-FIVE  PERCENT IF THE INSURED IS LESS THAN FIFTY-FIVE YEARS
OF AGE, BUT FIFTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR; OR
  (D) TWENTY PERCENT IF THE INSURED IS FIFTY-FIVE OR MORE YEARS  OF  AGE
AT THE END OF THE TAX YEAR.
  In  order  to  qualify for such credit, the taxpayer's premium payment
must be for the purchase of or for continuing coverage under a long-term
care insurance policy that qualifies for such credit pursuant to section
one thousand one hundred seventeen of the insurance law.
  S 6. Paragraph (a) of subdivision 25-a of section 210 of the tax  law,
as amended by section 18 of part B of chapter 58 of the laws of 2004, is
amended to read as follows:
  (a)  A  taxpayer  shall be allowed a credit against the tax imposed by
this article equal to [twenty percent] THE FOLLOWING PERCENTAGES of  the
premium paid during the taxable year for long-term care insurance:
  (I)  FORTY  PERCENT  IF THE INSURED IS LESS THAN FORTY YEARS OF AGE AT
THE END OF THE TAX YEAR;
  (II) THIRTY PERCENT IF THE INSURED IS LESS THAN FIFTY  YEARS  OF  AGE,
BUT FORTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR;
  (III) TWENTY-FIVE PERCENT IF THE INSURED IS LESS THAN FIFTY-FIVE YEARS
OF AGE, BUT FIFTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR; OR
  (IV)  TWENTY PERCENT IF THE INSURED IS FIFTY-FIVE OR MORE YEARS OF AGE
AT THE END OF THE TAX YEAR.
  In order to qualify for such credit, the  taxpayer's  premium  payment
must be for the purchase of or for continuing coverage under a long-term
care insurance policy that qualifies for such credit pursuant to section
one thousand one hundred seventeen of the insurance law.
  S  7. Paragraph 1 of subsection (aa) of section 606 of the tax law, as
amended by section 1 of part P of chapter 61 of the  laws  of  2005,  is
amended to read as follows:
  (1)  Residents.  A  taxpayer shall be allowed a credit against the tax
imposed by this article equal to [twenty percent] THE FOLLOWING PERCENT-
AGES of the premium paid during the  taxable  year  for  long-term  care
insurance:
  (A)  FORTY  PERCENT  IF THE INSURED IS LESS THAN FORTY YEARS OF AGE AT
THE END OF THE TAX YEAR;
  (B) THIRTY PERCENT IF THE INSURED IS LESS THAN FIFTY YEARS OF AGE, BUT
FORTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR;
  (C) TWENTY-FIVE PERCENT IF THE INSURED IS LESS THAN  FIFTY-FIVE  YEARS
OF AGE, BUT FIFTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR; OR
  (D)  TWENTY  PERCENT IF THE INSURED IS FIFTY-FIVE OR MORE YEARS OF AGE
AT THE END OF THE TAX YEAR.
  In order to qualify for such credit, the  taxpayer's  premium  payment
must be for the purchase of or for continuing coverage under a long-term
care insurance policy that qualifies for such credit pursuant to section
one  thousand  one hundred seventeen of the insurance law. If the amount
of the credit allowable under this subsection for any taxable year shall
exceed the taxpayer's tax for such year, the excess may be carried  over
to  the  following year or years and may be deducted from the taxpayer's
tax for such year or years.
  S 8. Paragraph 1 of subsection (k) of section 1456 of the tax law,  as
amended  by  section  20 of part B of chapter 58 of the laws of 2004, is
amended to read as follows:

S. 3071                             4

  (1) A taxpayer shall be allowed a credit against the  tax  imposed  by
this  article equal to [twenty percent] THE FOLLOWING PERCENTAGES of the
premium paid during the taxable year for long-term care insurance:
  (A)  FORTY  PERCENT  IF THE INSURED IS LESS THAN FORTY YEARS OF AGE AT
THE END OF THE TAX YEAR;
  (B) THIRTY PERCENT IF THE INSURED IS LESS THAN FIFTY YEARS OF AGE, BUT
FORTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR;
  (C) TWENTY-FIVE PERCENT IF THE INSURED IS LESS THAN  FIFTY-FIVE  YEARS
OF AGE, BUT FIFTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR; OR
  (D)  TWENTY  PERCENT IF THE INSURED IS FIFTY-FIVE OR MORE YEARS OF AGE
AT THE END OF THE TAX YEAR.
  In order to qualify for such credit, the  taxpayer's  premium  payment
must be for the purchase of or for continuing coverage under a long-term
care insurance policy that qualifies for such credit pursuant to section
one thousand one hundred seventeen of the insurance law.
  S 9. Paragraph 1 of subdivision (m) of section 1511 of the tax law, as
amended  by  section  21 of part B of chapter 58 of the laws of 2004, is
amended to read as follows:
  (1) A taxpayer shall be allowed a credit against the  tax  imposed  by
this  article equal to [twenty percent] THE FOLLOWING PERCENTAGES of the
premium paid during the taxable year for long-term care insurance:
  (A) FORTY PERCENT IF THE INSURED IS LESS THAN FIFTY YEARS  OF  AGE  AT
THE END OF THE TAX YEAR;
  (B) THIRTY PERCENT IF THE INSURED IS LESS THAN FIFTY YEARS OF AGE, BUT
FORTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR;
  (C)  TWENTY-FIVE  PERCENT IF THE INSURED IS LESS THAN FIFTY-FIVE YEARS
OF AGE, BUT FIFTY OR MORE YEARS OF AGE, AT THE END OF THE TAX YEAR; OR
  (D) TWENTY PERCENT IF THE INSURED IS FIFTY-FIVE OR MORE YEARS  OF  AGE
AT THE END OF THE TAX YEAR.
  In  order  to  qualify for such credit, the taxpayer's premium payment
must be for the purchase of or for continuing coverage under a long-term
care insurance policy that qualifies for such credit pursuant to section
one thousand one hundred seventeen of the insurance law.
  S 10. Subdivision 4 of section 3602  of  the  public  health  law,  as
amended  by  chapter  600  of  the  laws  of 2002, is amended to read as
follows:
  4. "Home  health  aide  services"  means  simple  health  care  tasks,
personal hygiene services, housekeeping tasks essential to the patient's
health  and  other  related  supportive services. Such services shall be
prescribed by a physician in accordance with a plan of treatment for the
patient and: (A) shall be under the supervision of a registered  profes-
sional  nurse  from a certified home health agency or, when appropriate,
from a provider of a long term home  health  care  program  and  of  the
appropriate professional therapist from such agency or provider when the
aide  carries  out simple procedures as an extension of physical, speech
or occupational therapy, OR (B) HOMEMAKER SERVICES WHICH CAN BE  ENGAGED
THROUGH A PRIVATE HOME AIDE, PROVIDED HOWEVER THAT SUCH AIDE HAS (1) MET
THE  STANDARDS  ESTABLISHED  BY THE DEPARTMENT OF FAMILY ASSISTANCE, AND
(2) SUCH SERVICES ARE REIMBURSABLE THROUGH THE PARTNERSHIP FOR LONG TERM
CARE PROGRAM PURSUANT TO SECTION  THREE  HUNDRED  SIXTY-SEVEN-F  OF  THE
SOCIAL SERVICES LAW.  Such services may also be prescribed or ordered by
a nurse practitioner to the extent authorized by law and consistent with
the  written practice agreement pursuant to subdivision three of section
six thousand nine hundred two of the education law and not prohibited by
federal law or regulation.

S. 3071                             5

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

S. 3071                             6

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

S. 3071                             7

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

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