Senate Bill S4137

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

                                  4137

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                              March 3, 2015
                               ___________

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

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

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

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

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09436-01-5
              

S. 4137                             2

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

S. 4137                             3

promulgate on an emergency basis any regulation he or she or such  coun-
cil  determines  necessary to implement any provision of this act on its
effective date.
  S 7. This act shall take effect on the one hundred eightieth day after
it shall have become a law.