S T A T E   O F   N E W   Y O R K
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                                 6363--A

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                             March 20, 2015
                               ___________

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

AN ACT to amend the social services law, in relation to medicaid co-pay-
  ments for prescription drugs and other services

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

  Section 1. Paragraph (b) of subdivision 6  of  section  367-a  of  the
social services law, as amended by section 15 of part B of chapter 57 of
the laws of 2015, is amended to read as follows:
  (b)  Co-payments  shall apply to all eligible persons for the services
defined in paragraph (d) of this subdivision with the exception of:
  (i) [individuals under twenty-one years of age;
  (ii) pregnant women;
  (iii)] individuals who are inpatients in a medical facility  who  have
been  required  to  spend  all  of their income for medical care, except
their personal needs allowance or residents of community based  residen-
tial facilities licensed by the office of mental health or the office of
mental retardation and developmental disabilities who have been required
to spend all of their income, except their personal needs allowance;
  [(iv)  individuals  enrolled  in  health  maintenance organizations or
other entities which provide comprehensive  health  services,  or  other
managed care programs for services covered by such programs, except that
such  persons,  other  than  persons otherwise exempted from co-payments
pursuant to subparagraphs (i), (ii), (iii) and (v)  of  this  paragraph,
and  other  than  those  persons  enrolled  in  a managed long term care
program, shall be subject to co-payments as  described  in  subparagraph
(v) of paragraph (d) of this subdivision;

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09435-03-6
              

A. 6363--A                          2

  (v)]  (II)  individuals  whose  family income is less than one hundred
percent of the federal poverty line, as defined in subparagraph four  of
paragraph  (a)  of subdivision one of section three hundred sixty-six of
this title, for a family of the same size; and
  [(vi)]  (III) any other individuals required to be excluded by federal
law or regulations.
  S 2. The opening paragraph  of  paragraph  (d)  of  subdivision  6  of
section  367-a of the social services law, as added by chapter 41 of the
laws of 1992, is amended to read as follows:
  Co-payments shall apply to [the following]  ALL  services  COVERED  BY
THIS  TITLE,  EXCEPT  DIAGNOSTIC  SERVICES, AND SHALL BE PRE-PAID AT THE
TIME WHEN SUCH SERVICES ARE RENDERED, subject  to  such  exceptions  for
subcategories  of  these  services  as recognized by the commissioner OF
HEALTH in regulations, provided in accordance with section three hundred
sixty-five-a of this [article] TITLE and the regulations of the  depart-
ment, to the extent permitted by title XIX of the federal social securi-
ty act:
  S  3.  The commissioner of health is authorized to promulgate or adopt
any rules or regulations necessary to implement the provisions  of  this
act  and  any  co-payments, procedures, forms, or instructions necessary
for such implementation may be adopted and issued on or after the effec-
tive date of this act. Notwithstanding any inconsistent provision of the
state administrative 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 are 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.
  S 4. This act shall take effect immediately.