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

                                   751

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                             January 7, 2015
                               ___________

Introduced  by M. of A. RODRIGUEZ, RIVERA, COLTON, WEPRIN, RAIA, DUPREY,
  MONTESANO,  HEASTIE,  CRESPO  --  Multi-Sponsored  by  --  M.  of   A.
  BROOK-KRASNY,  CAMARA,  CROUCH,  JOHNS, MAGEE, MALLIOTAKIS, McDONOUGH,
  MOYA, TENNEY -- read once and referred to the Committee on Health

AN ACT to amend the public health law, in relation to  establishing  the
  Medicaid  identification  and  anti-fraud  biometric  technology pilot
  program; and to amend the social services law, in relation to conform-
  ing medical assistance identification with the Medicaid identification
  and anti-fraud biometric technology program; and making  an  appropri-
  ation therefor

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

  Section 1. The public health law is amended by adding  a  new  article
2-B to read as follows:
                                ARTICLE 2-B
            MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC
                        TECHNOLOGY PILOT PROGRAM
SECTION 290. MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
               PILOT PROGRAM.
        291. DEFINITIONS.
        292. BIOMETRIC TECHNOLOGY USE REQUIREMENT.
        293. RULES AND REGULATIONS.
  S  290.  MEDICAID  IDENTIFICATION  AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
PILOT PROGRAM. THERE IS HEREBY ESTABLISHED THE  MEDICAID  IDENTIFICATION
AND ANTI-FRAUD BIOMETRIC TECHNOLOGY PILOT PROGRAM.
  S 291. DEFINITIONS. AS USED IN THIS ARTICLE:
  1.  "BIOMETRIC TECHNOLOGY" MEANS TECHNOLOGY THAT MEASURES AND ANALYZES
BIOLOGICAL DATA, INCLUDING BUT  NOT  LIMITED  TO  DNA,  FINGER  IMAGING,
VASCULAR  PATTERNS,  EYE  RETINAS  AND  IRISES,  VOICE  PATTERNS, FACIAL
PATTERNS AND HAND MEASUREMENTS, FOR AUTHENTICATION PURPOSES.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00759-01-5

              

A. 751                              2

  2.  "BIOMETRIC VERIFICATION DEVICE" MEANS A DEVICE  CAPABLE  OF  USING
BIOMETRIC  VERIFICATION  TECHNOLOGY TO VERIFY THE IDENTITY OF A MEDICAID
RECIPIENT OR PROVIDER.
  S  292.  BIOMETRIC  TECHNOLOGY  USE REQUIREMENT. 1. THE DEPARTMENT, IN
CONSULTATION WITH THE OFFICE OF THE MEDICAID INSPECTOR GENERAL  AND  THE
OFFICE OF THE ATTORNEY GENERAL, SHALL DEVELOP A REQUEST FOR PROPOSALS TO
IMPLEMENT  A PROGRAM AUTHORIZING THE USE OF BIOMETRIC TECHNOLOGY FOR THE
PURPOSES OF PATIENT AND PROVIDER IDENTIFICATION AND FOR USE AS AN  ANTI-
FRAUD APPLICATION IN THE MEDICAID PROGRAM.
  2.  SUCH  REQUEST  FOR  PROPOSALS  SHALL INCLUDE AT A MINIMUM THAT (A)
MEDICAID RECIPIENTS AND PROVIDERS SHALL PROVIDE BIOMETRIC PROOF OF THEIR
IDENTITY ALONG WITH OTHER INFORMATION DEEMED NECESSARY  BY  THE  COMMIS-
SIONER.
  (B)  SUCH  PROGRAM  WILL BE CAPABLE OF STORING BIOMETRIC MARKERS AND A
LOG OF DOCTOR AND PHARMACY VISITS FOR EACH SERVICE BILLED TO  THE  MEDI-
CAID PROGRAM.
  (C)  MEDICAID  IDENTIFICATION  SHALL  BE ISSUED TO AND ACCEPTED BY THE
ADMITTING STAFF OF THE HEALTH CARE FACILITY.
  (D) MEDICAID RECIPIENTS SHALL BE REQUIRED TO PROVIDE  BIOMETRIC  PROOF
OF  IDENTITY AT THE TIME OF EACH VISIT TO A DOCTOR'S OFFICE OR CLINIC AT
THE POINT OF ACTUALLY BEING SEEN BY THE DOCTOR OR  CLINICAL  STAFF,  AND
SHALL  AGAIN  PROVIDE  PROOF  OF  IDENTITY  UPON  COMPLETION  OF CARE OR
SERVICES.
  (E)  PROVISIONS  SHALL  BE  INCLUDED   FOR   EMERGENCY   SERVICES   OR
PRESCRIPTIONS  AND ALTERNATE IDENTIFICATION METHODS FOR MEDICAID RECIPI-
ENTS PHYSICALLY OR MENTALLY UNABLE TO PROVIDE BIOMETRIC IDENTIFICATION.
  (F) FRAUD PREVENTION MARKERS INCORPORATED INTO SOFTWARE WHICH SHALL BE
USED TO OPERATE THE HARDWARE COMPONENT OF THE BIOMETRIC TECHNOLOGY SHALL
PREVENT AND/OR REJECT THE PAYMENT BY THE MEDICAID PROGRAM AND ALERT  THE
SERVICE  PROVIDER  AT  POINT  OF  SERVICE IF FRAUD OR POTENTIAL FRAUD IS
IDENTIFIED BY THE BIOMETRIC TECHNOLOGY SYSTEM.
  (G) PROVISIONS SHALL BE INCLUDED TO ENSURE  THAT  MEDICAID  RECIPIENTS
HAVE  ACCESS  TO  EMERGENCY  HEALTH  SERVICES IN THE CASE OF A BIOMETRIC
TECHNOLOGY SYSTEM MALFUNCTION OR FRAUD DETECTION ALARM.
  (H) EVALUATION AND SELECTION OF AN IDENTITY CREDENTIALING SYSTEM  THAT
ADDRESSES THE REQUIREMENTS OF MEDICAID BENEFICIARIES AND PROVIDERS SHALL
BE  BASED  ON  THE  FOLLOWING  CRITERIA:  SECURITY,  PRIVACY, USABILITY,
PERFORMANCE, HYGIENE, BIOMETRIC CAPTURE AND  STORAGE  REQUIREMENTS,  AND
INTEROPERABILITY.
  (I)  SUCH PROGRAM SHALL BE OPERATIONAL WITHIN TWELVE MONTHS OF PROGRAM
APPROVAL AND WILL OPERATE FOR THREE YEARS.
  3. SUCH REQUEST FOR PROPOSALS SHALL SET FORTH REQUIREMENTS AS  TO  THE
RESULTS AND GOALS TO BE ACHIEVED, RATHER THAN SPECIFIC TECHNICAL METHODS
OR  SYSTEMS,  TO  ALLOW  CONSIDERATION  OF THE WIDEST POSSIBLE CHOICE OF
AVAILABLE TECHNOLOGY.
  4. SUCH REQUEST FOR PROPOSALS SHALL  REQUIRE:  (A)  THAT  THE  PROGRAM
SHALL  BE  REVENUE NEUTRAL FROM INCEPTION, WHEREBY ANY PROGRAM COSTS ARE
AT LEAST OFFSET BY STATE MEDICAID SAVINGS, AND SHALL HAVE AS  A  PRIMARY
GOAL REDUCTION OF MEDICAID EXPENDITURES THROUGH ELIMINATION OF FRAUD AND
ABUSE;  AND (B) THAT THE PROGRAM SHALL BE COST NEUTRAL TO PROVIDERS FROM
INCEPTION, WHEREBY ANY PROVIDER COSTS ARE AT LEAST  OFFSET  BY  PROVIDER
SAVINGS,  AND  SHALL  HAVE  AS  A  PRIMARY GOAL PROVIDER SAVINGS THROUGH
INCREASED EFFICIENCIES.
  5. (A) SUCH REQUEST FOR PROPOSALS FOR THE IMPLEMENTATION OF A  PROGRAM
FOR  BIOMETRIC  TECHNOLOGY  USE  SHALL BE PUBLISHED ON OR BEFORE JANUARY

A. 751                              3

FIFTEENTH, TWO THOUSAND SEVENTEEN,  AND  SHALL  PROVIDE  THAT  PROPOSALS
SHALL BE OPENED ON OR BEFORE MARCH FIRST, TWO THOUSAND SEVENTEEN.
  (B) THE COMMISSIONER SHALL REPORT TO THE GOVERNOR, THE TEMPORARY PRES-
IDENT  OF THE SENATE, THE SPEAKER OF THE ASSEMBLY, AND THE CHAIRS OF THE
SENATE AND ASSEMBLY HEALTH COMMITTEES ON OR BEFORE MARCH THIRTIETH,  TWO
THOUSAND  SEVENTEEN  WITH REGARD TO THE PROGRESS MADE IN THE DEVELOPMENT
OF CRITERIA FOR A PROGRAM OF BIOMETRIC IDENTIFICATION AND OF THE  IMPLE-
MENTATION OF SUCH PROGRAM.
  6.    THE COMMISSIONER SHALL, UPON SUBMISSION OF SATISFACTORY EVIDENCE
OF COMPLIANCE WITH THE PROVISIONS OF THIS TITLE,  APPROVE  TWO  MEDICAID
IDENTIFICATION  AND  ANTI-FRAUD BIOMETRIC TECHNOLOGY PILOT PROGRAMS, ONE
TO BE LOCATED IN AN UPSTATE HOSPITAL AND ONE TO BE LOCATED  IN  A  DOWN-
STATE HOSPITAL.
  7.  EACH  HOSPITAL WILL BE APPROPRIATED THREE HUNDRED THOUSAND DOLLARS
TO ASSIST IN ENABLING THE MEDICAID IDENTIFICATION AND ANTI-FRAUD  BIOME-
TRIC TECHNOLOGY PILOT PROGRAM.
  S  293.  RULES  AND  REGULATIONS.  THE  COMMISSIONER IS AUTHORIZED AND
DIRECTED TO PROMULGATE SUCH RULES AND REGULATIONS AS HE OR SHE MAY  DEEM
NECESSARY OR APPROPRIATE TO EFFECTUATE THE PURPOSES OF THIS ARTICLE.
  S  2.    Subdivision 1 of section 367-b of the social services law, as
added by chapter 639 of the laws of 1976, is amended to read as follows:
  1. The department, IN CONSULTATION WITH THE  COMMISSIONER  OF  HEALTH,
shall  design  and  implement a statewide medical assistance information
and payments system for the purpose of providing individual  and  aggre-
gate  data  to  social services districts to assist them in making basic
management decisions, to the department  and  other  state  agencies  to
assist  in  the administration of the medical assistance program, and to
the governor and the legislature as may be necessary to assist in making
major administrative and policy decisions affecting such program.   Such
system shall be designed so as to be capable of the following:
  a. receiving and processing information relating to the eligibility of
each  person  applying  for  medical assistance and of issuing a medical
assistance identification card, AND WHEN AVAILABLE UTILIZING THE  BIOME-
TRIC  IDENTIFICATION  ISSUED  BY THE DEPARTMENT OF HEALTH, CONFORMING TO
THE REQUIREMENTS SET FORTH IN THE MEDICAID IDENTIFICATION AND ANTI-FRAUD
BIOMETRIC TECHNOLOGY PILOT PROGRAM ESTABLISHED PURSUANT TO ARTICLE TWO-B
OF THE PUBLIC HEALTH LAW to persons  determined  by  a  social  services
official to be eligible for such assistance;
  b.    ACTIVATING  MEDICAL  ASSISTANCE  IDENTIFICATION  BY REQUIRING AN
APPLICANT RECEIVING SUCH IDENTIFICATION FROM THE DEPARTMENT TO  HAVE  IT
VERIFIED  AT  A  SOCIAL  SERVICES DISTRICT OFFICE IN THE SOCIAL SERVICES
DISTRICT IN WHICH THE APPLICANT RESIDES;
  C. receiving and processing information  relating  to  each  qualified
provider of medical assistance furnishing care, services or supplies for
which claims for payment are made pursuant to this title;
  [c.]  D.  receiving and processing, in a form and manner prescribed by
the department, all claims for medical care, services and supplies,  and
making  payments for valid claims to providers of medical care, services
and supplies on behalf of social services districts;
  [d.] E. maintaining information necessary  to  allow  the  department,
consistent  with  the  powers and duties of the department of health, to
review the appropriateness, scope and duration of medical care, services
and supplies provided to any eligible person pursuant to  this  chapter;
and
  [e.]  F.  initiating  implementation of such a system for the district
comprising the city of New York, in a manner compatible  with  expansion

A. 751                              4

of  such system to districts other than the district comprising the city
of New York.
  S  3.   The sum of six hundred thousand dollars ($600,000), or so much
thereof as may be necessary, is hereby appropriated to the department of
health out of any moneys in the state treasury in the  general  fund  to
the credit of the Medicaid identification and anti-fraud biometric tech-
nology  pilot  program, not otherwise appropriated, and made immediately
available, for the purpose of carrying out the provisions of  this  act.
Such moneys shall be payable on the audit and warrant of the comptroller
on  vouchers  certified  or  approved by the department of health in the
manner prescribed by law.
  S 4.  This act shall take effect immediately.