S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1435
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 12, 2017
                                ___________
 
 Introduced by M. of A. CAHILL -- Multi-Sponsored by -- M. of A. CYMBROW-
   ITZ,  ENGLEBRIGHT, PEOPLES-STOKES, RIVERA -- read once and referred to
   the Committee on Health
 
 AN ACT to amend the social services law, in relation to amounts  payable
   under medical assistance
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph (d) of subdivision 1  of  section  367-a  of  the
 social services law, as amended by section 1 of part J1 of chapter 63 of
 the  laws of 2003, subparagraph (iii) as amended by section 31 of part B
 of chapter 57 of the laws of 2015, subparagraph (iv) as added by section
 16 of part B of chapter 59 of the laws of 2016, is amended  to  read  as
 follows:
   (d)  [(i)] Amounts payable under this title for medical assistance for
 items and services provided to eligible persons who are  also  benefici-
 aries  under  part  A  AND/OR PART B AND/OR PART C of title XVIII of the
 federal social security act and items and services provided to qualified
 medicare beneficiaries under part A AND/OR PART B AND/OR PART C of title
 XVIII of the federal social security act shall  not  be  less  than  the
 amount  of  any  deductible  and co-insurance liability of such eligible
 persons or for which such eligible persons or  such  qualified  medicare
 beneficiaries  would  be liable under federal law were they not eligible
 for medical assistance or were they not qualified medicare beneficiaries
 with respect to such benefits under such  part  A  AND/OR  SUCH  PART  B
 AND/OR PART C.
   [(ii)  Amounts  payable  under  this  title for medical assistance for
 items and services provided to eligible persons who are  also  benefici-
 aries under part B of title XVIII of the federal social security act and
 items  and  services  provided to qualified medicare beneficiaries under
 part B of title XVIII of the federal social security act  shall  not  be
 less  than  the  amount  of  any  deductible  liability of such eligible

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

                                                            LBD01416-01-7

 A. 1435                             2

 persons or for which such eligible persons or  such  qualified  medicare
 beneficiaries  would  be liable under federal law were they not eligible
 for medical assistance or were they not qualified medicare beneficiaries
 with respect to such benefits under such part B.
   (iii)  With respect to items and services provided to eligible persons
 who are also beneficiaries under part B of title XVIII  of  the  federal
 social  security  act and items and services provided to qualified medi-
 care beneficiaries under part B of title XVIII  of  the  federal  social
 security  act,  the amount payable for services covered under this title
 shall be the amount of  any  co-insurance  liability  of  such  eligible
 persons  pursuant  to  federal  law  were  they not eligible for medical
 assistance or  were  they  not  qualified  medicare  beneficiaries  with
 respect  to  such  benefits  under such part B, but shall not exceed the
 amount that otherwise would be made under this title if provided  to  an
 eligible person other than a person who is also a beneficiary under part
 B  or is a qualified medicare beneficiary minus the amount payable under
 part B; provided, however, amounts payable under this  title  for  items
 and  services  provided  to  eligible persons who are also beneficiaries
 under part B or to qualified  medicare  beneficiaries  by  an  ambulance
 service  under the authority of an operating certificate issued pursuant
 to article thirty of the public  health  law,  a  psychologist  licensed
 under article one hundred fifty-three of the education law, or a facili-
 ty  under  the  authority of an operating certificate issued pursuant to
 article sixteen, thirty-one or thirty-two of the mental hygiene law  and
 with  respect  to  outpatient  hospital  and  clinic  items and services
 provided by a facility under the authority of an  operating  certificate
 issued  pursuant to article twenty-eight of the public health law, shall
 not be less than the amount of any co-insurance liability of such eligi-
 ble persons or such qualified medicare beneficiaries, or for which  such
 eligible  persons  or  such  qualified  medicare  beneficiaries would be
 liable under federal law were they not eligible for  medical  assistance
 or  were  they not qualified medicare beneficiaries with respect to such
 benefits under part B.
   (iv) If a health plan participating in part C of title  XVIII  of  the
 federal  social  security  act  pays  for items and services provided to
 eligible persons who are also beneficiaries under part B of title  XVIII
 of  the  federal  social security act or to qualified medicare benefici-
 aries, the amount payable for services under this title shall be  eight-
 y-five  percent  of  the  amount  of  any co-insurance liability of such
 eligible persons pursuant to federal law if they were not  eligible  for
 medical  assistance  or  were  not qualified medicare beneficiaries with
 respect to such benefits under such part B; provided,  however,  amounts
 payable  under  this  title  for items and services provided to eligible
 persons who are also beneficiaries under part B or to qualified medicare
 beneficiaries by an ambulance service under the authority of an  operat-
 ing  certificate  issued pursuant to article thirty of the public health
 law, or a psychologist licensed under article one hundred fifty-three of
 the education law, shall not be less than the amount of any co-insurance
 liability of such eligible persons or such qualified medicare  benefici-
 aries,  or  for  which  such eligible persons or such qualified medicare
 beneficiaries would be liable under federal law were they  not  eligible
 for medical assistance or were they not qualified medicare beneficiaries
 with respect to such benefits under part B.]
   §  2.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after July 1, 2003.