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.