S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2783
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 25, 2019
                                ___________
 
 Introduced  by  M.  of  A.  SCHIMMINGER -- read once and referred to the
   Committee on Health
 
 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;
   (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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD03827-01-9

 A. 2783                             2
 
   [(vi)]  (III) any other individuals required to be excluded by federal
 law or regulations.
   §  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:
   § 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.
   § 4. This act shall take effect immediately.