S T A T E O F N E W Y O R K
________________________________________________________________________
155
2021-2022 Regular Sessions
I N A S S E M B L Y
(PREFILED)
January 6, 2021
___________
Introduced by M. of A. GOTTFRIED, DINOWITZ, LALOR -- read once and
referred to the Committee on Health
AN ACT to amend the public health law and the social services law, in
relation to automatic enrollment and recertification simplification
for Medicaid eligible recipients
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Paragraph (b) of subdivision 7 of section 4403-f of the
public health law is amended by adding a new subparagraph (iv) to read
as follows:
(IV) WHERE A PERSON DETERMINED ELIGIBLE FOR MEDICAID ("MEDICAID RECIP-
IENT") HAS BEEN DETERMINED BY THE COMMISSIONER OR HIS OR HER DESIGNEE TO
REQUIRE COMMUNITY-BASED LONG TERM CARE SERVICES FOR MORE THAN A CONTIN-
UOUS PERIOD OF ONE HUNDRED TWENTY DAYS, AND THE MEDICAID RECIPIENT HAS
NOT SELECTED AND ENROLLED IN A MANAGED LONG TERM CARE PLAN PRIOR TO ANY
EXPIRATION DATE OF SUCH DETERMINATION OF NEED FOR LONG TERM CARE, AFTER
BEING PROVIDED WITH INFORMATION TO MAKE AN INFORMED CHOICE, THE COMMIS-
SIONER SHALL ASSIGN THE RECIPIENT TO A MANAGED LONG TERM CARE PLAN,
TAKING INTO ACCOUNT CONSISTENCY WITH ANY PRIOR COMMUNITY-BASED DIRECT
CARE WORKERS HAVING RECENTLY SERVED THE RECIPIENT, QUALITY PERFORMANCE
CRITERIA, CAPACITY, AND GEOGRAPHIC ACCESSIBILITY. THE COMMISSIONER MAY
ASSIGN PARTICIPANTS PURSUANT TO SUCH CRITERIA ON A WEIGHTED BASIS. A
RECIPIENT ASSIGNED TO A MANAGED LONG TERM CARE PLAN UNDER THIS SUBPARA-
GRAPH SHALL BE DEEMED TO HAVE BEEN DETERMINED TO BE IN NEED OF LONG TERM
CARE SERVICES FOR MORE THAN A CONTINUOUS PERIOD OF ONE HUNDRED TWENTY
DAYS AND ELIGIBLE TO BE ENROLLED IN A MANAGED LONG TERM CARE PLAN.
§ 2. Paragraph (b) of subdivision 2 of section 366-a of the social
services law, as added by section 51 of part A of chapter 1 of the laws
of 2002, is amended to read as follows:
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00500-01-1
A. 155 2
(b) Notwithstanding the provisions of paragraph (a) of this subdivi-
sion, an applicant or recipient may attest to the amount of his or her
accumulated resources, unless such applicant or recipient is seeking
medical assistance payment for long term care services FOR THE FIRST
TIME. A RECIPIENT WHO HAS ALREADY PROVIDED DOCUMENTATION OF RESOURCES
MAY ATTEST TO THE AMOUNT OF ACCUMULATED RESOURCES IF IT HAS REMAINED THE
SAME OR IS LESS THAN THE AMOUNT ORIGINALLY DOCUMENTED. For purposes of
this paragraph, long term care services shall mean care, treatment,
maintenance, and services described in paragraph (b) of subdivision [1]
ONE of section three hundred sixty-seven-f of this title, with the
exception of short term rehabilitation, as defined by the commissioner
of health.
§ 3. Paragraph (d) of subdivision 5 of section 366-a of the social
services law, as amended by section 12 of part D of chapter 56 of the
laws of 2013, is relettered paragraph (e) and three new paragraphs (f),
(g) and (h) are added to read as follows:
(F) NOTWITHSTANDING PARAGRAPH (B) OF SUBDIVISION TWO OF THIS SECTION
AND PARAGRAPHS (A), (B), (C) AND (D) OF THIS SUBDIVISION, THE FOLLOWING
RECIPIENTS WILL BE RECERTIFIED AUTOMATICALLY, UNLESS THERE HAS BEEN A
FINDING OF LACK OF ELIGIBILITY FOR MEDICAID:
(I) ENROLLEES IN MEDICAID MANAGED LONG TERM CARE PLANS AS DEFINED IN
SECTION FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW;
(II) ENROLLEES IN MEDICAID MANAGED CARE PLANS AS DEFINED IN SECTION
THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE WHO RECEIVE PERSONAL CARE
SERVICES PURSUANT TO PARAGRAPH (E) OF SUBDIVISION TWO OF SECTION THREE
HUNDRED SIXTY-FIVE-A OF THIS TITLE OR CONSUMER DIRECTED PERSONAL ASSIST-
ANCE SERVICES PURSUANT TO SECTION THREE HUNDRED SIXTY-FIVE-F OF THIS
TITLE;
(III) ENROLLEES RECEIVING MEDICAID IN THE AGED, BLIND AND DISABLED
CATEGORY WHO RECEIVE FIXED INCOME FROM THE SOCIAL SECURITY ADMINIS-
TRATION (SSA); AND
(IV) MEDICARE SAVINGS PROGRAM (MSP) RECIPIENTS WHO HAVE A FIXED INCOME
FROM THE SOCIAL SECURITY ADMINISTRATION (SSA).
(G) NOTHING IN PARAGRAPH (E) OF THIS SUBDIVISION SHOULD BE CONSTRUED
TO ALTER A MEDICAID RECIPIENT'S OBLIGATION TO INFORM THE PUBLIC WELFARE
DISTRICT OF CHANGES IN INCOME OR OTHER FACTORS THAT MIGHT IMPACT ELIGI-
BILITY PURSUANT TO SUBDIVISION FOUR OF THIS SECTION.
(H) UPON A FINDING OF LACK OF ELIGIBILITY, RECIPIENTS IDENTIFIED IN
PARAGRAPH (E) OF THIS SUBDIVISION WILL BE ENTITLED TO NOTICE AND HEARING
RIGHTS AS PROVIDED IN SECTION TWENTY-TWO OF THIS CHAPTER.
§ 4. This act shall take effect on the one hundred eightieth day after
it shall have become a law; provided that the amendments to paragraph
(b) of subdivision 7 of section 4403-f of the public health law made by
section one of this act shall be subject to the expiration and reversion
of such paragraph and shall expire and be deemed repealed therewith and
provided further that such amendments shall not affect the repeal of
such section and shall expire and be deemed repealed therewith. Effec-
tive immediately, the commissioner of health shall make regulations and
take other actions reasonably necessary to implement this act on that
date.