Assembly Bill A9544

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9544
 
                           I N  A S S E M B L Y
 
                              March 16, 2022
                                ___________
 
 Introduced  by M. of A. CARROLL -- read once and referred to the Commit-
   tee on Health
 
 AN ACT to amend the social services law and  the  workers'  compensation
   law, in relation to payment for contingency management programs
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. The social services law is amended by adding a new  section
 367-w to read as follows:
   §  367-W.  PAYMENT  FOR  CONTINGENCY  MANAGEMENT  PROGRAMS. 1. FOR THE
 PURPOSE OF  THIS  SECTION,  "CONTINGENCY  MANAGEMENT  PROGRAM"  MEANS  A
 SUBSTANCE  USE  DISORDER  TREATMENT  SERVICE  THAT PROVIDES AN INCENTIVE
 STRUCTURE, INCLUDING SCALING REWARDS FOR CONTINUED EVIDENCE OF SPECIFIED
 BEHAVIORS OR ADHERENCE TO TREATMENT GOALS, THAT REWARDS PARTICIPANTS FOR
 SPECIFIED BEHAVIORS, PROVIDED THE RECEIPT OF  ANY  INCENTIVE  OR  REWARD
 PURSUANT  TO  SUCH A PROGRAM SHALL NOT BE CONSIDERED INCOME FOR PURPOSES
 OF ELIGIBILITY FOR PUBLIC BENEFITS OR OTHER  PUBLIC  ASSISTANCE  TO  THE
 EXTENT ALLOWED BY LAW.
   2.  THE  COMMISSIONER  MAY AUTHORIZE THE PAYMENT OF MEDICAL ASSISTANCE
 FUNDS FOR CONTINGENCY MANAGEMENT PROGRAMS.  THE COMMISSIONER  SHALL,  IN
 CONSULTATION  WITH  THE  AIDS  INSTITUTE  AND  THE  OFFICE  OF ADDICTION
 SERVICES AND SUPPORTS:
   A. ISSUE GUIDANCE ON THE USE OF CONTINGENCY  MANAGEMENT  PROGRAMS  FOR
 BENEFICIARIES  WHO  ACCESS  SUBSTANCE  USE  DISORDER  SERVICES UNDER THE
 MEDICAL ASSISTANCE PROGRAM;
   B. ESTABLISH LIMITS ON THE NUMBER AND VALUE OF INCENTIVES AVAILABLE TO
 BENEFICIARIES WHO RECEIVE SERVICES PURSUANT TO A CONTINGENCY  MANAGEMENT
 PROGRAM; AND
   C.  DETERMINE  MAXIMUM  ALLOWABLE  RATES  FOR  CONTINGENCY  MANAGEMENT
 PROGRAMS BASED  UPON  THE  MEDICAL  ASSISTANCE  PROGRAM  FEE-FOR-SERVICE
 OUTPATIENT  RATES  FOR  THE  SAME OR SIMILAR SERVICES, OR ANY OTHER DATA
 DEEMED RELIABLE AND RELEVANT BY THE COMMISSIONER.
   3. SUBDIVISION TWO OF THIS SECTION SHALL BE EFFECTIVE IF, AND AS  LONG
 AS,  FEDERAL FINANCIAL PARTICIPATION IS AVAILABLE FOR MEDICAL ASSISTANCE
 EXPENDITURES MADE PURSUANT TO IT.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD13441-03-1
 A. 9544                             2
 
   4. FOR THE PURPOSES OF IMPLEMENTING  THIS  SECTION,  THE  COMMISSIONER
 SHALL  SEEK  ANY NECESSARY FEDERAL APPROVALS, INCLUDING APPROVALS OF ANY
 STATE PLAN AMENDMENT OR FEDERAL WAIVERS,  BY  THE  FEDERAL  CENTERS  FOR
 MEDICARE  AND MEDICAID SERVICES NO LATER THAN DECEMBER THIRTY-FIRST, TWO
 THOUSAND TWENTY-TWO.
   §  2.  Subdivision  2  of  section 366-d of the social services law is
 amended by adding a new paragraph (e) to read as follows:
   (E)  THIS  SUBDIVISION  SHALL  NOT  APPLY  TO  CONTINGENCY  MANAGEMENT
 PROGRAMS  OPERATED  PURSUANT  TO  SECTION THREE HUNDRED SIXTY-SEVEN-W OF
 THIS TITLE.
   § 3. Paragraph (g) of subdivision 2 of section 13-d  of  the  workers'
 compensation  law,  as  amended by section 2 of part CC of chapter 55 of
 the laws of 2019, is amended to read as follows:
   (g) has directly or indirectly requested, received or participated  in
 the division, transference, assignment, rebating, splitting or refunding
 of a fee for, or has directly or indirectly requested, received or prof-
 ited  by  means of a credit or other valuable consideration as a commis-
 sion, discount or gratuity in connection with the furnishing of  medical
 or  surgical  care,  an  independent  medical  examination, diagnosis or
 treatment or service, including X-ray examination and treatment, or  for
 or in connection with the sale, rental, supplying or furnishing of clin-
 ical  laboratory  services  or  supplies,  X-ray  laboratory services or
 supplies, inhalation therapy service or  equipment,  ambulance  service,
 hospital or medical supplies, physiotherapy or other therapeutic service
 or  equipment,  artificial  limbs, teeth or eyes, orthopedic or surgical
 appliances or  supplies,  optical  appliances,  supplies  or  equipment,
 devices  for  aid  of hearing, drugs, medication or medical supplies, or
 any other goods, services or supplies prescribed for medical  diagnosis,
 care  or  treatment, under this chapter; except that reasonable payment,
 not exceeding the technical component fee permitted in the  medical  fee
 schedule, established under this chapter for X-ray examinations, diagno-
 sis  or treatment, may be made by a provider duly authorized as a roent-
 genologist to any hospital furnishing facilities and equipment for  such
 examination,  diagnosis  or  treatment,  provided such hospital does not
 also submit a charge for the same services. Nothing  contained  in  this
 paragraph  shall  prohibit  such  providers who practice as partners, in
 groups or as a professional corporation or as a university faculty prac-
 tice corporation from pooling fees and moneys received,  either  by  the
 partnership,   professional  corporation,  university  faculty  practice
 corporation or group by the individual members thereof, for professional
 services furnished by any individual professional member, or employee of
 such partnership, corporation or  group,  nor  shall  the  professionals
 constituting  the  partnerships,  corporations,  or groups be prohibited
 from sharing, dividing or apportioning the fees and moneys  received  by
 them  or  by  the partnership, corporation or group in accordance with a
 partnership or other  agreement.  THIS  PARAGRAPH  SHALL  NOT  APPLY  TO
 CONTINGENCY  MANAGEMENT  PROGRAMS  OPERATED  PURSUANT  TO  SECTION THREE
 HUNDRED SIXTY-SEVEN-W OF THE SOCIAL SERVICES LAW.
   § 4. This act shall take effect immediately.