[ ] is old law to be omitted.
LBD12671-01-2
S. 8007 2 A. 9007
percent across the board payment increase to all qualifying fee-for-
service Medicaid rates (Part I); to amend the public health law, in
relation to extending the statutory requirement to reweight and rebase
acute hospital rates (Part J); to amend the public health law, in
relation to the creation of a new statewide health care facility
transformation program (Part K); to amend the public health law, in
relation to streamlining and adding criteria to the certificate of
need process (Part L); to amend the public health law, in relation to
the definition of revenue in the minimum spending statute for nursing
homes and the rates of payment and rates of reimbursement for residen-
tial health care facilities, and in relation to making a temporary
payment to facilities in severe financial distress (Part M); to amend
the social services law, in relation to Medicaid eligibility require-
ments for seniors and disabled individuals; and to repeal certain
provisions of such law relating thereto (Part N); to amend the social
services law, in relation to private duty nursing services reimburse-
ment for nurses servicing adult members; to amend part MM of chapter
56 of the laws of 2020 directing the department of health to establish
or procure the services of an independent panel of clinical profes-
sionals and to develop and implement a uniform task-based assessment
tool, in relation to directing the department of health to develop
guidelines and standards for the use of tasking tools; and to amend
the public health law, in relation to establishing programs of all-in-
clusive care for the elderly (Part O); to amend the social services
law and the public health law, in relation to providing authority for
the department of health to competitively procure managed care organ-
izations and requiring Medicaid managed care organizations, the essen-
tial plan and qualified health plans to contract with national cancer
institute-designated cancer centers, where such centers agree to
certain terms and conditions; and to repeal certain provisions of the
social services law relating thereto (Part P); to amend the public
health law and the social services law, in relation to permitting the
commissioner of health to submit a waiver that expands eligibility for
New York's basic health program and increases the federal poverty
limit cap for basic health program eligibility from two hundred to two
hundred fifty percent; to amend the social services law, in relation
to allowing pregnant individuals to be eligible for the basic health
program and maintain coverage in the basic health program for one year
post pregnancy and to deem a child born to an individual covered under
the basic health program to be eligible for medical assistance; and
providing for the repeal of certain provisions upon the expiration
thereof (Part Q); to amend the insurance law, in relation to requiring
private insurance plans to cover abortion services without cost-shar-
ing (Part R); to amend the social services law, in relation to includ-
ing expanded pre-natal and post-partum care as standard coverage when
determined to be necessary and the continuance of eligibility for
pregnant individuals to receive medical assistance in certain situ-
ations; and to repeal section 369-hh of the social services law (Part
S); to amend the public health law, in relation to requiring third
trimester syphilis testing (Part T); to amend the public health law,
in relation to expanding benefits in the Child Health Plus Program,
eliminating the premium contribution for certain households and trans-
ferring Child Health Plus rate setting authority from the Department
of Financial Services to the Department of Health (Part U); to amend
the public health law and the insurance law, in relation to reimburse-
ment for commercial and Medicaid services provided via telehealth
S. 8007 3 A. 9007
(Part V); to amend the social services law, in relation to eliminating
unnecessary requirements from the utilization threshold program (Part
W); to amend the public health law, in relation to redefining the
duties and renaming the office of minority health to the office of
health equity and renaming the minority health council to the health
equity council (Part X); to amend the domestic relations law, in
relation to marriage certificates (Part Y); to amend chapter 266 of
the laws of 1986 amending the civil practice law and rules and other
laws relating to malpractice and professional medical conduct, in
relation to the purchase of excess coverage by physicians and dentists
and reimbursement of costs therefor, and to extending the physicians
medical malpractice program; to amend part J of chapter 63 of the laws
of 2001 amending chapter 266 of the laws of 1986, amending the civil
practice law and rules and other laws relating to malpractice and
professional medical conduct, relating to the effectiveness of certain
provisions of such chapter, in relation to extending certain
provisions concerning the hospital excess liability pool; and to amend
part H of chapter 57 of the laws of 2017, amending the New York Health
Care Reform Act of 1996 and other laws relating to extending certain
provisions relating thereto, in relation to extending provisions
relating to excess coverage (Part Z); to amend the financial services
law, the insurance law and the public health law, in relation to clar-
ifying provisions regarding emergency medical services and surprise
bills; and to repeal certain provisions of such law relating thereto
(Subpart A); to amend the insurance law and the public health law, in
relation to the federal no surprises act (Subpart B); and to amend the
insurance law and the public health law, in relation to administrative
simplification (Subpart C) (Part AA); to amend the public health law,
in relation to prescriber prevails; and to repeal certain provisions
of the social services law relating to coverage for certain
prescription drugs (Part BB); to amend the social services law, the
executive law and the public health law, in relation to extending
various provisions relating to health and mental hygiene; to amend
chapter 58 of the laws of 2009, amending the public health law relat-
ing to payment by governmental agencies for general hospital inpatient
services, in relation to the effectiveness thereof; to amend chapter
56 of the laws of 2013, amending the public health law relating to the
general public health work program, in relation to the effectiveness
thereof; to amend chapter 474 of the laws of 1996, amending the educa-
tion law and other laws relating to rates for residential health care
facilities, in relation to the effectiveness thereof; to amend chapter
21 of the laws of 2011, amending the education law relating to author-
izing pharmacists to perform collaborative drug therapy management
with physicians in certain settings, in relation to the effectiveness
thereof; to amend chapter 54 of the laws of 2016, amending part C of
chapter 58 of the laws of 2005 relating to authorizing reimbursements
for expenditures made by or on behalf of social services districts for
medical assistance for needy persons and administration thereof, in
relation to the effectiveness thereof; to amend chapter 56 of the laws
of 2020, amending the tax law and the social services law relating to
certain Medicaid management, in relation to the effectiveness thereof;
to amend chapter 74 of the laws of 2020, relating to directing the
department of health to convene a work group on rare diseases, in
relation to the effectiveness thereof; and to amend chapter 414 of the
laws of 2018, creating the radon task force, in relation to the effec-
tiveness thereof (Part CC); in relation to establishing a cost of
S. 8007 4 A. 9007
living adjustment for designated human services programs (Part DD); to
amend the mental hygiene law, in relation to a 9-8-8 suicide
prevention and behavioral health crisis hotline system (Part EE); to
amend the social services law, in relation to reinvesting savings
recouped from behavioral health transition into managed care back into
behavioral health services (Part FF); to amend chapter 57 of the laws
of 2019 amending the public health law relating to waiver of certain
regulations, in relation to the effectiveness thereof (Part GG); to
amend the public health law, in relation to requiring a stock of
opioid agonist medication for the treatment of an opioid use disorder
(Part HH); to amend the mental hygiene law, in relation to community
residences for addiction (Part II); to amend the mental hygiene law,
in relation to expanding the scope of the alcohol awareness program to
become the substance use awareness program (Part JJ); to amend the
facilities development corporation act in relation to authorizing the
facilities development corporation to acquire, improve and lease
mental health facilities providing services for the treatment of
addiction (Part KK); to amend chapter 56 of the laws of 2013 amending
the public health law and other laws relating to general hospital
reimbursement for annual rates, in relation to extending government
rates for behavioral services and referencing the office of addiction
services and supports; to amend part H of chapter 111 of the laws of
2010 relating to increasing Medicaid payments to providers through
managed care organizations and providing equivalent fees through an
ambulatory patient group methodology, in relation to extending govern-
ment rates for behavioral services referencing the office of addiction
services and supports and in relation to the effectiveness thereof
(Part LL); to amend Kendra's law, in relation to extending the expira-
tion thereof; and to amend the mental hygiene law, in relation to
extending Kendra's law and assisted outpatient treatment (Part MM); to
amend the mental hygiene law, in relation to rental and mortgage
payments for the mentally ill (Part NN); and to amend part L of chap-
ter 59 of the laws of 2016, amending the mental hygiene law relating
to the appointment of temporary operators for the continued operation
of programs and the provision of services for persons with serious
mental illness and/or developmental disabilities and/or chemical
dependence, in relation to the effectiveness thereof (Part OO)
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. This act enacts into law major components of legislation
necessary to implement the state health and mental hygiene budget for
the 2022-2023 state fiscal year. Each component is wholly contained
within a Part identified as Parts A through OO. The effective date for
each particular provision contained within such Part is set forth in the
last section of such Part. Any provision in any section contained within
a Part, including the effective date of the Part, which makes a refer-
ence to a section "of this act", when used in connection with that
particular component, shall be deemed to mean and refer to the corre-
sponding section of the Part in which it is found. Section three of this
act sets forth the general effective date of this act.
PART A
S. 8007 5 A. 9007
Section 1. Short title. This act shall be known and may be cited as
the "nurses across New York (NANY) program".
§ 2. The public health law is amended by adding a new section 2807-aa
to read as follows:
§ 2807-AA. NURSE LOAN REPAYMENT PROGRAM. 1.(A) MONIES SHALL BE MADE
AVAILABLE, SUBJECT TO APPROPRIATIONS, FOR PURPOSES OF LOAN REPAYMENT IN
ACCORDANCE WITH THE PROVISIONS OF THIS SECTION FOR REGISTERED PROFES-
SIONAL NURSES LICENSED TO PRACTICE PURSUANT TO SECTION SIXTY-NINE
HUNDRED FIVE OF THE EDUCATION LAW. NOTWITHSTANDING SECTIONS ONE HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW AND SECTIONS
ONE HUNDRED FORTY-TWO AND ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVEL-
OPMENT LAW, OR ANY OTHER CONTRARY PROVISION OF LAW, SUCH FUNDING SHALL
BE ALLOCATED REGIONALLY WITH ONE-THIRD OF AVAILABLE FUNDS GOING TO NEW
YORK CITY AND TWO-THIRDS OF AVAILABLE FUNDS GOING TO THE REST OF THE
STATE AND SHALL BE DISTRIBUTED IN A MANNER TO BE DETERMINED BY THE
COMMISSIONER WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSALS.
(I) FUNDING AWARDED PURSUANT TO THIS SECTION SHALL BE AWARDED TO REPAY
LOANS OF NURSES WHO WORK IN AREAS DETERMINED TO BE UNDERSERVED COMMUNI-
TIES BY THE COMMISSIONER AND WHO AGREE TO WORK IN SUCH AREAS FOR A PERI-
OD OF THREE CONSECUTIVE YEARS. A NURSE MAY BE DEEMED TO BE PRACTICING IN
AN UNDERSERVED AREA IF THEY PRACTICE IN A FACILITY OR PHYSICIAN'S OFFICE
THAT PRIMARILY SERVES AN UNDERSERVED POPULATION AS DETERMINED BY THE
COMMISSIONER, WITHOUT REGARD TO WHETHER THE POPULATION OR THE FACILITY
OR PHYSICIAN'S OFFICE IS LOCATED IN AN UNDERSERVED AREA.
(II) FUNDING AWARDED PURSUANT TO THIS SECTION SHALL NOT EXCEED THE
TOTAL QUALIFYING OUTSTANDING DEBT OF THE NURSE FROM STUDENT LOANS TO
COVER TUITION AND OTHER RELATED EDUCATIONAL EXPENSES, MADE BY OR GUARAN-
TEED BY THE FEDERAL OR STATE GOVERNMENT, OR MADE BY A LENDING OR EDUCA-
TIONAL INSTITUTION APPROVED UNDER TITLE IV OF THE FEDERAL HIGHER EDUCA-
TION ACT. LOAN REPAYMENT AWARDS SHALL BE USED SOLELY TO REPAY SUCH
OUTSTANDING DEBT.
(III) A NURSE RECEIVING FUNDS PURSUANT TO THIS SECTION SHALL BE ELIGI-
BLE FOR A LOAN REPAYMENT AWARD TO BE DETERMINED BY THE COMMISSIONER OVER
A THREE-YEAR PERIOD DISTRIBUTED AS FOLLOWS: THIRTY PERCENT OF TOTAL
AWARD FOR THE FIRST YEAR; THIRTY PERCENT OF TOTAL AWARD FOR THE SECOND
YEAR; AND ANY UNPAID BALANCE OF THE TOTAL AWARD NOT TO EXCEED THE MAXI-
MUM AWARD AMOUNT FOR THE THIRD YEAR.
(IV) IN THE EVENT THAT A THREE-YEAR COMMITMENT PURSUANT TO THE AGREE-
MENT REFERENCED IN SUBPARAGRAPH (I) OF THIS PARAGRAPH IS NOT FULFILLED,
THE RECIPIENT SHALL BE RESPONSIBLE FOR REPAYMENT OF AMOUNTS PAID WHICH
SHALL BE CALCULATED IN ACCORDANCE WITH THE FORMULA SET FORTH IN SUBDIVI-
SION (B) OF SECTION TWO HUNDRED FIFTY-FOUR-O OF TITLE FORTY-TWO OF THE
UNITED STATES CODE, AS AMENDED.
(B) THE COMMISSIONER MAY POSTPONE, CHANGE OR WAIVE THE SERVICE OBLI-
GATION AND REPAYMENT AMOUNTS SET FORTH IN SUBPARAGRAPHS (I) AND (IV) OF
PARAGRAPH (A) OF THIS SUBDIVISION IN INDIVIDUAL CIRCUMSTANCES WHERE
THERE IS COMPELLING NEED OR HARDSHIP.
2. TO DEVELOP A STREAMLINED APPLICATION PROCESS FOR THE NURSE LOAN
REPAYMENT PROGRAM SET FORTH IN SUBDIVISION ONE OF THIS SECTION, THE
DEPARTMENT SHALL APPOINT A WORK GROUP FROM RECOMMENDATIONS MADE BY ASSO-
CIATIONS REPRESENTING NURSES, GENERAL HOSPITALS AND OTHER HEALTH CARE
FACILITIES. SUCH RECOMMENDATIONS SHALL BE MADE BY SEPTEMBER THIRTIETH,
TWO THOUSAND TWENTY-TWO.
3. IN THE EVENT THERE ARE UNDISTRIBUTED FUNDS WITHIN AMOUNTS MADE
AVAILABLE FOR DISTRIBUTIONS PURSUANT TO THIS SECTION, SUCH FUNDS MAY BE
REALLOCATED AND DISTRIBUTED IN CURRENT OR SUBSEQUENT DISTRIBUTION PERI-
S. 8007 6 A. 9007
ODS IN A MANNER DETERMINED BY THE COMMISSIONER FOR THE PURPOSE SET FORTH
IN THIS SECTION.
§ 3. This act shall take effect immediately; provided, however, that
section two of this act shall be deemed to have been in full force and
effect on and after April 1, 2022.
PART B
Section 1. The education law is amended by adding a new article 169 to
read as follows:
ARTICLE 169
INTERSTATE MEDICAL LICENSURE COMPACT
SECTION 8860. SHORT TITLE.
8861. PURPOSE.
8862. DEFINITIONS.
8863. ELIGIBILITY.
8864. DESIGNATION OF STATE OF PRINCIPAL LICENSE.
8865. APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE.
8866. FEES FOR EXPEDITED LICENSURE.
8867. RENEWAL AND CONTINUED PARTICIPATION.
8868. COORDINATED INFORMATION SYSTEM.
8869. JOINT INVESTIGATIONS.
8870. DISCIPLINARY ACTIONS.
8871. INTERSTATE MEDICAL LICENSURE COMPACT COMMISSION.
8872. POWERS AND DUTIES OF THE INTERSTATE COMMISSION.
8873. FINANCE POWERS.
8874. ORGANIZATION AND OPERATION OF THE INTERSTATE COMMISSION.
8875. RULEMAKING FUNCTIONS OF THE INTERSTATE COMMISSION.
8876. OVERSIGHT OF INTERSTATE COMPACT.
8877. ENFORCEMENT OF INTERSTATE COMPACT.
8878. DEFAULT PROCEDURES.
8879. DISPUTE RESOLUTION.
8880. MEMBER STATES, EFFECTIVE DATE AND AMENDMENT.
8881. WITHDRAWAL.
8882. DISSOLUTION.
8883. SEVERABILITY AND CONSTRUCTION.
8884. BINDING EFFECT OF COMPACT AND OTHER LAWS.
§ 8860. SHORT TITLE. THIS ARTICLE SHALL BE KNOWN AND MAY BE CITED AS
THE "INTERSTATE MEDICAL LICENSURE COMPACT".
§ 8861. PURPOSE. IN ORDER TO STRENGTHEN ACCESS TO HEALTH CARE, AND IN
RECOGNITION OF THE ADVANCES IN THE DELIVERY OF HEALTH CARE, THE MEMBER
STATES OF THE INTERSTATE MEDICAL LICENSURE COMPACT HAVE ALLIED IN COMMON
PURPOSE TO DEVELOP A COMPREHENSIVE PROCESS THAT COMPLEMENTS THE EXISTING
LICENSING AND REGULATORY AUTHORITY OF STATE MEDICAL BOARDS, PROVIDES A
STREAMLINED PROCESS THAT ALLOWS PHYSICIANS TO BECOME LICENSED IN MULTI-
PLE STATES, THEREBY ENHANCING THE PORTABILITY OF A MEDICAL LICENSE AND
ENSURING THE SAFETY OF PATIENTS. THE COMPACT CREATES ANOTHER PATHWAY
FOR LICENSURE AND DOES NOT OTHERWISE CHANGE A STATE'S EXISTING MEDICAL
PRACTICE ACT. THE COMPACT ALSO ADOPTS THE PREVAILING STANDARD FOR LICEN-
SURE AND AFFIRMS THAT THE PRACTICE OF MEDICINE OCCURS WHERE THE PATIENT
IS LOCATED AT THE TIME OF THE PHYSICIAN-PATIENT ENCOUNTER, AND THERE-
FORE, REQUIRES THE PHYSICIAN TO BE UNDER THE JURISDICTION OF THE STATE
MEDICAL BOARD WHERE THE PATIENT IS LOCATED. STATE MEDICAL BOARDS THAT
PARTICIPATE IN THE COMPACT RETAIN THE JURISDICTION TO IMPOSE AN ADVERSE
ACTION AGAINST A LICENSE TO PRACTICE MEDICINE IN THAT STATE ISSUED TO A
PHYSICIAN THROUGH THE PROCEDURES IN THE COMPACT.
S. 8007 7 A. 9007
§ 8862. DEFINITIONS. IN THIS COMPACT:
1. "BYLAWS" MEANS THOSE BYLAWS ESTABLISHED BY THE INTERSTATE COMMIS-
SION PURSUANT TO SECTION EIGHTY-EIGHT HUNDRED SEVENTY-ONE OF THIS ARTI-
CLE FOR ITS GOVERNANCE, OR FOR DIRECTING AND CONTROLLING ITS ACTIONS AND
CONDUCT.
2. "COMMISSIONER" MEANS THE VOTING REPRESENTATIVE APPOINTED BY EACH
MEMBER BOARD PURSUANT TO SECTION EIGHTY-EIGHT HUNDRED SEVENTY-ONE OF
THIS ARTICLE.
3. "CONVICTION" MEANS A FINDING BY A COURT THAT AN INDIVIDUAL IS GUIL-
TY OF A CRIMINAL OFFENSE THROUGH ADJUDICATION, OR ENTRY OF A PLEA OF
GUILT OR NO CONTEST TO THE CHARGE BY THE OFFENDER. EVIDENCE OF AN ENTRY
OF A CONVICTION OF A CRIMINAL OFFENSE BY THE COURT SHALL BE CONSIDERED
FINAL FOR PURPOSES OF DISCIPLINARY ACTION BY A MEMBER BOARD.
4. "EXPEDITED LICENSE" MEANS A FULL AND UNRESTRICTED MEDICAL LICENSE
GRANTED BY A MEMBER STATE TO AN ELIGIBLE PHYSICIAN THROUGH THE PROCESS
SET FORTH IN THE COMPACT.
5. "INTERSTATE COMMISSION" MEANS THE INTERSTATE COMMISSION CREATED
PURSUANT TO SECTION EIGHTY-EIGHT HUNDRED SEVENTY-ONE OF THIS ARTICLE.
6. "LICENSE" MEANS AUTHORIZATION BY A STATE FOR A PHYSICIAN TO ENGAGE
IN THE PRACTICE OF MEDICINE, WHICH WOULD BE UNLAWFUL WITHOUT THE AUTHOR-
IZATION.
7. "MEDICAL PRACTICE ACT" MEANS LAWS AND REGULATIONS GOVERNING THE
PRACTICE OF ALLOPATHIC AND OSTEOPATHIC MEDICINE WITHIN A MEMBER STATE.
8. "MEMBER BOARD" MEANS A STATE AGENCY IN A MEMBER STATE THAT ACTS IN
THE SOVEREIGN INTERESTS OF THE STATE BY PROTECTING THE PUBLIC THROUGH
LICENSURE, REGULATION, AND EDUCATION OF PHYSICIANS AS DIRECTED BY THE
STATE GOVERNMENT.
9. "MEMBER STATE" MEANS A STATE THAT HAS ENACTED THE COMPACT.
10. "PRACTICE OF MEDICINE" MEANS THE CLINICAL PREVENTION, DIAGNOSIS,
OR TREATMENT OF HUMAN DISEASE, INJURY, OR CONDITION REQUIRING A PHYSI-
CIAN TO OBTAIN AND MAINTAIN A LICENSE IN COMPLIANCE WITH THE MEDICAL
PRACTICE ACT OF A MEMBER STATE.
11. "PHYSICIAN" MEANS ANY PERSON WHO:
(A) IS A GRADUATE OF A MEDICAL SCHOOL ACCREDITED BY THE LIAISON
COMMITTEE ON MEDICAL EDUCATION, THE COMMISSION ON OSTEOPATHIC COLLEGE
ACCREDITATION, OR A MEDICAL SCHOOL LISTED IN THE INTERNATIONAL MEDICAL
EDUCATION DIRECTORY OR ITS EQUIVALENT;
(B) PASSED EACH COMPONENT OF THE UNITED STATES MEDICAL LICENSING EXAM-
INATION (USMLE) OR THE COMPREHENSIVE OSTEOPATHIC MEDICAL LICENSING EXAM-
INATION (COMLEX-USA) WITHIN THREE ATTEMPTS, OR ANY OF ITS PREDECESSOR
EXAMINATIONS ACCEPTED BY A STATE MEDICAL BOARD AS AN EQUIVALENT EXAMINA-
TION FOR LICENSURE PURPOSES;
(C) SUCCESSFULLY COMPLETED GRADUATE MEDICAL EDUCATION APPROVED BY THE
ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION OR THE AMERICAN
OSTEOPATHIC ASSOCIATION;
(D) HOLDS SPECIALTY CERTIFICATION OR A TIME-UNLIMITED SPECIALTY
CERTIFICATE RECOGNIZED BY THE AMERICAN BOARD OF MEDICAL SPECIALTIES OR
THE AMERICAN OSTEOPATHIC ASSOCIATION'S BUREAU OF OSTEOPATHIC SPECIAL-
ISTS;
(E) POSSESSES A FULL AND UNRESTRICTED LICENSE TO ENGAGE IN THE PRAC-
TICE OF MEDICINE ISSUED BY A MEMBER BOARD;
(F) HAS NEVER BEEN CONVICTED, RECEIVED ADJUDICATION, DEFERRED ADJUDI-
CATION, COMMUNITY SUPERVISION, OR DEFERRED DISPOSITION FOR ANY OFFENSE
BY A COURT OF APPROPRIATE JURISDICTION;
(G) HAS NEVER HELD A LICENSE AUTHORIZING THE PRACTICE OF MEDICINE
SUBJECTED TO DISCIPLINE BY A LICENSING AGENCY IN ANY STATE, FEDERAL, OR
S. 8007 8 A. 9007
FOREIGN JURISDICTION, EXCLUDING ANY ACTION RELATED TO NON-PAYMENT OF
FEES RELATED TO A LICENSE;
(H) HAS NEVER HAD A CONTROLLED SUBSTANCE LICENSE OR PERMIT SUSPENDED
OR REVOKED BY A STATE OR THE UNITED STATES DRUG ENFORCEMENT ADMINIS-
TRATION; AND
(I) IS NOT UNDER ACTIVE INVESTIGATION BY A LICENSING AGENCY OR LAW
ENFORCEMENT AUTHORITY IN ANY STATE, FEDERAL, OR FOREIGN JURISDICTION.
12. "OFFENSE" MEANS A FELONY, GROSS MISDEMEANOR, OR CRIME OF MORAL
TURPITUDE.
13. "RULE" MEANS A WRITTEN STATEMENT BY THE INTERSTATE COMMISSION
PROMULGATED PURSUANT TO SECTION EIGHTY-EIGHT HUNDRED SEVENTY-TWO OF THIS
ARTICLE THAT IS OF GENERAL APPLICABILITY, IMPLEMENTS, INTERPRETS, OR
PRESCRIBES A POLICY OR PROVISION OF THE COMPACT, OR AN ORGANIZATIONAL,
PROCEDURAL, OR PRACTICE REQUIREMENT OF THE INTERSTATE COMMISSION, AND
HAS THE FORCE AND EFFECT OF STATUTORY LAW IN A MEMBER STATE, AND
INCLUDES THE AMENDMENT, REPEAL, OR SUSPENSION OF AN EXISTING RULE.
14. "STATE" MEANS ANY STATE, COMMONWEALTH, DISTRICT, OR TERRITORY OF
THE UNITED STATES.
15. "STATE OF PRINCIPAL LICENSE" MEANS A MEMBER STATE WHERE A PHYSI-
CIAN HOLDS A LICENSE TO PRACTICE MEDICINE AND WHICH HAS BEEN DESIGNATED
AS SUCH BY THE PHYSICIAN FOR PURPOSES OF REGISTRATION AND PARTICIPATION
IN THE COMPACT.
§ 8863. ELIGIBILITY. 1. A PHYSICIAN MUST MEET THE ELIGIBILITY REQUIRE-
MENTS AS DEFINED IN SUBDIVISION ELEVEN OF SECTION EIGHTY-EIGHT HUNDRED
SIXTY-TWO OF THIS ARTICLE TO RECEIVE AN EXPEDITED LICENSE UNDER THE
TERMS AND PROVISIONS OF THE COMPACT.
2. A PHYSICIAN WHO DOES NOT MEET THE REQUIREMENTS OF SUBDIVISION ELEV-
EN OF SECTION EIGHTY-EIGHT HUNDRED SIXTY-TWO OF THIS ARTICLE MAY OBTAIN
A LICENSE TO PRACTICE MEDICINE IN A MEMBER STATE IF THE INDIVIDUAL
COMPLIES WITH ALL LAWS AND REQUIREMENTS, OTHER THAN THE COMPACT, RELAT-
ING TO THE ISSUANCE OF A LICENSE TO PRACTICE MEDICINE IN THAT STATE.
§ 8864. DESIGNATION OF STATE OF PRINCIPAL LICENSE. 1. A PHYSICIAN
SHALL DESIGNATE A MEMBER STATE AS THE STATE OF PRINCIPAL LICENSE FOR
PURPOSES OF REGISTRATION FOR EXPEDITED LICENSURE THROUGH THE COMPACT IF
THE PHYSICIAN POSSESSES A FULL AND UNRESTRICTED LICENSE TO PRACTICE
MEDICINE IN THAT STATE, AND THE STATE IS:
(A) THE STATE OF PRIMARY RESIDENCE FOR THE PHYSICIAN, OR
(B) THE STATE WHERE AT LEAST TWENTY-FIVE PERCENT OF THE PRACTICE OF
MEDICINE OCCURS, OR
(C) THE LOCATION OF THE PHYSICIAN'S EMPLOYER, OR
(D) IF NO STATE QUALIFIES UNDER PARAGRAPH (A), (B), OR (C) OF THIS
SUBDIVISION, THE STATE DESIGNATED AS STATE OF RESIDENCE FOR PURPOSE OF
FEDERAL INCOME TAX.
2. A PHYSICIAN MAY REDESIGNATE A MEMBER STATE AS STATE OF PRINCIPAL
LICENSE AT ANY TIME, AS LONG AS THE STATE MEETS THE REQUIREMENTS OF
SUBDIVISION ONE OF THIS SECTION.
3. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES TO FACILI-
TATE REDESIGNATION OF ANOTHER MEMBER STATE AS THE STATE OF PRINCIPAL
LICENSE.
§ 8865. APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE. 1. A PHYSI-
CIAN SEEKING LICENSURE THROUGH THE COMPACT SHALL FILE AN APPLICATION FOR
AN EXPEDITED LICENSE WITH THE MEMBER BOARD OF THE STATE SELECTED BY THE
PHYSICIAN AS THE STATE OF PRINCIPAL LICENSE.
2. UPON RECEIPT OF AN APPLICATION FOR AN EXPEDITED LICENSE, THE MEMBER
BOARD WITHIN THE STATE SELECTED AS THE STATE OF PRINCIPAL LICENSE SHALL
EVALUATE WHETHER THE PHYSICIAN IS ELIGIBLE FOR EXPEDITED LICENSURE AND
S. 8007 9 A. 9007
ISSUE A LETTER OF QUALIFICATION, VERIFYING OR DENYING THE PHYSICIAN'S
ELIGIBILITY, TO THE INTERSTATE COMMISSION.
(A) STATIC QUALIFICATIONS, WHICH INCLUDE VERIFICATION OF MEDICAL
EDUCATION, GRADUATE MEDICAL EDUCATION, RESULTS OF ANY MEDICAL OR LICENS-
ING EXAMINATION, AND OTHER QUALIFICATIONS AS DETERMINED BY THE INTER-
STATE COMMISSION THROUGH RULE, SHALL NOT BE SUBJECT TO ADDITIONAL PRIMA-
RY SOURCE VERIFICATION WHERE ALREADY PRIMARY SOURCE VERIFIED BY THE
STATE OF PRINCIPAL LICENSE.
(B) THE MEMBER BOARD WITHIN THE STATE SELECTED AS THE STATE OF PRINCI-
PAL LICENSE SHALL, IN THE COURSE OF VERIFYING ELIGIBILITY, PERFORM A
CRIMINAL BACKGROUND CHECK OF AN APPLICANT, INCLUDING THE USE OF THE
RESULTS OF FINGERPRINT OR OTHER BIOMETRIC DATA CHECKS COMPLIANT WITH THE
REQUIREMENTS OF THE FEDERAL BUREAU OF INVESTIGATION, WITH THE EXCEPTION
OF FEDERAL EMPLOYEES WHO HAVE SUITABILITY DETERMINATION IN ACCORDANCE
WITH U.S. C.F.R. § 731.202.
(C) APPEAL ON THE DETERMINATION OF ELIGIBILITY SHALL BE MADE TO THE
MEMBER STATE WHERE THE APPLICATION WAS FILED AND SHALL BE SUBJECT TO THE
LAW OF THAT STATE.
3. UPON VERIFICATION UNDER SUBDIVISION TWO OF THIS SECTION, PHYSICIANS
ELIGIBLE FOR AN EXPEDITED LICENSE SHALL COMPLETE THE REGISTRATION PROC-
ESS ESTABLISHED BY THE INTERSTATE COMMISSION TO RECEIVE A LICENSE IN A
MEMBER STATE SELECTED PURSUANT TO SUBDIVISION ONE OF THIS SECTION,
INCLUDING THE PAYMENT OF ANY APPLICABLE FEES.
4. AFTER RECEIVING VERIFICATION OF ELIGIBILITY UNDER SUBDIVISION TWO
OF THIS SECTION AND ANY FEES UNDER SUBDIVISION THREE OF THIS SECTION, A
MEMBER BOARD SHALL ISSUE AN EXPEDITED LICENSE TO THE PHYSICIAN. THIS
LICENSE SHALL AUTHORIZE THE PHYSICIAN TO PRACTICE MEDICINE IN THE ISSU-
ING STATE CONSISTENT WITH THE MEDICAL PRACTICE ACT AND ALL APPLICABLE
LAWS AND REGULATIONS OF THE ISSUING MEMBER BOARD AND MEMBER STATE.
5. AN EXPEDITED LICENSE SHALL BE VALID FOR A PERIOD CONSISTENT WITH
THE LICENSURE PERIOD IN THE MEMBER STATE AND IN THE SAME MANNER AS
REQUIRED FOR OTHER PHYSICIANS HOLDING A FULL AND UNRESTRICTED LICENSE
WITHIN THE MEMBER STATE.
6. AN EXPEDITED LICENSE OBTAINED THOUGH THE COMPACT SHALL BE TERMI-
NATED IF A PHYSICIAN FAILS TO MAINTAIN A LICENSE IN THE STATE OF PRINCI-
PAL LICENSURE FOR A NON-DISCIPLINARY REASON, WITHOUT REDESIGNATION OF A
NEW STATE OF PRINCIPAL LICENSURE.
7. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES REGARDING
THE APPLICATION PROCESS, INCLUDING PAYMENT OF ANY APPLICABLE FEES, AND
THE ISSUANCE OF AN EXPEDITED LICENSE.
§ 8866. FEES FOR EXPEDITED LICENSURE. 1. A MEMBER STATE ISSUING AN
EXPEDITED LICENSE AUTHORIZING THE PRACTICE OF MEDICINE IN THAT STATE MAY
IMPOSE A FEE FOR A LICENSE ISSUED OR RENEWED THROUGH THE COMPACT.
2. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES REGARDING
FEES FOR EXPEDITED LICENSES.
§ 8867. RENEWAL AND CONTINUED PARTICIPATION. 1. A PHYSICIAN SEEKING TO
RENEW AN EXPEDITED LICENSE GRANTED IN A MEMBER STATE SHALL COMPLETE A
RENEWAL PROCESS WITH THE INTERSTATE COMMISSION IF THE PHYSICIAN:
(A) MAINTAINS A FULL AND UNRESTRICTED LICENSE IN A STATE OF PRINCIPAL
LICENSE;
(B) HAS NOT BEEN CONVICTED, RECEIVED ADJUDICATION, DEFERRED ADJUDI-
CATION, COMMUNITY SUPERVISION, OR DEFERRED DISPOSITION FOR ANY OFFENSE
BY A COURT OF APPROPRIATE JURISDICTION;
(C) HAS NOT HAD A LICENSE AUTHORIZING THE PRACTICE OF MEDICINE SUBJECT
TO DISCIPLINE BY A LICENSING AGENCY IN ANY STATE, FEDERAL, OR FOREIGN
S. 8007 10 A. 9007
JURISDICTION, EXCLUDING ANY ACTION RELATED TO NON-PAYMENT OF FEES
RELATED TO A LICENSE; AND
(D) HAS NOT HAD A CONTROLLED SUBSTANCE LICENSE OR PERMIT SUSPENDED OR
REVOKED BY A STATE OR THE UNITED STATES DRUG ENFORCEMENT ADMINISTRATION.
2. PHYSICIANS SHALL COMPLY WITH ALL CONTINUING PROFESSIONAL DEVELOP-
MENT OR CONTINUING MEDICAL EDUCATION REQUIREMENTS FOR RENEWAL OF A
LICENSE ISSUED BY A MEMBER STATE.
3. THE INTERSTATE COMMISSION SHALL COLLECT ANY RENEWAL FEES CHARGED
FOR THE RENEWAL OF A LICENSE AND DISTRIBUTE THE FEES TO THE APPLICABLE
MEMBER BOARD.
4. UPON RECEIPT OF ANY RENEWAL FEES COLLECTED IN SUBDIVISION THREE OF
THIS SECTION, A MEMBER BOARD SHALL RENEW THE PHYSICIAN'S LICENSE.
5. PHYSICIAN INFORMATION COLLECTED BY THE INTERSTATE COMMISSION DURING
THE RENEWAL PROCESS WILL BE DISTRIBUTED TO ALL MEMBER BOARDS.
6. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES TO ADDRESS
RENEWAL OF LICENSES OBTAINED THROUGH THE COMPACT.
§ 8868. COORDINATED INFORMATION SYSTEM. 1. THE INTERSTATE COMMISSION
SHALL ESTABLISH A DATABASE OF ALL PHYSICIANS LICENSED, OR WHO HAVE
APPLIED FOR LICENSURE, UNDER SECTION EIGHTY-EIGHT HUNDRED SIXTY-FIVE OF
THIS ARTICLE.
2. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, MEMBER BOARDS SHALL
REPORT TO THE INTERSTATE COMMISSION ANY PUBLIC ACTION OR COMPLAINTS
AGAINST A LICENSED PHYSICIAN WHO HAS APPLIED OR RECEIVED AN EXPEDITED
LICENSE THROUGH THE COMPACT.
3. MEMBER BOARDS SHALL REPORT DISCIPLINARY OR INVESTIGATORY INFORMA-
TION DETERMINED AS NECESSARY AND PROPER BY RULE OF THE INTERSTATE
COMMISSION.
4. MEMBER BOARDS MAY REPORT ANY NON-PUBLIC COMPLAINT, DISCIPLINARY, OR
INVESTIGATORY INFORMATION NOT REQUIRED BY SUBDIVISION THREE OF THIS
SECTION TO THE INTERSTATE COMMISSION.
5. MEMBER BOARDS SHALL SHARE COMPLAINT OR DISCIPLINARY INFORMATION
ABOUT A PHYSICIAN UPON REQUEST OF ANOTHER MEMBER BOARD.
6. ALL INFORMATION PROVIDED TO THE INTERSTATE COMMISSION OR DISTRIB-
UTED BY MEMBER BOARDS SHALL BE CONFIDENTIAL, FILED UNDER SEAL, AND USED
ONLY FOR INVESTIGATORY OR DISCIPLINARY MATTERS.
7. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES FOR
MANDATED OR DISCRETIONARY SHARING OF INFORMATION BY MEMBER BOARDS.
§ 8869. JOINT INVESTIGATIONS. 1. LICENSURE AND DISCIPLINARY RECORDS OF
PHYSICIANS ARE DEEMED INVESTIGATIVE.
2. IN ADDITION TO THE AUTHORITY GRANTED TO A MEMBER BOARD BY ITS
RESPECTIVE MEDICAL PRACTICE ACT OR OTHER APPLICABLE STATE LAW, A MEMBER
BOARD MAY PARTICIPATE WITH OTHER MEMBER BOARDS IN JOINT INVESTIGATIONS
OF PHYSICIANS LICENSED BY THE MEMBER BOARDS.
3. A SUBPOENA ISSUED BY A MEMBER STATE SHALL BE ENFORCEABLE IN OTHER
MEMBER STATES.
4. MEMBER BOARDS MAY SHARE ANY INVESTIGATIVE, LITIGATION, OR COMPLI-
ANCE MATERIALS IN FURTHERANCE OF ANY JOINT OR INDIVIDUAL INVESTIGATION
INITIATED UNDER THE COMPACT.
5. ANY MEMBER STATE MAY INVESTIGATE ACTUAL OR ALLEGED VIOLATIONS OF
THE STATUTES AUTHORIZING THE PRACTICE OF MEDICINE IN ANY OTHER MEMBER
STATE IN WHICH A PHYSICIAN HOLDS A LICENSE TO PRACTICE MEDICINE.
§ 8870. DISCIPLINARY ACTIONS. 1. ANY DISCIPLINARY ACTION TAKEN BY ANY
MEMBER BOARD AGAINST A PHYSICIAN LICENSED THROUGH THE COMPACT SHALL BE
DEEMED UNPROFESSIONAL CONDUCT WHICH MAY BE SUBJECT TO DISCIPLINE BY
OTHER MEMBER BOARDS, IN ADDITION TO ANY VIOLATION OF THE MEDICAL PRAC-
TICE ACT OR REGULATIONS IN THAT STATE.
S. 8007 11 A. 9007
2. IF A LICENSE GRANTED TO A PHYSICIAN BY THE MEMBER BOARD IN THE
STATE OF PRINCIPAL LICENSE IS REVOKED, SURRENDERED OR RELINQUISHED IN
LIEU OF DISCIPLINE, OR SUSPENDED, THEN ALL LICENSES ISSUED TO THE PHYSI-
CIAN BY MEMBER BOARDS SHALL AUTOMATICALLY BE PLACED, WITHOUT FURTHER
ACTION NECESSARY BY ANY MEMBER BOARD, ON THE SAME STATUS. IF THE MEMBER
BOARD IN THE STATE OF PRINCIPAL LICENSE SUBSEQUENTLY REINSTATES THE
PHYSICIAN'S LICENSE, A LICENSE ISSUED TO THE PHYSICIAN BY ANY OTHER
MEMBER BOARD SHALL REMAIN ENCUMBERED UNTIL THAT RESPECTIVE MEMBER BOARD
TAKES ACTION TO REINSTATE THE LICENSE IN A MANNER CONSISTENT WITH THE
MEDICAL PRACTICE ACT OF THAT STATE.
3. IF DISCIPLINARY ACTION IS TAKEN AGAINST A PHYSICIAN BY A MEMBER
BOARD NOT IN THE STATE OF PRINCIPAL LICENSE, ANY OTHER MEMBER BOARD MAY
DEEM THE ACTION CONCLUSIVE AS TO MATTER OF LAW AND FACT DECIDED, AND:
(A) IMPOSE THE SAME OR LESSER SANCTION OR SANCTIONS AGAINST THE PHYSI-
CIAN SO LONG AS SUCH SANCTIONS ARE CONSISTENT WITH THE MEDICAL PRACTICE
ACT OF THAT STATE; OR
(B) PURSUE SEPARATE DISCIPLINARY ACTION AGAINST THE PHYSICIAN UNDER
ITS RESPECTIVE MEDICAL PRACTICE ACT, REGARDLESS OF THE ACTION TAKEN IN
OTHER MEMBER STATES.
4. IF A LICENSE GRANTED TO A PHYSICIAN BY A MEMBER BOARD IS REVOKED,
SURRENDERED, OR RELINQUISHED IN LIEU OF DISCIPLINE, OR SUSPENDED, THEN
ANY LICENSE OR LICENSES ISSUED TO THE PHYSICIAN BY ANY OTHER MEMBER
BOARD OR BOARDS SHALL BE SUSPENDED, AUTOMATICALLY AND IMMEDIATELY WITH-
OUT FURTHER ACTION NECESSARY BY THE OTHER MEMBER BOARD OR BOARDS, FOR
NINETY DAYS UPON ENTRY OF THE ORDER BY THE DISCIPLINING BOARD, TO PERMIT
THE MEMBER BOARD OR BOARDS TO INVESTIGATE THE BASIS FOR THE ACTION UNDER
THE MEDICAL PRACTICE ACT OF THAT STATE. A MEMBER BOARD MAY TERMINATE THE
AUTOMATIC SUSPENSION OF THE LICENSE IT ISSUED PRIOR TO THE COMPLETION OF
THE NINETY DAY SUSPENSION PERIOD IN A MANNER CONSISTENT WITH THE MEDICAL
PRACTICE ACT OF THAT STATE.
§ 8871. INTERSTATE MEDICAL LICENSURE COMPACT COMMISSION. 1. THE MEMBER
STATES HEREBY CREATE THE "INTERSTATE MEDICAL LICENSURE COMPACT COMMIS-
SION".
2. THE PURPOSE OF THE INTERSTATE COMMISSION IS THE ADMINISTRATION OF
THE INTERSTATE MEDICAL LICENSURE COMPACT, WHICH IS A DISCRETIONARY STATE
FUNCTION.
3. THE INTERSTATE COMMISSION SHALL BE A BODY CORPORATE AND JOINT AGEN-
CY OF THE MEMBER STATES AND SHALL HAVE ALL THE RESPONSIBILITIES, POWERS,
AND DUTIES SET FORTH IN THE COMPACT, AND SUCH ADDITIONAL POWERS AS MAY
BE CONFERRED UPON IT BY A SUBSEQUENT CONCURRENT ACTION OF THE RESPECTIVE
LEGISLATURES OF THE MEMBER STATES IN ACCORDANCE WITH THE TERMS OF THE
COMPACT.
4. THE INTERSTATE COMMISSION SHALL CONSIST OF TWO VOTING REPRESEN-
TATIVES APPOINTED BY EACH MEMBER STATE WHO SHALL SERVE AS COMMISSIONERS.
IN STATES WHERE ALLOPATHIC AND OSTEOPATHIC PHYSICIANS ARE REGULATED BY
SEPARATE MEMBER BOARDS, OR IF THE LICENSING AND DISCIPLINARY AUTHORITY
IS SPLIT BETWEEN MULTIPLE MEMBER BOARDS WITHIN A MEMBER STATE, THE
MEMBER STATE SHALL APPOINT ONE REPRESENTATIVE FROM EACH MEMBER BOARD. A
COMMISSIONER SHALL BE A OR AN:
(A) ALLOPATHIC OR OSTEOPATHIC PHYSICIAN APPOINTED TO A MEMBER BOARD;
(B) EXECUTIVE DIRECTOR, EXECUTIVE SECRETARY, OR SIMILAR EXECUTIVE OF A
MEMBER BOARD; OR
(C) MEMBER OF THE PUBLIC APPOINTED TO A MEMBER BOARD.
5. THE INTERSTATE COMMISSION SHALL MEET AT LEAST ONCE EACH CALENDAR
YEAR. A PORTION OF THIS MEETING SHALL BE A BUSINESS MEETING TO ADDRESS
SUCH MATTERS AS MAY PROPERLY COME BEFORE THE COMMISSION, INCLUDING THE
S. 8007 12 A. 9007
ELECTION OF OFFICERS. THE CHAIRPERSON MAY CALL ADDITIONAL MEETINGS AND
SHALL CALL FOR A MEETING UPON THE REQUEST OF A MAJORITY OF THE MEMBER
STATES.
6. THE BYLAWS MAY PROVIDE FOR MEETINGS OF THE INTERSTATE COMMISSION TO
BE CONDUCTED BY TELECOMMUNICATION OR ELECTRONIC COMMUNICATION.
7. EACH COMMISSIONER PARTICIPATING AT A MEETING OF THE INTERSTATE
COMMISSION IS ENTITLED TO ONE VOTE. A MAJORITY OF COMMISSIONERS SHALL
CONSTITUTE A QUORUM FOR THE TRANSACTION OF BUSINESS, UNLESS A LARGER
QUORUM IS REQUIRED BY THE BYLAWS OF THE INTERSTATE COMMISSION. A COMMIS-
SIONER SHALL NOT DELEGATE A VOTE TO ANOTHER COMMISSIONER. IN THE ABSENCE
OF ITS COMMISSIONER, A MEMBER STATE MAY DELEGATE VOTING AUTHORITY FOR A
SPECIFIED MEETING TO ANOTHER PERSON FROM THAT STATE WHO SHALL MEET THE
REQUIREMENTS OF SUBDIVISION FOUR OF THIS SECTION.
8. THE INTERSTATE COMMISSION SHALL PROVIDE PUBLIC NOTICE OF ALL MEET-
INGS AND ALL MEETINGS SHALL BE OPEN TO THE PUBLIC. THE INTERSTATE
COMMISSION MAY CLOSE A MEETING, IN FULL OR IN PORTION, WHERE IT DETER-
MINES BY A TWO-THIRDS VOTE OF THE COMMISSIONERS PRESENT THAT AN OPEN
MEETING WOULD BE LIKELY TO:
(A) RELATE SOLELY TO THE INTERNAL PERSONNEL PRACTICES AND PROCEDURES
OF THE INTERSTATE COMMISSION;
(B) DISCUSS MATTERS SPECIFICALLY EXEMPTED FROM DISCLOSURE BY FEDERAL
STATUTE;
(C) DISCUSS TRADE SECRETS, COMMERCIAL, OR FINANCIAL INFORMATION THAT
IS PRIVILEGED OR CONFIDENTIAL;
(D) INVOLVE ACCUSING A PERSON OF A CRIME, OR FORMALLY CENSURING A
PERSON;
(E) DISCUSS INFORMATION OF A PERSONAL NATURE WHERE DISCLOSURE WOULD
CONSTITUTE A CLEARLY UNWARRANTED INVASION OF PERSONAL PRIVACY;
(F) DISCUSS INVESTIGATIVE RECORDS COMPILED FOR LAW ENFORCEMENT
PURPOSES; OR
(G) SPECIFICALLY RELATE TO THE PARTICIPATION IN A CIVIL ACTION OR
OTHER LEGAL PROCEEDING.
9. THE INTERSTATE COMMISSION SHALL KEEP MINUTES WHICH SHALL FULLY
DESCRIBE ALL MATTERS DISCUSSED IN A MEETING AND SHALL PROVIDE A FULL AND
ACCURATE SUMMARY OF ACTIONS TAKEN, INCLUDING RECORD OF ANY ROLL CALL
VOTES.
10. THE INTERSTATE COMMISSION SHALL MAKE ITS INFORMATION AND OFFICIAL
RECORDS, TO THE EXTENT NOT OTHERWISE DESIGNATED IN THE COMPACT OR BY ITS
RULES, AVAILABLE TO THE PUBLIC FOR INSPECTION.
11. THE INTERSTATE COMMISSION SHALL ESTABLISH AN EXECUTIVE COMMITTEE,
WHICH SHALL INCLUDE OFFICERS, MEMBERS, AND OTHERS AS DETERMINED BY THE
BYLAWS. THE EXECUTIVE COMMITTEE SHALL HAVE THE POWER TO ACT ON BEHALF OF
THE INTERSTATE COMMISSION, WITH THE EXCEPTION OF RULEMAKING, DURING
PERIODS WHEN THE INTERSTATE COMMISSION IS NOT IN SESSION. WHEN ACTING ON
BEHALF OF THE INTERSTATE COMMISSION, THE EXECUTIVE COMMITTEE SHALL OVER-
SEE THE ADMINISTRATION OF THE COMPACT INCLUDING ENFORCEMENT AND COMPLI-
ANCE WITH THE PROVISIONS OF THE COMPACT, ITS BYLAWS AND RULES, AND OTHER
SUCH DUTIES AS NECESSARY.
12. THE INTERSTATE COMMISSION MAY ESTABLISH OTHER COMMITTEES FOR
GOVERNANCE AND ADMINISTRATION OF THE COMPACT.
§ 8872. POWERS AND DUTIES OF THE INTERSTATE COMMISSION. THE INTERSTATE
COMMISSION SHALL HAVE THE DUTY AND POWER TO:
1. OVERSEE AND MAINTAIN THE ADMINISTRATION OF THE COMPACT;
2. PROMULGATE RULES WHICH SHALL BE BINDING TO THE EXTENT AND IN THE
MANNER PROVIDED FOR IN THE COMPACT;
S. 8007 13 A. 9007
3. ISSUE, UPON THE REQUEST OF A MEMBER STATE OR MEMBER BOARD, ADVISORY
OPINIONS CONCERNING THE MEANING OR INTERPRETATION OF THE COMPACT, ITS
BYLAWS, RULES, AND ACTIONS;
4. ENFORCE COMPLIANCE WITH COMPACT PROVISIONS, THE RULES PROMULGATED
BY THE INTERSTATE COMMISSION, AND THE BYLAWS, USING ALL NECESSARY AND
PROPER MEANS, INCLUDING BUT NOT LIMITED TO THE USE OF JUDICIAL PROCESS;
5. ESTABLISH AND APPOINT COMMITTEES INCLUDING, BUT NOT LIMITED TO, AN
EXECUTIVE COMMITTEE AS REQUIRED BY SECTION EIGHTY-EIGHT HUNDRED SEVEN-
TY-ONE OF THIS ARTICLE, WHICH SHALL HAVE THE POWER TO ACT ON BEHALF OF
THE INTERSTATE COMMISSION IN CARRYING OUT ITS POWERS AND DUTIES;
6. PAY, OR PROVIDE FOR THE PAYMENT OF THE EXPENSES RELATED TO THE
ESTABLISHMENT, ORGANIZATION, AND ONGOING ACTIVITIES OF THE INTERSTATE
COMMISSION;
7. ESTABLISH AND MAINTAIN ONE OR MORE OFFICES;
8. BORROW, ACCEPT, HIRE, OR CONTRACT FOR SERVICES OF PERSONNEL;
9. PURCHASE AND MAINTAIN INSURANCE AND BONDS;
10. EMPLOY AN EXECUTIVE DIRECTOR WHO SHALL HAVE SUCH POWERS TO EMPLOY,
SELECT OR APPOINT EMPLOYEES, AGENTS, OR CONSULTANTS, AND TO DETERMINE
THEIR QUALIFICATIONS, DEFINE THEIR DUTIES, AND FIX THEIR COMPENSATION;
11. ESTABLISH PERSONNEL POLICIES AND PROGRAMS RELATING TO CONFLICTS OF
INTEREST, RATES OF COMPENSATION, AND QUALIFICATIONS OF PERSONNEL;
12. ACCEPT DONATIONS AND GRANTS OF MONEY, EQUIPMENT, SUPPLIES, MATERI-
ALS AND SERVICES, AND TO RECEIVE, UTILIZE, AND DISPOSE OF IT IN A MANNER
CONSISTENT WITH THE CONFLICT OF INTEREST POLICIES ESTABLISHED BY THE
INTERSTATE COMMISSION;
13. LEASE, PURCHASE, ACCEPT CONTRIBUTIONS OR DONATIONS OF, OR OTHER-
WISE TO OWN, HOLD, IMPROVE, OR USE, ANY PROPERTY, REAL, PERSONAL, OR
MIXED;
14. SELL, CONVEY, MORTGAGE, PLEDGE, LEASE, EXCHANGE, ABANDON, OR
OTHERWISE DISPOSE OF ANY PROPERTY, REAL, PERSONAL, OR MIXED;
15. ESTABLISH A BUDGET AND MAKE EXPENDITURES;
16. ADOPT A SEAL AND BYLAWS GOVERNING THE MANAGEMENT AND OPERATION OF
THE INTERSTATE COMMISSION;
17. REPORT ANNUALLY TO THE LEGISLATURES AND GOVERNORS OF THE MEMBER
STATES CONCERNING THE ACTIVITIES OF THE INTERSTATE COMMISSION DURING THE
PRECEDING YEAR. SUCH REPORTS SHALL ALSO INCLUDE REPORTS OF FINANCIAL
AUDITS AND ANY RECOMMENDATIONS THAT MAY HAVE BEEN ADOPTED BY THE INTER-
STATE COMMISSION;
18. COORDINATE EDUCATION, TRAINING, AND PUBLIC AWARENESS REGARDING THE
COMPACT, ITS IMPLEMENTATION, AND ITS OPERATION;
19. MAINTAIN RECORDS IN ACCORDANCE WITH THE BYLAWS;
20. SEEK AND OBTAIN TRADEMARKS, COPYRIGHTS, AND PATENTS; AND
21. PERFORM SUCH FUNCTIONS AS MAY BE NECESSARY OR APPROPRIATE TO
ACHIEVE THE PURPOSES OF THE COMPACT.
§ 8873. FINANCE POWERS. 1. THE INTERSTATE COMMISSION MAY LEVY ON AND
COLLECT AN ANNUAL ASSESSMENT FROM EACH MEMBER STATE TO COVER THE COST OF
THE OPERATIONS AND ACTIVITIES OF THE INTERSTATE COMMISSION AND ITS
STAFF. THE TOTAL ASSESSMENT MUST BE SUFFICIENT TO COVER THE ANNUAL BUDG-
ET APPROVED EACH YEAR FOR WHICH REVENUE IS NOT PROVIDED BY OTHER SOURC-
ES. THE AGGREGATE ANNUAL ASSESSMENT AMOUNT SHALL BE ALLOCATED UPON A
FORMULA TO BE DETERMINED BY THE INTERSTATE COMMISSION, WHICH SHALL
PROMULGATE A RULE BINDING UPON ALL MEMBER STATES.
2. THE INTERSTATE COMMISSION SHALL NOT INCUR OBLIGATIONS OF ANY KIND
PRIOR TO SECURING THE FUNDS ADEQUATE TO MEET THE SAME.
3. THE INTERSTATE COMMISSION SHALL NOT PLEDGE THE CREDIT OF ANY OF THE
MEMBER STATES, EXCEPT BY, AND WITH THE AUTHORITY OF, THE MEMBER STATE.
S. 8007 14 A. 9007
4. THE INTERSTATE COMMISSION SHALL BE SUBJECT TO A YEARLY FINANCIAL
AUDIT CONDUCTED BY A CERTIFIED OR LICENSED PUBLIC ACCOUNTANT AND THE
REPORT OF THE AUDIT SHALL BE INCLUDED IN THE ANNUAL REPORT OF THE INTER-
STATE COMMISSION.
§ 8874. ORGANIZATION AND OPERATION OF THE INTERSTATE COMMISSION. 1.
THE INTERSTATE COMMISSION SHALL, BY A MAJORITY OF COMMISSIONERS PRESENT
AND VOTING, ADOPT BYLAWS TO GOVERN ITS CONDUCT AS MAY BE NECESSARY OR
APPROPRIATE TO CARRY OUT THE PURPOSES OF THE COMPACT WITHIN TWELVE
MONTHS OF THE FIRST INTERSTATE COMMISSION MEETING.
2. THE INTERSTATE COMMISSION SHALL ELECT OR APPOINT ANNUALLY FROM
AMONG ITS COMMISSIONERS A CHAIRPERSON, A VICE-CHAIRPERSON, AND A TREAS-
URER, EACH OF WHOM SHALL HAVE SUCH AUTHORITY AND DUTIES AS MAY BE SPECI-
FIED IN THE BYLAWS. THE CHAIRPERSON, OR IN THE CHAIRPERSON'S ABSENCE OR
DISABILITY, THE VICE-CHAIRPERSON, SHALL PRESIDE AT ALL MEETINGS OF THE
INTERSTATE COMMISSION.
3. OFFICERS SELECTED PURSUANT TO SUBDIVISION TWO OF THIS SECTION SHALL
SERVE WITHOUT REMUNERATION FROM THE INTERSTATE COMMISSION.
4. THE OFFICERS AND EMPLOYEES OF THE INTERSTATE COMMISSION SHALL BE
IMMUNE FROM SUIT AND LIABILITY, EITHER PERSONALLY OR IN THEIR OFFICIAL
CAPACITY, FOR A CLAIM FOR DAMAGE TO OR LOSS OF PROPERTY OR PERSONAL
INJURY OR OTHER CIVIL LIABILITY CAUSED OR ARISING OUT OF, OR RELATING
TO, AN ACTUAL OR ALLEGED ACT, ERROR, OR OMISSION THAT OCCURRED, OR THAT
SUCH PERSON HAD A REASONABLE BASIS FOR BELIEVING OCCURRED, WITHIN THE
SCOPE OF INTERSTATE COMMISSION EMPLOYMENT, DUTIES, OR RESPONSIBILITIES;
PROVIDED THAT SUCH PERSON SHALL NOT BE PROTECTED FROM SUIT OR LIABILITY
FOR DAMAGE, LOSS, INJURY, OR LIABILITY CAUSED BY THE INTENTIONAL OR
WILLFUL AND WANTON MISCONDUCT OF SUCH PERSON.
(A) THE LIABILITY OF THE EXECUTIVE DIRECTOR AND EMPLOYEES OF THE
INTERSTATE COMMISSION OR REPRESENTATIVES OF THE INTERSTATE COMMISSION,
ACTING WITHIN THE SCOPE OF SUCH PERSON'S EMPLOYMENT OR DUTIES FOR ACTS,
ERRORS, OR OMISSIONS OCCURRING WITHIN SUCH PERSON'S STATE, MAY NOT
EXCEED THE LIMITS OF LIABILITY SET FORTH UNDER THE CONSTITUTION AND LAWS
OF THAT STATE FOR STATE OFFICIALS, EMPLOYEES, AND AGENTS. THE INTERSTATE
COMMISSION IS CONSIDERED TO BE AN INSTRUMENTALITY OF THE STATES FOR THE
PURPOSES OF ANY SUCH ACTION. NOTHING IN THIS PARAGRAPH SHALL BE
CONSTRUED TO PROTECT SUCH PERSON FROM SUIT OR LIABILITY FOR DAMAGE,
LOSS, INJURY, OR LIABILITY CAUSED BY THE INTENTIONAL OR WILLFUL AND
WANTON MISCONDUCT OF SUCH PERSON.
(B) THE INTERSTATE COMMISSION SHALL DEFEND THE EXECUTIVE DIRECTOR, ITS
EMPLOYEES, AND SUBJECT TO THE APPROVAL OF THE ATTORNEY GENERAL OR OTHER
APPROPRIATE LEGAL COUNSEL OF THE MEMBER STATE REPRESENTED BY AN INTER-
STATE COMMISSION REPRESENTATIVE, SHALL DEFEND SUCH INTERSTATE COMMISSION
REPRESENTATIVE IN ANY CIVIL ACTION SEEKING TO IMPOSE LIABILITY ARISING
OUT OF AN ACTUAL OR ALLEGED ACT, ERROR OR OMISSION THAT OCCURRED WITHIN
THE SCOPE OF INTERSTATE COMMISSION EMPLOYMENT, DUTIES OR RESPONSIBIL-
ITIES, OR THAT THE DEFENDANT HAD A REASONABLE BASIS FOR BELIEVING
OCCURRED WITHIN THE SCOPE OF INTERSTATE COMMISSION EMPLOYMENT, DUTIES,
OR RESPONSIBILITIES, PROVIDED THAT THE ACTUAL OR ALLEGED ACT, ERROR, OR
OMISSION DID NOT RESULT FROM INTENTIONAL OR WILLFUL AND WANTON MISCON-
DUCT ON THE PART OF SUCH PERSON.
(C) TO THE EXTENT NOT COVERED BY THE STATE INVOLVED, MEMBER STATE, OR
THE INTERSTATE COMMISSION, THE REPRESENTATIVES OR EMPLOYEES OF THE
INTERSTATE COMMISSION SHALL BE HELD HARMLESS IN THE AMOUNT OF A SETTLE-
MENT OR JUDGMENT, INCLUDING ATTORNEY'S FEES AND COSTS, OBTAINED AGAINST
SUCH PERSONS ARISING OUT OF AN ACTUAL OR ALLEGED ACT, ERROR, OR OMISSION
THAT OCCURRED WITHIN THE SCOPE OF INTERSTATE COMMISSION EMPLOYMENT,
S. 8007 15 A. 9007
DUTIES, OR RESPONSIBILITIES, OR THAT SUCH PERSONS HAD A REASONABLE BASIS
FOR BELIEVING OCCURRED WITHIN THE SCOPE OF INTERSTATE COMMISSION EMPLOY-
MENT, DUTIES, OR RESPONSIBILITIES, PROVIDED THAT THE ACTUAL OR ALLEGED
ACT, ERROR, OR OMISSION DID NOT RESULT FROM INTENTIONAL OR WILLFUL AND
WANTON MISCONDUCT ON THE PART OF SUCH PERSONS.
§ 8875. RULEMAKING FUNCTIONS OF THE INTERSTATE COMMISSION. 1. THE
INTERSTATE COMMISSION SHALL PROMULGATE REASONABLE RULES IN ORDER TO
EFFECTIVELY AND EFFICIENTLY ACHIEVE THE PURPOSES OF THE COMPACT.
NOTWITHSTANDING THE FOREGOING, IN THE EVENT THE INTERSTATE COMMISSION
EXERCISES ITS RULEMAKING AUTHORITY IN A MANNER THAT IS BEYOND THE SCOPE
OF THE PURPOSES OF THE COMPACT, OR THE POWERS GRANTED HEREUNDER, THEN
SUCH AN ACTION BY THE INTERSTATE COMMISSION SHALL BE INVALID AND HAVE NO
FORCE OR EFFECT.
2. RULES DEEMED APPROPRIATE FOR THE OPERATIONS OF THE INTERSTATE
COMMISSION SHALL BE MADE PURSUANT TO A RULEMAKING PROCESS THAT SUBSTAN-
TIALLY CONFORMS TO THE FEDERAL MODEL STATE ADMINISTRATIVE PROCEDURE ACT
OF 2010, AND SUBSEQUENT AMENDMENTS THERETO.
3. NOT LATER THAN THIRTY DAYS AFTER A RULE IS PROMULGATED, ANY PERSON
MAY FILE A PETITION FOR JUDICIAL REVIEW OF THE RULE IN THE UNITED STATES
DISTRICT COURT FOR THE DISTRICT OF COLUMBIA OR THE FEDERAL DISTRICT
WHERE THE INTERSTATE COMMISSION HAS ITS PRINCIPAL OFFICES, PROVIDED THAT
THE FILING OF SUCH A PETITION SHALL NOT STAY OR OTHERWISE PREVENT THE
RULE FROM BECOMING EFFECTIVE UNLESS THE COURT FINDS THAT THE PETITIONER
HAS A SUBSTANTIAL LIKELIHOOD OF SUCCESS. THE COURT SHALL GIVE DEFERENCE
TO THE ACTIONS OF THE INTERSTATE COMMISSION CONSISTENT WITH APPLICABLE
LAW AND SHALL NOT FIND THE RULE TO BE UNLAWFUL IF THE RULE REPRESENTS A
REASONABLE EXERCISE OF THE AUTHORITY GRANTED TO THE INTERSTATE COMMIS-
SION.
§ 8876. OVERSIGHT OF INTERSTATE COMPACT. 1. THE EXECUTIVE, LEGISLA-
TIVE, AND JUDICIAL BRANCHES OF STATE GOVERNMENT IN EACH MEMBER STATE
SHALL ENFORCE THE COMPACT AND SHALL TAKE ALL ACTIONS NECESSARY AND
APPROPRIATE TO EFFECTUATE THE COMPACT'S PURPOSES AND INTENT. THE
PROVISIONS OF THE COMPACT AND THE RULES PROMULGATED HEREUNDER SHALL HAVE
STANDING AS STATUTORY LAW BUT SHALL NOT OVERRIDE EXISTING STATE AUTHORI-
TY TO REGULATE THE PRACTICE OF MEDICINE.
2. ALL COURTS SHALL TAKE JUDICIAL NOTICE OF THE COMPACT AND THE RULES
IN ANY JUDICIAL OR ADMINISTRATIVE PROCEEDING IN A MEMBER STATE PERTAIN-
ING TO THE SUBJECT MATTER OF THE COMPACT WHICH MAY AFFECT THE POWERS,
RESPONSIBILITIES OR ACTIONS OF THE INTERSTATE COMMISSION.
3. THE INTERSTATE COMMISSION SHALL BE ENTITLED TO RECEIVE ALL SERVICE
OF PROCESS IN ANY SUCH PROCEEDING, AND SHALL HAVE STANDING TO INTERVENE
IN THE PROCEEDING FOR ALL PURPOSES. FAILURE TO PROVIDE SERVICE OF PROC-
ESS TO THE INTERSTATE COMMISSION SHALL RENDER A JUDGMENT OR ORDER VOID
AS TO THE INTERSTATE COMMISSION, THE COMPACT, OR PROMULGATED RULES.
§ 8877. ENFORCEMENT OF INTERSTATE COMPACT. 1. THE INTERSTATE COMMIS-
SION, IN THE REASONABLE EXERCISE OF ITS DISCRETION, SHALL ENFORCE THE
PROVISIONS AND RULES OF THE COMPACT.
2. THE INTERSTATE COMMISSION MAY, BY MAJORITY VOTE OF THE COMMISSION-
ERS, INITIATE LEGAL ACTION IN THE UNITED STATES DISTRICT COURT FOR THE
DISTRICT OF COLUMBIA, OR, AT THE DISCRETION OF THE INTERSTATE COMMIS-
SION, IN THE FEDERAL DISTRICT WHERE THE INTERSTATE COMMISSION HAS ITS
PRINCIPAL OFFICES, TO ENFORCE COMPLIANCE WITH THE PROVISIONS OF THE
COMPACT, AND ITS PROMULGATED RULES AND BYLAWS, AGAINST A MEMBER STATE IN
DEFAULT. THE RELIEF SOUGHT MAY INCLUDE BOTH INJUNCTIVE RELIEF AND
DAMAGES. IN THE EVENT JUDICIAL ENFORCEMENT IS NECESSARY, THE PREVAILING
S. 8007 16 A. 9007
PARTY SHALL BE AWARDED ALL COSTS OF SUCH LITIGATION INCLUDING REASONABLE
ATTORNEY'S FEES.
3. THE REMEDIES HEREIN SHALL NOT BE THE EXCLUSIVE REMEDIES OF THE
INTERSTATE COMMISSION. THE INTERSTATE COMMISSION MAY AVAIL ITSELF OF
ANY OTHER REMEDIES AVAILABLE UNDER STATE LAW OR THE REGULATION OF A
PROFESSION.
§ 8878. DEFAULT PROCEDURES. 1. THE GROUNDS FOR DEFAULT INCLUDE, BUT
ARE NOT LIMITED TO, FAILURE OF A MEMBER STATE TO PERFORM SUCH OBLI-
GATIONS OR RESPONSIBILITIES IMPOSED UPON IT BY THE COMPACT, OR THE RULES
AND BYLAWS OF THE INTERSTATE COMMISSION PROMULGATED UNDER THE COMPACT.
2. IF THE INTERSTATE COMMISSION DETERMINES THAT A MEMBER STATE HAS
DEFAULTED IN THE PERFORMANCE OF ITS OBLIGATIONS OR RESPONSIBILITIES
UNDER THE COMPACT, OR THE BYLAWS OR PROMULGATED RULES, THE INTERSTATE
COMMISSION SHALL:
(A) PROVIDE WRITTEN NOTICE TO THE DEFAULTING STATE AND OTHER MEMBER
STATES, OF THE NATURE OF THE DEFAULT, THE MEANS OF CURING THE DEFAULT,
AND ANY ACTION TAKEN BY THE INTERSTATE COMMISSION. THE INTERSTATE
COMMISSION SHALL SPECIFY THE CONDITIONS BY WHICH THE DEFAULTING STATE
MUST CURE ITS DEFAULT; AND
(B) PROVIDE REMEDIAL TRAINING AND SPECIFIC TECHNICAL ASSISTANCE
REGARDING THE DEFAULT.
3. IF THE DEFAULTING STATE FAILS TO CURE THE DEFAULT, THE DEFAULTING
STATE SHALL BE TERMINATED FROM THE COMPACT UPON AN AFFIRMATIVE VOTE OF A
MAJORITY OF THE COMMISSIONERS AND ALL RIGHTS, PRIVILEGES, AND BENEFITS
CONFERRED BY THE COMPACT SHALL TERMINATE ON THE EFFECTIVE DATE OF TERMI-
NATION. A CURE OF THE DEFAULT DOES NOT RELIEVE THE OFFENDING STATE OF
OBLIGATIONS OR LIABILITIES INCURRED DURING THE PERIOD OF THE DEFAULT.
4. TERMINATION OF MEMBERSHIP IN THE COMPACT SHALL BE IMPOSED ONLY
AFTER ALL OTHER MEANS OF SECURING COMPLIANCE HAVE BEEN EXHAUSTED. NOTICE
OF INTENT TO TERMINATE SHALL BE GIVEN BY THE INTERSTATE COMMISSION TO
THE GOVERNOR, THE MAJORITY AND MINORITY LEADERS OF THE DEFAULTING
STATE'S LEGISLATURE, AND EACH OF THE MEMBER STATES.
5. THE INTERSTATE COMMISSION SHALL ESTABLISH RULES AND PROCEDURES TO
ADDRESS LICENSES AND PHYSICIANS THAT ARE MATERIALLY IMPACTED BY THE
TERMINATION OF A MEMBER STATE, OR THE WITHDRAWAL OF A MEMBER STATE.
6. THE MEMBER STATE WHICH HAS BEEN TERMINATED IS RESPONSIBLE FOR ALL
DUES, OBLIGATIONS, AND LIABILITIES INCURRED THROUGH THE EFFECTIVE DATE
OF TERMINATION INCLUDING OBLIGATIONS, THE PERFORMANCE OF WHICH EXTENDS
BEYOND THE EFFECTIVE DATE OF TERMINATION.
7. THE INTERSTATE COMMISSION SHALL NOT BEAR ANY COSTS RELATING TO ANY
STATE THAT HAS BEEN FOUND TO BE IN DEFAULT OR WHICH HAS BEEN TERMINATED
FROM THE COMPACT, UNLESS OTHERWISE MUTUALLY AGREED UPON IN WRITING
BETWEEN THE INTERSTATE COMMISSION AND THE DEFAULTING STATE.
8. THE DEFAULTING STATE MAY APPEAL THE ACTION OF THE INTERSTATE
COMMISSION BY PETITIONING THE UNITED STATES DISTRICT COURT FOR THE
DISTRICT OF COLUMBIA OR THE FEDERAL DISTRICT WHERE THE INTERSTATE
COMMISSION HAS ITS PRINCIPAL OFFICES. THE PREVAILING PARTY SHALL BE
AWARDED ALL COSTS OF SUCH LITIGATION INCLUDING REASONABLE ATTORNEY'S
FEES.
§ 8879. DISPUTE RESOLUTION. 1. THE INTERSTATE COMMISSION SHALL
ATTEMPT, UPON THE REQUEST OF A MEMBER STATE, TO RESOLVE DISPUTES WHICH
ARE SUBJECT TO THE COMPACT AND WHICH MAY ARISE AMONG MEMBER STATES OR
MEMBER BOARDS.
2. THE INTERSTATE COMMISSION SHALL PROMULGATE RULES PROVIDING FOR BOTH
MEDIATION AND BINDING DISPUTE RESOLUTION AS APPROPRIATE.
S. 8007 17 A. 9007
§ 8880. MEMBER STATES, EFFECTIVE DATE AND AMENDMENT. 1. ANY STATE IS
ELIGIBLE TO BECOME A MEMBER STATE OF THE COMPACT.
2. THE COMPACT SHALL BECOME EFFECTIVE AND BINDING UPON LEGISLATIVE
ENACTMENT OF THE COMPACT INTO LAW BY NO LESS THAN SEVEN STATES. THERE-
AFTER, IT SHALL BECOME EFFECTIVE AND BINDING ON A STATE UPON ENACTMENT
OF THE COMPACT INTO LAW BY THAT STATE.
3. THE GOVERNORS OF NON-MEMBER STATES, OR THEIR DESIGNEES, SHALL BE
INVITED TO PARTICIPATE IN THE ACTIVITIES OF THE INTERSTATE COMMISSION ON
A NON-VOTING BASIS PRIOR TO ADOPTION OF THE COMPACT BY ALL STATES.
4. THE INTERSTATE COMMISSION MAY PROPOSE AMENDMENTS TO THE COMPACT FOR
ENACTMENT BY THE MEMBER STATES. NO AMENDMENT SHALL BECOME EFFECTIVE AND
BINDING UPON THE INTERSTATE COMMISSION AND THE MEMBER STATES UNLESS AND
UNTIL IT IS ENACTED INTO LAW BY UNANIMOUS CONSENT OF THE MEMBER STATES.
§ 8881. WITHDRAWAL. 1. ONCE EFFECTIVE, THE COMPACT SHALL CONTINUE IN
FORCE AND REMAIN BINDING UPON EACH AND EVERY MEMBER STATE; PROVIDED THAT
A MEMBER STATE MAY WITHDRAW FROM THE COMPACT BY SPECIFICALLY REPEALING
THE STATUTE WHICH ENACTED THE COMPACT INTO LAW.
2. WITHDRAWAL FROM THE COMPACT SHALL BE BY THE ENACTMENT OF A STATUTE
REPEALING THE SAME, BUT SHALL NOT TAKE EFFECT UNTIL ONE YEAR AFTER THE
EFFECTIVE DATE OF SUCH STATUTE AND UNTIL WRITTEN NOTICE OF THE WITH-
DRAWAL HAS BEEN GIVEN BY THE WITHDRAWING STATE TO THE GOVERNOR OF EACH
OTHER MEMBER STATE.
3. THE WITHDRAWING STATE SHALL IMMEDIATELY NOTIFY THE CHAIRPERSON OF
THE INTERSTATE COMMISSION IN WRITING UPON THE INTRODUCTION OF LEGIS-
LATION REPEALING THE COMPACT IN THE WITHDRAWING STATE.
4. THE INTERSTATE COMMISSION SHALL NOTIFY THE OTHER MEMBER STATES OF
THE WITHDRAWING STATE'S INTENT TO WITHDRAW WITHIN SIXTY DAYS OF ITS
RECEIPT OF NOTICE PROVIDED UNDER SUBDIVISION THREE OF THIS SECTION.
5. THE WITHDRAWING STATE IS RESPONSIBLE FOR ALL DUES, OBLIGATIONS AND
LIABILITIES INCURRED THROUGH THE EFFECTIVE DATE OF WITHDRAWAL, INCLUDING
OBLIGATIONS, THE PERFORMANCE OF WHICH EXTEND BEYOND THE EFFECTIVE DATE
OF WITHDRAWAL.
6. REINSTATEMENT FOLLOWING WITHDRAWAL OF A MEMBER STATE SHALL OCCUR
UPON THE WITHDRAWING STATE REENACTING THE COMPACT OR UPON SUCH LATER
DATE AS DETERMINED BY THE INTERSTATE COMMISSION.
7. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES TO ADDRESS
THE IMPACT OF THE WITHDRAWAL OF A MEMBER STATE ON LICENSES GRANTED IN
OTHER MEMBER STATES TO PHYSICIANS WHO DESIGNATED THE WITHDRAWING MEMBER
STATE AS THE STATE OF PRINCIPAL LICENSE.
§ 8882. DISSOLUTION. 1. THE COMPACT SHALL DISSOLVE EFFECTIVE UPON THE
DATE OF THE WITHDRAWAL OR DEFAULT OF THE MEMBER STATE WHICH REDUCES THE
MEMBERSHIP IN THE COMPACT TO ONE MEMBER STATE.
2. UPON THE DISSOLUTION OF THE COMPACT, THE COMPACT BECOMES NULL AND
VOID AND SHALL BE OF NO FURTHER FORCE OR EFFECT, AND THE BUSINESS AND
AFFAIRS OF THE INTERSTATE COMMISSION SHALL BE CONCLUDED AND SURPLUS
FUNDS SHALL BE DISTRIBUTED IN ACCORDANCE WITH THE BYLAWS.
§ 8883. SEVERABILITY AND CONSTRUCTION. 1. THE PROVISIONS OF THE
COMPACT SHALL BE SEVERABLE, AND IF ANY PHRASE, CLAUSE, SENTENCE, OR
PROVISION IS DEEMED UNENFORCEABLE, THE REMAINING PROVISIONS OF THE
COMPACT SHALL BE ENFORCEABLE.
2. THE PROVISIONS OF THE COMPACT SHALL BE LIBERALLY CONSTRUED TO
EFFECTUATE ITS PURPOSES.
3. NOTHING IN THE COMPACT SHALL BE CONSTRUED TO PROHIBIT THE APPLICA-
BILITY OF OTHER INTERSTATE COMPACTS TO WHICH THE STATES ARE MEMBERS.
S. 8007 18 A. 9007
§ 8884. BINDING EFFECT OF COMPACT AND OTHER LAWS. 1. NOTHING CONTAINED
IN THIS ARTICLE SHALL PREVENT THE ENFORCEMENT OF ANY OTHER LAW OF A
MEMBER STATE THAT IS NOT INCONSISTENT WITH THE COMPACT.
2. ALL LAWS IN A MEMBER STATE IN CONFLICT WITH THE COMPACT ARE SUPER-
SEDED TO THE EXTENT OF THE CONFLICT.
3. ALL LAWFUL ACTIONS OF THE INTERSTATE COMMISSION, INCLUDING ALL
RULES AND BYLAWS PROMULGATED BY THE COMMISSION, ARE BINDING UPON THE
MEMBER STATES.
4. ALL AGREEMENTS BETWEEN THE INTERSTATE COMMISSION AND THE MEMBER
STATES ARE BINDING IN ACCORDANCE WITH THEIR TERMS.
5. IN THE EVENT ANY PROVISION OF THE COMPACT EXCEEDS THE CONSTITU-
TIONAL LIMITS IMPOSED ON THE LEGISLATURE OF ANY MEMBER STATE, SUCH
PROVISION SHALL BE INEFFECTIVE TO THE EXTENT OF THE CONFLICT WITH THE
CONSTITUTIONAL PROVISION IN QUESTION IN THAT MEMBER STATE.
§ 2. Article 170 of the education law is renumbered article 171 and a
new article 170 is added to title 8 of the education law to read as
follows:
ARTICLE 170
NURSE LICENSURE COMPACT
SECTION 8900. NURSE LICENSURE COMPACT.
8901. FINDINGS AND DECLARATION OF PURPOSE.
8902. DEFINITIONS.
8903. GENERAL PROVISIONS AND JURISDICTION.
8904. APPLICATIONS FOR LICENSURE IN A PARTY STATE.
8905. ADDITIONAL AUTHORITIES INVESTED IN PARTY STATE LICENSING
BOARDS.
8906. COORDINATED LICENSURE INFORMATION SYSTEM AND EXCHANGE OF
INFORMATION.
8907. ESTABLISHMENT OF THE INTERSTATE COMMISSION OF NURSE LICEN-
SURE COMPACT ADMINISTRATORS.
8908. RULEMAKING.
8909. OVERSIGHT, DISPUTE RESOLUTION AND ENFORCEMENT.
8910. EFFECTIVE DATE, WITHDRAWAL AND AMENDMENT.
8911. CONSTRUCTION AND SEVERABILITY.
§ 8900. NURSE LICENSURE COMPACT. THE NURSE LICENSE COMPACT AS SET
FORTH IN THE ARTICLE IS HEREBY ADOPTED AND ENTERED INTO WITH ALL PARTY
STATES JOINING THEREIN.
§ 8901. FINDINGS AND DECLARATION OF PURPOSE 1. FINDINGS. THE PARTY
STATES FIND THAT:
A. THE HEALTH AND SAFETY OF THE PUBLIC ARE AFFECTED BY THE DEGREE OF
COMPLIANCE WITH AND THE EFFECTIVENESS OF ENFORCEMENT ACTIVITIES RELATED
TO STATE NURSE LICENSURE LAWS;
B. VIOLATIONS OF NURSE LICENSURE AND OTHER LAWS REGULATING THE PRAC-
TICE OF NURSING MAY RESULT IN INJURY OR HARM TO THE PUBLIC;
C. THE EXPANDED MOBILITY OF NURSES AND THE USE OF ADVANCED COMMUNI-
CATION TECHNOLOGIES AS PART OF OUR NATION'S HEALTH CARE DELIVERY SYSTEM
REQUIRE GREATER COORDINATION AND COOPERATION AMONG STATES IN THE AREAS
OF NURSE LICENSURE AND REGULATION;
D. NEW PRACTICE MODALITIES AND TECHNOLOGY MAKE COMPLIANCE WITH INDI-
VIDUAL STATE NURSE LICENSURE LAWS DIFFICULT AND COMPLEX;
E. THE CURRENT SYSTEM OF DUPLICATIVE LICENSURE FOR NURSES PRACTICING
IN MULTIPLE STATES IS CUMBERSOME AND REDUNDANT FOR BOTH NURSES AND
STATES; AND
F. UNIFORMITY OF NURSE LICENSURE REQUIREMENTS THROUGHOUT THE STATES
PROMOTES PUBLIC SAFETY AND PUBLIC HEALTH BENEFITS.
S. 8007 19 A. 9007
2. DECLARATION OF PURPOSE. THE GENERAL PURPOSES OF THIS COMPACT ARE
TO:
A. FACILITATE THE STATES' RESPONSIBILITY TO PROTECT THE PUBLIC'S
HEALTH AND SAFETY;
B. ENSURE AND ENCOURAGE THE COOPERATION OF PARTY STATES IN THE AREAS
OF NURSE LICENSURE AND REGULATION;
C. FACILITATE THE EXCHANGE OF INFORMATION BETWEEN PARTY STATES IN THE
AREAS OF NURSE REGULATION, INVESTIGATION AND ADVERSE ACTIONS;
D. PROMOTE COMPLIANCE WITH THE LAWS GOVERNING THE PRACTICE OF NURSING
IN EACH JURISDICTION;
E. INVEST ALL PARTY STATES WITH THE AUTHORITY TO HOLD A NURSE ACCOUNT-
ABLE FOR MEETING ALL STATE PRACTICE LAWS IN THE STATE IN WHICH THE
PATIENT IS LOCATED AT THE TIME CARE IS RENDERED THROUGH THE MUTUAL
RECOGNITION OF PARTY STATE LICENSES;
F. DECREASE REDUNDANCIES IN THE CONSIDERATION AND ISSUANCE OF NURSE
LICENSES; AND
G. PROVIDE OPPORTUNITIES FOR INTERSTATE PRACTICE BY NURSES WHO MEET
UNIFORM LICENSURE REQUIREMENTS.
§ 8902. DEFINITIONS. 1. DEFINITIONS. AS USED IN THIS COMPACT:
A. "ADVERSE ACTION" MEANS ANY ADMINISTRATIVE, CIVIL, EQUITABLE OR
CRIMINAL ACTION PERMITTED BY A STATE'S LAWS WHICH IS IMPOSED BY A
LICENSING BOARD OR OTHER AUTHORITY AGAINST A NURSE, INCLUDING ACTIONS
AGAINST AN INDIVIDUAL'S LICENSE OR MULTISTATE LICENSURE PRIVILEGE SUCH
AS REVOCATION, SUSPENSION, PROBATION, MONITORING OF THE LICENSEE, LIMI-
TATION ON THE LICENSEE'S PRACTICE, OR ANY OTHER ENCUMBRANCE ON LICENSURE
AFFECTING A NURSE'S AUTHORIZATION TO PRACTICE, INCLUDING ISSUANCE OF A
CEASE AND DESIST ACTION.
B. "ALTERNATIVE PROGRAM" MEANS A NON-DISCIPLINARY MONITORING PROGRAM
APPROVED BY A LICENSING BOARD.
C. "COORDINATED LICENSURE INFORMATION SYSTEM" MEANS AN INTEGRATED
PROCESS FOR COLLECTING, STORING AND SHARING INFORMATION ON NURSE LICEN-
SURE AND ENFORCEMENT ACTIVITIES RELATED TO NURSE LICENSURE LAWS THAT IS
ADMINISTERED BY A NONPROFIT ORGANIZATION COMPOSED OF AND CONTROLLED BY
LICENSING BOARDS.
D. "COMMISSION" MEANS THE INTERSTATE COMMISSION OF NURSE LICENSURE
COMPACT ADMINISTRATORS.
E. "CURRENT SIGNIFICANT INVESTIGATIVE INFORMATION" MEANS:
1. INVESTIGATIVE INFORMATION THAT A LICENSING BOARD, AFTER A PRELIMI-
NARY INQUIRY THAT INCLUDES NOTIFICATION AND AN OPPORTUNITY FOR THE NURSE
TO RESPOND, IF REQUIRED BY STATE LAW, HAS REASON TO BELIEVE IS NOT
GROUNDLESS AND, IF PROVED TRUE, WOULD INDICATE MORE THAN A MINOR INFRAC-
TION; OR
2. INVESTIGATIVE INFORMATION THAT INDICATES THAT THE NURSE REPRESENTS
AN IMMEDIATE THREAT TO PUBLIC HEALTH AND SAFETY REGARDLESS OF WHETHER
THE NURSE HAS BEEN NOTIFIED AND HAD AN OPPORTUNITY TO RESPOND; OR
3. ANY INFORMATION CONCERNING A NURSE REPORTED TO A LICENSING BOARD BY
A HEALTH CARE ENTITY, HEALTH CARE PROFESSIONAL, OR ANY OTHER PERSON,
WHICH INDICATES THAT THE NURSE DEMONSTRATED AN IMPAIRMENT, GROSS INCOM-
PETENCE, OR UNPROFESSIONAL CONDUCT THAT WOULD PRESENT AN IMMINENT DANGER
TO A PATIENT OR THE PUBLIC HEALTH, SAFETY, OR WELFARE.
F. "ENCUMBRANCE" MEANS A REVOCATION OR SUSPENSION OF, OR ANY LIMITA-
TION ON, THE FULL AND UNRESTRICTED PRACTICE OF NURSING IMPOSED BY A
LICENSING BOARD.
G. "HOME STATE" MEANS THE PARTY STATE WHICH IS THE NURSE'S PRIMARY
STATE OF RESIDENCE.
S. 8007 20 A. 9007
H. "LICENSING BOARD" MEANS A PARTY STATE'S REGULATORY BODY RESPONSIBLE
FOR ISSUING NURSE LICENSES.
I. "MULTISTATE LICENSE" MEANS A LICENSE TO PRACTICE AS A REGISTERED
NURSE (RN) OR AS A LICENSED PRACTICAL/VOCATIONAL NURSE (LPN/VN), WHICH
IS ISSUED BY A HOME STATE LICENSING BOARD, AND WHICH AUTHORIZES THE
LICENSED NURSE TO PRACTICE IN ALL PARTY STATES UNDER A MULTISTATE LICEN-
SURE PRIVILEGE.
J. "MULTISTATE LICENSURE PRIVILEGE" MEANS A LEGAL AUTHORIZATION ASSO-
CIATED WITH A MULTISTATE LICENSE PERMITTING THE PRACTICE OF NURSING AS
EITHER A RN OR A LPN/VN IN A REMOTE STATE.
K. "NURSE" MEANS RN OR LPN/VN, AS THOSE TERMS ARE DEFINED BY EACH
PARTY STATE'S PRACTICE LAWS.
L. "PARTY STATE" MEANS ANY STATE THAT HAS ADOPTED THIS COMPACT.
M. "REMOTE STATE" MEANS A PARTY STATE, OTHER THAN THE HOME STATE.
N. "SINGLE-STATE LICENSE" MEANS A NURSE LICENSE ISSUED BY A PARTY
STATE THAT AUTHORIZES PRACTICE ONLY WITHIN THE ISSUING STATE AND DOES
NOT INCLUDE A MULTISTATE LICENSURE PRIVILEGE TO PRACTICE IN ANY OTHER
PARTY STATE.
O. "STATE" MEANS A STATE, TERRITORY OR POSSESSION OF THE UNITED STATES
AND THE DISTRICT OF COLUMBIA.
P. "STATE PRACTICE LAWS" MEANS A PARTY STATE'S LAWS, RULES AND REGU-
LATIONS THAT GOVERN THE PRACTICE OF NURSING, DEFINE THE SCOPE OF NURSING
PRACTICE, AND CREATE THE METHODS AND GROUNDS FOR IMPOSING DISCIPLINE.
"STATE PRACTICE LAWS" SHALL NOT INCLUDE REQUIREMENTS NECESSARY TO OBTAIN
AND RETAIN A LICENSE, EXCEPT FOR QUALIFICATIONS OR REQUIREMENTS OF THE
HOME STATE.
§ 8903. GENERAL PROVISIONS AND JURISDICTION. 1. GENERAL PROVISIONS AND
JURISDICTION. A. A MULTISTATE LICENSE TO PRACTICE REGISTERED OR LICENSED
PRACTICAL/VOCATIONAL NURSING ISSUED BY A HOME STATE TO A RESIDENT IN
THAT STATE WILL BE RECOGNIZED BY EACH PARTY STATE AS AUTHORIZING A NURSE
TO PRACTICE AS A REGISTERED NURSE (RN) OR AS A LICENSED
PRACTICAL/VOCATIONAL NURSE (LPN/VN), UNDER A MULTISTATE LICENSURE PRIVI-
LEGE, IN EACH PARTY STATE.
B. A STATE SHALL IMPLEMENT PROCEDURES FOR CONSIDERING THE CRIMINAL
HISTORY RECORDS OF APPLICANTS FOR AN INITIAL MULTISTATE LICENSE OR
LICENSURE BY ENDORSEMENT. SUCH PROCEDURES SHALL INCLUDE THE SUBMISSION
OF FINGERPRINTS OR OTHER BIOMETRIC-BASED INFORMATION BY APPLICANTS FOR
THE PURPOSE OF OBTAINING AN APPLICANT'S CRIMINAL HISTORY RECORD INFORMA-
TION FROM THE FEDERAL BUREAU OF INVESTIGATION AND THE AGENCY RESPONSIBLE
FOR RETAINING THAT STATE'S CRIMINAL RECORDS.
C. EACH PARTY STATE SHALL REQUIRE ITS LICENSING BOARD TO AUTHORIZE AN
APPLICANT TO OBTAIN OR RETAIN A MULTISTATE LICENSE IN THE HOME STATE
ONLY IF THE APPLICANT:
I. MEETS THE HOME STATE'S QUALIFICATIONS FOR LICENSURE OR RENEWAL OF
LICENSURE, AND COMPLIES WITH ALL OTHER APPLICABLE STATE LAWS;
II. (1) HAS GRADUATED OR IS ELIGIBLE TO GRADUATE FROM A LICENSING
BOARD-APPROVED RN OR LPN/VN PRELICENSURE EDUCATION PROGRAM; OR
(2) HAS GRADUATED FROM A FOREIGN RN OR LPN/VN PRELICENSURE EDUCATION
PROGRAM THAT HAS BEEN: (A) APPROVED BY THE AUTHORIZED ACCREDITING BODY
IN THE APPLICABLE COUNTRY, AND (B) VERIFIED BY AN INDEPENDENT CREDEN-
TIALS REVIEW AGENCY TO BE COMPARABLE TO A LICENSING BOARD-APPROVED PREL-
ICENSURE EDUCATION PROGRAM;
III. HAS, IF A GRADUATE OF A FOREIGN PRELICENSURE EDUCATION PROGRAM
NOT TAUGHT IN ENGLISH OR IF ENGLISH IS NOT THE INDIVIDUAL'S NATIVE
LANGUAGE, SUCCESSFULLY PASSED AN ENGLISH PROFICIENCY EXAMINATION THAT
INCLUDES THE COMPONENTS OF READING, SPEAKING, WRITING AND LISTENING;
S. 8007 21 A. 9007
IV. HAS SUCCESSFULLY PASSED AN NCLEX-RN OR NCLEX-PN EXAMINATION OR
RECOGNIZED PREDECESSOR, AS APPLICABLE;
V. IS ELIGIBLE FOR OR HOLDS AN ACTIVE, UNENCUMBERED LICENSE;
VI. HAS SUBMITTED, IN CONNECTION WITH AN APPLICATION FOR INITIAL
LICENSURE OR LICENSURE BY ENDORSEMENT, FINGERPRINTS OR OTHER BIOMETRIC
DATA FOR THE PURPOSE OF OBTAINING CRIMINAL HISTORY RECORD INFORMATION
FROM THE FEDERAL BUREAU OF INVESTIGATION AND THE AGENCY RESPONSIBLE FOR
RETAINING THAT STATE'S CRIMINAL RECORDS;
VII. HAS NOT BEEN CONVICTED OR FOUND GUILTY, OR HAS ENTERED INTO AN
AGREED DISPOSITION, OF A FELONY OFFENSE UNDER APPLICABLE STATE OR FEDER-
AL CRIMINAL LAW;
VIII. HAS NOT BEEN CONVICTED OR FOUND GUILTY, OR HAS ENTERED INTO AN
AGREED DISPOSITION, OF A MISDEMEANOR OFFENSE RELATED TO THE PRACTICE OF
NURSING AS DETERMINED ON A CASE-BY-CASE BASIS;
IX. IS NOT CURRENTLY ENROLLED IN AN ALTERNATIVE PROGRAM;
X. IS SUBJECT TO SELF-DISCLOSURE REQUIREMENTS REGARDING CURRENT
PARTICIPATION IN AN ALTERNATIVE PROGRAM; AND
XI. HAS A VALID UNITED STATES SOCIAL SECURITY NUMBER.
D. ALL PARTY STATES SHALL BE AUTHORIZED, IN ACCORDANCE WITH EXISTING
STATE DUE PROCESS LAW, TO TAKE ADVERSE ACTION AGAINST A NURSE'S MULTI-
STATE LICENSURE PRIVILEGE SUCH AS REVOCATION, SUSPENSION, PROBATION OR
ANY OTHER ACTION THAT AFFECTS A NURSE'S AUTHORIZATION TO PRACTICE UNDER
A MULTISTATE LICENSURE PRIVILEGE, INCLUDING CEASE AND DESIST ACTIONS. IF
A PARTY STATE TAKES SUCH ACTION, IT SHALL PROMPTLY NOTIFY THE ADMINIS-
TRATOR OF THE COORDINATED LICENSURE INFORMATION SYSTEM. THE ADMINISTRA-
TOR OF THE COORDINATED LICENSURE INFORMATION SYSTEM SHALL PROMPTLY NOTI-
FY THE HOME STATE OF ANY SUCH ACTIONS BY REMOTE STATES.
E. A NURSE PRACTICING IN A PARTY STATE SHALL COMPLY WITH THE STATE
PRACTICE LAWS OF THE STATE IN WHICH THE CLIENT IS LOCATED AT THE TIME
SERVICE IS PROVIDED. THE PRACTICE OF NURSING IS NOT LIMITED TO PATIENT
CARE BUT SHALL INCLUDE ALL NURSING PRACTICE AS DEFINED BY THE STATE
PRACTICE LAWS OF THE PARTY STATE IN WHICH THE CLIENT IS LOCATED. THE
PRACTICE OF NURSING IN A PARTY STATE UNDER A MULTISTATE LICENSURE PRIVI-
LEGE WILL SUBJECT A NURSE TO THE JURISDICTION OF THE LICENSING BOARD,
THE COURTS AND THE LAWS OF THE PARTY STATE IN WHICH THE CLIENT IS
LOCATED AT THE TIME SERVICE IS PROVIDED.
F. INDIVIDUALS NOT RESIDING IN A PARTY STATE SHALL CONTINUE TO BE ABLE
TO APPLY FOR A PARTY STATE'S SINGLE-STATE LICENSE AS PROVIDED UNDER THE
LAWS OF EACH PARTY STATE. HOWEVER, THE SINGLE-STATE LICENSE GRANTED TO
THESE INDIVIDUALS WILL NOT BE RECOGNIZED AS GRANTING THE PRIVILEGE TO
PRACTICE NURSING IN ANY OTHER PARTY STATE. NOTHING IN THIS COMPACT SHALL
AFFECT THE REQUIREMENTS ESTABLISHED BY A PARTY STATE FOR THE ISSUANCE OF
A SINGLE-STATE LICENSE.
G. ANY NURSE HOLDING A HOME STATE MULTISTATE LICENSE, ON THE EFFECTIVE
DATE OF THIS COMPACT, MAY RETAIN AND RENEW THE MULTISTATE LICENSE ISSUED
BY THE NURSE'S THEN-CURRENT HOME STATE, PROVIDED THAT:
I. A NURSE, WHO CHANGES PRIMARY STATE OF RESIDENCE AFTER THIS
COMPACT'S EFFECTIVE DATE, SHALL MEET ALL APPLICABLE REQUIREMENTS SET
FORTH IN THIS ARTICLE TO OBTAIN A MULTISTATE LICENSE FROM A NEW HOME
STATE.
II. A NURSE WHO FAILS TO SATISFY THE MULTISTATE LICENSURE REQUIREMENTS
SET FORTH IN THIS ARTICLE DUE TO A DISQUALIFYING EVENT OCCURRING AFTER
THIS COMPACT'S EFFECTIVE DATE SHALL BE INELIGIBLE TO RETAIN OR RENEW A
MULTISTATE LICENSE, AND THE NURSE'S MULTISTATE LICENSE SHALL BE REVOKED
OR DEACTIVATED IN ACCORDANCE WITH APPLICABLE RULES ADOPTED BY THE
COMMISSION.
S. 8007 22 A. 9007
§ 8904. APPLICATIONS FOR LICENSURE IN A PARTY STATE. 1. APPLICATIONS
FOR LICENSURE IN A PARTY STATE. A. UPON APPLICATION FOR A MULTISTATE
LICENSE, THE LICENSING BOARD IN THE ISSUING PARTY STATE SHALL ASCERTAIN,
THROUGH THE COORDINATED LICENSURE INFORMATION SYSTEM, WHETHER THE APPLI-
CANT HAS EVER HELD, OR IS THE HOLDER OF, A LICENSE ISSUED BY ANY OTHER
STATE, WHETHER THERE ARE ANY ENCUMBRANCES ON ANY LICENSE OR MULTISTATE
LICENSURE PRIVILEGE HELD BY THE APPLICANT, WHETHER ANY ADVERSE ACTION
HAS BEEN TAKEN AGAINST ANY LICENSE OR MULTISTATE LICENSURE PRIVILEGE
HELD BY THE APPLICANT AND WHETHER THE APPLICANT IS CURRENTLY PARTICIPAT-
ING IN AN ALTERNATIVE PROGRAM.
B. A NURSE MAY HOLD A MULTISTATE LICENSE, ISSUED BY THE HOME STATE, IN
ONLY ONE PARTY STATE AT A TIME.
C. IF A NURSE CHANGES PRIMARY STATE OF RESIDENCE BY MOVING BETWEEN TWO
PARTY STATES, THE NURSE MUST APPLY FOR LICENSURE IN THE NEW HOME STATE,
AND THE MULTISTATE LICENSE ISSUED BY THE PRIOR HOME STATE WILL BE DEAC-
TIVATED IN ACCORDANCE WITH APPLICABLE RULES ADOPTED BY THE COMMISSION.
I. THE NURSE MAY APPLY FOR LICENSURE IN ADVANCE OF A CHANGE IN PRIMARY
STATE OF RESIDENCE.
II. A MULTISTATE LICENSE SHALL NOT BE ISSUED BY THE NEW HOME STATE
UNTIL THE NURSE PROVIDES SATISFACTORY EVIDENCE OF A CHANGE IN PRIMARY
STATE OF RESIDENCE TO THE NEW HOME STATE AND SATISFIES ALL APPLICABLE
REQUIREMENTS TO OBTAIN A MULTISTATE LICENSE FROM THE NEW HOME STATE.
D. IF A NURSE CHANGES PRIMARY STATE OF RESIDENCE BY MOVING FROM A
PARTY STATE TO A NON-PARTY STATE, THE MULTISTATE LICENSE ISSUED BY THE
PRIOR HOME STATE WILL CONVERT TO A SINGLE-STATE LICENSE, VALID ONLY IN
THE FORMER HOME STATE.
§ 8905. ADDITIONAL AUTHORITIES INVESTED IN PARTY STATE LICENSING
BOARDS. 1. LICENSING BOARD AUTHORITY. IN ADDITION TO THE OTHER POWERS
CONFERRED BY STATE LAW, A LICENSING BOARD SHALL HAVE THE AUTHORITY TO:
A. TAKE ADVERSE ACTION AGAINST A NURSE'S MULTISTATE LICENSURE PRIVI-
LEGE TO PRACTICE WITHIN THAT PARTY STATE.
I. ONLY THE HOME STATE SHALL HAVE THE POWER TO TAKE ADVERSE ACTION
AGAINST A NURSE'S LICENSE ISSUED BY THE HOME STATE.
II. FOR PURPOSES OF TAKING ADVERSE ACTION, THE HOME STATE LICENSING
BOARD SHALL GIVE THE SAME PRIORITY AND EFFECT TO REPORTED CONDUCT
RECEIVED FROM A REMOTE STATE AS IT WOULD IF SUCH CONDUCT HAD OCCURRED
WITHIN THE HOME STATE. IN SO DOING, THE HOME STATE SHALL APPLY ITS OWN
STATE LAWS TO DETERMINE APPROPRIATE ACTION.
B. ISSUE CEASE AND DESIST ORDERS OR IMPOSE AN ENCUMBRANCE ON A NURSE'S
AUTHORITY TO PRACTICE WITHIN THAT PARTY STATE.
C. COMPLETE ANY PENDING INVESTIGATIONS OF A NURSE WHO CHANGES PRIMARY
STATE OF RESIDENCE DURING THE COURSE OF SUCH INVESTIGATIONS. THE LICENS-
ING BOARD SHALL ALSO HAVE THE AUTHORITY TO TAKE APPROPRIATE ACTION OR
ACTIONS AND SHALL PROMPTLY REPORT THE CONCLUSIONS OF SUCH INVESTIGATIONS
TO THE ADMINISTRATOR OF THE COORDINATED LICENSURE INFORMATION SYSTEM.
THE ADMINISTRATOR OF THE COORDINATED LICENSURE INFORMATION SYSTEM SHALL
PROMPTLY NOTIFY THE NEW HOME STATE OF ANY SUCH ACTIONS.
D. ISSUE SUBPOENAS FOR BOTH HEARINGS AND INVESTIGATIONS THAT REQUIRE
THE ATTENDANCE AND TESTIMONY OF WITNESSES, AS WELL AS THE PRODUCTION OF
EVIDENCE. SUBPOENAS ISSUED BY A LICENSING BOARD IN A PARTY STATE FOR THE
ATTENDANCE AND TESTIMONY OF WITNESSES OR THE PRODUCTION OF EVIDENCE FROM
ANOTHER PARTY STATE SHALL BE ENFORCED IN THE LATTER STATE BY ANY COURT
OF COMPETENT JURISDICTION, ACCORDING TO THE PRACTICE AND PROCEDURE OF
THAT COURT APPLICABLE TO SUBPOENAS ISSUED IN PROCEEDINGS PENDING BEFORE
IT. THE ISSUING AUTHORITY SHALL PAY ANY WITNESS FEES, TRAVEL EXPENSES,
S. 8007 23 A. 9007
MILEAGE AND OTHER FEES REQUIRED BY THE SERVICE STATUTES OF THE STATE IN
WHICH THE WITNESSES OR EVIDENCE ARE LOCATED.
E. OBTAIN AND SUBMIT, FOR EACH NURSE LICENSURE APPLICANT, FINGERPRINT
OR OTHER BIOMETRIC-BASED INFORMATION TO THE FEDERAL BUREAU OF INVESTI-
GATION FOR CRIMINAL BACKGROUND CHECKS, RECEIVE THE RESULTS OF THE FEDER-
AL BUREAU OF INVESTIGATION RECORD SEARCH ON CRIMINAL BACKGROUND CHECKS
AND USE THE RESULTS IN MAKING LICENSURE DECISIONS.
F. IF OTHERWISE PERMITTED BY STATE LAW, RECOVER FROM THE AFFECTED
NURSE THE COSTS OF INVESTIGATIONS AND DISPOSITION OF CASES RESULTING
FROM ANY ADVERSE ACTION TAKEN AGAINST THAT NURSE.
G. TAKE ADVERSE ACTION BASED ON THE FACTUAL FINDINGS OF THE REMOTE
STATE, PROVIDED THAT THE LICENSING BOARD FOLLOWS ITS OWN PROCEDURES FOR
TAKING SUCH ADVERSE ACTION.
2. ADVERSE ACTIONS. A. IF ADVERSE ACTION IS TAKEN BY THE HOME STATE
AGAINST A NURSE'S MULTISTATE LICENSE, THE NURSE'S MULTISTATE LICENSURE
PRIVILEGE TO PRACTICE IN ALL OTHER PARTY STATES SHALL BE DEACTIVATED
UNTIL ALL ENCUMBRANCES HAVE BEEN REMOVED FROM THE MULTISTATE LICENSE.
ALL HOME STATE DISCIPLINARY ORDERS THAT IMPOSE ADVERSE ACTION AGAINST A
NURSE'S MULTISTATE LICENSE SHALL INCLUDE A STATEMENT THAT THE NURSE'S
MULTISTATE LICENSURE PRIVILEGE IS DEACTIVATED IN ALL PARTY STATES DURING
THE PENDENCY OF THE ORDER.
B. NOTHING IN THIS COMPACT SHALL OVERRIDE A PARTY STATE'S DECISION
THAT PARTICIPATION IN AN ALTERNATIVE PROGRAM MAY BE USED IN LIEU OF
ADVERSE ACTION. THE HOME STATE LICENSING BOARD SHALL DEACTIVATE THE
MULTISTATE LICENSURE PRIVILEGE UNDER THE MULTISTATE LICENSE OF ANY NURSE
FOR THE DURATION OF THE NURSE'S PARTICIPATION IN AN ALTERNATIVE PROGRAM.
§ 8906. COORDINATED LICENSURE INFORMATION SYSTEM AND EXCHANGE OF
INFORMATION. 1. COORDINATED LICENSURE INFORMATION SYSTEM AND EXCHANGE
OF INFORMATION. A. ALL PARTY STATES SHALL PARTICIPATE IN A COORDINATED
LICENSURE INFORMATION SYSTEM OF ALL LICENSED REGISTERED NURSES (RNS) AND
LICENSED PRACTICAL/VOCATIONAL NURSES (LPNS/VNS). THIS SYSTEM WILL
INCLUDE INFORMATION ON THE LICENSURE AND DISCIPLINARY HISTORY OF EACH
NURSE, AS SUBMITTED BY PARTY STATES, TO ASSIST IN THE COORDINATION OF
NURSE LICENSURE AND ENFORCEMENT EFFORTS.
B. THE COMMISSION, IN CONSULTATION WITH THE ADMINISTRATOR OF THE COOR-
DINATED LICENSURE INFORMATION SYSTEM, SHALL FORMULATE NECESSARY AND
PROPER PROCEDURES FOR THE IDENTIFICATION, COLLECTION AND EXCHANGE OF
INFORMATION UNDER THIS COMPACT.
C. ALL LICENSING BOARDS SHALL PROMPTLY REPORT TO THE COORDINATED
LICENSURE INFORMATION SYSTEM ANY ADVERSE ACTION, ANY CURRENT SIGNIFICANT
INVESTIGATIVE INFORMATION, DENIALS OF APPLICATIONS WITH THE REASONS FOR
SUCH DENIALS AND NURSE PARTICIPATION IN ALTERNATIVE PROGRAMS KNOWN TO
THE LICENSING BOARD REGARDLESS OF WHETHER SUCH PARTICIPATION IS DEEMED
NONPUBLIC OR CONFIDENTIAL UNDER STATE LAW.
D. CURRENT SIGNIFICANT INVESTIGATIVE INFORMATION AND PARTICIPATION IN
NONPUBLIC OR CONFIDENTIAL ALTERNATIVE PROGRAMS SHALL BE TRANSMITTED
THROUGH THE COORDINATED LICENSURE INFORMATION SYSTEM ONLY TO PARTY STATE
LICENSING BOARDS.
E. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, ALL PARTY STATE LICENS-
ING BOARDS CONTRIBUTING INFORMATION TO THE COORDINATED LICENSURE INFOR-
MATION SYSTEM MAY DESIGNATE INFORMATION THAT MAY NOT BE SHARED WITH
NON-PARTY STATES OR DISCLOSED TO OTHER ENTITIES OR INDIVIDUALS WITHOUT
THE EXPRESS PERMISSION OF THE CONTRIBUTING STATE.
F. ANY PERSONALLY IDENTIFIABLE INFORMATION OBTAINED FROM THE COORDI-
NATED LICENSURE INFORMATION SYSTEM BY A PARTY STATE LICENSING BOARD
SHALL NOT BE SHARED WITH NON-PARTY STATES OR DISCLOSED TO OTHER ENTITIES
S. 8007 24 A. 9007
OR INDIVIDUALS EXCEPT TO THE EXTENT PERMITTED BY THE LAWS OF THE PARTY
STATE CONTRIBUTING THE INFORMATION.
G. ANY INFORMATION CONTRIBUTED TO THE COORDINATED LICENSURE INFORMA-
TION SYSTEM THAT IS SUBSEQUENTLY REQUIRED TO BE EXPUNGED BY THE LAWS OF
THE PARTY STATE CONTRIBUTING THAT INFORMATION SHALL ALSO BE EXPUNGED
FROM THE COORDINATED LICENSURE INFORMATION SYSTEM.
H. THE COMPACT ADMINISTRATOR OF EACH PARTY STATE SHALL FURNISH A
UNIFORM DATA SET TO THE COMPACT ADMINISTRATOR OF EACH OTHER PARTY STATE,
WHICH SHALL INCLUDE, AT A MINIMUM:
I. IDENTIFYING INFORMATION;
II. LICENSURE DATA;
III. INFORMATION RELATED TO ALTERNATIVE PROGRAM PARTICIPATION; AND
IV. OTHER INFORMATION THAT MAY FACILITATE THE ADMINISTRATION OF THIS
COMPACT, AS DETERMINED BY COMMISSION RULES.
I. THE COMPACT ADMINISTRATOR OF A PARTY STATE SHALL PROVIDE ALL INVES-
TIGATIVE DOCUMENTS AND INFORMATION REQUESTED BY ANOTHER PARTY STATE.
§ 8907. ESTABLISHMENT OF THE INTERSTATE COMMISSION OF NURSE LICENSURE
COMPACT ADMINISTRATORS. 1. COMMISSION OF NURSE LICENSURE COMPACT ADMIN-
ISTRATORS. THE PARTY STATES HEREBY CREATE AND ESTABLISH A JOINT PUBLIC
ENTITY KNOWN AS THE INTERSTATE COMMISSION OF NURSE LICENSURE COMPACT
ADMINISTRATORS. THE COMMISSION IS AN INSTRUMENTALITY OF THE PARTY
STATES.
2. VENUE. VENUE IS PROPER, AND JUDICIAL PROCEEDINGS BY OR AGAINST THE
COMMISSION SHALL BE BROUGHT SOLELY AND EXCLUSIVELY, IN A COURT OF COMPE-
TENT JURISDICTION WHERE THE PRINCIPAL OFFICE OF THE COMMISSION IS
LOCATED. THE COMMISSION MAY WAIVE VENUE AND JURISDICTIONAL DEFENSES TO
THE EXTENT IT ADOPTS OR CONSENTS TO PARTICIPATE IN ALTERNATIVE DISPUTE
RESOLUTION PROCEEDINGS.
3. SOVEREIGN IMMUNITY. NOTHING IN THIS COMPACT SHALL BE CONSTRUED TO
BE A WAIVER OF SOVEREIGN IMMUNITY.
4. MEMBERSHIP, VOTING AND MEETINGS. A. EACH PARTY STATE SHALL HAVE AND
BE LIMITED TO ONE ADMINISTRATOR. THE HEAD OF THE STATE LICENSING BOARD
OR DESIGNEE SHALL BE THE ADMINISTRATOR OF THIS COMPACT FOR EACH PARTY
STATE. ANY ADMINISTRATOR MAY BE REMOVED OR SUSPENDED FROM OFFICE AS
PROVIDED BY THE LAW OF THE STATE FROM WHICH THE ADMINISTRATOR IS
APPOINTED. ANY VACANCY OCCURRING IN THE COMMISSION SHALL BE FILLED IN
ACCORDANCE WITH THE LAWS OF THE PARTY STATE IN WHICH THE VACANCY EXISTS.
B. EACH ADMINISTRATOR SHALL BE ENTITLED TO ONE VOTE WITH REGARD TO THE
PROMULGATION OF RULES AND CREATION OF BYLAWS AND SHALL OTHERWISE HAVE AN
OPPORTUNITY TO PARTICIPATE IN THE BUSINESS AND AFFAIRS OF THE COMMIS-
SION. AN ADMINISTRATOR SHALL VOTE IN PERSON OR BY SUCH OTHER MEANS AS
PROVIDED IN THE BYLAWS. THE BYLAWS MAY PROVIDE FOR AN ADMINISTRATOR'S
PARTICIPATION IN MEETINGS BY TELEPHONE OR OTHER MEANS OF COMMUNICATION.
C. THE COMMISSION SHALL MEET AT LEAST ONCE DURING EACH CALENDAR YEAR.
ADDITIONAL MEETINGS SHALL BE HELD AS SET FORTH IN THE BYLAWS OR RULES OF
THE COMMISSION.
D. ALL MEETINGS SHALL BE OPEN TO THE PUBLIC, AND PUBLIC NOTICE OF
MEETINGS SHALL BE GIVEN IN THE SAME MANNER AS REQUIRED UNDER THE RULE-
MAKING PROVISIONS IN SECTION EIGHTY-NINE HUNDRED THREE OF THIS ARTICLE.
5. CLOSED MEETINGS. A. THE COMMISSION MAY CONVENE IN A CLOSED, NONPUB-
LIC MEETING IF THE COMMISSION SHALL DISCUSS:
I. NONCOMPLIANCE OF A PARTY STATE WITH ITS OBLIGATIONS UNDER THIS
COMPACT;
II. THE EMPLOYMENT, COMPENSATION, DISCIPLINE OR OTHER PERSONNEL
MATTERS, PRACTICES OR PROCEDURES RELATED TO SPECIFIC EMPLOYEES OR OTHER
S. 8007 25 A. 9007
MATTERS RELATED TO THE COMMISSION'S INTERNAL PERSONNEL PRACTICES AND
PROCEDURES;
III. CURRENT, THREATENED OR REASONABLY ANTICIPATED LITIGATION;
IV. NEGOTIATION OF CONTRACTS FOR THE PURCHASE OR SALE OF GOODS,
SERVICES OR REAL ESTATE;
V. ACCUSING ANY PERSON OF A CRIME OR FORMALLY CENSURING ANY PERSON;
VI. DISCLOSURE OF TRADE SECRETS OR COMMERCIAL OR FINANCIAL INFORMATION
THAT IS PRIVILEGED OR CONFIDENTIAL;
VII. DISCLOSURE OF INFORMATION OF A PERSONAL NATURE WHERE DISCLOSURE
WOULD CONSTITUTE A CLEARLY UNWARRANTED INVASION OF PERSONAL PRIVACY;
VIII. DISCLOSURE OF INVESTIGATORY RECORDS COMPILED FOR LAW ENFORCEMENT
PURPOSES;
IX. DISCLOSURE OF INFORMATION RELATED TO ANY REPORTS PREPARED BY OR ON
BEHALF OF THE COMMISSION FOR THE PURPOSE OF INVESTIGATION OF COMPLIANCE
WITH THIS COMPACT; OR
X. MATTERS SPECIFICALLY EXEMPTED FROM DISCLOSURE BY FEDERAL OR STATE
STATUTE.
B. IF A MEETING, OR PORTION OF A MEETING, IS CLOSED PURSUANT TO THIS
PARAGRAPH THE COMMISSION'S LEGAL COUNSEL OR DESIGNEE SHALL CERTIFY THAT
THE MEETING MAY BE CLOSED AND SHALL REFERENCE EACH RELEVANT EXEMPTING
PROVISION. THE COMMISSION SHALL KEEP MINUTES THAT FULLY AND CLEARLY
DESCRIBE ALL MATTERS DISCUSSED IN A MEETING AND SHALL PROVIDE A FULL AND
ACCURATE SUMMARY OF ACTIONS TAKEN, AND THE REASONS THEREFOR, INCLUDING A
DESCRIPTION OF THE VIEWS EXPRESSED. ALL DOCUMENTS CONSIDERED IN
CONNECTION WITH AN ACTION SHALL BE IDENTIFIED IN SUCH MINUTES. ALL
MINUTES AND DOCUMENTS OF A CLOSED MEETING SHALL REMAIN UNDER SEAL,
SUBJECT TO RELEASE BY A MAJORITY VOTE OF THE COMMISSION OR ORDER OF A
COURT OF COMPETENT JURISDICTION.
C. THE COMMISSION SHALL, BY A MAJORITY VOTE OF THE ADMINISTRATORS,
PRESCRIBE BYLAWS OR RULES TO GOVERN ITS CONDUCT AS MAY BE NECESSARY OR
APPROPRIATE TO CARRY OUT THE PURPOSES AND EXERCISE THE POWERS OF THIS
COMPACT, INCLUDING BUT NOT LIMITED TO:
I. ESTABLISHING THE FISCAL YEAR OF THE COMMISSION;
II. PROVIDING REASONABLE STANDARDS AND PROCEDURES:
(1) FOR THE ESTABLISHMENT AND MEETINGS OF OTHER COMMITTEES; AND
(2) GOVERNING ANY GENERAL OR SPECIFIC DELEGATION OF ANY AUTHORITY OR
FUNCTION OF THE COMMISSION;
III. PROVIDING REASONABLE PROCEDURES FOR CALLING AND CONDUCTING MEET-
INGS OF THE COMMISSION, ENSURING REASONABLE ADVANCE NOTICE OF ALL MEET-
INGS AND PROVIDING AN OPPORTUNITY FOR ATTENDANCE OF SUCH MEETINGS BY
INTERESTED PARTIES, WITH ENUMERATED EXCEPTIONS DESIGNED TO PROTECT THE
PUBLIC'S INTEREST, THE PRIVACY OF INDIVIDUALS, AND PROPRIETARY INFORMA-
TION, INCLUDING TRADE SECRETS. THE COMMISSION MAY MEET IN CLOSED SESSION
ONLY AFTER A MAJORITY OF THE ADMINISTRATORS VOTE TO CLOSE A MEETING IN
WHOLE OR IN PART. AS SOON AS PRACTICABLE, THE COMMISSION MUST MAKE
PUBLIC A COPY OF THE VOTE TO CLOSE THE MEETING REVEALING THE VOTE OF
EACH ADMINISTRATOR, WITH NO PROXY VOTES ALLOWED;
IV. ESTABLISHING THE TITLES, DUTIES AND AUTHORITY AND REASONABLE
PROCEDURES FOR THE ELECTION OF THE OFFICERS OF THE COMMISSION;
V. PROVIDING REASONABLE STANDARDS AND PROCEDURES FOR THE ESTABLISHMENT
OF THE PERSONNEL POLICIES AND PROGRAMS OF THE COMMISSION. NOTWITHSTAND-
ING ANY CIVIL SERVICE OR OTHER SIMILAR LAWS OF ANY PARTY STATE, THE
BYLAWS SHALL EXCLUSIVELY GOVERN THE PERSONNEL POLICIES AND PROGRAMS OF
THE COMMISSION; AND
VI. PROVIDING A MECHANISM FOR WINDING UP THE OPERATIONS OF THE COMMIS-
SION AND THE EQUITABLE DISPOSITION OF ANY SURPLUS FUNDS THAT MAY EXIST
S. 8007 26 A. 9007
AFTER THE TERMINATION OF THIS COMPACT AFTER THE PAYMENT OR RESERVING OF
ALL OF ITS DEBTS AND OBLIGATIONS.
6. GENERAL PROVISIONS. A. THE COMMISSION SHALL PUBLISH ITS BYLAWS AND
RULES, AND ANY AMENDMENTS THERETO, IN A CONVENIENT FORM ON THE WEBSITE
OF THE COMMISSION.
B. THE COMMISSION SHALL MAINTAIN ITS FINANCIAL RECORDS IN ACCORDANCE
WITH THE BYLAWS.
C. THE COMMISSION SHALL MEET AND TAKE SUCH ACTIONS AS ARE CONSISTENT
WITH THE PROVISIONS OF THIS COMPACT AND THE BYLAWS.
7. POWERS OF THE COMMISSION. THE COMMISSION SHALL HAVE THE FOLLOWING
POWERS:
A. TO PROMULGATE UNIFORM RULES TO FACILITATE AND COORDINATE IMPLEMEN-
TATION AND ADMINISTRATION OF THIS COMPACT. THE RULES SHALL HAVE THE
FORCE AND EFFECT OF LAW AND SHALL BE BINDING IN ALL PARTY STATES;
B. TO BRING AND PROSECUTE LEGAL PROCEEDINGS OR ACTIONS IN THE NAME OF
THE COMMISSION, PROVIDED THAT THE STANDING OF ANY LICENSING BOARD TO SUE
OR BE SUED UNDER APPLICABLE LAW SHALL NOT BE AFFECTED;
C. TO PURCHASE AND MAINTAIN INSURANCE AND BONDS;
D. TO BORROW, ACCEPT OR CONTRACT FOR SERVICES OF PERSONNEL, INCLUDING,
BUT NOT LIMITED TO, EMPLOYEES OF A PARTY STATE OR NONPROFIT ORGANIZA-
TIONS;
E. TO COOPERATE WITH OTHER ORGANIZATIONS THAT ADMINISTER STATE
COMPACTS RELATED TO THE REGULATION OF NURSING, INCLUDING BUT NOT LIMITED
TO SHARING ADMINISTRATIVE OR STAFF EXPENSES, OFFICE SPACE OR OTHER
RESOURCES;
F. TO HIRE EMPLOYEES, ELECT OR APPOINT OFFICERS, FIX COMPENSATION,
DEFINE DUTIES, GRANT SUCH INDIVIDUALS APPROPRIATE AUTHORITY TO CARRY OUT
THE PURPOSES OF THIS COMPACT, AND TO ESTABLISH THE COMMISSION'S PERSON-
NEL POLICIES AND PROGRAMS RELATING TO CONFLICTS OF INTEREST, QUALIFICA-
TIONS OF PERSONNEL AND OTHER RELATED PERSONNEL MATTERS;
G. TO ACCEPT ANY AND ALL APPROPRIATE DONATIONS, GRANTS AND GIFTS OF
MONEY, EQUIPMENT, SUPPLIES, MATERIALS AND SERVICES, AND TO RECEIVE,
UTILIZE AND DISPOSE OF THE SAME; PROVIDED THAT AT ALL TIMES THE COMMIS-
SION SHALL AVOID ANY APPEARANCE OF IMPROPRIETY OR CONFLICT OF INTEREST;
H. TO LEASE, PURCHASE, ACCEPT APPROPRIATE GIFTS OR DONATIONS OF, OR
OTHERWISE TO OWN, HOLD, IMPROVE OR USE, ANY PROPERTY, WHETHER REAL,
PERSONAL OR MIXED; PROVIDED THAT AT ALL TIMES THE COMMISSION SHALL AVOID
ANY APPEARANCE OF IMPROPRIETY;
I. TO SELL, CONVEY, MORTGAGE, PLEDGE, LEASE, EXCHANGE, ABANDON OR
OTHERWISE DISPOSE OF ANY PROPERTY, WHETHER REAL, PERSONAL OR MIXED;
J. TO ESTABLISH A BUDGET AND MAKE EXPENDITURES;
K. TO BORROW MONEY;
L. TO APPOINT COMMITTEES, INCLUDING ADVISORY COMMITTEES COMPRISED OF
ADMINISTRATORS, STATE NURSING REGULATORS, STATE LEGISLATORS OR THEIR
REPRESENTATIVES, AND CONSUMER REPRESENTATIVES, AND OTHER SUCH INTERESTED
PERSONS;
M. TO PROVIDE AND RECEIVE INFORMATION FROM, AND TO COOPERATE WITH, LAW
ENFORCEMENT AGENCIES;
N. TO ADOPT AND USE AN OFFICIAL SEAL; AND
O. TO PERFORM SUCH OTHER FUNCTIONS AS MAY BE NECESSARY OR APPROPRIATE
TO ACHIEVE THE PURPOSES OF THIS COMPACT CONSISTENT WITH THE STATE REGU-
LATION OF NURSE LICENSURE AND PRACTICE.
8. FINANCING OF THE COMMISSION. A. THE COMMISSION SHALL PAY, OR
PROVIDE FOR THE PAYMENT OF, THE REASONABLE EXPENSES OF ITS ESTABLISH-
MENT, ORGANIZATION AND ONGOING ACTIVITIES.
S. 8007 27 A. 9007
B. THE COMMISSION MAY ALSO LEVY ON AND COLLECT AN ANNUAL ASSESSMENT
FROM EACH PARTY STATE TO COVER THE COST OF ITS OPERATIONS, ACTIVITIES
AND STAFF IN ITS ANNUAL BUDGET AS APPROVED EACH YEAR. THE AGGREGATE
ANNUAL ASSESSMENT AMOUNT, IF ANY, SHALL BE ALLOCATED BASED UPON A FORMU-
LA TO BE DETERMINED BY THE COMMISSION, WHICH SHALL PROMULGATE A RULE
THAT IS BINDING UPON ALL PARTY STATES.
C. THE COMMISSION SHALL NOT INCUR OBLIGATIONS OF ANY KIND PRIOR TO
SECURING THE FUNDS ADEQUATE TO MEET THE SAME; NOR SHALL THE COMMISSION
PLEDGE THE CREDIT OF ANY OF THE PARTY STATES, EXCEPT BY, AND WITH THE
AUTHORITY OF, SUCH PARTY STATE.
D. THE COMMISSION SHALL KEEP ACCURATE ACCOUNTS OF ALL RECEIPTS AND
DISBURSEMENTS. THE RECEIPTS AND DISBURSEMENTS OF THE COMMISSION SHALL BE
SUBJECT TO THE AUDIT AND ACCOUNTING PROCEDURES ESTABLISHED UNDER ITS
BYLAWS. HOWEVER, ALL RECEIPTS AND DISBURSEMENTS OF FUNDS HANDLED BY THE
COMMISSION SHALL BE AUDITED YEARLY BY A CERTIFIED OR LICENSED PUBLIC
ACCOUNTANT, AND THE REPORT OF THE AUDIT SHALL BE INCLUDED IN AND BECOME
PART OF THE ANNUAL REPORT OF THE COMMISSION.
9. QUALIFIED IMMUNITY, DEFENSE AND INDEMNIFICATION. A. THE ADMINISTRA-
TORS, OFFICERS, EXECUTIVE DIRECTOR, EMPLOYEES AND REPRESENTATIVES OF THE
COMMISSION SHALL BE IMMUNE FROM SUIT AND LIABILITY, EITHER PERSONALLY OR
IN THEIR OFFICIAL CAPACITY, FOR ANY CLAIM FOR DAMAGE TO OR LOSS OF PROP-
ERTY OR PERSONAL INJURY OR OTHER CIVIL LIABILITY CAUSED BY OR ARISING
OUT OF ANY ACTUAL OR ALLEGED ACT, ERROR OR OMISSION THAT OCCURRED, OR
THAT THE PERSON AGAINST WHOM THE CLAIM IS MADE HAD A REASONABLE BASIS
FOR BELIEVING OCCURRED, WITHIN THE SCOPE OF THE COMMISSION'S EMPLOYMENT,
DUTIES OR RESPONSIBILITIES; PROVIDED THAT NOTHING IN THIS PARAGRAPH
SHALL BE CONSTRUED TO PROTECT ANY SUCH PERSON FROM SUIT OR LIABILITY FOR
ANY DAMAGE, LOSS, INJURY OR LIABILITY CAUSED BY THE INTENTIONAL, WILLFUL
OR WANTON MISCONDUCT OF THAT PERSON.
B. THE COMMISSION SHALL DEFEND ANY ADMINISTRATOR, OFFICER, EXECUTIVE
DIRECTOR, EMPLOYEE OR REPRESENTATIVE OF THE COMMISSION IN ANY CIVIL
ACTION SEEKING TO IMPOSE LIABILITY ARISING OUT OF ANY ACTUAL OR ALLEGED
ACT, ERROR OR OMISSION THAT OCCURRED WITHIN THE SCOPE OF THE COMMIS-
SION'S EMPLOYMENT, DUTIES OR RESPONSIBILITIES, OR THAT THE PERSON
AGAINST WHOM THE CLAIM IS MADE HAD A REASONABLE BASIS FOR BELIEVING
OCCURRED WITHIN THE SCOPE OF THE COMMISSION'S EMPLOYMENT, DUTIES OR
RESPONSIBILITIES; PROVIDED THAT NOTHING HEREIN SHALL BE CONSTRUED TO
PROHIBIT THAT PERSON FROM RETAINING HIS OR HER OWN COUNSEL; AND PROVIDED
FURTHER THAT THE ACTUAL OR ALLEGED ACT, ERROR OR OMISSION DID NOT RESULT
FROM THAT PERSON'S INTENTIONAL, WILLFUL OR WANTON MISCONDUCT.
C. THE COMMISSION SHALL INDEMNIFY AND HOLD HARMLESS ANY ADMINISTRATOR,
OFFICER, EXECUTIVE DIRECTOR, EMPLOYEE OR REPRESENTATIVE OF THE COMMIS-
SION FOR THE AMOUNT OF ANY SETTLEMENT OR JUDGMENT OBTAINED AGAINST THAT
PERSON ARISING OUT OF ANY ACTUAL OR ALLEGED ACT, ERROR OR OMISSION THAT
OCCURRED WITHIN THE SCOPE OF THE COMMISSION'S EMPLOYMENT, DUTIES OR
RESPONSIBILITIES, OR THAT SUCH PERSON HAD A REASONABLE BASIS FOR BELIEV-
ING OCCURRED WITHIN THE SCOPE OF THE COMMISSION'S EMPLOYMENT, DUTIES OR
RESPONSIBILITIES, PROVIDED THAT THE ACTUAL OR ALLEGED ACT, ERROR OR
OMISSION DID NOT RESULT FROM THE INTENTIONAL, WILLFUL OR WANTON MISCON-
DUCT OF THAT PERSON.
§ 8908. RULEMAKING. 1. RULEMAKING. A. THE COMMISSION SHALL EXERCISE
ITS RULEMAKING POWERS PURSUANT TO THE CRITERIA SET FORTH IN THIS ARTICLE
AND THE RULES ADOPTED THEREUNDER. RULES AND AMENDMENTS SHALL BECOME
BINDING AS OF THE DATE SPECIFIED IN EACH RULE OR AMENDMENT AND SHALL
HAVE THE SAME FORCE AND EFFECT AS PROVISIONS OF THIS COMPACT.
S. 8007 28 A. 9007
B. RULES OR AMENDMENTS TO THE RULES SHALL BE ADOPTED AT A REGULAR OR
SPECIAL MEETING OF THE COMMISSION.
2. NOTICE. A. PRIOR TO PROMULGATION AND ADOPTION OF A FINAL RULE OR
RULES BY THE COMMISSION, AND AT LEAST SIXTY DAYS IN ADVANCE OF THE MEET-
ING AT WHICH THE RULE WILL BE CONSIDERED AND VOTED UPON, THE COMMISSION
SHALL FILE A NOTICE OF PROPOSED RULEMAKING:
I. ON THE WEBSITE OF THE COMMISSION; AND
II. ON THE WEBSITE OF EACH LICENSING BOARD OR THE PUBLICATION IN WHICH
EACH STATE WOULD OTHERWISE PUBLISH PROPOSED RULES.
B. THE NOTICE OF PROPOSED RULEMAKING SHALL INCLUDE:
I. THE PROPOSED TIME, DATE AND LOCATION OF THE MEETING IN WHICH THE
RULE WILL BE CONSIDERED AND VOTED UPON;
II. THE TEXT OF THE PROPOSED RULE OR AMENDMENT, AND THE REASON FOR THE
PROPOSED RULE;
III. A REQUEST FOR COMMENTS ON THE PROPOSED RULE FROM ANY INTERESTED
PERSON; AND
IV. THE MANNER IN WHICH INTERESTED PERSONS MAY SUBMIT NOTICE TO THE
COMMISSION OF THEIR INTENTION TO ATTEND THE PUBLIC HEARING AND ANY WRIT-
TEN COMMENTS.
C. PRIOR TO ADOPTION OF A PROPOSED RULE, THE COMMISSION SHALL ALLOW
PERSONS TO SUBMIT WRITTEN DATA, FACTS, OPINIONS AND ARGUMENTS, WHICH
SHALL BE MADE AVAILABLE TO THE PUBLIC.
3. PUBLIC HEARINGS ON RULES. A. THE COMMISSION SHALL GRANT AN OPPORTU-
NITY FOR A PUBLIC HEARING BEFORE IT ADOPTS A RULE OR AMENDMENT.
B. THE COMMISSION SHALL PUBLISH THE PLACE, TIME AND DATE OF THE SCHED-
ULED PUBLIC HEARING.
I. HEARINGS SHALL BE CONDUCTED IN A MANNER PROVIDING EACH PERSON WHO
WISHES TO COMMENT A FAIR AND REASONABLE OPPORTUNITY TO COMMENT ORALLY OR
IN WRITING. ALL HEARINGS WILL BE RECORDED, AND A COPY WILL BE MADE
AVAILABLE UPON REQUEST.
II. NOTHING IN THIS SECTION SHALL BE CONSTRUED AS REQUIRING A SEPARATE
HEARING ON EACH RULE. RULES MAY BE GROUPED FOR THE CONVENIENCE OF THE
COMMISSION AT HEARINGS REQUIRED BY THIS SECTION.
C. IF NO ONE APPEARS AT THE PUBLIC HEARING, THE COMMISSION MAY PROCEED
WITH PROMULGATION OF THE PROPOSED RULE.
D. FOLLOWING THE SCHEDULED HEARING DATE, OR BY THE CLOSE OF BUSINESS
ON THE SCHEDULED HEARING DATE IF THE HEARING WAS NOT HELD, THE COMMIS-
SION SHALL CONSIDER ALL WRITTEN AND ORAL COMMENTS RECEIVED.
4. VOTING ON RULES. THE COMMISSION SHALL, BY MAJORITY VOTE OF ALL
ADMINISTRATORS, TAKE FINAL ACTION ON THE PROPOSED RULE AND SHALL DETER-
MINE THE EFFECTIVE DATE OF THE RULE, IF ANY, BASED ON THE RULEMAKING
RECORD AND THE FULL TEXT OF THE RULE.
5. EMERGENCY RULES. UPON DETERMINATION THAT AN EMERGENCY EXISTS, THE
COMMISSION MAY CONSIDER AND ADOPT AN EMERGENCY RULE WITHOUT PRIOR
NOTICE, OPPORTUNITY FOR COMMENT OR HEARING, PROVIDED THAT THE USUAL
RULEMAKING PROCEDURES PROVIDED IN THIS COMPACT AND IN THIS SECTION SHALL
BE RETROACTIVELY APPLIED TO THE RULE AS SOON AS REASONABLY POSSIBLE, IN
NO EVENT LATER THAN NINETY DAYS AFTER THE EFFECTIVE DATE OF THE RULE.
FOR THE PURPOSES OF THIS PROVISION, AN EMERGENCY RULE IS ONE THAT MUST
BE ADOPTED IMMEDIATELY IN ORDER TO:
A. MEET AN IMMINENT THREAT TO PUBLIC HEALTH, SAFETY OR WELFARE;
B. PREVENT A LOSS OF THE COMMISSION OR PARTY STATE FUNDS; OR
C. MEET A DEADLINE FOR THE PROMULGATION OF AN ADMINISTRATIVE RULE THAT
IS REQUIRED BY FEDERAL LAW OR RULE.
6. REVISIONS. THE COMMISSION MAY DIRECT REVISIONS TO A PREVIOUSLY
ADOPTED RULE OR AMENDMENT FOR PURPOSES OF CORRECTING TYPOGRAPHICAL
S. 8007 29 A. 9007
ERRORS, ERRORS IN FORMAT, ERRORS IN CONSISTENCY OR GRAMMATICAL ERRORS.
PUBLIC NOTICE OF ANY REVISIONS SHALL BE POSTED ON THE WEBSITE OF THE
COMMISSION. THE REVISION SHALL BE SUBJECT TO CHALLENGE BY ANY PERSON FOR
A PERIOD OF THIRTY DAYS AFTER POSTING. THE REVISION MAY BE CHALLENGED
ONLY ON GROUNDS THAT THE REVISION RESULTS IN A MATERIAL CHANGE TO A
RULE. A CHALLENGE SHALL BE MADE IN WRITING, AND DELIVERED TO THE
COMMISSION, PRIOR TO THE END OF THE NOTICE PERIOD. IF NO CHALLENGE IS
MADE, THE REVISION WILL TAKE EFFECT WITHOUT FURTHER ACTION. IF THE
REVISION IS CHALLENGED, THE REVISION MAY NOT TAKE EFFECT WITHOUT THE
APPROVAL OF THE COMMISSION.
§ 8909. OVERSIGHT, DISPUTE RESOLUTION AND ENFORCEMENT. 1. OVERSIGHT.
A. EACH PARTY STATE SHALL ENFORCE THIS COMPACT AND TAKE ALL ACTIONS
NECESSARY AND APPROPRIATE TO EFFECTUATE THIS COMPACT'S PURPOSES AND
INTENT.
B. THE COMMISSION SHALL BE ENTITLED TO RECEIVE SERVICE OF PROCESS IN
ANY PROCEEDING THAT MAY AFFECT THE POWERS, RESPONSIBILITIES OR ACTIONS
OF THE COMMISSION, AND SHALL HAVE STANDING TO INTERVENE IN SUCH A
PROCEEDING FOR ALL PURPOSES. FAILURE TO PROVIDE SERVICE OF PROCESS IN
SUCH PROCEEDING TO THE COMMISSION SHALL RENDER A JUDGMENT OR ORDER VOID
AS TO THE COMMISSION, THIS COMPACT OR PROMULGATED RULES.
2. DEFAULT, TECHNICAL ASSISTANCE AND TERMINATION. A. IF THE COMMISSION
DETERMINES THAT A PARTY STATE HAS DEFAULTED IN THE PERFORMANCE OF ITS
OBLIGATIONS OR RESPONSIBILITIES UNDER THIS COMPACT OR THE PROMULGATED
RULES, THE COMMISSION SHALL:
I. PROVIDE WRITTEN NOTICE TO THE DEFAULTING STATE AND OTHER PARTY
STATES OF THE NATURE OF THE DEFAULT, THE PROPOSED MEANS OF CURING THE
DEFAULT OR ANY OTHER ACTION TO BE TAKEN BY THE COMMISSION; AND
II. PROVIDE REMEDIAL TRAINING AND SPECIFIC TECHNICAL ASSISTANCE
REGARDING THE DEFAULT.
B. IF A STATE IN DEFAULT FAILS TO CURE THE DEFAULT, THE DEFAULTING
STATE'S MEMBERSHIP IN THIS COMPACT MAY BE TERMINATED UPON AN AFFIRMATIVE
VOTE OF A MAJORITY OF THE ADMINISTRATORS, AND ALL RIGHTS, PRIVILEGES AND
BENEFITS CONFERRED BY THIS COMPACT MAY BE TERMINATED ON THE EFFECTIVE
DATE OF TERMINATION. A CURE OF THE DEFAULT DOES NOT RELIEVE THE OFFEND-
ING STATE OF OBLIGATIONS OR LIABILITIES INCURRED DURING THE PERIOD OF
DEFAULT.
C. TERMINATION OF MEMBERSHIP IN THIS COMPACT SHALL BE IMPOSED ONLY
AFTER ALL OTHER MEANS OF SECURING COMPLIANCE HAVE BEEN EXHAUSTED. NOTICE
OF INTENT TO SUSPEND OR TERMINATE SHALL BE GIVEN BY THE COMMISSION TO
THE GOVERNOR OF THE DEFAULTING STATE AND TO THE EXECUTIVE OFFICER OF THE
DEFAULTING STATE'S LICENSING BOARD AND EACH OF THE PARTY STATES.
D. A STATE WHOSE MEMBERSHIP IN THIS COMPACT HAS BEEN TERMINATED IS
RESPONSIBLE FOR ALL ASSESSMENTS, OBLIGATIONS AND LIABILITIES INCURRED
THROUGH THE EFFECTIVE DATE OF TERMINATION, INCLUDING OBLIGATIONS THAT
EXTEND BEYOND THE EFFECTIVE DATE OF TERMINATION.
E. THE COMMISSION SHALL NOT BEAR ANY COSTS RELATED TO A STATE THAT IS
FOUND TO BE IN DEFAULT OR WHOSE MEMBERSHIP IN THIS COMPACT HAS BEEN
TERMINATED UNLESS AGREED UPON IN WRITING BETWEEN THE COMMISSION AND THE
DEFAULTING STATE.
F. THE DEFAULTING STATE MAY APPEAL THE ACTION OF THE COMMISSION BY
PETITIONING THE U.S. DISTRICT COURT FOR THE DISTRICT OF COLUMBIA OR THE
FEDERAL DISTRICT IN WHICH THE COMMISSION HAS ITS PRINCIPAL OFFICES. THE
PREVAILING PARTY SHALL BE AWARDED ALL COSTS OF SUCH LITIGATION, INCLUD-
ING REASONABLE ATTORNEYS' FEES.
S. 8007 30 A. 9007
3. DISPUTE RESOLUTION. A. UPON REQUEST BY A PARTY STATE, THE COMMIS-
SION SHALL ATTEMPT TO RESOLVE DISPUTES RELATED TO THE COMPACT THAT ARISE
AMONG PARTY STATES AND BETWEEN PARTY AND NON-PARTY STATES.
B. THE COMMISSION SHALL PROMULGATE A RULE PROVIDING FOR BOTH MEDIATION
AND BINDING DISPUTE RESOLUTION FOR DISPUTES, AS APPROPRIATE.
C. IN THE EVENT THE COMMISSION CANNOT RESOLVE DISPUTES AMONG PARTY
STATES ARISING UNDER THIS COMPACT:
I. THE PARTY STATES MAY SUBMIT THE ISSUES IN DISPUTE TO AN ARBITRATION
PANEL, WHICH WILL BE COMPRISED OF INDIVIDUALS APPOINTED BY THE COMPACT
ADMINISTRATOR IN EACH OF THE AFFECTED PARTY STATES, AND AN INDIVIDUAL
MUTUALLY AGREED UPON BY THE COMPACT ADMINISTRATORS OF ALL THE PARTY
STATES INVOLVED IN THE DISPUTE.
II. THE DECISION OF A MAJORITY OF THE ARBITRATORS SHALL BE FINAL AND
BINDING.
4. ENFORCEMENT. A. THE COMMISSION, IN THE REASONABLE EXERCISE OF ITS
DISCRETION, SHALL ENFORCE THE PROVISIONS AND RULES OF THIS COMPACT.
B. BY MAJORITY VOTE, THE COMMISSION MAY INITIATE LEGAL ACTION IN THE
U.S. DISTRICT COURT FOR THE DISTRICT OF COLUMBIA OR THE FEDERAL
DISTRICT IN WHICH THE COMMISSION HAS ITS PRINCIPAL OFFICES AGAINST A
PARTY STATE THAT IS IN DEFAULT TO ENFORCE COMPLIANCE WITH THE PROVISIONS
OF THIS COMPACT AND ITS PROMULGATED RULES AND BYLAWS. THE RELIEF SOUGHT
MAY INCLUDE BOTH INJUNCTIVE RELIEF AND DAMAGES. IN THE EVENT JUDICIAL
ENFORCEMENT IS NECESSARY, THE PREVAILING PARTY SHALL BE AWARDED ALL
COSTS OF SUCH LITIGATION, INCLUDING REASONABLE ATTORNEYS' FEES.
C. THE REMEDIES HEREIN SHALL NOT BE THE EXCLUSIVE REMEDIES OF THE
COMMISSION. THE COMMISSION MAY PURSUE ANY OTHER REMEDIES AVAILABLE UNDER
FEDERAL OR STATE LAW.
§ 8910. EFFECTIVE DATE, WITHDRAWAL AND AMENDMENT. 1. EFFECTIVE DATE.
A. THIS COMPACT SHALL BECOME EFFECTIVE AND BINDING ON THE EARLIER OF
THE DATE OF LEGISLATIVE ENACTMENT OF THIS COMPACT INTO LAW BY NO LESS
THAN TWENTY-SIX STATES OR THE EFFECTIVE DATE OF THE CHAPTER OF THE LAWS
OF TWO THOUSAND TWENTY-TWO THAT ENACTED THIS COMPACT. THEREAFTER, THE
COMPACT SHALL BECOME EFFECTIVE AND BINDING AS TO ANY OTHER COMPACTING
STATE UPON ENACTMENT OF THE COMPACT INTO LAW BY THAT STATE. ALL PARTY
STATES TO THIS COMPACT, THAT ALSO WERE PARTIES TO THE PRIOR NURSE LICEN-
SURE COMPACT, SUPERSEDED BY THIS COMPACT, (HEREIN REFERRED TO AS "PRIOR
COMPACT"), SHALL BE DEEMED TO HAVE WITHDRAWN FROM SAID PRIOR COMPACT
WITHIN SIX MONTHS AFTER THE EFFECTIVE DATE OF THIS COMPACT.
B. EACH PARTY STATE TO THIS COMPACT SHALL CONTINUE TO RECOGNIZE A
NURSE'S MULTISTATE LICENSURE PRIVILEGE TO PRACTICE IN THAT PARTY STATE
ISSUED UNDER THE PRIOR COMPACT UNTIL SUCH PARTY STATE HAS WITHDRAWN FROM
THE PRIOR COMPACT.
2. WITHDRAWAL. A. ANY PARTY STATE MAY WITHDRAW FROM THIS COMPACT BY
ENACTING A STATUTE REPEALING THE SAME. A PARTY STATE'S WITHDRAWAL SHALL
NOT TAKE EFFECT UNTIL SIX MONTHS AFTER ENACTMENT OF THE REPEALING STAT-
UTE.
B. A PARTY STATE'S WITHDRAWAL OR TERMINATION SHALL NOT AFFECT THE
CONTINUING REQUIREMENT OF THE WITHDRAWING OR TERMINATED STATE'S LICENS-
ING BOARD TO REPORT ADVERSE ACTIONS AND SIGNIFICANT INVESTIGATIONS
OCCURRING PRIOR TO THE EFFECTIVE DATE OF SUCH WITHDRAWAL OR TERMINATION.
C. NOTHING CONTAINED IN THIS COMPACT SHALL BE CONSTRUED TO INVALIDATE
OR PREVENT ANY NURSE LICENSURE AGREEMENT OR OTHER COOPERATIVE ARRANGE-
MENT BETWEEN A PARTY STATE AND A NON-PARTY STATE THAT IS MADE IN ACCORD-
ANCE WITH THE OTHER PROVISIONS OF THIS COMPACT.
3. AMENDMENT. A. THIS COMPACT MAY BE AMENDED BY THE PARTY STATES. NO
AMENDMENT TO THIS COMPACT SHALL BECOME EFFECTIVE AND BINDING UPON THE
S. 8007 31 A. 9007
PARTY STATES UNLESS AND UNTIL IT IS ENACTED INTO THE LAWS OF ALL PARTY
STATES.
B. REPRESENTATIVES OF NON-PARTY STATES TO THIS COMPACT SHALL BE
INVITED TO PARTICIPATE IN THE ACTIVITIES OF THE COMMISSION, ON A NONVOT-
ING BASIS, PRIOR TO THE ADOPTION OF THIS COMPACT BY ALL STATES.
§ 8911. CONSTRUCTION AND SEVERABILITY. 1. CONSTRUCTION AND SEVERABIL-
ITY. THIS COMPACT SHALL BE LIBERALLY CONSTRUED SO AS TO EFFECTUATE THE
PURPOSES THEREOF. THE PROVISIONS OF THIS COMPACT SHALL BE SEVERABLE, AND
IF ANY PHRASE, CLAUSE, SENTENCE OR PROVISION OF THIS COMPACT IS DECLARED
TO BE CONTRARY TO THE CONSTITUTION OF ANY PARTY STATE OR OF THE UNITED
STATES, OR IF THE APPLICABILITY THEREOF TO ANY GOVERNMENT, AGENCY,
PERSON OR CIRCUMSTANCE IS HELD TO BE INVALID, THE VALIDITY OF THE
REMAINDER OF THIS COMPACT AND THE APPLICABILITY THEREOF TO ANY GOVERN-
MENT, AGENCY, PERSON OR CIRCUMSTANCE SHALL NOT BE AFFECTED THEREBY. IF
THIS COMPACT SHALL BE HELD TO BE CONTRARY TO THE CONSTITUTION OF ANY
PARTY STATE, THIS COMPACT SHALL REMAIN IN FULL FORCE AND EFFECT AS TO
THE REMAINING PARTY STATES AND IN FULL FORCE AND EFFECT AS TO THE PARTY
STATE AFFECTED AS TO ALL SEVERABLE MATTERS.
§ 3. Section 6501 of the education law is amended by adding a new
subdivision 3 to read as follows:
3. A. AN APPLICANT FOR LICENSURE IN A QUALIFIED HIGH-NEED HEALTHCARE
PROFESSION WHO PROVIDES DOCUMENTATION AND ATTESTATION THAT HE OR SHE
HOLDS A LICENSE IN GOOD STANDING FROM ANOTHER STATE, MAY REQUEST THE
ISSUANCE OF A TEMPORARY PRACTICE PERMIT, WHICH, IF GRANTED WILL PERMIT
THE APPLICANT TO WORK UNDER THE SUPERVISION OF A NEW YORK STATE LICENSEE
IN ACCORDANCE WITH REGULATIONS OF THE COMMISSIONER. THE DEPARTMENT MAY
GRANT SUCH TEMPORARY PRACTICE PERMIT WHEN IT APPEARS BASED ON THE APPLI-
CATION AND SUPPORTING DOCUMENTATION RECEIVED THAT THE APPLICANT WILL
MEET THE REQUIREMENTS FOR LICENSURE IN THIS STATE BECAUSE HE OR SHE HAS
PROVIDED DOCUMENTATION AND ATTESTATION THAT THEY HOLD A LICENSE IN GOOD
STANDING FROM ANOTHER STATE WITH SIGNIFICANTLY COMPARABLE LICENSURE
REQUIREMENTS TO THOSE OF THIS STATE, EXCEPT THE DEPARTMENT HAS NOT BEEN
ABLE TO SECURE DIRECT SOURCE VERIFICATION OF THE APPLICANT'S UNDERLYING
CREDENTIALS (E.G., LICENSE VERIFICATION, RECEIPT OF ORIGINAL TRANSCRIPT,
EXPERIENCE VERIFICATION). SUCH PERMIT SHALL BE VALID FOR SIX MONTHS OR
UNTIL TEN DAYS AFTER NOTIFICATION THAT THE APPLICANT DOES NOT MEET THE
QUALIFICATIONS FOR LICENSURE. AN ADDITIONAL SIX MONTHS MAY BE GRANTED
UPON A DETERMINATION BY THE DEPARTMENT THAT THE APPLICANT IS EXPECTED TO
QUALIFY FOR THE FULL LICENSE UPON RECEIPT OF THE REMAINING DIRECT SOURCE
VERIFICATION DOCUMENTS REQUESTED BY THE DEPARTMENT IN SUCH TIME PERIOD
AND THAT THE DELAY IN PROVIDING THE NECESSARY DOCUMENTATION FOR FULL
LICENSURE WAS DUE TO EXTENUATING CIRCUMSTANCES WHICH THE APPLICANT COULD
NOT AVOID.
B. A TEMPORARY PRACTICE PERMIT ISSUED UNDER PARAGRAPH A OF THIS SUBDI-
VISION SHALL BE SUBJECT TO THE FULL DISCIPLINARY AND REGULATORY AUTHORI-
TY OF THE BOARD OF REGENTS AND THE DEPARTMENT, PURSUANT TO THIS TITLE,
AS IF SUCH AUTHORIZATION WERE A PROFESSIONAL LICENSE ISSUED UNDER THIS
ARTICLE.
C. FOR PURPOSES OF THIS SUBDIVISION "HIGH-NEED HEALTHCARE PROFESSION"
MEANS A LICENSED HEALTHCARE PROFESSION OF WHICH THERE ARE AN INSUFFI-
CIENT NUMBER OF LICENSEES TO SERVE IN THE STATE OR A REGION OF THE
STATE, AS DETERMINED BY THE COMMISSIONER OF HEALTH, IN CONSULTATION WITH
THE COMMISSIONER OF EDUCATION. THE COMMISSIONER OF HEALTH SHALL MAIN-
TAIN A LIST OF SUCH LICENSED PROFESSIONS, WHICH SHALL BE POSTED ONLINE
AND UPDATED FROM TIME TO TIME AS WARRANTED.
S. 8007 32 A. 9007
§ 4. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022; provided,
however, section three of this act shall take effect on the ninetieth
day after it shall have become a law. Effective immediately, the addi-
tion, amendment and/or repeal of any rule or regulation necessary for
the implementation of this act on its effective date are authorized to
be made and completed on or before such effective date.
PART C
Section 1. Subdivision 6 of section 571 of the public health law, as
amended by chapter 444 of the laws of 2013, is amended to read as
follows:
6. "Qualified health care professional" means a physician, dentist,
podiatrist, optometrist performing a clinical laboratory test that does
not use an invasive modality as defined in section seventy-one hundred
one of the education law, PHARMACIST, physician assistant, specialist
assistant, nurse practitioner, or midwife, who is licensed and regis-
tered with the state education department.
§ 2. Section 6801 of the education law, is amended by adding a new
subdivision 7 to read as follows:
7. A LICENSED PHARMACIST IS A QUALIFIED HEALTH CARE PROFESSIONAL UNDER
SECTION FIVE HUNDRED SEVENTY-ONE OF THE PUBLIC HEALTH LAW FOR THE
PURPOSES OF DIRECTING A LIMITED SERVICE LABORATORY AND ORDERING AND
ADMINISTERING TESTS APPROVED BY THE FOOD AND DRUG ADMINISTRATION (FDA),
SUBJECT TO CERTIFICATE OF WAIVER REQUIREMENTS ESTABLISHED PURSUANT TO
THE FEDERAL CLINICAL LABORATORY IMPROVEMENT ACT OF NINETEEN HUNDRED
EIGHTY-EIGHT.
§ 3. Subparagraph (iv) of paragraph (a) of subdivision 3 of section
6902 of the education law, as amended by section 2 of part D of chapter
56 of the laws of 2014, is amended to read as follows:
(iv) The practice protocol shall reflect current accepted medical and
nursing practice[. The protocols shall be filed with the department
within ninety days of the commencement of the practice] and may be
updated periodically. The commissioner shall make regulations establish-
ing the procedure for the review of protocols and the disposition of any
issues arising from such review.
§ 4. Paragraph (b) of subdivision 3 of section 6902 of the education
law, as added by section 2 of part D of chapter 56 of the laws of 2014,
is amended to read as follows:
(b) Notwithstanding subparagraph (i) of paragraph (a) of this subdivi-
sion[,]:
(I) a nurse practitioner, certified under section sixty-nine hundred
ten of this article and practicing for more than three thousand six
hundred hours IN A SPECIALTY AREA OTHER THAN PRIMARY CARE OR SUCH OTHER
RELATED AREAS AS DETERMINED BY THE COMMISSIONER OF HEALTH, may comply
with this paragraph in lieu of complying with the requirements of para-
graph (a) of this subdivision relating to collaboration with a physi-
cian, a written practice agreement and written practice protocols. A
nurse practitioner complying with this paragraph shall have collabora-
tive relationships with one or more licensed physicians qualified to
collaborate in the specialty involved or a hospital, licensed under
article twenty-eight of the public health law, that provides services
through licensed physicians qualified to collaborate in the specialty
involved and having privileges at such institution. As evidence that the
nurse practitioner maintains collaborative relationships, the nurse
S. 8007 33 A. 9007
practitioner shall complete and maintain a form, created by the depart-
ment, to which the nurse practitioner shall attest, that describes such
collaborative relationships. For purposes of this paragraph, "collabora-
tive relationships" shall mean that the nurse practitioner shall commu-
nicate, whether in person, by telephone or through written (including
electronic) means, with a licensed physician qualified to collaborate in
the specialty involved or, in the case of a hospital, communicate with a
licensed physician qualified to collaborate in the specialty involved
and having privileges at such hospital, for the purposes of exchanging
information, as needed, in order to provide comprehensive patient care
and to make referrals as necessary. Such form shall also reflect the
nurse practitioner's acknowledgement that if reasonable efforts to
resolve any dispute that may arise with the collaborating physician or,
in the case of a collaboration with a hospital, with a licensed physi-
cian qualified to collaborate in the specialty involved and having priv-
ileges at such hospital, about a patient's care are not successful, the
recommendation of the physician shall prevail. Such form shall be
updated as needed and may be subject to review by the department. The
nurse practitioner shall maintain documentation that supports such
collaborative relationships. Failure to comply with the requirements
found in this paragraph by a nurse practitioner who is not complying
with such provisions of paragraph (a) of this subdivision, shall be
subject to professional misconduct provisions as set forth in article
one hundred thirty of this title.
(II) A NURSE PRACTITIONER, CERTIFIED UNDER SECTION SIXTY-NINE
HUNDRED TEN OF THIS ARTICLE AND PRACTICING FOR MORE THAN THREE THOUSAND
SIX HUNDRED HOURS IN PRIMARY CARE, SHALL BE EXEMPT FROM THE REQUIREMENTS
OF SUBPARAGRAPH (I) OF PARAGRAPH (A) OF THIS SUBDIVISION. FOR PURPOSES
OF THIS PARAGRAPH, "PRIMARY CARE" SHALL INCLUDE BUT NOT BE LIMITED TO
GENERAL PEDIATRICS, GENERAL ADULT MEDICINE, GENERAL GERIATRIC MEDICINE,
GENERAL INTERNAL MEDICINE, OBSTETRICS AND GYNECOLOGY, FAMILY MEDICINE,
OR SUCH OTHER RELATED AREAS AS DETERMINED BY THE COMMISSIONER OF HEALTH.
§ 5. Section 3 of part D of chapter 56 of the laws of 2014, amending
the education law relating to enacting the "nurse practitioners modern-
ization act", as amended by section 10 of part S of chapter 57 of the
laws of 2021, is amended to read as follows:
§ 3. This act shall take effect on the first of January after it shall
have become a law [and shall expire June 30 of the seventh year after it
shall have become a law, when upon such date the provisions of this act
shall be deemed repealed]; provided, however, that effective immediate-
ly, the addition, amendment and/or repeal of any rule or regulation
necessary for the implementation of this act on its effective date is
authorized and directed to be made and completed on or before such
effective date.
§ 6. Section 6908 of the education law is amended by adding a new
subdivision 3 to read as follows:
3. THIS ARTICLE SHALL NOT BE CONSTRUED AS PROHIBITING MEDICATION-RE-
LATED TASKS PROVIDED BY A CERTIFIED MEDICATION AIDE IN ACCORDANCE WITH
REGULATIONS DEVELOPED BY THE COMMISSIONER, IN CONSULTATION WITH THE
COMMISSIONER OF HEALTH. AT A MINIMUM, SUCH REGULATIONS SHALL:
A. SPECIFY THE MEDICATION-RELATED TASKS THAT MAY BE PERFORMED BY
CERTIFIED MEDICATION AIDES PURSUANT TO THIS SUBDIVISION. SUCH TASKS
SHALL INCLUDE THE ADMINISTRATION OF MEDICATIONS WHICH ARE ROUTINE AND
PRE-FILLED OR OTHERWISE PACKAGED IN A MANNER THAT PROMOTES RELATIVE EASE
OF ADMINISTRATION, PROVIDED THAT ADMINISTRATION OF MEDICATIONS BY
INJECTION, STERILE PROCEDURES, AND CENTRAL LINE MAINTENANCE SHALL BE
S. 8007 34 A. 9007
PROHIBITED. PROVIDED, HOWEVER, SUCH PROHIBITION SHALL NOT APPLY TO
INJECTIONS OF INSULIN OR OTHER INJECTIONS FOR DIABETES CARE, TO
INJECTIONS OF LOW MOLECULAR WEIGHT HEPARIN, AND TO PRE-FILLED AUTO-IN-
JECTIONS OF NALOXONE AND EPINEPHRINE FOR EMERGENCY PURPOSES, AND
PROVIDED, FURTHER, THAT ENTITIES EMPLOYING CERTIFIED MEDICATION AIDES
PURSUANT TO THIS SUBDIVISION SHALL ESTABLISH A SYSTEMATIC APPROACH TO
ADDRESS DRUG DIVERSION;
B. PROVIDE THAT MEDICATION-RELATED TASKS PERFORMED BY CERTIFIED MEDI-
CATION AIDES MAY BE PERFORMED ONLY UNDER THE SUPERVISION OF A REGISTERED
PROFESSIONAL NURSE LICENSED IN NEW YORK STATE, AS SET FORTH IN THIS
SUBDIVISION AND SUBDIVISION ELEVEN OF SECTION SIXTY-NINE HUNDRED NINE OF
THIS ARTICLE, WHERE SUCH NURSE IS EMPLOYED BY A RESIDENTIAL HEALTH CARE
FACILITY LICENSED PURSUANT TO ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH
LAW;
C. ESTABLISH A PROCESS BY WHICH A REGISTERED PROFESSIONAL NURSE MAY
ASSIGN MEDICATION-RELATED TASKS TO A CERTIFIED MEDICATION AIDE. SUCH
PROCESS SHALL INCLUDE, BUT NOT BE LIMITED TO:
(I) ALLOWING ASSIGNMENT OF MEDICATION-RELATED TASKS TO A CERTIFIED
MEDICATION AIDE ONLY WHERE SUCH CERTIFIED MEDICATION AIDE HAS DEMON-
STRATED TO THE SATISFACTION OF THE SUPERVISING REGISTERED PROFESSIONAL
NURSE COMPETENCY IN EVERY MEDICATION-RELATED TASK THAT SUCH CERTIFIED
MEDICATION AIDE IS AUTHORIZED TO PERFORM, A WILLINGNESS TO PERFORM SUCH
MEDICATION-RELATED TASKS, AND THE ABILITY TO EFFECTIVELY AND EFFICIENTLY
COMMUNICATE WITH THE INDIVIDUAL RECEIVING SERVICES AND UNDERSTAND SUCH
INDIVIDUAL'S NEEDS;
(II) AUTHORIZING THE SUPERVISING REGISTERED PROFESSIONAL NURSE TO
REVOKE ANY ASSIGNED MEDICATION-RELATED TASK FROM A CERTIFIED MEDICATION
AIDE FOR ANY REASON; AND
(III) AUTHORIZING MULTIPLE REGISTERED PROFESSIONAL NURSES TO JOINTLY
AGREE TO ASSIGN MEDICATION-RELATED TASKS TO A CERTIFIED MEDICATION AIDE,
PROVIDED FURTHER THAT ONLY ONE REGISTERED PROFESSIONAL NURSE SHALL BE
REQUIRED TO DETERMINE IF THE CERTIFIED MEDICATION AIDE HAS DEMONSTRATED
COMPETENCY IN THE MEDICATION-RELATED TASK TO BE PERFORMED;
D. PROVIDE THAT MEDICATION-RELATED TASKS MAY BE PERFORMED ONLY IN
ACCORDANCE WITH AND PURSUANT TO AN AUTHORIZED HEALTH PRACTITIONER'S
ORDERED CARE;
E. PROVIDE THAT ONLY A CERTIFIED NURSE AIDE MAY PERFORM MEDICATION-RE-
LATED TASKS AS A CERTIFIED MEDICATION AIDE WHEN SUCH AIDE HAS:
(I) A VALID NEW YORK STATE NURSE AIDE CERTIFICATE;
(II) A HIGH SCHOOL DIPLOMA, GED OR SIMILAR EDUCATION CREDENTIAL;
(III) EVIDENCE OF BEING AT LEAST EIGHTEEN YEARS OLD;
(IV) AT LEAST ONE YEAR OF EXPERIENCE PROVIDING NURSE AIDE SERVICES IN
AN ARTICLE TWENTY-EIGHT RESIDENTIAL HEALTH CARE FACILITY;
(V) THE ABILITY TO READ, WRITE, AND SPEAK ENGLISH AND TO PERFORM BASIC
MATH SKILLS;
(VI) COMPLETED THE REQUISITE TRAINING AND DEMONSTRATED COMPETENCIES OF
A CERTIFIED MEDICATION AIDE AS DETERMINED BY THE COMMISSIONER IN CONSUL-
TATION WITH THE COMMISSIONER OF HEALTH;
(VII) SUCCESSFULLY COMPLETED COMPETENCY EXAMINATIONS SATISFACTORY TO
THE COMMISSIONER IN CONSULTATION WITH THE COMMISSIONER OF HEALTH; AND
(VIII) MEETS OTHER APPROPRIATE QUALIFICATIONS AS DETERMINED BY THE
COMMISSIONER IN CONSULTATION WITH THE COMMISSIONER OF HEALTH;
F. PROHIBIT A CERTIFIED MEDICATION AIDE FROM HOLDING THEMSELVES OUT,
OR ACCEPTING EMPLOYMENT AS, A PERSON LICENSED TO PRACTICE NURSING UNDER
THE PROVISIONS OF THIS ARTICLE;
S. 8007 35 A. 9007
G. PROVIDE THAT A CERTIFIED MEDICATION AIDE IS NOT REQUIRED NOR
PERMITTED TO ASSESS THE MEDICATION OR MEDICAL NEEDS OF AN INDIVIDUAL;
H. PROVIDE THAT A CERTIFIED MEDICATION AIDE SHALL NOT BE AUTHORIZED TO
PERFORM ANY MEDICATION-RELATED TASKS OR ACTIVITIES PURSUANT TO THIS
SUBDIVISION THAT ARE OUTSIDE THE SCOPE OF PRACTICE OF A LICENSED PRACTI-
CAL NURSE OR ANY MEDICATION-RELATED TASKS THAT HAVE NOT BEEN APPROPRI-
ATELY ASSIGNED BY THE SUPERVISING REGISTERED PROFESSIONAL NURSE;
I. PROVIDE THAT A CERTIFIED MEDICATION AIDE SHALL DOCUMENT ALL MEDICA-
TION-RELATED TASKS PROVIDED TO AN INDIVIDUAL, INCLUDING MEDICATION
ADMINISTRATION TO EACH INDIVIDUAL THROUGH THE USE OF A MEDICATION ADMIN-
ISTRATION RECORD; AND
J. PROVIDE THAT THE SUPERVISING REGISTERED PROFESSIONAL NURSE SHALL
RETAIN THE DISCRETION TO DECIDE WHETHER TO ASSIGN MEDICATION-RELATED
TASKS TO CERTIFIED MEDICATION AIDES UNDER THIS PROGRAM AND SHALL NOT BE
SUBJECT TO COERCION, RETALIATION, OR THE THREAT OF RETALIATION.
§ 7. Section 6909 of the education law is amended by adding a new
subdivision 11 to read as follows:
11. A REGISTERED PROFESSIONAL NURSE, WHILE WORKING FOR A RESIDENTIAL
HEALTH CARE FACILITY LICENSED PURSUANT TO ARTICLE TWENTY-EIGHT OF THE
PUBLIC HEALTH LAW, MAY, IN ACCORDANCE WITH THIS SUBDIVISION, ASSIGN
CERTIFIED MEDICATION AIDES TO PERFORM MEDICATION-RELATED TASKS FOR INDI-
VIDUALS PURSUANT TO THE PROVISIONS OF SUBDIVISION THREE OF SECTION
SIXTY-NINE HUNDRED EIGHT OF THIS ARTICLE AND SUPERVISE CERTIFIED MEDICA-
TION AIDES WHO PERFORM ASSIGNED MEDICATION-RELATED TASKS.
§ 8. Paragraph (a) of subdivision 3 of section 2803-j of the public
health law, as added by chapter 717 of the laws of 1989, is amended to
read as follows:
(a) Identification of individuals who have successfully completed a
nurse aide training and competency evaluation program, [or] a nurse aide
competency evaluation program, OR A MEDICATION AIDE PROGRAM;
§ 9. Subdivision 6 of section 6527 of the education law is amended by
adding a new paragraph (h) to read as follows:
(H) ADMINISTERING TESTS TO DETERMINE THE PRESENCE OF SARS-COV-2 OR ITS
ANTIBODIES, INFLUENZA VIRUS OR RESPIRATORY SYNCYTIAL VIRUS.
§ 10. Subdivision 4 of section 6909 of the education law is amended by
adding a new paragraph (h) to read as follows:
(H) ADMINISTERING TESTS TO DETERMINE THE PRESENCE OF SARS-COV-2 OR ITS
ANTIBODIES, INFLUENZA VIRUS OR RESPIRATORY SYNCYTIAL VIRUS.
§ 11. Section 6909 of the education law is amended by adding a new
subdivision 11 to read as follows:
11. A REGISTERED PROFESSIONAL NURSE OR CERTIFIED NURSE PRACTITIONER
MAY, IN ACCORDANCE WITH THIS SUBDIVISION, ASSIGN THE TASK OF ADMINISTER-
ING TESTS TO DETERMINE THE PRESENCE OF SARS-COV-2 OR ITS ANTIBODIES,
INFLUENZA VIRUS OR RESPIRATORY SYNCYTIAL VIRUS, TO AN INDIVIDUAL,
PROVIDED THAT:
(A) PRIOR TO MAKING SUCH ASSIGNMENT THE REGISTERED PROFESSIONAL NURSE
OR CERTIFIED NURSE PRACTITIONER SHALL PROVIDE THE INDIVIDUAL ASSIGNED
SUCH TASK WITH SPECIFIC INSTRUCTIONS FOR PERFORMING THE SPECIMEN
COLLECTION AND CRITERIA FOR IDENTIFYING, REPORTING AND RESPONDING TO
PROBLEMS OR COMPLICATIONS;
(B) THE REGISTERED PROFESSIONAL NURSE OR CERTIFIED NURSE PRACTITIONER
PROVIDES TRAINING TO THE INDIVIDUAL AND PERSONALLY VERIFIES THAT THE
INDIVIDUAL CAN SAFELY AND COMPETENTLY PERFORM THE TASKS ASSIGNED;
(C) THE REGISTERED PROFESSIONAL NURSE OR CERTIFIED NURSE PRACTITIONER
DETERMINES THAT THE INDIVIDUAL IS WILLING TO PERFORM SUCH TASK; AND
S. 8007 36 A. 9007
(D) THE SPECIMEN COLLECTION IS CONSISTENT WITH AN AUTHORIZED HEALTH
PRACTITIONER'S ORDERED CARE.
§ 12. Section 6527 of the education law is amended by adding a new
subdivision 11 to read as follows:
11. A PHYSICIAN MAY, IN ACCORDANCE WITH THIS SUBDIVISION, ASSIGN THE
TASK OF ADMINISTERING TESTS TO DETERMINE THE PRESENCE OF SARS-COV-2 OR
ITS ANTIBODIES, INFLUENZA VIRUS OR RESPIRATORY SYNCYTIAL VIRUS, TO AN
INDIVIDUAL, PROVIDED THAT:
(A) PRIOR TO MAKING SUCH ASSIGNMENT THE PHYSICIAN SHALL PROVIDE THE
INDIVIDUAL ASSIGNED SUCH TASK WITH SPECIFIC INSTRUCTIONS FOR PERFORMING
THE SPECIMEN COLLECTION AND CRITERIA FOR IDENTIFYING, REPORTING AND
RESPONDING TO PROBLEMS OR COMPLICATIONS;
(B) THE PHYSICIAN PROVIDES TRAINING TO THE INDIVIDUAL AND PERSONALLY
VERIFIES THAT THE INDIVIDUAL CAN SAFELY AND COMPETENTLY PERFORM THE
TASKS ASSIGNED;
(C) THE PHYSICIAN DETERMINES THAT THE INDIVIDUAL IS WILLING TO PERFORM
SUCH TASK; AND
(D) THE SPECIMEN COLLECTION IS CONSISTENT WITH AN AUTHORIZED HEALTH
PRACTITIONER'S ORDERED CARE.
§ 13. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022; provided,
however, that sections six, seven and eight of this act shall expire and
be deemed repealed two years after it shall have become a law.
PART D
Section 1. The social services law is amended by adding a new section
367-w to read as follows:
§ 367-W. HEALTH CARE AND MENTAL HYGIENE WORKER BONUSES. 1. PURPOSE
AND INTENT. NEW YORK'S ESSENTIAL FRONT LINE HEALTH CARE AND MENTAL
HYGIENE WORKERS HAVE SEEN US THROUGH A ONCE-IN-A-CENTURY PUBLIC HEALTH
CRISIS AND TURNED OUR STATE INTO A MODEL FOR BATTLING AND BEATING
COVID-19. TO ATTRACT TALENTED PEOPLE INTO THE PROFESSION AT A TIME OF
SUCH SIGNIFICANT STRAIN WHILE ALSO RETAINING THOSE WHO HAVE BEEN WORKING
SO TIRELESSLY THESE PAST TWO YEARS, WE MUST RECOGNIZE THE EFFORTS OF OUR
HEALTH CARE AND MENTAL HYGIENE WORKFORCE AND REWARD THEM FINANCIALLY FOR
THEIR SERVICE.
TO DO THAT, THE COMMISSIONER OF HEALTH IS HEREBY DIRECTED TO SEEK
ADDITIONAL FEDERAL SPENDING AUTHORITY UNDER SECTION 9817 OF THE AMERICAN
RESCUE PLAN ACT OF 2021 TO MAXIMIZE FEDERAL FINANCIAL PARTICIPATION WITH
RESPECT TO SPENDING ON HOME AND COMMUNITY BASED SERVICES AND TO SEEK
SUCH OTHER FEDERAL APPROVALS AS APPLICABLE, AND, SUBJECT TO FEDERAL
FINANCIAL PARTICIPATION, TO SUPPORT WITH FEDERAL AND STATE FUNDING
BONUSES TO BE MADE AVAILABLE DURING THE STATE FISCAL YEAR OF 2023 TO
RECRUIT, RETAIN, AND REWARD HEALTH CARE AND MENTAL HYGIENE WORKERS.
2. DEFINITIONS. AS USED IN THIS SECTION, THE TERM:
(A) "EMPLOYEE" MEANS CERTAIN FRONT LINE HEALTH CARE AND MENTAL HYGIENE
PRACTITIONERS, TECHNICIANS, ASSISTANTS AND AIDES THAT PROVIDE HANDS ON
HEALTH OR CARE SERVICES TO INDIVIDUALS, WITHOUT REGARD TO WHETHER THE
PERSON WORKS FULL-TIME, PART-TIME, ON A SALARIED, HOURLY, OR TEMPORARY
BASIS, OR AS AN INDEPENDENT CONTRACTOR, THAT RECEIVED AN ANNUALIZED BASE
SALARY OF ONE HUNDRED THOUSAND DOLLARS OR LESS, TO INCLUDE SUCH TITLES
AS DETERMINED BY THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER
OF MENTAL HEALTH, THE COMMISSIONER FOR PEOPLE WITH DEVELOPMENTAL DISA-
BILITIES, THE COMMISSIONER OF ADDICTION SERVICES AND SUPPORTS, AND THE
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COMMISSIONER OF CHILDREN AND FAMILY SERVICES, AS APPLICABLE, AND
APPROVED BY THE DIRECTOR OF BUDGET.
(B) "EMPLOYER" MEANS A PROVIDER ENROLLED IN THE MEDICAL ASSISTANCE
PROGRAM UNDER THIS TITLE THAT EMPLOYS AT LEAST ONE EMPLOYEE AND THAT
BILLS FOR SERVICES UNDER THE STATE PLAN OR A HOME AND COMMUNITY BASED
SERVICES WAIVER AUTHORIZED PURSUANT TO SUBDIVISION (C) OF SECTION NINE-
TEEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT, OR THAT HAS A
PROVIDER AGREEMENT TO BILL FOR SERVICES PROVIDED OR ARRANGED THROUGH A
MANAGED CARE PROVIDER UNDER SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS
TITLE OR A MANAGED LONG TERM CARE PLAN UNDER SECTION FORTY-FOUR HUNDRED
THREE-F OF THE PUBLIC HEALTH LAW, TO INCLUDE:
(I) PROVIDERS AND FACILITIES LICENSED, CERTIFIED OR OTHERWISE AUTHOR-
IZED UNDER ARTICLES TWENTY-EIGHT, THIRTY, THIRTY-SIX OR FORTY OF THE
PUBLIC HEALTH LAW, ARTICLES SIXTEEN, THIRTY-ONE, THIRTY-TWO OR THIRTY-
SIX OF THE MENTAL HYGIENE LAW, ARTICLE SEVEN OF THIS CHAPTER, FISCAL
INTERMEDIARIES UNDER SECTION THREE HUNDRED SIXTY-FIVE-F OF THIS TITLE,
AND PHARMACIES REGISTERED UNDER SECTION SIX THOUSAND EIGHT HUNDRED EIGHT
OF THE EDUCATION LAW;
(II) PROGRAMS FUNDED BY THE OFFICE OF MENTAL HEALTH, THE OFFICE OF
ADDICTION SERVICES AND SUPPORTS, OR THE OFFICE FOR PEOPLE WITH DEVELOP-
MENTAL DISABILITIES; AND
(III) OTHER PROVIDER TYPES DETERMINED BY THE COMMISSIONER AND APPROVED
BY THE DIRECTOR OF THE BUDGET;
(IV) PROVIDED, HOWEVER, THAT UNLESS THE PROVIDER IS SUBJECT TO A
CERTIFICATE OF NEED PROCESS AS A CONDITION OF STATE LICENSURE OR
APPROVAL, SUCH PROVIDER SHALL NOT BE AN EMPLOYER UNDER THIS SECTION
UNLESS AT LEAST TWENTY PERCENT OF THE PROVIDER'S PATIENTS OR PERSONS
SERVED ARE ELIGIBLE FOR SERVICES UNDER THIS TITLE AND TITLE XIX OF THE
FEDERAL SOCIAL SECURITY ACT.
3. TRACKING AND SUBMISSION OF CLAIMS FOR BONUSES. (A) THE COMMISSION-
ER, IN CONSULTATION WITH THE COMMISSIONER OF LABOR AND THE MEDICAID
INSPECTOR GENERAL, AND SUBJECT TO ANY NECESSARY APPROVALS BY THE FEDERAL
CENTERS FOR MEDICARE AND MEDICAID SERVICES, SHALL DEVELOP SUCH FORMS AND
PROCEDURES AS MAY BE NEEDED TO IDENTIFY THE NUMBER OF HOURS EMPLOYEES
WORKED AND TO PROVIDE REIMBURSEMENT TO EMPLOYERS FOR THE PURPOSES OF
FUNDING EMPLOYEE BONUSES IN ACCORDANCE WITH HOURS WORKED DURING THE
VESTING PERIOD.
(B) USING THE FORMS AND PROCESSES DEVELOPED BY THE COMMISSIONER UNDER
THIS SUBDIVISION, EMPLOYERS SHALL, FOR A PERIOD OF TIME SPECIFIED BY THE
COMMISSIONER:
(I) TRACK THE NUMBER OF HOURS THAT EMPLOYEES WORK DURING THE VESTING
PERIOD AND, AS APPLICABLE, THE NUMBER OF PATIENTS SERVED BY THE EMPLOYER
WHO ARE ELIGIBLE FOR SERVICES UNDER THIS TITLE; AND
(II) SUBMIT CLAIMS FOR REIMBURSEMENT OF EMPLOYEE BONUS PAYMENTS. IN
FILLING OUT THE INFORMATION REQUIRED TO SUBMIT SUCH CLAIMS, EMPLOYERS
SHALL USE INFORMATION OBTAINED FROM TRACKING REQUIRED PURSUANT TO PARA-
GRAPH (A) OF THIS SUBDIVISION AND PROVIDE SUCH OTHER INFORMATION AS MAY
BE PRESCRIBED BY THE COMMISSIONER. IN DETERMINING AN EMPLOYEE'S ANNUAL-
IZED BASE SALARY, THE EMPLOYER SHALL USE INFORMATION BASED ON PAYROLL
RECORDS FROM CALENDAR YEAR TWO THOUSAND TWENTY-ONE, IF AVAILABLE TO THE
EMPLOYER.
(C) EMPLOYERS SHALL BE RESPONSIBLE FOR DETERMINING WHETHER AN EMPLOYEE
IS ELIGIBLE UNDER THIS SECTION AND SHALL MAINTAIN AND MAKE AVAILABLE
UPON REQUEST ALL RECORDS, DATA AND INFORMATION THE EMPLOYER RELIED UPON
IN MAKING THE DETERMINATION THAT AN EMPLOYEE WAS ELIGIBLE, IN ACCORDANCE
WITH PARAGRAPH (D) OF THIS SUBDIVISION.
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(D) EMPLOYERS SHALL MAINTAIN CONTEMPORANEOUS RECORDS FOR ALL TRACKING
AND CLAIMS RELATED INFORMATION AND DOCUMENTS REQUIRED TO SUBSTANTIATE
CLAIMS SUBMITTED UNDER THIS SECTION FOR A PERIOD OF NO LESS THAN SIX
YEARS. EMPLOYERS SHALL FURNISH SUCH RECORDS AND INFORMATION, UPON
REQUEST, TO THE COMMISSIONER, THE MEDICAID INSPECTOR GENERAL, THE
COMMISSIONER OF LABOR, THE SECRETARY OF THE UNITED STATES DEPARTMENT OF
HEALTH AND HUMAN SERVICES, AND THE DEPUTY ATTORNEY GENERAL FOR MEDICAID
FRAUD CONTROL.
4. PAYMENT OF WORKER BONUSES. (A) EMPLOYERS SHALL BE REQUIRED TO PAY
BONUSES TO EMPLOYEES PURSUANT TO A SCHEDULE ISSUED BY THE COMMISSIONER
BASED ON THE NUMBER OF HOURS WORKED DURING THE VESTING PERIOD. THE SCHE-
DULE SHALL DIVIDE THE PAYMENT OF BONUSES INTO TWO VESTING PERIODS BASED
ON THE EMPLOYEE'S START DATE WITH THE EMPLOYER. NO EMPLOYEE'S FIRST
VESTING PERIOD MAY BEGIN LATER THAN MARCH THIRTY-FIRST, TWO THOUSAND
TWENTY-THREE, AND IN TOTAL BOTH VESTING PERIODS MAY NOT EXCEED ONE YEAR
IN DURATION. THE SCHEDULE SHALL PROVIDE FOR TOTAL PAYMENTS NOT TO EXCEED
THREE THOUSAND DOLLARS PER EMPLOYEE IN ACCORDANCE WITH THE FOLLOWING:
(I) EMPLOYEES WHO HAVE WORKED AN AVERAGE OF AT LEAST TWENTY BUT LESS
THAN THIRTY HOURS PER WEEK OVER THE COURSE OF A VESTING PERIOD WOULD
RECEIVE A FIVE HUNDRED DOLLAR BONUS FOR THE VESTING PERIOD;
(II) EMPLOYEES WHO HAVE WORKED AN AVERAGE OF AT LEAST THIRTY BUT LESS
THAN FORTY HOURS PER WEEK OVER THE COURSE OF A VESTING PERIOD WOULD
RECEIVE A ONE THOUSAND DOLLAR BONUS FOR SUCH VESTING PERIOD;
(III) EMPLOYEES WHO HAVE WORKED AN AVERAGE OF AT LEAST FORTY HOURS PER
WEEK OVER THE COURSE OF A VESTING PERIOD WOULD RECEIVE A ONE THOUSAND
FIVE HUNDRED DOLLAR BONUS FOR SUCH VESTING PERIOD.
(B) NOTWITHSTANDING PARAGRAPH (A) OF THIS SUBDIVISION, THE COMMISSION-
ER MAY THROUGH REGULATION SPECIFY AN ALTERNATIVE NUMBER OF VESTING PERI-
ODS, PROVIDED THAT TOTAL PAYMENTS DO NOT EXCEED THREE THOUSAND DOLLARS
PER EMPLOYEE.
(C) EMPLOYEES SHALL BE ELIGIBLE FOR BONUSES FOR NO MORE THAN TWO VEST-
ING PERIODS, IN AN AMOUNT EQUAL TO BUT NOT GREATER THAN THREE THOUSAND
DOLLARS PER EMPLOYEE.
(D) ANY BONUS DUE AND PAYABLE TO AN EMPLOYEE UNDER THIS SECTION SHALL
BE MADE BY THE EMPLOYER NO LATER THAN THIRTY DAYS AFTER THE BONUS IS
PAID TO THE EMPLOYER.
(E) NO PORTION OF ANY DOLLARS RECEIVED FROM CLAIMS UNDER SUBPARAGRAPH
(II) OF PARAGRAPH (B) OF SUBDIVISION THREE OF THIS SECTION FOR EMPLOYEE
BONUSES SHALL BE RETURNED TO ANY PERSON OTHER THAN THE EMPLOYEE TO WHOM
THE BONUS IS DUE OR USED TO REDUCE THE TOTAL COMPENSATION AN EMPLOYER IS
OBLIGATED TO PAY TO AN EMPLOYEE UNDER SECTION THIRTY-SIX HUNDRED FOUR-
TEEN-C OF THE PUBLIC HEALTH LAW, SECTION SIX HUNDRED FIFTY-TWO OF THE
LABOR LAW, OR ANY OTHER PROVISIONS OF LAW OR REGULATIONS, OR PURSUANT TO
ANY COLLECTIVELY BARGAINED AGREEMENT.
(F) NO PORTION OF ANY BONUS AVAILABLE PURSUANT TO THIS SUBDIVISION
SHALL BE PAYABLE TO A PERSON WHO HAS BEEN SUSPENDED OR EXCLUDED UNDER
THE MEDICAL ASSISTANCE PROGRAM DURING THE VESTING PERIOD AND AT THE TIME
AN EMPLOYER SUBMITS A CLAIM UNDER THIS SECTION.
5. AUDITS, INVESTIGATIONS AND REVIEWS. (A) THE MEDICAID INSPECTOR
GENERAL SHALL, IN COORDINATION WITH THE COMMISSIONER, CONDUCT AUDITS,
INVESTIGATIONS AND REVIEWS OF EMPLOYERS REQUIRED TO SUBMIT CLAIMS UNDER
THIS SECTION. SUCH CLAIMS, INAPPROPRIATELY PAID, UNDER THIS SECTION
SHALL CONSTITUTE OVERPAYMENTS AS THAT TERM IS DEFINED UNDER THE REGU-
LATIONS GOVERNING THE MEDICAL ASSISTANCE PROGRAM. THE MEDICAID INSPECTOR
GENERAL MAY RECOVER SUCH OVERPAYMENTS TO EMPLOYERS AS IT WOULD AN OVER-
PAYMENT UNDER THE MEDICAL ASSISTANCE PROGRAM, IMPOSE SANCTIONS UP TO AND
S. 8007 39 A. 9007
INCLUDING EXCLUSION FROM THE MEDICAL ASSISTANCE PROGRAM, IMPOSE PENAL-
TIES, AND TAKE ANY OTHER ACTION AUTHORIZED BY LAW WHERE:
(I) AN EMPLOYER CLAIMS A BONUS NOT DUE TO AN EMPLOYEE OR A BONUS
AMOUNT IN EXCESS OF THE CORRECT BONUS AMOUNT DUE TO AN EMPLOYEE;
(II) AN EMPLOYER CLAIMS, RECEIVES AND FAILS TO PAY ANY PART OF THE
BONUS DUE TO A DESIGNATED EMPLOYEE;
(III) AN EMPLOYER FAILS TO CLAIM A BONUS DUE TO AN EMPLOYEE.
(B) ANY EMPLOYER IDENTIFIED IN PARAGRAPH (A) OF THIS SUBDIVISION WHO
FAILS TO IDENTIFY, CLAIM AND PAY ANY BONUS FOR MORE THAN TEN PERCENT OF
ITS EMPLOYEES ELIGIBLE FOR THE BONUS SHALL ALSO BE SUBJECT TO ADDITIONAL
PENALTIES UNDER SUBDIVISION FOUR OF SECTION ONE HUNDRED FORTY-FIVE-B OF
THIS ARTICLE.
(C) ANY EMPLOYER WHO FAILS TO PAY ANY PART OF THE BONUS PAYMENT TO A
DESIGNATED EMPLOYEE SHALL REMAIN LIABLE TO PAY SUCH BONUS TO THAT
EMPLOYEE, REGARDLESS OF ANY RECOVERY, SANCTION OR PENALTY THE MEDICAID
INSPECTOR GENERAL MAY IMPOSE.
(D) IN ALL INSTANCES RECOVERY OF INAPPROPRIATE BONUS PAYMENTS SHALL BE
RECOVERED FROM THE EMPLOYER. THE EMPLOYER SHALL NOT HAVE THE RIGHT TO
RECOVER ANY INAPPROPRIATELY PAID BONUS FROM THE EMPLOYEE.
(E) WHERE THE MEDICAID INSPECTOR GENERAL SANCTIONS AN EMPLOYER FOR
VIOLATIONS UNDER THIS SECTION, THEY MAY ALSO SANCTION ANY AFFILIATES AS
DEFINED UNDER THE REGULATIONS GOVERNING THE MEDICAL ASSISTANCE PROGRAM.
6. RULES AND REGULATIONS. THE COMMISSIONER, IN CONSULTATION WITH THE
MEDICAID INSPECTOR GENERAL AS IT RELATES TO SUBDIVISION FIVE OF THIS
SECTION, MAY PROMULGATE RULES, TO IMPLEMENT THIS SECTION PURSUANT TO
EMERGENCY REGULATION; PROVIDED, HOWEVER, THAT THIS PROVISION SHALL NOT
BE CONSTRUED AS REQUIRING THE COMMISSIONER TO ISSUE REGULATIONS TO
IMPLEMENT THIS SECTION.
§ 2. Subparagraphs (iv) and (v) of paragraph (a) of subdivision 4 of
section 145-b of the social services law, as amended by section 1 of
part QQ of chapter 56 of the laws of 2020, are amended to read as
follows:
(iv) such person arranges or contracts, by employment, agreement, or
otherwise, with an individual or entity that the person knows or should
know is suspended or excluded from the medical assistance program at the
time such arrangement or contract regarding activities related to the
medical assistance program is made[.];
(v) SUCH PERSON HAD AN OBLIGATION TO IDENTIFY, CLAIM, AND PAY A BONUS
UNDER SUBDIVISION THREE OF SECTION THREE HUNDRED SIXTY-SEVEN-W OF THIS
ARTICLE AND SUCH PERSON FAILED TO IDENTIFY, CLAIM AND PAY SUCH BONUS.
(VI) For purposes of this paragraph, "person" as used in subparagraph
(i) OF THIS PARAGRAPH does not include recipients of the medical assist-
ance program; and "person" as used in subparagraphs (ii) [--], (III) AND
(iv) OF THIS PARAGRAPH, is as defined in paragraph (e) of subdivision
[(6)] SIX of section three hundred sixty-three-d of this [chapter] ARTI-
CLE; AND "PERSON" AS USED IN SUBPARAGRAPH (V) OF THIS PARAGRAPH INCLUDES
EMPLOYERS AS DEFINED IN SECTION THREE HUNDRED SIXTY-SEVEN-W OF THIS
ARTICLE.
§ 3. Paragraph (c) of subdivision 4 of section 145-b of the social
services law is amended by adding a new subparagraph (iii) to read as
follows:
(III) FOR SUBPARAGRAPH (V) OF PARAGRAPH (A) OF THIS SUBDIVISION, A
MONETARY PENALTY SHALL BE IMPOSED FOR CONDUCT DESCRIBED IN SUBPARAGRAPHS
(I), (II) AND (III) OF PARAGRAPH (A) OF SUBDIVISION FIVE OF SECTION
THREE HUNDRED SIXTY-SEVEN-W OF THIS ARTICLE SHALL NOT EXCEED ONE THOU-
S. 8007 40 A. 9007
SAND DOLLARS PER FAILURE TO IDENTIFY, CLAIM AND PAY A BONUS FOR EACH
EMPLOYEE.
§ 4. Health care and mental hygiene worker bonuses for state employ-
ees. 1. An employee who is employed by a state operated facility, an
institutional or direct-care setting operated by the executive branch of
the State of New York or a public hospital operated by the state univer-
sity of New York and who is deemed substantially equivalent to the defi-
nition of employee pursuant to paragraph (a) of subdivision 2 of section
367-w of the social services law as determined by the commissioner of
health, in consultation with the chancellor of the state university of
New York, the commissioner of the department of civil service, the
director of the office of employee relations, and the commissioners of
other state agencies, as applicable, and approved by the director of
budget, shall be eligible for the health care and mental hygiene worker
bonus. Such bonus shall only be paid to employees that receive an annu-
alized base salary of one hundred thousand dollars or less.
2. Employees shall be eligible for health care and mental hygiene
worker bonuses in an amount up to but not exceeding three thousand
dollars per employee. The payment of bonuses shall be paid based on the
total number of hours worked during two vesting periods based on the
employee's start date with the employer. No employee's first vesting
period may begin later than March thirty-first, two thousand twenty-
three, and in total both vesting periods may not exceed one year in
duration. For each vesting period, payments shall be in accordance with
the following:
(a) employees who have worked an average of at least twenty but less
than thirty hours per week over the course of a vesting period shall
receive a five hundred dollar bonus for the vesting period;
(b) employees who have worked an average of at least thirty but less
than thirty-seven and one half hours per week over the course of a vest-
ing period shall receive a one thousand dollar bonus for such vesting
period; and
(c) employees who have worked an average of at least thirty-seven and
one half hours per week over the course of a vesting period shall
receive a one thousand five hundred dollar bonus for such vesting peri-
od.
§ 5. An employee under this act shall be limited to a bonus of three
thousand dollars per employee without regard to which section or
sections such employee may be eligible.
§ 6. Notwithstanding any provision of law to the contrary, any bonus
payment paid pursuant to this act, to the extent includible in gross
income for federal income tax purposes, shall not be subject to state or
local income tax.
§ 7. This act shall take effect immediately.
PART E
Section 1. Subdivision 1 of section 605 of the public health law, as
amended by section 20 of part E of chapter 56 of the laws of 2013, is
amended to read as follows:
1. A state aid base grant shall be reimbursed to municipalities for
the core public health services identified in section six hundred two of
this title, in an amount of the greater of [sixty-five] ONE DOLLAR AND
THIRTY cents per capita, [for each person in the municipality,] or [six
hundred fifty thousand dollars] SEVEN HUNDRED FIFTY THOUSAND DOLLARS,
provided that the municipality expends at least [six hundred fifty thou-
S. 8007 41 A. 9007
sand dollars] SEVEN HUNDRED FIFTY THOUSAND DOLLARS, for such core public
health services. A municipality must provide all the core public health
services identified in section six hundred two of this title to qualify
for such base grant unless the municipality has the approval of the
commissioner to expend the base grant on a portion of such core public
health services. If any services in such section are not provided, the
commissioner [may] SHALL limit the municipality's per capita or base
grant to reflect the scope of the reduced services, IN AN AMOUNT NOT TO
EXCEED FIVE HUNDRED SEVENTY-SEVEN THOUSAND FIVE HUNDRED DOLLARS. The
commissioner may use the amount that is not granted to contract with
agencies, associations, or organizations to provide such services; or
the health department may use such proportionate share to provide the
services upon approval of the director of the division of the budget.
§ 2. Subdivision 2 of section 605 of the public health law, as amended
by section 1 of part O of chapter 57 of the laws of 2019, is amended to
read as follows:
2. State aid reimbursement for public health services provided by a
municipality under this title, shall be made if the municipality is
providing some or all of the core public health services identified in
section six hundred two of this title, pursuant to an approved applica-
tion for state aid, at a rate of no less than thirty-six per centum,
except for the city of New York which shall receive no less than twenty
per centum, of the difference between the amount of moneys expended by
the municipality for public health services required by section six
hundred two of this title during the fiscal year and the base grant
provided pursuant to subdivision one of this section. PROVIDED, HOWEVER,
THAT A MUNICIPALITY'S FRINGE BENEFIT COSTS SHALL BE ELIGIBLE FOR
REIMBURSEMENT AT A FRINGE BENEFIT RATE NOT TO EXCEED FIFTY PER CENTUM,
AS DEFINED BY SECTION SIX HUNDRED SIXTEEN OF THIS ARTICLE. No such
reimbursement shall be provided for services that are not eligible for
state aid pursuant to this article.
§ 3. Subdivisions 1 and 2 of section 616 of the public health law,
subdivision 1 as amended by section 2 of part O of chapter 57 of the
laws of 2019 and subdivision 2 as added by chapter 901 of the laws of
1986, are amended, and a new subdivision 4 is added to read as follows:
1. The total amount of state aid provided pursuant to this article
shall be limited to the amount of the annual appropriation made by the
legislature. In no event, however, shall such state aid be less than an
amount to provide the full base grant and, as otherwise provided by
subdivision two of section six hundred five of this article, no less
than thirty-six per centum, except for the city of New York which shall
receive no less than twenty per centum, AND REIMBURSEMENT OF A MUNICI-
PALITY'S FRINGE BENEFIT COSTS NOT TO EXCEED A FRINGE BENEFIT RATE OF
FIFTY PER CENTUM AS DEFINED BY SUBDIVISION FOUR OF THIS SECTION, of the
difference between the amount of moneys expended by the municipality for
eligible public health services pursuant to an approved application for
state aid during the fiscal year and the base grant provided pursuant to
subdivision one of section six hundred five of this article.
2. No payments shall be made from moneys appropriated for the purpose
of this article to a municipality for contributions by the municipality
for indirect costs [and fringe benefits, including but not limited to,
employee retirement funds, health insurance and federal old age and
survivors insurance].
4. MONEYS APPROPRIATED FOR THE PURPOSES OF THIS ARTICLE TO A MUNICI-
PALITY MAY INCLUDE REIMBURSEMENT OF A MUNICIPALITY'S FRINGE BENEFITS,
S. 8007 42 A. 9007
INCLUDING BUT NOT LIMITED TO EMPLOYEE RETIREMENT FUNDS, HEALTH INSURANCE
AND FEDERAL OLD AGE AND SURVIVOR'S INSURANCE.
§ 4. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022.
PART F
Section 1. Section 3002 of the public health law is amended by adding
a new subdivision 1-a to read as follows:
1-A. THE STATE EMERGENCY MEDICAL SERVICES COUNCIL SHALL ADVISE THE
COMMISSIONER ON SUCH ISSUES AS THE COMMISSIONER MAY REQUIRE RELATED TO
THE PROVISION OF EMERGENCY MEDICAL SERVICE, SPECIALTY CARE, DESIGNATED
FACILITY CARE, AND DISASTER MEDICAL CARE, AND ASSIST IN THE COORDINATION
OF SUCH. THIS SHALL INCLUDE, BUT IS NOT LIMITED TO, THE RECOMMENDATION,
PERIODIC REVISION, AND APPLICATION OF RULES AND REGULATIONS, APPROPRI-
ATENESS REVIEW STANDARDS, TREATMENT PROTOCOLS, AND QUALITY IMPROVEMENT
STANDARDS. THE STATE EMERGENCY MEDICAL SERVICES COUNCIL SHALL MEET AS
FREQUENTLY AS DETERMINED NECESSARY BY THE COMMISSIONER.
§ 2. Section 3003 of the public health law is amended by adding a new
subdivision 1-a to read as follows:
1-A. EACH REGIONAL EMERGENCY MEDICAL SERVICES COUNCIL SHALL ADVISE THE
STATE EMERGENCY MEDICAL SERVICES COUNCIL, THE COMMISSIONER AND THE
DEPARTMENT ON SUCH ISSUES AS THE STATE EMERGENCY MEDICAL SERVICES COUN-
CIL, THE COMMISSIONER AND THE DEPARTMENT MAY REQUIRE, RELATED TO THE
PROVISION OF EMERGENCY MEDICAL SERVICE, SPECIALTY CARE, DESIGNATED
FACILITY CARE, AND DISASTER MEDICAL CARE, AND ASSIST IN THE REGIONAL
COORDINATION OF SUCH.
§ 3. The public health law is amended by adding a new section 3004 to
read as follows:
§ 3004. EMERGENCY MEDICAL SERVICES QUALITY AND SUSTAINABILITY ASSUR-
ANCE PROGRAM. THE COMMISSIONER, WITH THE ADVICE OF THE STATE EMERGENCY
MEDICAL ADVISORY COMMITTEE, MAY CREATE AN EMERGENCY MEDICAL SERVICES
QUALITY AND SUSTAINABILITY ASSURANCE PROGRAM. STANDARDS AND REQUIRE-
MENTS OF THE QUALITY AND SUSTAINABILITY ASSURANCE PROGRAM MAY INCLUDE
BUT NOT BE LIMITED TO: CLINICAL STANDARDS, QUALITY METRICS, SAFETY STAN-
DARDS, EMERGENCY VEHICLE OPERATOR STANDARDS, CLINICAL COMPETENCIES,
SUSTAINABILITY METRICS AND MINIMUM REQUIREMENTS FOR QUALITY ASSURANCE
AND SUSTAINABILITY ASSURANCE PROGRAMS TO BE FOLLOWED BY EMERGENCY
MEDICAL SERVICES AGENCIES, TO PROMOTE POSITIVE PATIENT OUTCOMES, SAFETY,
AND EMERGENCY MEDICAL SERVICES SYSTEM SUSTAINABILITY THROUGHOUT THE
STATE. THE COMMISSIONER IS HEREBY AUTHORIZED TO PROMULGATE REGULATIONS
RELATED TO THE STANDARDS AND REQUIREMENTS OF THE QUALITY AND SUSTAINA-
BILITY ASSURANCE PROGRAM. QUALITY AND SUSTAINABILITY ASSURANCE PROGRAMS
SHALL REQUIRE EACH EMERGENCY MEDICAL SERVICES AGENCY TO PERFORM REGULAR
AND PERIODIC REVIEW OF QUALITY AND SUSTAINABILITY ASSURANCE PROGRAM
METRICS, IDENTIFICATION OF AGENCY DEFICIENCIES AND STRENGTHS, DEVELOP-
MENT OF PROGRAMS TO IMPROVE AGENCY METRICS, STRENGTHEN SYSTEM SUSTAINA-
BILITY, AND CONTINUOUS MONITORING OF CARE PROVIDED. THE DEPARTMENT MAY
CONTRACT FOR SERVICES TO ASSIST IN THE OVERSIGHT OF THESE METRICS STATE-
WIDE WITH SUBJECT MATTER EXPERTS TO ASSIST IN THE OVERSIGHT OF THESE
METRICS STATEWIDE. THE DEPARTMENT MAY DELEGATE AUTHORITY TO OVERSEE
THESE METRICS AND REGULATIONS TO COUNTIES OR OTHER CONTRACTORS AS DETER-
MINED BY THE COMMISSIONER. EMERGENCY MEDICAL SERVICES AGENCIES THAT DO
NOT MEET THE STANDARDS AND REQUIREMENTS SET FORTH IN THE QUALITY ASSUR-
ANCE PROGRAM SET BY THE COMMISSIONER MAY BE SUBJECT TO ENFORCEMENT
ACTIONS, INCLUDING BUT NOT LIMITED TO REVOCATION, SUSPENSION, PERFORM-
S. 8007 43 A. 9007
ANCE IMPROVEMENT PLANS, OR RESTRICTION FROM SPECIFIC TYPES OF RESPONSE
SUCH AS BUT NOT LIMITED TO SUSPENSION OF ABILITY TO RESPOND TO REQUESTS
FOR EMERGENCY MEDICAL ASSISTANCE OR TO PERFORM EMERGENCY MEDICAL
SERVICES.
§ 4. The public health law is amended by adding a new section 3018 to
read as follows:
§ 3018. STATEWIDE COMPREHENSIVE EMERGENCY MEDICAL SYSTEM PLAN. 1. THE
DEPARTMENT, IN CONSULTATION WITH THE STATE EMERGENCY MEDICAL ADVISORY
COMMITTEE, SHALL DEVELOP AND MAINTAIN A STATEWIDE COMPREHENSIVE EMERGEN-
CY MEDICAL SYSTEM PLAN THAT SHALL PROVIDE FOR A COORDINATED EMERGENCY
MEDICAL SYSTEM IN NEW YORK STATE, INCLUDING BUT NOT BE LIMITED TO:
(A) ESTABLISHING A COMPREHENSIVE STATEWIDE EMERGENCY MEDICAL SYSTEM,
INCORPORATING FACILITIES, TRANSPORTATION, WORKFORCE, COMMUNICATIONS, AND
OTHER TO IMPROVE THE DELIVERY OF EMERGENCY MEDICAL SERVICE AND THEREBY
DECREASE MORBIDITY, HOSPITALIZATION, DISABILITY, AND MORTALITY;
(B) IMPROVING THE ACCESSIBILITY OF HIGH-QUALITY EMERGENCY MEDICAL
SERVICE;
(C) COORDINATING PROFESSIONAL MEDICAL ORGANIZATIONS, HOSPITALS, AND
OTHER PUBLIC AND PRIVATE AGENCIES IN DEVELOPING APPROACHES WHEREBY
PERSONS WHO ARE PRESENTLY USING THE EXISTING EMERGENCY DEPARTMENT FOR
ROUTINE, NONURGENT, PRIMARY MEDICAL CARE WILL BE SERVED APPROPRIATELY
AND ECONOMICALLY; AND
(D) CONDUCTING, PROMOTING, AND ENCOURAGING PROGRAMS OF EDUCATION AND
TRAINING DESIGNED TO UPGRADE THE KNOWLEDGE AND SKILLS OF EMERGENCY
MEDICAL SERVICE PRACTITIONERS TRAINING THROUGHOUT NEW YORK STATE WITH
EMPHASIS ON REGIONS UNDERSERVED BY EMERGENCY MEDICAL SERVICES.
2. THE STATEWIDE COMPREHENSIVE EMERGENCY MEDICAL SYSTEM PLAN SHALL BE
REVIEWED, UPDATED IF NECESSARY, AND PUBLISHED EVERY FIVE YEARS ON THE
DEPARTMENT'S WEBSITE, OR AT SUCH TIMES AS MAY BE NECESSARY TO IMPROVE
THE EFFECTIVENESS AND EFFICIENCY OF THE STATE'S EMERGENCY MEDICAL
SERVICE SYSTEM.
3. EACH REGIONAL EMERGENCY MEDICAL ADVISORY COMMITTEE SHALL DEVELOP
AND MAINTAIN A COMPREHENSIVE REGIONAL EMERGENCY MEDICAL SYSTEM PLAN THAT
SHALL PROVIDE FOR A COORDINATED EMERGENCY MEDICAL SYSTEM WITHIN THE
REGION. SUCH PLANS SHALL BE SUBJECT TO REVIEW BY THE STATE EMERGENCY
MEDICAL ADVISORY COMMITTEE AND APPROVAL BY THE DEPARTMENT.
4. EACH COUNTY SHALL DEVELOP AND MAINTAIN A COMPREHENSIVE COUNTY EMER-
GENCY MEDICAL SYSTEM PLAN THAT SHALL PROVIDE FOR A COORDINATED EMERGENCY
MEDICAL SYSTEM WITHIN THE COUNTY. THE COUNTY OFFICE OF EMERGENCY MEDICAL
SERVICES SHALL BE RESPONSIBLE FOR THE DEVELOPMENT AND MAINTENANCE OF THE
COMPREHENSIVE COUNTY EMERGENCY MEDICAL SYSTEM PLAN. SUCH PLANS SHALL BE
SUBJECT TO REVIEW BY THE REGIONAL EMERGENCY MEDICAL ADVISORY COMMITTEE,
THE STATE ADVISORY COUNCIL AND APPROVAL BY THE DEPARTMENT. THE DEPART-
MENT SHALL BE RESPONSIBLE FOR OVERSIGHT OF EACH COUNTY'S COMPLIANCE WITH
THEIR PLAN.
5. THE COMMISSIONER MAY PROMULGATE REGULATIONS TO ENSURE COMPLIANCE
WITH THIS SECTION.
§ 5. The public health law is amended by adding a new section 3019 to
read as follows:
§ 3019. EMERGENCY MEDICAL SYSTEMS TRAINING PROGRAM. 1. THERE IS HEREBY
ESTABLISHED A TRAINING PROGRAM FOR EMERGENCY MEDICAL SYSTEMS THAT
INCLUDES STUDENTS, EMERGENCY MEDICAL SERVICE PRACTITIONERS, AGENCIES,
FACILITIES, AND PERSONNEL, AND THE COMMISSIONER MAY PROVIDE FUNDING
WITHIN THE AMOUNT APPROPRIATED TO CONDUCT SUCH TRAINING PROGRAMS. UNTIL
SUCH TIME AS THE DEPARTMENT ANNOUNCES THE TRAINING PROGRAM PURSUANT TO
THIS SECTION IS IN EFFECT, ALL CURRENT STANDARDS, CURRICULUMS, AND
S. 8007 44 A. 9007
REQUIREMENTS FOR STUDENTS, EMERGENCY MEDICAL SERVICE PRACTITIONERS,
AGENCIES, FACILITIES, AND PERSONNEL SHALL REMAIN IN EFFECT.
2. THE DEPARTMENT, IN CONSULTATION WITH THE STATE EMERGENCY MEDICAL
ADVISORY COUNCIL, SHALL ESTABLISH MINIMUM EDUCATION STANDARDS, CURRIC-
ULUMS AND REQUIREMENTS FOR ALL EMERGENCY MEDICAL SYSTEM TRAINING
PROGRAMS. NO PERSON SHALL PROFESS TO PROVIDE EMERGENCY MEDICAL SYSTEM
TRAINING WITHOUT THE APPROVAL OF THE DEPARTMENT.
3. THE DEPARTMENT IS AUTHORIZED TO PROVIDE, EITHER DIRECTLY OR THROUGH
CONTRACT, EMERGENCY MEDICAL SYSTEM TRAINING FOR EMERGENCY MEDICAL
SERVICE PRACTITIONERS AND EMERGENCY MEDICAL SYSTEM AGENCY PERSONNEL,
DEVELOP AND DISTRIBUTE TRAINING MATERIALS FOR USE BY INSTRUCTORS, AND TO
RECRUIT ADDITIONAL INSTRUCTORS TO PROVIDE TRAINING.
4. THE DEPARTMENT MAY VISIT AND INSPECT ANY EMERGENCY MEDICAL SYSTEM
TRAINING PROGRAM OR TRAINING CENTER OPERATING UNDER THIS ARTICLE AND THE
REGULATIONS ADOPTED THEREFORE TO ENSURE COMPLIANCE.
5. THE COMMISSIONER SHALL, WITHIN AMOUNTS APPROPRIATED, ESTABLISH A
PUBLIC SERVICE CAMPAIGN TO RECRUIT ADDITIONAL PERSONNEL INTO THE EMER-
GENCY MEDICAL SYSTEM FIELDS.
6. THE COMMISSIONER SHALL, WITHIN AMOUNTS APPROPRIATED, ESTABLISH AN
EMERGENCY MEDICAL SYSTEM MENTAL HEALTH AND WELLNESS PROGRAM THAT
PROVIDES RESOURCES TO EMERGENCY MEDICAL SERVICE PRACTITIONERS TO REDUCE
BURNOUT, PREVENT SUICIDES, AND INCREASE SAFETY.
7. THE DEPARTMENT MAY CREATE OR ADOPT WITH THE APPROVAL OF THE COMMIS-
SIONER ADDITIONAL STANDARDS, TRAINING AND CRITERIA TO BECOME A CREDENT-
IALLED EMERGENCY MEDICAL SERVICE PRACTITIONER TO PROVIDE SPECIALIZED,
ADVANCED, OR OTHER SERVICES THAT FURTHER SUPPORT OR ADVANCE THE EMERGEN-
CY MEDICAL SYSTEM.
§ 6. Section 3008 of the public health law is amended by adding a new
subdivision 8 to read as follows:
8. (A) NOTWITHSTANDING ANY OTHER PROVISION OF LAW, ALL DETERMINATIONS
OF NEED SHALL BE CONSISTENT WITH THE STATE EMERGENCY MEDICAL SYSTEM PLAN
ESTABLISHED IN SECTION THREE THOUSAND EIGHTEEN OF THIS ARTICLE. THE
COMMISSIONER MAY PROMULGATE REGULATIONS TO PROVIDE FOR THE STANDARDS ON
THE DETERMINATION OF NEED. THE DEPARTMENT SHALL ISSUE A NEW EMERGENCY
MEDICAL SYSTEM AGENCY CERTIFICATE ONLY UPON A DETERMINATION THAT A
PUBLIC NEED FOR THE PROPOSED SERVICE HAS BEEN ESTABLISHED PURSUANT TO
REGULATION. IF THE DEPARTMENT DETERMINES THAT A PUBLIC NEED EXISTS FOR
ONLY A PORTION OF A PROPOSED SERVICE, A CERTIFICATE MAY BE ISSUED FOR
THAT PORTION. PRIOR TO REACHING A FINAL DETERMINATION OF NEED, THE
DEPARTMENT SHALL FORWARD A SUMMARY OF THE PROPOSED SERVICE INCLUDING ANY
DOCUMENTATION RECEIVED OR SUBSEQUENT REPORTS CREATED THERETO, TO THE
STATE EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL FOR REVIEW AND RECOM-
MENDATION TO THE DEPARTMENT ON THE APPROVAL OF THE APPLICATION. AN
APPLICANT OR OTHER CONCERNED PARTY MAY APPEAL ANY DETERMINATION MADE BY
THE DEPARTMENT PURSUANT TO THIS SECTION WITHIN FOURTEEN DAYS. APPEALS
SHALL BE HEARD PURSUANT TO THE PROVISIONS OF SECTION TWELVE-A OF THIS
CHAPTER, AND A FINAL DETERMINATION AS TO NEED SHALL BE MADE BY THE
COMMISSIONER UPON REVIEW OF THE REPORT AND RECOMMENDATION OF THE PRESID-
ING ADMINISTRATIVE LAW JUDGE.
(B) NOTWITHSTANDING THE PROVISIONS OF PARAGRAPH (A) OF THIS SUBDIVI-
SION, THE COMMISSIONER MAY PROMULGATE REGULATIONS TO PROVIDE FOR THE
ISSUANCE OF AN EMERGENCY MEDICAL SYSTEM AGENCY CERTIFICATE WITHOUT A
DETERMINATION OF PUBLIC NEED.
§ 7. Subdivision 1 of section 3001 of the public health law, as
amended by chapter 804 of the laws of 1992, is amended to read as
follows:
S. 8007 45 A. 9007
1. "Emergency medical service" means [initial emergency medical
assistance including, but not limited to, the treatment of trauma,
burns, respiratory, circulatory and obstetrical emergencies] CARE OF A
PERSON TO, FROM, AT, IN, OR BETWEEN THE PERSON'S HOME, SCENE OF INJURY,
HOSPITALS, HEALTH CARE FACILITIES, PUBLIC EVENTS OR OTHER LOCATIONS, BY
EMERGENCY MEDICAL SERVICES PRACTITIONERS AS A PATIENT CARE TEAM MEMBER,
FOR EMERGENCY, NON-EMERGENCY, SPECIALTY, LOW ACUITY, PREVENTATIVE, OR
INTERFACILITY CARE; EMERGENCY AND NON-EMERGENCY MEDICAL DISPATCH; COOR-
DINATION OF EMERGENCY MEDICAL SYSTEM EQUIPMENT AND PERSONNEL; ASSESS-
MENT; TREATMENT, TRANSPORTATION, ROUTING, REFERRALS AND COMMUNICATIONS
WITH TREATMENT FACILITIES AND MEDICAL PERSONNEL; PUBLIC EDUCATION, INJU-
RY PREVENTION AND WELLNESS INITIATIVES; ADMINISTRATION OF IMMUNIZATIONS
AS APPROVED BY THE STATE EMERGENCY MEDICAL SERVICES COUNCIL; AND
FOLLOW-UP AND RESTORATIVE CARE.
§ 8. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022.
PART G
Section 1. Notwithstanding any other provision of law, rule, or regu-
lation to the contrary, the following articles of title 8 of the educa-
tion law governing the healthcare professions are hereby REPEALED and
all removed provisions, and all powers authorized pursuant to such
provisions, are hereby added to the public health law under the authori-
ty of the commissioner of health, pursuant to a plan to be proposed not
inconsistent with this section, which shall include the text of the new
laws to be adopted.
Article 131 MEDICINE
Article 131-A DEFINITIONS OF PROFESSIONAL MISCONDUCT APPLICABLE TO
PHYSICIANS, PHYSICIAN'S ASSISTANTS AND SPECIALIST'S ASSISTANTS
Article 131-B PHYSICIAN ASSISTANTS
Article 131-C SPECIALIST ASSISTANTS
Article 132 CHIROPRACTIC
Article 133 DENTISTRY, DENTAL HYGIENE, AND REGISTERED DENTAL ASSISTING
Article 134 LICENSED PERFUSIONISTS
Article 136 PHYSICAL THERAPY AND PHYSICAL THERAPIST ASSISTANTS
Article 137 PHARMACY
Article 137-A REGISTERED PHARMACY TECHNICIANS
Article 139 NURSING
Article 140 PROFESSIONAL MIDWIFERY PRACTICE ACT
Article 141 PODIATRY
Article 143 OPTOMETRY
Article 144 OPHTHALMIC DISPENSING
Article 153 PSYCHOLOGY
Article 154 SOCIAL WORK
Article 155 MASSAGE THERAPY
Article 156 OCCUPATIONAL THERAPY
Article 157 DIETETICS AND NUTRITION
Article 159 SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
Article 160 ACUPUNCTURE
Article 162 ATHLETIC TRAINERS
Article 163 MENTAL HEALTH PRACTITIONERS
Article 164 RESPIRATORY THERAPISTS AND RESPIRATORY THERAPY TECHNICIANS
Article 165 CLINICAL LABORATORY TECHNOLOGY PRACTICE ACT
Article 166 MEDICAL PHYSICS PRACTICE
Article 167 APPLIED BEHAVIOR ANALYSIS
S. 8007 46 A. 9007
Article 168 LICENSED PATHOLOGISTS' ASSISTANTS
§ 2. Transfer of functions, powers, duties and obligations. Notwith-
standing any inconsistent provisions of law to the contrary, effective
January 1, 2023, all functions, powers, duties and obligations of the
education department concerning the professions of medicine, physicians,
physicians assistants, specialist assistants, chiropractic, dentistry,
dental hygiene, registered dental assisting, perfusionists, physical
therapy, physical therapy assistants, pharmacy, registered pharmacy
technicians, nursing, professional midwifery, podiatry, optometry,
ophthalmic dispensing, psychology, social work, massage therapy, occupa-
tional therapy, dietetics and nutrition, speech-language pathologists
and audiologist, acupuncture, athletic trainers, mental health practi-
tioners, respiratory therapists, respiratory therapy technicians, clin-
ical laboratory technology, medical physics, applied behavior analysis,
and licensed pathologists' assistants under title 8 of the education law
shall be transferred to the New York state department of health.
§ 3. Transfer of records. All books, papers and property of the state
education department with respect to the functions, powers and duties
transferred by sections one through nine of this act are to be delivered
to the appropriate offices within the department of health, at such
place and time, and in such manner as the department of health requires.
§ 4. Continuity of authority. For the purpose of all functions,
powers, duties and obligations of the state education department trans-
ferred to and assumed by the department of health, the department of
health shall continue the operation of the provisions previously done by
the state education department, pursuant to sections one through nine of
this act.
§ 5. Completion of unfinished business. Any business or other matter
undertaken or commenced by the state education department pertaining to
or connected with the functions, powers, duties and obligations hereby
transferred and assigned to the department of health and pending on the
effective date of January 1, 2023 shall be conducted and completed by
the department of health in the same manner and under the same terms and
conditions and with the same effect as if conducted and completed by the
state education department.
§ 6. Continuation of rules and regulations. All rules, regulations,
acts, orders, determinations, and decisions of the state education
department in force at the time of such transfer and assumption, shall
continue in force and effect as rules, regulations, acts, orders, deter-
minations and decisions of the department of health until duly modified
or abrogated by the department of health.
§ 7. Terms occurring in laws, contracts and other documents. When-
ever the state education department is referred to or designated in any
law, contract or document pertaining to the functions, powers, obli-
gations and duties hereby transferred and assigned, such reference or
designation shall be deemed to refer to department of health or the
commissioner thereof.
§ 8. Existing rights and remedies preserved. No existing right or
remedy of any character shall be lost, impaired or affected by reason of
sections one through nine of this act.
§ 9. Pending actions or proceedings. No action or proceeding pending
at the time when sections one through nine of this act shall take effect
relating to the functions, powers and duties of the state education
department transferred pursuant to sections one through nine of this
act, brought by or against the state education department or board of
regents shall be affected by any provision of sections one through one
S. 8007 47 A. 9007
hundred forty of this act, but the same may be prosecuted or defended in
the name of commissioner of the department of health. In all such
actions and proceedings, the commissioner of health, upon application to
the court, shall be substituted as a party.
§ 10. This act shall take effect January 1, 2023.
PART H
Section 1. Subdivision 1 of section 91 of part H of chapter 59 of the
laws of 2011, amending the public health law and other laws relating to
general hospital reimbursement for annual rates, as amended by section 2
of part A of chapter 56 of the laws of 2013, is amended to read as
follows:
1. Notwithstanding any inconsistent provision of state law, rule or
regulation to the contrary, subject to federal approval, the year to
year rate of growth of department of health state funds Medicaid spend-
ing shall not exceed the [ten] FIVE year rolling average of the [medical
component of the consumer price index as published by the United States
department of labor, bureau of labor statistics,] MEDICAID SPENDING
ANNUAL GROWTH RATE PROJECTIONS WITHIN THE NATIONAL HEALTH EXPENDITURE
ACCOUNTS PRODUCED BY THE OFFICE OF THE ACTUARY IN THE FEDERAL CENTERS
FOR MEDICARE AND MEDICAID SERVICES for the preceding [ten] FIVE years;
provided, however, that for state fiscal year 2013-14 and for each
fiscal year thereafter, the maximum allowable annual increase in the
amount of department of health state funds Medicaid spending shall be
calculated by multiplying the department of health state funds Medicaid
spending for the previous year, minus the amount of any department of
health state operations spending included therein, by such [ten] FIVE
year rolling average.
§ 2. Paragraph (a) of subdivision 1 of section 92 of part H of chapter
59 of the laws of 2011, amending the public health law and other laws
relating to relating to known and projected department of health state
fund Medicaid expenditures, as amended by section 1 of part A of chapter
57 of the laws of 2021, is amended to read as follows:
(a) For state fiscal years 2011-12 through [2021-22] 2023-24, the
director of the budget, in consultation with the commissioner of health
referenced as "commissioner" for purposes of this section, shall assess
on a quarterly basis, as reflected in quarterly reports pursuant to
subdivision five of this section known and projected department of
health state funds medicaid expenditures by category of service and by
geographic regions, as defined by the commissioner.
§ 3. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022.
PART I
Section 1. 1. Notwithstanding any provision of law to the contrary,
for the state fiscal years beginning April 1, 2022 and ending on March
31, 2024, all department of health Medicaid payments made for services
provided on and after April 1, 2022, shall be subject to a uniform rate
increase of one percent, subject to the approval of the commissioner of
the department of health and director of the budget. Such rate increase
shall be subject to federal financial participation.
2. The following types of payments shall be exempt from increases
pursuant to this section:
S. 8007 48 A. 9007
(a) payments that would violate federal law including, but not limited
to, hospital disproportionate share payments that would be in excess of
federal statutory caps;
(b) payments made by other state agencies including, but not limited
to, those made pursuant to articles 16, 31 and 32 of the mental hygiene
law;
(c) payments the state is obligated to make pursuant to court orders
or judgments;
(d) payments for which the non-federal share does not reflect any
state funding; and
(e) at the discretion of the commissioner of health and the director
of the budget, payments with regard to which it is determined that
application of increases pursuant to this section would result, by oper-
ation of federal law, in a lower federal medical assistance percentage
applicable to such payments.
§ 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022.
PART J
Section 1. Paragraph (c) of subdivision 35 of section 2807-c of the
public health law, as amended by section 32 of part C of chapter 60 of
the laws of 2014, is amended to read as follows:
(c) The base period reported costs and statistics used for rate-set-
ting for operating cost components, including the weights assigned to
diagnostic related groups, shall be updated no less frequently than
every four years and the new base period [shall] MAY be no more than
four years prior to the first applicable rate period that utilizes such
new base period provided, however, that the first updated base period
shall begin on or after April first, two thousand fourteen, but no later
than July first, two thousand fourteen; AND FURTHER PROVIDED THAT THE
UPDATED BASE PERIOD SUBSEQUENT TO JULY FIRST, TWO THOUSAND EIGHTEEN
SHALL BEGIN ON OR AFTER JANUARY FIRST, TWO THOUSAND TWENTY-FOUR.
§ 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022.
PART K
Section 1. The public health law is amended by adding a new section
2825-g to read as follows:
§ 2825-G. HEALTH CARE FACILITY TRANSFORMATION PROGRAM: STATEWIDE IV.
1. A STATEWIDE HEALTH CARE FACILITY TRANSFORMATION PROGRAM IS HEREBY
ESTABLISHED WITHIN THE DEPARTMENT FOR THE PURPOSE OF TRANSFORMING, REDE-
SIGNING, AND STRENGTHENING QUALITY HEALTH CARE SERVICES IN ALIGNMENT
WITH STATEWIDE AND REGIONAL HEALTH CARE NEEDS, AND IN THE ONGOING
PANDEMIC RESPONSE. THE PROGRAM SHALL ALSO PROVIDE FUNDING, SUBJECT TO
LAWFUL APPROPRIATION, IN SUPPORT OF CAPITAL PROJECTS THAT FACILITATE
FURTHERING SUCH TRANSFORMATIONAL GOALS.
2. THE COMMISSIONER SHALL ENTER INTO AN AGREEMENT WITH THE DORMITORY
AUTHORITY OF THE STATE OF NEW YORK PURSUANT TO SECTION SIXTEEN HUNDRED
EIGHTY-R OF THE PUBLIC AUTHORITIES LAW, WHICH SHALL APPLY TO THIS AGREE-
MENT, SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE DIVISION OF THE
BUDGET, FOR THE PURPOSES OF THE DISTRIBUTION, AND ADMINISTRATION OF
AVAILABLE FUNDS, PURSUANT TO SUCH AGREEMENT, AND MADE AVAILABLE PURSUANT
TO THIS SECTION AND APPROPRIATION. SUCH FUNDS MAY BE AWARDED AND
DISTRIBUTED BY THE DEPARTMENT FOR GRANTS TO HEALTH CARE FACILITIES
S. 8007 49 A. 9007
INCLUDING BUT NOT LIMITED TO, HOSPITALS, RESIDENTIAL HEALTH CARE FACILI-
TIES, ADULT CARE FACILITIES LICENSED UNDER TITLE TWO OF ARTICLE SEVEN OF
THE SOCIAL SERVICES LAW, DIAGNOSTIC AND TREATMENT CENTERS, AND CLINICS
LICENSED PURSUANT TO THIS CHAPTER OR THE MENTAL HYGIENE LAW, CHILDREN'S
RESIDENTIAL TREATMENT FACILITIES LICENSED PURSUANT TO ARTICLE THIRTY-ONE
OF THE MENTAL HYGIENE LAW, ASSISTED LIVING PROGRAMS APPROVED BY THE
DEPARTMENT PURSUANT TO SECTION FOUR HUNDRED SIXTY-ONE-L OF THE SOCIAL
SERVICES LAW, BEHAVIORAL HEALTH FACILITIES LICENSED PURSUANT TO ARTICLES
THIRTY-ONE AND THIRTY-TWO OF THE MENTAL HYGIENE LAW, AND INDEPENDENT
PRACTICE ASSOCIATIONS OR ORGANIZATIONS. A COPY OF SUCH AGREEMENT, AND
ANY AMENDMENTS THERETO, SHALL BE PROVIDED BY THE DEPARTMENT TO THE CHAIR
OF THE SENATE FINANCE COMMITTEE, THE CHAIR OF THE ASSEMBLY WAYS AND
MEANS COMMITTEE, AND THE DIRECTOR OF THE DIVISION OF THE BUDGET NO LATER
THAN THIRTY DAYS AFTER SUCH AGREEMENT IS FINALIZED. PROJECTS AWARDED,
IN WHOLE OR PART, UNDER SECTIONS TWENTY-EIGHT HUNDRED TWENTY-FIVE-A AND
TWENTY-EIGHT HUNDRED TWENTY-FIVE-B OF THIS ARTICLE SHALL NOT BE ELIGIBLE
FOR GRANTS OR AWARDS MADE AVAILABLE UNDER THIS SECTION.
3. NOTWITHSTANDING SUBDIVISION TWO OF THIS SECTION OR ANY INCONSISTENT
PROVISION OF LAW TO THE CONTRARY, AND UPON APPROVAL OF THE DIRECTOR OF
THE BUDGET, THE COMMISSIONER MAY, SUBJECT TO THE AVAILABILITY OF LAWFUL
APPROPRIATION, AWARD UP TO FOUR HUNDRED FIFTY MILLION DOLLARS OF THE
FUNDS MADE AVAILABLE PURSUANT TO THIS SECTION FOR UNFUNDED PROJECT
APPLICATIONS SUBMITTED IN RESPONSE TO THE REQUEST FOR APPLICATION NUMBER
18406 ISSUED BY THE DEPARTMENT ON SEPTEMBER THIRTIETH, TWO THOUSAND
TWENTY-ONE PURSUANT TO SECTION TWENTY-EIGHT HUNDRED TWENTY-FIVE-F OF
THIS ARTICLE. AUTHORIZED AMOUNTS TO BE AWARDED PURSUANT TO APPLICATIONS
SUBMITTED IN RESPONSE TO THE REQUEST FOR APPLICATION NUMBER 18406 SHALL
BE AWARDED NO LATER THAN DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-TWO.
PROVIDED, HOWEVER, THAT A MINIMUM OF:
(A) TWENTY-FIVE MILLION DOLLARS OF TOTAL AWARDED FUNDS SHALL BE MADE
TO COMMUNITY-BASED HEALTH CARE PROVIDERS, WHICH FOR PURPOSES OF THIS
SECTION SHALL BE DEFINED AS A DIAGNOSTIC AND TREATMENT CENTER LICENSED
OR GRANTED AN OPERATING CERTIFICATE UNDER THIS ARTICLE;
(B) TWENTY-FIVE MILLION DOLLARS OF TOTAL AWARDED FUNDS SHALL BE MADE
TO A MENTAL HEALTH CLINIC LICENSED OR GRANTED AN OPERATING CERTIFICATE
UNDER ARTICLE THIRTY-ONE OF THE MENTAL HYGIENE LAW; A SUBSTANCE USE
DISORDER TREATMENT CLINIC LICENSED OR GRANTED AN OPERATING CERTIFICATE
UNDER ARTICLE THIRTY-TWO OF THE MENTAL HYGIENE LAW; INDEPENDENT PRACTICE
ASSOCIATIONS OR ORGANIZATIONS; A CLINIC LICENSED OR GRANTED AN OPERATING
CERTIFICATE UNDER ARTICLE SIXTEEN OF THE MENTAL HYGIENE LAW; A HOME CARE
PROVIDER CERTIFIED OR LICENSED PURSUANT TO ARTICLE THIRTY-SIX OF THIS
CHAPTER; OR HOSPICES LICENSED OR GRANTED AN OPERATING CERTIFICATE PURSU-
ANT TO ARTICLE FORTY OF THIS CHAPTER; AND
(C) FIFTY MILLION DOLLARS OF TOTAL AWARDED FUNDS SHALL BE MADE TO
RESIDENTIAL HEALTH CARE FACILITIES OR ADULT CARE FACILITIES.
4. NOTWITHSTANDING SECTIONS ONE HUNDRED TWELVE AND ONE HUNDRED SIXTY-
THREE OF THE STATE FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND ONE
HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOPMENT LAW, OR ANY INCONSISTENT
PROVISION OF LAW TO THE CONTRARY, UP TO TWO HUNDRED MILLION DOLLARS OF
THE FUNDS APPROPRIATED FOR THIS PROGRAM SHALL BE AWARDED, WITHOUT A
COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS, FOR GRANTS TO HEALTH
CARE PROVIDERS FOR PURPOSES OF MODERNIZATION OF AN EMERGENCY DEPARTMENT
OF REGIONAL SIGNIFICANCE. FOR PURPOSES OF THIS SUBDIVISION, AN EMERGENCY
DEPARTMENT SHALL BE CONSIDERED TO HAVE REGIONAL SIGNIFICANCE IF IT: (A)
SERVES AS LEVEL 1 TRAUMA CENTER WITH THE HIGHEST VOLUME IN ITS REGION;
(B) INCLUDES THE CAPACITY TO SEGREGATE PATIENTS WITH COMMUNICABLE
S. 8007 50 A. 9007
DISEASES, TRAUMA OR SEVERE BEHAVIORAL HEALTH ISSUES FROM OTHER PATIENTS
IN THE EMERGENCY DEPARTMENT; (C) PROVIDES TRAINING IN EMERGENCY CARE AND
TRAUMA CARE TO RESIDENTS FROM MULTIPLE HOSPITALS IN THE REGION; AND (D)
SERVES A HIGH PROPORTION OF MEDICAID PATIENTS.
5. (A) NOTWITHSTANDING SECTIONS ONE HUNDRED TWELVE AND ONE HUNDRED
SIXTY-THREE OF THE STATE FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND
ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOPMENT LAW, OR ANY INCON-
SISTENT PROVISION OF LAW TO THE CONTRARY, UP TO SEVEN HUNDRED FIFTY
MILLION DOLLARS OF THE FUNDS APPROPRIATED FOR THIS PROGRAM SHALL BE
AWARDED, WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS, FOR
GRANTS TO HEALTH CARE PROVIDERS (HEREAFTER "APPLICANTS").
(B) AWARDS MADE PURSUANT TO THIS SUBDIVISION SHALL PROVIDE FUNDING
ONLY FOR CAPITAL PROJECTS, TO THE EXTENT LAWFUL APPROPRIATION AND FUND-
ING IS AVAILABLE, TO BUILD INNOVATIVE, PATIENT-CENTERED MODELS OF CARE,
INCREASE ACCESS TO CARE, TO IMPROVE THE QUALITY OF CARE AND TO ENSURE
FINANCIAL SUSTAINABILITY OF HEALTH CARE PROVIDERS.
6. NOTWITHSTANDING SECTIONS ONE HUNDRED TWELVE AND ONE HUNDRED SIXTY-
THREE OF THE STATE FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND ONE
HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOPMENT LAW, OR ANY INCONSISTENT
PROVISION OF LAW TO THE CONTRARY, UP TO ONE HUNDRED FIFTY MILLION
DOLLARS OF THE FUNDS APPROPRIATED FOR THIS PROGRAM SHALL BE AWARDED,
WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS, FOR TECHNO-
LOGICAL AND TELEHEALTH TRANSFORMATION PROJECTS.
7. NOTWITHSTANDING SECTIONS ONE HUNDRED TWELVE AND ONE HUNDRED SIXTY-
THREE OF THE STATE FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND ONE
HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOPMENT LAW, OR ANY INCONSISTENT
PROVISION OF LAW TO THE CONTRARY, UP TO FIFTY MILLION DOLLARS OF THE
FUNDS APPROPRIATED FOR THIS PROGRAM SHALL BE AWARDED, WITHOUT A COMPET-
ITIVE BID OR A REQUEST FOR PROPOSAL PROCESS, TO RESIDENTIAL AND COMMUNI-
TY-BASED ALTERNATIVES TO THE TRADITIONAL MODEL OF NURSING HOME CARE.
8. SELECTION OF AWARDS MADE BY THE DEPARTMENT PURSUANT TO SUBDIVISIONS
THREE, FOUR, FIVE, SIX AND SEVEN OF THIS SECTION SHALL BE CONTINGENT ON
AN EVALUATION PROCESS ACCEPTABLE TO THE COMMISSIONER AND APPROVED BY THE
DIRECTOR OF THE DIVISION OF THE BUDGET. DISBURSEMENT OF AWARDS MAY BE
CONTINGENT ON ACHIEVING CERTAIN PROCESS AND PERFORMANCE METRICS AND
MILESTONES THAT ARE STRUCTURED TO ENSURE THAT THE GOALS OF THE PROJECT
ARE ACHIEVED.
9. THE DEPARTMENT SHALL PROVIDE A REPORT ON A QUARTERLY BASIS TO THE
CHAIRS OF THE SENATE FINANCE, ASSEMBLY WAYS AND MEANS, AND SENATE AND
ASSEMBLY HEALTH COMMITTEES, UNTIL SUCH TIME AS THE DEPARTMENT DETERMINES
THAT THE PROJECTS THAT RECEIVE FUNDING PURSUANT TO THIS SECTION ARE
SUBSTANTIALLY COMPLETE. SUCH REPORTS SHALL BE SUBMITTED NO LATER THAN
SIXTY DAYS AFTER THE CLOSE OF THE QUARTER, AND SHALL INCLUDE, FOR EACH
AWARD, THE NAME OF THE APPLICANT, A DESCRIPTION OF THE PROJECT OR
PURPOSE, THE AMOUNT OF THE AWARD, DISBURSEMENT DATE, AND STATUS OF
ACHIEVEMENT OF PROCESS AND PERFORMANCE METRICS AND MILESTONES PURSUANT
TO SUBDIVISION SIX OF THIS SECTION.
§ 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022.
PART L
Section 1. Subdivision 3 of section 2801-a of the public health law,
as amended by section 57 of part A of chapter 58 of the laws of 2010, is
amended to read as follows:
S. 8007 51 A. 9007
3. The public health and health planning council shall not approve a
certificate of incorporation, articles of organization or application
for establishment unless it is satisfied, insofar as applicable, as to
(a) the public need for the existence of the institution at the time and
place and under the circumstances proposed, provided, however, that in
the case of an institution proposed to be established or operated by an
organization defined in subdivision one of section one hundred seventy-
two-a of the executive law, the needs of the members of the religious
denomination concerned, for care or treatment in accordance with their
religious or ethical convictions, shall be deemed to be public need; (b)
the character, competence, and standing in the community, of the
proposed incorporators, directors, sponsors, stockholders, members,
CONTROLLING PERSONS, or operators; with respect to any proposed incorpo-
rator, director, sponsor, stockholder, member , CONTROLLING PERSON, or
operator who is already or within the past [ten] SEVEN years [has] been
an incorporator, director, sponsor, member, principal stockholder, prin-
cipal member, CONTROLLING PERSON, or operator any hospital OR OTHER
HEALTH-RELATED OR LONG-TERM CARE FACILITY, PROGRAM OR AGENCY, INCLUDING
BUT NOT LIMITED TO, private proprietary home for adults, residence for
adults, or non-profit home for the aged or blind which has been issued
an operating certificate by the state department of social services, or
a halfway house, hostel or other residential facility or institution for
the care, custody or treatment of the mentally disabled which is subject
to approval by the department of mental hygiene, no approval shall be
granted unless the public health and health planning council, having
afforded an adequate opportunity to members of health systems agencies,
if any, having geographical jurisdiction of the area where the institu-
tion is to be located to be heard, shall affirmatively find by substan-
tial evidence as to each such incorporator, director, sponsor, MEMBER,
principal stockholder, PRINCIPAL MEMBER, CONTROLLING PERSON, or operator
that a substantially consistent high level of care is being or was being
rendered in each such hospital, home, residence, halfway house, hostel,
or other residential facility or institution [with] IN which such person
is or was affiliated; for the purposes of this paragraph, the public
health and health planning council shall adopt rules and regulations,
subject to the approval of the commissioner, to establish the criteria
to be used to determine whether a substantially consistent high level of
care has been rendered, provided, however, that there shall not be a
finding that a substantially consistent high level of care has been
rendered where there have been violations of the state hospital code, or
other applicable rules and regulations, that (i) threatened to directly
affect the health, safety or welfare of any patient or resident, and
(ii) were recurrent or were not promptly corrected; (c) the financial
resources of the proposed institution and its sources of future reven-
ues; and (d) such other matters as it shall deem pertinent.
§ 2. Paragraphs (b) and (c) of subdivision 4 of section 2801-a of the
public health law, as amended by section 57 of part A of chapter 58 of
the laws of 2010, are amended to read as follows:
(b) [(i)] Any transfer, assignment or other disposition of [ten
percent or more of] an interest, STOCK, or voting rights in a SOLE
PROPRIETORSHIP, partnership [or], limited liability company, NON-FOR-
PROFIT CORPORATION, OR CORPORATION which is the operator of a hospital
[to a new partner or member] OR ANY TRANSFER, ASSIGNMENT OR OTHER DISPO-
SITION WHICH RESULTS IN THE OWNERSHIP OR CONTROL OF AN INTEREST, STOCK,
OR VOTING RIGHTS IN THAT OPERATOR, shall be approved by the public
health and health planning council, in accordance with the provisions of
S. 8007 52 A. 9007
subdivisions two [and], three, AND THREE-B of this section, except that:
[(A) any such change shall be subject to the approval by the public]
(I) PUBLIC health and health planning council APPROVAL in accordance
with paragraph (b) of [subdivision] SUBDIVISIONS three AND THREE-B of
this section SHALL BE REQUIRED only with respect to [the new partner or
member, and] any [remaining partners or members] PERSON, PARTNER,
MEMBER, OR STOCKHOLDER who [have] HAS not been previously approved for
that [facility] OPERATOR in accordance with [such paragraph, and (B)
such change shall not be subject to paragraph (a) of subdivision three
of this section] PARAGRAPH (B) OF SUBDIVISION THREE AND SUBDIVISION
THREE-B OF THIS SECTION.
(ii) [With] SUCH CHANGE SHALL NOT BE SUBJECT TO THE PUBLIC NEED
ASSESSMENT DESCRIBED IN PARAGRAPH (A) OF SUBDIVISION THREE OF THIS
SECTION.
(III) NO PRIOR APPROVAL OF THE PUBLIC HEALTH AND HEALTH PLANNING COUN-
CIL SHALL BE REQUIRED WITH respect to a transfer, assignment or disposi-
tion [involving less than ten percent of], DIRECTLY OR INDIRECTLY, OF:
(A) an interest, STOCK, or voting rights OF LESS THAN TEN PERCENT in
[such partnership or limited liability company] THE OPERATOR, to [a new]
ANY PERSON, partner [or], member, [no prior approval of the public
health and health planning council shall be required] OR STOCKHOLDER WHO
HAS NOT BEEN PREVIOUSLY APPROVED BY THE PUBLIC HEALTH AND HEALTH PLAN-
NING COUNCIL, OR ITS PREDECESSOR FOR THAT OPERATOR. However, no such
transaction shall be effective unless at least ninety days prior to the
intended effective date thereof, the [partnership or limited liability
company] OPERATOR fully completes and files with the public health and
health planning council notice on a form, to be developed by the public
health and health planning council, which shall disclose such informa-
tion as may reasonably be necessary FOR THE DEPARTMENT TO RECOMMEND AND
for the public health and health planning council to determine whether
it should bar the transaction for any of the reasons set forth in [item
(A), (B), (C) or (D)] CLAUSE ONE, TWO, THREE OR FOUR below, AND HAS
FULLY RESPONDED TO ANY REQUEST FOR ADDITIONAL INFORMATION BY THE DEPART-
MENT ACTING ON BEHALF OF THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL
DURING THE REVIEW PERIOD. SUCH TRANSACTION WILL BE FINAL UPON COMPLETION
OF THE REVIEW PERIOD, WHICH SHALL BE NO LONGER THAN NINETY DAYS FROM THE
DATE THE DEPARTMENT RECEIVES A COMPLETE RESPONSE TO ITS FINAL REQUEST
FOR ADDITIONAL INFORMATION, UNLESS, PRIOR THERETO, THE PUBLIC HEALTH AND
HEALTH PLANNING COUNCIL HAS NOTIFIED EACH PARTY TO THE PROPOSED TRANS-
ACTION THAT IT HAS BARRED SUCH TRANSACTIONS. [Within ninety days from
the date of receipt of such notice, the] THE public health and health
planning council may bar any transaction under this subparagraph: [(A)]
(1) if the equity position of the partnership [or], limited liability
company, OR CORPORATION THAT OPERATES A HOSPITAL FOR PROFIT, determined
in accordance with generally accepted accounting principles, would be
reduced as a result of the transfer, assignment or disposition; [(B)]
(2) if the transaction would result in the ownership of a partnership or
membership interest OR STOCK by any persons who have been convicted of a
felony described in subdivision five of section twenty-eight hundred six
of this article; [(C)] (3) if there are reasonable grounds to believe
that the proposed transaction does not satisfy the character and compe-
tence criteria set forth in subdivision three OR THREE-B of this
section; or [(D)] (4) if the transaction, together with all transactions
under this subparagraph for the [partnership, or successor,] OPERATOR
during any five year period would, in the aggregate, involve twenty-five
percent or more of the interest in the [partnership] OPERATOR. The
S. 8007 53 A. 9007
public health and health planning council shall state specific reasons
for barring any transaction under this subparagraph and shall so notify
each party to the proposed transaction[.]; OR
[(iii) With respect to a transfer, assignment or disposition of] (B)
an interest, STOCK, or voting rights [in such partnership or limited
liability company] to any [remaining] PERSON, partner [or], member,
[which transaction involves the withdrawal of the transferor from the
partnership or limited liability company, no prior approval of the
public health and health planning council shall be required] OR STOCK-
HOLDER, PREVIOUSLY APPROVED BY THE PUBLIC HEALTH AND HEALTH PLANNING
COUNCIL, OR ITS PREDECESSOR, FOR THAT OPERATOR. However, no such trans-
action shall be effective unless at least ninety days prior to the
intended effective date thereof, the [partnership or limited liability
company] OPERATOR fully completes and files with the public health and
health planning council notice on a form, to be developed by the public
health and health planning council, which shall disclose such informa-
tion as may reasonably be necessary FOR THE DEPARTMENT TO RECOMMEND AND
for the public health and health planning council to determine whether
it should bar the transaction for the reason set forth below, AND HAS
FULLY RESPONDED TO ANY REQUEST FOR ADDITIONAL INFORMATION BY THE DEPART-
MENT ACTING ON BEHALF OF THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL
DURING THE REVIEW PERIOD. SUCH TRANSACTION WILL BE FINAL UPON COMPLETION
OF THE REVIEW PERIOD, WHICH SHALL BE NO LONGER THAN NINETY DAYS FROM THE
DATE THE DEPARTMENT RECEIVES A COMPLETE RESPONSE TO ITS FINAL REQUEST
FOR ADDITIONAL INFORMATION, UNLESS, PRIOR THERETO, THE PUBLIC HEALTH AND
HEALTH PLANNING COUNCIL HAS NOTIFIED EACH PARTY TO THE PROPOSED TRANS-
ACTION THAT IT HAS BARRED SUCH TRANSACTIONS. [Within ninety days from
the date of receipt of such notice, the] THE public health and health
planning council may bar any transaction under this subparagraph if the
equity position of the partnership [or], limited liability company, OR
CORPORATION THAT OPERATES A HOSPITAL FOR PROFIT, determined in accord-
ance with generally accepted accounting principles, would be reduced as
a result of the transfer, assignment or disposition. The public health
and health planning council shall state specific reasons for barring any
transaction under this subparagraph and shall so notify each party to
the proposed transaction.
(c) [Any transfer, assignment or other disposition of ten percent or
more of the stock or voting rights thereunder of a corporation which is
the operator of a hospital or which is a member of a limited liability
company which is the operator of a hospital to a new stockholder, or any
transfer, assignment or other disposition of the stock or voting rights
thereunder of such a corporation which results in the ownership or
control of more than ten percent of the stock or voting rights there-
under of such corporation by any person not previously approved by the
public health and health planning council, or its predecessor, for that
corporation shall be subject to approval by the public health and health
planning council, in accordance with the provisions of subdivisions two
and three of this section and rules and regulations pursuant thereto;
except that: any such transaction shall be subject to the approval by
the public health and health planning council in accordance with para-
graph (b) of subdivision three of this section only with respect to a
new stockholder or a new principal stockholder; and shall not be subject
to paragraph (a) of subdivision three of this section. In the absence of
such approval, the operating certificate of such hospital shall be
subject to revocation or suspension. No prior approval of the public
health and health planning council shall be required with respect to a
S. 8007 54 A. 9007
transfer, assignment or disposition of ten percent or more of the stock
or voting rights thereunder of a corporation which is the operator of a
hospital or which is a member of a limited liability company which is
the owner of a hospital to any person previously approved by the public
health and health planning council, or its predecessor, for that corpo-
ration. However, no such transaction shall be effective unless at least
ninety days prior to the intended effective date thereof, the stockhold-
er completes and files with the public health and health planning coun-
cil notice on forms to be developed by the public health and health
planning council, which shall disclose such information as may reason-
ably be necessary for the public health and health planning council to
determine whether it should bar the transaction. Such transaction will
be final as of the intended effective date unless, prior thereto, the
public health and health planning council shall state specific reasons
for barring such transactions under this paragraph and shall notify each
party to the proposed transaction.] Nothing in this [paragraph] SUBDIVI-
SION shall be construed as permitting [a] ANY person, PARTNER, MEMBER,
OR STOCKHOLDER not previously approved by the public health and health
planning council for that [corporation] OPERATOR to [become the owner
of] OWN OR CONTROL, DIRECTLY OR INDIRECTLY, ten percent or more of the
INTEREST, stock, OR VOTING RIGHTS of [a] ANY PARTNERSHIP, LIMITED
LIABILITY COMPANY, NOT-FOR-PROFIT CORPORATION, OR corporation which is
the operator of a hospital or A CORPORATION which is a member of a
limited liability company which is the owner of a hospital without first
obtaining the approval of the public health and health planning council.
IN THE ABSENCE OF APPROVAL BY THE PUBLIC HEALTH AND HEALTH PLANNING
COUNCIL AS REQUIRED UNDER THIS SUBDIVISION, THE OPERATING CERTIFICATE OF
SUCH HOSPITAL SHALL BE SUBJECT TO REVOCATION OR SUSPENSION. FAILURE TO
PROVIDE NOTICE AS REQUIRED UNDER THIS SUBDIVISION MAY SUBJECT THE OPER-
ATING CERTIFICATE OF SUCH OPERATOR TO REVOCATION OR SUSPENSION.
§ 3. Section 3611-a of the public health law, as amended by section 92
of part C of chapter 58 of the laws of 2009, subdivisions 1 and 2 as
amended by section 67 of part A of chapter 58 of the laws of 2010, is
amended to read as follows:
§ 3611-a. Change in the operator or owner. 1. Any [change in the
person who, or any] transfer, assignment, or other disposition of an
interest, STOCK, or voting rights [of ten percent or more] IN A SOLE
PROPRIETORSHIP, PARTNERSHIP, LIMITED LIABILITY COMPANY, NOT-FOR-PROFIT
CORPORATION OR CORPORATION WHICH IS THE OPERATOR OF A LICENSED HOME CARE
SERVICES AGENCY OR A CERTIFIED HOME HEALTH AGENCY, or any transfer,
assignment or other disposition which results in the ownership or
control of an interest, STOCK, or voting rights [of ten percent or
more,] in [a limited liability company or a partnership which is the]
THAT operator [of a licensed home care services agency or a certified
home health agency], shall be approved by the public health and health
planning council, in accordance with the provisions of subdivision four
of section thirty-six hundred five of this article relative to licensure
or subdivision two of section thirty-six hundred six of this article
relative to certificate of approval, except that:
(a) Public health and health planning council approval shall be
required only with respect to the person, [or the] PARTNER, member or
[partner] STOCKHOLDER that is acquiring the interest, STOCK, or voting
rights[; and].
(b) With respect to certified home health agencies, such change shall
not be subject to the public need assessment described in paragraph (a)
of subdivision two of section thirty-six hundred six of this article.
S. 8007 55 A. 9007
(C) WITH RESPECT TO LICENSED HOME CARE SERVICES AGENCIES, THE COMMIS-
SIONER MAY PROMULGATE REGULATIONS DIRECTING WHETHER SUCH CHANGE SHALL BE
SUBJECT TO THE PUBLIC NEED ASSESSMENT DESCRIBED IN PARAGRAPH (A) OF
SUBDIVISION FOUR OF SECTION THIRTY-SIX HUNDRED FIVE OF THIS ARTICLE.
[(c)] (D) No prior approval of the public health and health planning
council shall be required with respect to a transfer, assignment or
disposition, DIRECTLY OR INDIRECTLY, of:
(i) an interest, STOCK, or voting rights to any person, PARTNER,
MEMBER, OR STOCKHOLDER previously approved by the public health and
health planning council, or its predecessor, for that operator. HOWEVER,
NO SUCH TRANSACTION SHALL BE EFFECTIVE UNLESS AT LEAST NINETY DAYS PRIOR
TO THE INTENDED EFFECTIVE DATE THEREOF, THE OPERATOR COMPLETES AND FILES
WITH THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL NOTICE ON FORMS TO BE
DEVELOPED BY THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL, WHICH SHALL
DISCLOSE SUCH INFORMATION AS MAY REASONABLY BE NECESSARY FOR THE DEPART-
MENT TO RECOMMEND AND FOR THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL
TO DETERMINE WHETHER IT SHOULD BAR THE TRANSACTION, AND HAS FULLY
RESPONDED TO ANY REQUEST FOR ADDITIONAL INFORMATION BY THE DEPARTMENT
ACTING ON BEHALF OF THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL DURING
THE REVIEW PERIOD. SUCH TRANSACTION WILL BE FINAL UPON COMPLETION OF THE
REVIEW PERIOD, WHICH SHALL BE NO LONGER THAN NINETY DAYS FROM THE DATE
THE DEPARTMENT RECEIVES A COMPLETE RESPONSE TO ITS FINAL REQUEST FOR
ADDITIONAL INFORMATION, UNLESS, PRIOR THERETO, THE PUBLIC HEALTH AND
HEALTH PLANNING COUNCIL HAS NOTIFIED EACH PARTY TO THE PROPOSED TRANS-
ACTION THAT IT HAS BARRED SUCH TRANSACTIONS UNDER THIS PARAGRAPH AND HAS
STATED SPECIFIC REASONS FOR BARRING SUCH TRANSACTIONS; or
(ii) an interest, STOCK, or voting rights of less than ten percent in
the operator TO ANY PERSON, PARTNER, MEMBER, OR STOCKHOLDER WHO HAS NOT
BEEN PREVIOUSLY APPROVED BY THE PUBLIC HEALTH AND HEALTH PLANNING COUN-
CIL FOR THAT OPERATOR. However, no such transaction shall be effective
unless at least ninety days prior to the intended effective date there-
of, the [partner or member] OPERATOR completes and files with the public
health and health planning council notice on forms to be developed by
the public health AND HEALTH PLANNING council, which shall disclose such
information as may reasonably be necessary FOR THE DEPARTMENT TO RECOM-
MEND AND for the public health and health planning council to determine
whether it should bar the transaction, AND HAS FULLY RESPONDED TO ANY
REQUEST FOR ADDITIONAL INFORMATION BY THE DEPARTMENT ACTING ON BEHALF OF
THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL DURING THE REVIEW PERIOD.
Such transaction will be final [as of the intended effective date] UPON
COMPLETION OF THE REVIEW PERIOD, WHICH SHALL BE NO LONGER THAN NINETY
DAYS FROM THE DATE THE DEPARTMENT RECEIVES A COMPLETE RESPONSE TO ITS
FINAL REQUEST FOR ADDITIONAL INFORMATION, unless, prior thereto, the
public health and health planning council [shall state] HAS NOTIFIED
EACH PARTY TO THE PROPOSED TRANSACTION THAT IT HAS BARRED SUCH TRANS-
ACTIONS UNDER THIS PARAGRAPH AND HAS STATED specific reasons for barring
such transactions [under this paragraph and shall notify each party to
the proposed transaction].
(III) NOTHING IN THIS SUBDIVISION SHALL BE CONSTRUED AS PERMITTING ANY
PERSON, PARTNER, MEMBER, OR STOCKHOLDER NOT PREVIOUSLY APPROVED BY THE
PUBLIC HEALTH AND HEALTH PLANNING COUNCIL FOR THAT OPERATOR TO OWN OR
CONTROL, DIRECTLY OR INDIRECTLY, TEN PERCENT OR MORE OF THE INTEREST,
STOCK, OR VOTING RIGHTS OF ANY PARTNERSHIP, LIMITED LIABILITY COMPANY,
NOT-FOR-PROFIT CORPORATION, OR CORPORATION WHICH IS THE OPERATOR OF A
LICENSED HOME CARE SERVICES AGENCY OR A CERTIFIED HOME HEALTH AGENCY
S. 8007 56 A. 9007
WITHOUT FIRST OBTAINING THE APPROVAL OF THE PUBLIC HEALTH AND HEALTH
PLANNING COUNCIL.
(IV) IN THE ABSENCE OF APPROVAL BY THE PUBLIC HEALTH AND HEALTH PLAN-
NING COUNCIL AS REQUIRED UNDER THIS PARAGRAPH, THE LICENSE OR CERTIF-
ICATE OF APPROVAL OF SUCH OPERATOR SHALL BE SUBJECT TO REVOCATION OR
SUSPENSION. FAILURE TO PROVIDE NOTICE AS REQUIRED UNDER THIS PARAGRAPH
MAY SUBJECT THE LICENSE OR CERTIFICATE OF APPROVAL OF SUCH OPERATOR TO
REVOCATION OR SUSPENSION THEREOF.
2. [Any transfer, assignment or other disposition of ten percent or
more of the stock or voting rights thereunder of a corporation which is
the operator of a licensed home care services agency or a certified home
health agency, or any transfer, assignment or other disposition of the
stock or voting rights thereunder of such a corporation which results in
the ownership or control of more than ten percent of the stock or voting
rights thereunder of such corporation by any person shall be subject to
approval by the public health and health planning council in accordance
with the provisions of subdivision four of section thirty-six hundred
five of this article relative to licensure or subdivision two of section
thirty-six hundred six of this article relative to certificate of
approval, except that:
(a) Public health and health planning council approval shall be
required only with respect to the person or entity acquiring such stock
or voting rights; and
(b) With respect to certified home health agencies, such change shall
not be subject to the public need assessment described in paragraph (a)
of subdivision two of section thirty-six hundred six of this article. In
the absence of such approval, the license or certificate of approval
shall be subject to revocation or suspension.
(c) No prior approval of the public health and health planning council
shall be required with respect to a transfer, assignment or disposition
of an interest or voting rights to any person previously approved by the
public health and health planning council, or its predecessor, for that
operator. However, no such transaction shall be effective unless at
least one hundred twenty days prior to the intended effective date ther-
eof, the partner or member completes and files with the public health
and health planning council notice on forms to be developed by the
public health and health planning council, which shall disclose such
information as may reasonably be necessary for the public health and
health planning council to determine whether it should bar the trans-
action. Such transaction will be final as of the intended effective date
unless, prior thereto, the public health and health planning council
shall state specific reasons for barring such transactions under this
paragraph and shall notify each party to the proposed transaction.
3.] (a) The commissioner shall charge to applicants for a change in
operator or owner of a licensed home care services agency or a certified
home health agency an application fee in the amount of two thousand
dollars.
(b) The fees paid by certified home health agencies pursuant to this
subdivision for any application approved in accordance with this section
shall be deemed allowable costs in the determination of reimbursement
rates established pursuant to this article. All fees pursuant to this
section shall be payable to the department of health for deposit into
the special revenue funds - other, miscellaneous special revenue fund -
339, certificate of need account.
S. 8007 57 A. 9007
§ 4. Paragraph (b) of subdivision 3 of section 4004 of the public
health law, as amended by section 69 of part A of chapter 58 of the laws
of 2010, is amended to read as follows:
(b) Any [change in the person, principal stockholder or] TRANSFER,
ASSIGNMENT OR OTHER DISPOSITION, OF AN INTEREST, STOCK, OR VOTING RIGHTS
IN A SOLE PROPRIETORSHIP, partnership, LIMITED LIABILITY COMPANY, NOT-
FOR-PROFIT CORPORATION, OR CORPORATION which is the operator of a
hospice, OR ANY TRANSFER, ASSIGNMENT OR OTHER DISPOSITION WHICH RESULTS
IN THE DIRECT OR INDIRECT OWNERSHIP OR CONTROL OF AN INTEREST, STOCK OR
VOTING RIGHTS IN THAT OPERATOR, shall be approved by the public health
and health planning council in accordance with the provisions of subdi-
visions one and two of this section[.]; PROVIDED, HOWEVER:
(I) PUBLIC HEALTH AND HEALTH PLANNING COUNCIL APPROVAL SHALL BE
REQUIRED ONLY WITH RESPECT TO THE PERSON, PARTNER, MEMBER, OR STOCKHOLD-
ER THAT IS ACQUIRING THE INTEREST, STOCK, OR VOTING RIGHTS.
(II) SUCH CHANGE SHALL NOT BE SUBJECT TO THE PUBLIC NEED ASSESSMENT
DESCRIBED IN PARAGRAPH (A) OF SUBDIVISION TWO OF THIS SECTION.
(III) NO PRIOR APPROVAL OF THE PUBLIC HEALTH AND HEALTH PLANNING COUN-
CIL SHALL BE REQUIRED WITH RESPECT TO A TRANSFER, ASSIGNMENT OR DISPOSI-
TION, DIRECTLY OR INDIRECTLY, OF:
(A) AN INTEREST, STOCK, OR VOTING RIGHTS TO ANY PERSON, PARTNER,
MEMBER, OR STOCKHOLDER PREVIOUSLY APPROVED BY THE PUBLIC HEALTH AND
HEALTH PLANNING COUNCIL, OR ITS PREDECESSOR, FOR THAT OPERATOR. HOWEVER,
NO SUCH TRANSACTION SHALL BE EFFECTIVE UNLESS AT LEAST NINETY DAYS PRIOR
TO THE INTENDED EFFECTIVE DATE THEREOF, THE OPERATOR COMPLETES AND FILES
WITH THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL NOTICE, ON FORMS TO
BE DEVELOPED BY THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL, WHICH
SHALL DISCLOSE SUCH INFORMATION AS MAY REASONABLY BE NECESSARY FOR THE
DEPARTMENT TO RECOMMEND AND FOR THE PUBLIC HEALTH AND HEALTH PLANNING
COUNCIL TO DETERMINE WHETHER IT SHOULD BAR THE TRANSACTION, AND HAS
FULLY RESPONDED TO ANY REQUEST FOR ADDITIONAL INFORMATION BY THE DEPART-
MENT ACTING ON BEHALF OF THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL
DURING THE REVIEW PERIOD. SUCH TRANSACTION WILL BE FINAL UPON COMPLETION
OF THE REVIEW PERIOD, WHICH SHALL BE NO LONGER THAN NINETY DAYS FROM THE
DATE THE DEPARTMENT RECEIVES A COMPLETE RESPONSE TO ITS FINAL REQUEST
FOR ADDITIONAL INFORMATION, UNLESS, PRIOR THERETO, THE PUBLIC HEALTH AND
HEALTH PLANNING COUNCIL HAS NOTIFIED EACH PARTY TO THE PROPOSED TRANS-
ACTION THAT IT HAS BARRED SUCH TRANSACTIONS UNDER THIS PARAGRAPH AND HAS
STATED SPECIFIC REASONS FOR BARRING SUCH TRANSACTIONS; OR
(B) AN INTEREST, STOCK, OR VOTING RIGHTS OF LESS THAN TEN PERCENT IN
THE OPERATOR TO ANY PERSON, PARTNER, MEMBER, OR STOCKHOLDER WHO HAS NOT
BEEN PREVIOUSLY APPROVED BY THE PUBLIC HEALTH AND HEALTH PLANNING COUN-
CIL FOR THAT OPERATOR. HOWEVER, NO SUCH TRANSACTION SHALL BE EFFECTIVE
UNLESS AT LEAST NINETY DAYS PRIOR TO THE INTENDED EFFECTIVE DATE THERE-
OF, THE OPERATOR COMPLETES AND FILES WITH THE PUBLIC HEALTH AND HEALTH
PLANNING COUNCIL NOTICE ON FORMS TO BE DEVELOPED BY THE PUBLIC HEALTH
AND HEALTH PLANNING COUNCIL, WHICH SHALL DISCLOSE SUCH INFORMATION AS
MAY REASONABLY BE NECESSARY FOR THE DEPARTMENT TO RECOMMEND AND FOR THE
PUBLIC HEALTH AND HEALTH PLANNING COUNCIL TO DETERMINE WHETHER IT SHOULD
BAR THE TRANSACTION, AND HAS FULLY RESPONDED TO ANY REQUEST FOR ADDI-
TIONAL INFORMATION BY THE DEPARTMENT ACTING ON BEHALF OF THE PUBLIC
HEALTH AND HEALTH PLANNING COUNCIL DURING THE REVIEW PERIOD. SUCH TRANS-
ACTION WILL BE FINAL UPON COMPLETION OF THE REVIEW PERIOD, WHICH SHALL
BE NO LONGER THAN NINETY DAYS FROM THE DATE THE DEPARTMENT RECEIVES A
COMPLETE RESPONSE TO ITS FINAL REQUEST FOR ADDITIONAL INFORMATION,
UNLESS, PRIOR THERETO, THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL HAS
S. 8007 58 A. 9007
NOTIFIED EACH PARTY TO THE PROPOSED TRANSACTION THAT IT HAS BARRED SUCH
TRANSACTIONS UNDER THIS PARAGRAPH AND HAS STATED SPECIFIC REASONS FOR
BARRING SUCH TRANSACTIONS.
(IV) NOTHING IN THIS SUBDIVISION SHALL BE CONSTRUED AS PERMITTING ANY
PERSON, PARTNER, MEMBER, OR STOCKHOLDER NOT PREVIOUSLY APPROVED BY THE
PUBLIC HEALTH AND HEALTH PLANNING COUNCIL FOR THAT OPERATOR TO OWN OR
CONTROL, DIRECTLY OR INDIRECTLY, TEN PERCENT OR MORE OF THE INTEREST,
STOCK, OR VOTING RIGHTS OF ANY PARTNERSHIP, LIMITED LIABILITY COMPANY,
NOT-FOR-PROFIT CORPORATION, OR CORPORATION WHICH IS THE OPERATOR OF A
HOSPICE WITHOUT FIRST OBTAINING THE APPROVAL OF THE PUBLIC HEALTH AND
HEALTH PLANNING COUNCIL.
(V) IN THE ABSENCE OF APPROVAL BY THE PUBLIC HEALTH AND HEALTH PLAN-
NING COUNCIL AS REQUIRED UNDER THIS PARAGRAPH, THE CERTIFICATE OF
APPROVAL OF SUCH OPERATOR SHALL BE SUBJECT TO REVOCATION OR SUSPENSION.
FAILURE TO PROVIDE NOTICE AS REQUIRED UNDER THIS PARAGRAPH MAY SUBJECT
THE CERTIFICATE OF APPROVAL OF SUCH OPERATOR TO REVOCATION OR SUSPEN-
SION.
§ 5. This act shall take effect immediately.
PART M
Section 1. Paragraph (a) of subdivision 2 of section 2828 of the
public health law, as added by section 1 of part GG of chapter 57 of the
laws of 2021, is amended to read as follows:
(a) "Revenue" shall mean the total operating revenue from or on behalf
of residents of the residential health care facility, government payers,
or third-party payers, to pay for a resident's occupancy of the residen-
tial health care facility, resident care, and the operation of the resi-
dential health care facility as reported in the residential health care
facility cost reports submitted to the department; provided, however,
that revenue shall exclude:
(I) the average increase in the capital portion of the Medicaid
reimbursement rate from the prior three years;
(II) FUNDING RECEIVED AS REIMBURSEMENT FOR THE ASSESSMENT UNDER
SUBPARAGRAPH (VI) OF PARAGRAPH (B) OF SUBDIVISION TWO OF SECTION TWEN-
TY-EIGHT HUNDRED SEVEN-D OF THIS ARTICLE, AS RECONCILED PURSUANT TO
PARAGRAPH (C) OF SUBDIVISION TEN OF SECTION TWENTY-EIGHT HUNDRED SEVEN-D
OF THIS ARTICLE; AND
(III) THE CAPITAL PER DIEM PORTION OF THE REIMBURSEMENT RATE FOR NURS-
ING HOMES THAT HAVE A FOUR- OR FIVE-STAR RATING ASSIGNED PURSUANT TO THE
INSPECTION RATING SYSTEM OF THE U.S. CENTERS FOR MEDICARE AND MEDICAID
SERVICES (CMS RATING).
§ 2. Subdivision 4 of section 2828 of the public health law, as added
by section 1 of part GG of chapter 57 of the laws of 2021, is amended to
read as follows:
4. The commissioner may waive the requirements of this section on a
case-by-case basis with respect to a nursing home that demonstrates to
the commissioner's satisfaction that it experienced unexpected or excep-
tional circumstances that prevented compliance. The commissioner may
also exclude from revenues and expenses, on a case-by-case basis,
extraordinary revenues and capital expenses, incurred due to a natural
disaster or other circumstances set forth by the commissioner in regu-
lation. THE COMMISSIONER MAY ALSO EXCLUDE FROM REVENUES, ON A CASE-BY-
CASE BASIS, THE CAPITAL PER DIEM PORTION OF THE REIMBURSEMENT RATE FOR
NURSING HOMES THAT HAVE A THREE-STAR CMS RATING. At least thirty days
before any action by the commissioner under this subdivision, the
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commissioner shall transmit the proposed action to the state office of
the long-term care ombudsman and the chairs of the senate and assembly
health committees, and post it on the department's website.
§ 3. Paragraph (d) of subdivision 2-c of section 2808 of the public
health law, as amended by section 26-a of part C of chapter 60 of the
laws of 2014, is amended to read as follows:
(d) The commissioner shall promulgate regulations, and may promulgate
emergency regulations, to implement the provisions of this subdivision.
Such regulations shall be developed in consultation with the nursing
home industry and advocates for residential health care facility resi-
dents and, further, the commissioner shall provide notification concern-
ing such regulations to the chairs of the senate and assembly health
committees, the chair of the senate finance committee and the chair of
the assembly ways and means committee. Such regulations shall include
provisions for rate adjustments or payment enhancements to facilitate a
minimum four-year transition of facilities to the rate-setting methodol-
ogy established by this subdivision and may also include, but not be
limited to, provisions for facilitating quality improvements in residen-
tial health care facilities. For purposes of facilitating quality
improvements through the establishment of a nursing home quality pool TO
BE FUNDED AT THE DISCRETION OF THE COMMISSIONER BY (I) ADJUSTMENTS IN
MEDICAL ASSISTANCE RATES, (II) FUNDS MADE AVAILABLE THROUGH STATE APPRO-
PRIATIONS, OR (III) A COMBINATION THEREOF, those facilities that
contribute to the quality pool, but are deemed ineligible for quality
pool payments due exclusively to a specific case of employee misconduct,
shall nevertheless be eligible for a quality pool payment if the facili-
ty properly reported the incident, did not receive a survey citation
from the commissioner or the Centers for Medicare and Medicaid Services
establishing the facility's culpability with regard to such misconduct
and, but for the specific case of employee misconduct, the facility
would have otherwise received a quality pool payment. Regulations
pertaining to the facilitation of quality improvement may be made effec-
tive for periods on and after January first, two thousand thirteen.
§ 4. The opening paragraph and paragraph (i) of subdivision (g) of
section 2826 of the public health law, as added by section 6 of part J
of chapter 60 of the laws of 2015, are amended to read as follows:
Notwithstanding subdivision (a) of this section, and within amounts
appropriated for such purposes as described herein, for the period of
April first, two thousand [fifteen] TWENTY-TWO through March thirty-
first, two thousand [sixteen] TWENTY-THREE, the commissioner may award a
temporary adjustment to the non-capital components of rates, or make
temporary lump-sum Medicaid payments to eligible [general hospitals]
FACILITIES in severe financial distress to enable such facilities to
maintain operations and vital services while such facilities establish
long term solutions to achieve sustainable health services. PROVIDED,
HOWEVER, THE COMMISSIONER IS AUTHORIZED TO MAKE SUCH A TEMPORARY ADJUST-
MENT OR MAKE SUCH TEMPORARY LUMP SUM PAYMENT ONLY PURSUANT TO CRITERIA,
AN EVALUATION PROCESS, AND TRANSFORMATION PLAN ACCEPTABLE TO THE COMMIS-
SIONER IN CONSULTATION WITH THE DIRECTOR OF THE DIVISION OF THE BUDGET.
(i) Eligible [general hospitals] FACILITIES shall include:
(A) a public hospital, which for purposes of this subdivision, shall
mean a general hospital operated by a county or municipality, but shall
exclude any such hospital operated by a public benefit corporation;
(B) a federally designated critical access hospital;
(C) a federally designated sole community hospital; [or]
(D) A RESIDENTIAL HEALTH CARE FACILITY;
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(E) AN ADULT CARE FACILITY;
(F) a general hospital that is a safety net hospital, which for
purpose of this subdivision shall mean:
(1) such hospital has at least thirty percent of its inpatient
discharges made up of Medicaid eligible individuals, uninsured individ-
uals or Medicaid dually eligible individuals and with at least thirty-
five percent of its outpatient visits made up of Medicaid eligible indi-
viduals, uninsured individuals or Medicaid dually-eligible individuals;
or
(2) such hospital serves at least thirty percent of the residents of a
county or a multi-county area who are Medicaid eligible individuals,
uninsured individuals or Medicaid dually-eligible individuals; OR
(G) AN INDEPENDENT PRACTICE ASSOCIATION OR ACCOUNTABLE CARE ORGANIZA-
TION AUTHORIZED UNDER APPLICABLE REGULATIONS THAT PARTICIPATE IN MANAGED
CARE PROVIDER NETWORK ARRANGEMENTS WITH ANY OF THE PROVIDER TYPES IN
SUBPARAGRAPHS (A) THROUGH (F) OF THIS PARAGRAPH.
§ 5. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022.
PART N
Section 1. Subparagraph 4 of paragraph (b) of subdivision 1 of section
366 of the social services law, as added by section 1 of part D of chap-
ter 56 of the laws of 2013, is amended to read as follows:
(4) An individual who is a pregnant woman or is a member of a family
that contains a dependent child living with a parent or other caretaker
relative is eligible for standard coverage if [his or her MAGI] THEIR
household income does not exceed [the MAGI-equivalent of] one hundred
[thirty] THIRTY-THREE percent of the [highest amount that ordinarily
would have been paid to a person without any income or resources under
the family assistance program as it existed on the first day of Novem-
ber, nineteen hundred ninety-seven] FEDERAL POVERTY LINE FOR THE APPLI-
CABLE FAMILY SIZE, which shall be calculated in accordance with guidance
issued by the Secretary of the United States department of health and
human services; for purposes of this subparagraph, the term dependent
child means a person who is under eighteen years of age, or is eighteen
years of age and a full-time student, who is deprived of parental
support or care by reason of the death, continued absence, or physical
or mental incapacity of a parent, or by reason of the unemployment of
the parent, as defined by the department of health.
§ 2. Subparagraph 2 of paragraph (c) of subdivision 1 of section 366
of the social services law, as added by section 1 of part D of chapter
56 of the laws of 2013, is amended to read as follows:
(2) An individual who, although not receiving public assistance or
care for [his or her] THEIR maintenance under other provisions of this
chapter, has income [and resources], including available support from
responsible relatives, that does not exceed the amounts set forth in
paragraph (a) of subdivision two of this section, and is (i) sixty-five
years of age or older, or certified blind or certified disabled or (ii)
for reasons other than income [or resources], is eligible for federal
supplemental security income benefits and/or additional state payments.
§ 3. Subparagraph 5 of paragraph (c) of subdivision 1 of section 366
of the social services law, as added by section 1 of part D of chapter
56 of the laws of 2013, is amended to read as follows:
(5) A disabled individual at least sixteen years of age, but under the
age of sixty-five, who: would be eligible for benefits under the supple-
S. 8007 61 A. 9007
mental security income program but for earnings in excess of the allow-
able limit; has net available income that does not exceed two hundred
fifty percent of the applicable federal income official poverty line, as
defined and updated by the United States department of health and human
services, for a one-person or two-person household, as defined by the
commissioner in regulation; [has household resources, as defined in
paragraph (e) of subdivision two of section three hundred sixty-six-c of
this title, other than retirement accounts, that do not exceed twenty
thousand dollars for a one-person household or thirty thousand dollars
for a two-person household, as defined by the commissioner in regu-
lation;] and contributes to the cost of medical assistance provided
pursuant to this subparagraph in accordance with subdivision twelve of
section three hundred sixty-seven-a of this title; for purposes of this
subparagraph, disabled means having a medically determinable impairment
of sufficient severity and duration to qualify for benefits under
section 1902(a)(10)(A)(ii)(xv) of the social security act.
§ 4. Subparagraph 10 of paragraph (c) of subdivision 1 of section 366
of the social services law, as added by section 1 of part D of chapter
56 of the laws of 2013, is amended to read as follows:
(10) A resident of a home for adults operated by a social services
district, or a residential care center for adults or community residence
operated or certified by the office of mental health, and has not,
according to criteria promulgated by the department consistent with this
title, sufficient income, or in the case of a person sixty-five years of
age or older, certified blind, or certified disabled, sufficient income
[and resources], including available support from responsible relatives,
to meet all the costs of required medical care and services available
under this title.
§ 5. Paragraph (a) of subdivision 2 of section 366 of the social
services law, as separately amended by chapter 32 and 588 of the laws of
1968, the opening paragraph as amended by chapter 41 of the laws of
1992, subparagraph 1 as amended by section 27 of part C of chapter 109
of the laws of 2006, subparagraphs 3 and 6 as amended by chapter 938 of
the laws of 1990, subparagraph 4 as amended by section 43 and subpara-
graph 7 as amended by section 47 of part C of chapter 58 of the laws of
2008, subparagraph 5 as amended by chapter 576 of the laws of 2007,
subparagraph 9 as amended by chapter 110 of the laws of 1971, subpara-
graph 10 as added by chapter 705 of the laws of 1988, clauses (i) and
(ii) of subparagraph 10 as amended by chapter 672 of the laws of 2019,
clause (iii) of subparagraph 10 as amended by chapter 170 of the laws of
1994, and subparagraph 11 as added by chapter 576 of the laws of 2015,
is amended to read as follows:
(a) The following [income and resources] shall be exempt and shall not
be taken into consideration in determining a person's eligibility for
medical care, services and supplies available under this title:
(1) (i) for applications for medical assistance filed on or before
December thirty-first, two thousand five, a homestead which is essential
and appropriate to the needs of the household;
(ii) for applications for medical assistance filed on or after January
first, two thousand six, a homestead which is essential and appropriate
to the needs of the household; provided, however, that in determining
eligibility of an individual for medical assistance for nursing facility
services and other long term care services, the individual shall not be
eligible for such assistance if the individual's equity interest in the
homestead exceeds seven hundred fifty thousand dollars; provided
further, that the dollar amount specified in this clause shall be
S. 8007 62 A. 9007
increased, beginning with the year two thousand eleven, from year to
year, in an amount to be determined by the secretary of the federal
department of health and human services, based on the percentage
increase in the consumer price index for all urban consumers, rounded to
the nearest one thousand dollars. If such secretary does not determine
such an amount, the department of health shall increase such dollar
amount based on such increase in the consumer price index. Nothing in
this clause shall be construed as preventing an individual from using a
reverse mortgage or home equity loan to reduce the individual's total
equity interest in the homestead. The home equity limitation established
by this clause shall be waived in the case of a demonstrated hardship,
as determined pursuant to criteria established by such secretary. The
home equity limitation shall not apply if one or more of the following
persons is lawfully residing in the individual's homestead: (A) the
spouse of the individual; or (B) the individual's child who is under the
age of twenty-one, or is blind or permanently and totally disabled, as
defined in section 1614 of the federal social security act.
(2) [essential personal property;
(3) a burial fund, to the extent allowed as an exempt resource under
the cash assistance program to which the applicant is most closely
related;
(4) savings in amounts equal to one hundred fifty percent of the
income amount permitted under subparagraph seven of this paragraph,
provided, however, that the amounts for one and two person households
shall not be less than the amounts permitted to be retained by house-
holds of the same size in order to qualify for benefits under the feder-
al supplemental security income program;
(5)] (i) such income as is disregarded or exempt under the cash
assistance program to which the applicant is most closely related for
purposes of this subparagraph, cash assistance program means either the
aid to dependent children program as it existed on the sixteenth day of
July, nineteen hundred ninety-six, or the supplemental security income
program; and
(ii) such income of a disabled person (as such term is defined in
section 1614(a)(3) of the federal social security act (42 U.S.C. section
1382c(a)(3)) or in accordance with any other rules or regulations estab-
lished by the social security administration), that is deposited in
trusts as defined in clause (iii) of subparagraph two of paragraph (b)
of this subdivision in the same calendar month within which said income
is received;
[(6)] (3) health insurance premiums;
[(7)] (4) income based on the number of family members in the medical
assistance household, as defined in regulations by the commissioner
consistent with federal regulations under title XIX of the federal
social security act [and calculated as follows:
(i) The amounts for one and two person households and families shall
be equal to twelve times the standard of monthly need for determining
eligibility for and the amount of additional state payments for aged,
blind and disabled persons pursuant to section two hundred nine of this
article rounded up to the next highest one hundred dollars for eligible
individuals and couples living alone, respectively.
(ii) The amounts for households of three or more shall be calculated
by increasing the income standard for a household of two, established
pursuant to clause (i) of this subparagraph, by fifteen percent for each
additional household member above two, such that the income standard for
a three-person household shall be one hundred fifteen percent of the
S. 8007 63 A. 9007
income standard for a two-person household, the income standard for a
four-person household shall be one hundred thirty percent of the income
standard for a two-person household, and so on.
(iii)] THAT DOES NOT EXCEED ONE HUNDRED THIRTY-EIGHT PERCENT OF THE
FEDERAL POVERTY LINE FOR THE APPLICABLE FAMILY SIZE, WHICH SHALL BE
CALCULATED IN ACCORDANCE WITH GUIDANCE ISSUED BY THE UNITED STATES
SECRETARY FOR HEALTH AND HUMAN SERVICES;
(5) No other income [or resources], including federal old-age, survi-
vors and disability insurance, state disability insurance or other
payroll deductions, whether mandatory or optional, shall be exempt and
all other income [and resources] shall be taken into consideration and
required to be applied toward the payment or partial payment of the cost
of medical care and services available under this title, to the extent
permitted by federal law.
[(9) Subject to subparagraph eight, the] (6) THE department, upon the
application of a local social services district, after passage of a
resolution by the local legislative body authorizing such application,
may adjust the income exemption based upon the variations between cost
of shelter in urban areas and rural areas in accordance with standards
prescribed by the United States secretary of health, education and
welfare.
[(10)] (7) (i) A person who is receiving or is eligible to receive
federal supplemental security income payments and/or additional state
payments is entitled to a personal needs allowance as follows:
(A) for the personal expenses of a resident of a residential health
care facility, as defined by section twenty-eight hundred one of the
public health law, the amount of fifty-five dollars per month;
(B) for the personal expenses of a resident of an intermediate care
facility operated or licensed by the office for people with develop-
mental disabilities or a patient of a hospital operated by the office of
mental health, as defined by subdivision ten of section 1.03 of the
mental hygiene law, the amount of thirty-five dollars per month.
(ii) A person who neither receives nor is eligible to receive federal
supplemental security income payments and/or additional state payments
is entitled to a personal needs allowance as follows:
(A) for the personal expenses of a resident of a residential health
care facility, as defined by section twenty-eight hundred one of the
public health law, the amount of fifty dollars per month;
(B) for the personal expenses of a resident of an intermediate care
facility operated or licensed by the office for people with develop-
mental disabilities or a patient of a hospital operated by the office of
mental health, as defined by subdivision ten of section 1.03 of the
mental hygiene law, the amount of thirty-five dollars per month.
(iii) Notwithstanding the provisions of clauses (i) and (ii) of this
subparagraph, the personal needs allowance for a person who is a veteran
having neither a spouse nor a child, or a surviving spouse of a veteran
having no child, who receives a reduced pension from the federal veter-
ans administration, and who is a resident of a nursing facility, as
defined in section 1919 of the federal social security act, shall be
equal to such reduced monthly pension but shall not exceed ninety
dollars per month.
[(11)] (8) subject to the availability of federal financial partic-
ipation, any amount, including earnings thereon, in a qualified NY ABLE
account as established pursuant to article eighty-four of the mental
hygiene law, any contributions to such NY ABLE account, and any distrib-
ution for qualified disability expenses from such account; provided
S. 8007 64 A. 9007
however, that such exemption shall be consistent with section 529A of
the Internal Revenue Code of 1986, as amended.
§ 6. Subparagraphs 1 and 2 of paragraph (b) of subdivision 2 of
section 366 of the social services law, subparagraph 1 as amended by
chapter 638 of the laws of 1993 and as designated by chapter 170 of the
laws of 1994, subparagraph 2 as added by chapter 170 of the laws of
1994, clause (iii) of subparagraph 2 as amended by chapter 187 of the
laws of 2017, clause (iv) of subparagraph 2 as amended by chapter 656 of
the laws of 1997 and as further amended by section 104 of part A of
chapter 62 of the laws of 2011, and clause (vi) of subparagraph 2 as
added by chapter 435 of the laws of 2018, are amended to read as
follows:
(1) In establishing standards for determining eligibility for and
amount of such assistance, the department shall take into account only
such income [and resources], in accordance with federal requirements, as
[are] IS available to the applicant or recipient and as would not be
required to be disregarded or set aside for future needs, and there
shall be a reasonable evaluation of any such income [or resources]. The
department shall not consider the availability of an option for an
accelerated payment of death benefits or special surrender value pursu-
ant to paragraph one of subsection (a) of section one thousand one
hundred thirteen of the insurance law, or an option to enter into a
viatical settlement pursuant to the provisions of article seventy-eight
of the insurance law, as an available resource in determining eligibil-
ity for an amount of such assistance, provided, however, that the
payment of such benefits shall be considered in determining eligibility
for and amount of such assistance. There shall not be taken into consid-
eration the financial responsibility of any individual for any applicant
or recipient of assistance under this title unless such applicant or
recipient is such individual's spouse or such individual's child who is
under twenty-one years of age. In determining the eligibility of a child
who is categorically eligible as blind or disabled, as determined under
regulations prescribed by the social security act for medical assist-
ance, the income [and resources] of parents or spouses of parents are
not considered available to that child if she/he does not regularly
share the common household even if the child returns to the common
household for periodic visits. In the application of standards of eligi-
bility with respect to income, costs incurred for medical care, whether
in the form of insurance premiums or otherwise, shall be taken into
account. Any person who is eligible for, or reasonably appears to meet
the criteria of eligibility for, benefits under title XVIII of the
federal social security act shall be required to apply for and fully
utilize such benefits in accordance with this chapter.
(2) In evaluating the income [and resources] available to an applicant
for or recipient of medical assistance, for purposes of determining
eligibility for and the amount of such assistance, the department must
consider assets [held in or] paid from trusts created by such applicant
or recipient, as determined pursuant to the regulations of the depart-
ment, in accordance with the provisions of this subparagraph.
(i) In the case of a revocable trust created by an applicant or recip-
ient, as determined pursuant to regulations of the department[: the
trust corpus must be considered to be an available resource;], payments
made from the trust to or for the benefit of such applicant or recipient
must be considered to be available income; and any other payments from
the trust must be considered to be assets disposed of by such applicant
S. 8007 65 A. 9007
or recipient for purposes of paragraph (d) of subdivision five of this
section.
(ii) In the case of an irrevocable trust created by an applicant or
recipient, as determined pursuant to regulations of the department: any
portion of the trust corpus, and of the income generated by the trust
corpus, from which no payment can under any circumstances be made to
such applicant or recipient must be considered, as of the date of estab-
lishment of the trust, or, if later, the date on which payment to the
applicant or recipient is foreclosed, to be assets disposed of by such
applicant or recipient for purposes of paragraph (d) of subdivision five
of this section; [any portion of the trust corpus, and of the income
generated by the trust corpus, from which payment could be made to or
for the benefit of such applicant or recipient must be considered to be
an available resource;] payments made from the trust to or for the bene-
fit of such applicant or recipient must be considered to be available
income; and any other payments from the trust must be considered to be
assets disposed of by such applicant or recipient for purposes of para-
graph (d) of subdivision five of this section.
(iii) Notwithstanding the provisions of clauses (i) and (ii) of this
subparagraph, in the case of an applicant or recipient who is disabled,
as such term is defined in section 1614(a)(3) of the federal social
security act, the department must not consider as available income [or
resources] the [corpus or] income of the following trusts which comply
with the provisions of the regulations authorized by clause (iv) of this
subparagraph: (A) a trust containing the assets of such a disabled indi-
vidual which was established for the benefit of the disabled individual
while such individual was under sixty-five years of age by the individ-
ual, a parent, grandparent, legal guardian, or court of competent juris-
diction, if upon the death of such individual the state will receive all
amounts remaining in the trust up to the total value of all medical
assistance paid on behalf of such individual; (B) and a trust containing
the assets of such a disabled individual established and managed by a
non-profit association which maintains separate accounts for the benefit
of disabled individuals, but, for purposes of investment and management
of trust funds, pools the accounts, provided that accounts in the trust
fund are established solely for the benefit of individuals who are disa-
bled as such term is defined in section 1614(a)(3) of the federal social
security act by such disabled individual, a parent, grandparent, legal
guardian, or court of competent jurisdiction, and to the extent that
amounts remaining in the individual's account are not retained by the
trust upon the death of the individual, the state will receive all such
remaining amounts up to the total value of all medical assistance paid
on behalf of such individual. Notwithstanding any law to the contrary,
a not-for-profit corporation may, in furtherance of and as an adjunct to
its corporate purposes, act as trustee of a trust for persons with disa-
bilities established pursuant to this subclause, provided that a trust
company, as defined in subdivision seven of section one hundred-c of the
banking law, acts as co-trustee.
(iv) The department shall promulgate such regulations as may be neces-
sary to carry out the provisions of this subparagraph. Such regulations
shall include provisions for: assuring the fulfillment of fiduciary
obligations of the trustee with respect to the remainder interest of the
department or state; monitoring pooled trusts; applying this subdivision
to legal instruments and other devices similar to trusts, in accordance
with applicable federal rules and regulations; and establishing proce-
dures under which the application of this subdivision will be waived
S. 8007 66 A. 9007
with respect to an applicant or recipient who demonstrates that such
application would work an undue hardship on him or her, in accordance
with standards specified by the secretary of the federal department of
health and human services. Such regulations may require: notification of
the department of the creation or funding of such a trust for the bene-
fit of an applicant for or recipient of medical assistance; notification
of the department of the death of a beneficiary of such a trust who is a
current or former recipient of medical assistance; in the case of a
trust, the corpus of which exceeds one hundred thousand dollars, notifi-
cation of the department of transactions tending to substantially
deplete the trust corpus; notification of the department of any trans-
actions involving transfers from the trust corpus for less than fair
market value; the bonding of the trustee when the assets of such a trust
equal or exceed one million dollars, unless a court of competent juris-
diction waives such requirement; and the bonding of the trustee when the
assets of such a trust are less than one million dollars, upon order of
a court of competent jurisdiction. The department, together with the
department of financial services, shall promulgate regulations governing
the establishment, management and monitoring of trusts established
pursuant to subclause (B) of clause (iii) of this subparagraph in which
a not-for-profit corporation and a trust company serve as co-trustees.
(v) Notwithstanding any acts, omissions or failures to act of a trus-
tee of a trust which the department or a local social services official
has determined complies with the provisions of clause (iii) and the
regulations authorized by clause (iv) of this subparagraph, the depart-
ment must not consider the [corpus or] income of any such trust as
available income [or resources] of the applicant or recipient who is
disabled, as such term is defined in section 1614(a)(3) of the federal
social security act. The department's remedy for redress of any acts,
omissions or failures to act by such a trustee which acts, omissions or
failures are considered by the department to be inconsistent with the
terms of the trust, contrary to applicable laws and regulations of the
department, or contrary to the fiduciary obligations of the trustee
shall be the commencement of an action or proceeding under subdivision
one of section sixty-three of the executive law to safeguard or enforce
the state's remainder interest in the trust, or such other action or
proceeding as may be lawful and appropriate as to assure compliance by
the trustee or to safeguard and enforce the state's remainder interest
in the trust.
(vi) The department shall provide written notice to an applicant for
or recipient of medical assistance who is or reasonably appears to be
eligible for medical assistance except for having income exceeding
applicable income levels. The notice shall inform the applicant or
recipient, in plain language, that in certain circumstances the medical
assistance program does not count the income of disabled applicants and
recipients if it is placed in a trust described in clause (iii) of this
subparagraph. The notice shall be included with the eligibility notice
provided to such applicants and recipients and shall reference where
additional information may be found on the department's website. This
clause shall not be construed to change any criterion for eligibility
for medical assistance.
§ 7. Paragraph (a) of subdivision 3 of section 366 of the social
services law, as amended by chapter 110 of the laws of 1971, is amended
to read as follows:
(a) Medical assistance shall be furnished to applicants in cases
where, although such applicant has a responsible relative with suffi-
S. 8007 67 A. 9007
cient income [and resources] to provide medical assistance as determined
by the regulations of the department, the income [and resources] of the
responsible relative are not available to such applicant because of the
absence of such relative or the refusal or failure of such relative to
provide the necessary care and assistance. In such cases, however, the
furnishing of such assistance shall create an implied contract with such
relative, and the cost thereof may be recovered from such relative in
accordance with title six of article three OF THIS CHAPTER and other
applicable provisions of law.
§ 8. Paragraph h of subdivision 6 of section 366 of the social
services law, as amended by section 69-b of part C of chapter 58 of the
laws of 2008, is amended to read as follows:
h. Notwithstanding any other provision of this chapter or any other
law to the contrary, for purposes of determining medical assistance
eligibility for persons specified in paragraph b of this subdivision,
the income [and resources] of responsible relatives shall not be deemed
available for as long as the person meets the criteria specified in this
subdivision.
§ 9. Subparagraph (vii) of paragraph (b) of subdivision 7 of section
366 of the social services law, as amended by chapter 324 of the laws of
2004, is amended to read as follows:
(vii) be ineligible for medical assistance because the income [and
resources] of responsible relatives are deemed available to him or her,
causing him or her to exceed the income or resource eligibility level
for such assistance;
§ 10. Paragraph j of subdivision 7 of section 366 of the social
services law, as amended by chapter 324 of the laws of 2004, is amended
to read as follows:
j. Notwithstanding any other provision of this chapter other than
subdivision six of this section or any other law to the contrary, for
purposes of determining medical assistance eligibility for persons spec-
ified in paragraph b of this subdivision, the income [and resources] of
a responsible relative shall not be deemed available for as long as the
person meets the criteria specified in this subdivision.
§ 11. Subdivision 8 of section 366 of the social services law, as
added by chapter 41 of the laws of 1992, is amended to read as follows:
8. Notwithstanding any inconsistent provision of this chapter or any
other law to the contrary, income [and resources] which are otherwise
exempt from consideration in determining a person's eligibility for
medical care, services and supplies available under this title, shall be
considered available for the payment or part payment of the costs of
such medical care, services and supplies as required by federal law and
regulations.
§ 12. Subparagraph (vi) of paragraph (b) of subdivision 9 of section
366 of the social services law, as added by chapter 170 of the laws of
1994, is amended to read as follows:
(vi) be eligible or, if discharged, would be eligible for medical
assistance, or are ineligible for medical assistance because the income
[and resources] of responsible relatives are or, if discharged, would be
deemed available to such persons causing them to exceed the income [or
resource] eligibility level for such assistance;
§ 13. Paragraph k of subdivision 9 of section 366 of the social
services law, as added by chapter 170 of the laws of 1994, is amended to
read as follows:
k. Notwithstanding any provision of this chapter other than subdivi-
sion six or seven of this section, or any other law to the contrary, for
S. 8007 68 A. 9007
purposes of determining medical assistance eligibility for persons spec-
ified in paragraphs b and c of this subdivision, the income [and
resources] of a responsible relative shall not be deemed available for
as long as the person meets the criteria specified in this subdivision.
§ 14. Paragraph (d) of subdivision 12 of section 366 of the social
services law, as added by section 1 of part E of chapter 58 of the laws
of 2006, is amended to read as follows:
(d) Notwithstanding any provision of this chapter or any other law to
the contrary, for purposes of determining medical assistance eligibility
for persons specified in paragraph (b) of this subdivision, the income
[and resources] of a legally responsible relative shall not be deemed
available for as long as the person meets the criteria specified in this
subdivision; provided, however, that such income shall continue to be
deemed unavailable should responsibility for the care and placement of
the person be returned to [his or her] THEIR parent or other legally
responsible person.
§ 15. Paragraph (b) of subdivision 2 of section 366-a of the social
services law is REPEALED and paragraphs (c) and (d), paragraph (d) as
added by section 29 of part B of chapter 58 of the laws of 2010, are
relettered paragraphs (b) and (c).
§ 16. Paragraph (c) of subdivision 2 of section 366-a of the social
services law, as added by section 29 of part B of section 58 of the laws
of 2010 and as relettered by section fifteen of this act, is amended to
read as follows:
(c) Notwithstanding the provisions of paragraph (a) of this subdivi-
sion, an applicant or recipient [whose eligibility under this title is
determined without regard to the amount of his or her accumulated
resources] may attest to the amount of interest income generated by
[such] resources if the amount of such interest income is expected to be
immaterial to medical assistance eligibility, as determined by the
commissioner of health. In the event there is an inconsistency between
the information reported by the applicant or recipient and any informa-
tion obtained by the commissioner of health from other sources and such
inconsistency is material to medical assistance eligibility, the commis-
sioner of health shall request that the applicant or recipient provide
adequate documentation to verify [his or her] THEIR interest income.
§ 17. Paragraph (d) of subdivision 2 of section 366-a of the social
services law is REPEALED.
§ 18. Paragraph (a) of subdivision 8 of section 366-a of the social
services law, as amended by section 7 of part B of chapter 58 of the
laws of 2010, is amended to read as follows:
(a) Notwithstanding subdivisions two and five of this section, infor-
mation concerning income [and resources] of applicants for and recipi-
ents of medical assistance may be verified by matching client informa-
tion with information contained in the wage reporting system established
by section one hundred seventy-one-a of the tax law and in similar
systems operating in other geographically contiguous states, by means of
an income verification performed pursuant to a memorandum of understand-
ing with the department of taxation and finance pursuant to subdivision
four of section one hundred seventy-one-b of the tax law, and, to the
extent required by federal law, with information contained in the non-
wage income file maintained by the United States internal revenue
service, in the beneficiary data exchange maintained by the United
States department of health and human services, and in the unemployment
insurance benefits file. Such matching shall provide for procedures
which document significant inconsistent results of matching activities.
S. 8007 69 A. 9007
Nothing in this section shall be construed to prohibit activities the
department reasonably believes necessary to conform with federal
requirements under section one thousand one hundred thirty-seven of the
social security act.
§ 19. Subdivision 1 of section 366-c of the social services law, as
added by chapter 558 of the laws of 1989, is amended to read as follows:
1. Notwithstanding any other provision of law to the contrary, in
determining the eligibility for medical assistance of a person defined
as an institutionalized spouse, the income [and resources] of such
person and the person's community spouse shall be treated as provided in
this section.
§ 20. Paragraphs (c), (d) and (e) of subdivision 2 of section 366-c of
the social services law are REPEALED and paragraphs (f), (g), (h), (i),
(j) and (k) of subdivision 2 are relettered paragraphs (c), (d), (e),
(f), (g) and (h).
§ 21. Subdivisions 5 and 6 of section 366-c of the social services law
are REPEALED and subdivisions 7 and 8 are renumbered subdivisions 5 and
6.
§ 22. Subdivisions 5 and 6 of section 366-c of the social services
law, as added by chapter 558 of the laws of 1989 and as relettered by
section twenty-one of this act, are amended to read as follows:
5. (a) At the beginning or after the commencement of a continuous
period of institutionalization, either spouse may request [an assessment
of the total value of their resources or] a determination of the commu-
nity spouse monthly income allowance, the amount of the family allow-
ance, or the method of computing the amount of the family allowance, or
the method of computing the amount of the community spouse income allow-
ance.
(b) [(i) Upon receipt of a request pursuant to paragraph (a) of this
subdivision together with all relevant documentation of the resources of
both spouses, the social services district shall assess and document the
total value of the spouses' resources and provide each spouse with a
copy of the assessment and the documentation upon which it was based. If
the request is not part of an application for medical assistance bene-
fits, the social services district may charge a fee for the assessment
which is related to the cost of preparing and copying the assessment and
documentation which fee may not exceed twenty-five dollars.
(ii) The social services district shall also notify each requesting
spouse of the community spouse monthly income allowance, of the amount,
if any, of the family allowances, and of the method of computing the
amount of the community spouse monthly income allowance.
(c)] The social services district shall also provide to the spouse a
notice of the right to a fair hearing at the time of provision of the
information requested under paragraph (a) of this subdivision or after a
determination of eligibility for medical assistance. Such notice shall
be in the form prescribed or approved by the commissioner and include a
statement advising the spouse of the right to a fair hearing under this
section.
6. (a) If, after a determination on an application for medical assist-
ance has been made, either spouse is dissatisfied with the determination
of the community spouse monthly allowance[,] OR the amount of monthly
income otherwise available to the community spouse, [the computation of
the spousal share of resources, the attribution of resources or the
determination of the community spouse's resource allocation,] the spouse
may request a fair hearing to dispute such determination. Such hearing
shall be held within thirty days of the request therefor.
S. 8007 70 A. 9007
(b) If either spouse establishes that the community spouse needs
income above the level established by the social services district as
the minimum monthly maintenance needs allowance, based upon exceptional
circumstances which result in significant financial distress (as defined
by the commissioner in regulations), the department shall substitute an
amount adequate to provide additional necessary income from the income
otherwise available to the institutionalized spouse.
[(c) If either spouse establishes that income generated by the commu-
nity spouse resource allowance, established by the social services
district, is inadequate to raise the community spouse's income to the
minimum monthly maintenance needs allowance, the department shall estab-
lish a resource allowance for the spousal share of the institutionalized
spouse adequate to provide such minimum monthly maintenance needs allow-
ance.]
§ 23. The commissioner of health shall, consistent with the social
services law, make any necessary amendments to the state plan for
medical assistance submitted pursuant to section three hundred sixty-
three of the social services law, in order to ensure federal financial
participation in expenditures under the provisions of this act. The
provisions of this act shall not take effect unless all necessary
approvals under federal law and regulation have been obtained to receive
federal financial participation for the costs of services provide here-
under.
§ 24. This act shall take effect January 1, 2023, subject to federal
financial participation; provided, however that the amendments to para-
graph h of subdivision 6 of section 366 of the social services law made
by section eight of this act shall not affect the repeal of such subdi-
vision and shall be deemed repealed therewith; provided further that the
commissioner of health shall notify the legislative bill drafting
commission upon the occurrence of federal financial participation in
order that the commission may maintain an accurate and timely effective
data base of the official text of the laws of the state of New York in
furtherance of effectuating the provisions of section 44 of the legisla-
tive law and section 70-b of the public officers law.
PART O
Section 1. Subdivision 3 of section 367-r of the social services law,
as added by section 2 of part PP of chapter 56 of the laws of 2020, is
amended and a new subdivision 4 is added to read as follows:
3. Provider directory for fee-for-service private duty nursing
services provided to medically fragile children AND ADULTS. The commis-
sioner of health is authorized to establish a directory of qualified
providers for the purpose of promoting the availability and ensuring
delivery of fee-for-service private duty nursing services to medically
fragile children and individuals transitioning out of such category of
care, AND MEDICALLY FRAGILE ADULTS. Qualified providers enrolling in
the directory shall ensure the availability and delivery of and shall
provide such services to those individuals as are in need of such
services, and shall receive increased reimbursement for such services
pursuant to paragraph (c) of subdivision two, AND PARAGRAPH (C) OF
SUBDIVISION FOUR of this section. The directory shall offer enrollment
to all private duty nursing services providers to promote and ensure the
participation in the directory of all nursing services providers avail-
able to serve medically fragile children AND ADULTS.
S. 8007 71 A. 9007
4. MEDICALLY FRAGILE ADULTS. (A) THE COMMISSIONER SHALL INCREASE RATES
FOR PRIVATE DUTY NURSING SERVICES THAT ARE PROVIDED TO MEDICALLY FRAGILE
ADULTS, AS SUCH TERM IS DEFINED BY THE COMMISSIONER IN REGULATION, TO
ENSURE THE AVAILABILITY OF SUCH SERVICES TO SUCH ADULTS. In establish-
ing rates of payment under this subdivision, the commissioner shall
consider the cost neutrality of such rates as related to the cost effec-
tiveness of caring for medically fragile adults in a non-institutional
setting as compared to an institutional setting. Such increased rates
for services rendered to such adults may take into consideration the
elements of cost, geographical differentials in the elements of cost
considered, economic factors in the area in which the private duty nurs-
ing service is provided, costs associated with the provision of private
duty nursing services to medically fragile adults, and the need for
incentives to improve services and institute economies and such
increased rates shall be payable only to those private duty nurses who
can demonstrate, to the satisfaction of the department of health, satis-
factory training and experience to provide services to such adults. Such
increased rates shall be determined based on application of the case mix
adjustment factor for AIDS home care program services rates as deter-
mined pursuant to applicable regulations of the department of health.
The commissioner may promulgate regulations to implement the provisions
of this subdivision.
(b) Private duty nursing services providers which have their rates
adjusted pursuant to paragraph (a) of this subdivision shall use such
funds solely for the purposes of recruitment and retention of private
duty nurses or to ensure the delivery of private duty nursing services
to medically fragile adults and are prohibited from using such funds for
any other purpose. Funds provided under paragraph (a) of this subdivi-
sion are not intended to supplant support provided by a local govern-
ment. Each such provider, with the exception of self-employed private
duty nurses, shall submit, at a time and in a manner to be determined by
the commissioner of health, a written certification attesting that such
funds will be used solely for the purpose of recruitment and retention
of private duty nurses or to ensure the delivery of private duty nursing
services to medically fragile adults. The commissioner of health and
their designees are authorized to audit each such provider to ensure
compliance with the written certification required by this subdivision
and shall recoup all funds determined to have been used for purposes
other than recruitment and retention of private duty nurses or the
delivery of private duty nursing services to medically fragile adults.
Such recoupment shall be in addition to any other penalties provided by
law.
(c) The commissioner of health shall, subject to the provisions of
paragraph (b) of this subdivision, and the provisions of subdivision
three of this section, and subject to the availability of federal finan-
cial participation, increase fees for the fee-for-service reimbursement
of private duty nursing services provided to medically fragile adults by
fee-for-service private duty nursing services providers who enroll and
participate in the provider directory pursuant to subdivision three of
this section, commencing April first, two thousand twenty-two, such that
such fees for reimbursement equal the final benchmark payment designed
to ensure adequate access to the service. In developing such benchmark
the commissioner of health may utilize the average two thousand eighteen
Medicaid managed care payments for reimbursement of such private duty
nursing services. The commissioner may promulgate regulations to imple-
ment the provisions of this paragraph.
S. 8007 72 A. 9007
§ 2. Section 21 of part MM of chapter 56 of the laws of 2020, direct-
ing the department of health to establish or procure the services of
an independent panel of clinical professionals and to develop and imple-
ment a uniform task-based assessment tool, is amended to read as
follows:
§ 21. The department of health shall develop[, directly or through
procurement, and shall implement an evidenced based validated uniform
task-based assessment tool no later than April 1, 2021,] GUIDELINES AND
STANDARDS FOR THE USE OF TASKING TOOLS to assist managed care plans and
local departments of social services to make appropriate and individual-
ized determinations for utilization of home care services in accordance
with applicable state and federal law and regulations, including the
number of personal care services and consumer directed personal assist-
ance hours of care each day[,] provided pursuant to the state's medical
assistance program, and how Medicaid recipients' needs for assistance
with activities of daily living can be met, such as through telehealth,
provided that services rendered via telehealth meet equivalent quality
and safety standards of services provided through non-electronic means,
and other available alternatives, including family and social supports.
[Notwithstanding the provisions of section 163 of the state finance law,
or sections 142 and 143 of the economic development law, or any contrary
provision of law, a contract may be entered without a competitive bid or
request for proposal process if such contract is for the purpose of
developing the evidence based validated uniform task-based assessment
tool described in this section, provided that:
(a) The department of health shall post on its website, for a period
of no less than 30 days:
(i) A description of the evidence based validated uniform task-based
assessment tool to be developed pursuant to the contract;
(ii) The criteria for contractor selection;
(iii) The period of time during which a prospective contractor may
seek to be selected by the department of health, which shall be no less
than 30 days after such information is first posted on the website; and
(iv) The manner by which a prospective contractor may submit a
proposal for selection, which may include submission by electronic
means;
(b) All reasonable and responsive submissions that are received from
prospective contractors in a timely fashion shall be reviewed by the
commissioner of health;
(c) The commissioner of health shall select such contractor that is
best suited to serve the purposes of this section and the needs of
recipients; and
(d) All decisions made and approaches taken pursuant to this section
shall be documented in a procurement record as defined in section one
hundred sixty-three of the state finance law.]
§ 3. The public health law is amended by adding a new article 29-EE to
read as follows:
ARTICLE 29-EE
PROGRAMS OF ALL-INCLUSIVE
CARE FOR THE ELDERLY
SECTION 2999-S. DEFINITIONS.
2999-T. PACE ORGANIZATION ESTABLISHMENT.
2999-U. CRITERIA FOR PROGRAM ELIGIBILITY AND LICENSURE.
2999-V. ELIGIBILITY AND ENROLLMENT.
2999-W. INCLUDED PROGRAM BENEFITS.
2999-X. REIMBURSEMENT.
S. 8007 73 A. 9007
§ 2999-S. DEFINITIONS. FOR THE PURPOSES OF THIS ARTICLE, THE FOLLOWING
TERMS SHALL HAVE THE FOLLOWING MEANINGS:
1. "PACE ORGANIZATION" MEANS A PACE PROVIDER, AS DEFINED IN 42 U.S.C.
§ 1395(EEE), ESTABLISHED IN ACCORDANCE WITH FEDERAL PUBLIC LAW 105-33,
SUBTITLE I OF TITLE IV OF THE BALANCED BUDGET ACT OF 1997, INCLUDING
AMENDMENTS THERETO.
2. "PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY", "PACE" OR "PACE
PROGRAM" SHALL INCLUDE THOSE PROGRAMS DEFINED AS "OPERATING DEMON-
STRATIONS" BY SECTION FORTY-FOUR HUNDRED THREE-F OF THIS CHAPTER.
3. "PACE CENTER" MEANS A FACILITY ESTABLISHED IN ACCORDANCE WITH REGU-
LATIONS PROMULGATED HEREUNDER THAT IS OPERATED BY A PACE ORGANIZATION
WHERE PRIMARY CARE AND OTHER SERVICES ARE FURNISHED TO ENROLLEES OF SUCH
PROGRAM.
§ 2999-T. PACE ORGANIZATION ESTABLISHMENT. 1. NOTWITHSTANDING ANY
INCONSISTENT PROVISION TO THE CONTRARY, THE COMMISSIONER SHALL ESTABLISH
A PROGRAM FOR ALL-INCLUSIVE CARE FOR THE ELDERLY IN NEW YORK, TO PROVIDE
COMMUNITY-BASED, RISK-BASED, AND CAPITATED LONG-TERM CARE SERVICES AS
OPTIONAL SERVICES UNDER THE STATE'S MEDICAID STATE PLAN AND ANY APPLICA-
BLE WAIVERS, AS WELL AS UNDER CONTRACTS ENTERED INTO BETWEEN THE FEDERAL
CENTERS FOR MEDICARE AND MEDICAID SERVICES, THE DEPARTMENT, AND PACE
ORGANIZATIONS.
2. THE ESTABLISHMENT OF SUCH A PROGRAM SHALL NOT PRECLUDE THE CONTIN-
UED OPERATION OF EXISTING APPROVED PACE ORGANIZATIONS AT THE TIME OF
ENACTMENT OR IMPLEMENTATION OF THIS ARTICLE. THE DEPARTMENT MAY ESTAB-
LISH A PROCESS, IF DEEMED NECESSARY, TO ASSIST THE TRANSITION OF SUCH
EXISTING PROGRAMS THROUGH PROCESSES AND REQUIREMENTS SET FORTH PURSUANT
TO THIS ARTICLE.
§ 2999-U. CRITERIA FOR PROGRAM ELIGIBILITY AND LICENSURE. 1. PROGRAM
CRITERIA. THE REQUIREMENTS OF THE PACE MODEL, AS PROVIDED FOR PURSUANT
TO 42 U.S.C. § 1395(EEE) AND 42 U.S.C. § 1396(U-4), INCLUDING AMENDMENTS
THERETO, SHALL NOT BE WAIVED OR MODIFIED. NEW YORK STATE PACE ORGANIZA-
TION REQUIREMENTS SHALL INCLUDE, BUT NOT BE LIMITED TO:
(A) THE PROVISION AND MAINTENANCE OF A PACE CENTER; AND
(B) THE ADOPTION AND IMPLEMENTATION OF AN INTERDISCIPLINARY TEAM
APPROACH TO CARE MANAGEMENT, CARE DELIVERY, AND CARE PLANNING.
2. CONTRACTING. (A) NOTWITHSTANDING SECTIONS ONE HUNDRED TWELVE AND
ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW AND SECTIONS ONE
HUNDRED FORTY-TWO AND ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOP-
MENT LAW, THE DEPARTMENT MAY ENTER INTO CONTRACTS, INCLUDING AMENDMENTS
OR EXTENSIONS THERETO, WITH PUBLIC OR PRIVATE ORGANIZATIONS THAT MEET
THE STANDARDS FOR LICENSURE ESTABLISHED UNDER THIS ARTICLE AND UNDER ANY
PROCESS ESTABLISHED TO ASSIST IN THE TRANSITION OF EXISTING PROGRAMS,
FOR IMPLEMENTATION AND OPERATION OF A PACE ORGANIZATION.
(B) THE DEPARTMENT MAY ENTER INTO ADDITIONAL CONTRACTS AS NECESSARY TO
IMPLEMENT, OPERATE OR OVERSEE THE PROGRAM, OR ANY OTHER CONTRACTS DEEMED
NECESSARY TO PROVIDE COMPREHENSIVE COMMUNITY-BASED, RISK-BASED AND CAPI-
TATED LONG-TERM CARE TO ELIGIBLE POPULATIONS UNDER THE PACE PROGRAM.
(C) PACE ORGANIZATIONS SHALL CONTRACT WITH THE FEDERAL CENTERS FOR
MEDICARE AND MEDICAID SERVICES TO ENTER INTO A PACE ORGANIZATION AGREE-
MENT.
3. LICENSURE. (A) IN SETTING FORTH REQUIREMENTS TO ESTABLISH THE
STATE'S PACE ORGANIZATION, THE DEPARTMENT SHALL PROVIDE FOR A UNIFIED
LICENSURE PROCESS FOR PACE ORGANIZATIONS THAT IS INCLUSIVE OF PROGRAM
REQUIREMENTS SET FORTH UNDER ARTICLES TWENTY-EIGHT, THIRTY-SIX, AND
FORTY-FOUR OF THIS CHAPTER, AS WELL AS PERTINENT REGULATORY REQUIREMENTS
S. 8007 74 A. 9007
FOR PACE ORGANIZATIONS IN ACCORDANCE WITH A REGULATORY APPROACH WHICH
SHALL BE ESTABLISHED BY THE DEPARTMENT.
(B) AN ENTITY MAY NOT OPERATE A PACE ORGANIZATION IN THE STATE WITHOUT
BEING LICENSED IN ACCORDANCE WITH THIS SUBDIVISION AND ANY REGULATIONS
PROMULGATED HEREUNDER; PROVIDED, HOWEVER, THAT THIS REQUIREMENT SHALL
NOT BE CONSTRUED TO DISALLOW THE OPERATION OF APPROVED PACE ORGANIZA-
TIONS AT THE TIME OF ENACTMENT OR IMPLEMENTATION OF THIS ACT IN ACCORD-
ANCE WITH ANY PROCESS ESTABLISHED BY THE DEPARTMENT TO ASSIST THE TRAN-
SITION OF SUCH EXISTING PROGRAMS THROUGH PROCESSES AND REQUIREMENTS SET
FORTH IN ACCORDANCE WITH THIS ARTICLE.
4. OPERATIONS AND OVERSIGHT. THE DEPARTMENT SHALL:
(A) ESTABLISH REQUIREMENTS FOR FINANCIAL SOLVENCY FOR PACE ORGANIZA-
TIONS IN COMPLIANCE WITH THOSE SET FORTH IN PARAGRAPH (C) OF SUBDIVISION
ONE OF SECTION FORTY-FOUR HUNDRED THREE OF THIS CHAPTER, AND SHALL
ESTABLISH A CONTINGENT RESERVE REQUIREMENT FOR PACE ORGANIZATIONS WHICH,
PURSUANT TO REGULATIONS, MAY BE DIFFERENT THAN OTHER PLANS;
(B) PROVIDE OVERSIGHT OF PACE ORGANIZATION OPERATIONS IN COORDINATION
WITH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES, INCLUDING THE
ESTABLISHMENT OF ANY RULES APPROPRIATE FOR THE SAFE, EFFICIENT AND
ORDERLY ADMINISTRATION OF THE PROGRAM AND FOR THE MAINTENANCE OR REVOCA-
TION OF LICENSURE UNDER THIS ARTICLE.
§ 2999-V. ELIGIBILITY AND ENROLLMENT. 1. TO BE ELIGIBLE FOR ENROLLMENT
IN A PACE ORGANIZATION, AN INDIVIDUAL MUST:
(A) BE AT LEAST FIFTY-FIVE YEARS OLD; AND
(B) MEET THE STATE'S ELIGIBILITY CRITERIA FOR NURSING HOME LEVEL OF
CARE; AND
(C) RESIDE WITHIN THE PACE APPROVED SERVICE AREA; AND
(D) BE ABLE TO BE MAINTAINED SAFELY IN A COMMUNITY-BASED SETTING AT
THE TIME OF ENROLLMENT WITH THE ASSISTANCE OF THE PACE ORGANIZATION; AND
(E) MEET ANY ADDITIONAL PROGRAM SPECIFIC ELIGIBILITY CONDITIONS
IMPOSED UNDER THE PACE PROGRAM AGREEMENT BETWEEN THE PACE ORGANIZATION,
THE DEPARTMENT, AND THE CENTERS FOR MEDICARE AND MEDICAID SERVICES; OR
(F) BE OTHERWISE ELIGIBLE FOR PARTICIPATION IN A PACE DEMONSTRATION OR
SPECIALTY PROGRAM AUTHORIZED BY THE FEDERAL PACE INNOVATION ACT AND
APPROVED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AND THE
DEPARTMENT. NOTWITHSTANDING ANY LAW OR REGULATION TO THE CONTRARY, IN
THE EVENT THAT FEDERAL LAW OR REGULATION PERMITS EXPANDED ELIGIBILITY OR
ENROLLMENT OPTIONS, ELIGIBILITY OR ENROLLMENT FOR THE APPLICABLE PACE
ORGANIZATIONS MAY, IF APPROVED BY THE DEPARTMENT, CONFORM TO SUCH STAND-
ARDS AS PERMITTED UNDER SUCH FEDERAL AUTHORITY.
2. ENROLLMENT AND PARTICIPATION BY INDIVIDUALS IN PACE ORGANIZATIONS
SHALL BE VOLUNTARY.
§ 2999-W. INCLUDED PROGRAM BENEFITS. ENROLLEES IN ALL PACE ORGANIZA-
TIONS SHALL BE PROVIDED A BENEFIT PACKAGE, REGARDLESS OF SOURCE OF
PAYMENT, THAT INCLUDES:
1. ALL MEDICARE-COVERED ITEMS AND SERVICES;
2. ALL MEDICAID-COVERED ITEMS AND SERVICES, AS SPECIFIED IN THE
STATE'S MEDICAID PLAN AND UNDER SECTION THREE HUNDRED SIXTY-FOUR-J OF
THE SOCIAL SERVICES LAW; AND
3. OTHER SUCH SERVICES AS DETERMINED NECESSARY BY THE INTERDISCIPLI-
NARY TEAM TO IMPROVE AND MAINTAIN THE PARTICIPANT'S OVERALL HEALTH
STATUS.
§ 2999-X. REIMBURSEMENT. THE DEPARTMENT SHALL DEVELOP AND IMPLEMENT,
IN CONFORMANCE WITH APPLICABLE FEDERAL REQUIREMENTS, A METHODOLOGY FOR
ESTABLISHING RATES OF PAYMENT FOR COSTS OF BENEFITS PROVIDED BY PACE
ORGANIZATIONS TO ITS MEDICAID ELIGIBLE ENROLLEES.
S. 8007 75 A. 9007
§ 4. This act shall take effect immediately; provided, however, that
section three of this act shall take effect upon the adoption of rules
and regulations by the commissioner of health governing the licensure of
PACE organizations as provided under article 29-EE of the public health
law as added by section three of this act; provided that the commission-
er of health shall notify the legislative bill drafting commission upon
the occurrence of the adoption of rules and regulations pursuant to such
section in order that the commission may maintain an accurate and timely
effective data base of the official text of the laws of the state of New
York in furtherance of effectuating the provisions of section 44 of the
legislative law and section 70-b of the public officers law. Effective
immediately, the addition, amendment and/or repeal of any rule or regu-
lation necessary for the implementation of this act on its effective
date are authorized to be made and completed on or before such effective
date.
PART P
Section 1. Subdivision 2 of section 364-j of the social services law
is amended by adding a new paragraph (d) to read as follows:
(D) EFFECTIVE APRIL FIRST, TWO THOUSAND TWENTY-TWO AND EXPIRING ON THE
DATE THE COMMISSIONER OF HEALTH PUBLISHES ON ITS WEBSITE A REQUEST FOR
PROPOSALS IN ACCORDANCE WITH PARAGRAPH (A) OF SUBDIVISION FIVE OF THIS
SECTION, THE COMMISSIONER OF HEALTH SHALL PLACE A MORATORIUM ON THE
PROCESSING AND APPROVAL OF APPLICATIONS SEEKING AUTHORITY TO ESTABLISH A
MANAGED CARE PROVIDER, INCLUDING APPLICATIONS SEEKING AUTHORIZATION TO
EXPAND THE SCOPE OF ELIGIBLE ENROLLEE POPULATIONS. SUCH MORATORIUM SHALL
NOT APPLY TO:
(I) APPLICATIONS SUBMITTED TO THE DEPARTMENT PRIOR TO JANUARY FIRST,
TWO THOUSAND TWENTY-TWO;
(II) APPLICATIONS SEEKING APPROVAL TO TRANSFER OWNERSHIP OR CONTROL OF
AN EXISTING MANAGED CARE PROVIDER;
(III) APPLICATIONS SEEKING AUTHORIZATION TO EXPAND AN EXISTING MANAGED
CARE PROVIDER'S APPROVED SERVICE AREA;
(IV) APPLICATIONS SEEKING AUTHORIZATION TO FORM OR OPERATE A MANAGED
CARE PROVIDER THROUGH AN ENTITY CERTIFIED UNDER SECTION FOUR THOUSAND
FOUR HUNDRED THREE-C OR FOUR THOUSAND FOUR HUNDRED THREE-G OF THE PUBLIC
HEALTH LAW;
(V) APPLICATIONS DEMONSTRATING TO THE COMMISSIONER OF HEALTH'S SATIS-
FACTION THAT SUBMISSION OF THE APPLICATION FOR CONSIDERATION WOULD BE
APPROPRIATE TO ADDRESS A SERIOUS CONCERN WITH CARE DELIVERY, SUCH AS A
LACK OF ADEQUATE ACCESS TO MANAGED CARE PROVIDERS IN A GEOGRAPHIC AREA
OR A LACK OF ADEQUATE AND APPROPRIATE CARE, LANGUAGE AND CULTURAL COMPE-
TENCE, OR SPECIAL NEEDS SERVICES.
§ 2. Subdivision 5 of section 364-j of the social services law, as
amended by section 15 of part C of chapter 58 of the laws of 2004, para-
graph (a) as amended by section 40 of part A of chapter 56 of the laws
of 2013, paragraphs (d), (e) and (f) as amended by section 80 of part H
of chapter 59 of the laws of 2011, is amended to read as follows:
5. Managed care programs shall be conducted in accordance with the
requirements of this section and, to the extent practicable, encourage
the provision of comprehensive medical services, pursuant to this arti-
cle.
(a) The managed care program NOTWITHSTANDING SECTIONS ONE HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, SECTIONS
ONE HUNDRED FORTY-TWO AND ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVEL-
S. 8007 76 A. 9007
OPMENT LAW, AND ANY OTHER INCONSISTENT PROVISION OF LAW, THE COMMISSION-
ER OF HEALTH shall, THROUGH A COMPETITIVE BID PROCESS BASED ON PROPOSALS
SUBMITTED TO THE DEPARTMENT, provide for the selection of qualified
managed care providers [by the commissioner of health] to participate in
the MANAGED CARE program PURSUANT TO A CONTRACT WITH THE DEPARTMENT,
including [comprehensive HIV special needs plans and] special needs
managed care plans in accordance with the provisions of section three
hundred sixty-five-m of this title; provided, however, that the commis-
sioner of health may contract directly with comprehensive HIV special
needs plans [consistent with standards set forth in this section] WITH-
OUT A COMPETITIVE BID PROCESS, and assure that such providers are acces-
sible taking into account the needs of persons with disabilities and the
differences between rural, suburban, and urban settings, and in suffi-
cient numbers to meet the health care needs of participants, and shall
consider the extent to which major public hospitals are included within
such providers' networks[.
(b) A proposal]; AND PROVIDED FURTHER THAT:
(I) PROPOSALS submitted by a managed care provider to participate in
the managed care program shall:
[(i)] (A) designate the geographic [area] AREAS, AS DEFINED BY THE
COMMISSIONER OF HEALTH IN THE REQUEST FOR PROPOSALS, to be served [by
the provider], and estimate the number of eligible participants and
actual participants in such designated area;
[(ii)] (B) include a network of health care providers in sufficient
numbers and geographically accessible to service program participants;
[(iii)] (C) describe the procedures for marketing in the program
location, including the designation of other entities which may perform
such functions under contract with the organization;
[(iv)] (D) describe the quality assurance, utilization review and case
management mechanisms to be implemented;
[(v)] (E) demonstrate the applicant's ability to meet the data analy-
sis and reporting requirements of the program;
[(vi)] (F) demonstrate financial feasibility of the program; and
[(vii)] (G) include such other information as the commissioner of
health may deem appropriate.
(II) IN ADDITION TO THE CRITERIA DESCRIBED IN SUBPARAGRAPH (I) OF THIS
PARAGRAPH, THE COMMISSIONER OF HEALTH SHALL ALSO CONSIDER:
(A) ACCESSIBILITY AND GEOGRAPHIC DISTRIBUTION OF NETWORK PROVIDERS,
TAKING INTO ACCOUNT THE NEEDS OF PERSONS WITH DISABILITIES AND THE
DIFFERENCES BETWEEN RURAL, SUBURBAN, AND URBAN SETTINGS;
(B) THE EXTENT TO WHICH MAJOR PUBLIC HOSPITALS ARE INCLUDED IN THE
SUBMITTED PROVIDER NETWORK;
(C) DEMONSTRATED CULTURAL AND LANGUAGE COMPETENCIES SPECIFIC TO THE
POPULATION OF PARTICIPANTS;
(D) THE CORPORATE ORGANIZATION AND STATUS OF THE BIDDER AS A CHARITA-
BLE CORPORATION UNDER THE NOT-FOR-PROFIT CORPORATION LAW;
(E) THE ABILITY OF A BIDDER TO OFFER PLANS IN MULTIPLE REGIONS;
(F) THE TYPE AND NUMBER OF PRODUCTS THE BIDDER PROPOSES TO OPERATE,
INCLUDING PRODUCTS BID FOR IN ACCORDANCE WITH THE PROVISIONS OF SUBDIVI-
SION SIX OF SECTION FOUR THOUSAND FOUR HUNDRED THREE-F OF THE PUBLIC
HEALTH LAW, AND OTHER PRODUCTS DETERMINED BY THE COMMISSIONER OF HEALTH,
INCLUDING BUT NOT NECESSARILY LIMITED TO THOSE OPERATED UNDER TITLE
ONE-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW AND SECTION THREE
HUNDRED SIXTY-NINE-GG OF THIS ARTICLE;
(G) WHETHER THE BIDDER PARTICIPATES IN PRODUCTS FOR INTEGRATED CARE
FOR PARTICIPANTS WHO ARE DUALLY ELIGIBLE FOR MEDICAID AND MEDICARE;
S. 8007 77 A. 9007
(H) WHETHER THE BIDDER PARTICIPATES IN VALUE BASED PAYMENT ARRANGE-
MENTS AS DEFINED BY THE DEPARTMENT, INCLUDING THE DELEGATION OF SIGNIF-
ICANT FINANCIAL RISK TO CLINICALLY INTEGRATED PROVIDER NETWORKS;
(I) THE BIDDER'S COMMITMENT TO PARTICIPATION IN MANAGED CARE IN THE
STATE;
(J) THE BIDDER'S COMMITMENT TO QUALITY IMPROVEMENT;
(K) THE BIDDER'S COMMITMENT TO COMMUNITY REINVESTMENT SPENDING, AS
SHALL BE DEFINED IN THE PROCUREMENT;
(L) FOR CURRENT OR PREVIOUSLY AUTHORIZED MANAGED CARE PROVIDERS, PAST
PERFORMANCE IN MEETING MANAGED CARE CONTRACT OR FEDERAL OR STATE
REQUIREMENTS, AND IF THE COMMISSIONER ISSUED ANY STATEMENTS OF FINDINGS,
STATEMENTS OF DEFICIENCY, INTERMEDIATE SANCTIONS OR ENFORCEMENT ACTIONS
TO A BIDDER FOR NON-COMPLIANCE WITH SUCH REQUIREMENTS, WHETHER THE
BIDDER ADDRESSED SUCH ISSUES IN A TIMELY MANNER;
(M) SUCH CRITERIA AS THE COMMISSIONER OF HEALTH SHALL DEVELOP, WITH
THE COMMISSIONERS OF THE OFFICE OF MENTAL HEALTH, THE OFFICE FOR PEOPLE
WITH DEVELOPMENTAL DISABILITIES, THE OFFICE OF ADDICTION SERVICES AND
SUPPORTS, AND THE OFFICE OF CHILDREN AND FAMILY SERVICES, AS APPLICABLE;
AND
(N) ANY OTHER CRITERIA DEEMED APPROPRIATE BY THE COMMISSIONER OF
HEALTH.
(III) SUBPARAGRAPHS (I) AND (II) OF THIS PARAGRAPH DESCRIBING PROPOSAL
CONTENT AND SELECTION CRITERIA REQUIREMENTS SHALL NOT BE CONSTRUED AS
LIMITING OR REQUIRING THE COMMISSIONER OF HEALTH TO EVALUATE SUCH
CONTENT OR CRITERIA ON A PASS-FAIL, SCALE, OR OTHER METHODOLOGICAL
BASIS; PROVIDED HOWEVER, THAT THE COMMISSIONER SHALL CONSIDER ALL SUCH
CONTENT AND CRITERIA USING METHODS DETERMINED BY THE COMMISSIONER OF
HEALTH IN THEIR DISCRETION AND, AS APPLICABLE, IN CONSULTATION WITH THE
COMMISSIONERS OF THE OFFICE OF MENTAL HEALTH, THE OFFICE FOR PEOPLE WITH
DEVELOPMENTAL DISABILITIES, THE OFFICE OF ADDICTION SERVICES AND
SUPPORTS, AND THE OFFICE OF CHILDREN AND FAMILY SERVICES.
(IV) THE DEPARTMENT OF HEALTH SHALL POST ON ITS WEBSITE:
(A) THE REQUEST FOR PROPOSALS AND A DESCRIPTION OF THE PROPOSED
SERVICES TO BE PROVIDED PURSUANT TO CONTRACTS IN ACCORDANCE WITH THIS
SUBDIVISION;
(B) THE CRITERIA ON WHICH THE DEPARTMENT SHALL DETERMINE QUALIFIED
BIDDERS AND EVALUATE THEIR PROPOSALS, INCLUDING ALL CRITERIA IDENTIFIED
IN THIS SUBDIVISION;
(C) THE MANNER BY WHICH A PROPOSAL MAY BE SUBMITTED, WHICH MAY INCLUDE
SUBMISSION BY ELECTRONIC MEANS;
(D) THE MANNER BY WHICH A MANAGED CARE PROVIDER MAY CONTINUE TO
PARTICIPATE IN THE MANAGED CARE PROGRAM PENDING AWARD OF MANAGED CARE
PROVIDERS THROUGH A COMPETITIVE BID PROCESS PURSUANT TO THIS SUBDIVI-
SION; AND
(E) UPON AWARD, THE MANAGED CARE PROVIDERS THAT THE COMMISSIONER
INTENDS TO CONTRACT WITH PURSUANT TO THIS SUBDIVISION, PROVIDED THAT THE
COMMISSIONER SHALL UPDATE SUCH LIST TO INDICATE THE FINAL SLATE OF
CONTRACTED MANAGED CARE PROVIDERS.
(V)(A) ALL RESPONSIVE SUBMISSIONS THAT ARE RECEIVED FROM BIDDERS IN A
TIMELY FASHION SHALL BE REVIEWED BY THE COMMISSIONER OF HEALTH IN
CONSULTATION WITH THE COMMISSIONERS OF THE OFFICE OF MENTAL HEALTH, THE
OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, THE OFFICE OF
ADDICTION SERVICES AND SUPPORTS, AND THE OFFICE OF CHILDREN AND FAMILY
SERVICES, AS APPLICABLE. THE COMMISSIONER SHALL CONSIDER COMMENTS
RESULTING FROM THE REVIEW OF PROPOSALS AND MAKE AWARDS IN CONSULTATION
WITH SUCH AGENCIES.
S. 8007 78 A. 9007
(B) THE COMMISSIONER OF HEALTH SHALL MAKE AWARDS UNDER THIS SUBDIVI-
SION FOR EACH PRODUCT, FOR WHICH PROPOSALS WERE REQUESTED, TO AT LEAST
TWO MANAGED CARE PROVIDERS IN EACH GEOGRAPHIC REGION DEFINED BY THE
COMMISSIONER IN THE REQUEST FOR PROPOSALS FOR WHICH AT LEAST TWO MANAGED
CARE PROVIDERS HAVE SUBMITTED A PROPOSAL, AND SHALL HAVE DISCRETION TO
OFFER MORE CONTRACTS BASED ON NEED FOR ACCESS; PROVIDED, HOWEVER, THAT
THE COMMISSIONER OF HEALTH SHALL NOT OFFER ANY MORE THAN FIVE (5)
CONTRACTS IN ANY ONE REGION.
(C) MANAGED CARE PROVIDERS AWARDED UNDER THIS SUBDIVISION SHALL BE
ENTITLED TO ENTER INTO A CONTRACT WITH THE DEPARTMENT FOR THE PURPOSE OF
PARTICIPATING IN THE MANAGED CARE PROGRAM. SUCH CONTRACTS SHALL RUN FOR
A TERM TO BE DETERMINED BY THE COMMISSIONER, WHICH MAY BE RENEWED OR
MODIFIED FROM TIME TO TIME WITHOUT A NEW REQUEST FOR PROPOSALS, TO
ENSURE CONSISTENCY WITH CHANGES IN FEDERAL AND STATE LAWS, REGULATIONS
OR POLICIES, INCLUDING BUT NOT LIMITED TO THE EXPANSION OR REDUCTION OF
MEDICAL ASSISTANCE SERVICES AVAILABLE TO PARTICIPANTS THROUGH A MANAGED
CARE PROVIDER.
(D) NOTHING IN THIS PARAGRAPH OR OTHER PROVISION OF THIS SECTION SHALL
BE CONSTRUED TO LIMIT IN ANY WAY THE ABILITY OF THE DEPARTMENT OF HEALTH
TO TERMINATE AWARDED CONTRACTS FOR CAUSE, WHICH SHALL INCLUDE BUT NOT BE
LIMITED TO ANY VIOLATION OF THE TERMS OF SUCH CONTRACTS OR VIOLATIONS OF
STATE OR FEDERAL LAWS AND REGULATIONS AND ANY LOSS OF NECESSARY STATE OR
FEDERAL FUNDING.
(E) NOTWITHSTANDING SECTIONS ONE HUNDRED TWELVE AND ONE HUNDRED
SIXTY-THREE OF THE STATE FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND
ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOPMENT LAW, AND ANY OTHER
INCONSISTENT PROVISION OF LAW, THE DEPARTMENT OF HEALTH MAY, IN ACCORD-
ANCE WITH THE PROVISIONS OF THIS PARAGRAPH, ISSUE NEW REQUESTS FOR
PROPOSALS AND AWARD NEW CONTRACTS FOR TERMS FOLLOWING AN EXISTING TERM
OF A CONTRACT ENTERED INTO UNDER THIS PARAGRAPH.
(B)(I) WITHIN SIXTY DAYS OF THE DEPARTMENT OF HEALTH ISSUING THE
REQUEST FOR PROPOSALS UNDER PARAGRAPH (A) OF THIS SUBDIVISION, A MANAGED
CARE PROVIDER THAT WAS APPROVED TO PARTICIPATE IN THE MANAGED CARE
PROGRAM PRIOR TO THE ISSUANCE OF THE REQUEST FOR PROPOSALS, SHALL SUBMIT
ITS INTENTION TO COMPLETE SUCH PROPOSAL TO THE DEPARTMENT.
(II) A MANAGED CARE PROVIDER THAT: (A) FAILS TO SUBMIT ITS INTENT
TIMELY, (B) INDICATES WITHIN THE SIXTY-DAYS ITS INTENT NOT TO COMPLETE
SUCH A PROPOSAL, (C) FAILS TO SUBMIT A PROPOSAL WITHIN THE FURTHER TIME-
FRAME SPECIFIED BY THE COMMISSIONER OF HEALTH IN THE REQUEST FOR
PROPOSALS, OR (D) IS NOT AWARDED THE ABILITY TO PARTICIPATE IN THE
MANAGED CARE PROGRAM UNDER PARAGRAPH (A) OF THIS SUBDIVISION, SHALL,
UPON DIRECTION FROM THE COMMISSIONER OF HEALTH, TERMINATE ITS SERVICES
AND OPERATIONS IN ACCORDANCE WITH THE CONTRACT BETWEEN THE MANAGED CARE
PROVIDER AND THE DEPARTMENT OF HEALTH AND SHALL BE ADDITIONALLY REQUIRED
TO MAINTAIN COVERAGE OF PARTICIPANTS FOR SUCH PERIOD OF TIME AS DETER-
MINED NECESSARY BY THE COMMISSIONER OF HEALTH TO ACHIEVE THE SAFE AND
ORDERLY TRANSFER OF PARTICIPANTS.
(c) [The commissioner of health shall make a determination whether to
approve, disapprove or recommend modification of the proposal] IF NECES-
SARY TO ENSURE ACCESS TO SUFFICIENT NUMBER OF MANAGED CARE PROVIDERS ON
A GEOGRAPHIC OR OTHER BASIS, INCLUDING A LACK OF ADEQUATE AND APPROPRI-
ATE CARE, LANGUAGE AND CULTURAL COMPETENCE, OR SPECIAL NEEDS SERVICES,
THE COMMISSIONER OF HEALTH MAY REISSUE A REQUEST FOR PROPOSALS AS
PROVIDED FOR UNDER PARAGRAPH (A) OF THIS SUBDIVISION, PROVIDED HOWEVER,
THAT SUCH REQUEST MAY BE LIMITED TO THE GEOGRAPHIC OR OTHER BASIS OF
NEED THAT THE REQUEST FOR PROPOSALS IS SEEKING TO ADDRESS. ANY AWARDS
S. 8007 79 A. 9007
MADE SHALL BE SUBJECT TO THE REQUIREMENTS OF THIS SECTION, INCLUDING BUT
NOT LIMITED TO THE MINIMUM AND MAXIMUM NUMBER OF AWARDS IN A REGION.
(d) [Notwithstanding any inconsistent provision of this title and
section one hundred sixty-three of the state finance law, the commis-
sioner of health may contract with managed care providers approved under
paragraph (b) of this subdivision, without a competitive bid or request
for proposal process, to provide coverage for participants pursuant to
this title.
(e) Notwithstanding any inconsistent provision of this title and
section one hundred forty-three of the economic development law, no
notice in the procurement opportunities newsletter shall be required for
contracts awarded by the commissioner of health, to qualified managed
care providers pursuant to this section.
(f)] The care and services described in subdivision four of this
section will be furnished by a managed care provider pursuant to the
provisions of this section when such services are furnished in accord-
ance with an agreement with the department of health, and meet applica-
ble federal law and regulations.
[(g)] (E) The commissioner of health may delegate some or all of the
tasks identified in this section to the local districts.
[(h)] (F) Any delegation pursuant to paragraph [(g)] (E) of this
subdivision shall be reflected in the contract between a managed care
provider and the commissioner of health.
§ 3. Subdivision 4 of section 365-m of the social services law is
REPEALED and a new subdivision 4 is added to read as follows:
4. THE COMMISSIONER OF HEALTH, JOINTLY WITH THE COMMISSIONERS OF THE
OFFICE OF MENTAL HEALTH AND THE OFFICE OF ADDICTION SERVICES AND
SUPPORTS, SHALL SELECT A LIMITED NUMBER OF SPECIAL NEEDS MANAGED CARE
PLANS UNDER SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE, IN ACCORD-
ANCE WITH SUBDIVISION FIVE OF SUCH SECTION, CAPABLE OF MANAGING THE
BEHAVIORAL AND PHYSICAL HEALTH NEEDS OF MEDICAL ASSISTANCE ENROLLEES
WITH SIGNIFICANT BEHAVIORAL HEALTH NEEDS.
§ 4. The opening paragraph of subdivision 2 of section 4403-f of the
public health law, as amended by section 8 of part C of chapter 58 of
the laws of 2007, is amended to read as follows:
An eligible applicant shall submit an application for a certificate of
authority to operate a managed long term care plan upon forms prescribed
by the commissioner, INCLUDING ANY SUCH FORMS OR PROCESS AS MAY BE
REQUIRED OR PRESCRIBED BY THE COMMISSIONER IN ACCORDANCE WITH THE
COMPETITIVE BID PROCESS UNDER SUBDIVISION SIX OF THIS SECTION. Such
eligible applicant shall submit information and documentation to the
commissioner which shall include, but not be limited to:
§ 5. Subdivision 3 of section 4403-f of the public health law, as
amended by section 41-a of part H of chapter 59 of the laws of 2011, is
amended to read as follows:
3. Certificate of authority; approval. (A) The commissioner shall not
approve an application for a certificate of authority unless the appli-
cant demonstrates to the commissioner's satisfaction:
[(a)] (I) that it will have in place acceptable quality-assurance
mechanisms, grievance procedures, mechanisms to protect the rights of
enrollees and case management services to ensure continuity, quality,
appropriateness and coordination of care;
[(b)] (II) that it will include an enrollment process which shall
ensure that enrollment in the plan is informed. The application shall
describe the disenrollment process, which shall provide that an other-
S. 8007 80 A. 9007
wise eligible enrollee shall not be involuntarily disenrolled on the
basis of health status;
[(c)] (III) satisfactory evidence of the character and competence of
the proposed operators and reasonable assurance that the applicant will
provide high quality services to an enrolled population;
[(d)] (IV) sufficient management systems capacity to meet the require-
ments of this section and the ability to efficiently process payment for
covered services;
[(e)] (V) readiness and capability to maximize reimbursement of and
coordinate services reimbursed pursuant to title XVIII of the federal
social security act and all other applicable benefits, with such benefit
coordination including, but not limited to, measures to support sound
clinical decisions, reduce administrative complexity, coordinate access
to services, maximize benefits available pursuant to such title and
ensure that necessary care is provided;
[(f)] (VI) readiness and capability to arrange and manage covered
services and coordinate non-covered services which could include prima-
ry, specialty, and acute care services reimbursed pursuant to title XIX
of the federal social security act;
[(g)] (VII) willingness and capability of taking, or cooperating in,
all steps necessary to secure and integrate any potential sources of
funding for services provided by the managed long term care plan,
including, but not limited to, funding available under titles XVI,
XVIII, XIX and XX of the federal social security act, the federal older
Americans act of nineteen hundred sixty-five, as amended, or any succes-
sor provisions subject to approval of the director of the state office
for aging, and through financing options such as those authorized pursu-
ant to section three hundred sixty-seven-f of the social services law;
[(h)] (VIII) that the contractual arrangements for providers of health
and long term care services in the benefit package are sufficient to
ensure the availability and accessibility of such services to the
proposed enrolled population consistent with guidelines established by
the commissioner; with respect to individuals in receipt of such
services prior to enrollment, such guidelines shall require the managed
long term care plan to contract with agencies currently providing such
services, in order to promote continuity of care. In addition, such
guidelines shall require managed long term care plans to offer and cover
consumer directed personal assistance services for eligible individuals
who elect such services pursuant to section three hundred sixty-five-f
of the social services law; and
[(i)] (IX) that the applicant is financially responsible and may be
expected to meet its obligations to its enrolled members.
(B) NOTWITHSTANDING THE PROVISIONS OF PARAGRAPH (A) OF THIS SUBDIVI-
SION, THE APPROVAL OF ANY APPLICATION FOR CERTIFICATION AS A MANAGED
LONG TERM CARE PLAN UNDER THIS SECTION FOR A PLAN THAT SEEKS TO COVER A
POPULATION OF ENROLLEES ELIGIBLE FOR SERVICES UNDER TITLE XIX OF THE
FEDERAL SOCIAL SECURITY ACT, SHALL BE SUBJECT TO AND CONDITIONED ON
SELECTION THROUGH THE COMPETITIVE BID PROCESS PROVIDED UNDER SUBDIVISION
SIX OF THIS SECTION.
§ 6. Subdivision 6 of section 4403-f of the public health law, as
amended by section 41-b of part H of chapter 59 of the laws of 2011,
paragraph (a) as amended by section 4 and paragraphs (d), (e) and (f) as
added by section 5 of part MM of chapter 56 of the laws of 2020, is
amended to read as follows:
6. Approval authority. [(a)] An applicant shall be issued a certif-
icate of authority as a managed long term care plan upon a determination
S. 8007 81 A. 9007
by the commissioner that the applicant complies with the operating
requirements for a managed long term care plan under this section;
PROVIDED, HOWEVER, THAT ANY MANAGED LONG TERM CARE PLAN SEEKING TO
PROVIDE HEALTH AND LONG TERM CARE SERVICES TO A POPULATION OF ENROLLEES
THAT ARE ELIGIBLE UNDER TITLE XIX OF THE FEDERAL SOCIAL SECURITY ACT
SHALL NOT RECEIVE A CERTIFICATE OF AUTHORITY, NOR BE ELIGIBLE FOR A
CONTRACT TO PROVIDE SUCH SERVICES WITH THE DEPARTMENT, UNLESS SELECTED
THROUGH THE COMPETITIVE BID PROCESS DESCRIBED IN THIS SUBDIVISION. [The
commissioner shall issue no more than seventy-five certificates of
authority to managed long term care plans pursuant to this section.
Nothing in this section shall be construed as requiring the department
to contract with or to contract for a particular line of business with
an entity certified under this section for the provision of services
available under title eleven of article five of the social services law.
(b) An operating demonstration shall be issued a certificate of
authority as a managed long term care plan upon a determination by the
commissioner that such demonstration complies with the operating
requirements for a managed long term care plan under this section.
Nothing in this section shall be construed to affect the continued legal
authority of an operating demonstration to operate its previously
approved program.
(c) For the period beginning April first, two thousand twelve and
ending March thirty-first, two thousand fifteen, the majority leader of
the senate and the speaker of the assembly may each recommend to the
commissioner, in writing, up to four eligible applicants to convert to
be approved managed long term care plans. An applicant shall only be
approved and issued a certificate of authority if the commissioner
determines that the applicant meets the requirements of subdivision
three of this section. The majority leader of the senate or the speaker
of the assembly may assign their authority to recommend one or more
applicants under this section to the commissioner.]
(A) NOTWITHSTANDING SECTIONS ONE HUNDRED TWELVE AND ONE HUNDRED
SIXTY-THREE OF THE STATE FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND
ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOPMENT LAW, AND ANY OTHER
INCONSISTENT PROVISION OF LAW, THE COMMISSIONER OF HEALTH SHALL, THROUGH
A COMPETITIVE BID PROCESS BASED ON PROPOSALS SUBMITTED TO THE DEPART-
MENT, PROVIDE FOR THE SELECTION OF QUALIFIED MANAGED LONG TERM CARE
PLANS TO PROVIDE HEALTH AND LONG TERM CARE SERVICES TO ENROLLEES WHO ARE
ELIGIBLE UNDER TITLE XIX OF THE FEDERAL SOCIAL SECURITY ACT PURSUANT TO
A CONTRACT WITH THE DEPARTMENT; PROVIDED, HOWEVER, THAT:
(I) A PROPOSAL SUBMITTED BY A MANAGED LONG TERM CARE PLAN SHALL
INCLUDE INFORMATION SUFFICIENT TO ALLOW THE COMMISSIONER TO EVALUATE THE
BIDDER IN ACCORDANCE WITH THE REQUIREMENTS IDENTIFIED IN SUBDIVISIONS
TWO THROUGH FOUR OF THIS SECTION.
(II) IN ADDITION TO THE CRITERIA DESCRIBED IN SUBPARAGRAPH (I) OF THIS
PARAGRAPH, THE COMMISSIONER SHALL ALSO CONSIDER:
(A) ACCESSIBILITY AND GEOGRAPHIC DISTRIBUTION OF NETWORK PROVIDERS,
TAKING INTO ACCOUNT THE NEEDS OF PERSONS WITH DISABILITIES AND THE
DIFFERENCES BETWEEN RURAL, SUBURBAN, AND URBAN SETTINGS;
(B) THE EXTENT TO WHICH MAJOR PUBLIC HOSPITALS ARE INCLUDED IN THE
SUBMITTED PROVIDER NETWORK, IF APPLICABLE;
(C) DEMONSTRATED CULTURAL AND LANGUAGE COMPETENCIES SPECIFIC TO THE
POPULATION OF PARTICIPANTS;
(D) THE CORPORATE ORGANIZATION AND STATUS OF THE BIDDER AS A CHARITA-
BLE CORPORATION UNDER THE NOT-FOR-PROFIT CORPORATION LAW;
(E) THE ABILITY OF A BIDDER TO OFFER PLANS IN MULTIPLE REGIONS;
S. 8007 82 A. 9007
(F) THE TYPE AND NUMBER OF PRODUCTS THE BIDDER PROPOSES TO OPERATE,
INCLUDING PRODUCTS APPLIED FOR IN ACCORDANCE WITH THE PROVISIONS OF
SUBDIVISION FIVE OF SECTION THREE HUNDRED SIXTY-FOUR-J OF THE SOCIAL
SERVICES LAW, AND OTHER PRODUCTS DETERMINED BY THE COMMISSIONER, INCLUD-
ING BUT NOT NECESSARILY LIMITED TO THOSE OPERATED UNDER TITLE ONE-A OF
ARTICLE TWENTY-FIVE OF THIS CHAPTER AND SECTION THREE HUNDRED SIXTY-
NINE-GG OF THE SOCIAL SERVICES LAW;
(G) WHETHER THE BIDDER PARTICIPATES IN PRODUCTS FOR INTEGRATED CARE
FOR PARTICIPANTS WHO ARE DUALLY ELIGIBLE FOR MEDICAID AND MEDICARE;
(H) WHETHER THE BIDDER PARTICIPATES IN VALUE BASED PAYMENT ARRANGE-
MENTS AS DEFINED BY THE DEPARTMENT, INCLUDING THE DELEGATION OF SIGNIF-
ICANT FINANCIAL RISK TO CLINICALLY INTEGRATED PROVIDER NETWORKS;
(I) THE BIDDER'S COMMITMENT TO PARTICIPATION IN MANAGED CARE IN THE
STATE;
(J) THE BIDDER'S COMMITMENT TO QUALITY IMPROVEMENT;
(K) THE BIDDER'S COMMITMENT TO COMMUNITY REINVESTMENT SPENDING, AS
SHALL BE DEFINED IN THE PROCUREMENT;
(L) FOR CURRENT OR PREVIOUSLY AUTHORIZED MANAGED CARE PROVIDERS, PAST
PERFORMANCE IN MEETING MANAGED CARE CONTRACT OR FEDERAL OR STATE
REQUIREMENTS, AND IF THE COMMISSIONER ISSUED ANY STATEMENTS OF FINDINGS,
STATEMENTS OF DEFICIENCY, INTERMEDIATE SANCTIONS OR ENFORCEMENT ACTIONS
TO A BIDDER FOR NON-COMPLIANCE WITH SUCH REQUIREMENTS, WHETHER THE
BIDDER ADDRESSED SUCH ISSUES IN A TIMELY MANNER;
(M) SUCH CRITERIA AS THE COMMISSIONER SHALL DEVELOP, WITH THE COMMIS-
SIONERS OF THE OFFICE OF MENTAL HEALTH, THE OFFICE FOR PEOPLE WITH
DEVELOPMENTAL DISABILITIES, THE OFFICE OF ADDICTION SERVICES AND
SUPPORTS, AND THE OFFICE OF CHILDREN AND FAMILY SERVICES; AND
(N) ANY OTHER CRITERIA DEEMED APPROPRIATE BY THE COMMISSIONER.
(III) SUBPARAGRAPHS (I) AND (II) OF THIS PARAGRAPH DESCRIBING PROPOSAL
CONTENT AND SELECTION CRITERIA REQUIREMENTS SHALL NOT BE CONSTRUED AS
LIMITING OR REQUIRING THE COMMISSIONER TO EVALUATE SUCH CONTENT OR
CRITERIA ON A PASS-FAIL, SCALE, OR OTHER PARTICULAR METHODOLOGICAL
BASIS; PROVIDED HOWEVER, THAT THE COMMISSIONER MUST CONSIDER ALL SUCH
CONTENT AND CRITERIA USING METHODS DETERMINED BY THE COMMISSIONER IN
THEIR DISCRETION AND, AS APPLICABLE, IN CONSULTATION WITH THE COMMIS-
SIONERS OF THE OFFICE OF MENTAL HEALTH, THE OFFICE FOR PEOPLE WITH
DEVELOPMENTAL DISABILITIES, THE OFFICE OF ADDICTION SERVICES AND
SUPPORTS, AND THE OFFICE OF CHILDREN AND FAMILY SERVICES.
(IV) THE DEPARTMENT SHALL POST ON ITS WEBSITE:
(A) THE REQUEST FOR PROPOSALS AND A DESCRIPTION OF THE PROPOSED
SERVICES TO BE PROVIDED PURSUANT TO CONTRACTS IN ACCORDANCE WITH THIS
SUBDIVISION;
(B) THE CRITERIA ON WHICH THE DEPARTMENT SHALL DETERMINE QUALIFIED
BIDDERS AND EVALUATE THEIR APPLICATIONS, INCLUDING ALL CRITERIA IDENTI-
FIED IN THIS SUBDIVISION;
(C) THE MANNER BY WHICH A PROPOSAL MAY BE SUBMITTED, WHICH MAY INCLUDE
SUBMISSION BY ELECTRONIC MEANS;
(D) THE MANNER BY WHICH A MANAGED LONG TERM CARE PLAN MAY CONTINUE TO
PROVIDE HEALTH AND LONG TERM CARE SERVICES TO ENROLLEES WHO ARE ELIGIBLE
UNDER TITLE XIX OF THE FEDERAL SOCIAL SECURITY ACT PENDING AWARDS TO
MANAGED LONG TERM CARE PLANS THROUGH A COMPETITIVE BID PROCESS PURSUANT
TO THIS SUBDIVISION; AND
(E) UPON AWARD, THE MANAGED LONG TERM CARE PLANS THAT THE COMMISSIONER
INTENDS TO CONTRACT WITH PURSUANT TO THIS SUBDIVISION, PROVIDED THAT THE
COMMISSIONER SHALL UPDATE SUCH LIST TO INDICATE THE FINAL SLATE OF
CONTRACTED MANAGED LONG TERM CARE PLANS.
S. 8007 83 A. 9007
(V) (A) ALL RESPONSIVE SUBMISSIONS THAT ARE RECEIVED FROM BIDDERS IN A
TIMELY FASHION SHALL BE REVIEWED BY THE COMMISSIONER OF HEALTH IN
CONSULTATION WITH THE COMMISSIONERS OF THE OFFICE OF MENTAL HEALTH, THE
OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, THE OFFICE OF
ADDICTION SERVICES AND SUPPORTS, AND THE OFFICE OF CHILDREN AND FAMILY
SERVICES, AS APPLICABLE. THE COMMISSIONER SHALL CONSIDER COMMENTS
RESULTING FROM THE REVIEW OF PROPOSALS AND MAKE AWARDS IN CONSULTATION
WITH SUCH AGENCIES.
(B) THE COMMISSIONER SHALL MAKE AWARDS UNDER THIS SUBDIVISION, FOR
EACH PRODUCT FOR WHICH PROPOSALS WERE REQUESTED, TO AT LEAST TWO MANAGED
LONG TERM CARE PLANS IN EACH GEOGRAPHIC REGION DEFINED BY THE COMMIS-
SIONER IN THE REQUEST FOR PROPOSALS FOR WHICH AT LEAST TWO MANAGED LONG
TERM CARE PLANS HAVE SUBMITTED A PROPOSAL, AND SHALL HAVE DISCRETION TO
OFFER MORE CONTRACTS BASED ON NEED FOR ACCESS; PROVIDED, HOWEVER, THAT
THE COMMISSIONER SHALL NOT OFFER ANY MORE THAN FIVE (5) CONTRACTS IN ANY
ONE REGION.
(C) MANAGED LONG TERM CARE PLANS AWARDED UNDER THIS SUBDIVISION SHALL
BE ENTITLED TO ENTER INTO A CONTRACT WITH THE DEPARTMENT FOR THE PURPOSE
OF PROVIDING HEALTH AND LONG TERM CARE SERVICES TO ENROLLEES WHO ARE
ELIGIBLE UNDER TITLE XIX OF THE FEDERAL SOCIAL SECURITY ACT. SUCH
CONTRACTS SHALL RUN FOR A TERM TO BE DETERMINED BY THE COMMISSIONER,
WHICH MAY BE RENEWED OR MODIFIED FROM TIME TO TIME WITHOUT A NEW REQUEST
FOR PROPOSALS, TO ENSURE CONSISTENCY WITH CHANGES IN FEDERAL AND STATE
LAWS, REGULATIONS OR POLICIES, INCLUDING BUT NOT LIMITED TO THE EXPAN-
SION OR REDUCTION OF MEDICAL ASSISTANCE SERVICES AVAILABLE TO PARTIC-
IPANTS THROUGH A MANAGED LONG TERM CARE PLAN.
(D) NOTHING IN THIS PARAGRAPH OR OTHER PROVISION OF THIS SECTION SHALL
BE CONSTRUED TO LIMIT IN ANY WAY THE ABILITY OF THE DEPARTMENT TO TERMI-
NATE AWARDED CONTRACTS FOR CAUSE, WHICH SHALL INCLUDE BUT NOT BE LIMITED
TO ANY VIOLATION OF THE TERMS OF SUCH CONTRACTS OR VIOLATIONS OF STATE
OR FEDERAL LAWS AND REGULATIONS AND ANY LOSS OF NECESSARY STATE OR
FEDERAL FUNDING.
(E) NOTWITHSTANDING SECTIONS ONE HUNDRED TWELVE AND ONE HUNDRED
SIXTY-THREE OF THE STATE FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND
ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOPMENT LAW, AND ANY OTHER
INCONSISTENT PROVISION OF LAW, THE DEPARTMENT MAY, IN ACCORDANCE WITH
THE PROVISIONS OF THIS PARAGRAPH, ISSUE NEW REQUESTS FOR PROPOSALS AND
AWARD NEW CONTRACTS FOR TERMS FOLLOWING AN EXISTING TERM OF A CONTRACT
ENTERED INTO UNDER THIS PARAGRAPH.
(B) (I) WITHIN SIXTY DAYS OF THE DEPARTMENT ISSUING THE REQUEST FOR
PROPOSALS UNDER PARAGRAPH (A) OF THIS SUBDIVISION, A MANAGED LONG TERM
CARE PLAN THAT WAS APPROVED TO PROVIDE HEALTH AND LONG TERM CARE
SERVICES TO ENROLLEES WHO ARE ELIGIBLE UNDER TITLE XIX OF THE FEDERAL
SOCIAL SECURITY ACT PRIOR TO THE ISSUANCE OF THE REQUEST FOR PROPOSALS,
SHALL SUBMIT ITS INTENTION TO COMPLETE SUCH PROPOSAL TO THE DEPARTMENT.
(II) A MANAGED LONG TERM CARE PLAN THAT: (A) FAILS TO SUBMIT ITS
INTENT TIMELY, (B) INDICATES WITHIN THE SIXTY DAYS ITS INTENT NOT TO
COMPLETE SUCH A PROPOSAL, (C) FAILS TO SUBMIT A PROPOSAL WITHIN THE
FURTHER TIMEFRAME SPECIFIED BY THE COMMISSIONER IN THE REQUEST FOR
PROPOSALS, OR (D) IS NOT AWARDED THE ABILITY TO PROVIDE HEALTH AND LONG
TERM CARE SERVICES TO ENROLLEES WHO ARE ELIGIBLE UNDER TITLE XIX OF THE
FEDERAL SOCIAL SECURITY ACT UNDER PARAGRAPH (A) OF THIS SUBDIVISION,
SHALL, UPON DIRECTION FROM THE COMMISSIONER, TERMINATE ITS SERVICES AND
OPERATIONS IN ACCORDANCE WITH THE CONTRACT BETWEEN THE MANAGED LONG TERM
CARE PLAN AND THE DEPARTMENT AND SHALL BE ADDITIONALLY REQUIRED TO MAIN-
TAIN COVERAGE OF ENROLLEES FOR SUCH PERIOD OF TIME AS DETERMINED NECES-
S. 8007 84 A. 9007
SARY BY THE COMMISSIONER TO ACHIEVE THE SAFE AND ORDERLY TRANSFER OF
ENROLLEES.
(C) ADDRESSING NEEDS FOR ADDITIONAL MANAGED LONG TERM CARE PLANS TO
ENSURE ACCESS AND CHOICE FOR ENROLLEES ELIGIBLE UNDER TITLE XIX OF THE
FEDERAL SOCIAL SECURITY ACT. IF NECESSARY TO ENSURE ACCESS TO SUFFICIENT
NUMBER OF MANAGED LONG TERM CARE PLANS ON A GEOGRAPHIC OR OTHER BASIS,
INCLUDING A LACK OF ADEQUATE AND APPROPRIATE CARE, LANGUAGE AND CULTURAL
COMPETENCE, OR SPECIAL NEEDS SERVICES, THE COMMISSIONER MAY REISSUE A
REQUEST FOR PROPOSALS AS PROVIDED FOR UNDER PARAGRAPH (A) OF THIS SUBDI-
VISION, PROVIDED HOWEVER THAT SUCH REQUEST MAY BE LIMITED TO THE
GEOGRAPHIC OR OTHER BASIS OF NEED THAT THE REQUEST FOR PROPOSALS SEEKS
TO ADDRESS. ANY AWARDS MADE SHALL BE SUBJECT TO THE REQUIREMENTS OF THIS
SECTION, INCLUDING BUT NOT LIMITED TO THE MINIMUM AND MAXIMUM NUMBER OF
AWARDS IN A REGION.
(d) (i) Effective April first, two thousand twenty, and expiring
[March thirty-first, two thousand twenty-two] ON THE DATE THE COMMIS-
SIONER PUBLISHES ON ITS WEBSITE A REQUEST FOR PROPOSALS IN ACCORDANCE
WITH SUBPARAGRAPH (IV) OF PARAGRAPH (A) OF THE SUBDIVISION, the commis-
sioner shall place a moratorium on the processing and approval of appli-
cations seeking a certificate of authority as a managed long term care
plan pursuant to this section, including applications seeking authori-
zation to expand an existing managed long term care plan's approved
service area or scope of eligible enrollee populations. Such moratorium
shall not apply to:
(A) applications submitted to the department prior to January first,
two thousand twenty;
(B) applications seeking approval to transfer ownership or control of
an existing managed long term care plan;
(C) applications demonstrating to the commissioner's satisfaction that
submission of the application for consideration would be appropriate to
address a serious concern with care delivery, such as a lack of adequate
access to managed long term care plans in a geographic area or a lack of
adequate and appropriate care, language and cultural competence, or
special needs services; and
(D) applications seeking to operate under the PACE (Program of All-In-
clusive Care for the Elderly) model as authorized by federal public law
105-33, subtitle I of title IV of the Balanced Budget Act of 1997, or to
serve individuals dually eligible for services and benefits under titles
XVIII and XIX of the federal social security act in conjunction with an
affiliated Medicare Dual Eligible Special Needs Plan, based on the need
for such plans and the experience of applicants in serving dually eligi-
ble individuals as determined by the commissioner in their discretion.
(ii) For the duration of the moratorium, the commissioner shall assess
the public need for managed long term care plans that are not integrated
with an affiliated Medicare plan, the ability of such plans to provide
high quality and cost effective care for their membership, and based on
such assessment develop a process and conduct an orderly wind-down and
elimination of such plans, which shall coincide with the expiration of
the moratorium unless the commissioner determines that a longer wind-
down period is needed.
(e) [For the duration of the moratorium under paragraph (d) of this
subdivision] FROM APRIL FIRST, TWO THOUSAND TWENTY, UNTIL MARCH THIRTY-
FIRST, TWO THOUSAND TWENTY-TWO, the commissioner shall establish, and
enforce by means of a premium withholding equal to three percent of the
base rate, an annual cap on total enrollment (enrollment cap) for each
managed long term care plan, subject to subparagraphs (ii) and (iii) of
S. 8007 85 A. 9007
this paragraph, based on a percentage of each plan's reported enrollment
as of October first, two thousand twenty.
(i) The specific percentage of each plan's enrollment cap shall be
established by the commissioner based on: (A) the ability of individuals
eligible for such plans to access health and long term care services,
(B) plan quality of care scores, (C) historical plan disenrollment, (D)
the projected growth of individuals eligible for such plans in different
regions of the state, (E) historical plan enrollment of patients with
varying levels of need and acuity, and (F) other factors in the commis-
sioner's discretion to ensure compliance with federal requirements,
appropriate access to plan services, and choice by eligible individuals.
(ii) In the event that a plan exceeds its annual enrollment cap, the
commissioner is authorized under this paragraph to retain all or a
portion of the premium withheld based on the amount over which a plan
exceeds its enrollment cap. Penalties assessed pursuant to this subdivi-
sion shall be determined by regulation.
(iii) The commissioner may not establish an annual cap on total
enrollment under this paragraph for plans' lines of business operating
under the PACE (Program of All-Inclusive Care for the Elderly) model as
authorized by federal public law 105-33, subtitle I of title IV of the
Balanced Budget Act of 1997, or that serve individuals dually eligible
for services and benefits under titles XVIII and XIX of the federal
social security act in conjunction with an affiliated Medicare Dual
Eligible Special Needs Plan.
[(f) In implementing the provisions of paragraphs (d) and (e) of this
subdivision, the commissioner shall, to the extent practicable, consider
and select methodologies that seek to maximize continuity of care and
minimize disruption to the provider labor workforce, and shall, to the
extent practicable and consistent with the ratios set forth herein,
continue to support contracts between managed long term care plans and
licensed home care services agencies that are based on a commitment to
quality and value.]
§ 7. Subparagraphs (v) and (vi) of paragraph (b) of subdivision 1 of
section 268-d of the public health law, as added by section 2 of part T
of chapter 57 of the laws of 2019, are amended to read as follows:
(v) meets standards specified and determined by the Marketplace,
provided that the standards do not conflict with or prevent the applica-
tion of federal requirements; [and]
(vi) CONTRACTS WITH ANY NATIONAL CANCER INSTITUTE-DESIGNATED CANCER
CENTER LICENSED BY THE DEPARTMENT WITHIN THE HEALTH PLAN'S SERVICE AREA
THAT IS WILLING TO AGREE TO PROVIDE CANCER-RELATED INPATIENT, OUTPATIENT
AND MEDICAL SERVICES TO ENROLLEES IN ALL HEALTH PLANS OFFERING COVERAGE
THROUGH THE MARKETPLACE IN SUCH CANCER CENTER'S SERVICE AREA UNDER THE
PREVAILING TERMS AND CONDITIONS THAT THE PLAN REQUIRES OF OTHER SIMILAR
PROVIDERS TO BE INCLUDED IN THE PLAN'S PROVIDER NETWORK, PROVIDED THAT
SUCH TERMS SHALL INCLUDE REIMBURSEMENT OF SUCH CENTER AT NO LESS THAN
THE FEE-FOR-SERVICE MEDICAID PAYMENT RATE AND METHODOLOGY APPLICABLE TO
THE CENTER'S INPATIENT AND OUTPATIENT SERVICES; AND
(VII) complies with the insurance law and this chapter requirements
applicable to health insurance issued in this state and any regulations
promulgated pursuant thereto that do not conflict with or prevent the
application of federal requirements; and
§ 8. Subdivision 4 of section 364-j of the social services law is
amended by adding a new paragraph (w) to read as follows:
(W) A MANAGED CARE PROVIDER SHALL PROVIDE OR ARRANGE, DIRECTLY OR
INDIRECTLY, INCLUDING BY REFERRAL, FOR ACCESS TO AND COVERAGE OF
S. 8007 86 A. 9007
SERVICES PROVIDED BY ANY NATIONAL CANCER INSTITUTE-DESIGNATED CANCER
CENTER LICENSED BY THE DEPARTMENT OF HEALTH WITHIN THE MANAGED CARE
PROVIDER'S SERVICE AREA THAT IS WILLING TO AGREE TO PROVIDE CANCER-RE-
LATED INPATIENT, OUTPATIENT AND MEDICAL SERVICES TO PARTICIPANTS IN ALL
MANAGED CARE PROVIDERS OFFERING COVERAGE TO MEDICAL ASSISTANCE RECIPI-
ENTS IN SUCH CANCER CENTER'S SERVICE AREA UNDER THE PREVAILING TERMS AND
CONDITIONS THAT THE MANAGED CARE PROVIDER REQUIRES OF OTHER SIMILAR
PROVIDERS TO BE INCLUDED IN THE MANAGED CARE PROVIDER'S NETWORK,
PROVIDED THAT SUCH TERMS SHALL INCLUDE REIMBURSEMENT OF SUCH CENTER AT
NO LESS THAN THE FEE-FOR-SERVICE MEDICAID PAYMENT RATE AND METHODOLOGY
APPLICABLE TO THE CENTER'S INPATIENT AND OUTPATIENT SERVICES.
§ 9. Paragraph (c) of subdivision 1 of section 369-gg of the social
services law, as amended by section 2 of part H of chapter 57 of the
laws of 2021, is amended to read as follows:
(c) "Health care services" means (i) the services and supplies as
defined by the commissioner in consultation with the superintendent of
financial services, and shall be consistent with and subject to the
essential health benefits as defined by the commissioner in accordance
with the provisions of the patient protection and affordable care act
(P.L. 111-148) and consistent with the benefits provided by the refer-
ence plan selected by the commissioner for the purposes of defining such
benefits, AND SHALL INCLUDE COVERAGE OF AND ACCESS TO THE SERVICES OF
ANY NATIONAL CANCER INSTITUTE-DESIGNATED CANCER CENTER LICENSED BY THE
DEPARTMENT OF HEALTH WITHIN THE SERVICE AREA OF THE APPROVED ORGANIZA-
TION THAT IS WILLING TO AGREE TO PROVIDE CANCER-RELATED INPATIENT,
OUTPATIENT AND MEDICAL SERVICES TO ALL ENROLLEES IN APPROVED ORGANIZA-
TIONS' PLANS IN SUCH CANCER CENTER'S SERVICE AREA UNDER THE PREVAILING
TERMS AND CONDITIONS THAT THE APPROVED ORGANIZATION REQUIRES OF OTHER
SIMILAR PROVIDERS TO BE INCLUDED IN THE APPROVED ORGANIZATION'S NETWORK,
PROVIDED THAT SUCH TERMS SHALL INCLUDE REIMBURSEMENT OF SUCH CENTER AT
NO LESS THAN THE FEE-FOR-SERVICE MEDICAID PAYMENT RATE AND METHODOLOGY
APPLICABLE TO BASIC HEALTH PROGRAM PLAN PAYMENTS FOR INPATIENT AND
OUTPATIENT SERVICES; and (ii) dental and vision services as defined by
the commissioner;
§ 10. Severability. If any clause, sentence, paragraph, section or
part of this act shall be adjudged by any court of competent jurisdic-
tion to be invalid and after exhaustion of all further judicial review,
the judgment shall not affect, impair or invalidate the remainder there-
of, but shall be confined in its operation to the clause, sentence,
paragraph, section or part of this act directly involved in the contro-
versy in which the judgment shall have been rendered.
§ 11. Sections one, two, three, four, five, six and ten of this act
shall take effect immediately; sections seven, eight and nine shall take
effect on the first of January next succeeding the date on which it
shall have become a law and shall apply to all coverage or policies
issued or renewed on or after such effective date and shall expire and
be deemed repealed five years after such date; provided, however, that
the amendments to section 364-j of the social services law made by
sections one, two and eight of this act, the amendments to section
4403-f of the public health law made by sections four, five and six of
this act and the amendments to paragraph (c) of subdivision 1 of section
369-gg of the social services law made by section nine of this act shall
not affect the repeal of such sections or such paragraph and shall be
deemed repealed therewith; provided, further, that this act shall not be
construed to prohibit managed care providers participating in the
managed care program and managed long term care plans approved to
S. 8007 87 A. 9007
provide health and long term care services to enrollees who are eligible
under title XIX of the federal social security act, that were so author-
ized as of the date this act becomes effective, from continuing oper-
ations as authorized until such time as awards are made in accordance
with this act and such additional time subject to direction from the
commissioner of health to ensure the safe and orderly transfer of
participants.
PART Q
Section 1. Section 268-c of the public health law is amended by adding
a new subdivision 25 to read as follows:
25. THE COMMISSIONER IS AUTHORIZED TO SUBMIT THE APPROPRIATE WAIVER
APPLICATIONS TO THE UNITED STATES SECRETARY OF HEALTH AND HUMAN SERVICES
AND/OR THE DEPARTMENT OF THE TREASURY TO WAIVE ANY APPLICABLE PROVISIONS
OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, PUB. L. 111-148 AS
AMENDED, OR SUCCESSOR PROVISIONS, AS PROVIDED FOR BY 42 U.S.C. 18052,
AND ANY OTHER WAIVERS NECESSARY TO ACHIEVE THE PURPOSES OF HIGH QUALITY,
AFFORDABLE COVERAGE THROUGH NY STATE OF HEALTH, THE OFFICIAL HEALTH PLAN
MARKETPLACE. THE COMMISSIONER SHALL IMPLEMENT THE STATE PLANS OF ANY
SUCH WAIVER IN A MANNER CONSISTENT WITH APPLICABLE STATE AND FEDERAL
LAWS, AS AUTHORIZED BY THE SECRETARY OF HEALTH AND HUMAN SERVICES AND/OR
THE SECRETARY OF THE TREASURY PURSUANT TO 42 U.S.C. 18052. COPIES OF
SUCH ORIGINAL WAIVER APPLICATIONS AND AMENDMENTS THERETO SHALL BE
PROVIDED TO THE CHAIR OF THE SENATE FINANCE COMMITTEE, THE CHAIR OF THE
ASSEMBLY WAYS AND MEANS COMMITTEE AND THE CHAIRS OF THE SENATE AND
ASSEMBLY HEALTH COMMITTEES SIMULTANEOUSLY WITH THEIR SUBMISSION TO THE
FEDERAL GOVERNMENT.
§ 2. Paragraph (d) of subdivision 3 of section 369-gg of the social
services law, as amended by section 2 of part H of chapter 57 of the
laws of 2021, is amended to read as follows:
(d) (i) EXCEPT AS PROVIDED BY SUBPARAGRAPH (II) OF THIS PARAGRAPH, has
household income at or below two hundred percent of the federal poverty
line defined and annually revised by the United States department of
health and human services for a household of the same size; and [(ii)]
has household income that exceeds one hundred thirty-three percent of
the federal poverty line defined and annually revised by the United
States department of health and human services for a household of the
same size; however, MAGI eligible aliens lawfully present in the United
States with household incomes at or below one hundred thirty-three
percent of the federal poverty line shall be eligible to receive cover-
age for health care services pursuant to the provisions of this title if
such alien would be ineligible for medical assistance under title eleven
of this article due to [his or her] THEIR immigration status[.];
(II) SUBJECT TO FEDERAL APPROVAL AND THE USE OF STATE FUNDS, UNLESS
THE COMMISSIONER MAY USE FUNDS UNDER SUBDIVISION SEVEN OF THIS SECTION,
HAS HOUSEHOLD INCOME AT OR BELOW TWO HUNDRED FIFTY PERCENT OF THE FEDER-
AL POVERTY LINE DEFINED AND ANNUALLY REVISED BY THE UNITED STATES
DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR A HOUSEHOLD OF THE SAME
SIZE; AND HAS HOUSEHOLD INCOME THAT EXCEEDS ONE HUNDRED THIRTY-THREE
PERCENT OF THE FEDERAL POVERTY LINE DEFINED AND ANNUALLY REVISED BY THE
UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR A HOUSEHOLD OF
THE SAME SIZE; HOWEVER, MAGI ELIGIBLE ALIENS LAWFULLY PRESENT IN THE
UNITED STATES WITH HOUSEHOLD INCOMES AT OR BELOW ONE HUNDRED THIRTY-
THREE PERCENT OF THE FEDERAL POVERTY LINE SHALL BE ELIGIBLE TO RECEIVE
COVERAGE FOR HEALTH CARE SERVICES PURSUANT TO THE PROVISIONS OF THIS
S. 8007 88 A. 9007
TITLE IF SUCH ALIEN WOULD BE INELIGIBLE FOR MEDICAL ASSISTANCE UNDER
TITLE ELEVEN OF THIS ARTICLE DUE TO THEIR IMMIGRATION STATUS;
(III) SUBJECT TO FEDERAL APPROVAL IF REQUIRED AND THE USE OF STATE
FUNDS, UNLESS THE COMMISSIONER MAY USE FUNDS UNDER SUBDIVISION SEVEN OF
THIS SECTION, A PREGNANT INDIVIDUAL WHO IS ELIGIBLE TO RECEIVE COVERAGE
FOR HEALTH CARE SERVICES PURSUANT TO SUBPARAGRAPH (I) OR (II) OF THIS
PARAGRAPH IS ELIGIBLE TO RECEIVE AND/OR TO CONTINUE TO RECEIVE HEALTH
CARE SERVICES PURSUANT TO THIS TITLE DURING THE PREGNANCY AND FOR A
PERIOD OF ONE YEAR FOLLOWING THE END OF THE PREGNANCY WITHOUT REGARD TO
ANY CHANGE IN THE INCOME OF THE HOUSEHOLD THAT INCLUDES THE PREGNANT
INDIVIDUAL, EVEN IF SUCH CHANGE WOULD RENDER THE PREGNANT INDIVIDUAL
INELIGIBLE TO RECEIVE HEALTH CARE SERVICES PURSUANT TO THIS TITLE; OR
(IV) SUBJECT TO FEDERAL APPROVAL, A CHILD BORN TO AN INDIVIDUAL ELIGI-
BLE FOR AND RECEIVING COVERAGE FOR HEALTH CARE SERVICES PURSUANT TO THIS
TITLE SHALL BE DEEMED TO HAVE APPLIED FOR MEDICAL ASSISTANCE AND TO HAVE
BEEN FOUND ELIGIBLE FOR SUCH ASSISTANCE ON THE DATE OF SUCH BIRTH AND TO
REMAIN ELIGIBLE FOR SUCH ASSISTANCE FOR A PERIOD OF ONE YEAR.
An applicant who fails to make an applicable premium payment, if any,
shall lose eligibility to receive coverage for health care services in
accordance with time frames and procedures determined by the commission-
er.
§ 3. Paragraph (d) of subdivision 3 of section 369-gg of the social
services law, as added by section 51 of part C of chapter 60 of the laws
of 2014, is amended to read as follows:
(d) (i) EXCEPT AS PROVIDED BY SUBPARAGRAPH (II) OF THIS PARAGRAPH, has
household income at or below two hundred percent of the federal poverty
line defined and annually revised by the United States department of
health and human services for a household of the same size; and [(ii)]
has household income that exceeds one hundred thirty-three percent of
the federal poverty line defined and annually revised by the United
States department of health and human services for a household of the
same size; however, MAGI eligible aliens lawfully present in the United
States with household incomes at or below one hundred thirty-three
percent of the federal poverty line shall be eligible to receive cover-
age for health care services pursuant to the provisions of this title if
such alien would be ineligible for medical assistance under title eleven
of this article due to [his or her] THEIR immigration status[.];
(II) SUBJECT TO FEDERAL APPROVAL AND THE USE OF STATE FUNDS, UNLESS
THE COMMISSIONER MAY USE FUNDS UNDER SUBDIVISION SEVEN OF THIS SECTION,
HAS HOUSEHOLD INCOME AT OR BELOW TWO HUNDRED FIFTY PERCENT OF THE FEDER-
AL POVERTY LINE DEFINED AND ANNUALLY REVISED BY THE UNITED STATES
DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR A HOUSEHOLD OF THE SAME
SIZE; AND HAS HOUSEHOLD INCOME THAT EXCEEDS ONE HUNDRED THIRTY-THREE
PERCENT OF THE FEDERAL POVERTY LINE DEFINED AND ANNUALLY REVISED BY THE
UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR A HOUSEHOLD OF
THE SAME SIZE; HOWEVER, MAGI ELIGIBLE ALIENS LAWFULLY PRESENT IN THE
UNITED STATES WITH HOUSEHOLD INCOMES AT OR BELOW ONE HUNDRED THIRTY-
THREE PERCENT OF THE FEDERAL POVERTY LINE SHALL BE ELIGIBLE TO RECEIVE
COVERAGE FOR HEALTH CARE SERVICES PURSUANT TO THE PROVISIONS OF THIS
TITLE IF SUCH ALIEN WOULD BE INELIGIBLE FOR MEDICAL ASSISTANCE UNDER
TITLE ELEVEN OF THIS ARTICLE DUE TO THEIR IMMIGRATION STATUS;
(III) SUBJECT TO FEDERAL APPROVAL IF REQUIRED AND THE USE OF STATE
FUNDS, UNLESS THE COMMISSIONER MAY USE FUNDS UNDER SUBDIVISION SEVEN OF
THIS SECTION, A PREGNANT INDIVIDUAL WHO IS ELIGIBLE TO RECEIVE COVERAGE
FOR HEALTH CARE SERVICES PURSUANT TO SUBPARAGRAPH (I) OR (II) OF THIS
PARAGRAPH IS ELIGIBLE TO RECEIVE AND/OR TO CONTINUE TO RECEIVE HEALTH
S. 8007 89 A. 9007
CARE SERVICES PURSUANT TO THIS TITLE DURING THE PREGNANCY AND FOR A
PERIOD OF ONE YEAR FOLLOWING THE END OF THE PREGNANCY WITHOUT REGARD TO
ANY CHANGE IN THE INCOME OF THE HOUSEHOLD THAT INCLUDES THE PREGNANT
INDIVIDUAL, EVEN IF SUCH CHANGE WOULD RENDER THE PREGNANT INDIVIDUAL
INELIGIBLE TO RECEIVE HEALTH CARE SERVICES PURSUANT TO THIS TITLE; OR
(IV) SUBJECT TO FEDERAL APPROVAL, A CHILD BORN TO AN INDIVIDUAL ELIGI-
BLE FOR AND RECEIVING COVERAGE FOR HEALTH CARE SERVICES PURSUANT TO THIS
TITLE SHALL BE DEEMED TO HAVE APPLIED FOR MEDICAL ASSISTANCE AND TO HAVE
BEEN FOUND ELIGIBLE FOR SUCH ASSISTANCE ON THE DATE OF SUCH BIRTH AND TO
REMAIN ELIGIBLE FOR SUCH ASSISTANCE FOR A PERIOD OF ONE YEAR.
An applicant who fails to make an applicable premium payment shall
lose eligibility to receive coverage for health care services in accord-
ance with time frames and procedures determined by the commissioner.
§ 4. Paragraph (c) of subdivision 1 of section 369-gg of the social
services law, as amended by section 2 of part H of chapter 57 of the
laws of 2021, is amended to read as follows:
(c) "Health care services" means (i) the services and supplies as
defined by the commissioner in consultation with the superintendent of
financial services, and shall be consistent with and subject to the
essential health benefits as defined by the commissioner in accordance
with the provisions of the patient protection and affordable care act
(P.L. 111-148) and consistent with the benefits provided by the refer-
ence plan selected by the commissioner for the purposes of defining such
benefits, [and] (ii) dental and vision services as defined by the
commissioner, AND (III) AS DEFINED BY THE COMMISSIONER AND SUBJECT TO
FEDERAL APPROVAL, CERTAIN SERVICES AND SUPPORTS PROVIDED TO ENROLLEES
ELIGIBLE PURSUANT TO SUBPARAGRAPH ONE OF PARAGRAPH (G) OF SUBDIVISION
ONE OF SECTION THREE HUNDRED SIXTY-SIX OF THIS ARTICLE WHO HAVE FUNC-
TIONAL LIMITATIONS AND/OR CHRONIC ILLNESSES THAT HAVE THE PRIMARY
PURPOSE OF SUPPORTING THE ABILITY OF THE ENROLLEE TO LIVE OR WORK IN THE
SETTING OF THEIR CHOICE, WHICH MAY INCLUDE THE INDIVIDUAL'S HOME, A
WORKSITE, OR A PROVIDER-OWNED OR CONTROLLED RESIDENTIAL SETTING;
§ 5. Paragraph (c) of subdivision 1 of section 369-gg of the social
services law, as added by section 51 of part C of chapter 60 of the laws
of 2014, is amended to read as follows:
(c) "Health care services" means (I) the services and supplies as
defined by the commissioner in consultation with the superintendent of
financial services, and shall be consistent with and subject to the
essential health benefits as defined by the commissioner in accordance
with the provisions of the patient protection and affordable care act
(P.L. 111-148) and consistent with the benefits provided by the refer-
ence plan selected by the commissioner for the purposes of defining such
benefits, AND (II) AS DEFINED BY THE COMMISSIONER AND SUBJECT TO FEDERAL
APPROVAL, CERTAIN SERVICES AND SUPPORTS PROVIDED TO ENROLLEES ELIGIBLE
PURSUANT TO SUBPARAGRAPH ONE OF PARAGRAPH (G) OF SUBDIVISION ONE OF
SECTION THREE HUNDRED SIXTY-SIX OF THIS ARTICLE WHO HAVE FUNCTIONAL
LIMITATIONS AND/OR CHRONIC ILLNESSES THAT HAVE THE PRIMARY PURPOSE OF
SUPPORTING THE ABILITY OF THE ENROLLEE TO LIVE OR WORK IN THE SETTING OF
THEIR CHOICE, WHICH MAY INCLUDE THE INDIVIDUAL'S HOME, A WORKSITE, OR A
PROVIDER-OWNED OR CONTROLLED RESIDENTIAL SETTING;
§ 6. Paragraph (c) of subdivision 1 of section 369-gg of the social
services law, as amended by section 2 of part H of chapter 57 of the
laws of 2021, is amended to read as follows:
(c) "Health care services" means (i) the services and supplies as
defined by the commissioner in consultation with the superintendent of
financial services, and shall be consistent with and subject to the
S. 8007 90 A. 9007
essential health benefits as defined by the commissioner in accordance
with the provisions of the patient protection and affordable care act
(P.L. 111-148) and consistent with the benefits provided by the refer-
ence plan selected by the commissioner for the purposes of defining such
benefits, [and] (ii) dental and vision services as defined by the
commissioner, AND (III) AS DEFINED BY THE COMMISSIONER AND SUBJECT TO
FEDERAL APPROVAL, CERTAIN SERVICES AND SUPPORTS PROVIDED TO ENROLLEES
WHO HAVE FUNCTIONAL LIMITATIONS AND/OR CHRONIC ILLNESSES THAT HAVE THE
PRIMARY PURPOSE OF SUPPORTING THE ABILITY OF THE ENROLLEE TO LIVE OR
WORK IN THE SETTING OF THEIR CHOICE, WHICH MAY INCLUDE THE INDIVIDUAL'S
HOME, A WORKSITE, OR A PROVIDER-OWNED OR CONTROLLED RESIDENTIAL SETTING;
§ 7. Paragraph (c) of subdivision 1 of section 369-gg of the social
services law, as added by section 51 of part C of chapter 60 of the laws
of 2014, is amended to read as follows:
(c) "Health care services" means (I) the services and supplies as
defined by the commissioner in consultation with the superintendent of
financial services, and shall be consistent with and subject to the
essential health benefits as defined by the commissioner in accordance
with the provisions of the patient protection and affordable care act
(P.L. 111-148) and consistent with the benefits provided by the refer-
ence plan selected by the commissioner for the purposes of defining such
benefits, AND (II) AS DEFINED BY THE COMMISSIONER AND SUBJECT TO FEDERAL
APPROVAL, CERTAIN SERVICES AND SUPPORTS PROVIDED TO ENROLLEES WHO HAVE
FUNCTIONAL LIMITATIONS AND/OR CHRONIC ILLNESSES THAT HAVE THE PRIMARY
PURPOSE OF SUPPORTING THE ABILITY OF THE ENROLLEE TO LIVE OR WORK IN THE
SETTING OF THEIR CHOICE, WHICH MAY INCLUDE THE INDIVIDUAL'S HOME, A
WORKSITE, OR A PROVIDER-OWNED OR CONTROLLED RESIDENTIAL SETTING;
§ 8. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022, provided
however:
(a) the amendments to paragraph (d) of subdivision 3 of section 369-gg
of the social services law made by section two of this act shall be
subject to the expiration and reversion of such paragraph pursuant to
section 3 of part H of chapter 57 of the laws of 2021 as amended, when
upon such date the provisions of section three of this act shall take
effect;
(b) section four of this act shall take effect January 1, 2023 and
shall expire and be deemed repealed December 31, 2024; provided, howev-
er, the amendments to paragraph (c) of subdivision 1 of section 369-gg
of the social services law made by such section of this act shall be
subject to the expiration and reversion of such paragraph pursuant to
section 2 of part H of chapter 57 of the laws of 2021 when upon such
date, the provisions of section five of this act shall take effect;
provided, however, the amendments to such paragraph made by section five
of this act shall expire and be deemed repealed December 31, 2024; and
(c) section six of this act shall take effect January 1, 2025;
provided, however, the amendments to paragraph (c) of subdivision 1 of
section 369-gg of the social services law made by such section of this
act shall be subject to the expiration and reversion of such paragraph
pursuant to section 2 of part H of chapter 57 of the laws of 2021 when
upon such date, the provisions of section seven of this act shall take
effect.
PART R
S. 8007 91 A. 9007
Section 1. Subsection (i) of section 3216 of the insurance law is
amended by adding a new paragraph 36 to read as follows:
(36) EVERY POLICY THAT PROVIDES MEDICAL, MAJOR MEDICAL OR SIMILAR
COMPREHENSIVE TYPE COVERAGE DELIVERED OR ISSUED FOR DELIVERY IN THIS
STATE SHALL PROVIDE COVERAGE FOR ABORTIONS. COVERAGE FOR ABORTIONS SHALL
NOT BE SUBJECT TO COPAYMENTS, OR COINSURANCE, OR ANNUAL DEDUCTIBLES,
UNLESS THE POLICY IS A HIGH DEDUCTIBLE HEALTH PLAN, AS DEFINED IN 26
U.S.C. § 223(C)(2), IN WHICH CASE COVERAGE FOR ABORTIONS MAY BE SUBJECT
TO THE PLAN'S ANNUAL DEDUCTIBLE.
§ 2. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 22 to read as follows:
(22) (A) EXCEPT AS PROVIDED IN SUBPARAGRAPH (B) OF THIS PARAGRAPH,
EVERY GROUP OR BLANKET POLICY THAT PROVIDES MEDICAL, MAJOR MEDICAL, OR
SIMILAR COMPREHENSIVE TYPE COVERAGE DELIVERED OR ISSUED FOR DELIVERY IN
THIS STATE SHALL PROVIDE COVERAGE FOR ABORTIONS. COVERAGE FOR ABORTIONS
SHALL NOT BE SUBJECT TO COPAYMENTS, OR COINSURANCE, OR ANNUAL DEDUCT-
IBLES, UNLESS THE POLICY IS A HIGH DEDUCTIBLE HEALTH PLAN, AS DEFINED IN
26 U.S.C. § 223(C)(2), IN WHICH CASE COVERAGE FOR ABORTIONS MAY BE
SUBJECT TO THE PLAN'S ANNUAL DEDUCTIBLE.
(B) A GROUP OR BLANKET POLICY THAT PROVIDES MEDICAL, MAJOR MEDICAL, OR
SIMILAR COMPREHENSIVE TYPE COVERAGE TO A RELIGIOUS EMPLOYER MAY EXCLUDE
COVERAGE FOR ABORTIONS ONLY IF THE INSURER:
(I) OBTAINS AN ANNUAL CERTIFICATION FROM THE GROUP OR BLANKET POLICY-
HOLDER THAT THE POLICYHOLDER IS A RELIGIOUS EMPLOYER AND THAT THE RELI-
GIOUS EMPLOYER REQUESTS A POLICY WITHOUT COVERAGE FOR ABORTIONS;
(II) ISSUES A RIDER TO EACH CERTIFICATE HOLDER AT NO PREMIUM TO BE
CHARGED TO THE CERTIFICATE HOLDER OR RELIGIOUS EMPLOYER FOR THE RIDER,
THAT PROVIDES COVERAGE FOR ABORTIONS SUBJECT TO THE SAME RULES AS WOULD
HAVE BEEN APPLIED TO THE SAME CATEGORY OF TREATMENT IN THE POLICY ISSUED
TO THE RELIGIOUS EMPLOYER. THE RIDER SHALL CLEARLY AND CONSPICUOUSLY
SPECIFY THAT THE RELIGIOUS EMPLOYER DOES NOT ADMINISTER ABORTION BENE-
FITS, BUT THAT THE INSURER IS ISSUING A RIDER FOR COVERAGE OF ABORTIONS,
AND SHALL PROVIDE THE INSURER'S CONTACT INFORMATION FOR QUESTIONS; AND
(III) PROVIDES NOTICE OF THE ISSUANCE OF THE POLICY AND RIDER TO THE
SUPERINTENDENT IN A FORM AND MANNER ACCEPTABLE TO THE SUPERINTENDENT.
(C) FOR THE PURPOSE OF THIS PARAGRAPH, "RELIGIOUS EMPLOYER" MEANS AN
ENTITY:
(I) FOR WHICH THE INCULCATION OF RELIGIOUS VALUES IS THE PURPOSE OF
THE ENTITY;
(II) THAT PRIMARILY EMPLOYS PERSONS WHO SHARE THE RELIGIOUS TENETS OF
THE ENTITY;
(III) THAT SERVES PRIMARILY PERSONS WHO SHARE THE RELIGIOUS TENETS OF
THE ENTITY; AND
(IV) THAT IS A NONPROFIT ORGANIZATION AS DESCRIBED IN 26 U.S.C. §
6033(A)(3)(A)(I) OR (III).
§ 3. Section 4303 of the insurance law is amended by adding a new
subsection (ss) to read as follows:
(SS)(1) EXCEPT AS PROVIDED IN PARAGRAPH TWO OF THIS SUBSECTION, EVERY
INDIVIDUAL AND GROUP CONTRACT THAT PROVIDES MEDICAL, MAJOR MEDICAL OR
SIMILAR COMPREHENSIVE TYPE COVERAGE DELIVERED OR ISSUED FOR DELIVERY IN
THIS STATE SHALL PROVIDE COVERAGE FOR ABORTIONS. COVERAGE FOR ABORTIONS
SHALL NOT BE SUBJECT TO COPAYMENTS, OR COINSURANCE, OR ANNUAL DEDUCT-
IBLES, UNLESS THE CONTRACT IS A HIGH DEDUCTIBLE HEALTH PLAN, AS DEFINED
IN 26 U.S.C. § 223(C)(2), IN WHICH CASE COVERAGE FOR ABORTIONS MAY BE
SUBJECT TO THE PLAN'S ANNUAL DEDUCTIBLE.
S. 8007 92 A. 9007
(2) A GROUP CONTRACT THAT PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
COMPREHENSIVE TYPE COVERAGE TO A RELIGIOUS EMPLOYER MAY EXCLUDE COVERAGE
FOR ABORTIONS ONLY IF THE CORPORATION:
(A) OBTAINS AN ANNUAL CERTIFICATION FROM THE GROUP CONTRACT HOLDER
THAT THE CONTRACT HOLDER IS A RELIGIOUS EMPLOYER AND THAT THE RELIGIOUS
EMPLOYER REQUESTS A CONTRACT WITHOUT COVERAGE FOR ABORTIONS;
(B) ISSUES A RIDER TO EACH CERTIFICATE HOLDER AT NO PREMIUM TO BE
CHARGED TO THE CERTIFICATE HOLDER OR RELIGIOUS EMPLOYER FOR THE RIDER,
THAT PROVIDES COVERAGE FOR ABORTIONS SUBJECT TO THE SAME RULES AS WOULD
HAVE BEEN APPLIED TO THE SAME CATEGORY OF TREATMENT IN THE CONTRACT
ISSUED TO THE RELIGIOUS EMPLOYER. THE RIDER SHALL CLEARLY AND CONSPICU-
OUSLY SPECIFY THAT THE RELIGIOUS EMPLOYER DOES NOT ADMINISTER ABORTION
BENEFITS, BUT THAT THE CORPORATION IS ISSUING A RIDER FOR COVERAGE OF
ABORTIONS, AND SHALL PROVIDE THE CORPORATION'S CONTACT INFORMATION FOR
QUESTIONS; AND
(III) PROVIDES NOTICE OF THE ISSUANCE OF THE CONTRACT AND RIDER TO THE
SUPERINTENDENT IN A FORM AND MANNER ACCEPTABLE TO THE SUPERINTENDENT.
(3) FOR THE PURPOSE OF THIS SUBSECTION, "RELIGIOUS EMPLOYER" MEANS AN
ENTITY:
(A) FOR WHICH THE INCULCATION OF RELIGIOUS VALUES IS THE PURPOSE OF
THE ENTITY;
(B) THAT PRIMARILY EMPLOYS PERSONS WHO SHARE THE RELIGIOUS TENETS OF
THE ENTITY;
(C) THAT SERVES PRIMARILY PERSONS WHO SHARE THE RELIGIOUS TENETS OF
THE ENTITY; AND
(D) THAT IS A NONPROFIT ORGANIZATION AS DESCRIBED IN 26 U.S.C. §
6033(A)(3)(A)(I) OR (III).
§ 4. This act shall take effect on the first of January next succeed-
ing the date on which it shall have become a law and shall apply to all
policies and contracts issued, renewed, modified, altered, or amended on
or after such date. Effective immediately, the addition, amendment, or
repeal of any rule or regulation necessary for the implementation of
this act on its effective date are authorized to be made and completed
on or before such effective date.
PART S
Section 1. Subdivision 2 of section 365-a of the social services law
is amended by adding a new paragraph (jj) to read as follows:
(JJ) PRE-NATAL AND POST-PARTUM CARE AND SERVICES FOR THE PURPOSE OF
IMPROVING MATERNAL HEALTH OUTCOMES AND REDUCTION OF MATERNAL MORTALITY,
AS DETERMINED BY THE COMMISSIONER OF HEALTH, WHEN SUCH SERVICES ARE
RECOMMENDED BY A PHYSICIAN OR OTHER LICENSED PRACTITIONER OF THE HEALING
ARTS, AND PROVIDED BY QUALIFIED PRACTITIONERS, AS DETERMINED BY THE
COMMISSIONER OF HEALTH; PROVIDED, HOWEVER, THAT THE PROVISIONS OF THIS
PARAGRAPH SHALL NOT TAKE EFFECT UNLESS ALL NECESSARY APPROVALS UNDER
FEDERAL LAW AND REGULATION HAVE BEEN OBTAINED TO RECEIVE FEDERAL FINAN-
CIAL PARTICIPATION IN THE COSTS OF SERVICES PROVIDED PURSUANT TO THIS
PARAGRAPH. NOTHING IN THIS PARAGRAPH SHALL BE CONSTRUED TO MODIFY ANY
LICENSURE, CERTIFICATION OR SCOPE OF PRACTICE PROVISION UNDER TITLE
EIGHT OF THE EDUCATION LAW.
§ 2. Subparagraph 3 of paragraph (d) of subdivision 1 of section 366
of the social services law, as added by section 1 of part D of chapter
56 of the laws of 2013, is amended to read as follows:
(3) cooperates with the appropriate social services official or the
department in establishing paternity or in establishing, modifying, or
S. 8007 93 A. 9007
enforcing a support order with respect to his or her child; provided,
however, that nothing herein contained shall be construed to require a
payment under this title for care or services, the cost of which may be
met in whole or in part by a third party; notwithstanding the foregoing,
a social services official shall not require such cooperation if the
social services official or the department determines that such actions
would be detrimental to the best interest of the child, applicant, or
recipient, or with respect to pregnant women during pregnancy and during
the [sixty-day] ONE YEAR period beginning on the last day of pregnancy,
in accordance with procedures and criteria established by regulations of
the department consistent with federal law; and
§ 3. Subparagraph 1 of paragraph (b) of subdivision 4 of section 366
of the social services law, as added by section 2 of part D of chapter
56 of the laws of 2013, is amended to read as follows:
(1) A pregnant woman eligible for medical assistance under subpara-
graph two or four of paragraph (b) of subdivision one of this section on
any day of her pregnancy will continue to be eligible for such care and
services [through the end of the month in which the sixtieth day follow-
ing the end of the pregnancy occurs,] FOR A PERIOD OF ONE YEAR BEGINNING
ON THE LAST DAY OF PREGNANCY, without regard to any change in the income
of the family that includes the pregnant woman, even if such change
otherwise would have rendered her ineligible for medical assistance.
NOTWITHSTANDING THE PROVISIONS OF THIS SUBPARAGRAPH, INDIVIDUALS WHO
MEET THE ELIGIBILITY REQUIREMENTS FOR MEDICAL ASSISTANCE UNDER SUBPARA-
GRAPH EIGHT OF PARAGRAPH (B) OF SUBDIVISION ONE OF THIS SECTION, SHALL
CONTINUE TO BE ELIGIBLE FOR MEDICAL ASSISTANCE UNDER THIS SUBPARAGRAPH
THROUGH THE END OF THE MONTH IN WHICH THE SIXTIETH DAY FOLLOWING THE
LAST DAY OF THE PREGNANCY OCCURS.
§ 4. Paragraph (b) of subdivision 1 of section 366 of the social
services law is amended by adding a new subparagraph 8 to read as
follows:
(8) NOTWITHSTANDING THE PROVISIONS OF SUBPARAGRAPH TWO OF THIS PARA-
GRAPH, A PREGNANT INDIVIDUAL THAT IS INELIGIBLE FOR FEDERALLY FUNDED
MEDICAL ASSISTANCE SOLELY DUE TO THEIR IMMIGRATION STATUS IS ELIGIBLE
FOR STANDARD COVERAGE IF THEIR MAGI HOUSEHOLD INCOME DOES NOT EXCEED THE
MAGI-EQUIVALENT OF TWO HUNDRED PERCENT OF THE FEDERAL POVERTY LINE FOR
THE APPLICABLE FAMILY SIZE, WHICH SHALL BE CALCULATED IN ACCORDANCE WITH
GUIDANCE ISSUED BY THE SECRETARY OF THE UNITED STATES DEPARTMENT OF
HEALTH AND HUMAN SERVICES.
§ 5. Section 369-hh of the social services law is REPEALED.
§ 6. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022; provided,
however, that sections two, three, four and five of this act shall take
effect January 1, 2023.
PART T
Section 1. Subdivision 1 of section 2308 of the public health law is
amended to read as follows:
1. Every physician OR OTHER AUTHORIZED PRACTITIONER attending pregnant
[women] PATIENTS in the state shall in the case of every [woman] PATIENT
so attended take or cause to be taken a sample of blood of such [woman]
PATIENT at the time of first examination, and submit such sample to an
approved laboratory for a standard serological test for syphilis. IN
ADDITION TO TESTING AT THE TIME OF FIRST EXAMINATION, EVERY SUCH PHYSI-
CIAN OR OTHER AUTHORIZED PRACTITIONER SHALL ORDER A SYPHILIS TEST DURING
S. 8007 94 A. 9007
THE THIRD TRIMESTER OF PREGNANCY CONSISTENT WITH ANY GUIDANCE AND REGU-
LATIONS ISSUED BY THE COMMISSIONER.
§ 2. This act shall take effect one year after it shall have become a
law. Effective immediately, any rules and regulations or guidance neces-
sary to implement the provisions of this act on its effective date are
authorized to be amended, repealed and/or promulgated on or before such
date.
PART U
Section 1. Subdivision 7 of section 2510 of the public health law, as
amended by chapter 436 of the laws of 2021, is amended to read as
follows:
7. "Covered health care services" means: the services of physicians,
optometrists, nurses, nurse practitioners, midwives and other related
professional personnel which are provided on an outpatient basis,
including routine well-child visits; diagnosis and treatment of illness
and injury; inpatient health care services; laboratory tests; diagnostic
x-rays; prescription and non-prescription drugs, ostomy AND OTHER
MEDICAL supplies and durable medical equipment; radiation therapy;
chemotherapy; hemodialysis; outpatient blood clotting factor products
and other treatments and services furnished in connection with the care
of hemophilia and other blood clotting protein deficiencies; emergency
room services; AMBULANCE SERVICES; hospice services; emergency, preven-
tive and routine dental care, including [medically necessary] orthodon-
tia but excluding cosmetic surgery; emergency, preventive and routine
vision care, including eyeglasses; speech and hearing services; [and,]
inpatient and outpatient mental health, alcohol and substance abuse
services, INCLUDING CHILDREN AND FAMILY TREATMENT AND SUPPORT SERVICES,
CHILDREN'S HOME AND COMMUNITY BASED SERVICES, ASSERTIVE COMMUNITY TREAT-
MENT SERVICES AND RESIDENTIAL REHABILITATION FOR YOUTH SERVICES; AND
HEALTH-RELATED SERVICES PROVIDED BY VOLUNTARY FOSTER CARE AGENCY HEALTH
FACILITIES LICENSED PURSUANT TO ARTICLE TWENTY-NINE-I OF THIS CHAPTER;
as defined by the commissioner [in consultation with the superinten-
dent]. "Covered health care services" shall not include drugs, proce-
dures and supplies for the treatment of erectile dysfunction when
provided to, or prescribed for use by, a person who is required to
register as a sex offender pursuant to article six-C of the correction
law, provided that any denial of coverage of such drugs, procedures or
supplies shall provide the patient with the means of obtaining addi-
tional information concerning both the denial and the means of challeng-
ing such denial.
§ 2. Subdivision 9 of section 2510 of the public health law is amended
by adding a new paragraph (e) to read as follows:
(E) FOR PERIODS ON OR AFTER OCTOBER FIRST, TWO THOUSAND TWENTY-TWO,
AMOUNTS AS FOLLOWS:
(I) NO PAYMENTS ARE REQUIRED FOR ELIGIBLE CHILDREN WHOSE FAMILY HOUSE-
HOLD INCOME IS LESS THAN TWO HUNDRED TWENTY-THREE PERCENT OF THE NON-
FARM FEDERAL POVERTY LEVEL AND FOR ELIGIBLE CHILDREN WHO ARE AMERICAN
INDIANS OR ALASKAN NATIVES, AS DEFINED BY THE UNITED STATES DEPARTMENT
OF HEALTH AND HUMAN SERVICES, WHOSE FAMILY HOUSEHOLD INCOME IS LESS THAN
TWO HUNDRED FIFTY-ONE PERCENT OF THE NON-FARM FEDERAL POVERTY LEVEL; AND
(II) FIFTEEN DOLLARS PER MONTH FOR EACH ELIGIBLE CHILD WHOSE FAMILY
HOUSEHOLD INCOME IS BETWEEN TWO HUNDRED TWENTY-THREE PERCENT AND TWO
HUNDRED FIFTY PERCENT OF THE NON-FARM FEDERAL POVERTY LEVEL, BUT NO MORE
THAN FORTY-FIVE DOLLARS PER MONTH PER FAMILY; AND
S. 8007 95 A. 9007
(III) THIRTY DOLLARS PER MONTH FOR EACH ELIGIBLE CHILD WHOSE FAMILY
HOUSEHOLD INCOME IS BETWEEN TWO HUNDRED FIFTY-ONE PERCENT AND THREE
HUNDRED PERCENT OF THE NON-FARM FEDERAL POVERTY LEVEL, BUT NO MORE THAN
NINETY DOLLARS PER MONTH PER FAMILY; AND
(IV) FORTY-FIVE DOLLARS PER MONTH FOR EACH ELIGIBLE CHILD WHOSE FAMILY
HOUSEHOLD INCOME IS BETWEEN THREE HUNDRED ONE PERCENT AND THREE HUNDRED
FIFTY PERCENT OF THE NON-FARM FEDERAL POVERTY LEVEL, BUT NO MORE THAN
ONE HUNDRED THIRTY-FIVE DOLLARS PER MONTH PER FAMILY; AND
(V) SIXTY DOLLARS PER MONTH FOR EACH ELIGIBLE CHILD WHOSE FAMILY
HOUSEHOLD INCOME IS BETWEEN THREE HUNDRED FIFTY-ONE PERCENT AND FOUR
HUNDRED PERCENT OF THE NON-FARM FEDERAL POVERTY LEVEL, BUT NO MORE THAN
ONE HUNDRED EIGHTY DOLLARS PER MONTH PER FAMILY.
§ 3. Subdivision 8 of section 2511 of the public health law is amended
by adding a new paragraph (i) to read as follows:
(I) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS TITLE, ARTI-
CLES THIRTY-TWO AND FORTY-THREE OF THE INSURANCE LAW AND SUBSECTION (E)
OF SECTION ELEVEN HUNDRED TWENTY OF THE INSURANCE LAW:
(I) THE COMMISSIONER SHALL, SUBJECT TO APPROVAL OF THE DIRECTOR OF THE
DIVISION OF THE BUDGET, DEVELOP REIMBURSEMENT METHODOLOGIES FOR DETER-
MINING THE AMOUNT OF SUBSIDY PAYMENTS MADE TO APPROVED ORGANIZATIONS FOR
THE COST OF COVERED HEALTH CARE SERVICES COVERAGE PROVIDED PURSUANT TO
THIS TITLE FOR PAYMENTS MADE ON AND AFTER JANUARY FIRST, TWO THOUSAND
TWENTY-FOUR.
(II) EFFECTIVE JANUARY FIRST, TWO THOUSAND TWENTY-THREE, THE COMMIS-
SIONER SHALL COORDINATE WITH THE SUPERINTENDENT OF FINANCIAL SERVICES
FOR THE TRANSITION OF THE SUBSIDY PAYMENT RATE SETTING FUNCTION TO THE
DEPARTMENT AND, IN CONJUNCTION WITH ITS INDEPENDENT ACTUARY, REVIEW
REIMBURSEMENT METHODOLOGIES DEVELOPED IN ACCORDANCE WITH SUBPARAGRAPH
(I) OF THIS PARAGRAPH. NOTWITHSTANDING SECTION ONE HUNDRED SIXTY-THREE
OF THE STATE FINANCE LAW, THE COMMISSIONER MAY SELECT AND CONTRACT WITH
THE INDEPENDENT ACTUARY SELECTED PURSUANT TO SUBDIVISION EIGHTEEN OF
SECTION THREE HUNDRED SIXTY-FOUR-J OF THE SOCIAL SERVICES LAW, WITHOUT A
COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS. SUCH INDEPENDENT ACTU-
ARY SHALL REVIEW AND MAKE RECOMMENDATIONS CONCERNING APPROPRIATE ACTUAR-
IAL ASSUMPTIONS RELEVANT TO THE ESTABLISHMENT OF REIMBURSEMENT METHODOL-
OGIES, INCLUDING BUT NOT LIMITED TO THE ADEQUACY OF SUBSIDY PAYMENT
AMOUNTS IN RELATION TO THE POPULATION TO BE SERVED ADJUSTED FOR CASE
MIX, THE SCOPE OF SERVICES APPROVED ORGANIZATIONS MUST PROVIDE, THE
UTILIZATION OF SUCH SERVICES AND THE NETWORK OF PROVIDERS REQUIRED TO
MEET STATE STANDARDS.
§ 4. Paragraph b of subdivision 7 of section 2511 of the public health
law, as amended by chapter 923 of the laws of 1990, is amended to read
as follows:
(b) The commissioner, in consultation with the superintendent, shall
make a determination whether to approve, disapprove or recommend modifi-
cation of the proposal. In order for a proposal to be approved by the
commissioner, the proposal must also be approved by the superintendent
with respect to the provisions of subparagraphs [(viii) through] (IX)
AND (xii) of paragraph (a) of this subdivision.
§ 5. This act shall take effect immediately; provided, however, that
sections one, three and four of this act shall take effect January 1,
2023 and section two of this act shall take effect April 1, 2022.
PART V
S. 8007 96 A. 9007
Section 1. Subdivision 1 of section 2999-dd of the public health law,
as amended by chapter 124 of the laws of 2020, is amended to read as
follows:
1. Health care services delivered by means of telehealth shall be
entitled to reimbursement under section three hundred sixty-seven-u of
the social services law ON THE SAME BASIS, AT THE SAME RATE, AND TO THE
SAME EXTENT THE EQUIVALENT SERVICES, AS MAY BE DEFINED IN REGULATIONS
PROMULGATED BY THE COMMISSIONER, ARE REIMBURSED WHEN DELIVERED IN
PERSON; PROVIDED, HOWEVER, THAT HEALTH CARE SERVICES DELIVERED BY MEANS
OF TELEHEALTH SHALL NOT REQUIRE REIMBURSEMENT TO A TELEHEALTH PROVIDER
FOR CERTAIN COSTS, INCLUDING BUT NOT LIMITED TO FACILITY FEES OR COSTS
REIMBURSED THROUGH AMBULATORY PATIENT GROUPS OR OTHER CLINIC REIMBURSE-
MENT METHODOLOGIES SET FORTH IN SECTION TWENTY-EIGHT HUNDRED SEVEN OF
THIS CHAPTER, IF SUCH COSTS WERE NOT INCURRED IN THE PROVISION OF TELE-
HEALTH SERVICES DUE TO NEITHER THE ORIGINATING SITE NOR THE DISTANT SITE
OCCURRING WITHIN A FACILITY OR OTHER CLINIC SETTING; AND FURTHER
provided, however, reimbursement for additional modalities, provider
categories and originating sites specified in accordance with section
twenty-nine hundred ninety-nine-ee of this article, and audio-only tele-
phone communication defined in regulations promulgated pursuant to
subdivision four of section twenty-nine hundred ninety-nine-cc of this
article, shall be contingent upon federal financial participation.
NOTWITHSTANDING THE PROVISIONS OF THIS SUBDIVISION, FOR SERVICES
LICENSED, CERTIFIED OR OTHERWISE AUTHORIZED PURSUANT TO ARTICLE SIXTEEN,
ARTICLE THIRTY-ONE OR ARTICLE THIRTY-TWO OF THE MENTAL HYGIENE LAW, SUCH
SERVICES PROVIDED BY TELEHEALTH, AS DEEMED APPROPRIATE BY THE RELEVANT
COMMISSIONER, SHALL BE REIMBURSED AT THE APPLICABLE IN PERSON RATES OR
FEES ESTABLISHED BY LAW, OR OTHERWISE ESTABLISHED OR CERTIFIED BY THE
OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, OFFICE OF MENTAL
HEALTH, OR THE OFFICE OF ADDICTION SERVICES AND SUPPORTS PURSUANT TO
ARTICLE FORTY-THREE OF THE MENTAL HYGIENE LAW.
§ 2. Subsection (a) of section 3217-h of the insurance law, as added
by chapter 6 of the laws of 2015, is amended to read as follows:
(a) (1) An insurer shall not exclude from coverage a service that is
otherwise covered under a policy that provides comprehensive coverage
for hospital, medical or surgical care because the service is delivered
via telehealth, as that term is defined in subsection (b) of this
section; provided, however, that an insurer may exclude from coverage a
service by a health care provider where the provider is not otherwise
covered under the policy. An insurer may subject the coverage of a
service delivered via telehealth to co-payments, coinsurance or deduct-
ibles provided that they are at least as favorable to the insured as
those established for the same service when not delivered via tele-
health. An insurer may subject the coverage of a service delivered via
telehealth to reasonable utilization management and quality assurance
requirements that are consistent with those established for the same
service when not delivered via telehealth.
(2) AN INSURER THAT PROVIDES COMPREHENSIVE COVERAGE FOR HOSPITAL,
MEDICAL OR SURGICAL CARE SHALL REIMBURSE COVERED SERVICES DELIVERED BY
MEANS OF TELEHEALTH ON THE SAME BASIS, AT THE SAME RATE, AND TO THE SAME
EXTENT THAT SUCH SERVICES ARE REIMBURSED WHEN DELIVERED IN PERSON;
PROVIDED THAT REIMBURSEMENT OF COVERED SERVICES DELIVERED VIA TELEHEALTH
SHALL NOT REQUIRE REIMBURSEMENT OF COSTS NOT ACTUALLY INCURRED IN THE
PROVISION OF THE TELEHEALTH SERVICES, INCLUDING CHARGES RELATED TO THE
USE OF A CLINIC OR OTHER FACILITY WHEN NEITHER THE ORIGINATING SITE NOR
DISTANT SITE OCCUR WITHIN THE CLINIC OR OTHER FACILITY.
S. 8007 97 A. 9007
(3) AN INSURER THAT PROVIDES COMPREHENSIVE COVERAGE FOR HOSPITAL,
MEDICAL, OR SURGICAL CARE WITH A NETWORK OF HEALTH CARE PROVIDERS SHALL
ENSURE THAT SUCH NETWORK IS ADEQUATE TO MEET THE TELEHEALTH NEEDS OF
INSURED INDIVIDUALS FOR SERVICES COVERED UNDER THE POLICY WHEN MEDICALLY
APPROPRIATE.
§ 3. Subsection (a) of section 4306-g of the insurance law, as added
by chapter 6 of the laws of 2015, is amended to read as follows:
(a) (1) A corporation shall not exclude from coverage a service that
is otherwise covered under a contract that provides comprehensive cover-
age for hospital, medical or surgical care because the service is deliv-
ered via telehealth, as that term is defined in subsection (b) of this
section; provided, however, that a corporation may exclude from coverage
a service by a health care provider where the provider is not otherwise
covered under the contract. A corporation may subject the coverage of a
service delivered via telehealth to co-payments, coinsurance or deduct-
ibles provided that they are at least as favorable to the insured as
those established for the same service when not delivered via tele-
health. A corporation may subject the coverage of a service delivered
via telehealth to reasonable utilization management and quality assur-
ance requirements that are consistent with those established for the
same service when not delivered via telehealth.
(2) A CORPORATION THAT PROVIDES COMPREHENSIVE COVERAGE FOR HOSPITAL,
MEDICAL OR SURGICAL CARE SHALL REIMBURSE COVERED SERVICES DELIVERED BY
MEANS OF TELEHEALTH ON THE SAME BASIS, AT THE SAME RATE, AND TO THE SAME
EXTENT THAT SUCH SERVICES ARE REIMBURSED WHEN DELIVERED IN PERSON;
PROVIDED THAT REIMBURSEMENT OF COVERED SERVICES DELIVERED VIA TELE-
HEALTH SHALL NOT REQUIRE REIMBURSEMENT OF COSTS NOT ACTUALLY INCURRED
IN THE PROVISION OF THE TELEHEALTH SERVICES, INCLUDING CHARGES RELATED
TO THE USE OF A CLINIC OR OTHER FACILITY WHEN NEITHER THE ORIGINATING
SITE NOR THE DISTANT SITE OCCUR WITHIN THE CLINIC OR OTHER FACILITY. THE
SUPERINTENDENT MAY PROMULGATE REGULATIONS TO IMPLEMENT THE PROVISIONS
OF THIS SECTION.
(3) A CORPORATION THAT PROVIDES COMPREHENSIVE COVERAGE FOR HOSPITAL,
MEDICAL, OR SURGICAL CARE WITH A NETWORK OF HEALTH CARE PROVIDERS SHALL
ENSURE THAT SUCH NETWORK IS ADEQUATE TO MEET THE TELEHEALTH NEEDS OF
INSURED INDIVIDUALS FOR SERVICES COVERED UNDER THE POLICY WHEN MEDICALLY
APPROPRIATE.
§ 4. Section 4406-g of the public health law is amended by adding two
new subdivisions 3 and 4 to read as follows:
3. A HEALTH MAINTENANCE ORGANIZATION THAT PROVIDES COMPREHENSIVE
COVERAGE FOR HOSPITAL, MEDICAL OR SURGICAL CARE SHALL REIMBURSE COVERED
SERVICES DELIVERED VIA TELEHEALTH ON THE SAME BASIS, AT THE SAME RATE,
AND TO THE EXTENT THAT SUCH SERVICES ARE REIMBURSED WHEN DELIVERED IN
PERSON; PROVIDED THAT REIMBURSEMENT OF COVERED SERVICES DELIVERED BY
MEANS OF TELEHEALTH SHALL NOT REQUIRE REIMBURSEMENT OF COSTS NOT ACTU-
ALLY INCURRED IN THE PROVISION OF THE TELEHEALTH SERVICES, INCLUDING
CHARGES RELATED TO THE USE OF A CLINIC OR OTHER FACILITY WHEN NEITHER
THE ORIGINATING SITE NOR THE DISTANT SITE OCCUR WITHIN THE CLINIC OR
OTHER FACILITY. THE COMMISSIONER, IN CONSULTATION WITH THE SUPERINTEN-
DENT, MAY PROMULGATE REGULATIONS TO IMPLEMENT THE PROVISIONS OF THIS
SECTION.
4. A HEALTH MAINTENANCE ORGANIZATION THAT PROVIDES COMPREHENSIVE
COVERAGE FOR HOSPITAL, MEDICAL, OR SURGICAL CARE WITH A NETWORK OF
HEALTH CARE PROVIDERS SHALL ENSURE THAT SUCH NETWORK IS ADEQUATE TO MEET
THE TELEHEALTH NEEDS OF INSURED INDIVIDUALS FOR SERVICES COVERED UNDER
THE POLICY WHEN MEDICALLY APPROPRIATE.
S. 8007 98 A. 9007
§ 5. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022.
PART W
Section 1. Section 365-g of the social services law, as added by chap-
ter 938 of the laws of 1990, subdivisions 1 and 3 as amended by chapter
165 of the laws of 1991, subdivisions 2 and 4 as amended by section 31
of part C of chapter 58 of the laws of 2008, clause (B) of subparagraph
(iii) of paragraph (b) of subdivision 3 as amended by chapter 59 of the
laws of 1993, subparagraphs (vi) and (vii) of paragraph (b) of subdivi-
sion 3 as amended and subparagraph (viii) as added by section 31-b of
part C of chapter 58 of the laws of 2008, subdivision 5 as amended by
chapter 41 of the laws of 1992, paragraphs (f) and (g) of subdivision 5
as amended by and paragraphs (h) and (i) as added by section 31-a of
part C of chapter 58 of the laws of 2008, is amended to read as follows:
§ 365-g. Utilization [thresholds] REVIEW for certain care, services
and supplies. 1. The department may implement a system for utilization
[controls] REVIEW, pursuant to this section, for persons eligible for
benefits under this title, [including annual service limitations or
utilization thresholds above which the department may not pay for addi-
tional care, services or supplies, unless such care, services or
supplies have been previously approved by the department or unless such
care, services or supplies were provided pursuant to subdivision three,
four or five of this section] TO EVALUATE THE APPROPRIATENESS AND QUALI-
TY OF MEDICAL ASSISTANCE, AND SAFEGUARD AGAINST UNNECESSARY UTILIZATION
OF CARE AND SERVICES, WHICH SHALL INCLUDE A POST-PAYMENT REVIEW PROCESS
TO DEVELOP AND REVIEW BENEFICIARY UTILIZATION PROFILES, PROVIDER SERVICE
PROFILES, AND EXCEPTIONS CRITERIA TO CORRECT MISUTILIZATION PRACTICES OF
BENEFICIARIES AND PROVIDERS; AND FOR REFERRAL TO THE OFFICE OF MEDICAID
INSPECTOR GENERAL WHERE SUSPECTED FRAUD, WASTE OR ABUSE ARE IDENTIFIED
IN THE UNNECESSARY OR INAPPROPRIATE USE OF CARE, SERVICES OR SUPPLIES
FURNISHED UNDER THIS TITLE.
2. The department may [implement] REVIEW utilization [thresholds] by
provider service type, medical procedure and patient, in consultation
with the state department of mental hygiene, other appropriate state
agencies, and other stakeholders including provider and consumer repre-
sentatives. In [developing] REVIEWING utilization [thresholds], the
department shall consider historical recipient utilization patterns,
patient-specific diagnoses and burdens of illness, and the anticipated
recipient needs in order to maintain good health.
3. [If the department implements a utilization threshold program, at a
minimum, such program must include:
(a) prior notice to the recipients affected by the utilization thresh-
old program, which notice must describe:
(i) the nature and extent of the utilization program, the procedures
for obtaining an exemption from or increase in a utilization threshold,
the recipients' fair hearing rights, and referral to an informational
toll-free hot-line operated by the department; and
(ii) alternatives to the utilization threshold program such as enroll-
ment in managed care programs and referral to preferred primary care
providers designated pursuant to subdivision twelve of section twenty-
eight hundred seven of the public health law; and
(b) procedures for:
(i) requesting an increase in amount of authorized services;
S. 8007 99 A. 9007
(ii) extending amount of authorized services when an application for
an increase in the amount of authorized services is pending;
(iii) requesting an exemption from utilization thresholds, which
procedure must:
(A) allow the recipient, or a provider on behalf of a recipient, to
apply to the department for an exemption from one or more utilization
thresholds based upon documentation of the medical necessity for
services in excess of the threshold,
(B) provided for exemptions consistent with department guidelines for
approving exemptions, which guidelines must be established by the
department in consultation with the department of health and, as appro-
priate, with the department of mental hygiene, and consistent with the
current regulations of the office of mental health governing outpatient
treatment.
(C) provide for an exemption when medical and clinical documentation
substantiates a condition of a chronic medical nature which requires
ongoing and frequent use of medical care, services or supplies such that
an increase in the amount of authorized services is not sufficient to
meet the medical needs of the recipient;
(iv) reimbursing a provider, regardless of the recipient's previous
use of services, when care, services or supplies are provided in a case
of urgent medical need, as defined by the department, or when provided
on an emergency basis, as defined by the department;
(v) notifying recipients of and referring recipients to appropriate
and accessible managed care programs and to preferred primary care
providers designated pursuant to subdivision twelve of section twenty-
eight hundred seven of the public health law at the same time such
recipients are notified that they are nearing or have reached the utili-
zation threshold for each specific provider type;
(vi) notifying recipients at the same time such recipients are noti-
fied that they have received an exemption from a utilization threshold,
an increase in the amount of authorized services, or that they are near-
ing or have reached their utilization threshold, of their possible
eligibility for federal disability benefits and directing such recipi-
ents to their social services district for information and assistance in
securing such benefits;
(vii) cooperating with social services districts in sharing informa-
tion collected and developed by the department regarding recipients'
medical records; and
(viii) assuring that no request for an increase in amount of author-
ized services or for an exemption from utilization thresholds shall be
denied unless the request is first reviewed by a health care profes-
sional possessing appropriate clinical expertise.
4.] The utilization [thresholds] REVIEW established pursuant to this
section shall not apply to [mental retardation and] developmental disa-
bilities services provided in clinics certified under article twenty-
eight of the public health law, or article twenty-two or article thir-
ty-one of the mental hygiene law.
[5.] 4. Utilization [thresholds] REVIEW established pursuant to this
section shall not apply to services, even though such services might
otherwise be subject to utilization [thresholds] REVIEW, when provided
as follows:
(a) through a managed care program;
(b) subject to prior approval or prior authorization;
(c) as family planning services;
(d) as methadone maintenance services;
S. 8007 100 A. 9007
(e) on a fee-for-services basis to in-patients in general hospitals
certified under article twenty-eight of the public health law or article
thirty-one of the mental hygiene law and residential health care facili-
ties, with the exception of podiatrists' services;
(f) for hemodialysis;
(g) through or by referral from a preferred primary care provider
designated pursuant to subdivision twelve of section twenty-eight
hundred seven of the public health law;
(h) pursuant to a court order; or
(i) as a condition of eligibility for any other public program,
including but not limited to public assistance.
[6.] 5. The department shall consult with representatives of medical
assistance providers, social services districts, voluntary organizations
that represent or advocate on behalf of recipients, the managed care
advisory council and other state agencies regarding the ongoing opera-
tion of a utilization [threshold] REVIEW system.
[7.] 6. On or before February first, nineteen hundred ninety-two, the
commissioner shall submit to the governor, the temporary president of
the senate and the speaker of the assembly a report detailing the imple-
mentation of the utilization threshold program and evaluating the
results of establishing utilization thresholds. Such report shall
include, but need not be limited to, a description of the program as
implemented; the number of requests for increases in service above the
threshold amounts by provider and type of service; the number of exten-
sions granted; the number of claims that were submitted for emergency
care or urgent care above the threshold level; the number of recipients
referred to managed care; an estimate of the fiscal savings to the
medical assistance program as a result of the program; recommendations
for medical condition that may be more appropriately served through
managed care programs; and the costs of implementing the program.
§ 2. This act shall take effect July 1, 2022; provided, however, that:
a. the amendments to subdivision 5 of section 365-g of the social
services law made by section one of this act shall not affect the expi-
ration and reversion of paragraphs (f) and (g) of such subdivision
pursuant to subdivision (i-1) of section 79 of chapter 58 of the laws of
2008, as amended; and
b. the amendments to subdivision 5 of section 365-g of the social
services law made by section one of this act shall not affect the repeal
of paragraphs (h) and (i) of such subdivision pursuant to subdivision
(i-1) of section 79 of part C of chapter 58 of the laws of 2008, as
amended.
PART X
Section 1. The title heading of title 2-F of article 2 of the public
health law, as added by chapter 757 of the laws of 1992 and as relet-
tered by chapter 443 of the laws of 1993, is amended to read as follows:
OFFICE OF [MINORITY] HEALTH EQUITY
§ 2. Section 240 of the public health law, as added by chapter 757 of
the laws of 1992 and as renumbered by chapter 443 of the laws of 1993,
is amended to read as follows:
§ 240. Definitions. For the purposes of this article:
1. "UNDERSERVED POPULATIONS" SHALL MEAN THOSE WHO HAVE EXPERIENCED
INJUSTICES AND DISADVANTAGES AS A RESULT OF THEIR RACE, ETHNICITY, SEXU-
AL ORIENTATION, GENDER IDENTITY, GENDER EXPRESSION, DISABILITY STATUS,
S. 8007 101 A. 9007
AGE, AND/OR SOCIOECONOMIC STATUS, AMONG OTHERS AS DETERMINED BY THE
COMMISSIONER OF HEALTH.
2. "[Minority] RACIALLY AND ETHNICALLY DIVERSE area" shall mean a
county with a non-white population of forty percent or more, or the
service area of an agency, corporation, facility or individual providing
medical and/or health services whose non-white population is forty
percent or more.
[2. "Minority health care provider" or "minority provider"] 3.
"PROVIDER" shall mean any agency, corporation, facility, or individual
providing medical and/or health care services to [residents of a minori-
ty area] UNDERSERVED POPULATIONS.
[3.] 4. "Office" shall mean the office of [minority] health EQUITY, as
created pursuant to section two hundred [thirty-eight-a] FORTY-ONE of
this [article] TITLE.
[4.] 5. "[Minority health] HEALTH EQUITY council" shall mean that
advisory body to the commissioner, created pursuant to the provisions of
section two hundred [thirty-eight-c] FORTY-THREE of this [article]
TITLE.
6. "HEALTH DISPARITIES" SHALL MEAN MEASURABLE DIFFERENCES IN HEALTH
STATUS, ACCESS TO CARE, AND QUALITY OF CARE AS DETERMINED BY RACE,
ETHNICITY, SEXUAL ORIENTATION, GENDER IDENTITY, A PREFERRED LANGUAGE
OTHER THAN ENGLISH, GENDER EXPRESSION, DISABILITY STATUS, AGING POPU-
LATION, AND SOCIOECONOMIC STATUS.
7. "HEALTH EQUITY" SHALL MEAN ACHIEVING THE HIGHEST LEVEL OF HEALTH
FOR ALL PEOPLE AND SHALL ENTAIL FOCUSED EFFORTS TO ADDRESS AVOIDABLE
INEQUALITIES BY EQUALIZING THOSE CONDITIONS FOR HEALTH FOR THOSE THAT
HAVE EXPERIENCED INJUSTICES, SOCIOECONOMIC DISADVANTAGES, AND SYSTEMIC
DISADVANTAGES.
8. "SOCIAL DETERMINANTS OF HEALTH" SHALL MEAN LIFE-ENHANCING
RESOURCES, SUCH AS AVAILABILITY OF HEALTHFUL FOODS, QUALITY HOUSING,
ECONOMIC OPPORTUNITY, SOCIAL RELATIONSHIPS, TRANSPORTATION, EDUCATION,
AND HEALTH CARE, WHOSE DISTRIBUTION ACROSS POPULATIONS EFFECTIVELY
DETERMINES THE LENGTH AND QUALITY OF LIFE.
§ 3. Section 241 of the public health law, as added by chapter 757 of
the laws of 1992 and as renumbered by chapter 443 of the laws of 1993,
is amended to read as follows:
§ 241. Office of [minority] health EQUITY created. There is hereby
created an office of [minority] health EQUITY within the state depart-
ment of health. Such office shall:
1. WORK COLLABORATIVELY WITH OTHER STATE AGENCIES AND AFFECTED STAKE-
HOLDERS, INCLUDING PROVIDERS AND REPRESENTATIVES OF UNDERSERVED POPU-
LATIONS, IN ORDER TO SET PRIORITIES, COLLECT AND DISSEMINATE DATA, AND
ALIGN RESOURCES WITHIN THE DEPARTMENT AND ACROSS OTHER STATE AGENCIES.
THE OFFICE SHALL ALSO CONDUCT HEALTH PROMOTION AND EDUCATIONAL OUTREACH,
AS WELL AS DEVELOP AND IMPLEMENT INTERVENTIONS AIMED AT ACHIEVING HEALTH
EQUITY AMONG UNDERSERVED POPULATIONS BY IMPLEMENTING STRATEGIES TO
ADDRESS THE VARYING COMPLEX CAUSES OF HEALTH DISPARITIES, INCLUDING THE
ECONOMIC, PHYSICAL, AND SOCIAL ENVIRONMENTS.
2. Integrate and coordinate selected state health care grant and loan
programs established specifically for [minority] PROMOTING health [care
providers and residents] EQUITY IN NEW YORK STATE. As part of this func-
tion, the office shall develop a coordinated application process for use
by [minority] providers, municipalities and others in seeking funds
and/or technical assistance on pertinent [minority health care] programs
and services TARGETED TO ADDRESS HEALTH EQUITY AMONG UNDERSERVED POPU-
LATIONS.
S. 8007 102 A. 9007
[2.] 3. Apply for grants, and accept gifts from private and public
sources for research to improve and enhance [minority] health [care
services and facilities] EQUITY. The office shall also promote [minori-
ty] health EQUITY research in universities and colleges.
[3.] 4. Together with the [minority] health EQUITY council, serve as
liaison and advocate for the department on [minority] health EQUITY
matters. This function shall include the provision of staff support to
the [minority] health EQUITY council and the establishment of appropri-
ate program linkages with related federal, state, and local agencies and
programs such as the office of [minority] health EQUITY of the public
health service, the agricultural extension service and migrant health
services.
[4.] 5. Assist medical schools and state agencies to develop compre-
hensive programs to improve [minority] THE DIVERSITY OF health personnel
[supply] WORKFORCE by promoting [minority] HEALTH EQUITY clinical train-
ing and curriculum improvement, and disseminating [minority] health
career information to high school and college students.
[5.] 6. Promote community strategic planning [or new or improved
health care delivery systems and networks in minority areas] TO ADDRESS
THE COMPLEX CAUSES OF HEALTH DISPARITIES, INCLUDING THE SOCIAL DETERMI-
NANTS OF HEALTH AND HEALTH CARE DELIVERY SYSTEMS AND NETWORKS, IN ORDER
TO IMPROVE HEALTH EQUITY. Strategic network planning and development may
include such considerations as HEALTHFUL FOODS, QUALITY HOUSING, ECONOM-
IC OPPORTUNITY, SOCIAL RELATIONSHIPS, TRANSPORTATION, AND EDUCATION, AS
WELL AS HEALTH CARE SYSTEMS, INCLUDING ASSOCIATED personnel, capital
facilities, reimbursement, primary care, long-term care, acute care,
rehabilitative, preventive, and related services on the health contin-
uum.
[6.] 7. Review the impact of programs, regulations, and [health care
reimbursement] policies on [minority] health [services delivery and
access] EQUITY.
§ 4. Section 242 of the public health law, as added by chapter 757 of
the laws of 1992 and as renumbered by chapter 443 of the laws of 1993,
is amended to read as follows:
§ 242. Preparation and distribution of reports. The department shall
submit a biennial report to the governor and the legislature describing
the activities of the office and health status of minority areas. The
first such report shall be transmitted on or before September first,
nineteen hundred ninety-four. Such report shall contain the following
information:
1. Activities of the office of [minority] health EQUITY, expenditures
incurred in carrying out such activities, and anticipated activities to
be undertaken in the future.
2. Progress in carrying out the functions and duties listed in section
two hundred [thirty-eight-a] FORTY-ONE of this [article] TITLE.
3. An analysis of the health status of [minority citizens] UNDERSERVED
POPULATIONS, INCLUDING THOSE POPULATIONS WITHIN RACIALLY AND ETHNICALLY
DIVERSE AREAS, and the status of [minority] health delivery systems
SERVING THOSE COMMUNITIES. Such analysis shall be conducted in cooper-
ation with the [minority] health EQUITY council and other interested
agencies.
4. Any recommended improvements to programs and/or regulations that
would enhance the cost effectiveness of the office, and programs
intended to meet the HEALTH AND health care needs of [minority citizens]
UNDERSERVED POPULATIONS.
S. 8007 103 A. 9007
§ 5. Section 243 of the public health law, as added by chapter 757 of
the laws of 1992 and as renumbered by chapter 443 of the laws of 1993,
subdivision 3 as amended by section 55 of part A of chapter 58 of the
laws of 2010, is amended to read as follows:
§ 243. [Minority health] HEALTH EQUITY council. 1. Appointment of
members. There shall be established in the office of [minority] health
EQUITY a [minority] health EQUITY council to consist of the commissioner
and fourteen members to be appointed by the governor with the advice and
consent of the senate. Membership on the council shall be reflective of
the diversity of the state's population including, but not limited to,
the various [minority] UNDERSERVED populations throughout the state.
2. Terms of office; vacancies. a. [The] UNLESS SPECIFIED OTHERWISE IN
THE BYLAWS OF THE HEALTH EQUITY COUNCIL, THE terms of office of members
of the [minority] health EQUITY council [shall] MAY be UP TO six years.
The members of the HEALTH EQUITY council shall continue in office until
the expiration of their terms and until their successors are appointed
and have qualified. Such appointments shall be made by the governor,
with the advice and consent of the senate, within one year following the
expiration of such terms.
b. Vacancies shall be filled by appointment by the governor for the
unexpired terms within one year of the date upon which such vacancies
occur. Any vacancy existing on the effective date of paragraph c of this
subdivision shall be filled by appointment within one year of such
effective date.
c. In making appointments to the council, the governor shall seek to
ensure that membership on the council reflects the diversity of the
state's population including, but not limited to the various [minority]
UNDERSERVED populations throughout the state.
3. Meetings. a. The [minority] health EQUITY council shall meet as
frequently as its business may require, and at least twice in each year.
b. The governor shall designate one of the members of the public
health and health planning council as its chair.
C. A MAJORITY OF THE APPOINTED VOTING MEMBERSHIP OF THE HEALTH EQUITY
COUNCIL SHALL CONSTITUTE A QUORUM.
4. Compensation and expenses. The members of the council shall serve
without compensation other than reimbursement of actual and necessary
expenses.
5. Powers and duties. The [minority] health EQUITY council shall, at
the request of the commissioner, consider any matter relating to the
preservation and improvement of [minority] health STATUS AMONG THE
STATE'S UNDERSERVED POPULATIONS, and may advise the commissioner [there-
on; and it may, from time to time, submit to the commissioner,] ON any
recommendations relating to the preservation and improvement of [minori-
ty] health EQUITY.
§ 6. This act shall take effect immediately.
PART Y
Section 1. The domestic relations law is amended by adding a new
section 20-c to read as follows:
§ 20-C. CERTIFICATION OF MARRIAGE; NEW CERTIFICATE IN CASE OF SUBSE-
QUENT CHANGE OF NAME OR GENDER. 1. A NEW MARRIAGE CERTIFICATE SHALL BE
ISSUED BY THE TOWN OR CITY CLERK WHERE THE MARRIAGE LICENSE AND CERTIF-
ICATE WAS ISSUED, UPON RECEIPT OF PROPER PROOF OF A CHANGE OF NAME OR
GENDER DESIGNATION. PROPER PROOF SHALL CONSIST OF: (A) A JUDGMENT, ORDER
OR DECREE AFFIRMING A CHANGE OF NAME OR GENDER DESIGNATION OF EITHER
S. 8007 104 A. 9007
PARTY TO A MARRIAGE; (B) AN AMENDED BIRTH CERTIFICATE DEMONSTRATING A
CHANGE OF NAME OR GENDER DESIGNATION; OR (C) SUCH OTHER PROOF AS MAY BE
ESTABLISHED BY THE COMMISSIONER OF HEALTH.
2. ON EVERY NEW MARRIAGE CERTIFICATE MADE PURSUANT TO THIS SECTION, A
NOTATION THAT IT IS FILED PURSUANT TO THIS SECTION SHALL BE ENTERED
THEREON.
3. WHEN A NEW MARRIAGE CERTIFICATE IS MADE PURSUANT TO THIS SECTION,
THE TOWN OR CITY CLERK SHALL SUBSTITUTE SUCH NEW CERTIFICATE FOR THE
MARRIAGE CERTIFICATE THEN ON FILE, IF ANY, AND SHALL SEND THE STATE
COMMISSIONER OF HEALTH A DIGITAL COPY OF THE NEW MARRIAGE CERTIFICATE IN
A FORMAT PRESCRIBED BY THE COMMISSIONER, WITH THE EXCEPTION OF THE CITY
CLERK OF NEW YORK WHO SHALL RETAIN THEIR COPY. THE TOWN OR CITY CLERK
SHALL MAKE A COPY OF THE NEW MARRIAGE CERTIFICATE FOR THE LOCAL RECORD
AND HOLD THE CONTENTS OF THE ORIGINAL MARRIAGE CERTIFICATE CONFIDENTIAL
ALONG WITH ALL SUPPORTING DOCUMENTATION, PAPERS AND COPIES PERTAINING
THERETO. IT SHALL NOT BE RELEASED OR OTHERWISE DIVULGED EXCEPT BY ORDER
OF A COURT OF COMPETENT JURISDICTION.
4. THE TOWN OR CITY CLERK SHALL BE ENTITLED TO A FEE OF TEN DOLLARS
FOR THE AMENDMENT AND CERTIFIED COPY OF ANY MARRIAGE CERTIFICATE IN
ACCORDANCE WITH THE PROVISIONS OF THIS SECTION.
5. THE STATE COMMISSIONER OF HEALTH MAY, IN THEIR DISCRETION, REPORT
TO THE ATTORNEY GENERAL ANY TOWN OR CITY CLERK THAT, WITHOUT CAUSE,
FAILS TO ISSUE A NEW MARRIAGE CERTIFICATE UPON RECEIPT OF PROPER PROOF
OF A CHANGE OF NAME OR GENDER DESIGNATION IN ACCORDANCE WITH THIS
SECTION. THE ATTORNEY GENERAL SHALL THEREUPON, IN THE NAME OF THE STATE
COMMISSIONER OF HEALTH OR THE PEOPLE OF THE STATE, INSTITUTE SUCH ACTION
OR PROCEEDING AS MAY BE NECESSARY TO COMPEL THE ISSUANCE OF SUCH NEW
MARRIAGE CERTIFICATE.
§ 2. This act shall take effect one year after it shall have become a
law.
PART Z
Section 1. Section 18 of chapter 266 of the laws of 1986, amending
the civil practice law and rules and other laws relating to malpractice
and professional medical conduct, is amended by adding a new subdivision
9 to read as follows:
(9) THIS SUBDIVISION SHALL APPLY ONLY TO EXCESS INSURANCE COVERAGE OR
EQUIVALENT EXCESS COVERAGE FOR PHYSICIANS OR DENTISTS THAT IS ELIGIBLE
TO BE PAID FOR FROM FUNDS AVAILABLE IN THE HOSPITAL EXCESS LIABILITY
POOL.
(A) NOTWITHSTANDING ANY LAW TO THE CONTRARY, FOR ANY POLICY PERIOD
BEGINNING ON OR AFTER JULY 1, 2021, EXCESS COVERAGE SHALL BE PURCHASED
BY A PHYSICIAN OR DENTIST DIRECTLY FROM A PROVIDER OF EXCESS INSURANCE
COVERAGE OR EQUIVALENT EXCESS COVERAGE. AT THE CONCLUSION OF THE POLICY
PERIOD THE SUPERINTENDENT OF FINANCIAL SERVICES AND THE COMMISSIONER OF
HEALTH OR THEIR DESIGNEE SHALL, FROM FUNDS AVAILABLE IN THE HOSPITAL
EXCESS LIABILITY POOL CREATED PURSUANT TO SUBDIVISION 5 OF THIS SECTION,
REIMBURSE FIFTY PERCENT OF THE PREMIUM TO THE PHYSICIAN OR DENTIST, AND
THE REMAINING FIFTY PERCENT SHALL BE PAID ONE YEAR THEREAFTER. IF THE
FUNDS AVAILABLE IN THE HOSPITAL EXCESS LIABILITY POOL ARE INSUFFICIENT
TO MEET THE PERCENT OF THE COSTS OF THE EXCESS COVERAGE, THE PROVISIONS
OF SUBDIVISION 8 OF THIS SECTION SHALL APPLY.
(B) NO PROVIDER OF EXCESS INSURANCE COVERAGE OR EQUIVALENT EXCESS
COVERAGE SHALL ISSUE EXCESS COVERAGE TO WHICH THIS SUBDIVISION APPLIES
TO ANY PHYSICIAN OR DENTIST UNLESS THAT PHYSICIAN OR DENTIST MEETS THE
S. 8007 105 A. 9007
ELIGIBILITY REQUIREMENTS FOR SUCH COVERAGE SET FORTH IN THIS SECTION.
THE SUPERINTENDENT OF FINANCIAL SERVICES AND THE COMMISSIONER OF HEALTH
OR THEIR DESIGNEE SHALL NOT MAKE ANY PAYMENT UNDER THIS SUBDIVISION TO A
PHYSICIAN OR DENTIST WHO DOES NOT MEET THE ELIGIBILITY REQUIREMENTS FOR
PARTICIPATION IN THE HOSPITAL EXCESS LIABILITY POOL PROGRAM SET FORTH IN
THIS SECTION.
(C) THE SUPERINTENDENT OF FINANCIAL SERVICES IN CONSULTATION WITH THE
COMMISSIONER OF HEALTH MAY PROMULGATE REGULATIONS GIVING EFFECT TO THE
PROVISIONS OF THIS SUBDIVISION.
§ 2. Paragraph (a) of subdivision 1 of section 18 of chapter 266 of
the laws of 1986, amending the civil practice law and rules and other
laws relating to malpractice and professional medical conduct, as
amended by section 1 of part K of chapter 57 of the laws of 2021, is
amended to read as follows:
(a) The superintendent of financial services and the commissioner of
health or their designee shall, from funds available in the hospital
excess liability pool created pursuant to subdivision 5 of this section,
purchase a policy or policies for excess insurance coverage, as author-
ized by paragraph 1 of subsection (e) of section 5502 of the insurance
law; or from an insurer, other than an insurer described in section 5502
of the insurance law, duly authorized to write such coverage and actual-
ly writing medical malpractice insurance in this state; or shall
purchase equivalent excess coverage in a form previously approved by the
superintendent of financial services for purposes of providing equiv-
alent excess coverage in accordance with section 19 of chapter 294 of
the laws of 1985, for medical or dental malpractice occurrences between
July 1, 1986 and June 30, 1987, between July 1, 1987 and June 30, 1988,
between July 1, 1988 and June 30, 1989, between July 1, 1989 and June
30, 1990, between July 1, 1990 and June 30, 1991, between July 1, 1991
and June 30, 1992, between July 1, 1992 and June 30, 1993, between July
1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995,
between July 1, 1995 and June 30, 1996, between July 1, 1996 and June
30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998
and June 30, 1999, between July 1, 1999 and June 30, 2000, between July
1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002,
between July 1, 2002 and June 30, 2003, between July 1, 2003 and June
30, 2004, between July 1, 2004 and June 30, 2005, between July 1, 2005
and June 30, 2006, between July 1, 2006 and June 30, 2007, between July
1, 2007 and June 30, 2008, between July 1, 2008 and June 30, 2009,
between July 1, 2009 and June 30, 2010, between July 1, 2010 and June
30, 2011, between July 1, 2011 and June 30, 2012, between July 1, 2012
and June 30, 2013, between July 1, 2013 and June 30, 2014, between July
1, 2014 and June 30, 2015, between July 1, 2015 and June 30, 2016,
between July 1, 2016 and June 30, 2017, between July 1, 2017 and June
30, 2018, between July 1, 2018 and June 30, 2019, between July 1, 2019
and June 30, 2020, between July 1, 2020 and June 30, 2021, [and] between
July 1, 2021 and June 30, 2022, AND BETWEEN JULY 1, 2022 AND JUNE 30,
2023 or reimburse the hospital where the hospital purchases equivalent
excess coverage as defined in subparagraph (i) of paragraph (a) of
subdivision 1-a of this section for medical or dental malpractice occur-
rences between July 1, 1987 and June 30, 1988, between July 1, 1988 and
June 30, 1989, between July 1, 1989 and June 30, 1990, between July 1,
1990 and June 30, 1991, between July 1, 1991 and June 30, 1992, between
July 1, 1992 and June 30, 1993, between July 1, 1993 and June 30, 1994,
between July 1, 1994 and June 30, 1995, between July 1, 1995 and June
30, 1996, between July 1, 1996 and June 30, 1997, between July 1, 1997
S. 8007 106 A. 9007
and June 30, 1998, between July 1, 1998 and June 30, 1999, between July
1, 1999 and June 30, 2000, between July 1, 2000 and June 30, 2001,
between July 1, 2001 and June 30, 2002, between July 1, 2002 and June
30, 2003, between July 1, 2003 and June 30, 2004, between July 1, 2004
and June 30, 2005, between July 1, 2005 and June 30, 2006, between July
1, 2006 and June 30, 2007, between July 1, 2007 and June 30, 2008,
between July 1, 2008 and June 30, 2009, between July 1, 2009 and June
30, 2010, between July 1, 2010 and June 30, 2011, between July 1, 2011
and June 30, 2012, between July 1, 2012 and June 30, 2013, between July
1, 2013 and June 30, 2014, between July 1, 2014 and June 30, 2015,
between July 1, 2015 and June 30, 2016, between July 1, 2016 and June
30, 2017, between July 1, 2017 and June 30, 2018, between July 1, 2018
and June 30, 2019, between July 1, 2019 and June 30, 2020, between July
1, 2020 and June 30, 2021, [and] between July 1, 2021 and June 30, 2022,
AND BETWEEN JULY 1, 2022 AND JUNE 30, 2023 for physicians or dentists
certified as eligible for each such period or periods pursuant to subdi-
vision 2 of this section by a general hospital licensed pursuant to
article 28 of the public health law; provided that no single insurer
shall write more than fifty percent of the total excess premium for a
given policy year; and provided, however, that such eligible physicians
or dentists must have in force an individual policy, from an insurer
licensed in this state of primary malpractice insurance coverage in
amounts of no less than one million three hundred thousand dollars for
each claimant and three million nine hundred thousand dollars for all
claimants under that policy during the period of such excess coverage
for such occurrences or be endorsed as additional insureds under a
hospital professional liability policy which is offered through a volun-
tary attending physician ("channeling") program previously permitted by
the superintendent of financial services during the period of such
excess coverage for such occurrences. During such period, such policy
for excess coverage or such equivalent excess coverage shall, when
combined with the physician's or dentist's primary malpractice insurance
coverage or coverage provided through a voluntary attending physician
("channeling") program, total an aggregate level of two million three
hundred thousand dollars for each claimant and six million nine hundred
thousand dollars for all claimants from all such policies with respect
to occurrences in each of such years provided, however, if the cost of
primary malpractice insurance coverage in excess of one million dollars,
but below the excess medical malpractice insurance coverage provided
pursuant to this act, exceeds the rate of nine percent per annum, then
the required level of primary malpractice insurance coverage in excess
of one million dollars for each claimant shall be in an amount of not
less than the dollar amount of such coverage available at nine percent
per annum; the required level of such coverage for all claimants under
that policy shall be in an amount not less than three times the dollar
amount of coverage for each claimant; and excess coverage, when combined
with such primary malpractice insurance coverage, shall increase the
aggregate level for each claimant by one million dollars and three
million dollars for all claimants; and provided further, that, with
respect to policies of primary medical malpractice coverage that include
occurrences between April 1, 2002 and June 30, 2002, such requirement
that coverage be in amounts no less than one million three hundred thou-
sand dollars for each claimant and three million nine hundred thousand
dollars for all claimants for such occurrences shall be effective April
1, 2002.
S. 8007 107 A. 9007
§ 3. Subdivision 3 of section 18 of chapter 266 of the laws of 1986,
amending the civil practice law and rules and other laws relating to
malpractice and professional medical conduct, as amended by section 2 of
part K of chapter 57 of the laws of 2021, is amended to read as follows:
(3)(a) The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
cost of excess malpractice insurance for medical or dental malpractice
occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988
and June 30, 1989, between July 1, 1989 and June 30, 1990, between July
1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992,
between July 1, 1992 and June 30, 1993, between July 1, 1993 and June
30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995
and June 30, 1996, between July 1, 1996 and June 30, 1997, between July
1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999,
between July 1, 1999 and June 30, 2000, between July 1, 2000 and June
30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002
and June 30, 2003, between July 1, 2003 and June 30, 2004, between July
1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006,
between July 1, 2006 and June 30, 2007, between July 1, 2007 and June
30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009
and June 30, 2010, between July 1, 2010 and June 30, 2011, between July
1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013,
between July 1, 2013 and June 30, 2014, between July 1, 2014 and June
30, 2015, between July 1, 2015 and June 30, 2016, between July 1, 2016
and June 30, 2017, between July 1, 2017 and June 30, 2018, between July
1, 2018 and June 30, 2019, between July 1, 2019 and June 30, 2020,
between July 1, 2020 and June 30, 2021, [and] between July 1, 2021 and
June 30, 2022, AND BETWEEN JULY 1, 2022 AND JUNE 30, 2023 allocable to
each general hospital for physicians or dentists certified as eligible
for purchase of a policy for excess insurance coverage by such general
hospital in accordance with subdivision 2 of this section, and may amend
such determination and certification as necessary.
(b) The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
cost of excess malpractice insurance or equivalent excess coverage for
medical or dental malpractice occurrences between July 1, 1987 and June
30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989
and June 30, 1990, between July 1, 1990 and June 30, 1991, between July
1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993,
between July 1, 1993 and June 30, 1994, between July 1, 1994 and June
30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996
and June 30, 1997, between July 1, 1997 and June 30, 1998, between July
1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000,
between July 1, 2000 and June 30, 2001, between July 1, 2001 and June
30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003
and June 30, 2004, between July 1, 2004 and June 30, 2005, between July
1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007,
between July 1, 2007 and June 30, 2008, between July 1, 2008 and June
30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010
and June 30, 2011, between July 1, 2011 and June 30, 2012, between July
1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014,
between July 1, 2014 and June 30, 2015, between July 1, 2015 and June
30, 2016, between July 1, 2016 and June 30, 2017, between July 1, 2017
and June 30, 2018, between July 1, 2018 and June 30, 2019, between July
1, 2019 and June 30, 2020, between July 1, 2020 and June 30, 2021, [and]
between July 1, 2021 and June 30, 2022, AND BETWEEN JULY 1, 2022 AND
S. 8007 108 A. 9007
JUNE 30, 2023 allocable to each general hospital for physicians or
dentists certified as eligible for purchase of a policy for excess
insurance coverage or equivalent excess coverage by such general hospi-
tal in accordance with subdivision 2 of this section, and may amend such
determination and certification as necessary. The superintendent of
financial services shall determine and certify to each general hospital
and to the commissioner of health the ratable share of such cost alloca-
ble to the period July 1, 1987 to December 31, 1987, to the period Janu-
ary 1, 1988 to June 30, 1988, to the period July 1, 1988 to December 31,
1988, to the period January 1, 1989 to June 30, 1989, to the period July
1, 1989 to December 31, 1989, to the period January 1, 1990 to June 30,
1990, to the period July 1, 1990 to December 31, 1990, to the period
January 1, 1991 to June 30, 1991, to the period July 1, 1991 to December
31, 1991, to the period January 1, 1992 to June 30, 1992, to the period
July 1, 1992 to December 31, 1992, to the period January 1, 1993 to June
30, 1993, to the period July 1, 1993 to December 31, 1993, to the period
January 1, 1994 to June 30, 1994, to the period July 1, 1994 to December
31, 1994, to the period January 1, 1995 to June 30, 1995, to the period
July 1, 1995 to December 31, 1995, to the period January 1, 1996 to June
30, 1996, to the period July 1, 1996 to December 31, 1996, to the period
January 1, 1997 to June 30, 1997, to the period July 1, 1997 to December
31, 1997, to the period January 1, 1998 to June 30, 1998, to the period
July 1, 1998 to December 31, 1998, to the period January 1, 1999 to June
30, 1999, to the period July 1, 1999 to December 31, 1999, to the period
January 1, 2000 to June 30, 2000, to the period July 1, 2000 to December
31, 2000, to the period January 1, 2001 to June 30, 2001, to the period
July 1, 2001 to June 30, 2002, to the period July 1, 2002 to June 30,
2003, to the period July 1, 2003 to June 30, 2004, to the period July 1,
2004 to June 30, 2005, to the period July 1, 2005 and June 30, 2006, to
the period July 1, 2006 and June 30, 2007, to the period July 1, 2007
and June 30, 2008, to the period July 1, 2008 and June 30, 2009, to the
period July 1, 2009 and June 30, 2010, to the period July 1, 2010 and
June 30, 2011, to the period July 1, 2011 and June 30, 2012, to the
period July 1, 2012 and June 30, 2013, to the period July 1, 2013 and
June 30, 2014, to the period July 1, 2014 and June 30, 2015, to the
period July 1, 2015 and June 30, 2016, to the period July 1, 2016 and
June 30, 2017, to the period July 1, 2017 to June 30, 2018, to the peri-
od July 1, 2018 to June 30, 2019, to the period July 1, 2019 to June 30,
2020, to the period July 1, 2020 to June 30, 2021, [and] to the period
July 1, 2021 to June 30, 2022, AND TO THE PERIOD JULY 1, 2022 TO JUNE
30, 2023.
§ 4. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
18 of chapter 266 of the laws of 1986, amending the civil practice law
and rules and other laws relating to malpractice and professional
medical conduct, as amended by section 3 of part K of chapter 57 of the
laws of 2021, are amended to read as follows:
(a) To the extent funds available to the hospital excess liability
pool pursuant to subdivision 5 of this section as amended, and pursuant
to section 6 of part J of chapter 63 of the laws of 2001, as may from
time to time be amended, which amended this subdivision, are insuffi-
cient to meet the costs of excess insurance coverage or equivalent
excess coverage for coverage periods during the period July 1, 1992 to
June 30, 1993, during the period July 1, 1993 to June 30, 1994, during
the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
to June 30, 1996, during the period July 1, 1996 to June 30, 1997,
during the period July 1, 1997 to June 30, 1998, during the period July
S. 8007 109 A. 9007
1, 1998 to June 30, 1999, during the period July 1, 1999 to June 30,
2000, during the period July 1, 2000 to June 30, 2001, during the period
July 1, 2001 to October 29, 2001, during the period April 1, 2002 to
June 30, 2002, during the period July 1, 2002 to June 30, 2003, during
the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
to June 30, 2005, during the period July 1, 2005 to June 30, 2006,
during the period July 1, 2006 to June 30, 2007, during the period July
1, 2007 to June 30, 2008, during the period July 1, 2008 to June 30,
2009, during the period July 1, 2009 to June 30, 2010, during the period
July 1, 2010 to June 30, 2011, during the period July 1, 2011 to June
30, 2012, during the period July 1, 2012 to June 30, 2013, during the
period July 1, 2013 to June 30, 2014, during the period July 1, 2014 to
June 30, 2015, during the period July 1, 2015 to June 30, 2016, during
the period July 1, 2016 to June 30, 2017, during the period July 1, 2017
to June 30, 2018, during the period July 1, 2018 to June 30, 2019,
during the period July 1, 2019 to June 30, 2020, during the period July
1, 2020 to June 30, 2021, [and] during the period July 1, 2021 to June
30, 2022, AND DURING THE PERIOD JULY 1, 2022 TO JUNE 30, 2023 allocated
or reallocated in accordance with paragraph (a) of subdivision 4-a of
this section to rates of payment applicable to state governmental agen-
cies, each physician or dentist for whom a policy for excess insurance
coverage or equivalent excess coverage is purchased for such period
shall be responsible for payment to the provider of excess insurance
coverage or equivalent excess coverage of an allocable share of such
insufficiency, based on the ratio of the total cost of such coverage for
such physician to the sum of the total cost of such coverage for all
physicians applied to such insufficiency.
(b) Each provider of excess insurance coverage or equivalent excess
coverage covering the period July 1, 1992 to June 30, 1993, or covering
the period July 1, 1993 to June 30, 1994, or covering the period July 1,
1994 to June 30, 1995, or covering the period July 1, 1995 to June 30,
1996, or covering the period July 1, 1996 to June 30, 1997, or covering
the period July 1, 1997 to June 30, 1998, or covering the period July 1,
1998 to June 30, 1999, or covering the period July 1, 1999 to June 30,
2000, or covering the period July 1, 2000 to June 30, 2001, or covering
the period July 1, 2001 to October 29, 2001, or covering the period
April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to
June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
covering the period July 1, 2004 to June 30, 2005, or covering the peri-
od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
June 30, 2007, or covering the period July 1, 2007 to June 30, 2008, or
covering the period July 1, 2008 to June 30, 2009, or covering the peri-
od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
June 30, 2011, or covering the period July 1, 2011 to June 30, 2012, or
covering the period July 1, 2012 to June 30, 2013, or covering the peri-
od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to
June 30, 2015, or covering the period July 1, 2015 to June 30, 2016, or
covering the period July 1, 2016 to June 30, 2017, or covering the peri-
od July 1, 2017 to June 30, 2018, or covering the period July 1, 2018 to
June 30, 2019, or covering the period July 1, 2019 to June 30, 2020, or
covering the period July 1, 2020 to June 30, 2021, or covering the peri-
od July 1, 2021 to June 30, 2022, OR COVERING THE PERIOD JULY 1, 2022 TO
JUNE 30, 2023 shall notify a covered physician or dentist by mail,
mailed to the address shown on the last application for excess insurance
coverage or equivalent excess coverage, of the amount due to such
provider from such physician or dentist for such coverage period deter-
S. 8007 110 A. 9007
mined in accordance with paragraph (a) of this subdivision. Such amount
shall be due from such physician or dentist to such provider of excess
insurance coverage or equivalent excess coverage in a time and manner
determined by the superintendent of financial services.
(c) If a physician or dentist liable for payment of a portion of the
costs of excess insurance coverage or equivalent excess coverage cover-
ing the period July 1, 1992 to June 30, 1993, or covering the period
July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to
June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
covering the period July 1, 1996 to June 30, 1997, or covering the peri-
od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or
covering the period July 1, 2000 to June 30, 2001, or covering the peri-
od July 1, 2001 to October 29, 2001, or covering the period April 1,
2002 to June 30, 2002, or covering the period July 1, 2002 to June 30,
2003, or covering the period July 1, 2003 to June 30, 2004, or covering
the period July 1, 2004 to June 30, 2005, or covering the period July 1,
2005 to June 30, 2006, or covering the period July 1, 2006 to June 30,
2007, or covering the period July 1, 2007 to June 30, 2008, or covering
the period July 1, 2008 to June 30, 2009, or covering the period July 1,
2009 to June 30, 2010, or covering the period July 1, 2010 to June 30,
2011, or covering the period July 1, 2011 to June 30, 2012, or covering
the period July 1, 2012 to June 30, 2013, or covering the period July 1,
2013 to June 30, 2014, or covering the period July 1, 2014 to June 30,
2015, or covering the period July 1, 2015 to June 30, 2016, or covering
the period July 1, 2016 to June 30, 2017, or covering the period July 1,
2017 to June 30, 2018, or covering the period July 1, 2018 to June 30,
2019, or covering the period July 1, 2019 to June 30, 2020, or covering
the period July 1, 2020 to June 30, 2021, or covering the period July 1,
2021 to June 30, 2022, OR COVERING THE PERIOD JULY 1, 2022 TO JUNE 30,
2023 determined in accordance with paragraph (a) of this subdivision
fails, refuses or neglects to make payment to the provider of excess
insurance coverage or equivalent excess coverage in such time and manner
as determined by the superintendent of financial services pursuant to
paragraph (b) of this subdivision, excess insurance coverage or equiv-
alent excess coverage purchased for such physician or dentist in accord-
ance with this section for such coverage period shall be cancelled and
shall be null and void as of the first day on or after the commencement
of a policy period where the liability for payment pursuant to this
subdivision has not been met.
(d) Each provider of excess insurance coverage or equivalent excess
coverage shall notify the superintendent of financial services and the
commissioner of health or their designee of each physician and dentist
eligible for purchase of a policy for excess insurance coverage or
equivalent excess coverage covering the period July 1, 1992 to June 30,
1993, or covering the period July 1, 1993 to June 30, 1994, or covering
the period July 1, 1994 to June 30, 1995, or covering the period July 1,
1995 to June 30, 1996, or covering the period July 1, 1996 to June 30,
1997, or covering the period July 1, 1997 to June 30, 1998, or covering
the period July 1, 1998 to June 30, 1999, or covering the period July 1,
1999 to June 30, 2000, or covering the period July 1, 2000 to June 30,
2001, or covering the period July 1, 2001 to October 29, 2001, or cover-
ing the period April 1, 2002 to June 30, 2002, or covering the period
July 1, 2002 to June 30, 2003, or covering the period July 1, 2003 to
June 30, 2004, or covering the period July 1, 2004 to June 30, 2005, or
covering the period July 1, 2005 to June 30, 2006, or covering the peri-
S. 8007 111 A. 9007
od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to
June 30, 2008, or covering the period July 1, 2008 to June 30, 2009, or
covering the period July 1, 2009 to June 30, 2010, or covering the peri-
od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to
June 30, 2012, or covering the period July 1, 2012 to June 30, 2013, or
covering the period July 1, 2013 to June 30, 2014, or covering the peri-
od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to
June 30, 2016, or covering the period July 1, 2016 to June 30, 2017, or
covering the period July 1, 2017 to June 30, 2018, or covering the peri-
od July 1, 2018 to June 30, 2019, or covering the period July 1, 2019 to
June 30, 2020, or covering the period July 1, 2020 to June 30, 2021, or
covering the period July 1, 2021 to June 30, 2022, OR COVERING THE PERI-
OD JULY 1, 2022 TO JUNE 1, 2023 that has made payment to such provider
of excess insurance coverage or equivalent excess coverage in accordance
with paragraph (b) of this subdivision and of each physician and dentist
who has failed, refused or neglected to make such payment.
(e) A provider of excess insurance coverage or equivalent excess
coverage shall refund to the hospital excess liability pool any amount
allocable to the period July 1, 1992 to June 30, 1993, and to the period
July 1, 1993 to June 30, 1994, and to the period July 1, 1994 to June
30, 1995, and to the period July 1, 1995 to June 30, 1996, and to the
period July 1, 1996 to June 30, 1997, and to the period July 1, 1997 to
June 30, 1998, and to the period July 1, 1998 to June 30, 1999, and to
the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
to June 30, 2001, and to the period July 1, 2001 to October 29, 2001,
and to the period April 1, 2002 to June 30, 2002, and to the period July
1, 2002 to June 30, 2003, and to the period July 1, 2003 to June 30,
2004, and to the period July 1, 2004 to June 30, 2005, and to the period
July 1, 2005 to June 30, 2006, and to the period July 1, 2006 to June
30, 2007, and to the period July 1, 2007 to June 30, 2008, and to the
period July 1, 2008 to June 30, 2009, and to the period July 1, 2009 to
June 30, 2010, and to the period July 1, 2010 to June 30, 2011, and to
the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
to June 30, 2013, and to the period July 1, 2013 to June 30, 2014, and
to the period July 1, 2014 to June 30, 2015, and to the period July 1,
2015 to June 30, 2016, to the period July 1, 2016 to June 30, 2017, and
to the period July 1, 2017 to June 30, 2018, and to the period July 1,
2018 to June 30, 2019, and to the period July 1, 2019 to June 30, 2020,
and to the period July 1, 2020 to June 30, 2021, and to the period July
1, 2021 to June 30, 2022, AND TO THE PERIOD JULY 1, 2022 TO JUNE 30,
2023 received from the hospital excess liability pool for purchase of
excess insurance coverage or equivalent excess coverage covering the
period July 1, 1992 to June 30, 1993, and covering the period July 1,
1993 to June 30, 1994, and covering the period July 1, 1994 to June 30,
1995, and covering the period July 1, 1995 to June 30, 1996, and cover-
ing the period July 1, 1996 to June 30, 1997, and covering the period
July 1, 1997 to June 30, 1998, and covering the period July 1, 1998 to
June 30, 1999, and covering the period July 1, 1999 to June 30, 2000,
and covering the period July 1, 2000 to June 30, 2001, and covering the
period July 1, 2001 to October 29, 2001, and covering the period April
1, 2002 to June 30, 2002, and covering the period July 1, 2002 to June
30, 2003, and covering the period July 1, 2003 to June 30, 2004, and
covering the period July 1, 2004 to June 30, 2005, and covering the
period July 1, 2005 to June 30, 2006, and covering the period July 1,
2006 to June 30, 2007, and covering the period July 1, 2007 to June 30,
2008, and covering the period July 1, 2008 to June 30, 2009, and cover-
S. 8007 112 A. 9007
ing the period July 1, 2009 to June 30, 2010, and covering the period
July 1, 2010 to June 30, 2011, and covering the period July 1, 2011 to
June 30, 2012, and covering the period July 1, 2012 to June 30, 2013,
and covering the period July 1, 2013 to June 30, 2014, and covering the
period July 1, 2014 to June 30, 2015, and covering the period July 1,
2015 to June 30, 2016, and covering the period July 1, 2016 to June 30,
2017, and covering the period July 1, 2017 to June 30, 2018, and cover-
ing the period July 1, 2018 to June 30, 2019, and covering the period
July 1, 2019 to June 30, 2020, and covering the period July 1, 2020 to
June 30, 2021, and covering the period July 1, 2021 to June 30, 2022,
AND COVERING THE PERIOD JULY 1, 2022 TO JUNE 30, 2023 for a physician or
dentist where such excess insurance coverage or equivalent excess cover-
age is cancelled in accordance with paragraph (c) of this subdivision.
§ 5. Section 40 of chapter 266 of the laws of 1986, amending the civil
practice law and rules and other laws relating to malpractice and
professional medical conduct, as amended by section 4 of part K of chap-
ter 57 of the laws of 2021, is amended to read as follows:
§ 40. The superintendent of financial services shall establish rates
for policies providing coverage for physicians and surgeons medical
malpractice for the periods commencing July 1, 1985 and ending June 30,
[2022] 2023; provided, however, that notwithstanding any other provision
of law, the superintendent shall not establish or approve any increase
in rates for the period commencing July 1, 2009 and ending June 30,
2010. The superintendent shall direct insurers to establish segregated
accounts for premiums, payments, reserves and investment income attrib-
utable to such premium periods and shall require periodic reports by the
insurers regarding claims and expenses attributable to such periods to
monitor whether such accounts will be sufficient to meet incurred claims
and expenses. On or after July 1, 1989, the superintendent shall impose
a surcharge on premiums to satisfy a projected deficiency that is
attributable to the premium levels established pursuant to this section
for such periods; provided, however, that such annual surcharge shall
not exceed eight percent of the established rate until July 1, [2022]
2023, at which time and thereafter such surcharge shall not exceed twen-
ty-five percent of the approved adequate rate, and that such annual
surcharges shall continue for such period of time as shall be sufficient
to satisfy such deficiency. The superintendent shall not impose such
surcharge during the period commencing July 1, 2009 and ending June 30,
2010. On and after July 1, 1989, the surcharge prescribed by this
section shall be retained by insurers to the extent that they insured
physicians and surgeons during the July 1, 1985 through June 30, [2022]
2023 policy periods; in the event and to the extent physicians and
surgeons were insured by another insurer during such periods, all or a
pro rata share of the surcharge, as the case may be, shall be remitted
to such other insurer in accordance with rules and regulations to be
promulgated by the superintendent. Surcharges collected from physicians
and surgeons who were not insured during such policy periods shall be
apportioned among all insurers in proportion to the premium written by
each insurer during such policy periods; if a physician or surgeon was
insured by an insurer subject to rates established by the superintendent
during such policy periods, and at any time thereafter a hospital,
health maintenance organization, employer or institution is responsible
for responding in damages for liability arising out of such physician's
or surgeon's practice of medicine, such responsible entity shall also
remit to such prior insurer the equivalent amount that would then be
collected as a surcharge if the physician or surgeon had continued to
S. 8007 113 A. 9007
remain insured by such prior insurer. In the event any insurer that
provided coverage during such policy periods is in liquidation, the
property/casualty insurance security fund shall receive the portion of
surcharges to which the insurer in liquidation would have been entitled.
The surcharges authorized herein shall be deemed to be income earned for
the purposes of section 2303 of the insurance law. The superintendent,
in establishing adequate rates and in determining any projected defi-
ciency pursuant to the requirements of this section and the insurance
law, shall give substantial weight, determined in his discretion and
judgment, to the prospective anticipated effect of any regulations
promulgated and laws enacted and the public benefit of stabilizing
malpractice rates and minimizing rate level fluctuation during the peri-
od of time necessary for the development of more reliable statistical
experience as to the efficacy of such laws and regulations affecting
medical, dental or podiatric malpractice enacted or promulgated in 1985,
1986, by this act and at any other time. Notwithstanding any provision
of the insurance law, rates already established and to be established by
the superintendent pursuant to this section are deemed adequate if such
rates would be adequate when taken together with the maximum authorized
annual surcharges to be imposed for a reasonable period of time whether
or not any such annual surcharge has been actually imposed as of the
establishment of such rates.
§ 6. Section 5 and subdivisions (a) and (e) of section 6 of part J of
chapter 63 of the laws of 2001, amending chapter 266 of the laws of
1986, amending the civil practice law and rules and other laws relating
to malpractice and professional medical conduct, as amended by section 5
of part K of chapter 57 of the laws of 2021, are amended to read as
follows:
§ 5. The superintendent of financial services and the commissioner of
health shall determine, no later than June 15, 2002, June 15, 2003, June
15, 2004, June 15, 2005, June 15, 2006, June 15, 2007, June 15, 2008,
June 15, 2009, June 15, 2010, June 15, 2011, June 15, 2012, June 15,
2013, June 15, 2014, June 15, 2015, June 15, 2016, June 15, 2017, June
15, 2018, June 15, 2019, June 15, 2020, June 15, 2021, [and] June 15,
2022, AND JUNE 15, 2023 the amount of funds available in the hospital
excess liability pool, created pursuant to section 18 of chapter 266 of
the laws of 1986, and whether such funds are sufficient for purposes of
purchasing excess insurance coverage for eligible participating physi-
cians and dentists during the period July 1, 2001 to June 30, 2002, or
July 1, 2002 to June 30, 2003, or July 1, 2003 to June 30, 2004, or July
1, 2004 to June 30, 2005, or July 1, 2005 to June 30, 2006, or July 1,
2006 to June 30, 2007, or July 1, 2007 to June 30, 2008, or July 1, 2008
to June 30, 2009, or July 1, 2009 to June 30, 2010, or July 1, 2010 to
June 30, 2011, or July 1, 2011 to June 30, 2012, or July 1, 2012 to June
30, 2013, or July 1, 2013 to June 30, 2014, or July 1, 2014 to June 30,
2015, or July 1, 2015 to June 30, 2016, or July 1, 2016 to June 30,
2017, or July 1, 2017 to June 30, 2018, or July 1, 2018 to June 30,
2019, or July 1, 2019 to June 30, 2020, or July 1, 2020 to June 30,
2021, or July 1, 2021 to June 30, 2022, OR JULY 1, 2022 TO JUNE 30, 2023
as applicable.
(a) This section shall be effective only upon a determination, pursu-
ant to section five of this act, by the superintendent of financial
services and the commissioner of health, and a certification of such
determination to the state director of the budget, the chair of the
senate committee on finance and the chair of the assembly committee on
ways and means, that the amount of funds in the hospital excess liabil-
S. 8007 114 A. 9007
ity pool, created pursuant to section 18 of chapter 266 of the laws of
1986, is insufficient for purposes of purchasing excess insurance cover-
age for eligible participating physicians and dentists during the period
July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July
1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1,
2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007
to June 30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to
June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June
30, 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30,
2014, or July 1, 2014 to June 30, 2015, or July 1, 2015 to June 30,
2016, or July 1, 2016 to June 30, 2017, or July 1, 2017 to June 30,
2018, or July 1, 2018 to June 30, 2019, or July 1, 2019 to June 30,
2020, or July 1, 2020 to June 30, 2021, or July 1, 2021 to June 30,
2022, OR JULY 1, 2022 TO JUNE 30, 2023 as applicable.
(e) The commissioner of health shall transfer for deposit to the
hospital excess liability pool created pursuant to section 18 of chapter
266 of the laws of 1986 such amounts as directed by the superintendent
of financial services for the purchase of excess liability insurance
coverage for eligible participating physicians and dentists for the
policy year July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30,
2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30,
2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
2007, as applicable, and the cost of administering the hospital excess
liability pool for such applicable policy year, pursuant to the program
established in chapter 266 of the laws of 1986, as amended, no later
than June 15, 2002, June 15, 2003, June 15, 2004, June 15, 2005, June
15, 2006, June 15, 2007, June 15, 2008, June 15, 2009, June 15, 2010,
June 15, 2011, June 15, 2012, June 15, 2013, June 15, 2014, June 15,
2015, June 15, 2016, June 15, 2017, June 15, 2018, June 15, 2019, June
15, 2020, June 15, 2021, [and] June 15, 2022, AND JUNE 15, 2023 as
applicable.
§ 7. Section 20 of part H of chapter 57 of the laws of 2017, amending
the New York Health Care Reform Act of 1996 and other laws relating to
extending certain provisions thereto, as amended by section 6 of part K
of chapter 57 of the laws of 2021, is amended to read as follows:
§ 20. Notwithstanding any law, rule or regulation to the contrary,
only physicians or dentists who were eligible, and for whom the super-
intendent of financial services and the commissioner of health, or their
designee, purchased, with funds available in the hospital excess liabil-
ity pool, a full or partial policy for excess coverage or equivalent
excess coverage for the coverage period ending the thirtieth of June,
two thousand [twenty-one] TWENTY-TWO, shall be eligible to apply for
such coverage for the coverage period beginning the first of July, two
thousand [twenty-one] TWENTY-TWO; provided, however, if the total number
of physicians or dentists for whom such excess coverage or equivalent
excess coverage was purchased for the policy year ending the thirtieth
of June, two thousand [twenty-one] TWENTY-TWO exceeds the total number
of physicians or dentists certified as eligible for the coverage period
beginning the first of July, two thousand [twenty-one] TWENTY-TWO, then
the general hospitals may certify additional eligible physicians or
dentists in a number equal to such general hospital's proportional share
of the total number of physicians or dentists for whom excess coverage
or equivalent excess coverage was purchased with funds available in the
hospital excess liability pool as of the thirtieth of June, two thousand
[twenty-one] TWENTY-TWO, as applied to the difference between the number
of eligible physicians or dentists for whom a policy for excess coverage
S. 8007 115 A. 9007
or equivalent excess coverage was purchased for the coverage period
ending the thirtieth of June, two thousand [twenty-one] TWENTY-TWO and
the number of such eligible physicians or dentists who have applied for
excess coverage or equivalent excess coverage for the coverage period
beginning the first of July, two thousand [twenty-one] TWENTY-TWO.
§ 8. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022.
PART AA
Section 1. This act enacts into law major components of legislation
relating to the federal no surprises act and administrative simplifi-
cation. Each component is wholly contained within a Subpart identified
as Subparts A through C. The effective date for each particular
provision contained within such Subpart is set forth in the last section
of such Subpart. Any provision in any section contained within a
Subpart, including the effective date of the Subpart, which makes a
reference to a section "of this act", when used in connection with that
particular component, shall be deemed to mean and refer to the corre-
sponding section of the Subpart in which it is found. Section three of
this act sets forth the general effective date of this act.
SUBPART A
Section 1. Section 601 of the financial services law, as added by
section 26 of part H of chapter 60 of the laws of 2014, is amended to
read as follows:
§ 601. Dispute resolution process established. The superintendent
shall establish a dispute resolution process by which a dispute for a
bill for emergency services or a surprise bill may be resolved. The
superintendent shall have the power to grant and revoke certifications
of independent dispute resolution entities to conduct the dispute resol-
ution process. The superintendent shall promulgate regulations estab-
lishing standards for the dispute resolution process, including a proc-
ess for certifying and selecting independent dispute resolution
entities. An independent dispute resolution entity shall use licensed
physicians in active practice in the same or similar specialty as the
physician providing the service that is subject to the dispute resol-
ution process of this article FOR DISPUTES THAT INVOLVE PHYSICIAN
SERVICES. To the extent practicable, the physician shall be licensed in
this state. DISPUTES SHALL BE SUBMITTED TO AN INDEPENDENT DISPUTE
RESOLUTION ENTITY WITHIN THREE YEARS OF THE DATE THE HEALTH CARE PLAN
MADE THE ORIGINAL PAYMENT ON THE CLAIM THAT IS THE SUBJECT OF THE
DISPUTE.
§ 2. Subsection (b) of section 602 of the financial services law is
REPEALED.
§ 3. Subsection (h) of section 603 of the financial services law, as
added by section 26 of part H of chapter 60 of the laws of 2014, is
amended to read as follows:
(h) "Surprise bill" means a bill for health care services, other than
emergency services, [received by] WITH RESPECT TO:
(1) an insured for services rendered by a non-participating [physi-
cian] PROVIDER at a participating hospital or ambulatory surgical
center, where a participating [physician] PROVIDER is unavailable or a
non-participating [physician] PROVIDER renders services without the
insured's knowledge, or unforeseen medical services arise at the time
S. 8007 116 A. 9007
the health care services are rendered; provided, however, that a
surprise bill shall not mean a bill received for health care services
when a participating [physician] PROVIDER is available and the insured
has elected to obtain services from a non-participating [physician]
PROVIDER;
(2) an insured for services rendered by a non-participating provider,
where the services were referred by a participating physician to a non-
participating provider without explicit written consent of the insured
acknowledging that the participating physician is referring the insured
to a non-participating provider and that the referral may result in
costs not covered by the health care plan; or
(3) a patient who is not an insured for services rendered by a physi-
cian at a hospital or ambulatory surgical center, where the patient has
not timely received all of the disclosures required pursuant to section
twenty-four of the public health law.
§ 4. Section 604 of the financial services law, as amended by chapter
377 of the laws of 2019, is amended to read as follows:
§ 604. Criteria for determining a reasonable fee. In determining the
appropriate amount to pay for a health care service, an independent
dispute resolution entity shall consider all relevant factors, includ-
ing:
(a) whether there is a gross disparity between the fee charged by the
[physician or hospital] PROVIDER for services rendered as compared to:
(1) fees paid to the involved [physician or hospital] PROVIDER for the
same services rendered by the [physician or hospital] PROVIDER to other
patients in health care plans in which the [physician or hospital]
PROVIDER is not participating, and
(2) in the case of a dispute involving a health care plan, fees paid
by the health care plan to reimburse similarly qualified [physicians or
hospitals] PROVIDERS for the same services in the same region who are
not participating with the health care plan;
(b) the level of training, education and experience of the [physician]
HEALTH CARE PROFESSIONAL, and in the case of a hospital, the teaching
staff, scope of services and case mix;
(c) the [physician's and hospital's] PROVIDER'S usual charge for
comparable services with regard to patients in health care plans in
which the [physician or hospital] PROVIDER is not participating;
(d) the circumstances and complexity of the particular case, including
time and place of the service;
(e) individual patient characteristics; [and, with regard to physician
services,]
(F) THE MEDIAN OF THE RATE RECOGNIZED BY THE HEALTH CARE PLAN TO REIM-
BURSE SIMILARLY QUALIFIED PROVIDERS FOR THE SAME OR SIMILAR SERVICES IN
THE SAME REGION THAT ARE PARTICIPATING WITH THE HEALTH CARE PLAN; AND
(G) WITH REGARD TO PHYSICIAN SERVICES, the usual and customary cost of
the service.
§ 5. Subsections (a) and (c) of section 605 of the financial services
law, as amended by chapter 377 of the laws of 2019, paragraphs 1 and 2
of subsection (a) as amended by section 1 of part YY of chapter 56 of
the laws of 2020, are amended to read as follows:
(a) Emergency services for an insured. (1) When a health care plan
receives a bill for emergency services from a non-participating [physi-
cian or hospital] PROVIDER, including a bill for inpatient services
which follow an emergency room visit, the health care plan shall pay an
amount that it determines is reasonable for the emergency services,
including inpatient services which follow an emergency room visit,
S. 8007 117 A. 9007
rendered by the non-participating [physician or hospital] PROVIDER, in
accordance with section three thousand two hundred twenty-four-a of the
insurance law, except for the insured's co-payment, coinsurance or
deductible, if any, and shall ensure that the insured shall incur no
greater out-of-pocket costs for the emergency services, including inpa-
tient services which follow an emergency room visit, than the insured
would have incurred with a participating [physician or hospital] PROVID-
ER. [If an insured assigns benefits to a non-participating physician or
hospital in relation to emergency services, including inpatient services
which follow an emergency room visit, provided by such non-participating
physician or hospital, the] THE non-participating [physician or hospi-
tal] PROVIDER may bill the health care plan for the services rendered.
Upon receipt of the bill, the health care plan shall pay the non-parti-
cipating [physician or hospital] PROVIDER the amount prescribed by this
section and any subsequent amount determined to be owed to the [physi-
cian or hospital] PROVIDER in relation to the emergency services
provided, including inpatient services which follow an emergency room
visit.
(2) A non-participating [physician or hospital] PROVIDER or a health
care plan may submit a dispute regarding a fee or payment for emergency
services, including inpatient services which follow an emergency room
visit, for review to an independent dispute resolution entity.
(3) The independent dispute resolution entity shall make a determi-
nation within thirty BUSINESS days of receipt of the dispute for review.
(4) In determining a reasonable fee for the services rendered, an
independent dispute resolution entity shall select either the health
care plan's payment or the non-participating [physician's or hospital's]
PROVIDER'S fee. The independent dispute resolution entity shall deter-
mine which amount to select based upon the conditions and factors set
forth in section six hundred four of this article. If an independent
dispute resolution entity determines, based on the health care plan's
payment and the non-participating [physician's or hospital's] PROVIDER'S
fee, that a settlement between the health care plan and non-participat-
ing [physician or hospital] PROVIDER is reasonably likely, or that both
the health care plan's payment and the non-participating [physician's or
hospital's] PROVIDER'S fee represent unreasonable extremes, then the
independent dispute resolution entity may direct both parties to attempt
a good faith negotiation for settlement. The health care plan and non-
participating [physician or hospital] PROVIDER may be granted up to ten
business days for this negotiation, which shall run concurrently with
the thirty BUSINESS day period for dispute resolution.
(c) The determination of an independent dispute resolution entity
shall be binding on the health care plan, [physician or hospital]
PROVIDER and patient, and shall be admissible in any court proceeding
between the health care plan, [physician or hospital] PROVIDER or
patient, or in any administrative proceeding between this state and the
[physician or hospital] PROVIDER.
§ 6. Subsection (d) of section 605 of the financial services law is
REPEALED and subsection (e) of section 605 of the financial services law
is relettered subsection (d).
§ 7. Section 606 of the financial services law, as amended by section
3 of part YY of chapter 56 of the laws of 2020, is amended to read as
follows:
§ 606. Hold harmless [and assignment of benefits] for insureds FROM
BILLS FOR EMERGENCY SERVICES AND SURPRISE BILLS. (a) [When an insured
assigns benefits for a surprise bill in writing to a non-participating
S. 8007 118 A. 9007
physician that knows the insured is insured under a health care plan,
the] A non-participating [physician] PROVIDER shall not bill [the] AN
insured FOR A SURPRISE BILL except for any applicable copayment, coinsu-
rance or deductible that would be owed if the insured utilized a partic-
ipating [physician] PROVIDER.
(b) [When an insured assigns benefits for emergency services, includ-
ing inpatient services which follow an emergency room visit, to a non-
participating physician or hospital that knows the insured is insured
under a health care plan, the] A non-participating [physician or hospi-
tal] PROVIDER shall not bill [the] AN insured FOR EMERGENCY SERVICES,
INCLUDING INPATIENT SERVICES WHICH FOLLOW AN EMERGENCY ROOM VISIT,
except for any applicable copayment, coinsurance or deductible that
would be owed if the insured utilized a participating [physician or
hospital] PROVIDER.
§ 8. Subsections (a), (b) and (c) of section 607 of the financial
services law, as added by section 26 of part H of chapter 60 of the laws
of 2014, are amended to read as follows:
(a) Surprise bill [received by] INVOLVING an insured [who assigns
benefits]. (1) [If] FOR A SURPRISE BILL INVOLVING an insured [assigns
benefits to a non-participating physician], the health care plan shall
pay the non-participating [physician] PROVIDER in accordance with para-
graphs two and three of this subsection.
(2) The non-participating [physician] PROVIDER may bill the health
care plan for the health care services rendered, and the health care
plan shall pay the non-participating [physician] PROVIDER the billed
amount or attempt to negotiate reimbursement with the non-participating
[physician] PROVIDER.
(3) If the health care plan's attempts to negotiate reimbursement for
health care services provided by a non-participating [physician] PROVID-
ER does not result in a resolution of the payment dispute between the
non-participating [physician] PROVIDER and the health care plan, the
health care plan shall pay the non-participating [physician] PROVIDER an
amount the health care plan determines is reasonable for the health care
services rendered, except for the insured's copayment, coinsurance or
deductible, in accordance with section three thousand two hundred twen-
ty-four-a of the insurance law, AND SHALL ENSURE THAT THE INSURED SHALL
INCUR NO GREATER OUT-OF-POCKET COSTS FOR THE SURPRISE BILL THAN THE
INSURED WOULD HAVE INCURRED WITH A PARTICIPATING PROVIDER.
(4) Either the health care plan or the non-participating [physician]
PROVIDER may submit the dispute regarding the surprise bill for review
to an independent dispute resolution entity, provided however, the
health care plan may not submit the dispute unless it has complied with
the requirements of paragraphs one, two and three of this subsection.
(5) The independent dispute resolution entity shall make a determi-
nation within thirty BUSINESS days of receipt of the dispute for review.
(6) When determining a reasonable fee for the services rendered, the
independent dispute resolution entity shall select either the health
care plan's payment or the non-participating [physician's] PROVIDER'S
fee. An independent dispute resolution entity shall determine which
amount to select based upon the conditions and factors set forth in
section six hundred four of this article. If an independent dispute
resolution entity determines, based on the health care plan's payment
and the non-participating [physician's] PROVIDER'S fee, that a settle-
ment between the health care plan and non-participating [physician]
PROVIDER is reasonably likely, or that both the health care plan's
payment and the non-participating [physician's] PROVIDER'S fee represent
S. 8007 119 A. 9007
unreasonable extremes, then the independent dispute resolution entity
may direct both parties to attempt a good faith negotiation for settle-
ment. The health care plan and non-participating [physician] PROVIDER
may be granted up to ten business days for this negotiation, which shall
run concurrently with the thirty BUSINESS day period for dispute resol-
ution.
(b) Surprise bill received by [an insured who does not assign benefits
or by] a patient who is not an insured.
(1) [An insured who does not assign benefits in accordance with
subsection (a) of this section or a] A patient who is not an insured and
who receives a surprise bill may submit a dispute regarding the surprise
bill for review to an independent dispute resolution entity.
(2) The independent dispute resolution entity shall determine a
reasonable fee for the services rendered based upon the conditions and
factors set forth in section six hundred four of this article.
(3) A patient [or insured who does not assign benefits in accordance
with subsection (a) of this section] shall not be required to pay the
physician's fee to be eligible to submit the dispute for review to the
independent dispute RESOLUTION entity.
(c) The determination of an independent dispute resolution entity
shall be binding on the patient, [physician] PROVIDER and health care
plan, and shall be admissible in any court proceeding between the
patient or insured, [physician] PROVIDER or health care plan, or in any
administrative proceeding between this state and the [physician] PROVID-
ER.
§ 9. Subsection (a) of section 608 of the financial services law, as
amended by chapter 375 of the laws of 2019, is amended to read as
follows:
(a) For disputes involving an insured, when the independent dispute
resolution entity determines the health care plan's payment is reason-
able, payment for the dispute resolution process shall be the responsi-
bility of the non-participating [physician or hospital] PROVIDER. When
the independent dispute resolution entity determines the non-participat-
ing [physician's or hospital's] PROVIDER'S fee is reasonable, payment
for the dispute resolution process shall be the responsibility of the
health care plan. When a good faith negotiation directed by the inde-
pendent dispute resolution entity pursuant to paragraph four of
subsection (a) of section six hundred five of this article, or paragraph
six of subsection (a) of section six hundred seven of this article
results in a settlement between the health care plan and non-participat-
ing [physician or hospital] PROVIDER, the health care plan and the non-
participating [physician or hospital] PROVIDER shall evenly divide and
share the prorated cost for dispute resolution.
§ 10. Subparagraph (A) of paragraph 1 of subsection (b) of section
4910 of the insurance law, as amended by chapter 219 of the laws of
2011, is amended to read as follows:
(A) the insured has had coverage of the health care service, which
would otherwise be a covered benefit under a subscriber contract or
governmental health benefit program, denied on appeal, in whole or in
part, pursuant to title one of this article on the grounds that such
health care service does not meet the health care plan's requirements
for medical necessity, appropriateness, health care setting, level of
care, [or] effectiveness of a covered benefit, OR OTHER GROUND CONSIST-
ENT WITH 42 U.S.C. § 300GG-19 AS DETERMINED BY THE SUPERINTENDENT, and
S. 8007 120 A. 9007
§ 11. Subparagraph (i) of paragraph (a) of subdivision 2 of section
4910 of the public health law, as amended by chapter 219 of the laws of
2011, is amended to read as follows:
(i) the enrollee has had coverage of a health care service, which
would otherwise be a covered benefit under a subscriber contract or
governmental health benefit program, denied on appeal, in whole or in
part, pursuant to title one of this article on the grounds that such
health care service does not meet the health care plan's requirements
for medical necessity, appropriateness, health care setting, level of
care, [or] effectiveness of a covered benefit, OR OTHER GROUND CONSIST-
ENT WITH 42 U.S.C. § 300GG-19 AS DETERMINED BY THE COMMISSIONER IN
CONSULTATION WITH THE SUPERINTENDENT OF FINANCIAL SERVICES, and
§ 12. This act shall take effect immediately.
SUBPART B
Section 1. Paragraph 1 of subsection (c) of section 109 of the insur-
ance law, as amended by section 55 of part A of chapter 62 of the laws
of 2011, is amended to read as follows:
(1) If the superintendent finds after notice and hearing that any
authorized insurer, representative of the insurer, licensed insurance
agent, licensed insurance broker, licensed adjuster, or any other person
or entity licensed, certified, registered, or authorized pursuant to
this chapter, has [wilfully] WILLFULLY violated the provisions of this
chapter or any regulation promulgated thereunder OR WITH RESPECT TO
ACCIDENT AND HEALTH INSURANCE, ANY PROVISION OF FEDERAL LAW OR REGU-
LATION, then the superintendent may order the person or entity to pay to
the people of this state a penalty in a sum not exceeding one thousand
dollars for each offense.
§ 2. Paragraph 17 of subsection (a) of section 3217-a of the insur-
ance law, as amended by section 9 of subpart A of part BB of chapter 57
of the laws of 2019, is amended to read as follows:
(17) where applicable, a listing by specialty, which may be in a sepa-
rate document that is updated annually, of the name, address, [and]
telephone number, AND DIGITAL CONTACT INFORMATION of all participating
providers, including facilities, and: (A) whether the provider is
accepting new patients; (B) in the case of mental health or substance
use disorder services providers, any affiliations with participating
facilities certified or authorized by the office of mental health or the
office of [alcoholism] ADDICTION SERVICES and [substance abuse services]
SUPPORTS, and any restrictions regarding the availability of the indi-
vidual provider's services; and (C) in the case of physicians, board
certification, languages spoken and any affiliations with participating
hospitals. The listing shall also be posted on the insurer's website and
the insurer shall update the website within fifteen days of the addition
or termination of a provider from the insurer's network or a change in a
physician's hospital affiliation;
§ 3. Section 3217-b of the insurance law is amended by adding two new
subsections (m) and (n) to read as follows:
(M) A CONTRACT BETWEEN AN INSURER AND A HEALTH CARE PROVIDER SHALL
INCLUDE A PROVISION THAT REQUIRES THE HEALTH CARE PROVIDER TO HAVE IN
PLACE BUSINESS PROCESSES TO ENSURE THE TIMELY PROVISION OF PROVIDER
DIRECTORY INFORMATION TO THE INSURER. A HEALTH CARE PROVIDER SHALL
SUBMIT SUCH PROVIDER DIRECTORY INFORMATION TO AN INSURER, AT A MINIMUM,
WHEN A PROVIDER BEGINS OR TERMINATES A NETWORK AGREEMENT WITH AN INSUR-
ER, WHEN THERE ARE MATERIAL CHANGES TO THE CONTENT OF THE PROVIDER
S. 8007 121 A. 9007
DIRECTORY INFORMATION OF THE HEALTH CARE PROVIDER, AND AT ANY OTHER
TIME, INCLUDING UPON THE INSURER'S REQUEST, AS THE HEALTH CARE PROVIDER
DETERMINES TO BE APPROPRIATE. FOR PURPOSES OF THIS SUBSECTION, "PROVID-
ER DIRECTORY INFORMATION" SHALL INCLUDE THE NAME, ADDRESS, SPECIALTY,
TELEPHONE NUMBER, AND DIGITAL CONTACT INFORMATION OF SUCH HEALTH CARE
PROVIDER; WHETHER THE PROVIDER IS ACCEPTING NEW PATIENTS; FOR MENTAL
HEALTH AND SUBSTANCE USE DISORDER SERVICES PROVIDERS, ANY AFFILIATIONS
WITH PARTICIPATING FACILITIES CERTIFIED OR AUTHORIZED BY THE OFFICE OF
MENTAL HEALTH OR THE OFFICE OF ADDICTION SERVICES AND SUPPORTS, AND ANY
RESTRICTIONS REGARDING THE AVAILABILITY OF THE INDIVIDUAL PROVIDER'S
SERVICES; AND IN THE CASE OF PHYSICIANS, BOARD CERTIFICATION, LANGUAGES
SPOKEN, AND ANY AFFILIATIONS WITH PARTICIPATING HOSPITALS.
(N) A CONTRACT BETWEEN AN INSURER AND A HEALTH CARE PROVIDER SHALL
INCLUDE A PROVISION THAT STATES THAT THE PROVIDER SHALL REIMBURSE THE
INSURED FOR THE FULL AMOUNT PAID BY THE INSURED IN EXCESS OF THE IN-NET-
WORK COST-SHARING AMOUNT, PLUS INTEREST AT AN INTEREST RATE DETERMINED
BY THE SUPERINTENDENT IN ACCORDANCE WITH 42 U.S.C. § 300GG-139(B), FOR
THE SERVICES INVOLVED WHEN THE INSURED IS PROVIDED WITH INACCURATE
NETWORK STATUS INFORMATION BY THE INSURER IN A PROVIDER DIRECTORY OR IN
RESPONSE TO A REQUEST THAT STATED THAT THE PROVIDER WAS A PARTICIPATING
PROVIDER WHEN THE PROVIDER WAS NOT A PARTICIPATING PROVIDER. NOTHING IN
THIS SUBSECTION SHALL PROHIBIT A HEALTH CARE PROVIDER FROM REQUIRING IN
THE TERMS OF A CONTRACT WITH AN INSURER THAT THE INSURER REMOVE, AT THE
TIME OF TERMINATION OF SUCH CONTRACT, THE PROVIDER FROM THE INSURER'S
PROVIDER DIRECTORY OR THAT THE INSURER BEAR FINANCIAL RESPONSIBILITY FOR
PROVIDING INACCURATE NETWORK STATUS INFORMATION TO AN INSURED.
§ 4. Paragraph 17 of subsection (a) of section 4324 of the insurance
law, as amended by section 34 of subpart A of part BB of chapter 57 of
the laws of 2019, is amended to read as follows:
(17) where applicable, a listing by specialty, which may be in a sepa-
rate document that is updated annually, of the name, address, [and]
telephone number, AND DIGITAL CONTACT INFORMATION of all participating
providers, including facilities, and: (A) whether the provider is
accepting new patients; (B) in the case of mental health or substance
use disorder services providers, any affiliations with participating
facilities certified or authorized by the office of mental health or the
office of [alcoholism] ADDICTION SERVICES and [substance abuse services]
SUPPORTS, and any restrictions regarding the availability of the indi-
vidual provider's services; (C) in the case of physicians, board certif-
ication, languages spoken and any affiliations with participating hospi-
tals. The listing shall also be posted on the corporation's website and
the corporation shall update the website within fifteen days of the
addition or termination of a provider from the corporation's network or
a change in a physician's hospital affiliation;
§ 5. Section 4325 of the insurance law is amended by adding two new
subsections (n) and (o) to read as follows:
(N) A CONTRACT BETWEEN A CORPORATION AND A HEALTH CARE PROVIDER SHALL
INCLUDE A PROVISION THAT REQUIRES THE HEALTH CARE PROVIDER TO HAVE IN
PLACE BUSINESS PROCESSES TO ENSURE THE TIMELY PROVISION OF PROVIDER
DIRECTORY INFORMATION TO THE CORPORATION. A HEALTH CARE PROVIDER SHALL
SUBMIT SUCH PROVIDER DIRECTORY INFORMATION TO A CORPORATION, AT A MINI-
MUM, WHEN A PROVIDER BEGINS OR TERMINATES A NETWORK AGREEMENT WITH A
CORPORATION, WHEN THERE ARE MATERIAL CHANGES TO THE CONTENT OF THE
PROVIDER DIRECTORY INFORMATION OF THE HEALTH CARE PROVIDER, AND AT ANY
OTHER TIME, INCLUDING UPON THE CORPORATION'S REQUEST, AS THE HEALTH CARE
PROVIDER DETERMINES TO BE APPROPRIATE. FOR PURPOSES OF THIS SUBSECTION,
S. 8007 122 A. 9007
"PROVIDER DIRECTORY INFORMATION" SHALL INCLUDE THE NAME, ADDRESS,
SPECIALTY, TELEPHONE NUMBER, AND DIGITAL CONTACT INFORMATION OF SUCH
HEALTH CARE PROVIDER; WHETHER THE PROVIDER IS ACCEPTING NEW PATIENTS;
FOR MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES PROVIDERS, ANY
AFFILIATIONS WITH PARTICIPATING FACILITIES CERTIFIED OR AUTHORIZED BY
THE OFFICE OF MENTAL HEALTH OR THE OFFICE OF ADDICTION SERVICES AND
SUPPORTS, AND ANY RESTRICTIONS REGARDING THE AVAILABILITY OF THE INDI-
VIDUAL PROVIDER'S SERVICES; AND IN THE CASE OF PHYSICIANS, BOARD CERTIF-
ICATION, LANGUAGES SPOKEN, AND ANY AFFILIATIONS WITH PARTICIPATING
HOSPITALS.
(O) A CONTRACT BETWEEN A CORPORATION AND A HEALTH CARE PROVIDER SHALL
INCLUDE A PROVISION THAT STATES THAT THE PROVIDER SHALL REIMBURSE THE
INSURED FOR THE FULL AMOUNT PAID BY THE INSURED IN EXCESS OF THE IN-NET-
WORK COST-SHARING AMOUNT, PLUS INTEREST AT AN INTEREST RATE DETERMINED
BY THE SUPERINTENDENT IN ACCORDANCE WITH 42 U.S.C. § 300GG-139(B), FOR
THE SERVICES INVOLVED WHEN THE INSURED IS PROVIDED WITH INACCURATE
NETWORK STATUS INFORMATION BY THE CORPORATION IN A PROVIDER DIRECTORY OR
IN RESPONSE TO A REQUEST THAT STATED THAT THE PROVIDER WAS A PARTICIPAT-
ING PROVIDER WHEN THE PROVIDER WAS NOT A PARTICIPATING PROVIDER. NOTH-
ING IN THIS SUBSECTION SHALL PROHIBIT A HEALTH CARE PROVIDER FROM
REQUIRING IN THE TERMS OF A CONTRACT WITH A CORPORATION THAT THE CORPO-
RATION REMOVE, AT THE TIME OF TERMINATION OF SUCH CONTRACT, THE PROVIDER
FROM THE CORPORATION'S PROVIDER DIRECTORY OR THAT THE CORPORATION BEAR
FINANCIAL RESPONSIBILITY FOR PROVIDING INACCURATE NETWORK STATUS INFOR-
MATION TO AN INSURED.
§ 6. Section 4406-c of the public health law is amended by adding two
new subdivisions 11 and 12 to read as follows:
11. A CONTRACT BETWEEN A HEALTH CARE PLAN AND A HEALTH CARE PROVIDER
SHALL INCLUDE A PROVISION THAT REQUIRES THE HEALTH CARE PROVIDER TO HAVE
IN PLACE BUSINESS PROCESSES TO ENSURE THE TIMELY PROVISION OF PROVIDER
DIRECTORY INFORMATION TO THE HEALTH CARE PLAN. A HEALTH CARE PROVIDER
SHALL SUBMIT SUCH PROVIDER DIRECTORY INFORMATION TO A HEALTH CARE PLAN,
AT A MINIMUM, WHEN A PROVIDER BEGINS OR TERMINATES A NETWORK AGREEMENT
WITH A HEALTH CARE PLAN, WHEN THERE ARE MATERIAL CHANGES TO THE CONTENT
OF THE PROVIDER DIRECTORY INFORMATION OF SUCH HEALTH CARE PROVIDER, AND
AT ANY OTHER TIME, INCLUDING UPON THE HEALTH CARE PLAN'S REQUEST, AS THE
HEALTH CARE PROVIDER DETERMINES TO BE APPROPRIATE. FOR PURPOSES OF THIS
SUBSECTION, "PROVIDER DIRECTORY INFORMATION" SHALL INCLUDE THE NAME,
ADDRESS, SPECIALTY, TELEPHONE NUMBER, AND DIGITAL CONTACT INFORMATION OF
SUCH HEALTH CARE PROVIDER; WHETHER THE PROVIDER IS ACCEPTING NEW
PATIENTS; FOR MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES PROVID-
ERS, ANY AFFILIATIONS WITH PARTICIPATING FACILITIES CERTIFIED OR AUTHOR-
IZED BY THE OFFICE OF MENTAL HEALTH OR THE OFFICE OF ADDICTION SERVICES
AND SUPPORTS, AND ANY RESTRICTIONS REGARDING THE AVAILABILITY OF THE
INDIVIDUAL PROVIDER'S SERVICES; AND IN THE CASE OF PHYSICIANS, BOARD
CERTIFICATION, LANGUAGES SPOKEN, AND ANY AFFILIATIONS WITH PARTICIPATING
HOSPITALS.
12. A CONTRACT BETWEEN A HEALTH CARE PLAN AND A HEALTH CARE PROVIDER
SHALL INCLUDE A PROVISION THAT STATES THAT THE PROVIDER SHALL REIMBURSE
THE ENROLLEE FOR THE FULL AMOUNT PAID BY THE ENROLLEE IN EXCESS OF THE
IN-NETWORK COST-SHARING AMOUNT, PLUS INTEREST AT AN INTEREST RATE DETER-
MINED BY THE COMMISSIONER IN ACCORDANCE WITH 42 U.S.C. § 300GG-139(B),
FOR THE SERVICES INVOLVED WHEN THE ENROLLEE IS PROVIDED WITH INACCURATE
NETWORK STATUS INFORMATION BY THE HEALTH CARE PLAN IN A PROVIDER DIREC-
TORY OR IN RESPONSE TO A REQUEST THAT STATED THAT THE PROVIDER WAS A
PARTICIPATING PROVIDER WHEN THE PROVIDER WAS NOT A PARTICIPATING PROVID-
S. 8007 123 A. 9007
ER. NOTHING IN THIS SUBDIVISION SHALL PROHIBIT A HEALTH CARE PROVIDER
FROM REQUIRING IN THE TERMS OF A CONTRACT WITH A HEALTH CARE PLAN THAT
THE HEALTH CARE PLAN REMOVE, AT THE TIME OF TERMINATION OF SUCH
CONTRACT, THE PROVIDER FROM THE HEALTH CARE PLAN'S PROVIDER DIRECTORY OR
THAT THE HEALTH CARE PLAN BEAR FINANCIAL RESPONSIBILITY FOR PROVIDING
INACCURATE NETWORK STATUS INFORMATION TO AN ENROLLEE.
§ 7. Paragraph (r) of subdivision 1 of section 4408 of the public
health law, as amended by section 41 of subpart A of part BB of chapter
57 of the laws of 2019, is amended to read as follows:
(r) a listing by specialty, which may be in a separate document that
is updated annually, of the name, address [and], telephone number, AND
DIGITAL CONTACT INFORMATION of all participating providers, including
facilities, and: (i) whether the provider is accepting new patients;
(ii) in the case of mental health or substance use disorder services
providers, any affiliations with participating facilities certified or
authorized by the office of mental health or the office of [alcoholism]
ADDICTION SERVICES and [substance abuse services] SUPPORTS, and any
restrictions regarding the availability of the individual provider's
services; and (iii) in the case of physicians, board certification,
languages spoken and any affiliations with participating hospitals. The
listing shall also be posted on the health maintenance organization's
website and the health maintenance organization shall update the website
within fifteen days of the addition or termination of a provider from
the health maintenance organization's network or a change in a physi-
cian's hospital affiliation;
§ 8. Subdivision 8 of section 24 of the public health law is renum-
bered subdivision 9 and a new subdivision 8 is added to read as follows:
8. A HEALTH CARE PROFESSIONAL, OR A GROUP PRACTICE OF HEALTH CARE
PROFESSIONALS, A DIAGNOSTIC AND TREATMENT CENTER OR A HEALTH CENTER
DEFINED UNDER 42 U.S.C. § 254B ON BEHALF OF HEALTH CARE PROFESSIONALS
RENDERING SERVICES AT THE GROUP PRACTICE, DIAGNOSTIC AND TREATMENT
CENTER OR HEALTH CENTER, AND A HOSPITAL SHALL MAKE PUBLICLY AVAILABLE,
AND IF APPLICABLE, POST ON THEIR PUBLIC WEBSITES, AND PROVIDE TO INDI-
VIDUALS WHO ARE ENROLLEES OF HEALTH CARE PLANS, A ONE-PAGE WRITTEN
NOTICE, IN CLEAR AND UNDERSTANDABLE LANGUAGE, CONTAINING INFORMATION ON
THE REQUIREMENTS AND PROHIBITIONS UNDER 42 U.S.C. §§ 300GG-131 AND
300GG-132 AND ARTICLE SIX OF THE FINANCIAL SERVICES LAW RELATING TO
PROHIBITIONS ON BALANCE BILLING FOR EMERGENCY SERVICES AND SURPRISE
BILLS, AND INFORMATION ON CONTACTING APPROPRIATE STATE AND FEDERAL AGEN-
CIES IF AN INDIVIDUAL BELIEVES A HEALTH CARE PROVIDER HAS VIOLATED ANY
REQUIREMENT DESCRIBED IN 42 U.S.C. §§ 300GG-131 AND 300GG-132 OR ARTICLE
SIX OF THE FINANCIAL SERVICES LAW.
§ 9. Subsection (e) of section 4804 of the insurance law, as added by
chapter 705 of the laws of 1996, is amended to read as follows:
(e) (1) If an insured's health care provider leaves the insurer's
in-network benefits portion of its network of providers for a managed
care product for reasons other than those for which the provider would
not be eligible to receive a hearing pursuant to paragraph one of
subsection (b) of section forty-eight hundred three of this chapter, the
insurer shall PROVIDE WRITTEN NOTICE TO THE INSURED OF THE PROVIDER'S
DISAFFILIATION AND permit the insured to continue an ongoing course of
treatment with the insured's current health care provider during a tran-
sitional period of [(i) up to]: (A) ninety days from THE LATER OF the
date of THE notice to the insured of the provider's disaffiliation from
the insurer's network OR THE EFFECTIVE DATE OF THE PROVIDER'S DISAFFIL-
IATION FROM THE INSURER'S NETWORK; or [(ii)] (B) if the insured [has
S. 8007 124 A. 9007
entered the second trimester of pregnancy] IS PREGNANT at the time of
the provider's disaffiliation, [for a transitional period that includes]
the [provision of] DURATION OF THE PREGNANCY AND post-partum care
directly related to the delivery.
(2) [Notwithstanding the provisions of paragraph one of this
subsection, such care shall be authorized by the insurer during] DURING
the transitional period [only if] the health care provider [agrees (i)
to] SHALL: (A) continue to accept reimbursement from the insurer at the
rates applicable prior to the start of the transitional period, AND
CONTINUE TO ACCEPT THE IN-NETWORK COST-SHARING FROM THE INSURED, IF ANY,
as payment in full; [(ii) to] (B) adhere to the insurer's quality assur-
ance requirements and [to] provide to the insurer necessary medical
information related to such care; and [(iii) to] (C) otherwise adhere to
the insurer's policies and procedures including, but not limited to,
procedures regarding referrals and obtaining pre-authorization and a
treatment plan approved by the insurer.
§ 10. Paragraph (e) of subdivision 6 of section 4403 of the public
health law, as added by chapter 705 of the laws of 1996, is amended to
read as follows:
(e) (1) If an enrollee's health care provider leaves the health main-
tenance organization's network of providers for reasons other than those
for which the provider would not be eligible to receive a hearing pursu-
ant to paragraph a of subdivision two of section forty-four hundred
six-d of this chapter, the health maintenance organization shall PROVIDE
WRITTEN NOTICE TO THE ENROLLEE OF THE PROVIDER'S DISAFFILIATION AND
permit the enrollee to continue an ongoing course of treatment with the
enrollee's current health care provider during a transitional period of:
(i) [up to] ninety days from the LATER OF THE date of THE notice to the
enrollee of the provider's disaffiliation from the organization's
network OR THE EFFECTIVE DATE OF THE PROVIDER'S DISAFFILIATION FROM THE
ORGANIZATION'S NETWORK; or (ii) if the enrollee [has entered the second
trimester of pregnancy] IS PREGNANT at the time of the provider's disaf-
filiation, [for a transitional period that includes] the [provision of]
DURATION OF THE PREGNANCY AND post-partum care directly related to the
delivery.
(2) [Notwithstanding the provisions of subparagraph one of this para-
graph, such care shall be authorized by the health maintenance organiza-
tion during] DURING the transitional period [only if] the health care
provider [agrees] SHALL: (i) [to] continue to accept reimbursement from
the health maintenance organization at the rates applicable prior to the
start of the transitional period, AND CONTINUE TO ACCEPT THE IN-NETWORK
COST-SHARING FROM THE ENROLLEE, IF ANY, as payment in full; (ii) [to]
adhere to the organization's quality assurance requirements and to
provide to the organization necessary medical information related to
such care; and (iii) [to] otherwise adhere to the organization's poli-
cies and procedures, including but not limited to procedures regarding
referrals and obtaining pre-authorization and a treatment plan approved
by the organization.
§ 11. This act shall take effect immediately.
SUBPART C
Section 1. Section 3217-d of the insurance law is amended by adding a
new subsection (e) to read as follows:
(E) AN INSURER THAT ISSUES A COMPREHENSIVE POLICY THAT USES A NETWORK
OF PROVIDERS AND IS NOT A MANAGED CARE HEALTH INSURANCE CONTRACT, AS
S. 8007 125 A. 9007
DEFINED IN SUBSECTION (C) OF SECTION FOUR THOUSAND EIGHT HUNDRED ONE OF
THIS CHAPTER, SHALL ESTABLISH AND MAINTAIN PROCEDURES FOR HEALTH CARE
PROFESSIONAL APPLICATIONS AND TERMINATIONS CONSISTENT WITH THE REQUIRE-
MENTS OF SECTION FOUR THOUSAND EIGHT HUNDRED THREE OF THIS CHAPTER AND
PROCEDURES FOR HEALTH CARE FACILITY APPLICATIONS CONSISTENT WITH SECTION
FOUR THOUSAND EIGHT HUNDRED SIX OF THIS CHAPTER.
§ 2. Section 4306-c of the insurance law is amended by adding a new
subsection (e) to read as follows:
(E) A CORPORATION, INCLUDING A MUNICIPAL COOPERATIVE HEALTH BENEFIT
PLAN CERTIFIED PURSUANT TO ARTICLE FORTY-SEVEN OF THIS CHAPTER AND A
STUDENT HEALTH PLAN ESTABLISHED OR MAINTAINED PURSUANT TO SECTION ONE
THOUSAND ONE HUNDRED TWENTY-FOUR OF THIS CHAPTER AS ADDED BY CHAPTER 246
OF THE LAWS OF 2012, THAT ISSUES A COMPREHENSIVE POLICY THAT USES A
NETWORK OF PROVIDERS AND IS NOT A MANAGED CARE HEALTH INSURANCE
CONTRACT, AS DEFINED IN SUBSECTION (C) OF SECTION FOUR THOUSAND EIGHT
HUNDRED ONE OF THIS CHAPTER, SHALL ESTABLISH AND MAINTAIN PROCEDURES FOR
HEALTH CARE PROFESSIONAL APPLICATIONS AND TERMINATIONS CONSISTENT WITH
THE REQUIREMENTS OF SECTION FOUR THOUSAND EIGHT HUNDRED THREE OF THIS
CHAPTER AND PROCEDURES FOR HEALTH CARE FACILITY APPLICATIONS CONSISTENT
WITH SECTION FOUR THOUSAND EIGHT HUNDRED SIX OF THIS CHAPTER.
§ 3. The insurance law is amended by adding a new section 4806 to read
as follows:
§ 4806. HEALTH CARE FACILITY APPLICATIONS. (A) AN INSURER THAT OFFERS
A MANAGED CARE PRODUCT SHALL, UPON REQUEST, MAKE AVAILABLE AND DISCLOSE
TO FACILITIES WRITTEN APPLICATION PROCEDURES AND MINIMUM QUALIFICATION
REQUIREMENTS THAT A FACILITY MUST MEET IN ORDER TO BE CONSIDERED BY THE
INSURER FOR PARTICIPATION IN THE IN-NETWORK BENEFITS PORTION OF THE
INSURER'S NETWORK FOR THE MANAGED CARE PRODUCT. THE INSURER SHALL
CONSULT WITH APPROPRIATELY QUALIFIED FACILITIES IN DEVELOPING ITS QUALI-
FICATION REQUIREMENTS FOR PARTICIPATION IN THE IN-NETWORK BENEFITS
PORTION OF THE INSURER'S NETWORK FOR THE MANAGED CARE PRODUCT. AN
INSURER SHALL COMPLETE REVIEW OF THE FACILITY'S APPLICATION TO PARTIC-
IPATE IN THE IN-NETWORK PORTION OF THE INSURER'S NETWORK AND, WITHIN
SIXTY DAYS OF RECEIVING A FACILITY'S COMPLETED APPLICATION TO PARTIC-
IPATE IN THE INSURER'S NETWORK, SHALL NOTIFY THE FACILITY AS TO: (1)
WHETHER THE FACILITY IS CREDENTIALED; OR (2) WHETHER ADDITIONAL TIME IS
NECESSARY TO MAKE A DETERMINATION BECAUSE OF A FAILURE OF A THIRD PARTY
TO PROVIDE NECESSARY DOCUMENTATION. IN SUCH INSTANCES WHERE ADDITIONAL
TIME IS NECESSARY BECAUSE OF A LACK OF NECESSARY DOCUMENTATION, AN
INSURER SHALL MAKE EVERY EFFORT TO OBTAIN SUCH INFORMATION AS SOON AS
POSSIBLE AND SHALL MAKE A FINAL DETERMINATION WITHIN TWENTY-ONE DAYS OF
RECEIVING THE NECESSARY DOCUMENTATION.
(B) FOR THE PURPOSES OF THIS SECTION, "FACILITY" SHALL MEAN A HEALTH
CARE PROVIDER THAT IS LICENSED OR CERTIFIED PURSUANT TO ARTICLE FIVE,
TWENTY-EIGHT, THIRTY-SIX, FORTY, FORTY-FOUR, OR FORTY-SEVEN OF THE
PUBLIC HEALTH LAW OR ARTICLE SIXTEEN, NINETEEN, THIRTY-ONE, THIRTY-TWO,
OR THIRTY-SIX OF THE MENTAL HYGIENE LAW.
§ 4. The public health law is amended by adding a new section 4406-h
to read as follows:
§ 4406-H. HEALTH CARE FACILITY APPLICATIONS. 1. A HEALTH CARE PLAN
SHALL, UPON REQUEST, MAKE AVAILABLE AND DISCLOSE TO FACILITIES WRITTEN
APPLICATION PROCEDURES AND MINIMUM QUALIFICATION REQUIREMENTS THAT A
FACILITY MUST MEET IN ORDER TO BE CONSIDERED BY THE HEALTH CARE PLAN FOR
PARTICIPATION IN THE IN-NETWORK BENEFITS PORTION OF THE HEALTH CARE
PLAN'S NETWORK. THE HEALTH CARE PLAN SHALL CONSULT WITH APPROPRIATELY
QUALIFIED FACILITIES IN DEVELOPING ITS QUALIFICATION REQUIREMENTS. A
S. 8007 126 A. 9007
HEALTH CARE PLAN SHALL COMPLETE REVIEW OF THE FACILITY'S APPLICATION TO
PARTICIPATE IN THE IN-NETWORK PORTION OF THE HEALTH CARE PLAN'S NETWORK
AND SHALL, WITHIN SIXTY DAYS OF RECEIVING A FACILITY'S COMPLETED APPLI-
CATION TO PARTICIPATE IN THE HEALTH CARE PLAN'S NETWORK, NOTIFY THE
FACILITY AS TO: (A) WHETHER THE FACILITY IS CREDENTIALED; OR (B) WHETH-
ER ADDITIONAL TIME IS NECESSARY TO MAKE A DETERMINATION BECAUSE OF A
FAILURE OF A THIRD PARTY TO PROVIDE NECESSARY DOCUMENTATION. IN SUCH
INSTANCES WHERE ADDITIONAL TIME IS NECESSARY BECAUSE OF A LACK OF NECES-
SARY DOCUMENTATION, A HEALTH CARE PLAN SHALL MAKE EVERY EFFORT TO OBTAIN
SUCH INFORMATION AS SOON AS POSSIBLE AND SHALL MAKE A FINAL DETERMI-
NATION WITHIN TWENTY-ONE DAYS OF RECEIVING THE NECESSARY DOCUMENTATION.
2. FOR THE PURPOSES OF THIS SECTION, "FACILITY" SHALL MEAN A HEALTH
CARE PROVIDER ENTITY OR ORGANIZATION THAT IS LICENSED OR CERTIFIED
PURSUANT TO ARTICLE FIVE, TWENTY-EIGHT, THIRTY-SIX, FORTY, FORTY-FOUR,
OR FORTY-SEVEN OF THIS CHAPTER OR ARTICLE SIXTEEN, NINETEEN, THIRTY-ONE,
THIRTY-TWO, OR THIRTY-SIX OF THE MENTAL HYGIENE LAW.
§ 5. Subsection (g) of section 4905 of the insurance law, as added by
chapter 705 of the laws of 1996, is amended to read as follows:
(g) When making prospective, concurrent and retrospective determi-
nations, utilization review agents shall collect only such information
as is necessary to make such determination and shall not routinely
require health care providers to numerically code diagnoses or proce-
dures to be considered for certification or routinely request copies of
medical records of all patients reviewed. During prospective or concur-
rent review, copies of medical records shall only be required when
necessary to verify that the health care services subject to such review
are medically necessary. In such cases, only the necessary or relevant
sections of the medical record shall be required. A utilization review
agent may request copies of partial or complete medical records retros-
pectively. [This subsection shall not apply to health maintenance organ-
izations licensed pursuant to article forty-three of this chapter or
certified pursuant to article forty-four of the public health law.]
§ 6. Subdivision 7 of section 4905 of the public health law, as added
by chapter 705 of the laws of 1996, is amended to read as follows:
7. When making prospective, concurrent and retrospective determi-
nations, utilization review agents shall collect only such information
as is necessary to make such determination and shall not routinely
require health care providers to numerically code diagnoses or proce-
dures to be considered for certification or routinely request copies of
medical records of all patients reviewed. During prospective or concur-
rent review, copies of medical records shall only be required when
necessary to verify that the health care services subject to such review
are medically necessary. In such cases, only the necessary or relevant
sections of the medical record shall be required. A utilization review
agent may request copies of partial or complete medical records retros-
pectively. [This subdivision shall not apply to health maintenance
organizations licensed pursuant to article forty-three of the insurance
law or certified pursuant to article forty-four of this chapter.]
§ 7. This act shall take effect immediately; provided, however, that
sections one through four of this act shall apply to credentialing
applications received on or after the ninetieth day after this act shall
have become a law; and provided further, that sections five and six of
this act shall apply to health care services performed on or after the
ninetieth day after this act shall have become a law.
§ 2. Severability clause. If any clause, sentence, paragraph, subdivi-
sion, section or subpart of this act shall be adjudged by any court of
S. 8007 127 A. 9007
competent jurisdiction to be invalid, such judgment shall not affect,
impair, or invalidate the remainder thereof, but shall be confined in
its operation to the clause, sentence, paragraph, subdivision, section
or subpart thereof directly involved in the controversy in which such
judgment shall have been rendered. It is hereby declared to be the
intent of the legislature that this act would have been enacted even if
such invalid provisions had not been included herein.
§ 3. This act shall take effect immediately, provided, however, that
the applicable effective dates of Subparts A through C of this act shall
be as specifically set forth in the last section of such Subparts.
PART BB
Section 1. Paragraph (b) of subdivision 3 of section 273 of the public
health law, as added by section 10 of part C of chapter 58 of the laws
of 2005, is amended to read as follows:
(b) In the event that the patient does not meet the criteria in para-
graph (a) of this subdivision, the prescriber may provide additional
information to the program to justify the use of a prescription drug
that is not on the preferred drug list. The program shall provide a
reasonable opportunity for a prescriber to reasonably present his or her
justification of prior authorization. [If, after consultation with the
program, the prescriber, in his or her reasonable professional judgment,
determines that] THE PROGRAM WILL CONSIDER THE ADDITIONAL INFORMATION
AND THE JUSTIFICATION PRESENTED TO DETERMINE WHETHER the use of a
prescription drug that is not on the preferred drug list is warranted,
AND the [prescriber's] PROGRAM'S determination shall be final.
§ 2. Subdivisions 25 and 25-a of section 364-j of the social services
law are REPEALED.
§ 3. This act shall take effect June 1, 2022.
PART CC
Section 1. Paragraph (m) of subdivision 3 of section 461-l of the
social services law, as added by section 2 of part B of chapter 57 of
the laws of 2018, is amended to read as follows:
(m) Beginning April first, two thousand [twenty-three] TWENTY-FIVE,
additional assisted living program beds shall be approved on a case by
case basis whenever the commissioner of health is satisfied that public
need exists at the time and place and under circumstances proposed by
the applicant.
(i) The consideration of public need may take into account factors
such as, but not limited to, regional occupancy rates for adult care
facilities and assisted living program occupancy rates and the extent to
which the project will serve individuals receiving medical assistance.
(ii) Existing assisted living program providers may apply for approval
to add up to nine additional assisted living program beds that do not
require major renovation or construction under an expedited review proc-
ess. The expedited review process is available to applicants that are in
good standing with the department of health, and are in compliance with
appropriate state and local requirements as determined by the department
of health. The expedited review process shall allow certification of the
additional beds for which the commissioner of health is satisfied that
public need exists within ninety days of such department's receipt of a
satisfactory application.
S. 8007 128 A. 9007
§ 2. Subdivision (f) of section 129 of part C of chapter 58 of the
laws of 2009, amending the public health law relating to payment by
governmental agencies for general hospital inpatient services, as
amended by section 6 of part E of chapter 57 of the laws of 2019, is
amended to read as follows:
(f) section twenty-five of this act shall expire and be deemed
repealed April 1, [2022] 2025;
§ 3. Subdivision (c) of section 122 of part E of chapter 56 of the
laws of 2013 amending the public health law relating to the general
public health work program, as amended by section 7 of part E of chapter
57 of the laws of 2019, is amended to read as follows:
(c) section fifty of this act shall take effect immediately [and shall
expire nine years after it becomes law];
§ 4. Paragraph (a) of subdivision 1 of section 212 of chapter 474 of
the laws of 1996, amending the education law and other laws relating to
rates for residential healthcare facilities, as amended by section 22 of
part E of chapter 57 of the laws of 2019, is amended to read as follows:
(a) Notwithstanding any inconsistent provision of law or regulation to
the contrary, effective beginning August 1, 1996, for the period April
1, 1997 through March 31, 1998, April 1, 1998 for the period April 1,
1998 through March 31, 1999, August 1, 1999, for the period April 1,
1999 through March 31, 2000, April 1, 2000, for the period April 1, 2000
through March 31, 2001, April 1, 2001, for the period April 1, 2001
through March 31, 2002, April 1, 2002, for the period April 1, 2002
through March 31, 2003, and for the state fiscal year beginning April 1,
2005 through March 31, 2006, and for the state fiscal year beginning
April 1, 2006 through March 31, 2007, and for the state fiscal year
beginning April 1, 2007 through March 31, 2008, and for the state fiscal
year beginning April 1, 2008 through March 31, 2009, and for the state
fiscal year beginning April 1, 2009 through March 31, 2010, and for the
state fiscal year beginning April 1, 2010 through March 31, 2016, and
for the state fiscal year beginning April 1, 2016 through March 31,
2019, and for the state fiscal year beginning April 1, 2019 through
March 31, 2022, AND FOR THE STATE FISCAL YEAR BEGINNING APRIL 1, 2022
THROUGH MARCH 31, 2025, the department of health is authorized to pay
public general hospitals, as defined in subdivision 10 of section 2801
of the public health law, operated by the state of New York or by the
state university of New York or by a county, which shall not include a
city with a population of over one million, of the state of New York,
and those public general hospitals located in the county of Westchester,
the county of Erie or the county of Nassau, additional payments for
inpatient hospital services as medical assistance payments pursuant to
title 11 of article 5 of the social services law for patients eligible
for federal financial participation under title XIX of the federal
social security act in medical assistance pursuant to the federal laws
and regulations governing disproportionate share payments to hospitals
up to one hundred percent of each such public general hospital's medical
assistance and uninsured patient losses after all other medical assist-
ance, including disproportionate share payments to such public general
hospital for 1996, 1997, 1998, and 1999, based initially for 1996 on
reported 1994 reconciled data as further reconciled to actual reported
1996 reconciled data, and for 1997 based initially on reported 1995
reconciled data as further reconciled to actual reported 1997 reconciled
data, for 1998 based initially on reported 1995 reconciled data as
further reconciled to actual reported 1998 reconciled data, for 1999
based initially on reported 1995 reconciled data as further reconciled
S. 8007 129 A. 9007
to actual reported 1999 reconciled data, for 2000 based initially on
reported 1995 reconciled data as further reconciled to actual reported
2000 data, for 2001 based initially on reported 1995 reconciled data as
further reconciled to actual reported 2001 data, for 2002 based initial-
ly on reported 2000 reconciled data as further reconciled to actual
reported 2002 data, and for state fiscal years beginning on April 1,
2005, based initially on reported 2000 reconciled data as further recon-
ciled to actual reported data for 2005, and for state fiscal years
beginning on April 1, 2006, based initially on reported 2000 reconciled
data as further reconciled to actual reported data for 2006, for state
fiscal years beginning on and after April 1, 2007 through March 31,
2009, based initially on reported 2000 reconciled data as further recon-
ciled to actual reported data for 2007 and 2008, respectively, for state
fiscal years beginning on and after April 1, 2009, based initially on
reported 2007 reconciled data, adjusted for authorized Medicaid rate
changes applicable to the state fiscal year, and as further reconciled
to actual reported data for 2009, for state fiscal years beginning on
and after April 1, 2010, based initially on reported reconciled data
from the base year two years prior to the payment year, adjusted for
authorized Medicaid rate changes applicable to the state fiscal year,
and further reconciled to actual reported data from such payment year,
and to actual reported data for each respective succeeding year. The
payments may be added to rates of payment or made as aggregate payments
to an eligible public general hospital.
§ 5. Section 5 of chapter 21 of the laws of 2011, amending the educa-
tion law relating to authorizing pharmacists to perform collaborative
drug therapy management with physicians in certain settings, as amended
by section 20 of part BB of chapter 56 of the laws of 2020, is amended
to read as follows:
§ 5. This act shall take effect on the one hundred twentieth day after
it shall have become a law[, provided, however, that the provisions of
sections two, three, and four of this act shall expire and be deemed
repealed July 1, 2022; provided, however, that the amendments to subdi-
vision 1 of section 6801 of the education law made by section one of
this act shall be subject to the expiration and reversion of such subdi-
vision pursuant to section 8 of chapter 563 of the laws of 2008, when
upon such date the provisions of section one-a of this act shall take
effect; provided, further, that effective]. EFFECTIVE immediately, the
addition, amendment and/or repeal of any rule or regulation necessary
for the implementation of this act on its effective date are authorized
and directed to be made and completed on or before such effective date.
§ 6. Section 2 of part II of chapter 54 of the laws of 2016, amending
part C of chapter 58 of the laws of 2005 relating to authorizing
reimbursements for expenditures made by or on behalf of social services
districts for medical assistance for needy persons and administration
thereof, as amended by section 1 of item C of subpart H of part XXX of
chapter 58 of the laws of 2020, is amended to read as follows:
§ 2. This act shall take effect immediately and shall expire and be
deemed repealed March 31, [2022] 2024.
§ 7. Section 5 of part ZZ of chapter 56 of the laws of 2020 amending
the tax law and the social services law relating to certain Medicaid
management, is amended to read as follows:
§ 5. This act shall take effect immediately [and shall be deemed
repealed two years after such effective date].
S. 8007 130 A. 9007
§ 8. Paragraph (c) of subdivision 6 of section 958 of the executive
law, as added by chapter 337 of the laws of 2018, is amended to read as
follows:
(c) prepare and issue a report on the working group's findings and
recommendations by May first, two thousand [nineteen] TWENTY-THREE to
the governor, the temporary president of the senate and the speaker of
the assembly.
§ 9. Subdivision 2 of section 207-a of the public health law, as added
by chapter 364 of the laws of 2018, is amended to read as follows:
2. Such report shall be submitted to the temporary president of the
senate and the speaker of the assembly no later than October first, two
thousand [nineteen] TWENTY-TWO. The department and the commissioner of
mental health may engage stakeholders in the compilation of the report,
including but not limited to, medical research institutions, health care
practitioners, mental health providers, county and local government, and
advocates.
§ 10. Sections 2 and 3 of chapter 74 of the laws of 2020 relating to
directing the department of health to convene a work group on rare
diseases, as amended by chapter 199 of the laws of 2021, are amended to
read as follows:
§ 2. The department of health, in collaboration with the department of
financial services, shall convene a workgroup of individuals with exper-
tise in rare diseases, including physicians, nurses and other health
care professionals with experience researching, diagnosing or treating
rare diseases; members of the scientific community engaged in rare
disease research; representatives from the health insurance industry;
individuals who have a rare disease or caregivers of a person with a
rare disease; and representatives of rare disease patient organizations.
The workgroup's focus shall include, but not be limited to: identifying
best practices that could improve the awareness of rare diseases and
referral of people with potential rare diseases to specialists and eval-
uating barriers to treatment, including financial barriers on access to
care. The department of health shall prepare a written report summariz-
ing opinions and recommendations from the workgroup which includes a
list of existing, publicly accessible resources on research, diagnosis,
treatment, coverage options and education relating to rare diseases. The
workgroup shall convene no later than December twentieth, two thousand
twenty-one and this report shall be submitted to the governor, speaker
of the assembly and temporary president of the senate no later than
[three] FOUR years following the effective date of this act and shall be
posted on the department of health's website.
§ 3. This act shall take effect on the same date and in the same
manner as a chapter of the laws of 2019, amending the public health law
relating to establishing the rare disease advisory council, as proposed
in legislative bills numbers S. 4497 and A. 5762; provided, however,
that the provisions of section two of this act shall expire and be
deemed repealed [three] FOUR years after such effective date.
§ 11. Sections 5 and 6 of chapter 414 of the laws of 2018, creating
the radon task force, as amended by section 1 of item M of subpart B of
part XXX of chapter 58 of the laws of 2020, are amended to read as
follows:
§ 5. A report of the findings and recommendations of the task force
and any proposed legislation necessary to implement such findings shall
be filed with the governor, the temporary president of the senate, the
speaker of the assembly, the minority leader of the senate, and the
S. 8007 131 A. 9007
minority leader of the assembly on or before November first, two thou-
sand [twenty-one] TWENTY-TWO.
§ 6. This act shall take effect immediately and shall expire and be
deemed repealed December 31, [2021] 2022.
§ 12. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022; provided,
however, that the amendments to section 2 of chapter 74 of the laws of
2020 made by section ten of this section and the amendments to section 5
of chapter 414 of the laws of 2018 made by section eleven of this act,
shall not affect the expiration of such section and be deemed to expire
therewith.
PART DD
Section 1. 1. Subject to available appropriations and approval of the
director of the budget, the commissioners of the office of mental
health, office for people with developmental disabilities, office of
addiction services and supports, office of temporary and disability
assistance, office of children and family services, and the state office
for the aging shall establish a state fiscal year 2022-23 cost of living
adjustment (COLA), effective April 1, 2022, for projecting for the
effects of inflation upon rates of payments, contracts, or any other
form of reimbursement for the programs and services listed in paragraphs
(i), (ii), (iii), (iv), (v), and (vi) of subdivision four of this
section. The COLA established herein shall be applied to the appropri-
ate portion of reimbursable costs or contract amounts. Where appropri-
ate, transfers to the department of health (DOH) shall be made as
reimbursement for the state share of medical assistance.
2. Notwithstanding any inconsistent provision of law, subject to the
approval of the director of the budget and available appropriations
therefore, for the period of April 1, 2022 through March 31, 2023, the
commissioners shall provide funding to support a five and four-tenths
percent (5.4%) cost of living adjustment under this section for all
eligible programs and services as determined pursuant to subdivision
four of this section.
3. Notwithstanding any inconsistent provision of law, and as approved
by the director of the budget, the 5.4 percent cost of living adjustment
(COLA) established herein shall be inclusive of all other cost of living
type increases, inflation factors, or trend factors that are newly
applied effective April 1, 2022. Except for the 5.4 percent cost of
living adjustment (COLA) established herein, for the period commencing
on April 1, 2022 and ending March 31, 2023 the commissioners shall not
apply any other new cost of living adjustments for the purpose of estab-
lishing rates of payments, contracts or any other form of reimbursement.
The phrase "all other cost of living type increases, inflation factors,
or trend factors" as defined in this subdivision shall not include
payments made pursuant to the American Rescue Plan Act or other federal
relief programs related to the Coronavirus Disease 2019 (COVID-19)
pandemic Public Health Emergency.
4. Eligible programs and services. (i) Programs and services funded,
licensed, or certified by the office of mental health (OMH) eligible for
the cost of living adjustment established herein, pending federal
approval where applicable, include: office of mental health licensed
outpatient programs, pursuant to parts 587 and 599 of title 14 CRR-NY of
the office of mental health regulations including clinic, continuing day
treatment, day treatment, intensive outpatient programs and partial
S. 8007 132 A. 9007
hospitalization; outreach; crisis residence; crisis stabilization,
crisis/respite beds; mobile crisis, part 590 comprehensive psychiatric
emergency program services; crisis intervention; home based crisis
intervention; family care; supported single room occupancy; supported
housing; supported housing community services; treatment congregate;
supported congregate; community residence - children and youth;
treatment/apartment; supported apartment; community residence single
room occupancy; on-site rehabilitation; employment programs; recreation;
respite care; transportation; psychosocial club; assertive community
treatment; case management; care coordination, including health home
plus services; local government unit administration; monitoring and
evaluation; children and youth vocational services; single point of
access; school-based mental health program; family support children and
youth; advocacy/support services; drop in centers; recovery centers;
transition management services; bridger; home and community based waiver
services; behavioral health waiver services authorized pursuant to the
section 1115 MRT waiver; self-help programs; consumer service dollars;
conference of local mental hygiene directors; multicultural initiative;
ongoing integrated supported employment services; supported education;
mentally ill/chemical abuse (MICA) network; personalized recovery
oriented services; children and family treatment and support services;
residential treatment facilities operating pursuant to part 584 of title
14-NYCRR; geriatric demonstration programs; community-based mental
health family treatment and support; coordinated children's service
initiative; homeless services; and promises zone.
(ii) Programs and services funded, licensed, or certified by the
office for people with developmental disabilities (OPWDD) eligible for
the cost of living adjustment established herein, pending federal
approval where applicable, include: local/unified services; chapter 620
services; voluntary operated community residential services; article 16
clinics; day treatment services; family support services; 100% day
training; epilepsy services; traumatic brain injury services; hepatitis
B services; independent practitioner services for individuals with
intellectual and/or developmental disabilities; crisis services for
individuals with intellectual and/or developmental disabilities; family
care residential habilitation; supervised residential habilitation;
supportive residential habilitation; respite; day habilitation; prevoca-
tional services; supported employment; community habilitation; interme-
diate care facility day and residential services; specialty hospital;
pathways to employment; intensive behavioral services; basic home and
community based services (HCBS) plan support; health home services
provided by care coordination organizations; community transition
services; family education and training; fiscal intermediary; support
broker; and personal resource accounts.
(iii) Programs and services funded, licensed, or certified by the
office of addiction services and supports (OASAS) eligible for the cost
of living adjustment established herein, pending federal approval where
applicable, include: medically supervised withdrawal services - residen-
tial; medically supervised withdrawal services - outpatient; medically
managed detoxification; medically monitored withdrawal; inpatient reha-
bilitation services; outpatient opioid treatment; residential opioid
treatment; KEEP units outpatient; residential opioid treatment to absti-
nence; problem gambling treatment; medically supervised outpatient;
outpatient rehabilitation; specialized services substance abuse
programs; home and community based waiver services pursuant to subdivi-
sion 9 of section 366 of the social services law; children and family
S. 8007 133 A. 9007
treatment and support services; continuum of care rental assistance case
management; NY/NY III post-treatment housing; NY/NY III housing for
persons at risk for homelessness; permanent supported housing; youth
clubhouse; recovery community centers; recovery community organizing
initiative; residential rehabilitation services for youth (RRSY); inten-
sive residential; community residential; supportive living; residential
services; job placement initiative; case management; family support
navigator; local government unit administration; peer engagement; voca-
tional rehabilitation; support services; HIV early intervention
services; dual diagnosis coordinator; problem gambling resource centers;
problem gambling prevention; prevention resource centers; primary
prevention services; other prevention services; and community services.
(iv) Programs and services funded, licensed, or certified by the
office of temporary and disability assistance (OTDA) eligible for the
cost of living adjustment established herein, pending federal approval
where applicable, include: nutrition outreach and education program
(NOEP).
(v) Programs and services funded, licensed, or certified by the office
of children and family services (OCFS) eligible for the cost of living
adjustment established herein, pending federal approval where applica-
ble, include: programs for which the office of children and family
services establishes maximum state aid rates pursuant to section 398-a
of the social services law and section 4003 of the education law; emer-
gency foster homes; foster family boarding homes and therapeutic foster
homes as defined by the regulations of the office of children and family
services; supervised settings as defined by subdivision twenty-two of
section 371 of the social services law; adoptive parents receiving
adoption subsidy pursuant to section 453 of the social services law; and
congregate and scattered supportive housing programs and supportive
services provided under the NY/NY III supportive housing agreement to
young adults leaving or having recently left foster care.
(vi) Programs and services funded, licensed, or certified by the state
office for the aging (SOFA) eligible for the cost of living adjustment
established herein, pending federal approval where applicable, include:
community services for the elderly; expanded in-home services for the
elderly; and supplemental nutrition assistance program.
5. Each local government unit or direct contract provider receiving
funding for the cost of living adjustment established herein shall
submit a written certification, in such form and at such time as each
commissioner shall prescribe, attesting how such funding will be or was
used to first promote the recruitment and retention of non-executive
direct care staff, non-executive direct support professionals, non-exe-
cutive clinical staff, or respond to other critical non-personal service
costs prior to supporting any salary increases or other compensation for
executive level job titles.
6. Notwithstanding any inconsistent provision of law to the contrary,
agency commissioners shall be authorized to recoup funding from a local
governmental unit or direct contract provider for the cost of living
adjustment established herein determined to have been used in a manner
inconsistent with the appropriation, or any other provision of this
section. Such agency commissioners shall be authorized to employ any
legal mechanism to recoup such funds, including an offset of other funds
that are owed to such local governmental unit or direct contract provid-
er.
§ 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022.
S. 8007 134 A. 9007
PART EE
Section 1. Short title. This act shall be known and may be cited as
the "9-8-8 suicide prevention and behavioral health crisis hotline act".
§ 2. The mental hygiene law is amended by adding a new section 36.03
to read as follows:
§ 36.03 9-8-8 SUICIDE PREVENTION AND BEHAVIORAL HEALTH CRISIS HOTLINE
SYSTEM.
(A) DEFINITIONS. WHEN USED IN THIS ARTICLE, THE FOLLOWING WORDS AND
PHRASES SHALL HAVE THE FOLLOWING MEANINGS UNLESS THE SPECIFIC CONTEXT
CLEARLY INDICATES OTHERWISE:
(1) "9-8-8" MEANS THE THREE DIGIT PHONE NUMBER DESIGNATED BY THE
FEDERAL COMMUNICATIONS COMMISSION FOR THE PURPOSE OF CONNECTING INDIVID-
UALS EXPERIENCING A BEHAVIORAL HEALTH CRISIS WITH SUICIDE PREVENTION AND
BEHAVIORAL HEALTH CRISIS COUNSELORS, MOBILE CRISIS TEAMS, AND CRISIS
STABILIZATION SERVICES AND OTHER BEHAVIORAL HEALTH CRISES SERVICES
THROUGH THE NATIONAL SUICIDE PREVENTION LIFELINE.
(2) "9-8-8 CRISIS HOTLINE CENTER" MEANS A STATE-IDENTIFIED AND FUNDED
CENTER PARTICIPATING IN THE NATIONAL SUICIDE PREVENTION LIFELINE NETWORK
TO RESPOND TO STATEWIDE OR REGIONAL 9-8-8 CALLS.
(3) "CRISIS STABILIZATION CENTERS" MEANS FACILITIES PROVIDING SHORT-
TERM OBSERVATION AND CRISIS STABILIZATION SERVICES JOINTLY LICENSED BY
THE OFFICE OF MENTAL HEALTH AND THE OFFICE OF ADDICTION SERVICES AND
SUPPORTS UNDER SECTION 36.01 OF THIS ARTICLE.
(4) "CRISIS RESIDENTIAL SERVICES" MEANS A SHORT-TERM RESIDENTIAL
PROGRAM DESIGNED TO PROVIDE RESIDENTIAL AND SUPPORT SERVICES TO PERSONS
WITH SYMPTOMS OF MENTAL ILLNESS WHO ARE AT RISK OF OR EXPERIENCING A
PSYCHIATRIC CRISIS.
(5) "CRISIS INTERVENTION SERVICES" MEANS THE CONTINUUM TO ADDRESS
CRISIS INTERVENTION, CRISIS STABILIZATION, AND CRISIS RESIDENTIAL TREAT-
MENT NEEDS THAT ARE WELLNESS, RESILIENCY, AND RECOVERY ORIENTED. CRISIS
INTERVENTION SERVICES INCLUDE BUT NOT LIMITED TO: CRISIS STABILIZATION
CENTERS, MOBILE CRISIS TEAMS, AND CRISIS RESIDENTIAL SERVICES.
(6) "MOBILE CRISIS TEAMS" MEANS A TEAM LICENSED, CERTIFIED, OR AUTHOR-
IZED BY THE OFFICE OF MENTAL HEALTH AND THE OFFICE OF ADDICTION SERVICES
AND SUPPORTS TO PROVIDE COMMUNITY-BASED MENTAL HEALTH OR SUBSTANCE USE
DISORDER INTERVENTIONS FOR INDIVIDUALS WHO ARE EXPERIENCING A MENTAL
HEALTH OR SUBSTANCE USE DISORDER CRISIS.
(7) "NATIONAL SUICIDE PREVENTION LIFELINE" OR "NSPL" MEANS THE
NATIONAL NETWORK OF LOCAL CRISIS CENTERS THAT PROVIDE FREE AND CONFIDEN-
TIAL EMOTIONAL SUPPORT TO PEOPLE IN SUICIDAL CRISIS OR EMOTIONAL
DISTRESS TWENTY-FOUR HOURS A DAY, SEVEN DAYS A WEEK VIA A TOLL-FREE
HOTLINE NUMBER, WHICH RECEIVES CALLS MADE THROUGH THE 9-8-8 SYSTEM. THE
TOLL-FREE NUMBER IS MAINTAINED BY THE ASSISTANT SECRETARY FOR MENTAL
HEALTH AND SUBSTANCE USE UNDER SECTION 50-E-3 OF THE PUBLIC HEALTH
SERVICE ACT, SECTION 290BB-36C OF TITLE 42 OF THE UNITED STATES CODE.
(B) THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH, IN CONJUNCTION
WITH THE COMMISSIONER OF THE OFFICE OF ADDICTION SERVICES AND SUPPORTS,
SHALL HAVE JOINT OVERSIGHT OF THE 9-8-8 SUICIDE PREVENTION AND BEHAV-
IORAL HEALTH CRISIS HOTLINE AND SHALL WORK IN CONCERT WITH NSPL FOR THE
PURPOSES OF ENSURING CONSISTENCY OF PUBLIC MESSAGING.
(C) THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH, IN CONJUNCTION
WITH THE COMMISSIONER OF THE OFFICE OF ADDICTION SERVICES AND SUPPORTS,
SHALL, ON OR BEFORE JULY SIXTEENTH, TWO THOUSAND TWENTY-TWO, DESIGNATE A
CRISIS HOTLINE CENTER OR CENTERS TO PROVIDE OR ARRANGE FOR CRISIS INTER-
VENTION SERVICES TO INDIVIDUALS ACCESSING THE 9-8-8 SUICIDE PREVENTION
S. 8007 135 A. 9007
AND BEHAVIORAL HEALTH CRISIS HOTLINE FROM ANYWHERE WITHIN THE STATE
TWENTY-FOUR HOURS A DAY, SEVEN DAYS A WEEK. EACH 9-8-8 CRISIS HOTLINE
CENTER SHALL DO ALL OF THE FOLLOWING:
(1) A DESIGNATED HOTLINE CENTER SHALL HAVE AN ACTIVE AGREEMENT WITH
THE ADMINISTRATOR OF THE NATIONAL SUICIDE PREVENTION LIFELINE FOR
PARTICIPATION WITHIN THE NETWORK.
(2) A DESIGNATED HOTLINE CENTER SHALL MEET NSPL REQUIREMENTS AND BEST
PRACTICES GUIDELINES FOR OPERATION AND CLINICAL STANDARDS.
(3) A DESIGNATED HOTLINE CENTER MAY UTILIZE TECHNOLOGY, INCLUDING BUT
NOT LIMITED TO, CHAT AND TEXT THAT IS INTEROPERABLE BETWEEN AND ACROSS
THE 9-8-8 SUICIDE PREVENTION AND BEHAVIORAL HEALTH CRISIS HOTLINE SYSTEM
AND THE ADMINISTRATOR OF THE NATIONAL SUICIDE PREVENTION LIFELINE.
(4) A DESIGNATED HOTLINE CENTER SHALL ACCEPT TRANSFERS OF ANY CALL
FROM 9-1-1 PERTAINING TO A BEHAVIORAL HEALTH CRISIS.
(5) A DESIGNATED HOTLINE CENTER SHALL ENSURE COORDINATION BETWEEN THE
9-8-8 CRISIS HOTLINE CENTERS, 9-1-1, BEHAVIORAL HEALTH CRISIS SERVICES,
AND, WHEN APPROPRIATE, OTHER SPECIALTY BEHAVIORAL HEALTH WARM LINES AND
HOTLINES AND OTHER EMERGENCY SERVICES. IF A LAW ENFORCEMENT, MEDICAL,
OR FIRE RESPONSE IS ALSO NEEDED, 9-8-8 AND 9-1-1 OPERATORS SHALL COORDI-
NATE THE SIMULTANEOUS DEPLOYMENT OF THOSE SERVICES WITH MOBILE CRISIS
SERVICES.
(6) A DESIGNATED HOTLINE CENTER SHALL HAVE THE AUTHORITY TO DEPLOY
CRISIS INTERVENTION SERVICES, INCLUDING BUT NOT LIMITED TO MOBILE CRISIS
TEAMS, AND COORDINATE ACCESS TO CRISIS STABILIZATION CENTERS, AND OTHER
MENTAL HEALTH CRISIS SERVICES, AS APPROPRIATE, AND ACCORDING TO GUIDE-
LINES AND BEST PRACTICES ESTABLISHED BY NEW YORK STATE AND THE NSPL.
(7) A DESIGNATED HOTLINE CENTER SHALL MEET THE REQUIREMENTS SET FORTH
BY NEW YORK STATE AND THE NSPL FOR SERVING HIGH RISK AND SPECIALIZED
POPULATIONS INCLUDING BUT NOT LIMITED TO: BLACK, AFRICAN AMERICAN,
HISPANIC, LATINO, ASIAN, PACIFIC ISLANDER, NATIVE AMERICAN, ALASKAN
NATIVE; LESBIAN, GAY, BISEXUAL, TRANSGENDER, NONBINARY, QUEER, AND QUES-
TIONING INDIVIDUALS; INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL
DISABILITIES; INDIVIDUALS EXPERIENCING HOMELESSNESS OR HOUSING INSTABIL-
ITY; IMMIGRANTS AND REFUGEES; CHILDREN AND YOUTH; OLDER ADULTS; AND
RELIGIOUS COMMUNITIES AS IDENTIFIED BY THE FEDERAL SUBSTANCE ABUSE AND
MENTAL HEALTH SERVICES ADMINISTRATION, INCLUDING TRAINING REQUIREMENTS
AND POLICIES FOR PROVIDING LINGUISTICALLY AND CULTURALLY COMPETENT CARE.
(8) A DESIGNATED HOTLINE CENTER SHALL PROVIDE FOLLOW-UP SERVICES AS
NEEDED TO INDIVIDUALS ACCESSING THE 9-8-8 SUICIDE PREVENTION AND BEHAV-
IORAL HEALTH CRISIS HOTLINE CONSISTENT WITH GUIDANCE AND POLICIES ESTAB-
LISHED BY NEW YORK STATE AND THE NSPL.
(9) A DESIGNATED HOTLINE CENTER SHALL PROVIDE DATA, AND REPORTS, AND
PARTICIPATE IN EVALUATIONS AND QUALITY IMPROVEMENT ACTIVITIES AS
REQUIRED BY THE OFFICE OF MENTAL HEALTH AND THE OFFICE OF ADDICTION
SERVICES AND SUPPORTS.
(D) THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH, IN CONJUNCTION
WITH THE COMMISSIONER OF THE OFFICE OF ADDICTION SERVICES AND SUPPORTS,
SHALL ESTABLISH A COMPREHENSIVE LIST OF REPORTING METRICS REGARDING THE
9-8-8 SUICIDE PREVENTION AND BEHAVIORAL HEALTH CRISIS HOTLINE'S USAGE,
SERVICES AND IMPACT WHICH SHALL INCLUDE, AT A MINIMUM:
(1) THE VOLUME OF REQUESTS FOR ASSISTANCE THAT THE 9-8-8 SUICIDE
PREVENTION AND BEHAVIORAL HEALTH CRISIS HOTLINE RECEIVED;
(2) THE AVERAGE LENGTH OF TIME TAKEN TO RESPOND TO EACH REQUEST FOR
ASSISTANCE, AND THE AGGREGATE RATES OF CALL ABANDONMENT;
(3) THE TYPES OF REQUESTS FOR ASSISTANCE THAT THE 9-8-8 SUICIDE
PREVENTION AND BEHAVIORAL HEALTH CRISIS HOTLINE RECEIVED; AND
S. 8007 136 A. 9007
(4) THE NUMBER OF MOBILE CRISIS TEAMS DISPATCHED.
(E) THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH, IN CONJUNCTION
WITH THE COMMISSIONER OF THE OFFICE OF ADDICTION SERVICES AND SUPPORTS,
SHALL SUBMIT AN ANNUAL REPORT ON OR BY DECEMBER THIRTY-FIRST, TWO THOU-
SAND TWENTY-THREE AND ANNUALLY THEREAFTER, REGARDING THE COMPREHENSIVE
LIST OF REPORTING METRICS TO THE GOVERNOR, THE TEMPORARY PRESIDENT OF
THE SENATE, THE SPEAKER OF THE ASSEMBLY, THE MINORITY LEADER OF THE
SENATE AND THE MINORITY LEADER OF THE ASSEMBLY.
(F) MONEYS ALLOCATED FOR THE PAYMENT OF COSTS DETERMINED IN CONSULTA-
TION WITH THE COMMISSIONERS OF MENTAL HEALTH AND THE OFFICE OF ADDICTION
SERVICES AND SUPPORTS ASSOCIATED WITH THE ADMINISTRATION, DESIGN,
INSTALLATION, CONSTRUCTION, OPERATION, OR MAINTENANCE OF A 9-8-8 SUICIDE
PREVENTION AND BEHAVIORAL HEALTH CRISIS HOTLINE SYSTEM SERVING THE
STATE, INCLUDING, BUT NOT LIMITED TO: STAFFING, HARDWARE, SOFTWARE,
CONSULTANTS, FINANCING AND OTHER ADMINISTRATIVE COSTS TO OPERATE CRISIS
CALL-CENTERS THROUGHOUT THE STATE AND THE PROVISION OF ACUTE AND CRISIS
SERVICES FOR MENTAL HEALTH AND SUBSTANCE USE DISORDER BY DIRECTLY
RESPONDING TO THE 9-8-8 HOTLINE ESTABLISHED PURSUANT TO THE NATIONAL
SUICIDE HOTLINE DESIGNATION ACT OF 2020 (47 U.S.C. § 251A) AND RULES
ADOPTED BY THE FEDERAL COMMUNICATIONS COMMISSION, INCLUDING SUCH COSTS
INCURRED BY THE STATE, SHALL NOT SUPPLANT ANY SEPARATE EXISTING, FUTURE
APPROPRIATIONS, OR FUTURE FUNDING SOURCES DEDICATED TO THE 9-8-8 CRISIS
RESPONSE SYSTEM.
§ 3. This act shall take effect immediately.
PART FF
Section 1. Subdivision 5 of section 365-m of the social services law,
as added by section 11 of part C of chapter 60 of the laws of 2014, is
amended to read as follows:
5. Pursuant to appropriations WITHIN THE OFFICES OF MENTAL HEALTH OR
ADDICTION SERVICES AND SUPPORTS, the department of health shall reinvest
[funds allocated for behavioral health services, which are general fund
savings directly related to] savings realized through the transition of
populations covered by this section from the applicable Medicaid fee-
for-service system to a managed care model, including savings [resulting
from the reduction of inpatient and outpatient behavioral health
services provided under the Medicaid programs licensed or certified
pursuant to article thirty-one or thirty-two of the mental hygiene law,
or programs that are licensed pursuant to both article thirty-one of the
mental hygiene law and article twenty-eight of the public health law, or
certified under both article thirty-two of the mental hygiene law and
article twenty-eight of the public health law] REALIZED THROUGH THE
RECOVERY OF PREMIUMS FROM MANAGED CARE PROVIDERS WHICH REPRESENT A
REDUCTION OF SPENDING ON QUALIFYING BEHAVIORAL HEALTH SERVICES AGAINST
ESTABLISHED PREMIUM TARGETS FOR BEHAVIORAL HEALTH SERVICES AND THE
MEDICAL LOSS RATIO APPLICABLE TO SPECIAL NEEDS MANAGED CARE PLANS, for
the purpose of increasing investment in community based behavioral
health services, including residential services certified by the office
of [alcoholism and substance abuse] ADDICTION services AND SUPPORTS.
The methodologies used to calculate the savings shall be developed by
the commissioner of health and the director of the budget in consulta-
tion with the commissioners of the office of mental health and the
office of [alcoholism and substance abuse] ADDICTION services AND
SUPPORTS. In no event shall the full annual value of the [community
based behavioral health service] reinvestment [savings attributable to
S. 8007 137 A. 9007
the transition to managed care] PURSUANT TO THIS SUBDIVISION exceed the
[twelve month value of the department of health general fund reductions
resulting from such transition] VALUE OF THE PREMIUMS RECOVERED FROM
MANAGED CARE PROVIDERS WHICH REPRESENT A REDUCTION OF SPENDING ON QUALI-
FYING BEHAVIORAL HEALTH SERVICES. Within any fiscal year where appropri-
ation increases are recommended for reinvestment, insofar as managed
care transition savings do not occur as estimated, [and general fund
savings do not result,] then spending for such reinvestment may be
reduced in the next year's annual budget itemization. [The commissioner
of health shall promulgate regulations, and prior to October first, two
thousand fifteen, may promulgate emergency regulations as required to
distribute funds pursuant to this subdivision; provided, however, that
any emergency regulations promulgated pursuant to this section shall
expire no later than December thirty-first, two thousand fifteen.] The
commissioner shall include [detailed descriptions of the methodology
used to calculate savings] INFORMATION REGARDING THE FUNDS AVAILABLE for
reinvestment[, the results of applying such methodologies, the details
regarding implementation of such reinvestment] pursuant to this
section[, and any regulations promulgated under this subdivision,] in
the annual report required under section forty-five-c of part A of chap-
ter fifty-six of the laws of two thousand thirteen.
§ 2. This act shall take effect immediately.
PART GG
Section 1. Section 7 of part H of chapter 57 of the laws of 2019,
amending the public health law relating to waiver of certain regu-
lations, as amended by section 7 of part S of chapter 57 of the laws of
2021, is amended to read as follows:
§ 7. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2019, provided,
however, that section two of this act shall expire on April 1, [2022]
2025.
§ 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022.
PART HH
Section 1. Section 3309 of the public health law is amended by adding
a new subdivision 8 to read as follows:
8. ANY PHARMACY REGISTERED BY THE NEW YORK STATE DEPARTMENT OF EDUCA-
TION AND THE FEDERAL DRUG ENFORCEMENT ADMINISTRATION (DEA) OR ITS
SUCCESSOR AGENCY THAT MAINTAINS A STOCK OF AND DIRECTLY DISPENSES
CONTROLLED SUBSTANCE MEDICATIONS PURSUANT TO PRESCRIPTIONS FOR HUMANS IN
THE STATE OF NEW YORK, SHALL MAINTAIN A MINIMUM STOCK OF A THIRTY DAY
SUPPLY OF BOTH AN OPIOID ANTAGONIST MEDICATION AND SEPARATELY AN OPIOID
PARTIAL AGONIST MEDICATION FOR THE TREATMENT OF AN OPIOID USE DISORDER,
TO THE EXTENT PERMITTED PURSUANT TO FEDERAL WHOLESALER THRESHOLD LIMITS.
FOR PURPOSES OF THIS SUBDIVISION, A THIRTY DAY SUPPLY OF OPIOID PARTIAL
AGONIST MEDICATION SHALL MEAN ANY COMBINATION OF DOSAGES SUFFICIENT TO
FILL A PRESCRIPTION OF SIXTEEN MILLIGRAMS PER DAY FOR A PERIOD OF THIRTY
DAYS. WHERE THE FOOD AND DRUG ADMINISTRATION HAS DEFINED AND APPROVED
ONE OR MORE THERAPEUTIC AND PHARMACEUTICAL EQUIVALENTS OF THESE MEDICA-
TIONS A PHARMACY IS NOT REQUIRED TO MAINTAIN A STOCK OF ALL SUCH
VERSIONS, SO LONG AS AT LEAST ONE VERSION OF AN OPIOID ANTAGONIST AND
ONE VERSION OF AN OPIOID PARTIAL AGONIST MEDICATION FOR THE TREATMENT OF
S. 8007 138 A. 9007
AN OPIOID USE DISORDER IS AVAILABLE TO DISPENSE. WHERE FEDERAL AND
STATE LAWS AND REGULATIONS PERMIT DISPENSING OF OPIOID FULL AGONIST
MEDICATION FOR THE TREATMENT OF AN OPIOID USE DISORDER, SUCH PHARMACY
MAY ALSO MAINTAIN A STOCK OF OPIOID FULL AGONIST MEDICATION CONSISTENT
WITH THIS SUBDIVISION.
§ 2. This act shall take effect on the one hundred eightieth day after
it shall have become a law.
PART II
Section 1. Paragraph 38 of section 1.03 of the mental hygiene law, as
amended by chapter 281 of the laws of 2019, is amended to read as
follows:
38. "Residential services facility" or "[Alcoholism community] COMMU-
NITY residence FOR ADDICTION" means any facility licensed or operated
pursuant to article thirty-two of this chapter which provides residen-
tial services for the treatment of an addiction disorder and a homelike
environment, including room, board and responsible supervision as part
of an overall service delivery system.
§ 2. Paragraph 1 of subdivision (a) of section 32.05 of the mental
hygiene law, as added by chapter 558 of the laws of 1999, is amended to
read as follows:
1. operation of a residential program, including a community residence
for the care, custody, or treatment of persons suffering from [chemical
abuse or dependence] AN ADDICTIVE DISORDER; provided, however, that
giving domestic care and comfort to a person in the home shall not
constitute such an operation; PROVIDED FURTHER THAT THE CERTIFICATION OF
A RECOVERY RESIDENCE, DEVELOPED AND ADMINISTERED BY THE COMMISSIONER
DIRECTLY OR PURSUANT TO A CONTRACT WITH A DESIGNATED ENTITY, SHALL HAVE
THE FOLLOWING STRUCTURE AND MEANING FOR PURPOSES OF THIS SECTION:
(I)(A) "RECOVERY RESIDENCE" MEANS A SHARED LIVING ENVIRONMENT FREE
FROM ALCOHOL AND ILLICIT DRUG USE WHICH UTILIZES PEER SUPPORTS AND
CONNECTION TO SERVICES TO PROMOTE SUSTAINED RECOVERY FROM SUBSTANCE USE
DISORDER.
(B) "CERTIFIED RECOVERY RESIDENCE" MEANS A RECOVERY RESIDENCE WHICH
COMPLIES WITH STANDARDS FOR THE OPERATION OF A CERTIFIED RECOVERY RESI-
DENCE WHICH ARE ISSUED BY THE OFFICE.
(II) THE COMMISSIONER SHALL REGULATE AND ASSURE THE CONSISTENT HIGH
QUALITY OF CERTIFIED RECOVERY RESIDENCES FOR INDIVIDUALS IN RECOVERY
FROM A SUBSTANCE USE DISORDER. THE COMMISSIONER, DIRECTLY OR PURSUANT TO
CONTRACT WITH A DESIGNATED ENTITY, SHALL IMPLEMENT STANDARDS FOR THE
OPERATION OF A CERTIFIED RECOVERY RESIDENCE, A VOLUNTARY CERTIFICATION
PROCESS, AND CONDUCT ONGOING MONITORING OF RECOVERY RESIDENCES.
(III) THE COMMISSIONER SHALL MAINTAIN ON THE OFFICE WEBSITE A LIST OF
CERTIFIED RECOVERY RESIDENCES.
§ 3. Section 41.52 of the mental hygiene law, as amended by chapter
223 of the laws of 1992, is amended to read as follows:
§ 41.52 Community residential services for [alcoholism] ADDICTION.
(a) The commissioner of [alcoholism and substance abuse services]
ADDICTION SERVICES AND SUPPORTS is authorized, within appropriations
made therefor, to establish a continuum of community residential
services for [alcoholism] ADDICTIVE DISORDER SERVICES.
(b) The commissioner shall establish standards for the operation and
funding of community residential services, including but not limited to:
(1) criteria for admission to and continued residence in each type of
community residence;
S. 8007 139 A. 9007
(2) periodic evaluation of services provided by community residences;
(3) staffing patterns for each type of community residence; and
(4) guidelines for determining state aid to community residences, as
described in [subdivision (c) of this section] ARTICLE TWENTY-FIVE OF
THIS CHAPTER.
(c) Within amounts available therefor and subject to regulations
established by the commissioner and notwithstanding any other provisions
of this article, the commissioner may provide state aid to local govern-
ments and to voluntary agencies in an amount up to one hundred percent
of net operating costs of community residences for alcoholism services.
The commissioner shall establish guidelines for determining the amount
of state aid provided pursuant to this section. The guidelines shall be
designed to enable the effective and efficient operation of such resi-
dences and shall include, but need not be limited to, standards for
determining anticipated revenue, for retention and use of income exceed-
ing the anticipated amount and for determining reasonable levels of
uncollectible income. Such state aid to voluntary agencies shall not be
granted unless the proposed community residence is consistent with the
relevant local services plan adopted pursuant to section 41.18 of this
article.
§ 4. This act shall take effect immediately.
PART JJ
Section 1. The section heading and subdivisions (a) and (d) of section
19.25 of the mental hygiene law, as added by chapter 223 of the laws of
1992, are amended to read as follows:
[Alcohol] SUBSTANCE USE awareness program.
(a) The office shall establish [an alcohol] A SUBSTANCE USE awareness
program within the office which shall focus upon, but not be limited to,
the health effects and social costs of [alcoholism and alcohol abuse]
ALCOHOL AND CANNABIS USE.
(d) A certificate of completion shall be sent to the court by the
[office] PROGRAM upon completion of the program by all participants.
§ 2. This act shall take effect immediately.
PART KK
Section 1. Section 9 of section 1 of chapter 359 of the laws of 1968,
constituting the facilities development corporation act is amended by
adding a new subdivision 7 to read as follows:
7. EXPEDITED PROCESS FOR MENTAL HYGIENE FACILITIES DEDICATED FOR THE
TREATMENT OF ADDICTION. TO MORE SWIFTLY COMBAT ADDICTION ISSUES AND
CONSISTENT WITH THE POLICIES OF THE STATE OF NEW YORK AS EXPRESSED IN
SECTION 19.01 OF THE MENTAL HYGIENE LAW, THE PROVISIONS OF THIS SUBDI-
VISION SHALL APPLY TO MENTAL HYGIENE FACILITIES CREATED, OR TO BE
CREATED, TO OFFER TREATMENT PROGRAMS, REHABILITATION SERVICES, AND
RELATED AND ATTENDANT SERVICES, FOR ADDICTION THAT ARE LICENSED, CERTI-
FIED OR OTHERWISE AUTHORIZED BY THE OFFICE OF ADDICTION SERVICES AND
SUPPORTS.
A. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, THE CORPORATION SHALL
HAVE THE AUTHORITY TO:
(I) ACQUIRE BY LEASE, PURCHASE, CONDEMNATION, GIFT OR OTHERWISE ANY
REAL PROPERTY IT DEEMS NECESSARY OR CONVENIENT FOR USE AS A MENTAL
HYGIENE FACILITY DEDICATED TO PROVIDING ADDICTION PROGRAMS, REHABILI-
TATION SERVICES, AND RELATED AND ATTENDANT SERVICES; AND SUCH LEASE,
S. 8007 140 A. 9007
PURCHASE OR ACQUISITION SHALL BE IN THE NAME OF THE STATE, ACTING BY AND
THROUGH THE CORPORATION OR THE DORMITORY AUTHORITY, AND ON BEHALF OF THE
OFFICE OF ADDICTION SERVICES AND SUPPORTS; AND
(II) DESIGN, CONSTRUCT, RECONSTRUCT, REHABILITATE AND IMPROVE SUCH
MENTAL HYGIENE FACILITIES ON BEHALF OF THE OFFICE OF ADDICTION SERVICES
AND SUPPORTS, OR CAUSE SUCH FACILITIES TO BE DESIGNED, CONSTRUCTED,
RECONSTRUCTED, REHABILITATED AND IMPROVED; AND
(III) IN CONNECTION WITH SUCH DESIGN, CONSTRUCTION, RECONSTRUCTION,
REHABILITATION AND IMPROVEMENT, TO INSTALL OR CAUSE TO BE INSTALLED
WATER, SEWER, GAS, ELECTRICAL, TELEPHONE, HEATING, AIR CONDITIONING AND
OTHER UTILITY SERVICES, INCLUDING APPROPRIATE CONNECTIONS; AND
(IV) MAKE SUCH MENTAL HYGIENE FACILITY AVAILABLE UNDER LEASE,
SUBLEASE, LICENSE OR PERMIT TO A VOLUNTARY AGENCY UPON SUCH TERMS AND
CONDITIONS AS DETERMINED BY THE OFFICE OF ADDICTION SERVICES AND
SUPPORTS; OR, NOTWITHSTANDING THE PROVISIONS OF THE PUBLIC LANDS LAW OR
ANY OTHER GENERAL OR SPECIAL LAW TO THE CONTRARY, TO CONVEY THE RIGHT,
TITLE AND INTEREST OF THE PEOPLE OF THE STATE OF NEW YORK IN AND TO SUCH
FACILITY AND THE LAND APPURTENANT THERETO TO SUCH VOLUNTARY AGENCY TO
OPERATE AS A MENTAL HYGIENE FACILITY UPON SUCH TERMS AND CONDITIONS AND
FOR SUCH CONSIDERATION, IF ANY, AS SHALL BE PROVIDED IN AN AGREEMENT
AMONG THE OFFICE OF ADDICTION SERVICES AND SUPPORTS, THE CORPORATION AND
SUCH VOLUNTARY AGENCY SUBJECT TO THE ATTORNEY GENERAL PASSING UPON THE
FORM AND SUFFICIENCY OF ANY DEED OF CONVEYANCE AND ANY LEASE OF REAL
PROPERTY AUTHORIZED TO BE GIVEN UNDER THIS SUBDIVISION, WHICH SHALL ONLY
BE EFFECTIVE ONCE THE DEED, LEASE, SUBLEASE OR AGREEMENT SHALL HAVE BEEN
SO APPROVED. NOTWITHSTANDING SECTIONS ONE HUNDRED TWELVE AND ONE
HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW AND SECTION ONE HUNDRED
FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR ANY OTHER INCONSISTENT
PROVISION OF LAW, SUCH VOLUNTARY AGENCY MAY BE SELECTED BY THE OFFICE OF
ADDICTION SERVICES AND SUPPORTS, WITHOUT A COMPETITIVE BID OR REQUEST
FOR PROPOSAL PROCESS.
B. ALL CONTRACTS WHICH ARE TO BE AWARDED PURSUANT TO THIS SUBDIVISION
SHALL BE PUBLICLY ADVERTISED PURSUANT TO ARTICLE FOUR-C OF THE ECONOMIC
DEVELOPMENT LAW.
§ 2. This act shall take effect immediately.
PART LL
Section 1. Section 48-a of part A of chapter 56 of the laws of 2013
amending the public health law and other laws relating to general hospi-
tal reimbursement for annual rates, as amended by section 18 of part E
of chapter 57 of the laws of 2019, is amended to read as follows:
§ 48-a. 1. Notwithstanding any contrary provision of law, the commis-
sioners of the office of [alcoholism and substance abuse] ADDICTION
services AND SUPPORTS and the office of mental health are authorized,
subject to the approval of the director of the budget, to transfer to
the commissioner of health state funds to be utilized as the state share
for the purpose of increasing payments under the medicaid program to
managed care organizations licensed under article 44 of the public
health law or under article 43 of the insurance law. Such managed care
organizations shall utilize such funds for the purpose of reimbursing
providers licensed pursuant to article 28 of the public health law or
article 36, 31 or 32 of the mental hygiene law for ambulatory behavioral
health services, as determined by the commissioner of health, in consul-
tation with the commissioner of [alcoholism and substance abuse]
ADDICTION services AND SUPPORTS and the commissioner of the office of
S. 8007 141 A. 9007
mental health, provided to medicaid enrolled outpatients and for all
other behavioral health services except inpatient included in New York
state's Medicaid redesign waiver approved by the centers for medicare
and Medicaid services (CMS). Such reimbursement shall be in the form of
fees for such services which are equivalent to the payments established
for such services under the ambulatory patient group (APG) rate-setting
methodology as utilized by the department of health, the office of
[alcoholism and substance abuse] ADDICTION services AND SUPPORTS, or the
office of mental health for rate-setting purposes or any such other fees
pursuant to the Medicaid state plan or otherwise approved by CMS in the
Medicaid redesign waiver; provided, however, that the increase to such
fees that shall result from the provisions of this section shall not, in
the aggregate and as determined by the commissioner of health, in
consultation with the commissioner of [alcoholism and substance abuse]
ADDICTION services AND SUPPORTS and the commissioner of the office of
mental health, be greater than the increased funds made available pursu-
ant to this section. The increase of such ambulatory behavioral health
fees to providers available under this section shall be for all rate
periods on and after the effective date of section [1] 18 of part [P] E
of chapter 57 of the laws of [2017] 2019 through March 31, [2023] 2027
for patients in the city of New York, for all rate periods on and after
the effective date of section [1] 18 of part [P] E of chapter 57 of the
laws of [2017] 2019 through March 31, [2023] 2027 for patients outside
the city of New York, and for all rate periods on and after the effec-
tive date of such chapter through March 31, [2023] 2027 for all services
provided to persons under the age of twenty-one; provided, however, the
commissioner of health, in consultation with the commissioner of [alco-
holism and substance abuse] ADDICTION services AND SUPPORTS and the
commissioner of mental health, may require, as a condition of approval
of such ambulatory behavioral health fees, that aggregate managed care
expenditures to eligible providers meet the alternative payment method-
ology requirements as set forth in attachment I of the New York state
medicaid section one thousand one hundred fifteen medicaid redesign team
waiver as approved by the centers for medicare and medicaid services.
The commissioner of health shall, in consultation with the commissioner
of [alcoholism and substance abuse] ADDICTION services AND SUPPORTS and
the commissioner of mental health, waive such conditions if a sufficient
number of providers, as determined by the commissioner, suffer a finan-
cial hardship as a consequence of such alternative payment methodology
requirements, or if he or she shall determine that such alternative
payment methodologies significantly threaten individuals access to ambu-
latory behavioral health services. Such waiver may be applied on a
provider specific or industry wide basis. Further, such conditions may
be waived, as the commissioner determines necessary, to comply with
federal rules or regulations governing these payment methodologies.
Nothing in this section shall prohibit managed care organizations and
providers from negotiating different rates and methods of payment during
such periods described above, subject to the approval of the department
of health. The department of health shall consult with the office of
[alcoholism and substance abuse] ADDICTION services AND SUPPORTS and the
office of mental health in determining whether such alternative rates
shall be approved. The commissioner of health may, in consultation with
the commissioner of [alcoholism and substance abuse] ADDICTION services
AND SUPPORTS and the commissioner of the office of mental health,
promulgate regulations, including emergency regulations promulgated
prior to October 1, 2015 to establish rates for ambulatory behavioral
S. 8007 142 A. 9007
health services, as are necessary to implement the provisions of this
section. Rates promulgated under this section shall be included in the
report required under section 45-c of part A of this chapter.
2. Notwithstanding any contrary provision of law, the fees paid by
managed care organizations licensed under article 44 of the public
health law or under article 43 of the insurance law, to providers
licensed pursuant to article 28 of the public health law or article 36,
31 or 32 of the mental hygiene law, for ambulatory behavioral health
services provided to patients enrolled in the child health insurance
program pursuant to title 1-A of article 25 of the public health law,
shall be in the form of fees for such services which are equivalent to
the payments established for such services under the ambulatory patient
group (APG) rate-setting methodology or any such other fees established
pursuant to the Medicaid state plan. The commissioner of health shall
consult with the commissioner of [alcoholism and substance abuse]
ADDICTION services AND SUPPORTS and the commissioner of the office of
mental health in determining such services and establishing such fees.
Such ambulatory behavioral health fees to providers available under this
section shall be for all rate periods on and after the effective date of
this chapter through March 31, [2023] 2027, provided, however, that
managed care organizations and providers may negotiate different rates
and methods of payment during such periods described above, subject to
the approval of the department of health. The department of health
shall consult with the office of [alcoholism and substance abuse]
ADDICTION services AND SUPPORTS and the office of mental health in
determining whether such alternative rates shall be approved. The
report required under section 16-a of part C of chapter 60 of the laws
of 2014 shall also include the population of patients enrolled in the
child health insurance program pursuant to title 1-A of article 25 of
the public health law in its examination on the transition of behavioral
health services into managed care.
§ 2. Section 1 of part H of chapter 111 of the laws of 2010 relating
to increasing Medicaid payments to providers through managed care organ-
izations and providing equivalent fees through an ambulatory patient
group methodology, as amended by section 19 of part E of chapter 57 of
the laws of 2019, is amended to read as follows:
Section 1. a. Notwithstanding any contrary provision of law, the
commissioners of mental health and [alcoholism and substance abuse]
ADDICTION services AND SUPPORTS are authorized, subject to the approval
of the director of the budget, to transfer to the commissioner of health
state funds to be utilized as the state share for the purpose of
increasing payments under the medicaid program to managed care organiza-
tions licensed under article 44 of the public health law or under arti-
cle 43 of the insurance law. Such managed care organizations shall
utilize such funds for the purpose of reimbursing providers licensed
pursuant to article 28 of the public health law, or pursuant to article
36, 31 or article 32 of the mental hygiene law for ambulatory behavioral
health services, as determined by the commissioner of health in consul-
tation with the commissioner of mental health and commissioner of [alco-
holism and substance abuse] ADDICTION services AND SUPPORTS, provided to
medicaid enrolled outpatients and for all other behavioral health
services except inpatient included in New York state's Medicaid redesign
waiver approved by the centers for medicare and Medicaid services (CMS).
Such reimbursement shall be in the form of fees for such services which
are equivalent to the payments established for such services under the
ambulatory patient group (APG) rate-setting methodology as utilized by
S. 8007 143 A. 9007
the department of health or by the office of mental health or office of
[alcoholism and substance abuse] ADDICTION services AND SUPPORTS for
rate-setting purposes or any such other fees pursuant to the Medicaid
state plan or otherwise approved by CMS in the Medicaid redesign waiver;
provided, however, that the increase to such fees that shall result from
the provisions of this section shall not, in the aggregate and as deter-
mined by the commissioner of health in consultation with the commission-
ers of mental health and [alcoholism and substance abuse] ADDICTION
services AND SUPPORTS, be greater than the increased funds made avail-
able pursuant to this section. The increase of such behavioral health
fees to providers available under this section shall be for all rate
periods on and after the effective date of section [2] 19 of part [P] E
of chapter 57 of the laws of [2017] 2019 through March 31, [2023] 2027
for patients in the city of New York, for all rate periods on and after
the effective date of section [2] 19 of part [P] E of chapter 57 of the
laws of [2017] 2019 through March 31, [2023] 2027 for patients outside
the city of New York, and for all rate periods on and after the effec-
tive date of section [2] 19 of part [P] E of chapter 57 of the laws of
[2017] 2019 through March 31, [2023] 2027 for all services provided to
persons under the age of twenty-one; provided, however, the commissioner
of health, in consultation with the commissioner of [alcoholism and
substance abuse] ADDICTION services AND SUPPORTS and the commissioner of
mental health, may require, as a condition of approval of such ambulato-
ry behavioral health fees, that aggregate managed care expenditures to
eligible providers meet the alternative payment methodology requirements
as set forth in attachment I of the New York state medicaid section one
thousand one hundred fifteen medicaid redesign team waiver as approved
by the centers for medicare and medicaid services. The commissioner of
health shall, in consultation with the commissioner of [alcoholism and
substance abuse] ADDICTION services AND SUPPORTS and the commissioner of
mental health, waive such conditions if a sufficient number of provid-
ers, as determined by the commissioner, suffer a financial hardship as a
consequence of such alternative payment methodology requirements, or if
he or she shall determine that such alternative payment methodologies
significantly threaten individuals access to ambulatory behavioral
health services. Such waiver may be applied on a provider specific or
industry wide basis. Further, such conditions may be waived, as the
commissioner determines necessary, to comply with federal rules or regu-
lations governing these payment methodologies. Nothing in this section
shall prohibit managed care organizations and providers from negotiating
different rates and methods of payment during such periods described,
subject to the approval of the department of health. The department of
health shall consult with the office of [alcoholism and substance abuse]
ADDICTION services AND SUPPORTS and the office of mental health in
determining whether such alternative rates shall be approved. The
commissioner of health may, in consultation with the commissioners of
mental health and [alcoholism and substance abuse] ADDICTION services
AND SUPPORTS, promulgate regulations, including emergency regulations
promulgated prior to October 1, 2013 that establish rates for behavioral
health services, as are necessary to implement the provisions of this
section. Rates promulgated under this section shall be included in the
report required under section 45-c of part A of chapter 56 of the laws
of 2013.
b. Notwithstanding any contrary provision of law, the fees paid by
managed care organizations licensed under article 44 of the public
health law or under article 43 of the insurance law, to providers
S. 8007 144 A. 9007
licensed pursuant to article 28 of the public health law or article 36,
31 or 32 of the mental hygiene law, for ambulatory behavioral health
services provided to patients enrolled in the child health insurance
program pursuant to title 1-A of article 25 of the public health law,
shall be in the form of fees for such services which are equivalent to
the payments established for such services under the ambulatory patient
group (APG) rate-setting methodology. The commissioner of health shall
consult with the commissioner of [alcoholism and substance abuse]
ADDICTION services AND SUPPORTS and the commissioner of the office of
mental health in determining such services and establishing such fees.
Such ambulatory behavioral health fees to providers available under this
section shall be for all rate periods on and after the effective date of
this chapter through March 31, [2023] 2027, provided, however, that
managed care organizations and providers may negotiate different rates
and methods of payment during such periods described above, subject to
the approval of the department of health. The department of health shall
consult with the office of [alcoholism and substance abuse] ADDICTION
services AND SUPPORTS and the office of mental health in determining
whether such alternative rates shall be approved. The report required
under section 16-a of part C of chapter 60 of the laws of 2014 shall
also include the population of patients enrolled in the child health
insurance program pursuant to title 1-A of article 25 of the public
health law in its examination on the transition of behavioral health
services into managed care.
§ 3. Section 2 of part H of chapter 111 of the laws of 2010, relating
to increasing Medicaid payments to providers through managed care organ-
izations and providing equivalent fees through an ambulatory patient
group methodology, as amended by section 20 of part E of chapter 57 of
the laws of 2019, is amended to read as follows:
§ 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2010, and shall
expire on March 31, [2023] 2027.
§ 4. This act shall take effect immediately; provided, however that
the amendments to section 1 of part H of chapter 111 of the laws of
2010, relating to increasing Medicaid payments to providers through
managed care organizations and providing equivalent fees through an
ambulatory patient group methodology, made by section two of this act
shall not affect the expiration of such section and shall expire there-
with.
PART MM
Section 1. Section 18 of chapter 408 of the laws of 1999, constituting
Kendra's law, as amended by chapter 67 of the laws of 2017, is amended
to read as follows:
§ 18. This act shall take effect immediately, provided that section
fifteen of this act shall take effect April 1, 2000, provided, further,
that subdivision (e) of section 9.60 of the mental hygiene law as added
by section six of this act shall be effective 90 days after this act
shall become law; and that this act shall expire and be deemed repealed
June 30, [2022] 2027.
§ 2. Paragraph 4 of subdivision (c) and paragraph 2 of subdivision (h)
of section 9.60 of the mental hygiene law, as amended by chapter 158 of
the laws of 2005, are amended and a new subdivision (s) is added to read
as follows:
S. 8007 145 A. 9007
(4) has a history of lack of compliance with treatment for mental
illness that has:
(i) EXCEPT AS OTHERWISE PROVIDED IN SUBPARAGRAPH (III) OF THIS PARA-
GRAPH, prior to the filing of the petition, at least twice within the
last thirty-six months been a significant factor in necessitating hospi-
talization in a hospital, or receipt of services in a forensic or other
mental health unit of a correctional facility or a local correctional
facility, not including any current period, or period ending within the
last six months, during which the person was or is hospitalized or
incarcerated; or
(ii) EXCEPT AS OTHERWISE PROVIDED IN SUBPARAGRAPH (III) OF THIS PARA-
GRAPH, prior to the filing of the petition, resulted in one or more acts
of serious violent behavior toward self or others or threats of, or
attempts at, serious physical harm to self or others within the last
forty-eight months, not including any current period, or period ending
within the last six months, in which the person was or is hospitalized
or incarcerated; [and] OR
(III) NOTWITHSTANDING SUBPARAGRAPHS (I) AND (II) OF THIS PARAGRAPH,
RESULTED IN THE ISSUANCE OF A COURT ORDER FOR ASSISTED OUTPATIENT TREAT-
MENT WHICH HAS EXPIRED WITHIN THE LAST SIX MONTHS, AND SINCE THE EXPIRA-
TION OF THE ORDER, THE PERSON HAS EXPERIENCED A SUBSTANTIAL INCREASE IN
SYMPTOMS OF MENTAL ILLNESS.
(2) The court shall not order assisted outpatient treatment unless an
examining physician, who recommends assisted outpatient treatment and
has personally examined the subject of the petition no more than ten
days before the filing of the petition, testifies in person OR BY VIDEO-
CONFERENCE at the hearing. Such physician shall state the facts and
clinical determinations which support the allegation that the subject of
the petition meets each of the criteria for assisted outpatient treat-
ment.
(S) A DIRECTOR OF COMMUNITY SERVICES OR HIS OR HER DESIGNEE MAY
REQUIRE A PROVIDER OF SERVICES OPERATED OR LICENSED BY THE OFFICE OF
MENTAL HEALTH TO PROVIDE INFORMATION, INCLUDING BUT NOT LIMITED TO CLIN-
ICAL RECORDS AND OTHER INFORMATION CONCERNING PERSONS RECEIVING ASSISTED
OUTPATIENT TREATMENT PURSUANT TO AN ACTIVE ASSISTED OUTPATIENT TREATMENT
ORDER, THAT IS DEEMED NECESSARY BY SUCH DIRECTOR OR DESIGNEE TO APPRO-
PRIATELY DISCHARGE THEIR DUTIES PURSUANT TO SECTION 9.47 OF THIS ARTI-
CLE, AND WHERE SUCH PROVIDER IS REQUIRED TO DISCLOSE SUCH INFORMATION
PURSUANT TO PARAGRAPH TWELVE OF SUBDIVISION (C) OF SECTION 33.13 OF THIS
CHAPTER.
§ 3. This act shall take effect immediately, provided, however that
the amendments to section 9.60 of the mental hygiene law made by section
two of this act shall not affect the repeal of such section and shall be
deemed repealed therewith.
PART NN
Section 1. Section 41.38 of the mental hygiene law, as amended by
chapter 218 of the laws of 1988, is amended to read as follows:
§ 41.38 Rental and mortgage payments of community residential facilities
for the mentally ill.
(A) "SUPPORTIVE HOUSING" SHALL MEAN, FOR THE PURPOSE OF THIS SECTION
ONLY, THE METHOD BY WHICH THE COMMISSIONER CONTRACTS TO PROVIDE RENTAL
SUPPORT AND FUNDING FOR NON-CLINICAL SUPPORT SERVICES IN ORDER TO MAIN-
TAIN RECIPIENT STABILITY.
S. 8007 146 A. 9007
(B) Notwithstanding any inconsistent provision of this article, the
commissioner may reimburse voluntary agencies for the reasonable cost of
rental of or the reasonable mortgage payment or the reasonable principal
and interest payment on a loan for the purpose of financing an ownership
interest in, and proprietary lease from, an organization formed for the
purpose of the cooperative ownership of real estate, together with other
necessary costs associated with rental or ownership of property, for a
community residence [or], a residential care center for adults, OR
SUPPORTIVE HOUSING, under [his] THEIR jurisdiction less any income
received from a state or federal agency or third party insurer which is
specifically intended to offset the cost of rental of the facility or
housing a client at the facility, subject to the availability of appro-
priations therefor and such commissioner's certification of the reason-
ableness of the rental cost, mortgage payment, principal and interest
payment on a loan as provided in this section or other necessary costs
associated with rental or ownership of property, with the approval of
the director of the budget.
§ 2. This act shall take effect April 1, 2022.
PART OO
Section 1. Section 4 of part L of chapter 59 of the laws of 2016,
amending the mental hygiene law relating to the appointment of temporary
operators for the continued operation of programs and the provision of
services for persons with serious mental illness and/or developmental
disabilities and/or chemical dependence, as amended by section 1 of part
U of chapter 57 of the laws of 2021, is amended to read as follows:
§ 4. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2016[;
provided, however, that sections one and two of this act shall expire
and be deemed repealed on March 31, 2022].
§ 2. This act shall take effect immediately.
§ 2. Severability clause. If any clause, sentence, paragraph, subdivi-
sion, section or part of this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment shall not affect,
impair, or invalidate the remainder thereof, but shall be confined in
its operation to the clause, sentence, paragraph, subdivision, section
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the legislature that this act would have been enacted even if such
invalid provisions had not been included herein.
§ 3. This act shall take effect immediately provided, however, that
the applicable effective date of Parts A through OO of this act shall be
as specifically set forth in the last section of such Parts.