S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    155
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 6, 2021
                                ___________
 
 Introduced  by  M.  of  A.  GOTTFRIED,  DINOWITZ, LALOR -- read once and
   referred to the Committee on Health
 
 AN ACT to amend the public health law and the social  services  law,  in
   relation  to  automatic  enrollment and recertification simplification
   for Medicaid eligible recipients

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Paragraph  (b)  of subdivision 7 of section 4403-f of the
 public health law is amended by adding a new subparagraph (iv)  to  read
 as follows:
   (IV) WHERE A PERSON DETERMINED ELIGIBLE FOR MEDICAID ("MEDICAID RECIP-
 IENT") HAS BEEN DETERMINED BY THE COMMISSIONER OR HIS OR HER DESIGNEE TO
 REQUIRE  COMMUNITY-BASED LONG TERM CARE SERVICES FOR MORE THAN A CONTIN-
 UOUS PERIOD OF ONE HUNDRED TWENTY DAYS, AND THE MEDICAID  RECIPIENT  HAS
 NOT  SELECTED AND ENROLLED IN A MANAGED LONG TERM CARE PLAN PRIOR TO ANY
 EXPIRATION DATE OF SUCH DETERMINATION OF NEED FOR LONG TERM CARE,  AFTER
 BEING  PROVIDED WITH INFORMATION TO MAKE AN INFORMED CHOICE, THE COMMIS-
 SIONER SHALL ASSIGN THE RECIPIENT TO A  MANAGED  LONG  TERM  CARE  PLAN,
 TAKING  INTO  ACCOUNT  CONSISTENCY WITH ANY PRIOR COMMUNITY-BASED DIRECT
 CARE WORKERS HAVING RECENTLY SERVED THE RECIPIENT,  QUALITY  PERFORMANCE
 CRITERIA,  CAPACITY, AND GEOGRAPHIC ACCESSIBILITY.  THE COMMISSIONER MAY
 ASSIGN PARTICIPANTS PURSUANT TO SUCH CRITERIA ON A WEIGHTED  BASIS.    A
 RECIPIENT  ASSIGNED TO A MANAGED LONG TERM CARE PLAN UNDER THIS SUBPARA-
 GRAPH SHALL BE DEEMED TO HAVE BEEN DETERMINED TO BE IN NEED OF LONG TERM
 CARE SERVICES FOR MORE THAN A CONTINUOUS PERIOD OF  ONE  HUNDRED  TWENTY
 DAYS AND ELIGIBLE TO BE ENROLLED IN A MANAGED LONG TERM CARE PLAN.
   §  2.  Paragraph  (b)  of subdivision 2 of section 366-a of the social
 services law, as added by section 51 of part A of chapter 1 of the  laws
 of 2002, is amended to read as follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD00500-01-1

 A. 155                              2
 
   (b)  Notwithstanding  the provisions of paragraph (a) of this subdivi-
 sion, an applicant or recipient may attest to the amount of his  or  her
 accumulated  resources,  unless  such  applicant or recipient is seeking
 medical assistance payment for long term care  services  FOR  THE  FIRST
 TIME.  A  RECIPIENT  WHO HAS ALREADY PROVIDED DOCUMENTATION OF RESOURCES
 MAY ATTEST TO THE AMOUNT OF ACCUMULATED RESOURCES IF IT HAS REMAINED THE
 SAME OR IS LESS THAN THE AMOUNT ORIGINALLY DOCUMENTED.  For purposes  of
 this  paragraph,  long  term  care  services shall mean care, treatment,
 maintenance, and services described in paragraph (b) of subdivision  [1]
 ONE  of  section  three  hundred  sixty-seven-f  of this title, with the
 exception of short term rehabilitation, as defined by  the  commissioner
 of health.
   §  3.  Paragraph  (d)  of subdivision 5 of section 366-a of the social
 services law, as amended by section 12 of part D of chapter  56  of  the
 laws  of 2013, is relettered paragraph (e) and three new paragraphs (f),
 (g) and (h) are added to read as follows:
   (F) NOTWITHSTANDING PARAGRAPH (B) OF SUBDIVISION TWO OF  THIS  SECTION
 AND  PARAGRAPHS (A), (B), (C) AND (D) OF THIS SUBDIVISION, THE FOLLOWING
 RECIPIENTS WILL BE RECERTIFIED AUTOMATICALLY, UNLESS THERE  HAS  BEEN  A
 FINDING OF LACK OF ELIGIBILITY FOR MEDICAID:
   (I)  ENROLLEES  IN MEDICAID MANAGED LONG TERM CARE PLANS AS DEFINED IN
 SECTION FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW;
   (II) ENROLLEES IN MEDICAID MANAGED CARE PLANS AS  DEFINED  IN  SECTION
 THREE  HUNDRED  SIXTY-FOUR-J  OF  THIS  TITLE  WHO RECEIVE PERSONAL CARE
 SERVICES PURSUANT TO PARAGRAPH (E) OF SUBDIVISION TWO OF  SECTION  THREE
 HUNDRED SIXTY-FIVE-A OF THIS TITLE OR CONSUMER DIRECTED PERSONAL ASSIST-
 ANCE  SERVICES  PURSUANT  TO  SECTION THREE HUNDRED SIXTY-FIVE-F OF THIS
 TITLE;
   (III) ENROLLEES RECEIVING MEDICAID IN THE  AGED,  BLIND  AND  DISABLED
 CATEGORY  WHO  RECEIVE  FIXED  INCOME  FROM THE SOCIAL SECURITY ADMINIS-
 TRATION (SSA); AND
   (IV) MEDICARE SAVINGS PROGRAM (MSP) RECIPIENTS WHO HAVE A FIXED INCOME
 FROM THE SOCIAL SECURITY ADMINISTRATION (SSA).
   (G) NOTHING IN PARAGRAPH (E) OF THIS SUBDIVISION SHOULD  BE  CONSTRUED
 TO  ALTER A MEDICAID RECIPIENT'S OBLIGATION TO INFORM THE PUBLIC WELFARE
 DISTRICT OF CHANGES IN INCOME OR OTHER FACTORS THAT MIGHT IMPACT  ELIGI-
 BILITY PURSUANT TO SUBDIVISION FOUR OF THIS SECTION.
   (H)  UPON  A  FINDING OF LACK OF ELIGIBILITY, RECIPIENTS IDENTIFIED IN
 PARAGRAPH (E) OF THIS SUBDIVISION WILL BE ENTITLED TO NOTICE AND HEARING
 RIGHTS AS PROVIDED IN SECTION TWENTY-TWO OF THIS CHAPTER.
   § 4. This act shall take effect on the one hundred eightieth day after
 it shall have become a law; provided that the  amendments  to  paragraph
 (b)  of subdivision 7 of section 4403-f of the public health law made by
 section one of this act shall be subject to the expiration and reversion
 of such paragraph and shall expire and be deemed repealed therewith  and
 provided  further  that  such  amendments shall not affect the repeal of
 such section and shall expire and be deemed repealed  therewith.  Effec-
 tive  immediately, the commissioner of health shall make regulations and
 take other actions reasonably necessary to implement this  act  on  that
 date.