S T A T E O F N E W Y O R K
________________________________________________________________________
8871
I N S E N A T E
March 22, 2024
___________
Introduced by Sen. JACKSON -- read twice and ordered printed, and when
printed to be committed to the Committee on Civil Service and Pensions
AN ACT to amend the civil service law, in relation to establishing the
Medicare maximization and assistance program to assist eligible state
retirees in obtaining certain Medicare benefits
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. The civil service law is amended by adding a new article 15
to read as follows:
ARTICLE XV
MEDICARE MAXIMIZATION AND ASSISTANCE PROGRAM
SECTION 300. DEFINITIONS.
301. PURPOSE.
302. ESTABLISHMENT OF THE MEDICARE MAXIMIZATION AND ASSISTANCE
PROGRAM.
303. INVESTMENT OF SAVINGS.
§ 300. DEFINITIONS. AS USED IN THIS ARTICLE, THE FOLLOWING TERMS SHALL
HAVE THE FOLLOWING MEANINGS:
1. "ELIGIBLE INDIVIDUAL" MEANS AN INDIVIDUAL RETIRED FROM STATE
SERVICE ELIGIBLE FOR BENEFITS PURSUANT TO ARTICLE ELEVEN OF THIS CHAP-
TER.
2. "PROGRAM" MEANS THE MEDICARE MAXIMIZATION AND ASSISTANCE PROGRAM
ESTABLISHED PURSUANT TO THE PROVISIONS OF THIS ARTICLE.
§ 301. PURPOSE. PERSONS WHO ARE UNDER AGE SIXTY-FIVE AND DISABLED ARE
FREQUENTLY ELIGIBLE FOR, BUT NOT RECEIVING SOCIAL SECURITY DISABILITY
INSURANCE AND MEDICARE. THE MEDICARE MAXIMIZATION AND ASSISTANCE PROGRAM
IS DESIGNED TO ENSURE THAT ELIGIBLE RETIREES ARE ABLE TO ACCESS ALL
BENEFITS AVAILABLE TO THEM. THE BENEFITS ACCRUE NOT JUST TO THE RETIREE,
BUT TO THE STATE IN ENSURING THAT MEDICARE SERVES AS THE PRIMARY PAYER
FOR ELIGIBLE PERSONS.
§ 302. ESTABLISHMENT OF THE MEDICARE MAXIMIZATION AND ASSISTANCE
PROGRAM. 1. THE COMMISSIONER SHALL ESTABLISH WITHIN THE DEPARTMENT A
MEDICARE MAXIMIZATION AND ASSISTANCE PROGRAM WHICH SHALL BE DESIGNED TO
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD15000-01-4
S. 8871 2
IDENTIFY STATE RETIREES ELIGIBLE FOR BUT NOT RECEIVING SOCIAL SECURITY
DISABILITY INSURANCE AND MEDICARE COVERAGE.
2. ELEMENTS OF THE PROGRAM SHALL INCLUDE:
(A) CONDUCTING AN ONGOING CLAIMS ANALYSIS OF RETIREES FOR THE PURPOSE
OF IDENTIFYING INDIVIDUALS WHO MAY BE ELIGIBLE FOR SOCIAL SECURITY DISA-
BILITY INSURANCE OR MEDICARE BENEFITS AND ARE NOT YET RECEIVING THEM;
(B) ASSISTING ANY INDIVIDUAL WHOSE CLAIMS HISTORY AND SOCIAL SECURITY
ELIGIBILITY QUALIFY SUCH INDIVIDUAL TO APPLY FOR AND BE AWARDED SOCIAL
SECURITY DISABILITY AND SUBSEQUENTLY MEDICARE. SUCH ASSISTANCE SHALL
INCLUDE THE FOLLOWING:
(I) DEVELOPING COMMUNICATION MATERIALS TO EDUCATE MEDICAID RECIPIENTS
ABOUT SOCIAL SECURITY DISABILITY INSURANCE BENEFITS;
(II) PERFORMING OUTREACH TO POPULATIONS TARGETED BY CLAIMS ANALYSIS;
(III) ANALYZING RESPONSES TO DETERMINE SOCIAL SECURITY DISABILITY
INSURANCE BENEFIT OR MEDICARE ELIGIBILITY;
(IV) REPRESENTING QUALIFIED INDIVIDUALS WITH THEIR CLAIM OR CLAIMS TO
QUALIFY FOR SOCIAL SECURITY DISABILITY INSURANCE BENEFITS AND MEDICARE
ENROLLMENT;
(V) MONITORING THE PROGRAM THROUGH REPORTING REQUIREMENTS AND OTHER
MEANS TO ENSURE CONTRACT PERFORMANCE AND QUALITY DELIVERY OF SERVICES;
AND
(VI) MONITORING THE QUALITY OF SERVICES DELIVERED TO PARTICIPANTS
THROUGH OUTCOME MEASUREMENTS.
3. UNDER NO CIRCUMSTANCES SHALL AN INDIVIDUAL ELIGIBLE FOR THIS
PROGRAM EXPERIENCE ANY ADVERSE CHANGE IN HEALTH BENEFITS OR OTHER BENE-
FITS AS A RESULT OF PARTICIPATING IN THIS PROGRAM. NO INDIVIDUAL SHALL
BE REQUIRED TO TRANSFER TO MEDICARE AS A RESULT OF PARTICIPATING IN THIS
PROGRAM.
4. THE COMMISSIONER SHALL PROVIDE THE DEPARTMENT AND THE LEGISLATURE
WITH AN ANNUAL REPORT SHOWING THE NUMBER OF MEDICAID RECIPIENTS WHO HAVE
TRANSITIONED TO SOCIAL SECURITY DISABILITY INSURANCE AND MEDICARE AND
THE AMOUNT OF SAVINGS REALIZED BY THE PROGRAM.
§ 303. INVESTMENT OF SAVINGS. THE STATE SHALL INVEST ANY NET SAVINGS
REALIZED FROM THE PROGRAM BACK INTO THE NEW YORK STATE HEALTH INSURANCE
PROGRAM FOR THE PURPOSE OF ELIMINATING OR LIMITING THE IMPACT OF ANY
PREMIUM RATE OR OTHER COST INCREASES THAT WOULD BE THE RESPONSIBILITY OF
AN EMPLOYEE OR RETIREE.
§ 2. This act shall take effect April 1, 2024; provided, however, if
this act shall become a law after such date it shall take effect imme-
diately and shall be deemed to have been in full force and effect on and
after such date.