The New York State Senate

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
     S. 4007                                                  A. 3007
 
                       S E N A T E - A S S E M B L Y
 
                             February 1, 2023
                                ___________
 
 IN  SENATE -- A BUDGET BILL, submitted by the Governor pursuant to arti-
   cle seven of the Constitution -- read twice and ordered  printed,  and
   when printed to be committed to the Committee on Finance
 
 IN  ASSEMBLY  --  A  BUDGET  BILL, submitted by the Governor pursuant to
   article seven of the Constitution -- read once  and  referred  to  the
   Committee on Ways and Means

 AN  ACT  to amend 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,  in relation to known and projected
   department of health state fund medicaid  expenditures  (Part  A);  to
   amend chapter 451 of the laws of 2007, amending the public health law,
   the  social  services  law and the insurance law relating to providing
   enhanced consumer and provider protections, in relation to the  effec-
   tiveness  of  certain  provisions relating to contracts between plans,
   insurers, or corporations and hospitals; to amend part C of chapter 58
   of the laws of 2007, amending the social services law and  other  laws
   relating  to adjustments of rates, in relation to the effectiveness of
   certain provisions relating to the amount  of  income  to  be  applied
   toward the cost of medical care, services and supplies of institution-
   alized spouses; to amend chapter 906 of the laws of 1984, amending the
   social services law relating to expanding medical assistance eligibil-
   ity  and the scope of services available to certain persons with disa-
   bilities, in relation to  the  effectiveness  thereof;  to  amend  the
   social  services  law,  in relation to the age of eligibility for home
   and community-based services waivers; to amend chapter 313 of the laws
   of 2018, amending the public health law relating to body imaging scan-
   ning equipment, in relation to the  effectiveness  thereof;  to  amend
   chapter 426 of the laws of 1983, amending the public health law relat-
   ing  to professional misconduct proceedings, in relation to the effec-
   tiveness of certain provisions thereof; to amend chapter  582  of  the
   laws  of  1984,  amending the public health law relating to regulating
   activities of physicians, in relation to the effectiveness of  certain
   provisions  thereof;  to  amend  the public health law, in relation to
   extending the demonstration period in certain physician committees; to
   amend chapter 505 of the laws of 1995, amending the public health  law
   relating  to  the  operation  of  department  of health facilities, in
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets

                       [ ] is old law to be omitted.
                                                            LBD12571-01-3
 S. 4007                             2                            A. 3007
 
   relation to the effectiveness thereof; to amend the public health law,
   in relation to reimbursement rate promulgation for residential  health
   care facilities; to amend the public health law, in relation to certi-
   fied  home health agency services payments; to amend chapter 19 of the
   laws of 1998, amending the social services law  relating  to  limiting
   the method of payment for prescription drugs under the medical assist-
   ance  program,  in relation to the effectiveness thereof; to amend the
   public health law,  in  relation  to  continuing  nursing  home  upper
   payment  limit  payments;  to  amend  chapter 904 of the laws of 1984,
   amending the public health law and the social services law relating to
   encouraging comprehensive health services, in relation to  the  effec-
   tiveness  thereof; to amend part X2 of chapter 62 of the laws of 2003,
   amending the public health law relating to allowing  for  the  use  of
   funds  of the office of professional medical conduct for activities of
   the patient health information and quality improvement act of 2000, in
   relation to  the  effectiveness  of  certain  provisions  relating  to
   increasing information available to patients; to amend part H of chap-
   ter 59 of the laws of 2011, amending the public health law relating to
   the statewide health information network of New York and the statewide
   planning  and  research  cooperative  system  and  general  powers and
   duties, in relation to making certain provisions permanent;  to  amend
   part  A  of chapter 58 of the laws of 2008, amending the elder law and
   other laws relating to reimbursement to participating provider pharma-
   cies and prescription drug coverage,  in  relation  to  extending  the
   expiration  of certain provisions thereof; to amend chapter 474 of the
   laws of 1996, amending the education law and other  laws  relating  to
   rates for residential health care facilities, in relation to extending
   the  effectiveness of certain provisions thereof;  to amend chapter 81
   of the laws of 1995, amending the public health  law  and  other  laws
   relating  to  medical reimbursement and welfare reform, in relation to
   extending the effectiveness of certain provisions  thereof;  to  amend
   the  social  services law, in relation to the effectiveness of certain
   provisions relating to negotiation of supplemental rebates relating to
   medication assisted treatment; to amend part B of chapter  57  of  the
   laws of 2015, amending the social services law and other laws relating
   to  supplemental rebates, in relation to the effectiveness thereof; to
   amend part KK of chapter 56 of the laws of 2020, amending  the  public
   health  law  relating to the designation of statewide general hospital
   quality and sole community pools and the reduction of capital  related
   inpatient expenses, in relation to the effectiveness thereof; to amend
   part C of chapter 60 of the laws of 2014, amending the social services
   law relating to fair hearings within the Fully Integrated Duals Advan-
   tage program, in relation to the effectiveness thereof; to amend chap-
   ter 779 of the laws of 1986, amending the social services law relating
   to  authorizing  services for non-residents in adult homes, residences
   for adults and enriched housing programs, in relation to extending the
   effectiveness of certain provisions thereof; to amend chapter  884  of
   the laws of 1990, amending the public health law relating to authoriz-
   ing  bad  debt  and  charity care allowances for certified home health
   agencies, in relation to extending the provisions  thereof;  to  amend
   chapter  81  of  the  laws of 1995, amending the public health law and
   other laws relating to medical reimbursement and  welfare  reform,  in
   relation  to  the effectiveness thereof; to amend part A of chapter 56
   of the laws of 2013, amending chapter 59 of the laws of 2011  amending
   the  public  health  law  and  other laws relating to general hospital
   reimbursement for annual rates, in relation  to  extending  government
 S. 4007                             3                            A. 3007
 
   rates  for behavioral services and adding an alternative payment meth-
   odology requirement; and to amend the public health law,  in  relation
   to  residential health care facility assessments; and to amend part MM
   of  chapter  57  of  the  laws  of 2021 amending the public health law
   relating to aiding in the transition to adulthood  for  children  with
   medical   fragility  living  in  pediatric  nursing  homes  and  other
   settings, in relation to the effectiveness thereof (Part B); to  amend
   part  A3  of chapter 62 of the laws of 2003 amending the general busi-
   ness law and other laws relating to enacting major  components  neces-
   sary  to  implement the state fiscal plan for the 2003-04 state fiscal
   year, in relation to extending the effectiveness of provisions  there-
   of;  to amend the New York Health Care Reform Act of 1996, in relation
   to extending certain provisions relating thereto;  to  amend  the  New
   York  Health  Care  Reform  Act  of 2000, in relation to extending the
   effectiveness of provisions thereof; to amend the public  health  law,
   in  relation  to extending certain provisions relating to the distrib-
   ution of pool allocations and graduate medical education; to amend the
   public health law, in relation to extending certain provisions  relat-
   ing  to health care initiative pool distributions; to amend the social
   services law, in relation to extending payment provisions for  general
   hospitals;  and to amend the public health law, in relation to extend-
   ing certain provisions relating to the assessments  on  covered  lives
   (Part  C); to amend the social services law, in relation to copayments
   for drugs; 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 D); to amend
   the public health law, in  relation  to  amending  and  extending  the
   voluntary  indigent  care  pool; in relation to establishing the defi-
   nition of rural emergency  hospital;  and  in  relation  to  expanding
   eligibility  for  vital access provider assurance program funding; and
   to amend Part I of chapter 57 of the laws of 2022 relating to  provid-
   ing a five percent across the board payment increase to all qualifying
   fee-for-service  Medicaid rates, in relation to Medicaid payments made
   for the operating component of hospital inpatient services  (Part  E);
   to  amend  chapter 266 of the laws of 1986 amending the civil practice
   law and rules and other laws relating to   malpractice   and   profes-
   sional medical  conduct, in relation to extending the effectiveness of
   certain provisions  thereof; 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,  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 F); to  amend  the  elder
   law,  in relation to programs for the aging (Part G); to amend section
   5 of part AAA of chapter 56 of the laws of 2022, amending  the  social
   services  law  relating to expanding Medicaid eligibility requirements
   for seniors and disabled individuals, in relation to the effectiveness
   of the basic health plan program; to amend the social services law, in
   relation to enacting the 1332 state innovation program; and  to  amend
   the  state  finance  law,  in  relation to establishing the 1332 state
   innovation program fund (Part H); to amend the public health  law,  in
   relation  to  extending authority to enroll certain recipients in need
   of more than 120 days of community based-long term care in  a  managed
 S. 4007                             4                            A. 3007
 
   long  term  care  plan; to amend the public health law, in relation to
   extending the moratorium on the processing and  approval  of  applica-
   tions  seeking  a certificate of authority as a managed long term care
   plan,  setting  performance standards for managed long term care plans
   and granting the commissioner of health the authority  to  procure  in
   the event the department of health determines that a sufficient number
   of  managed long term care plans have not met the enhanced performance
   standards; to amend the social services law,  in  relation  to  fiscal
   intermediaries;  to  amend  part  I  of chapter 57 of the laws of 2022
   providing a one percent across the board payment increase to all qual-
   ifying fee-for-service Medicaid rates, in  relation  to  providing  an
   additional  increase  to all qualifying fee-for-service Medicaid rates
   for the operating component  of  residential  health  care  facilities
   services  and an additional increase to all qualifying fee-for-service
   Medicaid  rates  for  the  operating  component  of  assisted   living
   programs;  to  amend  the  public health law, in relation to home care
   worker wage parity; to amend part H of chapter 59 of the laws of  2011
   amending  the  public  health law and other laws relating to known and
   projected department of health state  fund  medical  expenditures,  in
   relation  to  extending  the  provisions  thereof;  to  repeal certain
   provisions of  the  social  services  law  relating  to  the  consumer
   directed  personal assistance program; to amend the public health law,
   in relation to establishing the state supplemental premium  assistance
   for  consumer  directed  personal  assistants;  and to amend the state
   finance law, in relation to creating the  CDPAP  supplemental  premium
   assistance  fund  (Part  I); to amend the insurance law and the public
   health law, in  relation  to  insurer,  organization,  or  corporation
   review  of certain documentation for certain claims (Part J); to amend
   the social services law, in relation to authorizing Medicaid eligibil-
   ity for certain services provided to individuals who are in a  correc-
   tional  institution,  and for certain services provided to individuals
   who are in an institution for mental disease (Part K);  to  amend  the
   insurance  law, in relation to site of service review and coverage for
   services provided at hospital-based outpatient clinics  (Part  L);  to
   amend  the  public  health law, in relation to streamlining and adding
   criteria to the certificate of need process and to  review  and  over-
   sight  of material transactions (Part M); to amend the social services
   law, in relation to expanding the Medicaid Buy-In program  for  people
   with  disabilities  (Part  N);  to  amend  the  public  health law, in
   relation to prohibiting the sale or distribution of  flavored  tobacco
   products  (Part  O);  to  amend  the public health law, in relation to
   establishing a new statewide health care transformative program  (Part
   P);  to  amend  the  social  services law, in relation to establishing
   Medicaid reimbursement for community health workers (CHWs)  for  high-
   risk  populations;  and to amend the public health law, in relation to
   permitting licensed mental health counselors and licensed marriage and
   family therapists in community health centers to be  reimbursed  (Part
   Q);  to  amend  the  social services law and the public health law, in
   relation to expanding Medicaid coverage of  preventative  health  care
   services  (Part  R);  to amend the public health law and the education
   law, in relation to modernizing the  state  of  New  York's  emergency
   medical  system  and  workforce; and to repeal certain sections of the
   public health law relating thereto  (Part  S);  to  amend  the  public
   health law, in relation to lead testing in certain multiple dwellings;
   and to amend the executive law, in relation to expanding the powers of
   the secretary of state with respect to the New York state uniform fire
 S. 4007                             5                            A. 3007
 
   prevention  and  building code (Part T); to amend the general business
   law, in relation to safeguarding abortion access through data  privacy
   protection  (Part  U);  to  amend  the  education  law, in relation to
   authorizing  licensed pharmacists to prescribe and order self-adminis-
   tered hormonal contraceptives and emergency contraceptive drug therapy
   in accordance with standardized procedures or protocols developed  and
   approved  by  the  board  of pharmacy (Part V); to amend the education
   law, in relation to the provision of HIV pre-exposure prophylaxis;  to
   amend  the public health law and the education law, in relation to the
   administration of COVID-19 and influenza tests; to  amend  part  C  of
   chapter  57 of the laws of 2022 amending the public health law and the
   education law relating  to  allowing  pharmacists  to  direct  limited
   service  laboratories  and order and administer COVID-19 and influenza
   tests and modernizing nurse practitioners, in relation to  the  effec-
   tiveness  thereof;  to amend the education law and the social services
   law, in relation to the scope of practice of nurses  and  pharmacists;
   to  amend  the  education  law, in relation to authorizing dentists to
   offer HIV and hepatitis C screening and diagnostic tests; to amend the
   education law and the public health law, in relation to the  scope  of
   practice  of physician assistants; to amend chapter 471 of the laws of
   2016 amending the education law and the public health law relating  to
   authorizing  certain  advanced  home  health  aides to perform certain
   advanced tasks, in relation to the effectiveness thereof; to amend the
   education law, in relation to the  scope  of  practice  of  medication
   aides;  to amend the education law, in relation to enacting the inter-
   state medical licensure  compact;  to  amend  the  education  law,  in
   relation  to  enacting  the nurse licensure compact; and providing for
   the repeal of certain provisions upon the expiration thereof (Part W);
   to amend the public health law,  in  relation  to  providing  for  the
   registration  of  temporary health care services agencies (Part X); to
   amend the civil practice law and  rules  and  the  judiciary  law,  in
   relation  to affidavits for medical debt actions (Subpart A); to amend
   the insurance law, in relation to prescription drug price  and  supply
   chain transparency; and to amend the state finance law, in relation to
   funds  deposited  in  the  pharmacy  benefit  manager  regulatory fund
   (Subpart B); to amend the public health law, in relation to  requiring
   hospitals  participating in the general hospital indigent care pool to
   use certain forms for the collection of medical debt (Subpart C);  and
   to  amend the insurance law, in relation to guaranty fund coverage for
   insurers writing health insurance (Subpart D) (Part Y); to  amend  the
   public  health law and the social services law, in relation to quality
   improvement and increased consumer  transparency  in  assisted  living
   residences  (Part  Z);  to amend the public health law, in relation to
   hepatitis C screening and requiring third trimester syphilis  testing;
   and  to  amend  chapter  425  of the laws of 2013 amending  the public
   health law relating to requiring hospitals to offer hepatitis C  test-
   ing,  in  relation  to  making such provisions permanent (Part AA); to
   amend the public health law, in relation to  adding  certain  fentanyl
   analogs to the schedules of controlled substances; to amend the public
   health  law,  in  relation  to the definition of "imitation controlled
   substance"; to amend the penal law and the criminal procedure law,  in
   relation  to  criminal  possession  and  sale  of imitation controlled
   substances; and to repeal certain provisions of the public health  law
   relating  thereto (Part BB); to amend the public health law, the state
   finance law, the civil practice law and rules, the  limited  liability
   company  law,  the  partnership law, the correction law, the education
 S. 4007                             6                            A. 3007
 
   law, the executive law, the mental hygiene law,  the  penal  law,  the
   surrogate's court procedure act, the social services law, the workers'
   compensation  law, the cannabis law, the county law, the general busi-
   ness  law,  the  insurance  law, the labor law, the criminal procedure
   law, the business corporation law, the vehicle and  traffic  law,  the
   administrative code of the city of New York, the military law, and the
   tax  law,  in  relation  to  repealing  articles  governing healthcare
   professions in the education law and adding  such  provisions  to  the
   public  health  law and transferring all functions, powers, duties and
   obligations relating thereto; to  repeal  certain  provisions  of  the
   education  law  relating  thereto; and to repeal certain provisions of
   the public health law relating  thereto  (Part  CC);  in  relation  to
   establishing a cost of living adjustment for designated human services
   programs (Part DD); to amend part A of chapter 56 of the laws of 2013,
   amending  the  social services law and other laws relating to enacting
   the major components of legislation necessary to implement the  health
   and  mental  hygiene  budget  for  the 2013-2014 state fiscal year, in
   relation to the effectiveness of certain provisions thereof (Part EE);
   to amend the education law, in relation to expanding the   description
   of  certain services which are not prohibited  by  statutes  governing
   the practice of nursing (Part FF); to amend the mental hygiene law and
   the education law,  in  relation  to  credentialing  qualified  mental
   health  associates  (Part  GG);  to  amend  the mental hygiene law, in
   relation to certified community behavioral health clinics  (Part  HH);
   to amend the insurance law and the financial services law, in relation
   to  insurance  coverage for behavioral health services (Subpart A); to
   amend the insurance law and the public  health  law,  in  relation  to
   utilization  review  standards for mental health services (Subpart B);
   to amend the insurance law and the public health law, in  relation  to
   telehealth  payment parity (Subpart C); to amend the insurance law, in
   relation to private rights of action (Subpart D); to amend the  insur-
   ance law, in relation to substance use disorder treatment (Subpart E);
   and  to amend the insurance law and the public health law, in relation
   to network adequacy for  mental  health  and  substance  use  disorder
   services  (Subpart  F) (Part II); and to amend the mental hygiene law,
   in relation to the imposition of  sanctions  by  the  commissioner  of
   mental health (Part JJ)
 
   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 2023-2024 state fiscal year.  Each  component  is  wholly  contained
 within  a  Part identified as Parts A through JJ. 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. 4007                             7                            A. 3007
 
   Section  1.  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 general hospital reimbursement  for  annual  rates,  as
 amended  by  section  2  of part H of chapter 57 of the laws of 2022, is
 amended to read as follows:
   (a)  For  state  fiscal  years  2011-12 through [2023-24] 2024-25, 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.
   §  2.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2023.
 
                                  PART B
 
   Section 1. Subdivision 1 of section 20 of chapter 451 of the  laws  of
 2007  amending  the  public  health law, the social services law and the
 insurance law relating  to  providing  enhanced  consumer  and  provider
 protections,  as  amended by chapter 181 of the laws of 2021, is amended
 to read as follows:
   1. sections four, eleven and thirteen  of this act shall  take  effect
 immediately  and  shall  expire  and  be deemed repealed June 30, [2023]
 2025;
   § 2. Subdivision 6-a of section 93 of part C of chapter 58 of the laws
 of 2007, amending the social services law and  other  laws  relating  to
 adjustments of rates, as amended by section 2 of part T of chapter 57 of
 the laws of 2018, is amended to read as follows:
   6-a.  section  fifty-seven  of  this  act  shall  expire and be deemed
 repealed [on March 31, 2023] MARCH 31, 2028; provided  that  the  amend-
 ments  made  by  such  section  to subdivision 4 of section 366-c of the
 social services law shall apply with respect to determining initial  and
 continuing  eligibility  for medical assistance, including the continued
 eligibility of recipients originally determined eligible  prior  to  the
 effective  date  of  this act, and provided further that such amendments
 shall not apply to any person or group of persons if it is  subsequently
 determined  by  the  Centers  for Medicare and Medicaid services or by a
 court of competent jurisdiction that  medical  assistance  with  federal
 financial  participation is available for the costs of services provided
 to such person or persons under  the  provisions  of  subdivision  4  of
 section  366-c of the social services law in effect immediately prior to
 the effective date of this act.
   § 3. Section 3 of chapter 906 of the laws of 1984, amending the social
 services law relating to expanding medical  assistance  eligibility  and
 the scope of services available to certain persons with disabilities, as
 amended  by  section  4  of part T of chapter 57 of the laws of 2018, is
 amended to read as follows:
   § 3. This act shall take effect on the thirtieth day  after  it  shall
 have  become  a  law  and  shall be of no further force and effect after
 [March 31, 2023] MARCH 31, 2028, at which time the  provisions  of  this
 act shall be deemed to be repealed.
   §  4.  Subparagraph (i) of paragraph b of subdivision 6 of section 366
 of the social services law, as amended by chapter 389  of  the  laws  of
 2008, is amended to read as follows:
   (i) be [eighteen] TWENTY-ONE years of age or under;
 S. 4007                             8                            A. 3007
 
   §  5.  Subparagraph (i) 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:
   (i) be [eighteen] TWENTY-ONE years of age or under;
   §  6.  Subparagraph (i) 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:
   (i) be under [eighteen] TWENTY-ONE years of age;
   § 7. Section 2 of chapter 313 of the laws of 2018, amending the public
 health law relating to body imaging scanning equipment,  is  amended  to
 read as follows:
   § 2. This act shall take effect on the one hundred twentieth day after
 it  shall  have  become  a law; provided, however, that, effective imme-
 diately, the addition, amendment, and/or repeal of any rules  and  regu-
 lations  necessary to implement the provisions of this act on its effec-
 tive date are directed to be completed on or before such effective date;
 and provided further, that this act shall expire and be deemed  repealed
 [five years after such effective date] JANUARY 30, 2029.
   § 8. Section 5 of chapter 426 of the laws of 1983, amending the public
 health  law  relating to professional misconduct proceedings, as amended
 by chapter 106 of the laws of 2018, is amended to read as follows:
   § 5. This act shall take effect June 1, 1983 and shall remain in  full
 force and effect until July 1, [2023] 2033.
   § 9. Section 5 of chapter 582 of the laws of 1984, amending the public
 health  law  relating to regulating activities of physicians, as amended
 by chapter 106 of the laws of 2018, is amended to read as follows:
   § 5. This act shall take effect immediately, provided however that the
 provisions of this act shall remain in full force and effect until  July
 1,  [2023] 2033 at which time the provisions of this act shall be deemed
 to be repealed.
   § 10. Subparagraph (ii) of paragraph (c) of subdivision 11 of  section
 230  of  the public health law, as amended by chapter 106 of the laws of
 2018, is amended to read as follows:
   (ii) Participation and membership during a  three  year  demonstration
 period  in  a physician committee of the Medical Society of the State of
 New York or the New York State Osteopathic Society whose purpose  is  to
 confront and refer to treatment physicians who are thought to be suffer-
 ing  from  alcoholism, drug abuse, or mental illness. Such demonstration
 period shall commence on April first, nineteen hundred eighty and termi-
 nate on May thirty-first, nineteen hundred eighty-three.  An  additional
 demonstration  period  shall  commence  on  June first, nineteen hundred
 eighty-three and  terminate  on  March  thirty-first,  nineteen  hundred
 eighty-six.  An  additional demonstration period shall commence on April
 first, nineteen hundred eighty-six and terminate on March  thirty-first,
 nineteen  hundred  eighty-nine. An additional demonstration period shall
 commence April first, nineteen hundred eighty-nine and  terminate  March
 thirty-first,  nineteen  hundred ninety-two. An additional demonstration
 period shall commence  April  first,  nineteen  hundred  ninety-two  and
 terminate  March  thirty-first,  nineteen  hundred ninety-five. An addi-
 tional demonstration period shall  commence  on  April  first,  nineteen
 hundred  ninety-five  and  terminate  on  March  thirty-first,  nineteen
 hundred ninety-eight. An additional demonstration period shall  commence
 on  April  first,  nineteen  hundred ninety-eight and terminate on March
 thirty-first, two thousand three.  An  additional  demonstration  period
 shall commence on April first, two thousand three and terminate on March
 thirty-first,  two thousand thirteen. An additional demonstration period
 S. 4007                             9                            A. 3007
 
 shall commence April first, two thousand thirteen and terminate on March
 thirty-first, two thousand eighteen. An additional demonstration  period
 shall  commence April first, two thousand eighteen and terminate on July
 first,  two thousand [twenty-three] THIRTY-THREE provided, however, that
 the commissioner may prescribe requirements for the continuation of such
 demonstration program, including periodic reviews of such  programs  and
 submission  of  any  reports  and data necessary to permit such reviews.
 During these additional periods, the  provisions  of  this  subparagraph
 shall also apply to a physician committee of a county medical society.
   §  11.  Section  4  of  chapter  505 of the laws of 1995, amending the
 public health law relating to the  operation  of  department  of  health
 facilities,  as amended by section 1 of part E of chapter 57 of the laws
 of 2019, is amended to read as follows:
   § 4. This act shall take effect immediately; provided,  however,  that
 the provisions of paragraph (b) of subdivision 4 of section 409-c of the
 public  health  law,  as  added by section three of this act, shall take
 effect January 1, 1996 and shall expire and be deemed repealed  [twenty-
 eight years from the effective date thereof] MARCH 31, 2028.
   §  12.  Paragraph  (b) of subdivision 17 of section 2808 of the public
 health law, as amended by section 15 of part E of chapter 57 of the laws
 of 2019, is amended to read as follows:
   (b) Notwithstanding any inconsistent provision of law or regulation to
 the contrary, for the state fiscal  years  beginning  April  first,  two
 thousand  ten and ending March thirty-first, two thousand [twenty-three]
 TWENTY-SEVEN, the commissioner shall not be required to revise certified
 rates of payment established pursuant to this article for  rate  periods
 prior to April first, two thousand [twenty-three] TWENTY-SEVEN, based on
 consideration  of  rate appeals filed by residential health care facili-
 ties or based upon adjustments to capital cost reimbursement as a result
 of approval by the commissioner of an application for construction under
 section twenty-eight hundred two of this article, in excess of an aggre-
 gate annual amount of eighty million dollars for each such state  fiscal
 year  provided,  however,  that for the period April first, two thousand
 eleven through March thirty-first, two thousand  twelve  such  aggregate
 annual  amount  shall  be  fifty million dollars. In revising such rates
 within such fiscal limit, the commissioner shall, in  prioritizing  such
 rate appeals, include consideration of which facilities the commissioner
 determines  are  facing  significant  financial hardship as well as such
 other considerations as the commissioner deems appropriate and, further,
 the commissioner is authorized to enter into agreements with such facil-
 ities or any other facility to resolve  multiple  pending  rate  appeals
 based  upon a negotiated aggregate amount and may offset such negotiated
 aggregate amounts against any  amounts  owed  by  the  facility  to  the
 department,  including,  but  not  limited  to, amounts owed pursuant to
 section twenty-eight hundred seven-d of this article; provided, however,
 that the commissioner's authority to negotiate such agreements resolving
 multiple pending rate appeals as hereinbefore described  shall  continue
 on and after April first, two thousand [twenty-three] TWENTY-SEVEN. Rate
 adjustments  made  pursuant  to  this  paragraph remain fully subject to
 approval by the director of the budget in accordance with the provisions
 of subdivision two of section twenty-eight hundred seven of  this  arti-
 cle.
   §  13.  Paragraph  (a) of subdivision 13 of section 3614 of the public
 health law, as amended by section 16 of part E of chapter 57 of the laws
 of 2019, is amended to read as follows:
 S. 4007                            10                            A. 3007
 
   (a) Notwithstanding any inconsistent provision of  law  or  regulation
 and  subject  to  the  availability  of federal financial participation,
 effective April first, two thousand twelve through  March  thirty-first,
 two  thousand  [twenty-three] TWENTY-SEVEN, payments by government agen-
 cies for services provided by certified home health agencies, except for
 such services provided to children under eighteen years of age and other
 discreet  groups  as  may  be determined by the commissioner pursuant to
 regulations, shall be based on episodic payments. In  establishing  such
 payments, a statewide base price shall be established for each sixty day
 episode  of  care  and  adjusted  by a regional wage index factor and an
 individual patient case mix index. Such episodic payments may be further
 adjusted for low utilization cases and to reflect a  percentage  limita-
 tion  of the cost for high-utilization cases that exceed outlier thresh-
 olds of such payments.
   § 14. Section 4 of chapter 19 of the laws of 1998, amending the social
 services law relating to limiting the method of payment for prescription
 drugs under the medical assistance program, as amended by section  2  of
 part  BB  of  chapter  56  of  the  laws  of 2020, is amended to read as
 follows:
   § 4. This act shall take effect 120 days after it shall have become  a
 law and shall expire and be deemed repealed March 31, [2023] 2026.
   §  15. Paragraph (e-1) of subdivision 12 of section 2808 of the public
 health law, as amended by section 3 of part BB of chapter 56 of the laws
 of 2020, is amended to read as follows:
   (e-1) Notwithstanding any inconsistent provision of law or regulation,
 the commissioner shall provide,  in  addition  to  payments  established
 pursuant  to  this  article  prior to application of this section, addi-
 tional payments under the medical assistance program pursuant  to  title
 eleven of article five of the social services law for non-state operated
 public  residential health care facilities, including public residential
 health care facilities located in the county of Nassau,  the  county  of
 Westchester  and  the  county  of Erie, but excluding public residential
 health care facilities operated by a town or city within  a  county,  in
 aggregate  annual  amounts of up to one hundred fifty million dollars in
 additional payments for the state fiscal year beginning April first, two
 thousand six and for the state fiscal year beginning  April  first,  two
 thousand  seven and for the state fiscal year beginning April first, two
 thousand eight and of up to three hundred million dollars in such aggre-
 gate annual additional payments for  the  state  fiscal  year  beginning
 April  first, two thousand nine, and for the state fiscal year beginning
 April first, two thousand ten and for the state  fiscal  year  beginning
 April  first, two thousand eleven, and for the state fiscal years begin-
 ning April first, two thousand twelve  and  April  first,  two  thousand
 thirteen,  and  of  up to five hundred million dollars in such aggregate
 annual additional payments for the state fiscal  years  beginning  April
 first,  two  thousand  fourteen,  April  first, two thousand fifteen and
 April first, two thousand sixteen and of  up  to  five  hundred  million
 dollars  in  such  aggregate  annual  additional  payments for the state
 fiscal years beginning April first, two thousand seventeen, April first,
 two thousand eighteen, and April first, two thousand nineteen, and of up
 to five hundred million dollars  in  such  aggregate  annual  additional
 payments  for the state fiscal years beginning April first, two thousand
 twenty, April first, two thousand twenty-one, and April first, two thou-
 sand twenty-two, AND OF UP TO  FIVE  HUNDRED  MILLION  DOLLARS  IN  SUCH
 AGGREGATE  ANNUAL  ADDITIONAL PAYMENTS FOR THE STATE FISCAL YEARS BEGIN-
 NING APRIL FIRST, TWO THOUSAND TWENTY-THREE, APRIL FIRST,  TWO  THOUSAND
 S. 4007                            11                            A. 3007
 
 TWENTY-FOUR, AND APRIL FIRST, TWO THOUSAND TWENTY-FIVE. The amount allo-
 cated  to each eligible public residential health care facility for this
 period shall be computed in accordance with the provisions of  paragraph
 (f)  of  this subdivision, provided, however, that patient days shall be
 utilized for such computation reflecting actual reported  data  for  two
 thousand  three  and  each representative succeeding year as applicable,
 and provided further,  however,  that,  in  consultation  with  impacted
 providers,  of  the funds allocated for distribution in the state fiscal
 year beginning April first, two  thousand  thirteen,  up  to  thirty-two
 million  dollars  may be allocated in accordance with paragraph (f-1) of
 this subdivision.
   § 16. Section 18 of chapter 904 of the  laws  of  1984,  amending  the
 public  health  law  and the social services law relating to encouraging
 comprehensive health services, as amended by section 4  of  part  BB  of
 chapter 56 of the laws of 2020, is amended to read as follows:
   §  18.  This  act  shall take effect immediately, except that sections
 six, nine, ten and eleven of this act shall take effect on the  sixtieth
 day after it shall have become a law, sections two, three, four and nine
 of  this  act  shall  expire  and be of no further force or effect on or
 after March 31, [2023] 2026, section two of this act shall  take  effect
 on  April  1,  1985 or seventy-five days following the submission of the
 report required by section one of this  act,  whichever  is  later,  and
 sections  eleven  and  thirteen  of  this  act shall expire and be of no
 further force or effect on or after March 31, 1988.
   § 17. Section 4 of part X2 of chapter 62 of the laws of 2003, amending
 the public health law relating to allowing for the use of funds  of  the
 office  of  professional  medical  conduct for activities of the patient
 health information and quality improvement act of 2000,  as  amended  by
 section  5  of  part BB of chapter 56 of the laws of 2020, is amended to
 read as follows:
   § 4. This act  shall  take  effect  immediately[;  provided  that  the
 provisions  of  section  one of this act shall be deemed to have been in
 full force and effect on and after April 1, 2003, and shall expire March
 31, 2023 when upon such date the provisions of  such  section  shall  be
 deemed repealed].
   §  18.  Subdivision  (o) of section 111 of part H of chapter 59 of the
 laws of 2011, amending the public health law relating to  the  statewide
 health  information  network  of New York and the statewide planning and
 research cooperative system and general powers and duties, as amended by
 section 6 of part BB of chapter 56 of the laws of 2020,  is  amended  to
 read as follows:
   [(o) sections thirty-eight and thirty-eight-a of this act shall expire
 and be deemed repealed March 31, 2023;]
   § 19. Section 32 of part A of chapter 58 of the laws of 2008, amending
 the  elder law and other laws relating to reimbursement to participating
 provider pharmacies  and  prescription  drug  coverage,  as  amended  by
 section  7  of  part BB of chapter 56 of the laws of 2020, is amended to
 read as follows:
   § 32. This act shall take effect immediately and shall  be  deemed  to
 have  been in full force and effect on and after April 1, 2008; provided
 however, that sections one, six-a, nineteen,  twenty,  twenty-four,  and
 twenty-five of this act shall take effect July 1, 2008; provided however
 that  sections  sixteen, seventeen and eighteen of this act shall expire
 April 1, [2023] 2026; provided, however, that  the  amendments  made  by
 section  twenty-eight  of this act shall take effect on the same date as
 section 1 of chapter 281 of the laws  of  2007  takes  effect;  provided
 S. 4007                            12                            A. 3007
 
 further,  that  sections twenty-nine, thirty, and thirty-one of this act
 shall take effect October 1, 2008; provided further, that section  twen-
 ty-seven  of  this  act  shall take effect January 1, 2009; and provided
 further,  that  section  twenty-seven  of  this  act shall expire and be
 deemed repealed March 31, [2023] 2026; and provided,  further,  however,
 that the amendments to subdivision 1 of section 241 of the education law
 made  by section twenty-nine of this act shall not affect the expiration
 of such subdivision and shall be deemed to expire therewith and provided
 that the amendments to section 272 of the  public  health  law  made  by
 section  thirty  of this act shall not affect the repeal of such section
 and shall be deemed repealed therewith.
   § 20. Section 228 of chapter 474 of the laws  of  1996,  amending  the
 education  law  and  other laws relating to rates for residential health
 care facilities, as amended by section 12 of part BB of  chapter  56  of
 the laws of 2020, is amended to read as follows:
   §  228.  1.  Definitions.  (a)  Regions, for purposes of this section,
 shall mean a downstate region to consist of Kings, New  York,  Richmond,
 Queens,  Bronx,  Nassau  and  Suffolk  counties and an upstate region to
 consist of all other New York state counties. A  certified  home  health
 agency  or  long  term  home health care program shall be located in the
 same county utilized by the commissioner of health for the establishment
 of rates pursuant to article 36 of the public health law.
   (b) Certified home health  agency  (CHHA)  shall  mean  such  term  as
 defined in section 3602 of the public health law.
   (c)  Long  term home health care program (LTHHCP) shall mean such term
 as defined in subdivision 8 of section 3602 of the public health law.
   (d) Regional group shall mean all those CHHAs and LTHHCPs, respective-
 ly, located within a region.
   (e) Medicaid revenue percentage, for purposes of this  section,  shall
 mean  CHHA  and  LTHHCP  revenues  attributable  to services provided to
 persons eligible for payments pursuant to title 11 of article 5  of  the
 social services law divided by such revenues plus CHHA and LTHHCP reven-
 ues attributable to services provided to beneficiaries of Title XVIII of
 the federal social security act (medicare).
   (f)  Base  period,  for  purposes of this section, shall mean calendar
 year 1995.
   (g) Target period. For purposes of this section, the 1996 target peri-
 od shall mean August 1, 1996 through March 31,  1997,  the  1997  target
 period  shall  mean  January 1, 1997 through November 30, 1997, the 1998
 target period shall mean January 1, 1998 through November 30, 1998,  the
 1999 target period shall mean January 1, 1999 through November 30, 1999,
 the  2000  target period shall mean January 1, 2000 through November 30,
 2000, the 2001 target period shall mean January 1, 2001 through November
 30, 2001, the 2002 target period shall  mean  January  1,  2002  through
 November  30,  2002,  the  2003 target period shall mean January 1, 2003
 through November 30, 2003, the 2004 target period shall mean January  1,
 2004  through  November  30, 2004, and the 2005 target period shall mean
 January 1, 2005 through November 30, 2005, the 2006 target period  shall
 mean  January  1,  2006  through  November 30, 2006, and the 2007 target
 period shall mean January 1, 2007 through November 30, 2007 and the 2008
 target period shall mean January 1, 2008 through November 30, 2008,  and
 the  2009  target period shall mean January 1, 2009 through November 30,
 2009 and the 2010 target period  shall  mean  January  1,  2010  through
 November  30, 2010 and the 2011 target period shall mean January 1, 2011
 through November 30, 2011 and the 2012 target period shall mean  January
 1,  2012 through November 30, 2012 and the 2013 target period shall mean
 S. 4007                            13                            A. 3007
 
 January 1, 2013 through November 30, 2013, and the  2014  target  period
 shall mean January 1, 2014 through November 30, 2014 and the 2015 target
 period shall mean January 1, 2015 through November 30, 2015 and the 2016
 target  period  shall mean January 1, 2016 through November 30, 2016 and
 the 2017 target period shall mean January 1, 2017 through  November  30,
 2017  and  the  2018  target  period  shall mean January 1, 2018 through
 November 30, 2018 and the 2019 target period shall mean January 1,  2019
 through  November 30, 2019 and the 2020 target period shall mean January
 1, 2020 through November 30, 2020[,] and the 2021  target  period  shall
 mean January 1, 2021 through November 30, 2021 and the 2022 target peri-
 od  shall  mean  January  1, 2022 through November 30, 2022 and the 2023
 target period shall mean January 1, 2023 through November 30,  2023  AND
 THE  2024  TARGET PERIOD SHALL MEAN JANUARY 1, 2024 THROUGH NOVEMBER 30,
 2024 AND THE 2025 TARGET PERIOD  SHALL  MEAN  JANUARY  1,  2025  THROUGH
 NOVEMBER  30, 2025 AND THE 2026 TARGET PERIOD SHALL MEAN JANUARY 1, 2026
 THROUGH NOVEMBER 30, 2026 AND THE 2027 TARGET PERIOD SHALL MEAN  JANUARY
 1, 2027 THROUGH NOVEMBER 30, 2027.
   2.  (a) Prior to February 1, 1997, for each regional group the commis-
 sioner of health shall calculate the 1996 medicaid  revenue  percentages
 for the period commencing August 1, 1996 to the last date for which such
 data is available and reasonably accurate.
   (b)  Prior  to  February  1, 1998, prior to February 1, 1999, prior to
 February 1, 2000, prior to February 1, 2001, prior to February 1,  2002,
 prior  to February 1, 2003, prior to February 1, 2004, prior to February
 1, 2005, prior to February 1, 2006, prior to February 1, 2007, prior  to
 February  1, 2008, prior to February 1, 2009, prior to February 1, 2010,
 prior to February 1, 2011, prior to February 1, 2012, prior to  February
 1,  2013, prior to February 1, 2014, prior to February 1, 2015, prior to
 February 1, 2016, prior to February 1, 2017, prior to February 1,  2018,
 prior  to February 1, 2019, prior to February 1, 2020, prior to February
 1, 2021, prior to February 1, 2022, [and] prior  to  February  1,  2023,
 PRIOR  TO FEBRUARY 1, 2024, PRIOR TO FEBRUARY 1, 2025, PRIOR TO FEBRUARY
 1, 2026 AND PRIOR TO FEBRUARY  1,  2027  for  each  regional  group  the
 commissioner of health shall calculate the prior year's medicaid revenue
 percentages  for  the period commencing January 1 through November 30 of
 such prior year.
   3. By September 15, 1996, for each regional group the commissioner  of
 health shall calculate the base period medicaid revenue percentage.
   4.  (a)  For  each  regional  group,  the 1996 target medicaid revenue
 percentage shall be calculated by subtracting the 1996 medicaid  revenue
 reduction percentages from the base period medicaid revenue percentages.
 The  1996  medicaid  revenue  reduction  percentage, taking into account
 regional and program differences in utilization of medicaid and medicare
 services, for the following regional groups shall be equal to:
   (i) one and one-tenth percentage points for CHHAs located  within  the
 downstate region;
   (ii)  six-tenths  of one percentage point for CHHAs located within the
 upstate region;
   (iii) one and eight-tenths percentage points for LTHHCPs located with-
 in the downstate region; and
   (iv) one and seven-tenths percentage points for LTHHCPs located within
 the upstate region.
   (b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004,  2005,  2006,  2007,
 2008,  2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019,
 2020, 2021, 2022 [and],  2023,  2024,  2025,  2026  AND  2027  for  each
 regional  group,  the target medicaid revenue percentage for the respec-
 S. 4007                            14                            A. 3007
 
 tive year shall be calculated by subtracting the respective year's medi-
 caid revenue reduction percentage from the base period medicaid  revenue
 percentage.  The  medicaid revenue reduction percentages for 1997, 1998,
 2000,  2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011,
 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020, 2021, 2022  [and],
 2023,  2024,  2025,  2026  AND  2027,  taking  into account regional and
 program differences in utilization of medicaid  and  medicare  services,
 for the following regional groups shall be equal to for each such year:
   (i)  one  and one-tenth percentage points for CHHAs located within the
 downstate region;
   (ii) six-tenths of one percentage point for CHHAs located  within  the
 upstate region;
   (iii) one and eight-tenths percentage points for LTHHCPs located with-
 in the downstate region; and
   (iv) one and seven-tenths percentage points for LTHHCPs located within
 the upstate region.
   (c) For each regional group, the 1999 target medicaid revenue percent-
 age  shall  be  calculated  by  subtracting  the  1999  medicaid revenue
 reduction percentage from the base period medicaid  revenue  percentage.
 The  1999  medicaid  revenue  reduction percentages, taking into account
 regional and program differences in utilization of medicaid and medicare
 services, for the following regional groups shall be equal to:
   (i) eight hundred twenty-five thousandths  (.825)  of  one  percentage
 point for CHHAs located within the downstate region;
   (ii)  forty-five  hundredths  (.45)  of one percentage point for CHHAs
 located within the upstate region;
   (iii) one and thirty-five  hundredths  percentage  points  (1.35)  for
 LTHHCPs located within the downstate region; and
   (iv)  one  and  two hundred seventy-five thousandths percentage points
 (1.275) for LTHHCPs located within the upstate region.
   5. (a) For each regional group, if the 1996 medicaid revenue  percent-
 age  is  not  equal  to  or  less  than the 1996 target medicaid revenue
 percentage, the commissioner of health shall compare the  1996  medicaid
 revenue  percentage  to  the  1996 target medicaid revenue percentage to
 determine the amount of the shortfall which, when divided  by  the  1996
 medicaid   revenue  reduction  percentage,  shall  be  called  the  1996
 reduction factor. These amounts, expressed as a  percentage,  shall  not
 exceed  one  hundred percent. If the 1996 medicaid revenue percentage is
 equal to or less than the 1996 target medicaid revenue  percentage,  the
 1996 reduction factor shall be zero.
   (b)  For  1997,  1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016, 2017,  2018,
 2019,  2020, 2021, 2022 [and], 2023, 2024, 2025, 2026 AND 2027, for each
 regional group, if the medicaid revenue percentage  for  the  respective
 year is not equal to or less than the target medicaid revenue percentage
 for  such respective year, the commissioner of health shall compare such
 respective year's medicaid revenue percentage to such respective  year's
 target medicaid revenue percentage to determine the amount of the short-
 fall  which,  when  divided  by  the  respective year's medicaid revenue
 reduction percentage, shall be called  the  reduction  factor  for  such
 respective  year.  These  amounts,  expressed as a percentage, shall not
 exceed one hundred percent. If the medicaid  revenue  percentage  for  a
 particular  year  is  equal  to or less than the target medicaid revenue
 percentage for that year, the reduction factor for that  year  shall  be
 zero.
 S. 4007                            15                            A. 3007
 
   6.  (a)  For  each  regional group, the 1996 reduction factor shall be
 multiplied by the following amounts to determine each  regional  group's
 applicable 1996 state share reduction amount:
   (i) two million three hundred ninety thousand dollars ($2,390,000) for
 CHHAs located within the downstate region;
   (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
 within the upstate region;
   (iii)  one  million  two hundred seventy thousand dollars ($1,270,000)
 for LTHHCPs located within the downstate region; and
   (iv) five hundred  ninety  thousand  dollars  ($590,000)  for  LTHHCPs
 located within the upstate region.
   For  each regional group reduction, if the 1996 reduction factor shall
 be zero, there shall be no 1996 state share reduction amount.
   (b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004,  2005,  2006,  2007,
 2008,  2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019,
 2020, 2021, 2022 [and], 2023,  2024,  2025,  2026  AND  2027,  for  each
 regional  group,  the  reduction factor for the respective year shall be
 multiplied by the following amounts to determine each  regional  group's
 applicable state share reduction amount for such respective year:
   (i) two million three hundred ninety thousand dollars ($2,390,000) for
 CHHAs located within the downstate region;
   (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
 within the upstate region;
   (iii)  one  million  two hundred seventy thousand dollars ($1,270,000)
 for LTHHCPs located within the downstate region; and
   (iv) five hundred  ninety  thousand  dollars  ($590,000)  for  LTHHCPs
 located within the upstate region.
   For  each  regional  group  reduction,  if  the reduction factor for a
 particular year shall be zero, there shall be no state  share  reduction
 amount for such year.
   (c) For each regional group, the 1999 reduction factor shall be multi-
 plied by the following amounts to determine each regional group's appli-
 cable 1999 state share reduction amount:
   (i) one million seven hundred ninety-two thousand five hundred dollars
 ($1,792,500) for CHHAs located within the downstate region;
   (ii)  five  hundred sixty-two thousand five hundred dollars ($562,500)
 for CHHAs located within the upstate region;
   (iii) nine hundred fifty-two thousand five hundred dollars  ($952,500)
 for LTHHCPs located within the downstate region; and
   (iv)  four  hundred forty-two thousand five hundred dollars ($442,500)
 for LTHHCPs located within the upstate region.
   For each regional group reduction, if the 1999 reduction factor  shall
 be zero, there shall be no 1999 state share reduction amount.
   7.  (a) For each regional group, the 1996 state share reduction amount
 shall be allocated by the commissioner of health among CHHAs and LTHHCPs
 on the basis of the extent  of  each  CHHA's  and  LTHHCP's  failure  to
 achieve  the  1996  target  medicaid revenue percentage, calculated on a
 provider specific basis utilizing revenues for this  purpose,  expressed
 as  a  proportion  of  the  total of each CHHA's and LTHHCP's failure to
 achieve the 1996 target medicaid revenue percentage within the  applica-
 ble  regional group. This proportion shall be multiplied by the applica-
 ble 1996 state share reduction amount calculation pursuant to  paragraph
 (a)  of  subdivision  6 of this section. This amount shall be called the
 1996 provider specific state share reduction amount.
   (b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003,  2004,  2005,  2006,
 2007,  2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018,
 S. 4007                            16                            A. 3007
 
 2019, 2020, 2021, 2022 [and], 2023, 2024, 2025, 2026 AND 2027  for  each
 regional group, the state share reduction amount for the respective year
 shall be allocated by the commissioner of health among CHHAs and LTHHCPs
 on  the  basis  of  the  extent  of  each CHHA's and LTHHCP's failure to
 achieve the target medicaid revenue percentage for the applicable  year,
 calculated  on  a  provider  specific  basis utilizing revenues for this
 purpose, expressed as a proportion of  the  total  of  each  CHHA's  and
 LTHHCP's  failure  to achieve the target medicaid revenue percentage for
 the applicable year within the applicable regional group.  This  propor-
 tion  shall be multiplied by the applicable year's state share reduction
 amount calculation pursuant to paragraph (b) or (c) of subdivision 6  of
 this  section.  This  amount shall be called the provider specific state
 share reduction amount for the applicable year.
   8. (a) The 1996 provider specific state share reduction  amount  shall
 be due to the state from each CHHA and LTHHCP and may be recouped by the
 state  by  March  31, 1997 in a lump sum amount or amounts from payments
 due to the CHHA and LTHHCP pursuant to title 11  of  article  5  of  the
 social services law.
   (b) The provider specific state share reduction amount for 1997, 1998,
 1999,  2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010,
 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020,  2021,  2022
 [and], 2023, 2024, 2025, 2026 AND 2027 respectively, shall be due to the
 state  from  each  CHHA and LTHHCP and each year the amount due for such
 year may be recouped by the state by March 31 of the following year in a
 lump sum amount or amounts from payments due  to  the  CHHA  and  LTHHCP
 pursuant to title 11 of article 5 of the social services law.
   9.  CHHAs  and  LTHHCPs shall submit such data and information at such
 times as the commissioner of health may require  for  purposes  of  this
 section.  The  commissioner of health may use data available from third-
 party payors.
   10. On or about June 1, 1997, for each regional group the commissioner
 of health shall calculate for the period August 1,  1996  through  March
 31,  1997  a  medicaid  revenue  percentage, a reduction factor, a state
 share reduction amount, and a provider specific  state  share  reduction
 amount  in  accordance with the methodology provided in paragraph (a) of
 subdivision 2, paragraph (a) of subdivision 5, paragraph (a) of subdivi-
 sion 6 and paragraph (a) of subdivision 7 of this section. The  provider
 specific state share reduction amount calculated in accordance with this
 subdivision  shall be compared to the 1996 provider specific state share
 reduction amount calculated in accordance with paragraph (a) of subdivi-
 sion 7 of this section. Any amount in excess of the amount determined in
 accordance with paragraph (a) of subdivision 7 of this section shall  be
 due  to  the  state  from  each  CHHA  and LTHHCP and may be recouped in
 accordance with paragraph (a) of subdivision 8 of this section.  If  the
 amount  is  less than the amount determined in accordance with paragraph
 (a) of subdivision 7 of this section, the difference shall  be  refunded
 to  the  CHHA and LTHHCP by the state no later than July 15, 1997. CHHAs
 and LTHHCPs shall submit data for the  period  August  1,  1996  through
 March 31, 1997 to the commissioner of health by April 15, 1997.
   11.  If  a  CHHA  or  LTHHCP  fails  to submit data and information as
 required for purposes of this section:
   (a) such CHHA or LTHHCP shall be presumed to have no decrease in medi-
 caid revenue percentage between  the  applicable  base  period  and  the
 applicable  target  period  for purposes of the calculations pursuant to
 this section; and
 S. 4007                            17                            A. 3007
 
   (b) the commissioner of health shall reduce the current rate  paid  to
 such  CHHA  and  such  LTHHCP by state governmental agencies pursuant to
 article 36 of the public health law by one percent for a  period  begin-
 ning on the first day of the calendar month following the applicable due
 date  as  established by the commissioner of health and continuing until
 the last day of the calendar month in which the required data and infor-
 mation are submitted.
   12. The commissioner of health shall inform in writing the director of
 the budget and the chair of the senate finance committee and  the  chair
 of  the  assembly  ways and means committee of the results of the calcu-
 lations pursuant to this section.
   § 21. Paragraph (f) of subdivision 1 of section 64 of  chapter  81  of
 the laws of 1995, amending the public health law and other laws relating
 to medical reimbursement and welfare reform, as amended by section 13 of
 part  BB  of  chapter  56  of  the  laws  of 2020, is amended to read as
 follows:
   (f) Prior to February 1, 2001, February 1,  2002,  February  1,  2003,
 February  1, 2004, February 1, 2005, February 1, 2006, February 1, 2007,
 February 1, 2008, February 1, 2009, February 1, 2010, February 1,  2011,
 February  1, 2012, February 1, 2013, February 1, 2014, February 1, 2015,
 February 1, 2016, February 1, 2017, February 1, 2018, February 1,  2019,
 February  1, 2020, February 1, 2021, February 1, 2022 [and], February 1,
 2023, FEBRUARY 1, 2024, FEBRUARY 1,  2025  AND  FEBRUARY  1,  2026,  the
 commissioner of health shall calculate the result of the statewide total
 of  residential  health care facility days of care provided to benefici-
 aries of title XVIII of the  federal  social  security  act  (medicare),
 divided  by  the  sum of such days of care plus days of care provided to
 residents eligible for payments pursuant to title 11 of article 5 of the
 social services law minus the  number  of  days  provided  to  residents
 receiving  hospice  care,  expressed  as  a  percentage,  for the period
 commencing January 1, through November 30, of the prior year respective-
 ly, based on such data for such period. This value shall be  called  the
 2000,  2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011,
 2012, 2013, 2014, 2015, 2016, 2017, 2018,  2019, 2020, 2021, 2022 [and],
 2023, 2024, 2025 AND 2026 statewide target percentage respectively.
   § 22. Subparagraph (ii) of paragraph (b) of subdivision 3  of  section
 64 of chapter 81 of the laws of 1995, amending the public health law and
 other  laws  relating  to  medical  reimbursement and welfare reform, as
 amended by section 14 of part BB of chapter 56 of the laws of  2020,  is
 amended to read as follows:
   (ii)  If  the  1997,  1998,  2000, 2001, 2002, 2003, 2004, 2005, 2006,
 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016, 2017,  2018,
 2019, 2020, 2021, 2022 [and], 2023, 2024, 2025 AND 2026 statewide target
 percentages are not for each year at least three percentage points high-
 er  than the statewide base percentage, the commissioner of health shall
 determine the percentage by which the statewide  target  percentage  for
 each year is not at least three percentage points higher than the state-
 wide  base  percentage. The percentage calculated pursuant to this para-
 graph shall be called the 1997, 1998,  2000,  2001,  2002,  2003,  2004,
 2005,  2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016,
 2017, 2018, 2019, 2020, 2021, 2022 [and],  2023,  2024,  2025  AND  2026
 statewide  reduction  percentage  respectively. If the 1997, 1998, 2000,
 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011,  2012,
 2013,  2014, 2015, 2016, 2017, 2018, 2019, 2020, 2021, 2022 [and], 2023,
 2024, 2025 AND 2026 statewide target percentage for the respective  year
 is  at  least  three  percentage  points  higher than the statewide base
 S. 4007                            18                            A. 3007
 
 percentage, the statewide reduction percentage for the  respective  year
 shall be zero.
   §  23. Subparagraph (iii) of paragraph (b) of subdivision 4 of section
 64 of chapter 81 of the laws of 1995, amending the public health law and
 other laws relating to medical  reimbursement  and  welfare  reform,  as
 amended  by  section 15 of part BB of chapter 56 of the laws of 2020, is
 amended to read as follows:
   (iii) The 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007,  2008,
 2009,  2010, 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020,
 2021, 2022 [and], 2023, 2024, 2025 AND 2026 statewide reduction percent-
 age shall be multiplied by one hundred two million dollars  respectively
 to  determine  the 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007,
 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018,  2019,
 2020,  2021,  2022  [and], 2023, 2024, 2025 AND 2026 statewide aggregate
 reduction amount. If the 1998 and the  2000,  2001,  2002,  2003,  2004,
 2005,  2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016,
 2017, 2018, 2019, 2020, 2021, 2022 [and],  2023,  2024,  2025  AND  2026
 statewide  reduction  percentage shall be zero respectively, there shall
 be no 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008,  2009,
 2010,  2011,  2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019 2020, 2021,
 2022 [and], 2023, 2024, 2025 AND 2026 reduction amount.
   § 24.  The opening paragraph of paragraph  (e)  of  subdivision  7  of
 section  367-a  of  the  social services law, as amended by section 1 of
 part GG of chapter 56 of the  laws  of  2020,  is  amended  to  read  as
 follows:
   During the period from April first, two thousand fifteen through March
 thirty-first,  two  thousand [twenty-three] TWENTY-SIX, the commissioner
 may, in lieu of a managed care provider  or  pharmacy  benefit  manager,
 negotiate  directly  and enter into an arrangement with a pharmaceutical
 manufacturer for the provision of supplemental rebates relating to phar-
 maceutical utilization by enrollees of managed care  providers  pursuant
 to section three hundred sixty-four-j of this title and may also negoti-
 ate directly and enter into such an agreement relating to pharmaceutical
 utilization  by  medical  assistance  recipients  not  so enrolled. Such
 rebate arrangements shall be limited to the  following:  antiretrovirals
 approved  by  the  FDA  for the treatment of HIV/AIDS, opioid dependence
 agents and opioid antagonists listed in  a  statewide  formulary  estab-
 lished  pursuant  to  subparagraph  (vii) of this paragraph, hepatitis C
 agents, high cost drugs as provided for in subparagraph (viii)  of  this
 paragraph,  gene  therapies as provided for in subparagraph (ix) of this
 paragraph, and any other class or drug designated  by  the  commissioner
 for  which  the  pharmaceutical  manufacturer  has  in  effect  a rebate
 arrangement with the federal secretary  of  health  and  human  services
 pursuant to 42 U.S.C. § 1396r-8, and for which the state has established
 standard  clinical  criteria. No agreement entered into pursuant to this
 paragraph shall have an initial term or be extended beyond  the  expira-
 tion or repeal of this paragraph.
   §  25. Subdivision 1 of section 60 of part B of chapter 57 of the laws
 of 2015, amending the social services law and  other  laws  relating  to
 supplemental  rebates,  as amended by section 8 of part GG of chapter 56
 of the laws of 2020, is amended to read as follows:
   1. section  one of this act shall expire and be deemed repealed  March
 31, [2026] 2029;
   § 26. Section 8 of part KK of chapter 56 of the laws of 2020, amending
 the  public  health law relating to the designation of statewide general
 S. 4007                            19                            A. 3007
 
 hospital quality and sole community pools and the reduction  of  capital
 related inpatient expenses, is amended to read as follows:
   §  8.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2020, provided,
 further that sections [three] FOUR through  [nine]  SEVEN  of  this  act
 shall  expire  and  be  deemed  repealed March 31, [2023] 2026; provided
 further, however, that the director of the budget may,  in  consultation
 with  the  commissioner  of health, delay the effective dates prescribed
 herein for a period of time which shall not exceed ninety days following
 the conclusion or termination of an executive order issued  pursuant  to
 section 28 of the executive law declaring a state disaster emergency for
 the  entire  state  of  New York, upon such delay the director of budget
 shall notify the chairs of the assembly ways  and  means  committee  and
 senate  finance  committee  and  the  chairs  of the assembly and senate
 health committee; provided further, however, that the  director  of  the
 budget  shall  notify  the legislative bill drafting commission upon the
 occurrence of a delay in the effective date of this act  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.
   §  27.  Subdivision  4-a  of section 71 of part C of chapter 60 of the
 laws of 2014, amending the social services law relating to fair hearings
 within the Fully Integrated  Duals  Advantage  program,  as  amended  by
 section  7  of  part MM of chapter 56 of the laws of 2020, is amended to
 read as follows:
   4-a. section twenty-two of this act shall take effect April  1,  2014,
 and shall be deemed expired January 1, [2024] 2027;
   §  28.  Section  4  of  chapter  779 of the laws of 1986, amending the
 social services law relating to authorizing services  for  non-residents
 in  adult homes, residences for adults and enriched housing programs, as
 amended by section 1 of item PP of subpart B of part XXX of  chapter  58
 of the laws of 2020, is amended to read as follows:
   § 4. This act shall take effect on the one hundred twentieth day after
 it  shall  have  become  a law and shall remain in full force and effect
 until July 1, [2023] 2027, provided however, that effective immediately,
 the addition, amendment and/or repeal of any rules or regulations neces-
 sary for the implementation of the foregoing sections of this act on its
 effective date are authorized and directed to be made and  completed  on
 or before such effective date.
   §  29.  Section  11  of  chapter 884 of the laws of 1990, amending the
 public health law relating to authorizing  bad  debt  and  charity  care
 allowances  for  certified home health agencies, as amended by section 1
 of part S of chapter 57 of the laws of  2021,  is  amended  to  read  as
 follows:
   § 11. This act shall take effect immediately and:
   (a) sections one and three shall expire on December 31, 1996,
   (b)  sections  four  through ten shall expire on June 30, [2023] 2025,
 and
   (c) provided that the amendment to section 2807-b of the public health
 law by section two of this act shall not affect the expiration  of  such
 section  2807-b  as  otherwise  provided  by  law and shall be deemed to
 expire therewith.
   § 30. Subdivision 5-a of section 246 of chapter  81  of  the  laws  of
 1995,  amending the public health law and other laws relating to medical
 S. 4007                            20                            A. 3007
 
 reimbursement and welfare reform, as amended by section 3 of part  S  of
 chapter 57 of the laws of 2021, is amended to read as follows:
   5-a.  Section sixty-four-a of this act shall be deemed to have been in
 full force and effect on and after April 1, 1995 through March 31,  1999
 and  on  and  after July 1, 1999 through March 31, 2000 and on and after
 April 1, 2000 through March 31, 2003 and on  and  after  April  1,  2003
 through March 31, 2007, and on and after April 1, 2007 through March 31,
 2009,  and on and after April 1, 2009 through March 31, 2011, and on and
 after April 1, 2011 through March 31, 2013, and on and  after  April  1,
 2013  through  March  31,  2015,  and on and after April 1, 2015 through
 March 31, 2017 and on and after April 1, 2017 through  March  31,  2019,
 and  on and after April 1, 2019 through March 31, 2021, and on and after
 April 1, 2021 through March 31, 2023, AND ON AND  AFTER  APRIL  1,  2023
 THROUGH MARCH 31, 2027;
   §  31.  Section  64-b  of chapter 81 of the laws of 1995, amending the
 public health law and other laws relating to medical  reimbursement  and
 welfare  reform,  as amended by section 4 of part S of chapter 57 of the
 laws of 2021, is amended to read as follows:
   §  64-b.  Notwithstanding  any  inconsistent  provision  of  law,  the
 provisions of subdivision 7 of section 3614 of the public health law, as
 amended,  shall  remain and be in full force and effect on April 1, 1995
 through March 31, 1999 and on July 1, 1999 through March 31, 2000 and on
 and after April 1, 2000 through March 31, 2003 and on and after April 1,
 2003 through March 31, 2007, and on and  after  April  1,  2007  through
 March  31,  2009, and on and after April 1, 2009 through March 31, 2011,
 and on and after April 1, 2011 through March 31, 2013, and on and  after
 April  1,  2013  through  March 31, 2015, and on and after April 1, 2015
 through March 31, 2017 and on and after April 1, 2017 through March  31,
 2019,  and on and after April 1, 2019 through March 31, 2021, and on and
 after April 1, 2021 through March 31, 2023, AND ON AND  AFTER  APRIL  1,
 2023 THROUGH MARCH 31, 2027.
   §  32. Section 4-a of part A of chapter 56 of the laws of 2013, amend-
 ing 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 5 of part S of chapter 57 of the laws of 2021,  is
 amended to read as follows:
   §  4-a.  Notwithstanding  paragraph  (c)  of subdivision 10 of section
 2807-c of the public health law, section 21 of chapter 1 of the laws  of
 1999,  or  any  other contrary provision of law, in determining rates of
 payments by state governmental agencies effective for services  provided
 on  and  after  January 1, 2017 through March 31, [2023] 2024, for inpa-
 tient and outpatient services provided by general hospitals,  for  inpa-
 tient services and adult day health care outpatient services provided by
 residential  health care facilities pursuant to article 28 of the public
 health law, except for residential health care facilities  or  units  of
 such  facilities  providing services primarily to children under twenty-
 one years of age, for home health care  services  provided  pursuant  to
 article  36  of the public health law by certified home health agencies,
 long term home health care programs and AIDS home care programs, and for
 personal care services provided pursuant to section 365-a of the  social
 services  law,  the  commissioner  of health shall apply no greater than
 zero trend factors attributable to the 2017,  2018,  2019,  2020,  2021,
 2022  [and], 2023, 2024 AND 2025 calendar years in accordance with para-
 graph (c) of subdivision 10 of section 2807-c of the public health  law,
 provided,  however, that such no greater than zero trend factors attrib-
 utable to such 2017, 2018, 2019, 2020, 2021, 2022 [and], 2023, 2024  AND
 S. 4007                            21                            A. 3007
 
 2025  calendar  years shall also be applied to rates of payment provided
 on and after January 1, 2017 through March 31, [2023] 2025 for  personal
 care services provided in those local social services districts, includ-
 ing  New  York city, whose rates of payment for such services are estab-
 lished by such local social services districts pursuant to  a  rate-set-
 ting exemption issued by the commissioner of health to such local social
 services  districts  in  accordance  with  applicable  regulations;  and
 provided further, however, that for rates of payment for assisted living
 program services provided on and after January 1, 2017 through March 31,
 [2023] 2025, such trend factors attributable to the  2017,  2018,  2019,
 2020,  2021,  2022  [and],  2023,  2024 AND 2025 calendar years shall be
 established at no greater than zero percent.
   § 33. Subdivision 2 of section 246 of chapter 81 of the laws of  1995,
 amending  the  public  health  law  and  other  laws relating to medical
 reimbursement and welfare reform, as amended by section 6 of part  S  of
 chapter 57 of the laws of 2021, is amended to read as follows:
   2.  Sections  five,  seven  through nine, twelve through fourteen, and
 eighteen of this act shall be deemed to have  been  in  full  force  and
 effect  on  and  after  April  1, 1995 through March 31, 1999 and on and
 after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
 through March 31, 2003 and on and after April 1, 2003 through March  31,
 2006  and  on  and after April 1, 2006 through March 31, 2007 and on and
 after April 1, 2007 through March 31, 2009 and on  and  after  April  1,
 2009  through  March 31, 2011 and sections twelve, thirteen and fourteen
 of this act shall be deemed to be in full force and effect on and  after
 April  1,  2011  through  March  31, 2015 and on and after April 1, 2015
 through March 31, 2017 and on and after April 1, 2017 through March  31,
 2019,  and on and after April 1, 2019 through March 31, 2021, and on and
 after April 1, 2021 through March 31, 2023, AND ON AND  AFTER  APRIL  1,
 2023 THROUGH MARCH 31, 2025;
   §  34.  Subparagraph (vi) of paragraph (b) of subdivision 2 of section
 2807-d of the public health law, as amended by section 11 of part  S  of
 chapter 57 of the laws of 2021, is amended to read as follows:
   (vi)  Notwithstanding  any contrary provision of this paragraph or any
 other provision of law or regulation to the  contrary,  for  residential
 health care facilities the assessment shall be six percent of each resi-
 dential  health care facility's gross receipts received from all patient
 care services and other operating income on a cash basis for the  period
 April  first,  two thousand two through March thirty-first, two thousand
 three for hospital  or  health-related  services,  including  adult  day
 services;  provided,  however,  that residential health care facilities'
 gross receipts attributable to payments received pursuant to title XVIII
 of the federal social security act (medicare) shall be excluded from the
 assessment; provided, however, that for all such gross receipts received
 on or after April first, two thousand three through March  thirty-first,
 two  thousand  five,  such assessment shall be five percent, and further
 provided that for all such gross receipts received  on  or  after  April
 first,  two thousand five through March thirty-first, two thousand nine,
 and on or after April first, two thousand  nine  through  March  thirty-
 first,  two  thousand  eleven  such assessment shall be six percent, and
 further provided that for all such gross receipts received on  or  after
 April  first,  two thousand eleven through March thirty-first, two thou-
 sand thirteen such assessment shall be six percent, and further provided
 that for all such gross receipts received on or after April  first,  two
 thousand  thirteen through March thirty-first, two thousand fifteen such
 assessment shall be six percent, and further provided that for all  such
 S. 4007                            22                            A. 3007
 
 gross  receipts  received  on or after April first, two thousand fifteen
 through March thirty-first, two thousand seventeen such assessment shall
 be six percent, and further provided that for all  such  gross  receipts
 received  on  or after April first, two thousand seventeen through March
 thirty-first,  two  thousand  nineteen  such  assessment  shall  be  six
 percent,  and further provided that for all such gross receipts received
 on or after April first, two thousand  nineteen  through  March  thirty-
 first, two thousand twenty-one such assessment shall be six percent, and
 further  provided  that for all such gross receipts received on or after
 April first, two thousand twenty-one  through  March  thirty-first,  two
 thousand  twenty-three such assessment shall be six percent, AND FURTHER
 PROVIDED THAT FOR ALL SUCH GROSS RECEIPTS RECEIVED  ON  OR  AFTER  APRIL
 FIRST,  TWO  THOUSAND TWENTY-THREE THROUGH MARCH THIRTY-FIRST, TWO THOU-
 SAND TWENTY-FIVE SUCH ASSESSMENT SHALL BE SIX PERCENT.
   § 35. Section 3 of part MM of chapter 57 of the laws of 2021  amending
 the  public health law relating to aiding in the transition to adulthood
 for children with medical fragility living in  pediatric  nursing  homes
 and other settings is amended to read as follows:
   § 3. This act shall take effect on the one hundred twentieth day after
 it  shall  have become a law; provided however, that section one of this
 act shall expire and be deemed repealed  [two]  FOUR  years  after  such
 effective date; and provided further, that section two of this act shall
 expire  and  be  deemed repealed [three] FIVE years after such effective
 date.
   § 36. This act shall take effect immediately and shall  be  deemed  to
 have been in full force and effect on and after April 1, 2023; provided,
 however,  that  the  amendments  to  subdivision 6 of section 366 of the
 social services law made by section four of this act  shall  not  affect
 the  repeal  of such subdivision and shall be deemed repealed therewith;
 provided further, however, that the amendments to subparagraph  (ii)  of
 paragraph  (c) of subdivision 11 of section 230 of the public health law
 made by section ten of this act shall not affect the expiration of  such
 subparagraph  and  shall  be  deemed  to  expire therewith; and provided
 further, however, that the amendments to the opening paragraph of  para-
 graph  (e)  of subdivision 7 of section 367-a of the social services law
 made by section twenty-four of this act shall not affect the  repeal  of
 such paragraph and shall be deemed repealed therewith.
 
                                  PART C
 
   Section  1.    Section 34 of part A3 of chapter 62 of the laws of 2003
 amending the general business law and other laws  relating  to  enacting
 major  components  necessary  to implement the state fiscal plan for the
 2003-04 state fiscal year, as amended by section 1 of part Y of  chapter
 56 of the laws of 2020, is amended to read as follows:
   §  34.  (1) Notwithstanding any inconsistent provision of law, rule or
 regulation and effective April 1, 2008 through March  31,  [2023]  2026,
 the commissioner of health is authorized to transfer and the state comp-
 troller  is authorized and directed to receive for deposit to the credit
 of the department of health's special revenue fund - other, health  care
 reform  act  (HCRA) resources fund - 061, provider collection monitoring
 account, within amounts appropriated each year,  those  funds  collected
 and  accumulated  pursuant  to  section 2807-v of the public health law,
 including income from invested funds, for the  purpose  of  payment  for
 administrative  costs  of  the  department of health related to adminis-
 S. 4007                            23                            A. 3007

 tration of  statutory  duties  for  the  collections  and  distributions
 authorized by section 2807-v of the public health law.
   (2)  Notwithstanding  any inconsistent provision of law, rule or regu-
 lation and effective April 1, 2008 through March 31,  [2023]  2026,  the
 commissioner  of  health  is  authorized to transfer and the state comp-
 troller is authorized and directed to receive for deposit to the  credit
 of  the department of health's special revenue fund - other, health care
 reform act (HCRA) resources fund - 061, provider  collection  monitoring
 account,  within  amounts  appropriated each year, those funds collected
 and accumulated and interest earned through surcharges on  payments  for
 health care services pursuant to section 2807-s of the public health law
 and from assessments pursuant to section 2807-t of the public health law
 for the purpose of payment for administrative costs of the department of
 health related to administration of statutory duties for the collections
 and  distributions  authorized by sections 2807-s, 2807-t, and 2807-m of
 the public health law.
   (3) Notwithstanding any inconsistent provision of law, rule  or  regu-
 lation  and  effective  April 1, 2008 through March 31, [2023] 2026, the
 commissioner of health is authorized to transfer and the comptroller  is
 authorized  to  deposit,  within  amounts  appropriated each year, those
 funds authorized for distribution in accordance with the  provisions  of
 paragraph  (a)  of  subdivision 1 of section 2807-l of the public health
 law for the purposes of payment for administrative costs of the  depart-
 ment  of  health  related  to  the  child  health insurance plan program
 authorized pursuant to title 1-A of article 25 of the public health  law
 into  the  special  revenue funds - other, health care reform act (HCRA)
 resources fund - 061, child health insurance account, established within
 the department of health.
   (5) Notwithstanding any inconsistent provision of law, rule  or  regu-
 lation  and  effective  April 1, 2008 through March 31, [2023] 2026, the
 commissioner of health is authorized to transfer and the comptroller  is
 authorized  to  deposit,  within  amounts  appropriated each year, those
 funds allocated pursuant to paragraph (j) of subdivision  1  of  section
 2807-v  of the public health law for the purpose of payment for adminis-
 trative costs of the department of health related to  administration  of
 the state's tobacco control programs and cancer services provided pursu-
 ant  to  sections  2807-r and 1399-ii of the public health law into such
 accounts established within the department of health for such purposes.
   (6) Notwithstanding any inconsistent provision of law, rule  or  regu-
 lation  and  effective  April 1, 2008 through March 31, [2023] 2026, the
 commissioner of health is authorized to transfer and the comptroller  is
 authorized  to deposit, within amounts appropriated each year, the funds
 authorized for distribution in accordance with the provisions of section
 2807-l of the public health law for the purposes of payment for adminis-
 trative costs of the department of health related to the programs funded
 pursuant to section 2807-l of the public health  law  into  the  special
 revenue  funds  -  other, health care reform act (HCRA) resources fund -
 061, pilot health insurance account, established within  the  department
 of health.
   (7)  Notwithstanding  any inconsistent provision of law, rule or regu-
 lation and effective April 1, 2008 through March 31,  [2023]  2026,  the
 commissioner  of health is authorized to transfer and the comptroller is
 authorized to deposit, within  amounts  appropriated  each  year,  those
 funds  authorized  for distribution in accordance with the provisions of
 subparagraph (ii) of paragraph (f) of subdivision 19 of  section  2807-c
 of  the public health law from monies accumulated and interest earned in
 S. 4007                            24                            A. 3007
 
 the bad debt and charity care and capital  statewide  pools  through  an
 assessment  charged  to  general hospitals pursuant to the provisions of
 subdivision 18 of section 2807-c of the  public  health  law  and  those
 funds  authorized  for distribution in accordance with the provisions of
 section 2807-l of the public health law for the purposes of payment  for
 administrative  costs  of  the  department of health related to programs
 funded under section 2807-l of the public health law  into  the  special
 revenue  funds  -  other, health care reform act (HCRA) resources fund -
 061, primary care initiatives account, established within the department
 of health.
   (8) Notwithstanding any inconsistent provision of law, rule  or  regu-
 lation  and  effective  April 1, 2008 through March 31, [2023] 2026, the
 commissioner of health is authorized to transfer and the comptroller  is
 authorized  to  deposit,  within  amounts  appropriated each year, those
 funds authorized for distribution in accordance with section  2807-l  of
 the  public  health  law  for the purposes of payment for administrative
 costs of the department of  health  related  to  programs  funded  under
 section 2807-l of the public health law into the special revenue funds -
 other,  health  care reform act (HCRA) resources fund - 061, health care
 delivery administration account, established within  the  department  of
 health.
   (9)  Notwithstanding  any inconsistent provision of law, rule or regu-
 lation and effective April 1, 2008 through March 31,  [2023]  2026,  the
 commissioner  of health is authorized to transfer and the comptroller is
 authorized to deposit, within  amounts  appropriated  each  year,  those
 funds  authorized  pursuant to sections 2807-d, 3614-a and 3614-b of the
 public health law and section 367-i of the social services law  and  for
 distribution  in  accordance  with  the  provisions  of subdivision 9 of
 section 2807-j of the public health law for the purpose of  payment  for
 administration of statutory duties for the collections and distributions
 authorized  by  sections  2807-c, 2807-d, 2807-j, 2807-k, 2807-l, 3614-a
 and 3614-b of the public health law and  section  367-i  of  the  social
 services  law into the special revenue funds - other, health care reform
 act (HCRA) resources fund - 061, provider collection monitoring account,
 established within the department of health.
   § 2. Subparagraphs (iv) and (v) of paragraph (a) of subdivision  9  of
 section 2807-j of the public health law, as amended by section 2 of part
 Y of chapter 56 of the laws of 2020, are amended to read as follows:
   (iv)  seven  hundred  sixty-five million dollars annually of the funds
 accumulated for the periods January first, two thousand through December
 thirty-first, two thousand [twenty-two] TWENTY FIVE, and
   (v) one hundred ninety-one million two hundred fifty thousand  dollars
 of  the  funds  accumulated  for  the period January first, two thousand
 [twenty-three]  TWENTY-SIX  through  March  thirty-first,  two  thousand
 [twenty-three] TWENTY-SIX.
   §  3. Subdivision 5 of section 168 of chapter 639 of the laws of 1996,
 constituting the New York Health Care Reform Act of 1996, as amended  by
 section  3  of  part  Y of chapter 56 of the laws of 2020, is amended to
 read as follows:
   5. sections 2807-c, 2807-j, 2807-s and 2807-t  of  the  public  health
 law,  as  amended  or as added by this act, shall expire on December 31,
 [2023] 2026, and shall be thereafter effective only in  respect  to  any
 act  done  on or before such date or action or proceeding arising out of
 such act including continued collections of funds from  assessments  and
 allowances  and  surcharges  established  pursuant  to  sections 2807-c,
 2807-j, 2807-s and 2807-t of the public health law,  and  administration
 S. 4007                            25                            A. 3007
 
 and  distributions  of funds from pools established pursuant to sections
 2807-c, 2807-j, 2807-k, 2807-l, 2807-m, 2807-s and 2807-t of the  public
 health  law  related  to  patient  services provided before December 31,
 [2023]  2026, and continued expenditure of funds authorized for programs
 and grants until the exhaustion of funds therefor;
   § 4. Subdivision 1 of section 138 of chapter 1 of the  laws  of  1999,
 constituting  the New York Health Care Reform Act of 2000, as amended by
 section 4 of part Y of chapter 56 of the laws of  2020,  is  amended  to
 read as follows:
   1.  sections  2807-c,  2807-j, 2807-s, and 2807-t of the public health
 law, as amended by this act, shall expire on December 31,  [2023]  2026,
 and shall be thereafter effective only in respect to any act done before
 such  date  or  action  or  proceeding arising out of such act including
 continued collections of  funds  from  assessments  and  allowances  and
 surcharges  established  pursuant to sections 2807-c, 2807-j, 2807-s and
 2807-t of the public health law, and administration and distributions of
 funds from  pools  established  pursuant  to  sections  2807-c,  2807-j,
 2807-k,  2807-l, 2807-m, 2807-s, 2807-t, 2807-v and 2807-w of the public
 health law, as amended or added by this act, related to patient services
 provided before December 31, [2023] 2026, and continued  expenditure  of
 funds  authorized  for programs and grants until the exhaustion of funds
 therefor;
   § 5. Section 2807-l of the public health law, as amended by section  5
 of  part  Y  of  chapter  56  of the laws of 2020, is amended to read as
 follows:
   § 2807-l. Health care initiatives pool distributions. 1. Funds accumu-
 lated in the health care initiatives pools pursuant to paragraph (b)  of
 subdivision  nine  of section twenty-eight hundred seven-j of this arti-
 cle, or the health care reform act  (HCRA)  resources  fund  established
 pursuant to section ninety-two-dd of the state finance law, whichever is
 applicable,  including  income from invested funds, shall be distributed
 or retained by the commissioner or by the state comptroller, as applica-
 ble, in accordance with the following.
   (a) Funds shall be reserved and accumulated  from  year  to  year  and
 shall  be  available, including income from invested funds, for purposes
 of distributions to programs to provide health care coverage  for  unin-
 sured  or underinsured children pursuant to sections twenty-five hundred
 ten and twenty-five hundred eleven of this chapter from  the  respective
 health  care  initiatives pools established for the following periods in
 the following amounts:
   (i) from the pool for the period January first, nineteen hundred nine-
 ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
 up to one hundred twenty million six hundred thousand dollars;
   (ii)  from  the  pool  for  the period January first, nineteen hundred
 ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
 eight,  up  to  one  hundred  sixty-four  million  five hundred thousand
 dollars;
   (iii) from the pool for the period  January  first,  nineteen  hundred
 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
 up to one hundred eighty-one million dollars;
   (iv)  from the pool for the period January first, two thousand through
 December thirty-first, two thousand, two hundred seven million dollars;
   (v) from the pool for the  period  January  first,  two  thousand  one
 through December thirty-first, two thousand one, two hundred thirty-five
 million dollars;
 S. 4007                            26                            A. 3007

   (vi)  from  the  pool  for  the period January first, two thousand two
 through December thirty-first, two thousand two, three  hundred  twenty-
 four million dollars;
   (vii)  from  the pool for the period January first, two thousand three
 through December thirty-first, two thousand three, up  to  four  hundred
 fifty million three hundred thousand dollars;
   (viii)  from  the pool for the period January first, two thousand four
 through December thirty-first, two thousand four,  up  to  four  hundred
 sixty million nine hundred thousand dollars;
   (ix)  from  the  pool  or  the health care reform act (HCRA) resources
 fund, whichever is applicable, for the period January first,  two  thou-
 sand  five  through  December thirty-first, two thousand five, up to one
 hundred fifty-three million eight hundred thousand dollars;
   (x) from the health care reform act  (HCRA)  resources  fund  for  the
 period  January  first,  two thousand six through December thirty-first,
 two thousand six, up to three hundred twenty-five million  four  hundred
 thousand dollars;
   (xi)  from  the  health  care reform act (HCRA) resources fund for the
 period January first, two thousand seven through December  thirty-first,
 two  thousand  seven, up to four hundred twenty-eight million fifty-nine
 thousand dollars;
   (xii) from the health care reform act (HCRA) resources  fund  for  the
 period  January first, two thousand eight through December thirty-first,
 two thousand ten, up to four hundred  fifty-three  million  six  hundred
 seventy-four thousand dollars annually;
   (xiii)  from  the health care reform act (HCRA) resources fund for the
 period January first, two thousand eleven, through  March  thirty-first,
 two  thousand  eleven,  up  to one hundred thirteen million four hundred
 eighteen thousand dollars;
   (xiv) from the health care reform act (HCRA) resources  fund  for  the
 period April first, two thousand eleven, through March thirty-first, two
 thousand  twelve,  up to three hundred twenty-four million seven hundred
 forty-four thousand dollars;
   (xv) from the health care reform act (HCRA)  resources  fund  for  the
 period April first, two thousand twelve, through March thirty-first, two
 thousand  thirteen,  up  to three hundred forty-six million four hundred
 forty-four thousand dollars;
   (xvi) from the health care reform act (HCRA) resources  fund  for  the
 period  April  first, two thousand thirteen, through March thirty-first,
 two thousand fourteen, up to three hundred seventy million  six  hundred
 ninety-five thousand dollars; and
   (xvii)  from the health care reform act (HCRA) resources fund for each
 state fiscal year for periods on and after  April  first,  two  thousand
 fourteen, within amounts appropriated.
   (b)  Funds  shall  be  reserved  and accumulated from year to year and
 shall be available, including income from invested funds,  for  purposes
 of  distributions  for  health  insurance  programs under the individual
 subsidy programs established pursuant to the expanded health care cover-
 age act of nineteen hundred eighty-eight as amended, and for  evaluation
 of  such  programs  from the respective health care initiatives pools or
 the health care reform act (HCRA) resources fund, whichever is  applica-
 ble, established for the following periods in the following amounts:
   (i)  (A)  an amount not to exceed six million dollars on an annualized
 basis for the  periods  January  first,  nineteen  hundred  ninety-seven
 through  December  thirty-first, nineteen hundred ninety-nine; up to six
 million dollars for the  period  January  first,  two  thousand  through
 S. 4007                            27                            A. 3007
 
 December  thirty-first, two thousand; up to five million dollars for the
 period January first, two thousand one  through  December  thirty-first,
 two  thousand  one;  up  to  four million dollars for the period January
 first, two thousand two through December thirty-first, two thousand two;
 up  to  two  million six hundred thousand dollars for the period January
 first, two thousand three through December  thirty-first,  two  thousand
 three;  up  to one million three hundred thousand dollars for the period
 January first, two thousand  four  through  December  thirty-first,  two
 thousand four; up to six hundred seventy thousand dollars for the period
 January  first,  two  thousand five through June thirtieth, two thousand
 five; up to one million three hundred thousand dollars  for  the  period
 April  first,  two thousand six through March thirty-first, two thousand
 seven; and up to one million three hundred thousand dollars annually for
 the period April first, two thousand seven through  March  thirty-first,
 two  thousand  nine,  shall be allocated to individual subsidy programs;
 and
   (B) an amount not to exceed seven million  dollars  on  an  annualized
 basis  for the periods during the period January first, nineteen hundred
 ninety-seven through December thirty-first, nineteen hundred ninety-nine
 and four million dollars annually for the  periods  January  first,  two
 thousand  through  December  thirty-first,  two  thousand two, and three
 million dollars for the period January first, two thousand three through
 December thirty-first, two thousand three, and two million  dollars  for
 the  period  January  first,  two thousand four through December thirty-
 first, two thousand four, and two million dollars for the period January
 first, two thousand five through June thirtieth, two thousand five shall
 be allocated to the catastrophic health care expense program.
   (ii) Notwithstanding any law to the contrary, the characterizations of
 the New York state small business health insurance  partnership  program
 as  in  effect  prior  to  June  thirtieth,  two thousand three, voucher
 program as in effect prior to December thirty-first, two  thousand  one,
 individual  subsidy  program  as  in effect prior to June thirtieth, two
 thousand five, and catastrophic  health  care  expense  program,  as  in
 effect prior to June thirtieth, two thousand five, may, for the purposes
 of  identifying  matching funds for the community health care conversion
 demonstration project described in a waiver of the provisions  of  title
 XIX  of the federal social security act granted to the state of New York
 and dated July fifteenth, nineteen hundred ninety-seven, may continue to
 be used to characterize the insurance programs in sections four thousand
 three hundred twenty-one-a, four thousand  three  hundred  twenty-two-a,
 four  thousand  three hundred twenty-six and four thousand three hundred
 twenty-seven of the insurance law, which are successor programs to these
 programs.
   (c) Up to seventy-eight million dollars shall be reserved and  accumu-
 lated  from  year  to  year  from the pool for the period January first,
 nineteen hundred ninety-seven through  December  thirty-first,  nineteen
 hundred  ninety-seven,  for  purposes  of  public health programs, up to
 seventy-six million dollars shall be reserved and accumulated from  year
 to  year  from the pools for the periods January first, nineteen hundred
 ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
 eight  and  January first, nineteen hundred ninety-nine through December
 thirty-first, nineteen hundred ninety-nine, up  to  eighty-four  million
 dollars  shall  be  reserved  and accumulated from year to year from the
 pools for the period January first, two thousand through December  thir-
 ty-first,  two  thousand,  up  to  eighty-five  million dollars shall be
 reserved and accumulated from year to year from the pools for the period
 S. 4007                            28                            A. 3007
 
 January first, two thousand one through December thirty-first, two thou-
 sand one, up to eighty-six million dollars shall be reserved and accumu-
 lated from year to year from the pools for the period January first, two
 thousand  two  through  December  thirty-first,  two thousand two, up to
 eighty-six million one hundred fifty thousand dollars shall be  reserved
 and  accumulated from year to year from the pools for the period January
 first, two thousand three through December  thirty-first,  two  thousand
 three,  up  to fifty-eight million seven hundred eighty thousand dollars
 shall be reserved and accumulated from year to year from the  pools  for
 the  period  January  first,  two thousand four through December thirty-
 first, two thousand four, up to sixty-eight million seven hundred thirty
 thousand dollars shall be reserved and accumulated  from  year  to  year
 from  the  pools  or  the  health care reform act (HCRA) resources fund,
 whichever is applicable, for the period January first, two thousand five
 through December thirty-first, two  thousand  five,  up  to  ninety-four
 million three hundred fifty thousand dollars shall be reserved and accu-
 mulated  from  year  to  year  from  the  health  care reform act (HCRA)
 resources fund for the period January first, two  thousand  six  through
 December  thirty-first,  two  thousand  six,  up to seventy million nine
 hundred thirty-nine thousand dollars shall be reserved  and  accumulated
 from  year to year from the health care reform act (HCRA) resources fund
 for the period January first, two thousand seven through December  thir-
 ty-first,  two  thousand  seven,  up  to  fifty-five million six hundred
 eighty-nine thousand dollars annually shall be reserved and  accumulated
 from  year to year from the health care reform act (HCRA) resources fund
 for the period January first, two thousand eight through December  thir-
 ty-first,  two thousand ten, up to thirteen million nine hundred twenty-
 two thousand dollars shall be reserved and accumulated from year to year
 from the health care reform act (HCRA) resources  fund  for  the  period
 January first, two thousand eleven through March thirty-first, two thou-
 sand  eleven,  and  for  periods  on and after April first, two thousand
 eleven, up to funding amounts specified below and  shall  be  available,
 including income from invested funds, for:
   (i)  deposit by the commissioner, within amounts appropriated, and the
 state comptroller is hereby  authorized  and  directed  to  receive  for
 deposit  to, to the credit of the department of health's special revenue
 fund - other, hospital based grants program account or the  health  care
 reform  act (HCRA) resources fund, whichever is applicable, for purposes
 of services  and  expenses  related  to  general  hospital  based  grant
 programs,  up  to  twenty-two million dollars annually from the nineteen
 hundred ninety-seven pool, nineteen hundred ninety-eight pool,  nineteen
 hundred  ninety-nine  pool, two thousand pool, two thousand one pool and
 two thousand two pool, respectively, up to  twenty-two  million  dollars
 from  the  two  thousand  three  pool, up to ten million dollars for the
 period January first, two thousand four through  December  thirty-first,
 two  thousand  four, up to eleven million dollars for the period January
 first, two thousand five through  December  thirty-first,  two  thousand
 five, up to twenty-two million dollars for the period January first, two
 thousand  six  through  December  thirty-first,  two thousand six, up to
 twenty-two million ninety-seven thousand dollars annually for the period
 January first, two thousand seven  through  December  thirty-first,  two
 thousand  ten,  up  to  five  million  five hundred twenty-four thousand
 dollars for the period January first, two thousand eleven through  March
 thirty-first,  two  thousand eleven, up to thirteen million four hundred
 forty-five thousand dollars for the period  April  first,  two  thousand
 eleven  through March thirty-first, two thousand twelve, and up to thir-
 S. 4007                            29                            A. 3007
 
 teen million three hundred  seventy-five  thousand  dollars  each  state
 fiscal  year  for  the  period  April first, two thousand twelve through
 March thirty-first, two thousand fourteen;
   (ii) deposit by the commissioner, within amounts appropriated, and the
 state  comptroller  is  hereby  authorized  and  directed to receive for
 deposit to, to the credit of the  emergency  medical  services  training
 account  established  in section ninety-seven-q of the state finance law
 or the health care reform act (HCRA) resources fund, whichever is appli-
 cable, up to sixteen million dollars on  an  annualized  basis  for  the
 periods  January  first,  nineteen hundred ninety-seven through December
 thirty-first, nineteen hundred ninety-nine, up to twenty million dollars
 for the period January first,  two  thousand  through  December  thirty-
 first,  two  thousand,  up  to twenty-one million dollars for the period
 January first, two thousand one through December thirty-first, two thou-
 sand one, up to twenty-two million dollars for the period January first,
 two thousand two through December thirty-first, two thousand two, up  to
 twenty-two  million  five  hundred fifty thousand dollars for the period
 January first, two thousand three  through  December  thirty-first,  two
 thousand  three,  up to nine million six hundred eighty thousand dollars
 for the period January first, two thousand four through  December  thir-
 ty-first,  two  thousand  four,  up to twelve million one hundred thirty
 thousand dollars for the period January first, two thousand five through
 December thirty-first, two thousand five, up to twenty-four million  two
 hundred  fifty  thousand dollars for the period January first, two thou-
 sand six through December thirty-first, two thousand six, up  to  twenty
 million four hundred ninety-two thousand dollars annually for the period
 January  first,  two  thousand  seven through December thirty-first, two
 thousand ten, up to  five  million  one  hundred  twenty-three  thousand
 dollars  for the period January first, two thousand eleven through March
 thirty-first, two thousand eleven, up to eighteen million three  hundred
 fifty  thousand  dollars for the period April first, two thousand eleven
 through March thirty-first, two thousand twelve, up to eighteen  million
 nine  hundred  fifty  thousand  dollars  for the period April first, two
 thousand twelve through March thirty-first, two thousand thirteen, up to
 nineteen million four hundred nineteen thousand dollars for  the  period
 April first, two thousand thirteen through March thirty-first, two thou-
 sand  fourteen,  and up to nineteen million six hundred fifty-nine thou-
 sand seven hundred dollars each state fiscal  year  for  the  period  of
 April first, two thousand fourteen through March thirty-first, two thou-
 sand [twenty-three] TWENTY-SIX;
   (iii)  priority  distributions  by  the  commissioner up to thirty-two
 million dollars on an annualized basis for the period January first, two
 thousand through December thirty-first, two thousand four, up  to  thir-
 ty-eight  million  dollars on an annualized basis for the period January
 first, two thousand five through  December  thirty-first,  two  thousand
 six,  up  to eighteen million two hundred fifty thousand dollars for the
 period January first, two thousand seven through December  thirty-first,
 two  thousand seven, up to three million dollars annually for the period
 January first, two thousand eight  through  December  thirty-first,  two
 thousand  ten, up to seven hundred fifty thousand dollars for the period
 January first, two thousand eleven through March thirty-first, two thou-
 sand eleven, up to two million nine hundred thousand dollars each  state
 fiscal  year  for  the  period  April first, two thousand eleven through
 March thirty-first, two thousand fourteen, and up to  two  million  nine
 hundred  thousand  dollars  each  state fiscal year for the period April
 first, two thousand fourteen through March  thirty-first,  two  thousand
 S. 4007                            30                            A. 3007
 
 [twenty-three]  TWENTY-SIX  to  be allocated (A) for the purposes estab-
 lished pursuant to subparagraph (ii) of  paragraph  (f)  of  subdivision
 nineteen  of  section twenty-eight hundred seven-c of this article as in
 effect  on December thirty-first, nineteen hundred ninety-six and as may
 thereafter be amended, up to fifteen million dollars  annually  for  the
 periods  January  first, two thousand through December thirty-first, two
 thousand four, up to twenty-one million dollars annually for the  period
 January  first,  two  thousand  five  through December thirty-first, two
 thousand six, and up to seven million five hundred thousand dollars  for
 the period January first, two thousand seven through March thirty-first,
 two thousand seven;
   (B)  pursuant  to  a  memorandum  of understanding entered into by the
 commissioner, the majority leader of the senate and the speaker  of  the
 assembly,  for  the purposes outlined in such memorandum upon the recom-
 mendation of the majority leader  of the senate,  up  to  eight  million
 five hundred thousand dollars annually for the period January first, two
 thousand through December thirty-first, two thousand six, and up to four
 million two hundred fifty thousand dollars for the period January first,
 two  thousand  seven through June thirtieth, two thousand seven, and for
 the purposes outlined in such memorandum upon the recommendation of  the
 speaker  of  the  assembly,  up  to  eight million five hundred thousand
 dollars annually for the periods January  first,  two  thousand  through
 December  thirty-first,  two  thousand  six,  and up to four million two
 hundred fifty thousand dollars for the period January first,  two  thou-
 sand seven through June thirtieth, two thousand seven; and
   (C)  for services and expenses, including grants, related to emergency
 assistance distributions as designated by the  commissioner.    Notwith-
 standing  section  one  hundred twelve or one hundred sixty-three of the
 state finance law or any other contrary provision of law, such  distrib-
 utions shall be limited to providers or programs where, as determined by
 the  commissioner,  emergency assistance is vital to protect the life or
 safety of patients, to ensure the retention of  facility  caregivers  or
 other  staff, or in instances where health facility operations are jeop-
 ardized, or where the public health is jeopardized  or  other  emergency
 situations  exist,  up  to three million dollars annually for the period
 April first, two thousand seven through March thirty-first, two thousand
 eleven, up to two million  nine  hundred  thousand  dollars  each  state
 fiscal  year  for  the  period  April first, two thousand eleven through
 March thirty-first, two  thousand  fourteen,  up  to  two  million  nine
 hundred  thousand  dollars  each  state fiscal year for the period April
 first, two thousand fourteen through March  thirty-first,  two  thousand
 seventeen,  up  to  two million nine hundred thousand dollars each state
 fiscal year for the period April first, two thousand  seventeen  through
 March  thirty-first,  two  thousand twenty, [and] up to two million nine
 hundred thousand dollars each state fiscal year  for  the  period  April
 first,  two  thousand  twenty  through  March thirty-first, two thousand
 twenty-three, AND UP TO TWO MILLION NINE HUNDRED THOUSAND  DOLLARS  EACH
 STATE  FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-THREE
 THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-SIX. Upon  any  distrib-
 ution of such funds, the commissioner shall immediately notify the chair
 and  ranking minority member of the senate finance committee, the assem-
 bly ways and means committee, the senate committee on  health,  and  the
 assembly committee on health;
   (iv)  distributions  by  the  commissioner  related  to poison control
 centers pursuant to subdivision seven of section  twenty-five  hundred-d
 of  this  chapter,  up  to  five  million dollars for the period January
 S. 4007                            31                            A. 3007
 
 first, nineteen  hundred  ninety-seven  through  December  thirty-first,
 nineteen hundred ninety-seven, up to three million dollars on an annual-
 ized  basis  for  the  periods during the period January first, nineteen
 hundred  ninety-eight  through  December  thirty-first, nineteen hundred
 ninety-nine, up to five million dollars annually for the periods January
 first, two thousand through December thirty-first, two thousand two,  up
 to  four  million  six hundred thousand dollars annually for the periods
 January first, two thousand three  through  December  thirty-first,  two
 thousand  four,  up to five million one hundred thousand dollars for the
 period January first, two thousand five through  December  thirty-first,
 two  thousand  six  annually,  up  to  five million one hundred thousand
 dollars annually for  the  period  January  first,  two  thousand  seven
 through  December  thirty-first,  two thousand nine, up to three million
 six hundred thousand dollars for the period January first, two  thousand
 ten through December thirty-first, two thousand ten, up to seven hundred
 seventy-five thousand dollars for the period January first, two thousand
 eleven  through  March  thirty-first,  two  thousand  eleven,  up to two
 million five hundred thousand dollars each state  fiscal  year  for  the
 period  April first, two thousand eleven through March thirty-first, two
 thousand fourteen, up to three million dollars each  state  fiscal  year
 for  the period April first, two thousand fourteen through March thirty-
 first, two thousand seventeen, up to three million  dollars  each  state
 fiscal  year  for the period April first, two thousand seventeen through
 March thirty-first, two thousand  twenty,  [and]  up  to  three  million
 dollars  each state fiscal year for the period April first, two thousand
 twenty through March thirty-first, two thousand twenty-three, AND UP  TO
 THREE MILLION DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST,
 TWO THOUSAND TWENTY-THREE THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWEN-
 TY-SIX; and
   (v)  deposit by the commissioner, within amounts appropriated, and the
 state comptroller is hereby  authorized  and  directed  to  receive  for
 deposit  to, to the credit of the department of health's special revenue
 fund - other, miscellaneous special revenue  fund  -  339  maternal  and
 child  HIV  services  account  or  the  health  care  reform  act (HCRA)
 resources fund, whichever is  applicable,  for  purposes  of  a  special
 program  for  HIV services for women and children, including adolescents
 pursuant to section twenty-five hundred-f-one of  this  chapter,  up  to
 five  million  dollars annually for the periods January first, two thou-
 sand through December thirty-first, two thousand two, up to five million
 dollars for the period January first, two thousand three through  Decem-
 ber  thirty-first,  two  thousand  three, up to two million five hundred
 thousand dollars for the period January first, two thousand four through
 December thirty-first, two thousand four, up to two million five hundred
 thousand dollars for the period January first, two thousand five through
 December thirty-first, two thousand five, up to five million dollars for
 the period January first, two  thousand  six  through  December  thirty-
 first,  two  thousand  six,  up to five million dollars annually for the
 period January first, two thousand seven through December  thirty-first,
 two  thousand  ten, up to one million two hundred fifty thousand dollars
 for the period January first, two thousand eleven through March  thirty-
 first,  two  thousand  eleven, and up to five million dollars each state
 fiscal year for the period April  first,  two  thousand  eleven  through
 March thirty-first, two thousand fourteen;
   (d)  (i)  An  amount  of up to twenty million dollars annually for the
 period January first, two thousand through  December  thirty-first,  two
 thousand  six,  up  to ten million dollars for the period January first,
 S. 4007                            32                            A. 3007
 
 two thousand seven through June thirtieth, two  thousand  seven,  up  to
 twenty  million dollars annually for the period January first, two thou-
 sand eight through December thirty-first, two thousand ten, up  to  five
 million  dollars  for  the  period  January  first,  two thousand eleven
 through March thirty-first, two thousand eleven, up to nineteen  million
 six hundred thousand dollars each state fiscal year for the period April
 first,  two  thousand  eleven  through  March thirty-first, two thousand
 fourteen, up to nineteen million six hundred thousand dollars each state
 fiscal year for the period April first, two  thousand  fourteen  through
 March  thirty-first,  two thousand seventeen, up to nineteen million six
 hundred thousand dollars each state fiscal year for the period of  April
 first,  two  thousand seventeen through March thirty-first, two thousand
 twenty, [and] up to nineteen million six hundred thousand  dollars  each
 state  fiscal  year  for  the period of April first, two thousand twenty
 through March thirty-first, two thousand twenty-three, AND UP  TO  NINE-
 TEEN MILLION SIX HUNDRED THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR THE
 PERIOD  OF  APRIL FIRST, TWO THOUSAND TWENTY-THREE THROUGH MARCH THIRTY-
 FIRST, TWO THOUSAND TWENTY-SIX,  shall  be  transferred  to  the  health
 facility restructuring pool established pursuant to section twenty-eight
 hundred fifteen of this article;
   (ii)  provided,  however, amounts transferred pursuant to subparagraph
 (i) of this paragraph may be reduced in an amount to be approved by  the
 director  of  the budget to reflect the amount received from the federal
 government under the state's 1115 waiver which  is  directed  under  its
 terms and conditions to the health facility restructuring program.
   (f) Funds shall be accumulated and transferred from as follows:
   (i) from the pool for the period January first, nineteen hundred nine-
 ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
 (A) thirty-four million  six hundred thousand dollars  shall  be  trans-
 ferred  to  funds  reserved and accumulated pursuant to paragraph (b) of
 subdivision nineteen of section twenty-eight  hundred  seven-c  of  this
 article,  and  (B)  eighty-two  million dollars shall be transferred and
 deposited and credited to the credit of the state general  fund  medical
 assistance local assistance account;
   (ii)  from  the  pool  for  the period January first, nineteen hundred
 ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
 eight, eighty-two million dollars shall be transferred and deposited and
 credited  to  the  credit  of  the state general fund medical assistance
 local assistance account;
   (iii) from the pool for the period  January  first,  nineteen  hundred
 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
 eighty-two  million dollars shall be transferred and deposited and cred-
 ited to the credit of the state general fund  medical  assistance  local
 assistance account;
   (iv)  from  the  pool  or  the health care reform act (HCRA) resources
 fund, whichever is applicable, for the period January first,  two  thou-
 sand  through  December  thirty-first,  two  thousand  four,  eighty-two
 million dollars annually, and for the period January first, two thousand
 five  through  December  thirty-first,  two  thousand  five,  eighty-two
 million  dollars,  and  for  the  period January first, two thousand six
 through December thirty-first,  two  thousand  six,  eighty-two  million
 dollars,  and  for  the period January first, two thousand seven through
 December thirty-first, two thousand seven, eighty-two  million  dollars,
 and  for  the  period January first, two thousand eight through December
 thirty-first, two thousand eight, ninety million seven hundred  thousand
 dollars  shall  be  deposited  by  the commissioner, and the state comp-
 S. 4007                            33                            A. 3007

 troller is hereby authorized and directed to receive for deposit to  the
 credit  of  the  state special revenue fund - other, HCRA transfer fund,
 medical assistance account;
   (v)  from  the  health  care  reform act (HCRA) resources fund for the
 period January first, two thousand nine through  December  thirty-first,
 two  thousand  nine, one hundred eight million nine hundred seventy-five
 thousand dollars, and for the period January  first,  two  thousand  ten
 through  December thirty-first, two thousand ten, one hundred twenty-six
 million one hundred thousand dollars, for the period January first,  two
 thousand  eleven through March thirty-first, two thousand eleven, twenty
 million five hundred thousand dollars, and for each  state  fiscal  year
 for  the  period  April first, two thousand eleven through March thirty-
 first, two thousand fourteen, one hundred forty-six million four hundred
 thousand dollars, shall be deposited by the commissioner, and the  state
 comptroller is hereby authorized and directed to receive for deposit, to
 the  credit  of  the  state  special revenue fund - other, HCRA transfer
 fund, medical assistance account.
   (g) Funds shall be transferred to primary health care  services  pools
 created  by  the  commissioner, and shall be available, including income
 from invested funds, for distributions in accordance with former section
 twenty-eight hundred seven-bb of this article from the respective health
 care initiatives pools  for  the  following  periods  in  the  following
 percentage  amounts  of  funds remaining after allocations in accordance
 with paragraphs (a) through (f) of this subdivision:
   (i) from the pool for the period January first, nineteen hundred nine-
 ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
 fifteen and eighty-seven-hundredths percent;
   (ii)  from  the  pool  for  the period January first, nineteen hundred
 ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
 eight, fifteen and eighty-seven-hundredths percent; and
   (iii)  from  the  pool  for the period January first, nineteen hundred
 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
 sixteen and thirteen-hundredths percent.
   (h) Funds shall be reserved and accumulated from year to year  by  the
 commissioner  and  shall  be  available,  including income from invested
 funds, for purposes of primary care education and training  pursuant  to
 article nine of this chapter from the respective health care initiatives
 pools  established for the following periods in the following percentage
 amounts of funds remaining after allocations in  accordance  with  para-
 graphs  (a)  through  (f) of this subdivision and shall be available for
 distributions as follows:
   (i) funds shall be reserved and accumulated:
   (A) from the pool for the period January first, nineteen hundred nine-
 ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
 six and thirty-five-hundredths percent;
   (B) from the pool for the period January first, nineteen hundred nine-
 ty-eight  through  December thirty-first, nineteen hundred ninety-eight,
 six and thirty-five-hundredths percent; and
   (C) from the pool for the period January first, nineteen hundred nine-
 ty-nine through December thirty-first, nineteen hundred ninety-nine, six
 and forty-five-hundredths percent;
   (ii) funds shall be available for distributions including income  from
 invested funds as follows:
   (A)  for purposes of the primary care physician loan repayment program
 in accordance with section nine hundred three of  this  chapter,  up  to
 five million dollars on an annualized basis;
 S. 4007                            34                            A. 3007
 
   (B)  for purposes of the primary care practitioner scholarship program
 in accordance with section nine hundred four of this chapter, up to  two
 million dollars on an annualized basis;
   (C) for purposes of minority participation in medical education grants
 in  accordance  with section nine hundred six of this chapter, up to one
 million dollars on an annualized basis; and
   (D) provided, however, that the commissioner may reallocate any  funds
 remaining  or unallocated for distributions for the primary care practi-
 tioner scholarship program in accordance with section nine hundred  four
 of this chapter.
   (i)  Funds  shall  be  reserved  and accumulated from year to year and
 shall be available, including income from invested funds,  for  distrib-
 utions  in  accordance  with  section  twenty-nine hundred fifty-two and
 section twenty-nine hundred fifty-eight of this chapter for rural health
 care delivery development and  rural  health  care  access  development,
 respectively,  from  the respective health care initiatives pools or the
 health care reform act (HCRA) resources fund, whichever  is  applicable,
 for  the  following periods in the following percentage amounts of funds
 remaining after allocations in accordance with  paragraphs  (a)  through
 (f) of this subdivision, and for periods on and after January first, two
 thousand, in the following amounts:
   (i) from the pool for the period January first, nineteen hundred nine-
 ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
 thirteen and forty-nine-hundredths percent;
   (ii) from the pool for the  period  January  first,  nineteen  hundred
 ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
 eight, thirteen and forty-nine-hundredths percent;
   (iii) from the pool for the period  January  first,  nineteen  hundred
 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
 thirteen and seventy-one-hundredths percent;
   (iv) from the pool for the periods January first, two thousand through
 December thirty-first, two thousand two, seventeen million dollars annu-
 ally,  and  for  the  period  January  first, two thousand three through
 December thirty-first, two thousand three, up to fifteen  million  eight
 hundred fifty thousand dollars;
   (v) from the pool or the health care reform act (HCRA) resources fund,
 whichever is applicable, for the period January first, two thousand four
 through  December thirty-first, two thousand four, up to fifteen million
 eight hundred fifty thousand dollars, for the period January first,  two
 thousand  five  through  December thirty-first, two thousand five, up to
 nineteen million two hundred thousand dollars, for  the  period  January
 first, two thousand six through December thirty-first, two thousand six,
 up  to  nineteen  million  two  hundred thousand dollars, for the period
 January first, two thousand seven  through  December  thirty-first,  two
 thousand  ten, up to eighteen million one hundred fifty thousand dollars
 annually, for the period January  first,  two  thousand  eleven  through
 March thirty-first, two thousand eleven, up to four million five hundred
 thirty-eight thousand dollars, for each state fiscal year for the period
 April  first,  two thousand eleven through March thirty-first, two thou-
 sand fourteen, up to sixteen million two hundred thousand dollars, up to
 sixteen million two hundred thousand dollars each state fiscal year  for
 the  period  April  first,  two  thousand fourteen through March thirty-
 first, two thousand seventeen, up to sixteen million two  hundred  thou-
 sand  dollars  each  state  fiscal  year for the period April first, two
 thousand seventeen through  March  thirty-first,  two  thousand  twenty,
 [and]  up  to  sixteen  million  two hundred thousand dollars each state
 S. 4007                            35                            A. 3007

 fiscal year for the period April  first,  two  thousand  twenty  through
 March thirty-first, two thousand twenty-three, AND UP TO SIXTEEN MILLION
 TWO HUNDRED THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL
 FIRST,  TWO  THOUSAND TWENTY-THREE THROUGH MARCH THIRTY-FIRST, TWO THOU-
 SAND TWENTY-SIX.
   (j) Funds shall be reserved and accumulated  from  year  to  year  and
 shall  be  available, including income from invested funds, for purposes
 of distributions related to health information and health  care  quality
 improvement  pursuant  to former section twenty-eight hundred seven-n of
 this article from the respective health care  initiatives  pools  estab-
 lished  for the following periods in the following percentage amounts of
 funds remaining after allocations  in  accordance  with  paragraphs  (a)
 through (f) of this subdivision:
   (i) from the pool for the period January first, nineteen hundred nine-
 ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
 six and thirty-five-hundredths percent;
   (ii) from the pool for the  period  January  first,  nineteen  hundred
 ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
 eight, six and thirty-five-hundredths percent; and
   (iii) from the pool for the period  January  first,  nineteen  hundred
 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
 six and forty-five-hundredths percent.
   (k)  Funds  shall  be  reserved  and accumulated from year to year and
 shall be available, including income  from  invested  funds,  for  allo-
 cations  and  distributions  in  accordance  with  section  twenty-eight
 hundred seven-p of this article  for  diagnostic  and  treatment  center
 uncompensated  care from the respective health care initiatives pools or
 the health care reform act (HCRA) resources fund, whichever is  applica-
 ble,  for  the following periods in the following percentage  amounts of
 funds remaining after allocations  in  accordance  with  paragraphs  (a)
 through  (f)  of  this subdivision, and for periods on and after January
 first, two thousand, in the following amounts:
   (i) from the pool for the period January first, nineteen hundred nine-
 ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
 thirty-eight and one-tenth percent;
   (ii)  from  the  pool  for  the period January first, nineteen hundred
 ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
 eight, thirty-eight and one-tenth percent;
   (iii)  from  the  pool  for the period January first, nineteen hundred
 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
 thirty-eight and seventy-one-hundredths percent;
   (iv) from the pool for the periods January first, two thousand through
 December thirty-first, two thousand  two,  forty-eight  million  dollars
 annually,  and  for the period January first, two thousand three through
 June thirtieth, two thousand three, twenty-four million dollars;
   (v) (A) from the pool or the health care reform act  (HCRA)  resources
 fund,  whichever  is applicable, for the period July first, two thousand
 three through December thirty-first,  two  thousand  three,  up  to  six
 million dollars, for the period January first, two thousand four through
 December  thirty-first,  two  thousand six, up to twelve million dollars
 annually, for the period  January  first,  two  thousand  seven  through
 December  thirty-first, two thousand thirteen, up to forty-eight million
 dollars annually, for the period January first,  two  thousand  fourteen
 through  March thirty-first, two thousand fourteen, up to twelve million
 dollars for the period April first, two thousand fourteen through  March
 thirty-first,  two thousand seventeen, up to forty-eight million dollars
 S. 4007                            36                            A. 3007
 
 annually, for the period April first,  two  thousand  seventeen  through
 March  thirty-first,  two  thousand  twenty,  up  to forty-eight million
 dollars annually, [and] for the period April first, two thousand  twenty
 through March thirty-first, two thousand twenty-three, up to forty-eight
 million  dollars  annually, AND FOR THE PERIOD APRIL FIRST, TWO THOUSAND
 TWENTY-THREE THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-SIX, UP  TO
 FORTY-EIGHT MILLION DOLLARS ANNUALLY;
   (B)  from  the  health  care  reform act (HCRA) resources fund for the
 period January first, two thousand six  through  December  thirty-first,
 two  thousand  six,  an  additional  seven million five hundred thousand
 dollars, for the period January first, two thousand seven through Decem-
 ber thirty-first, two thousand thirteen,  an  additional  seven  million
 five  hundred  thousand  dollars annually, for the period January first,
 two thousand fourteen through March thirty-first, two thousand fourteen,
 an additional one million eight hundred seventy-five  thousand  dollars,
 for  the period April first, two thousand fourteen through March thirty-
 first, two thousand seventeen, an additional seven million five  hundred
 thousand  dollars  annually,  for  the  period April first, two thousand
 seventeen through March thirty-first, two thousand twenty, an additional
 seven million five hundred thousand  dollars  annually,  [and]  for  the
 period  April first, two thousand twenty through March thirty-first, two
 thousand twenty-three, an additional seven million five hundred thousand
 dollars annually, AND FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  TWENTY-
 THREE THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-SIX, AN ADDITIONAL
 SEVEN  MILLION FIVE HUNDRED THOUSAND DOLLARS ANNUALLY for voluntary non-
 profit diagnostic and treatment center uncompensated care in  accordance
 with  subdivision four-c of section twenty-eight hundred seven-p of this
 article; and
   (vi) funds reserved and accumulated pursuant  to  this  paragraph  for
 periods  on and after July first, two thousand three, shall be deposited
 by the commissioner, within amounts appropriated, and  the  state  comp-
 troller  is hereby authorized and directed to receive for deposit to the
 credit of the state special revenue funds - other, HCRA  transfer  fund,
 medical  assistance  account, for purposes of funding the state share of
 rate adjustments made pursuant to section twenty-eight  hundred  seven-p
 of  this article, provided, however, that in the event federal financial
 participation is not available for rate  adjustments  made  pursuant  to
 paragraph (b) of subdivision one of section twenty-eight hundred seven-p
 of this article, funds shall be distributed pursuant to paragraph (a) of
 subdivision  one of section twenty-eight hundred seven-p of this article
 from the respective health care initiatives pools  or  the  health  care
 reform act (HCRA) resources fund, whichever is applicable.
   (l)  Funds  shall be reserved and accumulated from year to year by the
 commissioner and shall be  available,  including  income  from  invested
 funds, for transfer to and allocation  for services and expenses for the
 payment  of benefits to recipients of  drugs under the AIDS drug assist-
 ance program (ADAP) - HIV uninsured  care  program  as  administered  by
 Health  Research  Incorporated  from  the respective  health care initi-
 atives pools or the health care reform act (HCRA) resources fund, which-
 ever is applicable, established for the following periods in the follow-
 ing  percentage  amounts  of  funds  remaining  after   allocations   in
 accordance  with paragraphs (a) through (f) of this subdivision, and for
 periods on and after January  first,  two  thousand,  in  the  following
 amounts:
 S. 4007                            37                            A. 3007
 
   (i) from the pool for the period January first, nineteen hundred nine-
 ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
 nine and fifty-two-hundredths percent;
   (ii)  from  the  pool  for  the period January first, nineteen hundred
 ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
 eight, nine and fifty-two-hundredths percent;
   (iii)  from  the  pool  for the period January first, nineteen hundred
 ninety-nine and December  thirty-first,  nineteen  hundred  ninety-nine,
 nine and sixty-eight-hundredths percent;
   (iv) from the pool for the periods January first, two thousand through
 December  thirty-first,  two  thousand two, up to twelve million dollars
 annually, and for the period January first, two thousand  three  through
 December  thirty-first, two thousand three, up to forty million dollars;
 and
   (v) from the pool or the health care reform act (HCRA) resources fund,
 whichever is applicable, for the periods  January  first,  two  thousand
 four  through  December thirty-first, two thousand four, up to fifty-six
 million dollars, for the period January first, two thousand five through
 December thirty-first, two thousand six, up  to  sixty  million  dollars
 annually,  for  the  period  January  first,  two thousand seven through
 December thirty-first, two thousand ten, up  to  sixty  million  dollars
 annually,  for  the  period  January  first, two thousand eleven through
 March thirty-first, two thousand eleven, up to fifteen million  dollars,
 each  state  fiscal year for the period April first, two thousand eleven
 through March thirty-first,  two  thousand  fourteen,  up  to  forty-two
 million three hundred thousand dollars and up to forty-one million fifty
 thousand  dollars each state fiscal year for the period April first, two
 thousand fourteen through  March  thirty-first,  two  thousand  [twenty-
 three] TWENTY-SIX.
   (m)  Funds  shall  be  reserved  and accumulated from year to year and
 shall be available, including income from invested funds,  for  purposes
 of  distributions  pursuant  to  section twenty-eight hundred seven-r of
 this article for cancer related services from the respective health care
 initiatives pools or the health care reform act (HCRA)  resources  fund,
 whichever  is  applicable,  established for the following periods in the
 following percentage amounts of funds  remaining  after  allocations  in
 accordance  with paragraphs (a) through (f) of this subdivision, and for
 periods on and after January  first,  two  thousand,  in  the  following
 amounts:
   (i) from the pool for the period January first, nineteen hundred nine-
 ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
 seven and ninety-four-hundredths percent;
   (ii) from the pool for the  period  January  first,  nineteen  hundred
 ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
 eight, seven and ninety-four-hundredths percent;
   (iii) from the pool for the period  January  first,  nineteen  hundred
 ninety-nine and December thirty-first, nineteen hundred ninety-nine, six
 and forty-five-hundredths percent;
   (iv)  from the pool for the period January first, two thousand through
 December thirty-first, two thousand two, up to ten million dollars on an
 annual basis;
   (v) from the pool for the period January  first,  two  thousand  three
 through  December  thirty-first,  two thousand four, up to eight million
 nine hundred fifty thousand dollars on an annual basis;
   (vi) from the pool or the health  care  reform  act  (HCRA)  resources
 fund,  whichever  is applicable, for the period January first, two thou-
 S. 4007                            38                            A. 3007
 
 sand five through December thirty-first, two thousand  six,  up  to  ten
 million  fifty thousand dollars on an annual basis, for the period Janu-
 ary first, two thousand seven through December thirty-first,  two  thou-
 sand  ten,  up  to nineteen million dollars annually, and for the period
 January first, two thousand eleven through March thirty-first, two thou-
 sand eleven, up to four million seven hundred fifty thousand dollars.
   (n) Funds shall be accumulated and transferred from  the  health  care
 reform act (HCRA) resources fund as follows: for the period April first,
 two  thousand  seven through March thirty-first, two thousand eight, and
 on an annual basis for the  periods  April  first,  two  thousand  eight
 through  November  thirtieth,  two  thousand  nine, funds within amounts
 appropriated shall be transferred and  deposited  and  credited  to  the
 credit  of  the state special revenue funds - other, HCRA transfer fund,
 medical assistance account, for purposes of funding the state  share  of
 rate  adjustments  made  to public and voluntary hospitals in accordance
 with paragraphs (i) and (j) of subdivision one of  section  twenty-eight
 hundred seven-c of this article.
   2.  Notwithstanding  any  inconsistent provision of law, rule or regu-
 lation, any funds accumulated  in  the  health  care  initiatives  pools
 pursuant  to  paragraph  (b) of subdivision nine of section twenty-eight
 hundred seven-j of this article, as a result of surcharges,  assessments
 or  other obligations during the periods January first, nineteen hundred
 ninety-seven through December  thirty-first,  nineteen  hundred  ninety-
 nine, which are unused or uncommitted for distributions pursuant to this
 section  shall  be  reserved  and  accumulated  from year to year by the
 commissioner and, within amounts appropriated, transferred and deposited
 into the special revenue funds - other,  miscellaneous  special  revenue
 fund  -  339,  child  health  insurance account or any successor fund or
 account, for purposes of distributions to  implement  the  child  health
 insurance  program  established pursuant to sections twenty-five hundred
 ten and twenty-five hundred eleven of this chapter for  periods  on  and
 after January first, two thousand one; provided, however, funds reserved
 and  accumulated  for  priority  distributions  pursuant to subparagraph
 (iii) of paragraph (c) of subdivision one of this section shall  not  be
 transferred  and  deposited  into such account pursuant to this subdivi-
 sion; and provided further, however, that any unused or uncommitted pool
 funds accumulated and allocated pursuant to paragraph (j) of subdivision
 one of this section shall be distributed  for  purposes  of  the  health
 information and quality improvement act of 2000.
   3.  Revenue  from  distributions pursuant to this section shall not be
 included in gross revenue  received  for  purposes  of  the  assessments
 pursuant to subdivision eighteen of section twenty-eight hundred seven-c
 of  this article, subject to the provisions of paragraph (e) of subdivi-
 sion eighteen of section twenty-eight hundred seven-c of  this  article,
 and  shall not be included in gross revenue received for purposes of the
 assessments pursuant to section twenty-eight  hundred  seven-d  of  this
 article,  subject  to  the  provisions  of subdivision twelve of section
 twenty-eight hundred seven-d of this article.
   § 6. Subdivision 5-a of section 2807-m of the public  health  law,  as
 amended  by  section  6  of part Y of chapter 56 of the laws of 2020, is
 amended to read as follows:
   5-a. Graduate medical education  innovations  pool.  (a)  Supplemental
 distributions.  (i)  Thirty-one  million  dollars for the period January
 first, two thousand eight through December  thirty-first,  two  thousand
 eight,  shall  be  set  aside  and reserved by the commissioner from the
 regional pools established pursuant to subdivision two of  this  section
 S. 4007                            39                            A. 3007
 
 and shall be available for distributions pursuant to subdivision five of
 this  section  and in accordance with section 86-1.89 of title 10 of the
 codes, rules and regulations of the state of New York as  in  effect  on
 January  first,  two  thousand eight; provided, however, for purposes of
 funding the empire clinical research investigation  program  (ECRIP)  in
 accordance  with paragraph eight of subdivision (e) and paragraph two of
 subdivision (f) of section 86-1.89 of title 10 of the codes,  rules  and
 regulations  of the state of New York, distributions shall be made using
 two regions defined as New York city and the rest of the state  and  the
 dollar amount set forth in subparagraph (i) of paragraph two of subdivi-
 sion  (f)  of  section 86-1.89 of title 10 of the codes, rules and regu-
 lations of the state of New York shall be increased from sixty  thousand
 dollars to seventy-five thousand dollars.
   (ii)  For  periods  on  and  after  January  first, two thousand nine,
 supplemental distributions pursuant to subdivision five of this  section
 and  in  accordance with section 86-1.89 of title 10 of the codes, rules
 and regulations of the state of New York shall no longer be made and the
 provisions of section 86-1.89 of title 10 of the codes, rules and  regu-
 lations of the state of New York shall be null and void.
   (b)  Empire  clinical  research  investigator  program  (ECRIP).  Nine
 million one hundred twenty thousand  dollars  annually  for  the  period
 January  first,  two  thousand  nine  through December thirty-first, two
 thousand ten, and two million two hundred eighty  thousand  dollars  for
 the  period  January  first,  two thousand eleven, through March thirty-
 first, two thousand eleven, nine million  one  hundred  twenty  thousand
 dollars  each state fiscal year for the period April first, two thousand
 eleven through March thirty-first, two thousand fourteen,  up  to  eight
 million  six  hundred twelve thousand dollars each state fiscal year for
 the period April first, two  thousand  fourteen  through  March  thirty-
 first,  two  thousand  seventeen, up to eight million six hundred twelve
 thousand dollars each state fiscal year for the period April first,  two
 thousand  seventeen  through  March  thirty-first,  two thousand twenty,
 [and] up to eight million six hundred twelve thousand dollars each state
 fiscal year for the period April  first,  two  thousand  twenty  through
 March  thirty-first,  two thousand twenty-three, AND UP TO EIGHT MILLION
 SIX HUNDRED TWELVE THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR THE PERI-
 OD APRIL FIRST, TWO THOUSAND TWENTY-THREE  THROUGH  MARCH  THIRTY-FIRST,
 TWO  THOUSAND TWENTY-SIX, shall be set aside and reserved by the commis-
 sioner from the regional pools established pursuant to  subdivision  two
 of this section to be allocated regionally with two-thirds of the avail-
 able funding going to New York city and one-third of the available fund-
 ing  going  to the rest of the state and shall be available for distrib-
 ution as follows:
   Distributions shall first be made to consortia  and  teaching  general
 hospitals  for the empire clinical research investigator program (ECRIP)
 to help secure federal funding for biomedical research,  train  clinical
 researchers,  recruit national leaders as faculty to act as mentors, and
 train residents and fellows  in  biomedical  research  skills  based  on
 hospital-specific  data  submitted  to the commissioner by consortia and
 teaching general hospitals in accordance with clause (G) of this subpar-
 agraph. Such distributions shall be made in accordance with the  follow-
 ing methodology:
   (A)  The  greatest  number  of clinical research positions for which a
 consortium or teaching general hospital may be funded pursuant  to  this
 subparagraph  shall  be  one  percent  of  the total number of residents
 training at the consortium or teaching general hospital on  July  first,
 S. 4007                            40                            A. 3007
 
 two  thousand  eight  for  the  period  January first, two thousand nine
 through December thirty-first, two thousand nine rounded up to the near-
 est one position.
   (B)  Distributions  made  to a consortium or teaching general hospital
 shall equal the product of the total number of clinical  research  posi-
 tions  submitted  by  a  consortium  or  teaching  general  hospital and
 accepted by the commissioner as meeting the criteria set forth in  para-
 graph  (b)  of subdivision one of this section, subject to the reduction
 calculation set forth in clause (C)  of  this  subparagraph,  times  one
 hundred ten thousand dollars.
   (C)  If  the  dollar  amount for the total number of clinical research
 positions in the region  calculated  pursuant  to  clause  (B)  of  this
 subparagraph  exceeds the total amount appropriated for purposes of this
 paragraph, including clinical research positions that continue from  and
 were funded in prior distribution periods, the commissioner shall elimi-
 nate  one-half  of  the  clinical  research  positions submitted by each
 consortium or teaching general hospital rounded down to the nearest  one
 position.  Such  reduction shall be repeated until the dollar amount for
 the total number of clinical research positions in the region  does  not
 exceed  the total amount appropriated for purposes of this paragraph. If
 the repeated reduction of the total number of  clinical  research  posi-
 tions  in  the region by one-half does not render a total funding amount
 that is equal to or less than the total amount reserved for that  region
 within  the  appropriation, the funding for each clinical research posi-
 tion in that region shall be  reduced  proportionally  in  one  thousand
 dollar  increments until the total dollar amount for the total number of
 clinical research positions in that region does  not  exceed  the  total
 amount  reserved for that region within the appropriation. Any reduction
 in funding will be effective for the duration of the award. No  clinical
 research  positions that continue from and were funded in prior distrib-
 ution periods shall be eliminated or reduced by such methodology.
   (D) Each consortium or teaching general  hospital  shall  receive  its
 annual distribution amount in accordance with the following:
   (I) Each consortium or teaching general hospital with a one-year ECRIP
 award  shall  receive  its  annual  distribution  amount  in  full  upon
 completion of the requirements set forth in items (I) and (II) of clause
 (G) of this subparagraph. The requirements set forth in items  (IV)  and
 (V)  of clause (G) of this subparagraph must be completed by the consor-
 tium or teaching general hospital in order for the consortium or  teach-
 ing  general  hospital  to be eligible to apply for ECRIP funding in any
 subsequent funding cycle.
   (II) Each consortium or teaching  general  hospital  with  a  two-year
 ECRIP  award  shall receive its first annual distribution amount in full
 upon completion of the requirements set forth in items (I) and  (II)  of
 clause  (G)  of  this  subparagraph. Each consortium or teaching general
 hospital will receive its second annual distribution amount in full upon
 completion of the requirements set forth in item (III) of clause (G)  of
 this  subparagraph.  The requirements set forth in items (IV) and (V) of
 clause (G) of this subparagraph must be completed by the  consortium  or
 teaching general hospital in order for the consortium or teaching gener-
 al  hospital to be eligible to apply for ECRIP funding in any subsequent
 funding cycle.
   (E) Each consortium or teaching general  hospital  receiving  distrib-
 utions pursuant to this subparagraph shall reserve seventy-five thousand
 dollars  to  primarily  fund  salary and fringe benefits of the clinical
 research position with the remainder going to fund  the  development  of
 S. 4007                            41                            A. 3007
 
 faculty  who  are involved in biomedical research, training and clinical
 care.
   (F)  Undistributed  or  returned  funds  available  to  fund  clinical
 research positions pursuant to this paragraph for a distribution  period
 shall  be  available to fund clinical research positions in a subsequent
 distribution period.
   (G) In order to be eligible for distributions pursuant to this subpar-
 agraph, each consortium and teaching general hospital shall  provide  to
 the  commissioner by July first of each distribution period, the follow-
 ing data and information on a hospital-specific  basis.  Such  data  and
 information  shall  be  certified as to accuracy and completeness by the
 chief executive officer, chief financial officer or chair of the consor-
 tium governing body of each consortium or teaching general hospital  and
 shall be maintained by each consortium and teaching general hospital for
 five years from the date of submission:
   (I)  For  each  clinical  research  position, information on the type,
 scope, training objectives,  institutional  support,  clinical  research
 experience of the sponsor-mentor, plans for submitting research outcomes
 to  peer reviewed journals and at scientific meetings, including a meet-
 ing sponsored by the department, the name of a principal contact  person
 responsible for tracking the career development of researchers placed in
 clinical  research positions, as defined in paragraph (c) of subdivision
 one of this section, and who is authorized to certify to the commission-
 er that all the requirements of the clinical  research  training  objec-
 tives  set  forth  in this subparagraph shall be met. Such certification
 shall be provided by July first of each distribution period;
   (II) For each clinical research position,  information  on  the  name,
 citizenship  status, medical education and training, and medical license
 number of the researcher, if applicable, shall be provided  by  December
 thirty-first of the calendar year following the distribution period;
   (III)  Information on the status of the clinical research plan, accom-
 plishments, changes in research activities, progress, and performance of
 the researcher shall be provided upon  completion  of  one-half  of  the
 award term;
   (IV)  A  final report detailing training experiences, accomplishments,
 activities and performance of the clinical researcher, and  data,  meth-
 ods,  results  and  analyses  of  the  clinical  research  plan shall be
 provided three months after the clinical research position ends; and
   (V) Tracking information concerning past  researchers,  including  but
 not  limited  to (A) background information, (B) employment history, (C)
 research status, (D) current research activities, (E)  publications  and
 presentations,  (F)  research  support,  and  (G)  any other information
 necessary to track the researcher; and
   (VI) Any other data or information required  by  the  commissioner  to
 implement this subparagraph.
   (H)  Notwithstanding  any  inconsistent provision of this subdivision,
 for periods on and after April first, two thousand thirteen, ECRIP grant
 awards shall be made in accordance with rules and regulations promulgat-
 ed by the commissioner. Such regulations shall, at a minimum:
   (1) provide that ECRIP grant awards shall be made with  the  objective
 of  securing  federal funding for biomedical research, training clinical
 researchers, recruiting national leaders as faculty to act  as  mentors,
 and training residents and fellows in biomedical research skills;
   (2)  provide that ECRIP grant applicants may include interdisciplinary
 research teams comprised of teaching general hospitals acting in collab-
 S. 4007                            42                            A. 3007
 
 oration with entities including but  not  limited  to  medical  centers,
 hospitals, universities and local health departments;
   (3) provide that applications for ECRIP grant awards shall be based on
 such  information requested by the commissioner, which shall include but
 not be limited to hospital-specific data;
   (4) establish the qualifications for  investigators  and  other  staff
 required for grant projects eligible for ECRIP grant awards; and
   (5)  establish a methodology for the distribution of funds under ECRIP
 grant awards.
   (c) Physician loan repayment program. One million nine  hundred  sixty
 thousand  dollars  for  the  period  January  first,  two thousand eight
 through December thirty-first, two  thousand  eight,  one  million  nine
 hundred  sixty  thousand dollars for the period January first, two thou-
 sand nine through December thirty-first, two thousand nine, one  million
 nine  hundred  sixty  thousand dollars for the period January first, two
 thousand ten through  December  thirty-first,  two  thousand  ten,  four
 hundred  ninety thousand dollars for the period January first, two thou-
 sand eleven through March thirty-first, two thousand eleven, one million
 seven hundred thousand dollars each state fiscal  year  for  the  period
 April  first,  two thousand eleven through March thirty-first, two thou-
 sand fourteen, up to one million seven  hundred  five  thousand  dollars
 each state fiscal year for the period April first, two thousand fourteen
 through  March  thirty-first,  two thousand seventeen, up to one million
 seven hundred five thousand dollars each state fiscal year for the peri-
 od April first, two thousand seventeen through March  thirty-first,  two
 thousand  twenty,  [and]  up  to one million seven hundred five thousand
 dollars each state fiscal year for the period April first, two  thousand
 twenty  through March thirty-first, two thousand twenty-three, AND UP TO
 ONE MILLION SEVEN HUNDRED FIVE THOUSAND DOLLARS EACH STATE  FISCAL  YEAR
 FOR  THE  PERIOD  APRIL  FIRST,  TWO THOUSAND TWENTY-THREE THROUGH MARCH
 THIRTY-FIRST, TWO THOUSAND TWENTY-SIX, shall be set aside  and  reserved
 by  the  commissioner  from  the  regional pools established pursuant to
 subdivision two of this section and shall be available for  purposes  of
 physician  loan  repayment  in  accordance  with subdivision ten of this
 section.  Notwithstanding  any  contrary  provision  of  this   section,
 sections  one  hundred  twelve  and one hundred sixty-three of the state
 finance 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  proposal  process
 as follows:
   (i) Funding shall first be awarded to repay loans of up to twenty-five
 physicians  who  train  in  primary care or specialty tracks in teaching
 general hospitals, and who enter and remain in primary care or specialty
 practices in underserved communities, as determined by the commissioner.
   (ii) After distributions in accordance with subparagraph (i)  of  this
 paragraph, all remaining funds shall be awarded to repay loans of physi-
 cians  who  enter  and  remain in primary care or specialty practices in
 underserved communities, as determined by  the  commissioner,  including
 but  not  limited  to  physicians working in general hospitals, or other
 health care facilities.
   (iii) In no case shall less than fifty percent of the funds  available
 pursuant  to  this  paragraph be distributed in accordance with subpara-
 graphs (i) and (ii) of this paragraph to physicians identified by gener-
 al hospitals.
 S. 4007                            43                            A. 3007
 
   (iv) In addition to the funds allocated under this paragraph, for  the
 period April first, two thousand fifteen through March thirty-first, two
 thousand  sixteen,  two  million  dollars  shall  be  available  for the
 purposes described in subdivision ten of this section;
   (v)  In  addition to the funds allocated under this paragraph, for the
 period April first, two thousand sixteen through March thirty-first, two
 thousand seventeen, two million  dollars  shall  be  available  for  the
 purposes described in subdivision ten of this section;
   (vi) Notwithstanding any provision of law to the contrary, and subject
 to the extension of the Health Care Reform Act of 1996, sufficient funds
 shall be available for the purposes described in subdivision ten of this
 section  in amounts necessary to fund the remaining year commitments for
 awards made pursuant to subparagraphs (iv) and (v) of this paragraph.
   (d) Physician practice support. Four  million  nine  hundred  thousand
 dollars  for the period January first, two thousand eight through Decem-
 ber thirty-first, two thousand eight, four million nine hundred thousand
 dollars annually for the period January first, two thousand nine through
 December thirty-first, two thousand ten, one million two  hundred  twen-
 ty-five  thousand  dollars  for  the  period January first, two thousand
 eleven through March thirty-first, two  thousand  eleven,  four  million
 three  hundred  thousand  dollars  each state fiscal year for the period
 April first, two thousand eleven through March thirty-first,  two  thou-
 sand  fourteen,  up to four million three hundred sixty thousand dollars
 each state fiscal year for the period April first, two thousand fourteen
 through March thirty-first, two thousand seventeen, up to  four  million
 three  hundred sixty thousand dollars for each state fiscal year for the
 period April first, two thousand seventeen through  March  thirty-first,
 two  thousand twenty, [and] up to four million three hundred sixty thou-
 sand dollars for each fiscal year for the period April first, two  thou-
 sand  twenty  through March thirty-first, two thousand twenty-three, AND
 UP TO FOUR MILLION THREE HUNDRED SIXTY THOUSAND DOLLARS FOR EACH  FISCAL
 YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-THREE THROUGH MARCH
 THIRTY-FIRST,  TWO  THOUSAND TWENTY-SIX, shall be set aside and reserved
 by the commissioner from the  regional  pools  established  pursuant  to
 subdivision  two  of this section and shall be available for purposes of
 physician practice support. Notwithstanding any  contrary  provision  of
 this section, sections one hundred twelve and one hundred sixty-three of
 the  state  finance  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 proposal
 process as follows:
   (i) Preference in funding shall first be accorded to teaching  general
 hospitals  for  up  to  twenty-five awards, to support costs incurred by
 physicians trained in primary or specialty tracks who thereafter  estab-
 lish  or join practices in underserved communities, as determined by the
 commissioner.
   (ii) After distributions in accordance with subparagraph (i)  of  this
 paragraph, all remaining funds shall be awarded to physicians to support
 the  cost  of  establishing or joining practices in underserved communi-
 ties, as determined by the commissioner,  and  to  hospitals  and  other
 health  care  providers to recruit new physicians to provide services in
 underserved communities, as determined by the commissioner.
 S. 4007                            44                            A. 3007
 
   (iii) In no case shall less than fifty percent of the funds  available
 pursuant  to  this  paragraph  be  distributed  to  general hospitals in
 accordance with subparagraphs (i) and (ii) of this paragraph.
   (e)  Work  group.  For  funding  available  pursuant to paragraphs (c)
 [and], (d) AND (e) of this subdivision:
   (i) The department shall appoint a  work  group  from  recommendations
 made  by  associations  representing  physicians,  general hospitals and
 other health care facilities to develop a streamlined application  proc-
 ess by June first, two thousand twelve.
   (ii) Subject to available funding, applications shall be accepted on a
 continuous  basis.  The department shall provide technical assistance to
 applicants to facilitate their completion of applications. An  applicant
 shall  be  notified  in  writing  by  the  department within ten days of
 receipt of an application as to whether the application is complete  and
 if  the  application is incomplete, what information is outstanding. The
 department shall act on an application within thirty days of receipt  of
 a complete application.
   (f) Study on physician workforce. Five hundred ninety thousand dollars
 annually for the period January first, two thousand eight through Decem-
 ber  thirty-first,  two  thousand  ten, one hundred forty-eight thousand
 dollars for the period January first, two thousand eleven through  March
 thirty-first, two thousand eleven, five hundred sixteen thousand dollars
 each  state  fiscal year for the period April first, two thousand eleven
 through March thirty-first, two thousand fourteen, up  to  four  hundred
 eighty-seven  thousand  dollars  each  state  fiscal year for the period
 April first, two thousand fourteen through March thirty-first, two thou-
 sand seventeen, up to four hundred  eighty-seven  thousand  dollars  for
 each  state  fiscal year for the period April first, two thousand seven-
 teen through March thirty-first, two thousand twenty, [and] up  to  four
 hundred  eighty-seven  thousand  dollars  each state fiscal year for the
 period April first, two thousand twenty through March thirty-first,  two
 thousand  twenty-three,  AND  UP  TO  FOUR HUNDRED EIGHTY-SEVEN THOUSAND
 DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND
 TWENTY-THREE  THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-SIX, shall
 be set aside and reserved by the commissioner from  the  regional  pools
 established  pursuant  to  subdivision  two of this section and shall be
 available to fund a study of physician  workforce  needs  and  solutions
 including,  but  not  limited  to, an analysis of residency programs and
 projected physician workforce  and  community  needs.  The  commissioner
 shall  enter  into  agreements with one or more organizations to conduct
 such study based on a request for proposal process.
   (g) Diversity in medicine/post-baccalaureate program.  Notwithstanding
 any  inconsistent provision of section one hundred twelve or one hundred
 sixty-three of the state finance law or any other law, one million  nine
 hundred  sixty  thousand  dollars annually for the period January first,
 two thousand eight through December thirty-first, two thousand ten, four
 hundred ninety thousand dollars for the period January first, two  thou-
 sand eleven through March thirty-first, two thousand eleven, one million
 seven  hundred  thousand  dollars  each state fiscal year for the period
 April first, two thousand eleven through March thirty-first,  two  thou-
 sand  fourteen, up to one million six hundred five thousand dollars each
 state fiscal year for the period  April  first,  two  thousand  fourteen
 through  March  thirty-first,  two thousand seventeen, up to one million
 six hundred five thousand dollars each state fiscal year for the  period
 April  first,  two  thousand  seventeen  through March thirty-first, two
 thousand twenty, [and] up to  one  million  six  hundred  five  thousand
 S. 4007                            45                            A. 3007
 
 dollars  each state fiscal year for the period April first, two thousand
 twenty through March thirty-first, two thousand twenty-three, AND UP  TO
 ONE MILLION SIX HUNDRED FIVE THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR
 THE  PERIOD APRIL FIRST, TWO THOUSAND TWENTY-THREE THROUGH MARCH THIRTY-
 FIRST, TWO THOUSAND TWENTY-SIX, shall be set aside and reserved  by  the
 commissioner from the regional pools established pursuant to subdivision
 two  of  this  section  and  shall be available for distributions to the
 Associated Medical Schools of New York to  fund  its  diversity  program
 including  existing and new post-baccalaureate programs for minority and
 economically disadvantaged students and encourage participation from all
 medical schools in New York. The associated medical schools of New  York
 shall report to the commissioner on an annual basis regarding the use of
 funds  for  such  purpose  in  such  form and manner as specified by the
 commissioner.
   (h) In the event there are undistributed  funds  within  amounts  made
 available for distributions pursuant to this subdivision, such funds may
 be  reallocated  and  distributed  in current or subsequent distribution
 periods in a manner determined by the commissioner for any  purpose  set
 forth in this subdivision.
   §  7.  Subdivision  4-c of section 2807-p of the public health law, as
 amended by section 10 of part Y of chapter 56 of the laws  of  2020,  is
 amended to read as follows:
   4-c. Notwithstanding any provision of law to the contrary, the commis-
 sioner  shall  make additional payments for uncompensated care to volun-
 tary non-profit diagnostic and treatment centers that are  eligible  for
 distributions  under  subdivision  four of this section in the following
 amounts: for the period June first, two thousand  six  through  December
 thirty-first,  two  thousand  six,  in  the amount of seven million five
 hundred thousand dollars, for the period  January  first,  two  thousand
 seven  through  December thirty-first, two thousand seven, seven million
 five hundred thousand dollars, for the period January first,  two  thou-
 sand  eight  through  December  thirty-first,  two thousand eight, seven
 million five hundred thousand dollars, for the period January first, two
 thousand nine through December thirty-first, two thousand nine,  fifteen
 million five hundred thousand dollars, for the period January first, two
 thousand  ten  through  December  thirty-first,  two thousand ten, seven
 million five hundred thousand dollars, for the period January first, two
 thousand eleven though December thirty-first, two thousand eleven, seven
 million five hundred thousand dollars, for the period January first, two
 thousand twelve through  December  thirty-first,  two  thousand  twelve,
 seven  million  five  hundred  thousand  dollars, for the period January
 first, two thousand thirteen through December thirty-first, two thousand
 thirteen, seven million five hundred thousand dollars,  for  the  period
 January  first, two thousand fourteen through December thirty-first, two
 thousand fourteen, seven million five hundred thousand dollars, for  the
 period  January  first,  two  thousand  fifteen through December thirty-
 first,  two  thousand  fifteen,  seven  million  five  hundred  thousand
 dollars,  for  the  period  January  first  two thousand sixteen through
 December thirty-first, two thousand sixteen, seven million five  hundred
 thousand  dollars,  for the period January first, two thousand seventeen
 through December thirty-first, two  thousand  seventeen,  seven  million
 five  hundred  thousand dollars, for the period January first, two thou-
 sand eighteen through  December  thirty-first,  two  thousand  eighteen,
 seven  million  five  hundred  thousand  dollars, for the period January
 first, two thousand nineteen through December thirty-first, two thousand
 nineteen, seven million five hundred thousand dollars,  for  the  period
 S. 4007                            46                            A. 3007
 
 January  first,  two  thousand twenty through December thirty-first, two
 thousand twenty, seven million five hundred thousand  dollars,  for  the
 period  January  first, two thousand twenty-one through December thirty-
 first,  two  thousand  twenty-one,  seven  million five hundred thousand
 dollars, for the period January first, two thousand  twenty-two  through
 December  thirty-first,  two  thousand  twenty-two,  seven  million five
 hundred thousand dollars, FOR THE PERIOD  JANUARY  FIRST,  TWO  THOUSAND
 TWENTY-THREE  THROUGH  DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-THREE,
 SEVEN MILLION FIVE HUNDRED THOUSAND  DOLLARS,  FOR  THE  PERIOD  JANUARY
 FIRST, TWO THOUSAND TWENTY-FOUR THROUGH DECEMBER THIRTY-FIRST, TWO THOU-
 SAND  TWENTY-FOUR,  SEVEN MILLION FIVE HUNDRED THOUSAND DOLLARS, FOR THE
 PERIOD JANUARY FIRST, TWO THOUSAND TWENTY-FIVE THROUGH DECEMBER  THIRTY-
 FIRST,  TWO  THOUSAND  TWENTY-FIVE,  SEVEN MILLION FIVE HUNDRED THOUSAND
 DOLLARS, and for the period January first, two  thousand  [twenty-three]
 TWENTY-SIX through March thirty-first, two thousand [twenty-three] TWEN-
 TY-SIX,  in  the  amount  of  one  million six hundred thousand dollars,
 provided, however, that for periods on  and  after  January  first,  two
 thousand  eight, such additional payments shall be distributed to volun-
 tary, non-profit diagnostic and treatment centers and to public diagnos-
 tic and treatment centers in accordance with paragraph (g)  of  subdivi-
 sion  four  of  this  section.  In  the  event  that  federal  financial
 participation  is  available  for  rate  adjustments  pursuant  to  this
 section, the commissioner shall make such payments as additional adjust-
 ments to rates of payment for voluntary non-profit diagnostic and treat-
 ment  centers  that  are  eligible  for  distributions under subdivision
 four-a of this section in the following amounts:  for  the  period  June
 first, two thousand six through December thirty-first, two thousand six,
 fifteen  million  dollars  in  the aggregate, and for the period January
 first, two thousand seven through June thirtieth,  two  thousand  seven,
 seven  million  five  hundred  thousand  dollars  in  the aggregate. The
 amounts allocated pursuant to this paragraph shall  be  aggregated  with
 and  distributed  pursuant  to  the  same  methodology applicable to the
 amounts allocated to such diagnostic  and  treatment  centers  for  such
 periods  pursuant  to subdivision four of this section if federal finan-
 cial participation is not available, or pursuant to  subdivision  four-a
 of  this  section  if  federal  financial  participation  is  available.
 Notwithstanding  section  three  hundred  sixty-eight-a  of  the  social
 services  law,  there  shall  be  no local share in a medical assistance
 payment adjustment under this subdivision.
   § 8. Subparagraph (xv) of paragraph (a) of subdivision  6  of  section
 2807-s  of  the public health law, as amended by section 11 of part Y of
 chapter 56 of the laws of 2020, is amended and a new subparagraph  (xvi)
 is added to read as follows:
   (xv) A gross annual statewide amount for the period January first, two
 thousand  fifteen  through  December thirty-first, two thousand [twenty-
 three] TWENTY-TWO, shall be one billion forty-five million dollars.
   (XVI) A GROSS ANNUAL STATEWIDE AMOUNT FOR THE  PERIOD  JANUARY  FIRST,
 TWO  THOUSAND  TWENTY-THREE TO DECEMBER THIRTY-FIRST, TWO THOUSAND TWEN-
 TY-SIX SHALL BE ONE BILLION EIGHTY-FIVE MILLION DOLLARS,  FORTY  MILLION
 DOLLARS  ANNUALLY OF WHICH SHALL BE ALLOCATED UNDER SECTION TWENTY-EIGHT
 HUNDRED SEVEN-O OF THIS ARTICLE AMONG  THE  MUNICIPALITIES  OF  AND  THE
 STATE  OF  NEW  YORK  BASED ON EACH MUNICIPALITY'S SHARE AND THE STATE'S
 SHARE OF EARLY INTERVENTION PROGRAM EXPENDITURES NOT REIMBURSABLE BY THE
 MEDICAL ASSISTANCE PROGRAM FOR THE LATEST TWELVE MONTH PERIOD FOR  WHICH
 SUCH DATA IS AVAILABLE.
 S. 4007                            47                            A. 3007
 
   §  9.  Paragraph  (g) of subdivision 6 of section 2807-s of the public
 health law, as added by chapter 820 of the laws of 2021, is  amended  to
 read as follows:
   (g)  A  further  gross  statewide amount for the state fiscal year two
 thousand twenty-two [and each state fiscal  year  thereafter]  shall  be
 forty million dollars.
   § 10. Subparagraph (xiii) of paragraph (a) of subdivision 7 of section
 2807-s  of  the public health law, as amended by section 12 of part Y of
 chapter 56 of the laws of 2020, is amended to read as follows:
   (xiii) twenty-three million eight hundred thirty-six thousand  dollars
 each  state  fiscal year for the period April first, two thousand twelve
 through March thirty-first, two thousand [twenty-three] TWENTY-SIX;
   § 11. Subdivision 6 of section 2807-t of the  public  health  law,  as
 amended  by  section  13 of part Y of chapter 56 of the laws of 2020, is
 amended to read as follows:
   6. Prospective adjustments. (a) The commissioner shall annually recon-
 cile the sum of the actual payments made  to  the  commissioner  or  the
 commissioner's designee for each region pursuant to section twenty-eight
 hundred  seven-s  of  this  article and pursuant to this section for the
 prior year with the regional allocation of the  gross  annual  statewide
 amount  specified  in  subdivision  six  of section twenty-eight hundred
 seven-s of this article for such prior year. The difference between  the
 actual  amount  raised  for  a region and the regional allocation of the
 specified gross annual amount for such prior year shall be applied as  a
 prospective adjustment to the regional allocation of the specified gross
 annual  payment  amount  for such region for the year next following the
 calculation of the reconciliation. The authorized dollar  value  of  the
 adjustments shall be the same as if calculated retrospectively.
   (b)  Notwithstanding  the provisions of paragraph (a) of this subdivi-
 sion, for covered lives assessment rate periods  on  and  after  January
 first,  two thousand fifteen through December thirty-first, two thousand
 [twenty-three] TWENTY-ONE, for amounts collected  in  the  aggregate  in
 excess of one billion forty-five million dollars on an annual basis, AND
 FOR  THE PERIOD JANUARY FIRST, TWO THOUSAND TWENTY-TWO TO DECEMBER THIR-
 TY-FIRST, TWO THOUSAND TWENTY-SIX FOR AMOUNTS COLLECTED IN THE AGGREGATE
 IN EXCESS OF ONE BILLION EIGHTY-FIVE MILLION DOLLARS ON AN ANNUAL BASIS,
 prospective adjustments shall be suspended if the annual  reconciliation
 calculation  from the prior year would otherwise result in a decrease to
 the regional allocation of the specified gross annual payment amount for
 that region, provided, however, that such  suspension  shall  be  lifted
 upon  a  determination  by  the  commissioner,  in consultation with the
 director of the budget, that sixty-five  million  dollars  in  aggregate
 collections  on  an  annual  basis over and above one billion forty-five
 million dollars on an annual basis FOR THE PERIOD ON AND  AFTER  JANUARY
 FIRST,  TWO THOUSAND FIFTEEN THROUGH DECEMBER THIRTY-FIRST, TWO THOUSAND
 TWENTY-ONE AND FOR THE PERIOD JANUARY FIRST, TWO THOUSAND TWENTY-TWO  TO
 DECEMBER  THIRTY-FIRST, TWO THOUSAND TWENTY-SIX FOR AMOUNTS COLLECTED IN
 THE AGGREGATE IN EXCESS OF ONE BILLION EIGHTY-FIVE MILLION DOLLARS ON AN
 ANNUAL BASIS have been reserved and set aside for deposit  in  the  HCRA
 resources  fund.  Any amounts collected in the aggregate at or below one
 billion forty-five million dollars on an annual basis FOR THE PERIOD  ON
 AND  AFTER  JANUARY FIRST, TWO THOUSAND FIFTEEN THROUGH DECEMBER THIRTY-
 FIRST, TWO THOUSAND TWENTY-TWO,  AND FOR THE PERIOD JANUARY  FIRST,  TWO
 THOUSAND  TWENTY-THREE TO DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-SIX
 FOR AMOUNTS COLLECTED IN THE AGGREGATE IN EXCESS OF ONE BILLION  EIGHTY-
 FIVE  MILLION  DOLLARS  ON AN ANNUAL BASIS, shall be subject to regional
 S. 4007                            48                            A. 3007
 
 adjustments reconciling any decreases or increases to the regional allo-
 cation in accordance with paragraph (a) of this subdivision.
   §  12.  Section 2807-v of the public health law, as amended by section
 14 of part Y of chapter 56 of the laws of 2020, is amended  to  read  as
 follows:
   § 2807-v. Tobacco  control  and  insurance  initiatives  pool distrib-
 utions.   1. Funds accumulated in  the  tobacco  control  and  insurance
 initiatives  pool or in the health care reform act (HCRA) resources fund
 established pursuant to section ninety-two-dd of the state finance  law,
 whichever  is applicable, including income from invested funds, shall be
 distributed or retained by the commissioner or by the state comptroller,
 as applicable, in accordance with the following:
   (a) Funds shall be  deposited  by  the  commissioner,  within  amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed to receive for deposit to  the  credit  of  the  state  special
 revenue  funds  -  other, HCRA transfer fund, medicaid fraud hotline and
 medicaid administration account, or any successor fund or  account,  for
 purposes  of  services  and  expenses  related to the toll-free medicaid
 fraud hotline established pursuant to section one hundred eight of chap-
 ter one of the laws of nineteen hundred  ninety-nine  from  the  tobacco
 control  and  insurance  initiatives  pool established for the following
 periods in the following amounts: four hundred thousand dollars annually
 for the periods January first, two  thousand  through  December  thirty-
 first,  two  thousand  two,  up to four hundred thousand dollars for the
 period January first, two thousand three through December  thirty-first,
 two  thousand  three, up to four hundred thousand dollars for the period
 January first, two thousand  four  through  December  thirty-first,  two
 thousand  four, up to four hundred thousand dollars for the period Janu-
 ary first, two thousand five through December thirty-first, two thousand
 five, up to four hundred thousand dollars for the period January  first,
 two  thousand six through December thirty-first, two thousand six, up to
 four hundred thousand dollars for the period January first, two thousand
 seven through December thirty-first, two  thousand  seven,  up  to  four
 hundred  thousand  dollars  for  the  period January first, two thousand
 eight through December thirty-first, two  thousand  eight,  up  to  four
 hundred thousand dollars for the period January first, two thousand nine
 through  December  thirty-first,  two  thousand nine, up to four hundred
 thousand dollars for the period January first, two thousand ten  through
 December  thirty-first,  two  thousand  ten,  up to one hundred thousand
 dollars for the period January first, two thousand eleven through  March
 thirty-first, two thousand eleven and within amounts appropriated on and
 after April first, two thousand eleven.
   (b)  Funds  shall  be  reserved  and accumulated from year to year and
 shall be available, including income from invested funds,  for  purposes
 of payment of audits or audit contracts necessary to determine payor and
 provider compliance with requirements set forth in sections twenty-eight
 hundred  seven-j,  twenty-eight hundred seven-s and twenty-eight hundred
 seven-t of this article from the tobacco control  and  insurance  initi-
 atives  pool  established  for  the  following  periods in the following
 amounts: five million six hundred  thousand  dollars  annually  for  the
 periods  January  first, two thousand through December thirty-first, two
 thousand two, up to five million dollars for the period  January  first,
 two thousand three through December thirty-first, two thousand three, up
 to  five million dollars for the period January first, two thousand four
 through December thirty-first, two thousand four,  up  to  five  million
 dollars for the period January first, two thousand five through December
 S. 4007                            49                            A. 3007
 
 thirty-first,  two  thousand  five,  up  to five million dollars for the
 period January first, two thousand six  through  December  thirty-first,
 two thousand six, up to seven million eight hundred thousand dollars for
 the  period  January  first, two thousand seven through December thirty-
 first, two thousand seven, and up to eight million three  hundred  twen-
 ty-five  thousand  dollars  for  the  period January first, two thousand
 eight through December thirty-first, two thousand  eight,  up  to  eight
 million  five hundred thousand dollars for the period January first, two
 thousand nine through December thirty-first, two thousand  nine,  up  to
 eight  million  five  hundred  thousand  dollars  for the period January
 first, two thousand ten through December thirty-first, two thousand ten,
 up to two million one hundred twenty-five thousand dollars for the peri-
 od January first, two thousand eleven through  March  thirty-first,  two
 thousand  eleven,  up to fourteen million seven hundred thousand dollars
 each state fiscal year for the period April first, two  thousand  eleven
 through  March thirty-first, two thousand fourteen, up to eleven million
 one hundred thousand dollars each state fiscal year for the period April
 first, two thousand fourteen through March  thirty-first,  two  thousand
 seventeen,  up to eleven million one hundred thousand dollars each state
 fiscal year for the period April first, two thousand  seventeen  through
 March  thirty-first, two thousand twenty, [and] up to eleven million one
 hundred thousand dollars each state fiscal year  for  the  period  April
 first,  two  thousand  twenty  through  March thirty-first, two thousand
 twenty-three, AND UP TO ELEVEN MILLION ONE HUNDRED THOUSAND DOLLARS EACH
 STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND  TWENTY-THREE
 THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-SIX.
   (c)  Funds  shall  be  deposited  by  the commissioner, within amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed  to  receive  for  deposit  to  the credit of the state special
 revenue funds - other, HCRA transfer fund, enhanced  community  services
 account,  or  any  successor fund or account, for mental health services
 programs for case management services for adults and children; supported
 housing; home and community based waiver services; family  based  treat-
 ment;  family support services; mobile mental health teams; transitional
 housing; and community oversight, established pursuant to articles seven
 and forty-one of the mental hygiene law and subdivision nine of  section
 three  hundred  sixty-six of the social services law; and for comprehen-
 sive care centers for eating disorders pursuant to  the  former  section
 twenty-seven  hundred  ninety-nine-l  of  this chapter, provided however
 that, for such centers, funds in the amount  of  five  hundred  thousand
 dollars  on  an  annualized basis shall be transferred from the enhanced
 community services account, or any successor fund or account, and depos-
 ited into the fund established by section  ninety-five-e  of  the  state
 finance  law;  from  the  tobacco control and insurance initiatives pool
 established for the following periods in the following amounts:
   (i) forty-eight million dollars to be reserved, to be retained or  for
 distribution  pursuant to a chapter of the laws of two thousand, for the
 period January first, two thousand through  December  thirty-first,  two
 thousand;
   (ii)  eighty-seven  million  dollars to be reserved, to be retained or
 for distribution pursuant to a chapter of the laws of two thousand  one,
 for  the period January first, two thousand one through December thirty-
 first, two thousand one;
   (iii) eighty-seven million dollars to be reserved, to be  retained  or
 for  distribution pursuant to a chapter of the laws of two thousand two,
 S. 4007                            50                            A. 3007
 
 for the period January first, two thousand two through December  thirty-
 first, two thousand two;
   (iv)  eighty-eight  million  dollars to be reserved, to be retained or
 for distribution pursuant to a chapter  of  the  laws  of  two  thousand
 three, for the period January first, two thousand three through December
 thirty-first, two thousand three;
   (v)  eighty-eight million dollars, plus five hundred thousand dollars,
 to be reserved, to be retained or for distribution pursuant to a chapter
 of the laws of two thousand four, and pursuant  to  the  former  section
 twenty-seven hundred ninety-nine-l of this chapter, for the period Janu-
 ary first, two thousand four through December thirty-first, two thousand
 four;
   (vi) eighty-eight million dollars, plus five hundred thousand dollars,
 to be reserved, to be retained or for distribution pursuant to a chapter
 of  the  laws  of  two thousand five, and pursuant to the former section
 twenty-seven hundred ninety-nine-l of this chapter, for the period Janu-
 ary first, two thousand five through December thirty-first, two thousand
 five;
   (vii)  eighty-eight  million  dollars,  plus  five  hundred   thousand
 dollars,  to be reserved, to be retained or for distribution pursuant to
 a chapter of the laws of  two  thousand  six,  and  pursuant  to  former
 section  twenty-seven  hundred  ninety-nine-l  of  this chapter, for the
 period January first, two thousand six  through  December  thirty-first,
 two thousand six;
   (viii)  eighty-six  million  four  hundred thousand dollars, plus five
 hundred thousand dollars, to be reserved, to be retained or for distrib-
 ution pursuant to a chapter of the laws of two thousand seven and pursu-
 ant to the former section twenty-seven  hundred  ninety-nine-l  of  this
 chapter, for the period January first, two thousand seven through Decem-
 ber thirty-first, two thousand seven; and
   (ix)  twenty-two  million nine hundred thirteen thousand dollars, plus
 one hundred twenty-five thousand dollars, to be reserved, to be retained
 or for distribution pursuant to a chapter of the laws  of  two  thousand
 eight  and  pursuant  to the former section twenty-seven hundred ninety-
 nine-l of this chapter, for the period January first, two thousand eight
 through March thirty-first, two thousand eight.
   (d) Funds shall be  deposited  by  the  commissioner,  within  amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed to receive for deposit to  the  credit  of  the  state  special
 revenue  funds  - other, HCRA transfer fund, medical assistance account,
 or any successor fund or account, for  purposes  of  funding  the  state
 share of services and expenses related to the family health plus program
 including up to two and one-half million dollars annually for the period
 January  first, two thousand through December thirty-first, two thousand
 two, for administration and marketing costs associated with such program
 established pursuant to clause (A) of subparagraph (v) of paragraph  (a)
 of  subdivision two of section three hundred sixty-nine-ee of the social
 services law from the tobacco control  and  insurance  initiatives  pool
 established for the following periods in the following amounts:
   (i) three million five hundred thousand dollars for the period January
 first, two thousand through December thirty-first, two thousand;
   (ii)  twenty-seven  million  dollars for the period January first, two
 thousand one through December thirty-first, two thousand one; and
   (iii) fifty-seven million dollars for the period  January  first,  two
 thousand two through December thirty-first, two thousand two.
 S. 4007                            51                            A. 3007
 
   (e)  Funds  shall  be  deposited  by  the commissioner, within amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed  to  receive  for  deposit  to  the credit of the state special
 revenue funds - other, HCRA transfer fund, medical  assistance  account,
 or  any  successor  fund  or  account, for purposes of funding the state
 share of services and expenses related to the family health plus program
 including up to two and one-half million dollars annually for the period
 January first, two thousand through December thirty-first, two  thousand
 two  for administration and marketing costs associated with such program
 established pursuant to clause (B) of subparagraph (v) of paragraph  (a)
 of  subdivision two of section three hundred sixty-nine-ee of the social
 services law from the tobacco control  and  insurance  initiatives  pool
 established for the following periods in the following amounts:
   (i)  two  million five hundred thousand dollars for the period January
 first, two thousand through December thirty-first, two thousand;
   (ii) thirty million five hundred thousand dollars for the period Janu-
 ary first, two thousand one through December thirty-first, two  thousand
 one; and
   (iii)  sixty-six  million  dollars  for  the period January first, two
 thousand two through December thirty-first, two thousand two.
   (f) Funds shall be  deposited  by  the  commissioner,  within  amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed to receive for deposit to  the  credit  of  the  state  special
 revenue  funds  -  other, HCRA transfer fund, medicaid fraud hotline and
 medicaid administration account, or any successor fund or  account,  for
 purposes of payment of administrative expenses of the department related
 to  the family health plus program established pursuant to section three
 hundred sixty-nine-ee of  the  social  services  law  from  the  tobacco
 control  and  insurance  initiatives  pool established for the following
 periods in the following amounts: five hundred thousand  dollars  on  an
 annual  basis for the periods January first, two thousand through Decem-
 ber thirty-first, two thousand six, five hundred  thousand  dollars  for
 the  period  January  first, two thousand seven through December thirty-
 first, two thousand seven, and five hundred  thousand  dollars  for  the
 period  January first, two thousand eight through December thirty-first,
 two thousand eight, five hundred thousand dollars for the period January
 first, two thousand nine through  December  thirty-first,  two  thousand
 nine,  five  hundred  thousand dollars for the period January first, two
 thousand ten  through  December  thirty-first,  two  thousand  ten,  one
 hundred  twenty-five  thousand dollars for the period January first, two
 thousand eleven through March  thirty-first,  two  thousand  eleven  and
 within amounts appropriated on and after April first, two thousand elev-
 en.
   (g)  Funds  shall  be  reserved  and accumulated from year to year and
 shall be available, including income from invested funds,  for  purposes
 of  services and expenses related to the health maintenance organization
 direct pay market program established pursuant to  sections  forty-three
 hundred  twenty-one-a and forty-three hundred twenty-two-a of the insur-
 ance law from the tobacco control and insurance initiatives pool  estab-
 lished for the following periods in the following amounts:
   (i)  up  to  thirty-five million dollars for the period January first,
 two thousand through December thirty-first, two thousand of which  fifty
 percentum  shall  be  allocated  to the program pursuant to section four
 thousand three hundred twenty-one-a  of  the  insurance  law  and  fifty
 percentum to the program pursuant to section four thousand three hundred
 twenty-two-a of the insurance law;
 S. 4007                            52                            A. 3007
 
   (ii)  up  to  thirty-six million dollars for the period January first,
 two thousand one through December  thirty-first,  two  thousand  one  of
 which  fifty  percentum  shall  be  allocated to the program pursuant to
 section four thousand three hundred twenty-one-a of  the  insurance  law
 and  fifty  percentum  to  the program pursuant to section four thousand
 three hundred twenty-two-a of the insurance law;
   (iii) up to thirty-nine million dollars for the period January  first,
 two  thousand  two  through  December  thirty-first, two thousand two of
 which fifty percentum shall be allocated  to  the  program  pursuant  to
 section  four  thousand  three hundred twenty-one-a of the insurance law
 and fifty percentum to the program pursuant  to  section  four  thousand
 three hundred twenty-two-a of the insurance law;
   (iv)  up  to  forty  million dollars for the period January first, two
 thousand three through December  thirty-first,  two  thousand  three  of
 which  fifty  percentum  shall  be  allocated to the program pursuant to
 section four thousand three hundred twenty-one-a of  the  insurance  law
 and  fifty  percentum  to  the program pursuant to section four thousand
 three hundred twenty-two-a of the insurance law;
   (v) up to forty million dollars for  the  period  January  first,  two
 thousand  four through December thirty-first, two thousand four of which
 fifty percentum shall be allocated to the program  pursuant  to  section
 four  thousand three hundred twenty-one-a of the insurance law and fifty
 percentum to the program pursuant to section four thousand three hundred
 twenty-two-a of the insurance law;
   (vi) up to forty million dollars for the  period  January  first,  two
 thousand  five through December thirty-first, two thousand five of which
 fifty percentum shall be allocated to the program  pursuant  to  section
 four  thousand three hundred twenty-one-a of the insurance law and fifty
 percentum to the program pursuant to section four thousand three hundred
 twenty-two-a of the insurance law;
   (vii) up to forty million dollars for the period  January  first,  two
 thousand  six  through  December thirty-first, two thousand six of which
 fifty percentum shall be allocated to the program  pursuant  to  section
 four  thousand three hundred twenty-one-a of the insurance law and fifty
 percentum shall be allocated to the program  pursuant  to  section  four
 thousand three hundred twenty-two-a of the insurance law;
   (viii)  up  to forty million dollars for the period January first, two
 thousand seven through December  thirty-first,  two  thousand  seven  of
 which  fifty  percentum  shall  be  allocated to the program pursuant to
 section four thousand three hundred twenty-one-a of  the  insurance  law
 and  fifty  percentum  shall  be  allocated  to  the program pursuant to
 section four thousand three hundred twenty-two-a of the  insurance  law;
 and
   (ix)  up  to  forty  million dollars for the period January first, two
 thousand eight through December  thirty-first,  two  thousand  eight  of
 which  fifty  per  centum  shall be allocated to the program pursuant to
 section four thousand three hundred twenty-one-a of  the  insurance  law
 and  fifty  per  centum  shall  be  allocated to the program pursuant to
 section four thousand three hundred twenty-two-a of the insurance law.
   (h) Funds shall be reserved and accumulated  from  year  to  year  and
 shall  be  available, including income from invested funds, for purposes
 of services and expenses related to  the  healthy  New  York  individual
 program  established  pursuant  to  sections four thousand three hundred
 twenty-six and four thousand three hundred twenty-seven of the insurance
 law from the tobacco control and insurance initiatives pool  established
 for the following periods in the following amounts:
 S. 4007                            53                            A. 3007
 
   (i)  up to six million dollars for the period January first, two thou-
 sand one through December thirty-first, two thousand one;
   (ii)  up  to twenty-nine million dollars for the period January first,
 two thousand two through December thirty-first, two thousand two;
   (iii) up to five million one hundred thousand dollars for  the  period
 January  first,  two  thousand  three through December thirty-first, two
 thousand three;
   (iv) up to twenty-four million six hundred thousand  dollars  for  the
 period  January  first, two thousand four through December thirty-first,
 two thousand four;
   (v) up to thirty-four million six hundred  thousand  dollars  for  the
 period  January  first, two thousand five through December thirty-first,
 two thousand five;
   (vi) up to fifty-four million eight hundred thousand dollars  for  the
 period  January  first,  two thousand six through December thirty-first,
 two thousand six;
   (vii) up to sixty-one million seven hundred thousand dollars  for  the
 period  January first, two thousand seven through December thirty-first,
 two thousand seven; and
   (viii) up to one hundred three million seven  hundred  fifty  thousand
 dollars  for the period January first, two thousand eight through Decem-
 ber thirty-first, two thousand eight.
   (i) Funds shall be reserved and accumulated  from  year  to  year  and
 shall  be  available, including income from invested funds, for purposes
 of services and expenses related to the healthy New York  group  program
 established  pursuant to sections four thousand three hundred twenty-six
 and four thousand three hundred twenty-seven of the insurance  law  from
 the  tobacco  control and insurance initiatives pool established for the
 following periods in the following amounts:
   (i) up to thirty-four million dollars for the  period  January  first,
 two thousand one through December thirty-first, two thousand one;
   (ii) up to seventy-seven million dollars for the period January first,
 two thousand two through December thirty-first, two thousand two;
   (iii)  up  to ten million five hundred thousand dollars for the period
 January first, two thousand three  through  December  thirty-first,  two
 thousand three;
   (iv)  up  to  twenty-four million six hundred thousand dollars for the
 period January first, two thousand four through  December  thirty-first,
 two thousand four;
   (v)  up  to  thirty-four  million six hundred thousand dollars for the
 period January first, two thousand five through  December  thirty-first,
 two thousand five;
   (vi)  up  to fifty-four million eight hundred thousand dollars for the
 period January first, two thousand six  through  December  thirty-first,
 two thousand six;
   (vii)  up  to sixty-one million seven hundred thousand dollars for the
 period January first, two thousand seven through December  thirty-first,
 two thousand seven; and
   (viii)  up  to  one hundred three million seven hundred fifty thousand
 dollars for the period January first, two thousand eight through  Decem-
 ber thirty-first, two thousand eight.
   (i-1) Notwithstanding the provisions of paragraphs (h) and (i) of this
 subdivision,  the  commissioner  shall  reserve and accumulate up to two
 million five hundred thousand dollars annually for the  periods  January
 first,  two  thousand  four  through December thirty-first, two thousand
 six, one million four hundred thousand dollars for  the  period  January
 S. 4007                            54                            A. 3007
 
 first,  two  thousand  seven through December thirty-first, two thousand
 seven, two million dollars for the period January  first,  two  thousand
 eight  through  December  thirty-first,  two  thousand eight, from funds
 otherwise  available  for  distribution  under  such  paragraphs for the
 services and expenses related to the  pilot  program  for  entertainment
 industry  employees  included  in subsection (b) of section one thousand
 one hundred twenty-two of the insurance law,  and  an  additional  seven
 hundred  thousand  dollars  annually  for the periods January first, two
 thousand four through December thirty-first, two thousand six, an  addi-
 tional  three hundred thousand dollars for the period January first, two
 thousand seven through June thirtieth, two thousand seven  for  services
 and expenses related to the pilot program for displaced workers included
 in  subsection (c) of section one thousand one hundred twenty-two of the
 insurance law.
   (j) Funds shall be reserved and accumulated  from  year  to  year  and
 shall  be  available, including income from invested funds, for purposes
 of services and expenses related  to  the  tobacco  use  prevention  and
 control  program established pursuant to sections thirteen hundred nine-
 ty-nine-ii and thirteen hundred ninety-nine-jj of this chapter, from the
 tobacco control and  insurance  initiatives  pool  established  for  the
 following periods in the following amounts:
   (i)  up  to  thirty  million dollars for the period January first, two
 thousand through December thirty-first, two thousand;
   (ii) up to forty million dollars for the  period  January  first,  two
 thousand one through December thirty-first, two thousand one;
   (iii)  up  to  forty million dollars for the period January first, two
 thousand two through December thirty-first, two thousand two;
   (iv) up to thirty-six million nine hundred fifty thousand dollars  for
 the  period  January  first, two thousand three through December thirty-
 first, two thousand three;
   (v) up to thirty-six million nine hundred fifty thousand  dollars  for
 the  period  January  first,  two thousand four through December thirty-
 first, two thousand four;
   (vi) up to forty million six hundred thousand dollars for  the  period
 January  first,  two  thousand  five  through December thirty-first, two
 thousand five;
   (vii) up to eighty-one million nine hundred thousand dollars  for  the
 period  January  first,  two thousand six through December thirty-first,
 two thousand six, provided, however, that within amounts appropriated, a
 portion of such funds may be transferred  to  the  Roswell  Park  Cancer
 Institute Corporation to support costs associated with cancer research;
   (viii)  up  to  ninety-four million one hundred fifty thousand dollars
 for the period January first, two thousand seven through December  thir-
 ty-first,  two  thousand  seven,  provided, however, that within amounts
 appropriated, a portion of such funds may be transferred to the  Roswell
 Park  Cancer  Institute  Corporation  to  support  costs associated with
 cancer research;
   (ix) up to ninety-four million one hundred fifty thousand dollars  for
 the  period  January  first, two thousand eight through December thirty-
 first, two thousand eight;
   (x) up to ninety-four million one hundred fifty thousand  dollars  for
 the  period  January  first,  two thousand nine through December thirty-
 first, two thousand nine;
   (xi) up to eighty-seven million seven  hundred  seventy-five  thousand
 dollars  for the period January first, two thousand ten through December
 thirty-first, two thousand ten;
 S. 4007                            55                            A. 3007

   (xii) up to twenty-one million four hundred  twelve  thousand  dollars
 for  the period January first, two thousand eleven through March thirty-
 first, two thousand eleven;
   (xiii) up to fifty-two million one hundred thousand dollars each state
 fiscal  year  for  the  period  April first, two thousand eleven through
 March thirty-first, two thousand fourteen;
   (xiv) up to six million dollars each state fiscal year for the  period
 April first, two thousand fourteen through March thirty-first, two thou-
 sand seventeen;
   (xv)  up  to six million dollars each state fiscal year for the period
 April first, two thousand  seventeen  through  March  thirty-first,  two
 thousand twenty; [and]
   (xvi)  up to six million dollars each state fiscal year for the period
 April first, two thousand twenty through March thirty-first,  two  thou-
 sand twenty-three; AND
   (XVII) UP TO SIX MILLION DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD
 APRIL  FIRST,  TWO THOUSAND TWENTY-THREE THROUGH MARCH THIRTY-FIRST, TWO
 THOUSAND TWENTY-SIX.
   (k) Funds shall be  deposited  by  the  commissioner,  within  amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed to receive for deposit to  the  credit  of  the  state  special
 revenue  fund - other, HCRA transfer fund, health care services account,
 or any successor fund or account, for purposes of services and  expenses
 related  to public health programs, including comprehensive care centers
 for eating disorders pursuant to the former section twenty-seven hundred
 ninety-nine-l of this chapter, provided however that, for such  centers,
 funds  in  the  amount of five hundred thousand dollars on an annualized
 basis shall be transferred from the health care services account, or any
 successor fund or account, and deposited into the  fund  established  by
 section  ninety-five-e  of  the  state  finance law for periods prior to
 March thirty-first, two thousand eleven, from the  tobacco  control  and
 insurance  initiatives pool established for the following periods in the
 following amounts:
   (i) up to thirty-one million dollars for the period January first, two
 thousand through December thirty-first, two thousand;
   (ii) up to forty-one million dollars for the period January first, two
 thousand one through December thirty-first, two thousand one;
   (iii) up to eighty-one million dollars for the period  January  first,
 two thousand two through December thirty-first, two thousand two;
   (iv)  one hundred twenty-two million five hundred thousand dollars for
 the period January first, two thousand three  through  December  thirty-
 first, two thousand three;
   (v)  one  hundred  eight  million  five  hundred seventy-five thousand
 dollars, plus an additional five hundred thousand dollars, for the peri-
 od January first, two thousand four through December  thirty-first,  two
 thousand four;
   (vi)  ninety-one million eight hundred thousand dollars, plus an addi-
 tional five hundred thousand dollars, for the period January first,  two
 thousand five through December thirty-first, two thousand five;
   (vii) one hundred fifty-six million six hundred thousand dollars, plus
 an  additional  five  hundred  thousand  dollars, for the period January
 first, two thousand six through December thirty-first, two thousand six;
   (viii) one hundred fifty-one million four  hundred  thousand  dollars,
 plus an additional five hundred thousand dollars, for the period January
 first,  two  thousand  seven through December thirty-first, two thousand
 seven;
 S. 4007                            56                            A. 3007
 
   (ix) one hundred sixteen  million  nine  hundred  forty-nine  thousand
 dollars, plus an additional five hundred thousand dollars, for the peri-
 od  January first, two thousand eight through December thirty-first, two
 thousand eight;
   (x)  one  hundred  sixteen  million  nine  hundred forty-nine thousand
 dollars, plus an additional five hundred thousand dollars, for the peri-
 od January first, two thousand nine through December  thirty-first,  two
 thousand nine;
   (xi)  one  hundred  sixteen  million  nine hundred forty-nine thousand
 dollars, plus an additional five hundred thousand dollars, for the peri-
 od January first, two thousand ten through  December  thirty-first,  two
 thousand ten;
   (xii)  twenty-nine  million  two  hundred  thirty-seven  thousand  two
 hundred fifty dollars, plus an additional one hundred twenty-five  thou-
 sand  dollars, for the period January first, two thousand eleven through
 March thirty-first, two thousand eleven;
   (xiii) one hundred twenty million thirty-eight  thousand  dollars  for
 the  period April first, two thousand eleven through March thirty-first,
 two thousand twelve; and
   (xiv) one hundred nineteen million four hundred seven thousand dollars
 each state fiscal year for the period April first, two  thousand  twelve
 through March thirty-first, two thousand fourteen.
   (l)  Funds  shall  be  deposited  by  the commissioner, within amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed  to  receive  for  deposit  to  the credit of the state special
 revenue funds - other, HCRA transfer fund, medical  assistance  account,
 or  any  successor  fund  or  account, for purposes of funding the state
 share of the personal care and certified home health agency rate or  fee
 increases  established  pursuant  to  subdivision three of section three
 hundred sixty-seven-o of  the  social  services  law  from  the  tobacco
 control  and  insurance  initiatives  pool established for the following
 periods in the following amounts:
   (i) twenty-three million two hundred thousand dollars for  the  period
 January first, two thousand through December thirty-first, two thousand;
   (ii)  twenty-three million two hundred thousand dollars for the period
 January first, two thousand one through December thirty-first, two thou-
 sand one;
   (iii) twenty-three million two hundred thousand dollars for the period
 January first, two thousand two through December thirty-first, two thou-
 sand two;
   (iv) up to sixty-five million two hundred  thousand  dollars  for  the
 period  January first, two thousand three through December thirty-first,
 two thousand three;
   (v) up to sixty-five million two  hundred  thousand  dollars  for  the
 period  January  first, two thousand four through December thirty-first,
 two thousand four;
   (vi) up to sixty-five million two hundred  thousand  dollars  for  the
 period  January  first, two thousand five through December thirty-first,
 two thousand five;
   (vii) up to sixty-five million two hundred thousand  dollars  for  the
 period  January  first,  two thousand six through December thirty-first,
 two thousand six;
   (viii) up to sixty-five million two hundred thousand dollars  for  the
 period  January first, two thousand seven through December thirty-first,
 two thousand seven; and
 S. 4007                            57                            A. 3007
 
   (ix) up to sixteen million three  hundred  thousand  dollars  for  the
 period January first, two thousand eight through March thirty-first, two
 thousand eight.
   (m)  Funds  shall  be  deposited  by  the commissioner, within amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed  to  receive  for  deposit  to  the credit of the state special
 revenue funds - other, HCRA transfer fund, medical  assistance  account,
 or  any  successor  fund  or  account, for purposes of funding the state
 share of services and expenses related to home  care  workers  insurance
 pilot  demonstration programs established pursuant to subdivision two of
 section three hundred sixty-seven-o of the social services law from  the
 tobacco  control  and  insurance  initiatives  pool  established for the
 following periods in the following amounts:
   (i) three million eight hundred thousand dollars for the period  Janu-
 ary first, two thousand through December thirty-first, two thousand;
   (ii) three million eight hundred thousand dollars for the period Janu-
 ary  first, two thousand one through December thirty-first, two thousand
 one;
   (iii) three million eight hundred  thousand  dollars  for  the  period
 January first, two thousand two through December thirty-first, two thou-
 sand two;
   (iv) up to three million eight hundred thousand dollars for the period
 January  first,  two  thousand  three through December thirty-first, two
 thousand three;
   (v) up to three million eight hundred thousand dollars for the  period
 January  first,  two  thousand  four  through December thirty-first, two
 thousand four;
   (vi) up to three million eight hundred thousand dollars for the period
 January first, two thousand  five  through  December  thirty-first,  two
 thousand five;
   (vii) up to three million eight hundred thousand dollars for the peri-
 od  January  first,  two thousand six through December thirty-first, two
 thousand six;
   (viii) up to three million eight  hundred  thousand  dollars  for  the
 period  January first, two thousand seven through December thirty-first,
 two thousand seven; and
   (ix) up to nine hundred fifty thousand dollars for the period  January
 first,  two  thousand  eight  through  March  thirty-first, two thousand
 eight.
   (n) Funds shall be transferred by the commissioner and shall be depos-
 ited to the credit of the special revenue funds -  other,  miscellaneous
 special  revenue  fund  - 339, elderly pharmaceutical insurance coverage
 program premium account authorized pursuant to the provisions  of  title
 three of article two of the elder law, or any successor fund or account,
 for  funding  state  expenses  relating  to the program from the tobacco
 control and insurance initiatives pool  established  for  the  following
 periods in the following amounts:
   (i)  one  hundred  seven million dollars for the period January first,
 two thousand through December thirty-first, two thousand;
   (ii) one hundred sixty-four million dollars  for  the  period  January
 first, two thousand one through December thirty-first, two thousand one;
   (iii)  three hundred twenty-two million seven hundred thousand dollars
 for the period January first, two thousand two through December  thirty-
 first, two thousand two;
 S. 4007                            58                            A. 3007
 
   (iv)  four hundred thirty-three million three hundred thousand dollars
 for the period January first, two thousand three through December  thir-
 ty-first, two thousand three;
   (v)  five  hundred four million one hundred fifty thousand dollars for
 the period January first, two thousand  four  through  December  thirty-
 first, two thousand four;
   (vi) five hundred sixty-six million eight hundred thousand dollars for
 the  period  January  first,  two thousand five through December thirty-
 first, two thousand five;
   (vii) six hundred three million one hundred fifty thousand dollars for
 the period January first, two  thousand  six  through  December  thirty-
 first, two thousand six;
   (viii)  six  hundred  sixty million eight hundred thousand dollars for
 the period January first, two thousand seven  through  December  thirty-
 first, two thousand seven;
   (ix)  three hundred sixty-seven million four hundred sixty-three thou-
 sand dollars for the period January first, two  thousand  eight  through
 December thirty-first, two thousand eight;
   (x)  three hundred thirty-four million eight hundred twenty-five thou-
 sand dollars for the period January first,  two  thousand  nine  through
 December thirty-first, two thousand nine;
   (xi)  three  hundred  forty-four million nine hundred thousand dollars
 for the period January first, two thousand ten through December  thirty-
 first, two thousand ten;
   (xii) eighty-seven million seven hundred eighty-eight thousand dollars
 for  the period January first, two thousand eleven through March thirty-
 first, two thousand eleven;
   (xiii) one hundred forty-three  million  one  hundred  fifty  thousand
 dollars  for  the  period April first, two thousand eleven through March
 thirty-first, two thousand twelve;
   (xiv) one hundred twenty million nine hundred fifty  thousand  dollars
 for  the  period  April first, two thousand twelve through March thirty-
 first, two thousand thirteen;
   (xv) one hundred twenty-eight million  eight  hundred  fifty  thousand
 dollars  for the period April first, two thousand thirteen through March
 thirty-first, two thousand fourteen;
   (xvi) one hundred twenty-seven million four hundred  sixteen  thousand
 dollars  each state fiscal year for the period April first, two thousand
 fourteen through March thirty-first, two thousand seventeen;
   (xvii) one hundred twenty-seven million four hundred sixteen  thousand
 dollars  each state fiscal year for the period April first, two thousand
 seventeen through March thirty-first, two thousand twenty; [and]
   (xviii) one hundred twenty-seven million four hundred sixteen thousand
 dollars each state fiscal year for the period April first, two  thousand
 twenty through March thirty-first, two thousand twenty-three; AND
   (XIX)  ONE  HUNDRED TWENTY-SEVEN MILLION FOUR HUNDRED SIXTEEN THOUSAND
 DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND
 TWENTY-THREE THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-SIX.
   (o)  Funds  shall be reserved and accumulated and shall be transferred
 to the Roswell Park  Cancer  Institute  Corporation,  from  the  tobacco
 control  and  insurance  initiatives  pool established for the following
 periods in the following amounts:
   (i) up to ninety million dollars for the  period  January  first,  two
 thousand through December thirty-first, two thousand;
   (ii)  up  to  sixty  million dollars for the period January first, two
 thousand one through December thirty-first, two thousand one;
 S. 4007                            59                            A. 3007
 
   (iii) up to eighty-five million dollars for the period January  first,
 two thousand two through December thirty-first, two thousand two;
   (iv)  eighty-five  million  two hundred fifty thousand dollars for the
 period January first, two thousand three through December  thirty-first,
 two thousand three;
   (v)  seventy-eight  million  dollars for the period January first, two
 thousand four through December thirty-first, two thousand four;
   (vi) seventy-eight million dollars for the period January  first,  two
 thousand five through December thirty-first, two thousand five;
   (vii)  ninety-one  million  dollars  for the period January first, two
 thousand six through December thirty-first, two thousand six;
   (viii) seventy-eight million dollars for the period January first, two
 thousand seven through December thirty-first, two thousand seven;
   (ix) seventy-eight million dollars for the period January  first,  two
 thousand eight through December thirty-first, two thousand eight;
   (x)  seventy-eight  million  dollars for the period January first, two
 thousand nine through December thirty-first, two thousand nine;
   (xi) seventy-eight million dollars for the period January  first,  two
 thousand ten through December thirty-first, two thousand ten;
   (xii)  nineteen  million  five hundred thousand dollars for the period
 January first, two thousand eleven through March thirty-first, two thou-
 sand eleven;
   (xiii) sixty-nine million eight hundred forty  thousand  dollars  each
 state  fiscal  year  for  the  period  April  first, two thousand eleven
 through March thirty-first, two thousand fourteen;
   (xiv) up to ninety-six million six hundred thousand dollars each state
 fiscal year for the period April first, two  thousand  fourteen  through
 March thirty-first, two thousand seventeen;
   (xv)  up to ninety-six million six hundred thousand dollars each state
 fiscal year for the period April first, two thousand  seventeen  through
 March thirty-first, two thousand twenty; [and]
   (xvi) up to ninety-six million six hundred thousand dollars each state
 fiscal  year  for  the  period  April first, two thousand twenty through
 March thirty-first, two thousand twenty-three; AND
   (XVII) UP TO NINETY-SIX MILLION  SIX  HUNDRED  THOUSAND  DOLLARS  EACH
 STATE  FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-THREE
 THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-SIX.
   (p) Funds shall be  deposited  by  the  commissioner,  within  amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed to receive for deposit to  the  credit  of  the  state  special
 revenue  funds - other, indigent care fund - 068, indigent care account,
 or any successor fund or account, for purposes of providing  a  medicaid
 disproportionate  share payment from the high need indigent care adjust-
 ment pool established pursuant to section twenty-eight  hundred  seven-w
 of this article, from the tobacco control and insurance initiatives pool
 established for the following periods in the following amounts:
   (i) eighty-two million dollars annually for the periods January first,
 two thousand through December thirty-first, two thousand two;
   (ii)  up  to  eighty-two million dollars for the period January first,
 two thousand three through December thirty-first, two thousand three;
   (iii) up to eighty-two million dollars for the period  January  first,
 two thousand four through December thirty-first, two thousand four;
   (iv)  up  to  eighty-two million dollars for the period January first,
 two thousand five through December thirty-first, two thousand five;
   (v) up to eighty-two million dollars for the period January first, two
 thousand six through December thirty-first, two thousand six;
 S. 4007                            60                            A. 3007
 
   (vi) up to eighty-two million dollars for the  period  January  first,
 two thousand seven through December thirty-first, two thousand seven;
   (vii)  up  to eighty-two million dollars for the period January first,
 two thousand eight through December thirty-first, two thousand eight;
   (viii) up to eighty-two million dollars for the period January  first,
 two thousand nine through December thirty-first, two thousand nine;
   (ix)  up  to  eighty-two million dollars for the period January first,
 two thousand ten through December thirty-first, two thousand ten;
   (x) up to twenty million five hundred thousand dollars for the  period
 January first, two thousand eleven through March thirty-first, two thou-
 sand eleven; and
   (xi)  up  to eighty-two million dollars each state fiscal year for the
 period April first, two thousand eleven through March thirty-first,  two
 thousand fourteen.
   (q)  Funds  shall  be  reserved  and accumulated from year to year and
 shall be available, including income from invested funds,  for  purposes
 of  providing  distributions  to  eligible  school  based health centers
 established pursuant to section eighty-eight of chapter one of the  laws
 of  nineteen hundred ninety-nine, from the tobacco control and insurance
 initiatives pool established for the following periods in the  following
 amounts:
   (i)  seven  million dollars annually for the period January first, two
 thousand through December thirty-first, two thousand two;
   (ii) up to seven million dollars for the  period  January  first,  two
 thousand three through December thirty-first, two thousand three;
   (iii)  up  to  seven million dollars for the period January first, two
 thousand four through December thirty-first, two thousand four;
   (iv) up to seven million dollars for the  period  January  first,  two
 thousand five through December thirty-first, two thousand five;
   (v)  up  to  seven  million  dollars for the period January first, two
 thousand six through December thirty-first, two thousand six;
   (vi) up to seven million dollars for the  period  January  first,  two
 thousand seven through December thirty-first, two thousand seven;
   (vii)  up  to  seven million dollars for the period January first, two
 thousand eight through December thirty-first, two thousand eight;
   (viii) up to seven million dollars for the period January  first,  two
 thousand nine through December thirty-first, two thousand nine;
   (ix)  up  to  seven  million dollars for the period January first, two
 thousand ten through December thirty-first, two thousand ten;
   (x) up to one million seven hundred fifty  thousand  dollars  for  the
 period  January  first,  two thousand eleven through March thirty-first,
 two thousand eleven;
   (xi) up to five million six hundred thousand dollars each state fiscal
 year for the period April first, two thousand eleven through March thir-
 ty-first, two thousand fourteen;
   (xii) up to five million two  hundred  eighty-eight  thousand  dollars
 each state fiscal year for the period April first, two thousand fourteen
 through March thirty-first, two thousand seventeen;
   (xiii)  up  to  five million two hundred eighty-eight thousand dollars
 each state fiscal year for the period April first, two  thousand  seven-
 teen through March thirty-first, two thousand twenty; [and]
   (xiv)  up  to  five  million two hundred eighty-eight thousand dollars
 each state fiscal year for the period April first, two  thousand  twenty
 through March thirty-first, two thousand twenty-three; AND
 S. 4007                            61                            A. 3007
 
   (XV) UP TO FIVE MILLION TWO HUNDRED EIGHTY-EIGHT THOUSAND DOLLARS EACH
 STATE  FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-THREE
 THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-SIX.
   (r) Funds shall be deposited by the commissioner within amounts appro-
 priated,  and the state comptroller is hereby authorized and directed to
 receive for deposit to the credit of the state special revenue  funds  -
 other,  HCRA transfer fund, medical assistance account, or any successor
 fund or account, for purposes of providing distributions for  supplemen-
 tary   medical  insurance  for  Medicare  part  B  premiums,  physicians
 services, outpatient services, medical  equipment,  supplies  and  other
 health services, from the tobacco control and insurance initiatives pool
 established for the following periods in the following amounts:
   (i)  forty-three  million  dollars  for  the period January first, two
 thousand through December thirty-first, two thousand;
   (ii) sixty-one million dollars for the period January first, two thou-
 sand one through December thirty-first, two thousand one;
   (iii) sixty-five million dollars for the  period  January  first,  two
 thousand two through December thirty-first, two thousand two;
   (iv)  sixty-seven million five hundred thousand dollars for the period
 January first, two thousand three  through  December  thirty-first,  two
 thousand three;
   (v)  sixty-eight  million  dollars  for  the period January first, two
 thousand four through December thirty-first, two thousand four;
   (vi) sixty-eight million dollars for the  period  January  first,  two
 thousand five through December thirty-first, two thousand five;
   (vii)  sixty-eight  million  dollars for the period January first, two
 thousand six through December thirty-first, two thousand six;
   (viii) seventeen million five hundred thousand dollars for the  period
 January  first,  two  thousand  seven through December thirty-first, two
 thousand seven;
   (ix) sixty-eight million dollars for the  period  January  first,  two
 thousand eight through December thirty-first, two thousand eight;
   (x)  sixty-eight  million  dollars  for  the period January first, two
 thousand nine through December thirty-first, two thousand nine;
   (xi) sixty-eight million dollars for the  period  January  first,  two
 thousand ten through December thirty-first, two thousand ten;
   (xii)  seventeen  million  dollars  for  the period January first, two
 thousand eleven through March thirty-first, two thousand eleven; and
   (xiii) sixty-eight million dollars each  state  fiscal  year  for  the
 period  April first, two thousand eleven through March thirty-first, two
 thousand fourteen.
   (s) Funds shall be deposited by the commissioner within amounts appro-
 priated, and the state comptroller is hereby authorized and directed  to
 receive  for  deposit to the credit of the state special revenue funds -
 other, HCRA transfer fund, medical assistance account, or any  successor
 fund  or  account,  for  purposes of providing distributions pursuant to
 paragraphs (s-5), (s-6),  (s-7)  and  (s-8)  of  subdivision  eleven  of
 section  twenty-eight  hundred  seven-c of this article from the tobacco
 control and insurance initiatives pool  established  for  the  following
 periods in the following amounts:
   (i)  eighteen  million dollars for the period January first, two thou-
 sand through December thirty-first, two thousand;
   (ii) twenty-four million dollars  annually  for  the  periods  January
 first, two thousand one through December thirty-first, two thousand two;
   (iii)  up to twenty-four million dollars for the period January first,
 two thousand three through December thirty-first, two thousand three;
 S. 4007                            62                            A. 3007
 
   (iv) up to twenty-four million dollars for the period  January  first,
 two thousand four through December thirty-first, two thousand four;
   (v)  up  to  twenty-four million dollars for the period January first,
 two thousand five through December thirty-first, two thousand five;
   (vi) up to twenty-four million dollars for the period  January  first,
 two thousand six through December thirty-first, two thousand six;
   (vii)  up to twenty-four million dollars for the period January first,
 two thousand seven through December thirty-first, two thousand seven;
   (viii) up to twenty-four million dollars for the period January first,
 two thousand eight through December thirty-first,  two  thousand  eight;
 and
   (ix)  up  to  twenty-two million dollars for the period January first,
 two thousand nine through November thirtieth, two thousand nine.
   (t) Funds shall be reserved and accumulated from year to year  by  the
 commissioner and shall be made available, including income from invested
 funds:
   (i)  For  the  purpose  of making grants to a state owned and operated
 medical school which does not have a state owned and  operated  hospital
 on  site  and  available for teaching purposes. Notwithstanding sections
 one hundred twelve and one hundred sixty-three of the state finance law,
 such grants shall be made in the amount of up to five  hundred  thousand
 dollars  for  the  period  January  first, two thousand through December
 thirty-first, two thousand;
   (ii) For the purpose of making grants to medical schools  pursuant  to
 section  eighty-six-a  of  chapter  one  of the laws of nineteen hundred
 ninety-nine in the sum of up to four  million  dollars  for  the  period
 January first, two thousand through December thirty-first, two thousand;
 and
   (iii)  The  funds  disbursed pursuant to subparagraphs (i) and (ii) of
 this paragraph from the tobacco control and insurance  initiatives  pool
 are  contingent upon meeting all funding amounts established pursuant to
 paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n),  (p),  (q),  (r)
 and  (s)  of  this  subdivision,  paragraph  (a)  of subdivision nine of
 section twenty-eight hundred seven-j of  this  article,  and  paragraphs
 (a),  (i)  and  (k)  of  subdivision one of section twenty-eight hundred
 seven-l of this article.
   (u) Funds shall be  deposited  by  the  commissioner,  within  amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed to receive for deposit to  the  credit  of  the  state  special
 revenue  funds  - other, HCRA transfer fund, medical assistance account,
 or any successor fund or account, for  purposes  of  funding  the  state
 share  of  services  and  expenses  related  to the nursing home quality
 improvement demonstration program established pursuant to section  twen-
 ty-eight  hundred  eight-d  of this article from the tobacco control and
 insurance initiatives pool established for the following periods in  the
 following amounts:
   (i)  up  to twenty-five million dollars for the period beginning April
 first, two thousand two and ending December thirty-first,  two  thousand
 two,  and  on  an  annualized  basis,  for each annual period thereafter
 beginning January first, two thousand three and ending December  thirty-
 first, two thousand four;
   (ii)  up  to eighteen million seven hundred fifty thousand dollars for
 the period January first, two thousand  five  through  December  thirty-
 first, two thousand five; and
 S. 4007                            63                            A. 3007
 
   (iii)  up  to  fifty-six million five hundred thousand dollars for the
 period January first, two thousand six  through  December  thirty-first,
 two thousand six.
   (v) Funds shall be transferred by the commissioner and shall be depos-
 ited  to the credit of the hospital excess liability pool created pursu-
 ant to section eighteen of chapter two hundred sixty-six of the laws  of
 nineteen  hundred  eighty-six,  or  any  successor  fund or account, for
 purposes of expenses related to the purchase of excess medical  malprac-
 tice  insurance and the cost of administrating the pool, including costs
 associated with the risk  management  program  established  pursuant  to
 section  forty-two  of part A of chapter one of the laws of two thousand
 two required by paragraph (a) of subdivision one of section eighteen  of
 chapter two hundred sixty-six of the laws of nineteen hundred eighty-six
 as may be amended from time to time, from the tobacco control and insur-
 ance  initiatives  pool  established  for  the  following periods in the
 following amounts:
   (i) up to fifty million dollars or so much as is needed for the period
 January first, two thousand two through December thirty-first, two thou-
 sand two;
   (ii) up to seventy-six million seven hundred thousand dollars for  the
 period  January first, two thousand three through December thirty-first,
 two thousand three;
   (iii) up to sixty-five million dollars for the period  January  first,
 two thousand four through December thirty-first, two thousand four;
   (iv)  up  to  sixty-five million dollars for the period January first,
 two thousand five through December thirty-first, two thousand five;
   (v) up to one hundred thirteen million eight hundred thousand  dollars
 for  the period January first, two thousand six through December thirty-
 first, two thousand six;
   (vi) up to one hundred thirty million dollars for the  period  January
 first,  two  thousand  seven through December thirty-first, two thousand
 seven;
   (vii) up to one hundred thirty million dollars for the period  January
 first,  two  thousand  eight through December thirty-first, two thousand
 eight;
   (viii) up to one hundred thirty million dollars for the period January
 first, two thousand nine through  December  thirty-first,  two  thousand
 nine;
   (ix)  up  to one hundred thirty million dollars for the period January
 first, two thousand ten through December thirty-first, two thousand ten;
   (x) up to thirty-two million five hundred  thousand  dollars  for  the
 period  January  first,  two thousand eleven through March thirty-first,
 two thousand eleven;
   (xi) up to one hundred  twenty-seven  million  four  hundred  thousand
 dollars  each state fiscal year for the period April first, two thousand
 eleven through March thirty-first, two thousand fourteen;
   (xii) up to one hundred twenty-seven  million  four  hundred  thousand
 dollars  each state fiscal year for the period April first, two thousand
 fourteen through March thirty-first, two thousand seventeen;
   (xiii) up to one hundred twenty-seven million  four  hundred  thousand
 dollars  each state fiscal year for the period April first, two thousand
 seventeen through March thirty-first, two thousand twenty; [and]
   (xiv) up to one hundred twenty-seven  million  four  hundred  thousand
 dollars  each state fiscal year for the period April first, two thousand
 twenty through March thirty-first, two thousand twenty-three; AND
 S. 4007                            64                            A. 3007
 
   (XV) UP TO ONE HUNDRED  TWENTY-SEVEN  MILLION  FOUR  HUNDRED  THOUSAND
 DOLLARS  EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND
 TWENTY-THREE THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-SIX.
   (w)  Funds  shall  be  deposited  by  the commissioner, within amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed  to  receive  for  deposit  to  the credit of the state special
 revenue funds - other, HCRA transfer fund, medical  assistance  account,
 or  any  successor  fund  or  account, for purposes of funding the state
 share of the treatment of breast and cervical cancer pursuant  to  para-
 graph  (d) of subdivision four of section three hundred sixty-six of the
 social services law, from the tobacco control and insurance  initiatives
 pool established for the following periods in the following amounts:
   (i)  up  to four hundred fifty thousand dollars for the period January
 first, two thousand two through December thirty-first, two thousand two;
   (ii) up to two million one hundred thousand  dollars  for  the  period
 January  first,  two  thousand  three through December thirty-first, two
 thousand three;
   (iii) up to two million one hundred thousand dollars  for  the  period
 January  first,  two  thousand  four  through December thirty-first, two
 thousand four;
   (iv) up to two million one hundred thousand  dollars  for  the  period
 January  first,  two  thousand  five  through December thirty-first, two
 thousand five;
   (v) up to two million one hundred  thousand  dollars  for  the  period
 January first, two thousand six through December thirty-first, two thou-
 sand six;
   (vi)  up  to  two  million one hundred thousand dollars for the period
 January first, two thousand seven  through  December  thirty-first,  two
 thousand seven;
   (vii)  up  to  two million one hundred thousand dollars for the period
 January first, two thousand eight  through  December  thirty-first,  two
 thousand eight;
   (viii)  up  to two million one hundred thousand dollars for the period
 January first, two thousand  nine  through  December  thirty-first,  two
 thousand nine;
   (ix)  up  to  two  million one hundred thousand dollars for the period
 January first, two thousand ten through December thirty-first, two thou-
 sand ten;
   (x) up to five hundred twenty-five thousand  dollars  for  the  period
 January first, two thousand eleven through March thirty-first, two thou-
 sand eleven;
   (xi)  up to two million one hundred thousand dollars each state fiscal
 year for the period April first, two thousand eleven through March thir-
 ty-first, two thousand fourteen;
   (xii) up to two million one hundred thousand dollars each state fiscal
 year for the period April first, two  thousand  fourteen  through  March
 thirty-first, two thousand seventeen;
   (xiii)  up  to  two  million  one  hundred thousand dollars each state
 fiscal year for the period April first, two thousand  seventeen  through
 March thirty-first, two thousand twenty; [and]
   (xiv) up to two million one hundred thousand dollars each state fiscal
 year for the period April first, two thousand twenty through March thir-
 ty-first, two thousand twenty-three; AND
   (XV)  UP TO TWO MILLION ONE HUNDRED THOUSAND DOLLARS EACH STATE FISCAL
 YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-THREE THROUGH MARCH
 THIRTY-FIRST, TWO THOUSAND TWENTY-SIX.
 S. 4007                            65                            A. 3007
 
   (x) Funds shall be  deposited  by  the  commissioner,  within  amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed to receive for deposit to  the  credit  of  the  state  special
 revenue  funds  - other, HCRA transfer fund, medical assistance account,
 or  any  successor  fund  or  account, for purposes of funding the state
 share of the non-public general hospital rates increases for recruitment
 and retention of health care workers from the tobacco control and insur-
 ance initiatives pool established  for  the  following  periods  in  the
 following amounts:
   (i) twenty-seven million one hundred thousand dollars on an annualized
 basis  for  the  period January first, two thousand two through December
 thirty-first, two thousand two;
   (ii) fifty million eight hundred thousand  dollars  on  an  annualized
 basis  for the period January first, two thousand three through December
 thirty-first, two thousand three;
   (iii) sixty-nine million three hundred thousand dollars on an  annual-
 ized  basis  for  the  period  January  first, two thousand four through
 December thirty-first, two thousand four;
   (iv) sixty-nine million three hundred thousand dollars for the  period
 January  first,  two  thousand  five  through December thirty-first, two
 thousand five;
   (v) sixty-nine million three hundred thousand dollars for  the  period
 January first, two thousand six through December thirty-first, two thou-
 sand six;
   (vi)  sixty-five million three hundred thousand dollars for the period
 January first, two thousand seven  through  December  thirty-first,  two
 thousand seven;
   (vii)  sixty-one  million  one  hundred fifty thousand dollars for the
 period January first, two thousand eight through December  thirty-first,
 two thousand eight; and
   (viii)  forty-eight  million seven hundred twenty-one thousand dollars
 for the period January first, two thousand nine through November thirti-
 eth, two thousand nine.
   (y) Funds shall be reserved and accumulated  from  year  to  year  and
 shall  be  available, including income from invested funds, for purposes
 of grants to public general hospitals for recruitment and  retention  of
 health  care  workers pursuant to paragraph (b) of subdivision thirty of
 section twenty-eight hundred seven-c of this article  from  the  tobacco
 control  and  insurance  initiatives  pool established for the following
 periods in the following amounts:
   (i) eighteen million five hundred thousand dollars  on  an  annualized
 basis  for  the  period January first, two thousand two through December
 thirty-first, two thousand two;
   (ii) thirty-seven million four hundred thousand dollars on an  annual-
 ized  basis  for  the  period  January first, two thousand three through
 December thirty-first, two thousand three;
   (iii) fifty-two million two hundred thousand dollars on an  annualized
 basis  for  the period January first, two thousand four through December
 thirty-first, two thousand four;
   (iv) fifty-two million two hundred thousand  dollars  for  the  period
 January  first,  two  thousand  five  through December thirty-first, two
 thousand five;
   (v) fifty-two million two hundred  thousand  dollars  for  the  period
 January first, two thousand six through December thirty-first, two thou-
 sand six;
 S. 4007                            66                            A. 3007
 
   (vi)  forty-nine  million  dollars  for  the period January first, two
 thousand seven through December thirty-first, two thousand seven;
   (vii)  forty-nine  million  dollars  for the period January first, two
 thousand eight through December thirty-first, two thousand eight; and
   (viii) twelve million two hundred fifty thousand dollars for the peri-
 od January first, two thousand  nine  through  March  thirty-first,  two
 thousand nine.
   Provided,  however,  amounts pursuant to this paragraph may be reduced
 in an amount to be approved by the director of  the  budget  to  reflect
 amounts  received  from  the  federal  government under the state's 1115
 waiver which are directed under its terms and conditions to  the  health
 workforce recruitment and retention program.
   (z)  Funds  shall  be  deposited  by  the commissioner, within amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed  to  receive  for  deposit  to  the credit of the state special
 revenue funds - other, HCRA transfer fund, medical  assistance  account,
 or  any  successor  fund  or  account, for purposes of funding the state
 share of the non-public residential health care facility rate  increases
 for  recruitment  and retention of health care workers pursuant to para-
 graph (a) of subdivision eighteen of section twenty-eight hundred  eight
 of  this article from the tobacco control and insurance initiatives pool
 established for the following periods in the following amounts:
   (i) twenty-one million five hundred thousand dollars on an  annualized
 basis  for  the  period January first, two thousand two through December
 thirty-first, two thousand two;
   (ii) thirty-three million three hundred thousand dollars on an annual-
 ized basis for the period January  first,  two  thousand  three  through
 December thirty-first, two thousand three;
   (iii)  forty-six  million three hundred thousand dollars on an annual-
 ized basis for the period  January  first,  two  thousand  four  through
 December thirty-first, two thousand four;
   (iv)  forty-six  million three hundred thousand dollars for the period
 January first, two thousand  five  through  December  thirty-first,  two
 thousand five;
   (v)  forty-six  million  three hundred thousand dollars for the period
 January first, two thousand six through December thirty-first, two thou-
 sand six;
   (vi) thirty million nine hundred thousand dollars for the period Janu-
 ary first, two thousand seven through December thirty-first,  two  thou-
 sand seven;
   (vii) twenty-four million seven hundred thousand dollars for the peri-
 od  January first, two thousand eight through December thirty-first, two
 thousand eight;
   (viii) twelve million three hundred seventy-five thousand dollars  for
 the  period  January  first,  two thousand nine through December thirty-
 first, two thousand nine;
   (ix) nine million three hundred thousand dollars for the period  Janu-
 ary  first, two thousand ten through December thirty-first, two thousand
 ten; and
   (x) two million three hundred twenty-five  thousand  dollars  for  the
 period  January  first,  two thousand eleven through March thirty-first,
 two thousand eleven.
   (aa) Funds shall be reserved and accumulated from  year  to  year  and
 shall  be  available, including income from invested funds, for purposes
 of grants to public residential health care facilities  for  recruitment
 and retention of health care workers pursuant to paragraph (b) of subdi-
 S. 4007                            67                            A. 3007

 vision  eighteen  of  section twenty-eight hundred eight of this article
 from the tobacco control and insurance initiatives pool established  for
 the following periods in the following amounts:
   (i) seven million five hundred thousand dollars on an annualized basis
 for  the period January first, two thousand two through December thirty-
 first, two thousand two;
   (ii) eleven million seven hundred thousand dollars  on  an  annualized
 basis  for the period January first, two thousand three through December
 thirty-first, two thousand three;
   (iii) sixteen million two hundred thousand dollars  on  an  annualized
 basis  for  the period January first, two thousand four through December
 thirty-first, two thousand four;
   (iv) sixteen million two hundred thousand dollars for the period Janu-
 ary first, two thousand five through December thirty-first, two thousand
 five;
   (v) sixteen million two hundred thousand dollars for the period  Janu-
 ary  first, two thousand six through December thirty-first, two thousand
 six;
   (vi) ten million eight hundred thousand dollars for the period January
 first, two thousand seven through December  thirty-first,  two  thousand
 seven;
   (vii)  six million seven hundred fifty thousand dollars for the period
 January first, two thousand eight  through  December  thirty-first,  two
 thousand eight; and
   (viii) one million three hundred fifty thousand dollars for the period
 January  first,  two  thousand  nine  through December thirty-first, two
 thousand nine.
   (bb)(i) Funds shall be deposited by the commissioner,  within  amounts
 appropriated,  and  subject  to  the  availability  of federal financial
 participation, and  the  state  comptroller  is  hereby  authorized  and
 directed  to  receive  for  deposit  to  the credit of the state special
 revenue funds - other, HCRA transfer fund, medical  assistance  account,
 or  any  successor  fund  or  account, for the purpose of supporting the
 state share of adjustments to Medicaid rates  of  payment  for  personal
 care  services  provided pursuant to paragraph (e) of subdivision two of
 section three hundred sixty-five-a of the social services law, for local
 social service districts which include a city with a population of  over
 one  million  persons  and  computed  and distributed in accordance with
 memorandums of understanding to be entered into between the state of New
 York and such local social service districts for the purpose of support-
 ing the recruitment and retention of personal care  service  workers  or
 any  worker  with  direct  patient care responsibility, from the tobacco
 control and insurance initiatives pool  established  for  the  following
 periods and the following amounts:
   (A) forty-four million dollars, on an annualized basis, for the period
 April  first,  two thousand two through December thirty-first, two thou-
 sand two;
   (B) seventy-four million dollars, on  an  annualized  basis,  for  the
 period  January first, two thousand three through December thirty-first,
 two thousand three;
   (C) one hundred four million dollars, on an annualized basis, for  the
 period  January  first, two thousand four through December thirty-first,
 two thousand four;
   (D) one hundred thirty-six million dollars, on  an  annualized  basis,
 for  the  period January first, two thousand five through December thir-
 ty-first, two thousand five;
 S. 4007                            68                            A. 3007
 
   (E) one hundred thirty-six million dollars, on  an  annualized  basis,
 for  the period January first, two thousand six through December thirty-
 first, two thousand six;
   (F)  one  hundred  thirty-six  million  dollars for the period January
 first, two thousand seven through December  thirty-first,  two  thousand
 seven;
   (G)  one  hundred  thirty-six  million  dollars for the period January
 first, two thousand eight through December  thirty-first,  two  thousand
 eight;
   (H)  one  hundred  thirty-six  million  dollars for the period January
 first, two thousand nine through  December  thirty-first,  two  thousand
 nine;
   (I)  one  hundred  thirty-six  million  dollars for the period January
 first, two thousand ten through December thirty-first, two thousand ten;
   (J) thirty-four million dollars for  the  period  January  first,  two
 thousand eleven through March thirty-first, two thousand eleven;
   (K)  up  to  one  hundred thirty-six million dollars each state fiscal
 year for the period April first, two thousand eleven through March thir-
 ty-first, two thousand fourteen;
   (L) up to one hundred thirty-six million  dollars  each  state  fiscal
 year  for  the  period March thirty-first, two thousand fourteen through
 April first, two thousand seventeen;
   (M) up to one hundred thirty-six million  dollars  each  state  fiscal
 year  for  the  period April first, two thousand seventeen through March
 thirty-first, two thousand twenty; [and]
   (N) up to one hundred thirty-six million  dollars  each  state  fiscal
 year for the period April first, two thousand twenty through March thir-
 ty-first, two thousand twenty-three; AND
   (O)  UP  TO  ONE  HUNDRED THIRTY-SIX MILLION DOLLARS EACH STATE FISCAL
 YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-THREE THROUGH MARCH
 THIRTY-FIRST, TWO THOUSAND TWENTY-SIX.
   (ii) Adjustments to Medicaid rates made  pursuant  to  this  paragraph
 shall  not, in aggregate, exceed the following amounts for the following
 periods:
   (A) for the period April first,  two  thousand  two  through  December
 thirty-first, two thousand two, one hundred ten million dollars;
   (B)  for the period January first, two thousand three through December
 thirty-first,  two  thousand  three,  one  hundred  eighty-five  million
 dollars;
   (C)  for  the period January first, two thousand four through December
 thirty-first, two thousand four, two hundred sixty million dollars;
   (D) for the period January first, two thousand five  through  December
 thirty-first, two thousand five, three hundred forty million dollars;
   (E)  for  the  period January first, two thousand six through December
 thirty-first, two thousand six, three hundred forty million dollars;
   (F) for the period January first, two thousand seven through  December
 thirty-first, two thousand seven, three hundred forty million dollars;
   (G)  for the period January first, two thousand eight through December
 thirty-first, two thousand eight, three hundred forty million dollars;
   (H) for the period January first, two thousand nine  through  December
 thirty-first, two thousand nine, three hundred forty million dollars;
   (I)  for  the  period January first, two thousand ten through December
 thirty-first, two thousand ten, three hundred forty million dollars;
   (J) for the period January first, two thousand  eleven  through  March
 thirty-first, two thousand eleven, eighty-five million dollars;
 S. 4007                            69                            A. 3007
 
   (K)  for  each  state  fiscal  year within the period April first, two
 thousand eleven through March thirty-first, two thousand fourteen, three
 hundred forty million dollars;
   (L)  for  each  state  fiscal  year within the period April first, two
 thousand fourteen through March thirty-first,  two  thousand  seventeen,
 three hundred forty million dollars;
   (M)  for  each  state  fiscal  year within the period April first, two
 thousand seventeen through  March  thirty-first,  two  thousand  twenty,
 three hundred forty million dollars; [and]
   (N)  for  each  state  fiscal  year within the period April first, two
 thousand twenty through March thirty-first, two  thousand  twenty-three,
 three hundred forty million dollars; AND
   (O)  FOR  EACH  STATE  FISCAL  YEAR WITHIN THE PERIOD APRIL FIRST, TWO
 THOUSAND TWENTY-THREE THROUGH MARCH THIRTY-FIRST, TWO  THOUSAND  TWENTY-
 SIX, THREE HUNDRED FORTY MILLION DOLLARS.
   (iii)  Personal care service providers which have their rates adjusted
 pursuant to this paragraph shall use  such  funds  for  the  purpose  of
 recruitment  and  retention  of  non-supervisory  personal care services
 workers or any worker with direct patient care responsibility  only  and
 are  prohibited  from  using such funds for any other purpose. Each such
 personal care services provider shall submit, at a time and in a  manner
 to  be determined by the commissioner, a written certification attesting
 that such funds will be used solely for the purpose of  recruitment  and
 retention of non-supervisory personal care services workers or any work-
 er  with direct patient care responsibility. The commissioner is author-
 ized to audit each such provider to ensure compliance with  the  written
 certification  required  by  this subdivision and shall recoup any funds
 determined to have been used for purposes  other  than  recruitment  and
 retention of non-supervisory personal care services workers or any work-
 er  with direct patient care responsibility. Such recoupment shall be in
 addition to any other penalties provided by law.
   (cc) Funds shall be deposited  by  the  commissioner,  within  amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed to receive for deposit to  the  credit  of  the  state  special
 revenue  funds  - other, HCRA transfer fund, medical assistance account,
 or any successor fund or account, for  the  purpose  of  supporting  the
 state  share  of  adjustments  to Medicaid rates of payment for personal
 care services provided pursuant to paragraph (e) of subdivision  two  of
 section three hundred sixty-five-a of the social services law, for local
 social  service  districts  which  shall not include a city with a popu-
 lation of over one million persons for the  purpose  of  supporting  the
 personal  care  services  worker  recruitment  and  retention program as
 established pursuant to  section  three  hundred  sixty-seven-q  of  the
 social  services law, from the tobacco control and insurance initiatives
 pool established for the following periods and the following amounts:
   (i) two million eight hundred thousand dollars for  the  period  April
 first, two thousand two through December thirty-first, two thousand two;
   (ii)  five  million  six  hundred  thousand  dollars, on an annualized
 basis, for the period January first, two thousand three through December
 thirty-first, two thousand three;
   (iii) eight million four hundred thousand dollars,  on  an  annualized
 basis,  for the period January first, two thousand four through December
 thirty-first, two thousand four;
   (iv) ten million eight hundred  thousand  dollars,  on  an  annualized
 basis,  for the period January first, two thousand five through December
 thirty-first, two thousand five;
 S. 4007                            70                            A. 3007
 
   (v) ten million eight  hundred  thousand  dollars,  on  an  annualized
 basis,  for  the period January first, two thousand six through December
 thirty-first, two thousand six;
   (vi)  eleven million two hundred thousand dollars for the period Janu-
 ary first, two thousand seven through December thirty-first,  two  thou-
 sand seven;
   (vii) eleven million two hundred thousand dollars for the period Janu-
 ary  first,  two thousand eight through December thirty-first, two thou-
 sand eight;
   (viii) eleven million two hundred  thousand  dollars  for  the  period
 January  first,  two  thousand  nine  through December thirty-first, two
 thousand nine;
   (ix) eleven million two hundred thousand dollars for the period  Janu-
 ary  first, two thousand ten through December thirty-first, two thousand
 ten;
   (x) two million eight hundred thousand dollars for the period  January
 first,  two  thousand  eleven  through  March thirty-first, two thousand
 eleven;
   (xi) up to eleven million two  hundred  thousand  dollars  each  state
 fiscal  year  for  the  period  April first, two thousand eleven through
 March thirty-first, two thousand fourteen;
   (xii) up to eleven million two hundred  thousand  dollars  each  state
 fiscal  year  for  the period April first, two thousand fourteen through
 March thirty-first, two thousand seventeen;
   (xiii) up to eleven million two hundred thousand  dollars  each  state
 fiscal  year  for the period April first, two thousand seventeen through
 March thirty-first, two thousand twenty; [and]
   (xiv) up to eleven million two hundred  thousand  dollars  each  state
 fiscal  year  for  the  period  April first, two thousand twenty through
 March thirty-first, two thousand twenty-three; AND
   (XV) UP TO ELEVEN MILLION TWO  HUNDRED  THOUSAND  DOLLARS  EACH  STATE
 FISCAL  YEAR  FOR  THE  PERIOD  APRIL  FIRST,  TWO THOUSAND TWENTY-THREE
 THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-SIX.
   (dd) Funds shall be deposited  by  the  commissioner,  within  amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed to receive for deposit to  the  credit  of  the  state  special
 revenue fund - other, HCRA transfer fund, medical assistance account, or
 any  successor  fund or account, for purposes of funding the state share
 of Medicaid expenditures for physician services from the tobacco control
 and insurance initiatives pool established for the following periods  in
 the following amounts:
   (i)  up to fifty-two million dollars for the period January first, two
 thousand two through December thirty-first, two thousand two;
   (ii) eighty-one million two hundred thousand dollars  for  the  period
 January  first,  two  thousand  three through December thirty-first, two
 thousand three;
   (iii) eighty-five million two hundred thousand dollars for the  period
 January  first,  two  thousand  four  through December thirty-first, two
 thousand four;
   (iv) eighty-five million two hundred thousand dollars for  the  period
 January  first,  two  thousand  five  through December thirty-first, two
 thousand five;
   (v) eighty-five million two hundred thousand dollars  for  the  period
 January first, two thousand six through December thirty-first, two thou-
 sand six;
 S. 4007                            71                            A. 3007
 
   (vi)  eighty-five  million two hundred thousand dollars for the period
 January first, two thousand seven  through  December  thirty-first,  two
 thousand seven;
   (vii)  eighty-five million two hundred thousand dollars for the period
 January first, two thousand eight  through  December  thirty-first,  two
 thousand eight;
   (viii) eighty-five million two hundred thousand dollars for the period
 January  first,  two  thousand  nine  through December thirty-first, two
 thousand nine;
   (ix) eighty-five million two hundred thousand dollars for  the  period
 January first, two thousand ten through December thirty-first, two thou-
 sand ten;
   (x)  twenty-one  million three hundred thousand dollars for the period
 January first, two thousand eleven through March thirty-first, two thou-
 sand eleven; and
   (xi) eighty-five million  two  hundred  thousand  dollars  each  state
 fiscal  year  for  the  period  April first, two thousand eleven through
 March thirty-first, two thousand fourteen.
   (ee) Funds shall be deposited  by  the  commissioner,  within  amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed to receive for deposit to  the  credit  of  the  state  special
 revenue fund - other, HCRA transfer fund, medical assistance account, or
 any  successor  fund or account, for purposes of funding the state share
 of the free-standing diagnostic and treatment center rate increases  for
 recruitment and retention of health care workers pursuant to subdivision
 seventeen of section twenty-eight hundred seven of this article from the
 tobacco  control  and  insurance  initiatives  pool  established for the
 following periods in the following amounts:
   (i) three million two hundred fifty thousand dollars  for  the  period
 April  first,  two thousand two through December thirty-first, two thou-
 sand two;
   (ii) three million two hundred fifty thousand dollars on an annualized
 basis for the period January first, two thousand three through  December
 thirty-first, two thousand three;
   (iii)  three  million two hundred fifty thousand dollars on an annual-
 ized basis for the period  January  first,  two  thousand  four  through
 December thirty-first, two thousand four;
   (iv)  three  million two hundred fifty thousand dollars for the period
 January first, two thousand  five  through  December  thirty-first,  two
 thousand five;
   (v)  three  million  two hundred fifty thousand dollars for the period
 January first, two thousand six through December thirty-first, two thou-
 sand six;
   (vi) three million two hundred fifty thousand dollars for  the  period
 January  first,  two  thousand  seven through December thirty-first, two
 thousand seven;
   (vii) three million four hundred thirty-eight thousand dollars for the
 period January first, two thousand eight through December  thirty-first,
 two thousand eight;
   (viii)  two million four hundred fifty thousand dollars for the period
 January first, two thousand  nine  through  December  thirty-first,  two
 thousand nine;
   (ix)  one million five hundred thousand dollars for the period January
 first, two thousand ten through December thirty-first, two thousand ten;
 and
 S. 4007                            72                            A. 3007
 
   (x) three hundred twenty-five thousand dollars for the period  January
 first,  two  thousand  eleven  through  March thirty-first, two thousand
 eleven.
   (ff)  Funds  shall  be  deposited  by the commissioner, within amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed  to  receive  for  deposit  to  the credit of the state special
 revenue fund - other, HCRA transfer fund, medical assistance account, or
 any successor fund or account, for purposes of funding the  state  share
 of  Medicaid expenditures for disabled persons as authorized pursuant to
 former subparagraphs twelve and thirteen of paragraph (a) of subdivision
 one of section three hundred sixty-six of the social services  law  from
 the  tobacco  control and insurance initiatives pool established for the
 following periods in the following amounts:
   (i) one million eight hundred thousand dollars for  the  period  April
 first, two thousand two through December thirty-first, two thousand two;
   (ii)  sixteen  million  four hundred thousand dollars on an annualized
 basis for the period January first, two thousand three through  December
 thirty-first, two thousand three;
   (iii) eighteen million seven hundred thousand dollars on an annualized
 basis  for  the period January first, two thousand four through December
 thirty-first, two thousand four;
   (iv) thirty million six hundred thousand dollars for the period  Janu-
 ary first, two thousand five through December thirty-first, two thousand
 five;
   (v) thirty million six hundred thousand dollars for the period January
 first, two thousand six through December thirty-first, two thousand six;
   (vi)  thirty million six hundred thousand dollars for the period Janu-
 ary first, two thousand seven through December thirty-first,  two  thou-
 sand seven;
   (vii)  fifteen million dollars for the period January first, two thou-
 sand eight through December thirty-first, two thousand eight;
   (viii) fifteen million dollars for the period January first, two thou-
 sand nine through December thirty-first, two thousand nine;
   (ix) fifteen million dollars for the period January first,  two  thou-
 sand ten through December thirty-first, two thousand ten;
   (x)  three million seven hundred fifty thousand dollars for the period
 January first, two thousand eleven through March thirty-first, two thou-
 sand eleven;
   (xi) fifteen million dollars each state fiscal  year  for  the  period
 April  first,  two thousand eleven through March thirty-first, two thou-
 sand fourteen;
   (xii) fifteen million dollars each state fiscal year  for  the  period
 April first, two thousand fourteen through March thirty-first, two thou-
 sand seventeen;
   (xiii)  fifteen  million dollars each state fiscal year for the period
 April first, two thousand  seventeen  through  March  thirty-first,  two
 thousand twenty; [and]
   (xiv)  fifteen  million  dollars each state fiscal year for the period
 April first, two thousand twenty through March thirty-first,  two  thou-
 sand twenty-three; AND
   (XV)  FIFTEEN  MILLION  DOLLARS  EACH STATE FISCAL YEAR FOR THE PERIOD
 APRIL FIRST, TWO THOUSAND TWENTY-THREE THROUGH MARCH  THIRTY-FIRST,  TWO
 THOUSAND TWENTY-SIX.
   (gg)  Funds  shall  be  reserved and accumulated from year to year and
 shall be available, including income from invested funds,  for  purposes
 of  grants  to non-public general hospitals pursuant to paragraph (c) of
 S. 4007                            73                            A. 3007

 subdivision thirty of section twenty-eight hundred seven-c of this arti-
 cle from the tobacco control and insurance initiatives pool  established
 for the following periods in the following amounts:
   (i)  up to one million three hundred thousand dollars on an annualized
 basis for the period January first, two thousand  two  through  December
 thirty-first, two thousand two;
   (ii) up to three million two hundred thousand dollars on an annualized
 basis  for the period January first, two thousand three through December
 thirty-first, two thousand three;
   (iii) up to five million six hundred thousand dollars on an annualized
 basis for the period January first, two thousand four  through  December
 thirty-first, two thousand four;
   (iv)  up  to eight million six hundred thousand dollars for the period
 January first, two thousand  five  through  December  thirty-first,  two
 thousand five;
   (v)  up to eight million six hundred thousand dollars on an annualized
 basis for the period January first, two thousand  six  through  December
 thirty-first, two thousand six;
   (vi)  up  to  two  million six hundred thousand dollars for the period
 January first, two thousand seven  through  December  thirty-first,  two
 thousand seven;
   (vii)  up  to  two million six hundred thousand dollars for the period
 January first, two thousand eight  through  December  thirty-first,  two
 thousand eight;
   (viii)  up  to two million six hundred thousand dollars for the period
 January first, two thousand  nine  through  December  thirty-first,  two
 thousand nine;
   (ix)  up  to  two  million six hundred thousand dollars for the period
 January first, two thousand ten through December thirty-first, two thou-
 sand ten; and
   (x) up to six hundred fifty thousand dollars for  the  period  January
 first,  two  thousand  eleven  through  March thirty-first, two thousand
 eleven.
   (hh) Funds shall be deposited  by  the  commissioner,  within  amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed to receive for deposit to the credit  of  the  special  revenue
 fund  -  other,  HCRA  transfer  fund,  medical  assistance  account for
 purposes of providing financial assistance to  residential  health  care
 facilities  pursuant  to subdivisions nineteen and twenty-one of section
 twenty-eight hundred eight of this article, from the tobacco control and
 insurance initiatives pool established for the following periods in  the
 following amounts:
   (i)  for  the  period  April  first, two thousand two through December
 thirty-first, two thousand two, ten million dollars;
   (ii) for the period January first, two thousand three through December
 thirty-first, two thousand three, nine million four hundred fifty  thou-
 sand dollars;
   (iii) for the period January first, two thousand four through December
 thirty-first,  two thousand four, nine million three hundred fifty thou-
 sand dollars;
   (iv) up to fifteen million dollars for the period January  first,  two
 thousand five through December thirty-first, two thousand five;
   (v)  up  to  fifteen million dollars for the period January first, two
 thousand six through December thirty-first, two thousand six;
   (vi) up to fifteen million dollars for the period January  first,  two
 thousand seven through December thirty-first, two thousand seven;
 S. 4007                            74                            A. 3007

   (vii)  up to fifteen million dollars for the period January first, two
 thousand eight through December thirty-first, two thousand eight;
   (viii) up to fifteen million dollars for the period January first, two
 thousand nine through December thirty-first, two thousand nine;
   (ix)  up  to fifteen million dollars for the period January first, two
 thousand ten through December thirty-first, two thousand ten;
   (x) up to three million seven hundred fifty thousand dollars  for  the
 period  January  first,  two thousand eleven through March thirty-first,
 two thousand eleven; and
   (xi) fifteen million dollars each state fiscal  year  for  the  period
 April  first,  two thousand eleven through March thirty-first, two thou-
 sand fourteen.
   (ii) Funds shall be deposited  by  the  commissioner,  within  amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed to receive for deposit to  the  credit  of  the  state  special
 revenue  funds  - other, HCRA transfer fund, medical assistance account,
 or any successor fund or account, for  the  purpose  of  supporting  the
 state  share of Medicaid expenditures for disabled persons as authorized
 by sections 1619 (a) and (b) of the federal social security act pursuant
 to the tobacco control and insurance initiatives  pool  established  for
 the following periods in the following amounts:
   (i)  six  million  four  hundred thousand dollars for the period April
 first, two thousand two through December thirty-first, two thousand two;
   (ii) eight million five hundred thousand dollars, for the period Janu-
 ary first, two thousand three through December thirty-first,  two  thou-
 sand three;
   (iii) eight million five hundred thousand dollars for the period Janu-
 ary first, two thousand four through December thirty-first, two thousand
 four;
   (iv)  eight million five hundred thousand dollars for the period Janu-
 ary first, two thousand five through December thirty-first, two thousand
 five;
   (v) eight million five hundred thousand dollars for the period January
 first, two thousand six through December thirty-first, two thousand six;
   (vi) eight million six hundred thousand dollars for the period January
 first, two thousand seven through December  thirty-first,  two  thousand
 seven;
   (vii) eight million five hundred thousand dollars for the period Janu-
 ary  first,  two thousand eight through December thirty-first, two thou-
 sand eight;
   (viii) eight million five hundred  thousand  dollars  for  the  period
 January  first,  two  thousand  nine  through December thirty-first, two
 thousand nine;
   (ix) eight million five hundred thousand dollars for the period  Janu-
 ary  first, two thousand ten through December thirty-first, two thousand
 ten;
   (x) two million one hundred twenty-five thousand dollars for the peri-
 od January first, two thousand eleven through  March  thirty-first,  two
 thousand eleven;
   (xi)  eight  million  five  hundred thousand dollars each state fiscal
 year for the period April first, two thousand eleven through March thir-
 ty-first, two thousand fourteen;
   (xii) eight million five hundred thousand dollars  each  state  fiscal
 year  for  the  period  April first, two thousand fourteen through March
 thirty-first, two thousand seventeen;
 S. 4007                            75                            A. 3007
 
   (xiii) eight million five hundred thousand dollars each  state  fiscal
 year  for  the  period April first, two thousand seventeen through March
 thirty-first, two thousand twenty; [and]
   (xiv)  eight  million  five hundred thousand dollars each state fiscal
 year for the period April first, two thousand twenty through March thir-
 ty-first, two thousand twenty-three; AND
   (XV) EIGHT MILLION FIVE HUNDRED THOUSAND  DOLLARS  EACH  STATE  FISCAL
 YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-THREE THROUGH MARCH
 THIRTY-FIRST, TWO THOUSAND TWENTY-SIX.
   (jj)  Funds  shall  be  reserved and accumulated from year to year and
 shall be available,  including  income  from  invested  funds,  for  the
 purposes  of  a grant program to improve access to infertility services,
 treatments and procedures, from the tobacco control and insurance initi-
 atives pool established for the period January first, two  thousand  two
 through  December  thirty-first,  two thousand two in the amount of nine
 million one hundred seventy-five thousand dollars, for the period  April
 first,  two  thousand six through March thirty-first, two thousand seven
 in the amount of five million dollars, for the period April  first,  two
 thousand  seven  through  March  thirty-first, two thousand eight in the
 amount of five million dollars, for the period April first, two thousand
 eight through March thirty-first, two thousand nine  in  the  amount  of
 five  million dollars, and for the period April first, two thousand nine
 through March thirty-first, two thousand  ten  in  the  amount  of  five
 million  dollars,  for  the period April first, two thousand ten through
 March thirty-first, two thousand eleven in the amount of two million two
 hundred thousand dollars, and for the period April first,  two  thousand
 eleven through March thirty-first, two thousand twelve up to one million
 one hundred thousand dollars.
   (kk)  Funds  shall  be  deposited  by the commissioner, within amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed  to  receive  for  deposit  to  the credit of the state special
 revenue funds -- other, HCRA transfer fund, medical assistance  account,
 or  any  successor  fund  or  account, for purposes of funding the state
 share of  Medical  Assistance  Program  expenditures  from  the  tobacco
 control  and  insurance  initiatives  pool established for the following
 periods in the following amounts:
   (i) thirty-eight million eight hundred thousand dollars for the period
 January first, two thousand two through December thirty-first, two thou-
 sand two;
   (ii) up to two hundred ninety-five  million  dollars  for  the  period
 January  first,  two  thousand  three through December thirty-first, two
 thousand three;
   (iii) up to four hundred seventy-two million dollars  for  the  period
 January  first,  two  thousand  four  through December thirty-first, two
 thousand four;
   (iv) up to nine hundred million dollars for the period January  first,
 two thousand five through December thirty-first, two thousand five;
   (v)  up  to  eight  hundred  sixty-six  million three hundred thousand
 dollars for the period January first, two thousand six through  December
 thirty-first, two thousand six;
   (vi)  up to six hundred sixteen million seven hundred thousand dollars
 for the period January first, two thousand seven through December  thir-
 ty-first, two thousand seven;
   (vii)  up  to  five hundred seventy-eight million nine hundred twenty-
 five thousand dollars for the period January first, two  thousand  eight
 through December thirty-first, two thousand eight; and
 S. 4007                            76                            A. 3007
 
   (viii)  within  amounts  appropriated  on and after January first, two
 thousand nine.
   (ll)  Funds  shall  be  deposited  by the commissioner, within amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed  to  receive  for  deposit  to  the credit of the state special
 revenue funds -- other, HCRA transfer fund, medical assistance  account,
 or  any  successor  fund  or  account, for purposes of funding the state
 share of Medicaid expenditures related to the city of New York from  the
 tobacco  control  and  insurance  initiatives  pool  established for the
 following periods in the following amounts:
   (i) eighty-two million seven hundred thousand dollars for  the  period
 January first, two thousand two through December thirty-first, two thou-
 sand two;
   (ii)  one hundred twenty-four million six hundred thousand dollars for
 the period January first, two thousand three  through  December  thirty-
 first, two thousand three;
   (iii)  one  hundred twenty-four million seven hundred thousand dollars
 for the period January first, two thousand four through  December  thir-
 ty-first, two thousand four;
   (iv)  one  hundred  twenty-four million seven hundred thousand dollars
 for the period January first, two thousand five through  December  thir-
 ty-first, two thousand five;
   (v) one hundred twenty-four million seven hundred thousand dollars for
 the  period  January  first,  two  thousand six through December thirty-
 first, two thousand six;
   (vi) one hundred twenty-four million seven  hundred  thousand  dollars
 for  the period January first, two thousand seven through December thir-
 ty-first, two thousand seven;
   (vii) one hundred twenty-four million seven hundred  thousand  dollars
 for  the period January first, two thousand eight through December thir-
 ty-first, two thousand eight;
   (viii) one hundred twenty-four million seven hundred thousand  dollars
 for  the  period January first, two thousand nine through December thir-
 ty-first, two thousand nine;
   (ix) one hundred twenty-four million seven  hundred  thousand  dollars
 for  the period January first, two thousand ten through December thirty-
 first, two thousand ten;
   (x) thirty-one million one hundred seventy-five thousand  dollars  for
 the  period  January  first,  two  thousand eleven through March thirty-
 first, two thousand eleven; and
   (xi) one hundred twenty-four million seven  hundred  thousand  dollars
 each  state  fiscal year for the period April first, two thousand eleven
 through March thirty-first, two thousand fourteen.
   (mm) Funds shall be deposited  by  the  commissioner,  within  amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed to receive for deposit to  the  credit  of  the  state  special
 revenue  funds  - other, HCRA transfer fund, medical assistance account,
 or any successor fund or account,  for  purposes  of  funding  specified
 percentages  of  the state share of services and expenses related to the
 family health plus program in accordance with the following schedule:
   (i) (A) for the period  January  first,  two  thousand  three  through
 December  thirty-first,  two  thousand  four, one hundred percent of the
 state share;
   (B) for the period January first, two thousand five  through  December
 thirty-first,  two  thousand  five,  seventy-five  percent  of the state
 share; and
 S. 4007                            77                            A. 3007
 
   (C) for periods beginning on and after  January  first,  two  thousand
 six, fifty percent of the state share.
   (ii)  Funding  for  the  family health plus program will include up to
 five million dollars annually for the period January first, two thousand
 three through December  thirty-first,  two  thousand  six,  up  to  five
 million dollars for the period January first, two thousand seven through
 December  thirty-first,  two  thousand  seven,  up  to seven million two
 hundred thousand dollars for the  period  January  first,  two  thousand
 eight  through  December  thirty-first,  two thousand eight, up to seven
 million two hundred thousand dollars for the period January  first,  two
 thousand  nine  through  December thirty-first, two thousand nine, up to
 seven million two hundred thousand dollars for the period January first,
 two thousand ten through December thirty-first, two thousand ten, up  to
 one million eight hundred thousand dollars for the period January first,
 two  thousand eleven through March thirty-first, two thousand eleven, up
 to six million forty-nine thousand dollars for the period  April  first,
 two  thousand eleven through March thirty-first, two thousand twelve, up
 to six million two hundred eighty-nine thousand dollars for  the  period
 April  first,  two thousand twelve through March thirty-first, two thou-
 sand thirteen, and up to six million  four  hundred  sixty-one  thousand
 dollars  for the period April first, two thousand thirteen through March
 thirty-first, two thousand fourteen, for  administration  and  marketing
 costs  associated  with such program established pursuant to clauses (A)
 and (B) of subparagraph (v) of paragraph (a) of subdivision two  of  THE
 FORMER  section  three  hundred sixty-nine-ee of the social services law
 from the tobacco control and insurance initiatives pool established  for
 the following periods in the following amounts:
   (A)  one  hundred  ninety million six hundred thousand dollars for the
 period January first, two thousand three through December  thirty-first,
 two thousand three;
   (B)  three hundred seventy-four million dollars for the period January
 first, two thousand four through  December  thirty-first,  two  thousand
 four;
   (C)  five  hundred  thirty-eight million four hundred thousand dollars
 for the period January first, two thousand five through  December  thir-
 ty-first, two thousand five;
   (D) three hundred eighteen million seven hundred seventy-five thousand
 dollars  for the period January first, two thousand six through December
 thirty-first, two thousand six;
   (E) four hundred eighty-two million eight hundred thousand dollars for
 the period January first, two thousand seven  through  December  thirty-
 first, two thousand seven;
   (F)  five hundred seventy million twenty-five thousand dollars for the
 period January first, two thousand eight through December  thirty-first,
 two thousand eight;
   (G) six hundred ten million seven hundred twenty-five thousand dollars
 for  the  period January first, two thousand nine through December thir-
 ty-first, two thousand nine;
   (H) six hundred twenty-seven million two hundred seventy-five thousand
 dollars for the period January first, two thousand ten through  December
 thirty-first, two thousand ten;
   (I)  one  hundred fifty-seven million eight hundred seventy-five thou-
 sand dollars for the period January first, two thousand  eleven  through
 March thirty-first, two thousand eleven;
 S. 4007                            78                            A. 3007
 
   (J) six hundred twenty-eight million four hundred thousand dollars for
 the  period April first, two thousand eleven through March thirty-first,
 two thousand twelve;
   (K)  six  hundred  fifty million four hundred thousand dollars for the
 period April first, two thousand twelve through March thirty-first,  two
 thousand thirteen;
   (L)  six  hundred  fifty million four hundred thousand dollars for the
 period April first, two thousand thirteen  through  March  thirty-first,
 two thousand fourteen; and
   (M)  up to three hundred ten million five hundred ninety-five thousand
 dollars for the period April first, two thousand fourteen through  March
 thirty-first, two thousand fifteen.
   (nn)  Funds  shall  be  deposited  by the commissioner, within amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed  to  receive  for  deposit  to  the credit of the state special
 revenue fund - other, HCRA transfer fund, health care services  account,
 or  any  successor  fund  or account, for purposes related to adult home
 initiatives for medicaid eligible residents  of  residential  facilities
 licensed pursuant to section four hundred sixty-b of the social services
 law  from the tobacco control and insurance initiatives pool established
 for the following periods in the following amounts:
   (i) up to four million dollars for the period January first, two thou-
 sand three through December thirty-first, two thousand three;
   (ii) up to six million dollars for the period January first, two thou-
 sand four through December thirty-first, two thousand four;
   (iii) up to eight million dollars for the period  January  first,  two
 thousand   five   through  December  thirty-first,  two  thousand  five,
 provided, however, that up to five million two  hundred  fifty  thousand
 dollars of such funds shall be received by the comptroller and deposited
 to  the  credit of the special revenue fund - other / aid to localities,
 HCRA transfer fund - 061, enhanced community services account -  05,  or
 any  successor fund or account, for the purposes set forth in this para-
 graph;
   (iv) up to eight million dollars for the  period  January  first,  two
 thousand  six through December thirty-first, two thousand six, provided,
 however, that up to five million two hundred fifty thousand  dollars  of
 such  funds  shall  be  received by the comptroller and deposited to the
 credit of the special revenue fund - other /  aid  to  localities,  HCRA
 transfer  fund  -  061, enhanced community services account - 05, or any
 successor fund or account, for the purposes set forth in this paragraph;
   (v) up to eight million dollars for  the  period  January  first,  two
 thousand  seven  through  December  thirty-first,  two  thousand  seven,
 provided, however, that up to five million two  hundred  fifty  thousand
 dollars of such funds shall be received by the comptroller and deposited
 to  the  credit of the special revenue fund - other / aid to localities,
 HCRA transfer fund - 061, enhanced community services account -  05,  or
 any  successor fund or account, for the purposes set forth in this para-
 graph;
   (vi) up to two million seven hundred fifty thousand  dollars  for  the
 period  January first, two thousand eight through December thirty-first,
 two thousand eight;
   (vii) up to two million seven hundred fifty thousand dollars  for  the
 period  January  first, two thousand nine through December thirty-first,
 two thousand nine;
 S. 4007                            79                            A. 3007
 
   (viii) up to two million seven hundred fifty thousand dollars for  the
 period  January  first,  two thousand ten through December thirty-first,
 two thousand ten; and
   (ix)  up  to  six hundred eighty-eight thousand dollars for the period
 January first, two thousand eleven through March thirty-first, two thou-
 sand eleven.
   (oo) Funds shall be reserved and accumulated from  year  to  year  and
 shall  be  available, including income from invested funds, for purposes
 of grants to non-public general hospitals pursuant to paragraph  (e)  of
 subdivision  twenty-five of section twenty-eight hundred seven-c of this
 article from the tobacco control and insurance initiatives  pool  estab-
 lished for the following periods in the following amounts:
   (i)  up  to five million dollars on an annualized basis for the period
 January first, two thousand  four  through  December  thirty-first,  two
 thousand four;
   (ii)  up  to  five  million  dollars for the period January first, two
 thousand five through December thirty-first, two thousand five;
   (iii) up to five million dollars for the  period  January  first,  two
 thousand six through December thirty-first, two thousand six;
   (iv)  up  to  five  million  dollars for the period January first, two
 thousand seven through December thirty-first, two thousand seven;
   (v) up to five million dollars for the period January first, two thou-
 sand eight through December thirty-first, two thousand eight;
   (vi) up to five million dollars for  the  period  January  first,  two
 thousand nine through December thirty-first, two thousand nine;
   (vii)  up  to  five  million dollars for the period January first, two
 thousand ten through December thirty-first, two thousand ten; and
   (viii) up to one million two hundred fifty thousand  dollars  for  the
 period  January  first,  two thousand eleven through March thirty-first,
 two thousand eleven.
   (pp) Funds shall be reserved and accumulated from  year  to  year  and
 shall  be  available,  including  income  from  invested  funds, for the
 purpose of supporting the provision of tax credits for  long  term  care
 insurance  pursuant  to subdivision one of section one hundred ninety of
 the tax law, paragraph  (a)  of  subdivision  fourteen  of  section  two
 hundred ten-B of such law, subsection (aa) of section six hundred six of
 such law and paragraph one of subdivision (m) of section fifteen hundred
 eleven of such law, in the following amounts:
   (i)  ten  million  dollars  for the period January first, two thousand
 four through December thirty-first, two thousand four;
   (ii) ten million dollars for the period January  first,  two  thousand
 five through December thirty-first, two thousand five;
   (iii)  ten  million dollars for the period January first, two thousand
 six through December thirty-first, two thousand six; and
   (iv) five million dollars for the period January first,  two  thousand
 seven through June thirtieth, two thousand seven.
   (qq)  Funds  shall  be  reserved and accumulated from year to year and
 shall be available,  including  income  from  invested  funds,  for  the
 purpose  of  supporting  the  long-term  care  insurance  education  and
 outreach program established pursuant to section two hundred seventeen-a
 of the elder law for the following periods in the following amounts:
   (i) up to five million dollars for the period January first, two thou-
 sand four through December thirty-first,  two  thousand  four;  of  such
 funds  one  million  nine  hundred  fifty thousand dollars shall be made
 available to the department for the purpose of developing,  implementing
 and  administering  the  long-term care insurance education and outreach
 S. 4007                            80                            A. 3007
 
 program and three million fifty thousand dollars shall be  deposited  by
 the  commissioner,  within  amounts appropriated, and the comptroller is
 hereby authorized and directed to receive for deposit to the  credit  of
 the  special  revenue  funds - other, HCRA transfer fund, long term care
 insurance resource center account of the state office for the  aging  or
 any  future  account designated for the purpose of implementing the long
 term care insurance education and outreach  program  and  providing  the
 long  term  care insurance resource centers with the necessary resources
 to carry out their operations;
   (ii) up to five million dollars for  the  period  January  first,  two
 thousand  five through December thirty-first, two thousand five; of such
 funds one million nine hundred fifty  thousand  dollars  shall  be  made
 available  to the department for the purpose of developing, implementing
 and administering the long-term care insurance  education  and  outreach
 program  and  three million fifty thousand dollars shall be deposited by
 the commissioner, within amounts appropriated, and  the  comptroller  is
 hereby  authorized  and directed to receive for deposit to the credit of
 the special revenue funds - other, HCRA transfer fund,  long  term  care
 insurance  resource  center account of the state office for the aging or
 any future account designated for the purpose of implementing  the  long
 term  care  insurance  education  and outreach program and providing the
 long term care insurance resource centers with the  necessary  resources
 to carry out their operations;
   (iii)  up  to  five  million dollars for the period January first, two
 thousand six through December thirty-first, two thousand  six;  of  such
 funds  one  million  nine  hundred  fifty thousand dollars shall be made
 available to the department for the purpose of developing,  implementing
 and  administering  the  long-term care insurance education and outreach
 program and three million fifty thousand dollars shall be made available
 to the office for the aging for the purpose of providing the  long  term
 care  insurance  resource  centers with the necessary resources to carry
 out their operations;
   (iv) up to five million dollars for  the  period  January  first,  two
 thousand  seven  through  December  thirty-first, two thousand seven; of
 such funds one million nine hundred fifty thousand dollars shall be made
 available to the department for the purpose of developing,  implementing
 and  administering  the  long-term care insurance education and outreach
 program and three million fifty thousand dollars shall be made available
 to the office for the aging for the purpose of providing the  long  term
 care  insurance  resource  centers with the necessary resources to carry
 out their operations;
   (v) up to five million dollars for the period January first, two thou-
 sand eight through December thirty-first, two thousand  eight;  of  such
 funds  one  million  nine  hundred  fifty thousand dollars shall be made
 available to the department for the purpose of developing,  implementing
 and  administering  the  long term care insurance education and outreach
 program and three million fifty thousand dollars shall be made available
 to the office for the aging for the purpose of providing the  long  term
 care  insurance  resource  centers with the necessary resources to carry
 out their operations;
   (vi) up to five million dollars for  the  period  January  first,  two
 thousand  nine through December thirty-first, two thousand nine; of such
 funds one million nine hundred fifty  thousand  dollars  shall  be  made
 available  to the department for the purpose of developing, implementing
 and administering the long-term care insurance  education  and  outreach
 program and three million fifty thousand dollars shall be made available
 S. 4007                            81                            A. 3007
 
 to  the  office for the aging for the purpose of providing the long-term
 care insurance resource centers with the necessary  resources  to  carry
 out their operations;
   (vii)  up to four hundred eighty-eight thousand dollars for the period
 January first, two thousand ten through March thirty-first, two thousand
 ten; of such funds four hundred eighty-eight thousand dollars  shall  be
 made  available  to the department for the purpose of developing, imple-
 menting and administering the long-term  care  insurance  education  and
 outreach program.
   (rr)  Funds shall be reserved and accumulated from the tobacco control
 and insurance initiatives pool and shall be available, including  income
 from  invested  funds, for the purpose of supporting expenses related to
 implementation of the provisions of title three of article twenty-nine-D
 of this chapter, for the following periods and in the following amounts:
   (i) up to ten million dollars for the period January first, two  thou-
 sand six through December thirty-first, two thousand six;
   (ii) up to ten million dollars for the period January first, two thou-
 sand seven through December thirty-first, two thousand seven;
   (iii)  up  to  ten  million  dollars for the period January first, two
 thousand eight through December thirty-first, two thousand eight;
   (iv) up to ten million dollars for the period January first, two thou-
 sand nine through December thirty-first, two thousand nine;
   (v) up to ten million dollars for the period January first, two  thou-
 sand ten through December thirty-first, two thousand ten; and
   (vi)  up  to  two million five hundred thousand dollars for the period
 January first, two thousand eleven through March thirty-first, two thou-
 sand eleven.
   (ss) Funds shall be reserved and accumulated from the tobacco  control
 and  insurance initiatives pool and used for a health care stabilization
 program established by the commissioner for the purposes of  stabilizing
 critical health care providers and health care programs whose ability to
 continue  to provide appropriate services are threatened by financial or
 other challenges, in the amount of up to  twenty-eight  million  dollars
 for the period July first, two thousand four through June thirtieth, two
 thousand  five.  Notwithstanding  the  provisions of section one hundred
 twelve of the state finance law or any other inconsistent  provision  of
 the state finance law or any other law, funds available for distribution
 pursuant  to  this  paragraph  may  be  allocated and distributed by the
 commissioner, or the state comptroller as applicable without  a  compet-
 itive bid or request for proposal process. Considerations relied upon by
 the commissioner in determining the allocation and distribution of these
 funds  shall  include,  but  not  be  limited to, the following: (i) the
 importance of the provider or program in meeting  critical  health  care
 needs  in  the  community  in  which  it  operates; (ii) the provider or
 program provision of care to under-served populations; (iii) the quality
 of the care or services the provider or program delivers; (iv) the abil-
 ity of the provider or program to continue  to  deliver  an  appropriate
 level  of  care or services if additional funding is made available; (v)
 the ability of the provider or program to access, in  a  timely  manner,
 alternative  sources  of  funding, including other sources of government
 funding; (vi) the ability of other providers or programs in the communi-
 ty to meet the community health care needs; (vii) whether  the  provider
 or  program  has an appropriate plan to improve its financial condition;
 and (viii) whether additional  funding  would  permit  the  provider  or
 program  to  consolidate,  relocate, or close programs or services where
 S. 4007                            82                            A. 3007
 
 such actions would result in greater stability  and  efficiency  in  the
 delivery of needed health care services or programs.
   (tt)  Funds  shall  be  reserved and accumulated from year to year and
 shall be available, including income from invested funds,  for  purposes
 of  providing  grants  for  two  long  term  care demonstration projects
 designed to test new models for the delivery of long term care  services
 established  pursuant  to  section  twenty-eight hundred seven-x of this
 chapter, for the following periods and in the following amounts:
   (i) up to five hundred thousand dollars for the period January  first,
 two thousand four through December thirty-first, two thousand four;
   (ii) up to five hundred thousand dollars for the period January first,
 two thousand five through December thirty-first, two thousand five;
   (iii)  up  to  five  hundred  thousand  dollars for the period January
 first, two thousand six through December thirty-first, two thousand six;
   (iv) up to one million dollars for the period January first, two thou-
 sand seven through December thirty-first, two thousand seven; and
   (v) up to two hundred fifty thousand dollars for  the  period  January
 first,  two  thousand  eight  through  March  thirty-first, two thousand
 eight.
   (uu) Funds shall be reserved and accumulated from  year  to  year  and
 shall  be  available,  including  income  from  invested  funds, for the
 purpose of supporting disease management and telemedicine  demonstration
 programs  authorized  pursuant  to  section twenty-one hundred eleven of
 this chapter for the following periods in the following amounts:
   (i) five million dollars for the period January  first,  two  thousand
 four  through  December  thirty-first, two thousand four, of which three
 million dollars shall be available for disease management  demonstration
 programs  and  two  million  dollars shall be available for telemedicine
 demonstration programs;
   (ii) five million dollars for the period January first,  two  thousand
 five  through  December  thirty-first, two thousand five, of which three
 million dollars shall be available for disease management  demonstration
 programs  and  two  million  dollars shall be available for telemedicine
 demonstration programs;
   (iii) nine million five hundred thousand dollars for the period  Janu-
 ary  first, two thousand six through December thirty-first, two thousand
 six, of which seven million  five  hundred  thousand  dollars  shall  be
 available  for disease management demonstration programs and two million
 dollars shall be available for telemedicine demonstration programs;
   (iv) nine million five hundred thousand dollars for the period January
 first, two thousand seven through December  thirty-first,  two  thousand
 seven,  of  which  seven  million five hundred thousand dollars shall be
 available for disease management demonstration programs and one  million
 dollars shall be available for telemedicine demonstration programs;
   (v)  nine million five hundred thousand dollars for the period January
 first, two thousand eight through December  thirty-first,  two  thousand
 eight,  of  which  seven  million five hundred thousand dollars shall be
 available for disease management demonstration programs and two  million
 dollars shall be available for telemedicine demonstration programs;
   (vi)  seven  million eight hundred thirty-three thousand three hundred
 thirty-three dollars for the period January  first,  two  thousand  nine
 through December thirty-first, two thousand nine, of which seven million
 five  hundred thousand dollars shall be available for disease management
 demonstration programs and three  hundred  thirty-three  thousand  three
 hundred  thirty-three dollars shall be available for telemedicine demon-
 S. 4007                            83                            A. 3007
 
 stration programs for  the  period  January  first,  two  thousand  nine
 through March first, two thousand nine;
   (vii)  one million eight hundred seventy-five thousand dollars for the
 period January first, two thousand ten through March  thirty-first,  two
 thousand  ten  shall  be  available for disease management demonstration
 programs.
   (ww) Funds shall be deposited  by  the  commissioner,  within  amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed to receive for the deposit to the credit of the  state  special
 revenue  funds  - other, HCRA transfer fund, medical assistance account,
 or any successor fund or account, for  purposes  of  funding  the  state
 share  of  the  general  hospital  rates  increases  for recruitment and
 retention of health care workers pursuant to paragraph (e)  of  subdivi-
 sion thirty of section twenty-eight hundred seven-c of this article from
 the  tobacco  control and insurance initiatives pool established for the
 following periods in the following amounts:
   (i) sixty million five hundred thousand dollars for the period January
 first, two thousand five through  December  thirty-first,  two  thousand
 five; and
   (ii)  sixty million five hundred thousand dollars for the period Janu-
 ary first, two thousand six through December thirty-first, two  thousand
 six.
   (xx)  Funds  shall  be  deposited  by the commissioner, within amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed  to  receive for the deposit to the credit of the state special
 revenue funds - other, HCRA transfer fund, medical  assistance  account,
 or  any  successor  fund  or  account, for purposes of funding the state
 share of the general hospital rates increases for rural hospitals pursu-
 ant to subdivision thirty-two of section twenty-eight hundred seven-c of
 this article from the tobacco control  and  insurance  initiatives  pool
 established for the following periods in the following amounts:
   (i) three million five hundred thousand dollars for the period January
 first,  two  thousand  five  through December thirty-first, two thousand
 five;
   (ii) three million five hundred thousand dollars for the period  Janu-
 ary  first, two thousand six through December thirty-first, two thousand
 six;
   (iii) three million five hundred thousand dollars for the period Janu-
 ary first, two thousand seven through December thirty-first,  two  thou-
 sand seven;
   (iv)  three million five hundred thousand dollars for the period Janu-
 ary first, two thousand eight through December thirty-first,  two  thou-
 sand eight; and
   (v)  three  million  two hundred eight thousand dollars for the period
 January first, two thousand nine through November thirtieth,  two  thou-
 sand nine.
   (yy)  Funds  shall  be  reserved and accumulated from year to year and
 shall be available,  within  amounts  appropriated  and  notwithstanding
 section  one  hundred  twelve  of  the  state  finance law and any other
 contrary provision of law, for the purpose of supporting grants  not  to
 exceed  five  million  dollars  to be made by the commissioner without a
 competitive bid or request for  proposal  process,  in  support  of  the
 delivery  of  critically  needed  health  care  services, to health care
 providers located in the counties of Erie and Niagara which  executed  a
 memorandum of closing and conducted a merger closing in escrow on Novem-
 ber  twenty-fourth, nineteen hundred ninety-seven and which entered into
 S. 4007                            84                            A. 3007
 
 a settlement dated December thirtieth, two thousand four for a  loss  on
 disposal  of  assets  under the provisions of title XVIII of the federal
 social security act applicable to mergers occurring  prior  to  December
 first, nineteen hundred ninety-seven.
   (zz)  Funds  shall  be  reserved and accumulated from year to year and
 shall be available, within amounts  appropriated,  for  the  purpose  of
 supporting  expenditures  authorized  pursuant  to  section twenty-eight
 hundred eighteen of this article from the tobacco control and  insurance
 initiatives  pool established for the following periods in the following
 amounts:
   (i) six million five hundred thousand dollars for the  period  January
 first,  two  thousand  five  through December thirty-first, two thousand
 five;
   (ii) one hundred eight million three hundred thousand dollars for  the
 period  January  first,  two thousand six through December thirty-first,
 two thousand six, provided, however, that within amounts appropriated in
 the two thousand six through two thousand seven  state  fiscal  year,  a
 portion  of  such  funds  may  be transferred to the Roswell Park Cancer
 Institute Corporation to fund capital costs;
   (iii) one hundred seventy-one million dollars for the  period  January
 first,  two  thousand  seven through December thirty-first, two thousand
 seven, provided, however, that within amounts appropriated  in  the  two
 thousand  six through two thousand seven state fiscal year, a portion of
 such funds may be transferred  to  the  Roswell  Park  Cancer  Institute
 Corporation to fund capital costs;
   (iv) one hundred seventy-one million five hundred thousand dollars for
 the  period  January  first, two thousand eight through December thirty-
 first, two thousand eight;
   (v) one hundred twenty-eight  million  seven  hundred  fifty  thousand
 dollars for the period January first, two thousand nine through December
 thirty-first, two thousand nine;
   (vi)  one  hundred thirty-one million three hundred seventy-five thou-
 sand dollars for the period January  first,  two  thousand  ten  through
 December thirty-first, two thousand ten;
   (vii)  thirty-four  million two hundred fifty thousand dollars for the
 period January first, two thousand eleven  through  March  thirty-first,
 two thousand eleven;
   (viii) four hundred thirty-three million three hundred sixty-six thou-
 sand  dollars  for  the  period April first, two thousand eleven through
 March thirty-first, two thousand twelve;
   (ix) one hundred fifty million eight hundred six thousand dollars  for
 the  period April first, two thousand twelve through March thirty-first,
 two thousand thirteen;
   (x) seventy-eight million seventy-one thousand dollars for the  period
 April first, two thousand thirteen through March thirty-first, two thou-
 sand fourteen.
   (aaa)  Funds  shall  be reserved and accumulated from year to year and
 shall be available, including income from invested funds,  for  services
 and  expenses related to school based health centers, in an amount up to
 three million five hundred thousand dollars for the period April  first,
 two  thousand  six through March thirty-first, two thousand seven, up to
 three million five hundred thousand dollars for the period April  first,
 two thousand seven through March thirty-first, two thousand eight, up to
 three  million five hundred thousand dollars for the period April first,
 two thousand eight through March thirty-first, two thousand nine, up  to
 three  million five hundred thousand dollars for the period April first,
 S. 4007                            85                            A. 3007
 
 two thousand nine through March thirty-first, two thousand  ten,  up  to
 three  million five hundred thousand dollars for the period April first,
 two thousand ten through March thirty-first, two thousand eleven, up  to
 two  million  eight  hundred thousand dollars each state fiscal year for
 the period April first, two thousand eleven through March  thirty-first,
 two thousand fourteen, up to two million six hundred forty-four thousand
 dollars  each state fiscal year for the period April first, two thousand
 fourteen through March thirty-first, two thousand seventeen, up  to  two
 million  six  hundred forty-four thousand dollars each state fiscal year
 for the period April first, two thousand seventeen through  March  thir-
 ty-first,  two  thousand  twenty,  [and]  up  to two million six hundred
 forty-four thousand dollars each state fiscal year for the period  April
 first,  two  thousand  twenty  through  March thirty-first, two thousand
 twenty-three, AND UP TO TWO  MILLION  SIX  HUNDRED  FORTY-FOUR  THOUSAND
 DOLLARS  EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND
 TWENTY-THREE THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-SIX.    The
 total  amount  of  funds  provided herein shall be distributed as grants
 based on the ratio of each provider's total enrollment for all sites  to
 the  total enrollment of all providers. This formula shall be applied to
 the total amount provided herein.
   (bbb) Funds shall be reserved and accumulated from year  to  year  and
 shall  be  available, including income from invested funds, for purposes
 of awarding  grants  to  operators  of  adult  homes,  enriched  housing
 programs and residences through the enhancing abilities and life experi-
 ence  (EnAbLe)  program  to  provide for the installation, operation and
 maintenance of air conditioning in resident rooms, consistent with  this
 paragraph,  in  an amount up to two million dollars for the period April
 first, two thousand six through March thirty-first, two thousand  seven,
 up  to three million eight hundred thousand dollars for the period April
 first, two thousand  seven  through  March  thirty-first,  two  thousand
 eight, up to three million eight hundred thousand dollars for the period
 April first, two thousand eight through March thirty-first, two thousand
 nine,  up to three million eight hundred thousand dollars for the period
 April first, two thousand nine through March thirty-first, two  thousand
 ten,  and  up  to  three  million eight hundred thousand dollars for the
 period April first, two thousand ten  through  March  thirty-first,  two
 thousand eleven. Residents shall not be charged utility cost for the use
 of  air  conditioners  supplied  under  the EnAbLe program. All such air
 conditioners must be operated in occupied resident rooms consistent with
 requirements applicable to common areas.
   (ccc) Funds shall be deposited by  the  commissioner,  within  amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed to receive for the deposit to the credit of the  state  special
 revenue  funds  - other, HCRA transfer fund, medical assistance account,
 or any successor fund or account, for  purposes  of  funding  the  state
 share of increases in the rates for certified home health agencies, long
 term  home  health  care  programs,  AIDS  home  care  programs, hospice
 programs and managed long term care plans and approved managed long term
 care operating demonstrations as defined in section  forty-four  hundred
 three-f  of  this  chapter  for recruitment and retention of health care
 workers pursuant to subdivisions nine  and  ten  of  section  thirty-six
 hundred  fourteen of this chapter from the tobacco control and insurance
 initiatives pool established for the following periods in the  following
 amounts:
   (i)  twenty-five  million dollars for the period June first, two thou-
 sand six through December thirty-first, two thousand six;
 S. 4007                            86                            A. 3007
 
   (ii) fifty million dollars for the period January first, two  thousand
 seven through December thirty-first, two thousand seven;
   (iii) fifty million dollars for the period January first, two thousand
 eight through December thirty-first, two thousand eight;
   (iv)  fifty million dollars for the period January first, two thousand
 nine through December thirty-first, two thousand nine;
   (v) fifty million dollars for the period January first,  two  thousand
 ten through December thirty-first, two thousand ten;
   (vi) twelve million five hundred thousand dollars for the period Janu-
 ary  first, two thousand eleven through March thirty-first, two thousand
 eleven;
   (vii) up to fifty million dollars each state fiscal year for the peri-
 od April first, two thousand  eleven  through  March  thirty-first,  two
 thousand fourteen;
   (viii)  up  to  fifty  million  dollars each state fiscal year for the
 period April first, two thousand fourteen  through  March  thirty-first,
 two thousand seventeen;
   (ix) up to fifty million dollars each state fiscal year for the period
 April  first,  two  thousand  seventeen  through March thirty-first, two
 thousand twenty; [and]
   (x) up to fifty million dollars each state fiscal year for the  period
 April  first,  two thousand twenty through March thirty-first, two thou-
 sand twenty-three; AND
   (XI) UP TO FIFTY MILLION DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD
 APRIL FIRST, TWO THOUSAND TWENTY-THREE THROUGH MARCH  THIRTY-FIRST,  TWO
 THOUSAND TWENTY-SIX.
   (ddd)  Funds  shall  be  deposited by the commissioner, within amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed  to  receive for the deposit to the credit of the state special
 revenue funds - other, HCRA transfer fund, medical  assistance  account,
 or  any  successor  fund  or  account, for purposes of funding the state
 share of increases in the medical assistance  rates  for  providers  for
 purposes  of  enhancing the provision, quality and/or efficiency of home
 care services pursuant  to  subdivision  eleven  of  section  thirty-six
 hundred  fourteen of this chapter from the tobacco control and insurance
 initiatives pool established for the following period in the  amount  of
 eight  million  dollars  for  the  period  April first, two thousand six
 through December thirty-first, two thousand six.
   (eee) Funds shall be reserved and accumulated from year  to  year  and
 shall  be available, including income from invested funds, to the Center
 for Functional Genomics at the State University of New York  at  Albany,
 for  the  purposes  of  the  Adirondack network for cancer education and
 research in rural communities grant program to improve access to  health
 care  and shall be made available from the tobacco control and insurance
 initiatives pool established for the following period in the  amount  of
 up  to  five  million dollars for the period January first, two thousand
 six through December thirty-first, two thousand six.
   (fff) Funds shall be made available to  the  empire  state  stem  cell
 trust fund established by section ninety-nine-p of the state finance law
 within  amounts  appropriated  up  to fifty million dollars annually and
 shall not exceed five hundred million dollars in total.
   (ggg) Funds shall be deposited by  the  commissioner,  within  amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed to receive for deposit to  the  credit  of  the  state  special
 revenue fund - other, HCRA transfer fund, medical assistance account, or
 any  successor  fund or account, for the purpose of supporting the state
 S. 4007                            87                            A. 3007
 
 share of Medicaid expenditures  for  hospital  translation  services  as
 authorized pursuant to paragraph (k) of subdivision one of section twen-
 ty-eight  hundred  seven-c  of this article from the tobacco control and
 initiatives  pool established for the following periods in the following
 amounts:
   (i) sixteen million dollars for the period July  first,  two  thousand
 eight through December thirty-first, two thousand eight; and
   (ii)  fourteen  million  seven hundred thousand dollars for the period
 January first, two thousand nine through November thirtieth,  two  thou-
 sand nine.
   (hhh)  Funds  shall  be  deposited by the commissioner, within amounts
 appropriated,  and  the  state  comptroller  is  hereby  authorized  and
 directed  to  receive  for  deposit  to  the credit of the state special
 revenue fund - other, HCRA transfer fund, medical assistance account, or
 any successor fund or account, for the purpose of supporting  the  state
 share  of  Medicaid  expenditures  for adjustments to inpatient rates of
 payment for general hospitals located in  the  counties  of  Nassau  and
 Suffolk  as  authorized  pursuant to paragraph (l) of subdivision one of
 section twenty-eight hundred seven-c of this article  from  the  tobacco
 control  and  initiatives  pool established for the following periods in
 the following amounts:
   (i) two million five hundred thousand dollars  for  the  period  April
 first,  two  thousand  eight through December thirty-first, two thousand
 eight; and
   (ii) two million two hundred ninety-two thousand dollars for the peri-
 od January first, two thousand  nine  through  November  thirtieth,  two
 thousand nine.
   (iii)  Funds shall be reserved and set aside and accumulated from year
 to year and shall be made available, including  income  from  investment
 funds,  for  the purpose of supporting the New York state medical indem-
 nity fund as authorized pursuant to title four of article  twenty-nine-D
 of this chapter, for the following periods and in the following amounts,
 provided,  however,  that  the commissioner is authorized to seek waiver
 authority from the federal centers for medicare  and  Medicaid  for  the
 purpose  of  securing  Medicaid federal financial participation for such
 program, in which case the funding authorized pursuant to this paragraph
 shall be utilized as the non-federal share for such payments:
   Thirty million dollars for the period April first, two thousand eleven
 through March thirty-first, two thousand twelve.
   2. (a) For periods prior to January  first,  two  thousand  five,  the
 commissioner  is  authorized  to  contract  with the article forty-three
 insurance law plans, or such other contractors as the commissioner shall
 designate, to receive and distribute funds from the tobacco control  and
 insurance  initiatives pool established pursuant to this section. In the
 event contracts with the article  forty-three  insurance  law  plans  or
 other  commissioner's  designees are effectuated, the commissioner shall
 conduct annual audits of the receipt and distribution of such funds. The
 reasonable costs and expenses of an administrator  as  approved  by  the
 commissioner,  not  to  exceed for personnel services on an annual basis
 five hundred thousand dollars, for collection and distribution of  funds
 pursuant to this section shall be paid from such funds.
   (b)  Notwithstanding any inconsistent provision of section one hundred
 twelve or one hundred sixty-three of the state finance law or any  other
 law,  at the discretion of the commissioner without a competitive bid or
 request for proposal process, contracts in effect for administration  of
 pools  established  pursuant  to  sections twenty-eight hundred seven-k,
 S. 4007                            88                            A. 3007
 
 twenty-eight hundred seven-l and twenty-eight hundred  seven-m  of  this
 article  for  the  period  January  first,  nineteen hundred ninety-nine
 through December  thirty-first,  nineteen  hundred  ninety-nine  may  be
 extended  to provide for administration pursuant to this section and may
 be amended as may be necessary.
   § 13. Paragraph (a) of subdivision 12 of section 367-b of  the  social
 services  law,  as  amended by section 15 of part Y of chapter 56 of the
 laws of 2020, is amended to read as follows:
   (a) For the purpose of regulating cash flow for general hospitals, the
 department shall develop and implement a payment methodology to  provide
 for  timely  payments  for inpatient hospital services eligible for case
 based payments per discharge based on diagnosis-related groups  provided
 during  the  period January first, nineteen hundred eighty-eight through
 March thirty-first  two  thousand  [twenty-three]  TWENTY-SIX,  by  such
 hospitals which elect to participate in the system.
   §  14.  Paragraph  (r)  of subdivision 9 of section 3614 of the public
 health law, as added by section 16 of part Y of chapter 56 of  the  laws
 of  2020, is amended and three new paragraphs (s), (t) and (u) are added
 to read as follows:
   (r) for the period April first, two thousand twenty-two through  March
 thirty-first,  two  thousand  twenty-three,  up  to  one hundred million
 dollars[.];
   (S) FOR THE PERIOD APRIL  FIRST,  TWO  THOUSAND  TWENTY-THREE  THROUGH
 MARCH  THIRTY-FIRST, TWO THOUSAND TWENTY-FOUR, UP TO ONE HUNDRED MILLION
 DOLLARS;
   (T) FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-FOUR THROUGH MARCH
 THIRTY-FIRST, TWO  THOUSAND  TWENTY-FIVE,  UP  TO  ONE  HUNDRED  MILLION
 DOLLARS;
   (U) FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-FIVE THROUGH MARCH
 THIRTY-FIRST,  TWO  THOUSAND  TWENTY-SIX,  UP  TO  ONE  HUNDRED  MILLION
 DOLLARS.
   § 15. Paragraph (v) of subdivision 1 of section 367-q  of  the  social
 services law, as added by section 17 of part Y of chapter 56 of the laws
 of  2020, is amended and three new paragraphs (w), (x) and (y) are added
 to read as follows:
   (v) for the period April first, two thousand twenty-two through  March
 thirty-first, two thousand twenty-three, up to twenty-eight million five
 hundred thousand dollars[.];
   (W)  FOR  THE  PERIOD  APRIL  FIRST, TWO THOUSAND TWENTY-THREE THROUGH
 MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-FOUR, UP TO TWENTY-EIGHT MILLION
 FIVE HUNDRED THOUSAND DOLLARS;
   (X) FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-FOUR THROUGH MARCH
 THIRTY-FIRST, TWO THOUSAND TWENTY-FIVE, UP TO TWENTY-EIGHT MILLION  FIVE
 HUNDRED THOUSAND DOLLARS;
   (Y) FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-FIVE THROUGH MARCH
 THIRTY-FIRST,  TWO  THOUSAND TWENTY-SIX, UP TO TWENTY-EIGHT MILLION FIVE
 HUNDRED THOUSAND DOLLARS.
   § 16. This act shall take effect April 1, 2023; 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 April 1, 2023; and further provided, that:
   (a) the amendments to sections 2807-j and 2807-s of the public  health
 law  made  by  sections  two, eight, nine, and ten of this act shall not
 affect the expiration of such sections and shall expire therewith;
 S. 4007                            89                            A. 3007
 
   (b) the amendments to subdivision 6 of section 2807-t  of  the  public
 health law made by section eleven of this act shall not affect the expi-
 ration of such section and shall be deemed to expire therewith; and
   (c)  the  amendments  to  paragraph  (i-1) of subdivision 1 of section
 2807-v of the public health law made by section twelve of this act shall
 not affect the repeal of such paragraph and  shall  be  deemed  repealed
 therewith.
 
                                  PART D

   Section  1.  Paragraph  (a)  of  subdivision 4 of section 365-a of the
 social services law, as amended by chapter 493 of the laws of  2010,  is
 amended to read as follows:
   (a) drugs which may be dispensed without a prescription as required by
 section sixty-eight hundred ten of the education law; provided, however,
 that  the state commissioner of health may by regulation specify certain
 of such drugs which may be reimbursed as an item of  medical  assistance
 in  accordance with the price schedule established by such commissioner.
 Notwithstanding any other provision of law, [additions] MODIFICATIONS to
 the list of drugs reimbursable under this  paragraph  may  be  filed  as
 regulations  by  the  commissioner  of  health  without prior notice and
 comment;
   § 2. 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.
   § 3. Subdivisions 25 and 25-a of section 364-j of the social  services
 law are REPEALED.
   §  4.  This  act  shall  take  effect  October  1, 2023; provided that
 sections two and three of this act shall take effect April 1, 2024.
 
                                  PART E
 
   Section 1.  Subdivision 5-d of section 2807-k  of  the  public  health
 law,  as  amended  by  section 3 of part KK of chapter 56 of the laws of
 2020, is amended to read as follows:
   5-d. (a) Notwithstanding any inconsistent provision of  this  section,
 section  twenty-eight  hundred  seven-w  of  this  article  or any other
 contrary provision of law, and subject to the  availability  of  federal
 financial  participation,  for  periods  on and after January first, two
 thousand twenty, through March thirty-first, two thousand [twenty-three]
 TWENTY-SIX, all  funds  available  for  distribution  pursuant  to  this
 section,  except for funds distributed pursuant to [subparagraph (v) of]
 paragraph (b) of subdivision five-b  of  this  section,  and  all  funds
 available  for  distribution  pursuant  to  section twenty-eight hundred
 S. 4007                            90                            A. 3007
 
 seven-w of this article, shall be reserved and set aside and distributed
 in accordance with the provisions of this subdivision.
   (b)  The commissioner shall promulgate regulations, and may promulgate
 emergency regulations, establishing methodologies for  the  distribution
 of  funds  as  described  in  paragraph (a) of this subdivision and such
 regulations shall include, but not be limited to, the following:
   (i) Such regulations shall  establish  methodologies  for  determining
 each  facility's  relative uncompensated care need amount based on unin-
 sured inpatient and outpatient units of service from the cost  reporting
 year  two years prior to the distribution year, multiplied by the appli-
 cable medicaid rates in effect January first of the  distribution  year,
 as summed and adjusted by a statewide cost adjustment factor and reduced
 by  the  sum  of  all  payment  amounts  collected  from  such uninsured
 patients, and as further adjusted  by  application  of  a  nominal  need
 computation  that shall take into account each facility's medicaid inpa-
 tient share.
   (ii) Annual distributions pursuant to such  regulations  for  the  two
 thousand  twenty  through two thousand [twenty-two] TWENTY-FIVE calendar
 years shall be in accord with the following:
   (A) one hundred thirty-nine  million  four  hundred  thousand  dollars
 shall be distributed as Medicaid Disproportionate Share Hospital ("DSH")
 payments to major public general hospitals; and
   (B)  nine  hundred sixty-nine million nine hundred thousand dollars as
 Medicaid DSH payments to eligible general hospitals,  other  than  major
 public general hospitals.
   For  the calendar years two thousand twenty through two thousand twen-
 ty-two, the total distributions to  eligible  general  hospitals,  other
 than  major  public  general hospitals, shall be subject to an aggregate
 reduction of one hundred fifty million dollars annually,  provided  that
 eligible  general  hospitals, other than major public general hospitals,
 that qualify as enhanced safety net hospitals under section two thousand
 eight hundred seven-c of this article  shall  not  be  subject  to  such
 reduction.
   FOR  THE CALENDAR YEARS TWO THOUSAND TWENTY-THREE THROUGH TWO THOUSAND
 TWENTY-FIVE, THE TOTAL  DISTRIBUTIONS  TO  ELIGIBLE  GENERAL  HOSPITALS,
 OTHER THAN MAJOR PUBLIC GENERAL HOSPITALS, SHALL BE SUBJECT TO AN AGGRE-
 GATE  REDUCTION OF TWO HUNDRED THIRTY-FIVE MILLION FOUR HUNDRED THOUSAND
 DOLLARS ANNUALLY, PROVIDED THAT ELIGIBLE GENERAL HOSPITALS,  OTHER  THAN
 MAJOR  PUBLIC  GENERAL  HOSPITALS  THAT  QUALIFY  AS ENHANCED SAFETY NET
 HOSPITALS UNDER SECTION TWO THOUSAND EIGHT HUNDRED SEVEN-C OF THIS ARTI-
 CLE AS OF APRIL FIRST, TWO THOUSAND TWENTY, SHALL NOT BE SUBJECT TO SUCH
 REDUCTION.
   Such [reduction] REDUCTIONS shall be determined by a methodology to be
 established by the commissioner. Such  [methodology]  METHODOLOGIES  may
 take  into  account  the  payor mix of each non-public general hospital,
 including the percentage of inpatient days paid by Medicaid.
   (iii) For calendar years two  thousand  twenty  through  two  thousand
 [twenty-two]   TWENTY-FIVE,  sixty-four  million  six  hundred  thousand
 dollars shall be distributed to eligible general hospitals,  other  than
 major  public general hospitals, that experience a reduction in indigent
 care pool payments pursuant to this subdivision,  and  that  qualify  as
 enhanced  safety  net hospitals under section two thousand eight hundred
 seven-c of this article as of April first,  two  thousand  twenty.  Such
 distribution shall be established pursuant to regulations promulgated by
 the  commissioner and shall be proportional to the reduction experienced
 by the facility.
 S. 4007                            91                            A. 3007
 
   (iv) Such regulations shall reserve one percent of the funds available
 for distribution in the two thousand fourteen and two  thousand  fifteen
 calendar  years,  and  for  calendar  years thereafter, pursuant to this
 subdivision, subdivision  fourteen-f  of  section  twenty-eight  hundred
 seven-c of this article, and sections two hundred eleven and two hundred
 twelve  of  chapter  four  hundred  seventy-four of the laws of nineteen
 hundred ninety-six, in a  "financial  assistance  compliance  pool"  and
 shall establish methodologies for the distribution of such pool funds to
 facilities  based  on  their  level  of compliance, as determined by the
 commissioner, with the provisions of subdivision nine-a of this section.
   (c) The commissioner shall annually report to  the  governor  and  the
 legislature  on the distribution of funds under this subdivision includ-
 ing, but not limited to:
   (i) the impact on safety net providers, including community providers,
 rural general hospitals and major public general hospitals;
   (ii) the provision of indigent care by units  of  services  and  funds
 distributed by general hospitals; and
   (iii) the extent to which access to care has been enhanced.
   §  2.  Subdivision  1  of  section  2801  of the public health law, as
 amended by section 1 of part Z of chapter 57 of the  laws  of  2019,  is
 amended to read as follows:
   1.  "Hospital"  means a facility or institution engaged principally in
 providing services by or under the supervision of a physician or, in the
 case of a dental clinic or dental dispensary, of a dentist, or,  in  the
 case  of  a  midwifery  birth  center, of a midwife, for the prevention,
 diagnosis or treatment of human  disease,  pain,  injury,  deformity  or
 physical  condition,  including, but not limited to, a general hospital,
 public health center, diagnostic center, treatment center, A RURAL EMER-
 GENCY HOSPITAL UNDER 42 USC 1395X(KKK), OR SUCCESSOR PROVISIONS,  dental
 clinic,  dental  dispensary, rehabilitation center other than a facility
 used solely for vocational rehabilitation,  nursing  home,  tuberculosis
 hospital,  chronic disease hospital, maternity hospital, midwifery birth
 center,  lying-in-asylum,  out-patient  department,  out-patient  lodge,
 dispensary  and  a laboratory or central service facility serving one or
 more such institutions, but the  term  hospital  shall  not  include  an
 institution, sanitarium or other facility engaged principally in provid-
 ing  services for the prevention, diagnosis or treatment of mental disa-
 bility and which is subject to the powers  of  visitation,  examination,
 inspection  and investigation of the department of mental hygiene except
 for those distinct parts of  such  a  facility  which  provide  hospital
 service. The provisions of this article shall not apply to a facility or
 institution  engaged  principally  in providing services by or under the
 supervision of the bona fide members and adherents of a recognized reli-
 gious organization whose teachings include reliance on  spiritual  means
 through prayer alone for healing in the practice of the religion of such
 organization  and  where  services are provided in accordance with those
 teachings. No provision of this article or any other  provision  of  law
 shall  be construed to: (a) limit the volume of mental health, substance
 use disorder services or developmental disability services that  can  be
 provided  by  a  provider  of  primary care services licensed under this
 article and authorized to provide integrated services in accordance with
 regulations issued by the commissioner in consultation with the  commis-
 sioner of the office of mental health, the commissioner of the office of
 alcoholism  and  substance  abuse  services  and the commissioner of the
 office for people with developmental disabilities, including regulations
 issued pursuant to subdivision seven of  section  three  hundred  sixty-
 S. 4007                            92                            A. 3007

 five-l  of the social services law or part L of chapter fifty-six of the
 laws of two thousand twelve; (b) require a provider licensed pursuant to
 article thirty-one of the mental hygiene law or  certified  pursuant  to
 article  sixteen  or  article  thirty-two  of  the mental hygiene law to
 obtain an operating certificate from the department if such provider has
 been authorized to provide integrated services in accordance with  regu-
 lations issued by the commissioner in consultation with the commissioner
 of  the office of mental health, the commissioner of the office of alco-
 holism and substance abuse services and the commissioner of  the  office
 for people with developmental disabilities, including regulations issued
 pursuant  to  subdivision seven of section three hundred sixty-five-l of
 the social services law or part L of chapter fifty-six of  the  laws  of
 two thousand twelve.
   §  3.  Section  2801-g of the public health law is amended by adding a
 new subdivision 4 to read as follows:
   4. AT LEAST THIRTY DAYS PRIOR TO A GENERAL HOSPITAL  APPLYING  TO  THE
 FEDERAL  CENTERS  FOR  MEDICARE  AND MEDICAID SERVICES TO CONVERT FROM A
 GENERAL HOSPITAL WITH INPATIENTS TO A RURAL EMERGENCY HOSPITAL UNDER  42
 USC  1395X(KKK),  OR  SUCCESSOR  PROVISIONS,  SUCH HOSPITAL SHALL HOLD A
 PUBLIC COMMUNITY  FORUM  FOR  THE  PURPOSE  OF  OBTAINING  PUBLIC  INPUT
 CONCERNING THE ANTICIPATED IMPACT OF THE HOSPITAL'S CLOSURE OF INPATIENT
 UNITS, INCLUDING BUT NOT LIMITED TO, THE IMPACT ON RECIPIENTS OF MEDICAL
 ASSISTANCE  FOR  NEEDY PERSONS, THE UNINSURED, AND MEDICALLY UNDERSERVED
 POPULATIONS, AND OPTIONS AND PROPOSALS TO  AMELIORATE  SUCH  ANTICIPATED
 IMPACT.  THE  HOSPITAL SHALL AFFORD ALL PUBLIC PARTICIPANTS A REASONABLE
 OPPORTUNITY TO SPEAK ABOUT RELEVANT MATTERS  AT  SUCH  COMMUNITY  FORUM.
 PRIOR  TO  ANY  COMMUNITY FORUM AND AS SOON AS PRACTICABLE, THE HOSPITAL
 SHALL BE REQUIRED TO:
   (A) NOTIFY THE OFFICE OF MENTAL  HEALTH  AND  THE  LOCAL  DIRECTOR  OF
 COMMUNITY  SERVICES  IN  THE EVENT SUCH GENERAL HOSPITAL HAS PSYCHIATRIC
 INPATIENT BEDS LICENSED UNDER ARTICLE THIRTY-ONE OF THE  MENTAL  HYGIENE
 LAW  OR  DESIGNATED  PURSUANT TO SECTION 9.39 OF THE MENTAL HYGIENE LAW,
 AND
   (B) NOTIFY THE OFFICE OF ADDICTION SERVICES AND SUPPORTS IN THE  EVENT
 SUCH  GENERAL  HOSPITAL  HAS  INPATIENT SUBSTANCE USE DISORDER TREATMENT
 PROGRAMS OR INPATIENT CHEMICAL DEPENDENCE  TREATMENT  PROGRAMS  LICENSED
 UNDER ARTICLE THIRTY-TWO OF THE MENTAL HYGIENE LAW.
   §  4.  The opening paragraph of subdivision (g) of section 2826 of the
 public health law, as amended by section 3 of part M of  chapter  57  of
 the laws of 2022, is 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  twenty-two through March thirty-first, two
 thousand twenty-three,] the commissioner may award a  temporary  adjust-
 ment  to the non-capital components of rates, or make temporary lump-sum
 Medicaid payments to eligible 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 adjustment or make such temporary lump sum payment
 only  pursuant  to criteria, AN APPLICATION, AND an evaluation process[,
 and transformation plan] acceptable to the commissioner in  consultation
 with  the  director  of the division of the budget. The department shall
 publish on its website the criteria, APPLICATION, AND evaluation process
 [and guidance for transformation plans] and notification  of  any  award
 recipients.
 S. 4007                            93                            A. 3007

   §  5.  Subparagraph (F) of paragraph (i) of subdivision (g) of section
 2826 of the public health law, as added by section 3 of part M of  chap-
 ter 57 of the laws of 2022, is amended to read as follows:
   (F)  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; OR AN ENTITY THAT WAS
 FORMED AS A PREFERRED PROVIDER SYSTEM PURSUANT TO  THE  DELIVERY  SYSTEM
 REFORM  INCENTIVE PAYMENT (DSRIP) PROGRAM AND COLLABORATED WITH AN INDE-
 PENDENT PRACTICE ASSOCIATION THAT RECEIVED VBP INNOVATOR STATUS FROM THE
 DEPARTMENT FOR PURPOSES OF MEETING  DSRIP  GOALS,  AND  WHICH  PREFERRED
 PROVIDER SYSTEM REMAINS OPERATIONAL AS AN INTEGRATED CARE SYSTEM.
   §  6.  The  opening  paragraph of paragraph (ii) 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, is amended to read as follows:
   Eligible  applicants  must  demonstrate  that without such award, they
 will be in severe financial distress [through  March  thirty-first,  two
 thousand sixteen], as evidenced by:
   §  7.  Subparagraph (A), the opening paragraph of subparagraph (E) and
 subparagraph (F) of paragraph (iii) 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:
   (A) [Applications under this subdivision]  ELIGIBLE  APPLICANTS  shall
 [include  a  multi-year  transformation  plan  that  is aligned with the
 delivery system reform incentive payment  ("DSRIP")  program  goals  and
 objectives.  Such plan shall be approved by] SUBMIT A COMPLETED APPLICA-
 TION TO the department [and shall demonstrate a path towards  long  term
 sustainability and improved patient care].
   The  department  shall review all applications under this subdivision,
 and [a] determine:
   (F) After review of all applications under  this  subdivision,  and  a
 determination of the aggregate amount of requested funds, the department
 [shall]  MAY make awards to eligible applicants; provided, however, that
 such awards may be in an amount lower than such requested funding, on  a
 per applicant or aggregate basis.
   §  8.  Paragraph  (v) 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, is amended to read as follows:
   (v) Payments made to awardees pursuant to this subdivision [shall  be]
 THAT  ARE  made on a monthly basis[. Such payments] will be based on the
 applicant's actual monthly financial performance during such period  and
 the  reasonable  cash  amount  necessary  to  sustain operations for the
 following month. The applicant's monthly financial performance shall  be
 measured  by  such  applicant's  monthly financial and activity reports,
 which shall include, but not be limited to, actual revenue and  expenses
 for  the  prior  month,  projected  cash need for the current month, and
 projected cash need for the following month.
   § 9. Part I of chapter 57 of the laws of 2022 relating to providing  a
 one percent across the board payment increase to all qualifying fee-for-
 service  Medicaid  rates, is amended by adding a new section 1-a to read
 as follows:
   § 1-A. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY,  FOR  THE
 STATE  FISCAL  YEARS  BEGINNING  APRIL 1, 2023, AND THEREAFTER, MEDICAID
 PAYMENTS MADE FOR THE OPERATING COMPONENT OF HOSPITAL INPATIENT SERVICES
 SHALL BE SUBJECT TO A UNIFORM RATE INCREASE OF FIVE PERCENT IN  ADDITION
 TO  THE  INCREASE  CONTAINED  IN SECTION ONE OF THIS ACT, SUBJECT TO THE
 S. 4007                            94                            A. 3007
 
 APPROVAL OF THE COMMISSIONER OF HEALTH AND THE DIRECTOR OF  THE  BUDGET.
 SUCH RATE INCREASE SHALL BE SUBJECT TO FEDERAL FINANCIAL PARTICIPATION.
   §  10.  This act shall take effect immediately; provided that sections
 two and three of this act shall take effect on the sixtieth day after it
 shall have become a law; provided, further,  that  sections  one,  four,
 five,  six,  seven,  eight, and nine of this act shall be deemed to have
 been in full force and effect on and after April 1, 2023.
 
                                  PART F
 
   Section 1. 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 Z of chapter 57 of the laws of 2022, 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, between July
 1, 2021 and June 30, 2022, [and] between July 1, 2022 and June 30, 2023,
 AND BETWEEN JULY 1, 2023 AND JUNE 30, 2024  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 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
 S. 4007                            95                            A. 3007
 
 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,
 between  July  1, 2021 and June 30, 2022, [and] between July 1, 2022 and
 June 30, 2023, AND BETWEEN JULY 1, 2023 AND JUNE 30, 2024 for physicians
 or dentists certified as eligible for each such period or periods pursu-
 ant to subdivision 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  cover-
 age  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
 S. 4007                            96                            A. 3007
 
 dollars  for all claimants for such occurrences shall be effective April
 1, 2002.
   §  2.  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 Z of chapter 57 of the laws of 2022, 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, between July 1,  2021  and  June
 30, 2022, [and] between July 1, 2022 and June 30, 2023, AND BETWEEN JULY
 1,  2023 AND JUNE 30, 2024 allocable to each general hospital for physi-
 cians 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
 S. 4007                            97                            A. 3007
 
 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,
 between July 1, 2021 and June 30, 2022, [and] between July 1,  2022  and
 June  30,  2023, AND BETWEEN JULY 1, 2023 AND JUNE 30, 2024 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 hospital 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  allocable  to the period July 1, 1987 to
 December 31, 1987, to the period January 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 period 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, to the period July 1, 2021 to June 30,
 2022, [and] to the period July 1, 2022 to June  30,  2023,  AND  TO  THE
 PERIOD JULY 1, 2023 TO JUNE 30, 2024.
   § 3. 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 Z of chapter 57 of the
 laws of 2022, 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
 S. 4007                            98                            A. 3007
 
 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
 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, during the period July 1,  2021  to  June  30,
 2022,  [and] during the period July 1, 2022 to June 30, 2023, AND DURING
 THE PERIOD JULY 1, 2023 TO JUNE 30, 2024  allocated  or  reallocated  in
 accordance  with  paragraph  (a)  of  subdivision 4-a of this section to
 rates of payment applicable to state governmental agencies, each  physi-
 cian  or  dentist  for  whom  a  policy for excess insurance coverage or
 equivalent excess coverage is purchased for such period shall be respon-
 sible for payment to the provider of excess insurance coverage or equiv-
 alent 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-
 S. 4007                            99                            A. 3007
 
 od July 1, 2021 to June 30, 2022, or covering the period July 1, 2022 to
 June 30, 2023, OR COVERING THE PERIOD JULY 1,  2023  TO  JUNE  30,  2024
 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 determined  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, OR COVERING THE PERIOD JULY 1, 2023 TO JUNE 30, 2024 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 equivalent excess coverage
 purchased for such physician or dentist in accordance 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
 S. 4007                            100                           A. 3007
 
 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-
 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] 30, 2023, OR COVERING  THE  PERIOD  JULY  1,
 2023  TO  JUNE 30, 2024 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,  AND TO THE PERIOD JULY 1, 2023 TO JUNE 30, 2024 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 covering 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 cover-
 S. 4007                            101                           A. 3007
 
 ing 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 cover-
 ing 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 covering 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  cover-
 ing  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 covering 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 cover-
 ing the period July 1, 2021 to June 30, 2022, and  covering  the  period
 July  1, 2022 to June 30, 2023 for, AND COVERING THE PERIOD JULY 1, 2023
 TO JUNE 30, 2024 a physician or  dentist  where  such  excess  insurance
 coverage  or  equivalent excess coverage is cancelled in accordance with
 paragraph (c) of this subdivision.
   § 4. 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 Z of chap-
 ter 57 of the laws of 2022, 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,
 [2023] 2024; 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, [2023]
 2024, 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, [2023]
 2024 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
 S. 4007                            102                           A. 3007
 
 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
 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.
   §  5. 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 Z of chapter 57 of the laws of 2022,  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, June 15, 2022,
 [and] June 15, 2023, AND JUNE 15, 2024 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 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,
 S. 4007                            103                           A. 3007
 
 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, OR JULY 1, 2023 TO JUNE 30, 2024
 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-
 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, OR JULY 1, 2023 TO JUNE 30, 2024
 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, June 15, 2022, [and] June 15,  2023,  AND  JUNE
 15, 2024 as applicable.
   §  6. 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 Z
 of chapter 57 of the laws of 2022, 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-two] TWENTY-THREE, shall be eligible to  apply  for
 such  coverage  for the coverage period beginning the first of July, two
 thousand [twenty-two] TWENTY-THREE;  provided,  however,  if  the  total
 S. 4007                            104                           A. 3007
 
 number of physicians or dentists for whom such excess coverage or equiv-
 alent excess coverage was purchased for the policy year ending the thir-
 tieth  of June, two thousand [twenty-two] TWENTY-THREE exceeds the total
 number  of physicians or dentists certified as eligible for the coverage
 period beginning the first of July, two  thousand  [twenty-two]  TWENTY-
 THREE, then the general hospitals may certify additional eligible physi-
 cians  or  dentists in a number equal to such general hospital's propor-
 tional 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-two] TWENTY-THREE, as applied to the differ-
 ence between the number of eligible physicians or dentists  for  whom  a
 policy  for  excess coverage or equivalent excess coverage was purchased
 for the coverage period ending  the  thirtieth  of  June,  two  thousand
 [twenty-two]  TWENTY-THREE 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 thou-
 sand [twenty-two] TWENTY-THREE.
   § 7. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2023.
 
                                  PART G
 
   Section 1. Paragraph (a) of subdivision 12 of section 203 of the elder
 law,  as added by section 1 of part U of chapter 57 of the laws of 2019,
 is amended to read as follows:
   (a) The director is hereby authorized to implement private pay  proto-
 cols  for programs and services administered by the office. These proto-
 cols may be implemented by area agencies on aging at  their  option  and
 such  protocols  shall not be applied to services for a participant when
 being paid for with federal funds or funds designated as federal  match,
 or  for  individuals  with  an income below [four] TWO hundred AND FIFTY
 percent of the federal poverty  level.  All  private  payments  received
 directly by an area agency on aging or indirectly by one of its contrac-
 tors shall be used to supplement, not supplant, funds by state, federal,
 or  county  appropriations.  Such private pay payments shall be set at a
 cost to the participant of not more than twenty percent above either the
 unit cost to the area agency on aging to provide the program or  service
 directly,  or  the  amount  that  the  area  agency on aging pays to its
 contractor to provide the  program  or  service.  Private  pay  payments
 received  under  this  subdivision  shall  be used by the area agency on
 aging to first reduce any unmet need for programs and services, and then
 to support and enhance services or programs provided by the area  agency
 on aging. No participant, regardless of income, shall be required to pay
 for  any  program  or  service that they are receiving at the time these
 protocols are implemented by the area agency on aging. This  subdivision
 shall not prevent cost sharing for the programs and services established
 pursuant  to section two hundred fourteen of this title [for individuals
 below four hundred percent of the  federal  poverty  level].  Consistent
 with  federal and state statute and regulations, when providing programs
 and services, area agencies on aging and their contractors shall contin-
 ue to give priority for programs and services to  individuals  with  the
 greatest  economic  or  social  needs. In the event that the capacity to
 provide programs and services is limited,  such  programs  and  services
 shall  be  provided to individuals with incomes below [four] TWO hundred
 AND FIFTY percent of the federal poverty level before such programs  and
 S. 4007                            105                           A. 3007
 
 services are provided to those participating in the private pay protocol
 pursuant to this subdivision.
   § 2. This act shall take effect immediately.
 
                                  PART H
 
   Section  1.   Section 5 of part AAA of chapter 56 of the laws of 2022,
 amending the social services law relating to expanding  Medicaid  eligi-
 bility  requirements for seniors and disabled individuals, is amended to
 read as follows:
   § 5. This act shall take effect January 1, 2023,  subject  to  federal
 financial  participation  for sections one, three, and four of this act;
 provided, however that [the] SECTION TWO OF THIS ACT SHALL  TAKE  EFFECT
 JANUARY 1, 2024. 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 legislative law and section 70-b of the public officers law.
   § 2. Short title. This act shall be known and  may  be  cited  as  the
 "1332 state innovation program".
   § 3. The social services law is amended by adding a new section 369-ii
 to read as follows:
   §  369-II.  1332 STATE INNOVATION PROGRAM. 1. AUTHORIZATION.  NOTWITH-
 STANDING SECTION THREE HUNDRED SIXTY-NINE-GG OF THIS TITLE,  SUBJECT  TO
 FEDERAL  APPROVAL, IF IT IS IN THE FINANCIAL INTEREST OF THE STATE TO DO
 SO, THE COMMISSIONER OF HEALTH IS AUTHORIZED, WITH THE APPROVAL  OF  THE
 DIRECTOR  OF  THE  BUDGET,  TO ESTABLISH A 1332 STATE INNOVATION PROGRAM
 PURSUANT TO SECTION 1332 OF THE PATIENT PROTECTION AND  AFFORDABLE  CARE
 ACT  (P.L.   111-148) AND SUBDIVISION TWENTY-FIVE OF SECTION TWO HUNDRED
 SIXTY-EIGHT-C OF THE PUBLIC HEALTH LAW.  THE  COMMISSIONER  OF  HEALTH'S
 AUTHORITY  PURSUANT  TO  THIS  SECTION  IS CONTINGENT UPON OBTAINING AND
 MAINTAINING ALL NECESSARY APPROVALS FROM THE  SECRETARY  OF  HEALTH  AND
 HUMAN SERVICES AND THE SECRETARY OF THE TREASURY BASED ON AN APPLICATION
 FOR  A  WAIVER FOR STATE INNOVATION. THE COMMISSIONER OF HEALTH MAY TAKE
 ALL ACTIONS NECESSARY TO OBTAIN SUCH APPROVALS.
   2. DEFINITIONS. FOR THE PURPOSES OF THIS SECTION:
   (A) "ELIGIBLE ORGANIZATION" MEANS  AN  INSURER  LICENSED  PURSUANT  TO
 ARTICLE  THIRTY-TWO  OR FORTY-TWO OF THE INSURANCE LAW, A CORPORATION OR
 AN ORGANIZATION UNDER ARTICLE FORTY-THREE OF THE INSURANCE  LAW,  OR  AN
 ORGANIZATION  CERTIFIED  UNDER  ARTICLE  FORTY-FOUR OF THE PUBLIC HEALTH
 LAW, INCLUDING PROVIDERS  CERTIFIED  UNDER  SECTION  FORTY-FOUR  HUNDRED
 THREE-E OF THE PUBLIC HEALTH LAW.
   (B) "APPROVED ORGANIZATION" MEANS AN ELIGIBLE ORGANIZATION APPROVED BY
 THE  COMMISSIONER OF HEALTH TO UNDERWRITE A 1332 STATE INNOVATION HEALTH
 INSURANCE PLAN PURSUANT TO THIS SECTION.
   (C) "HEALTH CARE SERVICES" MEANS:
   (I) THE SERVICES AND SUPPLIES AS DEFINED BY THE COMMISSIONER OF HEALTH
 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 REFERENCE PLAN SELECTED BY THE COMMIS-
 SIONER OF HEALTH 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
 S. 4007                            106                           A. 3007
 
 WITHIN  THE SERVICE AREA OF THE APPROVED ORGANIZATION THAT IS WILLING TO
 AGREE  TO  PROVIDE  CANCER-RELATED  INPATIENT,  OUTPATIENT  AND  MEDICAL
 SERVICES  TO  ALL  ENROLLEES  IN  APPROVED  ORGANIZATIONS' 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  THE
 CENTER'S INPATIENT AND OUTPATIENT SERVICES;
   (II)  DENTAL  AND  VISION  SERVICES  AS DEFINED BY THE COMMISSIONER OF
 HEALTH, AND
   (III) AS DEFINED BY THE COMMISSIONER OF HEALTH 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.
   (D) "QUALIFIED HEALTH PLAN" MEANS A HEALTH PLAN THAT MEETS THE  CRITE-
 RIA  FOR  CERTIFICATION DESCRIBED IN § 1311(C) OF THE PATIENT PROTECTION
 AND AFFORDABLE CARE ACT (P.L. 111-148), AND IS  OFFERED  TO  INDIVIDUALS
 THROUGH  THE  NY  STATE  OF  HEALTH, THE OFFICIAL HEALTH MARKETPLACE, OR
 MARKETPLACE, AS DEFINED  IN  SUBDIVISION  TWO  OF  SECTION  TWO  HUNDRED
 SIXTY-EIGHT-A OF THE PUBLIC HEALTH LAW.
   (E) "BASIC HEALTH INSURANCE PLAN" MEANS A HEALTH PLAN PROVIDING HEALTH
 CARE  SERVICES,  SEPARATE AND APART FROM QUALIFIED HEALTH PLANS, THAT IS
 ISSUED BY AN APPROVED ORGANIZATION  AND  CERTIFIED  IN  ACCORDANCE  WITH
 SECTION THREE HUNDRED SIXTY-NINE-GG OF THIS TITLE.
   (F)  "1332 STATE INNOVATION PLAN" MEANS A STANDARD HEALTH PLAN PROVID-
 ING HEALTH CARE SERVICES, SEPARATE AND APART  FROM  A  QUALIFIED  HEALTH
 PLAN  AND  A  BASIC HEALTH INSURANCE PLAN, THAT IS ISSUED BY AN APPROVED
 ORGANIZATION AND CERTIFIED IN ACCORDANCE WITH THIS SECTION.
   3. STATE INNOVATION PLAN ELIGIBLE INDIVIDUAL. (A) A PERSON IS ELIGIBLE
 TO RECEIVE COVERAGE FOR HEALTH CARE UNDER THIS SECTION IF THEY:
   (I) RESIDE IN NEW YORK STATE AND ARE UNDER SIXTY-FIVE YEARS OF AGE;
   (II) ARE NOT ELIGIBLE FOR MEDICAL ASSISTANCE  UNDER  TITLE  ELEVEN  OF
 THIS  ARTICLE  OR FOR THE CHILD HEALTH INSURANCE PLAN DESCRIBED IN TITLE
 ONE-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW;
   (III) ARE NOT ELIGIBLE FOR MINIMUM ESSENTIAL COVERAGE, AS  DEFINED  IN
 SECTION  5000A(F)  OF  THE  INTERNAL REVENUE SERVICE CODE OF 1986, OR IS
 ELIGIBLE FOR AN EMPLOYER-SPONSORED  PLAN  THAT  IS  NOT  AFFORDABLE,  IN
 ACCORDANCE WITH SECTION 5000A(F) OF SUCH CODE; AND
   (IV)  HAVE  HOUSEHOLD  INCOME AT OR BELOW TWO HUNDRED FIFTY 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 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 NONCITIZENS LAWFULLY
 PRESENT IN THE UNITED STATES WITH HOUSEHOLD  INCOMES  AT  OR  BELOW  ONE
 HUNDRED THIRTY-THREE PERCENT OF THE FEDERAL POVERTY LINE SHALL BE ELIGI-
 BLE  TO  RECEIVE  COVERAGE  FOR  HEALTH  CARE  SERVICES  PURSUANT TO THE
 PROVISIONS OF THIS SECTION IF SUCH NONCITIZEN WOULD  BE  INELIGIBLE  FOR
 MEDICAL ASSISTANCE UNDER TITLE ELEVEN OF THIS ARTICLE DUE TO THEIR IMMI-
 GRATION STATUS.
   (B)  SUBJECT TO FEDERAL APPROVAL, A CHILD BORN TO AN INDIVIDUAL ELIGI-
 BLE FOR AND RECEIVING COVERAGE FOR HEALTH CARE SERVICES PURSUANT TO THIS
 S. 4007                            107                           A. 3007

 SECTION WHO BUT FOR THEIR ELIGIBILITY UNDER THIS SECTION WOULD BE ELIGI-
 BLE FOR COVERAGE PURSUANT TO SUBPARAGRAPHS TWO OR FOUR OF PARAGRAPH  (B)
 OF  SUBDIVISION  ONE OF SECTION THREE HUNDRED SIXTY-SIX OF THIS ARTICLE,
 SHALL  BE  ADMINISTRATIVELY  ENROLLED, AS DEFINED BY THE COMMISSIONER OF
 HEALTH, IN 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.
   (C) SUBJECT TO FEDERAL APPROVAL, AN INDIVIDUAL WHO IS ELIGIBLE FOR AND
 RECEIVING COVERAGE FOR HEALTH CARE SERVICES PURSUANT TO THIS SECTION  IS
 ELIGIBLE  TO  CONTINUE  TO RECEIVE HEALTH CARE SERVICES PURSUANT TO THIS
 SECTION DURING THE INDIVIDUAL'S 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 SECTION.
   (D) FOR THE PURPOSES OF THIS SECTION, 1332  STATE  INNOVATION  PROGRAM
 ELIGIBLE  INDIVIDUALS  ARE  PROHIBITED  FROM  BEING TREATED AS QUALIFIED
 INDIVIDUALS UNDER SECTION 1312 OF THE AFFORDABLE CARE ACT AND AS  ELIGI-
 BLE INDIVIDUALS UNDER SECTION 1331 OF THE ACA AND ENROLLING IN QUALIFIED
 HEALTH  PLAN THROUGH THE MARKETPLACE OR STANDARD HEALTH PLAN THROUGH THE
 BASIC HEALTH PROGRAM.
   4. ENROLLMENT. (A) SUBJECT TO FEDERAL APPROVAL,  THE  COMMISSIONER  OF
 HEALTH  IS  AUTHORIZED TO ESTABLISH AN APPLICATION AND ENROLLMENT PROCE-
 DURE FOR PROSPECTIVE ENROLLEES. SUCH PROCEDURE WILL INCLUDE A  VERIFICA-
 TION  SYSTEM  FOR  APPLICANTS,  WHICH  MUST  BE CONSISTENT WITH 42 USC §
 1320B-7.
   (B) SUCH PROCEDURE SHALL ALLOW FOR CONTINUOUS ENROLLMENT FOR ENROLLEES
 TO THE 1332 STATE INNOVATION PROGRAM WHERE AN INDIVIDUAL MAY  APPLY  AND
 ENROLL FOR COVERAGE AT ANY POINT.
   (C)  UPON  AN  APPLICANT'S ENROLLMENT IN A 1332 STATE INNOVATION PLAN,
 COVERAGE FOR HEALTH CARE SERVICES PURSUANT TO  THE  PROVISIONS  OF  THIS
 SECTION  SHALL BE RETROACTIVE TO THE FIRST DAY OF THE MONTH IN WHICH THE
 INDIVIDUAL WAS DETERMINED ELIGIBLE, EXCEPT IN THE CASE OF PROGRAM  TRAN-
 SITIONS WITHIN THE MARKETPLACE.
   (D)  A  PERSON WHO HAS ENROLLED FOR COVERAGE PURSUANT TO THIS SECTION,
 AND WHO LOSES ELIGIBILITY TO ENROLL IN THE 1332 STATE INNOVATION PROGRAM
 FOR A REASON OTHER THAN CITIZENSHIP STATUS,  LACK  OF  STATE  RESIDENCE,
 FAILURE  TO PROVIDE A VALID SOCIAL SECURITY NUMBER, PROVIDING INACCURATE
 INFORMATION THAT WOULD AFFECT ELIGIBILITY WHEN  REQUESTING  OR  RENEWING
 HEALTH COVERAGE PURSUANT TO THIS SECTION, OR FAILURE TO MAKE AN APPLICA-
 BLE  PREMIUM  PAYMENT, BEFORE THE END OF A TWELVE MONTH PERIOD BEGINNING
 ON THE EFFECTIVE DATE OF THE PERSON'S INITIAL ELIGIBILITY FOR  COVERAGE,
 OR  BEFORE THE END OF A TWELVE MONTH PERIOD BEGINNING ON THE DATE OF ANY
 SUBSEQUENT DETERMINATION OF ELIGIBILITY, SHALL  HAVE  THEIR  ELIGIBILITY
 FOR  COVERAGE  CONTINUED  UNTIL  THE  END  OF  SUCH TWELVE MONTH PERIOD,
 PROVIDED THAT THE STATE RECEIVES FEDERAL APPROVAL FOR USING FUNDS  UNDER
 AN APPROVED 1332 WAIVER.
   5.  PREMIUMS.  SUBJECT TO FEDERAL APPROVAL, THE COMMISSIONER OF HEALTH
 SHALL ESTABLISH PREMIUM PAYMENTS ENROLLEES IN A  1332  STATE  INNOVATION
 PLAN  SHALL  PAY  TO  APPROVED ORGANIZATIONS FOR COVERAGE OF HEALTH CARE
 SERVICES PURSUANT TO THIS SECTION. SUCH PREMIUM PAYMENTS SHALL BE ESTAB-
 LISHED IN THE FOLLOWING MANNER:
   (A) UP TO FIFTEEN DOLLARS MONTHLY FOR AN INDIVIDUAL WITH  A  HOUSEHOLD
 INCOME  ABOVE  TWO HUNDRED PERCENT OF THE FEDERAL POVERTY LINE BUT AT OR
 BELOW TWO HUNDRED FIFTY PERCENT OF THE FEDERAL POVERTY LINE DEFINED  AND
 S. 4007                            108                           A. 3007
 
 ANNUALLY  REVISED  BY  THE  UNITED STATES DEPARTMENT OF HEALTH AND HUMAN
 SERVICES FOR A HOUSEHOLD OF THE SAME SIZE; AND
   (B)  NO PAYMENT IS REQUIRED FOR INDIVIDUALS WITH A 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.
   6. COST-SHARING. THE COMMISSIONER OF HEALTH SHALL ESTABLISH COST-SHAR-
 ING OBLIGATIONS FOR ENROLLEES, SUBJECT TO  FEDERAL  APPROVAL,  INCLUDING
 CHILDBIRTH  AND  NEWBORN  CARE  CONSISTENT  WITH  THE MEDICAL ASSISTANCE
 PROGRAM UNDER TITLE ELEVEN OF THIS ARTICLE. THERE SHALL BE NO COST-SHAR-
 ING OBLIGATIONS FOR ENROLLEES FOR:
   (A) DENTAL AND VISION SERVICES AS  DEFINED  IN  SUBPARAGRAPH  (II)  OF
 PARAGRAPH (C) OF SUBDIVISION TWO OF THIS SECTION; AND
   (B)  SERVICES  AND  SUPPORTS AS DEFINED IN SUBPARAGRAPH (III) OF PARA-
 GRAPH (C) OF SUBDIVISION TWO OF THIS SECTION.
   7. RATES OF PAYMENT. (A) THE COMMISSIONER OF HEALTH SHALL  SELECT  THE
 CONTRACT  WITH AN INDEPENDENT ACTUARY TO STUDY AND RECOMMEND APPROPRIATE
 REIMBURSEMENT METHODOLOGIES FOR THE COST OF HEALTH CARE SERVICE COVERAGE
 PURSUANT TO THIS SECTION. SUCH INDEPENDENT ACTUARY SHALL REVIEW AND MAKE
 RECOMMENDATIONS CONCERNING APPROPRIATE ACTUARIAL ASSUMPTIONS RELEVANT TO
 THE ESTABLISHMENT OF  REIMBURSEMENT  METHODOLOGIES,  INCLUDING  BUT  NOT
 LIMITED  TO;  THE  ADEQUACY OF RATES OF PAYMENT IN RELATION TO THE POPU-
 LATION TO BE SERVED ADJUSTED FOR CASE MIX,  THE  SCOPE  OF  HEALTH  CARE
 SERVICES  APPROVED  ORGANIZATIONS  MUST PROVIDE, THE UTILIZATION OF SUCH
 SERVICES AND THE NETWORK OF PROVIDERS REQUIRED TO MEET STATE STANDARDS.
   (B) UPON  CONSULTATION  WITH  THE  INDEPENDENT  ACTUARY  AND  ENTITIES
 REPRESENTING  APPROVED  ORGANIZATIONS,  THE COMMISSIONER OF HEALTH SHALL
 DEVELOP REIMBURSEMENT METHODOLOGIES AND FEE  SCHEDULES  FOR  DETERMINING
 RATES  OF  PAYMENT, WHICH RATES SHALL BE APPROVED BY THE DIRECTOR OF THE
 DIVISION OF THE BUDGET, TO BE MADE BY THE DEPARTMENT TO APPROVED  ORGAN-
 IZATIONS  FOR THE COST OF HEALTH CARE SERVICES COVERAGE PURSUANT TO THIS
 SECTION. SUCH REIMBURSEMENT METHODOLOGIES AND FEE SCHEDULES MAY  INCLUDE
 PROVISIONS FOR CAPITATION ARRANGEMENTS.
   (C)  THE COMMISSIONER OF HEALTH SHALL HAVE THE AUTHORITY TO PROMULGATE
 REGULATIONS, INCLUDING EMERGENCY REGULATIONS,  NECESSARY  TO  EFFECTUATE
 THE PROVISIONS OF THIS SUBDIVISION.
   (D)  THE  DEPARTMENT  OF  HEALTH SHALL REQUIRE THE INDEPENDENT ACTUARY
 SELECTED PURSUANT TO PARAGRAPH (A) OF  THIS  SUBDIVISION  TO  PROVIDE  A
 COMPLETE ACTUARIAL REPORT, ALONG WITH ALL ACTUARIAL ASSUMPTIONS MADE AND
 ALL  OTHER  DATA, MATERIALS AND METHODOLOGIES USED IN THE DEVELOPMENT OF
 RATES FOR THE 1332 STATE INNOVATION PLAN AUTHORIZED UNDER THIS  SECTION.
 SUCH REPORT SHALL BE PROVIDED ANNUALLY TO THE TEMPORARY PRESIDENT OF THE
 SENATE AND THE SPEAKER OF THE ASSEMBLY.
   8.  AN  INDIVIDUAL  WHO  IS LAWFULLY ADMITTED FOR PERMANENT RESIDENCE,
 PERMANENTLY RESIDING IN THE UNITED STATES UNDER COLOR OF LAW, OR WHO  IS
 A  NON-CITIZEN  IN  A  VALID NONIMMIGRANT STATUS, AS DEFINED IN 8 U.S.C.
 1101(A)(15), AND WHO WOULD BE INELIGIBLE FOR  MEDICAL  ASSISTANCE  UNDER
 TITLE  ELEVEN  OF  THIS  ARTICLE  DUE TO THEIR IMMIGRATION STATUS IF THE
 PROVISIONS OF SECTION  ONE  HUNDRED  TWENTY-TWO  OF  THIS  CHAPTER  WERE
 APPLIED, SHALL BE CONSIDERED TO BE INELIGIBLE FOR MEDICAL ASSISTANCE FOR
 PURPOSES OF PARAGRAPHS (B) AND (C) OF SUBDIVISION THREE OF THIS SECTION.
   9.  REPORTING. THE COMMISSIONER OF HEALTH SHALL SUBMIT A REPORT TO THE
 TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY  ANNU-
 ALLY  BY  DECEMBER THIRTY-FIRST. THE REPORT SHALL INCLUDE, AT A MINIMUM,
 AN ANALYSIS OF THE 1332 STATE INNOVATION PROGRAM AND ITS IMPACT  ON  THE
 FINANCIAL INTEREST OF THE STATE; ITS IMPACT ON THE MARKETPLACE INCLUDING
 S. 4007                            109                           A. 3007
 
 ENROLLMENT  AND PREMIUMS; ITS IMPACT ON THE NUMBER OF UNINSURED INDIVID-
 UALS IN THE STATE; ITS IMPACT ON THE MEDICAID GLOBAL CAP; AND THE  DEMO-
 GRAPHICS  OF  THE  1332 STATE INNOVATION PROGRAM ENROLLEES INCLUDING AGE
 AND IMMIGRATION STATUS.
   10. SEVERABILITY. IF THE SECRETARY OF HEALTH AND HUMAN SERVICES OR THE
 SECRETARY  OF  THE TREASURY DO NOT APPROVE ANY PROVISION OF THE APPLICA-
 TION FOR A STATE INNOVATION WAIVER, SUCH DECISION SHALL IN NO WAY AFFECT
 OR IMPAIR ANY OTHER PROVISIONS THAT THE SECRETARIES  MAY  APPROVE  UNDER
 THIS SECTION.
   §  4. The state finance law is amended by adding a new section 98-d to
 read as follows:
   § 98-D. 1332 STATE INNOVATION PROGRAM FUND. 1. THERE IS HEREBY  ESTAB-
 LISHED IN THE JOINT CUSTODY OF THE STATE COMPTROLLER AND THE COMMISSION-
 ER OF TAXATION AND FINANCE A SPECIAL FUND TO BE KNOWN AS THE "1332 STATE
 INNOVATION PROGRAM FUND".
   2.  SUCH  FUND SHALL BE KEPT SEPARATE AND SHALL NOT BE COMMINGLED WITH
 ANY OTHER FUNDS IN THE CUSTODY OF THE STATE COMPTROLLER AND THE  COMMIS-
 SIONER OF TAXATION AND FINANCE.
   3.  SUCH  FUND  SHALL  CONSIST  OF MONEYS TRANSFERRED FROM THE FEDERAL
 GOVERNMENT PURSUANT TO 42 U.S.C. 18052 AND AN APPROVED 1332 STATE  INNO-
 VATION PROGRAM WAIVER APPLICATION FOR THE PURPOSE IMPLEMENTING THE STATE
 PLAN  UNDER  THE  1332 STATE INNOVATION PROGRAM, ESTABLISHED PURSUANT TO
 SECTION THREE HUNDRED SIXTY-NINE-II OF THE SOCIAL SERVICES LAW.
   4. UPON FEDERAL APPROVAL, ALL MONEYS IN SUCH FUND  SHALL  BE  USED  TO
 IMPLEMENT  AND  OPERATE  THE  1332 STATE INNOVATION PROGRAM, PURSUANT TO
 SECTION THREE HUNDRED SIXTY-NINE-II OF THE SOCIAL SERVICES  LAW,  EXCEPT
 TO THE EXTENT THAT THE PROVISIONS OF SUCH SECTION CONFLICT OR ARE INCON-
 SISTENT  WITH  FEDERAL LAW, IN WHICH CASE THE PROVISIONS OF SUCH FEDERAL
 LAW SHALL SUPERSEDE SUCH STATE LAW PROVISIONS.
   § 5. 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.
   §  6.  This  act  shall take effect immediately and shall be deemed to
 have been in full force  and  effect  on  and  after  January  1,  2023;
 provided  that  section  three  of this act shall be contingent upon the
 commissioner of health obtaining and maintaining all necessary approvals
 from the secretary of health and human services and the secretary of the
 treasury based on an application  for  a  waiver  for  state  innovation
 pursuant  to  section 1332 of the patient protection and affordable care
 act (P.L.  111-148) and subdivision 25 of section 268-c  of  the  public
 health  law.  The department of health shall notify the legislative bill
 drafting commission upon  the  occurrence  of  approval  of  the  waiver
 program in order that the commission may maintain an accurate and timely
 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 I
 S. 4007                            110                           A. 3007
 
   Section 1. Subdivision (i) of section 111 of part H of chapter  59  of
 the laws of 2011, amending the public health law and other laws relating
 to  known and projected department of health state fund medical expendi-
 tures, as amended by section 8 of part E of chapter 57 of  the  laws  of
 2019, is amended to read as follows:
   (i)  the amendments to paragraph (b) and subparagraph (i) of paragraph
 (g) of subdivision 7 of section 4403-f of the public health law made  by
 section  forty-one-b  of  this act shall expire and be repealed April 1,
 [2023] 2027;
   § 2. 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-A OF  THIS  SECTION.  Such
 eligible  applicant  shall  submit  information and documentation to the
 commissioner which shall include, but not be limited to:
   § 3. Paragraph (a) of subdivision 6 of section 4403-f  of  the  public
 health law, as amended by section 4 of part MM of chapter 56 of the laws
 of 2020, is amended to read as follows:
   (a)  An  applicant  shall  be  issued  a certificate of authority as a
 managed long term care plan upon a  determination  by  the  commissioner
 that  the  applicant  complies  with  the  operating  requirements for a
 managed long term care plan under this section. The  commissioner  shall
 issue  no  more  than  seventy-five certificates of authority to managed
 long term care plans pursuant to this section.
   (A-1) 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.  A MANAGED LONG TERM CARE PLAN  THAT  HAS  BEEN  ISSUED  A
 CERTIFICATE OF AUTHORITY, OR AN APPLICANT FOR A CERTIFICATE OF AUTHORITY
 AS A MANAGED LONG TERM CARE PLAN THAT HAS, IN THE SOLE DISCRETION OF THE
 COMMISSIONER,  IN  ANY OF THE THREE CALENDAR YEARS IMMEDIATELY PRECEDING
 THE APPLICATION, MET ANY OF THE FOLLOWING CRITERIA SHALL NOT BE ELIGIBLE
 FOR A CONTRACT FOR THE PROVISION OF SERVICES AVAILABLE UNDER TITLE ELEV-
 EN OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW: (I) CLASSIFIED AS A  POOR
 PERFORMER,  OR  SUBSTANTIALLY  SIMILAR  TERMINOLOGY,  BY THE CENTERS FOR
 MEDICARE AND MEDICAID SERVICES; (II) AN EXCESSIVE VOLUME  OF  PENALTIES,
 STATEMENTS OF FINDINGS, STATEMENTS OF DEFICIENCY, INTERMEDIATE SANCTIONS
 OR   ENFORCEMENT  ACTIONS,  REGARDLESS  OF  WHETHER  THE  APPLICANT  HAS
 ADDRESSED SUCH ISSUES IN A TIMELY MANNER; OR  (III)  OTHER  CRITERIA  AS
 DEEMED APPROPRIATE BY THE COMMISSIONER.
   §  4.  The  opening  paragraph of subparagraph (i) of paragraph (d) of
 subdivision 6 of section 4403-f of the public health law,  as  added  by
 section  5  of  part MM of chapter 56 of the laws of 2020, is amended to
 read as follows:
   Effective April first, two thousand twenty, and expiring  March  thir-
 ty-first, two thousand [twenty-two] TWENTY-SEVEN, the commissioner shall
 place  a moratorium on the processing and approval of applications seek-
 ing a certificate of authority as a managed long term care plan pursuant
 to this section, including applications seeking authorization 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:
 S. 4007                            111                           A. 3007
 
   §  5.  Section  4403-f of the public health law is amended by adding a
 new subdivision 6-a to read as follows:
   6-A.  PERFORMANCE  STANDARDS AND PROCUREMENT. (A) ON OR BEFORE OCTOBER
 FIRST, TWO THOUSAND TWENTY-FOUR, EACH MANAGED LONG TERM CARE  PLAN  THAT
 HAS  BEEN  ISSUED  A  CERTIFICATE  OF AUTHORITY PURSUANT TO THIS SECTION
 SHALL HAVE DEMONSTRATED EXPERIENCE OPERATING A MANAGED  LONG  TERM  CARE
 PLAN  THAT CONTINUOUSLY ENROLLED NO FEWER THAN TWENTY THOUSAND ENROLLEES
 AND/OR  DEMONSTRATED  EXPERIENCE  OPERATING  A  MEDICARE  DUAL  ELIGIBLE
 SPECIAL  NEEDS  PLAN,  OR  AN INTEGRATED MEDICAID PRODUCT OFFERED BY THE
 DEPARTMENT, THAT HAS CONTINUOUSLY ENROLLED NO FEWER THAN  FIVE  THOUSAND
 RESIDENTS  OF  THIS STATE IN THE IMMEDIATELY PRECEDING CALENDAR YEAR. IN
 ADDITION, A MANAGED LONG TERM CARE PLAN SHALL SUFFICIENTLY  DEMONSTRATE,
 IN  THE  SOLE  DISCRETION  OF THE COMMISSIONER, SUCCESS IN THE FOLLOWING
 PERFORMANCE CATEGORIES:
   (I) IN ADDITION TO MEETING THE REQUIREMENTS OF PARAGRAPH (J) OF SUBDI-
 VISION SEVEN OF THIS SECTION, COMMITMENT TO CONTRACTING WITH THE MINIMUM
 NUMBER OF LICENSED HOME CARE SERVICE AGENCIES NEEDED TO  PROVIDE  NECES-
 SARY PERSONAL CARE SERVICES TO THE GREATEST PRACTICABLE NUMBER OF ENROL-
 LEES,  AND  WITH  THE  MINIMUM NUMBER OF FISCAL INTERMEDIARIES NEEDED TO
 PROVIDE NECESSARY CONSUMER DIRECTED PERSONAL ASSISTANCE SERVICES TO  THE
 GREATEST  PRACTICABLE  NUMBER  OF  ENROLLEES  IN ACCORDANCE WITH SECTION
 THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL SERVICES LAW;
   (II) READINESS TO TIMELY IMPLEMENT AND ADHERE  TO  MAXIMUM  WAIT  TIME
 CRITERIA  FOR  KEY  CATEGORIES OF SERVICE IN ACCORDANCE WITH LAWS, RULES
 AND REGULATIONS OF THE DEPARTMENT OR THE CENTER FOR MEDICARE  AND  MEDI-
 CAID SERVICES;
   (III)  IMPLEMENTATION  OF  A COMMUNITY REINVESTMENT PLAN THAT HAS BEEN
 APPROVED BY THE DEPARTMENT AND COMMITS A PERCENTAGE OF THE MANAGED  LONG
 TERM  CARE  PLAN'S  SURPLUS TO HEALTH RELATED SOCIAL NEEDS AND ADVANCING
 HEALTH EQUITY IN THE MANAGED LONG TERM CARE PLAN'S SERVICE AREA;
   (IV) COMMITMENT TO QUALITY IMPROVEMENT;
   (V) 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;
   (VI) DEMONSTRATED CULTURAL AND LANGUAGE COMPETENCIES SPECIFIC  TO  THE
 POPULATION OF PARTICIPANTS;
   (VII) BREADTH OF SERVICE AREA ACROSS MULTIPLE REGIONS;
   (VIII)  ABILITY  TO  SERVE  ENROLLEES ACROSS THE CONTINUUM OF CARE, AS
 DEMONSTRATED BY THE TYPE AND NUMBER OF PRODUCTS THE  MANAGED  LONG  TERM
 CARE  OPERATES  OR HAS APPLIED TO OPERATE, INCLUDING INTEGRATED CARE FOR
 PARTICIPANTS WHO ARE DUALLY ELIGIBLE  FOR  MEDICAID  AND  MEDICARE,  AND
 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;
   (IX) VALUE BASED CARE READINESS AND EXPERIENCE; AND
   (X) SUCH OTHER CRITERIA AS DEEMED APPROPRIATE BY THE COMMISSIONER.
   (B) (I) NOTWITHSTANDING THE PROVISIONS OF PARAGRAPH (A) OF THIS SUBDI-
 VISION, IF NO SOONER THAN OCTOBER FIRST, TWO  THOUSAND  TWENTY-FOUR  THE
 COMMISSIONER  HAS DETERMINED, IN THEIR SOLE DISCRETION, THAT AN INSUFFI-
 CIENT NUMBER OF MANAGED LONG TERM CARE PLANS HAVE  MET  THE  PERFORMANCE
 STANDARDS  SET  FORTH IN PARAGRAPH (A) OF THIS SUBDIVISION, EACH MANAGED
 LONG TERM CARE PLAN THAT HAS BEEN ISSUED A CERTIFICATE OF  AUTHORITY  TO
 COVER A POPULATION OF ENROLLEES ELIGIBLE FOR SERVICES UNDER TITLE XIX OF
 THE  FEDERAL SOCIAL SECURITY ACT SHALL BE REQUIRED TO SUBMIT AN APPLICA-
 TION FOR CONTINUANCE OF ITS CERTIFICATION OF AUTHORITY TO OPERATE  AS  A
 MANAGED  LONG TERM CARE PLAN UNDER THIS SECTION, AND SHALL BE SUBJECT TO
 SELECTION THROUGH A COMPETITIVE BID PROCESS BASED ON PROPOSALS SUBMITTED
 S. 4007                            112                           A. 3007
 
 TO THE DEPARTMENT, WHICH COMPETITIVE BID PROCESS MAY  BE  LIMITED  TO  A
 GEOGRAPHIC  OR  OTHER  REASONABLE  BASIS  OF  NEED, AS DETERMINED BY THE
 COMMISSIONER. IN MAKING A DETERMINATION REGARDING THE NEED FOR A COMPET-
 ITIVE  BID  PROCESS, THE COMMISSIONER SHALL CONSIDER WHETHER ANY MANAGED
 LONG TERM CARE PLANS THAT HAVE NOT MET  THE  PERFORMANCE  STANDARDS  ARE
 ENGAGED  IN A MERGER, ACQUISITION, OR SIMILAR TRANSACTION WITH A MANAGED
 LONG TERM CARE PLAN THAT HAS MET THE PERFORMANCE STANDARDS, AS EVIDENCED
 THROUGH AN EXECUTED DEFINITIVE AGREEMENT BY SUCH MANAGED LONG TERM  CARE
 PLANS.
   (II)  IN  THE EVENT THE COMMISSIONER DETERMINES TO SELECT MANAGED LONG
 TERM CARE PLANS THROUGH A COMPETITIVE BID PROCESS, ANY PROPOSAL  SUBMIT-
 TED TO THE DEPARTMENT THROUGH THE COMPETITIVE BID PROCESS SHALL INCLUDE:
   (A) THE CRITERIA SET FORTH IN PARAGRAPH (A) OF THIS SUBDIVISION;
   (B)  THE  TYPE  AND NUMBER OF PRODUCTS THE BIDDER PROPOSES TO OPERATE,
 INCLUDING THOSE PROVIDING INTEGRATED CARE TO 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; AND
   (C) THE BIDDER'S COMMITMENT TO OFFERING PLANS IN MULTIPLE REGIONS,  AS
 SUCH  REGIONS ARE DEFINED BY THE DEPARTMENT, AND IN EVERY COUNTY OF EACH
 REGION FOR WHICH THEY ARE SUBMITTING A BID.
   (III) MANAGED LONG TERM CARE PLANS AWARDED UNDER THIS PARAGRAPH  SHALL
 BE ENTITLED TO ENTER INTO A CONTRACT WITH THE DEPARTMENT FOR THE PURPOSE
 OF  OFFERING  MANAGED  LONG  TERM CARE SERVICES TO ENROLLEES PURSUANT TO
 THIS SECTION.
   (IV) MANAGED LONG TERM CARE PLANS WHICH SUBMIT A BID THROUGH A COMPET-
 ITIVE BID PROCESS AND ARE NOT AWARDED UNDER THIS PARAGRAPH  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 MAINTAIN
 COVERAGE OF PARTICIPANTS FOR SUCH PERIOD OF TIME AS DETERMINED NECESSARY
 BY THE COMMISSIONER TO ACHIEVE THE SAFE AND ORDERLY TRANSFER OF  PARTIC-
 IPANTS. PARTICIPANTS WHO, AFTER NO LESS THAN SIXTY DAYS NOTICE, HAVE NOT
 SELECTED  ANOTHER PLAN WILL BE ASSIGNED TO A MANAGED LONG TERM CARE PLAN
 OR PLANS, AS DETERMINED BY THE COMMISSIONER.
   (C) 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, IN THE EVENT THE COMMISSIONER  DETERMINES
 TO  PROVIDE  FOR THE SELECTION OF QUALIFIED MANAGED LONG TERM CARE PLANS
 IN ACCORDANCE WITH PARAGRAPH (B) OF THIS SUBDIVISION THROUGH  A  COMPET-
 ITIVE BID PROCESS, SUCH PROCESS SHALL BE BASED ON PROPOSALS SUBMITTED TO
 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  PARAGRAPH  (B)
 OF THIS SUBDIVISION.
   (II) IN ADDITION TO THE CRITERIA DESCRIBED IN SUBPARAGRAPH (I) OF THIS
 PARAGRAPH, THE COMMISSIONER SHALL ALSO CONSIDER:
   (A)  THE CORPORATE ORGANIZATION AND STATUS OF THE BIDDER AS A CHARITA-
 BLE CORPORATION UNDER THE NOT-FOR-PROFIT CORPORATION LAW;
   (B) 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
 S. 4007                            113                           A. 3007

 TO  A  BIDDER  FOR  NON-COMPLIANCE  WITH  SUCH REQUIREMENTS, WHETHER THE
 BIDDER ADDRESSED SUCH ISSUES IN A TIMELY MANNER; AND
   (C) 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)  NO  SOONER  THAN  OCTOBER  FIRST,  TWO  THOUSAND TWENTY-FOUR 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.
   (V) (A) NO SOONER  THAN  APRIL  FIRST  TWO  THOUSAND  TWENTY-SIX,  THE
 COMMISSIONER  SHALL  MAKE  AWARDS UNDER THIS SUBDIVISION TO AT LEAST TWO
 MANAGED LONG TERM CARE PLANS IN EACH GEOGRAPHIC REGION  DEFINED  BY  THE
 COMMISSIONER 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.
   (B) 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, 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  DETER-
 MINED 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
 THE  EXPANSION  OR REDUCTION OF MEDICAL ASSISTANCE SERVICES AVAILABLE TO
 PARTICIPANTS THROUGH A MANAGED LONG TERM CARE PLAN.
   (C) 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
 S. 4007                            114                           A. 3007
 
 OR  FEDERAL  LAWS  AND  REGULATIONS  AND  ANY LOSS OF NECESSARY STATE OR
 FEDERAL FUNDING.
   (D)  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.
   (VI) (A) WITHIN SIXTY DAYS OF THE DEPARTMENT ISSUING THE  REQUEST  FOR
 PROPOSALS,  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.
   (B) A MANAGED LONG TERM CARE PLAN THAT: (1) FAILS TO SUBMIT ITS INTENT
 TIMELY,  (2)  INDICATES WITHIN THE SIXTY DAYS ITS INTENT NOT TO COMPLETE
 SUCH A PROPOSAL, OR (3) FAILS TO SUBMIT A PROPOSAL  WITHIN  THE  FURTHER
 TIMEFRAME  SPECIFIED  BY  THE COMMISSIONER IN THE REQUEST FOR PROPOSALS,
 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-
 SARY BY THE COMMISSIONER TO ACHIEVE THE SAFE  AND  ORDERLY  TRANSFER  OF
 ENROLLEES.
   (VII)  IF NECESSARY TO ENSURE ACCESS TO A 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  (B)  OF  THIS  SUBDIVISION,
 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  SHALL  BE SUBJECT TO THE REQUIREMENTS OF THIS SECTION, INCLUDING
 THE MINIMUM AND MAXIMUM NUMBER OF AWARDS IN A REGION.
   (D) IN THE EVENT THE COMMISSIONER, IN THEIR  SOLE  DISCRETION  AT  ANY
 TIME ON OR AFTER OCTOBER FIRST, TWO THOUSAND TWENTY-FOUR, DETERMINES NOT
 TO  SELECT  MANAGED LONG TERM CARE PLANS THROUGH A COMPETITIVE BID PROC-
 ESS, THE COMMISSIONER SHALL REQUIRE A MANAGED LONG TERM CARE  PLAN  THAT
 HAS NOT MET THE PERFORMANCE STANDARDS SET FORTH IN PARAGRAPH (A) OF THIS
 SUBDIVISION  TO  ESTABLISH  AND IMPLEMENT A PERFORMANCE IMPROVEMENT PLAN
 ACCEPTABLE TO THE COMMISSIONER. THE DETERMINATION NOT TO SELECT  MANAGED
 LONG  TERM CARE PLANS THROUGH A COMPETITIVE BID PROCESS AND TO REQUIRE A
 PERFORMANCE IMPROVEMENT PLAN SHALL NOT PRECLUDE  THE  COMMISSIONER  FROM
 MAKING  A  LATER  DETERMINATION  TO  SELECT MANAGED LONG TERM CARE PLANS
 THROUGH A COMPETITIVE BID PROCESS. IN MAKING THE  DETERMINATION  WHETHER
 TO  SELECT  THROUGH  A  COMPETITIVE  BID PROCESS, THE COMMISSIONER SHALL
 CONSIDER THE STANDARDS SET FORTH IN PARAGRAPH (A) OF THIS SUBDIVISION.
   (E) THE COMMISSIONER SHALL HAVE  THE  AUTHORITY  TO  PROMULGATE  REGU-
 LATIONS,  INCLUDING  EMERGENCY REGULATIONS, TO EFFECTUATE THE PROVISIONS
 OF THIS SUBDIVISION.
   (F) THE COMMISSIONER SHALL HAVE THE AUTHORITY TO  ADD  OR  MODIFY  ALL
 CRITERIA IN THIS SUBDIVISION.
   §  6.  Subparagraph  (i)  of paragraph (g) of subdivision 7 of section
 4403-f of the public health law, as amended by section 1 of part GGG  of
 chapter 59 of the laws of 2017, is amended to read as follows:
 S. 4007                            115                           A. 3007
 
   (i)  Managed long term care plans and demonstrations may enroll eligi-
 ble persons in the plan  or  demonstration  upon  the  completion  of  a
 comprehensive  assessment  that shall include, but not be limited to, an
 evaluation of the medical, social, cognitive, and environmental needs of
 each  prospective  enrollee  in such program. This assessment shall also
 serve as the basis for the development and provision of  an  appropriate
 plan  of  care  for  the enrollee, INCLUDING APPROPRIATE COMMUNITY-BASED
 REFERRALS. Upon approval of federal waivers pursuant to paragraph (b) of
 this subdivision which require medical assistance recipients who require
 community-based long term care services to enroll in a  plan,  and  upon
 approval  of  the  commissioner,  a  plan may enroll an applicant who is
 currently receiving home and community-based services and  complete  the
 comprehensive  assessment within thirty days of enrollment provided that
 the plan continues to cover transitional care until  such  time  as  the
 assessment is completed.
   §  6-a.  Subparagraph (i) of paragraph (g) of subdivision 7 of section
 4403-f of the public health law, as added by section 65-c of part  A  of
 chapter 57 of the laws of 2006 and relettered by section 20 of part C of
 chapter 58 of the laws of 2007, is amended to read as follows:
   (i)  Managed long term care plans and demonstrations may enroll eligi-
 ble persons in the plan  or  demonstration  upon  the  completion  of  a
 comprehensive  assessment  that shall include, but not be limited to, an
 evaluation of the  medical,  social  and  environmental  needs  of  each
 prospective  enrollee  in such program. This assessment shall also serve
 as the basis for the development and provision of an appropriate plan of
 care for the prospective enrollee, INCLUDING APPROPRIATE COMMUNITY-BASED
 REFERRALS.
   § 7. Subparagraphs (i) and (ii) of paragraph (a) of subdivision 4-a of
 section 365-f of the social services law, as amended  by  section  3  of
 part  G  of  chapter  57  of  the laws of 2019, the opening paragraph of
 subparagraph (i) as amended by section 2 of part PP of chapter 57 of the
 laws of 2022, are amended to read as follows:
   (i) "Fiscal intermediary" means an entity that provides fiscal  inter-
 mediary  services  and  has  a contract for providing such services with
 [the department of health and is selected through the procurement  proc-
 ess described in paragraphs (b), (b-1), (b-2) and (b-3) of this subdivi-
 sion. Eligible applicants for contracts shall be entities that are capa-
 ble  of appropriately providing fiscal intermediary services, performing
 the responsibilities of a fiscal intermediary, and complying  with  this
 section, including but not limited to entities that]:
   (A)  [are  a  service  center for independent living under section one
 thousand one hundred twenty-one  of  the  education  law;  or]  A  LOCAL
 DEPARTMENT OF SOCIAL SERVICES;
   (B)  [have  been established as fiscal intermediaries prior to January
 first, two thousand twelve and have  been  continuously  providing  such
 services  for  eligible individuals under this section.] AN ORGANIZATION
 LICENSED UNDER ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW; OR
   (C) AN ACCOUNTABLE CARE ORGANIZATION CERTIFIED UNDER  ARTICLE  TWENTY-
 NINE-E  OF  THE  PUBLIC  HEALTH  LAW  OR  AN  INTEGRATED DELIVERY SYSTEM
 COMPOSED PRIMARILY OF HEALTH CARE PROVIDERS RECOGNIZED BY THE DEPARTMENT
 AS A PERFORMING PROVIDER SYSTEM UNDER THE DELIVERY SYSTEM REFORM  INCEN-
 TIVE PAYMENT PROGRAM.
   (ii)   Fiscal   intermediary  services  shall  include  the  following
 services, performed on behalf of the consumer to facilitate his  or  her
 role as the employer:
 S. 4007                            116                           A. 3007
 
   (A) wage and benefit processing for consumer directed personal assist-
 ants;
   (B) processing all income tax and other required wage withholdings;
   (C)  complying with workers' compensation, disability and unemployment
 requirements;
   (D) maintaining personnel records for each consumer directed  personal
 assistant,  including  time  records  and other documentation needed for
 wages and benefit processing and a copy  of  the  medical  documentation
 required pursuant to regulations established by the commissioner;
   (E) ensuring that the health status of each consumer directed personal
 assistant  is assessed prior to service delivery pursuant to regulations
 issued by the commissioner;
   (F) maintaining records of service authorizations or reauthorizations;
   (G) monitoring the consumer's or, if applicable, the designated repre-
 sentative's continuing ability to fulfill  the  consumer's  responsibil-
 ities under the program and promptly notifying the authorizing entity of
 any  circumstance  that may affect the consumer's or, if applicable, the
 designated representative's ability to fulfill such responsibilities;
   (H) complying with regulations established by the commissioner  speci-
 fying  the  responsibilities of fiscal intermediaries providing services
 under this title; AND
   (I) entering into a department approved  memorandum  of  understanding
 with  the  consumer  that  describes the parties' responsibilities under
 this program[; and
   (J) other related responsibilities which may include, as determined by
 the commissioner, assisting consumers to perform the consumers'  respon-
 sibilities  under  this  section  and department regulations in a manner
 that does not infringe upon the consumer's responsibilities and self-di-
 rection].
   § 8. Paragraph (b) of subdivision 4-a of section 365-f of  the  social
 services  law,  as  amended  by section 4 of part G of chapter 57 of the
 laws of 2019, subparagraph (vi) as amended by section 1 of  part  LL  of
 chapter 57 of the laws of 2021, is amended to read as follows:
   (b) [Notwithstanding any inconsistent provision of section one hundred
 sixty-three  of  the state finance law, or section one hundred forty-two
 of the economic  development  law  the  commissioner  shall  enter  into
 contracts  under  this subdivision with eligible contractors that submit
 an offer for a contract, provided, however, that:
   (i) the department shall post on its website:
   (A) a description of the proposed services to be provided pursuant  to
 contracts in accordance with this subdivision;
   (B)  that  the  selection  of  contractors  shall be based on criteria
 reasonably related to the contractors' ability to provide fiscal  inter-
 mediary  services including but not limited to: ability to appropriately
 serve individuals participating in the program, geographic  distribution
 that  would  ensure  access in rural and underserved areas, demonstrated
 cultural and language competencies specific to the population of consum-
 ers and those of the available  workforce,  ability  to  provide  timely
 consumer  assistance,  experience serving individuals with disabilities,
 the availability of consumer peer support, and  demonstrated  compliance
 with  all  applicable  federal and state laws and regulations, including
 but not limited to those relating to wages and labor;
   (C)  the  manner  by  which  prospective  contractors  may  seek  such
 selection, which may include submission by electronic means;
 S. 4007                            117                           A. 3007

   (ii)  all  reasonable  and  responsive  offers  that are received from
 prospective contractors in timely  fashion  shall  be  reviewed  by  the
 commissioner;
   (iii)  the  commissioner shall award such contracts to the contractors
 that best meet the criteria for selection and are best suited  to  serve
 the purposes of this section and the needs of consumers;
   (iv)  all entities providing fiscal intermediary services on or before
 April first, two thousand nineteen, shall submit an offer for a contract
 under this section within sixty days after  the  commissioner  publishes
 the  initial  offer  on the department's website. Such entities shall be
 deemed authorized to provide such services unless: (A) the entity  fails
 to  submit  an  offer for a contract under this section within the sixty
 days; or (B) the entity's offer for a contract  under  this  section  is
 denied;
   (v) all decisions made and approaches taken pursuant to this paragraph
 shall  be  documented  in a procurement record as defined in section one
 hundred sixty-three of the state finance law; and
   (vi) the commissioner is authorized to  either  reoffer  contracts  or
 utilize  the  previous  offer,  to  ensure  that  all provisions of this
 section are met.] AS OF JANUARY FIRST, TWO THOUSAND TWENTY-FOUR NO ENTI-
 TY SHALL PROVIDE, DIRECTLY  OR  THROUGH  CONTRACT,  FISCAL  INTERMEDIARY
 SERVICES WITHOUT AN AUTHORIZATION AS A FISCAL INTERMEDIARY ISSUED BY THE
 COMMISSIONER  IN  ACCORDANCE WITH THIS SUBDIVISION. THE COMMISSIONER MAY
 ISSUE  REGULATIONS,  INCLUDING  EMERGENCY  REGULATIONS,  CLARIFYING  THE
 AUTHORIZATION PROCESS, STANDARDS AND TIME FRAMES.
   §  9.  Paragraphs (b-1), (b-2) and (b-3) of subdivision 4-a of section
 365-f of the social services law are REPEALED.
   § 10. Subdivision 4-b of section 365-f of the social services law,  as
 amended  by  section  8  of part G of chapter 57 of the laws of 2019, is
 amended to read as follows:
   4-b. Actions involving the authorization of a fiscal intermediary.
   (a) [The department may terminate  a  fiscal  intermediary's  contract
 under  this section or suspend or limit the fiscal intermediary's rights
 and privileges under the contract upon thirty day's  written  notice  to
 the  fiscal  intermediary,  if  the  commissioner  finds that the fiscal
 intermediary has failed to comply with the provisions of this section or
 regulations promulgated hereunder. The written notice shall include:
   (i) A description of the conduct and the issues related  thereto  that
 have been identified as failure of compliance; and
   (ii)  the  time  frame  of the conduct that fails compliance] A FISCAL
 INTERMEDIARY'S AUTHORIZATION  MAY  BE  REVOKED,  SUSPENDED,  LIMITED  OR
 ANNULLED  UPON THIRTY DAYS WRITTEN NOTICE TO THE FISCAL INTERMEDIARY, IF
 THE COMMISSIONER FINDS THAT THE FISCAL INTERMEDIARY HAS FAILED TO COMPLY
 WITH THE PROVISIONS OF THIS SUBDIVISION OR REGULATIONS PROMULGATED HERE-
 UNDER.
   (b) Notwithstanding the foregoing, upon determining  that  the  public
 health  or safety would be imminently endangered by the continued opera-
 tion or actions of the fiscal intermediary, the commissioner may [termi-
 nate]  REVOKE,  SUSPEND,  LIMIT  OR  ANNUL  the  fiscal   intermediary's
 [contract or suspend or limit the fiscal intermediary's rights and priv-
 ileges  under  the  contract]  AUTHORIZATION  immediately  [upon written
 notice].
   (c) All orders or  determinations  under  this  subdivision  shall  be
 subject  to  review  as  provided  in article seventy-eight of the civil
 practice law and rules.
 S. 4007                            118                           A. 3007
 
   § 11. Paragraph (c) of subdivision 4-d of section 365-f of the  social
 services  law, as added by section 7 of part G of chapter 57 of the laws
 of 2019, is amended to read as follows:
   (c)  Where  a  fiscal  intermediary is suspending or ceasing operation
 pursuant to an order under subdivision four-b of this section,  [or  has
 failed  to submit an offer for a contract, or has been denied a contract
 under this section,] all the provisions of this subdivision shall  apply
 except  subparagraph (i) of paragraph (a) of this subdivision, notice of
 which to all parties shall be provided by the department as appropriate.
   § 12. Paragraph (d) of subdivision 4-d of section 365-f of the  social
 services law, as added by section 3 of part LL of chapter 57 of the laws
 of 2021 is REPEALED.
   §  13.    Part  I  of  chapter 57 of the laws of 2022, providing a one
 percent across the board payment increase to all qualifying fee-for-ser-
 vice Medicaid rates, is amended by adding two new sections 1-a  and  1-b
 to read as follows:
   §  1-A.  NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, FOR THE
 STATE FISCAL YEARS BEGINNING APRIL 1,  2023,  AND  THEREAFTER,  MEDICAID
 PAYMENTS  MADE  FOR  THE  OPERATING COMPONENT OF RESIDENTIAL HEALTH CARE
 FACILITIES SERVICES SHALL BE SUBJECT TO A UNIFORM RATE INCREASE OF  FIVE
 PERCENT IN ADDITION TO  THE  INCREASE  CONTAINED  IN  SUBDIVISION  1  OF
 SECTION  1  OF THIS PART, SUBJECT TO THE APPROVAL OF THE COMMISSIONER OF
 THE DEPARTMENT OF HEALTH AND THE  DIRECTOR  OF  THE  BUDGET.  SUCH  RATE
 INCREASE SHALL BE SUBJECT TO FEDERAL FINANCIAL PARTICIPATION.
   §  1-B.  NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, FOR THE
 STATE FISCAL YEARS BEGINNING APRIL 1,  2023,  AND  THEREAFTER,  MEDICAID
 PAYMENTS MADE FOR THE OPERATING COMPONENT OF ASSISTED LIVING PROGRAMS AS
 DEFINED  BY  PARAGRAPH  (A)  OF  SUBDIVISION ONE OF SECTION 461-L OF THE
 SOCIAL SERVICES LAW SHALL BE SUBJECT TO A UNIFORM RATE INCREASE OF  FIVE
 PERCENT  IN  ADDITION  TO  THE INCREASE CONTAINED IN SECTION ONE OF THIS
 PART, SUBJECT TO THE APPROVAL OF THE COMMISSIONER OF THE  DEPARTMENT  OF
 HEALTH  AND  THE  DIRECTOR  OF  THE  BUDGET. SUCH RATE INCREASE SHALL BE
 SUBJECT TO FEDERAL FINANCIAL PARTICIPATION.
   § 14. Paragraphs (d) and (i) of subdivision 1 and subdivisions  2,  4,
 5,  5-a, 6, 6-a, 7, 7-a, 9 and 10 of section 3614-c of the public health
 law, paragraphs (d) and (i) of subdivision 1 and subdivisions 2,  4,  5,
 6,  7,  9  and  10  as  amended and subdivisions 6-a and 7-a as added by
 section 1 and subdivision 5-a as added by section  1-a  of  part  OO  of
 chapter 56 of the laws of 2020, are amended to read as follows:
   (d)  "Home  care  aide"  means a home health aide, personal care aide,
 home  attendant,  [personal  assistant  performing   consumer   directed
 personal  assistance  services  pursuant to section three hundred sixty-
 five-f of the social services law,]  or  other  licensed  or  unlicensed
 person  whose  primary  responsibility includes the provision of in-home
 assistance with activities of daily living, instrumental  activities  of
 daily  living or health-related tasks; provided, however, that home care
 aide does not include any individual (i) working on a casual  basis,  or
 (ii) [(except for a person employed under the consumer directed personal
 assistance  program  under  section  three  hundred  sixty-five-f of the
 social services law)] who is  a  relative  through  blood,  marriage  or
 adoption  of: (1) the employer; or (2) the person for whom the worker is
 delivering services, under a program funded or administered by  federal,
 state or local government.
   [(i) "Fiscal intermediary" means a fiscal intermediary in the consumer
 directed  personal assistance program under section three hundred sixty-
 five-f of the social services law.]
 S. 4007                            119                           A. 3007

   2. Notwithstanding any inconsistent provision of law,  rule  or  regu-
 lation,  no  payments  by government agencies shall be made to certified
 home health agencies, long term home health care programs, managed  care
 plans,  [fiscal  intermediaries,] the nursing home transition and diver-
 sion  waiver program under section three hundred sixty-six of the social
 services law, or the traumatic brain injury waiver program under section
 twenty-seven hundred forty of this  chapter  for  any  episode  of  care
 furnished, in whole or in part, by any home care aide who is compensated
 at amounts less than the applicable minimum rate of home care aide total
 compensation established pursuant to this section.
   4.  The terms of this section shall apply equally to services provided
 by home care aides who work on episodes of care as direct  employees  of
 certified  home health agencies, long term home health care programs, or
 managed care plans, or as employees of licensed home care services agen-
 cies, limited licensed home care services agencies, [or fiscal  interme-
 diaries,] or under any other arrangement.
   5.  No payments by government agencies shall be made to certified home
 health agencies, licensed home care services agencies,  long  term  home
 health  care  programs,  managed care plans, [fiscal intermediaries] for
 any episode of care without the certified home health  agency,  licensed
 home  care  services  agency,  long  term  home  health care program, OR
 managed care plan [or the fiscal intermediary], having  delivered  prior
 written certification to the commissioner annually, at a time prescribed
 by the commissioner, on forms prepared by the department in consultation
 with  the  department  of  labor,  that all services provided under each
 episode of care during the period covered by the  certification  are  in
 full  compliance  with  the  terms  of  this section and any regulations
 promulgated pursuant to this section and that no portion of the  dollars
 spent  or  to be spent to satisfy the wage or benefit portion under this
 section shall be returned to the certified home health agency,  licensed
 home  care  services  agency,  long  term  home  health care program, OR
 managed care plan, [or fiscal intermediary,] related  persons  or  enti-
 ties,  other than to a home care aide as defined in this section to whom
 the wage or benefits are due, as a refund, dividend, profit, or  in  any
 other  manner.    Such  written certification shall also verify that the
 certified home health agency, long term home  health  care  program,  or
 managed  care  plan  has  received  from the licensed home care services
 agency, [fiscal intermediary,] or other third party an annual  statement
 of  wage  parity hours and expenses on a form provided by the department
 of labor accompanied by  an  independently-audited  financial  statement
 verifying such expenses.
   5-a.  No  portion  of  the dollars spent or to be spent to satisfy the
 wage or benefit portion under this section  shall  be  returned  to  the
 certified  home  health agency, licensed home care services agency, long
 term home health care program, OR managed care plan, [or fiscal interme-
 diary,] related persons or entities, other than to a home care  aide  as
 defined  in  this  section  to  whom  the wage or benefits are due, as a
 refund, dividend, profit, or in any other manner.
   6. If a certified home health  agency,  long  term  home  health  care
 program  or  managed care plan elects to provide home care aide services
 through contracts with licensed home  care  services  agencies,  [fiscal
 intermediaries,]  or  through  other  third  parties,  provided that the
 episode of care on which the home care aide works is covered  under  the
 terms  of this section, the certified home health agency, long term home
 health  care  program,  or  managed  care  plan  shall  include  in  its
 contracts,  a  requirement  that  it  be provided with a written certif-
 S. 4007                            120                           A. 3007
 
 ication, verified by oath, from the licensed home care services  agency,
 [fiscal  intermediary,]  or  other third party, on forms prepared by the
 department in consultation with the department of labor,  which  attests
 to the licensed home care services agency's, [fiscal intermediary's,] or
 other  third  party's  compliance  with  the terms of this section. Such
 contracts shall also obligate the licensed home  care  services  agency,
 [fiscal  intermediary,]  or  other  third party to provide the certified
 home health agency, long term home health care program, or managed  care
 plan  all  information  from  the  licensed  home  care services agency,
 [fiscal intermediary] or other third party necessary to  verify  compli-
 ance  with  the  terms  of  this  section, which shall include an annual
 compliance statement of  wage  parity  hours  and  expenses  on  a  form
 provided  by the department of labor accompanied by an independently-au-
 dited financial statement verifying such expenses.  Such  annual  state-
 ments shall be available no less than annually for the previous calendar
 year, at a time as prescribed by the commissioner.  Such certifications,
 the  information  necessary to verify compliance, and the annual compli-
 ance statement and financial statements shall be retained by all  certi-
 fied  home  health  agencies,  long  term  home health care programs, or
 managed care plans,  and  all  licensed  home  care  services  agencies,
 [fiscal  intermediaries,] or other third parties for a period of no less
 than ten years, and made available to the department upon  request.  Any
 licensed  home  care  services  agency,  [fiscal intermediary,] or other
 third party who shall upon oath verify  any  statement  required  to  be
 transmitted  under this section and any regulations promulgated pursuant
 to this section which is known by such party to be false shall be guilty
 of perjury and punishable as provided by the penal law.
   6-a. The certified home health agency,  long  term  home  health  care
 program, or managed care plan shall review and assess the annual compli-
 ance  statement  of  wage  parity  hours and expenses and make a written
 referral to the department of labor for any reasonably  suspected  fail-
 ures  of  licensed home care services agencies, [fiscal intermediaries,]
 or third parties to conform to the  wage  parity  requirements  of  this
 section.
   7.  The  commissioner  shall  distribute  to all certified home health
 agencies, long term home health care programs, managed care  plans,  AND
 licensed  home care services agencies[, and fiscal intermediaries] offi-
 cial notice of the minimum rates of home care aide compensation at least
 one hundred twenty days prior to the effective date of each minimum rate
 for each social services district covered by the terms of this section.
   7-a. Any certified home health agency,  licensed  home  care  services
 agency,  long  term  home  health  care  program, managed care plan, [or
 fiscal intermediary,] or other third party that willfully pays less than
 such stipulated minimums regarding wages and supplements, as established
 in this section, shall be guilty of a misdemeanor  and  upon  conviction
 shall be punished, for a first offense by a fine of five hundred dollars
 or  by  imprisonment  for not more than thirty days, or by both fine and
 imprisonment; for a second offense by a fine of  one  thousand  dollars,
 and in addition thereto the contract on which the violation has occurred
 shall  be forfeited; and no such person or corporation shall be entitled
 to receive any sum nor shall any officer, agent or employee of the state
 pay the same or authorize its payment from the funds under  his  or  her
 charge  or  control  to any person or corporation for work done upon any
 contract, on which the certified home health agency, licensed home  care
 services  agency, long term home health care program, managed care plan,
 S. 4007                            121                           A. 3007
 
 [or fiscal intermediary,] or other third party has been convicted  of  a
 second offense in violation of the provisions of this section.
   9.  Nothing  in  this section should be construed as applicable to any
 service provided by certified home health agencies, licensed  home  care
 services  agencies, long term home health care programs, or managed care
 plans[, or fiscal intermediaries] except for all episodes of care  reim-
 bursed in whole or in part by the New York Medicaid program.
   10.  No  certified home health agency, managed care plan, or long term
 home health care program shall be liable for recoupment of  payments  or
 any  other  penalty  under  this section for services provided through a
 licensed home care services  agency,  [fiscal  intermediary,]  or  other
 third  party with which the certified home health agency, long term home
 health care program, or managed care plan has  a  contract  because  the
 licensed  agency,  [fiscal intermediary,] or other third party failed to
 comply with the provisions of this section if the certified home  health
 agency,  long  term  home  health care program, or managed care plan has
 reasonably and in good faith collected certifications and  all  informa-
 tion  required  pursuant to this section and conducts the monitoring and
 reporting required by this section.
   § 15. Subdivision 1 of section 3614-f of the  public  health  law,  as
 added  by  section  1  of  part XX of chapter 56 of the laws of 2022, is
 amended to read as follows:
   1. For the purpose of this section, "home care aide" shall  [have  the
 same meaning as defined in section thirty-six hundred fourteen-c of this
 article]  MEAN  A  HOME HEALTH AIDE, PERSONAL CARE AIDE, HOME ATTENDANT,
 PERSONAL ASSISTANT  PERFORMING  CONSUMER  DIRECTED  PERSONAL  ASSISTANCE
 SERVICES  PURSUANT  TO  SECTION THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL
 SERVICES LAW, OR OTHER  LICENSED  OR  UNLICENSED  PERSON  WHOSE  PRIMARY
 RESPONSIBILITY INCLUDES THE PROVISIONS OF IN-HOME ASSISTANCE WITH ACTIV-
 ITIES  OF  DAILY  LIVING,  INSTRUMENTAL  ACTIVITIES  OF  DAILY LIVING OR
 HEALTH-RELATED TASKS; PROVIDED, HOWEVER, THAT HOME CARE  AIDE  DOES  NOT
 INCLUDE  ANY  INDIVIDUAL  (I) WORKING ON A CASUAL BASIS, OR (II) (EXPECT
 FOR A PERSON EMPLOYED UNDER THE CONSUMER  DIRECTED  PERSONAL  ASSISTANCE
 PROGRAM  UNDER SECTION THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL SERVICES
 LAW) WHO IS A RELATIVE THROUGH BLOOD, MARRIAGE OR ADOPTION OF:  (1)  THE
 EMPLOYER;  OR  (2)  THE  PERSON  WHOM THE WORKER IS DELIVERING SERVICES,
 UNDER A PROGRAM FUNDED  OR  ADMINISTERED  BY  FEDERAL,  STATE  OR  LOCAL
 GOVERNMENT.
   §  16. The public health law is amended by adding a new section 3614-g
 to read as follows:
   § 3614-G. STATE SUPPLEMENTAL PREMIUM ASSISTANCE FOR CONSUMER  DIRECTED
 PERSONAL ASSISTANTS.
   1.  STATE  SUPPLEMENTAL ASSISTANCE FOR THE PAYMENT OF QUALIFIED HEALTH
 PLAN PREMIUMS SHALL BE AVAILABLE  TO  A  PERSONAL  ASSISTANT  PERFORMING
 CONSUMER DIRECTED PERSONAL ASSISTANCE SERVICES PURSUANT TO SECTION THREE
 HUNDRED  SIXTY-FIVE-F  OF  THE  SOCIAL  SERVICES LAW, PROVIDED THAT SUCH
 PERSONAL ASSISTANT:
   (A) ATTESTS ON THE NY STATE OF  HEALTH  MARKETPLACE  APPLICATION  THAT
 THEY  ARE  PROVIDING  SUCH  SERVICES  ON  A FULL-TIME BASIS OR PART-TIME
 BASIS, AS DEFINED IN APPLICABLE REGULATION,
   (B) IS ELIGIBLE FOR FEDERAL PREMIUM TAX CREDITS  PURSUANT  TO  SECTION
 36B(B)(3)(A) OF THE INTERNAL REVENUE CODE,
   (C)  IS   NOT   OTHERWISE   ELIGIBLE  FOR COMPREHENSIVE COVERAGE UNDER
 TITLE 11 OR 11-D  OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW; AND
 S. 4007                            122                           A. 3007
 
   (D) IS ENROLLED IN A  QUALIFIED  HEALTH  PLAN  DEFINED  IN  42  U.S.C.
 18021(A),  CERTIFIED  BY  THE NY STATE OF HEALTH MARKETPLACE, WHICH DOES
 NOT INCLUDE A CATASTROPHIC PLAN DESCRIBED IN 42 U.S.C. 18022(E).
   2. THE AMOUNT OF THE SUPPLEMENTAL PREMIUM ASSISTANCE SHALL BE EQUAL TO
 AT LEAST THE CONTRIBUTION FOR THE BENCHMARK SILVER QUALIFIED HEALTH PLAN
 AVAILABLE  IN  SUCH  PERSONAL ASSISTANT'S COUNTY OF RESIDENCE, AND SHALL
 ACCOUNT FOR THE FULL-TIME OR PART-TIME STATUS OF THE PERSONAL ASSISTANT.
 PERSONAL ASSISTANTS WORKING PART-TIME SHALL BE ELIGIBLE FOR A MINIMUM OF
 ONE-HALF OF THE STATE SUPPLEMENTAL PREMIUM CREDIT AVAILABLE FOR PERSONAL
 ASSISTANTS WORKING FULL-TIME. SUCH CREDIT SHALL BE PAID DIRECTLY TO  THE
 QUALIFIED  HEALTH  PLAN  ISSUER. ANY SUBSIDIES PROVIDED PURSUANT TO THIS
 SECTION SHALL BE IN ACCORDANCE WITH A SCHEDULE OR METHODOLOGY  PUBLISHED
 BY  THE  COMMISSIONER, WHICH MAY BE BASED ON A SLIDING SCALE IN RELATION
 TO THE HOUSEHOLD INCOME OF THE PERSONAL ASSISTANT, OR SUCH OTHER METHOD-
 OLOGY AS THE COMMISSIONER DEEMS APPROPRIATE.
   3. APPLICANTS FOR COVERAGE THROUGH THE NY STATE  MARKETPLACE  WHO  ARE
 NEWLY  ELIGIBLE  FOR  SUPPLEMENTAL  PREMIUM  ASSISTANCE PURSUANT TO THIS
 SECTION SHALL BE ELIGIBLE FOR A SPECIAL ENROLLMENT PERIOD THROUGH THE NY
 STATE OF HEALTH MARKETPLACE.
   4. THE COMMISSIONER SHALL SUBMIT SUCH APPLICATIONS TO THE SECRETARY OF
 THE DEPARTMENT OF HEALTH AND HUMAN SERVICES OR TREASURY AS MAY BE NECES-
 SARY TO RECEIVE FEDERAL FINANCIAL PARTICIPATION IN THE COSTS OF PAYMENTS
 MADE PURSUANT TO THIS SECTION; PROVIDED FURTHER, HOWEVER,  THAT  NOTHING
 IN  THIS  SECTION  SHALL  BE  DEEMED  TO AFFECT THE PAYMENT OF THE STATE
 SUPPLEMENTAL PREMIUM ASSISTANCE PURSUANT TO  APPLICABLE  LAW  AND  REGU-
 LATION  IF FEDERAL FINANCIAL PARTICIPATION IN THE COSTS OF SUCH PAYMENTS
 IS NOT AVAILABLE.
   5. FISCAL INTERMEDIARIES AND PERSONAL ASSISTANTS UNDER  SECTION  THREE
 HUNDRED  SIXTY-FIVE-F  OF  THE  SOCIAL SERVICES LAW SHALL BE REQUIRED TO
 PROVIDE SUCH INFORMATION AS IS  NECESSARY  FOR  THE  IMPLEMENTATION  AND
 OPERATION  OF  THIS  SECTION. THE DEPARTMENT SHALL SPECIFY THE FREQUENCY
 AND FORMAT OF SUCH REPORTING AND DETERMINE THE TYPE AND AMOUNT OF INFOR-
 MATION TO BE SUBMITTED, INCLUDING ANY SUPPORTING DOCUMENTATION.
   6. THE COMMISSIONER SHALL PROMULGATE ANY  RULES  AND  REGULATIONS  AND
 TAKE SUCH STEPS AS MAY BE NECESSARY FOR THE IMPLEMENTATION AND OPERATION
 OF THIS SECTION.
   §  17.  The  state  finance  law  is  amended  by adding a new section
 97-bbbbb to read as follows:
   § 97-BBBBB. CDPAP SUPPLEMENTAL PREMIUM  ASSISTANCE  FUND.    1.  CDPAP
 SUPPLEMENTAL PREMIUM ASSISTANCE FUND. THERE IS HEREBY ESTABLISHED IN THE
 JOINT  CUSTODY OF THE STATE COMPTROLLER AND THE COMMISSIONER OF TAXATION
 AND FINANCE A SPECIAL FUND TO BE KNOWN AS THE "CDPAP SUPPLEMENTAL PREMI-
 UM ASSISTANCE FUND".
   2. SUCH FUND SHALL BE KEPT SEPARATE AND SHALL NOT BE  COMMINGLED  WITH
 ANY  OTHER FUNDS IN THE CUSTODY OF THE STATE COMPTROLLER AND THE COMMIS-
 SIONER OF TAXATION AND FINANCE.
   3. SUCH FUND SHALL CONSIST OF MONEYS APPROPRIATED  FOR  STATE  SUPPLE-
 MENTAL  PREMIUM  ASSISTANCE  FOR  THE  PAYMENT  OF QUALIFIED HEALTH PLAN
 PREMIUM OF ELIGIBLE  ENROLLEES  PERFORMING  CONSUMER  DIRECTED  PERSONAL
 ASSISTANCE SERVICES, IN ACCORDANCE WITH SECTION THIRTY-SIX HUNDRED FOUR-
 TEEN-G OF THE SOCIAL SERVICES LAW, OR TRANSFERRED TO SUCH ACCOUNT PURSU-
 ANT TO APPLICABLE LAW.
   4.  THE  MONEYS,  WHEN ALLOCATED IN ACCORDANCE WITH SECTION THIRTY-SIX
 HUNDRED FOURTEEN-G OF THE SOCIAL SERVICES LAW, SHALL BE PAID OUT OF  THE
 FUND TO QUALIFIED HEALTH PLANS ON BEHALF OF ELIGIBLE ENROLLEES.
 S. 4007                            123                           A. 3007
 
   §  18. This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2023; provided,
 however, that:
   (a)  the amendments to section 4403-f of the public health law made by
 sections two through six-a of this act shall not affect  the  repeal  of
 such section and shall be deemed repealed therewith;
   (b) the amendments to subparagraph (i) of paragraph (g) of subdivision
 7 of section 4403-f of the public health law made by section six of this
 act  shall  be  subject to the expiration and reversion of such subpara-
 graph pursuant to subdivision (i) of section 111 of part H of chapter 59
 of the laws of 2011, as amended, when upon such date the  provisions  of
 section six-a of this act shall take effect;
   (c)  sections  fourteen, sixteen, and seventeen of this act shall take
 effect on and after the first of January next  succeeding  the  date  of
 enactment  of a state supplemental premium assistance program in accord-
 ance with sections sixteen and seventeen  of  this  act,  takes  effect;
 provided,  however,  such  sections  fourteen, sixteen, and seventeen of
 this act shall  take  effect  no  earlier  than  January  1,  2025;  and
 provided,  further, the commissioner of health shall notify the legisla-
 tive bill drafting commission upon the occurrence of  the  establishment
 of  such state supplemental premium assistance program 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
 effecting  the  provisions  of  section  44  of  the legislative law and
 section 70-b of the public officers law; and
   (d) effective immediately, the commissioner of health shall promulgate
 any rules and regulations and take such steps, including  requiring  the
 submission  of  reports  or  surveys  by fiscal intermediaries under the
 consumer directed personal assistance program, as may be  necessary  for
 the timely implementation of this act on or before such effective date.
 
                                  PART J
 
   Section  1.  Subsection (a) of section 3224-a of the insurance law, as
 amended by chapter 237 of the laws  of  2009,  is  amended  to  read  as
 follows:
   (a)  Except  in a case where the obligation of an insurer or an organ-
 ization or corporation licensed or certified pursuant to article  forty-
 three or forty-seven of this chapter or article forty-four of the public
 health  law to pay a claim submitted by a policyholder or person covered
 under such policy ("covered person") or make a payment to a health  care
 provider  is  not  reasonably clear, or when there is a reasonable basis
 supported by specific information available for  review  by  the  super-
 intendent  that such claim or bill for health care services rendered was
 submitted fraudulently, such  insurer  or  organization  or  corporation
 shall  pay  the  claim  to  a  policyholder  or covered person or make a
 payment to a health care provider within thirty days  of  receipt  of  a
 claim  or  bill  for  THE  services rendered that is transmitted via the
 internet or electronic mail[,] or forty-five days of receipt of a  claim
 or  bill for services rendered that is submitted by other means, such as
 paper or facsimile.
   (1) WHERE THE OBLIGATION OF AN INSURER OR AN  ORGANIZATION  OR  CORPO-
 RATION  LICENSED  OR CERTIFIED PURSUANT TO ARTICLE FORTY-THREE OR FORTY-
 SEVEN OF THIS CHAPTER OR ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW  TO
 PAY  SUCH  A  CLAIM  IS  CLEAR,  EXCEPT FOR THE DESIRE OF THE INSURER OR
 ORGANIZATION OR CORPORATION TO REVIEW CLINICAL DOCUMENTATION OR, TO  THE
 S. 4007                            124                           A. 3007
 
 EXTENT  AGREED  UPON  BY  A  HOSPITAL AND THE INSURER OR ORGANIZATION OR
 CORPORATION, ELECTRONIC MEDICAL RECORDS, TO CONFIRM THE MEDICAL NECESSI-
 TY OF EMERGENCY SERVICES OR INPATIENT SERVICES  FOLLOWING  AN  EMERGENCY
 DEPARTMENT    VISIT  PROVIDED  BY  A  HOSPITAL  THAT PARTICIPATES IN THE
 NETWORK OF THE INSURER OR ORGANIZATION OR  CORPORATION,  WHICH  INCLUDES
 WHETHER  THE  SERVICES PROVIDED WERE EMERGENCY SERVICES OR THAT THE SITE
 OF SERVICE OR LEVEL OF CARE BILLED  WAS  APPROPRIATE  FOR  THE  SERVICES
 PROVIDED, THE INSURER OR ORGANIZATION OR CORPORATION SHALL PAY THE CLAIM
 AT  THE CONTRACTED RATE FOR THE SERVICES AND SITE BILLED BY THE HOSPITAL
 WITHIN THE TIMEFRAMES SET FORTH IN THIS  SUBSECTION.    THE  INSURER  OR
 ORGANIZATION OR CORPORATION MAY, WITHIN THIRTY DAYS OF PAYING THE CLAIM,
 REQUEST  THAT  THE  HOSPITAL  SUBMIT  TO  THE INSURER OR ORGANIZATION OR
 CORPORATION ONLY THE CLINICAL DOCUMENTATION OR,  TO  THE  EXTENT  AGREED
 UPON  BY  THE  HOSPITAL  AND THE INSURER OR ORGANIZATION OR CORPORATION,
 ELECTRONIC MEDICAL RECORDS, NECESSARY TO CONFIRM THE  MEDICAL  NECESSITY
 OF  THE  EMERGENCY SERVICES OR INPATIENT SERVICES FOLLOWING AN EMERGENCY
 DEPARTMENT VISIT PROVIDED BY THE HOSPITAL, WHICH  INCLUDES  WHETHER  THE
 SERVICES  PROVIDED  BY  THE HOSPITAL WERE EMERGENCY SERVICES OR THAT THE
 SITE OF SERVICE OR LEVEL OF CARE BILLED WAS APPROPRIATE FOR THE SERVICES
 PROVIDED. THE HOSPITAL SHALL PROVIDE THE CLINICAL DOCUMENTATION  TO  THE
 INSURER  OR  ORGANIZATION  OR  CORPORATION WITHIN FORTY-FIVE DAYS OF ITS
 REQUEST.
   (2) UNLESS OTHERWISE AGREED UPON BY THE HOSPITAL AND  THE  INSURER  OR
 ORGANIZATION  OR  CORPORATION, AN INSURER OR ORGANIZATION OR CORPORATION
 MAY SUBMIT A CLAIM, WITHIN  NINETY  DAYS  OF  RECEIPT  OF  THE  CLINICAL
 DOCUMENTATION FROM THE HOSPITAL, TO A JOINT COMMITTEE COMPOSED OF CLINI-
 CIANS  FROM  THE INSURER OR ORGANIZATION OR CORPORATION AND THE HOSPITAL
 FOR A POST-PAYMENT AUDIT. IF THE  HOSPITAL  FAILS  TO  PROVIDE  CLINICAL
 DOCUMENTATION  TO  THE  INSURER  OR  ORGANIZATION  OR CORPORATION WITHIN
 FORTY-FIVE DAYS OF THE REQUEST, THE INSURER OR  ORGANIZATION  OR  CORPO-
 RATION  MAY  SUBMIT  THE  CLAIM TO THE JOINT COMMITTEE FOR REVIEW WITHIN
 NINETY DAYS AFTER THE END  OF  THE  FORTY-FIVE  DAY  PERIOD.  THE  JOINT
 COMMITTEE  SHALL MEET AT LEAST QUARTERLY TO REVIEW SUCH CLAIMS.  NOTHING
 HEREIN SHALL REQUIRE THE JOINT COMMITTEE TO BE REGISTERED AS A  UTILIZA-
 TION  REVIEW  AGENT UNDER ARTICLE FORTY-NINE OF THE PUBLIC HEALTH LAW OR
 FILE A UTILIZATION REVIEW REPORT UNDER ARTICLE FORTY-NINE OF THIS  CHAP-
 TER.
   (3) WITHIN NINETY DAYS OF THE JOINT COMMITTEE'S RECEIPT OF THE REQUEST
 TO  REVIEW THE CLAIM FROM AN INSURER OR ORGANIZATION OR CORPORATION, THE
 JOINT COMMITTEE SHALL REQUEST THE CLINICAL DOCUMENTATION FROM THE HOSPI-
 TAL, REVIEW THE CLAIM AND INFORMATION SUBMITTED BY THE PARTIES, AND MAKE
 A JOINT DETERMINATION AS  TO  THE  MEDICAL  NECESSITY  OF  THE  SERVICES
 PROVIDED, WHICH INCLUDES WHETHER THE SERVICES WERE EMERGENCY SERVICES OR
 THAT THE SITE OF SERVICE OR LEVEL OF CARE BILLED WAS APPROPRIATE FOR THE
 SERVICES;  PROVIDED, HOWEVER, THE INSURER OR ORGANIZATION OR CORPORATION
 AND HOSPITAL MAY AGREE TO MEET MORE FREQUENTLY THAN EVERY  NINETY  DAYS,
 SO  LONG  AS SUCH FREQUENCY DOES NOT REQUIRE THE JOINT COMMITTEE TO MEET
 MORE FREQUENTLY THAN EVERY THIRTY  DAYS.  FAILURE  BY  THE  HOSPITAL  TO
 PROVIDE  THE  CLINICAL DOCUMENTATION TO THE JOINT COMMITTEE WITHIN SIXTY
 DAYS OF REQUEST, OR AN ALTERNATIVE TIMEFRAME AS MAY BE  AGREED  UPON  BY
 ALL  PARTIES,  SHALL  RESULT  IN A FINAL DETERMINATION THAT THE SERVICES
 WERE NOT MEDICALLY NECESSARY BY THE JOINT COMMITTEE, WHICH SHALL NOT  BE
 SUBJECT  TO  REVIEW UNDER ARTICLE FORTY-NINE OF THIS CHAPTER AND ARTICLE
 FORTY-NINE OF THE PUBLIC HEALTH LAW.
   (A) IN THE EVENT A JOINT DETERMINATION CANNOT BE  AGREED  UPON  WITHIN
 THE NINETY-DAY PERIOD, THE HOSPITAL OR INSURER OR ORGANIZATION OR CORPO-
 S. 4007                            125                           A. 3007
 
 RATION  MAY REFER THE CLAIM TO A MUTUALLY AGREED UPON INDEPENDENT THIRD-
 PARTY REVIEW AGENT WITHIN FIVE BUSINESS DAYS FROM THE END OF  THE  NINE-
 TY-DAY PERIOD, FOR A DETERMINATION. THE DETERMINATION OF THE INDEPENDENT
 THIRD-PARTY REVIEW AGENT SHALL BE BINDING.
   (B)  THE HOSPITAL AND THE INSURER OR ORGANIZATION OR CORPORATION SHALL
 DESIGNATE ONE OR  MORE  MUTUALLY  AGREED  UPON  INDEPENDENT  THIRD-PARTY
 REVIEW  AGENTS  IN THE PARTICIPATING PROVIDER AGREEMENT. IF THE HOSPITAL
 AND THE INSURER OR ORGANIZATION  OR  CORPORATION  ARE  UNABLE  TO  REACH
 AGREEMENT  IN  THE PARTICIPATING PROVIDER AGREEMENT ON ONE OR MORE INDE-
 PENDENT THIRD-PARTY REVIEW AGENTS, THEN THE INSURER OR  ORGANIZATION  OR
 CORPORATION  MAY SELECT AN INDEPENDENT THIRD-PARTY REVIEW AGENT THAT HAS
 BEEN CERTIFIED  BY THE SUPERINTENDENT AS AN EXTERNAL APPEAL AGENT PURSU-
 ANT TO ARTICLE FORTY-NINE OF THIS CHAPTER OR AS AN  INDEPENDENT  DISPUTE
 RESOLUTION ENTITY PURSUANT TO ARTICLE SIX OF THE FINANCIAL SERVICES LAW.
 IF THE INDEPENDENT THIRD-PARTY REVIEW AGENT DETERMINES THAT THE SERVICES
 PROVIDED  WERE NOT MEDICALLY NECESSARY, IN WHOLE OR IN PART, THE INSURER
 OR CORPORATION OR ORGANIZATION MAY RECOUP, OFFSET, OR OTHERWISE  REQUIRE
 THE  HOSPITAL TO REFUND ANY OVERPAYMENT RESULTING FROM ITS DETERMINATION
 CONSISTENT WITH SUBSECTION (B) OF SECTION  THREE  THOUSAND  TWO  HUNDRED
 TWENTY-FOUR-B OF THIS ARTICLE WITHIN THIRTY DAYS.  THE INSURER OR ORGAN-
 IZATION  OR CORPORATION SHALL PROVIDE WRITTEN NOTIFICATION TO THE HOSPI-
 TAL OF SUCH RECOUP OR OFFSET, WHICH SHALL INCLUDE: (I) THE CLAIM NUMBER;
 (II) THE AMOUNT OF THE OVERPAYMENT; AND (III)  THE  DATE  OF  THE  JOINT
 COMMITTEE DETERMINATION.
   (C) DURING THE ENTIRETY OF THE REVIEW PROCESS, THE HOSPITAL SHALL PEND
 THE  IMPOSITION  OF  ANY COPAYMENT, COINSURANCE OR DEDUCTIBLE UNTIL SUCH
 TIME AS THERE IS A FINAL DETERMINATION AS TO  WHETHER  THE  SERVICES  IN
 QUESTION  WERE MEDICALLY NECESSARY. THE HOSPITAL MAY THEREAFTER BILL THE
 INSURED FOR THE AMOUNT OF THE COPAYMENT, COINSURANCE OR  DEDUCTIBLE  FOR
 SERVICES DETERMINED TO BE MEDICALLY NECESSARY AND SHALL HOLD THE INSURED
 HARMLESS  FOR  ANY  OTHER AMOUNTS, INCLUDING AMOUNTS FOR SERVICES DETER-
 MINED TO BE NOT MEDICALLY NECESSARY.
   (4) NOTHING IN THIS SUBSECTION SHALL IN ANY WAY BE DEEMED TO LIMIT THE
 ABILITY OF INSURERS OR ORGANIZATIONS OR CORPORATIONS  AND  HOSPITALS  TO
 AGREE TO ESTABLISH PARAMETERS FOR REFERRAL OR REVIEW OF MEDICAL RECORDS,
 INCLUDING  WHILE  THE  INSURED  IS  IN  THE HOSPITAL, OR FOR INSURERS OR
 ORGANIZATIONS OR CORPORATIONS TO REQUIRE PREAUTHORIZATION  FOR  SERVICES
 THAT ARE NOT EMERGENCY SERVICES.
   (5)  FOR  PURPOSES OF THIS SUBSECTION, "HOSPITAL" SHALL MEAN A GENERAL
 HOSPITAL AS DEFINED IN SECTION TWO THOUSAND EIGHT  HUNDRED  ONE  OF  THE
 PUBLIC HEALTH LAW.
   (6)  NOTHING IN THIS SUBSECTION SHALL PRECLUDE AN INSURER OR ORGANIZA-
 TION OR CORPORATION AND A HOSPITAL FROM AGREEING TO OTHER DISPUTE RESOL-
 UTION MECHANISMS, PROVIDED THAT THE PARTIES MAY NOT NEGOTIATE  AWAY  THE
 REQUIREMENT  THAT  THE  INSURER  OR  ORGANIZATION OR CORPORATION PAY THE
 CLAIM AS BILLED BY THE  HOSPITAL  PRIOR  TO  REVIEWING  SUCH  CLAIM  FOR
 MEDICAL  NECESSITY.  WHEN  A  HOSPITAL AND AN INSURER OR ORGANIZATION OR
 CORPORATION ARE PARTIES TO A PARTICIPATING PROVIDER AGREEMENT APPLICABLE
 TO THE INPATIENT HOSPITAL ADMISSION BEING REVIEWED BY THE JOINT  COMMIT-
 TEE, THE DEFINITION OF MEDICAL NECESSITY SET FORTH IN SUCH PARTICIPATING
 PROVIDER AGREEMENT SHALL APPLY FOR PURPOSES OF JOINT COMMITTEE AND INDE-
 PENDENT THIRD-PARTY REVIEW.
   § 2. Subsection (b) of section 3224-a of the insurance law, as amended
 by chapter 694 of the laws of 2021, is amended to read as follows:
   (b) In a case where the obligation of an insurer or an organization or
 corporation  licensed  or  certified  pursuant to article forty-three or
 S. 4007                            126                           A. 3007
 
 forty-seven of this chapter or article forty-four of the  public  health
 law  to  pay a claim or make a payment for health care services rendered
 is not reasonably clear due to a good faith dispute regarding the eligi-
 bility  of  a  person  for coverage, the liability of another insurer or
 corporation or organization for all or part of the claim, the amount  of
 the  claim,  the  benefits covered under a contract or agreement, or the
 manner in which services were accessed or provided, an insurer or organ-
 ization or corporation shall pay any undisputed portion of the claim  in
 accordance  with  this  subsection  and notify the policyholder, covered
 person or health care provider in writing, and through the  internet  or
 other electronic means for claims submitted in that manner, within thir-
 ty calendar days of the receipt of the claim:
   (1) whether the claim or bill has been denied or partially approved;
   (2) which claim or medical payment that it is not obligated to pay THE
 CLAIM, stating the specific reasons why it is not liable; and
   (3)  to request all additional information needed to determine liabil-
 ity to pay the claim or make the health care payment; and
   (4) of the specific type  of  plan  or  product  the  policyholder  or
 covered  person  is  enrolled  in; provided that nothing in this section
 shall authorize discrimination based on the source of payment.
   Upon receipt of the information requested in paragraph three  of  this
 subsection  or  an  appeal  of  a claim or bill for health care services
 denied pursuant to this subsection, an insurer or organization or corpo-
 ration licensed or certified pursuant to article forty-three  or  forty-
 seven  of  this  chapter  or article forty-four of the public health law
 shall comply with subsection (a) of this section; provided, that if  the
 insurer or organization or corporation licensed or certified pursuant to
 article forty-three or forty-seven of this chapter or article forty-four
 of  the  public health law determines that payment or additional payment
 is due on [the] A claim[,] AS A RESULT OF AN INTERNAL OR EXTERNAL APPEAL
 DETERMINATION MADE PURSUANT TO SECTION FOUR THOUSAND NINE  HUNDRED  FOUR
 OR TITLE TWO OF ARTICLE FORTY-NINE OF THIS CHAPTER OR SECTION FOUR THOU-
 SAND  NINE HUNDRED FOUR OR TITLE TWO OF ARTICLE FORTY-NINE OF THE PUBLIC
 HEALTH LAW, such payment shall be made to the  policyholder  or  covered
 person or health care provider within fifteen days of the determination.
 Any  denial  or  partial  approval  of claim or payment and the specific
 reasons for such denial or partial approval pursuant to this  subsection
 shall be prominently displayed on a written notice with at least twelve-
 point  type.  A  partial approval of claim or payment shall state at the
 top of such written notice  with  at  least  fourteen-point  type  bold:
 "NOTICE  OF  PARTIAL APPROVAL OF MEDICAL COVERAGE". A denial of claim or
 payment shall state at the top of such  written  notice  with  at  least
 fourteen-point  type  bold:  "NOTICE OF DENIAL OF MEDICAL COVERAGE". Any
 additional terms or  conditions  included  on  such  notice  of  partial
 approval  or  such  notice  of  denial,  such as but not limited to time
 restraints to file an appeal, shall be included with  at  least  twelve-
 point type.
   §  3.  Paragraphs  4  and 5 of subsection (b) of section 3224-b of the
 insurance law are renumbered paragraphs 6 and 7 and two new paragraphs 4
 and 5 are added to read as follows:
   (4) A REVIEW OR AUDIT OF CLAIMS BY OR ON BEHALF OF A HEALTH PLAN SHALL
 NOT REVERSE OR OTHERWISE ALTER A MEDICAL NECESSITY DETERMINATION,  WHICH
 INCLUDES,  A  SITE  OF  SERVICE OR LEVEL OF CARE DETERMINATION MADE BY A
 UTILIZATION REVIEW AGENT OR EXTERNAL APPEAL AGENT  PURSUANT  TO  ARTICLE
 FORTY-NINE  OF  THIS  CHAPTER OR ARTICLE FORTY-NINE OF THE PUBLIC HEALTH
 LAW.
 S. 4007                            127                           A. 3007
 
   (5) A REVIEW OR AUDIT OF CLAIMS BY OR ON BEHALF OF A HEALTH PLAN SHALL
 NOT DOWNGRADE THE CODING OF A CLAIM IF IT HAS THE EFFECT OF REVERSING OR
 ALTERING A MEDICAL NECESSITY DETERMINATION, WHICH INCLUDES, A  LEVEL  OF
 CARE  DETERMINATION  MADE  BY  OR ON BEHALF OF THE HEALTH PLAN; PROVIDED
 HOWEVER,  THAT  NOTHING  IN  THIS  PARAGRAPH SHALL LIMIT A HEALTH PLAN'S
 ABILITY TO REVIEW OR AUDIT CLAIMS FOR FRAUD, WASTE OR ABUSE.
   § 4. The opening paragraph of subsection (c) of section  4904  of  the
 insurance  law, as amended by section 18 of part YY of chapter 56 of the
 laws of 2020, is amended to read as follows:
   A utilization review agent shall establish a standard  appeal  process
 which includes procedures for appeals to be filed in writing or by tele-
 phone.  A  utilization  review  agent must establish a period of no less
 than forty-five days after receipt of notification by the insured of the
 initial utilization review determination and receipt  of  all  necessary
 information  to file the appeal from said determination. The utilization
 review agent must provide written acknowledgment of the  filing  of  the
 appeal  to  the  appealing  party within fifteen days of such filing and
 shall make a determination with regard to the appeal within thirty  days
 of  the receipt of necessary information to conduct the appeal and, upon
 overturning the adverse decision, shall comply with subsection [(a)] (B)
 of section three thousand two hundred twenty-four-a of this  chapter  as
 applicable.  The  utilization review agent shall notify the insured, the
 insured's designee and, where appropriate,  the  insured's  health  care
 provider,  in  writing  of  the appeal determination within two business
 days of the rendering of such determination.
   § 5. The opening paragraph of subdivision 3 of  section  4904  of  the
 public  health law, as amended by section 17 of part YY of chapter 56 of
 the laws of 2020, is amended to read as follows:
   A utilization review agent shall establish a standard  appeal  process
 which includes procedures for appeals to be filed in writing or by tele-
 phone.  A  utilization  review  agent must establish a period of no less
 than forty-five days after receipt of notification by  the  enrollee  of
 the  initial  utilization review determination and receipt of all neces-
 sary information to file the appeal from said determination. The  utili-
 zation review agent must provide written acknowledgment of the filing of
 the appeal to the appealing party within fifteen days of such filing and
 shall  make a determination with regard to the appeal within thirty days
 of the receipt of necessary information to conduct the appeal and,  upon
 overturning  the  adverse  determination,  shall  comply with subsection
 [(a)] (B) of section three thousand two  hundred  twenty-four-a  of  the
 insurance  law  as applicable. The utilization review agent shall notify
 the enrollee,  the  enrollee's  designee  and,  where  appropriate,  the
 enrollee's health care provider, in writing, of the appeal determination
 within  two  business  days  of the rendering of such determination. The
 notice of the appeal determination shall include:
   § 6. Nothing in this act shall limit the authority of  the  office  of
 the  medicaid  inspector general, the department of health, or the state
 from conducting  oversight  activities,  audits,  recovering  funds  and
 imposing  penalties  in  accordance  with any relevant rule, regulation,
 provision of law or contract.
   § 7. This act shall take effect January 1, 2024.
 
                                  PART K
 
   Section 1.  Subparagraphs 1 and 2 of paragraph (e) of subdivision 1 of
 section 366 of the social services law, as added by section 1 of part  D
 S. 4007                            128                           A. 3007
 
 of  chapter  56  of  the laws of 2013, clause (iii) of subparagraph 2 as
 amended by chapter 477 of the laws of  2022,  are  amended  to  read  as
 follows:
   (1)  is  an  inmate  or  patient in an institution or facility wherein
 medical assistance may not be provided  in  accordance  with  applicable
 federal  or state requirements, except for persons described in subpara-
 graph ten of paragraph (c) of this subdivision or subdivision  one-a  or
 subdivision  one-b  of  this  section;  OR  EXCEPT  FOR CERTAIN SERVICES
 PROVIDED TO PERSONS IN A CORRECTIONAL INSTITUTION OR FACILITY  PERMITTED
 BY A WAIVER AUTHORIZED PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE
 FEDERAL  SOCIAL  SECURITY ACT; IF, SO LONG AS, AND TO THE EXTENT FEDERAL
 FINANCIAL PARTICIPATION IS  AVAILABLE  FOR  SUCH  EXPENDITURES  PROVIDED
 PURSUANT TO SUCH WAIVER; or
   (2)  is  a  patient in a public institution operated primarily for the
 treatment of tuberculosis or care of the  mentally  disabled,  with  the
 exception  of:  (i)  a  person  sixty-five  years  of age or older and a
 patient in any such institution; (ii) a person under twenty-one years of
 age and receiving in-patient psychiatric services in a  public  institu-
 tion  operated  primarily for the care of the mentally disabled; (iii) a
 patient in a public institution operated primarily for the care of indi-
 viduals with developmental disabilities who is receiving medical care or
 treatment in that part of such institution that has been approved pursu-
 ant to law as a hospital or nursing home; (iv) a patient in an  institu-
 tion  operated  by  the  state department of mental hygiene, while under
 care in a hospital on release from such institution for the  purpose  of
 receiving  care  in  such  hospital;  [or] (v) is a person residing in a
 community residence or a residential care center  for  adults;  OR  (VI)
 CERTAIN  SERVICES  PROVIDED  TO  PERSONS  IN  AN  INSTITUTION FOR MENTAL
 DISEASES PERMITTED BY A WAIVER AUTHORIZED  PURSUANT  TO  SECTION  ELEVEN
 HUNDRED  FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT; IF, SO LONG AS, AND
 TO THE EXTENT FEDERAL FINANCIAL  PARTICIPATION  IS  AVAILABLE  FOR  SUCH
 EXPENDITURES PROVIDED PURSUANT TO SUCH WAIVER.
   §  2.    This act shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2023.
 
                                  PART L
 
   Section 1. Section 3241 of the insurance law is amended  by  adding  a
 new subsection (d) to read as follows:
   (D)(1) FOR PURPOSES OF THIS SUBSECTION:
   (A) "FREE-STANDING AMBULATORY SURGICAL CENTER" SHALL MEAN A DIAGNOSTIC
 AND  TREATMENT CENTER AUTHORIZED PURSUANT TO ARTICLE TWENTY-EIGHT OF THE
 PUBLIC HEALTH LAW AND OPERATED INDEPENDENTLY FROM A HOSPITAL.
   (B) "HEALTH CARE PLAN" SHALL MEAN AN INSURER, A CORPORATION  ORGANIZED
 PURSUANT  TO  ARTICLE  FORTY-THREE OF THIS CHAPTER, A HEALTH MAINTENANCE
 ORGANIZATION CERTIFIED PURSUANT TO  ARTICLE  FORTY-FOUR  OF  THE  PUBLIC
 HEALTH LAW, A MUNICIPAL COOPERATIVE HEALTH BENEFIT PLAN CERTIFIED PURSU-
 ANT  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, THAT ISSUES A HEALTH INSURANCE POLICY OR
 CONTRACT OR THAT ARRANGES FOR CARE AND  SERVICES  FOR  MEMBERS  UNDER  A
 CONTRACT  WITH  THE  DEPARTMENT  OF HEALTH WITH A NETWORK OF HEALTH CARE
 PROVIDERS AND UTILIZES SITE OF SERVICE REVIEW TO DETERMINE COVERAGE  FOR
 SERVICES DELIVERED BY PARTICIPATING PROVIDERS.
 S. 4007                            129                           A. 3007
 
   (C)  "HOSPITAL-BASED OUTPATIENT CLINIC" SHALL MEAN A CLINIC AUTHORIZED
 PURSUANT TO ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW AND LISTED  ON
 A HOSPITAL'S OPERATING CERTIFICATE.
   (D)  "SITE  OF SERVICE REVIEW" SHALL MEAN CRITERIA APPLIED BY A HEALTH
 CARE PLAN FOR PURPOSES  OF  DETERMINING  WHETHER  A  PROCEDURE  WILL  BE
 COVERED  FOR  A  GIVEN  INSURED  OR  ENROLLEE WHEN RENDERED BY A NETWORK
 PROVIDER AT A HOSPITAL-BASED OUTPATIENT CLINIC RATHER THAN A FREE-STAND-
 ING AMBULATORY SURGICAL CENTER.
   (2) SITE OF SERVICE REVIEW  SHALL  BE  DEEMED  UTILIZATION  REVIEW  IN
 ACCORDANCE WITH AND SUBJECT TO THE REQUIREMENTS AND PROTECTIONS OF ARTI-
 CLE  FORTY-NINE  OF  THIS  CHAPTER  AND ARTICLE FORTY-NINE OF THE PUBLIC
 HEALTH LAW, INCLUDING THE RIGHT  TO  INTERNAL  AND  EXTERNAL  APPEAL  OF
 DENIALS RELATED TO SITE OF SERVICE.
   (3) SITE OF SERVICE REVIEW SHALL PRIORITIZE PATIENT HEALTH AND SAFETY,
 PATIENT CHOICE OF HEALTH CARE PROVIDER, AND ACCESS TO CARE AND SHALL NOT
 BE BASED SOLELY ON COST.
   (4)  A  HEALTH  CARE PLAN SHALL HAVE ADEQUATE FREE-STANDING AMBULATORY
 SURGICAL CENTER PROVIDERS TO MEET  THE  HEALTH  NEEDS  OF  INSUREDS  AND
 ENROLLEES  AND  TO PROVIDE AN APPROPRIATE CHOICE OF PROVIDERS SUFFICIENT
 TO RENDER THE SERVICES COVERED UNDER THE POLICY OR CONTRACT.
   (5) EXCEPT AS PROVIDED IN PARAGRAPH SIX OF THIS  SUBSECTION,  STARTING
 JANUARY  FIRST,  TWO  THOUSAND  TWENTY-FOUR,  A  HEALTH  CARE PLAN SHALL
 PROVIDE NOTICE DISCLOSING AND CLEARLY EXPLAINING  THE  SITE  OF  SERVICE
 REVIEW TO:
   (A)  POLICYHOLDERS,  CONTRACT  HOLDERS,  INSUREDS,  AND  ENROLLEES AND
 PROSPECTIVE POLICYHOLDERS, CONTRACT HOLDERS, INSUREDS, AND ENROLLEES  AT
 THE TIME OF PLAN AND POLICY OR CONTRACT SELECTION. THIS DISCLOSURE SHALL
 INCLUDE  A  STATEMENT THAT SITE OF SERVICE REVIEW MAY LIMIT THE SETTINGS
 IN WHICH SERVICES COVERED UNDER THE POLICY OR CONTRACT MAY  BE  PROVIDED
 AND  RENDER  A  PARTICIPATING  PROVIDER  UNABLE TO PERFORM A SERVICE AND
 SHALL DISCLOSE TO INSUREDS OR ENROLLEES ANY QUALITY  OR  COST  DIFFEREN-
 TIAL,  INCLUDING  DIFFERENCES IN OUT-OF-POCKET COSTS, BETWEEN THE HOSPI-
 TAL-BASED OUTPATIENT CLINIC AND THE  FREE-STANDING  AMBULATORY  SURGICAL
 CENTER   WHEN   SERVICES  AT  A  HOSPITAL-BASED  OUTPATIENT  CLINIC  ARE
 REQUESTED, OR AT  ANY  OTHER  TIME  UPON  THE  INSURED'S  OR  ENROLLEE'S
 REQUEST.  PROVIDER DIRECTORIES SHALL ALSO INDICATE WHEN HEALTH CARE PLAN
 SITE OF SERVICE REVIEW MAY LIMIT THE SCOPE  OF  SERVICES  THAT  WILL  BE
 COVERED WHEN DELIVERED BY A PARTICIPATING PROVIDER;
   (B)  PARTICIPATING PROVIDERS AT LEAST NINETY DAYS PRIOR TO IMPLEMENTA-
 TION.  A HEALTH CARE PLAN SHALL ALSO INFORM PROVIDERS OF THE PROCESS FOR
 REQUESTING COVERAGE OF A SERVICE IN A HOSPITAL-BASED  OUTPATIENT  CLINIC
 SETTING,  INCLUDING  THE  RIGHT  TO REQUEST A REAL TIME CLINICAL PEER TO
 PEER DISCUSSION AS PART OF THE AUTHORIZATION PROCESS; AND
   (C) THE SUPERINTENDENT AND, AS  APPLICABLE,  TO  THE  COMMISSIONER  OF
 HEALTH,  AT  LEAST  FORTY-FIVE  DAYS  PRIOR  TO NOTIFYING POLICYHOLDERS,
 CONTRACT HOLDERS, INSUREDS AND ENROLLEES AND PROSPECTIVE  POLICYHOLDERS,
 CONTRACT  HOLDERS, INSUREDS AND ENROLLEES AND PARTICIPATING PROVIDERS IN
 ACCORDANCE WITH THIS SUBSECTION. SUCH NOTICE TO THE SUPERINTENDENT  AND,
 AS APPLICABLE, TO THE COMMISSIONER OF HEALTH, SHALL INCLUDE DRAFT COMMU-
 NICATIONS  TO  THE FOREGOING PERSONS FOR PURPOSES OF COMPLYING WITH THIS
 SUBSECTION.
   (6) A HEALTH CARE PLAN THAT HAS IMPLEMENTED  SITE  OF  SERVICE  REVIEW
 PRIOR  TO  JANUARY  FIRST,  TWO  THOUSAND  TWENTY-FOUR SHALL PROVIDE THE
 DISCLOSURES SET FORTH IN PARAGRAPH FIVE OF THIS SUBSECTION AT THE BEGIN-
 NING OF THE OPEN ENROLLMENT PERIOD FOR INDIVIDUAL HEALTH INSURANCE POLI-
 CIES  AND  CONTRACTS,  AND  FOR  GROUP  HEALTH  INSURANCE  POLICIES  AND
 S. 4007                            130                           A. 3007
 
 CONTRACTS,  PRIOR  TO  ISSUANCE, RENEWAL, OR JANUARY FIRST, TWO THOUSAND
 TWENTY-FOUR, WHICHEVER IS EARLIER.
   (7)  STARTING JANUARY FIRST, TWO THOUSAND TWENTY-FOUR, AT A MINIMUM, A
 HEALTH CARE PLAN SHALL APPROVE A SERVICE COVERED  UNDER  THE  POLICY  OR
 CONTRACT AND REQUESTED TO BE PERFORMED BY A NETWORK PROVIDER AT A HOSPI-
 TAL-BASED OUTPATIENT CLINIC IN THE FOLLOWING SITUATIONS:
   (A)  THE PROCEDURE CANNOT BE SAFELY PERFORMED IN A FREE-STANDING AMBU-
 LATORY SURGICAL CENTER DUE TO THE INSURED'S OR ENROLLEE'S HEALTH  CONDI-
 TION OR THE HEALTH CARE SERVICES;
   (B)  THERE  IS NOT SUFFICIENT FREE-STANDING AMBULATORY SURGICAL CENTER
 CAPACITY IN THE INSURED'S OR ENROLLEE'S GEOGRAPHIC AREA; OR
   (C) THE PROVISION OF HEALTH CARE SERVICES AT A FREE-STANDING AMBULATO-
 RY SURGICAL CENTER WOULD RESULT IN UNDUE DELAY.
   (8) STARTING JANUARY FIRST, TWO THOUSAND TWENTY-FOUR, SITE OF  SERVICE
 CLINICAL  REVIEW CRITERIA DEVELOPED BY HEALTH CARE PLANS SHALL ALSO TAKE
 INTO CONSIDERATION WHETHER:
   (A) THE INSURED'S OR ENROLLEE'S IN-NETWORK TREATING  PHYSICIAN  RECOM-
 MENDS  THAT THE SERVICE BE PROVIDED AT A HOSPITAL-BASED OUTPATIENT CLIN-
 IC;
   (B) THE INSURED'S IN-NETWORK TREATING PHYSICIAN IS NOT CREDENTIALED OR
 DOES NOT HAVE PRIVILEGES AT A FREE-STANDING AMBULATORY SURGICAL  CENTER;
 OR
   (C)  THE  INSURED  HAS  AN ESTABLISHED RELATIONSHIP WITH AN IN-NETWORK
 TREATING PHYSICIAN WHO PERFORMS THE REQUESTED  SERVICE  IN  A  HOSPITAL-
 BASED OUTPATIENT CLINIC.
   § 2. This act shall take effect April 1, 2023.

                                  PART M
 
   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:
   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, or
 operators; with respect to any proposed incorporator, director, sponsor,
 stockholder, member, or operator who is already or within the past [ten]
 SEVEN years [has] been an incorporator, director, sponsor, member, prin-
 cipal stockholder, principal member, or  operator  OF  any  hospital  OR
 OTHER  HEALTH-RELATED  OR  LONG-TERM  CARE  FACILITY, PROGRAM OR AGENCY,
 INCLUDING BUT NOT LIMITED TO, private proprietary home for adults, resi-
 dence 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
 S. 4007                            131                           A. 3007
 
 council, having afforded an adequate opportunity to  members  of  health
 systems  agencies,  if any, having geographical jurisdiction of the area
 where the institution is to be located to be heard, shall  affirmatively
 find  by  substantial  evidence  as to each such incorporator, director,
 sponsor, MEMBER, principal stockholder, PRINCIPAL  MEMBER,  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, OR CORPO-
 RATION which is the operator of a hospital [to a new partner or  member]
 OR  ANY  TRANSFER,  ASSIGNMENT OR OTHER DISPOSITION 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  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] PARAGRAPHS.
   (II) SUCH change shall not be subject to THE  PUBLIC  NEED  ASSESSMENT
 DESCRIBED IN paragraph (a) of subdivision three of this section.
   [(ii)  With]  (III)  NO PRIOR APPROVAL OF THE PUBLIC HEALTH AND HEALTH
 PLANNING COUNCIL SHALL BE REQUIRED WITH respect to a  transfer,  assign-
 ment  or  disposition  [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 OPER-
 ATOR, 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  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 [partnership or
 limited liability company] OPERATOR fully completes and files  with  the
 public health and health planning council notice on a form, to be devel-
 oped  by  the  public  health  and  health planning council, which shall
 S. 4007                            132                           A. 3007
 
 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 for any of the
 reasons set forth in item [(A), (B), (C) or (D)] ONE, TWO, THREE OR FOUR
 below, AND HAS FULLY RESPONDED TO ANY REQUEST FOR ADDITIONAL INFORMATION
 BY THE DEPARTMENT ACTING ON BEHALF OF THE PUBLIC HEALTH AND HEALTH PLAN-
 NING  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  TRANSACTION  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 reason-
 able grounds to believe that the proposed transaction does  not  satisfy
 the  character and competence 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  aggre-
 gate,  involve twenty-five percent or more of the interest in the [part-
 nership] OPERATOR. The public health and health planning  council  shall
 state  specific  reasons for barring any transaction under this subpara-
 graph 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
 S. 4007                            133                           A. 3007
 
 planning council may bar any transaction under this subparagraph if  the
 equity position of the [partnership or limited liability company] OPERA-
 TOR, determined in accordance with generally accepted accounting princi-
 ples, would be reduced as a result of the transfer, assignment or dispo-
 sition.  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
 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, 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
 S. 4007                            134                           A. 3007

 UNDER THIS SUBDIVISION MAY SUBJECT THE  OPERATING  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,  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  liabil-
 ity  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.
   (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
 S. 4007                            135                           A. 3007
 
 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,
 OR  CORPORATION  WHICH  IS THE OPERATOR OF A LICENSED HOME CARE SERVICES
 AGENCY OR A CERTIFIED HOME HEALTH AGENCY  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
 S. 4007                            136                           A. 3007

 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.
   §  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, OR
 CORPORATION which is the operator of a hospice, OR ANY TRANSFER, ASSIGN-
 MENT OR OTHER DISPOSITION WHICH RESULTS IN THE DIRECT OR INDIRECT OWNER-
 SHIP 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  subdivisions  one and two of this
 section[.]; EXCEPT THAT:
   (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
 S. 4007                            137                           A. 3007
 
 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
 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,
 OR  CORPORATION WHICH IS THE OPERATOR OF A HOSPICE WITHOUT FIRST OBTAIN-
 ING 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. The public health law is amended by adding a new article 45-A to
 read as follows:
                                ARTICLE 45-A
               REVIEW AND OVERSIGHT OF MATERIAL TRANSACTIONS
 SECTION 4550. LEGISLATIVE PURPOSE AND INTENT.
         4551. DEFINITIONS.
         4552. REVIEW AND OVERSIGHT OF MATERIAL TRANSACTIONS.
         4553. NOTICE OF MATERIAL TRANSACTION; REQUIREMENTS.
         4554. MATERIAL TRANSACTION REVIEW.
         4555. PENALTY FOR NONCOMPLIANCE; INJUNCTIVE RELIEF.
         4556. RULES AND REGULATIONS.
         4557. SEPARABILITY.
   § 4550. LEGISLATIVE PURPOSE AND INTENT. WHILE HOSPITALS  REMAIN  VITAL
 TO  THE HEALTH SYSTEM, SERVICES ARE INCREASINGLY BEING DELIVERED THROUGH
 AMBULATORY CARE. THIS SHIFT TO AMBULATORY CARE IS  GIVING  RISE  TO  NEW
 HEALTH CARE DELIVERY STRUCTURES THAT ARE NOT SUBJECT TO THE SAME FACILI-
 S. 4007                            138                           A. 3007
 
 TY LICENSURE AND OVERSIGHT REQUIREMENTS. IN PARTICULAR, THERE HAS BEEN A
 PROLIFERATION  OF  LARGE  PHYSICIAN  PRACTICES BEING MANAGED BY ENTITIES
 THAT ARE INVESTOR-BACKED. AS A GENERAL MATTER, PHYSICIAN  PRACTICES  ARE
 SUBJECT  TO FAR LESS REGULATION AND OVERSIGHT THAN HOSPITALS UNDER ARTI-
 CLE TWENTY-EIGHT OF THIS CHAPTER, HOME CARE AGENCIES UNDER ARTICLE THIR-
 TY-SIX OF THIS CHAPTER, HOSPICE PROVIDERS, OR  PROVIDERS  OF  BEHAVIORAL
 HEALTH  SERVICES  UNDER ARTICLES THIRTY-ONE AND THIRTY-TWO OF THE MENTAL
 HYGIENE LAW, AS WELL AS MANAGED CARE  ORGANIZATIONS  OR  OTHER  INSURERS
 AUTHORIZED  UNDER THIS CHAPTER OR THE INSURANCE LAW. EVEN AS THESE INVE-
 STOR-BACKED ENTITIES INCREASINGLY TAKE ON THE CHARACTERISTICS ASSOCIATED
 WITH DIAGNOSTIC AND TREATMENT CENTERS UNDER ARTICLE TWENTY-EIGHT OF THIS
 CHAPTER OR OTHER LICENSED PROVIDER TYPES, OR MAY ASSUME MORE  RISK  FROM
 MANAGED  CARE  ORGANIZATIONS  AND LICENSED INSURERS, THEY REMAIN UNREGU-
 LATED BY THE STATE OUTSIDE OF THE LICENSURE OF  THE  INDIVIDUAL  PRACTI-
 TIONERS  WHO  PRACTICE  AT THESE SITES AND ENROLLMENT IN MEDICAID. MORE-
 OVER, TRANSACTIONS INVOLVING THE CHANGE OF CONTROL, BY VIRTUE OF A SALE,
 MERGER OR ACQUISITION OF THESE PROVIDERS, ARE NOT SUBJECT TO  ANY  STATE
 CHANGE  OF  OWNERSHIP OR CONTROL REVIEW, SUCH THAT THE STATE IS NOT ABLE
 TO TRACK OR MONITOR THE IMPACT OF THESE TRANSACTIONS ON  COST,  QUALITY,
 ACCESS, EQUITY, AND COMPETITION.
   THIS  PHENOMENON  MAY  HAVE  A NEGATIVE IMPACT ON PATIENT CARE, HEALTH
 CARE COSTS, AND ULTIMATELY ACCESS TO  SERVICES.  THESE  LARGE  INVESTOR-
 BACKED HEALTH CARE ENTITIES SHIFT VOLUME AND BUSINESS AWAY FROM COMMUNI-
 TY  HOSPITALS  AND  THEIR  AMBULATORY CARE NETWORKS AND OTHER SAFETY NET
 PROVIDERS,  UNDERMINING  THEIR  FINANCIAL  SUSTAINABILITY,  WHICH   MUST
 CONTINUE  TO  PROVIDE  ESSENTIAL SERVICES TO THE COMMUNITY. IN ADDITION,
 THE CONCENTRATION OF THESE  INVESTOR-BACKED  PHYSICIAN  PRACTICES  IS  A
 SIGNIFICANT  CONTRIBUTOR  TO  HEALTH CARE COST INFLATION, WHICH HAS ALSO
 GIVEN RISE TO OTHER  LEGISLATION,  INCLUDING  THE  NO  SURPRISE  BILLING
 PROVISIONS IN THE FINANCIAL SERVICES LAW.
   §  4551.  DEFINITIONS. FOR THE PURPOSES OF THIS ARTICLE, THE FOLLOWING
 TERMS SHALL HAVE THE FOLLOWING MEANINGS:
   1. "CONTROL" MEANS THE POSSESSION, DIRECT OR INDIRECT, OF THE POWER TO
 DIRECT OR CAUSE THE DIRECTION OF THE MANAGEMENT AND POLICIES OF A HEALTH
 CARE ENTITY, WHETHER THROUGH THE  OWNERSHIP  OF  VOTING  SECURITIES,  BY
 CONTRACT  (EXCEPT  A  COMMERCIAL  CONTRACT  FOR  GOODS OR NON-MANAGEMENT
 SERVICES) OR OTHERWISE; BUT NO PERSON SHALL BE DEEMED TO CONTROL ANOTHER
 PERSON SOLELY BY REASON OF BEING AN OFFICER OR DIRECTOR OF A HEALTH CARE
 ENTITY.  "CONTROL" SHALL BE PRESUMED TO EXIST IF ANY PERSON DIRECTLY  OR
 INDIRECTLY  OWNS,  CONTROLS, OR HOLDS WITH THE POWER TO VOTE TEN PERCENT
 OR MORE OF THE VOTING SECURITIES OF A HEALTH CARE ENTITY.
   2. "HEALTH CARE ENTITY" SHALL INCLUDE BUT NOT BE LIMITED TO  A  PHYSI-
 CIAN  PRACTICE  OR  MANAGEMENT  SERVICES  ORGANIZATION OR SIMILAR ENTITY
 PROVIDING ALL OR SUBSTANTIALLY ALL ADMINISTRATIVE OR MANAGEMENT SERVICES
 UNDER CONTRACT WITH ONE OR MORE PHYSICIAN  PRACTICE,  PROVIDER-SPONSORED
 ORGANIZATION,  HEALTH  INSURANCE  PLAN, OR ANY OTHER KIND OF HEALTH CARE
 FACILITY, ORGANIZATION OR PLAN PROVIDING HEALTH CARE  SERVICES  IN  THIS
 STATE;  PROVIDED, HOWEVER, THAT A "HEALTH CARE ENTITY" SHALL NOT INCLUDE
 AN INSURER DIRECTLY AUTHORIZED TO DO BUSINESS IN THIS STATE, OR A  PHAR-
 MACY  BENEFIT MANAGER REGISTERED OR LICENSED IN THIS STATE. AN "INSURER"
 SHALL NOT INCLUDE NON-INSURANCE SUBSIDIARIES AND AFFILIATED ENTITIES  OF
 INSURANCE COMPANIES REGULATED UNDER THE INSURANCE LAW OR THIS CHAPTER.
   3.  "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
 S. 4007                            139                           A. 3007
 
 HAVE EXPERIENCED INJUSTICES, SOCIOECONOMIC DISADVANTAGES,  AND  SYSTEMIC
 DISADVANTAGES.
   4. "MATERIAL TRANSACTION" SHALL MEAN:
   (A)  ANY OF THE FOLLOWING, OCCURRING DURING A SINGLE TRANSACTION OR IN
 A SERIES OF RELATED TRANSACTIONS, THAT TAKE PLACE WITHIN A  TIME  PERIOD
 AND  MEET  OR  EXCEED  THRESHOLDS,  AS DETERMINED BY THE COMMISSIONER IN
 REGULATION, FOR FACTORS INCLUDING BUT NOT LIMITED TO CHANGES IN REVENUE:
   (I) A MERGER WITH A HEALTH CARE ENTITY;
   (II) AN ACQUISITION OF ONE OR MORE HEALTH CARE ENTITIES, INCLUDING BUT
 NOT LIMITED TO THE ASSIGNMENT, SALE,  OR  OTHER  CONVEYANCE  OF  ASSETS,
 VOTING  SECURITIES,  MEMBERSHIP, OR PARTNERSHIP INTEREST OR THE TRANSFER
 OF CONTROL;
   (III) AN AFFILIATION OR CONTRACT FORMED BETWEEN A HEALTH  CARE  ENTITY
 AND ANOTHER PERSON; OR
   (IV)  THE  FORMATION OF A PARTNERSHIP, JOINT VENTURE, ACCOUNTABLE CARE
 ORGANIZATION, PARENT ORGANIZATION, OR MANAGEMENT  SERVICES  ORGANIZATION
 FOR THE PURPOSE OF ADMINISTERING CONTRACTS WITH HEALTH PLANS, THIRD-PAR-
 TY  ADMINISTRATORS,  PHARMACY BENEFIT MANAGERS, OR HEALTH CARE PROVIDERS
 AS PRESCRIBED BY THE COMMISSIONER BY REGULATION.
   (B) "MATERIAL TRANSACTION" SHALL NOT INCLUDE A CLINICAL AFFILIATION OF
 HEALTH CARE ENTITIES FORMED FOR THE PURPOSE OF COLLABORATING ON CLINICAL
 TRIALS OR GRADUATE MEDICAL EDUCATION PROGRAMS AND SHALL NOT INCLUDE  ANY
 TRANSACTION  THAT  IS  ALREADY  SUBJECT  TO REVIEW UNDER ARTICLE TWENTY-
 EIGHT, THIRTY, THIRTY-SIX, FORTY, FORTY-SIX, FORTY-SIX-A, OR FORTY-SIX-B
 OF THIS CHAPTER.
   § 4552. REVIEW AND OVERSIGHT OF MATERIAL TRANSACTIONS. 1. THE  DEPART-
 MENT  SHALL  HAVE  THE  AUTHORITY  TO REVIEW AND APPROVE MATERIAL TRANS-
 ACTIONS, WHICH MAY BE FURTHER DEFINED BY THE COMMISSIONER IN REGULATION,
 TO ASSESS SUCH TRANSACTIONS' IMPACT ON  COST,  QUALITY,  ACCESS,  HEALTH
 EQUITY AND COMPETITION IN THE HEALTH CARE SERVICE MARKET.
   2. IN ACCORDANCE WITH THIS ARTICLE, AND WITH THE RULES AND REGULATIONS
 PROMULGATED  BY  THE COMMISSIONER PURSUANT TO SECTION FORTY-FIVE HUNDRED
 FIFTY-SIX OF THIS ARTICLE, THE DEPARTMENT SHALL ADOPT CRITERIA  FOR  THE
 CONSIDERATION  OF REQUESTS BY HEALTH CARE ENTITIES TO CONSUMMATE A MATE-
 RIAL TRANSACTION. THE CRITERIA  SHALL  INCLUDE  THE  FACTORS  LISTED  IN
 SUBDIVISION  ONE  OF SECTION FORTY-FIVE HUNDRED FIFTY-FOUR OF THIS ARTI-
 CLE.
   3. NOTHING IN THIS ARTICLE SHALL LIMIT OR RESTRICT  THE  AUTHORITY  OF
 THE SUPERINTENDENT OF FINANCIAL SERVICES UNDER ARTICLE FIFTEEN, SIXTEEN,
 SEVENTEEN,  FORTY-TWO, FORTY-THREE, SEVENTY-ONE, OR SEVENTY-THREE OF THE
 INSURANCE LAW, OR REGULATIONS PROMULGATED THEREUNDER.
   § 4553. NOTICE OF MATERIAL TRANSACTION; REQUIREMENTS. 1. A HEALTH CARE
 ENTITY SHALL NOT CONSUMMATE A  MATERIAL  TRANSACTION  WITHOUT  OBTAINING
 APPROVAL FROM THE DEPARTMENT FOR SUCH MATERIAL TRANSACTION.
   2.  IN  ORDER  TO  OBTAIN  APPROVAL  OF  A MATERIAL TRANSACTION BY THE
 DEPARTMENT, A HEALTH CARE ENTITY SHALL SUBMIT TO THE DEPARTMENT  WRITTEN
 NOTICE AND APPLICATION, WITH SUPPORTING DOCUMENTATION AS DESCRIBED BELOW
 AND  FURTHER  DEFINED  IN  REGULATION,  WHICH THE DEPARTMENT SHALL BE IN
 RECEIPT OF AT LEAST THIRTY DAYS BEFORE THE DESIRED CLOSING DATE  OF  THE
 TRANSACTION,  IN  THE FORM AND MANNER PRESCRIBED BY THE DEPARTMENT. SUCH
 WRITTEN NOTICE SHALL INCLUDE, BUT NOT BE LIMITED TO:
   (A) THE NAMES OF THE PARTIES TO THE PROPOSED MATERIAL TRANSACTION  AND
 THEIR CURRENT ADDRESSES;
   (B)  COPIES  OF  ANY  DEFINITIVE AGREEMENTS GOVERNING THE TERMS OF THE
 MATERIAL TRANSACTION, INCLUDING PRE- AND POST-CLOSING CONDITIONS;
 S. 4007                            140                           A. 3007
 
   (C) IDENTIFICATION OF ALL LOCATIONS WHERE  HEALTH  CARE  SERVICES  ARE
 CURRENTLY  PROVIDED BY EACH PARTY AND THE REVENUE GENERATED IN THE STATE
 FROM SUCH LOCATIONS;
   (D)  ANY PLANS TO REDUCE OR ELIMINATE SERVICES AND/OR PARTICIPATION IN
 SPECIFIC PLAN NETWORKS;
   (E) THE DESIRED CLOSING DATE OF THE PROPOSED MATERIAL TRANSACTION;
   (F) A BRIEF DESCRIPTION OF THE NATURE  AND  PURPOSE  OF  THE  PROPOSED
 MATERIAL  TRANSACTION,  WHICH  WILL  BE  USED TO INFORM THE REVIEW UNDER
 SECTION FORTY-FIVE HUNDRED FIFTY-FOUR OF THIS ARTICLE, INCLUDING:
   (I) THE ANTICIPATED IMPACT OF THE MATERIAL TRANSACTION ON COST, QUALI-
 TY, ACCESS, HEALTH EQUITY, AND  COMPETITION  IN  THE  IMPACTED  MARKETS,
 WHICH MAY BE SUPPORTED BY DATA AND A FORMAL MARKET IMPACT ANALYSIS; AND
   (II)  ANY COMMITMENTS BY THE HEALTH CARE ENTITY TO ADDRESS ANTICIPATED
 IMPACTS; AND
   (G) A NON-REFUNDABLE APPLICATION FEE.
   3. EXCEPT AS PROVIDED IN SUBDIVISION TWO OF SECTION FORTY-FIVE HUNDRED
 FIFTY-FOUR OF THIS ARTICLE, SUPPORTING  DOCUMENTATION  AS  DESCRIBED  IN
 SUBDIVISION TWO OF THIS SECTION SHALL NOT BE SUBJECT TO DISCLOSURE UNDER
 ARTICLE SIX OF THE PUBLIC OFFICERS LAW.
   §  4554.  MATERIAL  TRANSACTION  REVIEW. 1. WHEN REVIEWING A POTENTIAL
 MATERIAL TRANSACTION, THE DEPARTMENT MAY CONSIDER THE FOLLOWING:
   (A) WHETHER THE PARTIES TO THE TRANSACTION CAN  DEMONSTRATE  THAT  THE
 POTENTIAL  POSITIVE  IMPACTS  OF  THE  MATERIAL TRANSACTION OUTWEIGH THE
 POTENTIAL NEGATIVE IMPACTS RELATED TO FACTORS SUCH AS:
   (I) PATIENT COSTS;
   (II) ACCESS TO SERVICES;
   (III) HEALTH EQUITY; AND
   (IV) HEALTH OUTCOMES;
   (B)   WHETHER THERE IS A  SUBSTANTIAL  LIKELIHOOD  OF  ANTICOMPETITIVE
 EFFECTS  FROM  THE  TRANSACTION THAT OUTWEIGH THE BENEFITS OF THE TRANS-
 ACTION INCLUDING BY INCREASING OR MAINTAINING  SERVICES  TO  UNDERSERVED
 POPULATIONS  OR  STABILIZING  THE  OPERATIONS  OF  THE EXISTING DELIVERY
 SYSTEM;
   (C) THE FINANCIAL CONDITION OF THE PARTIES TO THE TRANSACTION;
   (D) THE CHARACTER AND COMPETENCE OF THE PARTIES  OR  ANY  OFFICERS  OR
 DIRECTORS THEREOF;
   (E) THE SOURCE OF THE FUNDS OR ASSETS FOR THE TRANSACTION;
   (F)  THE  FAIRNESS  OF  ANY EXCHANGE OF SHARES, ASSETS, CASH, OR OTHER
 CONSIDERATION FOR THE SHARES OR ASSETS TO BE RECEIVED; AND
   (G) ANY OTHER RELEVANT INFORMATION NECESSARY TO DETERMINE  THE  IMPACT
 OF THE MATERIAL TRANSACTION.
   2.  IF  THE DEPARTMENT DOES NOT ACT ON THE APPLICATION AS DESCRIBED IN
 SUBDIVISIONS THREE AND FOUR  OF  THIS  SECTION  WITHIN  THIRTY  DAYS  OF
 RECEIPT  OF  WRITTEN  NOTICE AND APPLICATION AS DESCRIBED IN SUBDIVISION
 TWO OF SECTION FORTY-FIVE HUNDRED FIFTY-THREE OF THIS ARTICLE, THEN  THE
 TRANSACTION SHALL BE DEEMED APPROVED. DURING SUCH THIRTY-DAY PERIOD, THE
 DEPARTMENT  SHALL POST IN A MANNER DETERMINED BY THE DEPARTMENT IN REGU-
 LATION FOR PUBLIC NOTICE AND PUBLIC COMMENT WHICH  MAY  HELP  TO  INFORM
 WHETHER  THE  DEPARTMENT  TAKES  FURTHER  ACTIONS  AS DETERMINED BY THIS
 SECTION. AT A MINIMUM, THE PUBLIC NOTICE SHALL INCLUDE:
   (A) A SUMMARY OF THE PROPOSED TRANSACTION;
   (B) AN EXPLANATION OF THE GROUPS OR INDIVIDUALS LIKELY TO BE  IMPACTED
 BY THE TRANSACTION;
   (C)  INFORMATION  ABOUT SERVICES CURRENTLY PROVIDED BY THE HEALTH CARE
 ENTITY, COMMITMENTS BY THE HEALTH CARE ENTITY TO CONTINUE SUCH  SERVICES
 AND ANY SERVICES THAT WILL BE REDUCED OR ELIMINATED; AND
 S. 4007                            141                           A. 3007
 
   (D)  DETAILS ABOUT HOW TO SUBMIT COMMENTS, IN A FORMAT THAT IS EASY TO
 FIND AND EASY TO READ.
   3.  THE  DEPARTMENT SHALL NOTIFY THE PARTIES TO THE TRANSACTION WITHIN
 THIRTY DAYS OF RECEIPT OF WRITTEN NOTICE AND APPLICATION AS DESCRIBED IN
 SUBDIVISION TWO OF SECTION FORTY-FIVE HUNDRED FIFTY-THREE OF THIS  ARTI-
 CLE  THAT  IT IS WITHHOLDING APPROVAL OF THE TRANSACTION IF NECESSARY TO
 CONDUCT A THOROUGH EXAMINATION AND  COMPLETE  ANALYSIS  OF  WHETHER  THE
 TRANSACTION  IS  CONSISTENT  WITH  THE  CRITERIA ESTABLISHED PURSUANT TO
 SUBDIVISION FOUR OF SECTION FORTY-FIVE HUNDRED FIFTY-TWO OF  THIS  ARTI-
 CLE, INCLUDING THE FACTORS LISTED IN SUBDIVISION ONE OF THIS SECTION.
   (A)  THE  DEPARTMENT  MAY REQUEST ADDITIONAL INFORMATION FROM A HEALTH
 CARE ENTITY THAT IS A PARTY TO THE MATERIAL TRANSACTION AND SUCH  ENTITY
 SHALL  PROMPTLY REPLY USING THE FORM OF COMMUNICATION REQUESTED AND SUCH
 REPLY SHALL BE AFFIRMED AS TRUE AND ACCURATE UNDER PENALTY OF PERJURY BY
 AN OFFICER OF THE ENTITY, IF REQUIRED.
   (B) A HEALTH CARE ENTITY SHALL NOT  REFUSE  TO  PROVIDE  DOCUMENTS  OR
 OTHER INFORMATION REQUESTED PURSUANT TO THIS ARTICLE ON THE GROUNDS THAT
 SUCH INFORMATION IS PRIVILEGED OR CONFIDENTIAL.
   (C)  THE DEPARTMENT MAY RETAIN ACTUARIES, ACCOUNTANTS OR OTHER PROFES-
 SIONALS INDEPENDENT OF THE DEPARTMENT AS NECESSARY TO ASSIST IN CONDUCT-
 ING ITS ANALYSIS OF A  PROPOSED  MATERIAL  TRANSACTION.  THE  DEPARTMENT
 SHALL  DESIGNATE  THE  PARTY OR PARTIES TO THE MATERIAL TRANSACTION THAT
 SHALL BEAR THE COST OF RETAINING SUCH PROFESSIONALS.
   (D)  THE DEPARTMENT MAY TAKE OTHER ACTIONS TO SEEK  PUBLIC  INPUT  AND
 OTHERWISE  ENGAGE  THE  PUBLIC  BEFORE  MAKING  A  DETERMINATION  ON THE
 PROPOSED MATERIAL TRANSACTION.
   4. (A) UNLESS THE MATERIAL TRANSACTION IS APPROVED PURSUANT TO  SUBDI-
 VISION  TWO  OF  THIS  SECTION, THE DEPARTMENT SHALL ISSUE A FINAL ORDER
 REGARDING THE MATERIAL TRANSACTION.
   (B) IF THE DEPARTMENT DISAPPROVES THE MATERIAL TRANSACTION OR APPROVES
 THE MATERIAL TRANSACTION SUBJECT TO CONDITIONS, THE DEPARTMENT MAY NOTI-
 FY THE ATTORNEY GENERAL OF THE DEPARTMENT'S  FINDINGS  AND  ANALYSIS  SO
 THAT  THE ATTORNEY GENERAL MAY, IF APPROPRIATE, CONDUCT AN INVESTIGATION
 INTO WHETHER THE HEALTH CARE ENTITIES HAVE ENGAGED IN UNFAIR COMPETITION
 OR ANTICOMPETITIVE BEHAVIOR AND, IF NECESSARY,  TAKE  STEPS  TO  PROTECT
 CONSUMERS IN THE HEALTH CARE SERVICES MARKET.
   (C)  PURSUANT  TO  THIS  SUBDIVISION,  THE  DEPARTMENT  SHALL HAVE THE
 AUTHORITY TO REQUIRE UNDERTAKINGS AS A CONDITION OF APPROVING A MATERIAL
 TRANSACTION, INCLUDING BUT NOT LIMITED TO, INVESTMENTS IN  THE  COMMUNI-
 TIES AFFECTED BY SUCH MATERIAL TRANSACTION, COMPETITION PROTECTIONS, AND
 CONTRIBUTIONS  TO  STATE-CONTROLLED  FUNDS,  INCLUDING  THE  HEALTH CARE
 TRANSFORMATION FUND PURSUANT  TO  SECTION  NINETY-TWO-HH  OF  THE  STATE
 FINANCE  LAW,  TO PRESERVE ACCESS OR TO OTHERWISE MITIGATE THE IMPACT OF
 THE MATERIAL TRANSACTION ON THE HEALTH CARE DELIVERY SYSTEM.
   5. A HEALTH CARE ENTITY THAT IS A PARTY TO AN APPROVED MATERIAL TRANS-
 ACTION SHALL NOTIFY THE DEPARTMENT UPON CLOSING OF  THE  TRANSACTION  IN
 THE FORM AND MANNER PRESCRIBED BY THE DEPARTMENT.
   § 4555. PENALTY FOR NONCOMPLIANCE; INJUNCTIVE RELIEF.  1.  THE DEPART-
 MENT  MAY  IMPOSE  A  CIVIL  PENALTY  IN AN AMOUNT OF UP TO TEN THOUSAND
 DOLLARS PER DAY FOR ANY VIOLATION OF THIS ARTICLE. ALL FEES, FINES,  AND
 PENALTIES  DERIVED  FROM  THE OPERATION OF THIS ARTICLE SHALL BE PAID TO
 THE DEPARTMENT AND SHALL BE DEPOSITED IN THE HEALTH CARE  TRANSFORMATION
 FUND  ESTABLISHED PURSUANT TO SECTION NINETY-TWO-HH OF THE STATE FINANCE
 LAW.
   2. THE ATTORNEY GENERAL MAY APPLY TO  THE  SUPREME  COURT  WITHIN  THE
 JUDICIAL  DISTRICT  IN  WHICH  A VIOLATION OF THIS ARTICLE IS ALLEGED TO
 S. 4007                            142                           A. 3007

 HAVE OCCURRED FOR  AN  ORDER  ENJOINING  OR  RESTRAINING  COMMISSION  OR
 CONTINUANCE  OF  THE  ACTS COMPLAINED OF. THEREUPON THE COURT SHALL HAVE
 JURISDICTION OF THE PROCEEDING AND SHALL HAVE POWER TO GRANT SUCH TEMPO-
 RARY  RELIEF  OR  RESTRAINING ORDER AS IT DEEMS JUST AND PROPER.  IN ANY
 SUCH PROCEEDING IT SHALL BE UNNECESSARY  TO  ALLEGE  OR  PROVE  THAT  AN
 ADEQUATE  REMEDY  AT LAW DOES NOT EXIST OR THAT IRREPARABLE DAMAGE WOULD
 RESULT IF SUCH ORDER WERE NOT  GRANTED.  THE  REMEDY  PROVIDED  BY  THIS
 SECTION SHALL BE IN ADDITION TO ANY OTHER REMEDY PROVIDED BY LAW.
   §  4556.  RULES  AND REGULATIONS. THE DEPARTMENT, IN CONSULTATION WITH
 THE DEPARTMENT OF FINANCIAL SERVICES, MAY  PROMULGATE  RULES  AND  REGU-
 LATIONS TO IMPLEMENT THE PROVISIONS OF THIS ARTICLE.
   § 4557. SEPARABILITY. IF ANY CLAUSE, SENTENCE, PARAGRAPH, SUBDIVISION,
 SECTION OR PART OF THIS ARTICLE SHALL BE ADJUDGED BY ANY COURT OF COMPE-
 TENT  JURISDICTION TO BE INVALID, THE JUDGMENT SHALL NOT AFFECT, IMPAIR,
 OR INVALIDATE THE REMAINDER THEREOF, BUT SHALL BE CONFINED IN ITS OPERA-
 TION TO THE CLAUSE, SENTENCE, PARAGRAPH, SUBDIVISION,  SECTION  OR  PART
 THEREOF DIRECTLY INVOLVED IN THE CONTROVERSY IN WHICH THE JUDGMENT SHALL
 HAVE BEEN RENDERED.
    §  6.  Paragraph  (b)  of subdivision 7 of section 2802 of the public
 health law, as amended by section 87 of part C of chapter 58 of the laws
 of 2009, is amended to read as follows:
   (b) At such  time  as  the  commissioner's  written  approval  of  the
 construction  is  granted,  each applicant shall pay the following addi-
 tional fee:
   (i) for hospital, nursing home and  diagnostic  and  treatment  center
 applications  that  require  approval by the council, the additional fee
 shall be [fifty-five] SIXTY hundredths of one percent of the total capi-
 tal value of the application, provided  however  that  applications  for
 construction of a safety net diagnostic and treatment center, as defined
 in  paragraph (c) of subdivision sixteen of section twenty-eight hundred
 one-a of  this  article,  shall  be  subject  to  a  fee  of  forty-five
 hundredths of one percent of the total capital value of the application;
 and
   (ii)  for  hospital,  nursing home and diagnostic and treatment center
 applications that do not require approval by the council, the additional
 fee shall be [thirty] THIRTY-FIVE hundredths of one percent of the total
 capital value of the application, provided however that safety net diag-
 nostic and treatment center applications, as defined in paragraph (c) of
 subdivision sixteen of section twenty-eight hundred one-a of this  arti-
 cle,  shall be subject to a fee of twenty-five hundredths of one percent
 of the total capital value of the application.
   § 7. Section 3605 of the public health law is amended  by  adding  two
 new subdivisions 1-a and 1-b to read as follows:
   1-A.  CORE  PUBLIC  HEALTH SERVICES, AS DEFINED IN SECTION SIX HUNDRED
 TWO OF THIS CHAPTER, WHEN PROVIDED IN  THE  HOME  BY  THE  LOCAL  HEALTH
 DEPARTMENT  OF  A  COUNTY  OR OF THE CITY OF NEW YORK, SHALL NOT REQUIRE
 LICENSURE UNDER THIS SECTION, PROVIDED  THAT  SUCH  SERVICES  SHALL  NOT
 INCLUDE:  HOME  HEALTH AIDE SERVICES; PERSONAL CARE SERVICES; OR NURSING
 SERVICES THAT  REQUIRE  MORE  THAN  MINIMAL  PATIENT  CONTACT.  FOR  THE
 PURPOSES   OF  THIS  SUBDIVISION  THE  TERM  "MINIMAL  PATIENT  CONTACT"
 INCLUDES, BUT IS NOT LIMITED TO, PROVIDING ASSESSMENTS  OF  NEW  MOTHERS
 AND  INFANTS,  DIRECT  OBSERVATION,  AND LEAD SCREENING. PATIENT CONTACT
 SHALL BE CONSIDERED MORE THAN MINIMAL  IF  IT  REQUIRES  MORE  THAN  SIX
 PATIENT VISITS. CORE PUBLIC HEALTH SERVICES THAT MAY BE PROVIDED WITHOUT
 A  LICENSE  PURSUANT TO THIS SUBDIVISION INCLUDE BUT ARE NOT LIMITED TO:
 IMMUNIZATIONS; TESTING FOR TUBERCULOSIS AND OBSERVATION OF  TUBERCULOSIS
 S. 4007                            143                           A. 3007
 
 SELF-DIRECTED   THERAPY;  VERBAL  ASSESSMENT,  COUNSELING  AND  REFERRAL
 SERVICES; AND SUCH OTHER SERVICES AS MAY BE DETERMINED  BY  THE  DEPART-
 MENT.
   1-B.  CORE  PUBLIC  HEALTH SERVICES, AS DEFINED IN SECTION SIX HUNDRED
 TWO OF THIS CHAPTER, WHEN PROVIDED BY LOCAL HEALTH  DEPARTMENTS  IN  THE
 HOME  AS  AUTHORIZED  UNDER  SUBDIVISION  ONE-A  OF THIS SECTION, MAY BE
 ELIGIBLE FOR REIMBURSEMENT UNDER TITLE XIX OF THE FEDERAL SOCIAL SECURI-
 TY ACT PROVIDED THAT  THE  SERVICES  PROVIDED  MEET  FEDERAL  AND  STATE
 REQUIREMENTS FOR SUCH REIMBURSEMENT.
   §  8.  Subdivision  2  of  section  3611  of the public health law, as
 amended by section 66 of part A of chapter 58 of the laws  of  2010,  is
 amended to read as follows:
   2. The public health and health planning council shall not act upon an
 application  for  licensure  or a certificate of approval for any agency
 referred to in subdivision one of this section unless it is satisfied as
 to the character, competence  and  standing  in  the  community  of  the
 proposed  incorporators, directors, sponsors, controlling persons, prin-
 cipal stockholders of the parent corporation, health related  subsidiary
 corporation  and  the New York state corporation established pursuant to
 paragraph (a) of subdivision one  of  this  section.    STOCKHOLDERS  OR
 MEMBERS  OF THIRD LEVEL OR HIGHER ENTITIES THAT WILL EXERCISE NO CONTROL
 OF THE AGENCY FUNCTIONS SHALL  NOT  BE  CONSIDERED  CONTROLLING  PERSONS
 SUBJECT  TO  CHARACTER  AND COMPETENCY REVIEW PROVIDED THAT AN AFFIDAVIT
 STATING THAT SUCH INDIVIDUALS WILL EXERCISE NO CONTROL OVER  THE  AGENCY
 FUNCTIONS IS SIGNED BY SUCH INDIVIDUALS AND SUBMITTED TO THE DEPARTMENT.
 For  the  purposes of this section the public health and health planning
 council may adopt rules and regulations  relative  to  what  constitutes
 parent and subsidiary corporations.
   §  9.  This  act shall take effect immediately; provided, however that
 section five of this act shall take effect on the ninetieth day after it
 shall have become a law and shall apply  to  material  transactions,  as
 defined  by  section  4551  of the public health law as added by section
 five of this act, closing on or after April  1,  2024.  Effective  imme-
 diately, the addition, 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 N
 
   Section 1. Section 366 of the social services law is amended by adding
 a new subdivision 16 to read as follows:
   16. (A) THE COMMISSIONER OF HEALTH IS AUTHORIZED TO SUBMIT THE  APPRO-
 PRIATE  WAIVERS AND/OR ANY OTHER REQUIRED REQUESTS FOR FEDERAL APPROVAL,
 INCLUDING BUT NOT LIMITED TO, THOSE AUTHORIZED IN SECTION ELEVEN HUNDRED
 FIFTEEN OF THE FEDERAL  SOCIAL  SECURITY  ACT,  IN  ORDER  TO  ESTABLISH
 EXPANDED  MEDICAL  ASSISTANCE  ELIGIBILITY FOR WORKING DISABLED INDIVID-
 UALS. SUCH WAIVER APPLICATIONS SHALL BE EXECUTED CONSISTENT  WITH  PARA-
 GRAPHS  (B),  (C),  (D) AND (E) OF THIS SUBDIVISION, TO THE EXTENT THOSE
 SECTIONS COMPLY WITH THE REQUIREMENTS OF SECTION ELEVEN HUNDRED  FIFTEEN
 OF  THE FEDERAL SOCIAL SECURITY ACT.  NOTWITHSTANDING SUBPARAGRAPHS FIVE
 AND SIX OF PARAGRAPH (C) OF SUBDIVISION ONE OF THIS SECTION AND SUBDIVI-
 SION TWELVE OF SECTION THREE HUNDRED SIXTY-SEVEN-A OF THIS TITLE, OR ANY
 OTHER PROVISION OF LAW TO THE CONTRARY,  IF  GRANTED  SUCH  WAIVER,  THE
 COMMISSIONER OF HEALTH MAY AUTHORIZE ELIGIBLE PERSONS TO RECEIVE MEDICAL
 ASSISTANCE  PURSUANT TO THE WAIVER IF, FOR SO LONG AS, AND TO THE EXTENT
 THAT, FINANCIAL PARTICIPATION IS AVAILABLE THEREFOR. THE WAIVER APPLICA-
 S. 4007                            144                           A. 3007

 TION SHALL PROVIDE FOR THIRTY THOUSAND PERSONS TO BE ELIGIBLE TO PARTIC-
 IPATE IN SUCH WAIVER.
   (B) INDIVIDUALS ELIGIBLE FOR PARTICIPATION IN SUCH WAIVER SHALL:
   (I) BE A DISABLED INDIVIDUAL, DEFINED AS HAVING A MEDICALLY DETERMINA-
 BLE  IMPAIRMENT OF SUFFICIENT SEVERITY AND DURATION TO QUALIFY FOR BENE-
 FITS UNDER TITLES II OR XVI OF THE SOCIAL SECURITY ACT;
   (II) BE AT LEAST SIXTEEN YEARS OF AGE;
   (III) BE OTHERWISE ELIGIBLE FOR MEDICAL ASSISTANCE BENEFITS,  BUT  FOR
 EARNINGS AND/OR RESOURCES IN EXCESS OF THE ALLOWABLE LIMIT;
   (IV) HAVE NET AVAILABLE INCOME, DETERMINED IN ACCORDANCE WITH SUBDIVI-
 SION  TWO OF THIS SECTION, THAT DOES NOT EXCEED TWO THOUSAND TWO HUNDRED
 FIFTY PERCENT OF THE APPLICABLE FEDERAL POVERTY  LINE,  AS  DEFINED  AND
 UPDATED BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES;
   (V)  HAVE 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 THREE HUNDRED THOUSAND DOLLARS;
   (VI) CONTRIBUTE TO THE COST OF MEDICAL ASSISTANCE PROVIDED PURSUANT TO
 THIS PARAGRAPH IN ACCORDANCE WITH PARAGRAPH (D) OF THIS SUBDIVISION; AND
   (VII)  MEET  SUCH  OTHER CRITERIA AS MAY BE ESTABLISHED BY THE COMMIS-
 SIONER AS MAY BE NECESSARY TO ADMINISTER THE PROVISIONS OF THIS SUBDIVI-
 SION IN AN EQUITABLE MANNER.
   (C) AN INDIVIDUAL AT LEAST SIXTEEN YEARS  OF  AGE  WHO:  IS  EMPLOYED;
 CEASES TO BE ELIGIBLE FOR PARTICIPATION IN SUCH WAIVER PURSUANT TO PARA-
 GRAPH  (B)  OF THIS SUBDIVISION BECAUSE THE PERSON, BY REASON OF MEDICAL
 IMPROVEMENT, IS DETERMINED AT THE TIME OF A REGULARLY SCHEDULED CONTINU-
 ING DISABILITY REVIEW TO NO LONGER BE CERTIFIED AS  DISABLED  UNDER  THE
 SOCIAL  SECURITY  ACT; CONTINUES TO HAVE A SEVERE MEDICALLY DETERMINABLE
 IMPAIRMENT, TO BE DETERMINED IN ACCORDANCE WITH APPLICABLE FEDERAL REGU-
 LATIONS; AND CONTRIBUTES TO THE  COST  OF  MEDICAL  ASSISTANCE  PROVIDED
 PURSUANT  TO  THIS  PARAGRAPH  IN  ACCORDANCE WITH PARAGRAPH (D) OF THIS
 SUBDIVISION, SHALL BE ELIGIBLE FOR PARTICIPATION  IN  SUCH  WAIVER.  FOR
 PURPOSES OF THIS PARAGRAPH, A PERSON IS CONSIDERED TO BE EMPLOYED IF THE
 PERSON IS EARNING AT LEAST THE APPLICABLE MINIMUM WAGE UNDER SECTION SIX
 OF THE FEDERAL FAIR LABOR STANDARDS ACT AND WORKING AT LEAST FORTY HOURS
 PER MONTH.
   (D)  PRIOR  TO RECEIVING MEDICAL ASSISTANCE PURSUANT TO SUCH WAIVER, A
 PERSON WHOSE NET AVAILABLE INCOME  IS  GREATER  THAN  OR  EQUAL  TO  TWO
 HUNDRED FIFTY PERCENT OF THE APPLICABLE FEDERAL POVERTY LINE SHALL PAY A
 MONTHLY PREMIUM, IN ACCORDANCE WITH A PROCEDURE TO BE ESTABLISHED BY THE
 COMMISSIONER.  THE  AMOUNT OF SUCH PREMIUM FOR A PERSON WHOSE NET AVAIL-
 ABLE INCOME IS GREATER THAN OR EQUAL TO TWO HUNDRED FIFTY PERCENT OF THE
 APPLICABLE FEDERAL POVERTY LINE, BUT LESS THAN THREE HUNDRED PERCENT  OF
 THE  APPLICABLE  FEDERAL  POVERTY LINE SHALL BE THREE HUNDRED AND FORTY-
 SEVEN DOLLARS. THE AMOUNT OF SUCH PREMIUM FOR A PERSON WHOSE NET  AVAIL-
 ABLE  INCOME  IS  GREATER  THAN OR EQUAL TO THREE HUNDRED PERCENT OF THE
 APPLICABLE FEDERAL POVERTY LINE, BUT LESS THAN FOUR HUNDRED  PERCENT  OF
 THE  APPLICABLE  FEDERAL  POVERTY  LINE  SHALL  BE FIVE HUNDRED EIGHTEEN
 DOLLARS. THE AMOUNT OF SUCH PREMIUM FOR A  PERSON  WHOSE  NET  AVAILABLE
 INCOME  IS GREATER THAN OR EQUAL TO FOUR HUNDRED PERCENT OF THE APPLICA-
 BLE FEDERAL POVERTY LINE, BUT LESS THAN  FIVE  HUNDRED  PERCENT  OF  THE
 APPLICABLE  FEDERAL POVERTY LINE SHALL BE SEVEN HUNDRED AND SEVENTY-NINE
 DOLLARS. THE AMOUNT OF SUCH PREMIUM FOR A  PERSON  WHOSE  NET  AVAILABLE
 INCOME  IS EQUAL TO OR GREATER THAN FIVE HUNDRED PERCENT OF THE APPLICA-
 BLE FEDERAL POVERTY LINE SHALL BE ONE THOUSAND FOUR HUNDRED  AND  FORTY-
 EIGHT  DOLLARS.  NO  PREMIUM  SHALL  BE REQUIRED FROM A PERSON WHOSE NET
 S. 4007                            145                           A. 3007
 
 AVAILABLE INCOME IS LESS THAN TWO HUNDRED FIFTY PERCENT OF THE  APPLICA-
 BLE FEDERAL POVERTY LINE.
   (E)  NOTWITHSTANDING  ANY OTHER PROVISION OF THIS SECTION OR ANY OTHER
 LAW TO THE CONTRARY, FOR  PURPOSES  OF  DETERMINING  MEDICAL  ASSISTANCE
 ELIGIBILITY FOR PERSONS SPECIFIED IN PARAGRAPH (B) OR (C) OF THIS SUBDI-
 VISION,  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.
   § 2. This act shall take effect on January 1, 2025.
 
                                  PART O
 
   Section 1. Subdivisions 1, 15, 16, 17 and 18 of section 1399-aa of the
 public health law, subdivision 1 as amended by chapter 13 of the laws of
 2003, subdivisions 15, 16, 17 and 18 as added by section 2 of part EE of
 chapter  56 of the laws of 2020, are amended and two new subdivisions 19
 and 20 are added to read as follows:
   1. "Enforcement officer"  means  the  enforcement  officer  designated
 pursuant  to  article thirteen-E of this chapter to enforce such article
 and hold hearings pursuant thereto; provided that in a city with a popu-
 lation of more than one million it shall also mean an officer or employ-
 ee or any agency of such city that is authorized to  enforce  any  local
 law  of  such  city related to the regulation of the sale of CIGARETTES,
 tobacco products, OR VAPOR PRODUCTS to minors.
   15. "Listed or non-discounted price" means the price listed for  ciga-
 rettes,  tobacco  products,  or  vapor  products [intended or reasonably
 expected to be used with or for the consumption of nicotine,]  on  their
 packages or any related shelving, posting, advertising or display at the
 location  where  the  cigarettes,  tobacco  products,  or vapor products
 [intended or reasonably expected to be used with or for the  consumption
 of  nicotine,]  are  sold  or offered for sale, including all applicable
 taxes.
   16. "Retail dealer" means a person licensed  by  the  commissioner  of
 taxation  and  finance  to  sell  cigarettes, tobacco products, or vapor
 products [in this state], OR A PERSON OR  BUSINESS  REQUIRED  TO  OBTAIN
 SUCH LICENSE.
   17.  "Vapor  products" means any noncombustible liquid or gel, regard-
 less of the presence of nicotine therein, that is  manufactured  into  a
 finished  product  for  use  in an electronic [cigarette, including any]
 device THAT DELIVERS VAPOR  WHICH  IS  INHALED,  INCLUDING  ANY  REFILL,
 CARTRIDGE,  DEVICE  OR COMPONENT THEREOF that contains OR IS INTENDED TO
 BE USED WITH such noncombustible liquid or gel.  "Vapor  product"  shall
 not  include any device, or any component thereof, that does not contain
 such noncombustible liquid or gel, or any product approved by the United
 States [food and drug administration] FOOD AND DRUG ADMINISTRATION as  a
 drug or medical device, or manufactured and dispensed pursuant to [title
 five-A  of  article thirty-three of this chapter] ARTICLE THREE, FOUR OR
 FIVE OF THE CANNABIS LAW.
   18. "Vapor products dealer" means a person licensed by the commission-
 er of taxation and finance to sell vapor products [in this state], OR  A
 PERSON OR BUSINESS REQUIRED TO OBTAIN SUCH LICENSE.
   19.  "TOBACCO  OR  VAPOR  SELLER" MEANS A PERSON, SOLE PROPRIETORSHIP,
 CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP OR OTHER  ENTERPRISE
 THAT MANUFACTURES, DISTRIBUTES, SELLS OR OFFERS TO SELL, WHETHER THROUGH
 RETAIL OR WHOLESALE, OR EXCHANGES OR OFFERS TO EXCHANGE, FOR ANY FORM OF
 CONSIDERATION,  CIGARETTES,  TOBACCO  PRODUCTS,  OR VAPOR PRODUCTS. THIS
 S. 4007                            146                           A. 3007
 
 DEFINITION IS WITHOUT REGARD TO  THE  QUANTITY  OF  CIGARETTES,  TOBACCO
 PRODUCTS, OR VAPOR PRODUCTS MANUFACTURED, DISTRIBUTED, SOLD, OFFERED FOR
 SALE, EXCHANGED, OR OFFERED FOR EXCHANGE.
   20.  "SMOKING PARAPHERNALIA" MEANS ANY PIPE, WATER PIPE, HOOKAH, ROLL-
 ING PAPERS, VAPORIZER  OR  ANY  OTHER  DEVICE,  EQUIPMENT  OR  APPARATUS
 DESIGNED FOR THE INHALATION OF TOBACCO.
   §  2.    Subdivisions  1, 1-a, 2, 3, 4 and 5 of section 1399-bb of the
 public health law, subdivisions 1, 2, 3, 4 and 5 as amended and subdivi-
 sion 1-a as added by section 4 of part EE of chapter 56 of the  laws  of
 2020, are amended to read as follows:
   1.  No  retail  dealer,  or  any  agent  or employee of [a] ANY retail
 dealer, engaged in the business of  selling  or  otherwise  distributing
 tobacco  products, vapor products [intended or reasonably expected to be
 used with or for the consumption of nicotine], or herbal cigarettes  for
 commercial purposes[, or any agent or employee of such retail dealer, or
 any  agent or employee of a retail dealer], shall knowingly, in further-
 ance of such business:
   (a) distribute without charge any  tobacco  products,  vapor  products
 [intended  or reasonably expected to be used with or for the consumption
 of nicotine], or herbal cigarettes to any individual, provided that  the
 distribution  of  a  package containing tobacco products, vapor products
 [intended or reasonably expected to be used with or for the  consumption
 of  nicotine],  or  herbal  cigarettes  in violation of this subdivision
 shall constitute a single violation without  regard  to  the  number  of
 items in the package; or
   (b)  distribute  price  reduction instruments which are redeemable for
 tobacco products, vapor products [intended or reasonably expected to  be
 used  with  or for the consumption of nicotine], or herbal cigarettes to
 any individual, provided  that  this  subdivision  shall  not  apply  to
 coupons  contained  in  newspapers, magazines or other types of publica-
 tions, coupons obtained through the purchase of tobacco products,  vapor
 products  [intended  or  reasonably  expected to be used with or for the
 consumption of nicotine], or herbal cigarettes or obtained at  locations
 which  sell  tobacco  products,  vapor  products [intended or reasonably
 expected to be used with or for the consumption of nicotine], or  herbal
 cigarettes  provided  that such distribution is confined to a designated
 area or to coupons sent through the mail.
   1-a. No retail dealer engaged in the business of selling or  otherwise
 distributing  tobacco  products,  herbal  cigarettes,  or vapor products
 [intended or reasonably expected to be used with or for the  consumption
 of  nicotine]  for commercial purposes, or any agent or employee of such
 retail dealer, shall knowingly, in furtherance of such business:
   (a) honor or accept a price reduction instrument  in  any  transaction
 related  to  the  sale  of tobacco products, herbal cigarettes, or vapor
 products [intended or reasonably expected to be used  with  or  for  the
 consumption of nicotine] to a consumer;
   (b) sell or offer for sale any tobacco products, herbal cigarettes, or
 vapor  products  [intended or reasonably expected to be used with or for
 the consumption of nicotine] to a  consumer  through  any  multi-package
 discount or otherwise provide to a consumer any tobacco products, herbal
 cigarettes,  or  vapor  products  [intended or reasonably expected to be
 used with or for the consumption of nicotine] for less than  the  listed
 price  or non-discounted price in exchange for the purchase of any other
 tobacco products, herbal cigarettes,  or  vapor  products  [intended  or
 reasonably  expected to be used with or for the consumption of nicotine]
 by such consumer;
 S. 4007                            147                           A. 3007
 
   (c) sell, offer for sale, or otherwise provide any product other  than
 a  tobacco  product,  herbal  cigarette,  or  vapor product [intended or
 reasonably expected to be used with or for the consumption of  nicotine]
 to  a consumer for less than the listed price or non-discounted price in
 exchange  for  the  purchase  of a tobacco product, herbal cigarette, or
 vapor product [intended or reasonably expected to be used  with  or  for
 the consumption of nicotine] by such consumer; or
   (d)  sell,  offer  for  sale,  or otherwise provide a tobacco product,
 herbal cigarette, or vapor product [intended or reasonably  expected  to
 be  used with or for the consumption of nicotine] to a consumer for less
 than the listed price or non-discounted price.
   2. The prohibitions contained in subdivision one of this section shall
 not apply to the following locations:
   (a) private social functions when seating arrangements are  under  the
 control  of  the  sponsor  of  the function and not the owner, operator,
 manager or person in charge of such indoor area;
   (b) conventions and trade shows; provided  that  the  distribution  is
 confined  to  designated areas generally accessible only to persons over
 the age of twenty-one;
   (c) events sponsored by tobacco, vapor product [intended or reasonably
 expected to be used with or for the consumption of nicotine], or  herbal
 cigarette  manufacturers  provided  that the distribution is confined to
 designated areas generally accessible only to persons over  the  age  of
 twenty-one;
   (d)  bars  as  defined  in subdivision one of section thirteen hundred
 ninety-nine-n of this chapter;
   (e) tobacco businesses as defined  in  subdivision  eight  of  section
 thirteen hundred ninety-nine-aa of this article;
   (f)  factories  as  defined  in  subdivision  nine of section thirteen
 hundred ninety-nine-aa of this article and construction sites;  provided
 that the distribution is confined to designated areas generally accessi-
 ble only to persons over the age of twenty-one.
   3.  No retail dealer shall distribute tobacco products, vapor products
 [intended or reasonably expected to be used with or for the  consumption
 of  nicotine],  or herbal cigarettes at the locations set forth in para-
 graphs (b), (c) and (f) of subdivision two of this section  unless  such
 person gives five days written notice to the enforcement officer.
   4.  No  retail  dealer engaged in the business of selling or otherwise
 distributing [electronic cigarettes  or]  vapor  products  [intended  or
 reasonably  expected to be used with or for the consumption of nicotine]
 for commercial purposes, or any agent or employee of such person,  shall
 knowingly,  in  furtherance  of such business, distribute without charge
 any [electronic cigarettes] VAPOR PRODUCTS to any individual under twen-
 ty-one years of age.
   5. The distribution  of  tobacco  products,  [electronic  cigarettes,]
 vapor  products  [intended or reasonably expected to be used with or for
 the consumption of nicotine], or herbal cigarettes pursuant to  subdivi-
 sion  two  of  this section or the distribution without charge of [elec-
 tronic cigarettes, or] vapor products [intended or  reasonably  expected
 to  be used with or for the consumption of nicotine], shall be made only
 to an individual who demonstrates, through (a)  a  driver's  license  or
 non-driver identification card issued by the commissioner of motor vehi-
 cles, the federal government, any United States territory, commonwealth,
 or  possession,  the District of Columbia, a state government within the
 United States, or a provincial government of the dominion of Canada, (b)
 a valid passport issued by the United States government or  the  govern-
 S. 4007                            148                           A. 3007
 
 ment  of  any other country, or (c) an identification card issued by the
 armed forces of the United States, indicating that the individual is  at
 least  twenty-one years of age. Such identification need not be required
 of  any  individual  who  reasonably  appears to be at least twenty-five
 years of age; provided, however, that such appearance shall not  consti-
 tute a defense in any proceeding alleging the sale of a tobacco product,
 [electronic  cigarette,]  vapor product [intended or reasonably expected
 to be used with or for the consumption of nicotine], or herbal cigarette
 or the distribution without charge of [electronic cigarettes, or]  vapor
 products  [intended  or  reasonably  expected to be used with or for the
 consumption of nicotine to an individual].
   § 3. The section heading and subdivisions 1, 2, 3, 4 and 7 of  section
 1399-cc  of  the  public health law, the section heading, subdivisions 1
 and 4 as amended by chapter 542 of the laws of 2014, subdivisions  2,  3
 and 7 as amended by chapter 100 of the laws of 2019, are amended to read
 as follows:
   Sale  of  tobacco  products,  herbal  cigarettes,  [liquid  nicotine,]
 shisha, [rolling papers or] smoking paraphernalia, OR VAPOR PRODUCTS  to
 minors prohibited. 1. As used in this section:
   (a)  "A  device  capable  of  deciphering  any electronically readable
 format" or "device" shall mean any commercial device or  combination  of
 devices  used at a point of sale or entry that is capable of reading the
 information encoded on the bar code or  magnetic  strip  of  a  driver's
 license  or  non-driver  identification card issued by the state commis-
 sioner of motor vehicles;
   (b) "Card holder" means any person presenting a  driver's  license  or
 non-driver identification card to a licensee, or to the agent or employ-
 ee of such licensee under this chapter;
   (c) ["Smoking paraphernalia" means any pipe, water pipe, hookah, roll-
 ing  papers,  vaporizer  or  any  other  device,  equipment or apparatus
 designed for the inhalation of tobacco;
   (d)] "Transaction scan" means the process involving an  automated  bar
 code  reader  by  which  a  licensee, or agent or employee of a licensee
 under this chapter reviews a driver's license or non-driver  identifica-
 tion  card  presented  as a precondition for the purchase of [a] tobacco
 [product] PRODUCTS, VAPOR PRODUCTS, or  herbal  cigarettes  pursuant  to
 subdivision three of this section; and
   [(e)] (D) "Liquid nicotine", "electronic liquid" or "e-liquid" means a
 liquid  composed of nicotine and other chemicals, and which is sold as a
 product that may be used in an electronic cigarette.
   2. Any person operating a place of business wherein tobacco  products,
 herbal  cigarettes, [liquid nicotine,] shisha or [electronic cigarettes]
 VAPOR PRODUCTS, are sold or offered for sale is prohibited from  selling
 such  TOBACCO  OR  VAPOR products, herbal cigarettes, [liquid nicotine,]
 shisha, [electronic cigarettes] or smoking paraphernalia to  individuals
 under  twenty-one  years of age, and shall post in a conspicuous place a
 sign upon which there shall be imprinted the following statement,  "SALE
 OF  CIGARETTES, CIGARS, CHEWING TOBACCO, POWDERED TOBACCO, SHISHA, VAPOR
 PRODUCTS, OR OTHER TOBACCO PRODUCTS, HERBAL  CIGARETTES,  [LIQUID  NICO-
 TINE,  ELECTRONIC  CIGARETTES, ROLLING PAPERS] OR SMOKING PARAPHERNALIA,
 TO PERSONS UNDER TWENTY-ONE YEARS OF AGE IS  PROHIBITED  BY  LAW."  Such
 sign  shall  be printed on a white card in red letters at least one-half
 inch in height.
   3. Sale of tobacco products,  herbal  cigarettes,  [liquid  nicotine,]
 shisha  [or  electronic  cigarettes],  OR VAPOR PRODUCTS in such places,
 other than by a vending machine, shall be made only to an individual who
 S. 4007                            149                           A. 3007
 
 demonstrates, through (a) a valid driver's license or non-driver's iden-
 tification card issued by the commissioner of motor vehicles, the feder-
 al government, any United States territory, commonwealth or  possession,
 the District of Columbia, a state government within the United States or
 a  provincial government of the dominion of Canada, or (b) a valid pass-
 port issued by the United States government or any other country, or (c)
 an identification card issued by the armed forces of the United  States,
 indicating that the individual is at least twenty-one years of age. Such
 identification  need  not  be  required of any individual who reasonably
 appears to be at least twenty-five years of age, provided, however, that
 such appearance shall not constitute a defense in any proceeding  alleg-
 ing  the sale of [a] tobacco [product,] PRODUCTS, VAPOR PRODUCTS, herbal
 cigarettes, [liquid nicotine,] OR shisha [or electronic  cigarettes]  to
 an individual under twenty-one years of age.
   4.  (a)  Any  person  operating  a  place  of business wherein tobacco
 products, VAPOR  PRODUCTS,  herbal  cigarettes,  [liquid  nicotine,]  OR
 shisha  [or  electronic  cigarettes]  are  sold  or offered for sale may
 perform a transaction scan as a precondition for such purchases.
   (b) In any instance where the information  deciphered  by  the  trans-
 action  scan  fails  to  match  the  information printed on the driver's
 license or non-driver identification card, or if  the  transaction  scan
 indicates  that  the  information  is false or fraudulent, the attempted
 transaction shall be denied.
   (c) In any proceeding pursuant to  section  thirteen  hundred  ninety-
 nine-ee  of  this  article, it shall be an affirmative defense that such
 person had produced a driver's license or non-driver identification card
 apparently issued by a governmental entity, successfully completed  that
 transaction  scan,  and  that the tobacco product, VAPOR PRODUCT, herbal
 cigarettes or [liquid nicotine] SHISHA had been sold, delivered or given
 to such person in reasonable reliance upon such identification and tran-
 saction scan.  In  evaluating  the  applicability  of  such  affirmative
 defense the commissioner shall take into consideration any written poli-
 cy adopted and implemented by the seller to effectuate the provisions of
 this  chapter.  Use  of  a  transaction scan shall not excuse any person
 operating a place of business wherein tobacco products,  VAPOR  PRODUCT,
 herbal  cigarettes,  [liquid  nicotine,]  OR shisha [or electronic ciga-
 rettes] are sold, or the agent or employee  of  such  person,  from  the
 exercise  of  reasonable  diligence  otherwise required by this chapter.
 Notwithstanding the above provisions, any such affirmative defense shall
 not be applicable in any civil or criminal proceeding, or in  any  other
 forum.
   7.  No  person operating a place of business wherein tobacco products,
 VAPOR PRODUCTS, herbal cigarettes,  [liquid  nicotine,]  OR  shisha  [or
 electronic  cigarettes]  are sold or offered for sale shall sell, permit
 to be sold, offer for sale or display  for  sale  any  tobacco  product,
 VAPOR PRODUCT, herbal cigarettes, [liquid nicotine,] OR shisha [or elec-
 tronic  cigarettes]  in  any manner, unless such products and cigarettes
 are stored for sale (a) behind a counter in an area accessible  only  to
 the  personnel of such business, or (b) in a locked container; provided,
 however, such restriction shall not  apply  to  tobacco  businesses,  as
 defined  in subdivision eight of section thirteen hundred ninety-nine-aa
 of this article, and to places  to  which  admission  is  restricted  to
 persons twenty-one years of age or older.
   §  4.  Section 1399-dd of the public health law, as amended by chapter
 448 of the laws of 2012, subdivision (d) as amended by  chapter  100  of
 the laws of 2019, is amended to read as follows:
 S. 4007                            150                           A. 3007
 
   §  1399-dd. Sale of tobacco products, herbal cigarettes or [electronic
 cigarettes] VAPOR PRODUCTS in vending machines. No person,  firm,  part-
 nership,  company  or  corporation shall operate a vending machine which
 dispenses tobacco products, herbal cigarettes or [electronic cigarettes]
 VAPOR  PRODUCTS  unless such machine is located: (a) in a bar as defined
 in subdivision one of section thirteen  hundred  ninety-nine-n  of  this
 chapter,  or  the bar area of a food service establishment with a valid,
 on-premises full liquor license; (b) in a private club; (c) in a tobacco
 business as defined in subdivision eight  of  section  thirteen  hundred
 ninety-nine-aa  of  this  article; or (d) in a place of employment which
 has an insignificant portion  of  its  regular  workforce  comprised  of
 people under the age of twenty-one years and only in such locations that
 are  not  accessible  to  the general public; provided, however, that in
 such locations the vending machine is located in plain  view  and  under
 the  direct  supervision  and  control  of  the  person in charge of the
 location or [his or her] THEIR designated agent or employee.
   § 5. The section heading and subdivisions 1 and 2 of section 1399-dd-1
 of the public health law, as added by section 13 of part EE  of  chapter
 56 of the laws of 2020, are amended to read as follows:
   Public display of tobacco AND VAPOR product [and electronic cigarette]
 advertisements  and smoking paraphernalia prohibited. 1. For purposes of
 this section[:
   (a) "Advertisement"] "ADVERTISEMENT"  means  words,  pictures,  photo-
 graphs,  symbols, graphics or visual images of any kind, or any combina-
 tion thereof, which bear a health warning required by  federal  statute,
 the  purpose  or effect of which is to identify a brand of a tobacco  OR
 VAPOR product, [electronic  cigarette,  or  vapor  product  intended  or
 reasonably expected to be used with or for the consumption of nicotine],
 a  trademark  of  a  tobacco OR VAPOR product, [electronic cigarette, or
 vapor product intended or reasonably expected to be used with or for the
 consumption of nicotine or] a trade name associated exclusively  with  a
 tobacco  OR  VAPOR  product,  [electronic  cigarette,  or  vapor product
 intended or reasonably expected to be used with or for  the  consumption
 of  nicotine]  or to promote the use or sale of a tobacco OR VAPOR prod-
 uct[, electronic cigarette, or  vapor  product  intended  or  reasonably
 expected to be used with or for the consumption of nicotine.
   (b)  "Smoking paraphernalia" means any pipe, water pipe, hookah, roll-
 ing papers, electronic cigarette, vaporizer or any other device,  equip-
 ment or apparatus designed for the inhalation of tobacco or nicotine.
   (c)  "Vapor  product"  means  any vapor product, as defined by section
 thirteen hundred ninety-nine-aa of this article, intended or  reasonably
 expected to be used with or for the consumption of nicotine.
   (d)  "Tobacco  products" shall have the same meaning as in subdivision
 five of section thirteen hundred ninety-nine-aa of this article.
   (e) "Electronic cigarette" shall have the same meaning as in  subdivi-
 sion  thirteen  of section thirteen hundred ninety-nine-aa of this arti-
 cle].
   2. (a) No person, corporation, partnership, sole  proprietor,  limited
 partnership,  association  or any other business entity may place, cause
 to be placed, maintain or to cause to be maintained,  smoking  parapher-
 nalia  [or],  tobacco  product, [electronic cigarette,] or vapor product
 [intended or reasonably expected to be used with or for the  consumption
 of  nicotine]  advertisements in a store front or exterior window or any
 door which is used for entry or egress by the public to the building  or
 structure  containing  a  place  of  business  within  one thousand five
 S. 4007                            151                           A. 3007
 
 hundred feet of a school, provided that within New York city such prohi-
 bitions shall only apply within five hundred feet of a school.
   (b)  Any  person,  corporation,  partnership, sole proprietor, limited
 partnership, association or any other business entity  in  violation  of
 this  section  shall be subject to a civil penalty of not more than five
 hundred dollars for a first violation and not  more  than  one  thousand
 dollars for a second or subsequent violation.
   §  6.  Subdivisions 2, 3 and 4 of section 1399-ee of the public health
 law, subdivision 2 and paragraphs  (e)  and  (f)  of  subdivision  3  as
 amended  by  section  6 of part EE of chapter 56 of the laws of 2020 and
 subdivisions 3 and 4 as amended by chapter 162 of the laws of 2002,  are
 amended to read as follows:
   2.  If  the  enforcement  officer  determines  after  a hearing that a
 violation of this article has occurred, [he or she] OR THAT A  STATE  OR
 LOCAL  HEALTH OFFICIAL WAS DENIED ACCESS TO A RETAIL STORE INCLUDING ALL
 PRODUCT DISPLAY AND STORAGE AREAS, FOR THE PURPOSE OF EVALUATING COMPLI-
 ANCE WITH THIS ARTICLE, THEY shall impose a civil penalty of  a  minimum
 of  three  hundred  dollars, but not to exceed one thousand five hundred
 dollars for a first violation, and a minimum of  one  thousand  dollars,
 but  not to exceed two thousand five hundred dollars for each subsequent
 violation, unless a different penalty  is  otherwise  provided  in  this
 article.  The  enforcement  officer  shall advise the retail dealer that
 upon the accumulation of three or more points pursuant to  this  section
 the department of taxation and finance shall suspend the dealer's regis-
 tration.  If  the  enforcement officer determines after a hearing that a
 retail dealer was selling tobacco OR VAPOR products while  their  regis-
 tration  was  suspended  or  permanently revoked pursuant to subdivision
 three or four of this section, [he or she] THEY  shall  impose  a  civil
 penalty of twenty-five hundred dollars.
   3.  (a)  Imposition  of points. If the enforcement officer determines,
 after a hearing, that the retail dealer violated subdivision  [one]  TWO
 of  section thirteen hundred ninety-nine-cc of this article with respect
 to a prohibited sale to a minor, [he or she] THEY shall, in addition  to
 imposing  any  other  penalty  required  or  permitted  pursuant to this
 section, assign two points to the retail dealer's record where the indi-
 vidual who committed  the  violation  did  not  hold  a  certificate  of
 completion from a state certified tobacco sales training program and one
 point where the retail dealer demonstrates that the person who committed
 the  violation  held  a certificate of completion from a state certified
 tobacco sales training program.
   (b) Revocation. If the enforcement officer determines, after  a  hear-
 ing,  that a retail dealer has violated this article four times within a
 three year time frame [he or she] THEY shall, in  addition  to  imposing
 any  other  penalty  required  or  permitted by this section, direct the
 commissioner of taxation and finance to revoke the dealer's registration
 for one year.
   (c) Duration of points. Points assigned to a  retail  dealer's  record
 shall  be  assessed  for  a period of thirty-six months beginning on the
 first day of the month following the assignment of points.
   (d) Reinspection. Any retail dealer who is assigned points pursuant to
 paragraph (a) of this subdivision shall  be  reinspected  at  least  two
 times  a  year  by  the  enforcement  officer  until points assessed are
 removed from the retail dealer's record.
   (e) Suspension. If the department determines that a retail dealer  has
 accumulated  three  points  or  more,  the  department  shall direct the
 commissioner of taxation and finance to suspend such dealer's  registra-
 S. 4007                            152                           A. 3007
 
 tion  for  one year. The three points serving as the basis for a suspen-
 sion shall be erased upon the completion of the one year penalty.
   (f) Surcharge. A two hundred fifty dollar surcharge to be assessed for
 every violation will be made available to enforcement officers and shall
 be  used  solely  for  compliance  checks  to  be conducted to determine
 compliance with this section.
   4. (a) If the enforcement officer determines, after a hearing, that  a
 retail  dealer  has  violated  this article while their registration was
 suspended pursuant to subdivision three of this section, [he or she] THE
 ENFORCEMENT OFFICER shall, in addition to  imposing  any  other  penalty
 required  or permitted by this section, direct the commissioner of taxa-
 tion and finance to permanently revoke the dealer's registration and not
 permit the dealer to obtain a new registration.
   (b) If the enforcement officer determines, after  a  hearing,  that  a
 vending  machine operator has violated this article three times within a
 two year period, or four or more times cumulatively  [he  or  she]  THEY
 shall,  in  addition to imposing any other penalty required or permitted
 by this section, direct the commissioner  of  taxation  and  finance  to
 suspend the vendor's registration for one year and not permit the vendor
 to obtain a new registration for such period.
   §  7.  Subdivision  1  of section 1399-ff of the public health law, as
 amended by chapter 100 of the laws  of  2019,  is  amended  to  read  as
 follows:
   1.  Where  a  civil  penalty  for  a  particular incident has not been
 imposed or an enforcement action regarding an alleged  violation  for  a
 particular  incident is not pending under section thirteen hundred nine-
 ty-nine-ee of this article, a parent or guardian of a person under twen-
 ty-one years of age to whom  tobacco  products,  herbal  cigarettes  [or
 electronic  cigarettes],  OR  VAPOR  PRODUCTS are sold or distributed in
 violation of this article may submit a complaint to an enforcement offi-
 cer setting forth the name and address of the alleged violator, the date
 of the alleged violation, the name and address of  the  complainant  and
 the person under twenty-one years of age, and a brief statement describ-
 ing  the  alleged  violation.  The  enforcement officer shall notify the
 alleged  violator  by  certified  or  registered  mail,  return  receipt
 requested, that a complaint has been submitted, and shall set a date, at
 least  fifteen  days  after the mailing of such notice, for a hearing on
 the complaint.  Such notice shall contain the information  submitted  by
 the complainant.
   §  8.  Subdivision  1  of section 1399-gg of the public health law, as
 amended by chapter 513 of the laws  of  2004,  is  amended  to  read  as
 follows:
   1.  All  tobacco cigarettes OR VAPOR PRODUCTS sold or offered for sale
 by a retail dealer shall be sold or offered for  sale  in  the  package,
 box,  carton  or other container provided by the manufacturer, importer,
 or packager which bears all health warnings required by applicable law.
   § 9.  The opening paragraph and subdivision 3 of  section  1399-hh  of
 the  public health law, as amended by section 8 of part EE of chapter 56
 of the laws of 2020, are amended to read as follows:
   The commissioner shall develop, plan  and  implement  a  comprehensive
 program  to  reduce  the  prevalence of tobacco [use, and vapor product,
 intended or reasonably expected to be used with or for  the  consumption
 of nicotine,] AND VAPOR PRODUCT use particularly among persons less than
 twenty-one  years of age. This program shall include, but not be limited
 to, support for enforcement of this article.
 S. 4007                            153                           A. 3007
 
   3. Monies made available to  enforcement  officers  pursuant  to  this
 section  shall  only  be  used  for  local  tobacco  and vapor product[,
 intended or reasonably expected to be used with or for  the  consumption
 of nicotine,] enforcement activities approved by the commissioner.
   §  10.   Subdivision 2 of section 1399-ii of the public health law, as
 amended by section 12 of part EE of chapter 56 of the laws of  2020,  is
 amended to read as follows:
   2.  The  department  shall  support  tobacco  and  vapor  product  use
 prevention and control activities including, but not limited to:
   (a) Community programs to prevent and reduce tobacco use through local
 involvement and partnerships;
   (b) School-based programs to prevent and reduce tobacco use and use of
 vapor products;
   (c) Marketing and advertising to discourage tobacco AND vapor  product
 [and liquid nicotine] use;
   (d) Nicotine cessation programs for youth and adults;
   (e)  Special  projects to reduce the disparities in smoking prevalence
 among various populations;
   (f)  Restriction  of  youth  access  to  tobacco  products  and  vapor
 products;
   (g) Surveillance of smoking and vaping rates; and
   (h)  Any  other activities determined by the commissioner to be neces-
 sary to implement the provisions of this section.
   Such programs shall be selected by the commissioner through an  appli-
 cation process which takes into account whether a program utilizes meth-
 ods  recognized  as  effective  in  reducing [nicotine] TOBACCO OR VAPOR
 PRODUCT use. Eligible applicants may include, but not be limited  to,  a
 health  care  provider, schools, a college or university, a local public
 health department, a public health organization, a health care  provider
 organization,  association  or  society,  municipal  corporation,  or  a
 professional education organization.
   § 11.  Section 1399-ii-1 of the public health law, as added by section
 11 of part EE of chapter 56 of the laws of 2020, is amended to  read  as
 follows:
   §   1399-ii-1.   [Electronic   cigarette  and  vaping]  VAPOR  PRODUCT
 prevention, awareness and control program. The  commissioner  shall,  in
 consultation  and  collaboration  with  the  commissioner  of education,
 establish and develop [an electronic cigarette and vaping] A VAPOR PROD-
 UCT prevention, control and awareness  program  within  the  department.
 Such  program  shall be designed to educate students, parents and school
 personnel about the health risks associated with vapor product  use  and
 control  measures to reduce the prevalence of vaping, particularly among
 persons less than twenty-one years of age.  Such program shall  include,
 but  not  be  limited  to, the creation of age-appropriate instructional
 tools and materials that may be used by all schools, and  marketing  and
 advertising materials to discourage [electronic cigarette] VAPOR PRODUCT
 use.
   § 12.  Subdivisions 1, 2 and 3 of section 1399-jj of the public health
 law,  as  amended  by  section 9 of part EE of chapter 56 of the laws of
 2020, are amended to read as follows:
   1. The commissioner shall evaluate the effectiveness of the efforts by
 state and local governments to reduce the use of  tobacco  products  and
 vapor  products[, intended or reasonably expected to be used with or for
 the consumption of nicotine,] among minors  and  adults.  The  principal
 measurements  of  effectiveness  shall include negative attitudes toward
 tobacco and vapor products[, intended or reasonably expected to be  used
 S. 4007                            154                           A. 3007

 with  or  for the consumption of nicotine,] use and reduction of tobacco
 and vapor products[, intended or reasonably expected to be used with  or
 for  the consumption of nicotine,] use among the general population, and
 given target populations.
   2.  The commissioner shall ensure that, to the extent practicable, the
 most current research findings regarding mechanisms to reduce and change
 attitudes toward tobacco and vapor  products[,  intended  or  reasonably
 expected  to  be  used with or for the consumption of nicotine,] use are
 used in tobacco and vapor product[, intended or reasonably  expected  to
 be  used  with  or  for the consumption of nicotine,] education programs
 administered by the department.
   3. To diminish tobacco and  vapor  product[,  intended  or  reasonably
 expected  to be used with or for the consumption of nicotine,] use among
 minors and adults, the commissioner shall ensure  that,  to  the  extent
 practicable,  the following is achieved: The department shall conduct an
 independent evaluation of  the  statewide  tobacco  use  prevention  and
 control  program  under  section thirteen hundred ninety-nine-ii of this
 article. The purpose of this evaluation is to direct the most  efficient
 allocation  of  state  resources  devoted to tobacco and vapor product[,
 intended or reasonably expected to be used with or for  the  consumption
 of   nicotine],  education  and  cessation  to  accomplish  the  maximum
 prevention and reduction of tobacco  and  vapor  product[,  intended  or
 reasonably expected to be used with or for the consumption of nicotine,]
 use  among  minors  and adults. Such evaluation shall be provided to the
 governor, the majority leader of the  senate  and  the  speaker  of  the
 assembly on or before September first, two thousand one, and annually on
 or  before  such  date  thereafter.  The comprehensive evaluation design
 shall be guided by the following:
   (a) sound evaluation principles including,  to  the  extent  feasible,
 elements of controlled experimental methods;
   (b)  an  evaluation  of  the  comparative  effectiveness of individual
 program designs which shall be used in  funding  decisions  and  program
 modifications; and
   (c)  an  evaluation  of  other  programs identified by state agencies,
 local lead agencies, and federal agencies.
   § 13. The opening paragraph and subdivision 2 of  section  1399-kk  of
 the public health law, as amended by section 10 of part EE of chapter 56
 of the laws of 2020, are amended to read as follows:
   The  commissioner  shall submit to the governor and the legislature an
 interim tobacco control report and annual tobacco control reports  which
 shall  describe  the  extent  of  the  use of tobacco products and vapor
 products[, intended or reasonably expected to be used with  or  for  the
 consumption  of nicotine,] by those under twenty-one years of age in the
 state and document the progress state and local governments have made in
 reducing such use among those under twenty-one years of age.
   2. The commissioner shall submit to the governor and  the  legislature
 an  annual  tobacco and vapor products[, intended or reasonably expected
 to be used with or for the  consumption  of  nicotine,]  control  report
 which shall describe the extent of the use of tobacco products and vapor
 products[,  intended  or  reasonably expected to be used with or for the
 consumption of nicotine,] by those under twenty-one years of age in  the
 state and document the progress state and local governments have made in
 reducing  such use among those under twenty-one years of age. The annual
 report shall be submitted to the governor  and  the  legislature  on  or
 before  March thirty-first of each year beginning on March thirty-first,
 nineteen hundred ninety-nine. The annual report  shall,  to  the  extent
 S. 4007                            155                           A. 3007
 
 practicable,  include  the  following  information on a county by county
 basis:
   (a)  number  of  licensed and registered tobacco retailers and vendors
 and licensed vapor products dealers;
   (b) the names and addresses of retailers and  vendors  who  have  paid
 fines, or have been otherwise penalized, due to enforcement actions;
   (c)  the  number  of  complaints filed against licensed and registered
 tobacco retailers and licensed vapor products dealers;
   (d) the number of fires caused or believed to  be  caused  by  tobacco
 products and vapor products[, intended or reasonably expected to be used
 with  or  for  the  consumption  of  nicotine,]  and deaths and injuries
 resulting therefrom;
   (e) the number and type of compliance checks conducted;
   (f) a survey of attitudes and behaviors regarding  tobacco  use  among
 those  under  twenty-one  years of age. The initial such survey shall be
 deemed to constitute the baseline survey;
   (g) the number of tobacco and vapor product[, intended  or  reasonably
 expected  to be used with or for the consumption of nicotine,] users and
 estimated trends in tobacco and vapor product[, intended  or  reasonably
 expected  to be used with or for the consumption of nicotine,] use among
 those under twenty-one years of age;
   (h) annual tobacco and vapor product[, intended or reasonably expected
 to be used with or for the consumption of nicotine,] sales;
   (i) tax revenue collected from the sale of tobacco products and  vapor
 products[,  intended  or  reasonably expected to be used with or for the
 consumption of nicotine];
   (j) the number of licensed tobacco retail outlets and  licensed  vapor
 products dealers;
   (k) the number of cigarette vending machines;
   (l) the number and type of compliance checks;
   (m)  the  names  of  entities  that have paid fines due to enforcement
 actions; and
   (n) the number of complaints filed  against  licensed  tobacco  retail
 outlets and licensed vapor products dealers.
   The annual tobacco and vapor product[, intended or reasonably expected
 to  be  used  with  or  for the consumption of nicotine,] control report
 shall, to the extent practicable, include the following information:
   (a) tobacco and vapor product[, intended or reasonably expected to  be
 used with or for the consumption of nicotine,] control efforts sponsored
 by  state  government  agencies  including  money spent to educate those
 under twenty-one years of age on the hazards of tobacco and vapor  prod-
 uct[,  intended  or  reasonably  expected  to  be  used  with or for the
 consumption of nicotine,] use;
   (b) recommendations for improving tobacco and vapor product[, intended
 or reasonably expected to be used with or for the consumption  of  nico-
 tine,] control efforts in the state; and
   (c) such other information as the commissioner deems appropriate.
   §  14.    Subdivisions 1-a, 2, 3, 4, 5 and 6 of section 1399-ll of the
 public health law, subdivisions 2, 3, 4, 5 and 6 as amended and subdivi-
 sion 1-a as added by section 3 of part EE of chapter 56 of the  laws  of
 2020, are amended to read as follows:
   1-a.  It  shall  be unlawful for any person engaged in the business of
 selling vapor products to ship or cause to be shipped any vapor products
 [intended or reasonably expected to be used with or for the  consumption
 of  nicotine]  to any person in this state who is not: (a) a person that
 receives a certificate of registration as a vapor products dealer  under
 S. 4007                            156                           A. 3007
 
 article  [twenty  eight-C]  TWENTY-EIGHT-C of the tax law; (b) an export
 warehouse proprietor pursuant to chapter 52 of the internal revenue code
 or an operator of a customs bonded warehouse pursuant to section 1311 or
 1555  of  title  19 of the United States Code; or (c) a person who is an
 officer, employee or agent of the United States government,  this  state
 or a department, agency, instrumentality or political subdivision of the
 United  States  or this state and presents [himself or herself] THEMSELF
 as such, when such person is acting in  accordance  with  [his  or  her]
 THEIR  official  duties. For purposes of this subdivision, a person is a
 licensed or registered agent or dealer described  in  paragraph  (a)  of
 this  subdivision  if  [his  or  her]  THEIR  name  appears on a list of
 licensed or registered agents or vapor product dealers published by  the
 department  of  taxation  and  finance, or if such person is licensed or
 registered as an agent or dealer under article [twenty eight-C]  TWENTY-
 EIGHT-C of the tax law.
   2. It shall be unlawful for any common or contract carrier to knowing-
 ly  transport cigarettes to any person in this state reasonably believed
 by such carrier to be other than a person described  in  paragraph  (a),
 (b)  or  (c)  of  subdivision  one  of this section. For purposes of the
 preceding sentence, if cigarettes are transported to  a  home  or  resi-
 dence,  it  shall  be  presumed that the common or contract carrier knew
 that such person was not a person described in paragraph (a), (b) or (c)
 of subdivision one of this section. It shall be unlawful for  any  other
 person  to  knowingly  transport cigarettes to any person in this state,
 other than to a person described in paragraph (a), (b) or (c) of  subdi-
 vision  one  of  this  section.  Nothing  in  this  subdivision shall be
 construed to prohibit a person other than a common or  contract  carrier
 from transporting not more than eight hundred cigarettes at any one time
 to  any  person  in  this  state. It shall be unlawful for any common or
 contract carrier to knowingly  transport  vapor  products  [intended  or
 reasonably  expected to be used with or for the consumption of nicotine]
 to any person in this state reasonably believed by such  carrier  to  be
 other  than  a person described in paragraph (a), (b) or (c) of subdivi-
 sion one-a of this section. For purposes of the preceding  sentence,  if
 vapor  products  [intended or reasonably expected to be used with or for
 the consumption of nicotine] are transported to a home or residence,  it
 shall  be  presumed  that  the common or contract carrier knew that such
 person was not a person described in paragraph (a), (b) or (c) of subdi-
 vision one-a of this section. It shall be unlawful for any other  person
 to  knowingly  transport vapor products [intended or reasonably expected
 to be used with or for the consumption of nicotine]  to  any  person  in
 this  state,  other  than to a person described in paragraph (a), (b) or
 (c) of subdivision one of this  section.  Nothing  in  this  subdivision
 shall  be construed to prohibit a person other than a common or contract
 carrier from transporting vapor products, provided that  the  amount  of
 vapor  products  [intended or reasonably expected to be used with or for
 the consumption of nicotine] shall not exceed the lesser of 500 millili-
 ters, or a total nicotine content of 3 grams at  any  one  time  to  any
 person in this state.
   3.  When  a person engaged in the business of selling cigarettes ships
 or causes to be shipped any cigarettes to  any  person  in  this  state,
 other  than  in the cigarette manufacturer's original container or wrap-
 ping, the container or wrapping must be plainly and visibly marked  with
 the  word "cigarettes". When a person engaged in the business of selling
 vapor products  ships  or  causes  to  be  shipped  any  vapor  products
 [intended  or reasonably expected to be used with or for the consumption
 S. 4007                            157                           A. 3007

 of nicotine] to any person in  this  state,  other  than  in  the  vapor
 products manufacturer's original container or wrapping, the container or
 wrapping  must  be  plainly  and  visibly  marked  with the words "vapor
 products".
   4.  Whenever a police officer designated in section 1.20 of the crimi-
 nal procedure law or a peace officer designated in subdivision  four  of
 section  2.10 of such law, acting pursuant to [his or her] THEIR special
 duties, shall discover any cigarettes or  vapor  products  [intended  or
 reasonably  expected to be used with or for the consumption of nicotine]
 which have been or which are being shipped or transported  in  violation
 of this section, such person is hereby empowered and authorized to seize
 and  take  possession  of such cigarettes or vapor products [intended or
 reasonably expected to be used with or for the consumption of nicotine],
 and such cigarettes or vapor products [intended or  reasonably  expected
 to  be used with or for the consumption of nicotine] shall be subject to
 a forfeiture action pursuant to the procedures provided for  in  article
 thirteen-A  of  the  civil  practice  law  and rules, as if such article
 specifically provided for forfeiture of  cigarettes  or  vapor  products
 [intended  or reasonably expected to be used with or for the consumption
 of nicotine] seized pursuant to this section as a pre-conviction forfei-
 ture crime.
   5. Any person who violates the provisions of subdivision  one,  one-a,
 or  two of this section shall be guilty of a class A misdemeanor and for
 a second or subsequent violation shall be guilty of a class E felony. In
 addition to the criminal penalty, any person who violates the provisions
 of subdivision one, one-a, two or three of this section shall be subject
 to a civil penalty not to  exceed  the  greater  of  (a)  five  thousand
 dollars  for  each such violation; (b) one hundred dollars for each pack
 of cigarettes shipped, caused to be shipped or transported in  violation
 of  such  subdivision; or (c) one hundred dollars for each vapor product
 [intended or reasonably expected to be used with or for the  consumption
 of  nicotine]  shipped, caused to be shipped or transported in violation
 of such subdivision.
   6. The attorney general may bring  an  action  to  recover  the  civil
 penalties  provided  by  subdivision  five  of this section and for such
 other relief as may be deemed necessary. In  addition,  the  corporation
 counsel of any political subdivision that imposes a tax on cigarettes or
 vapor  products [intended or reasonably expected to used with or for the
 consumption of nicotine] may bring an action to recover the civil penal-
 ties provided by subdivision five of this section  and  for  such  other
 relief  as  may  be  deemed  necessary with respect to any cigarettes or
 vapor products [intended or reasonably expected to be used with  or  for
 the  consumption  of  nicotine]  shipped, caused to be shipped or trans-
 ported in violation of this section to any person  located  within  such
 political  subdivision.  All civil penalties obtained in any such action
 shall be retained by the state or political  subdivision  bringing  such
 action, provided that no person shall be required to pay civil penalties
 to  both  the state and a political subdivision with respect to the same
 violation of this section.
   § 15.  Paragraph (a) of subdivision 2 of section 1399-mm of the public
 health law, as added by chapter 549 of the laws of 2003, is  amended  to
 read as follows:
   (a)  The provisions of subdivision one of this section shall not apply
 to a tobacco business, as defined in SUBDIVISION EIGHT OF section  thir-
 teen hundred [ninety-nine-n] NINETY-NINE-AA of this [chapter] ARTICLE.
 S. 4007                            158                           A. 3007
 
   §  16. Section 1399-mm-1 of the public health law, as added by section
 1 of part EE of chapter 56 of the laws of 2020, is amended  to  read  as
 follows:
   § 1399-mm-1. Sale of flavored products prohibited. 1. For the purposes
 of  this  section  "flavored"  shall  mean  any vapor OR TOBACCO product
 [intended or reasonably expected to be used with or for the  consumption
 of  nicotine,] with a [distinguishable] taste [or], aroma, OR SENSATION,
 DISTINGUISHABLE BY AN ORDINARY CONSUMER, other than the taste  or  aroma
 of tobacco, imparted either prior to or during consumption of such prod-
 uct  or a component part thereof, including but not limited to tastes or
 aromas relating to any fruit, chocolate, vanilla, honey,  candy,  cocoa,
 dessert,  alcoholic beverage, mint, wintergreen, menthol, herb or spice,
 or any concept flavor that imparts a taste or aroma that is distinguish-
 able from tobacco flavor but may not  relate  to  any  particular  known
 flavor, OR A COOLING OR NUMBING SENSATION IMPARTED DURING CONSUMPTION OF
 A  TOBACCO OR VAPOR PRODUCT. THIS SHALL NOT INCLUDE ANY PRODUCT APPROVED
 BY THE UNITED STATES FOOD AND DRUG ADMINISTRATION AS A DRUG  OR  MEDICAL
 DEVICE.   A vapor OR TOBACCO product [intended or reasonably expected to
 be used with or for the consumption of nicotine,] shall be  presumed  to
 be  flavored  if  a product's PACKAGING OR LABELING, OR IF THE PRODUCT'S
 retailer, manufacturer, or a manufacturer's agent or employee, has  made
 a  statement  or  claim  directed  to  consumers  or the public, whether
 expressed or implied, that such product or device  has  a  [distinguish-
 able]  taste  [or], aroma, OR SENSATION, AS DISTINGUISHABLE BY THE ORDI-
 NARY CONSUMER, other than the taste [or], aroma, OR SENSATION of  tobac-
 co.
   2.  No  vapor  products  dealer, OR RETAIL DEALER, OR TOBACCO OR VAPOR
 SELLER, or any agent or employee of  a  vapor  products  dealer,  RETAIL
 DEALER,  OR  A TOBACCO OR VAPOR SELLER, shall sell or offer for sale [at
 retail in the state], OR EXCHANGE OR OFFER FOR EXCHANGE, FOR ANY FORM OF
 CONSIDERATION, any  flavored  vapor  OR  TOBACCO  product  [intended  or
 reasonably expected to be used with or for the consumption of nicotine],
 WHETHER THROUGH RETAIL OR WHOLESALE.
   3.  NO VAPOR PRODUCTS DEALER, RETAIL DEALER, OR TOBACCO OR VAPOR SELL-
 ER  OR  ANY AGENT OR EMPLOYEE OF A VAPOR PRODUCTS DEALER, RETAIL DEALER,
 OR TOBACCO OR VAPOR SELLER, ACTING IN THE CAPACITY THEREOF,  SHALL  KEEP
 IN  INVENTORY,  STORE,  STOW,  WAREHOUSE,  PROCESS,  PACKAGE,  SHIP,  OR
 DISTRIBUTE FLAVORED VAPOR OR TOBACCO PRODUCTS ANYWHERE IN,  OR  ADJACENT
 TO,  A  PLACE  OF  BUSINESS  WHERE  VAPOR  OR TOBACCO PRODUCTS ARE SOLD,
 OFFERED FOR SALE, EXCHANGED, OR OFFERED FOR EXCHANGE, FOR  ANY  FORM  OF
 CONSIDERATION, AT RETAIL.
   4. Any vapor products dealer, RETAIL DEALER, OR TOBACCO OR VAPOR SELL-
 ER,  or any agent or employee of a vapor products dealer, RETAIL DEALER,
 OR TOBACCO OR VAPOR SELLER, who violates the provisions of this  section
 shall be subject to a civil penalty of not more than one hundred dollars
 for  each  individual  package  of  flavored  vapor  OR  TOBACCO product
 [intended or reasonably expected to be used with or for the  consumption
 of  nicotine  sold  or  offered  for  sale, provided, however, that with
 respect to a manufacturer, it shall be an affirmative defense to a find-
 ing of violation pursuant to this section that such  sale  or  offer  of
 sale,  as  applicable, occurred without the knowledge, consent, authori-
 zation, or involvement, direct or indirect, of such  manufacturer]  SOLD
 OR  OFFERED FOR SALE, OR EXCHANGED OR OFFERED FOR EXCHANGE, FOR ANY FORM
 OF CONSIDERATION, WHETHER THROUGH RETAIL OR WHOLESALE, OR KEPT IN INVEN-
 TORY, STORED,  STOWED,  WAREHOUSED,  PROCESSED,  PACKAGED,  SHIPPED,  OR
 DISTRIBUTED ANYWHERE IN, OR ADJACENT TO, A PLACE OF BUSINESS WHERE VAPOR
 S. 4007                            159                           A. 3007
 
 OR  TOBACCO  PRODUCTS  ARE SOLD, OFFERED FOR SALE, EXCHANGED, OR OFFERED
 FOR EXCHANGE, FOR ANY FORM OF CONSIDERATION, AT RETAIL.   Violations  OF
 THE  PROVISIONS  of this section shall be enforced pursuant to [section]
 SECTIONS  thirteen  hundred  ninety-nine-ff AND THIRTEEN HUNDRED NINETY-
 NINE-EE of this article,  [except  that  any]  PROVIDED,  HOWEVER,  THAT
 VIOLATIONS OF THE PROVISIONS OF THIS SECTION MAY ALSO BE ENFORCED BY THE
 COMMISSIONER.  ANY person may submit a complaint to an enforcement offi-
 cer that a violation of this section has occurred.
   [4. The provisions of this  section  shall  not  apply  to  any  vapor
 products  dealer,  or  any agent or employee of a vapor products dealer,
 who sells or offers for sale, or who possess  with  intent  to  sell  or
 offer  for  sale,  any  flavored  vapor  product  intended or reasonably
 expected to be used with or for the consumption  of  nicotine  that  the
 U.S.  Food  and  Drug Administration has authorized to legally market as
 defined under 21 U.S.C. § 387j and that has received a premarket  review
 approval  order  under  21  U.S.C. § 387j(c) et seq.] 5. NOTHING IN THIS
 SECTION SHALL BE CONSTRUED TO PENALIZE THE PURCHASE, USE, OR  POSSESSION
 OF  A  TOBACCO  PRODUCT  OR VAPOR PRODUCT BY ANY PERSON NOT ENGAGED AS A
 VAPOR PRODUCTS DEALER, RETAIL DEALER, TOBACCO OR VAPOR  SELLER,  OR  ANY
 AGENT  OR EMPLOYEE OF A VAPOR PRODUCTS DEALER, RETAIL DEALER, OR TOBACCO
 OR VAPOR SELLER.
   § 17. Subdivision 1 of section 1399-mm-2 of the public health law,  as
 added  by  section  1  of  part EE of chapter 56 of the laws of 2020, is
 amended to read as follows:
   1. No tobacco product, herbal cigarette, or vapor product [intended or
 reasonably expected to be used with or for the consumption of nicotine,]
 shall be sold in a pharmacy or in a retail establishment that contains a
 pharmacy operated as a department as defined by paragraph f of  subdivi-
 sion  two  of  section  sixty-eight  hundred eight of the education law.
 Provided,  however,  that  such  prohibition  on  the  sale  of  tobacco
 products,  herbal  cigarettes, or vapor products [intended or reasonably
 expected to be used with or for the consumption of nicotine,] shall  not
 apply  to  any  other  business  that owns or leases premises within any
 building or other facility that also contains a  pharmacy  or  a  retail
 establishment  that  contains  a  pharmacy  operated  as a department as
 defined by paragraph f of subdivision two of section sixty-eight hundred
 eight of the education law.
   § 18. Subdivision 1 of section 1399-mm-3 of the public health law,  as
 added  by  section  1  of  part EE of chapter 56 of the laws of 2020, is
 amended to read as follows:
   1. For the purposes of this section  "carrier  oils"  shall  mean  any
 ingredient  of  a  vapor  product intended to control the consistency or
 other physical characteristics of such vapor  product,  to  control  the
 consistency or other physical characteristics of vapor, or to facilitate
 the production of vapor when such vapor product is used in an electronic
 [cigarette]  DEVICE.    "Carrier  oils"  shall  not  include any product
 approved by the United States [food and drug  administration]  FOOD  AND
 DRUG  ADMINISTRATION  as  a  drug  or medical device or manufactured and
 dispensed pursuant to title five-A of article thirty-three of this chap-
 ter.
   § 19. This act shall take effect September 1, 2023.
 
                                  PART P
 
   Section 1. The public health law is amended by adding  a  new  section
 2825-h to read as follows:
 S. 4007                            160                           A. 3007
 
   §  2825-H.  HEALTH CARE FACILITY TRANSFORMATION PROGRAM:  STATEWIDE V.
 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  PRESIDENT
 OF  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 AGREEMENT, SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE
 DIVISION OF THE BUDGET, FOR THE PURPOSES OF THE DISTRIBUTION AND  ADMIN-
 ISTRATION OF AVAILABLE FUNDS PURSUANT TO SUCH AGREEMENT, AND MADE AVAIL-
 ABLE  PURSUANT  TO  THIS  SECTION  AND  APPROPRIATION. SUCH FUNDS MAY BE
 AWARDED AND DISTRIBUTED BY THE DEPARTMENT  FOR  GRANTS  TO  HEALTH  CARE
 PROVIDERS  INCLUDING  BUT  NOT LIMITED TO, HOSPITALS, RESIDENTIAL HEALTH
 CARE FACILITIES, ADULT CARE FACILITIES LICENSED UNDER TITLE TWO OF ARTI-
 CLE SEVEN OF THE SOCIAL SERVICES LAW, DIAGNOSTIC AND  TREATMENT  CENTERS
 LICENSED  OR  GRANTED AN OPERATING CERTIFICATE UNDER THIS CHAPTER, CLIN-
 ICS, INCLUDING BUT NOT LIMITED TO THOSE LICENSED OR GRANTED AN OPERATING
 CERTIFICATE UNDER THIS CHAPTER OR THE  MENTAL  HYGIENE  LAW,  CHILDREN'S
 RESIDENTIAL  TREATMENT  FACILITIES  LICENSED UNDER ARTICLE THIRTY-ONE OF
 THE MENTAL HYGIENE LAW, ASSISTED LIVING PROGRAMS APPROVED BY THE DEPART-
 MENT PURSUANT TO SECTION FOUR HUNDRED SIXTY-ONE-L OF THE SOCIAL SERVICES
 LAW, BEHAVIORAL HEALTH  FACILITIES  LICENSED  OR  GRANTED  AN  OPERATING
 CERTIFICATE PURSUANT TO ARTICLES THIRTY-ONE AND THIRTY-TWO OF THE MENTAL
 HYGIENE  LAW,  HOME  CARE  PROVIDERS CERTIFIED OR LICENSED UNDER ARTICLE
 THIRTY-SIX OF THIS CHAPTER, PRIMARY CARE PROVIDERS, HOSPICES LICENSED OR
 GRANTED AN OPERATING CERTIFICATE PURSUANT TO ARTICLE FORTY OF THIS CHAP-
 TER, COMMUNITY-BASED PROGRAMS FUNDED UNDER THE OFFICE OF MENTAL  HEALTH,
 THE  OFFICE  OF  ADDICTION  SERVICES AND SUPPORTS, THE OFFICE FOR PEOPLE
 WITH DEVELOPMENTAL DISABILITIES, OR THROUGH LOCAL GOVERNMENTAL UNITS  AS
 DEFINED  UNDER  ARTICLE FORTY-ONE OF THE MENTAL HYGIENE LAW, INDEPENDENT
 PRACTICE ASSOCIATIONS OR ORGANIZATIONS, AND  RESIDENTIAL  FACILITIES  OR
 DAY  PROGRAM  FACILITIES  LICENSED  OR  GRANTED AN OPERATING CERTIFICATE
 UNDER ARTICLE SIXTEEN OF THE MENTAL HYGIENE LAW. A COPY OF  SUCH  AGREE-
 MENT, 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  SECTION  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 FIVE HUNDRED MILLION DOLLARS OF THE FUNDS APPROPRI-
 ATED FOR THIS PROGRAM SHALL BE AWARDED, WITHOUT  A  COMPETITIVE  BID  OR
 REQUEST  FOR  PROPOSAL  PROCESS, FOR GRANTS TO HEALTH CARE PROVIDERS, AS
 DEFINED IN SUBDIVISION TWO OF THIS SECTION. AWARDS MADE PURSUANT TO THIS
 SUBDIVISION SHALL PROVIDE FUNDING ONLY  FOR  CAPITAL  PROJECTS,  TO  THE
 EXTENT  LAWFUL  APPROPRIATION AND FUNDING IS AVAILABLE, TO BUILD INNOVA-
 TIVE, PATIENT-CENTERED MODELS OF  CARE,  INCREASE  ACCESS  TO  CARE,  TO
 IMPROVE  THE  QUALITY  OF CARE AND TO ENSURE FINANCIAL SUSTAINABILITY OF
 HEALTH CARE PROVIDERS.
 S. 4007                            161                           A. 3007
 
   4. NOTWITHSTANDING  SECTION  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 FIVE HUNDRED MILLION DOLLARS OF THE FUNDS  APPROPRI-
 ATED  FOR  THIS  PROGRAM  SHALL BE AWARDED, WITHOUT A COMPETITIVE BID OR
 REQUEST FOR PROPOSAL PROCESS, FOR TECHNOLOGICAL AND TELEHEALTH TRANSFOR-
 MATION PROJECTS.
   5. SELECTION OF AWARDS MADE BY THE DEPARTMENT PURSUANT TO SUBDIVISIONS
 THREE AND FOUR 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
 THE  HEALTH  CARE PROVIDER AS DEFINED IN SUBDIVISION TWO OF THIS SECTION
 ACHIEVING CERTAIN PROCESS AND PERFORMANCE METRICS  AND  MILESTONES  THAT
 ARE STRUCTURED TO ENSURE THAT THE GOALS OF THE PROJECT ARE ACHIEVED.
   6.  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 HEALTH CARE PROVIDER AS  DEFINED  IN  SUBDIVISION
 TWO OF THIS SECTION, 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  FIVE  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, 2023.
 
                                  PART Q
 
   Section 1. Subdivision 2 of section 365-a of the social  services  law
 is amended by adding new paragraph (kk) to read as follows:
   (KK)   COMMUNITY HEALTH WORKER SERVICES FOR CHILDREN UNDER AGE TWENTY-
 ONE, AND FOR ADULTS WITH HEALTH-RELATED SOCIAL NEEDS, WHEN SUCH SERVICES
 ARE RECOMMENDED BY A PHYSICIAN OR OTHER HEALTH CARE PRACTITIONER AUTHOR-
 IZED UNDER TITLE EIGHT OF THE EDUCATION LAW, AND PROVIDED  BY  QUALIFIED
 COMMUNITY  HEALTH  WORKERS, 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  FINANCIAL  PARTICIPATION  IN  THE
 COSTS  OF  HEALTH  CARE  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. Clause (C) of subparagraph (ii) of paragraph (f)  of  subdivision
 2-a  of  section 2807 of the public health law, as amended by section 43
 of part B of chapter 58 of the laws of  2010,  is  amended  to  read  as
 follows:
   (C)  [individual  psychotherapy]  services provided by licensed social
 workers, LICENSED MENTAL HEALTH COUNSELORS  AND  LICENSED  MARRIAGE  AND
 FAMILY  THERAPISTS,  in  accordance with licensing criteria set forth in
 applicable regulations[, to persons under the age of twenty-one  and  to
 persons  requiring  such services as a result of or related to pregnancy
 or giving birth]; and
   § 3. This act shall take effect January 1, 2024.
 S. 4007                            162                           A. 3007
 
                                  PART R
 
   Section  1.  Subdivision 2 of section 365-a of the social services law
 is amended by adding two  new  paragraphs  (kk)  and  (ll)  to  read  as
 follows:
   (KK)  CARE  AND  SERVICES  OF  NUTRITIONISTS  AND DIETITIANS CERTIFIED
 PURSUANT TO ARTICLE ONE HUNDRED FIFTY-SEVEN OF THE EDUCATION LAW  ACTING
 WITHIN THEIR SCOPE OF PRACTICE.
   (LL) ARTHRITIS SELF-MANAGEMENT TRAINING SERVICES FOR PERSONS DIAGNOSED
 WITH  OSTEOARTHRITIS  WHEN  SUCH  SERVICES  ARE  ORDERED BY A PHYSICIAN,
 REGISTERED PHYSICIAN'S  ASSISTANT,  REGISTERED  NURSE  PRACTITIONER,  OR
 LICENSED  MIDWIFE  AND PROVIDED BY QUALIFIED EDUCATORS, AS DETERMINED BY
 THE COMMISSIONER OF HEALTH, PROVIDED, HOWEVER, THAT  THE  PROVISIONS  OF
 THIS  PARAGRAPH  SHALL  NOT  APPLY  UNLESS ALL NECESSARY APPROVALS UNDER
 FEDERAL LAW AND REGULATION HAVE BEEN OBTAINED TO RECEIVE FEDERAL  FINAN-
 CIAL  PARTICIPATION IN THE COSTS OF HEALTH CARE SERVICES PROVIDED PURSU-
 ANT 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.  Clause (A) of subparagraph (ii) of paragraph (f) of subdivision
 2-a of section 2807 of the public health law, as amended by  section  43
 of  part  B  of  chapter  58  of the laws of 2010, is amended to read as
 follows:
   (A) services provided in accordance with the provisions of  paragraphs
 (q)  [and],  (r),  AND  (LL) of subdivision two of section three hundred
 sixty-five-a of the social services law; and
   § 3. This act shall take effect July 1, 2023; provided, however,  that
 paragraph  (ll) of subdivision 2 of section 365-a of the social services
 law added by section one of this act and section two of this act,  shall
 take effect October 1, 2023.
 
                                  PART S
 
   Section  1. 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:
   1.  "Emergency  medical  service"  means  [initial  emergency  medical
 assistance including, but not  limited  to,  the  treatment  of  trauma,
 burns,  respiratory,  circulatory and obstetrical emergencies] A COORDI-
 NATED SYSTEM OF HEALTHCARE DELIVERY THAT RESPONDS TO THE NEEDS  OF  SICK
 AND  INJURED  ADULTS  AND  CHILDREN, BY PROVIDING: ESSENTIAL CARE AT THE
 SCENE OF AN EMERGENCY, NON-EMERGENCY, SPECIALTY NEED  OR  PUBLIC  EVENT;
 COMMUNITY  EDUCATION  AND PREVENTION PROGRAMS; MOBILE INTEGRATED HEALTH-
 CARE PROGRAMS; GROUND AND AIR AMBULANCE SERVICES; CENTRALIZED ACCESS AND
 EMERGENCY MEDICAL DISPATCH;  TRAINING  FOR  EMERGENCY  MEDICAL  SERVICES
 PRACTITIONERS;  MEDICAL FIRST RESPONSE; MOBILE TRAUMA CARE SYSTEMS; MASS
 CASUALTY MANAGEMENT; MEDICAL DIRECTION; OR QUALITY  CONTROL  AND  SYSTEM
 EVALUATION PROCEDURES.
   §  2. 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  AND
 ASSIST  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.    THIS SHALL
 INCLUDE, BUT SHALL NOT  BE  LIMITED  TO,  THE  RECOMMENDATION,  PERIODIC
 REVISION,  AND  APPLICATION  OF  RULES  AND REGULATIONS, APPROPRIATENESS
 S. 4007                            163                           A. 3007
 
 REVIEW STANDARDS, TREATMENT PROTOCOLS, WORKFORCE DEVELOPMENT, AND QUALI-
 TY IMPROVEMENT STANDARDS. THE STATE EMERGENCY MEDICAL  SERVICES  COUNCIL
 SHALL  MEET  AT  LEAST  THREE  TIMES  PER YEAR OR MORE FREQUENTLY AT THE
 REQUEST OF THE CHAIRPERSON OR DEPARTMENT AND APPROVED BY THE COMMISSION-
 ER.
   §  2-a.  Subdivision  1 of section 3002-a of the public health law, as
 amended by chapter 567 of the laws  of  2011,  is  amended  to  read  as
 follows:
   1.  There shall be a state emergency medical advisory committee of the
 state  emergency  medical  services  council  consisting  of  thirty-one
 members.  Twenty-three  members  shall  be  physicians  appointed by the
 commissioner, including one [nominated by]  MEMBER  FROM  each  regional
 emergency  medical  services  council,  an additional physician from the
 city of New York, one pediatrician, one trauma  surgeon,  one  [psychia-
 trist]  PHYSICIAN  AT  LARGE and the chairperson. Each of the physicians
 shall have demonstrated knowledge and experience  in  emergency  medical
 services.   There   shall  be  eight  non-physician  non-voting  members
 appointed by the chairperson of the state council, at least five of whom
 shall be members of the state emergency medical services council at  the
 time  of  their appointment. At least one of the eight shall be an emer-
 gency nurse, at least one shall be an advanced emergency medical techni-
 cian, at least one shall be a basic emergency medical technician, and at
 least one shall be employed in a hospital  setting  with  administrative
 responsibility for a hospital emergency department or service.
   §  3. 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 AND DEPARTMENT ON  SUCH  ISSUES
 AS  THE  STATE  EMERGENCY  MEDICAL  SERVICES  COUNCIL  OR DEPARTMENT MAY
 REQUIRE, RELATED TO THE PROVISION OF EMERGENCY MEDICAL SERVICE, SPECIAL-
 TY CARE, DESIGNATED FACILITY CARE, AND DISASTER MEDICAL CARE, AND  SHALL
 CARRY  OUT  DUTIES  TO  ASSIST  IN THE REGIONAL COORDINATION OF SUCH, AS
 OUTLINED BY THE STATE EMERGENCY MEDICAL SERVICES COUNCIL  WITH  APPROVAL
 OF THE DEPARTMENT.
   §  4. The public health law is amended by adding a new section 3004 to
 read as follows:
   § 3004. EMERGENCY MEDICAL SERVICES SYSTEM AND AGENCY PERFORMANCE STAN-
 DARDS. 1. THE STATE EMERGENCY MEDICAL SERVICES COUNCIL, IN COLLABORATION
 AND WITH FINAL APPROVAL OF THE DEPARTMENT,  SHALL  CREATE  AN  EMERGENCY
 MEDICAL  SERVICES  SYSTEM  AND AGENCY PERFORMANCE STANDARDS (HEREINAFTER
 REFERRED TO AS "PERFORMANCE STANDARDS") FOR THE  PURPOSE  OF  SUSTAINING
 AND  EVOLVING A RELIABLE EMERGENCY MEDICAL SERVICES SYSTEM INCLUDING BUT
 NOT LIMITED TO EMERGENCY MEDICAL SERVICES AGENCIES AND ANY  FACILITY  OR
 AGENCY THAT DISPATCHES OR ACCEPTS EMERGENCY MEDICAL SERVICES RESOURCES.
   2.  THE PERFORMANCE STANDARDS MAY INCLUDE BUT SHALL NOT BE LIMITED TO:
 SAFETY INITIATIVES, EMERGENCY VEHICLE OPERATIONS, OPERATIONAL  COMPETEN-
 CIES,  PLANNING, TRAINING, ONBOARDING, WORKFORCE DEVELOPMENT AND ENGAGE-
 MENT, SURVEY RESPONSES, LEADERSHIP AND OTHER STANDARDS  AND  METRICS  AS
 DETERMINED  BY  THE  STATE  EMERGENCY  MEDICAL  SERVICES  COUNCIL,  WITH
 APPROVAL OF THE DEPARTMENT, TO PROMOTE POSITIVE PATIENT OUTCOMES,  SAFE-
 TY,  PROVIDER  RETENTION AND EMERGENCY MEDICAL SERVICES SYSTEM SUSTAINA-
 BILITY THROUGHOUT THE STATE.
   3. THE PERFORMANCE STANDARDS  SHALL  REQUIRE  EACH  EMERGENCY  MEDICAL
 SERVICES  AGENCY,  DISPATCH  AGENCY  OR  FACILITY THAT ACCEPTS EMERGENCY
 MEDICAL SERVICES RESOURCES TO PERFORM REGULAR AND PERIODIC REVIEW OF THE
 PERFORMANCE STANDARDS AND ITS METRICS, PERFORM  SURVEYS,  IDENTIFICATION
 S. 4007                            164                           A. 3007

 OF AGENCY DEFICIENCIES AND STRENGTHS, DEVELOPMENT OF PROGRAMS TO IMPROVE
 AGENCY  METRICS,  STRENGTHEN  SYSTEM  SUSTAINABILITY AND OPERATIONS, AND
 IMPROVE THE DELIVERY OF PATIENT CARE.
   4. THE DEPARTMENT, AFTER CONSULTATION WITH THE STATE EMERGENCY MEDICAL
 SERVICES  COUNCIL, MAY CONTRACT FOR SERVICES WITH SUBJECT MATTER EXPERTS
 TO ASSIST IN THE OVERSIGHT OF THE PERFORMANCE STANDARDS STATEWIDE.
   5. EMERGENCY MEDICAL SERVICES AGENCIES THAT DO NOT MEET  THE  PERFORM-
 ANCE  STANDARDS  SET FORTH IN THIS SECTION MAY BE SUBJECT TO ENFORCEMENT
 ACTIONS, INCLUDING BUT NOT LIMITED TO REVOCATION,  SUSPENSION,  PERFORM-
 ANCE  IMPROVEMENT  PLANS, OR RESTRICTION FROM SPECIFIC TYPES OF RESPONSE
 INCLUDING BUT NOT  LIMITED  TO  SUSPENSION  OF  ABILITY  TO  RESPOND  TO
 REQUESTS  FOR  EMERGENCY  MEDICAL  ASSISTANCE  OR  TO  PERFORM EMERGENCY
 MEDICAL SERVICES.
   § 5. The public health law is amended by adding a new section 3018  to
 read as follows:
   § 3018. STATEWIDE COMPREHENSIVE EMERGENCY MEDICAL SERVICE SYSTEM PLAN.
 1.  THE  STATE  EMERGENCY MEDICAL SERVICES COUNCIL, IN COLLABORATION AND
 WITH FINAL APPROVAL OF THE DEPARTMENT,  SHALL  DEVELOP  AND  MAINTAIN  A
 STATEWIDE COMPREHENSIVE EMERGENCY MEDICAL SERVICE SYSTEM PLAN THAT SHALL
 PROVIDE  FOR A COORDINATED EMERGENCY MEDICAL SERVICES SYSTEM IN NEW YORK
 STATE, INCLUDING BUT NOT LIMITED TO:
   (A) ESTABLISHING A COMPREHENSIVE STATEWIDE EMERGENCY  MEDICAL  SERVICE
 SYSTEM,  CONSISTING  OF  FACILITIES, TRANSPORTATION, WORKFORCE, COMMUNI-
 CATIONS, AND OTHER COMPONENTS, TO  IMPROVE  THE  DELIVERY  OF  EMERGENCY
 MEDICAL  SERVICES AND THEREBY DECREASE MORBIDITY, HOSPITALIZATION, DISA-
 BILITY, 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  ALTERNATIVE  DELIVERY
 MODELS  WHEREBY  PERSONS  WHO ARE PRESENTLY USING THE EXISTING EMERGENCY
 DEPARTMENT FOR ROUTINE, NONURGENT, AND  PRIMARY  MEDICAL  CARE  WILL  BE
 SERVED APPROPRIATELY; 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 WITH LIMITED ACCESS TO  EMERGENCY  MEDICAL  SERVICES
 TRAINING.
   2.  THE  STATEWIDE COMPREHENSIVE EMERGENCY MEDICAL SERVICE 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 SERVICES COUNCIL SHALL DEVELOP AND
 MAINTAIN A COMPREHENSIVE REGIONAL EMERGENCY MEDICAL SERVICE SYSTEM  PLAN
 OR  ADOPT  THE  STATEWIDE COMPREHENSIVE EMERGENCY MEDICAL SERVICE SYSTEM
 PLAN, TO PROVIDE FOR A  COORDINATED  EMERGENCY  MEDICAL  SERVICE  SYSTEM
 WITHIN  THE  REGION. SUCH PLANS SHALL BE WRITTEN IN A FORMAT APPROVED BY
 THE STATE EMERGENCY MEDICAL SERVICES COUNCIL. FURTHER, SUCH PLANS  SHALL
 BE  SUBJECT  TO  REVIEW  AND  APPROVAL  BY  THE  STATE EMERGENCY MEDICAL
 SERVICES COUNCIL AND FINAL APPROVAL BY THE DEPARTMENT.
   4. EACH COUNTY SHALL DEVELOP AND MAINTAIN A COMPREHENSIVE COUNTY EMER-
 GENCY MEDICAL SERVICE SYSTEM PLAN THAT SHALL PROVIDE FOR  A  COORDINATED
 EMERGENCY MEDICAL SERVICE SYSTEM WITHIN THE COUNTY, TO PROVIDE ESSENTIAL
 EMERGENCY  MEDICAL  SERVICES  FOR  ALL RESIDENTS WITHIN THE COUNTY. SUCH
 PLAN SHALL BE WRITTEN IN  A  FORMAT  APPROVED  BY  THE  STATE  EMERGENCY
 S. 4007                            165                           A. 3007
 
 MEDICAL  SERVICES  COUNCIL.  THE  COUNTY  OFFICE  OF  EMERGENCY  MEDICAL
 SERVICES SHALL BE RESPONSIBLE FOR THE DEVELOPMENT,  IMPLEMENTATION,  AND
 MAINTENANCE OF THE COMPREHENSIVE COUNTY EMERGENCY MEDICAL SERVICE SYSTEM
 PLAN.    SUCH PLANS, AS DETERMINED BY THE DEPARTMENT AND THE STATE EMER-
 GENCY MEDICAL SERVICES COUNCIL, MAY REQUIRE REVIEW AND APPROVAL  BY  THE
 REGIONAL EMERGENCY MEDICAL SERVICES COUNCIL, THE STATE EMERGENCY MEDICAL
 SERVICES  COUNCIL  AND  THE DEPARTMENT. SUCH   PLAN  SHALL  OUTLINE  THE
 PRIMARY RESPONDING EMERGENCY MEDICAL SERVICES AGENCY  FOR  REQUESTS  FOR
 SERVICE FOR EACH PART OF THE COUNTY.
   §  6. The public health law is amended by adding a new section 3019 to
 read as follows:
   § 3019. EMERGENCY MEDICAL SERVICE  TRAINING  PROGRAMS.  1.  THE  STATE
 EMERGENCY  MEDICAL  SERVICES  COUNCIL  SHALL MAKE RECOMMENDATIONS TO THE
 DEPARTMENT FOR THE DEPARTMENT TO  IMPLEMENT  STANDARDS  RELATED  TO  THE
 ESTABLISHMENT OF TRAINING PROGRAMS FOR EMERGENCY MEDICAL SERVICE SYSTEMS
 THAT  INCLUDES BUT IS NOT LIMITED TO STUDENTS, EMERGENCY MEDICAL SERVICE
 PRACTITIONERS, EMERGENCY MEDICAL SERVICES AGENCIES, APPROVED EDUCATIONAL
 INSTITUTIONS, GEOGRAPHIC  AREAS,  FACILITIES,  AND  PERSONNEL,  AND  THE
 COMMISSIONER  SHALL FUND SUCH TRAINING PROGRAMS IN FULL OR IN PART BASED
 ON STATE APPROPRIATIONS. UNTIL SUCH TIME AS THE DEPARTMENT ANNOUNCES THE
 STANDARDS FOR TRAINING PROGRAMS PURSUANT TO THIS  SECTION,  ALL  CURRENT
 STANDARDS, CURRICULUMS, AND REQUIREMENTS FOR STUDENTS, EMERGENCY MEDICAL
 SERVICE  PRACTITIONERS, AGENCIES, FACILITIES, AND PERSONNEL SHALL REMAIN
 IN EFFECT.
   2. THE STATE EMERGENCY MEDICAL SERVICES COUNCIL, WITH  FINAL  APPROVAL
 OF  THE DEPARTMENT, SHALL ESTABLISH MINIMUM EDUCATION STANDARDS, CURRIC-
 ULUMS, PERFORMANCE METRICS AND REQUIREMENTS FOR  ALL  EMERGENCY  MEDICAL
 SYSTEM  EDUCATIONAL  INSTITUTIONS.  NO PERSON OR EDUCATIONAL INSTITUTION
 SHALL PROFESS TO PROVIDE EMERGENCY  MEDICAL  SERVICES  TRAINING  WITHOUT
 MEETING THE REQUIREMENTS SET FORTH IN REGULATION AND ONLY AFTER APPROVAL
 OF THE DEPARTMENT AND IN THE GEOGRAPHICAL AREA DETERMINED BY THE DEPART-
 MENT.
   3. THE DEPARTMENT IS AUTHORIZED TO PROVIDE, EITHER DIRECTLY OR THROUGH
 CONTRACT,  FOR  LOCAL OR STATEWIDE INITIATIVES, EMERGENCY MEDICAL SYSTEM
 TRAINING FOR  EMERGENCY  MEDICAL  SERVICE  PRACTITIONERS  AND  EMERGENCY
 MEDICAL  SERVICES  AGENCY  PERSONNEL,  USING  FUNDING  INCLUDING BUT NOT
 LIMITED TO ALLOCATIONS  TO  AID  TO  LOCALITIES  FOR  EMERGENCY  MEDICAL
 SERVICES TRAINING.
   4.  THE  DEPARTMENT MAY VISIT AND INSPECT ANY EMERGENCY MEDICAL SYSTEM
 TRAINING PROGRAM OR TRAINING CENTER  OPERATING  UNDER  THIS  ARTICLE  TO
 ENSURE  COMPLIANCE  WITH  ALL  APPLICABLE REGULATIONS AND STANDARDS. THE
 DEPARTMENT MAY REQUEST THE STATE OR REGIONAL EMERGENCY MEDICAL  SERVICES
 COUNCIL'S  ASSISTANCE TO ENSURE THE COMPLIANCE, MAINTENANCE, AND COORDI-
 NATION OF TRAINING PROGRAMS. THE DEPARTMENT, IN  CONSULTATION  WITH  THE
 STATE  EMERGENCY  MEDICAL  SERVICES COUNCIL, MAY SET STANDARDS AND REGU-
 LATIONS FOR EMERGENCY MEDICAL SERVICES EDUCATIONAL INSTITUTIONS.   EMER-
 GENCY MEDICAL SERVICES EDUCATIONAL INSTITUTIONS THAT FAIL TO MEET APPLI-
 CABLE  STANDARDS  AND  REGULATIONS MAY BE SUBJECT TO ENFORCEMENT ACTION,
 INCLUDING  BUT  NOT  LIMITED  TO  REVOCATION,  SUSPENSION,   PERFORMANCE
 IMPROVEMENT PLANS, OR RESTRICTION FROM SPECIFIC TYPES OF EDUCATION.
   5.  STUDENTS  OF AN EMERGENCY MEDICAL SERVICES EDUCATIONAL INSTITUTION
 AUTHORIZED PURSUANT TO  THIS  SECTION,  SHALL  BE  CONSIDERED  EMERGENCY
 MEDICAL  SERVICES  STUDENTS  AND SUBJECT TO THE STANDARDS ESTABLISHED IN
 THIS ARTICLE, REGULATIONS PROMULGATED PURSUANT TO THIS ARTICLE  AND  ALL
 APPLICABLE  STANDARDS,  AS  IF  THEY  WERE  A LICENSED EMERGENCY MEDICAL
 SERVICES PRACTITIONER AND MAY BE SUBJECT TO ENFORCEMENT ACTION AS SUCH.
 S. 4007                            166                           A. 3007
 
   § 7. Section 3012 of the public health law is amended by adding a  new
 subdivision 5 to read as follows:
   5.  IT  SHALL  BE A VIOLATION OF THIS CHAPTER, SUBJECT TO CIVIL PENAL-
 TIES, FOR ANY PERSON TO HOLD THEMSELVES  OUT  AS  AN  EMERGENCY  MEDICAL
 SERVICES  PRACTITIONER  WHO IS NOT DESIGNATED BY THE DEPARTMENT PURSUANT
 TO THIS ARTICLE OR OTHERWISE LAWFULLY AUTHORIZED, TO  PROVIDE  EMERGENCY
 MEDICAL  SERVICES,  OR TO ATTEMPT TO BECOME AN EMERGENCY MEDICAL PRACTI-
 TIONER IN AN UNLAWFUL OR UNETHICAL MANNER.
   § 8. The public health law is amended by adding a new section 3020  to
 read as follows:
   §  3020.  RECRUITMENT AND RETENTION. 1.  THE COMMISSIONER SHALL ESTAB-
 LISH AND FUND WITHIN AMOUNTS APPROPRIATED, A PUBLIC SERVICE CAMPAIGN  TO
 RECRUIT ADDITIONAL PERSONNEL INTO THE EMERGENCY MEDICAL SYSTEM FIELDS.
   2.  THE COMMISSIONER SHALL ESTABLISH AND FUND WITHIN AMOUNTS APPROPRI-
 ATED AN EMERGENCY MEDICAL SYSTEM MENTAL HEALTH AND WELLNESS PROGRAM THAT
 PROVIDES RESOURCES TO EMERGENCY MEDICAL SERVICE PRACTITIONERS.
   3.  THE COMMISSIONER MAY ESTABLISH IN  REGULATION  STANDARDS  FOR  THE
 LICENSURE  OF EMERGENCY MEDICAL SERVICES PRACTITIONERS BY THE DEPARTMENT
 OF HEALTH.
   4. THE DEPARTMENT, WITH THE APPROVAL OF THE  STATE  EMERGENCY  MEDICAL
 SERVICES  COUNCIL,  MAY  CREATE OR ADOPT ADDITIONAL STANDARDS, TRAINING,
 AND CRITERIA TO BECOME AN EMERGENCY MEDICAL SERVICE PRACTITIONER CREDEN-
 TIALED TO PROVIDE SPECIALIZED, ADVANCED, OR OTHER SERVICES THAT  FURTHER
 SUPPORT  OR  ADVANCE  THE EMERGENCY MEDICAL SYSTEM. THE DEPARTMENT, WITH
 APPROVAL OF THE STATE EMERGENCY MEDICAL SERVICES COUNCIL  MAY  ALSO  SET
 STANDARDS AND REQUIREMENTS TO REQUIRE SPECIALIZED CREDENTIALS TO PERFORM
 CERTAIN FUNCTIONS IN THE EMERGENCY MEDICAL SERVICES SYSTEM.
   5.  THE  DEPARTMENT,  WITH  APPROVAL  OF  THE  STATE EMERGENCY MEDICAL
 SERVICES COUNCIL MAY ALSO SET STANDARDS  FOR  EMERGENCY  MEDICAL  SYSTEM
 AGENCIES  TO  BECOME  ACCREDITED  IN  A SPECIFIC AREA TO INCREASE SYSTEM
 PERFORMANCE AND AGENCY RECOGNITION.
   § 9. Section 3008 of the public health  law  is  REPEALED  and  a  new
 section 3008 is added to read as follows:
   § 3008. APPLICATIONS FOR NEW OR MODIFIED OPERATING AUTHORITY. 1. EVERY
 APPLICATION  FOR  NEW  OR  MODIFIED OPERATING AUTHORITY SHALL BE MADE IN
 WRITING TO THE STATE EMERGENCY MEDICAL SERVICES COUNCIL AND SHALL SPECI-
 FY THE PRIMARY TERRITORY WITHIN WHICH THE APPLICANT REQUESTS TO OPERATE,
 BE VERIFIED UNDER OATH, AND SHALL BE  IN  SUCH  FORM  AND  CONTAIN  SUCH
 INFORMATION  AS REQUIRED BY THE RULES AND REGULATIONS PROMULGATED PURSU-
 ANT TO THIS ARTICLE.
   2. NOTICE OF THE APPLICATION SHALL BE  FORWARDED  TO  THE  APPROPRIATE
 REGIONAL EMERGENCY MEDICAL SERVICES COUNCIL.
   3.  ALL DETERMINATIONS OF NEW OR MODIFIED OPERATING AUTHORITY SHALL BE
 MADE BY THE STATE  EMERGENCY  MEDICAL  SERVICES  COUNCIL  AND  SHALL  BE
 CONSISTENT  WITH  THE  STATE  EMERGENCY MEDICAL SYSTEM PLAN, ONCE ESTAB-
 LISHED PURSUANT TO SECTION THREE THOUSAND EIGHTEEN OF THIS ARTICLE.  THE
 DEPARTMENT MAY PROMULGATE REGULATIONS TO PROVIDE FOR STANDARDS FOR EVAL-
 UATION  OF  NEW  OR  MODIFIED  OPERATING  AUTHORITY, AND THE PROCESS FOR
 DETERMINATION OF OPERATING AUTHORITY SHALL  BE  APPROVED  BY  THE  STATE
 EMERGENCY MEDICAL SERVICES COUNCIL AND CARRIED OUT THEREAFTER.
   4.  THE  STATE  EMERGENCY  MEDICAL  SERVICES  COUNCIL MAY CREATE A NEW
 COMMITTEE TO HEAR AND MAKE DETERMINATIONS ON ALL  REQUESTS  FOR  NEW  OR
 MODIFIED  OPERATING  AUTHORITY. SUCH COMMITTEE SHALL BE COMPRISED OF ONE
 STATE EMERGENCY MEDICAL COUNCIL  MEMBER  FROM  EACH  REGIONAL  EMERGENCY
 MEDICAL SERVICES COUNCIL.
 S. 4007                            167                           A. 3007
 
   5.  IF THE STATE EMERGENCY MEDICAL SERVICES COUNCIL PROPOSES TO DISAP-
 PROVE AN APPLICATION UNDER THIS SECTION, IT SHALL AFFORD  THE  APPLICANT
 AN  OPPORTUNITY TO REQUEST A PUBLIC HEARING. THE STATE EMERGENCY MEDICAL
 SERVICES COUNCIL MAY HOLD A PUBLIC HEARING ON THE APPLICATION ON ITS OWN
 MOTION.    ANY  PUBLIC  HEARING HELD PURSUANT TO THIS SUBDIVISION MAY BE
 CONDUCTED BY THE STATE EMERGENCY MEDICAL SERVICES  COUNCIL,  OR  BY  ANY
 INDIVIDUAL DESIGNATED BY THE STATE EMERGENCY MEDICAL SERVICES COUNCIL.
   6.  NOTWITHSTANDING  THE  PROVISIONS  OF SUBDIVISIONS ONE AND THREE OF
 THIS SECTION,  DURING  AN  EMERGENCY  THE  COMMISSIONER  MAY  WAIVE  THE
 REQUIREMENT  FOR  A  DETERMINATION  OF  OPERATING  AUTHORITY AND ISSUE A
 TEMPORARY EMERGENCY MEDICAL SYSTEM AGENCY CERTIFICATE.
   7. NOTWITHSTANDING THE PROVISIONS OF SUBDIVISIONS  ONE  AND  THREE  OF
 THIS  SECTION, THE COMMISSIONER MAY WAIVE THE REQUIREMENT FOR A DETERMI-
 NATION OF OPERATING AUTHORITY AND ISSUE A MUNICIPALITY,  SPECIAL  TAXING
 DISTRICT,  GOVERNMENT AGENCY OR NATIVE AMERICAN TRIBAL COUNCIL, AN EMER-
 GENCY MEDICAL SYSTEM AGENCY CERTIFICATE, PROVIDED THE ISSUANCE  OF  SUCH
 CERTIFICATE IS FINANCIALLY SUPPORTED BY THE MUNICIPALITY, SPECIAL TAXING
 DISTRICT, GOVERNMENT AGENCY OR NATIVE AMERICAN TRIBAL COUNCIL.
   § 10. Section 3032 of the public health law is REPEALED.
   §  11.  The  public  health  law is amended by adding six new sections
 3032, 3033, 3034, 3035, 3036 and 3037 to read as follows:
   § 3032. MOBILE INTEGRATED HEALTHCARE.  1. "MOBILE  INTEGRATED  HEALTH-
 CARE"  MEANS  THE  PROVISION  OF PATIENT-CENTERED MOBILE RESOURCES WHICH
 INCLUDES A WELL-ORGANIZED SYSTEM OF SERVICES TO ADDRESS HEALTHCARE  GAPS
 AND DECREASE DEMAND ON PORTIONS OF THE HEALTHCARE SYSTEM IDENTIFIED BY A
 COMMUNITY  NEEDS ASSESSMENT, INTEGRATED INTO THE LOCAL HEALTHCARE SYSTEM
 WORKING IN A COLLABORATIVE MANNER  AS  A  PATIENT  CARE  TEAM  THAT  MAY
 INCLUDE,  BUT NOT LIMITED TO, PHYSICIANS, MID-LEVEL PRACTITIONERS, NURS-
 ES, HOME CARE AGENCIES, EMERGENCY MEDICAL SERVICES PRACTITIONERS,  EMER-
 GENCY   MEDICAL  SERVICES  AGENCIES  AND  OTHER  COMMUNITY  HEALTH  TEAM
 COLLEAGUES, TO MEET THE NEEDS OF THE COMMUNITY.
   2. EMERGENCY MEDICAL SERVICE AGENCIES MAY  ESTABLISH  A  MOBILE  INTE-
 GRATED  HEALTHCARE PROGRAM, PROVIDED THEY MEET ALL STANDARDS ESTABLISHED
 BY THE DEPARTMENT, THAT THE DELIVERY OF SUCH SERVICES IN FULL OR IN PART
 WILL NOT DECREASE THE AGENCY'S ABILITY TO RESPOND TO REQUESTS FOR  EMER-
 GENCY  ASSISTANCE  AND  THE  AGENCY  RECEIVES  EXPRESS APPROVAL FROM THE
 DEPARTMENT. THE DEPARTMENT MAY REVOKE OR SUSPEND  AN  EMERGENCY  MEDICAL
 SERVICE  AGENCY'S  APPROVAL  TO  PROVIDE  A MOBILE INTEGRATED HEALTHCARE
 PROGRAM IF THE DEPARTMENT FINDS THAT ONE OR MORE  STANDARDS  ESTABLISHED
 BY  THE  DEPARTMENT  HAVE NOT BEEN MET. THE DEPARTMENT, IN COLLABORATION
 WITH THE STATE  EMERGENCY  MEDICAL  SERVICES  COUNCIL,  SHALL  ESTABLISH
 CRITERIA AND STANDARDS FOR THE OPERATION OF MOBILE INTEGRATED HEALTHCARE
 PROGRAMS  AND MOBILE INTEGRATED HEALTHCARE PROGRAMS SHALL ADHERE TO SUCH
 CRITERIA AND STANDARDS.
   3. NOTWITHSTANDING SECTIONS SIXTY-FIVE HUNDRED TWENTY-ONE  AND  SIXTY-
 NINE  HUNDRED  TWO  OF  THE EDUCATION LAW, AN EMERGENCY MEDICAL SERVICES
 PRACTITIONER, LICENSED PURSUANT TO THIS ARTICLE, SHALL BE AUTHORIZED  TO
 ADMINISTER  IMMUNIZATIONS  PURSUANT TO A PATIENT SPECIFIC OR NON-PATIENT
 SPECIFIC STANDING REGIMEN ORDERED BY A LICENSED PHYSICIAN  AND  PURSUANT
 TO PROTOCOLS ADOPTED BY THE STATE EMERGENCY MEDICAL SERVICES COUNCIL AND
 ANY STANDARDS ESTABLISHED BY THE DEPARTMENT.
   4.  NOTWITHSTANDING  SECTIONS SIXTY-FIVE HUNDRED TWENTY-ONE AND SIXTY-
 NINE HUNDRED TWO OF THE EDUCATION LAW,  AN  EMERGENCY  MEDICAL  SERVICES
 PRACTITIONER,  LICENSED  PURSUANT  TO THIS ARTICLE, MAY BE AUTHORIZED BY
 THE DEPARTMENT TO ADMINISTER BUPRENORPHINE  PURSUANT  TO  A  NON-PATIENT
 SPECIFIC  STANDING  REGIMEN ORDERED BY A LICENSED PHYSICIAN AND PURSUANT
 S. 4007                            168                           A. 3007
 
 TO PROTOCOLS ADOPTED BY THE STATE EMERGENCY MEDICAL SERVICES COUNCIL AND
 ANY STANDARDS ESTABLISHED BY THE DEPARTMENT.
   §  3033.  REGIONAL  EMERGENCY MEDICAL SERVICE DISTRICT. 1. A "REGIONAL
 EMERGENCY MEDICAL SERVICE DISTRICT" MEANS A SPECIAL DISTRICT AS  DEFINED
 IN  SUBDIVISION  SIXTEEN OF SECTION ONE HUNDRED TWO OF THE REAL PROPERTY
 TAX LAW CREATED FOR THE PURPOSE OF ENSURING THE  ESSENTIAL  SERVICES  OF
 EMERGENCY MEDICAL CARE, COORDINATING THE EMERGENCY MEDICAL SYSTEM WITHIN
 THE  DISTRICT  AND PROVIDING WHEN NEEDED EMERGENCY MEDICAL SERVICES ON A
 REGIONAL BASIS EITHER DIRECTLY OR THROUGH CONTRACT WITH BUT NOT  LIMITED
 TO   TOWNS,  COUNTIES,  MUNICIPALITIES,  LICENSED  AMBULANCE  AND  FIRST
 RESPONSE AGENCIES, AIR MEDICAL PROVIDERS AND OTHERS AS DETERMINED BY THE
 DISTRICT COUNCIL. THERE SHALL BE TEN REGIONAL  SERVICE  DISTRICTS  WHICH
 WILL  CORRESPOND  TO  ECONOMIC  DEVELOPMENT  REGIONS  AS  ESTABLISHED IN
 SECTION TWO HUNDRED THIRTY OF THE  ECONOMIC  DEVELOPMENT  LAW  THAT  ARE
 ESTABLISHED IN ALL AREAS OF THE STATE AND OPERATE UNDER THE DIRECTION OF
 THE DEPARTMENT.
   2. A GROUP OF FIVE EMERGENCY MEDICAL SERVICE PROVIDERS IN EACH REGION,
 WITH NOMINATIONS MADE FROM ANYONE IN THE DISTRICT AND APPOINTMENT BY THE
 COMMISSIONER,  SHALL  ACT  AS  A COUNCIL TO DIRECT THE OPERATIONS OF THE
 EMERGENCY MEDICAL SERVICES SYSTEM IN THEIR  REGION.  NO  LESS  THAN  ONE
 MEMBER  OF THE COUNCIL SHALL BE A LICENSED PHYSICIAN WHO IS BOARD CERTI-
 FIED IN EMERGENCY MEDICINE OR EMERGENCY MEDICAL SERVICES AND HAS EXPERI-
 ENCE WORKING  WITH  EMERGENCY  MEDICAL  SERVICES  ORGANIZATIONS,  UNLESS
 OTHERWISE DETERMINED BY THE COMMISSIONER. THE DEPARTMENT SHALL ESTABLISH
 TERM LIMITS IN REGULATION.
   3.  AN  EMERGENCY  MEDICAL  SERVICE  PRACTITIONER,  NOMINATED  BY  THE
 REGIONAL EMERGENCY MEDICAL SERVICE DISTRICT COUNCIL AND APPOINTED BY THE
 COMMISSIONER, SHALL BE THE REGIONAL EMERGENCY MEDICAL  SERVICE  DISTRICT
 DIRECTOR  AND  SHALL  BE CHARGED WITH CARRYING OUT THE ADMINISTRATION OF
 THE REGIONAL EMERGENCY MEDICAL SERVICE DISTRICT WHEN THE COUNCIL IS  NOT
 IN SESSION.
   4.  A  PHYSICIAN  BOARD  CERTIFIED  IN EMERGENCY MEDICINE OR EMERGENCY
 MEDICAL SERVICES AND WHO HAS EXPERIENCE WORKING WITH  EMERGENCY  MEDICAL
 SERVICES  ORGANIZATIONS,  NOMINATED  BY  THE  REGIONAL EMERGENCY MEDICAL
 SERVICE DISTRICT COUNCIL AND APPOINTED BY THE COMMISSIONER, SHALL BE THE
 REGIONAL EMERGENCY MEDICAL SERVICES MEDICAL DIRECTOR. THE REGIONAL EMER-
 GENCY MEDICAL SERVICES MEDICAL DIRECTOR SHALL  REPORT  TO  THE  DISTRICT
 DIRECTOR  OR THEIR DESIGNEE, AND SHALL BE CHARGED WITH PROVIDING MEDICAL
 DIRECTION OVERSIGHT AND QUALITY  ASSURANCE  TO  THE  REGIONAL  EMERGENCY
 MEDICAL SERVICE DISTRICT.
   5.  THE  REGIONAL  EMERGENCY  MEDICAL SERVICES DISTRICTS SHALL OPERATE
 UNDER THE DIRECTION AND OVERSIGHT OF THE DEPARTMENT TO ENSURE THE  EMER-
 GENCY  MEDICAL  SERVICES  SYSTEM  IS  RELIABLE, SUSTAINABLE AND PROVIDES
 QUALITY CARE TO THE RESIDENTS, COMMUTERS AND VISITORS OF THE DISTRICT.
   § 3034. STATE EMERGENCY MEDICAL SERVICES TASK FORCE. 1. THE DEPARTMENT
 SHALL DEVELOP A STATE EMERGENCY MEDICAL SERVICES (EMS) TASK FORCE, OPER-
 ATED BY THE DEPARTMENT, THAT MAY COORDINATE AND OPERATE  RESOURCES  THAT
 ARE  NEEDED  AROUND THE STATE IN SITUATIONS SUCH AS BUT NOT LIMITED TO A
 DISASTER, LARGE EVENT, SPECIALIZED RESPONSE, COMMUNITY  NEED,  OR  OTHER
 NEED AS DETERMINED BY THE COMMISSIONER.
   2.  THE  STATE  EMS  TASK FORCE SHALL BE MADE UP OF NON-GOVERNMENT AND
 GOVERNMENT AGENCIES, THAT ARE  LICENSED  TO  PROVIDE  EMERGENCY  MEDICAL
 SERVICES  IN THE STATE INCLUDING BUT NOT LIMITED TO COMMERCIAL AGENCIES,
 NONPROFITS, FIRE DEPARTMENTS AND THIRD SERVICES.
   3. THE DEPARTMENT WILL ALLOCATE FUNDS TO EFFECTUATE  THE  DELIVERY  OF
 THE  STATE  EMS TASK FORCE THAT WILL ALLOW FOR CONTRACTING WITH LICENSED
 S. 4007                            169                           A. 3007
 
 EMERGENCY  MEDICAL  SERVICES  AGENCIES,  THE  PURCHASE  OF   SPECIALIZED
 RESPONSE  EQUIPMENT, STAFF TO CARRY OUT THE DAILY FUNCTIONS OF THE STATE
 EMS TASK FORCE EITHER DIRECTLY OR BY CONTRACT  AND  OTHER  FUNCTIONS  AS
 DETERMINED BY THE DEPARTMENT.
   4. THE STATE EMERGENCY MEDICAL SERVICES COUNCIL SHALL MAKE RECOMMENDA-
 TIONS  TO  THE  DEPARTMENT TO EFFECTUATE THE DEVELOPMENT AND DELIVERY OF
 CARE BY THE STATE EMS TASK FORCE.
   5. THE STATE EMS TASK  FORCE  SHALL  HAVE  THE  AUTHORITY  TO  OPERATE
 THROUGHOUT  NEW YORK STATE OR OUTSIDE OF THE STATE WITH PRIOR PERMISSION
 OF THE COMMISSIONER. NOTWITHSTANDING ANY LAW TO THE CONTRARY,  CONTRACTS
 LET  BY  THE  STATE  EMS  TASK  FORCE  SHALL BE EXEMPT FROM SECTIONS ONE
 HUNDRED TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW.
   § 3035. DEMONSTRATION PROJECTS. THE DEPARTMENT, IN  CONSULTATION  WITH
 THE  STATE  EMERGENCY  MEDICAL SERVICES COUNCIL, MAY ALLOW DEMONSTRATION
 PROJECTS RELATED TO THE EMERGENCY  MEDICAL  SYSTEM.  SUCH  DEMONSTRATION
 PROJECTS MAY ALLOW FOR WAIVERS OF CERTAIN PARTS OF THIS ARTICLE, ARTICLE
 THIRTY-A  OF  THIS  CHAPTER,  AND  APPLICABLE  REGULATIONS, PROVIDED THE
 DEMONSTRATION PROJECT MEETS ANY APPLICABLE STANDARDS SET  FORTH  BY  THE
 DEPARTMENT.
   §  3036.  EMERGENCY  MEDICAL SYSTEM SUPPORT SERVICES. THE COMMISSIONER
 MAY PROMULGATE REGULATIONS, WITH THE APPROVAL  OF  THE  STATE  EMERGENCY
 MEDICAL  SERVICES  COUNCIL, TO SET STANDARDS AND CRITERIA FOR BASIC LIFE
 SUPPORT FIRST RESPONSE AGENCIES, EMERGENCY MEDICAL DISPATCH, AND SPECIAL
 EVENT SERVICES, TO STRENGTHEN  THE  EMERGENCY  MEDICAL  SERVICE  SYSTEM.
 THESE  ORGANIZATIONS SHALL NOT BE REQUIRED TO MEET THE STANDARDS SET FOR
 DETERMINATION OF OPERATING AUTHORITY AS OUTLINED IN SECTION THREE  THOU-
 SAND  EIGHT  OF  THIS  ARTICLE  UNLESS OTHERWISE DETERMINED BY THE STATE
 EMERGENCY MEDICAL SERVICES COUNCIL AND APPROVED BY THE DEPARTMENT.
   § 3037. RULES AND REGULATIONS. THE COMMISSIONER, UPON APPROVAL OF  THE
 STATE EMERGENCY MEDICAL SERVICES COUNCIL, MAY PROMULGATE RULES AND REGU-
 LATIONS TO EFFECTUATE THE PURPOSES OF THIS ARTICLE.
   §  12.  Section  6909  of the education law is amended by adding a new
 subdivision 11 to read as follows:
   11. A CERTIFIED NURSE PRACTITIONER MAY PRESCRIBE AND ORDER  A  NON-PA-
 TIENT  SPECIFIC  REGIMEN  TO  AN EMERGENCY MEDICAL SERVICES PRACTITIONER
 LICENSED BY THE DEPARTMENT OF HEALTH PURSUANT TO ARTICLE THIRTY  OF  THE
 PUBLIC  HEALTH  LAW,  PURSUANT TO REGULATIONS PROMULGATED BY THE COMMIS-
 SIONER, AND CONSISTENT WITH THE PUBLIC  HEALTH  LAW,  FOR  ADMINISTERING
 IMMUNIZATIONS.  NOTHING  IN  THIS SUBDIVISION SHALL AUTHORIZE UNLICENSED
 PERSONS TO ADMINISTER IMMUNIZATIONS, VACCINES OR OTHER DRUGS.
   § 13. Section 6527 of the education law is amended  by  adding  a  new
 subdivision 11 to read as follows:
   11. A LICENSED PHYSICIAN MAY PRESCRIBE AND ORDER A NON-PATIENT SPECIF-
 IC REGIMEN TO AN EMERGENCY MEDICAL SERVICES PRACTITIONER LICENSED BY THE
 DEPARTMENT  OF  HEALTH  PURSUANT  TO ARTICLE THIRTY OF THE PUBLIC HEALTH
 LAW, PURSUANT  TO  REGULATIONS  PROMULGATED  BY  THE  COMMISSIONER,  AND
 CONSISTENT  WITH THE PUBLIC HEALTH LAW, FOR ADMINISTERING IMMUNIZATIONS.
 NOTHING IN THIS SUBDIVISION SHALL AUTHORIZE UNLICENSED PERSONS TO ADMIN-
 ISTER IMMUNIZATIONS, VACCINES OR OTHER DRUGS.
   § 14. This act shall take effect immediately; provided, however,  that
 section  3033  of  the  public health law, as added by section eleven of
 this act, shall take effect on the ninetieth day  after  it  shall  have
 become a law.
 
                                  PART T
 S. 4007                            170                           A. 3007
 
   Section  1.  The  public health law is amended by adding a new section
 1377 to read as follows:
   §  1377.  STATE  RENTAL REGISTRY AND PROACTIVE INSPECTIONS TO IDENTIFY
 LEAD HAZARDS. 1. THE DEPARTMENT SHALL DEVELOP A REGISTRY FOR  ALL  RESI-
 DENTIAL DWELLINGS WITH TWO OR MORE UNITS BUILT PRIOR TO NINETEEN HUNDRED
 EIGHTY  WHICH,  BY  VIRTUE  OF  THEIR  MUNICIPAL ZONING DESIGNATION, ARE
 POTENTIALLY ELIGIBLE FOR RENTAL, LEASE,  LET  OR  HIRING  OUT,  AND  ARE
 LOCATED  WITHIN  COMMUNITIES OF CONCERN AS IDENTIFIED BY THE DEPARTMENT.
 SUCH  REGISTRY  SHALL  ONLY  INCLUDE  QUALIFYING  RESIDENTIAL  DWELLINGS
 OUTSIDE NEW YORK CITY.
   2.  ALL  RESIDENTIAL  DWELLINGS  QUALIFYING FOR REGISTRATION IN ACCORD
 WITH THIS SECTION MUST BE CERTIFIED AS FREE OF LEAD PAINT HAZARDS  BASED
 ON  INSPECTIONS  CONDUCTED  ON  A  TRI-ANNUAL  BASIS. INSPECTION CERTIF-
 ICATIONS MUST BE SUBMITTED TO  THE  LOCAL  HEALTH  DEPARTMENT  OR  THEIR
 DESIGNEE FOR RECORDING IN THE RENTAL REGISTRY.
   3. THE COMMISSIONER SHALL PROMULGATE REGULATIONS AS NEEDED TO ADMINIS-
 TER,  COORDINATE,  AND ENFORCE THIS SECTION, INCLUDING THE ESTABLISHMENT
 OF FINES TO BE LEVIED IN THE EVENT OF NON-COMPLIANCE WITH  THE  REQUIRE-
 MENTS OF THIS SECTION.
   4.  INSPECTION  REQUIREMENTS SHALL BE BASED ON REGULATION AND GUIDANCE
 FROM THE DEPARTMENT AND MAY INCLUDE QUALIFICATIONS FOR INSPECTORS, MINI-
 MUM REQUIREMENTS OF A COMPLIANT INSPECTION AND A PROCESS  FOR  REPORTING
 INSPECTION  RESULTS  TO  LOCAL  HEALTH  DEPARTMENTS.  MINIMUM INSPECTION
 REQUIREMENTS MAY INCLUDE VISUAL INSPECTIONS FOR DETERIORATED  PAINT  AND
 OUTDOOR  SOIL CONDITIONS, AS WELL AS THE COLLECTION OF DUST WIPE SAMPLES
 OBTAINED IN ACCORDANCE WITH UNITED STATES ENVIRONMENTAL PROTECTION AGEN-
 CY PROTOCOLS FOR SUCH PROCEDURES.
   5. REMEDIATION OF  LEAD-BASED  PAINT  HAZARDS  MUST  BE  CONDUCTED  IN
 COMPLIANCE  WITH  ALL  MUNICIPAL  REQUIREMENTS AND SPECIFIC REQUIREMENTS
 SPECIFIED IN REGULATION.
   § 2. Paragraphs h and i of subdivision 1 of section 381 of the  execu-
 tive law, as added by chapter 560 of the laws of 2010, are amended and a
 new paragraph j is added to read as follows:
   h.  minimum  basic  training  and in-service training requirements for
 personnel charged with administration and enforcement of the state ener-
 gy conservation construction code; [and]
   i. standards and procedures for measuring the rate of compliance  with
 the  state energy conservation construction code, and provisions requir-
 ing that such rate of compliance be measured on an annual basis[.]; AND
   J. PROCEDURES REQUIRING THE DOCUMENTATION  OF  COMPLIANCE  WITH  REGU-
 LATIONS  ADOPTED  PURSUANT  TO SECTION THIRTEEN HUNDRED SEVENTY-SEVEN OF
 THE PUBLIC HEALTH LAW AS A CONDITION TO ISSUANCE  OF  A  CERTIFICATE  OF
 OCCUPANCY  OR CERTIFICATE OF COMPLIANCE FOLLOWING A PERIODIC FIRE SAFETY
 AND PROPERTY MAINTENANCE INSPECTION FOR MULTIPLE DWELLINGS.
   § 3. This  act  shall  take  effect  immediately;  provided,  however,
 section one of this act shall take effect eighteen months after it shall
 have  become  a  law; and provided further, however, section two of this
 act shall take effect two years  after  it  shall  have  become  a  law.
 Effective  immediately,  the  addition,  amendment, and/or repeal of any
 rule or regulation necessary for the timely implementation of  this  act
 on  or before its effective date are authorized to be made and completed
 on or before such effective date.
 
                                  PART U
 S. 4007                            171                           A. 3007
 
   Section 1.   The general business law  is  amended  by  adding  a  new
 section 394-f to read as follows:
   §  394-F. WARRANTS FOR REPRODUCTIVE HEALTH RELATED ELECTRONIC DATA. 1.
 FOR THE PURPOSES OF THIS SECTION, THE FOLLOWING  TERMS  SHALL  HAVE  THE
 FOLLOWING MEANINGS:
   A.  "ELECTRONIC  COMMUNICATION"  MEANS ANY TRANSFER OF SIGNS, SIGNALS,
 WRITING, IMAGES, SOUNDS, DATA, OR INTELLIGENCE OF ANY NATURE TRANSMITTED
 IN WHOLE OR IN PART BY A WIRE, RADIO,  ELECTROMAGNETIC,  PHOTOELECTRONIC
 OR PHOTO-OPTICAL SYSTEM; PROVIDED, HOWEVER, SUCH TERM SHALL NOT INCLUDE:
   I. ANY TELEPHONIC OR TELEGRAPHIC COMMUNICATION.
   II. ANY COMMUNICATION MADE THROUGH A TONE ONLY PAGING DEVICE.
   III. ANY COMMUNICATION MADE THROUGH A TRACKING DEVICE CONSISTING OF AN
 ELECTRONIC  OR MECHANICAL DEVICE WHICH PERMITS THE TRACKING OF THE MOVE-
 MENT OF A PERSON OR OBJECT.
   IV. ANY COMMUNICATION THAT IS DISSEMINATED BY  THE  SENDER  THROUGH  A
 METHOD  OF TRANSMISSION THAT IS CONFIGURED SO THAT SUCH COMMUNICATION IS
 READILY ACCESSIBLE TO THE PUBLIC.
   B.  "ELECTRONIC  COMMUNICATION  SERVICES"  MEANS  ANY  SERVICE   WHICH
 PROVIDES  TO  USERS THEREOF THE ABILITY TO SEND OR RECEIVE WIRE OR ELEC-
 TRONIC COMMUNICATIONS.
   C. "PROHIBITED VIOLATION" MEANS ANY CIVIL OR CRIMINAL OFFENSE  DEFINED
 UNDER THE LAWS OF ANOTHER STATE THAT CREATES CIVIL OR CRIMINAL LIABILITY
 OR  ANY THEORY OF VICARIOUS, JOINT, SEVERAL OR CONSPIRACY LIABILITY FOR,
 IN WHOLE OR IN PART BASED ON OR ARISING OUT OF, EITHER OF THE FOLLOWING,
 UNLESS SUCH OUT-OF-STATE PROCEEDING I. SOUNDS IN TORT OR  CONTRACT;  II.
 IS  ACTIONABLE,  IN  AN  EQUIVALENT OR SIMILAR MANNER, UNDER THE LAWS OF
 THIS STATE; OR III. WAS BROUGHT BY THE PATIENT WHO RECEIVED REPRODUCTIVE
 HEALTH CARE, OR THE PATIENT'S LEGAL REPRESENTATIVE:
   (1) PROVIDING, FACILITATING, OR  OBTAINING  REPRODUCTIVE  HEALTH  CARE
 SERVICES THAT ARE LAWFUL UNDER NEW YORK LAW; OR
   (2)  INTENDING  OR ATTEMPTING TO PROVIDE, FACILITATE, OR OBTAIN REPRO-
 DUCTIVE HEALTH CARE SERVICES THAT ARE LAWFUL UNDER NEW YORK LAW.
   D. "REPRODUCTIVE HEALTH CARE SERVICES" MEANS ANY SERVICES  RELATED  TO
 THE  PERFORMANCE  OR  AIDING  WITHIN  THE  PERFORMANCE  OF  AN  ABORTION
 PERFORMED WITHIN THIS STATE THAT IS PERFORMED  IN  ACCORDANCE  WITH  THE
 APPLICABLE  LAW OF THIS STATE, ENDING, SEEKING TO END, OR AIDING ANOTHER
 IN ENDING THEIR PREGNANCY WITHIN THIS STATE, OR PROCURING OR  AIDING  IN
 THE PROCUREMENT OF AN ABORTION WITHIN THIS STATE.
   2.  ANY  PERSON OR ENTITY THAT IS HEADQUARTERED OR INCORPORATED IN NEW
 YORK THAT PROVIDES ELECTRONIC COMMUNICATIONS  SERVICES  TO  THE  GENERAL
 PUBLIC,  WHEN  SERVED  WITH A WARRANT ISSUED BY ANOTHER STATE TO PRODUCE
 RECORDS THAT WOULD REVEAL THE IDENTITY  OF  THE  CUSTOMERS  USING  THOSE
 SERVICES,  DATA  STORED BY OR ON BEHALF OF THE CUSTOMERS, THE CUSTOMERS'
 USAGE OF THOSE SERVICES, THE RECIPIENT OR DESTINATION OF  COMMUNICATIONS
 SENT TO OR FROM THOSE CUSTOMERS, OR THE CONTENT OF THOSE COMMUNICATIONS,
 SHALL  NOT  PRODUCE  THOSE  RECORDS WHEN THE CORPORATION KNOWS OR SHOULD
 KNOW THAT THE WARRANT RELATES TO AN INVESTIGATION INTO,  OR  ENFORCEMENT
 OF, A PROHIBITED VIOLATION.
   3.  ANY  PERSON OR ENTITY THAT IS HEADQUARTERED OR INCORPORATED IN NEW
 YORK MAY COMPLY WITH A WARRANT AS DESCRIBED IN SUBDIVISION TWO  OF  THIS
 SECTION  IF  THE  WARRANT  IS  ACCOMPANIED BY AN ATTESTATION MADE BY THE
 ENTITY SEEKING THE RECORDS THAT THE EVIDENCE SOUGHT IS NOT RELATED TO AN
 INVESTIGATION INTO, OR ENFORCEMENT OF, A PROHIBITED VIOLATION.
   4. THE ATTORNEY GENERAL MAY COMMENCE A  CIVIL  ACTION  TO  COMPEL  ANY
 CORPORATION  HEADQUARTERED  OR  INCORPORATED  IN  NEW YORK THAT PROVIDES
 S. 4007                            172                           A. 3007
 
 ELECTRONIC COMMUNICATIONS SERVICES OR REMOTE COMPUTING SERVICES  TO  THE
 GENERAL PUBLIC TO COMPLY WITH THE PROVISIONS OF THIS SECTION.
   § 2. The general business law is amended by adding a new section 394-g
 to read as follows:
   § 394-G. GEOFENCING OF HEALTH CARE FACILITIES.  1. FOR THE PURPOSES OF
 THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANINGS:
   A.  "DIGITAL ADVERTISEMENT" MEANS ANY COMMUNICATION DELIVERED BY ELEC-
 TRONIC MEANS THAT IS INTENDED TO BE USED FOR THE PURPOSES OF  MARKETING,
 SOLICITATION, OR DISSEMINATION OF INFORMATION RELATED, DIRECTLY OR INDI-
 RECTLY,  TO  GOODS  OR  SERVICES PROVIDED BY THE DIGITAL ADVERTISER OR A
 THIRD PARTY.
   B. "GEOFENCING" MEANS A TECHNOLOGY THAT USES GLOBAL POSITIONING SYSTEM
 COORDINATES, CELL TOWER CONNECTIVITY,  CELLULAR  DATA,  RADIO  FREQUENCY
 IDENTIFICATION,  WI-FI DATA AND/OR ANY OTHER FORM OF LOCATION DETECTION,
 TO  ESTABLISH  A  VIRTUAL  BOUNDARY  OR  "GEOFENCE" AROUND A  PARTICULAR
 LOCATION  THAT   ALLOWS  A  DIGITAL  ADVERTISER  TO  TRACK  THE LOCATION
 OF  AN  INDIVIDUAL  USER  AND  ELECTRONICALLY DELIVER  TARGETED  DIGITAL
 ADVERTISEMENTS  DIRECTLY TO SUCH USER'S MOBILE DEVICE  UPON  SUCH USER'S
 ENTRY INTO THE GEOFENCED AREA.
   C. "HEALTH CARE FACILITY" MEANS ANY GOVERNMENTAL  OR  PRIVATE  AGENCY,
 DEPARTMENT,   INSTITUTION,  CLINIC,  LABORATORY,  HOSPITAL,  PHYSICIAN'S
 OFFICE, NURSING CARE FACILITY, HEALTH MAINTENANCE ORGANIZATION,  ASSOCI-
 ATION  OR  OTHER  SIMILAR  ENTITY  THAT PROVIDES MEDICAL CARE OR RELATED
 SERVICES PURSUANT TO THE PROVISIONS OF THE  PUBLIC  HEALTH  LAW  OR  THE
 MENTAL  HYGIENE  LAW,  INCLUDING  THE BUILDING OR STRUCTURE IN WHICH THE
 FACILITY IS LOCATED.
   D. "USER" MEANS A NATURAL PERSON WHO OWNS OR USES A MOBILE  DEVICE  OR
 ANY  OTHER  CONNECTED  ELECTRONIC  DEVICE  CAPABLE  OF RECEIVING DIGITAL
 ADVERTISEMENTS.
   2. IT SHALL BE UNLAWFUL FOR ANY PERSON, CORPORATION,  PARTNERSHIP,  OR
 ASSOCIATION  TO  ESTABLISH A GEOFENCE OR SIMILAR VIRTUAL BOUNDARY AROUND
 ANY HEALTH CARE FACILITY, AS DEFINED PURSUANT TO PARAGRAPH C OF SUBDIVI-
 SION ONE OF THIS SECTION, FOR THE PURPOSE OF  DELIVERING  BY  ELECTRONIC
 MEANS  A  DIGITAL  ADVERTISEMENT TO A USER AT OR WITHIN SUCH HEALTH CARE
 FACILITY, AND IT SHALL BE UNLAWFUL FOR ANY PERSON, CORPORATION, PARTNER-
 SHIP, OR ASSOCIATION TO DELIVER BY ELECTRONIC MEANS ANY  DIGITAL  ADVER-
 TISEMENT  TO  A  USER AT OR WITHIN ANY SUCH HEALTH CARE FACILITY THROUGH
 THE USE OF GEOFENCING OR SIMILAR VIRTUAL BOUNDARY.
   § 3. Severability. If any provision of this article or the application
 thereof to any person or circumstances is held invalid,  the  invalidity
 thereof shall not affect other provisions or applications of the article
 which  can be given effect without the invalid provision or application,
 and to this end the provisions of this article are severable.
   § 4. This act shall take effect on the thirtieth day  after  it  shall
 have become a law.
 
                                  PART V
 
   Section  1.  Section  6801 of the education law is amended by adding a
 new subdivision 9 to read as follows:
   9. A LICENSED PHARMACIST WITHIN THEIR LAWFUL  SCOPE  OF  PRACTICE  MAY
 PRESCRIBE  AND ORDER SELF-ADMINISTERED HORMONAL CONTRACEPTIVES AND EMER-
 GENCY CONTRACEPTIVE DRUG THERAPY IN ACCORDANCE WITH STANDARDIZED  PROCE-
 DURES  OR  PROTOCOLS  DEVELOPED AND APPROVED BY THE BOARD OF PHARMACY IN
 CONSULTATION WITH THE DEPARTMENT OF HEALTH.
 S. 4007                            173                           A. 3007
 
   (A) THE STANDARDIZED PROCEDURE OR  PROTOCOL  SHALL  REQUIRE  THAT  THE
 PATIENT  USE  A  SELF-SCREENING  TOOL  THAT  WILL  IDENTIFY PATIENT RISK
 FACTORS FOR USE OF SELF-ADMINISTERED HORMONAL CONTRACEPTIVES  AND  EMER-
 GENCY  CONTRACEPTIVE  DRUG  THERAPY,  BASED ON THE CURRENT UNITED STATES
 MEDICAL  ELIGIBILITY CRITERIA (USMEC) FOR CONTRACEPTIVE USE DEVELOPED BY
 THE FEDERAL CENTERS FOR DISEASE CONTROL AND  PREVENTION,  AND  THAT  THE
 PHARMACIST  REFER THE PATIENT TO THE PATIENT'S PRIMARY CARE PROVIDER OR,
 IF THE PATIENT DOES NOT HAVE A PRIMARY CARE PROVIDER, TO NEARBY CLINICS,
 UPON FURNISHING A SELF-ADMINISTERED HORMONAL CONTRACEPTIVE OR  EMERGENCY
 CONTRACEPTIVE  DRUG  THERAPY  PURSUANT  TO THIS SUBDIVISION, OR IF IT IS
 DETERMINED THAT USE OF A  SELF-ADMINISTERED  HORMONAL  CONTRACEPTIVE  OR
 EMERGENCY CONTRACEPTIVE DRUG THERAPY IS NOT RECOMMENDED.
   (B)  PRIOR TO PRESCRIBING SELF-ADMINISTERED HORMONAL CONTRACEPTIVES OR
 EMERGENCY CONTRACEPTIVE DRUG THERAPY UNDER THIS SUBDIVISION,  A  PHARMA-
 CIST  SHALL  COMPLETE  A  TRAINING PROGRAM ON SELF-ADMINISTERED HORMONAL
 CONTRACEPTIVES OR EMERGENCY CONTRACEPTIVE DRUG THERAPY,  AS  APPLICABLE,
 THAT  CONSISTS  OF AT LEAST ONE HOUR OF APPROVED CONTINUING EDUCATION ON
 SELF-ADMINISTERED HORMONAL  CONTRACEPTIVES  OR  EMERGENCY  CONTRACEPTIVE
 DRUG THERAPY.
   (C)  A  PHARMACIST, PHARMACIST'S EMPLOYER, OR PHARMACIST'S AGENT SHALL
 NOT DIRECTLY CHARGE A PATIENT A SEPARATE CONSULTATION FEE  FOR  SELF-AD-
 MINISTERED HORMONAL CONTRACEPTIVES OR EMERGENCY CONTRACEPTIVE DRUG THER-
 APY  SERVICES  INITIATED PURSUANT TO THIS SUBDIVISION, BUT MAY CHARGE AN
 ADMINISTRATIVE FEE NOT TO EXCEED TEN DOLLARS ABOVE THE  RETAIL  COST  OF
 THE  DRUG. UPON AN ORAL, TELEPHONIC, ELECTRONIC, OR WRITTEN REQUEST FROM
 A PATIENT OR CUSTOMER,  A  PHARMACIST  OR  PHARMACIST'S  EMPLOYEE  SHALL
 DISCLOSE  THE  TOTAL RETAIL PRICE THAT A CONSUMER WOULD PAY FOR SELF-AD-
 MINISTERED HORMONAL CONTRACEPTIVES OR EMERGENCY CONTRACEPTIVE DRUG THER-
 APY. AS USED IN THIS PARAGRAPH, TOTAL RETAIL  PRICE  INCLUDES  PROVIDING
 THE  CONSUMER WITH SPECIFIC INFORMATION REGARDING THE PRICE OF THE SELF-
 ADMINISTERED HORMONAL CONTRACEPTIVES  OR  EMERGENCY  CONTRACEPTIVE  DRUG
 THERAPY AND THE PRICE OF THE ADMINISTRATIVE FEE CHARGED. THIS LIMITATION
 IS  NOT INTENDED TO INTERFERE WITH OTHER CONTRACTUALLY AGREED-UPON TERMS
 BETWEEN A PHARMACIST, A PHARMACIST'S EMPLOYER, OR A PHARMACIST'S  AGENT,
 AND  A  HEALTH CARE SERVICE PLAN OR INSURER. PATIENTS WHO ARE INSURED OR
 COVERED AND RECEIVE A PHARMACY BENEFIT THAT COVERS THE COST OF  SELF-AD-
 MINISTERED HORMONAL CONTRACEPTIVES OR EMERGENCY CONTRACEPTIVE DRUG THER-
 APY  SHALL  NOT  BE REQUIRED TO PAY AN ADMINISTRATIVE FEE. SUCH PATIENTS
 SHALL BE REQUIRED TO PAY COPAYMENTS PURSUANT TO THE TERMS AND CONDITIONS
 OF THEIR COVERAGE. THIS PARAGRAPH SHALL NOT APPLY TO DEDICATED EMERGENCY
 CONTRACEPTIVE DRUGS  CLASSIFIED  AS  OVER-THE-COUNTER  PRODUCTS  BY  THE
 FEDERAL FOOD AND DRUG ADMINISTRATION.
   (D) FOR EACH EMERGENCY CONTRACEPTIVE DRUG THERAPY OR SELF-ADMINISTERED
 HORMONAL CONTRACEPTIVE INITIATED PURSUANT TO THIS SUBDIVISION, THE PHAR-
 MACIST  SHALL  PROVIDE  THE  RECIPIENT  OF  THE DRUG WITH A STANDARDIZED
 FACTSHEET THAT INCLUDES, BUT IS NOT  LIMITED  TO,  THE  INDICATIONS  AND
 CONTRAINDICATIONS  FOR USE OF THE DRUG, THE APPROPRIATE METHOD FOR USING
 THE DRUG, THE NEED FOR MEDICAL FOLLOW-UP, AND OTHER APPROPRIATE INFORMA-
 TION. THE BOARD OF PHARMACY SHALL DEVELOP THIS FORM IN CONSULTATION WITH
 THE DEPARTMENT OF HEALTH. THIS SECTION DOES  NOT  PRECLUDE  THE  USE  OF
 EXISTING  PUBLICATIONS DEVELOPED BY NATIONALLY RECOGNIZED MEDICAL ORGAN-
 IZATIONS.
   § 2. This act shall take effect immediately.
 
                                  PART W
 S. 4007                            174                           A. 3007
 
   Section 1. Subdivision 7-a of section 6527 of the  education  law,  as
 added by chapter 502 of the laws of 2016, is amended to read as follows:
   7-a.  A  licensed physician may prescribe and order a patient specific
 order or non-patient specific order to a licensed  pharmacist,  pursuant
 to  regulations promulgated by the commissioner in consultation with the
 commissioner of health, and consistent with the public health  law,  for
 dispensing  up  to a seven day starter pack of HIV post-exposure prophy-
 laxis  for  the  purpose  of  preventing  human  immunodeficiency  virus
 infection  following  a potential human immunodeficiency virus exposure.
 A LICENSED PHYSICIAN MAY ALSO PRESCRIBE AND ORDER A PATIENT SPECIFIC  OR
 NON-PATIENT  SPECIFIC  ORDER TO A LICENSED PHARMACIST, PURSUANT TO REGU-
 LATIONS PROMULGATED BY THE COMMISSIONER IN CONSULTATION WITH THE COMMIS-
 SIONER OF HEALTH, AND CONSISTENT WITH THE PUBLIC HEALTH LAW AND  SECTION
 SIXTY-EIGHT HUNDRED ONE OF THIS TITLE, FOR HIV PRE-EXPOSURE PROPHYLAXIS,
 PROVIDED,  HOWEVER,  THAT  THE  REGULATIONS PROMULGATED PURSUANT TO THIS
 SUBDIVISION SHALL REQUIRE THAT THE HIV PRE-EXPOSURE PROPHYLAXIS  AUTHOR-
 IZED TO BE DISPENSED BY A LICENSED PHARMACIST SHALL PROVIDE FOR AT LEAST
 A THIRTY-DAY, BUT NO MORE THAN A SIXTY-DAY, SUPPLY OF SUCH PROPHYLAXIS.
   §  2.  Subdivision 8 of section 6909 of the education law, as added by
 chapter 502 of the laws of 2016, is amended to read as follows:
   8. A certified nurse practitioner may prescribe and  order  a  patient
 specific  order  or non-patient specific order to a licensed pharmacist,
 pursuant to regulations promulgated by the commissioner in  consultation
 with  the  commissioner of health, and consistent with the public health
 law, for dispensing up to a seven day starter pack of HIV  post-exposure
 prophylaxis  for  the purpose of preventing human immunodeficiency virus
 infection following a potential human immunodeficiency  virus  exposure.
 A  CERTIFIED  NURSE  PRACTITIONER MAY ALSO PRESCRIBE AND ORDER A PATIENT
 SPECIFIC OR NON-PATIENT SPECIFIC ORDER TO A LICENSED PHARMACIST,  PURSU-
 ANT  TO REGULATIONS PROMULGATED BY THE COMMISSIONER IN CONSULTATION WITH
 THE COMMISSIONER OF HEALTH, AND CONSISTENT WITH THE  PUBLIC  HEALTH  LAW
 AND  SECTION SIXTY-EIGHT HUNDRED ONE OF THIS TITLE, FOR HIV PRE-EXPOSURE
 PROPHYLAXIS, PROVIDED, HOWEVER, THAT THE REGULATIONS PROMULGATED  PURSU-
 ANT  TO THIS SUBDIVISION SHALL REQUIRE THAT THE HIV PRE-EXPOSURE PROPHY-
 LAXIS AUTHORIZED TO BE DISPENSED BY A LICENSED PHARMACIST SHALL  PROVIDE
 FOR  AT LEAST A THIRTY-DAY, BUT NO MORE THAN A SIXTY-DAY, SUPPLY OF SUCH
 PROPHYLAXIS.
   § 3. Subdivision 5 of section 6801 of the education law, as  added  by
 chapter  502  of the laws of 2016, is amended and a new subdivision 9 is
 added to read as follows:
   5. A licensed pharmacist may execute a non-patient specific order, for
 dispensing up to a seven day starter pack of HIV  post-exposure  prophy-
 laxis  medications  for the purpose of preventing human immunodeficiency
 virus infection, by a physician licensed in this state or nurse  practi-
 tioner  certified  in  this  state,  pursuant  to  rules and regulations
 promulgated by the commissioner in consultation with the commissioner of
 health following a potential human immunodeficiency virus exposure.  THE
 PHARMACIST SHALL ALSO INFORM THE PATIENT OF THE AVAILABILITY OF  PRE-EX-
 POSURE  PROPHYLAXIS FOR PERSONS WHO ARE AT SUBSTANTIAL RISK OF ACQUIRING
 HIV.
   9. A LICENSED PHARMACIST MAY EXECUTE A NON-PATIENT SPECIFIC ORDER, FOR
 DISPENSING HIV PRE-EXPOSURE PROPHYLAXIS, PURSUANT  TO  RULES  AND  REGU-
 LATIONS PROMULGATED BY THE COMMISSIONER IN CONSULTATION WITH THE COMMIS-
 SIONER  OF  HEALTH  PROVIDED,  HOWEVER,  THAT  THE RULES AND REGULATIONS
 PROMULGATED PURSUANT TO THIS SUBDIVISION  SHALL  REQUIRE  THAT  THE  HIV
 PRE-EXPOSURE  PROPHYLAXIS AUTHORIZED TO BE DISPENSED BY A LICENSED PHAR-
 S. 4007                            175                           A. 3007
 
 MACIST SHALL PROVIDE FOR AT LEAST A  THIRTY-DAY,  BUT  NO  MORE  THAN  A
 SIXTY-DAY,  SUPPLY  OF  SUCH PROPHYLAXIS. AND PROVIDED FURTHER, THAT THE
 FOLLOWING CONDITIONS SHALL BE MET BEFORE A PHARMACIST MAY DISPENSE  PRE-
 EXPOSURE PROPHYLAXIS:
   (A)  THE  PHARMACIST  HAS  COMPLETED  A  TRAINING  PROGRAM  CREATED OR
 APPROVED BY THE DEPARTMENT OF HEALTH ON THE USE OF PRE-EXPOSURE  PROPHY-
 LAXIS. THE TRAINING PROGRAM SHALL EDUCATE PHARMACISTS ABOUT THE REQUIRE-
 MENTS OF THIS SUBDIVISION, THE RISKS AND SIDE EFFECTS OF THE MEDICATION,
 PATIENT  INSURANCE  AND  COST  BURDENS,  AND  ANY  OTHER INFORMATION THE
 DEPARTMENT OF HEALTH DEEMS NECESSARY OR IMPORTANT;
   (B) THE PATIENT IS HIV NEGATIVE, AS DOCUMENTED BY A NEGATIVE HIV  TEST
 RESULT   OBTAINED   WITHIN   THE   PREVIOUS   SEVEN  DAYS  FROM  AN  HIV
 ANTIGEN/ANTIBODY TEST OR ANTIBODY-ONLY TEST OR FROM A  RAPID,  POINT-OF-
 CARE FINGERSTICK BLOOD TEST APPROVED BY THE FEDERAL FOOD AND DRUG ADMIN-
 ISTRATION.  IF  THE  PATIENT DOES NOT PROVIDE EVIDENCE OF A NEGATIVE HIV
 TEST IN ACCORDANCE WITH THIS PARAGRAPH, THE PHARMACIST MAY RECOMMEND  OR
 ORDER  AN HIV TEST. IF THE PATIENT TESTS POSITIVE FOR HIV INFECTION, THE
 PHARMACIST SHALL DIRECT THE PATIENT TO A LICENSED PHYSICIAN AND  PROVIDE
 THE  PATIENT  WITH  A  LIST OF HEALTH CARE SERVICE PROVIDERS AND CLINICS
 WITHIN THE COUNTY WHERE THE PHARMACIST IS LOCATED OR ADJACENT COUNTIES;
   (C) THE PATIENT DOES NOT REPORT ANY SIGNS OR  SYMPTOMS  OF  ACUTE  HIV
 INFECTION  ON A SELF-REPORTED CHECKLIST OF ACUTE HIV INFECTION SIGNS AND
 SYMPTOMS;
   (D) THE PATIENT DOES NOT REPORT  TAKING  ANY  CONTRAINDICATED  MEDICA-
 TIONS;
   (E)  THE  PHARMACIST  DOES NOT FURNISH MORE THAN A SIXTY-DAY SUPPLY OF
 PRE-EXPOSURE PROPHYLAXIS TO A SINGLE PATIENT MORE THAN ONCE EVERY  YEAR,
 UNLESS DIRECTED OTHERWISE BY A PRESCRIBER;
   (F)  THE  PHARMACIST  PROVIDES  WRITTEN  INFORMATION, PUBLISHED BY THE
 DEPARTMENT OF HEALTH, TO THE PATIENT ON THE ONGOING USE OF  PRE-EXPOSURE
 PROPHYLAXIS,  WHICH  MAY  INCLUDE  EDUCATION  ABOUT SIDE EFFECTS, SAFETY
 DURING PREGNANCY AND BREASTFEEDING, ADHERENCE TO RECOMMENDED DOSING, AND
 THE IMPORTANCE OF TIMELY TESTING AND TREATMENT, AS APPLICABLE, FOR  HIV,
 RENAL FUNCTION, HEPATITIS B, HEPATITIS C, SEXUALLY TRANSMITTED DISEASES,
 AND  PREGNANCY FOR INDIVIDUALS OF CHILD-BEARING CAPACITY. THE PHARMACIST
 SHALL NOTIFY THE PATIENT THAT THE PATIENT MUST BE  SEEN  BY  A  LICENSED
 PHYSICIAN  TO  RECEIVE SUBSEQUENT PRESCRIPTIONS FOR PRE-EXPOSURE PROPHY-
 LAXIS; AND
   (G) THE PHARMACIST PROVIDES INFORMATION, DEVELOPED BY THE COMMISSIONER
 OF HEALTH, TO THE PATIENT, OR WHEN THE PATIENT LACKS CAPACITY TO CONSENT
 TO A PERSON AUTHORIZED TO CONSENT TO HEALTH CARE FOR SUCH INDIVIDUAL, ON
 THE IMPORTANCE OF HAVING A HEALTH CARE PROVIDER AND IF THE PATIENT  DOES
 NOT HAVE A HEALTH CARE PROVIDER THE PHARMACIST SHALL PROVIDE THE PATIENT
 A  LIST  OF  LICENSED  PHYSICIANS, CLINICS, OR OTHER HEALTH CARE SERVICE
 PROVIDERS WITHIN THE COUNTY WHERE THE PHARMACIST IS LOCATED OR  ADJACENT
 COUNTIES.
   § 4. Subdivision 6 of section 571 of the public health law, as amended
 by  section 1 of part C of chapter 57 of the laws of 2022, 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 administering [COVID-19 and influ-
 enza] tests pursuant to subdivision seven of section sixty-eight hundred
 one of the education law,  physician  assistant,  specialist  assistant,
 S. 4007                            176                           A. 3007
 
 nurse  practitioner, or midwife, who is licensed and registered with the
 state education department.
   § 5. Subdivision 7 of section 6801 of the education law, as amended by
 section  2  of  part  C of chapter 57 of the laws of 2022, is amended 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 [COVID-19 and influenza] tests authorized 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.
   § 6. Section 8 of part C of chapter 57 of the laws  of  2022  amending
 the public health law and the education law relating to allowing pharma-
 cists  to  direct  limited service laboratories and order and administer
 COVID-19 and influenza tests and  modernizing  nurse  practitioners,  is
 amended to read as follows:
   §  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, that sections [one, two,] three[,] AND four[, six and seven] of
 this act shall expire and be deemed repealed two years  after  it  shall
 have become a law.
   §  7.  Section  6801  of  the education law is amended by adding a new
 subdivision 10 to read as follows:
   10. A LICENSED PHARMACIST WITHIN THEIR LAWFUL SCOPE  OF  PRACTICE  MAY
 PRESCRIBE AND ORDER MEDICATIONS TO TREAT NICOTINE DEPENDENCE APPROVED BY
 THE FEDERAL FOOD AND DRUG ADMINISTRATION FOR SMOKING CESSATION.
   §  8.  Section  6801  of  the education law is amended by adding a new
 subdivision 11 to read as follows:
   11. A LICENSED PHARMACIST WITHIN THEIR LAWFUL SCOPE  OF  PRACTICE  MAY
 PRESCRIBE  AND  ORDER  OPIOID ANTAGONISTS, LIMITED TO NALOXONE AND OTHER
 MEDICATIONS APPROVED BY THE DEPARTMENT OF HEALTH FOR SUCH PURPOSE PURSU-
 ANT TO SECTIONS  THIRTY-THREE  HUNDRED  NINE  AND  THIRTY-THREE  HUNDRED
 NINE-B OF THE PUBLIC HEALTH LAW.
   § 9. Section 6801-a of the education law, as amended by chapter 238 of
 the laws of 2015, is amended to read as follows:
   §   6801-a.   Collaborative  drug  therapy  management  [demonstration
 program].  1. As used in this section, the following  terms  shall  have
 the following meanings:
   a.  "Board"  shall  mean the state board of pharmacy as established by
 section sixty-eight hundred four of this article.
   b. "Clinical services" shall mean the collection and interpretation of
 patient data for the purpose of [initiating, modifying  and]  monitoring
 drug  therapy  AND PRESCRIBING IN ORDER TO ADJUST OR MANAGE DRUG THERAPY
 with associated accountability and  responsibility  for  outcomes  in  a
 direct patient care setting.
   c.  "Collaborative drug therapy management" shall mean the performance
 of clinical services by a pharmacist relating to the review,  evaluation
 and  management  of drug therapy to a patient, who is being treated by a
 physician OR NURSE PRACTITIONER for a  specific  disease  or  associated
 disease  states, in accordance with a written agreement or protocol with
 a voluntarily participating physician [and in accordance with the  poli-
 cies,  procedures, and protocols of the facility] OR NURSE PRACTITIONER.
 Such agreement or protocol as entered into by  the  physician  OR  NURSE
 PRACTITIONER, and a pharmacist, may include[, and shall be limited to]:
 S. 4007                            177                           A. 3007
 
   (i) [adjusting or managing] PRESCRIBING IN ORDER TO ADJUST OR MANAGE a
 drug  regimen of a patient, pursuant to a patient specific order or NON-
 PATIENT SPECIFIC protocol made by  the  patient's  physician,  OR  NURSE
 PRACTITIONER,  which  may  include adjusting drug strength, frequency of
 administration  or  route of administration[. Adjusting the drug regimen
 shall not include substituting] or selecting a  [different]  drug  which
 differs  from  that  initially  prescribed  by  the  patient's physician
 [unless such substitution is expressly] OR NURSE PRACTITIONER AS author-
 ized in the written [order] AGREEMENT or  protocol,  PROVIDED,  HOWEVER,
 THAT  THE  PHARMACIST  SHALL APPROPRIATELY CONSIDER CLINICAL BENEFIT AND
 COST TO THE PATIENT AND/OR PAYER IN DISCHARGING THESE  RESPONSIBILITIES.
 The  pharmacist shall be required to immediately document in the patient
 record changes made to the patient's drug  therapy  and  shall  use  any
 reasonable  means  or  method established by the facility OR PRACTICE to
 notify the patient's other treating physicians [with whom he or she does
 not have a written agreement or protocol  regarding  such  changes.  The
 patient's physician may prohibit, by written instruction, any adjustment
 or  change  in  the patient's drug regimen by the pharmacist], PHYSICIAN
 ASSISTANTS, NURSE PRACTITIONERS AND OTHER PROFESSIONALS AS  REQUIRED  BY
 THE FACILITY OR THE COLLABORATIVE PRACTICE AGREEMENT;
   (ii) evaluating and[, only if specifically] AS authorized by the WRIT-
 TEN  AGREEMENT OR protocol and only to the extent necessary to discharge
 the responsibilities set forth in this section, ordering  disease  state
 laboratory tests related to the drug therapy management for the specific
 disease or disease [state] STATES specified within the written agreement
 or protocol; and
   (iii) [only if specifically] AS authorized by the written agreement or
 protocol  and only to the extent necessary to discharge the responsibil-
 ities set forth in this section, ordering or performing routine  patient
 monitoring  functions  as  may  be necessary in the drug therapy manage-
 ment[, including the collecting and reviewing of patient histories,  and
 ordering  or checking patient vital signs, including pulse, temperature,
 blood pressure and respiration].
   d. "Facility" shall mean[:  (i)]  a  [teaching  hospital  or]  general
 hospital, [including any] diagnostic center, treatment center, or hospi-
 tal-based  outpatient  department  as  defined  in  section twenty-eight
 hundred one of the public health law[; or (ii)],  A  RESIDENTIAL  HEALTH
 CARE  FACILITY  OR  a nursing home with an on-site pharmacy staffed by a
 licensed pharmacist OR ANY FACILITY AS DEFINED IN  SECTION  TWENTY-EIGHT
 HUNDRED  ONE  OF  THE  PUBLIC  HEALTH  LAW OR OTHER ENTITY THAT PROVIDES
 DIRECT PATIENT CARE UNDER THE AUSPICES OF A MEDICAL DIRECTOR;  provided,
 however,  for the purposes of this section the term "facility" shall not
 include dental clinics, dental dispensaries,  [residential  health  care
 facilities] and rehabilitation centers.
   For  the purposes of this section, [a "teaching hospital" shall mean a
 hospital licensed pursuant to article twenty-eight of the public  health
 law  that  is  eligible  to  receive direct or indirect graduate medical
 education payments pursuant to article twenty-eight of the public health
 law] A "PRACTICE" SHALL MEAN A PLACE OR SITUATION IN  WHICH  PHYSICIANS,
 AND NURSE PRACTITIONERS EITHER ALONE OR IN GROUP PRACTICES PROVIDE DIAG-
 NOSTIC AND TREATMENT CARE FOR PATIENTS.
   e.  ["Physician"]  "PHYSICIAN  OR  NURSE  PRACTITIONER" shall mean the
 physician OR NURSE PRACTITIONER selected by or assigned  to  a  patient,
 who has primary responsibility for the treatment and care of the patient
 for  the  disease  and associated disease states that are the subject of
 the collaborative drug therapy management.
 S. 4007                            178                           A. 3007
 
   f. "Written agreement or protocol"  shall  mean  a  written  document,
 pursuant to and consistent with any applicable state or federal require-
 ments,  that  addresses  a specific disease or associated disease states
 and that describes the nature and scope of  collaborative  drug  therapy
 management  to  be  undertaken by the pharmacists, in collaboration with
 the participating physician, NURSE PRACTITIONER OR FACILITY  in  accord-
 ance with the provisions of this section.
   2.  a. A pharmacist who meets the experience requirements of paragraph
 b of this subdivision and who is [employed by  or  otherwise  affiliated
 with  a facility] CERTIFIED BY THE DEPARTMENT TO ENGAGE IN COLLABORATIVE
 DRUG THERAPY MANAGEMENT AND WHO  IS  EITHER  EMPLOYED  BY  OR  OTHERWISE
 AFFILIATED  WITH A FACILITY OR IS PARTICIPATING WITH A PRACTICING PHYSI-
 CIAN OR NURSE PRACTITIONER shall be permitted to enter  into  a  written
 agreement or protocol with a physician, OR NURSE PRACTITIONER OR FACILI-
 TY  authorizing  collaborative  drug  therapy management, subject to the
 limitations set forth in this section, within the scope of such  employ-
 ment  [or],  affiliation OR PARTICIPATION. ONLY PHARMACISTS SO CERTIFIED
 MAY ENGAGE IN COLLABORATIVE DRUG THERAPY MANAGEMENT AS DEFINED  IN  THIS
 SECTION.
   b. A participating pharmacist must[:
   (i)(A)  have been awarded either a master of science in clinical phar-
 macy or a doctor of pharmacy degree;
   (B)] maintain a current unrestricted license[;], and
   [(C) have a minimum of two years experience, of  which  at  least  one
 year  of  such  experience shall include clinical experience in a health
 facility, which involves consultation with physicians  with  respect  to
 drug  therapy  and  may include a residency at a facility involving such
 consultation; or
   (ii)(A) have been awarded a bachelor of science in pharmacy;
   (B) maintain a current unrestricted license; and
   (C) within the last seven years, have a minimum of three years experi-
 ence, of which at least one year of such experience shall include  clin-
 ical  experience  in a health facility, which involves consultation with
 physicians with respect to drug therapy and may include a residency at a
 facility involving such consultation; and
   (iii) meet any additional education, experience, or other requirements
 set forth by the department in consultation with the board] SHALL SATIS-
 FY ANY TWO OF THE FOLLOWING CRITERIA:
   (I) CERTIFICATION IN A RELEVANT AREA OF  PRACTICE  INCLUDING  BUT  NOT
 LIMITED  TO  AMBULATORY CARE, CRITICAL CARE, GERIATRIC PHARMACY, NUCLEAR
 PHARMACY, NUTRITION SUPPORT PHARMACY, ONCOLOGY PHARMACY, PEDIATRIC PHAR-
 MACY, PHARMACOTHERAPY, OR PSYCHIATRIC PHARMACY, FROM A NATIONAL  ACCRED-
 ITING BODY AS APPROVED BY THE DEPARTMENT;
   (II) POSTGRADUATE RESIDENCY THROUGH AN ACCREDITED POSTGRADUATE PROGRAM
 REQUIRING  AT LEAST FIFTY PERCENT OF THE EXPERIENCE BE IN DIRECT PATIENT
 CARE SERVICES WITH INTERDISCIPLINARY TERMS; OR
   (III) HAVE PROVIDED CLINICAL SERVICES TO PATIENTS  FOR  AT  LEAST  ONE
 YEAR EITHER:
   (A) UNDER A COLLABORATIVE PRACTICE AGREEMENT OR PROTOCOL WITH A PHYSI-
 CIAN, NURSE PRACTITIONER OR FACILITY; OR
   (B)    HAVE DOCUMENTED EXPERIENCE IN PROVISION OF CLINICAL SERVICES TO
 PATIENTS FOR AT LEAST ONE YEAR OR ONE THOUSAND HOURS, AND DEEMED ACCEPT-
 ABLE TO THE DEPARTMENT UPON RECOMMENDATION OF THE BOARD OF PHARMACY.
   c. Notwithstanding any provision of law, nothing in this section shall
 prohibit a licensed pharmacist from engaging in clinical services  asso-
 ciated  with  collaborative  drug  therapy  management, in order to gain
 S. 4007                            179                           A. 3007

 experience necessary to qualify under [clause (C) of subparagraph (i) or
 (ii) of paragraph b] CLAUSE (B) OF SUBPARAGRAPH (III) OF PARAGRAPH B  of
 this  subdivision,  provided that such practice is under the supervision
 of  a  pharmacist  that  currently meets the referenced requirement, and
 that such practice is authorized under the written agreement or protocol
 with the physician OR NURSE PRACTITIONER OR FACILITY.
   d. Notwithstanding any provision of this section, nothing herein shall
 authorize the pharmacist to diagnose disease. In the event that a treat-
 ing physician OR NURSE PRACTITIONER may disagree with  the  exercise  of
 professional  judgment  by  a  pharmacist,  the judgment of the treating
 physician OR NURSE PRACTITIONER shall prevail.
   3. [The physician who is a party to a written  agreement  or  protocol
 authorizing  collaborative  drug therapy management shall be employed by
 or otherwise affiliated with the same facility with which the pharmacist
 is also employed or affiliated.
   4. The existence of a written agreement or protocol  on  collaborative
 drug therapy management and the patient's right to choose to not partic-
 ipate in collaborative drug therapy management shall be disclosed to any
 patient  who  is  eligible to receive collaborative drug therapy manage-
 ment. Collaborative drug therapy management shall not be utilized unless
 the patient or the  patient's  authorized  representative  consents,  in
 writing,  to such management. If the patient or the patient's authorized
 representative consents, it shall be  noted  on  the  patient's  medical
 record.  If  the  patient or the patient's authorized representative who
 consented to collaborative drug therapy management chooses to no  longer
 participate  in  such  management, at any time, it shall be noted on the
 patient's medical record. In addition,  the  existence  of  the  written
 agreement or protocol and the patient's consent to such management shall
 be  disclosed  to the patient's primary physician and any other treating
 physician or healthcare provider.
   5.] A PHARMACIST WHO IS CERTIFIED  BY  THE  DEPARTMENT  TO  ENGAGE  IN
 COLLABORATIVE  DRUG THERAPY MANAGEMENT MAY ENTER INTO A WRITTEN COLLABO-
 RATIVE PRACTICE AGREEMENT OR PROTOCOL WITH A  PHYSICIAN,  NURSE  PRACTI-
 TIONER  OR FACILITY AND MAY PRACTICE AS AN INDEPENDENT  PHARMACIST OR AS
 AN EMPLOYEE OF A PHARMACY OR OTHER HEALTH CARE PROVIDER. IN A  FACILITY,
 THE  PHYSICIAN  OR NURSE PRACTITIONER AND THE PHARMACIST WHO ARE PARTIES
 TO A WRITTEN AGREEMENT OR PROTOCOL AUTHORIZING COLLABORATIVE DRUG THERA-
 PY MANAGEMENT SHALL BE EMPLOYED BY OR BE OTHERWISE AFFILIATED  WITH  THE
 FACILITY.
   4. Participation in a written agreement or protocol authorizing colla-
 borative  drug  therapy  management  shall be voluntary, and no patient,
 physician, NURSE PRACTITIONER, pharmacist, or facility shall be required
 to participate.
   [6. Nothing in this section shall be deemed  to  limit  the  scope  of
 practice of pharmacy nor be deemed to limit the authority of pharmacists
 and physicians to engage in medication management prior to the effective
 date of this section and to the extent authorized by law.]
   §  10. Section 6601 of the education law, as amended by chapter 576 of
 the laws of 2001, is amended to read as follows:
   § 6601. Definition of practice  of  dentistry.  The  practice  of  the
 profession  of  dentistry is defined as diagnosing, treating, operating,
 or prescribing for any disease, pain,  injury,  deformity,  or  physical
 condition  of  the  oral and maxillofacial area related to restoring and
 maintaining dental  health.  The  practice  of  dentistry  includes  the
 prescribing  and  fabrication  of  dental prostheses and appliances. The
 practice of dentistry may include  performing  physical  evaluations  in
 S. 4007                            180                           A. 3007
 
 conjunction  with  the  provision  of  dental treatment. THE PRACTICE OF
 DENTISTRY MAY ALSO INCLUDE ORDERING AND ADMINISTERING HIV AND  HEPATITIS
 C  SCREENING  TESTS  OR DIAGNOSTIC TESTS AUTHORIZED BY THE FOOD AND DRUG
 ADMINISTRATION  (FDA)  AND SUBJECT TO CERTIFICATE OF WAIVER REQUIREMENTS
 ESTABLISHED PURSUANT TO THE FEDERAL CLINICAL LABORATORY IMPROVEMENT  ACT
 OF NINETEEN HUNDRED EIGHTY-EIGHT.
   § 11. Subdivision 4 of section 6909 of the education law is amended by
 adding four new paragraphs (i), (j), (k) and (l) to read as follows:
   (I)  THE  ORDERING  OF ASTHMA SELF-MANAGEMENT EDUCATION AND HOME-BASED
 ASTHMA SERVICES.
   (J) THE URGENT OR EMERGENCY TREATMENT OF ASTHMA.
   (K) PROVIDING STOOL TESTS TO SCREEN FOR COLORECTAL CANCER.
   (L) THE ORDERING OF DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT.
   § 12. Subdivision 6 of section 6527 of the education law is amended by
 adding four new paragraphs (i), (j), (k) and (l) to read as follows:
   (I) THE ORDERING OF ASTHMA SELF-MANAGEMENT  EDUCATION  AND  HOME-BASED
 ASTHMA SERVICES.
   (J) THE URGENT OR EMERGENCY TREATMENT OF ASTHMA.
   (K) PROVIDING STOOL TESTS TO SCREEN FOR COLORECTAL CANCER.
   (L) THE ORDERING OF DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT.
   §  13.  Section  6801  of the education law is amended by adding a new
 subdivision 12 to read as follows:
   12. A LICENSED PHARMACIST WITHIN THEIR LAWFUL SCOPE  OF  PRACTICE  MAY
 ORDER  DIABETES  SELF-MANAGEMENT  EDUCATION AND SUPPORT AND ASTHMA SELF-
 MANAGEMENT EDUCATION AND HOME-BASED ASTHMA SERVICES  FOR  PATIENTS,  AND
 ANY  OTHER  SERVICES  AUTHORIZED  IN  REGULATION  BY THE COMMISSIONER IN
 COLLABORATION WITH THE COMMISSIONER OF HEALTH.
   § 14. Paragraph (q) of subdivision 2 of section 365-a  of  the  social
 services  law,  as  amended by section 35 of part B of chapter 58 of the
 laws of 2010, is amended to read as follows:
   (q) diabetes self-management training services for  persons  diagnosed
 with  diabetes when such services are ordered by a physician, registered
 physician assistant, registered nurse practitioner, LICENSED  PHARMACIST
 or licensed midwife and provided by a licensed, registered, or certified
 health  care  professional, as determined by the commissioner of health,
 who is certified as a diabetes educator by  the  National  Certification
 Board  for  Diabetes  Educators,  or  a successor national certification
 board, or provided by such a  professional  who  is  affiliated  with  a
 program  certified  by  the  American Diabetes Association, the American
 Association of Diabetes Educators, the Indian Health  Services,  or  any
 other  national  accreditation  organization  approved  by  the  federal
 centers for medicare and medicaid services; 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 financial participation in the costs  of  health  care  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.
   §  15.  Paragraph  (r) of subdivision 2 of section 365-a of the social
 services law, as added by section 32 of part C of chapter 58 of the laws
 of 2008,  is amended to read as follows:
   (r) asthma self-management training  services  for  persons  diagnosed
 with  asthma  when  such services are ordered by a physician, registered
 physician's  assistant,  registered  nurse  practitioner,     REGISTERED
 PROFESSIONAL NURSE, LICENSED PHARMACIST or licensed midwife and provided
 by  a  licensed,  registered,  or certified health care professional, as
 S. 4007                            181                           A. 3007

 determined by the commissioner of health, who is certified as an  asthma
 educator  by  the  National  Asthma  Educator  Certification Board, or a
 successor national certification  board;  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 financial participation in the costs  of  health  care  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.
   § 16. Paragraph (v) of subdivision 2 of section 365-a  of  the  social
 services  law, as added by section 4 of part B of chapter 58 of the laws
 of 2010, is amended to read as follows:
   (v) ORDERING AND administration of vaccinations [in a pharmacy], MEDI-
 CATIONS, SELF-MANAGEMENT EDUCATION, AND HOME-BASED SERVICES by a [certi-
 fied] LICENSED pharmacist within [his or her] THEIR scope of practice.
   § 17. Section 6542 of the education law, as amended by chapter  48  of
 the laws of 2012, subdivisions 3 and 5 as amended by section 1 of part T
 of chapter 57 of the laws of 2013, is amended to read as follows:
   §  6542. Performance of medical services. 1. Notwithstanding any other
 provision of law, a physician assistant may  perform  medical  services,
 but  only  when  under the supervision of a physician and only when such
 acts and duties as are assigned to him or her are within  the  scope  of
 practice  of  such  supervising  physician UNLESS OTHERWISE PERMITTED BY
 THIS SECTION.
   1-A. A PHYSICIAN ASSISTANT MAY PRACTICE WITHOUT THE SUPERVISION  OF  A
 PHYSICIAN UNDER THE FOLLOWING CIRCUMSTANCES:
   A.  WHERE  THE  PHYSICIAN ASSISTANT, LICENSED UNDER SECTION SIXTY-FIVE
 HUNDRED FORTY-ONE OF THIS ARTICLE HAS  PRACTICED  FOR  MORE  THAN  EIGHT
 THOUSAND HOURS AND:
   (I)    IS PRACTICING IN PRIMARY CARE.  FOR PURPOSES OF THIS PARAGRAPH,
 "PRIMARY CARE" SHALL MEAN NON-SURGICAL CARE IN  THE  FIELDS  OF  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; OR
   (II) IS EMPLOYED BY A HEALTH  SYSTEM  OR  HOSPITAL  ESTABLISHED  UNDER
 ARTICLE  TWENTY-EIGHT OF THE PUBLIC HEALTH LAW, AND THE HEALTH SYSTEM OR
 HOSPITAL DETERMINES THE PHYSICIAN ASSISTANT MEETS THE QUALIFICATIONS  OF
 THE  MEDICAL  STAFF  BYLAWS  AND THE HEALTH SYSTEM OR HOSPITAL GIVES THE
 PHYSICIAN ASSISTANT PRIVILEGES;
   B.   WHERE A PHYSICIAN ASSISTANT  LICENSED  UNDER  SECTION  SIXTY-FIVE
 HUNDRED  FORTY-ONE  OF  THIS ARTICLE HAS COMPLETED A PROGRAM APPROVED BY
 THE DEPARTMENT OF HEALTH, IN CONSULTATION WITH THE DEPARTMENT, WHEN SUCH
 SERVICES ARE PERFORMED WITHIN THE SCOPE OF SUCH PROGRAM.
   C. THE DEPARTMENT AND THE  DEPARTMENT  OF  HEALTH  ARE  AUTHORIZED  TO
 PROMULGATE AND UPDATE REGULATIONS PURSUANT TO THIS SECTION.
   2.  [Supervision]  WHERE  SUPERVISION  IS REQUIRED BY THIS SECTION, IT
 shall be continuous but shall not be construed as necessarily  requiring
 the physical presence of the supervising physician at the time and place
 where such services are performed.
   3.  [No  physician  shall employ or supervise more than four physician
 assistants in his or her private practice.
   4.] Nothing in this article shall prohibit a hospital  from  employing
 physician  assistants  provided  they  [work  under the supervision of a
 physician designated by the hospital and not beyond the scope  of  prac-
 tice of such physician. The numerical limitation of subdivision three of
 this section shall not apply to services performed in a hospital.
 S. 4007                            182                           A. 3007

   5.  Notwithstanding any other provision of this article, nothing shall
 prohibit a physician employed by or rendering services to the department
 of corrections and community supervision under contract from supervising
 no more than six physician assistants in his or  her  practice  for  the
 department of corrections and community supervision.
   6.  Notwithstanding  any  other  provision  of  law,  a  trainee in an
 approved program may perform medical services  when  such  services  are
 performed  within the scope of such program.] MEET THE QUALIFICATIONS OF
 THE MEDICAL STAFF BYLAWS AND ARE GIVEN PRIVILEGES AND OTHERWISE MEET THE
 REQUIREMENTS OF THIS SECTION.
   4. A PHYSICIAN ASSISTANT SHALL BE AUTHORIZED TO  PRESCRIBE,  DISPENSE,
 ORDER,  ADMINISTER, OR PROCURE ITEMS NECESSARY TO COMMENCE OR COMPLETE A
 COURSE OF THERAPY.
   5. A PHYSICIAN ASSISTANT MAY PRESCRIBE AND ORDER  A  PATIENT  SPECIFIC
 ORDER OR NON-PATIENT SPECIFIC REGIMEN TO A LICENSED PHARMACIST OR REGIS-
 TERED  PROFESSIONAL  NURSE,  PURSUANT  TO REGULATIONS PROMULGATED BY THE
 COMMISSIONER OF HEALTH, AND CONSISTENT WITH THE PUBLIC HEALTH  LAW,  FOR
 ADMINISTERING IMMUNIZATIONS. NOTHING IN THIS SUBDIVISION SHALL AUTHORIZE
 UNLICENSED PERSONS TO ADMINISTER IMMUNIZATIONS, VACCINES OR OTHER DRUGS.
   6.  WHERE  A  PHYSICIAN  ASSISTANT  LICENSED  UNDER SECTION SIXTY-FIVE
 HUNDRED FORTY-ONE OF THIS ARTICLE HAS COMPLETED A  PROGRAM  APPROVED  BY
 THE DEPARTMENT OF HEALTH, IN CONSULTATION WITH THE DEPARTMENT, WHEN SUCH
 SERVICES ARE PERFORMED WITHIN THE SCOPE OF SUCH PROGRAM.
   7.  Nothing  in this article, or in article thirty-seven of the public
 health law, shall be construed  to  authorize  physician  assistants  to
 perform  those  specific  functions and duties specifically delegated by
 law to those persons licensed as allied health professionals  under  the
 public health law or this chapter.
   §  18.  Subdivision  1  of  section  3701 of the public health law, as
 amended by chapter 48 of the  laws  of  2012,  is  amended  to  read  as
 follows:
   1.  to  promulgate  regulations  defining  and  restricting the duties
 [which may be assigned to] OF physician assistants [by their supervising
 physician, the degree of supervision required and the  manner  in  which
 such duties may be performed] CONSISTENT WITH SECTION SIXTY-FIVE HUNDRED
 FORTY-TWO OF THE EDUCATION LAW.;
   §  19. Section 3702 of the public health law, as amended by chapter 48
 of the laws of 2012, is amended to read as follows:
   § 3702. Special provisions. 1. Inpatient medical  orders.  A  licensed
 physician  assistant  employed or extended privileges by a hospital may,
 if permissible under the bylaws, rules and regulations of the  hospital,
 write  medical  orders,  including  those  for controlled substances AND
 DURABLE MEDICAL EQUIPMENT, for inpatients [under the care of the  physi-
 cian  responsible  for  his or her supervision. Countersignature of such
 orders may be required if deemed necessary and appropriate by the super-
 vising physician or the hospital, but in no event shall countersignature
 be required prior to execution].
   2. Withdrawing blood. A  licensed  physician  assistant  or  certified
 nurse practitioner acting within his or her lawful scope of practice may
 supervise  and  direct the withdrawal of blood for the purpose of deter-
 mining the alcoholic or drug content therein under subparagraph  one  of
 paragraph  (a) of subdivision four of section eleven hundred ninety-four
 of the vehicle and traffic law, notwithstanding  any  provision  to  the
 contrary in clause (ii) of such subparagraph.
   3.  Prescriptions  for  controlled  substances.  A  licensed physician
 assistant, in good faith and acting within his or her  lawful  scope  of
 S. 4007                            183                           A. 3007
 
 practice, and to the extent assigned by his or her supervising physician
 AS  APPLICABLE  BY SECTION SIXTY-FIVE HUNDRED FORTY-TWO OF THE EDUCATION
 LAW, may prescribe controlled substances as a practitioner under article
 thirty-three  of this chapter, to patients under the care of such physi-
 cian responsible for  his  or  her  supervision.  The  commissioner,  in
 consultation  with  the  commissioner  of education, may promulgate such
 regulations as are necessary to carry out the purposes of this section.
   § 20. Section 3703 of the public health law, as amended by chapter  48
 of the laws of 2012, is amended to read as follows:
   §  3703. Statutory construction. A physician assistant may perform any
 function in conjunction with a medical service lawfully performed by the
 physician assistant, in any health care setting, that a statute  author-
 izes  or  directs  a physician to perform and that is appropriate to the
 education, training and experience of the licensed  physician  assistant
 and within the ordinary practice of the supervising physician, AS APPLI-
 CABLE  PURSUANT TO SECTION SIXTY-FIVE HUNDRED FORTY-TWO OF THE EDUCATION
 LAW. This section shall not be construed to  increase  or  decrease  the
 lawful  scope  of  practice of a physician assistant under the education
 law.
   § 21. Paragraph a of subdivision 2 of section  902  of  the  education
 law,  as  amended by chapter 376 of the laws of 2015, is amended to read
 as follows:
   a. The board of education, and the trustee or  board  of  trustees  of
 each  school district, shall employ, at a compensation to be agreed upon
 by the parties, a qualified physician, A PHYSICIAN ASSISTANT, or a nurse
 practitioner to the extent authorized by  the  nurse  practice  act  and
 consistent  with  subdivision three of section six thousand nine hundred
 two of this chapter, to perform the duties of  the  director  of  school
 health  services, including any duties conferred on the school physician
 or school medical inspector under any provision of law, to  perform  and
 coordinate the provision of health services in the public schools and to
 provide  health  appraisals  of students attending the public schools in
 the city or district. The physicians,  PHYSICIANS  ASSISTANTS  or  nurse
 practitioners  so employed shall be duly licensed pursuant to applicable
 law.
   § 22. Subdivision 5 of section 6810 of the education law, as added  by
 chapter 881 of the laws of 1972, is amended to read as follows:
   5. Records of all prescriptions filled or refilled shall be maintained
 for  a period of at least five years and upon request made available for
 inspection and copying by  a  representative  of  the  department.  Such
 records   shall  indicate  date  of  filling  or  refilling,  [doctor's]
 PRESCRIBER'S name, patient's name and address and the name  or  initials
 of   the   pharmacist   who   prepared,  compounded,  or  dispensed  the
 prescription. Records of prescriptions for controlled  substances  shall
 be  maintained  pursuant  to requirements of article thirty-three of the
 public health law.
   § 23. Subdivision 27 of section 3302 of  the  public  health  law,  as
 amended  by  chapter  92  of  the  laws  of  2021, is amended to read as
 follows:
   27. "Practitioner" means:
   A physician, PHYSICIAN ASSISTANT, dentist,  podiatrist,  veterinarian,
 scientific  investigator, or other person licensed, or otherwise permit-
 ted to dispense, administer  or  conduct  research  with  respect  to  a
 controlled  substance  in the course of a licensed professional practice
 or research licensed pursuant to this  article.  Such  person  shall  be
 deemed  a "practitioner" only as to such substances, or conduct relating
 S. 4007                            184                           A. 3007
 
 to such substances, as is permitted by [his] THEIR  license,  permit  or
 otherwise permitted by law.
   §  24.  Paragraph  b of subdivision 2 of section 6908 of the education
 law, as added by chapter 471 of the laws of 2016, is amended to read  as
 follows:
   b. provide that advanced tasks performed by advanced home health aides
 may  be  performed  only  under the [direct] supervision of a registered
 professional nurse licensed in New York state,  as  set  forth  in  this
 subdivision  and subdivision eight of section sixty-nine hundred nine of
 this article, where such nurse is employed by a home care services agen-
 cy licensed or certified pursuant to article thirty-six  of  the  public
 health law, a hospice program certified pursuant to article forty of the
 public  health  law,  or  an enhanced assisted living residence licensed
 pursuant to article seven of  the  social  services  law  and  certified
 pursuant  to  article forty-six-B of the public health law. Such nursing
 supervision shall:
   (i) include training and periodic assessment  of  the  performance  of
 advanced tasks;
   (ii)  be  determined  by the registered professional nurse responsible
 for supervising such advanced tasks based upon the  complexity  of  such
 advanced  tasks,  the  skill  and experience of the advanced home health
 aide, and the health status of the individual  for  whom  such  advanced
 tasks are being performed;
   (iii) include a comprehensive initial and thereafter regular and ongo-
 ing assessment of the individual's needs;
   (iv)  include as a requirement that the supervising registered profes-
 sional nurse shall visit individuals receiving services for the  purpose
 of  supervising  the services provided by advanced home health aides [no
 less than once every two weeks] and include  as  a  requirement  that  a
 registered  professional  nurse  shall  be available by telephone to the
 advanced home health aide twenty-four hours a day, seven  days  a  week,
 provided  that  a  registered  professional  nurse shall be available to
 visit an individual receiving  services  as  necessary  to  protect  the
 health and safety of such individual; and
   (v) as shall be specified by the commissioner, be provided in a manner
 that  takes  into account individual care needs, case mix complexity and
 geographic considerations and provide that  the  number  of  individuals
 served  by a supervising registered professional nurse is reasonable and
 prudent.
   § 25. Subparagraph (i) of paragraph (c) of subdivision  8  of  section
 6909  of the education law, as added by chapter 471 of the laws of 2016,
 is amended to read as follows:
   (i) visit individuals receiving services for the purpose of  supervis-
 ing  the  services  provided by advanced home health aides [no less than
 once every two weeks]; and
   § 26. Subdivision (b) of section 12 of chapter 471 of the laws of 2016
 amending the education law and the public health law relating to author-
 izing certain advanced home health aides  to  perform  certain  advanced
 tasks, is amended to read as follows:
   b. this act shall expire and be deemed repealed March 31, [2023] 2029.
   §  27.  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
 RELATED 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:
 S. 4007                            185                           A. 3007
 
   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
 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
 S. 4007                            186                           A. 3007
 
   (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 THEMSELF OUT, OR
 ACCEPTING EMPLOYMENT AS, A PERSON LICENSED TO PRACTICE NURSING UNDER THE
 PROVISIONS OF THIS ARTICLE;
   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.
   §  28.  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.
   § 29. 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;
   § 30. 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.
 S. 4007                            187                           A. 3007

         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.
   § 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.
 S. 4007                            188                           A. 3007
 
   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
 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
 S. 4007                            189                           A. 3007
 
 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
 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-
 S. 4007                            190                           A. 3007
 
 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
 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.
 S. 4007                            191                           A. 3007
 
   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.
   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
 S. 4007                            192                           A. 3007
 
 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
 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;
 S. 4007                            193                           A. 3007
 
   (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;
   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;
 S. 4007                            194                           A. 3007

   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.
   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
 S. 4007                            195                           A. 3007
 
 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,
 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
 S. 4007                            196                           A. 3007
 
 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
 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-
 S. 4007                            197                           A. 3007
 
 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.
   § 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.
 S. 4007                            198                           A. 3007
 
   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.
   § 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.
   § 31. 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.
 S. 4007                            199                           A. 3007
 
         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.
   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.
 S. 4007                            200                           A. 3007
 
   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.
   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
 S. 4007                            201                           A. 3007
 
 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;
   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.
 S. 4007                            202                           A. 3007
 
   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.
   § 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.
 S. 4007                            203                           A. 3007
 
   § 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,
 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.
 S. 4007                            204                           A. 3007
 
   § 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
 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
 S. 4007                            205                           A. 3007
 
 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
 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,
 S. 4007                            206                           A. 3007
 
 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
 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;
 S. 4007                            207                           A. 3007
 
   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.
   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
 S. 4007                            208                           A. 3007
 
 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.
   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.
 S. 4007                            209                           A. 3007
 
   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
 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:
 S. 4007                            210                           A. 3007
 
   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.
   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.
 S. 4007                            211                           A. 3007
 
   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-THREE 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
 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.
   § 32. 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
 S. 4007                            212                           A. 3007
 
 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.
   § 33. This act shall take effect immediately; provided however, that:
   a.  section  seven  of this act shall take effect nine months after it
 shall have become a law;
   b. sections seventeen, eighteen, nineteen, twenty,  twenty-one,  twen-
 ty-two  and twenty-three of this act shall take effect one year after it
 shall have become a law;
   c. sections twenty-seven, twenty-eight and  twenty-nine  of  this  act
 shall  expire  and  be  deemed  repealed two years after they shall have
 become a law;
   d. sections thirty and thirty-one of this act shall   be   deemed   to
 have been in full force and effect on and after April 1, 2023;
   e.  section  thirty-two of this act shall take effect on the ninetieth
 day after it shall have become a law;
   f. the amendments to section 6801-a  of  the  education  law  made  by
 section nine of this act shall not affect the repeal of such section and
 shall be deemed to be repealed therewith; and
   g.  the  amendments  to subdivision 2 of section 6908 of the education
 law made by section twenty-four of this act shall not affect the  repeal
 of such subdivision and shall be deemed to be repealed therewith.
   h.  the  amendments  to subdivision 8 of section 6909 of the education
 law made by section twenty-five of this act shall not affect the  repeal
 of such subdivision and shall be deemed repealed therewith.
   Effective  immediately,  the  addition, amendment and/or repeal of any
 rule or regulation necessary for the implementation of this act  on  its
 S. 4007                            213                           A. 3007
 
 effective  date  are authorized and directed to be made and completed on
 or before such effective date.
 
                                  PART X
 
   Section  1.  The  public health law is amended by adding a new article
 29-K to read as follows:
                               ARTICLE 29-K
          REGISTRATION OF TEMPORARY HEALTH CARE SERVICES AGENCIES
 SECTION 2999-II. DEFINITIONS.
         2999-JJ. REGISTRATION OF TEMPORARY HEALTH  CARE  SERVICES  AGEN-
                    CIES; REQUIREMENTS.
         2999-KK. TEMPORARY HEALTH CARE SERVICES AGENCIES; MINIMUM STAND-
                    ARDS.
         2999-LL. VIOLATIONS; PENALTIES.
         2999-MM. RATES FOR TEMPORARY HEALTH CARE SERVICES; REPORTS.
   § 2999-II. DEFINITIONS. FOR THE PURPOSES OF THIS ARTICLE:
   1.  "CERTIFIED NURSE AIDE" MEANS A PERSON INCLUDED IN THE NURSING HOME
 NURSE AIDE REGISTRY PURSUANT TO SECTION TWENTY-EIGHT HUNDRED THREE-J  OF
 THIS  CHAPTER AS ADDED BY CHAPTER SEVEN HUNDRED SEVENTEEN OF THE LAWS OF
 NINETEEN HUNDRED EIGHTY-NINE.
   2. "CONTROLLING PERSON" MEANS A PERSON, OFFICER,  PROGRAM  ADMINISTRA-
 TOR,  OR  DIRECTOR  WHOSE  RESPONSIBILITIES INCLUDE THE DIRECTION OF THE
 MANAGEMENT OR POLICIES OF  A  TEMPORARY  HEALTH  CARE  SERVICES  AGENCY.
 "CONTROLLING  PERSON"  ALSO  MEANS  AN  INDIVIDUAL WHO, DIRECTLY OWNS AT
 LEAST TEN PERCENT VOTING INTEREST  IN  A  CORPORATION,  PARTNERSHIP,  OR
 OTHER BUSINESS ENTITY THAT IS A CONTROLLING PERSON.
   3.  "HEALTH  CARE  ENTITY"  MEANS AN AGENCY, CORPORATION, FACILITY, OR
 INDIVIDUAL PROVIDING MEDICAL OR HEALTH CARE SERVICES.
   4. "HEALTH CARE PERSONNEL" MEANS NURSES,  CERTIFIED  NURSE  AIDES  AND
 LICENSED  OR  UNLICENSED  DIRECT  CARE WORKERS EMPLOYED BY THE TEMPORARY
 HEALTH CARE SERVICES AGENCY TO PROVIDE TEMPORARY SERVICES  IN  A  HEALTH
 CARE ENTITY.
   5.  "NURSE" MEANS A REGISTERED PROFESSIONAL NURSE, OR A LICENSED PRAC-
 TICAL NURSE AS DEFINED BY ARTICLE ONE HUNDRED THIRTY-NINE OF THE  EDUCA-
 TION LAW.
   6.  "DIRECT  CARE  WORKER"  MEANS  AN  EMPLOYEE WHO IS RESPONSIBLE FOR
 PATIENT/RESIDENT HANDLING OR PATIENT/RESIDENT ASSESSMENT AS A REGULAR OR
 INCIDENTAL PART OF THEIR EMPLOYMENT, INCLUDING  ANY  LICENSED  OR  UNLI-
 CENSED HEALTH CARE WORKER.
   7.  "PERSON"  MEANS  AN INDIVIDUAL, FIRM, CORPORATION, PARTNERSHIP, OR
 ASSOCIATION.
   8. "TEMPORARY HEALTH CARE SERVICES AGENCY" OR "AGENCY" MEANS A PERSON,
 FIRM, CORPORATION, PARTNERSHIP, ASSOCIATION OR OTHER ENTITY IN THE BUSI-
 NESS OF PROVIDING OR  PROCURING  TEMPORARY  EMPLOYMENT  OF  HEALTH  CARE
 PERSONNEL FOR HEALTH CARE ENTITIES. TEMPORARY HEALTH CARE SERVICES AGEN-
 CY SHALL INCLUDE A NURSES' REGISTRY LICENSED UNDER ARTICLE ELEVEN OF THE
 GENERAL  BUSINESS  LAW AND ENTITIES THAT UTILIZE APPS OR OTHER TECHNOLO-
 GY-BASED SOLUTIONS TO PROVIDE OR PROCURE TEMPORARY EMPLOYMENT OF  HEALTH
 CARE  PERSONNEL  IN HEALTH CARE ENTITIES. TEMPORARY HEALTH CARE SERVICES
 AGENCY SHALL NOT INCLUDE: (A) AN INDIVIDUAL WHO ONLY ENGAGES IN  PROVID-
 ING  THE  INDIVIDUAL'S  OWN SERVICES ON A TEMPORARY BASIS TO HEALTH CARE
 ENTITIES; OR (B) A HOME CARE AGENCY LICENSED UNDER ARTICLE THIRTY-SIX OF
 THIS CHAPTER.
   § 2999-JJ. REGISTRATION OF TEMPORARY HEALTH  CARE  SERVICES  AGENCIES;
 REQUIREMENTS.  1.  ANY  PERSON  WHO  OPERATES  A  TEMPORARY  HEALTH CARE
 S. 4007                            214                           A. 3007
 
 SERVICES AGENCY SHALL REGISTER THE  AGENCY  WITH  THE  DEPARTMENT.  EACH
 SEPARATE  LOCATION  OF  THE BUSINESS OF A TEMPORARY HEALTH CARE SERVICES
 AGENCY SHALL HAVE A SEPARATE REGISTRATION.
   2.  THE  COMMISSIONER  SHALL PUBLISH GUIDELINES ESTABLISHING THE FORMS
 AND PROCEDURES FOR APPLICATIONS FOR REGISTRATION. FORMS MUST INCLUDE, AT
 A MINIMUM ALL OF THE FOLLOWING:
   (A) THE NAMES AND ADDRESSES OF  THE  TEMPORARY  HEALTH  CARE  SERVICES
 AGENCY CONTROLLING PERSON OR PERSONS.
   (B) THE NAMES AND ADDRESSES OF HEALTH CARE ENTITIES WHERE THE CONTROL-
 LING PERSON OR PERSONS OR THEIR FAMILY MEMBERS:
   (I) HAVE AN OWNERSHIP RELATIONSHIP; OR
   (II) DIRECT THE MANAGEMENT OR POLICIES OF SUCH HEALTH CARE ENTITIES.
   (C)  A DEMONSTRATION THAT THE APPLICANT IS OF GOOD MORAL CHARACTER AND
 ABLE TO COMPLY WITH ALL APPLICABLE STATE LAWS AND  REGULATIONS  RELATING
 TO THE ACTIVITIES IN WHICH IT INTENDS TO ENGAGE UNDER THE REGISTRATION.
   (D)  REGISTRATION AND REGISTRATION ANNUAL RENEWAL FEES OF ONE THOUSAND
 DOLLARS AND MAY ONLY BE USED FOR THE PURPOSE OF OPERATING THIS REGISTRY.
   (E) THE STATE OF INCORPORATION OF THE AGENCY.
   (F) ANY ADDITIONAL INFORMATION THAT  THE  COMMISSIONER  DETERMINES  IS
 NECESSARY TO PROPERLY EVALUATE AN APPLICATION FOR REGISTRATION.
   3.  AS  A  CONDITION OF REGISTRATION, A TEMPORARY HEALTH CARE SERVICES
 AGENCY:
   (A) SHALL DOCUMENT THAT EACH TEMPORARY  EMPLOYEE  PROVIDED  TO  HEALTH
 CARE  ENTITIES  CURRENTLY  MEETS  THE  MINIMUM  LICENSING, TRAINING, AND
 CONTINUING EDUCATION STANDARDS FOR THE POSITION IN  WHICH  THE  EMPLOYEE
 WILL BE WORKING.
   (B)  SHALL  COMPLY  WITH ALL PERTINENT REQUIREMENTS AND QUALIFICATIONS
 FOR PERSONNEL EMPLOYED IN HEALTH CARE ENTITIES.
   (C) SHALL NOT RESTRICT IN ANY MANNER THE EMPLOYMENT  OPPORTUNITIES  OF
 ITS EMPLOYEES.
   (D)  SHALL  MAINTAIN  INSURANCE COVERAGE FOR WORKERS' COMPENSATION AND
 DISABILITY COVERAGE FOR ALL HEALTH CARE PERSONNEL PROVIDED  OR  PROCURED
 BY THE AGENCY.
   (E)  SHALL  NOT  REQUIRE THE PAYMENT OF LIQUIDATED DAMAGES, EMPLOYMENT
 FEES, OR OTHER COMPENSATION SHOULD THE EMPLOYEE BE HIRED AS A  PERMANENT
 EMPLOYEE  OF  A  HEALTH CARE ENTITY IN ANY CONTRACT WITH ANY EMPLOYEE OR
 HEALTH CARE ENTITY OR OTHERWISE.
   (F) SHALL DOCUMENT THAT EACH TEMPORARY  EMPLOYEE  PROVIDED  TO  HEALTH
 CARE  ENTITIES  IS  JOINTLY EMPLOYED BY THE AGENCY AND THE ENTITY AND IS
 NOT AN INDEPENDENT CONTRACTOR.
   (G) SHALL RETAIN ALL RECORDS OF EMPLOYMENT FOR SIX CALENDAR YEARS  AND
 MAKE THEM AVAILABLE TO THE DEPARTMENT UPON REQUEST.
   (H)  SHALL  COMPLY WITH ANY REQUESTS MADE BY THE DEPARTMENT TO EXAMINE
 THE BOOKS AND RECORDS OF THE AGENCY, SUBPOENA  WITNESSES  AND  DOCUMENTS
 AND  MAKE SUCH OTHER INVESTIGATION AS IS NECESSARY IN THE EVENT THAT THE
 DEPARTMENT HAS REASON TO BELIEVE THAT THE BOOKS OR RECORDS DO NOT  ACCU-
 RATELY  REFLECT THE FINANCIAL CONDITION OR FINANCIAL TRANSACTIONS OF THE
 AGENCY.
   (I) SHALL COMPLY WITH ANY ADDITIONAL REQUIREMENTS THE  DEPARTMENT  MAY
 DEEM NECESSARY.
   4. A REGISTRATION ISSUED BY THE COMMISSIONER ACCORDING TO THIS SECTION
 SHALL  BE EFFECTIVE FOR A PERIOD OF ONE YEAR, UNLESS THE REGISTRATION IS
 REVOKED OR SUSPENDED, OR UNLESS OWNERSHIP INTEREST  OF  TEN  PERCENT  OR
 MORE,  OR  MANAGEMENT  OF  THE TEMPORARY HEALTH CARE SERVICES AGENCY, IS
 SOLD OR TRANSFERRED. WHEN OWNERSHIP INTEREST OF TEN PERCENT OR MORE,  OR
 MANAGEMENT  OF A TEMPORARY HEALTH CARE SERVICES AGENCY IS SOLD OR TRANS-
 S. 4007                            215                           A. 3007
 
 FERRED, THE REGISTRATION OF THE AGENCY MAY BE  TRANSFERRED  TO  THE  NEW
 OWNER  OR  OPERATOR  FOR THIRTY DAYS, OR UNTIL THE NEW OWNER OR OPERATOR
 APPLIES AND IS GRANTED OR DENIED A NEW REGISTRATION, WHICHEVER IS  SOON-
 ER.
   5.  THE  COMMISSIONER  MAY,  AFTER  APPROPRIATE  NOTICE  AND  HEARING,
 SUSPEND, REVOKE, OR REFUSE TO ISSUE OR RENEW ANY REGISTRATION  OR  ISSUE
 ANY  FINES  ESTABLISHED  PURSUANT TO SECTION TWENTY-NINE HUNDRED NINETY-
 NINE-LL OF THIS ARTICLE IF THE APPLICANT FAILS TO COMPLY WITH THIS ARTI-
 CLE OR ANY GUIDELINES, RULES AND REGULATIONS PROMULGATED THEREUNDER.
   6. THE COMMISSIONER SHALL MAKE AVAILABLE A LIST  OF  TEMPORARY  HEALTH
 CARE  SERVICES  AGENCIES  REGISTERED  WITH THE DEPARTMENT ON THE DEPART-
 MENT'S PUBLIC WEBSITE.
   7. THE DEPARTMENT SHALL PUBLISH A QUARTERLY REPORT  CONTAINING  AGGRE-
 GATED  AND  DE-IDENTIFIED DATA COLLECTED PURSUANT TO THIS ARTICLE ON THE
 WEBSITE OF THE DEPARTMENT.
   8. THE DEPARTMENT, IN CONSULTATION WITH THE DEPARTMENT OF LABOR, SHALL
 PROVIDE A REPORT TO THE GOVERNOR AND  LEGISLATURE  ON  OR  BEFORE  MARCH
 THIRTY-FIRST,  TWO THOUSAND TWENTY-FOUR, SUMMARIZING THE KEY FINDINGS OF
 THE DATA COLLECTED  PURSUANT  TO  THIS  ARTICLE.  THE  DEPARTMENT  SHALL
 FURTHER  HAVE  AUTHORITY  TO UTILIZE ANY DATA COLLECTED PURSUANT TO THIS
 ARTICLE FOR ADDITIONAL PURPOSES CONSISTENT WITH THIS CHAPTER,  INCLUDING
 BUT  NOT  LIMITED  TO  DETERMINATIONS OF WHETHER AN ACUTE LABOR SHORTAGE
 EXISTS, OR ANY OTHER PURPOSE THE DEPARTMENT DEEMS NECESSARY  FOR  HEALTH
 CARE RELATED DATA PURPOSES.
   9.  THE  ATTORNEY  GENERAL  SHALL, UPON THE REQUEST OF THE DEPARTMENT,
 BRING AN ACTION FOR AN INJUNCTION AGAINST ANY PERSON  WHO  VIOLATES  ANY
 PROVISION  OF  THIS  ARTICLE; PROVIDED, THE DEPARTMENT SHALL FURNISH THE
 ATTORNEY GENERAL WITH SUCH MATERIAL, EVIDENTIARY MATTER OR PROOF AS  MAY
 BE REQUESTED BY THE ATTORNEY GENERAL FOR THE PROSECUTION OF SUCH ACTION.
   § 2999-KK. TEMPORARY HEALTH CARE SERVICES AGENCIES; MINIMUM STANDARDS.
 1.  A TEMPORARY HEALTH CARE SERVICES AGENCY SHALL APPOINT AN ADMINISTRA-
 TOR  QUALIFIED BY TRAINING, EXPERIENCE OR EDUCATION TO OPERATE THE AGEN-
 CY.  EACH SEPARATE AGENCY LOCATION SHALL HAVE ITS OWN ADMINISTRATOR.
   2. A TEMPORARY HEALTH CARE SERVICES AGENCY SHALL DEVELOP AND  MAINTAIN
 WRITTEN  EMPLOYMENT POLICIES AND PROCEDURES. THE AGENCY SHALL INFORM ITS
 EMPLOYEES OF THE TERMS AND CONDITIONS OF EMPLOYMENT BY  THAT  AGENCY  AT
 THE TIME OF HIRE, AS WELL AS NO LESS THAN ANNUALLY THEREAFTER.
   3.  A  TEMPORARY  HEALTH  CARE SERVICES AGENCY SHALL MAINTAIN HOURS OF
 OPERATION AT EACH OF ITS LOCATIONS SUFFICIENT TO  MEET  THE  OBLIGATIONS
 UNDER ITS WRITTEN AGREEMENTS WITH HEALTH CARE ENTITIES.
   4.  A  TEMPORARY  HEALTH CARE SERVICES AGENCY SHALL MAINTAIN A WRITTEN
 AGREEMENT OR CONTRACT WITH EACH HEALTH CARE ENTITY, WHICH SHALL INCLUDE,
 AT A MINIMUM:
   (A) THE REQUIRED MINIMUM LICENSING, TRAINING, AND CONTINUING EDUCATION
 REQUIREMENTS FOR EACH ASSIGNED HEALTH CARE PERSONNEL.
   (B) ANY REQUIREMENT FOR MINIMUM ADVANCE  NOTICE  IN  ORDER  TO  ENSURE
 PROMPT ARRIVAL OF ASSIGNED HEALTH CARE PERSONNEL.
   (C)  THE  MAXIMUM RATES THAT CAN BE BILLED OR CHARGED BY THE TEMPORARY
 HEALTH CARE SERVICES AGENCY  PURSUANT  TO  SECTION  TWENTY-NINE  HUNDRED
 NINETY-NINE-MM OF THIS ARTICLE AND ANY APPLICABLE REGULATIONS.
   (D)  THE  RATES  TO  BE  CHARGED BY THE TEMPORARY HEALTH CARE SERVICES
 AGENCY.
   (E) PROCEDURES FOR THE  INVESTIGATION  AND  RESOLUTION  OF  COMPLAINTS
 ABOUT  THE  PERFORMANCE OF TEMPORARY HEALTH CARE SERVICES AGENCY PERSON-
 NEL.
 S. 4007                            216                           A. 3007
 
   (F) PROCEDURES FOR NOTICE FROM HEALTH  CARE  ENTITIES  OF  FAILURE  OF
 MEDICAL PERSONNEL TO REPORT TO ASSIGNMENTS AND FOR BACK-UP STAFF IN SUCH
 INSTANCES.
   (G) PROCEDURES FOR NOTICE OF ACTUAL OR SUSPECTED ABUSE, THEFT, TAMPER-
 ING OR OTHER DIVERSION OF CONTROLLED SUBSTANCES BY MEDICAL PERSONNEL.
   (H)  THE  TYPES  AND QUALIFICATIONS OF HEALTH CARE PERSONNEL AVAILABLE
 FOR ASSIGNMENT THROUGH THE TEMPORARY HEALTH CARE SERVICES AGENCY.
   5. A TEMPORARY HEALTH CARE SERVICES AGENCY SHALL SUBMIT TO THE DEPART-
 MENT COPIES OF ALL CONTRACTS BETWEEN THE AGENCY AND A HEALTH CARE ENTITY
 TO WHICH IT ASSIGNS OR REFERS HEALTH CARE PERSONNEL, AND COPIES  OF  ALL
 INVOICES  TO  HEALTH CARE ENTITIES PERSONNEL. EXECUTED CONTRACTS MUST BE
 SENT TO THE DEPARTMENT WITHIN FIVE BUSINESS DAYS OF THEIR EFFECTIVE DATE
 AND ARE NOT SUBJECT TO DISCLOSURE UNDER ARTICLE SIX OF THE PUBLIC  OFFI-
 CERS LAW.
   6.  THE  COMMISSIONER  MAY  PROMULGATE  REGULATIONS  TO  IMPLEMENT THE
 REQUIREMENTS OF THIS SECTION AND TO ESTABLISH ADDITIONAL MINIMUM  STAND-
 ARDS  FOR  THE  OPERATION  OF  TEMPORARY  HEALTH CARE SERVICES AGENCIES,
 INCLUDING BUT NOT LIMITED TO PRICING, FEES,  ADMINISTRATIVE  COSTS,  AND
 BUSINESS PRACTICES.
   7.  THE COMMISSIONER MAY WAIVE THE REQUIREMENTS OF THIS ARTICLE DURING
 A DECLARED STATE OR FEDERAL PUBLIC HEALTH EMERGENCY.
   § 2999-LL. VIOLATIONS; PENALTIES. IN ADDITION TO OTHER REMEDIES AVAIL-
 ABLE BY LAW, VIOLATIONS OF THE PROVISIONS OF THIS ARTICLE AND ANY  REGU-
 LATIONS  PROMULGATED  THEREUNDER SHALL BE SUBJECT TO PENALTIES AND FINES
 PURSUANT TO SECTION TWELVE OF THIS CHAPTER; PROVIDED, HOWEVER, THAT EACH
 VIOLATION COMMITTED BY EACH INDIVIDUAL EMPLOYEE OF  A  TEMPORARY  HEALTH
 CARE SERVICES AGENCY SHALL BE CONSIDERED A SEPARATE VIOLATION.
   § 2999-MM. RATES FOR TEMPORARY HEALTH CARE SERVICES; REPORTS. A TEMPO-
 RARY  HEALTH  CARE SERVICES AGENCY SHALL REPORT QUARTERLY TO THE DEPART-
 MENT A FULL DISCLOSURE OF CHARGES AND COMPENSATION, INCLUDING A SCHEDULE
 OF ALL HOURLY BILL RATES PER CATEGORY OF EMPLOYEE, A FULL DESCRIPTION OF
 ADMINISTRATIVE CHARGES, AND A SCHEDULE OF RATES OF ALL COMPENSATION  PER
 CATEGORY OF EMPLOYEE, INCLUDING, BUT NOT LIMITED TO:
   1.  HOURLY REGULAR PAY RATE, SHIFT DIFFERENTIAL, WEEKEND DIFFERENTIAL,
 HAZARD PAY, CHARGE NURSE ADD-ON, OVERTIME, HOLIDAY PAY, TRAVEL OR  MILE-
 AGE PAY, AND ANY HEALTH OR OTHER FRINGE BENEFITS PROVIDED;
   2.  THE  PERCENTAGE  OF  HEALTH  CARE  ENTITY  DOLLARS THAT THE AGENCY
 EXPENDED ON TEMPORARY PERSONNEL  WAGES  AND  BENEFITS  COMPARED  TO  THE
 TEMPORARY HEALTH CARE SERVICES AGENCY'S PROFITS AND OTHER ADMINISTRATIVE
 COSTS;
   3.  A  LIST  OF  THE  STATES AND ZIP CODES OF THEIR EMPLOYEES' PRIMARY
 RESIDENCES;
   4. THE NAMES OF ALL HEALTH CARE ENTITIES THEY HAVE  CONTRACTED  WITHIN
 NEW YORK STATE;
   5. THE NUMBER OF EMPLOYEES OF THE TEMPORARY HEALTH CARE SERVICES AGEN-
 CY WORKING AT EACH ENTITY; AND
   6. ANY OTHER INFORMATION PRESCRIBED BY THE COMMISSIONER.
   §  2.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2023.

                                  PART Y
 
   Section 1. This Part enacts into law major components  of  legislation
 relating  to  medical  debt  and  drug  prices. Each component is wholly
 contained within a Subpart identified  as  Subparts  A  through  D.  The
 effective  date  for  each  particular  provision  contained within such
 S. 4007                            217                           A. 3007
 
 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 reference to a section "of this  act",  when
 used  in  connection  with that particular component, shall be deemed to
 mean and refer to the corresponding section of the Subpart in  which  it
 is  found.  Section  three of this Part sets forth the general effective
 date of this Part.
 
                                 SUBPART A
 
   Section 1. Subdivisions (f) and (j) of section 3215 of the civil prac-
 tice law and rules, subdivision (f) as amended and  subdivision  (j)  as
 added  by chapter 593 of the laws of 2021, subdivision (f) as separately
 amended by chapter 831 of the laws of  2021,  are  amended  to  read  as
 follows:
   (f)  Proof.  On any application for judgment by default, the applicant
 shall file proof of service of the  summons  and  the  complaint,  or  a
 summons  and  notice  served  pursuant to subdivision (b) of rule 305 or
 subdivision (a) of rule 316 of this chapter,  and  proof  of  the  facts
 constituting  the  claim,  the default and the amount due, including, if
 applicable, a statement that the interest rate for consumer debt  pursu-
 ant  to section five thousand four of this chapter applies, by affidavit
 made by the party, or where the state of New York is the  plaintiff,  by
 affidavit  made  by  an attorney from the office of the attorney general
 who has or obtains knowledge of  such  facts  through  review  of  state
 records or otherwise. Where a verified complaint has been served, it may
 be  used  as  the  affidavit of the facts constituting the claim and the
 amount due; in such case, an affidavit as to the default shall  be  made
 by  the  party  or  the  party's attorney. In an action arising out of a
 consumer credit transaction, if the plaintiff is not the original credi-
 tor, the applicant shall include: (1) an affidavit by the original cred-
 itor of the facts constituting the debt, the  default  in  payment,  the
 sale  or  assignment of the debt, and the amount due at the time of sale
 or assignment; (2) for each subsequent assignment or sale of the debt to
 another entity, an affidavit of sale of the debt  by  the  debt  seller,
 completed  by  the seller or assignor; and (3) an affidavit of a witness
 of the plaintiff, which includes a chain of title of the debt, completed
 by the plaintiff or plaintiff's  witness.  IN  AN  ACTION  ARISING  FROM
 MEDICAL  DEBT, IF THE PLAINTIFF IS NOT A HOSPITAL LICENSED UNDER ARTICLE
 TWENTY-EIGHT OF THE PUBLIC HEALTH LAW  OR  A  HEALTH  CARE  PROFESSIONAL
 AUTHORIZED  UNDER  TITLE EIGHT OF THE EDUCATION LAW, THE APPLICANT SHALL
 INCLUDE: (1) AN AFFIDAVIT BY THE HOSPITAL OR HEALTH CARE PROFESSIONAL OF
 THE FACTS CONSTITUTING THE MEDICAL DEBT, THE  DEFAULT  IN  PAYMENT,  THE
 SALE  OR  ASSIGNMENT OF THE MEDICAL DEBT, AND THE AMOUNT DUE AT THE TIME
 OF SALE OR ASSIGNMENT; (2) FOR EACH SUBSEQUENT ASSIGNMENT OR SALE OF THE
 MEDICAL DEBT TO ANOTHER ENTITY, AN AFFIDAVIT OF SALE OF THE MEDICAL DEBT
 BY THE DEBT SELLER, COMPLETED BY THE SELLER  OR  ASSIGNOR;  AND  (3)  AN
 AFFIDAVIT OF A WITNESS OF THE PLAINTIFF, WHICH INCLUDES A CHAIN OF TITLE
 OF  THE MEDICAL DEBT, COMPLETED BY THE PLAINTIFF OR PLAINTIFF'S WITNESS.
 The chief administrative judge shall issue form  affidavits  to  satisfy
 the  requirements  of  this subdivision for consumer credit transactions
 AND ACTIONS ARISING FROM MEDICAL DEBT. When jurisdiction is based on  an
 attachment  of  property,  the  affidavit  must  state  that an order of
 attachment granted in the action has been levied on the property of  the
 defendant,  describe  the property and state its value. Proof of mailing
 S. 4007                            218                           A. 3007
 
 the notice required by subdivision (g) of this section,  where  applica-
 ble, shall also be filed.
   (j)  Affidavit. A request for a default judgment entered by the clerk,
 must be accompanied by an affidavit  by  the  plaintiff  or  plaintiff's
 attorney  stating that after reasonable inquiry, he or she has reason to
 believe that the statute of  limitations  has  not  expired.  The  chief
 administrative judge shall issue form affidavits to satisfy the require-
 ments  of  this subdivision for consumer credit transactions AND ACTIONS
 ARISING FROM MEDICAL DEBT.
   § 2. Subdivision 2 of section 212 of the judiciary law is  amended  by
 adding a new paragraph (cc) to read as follows:
   (CC)  MAKE AVAILABLE FORM AFFIDAVITS REQUIRED FOR A MOTION FOR DEFAULT
 JUDGMENT IN AN ACTION ARISING FROM MEDICAL DEBT AS REQUIRED BY  SUBDIVI-
 SION (F) OF SECTION THIRTY-TWO HUNDRED FIFTEEN OF THE CIVIL PRACTICE LAW
 AND RULES.
   § 3. This act shall take effect on the one hundred eightieth day after
 it shall have become a law.
 
                                 SUBPART B
 
   Section  1.  This  act  shall  be  known  and  may  be  cited  as  the
 "Prescription Drug Price and Supply Chain Transparency Act of 2023".
   § 2. Legislative intent.  The  state  has  a  compelling  interest  in
 providing  for transparency into the price of prescription drugs and the
 regulation  of  entities  that  play  a  role  in  the  distribution  of
 prescription drugs in this state. The impact of ever rising prescription
 drug  costs impacts consumers in this state both at the pharmacy counter
 and in health plan premium costs.  Prescription  drug  costs  also  have
 direct  costs  to  the state fiscal, health insurance companies, pharma-
 cies, pharmacy benefit managers, hospitals, employers, and unions.
   § 3. The insurance law is amended by adding a new article 30  to  read
 as follows:
 
                                ARTICLE 30
            PRESCRIPTION DRUG PRICE AND SUPPLY CHAIN TRANSPARENCY
 
 SECTION 3001. DEFINITIONS.
         3002. FILING REQUIREMENT.
         3003. SPECIAL REPORTS AND OTHER POWERS.
         3004. REPORTING OF DRUG PRICE INCREASES.
         3005. REPORTING OF PAY FOR DELAY AGREEMENTS.
         3006. REGISTRATION OF PHARMACY SERVICES ADMINISTRATIVE ORGANIZA-
                 TIONS.
         3007.  REQUIRED  DISCLOSURES BY PHARMACY SERVICES ADMINISTRATIVE
                 ORGANIZATIONS.
         3008. REGISTRATION OF PHARMACY SWITCH COMPANIES.
         3009. REQUIRED DISCLOSURES BY PHARMACY SWITCH COMPANIES.
         3010. REGISTRATION OF REBATE AGGREGATORS.
         3011. REQUIRED DISCLOSURES BY REBATE AGGREGATORS.
         3012. DEPOSIT OF PENALTIES AND FEES.
   § 3001. DEFINITIONS. (A) FOR THE PURPOSES OF THIS ARTICLE,  THE  DEFI-
 NITIONS  CONTAINED  IN SECTION TWO HUNDRED EIGHTY-A OF THE PUBLIC HEALTH
 LAW SHALL APPLY TO THIS ARTICLE AS IF SPECIFICALLY SET FORTH HEREIN.
   (B) THE FOLLOWING WORDS OR PHRASES, AS USED  IN  THIS  ARTICLE,  SHALL
 HAVE THE FOLLOWING MEANINGS, UNLESS THE CONTEXT OTHERWISE REQUIRES:
 S. 4007                            219                           A. 3007
 
   (1)  "MANUFACTURER"  MEANS  AN  ENTITY  ENGAGED  IN THE MANUFACTURE OF
 PRESCRIPTION DRUGS SOLD IN THIS STATE.
   (2)  "PHARMACY SERVICES ADMINISTRATIVE ORGANIZATION" OR "PSAO" MEANS A
 ENTITY THAT IS OPERATING IN THIS STATE AND THAT CONTRACTS WITH A PHARMA-
 CY FOR THE PURPOSE OF CONDUCTING BUSINESS ON THE PHARMACY'S BEHALF  WITH
 WHOLESALERS, DISTRIBUTORS, HEALTH PLANS OR PHARMACY BENEFIT MANAGERS.
   (3) "REBATE AGGREGATOR" MEANS AN ENTITY THAT PROVIDES FORMULARY REBATE
 ADMINISTRATIVE SERVICES FOR PHARMACY BENEFIT MANAGERS OR OTHERWISE NEGO-
 TIATES  REBATES  WITH MANUFACTURERS ON BEHALF OF PHARMACY BENEFIT MANAG-
 ERS.
   (4) "SWITCH COMPANY" MEANS AN ENTITY  THAT  ACTS  AS  AN  INTERMEDIARY
 BETWEEN A PHARMACY AND A PHARMACY BENEFIT MANAGER OR HEALTH PLAN FOR THE
 PURPOSE OF ROUTING INSURANCE CLAIMS DATA TO OR FROM A PHARMACY.
   (5)  "WHOLESALER"  MEANS  AN  ENTITY  THAT BOTTLES, PACKS OR PURCHASES
 DRUGS, DEVICES OR COSMETICS FOR THE PURPOSE OF SELLING OR  RESELLING  TO
 PHARMACIES OR TO OTHER CHANNELS.
   §  3002.  FILING REQUIREMENT. NOTWITHSTANDING ANY LAW TO THE CONTRARY,
 ANY FILING OR SUBMISSION REQUIRED UNDER THIS ARTICLE SHALL BE MADE ELEC-
 TRONICALLY UNLESS THE ENTITY REQUIRED TO MAKE THAT FILING OR  SUBMISSION
 DEMONSTRATES  UNDUE HARDSHIP, IMPRACTICABILITY OR GOOD CAUSE AS REQUIRED
 BY SECTION THREE HUNDRED SIXTEEN OF THIS CHAPTER.
   § 3003. SPECIAL REPORTS AND OTHER POWERS. (A) THE  SUPERINTENDENT  MAY
 ADDRESS  TO  ANY ENTITY REQUIRED TO REGISTER OR REPORT INFORMATION UNDER
 THIS ARTICLE, OR ITS OFFICERS, OR ANY  AGENT  OR  EMPLOYEE  THEREOF  ANY
 INQUIRY  IN  RELATION TO ITS BUSINESS OR ANY MATTER CONNECTED THEREWITH.
 EVERY INDIVIDUAL OR ENTITY SO ADDRESSED SHALL REPLY IN WRITING  TO  SUCH
 INQUIRY PROMPTLY AND TRUTHFULLY, AND SUCH REPLY SHALL BE, IF REQUIRED BY
 THE SUPERINTENDENT, SUBSCRIBED BY SUCH INDIVIDUAL, OR BY SUCH OFFICER OR
 OFFICERS  OF  THE  ENTITY, OR BY SUCH AGENT OR EMPLOYEE OF THE ENTITY AS
 THE SUPERINTENDENT SHALL DESIGNATE, AND AFFIRMED BY THEM AS  TRUE  UNDER
 THE PENALTIES OF PERJURY.
   (B) IN THE EVENT ANY INDIVIDUAL OR ENTITY DOES NOT SUBMIT A GOOD FAITH
 RESPONSE  TO  AN  INQUIRY FROM THE SUPERINTENDENT PURSUANT TO SUBSECTION
 (A) OF THIS SECTION WITHIN A TIME PERIOD SPECIFIED BY THE SUPERINTENDENT
 OF NOT LESS THAN FIFTEEN BUSINESS DAYS, THE SUPERINTENDENT IS AUTHORIZED
 TO LEVY A CIVIL PENALTY, AFTER NOTICE AND HEARING, AGAINST  SUCH  PERSON
 NOT  TO EXCEED ONE THOUSAND DOLLARS PER DAY FOR EACH DAY BEYOND THE DATE
 SPECIFIED BY THE SUPERINTENDENT FOR RESPONSE TO THE INQUIRY.
   (C) IN ADDITION TO ALL OTHER POWERS GRANTED BY LAW, THE SUPERINTENDENT
 IS HEREBY EMPOWERED TO ORDER ANY PERSON OR ENTITY REQUIRED  TO  REGISTER
 OR  REPORT  INFORMATION  UNDER  THIS  ARTICLE  TO  CEASE AND DESIST FROM
 VIOLATIONS OF THIS ARTICLE AND FOLLOWING ISSUANCE OF SUCH AN  ORDER  MAY
 BRING  AND MAINTAIN AN ACTION IN ANY COURT OF COMPETENT JURISDICTION FOR
 AN INJUNCTION OR OTHER APPROPRIATE RELIEF TO ENJOIN THREATENED OR EXIST-
 ING VIOLATIONS OF THIS ARTICLE OR  OF  THE  SUPERINTENDENT'S  ORDERS  OR
 REGULATIONS,  SUCH ACTION MAY SPECIFICALLY SEEK RESTITUTION ON BEHALF OF
 PERSONS AGGRIEVED BY A VIOLATION OF THIS  ARTICLE  OR  ORDERS  OR  REGU-
 LATIONS OF THE SUPERINTENDENT.
   (D)  IN ADDITION TO ALL OTHER POWERS GRANTED BY LAW, WHENEVER IT SHALL
 APPEAR TO THE SUPERINTENDENT, EITHER UPON COMPLAINT OR  OTHERWISE,  THAT
 IN  THE COURSE OF ITS BUSINESS WITHIN OR FROM THIS STATE THAT ANY ENTITY
 SHALL HAVE EMPLOYED, OR EMPLOYS, OR IS  ABOUT  TO  EMPLOY  ANY  BUSINESS
 PRACTICE  OR  SHALL  HAVE  PERFORMED,  OR  IS PERFORMING, OR IS ABOUT TO
 PERFORM ANY ACT IN VIOLATION OF THIS ARTICLE OR ORDERS OR REGULATIONS OF
 THE SUPERINTENDENT, OR THE SUPERINTENDENT  BELIEVES  IT  TO  BE  IN  THE
 PUBLIC  INTEREST  THAT AN INVESTIGATION BE MADE, THE SUPERINTENDENT MAY,
 S. 4007                            220                           A. 3007
 
 IN THE SUPERINTENDENT'S DISCRETION, EITHER REQUIRE OR PERMIT SUCH ENTITY
 OR ANY AGENT OR EMPLOYEE THEREOF, TO FILE WITH THE DEPARTMENT  A  STATE-
 MENT  IN WRITING UNDER OATH OR OTHERWISE AS TO ALL THE FACTS AND CIRCUM-
 STANCES  CONCERNING  THE SUBJECT MATTER THAT THE SUPERINTENDENT BELIEVES
 IS IN THE PUBLIC INTEREST TO  INVESTIGATE,  AND  FOR  THAT  PURPOSE  MAY
 PRESCRIBE  FORMS  UPON  WHICH  SUCH STATEMENTS SHALL BE MADE. THE SUPER-
 INTENDENT MAY ALSO REQUIRE SUCH OTHER DATA AND INFORMATION AS THE SUPER-
 INTENDENT MAY DEEM RELEVANT AND MAY MAKE SUCH  SPECIAL  AND  INDEPENDENT
 INVESTIGATIONS  AS  THE  SUPERINTENDENT MAY DEEM NECESSARY IN CONNECTION
 WITH THE MATTER. IT SHALL BE THE DUTY  OF  ALL  PUBLIC  OFFICERS,  THEIR
 DEPUTIES,  ASSISTANTS,  SUBORDINATES,  CLERKS OR EMPLOYEES AND ALL OTHER
 PERSONS TO RENDER AND FURNISH TO THE SUPERINTENDENT, WHEN  REQUESTED  IN
 CONNECTION  WITH AN INVESTIGATION UNDER THIS SUBSECTION, ALL INFORMATION
 AND ASSISTANCE IN THEIR POSSESSION OR WITHIN THEIR POWER.
   (E) ANY ENTITY WHO VIOLATES AN ORDER UNDER SUBSECTION (C)  OR  (D)  OF
 THIS  SECTION  SHALL  BE  SUBJECT TO A CIVIL PENALTY, AFTER NOTICE AND A
 HEARING, OF NOT MORE THAN TEN THOUSAND DOLLARS PER ACT IN VIOLATION,  IN
 ADDITION TO ANY OTHER PENALTY PROVIDED BY LAW.
   (F)  ANY  COMMUNICATIONS  OR  DOCUMENTS SENT OR RECEIVED IN CONNECTION
 WITH AN INVESTIGATION UNDER THIS ARTICLE,  AND  MATERIALS  REFERRING  TO
 SUCH INFORMATION IN THE POSSESSION OF THE SUPERINTENDENT SHALL BE CONFI-
 DENTIAL AND NOT SUBJECT TO DISCLOSURE BY THE SUPERINTENDENT EXCEPT WHERE
 AND  AS  THE  SUPERINTENDENT DETERMINES THAT DISCLOSURE IS IN THE PUBLIC
 INTEREST.  THIS SUBSECTION SHALL NOT APPLY TO INFORMATION, DOCUMENTS AND
 MATERIALS IN THE POSSESSION AND UNDER THE CONTROL  OF  AN  ENTITY  OTHER
 THAN THE SUPERINTENDENT.
   §  3004.  REPORTING OF DRUG PRICE INCREASES. (A)(1) NO MANUFACTURER OR
 WHOLESALER MAY CHARGE ANY PRICE FOR A  DRUG  BASED  ON  AN  INCREASE  IN
 WHOLESALE ACQUISITION COST, AVERAGE WHOLESALE PRICE, OR ANY OTHER METRIC
 UNLESS THE MANUFACTURER SHALL FIRST REPORT THE PRICE TO THE DEPARTMENT.
   (2)  NO ENTITY MAY SELL OR DISTRIBUTE IN THIS STATE ANY DRUG FOR WHICH
 A REPORT WAS REQUIRED TO BE MADE UNDER THIS SUBSECTION UNTIL SUCH REPORT
 IS MADE.
   (B) THE REPORT REQUIRED BY SUBSECTION (A) OF  THIS  SECTION  SHALL  BE
 MADE  IN  A  FORM  AND MANNER PRESCRIBED BY THE SUPERINTENDENT, SHALL BE
 MADE INDIVIDUALLY FOR EACH NATIONAL DRUG CODE,  AND  SHALL  INCLUDE  THE
 FOLLOWING:
   (1) THE NAME OR NAMES OF THE DRUG;
   (2) THE NATIONAL DRUG CODE FOR THE DRUG;
   (3) THE PRICE OF THE DRUG PRIOR TO THE INCREASE;
   (4) THE PRICE OF THE DRUG FOLLOWING THE INCREASE;
   (5) THE EFFECTIVE DATE OF THE INCREASE;
   (6) THE DATE ON WHICH THE DECISION WAS MADE TO INCREASE THE PRICE; AND
   (7) THE REASON AND JUSTIFICATION FOR THE INCREASE.
   (C) NOT LATER THAN MAY FIRST, TWO THOUSAND TWENTY-FIVE, THE DEPARTMENT
 SHALL BEGIN PUBLISHING REPORTS RECEIVED UNDER THIS SECTION ON A PUBLICLY
 ACCESSIBLE ONLINE DATABASE, WHICH IS SEARCHABLE AT LEAST BY MANUFACTURER
 NAME,  DRUG  NAME,  AND  NATIONAL DRUG CODE. REPORTS SHALL BE POSTED NOT
 LATER THAN FIFTEEN BUSINESS DAYS  AFTER  THEY  ARE  RECEIVED  AND  SHALL
 REMAIN  ON  THE DATABASE FOR NOT LESS THAN ONE HUNDRED EIGHTY DAYS AFTER
 THE EFFECTIVE DATE OF THE INCREASE OR THE FIRST DATE THE REPORT IS POST-
 ED, WHICHEVER IS LATER, PROVIDED, HOWEVER, THAT THE  SUPERINTENDENT  MAY
 DELAY THE POSTING OF A REPORT IF POSTING WITHIN FIFTEEN BUSINESS DAYS OF
 RECEIPT IS NOT FEASIBLE.
   (D) NOTWITHSTANDING ANY LAW TO THE CONTRARY, THE INFORMATION CONTAINED
 IN  PARAGRAPHS  SIX  AND  SEVEN OF SUBSECTION (B) OF THIS SECTION OR ANY
 S. 4007                            221                           A. 3007
 
 STATEMENT REQUIRED UNDER SUBSECTION (G) OF THIS SECTION,  TOGETHER  WITH
 ANY  COMMUNICATIONS, DOCUMENTS, AND MATERIALS REFERRING TO SUCH INFORMA-
 TION IN THE POSSESSION OF THE SUPERINTENDENT, SHALL BE CONFIDENTIAL  AND
 NOT SUBJECT TO DISCLOSURE BY THE SUPERINTENDENT, EXCEPT WHERE THE SUPER-
 INTENDENT  DETERMINES  THAT  DISCLOSURE  IS IN THE PUBLIC INTEREST. THIS
 SUBSECTION SHALL NOT APPLY TO INFORMATION, DOCUMENTS  AND  MATERIALS  IN
 THE  POSSESSION AND UNDER THE CONTROL OF AN ENTITY OTHER THAN THE SUPER-
 INTENDENT.
   (E) NO REPORT SHALL BE CONSIDERED VALIDLY FILED UNLESS ACCOMPANIED  BY
 A FILING FEE IN AN AMOUNT SET FORTH IN THIS SUBSECTION.
   (1) FOR ANY REPORT INVOLVING AN INCREASE THAT WILL NOT TAKE EFFECT FOR
 ONE  HUNDRED TWENTY DAYS OR MORE AND FOR WHICH THE EFFECTIVE DATE OF THE
 CHANGE IS BETWEEN THE FIRST OF JANUARY AND THE THIRTY-FIRST  OF  JANUARY
 AND:
   (A)  FOR  WHICH  THE INCREASE WILL RESULT IN A CHANGE OF LESS THAN TEN
 PERCENT PER UNIT OVER THE PRICE OF THE SAME DRUG  THREE  HUNDRED  SIXTY-
 FIVE  DAYS  BEFORE  THE  EFFECTIVE  DATE OF THE CHANGE, THE FEE SHALL BE
 TWENTY-FIVE DOLLARS;
   (B) FOR WHICH THE INCREASE WILL RESULT IN A CHANGE OF LESS THAN  TWEN-
 TY-FIVE  PERCENT  PER UNIT OVER THE PRICE OF THE SAME DRUG THREE HUNDRED
 SIXTY-FIVE DAYS BEFORE THE EFFECTIVE DATE OF THE CHANGE, THE  FEE  SHALL
 BE TWENTY-FIVE DOLLARS;
   (C)  FOR WHICH THE INCREASE WILL RESULT IN A CHANGE OF LESS THAN FIFTY
 PERCENT PER UNIT OVER THE PRICE OF THE SAME DRUG  THREE  HUNDRED  SIXTY-
 FIVE  DAYS BEFORE THE EFFECTIVE DATE OF THE CHANGE, THE FEE SHALL BE TWO
 HUNDRED FIFTY DOLLARS; OR
   (D) FOR WHICH THE INCREASE WILL RESULT IN A CHANGE OF FIFTY PERCENT OR
 GREATER PER UNIT OVER THE PRICE OF THE SAME DRUG  THREE  HUNDRED  SIXTY-
 FIVE  DAYS BEFORE THE EFFECTIVE DATE OF THE CHANGE, THE FEE SHALL BE ONE
 THOUSAND DOLLARS.
   (2) FOR ANY REPORT INVOLVING AN INCREASE THAT WILL NOT TAKE EFFECT FOR
 ONE HUNDRED TWENTY DAYS OR MORE AND FOR  WHICH  THE  EFFECTIVE  DATE  IS
 OUTSIDE OF THE MONTH OF JANUARY AND:
   (A)  FOR  WHICH  THE INCREASE WILL RESULT IN A CHANGE OF LESS THAN TEN
 PERCENT PER UNIT OVER THE PRICE OF THE SAME DRUG  THREE  HUNDRED  SIXTY-
 FIVE  DAYS BEFORE THE EFFECTIVE DATE OF THE CHANGE, THE FEE SHALL BE TWO
 THOUSAND FIVE HUNDRED DOLLARS;
   (B) FOR WHICH THE INCREASE WILL RESULT IN A CHANGE OF LESS THAN  TWEN-
 TY-FIVE  PERCENT  PER UNIT OVER THE PRICE OF THE SAME DRUG THREE HUNDRED
 SIXTY-FIVE DAYS BEFORE THE EFFECTIVE DATE OF THE CHANGE, THE  FEE  SHALL
 BE FIVE THOUSAND DOLLARS;
   (C)  FOR WHICH THE INCREASE WILL RESULT IN A CHANGE OF LESS THAN FIFTY
 PERCENT PER UNIT OVER THE PRICE OF THE SAME DRUG  THREE  HUNDRED  SIXTY-
 FIVE  DAYS  BEFORE  THE  EFFECTIVE  DATE OF THE CHANGE, THE FEE SHALL BE
 SEVEN THOUSAND FIVE HUNDRED DOLLARS; OR
   (D) FOR WHICH THE INCREASE WILL RESULT IN A CHANGE OF FIFTY PERCENT OR
 GREATER PER UNIT OVER THE PRICE OF THE SAME DRUG  THREE  HUNDRED  SIXTY-
 FIVE  DAYS BEFORE THE EFFECTIVE DATE OF THE CHANGE, THE FEE SHALL BE TEN
 THOUSAND DOLLARS.
   (3) FOR ANY REPORT INVOLVING AN INCREASE THAT WILL TAKE EFFECT IN LESS
 THAN ONE HUNDRED TWENTY DAYS AND FOR WHICH THE  EFFECTIVE  DATE  OF  THE
 CHANGE  IS  BETWEEN THE FIRST OF JANUARY AND THE THIRTY-FIRST OF JANUARY
 AND:
   (A) FOR WHICH THE INCREASE WILL RESULT IN A CHANGE OF  LESS  THAN  TEN
 PERCENT  PER  UNIT  OVER THE PRICE OF THE SAME DRUG THREE HUNDRED SIXTY-
 S. 4007                            222                           A. 3007
 
 FIVE DAYS BEFORE THE EFFECTIVE DATE OF THE CHANGE, THE FEE SHALL BE  TWO
 THOUSAND FIVE HUNDRED DOLLARS;
   (B)  FOR WHICH THE INCREASE WILL RESULT IN A CHANGE OF LESS THAN TWEN-
 TY-FIVE PERCENT PER UNIT OVER THE PRICE OF THE SAME DRUG  THREE  HUNDRED
 SIXTY-FIVE  DAYS  BEFORE THE EFFECTIVE DATE OF THE CHANGE, THE FEE SHALL
 BE FIVE THOUSAND DOLLARS;
   (C) FOR WHICH THE INCREASE WILL RESULT IN A CHANGE OF LESS THAN  FIFTY
 PERCENT  PER  UNIT  OVER THE PRICE OF THE SAME DRUG THREE HUNDRED SIXTY-
 FIVE DAYS BEFORE THE EFFECTIVE DATE OF THE  CHANGE,  THE  FEE  SHALL  BE
 SEVEN THOUSAND FIVE HUNDRED DOLLARS; OR
   (D) FOR WHICH THE INCREASE WILL RESULT IN A CHANGE OF FIFTY PERCENT OR
 GREATER  PER  UNIT  OVER THE PRICE OF THE SAME DRUG THREE HUNDRED SIXTY-
 FIVE DAYS BEFORE THE EFFECTIVE DATE OF THE CHANGE, THE FEE SHALL BE  TEN
 THOUSAND DOLLARS.
   (4) FOR ANY REPORT INVOLVING AN INCREASE THAT WILL TAKE EFFECT IN LESS
 THAN  ONE  HUNDRED  TWENTY  DAYS AND FOR WHICH THE EFFECTIVE DATE OF THE
 CHANGE IS OUTSIDE OF THE MONTH OF JANUARY AND:
   (A) FOR WHICH THE INCREASE WILL RESULT IN A CHANGE OF  LESS  THAN  TEN
 PERCENT  PER  UNIT  OVER THE PRICE OF THE SAME DRUG THREE HUNDRED SIXTY-
 FIVE DAYS BEFORE THE EFFECTIVE DATE OF THE  CHANGE,  THE  FEE  SHALL  BE
 TWENTY-FIVE THOUSAND DOLLARS;
   (B)  FOR WHICH THE INCREASE WILL RESULT IN A CHANGE OF LESS THAN TWEN-
 TY-FIVE PERCENT PER UNIT OVER THE PRICE OF THE SAME DRUG  THREE  HUNDRED
 SIXTY-FIVE  DAYS  BEFORE THE EFFECTIVE DATE OF THE CHANGE, THE FEE SHALL
 BE FIFTY THOUSAND DOLLARS;
   (C) FOR WHICH THE INCREASE WILL RESULT IN A CHANGE OF LESS THAN  FIFTY
 PERCENT  PER  UNIT  OVER THE PRICE OF THE SAME DRUG THREE HUNDRED SIXTY-
 FIVE DAYS BEFORE THE EFFECTIVE DATE OF THE  CHANGE,  THE  FEE  SHALL  BE
 SEVENTY-FIVE THOUSAND DOLLARS; OR
   (D) FOR WHICH THE INCREASE WILL RESULT IN A CHANGE OF FIFTY PERCENT OR
 GREATER  PER  UNIT  OVER THE PRICE OF THE SAME DRUG THREE HUNDRED SIXTY-
 FIVE DAYS BEFORE THE EFFECTIVE DATE OF THE CHANGE, THE FEE SHALL BE  ONE
 HUNDRED THOUSAND DOLLARS.
   (5)  FOR  ANY  REPORT MADE AFTER THE EFFECTIVE DATE OF THE CHANGE, THE
 FEE SHALL BE ONE HUNDRED THOUSAND DOLLARS PLUS TEN THOUSAND DOLLARS  FOR
 EACH DAY AFTER THE EFFECTIVE DATE BEFORE THE REPORT IS MADE.
   (F)  AFTER NOTICE AND A HEARING, THE SUPERINTENDENT MAY IMPOSE A CIVIL
 PENALTY ON ANY ENTITY THAT VIOLATES SUBSECTION (A) OF THIS SECTION IN AN
 AMOUNT NOT TO EXCEED ONE MILLION DOLLARS PER VIOLATION.  IN  CONSIDERING
 THE AMOUNT OF ANY SUCH CIVIL PENALTY, THE SUPERINTENDENT SHALL CONSIDER:
   (1) THE TIMING OF THE INCREASE;
   (2) THE COST OF THE DRUG;
   (3) THE IMPACT ON CONSUMERS;
   (4) WHETHER SUCH VIOLATION IS A FIRST OFFENSE; AND
   (5)  REMEDIAL  MEASURES  THE ENTITY HAS PUT IN PLACE TO PREVENT FUTURE
 VIOLATIONS.
   (G) WHENEVER A REPORT IS MADE INVOLVING AN  INCREASE  THAT  WILL  TAKE
 EFFECT  IN  LESS  THAN  ONE HUNDRED TWENTY DAYS, THE MANUFACTURER OF THE
 DRUG SHALL PROVIDE TO THE SUPERINTENDENT A STATEMENT OF THE REASON  THAT
 THE INCREASE MUST TAKE EFFECT IN LESS THAN ONE HUNDRED TWENTY DAYS. WHEN
 THE  SUPERINTENDENT BELIEVES IT IS IN THE PUBLIC INTEREST THAT AN INVES-
 TIGATION BE MADE, THE SUPERINTENDENT MAY MAKE  INDEPENDENT  AND  SPECIAL
 INVESTIGATIONS INTO THE MATTER AS THE SUPERINTENDENT DEEMS APPROPRIATE.
   §  3005.  REPORTING OF PAY FOR DELAY AGREEMENTS. (A) EACH MANUFACTURER
 DOING BUSINESS IN THIS STATE THAT MANUFACTURES A BRAND NAME PRESCRIPTION
 DRUG AND ENTERS INTO AN ARRANGEMENT,  THROUGH  AGREEMENT  OR  OTHERWISE,
 S. 4007                            223                           A. 3007
 
 WITH  ANOTHER PHARMACEUTICAL MANUFACTURER THAT HAS THE PURPOSE OR EFFECT
 OF DELAYING OR PREVENTING SUCH OTHER  MANUFACTURER  FROM  INTRODUCING  A
 GENERIC  SUBSTITUTE  FOR SUCH DRUG INTO THE MARKETPLACE SHALL, NOT LATER
 THAN  THIRTY  DAYS  AFTER ENTERING INTO SUCH ARRANGEMENT, SEND NOTICE TO
 THE SUPERINTENDENT, IN A FORM AND MANNER PRESCRIBED BY  THE  SUPERINTEN-
 DENT, DISCLOSING THE NAME OF SUCH DRUG, THE WHOLESALE PRICE, THE DISEASE
 OR  DISEASES SUCH DRUG IS COMMONLY PRESCRIBED TO TREAT, THE MANUFACTURER
 OF SUCH DRUG, THE NAME OF THE GENERIC MANUFACTURER, THE  LENGTH  OF  THE
 DELAY, AND SUCH OTHER INFORMATION AS THE SUPERINTENDENT MAY REQUIRE.
   (B)  THE SUPERINTENDENT SHALL, NO LATER THAN THIRTY DAYS AFTER RECEIV-
 ING A NOTICE PURSUANT TO SUBSECTION (A) OF THIS SECTION, PROVIDE  NOTICE
 OF  THE  FILING  TO  THE DRUG ACCOUNTABILITY BOARD, THE DRUG UTILIZATION
 REVIEW BOARD ESTABLISHED UNDER SECTION THREE  HUNDRED  SIXTY-NINE-BB  OF
 THE  SOCIAL  SERVICES  LAW  AND  ALL MEDICAID MANAGED CARE PLANS, HEALTH
 PLANS AND PHARMACY BENEFITS MANAGERS. IT SHALL BE SUFFICIENT NOTICE  FOR
 THE SUPERINTENDENT TO MAKE AVAILABLE AN EMAIL NOTIFICATION LIST TO WHICH
 ANY OF THE AFOREMENTIONED ENTITIES MAY ELECT TO RECEIVE NOTICE.
   (C) NO LATER THAN JUNE FIRST, TWO THOUSAND TWENTY-FOUR, THE DEPARTMENT
 SHALL POST ON ITS WEBSITE WITHIN THIRTY DAYS OF RECEIPT THEREOF, ALL THE
 NOTICES  REQUIRED PURSUANT TO SUBSECTION (A) OF THIS SECTION IN A FORMAT
 AND MANNER DEVELOPED BY THE SUPERINTENDENT THAT IS SEARCHABLE  BY  DRUG,
 COST,  DISEASE, AND MANUFACTURER BOTH FOR THE BRAND AND GENERIC DRUG FOR
 PUBLIC REVIEW.
   (D) EACH NOTICE REQUIRED UNDER SUBSECTION (A) OF THIS SECTION SHALL BE
 ACCOMPANIED BY A FILING FEE OF ONE HUNDRED DOLLARS.
   (E) FOR A VIOLATION BY A MANUFACTURER OF A BRAND NAME DRUG  WHO  KNOW-
 INGLY  OR  NEGLIGENTLY FAILS TO NOTIFY THE SUPERINTENDENT AS REQUIRED IN
 SUBSECTION (A) OF THIS  SECTION,  THE  SUPERINTENDENT  SHALL  FINE  SUCH
 MANUFACTURER  NO  LESS  THAN  FIVE  THOUSAND  DOLLARS  FOR EACH DAY SUCH
 MANUFACTURER FAILS TO PROPERLY NOTIFY THE SUPERINTENDENT PURSUANT TO THE
 REQUIREMENTS OF THIS SECTION FOR THE FIRST VIOLATION AND  NO  LESS  THAN
 TEN  THOUSAND  DOLLARS  FOR EACH DAY SUCH MANUFACTURER FAILS TO PROPERLY
 NOTIFY THE SUPERINTENDENT PURSUANT TO THE REQUIREMENTS OF  THIS  SECTION
 FOR EACH VIOLATION THEREAFTER.
   §  3006.  REGISTRATION  OF  PHARMACY SERVICES ADMINISTRATIVE ORGANIZA-
 TIONS.  (A) NO PSAO SHALL OPERATE IN  THIS  STATE  AFTER  MARCH  THIRTY-
 FIRST,  TWO  THOUSAND  TWENTY-FOUR  WITHOUT  FIRST  REGISTERING WITH THE
 DEPARTMENT.
   (B) A PSAO SEEKING REGISTRATION SHALL  FILE,  IN  A  FORM  AND  MANNER
 DETERMINED  BY  THE SUPERINTENDENT, INFORMATION THAT INCLUDES AT A MINI-
 MUM:
   (1) THE LEGAL NAME OF THE ENTITY;
   (2) ANY TRADE OR OTHER NAMES USED BY THE ENTITY;
   (3) THE ORGANIZATIONAL STRUCTURE OF THE ENTITY;
   (4) THE PHARMACIES LOCATED WITHIN THIS STATE  WITH  WHICH  THE  ENTITY
 PROVIDES SERVICES;
   (5) THE PERSONS WHO EXERCISE CONTROL OF THE ENTITY;
   (6) A PRIMARY POINT OF CONTACT FOR THE ENTITY;
   (7) AN AGENT FOR SERVICE OF PROCESS;
   (8) A SET OF AUDITED FINANCIALS FOR THE PRIOR FISCAL YEAR; AND
   (9) SUCH OTHER INFORMATION AS THE SUPERINTENDENT SHALL REQUIRE.
   (C)  THE SUPERINTENDENT SHALL ACCEPT A REGISTRATION ONLY IF THE SUPER-
 INTENDENT DETERMINES THAT ALL THE REQUIRED INFORMATION HAS BEEN PROVIDED
 IN A SATISFACTORY FORM AND  HAS  RECEIVED  PAYMENT  OF  A  NONREFUNDABLE
 REGISTRATION FEE OF FIVE THOUSAND DOLLARS.
 S. 4007                            224                           A. 3007
 
   (D)  IF  ANY  OF  THE  INFORMATION CONTAINED IN THE REGISTRATION SHALL
 CHANGE, THE PSAO SHALL NOTIFY THE DEPARTMENT OF THE CHANGE IN A FORM AND
 MANNER PRESCRIBED BY THE SUPERINTENDENT FOR SUCH PURPOSE WITHIN  TWENTY-
 ONE  DAYS  OF  THE  CHANGE.  THE REQUIREMENT TO UPDATE SHALL INCLUDE THE
 FILING  OF A NEW SET OF AUDITED FINANCIALS UPON ADOPTION. FOR ANY CHANGE
 OTHER THAN NEW AUDITED  FINANCIALS,  THE  FILING  SHALL  NOT  BE  DEEMED
 COMPLETE UNLESS ACCOMPANIED BY A PAYMENT OF A FEE OF FIFTY DOLLARS.
   (E)  EVERY  PSAO  REGISTRATION  ISSUED  PURSUANT TO THIS SECTION SHALL
 EXPIRE TWELVE MONTHS AFTER THE DATE OF  ISSUE.  A  PSAO  MAY  RENEW  ITS
 REGISTRATION FOR ANOTHER TWELVE MONTHS UPON THE FILING OF AN APPLICATION
 IN CONFORMITY WITH THIS SECTION.
   (F)  BEFORE  A PSAO REGISTRATION SHALL BE RENEWED, THE PSAO SHALL FILE
 AN  APPLICATION  FOR  RENEWAL  IN  SUCH  FORM  AS   THE   SUPERINTENDENT
 PRESCRIBES, AND PAY A FEE OF FIVE THOUSAND DOLLARS.
   (G)  IF  A PSAO FILES A RENEWAL APPLICATION WITH THE SUPERINTENDENT AT
 LEAST ONE MONTH BEFORE ITS EXPIRATION, THEN THE REGISTRATION  SOUGHT  TO
 BE  RENEWED  SHALL  CONTINUE  IN  FULL FORCE AND EFFECT EITHER UNTIL THE
 ISSUANCE BY THE SUPERINTENDENT OF THE RENEWAL REGISTRATION  APPLIED  FOR
 OR  UNTIL FIVE DAYS AFTER THE SUPERINTENDENT SHALL HAVE REFUSED TO ISSUE
 SUCH RENEWAL REGISTRATION AND GIVEN NOTICE OF SUCH REFUSAL TO THE APPLI-
 CANT, OTHERWISE THE PSAO REGISTRATION SHALL EXPIRE  AND  THE  REGISTRANT
 SHALL HAVE NO EXPECTATION OF RENEWAL.
   §  3007.  REQUIRED  DISCLOSURES  BY  PHARMACY  SERVICES ADMINISTRATIVE
 ORGANIZATIONS. (A) (1) EACH PSAO  SHALL  AT  THE  TIME  OF  REGISTRATION
 PURSUANT  TO  SECTION THREE THOUSAND SIX OF THIS ARTICLE DISCLOSE TO THE
 DEPARTMENT THE EXTENT OF ANY OWNERSHIP OR CONTROL OF THE PSAO OR BY  THE
 PSAO OF ANY PARENT COMPANY, SUBSIDIARY, OR AFFILIATE THAT:
   (A) PROVIDES PHARMACY SERVICES;
   (B) PROVIDES PRESCRIPTION DRUG OR DEVICE SERVICES; OR
   (C)  MANUFACTURES,  SELLS,  OR DISTRIBUTES PRESCRIPTION DRUGS, BIOLOG-
 ICALS, OR MEDICAL DEVICES.
   (2) A PSAO SHALL FURNISH A COPY OF THE DISCLOSURE MADE AT THE TIME  OF
 REGISTRATION  TO  ALL PHARMACIES LOCATED IN THIS STATE WITH WHICH IT HAS
 CONTRACT IN PLACE AT THE TIME OF THE  REGISTRATION.  A  PSAO  SHALL  NOT
 COLLECT  ANY  FEE FOR ANY SERVICES PROVIDED TO A PHARMACY FOR ANY PERIOD
 BEGINNING FIVE DAYS AFTER THE FILING OF A REGISTRATION WITH THE  DEPART-
 MENT UNTIL THE DISCLOSURE IS SENT TO THE PHARMACY.
   (3)  NOT LATER THAN APRIL FIRST, TWO THOUSAND TWENTY-FIVE, THE DEPART-
 MENT SHALL PUBLISH ALL DISCLOSURES RECEIVED UNDER THIS SUBSECTION  ON  A
 PUBLICLY  ACCESSIBLE  ONLINE  DATABASE,  WHICH IS SEARCHABLE AT LEAST BY
 PSAO NAME. ALL DISCLOSURES SHALL BE POSTED NOT LATER THAN  TEN  BUSINESS
 DAYS  AFTER  A REGISTRATION IS ACCEPTED AND SHALL REMAIN ON THE DATABASE
 FOR THE DURATION OF THE REGISTRATION OF THE PSAO.
   (B) (1) PRIOR TO ENTERING INTO ANY CONTRACT WITH ANY PHARMACY  LOCATED
 IN  THIS STATE, INCLUDING A CONTRACT WITH A GROUP OF PHARMACIES AT LEAST
 ONE OF WHICH IS IN THIS STATE, A PSAO SHALL FURNISH TO  THE  PHARMACY  A
 WRITTEN  DISCLOSURE  OF  THE  INFORMATION  REQUIRED  TO  BE DISCLOSED IN
 SUBSECTION (A) OF THIS SECTION. NO CONTRACT WITH  A  PHARMACY  SHALL  BE
 ENFORCEABLE  AGAINST  THE PHARMACY BY A PSAO UNLESS THAT PSAO MAKES THIS
 DISCLOSURE PRIOR TO THE  AGREEMENT.  IN  ADDITION  TO  ANY  OTHER  POWER
 CONFERRED  BY  LAW, THE SUPERINTENDENT MAY PRESCRIBE THE FORM AND MANNER
 OF SUCH DISCLOSURES.
   (2) A PSAO THAT OWNS, IS OWNED BY, IN WHOLE OR IN  PART,  OR  CONTROLS
 ANY  ENTITY THAT MANUFACTURES, SELLS, OR DISTRIBUTES PRESCRIPTION DRUGS,
 BIOLOGICALS, OR MEDICAL DEVICES SHALL NOT, AS A  CONDITION  OF  ENTERING
 INTO  A CONTRACT WITH A PHARMACY, REQUIRE THAT THE PHARMACY PURCHASE ANY
 S. 4007                            225                           A. 3007
 
 DRUGS OR MEDICAL DEVICES FROM AN ENTITY WITH WHICH THE PSAO HAS A FINAN-
 CIAL INTEREST, OR AN ENTITY WITH AN OWNERSHIP INTEREST IN THE PSAO.
   (3)  NO PSAO SHALL ENTER INTO A CONTRACT WITH A PHARMACY IN THIS STATE
 UNLESS THAT CONTRACT SHALL  PROVIDE  THAT  ALL  REMITTANCES  FOR  CLAIMS
 SUBMITTED  BY  A PHARMACY BENEFIT MANAGER OR THIRD-PARTY PAYER ON BEHALF
 OF A PHARMACY TO THE PSAO SHALL BE PASSED THROUGH BY  THE  PSAO  TO  THE
 PHARMACY  WITHIN  A  REASONABLE  AMOUNT  OF  TIME,  ESTABLISHED  IN  THE
 CONTRACT, AFTER RECEIPT OF THE REMITTANCE BY THE PSAO FROM THE  PHARMACY
 BENEFIT MANAGER OR THIRD-PARTY PAYER.
   (C)  (1)  A  PSAO  THAT  PROVIDES,  ACCEPTS,  OR PROCESSES A DISCOUNT,
 CONCESSION, OR PRODUCT VOUCHER, TO REDUCE,  DIRECTLY  OR  INDIRECTLY,  A
 COVERED  INDIVIDUAL'S  OUT-OF-POCKET  EXPENSE FOR THE ORDER, DISPENSING,
 SUBSTITUTION, SALE, OR PURCHASE OF A PRESCRIPTION DRUG SHALL MAKE AVAIL-
 ABLE TO EACH PHARMACY IN THIS STATE THAT IT CONTRACTS WITH OR  WHICH  IT
 CONTRACTED  WITH  IN  THE  PRIOR  CALENDAR  YEAR,  AN ANNUAL REPORT THAT
 INCLUDES:
   (A) AN AGGREGATED TOTAL OF ALL SUCH TRANSACTIONS, BY THE PHARMACY; AND
   (B) AN AGGREGATED TOTAL OF ANY PAYMENTS RECEIVED BY  THE  PSAO  ITSELF
 FOR  PROVIDING,  PROCESSING,  OR  ACCEPTING ANY DISCOUNT, CONCESSION, OR
 PRODUCT VOUCHER ON BEHALF OF A PHARMACY.
   (2) A PHARMACY IN THIS STATE THAT IS A PARTY TO A CONTRACT WITH A PSAO
 SHALL HAVE A RIGHT TO AN ACCOUNTING OF THE FUNDS RECEIVED  BY  THE  PSAO
 FOR  GOODS  OR SERVICES PROVIDED BY THE PHARMACY TO PATIENTS AND CUSTOM-
 ERS.
   § 3008. REGISTRATION OF  PHARMACY  SWITCH  COMPANIES.  (A)  NO  SWITCH
 COMPANY MAY DO BUSINESS IN THIS STATE AFTER JUNE THIRTIETH, TWO THOUSAND
 TWENTY-FOUR WITHOUT FIRST REGISTERING WITH THE DEPARTMENT.
   (B)  A SWITCH COMPANY SEEKING REGISTRATION SHALL FILE WITH THE DEPART-
 MENT, IN A FORM AND MANNER DETERMINED BY THE SUPERINTENDENT, INFORMATION
 INCLUDING BUT NOT LIMITED TO:
   (1) THE LEGAL NAME OF THE ENTITY;
   (2) ANY TRADE OR OTHER NAMES USED BY THE ENTITY;
   (3) THE ORGANIZATIONAL STRUCTURE OF THE ENTITY;
   (4) THE PHARMACIES LOCATED WITHIN THIS STATE AND THE PHARMACY  BENEFIT
 MANAGERS LICENSED IN THIS STATE WITH WHICH THE ENTITY PROVIDES SERVICES;
   (5) THE PERSONS WHO EXERCISE CONTROL OF THE ENTITY;
   (6) A PRIMARY POINT OF CONTACT FOR THE ENTITY;
   (7) AN AGENT FOR SERVICE OF PROCESS;
   (8) A SET OF AUDITED FINANCIALS FOR THE PRIOR FISCAL YEAR; AND
   (9)  SUCH  OTHER  INFORMATION OR DOCUMENTS AS THE SUPERINTENDENT SHALL
 REQUIRE.
   (C) THE SUPERINTENDENT SHALL ACCEPT A REGISTRATION ONLY IF HE  OR  SHE
 DEEMS THAT ALL THE REQUIRED INFORMATION HAS BEEN PROVIDED IN A SATISFAC-
 TORY  FORM  AND HAS RECEIVED PAYMENT OF A NONREFUNDABLE REGISTRATION FEE
 OF ONE THOUSAND DOLLARS.
   (D) IF ANY OF THE INFORMATION  CONTAINED  IN  THE  REGISTRATION  SHALL
 CHANGE,  THE SWITCH COMPANY SHALL NOTIFY THE DEPARTMENT OF THE CHANGE IN
 A FORM AND MANNER PRESCRIBED BY  THE  SUPERINTENDENT  FOR  SUCH  PURPOSE
 WITHIN  TWENTY-ONE  DAYS  OF THE CHANGE. THE REQUIREMENT TO UPDATE SHALL
 INCLUDE THE FILING OF A NEW SET OF AUDITED FINANCIALS UPON ADOPTION. FOR
 ANY CHANGE OTHER THAN NEW AUDITED FINANCIALS, THE FILING  SHALL  NOT  BE
 DEEMED  COMPLETE  UNLESS  ACCOMPANIED  BY  A  PAYMENT  OF A FEE OF FIFTY
 DOLLARS.
   (E) EVERY PHARMACY SWITCH COMPANY'S REGISTRATION SHALL  EXPIRE  TWELVE
 MONTHS  AFTER  THE  DATE OF ISSUE. EVERY REGISTRATION ISSUED PURSUANT TO
 S. 4007                            226                           A. 3007
 
 THIS SECTION MAY BE RENEWED FOR THE ENSUING PERIOD OF TWELVE MONTHS UPON
 THE FILING OF AN APPLICATION IN CONFORMITY WITH THIS SUBSECTION.
   (F)  BEFORE A PHARMACY SWITCH COMPANY'S REGISTRATION SHALL BE RENEWED,
 THE PHARMACY SWITCH COMPANY SHALL PROPERLY FILE IN  THE  OFFICE  OF  THE
 SUPERINTENDENT  AN  APPLICATION  FOR  RENEWAL IN SUCH FORM AS THE SUPER-
 INTENDENT PRESCRIBES, AND PAY A FEE OF ONE THOUSAND DOLLARS.
   (G) IF AN APPLICATION FOR A RENEWAL REGISTRATION SHALL HAVE BEEN FILED
 WITH THE SUPERINTENDENT AT LEAST ONE MONTH BEFORE ITS  EXPIRATION,  THEN
 THE  REGISTRATION  SOUGHT TO BE RENEWED SHALL CONTINUE IN FULL FORCE AND
 EFFECT EITHER UNTIL THE ISSUANCE BY THE SUPERINTENDENT  OF  THE  RENEWAL
 REGISTRATION  APPLIED  FOR  OR  UNTIL FIVE DAYS AFTER THE SUPERINTENDENT
 SHALL HAVE REFUSED TO ISSUE SUCH RENEWAL REGISTRATION AND  GIVEN  NOTICE
 OF  SUCH  REFUSAL  TO  THE  APPLICANT,  OTHERWISE THE REGISTRATION SHALL
 EXPIRE AND THE REGISTRANT SHALL HAVE NO EXPECTATION OF RENEWAL.
   § 3009. REQUIRED DISCLOSURES BY PHARMACY SWITCH  COMPANIES.  (A)  EACH
 SWITCH  COMPANY SHALL ANNUALLY DISCLOSE TO THE DEPARTMENT, IN A FORM AND
 MANNER PRESCRIBED BY THE SUPERINTENDENT, SUCH INFORMATION AS THE  SUPER-
 INTENDENT  DEEMS  NECESSARY  FOR THE PROPER SUPERVISION OF THE INDUSTRY.
 SUCH INFORMATION SHALL INCLUDE:
   (1) A LIST OF SERVICES THE SWITCH COMPANY PROVIDES AND THE  INDUSTRIES
 TO WHICH THEY ARE PROVIDED;
   (2)  INFORMATION ON ELECTRONIC VOUCHER SERVICES PROVIDED BY THE SWITCH
 COMPANY, INCLUDING:
   (A) A LIST OF MANUFACTURERS THAT THE SWITCH COMPANY HAS CONTRACTS WITH
 OR FOR WHICH IT TRANSMITS ELECTRONIC VOUCHERS;
   (B) A LIST OF MEDICATIONS AND THE NATIONAL DRUG CODES (NDCS) FOR WHICH
 THE SWITCH COMPANY MAY APPLY ELECTRONIC VOUCHERS; AND
   (C) THE TOTAL AMOUNT OF MONEY COLLECTED FROM MANUFACTURERS RELATED  TO
 TRANSMISSION OF ELECTRONIC VOUCHERS; AND
   (3)  THE  NUMBER OF TRANSACTIONS PROCESSED IN THIS STATE AND THE TOTAL
 AMOUNT OF REVENUE ATTRIBUTABLE TO THOSE TRANSACTIONS.
   (B) A SWITCH COMPANY SHALL DISCLOSE TO EACH PHARMACY  BENEFIT  MANAGER
 WITH  WHICH IT DOES BUSINESS ANY INSTANCE IN WHICH AN ELECTRONIC VOUCHER
 WAS APPLIED IN THE COURSE OF ROUTING THE CLAIM.
   § 3010. REGISTRATION OF REBATE AGGREGATORS. (A) NO  REBATE  AGGREGATOR
 MAY  DO  BUSINESS  IN THIS STATE AFTER SEPTEMBER THIRTIETH, TWO THOUSAND
 TWENTY-FOUR WITHOUT FIRST REGISTERING WITH THE DEPARTMENT.
   (B) A REBATE AGGREGATOR SEEKING REGISTRATION SHALL FILE, IN A FORM AND
 MANNER DETERMINED BY THE SUPERINTENDENT, INFORMATION INCLUDING  BUT  NOT
 LIMITED TO:
   (1) THE LEGAL NAME OF THE ENTITY;
   (2) ANY TRADE OR OTHER NAMES USED BY THE ENTITY;
   (3) THE ORGANIZATIONAL STRUCTURE OF THE ENTITY;
   (4)  THE  HEALTH  PLANS  AND THE PHARMACY BENEFIT MANAGERS LICENSED IN
 THIS STATE FOR WHICH THE ENTITY PROVIDES SERVICES;
   (5) THE PERSONS WHO EXERCISE CONTROL OF THE ENTITY;
   (6) A PRIMARY POINT OF CONTACT FOR THE ENTITY;
   (7) AN AGENT FOR SERVICE OF PROCESS;
   (8) A SET OF AUDITED FINANCIALS FOR THE PRIOR FISCAL YEAR; AND
   (9) SUCH OTHER INFORMATION OR DOCUMENTS AS  THE  SUPERINTENDENT  SHALL
 REQUIRE.
   (C)  THE  SUPERINTENDENT SHALL ACCEPT A REGISTRATION ONLY IF HE OR SHE
 DEEMS THAT ALL THE REQUIRED INFORMATION HAS BEEN PROVIDED IN A SATISFAC-
 TORY FORM AND HAS RECEIVED PAYMENT OF A NONREFUNDABLE  REGISTRATION  FEE
 OF ONE THOUSAND DOLLARS.
 S. 4007                            227                           A. 3007
 
   (D)  IF  ANY  OF  THE  INFORMATION CONTAINED IN THE REGISTRATION SHALL
 CHANGE THE REBATE AGGREGATOR SHALL NOTIFY THE DEPARTMENT OF  THE  CHANGE
 IN  A  FORM AND MANNER PRESCRIBED BY THE SUPERINTENDENT FOR SUCH PURPOSE
 WITHIN TWENTY-ONE DAYS OF THE CHANGE. THE REQUIREMENT  TO  UPDATE  SHALL
 INCLUDE THE FILING OF A NEW SET OF AUDITED FINANCIALS UPON ADOPTION. FOR
 ANY  CHANGE  OTHER  THAN NEW AUDITED FINANCIALS, THE FILING SHALL NOT BE
 DEEMED COMPLETE UNLESS ACCOMPANIED BY  A  PAYMENT  OF  A  FEE  OF  FIFTY
 DOLLARS.
   (E)  EVERY REBATE AGGREGATOR'S REGISTRATION SHALL EXPIRE TWELVE MONTHS
 AFTER THE DATE OF ISSUE. EVERY  REGISTRATION  ISSUED  PURSUANT  TO  THIS
 SECTION  MAY BE RENEWED FOR THE ENSUING PERIOD OF TWELVE MONTHS UPON THE
 FILING OF AN APPLICATION IN CONFORMITY WITH THIS SUBSECTION.
   (F) BEFORE A REBATE AGGREGATOR'S REGISTRATION SHALL  BE  RENEWED,  THE
 REBATE  AGGREGATOR  SHALL PROPERLY FILE IN THE OFFICE OF THE SUPERINTEN-
 DENT AN APPLICATION FOR RENEWAL  IN  SUCH  FORM  AS  THE  SUPERINTENDENT
 PRESCRIBES, AND PAY A FEE OF ONE THOUSAND DOLLARS.
   (G) IF AN APPLICATION FOR A RENEWAL REGISTRATION SHALL HAVE BEEN FILED
 WITH  THE  SUPERINTENDENT AT LEAST ONE MONTH BEFORE ITS EXPIRATION, THEN
 THE REGISTRATION SOUGHT TO BE RENEWED SHALL CONTINUE IN FULL  FORCE  AND
 EFFECT  EITHER  UNTIL  THE ISSUANCE BY THE SUPERINTENDENT OF THE RENEWAL
 REGISTRATION APPLIED FOR OR UNTIL FIVE  DAYS  AFTER  THE  SUPERINTENDENT
 SHALL  HAVE  REFUSED TO ISSUE SUCH RENEWAL REGISTRATION AND GIVEN NOTICE
 OF SUCH REFUSAL TO  THE  APPLICANT,  OTHERWISE  THE  REGISTRATION  SHALL
 EXPIRE AND THE REGISTRANT SHALL HAVE NO EXPECTATION OF RENEWAL.
   §  3011.  REQUIRED  DISCLOSURES BY REBATE AGGREGATORS. (A) EACH REBATE
 AGGREGATOR THAT HAS A CONTRACT OR ARRANGEMENT WITH  A  PHARMACY  BENEFIT
 MANAGER  SERVING  A  HEALTH  PLAN SHALL, ON AN ANNUAL BASIS, DISCLOSE IN
 WRITING TO THE HEALTH PLAN THE FOLLOWING:
   (1) FEE STRUCTURE PROVISIONS OF ANY CONTRACT  OR  ARRANGEMENT  BETWEEN
 THE REBATE AGGREGATOR AND PHARMACY BENEFIT MANAGER OR DRUG MANUFACTURER,
 INCLUDING:
   (A) FEES COLLECTED FOR AGGREGATING REBATES DUE TO THE HEALTH PLAN; AND
   (B)  SUCH OTHER INFORMATION AS THE SUPERINTENDENT MAY REQUIRE BY REGU-
 LATION; AND
   (2)  QUANTIFICATION  OF  INFLATIONARY   PAYMENTS,   CREDITS,   GRANTS,
 REIMBURSEMENTS,  OTHER  FINANCIAL  OR  OTHER REIMBURSEMENTS, INCENTIVES,
 INDUCEMENTS, REFUNDS OR OTHER BENEFITS RECEIVED BY THE REBATE AGGREGATOR
 FROM THE DRUG MANUFACTURER AND RETAINED BY THE REBATE AGGREGATOR, WHETH-
 ER REFERRED TO AS A REBATE, A DISCOUNT, OR OTHERWISE.
   (B) (1) EACH REBATE AGGREGATOR SHALL, AT  THE  TIME  OF  REGISTRATION,
 DISCLOSE TO THE DEPARTMENT THE EXTENT OF ANY OWNERSHIP OR CONTROL OF THE
 REBATE  AGGREGATOR  OR  BY  THE REBATE AGGREGATOR OF ANY PARENT COMPANY,
 SUBSIDIARY, OR OTHER AFFILIATED  ORGANIZATIONS  THAT  PROVIDES  PHARMACY
 BENEFIT MANAGEMENT SERVICES.
   (2)  EACH  REBATE  AGGREGATOR SHALL ON AN ANNUAL BASIS DISCLOSE TO THE
 DEPARTMENT THE INFORMATION REQUESTED BY THE SUPERINTENDENT, INCLUDING:
   (A) ANY PAYMENTS MADE TO A REBATE AGGREGATOR BY  A  DRUG  MANUFACTURER
 RELATING TO A DRUG'S UTILIZATION, INCLUDING INFLATIONARY PAYMENTS, CRED-
 ITS,  GRANTS,  REIMBURSEMENTS,  OTHER FINANCIAL OR OTHER REIMBURSEMENTS,
 INCENTIVES, INDUCEMENTS, REFUNDS  OR  OTHER  BENEFITS  RECEIVED  BY  THE
 REBATE  AGGREGATOR,  WHETHER  REFERRED  TO  AS  A REBATE, A DISCOUNT, OR
 OTHERWISE;
   (B) ANY PAYMENTS MADE, INCLUDING THOSE DESCRIBED IN  SUBPARAGRAPH  (A)
 OF THIS PARAGRAPH AND SUBSEQUENTLY RETAINED BY A REBATE AGGREGATOR;
   (C)  ANY FEES CHARGED BY THE REBATE AGGREGATOR TO THE PHARMACY BENEFIT
 MANAGER OR DRUG MANUFACTURER RELATING TO A DRUG'S UTILIZATION;
 S. 4007                            228                           A. 3007
 
   (D) ANY PAYMENTS MADE TO A REBATE AGGREGATOR FROM A  PROGRAM  ADMINIS-
 TERED  BY A DRUG MANUFACTURER FOR THE PURPOSE OF ASSISTING PATIENTS WITH
 THE COST OF PRESCRIPTION DRUGS, INCLUDING COPAYMENT ASSISTANCE PROGRAMS,
 DISCOUNT CARDS, AND COUPONS; AND
   (E)  THE  TERMS  AND CONDITIONS OF ANY CONTRACT OR ARRANGEMENT BETWEEN
 THE REBATE AGGREGATOR AND A PHARMACY BENEFIT MANAGER OR DRUG MANUFACTUR-
 ER.
   § 3012. DEPOSIT OF PENALTIES AND FEES. PENALTIES  AND  FEES  COLLECTED
 PURSUANT  TO  THIS  ARTICLE SHALL BE DEPOSITED INTO THE PHARMACY BENEFIT
 MANAGER REGULATORY FUND ESTABLISHED PURSUANT TO  SECTION  NINETY-NINE-OO
 OF THE STATE FINANCE LAW.
   § 4. Subdivision 3 of section 99-oo of the state finance law, as added
 by chapter 128 of the laws of 2022, is amended to read as follows:
   3.  Such  fund  shall  consist  of money received by the state as fees
 under [article] ARTICLES twenty-nine AND THIRTY of the insurance law  or
 penalties ordered under [article] ARTICLES twenty-nine AND THIRTY of the
 insurance  law  and  all  other monies appropriated, credited, or trans-
 ferred thereto from any other fund or source pursuant to law. All monies
 shall remain in such fund unless and until directed by statute or appro-
 priation.
   § 5.  This act shall take effect on the one hundred fiftieth day after
 it shall have become a law.
 
                                 SUBPART C
 
   Section 1. Subdivision 9 of section 2807-k of the public  health  law,
 as amended by section 17 of part B of chapter 60 of the laws of 2014, is
 amended to read as follows:
   9.  In order for a general hospital to participate in the distribution
 of funds from the pool, the  general  hospital  must  implement  minimum
 collection policies and procedures approved by the commissioner, UTILIZ-
 ING  ONLY  A UNIFORM FINANCIAL ASSISTANCE FORM DEVELOPED AND PROVIDED BY
 THE DEPARTMENT.
   § 2. This act shall take effect April 1, 2024.
 
                                 SUBPART D
 
   Section 1.  Legislative findings.  The legislature finds that it is in
 the best interest of the people of this state to expand  article  77  of
 the  insurance law to protect insureds and health care providers against
 the failure or inability of a health or property/casualty insurer  writ-
 ing  health  insurance  to  perform  its  contractual obligations due to
 financial impairment or insolvency.   The  superintendent  of  financial
 services  has  the right and responsibility to enforce the insurance law
 and the authority to seek redress against any person responsible for the
 impairment or insolvency of the insurer, and  nothing  in  this  act  is
 intended to restrict or limit such right, responsibility, or authority.
   § 2.  The article heading of article 77 of the insurance law, as added
 by chapter 802 of the laws of 1985, is amended to read as follows:
                    THE LIFE AND HEALTH INSURANCE COMPANY
                           GUARANTY CORPORATION
                              OF NEW YORK ACT
   § 3. Section 7701 of the insurance law, as added by chapter 802 of the
 laws of 1985, is amended to read as follows:
 S. 4007                            229                           A. 3007
 
   §  7701.  Short title. This article shall be known and may be cited as
 "The Life AND HEALTH Insurance Company Guaranty Corporation of New  York
 Act".
   §  4.  Section 7702 of the insurance law, as amended by chapter 454 of
 the laws of 2014, is amended to read as follows:
   § 7702. Purpose. The purpose of this article is to  provide  funds  to
 protect  policy  owners, insureds, HEALTH CARE PROVIDERS, beneficiaries,
 annuitants, payees and assignees  of  life  insurance  policies,  health
 insurance  policies,  annuity  contracts, funding agreements and supple-
 mental contracts issued by life insurance  companies,  HEALTH  INSURANCE
 COMPANIES, AND PROPERTY/CASUALTY INSURANCE COMPANIES, subject to certain
 limitations,  against  failure  in  the performance of contractual obli-
 gations due to the impairment or insolvency of the insurer issuing  such
 policies,  contracts,  or  funding  agreements.  In  the judgment of the
 legislature, the foregoing objects and purposes  not  being  capable  of
 accomplishment by a corporation created under general laws, the creation
 of  a  not-for-profit  corporation  of  insurers is provided for by this
 article to enable the guarantee of payment of benefits and of  continua-
 tion of coverages, and members of the corporation are subject to assess-
 ment to carry out the purposes of this article.
   §  5.  Paragraphs  1  and  2  of subsection (a) of section 7703 of the
 insurance law, as added by chapter 454 of the laws of 2014, are  amended
 to read as follows:
   (1) This article shall apply to direct life insurance policies, health
 insurance  policies,  annuity contracts, funding agreements, and supple-
 mental contracts issued by a life insurance  company,  HEALTH  INSURANCE
 COMPANY,  OR  PROPERTY/CASUALTY  INSURANCE  COMPANY licensed to transact
 life or health insurance or annuities in this  state  at  the  time  the
 policy,  contract,  or  funding  agreement  was issued or on the date of
 entry of a court order of liquidation or rehabilitation with respect  to
 such a company that is an impaired or insolvent insurer, as the case may
 be.
   (2)  Except  as otherwise provided in this section, this article shall
 apply to the policies, contracts, and funding  agreements  specified  in
 paragraph one of this subsection with regard to a person who is:
   (A)  an owner or certificate holder under a policy, contract, or fund-
 ing agreement and in each case who:
   (i) is a resident OF THIS STATE; or
   (ii) is not a resident OF THIS  STATE,  but  only  under  all  of  the
 following conditions:
   (I) (AA) the insurer that issued the policy, contract, or agreement is
 domiciled in this state; OR
   (BB)  THE  INSURER  THAT  ISSUED THE POLICY, CONTRACT, OR AGREEMENT IS
 DOMICILED OUTSIDE THIS STATE AND THE INSURER  DELIVERED  OR  ISSUED  FOR
 DELIVERY  THE  POLICY,  CONTRACT,  OR AGREEMENT IN THIS STATE; PROVIDED,
 HOWEVER, THAT FOR THE PURPOSE OF THIS SUBITEM, ANY CERTIFICATE ISSUED TO
 AN INDIVIDUAL UNDER ANY GROUP OR BLANKET POLICY OR CONTRACT DELIVERED OR
 ISSUED FOR DELIVERY IN THIS STATE  SHALL  BE  CONSIDERED  TO  HAVE  BEEN
 DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE;
   (II)  the  state  or  states in which the person resides has or have a
 guaranty entity similar to the corporation created by this article; and
   (III) the person is not eligible for coverage by a guaranty entity  in
 any  other  state  because the insurer was not licensed or authorized in
 that state at the time specified in that state's  guaranty  entity  law;
 [or]
 S. 4007                            230                           A. 3007
 
   (B)  the  beneficiary,  assignee,  or payee of the person specified in
 subparagraph (A) of this  paragraph,  regardless  of  where  the  person
 resides; OR
   (C)  A  HEALTH  CARE  PROVIDER  THAT HAS RENDERED SERVICES TO A PERSON
 SPECIFIED IN SUBPARAGRAPH (A) OF THIS PARAGRAPH.
   § 6. Subsections (c), (d), (e), (h), and (i) of section  7705  of  the
 insurance  law,  subsections (c), (e) and (i) as added by chapter 802 of
 the laws of 1985 and subsections (d) and (h) as amended by  chapter  454
 of  the  laws  of 2014, are amended and a new subsection (m) is added to
 read as follows:
   (c) "Corporation" means The Life AND HEALTH Insurance Company Guaranty
 Corporation of New York  created  under  section  seven  thousand  seven
 hundred six of this article unless the context otherwise requires.
   (d) "Covered  policy" means any of the kinds of insurance specified in
 paragraph one, two or three of subsection (a) of  section  one  thousand
 one  hundred thirteen of this chapter, any supplemental contract, or any
 funding agreement referred to in  section  three  thousand  two  hundred
 twenty-two  of  this chapter, or any portion or part thereof, within the
 scope of this article under section seven thousand seven  hundred  three
 of  this  article,  except  that any certificate issued to an individual
 under any group OR BLANKET policy or contract shall be considered to  be
 a  separate  covered policy for purposes of section seven thousand seven
 hundred eight of this article.
   (e) "Health insurance" means the kinds of  insurance  specified  under
 items  (i)  and  (ii)  of  paragraph  three  AND PARAGRAPH THIRTY-ONE of
 subsection (a) of section one thousand  one  hundred  thirteen  of  this
 chapter, AND SECTION ONE THOUSAND ONE HUNDRED SEVENTEEN OF THIS CHAPTER;
 MEDICAL  EXPENSE  INDEMNITY, DENTAL EXPENSE INDEMNITY, HOSPITAL SERVICE,
 OR HEALTH SERVICE UNDER ARTICLE FORTY-THREE OF THIS CHAPTER; AND COMPRE-
 HENSIVE HEALTH SERVICES UNDER ARTICLE FORTY-FOUR OF  THE  PUBLIC  HEALTH
 LAW.   "HEALTH INSURANCE" SHALL NOT INCLUDE HOSPITAL, MEDICAL, SURGICAL,
 PRESCRIPTION DRUG, OR OTHER HEALTH CARE BENEFITS PURSUANT TO:  (1)  PART
 C  OF  TITLE  XVIII  OF THE SOCIAL SECURITY ACT (42 U.S.C. § 1395W-21 ET
 SEQ.) OR PART D OF TITLE XVIII OF THE SOCIAL SECURITY ACT (42  U.S.C.  §
 1395W-101  ET  SEQ.),  COMMONLY  KNOWN AS MEDICARE PARTS C AND D, OR ANY
 REGULATIONS PROMULGATED THEREUNDER; (2) TITLES XIX AND XXI OF THE SOCIAL
 SECURITY ACT (42 U.S.C.  § 1396 ET SEQ.), COMMONLY KNOWN AS THE MEDICAID
 AND CHILD HEALTH INSURANCE  PROGRAMS,  OR  ANY  REGULATIONS  PROMULGATED
 THEREUNDER;  OR (3) THE BASIC HEALTH PROGRAM UNDER SECTION THREE HUNDRED
 SIXTY-NINE-GG OF THE SOCIAL SERVICES LAW.
   (h)  (1) "Member insurer" means:
   (A) any life insurance company licensed to transact in this state  any
 kind  of  insurance  to  which  this article applies under section seven
 thousand seven hundred three of this article;  provided,  however,  that
 the term "member insurer" also means any life insurance company formerly
 licensed  to  transact in this state any kind of insurance to which this
 article applies under section seven thousand seven hundred three of this
 article; AND
   (B) AN INSURER LICENSED OR FORMERLY LICENSED  TO  WRITE  ACCIDENT  AND
 HEALTH  INSURANCE  OR  SALARY PROTECTION INSURANCE IN THIS STATE, CORPO-
 RATION ORGANIZED PURSUANT TO ARTICLE FORTY-THREE OF THIS CHAPTER, RECIP-
 ROCAL INSURER ORGANIZED PURSUANT TO ARTICLE SIXTY-ONE OF  THIS  CHAPTER,
 COOPERATIVE  PROPERTY/CASUALTY  INSURANCE  COMPANY  OPERATING  UNDER  OR
 SUBJECT   TO   ARTICLE   SIXTY-SIX   OF    THIS    CHAPTER,    NONPROFIT
 PROPERTY/CASUALTY   INSURANCE  COMPANY  ORGANIZED  PURSUANT  TO  ARTICLE
 SIXTY-SEVEN OF THIS CHAPTER, AND HEALTH MAINTENANCE ORGANIZATION  CERTI-
 S. 4007                            231                           A. 3007
 
 FIED  PURSUANT  TO ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW, WHICH IS
 NOT A MEMBER OF, OR PARTICIPANT IN,  THE  FUND  OR  CORPORATION  CREATED
 PURSUANT TO ARTICLE SEVENTY-FIVE OR SEVENTY-SEVEN OF THIS CHAPTER.
   (2)  "MEMBER INSURER" SHALL NOT INCLUDE A MUNICIPAL COOPERATIVE HEALTH
 BENEFIT PLAN ESTABLISHED PURSUANT TO ARTICLE FORTY-SEVEN OF  THIS  CHAP-
 TER,  AN  EMPLOYEE  WELFARE  FUND REGISTERED UNDER ARTICLE FORTY-FOUR OF
 THIS CHAPTER,  A  FRATERNAL  BENEFIT  SOCIETY  ORGANIZED  UNDER  ARTICLE
 FORTY-FIVE  OF  THIS  CHAPTER, AN INSTITUTION OF HIGHER EDUCATION WITH A
 CERTIFICATE OF AUTHORITY UNDER SECTION ONE THOUSAND ONE HUNDRED  TWENTY-
 FOUR  OF  THIS CHAPTER, OR A CONTINUING CARE RETIREMENT COMMUNITY WITH A
 CERTIFICATE OF AUTHORITY UNDER ARTICLE FORTY-SIX OR FORTY-SIX-A  OF  THE
 PUBLIC HEALTH LAW.
   (i) "Premiums"  means  direct gross insurance premiums and annuity and
 funding agreement considerations  received  on  covered  policies,  less
 return premiums and considerations thereon and dividends paid or credit-
 ed to policyholders OR CONTRACT HOLDERS on such direct business, subject
 to  such modifications as the superintendent may establish by regulation
 or order as necessary to facilitate the equitable administration of this
 article.   Premiums  do  not  include  premiums  and  considerations  on
 contracts between insurers and reinsurers. For the purposes of determin-
 ing  the  assessment for an insurer under this article, the term "premi-
 ums", with respect to a group annuity contract (or portion of  any  such
 contract) that does not guarantee annuity benefits to any specific indi-
 vidual identified in the contract and with respect to any funding agree-
 ment  issued to fund benefits under any employee benefit plan, means the
 lesser of one million  dollars  or  the  premium  attributable  to  that
 portion  of  such group contract that does not guarantee benefits to any
 specific individuals or such agreements that  fund  benefits  under  any
 employee benefit plan.
   (M)  "LONG-TERM  CARE  INSURANCE" MEANS AN INSURANCE POLICY, RIDER, OR
 CERTIFICATE ADVERTISED, MARKETED, OFFERED, OR DESIGNED TO PROVIDE COVER-
 AGE, SUBJECT TO ELIGIBILITY REQUIREMENTS, FOR NOT LESS THAN  TWENTY-FOUR
 CONSECUTIVE  MONTHS  FOR  EACH  COVERED  PERSON  ON AN EXPENSE INCURRED,
 INDEMNITY, PREPAID OR OTHER BASIS AND PROVIDES AT LEAST THE BENEFITS SET
 FORTH IN PART FIFTY-TWO OF TITLE ELEVEN OF THE OFFICIAL  COMPILATION  OF
 CODES, RULES AND REGULATIONS OF THIS STATE.
   § 7.  Subsection (a) of section 7706 of the insurance law, as added by
 chapter 802 of the laws of 1985, is amended to read as follows:
   (a)  There is created a not-for-profit corporation to be known as "The
 Life AND HEALTH Insurance Company Guaranty Corporation of New York".  To
 the  extent that the provisions of the not-for-profit corporation law do
 not conflict with the provisions of this article or the plan  of  opera-
 tion  of  the  corporation  hereunder the not-for-profit corporation law
 shall apply to the corporation and the corporation shall  be  a  type  C
 corporation pursuant to the not-for-profit corporation law. If an appli-
 cable  provision  of this article or the plan of operation of the corpo-
 ration hereunder relates to a matter embraced  in  a  provision  of  the
 not-for-profit  corporation  law  but is not in conflict therewith, both
 provisions shall apply. All member insurers shall be and remain  members
 of  the corporation as a condition of their authority to transact insur-
 ance in this state. The corporation shall perform  its  functions  under
 the plan of operation established and approved under section seven thou-
 sand  seven  hundred  ten  of this article and shall exercise its powers
 through a board of directors established under  section  seven  thousand
 seven  hundred seven of this article. For purposes of administration and
 assessment the corporation shall maintain two accounts:
 S. 4007                            232                           A. 3007
 
   (1) the health insurance account; and
   (2) the life insurance, annuity and funding agreement account.
   §  8. Subsection (d) of section 7707 of the insurance law, as added by
 chapter 802 of the laws of 1985, is amended to read as follows:
   (d) The superintendent shall be ex-officio  [chairman]  CHAIR  of  the
 board of directors but shall not be entitled to vote.
   §  9.  Paragraph  7 of subsection (h) of section 7708 of the insurance
 law, as amended by chapter 454 of the laws of 2014, is amended  to  read
 as follows:
   (7)  exercise,  for  the  purposes  of  this article and to the extent
 approved by the superintendent, the powers of a domestic  life,  HEALTH,
 OR  PROPERTY/CASUALTY  insurance  company, but in no case may the corpo-
 ration issue insurance policies OR CONTRACTS or annuity contracts  other
 than those issued to perform the contractual obligations of the impaired
 or insolvent insurer;
   §  10.  Paragraph 2 of subsection (c) of section 7709 of the insurance
 law, as added by chapter 802 of the laws of 1985, is amended to read  as
 follows:
   (2)  The  amount  of  any  class  B  or class C assessment, EXCEPT FOR
 ASSESSMENTS RELATED TO LONG-TERM CARE INSURANCE, shall be allocated  for
 assessment purposes among the accounts in the proportion that the premi-
 ums  received  by  the  impaired or insolvent insurer on the policies or
 contracts covered by each account for the last calendar  year  preceding
 the  assessment  in  which  the  impaired  or insolvent insurer received
 premiums bears to the premiums received by such insurer for such  calen-
 dar  year  on all covered policies. THE AMOUNT OF ANY CLASS B OR CLASS C
 ASSESSMENT FOR LONG-TERM CARE  INSURANCE  WRITTEN  BY  THE  IMPAIRED  OR
 INSOLVENT INSURER SHALL BE ALLOCATED ACCORDING TO A METHODOLOGY INCLUDED
 IN  THE PLAN OF OPERATION AND APPROVED BY THE SUPERINTENDENT.  THE METH-
 ODOLOGY SHALL PROVIDE FOR FIFTY PERCENT OF THE ASSESSMENT  TO  BE  ALLO-
 CATED  TO A HEALTH INSURANCE COMPANY MEMBER INSURER AND FIFTY PERCENT TO
 BE ALLOCATED TO A  LIFE  INSURANCE  COMPANY  MEMBER  INSURER;  PROVIDED,
 HOWEVER,  THAT  A PROPERTY/CASUALTY INSURER THAT WRITES HEALTH INSURANCE
 SHALL BE CONSIDERED A HEALTH INSURANCE COMPANY MEMBER FOR THIS  PURPOSE.
 Class B and class C assessments against member insurers for each account
 shall  be  in  the  proportion that the premiums received on business in
 this state by each assessed member insurer on policies covered  by  each
 account  for  the three calendar years preceding the assessment bears to
 such premiums received on business in this state for such calendar years
 by all assessed member insurers.
   § 11.  Subsection (a) of section 7712 of the insurance law,  as  added
 by chapter 802 of the laws of 1985, is amended to read as follows:
   (a) The superintendent shall annually, within six months following the
 close of each calendar year, furnish to the commissioner of taxation and
 finance  and  the  director of the division of the budget a statement of
 operations for the life insurance guaranty corporation and the life  AND
 HEALTH  insurance  company guaranty corporation of New York. Such state-
 ment shall show the assessments,  less  any  refunds  or  reimbursements
 thereof,  paid  by  each insurance company pursuant to the provisions of
 article seventy-five or section seven thousand  seven  hundred  nine  of
 this article, for the purposes of meeting the requirements of this chap-
 ter.  Each  statement, starting with the statement furnished in the year
 nineteen hundred eighty-six and ending with the statement  furnished  in
 the  year  two  thousand,  shall show the annual activity for every year
 commencing from nineteen hundred eighty-five through the  most  recently
 completed year. Each statement furnished in each year after the year two
 S. 4007                            233                           A. 3007
 
 thousand  shall  reflect  such  assessments  paid  during  the preceding
 fifteen calendar years. The superintendent shall also furnish a copy  of
 such statement to each such insurance company.
   §  12.  Subsections (a), (d), and (g) of section 7719 of the insurance
 law, as added by chapter 454 of the laws of 2014, are amended to read as
 follows:
   (a) The corporation may incorporate one or more not-for-profit  corpo-
 rations,  known  as a resolution facility, in connection with the liqui-
 dation of an insolvent domestic life insurance company, HEALTH INSURANCE
 COMPANY, OR PROPERTY/CASUALTY INSURANCE COMPANY under  article  seventy-
 four  of  this chapter for the purpose of administering and disposing of
 the business of the insolvent [domestic life] insurance company.
   (d) A resolution facility may:
   (1) guarantee,  assume,  or  reinsure,  or  cause  to  be  guaranteed,
 assumed,  or reinsured, the covered policies, or arrange for replacement
 by policies found by the superintendent to be substantially  similar  to
 the covered policies;
   (2)  exercise,  for  the  purposes  of  this article and to the extent
 approved by the superintendent, the powers of a domestic life  insurance
 company, HEALTH INSURANCE COMPANY, OR PROPERTY/CASUALTY INSURANCE COMPA-
 NY  but in no case may the resolution facility issue insurance policies,
 annuity contracts, funding agreements, or supplemental  contracts  other
 than those issued to perform the contractual obligations of the impaired
 or insolvent insurer;
   (3)  assure  payment  of  the contractual obligations of the insolvent
 insurer; and
   (4) provide such moneys, pledges, notes, guarantees, or other means as
 are reasonably necessary to discharge its duties.
   (g) (1) If the superintendent determines that the resolution  facility
 is  not  administering  and  disposing  of  the business of an insolvent
 domestic  life  insurance  company,   HEALTH   INSURANCE   COMPANY,   OR
 PROPERTY/CASUALTY  INSURANCE  COMPANY  consistent  with  the  resolution
 facility's certificate of incorporation,  plan  of  operation,  or  this
 section,  then the superintendent shall provide notice to the resolution
 facility and the resolution facility shall have thirty days  to  respond
 to the superintendent and cure the defect.
   (2)  If,  after  thirty  days, the superintendent continues to believe
 that the resolution facility is not administering and disposing  of  the
 business  of an insolvent domestic life insurance company, HEALTH INSUR-
 ANCE COMPANY, OR PROPERTY/CASUALTY INSURANCE COMPANY consistent with the
 resolution facility's certificate of incorporation, plan  of  operation,
 or  this  section, then the superintendent may apply to the court for an
 order directing the resolution facility to correct the  defect  or  take
 other appropriate actions.
   §  13.  The  insurance  law is amended by adding a new section 7720 to
 read as follows:
   § 7720. PENALTIES. (A) IF ANY MEMBER INSURER FAILS TO MAKE ANY PAYMENT
 REQUIRED BY THIS ARTICLE, OR IF THE SUPERINTENDENT HAS CAUSE TO  BELIEVE
 THAT ANY OTHER STATEMENT FILED IS FALSE OR INACCURATE IN ANY PARTICULAR,
 OR  THAT  ANY  PAYMENT MADE IS INCORRECT, THE SUPERINTENDENT MAY EXAMINE
 ALL THE BOOKS AND RECORDS OF THE MEMBER INSURER TO ASCERTAIN  THE  FACTS
 AND  DETERMINE THE CORRECT AMOUNT TO BE PAID. BASED ON SUCH FINDING, THE
 CORPORATION MAY PROCEED  IN  ANY  COURT  OF  COMPETENT  JURISDICTION  TO
 RECOVER  FOR  THE BENEFIT OF THE FUND ANY SUMS SHOWN TO BE DUE UPON SUCH
 EXAMINATION AND DETERMINATION.
 S. 4007                            234                           A. 3007
 
   (B) ANY MEMBER INSURER THAT FAILS TO MAKE ANY SUCH REQUIRED STATEMENT,
 OR TO MAKE ANY PAYMENT TO THE FUND WHEN DUE, SHALL FORFEIT TO THE CORPO-
 RATION FOR DEPOSIT IN THE FUND A PENALTY OF FIVE PERCENT OF  THE  AMOUNT
 DETERMINED  TO  BE DUE PLUS ONE PERCENT OF SUCH AMOUNT FOR EACH MONTH OF
 DELAY,  OR  FRACTION THEREOF, AFTER THE EXPIRATION OF THE FIRST MONTH OF
 SUCH DELAY. IF SATISFIED THAT THE DELAY WAS EXCUSABLE,  THE  CORPORATION
 MAY REMIT ALL OR ANY PART OF THE PENALTY.
   (C) THE SUPERINTENDENT, IN THE SUPERINTENDENT'S DISCRETION, MAY REVOKE
 THE CERTIFICATE OF AUTHORITY TO DO BUSINESS IN THIS STATE OF ANY FOREIGN
 MEMBER  INSURER  THAT  FAILS  TO  COMPLY WITH THIS ARTICLE OR TO PAY ANY
 PENALTY IMPOSED HEREUNDER.
   § 14. The insurance law is amended by adding a  new  section  3245  to
 read as follows:
   §  3245.  LIABILITY TO PROVIDERS IN THE EVENT OF AN INSOLVENCY. IN THE
 EVENT AN INSURANCE COMPANY AUTHORIZED  TO  DO  AN  ACCIDENT  AND  HEALTH
 INSURANCE  BUSINESS  IN  THIS  STATE IS DEEMED INSOLVENT, AS PROVIDED IN
 SECTION ONE THOUSAND THREE HUNDRED NINE  OF  THIS  CHAPTER,  NO  INSURED
 COVERED UNDER A POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE BY
 THE  INSURANCE  COMPANY  SHALL  BE LIABLE TO ANY PROVIDER OF HEALTH CARE
 SERVICES FOR ANY COVERED SERVICES OF THE INSOLVENT INSURANCE COMPANY. NO
 PROVIDER OF HEALTH CARE SERVICES OR ANY REPRESENTATIVE OF SUCH  PROVIDER
 SHALL  COLLECT  OR ATTEMPT TO COLLECT FROM THE INSURED SUMS OWED BY SUCH
 INSURANCE COMPANY, AND NO PROVIDER OR REPRESENTATIVE  OF  SUCH  PROVIDER
 MAY  MAINTAIN  ANY ACTION AT LAW AGAINST AN INSURED TO COLLECT SUMS OWED
 TO SUCH PROVIDER BY SUCH INSURANCE COMPANY.
   § 15. 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 Subparts A through D of this act  shall
 be as specifically set forth in the last section of such Subparts.

                                  PART Z
 
   Section  1.  Subdivisions 7 and 8 of section 4656 of the public health
 law, as added by chapter 2 of the laws of 2004, are renumbered  subdivi-
 sions 8 and 9 and a new subdivision 7 is added to read as follows:
   7.  ASSISTED  LIVING  QUALITY  IMPROVEMENT STANDARDS. (A) ALL ASSISTED
 LIVING RESIDENCES, AS DEFINED IN SUBDIVISION ONE  OF  SECTION  FORTY-SIX
 HUNDRED  FIFTY-ONE  OF THIS ARTICLE, INCLUDING THOSE LICENSED AND CERTI-
 FIED AS AN ASSISTED LIVING  RESIDENCE,  SPECIAL  NEEDS  ASSISTED  LIVING
 RESIDENCE, OR ENHANCED ASSISTED LIVING RESIDENCE, SHALL:
   (I)  REPORT  ANNUALLY  ON  QUALITY  MEASURES  TO BE ESTABLISHED BY THE
 DEPARTMENT, IN THE FORM AND FORMAT PRESCRIBED BY  THE  DEPARTMENT,  WITH
 THE  FIRST  REPORT  DUE NO LATER THAN JANUARY THIRTY-FIRST, TWO THOUSAND
 TWENTY-FOUR; AND
   (II) POST THE MONTHLY  SERVICE  RATE,  STAFFING  COMPLEMENT,  APPROVED
 ADMISSION OR RESIDENCY AGREEMENT, AND A CONSUMER-FRIENDLY SUMMARY OF ALL
 SERVICE  FEES  IN A CONSPICUOUS PLACE ON THE FACILITY'S WEBSITE AND IN A
 S. 4007                            235                           A. 3007
 
 PUBLIC SPACE WITHIN THE FACILITY. SUCH INFORMATION SHALL BE MADE  AVAIL-
 ABLE  TO  THE  PUBLIC ON FORMS DEVELOPED BY THE DEPARTMENT. BEGINNING ON
 JANUARY FIRST, TWO THOUSAND TWENTY-FOUR, THIS INFORMATION SHALL ALSO  BE
 REPORTED TO THE DEPARTMENT.
   (B)  THE  DEPARTMENT  SHALL  SCORE  THE RESULTS OF THE ASSISTED LIVING
 QUALITY REPORTING OBTAINED PURSUANT TO PARAGRAPH (A)  OF  THIS  SUBDIVI-
 SION.  TOP  SCORING  FACILITIES  SHALL  BE GRANTED THE CLASSIFICATION OF
 ADVANCED STANDING ON THEIR ANNUAL SURVEILLANCE SCHEDULES.
   (I) NOTWITHSTANDING SUBPARAGRAPH ONE OF PARAGRAPH (A)  OF  SUBDIVISION
 TWO  OF  SECTION  FOUR  HUNDRED  SIXTY-ONE-A OF THE SOCIAL SERVICES LAW,
 FACILITIES  ACHIEVING  AN  ADVANCED  STANDING  CLASSIFICATION  SHALL  BE
 SURVEYED EVERY TWELVE TO EIGHTEEN MONTHS.  ALL OTHER FACILITIES SHALL BE
 SURVEYED ON AN UNANNOUNCED BASIS NO LESS THAN ANNUALLY; PROVIDED, HOWEV-
 ER,  THAT THIS SHALL NOT APPLY TO SURVEYS, INSPECTIONS OR INVESTIGATIONS
 BASED ON COMPLAINTS RECEIVED BY THE DEPARTMENT UNDER ANY OTHER PROVISION
 OF LAW.
   (II)  FACILITIES  MAY  REMAIN  ON  ADVANCED  STANDING   CLASSIFICATION
 PROVIDED  THEY  MEET THE SCORING REQUIREMENTS IN ASSISTED LIVING QUALITY
 REPORTING.
   (C) (I) EFFECTIVE JANUARY THIRTY-FIRST, TWO THOUSAND TWENTY-FOUR,  THE
 DEPARTMENT  MAY  POST  ON ITS WEBSITE THE RESULTS OF THE ASSISTED LIVING
 QUALITY REPORTING, COLLECTED PURSUANT TO SUBPARAGRAPH (I)  OF  PARAGRAPH
 (A) OF THIS SUBDIVISION.
   § 2. Subparagraph 1 of paragraph (a) of subdivision 2 of section 461-a
 of  the  social  services  law, as amended by chapter 735 of the laws of
 1994, is amended and a new  subparagraph  (1-a)  is  added  to  read  as
 follows:
   (1) Such facilities receiving the department's highest rating shall be
 inspected  at  least once every eighteen months on an unannounced basis.
 SUCH RATING DETERMINATION SHALL BE MADE PURSUANT  TO  AN  EVALUATION  OF
 QUALITY  INDICATORS  AS DEVELOPED BY THE DEPARTMENT AND PUBLISHED ON THE
 DEPARTMENT'S WEBSITE.
   (1-A) (I) ADULT CARE FACILITIES DUALLY LICENSED  TO  PROVIDE  ASSISTED
 LIVING  PURSUANT  TO  THE  REQUIREMENTS  SPECIFIED  IN SECTION FORTY-SIX
 HUNDRED FIFTY-THREE OF THE PUBLIC HEALTH LAW MAY SEEK  ACCREDITATION  BY
 ONE OR MORE NATIONALLY RECOGNIZED ACCREDITING AGENCIES DETERMINED BY THE
 COMMISSIONER.
   (II) SUCH ACCREDITATION AGENCIES SHALL REPORT DATA AND INFORMATION, IN
 A  MANNER  AND FORM AS DETERMINED BY THE DEPARTMENT, PERTAINING TO THOSE
 ASSISTED LIVING RESIDENCES ACCREDITED BY SUCH AGENCIES,  THOSE  ASSISTED
 LIVING  RESIDENCES  THAT SEEK BUT DO NOT RECEIVE SUCH ACCREDITATION, AND
 THOSE ASSISTED LIVING RESIDENCES WHICH OBTAIN  BUT  LOSE  SUCH  ACCREDI-
 TATION.
   (III) NOTWITHSTANDING THE PROVISIONS OF SUBPARAGRAPH ONE OF THIS PARA-
 GRAPH,  OR  ANY OTHER PROVISION OF LAW, ASSISTED LIVING RESIDENCES WHICH
 HAVE OBTAINED ACCREDITATION FROM A NATIONALLY  RECOGNIZED  ACCREDITATION
 ORGANIZATION  APPROVED  BY  THE  DEPARTMENT  AND  WHICH MEET ELIGIBILITY
 CRITERIA, AS DETERMINED BY THE DEPARTMENT, MAY, AT THE DISCRETION OF THE
 COMMISSIONER, BE EXEMPT FROM  DEPARTMENT  INSPECTION  REQUIRED  IN  THIS
 SUBDIVISION  FOR  THE DURATION THEY MAINTAIN THEIR ACCREDITATION IN GOOD
 STANDING. THE OPERATOR OF AN ADULT CARE FACILITY THAT OBTAINS BUT SUBSE-
 QUENTLY LOSES ACCREDITATION SHALL REPORT SUCH  LOSS  TO  THE  DEPARTMENT
 WITHIN  TEN BUSINESS DAYS IN A MANNER AND FORM DETERMINED BY THE DEPART-
 MENT AND WILL  NO  LONGER  BE  EXEMPT  FROM  THE  DEPARTMENT  INSPECTION
 REQUIRED IN THIS SUBDIVISION. THE DEPARTMENT SHALL POST ON ITS WEBSITE A
 LIST OF ALL ACCREDITED ASSISTED LIVING RESIDENCES.
 S. 4007                            236                           A. 3007
 
   § 3. This act shall take effect on the one hundred twentieth day after
 it shall have become a law.
 
                                  PART AA
 
   Section  1. Section 3 of chapter 425 of the laws of 2013, amending the
 public health law relating to requiring hospitals to offer  hepatitis  C
 testing,  as  amended  by chapter 284 of the laws of 2019, is amended to
 read as follows:
   § 3. 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 expire and
 be deemed repealed January 1, 2026; provided, however, that the  commis-
 sioner  of health is authorized to adopt rules and regulations necessary
 to implement this act prior to such effective date].
   § 2. Subdivisions 1 and 2 of section 2171 of the public health law, as
 added by chapter 425 of the  laws  of  2013,  are  amended  to  read  as
 follows:
   1.  Every  individual  [born  between  the  years  of nineteen hundred
 forty-five and nineteen hundred sixty-five] AGE EIGHTEEN AND  OLDER  (OR
 YOUNGER  THAN EIGHTEEN IF THERE IS EVIDENCE OR INDICATION OF RISK ACTIV-
 ITY) who receives health services as an inpatient OR  in  THE  EMERGENCY
 DEPARTMENT  OF  a general hospital defined in subdivision ten of section
 twenty-eight hundred one of this chapter or who  receives  primary  care
 services in an outpatient department of such hospital or in a diagnostic
 and treatment center licensed under article twenty-eight of this chapter
 or  from  a  physician,  physician assistant [or], nurse practitioner OR
 MIDWIFE providing primary care shall be offered a hepatitis C  screening
 test [or hepatitis C diagnostic test] unless the health care practition-
 er providing such services reasonably believes that:
   (a)  the individual is being treated for a life threatening emergency;
 or
   (b) the individual has previously been offered or has been the subject
 of a hepatitis C screening test (except that a test shall be offered  if
 otherwise indicated); or
   (c)  the individual lacks capacity to consent to a hepatitis C screen-
 ing test.
   2. If an individual accepts the offer of a hepatitis C screening  test
 and  the  screening  test  is  reactive,  [the]  AN HCV RNA TEST MUST BE
 PERFORMED, ON THE SAME SPECIMEN OR A SECOND SPECIMEN  COLLECTED  AT  THE
 SAME TIME AS THE INITIAL HCV SCREENING TEST SPECIMEN, TO CONFIRM DIAGNO-
 SIS  OF  CURRENT  INFECTION. THE health care provider shall either offer
 [the individual] ALL PERSONS WITH A DETECTABLE HCV  RNA  TEST  follow-up
 HCV  health  care AND TREATMENT or refer the individual to a health care
 provider who can provide follow-up HCV health care AND TREATMENT.   [The
 follow-up health care shall include a hepatitis C diagnostic test.]
   §  3.  The public health law is amended by adding a new section 2500-l
 to read as follows:
   § 2500-L. PREGNANT PEOPLE, BLOOD TEST FOR  HEPATITIS  C  VIRUS  (HCV);
 FOLLOW-UP  CARE.    1.  EVERY PHYSICIAN OR OTHER AUTHORIZED PRACTITIONER
 ATTENDING A PREGNANT PERSON IN THE STATE SHALL ORDER A HEPATITIS C VIRUS
 (HCV) SCREENING TEST AND IF THE TEST IS REACTIVE, AN HCV RNA  TEST  MUST
 BE PERFORMED ON THE SAME SPECIMEN, OR A SECOND SPECIMEN COLLECTED AT THE
 SAME TIME AS THE INITIAL HCV SCREENING TEST SPECIMEN, TO CONFIRM DIAGNO-
 SIS  OF  CURRENT  INFECTION. THE HEALTH CARE PROVIDER SHALL EITHER OFFER
 ALL PERSONS WITH A DETECTABLE HCV RNA TEST FOLLOW-UP HCV HEALTH CARE AND
 S. 4007                            237                           A. 3007
 
 TREATMENT OR REFER THE INDIVIDUAL TO A  HEALTH  CARE  PROVIDER  WHO  CAN
 PROVIDE FOLLOW-UP HCV HEALTH CARE AND TREATMENT.
   2. THE PHYSICIAN OR OTHER AUTHORIZED PRACTITIONER ATTENDING A PREGNANT
 PERSON  SHALL  RECORD  THE  HCV TEST RESULTS PROMINENTLY IN THE PREGNANT
 PERSON'S MEDICAL RECORD AT OR BEFORE THE TIME OF HOSPITAL ADMISSION  FOR
 DELIVERY.
   3.  THE  COMMISSIONER MAY PROMULGATE SUCH RULES AND REGULATIONS AS ARE
 NECESSARY TO CARRY OUT THE REQUIREMENTS OF THIS SECTION.
   § 4. The section heading of section 2308 of the public health law,  as
 amended  by  section  37 of part E of chapter 56 of the laws of 2013, is
 amended to read as follows:
   Sexually transmitted disease; pregnant [women] PERSONS; blood test for
 syphilis.
   § 5. 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] PERSONS in the state shall in the case of every  [woman]  PERSON
 so  attended take or cause to be taken a sample of blood of such [woman]
 PERSON 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
 THE  THIRD TRIMESTER OF PREGNANCY CONSISTENT WITH ANY GUIDANCE AND REGU-
 LATIONS ISSUED BY THE COMMISSIONER.
   § 6. This act shall take effect immediately;  provided,  however  that
 sections  two,  three, four and five shall take effect one year after it
 shall have become a law. 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  to be made and
 completed on or before such effective date.
 
                                  PART BB
 
   Section 1.  Paragraphs 59 and 61 of subdivision (b) of schedule  I  of
 section  3306 of the public health law, as added by section 2 of part CC
 of chapter 56 of the laws of 2020, are amended and 30 new paragraphs 71,
 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88,  89,
 90,  91,  92,  93,  94,  95, 96, 97, 98, 99 and 100 are added to read as
 follows:
   (59) [N-{1-{2-hydroxy-2-(thiophen-2-yl)ethyl}piperidin-4-yl}-N-phenylp-
 ropionamide]   N-{1-{2-HYDROXY-2-(THIOPHEN-2-YL)ETHYL}PIPERIDIN-4-YL}-N-
 PHENYL PROPIONAMIDE. Other name:  Beta-Hydroxythiofentanyl.
   (61)  [3,4-Dichloro-N-{2-(dimethylamino)cyclohexyl}-N-methylbenzamide]
 3,4-DICHLORO-N-{2-(DIMETHYLAMINO)CYCLOHEXYL}-N-METHYLBENZAMIDE.    Other
 name: U-47700.
    (71)  N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLPENTANAMIDE.  OTHER NAME:
 VALERYL FENTANYL.
   (72)      N-(4-METHOXYPHENYL)-N-(1-PHENETHYLPIPERIDIN-4-YL)BUTYRAMIDE.
 OTHER NAME: PARA-METHOXYBUTYRYL FENTANYL.
   (73)    N-(4-CHLOROPHENYL)-N-(1-PHENETHYLPIPERIDIN-4-YL)ISOBUTYRAMIDE.
 OTHER NAME: PARA-CHLOROISOBUTYRYL FENTANYL.
   (74) N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLISOBUTYRAMIDE.  OTHER NAME:
 ISOBUTYRYL FENTANYL.
   (75)    N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLCYCLOPENTANECARBOXAMIDE.
 OTHER NAME: CYCLOPENTYL FENTANYL.
 S. 4007                            238                           A. 3007
 
   (76)  (E)-N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLBUT-2-ENAMIDE.   OTHER
 NAME: CROTONYL FENTANYL.
   (77)        N-(1-(2-FLUOROPHENETHYL)PIPERIDIN-4-YL)-N-(2-FLUOROPHENYL)
 PROPIONAMIDE. OTHER  NAMES:  2'-FLUORO  ORTHO-FLUOROFENTANYL;  2'-FLUORO
 2-FLUOROFENTANYL.
   (78) N-(2-METHYLPHENYL)-N-(1-PHENETHYLPIPERIDIN-4-YL)ACETAMIDE.  OTHER
 NAMES:  ORTHO-METHYL ACETYLFENTANYL; 2-METHYL ACETYLFENTANYL.
   (79)  N-(1-PHENETHYLPIPERIDIN-4-YL)-N,  3-DIPHENYLPROPANAMIDE.   OTHER
 NAMES:   BETA'-PHENYL FENTANYL; BETA'-PHENYL FENTANYL; 3-PHENYLPROPANOYL
 FENTANYL.
   (80)    N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLTHIOPHENE-2-CARBOXAMIDE.
 OTHER  NAMES:    THIOFURANYL FENTANYL; 2-THIOFURANYL FENTANYL; THIOPHENE
 FENTANYL.
   (81) N-PHENYL-N-(1-(2-PHENYLPROPYL)PIPERIDIN-4-YL)PROPIONAMIDE.  OTHER
 NAMES: BETA-METHYL FENTANYL; BETA-METHYL FENTANYL.
   (82) N-(2-FLUOROPHENYL)-N-(1-PHENETHYLPIPERIDIN-4-YL)BUTYRAMIDE.
 OTHER NAMES: ORTHO-FLUOROBUTYRYL FENTANYL; 2-FLUOROBUTYRYL FENTANYL.
   (83)  N-(1-(4-METHYLPHENETHYL)PIPERIDIN-4-YL)-N-PHENYLACETAMIDE. OTHER
 NAME: 4'-METHYL ACETYL FENTANYL.
   (84) 2-METHOXY-N-(2-METHYLPHENYL)-N-(1-PHENETHYLPIPERIDIN-4-YL)ACETAMIDE.
 OTHER NAMES: ORTHO-METHYL METHOXYACETYLFENTANYL; 2-METHYL  METHOXYACETYL
 FENTANYL.
   (85) N-(4-METHYLPHENYL)-N-(1-PHENETHYLPIPERIDIN-4-YL)PROPIONAMIDE.
 OTHER NAMES: PARA-METHYLFENTANYL; 4-METHYLFENTANYL.
   (86)   N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLBENZAMIDE.  OTHER  NAMES:
 PHENYL FENTANYL; BENZOYL FENTANYL.
   (87) ETHYL (1-PHENETHYLPIPERIDIN-4-YL)(PHENYL)CARBAMATE.  OTHER  NAME:
 FENTANYL CARBAMATE.
   (88) N-(2-FLUOROPHENYL)-N-(1-PHENETHYLPIPERIDIN-4-YL)ACRYLAMIDE.
 OTHER NAME: ORTHO-FLUOROACRYL FENTANYL.
   (89) N-(2-FLUOROPHENYL)-N-(1-PHENETHYLPIPERIDIN-4-YL)ISOBUTYRAMIDE.
 OTHER NAME: ORTHO-FLUOROISOBUTYRYL FENTANYL.
   (90) N-(4-FLUOROPHENYL)-N-(1-PHENETHYLPIPERIDIN-4-YL)FURAN-2-CARBOXAMIDE.
 OTHER NAME: PARA-FLUORO FURANYL FENTANYL.
   (91) N,N-DIETHYL-2-(2-(4-ISOPROPOXYBENZYL)-5-NITRO-1H-BENZIMIDAZOL-1-YL)
 ETHAN-1-AMINE. OTHER NAME: ISOTONITAZENE.
   (92) 1-(1-(1-(4-BROMOPHENYL)ETHYL)PIPERIDIN-4-YL)-1,3-DIHYDRO-2H-
 BENZO[d]IMIDAZOL-2-ONE. OTHER NAMES:  BRORPHINE; 1-[1-[1-(4-bromophenyl)
 ethyl]-4-piperidinyl]-1,3-DIHYDRO-2H-BENZIMIDAZOL-2-ONE.
   (93) 2-(2-(4-BUTOXYBENZYL)-5-NITRO-1H-BENZIMIDAZOL-1-YL)-N,N-DIETHYLETHAN
 -1-AMINE. OTHER NAME: BUTONITAZENE.
   (94) 2-(2-(4-ETHOXYBENZYL)-1H-BENZIMIDAZOL-1-YL)-N,N-DIETHYLETHAN-1-AMINE.
 OTHER NAMES: ETODESNITAZENE; ETAZENE.
   (95) N,N-DIETHYL-2-(2-(4-FLUOROBENZYL)-5-NITRO-1H-BENZIMIDAZOL-1-YL)ETHAN-
 1-AMINE. OTHER NAME: FLUNITAZENE.
   (96) N,N-DIETHYL-2-(2-(4-METHOXYBENZYL)-1H-BENZIMIDAZOL-1-YL)ETHAN-1-
 AMINE. OTHER NAME: METODESNITAZENE.
   (97) N,N-DIETHYL-2-(2-(4-METHOXYBENZYL)-5-NITRO-1H-BENZIMIDAZOL-1-YL)
 ETHAN-1-AMINE. OTHER NAME: METONITAZENE.
   (98) 2-(4-ETHOXYBENZYL)-5-NITRO-1-(2-(PYRROLIDIN-1-YL)ETHYL)-1H-
 BENZIMIDAZOLE. OTHER NAMES: N-PYRROLIDINO ETONITAZENE; ETONITAZEPYNE.
   (99) N,N-DIETHYL-2-(5-NITRO-2-(4-PROPOXYBENZYL)-1H-BENZIMIDAZOL-1-YL)
 ETHAN-1-AMINE. OTHER NAME: PROTONITAZENE.
   (100)  FENTANYL-RELATED  SUBSTANCES,  THEIR  ISOMERS,  ESTERS, ETHERS,
 SALTS AND SALTS OF ISOMERS, ESTERS AND ETHERS.
 S. 4007                            239                           A. 3007
 
   (I) FENTANYL-RELATED SUBSTANCE MEANS ANY SUBSTANCE NOT OTHERWISE LIST-
 ED UNDER ANOTHER ADMINISTRATION CONTROLLED SUBSTANCE  CODE  NUMBER,  AND
 FOR WHICH NO EXEMPTION OR APPROVAL IS IN EFFECT UNDER SECTION 505 OF THE
 FEDERAL  FOOD,  DRUG,  AND  COSMETIC ACT (21 U.S.C. 355), THAT IS STRUC-
 TURALLY  RELATED  TO  FENTANYL BY ONE OR MORE OF THE FOLLOWING MODIFICA-
 TIONS:
   (A) REPLACEMENT OF THE PHENYL PORTION OF THE PHENETHYL  GROUP  BY  ANY
 MONOCYCLE, WHETHER OR NOT FURTHER SUBSTITUTED IN OR ON THE MONOCYCLE;
   (B)  SUBSTITUTION  IN  OR  ON THE PHENETHYL GROUP WITH ALKYL, ALKENYL,
 ALKOXYL, HYDROXYL, HALO, HALOALKYL, AMINO OR NITRO GROUPS;
   (C) SUBSTITUTION IN OR ON THE PIPERIDINE  RING  WITH  ALKYL,  ALKENYL,
 ALKOXYL, ESTER, ETHER, HYDROXYL, HALO, HALOALKYL, AMINO OR NITRO GROUPS;
   (D) REPLACEMENT OF THE ANILINE RING WITH ANY AROMATIC MONOCYCLE WHETH-
 ER OR NOT FURTHER SUBSTITUTED IN OR ON THE AROMATIC MONOCYCLE; AND/OR
   (E) REPLACEMENT OF THE N-PROPIONYL GROUP BY ANOTHER ACYL GROUP.
   (II)  THIS  DEFINITION  INCLUDES, BUT IS NOT LIMITED TO, THE FOLLOWING
 SUBSTANCES:
   (A)-(B) [Reserved]
   § 2. Paragraph 3 of subdivision (g) of schedule II of section 3306  of
 the public health law, as added by section 7 of part C of chapter 447 of
 the laws of 2012, is amended to read as follows:
   (3) Immediate precursor to fentanyl:
   (i)  [4-anilino-N-phenethyl-4-piperidine  (ANPP)]  4-ANILINO-N-PHENEN-
 ETHYLPIPERIDINE (ANPP).
   (II) N-PHENYL-N-(PIPERIDIN-4-YL)PROPIONAMIDE (NORFENTANYL).
   § 3. Paragraph c of subdivision 1 of section 3383 of the public health
 law, as added by chapter 494 of the laws of 1982, is amended to read  as
 follows:
   c. "Imitation controlled substance" means: (1) a substance, other than
 a  drug  for  which  a  prescription is required pursuant to article one
 hundred thirty-seven of the education law,  that  is  not  a  controlled
 substance,  which  by dosage unit appearance, including color, shape and
 size  and  by  a  representation  is  represented  to  be  a  controlled
 substance,  as  defined in the penal law; OR (2) A CONTROLLED SUBSTANCE,
 WHICH BY DOSAGE UNIT APPEARANCE, INCLUDING COLOR, SHAPE AND SIZE AND  BY
 A  REPRESENTATION IS REPRESENTED TO BE A DIFFERENT CONTROLLED SUBSTANCE,
 AS DEFINED IN THE  PENAL  LAW.  Evidence  of  representations  that  the
 substance  is  a  controlled substance may include but is not limited to
 oral or written representations by the manufacturer or  seller,  as  the
 case may be, about the substance with regard to:
   (i) its price, nature, use or effect as a controlled substance; or
   (ii)  its  packaging  in a manner normally used for illicit controlled
 substances; or
   (iii) markings on the substance; OR
   (IV) HAVING BEEN PRESCRIBED OR PROVIDED BY A PHARMACIST OR HEALTH CARE
 PRACTITIONER.
   § 4. Subdivision 7 of  section  3383  of  the  public  health  law  is
 REPEALED and subdivision 8 is renumbered subdivision 7.
   §  5.  Subdivision  21  of section 10.00 of the penal law, as added by
 chapter 1 of the laws of 2013, is amended to read as follows:
   21. "Drug trafficking felony" means  any  of  the  following  offenses
 defined  in article two hundred twenty of this chapter: violation of use
 of a child to commit  a  controlled  substance  offense  as  defined  in
 section  220.28;  criminal  sale of a controlled substance in the fourth
 degree as defined in section  220.34;  criminal  sale  of  a  controlled
 substance  in  the  third  degree as defined in section 220.39; criminal
 S. 4007                            240                           A. 3007
 
 sale of a controlled substance  in  the  second  degree  as  defined  in
 section  220.41;  criminal  sale  of a controlled substance in the first
 degree as defined in section  220.43;  criminal  sale  of  a  controlled
 substance in or near school grounds as defined in section 220.44; unlaw-
 ful  manufacture  of  methamphetamine in the second degree as defined in
 section 220.74; unlawful manufacture of  methamphetamine  in  the  first
 degree  as defined in section 220.75; or operating as a major trafficker
 as defined in section 220.77; CRIMINAL SALE OF AN  IMITATION  CONTROLLED
 SUBSTANCE  IN  THE  FIFTH  DEGREE AS DEFINED IN SECTION 220.83; CRIMINAL
 SALE OF AN IMITATION CONTROLLED SUBSTANCE IN THE THIRD DEGREE AS DEFINED
 IN  SECTION  220.84;  AND  CRIMINAL  SALE  OF  AN  IMITATION  CONTROLLED
 SUBSTANCE IN THE FIRST DEGREE AS DEFINED IN SECTION 220.85.
   §  6. Paragraphs (a) and (b) of subdivision 1 of section 460.10 of the
 penal law, paragraph (a) as amended by chapter 134 of the laws  of  2019
 and  paragraph  (b)  as  amended by chapter 442 of the laws of 2006, are
 amended to read as follows:
   (a) Any of the felonies set forth in this  chapter:  sections  120.05,
 120.10 and 120.11 relating to assault; sections 121.12 and 121.13 relat-
 ing  to  strangulation;  sections 125.10 to 125.27 relating to homicide;
 sections 130.25, 130.30 and 130.35 relating to rape; sections 135.20 and
 135.25 relating to kidnapping; sections 135.35 and  135.37  relating  to
 labor trafficking; section 135.65 relating to coercion; sections 140.20,
 140.25  and  140.30  relating  to  burglary; sections 145.05, 145.10 and
 145.12 relating to criminal mischief; article one hundred fifty relating
 to arson; sections 155.30, 155.35, 155.40 and 155.42 relating  to  grand
 larceny;  sections  177.10, 177.15, 177.20 and 177.25 relating to health
 care fraud; article one hundred  sixty  relating  to  robbery;  sections
 165.45,  165.50,  165.52  and  165.54 relating to criminal possession of
 stolen property; sections 165.72 and 165.73 relating to trademark  coun-
 terfeiting;  sections 170.10, 170.15, 170.25, 170.30, 170.40, 170.65 and
 170.70 relating to forgery; sections 175.10, 175.25, 175.35, 175.40  and
 210.40 relating to false statements; sections 176.15, 176.20, 176.25 and
 176.30  relating to insurance fraud; sections 178.20 and 178.25 relating
 to criminal diversion of  prescription  medications  and  prescriptions;
 sections 180.03, 180.08, 180.15, 180.25, 180.40, 180.45, 200.00, 200.03,
 200.04,  200.10, 200.11, 200.12, 200.20, 200.22, 200.25, 200.27, 200.56,
 215.00, 215.05 and 215.19 relating to bribery; sections 187.10,  187.15,
 187.20  and  187.25  relating  to  residential  mortgage fraud, sections
 190.40 and 190.42 relating to criminal usury; section 190.65 relating to
 schemes to defraud; any felony defined in article four  hundred  ninety-
 six;  sections  205.60  and  205.65  relating  to hindering prosecution;
 sections 210.10, 210.15, and 215.51 relating to  perjury  and  contempt;
 section  215.40  relating  to tampering with physical evidence; sections
 220.06, 220.09, 220.16, 220.18, 220.21, 220.31, 220.34, 220.39,  220.41,
 220.43, 220.46, 220.55, 220.60, 220.65 and 220.77 relating to controlled
 substances;  sections  225.10  and 225.20 relating to gambling; sections
 230.25, 230.30, and 230.32 relating to promoting  prostitution;  section
 230.34  relating  to  sex  trafficking; section 230.34-a relating to sex
 trafficking of a child;  sections  235.06,  235.07,  235.21  and  235.22
 relating  to obscenity; sections 263.10 and 263.15 relating to promoting
 a sexual performance  by  a  child;  sections  265.02,  265.03,  265.04,
 265.11,  265.12,  265.13  and  the  provisions  of  section 265.10 which
 constitute a felony relating to firearms and  other  dangerous  weapons;
 sections  265.14  and  265.16  relating  to  criminal sale of a firearm;
 section 265.50 relating to the criminal manufacture, sale  or  transport
 of  an  undetectable  firearm, rifle or shotgun; section 275.10, 275.20,
 S. 4007                            241                           A. 3007
 
 275.30, or 275.40 relating to unauthorized recordings; SECTIONS  220.82,
 220.83,  220.84  AND 220.85 RELATING TO IMITATION CONTROLLED SUBSTANCES;
 and sections 470.05, 470.10, 470.15 and 470.20 relating to  money  laun-
 dering; or
   (b)  Any  felony  set  forth  elsewhere  in the laws of this state and
 defined by the tax law relating to alcoholic beverage, cigarette,  gaso-
 line  and  similar motor fuel taxes; article seventy-one of the environ-
 mental conservation law relating to water pollution, hazardous waste  or
 substances  hazardous or acutely hazardous to public health or safety of
 the environment; article twenty-three-A  of  the  general  business  law
 relating  to  prohibited acts concerning stocks, bonds and other securi-
 ties, article twenty-two of the general business law concerning  monopo-
 lies;  ARTICLE  THIRTY-THREE  OF  THE  PUBLIC  HEALTH  LAW  RELATING  TO
 CONTROLLED SUBSTANCES OR IMITATION CONTROLLED SUBSTANCES.
   § 7. Paragraph (c) of subdivision 8 of section 700.05 of the  criminal
 procedure  law, as amended by chapter 92 of the laws of 2021, is amended
 and a new paragraph (w) is added to read as follows:
   (c) Criminal possession of  a  controlled  substance  in  the  seventh
 degree  as  defined  in  section  220.03  of  the  penal  law,  criminal
 possession of a controlled substance in the fifth degree as  defined  in
 section  220.06  of  the  penal law, criminal possession of a controlled
 substance in the fourth degree as defined in section 220.09 of the penal
 law, criminal possession of a controlled substance in the  third  degree
 as  defined in section 220.16 of the penal law, criminal possession of a
 controlled substance in the second degree as defined in  section  220.18
 of  the  penal law, criminal possession of a controlled substance in the
 first degree as defined in section 220.21 of  the  penal  law,  criminal
 sale of a controlled substance in the fifth degree as defined in section
 220.31  of the penal law, criminal sale of a controlled substance in the
 fourth degree as defined in section 220.34 of the  penal  law,  criminal
 sale of a controlled substance in the third degree as defined in section
 220.39  of the penal law, criminal sale of a controlled substance in the
 second degree as defined in section 220.41 of the  penal  law,  criminal
 sale of a controlled substance in the first degree as defined in section
 220.43  of  the penal law, criminally possessing a hypodermic instrument
 as defined in section 220.45 of  the  penal  law,  criminal  sale  of  a
 prescription  for  a controlled substance or a controlled substance by a
 practitioner or pharmacist as defined in section  220.65  of  the  penal
 law,  criminal  possession  of methamphetamine manufacturing material in
 the second degree as defined in section 220.70 of the penal law,  crimi-
 nal  possession  of  methamphetamine manufacturing material in the first
 degree  as  defined  in  section  220.71  of  the  penal  law,  criminal
 possession of precursors of methamphetamine as defined in section 220.72
 of  the  penal law, unlawful manufacture of methamphetamine in the third
 degree as defined in section 220.73 of the penal law, unlawful  manufac-
 ture  of  methamphetamine  in  the  second  degree as defined in section
 220.74 of the penal law, unlawful manufacture of methamphetamine in  the
 first  degree  as  defined  in section 220.75 of the penal law, unlawful
 disposal of methamphetamine laboratory material as  defined  in  section
 220.76  of  the penal law, operating as a major trafficker as defined in
 section 220.77 of the penal law, CRIMINAL  POSSESSION  OF  AN  IMITATION
 CONTROLLED SUBSTANCE IN THE THIRD DEGREE AS DEFINED IN SECTION 220.82 OF
 THE PENAL LAW, CRIMINAL SALE OF AN IMITATION CONTROLLED SUBSTANCE IN THE
 FIFTH  DEGREE  AS  DEFINED  IN SECTION 220.83 OF THE PENAL LAW, CRIMINAL
 SALE OF AN IMITATION CONTROLLED SUBSTANCE IN THE THIRD DEGREE AS DEFINED
 IN SECTION 220.84 OF THE  PENAL  LAW,  CRIMINAL  SALE  OF  AN  IMITATION
 S. 4007                            242                           A. 3007

 CONTROLLED SUBSTANCE IN THE FIRST DEGREE AS DEFINED IN SECTION 220.85 OF
 THE  PENAL  LAW,  promoting  gambling in the second degree as defined in
 section 225.05 of the penal law, promoting gambling in the first  degree
 as  defined  in  section 225.10 of the penal law, possession of gambling
 records in the second degree as defined in section 225.15 of  the  penal
 law,  possession  of  gambling records in the first degree as defined in
 section 225.20 of the penal law, and possession of a gambling device  as
 defined in section 225.30 of the penal law;
   (W)  ANY OF THE ACTS DESIGNATED AS FELONIES IN ARTICLE THIRTY-THREE OF
 THE PUBLIC HEALTH LAW.
   § 8. Section 220.00 of the penal law is amended by adding a new subdi-
 vision 6 to read as follows:
   6. "IMITATION CONTROLLED SUBSTANCE" SHALL HAVE  THE  SAME  MEANING  AS
 PROVIDED  FOR  IN PARAGRAPH C OF SUBDIVISION ONE OF SECTION THIRTY-THREE
 HUNDRED EIGHTY-THREE OF THE PUBLIC HEALTH LAW.
   § 9. The penal law is amended by  adding  five  new  sections  220.81,
 220.82, 220.83, 220.84 and 220.85 to read as follows:
 § 220.81 CRIMINAL POSSESSION OF AN IMITATION CONTROLLED SUBSTANCE IN THE
            FIFTH DEGREE.
   A  PERSON  IS GUILTY OF CRIMINAL POSSESSION OF AN IMITATION CONTROLLED
 SUBSTANCE IN THE FIFTH DEGREE WHEN HE OR SHE  KNOWINGLY  AND  UNLAWFULLY
 POSSESSES  AN IMITATION CONTROLLED SUBSTANCE, AS DEFINED IN SUBPARAGRAPH
 ONE OF PARAGRAPH C OF SUBDIVISION ONE OF  SECTION  THIRTY-THREE  HUNDRED
 EIGHTY-THREE OF THE PUBLIC HEALTH LAW, WITH THE INTENT TO SELL IT.
   CRIMINAL  POSSESSION OF AN IMITATION CONTROLLED SUBSTANCE IN THE FIFTH
 DEGREE IS A CLASS A MISDEMEANOR.
 § 220.82 CRIMINAL POSSESSION OF AN IMITATION CONTROLLED SUBSTANCE IN THE
            THIRD DEGREE.
   A PERSON IS GUILTY OF CRIMINAL POSSESSION OF AN  IMITATION  CONTROLLED
 SUBSTANCE  IN  THE  THIRD DEGREE WHEN HE OR SHE KNOWINGLY AND UNLAWFULLY
 POSSESSES AN IMITATION CONTROLLED SUBSTANCE, AS DEFINED IN  SUBPARAGRAPH
 TWO  OF  PARAGRAPH  C OF SUBDIVISION ONE OF SECTION THIRTY-THREE HUNDRED
 EIGHTY-THREE OF THE PUBLIC HEALTH LAW, WITH THE INTENT TO SELL IT.
   CRIMINAL POSSESSION OF AN IMITATION CONTROLLED SUBSTANCE IN THE  THIRD
 DEGREE IS A CLASS D FELONY.
 § 220.83 CRIMINAL SALE OF AN IMITATION CONTROLLED SUBSTANCE IN THE FIFTH
            DEGREE.
   A  PERSON  IS  GUILTY  OF  CRIMINAL  SALE  OF  AN IMITATION CONTROLLED
 SUBSTANCE IN THE FIFTH DEGREE WHEN HE OR SHE  KNOWINGLY  AND  UNLAWFULLY
 SELLS  AN IMITATION CONTROLLED SUBSTANCE, AS DEFINED IN SUBPARAGRAPH ONE
 OF PARAGRAPH C OF SUBDIVISION ONE OF SECTION THIRTY-THREE HUNDRED EIGHT-
 Y-THREE OF THE PUBLIC HEALTH LAW.
   CRIMINAL SALE OF AN IMITATION CONTROLLED SUBSTANCE IN THE FIFTH DEGREE
 IS A CLASS E FELONY.
 § 220.84 CRIMINAL SALE OF AN IMITATION CONTROLLED SUBSTANCE IN THE THIRD
            DEGREE.
   A PERSON IS  GUILTY  OF  CRIMINAL  SALE  OF  AN  IMITATION  CONTROLLED
 SUBSTANCE  IN  THE  THIRD DEGREE WHEN HE OR SHE KNOWINGLY AND UNLAWFULLY
 SELLS AN IMITATION CONTROLLED SUBSTANCE, AS DEFINED IN SUBPARAGRAPH  TWO
 OF PARAGRAPH C OF SUBDIVISION ONE OF SECTION THIRTY-THREE HUNDRED EIGHT-
 Y-THREE OF THE PUBLIC HEALTH LAW.
   CRIMINAL SALE OF AN IMITATION CONTROLLED SUBSTANCE IN THE THIRD DEGREE
 IS A CLASS C FELONY.
 § 220.85 CRIMINAL SALE OF AN IMITATION CONTROLLED SUBSTANCE IN THE FIRST
            DEGREE.
 S. 4007                            243                           A. 3007
 
   A  PERSON  IS  GUILTY  OF  CRIMINAL  SALE  OF  AN IMITATION CONTROLLED
 SUBSTANCE IN THE FIRST DEGREE WHEN HE OR SHE  KNOWINGLY  AND  UNLAWFULLY
 SELLS  AN  IMITATION CONTROLLED SUBSTANCE AND HE OR SHE KNOWS OR REASON-
 ABLY SHOULD KNOW THAT THE IMITATION CONTROLLED SUBSTANCE COULD CAUSE THE
 SERIOUS  PHYSICAL  INJURY   OF ANOTHER PERSON, AS DEFINED BY SUBDIVISION
 TEN OF SECTION 10.00 OF THIS CHAPTER, OR HE OR SHE KNOWS  OR  REASONABLY
 SHOULD  KNOW  THAT  THE  IMITATION  CONTROLLED SUBSTANCE COULD CAUSE THE
 DEATH OF ANOTHER PERSON, AND THE IMITATION CONTROLLED  SUBSTANCE  CAUSES
 THE SERIOUS PHYSICAL INJURY OR DEATH OF ANOTHER PERSON.
   CRIMINAL SALE OF AN IMITATION CONTROLLED SUBSTANCE IN THE FIRST DEGREE
 IS A CLASS A-1 FELONY.
   §  10.  Section  220.25 of the penal law, as amended by chapter 276 of
 the laws of 1973, subdivision 1 as amended by chapter 278 of the laws of
 1973 and subdivision 2 as amended by chapter 341 of the laws of 1985, is
 amended to read as follows:
 § 220.25 Criminal possession of a controlled substance OR  AN  IMITATION
            CONTROLLED SUBSTANCE; presumption.
   1.  The  presence of a controlled substance OR AN IMITATION CONTROLLED
 SUBSTANCE in an automobile, other than a public omnibus, is  presumptive
 evidence  of  knowing possession thereof by each and every person in the
 automobile at the time such controlled substance OR IMITATION CONTROLLED
 SUBSTANCE was found; except that such presumption does not apply (a)  to
 a  duly  licensed operator of an automobile who is at the time operating
 it for hire in the lawful and proper pursuit of his trade, or (b) to any
 person in the automobile if one of them, having obtained the  controlled
 substance  OR IMITATION CONTROLLED SUBSTANCE and not being under duress,
 is authorized to possess it and such controlled substance  OR  IMITATION
 CONTROLLED  SUBSTANCE  is  in  the  same  container  as when he received
 possession thereof, or (c) when the controlled  substance  OR  IMITATION
 CONTROLLED  SUBSTANCE  is  concealed upon the person of one of the occu-
 pants.
   2. The presence of a narcotic drug, narcotic preparation, marihuana or
 phencyclidine in open view in a room, other than a public  place,  under
 circumstances evincing an intent to unlawfully mix, compound, package or
 otherwise  prepare  for  sale  such  controlled  substance  OR IMITATION
 CONTROLLED SUBSTANCE is presumptive evidence of knowing possession ther-
 eof by each and every person  in  close  proximity  to  such  controlled
 substance  OR IMITATION CONTROLLED SUBSTANCE at the time such controlled
 substance OR IMITATION CONTROLLED SUBSTANCE was found; except that  such
 presumption  does  not  apply  to  any  such persons if (a) one of them,
 having  obtained  such  controlled  substance  OR  IMITATION  CONTROLLED
 SUBSTANCE  and  not  being under duress, is authorized to possess it and
 such controlled substance OR IMITATION CONTROLLED SUBSTANCE  is  in  the
 same  container  as  when  he received possession thereof, or (b) one of
 them has such controlled substance  OR  IMITATION  CONTROLLED  SUBSTANCE
 upon his person.
   § 11. This act shall take effect immediately.
 
                                  PART CC

   Section 1. Articles 131, 131-A, 131-B, 131-C, 132, 133, 134, 136, 137,
 137-A,  139, 140, 141, 143, 144, 153, 154, 155, 156, 157, 159, 160, 162,
 163, 164, 165, 166, 167 and 168 of the education law are REPEALED.
   § 2. The public health law is amended by adding a new  article  51  to
 read as follows:
 S. 4007                            244                           A. 3007
 
                                ARTICLE 51
                      LICENSED HEALTHCARE PROFESSIONS
                                  TITLE 1
            LICENSED HEALTHCARE PROFESSIONS GENERAL PROVISIONS
                                SUBTITLE 1
                           INTRODUCTORY SUMMARY
 SECTION 6500.   INTRODUCTION.
         6501.   ADMISSION TO A PROFESSION (LICENSING).
         6501-A. AFFIRMATION OF APPLICATIONS.
         6502.   DURATION AND REGISTRATION OF A LICENSE.
         6502-A. RENEWAL   OF  PROFESSIONAL  LICENSE,  CERTIFICATION,  OR
                   REGISTRATION.
         6503.   PRACTICE OF A PROFESSION.
         6503-A. WAIVER  FOR  ENTITIES  PROVIDING  CERTAIN   PROFESSIONAL
                   SERVICES.
         6503-B. WAIVER  FOR  CERTAIN SPECIAL EDUCATION SCHOOLS AND EARLY
                   INTERVENTION AGENCIES.
         6504.   REGULATION OF THE PROFESSIONS.
         6505.   CONSTRUCTION.
         6505-A. PROFESSIONAL REFERRALS.
         6505-B. COURSE WORK OR TRAINING IN INFECTION CONTROL PRACTICES.
         6505-C. ARTICULATION BETWEEN MILITARY AND CIVILIAN  PROFESSIONAL
                   CAREERS.
   §  6500. INTRODUCTION. THIS ARTICLE PROVIDES FOR THE REGULATION OF THE
 ADMISSION TO AND THE PRACTICE OF CERTAIN PROFESSIONS. THIS  FIRST  TITLE
 APPLIES  TO  ALL  THE  PROFESSIONS INCLUDED IN THIS ARTICLE, EXCEPT THAT
 PREHEARING PROCEDURES AND HEARING  PROCEDURES  IN  CONNECTION  WITH  THE
 REGULATION  OF  PROFESSIONAL  CONDUCT  OF THE PROFESSION OF MEDICINE AND
 PHYSICIAN'S ASSISTANTS AND SPECIALIST'S ASSISTANTS  SHALL  BE  CONDUCTED
 PURSUANT  TO  THE PROVISIONS OF TITLE TWO-A OF ARTICLE TWO OF THIS CHAP-
 TER. EACH OF THE REMAINING TITLES APPLIES TO A PARTICULAR PROFESSION.
   § 6501. ADMISSION TO A PROFESSION (LICENSING). 1. ADMISSION  TO  PRAC-
 TICE  OF  A  PROFESSION IN THIS STATE IS ACCOMPLISHED BY A LICENSE BEING
 ISSUED TO A QUALIFIED APPLICANT BY THE HEALTH DEPARTMENT. TO QUALIFY FOR
 A LICENSE AN APPLICANT SHALL MEET THE  REQUIREMENTS  PRESCRIBED  IN  THE
 TITLE  FOR  THE  PARTICULAR  PROFESSION  AND SHALL MEET THE REQUIREMENTS
 PRESCRIBED IN SECTION 3-503 OF THE GENERAL OBLIGATIONS LAW.
   2. A. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, ANY APPLI-
 CANT SEEKING TO QUALIFY FOR A LICENSE PURSUANT TO THIS  ARTICLE  WHO  IS
 THE  SPOUSE  OF  AN ACTIVE DUTY MEMBER OF THE ARMED FORCES OF THE UNITED
 STATES, NATIONAL GUARD OR RESERVES AS DEFINED IN 10 U.S.C. SECTIONS 1209
 AND 1211, AND SUCH SPOUSE IS TRANSFERRED BY THE MILITARY TO  THIS  STATE
 SHALL  BE  AFFORDED  AN  EXPEDITED  REVIEW OF HIS OR HER APPLICATION FOR
 LICENSURE. SUCH APPLICATION SHALL BE ON A FORM PRESCRIBED BY THE DEPART-
 MENT AND SHALL INCLUDE AN ATTESTATION BY THE APPLICANT OF  THE  MILITARY
 STATUS  OF HIS OR HER SPOUSE AND ANY OTHER SUCH SUPPORTING DOCUMENTATION
 THAT THE DEPARTMENT MAY REQUIRE. UPON REVIEW OF  SUCH  APPLICATION,  THE
 DEPARTMENT SHALL ISSUE A LICENSE TO THE APPLICANT IF THE APPLICANT HOLDS
 A  LICENSE  IN  GOOD STANDING IN ANOTHER STATE AND IN THE OPINION OF THE
 DEPARTMENT, THE REQUIREMENTS FOR  LICENSURE  OF  SUCH  OTHER  STATE  ARE
 SUBSTANTIALLY  EQUIVALENT  TO  THE  REQUIREMENTS  FOR  LICENSURE IN THIS
 STATE.
   B. IN ADDITION TO THE EXPEDITED REVIEW GRANTED IN PARAGRAPH A OF  THIS
 SUBDIVISION,  AN  APPLICANT WHO PROVIDES SATISFACTORY DOCUMENTATION 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
 S. 4007                            245                           A. 3007
 
 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 APPLICATION AND SUPPORTING DOCUMENTATION RECEIVED THAT THE
 APPLICANT WILL MEET THE REQUIREMENTS FOR LICENSURE IN THIS STATE BECAUSE
 HE OR SHE HOLDS 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  VERIFI-
 CATION  OF  THE  APPLICANT'S  UNDERLYING  CREDENTIALS  (E.G., 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 MILITARY SPOUSE COULD NOT AVOID.
   C. A TEMPORARY PRACTICE PERMIT ISSUED UNDER PARAGRAPH B OF THIS SUBDI-
 VISION SHALL BE SUBJECT TO THE FULL DISCIPLINARY AND REGULATORY AUTHORI-
 TY OF THE DEPARTMENT, PURSUANT TO THIS ARTICLE, AS IF SUCH AUTHORIZATION
 WERE A PROFESSIONAL LICENSE ISSUED UNDER THIS ARTICLE.
   D. THE DEPARTMENT SHALL REDUCE THE INITIAL LICENSURE  APPLICATION  FEE
 BY  ONE-HALF  FOR  ANY  APPLICATION SUBMITTED BY A MILITARY SPOUSE UNDER
 THIS SUBDIVISION.
   § 6501-A.  AFFIRMATION  OF  APPLICATIONS.  NOTWITHSTANDING  ANY  OTHER
 PROVISION OF LAW TO THE CONTRARY, ANY APPLICATION REQUIRED BY THIS ARTI-
 CLE  TO  BE FILED WITH THE DEPARTMENT MAY, IN LIEU OF BEING CERTIFIED OR
 SWORN UNDER OATH, BE SUBSCRIBED BY THE APPLICANT  AND  AFFIRMED  BY  THE
 APPLICANT AS TRUE UNDER PENALTIES OF PERJURY.
   §  6502. DURATION AND REGISTRATION OF A LICENSE. 1. A LICENSE SHALL BE
 VALID DURING  THE  LIFE  OF  THE  HOLDER  UNLESS  REVOKED,  ANNULLED  OR
 SUSPENDED BY COMMISSIONER OR IN THE CASE OF PHYSICIANS, PHYSICIANS PRAC-
 TICING  UNDER  A  LIMITED  PERMIT,  PHYSICIAN'S ASSISTANTS, SPECIALIST'S
 ASSISTANTS AND MEDICAL RESIDENTS, THE  LICENSEE  IS  STRICKEN  FROM  THE
 ROSTER  OF  SUCH LICENSEES BY THE COMMISSIONER ON THE ORDER OF THE STATE
 BOARD FOR PROFESSIONAL MEDICAL CONDUCT. A LICENSEE  MUST  REGISTER  WITH
 THE  DEPARTMENT AND MEET THE REQUIREMENTS PRESCRIBED IN SECTION 3-503 OF
 THE GENERAL OBLIGATIONS LAW TO PRACTICE IN THIS STATE.
   2. THE DEPARTMENT SHALL ESTABLISH THE BEGINNING DATES OF THE REGISTRA-
 TION PERIODS FOR EACH PROFESSION AND MAIL AN APPLICATION  FOR  REGISTRA-
 TION  CONFORMING  TO  THE  REQUIREMENTS  OF SECTION 3-503 OF THE GENERAL
 OBLIGATIONS LAW TO EVERY LICENSEE CURRENTLY  REGISTERED  AT  LEAST  FOUR
 MONTHS PRIOR TO THE BEGINNING OF THE REGISTRATION PERIOD FOR THE RESPEC-
 TIVE PROFESSION.
   3.  AN  APPLICATION FOR REGISTRATION AND THE REQUIRED REGISTRATION FEE
 SHALL BE SUBMITTED TOGETHER WITH OR AS A PART OF THE APPLICATION  FOR  A
 LICENSE.  A  PERSON  INITIALLY  LICENSED OR A LICENSEE RESUMING PRACTICE
 AFTER A LAPSE OF REGISTRATION DURING THE LAST TWO YEARS OF  A  TRIENNIAL
 REGISTRATION  PERIOD SHALL RECEIVE A PRORATED REFUND OF ONE-THIRD OF THE
 TOTAL REGISTRATION FEE FOR EACH FULL YEAR OF THE TRIENNIAL  PERIOD  THAT
 HAS  ELAPSED  PRIOR  TO  THE DATE OF REGISTRATION. EXCEPT AS PROVIDED IN
 SUBDIVISION THREE-A OF THIS SECTION,  THE  DEPARTMENT  SHALL  RENEW  THE
 REGISTRATION OF EACH LICENSEE UPON RECEIPT OF A PROPER APPLICATION, ON A
 FORM  PRESCRIBED BY THE DEPARTMENT AND CONFORMING TO THE REQUIREMENTS OF
 SECTION 3-503 OF THE GENERAL OBLIGATIONS LAW, AND THE REGISTRATION  FEE.
 S. 4007                            246                           A. 3007

 ANY  LICENSEE  WHO FAILS TO REGISTER BY THE BEGINNING OF THE APPROPRIATE
 REGISTRATION PERIOD SHALL BE REQUIRED TO PAY AN ADDITIONAL FEE FOR  LATE
 FILING OF TEN DOLLARS FOR EACH MONTH THAT REGISTRATION HAS BEEN DELAYED.
 NO  LICENSEE  RESUMING  PRACTICE  AFTER A LAPSE OF REGISTRATION SHALL BE
 PERMITTED TO PRACTICE WITHOUT  ACTUAL  POSSESSION  OF  THE  REGISTRATION
 CERTIFICATE.
   3-A.  PRIOR  TO  ISSUING ANY REGISTRATION PURSUANT TO THIS SECTION AND
 SECTION SIXTY-FIVE HUNDRED TWENTY-FOUR OF THIS ARTICLE,  THE  DEPARTMENT
 SHALL  REQUEST AND REVIEW ANY INFORMATION RELATING TO AN APPLICANT WHICH
 REASONABLY APPEARS TO RELATE TO PROFESSIONAL MISCONDUCT IN  HIS  OR  HER
 PROFESSIONAL PRACTICE IN THIS AND ANY OTHER JURISDICTION. THE DEPARTMENT
 SHALL  ADVISE THE DIRECTOR OF THE OFFICE OF PROFESSIONAL MEDICAL CONDUCT
 IN THE DEPARTMENT OF ANY INFORMATION ABOUT AN APPLICANT WHICH REASONABLY
 APPEARS TO BE PROFESSIONAL MISCONDUCT AS DEFINED IN SECTIONS  SIXTY-FIVE
 HUNDRED THIRTY AND SIXTY-FIVE HUNDRED THIRTY-ONE OF THIS ARTICLE, WITHIN
 SEVEN DAYS OF ITS DISCOVERY. THE REGISTRATION OR RE-REGISTRATION OF SUCH
 APPLICANT SHALL NOT BE DELAYED FOR A PERIOD EXCEEDING THIRTY DAYS UNLESS
 THE  DIRECTOR  FINDS A BASIS FOR RECOMMENDING SUMMARY ACTION PURSUANT TO
 SUBDIVISION TWELVE OF SECTION TWO HUNDRED THIRTY OF THIS  CHAPTER  AFTER
 CONSULTATION WITH A COMMITTEE ON PROFESSIONAL CONDUCT OF THE STATE BOARD
 FOR PROFESSIONAL MEDICAL CONDUCT, IF WARRANTED. RE-REGISTRATION SHALL BE
 ISSUED  IF  THE  COMMISSIONER  OF  HEALTH FAILS TO ISSUE A SUMMARY ORDER
 PURSUANT TO SUBDIVISION TWELVE OF SECTION TWO  HUNDRED  THIRTY  OF  THIS
 CHAPTER  WITHIN NINETY DAYS OF NOTICE BY THE DEPARTMENT PURSUANT TO THIS
 SUBDIVISION.  RE-REGISTRATION SHALL BE DENIED IF THE COMMISSIONER ISSUES
 A SUMMARY ORDER PURSUANT TO SUBDIVISION TWELVE OF  SECTION  TWO  HUNDRED
 THIRTY OF THIS CHAPTER.
   4.  ANY LICENSEE WHO IS NOT ENGAGING IN THE PRACTICE OF HIS PROFESSION
 IN THIS STATE AND DOES NOT  DESIRE  TO  REGISTER  SHALL  SO  ADVISE  THE
 DEPARTMENT. SUCH LICENSEE SHALL NOT BE REQUIRED TO PAY AN ADDITIONAL FEE
 FOR FAILURE TO REGISTER AT THE BEGINNING OF THE REGISTRATION PERIOD.
   5.  LICENSEES  SHALL  NOTIFY  THE  DEPARTMENT OF ANY CHANGE OF NAME OR
 MAILING ADDRESS WITHIN THIRTY DAYS OF SUCH CHANGE. FAILURE  TO  REGISTER
 OR  PROVIDE  SUCH  NOTICE  WITHIN ONE HUNDRED EIGHTY DAYS OF SUCH CHANGE
 SHALL BE WILLFUL FAILURE UNDER SECTION SIXTY-FIVE HUNDRED THIRTY OF THIS
 ARTICLE.
   6. THE FEE FOR REPLACEMENT  OF  A  LOST  REGISTRATION  CERTIFICATE  OR
 LICENSE  OR  FOR  REGISTRATION  OF  AN  ADDITIONAL  OFFICE  SHALL BE TEN
 DOLLARS.
   7. AN ADDITIONAL FEE OF TWENTY-FIVE DOLLARS SHALL BE CHARGED  FOR  THE
 LICENSURE  OR  REGISTRATION  OF ANY APPLICANT WHO SUBMITS A BAD CHECK TO
 THE DEPARTMENT.
   § 6502-A. RENEWAL OF PROFESSIONAL LICENSE, CERTIFICATION, OR REGISTRA-
 TION. 1. THIS SECTION SHALL APPLY TO HEALTHCARE PROFESSIONALS  LICENSED,
 CERTIFIED,  REGISTERED OR AUTHORIZED PURSUANT TO THIS ARTICLE OTHER THAN
 THOSE LICENSED OR REGISTERED PURSUANT TO TITLE TWO OF THIS ARTICLE.
   2. IN CONJUNCTION  WITH  AND  AS  A  CONDITION  OF  EACH  REGISTRATION
 RENEWAL,  THE PROFESSIONALS DESCRIBED IN SUBDIVISION ONE OF THIS SECTION
 SHALL PROVIDE TO THE DEPARTMENT, AND THE DEPARTMENT SHALL COLLECT,  SUCH
 INFORMATION AND DOCUMENTATION REQUIRED BY THE DEPARTMENT AS IS NECESSARY
 TO  ENABLE  THE DEPARTMENT TO EVALUATE ACCESS TO NEEDED SERVICES IN THIS
 STATE, INCLUDING, BUT NOT LIMITED TO, THE LOCATION AND TYPE  OF  SETTING
 IN  WHICH THE PROFESSIONAL PRACTICES AND OTHER RELEVANT INFORMATION. THE
 DEPARTMENT SHALL MAKE SUCH DATA AVAILABLE  IN  AGGREGATE,  DE-IDENTIFIED
 FORM ON A PUBLICLY ACCESSIBLE WEBSITE.
 S. 4007                            247                           A. 3007
 
   3.  THE  DATES BY WHICH THE PROFESSIONALS DESCRIBED IN SUBDIVISION ONE
 OF THIS SECTION MUST COMPLY WITH THE REQUIREMENTS OF SUBDIVISION TWO  OF
 THIS  SECTION  SHALL  BE  DETERMINED  BY  THE DEPARTMENT AND MAY VARY BY
 PROFESSION, TO ALLOW THE DEVELOPMENT AND REFINEMENT OF NECESSARY PROGRAM
 FEATURES  AND  TO  ALLOW  SUFFICIENT  ADVANCED  NOTICE TO BE PROVIDED TO
 AFFECTED PROFESSIONALS. THE PROVISIONS OF THIS SECTION SHALL  BE  EFFEC-
 TIVE  ONLY  IF  AND  FOR  SO  LONG  AS  AN APPROPRIATION IS MADE FOR THE
 PURPOSES OF ITS IMPLEMENTATION.
   § 6503. PRACTICE OF A PROFESSION.  ADMISSION  TO  THE  PRACTICE  OF  A
 PROFESSION  ENTITLES  THE  LICENSEE  TO:  1.  PRACTICE THE PROFESSION AS
 DEFINED IN THE TITLE FOR THE PARTICULAR PROFESSION;
   2. ENTITLES THE INDIVIDUAL LICENSEE TO USE THE PROFESSIONAL  TITLE  AS
 PROVIDED IN THE TITLE FOR THE PARTICULAR PROFESSION; AND
   3.  SUBJECTS  THE LICENSEE TO THE PROCEDURES AND PENALTIES FOR PROFES-
 SIONAL MISCONDUCT AS PRESCRIBED IN THIS ARTICLE.
   § 6503-A. WAIVER FOR ENTITIES PROVIDING CERTAIN PROFESSIONAL SERVICES.
 1. A.  NOTWITHSTANDING ANY LAWS TO THE CONTRARY, EXCEPT AS  PROVIDED  IN
 SUBDIVISION TWO OF THIS SECTION, A NOT-FOR-PROFIT CORPORATION FORMED FOR
 CHARITABLE, EDUCATIONAL, OR RELIGIOUS PURPOSES OR OTHER SIMILAR PURPOSES
 DEEMED  ACCEPTABLE  BY  THE  DEPARTMENT;  OR AN EDUCATION CORPORATION AS
 DEFINED IN SUBDIVISION ONE OF  SECTION  TWO  HUNDRED  SIXTEEN-A  OF  THE
 EDUCATION  LAW MAY PROVIDE THE FOLLOWING SERVICES, PROVIDED THAT, EXCEPT
 AS OTHERWISE PROVIDED IN PARAGRAPH B OF THIS SUBDIVISION, THE ENTITY WAS
 IN EXISTENCE PRIOR TO THE EFFECTIVE DATE OF THIS SECTION AND HAS APPLIED
 TO THE DEPARTMENT FOR A WAIVER PURSUANT TO THIS SECTION BY NO LATER THAN
 FEBRUARY FIRST, TWO THOUSAND TWENTY-FOUR:
   (I) SERVICES PROVIDED UNDER TITLE EIGHTEEN, TWENTY-FIVE OR TWENTY-NINE
 OF THIS ARTICLE FOR WHICH LICENSURE WOULD BE REQUIRED, OR
   (I