Senate Bill S1617

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1617
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                             January 13, 2025
                                ___________
 
 Introduced  by  Sens.  RIVERA,  JACKSON,  MAY  -- read twice and ordered
   printed, and when printed to be committed to the Committee on Health
 
 AN ACT to amend the public health law and the social  services  law,  in
   relation  to  automatic  enrollment and recertification simplification
   for Medicaid eligible recipients

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Paragraph  (b)  of subdivision 7 of section 4403-f of the
 public health law is amended by adding a new subparagraph (iv)  to  read
 as follows:
   (IV) WHERE A PERSON DETERMINED ELIGIBLE FOR MEDICAID ("MEDICAID RECIP-
 IENT")  HAS  BEEN DETERMINED BY THE COMMISSIONER OR THE DESIGNEE OF SUCH
 COMMISSIONER TO REQUIRE COMMUNITY-BASED LONG TERM CARE SERVICES FOR MORE
 THAN A CONTINUOUS PERIOD OF ONE HUNDRED TWENTY DAYS,  AND  THE  MEDICAID
 RECIPIENT HAS NOT SELECTED AND ENROLLED IN A MANAGED LONG TERM CARE PLAN
 PRIOR TO ANY EXPIRATION DATE OF SUCH DETERMINATION OF NEED FOR LONG TERM
 CARE,  AFTER BEING PROVIDED WITH INFORMATION TO MAKE AN INFORMED CHOICE,
 THE COMMISSIONER SHALL ASSIGN THE RECIPIENT TO A MANAGED LONG TERM  CARE
 PLAN,  TAKING  INTO  ACCOUNT  CONSISTENCY WITH ANY PRIOR COMMUNITY-BASED
 DIRECT CARE  WORKERS  HAVING  RECENTLY  SERVED  THE  RECIPIENT,  QUALITY
 PERFORMANCE  CRITERIA,  CAPACITY,  AND  GEOGRAPHIC  ACCESSIBILITY.   THE
 COMMISSIONER MAY ASSIGN PARTICIPANTS PURSUANT  TO  SUCH  CRITERIA  ON  A
 WEIGHTED  BASIS.   A RECIPIENT ASSIGNED TO A MANAGED LONG TERM CARE PLAN
 UNDER THIS SUBPARAGRAPH SHALL BE DEEMED TO HAVE BEEN DETERMINED TO BE IN
 NEED OF LONG TERM CARE SERVICES FOR MORE THAN A CONTINUOUS PERIOD OF ONE
 HUNDRED TWENTY DAYS AND ELIGIBLE TO BE ENROLLED IN A MANAGED  LONG  TERM
 CARE PLAN.
   §  2.  Paragraph  (b)  of subdivision 2 of section 366-a of the social
 services law, as added by section 51 of part A of chapter 1 of the  laws
 of 2002, is amended to read as follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD04128-01-5
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   (b)  Notwithstanding  the provisions of paragraph (a) of this subdivi-
 sion, an applicant or recipient may attest to the amount of [his or her]
 THEIR accumulated resources, unless such applicant or recipient is seek-
 ing medical assistance payment for long term care services FOR THE FIRST
 TIME.  A  RECIPIENT  WHO HAS ALREADY PROVIDED DOCUMENTATION OF RESOURCES
 MAY ATTEST TO THE AMOUNT OF ACCUMULATED RESOURCES IF IT HAS REMAINED THE
 SAME OR IS LESS THAN THE AMOUNT ORIGINALLY DOCUMENTED.  For purposes  of
 this  paragraph,  long  term  care  services shall mean care, treatment,
 maintenance, and services described in paragraph (b) of subdivision  [1]
 ONE  of  section  three  hundred  sixty-seven-f  of this title, with the
 exception of short term rehabilitation, as defined by  the  commissioner
 of health.
   §  3.  Paragraph  (d)  of subdivision 5 of section 366-a of the social
 services law, as amended by section 12 of part D of chapter  56  of  the
 laws  of 2013, is relettered paragraph (e) and three new paragraphs (f),
 (g) and (h) are added to read as follows:
   (F) NOTWITHSTANDING PARAGRAPH (B) OF SUBDIVISION TWO OF  THIS  SECTION
 AND  PARAGRAPHS (A), (B), (C) AND (D) OF THIS SUBDIVISION, THE FOLLOWING
 RECIPIENTS WILL BE RECERTIFIED AUTOMATICALLY, UNLESS THERE  HAS  BEEN  A
 FINDING OF LACK OF ELIGIBILITY FOR MEDICAID:
   (I)  ENROLLEES  IN MEDICAID MANAGED LONG TERM CARE PLANS AS DEFINED IN
 SECTION FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW;
   (II) ENROLLEES IN MEDICAID MANAGED CARE PLANS AS  DEFINED  IN  SECTION
 THREE  HUNDRED  SIXTY-FOUR-J  OF  THIS  TITLE  WHO RECEIVE PERSONAL CARE
 SERVICES PURSUANT TO PARAGRAPH (E) OF SUBDIVISION TWO OF  SECTION  THREE
 HUNDRED SIXTY-FIVE-A OF THIS TITLE OR CONSUMER DIRECTED PERSONAL ASSIST-
 ANCE  SERVICES  PURSUANT  TO  SECTION THREE HUNDRED SIXTY-FIVE-F OF THIS
 TITLE;
   (III) ENROLLEES RECEIVING MEDICAID IN THE  AGED,  BLIND  AND  DISABLED
 CATEGORY  WHO  RECEIVE  FIXED  INCOME  FROM THE SOCIAL SECURITY ADMINIS-
 TRATION (SSA); AND
   (IV) MEDICARE SAVINGS PROGRAM (MSP) RECIPIENTS WHO HAVE A FIXED INCOME
 FROM THE SOCIAL SECURITY ADMINISTRATION (SSA).
   (G) NOTHING IN PARAGRAPH (E) OF THIS SUBDIVISION SHOULD  BE  CONSTRUED
 TO  ALTER A MEDICAID RECIPIENT'S OBLIGATION TO INFORM THE PUBLIC WELFARE
 DISTRICT OF CHANGES IN INCOME OR OTHER FACTORS THAT MIGHT IMPACT  ELIGI-
 BILITY PURSUANT TO SUBDIVISION FOUR OF THIS SECTION.
   (H)  UPON  A  FINDING OF LACK OF ELIGIBILITY, RECIPIENTS IDENTIFIED IN
 PARAGRAPH (E) OF THIS SUBDIVISION WILL BE ENTITLED TO NOTICE AND HEARING
 RIGHTS AS PROVIDED IN SECTION TWENTY-TWO OF THIS CHAPTER.
   § 4. This act shall take effect on the one hundred eightieth day after
 it shall have become a law; provided that the  amendments  to  paragraph
 (b)  of subdivision 7 of section 4403-f of the public health law made by
 section one of this act shall be subject to the expiration and reversion
 of such paragraph and shall expire and be deemed repealed therewith  and
 provided  further  that  such  amendments shall not affect the repeal of
 such section and shall expire and be deemed repealed  therewith.  Effec-
 tive  immediately, the commissioner of health shall make regulations and
 take other actions reasonably necessary to implement this  act  on  that
 date.  Provided,  further, that sections two and three of this act shall
 only take effect when the  federal  center  for  Medicaid  and  Medicare
 services  (CMS)  approves in writing to the state commissioner of health
 that the changes do not affect federal financial participation; provided
 that the commissioner of health shall notify the legislative bill draft-
 ing commission upon the occurrence of the enactment of  the  legislation
 provided  for  in  sections  two and three of this act in order that the
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 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.