text:
S07507 Summary:
BILL NO S07507C
SAME AS SAME AS UNI. A09507-C
SPONSOR BUDGET
COSPNSR
Amd Various Laws, generally
Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2018-2019 state fiscal year; relates to distributions from the general hospital indigent care pool; directs a review of the feasibility of creating a burn center in Kings county; and relates to rates of reimbursement for certain residential health care facilities (Part A); relates to payments to residential health care facilities; relates to assisted living program providers licensed in the state; relates to limitations on licensed home care service agency contracts and registration of licensed home care services agencies; relates to advertising by fiscal intermediaries; and relates to medicaid reimbursement rates for hospice providers (Part B); relates to health homes and penalties for managed care providers (Part C); relates to drug coverage, updating the professional dispensing fee, copayments, and amends the Medicaid drug cap (Part D); requires a report on monies collected under the false claims act detailing what monies were collected and how such monies were spent (Part J); relates to home care services, direct care costs, and medicaid expenditures; and extends the medicaid global cap (Part K); relates to extending provisions relating to coverage for malpractice and professional medical conduct (Part M); establishes a cost of living adjustment for designated human services and provides for the repeal of certain provisions of law relating thereto (Part N); relates to the health care facility transformation program (Part Q); relates to integrated services (Subpart B); relates to telehealth services (Subpart C) (Part S); relates to the effectiveness of provisions of law relating to authorizing the commissioner of health to apply federally established consumer price index penalties for generic drugs, and authorizing the commissioner of health to impose penalties on managed care plans for reporting late or incorrect encounter data; relates to the effectiveness of provisions of law relating to adjustments of rates; relates to the effectiveness of provisions of law relating to authorizing reimbursements for expenditures made by or on behalf of social services districts for medical assistance for needy persons and administration thereof; relates to the effectiveness of provisions relating to expanding medical assistance eligibility and the scope of services available to certain persons with disabilities; relates to rate of payments; relates to agreements with pharmaceutical manufacturers; relates to amending the social services law and other laws relating to supplemental rebates; and relates to participation and membership in a demonstration period (Part T); clarifies the authority of the commissioners in the department of mental hygiene to design and implement time-limited demonstration programs; extender (Part U); relates to the membership of subcommittees for mental health of community service boards and the duties of such subcommittees and creating the community mental health and workforce reinvestment account relating to extending such provisions relating thereto (Part V); relates to the receipt of federal and state benefits received by individuals receiving care in facilities operated by an office of the department of mental hygiene; extender (Part X); relates to persons practicing in certain licensed programs or services who are exempt from practice requirements of professionals licensed by the department of education (Part Y); adds demonstration waivers to waivers allowable for home and community-based services; relates to waivers for high quality integrated care (Part Z); establishes a cost of living adjustment for designated human services programs; extender (Part AA); expands the list of controlled substances (Part BB); relates to inquiries or complaints of professional misconduct (Part CC); relates to authorizing a licensed pharmacist to administer influenza vaccine to children between two and eighteen years of age pursuant to a non-patient specific regimen; extends certain provisions of law relating thereto; provides reporting requirements for vaccines administered by pharmacists to individuals less than 19 years of age (Part DD); relates to insurance payments for independent practitioner services for individuals with developmental disabilities (Part EE); relates to establishing the office of the independent substance use disorder and mental health ombudsman for the purpose of assisting individuals with a substance use disorder and/or mental illness (Part FF); creates a certified peer recovery advocate services program (Part GG); ensures that sexual assault survivors are not billed for sexual assault forensic exams and are notified orally and in writing of the option to decline to provide private health insurance information and have the office of victim services reimburse the hospital for the exam; also provides that if such exam is covered by insurance, such coverage shall not be subject to annual deductibles or coinsurance; requires collection and storage of such evidence; relates to state-operated individualized residential alternatives; and relates to the closure or transfer of a state-operated individualized residential alternative (Part II); establishes a training program for first responders for handling emergency situations involving individuals with autism spectrum disorder and other developmental disabilities (Part JJ); requires bids submitted to the state or any agency or department of the state to contain a certification concerning sexual harassment (Subpart A); prohibits mandatory arbitration clauses (Subpart B); relates to reimbursement of funds paid by state agencies, state entities and public entities for the payment of awards adjudicated in sexual harassment claims (Subpart C); relates to nondisclosure agreements (Subpart D); establishes a model policy regarding the prevention of sexual harassment and a model training program to prevent sexual harassment in the workplace (Subpart E); relates to sexual harassment relating to non-employees (Subpart F) (Part KK); authorizes a voluntary public water system consolidation study (Part LL); relates to pharmacy audits by pharmacy benefit managers; relates to contracts between pharmacy benefit managers and pharmacies; relates to outpatient treatment; relates to establishing the children and recovering mothers program and a workgroup to study and evaluate barriers and challenges in identifying and treating expectant mothers, newborns and new parents with a substance use disorder; relates to screening students for lead when enrolling in child care, pre-school or kindergarten; relates to the lead service line replacement grant program; directs the New York state department of health to conduct a study of the high burden of asthma in the boroughs of Brooklyn and Manhattan in the city of New York; and relates to providing coverage for pasteurized donor human milk (PDHM) (Part MM); and enacts the opioid stewardship act; repealer (Part NN).
S07507 Actions:
01/18/2018 REFERRED TO FINANCE
02/16/2018 AMEND (T) AND RECOMMIT TO FINANCE
02/16/2018 PRINT NUMBER 7507A
03/13/2018 PRINT NUMBER 7507B
03/30/2018 PRINT NUMBER 7507C
03/30/2018 ORDERED TO THIRD READING CAL.737
03/30/2018 MESSAGE OF NECESSITY - 3 DAY MESSAGE
03/30/2018 PASSED SENATE
03/30/2018 DELIVERED TO ASSEMBLY
03/30/2018 referred to ways and means
03/30/2018 substituted for a9507c
03/30/2018 ordered to third reading rules cal.21
03/30/2018 motion to amend lost
03/30/2018 passed assembly
03/30/2018 returned to senate
04/02/2018 DELIVERED TO GOVERNOR
04/12/2018 SIGNED CHAP.57
S07507 Committee&nbspVotes:
S07507 Floor&nbspVotes:
DATE:03/30/2018MOTION:DIPIETRO; To amend                                     YEA/NAY: 39/90
Abbate ER Crouch NO Gunther NO Mayer NO Pichardo NO Taylor NO
Abinanti NO Curran Y Harris NO McDonald NO Pretlow NO Thiele NO
Arroyo NO Cusick Y Hawley Y McDonough ER Quart ER Titone NO
Aubry NO Cymbrowitz NO Hevesi NO Miller B Y Ra Y Titus NO
Barclay Y Davila NO Hikind ER Miller MG Y Raia Y Vanel NO
Barnwell Y De La Rosa NO Hooper NO Miller ML Y Ramos NO Walker NO
Barrett ER DenDekker NO Hunter NO Montesano Y Richardson NO Wallace NO
Barron NO Dickens NO Hyndman NO Morelle NO Rivera NO Walsh Y
Benedetto NO Dilan NO Jaffee NO Morinello Y Rodriguez NO Walter Y
Bichotte NO Dinowitz NO Jean-Pierre NO Mosley NO Rosenthal D ER Weinstein NO
Blake NO DiPietro Y Jenne NO Murray Y Rosenthal L NO Weprin ER
Blankenbush Y D'Urso NO Johns Y Niou NO Rozic ER Williams NO
Brabenec Y Englebright NO Jones NO Nolan NO Ryan NO Woerner NO
Braunstein NO Errigo Y Joyner NO Norris Y Santabarbara NO Wright NO
Brindisi NO Fahy NO Kim NO Oaks Y Schimminger Y Zebrowski NO
Bronson NO Finch Y Kolb Y O'Donnell NO Seawright NO Mr. Speaker NO
Buchwald ER Fitzpatrick Y Lalor Y Ortiz NO Sepulveda NO
Butler Y Friend Y Lavine NO Otis NO Simon NO
Byrne Y Galef NO Lawrence Y Palmesano Y Simotas NO
Cahill NO Gantt ER Lentol NO Palumbo Y Skartados ER
Carroll NO Garbarino Y Lifton NO Paulin NO Skoufis NO
Castorina Y Giglio Y Lupardo NO Pellegrino NO Solages NO
Colton NO Glick NO Magee NO Peoples-Stokes NO Stec Y
Cook NO Goodell Y Magnarelli NO Perry ER Steck NO
Crespo NO Gottfried NO Malliotakis Y Pheffer Amato NO Stirpe NO
DATE:03/30/2018Assembly Vote                            YEA/NAY: 106/26
Abbate ER Crouch NO Gunther Y Mayer Y Pichardo Y Taylor Y
Abinanti Y Curran Y Harris Y McDonald Y Pretlow Y Thiele Y
Arroyo Y Cusick Y Hawley NO McDonough ER Quart ER Titone Y
Aubry Y Cymbrowitz Y Hevesi Y Miller B NO Ra Y Titus Y
Barclay NO Davila Y Hikind ER Miller MG Y Raia Y Vanel Y
Barnwell Y De La Rosa Y Hooper Y Miller ML Y Ramos Y Walker Y
Barrett ER DenDekker Y Hunter Y Montesano Y Richardson Y Wallace Y
Barron Y Dickens Y Hyndman Y Morelle Y Rivera Y Walsh NO
Benedetto Y Dilan Y Jaffee Y Morinello NO Rodriguez Y Walter NO
Bichotte Y Dinowitz Y Jean-Pierre Y Mosley Y Rosenthal D Y Weinstein Y
Blake Y DiPietro NO Jenne Y Murray NO Rosenthal L Y Weprin Y
Blankenbush NO D'Urso Y Johns Y Niou Y Rozic Y Williams Y
Brabenec NO Englebright Y Jones Y Nolan Y Ryan Y Woerner Y
Braunstein Y Errigo NO Joyner Y Norris NO Santabarbara Y Wright Y
Brindisi Y Fahy Y Kim Y Oaks NO Schimminger Y Zebrowski Y
Bronson Y Finch NO Kolb NO O'Donnell Y Seawright Y Mr. Speaker Y
Buchwald ER Fitzpatrick NO Lalor NO Ortiz Y Sepulveda Y
Butler NO Friend NO Lavine Y Otis Y Simon Y
Byrne NO Galef Y Lawrence NO Palmesano NO Simotas Y
Cahill Y Gantt ER Lentol Y Palumbo Y Skartados ER
Carroll Y Garbarino Y Lifton Y Paulin Y Skoufis Y
Castorina NO Giglio Y Lupardo Y Pellegrino Y Solages Y
Colton Y Glick Y Magee Y Peoples-Stokes Y Stec NO
Cook Y Goodell NO Magnarelli Y Perry ER Steck Y
Crespo Y Gottfried Y Malliotakis Y Pheffer Amato Y Stirpe Y
S07507 Text:
S. 7507--C                                            A. 9507--C
SENATE - ASSEMBLY
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 -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee  --  committee  discharged,  bill  amended,  ordered
reprinted  as  amended  and recommitted to said committee -- committee
to said committee
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 --  committee  discharged,  bill  amended,
ordered  reprinted  as  amended  and  recommitted to said committee --
again reported from said committee with amendments, ordered  reprinted
as  amended  and  recommitted to said committee -- again reported from
said committee with  amendments,  ordered  reprinted  as  amended  and
recommitted to said committee
AN  ACT  to amend the public health law, in relation to rate methodology
for capital expenditures to hospitals and residential nursing  facili-
ties; to amend the social services law, in relation to standard cover-
age  for  physical therapy services under medical assistance for needy
persons programs; to direct a review of  the  feasibility  of  a  burn
center  in Kings county; and in relation to rates of reimbursement for
certain residential health care facilities  (Part  A);  to  amend  the
public  health law, in relation to payments to residential health care
facilities; to amend the social services law  and  the  public  health
law,  in relation to assisted living program providers licensed in the
state; to amend the social services law, in relation to  payments  for
certain  medical assistance provided to eligible persons participating
in the New York traumatic brain injury waiver program;  to  amend  the
public  health  law,  in relation to limitations on licensed home care
service agency  contracts  and  registration  of  licensed  home  care
services  agencies;  to  amend the social services law, in relation to
advertising by fiscal intermediaries;  and  in  relation  to  medicaid
reimbursement  rates  for  hospice  providers  (Part  B); to amend the
social services law and the public health law, in relation  to  health
homes  and penalties for managed care providers (Part C); to amend the
S. 7507--C                          2                         A. 9507--C
social services law and the public health law,  in  relation  to  drug
coverage, updating the professional dispensing fee and copayments; and
in  relation  to the Medicaid drug cap (Part D); intentionally omitted
(Part  E); intentionally omitted (Part F); intentionally omitted (Part
G); intentionally omitted (Part H); intentionally omitted (Part I); to
amend the state finance law, in relation to the false claims act (Part
J); to amend the public health law and  the  social  services  law  in
relation  to  home  care  services and direct care costs; and to amend
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 medicaid expenditures, in  relation  to  extending  the  medicaid
global  cap (Part K); intentionally omitted (Part L); to amend chapter
266 of the laws of 1986, amending the civil practice law and rules and
other laws relating to malpractice and professional  medical  conduct,
in  relation  to  apportioning  premium for certain policies; to amend
part J of chapter 63 of the laws of 2001 amending chapter 266  of  the
laws of 1986, amending the civil practice law and rules and other laws
relating  to malpractice and professional medical conduct, relating to
the effectiveness of certain provisions of such chapter,  in  relation
to extending certain provisions concerning the hospital excess liabil-
ity  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 M); to amend
part  C  of  chapter  57  of  the laws of 2006, establishing a cost of
living adjustment for designated human services, in  relation  to  the
determination thereof; and to repeal certain provisions thereof relat-
ing  to  eligible  programs  (Part N); intentionally omitted (Part O);
intentionally omitted (Part P); to amend the  public  health  law,  in
relation  to the health care facility transformation program (Part Q);
intentionally omitted (Part R); intentionally omitted (Subpart A);  to
amend the public health law and the mental hygiene law, in relation to
integrated  services  (Subpart B); and to amend the public health law,
in relation to the definitions of telehealth, and to amend the  social
services law, in relation to payment for telehealh services and remote
patient  monitoring  and  to  repeal  certain provisions of the public
health law relating thereto (Subpart C)(Part S); to amend  chapter  59
of  the  laws of 2016, amending the social services law and other laws
relating to authorizing the commissioner of health to apply  federally
established  consumer  price  index  penalties  for generic drugs, and
authorizing the commissioner of health to impose penalties on  managed
care plans for reporting late or incorrect encounter data, in relation
to  the  effectiveness of certain provisions of such chapter; to amend
chapter 58 of the laws of 2007, amending the social services  law  and
other laws relating to adjustments of rates, in relation to the effec-
tiveness of certain provisions of such chapter; to amend chapter 54 of
the  laws  of  2016, amending part C of chapter 58 of the laws of 2005
relating to authorizing reimbursements for expenditures made by or  on
behalf  of  social services districts for medical assistance for needy
persons and administration thereof, in relation to  the  effectiveness
thereof; to amend chapter 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,
in  relation  to the effectiveness thereof; to amend 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 relating to the cap on  local  Medicaid
expenditures,  in  relation  to rates of payments; to amend the social
services law, in relation to agreements with  pharmaceutical  manufac-
turers;  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; and to amend the
public health law, in relation to participation and  membership  in  a
demonstration  period  (Part T); to amend part NN of chapter 58 of the
laws of 2015, amending the mental hygiene law relating  to  clarifying
the authority of the commissioners in the department of mental hygiene
to  design  and  implement  time-limited  demonstration  programs,  in
relation to the effectiveness thereof (Part U); to amend chapter 62 of
the laws of 2003, amending  the  mental  hygiene  law  and  the  state
finance  law relating to the community mental health support and work-
force reinvestment program, the membership of subcommittees for mental
health of community services boards and the duties of such  subcommit-
tees  and creating the community mental health and workforce reinvest-
ment account, in relation to extending such provisions relating there-
to (Part V); intentionally omitted (Part W); to amend chapter  111  of
the  laws  of  2010,  amending  the mental hygiene law relating to the
receipt of federal and state benefits received by individuals  receiv-
ing  care  in  facilities  operated  by an office of the department of
mental hygiene, in relation to the effectiveness thereof (Part X);  to
amend  the education law, in relation to persons practicing in certain
licensed programs or services who are exempt  from  practice  require-
ments  of  professionals  licensed  by the department of education; to
amend chapter 420 of the laws of  2002,  amending  the  education  law
relating  to  the  profession of social work, in relation to extending
the expiration of certain provisions thereof; to amend chapter 676  of
the  laws of 2002, amending the education law relating to the practice
of psychology, in relation to  extending  the  expiration  of  certain
provisions; and to amend chapter 130 of the laws of 2010, amending the
education  law and other laws relating to the registration of entities
providing certain  professional  services  and  licensure  of  certain
professions, in relation to extending certain provisions thereof (Part
Y);  to  amend  the  social services law, in relation to adding demon-
stration waivers to waivers allowable  for  home  and  community-based
services;  to  amend  the  social  services law, in relation to adding
successor federal waivers to waivers granted under subsection  (c)  of
section  1915 of the federal social security law, in relation to nurs-
ing facility services; to amend the social services law,  in  relation
to  waivers  for high quality and integrated care; to amend the mental
hygiene law, in relation to adding new and successor  federal  waivers
to  waivers in relation to home and community-based services; 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 legis-
lation 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;  to  amend  the  public  health  law, in
relation to expansion of comprehensive health services plans; to amend
chapter 659 of the laws of 1997, amending the public  health  law  and
other laws relating to creation of continuing care retirement communi-
ties, in relation to extending provisions thereof; to amend the public
health  law,  in  relation to managed long term care plans, health and
long  term  care  services  and  developmental  disability  individual
support  and  care coordination organizations; to amend chapter 165 of
the laws of 1991, amending the public health law and other laws relat-
ing to establishing payments for medical assistance,  in  relation  to
extending  the provisions thereof; to amend the mental hygiene law, in
relation  to reimbursement rates; and to amend chapter 710 of the laws
of 1988, amending the social services law and the education law relat-
ing to medical assistance eligibility of certain persons and providing
for managed  medical  care  demonstration  programs,  in  relation  to
extending  the provisions thereof (Part Z); to amend part C of chapter
57 of the laws of 2006, relating to  establishing  a  cost  of  living
adjustment  for designated human services programs, in relation to the
inclusion and development of certain cost of living adjustments  (Part
AA); to amend the public health law, in relation to expanding the list
of controlled substances (Part BB); to amend the public health law, in
relation  to  inquiries or complaints of professional misconduct (Part
CC); to amend the education law, in relation to authorizing a licensed
pharmacist to administer influenza vaccine to children between two and
eighteen years of age pursuant to a non-patient specific  regimen;  to
amend the public health law, in relation to reporting requirements for
vaccines administered by pharmacists to individuals less than nineteen
years  of  age; to amend chapter 563 of the laws of 2008, amending the
education law and the public health law relating to immunizing  agents
to be administered to adults by pharmacists, in relation to making the
provisions permanent; to amend chapter 116 of the laws of 2012, amend-
ing  the  education  law relating to authorizing a licensed pharmacist
and certified nurse  practitioner  to  administer  certain  immunizing
agents,  in  relation  to  making certain provisions permanent; and to
amend chapter 21 of the laws  of  2011,  amending  the  education  law
relating  to  authorizing  pharmacists  to  perform collaborative drug
therapy management with physicians in certain settings, in relation to
making certain provisions permanent (Part DD);  to  amend  the  social
services  law, in relation to insurance payments for independent prac-
titioner services  for  individuals  with  developmental  disabilities
(Part  EE); to amend the mental hygiene law, in relation to establish-
ing the office of the independent substance use  disorder  and  mental
health  ombudsman  (Part  FF);  to  amend  the  mental hygiene law, in
relation to a certified peer recovery advocate services program  (Part
GG);  to amend the public health law, the executive law and the insur-
ance law, in relation to sexual assault forensic exams; and to  repeal
certain  provisions  of  the  public health law relating thereto (Part
HH); to amend the mental hygiene law, in  relation  to  state-operated
individualized  residential alternatives; and to amend part Q of chap-
ter 59 of the laws of 2016, amending the mental hygiene  law  relating
to the closure or transfer of a state-operated individualized residen-
tial  alternative, in relation to the effectiveness thereof (Part II);
to amend the mental hygiene law, the public health law and the  execu-
tive  law,  in  relation  to establishing a training program for first
responders for handling  emergency  situations  involving  individuals
with  autism  spectrum  disorder  and other developmental disabilities
(Part JJ); to amend the state finance law, in  relation  to  requiring
bids  submitted  to the state or any agency or department of the state
to contain a certification concerning sexual harassment  (Subpart  A);
to  amend the civil practice law and rules, in relation to prohibiting
mandatory arbitration clauses (Subpart B); to amend the  public  offi-
cers  law,  in  relation to reimbursement of funds paid by state agen-
cies, state entities and public entities for  the  payment  of  awards
adjudicated  in  sexual  harassment  claims  (Subpart C); to amend the
general obligations law and the  civil  practice  law  and  rules,  in
relation  to  nondisclosure agreements (Subpart D); to amend the labor
law, in relation to the establishment of a model policy regarding  the
prevention  of  sexual  harassment  and  a  model  training program to
prevent sexual harassment in the workplace (Subpart E); and  to  amend
the  executive  law, in relation to sexual harassment relating to non-
employees (Subpart F) (Part KK); to amend the public  health  law,  in
relation  to authorizing a voluntary public water system consolidation
study (Part LL); to amend the public health law, in relation to  phar-
macy  audits  by pharmacy benefit managers; to amend the public health
law, in relation to contracts between pharmacy  benefit  managers  and
pharmacies;  to  amend  the  insurance  law, in relation to outpatient
treatment; to amend the public health law, in relation to establishing
the children and recovering mothers program and a workgroup  to  study
and  evaluate  barriers  and  challenges  in  identifying and treating
expectant mothers, newborns and  new  parents  with  a  substance  use
disorder;  to  amend  the  public health law, in relation to screening
students for lead when enrolling in child care, pre-school or  kinder-
garten;  to  amend  the  public  health  law,  in relation to the lead
service line replacement grant program; to direct the New  York  state
department  of  health to conduct a study of the high burden of asthma
in the boroughs of Brooklyn and Manhattan in the city of New York; and
to amend the insurance law, in  relation  to  providing  coverage  for
pasteurized donor human milk (PDHM) (Part MM); and to amend the public
health  law  and  the  state  finance law, in relation to enacting the
opioid  stewardship  act;  and  providing  for  the  repeal  of   such
provisions upon expiration thereof (Part NN)
The  People of the State of New York, represented in Senate and Assem-
1    Section 1. This act enacts into law major  components  of  legislation
2  which are necessary to implement the state fiscal plan for the 2018-2019
3  state  fiscal  year.  Each  component  is wholly contained within a Part
4  identified as Parts A through NN. The effective date for each particular
5  provision contained within such Part is set forth in the last section of
6  such Part. Any provision in any section contained within a Part, includ-
7  ing the effective date of the Part, which makes a reference to a section
8  "of this act", when used in connection with that  particular  component,
9  shall  be  deemed  to mean and refer to the corresponding section of the
10  Part in which it is found. Section three of  this  act  sets  forth  the
11  general effective date of this act.
12                                   PART A
13    Section 1. Intentionally omitted.
14    §  2.  Subdivision  5-d of section 2807-k of the public health law, as
15  amended by section 1 of part E of chapter 57 of the  laws  of  2015,  is
16  amended to read as follows:
17    5-d.  (a)  Notwithstanding any inconsistent provision of this section,
18  section twenty-eight hundred  seven-w  of  this  article  or  any  other
19  contrary  provision  of  law, and subject to the availability of federal
20  financial participation, for periods on and  after  January  first,  two
21  thousand  thirteen,  through [December] March thirty-first, two thousand
22  [eighteen] twenty, all funds available for distribution pursuant to this
1  section, except for funds distributed pursuant to  subparagraph  (v)  of
2  paragraph  (b)  of  subdivision  five-b  of  this section, and all funds
3  available for distribution  pursuant  to  section  twenty-eight  hundred
4  seven-w of this article, shall be reserved and set aside and distributed
5  in accordance with the provisions of this subdivision.
6    (b)  The commissioner shall promulgate regulations, and may promulgate
7  emergency regulations, establishing methodologies for  the  distribution
8  of  funds  as  described  in  paragraph (a) of this subdivision and such
9  regulations shall include, but not be limited to, the following:
10    (i) Such regulations shall  establish  methodologies  for  determining
11  each  facility's  relative uncompensated care need amount based on unin-
12  sured inpatient and outpatient units of service from the cost  reporting
13  year  two years prior to the distribution year, multiplied by the appli-
14  cable medicaid rates in effect January first of the  distribution  year,
15  as summed and adjusted by a statewide cost adjustment factor and reduced
16  by  the  sum  of  all  payment  amounts  collected  from  such uninsured
17  patients, and as further adjusted  by  application  of  a  nominal  need
18  computation  that shall take into account each facility's medicaid inpa-
19  tient share.
20    (ii) Annual distributions pursuant to such  regulations  for  the  two
21  thousand  thirteen  through  two  thousand  [eighteen] nineteen calendar
22  years shall be in accord with the following:
23    (A) one hundred thirty-nine  million  four  hundred  thousand  dollars
24  shall be distributed as Medicaid Disproportionate Share Hospital ("DSH")
25  payments to major public general hospitals; and
26    (B)  nine hundred ninety-four million nine hundred thousand dollars as
27  Medicaid DSH payments to eligible general hospitals,  other  than  major
28  public general hospitals.
29    (iii)(A)  Such  regulations  shall establish transition adjustments to
30  the distributions made pursuant to clauses (A) and (B)  of  subparagraph
31  (ii)  of this paragraph such that no facility experiences a reduction in
32  indigent care pool payments pursuant to this subdivision that is greater
33  than the percentages, as specified in clause (C) of this subparagraph as
34  compared to the average distribution that each  such  facility  received
35  for  the three calendar years prior to two thousand thirteen pursuant to
36  this section and section twenty-eight hundred seven-w of this article.
37    (B) Such regulations shall also  establish  adjustments  limiting  the
38  increases  in  indigent  care  pool  payments  experienced by facilities
39  pursuant to this subdivision by an amount that will be, as determined by
40  the commissioner and in conjunction with such other funding  as  may  be
41  available  for  this  purpose, sufficient to ensure full funding for the
42  transition adjustment payments authorized by clause (A) of this subpara-
43  graph.
44    (C) No facility shall experience a reduction  in  indigent  care  pool
45  payments pursuant to this subdivision that: for the calendar year begin-
46  ning  January first, two thousand thirteen, is greater than two and one-
47  half percent; for the calendar year beginning January first,  two  thou-
48  sand  fourteen, is greater than five percent; and, for the calendar year
49  beginning on January first, two thousand  fifteen[,];  is  greater  than
50  seven and one-half percent, and for the calendar year beginning on Janu-
51  ary  first,  two  thousand sixteen, is greater than ten percent; and for
52  the calendar year beginning on January first, two thousand seventeen, is
53  greater than twelve and one-half percent;  and  for  the  calendar  year
54  beginning  on  January  first,  two  thousand  eighteen, is greater than
55  fifteen percent; and for the calendar year beginning on  January  first,
56  two thousand nineteen, is greater than seventeen and one-half percent.
1    (iv) Such regulations shall reserve one percent of the funds available
2  for  distribution  in the two thousand fourteen and two thousand fifteen
3  calendar years, and for calendar  years  thereafter,  pursuant  to  this
4  subdivision,  subdivision  fourteen-f  of  section  twenty-eight hundred
5  seven-c of this article, and sections two hundred eleven and two hundred
6  twelve  of  chapter  four  hundred  seventy-four of the laws of nineteen
7  hundred ninety-six, in a  "financial  assistance  compliance  pool"  and
8  shall establish methodologies for the distribution of such pool funds to
9  facilities  based  on  their  level  of compliance, as determined by the
10  commissioner, with the provisions of subdivision nine-a of this section.
11    (c) The commissioner shall annually report to  the  governor  and  the
12  legislature  on the distribution of funds under this subdivision includ-
13  ing, but not limited to:
14    (i) the impact on safety net providers, including community providers,
15  rural general hospitals and major public general hospitals;
16    (ii) the provision of indigent care by units  of  services  and  funds
17  distributed by general hospitals; and
18    (iii) the extent to which access to care has been enhanced.
19    § 3. Intentionally omitted.
21    §  5.  Paragraph  (h)  of subdivision 2 of section 365-a of the social
22  services law, as amended by chapter 220 of the laws of 2011, is  amended
23  to read as follows:
24    (h)  speech therapy, and when provided at the direction of a physician
25  or nurse practitioner, physical therapy including related rehabilitative
26  services and occupational therapy; provided, however, that speech thera-
27  py[, physical therapy] and occupational therapy each shall be limited to
28  coverage of twenty visits per year; physical therapy shall be limited to
29  coverage of forty visits per year; such limitation shall  not  apply  to
30  persons  with  developmental  disabilities or, notwithstanding any other
31  provision of law to the contrary, to persons with traumatic brain  inju-
32  ry;
33    §  6.  The  commissioner  of  health is directed to conduct a study to
34  review the feasibility of creating a burn center in Kings County.
35    The commissioner of health shall report his or  her  findings  to  the
36  governor, the speaker of the assembly, the minority leader of the assem-
37  bly,  the  temporary  president of the senate and the minority leader of
38  the senate on or before one year from  the  date  this  act  shall  take
39  effect.
40    §  7.  Section  4403-f of the public health law is amended by adding a
41  new subdivision 8-a to read as follows:
42    8-a. Rates for certain residential health care facilities.    Notwith-
43  standing  any  other provision of law or regulation to the contrary, any
44  residential health care facility established pursuant to  article  twen-
45  ty-eight  of  this chapter located in a county with a population of more
46  than seventy-two thousand and less than  seventy-five  thousand  persons
47  based  on the two thousand ten federal census shall be reimbursed by any
48  managed long term care plan,  approved  pursuant  to  this  section  and
49  contracting  with  the department, at a rate of no less than one hundred
50  four percent of the average rate of reimbursement in existence on  March
51  first, two thousand eighteen for such county.
52    §  8.  Subdivision  2-c  of  section  2808 of the public health law is
53  amended by adding a new paragraph (g) to read as follows:
54    (g) Notwithstanding any other provision of law or  regulation  to  the
55  contrary,  any  residential health care facility established pursuant to
56  this article located in a county with a population of more  than  seven-
1  ty-two thousand and less then seventy-five thousand persons based on the
2  two  thousand  ten federal census, and operating between one hundred ten
3  and one hundred thirty beds, being reimbursed by  the  department  on  a
4  fee-for-services  basis,  shall  be reimbursed at a rate of no less than
5  one hundred seventeen percent of the fee-for-service rate of  reimburse-
6  ment calculated pursuant to this section for that facility for inpatient
7  services provided on or after March first, two thousand eighteen.
8    §  9.  This act shall take effect immediately; provided, however, that
9  the amendments to section 4403-f  of  the  public  health  law  made  by
10  section  seven  of  this act shall not affect the repeal of such section
11  and shall be deemed repealed therewith.
12                                   PART B
13    Section 1. Subdivision 2-c of section 2808 of the public health law is
15    (g) The commissioner shall reduce Medicaid revenue  to  a  residential
16  health  care facility in a payment year by two percent if in each of the
17  two most recent payment years for which  New  York  state  nursing  home
18  quality  initiative  data  is  available, the facility was ranked in the
19  lowest two quintiles of facilities based on  its  nursing  home  quality
20  initiative  performance,  and  was  ranked in the lowest quintile in the
21  most recent payment year. The commissioner shall waive  the  application
22  of  this paragraph to a facility if the commissioner determines that the
23  facility is in financial distress.
24    § 2. Subdivision 3 of section 461-l of  the  social  services  law  is
25  amended  by  adding four new paragraphs (k), (l), (m) and (n) to read as
26  follows:
27    (k) (i) Existing assisted living program providers may  apply  to  the
28  department  of health for approval to add up to nine additional assisted
29  living  program  beds  that  do  not   require   major   renovation   or
30  construction.  Eligible applicants are those that agree to dedicate such
31  beds to serve only individuals receiving medical assistance, are in good
32  standing with the department of  health,  and  are  in  compliance  with
33  appropriate state and local requirements as determined by the department
34  of health.
35    (ii)  Existing assisted living program providers licensed on or before
36  April first, two thousand eighteen may submit  applications  under  this
37  paragraph  beginning no later than June thirtieth, two thousand eighteen
38  and until a deadline to be  determined  by  the  department  of  health.
39  Existing  assisted  living program providers licensed on or before April
40  first, two thousand twenty may submit  such  applications  beginning  no
41  later  than  June thirtieth, two thousand twenty and until a deadline to
42  be determined by the department of health.
43    (iii) The number of additional assisted living program  beds  approved
44  under  this  paragraph  shall be based on the total number of previously
45  awarded beds either withdrawn by applicants or denied by the  department
46  of health.  The commissioner of health shall utilize an expedited review
47  process allowing certification of the additional beds within ninety days
48  of such department's receipt of a satisfactory application.
49    (l)  (i) The commissioner of health is authorized to solicit and award
50  applications for up to a total  of  five  hundred  new  assisted  living
51  program  beds in those counties where there is one or no assisted living
52  program providers, pursuant to criteria to be determined by the  commis-
53  sioner.
1    (ii)  The  commissioner  of  health is authorized to solicit and award
2  applications for up to five hundred new assisted living program beds  in
3  counties  where  utilization  of  existing  assisted living program beds
4  exceeds eighty-five percent. All applicants shall  comply  with  federal
5  home  and  community-based settings requirements, as set forth in 42 CFR
6  Part 441 Subpart G. To be eligible for an award, an applicant must agree
7  to:
8    (A) Dedicate such beds to serve  only  individuals  receiving  medical
9  assistance;
10    (B)  Develop  and  execute collaborative agreements within twenty-four
11  months of an application being made to  the  department  of  health,  in
12  accordance  with guidance to be published by such department, between at
13  least one of each of the following entities: an adult care  facility;  a
14  residential health care facility; and a general hospital; and
15    (C) Enter into an agreement with an existing managed care entity.
16    (iii)  The  commissioner of health is authorized to award any assisted
17  living program beds for which a solicitation is made under  subparagraph
18  (i)  of  this  paragraph,  but which are not awarded, to applicants that
19  meet all applicable criteria  pursuant  to  a  solicitation  made  under
20  subparagraph (ii) of this paragraph.
21    (m)  Beginning  April  first,  two  thousand  twenty-three, additional
22  assisted living program beds shall be approved on a case by  case  basis
23  whenever the commissioner of health is satisfied that public need exists
24  at the time and place and under circumstances proposed by the applicant.
25    (i)  The  consideration  of  public need may take into account factors
26  such as, but not limited to, regional occupancy  rates  for  adult  care
27  facilities and assisted living program occupancy rates and the extent to
28  which the project will serve individuals receiving medical assistance.
29    (ii) Existing assisted living program providers may apply for approval
30  to  add  up  to nine additional assisted living program beds that do not
31  require major renovation or construction under an expedited review proc-
32  ess. The expedited review process is available to applicants that are in
33  good standing with the department of health, and are in compliance  with
35  of  health.    The expedited review process shall allow certification of
36  the additional beds for which the commissioner of  health  is  satisfied
37  that  public need exists within ninety days of such department's receipt
38  of a satisfactory application.
39    (n) The commissioner of health is authorized to create  a  program  to
40  subsidize  the cost of assisted living for those individuals living with
41  Alzheimer's disease and  dementia  who  are  not  eligible  for  medical
42  assistance pursuant to title eleven of article five of this chapter. The
43  program  shall  authorize  up  to  two  hundred  vouchers to individuals
44  through an application process and pay for up to seventy-five percent of
45  the average private pay rate in the respective region. The  commissioner
46  of   health  may  propose  rules  and  regulations  to  effectuate  this
47  provision.
48    § 3. Subparagraph (i) of paragraph (b) of  subdivision  7  of  section
49  4403-f of the public health law, as amended by section 41-b of part H of
50  chapter 59 of the laws of 2011, is amended to read as follows:
51    (i) The commissioner shall, to the extent necessary, submit the appro-
52  priate waivers, including, but not limited to, those authorized pursuant
53  to  sections  eleven hundred fifteen and nineteen hundred fifteen of the
54  federal social security act, or  successor  provisions,  and  any  other
55  waivers  necessary  to achieve the purposes of high quality, integrated,
56  and cost effective care and integrated  financial  eligibility  policies
S. 7507--C                         10                         A. 9507--C
1  under  the  medical assistance program or pursuant to title XVIII of the
2  federal social security act. In addition, the commissioner is authorized
3  to submit the appropriate waivers, including but not  limited  to  those
4  authorized  pursuant  to  sections  eleven  hundred fifteen and nineteen
5  hundred  fifteen  of  the  federal  social  security  act  or  successor
6  provisions, and any other waivers necessary to require on or after April
7  first,  two thousand twelve, medical assistance recipients who are twen-
8  ty-one years of age or older and who require community-based  long  term
9  care services, as specified by the commissioner, for a continuous period
10  of  more  than  one  hundred  and  twenty days, to receive such services
11  through an available plan certified pursuant to this  section  or  other
12  program  model  that meets guidelines specified by the commissioner that
13  support coordination and integration of services. Such guidelines  shall
14  address  the  requirements  of  paragraphs (a), (b), (c), (d), (e), (f),
15  (g), (h), and (i) of subdivision  three  of  this  section  as  well  as
16  payment  methods  that ensure provider accountability for cost effective
17  quality outcomes. Such other program models may include long  term  home
18  health  care  programs  that comply with such guidelines. Copies of such
19  original waiver applications and amendments thereto shall be provided to
20  the chairs of the senate finance committee, the assembly ways and  means
21  committee  and  the senate and assembly health committees simultaneously
22  with their submission to the federal government.
23    § 4. Subparagraphs (vii) and (viii) of paragraph (b) of subdivision  7
24  of  section  4403-f  of  the public health law are redesignated subpara-
25  graphs (viii) and (ix) and a new subparagraph (vii) is added to read  as
27    (vii)  If  another long term care plan certified under this section is
28  available, medical assistance recipients  required  to  enroll  in  such
29  plans  pursuant  to  this  section,  including  recipients who have been
30  assigned to a provider by the commissioner,  may  change  plans  without
31  cause  within  ninety  days  of either notification of enrollment or the
32  effective date of enrollment into a plan, whichever is later, by submit-
33  ting a request to the entity designated by the department in a format to
34  be determined by the department. In accordance with federal statutes and
35  regulations, after such ninety-day period, the department may prohibit a
36  recipient from changing plans more frequently  than  once  every  twelve
37  months,  except  for  good cause. Good cause may include poor quality of
38  care, lack of access to covered services, lack of  access  to  providers
39  experienced  in  dealing with the enrollee's care needs, or as otherwise
40  determined by the commissioner.
41    § 5. Clauses 11 and 12 of subparagraph (v) of paragraph (b) of  subdi-
42  vision  7  of  section  4403-f  of  the public health law, as amended by
43  section 48 of part A of chapter 56 of the laws of 2013, are  amended  to
44  read as follows:
45    (11) a person who is eligible for medical assistance pursuant to para-
46  graph  (b) of subdivision four of section three hundred sixty-six of the
47  social services law; [and]
48    (12) Native Americans; and
49    (13) a person who is permanently  placed  in  a  nursing  home  for  a
50  consecutive  period  of  three  months  or  more.  In  implementing this
51  provision, the department shall continue to support service delivery and
52  outcomes that result in community living for enrollees.
53    § 6. Section 4403-f of the public health law is amended  by  adding  a
54  new subdivision 11-b to read as follows:
55    11-b.  In  cases of a managed long term care plan merger, acquisition,
56  or other similar arrangement approved by the department,  any  receiving
1  plan  that  is  a  party to the arrangement shall submit a report to the
2  department within twelve months of the  effective  date  of  the  trans-
3  action.  Such  reports shall be in a form and format to be determined by
4  the  department  and  shall  include, but not be limited to, information
5  about the enrollees transferred and enrollee service authorization  data
6  before  and  after  transfer. The department shall make a summary of the
7  report available to the public.
8    § 7. Intentionally omitted.
9    § 8. Subdivision 1 of section 367-a of  the  social  services  law  is
10  amended by adding a new paragraph (h) to read as follows:
11    (h)  Amounts  payable  under  this title for medical assistance in the
12  form of freestanding clinic services pursuant to article twenty-eight of
13  the public health law provided to eligible persons participating in  the
14  New  York  traumatic  brain injury waiver program who are also benefici-
15  aries under part B of title XVIII of the federal social security act  or
16  who  are qualified medicare beneficiaries under part B of title XVIII of
17  such act shall not be less than the approved medical assistance  payment
18  level less the amount payable under part B.
19    § 9. The commissioner of health, in consultation with the rural health
20  council,  shall  conduct  a  study  of home and community based services
21  available to recipients of the Medicaid program in rural  areas  of  the
22  state. Such study shall include a review and analysis of factors affect-
23  ing  such  availability,  including  but  not  limited to transportation
24  costs, costs of direct  care  personnel  including  home  health  aides,
25  personal  care  attendants  and other direct service personnel, opportu-
26  nities for telehealth services, and technological  advances  to  improve
27  efficiencies. Consistent with the results of the study, the commissioner
28  of  health is authorized to provide a targeted Medicaid rate enhancement
29  to fee-for-service personal care rates and rates under  Medicaid  waiver
30  programs  such  as  the nursing home transition and diversion waiver and
31  the traumatic brain injury program waiver, in  an  aggregate  amount  of
32  three  million  dollars minus the cost of conducting the study; provided
33  further, that nothing in this section shall be deemed to affect  payment
34  for  the costs of the study and any related Medicaid rate enhancement if
35  federal participation is not available for such costs.
36    § 9-a. Subdivision 7 of section 4403-f of the  public  health  law  is
37  amended by adding a new paragraph (j) to read as follows:
38    (j)  Limitations  on licensed home care service agency contracts.  (i)
39  The commissioner may establish methodologies  to  limit  the  number  of
40  licensed  home care services agencies licensed pursuant to article thir-
41  ty-six of the public health law with which managed long term care  plans
42  may  enter into contracts, provided that such limitations are consistent
43  with the specifications set forth in this paragraph.
44    (ii) Managed long term care plans operating in the city  of  New  York
45  and/or  the  counties of Nassau, Suffolk, and Westchester may enter into
46  contracts with licensed home care services agencies in such region in  a
47  maximum number calculated based upon the following methodology:
48    (A)  As  of  October  first,  two  thousand eighteen, one contract per
49  seventy-five members enrolled in the plan within such region; and
50    (B) As of October first, two thousand nineteen, one contract  per  one
51  hundred members enrolled in the plan within such region.
52    (iii)  Managed  long  term care plans operating in counties other than
53  those in the city of New York and the counties of Nassau,  Suffolk,  and
54  Westchester  may  enter  into contracts with licensed home care services
55  agencies in such region in a maximum number calculated  based  upon  the
56  following methodology:
1    (A)  As  of  October  first,  two  thousand eighteen, one contract per
2  forty-five members enrolled in the plan within such region.
3    (B) As of October first, two thousand nineteen, one contract per sixty
4  members enrolled in the plan within such region.
5    (iv) Notwithstanding subparagraphs (ii) and (iii) of this paragraph, a
6  managed long term care plan shall not enter into less than the number of
7  contracts  with  licensed  home care services agencies in each county in
8  which the plan operates  as  is  necessary  to  remain  consistent  with
9  network  adequacy  standards, as determined by the department in accord-
10  ance with federal regulations.
11    (v) When calculating the number of additional contracts that a managed
12  long term care plan may enter using the methodologies established pursu-
13  ant to this paragraph, any fractional result shall be rounded down.
14    (vi) The commissioner may increase the number of  licensed  home  care
15  services agencies with which a managed long term care plan may contract,
16  on  a  county  by county basis, if the commissioner determines that such
17  increase is necessary to: ensure adequate  access  to  services  in  the
18  geographic  area  including,  but not limited to, special needs services
19  and services that are culturally and linguistically appropriate;  or  to
20  avoid disruption in services in the geographic area.
21    (vii)  Any licensed home care services agency that ceases operation as
22  a result of this paragraph shall conform with  all  applicable  require-
23  ments,  including  but  not limited to demonstrating to the department's
24  satisfaction continuity of care for individuals receiving services  from
25  the agency.
26    (viii)  The  commissioner  may require managed long term care plans to
27  provide evidence of compliance with this paragraph, on an annual basis.
28    (ix) In implementing the provisions of this paragraph, the commission-
29  er shall, to the extent practicable, consider and  select  methodologies
30  that  seek to maximize continuity of care and minimize disruption to the
31  provider labor workforce, and  shall,  to  the  extent  practicable  and
32  consistent  with  the  ratios  set  forth  herein,  continue  to support
33  contracts between managed long term care plans and  licensed  home  care
34  services agencies that are based on a commitment to quality and value.
35    (x)  This  subparagraph  applies where implementation of the limits on
36  contracts with licensed home care service agencies of this paragraph (i)
37  would otherwise require an enrollee's care to be  transferred  from  the
38  enrollee's current licensed home care service agency to another licensed
39  care service agency, and (ii) the enrollee (or the enrollee's authorized
40  representative) wants the enrollee to continue to be cared for by one or
41  more  employees  of  the  current licensed home care service agency, and
42  that continuation would otherwise be  provided.  In  such  a  case:  the
43  enrollee's  managed long term care plan may contract with the enrollee's
44  current licensed home care service agency for the purpose of  continuing
45  the  enrollee's  care  by  such  employee or employees, and the contract
46  shall not count towards the limits on contracts under this paragraph for
47  a period of three months.
48    § 9-b. Subdivisions 4 and 6 of section 3605 of the public health  law,
49  subdivision  4  as  amended by section 62 of part A of chapter 58 of the
50  laws of 2010, subdivision 6 as added by chapter 959 of the laws of 1984,
51  are amended to read as follows:
52    4. The public health and health planning council shall not approve  an
53  application  for  licensure unless it is satisfied as to: (a) the public
54  need for the existence of the licensed home health care  service  agency
55  at  the  time  and  place  and under the circumstances proposed; (b) the
56  character, competence and standing in the community of  the  applicant's
1  incorporators,  directors,  sponsors, stockholders or operators; (c) the
2  financial resources of the proposed licensed home  health  care  service
3  agency and its sources of financial revenues; and (d) such other matters
4  as it shall deem pertinent.
5    6. Neither [public need,] tax status nor profit-making status shall be
6  criteria for licensure.
7    §  9-c.  Subdivision  2 of section 3605-a of the public health law, as
8  added by chapter 959 of the laws of 1984, is amended to read as follows:
9    2. No such license shall be revoked, suspended, limited,  annulled  or
10  denied  without  a  hearing.  However,  a  license  may  be  temporarily
11  suspended or limited without a hearing for a period  not  in  excess  of
12  thirty days upon written notice to the agency following a finding by the
13  department  that  the  public  health  or  safety is in imminent danger.
14  Notwithstanding the provisions of this section, no  licensed  home  care
15  services  agency  shall be permitted to operate unless it has registered
16  with the department pursuant to section  thirty-six  hundred  five-b  of
17  this article.
18    § 9-d. The public health law is amended by adding a new section 3605-b
20    §  3605-b.  Registration  of licensed home care services agencies.  1.
21  (a) Notwithstanding any provision of law to the  contrary,  no  licensed
22  home  care  services agency (LHCSA) licensed pursuant to section thirty-
23  six hundred five of this article  shall  be  operated,  provide  nursing
24  services,  home  health  aide  services,  or  personal care services, or
25  receive reimbursement from any source for the provision of such services
26  during any period of time on or after January first, two thousand  nine-
27  teen,  unless  it  has  registered  with  the  commissioner  in a manner
28  prescribed by the department.
29    (b) A LHCSA that fails to submit a complete and accurate  set  of  all
30  required  registration  materials  by  the  deadline  established by the
31  commissioner shall be required to pay a fee of five hundred dollars  for
32  each  month  or  part thereof that the LHCSA is in default. A LHCSA that
33  failed to register in the prior year by the deadline of the current year
34  shall not be permitted to register for the upcoming registration  period
35  unless it submits any unpaid late fees.
36    (c)  The  department  shall  post  on its public website a list of all
37  LHCSAs, which shall indicate the current  registration  status  of  each
38  LHCSA.
39    (d)  The  department shall institute proceedings to revoke the license
40  of any LHCSA that fails to register for two annual registration periods,
41  whether or not such periods are consecutive. The department  shall  have
42  the discretion to pursue revocation of the license of a LHCSA on grounds
43  that  it  evidences  a  pattern  of late registration over the course of
44  multiple years.
45    § 9-e. Effective April 1, 2018, the commissioner of health shall place
46  a moratorium on the processing  and  approval  of  applications  seeking
47  licensure  of  a  licensed home care services agency pursuant to section
48  3605 of the public health  law  that  have  not  received  establishment
49  approval  or  contingent establishment approval by the public health and
50  health planning council, except for: (a) an application  seeking  licen-
51  sure  of  a licensed home care services agency that is submitted with an
52  application for approval as an assisted living program authorized pursu-
53  ant to section 461-l of the social  services  law;  (b)  an  application
54  seeking  approval  to  transfer  ownership for an existing licensed home
55  care services agency that has been licensed and operating for a  minimum
56  of  five years for the purpose of consolidating ownership of two or more
1  licensed home care services agencies; and  (c)  an  application  seeking
2  licensure  of  a  home  care  services agency where the applicant demon-
3  strates  to  the  satisfaction  of  the  commissioner  of  health   that
4  submission  of  the application to the public health and health planning
5  council for consideration would  be  appropriate  on  grounds  that  the
6  application addresses a serious concern such as a lack of access to home
7  care services in the geographic area or a lack of adequate and appropri-
8  ate  care,  language and cultural competence, or special needs services.
9  Such moratorium shall expire on March  31,  2020.  In  implementing  the
10  provisions  of this section, the commissioner shall, to the extent prac-
11  ticable, review and, where appropriate, prioritize presentation  to  the
12  public health and health planning council of complete applications under
13  paragraph  (b)  of this section where the applicants demonstrate, to the
14  satisfaction of the commissioner, that the proposed change in  ownership
15  is  consistent  with  the  goals  of  paragraph  (j) of subdivision 7 of
16  section 4403-f of the public health law.
17    § 9-f. Section 365-f of the social services law is amended by adding a
18  new subdivision 4-c to read as follows:
19    4-c. Advertising by fiscal intermediaries.  (a) A fiscal  intermediary
20  shall  not  publish  any  advertisement that is false or misleading. For
21  purposes of this subdivision, an advertisement is any material  produced
22  in  any  medium that can reasonably be interpreted as intended to market
23  the fiscal intermediary's services to medical assistance recipients.
24    (b) Fiscal intermediaries  shall  submit  all  advertisements  to  the
25  department  prior  to  dissemination.  Fiscal  intermediaries  shall not
26  disseminate any advertisement until it has been approved by the  depart-
27  ment.  The department shall render a decision on such submissions within
28  thirty days.
29    (c) Upon a  fiscal  intermediary's  receipt  of  notification  by  the
30  commissioner  that  the  fiscal intermediary has disseminated a false or
31  misleading advertisement, or that the fiscal  intermediary  disseminated
32  an  advertisement without the department's approval, the fiscal interme-
33  diary shall have thirty days  to  cease  disseminating  or  remove  such
34  advertisement.
35    (d)  Upon  the commissioner's determination that a fiscal intermediary
36  has disseminated two advertisements that are either false or  misleading
37  or  that  were  not  approved  by  the  department, such entity shall be
38  prohibited from providing fiscal intermediary services and any  authori-
39  zation  granted  shall  be  immediately  revoked,  suspended, limited or
40  annulled pursuant to subdivision four-b of this section. The  department
41  shall  maintain  a list of such entities and shall make such list avail-
42  able to contracting entities listed in subparagraph (i) of paragraph (a)
43  of subdivision four-a of this section.
44    § 10. Paragraph (d-2) of subdivision 3 of section 364-j of the  social
45  services  law,  as  added by section 20-a of part B of chapter 59 of the
46  laws of 2016, is amended to read as follows:
47    (d-2) Services provided  pursuant  to  waivers,  granted  pursuant  to
48  subsection  (c)  of  section 1915 of the federal social security act, to
49  persons suffering from traumatic brain injuries or qualifying for  nurs-
50  ing  home  diversion  and  transition services, shall not be provided to
51  medical assistance recipients through managed  care  programs  until  at
52  least January first, two thousand [eighteen] twenty-two.
53    § 11. Section 4012 of the public health law is amended by adding a new
54  subdivision 5 to read as follows:
55    5.  The  commissioner  shall establish a methodology as of July first,
56  two thousand eighteen subject to federal  financial  participation  that
1  shall   ensure  a  prospective  ten-percent  increase  in  the  medicaid
2  reimbursement rates for hospice providers, relative to the reimbursement
3  rate, as of March thirty-first,  two  thousand  eighteen,  for  services
4  provided  by such providers on and after April first, two thousand eigh-
5  teen.
6    § 12. This act shall take effect immediately; provided, however,  that
7  the  amendments  to  paragraph (b) of subdivision 7 of section 4403-f of
8  the public health law made by sections three, four and five of this  act
9  shall  not  affect the expiration of such paragraph pursuant to subdivi-
10  sion (i) of section 111 of part H of chapter 59 of the laws of 2011,  as
11  amended,  and  shall  be  deemed to expire therewith; provided, further,
12  that the amendments to section 4403-f of the public health law  made  by
13  sections  three, four, five, six and nine-a of this act shall not affect
14  the repeal of such section pursuant to chapter 659 of the laws of  1997,
15  as  amended,  and shall be deemed repealed therewith; provided, further,
16  that section four of this act shall take  effect  on  October  1,  2018;
17  provided,  further,  that  section  nine-b of this act shall take effect
18  April 1, 2020; provided further  that  the  commissioner  of  health  is
19  authorized  to  issue  regulations  establishing the methodology for the
20  determination of public need pursuant to subdivision 4 of  section  3605
21  of  the  public health law, as amended by section two of this act, prior
22  to such date; provided, further, that section nine-f of this  act  shall
23  apply  to  marketing  contracts entered into after the effective date of
24  this act; and provided, further that the amendments to section 364-j  of
25  the social services law made by section ten of this act shall not affect
26  the repeal of such section and shall be deemed repealed therewith.
27                                   PART C
29    §  2.  Section 365-l of the social services law is amended by adding a
30  new subdivision 2-d to read as follows:
31    2-d. The commissioner shall establish reasonable  targets  for  health
32  home  participation  by  enrollees  of  special needs managed care plans
33  designated pursuant to subdivision four of section three hundred  sixty-
34  five-m  of  this  title  and  by  high-risk  enrollees of other Medicaid
35  managed care plans operating pursuant to section  three  hundred  sixty-
36  four-j  of this title, and shall encourage both the managed care provid-
37  ers and the health homes to work  collaboratively  with  each  other  to
38  achieve  such  targets. The commissioner may assess penalties under this
39  subdivision in instances of failure to meet  the  participation  targets
40  established  pursuant  to  this  subdivision,  where  the department has
41  determined that such failure reflected the absence of a good  faith  and
42  reasonable  effort  to  achieve  the  participation targets, except that
43  managed care providers shall not be  penalized  for  the  failure  of  a
44  health  home  to  work  collaboratively toward meeting the participation
45  targets and a health home shall not be penalized for the  failure  of  a
46  managed care provider to work collaboratively toward meeting the partic-
47  ipation targets.
48    §  3.  Subdivision  6  of  section  2899  of the public health law, as
49  amended by chapter 471 of the laws  of  2016,  is  amended  to  read  as
51    6.  "Provider"  shall  mean:  (a) any residential health care facility
52  licensed under article twenty-eight of this chapter;  or  any  certified
53  home health agency, licensed home care services agency or long term home
54  health  care program certified under article thirty-six of this chapter;
1  any hospice program certified pursuant to article forty of this chapter;
2  or any adult home, enriched housing  program  or  residence  for  adults
3  licensed under article seven of the social services law; or (b) a health
4  home, or any subcontractor of such health home, who contracts with or is
5  approved  or  otherwise  authorized  by the department to provide health
6  home services to all those enrolled pursuant to a diagnosis of a  devel-
7  opmental disability as defined in subdivision twenty-two of section 1.03
8  of  the  mental hygiene law and enrollees who are under twenty-one years
9  of age under section three hundred sixty-five-l of the  social  services
10  law,  or  any  entity that provides home and community based services to
11  enrollees who are under twenty-one years of age  under  a  demonstration
12  program pursuant to section eleven hundred fifteen of the federal social
13  security act.
14    §  3-a.  Subdivision  7 of section 2899-a of the public health law, as
15  amended by chapter 88 of the  laws  of  2016,  is  amended  to  read  as
17    7.  The  department promptly shall make all determinations and actions
18  required by subdivision five of section eight  hundred  forty-five-b  of
19  the  executive  law upon receipt of the information from the division of
20  criminal justice services  and  the  federal  bureau  of  investigation,
21  provided  that  when  rendering  a  determination  to  propose denial of
22  employment eligibility, the department shall provide the individual  who
23  is  the subject of the criminal history information check with a copy of
24  such criminal history information and a copy of  article  twenty-three-A
25  of  the correction law and inform such individual of his or her right to
26  seek correction of any incorrect information contained in such  criminal
27  history  information  pursuant  to the regulations and procedures estab-
28  lished by the division of  criminal  justice  services.  The  department
29  shall  create  a  permanent record, update the information in accordance
30  with section eight hundred forty-five-b of the executive  law  and  make
31  only  records  or  information  received  from  the division of criminal
32  justice services available to providers pursuant to this section.
33    § 4. Paragraph (b) of subdivision 9 of section 2899-a  of  the  public
34  health  law,  as added by chapter 331 of the laws of 2006, is amended to
36    (b) Residential health care facilities licensed  pursuant  to  article
37  twenty-eight of this chapter and certified home health care agencies and
38  long-term  home  health  care programs certified or approved pursuant to
39  article thirty-six of this chapter or a health home, or any  subcontrac-
40  tor  of such health home, who contracts with or is approved or otherwise
41  authorized by the department to provide  health  home  services  to  all
42  those  enrolled pursuant to a diagnosis of a developmental disability as
43  defined in subdivision twenty-two of section 1.03 of the mental  hygiene
44  law  and  enrollees  who are under twenty-one years of age under section
45  three hundred sixty-five-l of the social services  law,  or  any  entity
46  that  provides  home  and  community based services to enrollees who are
47  under twenty-one years of age under a demonstration program pursuant  to
48  section  eleven hundred fifteen of the federal social security act, may,
49  subject to the availability of federal financial participation, claim as
50  reimbursable costs under the medical assistance program, costs  reflect-
51  ing  the  fee  established  pursuant  to law by the division of criminal
52  justice services for processing a criminal  history  information  check,
53  the  fee  imposed  by the federal bureau of investigation for a national
54  criminal history check, and costs associated with obtaining the  finger-
55  prints, provided, however, that for the purposes of determining rates of
56  payment pursuant to article twenty-eight of this chapter for residential
1  health  care  facilities,  such  reimbursable  fees  and  costs shall be
2  reflected as timely as practicable in such rates within  the  applicable
3  rate period.
4    §  5.  Subdivision  10  of section 2899-a of the public health law, as
5  amended by chapter 206 of the laws  of  2017,  is  amended  to  read  as
6  follows:
7    10.  Notwithstanding  subdivision  eleven  of  section  eight  hundred
8  forty-five-b of the executive  law,  a  certified  home  health  agency,
9  licensed home care services agency or long term home health care program
10  certified, licensed or approved under article thirty-six of this chapter
11  or  a  home  care services agency exempt from certification or licensure
12  under article thirty-six of this chapter, a hospice program under  arti-
13  cle forty of this chapter, or an adult home, enriched housing program or
14  residence for adults licensed under article seven of the social services
15  law,  or  a  health  home, or any subcontractor of such health home, who
16  contracts with or is approved or otherwise authorized by the  department
17  to  provide health home services to all enrollees enrolled pursuant to a
18  diagnosis of a developmental disability as defined in subdivision  twen-
19  ty-two  of  section 1.03 of the mental hygiene law and enrollees who are
20  under twenty-one years of age under section three  hundred  sixty-five-l
21  of  the social services law, or any entity that provides home and commu-
22  nity based services to enrollees who are under twenty-one years  of  age
23  under a demonstration program pursuant to section eleven hundred fifteen
24  of the federal social security act may temporarily approve a prospective
25  employee while the results of the criminal history information check and
26  the  determination  are  pending,  upon  the condition that the provider
27  conducts appropriate direct observation and evaluation of the  temporary
28  employee,  while he or she is temporarily employed, and the care recipi-
29  ent; provided, however, that for a health home, or any subcontractor  of
30  a health home, who contracts with or is approved or otherwise authorized
31  by  the  department  to  provide  health  home services to all enrollees
32  enrolled pursuant to a diagnosis of developmental disability as  defined
33  in  subdivision twenty-two of section 1.03 of the mental hygiene law and
34  enrollees who are under twenty-one years  of  age  under  section  three
35  hundred  sixty-five-l  of  the  social  services law, or any entity that
36  provides home and community based services to enrollees  who  are  under
37  twenty-one  years  of  age  under  a  demonstration  program pursuant to
38  section eleven hundred fifteen  of  the  federal  social  security  act,
39  direct  observation  and  evaluation of temporary employees shall not be
40  required until April first, two thousand nineteen.  The results of  such
41  observations  shall  be documented in the temporary employee's personnel
42  file and shall be maintained. For purposes of providing such appropriate
43  direct observation and evaluation, the provider shall utilize  an  indi-
44  vidual employed by such provider with a minimum of one year's experience
45  working in an agency certified, licensed or approved under article thir-
46  ty-six  of  this  chapter  or an adult home, enriched housing program or
48  law, a health home, or  any  subcontractor  of  such  health  home,  who
49  contracts  with or is approved or otherwise authorized by the department
50  to provide health home services to those enrolled pursuant to a  diagno-
51  sis  of  a developmental disability as defined in subdivision twenty-two
52  of section 1.03 of the mental hygiene law and enrollees  who  are  under
53  twenty-one  years of age under section three hundred sixty-five-l of the
54  social services law, or any entity  that  provides  home  and  community
55  based  services to enrollees who are under twenty-one years of age under
56  a demonstration program pursuant to section eleven  hundred  fifteen  of
1  the  federal  social  security act. If the temporary employee is working
2  under contract with another provider  certified,  licensed  or  approved
3  under  article  thirty-six  of  this  chapter,  such contract provider's
4  appropriate direct observation and evaluation of the temporary employee,
5  shall  be  considered sufficient for the purposes of complying with this
6  subdivision.
7    § 6. Subdivision 3 of section 424-a of the  social  services  law,  as
8  amended  by  section  3  of part Q of chapter 56 of the laws of 2017, is
9  amended to read as follows:
10    3. For purposes of this section,  the  term  "provider"  or  "provider
11  agency"  shall  mean:  an  authorized agency; the office of children and
12  family services; juvenile detention facilities subject  to  the  certif-
13  ication  of  the office of children and family services; programs estab-
14  lished pursuant to article nineteen-H of the executive law; non-residen-
15  tial or residential programs or facilities licensed or operated  by  the
16  office  of  mental  health  or  the office for people with developmental
17  disabilities except family care homes; licensed child day care  centers,
18  including  head  start  programs which are funded pursuant to title V of
19  the federal economic opportunity act of nineteen hundred sixty-four,  as
20  amended;  early  intervention  service  established  pursuant to section
21  twenty-five hundred forty of the public health law;  preschool  services
22  established  pursuant to section forty-four hundred ten of the education
23  law; school-age child care programs; special  act  school  districts  as
24  enumerated  in  chapter  five  hundred sixty-six of the laws of nineteen
25  hundred sixty-seven, as amended; programs and facilities licensed by the
26  office of alcoholism and substance abuse services;  residential  schools
27  which  are operated, supervised or approved by the education department;
28  health homes, or any subcontractor of such health homes,  who  contracts
29  with  or is approved or otherwise authorized by the department of health
30  to provide health home services to all  those  enrolled  pursuant  to  a
31  diagnosis  of a developmental disability as defined in subdivision twen-
32  ty-two of section 1.03 of the mental hygiene law and enrollees  who  are
33  under  twenty-one  years of age under section three hundred sixty-five-l
34  of this chapter, or any entity that provides home  and  community  based
35  services  to  enrollees  who  are  under twenty-one years of age under a
36  demonstration program pursuant to section eleven hundred fifteen of  the
37  federal  social  security  act;  publicly-funded  emergency shelters for
38  families with children, provided, however, for purposes of this section,
39  when the provider or provider  agency  is  a  publicly-funded  emergency
40  shelter  for families with children, then all references in this section
41  to the "potential for regular and substantial contact  with  individuals
42  who  are  cared  for by the agency" shall mean the potential for regular
43  and substantial contact with children who are served  by  such  shelter;
44  and  any  other  facility  or provider agency, as defined in subdivision
45  four of section four hundred eighty-eight of this chapter, in regard  to
46  the  employment  of staff, or use of providers of goods and services and
47  staff of such providers, consultants, interns and volunteers.
48    § 7. Paragraph (a) of subdivision 1  of  section  413  of  the  social
49  services  law,  as  amended  by section 2 of part Q of chapter 56 of the
51    (a) The following persons and officials  are  required  to  report  or
52  cause  a  report to be made in accordance with this title when they have
53  reasonable cause to suspect that a child coming  before  them  in  their
54  professional  or  official capacity is an abused or maltreated child, or
55  when they have reasonable cause to suspect that a child is an abused  or
56  maltreated  child  where the parent, guardian, custodian or other person
1  legally responsible for such child comes before them  in  their  profes-
2  sional  or  official  capacity and states from personal knowledge facts,
3  conditions or circumstances which, if correct, would render the child an
4  abused  or maltreated child: any physician; registered physician assist-
5  ant; surgeon; medical  examiner;  coroner;  dentist;  dental  hygienist;
6  osteopath;  optometrist;  chiropractor;  podiatrist;  resident;  intern;
7  psychologist; registered nurse; social worker; emergency medical techni-
8  cian; licensed creative arts therapist;  licensed  marriage  and  family
9  therapist;  licensed  mental  health  counselor; licensed psychoanalyst;
10  licensed behavior analyst; certified behavior analyst assistant;  hospi-
11  tal  personnel  engaged in the admission, examination, care or treatment
12  of persons; a Christian Science  practitioner;  school  official,  which
13  includes  but  is not limited to school teacher, school guidance counse-
14  lor, school psychologist, school social  worker,  school  nurse,  school
15  administrator  or  other school personnel required to hold a teaching or
16  administrative license or certificate;  full  or  part-time  compensated
17  school employee required to hold a temporary coaching license or profes-
18  sional coaching certificate; social services worker; employee of a publ-
19  icly-funded  emergency shelter for families with children; director of a
20  children's overnight camp, summer day camp or traveling summer day camp,
21  as such camps are defined in section thirteen hundred ninety-two of  the
22  public health law; day care center worker; school-age child care worker;
23  provider  of family or group family day care; employee or volunteer in a
24  residential care facility for children that is  licensed,  certified  or
25  operated  by  the  office  of children and family services; or any other
26  child care or foster care worker; mental health professional;  substance
27  abuse  counselor;  alcoholism counselor; all persons credentialed by the
28  office of alcoholism and substance abuse services;  employees,  who  are
29  expected  to  have  regular  and substantial contact with children, of a
30  health home or health home care management  agency  contracting  with  a
31  health  home  as  designated  by the department of health and authorized
32  under section three hundred sixty-five-l of this chapter or such employ-
33  ees who provide home and community based services under a  demonstration
35  security  act  who  are expected to have regular and substantial contact
36  with children; peace  officer;  police  officer;  district  attorney  or
37  assistant  district  attorney;  investigator employed in the office of a
38  district attorney; or other law enforcement official.
39    § 8. Notwithstanding any inconsistent provision of  sections  112  and
40  163  of  the  state finance law, or sections 142 and 143 of the economic
41  development law, or any other contrary provision of law,  excepting  the
42  13  responsible vendor requirements of the state finance law, including,
43  but not limited to, sections 163 and 139-k of the state finance law, the
44  commissioner of health is authorized to amend or  otherwise  extend  the
45  terms of a contract awarded prior to the effective date and entered into
46  pursuant  to  subdivision 24 of section 206 of the public health law, as
47  added by section 39 of part C of chapter 58 of the laws of 2008,  and  a
48  contract awarded prior to the effective date and entered into to conduct
49  enrollment broker and conflict-free evaluation services for the Medicaid
50  program,  both for a period of three years, without a competitive bid or
51  request for proposal  process,  upon  determination  that  the  existing
52  contractor  is  qualified  to  continue  to  provide  such services, and
53  provided that efficiency savings  are  achieved  during  the  period  of
54  extension;  and  provided,  further, that the department of health shall
55  submit a request for applications for  such  contract  during  the  time
56  period  specified in this section and may terminate the contract identi-
1  fied herein prior to expiration of  the  extension  authorized  by  this
2  section.
4  the amendments to subdivision 6 of section 2899 of the public health law
5  made by section three of this act shall take effect on the same date and
6  in the same manner as section 8 of chapter 471 of the laws of  2016,  as
7  amended, takes effect and shall not affect the expiration of such subdi-
8  vision  and  shall be deemed to expire therewith; provided, further that
9  section three-a of this act shall take effect on the one hundred  eight-
10  ieth day after it shall have become a law.
11                                   PART D
12    Section  1.  Paragraph  (d)  of  subdivision 9 of section 367-a of the
13  social services law, as amended by section 7 of part D of chapter 57  of
14  the laws of 2017, is amended to read as follows:
15    (d)  In addition to the amounts paid pursuant to paragraph (b) of this
16  subdivision, the department shall pay a professional pharmacy dispensing
17  fee for each such drug dispensed in the amount of ten dollars and  eight
18  cents  per  prescription  or  written order of a practitioner; provided,
19  however that this professional dispensing fee will not  apply  to  drugs
20  that  are available without a prescription as required by section sixty-
21  eight hundred ten of the education law but do not meet the definition of
22  a covered outpatient drug pursuant to Section 1927K of the Social  Secu-
23  rity Act.
29    §  7.  Subdivision  4  of  section 365-a of the social services law is
31    (h) opioids prescribed in violation of the treatment plan standards of
32  subdivision eight of section  thirty-three  hundred  thirty-one  of  the
33  public  health  law or treatment plan standards as otherwise required by
34  the commissioner.
35    § 7-a. Section 3331 of the public health law is amended  by  adding  a
36  new subdivision 8 to read as follows:
37    8.  No  opioids  shall  be prescribed to a patient initiating or being
38  maintained on opioid treatment for pain which has lasted more than three
39  months or past the time of normal tissue  healing,  unless  the  medical
40  record contains a written treatment plan that follows generally accepted
41  national  professional  or  governmental guidelines. The requirements of
42  this paragraph shall not apply in the case of  patients  who  are  being
43  treated for cancer that is not in remission, who are in hospice or other
44  end-of-life  care,  or whose pain is being treated as part of palliative
45  care practices.
46    § 8. Section 280 of the public health law, as added by  section  1  of
47  part D of chapter 57 of the laws of 2017, is amended to read as follows:
48    § 280. Medicaid drug cap. 1. The legislature hereby finds and declares
49  that  there is a significant public interest for the Medicaid program to
50  manage drug costs in a manner that ensures patient access while  provid-
51  ing  financial  stability  for  the  state  and participating providers.
52  Since two thousand eleven, the state  has  taken  significant  steps  to
53  contain  costs  in the Medicaid program by imposing a statutory limit on
54  annual growth. Drug expenditures,  however,  continually  outpace  other
1  cost  components  causing  significant pressure on the state, providers,
2  and patient access operating under the Medicaid global cap. It is there-
3  fore intended that the department establish a Medicaid  drug  cap  as  a
4  separate  component  within the Medicaid global cap as part of a focused
5  and sustained effort to balance the growth of drug expenditures with the
6  growth of total Medicaid expenditures.
7    2. The commissioner shall establish  a  year  to  year  department  of
8  health  [state-funds]  state  funds Medicaid drug [spending] expenditure
9  growth target as follows:
10    (a) for state fiscal year two thousand seventeen--two  thousand  eigh-
11  teen,  be  limited to the ten-year rolling average of the medical compo-
12  nent of the consumer price index plus five percent and minus a  pharmacy
13  savings target of fifty-five million dollars; and
14    (b)  for  state  fiscal year two thousand eighteen--two thousand nine-
15  teen, be limited to the ten-year rolling average of the  medical  compo-
16  nent  of the consumer price index plus four percent and minus a pharmacy
17  savings target of eighty-five million dollars[.]; and
18    (c) for state fiscal year two thousand nineteen--two thousand  twenty,
19  be  limited  to the ten-year rolling average of the medical component of
20  the consumer price index plus four percent and minus a pharmacy  savings
21  target of eighty-five million dollars.
22    3.  The  department  and  the division of the budget shall assess on a
23  quarterly basis the projected total amount to be expended in the year on
24  a cash basis by the Medicaid program for each drug,  and  the  projected
25  annual  amount of state funds Medicaid drug expenditures on a cash basis
26  for all drugs, which shall be a component of the projected department of
27  health state funds Medicaid  expenditures  calculated  for  purposes  of
28  sections  ninety-one  and  ninety-two of part H of chapter fifty-nine of
29  the laws of two thousand eleven. For purposes  of  this  section,  state
30  funds  Medicaid  drug expenditures include amounts expended for drugs in
31  both the Medicaid fee-for-service  program  and  Medicaid  managed  care
32  programs,  minus  the  amount  of  any drug rebates or supplemental drug
33  rebates received by the department, including rebates pursuant to subdi-
34  vision five of this section with respect to rebate targets.  The depart-
35  ment and the division of the budget shall report quarterly to  the  drug
36  utilization review board the projected state funds Medicaid drug expend-
37  itures  including the amounts, in aggregate thereof, attributable to the
38  net cost of: changes in the utilization of drugs by Medicaid recipients;
39  changes in the number of Medicaid recipients; changes  to  the  cost  of
40  brand  name drugs and changes to the cost of generic drugs. The informa-
41  tion contained in the report shall not be publicly released in a  manner
42  that allows for the identification of an individual drug or manufacturer
43  or  that  is likely to compromise the financial competitive, or proprie-
44  tary nature of the information.
45    (a) In the event the director of the budget determines, based on Medi-
46  caid drug expenditures for the previous quarter or other relevant infor-
47  mation, that the total department of health state  funds  Medicaid  drug
48  expenditure  is projected to exceed the annual growth limitation imposed
49  by subdivision two of this section, the commissioner  may  identify  and
50  refer  drugs to the drug utilization review board established by section
51  three hundred sixty-nine-bb of the social services law for a recommenda-
52  tion as to whether a target supplemental Medicaid rebate should be  paid
53  by  the manufacturer of the drug to the department and the target amount
54  of the rebate.
55    (b) If the department intends to refer a drug to the drug  utilization
56  review  board pursuant to paragraph (a) of this subdivision, the depart-
1  ment shall notify the manufacturer of such drug  and  shall  attempt  to
2  reach  agreement with the manufacturer on a rebate for the drug prior to
3  referring the drug to the drug utilization review board for review.
4    (c)  In  the  event  that  the  commissioner and the manufacturer have
5  previously agreed to a supplemental rebate for a drug pursuant to  para-
6  graph  (b)  of this subdivision or paragraph (e) of subdivision seven of
7  section three hundred sixty-seven-a of the social services law, the drug
8  shall not be referred to the  drug  utilization  review  board  for  any
9  further  supplemental  rebate  for  the  duration of the previous rebate
10  agreement.
11    (d) The department shall consider a drug's actual cost to  the  state,
12  including  current rebate amounts, prior to seeking an additional rebate
13  pursuant to paragraph (b) or (c) of this subdivision and shall take into
14  consideration whether the manufacturer of the drug is providing  signif-
15  icant discounts relative to other drugs covered by the Medicaid program.
16    (e) The commissioner shall be authorized to take the actions described
17  in  this  section  only  so long as total Medicaid drug expenditures are
18  projected to exceed the annual growth limitation imposed by  subdivision
19  two of this section.
20    4.  In  determining  whether to recommend a target supplemental rebate
21  for a drug, the drug utilization review board shall consider the  actual
22  cost  of  the  drug to the Medicaid program, including federal and state
23  rebates, and may consider, among other things:
24    (a) the drug's impact on the Medicaid drug spending growth target  and
25  the  adequacy of capitation rates of participating Medicaid managed care
26  plans, and the drug's affordability and value to the  Medicaid  program;
27  or
28    (b) significant and unjustified increases in the price of the drug; or
29    (c) whether the drug may be priced disproportionately to its therapeu-
30  tic benefits.
31    5. (a) If the drug utilization review board recommends a target rebate
32  amount  on  a  drug referred by the commissioner, the commissioner shall
33  require a supplemental rebate to be paid by the drug's  manufacturer  in
34  an  amount  not  to  exceed such target rebate amount. With respect to a
35  rebate required in state fiscal year two thousand  seventeen--two  thou-
36  sand  eighteen,  the  rebate  requirement shall apply beginning with the
37  month of April, two thousand seventeen, without regard to the  date  the
38  department enters into the rebate agreement with the manufacturer.
39    (b) The supplemental rebate required by paragraph (a) of this subdivi-
40  sion shall apply to drugs dispensed to enrollees of managed care provid-
41  ers  pursuant  to  section  three  hundred  sixty-four-j  of  the social
42  services law and to drugs dispensed to Medicaid recipients who  are  not
43  enrollees of such providers.
44    (c)  If  the  drug utilization review board recommends a target rebate
45  amount for a drug and the department is unable  to  negotiate  a  rebate
46  from the manufacturer in an amount that is at least seventy-five percent
47  of the target rebate amount, the commissioner is authorized to waive the
48  provisions  of paragraph (b) of subdivision three of section two hundred
49  seventy-three of this article and the provisions of  subdivisions  twen-
50  ty-five  and  twenty-five-a of section three hundred sixty-four-j of the
51  social services law with respect to  such  drug;  however,  this  waiver
52  shall  not be implemented in situations where it would prevent access by
53  a Medicaid recipient to a drug which is the only treatment for a partic-
54  ular disease or condition. Under no circumstances shall the commissioner
55  be authorized to waive such provisions with respect  to  more  than  two
56  drugs in a given time.
1    (d) Where the department and a manufacturer enter into a rebate agree-
2  ment  pursuant  to  this  section,  which may be in addition to existing
3  rebate agreements entered into by the manufacturer with respect  to  the
4  same  drug,  no  additional  rebates shall be required to be paid by the
5  manufacturer to a managed care provider or any of a managed care provid-
6  er's  agents, including but not limited to any pharmacy benefit manager,
7  while the department is collecting the rebate pursuant to this section.
8    (e) In formulating a recommendation concerning a target rebate  amount
9  for a drug, the drug utilization review board may consider:
10    (i)  publicly  available  information  relevant  to the pricing of the
11  drug;
12    (ii) information supplied by the department relevant to the pricing of
13  the drug;
14    (iii) information relating to value-based pricing;
15    (iv) the seriousness and prevalence of the disease or  condition  that
16  is treated by the drug;
17    (v) the extent of utilization of the drug;
18    (vi)  the  effectiveness  of  the  drug in treating the conditions for
19  which it is prescribed, or in improving a patient's health,  quality  of
20  life, or overall health outcomes;
21    (vii)  the  likelihood  that  use of the drug will reduce the need for
22  other medical care, including hospitalization;
23    (viii) the average wholesale price, wholesale acquisition cost, retail
24  price of the drug, and the cost of the  drug  to  the  Medicaid  program
25  minus rebates received by the state;
26    (ix)  in  the  case  of  generic  drugs,  the number of pharmaceutical
27  manufacturers that produce the drug;
28    (x) whether there are pharmaceutical equivalents to the drug; and
29    (xi) information supplied by the manufacturer, if any, explaining  the
30  relationship between the pricing of the drug and the cost of development
31  of  the  drug  and/or  the  therapeutic  benefit of the drug, or that is
32  otherwise pertinent to the manufacturer's  pricing  decision;  any  such
33  information  provided  shall be considered confidential and shall not be
34  disclosed by the drug utilization review board in a form that identifies
35  a specific manufacturer or prices charged for drugs by such  manufactur-
36  er.
38  amount  and  the  department  is  unsuccessful in entering into a rebate
39  agreement with the manufacturer of the drug satisfactory to the  depart-
40  ment,  the  drug manufacturer shall in that event be required to provide
41  to the department, on a standard reporting form developed by the depart-
42  ment, the following information:
43    (i) the actual cost of developing, manufacturing, producing (including
44  the cost per dose of production), and distributing the drug;
45    (ii) research and development costs of the drug, including payments to
46  predecessor  entities  conducting  research  and  development,  such  as
47  biotechnology  companies,  universities and medical schools, and private
48  research institutions;
49    (iii) administrative, marketing, and advertising costs for  the  drug,
50  apportioned  by  marketing  activities  that  are directed to consumers,
51  marketing activities that are directed to  prescribers,  and  the  total
52  cost  of  all  marketing  and  advertising that is directed primarily to
53  consumers and prescribers in New York,  including  but  not  limited  to
54  prescriber detailing, copayment discount programs, and direct-to-consum-
55  er marketing;
56    (iv) the extent of utilization of the drug;
1    (v)  prices  for  the  drug that are charged to purchasers outside the
2  United States;
3    (vi)  prices charged to typical purchasers in the state, including but
4  not limited to pharmacies, pharmacy  chains,  pharmacy  wholesalers,  or
5  other direct purchasers;
6    (vii) the average rebates and discounts provided per payer type in the
7  State; and
8    (viii) the average profit margin of each drug over the prior five-year
9  period and the projected profit margin anticipated for such drug.
10    (b) All information disclosed pursuant to paragraph (a) of this subdi-
11  vision  shall  be  considered confidential and shall not be disclosed by
12  the department in a form that  identifies  a  specific  manufacturer  or
13  prices charged for drugs by such manufacturer.
14    7.  (a)  If,  after  taking  into account all rebates and supplemental
15  rebates received by the department, including rebates received  to  date
16  pursuant  to  this  section,  total Medicaid drug expenditures are still
18  two of this section, the commissioner [of health] may: [subject drugs to
19  prior  approval  in  accordance  with existing processes and procedures,
20  which may include all drugs of a manufacturer that has not entered  into
21  a  supplemental  rebate agreement required by this section;] subject any
22  drug of a manufacturer referred to the  drug  utilization  review  board
23  under  this  section to prior approval in accordance with existing proc-
24  esses and procedures when such  manufacturer  has  not  entered  into  a
25  supplemental  rebate  agreement  as  required by this section; directing
26  managed care plans to remove from their Medicaid formularies those drugs
27  [with respect to which a] that the drug utilization review board  recom-
28  mends  a  target  rebate  amount  for and the manufacturer has failed to
29  enter into a rebate agreement required by this  section;  promoting  the
30  use  of cost effective and clinically appropriate drugs other than those
31  of a manufacturer who has a drug that the drug utilization review  board
32  recommends  a  target  rebate  amount and the manufacturer has failed to
33  enter into  a  rebate  agreement  required  by  this  section;  allowing
34  manufacturers  to  accelerate  rebate  payments  under  existing  rebate
35  contracts; and such other actions as authorized by law. The commissioner
36  shall provide written notice to the legislature  thirty  days  prior  to
37  taking  action pursuant to this paragraph, unless action is necessary in
38  the fourth quarter of a fiscal  year  to  prevent  total  Medicaid  drug
39  expenditures from exceeding the limitation imposed by subdivision two of
40  this  section,  in which case such notice to the legislature may be less
41  than thirty days.
42    (b) The commissioner shall be authorized to take the actions described
43  in paragraph (a) of this subdivision only so long as total Medicaid drug
44  expenditures are  projected  to  exceed  the  annual  growth  limitation
45  imposed by subdivision two of this section. In addition, no such actions
46  shall be deemed to supersede the provisions of paragraph (b) of subdivi-
47  sion  three  of section two hundred seventy-three of this article or the
48  provisions of subdivisions  twenty-five  and  twenty-five-a  of  section
49  three hundred sixty-four-j of the social services law, except as allowed
50  by  paragraph  (c) of subdivision five of this section; provided further
51  that nothing in this section shall prevent access by a Medicaid  recipi-
52  ent  to  a  drug which is the only treatment for a particular disease or
53  condition.
54    8. The commissioner shall report by February  first  annually  to  the
55  drug  utilization  review board on savings achieved through the drug cap
56  in the last year. Such report shall provide data on  what  savings  were
1  achieved  through actions pursuant to subdivisions three, five and seven
2  of this section, respectively, and what savings  were  achieved  through
3  other means and how such savings were calculated and implemented.
4    §  9.  This  act  shall take effect immediately and shall be deemed to
5  have been in full force and effect on and after April 1, 2018; provided,
6  however, that the amendments  to  paragraph  (d)  of  subdivision  9  of
7  section 367-a of the social services law made by section one of this act
8  shall  not  affect the expiration or repeal of such provisions and shall
9  expire or be deemed repealed therewith.
10                                   PART E
11                            Intentionally Omitted
12                                   PART F
14                                   PART G
16                                   PART H
18                                   PART I
20                                   PART J
21    Section 1. Paragraph (h) of subdivision 1 of section 189 of the  state
22  finance law, as amended by section 8 of part A of chapter 56 of the laws
23  of 2013, is amended to read as follows:
24    (h) knowingly conceals or knowingly and improperly avoids or decreases
25  an  obligation  to  pay  or transmit money or property to the state or a
26  local government, or conspires to do the same; shall be  liable  to  the
27  state  or  a local government, as applicable, for a civil penalty of not
28  less than six  thousand  dollars  and  not  more  than  twelve  thousand
29  dollars,  as adjusted to be equal to the civil penalty allowed under the
30  federal False Claims Act, 31 U.S.C. sec. 3729, et seq., as  amended,  as
31  adjusted  for inflation by the Federal Civil Penalties Inflation Adjust-
32  ment Act of 1990, as amended (28 U.S.C. 2461 note; Pub. L. No. 101-410),
33  plus three times the amount  of  all  damages,  including  consequential
34  damages, which the state or local government sustains because of the act
35  of that person.
36    § 2. The state finance law is amended by adding a new section 190-b to
38    § 190-b. Medicaid fraud recovery reporting. The attorney general shall
39  make  an annual report to the temporary president of the senate, speaker
40  of the assembly, chair of the senate finance  committee,  chair  of  the
41  assembly ways and means committee, chair of the senate health committee,
42  and  chair  of  the assembly health committee by April fifteenth of each
43  year. Such report shall include the amount of monies  recovered  by  the
1  medicaid  fraud  control  unit  pursuant to the false claims act for the
2  preceding calendar year.
3    § 3. This act shall take effect September 30, 2018.
4                                   PART K
5    Section  1. Section 3612 of the public health law is amended by adding
6  a new subdivision 8 to read as follows:
7    8. (a) The commissioner may require a health  home  or  licensed  home
8  care  services agency to report on the costs incurred by the health home
9  or licensed home care services agency in rendering health care  services
10  to  Medicaid  beneficiaries.  The  department  of health may specify the
11  frequency and format of such reports, determine the type and  amount  of
12  information  to  be  submitted, and require the submission of supporting
13  documentation, provided, however, that the department shall  provide  no
14  less than ninety calendar days' notice before such reports are due.
15    (b)  If  the department determines that the cost report submitted by a
16  provider is inaccurate or incomplete, the department  shall  notify  the
17  provider  in  writing and advise the provider of the correction or addi-
18  tional information that the provider  must  submit.  The  provider  must
19  submit  the  corrected  or additional information within thirty calendar
20  days from the date the provider receives the notice.
21    (c) The department shall grant a provider an additional thirty  calen-
22  dar  days  to  submit  the original, corrected or additional cost report
23  when the provider, prior to the date the report is due, submits a  writ-
24  ten  request  to  the department for an extension and establishes to the
25  department's satisfaction that the provider cannot submit the report  by
26  the date due for reasons beyond the provider's control.
27    (d)  All reports shall be certified by the owner, administrator, chief
28  executive officer, or public official responsible for the  operation  of
29  the  provider.  The cost report form shall include a certification form,
30  which shall specify who must certify the report.
31    § 1-a. Subdivision 4-a of section 365-f of the social services law  is
32  amended by adding a new paragraph (i) to read as follows:
33    (i)  (i)  The commissioner may require a fiscal intermediary to report
34  on the direct care  and  administrative  costs  of  personal  assistance
35  services as accounted for by the fiscal intermediary. The department may
36  specify the frequency and format of such reports, determine the type and
37  amount  of  information  to  be submitted, and require the submission of
38  supporting documentation, provided, however, that the  department  shall
39  provide  no  less  than ninety calendar days' notice before such reports
40  are due.
41    (ii) If the department determines that the cost report submitted by  a
42  provider  is  inaccurate  or incomplete, the department shall notify the
43  provider in writing and advise the provider of the correction  or  addi-
44  tional  information  that  the  provider  must submit. The provider must
45  submit the corrected or additional information  within  thirty  calendar
47    (iii)  The  department  shall  grant  a  provider an additional thirty
48  calendar days to submit  the  original,  corrected  or  additional  cost
49  report when the provider, prior to the date the report is due, submits a
50  written  request  to  the department for an extension and establishes to
51  the department's satisfaction that the provider cannot submit the report
52  by the date due for reasons beyond the provider's control.
53    (iv) All reports shall be certified by the owner, administrator, chief
1  the  provider.  The cost report form shall include a certification form,
2  which shall specify who must certify the report.
3    §  2.  Subdivision 1 of section 92 of part H of chapter 59 of the laws
4  of 2011, amending the public health law and other laws relating to known
5  and projected department of health state fund medicaid expenditures,  as
6  amended  by  section  1  of part G of chapter 57 of the laws of 2017, is
8    1. For state fiscal  years  2011-12  through  [2018-19]  2019-20,  the
9  director  of the budget, in consultation with the commissioner of health
10  referenced as "commissioner" for purposes of this section, shall  assess
11  on a monthly basis, as reflected in monthly reports pursuant to subdivi-
12  sion five of this section known and projected department of health state
13  funds  medicaid  expenditures  by  category of service and by geographic
14  regions, as defined by the commissioner, and  if  the  director  of  the
15  budget  determines that such expenditures are expected to cause medicaid
16  disbursements for such period to  exceed  the  projected  department  of
17  health  medicaid  state funds disbursements in the enacted budget finan-
18  cial plan pursuant to subdivision 3 of section 23 of the  state  finance
19  law,  the  commissioner  of health, in consultation with the director of
20  the budget, shall develop a medicaid savings allocation  plan  to  limit
21  such  spending  to  the  aggregate  limit level specified in the enacted
22  budget financial  plan,  provided,  however,  such  projections  may  be
23  adjusted by the director of the budget to account for any changes in the
24  New  York state federal medical assistance percentage amount established
25  pursuant to the federal social security act, changes in provider  reven-
26  ues,  reductions  to  local  social services district medical assistance
27  administration, minimum wage increases, and beginning April 1, 2012  the
28  operational costs of the New York state medical indemnity fund and state
29  costs  or  savings  from the basic health plan.  Such projections may be
30  adjusted by the director of the budget to account for increased or expe-
31  dited department of health state funds medicaid expenditures as a result
32  of a natural or other type of disaster, including a governmental  decla-
33  ration of emergency.
34    §  3.  Section  2807-c of the public health law is amended by adding a
35  new subdivision 34 to read as follows:
36    34. Enhanced safety net hospital program. (a) For the purposes of this
37  subdivision, "enhanced safety net hospital" shall mean a hospital which:
38    (i) in any of the previous three calendar years, has met the following
39  criteria:
40    (A) not less than fifty percent of  the  patients  it  treats  receive
41  medicaid or are medically uninsured;
42    (B)  not  less  than  forty  percent  of  its inpatient discharges are
43  covered by medicaid;
44    (C) twenty-five percent or less of its discharged patients are commer-
45  cially insured;
46    (D) not less than three percent of the patients it  provides  services
47  to are attributed to the care of uninsured patients; and
48    (E)  provides care to uninsured patients in its emergency room, hospi-
49  tal based clinics and community based clinics, including  the  provision
50  of important community services, such as dental care and prenatal care;
51    (ii)  is  a public hospital operated by a county, municipality, public
52  benefit corporation or the state university of New York;
53    (iii) is federally designated as a critical access hospital; or
54    (iv) is federally designated as a sole community hospital.
55    (b) Within amounts appropriated, the commissioner shall adjust medical
56  assistance rates to enhanced safety net hospitals for  the  purposes  of
1  supporting  critically  needed  health  care  services and to ensure the
2  continued maintenance and operation of such hospitals.
3    (c)  Payments  made pursuant to this subdivision may be added to rates
4  of payment or made as aggregate payments to eligible general hospitals.
5    § 4. This act shall take effect immediately.
6                                   PART L
7                            Intentionally Omitted
8                                   PART M
9    Section 1.  Paragraph (a) of subdivision 1 of section  18  of  chapter
10  266  of  the laws of 1986, amending the civil practice law and rules and
11  other laws relating to malpractice and professional medical conduct,  as
12  amended  by  section  15 of part H of chapter 57 of the laws of 2017, is
14    (a) The superintendent of financial services and the  commissioner  of
15  health  or  their  designee  shall, from funds available in the hospital
16  excess liability pool created pursuant to subdivision 5 of this section,
17  purchase a policy or policies for excess insurance coverage, as  author-
18  ized  by  paragraph 1 of subsection (e) of section 5502 of the insurance
19  law; or from an insurer, other than an insurer described in section 5502
20  of the insurance law, duly authorized to write such coverage and actual-
21  ly writing  medical  malpractice  insurance  in  this  state;  or  shall
22  purchase equivalent excess coverage in a form previously approved by the
23  superintendent  of  financial  services for purposes of providing equiv-
24  alent excess coverage in accordance with section 19 of  chapter  294  of
25  the  laws of 1985, for medical or dental malpractice occurrences between
26  July 1, 1986 and June 30, 1987, between July 1, 1987 and June 30,  1988,
27  between  July  1,  1988 and June 30, 1989, between July 1, 1989 and June
28  30, 1990, between July 1, 1990 and June 30, 1991, between July  1,  1991
29  and  June 30, 1992, between July 1, 1992 and June 30, 1993, between July
30  1, 1993 and June 30, 1994, between July  1,  1994  and  June  30,  1995,
43  between  July  1, 2016 and June 30, 2017, [and] between July 1, 2017 and
44  June 30, 2018, and between July 1, 2018 and June 30, 2019  or  reimburse
45  the  hospital where the hospital purchases equivalent excess coverage as
46  defined in subparagraph (i) of paragraph (a) of subdivision 1-a of  this
47  section  for  medical  or dental malpractice occurrences between July 1,
48  1987 and June 30, 1988, between July 1, 1988 and June 30, 1989,  between
49  July  1, 1989 and June 30, 1990, between July 1, 1990 and June 30, 1991,
50  between July 1, 1991 and June 30, 1992, between July 1,  1992  and  June
51  30,  1993,  between July 1, 1993 and June 30, 1994, between July 1, 1994
52  and June 30, 1995, between July 1, 1995 and June 30, 1996, between  July
1  1,  1996  and  June  30,  1997,  between July 1, 1997 and June 30, 1998,
2  between July 1, 1998 and June 30, 1999, between July 1,  1999  and  June
3  30,  2000,  between July 1, 2000 and June 30, 2001, between July 1, 2001
4  and  June 30, 2002, between July 1, 2002 and June 30, 2003, between July
5  1, 2003 and June 30, 2004, between July  1,  2004  and  June  30,  2005,
6  between  July  1,  2005 and June 30, 2006, between July 1, 2006 and June
7  30, 2007, between July 1, 2007 and June 30, 2008, between July  1,  2008
12  and June 30, 2016, between July 1, 2016 and June 30, 2017, [and] between
13  July  1,  2017  and June 30, 2018, and between July 1, 2018 and June 30,
14  2019 for physicians or dentists certified  as  eligible  for  each  such
15  period or periods pursuant to subdivision 2 of this section by a general
16  hospital  licensed  pursuant  to  article  28  of the public health law;
17  provided that no single insurer shall write more than fifty  percent  of
18  the total excess premium for a given policy year; and provided, however,
19  that such eligible physicians or dentists must have in force an individ-
20  ual  policy,  from an insurer licensed in this state of primary malprac-
21  tice insurance coverage in amounts of no less  than  one  million  three
22  hundred  thousand  dollars  for  each  claimant  and  three million nine
23  hundred thousand dollars for all claimants under that policy during  the
24  period  of  such  excess coverage for such occurrences or be endorsed as
25  additional insureds under a hospital professional liability policy which
26  is  offered  through  a  voluntary  attending  physician  ("channeling")
27  program previously permitted by the superintendent of financial services
28  during  the  period of such excess coverage for such occurrences. During
29  such period, such policy for excess coverage or such  equivalent  excess
30  coverage  shall, when combined with the physician's or dentist's primary
31  malpractice insurance coverage or coverage provided through a  voluntary
32  attending  physician ("channeling") program, total an aggregate level of
33  two million three hundred thousand dollars for  each  claimant  and  six
34  million  nine  hundred  thousand dollars for all claimants from all such
35  policies with respect to occurrences in each  of  such  years  provided,
36  however, if the cost of primary malpractice insurance coverage in excess
37  of  one million dollars, but below the excess medical malpractice insur-
38  ance coverage provided pursuant to this act, exceeds the  rate  of  nine
39  percent per annum, then the required level of primary malpractice insur-
40  ance  coverage  in excess of one million dollars for each claimant shall
41  be in an amount of not less than the  dollar  amount  of  such  coverage
42  available at nine percent per annum; the required level of such coverage
43  for  all claimants under that policy shall be in an amount not less than
44  three times the dollar amount of coverage for each claimant; and  excess
45  coverage,  when  combined with such primary malpractice insurance cover-
46  age, shall increase the aggregate level for each claimant by one million
47  dollars and three  million  dollars  for  all  claimants;  and  provided
48  further,  that,  with respect to policies of primary medical malpractice
49  coverage that include occurrences between April 1,  2002  and  June  30,
50  2002,  such  requirement  that  coverage  be in amounts no less than one
51  million three hundred thousand  dollars  for  each  claimant  and  three
52  million  nine hundred thousand dollars for all claimants for such occur-
53  rences shall be effective April 1, 2002.
54    § 2. Subdivision 3 of section 18 of chapter 266 of the laws  of  1986,
55  amending  the  civil  practice  law and rules and other laws relating to
56  malpractice and professional medical conduct, as amended by  section  16
1  of  part  H  of  chapter  57  of the laws of 2017, is amended to read as
3    (3)(a)  The  superintendent  of financial services shall determine and
4  certify to each general hospital and to the commissioner of  health  the
5  cost  of  excess malpractice insurance for medical or dental malpractice
6  occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988
7  and June 30, 1989, between July 1, 1989 and June 30, 1990, between  July
12  1,  1997  and  June  30,  1998,  between July 1, 1998 and June 30, 1999,
20  1,  2011  and June 30, 2012, between July 1, 2012 and June 30, 2013, and
22  30,  2015,  between  July 1, 2015 and June 30, 2016, and between July 1,
23  2016 and June 30, 2017, [and] between July 1, 2017 and  June  30,  2018,
24  and  between  July  1,  2018 and June 30, 2019 allocable to each general
25  hospital for physicians or dentists certified as eligible  for  purchase
26  of  a  policy  for excess insurance coverage by such general hospital in
27  accordance with subdivision 2 of this section, and may amend such deter-
28  mination and certification as necessary.
29    (b) The superintendent  of  financial  services  shall  determine  and
30  certify  to  each general hospital and to the commissioner of health the
31  cost of excess malpractice insurance or equivalent excess  coverage  for
32  medical  or dental malpractice occurrences between July 1, 1987 and June
49  30, 2016, [and] between July 1, 2016 and June 30,  2017,  [and]  between
51  2019 allocable to each  general  hospital  for  physicians  or  dentists
52  certified  as  eligible  for  purchase  of a policy for excess insurance
53  coverage or equivalent excess  coverage  by  such  general  hospital  in
55  mination and certification as necessary. The superintendent of financial
56  services shall determine and certify to each general hospital and to the
1  commissioner  of  health the ratable share of such cost allocable to the
2  period July 1, 1987 to December 31, 1987, to the period January 1,  1988
3  to  June  30,  1988, to the period July 1, 1988 to December 31, 1988, to
4  the  period January 1, 1989 to June 30, 1989, to the period July 1, 1989
5  to December 31, 1989, to the period January 1, 1990 to June 30, 1990, to
6  the period July 1, 1990 to December 31, 1990, to the period  January  1,
7  1991  to June 30, 1991, to the period July 1, 1991 to December 31, 1991,
8  to the period January 1, 1992 to June 30, 1992, to the  period  July  1,
9  1992  to  December  31,  1992, to the period January 1, 1993 to June 30,
10  1993, to the period July 1, 1993 to December 31,  1993,  to  the  period
11  January 1, 1994 to June 30, 1994, to the period July 1, 1994 to December
12  31,  1994, to the period January 1, 1995 to June 30, 1995, to the period
13  July 1, 1995 to December 31, 1995, to the period January 1, 1996 to June
14  30, 1996, to the period July 1, 1996 to December 31, 1996, to the period
16  31, 1997, to the period January 1, 1998 to June 30, 1998, to the  period
21  July 1, 2001 to June 30, 2002, to the period July 1, 2002  to  June  30,
22  2003, to the period July 1, 2003 to June 30, 2004, to the period July 1,
23  2004  to June 30, 2005, to the period July 1, 2005 and June 30, 2006, to
24  the period July 1, 2006 and June 30, 2007, to the period  July  1,  2007
25  and  June 30, 2008, to the period July 1, 2008 and June 30, 2009, to the
26  period July 1, 2009 and June 30, 2010, to the period July  1,  2010  and
27  June  30,  2011,  to  the  period July 1, 2011 and June 30, 2012, to the
30  period July 1, 2015 and June 30, 2016, and between July 1, 2016 and June
31  30, 2017, and to the period July 1, 2017 [and] to June 30, 2018, and  to
32  the period July 1, 2018 to June 30, 2019.
33    § 3. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
34  18  of  chapter 266 of the laws of 1986, amending the civil practice law
35  and rules and  other  laws  relating  to  malpractice  and  professional
36  medical conduct, as amended by section 17 of part H of chapter 57 of the
37  laws of 2017, are amended to read as follows:
38    (a)  To  the  extent  funds available to the hospital excess liability
39  pool pursuant to subdivision 5 of this section as amended, and  pursuant
40  to  section  6  of part J of chapter 63 of the laws of 2001, as may from
41  time to time be amended, which amended this  subdivision,  are  insuffi-
42  cient  to  meet  the  costs  of  excess insurance coverage or equivalent
43  excess coverage for coverage periods during the period July 1,  1992  to
44  June  30,  1993, during the period July 1, 1993 to June 30, 1994, during
45  the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
46  to June 30, 1996, during the period July  1,  1996  to  June  30,  1997,
47  during  the period July 1, 1997 to June 30, 1998, during the period July
48  1, 1998 to June 30, 1999, during the period July 1,  1999  to  June  30,
49  2000, during the period July 1, 2000 to June 30, 2001, during the period
50  July  1,  2001  to  October 29, 2001, during the period April 1, 2002 to
51  June 30, 2002, during the period July 1, 2002 to June 30,  2003,  during
53  to  June  30,  2005,  during  the  period July 1, 2005 to June 30, 2006,
54  during the period July 1, 2006 to June 30, 2007, during the period  July
55  1,  2007  to  June  30, 2008, during the period July 1, 2008 to June 30,
1  July 1, 2010 to June 30, 2011, during the period July 1,  2011  to  June
2  30,  2012,  during  the period July 1, 2012 to June 30, 2013, during the
3  period July 1, 2013 to June 30, 2014, during the period July 1, 2014  to
4  June  30,  2015,  during the period July 1, 2015 [and] to June 30, 2016,
5  during the period July 1, 2016 [and] to June 30, 2017, [and] during  the
6  period  July  1, 2017 [and] to June 30, 2018, and during the period July
7  1, 2018 to June 30, 2019 allocated or  reallocated  in  accordance  with
8  paragraph  (a)  of  subdivision  4-a of this section to rates of payment
9  applicable to state governmental agencies, each physician or dentist for
10  whom a policy for excess insurance coverage or equivalent excess  cover-
11  age is purchased for such period shall be responsible for payment to the
12  provider  of  excess insurance coverage or equivalent excess coverage of
13  an allocable share of such insufficiency, based  on  the  ratio  of  the
14  total  cost  of such coverage for such physician to the sum of the total
15  cost of such coverage for all physicians applied to such insufficiency.
16    (b) Each provider of excess insurance coverage  or  equivalent  excess
17  coverage  covering the period July 1, 1992 to June 30, 1993, or covering
18  the period July 1, 1993 to June 30, 1994, or covering the period July 1,
19  1994 to June 30, 1995, or covering the period July 1, 1995 to  June  30,
20  1996,  or covering the period July 1, 1996 to June 30, 1997, or covering
24  the period July 1, 2001 to October 29,  2001,  or  covering  the  period
25  April  1,  2002 to June 30, 2002, or covering the period July 1, 2002 to
26  June 30, 2003, or covering the period July 1, 2003 to June 30, 2004,  or
27  covering the period July 1, 2004 to June 30, 2005, or covering the peri-
28  od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
29  June  30, 2007, or covering the period July 1, 2007 to June 30, 2008, or
38  June 30, 2019 shall notify a  covered  physician  or  dentist  by  mail,
39  mailed to the address shown on the last application for excess insurance
40  coverage  or  equivalent  excess  coverage,  of  the  amount due to such
41  provider from such physician or dentist for such coverage period  deter-
42  mined  in accordance with paragraph (a) of this subdivision. Such amount
43  shall be due from such physician or dentist to such provider  of  excess
44  insurance  coverage  or  equivalent excess coverage in a time and manner
45  determined by the superintendent of financial services.
46    (c) If a physician or dentist liable for payment of a portion  of  the
47  costs  of excess insurance coverage or equivalent excess coverage cover-
48  ing the period July 1, 1992 to June 30, 1993,  or  covering  the  period
49  July  1,  1993  to June 30, 1994, or covering the period July 1, 1994 to
55  od July 1, 2001 to October 29, 2001, or covering  the  period  April  1,
56  2002  to  June 30, 2002, or covering the period July 1, 2002 to June 30,
1  2003, or covering the period July 1, 2003 to June 30, 2004, or  covering
2  the period July 1, 2004 to June 30, 2005, or covering the period July 1,
3  2005  to  June 30, 2006, or covering the period July 1, 2006 to June 30,
4  2007,  or covering the period July 1, 2007 to June 30, 2008, or covering
6  2009 to June 30, 2010, or covering the period July 1, 2010 to  June  30,
13  2019  determined  in  accordance  with paragraph (a) of this subdivision
14  fails, refuses or neglects to make payment to  the  provider  of  excess
15  insurance coverage or equivalent excess coverage in such time and manner
16  as  determined  by  the superintendent of financial services pursuant to
17  paragraph (b) of this subdivision, excess insurance coverage  or  equiv-
18  alent excess coverage purchased for such physician or dentist in accord-
19  ance  with  this section for such coverage period shall be cancelled and
20  shall be null and void as of the first day on or after the  commencement
21  of  a  policy  period  where  the liability for payment pursuant to this
22  subdivision has not been met.
23    (d) Each provider of excess insurance coverage  or  equivalent  excess
24  coverage  shall  notify the superintendent of financial services and the
25  commissioner of health or their designee of each physician  and  dentist
26  eligible  for  purchase  of  a  policy  for excess insurance coverage or
27  equivalent excess coverage covering the period July 1, 1992 to June  30,
34  2001, or covering the period July 1, 2001 to October 29, 2001, or cover-
35  ing  the  period  April 1, 2002 to June 30, 2002, or covering the period
36  July 1, 2002 to June 30, 2003, or covering the period July  1,  2003  to
48  od  July 1, 2018 to June 30, 2019 that has made payment to such provider
49  of excess insurance coverage or equivalent excess coverage in accordance
50  with paragraph (b) of this subdivision and of each physician and dentist
51  who has failed, refused or neglected to make such payment.
52    (e) A provider of  excess  insurance  coverage  or  equivalent  excess
53  coverage  shall  refund to the hospital excess liability pool any amount
54  allocable to the period July 1, 1992 to June 30, 1993, and to the period
55  July 1, 1993 to June 30, 1994, and to the period July 1,  1994  to  June
56  30,  1995,  and  to the period July 1, 1995 to June 30, 1996, and to the
1  period July 1, 1996 to June 30, 1997, and to the period July 1, 1997  to
2  June  30,  1998, and to the period July 1, 1998 to June 30, 1999, and to
3  the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
4  to  June  30,  2001, and to the period July 1, 2001 to October 29, 2001,
5  and to the period April 1, 2002 to June 30, 2002, and to the period July
6  1, 2002 to June 30, 2003, and to the period July 1,  2003  to  June  30,
7  2004, and to the period July 1, 2004 to June 30, 2005, and to the period
8  July  1,  2005  to June 30, 2006, and to the period July 1, 2006 to June
9  30, 2007, and to the period July 1, 2007 to June 30, 2008,  and  to  the
10  period  July 1, 2008 to June 30, 2009, and to the period July 1, 2009 to
11  June 30, 2010, and to the period July 1, 2010 to June 30, 2011,  and  to
12  the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
13  to  June  30, 2013, and to the period July 1, 2013 to June 30, 2014, and
14  to the period July 1, 2014 to June 30, 2015, and to the period  July  1,
15  2015  to June 30, 2016, to the period July 1, 2016 to June 30, 2017, and
17  2018  to  June 30, 2019 received from the hospital excess liability pool
18  for purchase of excess insurance coverage or equivalent excess  coverage
19  covering  the  period  July  1,  1992 to June 30, 1993, and covering the
20  period July 1, 1993 to June 30, 1994, and covering the  period  July  1,
21  1994  to June 30, 1995, and covering the period July 1, 1995 to June 30,
22  1996, and covering the period July 1, 1996 to June 30, 1997, and  cover-
23  ing  the  period  July 1, 1997 to June 30, 1998, and covering the period
24  July 1, 1998 to June 30, 1999, and covering the period July 1,  1999  to
25  June  30,  2000,  and covering the period July 1, 2000 to June 30, 2001,
26  and covering the period July 1, 2001 to October 29, 2001,  and  covering
27  the  period April 1, 2002 to June 30, 2002, and covering the period July
28  1, 2002 to June 30, 2003, and covering the period July 1, 2003  to  June
29  30,  2004,  and  covering  the period July 1, 2004 to June 30, 2005, and
30  covering the period July 1, 2005 to June  30,  2006,  and  covering  the
31  period  July  1,  2006 to June 30, 2007, and covering the period July 1,
32  2007 to June 30, 2008, and covering the period July 1, 2008 to June  30,
33  2009,  and covering the period July 1, 2009 to June 30, 2010, and cover-
34  ing the period July 1, 2010 to June 30, 2011, and  covering  the  period
35  July  1,  2011 to June 30, 2012, and covering the period July 1, 2012 to
36  June 30, 2013, and covering the period July 1, 2013 to  June  30,  2014,
37  and  covering the period July 1, 2014 to June 30, 2015, and covering the
40  2018, and covering the period July 1, 2018 to June 30, 2019 for a physi-
41  cian or dentist where  such  excess  insurance  coverage  or  equivalent
42  excess  coverage  is  cancelled in accordance with paragraph (c) of this
43  subdivision.
44    § 4. Section 40 of chapter 266 of the laws of 1986, amending the civil
45  practice law and rules  and  other  laws  relating  to  malpractice  and
46  professional  medical  conduct,  as  amended  by section 18 of part H of
48    § 40. The superintendent of financial services shall  establish  rates
49  for  policies  providing  coverage  for  physicians and surgeons medical
50  malpractice for the periods commencing July 1, 1985 and ending June  30,
51  [2018] 2019; provided, however, that notwithstanding any other provision
52  of  law,  the superintendent shall not establish or approve any increase
53  in rates for the period commencing July 1,  2009  and  ending  June  30,
54  2010.  The  superintendent shall direct insurers to establish segregated
55  accounts for premiums, payments, reserves and investment income  attrib-
56  utable to such premium periods and shall require periodic reports by the
1  insurers  regarding  claims and expenses attributable to such periods to
2  monitor whether such accounts will be sufficient to meet incurred claims
3  and expenses. On or after July 1, 1989, the superintendent shall  impose
4  a  surcharge  on  premiums  to  satisfy  a  projected deficiency that is
5  attributable to the premium levels established pursuant to this  section
6  for  such  periods;  provided, however, that such annual surcharge shall
7  not exceed eight percent of the established rate until  July  1,  [2018]
8  2019, at which time and thereafter such surcharge shall not exceed twen-
9  ty-five  percent  of  the  approved  adequate rate, and that such annual
10  surcharges shall continue for such period of time as shall be sufficient
11  to satisfy such deficiency. The superintendent  shall  not  impose  such
12  surcharge  during the period commencing July 1, 2009 and ending June 30,
13  2010. On and after July  1,  1989,  the  surcharge  prescribed  by  this
14  section  shall  be  retained by insurers to the extent that they insured
15  physicians and surgeons during the July 1, 1985 through June 30,  [2018]
16  2019  policy  periods;  in  the  event  and to the extent physicians and
17  surgeons were insured by another insurer during such periods, all  or  a
18  pro  rata  share of the surcharge, as the case may be, shall be remitted
19  to such other insurer in accordance with rules  and  regulations  to  be
20  promulgated by the superintendent.  Surcharges collected from physicians
21  and  surgeons  who  were not insured during such policy periods shall be
22  apportioned among all insurers in proportion to the premium  written  by
23  each  insurer  during such policy periods; if a physician or surgeon was
24  insured by an insurer subject to rates established by the superintendent
25  during such policy periods, and  at  any  time  thereafter  a  hospital,
26  health  maintenance organization, employer or institution is responsible
27  for responding in damages for liability arising out of such  physician's
28  or  surgeon's  practice  of medicine, such responsible entity shall also
29  remit to such prior insurer the equivalent amount  that  would  then  be
30  collected  as  a  surcharge if the physician or surgeon had continued to
31  remain insured by such prior insurer. In  the  event  any  insurer  that
32  provided  coverage  during  such  policy  periods is in liquidation, the
33  property/casualty insurance security fund shall receive the  portion  of
34  surcharges to which the insurer in liquidation would have been entitled.
35  The surcharges authorized herein shall be deemed to be income earned for
36  the  purposes of section 2303 of the insurance law.  The superintendent,
37  in establishing adequate rates and in determining  any  projected  defi-
38  ciency  pursuant  to  the requirements of this section and the insurance
39  law, shall give substantial weight, determined  in  his  discretion  and
40  judgment,  to  the  prospective  anticipated  effect  of any regulations
41  promulgated and laws enacted and the  public  benefit  of    stabilizing
42  malpractice rates and minimizing rate level fluctuation during the peri-
43  od  of  time  necessary for the development of more reliable statistical
44  experience as to the efficacy of such  laws  and  regulations  affecting
45  medical, dental or podiatric malpractice enacted or promulgated in 1985,
46  1986,  by this act and at any other time.  Notwithstanding any provision
47  of the insurance law, rates already established and to be established by
48  the superintendent pursuant to this section are deemed adequate if  such
49  rates  would be adequate when taken together with the maximum authorized
50  annual surcharges to be imposed for a reasonable period of time  whether
51  or  not  any  such  annual surcharge has been actually imposed as of the
52  establishment of such rates.
53    § 5.  Section 5 and subdivisions (a) and (e) of section 6 of part J of
54  chapter 63 of the laws of 2001, amending chapter  266  of  the  laws  of
55  1986,  amending the civil practice law and rules and other laws relating
56  to malpractice and professional medical conduct, relating to the  effec-
1  tiveness of certain provisions of such chapter, as amended by section 19
2  of  part  H  of  chapter  57 of the laws of 2017, are amended to read as
4    §  5. The superintendent of financial services and the commissioner of
5  health shall determine, no later than June 15, 2002, June 15, 2003, June
6  15, 2004, June 15, 2005, June 15, 2006, June 15, 2007,  June  15,  2008,
7  June  15,  2009,  June  15, 2010, June 15, 2011, June 15, 2012, June 15,
8  2013, June 15, 2014, June 15, 2015, June 15, 2016, June 15, 2017,  [and]
9  June  15,  2018,  and June 15, 2019 the amount of funds available in the
10  hospital excess liability pool, created pursuant to section 18 of  chap-
11  ter  266  of the laws of 1986, and whether such funds are sufficient for
12  purposes of purchasing excess insurance coverage  for  eligible  partic-
13  ipating  physicians  and dentists during the period July 1, 2001 to June
14  30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003 to June  30,
15  2004,  or  July  1,  2004  to June 30, 2005, or July 1, 2005 to June 30,
16  2006, or July 1, 2006 to June 30, 2007, or July  1,  2007  to  June  30,
21  2016, or July 1, 2016 to June 30, 2017, or [to] July 1, 2017 to June 30,
22  2018, or July 1, 2018 to June 30, 2019 as applicable.
23    (a)  This section shall be effective only upon a determination, pursu-
24  ant to section five of this act,  by  the  superintendent  of  financial
25  services  and  the  commissioner  of health, and a certification of such
26  determination to the state director of the  budget,  the  chair  of  the
27  senate  committee  on finance and the chair of the assembly committee on
28  ways and means, that the amount of funds in the hospital excess  liabil-
29  ity  pool,  created pursuant to section 18 of chapter 266 of the laws of
30  1986, is insufficient for purposes of purchasing excess insurance cover-
31  age for eligible participating physicians and dentists during the period
32  July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July
33  1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or  July  1,
34  2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007
35  to  June  30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to
36  June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June
41    (e)  The  commissioner  of  health  shall  transfer for deposit to the
42  hospital excess liability pool created pursuant to section 18 of chapter
43  266 of the laws of 1986 such amounts as directed by  the  superintendent
44  of  financial  services  for  the purchase of excess liability insurance
45  coverage for eligible participating  physicians  and  dentists  for  the
46  policy  year  July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30,
49  2007, as applicable, and the cost of administering the  hospital  excess
50  liability pool for such applicable policy year,  pursuant to the program
51  established  in  chapter  266  of the laws of 1986, as amended, no later
52  than June 15, 2002, June 15, 2003, June 15, 2004, June  15,  2005,  June
53  15,  2006,  June  15, 2007, June 15, 2008, June 15, 2009, June 15, 2010,
54  June 15, 2011, June 15, 2012, June 15, 2013, June  15,  2014,  June  15,
55  2015,  June  15,  2016, June 15, 2017, [and] June 15, 2018, and June 15,
56  2019 as applicable.
1    § 6. Section 20 of part H of chapter 57 of the laws of 2017,  amending
2  the  New  York Health Care Reform Act of 1996 and other laws relating to
3  extending certain provisions thereto, is amended to read as follows:
4    §  20.  Notwithstanding  any  law, rule or regulation to the contrary,
5  only physicians or dentists who were eligible, and for whom  the  super-
6  intendent of financial services and the commissioner of health, or their
7  designee, purchased, with funds available in the hospital excess liabil-
8  ity  pool,  a  full  or partial policy for excess coverage or equivalent
9  excess coverage for the coverage period ending the  thirtieth  of  June,
10  two  thousand  [seventeen] eighteen, shall be eligible to apply for such
11  coverage for the coverage period beginning the first of July, two  thou-
12  sand  [seventeen]  eighteen;  provided,  however, if the total number of
13  physicians or dentists for  whom  such  excess  coverage  or  equivalent
14  excess  coverage  was purchased for the policy year ending the thirtieth
15  of June, two thousand [seventeen] eighteen exceeds the total  number  of
16  physicians  or  dentists  certified  as eligible for the coverage period
17  beginning the first of July, two thousand [seventeen] eighteen, then the
18  general hospitals may certify additional eligible physicians or dentists
19  in a number equal to such general hospital's proportional share  of  the
20  total  number  of  physicians  or  dentists  for whom excess coverage or
21  equivalent excess coverage was purchased with  funds  available  in  the
22  hospital excess liability pool as of the thirtieth of June, two thousand
23  [seventeen] eighteen, as applied to the difference between the number of
24  eligible physicians or dentists for whom a policy for excess coverage or
25  equivalent  excess coverage was purchased for the coverage period ending
26  the thirtieth of June, two thousand [seventeen] eighteen and the  number
27  of  such  eligible  physicians  or  dentists who have applied for excess
28  coverage or equivalent excess coverage for the coverage period beginning
29  the first of July, two thousand [seventeen] eighteen.
30    § 7. This act shall take effect immediately.
31                                   PART N
32    Section 1. The opening paragraph of subdivision 1 of section 1 of part
33  C of chapter 57 of the laws of  2006,  establishing  a  cost  of  living
34  adjustment for designated human services, is amended to read as follows:
35    Subject  to  available appropriations, the commissioners of the office
36  of mental health, office of mental retardation and  developmental  disa-
37  bilities, office of alcoholism and substance abuse services, [department
38  of  health,] office of children and family services and the state office
39  for the aging shall  establish  an  annual  cost  of  living  adjustment
40  (COLA), subject to the approval of the director of the budget, effective
41  April  first of each state fiscal year, provided, however, that in state
42  fiscal year 2006-07, the cost of living  adjustment  will  be  effective
43  October  first,  to  project  for the effects of inflation, for rates of
44  payments, contracts or any other form of reimbursement for the  programs
45  listed  in  paragraphs  (i),  (ii), (iii), (iv)[,] and (v) [and (vi)] of
46  subdivision four of this section. The  COLA  shall  be  applied  to  the
47  appropriate portion of reimbursable costs or contract amounts.
48    § 2. Paragraph (iv) of subdivision 4 of section 1 of part C of chapter
49  57  of  the  laws  of 2006, establishing a cost of living adjustment for
50  designated human services, is REPEALED and paragraphs (v) and  (vi)  are
51  renumbered paragraphs (iv) and (v).
53                                   PART O
2                                   PART P
4                                   PART Q
5    Section  1.  The  public health law is amended by adding a new section
6  2825-f to read as follows:
7    § 2825-f. Health care facility transformation program:  statewide III.
8  1. A statewide health care facility  transformation  program  is  hereby
9  established  under  the joint administration of the commissioner and the
10  president of the dormitory authority of the state of New  York  for  the
11  purpose  of strengthening and protecting continued access to health care
12  services in communities. The program shall provide funding in support of
13  capital projects, debt retirement, working capital or other  non-capital
14  projects  that  facilitate health care transformation activities includ-
15  ing, but not limited to, merger,  consolidation,  acquisition  or  other
16  activities  intended  to:  (a) create financially sustainable systems of
17  care; (b) preserve or expand essential health care services; (c) modern-
18  ize obsolete facility physical plants  and  infrastructure;  (d)  foster
19  participation  in  alternative  payment  arrangements including, but not
20  limited to, contracts with  managed  care  plans  and  accountable  care
21  organizations;  (e) for residential health care facilities, increase the
22  quality of resident care or experience; or (f) improve  health  informa-
23  tion  technology infrastructure, including telehealth, to strengthen the
24  acute, post-acute and long-term care  continuum.  Grants  shall  not  be
25  available  to  support  general  operating expenses. The issuance of any
26  bonds or notes hereunder shall be subject  to  section  sixteen  hundred
27  eighty-r  of the public authorities law and the approval of the director
28  of the division of the budget, and any projects funded through the issu-
29  ance of bonds or notes hereunder shall be approved by the New York state
30  public authorities control board, as required under section fifty-one of
31  the public authorities law.
32    2. The commissioner and the president of the dormitory authority shall
33  enter into an agreement, subject to approval  by  the  director  of  the
34  budget,  and  subject  to section sixteen hundred eighty-r of the public
35  authorities law, for the purposes of awarding, distributing, and  admin-
36  istering  the  funds made available pursuant to this section. Such funds
37  may be distributed by the commissioner for grants to general  hospitals,
38  residential health care facilities, adult care facilities licensed under
39  title  two  of  article seven of the social services law, diagnostic and
40  treatment centers and clinics licensed pursuant to this chapter  or  the
41  mental hygiene law, children's residential treatment facilities licensed
42  pursuant  to  article  thirty-one  of  the  mental hygiene law, assisted
43  living programs approved by the  department  pursuant  to  section  four
44  hundred  sixty-one-l  of  the  social  services law, and community-based
45  health care providers as defined in subdivision three  of  this  section
46  for  grants in support of the purposes set forth in this section. A copy
47  of such agreement, and any amendments thereto, shall be provided to  the
48  chair  of  the  senate finance committee, the chair of the assembly ways
49  and means committee, and the director of the division of the  budget  no
50  later  than  thirty  days prior to the release of a request for applica-
51  tions for funding under this program.  Projects  awarded,  in  whole  or
52  part, under sections twenty-eight hundred twenty-five-a and twenty-eight
1  hundred  twenty-five-b  of this article shall not be eligible for grants
2  or awards made available under this section.
3    3.  Notwithstanding  section  one  hundred  sixty-three  of  the state
4  finance law or any inconsistent provision of law to the contrary, up  to
5  four  hundred seventy-five million dollars of the funds appropriated for
6  this program shall be awarded without a competitive bid or  request  for
7  proposal  process for grants to health care providers (hereafter "appli-
8  cants"). Provided, however, that a minimum of: (a) sixty million dollars
9  of total awarded funds shall be  made  to  community-based  health  care
10  providers,  which  for  purposes  of  this section shall be defined as a
11  diagnostic and treatment center licensed or granted an operating certif-
12  icate under this article; a mental health clinic licensed or granted  an
13  operating  certificate  under  article  thirty-one of the mental hygiene
14  law; a substance use disorder treatment clinic licensed  or  granted  an
15  operating  certificate  under  article  thirty-two of the mental hygiene
16  law; a primary care provider; a clinic licensed or granted an  operating
17  certificate under article sixteen of the mental hygiene law; a home care
18  provider  certified  or  licensed pursuant to article thirty-six of this
19  chapter; or hospices licensed or granted an operating certificate pursu-
20  ant to article forty of this chapter and (b) forty-five million  dollars
21  of  the  total  awarded  funds  shall be made to residential health care
22  facilities.
23    4. Notwithstanding any inconsistent subdivision of this section or any
24  other provision of law to  the  contrary,  the  commissioner,  with  the
25  approval  of the director of the budget, may expend up to twenty million
26  dollars of the funds appropriated for this program pursuant to  subdivi-
27  sion  three  of this section, not including funds dedicated for communi-
28  ty-based health care providers under paragraph (a) of  such  subdivision
29  or  for  residential  health care facilities under paragraph (b) of such
30  subdivision, for awards made pursuant to paragraph  (l)  of  subdivision
31  three  of  section  four hundred sixty-one-l of the social services law,
32  provided that funding shall be prioritized for awards made  pursuant  to
33  subparagraph (i) of such paragraph, with remaining funding available for
34  awards made pursuant to subparagraphs (ii) and (iii) of such paragraph.
35    5.  In  determining awards for eligible applicants under this section,
36  the commissioner shall consider criteria including, but not limited to:
37    (a) the extent to which the proposed project will  contribute  to  the
38  integration  of  health care services or the long term sustainability of
39  the applicant or preservation of essential health services in the commu-
40  nity or communities served by the applicant;
41    (b) the extent to which the proposed project  or  purpose  is  aligned
42  with  delivery  system  reform incentive payment ("DSRIP") program goals
43  and objectives;
44    (c) the geographic distribution of funds;
45    (d) the relationship  between  the  proposed  project  and  identified
46  community need;
47    (e)  the  extent  to  which  the  applicant  has access to alternative
48  financing;
49    (f) the extent to which the proposed project furthers the  development
50  of primary care and other outpatient services;
51    (g)  the extent to which the proposed project benefits Medicaid enrol-
52  lees and uninsured individuals;
53    (h) the extent to  which  the  applicant  has  engaged  the  community
54  affected  by  the  proposed  project  and  the manner in which community
55  engagement has shaped such project; and
1    (i) the extent to which the proposed project addresses potential  risk
2  to patient safety and welfare.
3    6.  Disbursement  of  awards  made  pursuant  to this section shall be
4  conditioned on the awardee achieving  certain  process  and  performance
5  metrics  and  milestones  as  determined  in  the sole discretion of the
6  commissioner.  Such metrics and milestones shall be structured to ensure
7  that the goals of the project are achieved, and such metrics  and  mile-
8  stones  shall  be  included  in  grant  disbursement agreements or other
9  contractual documents as required by the commissioner.
10    7. The department shall provide a report on a quarterly basis  to  the
11  chairs  of  the  senate finance, assembly ways and means, and senate and
12  assembly health committees, until such time as the department determines
13  that the projects that receive funding  pursuant  to  this  section  are
14  substantially  complete.  Such  reports shall be submitted no later than
15  sixty days after the close of the quarter, and shall include,  for  each
16  award,  the  name  of  the  applicant,  a  description of the project or
17  purpose, the amount of the  award,  disbursement  date,  and  status  of
18  achievement  of  process and performance metrics and milestones pursuant
19  to subdivision six of this section.
20    § 2. This act shall take effect immediately and  shall  be  deemed  to
21  have been in full force and effect on and after April 1, 2018.
22                                   PART R
24                                   PART S
25    Section  1.  This Part enacts into law major components of legislation
26  which are necessary to effectuate recommendations made as  part  of  the
27  Regulatory  Modernization  Initiative  undertaken  by  the Department of
28  Health. Each component is wholly contained within a  Subpart  identified
29  as  Subparts  A  through  C.  The  effective  date  for  each particular
30  provision contained within such Subpart is set forth in the last section
31  of such Subpart.  Any  provision  in  any  section  contained  within  a
32  Subpart,  including  the  effective  date  of the Subpart, which makes a
33  reference to a section "of this act," when used in connection with  that
34  particular  component,  shall  be deemed to mean and refer to the corre-
35  sponding section of the Subpart in which it is found. Section  three  of
36  this Part sets forth the general effective date of this Part.
37                                  SUBPART A
38                           Intentionally omitted.
39                                  SUBPART B
40    Section  1. Subdivision 1 of section 2801 of the public health law, as
43    1.  "Hospital"  means a facility or institution engaged principally in
44  providing services by or under the supervision of a physician or, in the
45  case of a dental clinic or dental dispensary, of a dentist, or,  in  the
46  case  of  a  midwifery  birth  center, of a midwife, for the prevention,
47  diagnosis or treatment of human  disease,  pain,  injury,  deformity  or
48  physical  condition,  including, but not limited to, a general hospital,
1  public health center, diagnostic center, treatment center, dental  clin-
2  ic,  dental dispensary, rehabilitation center other than a facility used
3  solely for vocational rehabilitation, nursing home, tuberculosis  hospi-
4  tal,  chronic  disease  hospital,  maternity  hospital,  midwifery birth
5  center,  lying-in-asylum,  out-patient  department,  out-patient  lodge,
6  dispensary  and  a laboratory or central service facility serving one or
7  more such institutions, but the  term  hospital  shall  not  include  an
8  institution, sanitarium or other facility engaged principally in provid-
9  ing  services for the prevention, diagnosis or treatment of mental disa-
10  bility and which is subject to the powers  of  visitation,  examination,
11  inspection  and investigation of the department of mental hygiene except
12  for those distinct parts of  such  a  facility  which  provide  hospital
13  service. The provisions of this article shall not apply to a facility or
14  institution  engaged  principally  in providing services by or under the
15  supervision of the bona fide members and adherents of a recognized reli-
16  gious organization whose teachings include reliance on  spiritual  means
17  through prayer alone for healing in the practice of the religion of such
18  organization  and  where  services are provided in accordance with those
19  teachings. No provision of this article or any other  provision  of  law
20  shall  be  construed  to:  (a)  limit  the  volume  of  mental health or
21  substance use disorder services that can be provided by  a  provider  of
22  primary  care  services  licensed  under  this article and authorized to
23  provide integrated services in accordance with regulations issued by the
24  commissioner in consultation with the  commissioner  of  the  office  of
25  mental  health  and  the  commissioner  of  the office of alcoholism and
26  substance abuse  services,  including  regulations  issued  pursuant  to
27  subdivision  seven  of  section three hundred sixty-five-l of the social
28  services law or part L of chapter fifty-six of the laws of two  thousand
29  twelve;  (b)  require a provider licensed pursuant to article thirty-one
30  of the mental hygiene law or certified pursuant to article thirty-two of
31  the mental hygiene law to  obtain  an  operating  certificate  from  the
32  department  if  such  provider has been authorized to provide integrated
33  services in accordance with regulations issued by  the  commissioner  in
34  consultation  with  the  commissioner of the office of mental health and
35  the commissioner  of  the  office  of  alcoholism  and  substance  abuse
36  services,  including regulations issued pursuant to subdivision seven of
37  section three hundred sixty-five-l of the social services law or part  L
38  of chapter fifty-six of the laws of two thousand twelve.
39    §  2.  Section  31.02 of the mental hygiene law is amended by adding a
40  new subdivision (f) to read as follows:
41    (f) No provision of this article or any other provision of  law  shall
42  be  construed to require a provider licensed pursuant to article twenty-
43  eight of the public health law or certified pursuant to article  thirty-
44  two  of  this chapter to obtain an operating certificate from the office
45  of mental health if such provider has been authorized to  provide  inte-
46  grated services in accordance with regulations issued by the commission-
47  er  of the office of mental health in consultation with the commissioner
48  of the department of health and the commissioner of the office of  alco-
49  holism and substance abuse services, including regulations issued pursu-
50  ant  to  subdivision  seven of section three hundred sixty-five-l of the
51  social services law or part L of chapter fifty-six of the  laws  of  two
52  thousand twelve.
53    §  3.  Subdivision  (b) of section 32.05 of the mental hygiene law, as
1    (b)  (i)  Methadone,  or such other controlled substance designated by
2  the commissioner of health as appropriate for such use, may be  adminis-
3  tered  to  an  addict, as defined in section thirty-three hundred two of
4  the public health law, by individual physicians,  groups  of  physicians
5  and  public  or private medical facilities certified pursuant to article
6  twenty-eight or thirty-three of the public health law as part of a chem-
7  ical dependence program which has been issued an  operating  certificate
8  by the commissioner pursuant to subdivision (b) of section 32.09 of this
9  article,  provided,  however,  that  such administration must be done in
10  accordance with all applicable federal and state laws  and  regulations.
11  Individual physicians or groups of physicians who have obtained authori-
12  zation  from  the  federal  government  to  administer  buprenorphine to
13  addicts may do so without obtaining an operating  certificate  from  the
14  commissioner.  (ii)  No provision of this article or any other provision
15  of law shall be construed to require a  provider  licensed  pursuant  to
16  article  twenty-eight  of the public health law or article thirty-one of
17  this chapter to obtain an operating certificate from the office of alco-
18  holism and substance abuse services if such provider has been authorized
19  to provide integrated services in accordance with regulations issued  by
20  the commissioner of alcoholism and substance abuse services in consulta-
21  tion  with  the commissioner of the department of health and the commis-
22  sioner of the office of  mental  health,  including  regulations  issued
23  pursuant  to  subdivision seven of section three hundred sixty-five-l of
24  the social services law or part L of chapter fifty-six of  the  laws  of
25  two thousand twelve.
26    § 4. This act shall take effect on the one hundred eightieth day after
27  it  shall have become a law; provided, however, that the commissioner of
28  the department of health, the  commissioner  of  the  office  of  mental
29  health,  and  the commissioner of the office of alcoholism and substance
30  abuse services are authorized to issue any rule or regulation  necessary
31  for the implementation of this act on or before its effective date.
32                                  SUBPART C
33    Section  1.  Paragraphs  (q),  (s) and (t) of subdivision 2 of section
34  2999-cc of the public health law, as amended by chapter 454 of the  laws
35  of  2015,  are  amended  and two new paragraphs (u) and (v) are added to
37    (q) a hospital as defined in article  twenty-eight  of  this  chapter,
38  including residential health care facilities serving special needs popu-
39  lations;
40    (s) a hospice as defined in article forty of this chapter; [and]
41    (t)  credentialed  alcoholism  and  substance abuse counselors creden-
42  tialed by the office of alcoholism and substance abuse services or by  a
43  credentialing  entity  approved by such office pursuant to section 19.07
44  of the mental hygiene law;
45    (u) providers authorized to provide services and service  coordination
46  under  the early intervention program pursuant to article twenty-five of
47  this chapter;
48    (v) clinics licensed or certified under article sixteen of the  mental
49  hygiene law and certified and non-certified day and residential programs
50  funded or operated by the office for people with developmental disabili-
51  ties; and
52    (w)  any  other provider as determined by the commissioner pursuant to
53  regulation or, in consultation with the commissioner, by the commission-
54  er of the office of mental health, the commissioner  of  the  office  of
1  alcoholism  and  substance  abuse  services,  or the commissioner of the
2  office  for  people  with   developmental   disabilities   pursuant   to
3  regulation.
4    §  2.  Subdivision  3  of section 2999-cc of the public health law, as
5  separately amended by chapters 238 and 285  of  the  laws  of  2017,  is
7    3.  "Originating  site"  means a site at which a patient is located at
8  the time health care services are delivered to him or her  by  means  of
9  telehealth.  Originating  sites  shall  be  limited  to:  (a) facilities
10  licensed under articles twenty-eight and forty of this  chapter[,];  (b)
11  facilities  as  defined in subdivision six of section 1.03 of the mental
12  hygiene law[,]; (c) certified  and  non-certified  day  and  residential
13  programs  funded or operated by the office for people with developmental
14  disabilities; (d) private physician's or dentist's offices located with-
15  in the state of New  York[,];  (e)  any  type  of  adult  care  facility
16  licensed under title two of article seven of the social services law[,];
17  (f) public, private and charter elementary and secondary schools, school
18  age  child care programs, and child day care centers within the state of
19  New York; and[, when a patient is  receiving  health  care  services  by
20  means  of  remote  patient monitoring,] (g) the patient's place of resi-
21  dence located within the state of New York or other  temporary  location
22  located within or outside the state of New York.
23    §  3.  Subdivision 7 of section 2999-cc of the public health, as added
24  by chapter 6 of the laws of 2015, is amended to read as follows:
25    7. "Remote patient monitoring" means the use of synchronous  or  asyn-
26  chronous   electronic  information  and  communication  technologies  to
27  collect personal health information and medical data from a  patient  at
28  an  originating  site  that is transmitted to a telehealth provider at a
29  distant site for use in the treatment and management of  medical  condi-
30  tions  that  require  frequent monitoring. Such technologies may include
31  additional interaction triggered  by  previous  transmissions,  such  as
32  interactive  queries  conducted through communication technologies or by
33  telephone. Such conditions shall include, but not be limited to, conges-
34  tive heart failure, diabetes,  chronic  obstructive  pulmonary  disease,
35  wound  care,  polypharmacy, mental or behavioral problems, and technolo-
36  gy-dependent care such as  continuous  oxygen,  ventilator  care,  total
37  parenteral  nutrition  or  enteral  feeding.   Remote patient monitoring
38  shall be ordered by a physician licensed pursuant to article one hundred
39  thirty-one of the education law, a nurse practitioner licensed  pursuant
40  to  article  one  hundred thirty-nine of the education law, or a midwife
41  licensed pursuant to article one hundred forty  of  the  education  law,
42  with which the patient has a substantial and ongoing relationship.
43    §  4.  Section 2999-dd of the public health law, as added by chapter 6
44  of the laws of 2015, is amended to read as follows:
45    § 2999-dd. Telehealth delivery of services. 1.  Health  care  services
46  delivered  by  means  of  telehealth  shall be entitled to reimbursement
47  under section three hundred sixty-seven-u of the social services law.
48    2. The department of health, the office of mental health,  the  office
49  of  alcoholism  and  substance abuse services, and the office for people
50  with developmental disabilities shall coordinate on the  issuance  of  a
51  single  guidance document, to be updated as appropriate, that shall: (a)
52  identify any differences in regulations or policies issued by the  agen-
53  cies,  including with respect to reimbursement pursuant to section three
54  hundred sixty-seven-u of the social services law; and (b) be designed to
55  assist consumers, providers,  and  health  plans  in  understanding  and
1  facilitating the appropriate use of telehealth in addressing barriers to
2  care.
3    §  5.  This  act shall take effect on the ninetieth day after it shall
4  have become a law.   Effective  immediately,  the  commissioner  of  the
5  department  of  health, the commissioner of the office of mental health,
6  the commissioner  of  the  office  of  alcoholism  and  substance  abuse
7  services,  and  the  commissioner of the office for people with develop-
8  mental disabilities are authorized and directed to issue,  amend  and/or
9  repeal  any  rule or regulation necessary for the implementation of this
10  act on or before its effective date.
11    § 2. Severability clause. If any clause, sentence, paragraph, subdivi-
12  sion, section or subpart of this act shall be adjudged by any  court  of
13  competent  jurisdiction  to  be invalid, such judgment shall not affect,
14  impair, or invalidate the remainder thereof, but shall  be  confined  in
15  its  operation  to the clause, sentence, paragraph, subdivision, section
16  or subpart thereof directly involved in the controversy  in  which  such
17  judgment  shall  have  been  rendered.  It  is hereby declared to be the
18  intent of the legislature that this act would have been enacted even  if
19  such invalid provisions had not been included herein.
20    §  3.  This act shall take effect immediately; provided, however, that
21  the applicable effective date of Subparts A through C of this act  shall
22  be as specifically set forth in the last section of such Subparts.
23                                   PART T
24    Section  1.   Subdivision (a) of section 31 of part B of chapter 59 of
25  the laws of 2016, amending the social services law and other laws relat-
26  ing to authorizing the commissioner of health to apply federally  estab-
27  lished consumer price index penalties for generic drugs, and authorizing
28  the commissioner of health to impose penalties on managed care plans for
29  reporting  late  or  incorrect  encounter  data,  is  amended to read as
31    (a) section eleven of this act shall expire  and  be  deemed  repealed
32  March 31, [2018] 2020;
33    § 2. Subdivision 6-a of section 93 of part C of chapter 58 of the laws
34  of  2007,  amending  the  social services law and other laws relating to
35  adjustments of rates, as amended by section 20 of part B of  chapter  56
37    6-a.  section  fifty-seven  of  this  act  shall  expire and be deemed
38  repealed on [December 31, 2018] March 31, 2023; provided that the amend-
39  ments made by such section to subdivision 4  of  section  366-c  of  the
40  social  services law shall apply with respect to determining initial and
41  continuing eligibility for medical assistance, including  the  continued
42  eligibility  of  recipients  originally determined eligible prior to the
43  effective date of this act, and provided further  that  such  amendments
44  shall  not apply to any person or group of persons if it is subsequently
45  determined by the Centers for Medicare and Medicaid  services  or  by  a
46  court  of  competent  jurisdiction  that medical assistance with federal
47  financial participation is available for the costs of services  provided
48  to  such  person  or  persons  under  the provisions of subdivision 4 of
49  section 366-c of the social services law in effect immediately prior  to
50  the effective date of this act.
51    §  3. Section 2 of part II of chapter 54 of the laws of 2016, amending
52  part C of chapter 58  of  the  laws  of  2005  relating  to  authorizing
53  reimbursements  for expenditures made by or on behalf of social services
1  districts for medical assistance for needy  persons  and  administration
2  thereof, is amended to read as follows:
3    §  2.  This  act shall take effect immediately and shall expire and be
4  deemed repealed [two years after it shall have become a law]  March  31,
5  2020.
6    § 4. Section 3 of chapter 906 of the laws of 1984, amending the social
7  services  law  relating  to expanding medical assistance eligibility and
8  the scope of services available to certain persons with disabilities, as
9  amended by section 25-a of part B of chapter 56 of the laws of 2013,  is
11    §  3.  This  act shall take effect on the thirtieth day after it shall
12  have become a law and shall be of no  further  force  and  effect  after
13  [December 31, 2018] March 31, 2023, at which time the provisions of this
14  act shall be deemed to be repealed.
15    § 5. Section 4-a of part A of chapter 56 of the laws of 2013, amending
16  chapter  59 of the laws of 2011 amending the public health law and other
17  laws relating to general hospital reimbursement for annual rates  relat-
18  ing  to  the cap on local Medicaid expenditures, as amended by section 9
19  of part I of chapter 57 of the laws of  2017,  is  amended  to  read  as
21    §  4-a.  Notwithstanding  paragraph  (c)  of subdivision 10 of section
22  2807-c of the public health law, section 21 of chapter 1 of the laws  of
23  1999,  or  any  other contrary provision of law, in determining rates of
24  payments by state governmental agencies effective for services  provided
25  on  and  after  January 1, [2019] 2017 through March 31, 2019, for inpa-
26  tient and outpatient services provided by general hospitals,  for  inpa-
27  tient services and adult day health care outpatient services provided by
28  residential  health care facilities pursuant to article 28 of the public
29  health law, except for residential health care facilities  or  units  of
30  such  facilities  providing services primarily to children under twenty-
31  one years of age, for home health care  services  provided  pursuant  to
32  article  36  of the public health law by certified home health agencies,
33  long term home health care programs and AIDS home care programs, and for
34  personal care services provided pursuant to section 365-a of the  social
35  services  law,  the  commissioner  of health shall apply no greater than
36  zero trend factors attributable to the 2017,  2018,  and  2019  calendar
37  [year]  years  in  accordance  with  paragraph  (c) of subdivision 10 of
38  section 2807-c of the public health law, provided, however, that such no
39  greater than zero trend factors attributable to  such  2017,  2018,  and
40  2019  calendar  [year]  years  shall also be applied to rates of payment
41  provided on and after January 1, [2019] 2017 through March 31, 2019  for
42  personal   care   services  provided  in  those  local  social  services
43  districts, including New York city, whose  rates  of  payment  for  such
44  services  are established by such local social services districts pursu-
45  ant to a rate-setting exemption issued by the commissioner of health  to
46  such local social services districts in accordance with applicable regu-
47  lations[,]; and provided further, however, that for rates of payment for
48  assisted living program services provided on and after January 1, [2019]
49  2017  through  March  31,  2019,  such trend factors attributable to the
50  2017, 2018, and 2019 calendar [year] years shall be  established  at  no
51  greater than zero percent.
52    §  5-a.  Paragraph (e) of subdivision 7 of section 367-a of the social
53  services law, as added by section 1 of part B of chapter 57 of the  laws
54  of 2015, the opening paragraph as amended by section 12 and subparagraph
55  (iv)  as  amended  by  section 13 of part B of chapter 59 of the laws of
56  2016, is amended to read as follows:
1    (e) During the period from April first, two thousand  fifteen  through
2  March  thirty-first,  two thousand [seventeen,] twenty, the commissioner
3  may, in lieu of a managed care provider, negotiate  directly  and  enter
4  into  an  agreement with a pharmaceutical manufacturer for the provision
5  of supplemental rebates relating to pharmaceutical utilization by enrol-
6  lees  of managed care providers pursuant to section three hundred sixty-
7  four-j of this title and may also negotiate directly and enter into such
8  an agreement relating to pharmaceutical utilization by  medical  assist-
9  ance  recipients  not so enrolled. Such rebates shall be limited to drug
10  utilization in the following classes: antiretrovirals  approved  by  the
11  FDA  for  the treatment of HIV/AIDS and hepatitis C agents for which the
12  pharmaceutical manufacturer has in effect a rebate  agreement  with  the
13  federal  secretary  of health and human services pursuant to 42 U.S.C. §
14  1396r-8, and for which  the  state  has  established  standard  clinical
15  criteria.  No  agreement  entered  into pursuant to this paragraph shall
16  have an initial term or be  extended  beyond  [March  thirty-first,  two
17  thousand twenty] the expiration or repeal of this paragraph.
18    (i)  The  manufacturer shall not pay supplemental rebates to a managed
19  care provider, or any of a managed care provider's agents, including but
20  not limited to any pharmacy benefit manager on the two classes of  drugs
21  subject  to  this  paragraph  when  the state is collecting supplemental
22  rebates and standard clinical criteria are imposed on the  managed  care
23  provider.
24    (ii)  The commissioner shall establish adequate rates of reimbursement
25  which shall take into account both the impact of the commissioner  nego-
26  tiating  such  rebates  and  any limitations imposed on the managed care
27  provider's ability to establish clinical criteria relating to the utili-
28  zation  of  such  drugs.  In  developing  the  managed  care  provider's
29  reimbursement  rate,  the  commissioner  shall  identify  the  amount of
30  reimbursement for such drugs as a separate and distinct  component  from
31  the reimbursement otherwise made for prescription drugs as prescribed by
32  this section.
33    (iii)  The  commissioner shall submit a report to the temporary presi-
34  dent of the senate and the speaker of the assembly annually by  December
35  thirty-first.  The report shall analyze the adequacy of rates to managed
36  care providers for drug expenditures related to the classes  under  this
37  paragraph.
38    (iv) Nothing in this paragraph shall be construed to require a pharma-
39  ceutical manufacturer to enter into a supplemental rebate agreement with
40  the  commissioner relating to pharmaceutical utilization by enrollees of
41  managed care providers pursuant to section three hundred sixty-four-j of
42  this title or relating to pharmaceutical utilization by medical  assist-
43  ance recipients not so enrolled.
44    (v)  All clinical criteria, including requirements for prior approval,
45  and all utilization review determinations established by  the  state  as
46  described  in  this  paragraph for either of the drug classes subject to
47  this paragraph shall be developed using evidence-based and peer-reviewed
48  clinical review criteria in accordance with article two-A of the  public
49  health law, as applicable.
50    (vi)  All  prior  authorization  and utilization review determinations
51  related to the coverage of any drug subject to this paragraph  shall  be
52  subject  to  article  forty-nine of the public health law, section three
53  hundred sixty-four-j of this title, and article forty-nine of the insur-
54  ance law, as applicable. Nothing in this paragraph  shall  diminish  any
55  rights  relating  to  access, prior authorization, or appeal relating to
1  any drug class or drug afforded to a recipient under any other provision
2  of law.
3    § 5-b. Subdivision 1 of section 60 of part B of chapter 57 of the laws
4  of  2015,  amending  the  social services law and other laws relating to
5  supplemental rebates, is amended and a new subdivision 1-a is  added  to
6  read as follows:
7    1.  [sections]  section   one [and fifty-two] of this act shall expire
8  and be deemed repealed March 31, [2020] 2023;
9    1-a. section fifty-two of this act shall expire and be deemed repealed
10  March 31, 2020;
11    § 5-c. Subparagraph (ii) of paragraph (c) of subdivision 11 of section
12  230 of the public health law, as amended by section  24  of  part  B  of
14    (ii)  Participation  and  membership during a three year demonstration
15  period in a physician committee of the Medical Society of the  State  of
16  New  York  or the New York State Osteopathic Society whose purpose is to
17  confront and refer to treatment physicians who are thought to be suffer-
18  ing from alcoholism, drug abuse, or mental illness.  Such  demonstration
19  period shall commence on April first, nineteen hundred eighty and termi-
20  nate  on May thirty-first, nineteen hundred eighty-three.  An additional
21  demonstration period shall commence  on  June  first,  nineteen  hundred
22  eighty-three  and  terminate  on  March  thirty-first,  nineteen hundred
23  eighty-six. An additional demonstration period shall commence  on  April
24  first,  nineteen hundred eighty-six and terminate on March thirty-first,
25  nineteen hundred eighty-nine. An additional demonstration  period  shall
26  commence  April  first, nineteen hundred eighty-nine and terminate March
27  thirty-first, nineteen hundred ninety-two. An  additional  demonstration
28  period  shall  commence  April  first,  nineteen  hundred ninety-two and
29  terminate March thirty-first, nineteen  hundred  ninety-five.  An  addi-
30  tional  demonstration  period  shall  commence  on April first, nineteen
31  hundred  ninety-five  and  terminate  on  March  thirty-first,  nineteen
32  hundred  ninety-eight. An additional demonstration period shall commence
33  on April first, nineteen hundred ninety-eight  and  terminate  on  March
34  thirty-first,  two  thousand  three.  An additional demonstration period
35  shall commence on April first, two thousand three and terminate on March
36  thirty-first, two thousand thirteen. An additional demonstration  period
37  shall commence April first, two thousand thirteen and terminate on March
38  thirty-first,  two thousand eighteen. An additional demonstration period
39  shall commence April first, two thousand eighteen and terminate on March
40  thirty-first, two thousand  twenty-three  provided,  however,  that  the
41  commissioner  may  prescribe  requirements  for the continuation of such
42  demonstration program, including periodic reviews of such  programs  and
43  submission  of  any  reports  and data necessary to permit such reviews.
44  During these additional periods, the  provisions  of  this  subparagraph
45  shall also apply to a physician committee of a county medical society.
47  the amendments to paragraph (e) of subdivision 7 of section 367-a of the
48  social services law made by section five-a of this act shall not  affect
49  the repeal of such paragraph and shall be deemed repealed therewith; and
50  provided,  further,  however that the amendments to subparagraph (ii) of
51  paragraph (c) of subdivision 11 of section 230 of the public health  law
52  made  by  section  five-c of this act shall not affect the expiration of
53  such subparagraph and shall be deemed to expire therewith.
54                                   PART U
1    Section 1. Section 2 of part NN of chapter 58 of  the  laws  of  2015,
2  amending  the mental hygiene law relating to clarifying the authority of
3  the commissioners in the department of  mental  hygiene  to  design  and
4  implement  time-limited  demonstration  programs,  is amended to read as
7  deemed repealed March 31, [2018] 2021.
9                                   PART V
10    Section 1. Section 7 of part R2 of chapter 62 of  the  laws  of  2003,
11  amending  the  mental  hygiene law and the state finance law relating to
12  the community mental health support and workforce reinvestment  program,
13  the  membership of subcommittees for mental health of community services
14  boards and the duties of such subcommittees and creating  the  community
15  mental  health and workforce reinvestment account, as amended by section
16  3 of part G of chapter 60 of the laws of 2014, is  amended  to  read  as
18    § 7. This act shall take effect immediately and shall expire March 31,
19  [2018]  2021  when  upon  such  date the provisions of this act shall be
20  deemed repealed.
22                                   PART W
24                                   PART X
25    Section 1. Section 3 of part A of chapter 111 of  the  laws  of  2010,
26  amending  the  mental hygiene law relating to the receipt of federal and
27  state benefits received by  individuals  receiving  care  in  facilities
28  operated by an office of the department of mental hygiene, as amended by
29  section  1  of  part LL of chapter 58 of the laws of 2015, is amended to
31    § 3. This act shall take effect immediately; and shall expire  and  be
32  deemed repealed June 30, [2018] 2021.
34                                   PART Y
35    Section  1.    Legislative  intent.  In  order  to provide a permanent
36  solution ending the entity exemption, the intent of this legislation  is
37  to provide needed clarity as to the activities and services that need to
38  be  performed  by  licensed  practitioners and those that do not require
39  such license thereby no longer necessitating the need for continuing the
40  exemption beyond what is provided herein.
41    § 2. Subdivision 10 of section 7605 of the education law, as added  by
42  section  4  of part AA of chapter 57 of the laws of 2013, is amended and
43  two new subdivisions 12 and 13 are added to read as follows:
44    10. (a) A person without a license from: performing assessments  [such
45  as] including but not limited to basic information collection, gathering
46  of  demographic  data, and informal observations, screening and referral
47  used for general eligibility for a program or  service  and  determining
48  the  functional  status  of an individual for the purpose of determining
1  need for services [unrelated to a behavioral health diagnosis or  treat-
2  ment  plan.   Such licensure shall not be required to create, develop or
3  implement a service plan unrelated to a behavioral health  diagnosis  or
4  treatment  plan];  advising individuals regarding the appropriateness of
5  benefits they are eligible for; providing general  advice  and  guidance
6  and  assisting  individuals or groups with difficult day to day problems
7  such as finding employment, locating sources of assistance, and organiz-
8  ing community groups to work  on  a  specific  problem;  providing  peer
9  services; selecting for suitability and providing substance abuse treat-
10  ment  services or group re-entry services to incarcerated individuals in
11  state correctional facilities; or providing  substance  abuse  treatment
12  services  or  re-entry  services  to  incarcerated  individuals in local
13  correctional facilities.
14    (b) A person without a license from creating, developing or implement-
15  ing a service plan or recovery plan that  is  not  a  behavioral  health
16  diagnosis  or  treatment  plan.  Such  service  or  recovery plans shall
17  include, but are not limited to, coordinating, evaluating or determining
18  the need for, or the provision of the following services:  job  training
19  and  employability[,];  housing[,];  homeless  services and shelters for
20  homeless individuals and families; refugee services; residential, day or
21  community habilitation services; general public assistance[,];  in  home
22  services and supports or home-delivered meals[, investigations conducted
23  or  assessments  made  by]; recovery supports; adult or child protective
24  services including investigations; detention as defined in section  five
25  hundred  two  of  the executive law; prevention and residential services
26  for victims of domestic violence;  services  for  runaway  and  homeless
27  youth; foster care, adoption, preventive services or services in accord-
28  ance  with an approved plan pursuant to section four hundred four of the
29  social services law, including, adoption and  foster  home  studies  and
30  assessments,  family  service  plans, transition plans [and], permanency
31  planning activities, and case planning or case management as such  terms
32  are  defined  in  the  regulations  of the office of children and family
33  services; residential rehabilitation; home and community based services;
34  and de-escalation techniques, peer services  or  skill  development.  [A
35  license  under this article shall not be required for persons to partic-
36  ipate]
37    (c)(i) A person without a license from participating as a member of  a
38  multi-disciplinary  team  to [implement] assist in the development of or
39  implementation of  a  behavioral  health  services  or  treatment  plan;
40  provided  [however,]  that  such  team shall include one or more profes-
41  sionals licensed under this article or articles one hundred  thirty-one,
42  one  hundred  thirty-nine,  one hundred fifty-four or one hundred sixty-
43  three of this  chapter;  and  provided,  further,  that  the  activities
44  performed  by  members of the team shall be consistent with the scope of
45  practice for each team member licensed or authorized under title VIII of
46  this chapter, and those who are not so authorized may not engage in  the
47  following  restricted  practices:    the diagnosis of mental, emotional,
48  behavioral, addictive  and  developmental  disorders  and  disabilities;
49  patient  assessment  and  evaluating; the provision of psychotherapeutic
50  treatment; the  provision  of  treatment  other  than  psychotherapeutic
51  treatment;  [and/or  the development and implementation of] or independ-
52  ently developing and implementing assessment-based  treatment  plans  as
53  defined in section seventy-seven hundred one of this [chapter] title.
54    (ii)  For  the purposes of this paragraph, "assist" shall include, but
55  not be limited to, the provision or performance of the following  tasks,
56  services,  or  functions  by an individual who has obtained the training
1  and experience required by the  applicable  state  oversight  agency  to
2  perform such task, service or function in facilities or programs operat-
3  ing pursuant to article nineteen-G of the executive law; articles seven,
4  sixteen,  thirty-one  or  thirty-two of the mental hygiene law; or title
5  three of article seven of the social services law:
6    (1) helping an individual with the completion of  forms  or  question-
7  naires;
8    (2) reviewing existing case records and collecting background informa-
9  tion  about an individual which may be used by the licensed professional
10  or multi-disciplinary team;
11    (3) gathering and  reporting  information  about  previous  behavioral
12  health  interventions,  hospitalizations, documented diagnosis, or prior
13  treatment for review by the licensed professional and multi-disciplinary
14  team;
15    (4) discussing with  the  individual  his  or  her  situation,  needs,
16  concerns,  and  thoughts in order to help identify services that support
17  the individual's goals, independence, and quality of life;
18    (5) providing advice, information, and assistance to  individuals  and
19  family members to identify needs and available resources in the communi-
20  ty to help meet the needs of the individual or family member;
21    (6)  engaging  in immediate and long-term problem solving, engaging in
22  the development of social skills, or providing  general  help  in  areas
23  including,  but not limited to, housing, employment, child care, parent-
24  ing, community based services, and finances;
25    (7) distributing paper copies of self-administered tests for the indi-
26  vidual to complete when such tests do not require  the  observation  and
27  judgment of a licensed professional;
28    (8)  monitoring treatment by the collection of written and/or observa-
29  tional data in accordance with the treatment plan and  providing  verbal
30  or written reports to the multi-disciplinary team;
31    (9) identifying gaps in services and coordinating access to or arrang-
32  ing  services  for  individuals  such  as  home  care,  community  based
33  services, housing, employment, transportation,  child  care,  vocational
34  training, or health care;
35    (10)  offering  education  programs  that  provide  information  about
36  disease identification and recommended treatments that may be  provided,
37  and how to access such treatment;
38    (11)  reporting  on  behavior,  actions, and responses to treatment by
39  collecting written and/or observational data as part of  a  multi-disci-
40  plinary team;
41    (12) using de-escalation techniques consistent with appropriate train-
42  ing;
43    (13)  performing  assessments using standardized, structured interview
44  tools or instruments;
45    (14) directly delivering services outlined in the  service  plan  that
46  are not clinical in nature but have been tailored to an individual based
47  on  any  diagnoses  such  individual  may  have received from a licensed
48  professional; and
49    (15) advocating with educational, judicial or other systems to protect
50  an individual's rights and access to appropriate services.
51    (d) Provided, further, that  nothing  in  this  subdivision  shall  be
52  construed as requiring a license for any particular activity or function
53  based  solely on the fact that the activity or function is not listed in
54  this subdivision.
55    12. Notwithstanding any other provision of law to the contrary,  noth-
56  ing  in  this article shall be construed to prohibit or limit the activ-
1  ities or services provided under this  article  by  any  person  who  is
2  employed  or  who commences employment in a program or service operated,
3  regulated, funded, or approved by the department of mental hygiene,  the
4  office  of children and family services, or a local governmental unit as
5  that term is defined in section 41.03 of the mental  hygiene  law  or  a
6  social  services  district as defined in section sixty-one of the social
7  services law on or before one year from the date  that  the  regulations
8  issued  in accordance with section six of the chapter of the laws of two
9  thousand eighteen which added  this  subdivision  appear  in  the  state
10  register or are adopted, whichever is later.  Such prohibitions or limi-
11  tations  shall  not  apply  to such employees for as long as they remain
12  employed by such programs or services and whether they  remain  employed
13  by  the  same  or  other  employers providing such programs or services.
14  Provided, however, that any person  who  commences  employment  in  such
15  program  or  service  after  such  date  and  performs services that are
16  restricted under this article shall be appropriately licensed or author-
17  ized under this article.  Each state oversight agency shall  create  and
18  maintain  a  process  to verify employment history of individuals exempt
19  under this subdivision.
20    13. The activities or services provided by a person  with  a  master's
21  level  degree  in psychology or its equivalent, working under the super-
22  vision of a licensed psychologist in  a  program  or  service  operated,
23  regulated,  funded, or approved by the department of mental hygiene, the
24  office of children and family services, or a local  government  unit  as
25  that  term  is  defined  in section 41.03 of the mental hygiene law or a
26  social services district as defined in section sixty-one of  the  social
27  services law.
28    §  3.  Paragraph (f) of subdivision 1 of section 7702 of the education
29  law, as amended by chapter 230 of the laws of 2004, is amended  and  two
30  new paragraphs (m) and (n) are added to read as follows:
31    (f)  [Assist]  Provide  advice  and guidance and assist individuals or
32  groups with difficult day to day problems such  as  finding  employment,
33  locating  sources of assistance, and organizing community groups to work
34  on a specific problem.
35    (m) Provide peer services.
36    (n) Collect basic information,  gathering  of  demographic  data,  and
37  informal observations, screening and referral used for general eligibil-
38  ity for a program or service and determining the functional status of an
39  individual for the purpose of determining the need for services.
40    §  4.  Subdivision 7 of section 7706 of the education law, as added by
41  section 5 of part AA of chapter 57 of the laws of 2013, is amended and a
42  new subdivision 8 is added to read as follows:
43    7. (a) Prevent a person without a license from: performing assessments
44  [such as] including but not limited  to  basic  information  collection,
45  gathering  of demographic data, and informal observations, screening and
46  referral used for general eligibility  for  a  program  or  service  and
47  determining  the  functional  status of an individual for the purpose of
48  determining need for services [unrelated to a behavioral health  diagno-
49  sis  or  treatment plan. Such licensure shall not be required to create,
50  develop or implement a service plan unrelated  to  a  behavioral  health
51  diagnosis  or treatment plan]; advising individuals regarding the appro-
52  priateness of benefits they are eligible for; providing  general  advice
53  and  guidance  and assisting individuals or groups with difficult day to
54  day problems such as finding employment, locating sources of assistance,
55  and organizing community groups to work on a specific problem; providing
56  peer services; selecting for suitability and providing  substance  abuse
1  treatment  services  or group re-entry services to incarcerated individ-
2  uals in state correctional  facilities;  or  providing  substance  abuse
3  treatment  services  or re-entry services to incarcerated individuals in
4  local correctional facilities.
5    (b)  Prevent  a  person without a license from creating, developing or
6  implementing a service plan or recovery plan that is  not  a  behavioral
7  health diagnosis or treatment plan. Such service or recovery plans shall
8  include, but are not limited to, coordinating, evaluating or determining
9  the  need  for, or the provision of the following services: job training
10  and employability[,]; housing[,]; homeless  services  and  shelters  for
12  community  habilitation  services; general public assistance[,]; in home
14  or assessments made by]; recovery supports; adult  or  child  protective
15  services  including investigations; detention as defined in section five
16  hundred two of the executive law; prevention  and  residential  services
17  for  victims  of  domestic  violence;  services for runaway and homeless
19  ance with an approved plan pursuant to section four hundred four of  the
20  social  services  law,  including,  adoption and foster home studies and
21  assessments, family service plans, transition  plans  [and],  permanency
22  planning  activities, and case planning or case management as such terms
23  are defined in the regulations of the  office  of  children  and  family
25  and  de-escalation  techniques,  peer  services or skill development. [A
26  license under this article shall not be required for persons to  partic-
28    (c)(i)  Prevent  a  person  without  a license from participating as a
29  member of a multi-disciplinary team to [implement] assist in the  devel-
30  opment of or implementation of a behavioral health services or treatment
31  plan;  provided  [however,]  that  such  team  shall include one or more
32  professionals licensed under this article or articles one hundred  thir-
33  ty-one,  one hundred thirty-nine, one hundred fifty-three or one hundred
34  sixty-three of this chapter; and provided, further, that the  activities
44  defined in section seventy-seven hundred one of this article.
48  and experience required by the  applicable  state  oversight  agency  to
49  perform such task, service or function in facilities or programs operat-
50  ing pursuant to article nineteen-G of the executive law; articles seven,
51  sixteen,  thirty-one  or  thirty-two of the mental hygiene law; or title
52  three of article seven of the social services law:
53    (1) helping an individual with the completion of  forms  or  question-
54  naires;
3  or multi-disciplinary team;
4    (3)  gathering  and  reporting  information  about previous behavioral
5  health interventions, hospitalizations, documented diagnosis,  or  prior
6  treatment for review by the licensed professional and multi-disciplinary
7  team;
8    (4)  discussing  with  the  individual  his  or  her situation, needs,
9  concerns, and thoughts in order to help identify services  that  support
11    (5)  providing  advice, information, and assistance to individuals and
14    (6) engaging in immediate and long-term problem solving,  engaging  in
15  the  development  of  social  skills, or providing general help in areas
16  including, but not limited to, housing, employment, child care,  parent-
19  vidual  to  complete  when such tests do not require the observation and
21    (8) monitoring treatment by the collection of written and/or  observa-
22  tional  data  in accordance with the treatment plan and providing verbal
26  services,  housing,  employment,  transportation, child care, vocational
29  disease  identification and recommended treatments that may be provided,
31    (11) reporting on behavior, actions, and  responses  to  treatment  by
32  collecting  written  and/or observational data as part of a multi-disci-
36    (13) performing assessments using standardized,  structured  interview
38    (14)  directly  delivering  services outlined in the service plan that
40  on any diagnoses such individual  may  have  received  from  a  licensed
44    (d)  Provided,  further,  that  nothing  in  this subdivision shall be
46  based solely on the fact that the activity or function is not listed  in
48    8. Notwithstanding any other provision of law to the contrary, nothing
49  in  this  article shall be construed to prohibit or limit the activities
50  or services provided under this article by any person who is employed or
51  who commences employment in a program or  service  operated,  regulated,
52  funded,  or  approved by the department of mental hygiene, the office of
53  children and family services, the department of corrections and communi-
54  ty supervision, the office of temporary and disability  assistance,  the
55  state  office  for  the  aging  and  the department of health or a local
56  governmental unit as that term is defined in section 41.03 of the mental
1  hygiene law or a social services district as defined in  section  sixty-
2  one  of the social services law on or before one year from the date that
3  the regulations issued in accordance with section six of the chapter  of
4  the laws of two thousand eighteen which added this subdivision appear in
5  the  state  register  or are adopted, whichever is later.  Such prohibi-
6  tions or limitations shall not apply to such employees for  as  long  as
7  they  remain  employed  by  such  programs  or services and whether they
8  remain employed by the same or other employers providing  such  programs
9  or services.  Provided however, that any person who commences employment
10  in  such  program  or service after such date and performs services that
11  are restricted under this article shall  be  appropriately  licensed  or
12  authorized under this article.  Each state oversight agency shall create
13  and  maintain  a  process  to  verify  employment history of individuals
14  exempt under this subdivision.
15    § 5. Subdivision 8 of section 8410 of the education law, as  added  by
17  two new subdivisions 9 and 10 are added to read as follows:
24  sis  or treatment plan.  Such licensure shall not be required to create,
32  treatment  services  or group re-entry services to incarcerated individ-
33  uals in state correctional  facilities;  or  providing  substance  abuse
34  treatment  services  or re-entry services to incarcerated individuals in
35  local correctional facilities.
36    (b) Prevent a person without a license from  creating,  developing  or
37  implementing  a  service  plan or recovery plan that is not a behavioral
38  health diagnosis or treatment plan. Such service or recovery plans shall
1  license  under this article shall not be required for persons to partic-
2  ipate]
3    (c)(i)  Prevent  a  person  without  a license from participating as a
4  member of a multi-disciplinary team to [implement] assist in the  devel-
5  opment of or implementation of a behavioral health services or treatment
6  plan;  provided  [however,]  that  such  team  shall include one or more
7  professionals licensed under this article or articles one hundred  thir-
8  ty-one,  one hundred thirty-nine, one hundred fifty-three or one hundred
9  fifty-four of this chapter; and provided, further, that  the  activities
19  defined in section seventy-seven hundred one of this chapter.
30    (2) reviewing existing case records and collecting background informa-
31  tion  about an individual which may be used by the licensed professional
1    (10)  offering  education  programs  that  provide  information  about
2  disease identification and recommended treatments that may be  provided,
3  and how to access such treatment;
4    (11)  reporting  on  behavior,  actions, and responses to treatment by
5  collecting written and/or observational data as part of  a  multi-disci-
6  plinary team;
7    (12) using de-escalation techniques consistent with appropriate train-
8  ing;
9    (13)  performing  assessments using standardized, structured interview
22  in this article shall be construed to prohibit or limit  the  activities
24  who  commences  employment  in a program or service operated, regulated,
25  funded, or approved by the department of mental hygiene, the  office  of
27  ty  supervision,  the office of temporary and disability assistance, the
28  state office for the aging and the  department  of  health  or  a  local
30  hygiene  law  or a social services district as defined in section sixty-
31  one of the social services law on or before one year from the date  that
32  the  regulations issued in accordance with section six of the chapter of
33  the laws of two thousand eighteen which added this subdivision appear in
34  the state register or are adopted, whichever is later.    Such  prohibi-
35  tions  or  limitations  shall not apply to such employees for as long as
36  they remain employed by such  programs  or  services  and  whether  they
37  remain  employed  by the same or other employers providing such programs
38  or services.  Provided however, that any person who commences employment
39  in such program or service after such date and  performs  services  that
40  are  restricted  under  this  article shall be appropriately licensed or
42  and maintain a process  to  verify  employment  history  of  individuals
44    10.  The  activities  or services provided by a person with a master's
45  level degree required for licensure pursuant to  this  article,  working
46  under the supervision of a professional licensed pursuant to article one
47  hundred fifty-three, one hundred fifty-four or this article in a program
48  or service operated, regulated, funded, or approved by the department of
49  mental  hygiene, the office of children and family services, the depart-
50  ment of corrections and community supervision, the office  of  temporary
51  and  disability  assistance,  the  state  office  for  the aging and the
52  department of health or a local government unit as that term is  defined
53  in section 41.03 of the mental hygiene law or a social services district
54  as defined in section sixty-one of the social services law.
55    § 6. 1. Not later than September 30, 2018, the state education depart-
56  ment (hereinafter referred to as "the department"), in consultation with
1  the  department  of  mental  hygiene,  the office of children and family
2  services, the office of temporary and disability assistance, the depart-
3  ment of corrections and community supervision, the state office for  the
4  aging,  and the department of health (hereinafter referred to as "execu-
5  tive agencies") shall develop formal guidance consistent with this chap-
6  ter for service providers authorized to  operate  under  the  respective
7  executive  agencies,  to  identify  the tasks and functions performed by
8  each agency's service provider workforce categorized as tasks and  func-
9  tions  restricted  to  licensed  personnel including tasks and functions
10  that do not require a license under articles 153, 154  and  163  of  the
11  education  law.  Subsequent  to  the  issuance of formal guidance by the
12  department pursuant to this section, the department  shall  adopt  regu-
13  lations  consistent  with  this  chapter.  Such regulations shall not be
14  issued on an emergency basis.
15    2. Not later than sixty days from  the  adoption  of  the  regulations
16  required  by this section, the executive agencies together shall issue a
17  single report to the governor, the temporary president  of  the  senate,
18  the speaker of the assembly, and the state education department that may
19  include  but  not be limited to, all matters where any individual agency
20  objects to or has concerns regarding regulations or guidance  issued  by
21  the  department pursuant to subdivision one of this section; a projected
22  fiscal impact or effect of any regulations or guidance on each executive
23  agency; identification of licensed professions shortage areas under each
24  executive agency; identification of appropriate rate, policy, or  legis-
25  lative   changes  that  may  address  workforce  shortages  in  licensed
26  professions or access to services; an analysis and identification of the
27  need for resources and investment to fortify the state's  mental  health
28  workforce;  an  identification  of  barriers to hiring licensees and the
29  mechanism and oversight structure used to  track  individuals  that  are
30  subject  to: subdivision 12 of section 7605 of the education law, subdi-
31  vision 8 of section 7706 of the  education  law,  or  subdivision  9  of
32  section 8410 of the education law; or any other pertinent information.
33    3. Upon issuance of the report required pursuant to subdivision two of
34  this  section,  the  state education department shall have sixty days to
35  issue a report to the governor, the temporary president of  the  senate,
36  and  the  speaker  of  the  assembly on any of the matters identified in
37  subdivision two of this section provided that such report may include an
38  analysis of, comments on, or responses to the report issued by  subdivi-
39  sion  two  of  this section. The governor shall provide to the executive
40  agencies a copy of the report required by this subdivision.
41    § 7. Programs and services operated, regulated, funded, or approved by
42  the department of mental hygiene, the  office  of  children  and  family
43  services,  the  department of corrections and community supervision, the
44  office of temporary and disability assistance, the state office for  the
45  aging  and  the department of health or a local governmental unit as the
46  term is defined in section 41.03 of the mental hygiene law or  a  social
47  services  district  as  defined in section 61 of the social services law
48  shall not be required to receive a waiver pursuant to section 6503-a  of
49  the education law and, further, such programs and services shall also be
50  considered to be approved settings for the receipt of supervised experi-
51  ence  for  the  professions governed by articles 153, 154 and 163 of the
52  education law.
53    § 8. Subdivision a of section 9 of chapter 420 of  the  laws  of  2002
54  amending the education law relating to the profession of social work, as
55  amended  by  section  1  of part J of chapter 59 of the laws of 2016, is
1    a. Nothing in this act shall  prohibit  or  limit  the  activities  or
2  services on the part of any person in the employ of a program or service
3  operated,  regulated,  funded,  or  approved by the department of mental
4  hygiene, the office of children  and  family  services,  the  office  of
5  temporary  and  disability assistance, the department of corrections and
6  community supervision, the state office for the aging, the department of
7  health, or a local governmental unit as that term is defined in  article
8  41 of the mental hygiene law or a social services district as defined in
9  section  61  of the social services law, provided, however, this section
10  shall not authorize the use of any title authorized pursuant to  article
11  154  of  the  education  law,  except  that this section shall be deemed
12  repealed [on July 1, 2018] one year from the date that  the  regulations
13  issued  in  accordance  with section six of part Y of the chapter of the
14  laws of 2018 which amended this subdivision appear in the  state  regis-
15  ter,  or  the  date  such  regulations  are adopted, whichever is later;
16  provided however that the state education department  shall  notify  the
17  legislative  bill  drafting  commission  upon the occurrence of the date
18  such regulations appear in the state register  and  the  date  of  their
19  adoption in order that the commission may maintain an accurate and time-
20  ly  effective  database of the official text of the laws of the state of
21  New York in furtherance of effectuating the provisions of section 44  of
22  the legislative law and section 70-b of the public officers law.
23    § 9. Subdivision a of section 17-a of chapter 676 of the laws of 2002,
24  amending  the  education  law relating to the practice of psychology, as
25  amended by section 2 of part J of chapter 59 of the  laws  of  2016,  is
27    a.  In  relation to activities and services provided under article 153
28  of the education law, nothing in this act shall prohibit or  limit  such
29  activities  or  services  on  the  part of any person in the employ of a
30  program or service operated,  regulated,  funded,  or  approved  by  the
31  department  of  mental  hygiene  or  the  office  of children and family
32  services, or a local governmental unit as that term is defined in  arti-
33  cle  41  of  the  mental  hygiene  law  or a social services district as
34  defined in section 61 of the social services law.  In relation to activ-
35  ities and services provided under article  163  of  the  education  law,
36  nothing  in this act shall prohibit or limit such activities or services
37  on the part of any person in the employ of a program  or  service  oper-
38  ated,  regulated,  funded,  or  approved  by  the  department  of mental
39  hygiene, the office of children and family services, the  department  of
40  corrections and community supervision, the office of temporary and disa-
41  bility  assistance, the state office for the aging and the department of
42  health or a local governmental unit as that term is defined  in  article
43  41 of the mental hygiene law or a social services district as defined in
44  section  61 of the social services law, pursuant to authority granted by
45  law. This section shall not authorize the use of  any  title  authorized
46  pursuant to article 153 or 163 of the education law by any such employed
47  person,  except  as  otherwise  provided  by such articles respectively.
48  This section shall be deemed repealed [July 1, 2018] one year  from  the
49  date  that the regulations issued in accordance with section six of part
50  Y of the chapter of the laws of  2018  which  amended  this  subdivision
51  appear  in the state register, or the date such regulations are adopted,
52  whichever is later; provided however that the state education department
53  shall notify the legislative bill drafting commission  upon  the  occur-
54  rence  of the date such regulations appear in the state register and the
55  date of their adoption in order that  the  commission  may  maintain  an
56  accurate  and timely effective database of the official text of the laws
1  of the state of New York in furtherance of effectuating  the  provisions
2  of  section  44  of  the  legislative law and section 70-b of the public
3  officers law.
4    §  10.  Section  16  of  chapter 130 of the laws of 2010, amending the
5  education law and other laws relating to the  registration  of  entities
6  providing  certain  professional  services  and the licensure of certain
7  professions, as amended by section 3 of part J of chapter 59 of the laws
8  of 2016, is amended to read as follows:
9    § 16. This act shall take effect immediately; provided  that  sections
10  thirteen, fourteen and fifteen of this act shall take effect immediately
11  and  shall  be deemed to have been in full force and effect on and after
12  June 1, 2010 and such sections shall be deemed repealed [July  1,  2018]
13  one  year  from  the date that the regulations issued in accordance with
14  section six of part Y of the chapter of the laws of 2018  which  amended
15  this  section appear in the state register, or the date such regulations
16  are adopted, whichever is later; provided however that the state  educa-
17  tion  department  shall  notify the legislative bill drafting commission
18  upon the occurrence of the date such regulations  appear  in  the  state
19  register and the date of their adoption in order that the commission may
20  maintain  an accurate and timely effective database of the official text
21  of the laws of the state of New York in furtherance of effectuating  the
22  provisions  of section 44 of the legislative law and section 70-b of the
23  public officers law; provided further that the amendments to  section  9
24  of  chapter  420 of the laws of 2002 amending the education law relating
25  to the profession of social work made by section thirteen  of  this  act
26  shall  repeal on the same date as such section repeals; provided further
27  that the amendments to section 17-a of chapter 676 of the laws  of  2002
28  amending  the  education law relating to the practice of psychology made
29  by section fourteen of this act shall repeal on the same  date  as  such
30  section repeals.
31    § 11. This act shall take effect immediately.
32                                   PART Z
33    Section  1.  Subparagraph  (vii)  of  paragraph  e of subdivision 3 of
34  section 364-j of the social services law, as amended by  section  38  of
35  part A of chapter 56 of the laws of 2013, is amended to read as follows:
36    (vii)  a  person  with  a  developmental  or  physical  disability who
37  receives home and  community-based  services  or  care-at-home  services
38  through  a  demonstration waiver under section eleven hundred fifteen of
39  the federal social security act, existing waivers under section nineteen
40  hundred fifteen (c) of the federal social security act, or who has char-
41  acteristics and needs similar to such persons;
42    § 2. Clause (x) of subparagraph 1 of paragraph (e) of subdivision 5 of
43  section 366 of the social services law, as added by section 26-a of part
44  C of chapter 109 of the laws of 2006, is amended to read as follows:
45    (x) "nursing facility services" means nursing care and health  related
46  services  provided  in a nursing facility; a level of care provided in a
47  hospital which is equivalent to the care which is provided in a  nursing
48  facility;  and  care, services or supplies provided pursuant to a waiver
49  granted pursuant to subsection (c) of section 1915 of the federal social
50  security act or successor federal waiver.
51    § 3. Section 366 of the social services law is amended by adding a new
52  subdivision 7-c to read as follows:
53    7-c. The commissioner of health in consultation with the  commissioner
54  of  developmental  disabilities  is authorized to submit the appropriate
1  waivers, including, but not limited to,  those  authorized  pursuant  to
2  section  eleven  hundred  fifteen of the federal social security act, in
3  order to achieve the purposes of high-quality and  integrated  care  and
4  services for a population of persons with developmental disabilities, as
5  such  term  is  defined in section 1.03 of the mental hygiene law.  Such
6  waiver applications  shall  be  executed  consistent  with  subdivisions
7  seven,  seven-a,  and  seven-b  of  this  section,  to  the extent those
8  sections comply with the requirements of section eleven hundred  fifteen
9  of the federal social security act. Nothing in subdivision seven of this
10  section  shall  prevent the commissioner of health, in consultation with
11  the commissioner of developmental disabilities, from  submitting  waiver
12  applications  expanding eligibility under such waivers to children under
13  eighteen years or age who are eligible for medical assistance.
14    § 4. Paragraph (a) of subdivision 2 of section  366-c  of  the  social
15  services  law,  as  amended by section 68 of part A of chapter 56 of the
17    (a) For purposes of this section an "institutionalized  spouse"  is  a
18  person  (i)  who  is  in  a  medical institution or nursing facility and
19  expected to remain in such facility or institution for at  least  thirty
20  consecutive  days;  or (ii) who is receiving care, services and supplies
21  pursuant to a waiver pursuant to  subsection  (c)  of  section  nineteen
22  hundred fifteen of the federal social security act, or successor to such
23  waiver,  or  is receiving care, services and supplies in a managed long-
24  term care plan pursuant to section eleven hundred fifteen of the  social
25  security  act;  and  (iii)  who  is  married to a person who is not in a
26  medical institution or nursing  facility  or  is  not  receiving  waiver
27  services  described  in  subparagraph  (ii) of this paragraph; provided,
28  however, that medical assistance shall be  furnished  pursuant  to  this
29  paragraph only if, for so long as, and to the extent that federal finan-
30  cial  participation  is available therefor.   The commissioner of health
31  shall make any amendments to the state plan for medical  assistance,  or
32  apply  for  any waiver or approval under the federal social security act
33  that are necessary to carry out the provisions of this paragraph.
34    § 5. The closing paragraph of subdivision 4 of section  366-c  of  the
35  social services law, as amended by section 42 of part D of chapter 58 of
37  provided,  however,  that,  to  the  extent required by federal law, the
38  terms of this subdivision shall not apply to persons who  are  receiving
39  care,  services  and  supplies  pursuant  to the following waivers under
40  section 1915(c) of the federal social security act: the nursing facility
41  transition and diversion waiver authorized pursuant to subdivision six-a
42  of section three hundred sixty-six of this title;  the  traumatic  brain
43  injury  waiver authorized pursuant to section twenty-seven hundred forty
44  of the public health law, the long term home health care program  waiver
45  authorized  pursuant  to  section  three  hundred  sixty-seven-c of this
46  title, and the home and community based services waiver for persons with
47  developmental disabilities, or successor to such waiver, administered by
48  the office [of mental retardation and]  for  people  with  developmental
49  disabilities pursuant to an agreement with the federal centers for medi-
50  care and Medicaid services.
51    §  6.  Paragraph  4  of subdivision (a) of section 16.03 of the mental
52  hygiene law, as added by section 6 of part MM of chapter 58 of the  laws
54    (4)  The provision of home and community based services approved under
55  a waiver program authorized pursuant to section eleven  hundred  fifteen
56  of  the  federal social security act or subdivision (c) of section nine-
1  teen hundred fifteen of the federal social security act and subdivisions
2  seven and seven-a of section  three  hundred  sixty-six  of  the  social
3  services  law, provided that an operating certificate issued pursuant to
4  this  paragraph  shall  only  authorize  services in a home or community
5  setting.
6    § 7. Paragraph 2 of subdivision (a) of section  16.11  of  the  mental
7  hygiene law, as added by section 10 of part MM of chapter 58 of the laws
9    (2)  The review of providers of services, as defined in paragraph four
10  of subdivision (a) of section 16.03 of this article, shall  ensure  that
11  the  provider  of  services  complies  with  all the requirements of the
12  applicable federal home and community based services waiver program,  or
13  other  successor  Medicaid  waiver program, and applicable federal regu-
14  lation, subdivisions seven and seven-a of section three  hundred  sixty-
15  six  of the social services law and rules and regulations adopted by the
16  commissioner.
17    § 8. Subdivision (b) of section 80.03 of the mental  hygiene  law,  as
18  amended  by  chapter  37  of  the  laws  of  2011, is amended to read as
20    (b) "A patient in need of surrogate decision-making" means  a  patient
21  as  defined  in subdivision twenty-three of section 1.03 of this chapter
22  who is: a resident of a mental hygiene facility including a resident  of
23  housing  programs funded by an office of the department or whose federal
24  funding application was approved by an office of the department  or  for
25  whom  such  facility  maintains  legal  admission  status  therefor; or,
26  receiving home and community-based  services  for  persons  with  mental
27  disabilities  provided  pursuant  to section 1915 or 1115 of the federal
28  social security act; or receiving individualized support  services;  or,
29  case management or service coordination funded, approved, or provided by
30  the  office  for  people  with developmental disabilities; and, for whom
31  major medical treatment is proposed, and who is determined by the surro-
32  gate decision-making committee to lack the  ability  to  consent  to  or
33  refuse  such  treatment,  but  shall  not include minors with parents or
34  persons with legal guardians, committees or conservators who are legally
35  authorized, available and willing to make such  health  care  decisions.
36  Once a person is eligible for surrogate decision-making, such person may
37  continue  to  receive  surrogate  decision-making  as authorized by this
38  section regardless of a change in residential status.
39    § 9. Subdivision 1-a of section 84 of part A of chapter 56 of the laws
40  of 2013, amending the social services law and  other  laws  relating  to
41  enacting  the major components of legislation necessary to implement the
42  health and mental hygiene budget for the 2013-2014 state fiscal year, is
43  amended and a new subdivision 1-b is added to read as follows:
44    1-a. sections seventy-three  through  eighty-a  shall  expire  and  be
45  deemed repealed September 30, [2019] 2023;
46    1-b.  the  commissioner  of  the  office for people with developmental
47  disabilities shall assess the quality and outcomes of managed  care  for
48  individuals with developmental disabilities, including their experiences
49  and  satisfaction,  and  report to the temporary president of the senate
50  and the speaker of the assembly no later than December 31, 2022;
51    § 10. Paragraph (a-1) of subdivision 8 of section 4403 of  the  public
52  health law, as amended by chapter 474 of the laws of 2015, is amended to
54    (a-1)  If  the  commissioner  and  the  commissioner of the office for
55  people with developmental disabilities determine that such  organization
56  lacks  the experience required in paragraph (a) of this subdivision, the
1  organization shall have an affiliation arrangement  with  an  entity  or
2  entities that are non-profit organizations or organizations whose share-
3  holders  are  solely controlled by non-profit organizations with experi-
4  ence serving persons with developmental disabilities, as demonstrated by
5  criteria  to  be  determined by the commissioner and the commissioner of
6  the office for people with developmental disabilities, with such  crite-
7  ria  including,  but  not  limited  to, residential, day, and employment
8  services such that  the  affiliated  entity  will  coordinate  and  plan
9  services  operated,  certified,  funded,  authorized  or approved by the
10  office for people with developmental disabilities or  will  oversee  and
11  approve such coordination and planning;
12    §  11.  Section  97  of  chapter 659 of the laws of 1997, amending the
13  public health law and other laws relating to creation of continuing care
14  retirement communities, as amended by section 20 of part D of chapter 57
16    § 97. This act shall take effect immediately, provided, however,  that
17  the  amendments to subdivision 4 of section 854 of the general municipal
18  law made by section seventy of this act shall not affect the  expiration
19  of such subdivision and shall be deemed to expire therewith and provided
20  further  that  sections  sixty-seven  and  sixty-eight of this act shall
21  apply to taxable years  beginning  on  or  after  January  1,  1998  and
22  provided  further  that sections eighty-one through eighty-seven of this
23  act shall expire and be deemed repealed on December 31, [2019] 2024  and
24  provided further, however, that the amendments to section ninety of this
25  act  shall  take effect January 1, 1998 and shall apply to all policies,
26  contracts, certificates, riders or other evidences of coverage  of  long
27  term  care  insurance  issued,  renewed, altered or modified pursuant to
28  section 3229 of the insurance law on or after such date.
29    § 12. Paragraph (a-1) of subdivision  12  of  section  4403-f  of  the
30  public  health  law,  as  amended by chapter 474 of the laws of 2015, is
32    (a-1) If the commissioner and  the  commissioner  of  the  office  for
33  people  with  developmental  disabilities determine that such plan lacks
34  the experience required in paragraph (a) of this subdivision,  the  plan
35  shall  have  an  affiliation arrangement with an entity or entities that
36  are non-profit organizations or  organizations  whose  shareholders  are
37  solely  controlled  by  non-profit organizations with experience serving
38  persons with developmental disabilities, as demonstrated by criteria  to
39  be determined by the commissioner and the commissioner of the office for
40  people  with  developmental  disabilities, with such criteria including,
41  but not limited to, residential, day and employment services, such  that
42  the affiliated entity will coordinate and plan services operated, certi-
43  fied,  funded,  authorized  or  approved  by  the office for people with
44  developmental disabilities or will oversee and approve such coordination
45  and planning;
46    § 13. Paragraph (d) of subdivision 1 of section 4403-g of  the  public
47  health  law,  as added by section 73 of part A of chapter 56 of the laws
49    (d) "Health and long term care services"  means  comprehensive  health
50  services  and  other  services as determined by the commissioner and the
51  commissioner of the office for people with  developmental  disabilities,
52  whether  provided by state-operated programs or not-for-profit entities,
53  including, but not limited to, habilitation services, home and  communi-
54  ty-based  and  institution-based  long term care services, and ancillary
55  services, that shall include medical supplies  and  nutritional  supple-
56  ments,  that are necessary to meet the needs of persons whom the plan is
1  authorized to enroll[, and may include primary care and  acute  care  if
2  the  DISCO is authorized to provide or arrange for such services].  Each
3  person enrolled in a DISCO shall  receive  health  and  long  term  care
4  services  designed  to  achieve person-centered outcomes, to enable that
5  person to live in  the  most  integrated  setting  appropriate  to  that
6  person's  needs,  and to enable that person to interact with nondisabled
7  persons to the fullest extent possible in social,  workplace  and  other
8  community  settings, provided that all such services are consistent with
9  such person's wishes to the extent that such wishes  are  known  and  in
10  accordance with such person's needs.
11    §  14.  Paragraph (b) of subdivision 3 of section 4403-g of the public
12  health law, as added by section 73 of part A of chapter 56 of  the  laws
14    (b)  A  description of the services to be covered by such DISCO, which
15  must include all health and long term care services, as defined in para-
16  graph (d) of subdivision one of this  section,  and  other  services  as
17  determined  by  the  commissioner and the commissioner of the office for
18  people with developmental disabilities;
19    § 15. Paragraph (j) of subdivision 4 of section 4403-g of  the  public
22    (j) Readiness and capability [to arrange and manage covered  services]
23  of organizing, marketing, managing, promoting and operating a health and
24  long  term  care  services plan, or has an affiliation agreement with an
25  entity that has such readiness and capability;
26    § 16. Subdivision (c) of section 62 of chapter  165  of  the  laws  of
27  1991,  amending  the public health law and other laws relating to estab-
28  lishing payments for medical assistance, as amended  by  section  17  of
30    (c)  section  364-j  of the social services law, as amended by section
31  eight of this act and subdivision 6  of  section  367-a  of  the  social
32  services  law as added by section twelve of this act shall expire and be
33  deemed repealed on March 31, [2019] 2024 and provided further, that  the
34  amendments to the provisions of section 364-j of the social services law
35  made  by  section  eight  of  this  act shall only apply to managed care
36  programs approved on or after the effective date of this act;
37    § 17. Subdivision (c) of section 13.40 of the mental hygiene  law,  as
38  added  by  section  72-b of part A of chapter 56 of the laws of 2013, is
40    (c) No person with a developmental  disability  who  is  receiving  or
41  applying  for  medical  assistance  and who is receiving, or eligible to
42  receive, services operated, funded, certified, authorized or approved by
43  the office, shall be required to enroll in a DISCO, HMO or MLTC in order
44  to receive such services until program features and reimbursement  rates
45  are  approved  by  the  commissioner and the commissioner of health, and
46  until such commissioners determine that a  sufficient  number  of  plans
47  that  are authorized to coordinate care for individuals pursuant to this
48  section or that are authorized to  operate  and  to  exclusively  enroll
49  persons  with developmental disabilities pursuant to subdivision twenty-
50  seven of section three hundred sixty-four-j of the social  services  law
51  are  operating in such person's county of residence to meet the needs of
52  persons with developmental disabilities, and that such entities meet the
53  standards of this section. No person shall be required to  enroll  in  a
54  DISCO, HMO or MLTC in order to receive services operated, funded, certi-
55  fied,  authorized or approved by the office until there are at least two
56  entities operating under this section in such person's county  of  resi-
1  dence,  unless  federal  approval  is secured to require enrollment when
2  there are less than two such entities operating in such county. Notwith-
3  standing the foregoing or any other law to the contrary, any health care
4  provider: (i) enrolled in the Medicaid program and (ii) rendering hospi-
5  tal  services,  as  such term is defined in section twenty-eight hundred
6  one of the public health law, to  an  individual  with  a  developmental
7  disability  who is enrolled in a DISCO, HMO or MLTC, or a prepaid health
8  services plan operating pursuant to section forty-four  hundred  three-a
9  of  the  public health law, including, but not limited to, an individual
10  who is enrolled in a plan authorized by  section  three  hundred  sixty-
11  four-j  or  the  social services law, shall accept as full reimbursement
12  the negotiated rate or, in the event that there is no  negotiated  rate,
13  the  rate  of payment that the applicable government agency would other-
14  wise pay for such rendered hospital services.
15    § 18. Section 11 of chapter 710 of the  laws  of  1988,  amending  the
16  social services law and the education law relating to medical assistance
17  eligibility  of  certain  persons and providing for managed medical care
18  demonstration programs, as amended by section 1 of part F of chapter  73
20    §  11.  This  act  shall  take  effect  immediately;  except  that the
21  provisions of sections one, two, three, four, eight and ten of this  act
22  shall take effect on the ninetieth day after it shall have become a law;
23  and  except  that the provisions of sections five, six and seven of this
24  act shall take effect January 1, 1989; and except that  effective  imme-
25  diately, the addition, amendment and/or repeal of any rule or regulation
26  necessary  for  the implementation of this act on its effective date are
27  authorized and directed to be made  and  completed  on  or  before  such
28  effective  date; provided, however, that the provisions of section 364-j
29  of the social services law, as added by section one of  this  act  shall
30  expire  and  be  deemed repealed on and after March 31, [2019] 2024, the
31  provisions of section 364-k of the social  services  law,  as  added  by
32  section  two  of  this act, except subdivision 10 of such section, shall
33  expire and be deemed repealed on and after  January  1,  1994,  and  the
34  provisions  of  subdivision  10  of section 364-k of the social services
35  law, as added by section two of this act, shall  expire  and  be  deemed
36  repealed on January 1, 1995.
37    §  19. This act shall take effect immediately; provided, however, that
38  the amendments to subparagraph (vii) of paragraph e of subdivision 3  of
39  section 364-j of the social services law made by section one of this act
40  shall not affect the repeal of such section and shall be deemed repealed
41  therewith; provided further, however, that the amendments to subdivision
42  4  of  section  366-c of the social services law made by section five of
43  this act shall not affect the expiration of such subdivision  and  shall
44  be  deemed  to  expire  therewith;  provided  further, however, that the
45  amendments to subdivision 8 of section 4403 of the  public  health  law,
46  made  by  section  ten  of this act, shall not affect the repeal of such
47  subdivision and shall be deemed repealed  therewith;  provided  further,
48  however,  that  the  amendments  to paragraph (a-1) of subdivision 12 of
49  section 4403-f of the public health law, made by section twelve of  this
50  act  shall  not affect the repeal of such section and shall be deemed to
51  be repealed therewith; provided further, however, that the amendments to
52  subdivision 12 of section 4403-f of  the  public  health  law,  made  by
53  section twelve of this act, shall not affect the repeal of such subdivi-
54  sion and shall be deemed repealed therewith; provided, further, however,
55  that  the amendments to section 4403-g of the public health law, made by
1  sections thirteen, fourteen and fifteen of this act shall not affect the
2  repeal of such section and shall be deemed repealed therewith.
3                                   PART AA
4    Section  1. Subdivisions 3-b and 3-c of section 1 of part C of chapter
5  57 of the laws of 2006,  relating  to  establishing  a  cost  of  living
6  adjustment for designated human services programs, as amended by section
7  1  of  part  Q of chapter 57 of the laws of 2017, are amended to read as
9    3-b. Notwithstanding any  inconsistent  provision  of  law,  beginning
10  April  1, 2009 and ending March 31, 2016 and beginning April 1, 2017 and
11  ending March 31, [2018] 2019, the commissioners shall not include a COLA
12  for the purpose of establishing rates  of  payments,  contracts  or  any
13  other  form  of  reimbursement,  provided  that the commissioners of the
14  office for people with developmental disabilities, the office of  mental
15  health,  and the office of alcoholism and substance abuse services shall
16  not include a COLA beginning April 1, 2017 and ending March 31, 2019.
17    3-c. Notwithstanding any  inconsistent  provision  of  law,  beginning
18  April 1, [2018] 2019 and ending March 31, [2021] 2022, the commissioners
19  shall develop the COLA under this section using the actual U.S. consumer
20  price  index  for  all  urban  consumers (CPI-U) published by the United
21  States department of labor, bureau of labor statistics  for  the  twelve
22  month  period  ending  in  July  of  the budget year prior to such state
23  fiscal  year,  for  the  purpose  of  establishing  rates  of  payments,
24  contracts or any other form of reimbursement.
25    §  2.  This  act  shall take effect immediately and shall be deemed to
26  have been in full force and effect on and after April 1, 2018; provided,
27  however, that the amendments to section 1 of part C of chapter 57 of the
28  laws of 2006 made by section one of this act shall not affect the repeal
29  of such section and shall be deemed repealed therewith.
30                                   PART BB
34    § 4. Subdivision (b) of schedule I  of  section  3306  of  the  public
35  health  law is amended by adding two new paragraphs 56 and 57 to read as
37    (56) 3,4-dichloro-N-{(1-dimethylamino)     cyclohexylmethyl}benzamide.
38  Some trade or other names: AH-7921.
39    (57) N-(1-phenethylpiperidin-4-yl)-N-phenylacetamide   (Acetyl  Fenta-
40  nyl).
41    § 5. Subdivision (d) of schedule I  of  section  3306  of  the  public
42  health  law  is  amended by adding three new paragraphs 36, 37 and 38 to
44    (36) 5-methoxy-N,N-dimethyltryptamine.
45    (37) Alpha-methyltryptamine. Some trade or other names: AMT.
46    (38) 5-methoxy-N,N-diisopropyltryptamine. Some trade or  other  names:
47  5-MeO-DIPT.
49    § 7. Schedule I of section 3306 of the public health law is amended by
50  adding two new subdivisions (g) and (h) to read as follows:
51    (g)  Synthetic  cannabinoids.  Unless  specifically excepted or unless
52  listed in another schedule, any material, compound, mixture, or prepara-
1  tion, which contains any quantity of the following synthetic cannabinoid
2  substances, or which contains any of its salts, isomers,  and  salts  of
3  isomers  whenever  the  existence  of  such salts, isomers, and salts of
4  isomers  is  possible  within  the  specific  chemical  designation (for
5  purposes of this paragraph only, the term "isomer" includes the optical,
6  position and geometric isomers):
7    (1) (1-pentyl-1H-indol-3-yl)(2,2,3,3-tetramethylcyclopropyl)    metha-
8  none.  Some trade or other names: UR-144.
9    (2) {1-(5-fluro-pentyl)-1H-indol-3-yl}(2,2,3,3-tetramethylcyclopropyl)
10  methanone. Some trade names or other names: 5-fluoro-UR-144, XLR11.
11    (3) N-(1-adamantyl)-1-pentyl-1H-indazole-3-carboxamide.  Some trade or
12  other names: APINACA, AKB48.
13    (4) quinolin-8-yl  1-pentyl-1H-indole-3-carboxylate.  Some  trade   or
14  other names: PB-22; QUPIC.
15    (5) quinolin-8-yl   1-(5-fluoropentyl)-1H-indole-3-carboxylate.   Some
16  trade or other names: 5-fluoro-PB-22; 5F-PB-22.
17    (6) N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(4-fluorobenzyl)-1H-indazo-
18  le-3-carboxamide. Some trade or other names: AB-FUBINACA.
19    (7) N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-pentyl-1H-indazole-3-
20  carboxamide. Some trade or other names: ADB-PINACA.
21    (8) N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(cyclohexylmethyl)-1H-
22  indazole-3-carboxamide. Some trade or other names: AB-CHMINACA.
23    (9) N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-pentyl-1H-indazole-3-
24  carboxamide. Some trade or other names: AB-PINACA.
25    (10) {1-(5-fluoropentyl)-1H-indazol-3-yl}(naphthalen-1-y1)methanone.
26  Some trade or other names: THJ-2201.
27    (h) (1) Cannabimimetic agents. Unless specifically exempted or  unless
29  tion  that  is  not approved by the federal food and drug administration
30  (FDA) which contains any quantity of  cannabimimetic  agents,  or  which
31  contains  their salts, isomers, and salts of isomers whenever the exist-
32  ence of such salts, isomers, and salts of isomers is possible within the
33  specific chemical designation.
34    (2) As used in this  subdivision,  the  term  "cannabimimetic  agents"
35  means any substance that is a cannabinoid receptor type 1 (CB1 receptor)
36  agonist  as demonstrated by binding studies and functional assays within
37  any of the following structural classes:
38    (i) 2-(3-hydroxycyclohexyl)phenol with substitution at the  5-position
39  of  the phenolic ring by alkyl or alkenyl, whether or not substituted on
40  the cyclohexyl ring to any extent.
41    (ii) 3-(1-naphthoyl)indole or 3-(1-naphthylmethane)indole  by  substi-
42  tution  at  the nitrogen atom of the indole ring, whether or not further
43  substituted on the indole ring to any extent, whether or not substituted
44  on the naphthoyl or naphthyl ring to any extent.
45    (iii) 3-(1-naphthoyl)pyrrole by substitution at the nitrogen  atom  of
46  the pyrrole ring, whether or not further substituted in the pyrrole ring
47  to  any  extent, whether or not substituted on the naphthoyl ring to any
48  extent.
49    (iv) 1-(1-naphthylmethylene)indene by substitution of  the  3-position
50  of  the  indene  ring,  whether or not further substituted in the indene
51  ring to any extent, whether or not substituted on the naphthyl  ring  to
52  any extent.
53    (v)  3-phenylacetylindole  or  3-benzoylindole  by substitution at the
54  nitrogen atom of the indole ring, whether or not further substituted  in
55  the  indole ring to any extent, whether or not substituted on the phenyl
56  ring to any extent.
1    (3) Such term includes:
2    (i)      5-(1,1-dimethylheptyl)-2-{(1R,3S)-3-hydroxycyclohexyl}-phenol
3  (CP-47,497);
4    (ii)      5-(1,1-dimethyloctyl)-2-{(1R,3S)-3-hydroxycyclohexyl}-phenol
5  (cannabicyclohexanol or CP-47,497 C8-homolog);
6    (iii) 1-pentyl-3-(1-naphthoyl)indole (JWH-018 and AM678);
7    (iv) 1-butyl-3-(1-naphthoyl)indole (JWH-073);
8    (v) 1-hexyl-3-(1-naphthoyl)indole (JWH-019);
9    (vi) 1-{2-(4-morpholinyl)ethyl}-3-(1-naphthoyl)indole (JWH-200);
10    (vii) 1-pentyl-3-(2-methoxyphenylacetyl)indole (JWH-250);
11    (viii) 1-pentyl-3-{1-(4-methoxynaphthoyl)}indole (JWH-081);
12    (ix) 1-pentyl-3-(4-methyl-1-naphthoyl)indole (JWH-122);
13    (x) 1-pentyl-3-(4-chloro-1-naphthoyl)indole (JWH-398);
14    (xi) 1-(5-fluoropentyl)-3-(1-naphthoyl)indole (AM2201);
15    (xii) 1-(5-fluoropentyl)-3-(2-iodobenzoyl)indole (AM694);
16    (xiii) 1-pentyl-3-{(4-methoxy)-benzoyl}indole (SR-19 and RCS-4);
17    (xiv)   1-cyclohexylethyl-3-(2-methoxyphenylacetyl)indole  (SR-18  and
18  RCS-8); and
19    (xv) 1-pentyl-3-(2-chlorophenylacetyl)indole (JWH-203).
20    § 8. This act shall take effect on the ninetieth day  after  it  shall
21  have become a law.
22                                   PART CC
25    §  3.  Paragraph  (b)  of  subdivision 12 of section 230 of the public
28    (b) When a licensee has pleaded or been found guilty or  convicted  of
29  committing  an  act  constituting  a  felony under New York state law or
30  federal law, or the law of  another  jurisdiction  which,  if  committed
31  within  this state, would have constituted a felony under New York state
32  law, or when a licensee has been charged with committing an act  consti-
33  tuting a felony under New York state or federal law or the law of anoth-
34  er jurisdiction, where the licensee's alleged conduct, which, if commit-
35  ted  within  this  state, would have constituted a felony under New York
36  state law, and in the  commissioner's  opinion  the  licensee's  alleged
37  conduct  constitutes  an imminent danger to the health of the people, or
38  when the duly authorized professional  disciplinary  agency  of  another
39  jurisdiction  has  made  a finding substantially equivalent to a finding
40  that the practice of medicine  by  the  licensee  in  that  jurisdiction
41  constitutes  an  imminent  danger to the health of its people, or when a
42  licensee has been disciplined by a duly authorized  professional  disci-
43  plinary  agency  of  another jurisdiction for acts which if committed in
44  this state would have constituted the basis for summary  action  by  the
45  commissioner  pursuant to paragraph (a) of this subdivision, the commis-
46  sioner, after a recommendation by a committee of professional conduct of
47  the state board for professional medical conduct, may order  the  licen-
48  see,  by written notice, to discontinue or refrain from practicing medi-
49  cine in whole or in part or to take certain actions authorized  pursuant
50  to  this  title immediately. The order of the commissioner shall consti-
51  tute summary action against the licensee and become  public  upon  issu-
52  ance.  The  summary  suspension  shall  remain in effect until the final
53  conclusion of a hearing which shall commence within ninety days  of  the
54  date  of  service  of  the  commissioner's order, end within ninety days
1  thereafter and otherwise be held in accordance  with  paragraph  (a)  of
2  this  subdivision, provided, however, that when the commissioner's order
3  is based upon a finding substantially equivalent to a finding  that  the
4  practice of medicine by the licensee in another jurisdiction constitutes
5  an  imminent  danger  to  the  health  of  its people, the hearing shall
6  commence within thirty days after the disciplinary proceedings  in  that
7  jurisdiction  are  finally concluded. If, at any time, the felony charge
8  is dismissed, withdrawn or reduced to a non-felony charge,  the  commis-
9  sioner's summary order shall terminate.
11                                   PART DD
12    Section  1. Subdivisions 2 and 4 of section 6801 of the education law,
13  as amended by chapter 46 of the laws of 2015, are  amended  to  read  as
15    2.  A  licensed  pharmacist may execute a non-patient specific regimen
16  prescribed or ordered by a physician licensed in  this  state  or  nurse
17  practitioner  certified in this state, pursuant to rules and regulations
18  promulgated by the commissioner. When a licensed pharmacist  administers
19  an immunizing agent, he or she shall:
20    (a)  report  such administration by electronic transmission or [fasci-
21  mile] facsimile to the patient's attending primary health  care  practi-
22  tioner  or  practitioners,  if any, and, to the extent practicable, make
23  himself or herself available to discuss the outcome  of  such  immuniza-
24  tion, including any adverse reactions, with the attending primary health
25  care  practitioner,  [or]  and to the statewide immunization registry or
26  the citywide immunization registry, as established pursuant  to  and  to
27  the  extent  permitted  by section twenty-one hundred sixty-eight of the
28  public health law; and
29    (b) provide information to  the  patient  or,  where  applicable,  the
30  person  legally responsible for the patient, on the importance of having
31  a primary health care practitioner, developed  by  the  commissioner  of
32  health; and
33    (c)  report  such administration, absent of any individually identifi-
34  able health information,  to  the  department  of  health  in  a  manner
35  required by the commissioner of health[.]; and
36    (d)  prior  to  administering the immunization, inform the patient or,
37  where applicable, the person legally responsible for the patient, of the
38  total cost of the immunization or immunizations, subtracting any  health
39  insurance  subsidization, if applicable. In the case the immunization is
40  not covered, the pharmacist must inform the patient or,  where  applica-
41  ble,  the person legally responsible for the patient, of the possibility
42  that the immunization may be covered when administered by a primary care
43  physician or practitioner; and
44    (e) administer the immunization or immunizations according to the most
45  current recommendations by the advisory committee for immunization prac-
46  tices (ACIP), provided however, that a  pharmacist  may  administer  any
47  immunization  authorized  under this section when specified by a patient
48  specific order.
49    4. When administering an immunization  in  a  pharmacy,  the  licensed
50  pharmacist  shall provide an area for the immunization that provides for
51  a patient's privacy. The privacy area should include:
52    a. a clearly visible posting of the most  current  "Recommended  Adult
53  Immunization Schedule" published by the advisory committee for immuniza-
54  tion practices (ACIP); and
1    (b)  education  materials  on  influenza  vaccinations for children as
2  determined by the commissioner and the commissioner of health.
3    §  2.  Subdivision 22 of section 6802 of the education law, as amended
4  by chapter 46 of the laws of 2015, is amended to read as follows:
5    22. "Administer", for the purpose of section sixty-eight  hundred  one
6  of this article, means:
7    a. the direct application of an immunizing agent to adults, whether by
8  injection,  ingestion,  inhalation  or  any  other  means, pursuant to a
9  patient specific order or non-patient  specific  regimen  prescribed  or
10  ordered  by a physician or certified nurse practitioner, who has a prac-
11  tice site in the county or adjoining county in which the immunization is
12  administered, for  immunizations  to  prevent  influenza,  pneumococcal,
13  acute  herpes  zoster,  meningococcal,  tetanus, diphtheria or pertussis
14  disease and medications required for emergency treatment of anaphylaxis.
15  If the commissioner of health determines that there is  an  outbreak  of
16  disease, or that there is the imminent threat of an outbreak of disease,
17  then the commissioner of health may issue a non-patient specific regimen
18  applicable statewide.
19    b.  the  direct application of an immunizing agent to children between
20  the ages of two and eighteen years of age, whether by injection,  inges-
21  tion,  inhalation  or  any  other  means, pursuant to a patient specific
22  order or non-patient specific regimen prescribed or ordered by a  physi-
23  cian  or  certified  nurse  practitioner, who has a practice site in the
24  county or adjoining county in which the  immunization  is  administered,
25  for immunization to prevent influenza and medications required for emer-
26  gency  treatment of anaphylaxis resulting from such immunization. If the
27  commissioner of health determines that there is an outbreak of  influen-
28  za,  or  that  there is the imminent threat of an outbreak of influenza,
31    § 2-a. Paragraph (a) of subdivision 3 of section 2168  of  the  public
34    (a)  (i)  Any  health  care  provider who administers any vaccine to a
35  person less than nineteen years of age or, on or after September  first,
36  two  thousand  nine, conducts a blood lead analysis of a sample obtained
37  from a person under eighteen years of age in accordance  with  paragraph
38  (h)  of subdivision two of this section; and immunizations received by a
39  person less than nineteen years of  age  in  the  past  if  not  already
40  reported,  shall  report  all  such immunizations and the results of any
41  blood lead analysis to the department in  a  format  prescribed  by  the
42  commissioner  within  fourteen  days of administration of such immuniza-
43  tions or of obtaining the results  of  any  such  blood  lead  analysis.
44  Health  care  providers administering immunizations to persons less than
45  nineteen years of age in the city of New York shall report, in a  format
46  prescribed  by  the  city  of New York commissioner of health and mental
47  hygiene, all such immunizations to the citywide  immunization  registry.
48  Health  care  providers  who  conduct  a blood lead analysis on a person
49  under eighteen years of age and who report the results of such  analysis
50  to the city of New York commissioner of health and mental hygiene pursu-
51  ant  to  New  York city reporting requirements shall be exempt from this
52  requirement for reporting blood  lead  analysis  results  to  the  state
53  commissioner  of  health;  provided,  however,  blood lead analysis data
54  collected from physician office  laboratories  by  the  commissioner  of
55  health and mental hygiene of the city of New York pursuant to the health
1  code  of  the  city of New York shall be provided to the department in a
2  format prescribed by the commissioner.
3    (ii)  A  pharmacist  who administers a vaccine pursuant to subdivision
4  two of section sixty-eight hundred one of the education law, to a person
5  less than nineteen years of age, shall report all such immunizations  to
6  the  department  in a format prescribed by the commissioner within four-
7  teen days of administration of such immunizations. Pharmacists  adminis-
8  tering  immunizations pursuant to subdivision two of section sixty-eight
9  hundred one of the education law to persons less than nineteen years  of
10  age  in the city of New York shall report, in a format prescribed by the
11  city of New York commissioner of health and  mental  hygiene,  all  such
12  immunizations to the citywide immunization registry.
13    § 3. Section 8 of chapter 563 of the laws of 2008, amending the educa-
14  tion  law  and the public health law relating to immunizing agents to be
15  administered to adults by pharmacists, as amended by chapter 46  of  the
17    §  8.  This  act shall take effect on the ninetieth day after it shall
18  have become a law   and shall expire and  be  deemed  repealed  July  1,
19  [2019] 2020.
21  tion  law  relating  to  authorizing a licensed pharmacist and certified
22  nurse practitioner to administer certain immunizing agents,  as  amended
23  by chapter 46 of the laws of 2015, is amended to read as follows:
24    §  5.   This act shall take effect on the ninetieth day after it shall
25  have become a law [and],  provided,  however,  that  the  provisions  of
26  sections  one,  two  and  four  of  this  act shall expire and be deemed
27  repealed July 1, [2019] 2020 provided, that:
28    (a) the amendments to subdivision 7 of section 6527 of  the  education
29  law  made by section one of this act shall not affect the repeal of such
30  subdivision and shall be deemed to be repealed therewith;
31    (b) the amendments to subdivision 7 of section 6909 of  the  education
32  law, made by section two of this act shall not affect the repeal of such
34    (c)  the amendments to subdivision 22 of section 6802 of the education
35  law made by section three of this act shall not  affect  the  repeal  of
36  such subdivision and shall be deemed to be repealed therewith; and
37    (d)  the  amendments  to  section  6801  of  the education law made by
38  section four of this act shall not affect the expiration of such section
39  and shall be deemed to expire therewith.
40    § 5. Section 5 of chapter 21 of the laws of 2011, amending the  educa-
41  tion  law  relating  to authorizing pharmacists to perform collaborative
42  drug therapy management with physicians in certain settings, as  amended
43  by chapter 238 of the laws of 2015, is amended to read as follows:
44    § 5. This act shall take effect on the one hundred twentieth day after
45  it shall have become a law [and], provided, however, that the provisions
46  of sections two, three, and four of this act shall expire [7 years after
47  such  effective  date  when  upon  such  date the provisions of this act
48  shall] and be deemed repealed July 1, 2020; provided, however, that  the
49  amendments to subdivision 1 of section 6801 of the education law made by
50  section one of this act shall be subject to the expiration and reversion
51  of  such subdivision pursuant to section 8 of chapter 563 of the laws of
52  2008, when upon such date the provisions of section one-a  of  this  act
53  shall  take  effect;  provided, further, that effective immediately, the
54  addition, amendment and/or repeal of any rule  or  regulation  necessary
55  for  the implementation of this act on its effective date are authorized
56  and directed to be made and completed on or before such effective date.
1    § 6. This act shall take effect  immediately;  provided,  however  the
2  amendments  to  section 6801 of the education law made by section one of
3  this act shall not effect the expiration of such section  and  shall  be
4  deemed  to  expire  therewith; provided, further, that the amendments to
5  subdivision  22 of section 6802 of the education law made by section two
6  of this act shall not affect the expiration of such section and shall be
7  deemed to expire therewith.
8                                   PART EE
9    Section 1. Paragraph (e) of subdivision 1  of  section  367-a  of  the
12    (e)  Amounts  payable  under  this title for medical assistance in the
13  form of clinic services pursuant to article twenty-eight of  the  public
14  health  law  [and],  article sixteen of the mental hygiene law and inde-
15  pendent practitioner services for individuals with  developmental  disa-
16  bilities  provided  to  eligible  persons diagnosed with a developmental
17  disability who are also beneficiaries under part B of title XVIII of the
18  federal social security act, or provided to  persons  diagnosed  with  a
19  developmental  disability who are qualified medicare beneficiaries under
20  part B of title XVIII of such act shall not be less  than  the  approved
21  medical assistance payment level less the amount payable under part B.
23                                   PART FF
24    Section  1.  The mental hygiene law is amended by adding a new section
25  33.27 to read as follows:
26  § 33.27 Independent substance use disorder and mental health ombudsman.
27    (a)  There  is  hereby  established  the  office  of  the  independent
28  substance  use disorder and mental health ombudsman program that will be
29  operated or selected by the office of  alcoholism  and  substance  abuse
30  services,  in  consultation  with  the  office  of mental health for the
31  purpose of assisting individuals with a substance  use  disorder  and/or
32  mental  illness to ensure that they receive appropriate health insurance
33  coverage.
34    (b) Such ombudsman  will  identify,  investigate,  refer  and  resolve
35  complaints  that  are  made  by,  or on behalf of, consumers relative to
36  health insurance coverage and access to initial and continuing substance
37  use disorder care and mental health care; accept, investigate, refer and
38  help to resolve complaints that are made by treatment providers relative
39  to health insurance coverage of and reimbursement for initial or contin-
40  uing substance use disorder and mental health care; accept, investigate,
41  refer and help to resolve complaints that are made by or  on  behalf  of
42  consumers or by providers relative to network adequacy for access to and
43  continuing substance use disorder and mental health care.
44    (c)  Notwithstanding  sections  one  hundred  twelve  and  one hundred
45  sixty-three of the state finance law and section one  hundred  forty-two
46  of  the economic development law, or any other inconsistent provision of
47  law, funds available for expenditure pursuant to this  section  for  the
48  establishment  of  an  ombudsman  for  substance use disorder and mental
49  health insurance coverage, may  be  allocated  and  distributed  by  the
50  commissioner  of  the office of alcoholism and substance abuse services,
51  subject to the approval of the director of the budget, without a compet-
52  itive bid or request for proposal process for the  establishment  of  an
1  ombudsman  for substance use disorder and mental health insurance cover-
2  age. Provided, however, that such allocation  or  distribution  must  be
3  based  on  objective  criteria  and  an  allocation  methodology that is
4  approved by the director of the budget.
5    § 2. This act shall take effect on the one hundred eightieth day after
6  it shall have become a law.
7                                   PART GG
8    Section  1.  The mental hygiene law is amended by adding a new section
9  19.18-b to read as follows:
10  § 19.18-b Certified peer recovery advocate services program.
11    1. For purposes of this subdivision "certified peer recovery  advocate
12  services"  means  participant-centered services that emphasize knowledge
13  and wisdom through lived experience in which  peers  are  encouraged  to
14  share   their  own  personal  experience  and  first-hand  knowledge  of
15  substance abuse, addiction, and recovery to support the  recovery  goals
16  of individuals who use drugs and/or alcohol.
17    2. The commissioner shall develop and administer a certification proc-
18  ess and standards of training and competency for certified peer recovery
19  advocate services.
20    3.  Certified  peer  recovery advocate services may include but not be
21  limited to:
22    (a) developing recovery plans;
23    (b) raising awareness of existing social and other support services;
24    (c) modeling coping skills;
25    (d) assisting with applying for benefits;
26    (e) accompanying clients to medical appointments;
27    (f) providing non-clinical crisis support, especially after periods of
28  hospitalization or incarceration;
29    (g) accompanying clients to court appearances and other appointments;
30    (h) working with participants to identify strengths;
31    (i) linking participants to formal recovery supports,  including,  but
32  not limited to, medication assisted treatment;
33    (j)  educating  program  participants about various modes of recovery,
34  including, but not limited to, medication assisted treatment;
35    (k) peer engagement coordination with hospital emergency  services  to
36  assist  any patient that has been administered an opioid antagonist by a
37  medical provider to establish connections to treatment,  including,  but
38  not  limited  to, medication assisted treatment and other supports after
39  an opioid overdose reversal or after discharge  from  another  substance
40  abuse related emergency department visit; and
41    (l)  peer  engagement  coordination  with law enforcement departments,
42  fire departments and other first responder  departments  to  assist  any
43  individual  that  has  been administered an opioid antagonist by a first
44  responder to establish connections  to  treatment,  including,  but  not
45  limited  to,  medication  assisted  treatment and other support services
46  after an opioid overdose reversal.
47    § 2. This act shall take effect immediately; provided,  however,  that
48  effective immediately, the addition, amendment and/or repeal of any rule
49  or regulation necessary for the implementation of this act on its effec-
50  tive  date  are  authorized  and directed to be made and completed on or
51  before such effective date.
52                                   PART HH
1    Section 1. Subdivision 1 of section 2805-i of the public  health  law,
2  as  amended  by  chapter  504  of  the laws of 1994 and paragraph (c) as
3  amended by chapter 39 of the  laws  of  2012,  is  amended  to  read  as
5    1.  Every  hospital providing treatment to alleged victims of a sexual
6  offense shall be responsible for:
7    (a) maintaining sexual offense evidence and the chain  of  custody  as
8  provided in subdivision two of this section[.];
9    (b)  contacting  a  rape  crisis or victim assistance organization, if
10  any, providing victim assistance to the geographic area served  by  that
11  hospital to establish the coordination of non-medical services to sexual
12  offense victims who request such coordination and services[.];
13    (c) offering and making available appropriate HIV post-exposure treat-
14  ment  therapies; including a seven day starter pack of HIV post-exposure
15  prophylaxis, in cases where it has been determined, in  accordance  with
16  guidelines  issued  by  the commissioner, that a significant exposure to
17  HIV has occurred, and informing the victim that payment  assistance  for
18  such  therapies  may  be  available  from  the office of victim services
19  pursuant to the provisions of article twenty-two of the  executive  law.
20  With  the  consent of the victim of a sexual assault, the hospital emer-
21  gency room department shall provide or arrange for  an  appointment  for
22  medical  follow-up  related  to  HIV post-exposure prophylaxis and other
23  care as appropriate; and
24    (d) ensuring sexual  assault  survivors  are  not  billed  for  sexual
25  assault  forensic  exams  and  are notified orally and in writing of the
26  option to decline to provide private health  insurance  information  and
27  have  the  office of victim services reimburse the hospital for the exam
28  pursuant to subdivision thirteen of section six  hundred  thirty-one  of
29  the executive law.
30    §  2.  Subdivision  2  of  section  2805-i of the public health law is
31  REPEALED and a new subdivision 2 is added to read as follows:
32    2. Sexual offense  evidence  shall  be  collected  and  maintained  as
34    (a)  All  sexual  offense evidence shall be kept in a locked, separate
35  and secure area for twenty years from the date of  collection;  provided
36  that such evidence shall be transferred to a new location(s) pursuant to
38    (b)  Sexual  offense  evidence  shall  include, but not be limited to,
39  slides, cotton swabs, clothing and other items. Where appropriate,  such
40  items  shall  be  refrigerated and the clothes and swabs shall be dried,
41  stored in paper bags, and labeled.   Each  item  of  evidence  shall  be
42  marked and logged with a code number corresponding to the alleged sexual
43  offense victim's medical record.
44    (c)  Upon  collection,  the  hospital  shall notify the alleged sexual
45  offense victim that, after twenty years,  the  sexual  offense  evidence
46  will  be  discarded  in compliance with state and local health codes and
47  that the alleged sexual offense victim's  clothes  or  personal  effects
48  will  be  returned to the alleged sexual offense victim at any time upon
49  request. The alleged sexual offense victim shall be given the option  of
50  providing  contact  information  for purposes of receiving notice of the
51  planned destruction of such evidence after the expiration of  the  twen-
52  ty-year period.
53    (d)  Until  April first, two thousand twenty-one, or earlier if deter-
54  mined feasible by the director of budget pursuant to  paragraph  (g)  of
55  this  subdivision, hospitals shall be responsible for securing long-term
56  sexual offense evidence pursuant to this section, after which such stor-
1  age shall be the responsibility of the custodian(s)  identified  in  the
2  plan  approved  by  the  director of budget pursuant to paragraph (g) of
3  this subdivision. Hospitals may enter into contracts with other entities
4  that  will  ensure  appropriate  and  secure long-term storage of sexual
5  offense evidence pursuant to this section until April first,  two  thou-
6  sand twenty-one.
7    (e)  Beginning April first, two thousand eighteen, the department, the
8  office of victim services, the division of criminal justice services and
9  the division of state police shall  jointly  study,  evaluate  and  make
10  recommendations  concerning the storage and monitoring of sexual offense
11  evidence for twenty years, including studying options for  the  use  of:
12  state-owned  or  operated  facilities;  facilities  owned or operated by
13  local government or law enforcement agencies; and  facilities  owned  or
14  operated by private entities.
15    (f)  On or before December first, two thousand nineteen, such agencies
16  shall submit a joint plan to the director  of  budget,  speaker  of  the
17  assembly,  and  president  pro  tempore  of the senate, which shall at a
18  minimum include: recommended  storage  location(s)  for  sexual  offense
19  evidence;  a  schedule  for  sexual  offense  evidence held by hospitals
20  pursuant to this section to be transferred to such  storage  location(s)
21  by  April  first,  two thousand twenty-one; and tracking, monitoring and
22  notification option(s).
23    (g) On or before January first, two thousand twenty, the  director  of
24  budget  shall  approve  a  plan that, at a minimum, establishes: storage
25  location(s) for sexual offense evidence by no later  than  April  first,
26  two  thousand  twenty-one;  a  reasonable  schedule  for  sexual offense
27  evidence maintained by hospitals pursuant to this section to  be  trans-
28  ferred to such storage location(s); and tracking, monitoring and notifi-
29  cation system(s).
30    (h)  Between  thirty  and  ten  days  prior  to the transfer of sexual
31  offense evidence to the  storage  location(s)  identified  in  the  plan
32  approved  by  the  director  of budget pursuant to paragraph (g) of this
33  subdivision, hospitals shall make diligent efforts to notify the alleged
34  sexual offense victim of the transfer of custody for  the  remainder  of
35  the twenty-year storage period.
36    (i)  On April first, two thousand twenty-one, or earlier if determined
37  feasible by the director of budget, responsibility for long-term storage
38  of sexual offense evidence shall transfer to the custodian(s) identified
39  in the plan approved by the director of budget pursuant to paragraph (g)
40  of this subdivision.
41    (j) After April first, two thousand twenty-one, or earlier  if  deter-
42  mined  feasible by the director of budget, hospitals shall ensure trans-
43  fer of sexual offense evidence collected pursuant to this section to the
44  custodian(s) identified in the plan approved by the director  of  budget
45  pursuant  to  paragraph  (g)  of  this  subdivision  within  ten days of
46  collection of such evidence, while maintaining chain of custody.
47    (k) At least ninety days prior to the expiration  of  the  twenty-year
48  storage  period for any sexual offense evidence, the custodian(s) of the
49  sexual offense evidence shall  make  diligent  efforts  to  contact  the
50  alleged  sexual  offense  victim  to  notify  the alleged sexual offense
51  victim that the sexual offense evidence will be discarded in  compliance
52  with  state  and  local health codes and that the alleged sexual offense
53  victim's clothes and personal effects will be returned  to  the  alleged
54  sexual offense victim upon request.
55    (l)  Notwithstanding  any  other  provision  in  this  section, sexual
56  offense evidence shall  not  continue  to  be  stored  where:  (i)  such
1  evidence  is not privileged and law enforcement requests its release, in
2  which case the custodian(s) shall comply with such request; or (ii) such
3  evidence is privileged and either (A) the alleged sexual offense  victim
4  gives  permission to release the evidence to law enforcement, or (B) the
5  alleged  sexual  offense  victim  signs  a   statement   directing   the
6  custodian(s)  to  dispose  of  the  evidence,  in  which case the sexual
7  offense evidence will be discarded in compliance with  state  and  local
8  health codes.
9    § 3. Subdivision 13 of section 631 of the executive law, as amended by
11    13. Notwithstanding any other provision of law, rule, or regulation to
12  the  contrary,  when  any New York state accredited hospital, accredited
13  sexual assault  examiner  program,  or  licensed  health  care  provider
14  furnishes  services  to  any  sexual assault survivor, including but not
15  limited to a health care forensic examination in accordance with the sex
16  offense evidence collection protocol and standards  established  by  the
17  department of health, such hospital, sexual assault examiner program, or
18  licensed  healthcare  provider shall provide such services to the person
19  without charge and shall  bill  the  office  directly.  The  office,  in
20  consultation  with  the  department of health, shall define the specific
21  services to be covered by the sexual assault forensic exam reimbursement
22  fee, which must include at a minimum forensic examiner services,  hospi-
23  tal  or  healthcare  facility  services related to the exam, and related
24  laboratory tests and necessary pharmaceuticals; including but not limit-
25  ed to HIV post-exposure prophylaxis provided  by  a  hospital  emergency
26  room  at the time of the forensic rape examination pursuant to paragraph
27  (c) of subdivision one of section twenty-eight  hundred  five-i  of  the
28  public  health  law. Follow-up HIV post-exposure prophylaxis costs shall
29  continue to be reimbursed according to established office procedure. The
30  office, in consultation with the department of health, shall also gener-
31  ate the necessary regulations and forms  for  the  direct  reimbursement
32  procedure.  The  rate  for reimbursement shall be the amount of itemized
33  charges not exceeding eight hundred dollars, to be reviewed and adjusted
34  annually by the office in consultation with the  department  of  health.
35  The  hospital,  sexual assault examiner program, or licensed health care
36  provider must accept this fee as payment in  full  for  these  specified
37  services.  No  additional  billing  of the survivor for said services is
38  permissible. A  sexual  assault  survivor  may  voluntarily  assign  any
39  private  insurance  benefits  to  which  she  or  he is entitled for the
40  healthcare forensic examination, in which case the hospital  or  health-
41  care provider may not charge the office; provided, however, in the event
42  the  sexual  assault survivor assigns any private health insurance bene-
43  fit, such coverage shall not be subject to annual deductibles or coinsu-
44  rance or balance  billing  by  the  hospital,  sexual  assault  examiner
45  program  or  licensed  health care provider.  A hospital, sexual assault
46  examiner program or licensed health care provider shall, at the time  of
47  the  initial  visit,  request assignment of any private health insurance
48  benefits to which the sexual assault survivor  is  entitled  on  a  form
49  prescribed  by the office; provided, however, such sexual assault survi-
50  vor shall be advised orally and in writing that he or she may decline to
51  provide such information regarding private health insurance benefits  if
52  he or she believes that the provision of such information would substan-
53  tially  interfere with his or her personal privacy or safety and in such
54  event, the sexual assault forensic exam fee shall be paid by the office.
55  Such sexual assault survivor shall also be advised that  providing  such
56  information  may  provide  additional  resources  to pay for services to
1  other sexual assault victims. If he or  she  declines  to  provide  such
2  health  insurance information, he or she shall indicate such decision on
3  the form provided by the hospital, sexual assault  examiner  program  or
4  licensed  health  care  provider,  which form shall be prescribed by the
5  office.
6    § 4. Subsection (i) of section 3216 of the insurance law is amended by
7  adding a new paragraph 34 to read as follows:
8    (34) Health care forensic examinations performed pursuant  to  section
9  twenty-eight  hundred  five-i of the public health law covered under the
10  policy shall not be subject to annual deductibles or coinsurance.
11    § 5. Subsection (l) of section 3221 of the insurance law is amended by
13    (20) Health care forensic examinations performed pursuant  to  section
14  twenty-eight  hundred  five-i of the public health law covered under the
17  subsection (rr) to read as follows:
18    (rr)  Health  care forensic examinations performed pursuant to section
19  twenty-eight hundred five-i of the public health law covered  under  the
20  contract shall not be subject to annual deductibles or coinsurance.
21    §  7.  This  act shall take effect immediately, and shall apply to all
22  policies and contracts issued, renewed, modified, altered or amended  on
23  or after the first of January next succeeding such effective date.
24                                   PART II
25    Section  1.  Paragraph  1  of  subdivision (d) of section 13.17 of the
26  mental hygiene law, as added by section 1 of part Q of chapter 59 of the
28    1. provide appropriate and timely notification to the temporary presi-
29  dent of the senate, and the speaker of the assembly, and to  appropriate
30  representatives  of  impacted  labor organizations. Such notification to
31  the representatives of impacted labor organizations  shall  be  made  as
32  soon  as practicable, but no less than [forty-five] ninety days prior to
33  such closure or transfer except in the  case  of  exigent  circumstances
34  impacting  the health, safety, or welfare of the residents of the IRA as
35  determined by the office. Provided, however, that nothing  herein  shall
36  limit  the ability of the office to effectuate such closure or transfer;
37  and
38    § 2. Section 2 of part Q of chapter 59 of the laws of  2016,  amending
39  the  mental  hygiene law relating to the closure or transfer of a state-
40  operated individualized residential alternative, is amended to  read  as
42    §  2.  This  act shall take effect immediately and shall expire and be
43  deemed repealed March 31, [2018] 2020.
44    § 3. This act shall take effect immediately, provided,  however,  that
45  the amendments to subdivision (d) of section 13.17 of the mental hygiene
47  subdivision and shall be deemed repealed therewith.
48                                   PART JJ
49    Section 1. The mental hygiene law is amended by adding a  new  section
51  § 13.43 First responder training.
1    (a) The commissioner, in consultation with the commissioner of health,
2  the office of fire prevention and control, the municipal police training
3  council,  and the superintendent of state police, shall develop a train-
4  ing program and associated training materials,  to  provide  instruction
5  and  information  to firefighters, police officers and emergency medical
6  services personnel on appropriate recognition  and  response  techniques
7  for  handling  emergency  situations  involving  individuals with autism
8  spectrum disorder and other  developmental  disabilities.  The  training
9  program and associated training materials shall include any other infor-
10  mation deemed necessary and appropriate by the commissioner.
11    (b)  Such  training  shall address appropriate response techniques for
12  dealing with both adults and minors with autism  spectrum  disorder  and
13  other developmental disabilities.
14    (c) Such training program may be developed as an online program.
15    §  2. The public health law is amended by adding a new section 3054 to
17    § 3054. Emergency situations involving individuals with  autism  spec-
18  trum disorder and other developmental disabilities. In coordination with
19  the  commissioner  of the office for people with developmental disabili-
20  ties, the commissioner shall provide the training  program  relating  to
21  handling emergency situations involving individuals with autism spectrum
22  disorder  and  other  developmental disabilities and associated training
23  materials pursuant to section 13.43 of the mental  hygiene  law  to  all
24  emergency  medical  services  personnel  including,  but not limited to,
25  first responders,  emergency  medical  technicians,  advanced  emergency
26  medical technicians and emergency vehicle operators.
27    §  3.  Section  156  of  the  executive law is amended by adding a new
28  subdivision 22 to read as follows:
29    22. In coordination with the commissioner of  the  office  for  people
30  with  developmental  disabilities, provide the training program relating
31  to handling emergency situations involving individuals with autism spec-
32  trum disorder and other developmental disabilities and associated train-
33  ing materials pursuant to section 13.43 of the mental hygiene law to all
34  firefighters, both paid and volunteer.    The  office  shall  adopt  all
35  necessary rules and regulations relating to such training, including the
36  process  by  which training hours are allocated to counties as well as a
37  uniform procedure  for  requesting  and  providing  additional  training
38  hours.
41    5. The council shall, in addition:
42    (a) Develop,  maintain  and  disseminate,  in  consultation  with  the
43  commissioner  of  the office for people with developmental disabilities,
44  written policies and procedures consistent with  section  13.43  of  the
45  mental  hygiene  law,  regarding  the  handling  of emergency situations
46  involving individuals with autism spectrum disorder and  other  develop-
47  mental disabilities.  Such policies and procedures shall make provisions
48  for the education and training of new and veteran police officers on the
49  handling of emergency situations involving individuals with autism spec-
50  trum disorder and other developmental disabilities; and
51    (b)  Recommend  to the governor, rules and regulations with respect to
52  the establishment and implementation on an ongoing basis of  a  training
53  program  for  all current and new police officers regarding the policies
54  and procedures established pursuant  to  this  subdivision,  along  with
55  recommendations for periodic retraining of police officers.
1    §  5.  The  executive  law is amended by adding a new section 214-f to
3    §  214-f.  Emergency  situations involving people with autism spectrum
4  disorder and other developmental disabilities. The superintendent shall,
5  for all members of the state police:
6    1. Develop, maintain and disseminate, in consultation with the commis-
7  sioner of the office for people with developmental disabilities, written
8  policies and procedures consistent with  section  13.43  of  the  mental
9  hygiene  law,  regarding  the handling of emergency situations involving
10  individuals with autism spectrum disorder and other developmental  disa-
11  bilities.    Such  policies and procedures shall make provisions for the
12  education and training of new and veteran police officers on the  handl-
13  ing  of  emergency  situations  involving individuals with developmental
14  disabilities; and
15    2. Recommend to the governor, rules and regulations  with  respect  to
16  establishment  and  implementation  on  an  ongoing  basis of a training
17  program for all current and new police officers regarding  the  policies
18  and  procedures  established  pursuant  to  this subdivision, along with
21  it shall have become a law; provided, however, that the commissioner  of
22  the office for people with developmental disabilities may promulgate any
23  rules and regulations necessary for the implementation of this act on or
25                                   PART KK
27  which are necessary to combat sexual harassment in the  workplace.  Each
28  component  is wholly contained within a Subpart identified as Subparts A
29  through F.  The effective date for each particular  provision  contained
30  within  such  Subpart  is set forth in the last section of such Subpart.
31  Any provision in any section contained within a Subpart,  including  the
32  effective  date of the Subpart, which makes a reference to a section "of
33  this act," when used in connection with that particular component, shall
34  be deemed to mean and refer to the corresponding section of the  Subpart
35  in  which it is found. Section three of this Part sets forth the general
36  effective date of the Part.
38    Section 1. The state finance law is amended by adding  a  new  section
39  139-l to read as follows:
40    §  139-l.  Statement  on  sexual harassment, in bids. 1. (a) Every bid
41  hereafter made to the state or any public department or agency  thereof,
42  where  competitive  bidding  is required by statute, rule or regulation,
43  for work or services performed or to be performed or goods sold or to be
44  sold, shall contain the following statement subscribed by the bidder and
45  affirmed by such bidder as true under the penalty of perjury:
46  "By submission of this bid, each  bidder  and  each  person  signing  on
47  behalf  of  any  bidder  certifies,  and in the case of a joint bid each
48  party thereto certifies as to its own  organization,  under  penalty  of
49  perjury,  that  the  bidder  has  and  has  implemented a written policy
50  addressing sexual harassment prevention in the  workplace  and  provides
51  annual  sexual  harassment  prevention training to all of its employees.
1  Such policy shall, at a minimum, meet the requirements  of  section  two
2  hundred one-g of the labor law."
3    (b)  Every bid hereafter made to the state or any public department or
4  agency thereof, where competitive bidding is not  required  by  statute,
5  rule or regulation, for work or services performed or to be performed or
6  goods  sold or to be sold, may contain, at the discretion of the depart-
7  ment, agency or official, the certification required pursuant  to  para-
8  graph (a) of this subdivision.
9    2.  Notwithstanding the foregoing, the statement required by paragraph
10  (a) of subdivision one of this section may be  submitted  electronically
11  in  accordance  with  the provisions of subdivision seven of section one
12  hundred sixty-three of this chapter.
13    3. A bid shall not be considered for award nor shall any award be made
14  to a bidder who has not complied with subdivision one of  this  section;
15  provided,  however, that if the bidder cannot make the foregoing certif-
16  ication, such bidder shall so state and shall furnish  with  the  bid  a
17  signed statement which sets forth in detail the reasons therefor.
18    4. Any bid hereafter made to the state or any public department, agen-
19  cy  or  official  thereof,  by  a  corporate bidder for work or services
20  performed or to be performed or goods sold or to be sold, where such bid
21  contains the statement required by  subdivision  one  of  this  section,
22  shall  be  deemed  to  have been authorized by the board of directors of
23  such bidder, and such authorization shall be deemed to include the sign-
24  ing and submission of such bid and the inclusion therein of such  state-
25  ment as the act and deed of the corporation.
26    § 2. Subdivision 7 of section 163 of the state finance law, as amended
27  by section 10 of part L of chapter 55 of the laws of 2012, is amended to
29    7. Method of procurement. Consistent with the requirements of subdivi-
30  sions  three and four of this section, state agencies shall select among
31  permissible methods of procurement including, but  not  limited  to,  an
32  invitation for bid, request for proposals or other means of solicitation
33  pursuant  to  guidelines  issued by the state procurement council. State
34  agencies may accept bids  electronically  including  submission  of  the
35  statement of non-collusion required by section one hundred thirty-nine-d
36  of  this chapter, and the statement of certification required by section
37  one hundred thirty-nine-l of this chapter, and,  starting  April  first,
38  two  thousand  twelve,  and  ending  March  thirty-first,  two  thousand
39  fifteen, may, for commodity, service and  technology  contracts  require
40  electronic  submission as the sole method for the submission of bids for
41  the solicitation. State agencies shall undertake no  more  than  eighty-
42  five  such  electronic bid solicitations, none of which shall be reverse
43  auctions, prior to April first, two thousand fifteen. In addition, state
44  agencies may conduct up to twenty reverse  auctions  through  electronic
45  means,  prior  to  April first, two thousand fifteen. Prior to requiring
46  the electronic submission of bids, the  agency  shall  make  a  determi-
47  nation,  which shall be documented in the procurement record, that elec-
48  tronic submission affords a fair and equal opportunity for  offerers  to
49  submit  responsive  offers.  Within thirty days of the completion of the
50  eighty-fifth electronic bid solicitation, or by April first,  two  thou-
51  sand  fifteen,  whichever  is  earlier, the commissioner shall prepare a
52  report assessing the use of electronic submissions and make  recommenda-
53  tions  regarding  future  use  of  this procurement method. In addition,
54  within thirty days of the completion of the  twentieth  reverse  auction
55  through  electronic  means,  or  by  April  first, two thousand fifteen,
56  whichever is earlier, the commissioner shall prepare a report  assessing
1  the  use of reverse auctions through electronic means and make recommen-
2  dations regarding future use of this procurement  method.  Such  reports
3  shall  be  published  on  the website of the office of general services.
4  Except  where  otherwise  provided by law, procurements shall be compet-
5  itive, and state agencies shall conduct formal competitive  procurements
6  to  the  maximum  extent  practicable. State agencies shall document the
7  determination of the method of procurement and the basis of award in the
8  procurement record. Where the basis for award is the best  value  offer,
9  the  state  agency  shall  document,  in  the  procurement record and in
10  advance of the initial receipt of offers, the determination of the eval-
11  uation criteria, which whenever possible, shall be quantifiable, and the
12  process to be used in the determination of best value and the manner  in
13  which the evaluation process and selection shall be conducted.
15  ing the date on which it shall have become  a  law;  provided,  however,
16  that the amendments to subdivision 7 of section 163 of the state finance
18  section and shall be deemed repealed therewith.
20    Section 1. The civil practice law and rules are amended  by  adding  a
21  new section 7515 to read as follows:
22    § 7515. Mandatory arbitration clauses; prohibited. (a) Definitions. As
23  used in this section:
24    1.  The  term  "employer"  shall  have the same meaning as provided in
25  subdivision five of section two hundred ninety-two of the executive law.
26    2. The term "prohibited clause" shall mean any clause or provision  in
27  any  contract  which  requires  as a condition of the enforcement of the
28  contract or obtaining remedies  under  the  contract  that  the  parties
29  submit to mandatory arbitration to resolve any allegation or claim of an
30  unlawful discriminatory practice of sexual harassment.
31    3.  The  term  "mandatory  arbitration  clause"  shall  mean a term or
32  provision contained in a written contract which requires the parties  to
33  such  contract  to  submit  any  matter  thereafter  arising  under such
34  contract to arbitration prior to the commencement of any legal action to
35  enforce the provisions of such contract and which also further  provides
36  language to the effect that the facts found or determination made by the
37  arbitrator  or panel of arbitrators in its application to a party alleg-
38  ing an unlawful discriminatory practice based on sexual harassment shall
39  be final and not subject to independent court review.
40    4. The term "arbitration" shall mean the  use  of  a  decision  making
41  forum  conducted  by  an  arbitrator  or panel of arbitrators within the
42  meaning and subject to the provisions of  article  seventy-five  of  the
43  civil practice law and rules.
44    (b)  (i)  Prohibition.  Except where inconsistent with federal law, no
45  written contract, entered into on or after the effective  date  of  this
46  section shall contain a prohibited clause as defined in paragraph two of
47  subdivision (a) of this section.
48    (ii)  Exceptions. Nothing contained in this section shall be construed
49  to impair or prohibit an employer from  incorporating  a  non-prohibited
50  clause  or  other  mandatory arbitration provision within such contract,
51  that the parties agree upon.
52    (iii) Mandatory arbitration clause null and void. Except where  incon-
53  sistent  with  federal  law, the provisions of such prohibited clause as
54  defined in paragraph two of subdivision (a) of  this  section  shall  be
1  null  and void. The inclusion of such clause in a written contract shall
2  not serve to impair the enforceability of any other  provision  of  such
3  contract.
4    (c) Where there is a conflict between any collective bargaining agree-
5  ment and this section, such agreement shall be controlling.
7  have become a law.
8                                  SUBPART C
9    Section 1. The public officers law is amended by adding a new  section
10  17-a to read as follows:
11    §  17-a. Reimbursement of funds paid by state agencies and state enti-
12  ties for the payment of awards adjudicated in sexual harassment  claims.
13  1.  As  used  in this section, the term "employee" shall mean any person
14  holding a position  by  election,  appointment,  or  employment  in  the
15  service  of  the state of New York, whether or not compensated. The term
16  "employee" shall include  a  former  employee  or  judicially  appointed
17  personal representative.
18    2.  Notwithstanding any law to the contrary, any employee who has been
19  subject to a final judgment of personal liability for intentional wrong-
20  doing related to a claim of sexual harassment, shall reimburse any state
21  agency or entity that makes a payment to a plaintiff for an  adjudicated
22  award based on a claim of sexual harassment resulting in a judgment, for
23  his  or  her  proportionate  share of such judgment. Such employee shall
24  personally reimburse such state agency or entity within ninety  days  of
25  the state agency or entity's payment of such award.
26    3.  If  such  employee  fails to reimburse such state agency or entity
27  pursuant to subdivision two of this section within ninety days from  the
28  date  such  state  agency  or  entity  makes a payment for the financial
29  award, the comptroller shall, upon obtaining a money judgment,  withhold
30  from  such  employee's  compensation  the  amounts allowable pursuant to
31  section fifty-two hundred thirty-one  of  the  civil  practice  law  and
32  rules.
33    4.  If  such  employee  is  no longer employed by such state agency or
34  entity such state agency or entity  shall  have  the  right  to  receive
35  reimbursement  through  the  enforcement of a money judgment pursuant to
36  article fifty-two of the civil practice law and rules.
37    § 2. The public officers law is amended by adding a new  section  18-a
39    § 18-a. Reimbursement of funds paid by a public entity for the payment
40  of  awards  adjudicated  in sexual harassment claims. 1. As used in this
41  section:
42    (a) The term "public entity" shall mean  (i)  a  county,  city,  town,
43  village  or  any  other  political  subdivision or civil division of the
44  state;  (ii)  a  school  district,  board  of  cooperative   educational
45  services, or any other governmental entity or combination or association
46  of  governmental  entities operating a public school, college, community
47  college or university; (iii) a public improvement or  special  district;
48  (iv)  a  public  authority,  commission, agency or public benefit corpo-
49  ration; or (v) any other separate corporate instrumentality or  unit  of
50  government;  but  shall  not  include the state of New York or any other
51  public entity the employees of which are covered by section  seventeen-a
52  of this article.
53    (b)  The  term  "employee"  shall  mean  any commissioner, member of a
54  public board or commission, trustee, director, officer, employee, or any
1  other person holding a position by election, appointment  or  employment
2  in  the service of a public entity, whether or not compensated. The term
3  "employee" shall include  a  former  employee  or  judicially  appointed
4  personal representative.
5    2.  Notwithstanding any law to the contrary, any employee who has been
6  subject to a final judgment of personal liability for intentional wrong-
7  doing related to a claim  of  sexual  harassment,  shall  reimburse  any
8  public  entity  that  makes  a payment to a plaintiff for an adjudicated
9  award based on a claim of sexual harassment resulting in a judgment, for
10  his or her proportionate share of such  judgment.  Such  employee  shall
11  personally reimburse such public entity within ninety days of the public
12  entity's payment of such award.
13    3.  If such employee fails to reimburse such public entity pursuant to
14  subdivision two of this section within ninety days from  the  date  such
15  public  entity makes a payment for the financial award, the chief fiscal
16  officer of such public entity shall, upon obtaining  a  money  judgment,
17  withhold  from such employee's compensation the amounts allowable pursu-
18  ant to section fifty-two hundred thirty-one of the  civil  practice  law
19  and rules.
20    4.  If such employee is no longer employed by such public entity, such
21  public entity shall have the right to receive reimbursement through  the
22  enforcement  of  a  money  judgment pursuant to article fifty-two of the
25                                  SUBPART D
26    Section 1. The general obligations law is  amended  by  adding  a  new
27  section 5-336 to read as follows:
28    §  5-336.  Nondisclosure  agreements. Notwithstanding any other law to
29  the contrary, no employer, its officers  or  employees  shall  have  the
30  authority to include or agree to include in any settlement, agreement or
31  other resolution of any claim, the factual foundation for which involves
32  sexual  harassment, any term or condition that would prevent the disclo-
33  sure of the underlying facts and circumstances to the  claim  or  action
34  unless the condition of confidentiality is the complainant's preference.
35  Any  such  term  or  condition  must be provided to all parties, and the
36  complainant shall have twenty-one days to consider such term  or  condi-
37  tion.   If   after  twenty-one  days  such  term  or  condition  is  the
38  complainant's preference, such preference shall be  memorialized  in  an
39  agreement  signed  by  all  parties. For a period of at least seven days
40  following the execution of such agreement, the  complainant  may  revoke
41  the  agreement,  and  the  agreement  shall  not  become effective or be
42  enforceable until such revocation period has expired.
43    § 2. The civil practice law and rules  is  amended  by  adding  a  new
44  section 5003-b to read as follows:
45    §  5003-b.  Nondisclosure agreements. Notwithstanding any other law to
46  the contrary, for any claim or cause of action,  whether  arising  under
47  common  law, equity, or any provision of law, the factual foundation for
48  which involves sexual harassment,  in  resolving,  by  agreed  judgment,
49  stipulation, decree, agreement to settle, assurance of discontinuance or
50  otherwise, no employer, its officer or employee shall have the authority
51  to  include or agree to include in such resolution any term or condition
52  that would prevent the disclosure of the underlying  facts  and  circum-
53  stances  to  the claim or action unless the condition of confidentiality
54  is the plaintiff's preference.  Any  such  term  or  condition  must  be
1  provided to all parties, and the plaintiff shall have twenty-one days to
2  consider  such  term or condition. If after twenty-one days such term or
3  condition is the plaintiff's preference, such preference shall be  memo-
4  rialized in an agreement signed by all parties. For a period of at least
5  seven  days following the execution of such agreement, the plaintiff may
6  revoke the agreement, and the agreement shall not become effective or be
7  enforceable until such revocation period has expired.
8    § 3. This act shall take effect on the ninetieth day  after  it  shall
10                                  SUBPART E
11    Section  1.  The labor law is amended by adding a new section 201-g to
13    § 201-g. Prevention of sexual  harassment.  1.  The  department  shall
14  consult  with the division of human rights to create and publish a model
15  sexual harassment prevention guidance  document  and  sexual  harassment
16  prevention  policy  that  employers  may  utilize in their adoption of a
17  sexual harassment prevention policy required by this section.
18     a. Such model sexual harassment prevention policy shall: (i) prohibit
19  sexual harassment consistent with guidance issued by the  department  in
20  consultation  with  the division of human rights and provide examples of
21  prohibited conduct that would  constitute  unlawful  sexual  harassment;
22  (ii)  include  but  not be limited to information concerning the federal
23  and state statutory provisions concerning sexual harassment and remedies
24  available to victims of sexual harassment and a statement that there may
25  be applicable local laws; (iii) include a standard complaint form;  (iv)
26  include  a  procedure  for  the timely and confidential investigation of
27  complaints and ensure due process for all parties; (v) inform  employees
28  of  their  rights  of  redress and all available forums for adjudicating
29  sexual  harassment  complaints  administratively  and  judicially;  (vi)
30  clearly  state  that  sexual harassment is considered a form of employee
31  misconduct and that  sanctions  will  be  enforced  against  individuals
32  engaging  in  sexual  harassment  and against supervisory and managerial
33  personnel who knowingly allow  such  behavior  to  continue;  and  (vii)
34  clearly state that retaliation against individuals who complain of sexu-
35  al  harassment  or who testify or assist in any proceeding under the law
36  is unlawful.
37    b. Every employer shall adopt the model sexual  harassment  prevention
38  policy  promulgated  pursuant  to this subdivision or establish a sexual
39  harassment prevention policy to prevent sexual harassment that equals or
40  exceeds the minimum standards provided by such model  sexual  harassment
41  prevention  policy.  Such  sexual  harassment prevention policy shall be
42  provided to all employees  in  writing.  Such  model  sexual  harassment
43  prevention policy shall be publicly available and posted on the websites
44  of both the department and the division of human rights.
45    2.  The department shall consult with the division of human rights and
46  produce a model sexual harassment prevention training program to prevent
47  sexual harassment in the workplace.
48    a. Such model sexual harassment prevention training program  shall  be
49  interactive  and  include:    (i)  an  explanation  of sexual harassment
50  consistent with guidance issued by the department in  consultation  with
51  the  division  of  human  rights;  (ii)  examples  of conduct that would
52  constitute unlawful sexual harassment; (iii) information concerning  the
53  federal  and state statutory provisions concerning sexual harassment and
54  remedies available to victims of sexual harassment; and (iv) information
1  concerning employees' rights of redress and  all  available  forums  for
2  adjudicating complaints.
3    b.  The  department  shall  include  information  in such model sexual
4  harassment prevention training program addressing conduct by supervisors
5  and any additional responsibilities for such supervisors.
6    c. Every employer shall utilize the model sexual harassment prevention
7  training program pursuant to this subdivision or  establish  a  training
8  program  for  employees  to  prevent  sexual  harassment  that equals or
9  exceeds the minimum standards provided  by  such  model  training.  Such
10  sexual harassment prevention training shall be provided to all employees
11  on an annual basis.
12    3.  The  commissioner  may  promulgate  regulations as he or she deems
13  necessary for the purposes  of  carrying  out  the  provisions  of  this
14  section.
16  it  shall  have  become a law.  Effective immediately, the department of
17  labor, in consultation with the division of human rights, is  authorized
18  to  create  the  model sexual harassment prevention policy and the model
19  sexual harassment prevention training program required to be created and
20  published pursuant to section 201-g of the labor law as added by section
21  one of this act.
22                                  SUBPART F
23    Section 1. The executive law is amended by adding a new section  296-d
25    §  296-d.  Sexual harassment relating to non-employees. It shall be an
26  unlawful discriminatory  practice  for  an  employer  to  permit  sexual
27  harassment  of  non-employees in its workplace.  An employer may be held
28  liable to a non-employee who is  a  contractor,  subcontractor,  vendor,
29  consultant  or other person providing services pursuant to a contract in
30  the workplace or who is an employee of such  contractor,  subcontractor,
31  vendor,  consultant  or  other  person  providing services pursuant to a
32  contract in the workplace, with respect to sexual harassment,  when  the
33  employer,  its agents or supervisors knew or should have known that such
34  non-employee was subjected to sexual harassment in the employer's  work-
35  place, and the employer failed to take immediate and appropriate correc-
36  tive action. In reviewing such cases involving non-employees, the extent
37  of  the  employer's control and any other legal responsibility which the
38  employer may have with respect to the conduct of the harasser  shall  be
39  considered.
40    §  2. Subdivision 4 of section 292 of the executive law, as amended by
42    4. The term "unlawful discriminatory  practice"  includes  only  those
43  practices  specified  in  sections  two  hundred ninety-six, two hundred
44  ninety-six-a  [and],  two   hundred   ninety-six-c   and   two   hundred
45  ninety-six-d of this article.
48  sion,  section  or subpart of this act shall be adjudged by any court of
49  competent jurisdiction to be invalid, such judgment  shall  not  affect,
50  impair,  or  invalidate  the remainder thereof, but shall be confined in
51  its operation to the clause, sentence, paragraph,  subdivision,  section
52  or  subject  thereof  directly involved in the controversy in which such
53  judgment shall have been rendered. It  is  hereby  declared  to  be  the
1  intent  of the legislature that this act would have been enacted even if
2  such invalid provisions had not been included herein.
4  the applicable effective dates of Subparts A  through  F  of  this  Part
5  shall be as specifically set forth in the last section of such Subparts.
6                                   PART LL
8  1114-a to read as follows:
9    § 1114-a. Voluntary public water system consolidation study. 1.  There
10  shall be established in the department, by the commissioner, a voluntary
11  public water system consolidation study designed to evaluate the  feasi-
12  bility  of the joining of public water systems in order to improve water
13  quality. Such study shall include:
14    (a) the feasibility of joining of two or more public water systems  to
15  form one water system;
16    (b)  the  feasibility of the consolidation of one or more public water
17  systems into a larger public water system;
18    (c) the  appropriate  technical,  managerial  and  financial  capacity
19  necessary  for  consolidation,  including  state  funding mechanisms and
20  incentives that could be utilized;
21    (d) potential public health impacts of consolidation, including abili-
22  ty to meet legally required water quality standards and  the  impact  on
23  monitoring, reporting and enforcement of drinking water standards;
24    (e)  appropriate and sufficient guidance from the department necessary
25  for those public water systems interested in consolidation; and
26    (f) recommendations for public water systems interested  in  voluntary
27  consolidation.
28    2.  The  department  shall  prepare and submit a report and supporting
29  materials to the governor, the temporary president of the senate and the
30  speaker of the assembly  setting  forth  the  information  gathered  and
31  recommendations  to  the  legislature  by January first of the following
32  year.
34                                   PART MM
35    Section 1. The public health law is amended by adding  a  new  section
36  280-c to read as follows:
37    §  280-c.  Pharmacy  audits  by  pharmacy benefit managers. 1.   Defi-
38  nitions. As used in this section, the following  terms  shall  have  the
39  following meanings:
40    (a)  "Pharmacy  benefit  manager"  shall  have  the same meaning as in
41  section two hundred eighty-a of this article.
42    (b) "Pharmacy" shall mean a pharmacy that has contracted with a  phar-
43  macy benefit manager for the provision of pharmacy services.
44    2.  When conducting an audit of a pharmacy's records, a pharmacy bene-
45  fit manager shall:
46    (a) not conduct an on-site audit of a pharmacy at any time during  the
47  first three calendar days of a month;
48    (b) notify the pharmacy or its contracting agent no later than fifteen
49  days  before the date of initial on-site audit. Such notification to the
50  pharmacy or its contracting agent shall be in writing  delivered  either
51  (i)  by  mail or common carrier, return receipt requested, or (ii) elec-
52  tronically with electronic receipt confirmation, addressed to the super-
1  vising pharmacist of record and pharmacy corporate office where applica-
2  ble, at least fifteen days before the date of an initial on-site audit;
3    (c)  limit  the  audit  period  to twenty-four months after the date a
4  claim is submitted to or adjudicated by the pharmacy benefit manager;
5    (d) include in the written advance notice of an on-site audit the list
6  of specific prescription numbers to be included in the audit that may or
7  may not include the final two digits of the prescription numbers;
8    (e) use the written and verifiable records of a hospital, physician or
9  other authorized practitioner, which are transmitted  by  any  means  of
10  communication, to validate the pharmacy records in accordance with state
11  and federal law;
12    (f)  limit  the  number  of  prescriptions audited to no more than one
13  hundred randomly selected in a twelve-month period, except in  cases  of
14  fraud;
15    (g)  provide  the pharmacy or its contracting agent with a copy of the
16  preliminary audit report within forty-five days after the conclusion  of
17  the audit;
18    (h)  be  allowed  to  conduct a follow-up audit on-site if a remote or
19  desk audit reveals the necessity for a review of additional claims;
20    (i) in the case of invoice audits, accept as validation invoices  from
21  any  wholesaler  registered  with the department of education from which
22  the pharmacy has purchased prescription drugs or, in the case of durable
23  medical equipment or sickroom  supplies,  invoices  from  an  authorized
24  distributor other than a wholesaler;
25    (j)  provide the pharmacy or its contracting agent with the ability to
26  provide  documentation  to  address  a  discrepancy  or  audit  finding,
27  provided  that such documentation must be received by the pharmacy bene-
28  fit manager no later than the  forty-fifth  day  after  the  preliminary
29  audit  report was provided to the pharmacy or its contracting agent. The
30  pharmacy benefit manager shall consider a reasonable  request  from  the
31  pharmacy  for an extension of time to submit documentation to address or
32  correct any findings in the report; and
33    (k) provide the pharmacy or its contracting agent with the final audit
34  report no later than sixty days  after  the  initial  audit  report  was
35  provided to the pharmacy or its contracting agent.
36    3. Any claim that was retroactively denied for a clerical error, typo-
37  graphical  error,  scrivener's  error or computer error shall be paid if
38  the prescription was properly and correctly dispensed, unless a  pattern
39  of  such  errors  exists,  fraudulent  billing  is  alleged or the error
40  results in actual financial loss to the entity.  A clerical error is  an
41  error that does not result in actual financial harm to the covered enti-
42  ty or consumer and does not include the dispensing of an incorrect dose,
43  amount  or  type  of medication or dispensing a prescription drug to the
44  wrong person.
45    4. This section shall not apply to:
46    (a) audits in which suspected fraudulent activity or other intentional
47  or willful misrepresentation is evidenced by a physical  review,  review
48  of claims data or statements, or other investigative methods; or
49    (b) audits of claims paid for by federally funded programs; or
50    (c) concurrent reviews or desk audits that occur within three business
51  days of transmission of a claim and where no chargeback or recoupment is
52  demanded.
53    §  2.  Section 280-a of the public health law is amended by adding two
54  new subdivisions 3 and 4 to read as follows:
55    3. No pharmacy  benefit  manager  shall,  with  respect  to  contracts
56  between  such pharmacy benefit manager and a pharmacy or, alternatively,
1  such pharmacy benefit manager and a pharmacy's contracting  agent,  such
2  as a pharmacy services administrative organization:
3    (a)  prohibit  or penalize a pharmacist or pharmacy from disclosing to
4  an individual purchasing a prescription medication  information  regard-
5  ing:
6    (1) the cost of the prescription medication to the individual, or
7    (2)  the  availability  of  any therapeutically equivalent alternative
8  medications or alternative methods of purchasing the prescription  medi-
9  cation, including but not limited to, paying a cash price; or
10    (b)  charge or collect from an individual a copayment that exceeds the
11  total submitted charges by the pharmacy for which the pharmacy is  paid.
12  If an individual pays a copayment, the pharmacy shall retain the adjudi-
13  cated  costs and the pharmacy benefit manager shall not redact or recoup
14  the adjudicated cost.
15    4. Any provision of a contract that violates the  provisions  of  this
16  section shall be deemed to be void and unenforceable.
17    §  3.  Paragraph 31 of subsection (i) of section 3216 of the insurance
18  law is amended by adding a new subparagraph (E) to read as follows:
19    (E) This subparagraph shall apply to facilities in this  state  certi-
20  fied  by  the  office of alcoholism and substance abuse services for the
21  provision of outpatient, intensive outpatient, outpatient rehabilitation
22  and opioid treatment that are participating in  the  insurer's  provider
23  network.  Coverage provided under this paragraph shall not be subject to
24  preauthorization. Coverage provided under this paragraph  shall  not  be
25  subject  to  concurrent  review  for  the  first two weeks of continuous
26  treatment, not to exceed fourteen visits, provided the facility notifies
27  the insurer of both the start of treatment  and  the  initial  treatment
28  plan  within  forty-eight  hours.  The  facility  shall perform clinical
29  assessment of the patient at each visit, including the periodic  consul-
30  tation  with  the  insurer  to  ensure  that  the  facility is using the
31  evidence-based and peer reviewed clinical review tool  utilized  by  the
32  insurer  which  is  designated by the office of alcoholism and substance
33  abuse services and appropriate to the age of the patient, to ensure that
34  the outpatient treatment is medically necessary  for  the  patient.  Any
35  utilization review of the treatment provided under this subparagraph may
36  include  a review of all services provided during such outpatient treat-
37  ment, including all services provided during  the  first  two  weeks  of
38  continuous  treatment, not to exceed fourteen visits, of such outpatient
39  treatment. Provided, however, the insurer shall only deny  coverage  for
40  any  portion  of  the  initial two weeks of continuous treatment, not to
41  exceed fourteen visits, for outpatient treatment on the basis that  such
42  treatment  was  not medically necessary if such outpatient treatment was
43  contrary to the evidence-based and peer reviewed  clinical  review  tool
44  utilized  by the insurer which is designated by the office of alcoholism
45  and substance abuse services.  An insured shall not have  any  financial
46  obligation  to  the  facility  for any treatment under this subparagraph
47  other than any copayment, coinsurance, or deductible otherwise  required
48  under the policy.
49    §  4.  Paragraph  7 of subsection (1) of section 3221 of the insurance
1  subject  to  concurrent  review  for  the  first two weeks of continuous
2  treatment, not to exceed fourteen visits, provided the facility notifies
3  the insurer of both the start of treatment  and  the  initial  treatment
4  plan  within  forty-eight  hours.  The  facility  shall perform clinical
5  assessment of the patient at each visit, including the periodic  consul-
6  tation  with  the  insurer  to  ensure  that  the  facility is using the
7  evidence-based and peer reviewed clinical review tool  utilized  by  the
8  insurer  which  is  designated by the office of alcoholism and substance
9  abuse services and appropriate to the age of the patient, to ensure that
26  adding a new paragraph 5 to read as follows:
27    (5)  This  paragraph shall apply to facilities in this state certified
28  by the office  of  alcoholism  and  substance  abuse  services  for  the
30  and opioid treatment that are participating in the corporation's provid-
31  er network. Coverage provided under this subsection shall not be subject
32  to  preauthorization.  Coverage provided under this subsection shall not
33  be subject to concurrent review for the first two  weeks  of  continuous
35  the corporation of both the start of treatment and the initial treatment
38  tation  with  the  corporation  to ensure that the facility is using the
40  corporation  which  is  designated  by  the  office  of  alcoholism  and
41  substance abuse services and appropriate to the age of the  patient,  to
42  ensure  that  the  outpatient  treatment  is medically necessary for the
43  patient. Any utilization review of the  treatment  provided  under  this
44  paragraph  may  include  a  review  of all services provided during such
45  outpatient treatment, including all services provided during  the  first
46  two  weeks  of  continuous  treatment, not to exceed fourteen visits, of
47  such outpatient treatment. Provided, however, the corporation shall only
48  deny coverage for any portion of the initial  two  weeks  of  continuous
49  treatment,  not  to  exceed fourteen visits, for outpatient treatment on
50  the basis that such treatment was not medically necessary if such outpa-
51  tient treatment was contrary to the  evidence-based  and  peer  reviewed
52  clinical  review tool utilized by the corporation which is designated by
53  the office of alcoholism and  substance  abuse  services.  A  subscriber
54  shall  not  have any financial obligation to the facility for any treat-
55  ment under this paragraph other  than  any  copayment,  coinsurance,  or
56  deductible otherwise required under the contract.
1    §  6. The public health law is amended by adding two new sections 2531
2  and 2532 to read as follows:
3    §  2531. Children and recovering mothers program. Subject to appropri-
4  ation, the commissioner, in consultation with the commissioner of  alco-
5  holism  and  substance  abuse  services,  is authorized to establish the
6  children and recovering mothers program, a program  aimed  at  providing
7  health  care providers, hospitals and midwifery birth centers with guid-
8  ance, education and assistance when providing care to expectant  mothers
9  with a substance use disorder.  Such program shall:
10    1. Provide information to both health care providers as well as expec-
11  tant mothers regarding use of medication assisted treatment for pregnant
12  women,  which  shall include information regarding buprenorphrine train-
13  ing, tools for  providers  on  effective  management  of  women  with  a
14  substance  use disorder during pregnancy, and a referral list of provid-
15  ers in the area;
16    2. Provide guidance and referral information for substance use  disor-
17  der  services,  home  visiting  services and other benefits and services
18  that they may be eligible for while expecting and after birth;
19    3. Develop a  system  for  rapid  consultation  and  referral  linkage
20  services  for  obstetricians  and  primary  care providers statewide who
21  provide care for expectant mothers with substance use disorders;
22    4. Provide guidance on the identification of  signs  and  symptoms  of
23  substance use disorder in expectant mothers; and
24    5. Anything else deemed necessary to implement the program.
25    §  2532.  Workgroup. The commissioner, in conjunction with the commis-
26  sioner of alcoholism and substance abuse services, shall convene a work-
27  group of stakeholders, including but not limited  to,  hospitals,  local
28  health   departments,   obstetricians,   midwives,   pediatricians,  and
29  substance use disorder providers to  study  and  evaluate  barriers  and
30  challenges  in  identifying and treating expectant mothers, newborns and
31  new parents with a substance use disorder. The workgroup shall report on
32  its findings and recommendations to the commissioner,  the  commissioner
33  of  alcoholism and substance abuse services, the speaker of the assembly
34  and the temporary president of the senate within one year of the  effec-
35  tive date of this section.
36    §  7.  Subparagraph  (i)  of paragraph (d) of subdivision 8 of section
37  2168 of the public health law, as amended by chapter 154 of the laws  of
39    (i)  schools  for  the  purpose  of  verifying immunization status for
40  eligibility for admission, for the purpose of confirming a  student  has
41  been  screened  for  lead  when  enrolling  in child care, pre-school or
42  kindergarten, and for the provision of appropriate educational materials
43  developed by the department pursuant to section thirteen hundred  seven-
44  ty-a  of  this  chapter  on the dangers of lead exposure, and the health
45  risks associated with elevated blood lead levels to the parents or legal
46  guardians of the student with an elevated blood lead level, as such term
47  is defined in subdivision six of section  thirteen  hundred  seventy  of
48  this  chapter,  as well as information on programs that may be available
49  to the student and the parents or legal guardians of the student;
50    § 8. Section 1114 of the public health law, as added by section  3  of
51  part T of chapter 57 of the laws of 2017, is amended to read as follows:
52    § 1114. Lead service line replacement grant program. 1. [To the extent
53  practicable,  the]  The  department  shall  allocate  appropriated funds
54  equitably among regions of the state. Within each region, the department
55  shall give priority to municipalities that have  a  high  percentage  of
56  elevated childhood blood lead levels, based on the most recent available
1  data.  In  distributing  the  awards  allocated  for each region to such
2  priority municipalities, the department shall also consider whether  the
3  community  is low income and the number of lead service lines in need of
4  replacement. The department may request that such municipalities provide
5  such documentation as the department may require to confirm award eligi-
6  bility.
7    2.  Further,  the department shall establish a statewide plan for lead
8  service line replacement, which shall include, at a minimum, a report on
9  the implementation of subdivision one of  this  section,  resources  and
10  techniques  for identifying lead service lines throughout the state, the
11  cost of replacing lead service lines, recommendations for municipalities
12  on methods for evaluating the status of lead service lines  present  and
13  guidance on replacement.
14    3. The department shall publish information, application forms, proce-
15  dures  and  guidelines  relating  to the program on its website and in a
16  manner that is accessible to the public and all potential award  recipi-
17  ents.
18    § 9. a. Notwithstanding any contrary provision of law, the commission-
19  er  of  the New York state department of health is hereby authorized and
20  directed to prepare or have prepared a  study  of,  and  recommendations
21  for,  evidence-based  interventions to address the high burden of asthma
22  in the boroughs of Brooklyn and Manhattan in the city of New York.  Such
23  study  shall  include  an  analysis of high risk neighborhoods examining
24  disparities in: income, race and ethnicity, public and private  housing,
25  and proximity to major sources of air pollution.
26    b.  The study and recommendations authorized pursuant to subdivision a
27  of this section shall be completed  within  twenty-four  months  of  the
28  effective date of this act.
29    §  10.  Subsection (i) of section 3216 of the insurance law is amended
30  by adding a new paragraph 34 to read as follows:
31    (34) Every policy that provides coverage  for  hospital,  surgical  or
32  medical  care shall provide the following coverage for pasteurized donor
33  human milk (PDHM), which may include fortifiers as medically  indicated,
34  for  inpatient use, for which a licensed medical practitioner has issued
35  an order for an infant who is medically or physically unable to  receive
36  maternal breast milk or participate in breast feeding or whose mother is
37  medically or physically unable to produce maternal breast milk at all or
38  in  sufficient quantities or participate in breast feeding despite opti-
39  mal lactation support. Such infant shall: (i) have  a  documented  birth
40  weight  of  less  than  one  thousand five hundred grams; or (ii) have a
41  congenital or acquired condition that places the infant at a  high  risk
42  for development of necrotizing enterocolitis.
43    §  11.  Subsection (1) of section 3221 of the insurance law is amended
45    (20) Every insurer delivering a group or blanket policy or  issuing  a
46  group  or blanket policy for delivery in this state that provides cover-
47  age for hospital, surgical or medical care shall provide  the  following
48  coverage  for  pasteurized  donor  human  milk (PDHM), which may include
49  fortifiers as medically  indicated,  for  inpatient  use,  for  which  a
50  licensed  medical  practitioner has issued an order for an infant who is
51  medically or physically  unable  to  receive  maternal  breast  milk  or
52  participate in breast feeding or whose mother is medically or physically
53  unable  to  produce maternal breast milk at all or in sufficient quanti-
54  ties or participate in breast feeding despite optimal lactation support.
55  Such infant shall: (i) have a documented birth weight of less  than  one
56  thousand  five  hundred  grams;  or  (ii)  have a congenital or acquired
1  condition that places the infant at  a  high  risk  for  development  of
2  necrotizing enterocolitis.
3    §  12.  Section  4303  of the insurance law is amended by adding a new
4  subsection (oo) to read as follows:
5    (oo) A medical  expense  indemnity  corporation,  a  hospital  service
6  corporation  or  a health service corporation that provides coverage for
7  hospital, surgical or medical care shall provide the following  coverage
8  for pasteurized donor human milk (PDHM), which may include fortifiers as
9  medically  indicated,  for  inpatient  use, for which a licensed medical
10  practitioner has issued an order for an infant who is medically or phys-
11  ically unable to receive maternal breast milk or participate  in  breast
12  feeding  or  whose  mother  is medically or physically unable to produce
13  maternal breast milk at all or in sufficient quantities  or  participate
14  in  breast feeding despite optimal lactation support. Such infant shall:
15  (i) have a documented birth  weight  of  less  than  one  thousand  five
16  hundred  grams;  or  (ii)  have  a congenital or acquired condition that
17  places the infant at a high risk for development of necrotizing  entero-
18  colitis.
20                                   PART NN
21    Section  1. Article 33 of the public health law is amended by adding a
22  new title 2-A to read as follows:
23                                  TITLE 2-A
24                           OPIOID STEWARDSHIP ACT
25  Section 3323. Opioid stewardship fund.
26    § 3323. Opioid stewardship fund. 1. Definitions:
27    (a) "Opioid stewardship payment" shall mean the  total  amount  to  be
28  paid  into the opioid stewardship fund for each state fiscal year as set
29  forth in subdivision two of this section.
30    (b) "Ratable share" shall mean the individual portion  of  the  opioid
31  stewardship  payment  to  be  paid  by each manufacturer and distributor
32  licensed under this article that sells or  distributes  opioids  in  the
33  state of New York.
34    (c) Notwithstanding any inconsistent provision of law to the contrary,
35  "distribute"  shall mean to deliver a controlled substance other than by
36  administering or dispensing to the ultimate user, including intra-compa-
37  ny transfers between any  division,  affiliate,  subsidiary,  parent  or
38  other  entity under complete common ownership and control.  For purposes
39  of this section, "distribute" shall not  include  controlled  substances
40  surrendered to reverse distributors, or donated to recipient entities or
41  third-party  intermediaries  pursuant  to  the  unused prescription drug
42  donation and redispensing program of section  two  hundred  eighty-b  of
43  this chapter.
44    2.  Opioid  stewardship payment imposed on manufacturers and distribu-
45  tors.  All manufacturers and distributors licensed  under  this  article
46  (hereinafter  referred  to  as  "licensees"),  that  sell  or distribute
47  opioids in the state of New York shall be  required  to  pay  an  opioid
48  stewardship  payment. On an annual basis, the commissioner shall certify
49  to the state comptroller the  amount  of  all  revenues  collected  from
50  opioid  stewardship  payments  and  any penalties imposed. The amount of
51  revenues so certified shall  be  deposited  quarterly  into  the  opioid
52  stewardship  fund  established pursuant to section ninety-seven-aaaaa of
53  the state finance law. No licensee shall pass the cost of their  ratable
54  share  amount to a purchaser, including the ultimate user of the opioid,
1  or such licensee shall be subject to penalties pursuant  to  subdivision
2  ten of this section.
3    3.  Determination  of  opioid  stewardship  payment.  The total opioid
4  stewardship payment amount shall be one hundred million dollars  annual-
5  ly, subject to downward adjustments pursuant to subdivision nine of this
7    4.  Reports  and  records.  Each manufacturer and distributor licensed
8  under this article that sells or distributes opioids in the state of New
9  York shall provide to the commissioner a report  detailing  all  opioids
10  sold  or distributed by such manufacturer or distributor in the state of
11  New York. Such report shall include:
12    (a) the manufacturer's or distributor's name, address,  phone  number,
13  federal Drug Enforcement Agency (DEA) registration number and controlled
14  substance license number issued by the department;
15    (b)  the  name,  address  and DEA registration number of the entity to
16  whom the opioid was sold or distributed;
17    (c) the date of the sale or distribution of the opioid;
18    (d) the gross receipt total,  in  dollars,  of  all  opioids  sold  or
19  distributed;
20    (e)  the  name  and  National  Drug  Code  (NDC) of the opioid sold or
22    (f) the number of containers and the strength and metric  quantity  of
23  controlled  substance  in  each container of the opioid sold or distrib-
24  uted;
25    (g) the total number of morphine milligram equivalents (MMEs) sold  or
26  distributed; and
27    (h) any other elements as deemed necessary by the commissioner.
28    4-a.  Initial  and  future  reports.  (a)  Such  information  shall be
29  reported annually to the department in  such  form  as  defined  by  the
30  commissioner, provided however that the initial report provided pursuant
31  to  subdivision four shall consist of all opioids sold or distributed in
32  the state of New York for the two thousand seventeen calendar year,  and
33  must  be submitted by August 1, 2018. Subsequent annual reports shall be
34  submitted on April first of each year based on the actual  opioid  sales
35  and distributions of the prior calendar year.
36    (b) For the purpose of such annual reporting, MMEs shall be determined
37  pursuant  to a formulation to be issued by the department and updated as
38  the department deems appropriate.
39    5. Determination of ratable share. Each manufacturer  and  distributor
40  licensed  under  this  article  that sells or distributes opioids in the
41  state of New York shall pay a portion of the  total  opioid  stewardship
42  payment amount. The ratable share shall be calculated as follows:
43    (a)  The  total amount of MMEs sold or distributed in the state of New
44  York by the licensee for the preceding calendar year, as reported by the
45  licensee pursuant to subdivision four of this section, shall be  divided
46  by  the  total amount of MME sold in the state of New York by all licen-
47  sees pursuant to this article to determine the licensee payment percent-
48  age.  The licensee payment percentage shall be multiplied by  the  total
49  opioid  stewardship  payment.   The product of such calculation shall be
50  the licensee's ratable share.  The department shall have  the  authority
51  to  adjust  the  total  number  of  a licensee's MMEs to account for the
52  nature and use of the product, as well as the type of entity  purchasing
53  the product from the licensee, when making such determination and adjust
54  the ratable share accordingly.
55    (b) The licensee's total amount of MME sold or distributed, as well as
56  the  total amount of MME sold or distributed by all licensees under this
1  article, used in the calculation of the ratable share shall not  include
2  the  MME of those opioids which are: (i) manufactured in New York state,
3  but whose final point of delivery or sale is outside of New York  state;
4  (ii)  sold  or  distributed to entities certified to operate pursuant to
5  article thirty-two of the mental hygiene law, or article  forty  of  the
6  public  health  law;  or  (iii)  the MMEs attributable to buprenorphine,
7  methadone or morphine.
8    (c) The department shall provide to the licensee, in  writing,  on  or
9  before  October fifteenth, two thousand eighteen, the licensee's ratable
10  share for the two thousand seventeen calendar  year.    Thereafter,  the
11  department  shall  notify  the licensee in writing annually on or before
12  October fifteenth of each year based on the opioids sold or  distributed
13  for the prior calendar year.
14    6. Payment of ratable share. The licensee shall make payments quarter-
15  ly  to  the  department  with  the  first  payment of the ratable share,
16  provided that the amount due on January  first,  two  thousand  nineteen
17  shall  be  for  the  full amount of the first annual payment, with addi-
18  tional payments to be due and owing on the first day  of  every  quarter
19  thereafter.
20    7.  Rebate  of  ratable  share. In any year for which the commissioner
21  determines that a licensee failed  to  report  required  information  as
22  required  by  this  section, those licensees complying with this section
23  shall receive a reduced assessment of their ratable share in the follow-
24  ing year equal to the amount in excess of any overpayment in  the  prior
25  payment period.
26    8.  Licensee  opportunity  to  appeal. A licensee shall be afforded an
27  opportunity to submit information to the department to justify  why  the
28  ratable  share  provided  to  the licensee, pursuant to paragraph (c) of
29  subdivision five of this section, or  amounts  paid  thereunder  are  in
30  error or otherwise not warranted. If the department determines thereaft-
31  er  that  all  or  a portion of such ratable share, as determined by the
32  commissioner pursuant to  subdivision  five  of  this  section,  is  not
33  warranted,  the department may: (a) adjust the ratable share; (b) adjust
34  the assessment of the ratable share in the following year equal  to  the
35  amount  in excess of any overpayment in the prior payment period; or (c)
36  refund amounts paid in error.
37    9. Department annual review. The department shall annually review  the
38  amount  of  state  operating funds spent in the office of alcoholism and
39  substance abuse services (OASAS) budget for opioid prevention, treatment
40  and recovery. The commissioner of OASAS shall certify to the  department
41  the  amount  of  annual  spending for such services, utilizing available
42  information on patient demographics and  the  actual  cost  of  services
43  delivered  by the state and by state-funded providers. The certification
44  of such spending shall begin in state fiscal  year  two  thousand  eigh-
45  teen-nineteen,  and  continue  annually  thereafter. The total amount of
46  such spending shall be provided to the department by the commissioner of
47  OASAS no later than June thirtieth of  each  year.  There  shall  be  no
48  stewardship  fund  payments  beginning  on July first in the event state
49  operating funds spent in the OASAS budget for opioid prevention,  treat-
50  ment and recovery in the most recently reported year is equal to or less
51  than  state operating funds spent for such purposes in state fiscal year
52  two thousand nine-ten.
53    10. Penalties. (a) The department may assess a  civil  penalty  in  an
54  amount  not  to exceed one thousand dollars per day against any licensee
55  that fails to comply with subdivisions four and four-a of this section.
1    (b) In addition to any other civil or  criminal  penalty  provided  by
2  law,  where a licensee has failed to pay its ratable share in accordance
3  with subdivision six of this section, the department may also  assess  a
4  penalty  of  no  less than ten percent and no greater than three hundred
5  percent of the ratable share due from such licensee.
6    (c)  Where  the ratable share, or any portion thereof, has been passed
7  on to a purchaser by a licensee, the commissioner may impose  a  penalty
8  not to exceed one million dollars per incident.
9    § 2. Subdivision 1 of section 3316 of the public health law is amended
10  by adding a new paragraph (c) to read as follows:
11    (c)  is  unlikely  during the period of his or her license to complete
12  the reports or to pay the ratable share required by title two-A of  this
13  article on or before the required date. Prior evidence of non-compliance
14  shall constitute substantial evidence of such.
15    § 3. The state finance law is amended by adding a new section 97-aaaaa
17    §  97-aaaaa.  Opioid stewardship fund.  1. There is hereby established
18  in the joint custody of the state comptroller and  the  commissioner  of
19  taxation  and  finance  an  account of the miscellaneous special revenue
20  account to be known as the "opioid stewardship fund".
21    2. Moneys in opioid stewardship fund shall be kept separate and  shall
22  not  be  commingled  with  any  other moneys in the custody of the state
23  comptroller and the commissioner of taxation and finance.
24    3. The opioid stewardship fund shall consist  of  moneys  appropriated
25  for  the  purpose  of  such  account, moneys transferred to such account
26  pursuant to law, contributions consisting of promises or grants  of  any
27  money  or  property  of  any kind or value, or any other thing of value,
28  including grants or  other  financial  assistance  from  any  agency  of
29  government  and moneys required by the provisions of this section or any
30  other law to be paid into or credited to this account.
31    4. Moneys of the opioid stewardship fund,  when  allocated,  shall  be
32  available,  subject  to  the  approval of the director of the budget, to
33  support programs operated by the New York state office of alcoholism and
34  substance abuse services or agencies certified, authorized, approved  or
35  otherwise  funded  by  the  New  York  state  office  of  alcoholism and
36  substance abuse services  to  provide  opioid  treatment,  recovery  and
37  prevention  and  education  services;  and  to  provide  support for the
38  prescription monitoring program  registry  as  established  pursuant  to
39  section thirty-three hundred forty-three-a of the public health law.
40    5.  At the request of the budget director, the state comptroller shall
41  transfer moneys to support the  costs  of  opioid  treatment,  recovery,
42  prevention,  education  services,  and  other related programs, from the
43  opioid stewardship fund to any other fund of the state to  support  this
44  purpose.
45    6.  (i)  Notwithstanding the provisions of any general or special law,
46  no moneys shall be available from the opioid stewardship  fund  until  a
47  certificate  of  allocation  and  a  schedule of amounts to be available
48  therefor shall have been issued by the director of the budget, upon  the
49  recommendation  of  the  commissioner  of  the  office of alcoholism and
50  substance abuse services, and a copy of such certificate filed with  the
51  comptroller, the chairman of the senate finance committee and the chair-
52  man of the assembly ways and means committee.
53    (ii) Such certificate may be amended from time to time by the director
54  of the budget, upon the recommendation of the commissioner of the office
55  of alcoholism and substance abuse services, and a copy of such amendment
1  shall  be filed with the comptroller, the chairman of the senate finance
2  committee and the chairman of the assembly ways and means committee.
3    7.  The  moneys,  when  allocated,  shall  be  paid  out of the opioid
4  stewardship fund, pursuant to subdivision  four  of  this  section,  and
5  subject  to the approval of the director of the budget, on the audit and
6  warrant of the comptroller on vouchers certified or approved by (i)  the
7  commissioner of the office of alcoholism and substance abuse services or
8  his  or  her  designee;  or  (ii)  the commissioner of the department of
9  health or his or her designee.
10    § 4. Severability. If any clause, sentence, paragraph, subdivision, or
11  section of this act shall be adjudged by any court of  competent  juris-
12  diction to be invalid, such judgment shall not affect, impair, or inval-
13  idate  the  remainder thereof, but shall be confined in its operation to
14  the  clause,  sentence,  paragraph,  subdivision,  or  section  directly
15  involved  in  the  controversy  in  which  such judgment shall have been
16  rendered. It is hereby declared to be the intent of the legislature that
17  this act would have been enacted even if such invalid provisions had not
18  been included herein.
19    § 5. This act shall take effect July 1, 2018 and shall expire  and  be
20  deemed  to  be repealed on June 30, 2024, provided that, effective imme-
22  necessary for the implementation of this act on its effective  date  are
23  authorized to be made and completed on or before such effective date.
25  sion,  section  or  part  of  this act shall be adjudged by any court of
29  or part thereof directly involved in the controversy in which such judg-
30  ment  shall  have been rendered. It has hereby declared to be the intent
31  of the legislature that this act would have been enacted  even  if  such
32  invalid provisions had not been included herein.
33    §  3.  This  act shall take effect immediately provided, however, that
34  the applicable effective date of Parts A through NN of this act shall be
35  as specifically set forth in the last section of such Parts.

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