Establishes a healthcare reinvestment fund suburban demonstration project; defines terms; creates an oversight committee; provides for distribution of funds and calculation of reinvestment fund payments; makes related changes.

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S6367-2011 Actions

• Feb 1, 2012: REFERRED TO HEALTH

S6367-2011 Memo

BILL NUMBER:S6367

TITLE OF BILL:
An act
to amend the public health law, in relation to establishing a healthcare
reinvestment fund suburban demonstration project

PURPOSE OR GENERAL IDEA OF BILL:
To create financial balance between
for-profit health insurers and health-maintenance organizations (HMOs)
and hospitals in the suburbs of New York City by requiring such
insurers and HMOs to contribute funds for reinvestment in health
information technology in the suburban area around New York City.

SUMMARY OF SPECIFIC PROVISIONS:
Section one provides the legislative intent.
Section two amends the public health law by adding a new section
2807-z which provides the definition of terms used throughout the bill.

Section two also describes: the healthcare reinvestment fund suburban
demonstration project; the composition and function of its oversight
committee; the distribution of reinvestment funds; how funds are to
be collected; how fund payments are to be calculated; the monthly
payments to be made to the reinvestment fund; how prospective
adjustments are to be calculated; and the ability of the commissioner
to require the designated third-party payors to provide additional
data.

Section three amends subdivision 8 of section 2807-t of the public
health law, as added by chapter 639 of the laws of 1996, to provide
for the payments required under new section 2807-z.

Section four amends subdivision 8 of section 2807-j of the public
health law, as amended by section 26 of subpart D of part V-1 of
chapter 57 of the laws of 2009, to include reference to payments made
under new section 2807-z.

Section five provides that sections 2807-t and 2807-j of the public
health law shall remain through June 30,2015.

Section six provides the effective date.

JUSTIFICATION:
Hospitals in the suburbs of New York City face
challenges that result in a significant competitive disadvantage when
compared to nearby hospitals in New Jersey and Connecticut. While
hospitals in the suburbs of New York City are struggling financially,
in general, the for-profit health insurers and health maintenance
organization operating in the suburban areas incur profits. This
legislation will provide balance between the financial health of
hospitals and that of for-profit health insurers and health

maintenance organizations by structuring a healthcare reinvestment
fund suburban demonstration project.

FISCAL IMPLICATION:
To be determined.

EFFECTIVE DATE:
This act shall take effect on July 1, 2012, with provisions.

S6367-2011 Text

                      S T A T E   O F   N E W   Y O R K
  ________________________________________________________________________

                                    6367

                              I N  SENATE

                              February 1, 2012
                                 ___________

  Introduced  by  Sen.  STEWART-COUSINS -- read twice and ordered printed,
    and when printed to be committed to the Committee on Health

  AN ACT to amend the public health law, in  relation  to  establishing  a
    healthcare reinvestment fund suburban demonstration project

    THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
  BLY, DO ENACT AS FOLLOWS:


    Section 1. Statement of legislative intent. The legislature finds that
  hospitals in the suburbs of New York city face challenges that result in
  a significant competitive disadvantage when compared to nearby hospitals
  in New Jersey and Connecticut. In particular,  reimbursement  rates  for
  these  New  York  state  suburban  hospitals are significantly lower. In
  addition, while hospitals in the suburbs of New York city are struggling
  financially, in general the for-profit health insurers and health  main-
  tenance organizations operating in the suburban area incur profits.
    The  legislature  finds  that  there needs to be a balance between the
  financial health of hospitals and that of for-profit health insurers and
  health maintenance organizations. While the state of New York is invest-
  ing in the health care infrastructure of New York state in an amount  of
  two  hundred  fifty  million  dollars  a year for four years through the
  health care efficiency and affordability law of  New  Yorkers  (HEAL-NY)
  capital  grant  program, health insurers should likewise provide invest-
  ment in the health care infrastructure of communities,  particularly  in
  the  area  of  health  information  technology as health insurers are an
  immediate benefactor of health information technology. Strengthening the
  financial health of the suburban hospitals will also improve quality  of
  care and help retain and attract businesses.
    The  legislature finds that requiring for-profit insurers and for-pro-
  fit health maintenance organizations to provide funds  for  reinvestment
  in  health  information  technology in the suburban area around New York
  city will provide a benefit to payors,  patients,  hospitals  and  busi-
  nesses.
    S  2.  The public health law is amended by adding a new section 2807-z
  to read as follows:


   EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                        [ ] is old law to be omitted.
                                                             LBD02768-03-2

 S. 6367                             2

    S 2807-Z. HEALTHCARE REINVESTMENT FUND SUBURBAN DEMONSTRATION PROJECT.
  1. DEFINITIONS. FOR THE PURPOSES OF THIS SECTION,  THE  FOLLOWING  TERMS
  SHALL HAVE THE FOLLOWING MEANINGS:

    (A)  "DEMONSTRATION  PROJECT"  SHALL  MEAN THE HEALTHCARE REINVESTMENT
  FUND  SUBURBAN  DEMONSTRATION  PROJECT  ESTABLISHED  PURSUANT  TO   THIS
  SECTION.
    (B)  "DESIGNATED  THIRD-PARTY  PAYORS" SHALL MEAN FOR-PROFIT ORGANIZA-
  TIONS OPERATING IN ACCORDANCE WITH ARTICLE FORTY-FOUR OF  THIS  CHAPTER,
  AND FOR-PROFIT COMMERCIAL INSURERS LICENSED TO DO BUSINESS IN THIS STATE
  AND AUTHORIZED TO WRITE ACCIDENT AND HEALTH INSURANCE AND WHOSE POLICIES
  PROVIDE  COVERAGE  ON  AN EXPENSE INCURRED BASIS. DESIGNATED THIRD PARTY
  PAYORS SHALL NOT INCLUDE SELF-INSURED FUNDS AND ADMINISTRATORS ACTING ON
  BEHALF OF SELF-INSURED FUNDS,  GOVERNMENTAL  AGENCIES  OR  PROVIDERS  OF
  COVERAGE  PURSUANT  TO  THE COMPREHENSIVE MOTOR VEHICLE REPARATIONS ACT,
  THE WORKERS' COMPENSATION LAW, THE VOLUNTEER FIREFIGHTERS' BENEFIT  LAW,
  OR THE VOLUNTEER AMBULANCE WORKERS' BENEFIT LAW.
    (C)  "FAMILY  UNIT"  SHALL HAVE THE SAME MEANING AS SET FORTH IN PARA-
  GRAPH (B) OF SUBDIVISION ONE OF SECTION TWENTY-EIGHT HUNDRED SEVEN-T  OF
  THIS ARTICLE.
    (D) "INDIVIDUAL" SHALL HAVE THE SAME MEANING AS SET FORTH IN PARAGRAPH
  (A)  OF  SUBDIVISION ONE OF SECTION TWENTY-EIGHT HUNDRED SEVEN-T OF THIS
  ARTICLE.
    (E) "REGIONAL HOSPITAL ASSOCIATIONS" SHALL MEAN THE REGIONAL  HOSPITAL
  ASSOCIATION  WITH  THE  MAJORITY  OF  ITS  MEMBERS LOCATED IN NASSAU AND
  SUFFOLK COUNTIES AND THE REGIONAL HOSPITAL ASSOCIATION WITH THE MAJORITY
  OF ITS MEMBERS  LOCATED  IN  WESTCHESTER,  ROCKLAND,  PUTNAM,  DUTCHESS,
  ORANGE, ULSTER AND SULLIVAN COUNTIES.
    (F)  "REINVESTMENT  FUNDS"  SHALL MEAN THE FUNDS AVAILABLE PURSUANT TO
  THE DEMONSTRATION PROJECT.
    (G) "SUBURBAN REGION" SHALL MEAN  THE  COUNTIES  OF  NASSAU,  SUFFOLK,
  WESTCHESTER, ROCKLAND, PUTNAM, DUTCHESS, ORANGE, ULSTER AND SULLIVAN.
    2.  HEALTHCARE  REINVESTMENT  FUND  SUBURBAN  DEMONSTRATION PROJECT. A
  HEALTHCARE REINVESTMENT FUND SUBURBAN  DEMONSTRATION  PROJECT  EFFECTIVE
  JULY  FIRST,  TWO  THOUSAND  TWELVE THROUGH JUNE THIRTIETH, TWO THOUSAND
  SIXTEEN, TO FUND THE INFORMATION TECHNOLOGY NEEDS OF  GENERAL  HOSPITALS
  LOCATED IN THE SUBURBAN REGION SHALL BE ESTABLISHED BY THE COMMISSIONER.
  A  TOTAL  OF SIXTY-SEVEN MILLION DOLLARS FROM THE FUNDS ACCUMULATED FROM
  THE PAYMENTS MADE IN ACCORDANCE WITH SUBDIVISION SEVEN OF  THIS  SECTION
  SHALL  BE  PROVIDED  ANNUALLY DURING THE PERIOD JULY FIRST, TWO THOUSAND
  TWELVE THROUGH JUNE THIRTIETH, TWO THOUSAND SIXTEEN, TO FUND THE  DEMON-
  STRATION PROJECT.
    3.    HEALTHCARE  REINVESTMENT  FUND OVERSIGHT COMMITTEE. A HEALTHCARE
  REINVESTMENT  FUND  OVERSIGHT  COMMITTEE  OF  TWELVE  MEMBERS  SHALL  BE
  APPOINTED TO OVERSEE THE DISTRIBUTION OF REINVESTMENT FUNDS. SIX MEMBERS
  SHALL  BE  APPOINTED BY EACH OF THE REGIONAL HOSPITAL ASSOCIATIONS. FOUR
  MEMBERS SHALL REPRESENT GENERAL HOSPITALS, FOUR MEMBERS SHALL  REPRESENT
  DESIGNATED THIRD-PARTY PAYORS AND FOUR MEMBERS SHALL REPRESENT THE BUSI-
  NESS COMMUNITY. THE HEALTHCARE REINVESTMENT OVERSIGHT COMMITTEE SHALL:

    (A)  MAKE  RECOMMENDATIONS ON USES OF THE REINVESTMENT FUNDS THAT WILL
  RESULT IN IMPROVED SHARING OF CLINICAL INFORMATION IN A  COST  EFFECTIVE
  MANNER  AMONG  (I) GENERAL HOSPITALS AND PHYSICIANS, (II) GENERAL HOSPI-
  TALS AND OTHER PROVIDERS INCLUDING OTHER GENERAL  HOSPITALS,  AND  (III)
  GENERAL HOSPITALS AND PAYORS;
    (B)  DEVELOP  A PROCESS TO ENSURE THAT GENERAL HOSPITALS USE THE REIN-
  VESTMENT FUNDS IN ACCORDANCE WITH THE RECOMMENDATIONS MADE  PURSUANT  TO
  PARAGRAPH (A) OF THIS SUBDIVISION; AND

 S. 6367                             3

    (C)  PROVIDE  A REPORT TO THE COMMISSIONER ON OR BEFORE JANUARY FIRST,
  TWO THOUSAND SIXTEEN, EVALUATING WHETHER THE DEMONSTRATION  PROJECT  HAS
  ACHIEVED  THE GOAL OF IMPROVING THE SHARING OF CLINICAL INFORMATION IN A
  COST EFFECTIVE MANNER, AND MAKING RECOMMENDATIONS ON WHETHER THE  DEMON-
  STRATION  PROJECT  SHOULD  BE CONTINUED AND ON POTENTIAL IMPROVEMENTS TO
  THE DEMONSTRATION PROJECT.
    4. DISTRIBUTION OF REINVESTMENT FUNDS.  THE REINVESTMENT  FUNDS  SHALL
  BE  DISTRIBUTED  TO EACH GENERAL HOSPITAL LOCATED IN THE SUBURBAN REGION
  PROPORTIONALLY BASED  ON  EACH  GENERAL  HOSPITAL'S  REPORTED  INPATIENT
  DISCHARGES  TO  THE  TOTAL  OF SUCH INPATIENT DISCHARGES FOR ALL GENERAL
  HOSPITALS LOCATED IN THE SUBURBAN REGION.   FOR THE PERIOD  JULY  FIRST,
  TWO  THOUSAND  TWELVE THROUGH JUNE THIRTIETH, TWO THOUSAND FOURTEEN, THE
  DISTRIBUTIONS SHALL BE BASED ON DISCHARGES REPORTED THROUGH  THE  STATE-
  WIDE PLANNING AND RESEARCH COOPERATIVE SYSTEM FOR TWO THOUSAND NINE, AND
  FOR THE PERIOD JULY FIRST, TWO THOUSAND FOURTEEN THROUGH JUNE THIRTIETH,
  TWO  THOUSAND  SIXTEEN,  THE  DISTRIBUTIONS SHALL BE BASED ON DISCHARGES
  REPORTED THROUGH THE STATEWIDE PLANNING AND RESEARCH COOPERATIVE  SYSTEM
  FOR TWO THOUSAND ELEVEN.
    5.  COLLECTION  OF  FUNDS.    THE COMMISSIONER SHALL CONTRACT WITH THE
  REGIONAL ASSOCIATIONS TO COLLECT AND DISTRIBUTE  FUNDS  FOR  THE  DEMON-
  STRATION PROJECT IN ACCORDANCE WITH THIS SECTION.
    6.  CALCULATION OF REINVESTMENT FUND PAYMENTS. (A) BASED ON THE NUMBER
  OF INDIVIDUALS AND THE NUMBER OF FAMILY UNITS REPORTED  TO  THE  COMMIS-
  SIONER  OR  THE  COMMISSIONER'S DESIGNEE PURSUANT TO SUBDIVISION FOUR OF
  SECTION TWENTY-EIGHT HUNDRED SEVEN-T OF THIS ARTICLE,  THE  COMMISSIONER
  SHALL  CALCULATE  THE TOTAL NUMBER OF "INDIVIDUAL MEMBER MONTHS" FOR THE
  SUBURBAN REGION FOR  ALL  DESIGNATED  THIRD-PARTY  PAYORS  TO  DETERMINE
  "AGGREGATE  INDIVIDUAL  MEMBER  MONTHS"  FOR  THE SUBURBAN REGION.   THE
  COMMISSIONER SHALL ALSO CALCULATE THE TOTAL  NUMBER  OF  "FAMILY  MEMBER
  MONTHS" FOR THE SUBURBAN REGION FOR ALL DESIGNATED THIRD-PARTY PAYORS TO
  DETERMINE  THE "AGGREGATE FAMILY MEMBER MONTHS" FOR THE SUBURBAN REGION.
  THE COMMISSIONER SHALL MULTIPLY THE AVERAGE NUMBER  OF  PERSONS  COVERED
  UNDER FAMILY INSURANCE CONTRACTS, AS REPORTED TO THE COMMISSIONER BY THE
  SUPERINTENDENT  OF  INSURANCE  PURSUANT  TO  SUBDIVISION FOUR OF SECTION
  TWENTY-EIGHT HUNDRED SEVEN-T OF THIS ARTICLE BY  THE  "AGGREGATE  FAMILY
  MEMBER  MONTHS"  TO  DETERMINE "ADJUSTED AGGREGATE FAMILY MEMBER MONTHS"
  FOR THE SUBURBAN REGION.   THE COMMISSIONER  SHALL  ADD  THE  NUMBER  OF
  "ADJUSTED  FAMILY  MEMBER  MONTHS"  FOR THE SUBURBAN REGION TO THE TOTAL
  NUMBER OF "AGGREGATE INDIVIDUAL MEMBER MONTHS" FOR THE SUBURBAN  REGION.
  THIS  AMOUNT  SHALL  BE  KNOWN  AS "TOTAL COVERED MEMBER MONTHS" FOR THE
  SUBURBAN REGION.
    (B) AN ANNUAL AMOUNT OF SIXTY-SEVEN MILLION DOLLARS SHALL  BE  DIVIDED
  BY  AN  ESTIMATE DERIVED FROM POPULATION BASED DATA SOURCES OF THE TOTAL
  COVERED MEMBER MONTHS DETERMINED CONSISTENT WITH THE PROVISIONS OF PARA-
  GRAPH (A) OF THIS SUBDIVISION IN THE SUBURBAN REGION  TO  ESTABLISH  THE
  "INDIVIDUAL  ANNUAL  PAYMENT AMOUNT" FOR JULY FIRST, TWO THOUSAND TWELVE
  THROUGH JUNE THIRTIETH, TWO THOUSAND THIRTEEN; JULY FIRST, TWO  THOUSAND
  THIRTEEN  THROUGH JUNE THIRTIETH, TWO THOUSAND FOURTEEN; JULY FIRST, TWO
  THOUSAND FOURTEEN THROUGH JUNE THIRTIETH, TWO THOUSAND FIFTEEN; AND JULY
  FIRST,  TWO  THOUSAND  FIFTEEN  THROUGH  JUNE  THIRTIETH,  TWO  THOUSAND
  SIXTEEN,  RESPECTIVELY.    THE INDIVIDUAL ANNUAL PAYMENT AMOUNT SHALL BE
  MULTIPLIED BY THE AVERAGE FAMILY SIZE REPORTED TO  THE  COMMISSIONER  BY
  THE  SUPERINTENDENT  OF  INSURANCE  TO ESTABLISH THE "FAMILY UNIT ANNUAL
  PAYMENT AMOUNT" IN THE SUBURBAN REGION  FOR  JULY  FIRST,  TWO  THOUSAND
  TWELVE  THROUGH  JUNE  THIRTIETH, TWO THOUSAND THIRTEEN; JULY FIRST, TWO
  THOUSAND THIRTEEN THROUGH JUNE THIRTIETH, TWO  THOUSAND  FOURTEEN;  JULY

 S. 6367                             4

  FIRST,  TWO  THOUSAND  FOURTEEN  THROUGH  JUNE  THIRTIETH,  TWO THOUSAND
  FIFTEEN; AND JULY FIRST, TWO THOUSAND FIFTEEN  THROUGH  JUNE  THIRTIETH,
  TWO THOUSAND SIXTEEN, RESPECTIVELY.
    7.  MONTHLY PAYMENTS.  WITHIN THIRTY DAYS AFTER THE END OF EACH MONTH,
  A DESIGNATED THIRD-PARTY PAYOR SHALL REMIT TO THE  COMMISSIONER  OR  THE
  COMMISSIONER'S  DESIGNEE  ONE-TWELFTH  OF  THE INDIVIDUAL ANNUAL PAYMENT
  AMOUNT FOR EACH OF THE INDIVIDUALS RESIDING IN THE SUBURBAN REGION WHICH
  WERE INCLUDED IN THE MEMBERSHIP ROLLS  OF  THAT  DESIGNATED  THIRD-PARTY
  PAYOR  DURING  ALL OR ANY PORTION OF THE PRIOR MONTH. WITHIN THIRTY DAYS
  AFTER THE END OF EACH MONTH, A DESIGNATED THIRD-PARTY PAYOR SHALL  REMIT
  TO  THE  COMMISSIONER  OR THE COMMISSIONER'S DESIGNEE ONE-TWELFTH OF THE
  FAMILY UNIT ANNUAL PAYMENT AMOUNT FOR EACH FAMILY  UNIT  FOR  WHICH  THE
  PRIMARY  INSURED  RESIDED  IN THE SUBURBAN REGION WHICH WERE INCLUDED IN
  THE MEMBERSHIP ROLLS OF THAT DESIGNATED THIRD-PARTY PAYOR DURING ALL  OR
  ANY PORTION OF THE PRIOR MONTH.
    8. PROSPECTIVE ADJUSTMENTS.  THE COMMISSIONER SHALL ANNUALLY RECONCILE
  THE  SUM  OF THE ACTUAL PAYMENTS MADE TO THE COMMISSIONER OR THE COMMIS-
  SIONER'S DESIGNEE PURSUANT TO  THIS  SECTION  WITH  SIXTY-SEVEN  MILLION
  DOLLARS.  THE  DIFFERENCE  BETWEEN  THE  ACTUAL PAYMENTS AND SIXTY-SEVEN
  MILLION DOLLARS SHALL BE APPLIED AS  A  PROSPECTIVE  ADJUSTMENT  TO  THE
  TOTAL  AMOUNT  DUE  FOR  THE  YEAR NEXT FOLLOWING THE CALCULATION OF THE
  RECONCILIATION. THE AUTHORIZED DOLLAR VALUE OF THE ADJUSTMENTS SHALL  BE
  THE SAME AS IF CALCULATED RETROSPECTIVELY.
    9.  REPORTED  DATA.    THE  COMMISSIONER  SHALL  HAVE THE AUTHORITY TO
  REQUIRE  THE  DESIGNATED  THIRD-PARTY  PAYORS  TO   PROVIDE   ADDITIONAL
  GEOGRAPHIC  BREAKDOWN  OF THE INDIVIDUAL MEMBER MONTHS AND FAMILY MEMBER
  MONTHS REPORTED PURSUANT TO SUBDIVISION  FOUR  OF  SECTION  TWENTY-EIGHT
  HUNDRED  SEVEN-T  OF  THIS ARTICLE IN ORDER FOR THE COMMISSIONER TO HAVE
  INDIVIDUAL MEMBER MONTHS AND  FAMILY  MEMBER  MONTHS  FOR  THE  SUBURBAN
  REGION.
    S  3.  Subdivision  8  of  section 2807-t of the public health law, as
  added by chapter 639 of the laws of 1996, is amended to read as follows:

    8. Liability  for  assessments.  (a)  The  assessments  determined  in
  accordance  with  this section AND THE PAYMENTS DETERMINED IN ACCORDANCE
  WITH SECTION TWENTY-EIGHT HUNDRED SEVEN-Z OF  THIS  ARTICLE  shall,  for
  individuals who have paid premiums directly to an insurer or to a health
  maintenance  organization  certified  pursuant  to article forty-four of
  this chapter or article forty-three of the insurance law for health care
  coverage which includes coverage of inpatient hospital services, be  the
  liability  of said individuals. The assessments determined in accordance
  with this section AND THE PAYMENTS DETERMINED IN ACCORDANCE WITH SECTION
  TWENTY-EIGHT HUNDRED SEVEN-Z OF THIS ARTICLE shall, for groups and enti-
  ties who have paid premiums to an insurer or  to  a  health  maintenance
  organization certified pursuant to article forty-four of this chapter or
  article  forty-three of the insurance law for health care coverage which
  includes coverage of inpatient hospital services, be  the  liability  of
  said  groups and entities. The assessments determined in accordance with
  this section shall,  for  individuals,  groups  and  entities  who  have
  contributed  to  a  self-insured  fund  for  health  care coverage which
  includes coverage of inpatient hospital services, be  the  liability  of
  said individuals, groups or entities.
    (b)  Specified  third-party  payors  AND DESIGNATED THIRD-PARTY PAYORS
  shall make payments to the commissioner or the  commissioner's  designee
  of the full amount of the assessments determined in accordance with this
  section   AND   THE  PAYMENTS  DETERMINED  IN  ACCORDANCE  WITH  SECTION
  TWENTY-EIGHT HUNDRED SEVEN-Z  OF  THIS  ARTICLE.  Specified  third-party

 S. 6367                             5

  payors AND DESIGNATED THIRD-PARTY PAYORS may recover amounts due or paid
  to  the  commissioner  or  the  commissioner's designee from the parties
  liable in accordance with paragraph (a) of this subdivision.
    S  4.  Paragraph  (a) of subdivision 8 of section 2807-j of the public
  health law, as amended by section 26 of subpart D of part V-1 of chapter
  57 of the laws of 2009, is amended to read as follows:

    (a) If a payment made pursuant to this section or to  section  twenty-
  eight  hundred  seven-s or twenty-eight hundred seven-t OR SECTION TWEN-
  TY-EIGHT HUNDRED SEVEN-Z of this article for a month to which an  allow-
  ance OR PAYMENT applies is less than ninety percent of the amount due or
  which  the  commissioner  estimates,  based  on  available financial and
  statistical data, is due for such month, interest shall be due and paya-
  ble to the commissioner by a designated provider of services,  or  by  a
  third-party  payor,  other  than  a  state governmental agency, that has
  elected OR IS REQUIRED to pay an allowance OR PAYMENT directly,  on  the
  difference between the amount paid and the amount due or estimated to be
  due  from  the  day  of  the month the payment was due until the date of
  payment. The rate of interest shall be twelve percent per annum  or,  if
  greater, at the rate of interest set by the commissioner of taxation and
  finance  with respect to underpayments of tax pursuant to subsection (e)
  of section one thousand ninety-six of the tax law minus four  percentage
  points.  Interest  under  this paragraph shall not be paid if the amount
  thereof is less than one dollar. Interest due from a designated provider
  of services, if not paid by  the  due  date  of  the  following  month's
  payment,  may be collected by the commissioner pursuant to paragraph (c)
  of subdivision six of this section in the same manner  as  an  allowance
  pursuant to subdivision two of this section.
    S 5. Notwithstanding the expiration date of sections 2807-t and 2807-j
  of  the  public health law, such sections shall remain in effect through
  June 30, 2016 with regard to their application to section 2807-z of  the
  public health law.
    S  6.  This  act shall take effect July 1, 2012; provided, however, if
  this act shall become a law after such date it shall take  effect  imme-
  diately and shall be deemed to have been in full force and effect on and
  after  July  1, 2012; provided, however, that the amendments to subdivi-
  sion 8 of section 2807-t of the public health law made by section  three
  of this act shall not affect the expiration of such section and shall be
  deemed  to  expire  therewith;  provided  further that the amendments to
  paragraph (a) of subdivision 8 of section 2807-j of  the  public  health
  law  made by section four of this act shall not affect the expiration of
  such section and shall be deemed to expire  therewith.  Effective  imme-
  diately, the addition, amendment and/or repeal of any rule or regulation
  necessary  for  the implementation of this act on its effective date are
  authorized and directed to be made  and  completed  on  or  before  such
  effective date.