S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                        2340--A
                              2011-2012 Regular Sessions
                                 I N  A S S E M B L Y
                                   January 18, 2011
                                      ___________
       Introduced  by  M. of A. SCHIMMINGER, GABRYSZAK -- Multi-Sponsored by --
         M. of A.  GIGLIO, HAWLEY, HOOPER, MAGEE, J. RIVERA --  read  once  and
         referred to the Committee on Health -- recommitted to the Committee on
         Health  in  accordance  with  Assembly  Rule  3,  sec.  2 -- committee
         discharged, bill amended, ordered reprinted as amended and recommitted
         to said committee
       AN ACT to amend the social services law, in relation  to  the  character
         and  adequacy  of  Medicaid  assistance and to repeal paragraph (n) of
         subdivision 2 of section 365-a of the social services law relating  to
         the care and services of audiologists
         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1. Paragraph (a) of subdivision 2  of  section  365-a  of  the
    2  social  services  law,  as amended by chapter 47 of the laws of 1996, is
    3  amended to read as follows:
    4    (a) services of qualified physicians, [dentists, nurses,  and  private
    5  duty  nursing  services  shall  be  further subject to the provisions of
    6  section three hundred  sixty-seven-o  of  this  chapter,]  optometrists,
    7  NURSE  MIDWIVES,  NURSE  PRACTITIONERS,  and  other related professional
    8  personnel;
    9    S 2. Paragraph (f) of subdivision 2 of section  365-a  of  the  social
   10  services  law, as added by chapter 184 of the laws of 1969 and as relet-
   11  tered by chapter 478 of the laws of 1980, is amended to read as follows:
   12    (f) preventive, prophylactic and other routine dental  care,  services
   13  and  supplies  ONLY  WHEN  PROVIDED  IN  A HOSPITAL OUTPATIENT OR CLINIC
   14  FACILITY REFERRED TO IN PARAGRAPH (C) OF THIS SUBDIVISION;
   15    S 3. Paragraph (g) of subdivision 2 of section  365-a  of  the  social
   16  services  law,  as  amended by section 23 of part H of chapter 59 of the
   17  laws of 2011, is amended to read as follows:
   18    (g) sickroom supplies,  eyeglasses,  AND  prosthetic  appliances  [and
   19  dental  prosthetic  appliances]  furnished  in accordance with the regu-
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD02430-03-2
A. 2340--A 2 1 lations of the department; provided further that: (i) the commissioner 2 of health is authorized to implement a preferred diabetic supply program 3 wherein the department of health will receive enhanced rebates from 4 preferred manufacturers of glucometers and test strips, and may subject 5 non-preferred manufacturers' glucometers and test strips to prior 6 authorization under section two hundred seventy-three of the public 7 health law; (ii) enteral formula therapy and nutritional supplements are 8 limited to coverage only for nasogastric, jejunostomy, or gastrostomy 9 tube feeding or for treatment of an inborn metabolic disorder, or to 10 address growth and development problems in children; (iii) prescription 11 footwear and inserts are limited to coverage only when used as an inte- 12 gral part of a lower limb orthotic appliance, as part of a diabetic 13 treatment plan, or to address growth and development problems in chil- 14 dren; [and] (iv) compression and support stockings are limited to cover- 15 age only for pregnancy or treatment of venous stasis ulcers; AND (V) THE 16 COMMISSIONER OF HEALTH IS AUTHORIZED TO REQUIRE PRIOR APPROVAL OF ANY 17 PRESCRIPTION DRUG THAT IS PRESCRIBED FOR A RESIDENT OF A NURSING HOME 18 AND THAT IS NOT REIMBURSED AS PART OF THE NURSING HOME'S MEDICAID RATE; 19 S 4. Paragraph (l) of subdivision 2 of section 365-a of the social 20 services law, as amended by chapter 81 of the laws of 1995, is amended 21 to read as follows: 22 (l) care and services of podiatrists, CLINICAL PSYCHOLOGISTS, NURSES 23 AND AUDIOLOGISTS, INCLUDING SUCH CARE AND SERVICES PROVIDED IN A HOSPI- 24 TAL OUT-PATIENT OR CLINIC FACILITY REFERRED TO IN PARAGRAPH (C) OF THIS 25 SUBDIVISION, AND DENTISTS, which care and services shall only be 26 provided upon referral by a physician, nurse practitioner or certified 27 nurse midwife in accordance with the program of early and periodic 28 screening and diagnosis established pursuant to subdivision three of 29 this section or to persons eligible for benefits under title XVIII of 30 the federal social security act as qualified medicare beneficiaries in 31 accordance with federal requirements therefor [and private duty nurses 32 which care and services shall only be provided in accordance with regu- 33 lations of the department of health; provided, however, that private 34 duty nursing services shall not be restricted when such services are 35 more appropriate and cost-effective than nursing services provided by a 36 home health agency pursuant to section three hundred sixty-seven-l]; 37 S 5. Paragraph (n) of subdivision 2 of section 365-a of the social 38 services law, as added by chapter 556 of the laws of 1986, is REPEALED. 39 S 6. The commissioner of health is authorized to promulgate or adopt 40 any rules or regulations necessary to implement the provisions of this 41 act and any procedures, forms, or instructions necessary for such imple- 42 mentation may be adopted and issued on or after the effective date of 43 this act. Notwithstanding any inconsistent provision of the state admin- 44 istrative procedure act or any other provision of law, rule or regu- 45 lation, the commissioner of health and the superintendent of insurance 46 and any appropriate council is authorized to adopt or amend or promul- 47 gate on an emergency basis any regulation he or she or such council 48 determines necessary to implement any provision of this act on its 49 effective date. 50 S 7. This act shall take effect on the one hundred eightieth day after 51 it shall have become a law.