Establishes the "Medicaid identification and anti-fraud biometric technology program", requiring the department of health, in consultation with the office of the medicaid inspector general and the office of the attorney general to implement a program requiring the use of biometric technology, as a means of identification and for use as an anti-fraud application in the Medicaid program.

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A6555F-2011 Actions

• Jun 5, 2012: held for consideration in health
• May 24, 2012: print number 6555f
• May 24, 2012: amend and recommit to health
• May 2, 2012: print number 6555e
• May 2, 2012: amend and recommit to health
• Feb 7, 2012: print number 6555d
• Feb 7, 2012: amend and recommit to health
• Jan 18, 2012: print number 6555c
• Jan 18, 2012: amend and recommit to health
• Jan 4, 2012: referred to health
• Jun 6, 2011: print number 6555b
• Jun 6, 2011: amend (t) and recommit to health
• Apr 14, 2011: print number 6555a
• Apr 14, 2011: amend (t) and recommit to health
• Mar 21, 2011: referred to health

A6555F-2011 Text

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

                                   6555--F

                         2011-2012 Regular Sessions

                            I N  ASSEMBLY

                               March 21, 2011
                                 ___________

  Introduced  by  M.  of  A. N. RIVERA, JEFFRIES, CRESPO, LINARES, COLTON,
    GIBSON, HEASTIE, CASTRO, WEPRIN, J. RIVERA, P. RIVERA, JAFFEE, MONTES-
    ANO, RAIA, DUPREY, ZEBROWSKI, SAYWARD, ROBINSON,  STEVENSON,  SCARBOR-
    OUGH,  HOOPER  --  Multi-Sponsored  by  --  M.  of  A. ABBATE, ARROYO,
    BOYLAND, BROOK-KRASNY, CALHOUN, CAMARA, CONTE, CROUCH, GUNTHER, JOHNS,
    MAGEE, MAISEL, MALLIOTAKIS, McDONOUGH, McENENY, MOYA, PERRY,  PRETLOW,
    RAMOS,  REILICH,  RODRIGUEZ,  TENNEY  -- read once and referred to the
    Committee on Health -- 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  --  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 -- 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 --
    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 establishing the
    Medicaid identification and anti-fraud biometric  technology  program;
    and  to  amend  the  social  services  law,  in relation to conforming
    medical assistance identification with the Medicaid identification and
    anti-fraud biometric technology program

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


    Section  1.  The  public health law is amended by adding a new article
  2-B to read as follows:

                                  ARTICLE 2-B
              MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC
                             TECHNOLOGY PROGRAM

   EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                        [ ] is old law to be omitted.
                                                             LBD09573-17-2

 A. 6555--F                          2

  SECTION 290. MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
                 PROGRAM.
          291. DEFINITIONS.
          292. BIOMETRIC TECHNOLOGY USE REQUIREMENT.
          293. RULES AND REGULATIONS.
    S  290.  MEDICAID  IDENTIFICATION  AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
  PROGRAM. THERE IS HEREBY ESTABLISHED  IN  THE  DEPARTMENT  THE  MEDICAID
  IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY PROGRAM.
    S 291. DEFINITIONS. AS USED IN THIS ARTICLE:

    1.  "BIOMETRIC TECHNOLOGY" MEANS TECHNOLOGY THAT MEASURES AND ANALYZES
  BIOLOGICAL DATA, INCLUDING BUT  NOT  LIMITED  TO  DNA,  FINGER  IMAGING,
  VASCULAR  PATTERNS,  EYE  RETINAS  AND  IRISES,  VOICE  PATTERNS, FACIAL
  PATTERNS AND HAND MEASUREMENTS, FOR AUTHENTICATION PURPOSES.
    2.  "BIOMETRIC VERIFICATION DEVICE" MEANS A DEVICE  CAPABLE  OF  USING
  BIOMETRIC  VERIFICATION  TECHNOLOGY TO VERIFY THE IDENTITY OF A MEDICAID
  RECIPIENT OR PROVIDER.
    S 292. BIOMETRIC TECHNOLOGY USE REQUIREMENT.  1.  THE  DEPARTMENT,  IN
  CONSULTATION  WITH  THE OFFICE OF THE MEDICAID INSPECTOR GENERAL AND THE
  OFFICE OF THE ATTORNEY GENERAL, SHALL DEVELOP A REQUEST FOR PROPOSALS TO
  IMPLEMENT A PROGRAM REQUIRING THE USE OF BIOMETRIC TECHNOLOGY BY  HOSPI-
  TALS,  CLINICS  AND PHARMACIES, FOR THE PURPOSES OF PATIENT AND PROVIDER
  IDENTIFICATION AND FOR USE AS AN ANTI-FRAUD APPLICATION IN THE  MEDICAID
  PROGRAM.
    2.  SUCH  REQUEST  FOR  PROPOSALS  SHALL INCLUDE AT A MINIMUM THAT (A)
  MEDICAID RECIPIENTS AND PROVIDERS SHALL PROVIDE BIOMETRIC PROOF OF THEIR
  IDENTITY ALONG WITH OTHER INFORMATION DEEMED NECESSARY  BY  THE  COMMIS-
  SIONER.
    (B)  SUCH  PROGRAM  WILL BE CAPABLE OF STORING BIOMETRIC MARKERS AND A
  LOG OF DOCTOR AND PHARMACY VISITS FOR EACH SERVICE BILLED TO  THE  MEDI-
  CAID PROGRAM.
    (C)  MEDICAID  IDENTIFICATION  SHALL  BE ISSUED TO AND ACCEPTED BY THE
  ADMITTING STAFF OF  HEALTH  CARE  FACILITIES,  MEDICAL  STAFF  PROVIDING
  SERVICE TO MEDICAID RECIPIENTS AND PHARMACY STAFF.
    (D)  MEDICAID  RECIPIENTS SHALL BE REQUIRED TO PROVIDE BIOMETRIC PROOF
  OF IDENTIFY AT THE TIME OF EACH VISIT TO A DOCTORS OFFICE OR  CLINIC  AT
  THE  POINT  OF  ACTUALLY BEING SEEN BY THE DOCTOR OR CLINICAL STAFF, AND
  SHALL AGAIN PROVIDE  PROOF  OF  IDENTITY  UPON  COMPLETION  OF  CARE  OR
  SERVICES.
    (E)  BIOMETRIC  VERIFICATION  DEVICES  SHALL  BE USED IN PHARMACIES TO
  VERIFY THE IDENTITY OF THE MEDICAID RECIPIENT AND THE  VALIDITY  OF  THE
  MEDICAID   COVERAGE   PRIOR   TO   OR  IN  CONJUNCTION  WITH  FILLING  A
  PRESCRIPTION.
    (F)  PROVISIONS  SHALL  BE  INCLUDED   FOR   EMERGENCY   SERVICES   OR
  PRESCRIPTIONS  AND ALTERNATE IDENTIFICATION METHODS FOR MEDICAID RECIPI-
  ENTS PHYSICALLY OR MENTALLY UNABLE TO PROVIDE BIOMETRIC IDENTIFICATION.
    (G) FRAUD PREVENTION MARKERS INCORPORATED INTO SOFTWARE WHICH SHALL BE
  USED TO OPERATE THE HARDWARE COMPONENT OF THE BIOMETRIC TECHNOLOGY SHALL
  PREVENT AND/OR REJECT THE PAYMENT BY THE MEDICAID PROGRAM AND ALERT  THE
  SERVICE  PROVIDER  AT  POINT  OF  SERVICE IF FRAUD OR POTENTIAL FRAUD IS
  IDENTIFIED BY THE BIOMETRIC TECHNOLOGY SYSTEM.
    (H) PROVISIONS SHALL BE INCLUDED TO ENSURE  THAT  MEDICAID  RECIPIENTS
  HAVE  ACCESS  TO  EMERGENCY  HEALTH  SERVICES IN THE CASE OF A BIOMETRIC
  TECHNOLOGY SYSTEM MALFUNCTION OR FRAUD DETECTION ALARM.
    (I) EVALUATION AND SELECTION OF AN IDENTIFY CREDENTIALING SYSTEM  THAT
  ADDRESSES THE REQUIREMENTS OF MEDICAID BENEFICIARIES AND PROVIDERS SHALL
  BE  BASED  ON  THE  FOLLOWING  CRITERIA:  SECURITY,  PRIVACY, USABILITY,

 A. 6555--F                          3

  PERFORMANCE, HYGIENE, BIOMETRIC CAPTURE AND  STORAGE  REQUIREMENTS,  AND
  INTEROPERABILITY.
    3.  SUCH  REQUEST FOR PROPOSALS SHALL SET FORTH REQUIREMENTS AS TO THE
  RESULTS AND GOALS TO BE ACHIEVED, RATHER THAN SPECIFIC TECHNICAL METHODS
  OR SYSTEMS, TO ALLOW CONSIDERATION OF  THE  WIDEST  POSSIBLE  CHOICE  OF
  AVAILABLE TECHNOLOGY.
    4.  SUCH  REQUEST  FOR  PROPOSALS  SHALL REQUIRE: (A) THAT THE PROGRAM
  SHALL BE REVENUE NEUTRAL FROM INCEPTION, WHEREBY ANY PROGRAM  COSTS  ARE
  AT  LEAST  OFFSET BY STATE MEDICAID SAVINGS, AND SHALL HAVE AS A PRIMARY
  GOAL REDUCTION OF MEDICAID EXPENDITURES THROUGH ELIMINATION OF FRAUD AND
  ABUSE; AND (B) THAT THE PROGRAM SHALL BE COST NEUTRAL TO PROVIDERS  FROM
  INCEPTION,  WHEREBY  ANY  PROVIDER COSTS ARE AT LEAST OFFSET BY PROVIDER
  SAVINGS, AND SHALL HAVE AS  A  PRIMARY  GOAL  PROVIDER  SAVINGS  THROUGH
  INCREASED EFFICIENCIES.
    5.  (A) SUCH REQUEST FOR PROPOSALS FOR THE IMPLEMENTATION OF A PROGRAM
  FOR BIOMETRIC TECHNOLOGY USE SHALL BE PUBLISHED  ON  OR  BEFORE  JANUARY
  FIFTEENTH, TWO THOUSAND THIRTEEN, AND SHALL PROVIDE THAT PROPOSALS SHALL
  BE OPENED ON OR BEFORE MARCH FIRST, TWO THOUSAND THIRTEEN.
    (B) THE COMMISSIONER SHALL REPORT TO THE GOVERNOR, THE TEMPORARY PRES-
  IDENT  OF  THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON OR BEFORE MARCH
  THIRTIETH, TWO THOUSAND THIRTEEN WITH REGARD TO THE PROGRESS MADE IN THE
  DEVELOPMENT OF CRITERIA FOR A PROGRAM OF BIOMETRIC IDENTIFICATION AND OF
  THE IMPLEMENTATION OF SUCH PROGRAM.
    S 293. RULES AND  REGULATIONS.  THE  COMMISSIONER  IS  AUTHORIZED  AND
  DIRECTED  TO PROMULGATE SUCH RULES AND REGULATIONS AS HE OR SHE MAY DEEM
  NECESSARY OR APPROPRIATE TO EFFECTUATE THE PURPOSES OF THIS ARTICLE.
    S 2.  Subdivision 1 of section 367-b of the social  services  law,  as
  added by chapter 639 of the laws of 1976, is amended to read as follows:

    1.  The  department,  IN CONSULTATION WITH THE COMMISSIONER OF HEALTH,
  shall design and implement a statewide  medical  assistance  information
  and  payments  system for the purpose of providing individual and aggre-
  gate data to social services districts to assist them  in  making  basic
  management  decisions,  to  the  department  and other state agencies to
  assist in the administration of the medical assistance program,  and  to
  the governor and the legislature as may be necessary to assist in making
  major  administrative and policy decisions affecting such program.  Such
  system shall be designed so as to be capable of the following:

    a. receiving and processing information relating to the eligibility of
  each person applying for medical assistance and  of  issuing  a  medical
  assistance  identification card, AND WHEN AVAILABLE UTILIZING THE BIOME-
  TRIC IDENTIFICATION ISSUED BY THE DEPARTMENT OF  HEALTH,  CONFORMING  TO
  THE REQUIREMENTS SET FORTH IN THE MEDICAID IDENTIFICATION AND ANTI-FRAUD
  BIOMETRIC  TECHNOLOGY  PROGRAM  ESTABLISHED PURSUANT TO ARTICLE TWO-B OF
  THE PUBLIC HEALTH LAW to persons determined by a social  services  offi-
  cial to be eligible for such assistance;
    b.    ACTIVATING  MEDICAL  ASSISTANCE  IDENTIFICATION  BY REQUIRING AN
  APPLICANT RECEIVING SUCH IDENTIFICATION FROM THE DEPARTMENT TO  HAVE  IT
  VERIFIED  AT  A  SOCIAL  SERVICES DISTRICT OFFICE IN THE SOCIAL SERVICES
  DISTRICT IN WHICH THE APPLICANT RESIDES;
    C. receiving and processing information  relating  to  each  qualified
  provider of medical assistance furnishing care, services or supplies for
  which claims for payment are made pursuant to this title;
    [c.]  D.  receiving and processing, in a form and manner prescribed by
  the department, all claims for medical care, services and supplies,  and
  making  payments for valid claims to providers of medical care, services
  and supplies on behalf of social services districts; AND

 A. 6555--F                          4

    [d.] E. maintaining information necessary  to  allow  the  department,
  consistent  with  the  powers and duties of the department of health, to
  review the appropriateness, scope and duration of medical care, services
  and supplies provided to any eligible person pursuant to this  chapter[;
  and
    e.  initiating  implementation  of  such  a  system  for  the district
  comprising the city of New York, in a manner compatible  with  expansion
  of  such system to districts other than the district comprising the city
  of New York].
    S 3.  This act shall take effect immediately.