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STATE OF NEW YORK
________________________________________________________________________

6555--E

2011-2012 Regular Sessions

IN 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  --  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,
  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 commit-
  tee 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

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
SECTION 290. MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
               PROGRAM.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09573-15-2
A. 6555--E                          2

        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,
PERFORMANCE, HYGIENE, BIOMETRIC CAPTURE AND  STORAGE  REQUIREMENTS,  AND
INTEROPERABILITY.
A. 6555--E                          3

  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.
  6. NO GOVERNMENT ENTITY, INCLUDING LOCAL SOCIAL SERVICES  DEPARTMENTS,
OR PARTICIPATING HEALTH CARE PROVIDER SHALL STORE OR SHARE ANY BIOMETRIC
DATA UTILIZED OR REQUESTED PURSUANT TO THIS ARTICLE.
  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
A. 6555--E                          4

making payments for valid claims to providers of medical care,  services
and supplies on behalf of social services districts; AND
  [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.