A8869B-2011 Actions

• Oct 3, 2012: approval memo.14
• Oct 3, 2012: signed chap.461
• Sep 21, 2012: delivered to governor
• Jun 21, 2012: RETURNED TO ASSEMBLY
• Jun 21, 2012: PASSED SENATE
• Jun 21, 2012: 3RD READING CAL.1465
• Jun 21, 2012: SUBSTITUTED FOR S6228B
• Jun 18, 2012: REFERRED TO RULES
• Jun 18, 2012: delivered to senate
• Jun 18, 2012: passed assembly
• Jun 12, 2012: amended on third reading 8869b
• Jun 11, 2012: ordered to third reading rules cal.101
• Jun 11, 2012: rules report cal.101
• Jun 11, 2012: reported
• Jun 6, 2012: reported referred to rules
• May 29, 2012: print number 8869a
• May 29, 2012: amend (t) and recommit to ways and means
• Jan 31, 2012: reported referred to ways and means
• Jan 4, 2012: referred to health

A8869B-2011 Votes

A8869B-2011 Text

 S T A T E   O F   N E W   Y O R K
 
 8869--B
 R. R. 101
 I N  ASSEMBLY
 (PREFILED)
 January 4, 2012
 
 Introduced  by  M. of A. GOTTFRIED, MAGNARELLI -- read once and referred
 to the Committee on Health -- reported and referred to  the  Committee
 on  Ways  and  Means  --  committee  discharged, bill amended, ordered
 reprinted as amended and recommitted to said committee --  amended  on
 the  special  order  of  third  reading, ordered reprinted as amended,
 retaining its place on the special order of third reading
 

AN ACT to amend the public health law, in relation to  accountable  care
 organizations
 

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

 

Section 1. Article 29-E of the public health law, as added by  section
 66  of  part  H of chapter 59 of the laws of 2011, is amended to read as
 follows:

 ARTICLE 29-E
 ACCOUNTABLE CARE ORGANIZATIONS [DEMONSTRATION PROGRAM]
 

Section 2999-n. Accountable care organizations; findings; purpose.
 2999-o. Definitions.
 2999-p. Establishment of [ACO demonstration program] ACOS.
 2999-q. Accountable care organizations; requirements.
 2999-r. Other laws.
 

S 2999-n. Accountable  care  organizations;  findings;  purpose.  [The
 legislature  intends  to  test the ability of accountable care organiza-
 tions to assume a role in delivering an array of health  care  services,
 from  primary  and  preventive care through acute inpatient hospital and
 post-hospital care.] The legislature finds that the formation and opera
 tion of accountable care organizations under this article,  and  subject
 to appropriate regulation, can be consistent with the purposes of feder
 al  and  state  anti-trust, anti-referral, and other statutes, including
 reducing over-utilization and expenditures. The legislature  finds  that
 the  development  of  accountable  care organizations under this article
 will reduce health care costs, promote effective  allocation  of  health
 care  resources,  and  enhance  the  quality and accessibility of health
 care. The legislature finds that this article is  necessary  to  promote
 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD13268-10-2
 
       A. 8869--B                          2
 the  formation  of accountable care organizations and protect the public
 interest and the interests of patients and health care providers.
 

S  2999-o.  Definitions.  As used in this article, the following terms
 shall have the following meanings, unless the context  clearly  requires
 otherwise:

 1.  "Accountable  care organization" or "ACO" means an organization of
 clinically integrated health care providers certified by the commission
 er under this article.
 2. "ACO PARTICIPANT" OR "PARTICIPANT" MEANS  A  HEALTH  CARE  PROVIDER
 THAT IS ONE OF THE HEALTH CARE PROVIDERS THAT COMPRISE THE ACO.
 3.  Certificate  of authority" or "certificate" means a certificate of
 authority issued by the commissioner under this article.
 [3.] 4. "CMS" MEANS THE FEDERAL  CENTERS  FOR  MEDICARE  AND  MEDICAID
 SERVICES.
 5. "CMS REGULATIONS" MEANS APPLICABLE FEDERAL LAWS AND CMS REGULATIONS
 AND POLICIES.
 6.  "Health  care  provider"  includes but is not limited to an entity
 licensed or certified under article twenty-eight or thirty-six  of  this
 chapter;  an entity licensed or certified under article sixteen, thirty
 one or thirty-two of the mental hygiene law; or a  health  care  practi
 tioner licensed or certified under title eight of the education law or a
 lawful  combination  of  such  health  care  practitioners; and may also
 include, to the extent provided by regulation of the commissioner, other
 entities that provide  technical  assistance,  information  systems  and
 services,  care coordination and other services to health care providers
 and patients participating in an ACO.
 [4.] 7. "MEDICARE-ONLY ACO" MEANS  AN  ACO  ISSUED  A  CERTIFICATE  OF
 AUTHORITY  UNDER SUBDIVISION FOUR OF SECTION TWENTY-NINE HUNDRED NINETY
 NINE-P OF THIS ARTICLE.
 8. "Primary care" means the health care  fields  of  family  practice,
 general pediatrics, primary care internal medicine, primary care obstet
 rics, or primary care gynecology, without regard to board certification,
 provided by a health care provider acting within his, her, or its lawful
 scope of practice.
 [5.]  9. "Third-party health care payer" has its ordinary meanings and
 may include any entities provided for by regulation of the commissioner,
 which may include an entity such as a pharmacy benefits manager,  fiscal
 administrator,  or administrative services provider that participates in
 the administration of a third-party health care payer system.
 [6. Any references to the "department of financial services"  and  the
 "superintendent of financial services" in this article shall mean, prior
 to  October third, two thousand eleven, respectively, the "department of
 insurance" and the "superintendent of insurance."]
 

S 2999-p. Establishment of [ACO demonstration  program]  ACOS.  1.  An
 accountable  care  organization:  (a)  is  an organization of clinically
 integrated health care providers that work together to provide,  manage,
 and  coordinate health care (including primary care) for a defined popu
 lation; with a mechanism for shared governance; the ability  to  negoti
 ate, receive, and distribute payments; and accountability for the quali
 ty,  cost,  and  delivery  of  health  care  to  the  ACO's patients; in
 accordance with this article; and (b) has been issued a  certificate  of
 authority by the commissioner under this article.
 2.  The  commissioner shall establish a [demonstration] program within
 the department to [test the ability] PROMOTE AND  REGULATE  THE  USE  of
 ACOs  to  deliver  an  array  of health care services for the purpose of
 
       A. 8869--B                          3
 improving the  quality,  coordination  and  accountability  of  services
 provided to patients in New York.
 3.  The commissioner may issue a certificate of authority to an entity
 that meets conditions for ACO certification as set forth in  regulations
 [promulgated]  MADE  by the commissioner pursuant to section twenty-nine
 hundred ninety-nine-q of this article. The commissioner shall not [issue
 more than seven certificates under this article, and  shall  not]  issue
 any  new certificate under this article after December thirty-first, two
 thousand [fifteen] SIXTEEN.
 4. (A) NOTWITHSTANDING SUBDIVISION THREE OF THIS SECTION, THE  COMMIS
 SIONER  SHALL ISSUE A CERTIFICATE OF AUTHORITY AS A MEDICARE-ONLY ACO TO
 AN ENTITY AUTHORIZED BY CMS TO BE AN ACCOUNTABLE CARE ORGANIZATION UNDER
 THE  MEDICARE  PROGRAM,  UPON  RECEIVING  AN   APPLICATION   TO   BE   A
 MEDICARE-ONLY  ACO  FROM  THE  ENTITY  DOCUMENTING ITS STATUS UNDER THIS
 SUBDIVISION. A CERTIFICATE OF AUTHORITY  UNDER  THIS  SUBDIVISION  SHALL
 ONLY  APPLY  TO  THE MEDICARE-ONLY ACO'S ACTIONS IN RELATION TO MEDICARE
 BENEFICIARIES UNDER ITS AUTHORIZATION FROM CMS.
 (B) TO THE EXTENT CONSISTENT WITH CMS REGULATIONS, A MEDICARE-ONLY ACO
 SHALL BE SUBJECT TO:

 (I) SUBDIVISION SEVEN OF SECTION TWENTY-NINE HUNDRED NINETY-NINE-Q AND
 SUBDIVISIONS  ONE,  TWO  AND  THREE  OF  SECTION   TWENTY-NINE   HUNDRED
 NINETY-NINE-R OF THIS ARTICLE, WITHOUT REGARD TO WHETHER THE COMMISSION
 ER HAS MADE REGULATIONS UNDER THIS ARTICLE; AND
 (II)  OTHER  PROVISIONS  OF  THIS  ARTICLE  TO THE EXTENT SPECIFICALLY
 PROVIDED BY THE COMMISSIONER IN REGULATIONS CONSISTENT WITH  THIS  ARTI
 CLE.
 5.  The commissioner may limit, suspend, or terminate a certificate of
 authority if an ACO is not operating in accordance with this article.
 [5.] 6. The commissioner is authorized to seek federal  approvals  and
 waivers  to  implement  this article, including but not limited to those
 approvals or waivers  necessary  to  obtain  federal  financial  partic
 ipation.
 

S 2999-q. Accountable care organizations; requirements. 1. The commis
 sioner  shall  [promulgate]  MAKE  regulations establishing criteria for
 certificates  of  authority,  quality  standards  for  ACOs,   reporting
 requirements and other matters deemed to be appropriate and necessary in
 the  operation  and evaluation of [the demonstration program] ACOS UNDER
 THIS ARTICLE. In [promulgating] MAKING such regulations, the commission
 er shall consult with the superintendent of financial  services,  health
 care  providers,  third-party health care payers, advocates representing
 patients, and other  appropriate  parties.  SUCH  REGULATIONS  SHALL  BE
 CONSISTENT,  TO  THE  EXTENT PRACTICAL AND CONSISTENT WITH THIS ARTICLE,
 WITH CMS REGULATIONS FOR ACCOUNTABLE CARE ORGANIZATIONS UNDER THE  MEDI
 CARE PROGRAM.
 2.  Such  regulations may, and shall as necessary for purposes of this
 article, address matters including but not limited to:

 (a) The governance, leadership and management  structure  of  the  ACO
 THAT  REASONABLY AND EQUITABLY REPRESENTS THE ACO'S PARTICIPANTS AND THE
 ACO'S PATIENTS, including the manner in which clinical  and  administra
 tive systems and clinical participation will be managed;
 (b)  Definition  of  the  population proposed to be served by the ACO,
 which may include reference to a geographical area and  patient  charac
 teristics;
 (c)  The character, competence and fiscal responsibility and soundness
 of an ACO and its principals, if and to the extent deemed appropriate by
 the commissioner;
 
       A. 8869--B                          4
 (d) The adequacy of an ACO's  network  of  participating  health  care
 providers, including primary care health care providers;
 (e)  Mechanisms  by  which an ACO will provide, manage, and coordinate
 quality health care for its patients [and provide] INCLUDING WHERE PRAC
 TICABLE ELEVATING THE SERVICES OF PRIMARY CARE HEALTH CARE PROVIDERS  TO
 MEET  PATIENT-CENTERED MEDICAL HOME STANDARDS, COORDINATING SERVICES FOR
 COMPLEX HIGH-NEED PATIENTS, AND PROVIDING access to health care  provid
 ers that are not participants in the ACO;
 (f)  Mechanisms by which the ACO shall receive and distribute payments
 to its participating health care providers, which may include  incentive
 payments  (WHICH  MAY  INCLUDE  MEDICAL HOME PAYMENTS) or mechanisms for
 pooling payments received by participating health  care  providers  from
 third-party payers and patients;
 (g)  Mechanisms  and  criteria  for accepting health care providers to
 participate in the ACO that are related to  the  needs  of  the  patient
 population  to be served and needs and purposes of the ACO, and prevent
 ing unreasonable discrimination;
 (h) Mechanisms for quality  assurance  and  grievance  procedures  for
 patients  or health care providers where appropriate, AND PROCEDURES FOR
 REVIEWING AND APPEALING PATIENT CARE DECISIONS;
 (i)  Mechanisms  that  promote  evidence-based  health  care,  patient
 engagement,  coordination  of care, electronic health records, including
 participation in health  information  exchanges,  [and]  other  enabling
 technologies   AND  INTEGRATED,  EFFICIENT  AND  EFFECTIVE  HEALTH  CARE
 SERVICES;
 (j) Performance standards for, and measures to assess, the quality and
 utilization of care provided by an ACO;
 (k) Appropriate requirements for ACOs to promote compliance  with  the
 purposes of this article;
 (l)  Posting  on  the department's website information about ACOs that
 would be useful to health care providers and patients, INCLUDING SIMILAR
 METRICS AS THE COMMISSIONER PUBLISHES FOR OTHER  ORGANIZATIONS  SUCH  AS
 MEDICAID MANAGED CARE PROVIDERS UNDER SECTION THREE HUNDRED SIXTY-FOUR-J
 OF  THE SOCIAL SERVICES LAW AND HEALTH HOMES UNDER SECTION THREE HUNDRED
 SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW;
 (m) Requirements for the submission of information and  data  by  ACOs
 and  their  participating and affiliated health care providers as neces
 sary for the evaluation of the success of  [the  demonstration  program]
 ACOS;
 (n) Protection of patient rights as appropriate;
 (o)  The  impact  of  the  establishment and operation of an ACO [on],
 INCLUDING PROVIDING THAT IT SHALL NOT DIMINISH access to any health care
 service FOR THE POPULATION SERVED AND in the area served; and
 (p) Establishment of standards, as appropriate, to promote the ability
 of an ACO to participate in applicable federal programs for ACOs.
 3. (A) THE ACO SHALL  PROVIDE  FOR  MEANINGFUL  PARTICIPATION  IN  THE
 COMPOSITION AND CONTROL OF THE ACO'S GOVERNING BODY FOR ACO PARTICIPANTS
 OR THEIR DESIGNATED REPRESENTATIVES.
 (B)  THE  ACO GOVERNING BODY SHALL INCLUDE AT LEAST ONE REPRESENTATIVE
 OF EACH OF THE FOLLOWING GROUPS:  (I)  RECIPIENTS  OF  MEDICAID,  FAMILY
 HEALTH PLUS, OR CHILD HEALTH PLUS; (II) PERSONS WITH OTHER HEALTH COVER
 AGE;  AND  (III) PERSONS WHO DO NOT HAVE HEALTH COVERAGE. SUCH REPRESEN
 TATIVES SHALL HAVE NO CONFLICT OF INTEREST WITH THE ACO AND NO IMMEDIATE
 FAMILY MEMBER WITH A CONFLICT OF INTEREST WITH THE ACO.
 (C) AT LEAST SEVENTY-FIVE PERCENT CONTROL OF THE ACO'S GOVERNING  BODY
 SHALL BE HELD BY ACO PARTICIPANTS.
 
       A. 8869--B                          5
 (D) MEMBERS OF THE ACO GOVERNING BODY SHALL HAVE A FIDUCIARY RELATION
 SHIP  WITH THE ACO AND SHALL BE SUBJECT TO CONFLICT OF INTEREST REQUIRE
 MENTS ADOPTED BY THE ACO AND IN REGULATIONS OF THE COMMISSIONER.
 (E)  THE ACO'S FINANCES, INCLUDING DIVIDENDS AND OTHER RETURN ON CAPI
 TAL, DEBT STRUCTURE, EXECUTIVE COMPENSATION, AND ACO PARTICIPANT COMPEN
 SATION, SHALL BE ARRANGED AND CONDUCTED TO MAXIMIZE THE  ACHIEVEMENT  OF
 THE PURPOSES OF THIS ARTICLE.
 4.  (A) AN ACO SHALL USE ITS BEST EFFORTS TO INCLUDE AMONG ITS PARTIC
 IPANTS, ON REASONABLE  TERMS  AND  CONDITIONS,  ANY  FEDERALLY-QUALIFIED
 HEALTH  CENTER  THAT  IS WILLING TO BE A PARTICIPANT AND THAT SERVES THE
 AREA AND POPULATION SERVED BY THE ACO.
 (B) AN ACO MAY SEEK TO FOCUS ON  PROVIDING  HEALTH  CARE  SERVICES  TO
 PATIENTS  WITH ONE OR MORE CHRONIC CONDITIONS OR SPECIAL NEEDS. HOWEVER,
 AN ACO MAY NOT OTHERWISE, ON THE BASIS OF A PERSON'S  MEDICAL  OR  DEMO
 GRAPHIC  CHARACTERISTICS,  DISCRIMINATE  FOR OR AGAINST OR DISCOURAGE OR
 ENCOURAGE ANY PERSON OR PERSON WITH RESPECT TO ENROLLING OR  PARTICIPAT
 ING IN THE ACO.
 (C)  AN ACO SHALL NOT, BY INCENTIVES OR OTHERWISE, DISCOURAGE A HEALTH
 CARE PROVIDER FROM PROVIDING OR AN  ENROLLEE  OR  PATIENT  FROM  SEEKING
 APPROPRIATE HEALTH CARE SERVICES.
 (D) AN ACO SHALL NOT DISCRIMINATE AGAINST OR DISADVANTAGE A PATIENT OR
 PATIENT'S REPRESENTATIVE FOR THE EXERCISE OF PATIENT AUTONOMY.
 (E) AN ACO MAY NOT LIMIT OR RESTRICT BENEFICIARIES TO USE OF PROVIDERS
 CONTRACTED  OR AFFILIATED WITH THE ACO. AN ACO MAY NOT REQUIRE A PATIENT
 TO OBTAIN THE PRIOR APPROVAL, FROM A PRIMARY CARE GATEKEEPER  OR  OTHER
 WISE,  BEFORE  UTILIZING THE SERVICES OF OTHER PROVIDERS. AN ACO MAY NOT
 MAKE ADVERSE DETERMINATIONS AS DEFINED IN  ARTICLE  FORTY-NINE  OF  THIS
 CHAPTER.
 5.    AN  ACO  MAY  PROVIDE  CARE  COORDINATION  FOR ITS PARTICIPATING
 PATIENTS, WHICH (A) SHALL INCLUDE BUT NOT BE LIMITED TO MANAGING, REFER
 RING TO, LOCATING, COORDINATING, AND MONITORING HEALTH CARE SERVICES FOR
 THE MEMBER TO ASSURE THAT ALL MEDICALLY NECESSARY HEALTH  CARE  SERVICES
 ARE MADE AVAILABLE TO AND ARE EFFECTIVELY USED BY THE MEMBER IN A TIMELY
 MANNER,  CONSISTENT  WITH PATIENT AUTONOMY; AND (B) IS NOT A REQUIREMENT
 FOR PRIOR AUTHORIZATION FOR HEALTH CARE SERVICES, AND REFERRAL SHALL NOT
 BE REQUIRED FOR A MEMBER TO RECEIVE A HEALTH CARE SERVICE.
 6. (a) Subject to regulations of the  commissioner:  (i)  an  ACO  may
 enter  into arrangements with one or more third-party health care payers
 to establish payment methodologies for  health  care  services  for  the
 third-party  health  care  payer's  enrollees provided by the ACO or for
 which the ACO is responsible, such as  full  or  partial  capitation  or
 other arrangements; (ii) such arrangements may include provision for the
 ACO to receive and distribute payments to the ACO's participating health
 care  providers,  including  incentive  payments and payments for health
 care services from third-party health  care  payers  and  patients;  and
 (iii)  an  ACO  may  include mechanisms for pooling payments received by
 participating  health  care  providers  from  third-party   payers   and
 patients.
 (b)  Subject  to regulations of the commissioner, the commissioner, in
 consultation with the superintendent of financial services, may  author
 ize  a third-party health care payer to participate in payment methodol
 ogies with an ACO under this subdivision, notwithstanding  any  contrary
 provision  of  this chapter, the insurance law, the social services law,
 or the elder law, on finding that the payment methodology is  consistent
 with the purposes of this article.
 
       A. 8869--B                          6
 [4.]  (C)  AN ACO MAY CONTRACT WITH A THIRD-PARTY HEALTH CARE PAYER TO
 SERVE AS ALL OR PART OF THE THIRD-PARTY  HEALTH  CARE  PAYER'S  PROVIDER
 NETWORK  OR CARE COORDINATION AGENT, PROVIDED IN THAT CASE THE ACO SHALL
 BE SUBJECT TO ALL PROVISIONS OF THIS CHAPTER OR THE INSURANCE LAW  WHICH
 ARE  APPLICABLE  TO  THE PROVIDER NETWORK OF THE THIRD-PARTY HEALTH CARE
 PAYER.
 7. The provision of health care services directly or indirectly by  an
 ACO  through  health care providers shall not be considered the practice
 of a profession under title eight of the education law by the ACO.
 

S 2999-r. Other laws. 1. (a) It is the policy of the state  to  permit
 and  encourage  cooperative,  collaborative and integrative arrangements
 among third-party health care payers and health care providers who might
 otherwise be competitors under the active supervision of the commission
 er. To the extent that it is necessary to  accomplish  the  purposes  of
 this  article,  competition  may be supplanted and the state may provide
 state action immunity under state and federal antitrust laws  to  payors
 and health care providers.
 (b)  The  commissioner  [may]  SHALL  engage  in  state supervision to
 promote state action immunity under state and federal antitrust laws and
 may inspect, require, or request additional documentation and take other
 actions under this article to verify and make sure that this article  is
 implemented in accordance with its intent and purpose.
 2.  With  respect  to  the  planning, implementation, and operation of
 ACOs, the commissioner, by regulation, [may] SHALL specifically  deline
 ate  safe harbors that exempt ACOs from the application of the following
 statutes:

 (a) article  twenty-two  of  the  general  business  law  relating  to
 arrangements and agreements in restraint of trade;
 (b)  article one hundred thirty-one-A of the education law relating to
 fee-splitting arrangements; and
 (c) title two-D of article two of this chapter relating to health care
 practitioner referrals.
 3. For the purposes of this article, an ACO shall be deemed  to  be  a
 hospital  for  purposes of sections twenty-eight hundred five-j, twenty
 eight hundred  five-k,  twenty-eight  hundred  five-l  and  twenty-eight
 hundred  five-m  of  this  chapter  and  subdivisions  three and five of
 section sixty-five hundred twenty-seven of the education law.
 4.  THE COMMISSIONER IS AUTHORIZED TO SEEK FEDERAL GRANTS,  APPROVALS,
 AND  WAIVERS  TO  IMPLEMENT  THIS  ARTICLE,  INCLUDING FEDERAL FINANCIAL
 PARTICIPATION UNDER  PUBLIC  HEALTH  COVERAGE.  THE  COMMISSIONER  SHALL
 PROVIDE  COPIES  OF  APPLICATIONS AND OTHER DOCUMENTS, INCLUDING DRAFTS,
 SUBMITTED  TO  THE  FEDERAL  GOVERNMENT  SEEKING  SUCH  FEDERAL  GRANTS,
 APPROVALS,  AND  WAIVERS  TO THE CHAIRS OF THE SENATE FINANCE COMMITTEE,
 THE ASSEMBLY WAYS AND MEANS  COMMITTEE,  AND  THE  SENATE  AND  ASSEMBLY
 HEALTH  COMMITTEES  SIMULTANEOUSLY  WITH THEIR SUBMISSION TO THE FEDERAL
 GOVERNMENT.
 5. THE COMMISSIONER MAY DIRECTLY, OR BY CONTRACT  WITH  NOT-FOR-PROFIT
 ORGANIZATIONS, PROVIDE:

 (A)  CONSUMER  ASSISTANCE  TO  PATIENTS SERVED BY AN ACO AS TO MATTERS
 RELATING TO ACOS;
 (B) TECHNICAL AND OTHER ASSISTANCE TO HEALTH  CARE  PROVIDERS  PARTIC
 IPATING IN AN ACO AS TO MATTERS RELATING TO THE ACO;
 (C)  ASSISTANCE  TO  ACOS TO PROMOTE THEIR FORMATION AND IMPROVE THEIR
 OPERATION, INCLUDING ASSISTANCE UNDER SECTION TWENTY-EIGHT HUNDRED EIGH
 TEEN OF THIS CHAPTER; AND
 
       A. 8869--B                          7
 (D) INFORMATION SHARING AND OTHER ASSISTANCE AMONG ACOS TO IMPROVE THE
 OPERATION OF ACOS.
 

S 2. The commissioner of health shall convene a workgroup to develop a
 proposal  whereby an ACO may serve, in place of a managed care plan: (a)
 Medicaid enrollees otherwise required to participate  in  managed  care,
 care  management, or care coordination under section 364-j of the social
 services law, section 4403-f of the public health law, or other law; and
 (b) enrollees in family health plus  under  section  369-ee  or  section
 369-ff  of  the  social services law and the child health insurance plan
 under title 1-A of article 25 of the public health  law.  The  workgroup
 shall  include,  but  not be limited to, representatives of: accountable
 care organizations or entities  seeking  to  form  an  accountable  care
 organization  under  article  29-E of the public health law; health care
 providers serving Medicaid enrollees; Medicaid, family health plus,  and
 child  health insurance plan enrollees; and the senate and the assembly.
 The workgroup shall report its recommendations for regulatory or  statu
 tory actions to the governor, the commissioner of health, and the legis
 lature.
 

S  3.

Section 2818 of the public health law is amended by adding a new
 subdivision 7 to read as follows:

 7. NOTWITHSTANDING SUBDIVISIONS ONE AND TWO OF THIS SECTION,  SECTIONS
 ONE HUNDRED TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW,
 OR  ANY  OTHER INCONSISTENT PROVISION OF LAW, OF THE FUNDS AVAILABLE FOR
 EXPENDITURE PURSUANT TO THIS SECTION, THE COMMISSIONER MAY ALLOCATE  AND
 DISTRIBUTE,  WITHOUT  A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS,
 GRANTS TO ACCOUNTABLE CARE ORGANIZATIONS UNDER ARTICLE TWENTY-NINE-E  OF
 THIS  CHAPTER FOR THE PURPOSE OF PROMOTING THEIR FORMATION AND IMPROVING
 THEIR OPERATION.   CONSIDERATION RELIED  UPON  BY  THE  COMMISSIONER  IN
 DETERMINING  THE  ALLOCATION  AND  DISTRIBUTION  OF  THESE  FUNDS  SHALL
 INCLUDE, BUT NOT BE LIMITED  TO,  THE  NEED  FOR  AND  CAPACITY  OF  THE
 ACCOUNTABLE  CARE  ORGANIZATION  TO  ACCOMPLISH  THE PURPOSES OF ARTICLE
 TWENTY-NINE-E OF THIS CHAPTER IN THE AREA TO BE SERVED.
 

S 4. This act shall take effect immediately.

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