Provides for persons whose eligibility for medical assistance is terminated to receive thirty days written notice in advance of the effective date of such termination and consideration of re-application for medical assistance within thirty days of submission of re-application.
Ayes (42): Adams, Addabbo, Alesi, Aubertine, Breslin, Diaz, Dilan, Duane, Espada, Foley, Fuschillo, Golden, Hassell-Thomps, Huntley, Johnson C, Klein, Krueger, Kruger, Leibell, Little, Marcellino, Maziarz, McDonald, Montgomery, Onorato, Oppenheimer, Padavan, Parker, Peralta, Perkins, Robach, Sampson, Savino, Schneiderman, Serrano, Smith, Squadron, Stachowski, Stavisky, Stewart-Cousins, Thompson, Valesky
Nays (19): Bonacic, DeFrancisco, Farley, Flanagan, Griffo, Hannon, Johnson O, Lanza, Larkin, LaValle, Libous, Nozzolio, Ranzenhofer, Saland, Seward, Skelos, Volker, Winner, Young
Excused (1): Morahan
TITLE OF BILL: An act to amend the social services law, in relation to notice and expedited re-application in cases of the termination of medical assistance eligibility
PURPOSE: To require the Office of Administrative Hearings (OAH) and the Office of Temporary and Disability Assistance (OTDA) to provide to an individual whose medical assistance has been terminated, notice of effective coverage end date. The bill also provides 30 days for an individual to notify OTDA of intent to appeal the determination before enrollment is terminated.
SUMMARY OF PROVISIONS: Section 1 amends subdivision 8 of section 22 of the social services law, to require that for all persons whose eligibility for medical assistance has been terminated to be notified in writing of the effective date of end of coverage. Such individuals will also be provided with information on their right to an appeal and how to undertake such process. An individual will have at least 30 days to notify OTDA of his/her intent to appeal the determination before enrollment is terminated. If the individual has been found guilty of fraud, the 30-day time period does not apply.
Section 2 provides for an immediate effective date.
EXISTING LAW: Currently, OTDA and OAH require individuals to attend a scheduled hearing about the termination of their Medicaid coverage. If the individual misses the appointment for any reason, the missed hearing could result in a default hearing, whereby an individual's Medicaid coverage is terminated without further notice.
JUSTIFICATION: If an individual's Medicaid coverage is terminated, he/she must undergo an arduous re-application procedure which may take from 30-60 days before being decided upon. The individual will be without coverage during this period, and depending on his/her medical needs, could be kept from receiving medication and treatment for serious medical conditions. This legislation is intended to provide individuals who have missed their scheduled hearing with written notification of their Medicaid termination date. Furthermore, it will provide means for an individual to appeal the termination before it goes into effect, which may prevent the individual from being left without critical medical services.
2007-08: S.1502 - Died in Committee 2007-08: A.4717 - Passed Assembly 2005-06: S.9674 - Referred to Rules 2003-04: S.5706/A.5559 - Died in Committee 2002: A.3237 - Passed Assembly 2001: A.3237 - Died in Committee
FISCAL IMPLICATIONS: None.
EFFECTIVE DATE: This act shall take effect immediately.
STATE OF NEW YORK ________________________________________________________________________ 1103--A Cal. No. 1098 2009-2010 Regular Sessions IN SENATE January 26, 2009 ___________Introduced by Sens. DILAN, ADAMS, BRESLIN, DIAZ, DUANE, HASSELL-THOMP- SON, HUNTLEY, KRUEGER, MONTGOMERY, ONORATO, PARKER, SAMPSON, SAVINO, SCHNEIDERMAN, SERRANO, STAVISKY -- read twice and ordered printed, and when printed to be committed to the Committee on Social Services -- recommitted to the Committee on Social Services in accordance with Senate Rule 6, sec. 8 -- committee discharged and said bill committed to the Committee on Health -- committee discharged and said bill committed to the Committee on Rules -- ordered to a third reading, amended and ordered reprinted, retaining its place in the order of third reading AN ACT to amend the social services law, in relation to notice and expe- dited re-application in cases of the termination of medical assistance eligibility THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subdivision 8 of section 22 of the social services law, as added by chapter 473 of the laws of 1978, is amended to read as follows: 8. The department shall promulgate such regulations, not inconsistent with federal or state law, as may be necessary to implement the provisions of this section. Such regulations shall require that a copy of all decisions made concerning appeals pursuant to this section shall be sent to each party to such appeals and their representatives, if any. SUCH REGULATIONS SHALL ALSO REQUIRE THAT PERSONS WHOSE ELIGIBILITY FOR MEDICAL ASSISTANCE IS TERMINATED BE NOTIFIED IN WRITING OF THE EFFECTIVE DATE OF SUCH TERMINATION AND BE PROVIDED WITH INFORMATION ON THEIR RIGHT TO AN APPEAL AND HOW TO UNDERTAKE SUCH PROCESS. THE INDIVIDUAL SHALL HAVE AT LEAST THIRTY DAYS TO NOTIFY THE DEPARTMENT OF THEIR INTENT TO APPEAL THE DETERMINATION BEFORE ENROLLMENT IS TERMINATED; PROVIDED THAT IN AN INSTANCE WHERE A PERSON HAS BEEN FOUND GUILTY OF FRAUD, SUCH THIR- TY DAY TIME PERIOD SHALL NOT APPLY. S 2. This act shall take effect immediately.EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD05014-03-0