S2684-2011 Actions

• Jan 17, 2012: PRINT NUMBER 2684A
• Jan 17, 2012: AMEND AND RECOMMIT TO HEALTH
• Jan 4, 2012: REFERRED TO HEALTH
• Jan 28, 2011: REFERRED TO HEALTH

S2684-2011 Memo

BILL NUMBER:S2684

TITLE OF BILL:
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

PURPOSE OF THE BILL:
Modifies the availability of Medicaid services to
bring them more in line with those of private health insurance
coverage.

SUMMARY OF SPECIFIC PROVISIONS:
§ 1- Amends paragraph (a) of
subdivision 2 of § 365-a of the Social Services Law to remove
dentists, nurses, and private duty nursing from those services
authorized under the subdivision. However, nurse midwives and nurse
practitioners are added.

§ 2- Amends paragraph (t) of subdivision 2 of § 365-a of the Social
Services Law to specify that coverage for preventive, prophylactic
and other routine dental care, services and supplies will be
authorized only when provided in a hospital outpatient or clinic
facility. § 3- Amends paragraph (g) of subdivision 2 of

§ 365-a of the Social Services Law to remove dental prosthetic
appliances from those services authorized under the subdivision and
to authorize the Commissioner of Health to require prior approval of
any prescription drug that is prescribed for a resident of a nursing
home that is not reimbursed as part of the nursing home's Medicaid
rate.

§ 4- Amends paragraph (1) of subdivision 2 of § 365-a of the Social
Services Law to add clinical psychologists, nurses and audiologists,
including such care and services provided in a hospital outpatient or
clinic facility, and dentists in those services and care provided in
accordance with the program of early and periodic screening and
diagnosis.

§ 5- Repeals paragraph (n) of subdivision 2 of § 365-a of the Social
Services Law which relates to services provided by audiologists.

§ 6- Allows the Commissioner of Health to promulgate or adopt any
rules or regulations necessary to implement the provisions of the bill.

§ 7- Effective date.

JUSTIFICATION:
The ultimate goal of this legislation is to bring
Medicaid coverage more in line with private health insurance
coverage. The costs associated with "optional" services, those
allowed for but not required by the federal government but required
by New York State, have increased substantially, causing fiscal
strife for many of the state's counties. These costs are often passed


along to the citizens of the state through higher property taxes or
other tax increases. This legislation in no way suggests that
monetary concerns outweigh the care of individuals. However, it is
unfair and inappropriate to ask working families to pay for services
covered under "optional" Medicaid coverage that they themselves may
not be able to afford or obtain under their own private health
insurance plan.

PRIOR LEGISLATIVE HISTORY:
2007-2008: A.4674
2005-2006: A.5465-A
2009-2010: S.7950/A.6677 -- HEALTH/Health

FISCAL IMPLICATIONS:
Yet to be determined. Cost savings to both
counties and the State are expected.

EFFECTIVE DATE:
On the one hundred eightieth day after it shall have
become a law.

S2684-2011 Text

 S T A T E   O F   N E W   Y O R K
 
 
                                         2684
 2011-2012 Regular Sessions
 I N  SENATE
 January 28, 2011
 
 Introduced  by  Sens.  RANZENHOFER,  MAZIARZ  --  read twice and ordered
 printed, and when printed to be committed to the Committee on Health
 

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:

 

Section 1. Paragraph (a) of subdivision 2  of  section  365-a  of  the
 social  services  law,  as amended by chapter 47 of the laws of 1996, is
 amended to read as follows:

 (a) services of qualified physicians, [dentists, nurses,  and  private
 duty  nursing  services  shall  be  further subject to the provisions of
 section three hundred  sixty-seven-o  of  this  chapter,]  optometrists,
 NURSE  MIDWIVES,  NURSE  PRACTITIONERS,  and  other related professional
 personnel;
 

S 2. Paragraph (f) of subdivision 2 of section  365-a  of  the  social
 services  law, as added by chapter 184 of the laws of 1969 and as relet
 tered by chapter 478 of the laws of 1980, is amended to read as follows:

 (f) preventive, prophylactic and other routine dental  care,  services
 and  supplies  ONLY  WHEN  PROVIDED  IN  A HOSPITAL OUTPATIENT OR CLINIC
 FACILITY REFERRED TO IN PARAGRAPH (C) OF THIS SUBDIVISION;
 

S 3. Paragraph (g) of subdivision 2 of section  365-a  of  the  social
 services  law,  as  amended by section 1 of part F of chapter 497 of the
 laws of 2008, is amended to read as follows:

 (g) sickroom supplies,  eyeglasses,  AND  prosthetic  appliances  [and
 dental  prosthetic  appliances]  furnished  in accordance with the regu
 lations of the department, provided that the commissioner of  health  is
 authorized  to implement a preferred diabetic supply program wherein the
 department of  health  will  receive  enhanced  rebates  from  preferred
 manufacturers  of  glucometers and test strips, and may subject non-pre
 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD02430-01-1
 
       S. 2684                             2
 ferred manufacturers' glucometers and test strips to prior authorization
 under section two hundred seventy-three of the public health law;  drugs
 provided  on  an  in-patient  basis,  those  drugs contained on the list
 established  by  regulation  of  the  commissioner of health pursuant to
 subdivision four of this section, and  those  drugs  which  may  not  be
 dispensed  without  a  prescription  as  required by section sixty-eight
 hundred ten of the education law and which the  commissioner  of  health
 shall determine to be reimbursable based upon such factors as the avail
 ability  of  such  drugs  or  alternatives at low cost if purchased by a
 medicaid recipient, or the essential nature of such drugs  as  described
 by such commissioner in regulations, provided, however, that such drugs,
 exclusive  of long-term maintenance drugs, shall be dispensed in quanti
 ties no greater than a thirty day supply or one hundred doses, whichever
 is greater; provided further that the commissioner of health is  author
 ized  to  require  prior  authorization for any refill of a prescription
 when less than seventy-five percent of the previously  dispensed  amount
 per  fill  should have been used were the product used as normally indi
 cated, AND PROVIDED FURTHER THAT  SUCH  COMMISSIONER  IS  AUTHORIZED  TO
 REQUIRE PRIOR APPROVAL OF ANY PRESCRIPTION DRUG THAT IS PRESCRIBED FOR A
 RESIDENT  OF  A  NURSING  HOME AND THAT IS NOT REIMBURSED AS PART OF THE
 NURSING HOME'S MEDICAID RATE; medical assistance shall not  include  any
 drug provided on other than an in-patient basis for which a recipient is
 charged or a claim is made in the case of a prescription drug, in excess
 of  the  maximum  reimbursable  amounts  to be established by department
 regulations in accordance with standards established by the secretary of
 the United States department of health and human services,  or,  in  the
 case  of  a  drug not requiring a prescription, in excess of the maximum
 reimbursable amount established by the commissioner of  health  pursuant
 to paragraph (a) of subdivision four of this section;
 

S  4.  Paragraph  (l)  of subdivision 2 of section 365-a of the social
 services law, as amended by chapter 81 of the laws of 1995,  is  amended
 to read as follows:

 (l)  care  and services of podiatrists, CLINICAL PSYCHOLOGISTS, NURSES
 AND AUDIOLOGISTS, INCLUDING SUCH CARE AND SERVICES PROVIDED IN A  HOSPI
 TAL  OUT-PATIENT OR CLINIC FACILITY REFERRED TO IN PARAGRAPH (C) OF THIS
 SUBDIVISION, AND  DENTISTS,  which  care  and  services  shall  only  be
 provided  upon  referral by a physician, nurse practitioner or certified
 nurse midwife in accordance with  the  program  of  early  and  periodic
 screening  and  diagnosis  established  pursuant to subdivision three of
 this section or to persons eligible for benefits under  title  XVIII  of
 the  federal  social security act as qualified medicare beneficiaries in
 accordance with federal requirements therefor [and private  duty  nurses
 which  care and services shall only be provided in accordance with regu-
 lations of the department of health;  provided,  however,  that  private
 duty  nursing  services  shall  not be restricted when such services are
 more appropriate and cost-effective than nursing services provided by  a
 home health agency pursuant to section three hundred sixty-seven-l];
 

S  5.  Paragraph  (n)  of subdivision 2 of section 365-a of the social
 services law, as added by chapter 556 of the laws of 1986, is REPEALED.
 

S 6. The commissioner of health is authorized to promulgate  or  adopt
 any  rules  or regulations necessary to implement the provisions of this
 act and any procedures, forms, or instructions necessary for such imple
 mentation may be adopted and issued on or after the  effective  date  of
 this act. Notwithstanding any inconsistent provision of the state admin
 istrative  procedure  act  or  any other provision of law, rule or regu
 lation, the commissioner of health and the superintendent  of  insurance
 
       S. 2684                             3
 and  any  appropriate council is authorized to adopt or amend or promul
 gate on an emergency basis any regulation he  or  she  or  such  council
 determines  necessary  to  implement  any  provision  of this act on its
 effective date.
 

S 7. This act shall take effect on the one hundred eightieth day after
 it shall have become a law.

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