S2684A-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

S2684A-2011 Memo

BILL NUMBER:S2684A

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.5465A
2009-2010: S.7950/A.6677 -- HEALTH/Health
2011:      S.2684 -- 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.

S2684A-2011 Text

 S T A T E   O F   N E W   Y O R K
 
 2684--A
 2011-2012 Regular Sessions
 I N  SENATE
 January 28, 2011
 
 Introduced  by  Sens.  RANZENHOFER,  MAZIARZ,  LARKIN  -- read twice and
 ordered printed, and when printed to be committed to the Committee  on
 Health  --  recommitted  to the Committee on Health in accordance with
 Senate Rule 6, sec. 8 -- committee discharged, bill  amended,  ordered
 reprinted as amended and recommitted to said committee
 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 23 of part H of chapter  59  of  the
 laws of 2011, 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 further that: (i) the commissioner
 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD02430-02-2
 
       S. 2684--A                          2
 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-preferred  manufacturers'  glucometers  and  test  strips  to  prior
 authorization under section two  hundred  seventy-three  of  the  public
 health law; (ii) enteral formula therapy and nutritional supplements are
 limited  to  coverage  only for nasogastric, jejunostomy, or gastrostomy
 tube feeding or for treatment of an inborn  metabolic  disorder,  or  to
 address  growth and development problems in children; (iii) prescription
 footwear and inserts are limited to coverage only when used as an  inte
 gral  part  of  a  lower  limb orthotic appliance, as part of a diabetic
 treatment plan, or to address growth and development problems  in  chil
 dren; [and] (iv) compression and support stockings are limited to cover
 age only for pregnancy or treatment of venous stasis ulcers; AND (V) THE
 COMMISSIONER  OF  HEALTH  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;
 

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
 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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