S T A T E   O F   N E W   Y O R K
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                                 5314--A

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                              May 13, 2015
                               ___________

Introduced  by  Sen.  RANZENHOFER -- read twice and ordered printed, and
  when printed to be committed to the Committee on Finance --  recommit-
  ted to the Committee on Finance 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 public health law, in relation to  establishing  the
  Medicaid  identification  and  anti-fraud  biometric  technology pilot
  program; and to amend the social services law, in relation to conform-
  ing medical assistance identification with the Medicaid identification
  and anti-fraud biometric technology program; and making  an  appropri-
  ation therefor

  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 PILOT PROGRAM
SECTION 290. MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
               PILOT PROGRAM.
        291. DEFINITIONS.
        292. BIOMETRIC TECHNOLOGY USE REQUIREMENT.
        293. RULES AND REGULATIONS.
  S  290.  MEDICAID  IDENTIFICATION  AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
PILOT PROGRAM. THERE IS HEREBY ESTABLISHED THE  MEDICAID  IDENTIFICATION
AND ANTI-FRAUD BIOMETRIC TECHNOLOGY PILOT 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.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00759-02-6
              

S. 5314--A                          2

  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 AUTHORIZING THE USE OF BIOMETRIC TECHNOLOGY 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 THE HEALTH CARE FACILITY.
  (D) MEDICAID RECIPIENTS SHALL BE REQUIRED TO PROVIDE  BIOMETRIC  PROOF
OF  IDENTITY AT THE TIME OF EACH VISIT TO A DOCTOR'S 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)  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.
  (F) 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.
  (G) 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.
  (H) EVALUATION AND SELECTION OF AN IDENTITY 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.
  (I)  SUCH PROGRAM SHALL BE OPERATIONAL WITHIN TWELVE MONTHS OF PROGRAM
APPROVAL AND WILL OPERATE FOR THREE YEARS.
  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

S. 5314--A                          3

FIFTEENTH, TWO THOUSAND EIGHTEEN, AND SHALL PROVIDE THAT PROPOSALS SHALL
BE OPENED ON OR BEFORE MARCH FIRST, TWO THOUSAND EIGHTEEN.
  (B) THE COMMISSIONER SHALL REPORT TO THE GOVERNOR, THE TEMPORARY PRES-
IDENT  OF THE SENATE, THE SPEAKER OF THE ASSEMBLY, AND THE CHAIRS OF THE
SENATE AND ASSEMBLY HEALTH COMMITTEES ON OR BEFORE MARCH THIRTIETH,  TWO
THOUSAND EIGHTEEN WITH REGARD TO THE PROGRESS MADE IN THE DEVELOPMENT OF
CRITERIA  FOR A PROGRAM OF BIOMETRIC IDENTIFICATION AND OF THE IMPLEMEN-
TATION OF SUCH PROGRAM.
  6.  THE COMMISSIONER SHALL, UPON SUBMISSION OF  SATISFACTORY  EVIDENCE
OF  COMPLIANCE  WITH  THE PROVISIONS OF THIS TITLE, APPROVE TWO MEDICAID
IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY PILOT  PROGRAMS,  ONE
TO  BE  LOCATED  IN AN UPSTATE HOSPITAL AND ONE TO BE LOCATED IN A DOWN-
STATE HOSPITAL.
  7. EACH HOSPITAL WILL BE APPROPRIATED THREE HUNDRED  THOUSAND  DOLLARS
TO  ASSIST IN ENABLING THE MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOME-
TRIC TECHNOLOGY PILOT PROGRAM.
  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 PILOT PROGRAM ESTABLISHED PURSUANT TO ARTICLE TWO-B
OF  THE  PUBLIC  HEALTH  LAW  to persons determined by a social services
official 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
making payments for valid claims to providers of medical care,  services
and supplies on behalf of social services districts;
  [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.] F. initiating implementation of such a system  for  the  district
comprising  the  city of New York, in a manner compatible with expansion

S. 5314--A                          4

of such system to districts other than the district comprising the  city
of New York.
  S  3.   The sum of six hundred thousand dollars ($600,000), or so much
thereof as may be necessary, is hereby appropriated to the department of
health out of any moneys in the state treasury in the  general  fund  to
the credit of the Medicaid identification and anti-fraud biometric tech-
nology  pilot  program, not otherwise appropriated, and made immediately
available, for the purpose of carrying out the provisions of  this  act.
Such moneys shall be payable on the audit and warrant of the comptroller
on  vouchers  certified  or  approved by the department of health in the
manner prescribed by law.
  S 4.  This act shall take effect immediately.