S T A T E   O F   N E W   Y O R K
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                                  6115

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                             August 6, 2009
                               ___________

Introduced  by  Sen.  DIAZ  --  read twice and ordered printed, and when
  printed to be committed to the Committee on Rules

AN ACT in relation to increasing access  to  pharmaceuticals  for  needy
  seniors  and the disabled through the expansion of eligibility for the
  medicaid program

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

  Section  1.  This act shall be known and may be cited as the "medicaid
prescription senior eligibility expansion program".
  S 2. Legislative  findings  and  intent.  The  legislature  finds  and
declares  that states are looking for solutions to improve the access of
needy seniors to prescription medicines. Nearly thirty percent of  medi-
care  enrollees  in the state have no coverage for pharmaceuticals, with
nearly a quarter of such enrollees  living  below  the  federal  poverty
level.   Furthermore, millions more elderly and disabled medicare enrol-
lees are underinsured for prescription drugs. A  federal  1115  medicaid
waiver  to extend prescription drug coverage to qualified medicare bene-
ficiaries and special low-income medicare  beneficiaries  would  provide
meaningful  access  to prescription drugs for the state's poor and near-
poor senior population. The legislature further  finds  that  a  federal
1115  medicaid  waiver enables the state to benefit from the well estab-
lished state-federal partnership in medicaid through access  to  federal
matching funds in addition to state funds.
  S 3. Definitions. As used in this act:
  1. "Department" means the department of health;
  2.  "Qualified  medicare  beneficiaries"  means medicare beneficiaries
with incomes equal to or below one hundred percent of the federal pover-
ty level who are eligible for medicaid assistance for  the  Part  A  and
Part  B  medicare premiums and for medicare deductibles and co-insurance
requirements as set forth in section 1905(p)(1)  of  title  XIX  of  the
social security act; and

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09921-01-9
              

S. 6115                             2

  3.  "Specified low-income medicare beneficiaries" means medicare bene-
ficiaries who have incomes greater  than  one  hundred  percent  of  the
federal  poverty  level  and  less  than and equal to one hundred twenty
percent of the federal poverty level and meet the requirements set forth
in section 1902(a)(10) (E)(iii) of title XIX of the social security act.
  S  4.  Medicaid  prescription senior eligibility expansion program. 1.
There is hereby established a medicaid prescription  senior  eligibility
expansion program. In order to become eligible for the program, an indi-
vidual must meet the following requirements:
  a. be a United States citizen or a lawfully admitted alien;
  b. be a state resident;
  c.  be  at  least sixty-five years of age or an individual between the
ages of nineteen and sixty-four who is otherwise eligible  for  benefits
under title II of the social security act;
  d. meet the definition of a qualified medicare beneficiary or a speci-
fied  low-income  medicare  beneficiary as set forth in section three of
this act; and
  e. be ineligible for and/or not receiving a prescription drug  benefit
through  a  medicare  supplemental policy or any other third party payer
prescription benefit.
  2. Individuals eligible for the medicaid prescription senior eligibil-
ity expansion program shall be entitled  to  the  medicaid  prescription
drug  coverage  as provided to medicaid recipients as set forth in title
XIX of the social security act.
  S 5. Program administration. 1. The department  shall  administer  the
medicaid prescription senior eligibility expansion program.
  2.  The  department  shall  apply  for  a federal medicare 1115 demon-
stration waiver from the federal secretary of health and human  services
to  expand  medicaid  eligibility  for the purposes of prescription drug
coverage to qualified medicare beneficiaries  and  specified  low-income
medicare  beneficiaries under the medicaid prescription senior eligibil-
ity expansion program.
  3. The department shall promulgate and adopt rules and regulations  as
are  necessary  to implement the provisions of the medicaid prescription
senior eligibility expansion program in a cost effective manner that are
consistent with the purposes of such program.
  S 6. Annual report. The department shall submit an  annual  report  to
the  legislature  beginning  one year from the date of implementation of
the medicaid prescription senior eligibility expansion program.
  S 7. This act shall take effect immediately.