Bill Text: NY A02006 | 2017-2018 | General Assembly | Introduced

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Bill Title: Modifies availability of medicaid services to bring them more in line with those of private health insurance coverage.

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2018-01-03 - referred to health [A02006 Detail]

Download: New_York-2017-A02006-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                          2006
                               2017-2018 Regular Sessions
                   IN ASSEMBLY
                                    January 17, 2017
                                       ___________
        Introduced  by M. of A. SCHIMMINGER, GOODELL -- Multi-Sponsored by -- M.
          of A.  DiPIETRO, GIGLIO, HAWLEY, HOOPER, MAGEE, RIVERA  --  read  once
          and referred 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:
     1    Section  1.  Paragraph  (a)  of  subdivision 2 of section 365-a of the
     2  social services law, as amended by chapter 47 of the laws  of  1996,  is
     3  amended to read as follows:
     4    (a)  services  of qualified physicians, [dentists, nurses, and private
     5  duty nursing services shall be further  subject  to  the  provisions  of
     6  section  three  hundred  sixty-seven-o  of  this chapter,] optometrists,
     7  nurse midwives, nurse  practitioners,  and  other  related  professional
     8  personnel;
     9    §  2.  Paragraph  (f)  of subdivision 2 of section 365-a of the social
    10  services law, as added by chapter 184 of the laws of 1969 and as  relet-
    11  tered by chapter 478 of the laws of 1980, is amended to read as follows:
    12    (f)  preventive,  prophylactic and other routine dental care, services
    13  and supplies only when provided  in  a  hospital  outpatient  or  clinic
    14  facility referred to in paragraph (c) of this subdivision;
    15    §  3.  Paragraph  (g)  of subdivision 2 of section 365-a of the social
    16  services law, as amended by section 21 of part A of chapter  56  of  the
    17  laws of 2013, is amended to read as follows:
    18    (g)  sickroom  supplies,  eyeglasses,  and  prosthetic appliances [and
    19  dental prosthetic appliances] furnished in  accordance  with  the  regu-
    20  lations  of  the department; provided further that: (i) the commissioner
    21  of health is authorized to implement a preferred diabetic supply program
    22  wherein the department of health  will  receive  enhanced  rebates  from
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05815-01-7
        A. 2006                             2
     1  preferred  manufacturers of glucometers and test strips, and may subject
     2  non-preferred  manufacturers'  glucometers  and  test  strips  to  prior
     3  authorization  under  section  two  hundred  seventy-three of the public
     4  health law; (ii) enteral formula therapy and nutritional supplements are
     5  limited  to  coverage  only for nasogastric, jejunostomy, or gastrostomy
     6  tube feeding, for treatment of  an  inborn  metabolic  disorder,  or  to
     7  address  growth  and  development  problems  in children, or, subject to
     8  standards established by the commissioner, for persons with a  diagnosis
     9  of  HIV  infection,  AIDS  or  HIV-related illness or other diseases and
    10  conditions; (iii) prescription  footwear  and  inserts  are  limited  to
    11  coverage  only  when  used  as an integral part of a lower limb orthotic
    12  appliance, as part of a diabetic treatment plan, or  to  address  growth
    13  and  development  problems  in  children;  (iv)  compression and support
    14  stockings are limited to coverage only for  pregnancy  or  treatment  of
    15  venous stasis ulcers; [and] (v) the commissioner of health is authorized
    16  to  implement  an  incontinence supply utilization management program to
    17  reduce costs without  limiting  access  through  the  existing  provider
    18  network,  including  but  not  limited  to  single  or  multiple  source
    19  contracts or,  a  preferred  incontinence  supply  program  wherein  the
    20  department  of  health  will  receive  enhanced  rebates  from preferred
    21  manufacturers of incontinence supplies, and  may  subject  non-preferred
    22  manufacturers' incontinence supplies to prior approval pursuant to regu-
    23  lations of the department, provided any necessary approvals under feder-
    24  al  law have been obtained to receive federal financial participation in
    25  the costs of incontinence supplies provided pursuant  to  this  subpara-
    26  graph;  and  (vi)  the  commissioner  of health is authorized to require
    27  prior approval of any prescription drug that is prescribed for  a  resi-
    28  dent of a nursing home and that is not reimbursed as part of the nursing
    29  home's medicaid rate;
    30    §  4.  Paragraph  (l)  of subdivision 2 of section 365-a of the social
    31  services law, as amended by chapter 81 of the laws of 1995,  is  amended
    32  to read as follows:
    33    (l)  care  and services of podiatrists, clinical psychologists, nurses
    34  and audiologists, including such care and services provided in a  hospi-
    35  tal  out-patient or clinic facility referred to in paragraph (c) of this
    36  subdivision, and  dentists,  which  care  and  services  shall  only  be
    37  provided  upon  referral by a physician, nurse practitioner or certified
    38  nurse midwife in accordance with  the  program  of  early  and  periodic
    39  screening  and  diagnosis  established  pursuant to subdivision three of
    40  this section or to persons eligible for benefits under  title  XVIII  of
    41  the  federal  social security act as qualified medicare beneficiaries in
    42  accordance with federal requirements therefor [and private  duty  nurses
    43  which  care and services shall only be provided in accordance with regu-
    44  lations of the department of health;  provided,  however,  that  private
    45  duty  nursing  services  shall  not be restricted when such services are
    46  more appropriate and cost-effective than nursing services provided by  a
    47  home health agency pursuant to section three hundred sixty-seven-l];
    48    §  5.  Paragraph  (n)  of subdivision 2 of section 365-a of the social
    49  services law, as added by chapter 556 of the laws of 1986, is REPEALED.
    50    § 6. The commissioner of health is authorized to promulgate  or  adopt
    51  any  rules  or regulations necessary to implement the provisions of this
    52  act and any procedures, forms, or instructions necessary for such imple-
    53  mentation may be adopted and issued on or after the  effective  date  of
    54  this act. Notwithstanding any inconsistent provision of the state admin-
    55  istrative  procedure  act  or  any other provision of law, rule or regu-
    56  lation, the commissioner of health and the superintendent  of  financial
        A. 2006                             3
     1  services  and any appropriate council is authorized to adopt or amend or
     2  promulgate on an emergency basis any regulation he or she or such  coun-
     3  cil  determines  necessary to implement any provision of this act on its
     4  effective date.
     5    § 7. This act shall take effect on the one hundred eightieth day after
     6  it shall have become a law.