Bill Text: NY A08807 | 2023-2024 | General Assembly | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2024-2025 state fiscal year; requires the commissioner of health to provide a quarterly report on known and expected department of health state funds Medicaid expenditures (Part A); extends various provisions related to health and mental hygiene (Part B); relates to the provision of certain early intervention services for children with handicapping conditions (Part C); reduces the hospital capital rate add-on; relates to the payment of certain funds for uncompensated care; extends provisions relating to certain Medicaid management; increases operating cost component of rates of payment for general hospital outpatient services; authorizes the department of health to make Medicaid payment increases for county operated free-standing clinics (Part D); freezes the operating component of the rates for skilled nursing facilities; reduces the capital component of the rates for skilled nursing facilities by an additional ten percent; expands admission eligibility to the NYS veteran's home for certain veterans of the Persian Gulf conflict (Part E); provides that the program for individuals living with Alzheimer's disease and dementia who are not eligible for medical assistance and reside in a special needs assisted living residence shall, subject to appropriations, authorize vouchers to individuals (Part F); eliminates the one percent Medicaid rate increase to managed care organizations (Part H); relates to coverage and reimbursement of certain drugs under the Medicaid drug cap program and pharmacy cost reporting (Part I); renames the basic health program to the essential plan; extends provisions related to providing long-term services and supports under the essential plan; adds references to the 1332 state innovation waiver; provides a new subsidy to assist low and moderate income New Yorkers; adds the 1332 state innovation program to the functions of the marketplace (Part J); extends certain provisions of law relating to malpractice and professional medical conduct (Part K); authorizes continuous coverage under medical assistance for needy persons and child health plus for eligible children up to age six (Part M); expands financial assistance for medical debt; provides additional consumer protection for medical debt; restricts the applications for and use of credit cards and medical financial products (Part O); extends authorization for pharmacists to order and administer certain tests and perform collaborative drug therapy management with physicians in certain settings (Part P); establishes the healthcare safety net transformation program for the purpose of supporting the transformation of safety net hospitals to improve access, equity, quality, and outcomes while increasing the financial sustainability of safety net hospitals (Part S); extends the effectiveness of certain provisions relating to membership of subcommittees for mental health of community service boards and the duties of such subcommittees and the community mental health and workforce reinvestment account (Part Y); extends certain provisions clarifying the authority of the commissioners in the department of mental hygiene to design and implement time-limited demonstration programs (Part Z); provides for reimbursement insurance rates for the provision of outpatient, intensive outpatient, outpatient rehabilitation and opioid treatment (Part AA); extends certain provisions of law relating to psychiatric emergency programs (Part BB); extends provisions for the care and custody of funds belonging to patients in facilities operated by the office of mental health (Part DD); establishes a cost of living adjustment for certain human services programs (Part FF); provides contracting flexibility in relation to 1115 Medicaid waivers (Part GG); relates to statewide fiscal intermediaries; creates a registration process for statewide fiscal intermediaries (Part HH); establishes a New York managed care organization provider tax (Part II); provides that services provided in school-based health centers shall not be provided to medical assistance recipients through certain managed care programs before April 1, 2025 (Part JJ); establishes a community doula expansion grant program to support community-based doulas and community-based doula organizations; provides for the repeal of such program upon expiration thereof (Part KK); provides for Medicaid reimbursement rates for treatment of medically fragile children at pediatric diagnostic and treatment centers and repeals such provisions upon expiration thereof (Part LL); establishes the nine member community advisory board for the modernization and revitalization of SUNY downstate health sciences university; requires such advisory board to solicit recommendations from healthcare experts, county health departments, community-based organizations, state and regional health care industry associations, labor unions, experts in hospital operations, and other interested parties; requires recommendations and a report to the governor, the temporary president of the senate and the speaker of the assembly no later than April 1, 2025; makes related provisions (Part MM); extends certain provisions relating to certain Medicaid payments made for hospital services (Part NN).
Spectrum: Committee Bill
Status: (Introduced) 2024-04-19 - substituted by s8307c [A08807 Detail]
Download: New_York-2023-A08807-Introduced.html
Bill Title: Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2024-2025 state fiscal year; requires the commissioner of health to provide a quarterly report on known and expected department of health state funds Medicaid expenditures (Part A); extends various provisions related to health and mental hygiene (Part B); relates to the provision of certain early intervention services for children with handicapping conditions (Part C); reduces the hospital capital rate add-on; relates to the payment of certain funds for uncompensated care; extends provisions relating to certain Medicaid management; increases operating cost component of rates of payment for general hospital outpatient services; authorizes the department of health to make Medicaid payment increases for county operated free-standing clinics (Part D); freezes the operating component of the rates for skilled nursing facilities; reduces the capital component of the rates for skilled nursing facilities by an additional ten percent; expands admission eligibility to the NYS veteran's home for certain veterans of the Persian Gulf conflict (Part E); provides that the program for individuals living with Alzheimer's disease and dementia who are not eligible for medical assistance and reside in a special needs assisted living residence shall, subject to appropriations, authorize vouchers to individuals (Part F); eliminates the one percent Medicaid rate increase to managed care organizations (Part H); relates to coverage and reimbursement of certain drugs under the Medicaid drug cap program and pharmacy cost reporting (Part I); renames the basic health program to the essential plan; extends provisions related to providing long-term services and supports under the essential plan; adds references to the 1332 state innovation waiver; provides a new subsidy to assist low and moderate income New Yorkers; adds the 1332 state innovation program to the functions of the marketplace (Part J); extends certain provisions of law relating to malpractice and professional medical conduct (Part K); authorizes continuous coverage under medical assistance for needy persons and child health plus for eligible children up to age six (Part M); expands financial assistance for medical debt; provides additional consumer protection for medical debt; restricts the applications for and use of credit cards and medical financial products (Part O); extends authorization for pharmacists to order and administer certain tests and perform collaborative drug therapy management with physicians in certain settings (Part P); establishes the healthcare safety net transformation program for the purpose of supporting the transformation of safety net hospitals to improve access, equity, quality, and outcomes while increasing the financial sustainability of safety net hospitals (Part S); extends the effectiveness of certain provisions relating to membership of subcommittees for mental health of community service boards and the duties of such subcommittees and the community mental health and workforce reinvestment account (Part Y); extends certain provisions clarifying the authority of the commissioners in the department of mental hygiene to design and implement time-limited demonstration programs (Part Z); provides for reimbursement insurance rates for the provision of outpatient, intensive outpatient, outpatient rehabilitation and opioid treatment (Part AA); extends certain provisions of law relating to psychiatric emergency programs (Part BB); extends provisions for the care and custody of funds belonging to patients in facilities operated by the office of mental health (Part DD); establishes a cost of living adjustment for certain human services programs (Part FF); provides contracting flexibility in relation to 1115 Medicaid waivers (Part GG); relates to statewide fiscal intermediaries; creates a registration process for statewide fiscal intermediaries (Part HH); establishes a New York managed care organization provider tax (Part II); provides that services provided in school-based health centers shall not be provided to medical assistance recipients through certain managed care programs before April 1, 2025 (Part JJ); establishes a community doula expansion grant program to support community-based doulas and community-based doula organizations; provides for the repeal of such program upon expiration thereof (Part KK); provides for Medicaid reimbursement rates for treatment of medically fragile children at pediatric diagnostic and treatment centers and repeals such provisions upon expiration thereof (Part LL); establishes the nine member community advisory board for the modernization and revitalization of SUNY downstate health sciences university; requires such advisory board to solicit recommendations from healthcare experts, county health departments, community-based organizations, state and regional health care industry associations, labor unions, experts in hospital operations, and other interested parties; requires recommendations and a report to the governor, the temporary president of the senate and the speaker of the assembly no later than April 1, 2025; makes related provisions (Part MM); extends certain provisions relating to certain Medicaid payments made for hospital services (Part NN).
Spectrum: Committee Bill
Status: (Introduced) 2024-04-19 - substituted by s8307c [A08807 Detail]
Download: New_York-2023-A08807-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ S. 8307 A. 8807 SENATE - ASSEMBLY January 17, 2024 ___________ IN SENATE -- A BUDGET BILL, submitted by the Governor pursuant to arti- cle seven of the Constitution -- read twice and ordered printed, and when printed to be committed to the Committee on Finance IN ASSEMBLY -- A BUDGET BILL, submitted by the Governor pursuant to article seven of the Constitution -- read once and referred to the Committee on Ways and Means AN ACT to amend part H of chapter 59 of the laws of 2011, amending the public health law and other laws relating to general hospital reimbursement for annual rates, in relation to known and projected department of health state fund medicaid expenditures (Part A); to amend the public health law, in relation to extending certain provisions related to the issuance of accountable care organization certifications and state oversight of antitrust provisions; and to amend part D of chapter 56 of the laws of 2013 amending the social services law relating to eligibility conditions, chapter 649 of the laws of 1996 amending the public health law, the mental hygiene law and the social services law relating to authorizing the establishment of special needs plans, part V of chapter 57 of the laws of 2022 amending the public health law and the insurance law relating to reimbursement for commercial and Medicaid services provided via tele- health, chapter 659 of the laws of 1997 amending the public health law and other laws relating to creation of continuing care retirement communities, part NN of chapter 57 of the laws of 2018 amending the public health law and the state finance law relating to enacting the opioid stewardship act, part II of chapter 54 of the laws of 2016 amending part C of chapter 58 of the laws of 2005 relating to author- izing reimbursements for expenditures made by or on behalf of social services districts for medical assistance for needy persons and admin- istration thereof, part B of chapter 57 of the laws of 2015 amending the social services law and other laws relating to energy audits and/or disaster preparedness reviews of residential healthcare facili- ties by the commissioner, and part H of chapter 57 of the laws of 2019 amending the public health law relating to waiver of certain regu- lations, in relation to the effectiveness thereof (Part B); to amend the education law, in relation to removing the exemption for school psychologists to render early intervention services; and to amend EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD12671-01-4S. 8307 2 A. 8807 chapter 217 of the laws of 2015, amending the education law relating to certified school psychologists and special education services and programs for preschool children with handicapping conditions, in relation to the effectiveness thereof (Part C); to amend the public health law, in relation to reducing the hospital capital rate add-on; to amend part ZZ of chapter 56 of the laws of 2020 amending the tax law and the social services law relating to certain Medicaid manage- ment, in relation to the effectiveness thereof; to amend part E of chapter 57 of the laws of 2015, amending the public health law relat- ing to the payment of certain funds for uncompensated care, in relation to certain payments being made as outpatient upper payment limit payments for outpatient hospital services during certain state fiscal years and calendar years; to amend part B of chapter 57 of the laws of 2015, amending the social services law relating to supple- mental rebates, in relation to authorizing the department of health to increase operating cost component of rates of payment for general hospital outpatient services and authorizing the department of health to pay a public hospital adjustment to public general hospitals during certain state fiscal years and calendar years; to amend the public health law, in relation to authorizing the commissioner to make addi- tional inpatient hospital payments during certain state fiscal years and calendar years; and to amend part B of chapter 58 of the laws of 2010, amending the social services law and the public health law relating to prescription drug coverage for needy persons and health care initiatives pools, in relation to authorizing the department of health to make Medicaid payment increases for county operated free- standing clinics during certain state fiscal years and calendar years (Part D); to amend the public health law, in relation to freezing the operating component of the rates for skilled nursing facilities, reducing the capital component of the rates for skilled nursing facil- ities by an additional ten percent, and eligibility for admission to the New York state veterans' home (Part E); to amend the social services law, in relation to making the special needs assisted living residence voucher program permanent; and to amend the public health law, in relation to assisted living quality improvement standards (Part F); to amend the public health law, in relation to home care worker wage parity; and to repeal certain provisions of the public health law relating thereto (Part G); to amend the financial services law, in relation to excluding managed care plans from the independent resolution process; to amend the social services law and the public health law, in relation to providing authority for the department of health to competitively procure managed care organizations participat- ing in medicaid managed care programs; to amend part I of chapter 57 of the laws of 2022, providing a one percent across the board payment increase to all qualifying fee-for-service Medicaid rates, in relation to eliminating the one percent rate increase to managed care organiza- tions; and to repeal certain provisions of the social services law relating thereto (Part H); to amend the social services law, in relation to copayments for drugs; to amend the public health law, in relation to prescriber prevails; to amend the public health law, in relation to the Medicaid drug cap and pharmacy cost reporting; and to repeal certain provisions of the social services law relating to coverage for certain prescription drugs (Part I); to amend the social services law, in relation to renaming the basic health program to the essential plan; to amend part H of chapter 57 of the laws of 2021, amending the social services law relating to eliminating consumer-paidS. 8307 3 A. 8807 premium payments in the basic health program, in relation to the effectiveness thereof; and to amend part BBB of chapter 56 of the laws of 2022, amending the public health law and other laws relating to permitting the commissioner of health to submit a waiver that expands eligibility for New York's basic health program and increases the federal poverty limit cap for basic health program eligibility from two hundred to two hundred fifty percent, in relation to extending certain provisions related to providing long-term services and supports under the essential plan; and to amend the public health law, in relation to adding references to the 1332 state innovation waiver, providing a new subsidy to assist low-income New Yorkers with the payment of premiums, cost sharing or both through the marketplace, and adding the 1332 state innovation program to the functions of the marketplace (Part J); to amend chapter 266 of the laws of 1986 amend- ing the civil practice law and rules and other laws relating to malp- ractice and professional medical conduct, in relation to insurance coverage paid for by funds from the hospital excess liability pool and extending the effectiveness of certain provisions thereof; to amend part J of chapter 63 of the laws of 2001 amending chapter 266 of the laws of 1986 amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, in relation to extending certain provisions concerning the hospital excess liabil- ity pool; and to amend part H of chapter 57 of the laws of 2017 amend- ing the New York Health Care Reform Act of 1996 and other laws relat- ing to extending certain provisions relating thereto, in relation to extending provisions relating to excess coverage (Part K); to amend the public health law and the state finance law, in relation to the discontinuation of the empire clinical research investigator program; to amend the public health law, in relation to the discontinuance of participation and membership during a three year demonstration period in a physician committee of the Medical Society of the State of New York or the New York State Osteopathic Society; to repeal subdivision 9 of section 2803 of the public health law, relating to the hospital audit program; to repeal section 461-s of the social services law, relating to enhancing the quality of adult living program for adult care facilities; to repeal paragraph (c) of subdivision 1 of section 461-b of the social services law, relating to an appropriation made available for the purposes of funding the operating assistance sub- program for enriched housing; to repeal article 27-H of the public health law, relating to the tick-borne disease institute; and to repeal paragraph (g) of subdivision 11 of section 230 of the public health law, relating to reporting of professional misconduct (Part L); to amend the social services law and the public health law, in relation to authorizing continuous coverage in Medicaid and child health plus, for eligible children ages zero to six (Part M); to amend the public health law, in relation to authorizing the commissioner of health to issue a statewide standing order for the provision of doula services, providing medical services to pregnant minors, and to the provision of contraception (Part N); to amend the public health law, in relation to expanding financial assistance; and to amend the gener- al business law, in relation to additional consumer protection for medical debt and restricting the applications for and use of credit cards and medical financial products (Part O); to amend part C of chapter 57 of the laws of 2022 amending the public health law and the education law relating to allowing pharmacists to direct limited service laboratories and order and administer COVID-19 and influenzaS. 8307 4 A. 8807 tests and modernizing nurse practitioners, and chapter 21 of the laws of 2011 amending the education law relating to authorizing pharmacists to perform collaborative drug therapy management with physicians in certain settings, in relation to the effectiveness thereof (Part P); to amend the education law and the public health law, in relation to the scope of practice of physician assistants, certified nurse aides, medical assistants, dentists and dental hygienists (Part Q); to amend the education law, in relation to enacting the interstate medical licensure compact; and to amend the education law, in relation to enacting the nurse licensure compact (Part R); to amend the public health law, in relation to establishing the healthcare safety net transformation program (Part S); to amend the public health law and the education law, in relation to making necessary changes to end the HIV, HCV, HBV, syphilis and mpox epidemics; and to repeal certain provisions the public health law relating thereto (Part T); to amend the public health law, in relation to increasing prescription monitor- ing program data retention periods and allowing enhanced data sharing to combat the opioid crisis, updating controlled substance schedules to conform with those of the federal drug enforcement administration, permitting providers to distribute three-day supplies of buprenor- phine, and updating the term "addict" to "person with a substance use disorder" in certain provisions of such law; and to repeal section 3372 of such law relating to practitioner patient reporting (Part U); to amend the public health law, in relation to expanding hospital services and home care collaboration into the home and community; to amend the public health law and the education law, in relation to modernizing the state of New York's emergency medical system and work- force; to amend the public health law, in relation to establishing the paramedic urgent care program; and to amend chapter 137 of the laws of 2023 amending the public health law relating to establishing a commu- nity-based paramedicine demonstration program, in relation to extend- ing the effectiveness thereof (Part V); to amend the elder law, in relation to establishing the interagency elder justice coordinating council (Part W); to amend part NN of chapter 57 of the laws of 2018 amending the public health law and other laws relating to enact- ing the opioid stewardship act, in relation to making the opioid stewardship fund permanent (Part X); to amend chapter 62 of the laws of 2003, amending the mental hygiene law and the state finance law relating to the community mental health support and workforce rein- vestment program, the membership of subcommittees for mental health of community services boards and the duties of such subcommittees and creating the community mental health and workforce reinvestment account, in relation to the effectiveness thereof (Part Y); to amend part NN of chapter 58 of the laws of 2015, amending the mental hygiene law relating to clarifying the authority of the commissioners in the department of mental hygiene to design and implement time-limited demonstration programs, in relation to making such provisions perma- nent (Part Z); to amend the insurance law, in relation to setting minimal reimbursement for behavioral health treatment (Part AA); to amend chapter 723 of the laws of 1989 amending the mental hygiene law and other laws relating to comprehensive psychiatric emergency programs, in relation to the effectiveness of certain provisions thereof (Part BB); to amend the social services law, in relation to clarifying the requirements related to referrals of substantiated reports of abuse or neglect from the justice center to the office of the Medicaid inspector general (Part CC); to amend part A of chapterS. 8307 5 A. 8807 111 of the laws of 2010 amending the mental hygiene law relating to the receipt of federal and state benefits received by individuals receiving care in facilities operated by an office of the department of mental hygiene, in relation to the effectiveness thereof (Part DD); to amend the education law, in relation to expanding the description of certain services which are not prohibited by statutes governing the practice of nursing (Part EE); and to establish a cost of living adjustment for designated human services programs (Part FF) The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. This act enacts into law major components of legislation 2 necessary to implement the state health and mental hygiene budget for 3 the 2024-2025 state fiscal year. Each component is wholly contained 4 within a Part identified as Parts A through FF. The effective date for 5 each particular provision contained within such Part is set forth in the 6 last section of such Part. Any provision in any section contained within 7 a Part, including the effective date of the Part, which makes a refer- 8 ence to a section "of this act", when used in connection with that 9 particular component, shall be deemed to mean and refer to the corre- 10 sponding section of the Part in which it is found. Section three of this 11 act sets forth the general effective date of this act. 12 PART A 13 Section 1. Paragraph (a) of subdivision 1 of section 92 of part H of 14 chapter 59 of the laws of 2011, amending the public health law and other 15 laws relating to general hospital reimbursement for annual rates, as 16 amended by section 1 of part A of chapter 57 of the laws of 2023, is 17 amended to read as follows: 18 (a) For state fiscal years 2011-12 through [2024-25] 2025-26, the 19 director of the budget, in consultation with the commissioner of health 20 referenced as "commissioner" for purposes of this section, shall assess 21 on a quarterly basis, as reflected in quarterly reports pursuant to 22 subdivision five of this section known and projected department of 23 health state funds medicaid expenditures by category of service and by 24 geographic regions, as defined by the commissioner. 25 § 2. This act shall take effect immediately and shall be deemed to 26 have been in full force and effect on and after April 1, 2024. 27 PART B 28 Section 1. Subdivision p of section 76 of part D of chapter 56 of the 29 laws of 2013 amending the social services law relating to eligibility 30 conditions, as amended by section 2 of part E of chapter 57 of the laws 31 of 2019, is amended to read as follows: 32 p. the amendments to subparagraph 7 of paragraph (b) of subdivision 1 33 of section 366 of the social services law made by section one of this 34 act shall expire and be deemed repealed October 1, [2024] 2029. 35 § 2. Section 10 of chapter 649 of the laws of 1996 amending the public 36 health law, the mental hygiene law and the social services law relating 37 to authorizing the establishment of special needs plans, as amended by 38 section 21 of part E of chapter 57 of the laws of 2019, is amended to 39 read as follows:S. 8307 6 A. 8807 1 § 10. This act shall take effect immediately and shall be deemed to 2 have been in full force and effect on and after July 1, 1996; provided, 3 however, that sections one, two and three of this act shall expire and 4 be deemed repealed [on] March 31, [2025] 2030 provided, however that the 5 amendments to section 364-j of the social services law made by section 6 four of this act shall not affect the expiration of such section and 7 shall be deemed to expire therewith and provided, further, that the 8 provisions of subdivisions 8, 9 and 10 of section 4401 of the public 9 health law, as added by section one of this act; section 4403-d of the 10 public health law as added by section two of this act and the provisions 11 of section seven of this act, except for the provisions relating to the 12 establishment of no more than twelve comprehensive HIV special needs 13 plans, shall expire and be deemed repealed on July 1, 2000. 14 § 3. Subdivision 3 of section 2999-p of the public health law, as 15 amended by section 8 of part BB of chapter 56 of the laws of 2020, is 16 amended to read as follows: 17 3. The commissioner may issue a certificate of authority to an entity 18 that meets conditions for ACO certification as set forth in regulations 19 made by the commissioner pursuant to section twenty-nine hundred nine- 20 ty-nine-q of this article. The commissioner shall not issue any new 21 certificate under this article after December thirty-first, two thousand 22 [twenty-four] twenty-eight. 23 § 4. Subdivision 1 of section 2999-aa of the public health law, as 24 amended by section 9 of part S of chapter 57 of the laws of 2021, is 25 amended to read as follows: 26 1. In order to promote improved quality and efficiency of, and access 27 to, health care services and to promote improved clinical outcomes to 28 the residents of New York, it shall be the policy of the state to 29 encourage, where appropriate, cooperative, collaborative and integrative 30 arrangements including but not limited to, mergers and acquisitions 31 among health care providers or among others who might otherwise be 32 competitors, under the active supervision of the commissioner. To the 33 extent such arrangements, or the planning and negotiations that precede 34 them, might be anti-competitive within the meaning and intent of the 35 state and federal antitrust laws, the intent of the state is to supplant 36 competition with such arrangements under the active supervision and 37 related administrative actions of the commissioner as necessary to 38 accomplish the purposes of this article, and to provide state action 39 immunity under the state and federal antitrust laws with respect to 40 activities undertaken by health care providers and others pursuant to 41 this article, where the benefits of such active supervision, arrange- 42 ments and actions of the commissioner outweigh any disadvantages likely 43 to result from a reduction of competition. The commissioner shall not 44 approve an arrangement for which state action immunity is sought under 45 this article without first consulting with, and receiving a recommenda- 46 tion from, the public health and health planning council. No arrangement 47 under this article shall be approved after December thirty-first, two 48 thousand [twenty-four] twenty-eight. 49 § 5. Section 7 of part V of chapter 57 of the laws of 2022 amending 50 the public health law and the insurance law relating to reimbursement 51 for commercial and Medicaid services provided via telehealth, is amended 52 to read as follows: 53 § 7. This act shall take effect immediately and shall be deemed to 54 have been in full force and effect on and after April 1, 2022; provided, 55 however, this act shall expire and be deemed repealed on and after April 56 1, [2024] 2025.S. 8307 7 A. 8807 1 § 6. Section 97 of chapter 659 of the laws of 1997 amending the public 2 health law and other laws relating to creation of continuing care 3 retirement communities, as amended by section 11 of part Z of chapter 57 4 of the laws of 2018, is amended to read as follows: 5 § 97. This act shall take effect immediately, provided, however, that 6 the amendments to subdivision 4 of section 854 of the general municipal 7 law made by section seventy of this act shall not affect the expiration 8 of such subdivision and shall be deemed to expire therewith and provided 9 further that sections sixty-seven and sixty-eight of this act shall 10 apply to taxable years beginning on or after January 1, 1998 and 11 provided further that sections eighty-one through eighty-seven of this 12 act shall expire and be deemed repealed on December 31, [2024] 2029 and 13 provided further, however, that the amendments to section ninety of this 14 act shall take effect January 1, 1998 and shall apply to all policies, 15 contracts, certificates, riders or other evidences of coverage of long 16 term care insurance issued, renewed, altered or modified pursuant to 17 section 3229 of the insurance law on or after such date. 18 § 7. Section 5 of part NN of chapter 57 of the laws of 2018 amending 19 the public health law and the state finance law relating to enacting the 20 opioid stewardship act, as amended by section 5 of part XX of chapter 59 21 of the laws of 2019, is amended to read as follows: 22 § 5. This act shall take effect July 1, 2018 and shall expire and be 23 deemed to be repealed on June 30, [2024] 2027, provided that, effective 24 immediately, the addition, amendment and/or repeal of any rule or regu- 25 lation necessary for the implementation of this act on its effective 26 date are authorized to be made and completed on or before such effective 27 date, and, provided that this act shall only apply to the sale or 28 distribution of opioids in the state of New York on or before December 29 31, 2018. 30 § 8. Section 2 of part II of chapter 54 of the laws of 2016 amending 31 part C of chapter 58 of the laws of 2005 relating to authorizing 32 reimbursements for expenditures made by or on behalf of social services 33 districts for medical assistance for needy persons and administration 34 thereof, as amended by section 6 of part CC of chapter 57 of the laws of 35 2022, is amended to read as follows: 36 § 2. This act shall take effect immediately and shall expire and be 37 deemed repealed March 31, [2024] 2026. 38 § 9. Subdivision 5 of section 60 of part B of chapter 57 of the laws 39 of 2015 amending the social services law and other laws relating to 40 energy audits and/or disaster preparedness reviews of residential 41 healthcare facilities by the commissioner, as amended by chapter 125 of 42 the laws of 2021, is amended to read as follows: 43 5. section thirty-eight of this act shall expire and be deemed 44 repealed July 1, [2024] 2027; 45 § 10. Section 7 of part H of chapter 57 of the laws of 2019, amending 46 the public health law relating to waiver of certain regulations, as 47 amended by section 1 of part GG of chapter 57 of the laws of 2022, is 48 amended to read as follows: 49 § 7. This act shall take effect immediately and shall be deemed to 50 have been in full force and effect on and after April 1, 2019, provided, 51 however, that section two of this act shall expire on April 1, [2024] 52 2026. 53 § 11. This act shall take effect immediately. 54 PART CS. 8307 8 A. 8807 1 Section 1. Paragraph d of subdivision 6 of section 4410 of the educa- 2 tion law, as amended by chapter 217 of the laws of 2015, is amended to 3 read as follows: 4 d. Notwithstanding any other provision of law to the contrary, the 5 exemption in subdivision one of section seventy-six hundred five of this 6 chapter shall apply to persons employed on a full-time or part-time 7 salary basis, which may include on an hourly, weekly, or monthly basis, 8 or on a fee for evaluation services basis provided that such person is 9 employed by and under the dominion and control of a center-based program 10 approved pursuant to subdivision nine of this section as a certified 11 school psychologist to provide activities, services and use of the title 12 psychologist to students enrolled in such approved center-based program; 13 and to certified school psychologists employed on a full-time or part- 14 time salary basis, which may include on an hourly, weekly, or monthly 15 basis, or on a fee for evaluation services basis provided that the 16 school psychologist is employed by and under the dominion and control of 17 a program that has been approved pursuant to paragraph b of subdivision 18 nine of this section, or subdivision nine-a of this section, to conduct 19 a multi-disciplinary evaluation of a preschool child having or suspected 20 of having a disability where authorized by paragraph a [or b] of subdi- 21 vision six of section sixty-five hundred three-b of this chapter[; and22to certified school psychologists employed on a full-time or part-time23salary basis, which may include on an hourly, weekly, or monthly basis,24or on a fee for evaluation services basis provided that such psychol-25ogist is employed by and under the dominion and control of an agency26approved in accordance with title two-A of article twenty-five of the27public health law to deliver early intervention program multidiscipli-28nary evaluations, service coordination services and early intervention29program services, where authorized by paragraph a or b of subdivision30six of section sixty-five hundred three-b of this chapter, each], in the 31 course of their employment. Nothing in this section shall be construed 32 to authorize a certified school psychologist or group of such school 33 psychologists to engage in independent practice or practice outside of 34 an employment relationship. 35 § 2. Subdivision 1 of section 7605 of the education law, as amended by 36 chapter 217 of the laws of 2015, is amended to read as follows: 37 1. The activities, services, and use of the title of psychologist, or 38 any derivation thereof, on the part of a person in the employ of a 39 federal, state, county or municipal agency, or other political subdivi- 40 sion, or a chartered elementary or secondary school or degree-granting 41 educational institution insofar as such activities and services are a 42 part of the duties of his salaried position; or on the part of a person 43 in the employ as a certified school psychologist on a full-time or part- 44 time salary basis, which may include on an hourly, weekly, or monthly 45 basis, or on a fee for evaluation services basis provided that such 46 person employed as a certified school psychologist is employed by and 47 under the dominion and control of a preschool special education program 48 approved pursuant to paragraph b of subdivision nine or subdivision 49 nine-a of section forty-four hundred ten of this chapter to provide 50 activities, services and to use the title "certified school psychol- 51 ogist", so long as this shall not be construed to permit the use of the 52 title "licensed psychologist", to students enrolled in such approved 53 program or to conduct a multidisciplinary evaluation of a preschool 54 child having or suspected of having a disability[; or on the part of a55person in the employ as a certified school psychologist on a full-time56or part-time salary basis, which may include on an hourly, weekly orS. 8307 9 A. 8807 1monthly basis, or on a fee for evaluation services basis provided that2such person employed as a certified school psychologist is employed by3and under the dominion and control of an agency approved in accordance4with title two-A of article twenty-five of the public health law to5deliver early intervention program multidisciplinary evaluations,6service coordination services and early intervention program services], 7 where each such preschool special education program [or early inter-8vention provider] is authorized by paragraph a [or b] of subdivision six 9 of section sixty-five hundred [three] three-b of this title[, each] in 10 the course of their employment. Nothing in this subdivision shall be 11 construed to authorize a certified school psychologist or group of such 12 school psychologists to engage in independent practice or practice 13 outside of an employment relationship. 14 § 3. Section 3 of chapter 217 of the laws of 2015, amending the educa- 15 tion law relating to certified school psychologists and special educa- 16 tion services and programs for preschool children with handicapping 17 conditions, as amended by chapter 339 of the laws of 2022, is amended to 18 read as follows: 19 § 3. This act shall take effect immediately and shall be deemed to 20 have been in full force and effect on and after July 1, 2014, provided, 21 however that the provisions of this act shall expire and be deemed 22 repealed June 30, [2024] 2026. 23 § 4. This act shall take effect immediately and shall be deemed to 24 have been in full force and effect on and after April 1, 2024; provided, 25 however, that the amendments to paragraph d of subdivision 6 of section 26 4410 of the education law made by section one of this act shall not 27 affect the expiration of such paragraph and shall be deemed to expire 28 therewith; provided further, however, that the amendments to subdivision 29 1 of section 7605 of the education law made by section two of this act 30 shall not affect the expiration of such subdivision and shall be deemed 31 to expire therewith. 32 PART D 33 Section 1. Paragraph (c) of subdivision 8 of section 2807-c of the 34 public health law, as amended by section 1 of part D of chapter 57 of 35 the laws of 2021, is amended to read as follows: 36 (c) In order to reconcile capital related inpatient expenses included 37 in rates of payment based on a budget to actual expenses and statistics 38 for the rate period for a general hospital, rates of payment for a 39 general hospital shall be adjusted to reflect the dollar value of the 40 difference between capital related inpatient expenses included in the 41 computation of rates of payment for a prior rate period based on a budg- 42 et and actual capital related inpatient expenses for such prior rate 43 period, each as determined in accordance with paragraph (a) of this 44 subdivision, adjusted to reflect increases or decreases in volume of 45 service in such prior rate period compared to statistics applied in 46 determining the capital related inpatient expenses component of rates of 47 payment based on a budget for such prior rate period. 48 For rates effective April first, two thousand twenty through March 49 thirty-first, two thousand twenty-one, the budgeted capital-related 50 expenses add-on as described in paragraph (a) of this subdivision, based 51 on a budget submitted in accordance to paragraph (a) of this subdivi- 52 sion, shall be reduced by five percent relative to the rate in effect on 53 such date; and the actual capital expenses add-on as described in para- 54 graph (a) of this subdivision, based on actual expenses and statisticsS. 8307 10 A. 8807 1 through appropriate audit procedures in accordance with paragraph (a) of 2 this subdivision shall be reduced by five percent relative to the rate 3 in effect on such date. 4 For rates effective [on and after] April first, two thousand twenty- 5 one through September thirtieth, two thousand twenty-four, the budgeted 6 capital-related expenses add-on as described in paragraph (a) of this 7 subdivision, based on a budget submitted in accordance to paragraph (a) 8 of this subdivision, shall be reduced by ten percent relative to the 9 rate in effect on such date; and the actual capital expenses add-on as 10 described in paragraph (a) of this subdivision, based on actual expenses 11 and statistics through appropriate audit procedures in accordance with 12 paragraph (a) of this subdivision shall be reduced by ten percent rela- 13 tive to the rate in effect on such date. 14 For rates effective on and after October first, two thousand twenty- 15 four, the budgeted capital-related expenses add-on as described in para- 16 graph (a) of this subdivision, based on a budget submitted in accordance 17 with paragraph (a) of this subdivision, shall be reduced by twenty 18 percent relative to the rate in effect on such date; and the actual 19 capital expenses add-on as described in paragraph (a) of this subdivi- 20 sion shall be reduced by twenty percent relative to the rate in effect 21 on such date. 22 For any rate year, all reconciliation add-on amounts calculated [on23and after] for the period of April first, two thousand twenty through 24 September thirtieth, two thousand twenty-four shall be reduced by ten 25 percent, and all reconciliation recoupment amounts calculated [on or26after] for the period of April first, two thousand twenty through 27 September thirtieth, two thousand twenty-four shall increase by ten 28 percent. 29 For any rate year, all reconciliation add-on amounts calculated on and 30 after October first, two thousand twenty-four shall be reduced by twenty 31 percent, and all reconciliation recoupment amounts calculated on or 32 after October first, two thousand twenty-four shall increase by twenty 33 percent. 34 Notwithstanding any inconsistent provision of subparagraph (i) of 35 paragraph (e) of subdivision nine of this section, capital related inpa- 36 tient expenses of a general hospital included in the computation of 37 rates of payment based on a budget shall not be included in the computa- 38 tion of a volume adjustment made in accordance with such subparagraph. 39 Adjustments to rates of payment for a general hospital made pursuant to 40 this paragraph shall be made in accordance with paragraph (c) of subdi- 41 vision eleven of this section. Such adjustments shall not be carried 42 forward except for such volume adjustment as may be authorized in 43 accordance with subparagraph (i) of paragraph (e) of subdivision nine of 44 this section for such general hospital. 45 § 2. Section 5 of part ZZ of chapter 56 of the laws of 2020 amending 46 the tax law and the social services law relating to certain Medicaid 47 management, as amended by section 3 of part RR of chapter 57 of the laws 48 of 2022, is amended to read as follows: 49 § 5. This act shall take effect immediately and shall be deemed 50 repealed [five] eight years after such effective date. 51 § 3. Section 2 of part E of chapter 57 of the laws of 2015, amending 52 the public health law relating to the payment of certain funds for 53 uncompensated care, is amended to read as follows: 54 § 2. Notwithstanding any inconsistent provision of law, rule or regu- 55 lation to the contrary, and subject to the availability of federal 56 financial participation pursuant to title XIX of the federal socialS. 8307 11 A. 8807 1 security act, effective for [periods on and after] each state fiscal 2 year from April 1, 2015, through December 31, 2024; and for the calendar 3 year January 1, 2025 through December 31, 2025; and for each calendar 4 year thereafter, payments pursuant to paragraph (i) of subdivision 35 of 5 section 2807-c of the public health law may be made as outpatient upper 6 payment limit payments for outpatient hospital services, not to exceed 7 an amount of three hundred thirty-nine million dollars annually between 8 payments authorized under this section and such section of the public 9 health law. Such payments shall be made as medical assistance payments 10 for outpatient services pursuant to title 11 of article 5 of the social 11 services law for patients eligible for federal financial participation 12 under title XIX of the federal social security act for general hospital 13 outpatient services and general hospital emergency room services issued 14 pursuant to paragraph (g) of subdivision 2 of section 2807 of the public 15 health law to general hospitals, other than major public general hospi- 16 tals, providing emergency room services and including safety net hospi- 17 tals, which shall, for the purpose of this paragraph, be defined as 18 having either: a Medicaid share of total inpatient hospital discharges 19 of at least thirty-five percent, including both fee-for-service and 20 managed care discharges for acute and exempt services; or a Medicaid 21 share of total discharges of at least thirty percent, including both 22 fee-for-service and managed care discharges for acute and exempt 23 services, and also providing obstetrical services. Eligibility to 24 receive such additional payments shall be based on data from the period 25 two years prior to the rate year, as reported on the institutional cost 26 report submitted to the department as of October first of the prior rate 27 year. No eligible general hospital's annual payment amount pursuant to 28 this section shall exceed the lower of the sum of the annual amounts due 29 that hospital pursuant to section twenty-eight hundred seven-k and 30 section twenty-eight hundred seven-w of the public health law; or the 31 hospital's facility specific projected disproportionate share hospital 32 payment ceiling established pursuant to federal law, provided, however, 33 that payment amounts to eligible hospitals in excess of the lower of 34 such sum or payment ceiling shall be reallocated to eligible hospitals 35 that do not have excess payment amounts. Such reallocations shall be 36 proportional to each such hospital's aggregate payment amount pursuant 37 to paragraph (i) of subdivision 35 of section 2807-c of the public 38 health law and this section to the total of all payment amounts for such 39 eligible hospitals. Such adjustment payment may be added to rates of 40 payment or made as aggregate payments to eligible general hospitals 41 other than major public general hospitals. The distribution of such 42 payments shall be pursuant to a methodology approved by the commissioner 43 of health in regulation. 44 § 4. Section 21 of part B of chapter 57 of the laws of 2015, amending 45 the social services law relating to supplemental rebates, is amended to 46 read as follows: 47 § 21. Notwithstanding any inconsistent provision of law, rule or regu- 48 lation to the contrary, and subject to the availability of federal 49 financial participation pursuant to title XIX of the federal social 50 security act, effective for [the period] each state fiscal year from 51 April 1, 2011 through [March 31, 2012, and state fiscal years] December 52 31, 2024; and for the calendar year January 1, 2025 through December 31, 53 2025; and for each calendar year thereafter, the department of health is 54 authorized to increase the operating cost component of rates of payment 55 for general hospital outpatient services and general hospital emergency 56 room services issued pursuant to paragraph (g) of subdivision 2 ofS. 8307 12 A. 8807 1 section 2807 of the public health law for public general hospitals, as 2 defined in subdivision 10 of section 2801 of the public health law, 3 other than those operated by the state of New York or the state univer- 4 sity of New York, and located in a city with a population over one 5 million, up to two hundred eighty-seven million dollars annually as 6 medical assistance payments for outpatient services pursuant to title 11 7 of article 5 of the social services law for patients eligible for feder- 8 al financial participation under title XIX of the federal social securi- 9 ty act based on such criteria and methodologies as the commissioner may 10 from time to time set through a memorandum of understanding with the New 11 York city health and hospitals corporation, and such adjustments shall 12 be paid by means of one or more estimated payments, with such estimated 13 payments to be reconciled to the commissioner of health's final adjust- 14 ment determinations after the disproportionate share hospital payment 15 adjustment caps have been calculated for such period under sections 16 1923(f) and (g) of the federal social security act. Such adjustment 17 payment may be added to rates of payment or made as aggregate payments 18 to eligible public general hospitals. 19 § 5. The opening paragraph of subparagraph (i) of paragraph (i) of 20 subdivision 35 of section 2807-c of the public health law, as amended by 21 section 4 of part C of chapter 56 of the laws of 2013, is amended to 22 read as follows: 23 Notwithstanding any inconsistent provision of this subdivision or any 24 other contrary provision of law and subject to the availability of 25 federal financial participation, for [the period] each state fiscal year 26 from July first, two thousand ten through [March thirty-first, two thou-27sand eleven,] December thirty-first, two thousand twenty-four; and [each28state fiscal year period] for the calendar year January first, two thou- 29 sand twenty-five through December thirty-first, two thousand twenty- 30 five; and for each calendar year thereafter, the commissioner shall make 31 additional inpatient hospital payments up to the aggregate upper payment 32 limit for inpatient hospital services after all other medical assistance 33 payments, but not to exceed two hundred thirty-five million five hundred 34 thousand dollars for the period July first, two thousand ten through 35 March thirty-first, two thousand eleven, three hundred fourteen million 36 dollars for each state fiscal year beginning April first, two thousand 37 eleven, through March thirty-first, two thousand thirteen, and no less 38 than three hundred thirty-nine million dollars for each state fiscal 39 year [thereafter] until December thirty-first, two thousand twenty-four; 40 and then from calendar year January first, two thousand twenty-five 41 through December thirty-first, two thousand twenty-five; and for each 42 calendar year thereafter, to general hospitals, other than major public 43 general hospitals, providing emergency room services and including safe- 44 ty net hospitals, which shall, for the purpose of this paragraph, be 45 defined as having either: a Medicaid share of total inpatient hospital 46 discharges of at least thirty-five percent, including both fee-for-ser- 47 vice and managed care discharges for acute and exempt services; or a 48 Medicaid share of total discharges of at least thirty percent, including 49 both fee-for-service and managed care discharges for acute and exempt 50 services, and also providing obstetrical services. Eligibility to 51 receive such additional payments shall be based on data from the period 52 two years prior to the rate year, as reported on the institutional cost 53 report submitted to the department as of October first of the prior rate 54 year. Such payments shall be made as medical assistance payments for 55 fee-for-service inpatient hospital services pursuant to title eleven of 56 article five of the social services law for patients eligible for feder-S. 8307 13 A. 8807 1 al financial participation under title XIX of the federal social securi- 2 ty act and in accordance with the following: 3 § 6. Section 18 of part B of chapter 57 of the laws of 2015, amending 4 the social services law relating to supplemental rebates, is amended to 5 read as follows: 6 § 18. Notwithstanding any inconsistent provision of law or regulation 7 to the contrary, and subject to the availability of federal financial 8 participation pursuant to title XIX of the federal social security act, 9 effective for [the period] each state fiscal year from April 1, 2012, 10 through [March 31, 2013, and state fiscal years] December 31, 2024; and 11 for the calendar year from January 1, 2025 through December 31, 2025; 12 and for each calendar year thereafter, the department of health is 13 authorized to pay a public hospital adjustment to public general hospi- 14 tals, as defined in subdivision 10 of section 2801 of the public health 15 law, other than those operated by the state of New York or the state 16 university of New York, and located in a city with a population of over 17 1 million, of up to one billion eighty million dollars annually as 18 medical assistance payments for inpatient services pursuant to title 11 19 of article 5 of the social services law for patients eligible for feder- 20 al financial participation under title XIX of the federal social securi- 21 ty act based on such criteria and methodologies as the commissioner may 22 from time to time set through a memorandum of understanding with the New 23 York city health and hospitals corporation, and such adjustments shall 24 be paid by means of one or more estimated payments, with such estimated 25 payments to be reconciled to the commissioner of health's final adjust- 26 ment determinations after the disproportionate share hospital payment 27 adjustment caps have been calculated for such period under sections 28 1923(f) and (g) of the federal social security act. Such adjustment 29 payment may be added to rates of payment or made as aggregate payments 30 to eligible public general hospitals. 31 § 7. Subdivision 1 of section 3-a of part B of chapter 58 of the laws 32 of 2010, amending the social services law and the public health law 33 relating to prescription drug coverage for needy persons and health care 34 initiatives pools, is amended to read as follows: 35 1. Notwithstanding any inconsistent provision of law, rule or regu- 36 lation to the contrary, and subject to the availability of federal 37 financial participation, effective for [the period] each state fiscal 38 year from August 1, 2010 through [March 31, 2011, and each state fiscal39year] December 31, 2024; and for the calendar year from January 1, 2025 40 through December 31, 2025; and for each calendar year thereafter, the 41 department of health is authorized to make Medicaid payment increases 42 for diagnostic and treatment centers (DTC) services issued pursuant to 43 section 2807 of the public health law for public DTCs operated by the 44 New York City Health and Hospitals Corporation, at the election of the 45 social services district in which an eligible DTC is physically located, 46 of up to twelve million six hundred thousand dollars on an annualized 47 basis for DTC services pursuant to title 11 of article 5 of the social 48 services law for patients eligible for federal financial participation 49 under title XIX of the federal social security act based on each such 50 DTC's proportionate share of the sum of all clinic visits for all facil- 51 ities eligible for an adjustment pursuant to this section for the base 52 year two years prior to the rate year. Such proportionate share payments 53 may be added to rates of payment or made as aggregate payments to eligi- 54 ble DTCs. 55 § 8. Subdivision 1 of section 3-b of part B of chapter 58 of the laws 56 of 2010, amending the social services law and the public health lawS. 8307 14 A. 8807 1 relating to prescription drug coverage for needy persons and health care 2 initiatives pools, is amended to read as follows: 3 1. Notwithstanding any inconsistent provision of law, rule or regu- 4 lation to the contrary, and subject to the availability of federal 5 financial participation, effective for [the period] each state fiscal 6 year from August 1, 2010 through [March 31, 2011, and each state fiscal7year] December 31, 2024; and for the calendar year from January 1, 2025 8 through December 31, 2025; and for each calendar year thereafter, the 9 department of health, is authorized to make Medicaid payment increases 10 for county operated diagnostic and treatment centers (DTC) services 11 issued pursuant to section 2807 of the public health law and for 12 services provided by county operated free-standing clinics licensed 13 pursuant to articles 31 and 32 of the mental hygiene law, but not 14 including facilities operated by the New York City Health and Hospitals 15 Corporation, of up to five million four hundred thousand dollars on an 16 annualized basis for such services pursuant to title 11 of article 5 of 17 the social services law for patients eligible for federal financial 18 participation under title XIX of the federal social security act. Local 19 social services districts may decline such increased payments to their 20 sponsored DTCs and free-standing clinics, provided they provide written 21 notification to the commissioner of health, within thirty days following 22 receipt of notification of a payment pursuant to this section. Distrib- 23 utions pursuant to this section shall be based on each facility's 24 proportionate share of the sum of all DTC and clinic visits for all 25 facilities receiving payments pursuant to this section for the base year 26 two years prior to the rate year. Such proportionate share payments may 27 be added to rates or payment or made as aggregate payments to eligible 28 facilities. 29 § 9. Paragraph (e-1) of subdivision 12 of section 2808 of the public 30 health law, as amended by section 15 of part B of chapter 57 of the laws 31 of 2023, is amended to read as follows: 32 (e-1) Notwithstanding any inconsistent provision of law or regulation, 33 the commissioner shall provide, in addition to payments established 34 pursuant to this article prior to application of this section, addi- 35 tional payments under the medical assistance program pursuant to title 36 eleven of article five of the social services law for non-state operated 37 public residential health care facilities, including public residential 38 health care facilities located in the county of Nassau, the county of 39 Westchester and the county of Erie, but excluding public residential 40 health care facilities operated by a town or city within a county, in 41 aggregate annual amounts of up to one hundred fifty million dollars in 42 additional payments for the state fiscal year beginning April first, two 43 thousand six and for the state fiscal year beginning April first, two 44 thousand seven and for the state fiscal year beginning April first, two 45 thousand eight and of up to three hundred million dollars in such aggre- 46 gate annual additional payments for the state fiscal year beginning 47 April first, two thousand nine, and for the state fiscal year beginning 48 April first, two thousand ten and for the state fiscal year beginning 49 April first, two thousand eleven, and for the state fiscal years begin- 50 ning April first, two thousand twelve and April first, two thousand 51 thirteen, and of up to five hundred million dollars in such aggregate 52 annual additional payments for the state fiscal years beginning April 53 first, two thousand fourteen, April first, two thousand fifteen and 54 April first, two thousand sixteen and of up to five hundred million 55 dollars in such aggregate annual additional payments for the state 56 fiscal years beginning April first, two thousand seventeen, April first,S. 8307 15 A. 8807 1 two thousand eighteen, and April first, two thousand nineteen, and of up 2 to five hundred million dollars in such aggregate annual additional 3 payments for the state fiscal years beginning April first, two thousand 4 twenty, April first, two thousand twenty-one, and April first, two thou- 5 sand twenty-two, and of up to five hundred million dollars in such 6 aggregate annual additional payments for the state fiscal years begin- 7 ning April first, two thousand twenty-three, and from April first, two 8 thousand twenty-four until December thirty-first, two thousand twenty- 9 four, and [April first, two thousand twenty-five] for the calendar year 10 January first, two thousand twenty-five through December thirty-first, 11 two thousand twenty-five, and for each calendar year thereafter. The 12 amount allocated to each eligible public residential health care facili- 13 ty for this period shall be computed in accordance with the provisions 14 of paragraph (f) of this subdivision, provided, however, that patient 15 days shall be utilized for such computation reflecting actual reported 16 data for two thousand three and each representative succeeding year as 17 applicable, and provided further, however, that, in consultation with 18 impacted providers, of the funds allocated for distribution in the state 19 fiscal year beginning April first, two thousand thirteen, up to thirty- 20 two million dollars may be allocated in accordance with paragraph (f-1) 21 of this subdivision. 22 § 10. This act shall take effect immediately; provided, however, 23 section one of this act shall take effect October 1, 2024; and provided, 24 further, that sections three, four, five, six, seven, eight and nine of 25 this act shall take effect January 1, 2025. 26 PART E 27 Section 1. Subparagraph (ii) of paragraph (b) of subdivision 2-b of 28 section 2808 of the public health law, as added by section 47 of part C 29 of chapter 109 of the laws of 2006, is amended to read as follows: 30 (ii) (A) The operating component of rates shall be subject to case mix 31 adjustment through application of the relative resource utilization 32 groups system of patient classification (RUG-III) employed by the feder- 33 al government with regard to payments to skilled nursing facilities 34 pursuant to title XVIII of the federal social security act (Medicare), 35 as revised by regulation to reflect New York state wages and fringe 36 benefits, provided, however, that such RUG-III classification system 37 weights shall be increased in the following amounts for the following 38 categories of residents: [(A)] (1) thirty minutes for the impaired 39 cognition A category, [(B)] (2) forty minutes for the impaired cognition 40 B category, and [(C)] (3) twenty-five minutes for the reduced physical 41 functions B category. Such adjustments shall be made in January and 42 July of each calendar year. Such adjustments and related patient classi- 43 fications in each facility shall be subject to audit review in accord- 44 ance with regulations promulgated by the commissioner. 45 (B) Effective April first, two thousand twenty-four, the operating 46 component of the rates for skilled nursing facilities shall remain 47 unchanged from the January two thousand twenty-four rates during the 48 development and until full implementation of a case mix methodology 49 using the Patient Driven Payment Model. 50 § 2. Subparagraph (iv) of paragraph (b) of subdivision 2-b of section 51 2808 of the public health law, as amended by section 1 of part NN of 52 chapter 56 of the laws of 2020, is amended to read as follows: 53 (iv) The capital cost component of rates on and after January first, 54 two thousand nine shall: (A) fully reflect the cost of local propertyS. 8307 16 A. 8807 1 taxes and payments made in lieu of local property taxes, as reported in 2 each facility's cost report submitted for the year two years prior to 3 the rate year; (B) provided, however, notwithstanding any inconsistent 4 provision of this article, commencing April first, two thousand twenty 5 for rates of payment for patients eligible for payments made by state 6 governmental agencies, the capital cost component determined in accord- 7 ance with this subparagraph and inclusive of any shared savings for 8 eligible facilities that elect to refinance their mortgage loans pursu- 9 ant to paragraph (d) of subdivision two-a of this section, shall be 10 reduced by the commissioner by five percent; and (C) provided, however, 11 notwithstanding any inconsistent provision of this article, commencing 12 April first, two thousand twenty-four for rates of payment for patients 13 eligible for payments made by state governmental agencies, the capital 14 cost component determined in accordance with this subparagraph and 15 inclusive of any shared savings for eligible facilities that elect to 16 refinance their mortgage loans pursuant to paragraph (d) of subdivision 17 two-a of this section, shall be reduced by the commissioner by an addi- 18 tional ten percent. 19 § 3. Paragraph (h) of subdivision 1 of section 2632 of the public 20 health law, as amended by chapter 414 of the laws of 2015, is amended to 21 read as follows: 22 (h) in the Persian Gulf conflict from the second day of August, nine- 23 teen hundred ninety to the end of such conflict including military 24 service in Operation Enduring Freedom, Operation Iraqi Freedom, Opera- 25 tion New Dawn or Operation Inherent Resolve and was the recipient of the 26 global war on terrorism expeditionary medal or the Iraq campaign medal 27 or the Afghanistan campaign medal; and who was a resident of the state 28 of New York at the time of entry upon such active duty or who shall have 29 been a resident of this state for [one year] six months next preceding 30 the application for admission shall be entitled to admission to said 31 home after the approval of the application by the board of visitors, 32 subject to the provisions of this article and to the conditions, limita- 33 tions and penalties prescribed by the regulations of the department. Any 34 such veteran or dependent, who otherwise fulfills the requirements set 35 forth in this section, may be admitted directly to the skilled nursing 36 facility or the health related facility provided such veteran or depend- 37 ent is certified by a physician designated or approved by the department 38 to require the type of care provided by such facilities. 39 § 4. This act shall take effect immediately and shall be deemed to 40 have been in full force and effect on and after April 1, 2024. 41 PART F 42 Section 1. Paragraph (n) of subdivision 3 of section 461-l of the 43 social services law, as amended by section 2 of part B of chapter 57 of 44 the laws of 2018, is amended to read as follows: 45 (n) The commissioner of health is authorized to create a program to 46 subsidize the cost of assisted living for those individuals living with 47 Alzheimer's disease and dementia who are not eligible for medical 48 assistance pursuant to title eleven of article five of this chapter and 49 reside in a special needs assisted living residence certified under 50 section forty-six hundred fifty-five of the public health law. The 51 program shall authorize up to two hundred vouchers to individuals 52 through an application process and pay for up to seventy-five percent of 53 the average private pay rate in the respective region. The commissionerS. 8307 17 A. 8807 1 of health may propose rules and regulations to effectuate this 2 provision. 3 § 2. Subdivisions 7 and 8 of section 4656 of the public health law, as 4 added by chapter 2 of the laws of 2004, are renumbered subdivisions 8 5 and 9 and a new subdivision 7 is added to read as follows: 6 7. (a) All assisted living residences, as defined in subdivision one 7 of section forty-six hundred fifty-one of this article, including those 8 licensed and certified as an assisted living residence, special needs 9 assisted living residence, or enhanced assisted living residence, shall: 10 (i) report annually on quality measures to be established by the 11 department, in the form and format prescribed by the department, with 12 the first report due no later than January thirty-first, two thousand 13 twenty-five; and 14 (ii) post the monthly service rate, staffing complement, approved 15 admission or residency agreement, and a consumer-friendly summary of all 16 service fees in a conspicuous place on the facility's website and in a 17 public space within the facility. Such information shall be made avail- 18 able to the public on forms developed by the department. Beginning on 19 January first, two thousand twenty-five, this information shall also be 20 reported to the department. 21 (b) The department shall score the results of the assisted living 22 quality reporting obtained pursuant to paragraph (a) of this subdivi- 23 sion. Top scoring facilities shall be granted the classification of 24 advanced standing on their annual surveillance schedules. 25 (i) Notwithstanding subparagraph one of paragraph (a) of subdivision 26 two of section four hundred sixty-one-a of the social services law, 27 facilities achieving an advanced standing classification shall be 28 surveyed every twelve to eighteen months. All other facilities shall be 29 surveyed on an unannounced basis no less than annually; provided, howev- 30 er, that this shall not apply to surveys, inspections or investigations 31 based on complaints received by the department under any other provision 32 of law. 33 (ii) Facilities may remain on advanced standing classification 34 provided they meet the scoring requirements in the assisted living qual- 35 ity reporting. 36 (c) Effective January thirty-first, two thousand twenty-five, the 37 department may post on its website the results of the assisted living 38 quality reporting collected pursuant to subparagraph (i) of paragraph 39 (a) of this subdivision. 40 § 3. Subparagraph 1 of paragraph (a) of subdivision 2 of section 461-a 41 of the social services law, as amended by chapter 735 of the laws of 42 1994, is amended and a new subparagraph 1-a is added to read as follows: 43 (1) Such facilities receiving the department's highest rating shall be 44 inspected at least once every eighteen months on an unannounced basis. 45 Such rating determination shall be made pursuant to an evaluation of 46 quality indicators as developed by the department and published on the 47 department's website. 48 (1-a) (i) Adult care facilities dually licensed to provide assisted 49 living pursuant to the requirements specified in section forty-six 50 hundred fifty-three of the public health law may seek accreditation by 51 one or more nationally recognized accrediting agencies determined by the 52 commissioner. 53 (ii) Such accreditation agencies shall report data and information, in 54 a manner and form as determined by the department, pertaining to those 55 assisted living residences accredited by such agencies, those assisted 56 living residences that seek but do not receive such accreditation, andS. 8307 18 A. 8807 1 those assisted living residences which obtain but lose such accredi- 2 tation. 3 (iii) Notwithstanding the provisions of subparagraph one of this para- 4 graph, or any other provision of law, assisted living residences which 5 have obtained accreditation from a nationally recognized accreditation 6 organization approved by the department and which meet eligibility 7 criteria, as determined by the department, may, at the discretion of the 8 commissioner, be exempt from the department inspection required in this 9 subdivision for the duration they maintain their accreditation in good 10 standing. The operator of an adult care facility that obtains but subse- 11 quently loses accreditation shall report such loss to the department 12 within ten business days in a manner and form determined by the depart- 13 ment and will no longer be exempt from the department inspection 14 required in this subdivision. The department shall post on its website a 15 list of all accredited assisted living residences. 16 § 4. This act shall take effect immediately and shall be deemed to 17 have been in full force and effect on and after April 1, 2024; provided, 18 however, the provisions of sections two and three of this act shall take 19 effect on the one hundred twentieth day after it shall have become a 20 law. 21 PART G 22 Section 1. Paragraph (i) of subdivision 1 of section 3614-c of the 23 public health law is REPEALED. 24 § 2. Paragraph (d) of subdivision 1, and subdivisions 2, 4, 5, 5-a, 6, 25 6-a, 7, 7-a, 9 and 10 of section 3614-c of the public health law, subdi- 26 visions 2, 4, 5, 6, 7, 9 and 10 as amended and subdivisions 6-a and 7-a 27 as added by section 1 and subdivision 5-a as added by section 1-a of 28 part OO of chapter 56 of the laws of 2020, are amended to read as 29 follows: 30 (d) "Home care aide" means a home health aide, personal care aide, 31 home attendant, [personal assistant performing consumer directed32personal assistance services pursuant to section three hundred sixty-33five-f of the social services law,] or other licensed or unlicensed 34 person whose primary responsibility includes the provision of in-home 35 assistance with activities of daily living, instrumental activities of 36 daily living or health-related tasks; provided, however, that home care 37 aide does not include any individual (i) working on a casual basis, or 38 (ii) [(except for a person employed under the consumer directed personal39assistance program under section three hundred sixty-five-f of the40social services law)] who is a relative through blood, marriage or 41 adoption of: (1) the employer; or (2) the person for whom the worker is 42 delivering services, under a program funded or administered by federal, 43 state or local government. 44 2. Notwithstanding any inconsistent provision of law, rule or regu- 45 lation, no payments by government agencies shall be made to certified 46 home health agencies, long term home health care programs, managed care 47 plans, [fiscal intermediaries,] the nursing home transition and diver- 48 sion waiver program under section three hundred sixty-six of the social 49 services law, or the traumatic brain injury waiver program under section 50 twenty-seven hundred forty of this chapter for any episode of care 51 furnished, in whole or in part, by any home care aide who is compensated 52 at amounts less than the applicable minimum rate of home care aide total 53 compensation established pursuant to this section.S. 8307 19 A. 8807 1 4. The terms of this section shall apply equally to services provided 2 by home care aides who work on episodes of care as direct employees of 3 certified home health agencies, long term home health care programs, or 4 managed care plans, or as employees of licensed home care services agen- 5 cies, limited licensed home care services agencies, [or fiscal interme-6diaries,] or under any other arrangement. 7 5. No payments by government agencies shall be made to certified home 8 health agencies, licensed home care services agencies, long term home 9 health care programs, managed care plans[, fiscal intermediaries] for 10 any episode of care without the certified home health agency, licensed 11 home care services agency, long term home health care program, or 12 managed care plan [or the fiscal intermediary], having delivered prior 13 written certification to the commissioner annually, at a time prescribed 14 by the commissioner, on forms prepared by the department in consultation 15 with the department of labor, that all services provided under each 16 episode of care during the period covered by the certification are in 17 full compliance with the terms of this section and any regulations 18 promulgated pursuant to this section and that no portion of the dollars 19 spent or to be spent to satisfy the wage or benefit portion under this 20 section shall be returned to the certified home health agency, licensed 21 home care services agency, long term home health care program, or 22 managed care plan, [or fiscal intermediary,] related persons or enti- 23 ties, other than to a home care aide as defined in this section to whom 24 the wage or benefits are due, as a refund, dividend, profit, or in any 25 other manner. Such written certification shall also verify that the 26 certified home health agency, long term home health care program, or 27 managed care plan has received from the licensed home care services 28 agency, [fiscal intermediary,] or other third party an annual statement 29 of wage parity hours and expenses on a form provided by the department 30 of labor accompanied by an independently-audited financial statement 31 verifying such expenses. 32 5-a. No portion of the dollars spent or to be spent to satisfy the 33 wage or benefit portion under this section shall be returned to the 34 certified home health agency, licensed home care services agency, long 35 term home health care program, or managed care plan, [or fiscal interme-36diary,] related persons or entities, other than to a home care aide as 37 defined in this section to whom the wage or benefits are due, as a 38 refund, dividend, profit, or in any other manner. 39 6. If a certified home health agency, long term home health care 40 program or managed care plan elects to provide home care aide services 41 through contracts with licensed home care services agencies, [fiscal42intermediaries,] or through other third parties, provided that the 43 episode of care on which the home care aide works is covered under the 44 terms of this section, the certified home health agency, long term home 45 health care program, or managed care plan shall include in its 46 contracts, a requirement that it be provided with a written certif- 47 ication, verified by oath, from the licensed home care services agency, 48 [fiscal intermediary,] or other third party, on forms prepared by the 49 department in consultation with the department of labor, which attests 50 to the licensed home care services agency's, [fiscal intermediary's,] or 51 other third party's compliance with the terms of this section. Such 52 contracts shall also obligate the licensed home care services agency, 53 [fiscal intermediary,] or other third party to provide the certified 54 home health agency, long term home health care program, or managed care 55 plan all information from the licensed home care services agency, 56 [fiscal intermediary] or other third party necessary to verify compli-S. 8307 20 A. 8807 1 ance with the terms of this section, which shall include an annual 2 compliance statement of wage parity hours and expenses on a form 3 provided by the department of labor accompanied by an independently-au- 4 dited financial statement verifying such expenses. Such annual state- 5 ments shall be available no less than annually for the previous calendar 6 year, at a time as prescribed by the commissioner. Such certifications, 7 the information necessary to verify compliance, and the annual compli- 8 ance statement and financial statements shall be retained by all certi- 9 fied home health agencies, long term home health care programs, or 10 managed care plans, and all licensed home care services agencies, 11 [fiscal intermediaries,] or other third parties for a period of no less 12 than ten years, and made available to the department upon request. Any 13 licensed home care services agency, [fiscal intermediary,] or other 14 third party who shall upon oath verify any statement required to be 15 transmitted under this section and any regulations promulgated pursuant 16 to this section which is known by such party to be false shall be guilty 17 of perjury and punishable as provided by the penal law. 18 6-a. The certified home health agency, long term home health care 19 program, or managed care plan shall review and assess the annual compli- 20 ance statement of wage parity hours and expenses and make a written 21 referral to the department of labor for any reasonably suspected fail- 22 ures of licensed home care services agencies, [fiscal intermediaries,] 23 or third parties to conform to the wage parity requirements of this 24 section. 25 7. The commissioner shall distribute to all certified home health 26 agencies, long term home health care programs, managed care plans, and 27 licensed home care services agencies[, and fiscal intermediaries] offi- 28 cial notice of the minimum rates of home care aide compensation at least 29 one hundred twenty days prior to the effective date of each minimum rate 30 for each social services district covered by the terms of this section. 31 7-a. Any certified home health agency, licensed home care services 32 agency, long term home health care program, managed care plan, [or33fiscal intermediary,] or other third party that willfully pays less than 34 such stipulated minimums regarding wages and supplements, as established 35 in this section, shall be guilty of a misdemeanor and upon conviction 36 shall be punished, for a first offense by a fine of five hundred dollars 37 or by imprisonment for not more than thirty days, or by both fine and 38 imprisonment; for a second offense by a fine of one thousand dollars, 39 and in addition thereto the contract on which the violation has occurred 40 shall be forfeited; and no such person or corporation shall be entitled 41 to receive any sum nor shall any officer, agent or employee of the state 42 pay the same or authorize its payment from the funds under his or her 43 charge or control to any person or corporation for work done upon any 44 contract, on which the certified home health agency, licensed home care 45 services agency, long term home health care program, managed care plan, 46 [or fiscal intermediary,] or other third party has been convicted of a 47 second offense in violation of the provisions of this section. 48 9. Nothing in this section should be construed as applicable to any 49 service provided by certified home health agencies, licensed home care 50 services agencies, long term home health care programs[,] or managed 51 care plans[, or fiscal intermediaries] except for all episodes of care 52 reimbursed in whole or in part by the New York Medicaid program. 53 10. No certified home health agency, managed care plan, or long term 54 home health care program shall be liable for recoupment of payments or 55 any other penalty under this section for services provided through a 56 licensed home care services agency, [fiscal intermediary,] or otherS. 8307 21 A. 8807 1 third party with which the certified home health agency, long term home 2 health care program, or managed care plan has a contract because the 3 licensed agency, [fiscal intermediary,] or other third party failed to 4 comply with the provisions of this section if the certified home health 5 agency, long term home health care program, or managed care plan has 6 reasonably and in good faith collected certifications and all informa- 7 tion required pursuant to this section and conducts the monitoring and 8 reporting required by this section. 9 § 3. This act shall take effect October 1, 2024. 10 PART H 11 Section 1. Section 602 of the financial services law, as added by 12 section 26 of part H of chapter 60 of the laws of 2014, is amended to 13 read as follows: 14 § 602. Applicability. [(a)] This article shall not apply to health 15 care services, including emergency services, where physician fees are 16 subject to schedules or other monetary limitations under any other law, 17 including the workers' compensation law and article fifty-one of the 18 insurance law, and shall not preempt any such law. This article also 19 shall not apply to health care services, including emergency services, 20 subject to medical assistance program coverage provided pursuant to 21 section three hundred sixty-four-j of the social services law. 22 § 2. Subdivision 2 of section 364-j of the social services law is 23 amended by adding a new paragraph (e) to read as follows: 24 (e) Effective April first, two thousand twenty-four and expiring on 25 the date the commissioner publishes on the department's website a 26 request for proposals in accordance with paragraph (a) of subdivision 27 five of this section, the commissioner shall place a moratorium on the 28 processing and approval of applications seeking authority to establish a 29 managed care provider, including applications seeking authorization to 30 expand the scope of eligible enrollee populations. Such moratorium shall 31 not apply to: 32 (i) applications submitted to the department prior to January first, 33 two thousand twenty-four; 34 (ii) applications seeking approval to transfer ownership or control of 35 an existing managed care provider; 36 (iii) applications seeking authorization to expand an existing managed 37 care provider's approved service area; 38 (iv) applications seeking authorization to form or operate a managed 39 care provider through an entity certified under section forty-four 40 hundred three-c or forty-four hundred three-g of the public health law; 41 (v) applications demonstrating to the commissioner's satisfaction that 42 submission of the application for consideration would be appropriate to 43 address a serious concern with care delivery, such as a lack of adequate 44 access to managed care providers in a geographic area or a lack of 45 adequate and appropriate care, language and cultural competence, or 46 special needs services. 47 § 3. Subdivision 5 of section 364-j of the social services law, as 48 amended by section 15 of part C of chapter 58 of the laws of 2004, para- 49 graph (a) as amended by section 40 of part A of chapter 56 of the laws 50 of 2013, and paragraphs (d), (e) and (f) as amended by section 80 of 51 part H of chapter 59 of the laws of 2011, is amended to read as follows: 52 5. Managed care programs shall be conducted in accordance with the 53 requirements of this section and, to the extent practicable, encourageS. 8307 22 A. 8807 1 the provision of comprehensive medical services, pursuant to this arti- 2 cle. 3 (a) The [managed care program] commissioner of health shall, through a 4 competitive bid process based on proposals submitted to the department, 5 provide for the selection of qualified managed care providers [by the6commissioner of health] to participate in the managed care program 7 pursuant to a contract with the department, including [comprehensive HIV8special needs plans and] special needs managed care plans in accordance 9 with the provisions of section three hundred sixty-five-m of this title; 10 provided, however, that the commissioner of health may contract directly 11 with comprehensive HIV special needs plans [consistent with standards12set forth in this section] without a competitive bid process, and assure 13 that such providers are accessible taking into account the needs of 14 persons with disabilities and the differences between rural, suburban, 15 and urban settings, and in sufficient numbers to meet the health care 16 needs of participants, and shall consider the extent to which major 17 public hospitals are included within such providers' networks[.]; and 18 provided further that: 19 [(b) A proposal] (i) Proposals submitted by a managed care provider to 20 participate in the managed care program shall: 21 [(i)] (A) designate the geographic [area] areas, as defined by the 22 commissioner in the request for proposals, to be served [by the provid-23er], and estimate the number of eligible participants and actual partic- 24 ipants in such designated area; 25 [(ii)] (B) include a network of health care providers in sufficient 26 numbers and geographically accessible to service program participants; 27 [(iii)] (C) describe the procedures for marketing in the program 28 location, including the designation of other entities which may perform 29 such functions under contract with the organization; 30 [(iv)] (D) describe the quality assurance, utilization review and case 31 management mechanisms to be implemented; 32 [(v)] (E) demonstrate the applicant's ability to meet the data analy- 33 sis and reporting requirements of the program; 34 [(vi)] (F) demonstrate financial feasibility of the program; and 35 [(vii)] (G) include such other information as the commissioner of 36 health may deem appropriate. 37 [(c) The commissioner of health shall make a determination whether to38approve, disapprove or recommend modification of the proposal.39(d) Notwithstanding any inconsistent provision of this title and40section one hundred sixty-three of the state finance law, the commis-41sioner of health may contract with managed care providers approved under42paragraph (b) of this subdivision, without a competitive bid or request43for proposal process, to provide coverage for participants pursuant to44this title.45(e) Notwithstanding any inconsistent provision of this title and46section one hundred forty-three of the economic development law, no47notice in the procurement opportunities newsletter shall be required for48contracts awarded by the commissioner of health, to qualified managed49care providers pursuant to this section.50(f)] (ii) In addition to the criteria described in subparagraph (i) of 51 this paragraph, the commissioner shall also consider: 52 (A) accessibility and geographic distribution of network providers, 53 taking into account the needs of persons with disabilities and the 54 differences between rural, suburban, and urban settings; 55 (B) the extent to which major public hospitals are included in the 56 submitted provider network;S. 8307 23 A. 8807 1 (C) demonstrated cultural and language competencies specific to the 2 population of participants; 3 (D) the corporate organization and status of the bidder as a charita- 4 ble corporation under the not-for-profit corporation law; 5 (E) the ability of a bidder to offer plans in multiple regions; 6 (F) the type and number of products the bidder proposes to operate, 7 including products bid for in accordance with the provisions of subdivi- 8 sion six of section forty-four hundred three-f of the public health law, 9 and other products determined by the commissioner, including but not 10 necessarily limited to those operated under title one-A of article twen- 11 ty-five of the public health law and section three hundred sixty-nine-gg 12 of this article; 13 (G) whether the bidder participates in products for integrated care 14 for participants who are dually eligible for Medicaid and medicare; 15 (H) whether the bidder participates in value based payment arrange- 16 ments as defined by the department, including the delegation of signif- 17 icant financial risk to clinically integrated provider networks; 18 (I) the bidder's commitment to participation in managed care in the 19 state; 20 (J) the bidder's commitment to quality improvement; 21 (K) the bidder's commitment to community reinvestment spending, as 22 shall be defined in the procurement; 23 (L) for current or previously authorized managed care providers, past 24 performance in meeting managed care contract or federal or state 25 requirements, and if the commissioner issued any statements of findings, 26 statements of deficiency, intermediate sanctions or enforcement actions 27 to a bidder for non-compliance with such requirements, whether the 28 bidder addressed such issues in a timely manner; and 29 (M) any other criteria deemed appropriate by the commissioner. 30 (iii) Subparagraphs (i) and (ii) of this paragraph describing proposal 31 content and selection criteria requirements shall not be construed as 32 limiting or requiring the commissioner to evaluate such content or 33 criteria on a pass/fail scale, or other methodological basis; provided 34 however, that the commissioner must consider all such content and crite- 35 ria using methods determined by the commissioner in their discretion 36 and, as applicable, in consultation with the commissioners of the office 37 of mental health, the office for people with developmental disabilities, 38 the office of addiction services and supports, and the office of chil- 39 dren and family services. 40 (iv) The department shall post on its website: 41 (A) The request for proposals and a description of the proposed 42 services to be provided pursuant to contracts in accordance with this 43 subdivision; 44 (B) The criteria on which the department shall determine qualified 45 bidders and evaluate their proposals, including all criteria identified 46 in this subdivision; 47 (C) The manner by which a proposal may be submitted, which may include 48 submission by electronic means; 49 (D) The manner by which a managed care provider may continue to 50 participate in the managed care program pending award of managed care 51 providers through a competitive bid process pursuant to this subdivi- 52 sion; and 53 (E) Upon award, the managed care providers that the commissioner 54 intends to contract with pursuant to this subdivision, provided that the 55 commissioner shall update such list to indicate the final slate of 56 contracted managed care providers.S. 8307 24 A. 8807 1 (v) (A) All responsible and responsive submissions that are received 2 from bidders in a timely fashion shall be reviewed by the commissioner 3 of health in consultation with the commissioners of the office of mental 4 health, the office for people with developmental disabilities, the 5 office of addiction services and supports, and the office of children 6 and family services, as applicable. The commissioner shall consider 7 comments resulting from the review of proposals and make awards in 8 consultation with such agencies. 9 (B) The commissioner may make awards under this subdivision for each 10 product, for which proposals were requested, to two or more managed care 11 providers in each geographic region defined by the commissioner in the 12 request for proposals for which at least two managed care providers have 13 submitted a proposal, and shall have discretion to offer more contracts 14 based on need for access. 15 (C) Managed care providers awarded under this subdivision shall be 16 entitled to enter into a contract with the department for the purpose of 17 participating in the managed care program. Such contracts shall run for 18 a term to be determined by the commissioner, which may be renewed or 19 modified from time to time without a new request for proposals, to 20 ensure consistency with changes in federal and state laws, regulations 21 and policies, including but not limited to the expansion or reduction of 22 medical assistance services available to the participants through a 23 managed care provider. 24 (D) Nothing in this paragraph or other provision of this section shall 25 be construed to limit in any way the ability of the department to termi- 26 nate awarded contracts for cause, which shall include but not be limited 27 to any violation of the terms of such contracts or violations of state 28 or federal laws and regulations and any loss of necessary state or 29 federal funding. 30 (E) Nothing in this paragraph or other provision of this section shall 31 be construed to limit in any way the ability of the department to issue 32 a new request for proposals for a term following an existing term of an 33 award. 34 (b) If necessary to ensure access to a sufficient number of managed 35 care providers on a geographic or other basis, including a lack of 36 adequate and appropriate care, language and cultural competence, or 37 special needs services, the commissioner may reissue a request for 38 proposals as provided for under paragraph (a) of this subdivision, 39 provided however that such request may be limited to the geographic or 40 other basis of need that the request for proposals is seeking to 41 address. Any awards made shall be subject to the requirements of this 42 section, including but not limited to the minimum and maximum number of 43 awards in a region. 44 (c) The care and services described in subdivision four of this 45 section will be furnished by a managed care provider pursuant to the 46 provisions of this section when such services are furnished in accord- 47 ance with an agreement with the department of health, and meet applica- 48 ble federal law and regulations. 49 [(g)] (d) The commissioner of health may delegate some or all of the 50 tasks identified in this section to the local districts. 51 [(h)] (e) Any delegation pursuant to paragraph [(g)] (d) of this 52 subdivision shall be reflected in the contract between a managed care 53 provider and the commissioner of health. 54 § 4. Subdivision 4 of section 365-m of the social services law is 55 REPEALED and a new subdivision 4 is added to read as follows:S. 8307 25 A. 8807 1 4. The commissioner of health, jointly with the commissioners of the 2 office of mental health and the office of addiction services and 3 supports, shall select a limited number of special needs managed care 4 plans under section three hundred sixty-four-j of this title, in accord- 5 ance with subdivision five of such section, capable of managing the 6 behavioral and physical health needs of medical assistance enrollees 7 with significant behavioral health needs. 8 § 5. The opening paragraph of subdivision 2 of section 4403-f of the 9 public health law, as amended by section 8 of part C of chapter 58 of 10 the laws of 2007, is amended to read as follows: 11 An eligible applicant shall submit an application for a certificate of 12 authority to operate a managed long term care plan upon forms prescribed 13 by the commissioner, including any such forms or processes as may be 14 required or prescribed by the commissioner in accordance with the 15 competitive bid process under subdivision six of this section. Such 16 eligible applicant shall submit information and documentation to the 17 commissioner which shall include, but not be limited to: 18 § 6. Subdivision 3 of section 4403-f of the public health law, as 19 amended by section 41-a of part H of chapter 59 of the laws of 2011, is 20 amended to read as follows: 21 3. Certificate of authority; approval. (a) The commissioner shall not 22 approve an application for a certificate of authority unless the appli- 23 cant demonstrates to the commissioner's satisfaction: 24 [(a)] (i) that it will have in place acceptable quality-assurance 25 mechanisms, grievance procedures, mechanisms to protect the rights of 26 enrollees and case management services to ensure continuity, quality, 27 appropriateness and coordination of care; 28 [(b)] (ii) that it will include an enrollment process which shall 29 ensure that enrollment in the plan is informed. The application shall 30 describe the disenrollment process, which shall provide that an other- 31 wise eligible enrollee shall not be involuntarily disenrolled on the 32 basis of health status; 33 [(c)] (iii) satisfactory evidence of the character and competence of 34 the proposed operators and reasonable assurance that the applicant will 35 provide high quality services to an enrolled population; 36 [(d)] (iv) sufficient management systems capacity to meet the require- 37 ments of this section and the ability to efficiently process payment for 38 covered services; 39 [(e)] (v) readiness and capability to maximize reimbursement of and 40 coordinate services reimbursed pursuant to title XVIII of the federal 41 social security act and all other applicable benefits, with such benefit 42 coordination including, but not limited to, measures to support sound 43 clinical decisions, reduce administrative complexity, coordinate access 44 to services, maximize benefits available pursuant to such title and 45 ensure that necessary care is provided; 46 [(f)] (vi) readiness and capability to arrange and manage covered 47 services and coordinate non-covered services which could include prima- 48 ry, specialty, and acute care services reimbursed pursuant to title XIX 49 of the federal social security act; 50 [(g)] (vii) willingness and capability of taking, or cooperating in, 51 all steps necessary to secure and integrate any potential sources of 52 funding for services provided by the managed long term care plan, 53 including, but not limited to, funding available under titles XVI, 54 XVIII, XIX and XX of the federal social security act, the federal older 55 Americans act of nineteen hundred sixty-five, as amended, or any succes- 56 sor provisions subject to approval of the director of the state officeS. 8307 26 A. 8807 1 for aging, and through financing options such as those authorized pursu- 2 ant to section three hundred sixty-seven-f of the social services law; 3 [(h)] (viii) that the contractual arrangements for providers of health 4 and long term care services in the benefit package are sufficient to 5 ensure the availability and accessibility of such services to the 6 proposed enrolled population consistent with guidelines established by 7 the commissioner; with respect to individuals in receipt of such 8 services prior to enrollment, such guidelines shall require the managed 9 long term care plan to contract with agencies currently providing such 10 services, in order to promote continuity of care. In addition, such 11 guidelines shall require managed long term care plans to offer and cover 12 consumer directed personal assistance services for eligible individuals 13 who elect such services pursuant to section three hundred sixty-five-f 14 of the social services law; and 15 [(i)] (ix) that the applicant is financially responsible and may be 16 expected to meet its obligations to its enrolled members. 17 (b) Notwithstanding paragraph (a) of this subdivision, the approval of 18 any application for certification as a managed long term care plan under 19 this section for a plan that seeks to cover a population of enrollees 20 eligible for services under title XIX of the federal social security 21 act, shall be subject to and conditioned on selection through the 22 competitive bid process provided under subdivision six of this section. 23 § 7. Subdivision 6 of section 4403-f of the public health law, as 24 amended by section 41-b of part H of chapter 59 of the laws of 2011, 25 paragraph (a) as amended by section 2 of part I of chapter 57 of the 26 laws of 2023, paragraphs (d), (e), and (f) as added by section 5 of part 27 MM of chapter 56 of the laws of 2020, and the opening paragraph of 28 subparagraph (i) of paragraph (d) as amended by section 3 of part I of 29 chapter 57 of the laws of 2023, is amended to read as follows: 30 6. Approval authority. [(a)] An applicant shall be issued a certif- 31 icate of authority as a managed long term care plan upon a determination 32 by the commissioner that the applicant complies with the operating 33 requirements for a managed long term care plan under this section; 34 provided, however, that any managed long term care plan seeking to 35 provide health and long term care services to a population of enrollees 36 that are eligible under title XIX of the federal social security act 37 shall not receive a certificate of authority, nor be eligible for a 38 contract to provide such services with the department, unless selected 39 through the competitive bid process described in this subdivision. [The40commissioner shall issue no more than seventy-five certificates of41authority to managed long term care plans pursuant to this section.42(a-1) Nothing in this section shall be construed as requiring the43department to contract with or to contract for a particular line of44business with an entity certified under this section for the provision45of services available under title eleven of article five of the social46services law. A managed long term care plan that has been issued a47certificate of authority, or an applicant for a certificate of authority48as a managed long term care plan that has in any of the three calendar49years immediately preceding the application, met any of the following50criteria shall not be eligible for a contract for the provision of51services available under title eleven of article five of the social52services law: (i) classified as a poor performer, or substantially simi-53lar terminology, by the centers for medicare and medicaid services; or54(ii) an excessive volume of penalties, statements of findings, state-55ments of deficiency, intermediate sanctions or enforcement actions,S. 8307 27 A. 8807 1regardless of whether the applicant has addressed such issues in a time-2ly manner.3(b) An operating demonstration shall be issued a certificate of4authority as a managed long term care plan upon a determination by the5commissioner that such demonstration complies with the operating6requirements for a managed long term care plan under this section.7Nothing in this section shall be construed to affect the continued legal8authority of an operating demonstration to operate its previously9approved program.10(c) For the period beginning April first, two thousand twelve and11ending March thirty-first, two thousand fifteen, the majority leader of12the senate and the speaker of the assembly may each recommend to the13commissioner, in writing, up to four eligible applicants to convert to14be approved managed long term care plans. An applicant shall only be15approved and issued a certificate of authority if the commissioner16determines that the applicant meets the requirements of subdivision17three of this section. The majority leader of the senate or the speaker18of the assembly may assign their authority to recommend one or more19applicants under this section to the commissioner] 20 (a) Notwithstanding sections one hundred twelve and one hundred 21 sixty-three of the state finance law, sections one hundred forty-two and 22 one hundred forty-three of the economic development law, and any other 23 inconsistent provision of law, the commissioner shall, through a compet- 24 itive bid process based on proposals submitted to the department, 25 provide for the selection of qualified managed long term care plans to 26 provide health and long term care services to enrollees who are eligible 27 under title XIX of the federal social security act pursuant to a 28 contract with the department; provided, however, that: 29 (i) A proposal submitted by a managed long term care plan shall 30 include information sufficient to allow the commissioner to evaluate the 31 bidder in accordance with the requirements identified in subdivisions 32 two, three and four of this section. 33 (ii) In addition to the criteria described in subparagraph (i) of this 34 paragraph, the commissioner shall also consider: 35 (A) accessibility and geographic distribution of network providers, 36 taking into account the needs of persons with disabilities and the 37 differences between rural, suburban, and urban settings; 38 (B) the extent to which major public hospitals are included in the 39 submitted provider network; 40 (C) demonstrated cultural and language competencies specific to the 41 population of participants; 42 (D) the corporate organization and status of the bidder as a charita- 43 ble corporation under the not-for-profit corporation law; 44 (E) the ability of a bidder to offer plans in multiple regions; 45 (F) the type and number of products the bidder proposes to operate, 46 including products applied for in accordance with the provisions of 47 subdivision five of section three hundred sixty-four-j of the social 48 services law, and other products determined by the commissioner, includ- 49 ing but not necessarily limited to those operated under title one-A of 50 article twenty-five of this chapter and section three hundred sixty- 51 nine-gg of the social services law; 52 (G) whether the bidder participates in products for integrated care 53 for participants who are dually eligible for Medicaid and medicare; 54 (H) whether the bidder participates in value based payment arrange- 55 ments as defined by the department, including the delegation of signif- 56 icant financial risk to clinically integrated provider networks;S. 8307 28 A. 8807 1 (I) the bidder's commitment to participation in managed care in the 2 state; 3 (J) the bidder's commitment to quality improvement; 4 (K) the bidder's commitment to community reinvestment spending, as 5 shall be defined in the procurement; 6 (L) for current or previously authorized managed care providers, past 7 performance in meeting managed care contract or federal or state 8 requirements, and if the commissioner issued any statements of findings, 9 statements of deficiency, intermediate sanctions or enforcement actions 10 to a bidder for non-compliance with such requirements, whether the 11 bidder addressed such issues in a timely manner; and 12 (M) any other criteria deemed appropriate by the commissioner. 13 (iii) Subparagraphs (i) and (ii) of this paragraph describing proposal 14 content and selection criteria requirements shall not be construed as 15 limiting or requiring the commissioner to evaluate such content or 16 criteria on a pass/fail scale, or other particular methodological basis; 17 provided however, that the commissioner must consider all such content 18 and criteria using methods determined by the commissioner in their 19 discretion and, as applicable, in consultation with the commissioners of 20 the office of mental health, the office for people with developmental 21 disabilities, the office of addiction services and supports, and the 22 office of children and family services. 23 (iv) The department shall post on its website: 24 (A) The request for proposals and a description of the proposed 25 services to be provided pursuant to contracts in accordance with this 26 subdivision; 27 (B) The criteria on which the department shall determine qualified 28 bidders and evaluate their applications, including all criteria identi- 29 fied in this subdivision; 30 (C) The manner by which a proposal may be submitted, which may include 31 submission by electronic means; 32 (D) The manner by which a managed long term care plan may continue to 33 provide health and long term care services to enrollees who are eligible 34 under title XIX of the federal social security act pending awards to 35 managed long term care plans through a competitive bid process pursuant 36 to this subdivision; and 37 (E) Upon award, the managed long term care plans that the commissioner 38 intends to contract with pursuant to this subdivision, provided that the 39 commissioner shall update such list to indicate the final slate of 40 contracted managed long term care plans. 41 (v) (A) All responsible and responsive submissions that are received 42 from bidders in a timely fashion shall be reviewed by the commissioner 43 in consultation with the commissioners of the office of mental health, 44 the office for people with developmental disabilities, the office of 45 addiction services and supports, and the office of children and family 46 services, as applicable. The commissioner shall consider comments 47 resulting from the review of proposals and make awards in consultation 48 with such agencies. 49 (B) The commissioner may make awards under this subdivision, for each 50 product for which proposals were requested, to two or more managed long 51 term care plans in each geographic region defined by the commissioner in 52 the request for proposals for which at least two managed long term care 53 plans have submitted a proposal, and shall have discretion to offer more 54 contracts based on need for access. 55 (C) Managed long term care plans awarded under this subdivision shall 56 be entitled to enter into a contract with the department for the purposeS. 8307 29 A. 8807 1 of providing health and long term care services to enrollees who are 2 eligible under title XIX of the federal social security act. Such 3 contracts shall run for a term to be determined by the commissioner, 4 which may be renewed or modified from time to time without a new request 5 for proposals, to ensure consistency with changes in federal and state 6 laws, regulations and policies, including but not limited to the expan- 7 sion or reduction of medical assistance services available to the 8 participants through a managed long term care plan. 9 (D) Nothing in this paragraph or other provision of this section shall 10 be construed to limit in any way the ability of the department to termi- 11 nate awarded contracts for cause, which shall include but not be limited 12 to any violation of the terms of such contracts or violations of state 13 or federal laws and regulations and any loss of necessary state or 14 federal funding. 15 (E) Nothing in this paragraph or other provision of this section shall 16 be construed to limit in any way the ability of the department to issue 17 a new request for proposals for a term following an existing term of an 18 award. 19 (b) Addressing needs for additional managed long term care plans to 20 ensure access and choice for enrollees eligible under title XIX of the 21 federal social security act. If necessary to ensure access to a suffi- 22 cient number of managed long term care plans on a geographic or other 23 basis, including a lack of adequate and appropriate care, language and 24 cultural competence, or special needs services, the commissioner may 25 reissue a request for proposals as provided for under paragraph (a) of 26 this subdivision, provided however that such request may be limited to 27 the geographic or other basis of need that the request for proposals 28 seeks to address. Any awards made shall be subject to the requirements 29 of this section, including but not limited to the minimum and maximum 30 number of awards in a region. 31 [(d)] (c) (i) Effective April first, two thousand twenty, and expiring 32 [March thirty-first, two thousand twenty-seven] on the date the commis- 33 sioner publishes on the department's website a request for proposals in 34 accordance with subparagraph (iv) of paragraph (a) of this subdivision, 35 the commissioner shall place a moratorium on the processing and approval 36 of applications seeking a certificate of authority as a managed long 37 term care plan pursuant to this section, including applications seeking 38 authorization to expand an existing managed long term care plan's 39 approved service area or scope of eligible enrollee populations. Such 40 moratorium shall not apply to: 41 (A) applications submitted to the department prior to January first, 42 two thousand twenty; 43 (B) applications seeking approval to transfer ownership or control of 44 an existing managed long term care plan; 45 (C) applications demonstrating to the commissioner's satisfaction that 46 submission of the application for consideration would be appropriate to 47 address a serious concern with care delivery, such as a lack of adequate 48 access to managed long term care plans in a geographic area or a lack of 49 adequate and appropriate care, language and cultural competence, or 50 special needs services; and 51 (D) applications seeking to operate under the PACE (Program of All-In- 52 clusive Care for the Elderly) model as authorized by federal public law 53 105-33, subtitle I of title IV of the Balanced Budget Act of 1997, or to 54 serve individuals dually eligible for services and benefits under titles 55 XVIII and XIX of the federal social security act in conjunction with an 56 affiliated Medicare Dual Eligible Special Needs Plan, based on the needS. 8307 30 A. 8807 1 for such plans and the experience of applicants in serving dually eligi- 2 ble individuals as determined by the commissioner in their discretion. 3 (ii) For the duration of the moratorium, the commissioner shall assess 4 the public need for managed long term care plans that are not integrated 5 with an affiliated Medicare plan, the ability of such plans to provide 6 high quality and cost effective care for their membership, and based on 7 such assessment develop a process and conduct an orderly wind-down and 8 elimination of such plans, which shall coincide with the expiration of 9 the moratorium unless the commissioner determines that a longer wind- 10 down period is needed. 11 [(e) For the duration of the moratorium under paragraph (d) of this12subdivision] (d) From April first, two thousand twenty, until March 13 thirty-first, two thousand twenty-four, the commissioner shall estab- 14 lish, and enforce by means of a premium withholding equal to three 15 percent of the base rate, an annual cap on total enrollment (enrollment 16 cap) for each managed long term care plan, subject to subparagraphs (ii) 17 and (iii) of this paragraph, based on a percentage of each plan's 18 reported enrollment as of October first, two thousand twenty. 19 (i) The specific percentage of each plan's enrollment cap shall be 20 established by the commissioner based on: (A) the ability of individuals 21 eligible for such plans to access health and long term care services, 22 (B) plan quality of care scores, (C) historical plan disenrollment, (D) 23 the projected growth of individuals eligible for such plans in different 24 regions of the state, (E) historical plan enrollment of patients with 25 varying levels of need and acuity, and (F) other factors in the commis- 26 sioner's discretion to ensure compliance with federal requirements, 27 appropriate access to plan services, and choice by eligible individuals. 28 (ii) In the event that a plan exceeds its annual enrollment cap, the 29 commissioner is authorized under this paragraph to retain all or a 30 portion of the premium withheld based on the amount over which a plan 31 exceeds its enrollment cap. Penalties assessed pursuant to this subdivi- 32 sion shall be determined by regulation. 33 (iii) The commissioner may not establish an annual cap on total 34 enrollment under this paragraph for plans' lines of business operating 35 under the PACE (Program of All-Inclusive Care for the Elderly) model as 36 authorized by federal public law 105-33, subtitle I of title IV of the 37 Balanced Budget Act of 1997, or that serve individuals dually eligible 38 for services and benefits under titles XVIII and XIX of the federal 39 social security act in conjunction with an affiliated Medicare Dual 40 Eligible Special Needs Plan. 41 [(f) In implementing the provisions of paragraphs (d) and (e) of this42subdivision, the commissioner shall, to the extent practicable, consider43and select methodologies that seek to maximize continuity of care and44minimize disruption to the provider labor workforce, and shall, to the45extent practicable and consistent with the ratios set forth herein,46continue to support contracts between managed long term care plans and47licensed home care services agencies that are based on a commitment to48quality and value.] 49 § 8. Section 1 of part I of chapter 57 of the laws of 2022, providing 50 a one percent across the board payment increase to all qualifying fee- 51 for-service Medicaid rates, is amended by adding two new subdivisions 3 52 and 4 to read as follows: 53 3. For the state fiscal years beginning April 1, 2024, and thereafter, 54 all department of health Medicaid payments made to Medicaid managed care 55 organizations will no longer be subject to the uniform rate increase in 56 subdivision one of this section.S. 8307 31 A. 8807 1 4. Rate adjustments made pursuant to subdivisions one through three of 2 this section shall not be subject to the notification requirements set 3 forth in subdivision 7 of section 2807 of the public health law. 4 § 9. Section 364-j of the social services law is amended by adding a 5 new subdivision 40 to read as follows: 6 40. (a) The commissioner shall be entitled to recover liquidated 7 damages from managed care organizations for failure to meet the contrac- 8 tual obligations and performance standards of their contract. 9 (b) The commissioner shall have sole discretion in determining whether 10 to impose a recovery of the financial loss and damages for noncompliance 11 with any provision of the contract. 12 (c) (i) Liquidated damages imposed by this subdivision against a 13 managed care organization shall be from two hundred fifty dollars up to 14 twenty-five thousand dollars per violation depending on the severity of 15 the noncompliance determined by the commissioner. 16 (ii) Any liquidated damages findings as a result of the review 17 required by this subdivision shall be due and payable sixty calendar 18 days from the issuance of a statement of damages regardless of any 19 dispute in the amount or interpretation of the amount due contained in 20 the notice. 21 (iii) The commissioner may elect, in their sole discretion, to collect 22 damages imposed by this section from, and as a set off against, payments 23 due to the managed care organization, or payments that becomes due any 24 time after the calculation of liquidated damages. Deductions shall 25 continue until the full amount of the noticed damages are paid in full. 26 (iv) All liquidated damages imposed by this subdivision shall be paid 27 out of the administrative costs and profits of the managed care organ- 28 ization. 29 (v) The managed care organization shall not pass the liquidated 30 damages imposed under this subdivision through to any provider and/or 31 subcontractor. 32 (d) (i) To dispute liquidated damages imposed by this subdivision the 33 managed care organization must submit a written request of its dispute 34 to the commissioner within thirty calendar days from the date of the 35 statement of damages. Such dispute shall be made in the form and manner 36 prescribed by the commissioner. 37 (ii) The department will deny any disputes that are not delivered in 38 the format and timeframe specified by the department. 39 (iii) The managed care organization waives any dispute not raised 40 within thirty calendar days of issuance of the statement of damages. It 41 also waives any arguments it fails to raise in writing within thirty 42 calendar days of issuance of the statement of damages, and waives the 43 right to use any materials, data, and/or information not contained in or 44 accompanying the managed care organization's submission submitted within 45 the thirty calendar days of issuance of the statement of damages in any 46 subsequent legal or administrative proceeding. 47 (iv) The commissioner or their designee shall decide the dispute, 48 reduce the decision to writing and issue their decision to the managed 49 care organization within ninety calendar days of receipt of the dispute. 50 This written decision shall be final. 51 (e) For purposes of this subdivision a violation shall mean a determi- 52 nation by the commissioner that the managed care organization failed to 53 act as required under the model contract or applicable federal and state 54 statutes, rules or regulations governing managed care organization. For 55 the purposes of this subdivision, each day that an ongoing violation 56 continues shall be a separate violation. In addition, each instance ofS. 8307 32 A. 8807 1 failing to furnish necessary and/or required medical services or items 2 to each enrollee shall be a separate violation. As well, each day that 3 the managed care organization fails to furnish necessary and/or required 4 medical services or items to enrollees shall be a separate violation. 5 (f) For purposes of this subdivision managed care organization shall 6 mean any managed care organizations subject to this section and article 7 forty-four of the public health law, including managed long term care 8 plans. 9 (g) Nothing in this subdivision shall prohibit the imposition of 10 damages, penalties or other relief, otherwise authorized by law, includ- 11 ing but not limited to cases of fraud, waste or abuse. 12 § 10. This act shall not be construed to prohibit managed care provid- 13 ers participating in the managed care program and managed long term care 14 plans approved to provide health and long term care services to enrol- 15 lees who are eligible under title XIX of the federal social security 16 act, that were so authorized as of the effective date of this act from 17 continuing operations as authorized until such time as awards are made 18 in accordance with this act and such additional time subject to direc- 19 tion from the commissioner of health to ensure the safe and orderly 20 transfer of participants. 21 § 11. This act shall take effect immediately and shall apply to 22 disputes filed with the superintendent of financial services pursuant to 23 article six of the financial services law on or after such effective 24 date; provided that: 25 (a) the amendments to section 364-j of the social services law made by 26 sections two, three and nine of this act shall not affect the repeal of 27 such section and shall be deemed repealed therewith; and 28 (b) the amendments to section 4403-f of the public health law made by 29 sections five, six and seven of this act shall not affect the repeal of 30 such section and shall be deemed repealed therewith. 31 PART I 32 Section 1. Paragraph (a) of subdivision 4 of section 365-a of the 33 social services law, as amended by chapter 493 of the laws of 2010, is 34 amended to read as follows: 35 (a) drugs which may be dispensed without a prescription as required by 36 section sixty-eight hundred ten of the education law; provided, however, 37 that the state commissioner of health may by regulation specify certain 38 of such drugs which may be reimbursed as an item of medical assistance 39 in accordance with the price schedule established by such commissioner. 40 Notwithstanding any other provision of law, [additions] modifications to 41 the list of drugs reimbursable under this paragraph may be filed as 42 regulations by the commissioner of health without prior notice and 43 comment; 44 § 2. Paragraph (b) of subdivision 3 of section 273 of the public 45 health law, as added by section 10 of part C of chapter 58 of the laws 46 of 2005, is amended to read as follows: 47 (b) In the event that the patient does not meet the criteria in para- 48 graph (a) of this subdivision, the prescriber may provide additional 49 information to the program to justify the use of a prescription drug 50 that is not on the preferred drug list. The program shall provide a 51 reasonable opportunity for a prescriber to reasonably present his or her 52 justification of prior authorization. [If, after consultation with the53program, the prescriber, in his or her reasonable professional judgment,54determines that] The program will consider the additional informationS. 8307 33 A. 8807 1 and the justification presented to determine whether the use of a 2 prescription drug that is not on the preferred drug list is warranted, 3 and the [prescriber's] program's determination shall be final. 4 § 3. Subdivisions 25 and 25-a of section 364-j of the social services 5 law are REPEALED. 6 § 4. Section 280 of the public health law, as amended by section 8 of 7 part D of chapter 57 of the laws of 2018, paragraph (b) of subdivision 2 8 as amended by section 5, subdivision 3 as amended by section 6, para- 9 graph (a) of subdivision 5 as amended by section 7, subparagraph (iii) 10 of paragraph (e) as amended by section 6-a and subdivision 8 as amended 11 by section 9 of part B of chapter 57 of the laws of 2019, paragraphs 12 (c) and (d) of subdivision 2 as amended and paragraph (e) of subdivision 13 2 as added by section 2 of part FFF of chapter 56 of the laws of 2020, 14 the opening paragraph of paragraph (a) of subdivision 6 and paragraph 15 (a) of subdivision 7 as amended by sections 3 and 4, respectively, of 16 part GG of chapter 56 of the laws of 2020, is amended to read as 17 follows: 18 § 280. Medicaid drug cap. 1. The legislature hereby finds and declares 19 that there is a significant public interest for the Medicaid program to 20 manage drug costs in a manner that ensures patient access while provid- 21 ing financial stability for the state and participating providers. 22 Since two thousand eleven, the state has taken significant steps to 23 contain costs in the Medicaid program by imposing a statutory limit on 24 annual growth. Drug expenditures, however, continually outpace other 25 cost components causing significant pressure on the state, providers, 26 and patient access operating under the Medicaid global cap. It is there- 27 fore intended that the department establish a [Medicaid drug cap as a28separate component within the Medicaid global cap] supplemental rebate 29 program as part of a focused and sustained effort to balance the growth 30 of drug expenditures with the growth of total Medicaid expenditures. 31 2. The commissioner shall [establish a year to year] review at least 32 annually the department of health state funds Medicaid drug [expenditure33growth target as follows:34(a) for state fiscal year two thousand seventeen--two thousand eigh-35teen, be limited to the ten-year rolling average of the medical compo-36nent of the consumer price index plus five percent and minus a pharmacy37savings target of fifty-five million dollars; and38(b) for state fiscal year two thousand eighteen--two thousand nine-39teen, be limited to the ten-year rolling average of the medical compo-40nent of the consumer price index plus four percent and minus a pharmacy41savings target of eighty-five million dollars;42(c) for state fiscal year two thousand nineteen--two thousand twenty,43be limited to the ten-year rolling average of the medical component of44the consumer price index plus four percent and minus a pharmacy savings45target of eighty-five million dollars;46(d) for state fiscal year two thousand twenty--two thousand twenty-47one, be limited to the ten-year rolling average of the medical component48of the consumer price index plus two percent; and49(e) for state fiscal year two thousand twenty-one--two thousand twen-50ty-two and fiscal years thereafter, be limited in accordance with subdi-51vision one of section ninety-one of part H of chapter fifty-nine of the52laws of two thousand eleven, as amended] expenditures to identify drugs, 53 including but not limited to, drugs in the eightieth percentile or high- 54 er of total spend, net of rebate or in the eightieth percentile or high- 55 er based on cost per claim, net of rebate.S. 8307 34 A. 8807 1 3. (a) The [department and the division of the budget shall assess on2a quarterly basis the projected total amount to be expended in the year3on a cash basis by the Medicaid program for each drug, and the projected4annual amount of state funds Medicaid drug expenditures on a cash basis5for all drugs, which shall be a component of the projected department of6health state funds Medicaid expenditures calculated for purposes of7sections ninety-one and ninety-two of part H of chapter fifty-nine of8the laws of two thousand eleven. For purposes of this section, state9funds Medicaid drug expenditures include amounts expended for drugs in10both the Medicaid fee-for-service program and Medicaid managed care11programs, minus the amount of any drug rebates or supplemental drug12rebates received by the department, including rebates pursuant to subdi-13vision five of this section with respect to rebate targets. The depart-14ment and the division of the budget shall report in December of each15year, for the prior April through October, to the drug utilization16review board the projected state funds Medicaid drug expenditures17including the amounts, in aggregate thereof, attributable to the net18cost of: changes in the utilization of drugs by Medicaid recipients;19changes in the number of Medicaid recipients; changes to the cost of20brand name drugs and changes to the cost of generic drugs. The informa-21tion contained in the report shall not be publicly released in a manner22that allows for the identification of an individual drug or manufacturer23or that is likely to compromise the financial competitive, or proprie-24tary nature of the information.25(a) In the event the director of the budget determines, based on Medi-26caid drug expenditures for the previous quarter or other relevant infor-27mation, that the total department of health state funds Medicaid drug28expenditure is projected to exceed the annual growth limitation imposed29by subdivision two of this section, the] commissioner may identify and 30 refer drugs, including but not limited to, drugs in the eightieth 31 percentile or higher of total spend, net of rebate or in the eightieth 32 percentile or higher based on cost per claim, net of rebate, to the drug 33 utilization review board established by section three hundred sixty- 34 nine-bb of the social services law for a recommendation as to whether a 35 target supplemental Medicaid rebate should be paid by the manufacturer 36 of the drug to the department and the target amount of the rebate. 37 (b) If the department intends to refer a drug to the drug utilization 38 review board pursuant to paragraph (a) of this subdivision, the depart- 39 ment shall notify the manufacturer of such drug and shall attempt to 40 reach agreement with the manufacturer on a rebate for the drug prior to 41 referring the drug to the drug utilization review board for review. 42 Such rebate may be based on evidence-based research, including, but not 43 limited to, such research operated or conducted by or for other state 44 governments, the federal government, the governments of other nations, 45 and third party payers or multi-state coalitions, provided however that 46 the department shall account for the effectiveness of the drug in treat- 47 ing the conditions for which it is prescribed or in improving a 48 patient's health, quality of life, or overall health outcomes, and the 49 likelihood that use of the drug will reduce the need for other medical 50 care, including hospitalization. 51 (c) In the event that the commissioner and the manufacturer have 52 previously agreed to a supplemental rebate for a drug pursuant to para- 53 graph (b) of this subdivision or paragraph (e) of subdivision seven of 54 section three hundred sixty-seven-a of the social services law, the drug 55 shall not be referred to the drug utilization review board for any 56 further supplemental rebate for the duration of the previous rebateS. 8307 35 A. 8807 1 agreement, provided however, the commissioner may refer a drug to the 2 drug utilization review board if the commissioner determines there are 3 significant and substantiated utilization or market changes, new 4 evidence-based research, or statutory or federal regulatory changes that 5 warrant additional rebates. In such cases, the department shall notify 6 the manufacturer and provide evidence of the changes or research that 7 would warrant additional rebates, and shall attempt to reach agreement 8 with the manufacturer on a rebate for the drug prior to referring the 9 drug to the drug utilization review board for review. 10 (d) The department shall consider a drug's actual cost to the state, 11 including current rebate amounts, prior to seeking an additional rebate 12 pursuant to paragraph (b) or (c) of this subdivision. 13 (e) [The commissioner shall be authorized to take the actions14described in this section only so long as total Medicaid drug expendi-15tures are projected to exceed the annual growth limitation imposed by16subdivision two of this section.] If the commissioner is unsuccessful in 17 entering into a rebate arrangement with the manufacturer of the drug 18 satisfactory to the department, the drug manufacturer shall, in that 19 event be required to provide to the department, on a standard reporting 20 form developed by the department, the following information: 21 (i) the actual cost of developing, manufacturing, producing (including 22 the cost per dose of production), and distributing the drug; 23 (ii) research and development costs of the drug, including payments to 24 predecessor entities conducting research and development, such as 25 biotechnology companies, universities and medical schools, and private 26 research institutions; 27 (iii) administrative, marketing, and advertising costs for the drug, 28 apportioned by marketing activities that are directed to consumers, 29 marketing activities that are directed to prescribers, and the total 30 cost of all marketing and advertising that is directed primarily to 31 consumers and prescribers in New York, including but not limited to 32 prescriber detailing, copayment discount programs, and direct-to-consum- 33 er marketing; 34 (iv) the extent of utilization of the drug; 35 (v) prices for the drug that are charged to purchasers outside the 36 United States; 37 (vi) prices charged to typical purchasers in the state, including but 38 not limited to pharmacies, pharmacy chains, pharmacy wholesalers, or 39 other direct purchasers; 40 (vii) the average rebates and discounts provided per payer type in the 41 state; and 42 (viii) the average profit margin of each drug over the prior five-year 43 period and the projected profit margin anticipated for such drug. 44 (f) All information disclosed pursuant to paragraph (e) of this subdi- 45 vision shall be considered confidential and shall not be disclosed by 46 the department in a form that identifies a specific manufacturer or 47 prices charged for drugs by such manufacturer. 48 4. In determining whether to recommend a target supplemental rebate 49 for a drug, the drug utilization review board shall consider the actual 50 cost of the drug to the Medicaid program, including federal and state 51 rebates, and may consider, among other things: 52 (a) the drug's impact on the Medicaid drug spending growth target and 53 the adequacy of capitation rates of participating Medicaid managed care 54 plans, and the drug's affordability and value to the Medicaid program; 55 or 56 (b) significant and unjustified increases in the price of the drug; orS. 8307 36 A. 8807 1 (c) whether the drug may be priced disproportionately to its therapeu- 2 tic benefits. 3 5. (a) If the drug utilization review board recommends a target rebate 4 amount on a drug referred by the commissioner, the department shall 5 negotiate with the drug's manufacturer for a supplemental rebate to be 6 paid by the manufacturer in an amount not to exceed such target rebate 7 amount. [A rebate requirement shall apply beginning with the first day8of the state fiscal year during which the rebate was required without9regard to the date the department enters into the rebate agreement with10the manufacturer.] 11 (b) The supplemental rebate required by paragraph (a) of this subdivi- 12 sion shall apply to drugs dispensed to enrollees of managed care provid- 13 ers pursuant to section three hundred sixty-four-j of the social 14 services law and to drugs dispensed to Medicaid recipients who are not 15 enrollees of such providers. 16 (c) [If the drug utilization review board recommends a target rebate17amount for a drug and the department is unable to negotiate a rebate18from the manufacturer in an amount that is at least seventy-five percent19of the target rebate amount, the commissioner is authorized to waive the20provisions of paragraph (b) of subdivision three of section two hundred21seventy-three of this article and the provisions of subdivisions twen-22ty-five and twenty-five-a of section three hundred sixty-four-j of the23social services law with respect to such drug; however, this waiver24shall not be implemented in situations where it would prevent access by25a Medicaid recipient to a drug which is the only treatment for a partic-26ular disease or condition. Under no circumstances shall the commissioner27be authorized to waive such provisions with respect to more than two28drugs in a given time.29(d)] Where the department and a manufacturer enter into a rebate 30 agreement pursuant to this section, which may be in addition to existing 31 rebate agreements entered into by the manufacturer with respect to the 32 same drug, no additional rebates shall be required to be paid by the 33 manufacturer to a managed care provider or any of a managed care provid- 34 er's agents, including but not limited to any pharmacy benefit manager, 35 while the department is collecting the rebate pursuant to this section. 36 [(e)] (d) In formulating a recommendation concerning a target rebate 37 amount for a drug, the drug utilization review board may consider: 38 (i) publicly available information relevant to the pricing of the 39 drug; 40 (ii) information supplied by the department relevant to the pricing of 41 the drug; 42 (iii) information relating to value-based pricing provided, however, 43 if the department directly invites any third party to provide cost-ef- 44 fectiveness analysis or research related to value-based pricing, and the 45 department receives and considers such analysis or research for use by 46 the board, such third party shall disclose any funding sources. The 47 department shall, if reasonably possible, make publicly available the 48 following documents in its possession that it relies upon to provide 49 cost effectiveness analyses or research related to value-based pricing: 50 (A) descriptions of underlying methodologies; (B) assumptions and limi- 51 tations of research findings; and (C) if available, data that presents 52 results in a way that reflects different outcomes for affected subpopu- 53 lations; 54 (iv) the seriousness and prevalence of the disease or condition that 55 is treated by the drug; 56 (v) the extent of utilization of the drug;S. 8307 37 A. 8807 1 (vi) the effectiveness of the drug in treating the conditions for 2 which it is prescribed, or in improving a patient's health, quality of 3 life, or overall health outcomes; 4 (vii) the likelihood that use of the drug will reduce the need for 5 other medical care, including hospitalization; 6 (viii) the average wholesale price, wholesale acquisition cost, retail 7 price of the drug, and the cost of the drug to the Medicaid program 8 minus rebates received by the state; 9 (ix) in the case of generic drugs, the number of pharmaceutical 10 manufacturers that produce the drug; 11 (x) whether there are pharmaceutical equivalents to the drug; and 12 (xi) information supplied by the manufacturer, if any, explaining the 13 relationship between the pricing of the drug and the cost of development 14 of the drug and/or the therapeutic benefit of the drug, or that is 15 otherwise pertinent to the manufacturer's pricing decision; any such 16 information, including the information on the standard reporting form 17 requirement in paragraph (e) of subdivision three of this section, 18 provided shall be considered confidential and shall not be disclosed by 19 the drug utilization review board in a form that identifies a specific 20 manufacturer or prices charged for drugs by such manufacturer. 21 6. [(a) If the drug utilization review board recommends a target22rebate amount or if the commissioner identifies a drug as a high cost23drug pursuant to subparagraph (vii) of paragraph (e) of subdivision 7 of24section three hundred sixty-seven-a of the social services law and the25department is unsuccessful in entering into a rebate arrangement with26the manufacturer of the drug satisfactory to the department, the drug27manufacturer shall in that event be required to provide to the depart-28ment, on a standard reporting form developed by the department, the29following information:30(i) the actual cost of developing, manufacturing, producing (including31the cost per dose of production), and distributing the drug;32(ii) research and development costs of the drug, including payments to33predecessor entities conducting research and development, such as34biotechnology companies, universities and medical schools, and private35research institutions;36(iii) administrative, marketing, and advertising costs for the drug,37apportioned by marketing activities that are directed to consumers,38marketing activities that are directed to prescribers, and the total39cost of all marketing and advertising that is directed primarily to40consumers and prescribers in New York, including but not limited to41prescriber detailing, copayment discount programs, and direct-to-consum-42er marketing;43(iv) the extent of utilization of the drug;44(v) prices for the drug that are charged to purchasers outside the45United States;46(vi) prices charged to typical purchasers in the state, including but47not limited to pharmacies, pharmacy chains, pharmacy wholesalers, or48other direct purchasers;49(vii) the average rebates and discounts provided per payer type in the50State; and51(viii) the average profit margin of each drug over the prior five-year52period and the projected profit margin anticipated for such drug.53(b) All information disclosed pursuant to paragraph (a) of this subdi-54vision shall be considered confidential and shall not be disclosed by55the department in a form that identifies a specific manufacturer or56prices charged for drugs by such manufacturer.S. 8307 38 A. 8807 17.] (a) [If, after] After taking into account all rebates and supple- 2 mental rebates received by the department, including rebates received to 3 date pursuant to this section[, total Medicaid drug expenditures are4still projected to exceed the annual growth limitation imposed by subdi-5vision two of this section], the commissioner may: subject any drug of a 6 manufacturer referred to the drug utilization review board under this 7 section to prior approval in accordance with existing processes and 8 procedures when such manufacturer has not entered into a supplemental 9 rebate arrangement as required by this section; direct a managed care 10 plan to limit or reduce reimbursement for a drug provided by a medical 11 practitioner if the drug utilization review board recommends a target 12 rebate amount for such drug and the manufacturer has failed to enter 13 into a rebate arrangement required by this section; direct managed care 14 plans to remove from their Medicaid formularies any drugs of a manufac- 15 turer who has a drug that the drug utilization review board recommends a 16 target rebate amount for and the manufacturer has failed to enter into a 17 rebate arrangement required by this section; promote the use of cost 18 effective and clinically appropriate drugs other than those of a 19 manufacturer who has a drug that the drug utilization review board 20 recommends a target rebate amount and the manufacturer has failed to 21 enter into a rebate arrangement required by this section; allow manufac- 22 turers to accelerate rebate payments under existing rebate contracts; 23 and such other actions as authorized by law. [The commissioner shall24provide written notice to the legislature thirty days prior to taking25action pursuant to this paragraph, unless action is necessary in the26fourth quarter of a fiscal year to prevent total Medicaid drug expendi-27tures from exceeding the limitation imposed by subdivision two of this28section, in which case such notice to the legislature may be less than29thirty days.] 30 (b) The commissioner shall be authorized to take the actions described 31 in paragraph (a) of this subdivision [only so long as total Medicaid32drug expenditures are projected to exceed the annual growth limitation33imposed by subdivision two of this section]. In addition, no such 34 actions shall be deemed to supersede the provisions of paragraph (b) of 35 subdivision three of section two hundred seventy-three of this article 36 or the provisions of subdivisions twenty-five and twenty-five-a of 37 section three hundred sixty-four-j of the social services law[, except38as allowed by paragraph (c) of subdivision five of this section]; 39 provided further that nothing in this section shall prevent access by a 40 Medicaid recipient to a drug which is the only treatment for a partic- 41 ular disease or condition. 42 [8.] 7. The commissioner, upon request of the chair of the drug utili- 43 zation review board, shall provide a report [by July first annually to44the drug utilization review board] on savings achieved through the drug 45 cap in the last fiscal year. Such report shall provide data on what 46 savings were achieved [through actions pursuant to subdivisions three,47five and seven of this section, respectively, and what savings were48achieved through other means] and how such savings were calculated and 49 implemented. 50 § 5. Paragraph (e) of subdivision 7 of section 367-a of the social 51 services law, as amended by section 1 of part GG of chapter 56 of the 52 laws of 2020, the opening paragraph as amended by section 24 of part B 53 of chapter 57 of the laws of 2023, is amended to read as follows: 54 (e) During the period from April first, two thousand fifteen through 55 March thirty-first, two thousand twenty-six, the commissioner may, in 56 lieu of a managed care provider or pharmacy benefit manager, negotiateS. 8307 39 A. 8807 1 directly and enter into an arrangement with a pharmaceutical manufactur- 2 er for the provision of supplemental rebates relating to pharmaceutical 3 utilization by enrollees of managed care providers pursuant to section 4 three hundred sixty-four-j of this title and may also negotiate directly 5 and enter into such an agreement relating to pharmaceutical utilization 6 by medical assistance recipients not so enrolled. Such rebate arrange- 7 ments shall be limited to the following: antiretrovirals approved by the 8 FDA for the treatment of HIV/AIDS, accelerated approval drugs estab- 9 lished pursuant to subparagraph (ix) of this paragraph, opioid depend- 10 ence agents and opioid antagonists listed in a statewide formulary 11 established pursuant to subparagraph (vii) of this paragraph, hepatitis 12 C agents, high cost drugs as provided for in subparagraph (viii) of this 13 paragraph, gene therapies as provided for in subparagraph (ix) of this 14 paragraph, and any other class or drug designated by the commissioner 15 for which the pharmaceutical manufacturer has in effect a rebate 16 arrangement with the federal secretary of health and human services 17 pursuant to 42 U.S.C. § 1396r-8, and for which the state has established 18 standard clinical criteria. No agreement entered into pursuant to this 19 paragraph shall have an initial term or be extended beyond the expira- 20 tion or repeal of this paragraph. 21 (i) The manufacturer shall not enter into any rebate arrangements with 22 a managed care provider, or any of a managed care provider's agents, 23 including but not limited to any pharmacy benefit manager on the gene 24 therapy, drug, or drug classes subject to this paragraph when the state 25 has a rebate arrangement in place and standard clinical criteria are 26 imposed on the managed care provider. 27 (ii) The commissioner shall establish adequate rates of reimbursement 28 which shall take into account both the impact of the commissioner nego- 29 tiating such arrangements and any limitations imposed on the managed 30 care provider's ability to establish clinical criteria relating to the 31 utilization of such drugs. In developing the managed care provider's 32 reimbursement rate, the commissioner shall identify the amount of 33 reimbursement for such drugs as a separate and distinct component from 34 the reimbursement otherwise made for prescription drugs as prescribed by 35 this section. 36 (iii) [The commissioner shall submit a report to the temporary presi-37dent of the senate and the speaker of the assembly annually by December38thirty-first. The report shall analyze the adequacy of rates to managed39care providers for drug expenditures related to the classes under this40paragraph.41(iv)] Nothing in this paragraph shall be construed to require a phar- 42 maceutical manufacturer to enter into a rebate arrangement satisfactory 43 to the commissioner relating to pharmaceutical utilization by enrollees 44 of managed care providers pursuant to section three hundred sixty-four-j 45 of this title or relating to pharmaceutical utilization by medical 46 assistance recipients not so enrolled. 47 [(v)] (iv) All clinical criteria, including requirements for prior 48 approval, and all utilization review determinations established by the 49 state as described in this paragraph for the gene therapies, drugs, or 50 drug classes subject to this paragraph shall be developed using 51 evidence-based and peer-reviewed clinical review criteria in accordance 52 with article two-A of the public health law, as applicable. 53 [(vi)] (v) All prior authorization and utilization review determi- 54 nations related to the coverage of any drug subject to this paragraph 55 shall be subject to article forty-nine of the public health law, section 56 three hundred sixty-four-j of this title, and article forty-nine of theS. 8307 40 A. 8807 1 insurance law, as applicable. Nothing in this paragraph shall diminish 2 any rights relating to access, prior authorization, or appeal relating 3 to any drug class or drug afforded to a recipient under any other 4 provision of law. 5 [(vii)] (vi) The department shall publish a statewide formulary of 6 opioid dependence agents and opioid antagonists, which shall include as 7 "preferred drugs" all drugs in such classes, which shall include all 8 subclasses of a given drug that have a different pharmacological route 9 of administration, provided that: 10 (A) for all drugs that are included as of the date of the enactment of 11 this subparagraph on a formulary of a managed care provider, as defined 12 in section three hundred sixty-four-j of this title, or in the Medicaid 13 fee-for-service preferred drug program pursuant to section two hundred 14 seventy-two of the public health law, the cost to the department for 15 such drug is equal to or less than the lowest cost paid for the drug by 16 any managed care provider or by the Medicaid fee-for-service program 17 after the application of any rebates, as of the date that the department 18 implements the statewide formulary established by this subparagraph. 19 Where there is a generic version of the drug approved by the Food and 20 Drug Administration as bioequivalent to a brand name drug pursuant to 21 21 U.S.C. § 355(j)(8)(B), the cost to the department for the brand and 22 generic versions shall be equal to or less than the lower of the two 23 maximum costs determined pursuant to the previous sentence; and 24 (B) for all drugs that are not included as of the date of the enact- 25 ment of this subparagraph on a formulary of a managed care provider, as 26 defined in section three hundred sixty-four-j of this title, or in the 27 Medicaid fee-for-service preferred drug program pursuant to section two 28 hundred seventy-two of the public health law, the department is able to 29 obtain the drug at a cost that is equal to or less than the lowest cost 30 to the department of other comparable drugs in the class, after the 31 application of any rebates. Where there is a generic version of the drug 32 approved by the Food and Drug Administration as bioequivalent to a brand 33 name drug pursuant to 21 U.S.C. § 355(j)(8)(B), the cost to the depart- 34 ment for the brand and generic versions shall be equal to or less than 35 the lower of the two maximum costs determined pursuant to the previous 36 sentence. 37 [(viii)] (vii) The commissioner may identify and refer high cost 38 drugs, as defined in clause (D) of this subparagraph, that are not 39 included as of the date of the enactment of this subparagraph on a 40 formulary of a managed care provider or covered by the Medicaid fee for 41 service of program to the drug utilization review board established by 42 section three hundred sixty-nine-bb of this article for a recommendation 43 as to whether a target supplemental Medicaid rebate should be paid by 44 the manufacturer of the drug to the department and the target amount of 45 the rebate. 46 (A) If the commissioner intends to refer a high cost drug to the drug 47 utilization review board pursuant to this subparagraph, the commissioner 48 shall notify the manufacturer of such drug and shall attempt to reach 49 agreement with the manufacturer on a rebate arrangement satisfactory to 50 the commissioner for the drug prior to referring the drug to the drug 51 utilization review board for review. Such arrangement may be based on 52 evidence based research, including, but not limited to, such research 53 operated or conducted by or for other state governments, the federal 54 government, the governments of other nations, and third party payers or 55 multi-state coalitions, provided however that the department shall 56 account for the effectiveness of the drug in treating the conditions forS. 8307 41 A. 8807 1 which it is prescribed or in improving a patient's health, quality of 2 life, or overall health outcomes, and the likelihood that use of the 3 drug will reduce the need for other medical care, including hospitaliza- 4 tion. 5 (B) In the event that the commissioner and the manufacturer have 6 previously agreed to a rebate arrangement for a drug pursuant to this 7 paragraph, the drug shall not be referred to the drug utilization review 8 board for any further rebate agreement for the duration of the previous 9 rebate agreement, provided however, the commissioner may refer a drug to 10 the drug utilization review board if the commissioner determines there 11 are significant and substantiated utilization or market changes, new 12 evidence-based research, or statutory or federal regulatory changes that 13 warrant additional rebates. In such cases, the department shall notify 14 the manufacturer and provide evidence of the changes or research that 15 would warrant additional rebates, and shall attempt to reach agreement 16 with the manufacturer on a rebate for the drug prior to referring the 17 drug to the drug utilization review board for review. 18 (C) If the commissioner is unsuccessful in entering into a rebate 19 arrangement with the manufacturer of the drug satisfactory to the 20 department, the drug manufacturer shall in that event be required to 21 provide to the department, on a standard reporting form developed by the 22 department, the information as described in paragraph (e) of subdivision 23 [six] three of section two hundred eighty of the public health law. All 24 information disclosed pursuant to this clause shall be considered confi- 25 dential and shall not be disclosed by the department in a form that 26 identifies a specific manufacturer or prices charged for drugs by such 27 manufacturer. 28 (D) For the purposes of this subparagraph, the term "high cost drug" 29 shall mean a brand name drug or biologic that has a launch wholesale 30 acquisition cost of thirty thousand dollars or more per year or course 31 of treatment, or a biosimilar drug that has a launch wholesale acquisi- 32 tion cost that is not at least fifteen percent lower than the referenced 33 brand biologic at the time the biosimilar is launched, or a generic drug 34 that has a wholesale acquisition cost of one hundred dollars or more for 35 a thirty day supply or recommended dosage approved for labeling by the 36 federal Food and Drug Administration, or a brand name drug or biologic 37 that has a wholesale acquisition cost increase of three thousand dollars 38 or more in any twelve-month period, or course of treatment if less than 39 twelve months. 40 [(ix)] (viii) For purposes of this paragraph, a "gene therapy" is a 41 drug (A) approved under section 505 of the Federal Food, Drug and 42 Cosmetics Act or licensed under subsection (a) or (k) of section 351 of 43 the Public Health Services Act; (B) that treats a rare disease or condi- 44 tion, as defined in 21 USC § 360bb(a)(2), that is life-threatening, as 45 defined in 42 CFR 321.18; (C) is considered a gene therapy by the feder- 46 al Food and Drug Administration for which a biologics license pursuant 47 to 21 CFR 600-680 is held; (D) if administered in accordance with the 48 labeling of such drug, is expected to result in either the cure of such 49 disease or condition or a reduction in the symptoms of such disease or 50 condition that materially improves the patient's length or quality of 51 life; and (E) is expected to achieve the result described in clause (D) 52 of this subparagraph after not more than three administrations. 53 (ix) For purposes of this paragraph, an "accelerated approval" is a 54 drug or labeled indication of a drug authorized by the Federal Food, 55 Drug and Cosmetic Act for drugs for serious conditions that fill an 56 unmet medical need based on whether the drug has an effect on a surro-S. 8307 42 A. 8807 1 gate clinical endpoint, and contingent upon verification of clinical 2 benefit in confirmatory trials. 3 § 6. Paragraph (g) of subdivision 2 of section 365-a of the social 4 services law, as amended by section 21 of part A of chapter 56 of the 5 laws of 2013, is amended to read as follows: 6 (g) sickroom supplies, eyeglasses, prosthetic appliances and dental 7 prosthetic appliances furnished in accordance with the regulations of 8 the department; provided further that: (i) the commissioner of health is 9 authorized to implement a preferred diabetic supply program wherein the 10 department of health will receive enhanced rebates from preferred 11 manufacturers [of] for products and supplies, including but not limited 12 to, glucometers and test strips, and may subject non-preferred manufac- 13 turers' products and supplies, including but not limited to, glucometers 14 and test strips to prior authorization under section two hundred seven- 15 ty-three of the public health law; (ii) enteral formula therapy and 16 nutritional supplements are limited to coverage only for nasogastric, 17 jejunostomy, or gastrostomy tube feeding, for treatment of an inborn 18 metabolic disorder, or to address growth and development problems in 19 children, or, subject to standards established by the commissioner, for 20 persons with a diagnosis of HIV infection, AIDS or HIV-related illness 21 or other diseases and conditions; (iii) prescription footwear and 22 inserts are limited to coverage only when used as an integral part of a 23 lower limb orthotic appliance, as part of a diabetic treatment plan, or 24 to address growth and development problems in children; (iv) compression 25 and support stockings are limited to coverage only for pregnancy or 26 treatment of venous stasis ulcers; and (v) the commissioner of health is 27 authorized to implement an incontinence supply utilization management 28 program to reduce costs without limiting access through the existing 29 provider network, including but not limited to single or multiple source 30 contracts or, a preferred incontinence supply program wherein the 31 department of health will receive enhanced rebates from preferred 32 manufacturers of incontinence supplies, and may subject non-preferred 33 manufacturers' incontinence supplies to prior approval pursuant to regu- 34 lations of the department, provided any necessary approvals under feder- 35 al law have been obtained to receive federal financial participation in 36 the costs of incontinence supplies provided pursuant to this subpara- 37 graph; 38 § 7. The public health law is amended by adding a new section 280-d to 39 read as follows: 40 § 280-d. Pharmacy cost reporting. 1. The department shall develop and 41 implement a cost reporting program for licensed pharmacies that partic- 42 ipate in the Medicaid program. Such program shall include a requirement 43 to submit an annual cost report on a form designated by the department. 44 Information shall include, but not be limited to, costs incurred during 45 procurement and dispensing of prescription drugs. 46 2. Such cost reports are subject to audit. In the event that any 47 information or data which a pharmacy has submitted to the department, on 48 the required reporting forms is inaccurate or incorrect, such pharmacy 49 shall within fifteen business days, submit to the department a 50 correction of such information or data. 51 3. Timely filing of such report is a requirement of participation in 52 the Medicaid pharmacy program. In the event that a pharmacy fails to 53 file the required reports on or before the required due date, such phar- 54 macy may be subject to removal as a provider from the fee-for-service 55 pharmacy program.S. 8307 43 A. 8807 1 § 8. Paragraphs (a), (b) and (c) of subdivision 9 of section 367-a of 2 the social services law, paragraphs (a) and (c) as amended by chapter 19 3 of the laws of 1998, paragraph (b) as amended by section 3 of part C of 4 chapter 58 of the laws of 2004, subparagraphs (i) and (ii) of paragraph 5 (b) as amended by section 7 of part D of chapter 57 of the laws of 2017, 6 and subparagraph (iii) of paragraph (b) as added by section 29 of part E 7 of chapter 63 of the laws of 2005, are amended to read as follows: 8 (a) for drugs provided by medical practitioners and claimed separately 9 by the practitioners[, the actual cost of the drugs to the practition-10ers; and] the lower of: 11 (i) (1) an amount equal to the national average drug acquisition cost 12 set by the federal centers for medicare and medicaid services for the 13 drug, if any, or if such amount is not available, the wholesale acquisi- 14 tion cost of the drug based on the package size dispensed from, as 15 reported by the prescription drug pricing service used by the depart- 16 ment, (2) the federal upper limit, if any, established by the federal 17 centers for medicare and medicaid services; (3) the state maximum acqui- 18 sition cost, if any, established pursuant to paragraph (e) of this 19 subdivision; or (4) the actual cost of the drug to the practitioner. 20 (ii) Notwithstanding subparagraph (i) and paragraph (e) of this subdi- 21 vision, if a drug has been purchased from a manufacturer by a covered 22 entity pursuant to section 340B of the federal public health service act 23 (42 USCA § 256b), the actual amount paid by such covered entity. For 24 purposes of this subparagraph, a "covered entity" is an entity that 25 meets the requirements of paragraph four of subsection (a) of such 26 section, that elects to participate in the program established by such 27 section, and that causes claims for payment for drugs covered by this 28 subparagraph to be submitted to the medical assistance program, either 29 directly or through an authorized contract pharmacy. No medical assist- 30 ance payments may be made to a covered entity or to an authorized 31 contract pharmacy of a covered entity for drugs that are eligible for 32 purchase under the section 340B program and are dispensed on an outpa- 33 tient basis to patients of the covered entity, other than under the 34 provisions of this subparagraph. 35 (b) for drugs dispensed by pharmacies: 36 (i) (A) if the drug dispensed is a generic prescription drug, the 37 lower of: (1) an amount equal to the national average drug acquisition 38 cost set by the federal centers for medicare and medicaid services for 39 the drug, if any, or if such amount if not available, the wholesale 40 acquisition cost of the drug based on the package size dispensed from, 41 as reported by the prescription drug pricing service used by the depart- 42 ment, less seventeen and one-half percent thereof; (2) the federal upper 43 limit, if any, established by the federal centers for medicare and medi- 44 caid services; (3) the state maximum acquisition cost, if any, estab- 45 lished pursuant to paragraph (e) of this subdivision; or (4) the 46 dispensing pharmacy's usual and customary price charged to the general 47 public; (B) if the drug dispensed is available without a prescription as 48 required by section sixty-eight hundred ten of the education law but is 49 reimbursed as an item of medical assistance pursuant to paragraph (a) of 50 subdivision four of section three hundred sixty-five-a of this title, 51 the lower of (1) an amount equal to the national average drug acquisi- 52 tion cost set by the federal centers for medicare and medicaid services 53 for the drug, if any, or if such amount is not available, the wholesale 54 acquisition cost of the drug based on the package size dispensed from, 55 as reported by the prescription drug pricing service used by the depart- 56 ment, (2) the federal upper limit, if any, established by the federalS. 8307 44 A. 8807 1 centers for medicare and medicaid services; (3) the state maximum acqui- 2 sition cost if any, established pursuant to paragraph (e) of this subdi- 3 vision; or (4) the dispensing pharmacy's usual and customary price 4 charged to the general public; 5 (ii) if the drug dispensed is a brand-name prescription drug, the 6 lower of: 7 (A) an amount equal to the national average drug acquisition cost set 8 by the federal centers for medicare and medicaid services for the drug, 9 if any, or if such amount is not available, the wholesale acquisition 10 cost of the drug based on the package size dispensed from, as reported 11 by the prescription drug pricing service used by the department[, less12three and three-tenths percent thereof]; or (B) the dispensing pharma- 13 cy's usual and customary price charged to the general public; and 14 (iii) notwithstanding subparagraphs (i) and (ii) of this paragraph and 15 paragraphs (d) and (e) of this subdivision, if the drug dispensed is a 16 drug that has been purchased from a manufacturer by a covered entity 17 pursuant to section 340B of the federal public health service act (42 18 USCA § 256b), the actual amount paid by such covered entity pursuant to 19 such section, plus the reasonable administrative costs, as determined by 20 the commissioner, incurred by the covered entity or by an authorized 21 contract pharmacy in connection with the purchase and dispensing of such 22 drug and the tracking of such transactions. For purposes of this subpar- 23 agraph, a "covered entity" is an entity that meets the requirements of 24 paragraph four of subsection (a) of such section, that elects to partic- 25 ipate in the program established by such section, and that causes claims 26 for payment for drugs covered by this subparagraph to be submitted to 27 the medical assistance program, either directly or through an authorized 28 contract pharmacy. No medical assistance payments may be made to a 29 covered entity or to an authorized contract pharmacy of a covered entity 30 for drugs that are eligible for purchase under the section 340B program 31 and are dispensed on an outpatient basis to patients of the covered 32 entity, other than under the provisions of this subparagraph. Pharmacies 33 submitting claims for reimbursement of drugs purchased pursuant to 34 section 340B of the public health service act shall notify the depart- 35 ment that the claim is eligible for purchase under the 340B program, 36 consistent with claiming instructions issued by the department to iden- 37 tify such claims. 38 (c) Notwithstanding subparagraph (i) of paragraph (b) of this subdivi- 39 sion, if a qualified prescriber certifies "brand medically necessary" or 40 "brand necessary" in his or her own handwriting directly on the face of 41 a prescription, or in the case of electronic prescriptions, inserts an 42 electronic direction to clarify "brand medically necessary" or "brand 43 necessary", for a multiple source drug for which a specific upper limit 44 of reimbursement has been established by the federal agency, in addition 45 to writing "d a w" in the box provided for such purpose on the 46 prescription form, payment under this title for such drug must be made 47 under the provisions of subparagraph (ii) of such paragraph. 48 § 9. This act shall take effect October 1, 2024; provided that 49 sections two and three of this act shall take effect January 1, 2025; 50 and provided however, that the amendments to paragraph (e) of subdivi- 51 sion 7 of section 367-a of the social services law made by section five 52 of this act shall not affect the repeal of such paragraph and shall be 53 deemed repealed therewith provided, further, that the amendments to 54 subdivision 9 of section 367-a of the social services law made by 55 section eight of this act shall not affect the expiration of such subdi-S. 8307 45 A. 8807 1 vision pursuant to section 4 of chapter 19 of the laws of 1998, as 2 amended, and shall expire therewith. 3 PART J 4 Section 1. The title heading of title 11-D of article 5 of the social 5 services law, as amended by section 1 of part H of chapter 57 of the 6 laws of 2021, is amended to read as follows: 7 [BASIC HEALTH PROGRAM] ESSENTIAL PLAN 8 § 2. Section 3 of part H of chapter 57 of the laws of 2021, amending 9 the social services law relating to eliminating consumer-paid premium 10 payments in the basic health program, is amended to read as follows: 11 § 3. This act shall take effect June 1, 2021 [and]; provided, however, 12 section two of this act shall expire and be deemed repealed should 13 federal approval be withdrawn or 42 U.S.C. 18051 be repealed; provided 14 that the commissioner of health shall notify the legislative bill draft- 15 ing commission upon the withdrawal of federal approval or the repeal of 16 42 U.S.C. 18051 in order that the commission may maintain an accurate 17 and timely effective data base of the official text of the laws of the 18 state of New York in furtherance of effectuating the provisions of 19 section 44 of the legislative law and section 70-b of the public offi- 20 cers law. 21 § 3. Subdivisions (b) and (c) of section 8 of part BBB of chapter 56 22 of the laws of 2022, amending the public health law and other laws 23 relating to permitting the commissioner of health to submit a waiver 24 that expands eligibility for New York's basic health program and 25 increases the federal poverty limit cap for basic health program eligi- 26 bility from two hundred to two hundred fifty percent, are amended to 27 read as follows: 28 (b) section four of this act shall expire and be deemed repealed 29 December 31, [2024] 2025; provided, however, the amendments to paragraph 30 (c) of subdivision 1 of section 369-gg of the social services law made 31 by such section of this act shall be subject to the expiration and 32 reversion of such paragraph pursuant to section 2 of part H of chapter 33 57 of the laws of 2021 when upon such date, the provisions of section 34 five of this act shall take effect; provided, however, the amendments to 35 such paragraph made by section five of this act shall expire and be 36 deemed repealed December 31, [2024] 2025; 37 (c) section six of this act shall take effect January 1, [2025] 2026; 38 provided, however, the amendments to paragraph (c) of subdivision 1 of 39 section 369-gg of the social services law made by such section of this 40 act shall be subject to the expiration and reversion of such paragraph 41 pursuant to section 2 of part H of chapter 57 of the laws of 2021 when 42 upon such date, the provisions of section seven of this act shall take 43 effect; and 44 § 4. Paragraph (a) of subdivision 1 of section 268-c of the public 45 health law, as added by section 2 of part T of chapter 57 of the laws of 46 2019, is amended to read as follows: 47 (a) Perform eligibility determinations for federal and state insurance 48 affordability programs including medical assistance in accordance with 49 section three hundred sixty-six of the social services law, child health 50 plus in accordance with section twenty-five hundred eleven of this chap- 51 ter, the basic health program in accordance with section three hundred 52 sixty-nine-gg of the social services law, the 1332 state innovation 53 program in accordance with section three hundred sixty-nine-ii of the 54 social services law, premium tax credits and cost-sharing reductions andS. 8307 46 A. 8807 1 qualified health plans in accordance with applicable law and other 2 health insurance programs as determined by the commissioner; 3 § 5. Subdivision 16 of section 268-c of the public health law, as 4 added by section 2 of part T of chapter 57 of the laws of 2019, is 5 amended to read as follows: 6 16. In accordance with applicable federal and state law, inform indi- 7 viduals of eligibility requirements for the Medicaid program under title 8 XIX of the social security act and the social services law, the chil- 9 dren's health insurance program (CHIP) under title XXI of the social 10 security act and this chapter, the basic health program under section 11 three hundred sixty-nine-gg of the social services law, the 1332 state 12 innovation program in accordance with section three hundred sixty-nine- 13 ii of the social services law, or any applicable state or local public 14 health insurance program and if, through screening of the application by 15 the Marketplace, the Marketplace determines that such individuals are 16 eligible for any such program, enroll such individuals in such program. 17 § 6. Section 268-c of the public health law is amended by adding a new 18 subdivision 26 to read as follows: 19 26. Subject to federal approval if required, the use of state funds 20 and the availability of funds in the 1332 state innovation program fund 21 established pursuant to section ninety-eight-d of the state finance law, 22 the commissioner shall have the authority to establish a program to 23 provide subsidies for the payment of premium or cost sharing or both to 24 assist individuals who are eligible to purchase qualified health plans 25 through the marketplace, or take such other action as appropriate to 26 reduce or eliminate qualified health plan premiums or cost-sharing or 27 both. 28 § 7. Subparagraph (i) of paragraph (a) of subdivision 4 of section 29 268-e of the public health law, as added by section 2 of part T of chap- 30 ter 57 of the laws of 2019, is amended to read as follows: 31 (i) An initial determination of eligibility, including: 32 (A) eligibility to enroll in a qualified health plan; 33 (B) eligibility for Medicaid; 34 (C) eligibility for Child Health Plus; 35 (D) eligibility for the Basic Health Program; 36 (E) eligibility for the 1332 state innovation program; 37 (F) the amount of advance payments of the premium tax credit and level 38 of cost-sharing reductions; 39 [(F)] (G) the amount of any other subsidy that may be available under 40 law; and 41 [(G)] (H) eligibility for such other health insurance programs as 42 determined by the commissioner; and 43 § 8. This act shall take effect immediately and shall be deemed to 44 have been in full force and effect on and after April 1, 2024; provided, 45 however, that sections four, five, six, and seven of this act shall take 46 effect January 1, 2025; provided, further, that section six of this act 47 shall only take effect upon the commissioner of health obtaining and 48 maintaining all necessary approvals from the secretary of health and 49 human services and the secretary of the treasury based on an amended 50 application for a waiver for state innovation pursuant to section 1332 51 of the patient protection and affordable care act (P.L. 111-148) and 52 subdivision 25 of section 268-c of the public health law; and provided, 53 further, that the commissioner of health shall notify the legislative 54 bill drafting commission upon the occurrence of the enactment of the 55 legislation provided for in section six of this act in order that the 56 commission may maintain an accurate and timely effective data base ofS. 8307 47 A. 8807 1 the official text of the laws of the state of New York in furtherance of 2 effectuating the provisions of section 44 of the legislative law and 3 section 70-b of the public officers law. 4 PART K 5 Section 1. Paragraph (a) of subdivision 1 of section 18 of chapter 266 6 of the laws of 1986, amending the civil practice law and rules and other 7 laws relating to malpractice and professional medical conduct, as 8 amended by section 1 of part F of chapter 57 of the laws of 2023, is 9 amended and a new subdivision 9 is added to read as follows: 10 (a) The superintendent of financial services and the commissioner of 11 health or their designee shall, from funds available in the hospital 12 excess liability pool created pursuant to subdivision 5 of this section, 13 purchase a policy or policies for excess insurance coverage, as author- 14 ized by paragraph 1 of subsection (e) of section 5502 of the insurance 15 law; or from an insurer, other than an insurer described in section 5502 16 of the insurance law, duly authorized to write such coverage and actual- 17 ly writing medical malpractice insurance in this state; or shall 18 purchase equivalent excess coverage in a form previously approved by the 19 superintendent of financial services for purposes of providing equiv- 20 alent excess coverage in accordance with section 19 of chapter 294 of 21 the laws of 1985, for medical or dental malpractice occurrences between 22 July 1, 1986 and June 30, 1987, between July 1, 1987 and June 30, 1988, 23 between July 1, 1988 and June 30, 1989, between July 1, 1989 and June 24 30, 1990, between July 1, 1990 and June 30, 1991, between July 1, 1991 25 and June 30, 1992, between July 1, 1992 and June 30, 1993, between July 26 1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995, 27 between July 1, 1995 and June 30, 1996, between July 1, 1996 and June 28 30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998 29 and June 30, 1999, between July 1, 1999 and June 30, 2000, between July 30 1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002, 31 between July 1, 2002 and June 30, 2003, between July 1, 2003 and June 32 30, 2004, between July 1, 2004 and June 30, 2005, between July 1, 2005 33 and June 30, 2006, between July 1, 2006 and June 30, 2007, between July 34 1, 2007 and June 30, 2008, between July 1, 2008 and June 30, 2009, 35 between July 1, 2009 and June 30, 2010, between July 1, 2010 and June 36 30, 2011, between July 1, 2011 and June 30, 2012, between July 1, 2012 37 and June 30, 2013, between July 1, 2013 and June 30, 2014, between July 38 1, 2014 and June 30, 2015, between July 1, 2015 and June 30, 2016, 39 between July 1, 2016 and June 30, 2017, between July 1, 2017 and June 40 30, 2018, between July 1, 2018 and June 30, 2019, between July 1, 2019 41 and June 30, 2020, between July 1, 2020 and June 30, 2021, between July 42 1, 2021 and June 30, 2022, between July 1, 2022 and June 30, 2023, [and] 43 between July 1, 2023 and June 30, 2024, and between July 1, 2024 and 44 June 30, 2025 or reimburse the hospital where the hospital purchases 45 equivalent excess coverage as defined in subparagraph (i) of paragraph 46 (a) of subdivision 1-a of this section for medical or dental malpractice 47 occurrences between July 1, 1987 and June 30, 1988, between July 1, 1988 48 and June 30, 1989, between July 1, 1989 and June 30, 1990, between July 49 1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992, 50 between July 1, 1992 and June 30, 1993, between July 1, 1993 and June 51 30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995 52 and June 30, 1996, between July 1, 1996 and June 30, 1997, between July 53 1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999, 54 between July 1, 1999 and June 30, 2000, between July 1, 2000 and JuneS. 8307 48 A. 8807 1 30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002 2 and June 30, 2003, between July 1, 2003 and June 30, 2004, between July 3 1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006, 4 between July 1, 2006 and June 30, 2007, between July 1, 2007 and June 5 30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009 6 and June 30, 2010, between July 1, 2010 and June 30, 2011, between July 7 1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, 8 between July 1, 2013 and June 30, 2014, between July 1, 2014 and June 9 30, 2015, between July 1, 2015 and June 30, 2016, between July 1, 2016 10 and June 30, 2017, between July 1, 2017 and June 30, 2018, between July 11 1, 2018 and June 30, 2019, between July 1, 2019 and June 30, 2020, 12 between July 1, 2020 and June 30, 2021, between July 1, 2021 and June 13 30, 2022, between July 1, 2022 and June 30, 2023, [and] between July 1, 14 2023 and June 30, 2024, and between July 1, 2024 and June 30, 2025 for 15 physicians or dentists certified as eligible for each such period or 16 periods pursuant to subdivision 2 of this section by a general hospital 17 licensed pursuant to article 28 of the public health law; provided that 18 no single insurer shall write more than fifty percent of the total 19 excess premium for a given policy year; and provided, however, that such 20 eligible physicians or dentists must have in force an individual policy, 21 from an insurer licensed in this state of primary malpractice insurance 22 coverage in amounts of no less than one million three hundred thousand 23 dollars for each claimant and three million nine hundred thousand 24 dollars for all claimants under that policy during the period of such 25 excess coverage for such occurrences or be endorsed as additional 26 insureds under a hospital professional liability policy which is offered 27 through a voluntary attending physician ("channeling") program previous- 28 ly permitted by the superintendent of financial services during the 29 period of such excess coverage for such occurrences. During such period, 30 such policy for excess coverage or such equivalent excess coverage 31 shall, when combined with the physician's or dentist's primary malprac- 32 tice insurance coverage or coverage provided through a voluntary attend- 33 ing physician ("channeling") program, total an aggregate level of two 34 million three hundred thousand dollars for each claimant and six million 35 nine hundred thousand dollars for all claimants from all such policies 36 with respect to occurrences in each of such years provided, however, if 37 the cost of primary malpractice insurance coverage in excess of one 38 million dollars, but below the excess medical malpractice insurance 39 coverage provided pursuant to this act, exceeds the rate of nine percent 40 per annum, then the required level of primary malpractice insurance 41 coverage in excess of one million dollars for each claimant shall be in 42 an amount of not less than the dollar amount of such coverage available 43 at nine percent per annum; the required level of such coverage for all 44 claimants under that policy shall be in an amount not less than three 45 times the dollar amount of coverage for each claimant; and excess cover- 46 age, when combined with such primary malpractice insurance coverage, 47 shall increase the aggregate level for each claimant by one million 48 dollars and three million dollars for all claimants; and provided 49 further, that, with respect to policies of primary medical malpractice 50 coverage that include occurrences between April 1, 2002 and June 30, 51 2002, such requirement that coverage be in amounts no less than one 52 million three hundred thousand dollars for each claimant and three 53 million nine hundred thousand dollars for all claimants for such occur- 54 rences shall be effective April 1, 2002. 55 (9) This subdivision shall apply only to excess insurance coverage or 56 equivalent excess coverage for physicians or dentists that is eligibleS. 8307 49 A. 8807 1 to be paid for from funds available in the hospital excess liability 2 pool. 3 (a) Notwithstanding any law to the contrary, for any policy period 4 beginning on or after July 1, 2023, excess coverage shall be purchased 5 by a physician or dentist directly from a provider of excess insurance 6 coverage or equivalent excess coverage. At the conclusion of the policy 7 period the superintendent of financial services and the commissioner of 8 health or their designee shall, from funds available in the hospital 9 excess liability pool created pursuant to subdivision 5 of this section, 10 pay fifty percent of the premium to the provider of excess insurance 11 coverage or equivalent excess coverage, and the remaining fifty percent 12 shall be paid one year thereafter. 13 (b) Notwithstanding any law to the contrary, for any policy period 14 beginning on or after July 1, 2024, excess coverage shall be purchased 15 by a physician or dentist directly from a provider of excess insurance 16 coverage or equivalent excess coverage. Such provider of excess insur- 17 ance coverage or equivalent excess coverage shall bill, in a manner 18 consistent with paragraph (f) of this subdivision, the physician or 19 dentist for an amount equal to fifty percent of the premium for such 20 coverage, as established pursuant to paragraph (d) of this subdivision, 21 during the policy period. At the conclusion of the policy period the 22 superintendent of financial services and the commissioner of health or 23 their designee shall, from funds available in the hospital excess 24 liability pool created pursuant to subdivision 5 of this section, pay 25 half of the remaining fifty percent of the premium to the provider of 26 excess insurance coverage or equivalent excess coverage, and the remain- 27 ing twenty-five percent shall be paid one year thereafter. If the funds 28 available in the hospital excess liability pool are insufficient to meet 29 the percent of the costs of the excess coverage, the provisions of 30 subdivision 8 of this section shall apply. 31 (c) If at the conclusion of the policy period, a physician or dentist, 32 eligible for excess coverage paid for from funds available in the hospi- 33 tal excess liability pool, has failed to pay an amount equal to fifty 34 percent of the premium as established pursuant to paragraph (d) of this 35 subdivision, such excess coverage shall be cancelled and shall be null 36 and void as of the first day on or after the commencement of a policy 37 period where the liability for payment pursuant to this subdivision has 38 not been met. The provider of excess coverage shall remit any portion of 39 premium paid by the eligible physician or dentist for such a policy 40 period. 41 (d) The superintendent of financial services shall establish a rate 42 consistent with subdivision 3 of this section that providers of excess 43 insurance coverage or equivalent excess coverage will charge for such 44 coverage for each policy period. For the policy period beginning July 1, 45 2024, the superintendent of financial services may direct that the 46 premium for that policy period be the same as it was for the policy 47 period that concluded June 30, 2023. 48 (e) No provider of excess insurance coverage or equivalent excess 49 coverage shall issue excess coverage to which this subdivision applies 50 to any physician or dentist unless that physician or dentist meets the 51 eligibility requirements for such coverage set forth in this section. 52 The superintendent of financial services and the commissioner of health 53 or their designee shall not make any payment under this subdivision to a 54 provider of excess insurance coverage or equivalent excess coverage for 55 excess coverage issued to a physician or dentist who does not meet theS. 8307 50 A. 8807 1 eligibility requirements for participation in the hospital excess 2 liability pool program set forth in this section. 3 (f) A provider of excess insurance coverage or equivalent coverage 4 that issues excess coverage under this subdivision shall bill the physi- 5 cian or dentist for the portion of the premium required under paragraph 6 (a) of this subdivision in twelve equal monthly installments or in such 7 other manner as the physician or dentist may agree. 8 (g) The superintendent of financial services in consultation with the 9 commissioner of health may promulgate regulations giving effect to the 10 provisions of this subdivision. 11 § 2. Subdivision 3 of section 18 of chapter 266 of the laws of 1986, 12 amending the civil practice law and rules and other laws relating to 13 malpractice and professional medical conduct, as amended by section 2 of 14 part F of chapter 57 of the laws of 2023, is amended to read as follows: 15 (3)(a) The superintendent of financial services shall determine and 16 certify to each general hospital and to the commissioner of health the 17 cost of excess malpractice insurance for medical or dental malpractice 18 occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988 19 and June 30, 1989, between July 1, 1989 and June 30, 1990, between July 20 1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992, 21 between July 1, 1992 and June 30, 1993, between July 1, 1993 and June 22 30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995 23 and June 30, 1996, between July 1, 1996 and June 30, 1997, between July 24 1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999, 25 between July 1, 1999 and June 30, 2000, between July 1, 2000 and June 26 30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002 27 and June 30, 2003, between July 1, 2003 and June 30, 2004, between July 28 1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006, 29 between July 1, 2006 and June 30, 2007, between July 1, 2007 and June 30 30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009 31 and June 30, 2010, between July 1, 2010 and June 30, 2011, between July 32 1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, 33 between July 1, 2013 and June 30, 2014, between July 1, 2014 and June 34 30, 2015, between July 1, 2015 and June 30, 2016, between July 1, 2016 35 and June 30, 2017, between July 1, 2017 and June 30, 2018, between July 36 1, 2018 and June 30, 2019, between July 1, 2019 and June 30, 2020, 37 between July 1, 2020 and June 30, 2021, between July 1, 2021 and June 38 30, 2022, between July 1, 2022 and June 30, 2023, [and] between July 1, 39 2023 and June 30, 2024, and between July 1, 2024 and June 30, 2025 allo- 40 cable to each general hospital for physicians or dentists certified as 41 eligible for purchase of a policy for excess insurance coverage by such 42 general hospital in accordance with subdivision 2 of this section, and 43 may amend such determination and certification as necessary. 44 (b) The superintendent of financial services shall determine and 45 certify to each general hospital and to the commissioner of health the 46 cost of excess malpractice insurance or equivalent excess coverage for 47 medical or dental malpractice occurrences between July 1, 1987 and June 48 30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989 49 and June 30, 1990, between July 1, 1990 and June 30, 1991, between July 50 1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993, 51 between July 1, 1993 and June 30, 1994, between July 1, 1994 and June 52 30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996 53 and June 30, 1997, between July 1, 1997 and June 30, 1998, between July 54 1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000, 55 between July 1, 2000 and June 30, 2001, between July 1, 2001 and June 56 30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003S. 8307 51 A. 8807 1 and June 30, 2004, between July 1, 2004 and June 30, 2005, between July 2 1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007, 3 between July 1, 2007 and June 30, 2008, between July 1, 2008 and June 4 30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010 5 and June 30, 2011, between July 1, 2011 and June 30, 2012, between July 6 1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014, 7 between July 1, 2014 and June 30, 2015, between July 1, 2015 and June 8 30, 2016, between July 1, 2016 and June 30, 2017, between July 1, 2017 9 and June 30, 2018, between July 1, 2018 and June 30, 2019, between July 10 1, 2019 and June 30, 2020, between July 1, 2020 and June 30, 2021, 11 between July 1, 2021 and June 30, 2022, between July 1, 2022 and June 12 30, 2023, [and] between July 1, 2023 and June 30, 2024, and between July 13 1, 2024 and June 30, 2025 allocable to each general hospital for physi- 14 cians or dentists certified as eligible for purchase of a policy for 15 excess insurance coverage or equivalent excess coverage by such general 16 hospital in accordance with subdivision 2 of this section, and may amend 17 such determination and certification as necessary. The superintendent of 18 financial services shall determine and certify to each general hospital 19 and to the commissioner of health the ratable share of such cost alloca- 20 ble to the period July 1, 1987 to December 31, 1987, to the period Janu- 21 ary 1, 1988 to June 30, 1988, to the period July 1, 1988 to December 31, 22 1988, to the period January 1, 1989 to June 30, 1989, to the period July 23 1, 1989 to December 31, 1989, to the period January 1, 1990 to June 30, 24 1990, to the period July 1, 1990 to December 31, 1990, to the period 25 January 1, 1991 to June 30, 1991, to the period July 1, 1991 to December 26 31, 1991, to the period January 1, 1992 to June 30, 1992, to the period 27 July 1, 1992 to December 31, 1992, to the period January 1, 1993 to June 28 30, 1993, to the period July 1, 1993 to December 31, 1993, to the period 29 January 1, 1994 to June 30, 1994, to the period July 1, 1994 to December 30 31, 1994, to the period January 1, 1995 to June 30, 1995, to the period 31 July 1, 1995 to December 31, 1995, to the period January 1, 1996 to June 32 30, 1996, to the period July 1, 1996 to December 31, 1996, to the period 33 January 1, 1997 to June 30, 1997, to the period July 1, 1997 to December 34 31, 1997, to the period January 1, 1998 to June 30, 1998, to the period 35 July 1, 1998 to December 31, 1998, to the period January 1, 1999 to June 36 30, 1999, to the period July 1, 1999 to December 31, 1999, to the period 37 January 1, 2000 to June 30, 2000, to the period July 1, 2000 to December 38 31, 2000, to the period January 1, 2001 to June 30, 2001, to the period 39 July 1, 2001 to June 30, 2002, to the period July 1, 2002 to June 30, 40 2003, to the period July 1, 2003 to June 30, 2004, to the period July 1, 41 2004 to June 30, 2005, to the period July 1, 2005 and June 30, 2006, to 42 the period July 1, 2006 and June 30, 2007, to the period July 1, 2007 43 and June 30, 2008, to the period July 1, 2008 and June 30, 2009, to the 44 period July 1, 2009 and June 30, 2010, to the period July 1, 2010 and 45 June 30, 2011, to the period July 1, 2011 and June 30, 2012, to the 46 period July 1, 2012 and June 30, 2013, to the period July 1, 2013 and 47 June 30, 2014, to the period July 1, 2014 and June 30, 2015, to the 48 period July 1, 2015 and June 30, 2016, to the period July 1, 2016 and 49 June 30, 2017, to the period July 1, 2017 to June 30, 2018, to the peri- 50 od July 1, 2018 to June 30, 2019, to the period July 1, 2019 to June 30, 51 2020, to the period July 1, 2020 to June 30, 2021, to the period July 1, 52 2021 to June 30, 2022, to the period July 1, 2022 to June 30, 2023, 53 [and] to the period July 1, 2023 to June 30, 2024, and to the period 54 July 1, 2024 to June 30, 2025. 55 § 3. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section 56 18 of chapter 266 of the laws of 1986, amending the civil practice lawS. 8307 52 A. 8807 1 and rules and other laws relating to malpractice and professional 2 medical conduct, as amended by section 3 of part F of chapter 57 of the 3 laws of 2023, are amended to read as follows: 4 (a) To the extent funds available to the hospital excess liability 5 pool pursuant to subdivision 5 of this section as amended, and pursuant 6 to section 6 of part J of chapter 63 of the laws of 2001, as may from 7 time to time be amended, which amended this subdivision, are insuffi- 8 cient to meet the costs of excess insurance coverage or equivalent 9 excess coverage for coverage periods during the period July 1, 1992 to 10 June 30, 1993, during the period July 1, 1993 to June 30, 1994, during 11 the period July 1, 1994 to June 30, 1995, during the period July 1, 1995 12 to June 30, 1996, during the period July 1, 1996 to June 30, 1997, 13 during the period July 1, 1997 to June 30, 1998, during the period July 14 1, 1998 to June 30, 1999, during the period July 1, 1999 to June 30, 15 2000, during the period July 1, 2000 to June 30, 2001, during the period 16 July 1, 2001 to October 29, 2001, during the period April 1, 2002 to 17 June 30, 2002, during the period July 1, 2002 to June 30, 2003, during 18 the period July 1, 2003 to June 30, 2004, during the period July 1, 2004 19 to June 30, 2005, during the period July 1, 2005 to June 30, 2006, 20 during the period July 1, 2006 to June 30, 2007, during the period July 21 1, 2007 to June 30, 2008, during the period July 1, 2008 to June 30, 22 2009, during the period July 1, 2009 to June 30, 2010, during the period 23 July 1, 2010 to June 30, 2011, during the period July 1, 2011 to June 24 30, 2012, during the period July 1, 2012 to June 30, 2013, during the 25 period July 1, 2013 to June 30, 2014, during the period July 1, 2014 to 26 June 30, 2015, during the period July 1, 2015 to June 30, 2016, during 27 the period July 1, 2016 to June 30, 2017, during the period July 1, 2017 28 to June 30, 2018, during the period July 1, 2018 to June 30, 2019, 29 during the period July 1, 2019 to June 30, 2020, during the period July 30 1, 2020 to June 30, 2021, during the period July 1, 2021 to June 30, 31 2022, during the period July 1, 2022 to June 30, 2023, [and] during the 32 period July 1, 2023 to June 30, 2024, and during the period July 1, 2024 33 to June 30, 2025 allocated or reallocated in accordance with paragraph 34 (a) of subdivision 4-a of this section to rates of payment applicable to 35 state governmental agencies, each physician or dentist for whom a policy 36 for excess insurance coverage or equivalent excess coverage is purchased 37 for such period shall be responsible for payment to the provider of 38 excess insurance coverage or equivalent excess coverage of an allocable 39 share of such insufficiency, based on the ratio of the total cost of 40 such coverage for such physician to the sum of the total cost of such 41 coverage for all physicians applied to such insufficiency. 42 (b) Each provider of excess insurance coverage or equivalent excess 43 coverage covering the period July 1, 1992 to June 30, 1993, or covering 44 the period July 1, 1993 to June 30, 1994, or covering the period July 1, 45 1994 to June 30, 1995, or covering the period July 1, 1995 to June 30, 46 1996, or covering the period July 1, 1996 to June 30, 1997, or covering 47 the period July 1, 1997 to June 30, 1998, or covering the period July 1, 48 1998 to June 30, 1999, or covering the period July 1, 1999 to June 30, 49 2000, or covering the period July 1, 2000 to June 30, 2001, or covering 50 the period July 1, 2001 to October 29, 2001, or covering the period 51 April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to 52 June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or 53 covering the period July 1, 2004 to June 30, 2005, or covering the peri- 54 od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to 55 June 30, 2007, or covering the period July 1, 2007 to June 30, 2008, or 56 covering the period July 1, 2008 to June 30, 2009, or covering the peri-S. 8307 53 A. 8807 1 od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to 2 June 30, 2011, or covering the period July 1, 2011 to June 30, 2012, or 3 covering the period July 1, 2012 to June 30, 2013, or covering the peri- 4 od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to 5 June 30, 2015, or covering the period July 1, 2015 to June 30, 2016, or 6 covering the period July 1, 2016 to June 30, 2017, or covering the peri- 7 od July 1, 2017 to June 30, 2018, or covering the period July 1, 2018 to 8 June 30, 2019, or covering the period July 1, 2019 to June 30, 2020, or 9 covering the period July 1, 2020 to June 30, 2021, or covering the peri- 10 od July 1, 2021 to June 30, 2022, or covering the period July 1, 2022 to 11 June 30, 2023, or covering the period July 1, 2023 to June 30, 2024, or 12 covering the period July 1, 2024 to June 30, 2025 shall notify a covered 13 physician or dentist by mail, mailed to the address shown on the last 14 application for excess insurance coverage or equivalent excess coverage, 15 of the amount due to such provider from such physician or dentist for 16 such coverage period determined in accordance with paragraph (a) of this 17 subdivision. Such amount shall be due from such physician or dentist to 18 such provider of excess insurance coverage or equivalent excess coverage 19 in a time and manner determined by the superintendent of financial 20 services. 21 (c) If a physician or dentist liable for payment of a portion of the 22 costs of excess insurance coverage or equivalent excess coverage cover- 23 ing the period July 1, 1992 to June 30, 1993, or covering the period 24 July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to 25 June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or 26 covering the period July 1, 1996 to June 30, 1997, or covering the peri- 27 od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to 28 June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or 29 covering the period July 1, 2000 to June 30, 2001, or covering the peri- 30 od July 1, 2001 to October 29, 2001, or covering the period April 1, 31 2002 to June 30, 2002, or covering the period July 1, 2002 to June 30, 32 2003, or covering the period July 1, 2003 to June 30, 2004, or covering 33 the period July 1, 2004 to June 30, 2005, or covering the period July 1, 34 2005 to June 30, 2006, or covering the period July 1, 2006 to June 30, 35 2007, or covering the period July 1, 2007 to June 30, 2008, or covering 36 the period July 1, 2008 to June 30, 2009, or covering the period July 1, 37 2009 to June 30, 2010, or covering the period July 1, 2010 to June 30, 38 2011, or covering the period July 1, 2011 to June 30, 2012, or covering 39 the period July 1, 2012 to June 30, 2013, or covering the period July 1, 40 2013 to June 30, 2014, or covering the period July 1, 2014 to June 30, 41 2015, or covering the period July 1, 2015 to June 30, 2016, or covering 42 the period July 1, 2016 to June 30, 2017, or covering the period July 1, 43 2017 to June 30, 2018, or covering the period July 1, 2018 to June 30, 44 2019, or covering the period July 1, 2019 to June 30, 2020, or covering 45 the period July 1, 2020 to June 30, 2021, or covering the period July 1, 46 2021 to June 30, 2022, or covering the period July 1, 2022 to June 30, 47 2023, or covering the period July 1, 2023 to June 30, 2024, or covering 48 the period July 1, 2024 to June 30, 2025 determined in accordance with 49 paragraph (a) of this subdivision fails, refuses or neglects to make 50 payment to the provider of excess insurance coverage or equivalent 51 excess coverage in such time and manner as determined by the superinten- 52 dent of financial services pursuant to paragraph (b) of this subdivi- 53 sion, excess insurance coverage or equivalent excess coverage purchased 54 for such physician or dentist in accordance with this section for such 55 coverage period shall be cancelled and shall be null and void as of theS. 8307 54 A. 8807 1 first day on or after the commencement of a policy period where the 2 liability for payment pursuant to this subdivision has not been met. 3 (d) Each provider of excess insurance coverage or equivalent excess 4 coverage shall notify the superintendent of financial services and the 5 commissioner of health or their designee of each physician and dentist 6 eligible for purchase of a policy for excess insurance coverage or 7 equivalent excess coverage covering the period July 1, 1992 to June 30, 8 1993, or covering the period July 1, 1993 to June 30, 1994, or covering 9 the period July 1, 1994 to June 30, 1995, or covering the period July 1, 10 1995 to June 30, 1996, or covering the period July 1, 1996 to June 30, 11 1997, or covering the period July 1, 1997 to June 30, 1998, or covering 12 the period July 1, 1998 to June 30, 1999, or covering the period July 1, 13 1999 to June 30, 2000, or covering the period July 1, 2000 to June 30, 14 2001, or covering the period July 1, 2001 to October 29, 2001, or cover- 15 ing the period April 1, 2002 to June 30, 2002, or covering the period 16 July 1, 2002 to June 30, 2003, or covering the period July 1, 2003 to 17 June 30, 2004, or covering the period July 1, 2004 to June 30, 2005, or 18 covering the period July 1, 2005 to June 30, 2006, or covering the peri- 19 od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to 20 June 30, 2008, or covering the period July 1, 2008 to June 30, 2009, or 21 covering the period July 1, 2009 to June 30, 2010, or covering the peri- 22 od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to 23 June 30, 2012, or covering the period July 1, 2012 to June 30, 2013, or 24 covering the period July 1, 2013 to June 30, 2014, or covering the peri- 25 od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to 26 June 30, 2016, or covering the period July 1, 2016 to June 30, 2017, or 27 covering the period July 1, 2017 to June 30, 2018, or covering the peri- 28 od July 1, 2018 to June 30, 2019, or covering the period July 1, 2019 to 29 June 30, 2020, or covering the period July 1, 2020 to June 30, 2021, or 30 covering the period July 1, 2021 to June 30, 2022, or covering the peri- 31 od July 1, 2022 to June 30, 2023, or covering the period July 1, 2023 to 32 June 30, 2024, or covering the period July 1, 2024 to June 30, 2025 that 33 has made payment to such provider of excess insurance coverage or equiv- 34 alent excess coverage in accordance with paragraph (b) of this subdivi- 35 sion and of each physician and dentist who has failed, refused or 36 neglected to make such payment. 37 (e) A provider of excess insurance coverage or equivalent excess 38 coverage shall refund to the hospital excess liability pool any amount 39 allocable to the period July 1, 1992 to June 30, 1993, and to the period 40 July 1, 1993 to June 30, 1994, and to the period July 1, 1994 to June 41 30, 1995, and to the period July 1, 1995 to June 30, 1996, and to the 42 period July 1, 1996 to June 30, 1997, and to the period July 1, 1997 to 43 June 30, 1998, and to the period July 1, 1998 to June 30, 1999, and to 44 the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000 45 to June 30, 2001, and to the period July 1, 2001 to October 29, 2001, 46 and to the period April 1, 2002 to June 30, 2002, and to the period July 47 1, 2002 to June 30, 2003, and to the period July 1, 2003 to June 30, 48 2004, and to the period July 1, 2004 to June 30, 2005, and to the period 49 July 1, 2005 to June 30, 2006, and to the period July 1, 2006 to June 50 30, 2007, and to the period July 1, 2007 to June 30, 2008, and to the 51 period July 1, 2008 to June 30, 2009, and to the period July 1, 2009 to 52 June 30, 2010, and to the period July 1, 2010 to June 30, 2011, and to 53 the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012 54 to June 30, 2013, and to the period July 1, 2013 to June 30, 2014, and 55 to the period July 1, 2014 to June 30, 2015, and to the period July 1, 56 2015 to June 30, 2016, to the period July 1, 2016 to June 30, 2017, andS. 8307 55 A. 8807 1 to the period July 1, 2017 to June 30, 2018, and to the period July 1, 2 2018 to June 30, 2019, and to the period July 1, 2019 to June 30, 2020, 3 and to the period July 1, 2020 to June 30, 2021, and to the period July 4 1, 2021 to June 30, 2022, and to the period July 1, 2022 to June 30, 5 2023, and to the period July 1, 2023 to June 30, 2024, and to the period 6 July 1, 2024 to June 30, 2025 received from the hospital excess liabil- 7 ity pool for purchase of excess insurance coverage or equivalent excess 8 coverage covering the period July 1, 1992 to June 30, 1993, and covering 9 the period July 1, 1993 to June 30, 1994, and covering the period July 10 1, 1994 to June 30, 1995, and covering the period July 1, 1995 to June 11 30, 1996, and covering the period July 1, 1996 to June 30, 1997, and 12 covering the period July 1, 1997 to June 30, 1998, and covering the 13 period July 1, 1998 to June 30, 1999, and covering the period July 1, 14 1999 to June 30, 2000, and covering the period July 1, 2000 to June 30, 15 2001, and covering the period July 1, 2001 to October 29, 2001, and 16 covering the period April 1, 2002 to June 30, 2002, and covering the 17 period July 1, 2002 to June 30, 2003, and covering the period July 1, 18 2003 to June 30, 2004, and covering the period July 1, 2004 to June 30, 19 2005, and covering the period July 1, 2005 to June 30, 2006, and cover- 20 ing the period July 1, 2006 to June 30, 2007, and covering the period 21 July 1, 2007 to June 30, 2008, and covering the period July 1, 2008 to 22 June 30, 2009, and covering the period July 1, 2009 to June 30, 2010, 23 and covering the period July 1, 2010 to June 30, 2011, and covering the 24 period July 1, 2011 to June 30, 2012, and covering the period July 1, 25 2012 to June 30, 2013, and covering the period July 1, 2013 to June 30, 26 2014, and covering the period July 1, 2014 to June 30, 2015, and cover- 27 ing the period July 1, 2015 to June 30, 2016, and covering the period 28 July 1, 2016 to June 30, 2017, and covering the period July 1, 2017 to 29 June 30, 2018, and covering the period July 1, 2018 to June 30, 2019, 30 and covering the period July 1, 2019 to June 30, 2020, and covering the 31 period July 1, 2020 to June 30, 2021, and covering the period July 1, 32 2021 to June 30, 2022, and covering the period July 1, 2022 to June 30, 33 2023 for, and covering the period July 1, 2023 to June 30, 2024, and 34 covering the period July 1, 2024 to June 30, 2025 a physician or dentist 35 where such excess insurance coverage or equivalent excess coverage is 36 cancelled in accordance with paragraph (c) of this subdivision. 37 § 4. Section 40 of chapter 266 of the laws of 1986, amending the civil 38 practice law and rules and other laws relating to malpractice and 39 professional medical conduct, as amended by section 4 of part F of chap- 40 ter 57 of the laws of 2023, is amended to read as follows: 41 § 40. The superintendent of financial services shall establish rates 42 for policies providing coverage for physicians and surgeons medical 43 malpractice for the periods commencing July 1, 1985 and ending June 30, 44 [2024] 2025; provided, however, that notwithstanding any other provision 45 of law, the superintendent shall not establish or approve any increase 46 in rates for the period commencing July 1, 2009 and ending June 30, 47 2010. The superintendent shall direct insurers to establish segregated 48 accounts for premiums, payments, reserves and investment income attrib- 49 utable to such premium periods and shall require periodic reports by the 50 insurers regarding claims and expenses attributable to such periods to 51 monitor whether such accounts will be sufficient to meet incurred claims 52 and expenses. On or after July 1, 1989, the superintendent shall impose 53 a surcharge on premiums to satisfy a projected deficiency that is 54 attributable to the premium levels established pursuant to this section 55 for such periods; provided, however, that such annual surcharge shall 56 not exceed eight percent of the established rate until July 1, [2024]S. 8307 56 A. 8807 1 2025, at which time and thereafter such surcharge shall not exceed twen- 2 ty-five percent of the approved adequate rate, and that such annual 3 surcharges shall continue for such period of time as shall be sufficient 4 to satisfy such deficiency. The superintendent shall not impose such 5 surcharge during the period commencing July 1, 2009 and ending June 30, 6 2010. On and after July 1, 1989, the surcharge prescribed by this 7 section shall be retained by insurers to the extent that they insured 8 physicians and surgeons during the July 1, 1985 through June 30, [2024] 9 2025 policy periods; in the event and to the extent physicians and 10 surgeons were insured by another insurer during such periods, all or a 11 pro rata share of the surcharge, as the case may be, shall be remitted 12 to such other insurer in accordance with rules and regulations to be 13 promulgated by the superintendent. Surcharges collected from physicians 14 and surgeons who were not insured during such policy periods shall be 15 apportioned among all insurers in proportion to the premium written by 16 each insurer during such policy periods; if a physician or surgeon was 17 insured by an insurer subject to rates established by the superintendent 18 during such policy periods, and at any time thereafter a hospital, 19 health maintenance organization, employer or institution is responsible 20 for responding in damages for liability arising out of such physician's 21 or surgeon's practice of medicine, such responsible entity shall also 22 remit to such prior insurer the equivalent amount that would then be 23 collected as a surcharge if the physician or surgeon had continued to 24 remain insured by such prior insurer. In the event any insurer that 25 provided coverage during such policy periods is in liquidation, the 26 property/casualty insurance security fund shall receive the portion of 27 surcharges to which the insurer in liquidation would have been entitled. 28 The surcharges authorized herein shall be deemed to be income earned for 29 the purposes of section 2303 of the insurance law. The superintendent, 30 in establishing adequate rates and in determining any projected defi- 31 ciency pursuant to the requirements of this section and the insurance 32 law, shall give substantial weight, determined in his discretion and 33 judgment, to the prospective anticipated effect of any regulations 34 promulgated and laws enacted and the public benefit of stabilizing 35 malpractice rates and minimizing rate level fluctuation during the peri- 36 od of time necessary for the development of more reliable statistical 37 experience as to the efficacy of such laws and regulations affecting 38 medical, dental or podiatric malpractice enacted or promulgated in 1985, 39 1986, by this act and at any other time. Notwithstanding any provision 40 of the insurance law, rates already established and to be established by 41 the superintendent pursuant to this section are deemed adequate if such 42 rates would be adequate when taken together with the maximum authorized 43 annual surcharges to be imposed for a reasonable period of time whether 44 or not any such annual surcharge has been actually imposed as of the 45 establishment of such rates. 46 § 5. Section 5 and subdivisions (a) and (e) of section 6 of part J of 47 chapter 63 of the laws of 2001, amending chapter 266 of the laws of 48 1986, amending the civil practice law and rules and other laws relating 49 to malpractice and professional medical conduct, as amended by section 5 50 of part F of chapter 57 of the laws of 2023, are amended to read as 51 follows: 52 § 5. The superintendent of financial services and the commissioner of 53 health shall determine, no later than June 15, 2002, June 15, 2003, June 54 15, 2004, June 15, 2005, June 15, 2006, June 15, 2007, June 15, 2008, 55 June 15, 2009, June 15, 2010, June 15, 2011, June 15, 2012, June 15, 56 2013, June 15, 2014, June 15, 2015, June 15, 2016, June 15, 2017, JuneS. 8307 57 A. 8807 1 15, 2018, June 15, 2019, June 15, 2020, June 15, 2021, June 15, 2022, 2 June 15, 2023, [and] June 15, 2024, and June 15, 2025 the amount of 3 funds available in the hospital excess liability pool, created pursuant 4 to section 18 of chapter 266 of the laws of 1986, and whether such funds 5 are sufficient for purposes of purchasing excess insurance coverage for 6 eligible participating physicians and dentists during the period July 1, 7 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003 8 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to 9 June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007 to June 10 30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to June 30, 11 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June 30, 12 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30, 13 2014, or July 1, 2014 to June 30, 2015, or July 1, 2015 to June 30, 14 2016, or July 1, 2016 to June 30, 2017, or July 1, 2017 to June 30, 15 2018, or July 1, 2018 to June 30, 2019, or July 1, 2019 to June 30, 16 2020, or July 1, 2020 to June 30, 2021, or July 1, 2021 to June 30, 17 2022, or July 1, 2022 to June 30, 2023, or July 1, 2023 to June 30, 18 2024, or July 1, 2024 to June 30, 2025 as applicable. 19 (a) This section shall be effective only upon a determination, pursu- 20 ant to section five of this act, by the superintendent of financial 21 services and the commissioner of health, and a certification of such 22 determination to the state director of the budget, the chair of the 23 senate committee on finance and the chair of the assembly committee on 24 ways and means, that the amount of funds in the hospital excess liabil- 25 ity pool, created pursuant to section 18 of chapter 266 of the laws of 26 1986, is insufficient for purposes of purchasing excess insurance cover- 27 age for eligible participating physicians and dentists during the period 28 July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 29 1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 30 2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007 31 to June 30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to 32 June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June 33 30, 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30, 34 2014, or July 1, 2014 to June 30, 2015, or July 1, 2015 to June 30, 35 2016, or July 1, 2016 to June 30, 2017, or July 1, 2017 to June 30, 36 2018, or July 1, 2018 to June 30, 2019, or July 1, 2019 to June 30, 37 2020, or July 1, 2020 to June 30, 2021, or July 1, 2021 to June 30, 38 2022, or July 1, 2022 to June 30, 2023, or July 1, 2023 to June 30, 2024 39 , or July 1, 2024 to June 30, 2025 as applicable. 40 (e) The commissioner of health shall transfer for deposit to the 41 hospital excess liability pool created pursuant to section 18 of chapter 42 266 of the laws of 1986 such amounts as directed by the superintendent 43 of financial services for the purchase of excess liability insurance 44 coverage for eligible participating physicians and dentists for the 45 policy year July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 46 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 47 2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30, 48 2007, as applicable, and the cost of administering the hospital excess 49 liability pool for such applicable policy year, pursuant to the program 50 established in chapter 266 of the laws of 1986, as amended, no later 51 than June 15, 2002, June 15, 2003, June 15, 2004, June 15, 2005, June 52 15, 2006, June 15, 2007, June 15, 2008, June 15, 2009, June 15, 2010, 53 June 15, 2011, June 15, 2012, June 15, 2013, June 15, 2014, June 15, 54 2015, June 15, 2016, June 15, 2017, June 15, 2018, June 15, 2019, June 55 15, 2020, June 15, 2021, June 15, 2022, June 15, 2023, [and] June 15, 56 2024, and June 15, 2025 as applicable.S. 8307 58 A. 8807 1 § 6. Section 20 of part H of chapter 57 of the laws of 2017, amending 2 the New York Health Care Reform Act of 1996 and other laws relating to 3 extending certain provisions thereto, as amended by section 6 of part F 4 of chapter 57 of the laws of 2023, is amended to read as follows: 5 § 20. Notwithstanding any law, rule or regulation to the contrary, 6 only physicians or dentists who were eligible, and for whom the super- 7 intendent of financial services and the commissioner of health, or their 8 designee, purchased, with funds available in the hospital excess liabil- 9 ity pool, a full or partial policy for excess coverage or equivalent 10 excess coverage for the coverage period ending the thirtieth of June, 11 two thousand [twenty-three] twenty-four, shall be eligible to apply for 12 such coverage for the coverage period beginning the first of July, two 13 thousand [twenty-three] twenty-four; provided, however, if the total 14 number of physicians or dentists for whom such excess coverage or equiv- 15 alent excess coverage was purchased for the policy year ending the thir- 16 tieth of June, two thousand [twenty-three] twenty-four exceeds the total 17 number of physicians or dentists certified as eligible for the coverage 18 period beginning the first of July, two thousand [twenty-three] twenty- 19 four, then the general hospitals may certify additional eligible physi- 20 cians or dentists in a number equal to such general hospital's propor- 21 tional share of the total number of physicians or dentists for whom 22 excess coverage or equivalent excess coverage was purchased with funds 23 available in the hospital excess liability pool as of the thirtieth of 24 June, two thousand [twenty-three] twenty-four, as applied to the differ- 25 ence between the number of eligible physicians or dentists for whom a 26 policy for excess coverage or equivalent excess coverage was purchased 27 for the coverage period ending the thirtieth of June, two thousand 28 [twenty-three] twenty-four and the number of such eligible physicians or 29 dentists who have applied for excess coverage or equivalent excess 30 coverage for the coverage period beginning the first of July, two thou- 31 sand [twenty-three] twenty-four. 32 § 7. This act shall take effect immediately and shall be deemed to 33 have been in full force and effect on and after April 1, 2024. 34 PART L 35 Section 1. Subdivision 9 of section 2803 of the public health law is 36 REPEALED. 37 § 2. Section 461-s of the social services law is REPEALED. 38 § 3. Subdivision 1, paragraph (f) of subdivision 3, paragraphs (a) and 39 (d) of subdivision 5 and subdivisions 5-a and 12 of section 2807-m of 40 the public health law, subdivision 1, paragraph (f) of subdivision 3, 41 paragraph (a) of subdivision 5 and subdivision 12 as amended and para- 42 graph (d) of subdivision 5 as added by section 6 of part Y of chapter 56 43 of the laws of 2020 and subdivision 5-a as amended by section 6 of part 44 C of chapter 57 of the laws of 2023, are amended to read as follows: 45 1. Definitions. For purposes of this section, the following defi- 46 nitions shall apply, unless the context clearly requires otherwise: 47 (a) ["Clinical research" means patient-oriented research, epidemiolog-48ic and behavioral studies, or outcomes research and health services49research that is approved by an institutional review board by the time50the clinical research position is filled.51(b) "Clinical research plan" means a plan submitted by a consortium or52teaching general hospital for a clinical research position which demon-53strates, in a form to be provided by the commissioner, the following:S. 8307 59 A. 8807 1(i) financial support for overhead, supervision, equipment and other2resources equal to the amount of funding provided pursuant to subpara-3graph (i) of paragraph (b) of subdivision five-a of this section by the4teaching general hospital or consortium for the clinical research posi-5tion;6(ii) experience the sponsor-mentor and teaching general hospital has7in clinical research and the medical field of the study;8(iii) methods, data collection and anticipated measurable outcomes of9the clinical research to be performed;10(iv) training goals, objectives and experience the researcher will be11provided to assess a future career in clinical research;12(v) scientific relevance, merit and health implications of the13research to be performed;14(vi) information on potential scientific meetings and peer review15journals where research results can be disseminated;16(vii) clear and comprehensive details on the clinical research posi-17tion;18(viii) qualifications necessary for the clinical research position and19strategy for recruitment;20(ix) non-duplication with other clinical research positions from the21same teaching general hospital or consortium;22(x) methods to track the career of the clinical researcher once the23term of the position is complete; and24(xi) any other information required by the commissioner to implement25subparagraph (i) of paragraph (b) of subdivision five-a of this section.26(xii) The clinical review plan submitted in accordance with this para-27graph may be reviewed by the commissioner in consultation with experts28outside the department of health.29(c) "Clinical research position" means a post-graduate residency posi-30tion which:31(i) shall not be required in order for the researcher to complete a32graduate medical education program;33(ii) may be reimbursed by other sources but only for costs in excess34of the funding distributed in accordance with subparagraph (i) of para-35graph (b) of subdivision five-a of this section;36(iii) shall exceed the minimum standards that are required by the37residency review committee in the specialty the researcher has trained38or is currently training;39(iv) shall not be previously funded by the teaching general hospital40or supported by another funding source at the teaching general hospital41in the past three years from the date the clinical research plan is42submitted to the commissioner;43(v) may supplement an existing research project;44(vi) shall be equivalent to a full-time position comprising of no less45than thirty-five hours per week for one or two years;46(vii) shall provide, or be filled by a researcher who has formalized47instruction in clinical research, including biostatistics, clinical48trial design, grant writing and research ethics;49(viii) shall be supervised by a sponsor-mentor who shall either (A) be50employed, contracted for employment or paid through an affiliated facul-51ty practice plan by a teaching general hospital which has received at52least one research grant from the National Institutes of Health in the53past five years from the date the clinical research plan is submitted to54the commissioner; (B) maintain a faculty appointment at a medical,55dental or podiatric school located in New York state that has received56at least one research grant from the National Institutes of Health inS. 8307 60 A. 8807 1the past five years from the date the clinical research plan is submit-2ted to the commissioner; or (C) be collaborating in the clinical3research plan with a researcher from another institution that has4received at least one research grant from the National Institutes of5Health in the past five years from the date the clinical research plan6is submitted to the commissioner; and7(ix) shall be filled by a researcher who is (A) enrolled or has8completed a graduate medical education program, as defined in paragraph9(i) of this subdivision; (B) a United States citizen, national, or10permanent resident of the United States; and (C) a graduate of a11medical, dental or podiatric school located in New York state, a gradu-12ate or resident in a graduate medical education program, as defined in13paragraph (i) of this subdivision, where the sponsoring institution, as14defined in paragraph (q) of this subdivision, is located in New York15state, or resides in New York state at the time the clinical research16plan is submitted to the commissioner.17(d)] "Consortium" means an organization or association, approved by 18 the commissioner in consultation with the council, of general hospitals 19 which provide graduate medical education, together with any affiliated 20 site; provided that such organization or association may also include 21 other providers of health care services, medical schools, payors or 22 consumers, and which meet other criteria pursuant to subdivision six of 23 this section. 24 [(e)] (b) "Council" means the New York state council on graduate 25 medical education. 26 [(f)] (c) "Direct medical education" means the direct costs of resi- 27 dents, interns and supervising physicians. 28 [(g)] (d) "Distribution period" means each calendar year set forth in 29 subdivision two of this section. 30 [(h)] (e) "Faculty" means persons who are employed by or under 31 contract for employment with a teaching general hospital or are paid 32 through a teaching general hospital's affiliated faculty practice plan 33 and maintain a faculty appointment at a medical school. Such persons 34 shall not be limited to persons with a degree in medicine. 35 [(i)] (f) "Graduate medical education program" means a post-graduate 36 medical education residency in the United States which has received 37 accreditation from a nationally recognized accreditation body or has 38 been approved by a nationally recognized organization for medical, 39 osteopathic, podiatric or dental residency programs including, but not 40 limited to, specialty boards. 41 [(j)] (g) "Indirect medical education" means the estimate of costs, 42 other than direct costs, of educational activities in teaching hospitals 43 as determined in accordance with the methodology applicable for purposes 44 of determining an estimate of indirect medical education costs for 45 reimbursement for inpatient hospital service pursuant to title XVIII of 46 the federal social security act (medicare). 47 [(k)] (h) "Medicare" means the methodology used for purposes of reim- 48 bursing inpatient hospital services provided to beneficiaries of title 49 XVIII of the federal social security act. 50 [(l)] (i) "Primary care" residents specialties shall include family 51 medicine, general pediatrics, primary care internal medicine, and prima- 52 ry care obstetrics and gynecology. In determining whether a residency is 53 in primary care, the commissioner shall consult with the council. 54 [(m)] (j) "Regions", for purposes of this section, shall mean the 55 regions as defined in paragraph (b) of subdivision sixteen of section 56 twenty-eight hundred seven-c of this article as in effect on June thir-S. 8307 61 A. 8807 1 tieth, nineteen hundred ninety-six. For purposes of distributions pursu- 2 ant to subdivision five-a of this section, except distributions made in 3 accordance with paragraph (a) of subdivision five-a of this section, 4 "regions" shall be defined as New York city and the rest of the state. 5 [(n)] (k) "Regional pool" means a professional education pool estab- 6 lished on a regional basis by the commissioner from funds available 7 pursuant to sections twenty-eight hundred seven-s and twenty-eight 8 hundred seven-t of this article. 9 [(o)] (l) "Resident" means a person in a graduate medical education 10 program which has received accreditation from a nationally recognized 11 accreditation body or in a program approved by any other nationally 12 recognized organization for medical, osteopathic or dental residency 13 programs including, but not limited to, specialty boards. 14 [(p) "Shortage specialty" means a specialty determined by the commis-15sioner, in consultation with the council, to be in short supply in the16state of New York.17(q)] (m) "Sponsoring institution" means the entity that has the over- 18 all responsibility for a program of graduate medical education. Such 19 institutions shall include teaching general hospitals, medical schools, 20 consortia and diagnostic and treatment centers. 21 [(r)] (n) "Weighted resident count" means a teaching general hospi- 22 tal's total number of residents as of July first, nineteen hundred nine- 23 ty-five, including residents in affiliated non-hospital ambulatory 24 settings, reported to the commissioner. Such resident counts shall 25 reflect the weights established in accordance with rules and regulations 26 adopted by the state hospital review and planning council and approved 27 by the commissioner for purposes of implementing subdivision twenty-five 28 of section twenty-eight hundred seven-c of this article and in effect on 29 July first, nineteen hundred ninety-five. Such weights shall not be 30 applied to specialty hospitals, specified by the commissioner, whose 31 primary care mission is to engage in research, training and clinical 32 care in specialty eye and ear, special surgery, orthopedic, joint 33 disease, cancer, chronic care or rehabilitative services. 34 [(s)] (o) "Adjustment amount" means an amount determined for each 35 teaching hospital for periods prior to January first, two thousand nine 36 by: 37 (i) determining the difference between (A) a calculation of what each 38 teaching general hospital would have been paid if payments made pursuant 39 to paragraph (a-3) of subdivision one of section twenty-eight hundred 40 seven-c of this article between January first, nineteen hundred ninety- 41 six and December thirty-first, two thousand three were based solely on 42 the case mix of persons eligible for medical assistance under the 43 medical assistance program pursuant to title eleven of article five of 44 the social services law who are enrolled in health maintenance organiza- 45 tions and persons paid for under the family health plus program enrolled 46 in approved organizations pursuant to title eleven-D of article five of 47 the social services law during those years, and (B) the actual payments 48 to each such hospital pursuant to paragraph (a-3) of subdivision one of 49 section twenty-eight hundred seven-c of this article between January 50 first, nineteen hundred ninety-six and December thirty-first, two thou- 51 sand three. 52 (ii) reducing proportionally each of the amounts determined in subpar- 53 agraph (i) of this paragraph so that the sum of all such amounts totals 54 no more than one hundred million dollars; 55 (iii) further reducing each of the amounts determined in subparagraph 56 (ii) of this paragraph by the amount received by each hospital as aS. 8307 62 A. 8807 1 distribution from funds designated in paragraph (a) of subdivision five 2 of this section attributable to the period January first, two thousand 3 three through December thirty-first, two thousand three, except that if 4 such amount was provided to a consortium then the amount of the 5 reduction for each hospital in the consortium shall be determined by 6 applying the proportion of each hospital's amount determined under 7 subparagraph (i) of this paragraph to the total of such amounts of all 8 hospitals in such consortium to the consortium award; 9 (iv) further reducing each of the amounts determined in subparagraph 10 (iii) of this paragraph by the amounts specified in paragraph [(t)] (p) 11 of this subdivision; and 12 (v) dividing each of the amounts determined in subparagraph (iii) of 13 this paragraph by seven. 14 [(t)] (p) "Extra reduction amount" shall mean an amount determined for 15 a teaching hospital for which an adjustment amount is calculated pursu- 16 ant to paragraph [(s)] (o) of this subdivision that is the hospital's 17 proportionate share of the sum of the amounts specified in paragraph 18 [(u)] (q) of this subdivision determined based upon a comparison of the 19 hospital's remaining liability calculated pursuant to paragraph [(s)] 20 (o) of this subdivision to the sum of all such hospital's remaining 21 liabilities. 22 [(u)] (q) "Allotment amount" shall mean an amount determined for 23 teaching hospitals as follows: 24 (i) for a hospital for which an adjustment amount pursuant to para- 25 graph [(s)] (o) of this subdivision does not apply, the amount received 26 by the hospital pursuant to paragraph (a) of subdivision five of this 27 section attributable to the period January first, two thousand three 28 through December thirty-first, two thousand three, or 29 (ii) for a hospital for which an adjustment amount pursuant to para- 30 graph [(s)] (o) of this subdivision applies and which received a 31 distribution pursuant to paragraph (a) of subdivision five of this 32 section attributable to the period January first, two thousand three 33 through December thirty-first, two thousand three that is greater than 34 the hospital's adjustment amount, the difference between the distrib- 35 ution amount and the adjustment amount. 36 (f) Effective January first, two thousand five through December thir- 37 ty-first, two thousand eight, each teaching general hospital shall 38 receive a distribution from the applicable regional pool based on its 39 distribution amount determined under paragraphs (c), (d) and (e) of this 40 subdivision and reduced by its adjustment amount calculated pursuant to 41 paragraph [(s)] (o) of subdivision one of this section and, for distrib- 42 utions for the period January first, two thousand five through December 43 thirty-first, two thousand five, further reduced by its extra reduction 44 amount calculated pursuant to paragraph [(t)] (p) of subdivision one of 45 this section. 46 (a) Up to thirty-one million dollars annually for the periods January 47 first, two thousand through December thirty-first, two thousand three, 48 and up to twenty-five million dollars plus the sum of the amounts speci- 49 fied in paragraph [(n)] (k) of subdivision one of this section for the 50 period January first, two thousand five through December thirty-first, 51 two thousand five, and up to thirty-one million dollars annually for the 52 period January first, two thousand six through December thirty-first, 53 two thousand seven, shall be set aside and reserved by the commissioner 54 from the regional pools established pursuant to subdivision two of this 55 section for supplemental distributions in each such region to be made by 56 the commissioner to consortia and teaching general hospitals in accord-S. 8307 63 A. 8807 1 ance with a distribution methodology developed in consultation with the 2 council and specified in rules and regulations adopted by the commis- 3 sioner. 4 (d) Notwithstanding any other provision of law or regulation, for the 5 period January first, two thousand five through December thirty-first, 6 two thousand five, the commissioner shall distribute as supplemental 7 payments the allotment specified in paragraph [(n)] (k) of subdivision 8 one of this section. 9 5-a. Graduate medical education innovations pool. (a) Supplemental 10 distributions. (i) Thirty-one million dollars for the period January 11 first, two thousand eight through December thirty-first, two thousand 12 eight, shall be set aside and reserved by the commissioner from the 13 regional pools established pursuant to subdivision two of this section 14 and shall be available for distributions pursuant to subdivision five of 15 this section and in accordance with section 86-1.89 of title 10 of the 16 codes, rules and regulations of the state of New York as in effect on 17 January first, two thousand eight[; provided, however, for purposes of18funding the empire clinical research investigation program (ECRIP) in19accordance with paragraph eight of subdivision (e) and paragraph two of20subdivision (f) of section 86-1.89 of title 10 of the codes, rules and21regulations of the state of New York, distributions shall be made using22two regions defined as New York city and the rest of the state and the23dollar amount set forth in subparagraph (i) of paragraph two of subdivi-24sion (f) of section 86-1.89 of title 10 of the codes, rules and regu-25lations of the state of New York shall be increased from sixty thousand26dollars to seventy-five thousand dollars]. 27 (ii) For periods on and after January first, two thousand nine, 28 supplemental distributions pursuant to subdivision five of this section 29 and in accordance with section 86-1.89 of title 10 of the codes, rules 30 and regulations of the state of New York shall no longer be made and the 31 provisions of section 86-1.89 of title 10 of the codes, rules and regu- 32 lations of the state of New York shall be null and void. 33 (b) [Empire clinical research investigator program (ECRIP). Nine34million one hundred twenty thousand dollars annually for the period35January first, two thousand nine through December thirty-first, two36thousand ten, and two million two hundred eighty thousand dollars for37the period January first, two thousand eleven, through March thirty-38first, two thousand eleven, nine million one hundred twenty thousand39dollars each state fiscal year for the period April first, two thousand40eleven through March thirty-first, two thousand fourteen, up to eight41million six hundred twelve thousand dollars each state fiscal year for42the period April first, two thousand fourteen through March thirty-43first, two thousand seventeen, up to eight million six hundred twelve44thousand dollars each state fiscal year for the period April first, two45thousand seventeen through March thirty-first, two thousand twenty, up46to eight million six hundred twelve thousand dollars each state fiscal47year for the period April first, two thousand twenty through March thir-48ty-first, two thousand twenty-three, and up to eight million six hundred49twelve thousand dollars each state fiscal year for the period April50first, two thousand twenty-three through March thirty-first, two thou-51sand twenty-six, shall be set aside and reserved by the commissioner52from the regional pools established pursuant to subdivision two of this53section to be allocated regionally with two-thirds of the available54funding going to New York city and one-third of the available funding55going to the rest of the state and shall be available for distribution56as follows:S. 8307 64 A. 8807 1Distributions shall first be made to consortia and teaching general2hospitals for the empire clinical research investigator program (ECRIP)3to help secure federal funding for biomedical research, train clinical4researchers, recruit national leaders as faculty to act as mentors, and5train residents and fellows in biomedical research skills based on6hospital-specific data submitted to the commissioner by consortia and7teaching general hospitals in accordance with clause (G) of this subpar-8agraph. Such distributions shall be made in accordance with the follow-9ing methodology:10(A) The greatest number of clinical research positions for which a11consortium or teaching general hospital may be funded pursuant to this12subparagraph shall be one percent of the total number of residents13training at the consortium or teaching general hospital on July first,14two thousand eight for the period January first, two thousand nine15through December thirty-first, two thousand nine rounded up to the near-16est one position.17(B) Distributions made to a consortium or teaching general hospital18shall equal the product of the total number of clinical research posi-19tions submitted by a consortium or teaching general hospital and20accepted by the commissioner as meeting the criteria set forth in para-21graph (b) of subdivision one of this section, subject to the reduction22calculation set forth in clause (C) of this subparagraph, times one23hundred ten thousand dollars.24(C) If the dollar amount for the total number of clinical research25positions in the region calculated pursuant to clause (B) of this26subparagraph exceeds the total amount appropriated for purposes of this27paragraph, including clinical research positions that continue from and28were funded in prior distribution periods, the commissioner shall elimi-29nate one-half of the clinical research positions submitted by each30consortium or teaching general hospital rounded down to the nearest one31position. Such reduction shall be repeated until the dollar amount for32the total number of clinical research positions in the region does not33exceed the total amount appropriated for purposes of this paragraph. If34the repeated reduction of the total number of clinical research posi-35tions in the region by one-half does not render a total funding amount36that is equal to or less than the total amount reserved for that region37within the appropriation, the funding for each clinical research posi-38tion in that region shall be reduced proportionally in one thousand39dollar increments until the total dollar amount for the total number of40clinical research positions in that region does not exceed the total41amount reserved for that region within the appropriation. Any reduction42in funding will be effective for the duration of the award. No clinical43research positions that continue from and were funded in prior distrib-44ution periods shall be eliminated or reduced by such methodology.45(D) Each consortium or teaching general hospital shall receive its46annual distribution amount in accordance with the following:47(I) Each consortium or teaching general hospital with a one-year ECRIP48award shall receive its annual distribution amount in full upon49completion of the requirements set forth in items (I) and (II) of clause50(G) of this subparagraph. The requirements set forth in items (IV) and51(V) of clause (G) of this subparagraph must be completed by the consor-52tium or teaching general hospital in order for the consortium or teach-53ing general hospital to be eligible to apply for ECRIP funding in any54subsequent funding cycle.55(II) Each consortium or teaching general hospital with a two-year56ECRIP award shall receive its first annual distribution amount in fullS. 8307 65 A. 8807 1upon completion of the requirements set forth in items (I) and (II) of2clause (G) of this subparagraph. Each consortium or teaching general3hospital will receive its second annual distribution amount in full upon4completion of the requirements set forth in item (III) of clause (G) of5this subparagraph. The requirements set forth in items (IV) and (V) of6clause (G) of this subparagraph must be completed by the consortium or7teaching general hospital in order for the consortium or teaching gener-8al hospital to be eligible to apply for ECRIP funding in any subsequent9funding cycle.10(E) Each consortium or teaching general hospital receiving distrib-11utions pursuant to this subparagraph shall reserve seventy-five thousand12dollars to primarily fund salary and fringe benefits of the clinical13research position with the remainder going to fund the development of14faculty who are involved in biomedical research, training and clinical15care.16(F) Undistributed or returned funds available to fund clinical17research positions pursuant to this paragraph for a distribution period18shall be available to fund clinical research positions in a subsequent19distribution period.20(G) In order to be eligible for distributions pursuant to this subpar-21agraph, each consortium and teaching general hospital shall provide to22the commissioner by July first of each distribution period, the follow-23ing data and information on a hospital-specific basis. Such data and24information shall be certified as to accuracy and completeness by the25chief executive officer, chief financial officer or chair of the consor-26tium governing body of each consortium or teaching general hospital and27shall be maintained by each consortium and teaching general hospital for28five years from the date of submission:29(I) For each clinical research position, information on the type,30scope, training objectives, institutional support, clinical research31experience of the sponsor-mentor, plans for submitting research outcomes32to peer reviewed journals and at scientific meetings, including a meet-33ing sponsored by the department, the name of a principal contact person34responsible for tracking the career development of researchers placed in35clinical research positions, as defined in paragraph (c) of subdivision36one of this section, and who is authorized to certify to the commission-37er that all the requirements of the clinical research training objec-38tives set forth in this subparagraph shall be met. Such certification39shall be provided by July first of each distribution period;40(II) For each clinical research position, information on the name,41citizenship status, medical education and training, and medical license42number of the researcher, if applicable, shall be provided by December43thirty-first of the calendar year following the distribution period;44(III) Information on the status of the clinical research plan, accom-45plishments, changes in research activities, progress, and performance of46the researcher shall be provided upon completion of one-half of the47award term;48(IV) A final report detailing training experiences, accomplishments,49activities and performance of the clinical researcher, and data, meth-50ods, results and analyses of the clinical research plan shall be51provided three months after the clinical research position ends; and52(V) Tracking information concerning past researchers, including but53not limited to (A) background information, (B) employment history, (C)54research status, (D) current research activities, (E) publications and55presentations, (F) research support, and (G) any other information56necessary to track the researcher; andS. 8307 66 A. 8807 1(VI) Any other data or information required by the commissioner to2implement this subparagraph.3(H) Notwithstanding any inconsistent provision of this subdivision,4for periods on and after April first, two thousand thirteen, ECRIP grant5awards shall be made in accordance with rules and regulations promulgat-6ed by the commissioner. Such regulations shall, at a minimum:7(1) provide that ECRIP grant awards shall be made with the objective8of securing federal funding for biomedical research, training clinical9researchers, recruiting national leaders as faculty to act as mentors,10and training residents and fellows in biomedical research skills;11(2) provide that ECRIP grant applicants may include interdisciplinary12research teams comprised of teaching general hospitals acting in collab-13oration with entities including but not limited to medical centers,14hospitals, universities and local health departments;15(3) provide that applications for ECRIP grant awards shall be based on16such information requested by the commissioner, which shall include but17not be limited to hospital-specific data;18(4) establish the qualifications for investigators and other staff19required for grant projects eligible for ECRIP grant awards; and20(5) establish a methodology for the distribution of funds under ECRIP21grant awards.22(c)] Physician loan repayment program. One million nine hundred sixty 23 thousand dollars for the period January first, two thousand eight 24 through December thirty-first, two thousand eight, one million nine 25 hundred sixty thousand dollars for the period January first, two thou- 26 sand nine through December thirty-first, two thousand nine, one million 27 nine hundred sixty thousand dollars for the period January first, two 28 thousand ten through December thirty-first, two thousand ten, four 29 hundred ninety thousand dollars for the period January first, two thou- 30 sand eleven through March thirty-first, two thousand eleven, one million 31 seven hundred thousand dollars each state fiscal year for the period 32 April first, two thousand eleven through March thirty-first, two thou- 33 sand fourteen, up to one million seven hundred five thousand dollars 34 each state fiscal year for the period April first, two thousand fourteen 35 through March thirty-first, two thousand seventeen, up to one million 36 seven hundred five thousand dollars each state fiscal year for the peri- 37 od April first, two thousand seventeen through March thirty-first, two 38 thousand twenty, up to one million seven hundred five thousand dollars 39 each state fiscal year for the period April first, two thousand twenty 40 through March thirty-first, two thousand twenty-three, and up to one 41 million seven hundred five thousand dollars each state fiscal year for 42 the period April first, two thousand twenty-three through March thirty- 43 first, two thousand twenty-six, shall be set aside and reserved by the 44 commissioner from the regional pools established pursuant to subdivision 45 two of this section and shall be available for purposes of physician 46 loan repayment in accordance with subdivision ten of this section. 47 Notwithstanding any contrary provision of this section, sections one 48 hundred twelve and one hundred sixty-three of the state finance law, or 49 any other contrary provision of law, such funding shall be allocated 50 regionally with one-third of available funds going to New York city and 51 two-thirds of available funds going to the rest of the state and shall 52 be distributed in a manner to be determined by the commissioner without 53 a competitive bid or request for proposal process as follows: 54 (i) Funding shall first be awarded to repay loans of up to twenty-five 55 physicians who train in primary care or specialty tracks in teachingS. 8307 67 A. 8807 1 general hospitals, and who enter and remain in primary care or specialty 2 practices in underserved communities, as determined by the commissioner. 3 (ii) After distributions in accordance with subparagraph (i) of this 4 paragraph, all remaining funds shall be awarded to repay loans of physi- 5 cians who enter and remain in primary care or specialty practices in 6 underserved communities, as determined by the commissioner, including 7 but not limited to physicians working in general hospitals, or other 8 health care facilities. 9 (iii) In no case shall less than fifty percent of the funds available 10 pursuant to this paragraph be distributed in accordance with subpara- 11 graphs (i) and (ii) of this paragraph to physicians identified by gener- 12 al hospitals. 13 (iv) In addition to the funds allocated under this paragraph, for the 14 period April first, two thousand fifteen through March thirty-first, two 15 thousand sixteen, two million dollars shall be available for the 16 purposes described in subdivision ten of this section; 17 (v) In addition to the funds allocated under this paragraph, for the 18 period April first, two thousand sixteen through March thirty-first, two 19 thousand seventeen, two million dollars shall be available for the 20 purposes described in subdivision ten of this section; 21 (vi) Notwithstanding any provision of law to the contrary, and subject 22 to the extension of the Health Care Reform Act of 1996, sufficient funds 23 shall be available for the purposes described in subdivision ten of this 24 section in amounts necessary to fund the remaining year commitments for 25 awards made pursuant to subparagraphs (iv) and (v) of this paragraph. 26 [(d)] (c) Physician practice support. Four million nine hundred thou- 27 sand dollars for the period January first, two thousand eight through 28 December thirty-first, two thousand eight, four million nine hundred 29 thousand dollars annually for the period January first, two thousand 30 nine through December thirty-first, two thousand ten, one million two 31 hundred twenty-five thousand dollars for the period January first, two 32 thousand eleven through March thirty-first, two thousand eleven, four 33 million three hundred thousand dollars each state fiscal year for the 34 period April first, two thousand eleven through March thirty-first, two 35 thousand fourteen, up to four million three hundred sixty thousand 36 dollars each state fiscal year for the period April first, two thousand 37 fourteen through March thirty-first, two thousand seventeen, up to four 38 million three hundred sixty thousand dollars for each state fiscal year 39 for the period April first, two thousand seventeen through March thir- 40 ty-first, two thousand twenty, up to four million three hundred sixty 41 thousand dollars for each fiscal year for the period April first, two 42 thousand twenty through March thirty-first, two thousand twenty-three, 43 and up to four million three hundred sixty thousand dollars for each 44 fiscal year for the period April first, two thousand twenty-three 45 through March thirty-first, two thousand twenty-six, shall be set aside 46 and reserved by the commissioner from the regional pools established 47 pursuant to subdivision two of this section and shall be available for 48 purposes of physician practice support. Notwithstanding any contrary 49 provision of this section, sections one hundred twelve and one hundred 50 sixty-three of the state finance law, or any other contrary provision of 51 law, such funding shall be allocated regionally with one-third of avail- 52 able funds going to New York city and two-thirds of available funds 53 going to the rest of the state and shall be distributed in a manner to 54 be determined by the commissioner without a competitive bid or request 55 for proposal process as follows:S. 8307 68 A. 8807 1 (i) Preference in funding shall first be accorded to teaching general 2 hospitals for up to twenty-five awards, to support costs incurred by 3 physicians trained in primary or specialty tracks who thereafter estab- 4 lish or join practices in underserved communities, as determined by the 5 commissioner. 6 (ii) After distributions in accordance with subparagraph (i) of this 7 paragraph, all remaining funds shall be awarded to physicians to support 8 the cost of establishing or joining practices in underserved communi- 9 ties, as determined by the commissioner, and to hospitals and other 10 health care providers to recruit new physicians to provide services in 11 underserved communities, as determined by the commissioner. 12 (iii) In no case shall less than fifty percent of the funds available 13 pursuant to this paragraph be distributed to general hospitals in 14 accordance with subparagraphs (i) and (ii) of this paragraph. 15 [(e)] (d) Work group. For funding available pursuant to paragraphs (b) 16 and (c)[, (d) and (e)] of this subdivision: 17 (i) The department shall appoint a work group from recommendations 18 made by associations representing physicians, general hospitals and 19 other health care facilities to develop a streamlined application proc- 20 ess by June first, two thousand twelve. 21 (ii) Subject to available funding, applications shall be accepted on a 22 continuous basis. The department shall provide technical assistance to 23 applicants to facilitate their completion of applications. An applicant 24 shall be notified in writing by the department within ten days of 25 receipt of an application as to whether the application is complete and 26 if the application is incomplete, what information is outstanding. The 27 department shall act on an application within thirty days of receipt of 28 a complete application. 29 [(f)] (e) Study on physician workforce. Five hundred ninety thousand 30 dollars annually for the period January first, two thousand eight 31 through December thirty-first, two thousand ten, one hundred forty-eight 32 thousand dollars for the period January first, two thousand eleven 33 through March thirty-first, two thousand eleven, five hundred sixteen 34 thousand dollars each state fiscal year for the period April first, two 35 thousand eleven through March thirty-first, two thousand fourteen, up to 36 four hundred eighty-seven thousand dollars each state fiscal year for 37 the period April first, two thousand fourteen through March thirty- 38 first, two thousand seventeen, up to four hundred eighty-seven thousand 39 dollars for each state fiscal year for the period April first, two thou- 40 sand seventeen through March thirty-first, two thousand twenty, up to 41 four hundred eighty-seven thousand dollars each state fiscal year for 42 the period April first, two thousand twenty through March thirty-first, 43 two thousand twenty-three, and up to four hundred eighty-seven thousand 44 dollars each state fiscal year for the period April first, two thousand 45 twenty-three through March thirty-first, two thousand twenty-six, shall 46 be set aside and reserved by the commissioner from the regional pools 47 established pursuant to subdivision two of this section and shall be 48 available to fund a study of physician workforce needs and solutions 49 including, but not limited to, an analysis of residency programs and 50 projected physician workforce and community needs. The commissioner 51 shall enter into agreements with one or more organizations to conduct 52 such study based on a request for proposal process. 53 [(g)] (f) Diversity in medicine/post-baccalaureate program. Notwith- 54 standing any inconsistent provision of section one hundred twelve or one 55 hundred sixty-three of the state finance law or any other law, one 56 million nine hundred sixty thousand dollars annually for the periodS. 8307 69 A. 8807 1 January first, two thousand eight through December thirty-first, two 2 thousand ten, four hundred ninety thousand dollars for the period Janu- 3 ary first, two thousand eleven through March thirty-first, two thousand 4 eleven, one million seven hundred thousand dollars each state fiscal 5 year for the period April first, two thousand eleven through March thir- 6 ty-first, two thousand fourteen, up to one million six hundred five 7 thousand dollars each state fiscal year for the period April first, two 8 thousand fourteen through March thirty-first, two thousand seventeen, up 9 to one million six hundred five thousand dollars each state fiscal year 10 for the period April first, two thousand seventeen through March thir- 11 ty-first, two thousand twenty, up to one million six hundred five thou- 12 sand dollars each state fiscal year for the period April first, two 13 thousand twenty through March thirty-first, two thousand twenty-three, 14 and up to one million six hundred five thousand dollars each state 15 fiscal year for the period April first, two thousand twenty-three 16 through March thirty-first, two thousand twenty-six, shall be set aside 17 and reserved by the commissioner from the regional pools established 18 pursuant to subdivision two of this section and shall be available for 19 distributions to the Associated Medical Schools of New York to fund its 20 diversity program including existing and new post-baccalaureate programs 21 for minority and economically disadvantaged students and encourage 22 participation from all medical schools in New York. The associated 23 medical schools of New York shall report to the commissioner on an annu- 24 al basis regarding the use of funds for such purpose in such form and 25 manner as specified by the commissioner. 26 [(h)] (g) In the event there are undistributed funds within amounts 27 made available for distributions pursuant to this subdivision, such 28 funds may be reallocated and distributed in current or subsequent 29 distribution periods in a manner determined by the commissioner for any 30 purpose set forth in this subdivision. 31 12. Notwithstanding any provision of law to the contrary, applications 32 submitted on or after April first, two thousand sixteen, for the physi- 33 cian loan repayment program pursuant to paragraph [(c)] (b) of subdivi- 34 sion five-a of this section and subdivision ten of this section or the 35 physician practice support program pursuant to paragraph [(d)] (c) of 36 subdivision five-a of this section, shall be subject to the following 37 changes: 38 (a) Awards shall be made from the total funding available for new 39 awards under the physician loan repayment program and the physician 40 practice support program, with neither program limited to a specific 41 funding amount within such total funding available; 42 (b) An applicant may apply for an award for either physician loan 43 repayment or physician practice support, but not both; 44 (c) An applicant shall agree to practice for three years in an under- 45 served area and each award shall provide up to forty thousand dollars 46 for each of the three years; and 47 (d) To the extent practicable, awards shall be timed to be of use for 48 job offers made to applicants. 49 § 4. Subparagraph (xvi) of paragraph (a) of subdivision 7 of section 50 2807-s of the public health law, as amended by section 8 of part Y of 51 chapter 56 of the laws of 2020, is amended to read as follows: 52 (xvi) provided further, however, for periods prior to July first, two 53 thousand nine, amounts set forth in this paragraph shall be reduced by 54 an amount equal to the actual distribution reductions for all facilities 55 pursuant to paragraph [(s)] (o) of subdivision one of section twenty- 56 eight hundred seven-m of this article.S. 8307 70 A. 8807 1 § 5. Subdivision (c) of section 92-dd of the state finance law, as 2 amended by section 9 of part Y of chapter 56 of the laws of 2020, is 3 amended to read as follows: 4 (c) The pool administrator shall, from appropriated funds transferred 5 to the pool administrator from the comptroller, continue to make 6 payments as required pursuant to sections twenty-eight hundred seven-k, 7 twenty-eight hundred seven-m (not including payments made pursuant to 8 subdivision five-b and paragraphs (b), (c)[, (d),, (f)] and [(g)] (f) of 9 subdivision five-a of section twenty-eight hundred seven-m), and twen- 10 ty-eight hundred seven-w of the public health law, paragraph (e) of 11 subdivision twenty-five of section twenty-eight hundred seven-c of the 12 public health law, paragraphs (b) and (c) of subdivision thirty of 13 section twenty-eight hundred seven-c of the public health law, paragraph 14 (b) of subdivision eighteen of section twenty-eight hundred eight of the 15 public health law, subdivision seven of section twenty-five hundred-d of 16 the public health law and section eighty-eight of chapter one of the 17 laws of nineteen hundred ninety-nine. 18 § 6. Paragraph (c) of subdivision 1 of section 461-b of the social 19 services law is REPEALED. 20 § 7. Article 27-H of the public health law is REPEALED. 21 § 8. Paragraph (c) of subdivision 11 of section 230 of the public 22 health law, as amended by chapter 343 of the laws of 1980, subparagraph 23 (ii) as amended by section 10 of part B of chapter 57 of the laws of 24 2023, is amended to read as follows: 25 (c) Notwithstanding the foregoing, no physician shall be responsible 26 for reporting pursuant to paragraph (a) of this subdivision with respect 27 to any information discovered by such physician solely as a result of: 28 [(i)] Participation in a properly conducted mortality and/or morbidity 29 conference, departmental meeting or a medical or tissue committee 30 constituted pursuant to the by-laws of a hospital which is duly estab- 31 lished pursuant to article twenty-eight of the public health law, unless 32 the procedures of such conference, department or committee of such 33 hospital shall have been declared to be unacceptable for the purpose 34 hereof by the commissioner, and provided that the obligations of report- 35 ing such information when appropriate to do so shall be the responsibil- 36 ity of the chairperson of such conference, department or committee, or 37 [(ii) Participation and membership during a three year demonstration38period in a physician committee of the Medical Society of the State of39New York or the New York State Osteopathic Society whose purpose is to40confront and refer to treatment physicians who are thought to be suffer-41ing from alcoholism, drug abuse, or mental illness. Such demonstration42period shall commence on April first, nineteen hundred eighty and termi-43nate on May thirty-first, nineteen hundred eighty-three. An additional44demonstration period shall commence on June first, nineteen hundred45eighty-three and terminate on March thirty-first, nineteen hundred46eighty-six. An additional demonstration period shall commence on April47first, nineteen hundred eighty-six and terminate on March thirty-first,48nineteen hundred eighty-nine. An additional demonstration period shall49commence April first, nineteen hundred eighty-nine and terminate March50thirty-first, nineteen hundred ninety-two. An additional demonstration51period shall commence April first, nineteen hundred ninety-two and52terminate March thirty-first, nineteen hundred ninety-five. An addi-53tional demonstration period shall commence on April first, nineteen54hundred ninety-five and terminate on March thirty-first, nineteen55hundred ninety-eight. An additional demonstration period shall commence56on April first, nineteen hundred ninety-eight and terminate on MarchS. 8307 71 A. 8807 1thirty-first, two thousand three. An additional demonstration period2shall commence on April first, two thousand three and terminate on March3thirty-first, two thousand thirteen. An additional demonstration period4shall commence April first, two thousand thirteen and terminate on March5thirty-first, two thousand eighteen. An additional demonstration period6shall commence April first, two thousand eighteen and terminate on July7first, two thousand twenty-eight provided, however, that the commission-8er may prescribe requirements for the continuation of such demonstration9program, including periodic reviews of such programs and submission of10any reports and data necessary to permit such reviews. During these11additional periods, the provisions of this subparagraph shall also apply12to a physician committee of a county medical society.] 13 § 9. Paragraph (g) of subdivision 11 of section 230 of the public 14 health law is REPEALED and paragraph (h) is relettered paragraph (g). 15 § 10. This act shall take effect immediately and shall be deemed to 16 have been in full force and effect on and after April 1, 2024; provided, 17 however, the amendments to subparagraph (xvi) of paragraph (a) of subdi- 18 vision 7 of section 2807-s of the public health law made by section four 19 of this act shall not affect the expiration of such section and shall be 20 deemed to expire therewith. 21 PART M 22 Section 1. Subparagraph 3 of paragraph (b) of subdivision 4 of section 23 366 of the social services law, as added by section 2 of part D of chap- 24 ter 56 of the laws of 2013, is amended to read as follows: 25 (3) (A) A child [under] between the [age] ages of six and nineteen who 26 is determined eligible for medical assistance under the provisions of 27 this section, shall, consistent with applicable federal requirements, 28 remain eligible for such assistance until [the earlier of:29(i)] the last day of the month which is twelve months following the 30 determination [or redetermination] or renewal of eligibility for such 31 assistance[; or32(ii) the last day of the month in which the child reaches the age of33nineteen]. 34 (B) A child under the age of six who is determined eligible for 35 medical assistance under the provisions of this section, shall, consist- 36 ent with applicable federal requirements, remain continuously eligible 37 for medical assistance coverage until the later of: 38 (i) the last day of the twelfth month following the determination or 39 renewal of eligibility for such assistance; or 40 (ii) the last day of the month in which the child reaches the age of 41 six. 42 § 2. Subdivision 6 of section 2510 of the public health law is amended 43 by adding a new paragraph (e) to read as follows: 44 (e) an eligible child under six years of age shall, consistent with 45 applicable federal requirements, remain continuously enrolled until the 46 later of: 47 (i) the last day of the twelfth month following the date of enrollment 48 or recertification in the child health insurance plan; or 49 (ii) the last day of the month in which the child reaches the age of 50 six. 51 § 3. This act shall take effect January 1, 2025. 52 PART NS. 8307 72 A. 8807 1 Section 1. Paragraph (d) of subdivision 4 of section 206 of the public 2 health law, as added by chapter 602 of the laws of 2007, is amended and 3 a new paragraph (e) is added to read as follows: 4 (d) assess civil penalties against a public water system which 5 provides water to the public for human consumption through pipes or 6 other constructed conveyances, as further defined in the state sanitary 7 code or, in the case of mass gatherings, the person who holds or 8 promotes the mass gathering as defined in subdivision five of section 9 two hundred twenty-five of this article not to exceed twenty-five thou- 10 sand dollars per day, for each violation of or failure to comply with 11 any term or provision of the state sanitary code as it relates to public 12 water systems that serve a population of five thousand or more persons 13 or any mass gatherings, which penalty may be assessed after a hearing or 14 an opportunity to be heard[.]; 15 (e) notwithstanding section sixty-five hundred thirty of the education 16 law, issue a non-patient specific statewide standing order for the 17 provision of doula services for pregnant, birthing, and postpartum indi- 18 viduals through twelve months postpartum. 19 § 2. Subdivision 3 of section 2504 of the public health law, as added 20 by chapter 976 of the laws of 1984, is amended to read as follows: 21 3. Any person, including a minor, who is pregnant may give effective 22 consent for any and all medical, dental, health and hospital services 23 relating to [prenatal] reproductive health care, including consent to 24 terminate a pregnancy for any reason. 25 § 3. The opening paragraph of section 2599-aa of the public health 26 law, as added by chapter 1 of the laws of 2019, is amended to read as 27 follows: 28 The legislature finds that comprehensive reproductive health care is a 29 fundamental component of every individual's health, privacy and 30 equality, including minors. Therefore, it is the policy of the state 31 that: 32 § 4. The public health law is amended by adding a new section 33 2599-bb-1 to read as follows: 34 § 2599-bb-1. Contraception. 1. A health care practitioner licensed, 35 certified, or authorized under title eight of the education law, acting 36 within their lawful scope of practice, may prescribe or distribute a 37 contraceptive device or medication when, according to the practitioner's 38 reasonable and good faith professional judgment based on the facts of 39 the patient's case, they determine the patient is able to medically 40 tolerate such treatment. 41 2. This article shall be construed and applied consistent with and 42 subject to applicable laws and applicable and authorized regulations 43 governing health care procedures. 44 § 5. This act shall take effect immediately and shall be deemed to 45 have been in full force and effect on and after April 1, 2024. 46 PART O 47 Section 1. Subdivision 1 of section 2807-k of the public health law is 48 amended by adding a new paragraph (h) to read as follows: 49 (h) "Underinsured" shall mean an individual with out of pocket medical 50 costs that amount to more than ten percent of such individual's gross 51 annual income for the past twelve months. 52 § 2. Subdivision 9-a of section 2807-k of the public health law, as 53 added by section 39-a of part A of chapter 57 of the laws of 2006 andS. 8307 73 A. 8807 1 paragraph (k) as added by section 43 of part B of chapter 58 of the laws 2 of 2008, is amended to read as follows: 3 9-a. (a) As a condition for participation in pool distributions 4 authorized pursuant to this section and section twenty-eight hundred 5 seven-w of this article for periods on and after January first, two 6 thousand nine, general hospitals shall, effective for periods on and 7 after January first, two thousand seven, establish financial aid poli- 8 cies and procedures, in accordance with the provisions of this subdivi- 9 sion, for reducing charges otherwise applicable to low-income individ- 10 uals without health insurance or underinsured individuals, or who have 11 exhausted their health insurance benefits, and who can demonstrate an 12 inability to pay full charges, and also, at the hospital's discretion, 13 for reducing or discounting the collection of co-pays and deductible 14 payments from those individuals who can demonstrate an inability to pay 15 such amounts. 16 (b) Such reductions from charges for [uninsured] patients with incomes 17 below at least [three] four hundred percent of the federal poverty level 18 shall result in a charge to such individuals that does not exceed [the19greater of] the amount that would have been paid for the same services 20 [by the "highest volume payor" for such general hospital as defined in21subparagraph (v) of this paragraph, or for services provided pursuant to22title XVIII of the federal social security act (medicare), or for23services] provided pursuant to title XIX of the federal social security 24 act (medicaid), and provided further that such amounts shall be adjusted 25 according to income level as follows: 26 (i) For patients with incomes [at or] below at least [one] two hundred 27 percent of the federal poverty level, the hospital shall [collect no28more than a nominal payment amount, consistent with guidelines estab-29lished by the commissioner] waive all charges. No nominal payment shall 30 be collected; 31 (ii) For patients with incomes between at least [one] two hundred 32 [one] percent and [one] up to three hundred [fifty] percent of the 33 federal poverty level, the hospital shall collect no more than the 34 amount identified after application of a proportional sliding fee sched- 35 ule under which patients with lower incomes shall pay the lowest amount. 36 Such schedule shall provide that the amount the hospital may collect for 37 such patients increases [from the nominal amount described in subpara-38graph (i) of this paragraph] in equal increments as the income of the 39 patient increases, up to a maximum of [twenty] ten percent of the 40 [greater of the] amount that would have been paid for the same services 41 [by the "highest volume payor" for such general hospital, as defined in42subparagraph (v) of this paragraph, or for services provided pursuant to43title XVIII of the federal social security act (medicare) or for44services] provided pursuant to title XIX of the federal social security 45 act (medicaid), or for underinsured patients, up to a maximum of ten 46 percent of the amount that would have been paid pursuant to such 47 patient's insurance cost sharing; 48 (iii) For patients with incomes between at least [one] three hundred 49 [fifty-one] one percent and [two] four hundred [fifty] percent of the 50 federal poverty level, the hospital shall collect no more than the 51 amount identified after application of a proportional sliding fee sched- 52 ule under which patients with lower income shall pay the lowest amounts. 53 Such schedule shall provide that the amount the hospital may collect for 54 such patients increases from the [twenty] ten percent figure described 55 in subparagraph (ii) of this paragraph in equal increments as the income 56 of the patient increases, up to a maximum of [the greater] twentyS. 8307 74 A. 8807 1 percent of the amount that would have been paid for the same services 2 [by the "highest volume payor" for such general hospital, as defined in3subparagraph (v) of this paragraph, or for services provided pursuant to4title XVIII of the federal social security act (medicare) or for5services] provided pursuant to title XIX of the federal social security 6 act (medicaid), or for underinsured patients, up to a maximum of twenty 7 percent of the amount that would have been paid pursuant to such 8 patient's insurance cost sharing; [and9(iv) For patients with incomes between at least two hundred fifty-one10percent and three hundred percent of the federal poverty level, the11hospital shall collect no more than the greater of the amount that would12have been paid for the same services by the "highest volume payor" for13such general hospital as defined in subparagraph (v) of this paragraph,14or for services provided pursuant to title XVIII of the federal social15security act (medicare), or for services provided pursuant to title XIX16of the federal social security act (medicaid).17(v) For the purposes of this paragraph, "highest volume payor" shall18mean the insurer, corporation or organization licensed, organized or19certified pursuant to article thirty-two, forty-two or forty-three of20the insurance law or article forty-four of this chapter, or other third-21party payor, which has a contract or agreement to pay claims for22services provided by the general hospital and incurred the highest23volume of claims in the previous calendar year.24(vi) A hospital may implement policies and procedures to permit, but25not require, consideration on a case-by-case basis of exceptions to the26requirements described in subparagraphs (i) and (ii) of this paragraph27based upon the existence of significant assets owned by the patient that28should be taken into account in determining the appropriate payment29amount for that patient's care, provided, however, that such proposed30policies and procedures shall be subject to the prior review and31approval of the commissioner and, if approved, shall be included in the32hospital's financial assistance policy established pursuant to this33section, and provided further that, if such approval is granted, the34maximum amount that may be collected shall not exceed the greater of the35amount that would have been paid for the same services by the "highest36volume payor" for such general hospital as defined in subparagraph (v)37of this paragraph, or for services provided pursuant to title XVIII of38the federal social security act (medicare), or for services provided39pursuant to title XIX of the federal social security act (medicaid). In40the event that a general hospital reviews a patient's assets in deter-41mining payment adjustments such policies and procedures shall not42consider as assets a patient's primary residence, assets held in a tax-43deferred or comparable retirement savings account, college savings44accounts, or cars used regularly by a patient or immediate family45members.46(vii)] (iv) Nothing in this paragraph shall be construed to limit a 47 hospital's ability to establish patient eligibility for payment 48 discounts at income levels higher than those specified herein and/or to 49 provide greater payment discounts for eligible patients than those 50 required by this paragraph. 51 (c) Such policies and procedures shall be clear, understandable, in 52 writing and publicly available in summary form and each general hospital 53 participating in the pool shall ensure that every patient is made aware 54 of the existence of such policies and procedures and is provided, in a 55 timely manner, with a summary of such policies and procedures [upon56request]. Any summary provided to patients shall, at a minimum, includeS. 8307 75 A. 8807 1 specific information as to income levels used to determine eligibility 2 for assistance, a description of the primary service area of the hospi- 3 tal and the means of applying for assistance. For general hospitals with 4 twenty-four hour emergency departments, such policies and procedures 5 shall require the written notification of patients during the intake and 6 registration process, and during discharge of the patient, and through 7 the conspicuous posting of language-appropriate information in the 8 general hospital, and information on bills and statements sent to 9 patients, that financial aid may be available to qualified patients and 10 how to obtain further information. For specialty hospitals without twen- 11 ty-four hour emergency departments, such notification shall take place 12 through written materials provided to patients during the intake and 13 registration process prior to the provision of any health care services 14 or procedures, and during discharge of the patient, and through informa- 15 tion on bills and statements sent to patients, that financial aid may be 16 available to qualified patients and how to obtain further information. 17 Application materials shall include a notice to patients that upon 18 submission of a completed application, including any information or 19 documentation needed to determine the patient's eligibility pursuant to 20 the hospital's financial assistance policy, the patient may disregard 21 any bills until the hospital has rendered a decision on the application 22 in accordance with this paragraph. 23 (d) Such policies and procedures shall include clear, objective crite- 24 ria for determining a patient's ability to pay and for providing such 25 adjustments to payment requirements as are necessary. In addition to 26 adjustment mechanisms such as sliding fee schedules and discounts to 27 fixed standards, such policies and procedures shall also provide for the 28 use of installment plans for the payment of outstanding balances by 29 patients pursuant to the provisions of the hospital's financial assist- 30 ance policy. The monthly payment under such a plan shall not exceed 31 [ten] five percent of the gross monthly income of the patient[,32provided, however, that if patient assets are considered under such a33policy, then patient assets which are not excluded assets pursuant to34subparagraph (vi) of paragraph (b) of this subdivision may be considered35in addition to the limit on monthly payments]. The rate of interest 36 charged to the patient on the unpaid balance, if any, shall not exceed 37 [the rate for a ninety-day security issued by the United States Depart-38ment of Treasury, plus .5] two percent and no plan shall include an 39 accelerator or similar clause under which a higher rate of interest is 40 triggered upon a missed payment. If such policies and procedures include 41 a requirement of a deposit prior to non-emergent, medically-necessary 42 care, such deposit must be included as part of any financial aid consid- 43 eration. Such policies and procedures shall be applied consistently to 44 all eligible patients. 45 (e) Such policies and procedures shall permit patients to apply for 46 assistance [within at least ninety days of the date of discharge or date47of service and provide at least twenty days for patients to submit a48completed application] at any time during the collection process. Such 49 policies and procedures may require that patients seeking payment 50 adjustments provide appropriate financial information and documentation 51 in support of their application, provided, however, that such applica- 52 tion process shall not be unduly burdensome or complex. General hospi- 53 tals shall, upon request, assist patients in understanding the hospi- 54 tal's policies and procedures and in applying for payment adjustments. 55 Application forms shall be printed in the "primary languages" of 56 patients served by the general hospital. For the purposes of this para-S. 8307 76 A. 8807 1 graph, "primary languages" shall include any language that is either (i) 2 used to communicate, during at least five percent of patient visits in a 3 year, by patients who cannot speak, read, write or understand the 4 English language at the level of proficiency necessary for effective 5 communication with health care providers, or (ii) spoken by non-English 6 speaking individuals comprising more than one percent of the primary 7 hospital service area population, as calculated using demographic infor- 8 mation available from the United States Bureau of the Census, supple- 9 mented by data from school systems. Decisions regarding such applica- 10 tions shall be made within thirty days of receipt of a completed 11 application. Such policies and procedures shall require that the hospi- 12 tal issue any denial/approval of such application in writing with infor- 13 mation on how to appeal the denial and shall require the hospital to 14 establish an appeals process under which it will evaluate the denial of 15 an application. Nothing in this subdivision shall be interpreted as 16 prohibiting a hospital from making the availability of financial assist- 17 ance contingent upon the patient first applying for coverage under title 18 XIX of the social security act (medicaid) or another insurance program 19 if, in the judgment of the hospital, the patient may be eligible for 20 medicaid or another insurance program, and upon the patient's cooper- 21 ation in following the hospital's financial assistance application 22 requirements, including the provision of information needed to make a 23 determination on the patient's application in accordance with the hospi- 24 tal's financial assistance policy. 25 (f) Such policies and procedures shall provide that patients with 26 incomes below [three] four hundred percent of the federal poverty level 27 are deemed presumptively eligible for payment adjustments and shall 28 conform to the requirements set forth in paragraph (b) of this subdivi- 29 sion, provided, however, that nothing in this subdivision shall be 30 interpreted as precluding hospitals from extending such payment adjust- 31 ments to other patients, either generally or on a case-by-case basis. 32 Such policies and procedures shall provide financial aid for emergency 33 hospital services, including emergency transfers pursuant to the federal 34 emergency medical treatment and active labor act (42 USC 1395dd), to 35 patients who reside in New York state and for medically necessary hospi- 36 tal services for patients who reside in the hospital's primary service 37 area as determined according to criteria established by the commission- 38 er. In developing such criteria, the commissioner shall consult with 39 representatives of the hospital industry, health care consumer advocates 40 and local public health officials. Such criteria shall be made available 41 to the public no less than thirty days prior to the date of implementa- 42 tion and shall, at a minimum: 43 (i) prohibit a hospital from developing or altering its primary 44 service area in a manner designed to avoid medically underserved commu- 45 nities or communities with high percentages of uninsured residents; 46 (ii) ensure that every geographic area of the state is included in at 47 least one general hospital's primary service area so that eligible 48 patients may access care and financial assistance; and 49 (iii) require the hospital to notify the commissioner upon making any 50 change to its primary service area, and to include a description of its 51 primary service area in the hospital's annual implementation report 52 filed pursuant to subdivision three of section twenty-eight hundred 53 three-l of this article. 54 (g) Nothing in this subdivision shall be interpreted as precluding 55 hospitals from extending payment adjustments for medically necessary 56 non-emergency hospital services to patients outside of the hospital'sS. 8307 77 A. 8807 1 primary service area. For patients determined to be eligible for finan- 2 cial aid under the terms of a hospital's financial aid policy, such 3 policies and procedures shall prohibit any limitations on financial aid 4 for services based on the medical condition of the applicant, other than 5 typical limitations or exclusions based on medical necessity or the 6 clinical or therapeutic benefit of a procedure or treatment. 7 (h) Such policies and procedures shall prohibit the denial of admis- 8 sion or denial of treatment for services that are reasonably anticipated 9 to be medically necessary because the patient has an unpaid medical 10 bill. Such policies and procedures shall [not permit] prohibit the 11 forced sale or foreclosure of a patient's primary residence in order to 12 collect an outstanding medical bill and shall require the hospital to 13 refrain from sending an account to collection if the patient has submit- 14 ted a completed application for financial aid, including any required 15 supporting documentation, while the hospital determines the patient's 16 eligibility for such aid. Such policies and procedures shall prohibit 17 the sale of medical debt accumulated pursuant to this section to a third 18 party, unless the third party explicitly purchases such medical debt in 19 order to relieve the debt of the patient. Such policies and procedures 20 shall provide for written notification, which shall include notification 21 on a patient bill, to a patient not less than thirty days prior to the 22 referral of debts for collection and shall require that the collection 23 agency obtain the hospital's written consent prior to commencing a legal 24 action. Such policies and procedures shall prohibit a hospital from 25 commencing a legal action related to the recovery of medical debt or 26 unpaid bills against patients with incomes below four hundred percent of 27 the federal poverty level. In any legal action related to the recovery 28 of medical debt or unpaid bills by or on behalf of a hospital, the 29 complaint shall be accompanied by an affidavit by the hospital's chief 30 financial officer stating that based upon the hospital's reasonable 31 effort to determine the patient's income, the patient whom they are 32 taking legal action against does not have an income below four hundred 33 percent of the federal poverty level. Such policies and procedures shall 34 require all general hospital staff who interact with patients or have 35 responsibility for billing and collections to be trained in such poli- 36 cies and procedures, and require the implementation of a mechanism for 37 the general hospital to measure its compliance with such policies and 38 procedures. Such policies and procedures shall require that any 39 collection agency under contract with a general hospital for the 40 collection of debts follow the hospital's financial assistance policy, 41 including providing information to patients on how to apply for finan- 42 cial assistance where appropriate. Such policies and procedures shall 43 prohibit collections from a patient who is determined to be eligible for 44 medical assistance pursuant to title XIX of the federal social security 45 act at the time services were rendered and for which services medicaid 46 payment is available. 47 (i) Reports required to be submitted to the department by each general 48 hospital as a condition for participation in the pools, and which 49 contain, in accordance with applicable regulations, a certification from 50 an independent certified public accountant or independent licensed 51 public accountant or an attestation from a senior official of the hospi- 52 tal that the hospital is in compliance with conditions of participation 53 in the pools, shall also contain, for reporting periods on and after 54 January first, two thousand seven: 55 (i) a report on hospital costs incurred and uncollected amounts in 56 providing services to eligible patients without insurance[, includingS. 8307 78 A. 8807 1the amount of care provided for a nominal payment amount,] during the 2 period covered by the report; 3 (ii) hospital costs incurred and uncollected amounts for deductibles 4 and coinsurance for eligible patients with insurance or other third-par- 5 ty payor coverage; 6 (iii) the number of patients, including their age, race, ethnicity, 7 gender and insurance status, organized according to United States postal 8 service zip code, who applied for financial assistance pursuant to the 9 hospital's financial assistance policy, and the number, organized 10 according to United States postal service zip code, whose applications 11 were approved and whose applications were denied; 12 (iv) the reimbursement received for indigent care from the pool estab- 13 lished pursuant to this section; 14 (v) the amount of funds that have been expended on charity care from 15 charitable bequests made or trusts established for the purpose of 16 providing financial assistance to patients who are eligible in accord- 17 ance with the terms of such bequests or trusts; 18 (vi) for hospitals located in social services districts in which the 19 district allows hospitals to assist patients with such applications, the 20 number of applications for eligibility under title XIX of the social 21 security act (medicaid) that the hospital assisted patients in complet- 22 ing and the number denied and approved; and 23 (vii) the hospital's financial losses resulting from services provided 24 under medicaid[; and25(viii) the number of liens placed on the primary residences of26patients through the collection process used by a hospital]. 27 (j) Within ninety days of the effective date of this subdivision each 28 hospital shall submit to the commissioner a written report on its poli- 29 cies and procedures for financial assistance to patients which are used 30 by the hospital on the effective date of this subdivision. Such report 31 shall include copies of its policies and procedures, including material 32 which is distributed to patients, and a description of the hospital's 33 financial aid policies and procedures. Such description shall include 34 the income levels of patients on which eligibility is based, the finan- 35 cial aid eligible patients receive and the means of calculating such 36 aid, and the service area, if any, used by the hospital to determine 37 eligibility. 38 (k) In the event it is determined by the commissioner that the state 39 will be unable to secure all necessary federal approvals to include, as 40 part of the state's approved state plan under title nineteen of the 41 federal social security act, a requirement, as set forth in paragraph 42 [one] (a) of this subdivision, that compliance with this subdivision is 43 a condition of participation in pool distributions authorized pursuant 44 to this section and section twenty-eight hundred seven-w of this arti- 45 cle, then such condition of participation shall be deemed null and void 46 and, notwithstanding section twelve of this chapter, failure to comply 47 with the provisions of this subdivision by a hospital on and after the 48 date of such determination shall make such hospital liable for a civil 49 penalty not to exceed ten thousand dollars for each such violation. The 50 imposition of such civil penalties shall be subject to the provisions of 51 section twelve-a of this chapter. 52 (l) A hospital or its collection agent shall not commence a civil 53 action against a patient or delegate a collection activity to a debt 54 collector for nonpayment for at least one hundred eighty days after the 55 first post-service bill is issued and until a hospital has made reason-S. 8307 79 A. 8807 1 able efforts to determine whether a patient qualifies for financial 2 assistance. 3 § 3. The public health law is amended by adding a new section 18-c to 4 read as follows: 5 § 18-c. Separate patient consent for treatment and payment for health 6 care services. Informed consent from a patient to provide any treatment, 7 procedure, examination or other direct health care services shall be 8 obtained separately from such patient's consent to pay for the services. 9 Consent to pay for any health care services by a patient shall not be 10 given prior to the patient receiving such services and discussing treat- 11 ment costs. For purposes of this section, "consent" means an action 12 which: (a) clearly and conspicuously communicates the individual's 13 authorization of an act or practice; (b) is made in the absence of any 14 mechanism in the user interface that has the purpose or substantial 15 effect of obscuring, subverting, or impairing decision-making or choice 16 to obtain consent; and (c) cannot be inferred from inaction. 17 § 4. The general business law is amended by adding two new sections 18 349-g and 519-a to read as follows: 19 § 349-g. Restrictions on applications for and use of credit cards and 20 medical financial products. 1. For purposes of this section, the follow- 21 ing terms shall have the following meanings: 22 (a) "Medical financial products" shall mean medical credit cards and 23 third-party medical installment loans. 24 (b) "Health care provider" shall mean a health care professional 25 licensed, registered or certified pursuant to title eight of the educa- 26 tion law. 27 (c) "Provider offices" shall mean either of the following: 28 (i) An office of a health care provider in solo practice; or 29 (ii) An office in which services or goods are personally provided by 30 the health care provider or by employees in that office, or personally 31 by independent contractors in that office, in accordance with law. 32 Employees and independent contractors shall be licensed or certified 33 when licensure or certification is required by law. 34 2. It shall be prohibited for any individual to complete any portion 35 of an application for medical financial products for the patient or 36 otherwise arrange for or establish an application that is not completely 37 filled out by the patient. 38 § 519-a. Medical financial products; payment for health care services. 39 1. For purposes of this section, the following terms shall have the 40 following meanings: 41 (a) "Credit card" shall have the same meaning as in section five 42 hundred eleven of this article. 43 (b) "Medical credit card" means a credit card issued under an open-end 44 or closed-end plan offered specifically for the payment of health care 45 services, products, or devices provided to a person. 46 2. No health care provider shall require credit card pre-authorization 47 nor require the patient to have a credit card on file prior to providing 48 emergency or medically necessary medical services to such patient. 49 3. Health care providers shall notify all patients about the risks of 50 paying for medical services with a credit card. Such notification shall 51 highlight the fact that by using a credit card to pay for medical 52 services, the patient is forgoing state and federal protections that 53 regard medical debt. The commissioner of health shall have the authori- 54 ty and sole discretion to set requirements for the contents of such 55 notices.S. 8307 80 A. 8807 1 § 5. This act shall take effect six months after it shall have become 2 a law. 3 PART P 4 Section 1. Section 8 of part C of chapter 57 of the laws of 2022 5 amending the public health law and the education law relating to allow- 6 ing pharmacists to direct limited service laboratories and order and 7 administer COVID-19 and influenza tests and modernizing nurse practi- 8 tioners, is amended to read as follows: 9 § 8. This act shall take effect immediately and shall be deemed to 10 have been in full force and effect on and after April 1, 2022; provided, 11 however, that sections [one, two,] three[,] and four[, six and seven] of 12 this act shall expire and be deemed repealed [two years after it shall13have become a law] April 1, 2026. 14 § 2. Section 5 of chapter 21 of the laws of 2011 amending the educa- 15 tion law relating to authorizing pharmacists to perform collaborative 16 drug therapy management with physicians in certain settings, as amended 17 by section 5 of part CC of chapter 57 of the laws of 2022, is amended to 18 read as follows: 19 § 5. This act shall take effect on the one hundred twentieth day after 20 it shall have become a law[, provided, however, that the provisions of21sections two, three, and four of this act shall expire and be deemed22repealed July 1, 2024]; provided, however, that the amendments to subdi- 23 vision 1 of section 6801 of the education law made by section one of 24 this act shall be subject to the expiration and reversion of such subdi- 25 vision pursuant to section 8 of chapter 563 of the laws of 2008, when 26 upon such date the provisions of section one-a of this act shall take 27 effect; provided, further, that effective immediately, the addition, 28 amendment and/or repeal of any rule or regulation necessary for the 29 implementation of this act on its effective date are authorized and 30 directed to be made and completed on or before such effective date. 31 § 3. This act shall take effect immediately and shall be deemed to 32 have been in full force and effect on and after April 1, 2024. 33 PART Q 34 Section 1. Section 6542 of the education law, as amended by chapter 48 35 of the laws of 2012, subdivisions 3 and 5 as amended by section 1 of 36 part T of chapter 57 of the laws of 2013, is amended to read as follows: 37 § 6542. Performance of medical services. 1. Notwithstanding any other 38 provision of law, a physician assistant may perform medical services, 39 but only when under the supervision of a physician and only when such 40 acts and duties as are assigned to him or her are within the scope of 41 practice of such supervising physician unless otherwise permitted by 42 this section. 43 1-a. (a) A physician assistant may practice without the supervision of 44 a physician under the following circumstances: 45 (i) Where the physician assistant, licensed under section sixty-five 46 hundred forty-one of this article has practiced for more than eight 47 thousand hours; and 48 (A) is practicing in primary care. For purposes of this clause, 49 "primary care" shall mean non-surgical care in the fields of general 50 pediatrics, general adult medicine, general geriatric medicine, general 51 internal medicine, obstetrics and gynecology, family medicine, or such 52 other related areas as determined by the commissioner of health; orS. 8307 81 A. 8807 1 (B) is employed by a health system or hospital established under arti- 2 cle twenty-eight of the public health law, and the health system or 3 hospital determines the physician assistant meets the qualifications of 4 the medical staff bylaws and the health system or hospital gives the 5 physician assistant privileges; and 6 (ii) Where a physician assistant licensed under section sixty-five 7 hundred forty-one of this article has completed a program approved by 8 the department of health, in consultation with the department, when such 9 services are performed within the scope of such program. 10 (b) The department and the department of health are authorized to 11 promulgate and update regulations pursuant to this section. 12 2. [Supervision] Where supervision is required by this section, it 13 shall be continuous but shall not be construed as necessarily requiring 14 the physical presence of the supervising physician at the time and place 15 where such services are performed. 16 3. [No physician shall employ or supervise more than four physician17assistants in his or her private practice.184.] Nothing in this article shall prohibit a hospital from employing 19 physician assistants provided they [work under the supervision of a20physician designated by the hospital and not beyond the scope of prac-21tice of such physician. The numerical limitation of subdivision three of22this section shall not apply to services performed in a hospital.235. Notwithstanding any other provision of this article, nothing shall24prohibit a physician employed by or rendering services to the department25of corrections and community supervision under contract from supervising26no more than six physician assistants in his or her practice for the27department of corrections and community supervision.286. Notwithstanding any other provision of law, a trainee in an29approved program may perform medical services when such services are30performed within the scope of such program.] meet the qualifications of 31 the medical staff bylaws and are given privileges and otherwise meet the 32 requirements of this section. 33 4. A physician assistant shall be authorized to prescribe, dispense, 34 order, administer, or procure items necessary to commence or complete a 35 course of therapy. 36 5. A physician assistant may prescribe and order a patient specific 37 order or non-patient specific regimen to a licensed pharmacist or regis- 38 tered professional nurse, pursuant to regulations promulgated by the 39 commissioner of health, and consistent with the public health law, for 40 administering immunizations. Nothing in this subdivision shall authorize 41 unlicensed persons to administer immunizations, vaccines or other drugs. 42 [7] 6. Nothing in this article, or in article thirty-seven of the 43 public health law, shall be construed to authorize physician assistants 44 to perform those specific functions and duties specifically delegated by 45 law to those persons licensed as allied health professionals under the 46 public health law or this chapter. 47 § 2. Subdivision 1 of section 3701 of the public health law, as 48 amended by chapter 48 of the laws of 2012, is amended to read as 49 follows: 50 1. to promulgate regulations defining and restricting the duties 51 [which may be assigned to] of physician assistants [by their supervising52physician, the degree of supervision required and the manner in which53such duties may be performed] consistent with section sixty-five hundred 54 forty-two of the education law.; 55 § 3. Section 3702 of the public health law, as amended by chapter 48 56 of the laws of 2012, is amended to read as follows:S. 8307 82 A. 8807 1 § 3702. Special provisions. 1. Inpatient medical orders. A licensed 2 physician assistant employed or extended privileges by a hospital may, 3 if permissible under the bylaws, rules and regulations of the hospital, 4 write medical orders, including those for controlled substances and 5 durable medical equipment, for inpatients [under the care of the physi-6cian responsible for his or her supervision. Countersignature of such7orders may be required if deemed necessary and appropriate by the super-8vising physician or the hospital, but in no event shall countersignature9be required prior to execution]. 10 2. Withdrawing blood. A licensed physician assistant or certified 11 nurse practitioner acting within his or her lawful scope of practice may 12 supervise and direct the withdrawal of blood for the purpose of deter- 13 mining the alcoholic or drug content therein under subparagraph one of 14 paragraph (a) of subdivision four of section eleven hundred ninety-four 15 of the vehicle and traffic law, notwithstanding any provision to the 16 contrary in clause (ii) of such subparagraph. 17 3. Prescriptions for controlled substances. A licensed physician 18 assistant, in good faith and acting within his or her lawful scope of 19 practice, and to the extent assigned by his or her supervising physician 20 as applicable by section sixty-five hundred forty-two of the education 21 law, may prescribe controlled substances as a practitioner under article 22 thirty-three of this chapter, to patients under the care of such physi- 23 cian responsible for his or her supervision. The commissioner, in 24 consultation with the commissioner of education, may promulgate such 25 regulations as are necessary to carry out the purposes of this section. 26 § 4. Section 3703 of the public health law, as amended by chapter 48 27 of the laws of 2012, is amended to read as follows: 28 § 3703. Statutory construction. A physician assistant may perform any 29 function in conjunction with a medical service lawfully performed by the 30 physician assistant, in any health care setting, that a statute author- 31 izes or directs a physician to perform and that is appropriate to the 32 education, training and experience of the licensed physician assistant 33 and within the ordinary practice of the supervising physician, as appli- 34 cable pursuant to section sixty-five hundred forty-two of the education 35 law. This section shall not be construed to increase or decrease the 36 lawful scope of practice of a physician assistant under the education 37 law. 38 § 5. Paragraph a of subdivision 2 of section 902 of the education law, 39 as amended by chapter 376 of the laws of 2015, is amended to read as 40 follows: 41 a. The board of education, and the trustee or board of trustees of 42 each school district, shall employ, at a compensation to be agreed upon 43 by the parties, a qualified physician, a physician assistant, or a nurse 44 practitioner to the extent authorized by the nurse practice act and 45 consistent with subdivision three of section six thousand nine hundred 46 two of this chapter, to perform the duties of the director of school 47 health services, including any duties conferred on the school physician 48 or school medical inspector under any provision of law, to perform and 49 coordinate the provision of health services in the public schools and to 50 provide health appraisals of students attending the public schools in 51 the city or district. The physicians, physicians assistants or nurse 52 practitioners so employed shall be duly licensed pursuant to applicable 53 law. 54 § 6. Subdivision 5 of section 6810 of the education law, as added by 55 chapter 881 of the laws of 1972, is amended to read as follows:S. 8307 83 A. 8807 1 5. Records of all prescriptions filled or refilled shall be maintained 2 for a period of at least five years and upon request made available for 3 inspection and copying by a representative of the department. Such 4 records shall indicate date of filling or refilling, [doctor's] 5 prescriber's name, patient's name and address and the name or initials 6 of the pharmacist who prepared, compounded, or dispensed the 7 prescription. Records of prescriptions for controlled substances shall 8 be maintained pursuant to requirements of article thirty-three of the 9 public health law. 10 § 7. Subdivision 27 of section 3302 of the public health law, as 11 amended by chapter 92 of the laws of 2021, is amended to read as 12 follows: 13 27. "Practitioner" means: 14 A physician, physician assistant, dentist, podiatrist, veterinarian, 15 scientific investigator, or other person licensed, or otherwise permit- 16 ted to dispense, administer or conduct research with respect to a 17 controlled substance in the course of a licensed professional practice 18 or research licensed pursuant to this article. Such person shall be 19 deemed a "practitioner" only as to such substances, or conduct relating 20 to such substances, as is permitted by [his] their license, permit or 21 otherwise permitted by law. 22 § 8. Section 6908 of the education law is amended by adding a new 23 subdivision 3 to read as follows: 24 3. This article shall not be construed as prohibiting medication 25 related tasks provided by a certified medication aide working in a resi- 26 dential health care facility, as defined in section twenty-eight hundred 27 one of the public health law, in accordance with regulations developed 28 by the commissioner, in consultation with the commissioner of health. 29 The commissioner, in consultation with the commissioner of health, shall 30 adopt regulations governing certified medication aides that, at a mini- 31 mum, shall: 32 a. specify the medication-related tasks that may be performed by 33 certified medication aides pursuant to this subdivision. Such tasks 34 shall include the administration of medications which are routine and 35 pre-filled or otherwise packaged in a manner that promotes relative ease 36 of administration, provided that administration of medications by 37 injection, sterile procedures, and central line maintenance shall be 38 prohibited. Provided, however, such prohibition shall not apply to 39 injections of insulin or other injections for diabetes care, to 40 injections of low molecular weight heparin, and to pre-filled auto-in- 41 jections of naloxone and epinephrine for emergency purposes, and 42 provided, further, that entities employing certified medication aides 43 pursuant to this subdivision shall establish a systematic approach to 44 address drug diversion; 45 b. provide that medication-related tasks performed by certified medi- 46 cation aides may be performed only under the supervision of a registered 47 professional nurse licensed in New York state, as set forth in this 48 subdivision and subdivision twelve of section sixty-nine hundred nine of 49 this article; 50 c. establish a process by which a registered professional nurse may 51 assign medication-related tasks to a certified medication aide. Such 52 process shall include, but not be limited to: 53 (i) allowing assignment of medication-related tasks to a certified 54 medication aide only where such certified medication aide has demon- 55 strated to the satisfaction of the supervising registered professional 56 nurse competency in every medication-related task that such certifiedS. 8307 84 A. 8807 1 medication aide is authorized to perform, a willingness to perform such 2 medication-related tasks, and the ability to effectively and efficiently 3 communicate with the individual receiving services and understand such 4 individual's needs; 5 (ii) authorizing the supervising registered professional nurse to 6 revoke any assigned medication-related task from a certified medication 7 aide for any reason; and 8 (iii) authorizing multiple registered professional nurses to jointly 9 agree to assign medication-related tasks to a certified medication aide, 10 provided further that only one registered professional nurse shall be 11 required to determine if the certified medication aide has demonstrated 12 competency in the medication-related task to be performed; 13 d. provide that medication-related tasks may be performed only in 14 accordance with and pursuant to an authorized health practitioner's 15 ordered care; 16 e. provide that only a certified nurse aide may perform medication-re- 17 lated tasks as a certified medication aide when such aide has: 18 (i) a valid New York state nurse aide certificate; 19 (ii) a high school diploma, or its equivalent; 20 (iii) evidence of being at least eighteen years old; 21 (iv) at least one year of experience providing nurse aide services in 22 a residential health care facility licensed pursuant to article twenty- 23 eight of the public health law or a similarly licensed facility in 24 another state or United States territory; 25 (v) the ability to read, write, and speak English and to perform basic 26 math skills; 27 (vi) completed the requisite training and demonstrated competencies of 28 a certified medication aide as determined by the commissioner of health 29 in consultation with the commissioner; 30 (vii) successfully completed competency examinations satisfactory to 31 the commissioner of health in consultation with the commissioner; and 32 (viii) meets other appropriate qualifications as determined by the 33 commissioner of health in consultation with the commissioner; 34 f. prohibit a certified medication aide from holding themselves out, 35 or accepting employment as, a person licensed to practice nursing under 36 the provisions of this article; 37 g. provide that a certified medication aide is not required nor 38 permitted to assess the medication or medical needs of an individual; 39 h. provide that a certified medication aide shall not be authorized to 40 perform any medication-related tasks or activities pursuant to this 41 subdivision that are outside the scope of practice of a licensed practi- 42 cal nurse or any medication-related tasks that have not been appropri- 43 ately assigned by the supervising registered professional nurse; 44 i. provide that a certified medication aide shall document all medica- 45 tion-related tasks provided to an individual, including medication 46 administration to each individual through the use of a medication admin- 47 istration record; and 48 j. provide that the supervising registered professional nurse shall 49 retain the discretion to decide whether to assign medication-related 50 tasks to certified medication aides under this program and shall not be 51 subject to coercion, retaliation, or the threat of retaliation. 52 § 9. Section 6909 of the education law is amended by adding two new 53 subdivisions 12 and 13 to read as follows: 54 12. A registered professional nurse, while working for a residential 55 health care facility licensed pursuant to article twenty-eight of the 56 public health law, may, in accordance with this subdivision, assignS. 8307 85 A. 8807 1 certified medication aides to perform medication-related tasks for indi- 2 viduals pursuant to the provisions of subdivision three of section 3 sixty-nine hundred eight of this article and supervise certified medica- 4 tion aides who perform assigned medication-related tasks. 5 13. Notwithstanding subdivision seven of section sixty-five hundred 6 nine of this title, a certified nurse practitioner may directly assign 7 and supervise a medical assistant in an outpatient setting the task of 8 drawing and administering immunizations to patients, provided such 9 medical assistant receives appropriate training from the certified nurse 10 practitioner and the certified nurse practitioner remains responsible 11 for the actions of the medical assistant. 12 § 10. Paragraph (a) of subdivision 3 of section 2803-j of the public 13 health law, as added by chapter 717 of the laws of 1989, is amended to 14 read as follows: 15 (a) Identification of individuals who have successfully completed a 16 nurse aide training and competency evaluation program, [or] a nurse aide 17 competency evaluation program, or a medication aide program; 18 § 11. Section 6527 of the education law is amended by adding a new 19 subdivision 12 to read as follows: 20 12. Notwithstanding subdivision eleven of section sixty-five hundred 21 thirty of this title, a licensed physician may directly assign and 22 supervise a medical assistant in an outpatient setting the task of draw- 23 ing and administering immunizations to patients, provided such medical 24 assistant receives appropriate training from the licensed physician and 25 the licensed physician remains responsible for the actions of the 26 medical assistant. 27 § 12. Section 6545 of the education law, as amended by chapter 48 of 28 the laws of 2012, is amended to read as follows: 29 § 6545. [Emergency services rendered by physician assistant] Special 30 provisions. 1. Notwithstanding any inconsistent provision of any gener- 31 al, special or local law, any physician assistant properly licensed in 32 this state who voluntarily and without the expectation of monetary 33 compensation renders first aid or emergency treatment at the scene of an 34 accident or other emergency, outside a hospital, doctor's office or any 35 other place having proper and necessary medical equipment, to a person 36 who is unconscious, ill or injured, shall not be liable for damages for 37 injuries alleged to have been sustained by such person or for damages 38 for the death of such person alleged to have occurred by reason of an 39 act or omission in the rendering of such first aid or emergency treat- 40 ment unless it is established that such injuries were or such death was 41 caused by gross negligence on the part of such physician assistant. 42 Nothing in this section shall be deemed or construed to relieve a 43 licensed physician assistant from liability for damages for injuries or 44 death caused by an act or omission on the part of a physician assistant 45 while rendering professional services in the normal and ordinary course 46 of his or her practice. 47 2. Notwithstanding subdivision eleven of section sixty-five hundred 48 thirty of this title, a licensed physician assistant authorized pursuant 49 to section sixty-five hundred forty-two of this article to practice 50 without supervision of a physician, may directly assign and supervise a 51 medical assistant in an outpatient setting the task of drawing and 52 administering immunizations to patients, provided such medical assistant 53 receives appropriate training from the licensed physician assistant and 54 the licensed physician assistant remains responsible for the actions of 55 the medical assistant.S. 8307 86 A. 8807 1 § 13. Section 6601 of the education law, as amended by chapter 576 of 2 the laws of 2001, is amended to read as follows: 3 § 6601. Definition of practice of dentistry. The practice of the 4 profession of dentistry is defined as diagnosing, treating, operating, 5 or prescribing for any disease, pain, injury, deformity, or physical 6 condition of the oral and maxillofacial area related to restoring and 7 maintaining dental health. The practice of dentistry includes the 8 prescribing and fabrication of dental prostheses and appliances. The 9 practice of dentistry may include performing physical evaluations in 10 conjunction with the provision of dental treatment, including the admin- 11 istration of vaccinations against influenza, SARS-CoV-2, Human papillo- 12 mavirus (HPV), and vaccinations related to a declared public health 13 emergency. The practice of dentistry may also include offering of HIV, 14 hepatitis C, and hemoglobin A1C screening or diagnostic tests. 15 § 14. Section 6605-b of the education law, as added by chapter 437 of 16 the laws of 2001 and subdivision 1 as amended by chapter 198 of the laws 17 of 2022, is amended to read as follows: 18 § 6605-b. Dental hygiene restricted local infiltration and block 19 anesthesia/nitrous oxide analgesia certificate. 1. A dental hygienist 20 shall not administer or monitor nitrous oxide analgesia or local infil- 21 tration or block anesthesia in the practice of dental hygiene without a 22 dental hygiene restricted local infiltration and block 23 anesthesia/nitrous oxide analgesia certificate and except under the 24 personal supervision of a dentist and in accordance with regulations 25 promulgated by the commissioner. Personal supervision, for purposes of 26 this section, means that the supervising dentist remains in the dental 27 office where the local infiltration or block anesthesia or nitrous oxide 28 analgesia services are being performed, personally authorizes and 29 prescribes the use of local infiltration or block anesthesia or nitrous 30 oxide analgesia for the patient and, before dismissal of the patient, 31 personally examines the condition of the patient after the use of local 32 infiltration or block anesthesia or nitrous oxide analgesia is 33 completed. It is professional misconduct for a dentist to fail to 34 provide the supervision required by this section, and any dentist found 35 guilty of such misconduct under the procedures prescribed in section 36 sixty-five hundred ten of this title shall be subject to the penalties 37 prescribed in section sixty-five hundred eleven of this title. 38 2. The commissioner shall promulgate regulations establishing stand- 39 ards and procedures for the issuance of such certificate. Such standards 40 shall require completion of an educational program and/or course of 41 training or experience sufficient to ensure that a dental hygienist is 42 specifically trained in the administration and monitoring of nitrous 43 oxide analgesia and local infiltration or block anesthesia, the possible 44 effects of such use, and in the recognition of and response to possible 45 emergency situations. 46 3. The fee for a dental hygiene restricted local infiltration and 47 block anesthesia/nitrous oxide analgesia certificate shall be twenty- 48 five dollars and shall be paid on a triennial basis upon renewal of such 49 certificate. A certificate may be suspended or revoked in the same 50 manner as a license to practice dental hygiene. 51 § 15. Subdivision 1 of section 6606 of the education law, as amended 52 by chapter 239 of the laws of 2013, is amended to read as follows: 53 1. The practice of the profession of dental hygiene is defined as the 54 performance of dental services which shall include removing calcareous 55 deposits, accretions and stains from the exposed surfaces of the teeth 56 which begin at the epithelial attachment and applying topical agentsS. 8307 87 A. 8807 1 indicated for a complete dental prophylaxis, removing cement, placing or 2 removing rubber dam, removing sutures, placing matrix band, providing 3 patient education, applying topical medication, placing pre-fit ortho- 4 dontic bands, using light-cure composite material, taking cephalometric 5 radiographs, taking two-dimensional and three-dimensional photography of 6 dentition, adjusting removable appliances including nightguards, bleach- 7 ing trays, retainers and dentures, placing and exposing diagnostic 8 dental X-ray films, performing topical fluoride applications and topical 9 anesthetic applications, polishing teeth, taking medical history, chart- 10 ing caries, taking impressions for study casts, placing and removing 11 temporary restorations, administering and monitoring nitrous oxide 12 analgesia and administering and monitoring local infiltration and block 13 anesthesia, subject to certification in accordance with section sixty- 14 six hundred five-b of this article, and any other function in the defi- 15 nition of the practice of dentistry as may be delegated by a licensed 16 dentist in accordance with regulations promulgated by the commissioner. 17 The practice of dental hygiene may be conducted in the office of any 18 licensed dentist or in any appropriately equipped school or public 19 institution but must be done either under the supervision of a licensed 20 dentist or, in the case of a registered dental hygienist working for a 21 hospital as defined in article twenty-eight of the public health law[,] 22 or pursuant to a collaborative arrangement with a licensed and regis- 23 tered dentist [who has a formal relationship with the same hospital] 24 pursuant to section sixty-six hundred seven-a of this article and in 25 accordance with regulations promulgated by the department in consulta- 26 tion with the department of health. [Such collaborative arrangement27shall not obviate or supersede any law or regulation which requires28identified services to be performed under the personal supervision of a29dentist. When dental hygiene services are provided pursuant to a colla-30borative agreement, such dental hygienist shall instruct individuals to31visit a licensed dentist for comprehensive examination or treatment.] 32 § 16. The education law is amended by adding a new section 6607-a to 33 read as follows: 34 § 6607-a. Practice of collaborative practice dental hygiene and use of 35 title "registered dental hygienist, collaborative practice" (RDH-CP). 1. 36 The practice of the profession of dental hygiene, as defined under this 37 article, may be performed in collaboration with a licensed dentist 38 provided such services are performed in accordance with a written prac- 39 tice agreement and written practice protocols to be known as a collabo- 40 rative practice agreement. Under a collaborative practice agreement, 41 dental hygienists may perform all services which are designated in regu- 42 lation without prior evaluation of a dentist or medical professional and 43 may be performed without supervision in a collaborative practice 44 setting. 45 2. (a) The collaborative practice agreement shall include consider- 46 ation for medically compromised patients, specific medical conditions, 47 and age-and procedure-specific practice protocols, including, but not 48 limited to recommended intervals for the performance of dental hygiene 49 services and a periodicity in which an examination by a dentist should 50 occur. 51 (b) The collaborative agreement shall be: 52 (i) signed and maintained by the dentist, the dental hygienist, and 53 the facility, program, or organization; 54 (ii) reviewed annually by the collaborating dentist and dental hygien- 55 ist; andS. 8307 88 A. 8807 1 (iii) made available to the department and other interested parties 2 upon request. 3 (c) Only one agreement between a collaborating dentist and registered 4 dental hygienist, collaborative practice (RDH-CP) may be in force at a 5 time. 6 3. Before performing any services authorized under this section, a 7 dental hygienist shall provide the patient with a written statement 8 advising the patient that the dental hygiene services provided are not a 9 substitute for a dental examination by a licensed dentist and instruct- 10 ing individuals to visit a licensed dentist for comprehensive examina- 11 tion or treatment. If the dental hygienist makes any referrals to the 12 patient for further dental procedures, the dental hygienist must fill 13 out a referral form and provide a copy of the form to the collaborating 14 dentist. 15 4. The collaborative practice dental hygienist may enter into a 16 contractual arrangement with any New York state licensed and registered 17 dentist, health care facility, program, and/or non-profit organization 18 to perform dental hygiene services in the following settings: dental 19 offices; long-term care facilities/skilled nursing facilities; public or 20 private schools; public health agencies/federally qualified health 21 centers; correctional facilities; public institutions/mental health 22 facilities; drug treatment facilities; and domestic violence shelters. 23 5. A collaborating dentist shall have collaborative agreements with no 24 more than six collaborative practice dental hygienists. The department 25 may grant exceptions to these limitations for public health settings on 26 a case-by-case basis. 27 6. A dental hygienist must make application to the department to prac- 28 tice as a registered dental hygienist, collaborative practice (RDH-CP) 29 and pay a fee set by the department. As a condition of collaborative 30 practice, the dental hygienist shall have been engaged in practice for 31 at least three years with a minimum of four thousand five hundred prac- 32 tice hours and shall complete an eight hour continuing education program 33 that includes instruction in medical emergency procedures, risk manage- 34 ment, dental hygiene jurisprudence and professional ethics. 35 § 17. This act shall take effect immediately and shall be deemed to 36 have been in full force and effect on and after April 1, 2024; provided, 37 however, that sections one through seven of this act shall take effect 38 one year after this act shall have become a law. 39 PART R 40 Section 1. The education law is amended by adding a new article 169 to 41 read as follows: 42 ARTICLE 169 43 INTERSTATE MEDICAL LICENSURE COMPACT 44 Section 8860. Short title. 45 8861. Purpose. 46 8862. Definitions. 47 8863. Eligibility. 48 8864. Designation of state of principal license. 49 8865. Application and issuance of expedited licensure. 50 8866. Fees for expedited licensure. 51 8867. Renewal and continued participation. 52 8868. Coordinated information system. 53 8869. Joint investigations. 54 8870. Disciplinary actions.S. 8307 89 A. 8807 1 8871. Interstate medical licensure compact commission. 2 8872. Powers and duties of the interstate commission. 3 8873. Finance powers. 4 8874. Organization and operation of the interstate commission. 5 8875. Rulemaking functions of the interstate commission. 6 8876. Oversight of interstate compact. 7 8877. Enforcement of interstate compact. 8 8878. Default procedures. 9 8879. Dispute resolution. 10 8880. Member states, effective date and amendment. 11 8881. Withdrawal. 12 8882. Dissolution. 13 8883. Severability and construction. 14 8884. Binding effect of compact and other laws. 15 § 8860. Short title. This article shall be known and may be cited as 16 the "interstate medical licensure compact". 17 § 8861. Purpose. In order to strengthen access to health care, and in 18 recognition of the advances in the delivery of health care, the member 19 states of the interstate medical licensure compact have allied in common 20 purpose to develop a comprehensive process that complements the existing 21 licensing and regulatory authority of state medical boards, provides a 22 streamlined process that allows physicians to become licensed in multi- 23 ple states, thereby enhancing the portability of a medical license and 24 ensuring the safety of patients. The compact creates another pathway 25 for licensure and does not otherwise change a state's existing medical 26 practice act. The compact also adopts the prevailing standard for licen- 27 sure and affirms that the practice of medicine occurs where the patient 28 is located at the time of the physician-patient encounter, and there- 29 fore, requires the physician to be under the jurisdiction of the state 30 medical board where the patient is located. State medical boards that 31 participate in the compact retain the jurisdiction to impose an adverse 32 action against a license to practice medicine in that state issued to a 33 physician through the procedures in the compact. 34 § 8862. Definitions. In this compact: 35 1. "Bylaws" means those bylaws established by the interstate commis- 36 sion pursuant to section eighty-eight hundred seventy-one of this arti- 37 cle for its governance, or for directing and controlling its actions and 38 conduct. 39 2. "Commissioner" means the voting representative appointed by each 40 member board pursuant to section eighty-eight hundred seventy-one of 41 this article. 42 3. "Conviction" means a finding by a court that an individual is guil- 43 ty of a criminal offense through adjudication, or entry of a plea of 44 guilt or no contest to the charge by the offender. Evidence of an entry 45 of a conviction of a criminal offense by the court shall be considered 46 final for purposes of disciplinary action by a member board. 47 4. "Expedited license" means a full and unrestricted medical license 48 granted by a member state to an eligible physician through the process 49 set forth in the compact. 50 5. "Interstate commission" means the interstate commission created 51 pursuant to section eighty-eight hundred seventy-one of this article. 52 6. "License" means authorization by a member state for a physician to 53 engage in the practice of medicine, which would be unlawful without 54 authorization. 55 7. "Medical practice act" means laws and regulations governing the 56 practice of allopathic and osteopathic medicine within a member state.S. 8307 90 A. 8807 1 8. "Member board" means a state agency in a member state that acts in 2 the sovereign interests of the state by protecting the public through 3 licensure, regulation, and education of physicians as directed by the 4 state government. 5 9. "Member state" means a state that has enacted the compact. 6 10. "Practice of medicine" means the clinical prevention, diagnosis, 7 or treatment of human disease, injury, or condition requiring a physi- 8 cian to obtain and maintain a license in compliance with the medical 9 practice act of a member state. 10 11. "Physician" means any person who: 11 (a) Is a graduate of a medical school accredited by the Liaison 12 Committee on Medical Education, the Commission on Osteopathic College 13 Accreditation, or a medical school listed in the International Medical 14 Education Directory or its equivalent; 15 (b) Passed each component of the United States Medical Licensing Exam- 16 ination (USMLE) or the Comprehensive Osteopathic Medical Licensing Exam- 17 ination (COMLEX-USA) within three attempts, or any of its predecessor 18 examinations accepted by a state medical board as an equivalent examina- 19 tion for licensure purposes; 20 (c) Successfully completed graduate medical education approved by the 21 Accreditation Council for Graduate Medical Education or the American 22 Osteopathic Association; 23 (d) Holds specialty certification or a time-unlimited specialty 24 certificate recognized by the American Board of Medical Specialties or 25 the American Osteopathic Association's Bureau of Osteopathic Special- 26 ists; 27 (e) Possesses a full and unrestricted license to engage in the prac- 28 tice of medicine issued by a member board; 29 (f) Has never been convicted, received adjudication, deferred adjudi- 30 cation, community supervision, or deferred disposition for any offense 31 by a court of appropriate jurisdiction; 32 (g) Has never held a license authorizing the practice of medicine 33 subjected to discipline by a licensing agency in any state, federal, or 34 foreign jurisdiction, excluding any action related to non-payment of 35 fees related to a license; 36 (h) Has never had a controlled substance license or permit suspended 37 or revoked by a state or the United States drug enforcement adminis- 38 tration; and 39 (i) Is not under active investigation by a licensing agency or law 40 enforcement authority in any state, federal, or foreign jurisdiction. 41 12. "Offense" means a felony, gross misdemeanor, or crime of moral 42 turpitude. 43 13. "Rule" means a written statement by the interstate commission 44 promulgated pursuant to section eighty-eight hundred seventy-two of this 45 article that is of general applicability, implements, interprets, or 46 prescribes a policy or provision of the compact, or an organizational, 47 procedural, or practice requirement of the interstate commission, and 48 has the force and effect of statutory law in a member state, and 49 includes the amendment, repeal, or suspension of an existing rule. 50 14. "State" means any state, commonwealth, district, or territory of 51 the United States. 52 15. "State of principal license" means a member state where a physi- 53 cian holds a license to practice medicine and which has been designated 54 as such by the physician for purposes of registration and participation 55 in the compact.S. 8307 91 A. 8807 1 § 8863. Eligibility. 1. A physician must meet the eligibility require- 2 ments as defined in subdivision eleven of section eighty-eight hundred 3 sixty-two of this article to receive an expedited license under the 4 terms and provisions of the compact. 5 2. A physician who does not meet the requirements of subdivision elev- 6 en of section eighty-eight hundred sixty-two of this article may obtain 7 a license to practice medicine in a member state if the individual 8 complies with all laws and requirements, other than the compact, relat- 9 ing to the issuance of a license to practice medicine in that state. 10 § 8864. Designation of state of principal license. 1. A physician 11 shall designate a member state as the state of principal license for 12 purposes of registration for expedited licensure through the compact if 13 the physician possesses a full and unrestricted license to practice 14 medicine in that state, and the state is: 15 (a) the state of principal residence for the physician, or 16 (b) the state where at least twenty-five percent of the practice of 17 medicine occurs, or 18 (c) the location of the physician's employer, or 19 (d) if no state qualifies under paragraph (a), (b), or (c) of this 20 subdivision, the state designated as state of residence for purpose of 21 federal income tax. 22 2. A physician may redesignate a member state as state of principal 23 license at any time, as long as the state meets the requirements of 24 subdivision one of this section. 25 3. The interstate commission is authorized to develop rules to facili- 26 tate redesignation of another member state as the state of principal 27 license. 28 § 8865. Application and issuance of expedited licensure. 1. A physi- 29 cian seeking licensure through the compact shall file an application for 30 an expedited license with the member board of the state selected by the 31 physician as the state of principal license. 32 2. Upon receipt of an application for an expedited license, the member 33 board within the state selected as the state of principal license shall 34 evaluate whether the physician is eligible for expedited licensure and 35 issue a letter of qualification, verifying or denying the physician's 36 eligibility, to the interstate commission. 37 (a) Static qualifications, which include verification of medical 38 education, graduate medical education, results of any medical or licens- 39 ing examination, and other qualifications as determined by the inter- 40 state commission through rule, shall not be subject to additional prima- 41 ry source verification where already primary source verified by the 42 state of principal license. 43 (b) The member board within the state selected as the state of princi- 44 pal license shall, in the course of verifying eligibility, perform a 45 criminal background check of an applicant, including the use of the 46 results of fingerprint or other biometric data checks compliant with the 47 requirements of the Federal Bureau of Investigation, with the exception 48 of federal employees who have suitability determination in accordance 49 with U.S. C.F.R. § 731.202. 50 (c) Appeal on the determination of eligibility shall be made to the 51 member state where the application was filed and shall be subject to the 52 law of that state. 53 3. Upon verification under subdivision two of this section, physicians 54 eligible for an expedited license shall complete the registration proc- 55 ess established by the interstate commission to receive a license in aS. 8307 92 A. 8807 1 member state selected pursuant to subdivision one of this section, 2 including the payment of any applicable fees. 3 4. After receiving verification of eligibility under subdivision two 4 of this section and any fees under subdivision three of this section, a 5 member board shall issue an expedited license to the physician. This 6 license shall authorize the physician to practice medicine in the issu- 7 ing state consistent with the medical practice act and all applicable 8 laws and regulations of the issuing member board and member state. 9 5. An expedited license shall be valid for a period consistent with 10 the licensure period in the member state and in the same manner as 11 required for other physicians holding a full and unrestricted license 12 within the member state. 13 6. An expedited license obtained though the compact shall be termi- 14 nated if a physician fails to maintain a license in the state of princi- 15 pal licensure for a non-disciplinary reason, without redesignation of a 16 new state of principal licensure. 17 7. The interstate commission is authorized to develop rules regarding 18 the application process, including payment of any applicable fees, and 19 the issuance of an expedited license. 20 § 8866. Fees for expedited licensure. 1. A member state issuing an 21 expedited license authorizing the practice of medicine in that state may 22 impose a fee for a license issued or renewed through the compact. 23 2. The interstate commission is authorized to develop rules regarding 24 fees for expedited licenses. 25 § 8867. Renewal and continued participation. 1. A physician seeking to 26 renew an expedited license granted in a member state shall complete a 27 renewal process with the interstate commission if the physician: 28 (a) Maintains a full and unrestricted license in a state of principal 29 license; 30 (b) Has not been convicted, received adjudication, deferred adjudi- 31 cation, community supervision, or deferred disposition for any offense 32 by a court of appropriate jurisdiction; 33 (c) Has not had a license authorizing the practice of medicine subject 34 to discipline by a licensing agency in any state, federal, or foreign 35 jurisdiction, excluding any action related to non-payment of fees 36 related to a license; and 37 (d) Has not had a controlled substance license or permit suspended or 38 revoked by a state or the United States drug enforcement administration. 39 2. Physicians shall comply with all continuing professional develop- 40 ment or continuing medical education requirements for renewal of a 41 license issued by a member state. 42 3. The interstate commission shall collect any renewal fees charged 43 for the renewal of a license and distribute the fees to the applicable 44 member board. 45 4. Upon receipt of any renewal fees collected in subdivision three of 46 this section, a member board shall renew the physician's license. 47 5. Physician information collected by the interstate commission during 48 the renewal process will be distributed to all member boards. 49 6. The interstate commission is authorized to develop rules to address 50 renewal of licenses obtained through the compact. 51 § 8868. Coordinated information system. 1. The interstate commission 52 shall establish a database of all physicians licensed, or who have 53 applied for licensure, under section eighty-eight hundred sixty-five of 54 this article. 55 2. Notwithstanding any other provision of law, member boards shall 56 report to the interstate commission any public action or complaintsS. 8307 93 A. 8807 1 against a licensed physician who has applied or received an expedited 2 license through the compact. 3 3. Member boards shall report disciplinary or investigatory informa- 4 tion determined as necessary and proper by rule of the interstate 5 commission. 6 4. Member boards may report any non-public complaint, disciplinary, or 7 investigatory information not required by subdivision three of this 8 section to the interstate commission. 9 5. Member boards shall share complaint or disciplinary information 10 about a physician upon request of another member board. 11 6. All information provided to the interstate commission or distrib- 12 uted by member boards shall be confidential, filed under seal, and used 13 only for investigatory or disciplinary matters. 14 7. The interstate commission is authorized to develop rules for 15 mandated or discretionary sharing of information by member boards. 16 § 8869. Joint investigations. 1. Licensure and disciplinary records of 17 physicians are deemed investigative. 18 2. In addition to the authority granted to a member board by its 19 respective medical practice act or other applicable state law, a member 20 board may participate with other member boards in joint investigations 21 of physicians licensed by the member boards. 22 3. A subpoena issued by a member state shall be enforceable in other 23 member states. 24 4. Member boards may share any investigative, litigation, or compli- 25 ance materials in furtherance of any joint or individual investigation 26 initiated under the compact. 27 5. Any member state may investigate actual or alleged violations of 28 the statutes authorizing the practice of medicine in any other member 29 state in which a physician holds a license to practice medicine. 30 § 8870. Disciplinary actions. 1. Any disciplinary action taken by any 31 member board against a physician licensed through the compact shall be 32 deemed unprofessional conduct which may be subject to discipline by 33 other member boards, in addition to any violation of the medical prac- 34 tice act or regulations in that state. 35 2. If a license granted to a physician by the member board in the 36 state of principal license is revoked, surrendered or relinquished in 37 lieu of discipline, or suspended, then all licenses issued to the physi- 38 cian by member boards shall automatically be placed, without further 39 action necessary by any member board, on the same status. If the member 40 board in the state of principal license subsequently reinstates the 41 physician's license, a license issued to the physician by any other 42 member board shall remain encumbered until that respective member board 43 takes action to reinstate the license in a manner consistent with the 44 medical practice act of that state. 45 3. If disciplinary action is taken against a physician by a member 46 board not in the state of principal license, any other member board may 47 deem the action conclusive as to matter of law and fact decided, and: 48 (a) impose the same or lesser sanction or sanctions against the physi- 49 cian so long as such sanctions are consistent with the medical practice 50 act of that state; or 51 (b) pursue separate disciplinary action against the physician under 52 its respective medical practice act, regardless of the action taken in 53 other member states. 54 4. If a license granted to a physician by a member board is revoked, 55 surrendered, or relinquished in lieu of discipline, or suspended, then 56 any license or licenses issued to the physician by any other memberS. 8307 94 A. 8807 1 board or boards shall be suspended, automatically and immediately with- 2 out further action necessary by the other member board or boards, for 3 ninety days upon entry of the order by the disciplining board, to permit 4 the member board or boards to investigate the basis for the action under 5 the medical practice act of that state. A member board may terminate the 6 automatic suspension of the license it issued prior to the completion of 7 the ninety day suspension period in a manner consistent with the medical 8 practice act of that state. 9 § 8871. Interstate medical licensure compact commission. 1. The member 10 states hereby create the "interstate medical licensure compact commis- 11 sion". 12 2. The purpose of the interstate commission is the administration of 13 the interstate medical licensure compact, which is a discretionary state 14 function. 15 3. The interstate commission shall be a body corporate and joint agen- 16 cy of the member states and shall have all the responsibilities, powers, 17 and duties set forth in the compact, and such additional powers as may 18 be conferred upon it by a subsequent concurrent action of the respective 19 legislatures of the member states in accordance with the terms of the 20 compact. 21 4. The interstate commission shall consist of two voting represen- 22 tatives appointed by each member state who shall serve as commissioners. 23 In states where allopathic and osteopathic physicians are regulated by 24 separate member boards, or if the licensing and disciplinary authority 25 is split between multiple member boards within a member state, the 26 member state shall appoint one representative from each member board. A 27 commissioner shall be a or an: 28 (a) Allopathic or osteopathic physician appointed to a member board; 29 (b) Executive director, executive secretary, or similar executive of a 30 member board; or 31 (c) Member of the public appointed to a member board. 32 5. The interstate commission shall meet at least once each calendar 33 year. A portion of this meeting shall be a business meeting to address 34 such matters as may properly come before the commission, including the 35 election of officers. The chairperson may call additional meetings and 36 shall call for a meeting upon the request of a majority of the member 37 states. 38 6. The bylaws may provide for meetings of the interstate commission to 39 be conducted by telecommunication or electronic communication. 40 7. Each commissioner participating at a meeting of the interstate 41 commission is entitled to one vote. A majority of commissioners shall 42 constitute a quorum for the transaction of business, unless a larger 43 quorum is required by the bylaws of the interstate commission. A commis- 44 sioner shall not delegate a vote to another commissioner. In the absence 45 of its commissioner, a member state may delegate voting authority for a 46 specified meeting to another person from that state who shall meet the 47 requirements of subdivision four of this section. 48 8. The interstate commission shall provide public notice of all meet- 49 ings and all meetings shall be open to the public. The interstate 50 commission may close a meeting, in full or in portion, where it deter- 51 mines by a two-thirds vote of the commissioners present that an open 52 meeting would be likely to: 53 (a) Relate solely to the internal personnel practices and procedures 54 of the interstate commission; 55 (b) Discuss matters specifically exempted from disclosure by federal 56 statute;S. 8307 95 A. 8807 1 (c) Discuss trade secrets, commercial, or financial information that 2 is privileged or confidential; 3 (d) Involve accusing a person of a crime, or formally censuring a 4 person; 5 (e) Discuss information of a personal nature where disclosure would 6 constitute a clearly unwarranted invasion of personal privacy; 7 (f) Discuss investigative records compiled for law enforcement 8 purposes; or 9 (g) Specifically relate to the participation in a civil action or 10 other legal proceeding. 11 9. The interstate commission shall keep minutes which shall fully 12 describe all matters discussed in a meeting and shall provide a full and 13 accurate summary of actions taken, including record of any roll call 14 votes. 15 10. The interstate commission shall make its information and official 16 records, to the extent not otherwise designated in the compact or by its 17 rules, available to the public for inspection. 18 11. The interstate commission shall establish an executive committee, 19 which shall include officers, members, and others as determined by the 20 bylaws. The executive committee shall have the power to act on behalf of 21 the interstate commission, with the exception of rulemaking, during 22 periods when the interstate commission is not in session. When acting on 23 behalf of the interstate commission, the executive committee shall over- 24 see the administration of the compact including enforcement and compli- 25 ance with the provisions of the compact, its bylaws and rules, and other 26 such duties as necessary. 27 12. The interstate commission shall establish other committees for 28 governance and administration of the compact. 29 § 8872. Powers and duties of the interstate commission. The interstate 30 commission shall have the duty and power to: 31 1. Oversee and maintain the administration of the compact; 32 2. Promulgate rules which shall be binding to the extent and in the 33 manner provided for in the compact; 34 3. Issue, upon the request of a member state or member board, advisory 35 opinions concerning the meaning or interpretation of the compact, its 36 bylaws, rules, and actions; 37 4. Enforce compliance with compact provisions, the rules promulgated 38 by the interstate commission, and the bylaws, using all necessary and 39 proper means, including but not limited to the use of judicial process; 40 5. Establish and appoint committees including, but not limited to, an 41 executive committee as required by section eighty-eight hundred seven- 42 ty-one of this article, which shall have the power to act on behalf of 43 the interstate commission in carrying out its powers and duties; 44 6. Pay, or provide for the payment of the expenses related to the 45 establishment, organization, and ongoing activities of the interstate 46 commission; 47 7. Establish and maintain one or more offices; 48 8. Borrow, accept, hire, or contract for services of personnel; 49 9. Purchase and maintain insurance and bonds; 50 10. Employ an executive director who shall have such powers to employ, 51 select or appoint employees, agents, or consultants, and to determine 52 their qualifications, define their duties, and fix their compensation; 53 11. Establish personnel policies and programs relating to conflicts of 54 interest, rates of compensation, and qualifications of personnel; 55 12. Accept donations and grants of money, equipment, supplies, materi- 56 als and services, and to receive, utilize, and dispose of it in a mannerS. 8307 96 A. 8807 1 consistent with the conflict of interest policies established by the 2 interstate commission; 3 13. Lease, purchase, accept contributions or donations of, or other- 4 wise to own, hold, improve, or use, any property, real, personal, or 5 mixed; 6 14. Sell, convey, mortgage, pledge, lease, exchange, abandon, or 7 otherwise dispose of any property, real, personal, or mixed; 8 15. Establish a budget and make expenditures; 9 16. Adopt a seal and bylaws governing the management and operation of 10 the interstate commission; 11 17. Report annually to the legislatures and governors of the member 12 states concerning the activities of the interstate commission during the 13 preceding year. Such reports shall also include reports of financial 14 audits and any recommendations that may have been adopted by the inter- 15 state commission; 16 18. Coordinate education, training, and public awareness regarding the 17 compact, its implementation, and its operation; 18 19. Maintain records in accordance with the bylaws; 19 20. Seek and obtain trademarks, copyrights, and patents; and 20 21. Perform such functions as may be necessary or appropriate to 21 achieve the purposes of the compact. 22 § 8873. Finance powers. 1. The interstate commission may levy on and 23 collect an annual assessment from each member state to cover the cost of 24 the operations and activities of the interstate commission and its 25 staff. The total assessment must be sufficient to cover the annual budg- 26 et approved each year for which revenue is not provided by other sourc- 27 es. The aggregate annual assessment amount shall be allocated upon a 28 formula to be determined by the interstate commission, which shall 29 promulgate a rule binding upon all member states. 30 2. The interstate commission shall not incur obligations of any kind 31 prior to securing the funds adequate to meet the same. 32 3. The interstate commission shall not pledge the credit of any of the 33 member states, except by, and with the authority of, the member state. 34 4. The interstate commission shall be subject to a yearly financial 35 audit conducted by a certified or licensed public accountant and the 36 report of the audit shall be included in the annual report of the inter- 37 state commission. 38 § 8874. Organization and operation of the interstate commission. 1. 39 The interstate commission shall, by a majority of commissioners present 40 and voting, adopt bylaws to govern its conduct as may be necessary or 41 appropriate to carry out the purposes of the compact within twelve 42 months of the first interstate commission meeting. 43 2. The interstate commission shall elect or appoint annually from 44 among its commissioners a chairperson, a vice-chairperson, and a treas- 45 urer, each of whom shall have such authority and duties as may be speci- 46 fied in the bylaws. The chairperson, or in the chairperson's absence or 47 disability, the vice-chairperson, shall preside at all meetings of the 48 interstate commission. 49 3. Officers selected pursuant to subdivision two of this section shall 50 serve without remuneration from the interstate commission. 51 4. The officers and employees of the interstate commission shall be 52 immune from suit and liability, either personally or in their official 53 capacity, for a claim for damage to or loss of property or personal 54 injury or other civil liability caused or arising out of, or relating 55 to, an actual or alleged act, error, or omission that occurred, or that 56 such person had a reasonable basis for believing occurred, within theS. 8307 97 A. 8807 1 scope of interstate commission employment, duties, or responsibilities; 2 provided that such person shall not be protected from suit or liability 3 for damage, loss, injury, or liability caused by the intentional or 4 willful and wanton misconduct of such person. 5 (a) The liability of the executive director and employees of the 6 interstate commission or representatives of the interstate commission, 7 acting within the scope of such person's employment or duties for acts, 8 errors, or omissions occurring within such person's state, may not 9 exceed the limits of liability set forth under the constitution and laws 10 of that state for state officials, employees, and agents. The interstate 11 commission is considered to be an instrumentality of the states for the 12 purposes of any such action. Nothing in this paragraph shall be 13 construed to protect such person from suit or liability for damage, 14 loss, injury, or liability caused by the intentional or willful and 15 wanton misconduct of such person. 16 (b) The interstate commission shall defend the executive director, its 17 employees, and subject to the approval of the attorney general or other 18 appropriate legal counsel of the member state represented by an inter- 19 state commission representative, shall defend such interstate commission 20 representative in any civil action seeking to impose liability arising 21 out of an actual or alleged act, error or omission that occurred within 22 the scope of interstate commission employment, duties or responsibil- 23 ities, or that the defendant had a reasonable basis for believing 24 occurred within the scope of interstate commission employment, duties, 25 or responsibilities, provided that the actual or alleged act, error, or 26 omission did not result from intentional or willful and wanton miscon- 27 duct on the part of such person. 28 (c) To the extent not covered by the state involved, member state, or 29 the interstate commission, the representatives or employees of the 30 interstate commission shall be held harmless in the amount of a settle- 31 ment or judgment, including attorney's fees and costs, obtained against 32 such persons arising out of an actual or alleged act, error, or omission 33 that occurred within the scope of interstate commission employment, 34 duties, or responsibilities, or that such persons had a reasonable basis 35 for believing occurred within the scope of interstate commission employ- 36 ment, duties, or responsibilities, provided that the actual or alleged 37 act, error, or omission did not result from intentional or willful and 38 wanton misconduct on the part of such persons. 39 § 8875. Rulemaking functions of the interstate commission. 1. The 40 interstate commission shall promulgate reasonable rules in order to 41 effectively and efficiently achieve the purposes of the compact. 42 Notwithstanding the foregoing, in the event the interstate commission 43 exercises its rulemaking authority in a manner that is beyond the scope 44 of the purposes of the compact, or the powers granted hereunder, then 45 such an action by the interstate commission shall be invalid and have no 46 force or effect. 47 2. Rules deemed appropriate for the operations of the interstate 48 commission shall be made pursuant to a rulemaking process that substan- 49 tially conforms to the federal Model State Administrative Procedure Act 50 of 2010, and subsequent amendments thereto. 51 3. Not later than thirty days after a rule is promulgated, any person 52 may file a petition for judicial review of the rule in the United States 53 District Court for the District of Columbia or the federal district 54 where the interstate commission has its principal offices, provided that 55 the filing of such a petition shall not stay or otherwise prevent the 56 rule from becoming effective unless the court finds that the petitionerS. 8307 98 A. 8807 1 has a substantial likelihood of success. The court shall give deference 2 to the actions of the interstate commission consistent with applicable 3 law and shall not find the rule to be unlawful if the rule represents a 4 reasonable exercise of the authority granted to the interstate commis- 5 sion. 6 § 8876. Oversight of interstate compact. 1. The executive, legisla- 7 tive, and judicial branches of state government in each member state 8 shall enforce the compact and shall take all actions necessary and 9 appropriate to effectuate the compact's purposes and intent. The 10 provisions of the compact and the rules promulgated hereunder shall have 11 standing as statutory law but shall not override existing state authori- 12 ty to regulate the practice of medicine. 13 2. All courts shall take judicial notice of the compact and the rules 14 in any judicial or administrative proceeding in a member state pertain- 15 ing to the subject matter of the compact which may affect the powers, 16 responsibilities or actions of the interstate commission. 17 3. The interstate commission shall be entitled to receive all service 18 of process in any such proceeding, and shall have standing to intervene 19 in the proceeding for all purposes. Failure to provide service of proc- 20 ess to the interstate commission shall render a judgment or order void 21 as to the interstate commission, the compact, or promulgated rules. 22 § 8877. Enforcement of interstate compact. 1. The interstate commis- 23 sion, in the reasonable exercise of its discretion, shall enforce the 24 provisions and rules of the compact. 25 2. The interstate commission may, by majority vote of the commission- 26 ers, initiate legal action in the United States District Court for the 27 District of Columbia, or, at the discretion of the interstate commis- 28 sion, in the federal district where the interstate commission has its 29 principal offices, to enforce compliance with the provisions of the 30 compact, and its promulgated rules and bylaws, against a member state in 31 default. The relief sought may include both injunctive relief and 32 damages. In the event judicial enforcement is necessary, the prevailing 33 party shall be awarded all costs of such litigation including reasonable 34 attorney's fees. 35 3. The remedies herein shall not be the exclusive remedies of the 36 interstate commission. The interstate commission may avail itself of 37 any other remedies available under state law or the regulation of a 38 profession. 39 § 8878. Default procedures. 1. The grounds for default include, but 40 are not limited to, failure of a member state to perform such obli- 41 gations or responsibilities imposed upon it by the compact, or the rules 42 and bylaws of the interstate commission promulgated under the compact. 43 2. If the interstate commission determines that a member state has 44 defaulted in the performance of its obligations or responsibilities 45 under the compact, or the bylaws or promulgated rules, the interstate 46 commission shall: 47 (a) Provide written notice to the defaulting state and other member 48 states, of the nature of the default, the means of curing the default, 49 and any action taken by the interstate commission. The interstate 50 commission shall specify the conditions by which the defaulting state 51 must cure its default; and 52 (b) Provide remedial training and specific technical assistance 53 regarding the default. 54 3. If the defaulting state fails to cure the default, the defaulting 55 state shall be terminated from the compact upon an affirmative vote of a 56 majority of the commissioners and all rights, privileges, and benefitsS. 8307 99 A. 8807 1 conferred by the compact shall terminate on the effective date of termi- 2 nation. A cure of the default does not relieve the offending state of 3 obligations or liabilities incurred during the period of the default. 4 4. Termination of membership in the compact shall be imposed only 5 after all other means of securing compliance have been exhausted. Notice 6 of intent to terminate shall be given by the interstate commission to 7 the governor, the majority and minority leaders of the defaulting 8 state's legislature, and each of the member states. 9 5. The interstate commission shall establish rules and procedures to 10 address licenses and physicians that are materially impacted by the 11 termination of a member state, or the withdrawal of a member state. 12 6. The member state which has been terminated is responsible for all 13 dues, obligations, and liabilities incurred through the effective date 14 of termination including obligations, the performance of which extends 15 beyond the effective date of termination. 16 7. The interstate commission shall not bear any costs relating to any 17 state that has been found to be in default or which has been terminated 18 from the compact, unless otherwise mutually agreed upon in writing 19 between the interstate commission and the defaulting state. 20 8. The defaulting state may appeal the action of the interstate 21 commission by petitioning the United States District Court for the 22 District of Columbia or the federal district where the interstate 23 commission has its principal offices. The prevailing party shall be 24 awarded all costs of such litigation including reasonable attorney's 25 fees. 26 § 8879. Dispute resolution. 1. The interstate commission shall 27 attempt, upon the request of a member state, to resolve disputes which 28 are subject to the compact and which may arise among member states or 29 member boards. 30 2. The interstate commission shall promulgate rules providing for both 31 mediation and binding dispute resolution as appropriate. 32 § 8880. Member states, effective date and amendment. 1. Any state is 33 eligible to become a member state of the compact. 34 2. The compact shall become effective and binding upon legislative 35 enactment of the compact into law by no less than seven states. There- 36 after, it shall become effective and binding on a state upon enactment 37 of the compact into law by that state. 38 3. The governors of non-member states, or their designees, shall be 39 invited to participate in the activities of the interstate commission on 40 a non-voting basis prior to adoption of the compact by all states. 41 4. The interstate commission may propose amendments to the compact for 42 enactment by the member states. No amendment shall become effective and 43 binding upon the interstate commission and the member states unless and 44 until it is enacted into law by unanimous consent of the member states. 45 § 8881. Withdrawal. 1. Once effective, the compact shall continue in 46 force and remain binding upon each and every member state; provided that 47 a member state may withdraw from the compact by specifically repealing 48 the statute which enacted the compact into law. 49 2. Withdrawal from the compact shall be by the enactment of a statute 50 repealing the same, but shall not take effect until one year after the 51 effective date of such statute and until written notice of the with- 52 drawal has been given by the withdrawing state to the governor of each 53 other member state. 54 3. The withdrawing state shall immediately notify the chairperson of 55 the interstate commission in writing upon the introduction of legis- 56 lation repealing the compact in the withdrawing state.S. 8307 100 A. 8807 1 4. The interstate commission shall notify the other member states of 2 the withdrawing state's intent to withdraw within sixty days of its 3 receipt of notice provided under subdivision three of this section. 4 5. The withdrawing state is responsible for all dues, obligations and 5 liabilities incurred through the effective date of withdrawal, including 6 obligations, the performance of which extend beyond the effective date 7 of withdrawal. 8 6. Reinstatement following withdrawal of a member state shall occur 9 upon the withdrawing state reenacting the compact or upon such later 10 date as determined by the interstate commission. 11 7. The interstate commission is authorized to develop rules to address 12 the impact of the withdrawal of a member state on licenses granted in 13 other member states to physicians who designated the withdrawing member 14 state as the state of principal license. 15 § 8882. Dissolution. 1. The compact shall dissolve effective upon the 16 date of the withdrawal or default of the member state which reduces the 17 membership in the compact to one member state. 18 2. Upon the dissolution of the compact, the compact becomes null and 19 void and shall be of no further force or effect, and the business and 20 affairs of the interstate commission shall be concluded and surplus 21 funds shall be distributed in accordance with the bylaws. 22 § 8883. Severability and construction. 1. The provisions of the 23 compact shall be severable, and if any phrase, clause, sentence, or 24 provision is deemed unenforceable, the remaining provisions of the 25 compact shall be enforceable. 26 2. The provisions of the compact shall be liberally construed to 27 effectuate its purposes. 28 3. Nothing in the compact shall be construed to prohibit the applica- 29 bility of other interstate compacts to which the states are members. 30 § 8884. Binding effect of compact and other laws. 1. Nothing contained 31 in this article shall prevent the enforcement of any other law of a 32 member state that is not inconsistent with the compact. 33 2. All laws in a member state in conflict with the compact are super- 34 seded to the extent of the conflict. 35 3. All lawful actions of the interstate commission, including all 36 rules and bylaws promulgated by the commission, are binding upon the 37 member states. 38 4. All agreements between the interstate commission and the member 39 states are binding in accordance with their terms. 40 5. In the event any provision of the compact exceeds the constitu- 41 tional limits imposed on the legislature of any member state, such 42 provision shall be ineffective to the extent of the conflict with the 43 constitutional provision in question in that member state. 44 § 2. Article 170 of the education law is renumbered article 171 and a 45 new article 170 is added to title 8 of the education law to read as 46 follows: 47 ARTICLE 170 48 NURSE LICENSURE COMPACT 49 Section 8900. Nurse licensure compact. 50 8901. Findings and declaration of purpose. 51 8902. Definitions. 52 8903. General provisions and jurisdiction. 53 8904. Applications for licensure in a party state. 54 8905. Additional authorities invested in party state licensing 55 boards.S. 8307 101 A. 8807 1 8906. Coordinated licensure information system and exchange of 2 information. 3 8907. Establishment of the interstate commission of nurse licen- 4 sure compact administrators. 5 8908. Rulemaking. 6 8909. Oversight, dispute resolution and enforcement. 7 8910. Effective date, withdrawal and amendment. 8 8911. Construction and severability. 9 § 8900. Nurse licensure compact. The nurse license compact as set 10 forth in the article is hereby adopted and entered into with all party 11 states joining therein. 12 § 8901. Findings and declaration of purpose 1. Findings. The party 13 states find that: 14 a. The health and safety of the public are affected by the degree of 15 compliance with and the effectiveness of enforcement activities related 16 to state nurse licensure laws; 17 b. Violations of nurse licensure and other laws regulating the prac- 18 tice of nursing may result in injury or harm to the public; 19 c. The expanded mobility of nurses and the use of advanced communi- 20 cation technologies as part of our nation's health care delivery system 21 require greater coordination and cooperation among states in the areas 22 of nurse licensure and regulation; 23 d. New practice modalities and technology make compliance with indi- 24 vidual state nurse licensure laws difficult and complex; 25 e. The current system of duplicative licensure for nurses practicing 26 in multiple states is cumbersome and redundant for both nurses and 27 states; and 28 f. Uniformity of nurse licensure requirements throughout the states 29 promotes public safety and public health benefits. 30 2. Declaration of purpose. The general purposes of this compact are 31 to: 32 a. Facilitate the states' responsibility to protect the public's 33 health and safety; 34 b. Ensure and encourage the cooperation of party states in the areas 35 of nurse licensure and regulation; 36 c. Facilitate the exchange of information between party states in the 37 areas of nurse regulation, investigation and adverse actions; 38 d. Promote compliance with the laws governing the practice of nursing 39 in each jurisdiction; 40 e. Invest all party states with the authority to hold a nurse account- 41 able for meeting all state practice laws in the state in which the 42 patient is located at the time care is rendered through the mutual 43 recognition of party state licenses; 44 f. Decrease redundancies in the consideration and issuance of nurse 45 licenses; and 46 g. Provide opportunities for interstate practice by nurses who meet 47 uniform licensure requirements. 48 § 8902. Definitions. 1. Definitions. As used in this compact: 49 a. "Adverse action" means any administrative, civil, equitable or 50 criminal action permitted by a state's laws which is imposed by a 51 licensing board or other authority against a nurse, including actions 52 against an individual's license or multistate licensure privilege such 53 as revocation, suspension, probation, monitoring of the licensee, limi- 54 tation on the licensee's practice, or any other encumbrance on licensure 55 affecting a nurse's authorization to practice, including issuance of a 56 cease and desist action.S. 8307 102 A. 8807 1 b. "Alternative program" means a non-disciplinary monitoring program 2 approved by a licensing board. 3 c. "Coordinated licensure information system" means an integrated 4 process for collecting, storing and sharing information on nurse licen- 5 sure and enforcement activities related to nurse licensure laws that is 6 administered by a nonprofit organization composed of and controlled by 7 licensing boards. 8 d. "Commission" means the interstate commission of nurse licensure 9 compact administrators. 10 e. "Current significant investigative information" means: 11 1. Investigative information that a licensing board, after a prelimi- 12 nary inquiry that includes notification and an opportunity for the nurse 13 to respond, if required by state law, has reason to believe is not 14 groundless and, if proved true, would indicate more than a minor infrac- 15 tion; or 16 2. Investigative information that indicates that the nurse represents 17 an immediate threat to public health and safety regardless of whether 18 the nurse has been notified and had an opportunity to respond. 19 f. "Encumbrance" means a revocation or suspension of, or any limita- 20 tion on, the full and unrestricted practice of nursing imposed by a 21 licensing board. 22 g. "Home state" means the party state which is the nurse's primary 23 state of residence. 24 h. "Licensing board" means a party state's regulatory body responsible 25 for issuing nurse licenses. 26 i. "Multistate license" means a license to practice as a registered 27 nurse (RN) or as a licensed practical/vocational nurse (LPN/VN), which 28 is issued by a home state licensing board, and which authorizes the 29 licensed nurse to practice in all party states under a multistate licen- 30 sure privilege. 31 j. "Multistate licensure privilege" means a legal authorization asso- 32 ciated with a multistate license permitting the practice of nursing as 33 either a RN or a LPN/VN in a remote state. 34 k. "Nurse" means RN or LPN/VN, as those terms are defined by each 35 party state's practice laws. 36 l. "Party state" means any state that has adopted this compact. 37 m. "Remote state" means a party state, other than the home state. 38 n. "Single-state license" means a nurse license issued by a party 39 state that authorizes practice only within the issuing state and does 40 not include a multistate licensure privilege to practice in any other 41 party state. 42 o. "State" means a state, territory or possession of the United States 43 and the District of Columbia. 44 p. "State practice laws" means a party state's laws, rules and regu- 45 lations that govern the practice of nursing, define the scope of nursing 46 practice, and create the methods and grounds for imposing discipline. 47 "State practice laws" shall not include requirements necessary to obtain 48 and retain a license, except for qualifications or requirements of the 49 home state. 50 § 8903. General provisions and jurisdiction. 1. General provisions and 51 jurisdiction. a. A multistate license to practice registered or licensed 52 practical/vocational nursing issued by a home state to a resident in 53 that state will be recognized by each party state as authorizing a nurse 54 to practice as a registered nurse (RN) or as a licensed 55 practical/vocational nurse (LPN/VN), under a multistate licensure privi- 56 lege, in each party state.S. 8307 103 A. 8807 1 b. A state shall implement procedures for considering the criminal 2 history records of applicants for an initial multistate license or 3 licensure by endorsement. Such procedures shall include the submission 4 of fingerprints or other biometric-based information by applicants for 5 the purpose of obtaining an applicant's criminal history record informa- 6 tion from the federal bureau of investigation and the agency responsible 7 for retaining that state's criminal records. 8 c. Each party state shall require its licensing board to authorize an 9 applicant to obtain or retain a multistate license in the home state 10 only if the applicant: 11 i. Meets the home state's qualifications for licensure or renewal of 12 licensure, and complies with all other applicable state laws; 13 ii. (1) Has graduated or is eligible to graduate from a licensing 14 board-approved RN or LPN/VN prelicensure education program; or 15 (2) Has graduated from a foreign RN or LPN/VN prelicensure education 16 program that has been: (A) approved by the authorized accrediting body 17 in the applicable country, and (B) verified by an independent creden- 18 tials review agency to be comparable to a licensing board-approved prel- 19 icensure education program; 20 iii. Has, if a graduate of a foreign prelicensure education program 21 not taught in English or if English is not the individual's native 22 language, successfully passed an English proficiency examination that 23 includes the components of reading, speaking, writing and listening; 24 iv. Has successfully passed an NCLEX-RN or NCLEX-PN examination or 25 recognized predecessor, as applicable; 26 v. Is eligible for or holds an active, unencumbered license; 27 vi. Has submitted, in connection with an application for initial 28 licensure or licensure by endorsement, fingerprints or other biometric 29 data for the purpose of obtaining criminal history record information 30 from the federal bureau of investigation and the agency responsible for 31 retaining that state's criminal records; 32 vii. Has not been convicted or found guilty, or has entered into an 33 agreed disposition, of a felony offense under applicable state or feder- 34 al criminal law; 35 viii. Has not been convicted or found guilty, or has entered into an 36 agreed disposition, of a misdemeanor offense related to the practice of 37 nursing as determined on a case-by-case basis; 38 ix. Is not currently enrolled in an alternative program; 39 x. Is subject to self-disclosure requirements regarding current 40 participation in an alternative program; and 41 xi. Has a valid United States social security number. 42 d. All party states shall be authorized, in accordance with existing 43 state due process law, to take adverse action against a nurse's multi- 44 state licensure privilege such as revocation, suspension, probation or 45 any other action that affects a nurse's authorization to practice under 46 a multistate licensure privilege, including cease and desist actions. If 47 a party state takes such action, it shall promptly notify the adminis- 48 trator of the coordinated licensure information system. The administra- 49 tor of the coordinated licensure information system shall promptly noti- 50 fy the home state of any such actions by remote states. 51 e. A nurse practicing in a party state shall comply with the state 52 practice laws of the state in which the client is located at the time 53 service is provided. The practice of nursing is not limited to patient 54 care but shall include all nursing practice as defined by the state 55 practice laws of the party state in which the client is located. The 56 practice of nursing in a party state under a multistate licensure privi-S. 8307 104 A. 8807 1 lege will subject a nurse to the jurisdiction of the licensing board, 2 the courts and the laws of the party state in which the client is 3 located at the time service is provided. 4 f. Individuals not residing in a party state shall continue to be able 5 to apply for a party state's single-state license as provided under the 6 laws of each party state. However, the single-state license granted to 7 these individuals will not be recognized as granting the privilege to 8 practice nursing in any other party state. Nothing in this compact shall 9 affect the requirements established by a party state for the issuance of 10 a single-state license. 11 g. Any nurse holding a home state multistate license, on the effective 12 date of this compact, may retain and renew the multistate license issued 13 by the nurse's then-current home state, provided that: 14 i. A nurse, who changes primary state of residence after this 15 compact's effective date, shall meet all applicable requirements set 16 forth in this article to obtain a multistate license from a new home 17 state. 18 ii. A nurse who fails to satisfy the multistate licensure requirements 19 set forth in this article due to a disqualifying event occurring after 20 this compact's effective date shall be ineligible to retain or renew a 21 multistate license, and the nurse's multistate license shall be revoked 22 or deactivated in accordance with applicable rules adopted by the 23 commission. 24 § 8904. Applications for licensure in a party state. 1. Applications 25 for licensure in a party state. a. Upon application for a multistate 26 license, the licensing board in the issuing party state shall ascertain, 27 through the coordinated licensure information system, whether the appli- 28 cant has ever held, or is the holder of, a license issued by any other 29 state, whether there are any encumbrances on any license or multistate 30 licensure privilege held by the applicant, whether any adverse action 31 has been taken against any license or multistate licensure privilege 32 held by the applicant and whether the applicant is currently participat- 33 ing in an alternative program. 34 b. A nurse may hold a multistate license, issued by the home state, in 35 only one party state at a time. 36 c. If a nurse changes primary state of residence by moving between two 37 party states, the nurse must apply for licensure in the new home state, 38 and the multistate license issued by the prior home state will be deac- 39 tivated in accordance with applicable rules adopted by the commission. 40 i. The nurse may apply for licensure in advance of a change in primary 41 state of residence. 42 ii. A multistate license shall not be issued by the new home state 43 until the nurse provides satisfactory evidence of a change in primary 44 state of residence to the new home state and satisfies all applicable 45 requirements to obtain a multistate license from the new home state. 46 d. If a nurse changes primary state of residence by moving from a 47 party state to a non-party state, the multistate license issued by the 48 prior home state will convert to a single-state license, valid only in 49 the former home state. 50 § 8905. Additional authorities invested in party state licensing 51 boards. 1. Licensing board authority. In addition to the other powers 52 conferred by state law, a licensing board shall have the authority to: 53 a. Take adverse action against a nurse's multistate licensure privi- 54 lege to practice within that party state. 55 i. Only the home state shall have the power to take adverse action 56 against a nurse's license issued by the home state.S. 8307 105 A. 8807 1 ii. For purposes of taking adverse action, the home state licensing 2 board shall give the same priority and effect to reported conduct 3 received from a remote state as it would if such conduct had occurred 4 within the home state. In so doing, the home state shall apply its own 5 state laws to determine appropriate action. 6 b. Issue cease and desist orders or impose an encumbrance on a nurse's 7 authority to practice within that party state. 8 c. Complete any pending investigations of a nurse who changes primary 9 state of residence during the course of such investigations. The licens- 10 ing board shall also have the authority to take appropriate action or 11 actions and shall promptly report the conclusions of such investigations 12 to the administrator of the coordinated licensure information system. 13 The administrator of the coordinated licensure information system shall 14 promptly notify the new home state of any such actions. 15 d. Issue subpoenas for both hearings and investigations that require 16 the attendance and testimony of witnesses, as well as the production of 17 evidence. Subpoenas issued by a licensing board in a party state for the 18 attendance and testimony of witnesses or the production of evidence from 19 another party state shall be enforced in the latter state by any court 20 of competent jurisdiction, according to the practice and procedure of 21 that court applicable to subpoenas issued in proceedings pending before 22 it. The issuing authority shall pay any witness fees, travel expenses, 23 mileage and other fees required by the service statutes of the state in 24 which the witnesses or evidence are located. 25 e. Obtain and submit, for each nurse licensure applicant, fingerprint 26 or other biometric-based information to the federal bureau of investi- 27 gation for criminal background checks, receive the results of the feder- 28 al bureau of investigation record search on criminal background checks 29 and use the results in making licensure decisions. 30 f. If otherwise permitted by state law, recover from the affected 31 nurse the costs of investigations and disposition of cases resulting 32 from any adverse action taken against that nurse. 33 g. Take adverse action based on the factual findings of the remote 34 state, provided that the licensing board follows its own procedures for 35 taking such adverse action. 36 2. Adverse actions. a. If adverse action is taken by the home state 37 against a nurse's multistate license, the nurse's multistate licensure 38 privilege to practice in all other party states shall be deactivated 39 until all encumbrances have been removed from the multistate license. 40 All home state disciplinary orders that impose adverse action against a 41 nurse's multistate license shall include a statement that the nurse's 42 multistate licensure privilege is deactivated in all party states during 43 the pendency of the order. 44 b. Nothing in this compact shall override a party state's decision 45 that participation in an alternative program may be used in lieu of 46 adverse action. The home state licensing board shall deactivate the 47 multistate licensure privilege under the multistate license of any nurse 48 for the duration of the nurse's participation in an alternative program. 49 § 8906. Coordinated licensure information system and exchange of 50 information. 1. Coordinated licensure information system and exchange 51 of information. a. All party states shall participate in a coordinated 52 licensure information system of all licensed registered nurses (RNs) and 53 licensed practical/vocational nurses (LPNs/VNs). This system will 54 include information on the licensure and disciplinary history of each 55 nurse, as submitted by party states, to assist in the coordination of 56 nurse licensure and enforcement efforts.S. 8307 106 A. 8807 1 b. The commission, in consultation with the administrator of the coor- 2 dinated licensure information system, shall formulate necessary and 3 proper procedures for the identification, collection and exchange of 4 information under this compact. 5 c. All licensing boards shall promptly report to the coordinated 6 licensure information system any adverse action, any current significant 7 investigative information, denials of applications with the reasons for 8 such denials and nurse participation in alternative programs known to 9 the licensing board regardless of whether such participation is deemed 10 nonpublic or confidential under state law. 11 d. Current significant investigative information and participation in 12 nonpublic or confidential alternative programs shall be transmitted 13 through the coordinated licensure information system only to party state 14 licensing boards. 15 e. Notwithstanding any other provision of law, all party state licens- 16 ing boards contributing information to the coordinated licensure infor- 17 mation system may designate information that may not be shared with 18 non-party states or disclosed to other entities or individuals without 19 the express permission of the contributing state. 20 f. Any personally identifiable information obtained from the coordi- 21 nated licensure information system by a party state licensing board 22 shall not be shared with non-party states or disclosed to other entities 23 or individuals except to the extent permitted by the laws of the party 24 state contributing the information. 25 g. Any information contributed to the coordinated licensure informa- 26 tion system that is subsequently required to be expunged by the laws of 27 the party state contributing that information shall also be expunged 28 from the coordinated licensure information system. 29 h. The compact administrator of each party state shall furnish a 30 uniform data set to the compact administrator of each other party state, 31 which shall include, at a minimum: 32 i. Identifying information; 33 ii. Licensure data; 34 iii. Information related to alternative program participation; and 35 iv. Other information that may facilitate the administration of this 36 compact, as determined by commission rules. 37 i. The compact administrator of a party state shall provide all inves- 38 tigative documents and information requested by another party state. 39 § 8907. Establishment of the interstate commission of nurse licensure 40 compact administrators. 1. Commission of nurse licensure compact admin- 41 istrators. The party states hereby create and establish a joint public 42 entity known as the interstate commission of nurse licensure compact 43 administrators. The commission is an instrumentality of the party 44 states. 45 2. Venue. Venue is proper, and judicial proceedings by or against the 46 commission shall be brought solely and exclusively, in a court of compe- 47 tent jurisdiction where the principal office of the commission is 48 located. The commission may waive venue and jurisdictional defenses to 49 the extent it adopts or consents to participate in alternative dispute 50 resolution proceedings. 51 3. Sovereign immunity. Nothing in this compact shall be construed to 52 be a waiver of sovereign immunity. 53 4. Membership, voting and meetings. a. Each party state shall have and 54 be limited to one administrator. The head of the state licensing board 55 or designee shall be the administrator of this compact for each party 56 state. Any administrator may be removed or suspended from office asS. 8307 107 A. 8807 1 provided by the law of the state from which the administrator is 2 appointed. Any vacancy occurring in the commission shall be filled in 3 accordance with the laws of the party state in which the vacancy exists. 4 b. Each administrator shall be entitled to one vote with regard to the 5 promulgation of rules and creation of bylaws and shall otherwise have an 6 opportunity to participate in the business and affairs of the commis- 7 sion. An administrator shall vote in person or by such other means as 8 provided in the bylaws. The bylaws may provide for an administrator's 9 participation in meetings by telephone or other means of communication. 10 c. The commission shall meet at least once during each calendar year. 11 Additional meetings shall be held as set forth in the bylaws or rules of 12 the commission. 13 d. All meetings shall be open to the public, and public notice of 14 meetings shall be given in the same manner as required under the rule- 15 making provisions in section eighty-nine hundred eight of this article. 16 5. Closed meetings. a. The commission may convene in a closed, nonpub- 17 lic meeting if the commission shall discuss: 18 i. Noncompliance of a party state with its obligations under this 19 compact; 20 ii. The employment, compensation, discipline or other personnel 21 matters, practices or procedures related to specific employees or other 22 matters related to the commission's internal personnel practices and 23 procedures; 24 iii. Current, threatened or reasonably anticipated litigation; 25 iv. Negotiation of contracts for the purchase or sale of goods, 26 services or real estate; 27 v. Accusing any person of a crime or formally censuring any person; 28 vi. Disclosure of trade secrets or commercial or financial information 29 that is privileged or confidential; 30 vii. Disclosure of information of a personal nature where disclosure 31 would constitute a clearly unwarranted invasion of personal privacy; 32 viii. Disclosure of investigatory records compiled for law enforcement 33 purposes; 34 ix. Disclosure of information related to any reports prepared by or on 35 behalf of the commission for the purpose of investigation of compliance 36 with this compact; or 37 x. Matters specifically exempted from disclosure by federal or state 38 statute. 39 b. If a meeting, or portion of a meeting, is closed pursuant to this 40 paragraph the commission's legal counsel or designee shall certify that 41 the meeting may be closed and shall reference each relevant exempting 42 provision. The commission shall keep minutes that fully and clearly 43 describe all matters discussed in a meeting and shall provide a full and 44 accurate summary of actions taken, and the reasons therefor, including a 45 description of the views expressed. All documents considered in 46 connection with an action shall be identified in such minutes. All 47 minutes and documents of a closed meeting shall remain under seal, 48 subject to release by a majority vote of the commission or order of a 49 court of competent jurisdiction. 50 c. The commission shall, by a majority vote of the administrators, 51 prescribe bylaws or rules to govern its conduct as may be necessary or 52 appropriate to carry out the purposes and exercise the powers of this 53 compact, including but not limited to: 54 i. Establishing the fiscal year of the commission; 55 ii. Providing reasonable standards and procedures: 56 (1) For the establishment and meetings of other committees; andS. 8307 108 A. 8807 1 (2) Governing any general or specific delegation of any authority or 2 function of the commission; 3 iii. Providing reasonable procedures for calling and conducting meet- 4 ings of the commission, ensuring reasonable advance notice of all meet- 5 ings and providing an opportunity for attendance of such meetings by 6 interested parties, with enumerated exceptions designed to protect the 7 public's interest, the privacy of individuals, and proprietary informa- 8 tion, including trade secrets. The commission may meet in closed session 9 only after a majority of the administrators vote to close a meeting in 10 whole or in part. As soon as practicable, the commission must make 11 public a copy of the vote to close the meeting revealing the vote of 12 each administrator, with no proxy votes allowed; 13 iv. Establishing the titles, duties and authority and reasonable 14 procedures for the election of the officers of the commission; 15 v. Providing reasonable standards and procedures for the establishment 16 of the personnel policies and programs of the commission. Notwithstand- 17 ing any civil service or other similar laws of any party state, the 18 bylaws shall exclusively govern the personnel policies and programs of 19 the commission; and 20 vi. Providing a mechanism for winding up the operations of the commis- 21 sion and the equitable disposition of any surplus funds that may exist 22 after the termination of this compact after the payment or reserving of 23 all of its debts and obligations. 24 6. General provisions. a. The commission shall publish its bylaws and 25 rules, and any amendments thereto, in a convenient form on the website 26 of the commission. 27 b. The commission shall maintain its financial records in accordance 28 with the bylaws. 29 c. The commission shall meet and take such actions as are consistent 30 with the provisions of this compact and the bylaws. 31 7. Powers of the commission. The commission shall have the following 32 powers: 33 a. To promulgate uniform rules to facilitate and coordinate implemen- 34 tation and administration of this compact. The rules shall have the 35 force and effect of law and shall be binding in all party states; 36 b. To bring and prosecute legal proceedings or actions in the name of 37 the commission, provided that the standing of any licensing board to sue 38 or be sued under applicable law shall not be affected; 39 c. To purchase and maintain insurance and bonds; 40 d. To borrow, accept or contract for services of personnel, including, 41 but not limited to, employees of a party state or nonprofit organiza- 42 tions; 43 e. To cooperate with other organizations that administer state 44 compacts related to the regulation of nursing, including but not limited 45 to sharing administrative or staff expenses, office space or other 46 resources; 47 f. To hire employees, elect or appoint officers, fix compensation, 48 define duties, grant such individuals appropriate authority to carry out 49 the purposes of this compact, and to establish the commission's person- 50 nel policies and programs relating to conflicts of interest, qualifica- 51 tions of personnel and other related personnel matters; 52 g. To accept any and all appropriate donations, grants and gifts of 53 money, equipment, supplies, materials and services, and to receive, 54 utilize and dispose of the same; provided that at all times the commis- 55 sion shall avoid any appearance of impropriety or conflict of interest;S. 8307 109 A. 8807 1 h. To lease, purchase, accept appropriate gifts or donations of, or 2 otherwise to own, hold, improve or use, any property, whether real, 3 personal or mixed; provided that at all times the commission shall avoid 4 any appearance of impropriety; 5 i. To sell, convey, mortgage, pledge, lease, exchange, abandon or 6 otherwise dispose of any property, whether real, personal or mixed; 7 j. To establish a budget and make expenditures; 8 k. To borrow money; 9 l. To appoint committees, including advisory committees comprised of 10 administrators, state nursing regulators, state legislators or their 11 representatives, and consumer representatives, and other such interested 12 persons; 13 m. To provide and receive information from, and to cooperate with, law 14 enforcement agencies; 15 n. To adopt and use an official seal; and 16 o. To perform such other functions as may be necessary or appropriate 17 to achieve the purposes of this compact consistent with the state regu- 18 lation of nurse licensure and practice. 19 8. Financing of the commission. a. The commission shall pay, or 20 provide for the payment of, the reasonable expenses of its establish- 21 ment, organization and ongoing activities. 22 b. The commission may also levy on and collect an annual assessment 23 from each party state to cover the cost of its operations, activities 24 and staff in its annual budget as approved each year. The aggregate 25 annual assessment amount, if any, shall be allocated based upon a formu- 26 la to be determined by the commission, which shall promulgate a rule 27 that is binding upon all party states. 28 c. The commission shall not incur obligations of any kind prior to 29 securing the funds adequate to meet the same; nor shall the commission 30 pledge the credit of any of the party states, except by, and with the 31 authority of, such party state. 32 d. The commission shall keep accurate accounts of all receipts and 33 disbursements. The receipts and disbursements of the commission shall be 34 subject to the audit and accounting procedures established under its 35 bylaws. However, all receipts and disbursements of funds handled by the 36 commission shall be audited yearly by a certified or licensed public 37 accountant, and the report of the audit shall be included in and become 38 part of the annual report of the commission. 39 9. Qualified immunity, defense and indemnification. a. The administra- 40 tors, officers, executive director, employees and representatives of the 41 commission shall be immune from suit and liability, either personally or 42 in their official capacity, for any claim for damage to or loss of prop- 43 erty or personal injury or other civil liability caused by or arising 44 out of any actual or alleged act, error or omission that occurred, or 45 that the person against whom the claim is made had a reasonable basis 46 for believing occurred, within the scope of the commission's employment, 47 duties or responsibilities; provided that nothing in this paragraph 48 shall be construed to protect any such person from suit or liability for 49 any damage, loss, injury or liability caused by the intentional, willful 50 or wanton misconduct of that person. 51 b. The commission shall defend any administrator, officer, executive 52 director, employee or representative of the commission in any civil 53 action seeking to impose liability arising out of any actual or alleged 54 act, error or omission that occurred within the scope of the commis- 55 sion's employment, duties or responsibilities, or that the person 56 against whom the claim is made had a reasonable basis for believingS. 8307 110 A. 8807 1 occurred within the scope of the commission's employment, duties or 2 responsibilities; provided that nothing herein shall be construed to 3 prohibit that person from retaining his or her own counsel; and provided 4 further that the actual or alleged act, error or omission did not result 5 from that person's intentional, willful or wanton misconduct. 6 c. The commission shall indemnify and hold harmless any administrator, 7 officer, executive director, employee or representative of the commis- 8 sion for the amount of any settlement or judgment obtained against that 9 person arising out of any actual or alleged act, error or omission that 10 occurred within the scope of the commission's employment, duties or 11 responsibilities, or that such person had a reasonable basis for believ- 12 ing occurred within the scope of the commission's employment, duties or 13 responsibilities, provided that the actual or alleged act, error or 14 omission did not result from the intentional, willful or wanton miscon- 15 duct of that person. 16 § 8908. Rulemaking. 1. Rulemaking. a. The commission shall exercise 17 its rulemaking powers pursuant to the criteria set forth in this article 18 and the rules adopted thereunder. Rules and amendments shall become 19 binding as of the date specified in each rule or amendment and shall 20 have the same force and effect as provisions of this compact. 21 b. Rules or amendments to the rules shall be adopted at a regular or 22 special meeting of the commission. 23 2. Notice. a. Prior to promulgation and adoption of a final rule or 24 rules by the commission, and at least sixty days in advance of the meet- 25 ing at which the rule will be considered and voted upon, the commission 26 shall file a notice of proposed rulemaking: 27 i. On the website of the commission; and 28 ii. On the website of each licensing board or the publication in which 29 each state would otherwise publish proposed rules. 30 b. The notice of proposed rulemaking shall include: 31 i. The proposed time, date and location of the meeting in which the 32 rule will be considered and voted upon; 33 ii. The text of the proposed rule or amendment, and the reason for the 34 proposed rule; 35 iii. A request for comments on the proposed rule from any interested 36 person; and 37 iv. The manner in which interested persons may submit notice to the 38 commission of their intention to attend the public hearing and any writ- 39 ten comments. 40 c. Prior to adoption of a proposed rule, the commission shall allow 41 persons to submit written data, facts, opinions and arguments, which 42 shall be made available to the public. 43 3. Public hearings on rules. a. The commission shall grant an opportu- 44 nity for a public hearing before it adopts a rule or amendment. 45 b. The commission shall publish the place, time and date of the sched- 46 uled public hearing. 47 i. Hearings shall be conducted in a manner providing each person who 48 wishes to comment a fair and reasonable opportunity to comment orally or 49 in writing. All hearings will be recorded, and a copy will be made 50 available upon request. 51 ii. Nothing in this section shall be construed as requiring a separate 52 hearing on each rule. Rules may be grouped for the convenience of the 53 commission at hearings required by this section. 54 c. If no one appears at the public hearing, the commission may proceed 55 with promulgation of the proposed rule.S. 8307 111 A. 8807 1 d. Following the scheduled hearing date, or by the close of business 2 on the scheduled hearing date if the hearing was not held, the commis- 3 sion shall consider all written and oral comments received. 4 4. Voting on rules. The commission shall, by majority vote of all 5 administrators, take final action on the proposed rule and shall deter- 6 mine the effective date of the rule, if any, based on the rulemaking 7 record and the full text of the rule. 8 5. Emergency rules. Upon determination that an emergency exists, the 9 commission may consider and adopt an emergency rule without prior 10 notice, opportunity for comment or hearing, provided that the usual 11 rulemaking procedures provided in this compact and in this section shall 12 be retroactively applied to the rule as soon as reasonably possible, in 13 no event later than ninety days after the effective date of the rule. 14 For the purposes of this provision, an emergency rule is one that must 15 be adopted immediately in order to: 16 a. Meet an imminent threat to public health, safety or welfare; 17 b. Prevent a loss of the commission or party state funds; or 18 c. Meet a deadline for the promulgation of an administrative rule that 19 is required by federal law or rule. 20 6. Revisions. The commission may direct revisions to a previously 21 adopted rule or amendment for purposes of correcting typographical 22 errors, errors in format, errors in consistency or grammatical errors. 23 Public notice of any revisions shall be posted on the website of the 24 commission. The revision shall be subject to challenge by any person for 25 a period of thirty days after posting. The revision may be challenged 26 only on grounds that the revision results in a material change to a 27 rule. A challenge shall be made in writing, and delivered to the 28 commission, prior to the end of the notice period. If no challenge is 29 made, the revision will take effect without further action. If the 30 revision is challenged, the revision may not take effect without the 31 approval of the commission. 32 § 8909. Oversight, dispute resolution and enforcement. 1. Oversight. 33 a. Each party state shall enforce this compact and take all actions 34 necessary and appropriate to effectuate this compact's purposes and 35 intent. 36 b. The commission shall be entitled to receive service of process in 37 any proceeding that may affect the powers, responsibilities or actions 38 of the commission, and shall have standing to intervene in such a 39 proceeding for all purposes. Failure to provide service of process in 40 such proceeding to the commission shall render a judgment or order void 41 as to the commission, this compact or promulgated rules. 42 2. Default, technical assistance and termination. a. If the commission 43 determines that a party state has defaulted in the performance of its 44 obligations or responsibilities under this compact or the promulgated 45 rules, the commission shall: 46 i. Provide written notice to the defaulting state and other party 47 states of the nature of the default, the proposed means of curing the 48 default or any other action to be taken by the commission; and 49 ii. Provide remedial training and specific technical assistance 50 regarding the default. 51 b. If a state in default fails to cure the default, the defaulting 52 state's membership in this compact may be terminated upon an affirmative 53 vote of a majority of the administrators, and all rights, privileges and 54 benefits conferred by this compact may be terminated on the effective 55 date of termination. A cure of the default does not relieve the offend-S. 8307 112 A. 8807 1 ing state of obligations or liabilities incurred during the period of 2 default. 3 c. Termination of membership in this compact shall be imposed only 4 after all other means of securing compliance have been exhausted. Notice 5 of intent to suspend or terminate shall be given by the commission to 6 the governor of the defaulting state and to the executive officer of the 7 defaulting state's licensing board and each of the party states. 8 d. A state whose membership in this compact has been terminated is 9 responsible for all assessments, obligations and liabilities incurred 10 through the effective date of termination, including obligations that 11 extend beyond the effective date of termination. 12 e. The commission shall not bear any costs related to a state that is 13 found to be in default or whose membership in this compact has been 14 terminated unless agreed upon in writing between the commission and the 15 defaulting state. 16 f. The defaulting state may appeal the action of the commission by 17 petitioning the U.S. District Court for the District of Columbia or the 18 federal district in which the commission has its principal offices. The 19 prevailing party shall be awarded all costs of such litigation, includ- 20 ing reasonable attorneys' fees. 21 3. Dispute resolution. a. Upon request by a party state, the commis- 22 sion shall attempt to resolve disputes related to the compact that arise 23 among party states and between party and non-party states. 24 b. The commission shall promulgate a rule providing for both mediation 25 and binding dispute resolution for disputes, as appropriate. 26 c. In the event the commission cannot resolve disputes among party 27 states arising under this compact: 28 i. The party states may submit the issues in dispute to an arbitration 29 panel, which will be comprised of individuals appointed by the compact 30 administrator in each of the affected party states, and an individual 31 mutually agreed upon by the compact administrators of all the party 32 states involved in the dispute. 33 ii. The decision of a majority of the arbitrators shall be final and 34 binding. 35 4. Enforcement. a. The commission, in the reasonable exercise of its 36 discretion, shall enforce the provisions and rules of this compact. 37 b. By majority vote, the commission may initiate legal action in the 38 U.S. District Court for the District of Columbia or the federal 39 district in which the commission has its principal offices against a 40 party state that is in default to enforce compliance with the provisions 41 of this compact and its promulgated rules and bylaws. The relief sought 42 may include both injunctive relief and damages. In the event judicial 43 enforcement is necessary, the prevailing party shall be awarded all 44 costs of such litigation, including reasonable attorneys' fees. 45 c. The remedies herein shall not be the exclusive remedies of the 46 commission. The commission may pursue any other remedies available under 47 federal or state law. 48 § 8910. Effective date, withdrawal and amendment. 1. Effective date. 49 a. This compact shall become effective and binding on the earlier of 50 the date of legislative enactment of this compact into law by no less 51 than twenty-six states or the effective date of the chapter of the laws 52 of two thousand twenty-four that enacted this compact. Thereafter, the 53 compact shall become effective and binding as to any other compacting 54 state upon enactment of the compact into law by that state. All party 55 states to this compact, that also were parties to the prior nurse licen- 56 sure compact, superseded by this compact, (herein referred to as "priorS. 8307 113 A. 8807 1 compact"), shall be deemed to have withdrawn from said prior compact 2 within six months after the effective date of this compact. 3 b. Each party state to this compact shall continue to recognize a 4 nurse's multistate licensure privilege to practice in that party state 5 issued under the prior compact until such party state has withdrawn from 6 the prior compact. 7 2. Withdrawal. a. Any party state may withdraw from this compact by 8 enacting a statute repealing the same. A party state's withdrawal shall 9 not take effect until six months after enactment of the repealing stat- 10 ute. 11 b. A party state's withdrawal or termination shall not affect the 12 continuing requirement of the withdrawing or terminated state's licens- 13 ing board to report adverse actions and significant investigations 14 occurring prior to the effective date of such withdrawal or termination. 15 c. Nothing contained in this compact shall be construed to invalidate 16 or prevent any nurse licensure agreement or other cooperative arrange- 17 ment between a party state and a non-party state that is made in accord- 18 ance with the other provisions of this compact. 19 3. Amendment. a. This compact may be amended by the party states. No 20 amendment to this compact shall become effective and binding upon the 21 party states unless and until it is enacted into the laws of all party 22 states. 23 b. Representatives of non-party states to this compact shall be 24 invited to participate in the activities of the commission, on a nonvot- 25 ing basis, prior to the adoption of this compact by all states. 26 § 8911. Construction and severability. 1. Construction and severabil- 27 ity. This compact shall be liberally construed so as to effectuate the 28 purposes thereof. The provisions of this compact shall be severable, and 29 if any phrase, clause, sentence or provision of this compact is declared 30 to be contrary to the constitution of any party state or of the United 31 States, or if the applicability thereof to any government, agency, 32 person or circumstance is held to be invalid, the validity of the 33 remainder of this compact and the applicability thereof to any govern- 34 ment, agency, person or circumstance shall not be affected thereby. If 35 this compact shall be held to be contrary to the constitution of any 36 party state, this compact shall remain in full force and effect as to 37 the remaining party states and in full force and effect as to the party 38 state affected as to all severable matters. 39 § 3. This act shall take effect immediately and shall be deemed to 40 have been in full force and effect on and after April 1, 2024. 41 PART S 42 Section 1. The public health law is amended by adding a new section 43 2825-i to read as follows: 44 § 2825-i. Healthcare safety net transformation program. 1. A statewide 45 healthcare safety net transformation program shall be established within 46 the department for the purpose of supporting the transformation of safe- 47 ty net hospitals to improve access, equity, quality, and outcomes while 48 increasing the financial sustainability of safety net hospitals. Such 49 program may provide or utilize new or existing capital funding, or oper- 50 ating subsidies, or both. A safety net hospital and a partner organiza- 51 tion may jointly apply for this program. 52 2. The commissioner shall enter an agreement with the president of the 53 dormitory authority of the state of New York pursuant to section sixteen 54 hundred eighty-r of the public authorities law, as required, which shallS. 8307 114 A. 8807 1 apply to this agreement, subject to the approval of the director of the 2 division of the budget, for the purposes of the distribution and admin- 3 istration of available funds pursuant to such agreement and made avail- 4 able pursuant to this section and subject to appropriation. Such funds 5 may be awarded and distributed by the department to safety net hospi- 6 tals, or a partner organization, in the form of grants. To qualify as a 7 safety net hospital for purposes of this section, a hospital shall: 8 (a) be either a public hospital, a rural emergency hospital, critical 9 access hospital or sole community hospital; 10 (b) have at least thirty percent of its inpatient discharges made up 11 of medical assistance program eligible individuals, uninsured individ- 12 uals or medical assistance program dually eligible individuals and at 13 least thirty-five percent of its outpatient visits made up of medical 14 assistance program eligible individuals, uninsured individuals or 15 medical assistance program dually-eligible individuals; 16 (c) serve at least thirty percent of the residents of a county or a 17 multi-county area who are medical assistance program eligible individ- 18 uals, uninsured individuals or medical assistance program dually-eligi- 19 ble individuals; or 20 (d) in the discretion of the commissioner, serve a significant popu- 21 lation of medical assistance program eligible individuals, uninsured 22 individuals or medical assistance program dually-eligible individuals. 23 3. Partner organizations may include, but are not limited to, health 24 systems, hospitals, health plans, residential health care facilities, 25 physician groups, community-based organization, or other healthcare 26 entities who can serve as partners in the transformation of the safety 27 net hospital. The commissioner shall have the discretion to deem any 28 organization a partner organization upon a finding that deeming so will 29 advance the goals of this section. 30 4. Notwithstanding any law to the contrary, and in accordance with 31 article four of the state finance law, the comptroller is hereby author- 32 ized and directed to transfer, upon request of the director of budget, 33 on or before March thirty-first, two thousand twenty-five, up to five 34 hundred million dollars to the department from amounts appropriated to 35 administer the programs established in sections twenty-eight hundred 36 twenty-five-g and twenty-eight hundred twenty-five-h of this article to 37 support this program. Notwithstanding section one hundred sixty-three 38 of the state finance law, sections one hundred forty-two and one hundred 39 forty-three of the economic development law or any inconsistent 40 provisions of law to the contrary, awards may be provided without a 41 competitive bid or request for proposal process to safety net hospitals 42 or partner organizations for purposes of increasing access, equity, 43 quality, outcomes, and long-term financial sustainability of such safety 44 net hospitals. 45 5. Notwithstanding any provision of law to the contrary, the commis- 46 sioner is authorized to waive any regulatory requirements to allow 47 applicants to more effectively or efficiently implement projects awarded 48 through the healthcare safety net transformation program, provided, 49 however, that regulations pertaining to patient safety, patient auton- 50 omy, patient privacy, patient rights, due process, scope of practice, 51 professional licensure, environmental protections, provider reimburse- 52 ment methodologies, or occupational standards and employee rights may 53 not be waived, nor shall any regulations be waived if such waiver would 54 risk patient safety. Such waiver shall not exceed the life of the 55 project or such shorter time periods as the commissioner may determine. 56 Any regulatory relief granted pursuant to this subdivision shall beS. 8307 115 A. 8807 1 specifically described and requested within each project application and 2 be reviewed by the commissioner. The waiver of any regulatory require- 3 ments shall be made in the sole discretion of the commissioner. 4 6. Qualifying safety net hospitals and their designated partner organ- 5 ization or organizations shall provide, as part of the application, 6 which shall be in a manner as prescribed by the commissioner, a trans- 7 formation plan that includes at least a five-year strategic and opera- 8 tional plan outlining the roles and responsibilities of each entity and 9 specifically state any regulatory flexibility which may be required to 10 implement such plan. The transformation plan shall also include a time- 11 line of key metrics and goals related to improved access, equity, quali- 12 ty, outcomes, and increased financial sustainability of the safety net 13 hospital. The request for level and type of support shall be specific 14 and detailed in the application. Continued support shall be contingent 15 upon the implementation of the approved plan and key milestones. Appli- 16 cations may include a range of collaboration models, including but not 17 be limited to merger, acquisition, a management services contract, or a 18 clinical integration. 19 7. The release of any funding will be contingent upon compliance with 20 the transformation plan and a determination that acceptable progress has 21 been made with such plan. If key milestones and goals are not met, addi- 22 tional financial resources may be withheld and redirected, upon the 23 recommendation of the commissioner and approval by the director of budg- 24 et. 25 § 2. This act shall take effect immediately and shall be deemed to 26 have been in full force and effect on and after April 1, 2024. 27 PART T 28 Section 1. Subdivision 1 of section 2130 of the public health law, as 29 amended by chapter 308 of the laws of 2010, is amended to read as 30 follows: 31 1. (a) Every physician or other person authorized by law to order 32 diagnostic tests or make a medical diagnosis, or any laboratory perform- 33 ing such tests shall immediately [(a)] (i) upon determination that a 34 person is [infected] positive/reactive with human immunodeficiency virus 35 (HIV), [(b)] (ii) upon diagnosis [that a person is afflicted] with [the36disease known as] acquired immune deficiency syndrome (AIDS), [(c)] 37 (iii) upon diagnosis [that a person is afflicted] with HIV related 38 illness, and [(d)] (iv) upon periodic monitoring of HIV infection by any 39 laboratory tests report such case or data to the commissioner. 40 (b) Any permitted clinical laboratory, as defined in section five 41 hundred seventy-one of this chapter, performing such diagnostic tests 42 shall also, upon determination that a test result is not 43 positive/reactive for HIV, report such negative HIV test result to the 44 commissioner. 45 § 2. Subdivision 1 of section 2102 of the public health law is amended 46 to read as follows: 47 1. Whenever any laboratory examination discloses evidence of communi- 48 cable disease, and for hepatitis B virus or syphilis upon determination 49 that a test result is not positive/reactive, the results of such exam- 50 ination together with all required pertinent facts, shall be immediately 51 reported by the person in charge of the laboratory or the person making 52 such examination to the local or state health official to whom the 53 attending physician is required to report such case.S. 8307 116 A. 8807 1 § 3. The public health law is amended by adding a new section 2172 to 2 read as follows: 3 § 2172. HCV infection; duty to report. In addition to reporting that a 4 hepatitis C virus (HCV) clinical laboratory test is reactive/positive as 5 required by section twenty-one hundred two of this article, any permit- 6 ted clinical laboratory, as defined in section five hundred seventy-one 7 of this chapter, performing such tests shall also, upon determination 8 that a test result is not positive/reactive with HCV, report such nega- 9 tive HCV test result to the commissioner. 10 § 4. Section 2781 of the public health law, as amended by chapter 308 11 of the laws of 2010, subdivisions 1 and 2 as amended by chapter 502 of 12 the laws of 2016 and subdivision 4 as amended by section 2 of part A of 13 chapter 60 of the laws of 2014, is amended to read as follows: 14 § 2781. HIV related testing. 1. Except as provided in section three 15 thousand one hundred twenty-one of the civil practice law and rules, or 16 unless otherwise specifically authorized or required by a state or 17 federal law, no person shall order the performance of an HIV related 18 test without first, at a minimum, [orally advising] providing notice by 19 means readily accessible in multiple languages to the protected individ- 20 ual, or, when the protected individual lacks capacity to consent, a 21 person authorized to consent to health care for such individual, that an 22 HIV-related test is being performed, or over the objection of such indi- 23 vidual or authorized persons. Such [advisement and objection, when24applicable] notice may be provided orally, in writing, by prominently 25 displayed signage, or by electronic means or other appropriate form of 26 communication. Such notice shall include information that HIV testing is 27 voluntary. A refusal of an HIV related test shall be noted in the indi- 28 vidual's record. 29 2. A person ordering the performance of an HIV related test shall 30 provide either directly or through a representative to the subject of an 31 HIV related test or, if the subject lacks capacity to consent, to a 32 person authorized pursuant to law to consent to health care for the 33 subject, an explanation that: 34 (a) HIV causes AIDS and can be transmitted through sexual activities 35 and needle-sharing, by pregnant women to their fetuses, and through 36 breastfeeding infants; 37 (b) there is treatment for HIV that can help an individual stay heal- 38 thy; 39 (c) individuals with HIV or AIDS can adopt safe practices to protect 40 uninfected and infected people in their lives from becoming infected or 41 multiply infected with HIV; 42 (d) testing is voluntary and can be done anonymously at a public test- 43 ing center; 44 (e) the law protects the confidentiality of HIV related test results; 45 (f) the law prohibits discrimination based on an individual's HIV 46 status and services are available to help with such consequences; and 47 (g) the law requires that an individual be advised before an HIV-re- 48 lated test is performed, and that no test shall be performed over his or 49 her objection. 50 Protocols shall be in place to ensure compliance with this section. 51 4. [A person authorized pursuant to law to order the performance of an52HIV related test shall provide directly or through a representative to53the person seeking such test, an opportunity to remain anonymous through54use of a coded system with no linking of individual identity to the test55request or results.] A health care provider who is not authorized by the 56 commissioner to provide HIV related tests on an anonymous basis shallS. 8307 117 A. 8807 1 refer a person who requests an anonymous test to a test site which does 2 provide anonymous testing. The provisions of this subdivision shall not 3 apply to a health care provider ordering the performance of an HIV 4 related test on an individual proposed for insurance coverage. 5 5. At the time of communicating the test result to the subject of the 6 test, a person ordering the performance of an HIV related test shall, 7 directly or through a representative: 8 (a) in the case of a test indicating evidence of HIV infection, 9 provide the subject of the test or, if the subject lacks capacity to 10 consent, the person authorized pursuant to law to consent to health care 11 for the subject with counseling or referrals for counseling: 12 (i) for coping with the emotional consequences of learning the result; 13 (ii) regarding the discrimination problems that disclosure of the 14 result could cause; 15 (iii) for behavior change to prevent transmission or contraction of 16 HIV infection; 17 (iv) to inform such person of available medical treatments; [and] 18 (v) regarding the need to notify his or her contacts; and 19 (vi) regarding pre- and post-exposure prophylaxis medications avail- 20 able to sexual partners to prevent HIV infection; and 21 (b) in the case of a test not indicating evidence of HIV infection, 22 provide (in a manner which may consist of oral or written reference to 23 information previously provided) the subject of the test, or if the 24 subject lacks capacity to consent, the person authorized pursuant to law 25 to consent to health care for the subject, with information: 26 (i) concerning the risks of participating in high risk sexual or 27 needle-sharing behavior; and 28 (ii) regarding pre- and post-exposure prophylaxis medications avail- 29 able to prevent HIV infection. 30 5-a. With the consent of the subject of a test indicating evidence of 31 HIV infection or, if the subject lacks capacity to consent, with the 32 consent of the person authorized pursuant to law to consent to health 33 care for the subject, the person who ordered the performance of the HIV 34 related test, or such person's representative, shall provide or arrange 35 with a health care provider for an appointment for follow-up medical 36 care for HIV for such subject. 37 6. The provisions of this section shall not apply to the performance 38 of an HIV related test: 39 (a) by a health care provider or health facility in relation to the 40 procuring, processing, distributing or use of a human body or a human 41 body part, including organs, tissues, eyes, bones, arteries, blood, 42 semen, or other body fluids, for use in medical research or therapy, or 43 for transplantation to individuals provided, however, that where the 44 test results are communicated to the subject, post-test counseling, as 45 described in subdivision five of this section, shall nonetheless be 46 required; or 47 (b) for the purpose of research if the testing is performed in a 48 manner by which the identity of the test subject is not known and may 49 not be retrieved by the researcher; or 50 (c) on a deceased person, when such test is conducted to determine the 51 cause of death or for epidemiological purposes; or 52 (d) conducted pursuant to section twenty-five hundred-f of this chap- 53 ter; or 54 (e) in situations involving occupational exposures which create a 55 significant risk of contracting or transmitting HIV infection, asS. 8307 118 A. 8807 1 defined in regulations of the department and pursuant to protocols 2 adopted by the department, 3 (i) provided that: 4 (A) the person who is the source of the occupational exposure is 5 deceased, comatose or is determined by his or her attending health care 6 professional to lack mental capacity to consent to an HIV related test 7 and is not reasonably expected to recover in time for the exposed person 8 to receive appropriate medical treatment, as determined by the exposed 9 person's attending health care professional who would order or provide 10 such treatment; 11 (B) there is no person available or reasonably likely to become avail- 12 able who has the legal authority to consent to the HIV related test on 13 behalf of the source person in time for the exposed person to receive 14 appropriate medical treatment; and 15 (C) the exposed person will benefit medically by knowing the source 16 person's HIV test results, as determined by the exposed person's health 17 care professional and documented in the exposed person's medical record; 18 (ii) in which case 19 (A) a provider shall order an anonymous HIV test of the source person; 20 and 21 (B) the results of such anonymous test, but not the identity of the 22 source person, shall be disclosed only to the attending health care 23 professional of the exposed person solely for the purpose of assisting 24 the exposed person in making appropriate decisions regarding post-expo- 25 sure medical treatment; and 26 (C) the results of the test shall not be disclosed to the source 27 person or placed in the source person's medical record. 28 7. In the event that an HIV related test is ordered by a physician or 29 certified nurse practitioner pursuant to the provisions of the education 30 law providing for non-patient specific regimens, then for the purposes 31 of this section the individual administering the test shall be deemed to 32 be the individual ordering the test. 33 § 5. Subdivision 4 of section 6909 of the education law is amended by 34 adding a new paragraph (m) to read as follows: 35 (m) undertaking the collection of specimens necessary to test to 36 determine the presence of the hepatitis B virus. 37 § 6. Subdivision 6 of section 6527 of the education law is amended by 38 adding a new paragraph (m) to read as follows: 39 (m) undertaking the collection of specimens necessary to test to 40 determine the presence of the hepatitis B virus. 41 § 7. Section 6801 of the education law is amended by adding a new 42 subdivision 10 to read as follows: 43 10. a. A licensed pharmacist may execute a non-patient specific order 44 for the dispensing of HIV Pre-exposure Prophylaxis (PrEP) prescribed or 45 ordered by the commissioner of health, a physician licensed in this 46 state or a nurse practitioner certified in this state pursuant to rules 47 and regulations promulgated by the commissioner. 48 b. Prior to dispensing HIV PrEP to a patient, and at a minimum of 49 every twelve months for each returning patient, the pharmacist shall: 50 (i) ensure that the patient is HIV negative, as documented by a nega- 51 tive HIV test result obtained within the previous seven days from an HIV 52 antigen/antibody test or antibody-only test or from a rapid, point-of- 53 care fingerstick blood test approved by the federal food and drug admin- 54 istration. If the patient does not provide evidence of a negative HIV 55 test in accordance with this paragraph, the pharmacist may recommend or 56 prescribe an HIV test. If the patient tests positive for HIV infection,S. 8307 119 A. 8807 1 the pharmacist shall direct the patient to a licensed physician and 2 provide the patient with a list of health care service providers and 3 clinics within the county where the pharmacist is located or adjacent 4 counties; 5 (ii) provide the patient with a self-screening risk assessment ques- 6 tionnaire, developed by the commissioner of health in consultation with 7 the commissioner, to be reviewed by the pharmacist to identify any known 8 risk factors and assist the patient's selection of an appropriate PrEP 9 medication; and 10 (iii) provide the patient with a fact sheet, developed by the commis- 11 sioner of health, that includes but is not limited to, the clinical 12 considerations and recommendations for use of PrEP, the appropriate 13 method for using PrEP, information on the importance of follow-up health 14 care, health care referral information, and the ability of the patient 15 to opt out of practitioner reporting requirements. 16 c. No pharmacist shall dispense PrEP under this subdivision without 17 receiving training in accordance with regulations promulgated by the 18 commissioner of health in consultation with the commissioner. 19 d. A pharmacist shall notify the patient's primary health care practi- 20 tioner, unless the patient opts out of such notification, within seven- 21 ty-two hours of dispensing PrEP, that PrEP has been dispensed. If the 22 patient does not have a primary health care practitioner, or is unable 23 to provide contact information for their primary health care practition- 24 er, the pharmacist shall provide the patient with a written record of 25 the PrEP medications dispensed, and advise the patient to consult an 26 appropriate health care practitioner. 27 e. Nothing in this subdivision shall prevent a pharmacist from refus- 28 ing to dispense a non-patient specific order of PrEP pursuant to this 29 subdivision if, in their professional judgment, potential adverse 30 effects, interactions, or other therapeutic complications could endanger 31 the health of the patient. 32 § 8. Section 6801 of the education law is amended by adding a new 33 subdivision 11 to read as follows: 34 11. A licensed pharmacist within their lawful scope of practice may 35 administer to patients eighteen years of age or older, immunizing agents 36 to prevent mpox pursuant to a patient specific order or a non-patient 37 specific order. When a licensed pharmacist administers an mpox immuniz- 38 ing agent, they shall comply with subdivisions two, three and four of 39 this section. 40 § 9. Section 2307 of the public health law is REPEALED. 41 § 10. This act shall take effect immediately; provided, however, 42 sections one, two, and three of this act shall take effect on the one 43 hundred eightieth day after it shall have become a law. Effective imme- 44 diately, the addition, amendment and/or repeal of any rule or regulation 45 necessary for the implementation of this act on its effective date are 46 authorized to be made and completed on or before such effective date. 47 PART U 48 Section 1. Section 3302 of the public health law is amended by adding 49 two new subdivisions 42 and 43 to read as follows: 50 42. "Public health surveillance" means the continuous, systematic 51 collection, analysis, and interpretation of health-related data needed 52 for the planning, implementation, and evaluation of public health prac- 53 tice. Public health surveillance may be used for all of the following 54 purposes:S. 8307 120 A. 8807 1 (a) as an early warning system for impending public health emergen- 2 cies; 3 (b) to document the impact of an intervention; 4 (c) to track progress towards specified goals; 5 (d) to monitor and clarify the epidemiology of health outcomes; 6 (e) to establish public health priorities; and 7 (f) to inform public health policy and strategies. 8 43. "Patient identifying information" means information or direct 9 identifiers and demographic information that can be used to readily 10 identify a particular patient as may be specified in more detail in 11 regulations promulgated by the commissioner. 12 § 2. Subparagraphs (ix) and (x) of paragraph (a) of subdivision 2 of 13 section 3343-a of the public health law, as added by section 2 of part A 14 of chapter 447 of the laws of 2012, are amended and a new subparagraph 15 (xi) is added to read as follows: 16 (ix) a situation where the registry is not operational as determined 17 by the department or where it cannot be accessed by the practitioner due 18 to a temporary technological or electrical failure, as set forth in 19 regulation; [or] 20 (x) a practitioner who has been granted a waiver due to technological 21 limitations that are not reasonably within the control of the practi- 22 tioner, or other exceptional circumstance demonstrated by the practi- 23 tioner, pursuant to a process established in regulation, and in the 24 discretion of the commissioner[.]; or 25 (xi) a practitioner prescribing or ordering a controlled substance for 26 use on the premises of a correctional facility, an inpatient mental 27 health facility licensed under the mental hygiene law, or a nursing home 28 licensed under article twenty-eight of this chapter. 29 § 3. Subdivision 4 of section 3370 of the public health law, as added 30 by chapter 965 of the laws of 1974 and as renumbered by chapter 178 of 31 the laws of 2010, is amended to read as follows: 32 4. The department shall cause to be expunged or otherwise destroyed, 33 within [five] ten years from the date of receipt thereof, any record of 34 the name of any patient received by it pursuant to the filing require- 35 ments of subdivision six of section thirty-three hundred thirty-one, 36 subdivision four of section thirty-three hundred thirty-three, and 37 subdivision four of section thirty-three hundred thirty-four of this 38 article. 39 § 4. Subdivision 1 of section 3371 of the public health law, as 40 amended by chapter 178 of the laws of 2010, paragraphs (d) and (e) as 41 amended and paragraphs (f), (g), (h), (i), and (j) as added by section 4 42 of part A of chapter 447 of the laws of 2012, is amended to read as 43 follows: 44 1. No person, who has knowledge by virtue of his or her office of the 45 identity of a particular patient or research subject, a manufacturing 46 process, a trade secret or a formula or possesses patient identifying 47 information shall disclose such knowledge, or any report or record ther- 48 eof, except: 49 (a) to another person employed by the department, for purposes of 50 executing provisions of this article; 51 (b) pursuant to judicial subpoena or court order in a criminal inves- 52 tigation or proceeding; 53 (c) to an agency, department of government, or official board author- 54 ized to regulate, license or otherwise supervise a person who is author- 55 ized by this article to deal in controlled substances, or in the courseS. 8307 121 A. 8807 1 of any investigation or proceeding by or before such agency, department 2 or board; 3 (d) to the prescription monitoring program registry and to authorized 4 users of such registry as set forth in subdivision two of this section; 5 (e) a vendor or contractor, as authorized by the department as neces- 6 sary for the operation and maintenance of the prescription monitoring 7 program registry; 8 (f) to a practitioner to inform him or her that a patient may be under 9 treatment with a controlled substance by another practitioner for the 10 purposes of subdivision two of this section, and to facilitate the 11 department's review of individual challenges to the accuracy of 12 controlled substances histories pursuant to subdivision six of section 13 thirty-three hundred forty-three-a of this article; 14 [(f)] (g) to a pharmacist to provide information regarding 15 prescriptions for controlled substances presented to the pharmacist for 16 the purposes of subdivision two of this section and to facilitate the 17 department's review of individual challenges to the accuracy of 18 controlled substances histories pursuant to subdivision six of section 19 thirty-three hundred forty-three-a of this article; 20 [(g)] (h) to the deputy attorney general for medicaid fraud control, 21 or his or her designee, in furtherance of an investigation of fraud, 22 waste or abuse of the Medicaid program, pursuant to an agreement with 23 the department; 24 [(h)] (i) to a program area within the department for the purpose of 25 conducting public health research, public health surveillance, or educa- 26 tion with data contained in the prescription monitoring program and not 27 for patient-level outreach: 28 (i) pursuant to an agreement with the commissioner; 29 (ii) when the release of such information is deemed appropriate by the 30 commissioner; 31 (iii) for use in accordance with measures required by the commissioner 32 to ensure that the security and confidentiality of the data is 33 protected; 34 (iv) for use and retention no longer than ten years; and 35 (v) provided that disclosure is restricted to individuals within the 36 department who are engaged in public health research, public health 37 surveillance, or education; 38 (j) to a local health department for the purpose of conducting public 39 health research, public health surveillance or education and not for 40 patient-level outreach: (i) pursuant to an agreement with the commis- 41 sioner; (ii) when the release of such information is deemed appropriate 42 by the commissioner; (iii) for use in accordance with measures required 43 by the commissioner to ensure that the security and confidentiality of 44 the data is protected; (iv) for use and retention no longer than ten 45 years; and [(iv)] (v) provided that disclosure is restricted to individ- 46 uals within the local health department who are engaged in the research 47 or education; 48 [(i)] (k) to a medical examiner or coroner who is an officer of or 49 employed by a state or local government, pursuant to his or her official 50 duties; and 51 [(j)] (l) to an individual for the purpose of providing such individ- 52 ual with his or her own controlled substance history or, in appropriate 53 circumstances, in the case of a patient who lacks capacity to make 54 health care decisions, a person who has legal authority to make such 55 decisions for the patient and who would have legal access to the 56 patient's health care records, if requested from the department pursuantS. 8307 122 A. 8807 1 to subdivision six of section thirty-three hundred forty-three-a of this 2 article or from a treating practitioner pursuant to subparagraph (iv) of 3 paragraph (a) of subdivision two of this section. 4 § 5. Subdivision (b) of schedule I of section 3306 of the public 5 health law is amended by adding eleven new paragraphs 93, 94, 95, 96, 6 97, 98, 99, 100, 101, 102 and 103 to read as follows: 7 (93) Zipeprol (1-methoxy-3-[4-(2-methoxy-2-phenylethyl)piperazin-1-yl] 8 -1-phenylpropan-2-ol). 9 (94) N,N-diethyl-2-(2-(4-methoxybenzyl)-5-nitro-1H-benzimidazol-1-yl)e 10 than-1-amine. Some trade or other names: Metonitazene. 11 (95) meta-fluorofentanyl(N-(3-fluorophenyl)-N-(1-phenethylpiperidin-4- 12 yl)propionamide). 13 (96) meta-fluoroisobutyryl fentanyl(N-(3-fluorophenyl)-N-(1-phenethylp 14 iperidin-4-yl)isobutyramide). 15 (97) para-methoxyfuranyl fentanyl (N-(4-methoxyphenyl)-N-(1-phenethylp 16 iperidin-4-yl)furan-2-carboxamide). 17 (98) 3-furanyl fentanyl(N-(1-phenethylpiperidin-4-yl)-N-phenylfuran-3- 18 carboxamide). 19 (99) 2',5'-dimethoxyfentanyl(N-(1-(2,5-dimethoxyphenethyl)piperidin-4- 20 yl)-N-phenylpropionamide). 21 (100) Isovaleryl fentanyl(3-methyl-N-(1-phenethylpiperidin-4-yl)-N-phe 22 nylbutanamide). 23 (101) ortho-fluorofuranyl fentanyl(N-(2-fluorophenyl)-N-(1-phenethylpi 24 peridin-4-yl)furan-2-carboxamide). 25 (102) alpha'-methyl butyryl fentanyl(2-methyl-N-(1-phenethylpiperidin- 26 4-yl)-N-phenylbutanamide). 27 (103) para-methylcyclopropyl fentanyl (N-(4-methylphenyl)-N-(1-pheneth 28 ylpiperidin-4-yl)cyclopropanecarboxamide). 29 § 6. Paragraphs 11 and 36 of subdivision (d) of schedule I of section 30 3306 of the public health law, paragraph 11 as added by chapter 664 of 31 the laws of 1985 and paragraph 36 as added by section 5 of part BB of 32 chapter 57 of the laws of 2018, are amended to read as follows: 33 (11) [Ibogane] Ibogaine. Some trade and other names: 7-ethyl-6, 6&, 7, 34 8, 9, 10, 12, 13-octahydro-2-methoxy-6, 9-methano-5h-pyrido {1',2':1,2} 35 azepino {5,4-b} indole: tabernanthe iboga. 36 (36) 5-methoxy-N,N-dimethyltryptamine. Some trade or other names: 37 5-methoxy-3-[2-(dimethylamino)ethyl]indole; 5-MeO-DMT. 38 § 7. Subdivision (d) of schedule I of section 3306 of the public 39 health law is amended by adding nineteen new paragraphs 32, 39, 40, 41, 40 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55 and 56 to read as 41 follows: 42 (32) 4-methyl-N-ethylcathinone. Some trade or other names: 4-MEC. 43 (39) 4-methyl-alpha-pyrrolidinopropiophenone. Some trade or other 44 names: 4-MePPP. 45 (40) Alpha-pyrrolidinopentiophenone. Some trade or other names: @-PVP. 46 (41) 1-(1,3-benzodioxol-5-yl)-2-(methylamino)butan-1-one. Some trade 47 or other names: Butylone; bk-MBDB. 48 (42) 2-(methylamino)-1-phenylpentan-1-one. Some trade or other names: 49 Pentedrone. 50 (43) 1-(1,3-benzodioxol-5-yl)-2-(methylamino)pentan-1-one. Some trade 51 or other names: Pentylone; bk-MBDP. 52 (44) 1-(naphthalen-2-yl)-2-(pyrrolidin-1-yl)pentan-1-one. Some trade 53 or other names: Naphyrone. 54 (45) Alpha-pyrrolidinobutiophenone. Some trade or other names: @-PBP. 55 (46) 1-(1,3-benzodioxol-5-yl)-2-(ethylamino)propan-1-one (ethylone).S. 8307 123 A. 8807 1 (47) N-ethylpentylone. Some trade or other names: ephylone, 2 1-(1,3-benzodioxol-5-yl)-2-(ethylamino)pentan-1-one). 3 (48) 1-(4-methoxyphenyl)-N-methylpropan-2-amine. Some trade or other 4 names: para-methoxymethamphetamine; PMMA. 5 (49) N-Ethylhexedrone. Some trade or other names: 6 @-ethylaminohexanophenone; 2-(ethylamino)-1-phenylhexan-1-one. 7 (50) alpha-Pyrrolidinohexanophenone. Some trade or other names: @-PHP; 8 alpha-pyrrolidinohexanophenone; 1-phenyl-2-(pyrrolidin-1-yl)hexan-1-one. 9 (51) 4-Methyl-alpha-ethylaminopentiophenone. Some trade or other 10 names: 4-MEAP; 2-(ethylamino)-1-(4-methylphenyl)pentan-1-one. 11 (52) 4'-Methyl-alpha-pyrrolidinohexiophenone. Some trade or other 12 names: MPHP; 4'-methyl-alpha-pyrrolidinohexanophenone; 13 1-(4-methylphenyl)-2-(pyrrolidin-1-yl)hexan-1-one. 14 (53) alpha-Pyrrolidinoheptaphenone. Some trade or other names: PV8; 15 1-phenyl-2-(pyrrolidin-1-yl)heptan-1-one. 16 (54) 4-Chloro-alpha-pyrrolidinovalerophenone. Some trade or other 17 names: 4-chloro-@-PVP; 4'-chloro-alpha-pyrrolidinopentiophenone; 18 1-(4-chlorophenyl)-2-(pyrrolidin-1-yl)pentan-1-one. 19 (55) 2-(ethylamino)-2-(3-methoxyphenyl)cyclohexan-1-one (methoxeta- 20 mine, MXE). 21 (56) 1-(1,3-benzodioxol-5-yl)-2-(ethylamino)butan-1-one. Some trade or 22 other names: eutylone; bk-EBDB. 23 § 8. Subdivision (e) of schedule I of section 3306 of the public 24 health law is amended by adding five new paragraphs 7, 8, 9, 10 and 11 25 to read as follows: 26 (7) 4-(2-chlorophenyl)-2-ethyl-9-methyl-6H-thieno{3,2-f}{1,2,4}triazol 27 o{4,3-a}{1,4}diazepine. Some trade or other names: etizolam. 28 (8) 8-chloro-6-(2-fluorophenyl)-1-methyl-4H-benzo{f}{1,2,4}triazolo{4, 29 3-a}{1,4}diazepine. Some trade or other names: flualprazolam. 30 (9) 6-(2-chlorophenyl)-1-methyl-8-nitro-4H-benzo{f}{1,2,4}triazolo{4,3 31 -a}{1,4}diazepine. Some trade or other names: clonazolam. 32 (10) 8-bromo-6-(2-fluorophenyl)-1-methyl-4H-benzo{f}{1,2,4}triazolo{4, 33 3-a}{1,4}diazepine (alternate chemical name: 8-bromo-6-(2-fluorophenyl)- 34 1-methyl-4H-{1,2,4}triazolo{4,3-a}{1,4}benzodiazepine). Some trade or 35 other names: flubromazolam. 36 (11) 7-chloro-5-(2-chlorophenyl)-1-methyl-1,3-dihydro-2H-benzo{e}{1,4} 37 diazepin-2-one. Some trade or other names: diclazepam. 38 § 9. Paragraphs 13 and 14 of subdivision (f) of schedule I of section 39 3306 of the public health law, as added by chapter 341 of the laws of 40 2013, are amended and four new paragraphs 25, 26, 27 and 28 are added to 41 read as follows: 42 (13) 3-Fluoromethcathinone. Some trade or other names: 3-fluoro-N 43 -methylcathinone; 3-FMC. 44 (14) 4-Fluoromethcathinone. Some trade or other names: 4-fluoro-N-me- 45 thylcathinone; 4-FMC; flephedrone. 46 (25) 7-[(10,11-dihydro-5H-dibenzo]a,d[cyclohepten-5-yl)amino]heptanoic 47 acid. Other name: amineptine. 48 (26) N-phenyl-N'-(3-(1-phenylpropan-2-yl)-1,2,3-oxadiazol-3-ium-5-yl) 49 carbamimidate. Other name: mesocarb. 50 (27) N-methyl-1-(thiophen-2-yl)propan-2-amine. Other name: methiopro- 51 pamine. 52 (28) 4,4'-Dimethylaminorex. Some trade or other names: 4,4'-DMAR; 53 4,5-dihydro-4-methyl-5-(4-methylphenyl)-2-oxazolamine; 4-methyl-5-(4 met 54 hylphenyl)-4,5-dihydro-1,3-oxazol-2-amine.S. 8307 124 A. 8807 1 § 10. Paragraphs 2, 6 and 10 of subdivision (g) of schedule I of 2 section 3306 of the public health law, as added by section 7 of part BB 3 of chapter 57 of the laws of 2018, are amended to read as follows: 4 (2) {1-(5-fluro-pentyl)-1H-indol-3-yl}(2,2,3,3-tetramethylcyclopropyl) 5 methanone. Some trade names or other names: 5-fluoro-UR-144[,]; XLR11. 6 (6) N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(4-fluorobenzyl)-1H-indazo 7 [-] le-3-carboxamide. Some trade or other names: AB-FUBINACA. 8 (10) {1-(5-fluoropentyl)-1H-indazol-3-yl}(naphthalen-1-[y1] yl)metha- 9 none. Some trade or other names: THJ-2201. 10 § 11. Subdivision (g) of schedule I of section 3306 of the public 11 health law is amended by adding nineteen new paragraphs 11, 12, 13, 14, 12 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28 and 29 to read as 13 follows: 14 (11) N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-(cyclohexylmethyl)-1H- 15 indazole-3-carboxamide. Some trade or other names: MAB-CHMINACA; 16 ADB-CHMINACA. 17 (12) methyl 2-(1-(4-fluorobenzyl)-1H-indazole-3-carboxamido)-3-methylb 18 utanoate. Some trade or other names: FUB-AMB; MMB-FUBINACA; AMB-FUBINA- 19 CA. 20 (13) methyl 2-(1-(cyclohexylmethyl)-1H-indole-3-carboxamido)-3,3- 21 dimethylbutanoate. Some trade or other names: MDMB-CHMICA; MMB-CHMINACA. 22 (14) methyl 2-(1-(4-fluorobenzyl)-1H-indazole-3-carboxamido)-3,3- 23 dimethylbutanoate. Some trade or other names: MDMB-FUBINACA. 24 (15) N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-(4-fluorobenzyl)-1H-in 25 dazole-3-carboxamide. Some trade or other names: ADB-FUBINACA. 26 (16) N-(adamantan-1-yl)-1-(5-fluoropentyl)-1H-indazole-3-carboxamide. 27 Some trade or other names: 5F-APINACA; 5F-AKB48. 28 (17) methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3-meth 29 ylbutanoate. Some trade or other names: 5F-AMB. 30 (18) methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3,3- 31 dimethylbutanoate. Some trade or other names: 5F-ADB; 5F-MDMB-PINACA. 32 (19) Naphthalen-1-yl 1-(5-fluoropentyl)-1H-indole-3-carboxylate. Some 33 trade or other names: NM2201; CBL2201. 34 (20)N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(5-fluoropentyl)-1H-indazol 35 e-3-carboxamide. Some trade or other names: 5F-AB-PINACA. 36 (21) 1-(4-cyanobutyl)-N-(2-phenylpropan-2-yl)-1H-indazole-3-carboxamid 37 e. Some trade or other names: 4-CN-CUMYL-BUTINACA; 4-cyano-CUMYL- BUTI- 38 NACA;4-CN-CUMYL BINACA; CUMYL-4CN-BINACA; SGT-78. 39 (22) methyl 2-(1-(cyclohexylmethyl)-1H-indole-3-carboxamido)-3-methyl 40 butanoate. Some trade or other names: MMB-CHMICA; AMB-CHMICA. 41 (23) 1-(5-fluoropentyl)-N-(2-phenylpropan-2-yl)-1H-pyrrolo{2,3-b}pyrid 42 ine-3-carboxamide. Some trade or other names: 5F-CUMYL-P7AICA. 43 (24) methyl 2-(1-(4-fluorobutyl)-1H-indazole-3-carboxamido)-3,3-dimet 44 hylbutanoate. Some trade or other names: 4F-MDMB-BINACA; 4F-MDMB-BUTINA- 45 CA. 46 (25) ethyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3,3-dimet 47 hylbutanoate. Some trade or other names: 5F-EDMB-PINACA. 48 (26) methyl 2-(1-(5-fluoropentyl)-1H-indole-3-carboxamido)-3,3-dimeth 49 ylbutanoate. Some trade or other names: 5F-MDMB-PICA; 5F-MDMB-2201. 50 (27) N-(adamantan-1-yl)-1-(4-fluorobenzyl)-1H-indazole-3-carboxamide. 51 Some trade or other names: FUB-AKB48; FUB-APINACA; AKB48 52 N-(4-FLUOROBENZYL). 53 (28) 1-(5-fluoropentyl)-N-(2-phenylpropan-2-yl)-1H-indazole-3-carbox 54 amide. Some trade or other names: 5F-CUMYL-PINACA; SGT-25. 55 (29) (1-4-fluorobenzyl)-1H-indol-3-yl)(2,2,3,3-tetramethylcyclopropyl) 56 methanone. Some trade or other names: FUB-144.S. 8307 125 A. 8807 1 § 12. Paragraph 1 of subdivision (b) of schedule II of section 3306 of 2 the public health law, as amended by section 1 of part C of chapter 447 3 of the laws of 2012, is amended to read as follows: 4 (1) Opium and opiate, and any salt, compound, derivative, or prepara- 5 tion of opium or opiate, excluding apomorphine, dextrorphan, nalbuphine, 6 naldemedine, nalmefene, naloxefol, naloxone, [and] 6&-naltrexol, 7 naltrexone, and samidorphan, and their respective salts, but including 8 the following: 9 1. Raw opium. 10 2. Opium extracts. 11 3. Opium fluid. 12 4. Powdered opium. 13 5. Granulated opium. 14 6. Tincture of opium. 15 7. Codeine. 16 8. Ethylmorphine. 17 9. Etorphine hydrochloride. 18 10. Hydrocodone (also known as dihydrocodeinone). 19 11. Hydromorphone. 20 12. Metopon. 21 13. Morphine. 22 14. Oxycodone. 23 15. Oxymorphone. 24 16. Thebaine. 25 17. Dihydroetorphine. 26 18. Oripavine. 27 19. Noroxymorphone. 28 § 13. Subdivision (c) of schedule II of section 3306 of the public 29 health law is amended by adding a new paragraph 30 to read as follows: 30 30. Oliceridine. (N-{(3-methoxythiophen-2-yl)methyl}({2-{(9R)-9- 31 (pyridin-2-yl)-6-oxaspiro{4.5}decan-9-yl}ethyl})amine). 32 § 14. Subdivision (f) of schedule II of section 3306 of the public 33 health law, as amended by chapter 589 of the laws of 1996, the undesig- 34 nated paragraph as amended by chapter 575 of the laws of 2001, is 35 amended to read as follows: 36 (f) Hallucinogenic substances. 37 (1) Nabilone: Another name for nabilone: (+,-)-trans 38 -3-(1,1-dimethylheptyl)-6, 6a, 7, 8, 10, 10a-hexahydro-1-hydroxy-6, 39 6-dimethyl-9H-dibenzo{b,d}pyran-9-one. 40 (2) Dronabinol {(-)-delta-9-trans tetrahydrocannabinol} in an oral 41 solution in a drug product approved for marketing by the United States 42 Food and Drug Administration. 43 § 15. Subparagraph (i) of paragraph 3 of subdivision (g) of schedule 44 II of section 3306 of the public health law, as amended by section 2 of 45 part BB of chapter 57 of the laws of 2023, is amended to read as 46 follows: 47 (i) [4-anilino-N-phenenethylpiperidine] 4-anilino-N-phenethylpiperi- 48 dine (ANPP). 49 § 16. Subdivision (h) of schedule II of section 3306 of the public 50 health law, as amended by section 8 of part C of chapter 447 of the laws 51 of 2012, is amended to read as follows: 52 (h) (1) Anabolic steroids. Unless specifically excepted or unless 53 listed in another schedule, "anabolic steroid" shall mean any drug or 54 hormonal substance, chemically and pharmacologically related to testos- 55 terone (other than estrogens, progestins, corticosteroids and dehydroe- 56 piandrosterone) and includes:S. 8307 126 A. 8807 1 [(1)] (i) 3{beta}, 17-dihydroxy-5a-androstane. 2 [(2)] (ii) 3{alpha}, 17{beta}-dihydroxy-5a-androstane. 3 [(3)] (iii) 5{alpha}-androstan-3,17-dione. 4 [(4)] (iv) 1-androstenediol (3{beta},17{beta}-dihydroxy-5 5 {alpha}-androst-1- ene). 6 [(5)] (v) 1-androstenediol (3{alpha},17{beta}-dihydroxy-5 7 {alpha}-androst-1- ene). 8 [(6)] (vi) 4-androstenediol (3{beta}, 17{beta}-dihydroxy- 9 androst-4-ene). 10 [(7)] (vii) 5-androstenediol (3{beta}, 17{beta}-dihydroxy- androst-5- 11 ene). 12 [(8)] (viii) 1-androstenedione ({5{alpha}}-androst-1-en-3, 17-dione). 13 [(9)] (ix) 4-androstenedione (androst-4-en-3,17-dione). 14 [(10)] (x) 5-androstenedione (androst-5-en-3,17-dione). 15 [(11)] (xi) Bolasterone (7{alpha},17{alpha}-dimethyl-17{beta} -hydrox- 16 yandrost-4-en-3-one). 17 [(12)] (xii) Boldenone (17{beta}-hydroxyandrost-1, 4,-diene -3-one). 18 [(13)] (xiii) Boldione (androsta-1,4-diene-3,17-dione). 19 [(14)] (xiv) Calusterone (7{beta}, 17{alpha}-dimethyl-17{beta}-hydrox- 20 yandrost- 4-en-3-one). 21 [(15)] (xv) Clostebol (4-chloro-17{beta}-hydroxyandrost-4-e n-3-one). 22 [(16)] (xvi) Dehydrochloromethyltestosterone (4-chloro-17 23 {beta}-hydroxy-17{alpha}-methyl-androst-1, 4-dien-3-one). 24 [(17)] (xvii) {Delta} 1-dihydrotestosterone (a.k.a. '1- 25 testosterone')(17{beta}-hydroxy-5{alpha}-androst-1-en-3-one). 26 [(18)] (xviii) 4-dihydrotestosterone (17{beta}-hydroxy- 27 androstan-3-one). 28 [(19)] (xix) Drostanolone (17{beta}-hydroxy-2{alpha}-methyl 29 -5{alpha} -androstan-3-one). 30 [(20)] (xx) Ethylestrenol (17{alpha}-ethyl-17{beta}-hydroxy 31 estr-4-ene). 32 [(21)] (xxi) Fluoxymesterone (9-fluoro-17{alpha}-methyl-11{beta}, 33 17 {beta}-dihydroxyandrost-4-en-3-one). 34 [(22)] (xxii) Formebolone (2-formyl-17{alpha}-methyl-11{alpha}, 35 17{beta}-dihydroxyandrost-1, 4-dien-3-one). 36 [(23)] (xxiii) Furazabol (17{alpha}-methyl-17{beta}-hydroxyandros 37 tano {2, 3-c}-furazan). 38 [(24)] (xxiv) 13{beta}-ethyl-17{beta}-hyroxygon-4-en-3-one. 39 [(25)] (xxv) 4-hydroxytestosterone (4, 17{beta}-dihydroxy-androst- 40 4-en-3-one). 41 [(26)] (xxvi) 4-hydroxy-19-nortestosterone (4,17{beta}-dihydroxy- 42 estr-4-en-3-one). 43 [(27)] (xxvii) desoxymethyltestosterone (17{alpha}-methyl-5 44 {alpha}-androst-2-en-17{beta}-ol) (a.k.a., madol). 45 [(28)] (xxviii) Mestanolone (17{alpha}-methyl-17{beta}- hydroxy- 5-an- 46 drostan-3-one). 47 [(29)] (xxix) Mesterolone (1{alpha}methyl-17{beta}-hydroxy- 48 {5{alpha}}-androstan-3-one). 49 [(30)] (xxx) Methandienone (17{alpha}-methyl-17{beta}-hydroxyandr 50 ost-1, 4-dien-3-one). 51 [(31)] (xxxi) Methandriol (17{alpha}-methyl-3{beta}, 17 52 {beta}-dihydroxyandrost-5-ene). 53 [(32)] (xxxii) Methenolone (1-methyl- 17{beta}-hydroxy-5 {alpha}- 54 androst- 1-en-3-one). 55 [(33)] (xxxiii) 17{alpha}-methyl-3{beta},17{beta}-dihydroxy - 5a-an- 56 drostane.S. 8307 127 A. 8807 1 [(34)] (xxxiv) 17{alpha}-methyl-3{alpha}, 17{beta}- dihydroxy- 5a-an- 2 drostane 3 [(35)] (xxxv) 17{alpha}-methyl-3{beta}, 17{beta}-dihydroxyandrost 4 -4-ene. 5 [(36)] (xxxvi) 17{alpha}-methyl-4-hydroxynandrolone (17{alpha}- 6 methyl-4-hydroxy-17{beta}-hydroxyestr-4-en-3-one). 7 [(37)] (xxxvii) Methyldienolone (17{alpha}-methyl-17{beta}- hydroxyes- 8 tra- 4,9(10)-dien-3-one). 9 [(38)] (xxxviii) Methyltrienolone (17{alpha}-methyl-17{beta}-hyd 10 roxyestra-4, 9-11-trien-3-one). 11 [(39)] (xxxix) Methyltestosterone(17{alpha}-methyl-17{beta}-hyd 12 roxyandrost-4-en-3-one). 13 [(40)] (xl) Mibolerone (7{alpha},17{alpha}-dimethyl-17 14 {beta}-hydroxyestr-4-en-3-one). 15 [(41)] (xli) 17{alpha}-methyl-{Delta} 1-dihydrotestosterone 16 (17b{beta}-hydroxy-17{alpha}-methyl-5{alpha}-androst-1-en-3-one) 17 (a.k.a. '17-{alpha}-methyl-1-testosterone'). 18 [(42)] (xlii) Nandrolone(17{beta}-hydroxyestr-4-en-3-one). 19 [(43)] (xliii) 19-nor-4-androstenediol (3{beta},17{beta}-dihydro 20 xyestr- 4-ene). 21 [(44)] (xliv) 19-nor-4-androstenediol (3{alpha},17{beta}-dihydrox- 22 yestr-4-ene). 23 [(45)] (xlv) 19-nor-5-androstenediol (3{beta},17{beta}-dihydroxyestr -5-ene). 24 [(46)] (xlvi) 19-nor-5-androstenediol (3{alpha},17{beta}-dihydrox- 25 yestr-5-ene). 26 [(47)] (xlvii) 19-nor-4,9(10)-androstadienedione (estra-4,9(10)- 27 diene-3,17-dione). 28 [(48)] (xlviii) 19-nor-4-androstenedione (estr-4-en-3,17-dione). 29 [(49)] (xlix) 19-nor-5-androstenedione (estr-5-en-3,17-dione). 30 [(50)] (l) Norbolethone (13{beta}, 17{alpha}-diethyl-17 31 {beta} -hydroxygon-4-en-3-one). 32 [(51)] (li) Norclostebol (4-chloro-17{beta}-hydroxyestr-4- en-3-one). 33 [(52)] (lii) Norethandrolone (17{alpha}-ethyl-17{beta}-hydroxyes 34 tr-4-en-3-one). 35 [(53)] (liii) Normethandrolone (17 {alpha}-methyl-17{beta}-hydroxy 36 estr-4-en-3-one). 37 [(54)] (liv) Oxandrolone (17{alpha}-methyl-17{beta}-hydroxy-2- 38 oxa- {5{alpha}}-androstan-3-one). 39 [(55)] (lv) Oxymesterone (17{alpha}-methyl-4, 17 {beta}-dihydroxy 40 androst-4-en-3-one). 41 [(56)] (lvi) Oxymetholone (17 {alpha}-methyl-2-hydroxymethylene- 42 17 {beta}-hydroxy-{5{alpha}}- androstan-3-one). 43 [(57)] (lvii) Stanozolol (17{alpha}-methyl-17{beta}-hydroxy-{5 44 {alpha}}- androst-2-eno{3, 2-c}-pyrazole). 45 [(58)] (lviii) Stenbolone (17{beta}-hydroxy-2-methyl-{5{alpha}}- 46 androst- 1-en-3-one). 47 [(59)] (lix) Testolactone (13-hydroxy-3-oxo-13, 17-secoandrosta- 48 1, 4-dien-17-oic acid lactone). 49 [(60)] (lx) Testosterone (17{beta}-hydroxyandrost-4-en-3-one). 50 [(61)] (lxi) Tetrahydrogestrinone (13{beta}, 17{alpha} 51 -diethyl-17{beta}-hydroxygon-4, 9, 11 -trien-3-one). 52 [(62)] (lxii) Trenbolone (17{beta}-hydroxyestr-4, 9, 11-trien- 3-one). 53 [(63)] (lxiii)5{alpha}-androstan-3,6,17-trione. 54 (lxiv) 6-bromo-androsta-1,4-diene-3,17-dione. 55 (lxv) 6-bromo-androstan-3,17-dione. 56 (lxvi) 4-chloro-17{alpha}-methyl-androsta-1,4-diene-3,17{beta}-diol.S. 8307 128 A. 8807 1 (lxvii) 4-chloro-17{alpha}-methyl-androst-4-ene-3{beta},17{beta}-diol. 2 (lxviii) 4-chloro-17{alpha}-methyl-17{beta}hydroxy-androst-4-en-3-one. 3 (lxix) 4-chloro-17{alpha}-methyl-17{beta}hydroxy-androst-4-ene-3,11-di 4 one. 5 (lxx) 2{alpha}, 17{alpha}-dimethyl-17{beta}-hydroxy-5{beta}-androstan-3 6 -one. 7 (lxxi) 2{alpha},3{alpha}-epithio-17{alpha}-methyl-5{alpha}androstan-17 8 {beta}-ol. 9 (lxxii) estra-4,9,11-triene-3,17-dione. 10 (lxxiii) [3,2-c]furazan-5{alpha}-androstan-17{beta}ol. 11 (lxxiv) 18a-homo-3-hydroxy-estra-2,5(10)-dien-17-one. 12 (lxxv) 4-hydroxy-androst-4-ene-3,17-dione. 13 (lxxvi) 17{beta}-hydroxy-androstano[2,3-d]isoxazole. 14 ((lxxvii) 17{beta}-hydroxy-androstano[3,2-c]isoxazole. 15 (lxxviii) 3{beta}-hydroxy-estra-4,9,11-trien-17-one. 16 (lxxix) Methasterone (2{alpha},17{alpha}-dimethyl-5{alpha}-androstan- 17 7{beta}-ol-3-one)or 2{alpha}17{alpha}-dimethyl-17{beta}-hydroxy-5 18 {alpha}-androstan-3-one). 19 (lxxx) 17{alpha}-methyl-androsta-1,4-diene-3,17{beta}-diol. 20 (lxxxi) 17{alpha}-methyl-5{alpha}-androstan-17{beta}-ol. 21 (lxxxii) 17{alpha}-methyl-androstan-3-hydroxyimine-17{beta}-ol. 22 (lxxxiii) 6{alpha}-methyl-androst-4-ene-3,17-dione. 23 (lxxxiv) 17{alpha}-methyl-androst-2-ene-3,17{beta}diol. 24 (lxxxv) Prostanozol(17{beta}-hydroxy-5{alpha}-androstano[3,2-c]pyrazole) 25 or[3,2-c]pyrazole-5{alpha}-androstan-17{beta}-ol. 26 (lxxxvi) [3,2-c]pyrazole-androst-4-en-17{beta}-ol. 27 (lxxxvii) Any salt, ester or ether of a drug or substance described or 28 listed in this subdivision. 29 (2) (i) Subject to subparagraph (ii) of this paragraph, a drug or 30 hormonal substance, other than estrogens, progestins, corticosteroids, 31 and dehydroepiandrosterone, that is not listed in paragraph one of this 32 subdivision and is derived from, or has a chemical structure substan- 33 tially similar to, one or more anabolic steroids listed in paragraph one 34 of this subdivision shall be considered to be an anabolic steroid for 35 purposes of this schedule if: 36 (A) the drug or substance has been created or manufactured with the 37 intent of producing a drug or other substance that either: 38 1. promotes muscle growth; or 39 2. otherwise causes a pharmacological effect similar to that of 40 testosterone; or 41 (B) the drug or substance has been, or is intended to be, marketed or 42 otherwise promoted in any manner suggesting that consuming it will 43 promote muscle growth or any other pharmacological effect similar to 44 that of testosterone. 45 (ii) A substance shall not be considered to be a drug or hormonal 46 substance for purposes of this subdivision if: 47 (A) it is: 48 1. an herb or other botanical; 49 2. a concentrate, metabolite, or extract of, or a constituent isolated 50 directly from, an herb or other botanical; or 51 3. a combination of two or more substances described in clause one or 52 two of this item; 53 (B) it is a dietary ingredient for purposes of the Federal Food, Drug, 54 and Cosmetic Act (21 U.S.C. 301 et seq.); and 55 (C) it is not anabolic or androgenic.S. 8307 129 A. 8807 1 (iii) In accordance with subdivision one of section thirty-three 2 hundred ninety-six of this article, any person claiming the benefit of 3 an exemption or exception under subparagraph (ii) of this paragraph 4 shall bear the burden of going forward with the evidence with respect to 5 such exemption or exception. 6 § 17. Subdivision (c) of schedule III of section 3306 of the public 7 health law is amended by adding two new paragraphs 15 and 16 to read as 8 follows: 9 (15) Perampanel. 10 (16) Xylazine, its salts, isomers and salts of isomers. 11 § 18. Subdivision (c) of schedule IV of section 3306 of the public 12 health law is amended by adding seven new paragraphs 54, 55, 56, 57, 58, 13 59 and 60 to read as follows: 14 (54) Alfaxalone. 15 (55) Brexanolone. 16 (56) Daridorexant. 17 (57) Lemborexant. 18 (58) Remimazolam. 19 (59) Suvorexant. 20 (60) Zuranolone. 21 § 19. Subdivision (e) of schedule IV of section 3306 of the public 22 health law is amended by adding two new paragraphs 13 and 14 to read as 23 follows: 24 (13) Serdexmethylphenidate. 25 (14) Solriamfetol. 26 § 20. Subdivision (f) of schedule IV of section 3306 of the public 27 health law, as added by chapter 664 of the laws of 1985, paragraph 2 as 28 added by chapter 457 of the laws of 2006 and paragraph 3 as added by 29 section 14 of part C of chapter 447 of the laws of 2012, is amended to 30 read as follows: 31 (f) Other substances. Unless specifically excepted or unless listed in 32 another schedule, any material, compound, mixture or preparation which 33 contains any quantity of the following substances, including its salts, 34 isomers, and salts of such isomers, whenever the existence of such 35 salts, isomers, and salts of isomers is possible: 36 (1) Pentazocine. 37 (2) Butorphanol (including its optical isomers). 38 (3) Tramadol in any quantities. 39 (4) Eluxadoline. (5-{{{(2S)-2-amino-3-{4-aminocarbonyl)-2,6-dimethyl 40 phenyl}-1-oxopropyl}{(1S)-1-(4-phenyl-1H-imidazol-2-yl)ethyl}amino}meth 41 yl}-2-methoxybenzoic acid). 42 (5) Lorcaserin. 43 § 21. Subdivision (d) of schedule V of section 3306 of the public 44 health law is amended by adding four new paragraphs 4, 5, 6 and 7 to 45 read as follows: 46 (4) Brivaracetam ((2S)-2-{(4R)-2-oxo-4-propylpyrrolidin-1-yl} butanam- 47 ide). Some trade or other names: BRV; UCB-34714; Briviact) (including 48 its salts). 49 (5) Cenobamate ({1R)-1-(2-chlorophenyl)-2-(tetrazol-2-yl)ethyl} 50 carbamate; 2H-tetrazole-2-ethanol, alpha-(2-chlorophenyl)-, carbamate 51 (ester), (alphaR)-; carbamic acid 52 (R)-(+)-1-(2-chlorophenyl)-2-(2H-tetrazol-2-yl)ethyl ester). 53 (6) Ganaxolone. 3@-hydroxy-3&-methyl-5@-pregnan-20-one. 54 (7) Lasmiditan 55 {2,4,6-trifluoro-N-(6-(1-methylpiperidine-4-carbonyl)pyridine-2-yl-benzam 56 ide}.S. 8307 130 A. 8807 1 § 22. Subdivision 2 of section 3342 of the public health law, as 2 amended by chapter 692 of the laws of 1976, is amended to read as 3 follows: 4 2. An institutional dispenser may dispense controlled substances for 5 use off its premises only pursuant to a prescription, prepared and filed 6 in conformity with this title, provided, however, that, in an emergency 7 situation as defined by rule or regulation of the department, a practi- 8 tioner in a hospital without a full-time pharmacy may dispense 9 controlled substances to a patient in a hospital emergency room for use 10 off the premises of the institutional dispenser for a period not to 11 exceed twenty-four hours, unless the federal drug enforcement adminis- 12 tration has authorized a longer time period for the purpose of initiat- 13 ing maintenance treatment, detoxification treatment, or both. 14 § 23. Subdivision 1 of section 3302 of the public health law, as 15 amended by chapter 92 of the laws of 2021, is amended to read as 16 follows: 17 1. "[Addict] Person with a substance use disorder" means a person who 18 habitually uses a controlled substance for a non-legitimate or unlawful 19 use, and who by reason of such use is dependent thereon. 20 § 24. Subdivision 1 of section 3331 of the public health law, as added 21 by chapter 878 of the laws of 1972, is amended to read as follows: 22 1. Except as provided in titles III or V of this article, no substance 23 in schedules II, III, IV, or V may be prescribed for or dispensed or 24 administered to [an addict] a person with a substance use disorder or 25 habitual user. 26 § 25. The title heading of title 5 of article 33 of the public health 27 law, as added by chapter 878 of the laws of 1972, is amended to read as 28 follows: 29 DISPENSING TO [ADDICTS] PERSONS WITH A SUBSTANCE USE 30 DISORDER AND HABITUAL USERS 31 § 26. Section 3350 of the public health law, as added by chapter 878 of 32 the laws of 1972, is amended to read as follows: 33 § 3350. Dispensing prohibition. Controlled substances may not be 34 prescribed for, or administered or dispensed to [addicts] persons with a 35 substance use disorder or habitual users of controlled substances, 36 except as provided by this title or title III. 37 § 27. Section 3351 of the public health law, as added by chapter 878 38 of the laws of 1972, subdivision 5 as amended by chapter 558 of the laws 39 of 1999, is amended to read as follows: 40 § 3351. Dispensing for medical use. 1. Controlled substances may be 41 prescribed for, or administered or dispensed to [an addict] a person 42 with a substance use disorder or habitual user: 43 (a) during emergency medical treatment unrelated to [abuse] such 44 substance use disorder or habitual use of controlled substances; 45 (b) who is a bona fide patient suffering from an incurable and fatal 46 disease such as cancer or advanced tuberculosis; 47 (c) who is aged, infirm, or suffering from serious injury or illness 48 and the withdrawal from controlled substances would endanger the life or 49 impede or inhibit the recovery of such person. 50 1-a. A practitioner may prescribe, order and dispense any schedule 51 III, IV, or V narcotic drug approved by the federal food and drug admin- 52 istration specifically for use in maintenance or detoxification treat- 53 ment to a person with a substance use disorder or habitual user.S. 8307 131 A. 8807 1 2. Controlled substances may be ordered for use by [an addict] a 2 person with a substance use disorder or habitual user by a practitioner 3 and administered by a practitioner [or], registered nurse, or paramedic 4 to relieve acute withdrawal symptoms. 5 3. Methadone, or such other controlled substance designated by the 6 commissioner as appropriate for such use, may be ordered for use of [an7addict] a person with a substance use disorder by a practitioner and 8 dispensed or administered by a practitioner or his designated agent as 9 interim treatment for [an addict on a waiting list for admission to an10authorized maintenance program] a person with a substance use disorder 11 while arrangements are being made for referral to treatment for such 12 addiction to controlled substances. 13 4. Methadone, or such other controlled substance designated by the 14 commissioner as appropriate for such use, may be administered to [an15addict] a person with a substance use disorder by a practitioner or by 16 [his] their designated agent acting under the direction and supervision 17 of a practitioner, as part of a [regime] regimen designed and intended 18 as maintenance or detoxification treatment or to withdraw a patient from 19 addiction to controlled substances. 20 5. [Methadone] Notwithstanding any other law and consistent with 21 federal requirements, methadone, or such other controlled substance 22 designated by the commissioner as appropriate for such use, may be 23 administered or dispensed directly to [an addict] a person with a 24 substance use disorder by a practitioner or by [his] their designated 25 agent acting under the direction and supervision of a practitioner, as 26 part of a substance [abuse or chemical dependence] use disorder program 27 approved pursuant to article [twenty-three or] thirty-two of the mental 28 hygiene law. 29 § 28. Section 3372 of the public health law is REPEALED. 30 § 29. This act shall take effect immediately. 31 PART V 32 Section 1. Section 2805-x of the public health law, as added by 33 section 48 of part B of chapter 57 of the laws of 2015, paragraph (d) of 34 subdivision 4 as added by chapter 697 of the laws of 2023, is amended to 35 read as follows: 36 § 2805-x. [Hospital-home care-physician] Health care delivery collab- 37 oration program. 1. The purpose of this section shall be to facilitate 38 innovation in [hospital, home care agency and physician collaboration in39meeting] collaborations between licensed and certified health care 40 providers and agencies, including: hospitals, home care agencies, emer- 41 gency medical services, skilled nursing facilities, and hospices, as 42 well as payors and other interdisciplinary providers, practitioners and 43 service entities, to meet the community's evolving health care needs in 44 a changing health care delivery landscape. It shall provide a framework 45 to support voluntary initiatives in collaboration to improve patient 46 care access and management, patient health outcomes, cost-effectiveness 47 in the use of health care services and community population health. 48 [Such collaborative initiatives may also include payors, skilled nursing49facilities and other interdisciplinary providers, practitioners and50service entities.] 51 2. For purposes of this section: 52 (a) "Hospital" shall include a general hospital as defined in this 53 article or other inpatient facility for rehabilitation or specialty care 54 within the definition of hospital in this article.S. 8307 132 A. 8807 1 (b) "Home care agency" shall mean a certified home health agency, long 2 term home health care program or licensed home care services agency as 3 defined in article thirty-six of this chapter. 4 (c) "Payor" shall mean a health plan approved pursuant to article 5 forty-four of this chapter, or article thirty-two or forty-three of the 6 insurance law. 7 (d) "Practitioner" shall mean any of the health, mental health or 8 health related professions licensed pursuant to title eight of the 9 education law. 10 (e) "Physician" shall mean a person duly licensed pursuant to article 11 one hundred thirty-one of the education law. 12 (f) "Hospice" shall mean an agency approved under article forty of 13 this chapter. 14 (g) "Emergency medical services" shall mean an agency approved under 15 article thirty of this chapter and authorized pursuant to section three 16 thousand eighteen of this chapter to provide community paramedicine. 17 (h) "Skilled nursing facility" shall mean a residential health care 18 facility or nursing home licensed pursuant to article twenty-eight of 19 this chapter. 20 3. The commissioner is authorized to provide financing including, but 21 not limited to, grants or positive adjustments in medical assistance 22 rates or premium payments, to the extent of funds available and allo- 23 cated or appropriated therefor, including funds provided to the state 24 through federal waivers, funds made available through state appropri- 25 ations and/or funding through section twenty-eight hundred seven-v of 26 this article, as well as waivers of regulations under title ten of the 27 New York codes, rules and regulations, to support the voluntary initi- 28 atives and objectives of this section. 29 4. [Hospital-home care-physician] Health care delivery collaborative 30 initiatives under this section may include, but shall not be limited to: 31 (a) [Hospital-home care-physician integration] Integration initiatives 32 between at least two of the following: hospitals, home care agencies, 33 physician, physicians' group, emergency medical services, hospice, and 34 skilled nursing facilities, including but not limited to: 35 (i) transitions in care initiatives to help effectively transition 36 patients to post-acute care at home, coordinate follow-up care and 37 address issues critical to care plan success and readmission avoidance; 38 (ii) clinical pathways for specified conditions, guiding patients' 39 progress and outcome goals, as well as effective health services use; 40 (iii) application of telehealth/telemedicine services in monitoring 41 and managing patient conditions, and promoting self-care/management, 42 improved outcomes and effective services use; 43 (iv) facilitation of physician house calls to homebound patients 44 and/or to patients for whom such home visits are determined necessary 45 and effective for patient care management; 46 (v) additional models for prevention of avoidable hospital readmis- 47 sions and emergency room visits; 48 (vi) health home development; 49 (vii) development and demonstration of new models of integrated or 50 collaborative care and care management not otherwise achievable through 51 existing models; and 52 (viii) bundled payment demonstrations for hospital-to-post-acute-care 53 for specified conditions or categories of conditions, in particular, 54 conditions predisposed to high prevalence of readmission, including 55 those currently subject to federal/state penalty, and other discharges 56 with extensive post-acute needs;S. 8307 133 A. 8807 1 (b) Recruitment, training and retention of hospital/home care direct 2 care staff and physicians, in geographic or clinical areas of demon- 3 strated need. Such initiatives may include, but are not limited to, the 4 following activities: 5 (i) outreach and public education about the need and value of service 6 in health occupations; 7 (ii) training/continuing education and regulatory facilitation for 8 cross-training to maximize flexibility in the utilization of staff, 9 including: 10 (A) training of hospital nurses in home care; 11 (B) dual certified nurse aide/home health aide certification; and 12 (C) dual personal care aide/HHA certification; 13 (iii) salary/benefit enhancement; 14 (iv) career ladder development; and 15 (v) other incentives to practice in shortage areas; and 16 (c) [Hospital - home care - physician] Health care delivery collabora- 17 tives for the care and management of special needs, high-risk and high- 18 cost patients, including but not limited to best practices, and training 19 and education of direct care practitioners and service employees. 20 (d) Collaborative programs to address disparities in health care 21 access or treatment, and/or conditions of higher prevalence, in certain 22 populations, where such collaborative programs could provide and manage 23 services in a more effective, person-centered and cost-efficient manner 24 for reduction or elimination of such disparities. 25 (i) Such programs may target one or more disparate conditions, or 26 areas of under-service, evidenced in defined populations, including but 27 not be limited to: 28 (A) cardiovascular disease; 29 (B) hypertension; 30 (C) diabetes; 31 (D) chronic kidney disease; 32 (E) obesity; 33 (F) asthma; 34 (G) sickle cell disease; 35 (H) sepsis; 36 (I) lupus; 37 (J) breast, lung, prostate and colorectal cancers; 38 (K) geographic shortage of primary care, prenatal/obstetric care, 39 specialty medical care, home health care, or culturally and linguis- 40 tically compatible care; 41 (L) alcohol, tobacco, or substance abuse; 42 (M) post-traumatic stress disorder and other conditions more prevalent 43 among veterans of the United States military services; 44 (N) attracting members of minority populations to the field and prac- 45 tice of medicine; and 46 (O) such other areas approved by the commissioner. 47 (ii) Collaborative [hospital-home care-physician] health care 48 delivery, and as applicable additional partner, models may include under 49 such disparities programs: 50 (A) service planning and design; 51 (B) recruitment of specialty personnel and/or specialty training of 52 professionals or other direct care personnel (including physicians, home 53 care and hospital staffs), patients and informal caregivers; 54 (C) continuing medical education and clinical training for physicians, 55 follow-up evaluations, and supporting educational materials;S. 8307 134 A. 8807 1 (D) use of evidenced-based approaches and/or best practices to treat- 2 ment; 3 (E) reimbursement of uncovered services; 4 (F) bundled or other integrated payment methods to support the neces- 5 sary, coordinated and cost-effective services; 6 (G) regulatory waivers to facilitate flexibility in provider collab- 7 oration and person-centered care; 8 (H) patient/family peer support and education; 9 (I) data collection, research and evaluation of efficacy; and/or 10 (J) other components or innovations satisfactory to the commissioner. 11 (iii) Nothing contained in this paragraph shall prevent a physician, 12 [physicians] physicians' group, home care agency, or hospital from indi- 13 vidually applying for said grant. 14 (iv) The commissioner shall consult with physicians, home care agen- 15 cies, hospitals, consumers, statewide associations representative of 16 such participants, and other experts in health care disparities, in 17 developing an application process for grant funding or rate adjustment, 18 and for request of state regulatory waivers, to facilitate implementa- 19 tion of disparities programs under this paragraph. 20 5. At a minimum, applications for collaborative initiatives under 21 this section must specifically identify the service gaps and/or communi- 22 ty need the collaboration seeks to address, and outline a projected 23 timeline for implementation and deliverable data to demonstrate mile- 24 stones to success. 25 6. Hospitals and home care agencies which are provided financing or 26 waivers pursuant to this section shall report to the commissioner on the 27 patient, service and cost experiences pursuant to this section, includ- 28 ing the extent to which the project goals are achieved. The commissioner 29 shall compile and make such reports available on the department's 30 website. 31 § 2. Subdivision 2 of section 3602 of the public health law, as added 32 by chapter 895 of the laws of 1977, is amended to read as follows: 33 2. "Home care services agency" means an organization primarily engaged 34 in arranging and/or providing directly or through contract arrangement 35 one or more of the following: Nursing services, home health aide 36 services, and other therapeutic and related services which may include, 37 but shall not be limited to, physical, speech and occupational therapy, 38 nutritional services, medical social services, personal care services, 39 homemaker services, and housekeeper or chore services, which may be of a 40 preventive, therapeutic, rehabilitative, health guidance, and/or 41 supportive nature to persons at home. For the purposes of this article, 42 a general hospital licensed pursuant to article twenty-eight of this 43 chapter shall not be considered "primarily engaged in arranging and/or 44 providing" nursing, home health, or other therapeutic services notwith- 45 standing that such services may be provided in a patient's residence, 46 provided that at least fifty-one percent of patient care hours for such 47 general hospital is generated from the treatment of patients within the 48 hospital, and that any patients treated in their residence have a preex- 49 isting clinical relationship with the general hospital. 50 § 3. Section 2803 of the public health law is amended by adding a new 51 subdivision 15 to read as follows: 52 15. Notwithstanding any contrary provision of this article, or any 53 rule or regulation to the contrary, the commissioner shall allow general 54 hospitals to provide off-site primary care and medical care services, 55 including but not limited to acute care and preventative wellness care, 56 that are:S. 8307 135 A. 8807 1 (a) not home care services defined in subdivision one of section thir- 2 ty-six hundred two of this chapter or the professional services enumer- 3 ated in subdivision two of such section; 4 (b) provided by a primary care professional, including a physician, 5 registered nurse, or physician assistant, to a patient with a pre-exist- 6 ing clinical relationship with the general hospital, or with the health 7 care professional providing the service; and 8 (c) provided to a patient who is unable to leave his or her residence 9 to receive services at the general hospital without unreasonable diffi- 10 culty due to circumstances, including but not limited to, clinical 11 impairment and conditions of immunosuppression. 12 (d) Nothing in this subdivision shall preclude a federally qualified 13 health center from providing off-site services in accordance with 14 department regulations. 15 (e) The department is authorized to establish medical assistance 16 program rates to effectuate this subdivision. For the purposes of the 17 department determining the applicable rates pursuant to such authority, 18 any general hospital approved pursuant to this subdivision shall report 19 to the department, in the form and format required by the department, 20 its annual operating costs, specifically for such off-site acute 21 services. Failure to timely submit such cost data to the department may 22 result in revocation of authority to participate in a program under this 23 section due to the inability to establish appropriate reimbursement 24 rates. 25 § 4. Subdivision 3 of section 3018 of the public health law, as added 26 by chapter 137 of the laws of 2023, is amended to read as follows: 27 3. (a) This program shall authorize mobile integrated and community 28 paramedicine programs presently operating and approved by the department 29 as of May eleventh, two thousand twenty-three, under the authority of 30 Executive Order Number 4 of two thousand twenty-one, entitled "Declaring 31 a Statewide Disaster Emergency Due to Healthcare staffing shortages in 32 the State of New York" to continue in the same manner and capacity as 33 currently approved [for a period of two years following the effective34date of this section] through March thirty-first, two thousand thirty- 35 one. 36 (b) Any program not lawfully operating and established pursuant to 37 paragraph (a) of this subdivision may apply to the department for 38 approval to operate a mobile integrated and community paramedicine 39 program, and any program currently operating pursuant to paragraph (a) 40 of this subdivision for a limited purpose, including but not limited to 41 vaccination administration, may apply to the department for approval to 42 modify its existing community paramedicine program. The department may 43 approve up to two hundred new or expanded programs pursuant to this 44 paragraph. Such applications must be submitted in the form and format 45 prescribed by the department. Programs approved pursuant to this para- 46 graph shall be permitted to operate through March thirty-first, two 47 thousand thirty-one. 48 § 5. Section 2 of chapter 137 of the laws of 2023 amending the public 49 health law relating to establishing a community-based paramedicine 50 demonstration program, is amended to read as follows: 51 § 2. This act shall take effect immediately and shall expire and be 52 deemed repealed [2 years after such date] March 31, 2031; provided, 53 however, that if this act shall have become a law on or after May 22, 54 2023 this act shall take effect immediately and shall be deemed to have 55 been in full force and effect on and after May 22, 2023.S. 8307 136 A. 8807 1 § 6. Subdivision 1 of section 3001 of the public health law, as 2 amended by chapter 804 of the laws of 1992, is amended to read as 3 follows: 4 1. "Emergency medical service" means [initial emergency medical5assistance including, but not limited to, the treatment of trauma,6burns, respiratory, circulatory and obstetrical emergencies] a coordi- 7 nated system of healthcare delivery that responds to the needs of sick 8 and injured individuals, by providing: essential emergency, non-emergen- 9 cy, specialty need or public event medical care; community education and 10 prevention programs; ground and air ambulance services; emergency 11 medical dispatch; training for emergency medical services practitioners; 12 medical first response; mobile trauma care systems; mass casualty 13 management; and medical direction. 14 § 7. Section 6909 of the education law is amended by adding a new 15 subdivision 12 to read as follows: 16 12. A certified nurse practitioner may prescribe and order a non-pa- 17 tient specific regimen to an emergency medical services practitioner 18 licensed by the department of health pursuant to article thirty of the 19 public health law, pursuant to regulations promulgated by the commis- 20 sioner, and consistent with the public health law, for administering 21 immunizations. Nothing in this subdivision shall authorize unlicensed 22 persons to administer immunizations, vaccines or other drugs. 23 § 8. Section 6527 of the education law is amended by adding a new 24 subdivision 12 to read as follows: 25 12. A licensed physician may prescribe and order a non-patient specif- 26 ic regimen to an emergency medical services practitioner licensed by the 27 department of health pursuant to article thirty of the public health 28 law, pursuant to regulations promulgated by the commissioner, and 29 consistent with the public health law, for administering immunizations. 30 Nothing in this subdivision shall authorize unlicensed persons to admin- 31 ister immunizations, vaccines or other drugs. 32 § 9. The public health law is amended by adding a new article 30-D to 33 read as follows: 34 ARTICLE 30-D 35 EMERGENCY MEDICAL SERVICES ESSENTIAL SERVICES ACT 36 Section 3080. Declaration of purpose. 37 3081. Application of article. 38 3082. Definitions. 39 3083. Designation of medical emergency response and emergency 40 medical dispatch agencies as essential services. 41 3084. Provision of emergency medical dispatch. 42 3085. Rules and regulations. 43 § 3080. Declaration of purpose. 1. The provision of prompt, efficient, 44 and effective emergency medical services and emergency medical dispatch 45 is crucial to the health and safety of the residents of New York state. 46 2. The establishment of a comprehensive and standardized system for 47 medical emergency response is essential to address life-threatening 48 conditions and ensure the well-being of individuals in need of urgent 49 medical care. 50 3. Ensuring that every county within New York state has the necessary 51 resources, trained personnel, and operational capabilities to provide 52 medical emergency response is a matter of public interest and state 53 priority. 54 4. It is imperative to standardize the approach to medical emergency 55 response and dispatch services to enhance the quality of care, maximizeS. 8307 137 A. 8807 1 efficiency, and improve outcomes for patients experiencing medical emer- 2 gencies. 3 5. The designation of medical emergency response and emergency medical 4 dispatch as essential services will ensure a uniform, effective, and 5 coordinated response to medical emergencies across the state. 6 6. This article aims to establish a framework for the provision, oper- 7 ation, and regulation of medical emergency response and dispatch 8 services, thereby safeguarding the health and safety of New York state's 9 residents and visitors. 10 § 3081. Application of article. This article shall apply to every 11 county except a county wholly contained within a city. 12 § 3082. Definitions. As used in this article, the following terms 13 shall have the following meanings: 14 1. "Medical emergency response" shall mean the rapid deployment of 15 ambulance services, advanced life support first response services, and 16 other first response services authorized by the department to provide 17 emergency medical services, as defined in section three thousand one of 18 this chapter, for the purpose of providing immediate emergency medical 19 care in response to emergency calls for acute conditions where rapid 20 intervention is vital to prevent death or serious harm. 21 2. "Emergency medical dispatch" means a protocol-driven system 22 approved by the department designed to manage, assess, and prioritize 23 medical emergency calls, provide critical pre-arrival instructions, and 24 dispatch medical emergency response services or provide referral to 25 appropriate non-emergency medical services where appropriate. 26 3. "EMS medical dispatch agency" means any individual, partnership, 27 association, corporation, municipality or any legal or public entity or 28 subdivision thereof licensed by the department who is engaged in receiv- 29 ing requests for emergency medical assistance from the public and 30 dispatching medical emergency response services as needed. 31 4. "Medical emergency readiness assessment" means the rating system 32 evaluating the preparedness, efficiency, and effectiveness of medical 33 emergency response within a community. 34 § 3083. Designation of medical emergency response and emergency 35 medical dispatch agencies as essential services. 1. Medical emergency 36 response and emergency medical dispatch agencies are hereby declared 37 essential services within New York state. 38 2. Every county, acting individually or jointly with any other county, 39 city, town, and village, shall ensure that an emergency medical service, 40 ambulance service, advanced life support first response service, other 41 first response services authorized by the department to provide emergen- 42 cy medical services, or a combination of such services are provided for 43 the purposes of effectuating medical emergency response within the boun- 44 daries of the county. 45 3. Every county acting individually or jointly with any other county, 46 city, town, and village, shall develop, implement, and maintain a 47 comprehensive county medical emergency response plan, in a format 48 approved by the department, ensuring the effective operation, coordi- 49 nation, and funding of medical emergency response. In furtherance of 50 that purpose, the county shall designate one or more primary medical 51 emergency response agencies that shall respond to all calls and demands 52 for such medical emergency response to persons entitled thereto, subject 53 to any limitations upon such service specified in an agreement, within 54 the boundaries of the county. No medical emergency response agency, 55 designated by the county in the plan, may refuse to respond to a requestS. 8307 138 A. 8807 1 for service unless they can prove, to the satisfaction of the depart- 2 ment, that they are unable to respond because of capacity limitations. 3 4. Notwithstanding the provisions of section three thousand eight of 4 this chapter, any county acting individually or jointly with any other 5 county, city, town, and village, that provides, either directly or 6 through agreement with existing services, an emergency medical service 7 or general ambulance service in accordance with section one hundred 8 twenty-two-b of the general municipal law, for the purpose of effectuat- 9 ing medical emergency response, upon meeting or exceeding all adminis- 10 trative and operational standards set by the department, and upon filing 11 written notice to the department in a manner prescribed by the depart- 12 ment, shall be deemed to have satisfied any and all requirements for 13 determination of public need for the establishment of additional emer- 14 gency medical services and the department shall issue a non-transfera- 15 ble, permanent municipal ambulance service operating certificate. Noth- 16 ing in this article shall be deemed to exclude any county issued a 17 municipal ambulance service operating certificate from complying with 18 any other requirement of article thirty of this chapter or any other 19 applicable provision of law or regulations promulgated thereunder. 20 5. Any county acting individually or jointly with any other county, 21 city, town, and village, that provides, either directly or through 22 agreement with an existing service, an emergency medical service or 23 general ambulance service in accordance with section one hundred twen- 24 ty-two-b of the general municipal law, for the purpose of effectuating 25 medical emergency response may establish a special district, after nine- 26 ty days notice to the department, as defined in subdivision sixteen of 27 section one hundred two of the real property tax law, for the financing 28 and operation of such emergency medical service or general ambulance 29 service in accordance with section one hundred twenty-two-b of the 30 general municipal law with an emergency medical services agency licensed 31 by the department to provide emergency medical services in the state. 32 Such special district shall be exempt from the provisions of section 33 three-c of the general municipal law until five years after the estab- 34 lishment of the special district. 35 6. The department shall establish standards, with the advice from the 36 state emergency medical services council, the state emergency medical 37 advisory committee and the state trauma advisory committee, establishing 38 minimum standards for the provision of emergency medical services by 39 first aid squads, basic life support first response services, special 40 event medical services, and other first response services not otherwise 41 defined in article thirty of this chapter. 42 § 3084. Provision of emergency medical dispatch. 1. Every emergency 43 medical dispatch agency operating within New York state shall provide 44 emergency medical dispatch services in accordance with protocols 45 approved by the department. 46 2. All emergency medical dispatch agencies shall be licensed by the 47 department. The department shall establish criteria for the licensing of 48 emergency medical dispatch agencies to ensure compliance with emergency 49 medical dispatch standards. 50 3. All emergency medical dispatchers employed by emergency medical 51 dispatch agencies must complete a certification training course approved 52 by the department and maintain continuous certification while employed 53 by the emergency medical dispatch agency as an emergency medical 54 dispatcher. The department shall establish minimum standards for emer- 55 gency medical dispatch training courses and dispatcher certification.S. 8307 139 A. 8807 1 § 3085. Rules and regulations. The commissioner may promulgate rules 2 and regulations to effectuate the purposes of this article. 3 § 10. The public health law is amended by adding a new section 3019 to 4 read as follows: 5 § 3019. Emergency medical services demonstration programs. 1. The 6 purpose of this section shall be to facilitate innovation in medical 7 care provided by emergency medical service practitioners in meeting the 8 community's health care needs, including collaboration with other health 9 care organizations operating under the provisions of section twenty- 10 eight hundred five-x of this chapter. It shall provide a framework to 11 support voluntary initiatives to improve patient care access and manage- 12 ment, patient health outcomes, and cost-effectiveness in the use of 13 health care services and community population health. 14 2. The commissioner is authorized to provide financing including, to 15 the extent of funds available and allocated or appropriated therefor, as 16 well as waivers of certain parts of this article, article thirty-A of 17 this chapter, and regulations under title ten of the New York codes, 18 rules and regulations, to support the voluntary initiatives and objec- 19 tives of this section. 20 § 11. The public health law is amended by adding a new section 3055 to 21 read as follows: 22 § 3055. EMS licensure and credentialing. 1. The department, with the 23 approval of the state emergency medical services council, may establish 24 minimum standards for the licensure of emergency medical services prac- 25 titioners including but not limited to emergency medical technicians and 26 advanced emergency medical technicians by the department. 27 2. The department, with the approval of the state emergency medical 28 services council, may establish minimum standards for specialized 29 credentialing of emergency medical service practitioners which shall 30 include, but not be limited to, emergency vehicle operator, critical 31 care paramedic, emergency medical dispatcher, emergency medical services 32 field training officer, emergency medical services administrator, emer- 33 gency medical control physician, and emergency medical services agency 34 medical director. 35 § 12. The public health law is amended by adding a new section 3029 to 36 read as follows: 37 § 3029. Paramedic urgent care program. 1. The department shall estab- 38 lish a paramedic urgent care program to evaluate the role of emergency 39 medical services personnel in the delivery of health care services in 40 rural counties of New York state. 41 2. Any organization that is authorized to provide advanced life 42 support services, in accordance with section three thousand thirty of 43 this article, may apply to the department for approval to operate a 44 paramedic urgent care. 45 3. Any paramedic urgent care programs approved by the department under 46 this section shall: (a) be under the overall supervision and direction 47 of a qualified physician; (b) be staffed by qualified medical and health 48 personnel, physician assistants, or nurse practitioners; (c) utilize 49 advanced emergency medical technicians whose scope of practice is appro- 50 priate for the medical services provided; (d) maintain a treatment-man- 51 agement record for each patient; and (e) be integrated with a hospital 52 or other appropriate healthcare organization. 53 4. Paramedic urgent care programs may integrate telehealth provided by 54 a telehealth provider, as those terms are defined in section twenty-nine 55 hundred ninety-nine-cc of this chapter. The commissioner may specify in 56 regulation additional acceptable modalities for the delivery of healthS. 8307 140 A. 8807 1 care services by paramedic care programs via telehealth, including but 2 not limited to audio-only or video-only telephone communications, online 3 portals and survey applications. 4 5. Nothing in this section shall be deemed to allow a person to 5 provide any service for which a license, registration, certification or 6 other authorization under title eight of the education law is required 7 and which the person does not possess, provided that any service being 8 excluded pursuant to this subdivision shall not include a service that 9 is within the scope of practice for the respective emergency medical 10 services personnel. 11 § 13. This act shall take effect immediately and shall be deemed to 12 have been in full force and effect on and after April 1, 2024; provided, 13 however, that the amendments to subdivision 3 of section 3018 of the 14 public health law made by section four of this act shall not affect the 15 repeal of such section and shall be deemed repealed therewith. 16 PART W 17 Section 1. The elder law is amended by adding a new section 226 to 18 read as follows: 19 § 226. Interagency elder justice coordinating council. 1. There is 20 hereby created within the office an elder justice coordinating council 21 consisting of representatives of state agencies whose work involves 22 elder justice to create greater collaboration and develop overarching 23 strategies, systems, and programs to be carried out in accordance with 24 the governor's elder justice priorities, with a goal of protecting older 25 adults from abuse and mistreatment. The council shall collaborate to 26 identify and support consistent policies and program operation, facili- 27 tate communication among state agencies, foster collaborative relation- 28 ships, and help state agencies keep informed of local, state, and 29 national developments in elder justice. 30 2. The council shall be chaired by the director of the office for the 31 aging, and shall include representation from the office of victims 32 services, the office of children and family services, the department of 33 financial services, the division of criminal justice services, the 34 office of mental health, the office for the prevention of domestic 35 violence, the department of health, the office for people with develop- 36 mental disabilities, the New York state police, the justice center for 37 the protection of people with special needs, and the department of 38 state's division of consumer protection. Additionally, the council shall 39 request input from stakeholders, advocates, experts, and coalitions. 40 3. The council shall: 41 (a) develop and implement a cohesive, comprehensive state plan on 42 elder justice that aligns state elder justice policy and programs across 43 state agency responsibilities; 44 (b) develop plans for a coordinated and comprehensive response from 45 state and local government and other entities when elder abuse is 46 reported; 47 (c) facilitate interagency planning and policy development on elder 48 justice; 49 (d) review and propose specific agency initiatives for their impact on 50 systems and services related to elder justice; 51 (e) coordinate activities for world elder abuse awareness day and 52 other events; and 53 (f) make recommendations to the governor that will improve New York's 54 elder abuse prevention and intervention efforts.S. 8307 141 A. 8807 1 4. Each member agency shall maintain control over, and responsibility 2 for, its own programs and policies. The council shall not take the place 3 of any existing interagency councils and committees. The council shall 4 serve to focus attention on elder justice comprehensively and create a 5 multidisciplinary mechanism to work toward alignment across agencies to 6 help achieve the governor's elder justice priorities. 7 5. The council shall meet regularly and shall submit a report on its 8 activities to the governor and the legislature no later than December 9 thirty-first, two thousand twenty-five and annually thereafter. 10 § 2. This act shall take effect immediately. 11 PART X 12 Section 1. Section 5 of part NN of chapter 57 of laws of 2018 amending 13 the public health law and other laws relating to the opioid stewardship 14 act, as amended by section 5 of part XX of chapter 59 of the laws of 15 2019, is amended to read as follows: 16 § 5. This act shall take effect July 1, 2018 and sections one, two and 17 four of this part shall expire and be deemed to be repealed on June 30, 18 2024, provided that, effective immediately, the addition, amendment 19 and/or repeal of any rule or regulation necessary for the implementation 20 of this act on its effective date are authorized to be made and 21 completed on or before such effective date, and, provided that this act 22 shall only apply to the sale or distribution of opioids in the state of 23 New York on or before December 31, 2018. 24 § 2. This act shall take effect immediately. 25 PART Y 26 Section 1. Section 7 of part R2 of chapter 62 of the laws of 2003, 27 amending the mental hygiene law and the state finance law relating to 28 the community mental health support and workforce reinvestment program, 29 the membership of subcommittees for mental health of community services 30 boards and the duties of such subcommittees and creating the community 31 mental health and workforce reinvestment account, as amended by section 32 1 of part W of chapter 57 of the laws of 2021, is amended to read as 33 follows: 34 § 7. This act shall take effect immediately [and shall expire March3531, 2024 when upon such date the provisions of this act shall be deemed36repealed]. 37 § 2. This act shall take effect immediately. 38 PART Z 39 Section 1. Section 2 of part NN of chapter 58 of the laws of 2015, 40 amending the mental hygiene law relating to clarifying the authority of 41 the commissioners in the department of mental hygiene to design and 42 implement time-limited demonstration programs, as amended by section 1 43 of part V of chapter 57 of the laws of 2021, is amended to read as 44 follows: 45 § 2. This act shall take effect immediately [and shall expire and be46deemed repealed March 31, 2024]. 47 § 2. This act shall take effect immediately. 48 PART AAS. 8307 142 A. 8807 1 Section 1. Paragraph 31 of subsection (i) of section 3216 of the 2 insurance law is amended by adding a new subparagraph (J) to read as 3 follows: 4 (J) This subparagraph shall apply to facilities in this state that are 5 licensed, certified, or otherwise authorized by the office of addiction 6 services and supports for the provision of outpatient, intensive outpa- 7 tient, outpatient rehabilitation and opioid treatment that are partic- 8 ipating in the insurer's provider network. Reimbursement for covered 9 outpatient treatment provided by such facilities shall be at a rate that 10 is not less than the rate that would be paid for such treatment pursuant 11 to the medical assistance program under title eleven of article five of 12 the social services law. 13 § 2. Paragraph 35 of subsection (i) of section 3216 of the insurance 14 law is amended by adding a new subparagraph (K) to read as follows: 15 (K) This subparagraph shall apply to outpatient treatment provided in 16 a facility issued an operating certificate by the commissioner of mental 17 health pursuant to the provisions of article thirty-one of the mental 18 hygiene law, or in a facility operated by the office of mental health, 19 or in a crisis stabilization center licensed pursuant to section 36.01 20 of the mental hygiene law, that is participating in the insurer's 21 provider network. Reimbursement for covered outpatient treatment 22 provided by such a facility shall be at a rate that is not less than the 23 rate that would be paid for such treatment pursuant to the medical 24 assistance program under title eleven of article five of the social 25 services law. 26 § 3. Paragraph 5 of subsection (l) of section 3221 of the insurance 27 law is amended by adding a new subparagraph (K) to read as follows: 28 (K) This subparagraph shall apply to outpatient treatment provided in 29 a facility issued an operating certificate by the commissioner of mental 30 health pursuant to the provisions of article thirty-one of the mental 31 hygiene law, or in a facility operated by the office of mental health, 32 or in a crisis stabilization center licensed pursuant to section 36.01 33 of the mental hygiene law, that is participating in the insurer's 34 provider network. Reimbursement for covered outpatient treatment 35 provided by such a facility shall be at a rate that is not less than the 36 rate that would be paid for such treatment pursuant to the medical 37 assistance program under title eleven of article five of the social 38 services law. 39 § 4. Paragraph 7 of subsection (l) of section 3221 of the insurance 40 law is amended by adding a new subparagraph (J) to read as follows: 41 (J) This subparagraph shall apply to facilities in this state that are 42 licensed, certified, or otherwise authorized by the office of addiction 43 services and supports for the provision of outpatient, intensive outpa- 44 tient, outpatient rehabilitation and opioid treatment that are partic- 45 ipating in the insurer's provider network. Reimbursement for covered 46 outpatient treatment provided by such facilities shall be at a rate that 47 is not less than the rate that would be paid for such treatment pursuant 48 to the medical assistance program under title eleven of article five of 49 the social services law. 50 § 5. Subsection (g) of section 4303 of the insurance law is amended by 51 adding a new paragraph 12 to read as follows: 52 (12) This paragraph shall apply to outpatient treatment provided in a 53 facility issued an operating certificate by the commissioner of mental 54 health pursuant to the provisions of article thirty-one of the mental 55 hygiene law, or in a facility operated by the office of mental health, 56 or in a crisis stabilization center licensed pursuant to section 36.01S. 8307 143 A. 8807 1 of the mental hygiene law, that is participating in the corporation's 2 provider network. Reimbursement for covered outpatient treatment 3 provided by such facility shall be at a rate that is not less than the 4 rate that would be paid for such treatment pursuant to the medical 5 assistance program under title eleven of article five of the social 6 services law. 7 § 6. Subsection (l) of section 4303 of the insurance law is amended by 8 adding a new paragraph 10 to read as follows: 9 (10) This paragraph shall apply to facilities in this state that are 10 licensed, certified, or otherwise authorized by the office of addiction 11 services and supports for the provision of outpatient, intensive outpa- 12 tient, outpatient rehabilitation and opioid treatment that are partic- 13 ipating in the corporation's provider network. Reimbursement for covered 14 outpatient treatment provided by such facilities shall be at a rate that 15 is not less than the rate that would be paid for such treatment pursuant 16 to the medical assistance program under title eleven of article five of 17 the social services law. 18 § 7. This act shall take effect January 1, 2025 and shall apply to 19 policies and contracts issued, renewed, modified, altered, or amended on 20 and after such date. 21 PART BB 22 Section 1. Sections 19 and 21 of chapter 723 of the laws of 1989 23 amending the mental hygiene law and other laws relating to comprehensive 24 psychiatric emergency programs, as amended by section 1 of part PPP of 25 chapter 58 of the laws of 2020, are amended to read as follows: 26 § 19. Notwithstanding any other provision of law, the commissioner of 27 mental health shall[, until July 1, 2024,] be solely authorized, in his 28 or her discretion, to designate those general hospitals, local govern- 29 mental units and voluntary agencies which may apply and be considered 30 for the approval and issuance of an operating certificate pursuant to 31 article 31 of the mental hygiene law for the operation of a comprehen- 32 sive psychiatric emergency program. 33 § 21. This act shall take effect immediately[, and sections one, two34and four through twenty of this act shall remain in full force and35effect, until July 1, 2024, at which time the amendments and additions36made by such sections of this act shall be deemed to be repealed, and37any provision of law amended by any of such sections of this act shall38revert to its text as it existed prior to the effective date of this39act]. 40 § 2. This act shall take effect immediately. 41 PART CC 42 Section 1. Subdivision 2 of section 493 of the social services law, as 43 added by section 1 of part B of chapter 501 of the laws of 2012, is 44 amended to read as follows: 45 2. For substantiated reports of abuse or neglect in facilities or 46 provider agencies in receipt of medical assistance and which are no 47 longer subject to amendment or appeal pursuant to section four hundred 48 ninety-four of this article, such information shall also be forwarded by 49 the justice center to the office of the Medicaid inspector general when 50 such abuse or neglect may [be relevant to an investigation of unaccepta-51ble practices as such practices are defined] result in [regulations of] 52 possible exclusion or other sanction by the office of the MedicaidS. 8307 144 A. 8807 1 inspector general as determined in consultation with the office of the 2 Medicaid inspector general. 3 § 2. This act shall take effect immediately. 4 PART DD 5 Section 1. Section 3 of part A of chapter 111 of the laws of 2010 6 amending the mental hygiene law relating to the receipt of federal and 7 state benefits received by individuals receiving care in facilities 8 operated by an office of the department of mental hygiene, as amended by 9 section 1 of part T of chapter 57 of the laws of 2021, is amended to 10 read as follows: 11 § 3. This act shall take effect immediately[; and shall expire and be12deemed repealed June 30, 2024]. 13 § 2. This act shall take effect immediately. 14 PART EE 15 Section 1. Subparagraph (v) of paragraph (a) of subdivision 1 of 16 section 6908 of the education law is renumbered subparagraph (vi) and a 17 new subparagraph (v) is added to read as follows: 18 (v) tasks provided by a direct support staff in non-facility based 19 programs certified, authorized or approved by the office for people with 20 developmental disabilities, so long as such staff does not hold themself 21 out as one who accepts employment solely for performing such care, and 22 where nursing services are under the instruction of a service recipient 23 or family or household member determined by a registered professional 24 nurse to be capable of providing such instruction. In the event that 25 the registered nurse determines that the service recipient, family, or 26 household member is not capable of providing such instruction, nursing 27 tasks may be performed by direct support staff pursuant to subparagraph 28 (vi) of this paragraph subject to the requirements set forth therein; or 29 § 2. This act shall take effect immediately and shall be deemed to 30 have been in full force and effect on and after April 1, 2024. 31 PART FF 32 Section 1. 1. Subject to available appropriations and approval of the 33 director of the budget, the commissioners of the office of mental 34 health, office for people with developmental disabilities, office of 35 addiction services and supports, office of temporary and disability 36 assistance, office of children and family services, and the state office 37 for the aging shall establish a state fiscal year 2024-2025 cost of 38 living adjustment (COLA), effective April 1, 2024, for projecting for 39 the effects of inflation upon rates of payments, contracts, or any other 40 form of reimbursement for the programs and services listed in paragraphs 41 (i), (ii), (iii), (iv), (v), and (vi) of subdivision four of this 42 section. The COLA established herein shall be applied to the appropriate 43 portion of reimbursable costs or contract amounts. Where appropriate, 44 transfers to the department of health (DOH) shall be made as reimburse- 45 ment for the state share of medical assistance. 46 2. Notwithstanding any inconsistent provision of law, subject to the 47 approval of the director of the budget and available appropriations 48 therefore, for the period of April 1, 2024 through March 31, 2025, the 49 commissioners shall provide funding to support a one and five-tenths 50 percent (1.5%) cost of living adjustment under this section for allS. 8307 145 A. 8807 1 eligible programs and services as determined pursuant to subdivision 2 four of this section. 3 3. Notwithstanding any inconsistent provision of law, and as approved 4 by the director of the budget, the 1.5 percent cost of living adjustment 5 (COLA) established herein shall be inclusive of all other cost of living 6 type increases, inflation factors, or trend factors that are newly 7 applied effective April 1, 2024. Except for the 1.5 percent cost of 8 living adjustment (COLA) established herein, for the period commencing 9 on April 1, 2024 and ending March 31, 2025 the commissioners shall not 10 apply any other new cost of living adjustments for the purpose of estab- 11 lishing rates of payments, contracts or any other form of reimbursement. 12 The phrase "all other cost of living type increases, inflation factors, 13 or trend factors" as defined in this subdivision shall not include 14 payments made pursuant to the American Rescue Plan Act or other federal 15 relief programs related to the Coronavirus Disease 2019 (COVID-19) 16 pandemic public health emergency. This subdivision shall not prevent the 17 office of children and family services from applying additional trend 18 factors or staff retention factors to eligible programs and services 19 under paragraph (v) of subdivision four of this section. 20 4. Eligible programs and services. (i) Programs and services funded, 21 licensed, or certified by the office of mental health (OMH) eligible for 22 the cost of living adjustment established herein, pending federal 23 approval where applicable, include: office of mental health licensed 24 outpatient programs, pursuant to parts 587 and 599 of title 14 CRR-NY of 25 the office of mental health regulations including clinic, continuing day 26 treatment, day treatment, intensive outpatient programs and partial 27 hospitalization; outreach; crisis residence; crisis stabilization, 28 crisis/respite beds; mobile crisis, part 590 comprehensive psychiatric 29 emergency program services; crisis intervention; home based crisis 30 intervention; family care; supported single room occupancy; supported 31 housing; supported housing community services; treatment congregate; 32 supported congregate; community residence - children and youth; 33 treatment/apartment; supported apartment; community residence single 34 room occupancy; on-site rehabilitation; employment programs; recreation; 35 respite care; transportation; psychosocial club; assertive community 36 treatment; case management; care coordination, including health home 37 plus services; local government unit administration; monitoring and 38 evaluation; children and youth vocational services; single point of 39 access; school-based mental health program; family support children and 40 youth; advocacy/support services; drop in centers; recovery centers; 41 transition management services; bridger; home and community based waiver 42 services; behavioral health waiver services authorized pursuant to the 43 section 1115 MRT waiver; self-help programs; consumer service dollars; 44 conference of local mental hygiene directors; multicultural initiative; 45 ongoing integrated supported employment services; supported education; 46 mentally ill/chemical abuse (MICA) network; personalized recovery 47 oriented services; children and family treatment and support services; 48 residential treatment facilities operating pursuant to part 584 of title 49 14-NYCRR; geriatric demonstration programs; community-based mental 50 health family treatment and support; coordinated children's service 51 initiative; homeless services; and promises zone. 52 (ii) Programs and services funded, licensed, or certified by the 53 office for people with developmental disabilities (OPWDD) eligible for 54 the cost of living adjustment established herein, pending federal 55 approval where applicable, include: local/unified services; chapter 620 56 services; voluntary operated community residential services; article 16S. 8307 146 A. 8807 1 clinics; day treatment services; family support services; 100% day 2 training; epilepsy services; traumatic brain injury services; hepatitis 3 B services; independent practitioner services for individuals with 4 intellectual and/or developmental disabilities; crisis services for 5 individuals with intellectual and/or developmental disabilities; family 6 care residential habilitation; supervised residential habilitation; 7 supportive residential habilitation; respite; day habilitation; prevoca- 8 tional services; supported employment; community habilitation; interme- 9 diate care facility day and residential services; specialty hospital; 10 pathways to employment; intensive behavioral services; basic home and 11 community based services (HCBS) plan support; community transition 12 services; family education and training; fiscal intermediary; support 13 broker; and personal resource accounts. 14 (iii) Programs and services funded, licensed, or certified by the 15 office of addiction services and supports (OASAS) eligible for the cost 16 of living adjustment established herein, pending federal approval where 17 applicable, include: medically supervised withdrawal services - residen- 18 tial; medically supervised withdrawal services - outpatient; medically 19 managed detoxification; medically monitored withdrawal; inpatient reha- 20 bilitation services; outpatient opioid treatment; residential opioid 21 treatment; KEEP units outpatient; residential opioid treatment to absti- 22 nence; problem gambling treatment; medically supervised outpatient; 23 outpatient rehabilitation; specialized services substance abuse 24 programs; home and community based waiver services pursuant to subdivi- 25 sion 9 of section 366 of the social services law; children and family 26 treatment and support services; continuum of care rental assistance case 27 management; NY/NY III post-treatment housing; NY/NY III housing for 28 persons at risk for homelessness; permanent supported housing; youth 29 clubhouse; recovery community centers; recovery community organizing 30 initiative; residential rehabilitation services for youth (RRSY); inten- 31 sive residential; community residential; supportive living; residential 32 services; job placement initiative; case management; family support 33 navigator; local government unit administration; peer engagement; voca- 34 tional rehabilitation; support services; HIV early intervention 35 services; dual diagnosis coordinator; problem gambling resource centers; 36 problem gambling prevention; prevention resource centers; primary 37 prevention services; other prevention services; and community services. 38 (iv) Programs and services funded, licensed, or certified by the 39 office of temporary and disability assistance (OTDA) eligible for the 40 cost of living adjustment established herein, pending federal approval 41 where applicable, include: nutrition outreach and education program 42 (NOEP). 43 (v) Programs and services funded, licensed, or certified by the office 44 of children and family services (OCFS) eligible for the cost of living 45 adjustment established herein, pending federal approval where applica- 46 ble, include: programs for which the office of children and family 47 services establishes maximum state aid rates pursuant to section 398-a 48 of the social services law and section 4003 of the education law; emer- 49 gency foster homes; foster family boarding homes and therapeutic foster 50 homes; supervised settings as defined by subdivision twenty-two of 51 section 371 of the social services law; adoptive parents receiving 52 adoption subsidy pursuant to section 453 of the social services law; and 53 congregate and scattered supportive housing programs and supportive 54 services provided under the NY/NY III supportive housing agreement to 55 young adults leaving or having recently left foster care.S. 8307 147 A. 8807 1 (vi) Programs and services funded, licensed, or certified by the state 2 office for the aging (SOFA) eligible for the cost of living adjustment 3 established herein, pending federal approval where applicable, include: 4 community services for the elderly; expanded in-home services for the 5 elderly; and supplemental nutrition assistance program. 6 5. Each local government unit or direct contract provider receiving 7 funding for the cost of living adjustment established herein shall 8 submit a written certification, in such form and at such time as each 9 commissioner shall prescribe, attesting how such funding will be or was 10 used to first promote the recruitment and retention of non-executive 11 direct care staff, non-executive direct support professionals, non-exe- 12 cutive clinical staff, or respond to other critical non-personal service 13 costs prior to supporting any salary increases or other compensation for 14 executive level job titles. 15 6. Notwithstanding any inconsistent provision of law to the contrary, 16 agency commissioners shall be authorized to recoup funding from a local 17 governmental unit or direct contract provider for the cost of living 18 adjustment established herein determined to have been used in a manner 19 inconsistent with the appropriation, or any other provision of this 20 section. Such agency commissioners shall be authorized to employ any 21 legal mechanism to recoup such funds, including an offset of other funds 22 that are owed to such local governmental unit or direct contract provid- 23 er. 24 § 2. This act shall take effect immediately and shall be deemed to 25 have been in full force and effect on and after April 1, 2024. 26 § 2. Severability clause. If any clause, sentence, paragraph, subdivi- 27 sion, section or part of this act shall be adjudged by any court of 28 competent jurisdiction to be invalid, such judgment shall not affect, 29 impair, or invalidate the remainder thereof, but shall be confined in 30 its operation to the clause, sentence, paragraph, subdivision, section 31 or part thereof directly involved in the controversy in which such judg- 32 ment shall have been rendered. It is hereby declared to be the intent of 33 the legislature that this act would have been enacted even if such 34 invalid provisions had not been included herein. 35 § 3. This act shall take effect immediately provided, however, that 36 the applicable effective date of Parts A through FF of this act shall be 37 as specifically set forth in the last section of such Parts.
