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S T A T E O F N E W Y O R K
________________________________________________________________________
S. 9007--C A. 10007--C
S E N A T E - A S S E M B L Y
January 21, 2026
___________
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 -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee -- committee discharged, bill amended, ordered
reprinted as amended and recommitted to said committee -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee
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 -- committee discharged, bill amended,
ordered reprinted as amended and recommitted to said committee --
again reported from said committee with amendments, ordered reprinted
as amended and recommitted to said committee -- again reported from
said committee with amendments, ordered reprinted as amended and
recommitted to said committee
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 quarterly assessment of
known and projected department of health state fund medicaid expendi-
tures (Part A); to amend chapter 165 of the laws of 1991, amending the
public health law and other laws relating to establishing payments for
medical assistance, in relation to the effectiveness thereof; to amend
chapter 710 of the laws of 1988, amending the social services law and
the education law relating to medical assistance eligibility of
certain persons and providing for managed medical care demonstration
programs, in relation to the effectiveness thereof; to amend chapter
904 of the laws of 1984, amending the public health law and the social
services law relating to encouraging comprehensive health services, in
relation to the effectiveness thereof; to amend part X2 of chapter 62
of the laws of 2003, amending the public health law relating to allow-
ing for the use of funds of the office of professional medical
conduct for activities of the patient health information and quality
improvement act of 2000, in relation to the effectiveness thereof; to
amend part H of chapter 59 of the laws of 2011, amending the
public health law relating to the statewide health information
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD12671-06-6
S. 9007--C 2 A. 10007--C
network of New York and the statewide planning and research
cooperative system and general powers and duties, in relation to the
effectiveness thereof; to amend part A of chapter 58 of the laws of
2008, amending the elder law and other laws relating to reimbursement
to participating provider pharmacies and prescription drug coverage,
in relation to the effectiveness thereof; to amend chapter 81 of the
laws of 1995, amending the public health law and other laws relating
to medical reimbursement and welfare reform, in relation to the effec-
tiveness thereof; to amend the social services law, in relation to the
effectiveness of certain provisions relating to negotiation of
supplemental rebates relating to medication assisted treatment; to
amend part B of chapter 57 of the laws of 2015, amending the social
services law and other laws relating to supplemental rebates, in
relation to the effectiveness thereof; to amend part KK of chapter 56
of the laws of 2020, amending the public health law relating to the
designation of statewide general hospital quality and sole community
pools and the reduction of capital related inpatient expenses, in
relation to the effectiveness thereof; to amend chapter 779 of the
laws of 1986, amending the social services law relating to authorizing
services for non-residents in adult homes, residences for adults and
enriched housing programs, in relation to the effectiveness thereof;
to amend part R of chapter 59 of the laws of 2016, amending the public
health law and the education law relating to electronic prescriptions,
in relation to the effectiveness thereof; to amend the public health
law, in relation to amending and extending the voluntary indigent care
pool; to amend part H of chapter 57 of the laws of 2019, amending the
public health law relating to waiver of certain regulations, in
relation to the effectiveness thereof; 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 labora-
tories and order and administer COVID-19 and influenza tests and
modernizing nurse practitioners, in relation to the effectiveness
thereof; to amend chapter 21 of the laws of 2011, amending the educa-
tion law relating to authorizing pharmacists to perform collaborative
drug therapy management with physicians in certain settings, in
relation to the effectiveness thereof; to amend chapter 520 of the
laws of 2024, amending the education law and the public health law
relating to amending physician assistant practice standards, in
relation to the effectiveness thereof; to amend 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 telehealth, in relation to the effectiveness thereof; to
amend part II of chapter 54 of the laws of 2016 amending part C of
chapter 58 of the laws of 2005 relating to authorizing reimbursements
for expenditures made by or on behalf of social services districts for
medical assistance for needy persons and administration thereof, in
relation to the effectiveness thereof; to amend part C of chapter 57
of the laws of 2018, amending the social services law and the public
health law relating to health homes and the penalties for managed care
providers, in relation to the effectiveness thereof; and to amend the
social services law, in relation to certain services provided pursuant
to a waiver for traumatic brain injuries (Part B); to amend the public
health law, in relation to extending certain provisions relating to
the distribution of pool allocations; to amend part A3 of chapter 62
of the laws of 2003 amending the public health law and other laws
relating to enacting major components necessary to implement the state
S. 9007--C 3 A. 10007--C
fiscal plan for the 2003-04 state fiscal year, in relation to extend-
ing the effectiveness of provisions thereof; to amend the New York
Health Care Reform Act of 1996, in relation to extending certain
provisions relating thereto; to amend the New York Health Care Reform
Act of 2000, in relation to extending the effectiveness of provisions
thereof; to amend the public health law, in relation to extending
certain provisions relating to health care initiative pool distrib-
utions; to amend the social services law, in relation to extending
payment provisions for general hospitals; to amend the public health
law, in relation to extending certain provisions relating to the
assessments on covered lives; to amend the public health law, in
relation to the comprehensive diagnostic and treatment centers indi-
gent care program, professional education pool funding, and tobacco
control and insurance initiatives pool distributions; to amend the
social services law, in relation to medical assistance information and
payment system; to amend the public health law, in relation to
payments for certified home health agency services, long term home
health care programs and AIDS home care programs; and to amend the
social services law, in relation to the personal care services worker
recruitment and retention program (Part C); to amend 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 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 concern-
ing the hospital excess liability pool; and to amend part H of chapter
57 of the laws of 2017 amending the New York Health Care Reform Act of
1996 and other laws relating to extending certain provisions relating
thereto, in relation to extending provisions relating to excess cover-
age (Part D); intentionally omitted (Part E); to amend the state
finance law, in relation to approval to spend moneys of the Percy T.
Phillips educational foundation of the Dental Society of the state of
New York fund; to amend the vehicle and traffic law, in relation to
distinctive license plates for members of the New York State Dental
Foundation; to amend part JJ of chapter 57 of the laws of 2025 amend-
ing the public health law relating to reporting pregnancy losses and
clarifying which agencies are responsible for such reports, in
relation to the effectiveness thereof; to amend part P of chapter 57
of the laws of 2025 amending the public health law relating to requir-
ing hospitals to provide stabilizing care to pregnant individuals, in
relation to the effectiveness thereof; to amend part GG of chapter 56
of the laws of 2020 amending the social services law and the public
health law relating to creating a single preferred-drug list for medi-
cation assisted treatment, in relation to the effectiveness thereof;
to amend the public health law, in relation to making technical
corrections thereto; to amend the social services law, in relation to
the look-back period for medical assistance; and to amend the insur-
ance law, in relation to referencing the continuing care retirement
community council (Part F); to amend the public health law, in
relation to modifying definitions related to automated external defi-
brillators (AEDs), designating the department of health as the entity
that may authorize the acquisition of AEDs, modifying requirements for
public access defibrillation providers, and establishing requirements
S. 9007--C 4 A. 10007--C
that providers of AEDs notify the receivers of their responsibilities;
and to amend the education law, in relation to AEDS (Part G); inten-
tionally omitted (Part H); to amend chapter 517 of the laws of 2016,
amending the public health law relating to payments from the New
York state medical indemnity fund, in relation to the effectiveness
thereof (Part I); to amend the public health law, in relation to
temporary health care services agencies (Part J); intentionally omit-
ted (Part K); to amend the public health law, in relation to restoring
prior enacted nursing home capital rate reductions (Part L); to amend
the social services law, in relation to the amount payable for certain
services provided to eligible persons who are also eligible for
medical assistance or are also qualified medicare beneficiaries, and
in relation to clarifying Medicaid requirements for biomarker testing;
and to repeal certain provisions of the social services law and the
public health law relating thereto (Part M); intentionally omitted
(Part N); 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 hospital and nursing
home fee-for-service reimbursement rates; and to amend the public
health law, in relation to certain reductions in hospital capital rate
add-ons (Part O); establishing a state fiscal year 2026-2027 targeted
inflationary increase to be applied to certain portions of reimbursa-
ble costs or contract amounts for certain programs and services (Part
P); intentionally omitted (Part Q); to amend the insurance law and the
public health law, in relation to substance-related and addictive
disorder services (Part R); intentionally omitted (Part S); 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 management, in
relation to the effectiveness thereof; and to amend the public health
law, in relation to minimum amounts of certain state aid for the city
of New York (Part T); to amend part A of chapter 56 of the laws of
2013 amending the public health law and other laws relating to general
hospital reimbursement for annual rates, in relation to extending
government rates for behavioral services and referencing the office of
addiction services and supports; to amend part H of chapter 111 of the
laws of 2010 relating to increasing Medicaid payments to providers
through managed care organizations and providing equivalent fees
through an ambulatory patient group methodology, in relation to
extending government rates for behavioral services referencing the
office of addiction services and supports and in relation to the
effectiveness thereof (Part U); to amend part Q of chapter 59 of the
laws of 2016, amending the mental hygiene law relating to the closure
or transfer of a state-operated individualized residential alterna-
tive, in relation to the effectiveness thereof (Part V); to amend
chapter 670 of the laws of 2021, requiring the office for people with
developmental disabilities to establish the care demonstration
program, in relation to the effectiveness thereof (Part W); to amend
the social services law, in relation to medical assistance for needy
persons age sixty-five or older who are eligible for medical assist-
ance but for their immigration status (Part X); to amend the public
health law, in relation to providing for an amended New York managed
care organization provider tax (Part Y); to amend the social services
law, in relation to coverage for services provided by school-based
health centers for medical assistance recipients (Part Z); to amend
part LL of chapter 57 of the laws of 2024, amending the public health
law relating to reimbursement rates for medically fragile children and
S. 9007--C 5 A. 10007--C
pediatric diagnostic and treatment centers, in relation to extending
the effectiveness thereof (Part AA); and to amend the financial
services law, in relation to dispute resolution for emergency services
and surprise bills; and providing for the repeal of certain provisions
upon expiration thereof (Part BB)
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. This act enacts into law major components of legislation
necessary to implement the state health and mental hygiene budget for
the 2026-2027 state fiscal year. Each component is wholly contained
within a Part identified as Parts A through BB. The effective date for
each particular provision contained within such Part is set forth in the
last section of such Part. Any provision in any section contained within
a Part, including the effective date of the Part, which makes a refer-
ence to a section "of this act", when used in connection with that
particular component, shall be deemed to mean and refer to the corre-
sponding section of the Part in which it is found. Section three of this
act sets forth the general effective date of this act.
PART A
Section 1. Paragraph (a) of subdivision 1 of section 92 of 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, as
amended by section 1 of part A of chapter 57 of the laws of 2025, is
amended to read as follows:
(a) For state fiscal years 2011-12 through [2026-27] 2027-28, the
director of the budget, in consultation with the commissioner of health
referenced as "commissioner" for purposes of this section, shall assess
on a quarterly basis, as reflected in quarterly reports pursuant to
subdivision five of this section known and projected department of
health state funds medicaid expenditures by category of service and by
geographic regions, as defined by the commissioner.
§ 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2026.
PART B
Section 1. Subdivision (c) of section 62 of chapter 165 of the laws of
1991, amending the public health law and other laws relating to estab-
lishing payments for medical assistance, as amended by section 9 of part
GG of chapter 56 of the laws of 2020, is amended to read as follows:
(c) section 364-j of the social services law, as amended by section
eight of this act and subdivision 6 of section 367-a of the social
services law as added by section twelve of this act shall expire and be
deemed repealed on March 31, [2026] 2029 and provided further, that the
amendments to the provisions of section 364-j of the social services law
made by section eight of this act shall only apply to managed care
programs approved on or after the effective date of this act;
§ 2. Section 11 of chapter 710 of the laws of 1988, amending the
social services law and the education law relating to medical assistance
eligibility of certain persons and providing for managed medical care
S. 9007--C 6 A. 10007--C
demonstration programs, as amended by section 10 of part GG of chapter
56 of the laws of 2020, is amended to read as follows:
§ 11. This act shall take effect immediately; except that the
provisions of sections one, two, three, four, eight and ten of this act
shall take effect on the ninetieth day after it shall have become a law;
and except that the provisions of sections five, six and seven of this
act shall take effect January 1, 1989; and except that effective imme-
diately, the addition, amendment and/or repeal of any rule or regulation
necessary for the implementation of this act on its effective date are
authorized and directed to be made and completed on or before such
effective date; provided, however, that the provisions of section 364-j
of the social services law, as added by section one of this act shall
expire and be deemed repealed on and after March 31, [2026] 2029, the
provisions of section 364-k of the social services law, as added by
section two of this act, except subdivision 10 of such section, shall
expire and be deemed repealed on and after January 1, 1994, and the
provisions of subdivision 10 of section 364-k of the social services
law, as added by section two of this act, shall expire and be deemed
repealed on January 1, 1995.
§ 3. Section 18 of chapter 904 of the laws of 1984, amending the
public health law and the social services law relating to encouraging
comprehensive health services, as amended by section 16 of part B of
chapter 57 of the laws of 2023, is amended to read as follows:
§ 18. This act shall take effect immediately, except that sections
six, nine, ten and eleven of this act shall take effect on the sixtieth
day after it shall have become a law, sections two, three, four and nine
of this act shall expire and be of no further force or effect on or
after March 31, [2026] 2029, section two of this act shall take effect
on April 1, 1985 or seventy-five days following the submission of the
report required by section one of this act, whichever is later, and
sections eleven and thirteen of this act shall expire and be of no
further force or effect on or after March 31, 1988.
§ 4. Section 4 of part X2 of chapter 62 of the laws of 2003, amending
the public health law relating to allowing for the use of funds of the
office of professional medical conduct for activities of the patient
health information and quality improvement act of 2000, as amended by
section 17 of part B of chapter 57 of the laws of 2023, is amended to
read as follows:
§ 4. This act shall take effect immediately; provided that the
provisions of section one of this act shall be deemed to have been in
full force and effect on and after April 1, 2003, and shall expire March
31, [2026] 2029 when upon such date the provisions of such section shall
be deemed repealed.
§ 5. Subdivision (o) of section 111 of part H of chapter 59 of the
laws of 2011, amending the public health law relating to the statewide
health information network of New York and the statewide planning and
research cooperative system and general powers and duties, as amended by
section 18 of part B of chapter 57 of the laws of 2023, is amended to
read as follows:
(o) sections thirty-eight and thirty-eight-a of this act shall expire
and be deemed repealed March 31, [2026] 2029;
§ 6. Section 32 of part A of chapter 58 of the laws of 2008, amending
the elder law and other laws relating to reimbursement to participating
provider pharmacies and prescription drug coverage, as amended by
section 19 of part B of chapter 57 of the laws of 2023, is amended to
read as follows:
S. 9007--C 7 A. 10007--C
§ 32. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2008; provided
however, that sections one, six-a, nineteen, twenty, twenty-four, and
twenty-five of this act shall take effect July 1, 2008; provided however
that sections sixteen, seventeen and eighteen of this act shall expire
April 1, [2026] 2029; provided, however, that the amendments made by
section twenty-eight of this act shall take effect on the same date as
section 1 of chapter 281 of the laws of 2007 takes effect; provided
further, that sections twenty-nine, thirty, and thirty-one of this act
shall take effect October 1, 2008; provided further, that section twen-
ty-seven of this act shall take effect January 1, 2009; and provided
further, that section twenty-seven of this act shall expire and be
deemed repealed March 31, [2026] 2029; and provided, further, however,
that the amendments to subdivision 1 of section 241 of the education law
made by section twenty-nine of this act shall not affect the expiration
of such subdivision and shall be deemed to expire therewith and provided
that the amendments to section 272 of the public health law made by
section thirty of this act shall not affect the repeal of such section
and shall be deemed repealed therewith.
§ 7. Paragraph (f) of subdivision 1 of section 64 of chapter 81 of the
laws of 1995, amending the public health law and other laws relating to
medical reimbursement and welfare reform, as amended by section 21 of
part B of chapter 57 of the laws of 2023, is amended to read as follows:
(f) Prior to February 1, 2001, February 1, 2002, February 1, 2003,
February 1, 2004, February 1, 2005, February 1, 2006, February 1, 2007,
February 1, 2008, February 1, 2009, February 1, 2010, February 1, 2011,
February 1, 2012, February 1, 2013, February 1, 2014, February 1, 2015,
February 1, 2016, February 1, 2017, February 1, 2018, February 1, 2019,
February 1, 2020, February 1, 2021, February 1, 2022 , February 1, 2023,
February 1, 2024, February 1, 2025 [and], February 1, 2026, FEBRUARY 1,
2027, FEBRUARY 1, 2028, AND FEBRUARY 1, 2029, the commissioner of health
shall calculate the result of the statewide total of residential health
care facility days of care provided to beneficiaries of title XVIII of
the federal social security act (medicare), divided by the sum of such
days of care plus days of care provided to residents eligible for
payments pursuant to title 11 of article 5 of the social services law
minus the number of days provided to residents receiving hospice care,
expressed as a percentage, for the period commencing January 1, through
November 30, of the prior year respectively, based on such data for such
period. This value shall be called the 2000, 2001, 2002, 2003, 2004,
2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016,
2017, 2018, 2019, 2020, 2021, 2022, 2023, 2024, 2025 [and], 2026, 2027,
2028 AND 2029 statewide target percentage respectively.
§ 8. Subparagraph (ii) of paragraph (b) of subdivision 3 of section 64
of chapter 81 of the laws of 1995, amending the public health law and
other laws relating to medical reimbursement and welfare reform, as
amended by section 22 of part B of chapter 57 of the laws of 2023, is
amended to read as follows:
(ii) If the 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018,
2019, 2020, 2021, 2022, 2023, 2024, 2025 [and], 2026, 2027, 2028, AND
2029 statewide target percentages are not for each year at least three
percentage points higher than the statewide base percentage, the commis-
sioner of health shall determine the percentage by which the statewide
target percentage for each year is not at least three percentage points
higher than the statewide base percentage. The percentage calculated
S. 9007--C 8 A. 10007--C
pursuant to this paragraph shall be called the 1997, 1998, 2000, 2001,
2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013,
2014, 2015, 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023, 2024, 2025
[and], 2026, 2027, 2028 AND 2029 statewide reduction percentage respec-
tively. If the 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018,
2019, 2020, 2021, 2022, 2023, 2024, 2025 [and], 2026, 2027, 2028 AND
2029 statewide target percentage for the respective year is at least
three percentage points higher than the statewide base percentage, the
statewide reduction percentage for the respective year shall be zero.
§ 9. Subparagraph (iii) of paragraph (b) of subdivision 4 of section
64 of chapter 81 of the laws of 1995, amending the public health law and
other laws relating to medical reimbursement and welfare reform, as
amended by section 23 of part B of chapter 57 of the laws of 2023, is
amended to read as follows:
(iii) The 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008,
2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020,
2021, 2022, 2023, 2024, 2025 [and], 2026, 2027, 2028, AND 2029 statewide
reduction percentage shall be multiplied by one hundred two million
dollars respectively to determine the 1998, 2000, 2001, 2002, 2003,
2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015,
2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023, 2024, 2025 [and], 2026,
2027, 2028, AND 2029 statewide aggregate reduction amount. If the 1998
and the 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009,
2010, 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020, 2021,
2022, 2023, 2024, 2025 [and], 2026, 2027, 2028, AND 2029 statewide
reduction percentage shall be zero respectively, there shall be no 1998,
2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011,
2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023,
2024, 2025 [and], 2026, 2027, 2028, AND 2029 reduction amount.
§ 10. The opening paragraph of paragraph (e) of subdivision 7 of
section 367-a of the social services law, as amended by section 5 of
part I of chapter 57 of the laws of 2024, is amended to read as follows:
During the period from April first, two thousand fifteen through March
thirty-first, two thousand [twenty-six] TWENTY-NINE, the commissioner
may, in lieu of a managed care provider or pharmacy benefit manager,
negotiate directly and enter into an arrangement with a pharmaceutical
manufacturer for the provision of supplemental rebates relating to phar-
maceutical utilization by enrollees of managed care providers pursuant
to section three hundred sixty-four-j of this title and may also negoti-
ate directly and enter into such an agreement relating to pharmaceutical
utilization by medical assistance recipients not so enrolled. Such
rebate arrangements shall be limited to the following: antiretrovirals
approved by the FDA for the treatment of HIV/AIDS, accelerated approval
drugs established pursuant to this paragraph, opioid dependence agents
and opioid antagonists listed in a statewide formulary established
pursuant to subparagraph (vii) of this paragraph, hepatitis C agents,
high cost drugs as provided for in subparagraph (viii) of this para-
graph, gene therapies as provided for in subparagraph (ix) of this para-
graph, and any other class or drug designated by the commissioner for
which the pharmaceutical manufacturer has in effect a rebate arrangement
with the federal secretary of health and human services pursuant to 42
U.S.C. § 1396r-8, and for which the state has established standard clin-
ical criteria. No agreement entered into pursuant to this paragraph
shall have an initial term or be extended beyond the expiration or
repeal of this paragraph. For purposes of this paragraph, an "acceler-
S. 9007--C 9 A. 10007--C
ated approval" is a drug or labeled indication of a drug authorized by
the Federal Food, Drug and Cosmetic Act for drugs approved under Subpart
H of 21 CFR Part 314 and Subpart E of 21 CFR Part 601 for serious condi-
tions that fill an unmet medical need based on whether the drug has an
effect on a surrogate clinical endpoint, and is pending verification of
clinical benefit in confirmatory trials.
§ 11. Subdivision 1 of section 60 of part B of chapter 57 of the laws
of 2015, amending the social services law and other laws relating to
supplemental rebates, as amended by section 25 of part B of chapter 57
of the laws of 2023, is amended to read as follows:
1. section one of this act shall expire and be deemed repealed March
31, [2029] 2032;
§ 12. Section 8 of part KK of chapter 56 of the laws of 2020, amending
the public health law relating to the designation of statewide general
hospital quality and sole community pools and the reduction of capital
related inpatient expenses, as amended by section 26 of part B of chap-
ter 57 of the laws of 2023, is amended to read as follows:
§ 8. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2020, provided,
further that sections four through seven of this act shall expire and be
deemed repealed March 31, [2026] 2029; provided further, however, that
the director of the budget may, in consultation with the commissioner of
health, delay the effective dates prescribed herein for a period of time
which shall not exceed ninety days following the conclusion or termi-
nation of an executive order issued pursuant to section 28 of the execu-
tive law declaring a state disaster emergency for the entire state of
New York, upon such delay the director of budget shall notify the chairs
of the assembly ways and means committee and senate finance committee
and the chairs of the assembly and senate health committee; provided
further, however, that the director of the budget shall notify the
legislative bill drafting commission upon the occurrence of a delay in
the effective date of this act in order that the commission may maintain
an accurate and timely effective data base of the official text of the
laws of the state of New York in furtherance of effectuating the
provisions of section 44 of the legislative law and section 70-b of the
public officers law.
§ 13. Section 4 of chapter 779 of the laws of 1986, amending the
social services law relating to authorizing services for non-residents
in adult homes, residences for adults and enriched housing programs, as
amended by section 28 of part B of chapter 57 of the laws of 2023, is
amended to read as follows:
§ 4. This act shall take effect on the one hundred twentieth day after
it shall have become a law and shall remain in full force and effect
until July 1, [2026] 2029, provided however, that effective immediately,
the addition, amendment and/or repeal of any rules or regulations neces-
sary for the implementation of the foregoing sections of this act on its
effective date are authorized and directed to be made and completed on
or before such effective date.
§ 14. Section 9 of part R of chapter 59 of the laws of 2016, amending
the public health law and the education law relating to electronic
prescriptions, as amended by section 35-b of part B of chapter 57 of the
laws of 2023, is amended to read as follows:
§ 9. This act shall take effect immediately; provided however, that
sections one and two of this act shall take effect on the first of June
next succeeding the date on which it shall have become a law and shall
expire and be deemed repealed June 1, [2026] 2029.
S. 9007--C 10 A. 10007--C
§ 15. Subdivision 5-d of section 2807-k of the public health law, as
amended by section 1 of part E of chapter 57 of the laws of 2023, clause
(A) of subparagraph (ii) of paragraph (b) as amended by section 2 of
part D of chapter 57 of the laws of 2025, is amended to read as follows:
5-d. (a) Notwithstanding any inconsistent provision of this section,
section twenty-eight hundred seven-w of this article or any other
contrary provision of law, and subject to the availability of federal
financial participation, for periods on and after January first, two
thousand twenty, through [March] DECEMBER thirty-first, two thousand
[twenty-six] TWENTY-NINE, all funds available for distribution pursuant
to this section, except for funds distributed pursuant to paragraph (b)
of subdivision five-b of this section, and all funds available for
distribution pursuant to section twenty-eight hundred seven-w of this
article, shall be reserved and set aside and distributed in accordance
with the provisions of this subdivision.
(b) The commissioner shall promulgate regulations, and may promulgate
emergency regulations, establishing methodologies for the distribution
of funds as described in paragraph (a) of this subdivision and such
regulations shall include, but not be limited to, the following:
(i) Such regulations shall establish methodologies for determining
each facility's relative uncompensated care need amount based on unin-
sured inpatient and outpatient units of service from the cost reporting
year two years prior to the distribution year, multiplied by the appli-
cable medicaid rates in effect January first of the distribution year,
as summed and adjusted by a statewide cost adjustment factor and reduced
by the sum of all payment amounts collected from such uninsured
patients, and as further adjusted by application of a nominal need
computation that shall take into account each facility's medicaid inpa-
tient share.
(ii) Annual distributions pursuant to such regulations for the two
thousand twenty through two thousand [twenty-five] TWENTY-NINE calendar
years shall be in accord with the following:
(A) (1) one hundred thirty-nine million four hundred thousand dollars
shall be distributed as Medicaid Disproportionate Share Hospital ("DSH")
payments to major public general hospitals;
(2) for the calendar years two thousand twenty-five and thereafter,
the total distributions to major public general hospitals shall be
subject to an aggregate reduction of one hundred thirteen million four
hundred thousand dollars annually, provided that general hospitals oper-
ated by the New York city health and hospitals corporation as estab-
lished by chapter one thousand sixteen of the laws of nineteen hundred
sixty-nine, as amended, shall not receive distributions pursuant to this
subdivision; and
(B) nine hundred sixty-nine million nine hundred thousand dollars as
Medicaid DSH payments to eligible general hospitals, other than major
public general hospitals.
For the calendar years two thousand twenty through two thousand twen-
ty-two, the total distributions to eligible general hospitals, other
than major public general hospitals, shall be subject to an aggregate
reduction of one hundred fifty million dollars annually, provided that
eligible general hospitals, other than major public general hospitals,
that qualify as enhanced safety net hospitals under section two thousand
eight hundred seven-c of this article shall not be subject to such
reduction.
For the calendar years two thousand twenty-three through two thousand
[twenty-five] TWENTY-NINE, the total distributions to eligible general
S. 9007--C 11 A. 10007--C
hospitals, other than major public general hospitals, shall be subject
to an aggregate reduction of two hundred thirty-five million four
hundred thousand dollars annually, provided that eligible general hospi-
tals, other than major public general hospitals that qualify as enhanced
safety net hospitals under section two thousand eight hundred seven-c of
this article as of April first, two thousand twenty, shall not be
subject to such reduction.
Such reductions shall be determined by a methodology to be established
by the commissioner. Such methodologies may take into account the payor
mix of each non-public general hospital, including the percentage of
inpatient days paid by Medicaid.
(iii) For calendar years two thousand twenty through two thousand
[twenty-five] TWENTY-NINE, sixty-four million six hundred thousand
dollars shall be distributed to eligible general hospitals, other than
major public general hospitals, that experience a reduction in indigent
care pool payments pursuant to this subdivision, and that qualify as
enhanced safety net hospitals under section two thousand eight hundred
seven-c of this article as of April first, two thousand twenty. Such
distribution shall be established pursuant to regulations promulgated by
the commissioner and shall be proportional to the reduction experienced
by the facility.
(iv) Such regulations shall reserve one percent of the funds available
for distribution in the two thousand fourteen and two thousand fifteen
calendar years, and for calendar years thereafter, pursuant to this
subdivision, subdivision fourteen-f of section twenty-eight hundred
seven-c of this article, and sections two hundred eleven and two hundred
twelve of chapter four hundred seventy-four of the laws of nineteen
hundred ninety-six, in a "financial assistance compliance pool" and
shall establish methodologies for the distribution of such pool funds to
facilities based on their level of compliance, as determined by the
commissioner, with the provisions of subdivision nine-a of this section.
(c) The commissioner shall annually report to the governor and the
legislature on the distribution of funds under this subdivision includ-
ing, but not limited to:
(i) the impact on safety net providers, including community providers,
rural general hospitals and major public general hospitals;
(ii) the provision of indigent care by units of services and funds
distributed by general hospitals; and
(iii) the extent to which access to care has been enhanced.
§ 16. Section 7 of part H of chapter 57 of the laws of 2019, amending
the public health law relating to waiver of certain regulations, as
amended by section 10 of part B of chapter 57 of the laws of 2024, is
amended to read as follows:
§ 7. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2019, provided,
however, that section two of this act shall expire on April 1, [2026]
2028.
§ 17. Section 8 of part C of chapter 57 of the laws of 2022, amending
the public health law and the education law relating to allowing pharma-
cists to direct limited service laboratories and order and administer
COVID-19 and influenza tests and modernizing nurse practitioners, as
amended by section 1 of part P of chapter 57 of the laws of 2024, is
amended to read as follows:
§ 8. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022; provided,
S. 9007--C 12 A. 10007--C
however, that sections one, two, three, four, six and seven of this act
shall expire and be deemed repealed July 1, [2026] 2030.
§ 18. Section 5 of chapter 21 of the laws of 2011, amending the educa-
tion law relating to authorizing pharmacists to perform collaborative
drug therapy management with physicians in certain settings, as amended
by section 2 of part P of chapter 57 of the laws of 2024, is amended to
read as follows:
§ 5. This act shall take effect on the one hundred twentieth day after
it shall have become a law, provided, however, that the provisions of
sections two, three, and four of this act shall expire and be deemed
repealed July 1, [2026] 2030; provided, however, that the amendments to
subdivision 1 of section 6801 of the education law made by section one
of this act shall be subject to the expiration and reversion of such
subdivision pursuant to section 8 of chapter 563 of the laws of 2008,
when upon such date the provisions of section one-a of this act shall
take effect; provided, further, that effective immediately, the addi-
tion, amendment and/or repeal of any rule or regulation necessary for
the implementation of this act on its effective date are authorized and
directed to be made and completed on or before such effective date.
§ 19. Section 4 of chapter 520 of the laws of 2024, amending the
education law and the public health law relating to amending physician
assistant practice standards, is amended to read as follows:
§ 4. This act shall take effect three months after it shall have
become a law; provided, however, that paragraph (l) of subdivision 7 of
section 6542 of the education law, as added by section one of this act,
shall expire and be deemed repealed July 1, [2026] 2030. Effective imme-
diately, the state education department and the department of health
are authorized to promulgate, amend and/or repeal any rule or regulation
necessary for the implementation of section one of this act on or before
such effective date.
§ 20. Section 7 of 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 telehealth, as amended
by section 5 of part B of chapter 57 of the laws of 2024, is amended to
read as follows:
§ 7. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022; provided,
however, this act shall expire and be deemed repealed on and after April
1, [2026] 2028.
§ 21. Section 2 of part II of chapter 54 of the laws of 2016 amending
part C of chapter 58 of the laws of 2005 relating to authorizing
reimbursements for expenditures made by or on behalf of social services
districts for medical assistance for needy persons and administration
thereof, as amended by section 8 of part B of chapter 57 of the laws of
2024, is amended to read as follows:
§ 2. This act shall take effect immediately and shall expire and be
deemed repealed March 31, [2026] 2028.
§ 22. Section 8 of part C of chapter 57 of the laws of 2018, amending
the social services law and the public health law relating to health
homes and penalties for managed care providers, as amended by section 2
of part QQ of chapter 57 of the laws of 2022, is amended to read as
follows:
§ 8. Notwithstanding any inconsistent provision of sections 112 and
163 of the state finance law, or sections 142 and 143 of the economic
development law, or any other contrary provision of law, excepting the
13 responsible vendor requirements of the state finance law, including,
S. 9007--C 13 A. 10007--C
but not limited to, sections 163 and 139-k of the state finance law, the
commissioner of health is authorized to amend or otherwise extend the
terms of a contract awarded prior to the effective date and entered into
pursuant to subdivision 24 of section 206 of the public health law, as
added by section 39 of part C of chapter 58 of the laws of 2008, without
a competitive bid or request for proposal process, upon determination
that the existing contractor is qualified to continue to provide such
services, and provided that efficiency savings are achieved during the
period of extension; and provided, further, that the department of
health shall submit a request for applications for such contract during
the time period specified in this section and may terminate the contract
identified herein prior to expiration of the extension authorized by
this section. Contracts entered into, amended, or extended pursuant to
this section shall not remain in force beyond August 19, [2026] 2027.
§ 23. Paragraph (d-2) of subdivision 3 of section 364-j of the social
services law, as amended by chapter 41 of the laws of 2025, is amended
to read as follows:
(d-2) Services provided pursuant to a waiver, granted pursuant to
subsection (c) of section 1915 of the federal social security act, to
persons suffering from traumatic brain injuries, shall not be provided
to medical assistance recipients through managed care programs estab-
lished pursuant to this section. Services provided pursuant to a waiver,
granted pursuant to subsection (c) of section 1915 of the federal social
security act, to persons qualifying for nursing home diversion and tran-
sition services, shall not be provided to medical assistance recipients
through managed care programs until at least January first, two thousand
[twenty-seven] TWENTY-EIGHT.
§ 24. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after March 31, 2026;
provided, however, that the amendments to the opening paragraph of para-
graph (e) of subdivision 7 of section 367-a of the social services law
made by section ten of this act shall not affect the repeal of such
paragraph and shall be deemed repealed therewith; and provided further
that the amendments to section 364-j of the social services law made by
section twenty-three of this act shall not affect the repeal of such
section and shall be deemed repealed therewith.
PART C
Section 1. Section 34 of part A3 of chapter 62 of the laws of 2003
amending the public health law and other laws relating to enacting major
components necessary to implement the state fiscal plan for the 2003-04
state fiscal year, as amended by section 1 of part C of chapter 57 of
the laws of 2023, is amended to read as follows:
§ 34. (1) Notwithstanding any inconsistent provision of law, rule or
regulation and effective April 1, 2008 through March 31, [2026] 2029,
the commissioner of health is authorized to transfer and the state comp-
troller is authorized and directed to receive for deposit to the credit
of the department of health's special revenue fund - other, health care
reform act (HCRA) resources fund - 061, provider collection monitoring
account, within amounts appropriated each year, those funds collected
and accumulated pursuant to section 2807-v of the public health law,
including income from invested funds, for the purpose of payment for
administrative costs of the department of health related to adminis-
tration of statutory duties for the collections and distributions
authorized by section 2807-v of the public health law.
S. 9007--C 14 A. 10007--C
(2) Notwithstanding any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31, [2026] 2029, the
commissioner of health is authorized to transfer and the state comp-
troller is authorized and directed to receive for deposit to the credit
of the department of health's special revenue fund - other, health care
reform act (HCRA) resources fund - 061, provider collection monitoring
account, within amounts appropriated each year, those funds collected
and accumulated and interest earned through surcharges on payments for
health care services pursuant to section 2807-s of the public health law
and from assessments pursuant to section 2807-t of the public health law
for the purpose of payment for administrative costs of the department of
health related to administration of statutory duties for the collections
and distributions authorized by sections 2807-s, 2807-t, and 2807-m of
the public health law.
(3) Notwithstanding any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31, [2026] 2029, the
commissioner of health is authorized to transfer and the comptroller is
authorized to deposit, within amounts appropriated each year, those
funds authorized for distribution in accordance with the provisions of
paragraph (a) of subdivision 1 of section 2807-l of the public health
law for the purposes of payment for administrative costs of the depart-
ment of health related to the child health insurance plan program
authorized pursuant to title 1-A of article 25 of the public health law
into the special revenue funds - other, health care reform act (HCRA)
resources fund - 061, child health insurance account, established within
the department of health.
(5) Notwithstanding any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31, [2026] 2029, the
commissioner of health is authorized to transfer and the comptroller is
authorized to deposit, within amounts appropriated each year, those
funds allocated pursuant to paragraph (j) of subdivision 1 of section
2807-v of the public health law for the purpose of payment for adminis-
trative costs of the department of health related to administration of
the state's tobacco control programs and cancer services provided pursu-
ant to sections 2807-r and 1399-ii of the public health law into such
accounts established within the department of health for such purposes.
(6) Notwithstanding any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31, [2026] 2029, the
commissioner of health is authorized to transfer and the comptroller is
authorized to deposit, within amounts appropriated each year, the funds
authorized for distribution in accordance with the provisions of section
2807-l of the public health law for the purposes of payment for adminis-
trative costs of the department of health related to the programs funded
pursuant to section 2807-l of the public health law into the special
revenue funds - other, health care reform act (HCRA) resources fund -
061, pilot health insurance account, established within the department
of health.
(7) Notwithstanding any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31, [2026] 2029, the
commissioner of health is authorized to transfer and the comptroller is
authorized to deposit, within amounts appropriated each year, those
funds authorized for distribution in accordance with the provisions of
subparagraph (ii) of paragraph (f) of subdivision 19 of section 2807-c
of the public health law from monies accumulated and interest earned in
the bad debt and charity care and capital statewide pools through an
assessment charged to general hospitals pursuant to the provisions of
S. 9007--C 15 A. 10007--C
subdivision 18 of section 2807-c of the public health law and those
funds authorized for distribution in accordance with the provisions of
section 2807-l of the public health law for the purposes of payment for
administrative costs of the department of health related to programs
funded under section 2807-l of the public health law into the special
revenue funds - other, health care reform act (HCRA) resources fund -
061, primary care initiatives account, established within the department
of health.
(8) Notwithstanding any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31, [2026] 2029, the
commissioner of health is authorized to transfer and the comptroller is
authorized to deposit, within amounts appropriated each year, those
funds authorized for distribution in accordance with section 2807-l of
the public health law for the purposes of payment for administrative
costs of the department of health related to programs funded under
section 2807-l of the public health law into the special revenue funds -
other, health care reform act (HCRA) resources fund - 061, health care
delivery administration account, established within the department of
health.
(9) Notwithstanding any inconsistent provision of law, rule or regu-
lation and effective April 1, 2008 through March 31, [2026] 2029, the
commissioner of health is authorized to transfer and the comptroller is
authorized to deposit, within amounts appropriated each year, those
funds authorized pursuant to sections 2807-d, 3614-a and 3614-b of the
public health law and section 367-i of the social services law and for
distribution in accordance with the provisions of subdivision 9 of
section 2807-j of the public health law for the purpose of payment for
administration of statutory duties for the collections and distributions
authorized by sections 2807-c, 2807-d, 2807-j, 2807-k, 2807-l, 3614-a
and 3614-b of the public health law and section 367-i of the social
services law into the special revenue funds - other, health care reform
act (HCRA) resources fund - 061, provider collection monitoring account,
established within the department of health.
§ 2. Subparagraphs (iv) and (v) of paragraph (a) of subdivision 9 of
section 2807-j of the public health law, as amended by section 2 of part
C of chapter 57 of the laws of 2023, are amended to read as follows:
(iv) seven hundred sixty-five million dollars annually of the funds
accumulated for the periods January first, two thousand through December
thirty-first, two thousand [twenty five] TWENTY-EIGHT, and
(v) one hundred ninety-one million two hundred fifty thousand dollars
of the funds accumulated for the period January first, two thousand
[twenty-six] TWENTY-NINE through March thirty-first, two thousand [twen-
ty-six] TWENTY-NINE.
§ 3. Subdivision 5 of section 168 of chapter 639 of the laws of 1996,
constituting the New York Health Care Reform Act of 1996, as amended by
section 3 of part C of chapter 57 of the laws of 2023, is amended to
read as follows:
5. sections 2807-c, 2807-j, 2807-s and 2807-t of the public health
law, as amended or as added by this act, shall expire on December 31,
[2026] 2029, and shall be thereafter effective only in respect to any
act done on or before such date or action or proceeding arising out of
such act including continued collections of funds from assessments and
allowances and surcharges established pursuant to sections 2807-c,
2807-j, 2807-s and 2807-t of the public health law, and administration
and distributions of funds from pools established pursuant to sections
2807-c, 2807-j, 2807-k, 2807-l, 2807-m, 2807-s and 2807-t of the public
S. 9007--C 16 A. 10007--C
health law related to patient services provided before December 31,
[2026] 2029, and continued expenditure of funds authorized for programs
and grants until the exhaustion of funds therefor;
§ 4. Subdivision 1 of section 138 of chapter 1 of the laws of 1999,
constituting the New York Health Care Reform Act of 2000, as amended by
section 4 of part C of chapter 57 of the laws of 2023, is amended to
read as follows:
1. sections 2807-c, 2807-j, 2807-s, and 2807-t of the public health
law, as amended by this act, shall expire on December 31, [2026] 2029,
and shall be thereafter effective only in respect to any act done before
such date or action or proceeding arising out of such act including
continued collections of funds from assessments and allowances and
surcharges established pursuant to sections 2807-c, 2807-j, 2807-s and
2807-t of the public health law, and administration and distributions of
funds from pools established pursuant to sections 2807-c, 2807-j,
2807-k, 2807-l, 2807-m, 2807-s, 2807-t, 2807-v and 2807-w of the public
health law, as amended or added by this act, related to patient services
provided before December 31, [2026] 2029, and continued expenditure of
funds authorized for programs and grants until the exhaustion of funds
therefor;
§ 5. Section 2807-l of the public health law, as amended by section 5
of part C of chapter 57 of the laws of 2023, is amended to read as
follows:
§ 2807-l. Health care initiatives pool distributions. 1. Funds accumu-
lated in the health care initiatives pools pursuant to paragraph (b) of
subdivision nine of section twenty-eight hundred seven-j of this arti-
cle, or the health care reform act (HCRA) resources fund established
pursuant to section ninety-two-dd of the state finance law, whichever is
applicable, including income from invested funds, shall be distributed
or retained by the commissioner or by the state comptroller, as applica-
ble, in accordance with the following.
(a) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for purposes
of distributions to programs to provide health care coverage for unin-
sured or underinsured children pursuant to sections twenty-five hundred
ten and twenty-five hundred eleven of this chapter from the respective
health care initiatives pools established for the following periods in
the following amounts:
(i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen hundred ninety-seven,
up to one hundred twenty million six hundred thousand dollars;
(ii) from the pool for the period January first, nineteen hundred
ninety-eight through December thirty-first, nineteen hundred ninety-
eight, up to one hundred sixty-four million five hundred thousand
dollars;
(iii) from the pool for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
up to one hundred eighty-one million dollars;
(iv) from the pool for the period January first, two thousand through
December thirty-first, two thousand, two hundred seven million dollars;
(v) from the pool for the period January first, two thousand one
through December thirty-first, two thousand one, two hundred thirty-five
million dollars;
(vi) from the pool for the period January first, two thousand two
through December thirty-first, two thousand two, three hundred twenty-
four million dollars;
S. 9007--C 17 A. 10007--C
(vii) from the pool for the period January first, two thousand three
through December thirty-first, two thousand three, up to four hundred
fifty million three hundred thousand dollars;
(viii) from the pool for the period January first, two thousand four
through December thirty-first, two thousand four, up to four hundred
sixty million nine hundred thousand dollars;
(ix) from the pool or the health care reform act (HCRA) resources
fund, whichever is applicable, for the period January first, two thou-
sand five through December thirty-first, two thousand five, up to one
hundred fifty-three million eight hundred thousand dollars;
(x) from the health care reform act (HCRA) resources fund for the
period January first, two thousand six through December thirty-first,
two thousand six, up to three hundred twenty-five million four hundred
thousand dollars;
(xi) from the health care reform act (HCRA) resources fund for the
period January first, two thousand seven through December thirty-first,
two thousand seven, up to four hundred twenty-eight million fifty-nine
thousand dollars;
(xii) from the health care reform act (HCRA) resources fund for the
period January first, two thousand eight through December thirty-first,
two thousand ten, up to four hundred fifty-three million six hundred
seventy-four thousand dollars annually;
(xiii) from the health care reform act (HCRA) resources fund for the
period January first, two thousand eleven, through March thirty-first,
two thousand eleven, up to one hundred thirteen million four hundred
eighteen thousand dollars;
(xiv) from the health care reform act (HCRA) resources fund for the
period April first, two thousand eleven, through March thirty-first, two
thousand twelve, up to three hundred twenty-four million seven hundred
forty-four thousand dollars;
(xv) from the health care reform act (HCRA) resources fund for the
period April first, two thousand twelve, through March thirty-first, two
thousand thirteen, up to three hundred forty-six million four hundred
forty-four thousand dollars;
(xvi) from the health care reform act (HCRA) resources fund for the
period April first, two thousand thirteen, through March thirty-first,
two thousand fourteen, up to three hundred seventy million six hundred
ninety-five thousand dollars; and
(xvii) from the health care reform act (HCRA) resources fund for each
state fiscal year for periods on and after April first, two thousand
fourteen, within amounts appropriated.
(b) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for purposes
of distributions for health insurance programs under the individual
subsidy programs established pursuant to the expanded health care cover-
age act of nineteen hundred eighty-eight as amended, and for evaluation
of such programs from the respective health care initiatives pools or
the health care reform act (HCRA) resources fund, whichever is applica-
ble, established for the following periods in the following amounts:
(i) (A) an amount not to exceed six million dollars on an annualized
basis for the periods January first, nineteen hundred ninety-seven
through December thirty-first, nineteen hundred ninety-nine; up to six
million dollars for the period January first, two thousand through
December thirty-first, two thousand; up to five million dollars for the
period January first, two thousand one through December thirty-first,
two thousand one; up to four million dollars for the period January
S. 9007--C 18 A. 10007--C
first, two thousand two through December thirty-first, two thousand two;
up to two million six hundred thousand dollars for the period January
first, two thousand three through December thirty-first, two thousand
three; up to one million three hundred thousand dollars for the period
January first, two thousand four through December thirty-first, two
thousand four; up to six hundred seventy thousand dollars for the period
January first, two thousand five through June thirtieth, two thousand
five; up to one million three hundred thousand dollars for the period
April first, two thousand six through March thirty-first, two thousand
seven; and up to one million three hundred thousand dollars annually for
the period April first, two thousand seven through March thirty-first,
two thousand nine, shall be allocated to individual subsidy programs;
and
(B) an amount not to exceed seven million dollars on an annualized
basis for the periods during the period January first, nineteen hundred
ninety-seven through December thirty-first, nineteen hundred ninety-nine
and four million dollars annually for the periods January first, two
thousand through December thirty-first, two thousand two, and three
million dollars for the period January first, two thousand three through
December thirty-first, two thousand three, and two million dollars for
the period January first, two thousand four through December thirty-
first, two thousand four, and two million dollars for the period January
first, two thousand five through June thirtieth, two thousand five shall
be allocated to the catastrophic health care expense program.
(ii) Notwithstanding any law to the contrary, the characterizations of
the New York state small business health insurance partnership program
as in effect prior to June thirtieth, two thousand three, voucher
program as in effect prior to December thirty-first, two thousand one,
individual subsidy program as in effect prior to June thirtieth, two
thousand five, and catastrophic health care expense program, as in
effect prior to June thirtieth, two thousand five, may, for the purposes
of identifying matching funds for the community health care conversion
demonstration project described in a waiver of the provisions of title
XIX of the federal social security act granted to the state of New York
and dated July fifteenth, nineteen hundred ninety-seven, may continue to
be used to characterize the insurance programs in sections four thousand
three hundred twenty-one-a, four thousand three hundred twenty-two-a,
four thousand three hundred twenty-six and four thousand three hundred
twenty-seven of the insurance law, which are successor programs to these
programs.
(c) Up to seventy-eight million dollars shall be reserved and accumu-
lated from year to year from the pool for the period January first,
nineteen hundred ninety-seven through December thirty-first, nineteen
hundred ninety-seven, for purposes of public health programs, up to
seventy-six million dollars shall be reserved and accumulated from year
to year from the pools for the periods January first, nineteen hundred
ninety-eight through December thirty-first, nineteen hundred ninety-
eight and January first, nineteen hundred ninety-nine through December
thirty-first, nineteen hundred ninety-nine, up to eighty-four million
dollars shall be reserved and accumulated from year to year from the
pools for the period January first, two thousand through December thir-
ty-first, two thousand, up to eighty-five million dollars shall be
reserved and accumulated from year to year from the pools for the period
January first, two thousand one through December thirty-first, two thou-
sand one, up to eighty-six million dollars shall be reserved and accumu-
lated from year to year from the pools for the period January first, two
S. 9007--C 19 A. 10007--C
thousand two through December thirty-first, two thousand two, up to
eighty-six million one hundred fifty thousand dollars shall be reserved
and accumulated from year to year from the pools for the period January
first, two thousand three through December thirty-first, two thousand
three, up to fifty-eight million seven hundred eighty thousand dollars
shall be reserved and accumulated from year to year from the pools for
the period January first, two thousand four through December thirty-
first, two thousand four, up to sixty-eight million seven hundred thirty
thousand dollars shall be reserved and accumulated from year to year
from the pools or the health care reform act (HCRA) resources fund,
whichever is applicable, for the period January first, two thousand five
through December thirty-first, two thousand five, up to ninety-four
million three hundred fifty thousand dollars shall be reserved and accu-
mulated from year to year from the health care reform act (HCRA)
resources fund for the period January first, two thousand six through
December thirty-first, two thousand six, up to seventy million nine
hundred thirty-nine thousand dollars shall be reserved and accumulated
from year to year from the health care reform act (HCRA) resources fund
for the period January first, two thousand seven through December thir-
ty-first, two thousand seven, up to fifty-five million six hundred
eighty-nine thousand dollars annually shall be reserved and accumulated
from year to year from the health care reform act (HCRA) resources fund
for the period January first, two thousand eight through December thir-
ty-first, two thousand ten, up to thirteen million nine hundred twenty-
two thousand dollars shall be reserved and accumulated from year to year
from the health care reform act (HCRA) resources fund for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven, and for periods on and after April first, two thousand
eleven, up to funding amounts specified below and shall be available,
including income from invested funds, for:
(i) deposit by the commissioner, within amounts appropriated, and the
state comptroller is hereby authorized and directed to receive for
deposit to, to the credit of the department of health's special revenue
fund - other, hospital based grants program account or the health care
reform act (HCRA) resources fund, whichever is applicable, for purposes
of services and expenses related to general hospital based grant
programs, up to twenty-two million dollars annually from the nineteen
hundred ninety-seven pool, nineteen hundred ninety-eight pool, nineteen
hundred ninety-nine pool, two thousand pool, two thousand one pool and
two thousand two pool, respectively, up to twenty-two million dollars
from the two thousand three pool, up to ten million dollars for the
period January first, two thousand four through December thirty-first,
two thousand four, up to eleven million dollars for the period January
first, two thousand five through December thirty-first, two thousand
five, up to twenty-two million dollars for the period January first, two
thousand six through December thirty-first, two thousand six, up to
twenty-two million ninety-seven thousand dollars annually for the period
January first, two thousand seven through December thirty-first, two
thousand ten, up to five million five hundred twenty-four thousand
dollars for the period January first, two thousand eleven through March
thirty-first, two thousand eleven, up to thirteen million four hundred
forty-five thousand dollars for the period April first, two thousand
eleven through March thirty-first, two thousand twelve, and up to thir-
teen million three hundred seventy-five thousand dollars each state
fiscal year for the period April first, two thousand twelve through
March thirty-first, two thousand fourteen;
S. 9007--C 20 A. 10007--C
(ii) deposit by the commissioner, within amounts appropriated, and the
state comptroller is hereby authorized and directed to receive for
deposit to, to the credit of the emergency medical services training
account established in section ninety-seven-q of the state finance law
or the health care reform act (HCRA) resources fund, whichever is appli-
cable, up to sixteen million dollars on an annualized basis for the
periods January first, nineteen hundred ninety-seven through December
thirty-first, nineteen hundred ninety-nine, up to twenty million dollars
for the period January first, two thousand through December thirty-
first, two thousand, up to twenty-one million dollars for the period
January first, two thousand one through December thirty-first, two thou-
sand one, up to twenty-two million dollars for the period January first,
two thousand two through December thirty-first, two thousand two, up to
twenty-two million five hundred fifty thousand dollars for the period
January first, two thousand three through December thirty-first, two
thousand three, up to nine million six hundred eighty thousand dollars
for the period January first, two thousand four through December thir-
ty-first, two thousand four, up to twelve million one hundred thirty
thousand dollars for the period January first, two thousand five through
December thirty-first, two thousand five, up to twenty-four million two
hundred fifty thousand dollars for the period January first, two thou-
sand six through December thirty-first, two thousand six, up to twenty
million four hundred ninety-two thousand dollars annually for the period
January first, two thousand seven through December thirty-first, two
thousand ten, up to five million one hundred twenty-three thousand
dollars for the period January first, two thousand eleven through March
thirty-first, two thousand eleven, up to eighteen million three hundred
fifty thousand dollars for the period April first, two thousand eleven
through March thirty-first, two thousand twelve, up to eighteen million
nine hundred fifty thousand dollars for the period April first, two
thousand twelve through March thirty-first, two thousand thirteen, up to
nineteen million four hundred nineteen thousand dollars for the period
April first, two thousand thirteen through March thirty-first, two thou-
sand fourteen, and up to nineteen million six hundred fifty-nine thou-
sand seven hundred dollars each state fiscal year for the period of
April first, two thousand fourteen through March thirty-first, two thou-
sand [twenty-six] TWENTY-NINE;
(iii) priority distributions by the commissioner up to thirty-two
million dollars on an annualized basis for the period January first, two
thousand through December thirty-first, two thousand four, up to thir-
ty-eight million dollars on an annualized basis for the period January
first, two thousand five through December thirty-first, two thousand
six, up to eighteen million two hundred fifty thousand dollars for the
period January first, two thousand seven through December thirty-first,
two thousand seven, up to three million dollars annually for the period
January first, two thousand eight through December thirty-first, two
thousand ten, up to seven hundred fifty thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven, up to two million nine hundred thousand dollars each state
fiscal year for the period April first, two thousand eleven through
March thirty-first, two thousand fourteen, and up to two million nine
hundred thousand dollars each state fiscal year for the period April
first, two thousand fourteen through March thirty-first, two thousand
[twenty-six] TWENTY-NINE to be allocated (A) for the purposes estab-
lished pursuant to subparagraph (ii) of paragraph (f) of subdivision
nineteen of section twenty-eight hundred seven-c of this article as in
S. 9007--C 21 A. 10007--C
effect on December thirty-first, nineteen hundred ninety-six and as may
thereafter be amended, up to fifteen million dollars annually for the
periods January first, two thousand through December thirty-first, two
thousand four, up to twenty-one million dollars annually for the period
January first, two thousand five through December thirty-first, two
thousand six, and up to seven million five hundred thousand dollars for
the period January first, two thousand seven through March thirty-first,
two thousand seven;
(B) pursuant to a memorandum of understanding entered into by the
commissioner, the majority leader of the senate and the speaker of the
assembly, for the purposes outlined in such memorandum upon the recom-
mendation of the majority leader of the senate, up to eight million
five hundred thousand dollars annually for the period January first, two
thousand through December thirty-first, two thousand six, and up to four
million two hundred fifty thousand dollars for the period January first,
two thousand seven through June thirtieth, two thousand seven, and for
the purposes outlined in such memorandum upon the recommendation of the
speaker of the assembly, up to eight million five hundred thousand
dollars annually for the periods January first, two thousand through
December thirty-first, two thousand six, and up to four million two
hundred fifty thousand dollars for the period January first, two thou-
sand seven through June thirtieth, two thousand seven; and
(C) for services and expenses, including grants, related to emergency
assistance distributions as designated by the commissioner. Notwith-
standing section one hundred twelve or one hundred sixty-three of the
state finance law or any other contrary provision of law, such distrib-
utions shall be limited to providers or programs where, as determined by
the commissioner, emergency assistance is vital to protect the life or
safety of patients, to ensure the retention of facility caregivers or
other staff, or in instances where health facility operations are jeop-
ardized, or where the public health is jeopardized or other emergency
situations exist, up to three million dollars annually for the period
April first, two thousand seven through March thirty-first, two thousand
eleven, up to two million nine hundred thousand dollars each state
fiscal year for the period April first, two thousand eleven through
March thirty-first, two thousand fourteen, up to two million nine
hundred thousand dollars each state fiscal year for the period April
first, two thousand fourteen through March thirty-first, two thousand
seventeen, up to two million nine hundred thousand dollars each state
fiscal year for the period April first, two thousand seventeen through
March thirty-first, two thousand twenty, up to two million nine hundred
thousand dollars each state fiscal year for the period April first, two
thousand twenty through March thirty-first, two thousand twenty-three,
[and] up to two million nine hundred thousand dollars each state fiscal
year for the period April first, two thousand twenty-three through March
thirty-first, two thousand twenty-six, AND UP TO TWO MILLION NINE
HUNDRED THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL
FIRST, TWO THOUSAND TWENTY-SIX THROUGH MARCH THIRTY-FIRST, TWO THOUSAND
TWENTY-NINE. Upon any distribution of such funds, the commissioner shall
immediately notify the chair and ranking minority member of the senate
finance committee, the assembly ways and means committee, the senate
committee on health, and the assembly committee on health;
(iv) distributions by the commissioner related to poison control
centers pursuant to subdivision seven of section twenty-five hundred-d
of this chapter, up to five million dollars for the period January
first, nineteen hundred ninety-seven through December thirty-first,
S. 9007--C 22 A. 10007--C
nineteen hundred ninety-seven, up to three million dollars on an annual-
ized basis for the periods during the period January first, nineteen
hundred ninety-eight through December thirty-first, nineteen hundred
ninety-nine, up to five million dollars annually for the periods January
first, two thousand through December thirty-first, two thousand two, up
to four million six hundred thousand dollars annually for the periods
January first, two thousand three through December thirty-first, two
thousand four, up to five million one hundred thousand dollars for the
period January first, two thousand five through December thirty-first,
two thousand six annually, up to five million one hundred thousand
dollars annually for the period January first, two thousand seven
through December thirty-first, two thousand nine, up to three million
six hundred thousand dollars for the period January first, two thousand
ten through December thirty-first, two thousand ten, up to seven hundred
seventy-five thousand dollars for the period January first, two thousand
eleven through March thirty-first, two thousand eleven, up to two
million five hundred thousand dollars each state fiscal year for the
period April first, two thousand eleven through March thirty-first, two
thousand fourteen, up to three million dollars each state fiscal year
for the period April first, two thousand fourteen through March thirty-
first, two thousand seventeen, up to three million dollars each state
fiscal year for the period April first, two thousand seventeen through
March thirty-first, two thousand twenty, up to three million dollars
each state fiscal year for the period April first, two thousand twenty
through March thirty-first, two thousand twenty-three, [and] up to three
million dollars each state fiscal year for the period April first, two
thousand twenty-three through March thirty-first, two thousand twenty-
six, AND UP TO THREE MILLION DOLLARS EACH STATE FISCAL YEAR FOR THE
PERIOD APRIL FIRST, TWO THOUSAND TWENTY-SIX THROUGH MARCH THIRTY-FIRST,
TWO THOUSAND TWENTY-NINE; and
(v) deposit by the commissioner, within amounts appropriated, and the
state comptroller is hereby authorized and directed to receive for
deposit to, to the credit of the department of health's special revenue
fund - other, miscellaneous special revenue fund - 339 maternal and
child HIV services account or the health care reform act (HCRA)
resources fund, whichever is applicable, for purposes of a special
program for HIV services for women and children, including adolescents
pursuant to section twenty-five hundred-f-one of this chapter, up to
five million dollars annually for the periods January first, two thou-
sand through December thirty-first, two thousand two, up to five million
dollars for the period January first, two thousand three through Decem-
ber thirty-first, two thousand three, up to two million five hundred
thousand dollars for the period January first, two thousand four through
December thirty-first, two thousand four, up to two million five hundred
thousand dollars for the period January first, two thousand five through
December thirty-first, two thousand five, up to five million dollars for
the period January first, two thousand six through December thirty-
first, two thousand six, up to five million dollars annually for the
period January first, two thousand seven through December thirty-first,
two thousand ten, up to one million two hundred fifty thousand dollars
for the period January first, two thousand eleven through March thirty-
first, two thousand eleven, and up to five million dollars each state
fiscal year for the period April first, two thousand eleven through
March thirty-first, two thousand fourteen;
(d) (i) An amount of up to twenty million dollars annually for the
period January first, two thousand through December thirty-first, two
S. 9007--C 23 A. 10007--C
thousand six, up to ten million dollars for the period January first,
two thousand seven through June thirtieth, two thousand seven, up to
twenty million dollars annually for the period January first, two thou-
sand eight through December thirty-first, two thousand ten, up to five
million dollars for the period January first, two thousand eleven
through March thirty-first, two thousand eleven, up to nineteen million
six hundred thousand dollars each state fiscal year for the period April
first, two thousand eleven through March thirty-first, two thousand
fourteen, up to nineteen million six hundred thousand dollars each state
fiscal year for the period April first, two thousand fourteen through
March thirty-first, two thousand seventeen, up to nineteen million six
hundred thousand dollars each state fiscal year for the period of April
first, two thousand seventeen through March thirty-first, two thousand
twenty, up to nineteen million six hundred thousand dollars each state
fiscal year for the period of April first, two thousand twenty through
March thirty-first, two thousand twenty-three, [and] up to nineteen
million six hundred thousand dollars each state fiscal year for the
period of April first, two thousand twenty-three through March thirty-
first, two thousand twenty-six, AND UP TO NINETEEN MILLION SIX HUNDRED
THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD OF APRIL FIRST,
TWO THOUSAND TWENTY-SIX THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWEN-
TY-NINE, shall be transferred to the health facility restructuring pool
established pursuant to section twenty-eight hundred fifteen of this
article;
(ii) provided, however, amounts transferred pursuant to subparagraph
(i) of this paragraph may be reduced in an amount to be approved by the
director of the budget to reflect the amount received from the federal
government under the state's 1115 waiver which is directed under its
terms and conditions to the health facility restructuring program.
(f) Funds shall be accumulated and transferred from as follows:
(i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen hundred ninety-seven,
(A) thirty-four million six hundred thousand dollars shall be trans-
ferred to funds reserved and accumulated pursuant to paragraph (b) of
subdivision nineteen of section twenty-eight hundred seven-c of this
article, and (B) eighty-two million dollars shall be transferred and
deposited and credited to the credit of the state general fund medical
assistance local assistance account;
(ii) from the pool for the period January first, nineteen hundred
ninety-eight through December thirty-first, nineteen hundred ninety-
eight, eighty-two million dollars shall be transferred and deposited and
credited to the credit of the state general fund medical assistance
local assistance account;
(iii) from the pool for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
eighty-two million dollars shall be transferred and deposited and cred-
ited to the credit of the state general fund medical assistance local
assistance account;
(iv) from the pool or the health care reform act (HCRA) resources
fund, whichever is applicable, for the period January first, two thou-
sand through December thirty-first, two thousand four, eighty-two
million dollars annually, and for the period January first, two thousand
five through December thirty-first, two thousand five, eighty-two
million dollars, and for the period January first, two thousand six
through December thirty-first, two thousand six, eighty-two million
dollars, and for the period January first, two thousand seven through
S. 9007--C 24 A. 10007--C
December thirty-first, two thousand seven, eighty-two million dollars,
and for the period January first, two thousand eight through December
thirty-first, two thousand eight, ninety million seven hundred thousand
dollars shall be deposited by the commissioner, and the state comp-
troller is hereby authorized and directed to receive for deposit to the
credit of the state special revenue fund - other, HCRA transfer fund,
medical assistance account;
(v) from the health care reform act (HCRA) resources fund for the
period January first, two thousand nine through December thirty-first,
two thousand nine, one hundred eight million nine hundred seventy-five
thousand dollars, and for the period January first, two thousand ten
through December thirty-first, two thousand ten, one hundred twenty-six
million one hundred thousand dollars, for the period January first, two
thousand eleven through March thirty-first, two thousand eleven, twenty
million five hundred thousand dollars, and for each state fiscal year
for the period April first, two thousand eleven through March thirty-
first, two thousand fourteen, one hundred forty-six million four hundred
thousand dollars, shall be deposited by the commissioner, and the state
comptroller is hereby authorized and directed to receive for deposit, to
the credit of the state special revenue fund - other, HCRA transfer
fund, medical assistance account.
(g) Funds shall be transferred to primary health care services pools
created by the commissioner, and shall be available, including income
from invested funds, for distributions in accordance with former section
twenty-eight hundred seven-bb of this article from the respective health
care initiatives pools for the following periods in the following
percentage amounts of funds remaining after allocations in accordance
with paragraphs (a) through (f) of this subdivision:
(i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen hundred ninety-seven,
fifteen and eighty-seven-hundredths percent;
(ii) from the pool for the period January first, nineteen hundred
ninety-eight through December thirty-first, nineteen hundred ninety-
eight, fifteen and eighty-seven-hundredths percent; and
(iii) from the pool for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
sixteen and thirteen-hundredths percent.
(h) Funds shall be reserved and accumulated from year to year by the
commissioner and shall be available, including income from invested
funds, for purposes of primary care education and training pursuant to
article nine of this chapter from the respective health care initiatives
pools established for the following periods in the following percentage
amounts of funds remaining after allocations in accordance with para-
graphs (a) through (f) of this subdivision and shall be available for
distributions as follows:
(i) funds shall be reserved and accumulated:
(A) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen hundred ninety-seven,
six and thirty-five-hundredths percent;
(B) from the pool for the period January first, nineteen hundred nine-
ty-eight through December thirty-first, nineteen hundred ninety-eight,
six and thirty-five-hundredths percent; and
(C) from the pool for the period January first, nineteen hundred nine-
ty-nine through December thirty-first, nineteen hundred ninety-nine, six
and forty-five-hundredths percent;
S. 9007--C 25 A. 10007--C
(ii) funds shall be available for distributions including income from
invested funds as follows:
(A) for purposes of the primary care physician loan repayment program
in accordance with section nine hundred three of this chapter, up to
five million dollars on an annualized basis;
(B) for purposes of the primary care practitioner scholarship program
in accordance with section nine hundred four of this chapter, up to two
million dollars on an annualized basis;
(C) for purposes of minority participation in medical education grants
in accordance with section nine hundred six of this chapter, up to one
million dollars on an annualized basis; and
(D) provided, however, that the commissioner may reallocate any funds
remaining or unallocated for distributions for the primary care practi-
tioner scholarship program in accordance with section nine hundred four
of this chapter.
(i) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for distrib-
utions in accordance with section twenty-nine hundred fifty-two and
section twenty-nine hundred fifty-eight of this chapter for rural health
care delivery development and rural health care access development,
respectively, from the respective health care initiatives pools or the
health care reform act (HCRA) resources fund, whichever is applicable,
for the following periods in the following percentage amounts of funds
remaining after allocations in accordance with paragraphs (a) through
(f) of this subdivision, and for periods on and after January first, two
thousand, in the following amounts:
(i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen hundred ninety-seven,
thirteen and forty-nine-hundredths percent;
(ii) from the pool for the period January first, nineteen hundred
ninety-eight through December thirty-first, nineteen hundred ninety-
eight, thirteen and forty-nine-hundredths percent;
(iii) from the pool for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
thirteen and seventy-one-hundredths percent;
(iv) from the pool for the periods January first, two thousand through
December thirty-first, two thousand two, seventeen million dollars annu-
ally, and for the period January first, two thousand three through
December thirty-first, two thousand three, up to fifteen million eight
hundred fifty thousand dollars;
(v) from the pool or the health care reform act (HCRA) resources fund,
whichever is applicable, for the period January first, two thousand four
through December thirty-first, two thousand four, up to fifteen million
eight hundred fifty thousand dollars, for the period January first, two
thousand five through December thirty-first, two thousand five, up to
nineteen million two hundred thousand dollars, for the period January
first, two thousand six through December thirty-first, two thousand six,
up to nineteen million two hundred thousand dollars, for the period
January first, two thousand seven through December thirty-first, two
thousand ten, up to eighteen million one hundred fifty thousand dollars
annually, for the period January first, two thousand eleven through
March thirty-first, two thousand eleven, up to four million five hundred
thirty-eight thousand dollars, for each state fiscal year for the period
April first, two thousand eleven through March thirty-first, two thou-
sand fourteen, up to sixteen million two hundred thousand dollars, up to
sixteen million two hundred thousand dollars each state fiscal year for
S. 9007--C 26 A. 10007--C
the period April first, two thousand fourteen through March thirty-
first, two thousand seventeen, up to sixteen million two hundred thou-
sand dollars each state fiscal year for the period April first, two
thousand seventeen through March thirty-first, two thousand twenty, up
to sixteen million two hundred thousand dollars each state fiscal year
for the period April first, two thousand twenty through March thirty-
first, two thousand twenty-three, [and] up to sixteen million two
hundred thousand dollars each state fiscal year for the period April
first, two thousand twenty-three through March thirty-first, two thou-
sand twenty-six, AND UP TO SIXTEEN MILLION TWO HUNDRED THOUSAND DOLLARS
EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-
SIX THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-NINE.
(j) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for purposes
of distributions related to health information and health care quality
improvement pursuant to former section twenty-eight hundred seven-n of
this article from the respective health care initiatives pools estab-
lished for the following periods in the following percentage amounts of
funds remaining after allocations in accordance with paragraphs (a)
through (f) of this subdivision:
(i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen hundred ninety-seven,
six and thirty-five-hundredths percent;
(ii) from the pool for the period January first, nineteen hundred
ninety-eight through December thirty-first, nineteen hundred ninety-
eight, six and thirty-five-hundredths percent; and
(iii) from the pool for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
six and forty-five-hundredths percent.
(k) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for allo-
cations and distributions in accordance with section twenty-eight
hundred seven-p of this article for diagnostic and treatment center
uncompensated care from the respective health care initiatives pools or
the health care reform act (HCRA) resources fund, whichever is applica-
ble, for the following periods in the following percentage amounts of
funds remaining after allocations in accordance with paragraphs (a)
through (f) of this subdivision, and for periods on and after January
first, two thousand, in the following amounts:
(i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen hundred ninety-seven,
thirty-eight and one-tenth percent;
(ii) from the pool for the period January first, nineteen hundred
ninety-eight through December thirty-first, nineteen hundred ninety-
eight, thirty-eight and one-tenth percent;
(iii) from the pool for the period January first, nineteen hundred
ninety-nine through December thirty-first, nineteen hundred ninety-nine,
thirty-eight and seventy-one-hundredths percent;
(iv) from the pool for the periods January first, two thousand through
December thirty-first, two thousand two, forty-eight million dollars
annually, and for the period January first, two thousand three through
June thirtieth, two thousand three, twenty-four million dollars;
(v) (A) from the pool or the health care reform act (HCRA) resources
fund, whichever is applicable, for the period July first, two thousand
three through December thirty-first, two thousand three, up to six
million dollars, for the period January first, two thousand four through
S. 9007--C 27 A. 10007--C
December thirty-first, two thousand six, up to twelve million dollars
annually, for the period January first, two thousand seven through
December thirty-first, two thousand thirteen, up to forty-eight million
dollars annually, for the period January first, two thousand fourteen
through March thirty-first, two thousand fourteen, up to twelve million
dollars for the period April first, two thousand fourteen through March
thirty-first, two thousand seventeen, up to forty-eight million dollars
annually, for the period April first, two thousand seventeen through
March thirty-first, two thousand twenty, up to forty-eight million
dollars annually, for the period April first, two thousand twenty
through March thirty-first, two thousand twenty-three, up to forty-eight
million dollars annually, [and] for the period April first, two thousand
twenty-three through March thirty-first, two thousand twenty-six, up to
forty-eight million dollars annually, AND FOR THE PERIOD APRIL FIRST,
TWO THOUSAND TWENTY-SIX THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWEN-
TY-NINE, UP TO FORTY-EIGHT MILLION DOLLARS ANNUALLY;
(B) from the health care reform act (HCRA) resources fund for the
period January first, two thousand six through December thirty-first,
two thousand six, an additional seven million five hundred thousand
dollars, for the period January first, two thousand seven through Decem-
ber thirty-first, two thousand thirteen, an additional seven million
five hundred thousand dollars annually, for the period January first,
two thousand fourteen through March thirty-first, two thousand fourteen,
an additional one million eight hundred seventy-five thousand dollars,
for the period April first, two thousand fourteen through March thirty-
first, two thousand seventeen, an additional seven million five hundred
thousand dollars annually, for the period April first, two thousand
seventeen through March thirty-first, two thousand twenty, an additional
seven million five hundred thousand dollars annually, for the period
April first, two thousand twenty through March thirty-first, two thou-
sand twenty-three, an additional seven million five hundred thousand
dollars annually, [and] for the period April first, two thousand twen-
ty-three through March thirty-first, two thousand twenty-six, an addi-
tional seven million five hundred thousand dollars annually, AND FOR THE
PERIOD APRIL FIRST, TWO THOUSAND TWENTY-SIX THROUGH MARCH THIRTY-FIRST,
TWO THOUSAND TWENTY-NINE, AN ADDITIONAL SEVEN MILLION FIVE HUNDRED THOU-
SAND DOLLARS ANNUALLY for voluntary non-profit diagnostic and treatment
center uncompensated care in accordance with subdivision four-c of
section twenty-eight hundred seven-p of this article; and
(vi) funds reserved and accumulated pursuant to this paragraph for
periods on and after July first, two thousand three, shall be deposited
by the commissioner, within amounts appropriated, and the state comp-
troller is hereby authorized and directed to receive for deposit to the
credit of the state special revenue funds - other, HCRA transfer fund,
medical assistance account, for purposes of funding the state share of
rate adjustments made pursuant to section twenty-eight hundred seven-p
of this article, provided, however, that in the event federal financial
participation is not available for rate adjustments made pursuant to
paragraph (b) of subdivision one of section twenty-eight hundred seven-p
of this article, funds shall be distributed pursuant to paragraph (a) of
subdivision one of section twenty-eight hundred seven-p of this article
from the respective health care initiatives pools or the health care
reform act (HCRA) resources fund, whichever is applicable.
(l) Funds shall be reserved and accumulated from year to year by the
commissioner and shall be available, including income from invested
funds, for transfer to and allocation for services and expenses for the
S. 9007--C 28 A. 10007--C
payment of benefits to recipients of drugs under the AIDS drug assist-
ance program (ADAP) - HIV uninsured care program as administered by
Health Research Incorporated from the respective health care initi-
atives pools or the health care reform act (HCRA) resources fund, which-
ever is applicable, established for the following periods in the follow-
ing percentage amounts of funds remaining after allocations in
accordance with paragraphs (a) through (f) of this subdivision, and for
periods on and after January first, two thousand, in the following
amounts:
(i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen hundred ninety-seven,
nine and fifty-two-hundredths percent;
(ii) from the pool for the period January first, nineteen hundred
ninety-eight through December thirty-first, nineteen hundred ninety-
eight, nine and fifty-two-hundredths percent;
(iii) from the pool for the period January first, nineteen hundred
ninety-nine and December thirty-first, nineteen hundred ninety-nine,
nine and sixty-eight-hundredths percent;
(iv) from the pool for the periods January first, two thousand through
December thirty-first, two thousand two, up to twelve million dollars
annually, and for the period January first, two thousand three through
December thirty-first, two thousand three, up to forty million dollars;
and
(v) from the pool or the health care reform act (HCRA) resources fund,
whichever is applicable, for the periods January first, two thousand
four through December thirty-first, two thousand four, up to fifty-six
million dollars, for the period January first, two thousand five through
December thirty-first, two thousand six, up to sixty million dollars
annually, for the period January first, two thousand seven through
December thirty-first, two thousand ten, up to sixty million dollars
annually, for the period January first, two thousand eleven through
March thirty-first, two thousand eleven, up to fifteen million dollars,
each state fiscal year for the period April first, two thousand eleven
through March thirty-first, two thousand fourteen, up to forty-two
million three hundred thousand dollars and up to forty-one million fifty
thousand dollars each state fiscal year for the period April first, two
thousand fourteen through March thirty-first, two thousand [twenty-six]
TWENTY-NINE.
(m) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for purposes
of distributions pursuant to section twenty-eight hundred seven-r of
this article for cancer related services from the respective health care
initiatives pools or the health care reform act (HCRA) resources fund,
whichever is applicable, established for the following periods in the
following percentage amounts of funds remaining after allocations in
accordance with paragraphs (a) through (f) of this subdivision, and for
periods on and after January first, two thousand, in the following
amounts:
(i) from the pool for the period January first, nineteen hundred nine-
ty-seven through December thirty-first, nineteen hundred ninety-seven,
seven and ninety-four-hundredths percent;
(ii) from the pool for the period January first, nineteen hundred
ninety-eight through December thirty-first, nineteen hundred ninety-
eight, seven and ninety-four-hundredths percent;
S. 9007--C 29 A. 10007--C
(iii) from the pool for the period January first, nineteen hundred
ninety-nine and December thirty-first, nineteen hundred ninety-nine, six
and forty-five-hundredths percent;
(iv) from the pool for the period January first, two thousand through
December thirty-first, two thousand two, up to ten million dollars on an
annual basis;
(v) from the pool for the period January first, two thousand three
through December thirty-first, two thousand four, up to eight million
nine hundred fifty thousand dollars on an annual basis;
(vi) from the pool or the health care reform act (HCRA) resources
fund, whichever is applicable, for the period January first, two thou-
sand five through December thirty-first, two thousand six, up to ten
million fifty thousand dollars on an annual basis, for the period Janu-
ary first, two thousand seven through December thirty-first, two thou-
sand ten, up to nineteen million dollars annually, and for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven, up to four million seven hundred fifty thousand dollars.
(n) Funds shall be accumulated and transferred from the health care
reform act (HCRA) resources fund as follows: for the period April first,
two thousand seven through March thirty-first, two thousand eight, and
on an annual basis for the periods April first, two thousand eight
through November thirtieth, two thousand nine, funds within amounts
appropriated shall be transferred and deposited and credited to the
credit of the state special revenue funds - other, HCRA transfer fund,
medical assistance account, for purposes of funding the state share of
rate adjustments made to public and voluntary hospitals in accordance
with paragraphs (i) and (j) of subdivision one of section twenty-eight
hundred seven-c of this article.
2. Notwithstanding any inconsistent provision of law, rule or regu-
lation, any funds accumulated in the health care initiatives pools
pursuant to paragraph (b) of subdivision nine of section twenty-eight
hundred seven-j of this article, as a result of surcharges, assessments
or other obligations during the periods January first, nineteen hundred
ninety-seven through December thirty-first, nineteen hundred ninety-
nine, which are unused or uncommitted for distributions pursuant to this
section shall be reserved and accumulated from year to year by the
commissioner and, within amounts appropriated, transferred and deposited
into the special revenue funds - other, miscellaneous special revenue
fund - 339, child health insurance account or any successor fund or
account, for purposes of distributions to implement the child health
insurance program established pursuant to sections twenty-five hundred
ten and twenty-five hundred eleven of this chapter for periods on and
after January first, two thousand one; provided, however, funds reserved
and accumulated for priority distributions pursuant to subparagraph
(iii) of paragraph (c) of subdivision one of this section shall not be
transferred and deposited into such account pursuant to this subdivi-
sion; and provided further, however, that any unused or uncommitted pool
funds accumulated and allocated pursuant to paragraph (j) of subdivision
one of this section shall be distributed for purposes of the health
information and quality improvement act of 2000.
3. Revenue from distributions pursuant to this section shall not be
included in gross revenue received for purposes of the assessments
pursuant to subdivision eighteen of section twenty-eight hundred seven-c
of this article, subject to the provisions of paragraph (e) of subdivi-
sion eighteen of section twenty-eight hundred seven-c of this article,
and shall not be included in gross revenue received for purposes of the
S. 9007--C 30 A. 10007--C
assessments pursuant to section twenty-eight hundred seven-d of this
article, subject to the provisions of subdivision twelve of section
twenty-eight hundred seven-d of this article.
§ 6. Intentionally omitted.
§ 7. Intentionally omitted.
§ 8. Intentionally omitted.
§ 9. Intentionally omitted.
§ 10. Paragraphs (b), (c), (d), (f) and (g) of subdivision 5-a of
section 2807-m of the public health law, as amended by section 6 of part
C of chapter 57 of the laws of 2023, are amended to read as follows:
(b) Empire clinical research investigator program (ECRIP). Nine
million one hundred twenty thousand dollars annually for the period
January first, two thousand nine through December thirty-first, two
thousand ten, and two million two hundred eighty thousand dollars for
the period January first, two thousand eleven, through March thirty-
first, two thousand eleven, nine million one hundred twenty thousand
dollars each state fiscal year for the period April first, two thousand
eleven through March thirty-first, two thousand fourteen, up to eight
million six hundred twelve thousand dollars each state fiscal year for
the period April first, two thousand fourteen through March thirty-
first, two thousand seventeen, up to eight million six hundred twelve
thousand dollars each state fiscal year for the period April first, two
thousand seventeen through March thirty-first, two thousand twenty, up
to eight million six hundred twelve thousand dollars each state fiscal
year for the period April first, two thousand twenty through March thir-
ty-first, two thousand twenty-three, and up to eight million six hundred
twelve thousand dollars each state fiscal year for the period April
first, two thousand twenty-three through March thirty-first, two thou-
sand [twenty-six] TWENTY-NINE, shall be set aside and reserved by the
commissioner from the regional pools established pursuant to subdivision
two of this section to be allocated regionally with two-thirds of the
available funding going to New York city and one-third of the available
funding going to the rest of the state and shall be available for
distribution as follows:
Distributions shall first be made to consortia and teaching general
hospitals for the empire clinical research investigator program (ECRIP)
to help secure federal funding for biomedical research, train clinical
researchers, recruit national leaders as faculty to act as mentors, and
train residents and fellows in biomedical research skills based on
hospital-specific data submitted to the commissioner by consortia and
teaching general hospitals in accordance with clause (G) of this subpar-
agraph. Such distributions shall be made in accordance with the follow-
ing methodology:
(A) The greatest number of clinical research positions for which a
consortium or teaching general hospital may be funded pursuant to this
subparagraph shall be one percent of the total number of residents
training at the consortium or teaching general hospital on July first,
two thousand eight for the period January first, two thousand nine
through December thirty-first, two thousand nine rounded up to the near-
est one position.
(B) Distributions made to a consortium or teaching general hospital
shall equal the product of the total number of clinical research posi-
tions submitted by a consortium or teaching general hospital and
accepted by the commissioner as meeting the criteria set forth in para-
graph (b) of subdivision one of this section, subject to the reduction
S. 9007--C 31 A. 10007--C
calculation set forth in clause (C) of this subparagraph, times one
hundred ten thousand dollars.
(C) If the dollar amount for the total number of clinical research
positions in the region calculated pursuant to clause (B) of this
subparagraph exceeds the total amount appropriated for purposes of this
paragraph, including clinical research positions that continue from and
were funded in prior distribution periods, the commissioner shall elimi-
nate one-half of the clinical research positions submitted by each
consortium or teaching general hospital rounded down to the nearest one
position. Such reduction shall be repeated until the dollar amount for
the total number of clinical research positions in the region does not
exceed the total amount appropriated for purposes of this paragraph. If
the repeated reduction of the total number of clinical research posi-
tions in the region by one-half does not render a total funding amount
that is equal to or less than the total amount reserved for that region
within the appropriation, the funding for each clinical research posi-
tion in that region shall be reduced proportionally in one thousand
dollar increments until the total dollar amount for the total number of
clinical research positions in that region does not exceed the total
amount reserved for that region within the appropriation. Any reduction
in funding will be effective for the duration of the award. No clinical
research positions that continue from and were funded in prior distrib-
ution periods shall be eliminated or reduced by such methodology.
(D) Each consortium or teaching general hospital shall receive its
annual distribution amount in accordance with the following:
(I) Each consortium or teaching general hospital with a one-year ECRIP
award shall receive its annual distribution amount in full upon
completion of the requirements set forth in items (I) and (II) of clause
(G) of this subparagraph. The requirements set forth in items (IV) and
(V) of clause (G) of this subparagraph must be completed by the consor-
tium or teaching general hospital in order for the consortium or teach-
ing general hospital to be eligible to apply for ECRIP funding in any
subsequent funding cycle.
(II) Each consortium or teaching general hospital with a two-year
ECRIP award shall receive its first annual distribution amount in full
upon completion of the requirements set forth in items (I) and (II) of
clause (G) of this subparagraph. Each consortium or teaching general
hospital will receive its second annual distribution amount in full upon
completion of the requirements set forth in item (III) of clause (G) of
this subparagraph. The requirements set forth in items (IV) and (V) of
clause (G) of this subparagraph must be completed by the consortium or
teaching general hospital in order for the consortium or teaching gener-
al hospital to be eligible to apply for ECRIP funding in any subsequent
funding cycle.
(E) Each consortium or teaching general hospital receiving distrib-
utions pursuant to this subparagraph shall reserve seventy-five thousand
dollars to primarily fund salary and fringe benefits of the clinical
research position with the remainder going to fund the development of
faculty who are involved in biomedical research, training and clinical
care.
(F) Undistributed or returned funds available to fund clinical
research positions pursuant to this paragraph for a distribution period
shall be available to fund clinical research positions in a subsequent
distribution period.
(G) In order to be eligible for distributions pursuant to this subpar-
agraph, each consortium and teaching general hospital shall provide to
S. 9007--C 32 A. 10007--C
the commissioner by July first of each distribution period, the follow-
ing data and information on a hospital-specific basis. Such data and
information shall be certified as to accuracy and completeness by the
chief executive officer, chief financial officer or chair of the consor-
tium governing body of each consortium or teaching general hospital and
shall be maintained by each consortium and teaching general hospital for
five years from the date of submission:
(I) For each clinical research position, information on the type,
scope, training objectives, institutional support, clinical research
experience of the sponsor-mentor, plans for submitting research outcomes
to peer reviewed journals and at scientific meetings, including a meet-
ing sponsored by the department, the name of a principal contact person
responsible for tracking the career development of researchers placed in
clinical research positions, as defined in paragraph (c) of subdivision
one of this section, and who is authorized to certify to the commission-
er that all the requirements of the clinical research training objec-
tives set forth in this subparagraph shall be met. Such certification
shall be provided by July first of each distribution period;
(II) For each clinical research position, information on the name,
citizenship status, medical education and training, and medical license
number of the researcher, if applicable, shall be provided by December
thirty-first of the calendar year following the distribution period;
(III) Information on the status of the clinical research plan, accom-
plishments, changes in research activities, progress, and performance of
the researcher shall be provided upon completion of one-half of the
award term;
(IV) A final report detailing training experiences, accomplishments,
activities and performance of the clinical researcher, and data, meth-
ods, results and analyses of the clinical research plan shall be
provided three months after the clinical research position ends; and
(V) Tracking information concerning past researchers, including but
not limited to (A) background information, (B) employment history, (C)
research status, (D) current research activities, (E) publications and
presentations, (F) research support, and (G) any other information
necessary to track the researcher; and
(VI) Any other data or information required by the commissioner to
implement this subparagraph.
(H) Notwithstanding any inconsistent provision of this subdivision,
for periods on and after April first, two thousand thirteen, ECRIP grant
awards shall be made in accordance with rules and regulations promulgat-
ed by the commissioner. Such regulations shall, at a minimum:
(1) provide that ECRIP grant awards shall be made with the objective
of securing federal funding for biomedical research, training clinical
researchers, recruiting national leaders as faculty to act as mentors,
and training residents and fellows in biomedical research skills;
(2) provide that ECRIP grant applicants may include interdisciplinary
research teams comprised of teaching general hospitals acting in collab-
oration with entities including but not limited to medical centers,
hospitals, universities and local health departments;
(3) provide that applications for ECRIP grant awards shall be based on
such information requested by the commissioner, which shall include but
not be limited to hospital-specific data;
(4) establish the qualifications for investigators and other staff
required for grant projects eligible for ECRIP grant awards; and
(5) establish a methodology for the distribution of funds under ECRIP
grant awards.
S. 9007--C 33 A. 10007--C
(c) Physician loan repayment program. One million nine hundred sixty
thousand dollars for the period January first, two thousand eight
through December thirty-first, two thousand eight, one million nine
hundred sixty thousand dollars for the period January first, two thou-
sand nine through December thirty-first, two thousand nine, one million
nine hundred sixty thousand dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten, four
hundred ninety thousand dollars for the period January first, two thou-
sand eleven through March thirty-first, two thousand eleven, one million
seven hundred thousand dollars each state fiscal year for the period
April first, two thousand eleven through March thirty-first, two thou-
sand fourteen, up to one million seven hundred five thousand dollars
each state fiscal year for the period April first, two thousand fourteen
through March thirty-first, two thousand seventeen, up to one million
seven hundred five thousand dollars each state fiscal year for the peri-
od April first, two thousand seventeen through March thirty-first, two
thousand twenty, up to one million seven hundred five thousand dollars
each state fiscal year for the period April first, two thousand twenty
through March thirty-first, two thousand twenty-three, [and] up to one
million seven hundred five thousand dollars each state fiscal year for
the period April first, two thousand twenty-three through March thirty-
first, two thousand twenty-six, AND UP TO ONE MILLION SEVEN HUNDRED FIVE
THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO
THOUSAND TWENTY-SIX THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-
NINE, shall be set aside and reserved by the commissioner from the
regional pools established pursuant to subdivision two of this section
and shall be available for purposes of physician loan repayment in
accordance with subdivision ten of this section. Notwithstanding any
contrary provision of this section, sections one hundred twelve and one
hundred sixty-three of the state finance law, or any other contrary
provision of law, such funding shall be allocated regionally with one-
third of available funds going to New York city and two-thirds of avail-
able funds going to the rest of the state and shall be distributed in a
manner to be determined by the commissioner without a competitive bid or
request for proposal process as follows:
(i) Funding shall first be awarded to repay loans of up to twenty-five
physicians who train in primary care or specialty tracks in teaching
general hospitals, and who enter and remain in primary care or specialty
practices in underserved communities, as determined by the commissioner.
(ii) After distributions in accordance with subparagraph (i) of this
paragraph, all remaining funds shall be awarded to repay loans of physi-
cians who enter and remain in primary care or specialty practices in
underserved communities, as determined by the commissioner, including
but not limited to physicians working in general hospitals, or other
health care facilities.
(iii) In no case shall less than fifty percent of the funds available
pursuant to this paragraph be distributed in accordance with subpara-
graphs (i) and (ii) of this paragraph to physicians identified by gener-
al hospitals.
(iv) In addition to the funds allocated under this paragraph, for the
period April first, two thousand fifteen through March thirty-first, two
thousand sixteen, two million dollars shall be available for the
purposes described in subdivision ten of this section;
(v) In addition to the funds allocated under this paragraph, for the
period April first, two thousand sixteen through March thirty-first, two
S. 9007--C 34 A. 10007--C
thousand seventeen, two million dollars shall be available for the
purposes described in subdivision ten of this section;
(vi) Notwithstanding any provision of law to the contrary, and subject
to the extension of the Health Care Reform Act of 1996, sufficient funds
shall be available for the purposes described in subdivision ten of this
section in amounts necessary to fund the remaining year commitments for
awards made pursuant to subparagraphs (iv) and (v) of this paragraph.
(d) Physician practice support. Four million nine hundred thousand
dollars for the period January first, two thousand eight through Decem-
ber thirty-first, two thousand eight, four million nine hundred thousand
dollars annually for the period January first, two thousand nine through
December thirty-first, two thousand ten, one million two hundred twen-
ty-five thousand dollars for the period January first, two thousand
eleven through March thirty-first, two thousand eleven, four million
three hundred thousand dollars each state fiscal year for the period
April first, two thousand eleven through March thirty-first, two thou-
sand fourteen, up to four million three hundred sixty thousand dollars
each state fiscal year for the period April first, two thousand fourteen
through March thirty-first, two thousand seventeen, up to four million
three hundred sixty thousand dollars for each state fiscal year for the
period April first, two thousand seventeen through March thirty-first,
two thousand twenty, up to four million three hundred sixty thousand
dollars for each fiscal year for the period April first, two thousand
twenty through March thirty-first, two thousand twenty-three, [and] up
to four million three hundred sixty thousand dollars for each fiscal
year for the period April first, two thousand twenty-three through March
thirty-first, two thousand twenty-six, AND UP TO FOUR MILLION THREE
HUNDRED SIXTY THOUSAND DOLLARS FOR EACH FISCAL YEAR FOR THE PERIOD APRIL
FIRST, TWO THOUSAND TWENTY-SIX THROUGH MARCH THIRTY-FIRST, TWO THOUSAND
TWENTY-NINE, shall be set aside and reserved by the commissioner from
the regional pools established pursuant to subdivision two of this
section and shall be available for purposes of physician practice
support. Notwithstanding any contrary provision of this section,
sections one hundred twelve and one hundred sixty-three of the state
finance law, or any other contrary provision of law, such funding shall
be allocated regionally with one-third of available funds going to New
York city and two-thirds of available funds going to the rest of the
state and shall be distributed in a manner to be determined by the
commissioner without a competitive bid or request for proposal process
as follows:
(i) Preference in funding shall first be accorded to teaching general
hospitals for up to twenty-five awards, to support costs incurred by
physicians trained in primary or specialty tracks who thereafter estab-
lish or join practices in underserved communities, as determined by the
commissioner.
(ii) After distributions in accordance with subparagraph (i) of this
paragraph, all remaining funds shall be awarded to physicians to support
the cost of establishing or joining practices in underserved communi-
ties, as determined by the commissioner, and to hospitals and other
health care providers to recruit new physicians to provide services in
underserved communities, as determined by the commissioner.
(iii) In no case shall less than fifty percent of the funds available
pursuant to this paragraph be distributed to general hospitals in
accordance with subparagraphs (i) and (ii) of this paragraph.
(f) Study on physician workforce. Five hundred ninety thousand dollars
annually for the period January first, two thousand eight through Decem-
S. 9007--C 35 A. 10007--C
ber thirty-first, two thousand ten, one hundred forty-eight thousand
dollars for the period January first, two thousand eleven through March
thirty-first, two thousand eleven, five hundred sixteen thousand dollars
each state fiscal year for the period April first, two thousand eleven
through March thirty-first, two thousand fourteen, up to four hundred
eighty-seven thousand dollars each state fiscal year for the period
April first, two thousand fourteen through March thirty-first, two thou-
sand seventeen, up to four hundred eighty-seven thousand dollars for
each state fiscal year for the period April first, two thousand seven-
teen through March thirty-first, two thousand twenty, up to four hundred
eighty-seven thousand dollars each state fiscal year for the period
April first, two thousand twenty through March thirty-first, two thou-
sand twenty-three, [and] up to four hundred eighty-seven thousand
dollars each state fiscal year for the period April first, two thousand
twenty-three through March thirty-first, two thousand twenty-six, AND UP
TO FOUR HUNDRED EIGHTY-SEVEN THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR
THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-SIX THROUGH MARCH THIRTY-
FIRST, TWO THOUSAND TWENTY-NINE, shall be set aside and reserved by the
commissioner from the regional pools established pursuant to subdivision
two of this section and shall be available to fund a study of physician
workforce needs and solutions including, but not limited to, an analysis
of residency programs and projected physician workforce and community
needs. The commissioner shall enter into agreements with one or more
organizations to conduct such study based on a request for proposal
process.
(g) [Diversity in medicine/post-baccalaureate program] SCHOLARS IN
MEDICINE AND SCIENCE AND SCHOLARSHIPS IN MEDICINE PROGRAMS. Notwith-
standing any inconsistent provision of section one hundred twelve or one
hundred sixty-three of the state finance law or any other law, one
million nine hundred sixty thousand dollars annually for the period
January first, two thousand eight through December thirty-first, two
thousand ten, four hundred ninety thousand dollars for the period Janu-
ary first, two thousand eleven through March thirty-first, two thousand
eleven, one million seven hundred thousand dollars each state fiscal
year for the period April first, two thousand eleven through March thir-
ty-first, two thousand fourteen, up to one million six hundred five
thousand dollars each state fiscal year for the period April first, two
thousand fourteen through March thirty-first, two thousand seventeen, up
to one million six hundred five thousand dollars each state fiscal year
for the period April first, two thousand seventeen through March thir-
ty-first, two thousand twenty, up to one million six hundred five thou-
sand dollars each state fiscal year for the period April first, two
thousand twenty through March thirty-first, two thousand twenty-three,
[and] up to one million six hundred five thousand dollars each state
fiscal year for the period April first, two thousand twenty-three
through March thirty-first, two thousand twenty-six, AND UP TO ONE
MILLION SIX HUNDRED FIVE THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR THE
PERIOD APRIL FIRST, TWO THOUSAND TWENTY-SIX THROUGH MARCH THIRTY-FIRST,
TWO THOUSAND TWENTY-NINE, shall be set aside and reserved by the commis-
sioner from the regional pools established pursuant to subdivision two
of this section and shall be available for distributions to the Associ-
ated Medical Schools of New York to fund its [diversity program] SCHOL-
ARS IN MEDICINE AND SCIENCE AND SCHOLARSHIPS IN MEDICINE PROGRAMS
including existing and new post-baccalaureate programs for minority and
economically disadvantaged students and encourage participation from all
medical schools in New York. The associated medical schools of New York
S. 9007--C 36 A. 10007--C
shall report to the commissioner on an annual basis regarding the use of
funds for such purpose in such form and manner as specified by the
commissioner.
§ 11. Intentionally omitted.
§ 12. Intentionally omitted.
§ 13. Subdivision 4-c of section 2807-p of the public health law, as
amended by section 7 of part C of chapter 57 of the laws of 2023, is
amended to read as follows:
4-c. Notwithstanding any provision of law to the contrary, the commis-
sioner shall make additional payments for uncompensated care to volun-
tary non-profit diagnostic and treatment centers that are eligible for
distributions under subdivision four of this section in the following
amounts: for the period June first, two thousand six through December
thirty-first, two thousand six, in the amount of seven million five
hundred thousand dollars, for the period January first, two thousand
seven through December thirty-first, two thousand seven, seven million
five hundred thousand dollars, for the period January first, two thou-
sand eight through December thirty-first, two thousand eight, seven
million five hundred thousand dollars, for the period January first, two
thousand nine through December thirty-first, two thousand nine, fifteen
million five hundred thousand dollars, for the period January first, two
thousand ten through December thirty-first, two thousand ten, seven
million five hundred thousand dollars, for the period January first, two
thousand eleven though December thirty-first, two thousand eleven, seven
million five hundred thousand dollars, for the period January first, two
thousand twelve through December thirty-first, two thousand twelve,
seven million five hundred thousand dollars, for the period January
first, two thousand thirteen through December thirty-first, two thousand
thirteen, seven million five hundred thousand dollars, for the period
January first, two thousand fourteen through December thirty-first, two
thousand fourteen, seven million five hundred thousand dollars, for the
period January first, two thousand fifteen through December thirty-
first, two thousand fifteen, seven million five hundred thousand
dollars, for the period January first two thousand sixteen through
December thirty-first, two thousand sixteen, seven million five hundred
thousand dollars, for the period January first, two thousand seventeen
through December thirty-first, two thousand seventeen, seven million
five hundred thousand dollars, for the period January first, two thou-
sand eighteen through December thirty-first, two thousand eighteen,
seven million five hundred thousand dollars, for the period January
first, two thousand nineteen through December thirty-first, two thousand
nineteen, seven million five hundred thousand dollars, for the period
January first, two thousand twenty through December thirty-first, two
thousand twenty, seven million five hundred thousand dollars, for the
period January first, two thousand twenty-one through December thirty-
first, two thousand twenty-one, seven million five hundred thousand
dollars, for the period January first, two thousand twenty-two through
December thirty-first, two thousand twenty-two, seven million five
hundred thousand dollars, for the period January first, two thousand
twenty-three through December thirty-first, two thousand twenty-three,
seven million five hundred thousand dollars, for the period January
first, two thousand twenty-four through December thirty-first, two thou-
sand twenty-four, seven million five hundred thousand dollars, for the
period January first, two thousand twenty-five through December thirty-
first, two thousand twenty-five, seven million five hundred thousand
dollars, FOR THE PERIOD JANUARY FIRST, TWO THOUSAND TWENTY-SIX THROUGH
S. 9007--C 37 A. 10007--C
DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-SIX, SEVEN MILLION FIVE
HUNDRED THOUSAND DOLLARS, FOR THE PERIOD JANUARY FIRST, TWO THOUSAND
TWENTY-SEVEN THROUGH DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-SEVEN,
SEVEN MILLION FIVE HUNDRED THOUSAND DOLLARS, FOR THE PERIOD JANUARY
FIRST, TWO THOUSAND TWENTY-EIGHT THROUGH DECEMBER THIRTY-FIRST, TWO
THOUSAND TWENTY-EIGHT, SEVEN MILLION FIVE HUNDRED THOUSAND DOLLARS, and
for the period January first, two thousand [twenty-six] TWENTY-NINE
through March thirty-first, two thousand [twenty-six] TWENTY-NINE, in
the amount of one million six hundred thousand dollars, provided, howev-
er, that for periods on and after January first, two thousand eight,
such additional payments shall be distributed to voluntary, non-profit
diagnostic and treatment centers and to public diagnostic and treatment
centers in accordance with paragraph (g) of subdivision four of this
section. In the event that federal financial participation is available
for rate adjustments pursuant to this section, the commissioner shall
make such payments as additional adjustments to rates of payment for
voluntary non-profit diagnostic and treatment centers that are eligible
for distributions under subdivision four-a of this section in the
following amounts: for the period June first, two thousand six through
December thirty-first, two thousand six, fifteen million dollars in the
aggregate, and for the period January first, two thousand seven through
June thirtieth, two thousand seven, seven million five hundred thousand
dollars in the aggregate. The amounts allocated pursuant to this para-
graph shall be aggregated with and distributed pursuant to the same
methodology applicable to the amounts allocated to such diagnostic and
treatment centers for such periods pursuant to subdivision four of this
section if federal financial participation is not available, or pursuant
to subdivision four-a of this section if federal financial participation
is available. Notwithstanding section three hundred sixty-eight-a of the
social services law, there shall be no local share in a medical assist-
ance payment adjustment under this subdivision.
§ 14. Paragraph (a) of subdivision 6 of section 2807-s of the public
health law is amended by adding a new subparagraph (xvii) to read as
follows:
(XVII) A GROSS ANNUAL STATEWIDE AMOUNT FOR THE PERIOD JANUARY FIRST,
TWO THOUSAND TWENTY-SEVEN TO DECEMBER THIRTY-FIRST, TWO THOUSAND TWEN-
TY-NINE SHALL BE ONE BILLION EIGHTY-FIVE MILLION DOLLARS, FORTY MILLION
DOLLARS ANNUALLY OF WHICH SHALL BE ALLOCATED UNDER SECTION TWENTY-EIGHT
HUNDRED SEVEN-O OF THIS ARTICLE AMONG THE MUNICIPALITIES OF AND THE
STATE OF NEW YORK BASED ON EACH MUNICIPALITY'S SHARE AND THE STATE'S
SHARE OF EARLY INTERVENTION PROGRAM EXPENDITURES NOT REIMBURSABLE BY THE
MEDICAL ASSISTANCE PROGRAM FOR THE LATEST TWELVE MONTH PERIOD FOR WHICH
SUCH DATA IS AVAILABLE.
§ 15. Subparagraph (xiii) of paragraph (a) of subdivision 7 of section
2807-s of the public health law, as amended by section 10 of part C of
chapter 57 of the laws of 2023, is amended to read as follows:
(xiii) twenty-three million eight hundred thirty-six thousand dollars
each state fiscal year for the period April first, two thousand twelve
through March thirty-first, two thousand [twenty-six] TWENTY-NINE;
§ 16. Paragraph (b) of subdivision 6 of section 2807-t of the public
health law, as amended by section 11 of part C of chapter 57 of the laws
of 2023, is amended to read as follows:
(b) Notwithstanding the provisions of paragraph (a) of this subdivi-
sion, for covered lives assessment rate periods on and after January
first, two thousand fifteen through December thirty-first, two thousand
twenty-one, for amounts collected in the aggregate in excess of one
S. 9007--C 38 A. 10007--C
billion forty-five million dollars on an annual basis, and for the peri-
od January first, two thousand twenty-two to December thirty-first, two
thousand [twenty-six] TWENTY-NINE for amounts collected in the aggregate
in excess of one billion eighty-five million dollars on an annual basis,
prospective adjustments shall be suspended if the annual reconciliation
calculation from the prior year would otherwise result in a decrease to
the regional allocation of the specified gross annual payment amount for
that region, provided, however, that such suspension shall be lifted
upon a determination by the commissioner, in consultation with the
director of the budget, that sixty-five million dollars in aggregate
collections on an annual basis over and above one billion forty-five
million dollars on an annual basis for the period on and after January
first, two thousand fifteen through December thirty-first, two thousand
twenty-one and for the period January first, two thousand twenty-two to
December thirty-first, two thousand [twenty-six] TWENTY-NINE for amounts
collected in the aggregate in excess of one billion eighty-five million
dollars on an annual basis have been reserved and set aside for deposit
in the HCRA resources fund. Any amounts collected in the aggregate at or
below one billion forty-five million dollars on an annual basis for the
period on and after January first, two thousand fifteen through December
thirty-first, two thousand twenty-two, and for the period January first,
two thousand twenty-three to December thirty-first, two thousand [twen-
ty-six] TWENTY-NINE for amounts collected in the aggregate in excess of
one billion eighty-five million dollars on an annual basis, shall be
subject to regional adjustments reconciling any decreases or increases
to the regional allocation in accordance with paragraph (a) of this
subdivision.
§ 17. Section 2807-v of the public health law, as amended by section
12 of part C of chapter 57 of the laws of 2023, is amended to read as
follows:
§ 2807-v. Tobacco control and insurance initiatives pool distrib-
utions. 1. Funds accumulated in the tobacco control and insurance
initiatives pool or in the health care reform act (HCRA) resources fund
established pursuant to section ninety-two-dd of the state finance law,
whichever is applicable, including income from invested funds, shall be
distributed or retained by the commissioner or by the state comptroller,
as applicable, in accordance with the following:
(a) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medicaid fraud hotline and
medicaid administration account, or any successor fund or account, for
purposes of services and expenses related to the toll-free medicaid
fraud hotline established pursuant to section one hundred eight of chap-
ter one of the laws of nineteen hundred ninety-nine from the tobacco
control and insurance initiatives pool established for the following
periods in the following amounts: four hundred thousand dollars annually
for the periods January first, two thousand through December thirty-
first, two thousand two, up to four hundred thousand dollars for the
period January first, two thousand three through December thirty-first,
two thousand three, up to four hundred thousand dollars for the period
January first, two thousand four through December thirty-first, two
thousand four, up to four hundred thousand dollars for the period Janu-
ary first, two thousand five through December thirty-first, two thousand
five, up to four hundred thousand dollars for the period January first,
two thousand six through December thirty-first, two thousand six, up to
S. 9007--C 39 A. 10007--C
four hundred thousand dollars for the period January first, two thousand
seven through December thirty-first, two thousand seven, up to four
hundred thousand dollars for the period January first, two thousand
eight through December thirty-first, two thousand eight, up to four
hundred thousand dollars for the period January first, two thousand nine
through December thirty-first, two thousand nine, up to four hundred
thousand dollars for the period January first, two thousand ten through
December thirty-first, two thousand ten, up to one hundred thousand
dollars for the period January first, two thousand eleven through March
thirty-first, two thousand eleven and within amounts appropriated on and
after April first, two thousand eleven.
(b) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for purposes
of payment of audits or audit contracts necessary to determine payor and
provider compliance with requirements set forth in sections twenty-eight
hundred seven-j, twenty-eight hundred seven-s and twenty-eight hundred
seven-t of this article from the tobacco control and insurance initi-
atives pool established for the following periods in the following
amounts: five million six hundred thousand dollars annually for the
periods January first, two thousand through December thirty-first, two
thousand two, up to five million dollars for the period January first,
two thousand three through December thirty-first, two thousand three, up
to five million dollars for the period January first, two thousand four
through December thirty-first, two thousand four, up to five million
dollars for the period January first, two thousand five through December
thirty-first, two thousand five, up to five million dollars for the
period January first, two thousand six through December thirty-first,
two thousand six, up to seven million eight hundred thousand dollars for
the period January first, two thousand seven through December thirty-
first, two thousand seven, and up to eight million three hundred twen-
ty-five thousand dollars for the period January first, two thousand
eight through December thirty-first, two thousand eight, up to eight
million five hundred thousand dollars for the period January first, two
thousand nine through December thirty-first, two thousand nine, up to
eight million five hundred thousand dollars for the period January
first, two thousand ten through December thirty-first, two thousand ten,
up to two million one hundred twenty-five thousand dollars for the peri-
od January first, two thousand eleven through March thirty-first, two
thousand eleven, up to fourteen million seven hundred thousand dollars
each state fiscal year for the period April first, two thousand eleven
through March thirty-first, two thousand fourteen, up to eleven million
one hundred thousand dollars each state fiscal year for the period April
first, two thousand fourteen through March thirty-first, two thousand
seventeen, up to eleven million one hundred thousand dollars each state
fiscal year for the period April first, two thousand seventeen through
March thirty-first, two thousand twenty, up to eleven million one
hundred thousand dollars each state fiscal year for the period April
first, two thousand twenty through March thirty-first, two thousand
twenty-three, [and] up to eleven million one hundred thousand dollars
each state fiscal year for the period April first, two thousand twenty-
three through March thirty-first, two thousand twenty-six, AND UP TO
ELEVEN MILLION ONE HUNDRED THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR
THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-SIX THROUGH MARCH THIRTY-
FIRST, TWO THOUSAND TWENTY-NINE.
(c) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
S. 9007--C 40 A. 10007--C
directed to receive for deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, enhanced community services
account, or any successor fund or account, for mental health services
programs for case management services for adults and children; supported
housing; home and community based waiver services; family based treat-
ment; family support services; mobile mental health teams; transitional
housing; and community oversight, established pursuant to articles seven
and forty-one of the mental hygiene law and subdivision nine of section
three hundred sixty-six of the social services law; and for comprehen-
sive care centers for eating disorders pursuant to the former section
twenty-seven hundred ninety-nine-l of this chapter, provided however
that, for such centers, funds in the amount of five hundred thousand
dollars on an annualized basis shall be transferred from the enhanced
community services account, or any successor fund or account, and depos-
ited into the fund established by section ninety-five-e of the state
finance law; from the tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
(i) forty-eight million dollars to be reserved, to be retained or for
distribution pursuant to a chapter of the laws of two thousand, for the
period January first, two thousand through December thirty-first, two
thousand;
(ii) eighty-seven million dollars to be reserved, to be retained or
for distribution pursuant to a chapter of the laws of two thousand one,
for the period January first, two thousand one through December thirty-
first, two thousand one;
(iii) eighty-seven million dollars to be reserved, to be retained or
for distribution pursuant to a chapter of the laws of two thousand two,
for the period January first, two thousand two through December thirty-
first, two thousand two;
(iv) eighty-eight million dollars to be reserved, to be retained or
for distribution pursuant to a chapter of the laws of two thousand
three, for the period January first, two thousand three through December
thirty-first, two thousand three;
(v) eighty-eight million dollars, plus five hundred thousand dollars,
to be reserved, to be retained or for distribution pursuant to a chapter
of the laws of two thousand four, and pursuant to the former section
twenty-seven hundred ninety-nine-l of this chapter, for the period Janu-
ary first, two thousand four through December thirty-first, two thousand
four;
(vi) eighty-eight million dollars, plus five hundred thousand dollars,
to be reserved, to be retained or for distribution pursuant to a chapter
of the laws of two thousand five, and pursuant to the former section
twenty-seven hundred ninety-nine-l of this chapter, for the period Janu-
ary first, two thousand five through December thirty-first, two thousand
five;
(vii) eighty-eight million dollars, plus five hundred thousand
dollars, to be reserved, to be retained or for distribution pursuant to
a chapter of the laws of two thousand six, and pursuant to former
section twenty-seven hundred ninety-nine-l of this chapter, for the
period January first, two thousand six through December thirty-first,
two thousand six;
(viii) eighty-six million four hundred thousand dollars, plus five
hundred thousand dollars, to be reserved, to be retained or for distrib-
ution pursuant to a chapter of the laws of two thousand seven and pursu-
ant to the former section twenty-seven hundred ninety-nine-l of this
S. 9007--C 41 A. 10007--C
chapter, for the period January first, two thousand seven through Decem-
ber thirty-first, two thousand seven; and
(ix) twenty-two million nine hundred thirteen thousand dollars, plus
one hundred twenty-five thousand dollars, to be reserved, to be retained
or for distribution pursuant to a chapter of the laws of two thousand
eight and pursuant to the former section twenty-seven hundred ninety-
nine-l of this chapter, for the period January first, two thousand eight
through March thirty-first, two thousand eight.
(d) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for purposes of funding the state
share of services and expenses related to the family health plus program
including up to two and one-half million dollars annually for the period
January first, two thousand through December thirty-first, two thousand
two, for administration and marketing costs associated with such program
established pursuant to clause (A) of subparagraph (v) of paragraph (a)
of subdivision two of FORMER section three hundred sixty-nine-ee of the
social services law from the tobacco control and insurance initiatives
pool established for the following periods in the following amounts:
(i) three million five hundred thousand dollars for the period January
first, two thousand through December thirty-first, two thousand;
(ii) twenty-seven million dollars for the period January first, two
thousand one through December thirty-first, two thousand one; and
(iii) fifty-seven million dollars for the period January first, two
thousand two through December thirty-first, two thousand two.
(e) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for purposes of funding the state
share of services and expenses related to the family health plus program
including up to two and one-half million dollars annually for the period
January first, two thousand through December thirty-first, two thousand
two for administration and marketing costs associated with such program
established pursuant to clause (B) of subparagraph (v) of paragraph (a)
of subdivision two of FORMER section three hundred sixty-nine-ee of the
social services law from the tobacco control and insurance initiatives
pool established for the following periods in the following amounts:
(i) two million five hundred thousand dollars for the period January
first, two thousand through December thirty-first, two thousand;
(ii) thirty million five hundred thousand dollars for the period Janu-
ary first, two thousand one through December thirty-first, two thousand
one; and
(iii) sixty-six million dollars for the period January first, two
thousand two through December thirty-first, two thousand two.
(f) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medicaid fraud hotline and
medicaid administration account, or any successor fund or account, for
purposes of payment of administrative expenses of the department related
to the family health plus program established pursuant to FORMER section
three hundred sixty-nine-ee of the social services law from the tobacco
control and insurance initiatives pool established for the following
S. 9007--C 42 A. 10007--C
periods in the following amounts: five hundred thousand dollars on an
annual basis for the periods January first, two thousand through Decem-
ber thirty-first, two thousand six, five hundred thousand dollars for
the period January first, two thousand seven through December thirty-
first, two thousand seven, and five hundred thousand dollars for the
period January first, two thousand eight through December thirty-first,
two thousand eight, five hundred thousand dollars for the period January
first, two thousand nine through December thirty-first, two thousand
nine, five hundred thousand dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten, one
hundred twenty-five thousand dollars for the period January first, two
thousand eleven through March thirty-first, two thousand eleven and
within amounts appropriated on and after April first, two thousand elev-
en.
(g) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for purposes
of services and expenses related to the health maintenance organization
direct pay market program established pursuant to sections [forty-three]
FOUR THOUSAND THREE hundred twenty-one-a and [forty-three] FOUR THOUSAND
THREE hundred twenty-two-a of the insurance law from the tobacco control
and insurance initiatives pool established for the following periods in
the following amounts:
(i) up to thirty-five million dollars for the period January first,
two thousand through December thirty-first, two thousand of which fifty
percentum shall be allocated to the program pursuant to section four
thousand three hundred twenty-one-a of the insurance law and fifty
percentum to the program pursuant to section four thousand three hundred
twenty-two-a of the insurance law;
(ii) up to thirty-six million dollars for the period January first,
two thousand one through December thirty-first, two thousand one of
which fifty percentum shall be allocated to the program pursuant to
section four thousand three hundred twenty-one-a of the insurance law
and fifty percentum to the program pursuant to section four thousand
three hundred twenty-two-a of the insurance law;
(iii) up to thirty-nine million dollars for the period January first,
two thousand two through December thirty-first, two thousand two of
which fifty percentum shall be allocated to the program pursuant to
section four thousand three hundred twenty-one-a of the insurance law
and fifty percentum to the program pursuant to section four thousand
three hundred twenty-two-a of the insurance law;
(iv) up to forty million dollars for the period January first, two
thousand three through December thirty-first, two thousand three of
which fifty percentum shall be allocated to the program pursuant to
section four thousand three hundred twenty-one-a of the insurance law
and fifty percentum to the program pursuant to section four thousand
three hundred twenty-two-a of the insurance law;
(v) up to forty million dollars for the period January first, two
thousand four through December thirty-first, two thousand four of which
fifty percentum shall be allocated to the program pursuant to section
four thousand three hundred twenty-one-a of the insurance law and fifty
percentum to the program pursuant to section four thousand three hundred
twenty-two-a of the insurance law;
(vi) up to forty million dollars for the period January first, two
thousand five through December thirty-first, two thousand five of which
fifty percentum shall be allocated to the program pursuant to section
four thousand three hundred twenty-one-a of the insurance law and fifty
S. 9007--C 43 A. 10007--C
percentum to the program pursuant to section four thousand three hundred
twenty-two-a of the insurance law;
(vii) up to forty million dollars for the period January first, two
thousand six through December thirty-first, two thousand six of which
fifty percentum shall be allocated to the program pursuant to section
four thousand three hundred twenty-one-a of the insurance law and fifty
percentum shall be allocated to the program pursuant to section four
thousand three hundred twenty-two-a of the insurance law;
(viii) up to forty million dollars for the period January first, two
thousand seven through December thirty-first, two thousand seven of
which fifty percentum shall be allocated to the program pursuant to
section four thousand three hundred twenty-one-a of the insurance law
and fifty percentum shall be allocated to the program pursuant to
section four thousand three hundred twenty-two-a of the insurance law;
and
(ix) up to forty million dollars for the period January first, two
thousand eight through December thirty-first, two thousand eight of
which fifty per centum shall be allocated to the program pursuant to
section four thousand three hundred twenty-one-a of the insurance law
and fifty per centum shall be allocated to the program pursuant to
section four thousand three hundred twenty-two-a of the insurance law.
(h) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for purposes
of services and expenses related to the healthy New York individual
program established pursuant to sections four thousand three hundred
twenty-six and four thousand three hundred twenty-seven of the insurance
law from the tobacco control and insurance initiatives pool established
for the following periods in the following amounts:
(i) up to six million dollars for the period January first, two thou-
sand one through December thirty-first, two thousand one;
(ii) up to twenty-nine million dollars for the period January first,
two thousand two through December thirty-first, two thousand two;
(iii) up to five million one hundred thousand dollars for the period
January first, two thousand three through December thirty-first, two
thousand three;
(iv) up to twenty-four million six hundred thousand dollars for the
period January first, two thousand four through December thirty-first,
two thousand four;
(v) up to thirty-four million six hundred thousand dollars for the
period January first, two thousand five through December thirty-first,
two thousand five;
(vi) up to fifty-four million eight hundred thousand dollars for the
period January first, two thousand six through December thirty-first,
two thousand six;
(vii) up to sixty-one million seven hundred thousand dollars for the
period January first, two thousand seven through December thirty-first,
two thousand seven; and
(viii) up to one hundred three million seven hundred fifty thousand
dollars for the period January first, two thousand eight through Decem-
ber thirty-first, two thousand eight.
(i) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for purposes
of services and expenses related to the healthy New York group program
established pursuant to sections four thousand three hundred twenty-six
and four thousand three hundred twenty-seven of the insurance law from
S. 9007--C 44 A. 10007--C
the tobacco control and insurance initiatives pool established for the
following periods in the following amounts:
(i) up to thirty-four million dollars for the period January first,
two thousand one through December thirty-first, two thousand one;
(ii) up to seventy-seven million dollars for the period January first,
two thousand two through December thirty-first, two thousand two;
(iii) up to ten million five hundred thousand dollars for the period
January first, two thousand three through December thirty-first, two
thousand three;
(iv) up to twenty-four million six hundred thousand dollars for the
period January first, two thousand four through December thirty-first,
two thousand four;
(v) up to thirty-four million six hundred thousand dollars for the
period January first, two thousand five through December thirty-first,
two thousand five;
(vi) up to fifty-four million eight hundred thousand dollars for the
period January first, two thousand six through December thirty-first,
two thousand six;
(vii) up to sixty-one million seven hundred thousand dollars for the
period January first, two thousand seven through December thirty-first,
two thousand seven; and
(viii) up to one hundred three million seven hundred fifty thousand
dollars for the period January first, two thousand eight through Decem-
ber thirty-first, two thousand eight.
(i-1) Notwithstanding the provisions of paragraphs (h) and (i) of this
subdivision, the commissioner shall reserve and accumulate up to two
million five hundred thousand dollars annually for the periods January
first, two thousand four through December thirty-first, two thousand
six, one million four hundred thousand dollars for the period January
first, two thousand seven through December thirty-first, two thousand
seven, two million dollars for the period January first, two thousand
eight through December thirty-first, two thousand eight, from funds
otherwise available for distribution under such paragraphs for the
services and expenses related to the pilot program for entertainment
industry employees included in subsection (b) of section one thousand
one hundred twenty-two of the insurance law, and an additional seven
hundred thousand dollars annually for the periods January first, two
thousand four through December thirty-first, two thousand six, an addi-
tional three hundred thousand dollars for the period January first, two
thousand seven through June thirtieth, two thousand seven for services
and expenses related to the pilot program for displaced workers included
in subsection (c) of section one thousand one hundred twenty-two of the
insurance law.
(j) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for purposes
of services and expenses related to the tobacco use prevention and
control program established pursuant to sections thirteen hundred nine-
ty-nine-ii and thirteen hundred ninety-nine-jj of this chapter, from the
tobacco control and insurance initiatives pool established for the
following periods in the following amounts:
(i) up to thirty million dollars for the period January first, two
thousand through December thirty-first, two thousand;
(ii) up to forty million dollars for the period January first, two
thousand one through December thirty-first, two thousand one;
(iii) up to forty million dollars for the period January first, two
thousand two through December thirty-first, two thousand two;
S. 9007--C 45 A. 10007--C
(iv) up to thirty-six million nine hundred fifty thousand dollars for
the period January first, two thousand three through December thirty-
first, two thousand three;
(v) up to thirty-six million nine hundred fifty thousand dollars for
the period January first, two thousand four through December thirty-
first, two thousand four;
(vi) up to forty million six hundred thousand dollars for the period
January first, two thousand five through December thirty-first, two
thousand five;
(vii) up to eighty-one million nine hundred thousand dollars for the
period January first, two thousand six through December thirty-first,
two thousand six, provided, however, that within amounts appropriated, a
portion of such funds may be transferred to the Roswell Park Cancer
Institute Corporation to support costs associated with cancer research;
(viii) up to ninety-four million one hundred fifty thousand dollars
for the period January first, two thousand seven through December thir-
ty-first, two thousand seven, provided, however, that within amounts
appropriated, a portion of such funds may be transferred to the Roswell
Park Cancer Institute Corporation to support costs associated with
cancer research;
(ix) up to ninety-four million one hundred fifty thousand dollars for
the period January first, two thousand eight through December thirty-
first, two thousand eight;
(x) up to ninety-four million one hundred fifty thousand dollars for
the period January first, two thousand nine through December thirty-
first, two thousand nine;
(xi) up to eighty-seven million seven hundred seventy-five thousand
dollars for the period January first, two thousand ten through December
thirty-first, two thousand ten;
(xii) up to twenty-one million four hundred twelve thousand dollars
for the period January first, two thousand eleven through March thirty-
first, two thousand eleven;
(xiii) up to fifty-two million one hundred thousand dollars each state
fiscal year for the period April first, two thousand eleven through
March thirty-first, two thousand fourteen;
(xiv) up to six million dollars each state fiscal year for the period
April first, two thousand fourteen through March thirty-first, two thou-
sand seventeen;
(xv) up to six million dollars each state fiscal year for the period
April first, two thousand seventeen through March thirty-first, two
thousand twenty;
(xvi) up to six million dollars each state fiscal year for the period
April first, two thousand twenty through March thirty-first, two thou-
sand twenty-three; [and]
(xvii) up to six million dollars each state fiscal year for the period
April first, two thousand twenty-three through March thirty-first, two
thousand twenty-six[.]; AND
(XVIII) UP TO SIX MILLION DOLLARS EACH STATE FISCAL YEAR FOR THE PERI-
OD APRIL FIRST, TWO THOUSAND TWENTY-SIX THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND TWENTY-NINE.
(k) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue fund - other, HCRA transfer fund, health care services account,
or any successor fund or account, for purposes of services and expenses
related to public health programs, including comprehensive care centers
S. 9007--C 46 A. 10007--C
for eating disorders pursuant to the former section twenty-seven hundred
ninety-nine-l of this chapter, provided however that, for such centers,
funds in the amount of five hundred thousand dollars on an annualized
basis shall be transferred from the health care services account, or any
successor fund or account, and deposited into the fund established by
section ninety-five-e of the state finance law for periods prior to
March thirty-first, two thousand eleven, from the tobacco control and
insurance initiatives pool established for the following periods in the
following amounts:
(i) up to thirty-one million dollars for the period January first, two
thousand through December thirty-first, two thousand;
(ii) up to forty-one million dollars for the period January first, two
thousand one through December thirty-first, two thousand one;
(iii) up to eighty-one million dollars for the period January first,
two thousand two through December thirty-first, two thousand two;
(iv) one hundred twenty-two million five hundred thousand dollars for
the period January first, two thousand three through December thirty-
first, two thousand three;
(v) one hundred eight million five hundred seventy-five thousand
dollars, plus an additional five hundred thousand dollars, for the peri-
od January first, two thousand four through December thirty-first, two
thousand four;
(vi) ninety-one million eight hundred thousand dollars, plus an addi-
tional five hundred thousand dollars, for the period January first, two
thousand five through December thirty-first, two thousand five;
(vii) one hundred fifty-six million six hundred thousand dollars, plus
an additional five hundred thousand dollars, for the period January
first, two thousand six through December thirty-first, two thousand six;
(viii) one hundred fifty-one million four hundred thousand dollars,
plus an additional five hundred thousand dollars, for the period January
first, two thousand seven through December thirty-first, two thousand
seven;
(ix) one hundred sixteen million nine hundred forty-nine thousand
dollars, plus an additional five hundred thousand dollars, for the peri-
od January first, two thousand eight through December thirty-first, two
thousand eight;
(x) one hundred sixteen million nine hundred forty-nine thousand
dollars, plus an additional five hundred thousand dollars, for the peri-
od January first, two thousand nine through December thirty-first, two
thousand nine;
(xi) one hundred sixteen million nine hundred forty-nine thousand
dollars, plus an additional five hundred thousand dollars, for the peri-
od January first, two thousand ten through December thirty-first, two
thousand ten;
(xii) twenty-nine million two hundred thirty-seven thousand two
hundred fifty dollars, plus an additional one hundred twenty-five thou-
sand dollars, for the period January first, two thousand eleven through
March thirty-first, two thousand eleven;
(xiii) one hundred twenty million thirty-eight thousand dollars for
the period April first, two thousand eleven through March thirty-first,
two thousand twelve; and
(xiv) one hundred nineteen million four hundred seven thousand dollars
each state fiscal year for the period April first, two thousand twelve
through March thirty-first, two thousand fourteen.
(l) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
S. 9007--C 47 A. 10007--C
directed to receive for deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for purposes of funding the state
share of the personal care and certified home health agency rate or fee
increases established pursuant to subdivision three of section three
hundred sixty-seven-o of the social services law from the tobacco
control and insurance initiatives pool established for the following
periods in the following amounts:
(i) twenty-three million two hundred thousand dollars for the period
January first, two thousand through December thirty-first, two thousand;
(ii) twenty-three million two hundred thousand dollars for the period
January first, two thousand one through December thirty-first, two thou-
sand one;
(iii) twenty-three million two hundred thousand dollars for the period
January first, two thousand two through December thirty-first, two thou-
sand two;
(iv) up to sixty-five million two hundred thousand dollars for the
period January first, two thousand three through December thirty-first,
two thousand three;
(v) up to sixty-five million two hundred thousand dollars for the
period January first, two thousand four through December thirty-first,
two thousand four;
(vi) up to sixty-five million two hundred thousand dollars for the
period January first, two thousand five through December thirty-first,
two thousand five;
(vii) up to sixty-five million two hundred thousand dollars for the
period January first, two thousand six through December thirty-first,
two thousand six;
(viii) up to sixty-five million two hundred thousand dollars for the
period January first, two thousand seven through December thirty-first,
two thousand seven; and
(ix) up to sixteen million three hundred thousand dollars for the
period January first, two thousand eight through March thirty-first, two
thousand eight.
(m) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for purposes of funding the state
share of services and expenses related to home care workers insurance
pilot demonstration programs established pursuant to subdivision two of
section three hundred sixty-seven-o of the social services law from the
tobacco control and insurance initiatives pool established for the
following periods in the following amounts:
(i) three million eight hundred thousand dollars for the period Janu-
ary first, two thousand through December thirty-first, two thousand;
(ii) three million eight hundred thousand dollars for the period Janu-
ary first, two thousand one through December thirty-first, two thousand
one;
(iii) three million eight hundred thousand dollars for the period
January first, two thousand two through December thirty-first, two thou-
sand two;
(iv) up to three million eight hundred thousand dollars for the period
January first, two thousand three through December thirty-first, two
thousand three;
S. 9007--C 48 A. 10007--C
(v) up to three million eight hundred thousand dollars for the period
January first, two thousand four through December thirty-first, two
thousand four;
(vi) up to three million eight hundred thousand dollars for the period
January first, two thousand five through December thirty-first, two
thousand five;
(vii) up to three million eight hundred thousand dollars for the peri-
od January first, two thousand six through December thirty-first, two
thousand six;
(viii) up to three million eight hundred thousand dollars for the
period January first, two thousand seven through December thirty-first,
two thousand seven; and
(ix) up to nine hundred fifty thousand dollars for the period January
first, two thousand eight through March thirty-first, two thousand
eight.
(n) Funds shall be transferred by the commissioner and shall be depos-
ited to the credit of the special revenue funds - other, miscellaneous
special revenue fund - 339, elderly pharmaceutical insurance coverage
program premium account authorized pursuant to the provisions of title
three of article two of the elder law, or any successor fund or account,
for funding state expenses relating to the program from the tobacco
control and insurance initiatives pool established for the following
periods in the following amounts:
(i) one hundred seven million dollars for the period January first,
two thousand through December thirty-first, two thousand;
(ii) one hundred sixty-four million dollars for the period January
first, two thousand one through December thirty-first, two thousand one;
(iii) three hundred twenty-two million seven hundred thousand dollars
for the period January first, two thousand two through December thirty-
first, two thousand two;
(iv) four hundred thirty-three million three hundred thousand dollars
for the period January first, two thousand three through December thir-
ty-first, two thousand three;
(v) five hundred four million one hundred fifty thousand dollars for
the period January first, two thousand four through December thirty-
first, two thousand four;
(vi) five hundred sixty-six million eight hundred thousand dollars for
the period January first, two thousand five through December thirty-
first, two thousand five;
(vii) six hundred three million one hundred fifty thousand dollars for
the period January first, two thousand six through December thirty-
first, two thousand six;
(viii) six hundred sixty million eight hundred thousand dollars for
the period January first, two thousand seven through December thirty-
first, two thousand seven;
(ix) three hundred sixty-seven million four hundred sixty-three thou-
sand dollars for the period January first, two thousand eight through
December thirty-first, two thousand eight;
(x) three hundred thirty-four million eight hundred twenty-five thou-
sand dollars for the period January first, two thousand nine through
December thirty-first, two thousand nine;
(xi) three hundred forty-four million nine hundred thousand dollars
for the period January first, two thousand ten through December thirty-
first, two thousand ten;
S. 9007--C 49 A. 10007--C
(xii) eighty-seven million seven hundred eighty-eight thousand dollars
for the period January first, two thousand eleven through March thirty-
first, two thousand eleven;
(xiii) one hundred forty-three million one hundred fifty thousand
dollars for the period April first, two thousand eleven through March
thirty-first, two thousand twelve;
(xiv) one hundred twenty million nine hundred fifty thousand dollars
for the period April first, two thousand twelve through March thirty-
first, two thousand thirteen;
(xv) one hundred twenty-eight million eight hundred fifty thousand
dollars for the period April first, two thousand thirteen through March
thirty-first, two thousand fourteen;
(xvi) one hundred twenty-seven million four hundred sixteen thousand
dollars each state fiscal year for the period April first, two thousand
fourteen through March thirty-first, two thousand seventeen;
(xvii) one hundred twenty-seven million four hundred sixteen thousand
dollars each state fiscal year for the period April first, two thousand
seventeen through March thirty-first, two thousand twenty;
(xviii) one hundred twenty-seven million four hundred sixteen thousand
dollars each state fiscal year for the period April first, two thousand
twenty through March thirty-first, two thousand twenty-three; [and]
(xix) one hundred twenty-seven million four hundred sixteen thousand
dollars each state fiscal year for the period April first, two thousand
twenty-three through March thirty-first, two thousand twenty-six[.]; AND
(XX) ONE HUNDRED TWENTY-SEVEN MILLION FOUR HUNDRED SIXTEEN THOUSAND
DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND
TWENTY-SIX THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-NINE.
(o) Funds shall be reserved and accumulated and shall be transferred
to the Roswell Park Cancer Institute Corporation, from the tobacco
control and insurance initiatives pool established for the following
periods in the following amounts:
(i) up to ninety million dollars for the period January first, two
thousand through December thirty-first, two thousand;
(ii) up to sixty million dollars for the period January first, two
thousand one through December thirty-first, two thousand one;
(iii) up to eighty-five million dollars for the period January first,
two thousand two through December thirty-first, two thousand two;
(iv) eighty-five million two hundred fifty thousand dollars for the
period January first, two thousand three through December thirty-first,
two thousand three;
(v) seventy-eight million dollars for the period January first, two
thousand four through December thirty-first, two thousand four;
(vi) seventy-eight million dollars for the period January first, two
thousand five through December thirty-first, two thousand five;
(vii) ninety-one million dollars for the period January first, two
thousand six through December thirty-first, two thousand six;
(viii) seventy-eight million dollars for the period January first, two
thousand seven through December thirty-first, two thousand seven;
(ix) seventy-eight million dollars for the period January first, two
thousand eight through December thirty-first, two thousand eight;
(x) seventy-eight million dollars for the period January first, two
thousand nine through December thirty-first, two thousand nine;
(xi) seventy-eight million dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten;
S. 9007--C 50 A. 10007--C
(xii) nineteen million five hundred thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven;
(xiii) sixty-nine million eight hundred forty thousand dollars each
state fiscal year for the period April first, two thousand eleven
through March thirty-first, two thousand fourteen;
(xiv) up to ninety-six million six hundred thousand dollars each state
fiscal year for the period April first, two thousand fourteen through
March thirty-first, two thousand seventeen;
(xv) up to ninety-six million six hundred thousand dollars each state
fiscal year for the period April first, two thousand seventeen through
March thirty-first, two thousand twenty;
(xvi) up to ninety-six million six hundred thousand dollars each state
fiscal year for the period April first, two thousand twenty through
March thirty-first, two thousand twenty-three; [and]
(xvii) up to ninety-six million six hundred thousand dollars each
state fiscal year for the period April first, two thousand twenty-three
through March thirty-first, two thousand twenty-six[.]; AND
(XVIII) UP TO NINETY-SIX MILLION SIX HUNDRED THOUSAND DOLLARS EACH
STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-SIX
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-NINE.
(p) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue funds - other, indigent care fund - 068, indigent care account,
or any successor fund or account, for purposes of providing a medicaid
disproportionate share payment from the high need indigent care adjust-
ment pool established pursuant to section twenty-eight hundred seven-w
of this article, from the tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
(i) eighty-two million dollars annually for the periods January first,
two thousand through December thirty-first, two thousand two;
(ii) up to eighty-two million dollars for the period January first,
two thousand three through December thirty-first, two thousand three;
(iii) up to eighty-two million dollars for the period January first,
two thousand four through December thirty-first, two thousand four;
(iv) up to eighty-two million dollars for the period January first,
two thousand five through December thirty-first, two thousand five;
(v) up to eighty-two million dollars for the period January first, two
thousand six through December thirty-first, two thousand six;
(vi) up to eighty-two million dollars for the period January first,
two thousand seven through December thirty-first, two thousand seven;
(vii) up to eighty-two million dollars for the period January first,
two thousand eight through December thirty-first, two thousand eight;
(viii) up to eighty-two million dollars for the period January first,
two thousand nine through December thirty-first, two thousand nine;
(ix) up to eighty-two million dollars for the period January first,
two thousand ten through December thirty-first, two thousand ten;
(x) up to twenty million five hundred thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven; and
(xi) up to eighty-two million dollars each state fiscal year for the
period April first, two thousand eleven through March thirty-first, two
thousand fourteen.
(q) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for purposes
S. 9007--C 51 A. 10007--C
of providing distributions to eligible school based health centers
established pursuant to section eighty-eight of chapter one of the laws
of nineteen hundred ninety-nine, from the tobacco control and insurance
initiatives pool established for the following periods in the following
amounts:
(i) seven million dollars annually for the period January first, two
thousand through December thirty-first, two thousand two;
(ii) up to seven million dollars for the period January first, two
thousand three through December thirty-first, two thousand three;
(iii) up to seven million dollars for the period January first, two
thousand four through December thirty-first, two thousand four;
(iv) up to seven million dollars for the period January first, two
thousand five through December thirty-first, two thousand five;
(v) up to seven million dollars for the period January first, two
thousand six through December thirty-first, two thousand six;
(vi) up to seven million dollars for the period January first, two
thousand seven through December thirty-first, two thousand seven;
(vii) up to seven million dollars for the period January first, two
thousand eight through December thirty-first, two thousand eight;
(viii) up to seven million dollars for the period January first, two
thousand nine through December thirty-first, two thousand nine;
(ix) up to seven million dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten;
(x) up to one million seven hundred fifty thousand dollars for the
period January first, two thousand eleven through March thirty-first,
two thousand eleven;
(xi) up to five million six hundred thousand dollars each state fiscal
year for the period April first, two thousand eleven through March thir-
ty-first, two thousand fourteen;
(xii) up to five million two hundred eighty-eight thousand dollars
each state fiscal year for the period April first, two thousand fourteen
through March thirty-first, two thousand seventeen;
(xiii) up to five million two hundred eighty-eight thousand dollars
each state fiscal year for the period April first, two thousand seven-
teen through March thirty-first, two thousand twenty;
(xiv) up to five million two hundred eighty-eight thousand dollars
each state fiscal year for the period April first, two thousand twenty
through March thirty-first, two thousand twenty-three; [and]
(xv) up to five million two hundred eighty-eight thousand dollars each
state fiscal year for the period April first, two thousand twenty-three
through March thirty-first, two thousand twenty-six[.]; AND
(XVI) UP TO FIVE MILLION TWO HUNDRED EIGHTY-EIGHT THOUSAND DOLLARS
EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-
SIX THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-NINE.
(r) Funds shall be deposited by the commissioner within amounts appro-
priated, and the state comptroller is hereby authorized and directed to
receive for deposit to the credit of the state special revenue funds -
other, HCRA transfer fund, medical assistance account, or any successor
fund or account, for purposes of providing distributions for supplemen-
tary medical insurance for Medicare part B premiums, physicians
services, outpatient services, medical equipment, supplies and other
health services, from the tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
(i) forty-three million dollars for the period January first, two
thousand through December thirty-first, two thousand;
S. 9007--C 52 A. 10007--C
(ii) sixty-one million dollars for the period January first, two thou-
sand one through December thirty-first, two thousand one;
(iii) sixty-five million dollars for the period January first, two
thousand two through December thirty-first, two thousand two;
(iv) sixty-seven million five hundred thousand dollars for the period
January first, two thousand three through December thirty-first, two
thousand three;
(v) sixty-eight million dollars for the period January first, two
thousand four through December thirty-first, two thousand four;
(vi) sixty-eight million dollars for the period January first, two
thousand five through December thirty-first, two thousand five;
(vii) sixty-eight million dollars for the period January first, two
thousand six through December thirty-first, two thousand six;
(viii) seventeen million five hundred thousand dollars for the period
January first, two thousand seven through December thirty-first, two
thousand seven;
(ix) sixty-eight million dollars for the period January first, two
thousand eight through December thirty-first, two thousand eight;
(x) sixty-eight million dollars for the period January first, two
thousand nine through December thirty-first, two thousand nine;
(xi) sixty-eight million dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten;
(xii) seventeen million dollars for the period January first, two
thousand eleven through March thirty-first, two thousand eleven; and
(xiii) sixty-eight million dollars each state fiscal year for the
period April first, two thousand eleven through March thirty-first, two
thousand fourteen.
(s) Funds shall be deposited by the commissioner within amounts appro-
priated, and the state comptroller is hereby authorized and directed to
receive for deposit to the credit of the state special revenue funds -
other, HCRA transfer fund, medical assistance account, or any successor
fund or account, for purposes of providing distributions pursuant to
paragraphs (s-5), (s-6), (s-7) and (s-8) of subdivision eleven of
section twenty-eight hundred seven-c of this article from the tobacco
control and insurance initiatives pool established for the following
periods in the following amounts:
(i) eighteen million dollars for the period January first, two thou-
sand through December thirty-first, two thousand;
(ii) twenty-four million dollars annually for the periods January
first, two thousand one through December thirty-first, two thousand two;
(iii) up to twenty-four million dollars for the period January first,
two thousand three through December thirty-first, two thousand three;
(iv) up to twenty-four million dollars for the period January first,
two thousand four through December thirty-first, two thousand four;
(v) up to twenty-four million dollars for the period January first,
two thousand five through December thirty-first, two thousand five;
(vi) up to twenty-four million dollars for the period January first,
two thousand six through December thirty-first, two thousand six;
(vii) up to twenty-four million dollars for the period January first,
two thousand seven through December thirty-first, two thousand seven;
(viii) up to twenty-four million dollars for the period January first,
two thousand eight through December thirty-first, two thousand eight;
and
(ix) up to twenty-two million dollars for the period January first,
two thousand nine through November thirtieth, two thousand nine.
S. 9007--C 53 A. 10007--C
(t) Funds shall be reserved and accumulated from year to year by the
commissioner and shall be made available, including income from invested
funds:
(i) For the purpose of making grants to a state owned and operated
medical school which does not have a state owned and operated hospital
on site and available for teaching purposes. Notwithstanding sections
one hundred twelve and one hundred sixty-three of the state finance law,
such grants shall be made in the amount of up to five hundred thousand
dollars for the period January first, two thousand through December
thirty-first, two thousand;
(ii) For the purpose of making grants to medical schools pursuant to
section eighty-six-a of chapter one of the laws of nineteen hundred
ninety-nine in the sum of up to four million dollars for the period
January first, two thousand through December thirty-first, two thousand;
and
(iii) The funds disbursed pursuant to subparagraphs (i) and (ii) of
this paragraph from the tobacco control and insurance initiatives pool
are contingent upon meeting all funding amounts established pursuant to
paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
and (s) of this subdivision, paragraph (a) of subdivision nine of
section twenty-eight hundred seven-j of this article, and paragraphs
(a), (i) and (k) of subdivision one of section twenty-eight hundred
seven-l of this article.
(u) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for purposes of funding the state
share of services and expenses related to the nursing home quality
improvement demonstration program established pursuant to section twen-
ty-eight hundred eight-d of this article from the tobacco control and
insurance initiatives pool established for the following periods in the
following amounts:
(i) up to twenty-five million dollars for the period beginning April
first, two thousand two and ending December thirty-first, two thousand
two, and on an annualized basis, for each annual period thereafter
beginning January first, two thousand three and ending December thirty-
first, two thousand four;
(ii) up to eighteen million seven hundred fifty thousand dollars for
the period January first, two thousand five through December thirty-
first, two thousand five; and
(iii) up to fifty-six million five hundred thousand dollars for the
period January first, two thousand six through December thirty-first,
two thousand six.
(v) Funds shall be transferred by the commissioner and shall be depos-
ited to the credit of the hospital excess liability pool created pursu-
ant to section eighteen of chapter two hundred sixty-six of the laws of
nineteen hundred eighty-six, or any successor fund or account, for
purposes of expenses related to the purchase of excess medical malprac-
tice insurance and the cost of administrating the pool, including costs
associated with the risk management program established pursuant to
section forty-two of part A of chapter one of the laws of two thousand
two required by paragraph (a) of subdivision one of section eighteen of
chapter two hundred sixty-six of the laws of nineteen hundred eighty-six
as may be amended from time to time, from the tobacco control and insur-
S. 9007--C 54 A. 10007--C
ance initiatives pool established for the following periods in the
following amounts:
(i) up to fifty million dollars or so much as is needed for the period
January first, two thousand two through December thirty-first, two thou-
sand two;
(ii) up to seventy-six million seven hundred thousand dollars for the
period January first, two thousand three through December thirty-first,
two thousand three;
(iii) up to sixty-five million dollars for the period January first,
two thousand four through December thirty-first, two thousand four;
(iv) up to sixty-five million dollars for the period January first,
two thousand five through December thirty-first, two thousand five;
(v) up to one hundred thirteen million eight hundred thousand dollars
for the period January first, two thousand six through December thirty-
first, two thousand six;
(vi) up to one hundred thirty million dollars for the period January
first, two thousand seven through December thirty-first, two thousand
seven;
(vii) up to one hundred thirty million dollars for the period January
first, two thousand eight through December thirty-first, two thousand
eight;
(viii) up to one hundred thirty million dollars for the period January
first, two thousand nine through December thirty-first, two thousand
nine;
(ix) up to one hundred thirty million dollars for the period January
first, two thousand ten through December thirty-first, two thousand ten;
(x) up to thirty-two million five hundred thousand dollars for the
period January first, two thousand eleven through March thirty-first,
two thousand eleven;
(xi) up to one hundred twenty-seven million four hundred thousand
dollars each state fiscal year for the period April first, two thousand
eleven through March thirty-first, two thousand fourteen;
(xii) up to one hundred twenty-seven million four hundred thousand
dollars each state fiscal year for the period April first, two thousand
fourteen through March thirty-first, two thousand seventeen;
(xiii) up to one hundred twenty-seven million four hundred thousand
dollars each state fiscal year for the period April first, two thousand
seventeen through March thirty-first, two thousand twenty;
(xiv) up to one hundred twenty-seven million four hundred thousand
dollars each state fiscal year for the period April first, two thousand
twenty through March thirty-first, two thousand twenty-three; [and]
(xv) up to one hundred twenty-seven million four hundred thousand
dollars each state fiscal year for the period April first, two thousand
twenty-three through March thirty-first, two thousand twenty-six[.]; AND
(XVI) UP TO ONE HUNDRED TWENTY-SEVEN MILLION FOUR HUNDRED THOUSAND
DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND
TWENTY-SIX THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-NINE.
(w) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for purposes of funding the state
share of the treatment of breast and cervical cancer pursuant to para-
graph (d) of subdivision four of section three hundred sixty-six of the
social services law, from the tobacco control and insurance initiatives
pool established for the following periods in the following amounts:
S. 9007--C 55 A. 10007--C
(i) up to four hundred fifty thousand dollars for the period January
first, two thousand two through December thirty-first, two thousand two;
(ii) up to two million one hundred thousand dollars for the period
January first, two thousand three through December thirty-first, two
thousand three;
(iii) up to two million one hundred thousand dollars for the period
January first, two thousand four through December thirty-first, two
thousand four;
(iv) up to two million one hundred thousand dollars for the period
January first, two thousand five through December thirty-first, two
thousand five;
(v) up to two million one hundred thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six;
(vi) up to two million one hundred thousand dollars for the period
January first, two thousand seven through December thirty-first, two
thousand seven;
(vii) up to two million one hundred thousand dollars for the period
January first, two thousand eight through December thirty-first, two
thousand eight;
(viii) up to two million one hundred thousand dollars for the period
January first, two thousand nine through December thirty-first, two
thousand nine;
(ix) up to two million one hundred thousand dollars for the period
January first, two thousand ten through December thirty-first, two thou-
sand ten;
(x) up to five hundred twenty-five thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven;
(xi) up to two million one hundred thousand dollars each state fiscal
year for the period April first, two thousand eleven through March thir-
ty-first, two thousand fourteen;
(xii) up to two million one hundred thousand dollars each state fiscal
year for the period April first, two thousand fourteen through March
thirty-first, two thousand seventeen;
(xiii) up to two million one hundred thousand dollars each state
fiscal year for the period April first, two thousand seventeen through
March thirty-first, two thousand twenty;
(xiv) up to two million one hundred thousand dollars each state fiscal
year for the period April first, two thousand twenty through March thir-
ty-first, two thousand twenty-three; [and]
(xv) up to two million one hundred thousand dollars each state fiscal
year for the period April first, two thousand twenty-three through March
thirty-first, two thousand twenty-six[.]; AND
(XVI) UP TO TWO MILLION ONE HUNDRED THOUSAND DOLLARS EACH STATE FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-SIX THROUGH MARCH
THIRTY-FIRST, TWO THOUSAND TWENTY-NINE.
(x) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for purposes of funding the state
share of the non-public general hospital rates increases for recruitment
and retention of health care workers from the tobacco control and insur-
ance initiatives pool established for the following periods in the
following amounts:
S. 9007--C 56 A. 10007--C
(i) twenty-seven million one hundred thousand dollars on an annualized
basis for the period January first, two thousand two through December
thirty-first, two thousand two;
(ii) fifty million eight hundred thousand dollars on an annualized
basis for the period January first, two thousand three through December
thirty-first, two thousand three;
(iii) sixty-nine million three hundred thousand dollars on an annual-
ized basis for the period January first, two thousand four through
December thirty-first, two thousand four;
(iv) sixty-nine million three hundred thousand dollars for the period
January first, two thousand five through December thirty-first, two
thousand five;
(v) sixty-nine million three hundred thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six;
(vi) sixty-five million three hundred thousand dollars for the period
January first, two thousand seven through December thirty-first, two
thousand seven;
(vii) sixty-one million one hundred fifty thousand dollars for the
period January first, two thousand eight through December thirty-first,
two thousand eight; and
(viii) forty-eight million seven hundred twenty-one thousand dollars
for the period January first, two thousand nine through November thirti-
eth, two thousand nine.
(y) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for purposes
of grants to public general hospitals for recruitment and retention of
health care workers pursuant to paragraph (b) of subdivision thirty of
section twenty-eight hundred seven-c of this article from the tobacco
control and insurance initiatives pool established for the following
periods in the following amounts:
(i) eighteen million five hundred thousand dollars on an annualized
basis for the period January first, two thousand two through December
thirty-first, two thousand two;
(ii) thirty-seven million four hundred thousand dollars on an annual-
ized basis for the period January first, two thousand three through
December thirty-first, two thousand three;
(iii) fifty-two million two hundred thousand dollars on an annualized
basis for the period January first, two thousand four through December
thirty-first, two thousand four;
(iv) fifty-two million two hundred thousand dollars for the period
January first, two thousand five through December thirty-first, two
thousand five;
(v) fifty-two million two hundred thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six;
(vi) forty-nine million dollars for the period January first, two
thousand seven through December thirty-first, two thousand seven;
(vii) forty-nine million dollars for the period January first, two
thousand eight through December thirty-first, two thousand eight; and
(viii) twelve million two hundred fifty thousand dollars for the peri-
od January first, two thousand nine through March thirty-first, two
thousand nine.
Provided, however, amounts pursuant to this paragraph may be reduced
in an amount to be approved by the director of the budget to reflect
amounts received from the federal government under the state's 1115
S. 9007--C 57 A. 10007--C
waiver which are directed under its terms and conditions to the health
workforce recruitment and retention program.
(z) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for purposes of funding the state
share of the non-public residential health care facility rate increases
for recruitment and retention of health care workers pursuant to para-
graph (a) of subdivision eighteen of section twenty-eight hundred eight
of this article from the tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
(i) twenty-one million five hundred thousand dollars on an annualized
basis for the period January first, two thousand two through December
thirty-first, two thousand two;
(ii) thirty-three million three hundred thousand dollars on an annual-
ized basis for the period January first, two thousand three through
December thirty-first, two thousand three;
(iii) forty-six million three hundred thousand dollars on an annual-
ized basis for the period January first, two thousand four through
December thirty-first, two thousand four;
(iv) forty-six million three hundred thousand dollars for the period
January first, two thousand five through December thirty-first, two
thousand five;
(v) forty-six million three hundred thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six;
(vi) thirty million nine hundred thousand dollars for the period Janu-
ary first, two thousand seven through December thirty-first, two thou-
sand seven;
(vii) twenty-four million seven hundred thousand dollars for the peri-
od January first, two thousand eight through December thirty-first, two
thousand eight;
(viii) twelve million three hundred seventy-five thousand dollars for
the period January first, two thousand nine through December thirty-
first, two thousand nine;
(ix) nine million three hundred thousand dollars for the period Janu-
ary first, two thousand ten through December thirty-first, two thousand
ten; and
(x) two million three hundred twenty-five thousand dollars for the
period January first, two thousand eleven through March thirty-first,
two thousand eleven.
(aa) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for purposes
of grants to public residential health care facilities for recruitment
and retention of health care workers pursuant to paragraph (b) of subdi-
vision eighteen of section twenty-eight hundred eight of this article
from the tobacco control and insurance initiatives pool established for
the following periods in the following amounts:
(i) seven million five hundred thousand dollars on an annualized basis
for the period January first, two thousand two through December thirty-
first, two thousand two;
(ii) eleven million seven hundred thousand dollars on an annualized
basis for the period January first, two thousand three through December
thirty-first, two thousand three;
S. 9007--C 58 A. 10007--C
(iii) sixteen million two hundred thousand dollars on an annualized
basis for the period January first, two thousand four through December
thirty-first, two thousand four;
(iv) sixteen million two hundred thousand dollars for the period Janu-
ary first, two thousand five through December thirty-first, two thousand
five;
(v) sixteen million two hundred thousand dollars for the period Janu-
ary first, two thousand six through December thirty-first, two thousand
six;
(vi) ten million eight hundred thousand dollars for the period January
first, two thousand seven through December thirty-first, two thousand
seven;
(vii) six million seven hundred fifty thousand dollars for the period
January first, two thousand eight through December thirty-first, two
thousand eight; and
(viii) one million three hundred fifty thousand dollars for the period
January first, two thousand nine through December thirty-first, two
thousand nine.
(bb)(i) Funds shall be deposited by the commissioner, within amounts
appropriated, and subject to the availability of federal financial
participation, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for the purpose of supporting the
state share of adjustments to Medicaid rates of payment for personal
care services provided pursuant to paragraph (e) of subdivision two of
section three hundred sixty-five-a of the social services law, for local
social service districts which include a city with a population of over
one million persons and computed and distributed in accordance with
memorandums of understanding to be entered into between the state of New
York and such local social service districts for the purpose of support-
ing the recruitment and retention of personal care service workers or
any worker with direct patient care responsibility, from the tobacco
control and insurance initiatives pool established for the following
periods and the following amounts:
(A) forty-four million dollars, on an annualized basis, for the period
April first, two thousand two through December thirty-first, two thou-
sand two;
(B) seventy-four million dollars, on an annualized basis, for the
period January first, two thousand three through December thirty-first,
two thousand three;
(C) one hundred four million dollars, on an annualized basis, for the
period January first, two thousand four through December thirty-first,
two thousand four;
(D) one hundred thirty-six million dollars, on an annualized basis,
for the period January first, two thousand five through December thir-
ty-first, two thousand five;
(E) one hundred thirty-six million dollars, on an annualized basis,
for the period January first, two thousand six through December thirty-
first, two thousand six;
(F) one hundred thirty-six million dollars for the period January
first, two thousand seven through December thirty-first, two thousand
seven;
(G) one hundred thirty-six million dollars for the period January
first, two thousand eight through December thirty-first, two thousand
eight;
S. 9007--C 59 A. 10007--C
(H) one hundred thirty-six million dollars for the period January
first, two thousand nine through December thirty-first, two thousand
nine;
(I) one hundred thirty-six million dollars for the period January
first, two thousand ten through December thirty-first, two thousand ten;
(J) thirty-four million dollars for the period January first, two
thousand eleven through March thirty-first, two thousand eleven;
(K) up to one hundred thirty-six million dollars each state fiscal
year for the period April first, two thousand eleven through March thir-
ty-first, two thousand fourteen;
(L) up to one hundred thirty-six million dollars each state fiscal
year for the period March thirty-first, two thousand fourteen through
April first, two thousand seventeen;
(M) up to one hundred thirty-six million dollars each state fiscal
year for the period April first, two thousand seventeen through March
thirty-first, two thousand twenty;
(N) up to one hundred thirty-six million dollars each state fiscal
year for the period April first, two thousand twenty through March thir-
ty-first, two thousand twenty-three; [and]
(O) up to one hundred thirty-six million dollars each state fiscal
year for the period April first, two thousand twenty-three through March
thirty-first, two thousand twenty-six[.]; AND
(P) UP TO ONE HUNDRED THIRTY-SIX MILLION DOLLARS EACH STATE FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-SIX THROUGH MARCH
THIRTY-FIRST, TWO THOUSAND TWENTY-NINE.
(ii) Adjustments to Medicaid rates made pursuant to this paragraph
shall not, in aggregate, exceed the following amounts for the following
periods:
(A) for the period April first, two thousand two through December
thirty-first, two thousand two, one hundred ten million dollars;
(B) for the period January first, two thousand three through December
thirty-first, two thousand three, one hundred eighty-five million
dollars;
(C) for the period January first, two thousand four through December
thirty-first, two thousand four, two hundred sixty million dollars;
(D) for the period January first, two thousand five through December
thirty-first, two thousand five, three hundred forty million dollars;
(E) for the period January first, two thousand six through December
thirty-first, two thousand six, three hundred forty million dollars;
(F) for the period January first, two thousand seven through December
thirty-first, two thousand seven, three hundred forty million dollars;
(G) for the period January first, two thousand eight through December
thirty-first, two thousand eight, three hundred forty million dollars;
(H) for the period January first, two thousand nine through December
thirty-first, two thousand nine, three hundred forty million dollars;
(I) for the period January first, two thousand ten through December
thirty-first, two thousand ten, three hundred forty million dollars;
(J) for the period January first, two thousand eleven through March
thirty-first, two thousand eleven, eighty-five million dollars;
(K) for each state fiscal year within the period April first, two
thousand eleven through March thirty-first, two thousand fourteen, three
hundred forty million dollars;
(L) for each state fiscal year within the period April first, two
thousand fourteen through March thirty-first, two thousand seventeen,
three hundred forty million dollars;
S. 9007--C 60 A. 10007--C
(M) for each state fiscal year within the period April first, two
thousand seventeen through March thirty-first, two thousand twenty,
three hundred forty million dollars;
(N) for each state fiscal year within the period April first, two
thousand twenty through March thirty-first, two thousand twenty-three,
three hundred forty million dollars; [and]
(O) for each state fiscal year within the period April first, two
thousand twenty-three through March thirty-first, two thousand twenty-
six, three hundred forty million dollars[.]; AND
(P) FOR EACH STATE FISCAL YEAR WITHIN THE PERIOD APRIL FIRST, TWO
THOUSAND TWENTY-SIX THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-
NINE, THREE HUNDRED FORTY MILLION DOLLARS.
(iii) Personal care service providers which have their rates adjusted
pursuant to this paragraph shall use such funds for the purpose of
recruitment and retention of non-supervisory personal care services
workers or any worker with direct patient care responsibility only and
are prohibited from using such funds for any other purpose. Each such
personal care services provider shall submit, at a time and in a manner
to be determined by the commissioner, a written certification attesting
that such funds will be used solely for the purpose of recruitment and
retention of non-supervisory personal care services workers or any work-
er with direct patient care responsibility. The commissioner is author-
ized to audit each such provider to ensure compliance with the written
certification required by this subdivision and shall recoup any funds
determined to have been used for purposes other than recruitment and
retention of non-supervisory personal care services workers or any work-
er with direct patient care responsibility. Such recoupment shall be in
addition to any other penalties provided by law.
(cc) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for the purpose of supporting the
state share of adjustments to Medicaid rates of payment for personal
care services provided pursuant to paragraph (e) of subdivision two of
section three hundred sixty-five-a of the social services law, for local
social service districts which shall not include a city with a popu-
lation of over one million persons for the purpose of supporting the
personal care services worker recruitment and retention program as
established pursuant to section three hundred sixty-seven-q of the
social services law, from the tobacco control and insurance initiatives
pool established for the following periods and the following amounts:
(i) two million eight hundred thousand dollars for the period April
first, two thousand two through December thirty-first, two thousand two;
(ii) five million six hundred thousand dollars, on an annualized
basis, for the period January first, two thousand three through December
thirty-first, two thousand three;
(iii) eight million four hundred thousand dollars, on an annualized
basis, for the period January first, two thousand four through December
thirty-first, two thousand four;
(iv) ten million eight hundred thousand dollars, on an annualized
basis, for the period January first, two thousand five through December
thirty-first, two thousand five;
(v) ten million eight hundred thousand dollars, on an annualized
basis, for the period January first, two thousand six through December
thirty-first, two thousand six;
S. 9007--C 61 A. 10007--C
(vi) eleven million two hundred thousand dollars for the period Janu-
ary first, two thousand seven through December thirty-first, two thou-
sand seven;
(vii) eleven million two hundred thousand dollars for the period Janu-
ary first, two thousand eight through December thirty-first, two thou-
sand eight;
(viii) eleven million two hundred thousand dollars for the period
January first, two thousand nine through December thirty-first, two
thousand nine;
(ix) eleven million two hundred thousand dollars for the period Janu-
ary first, two thousand ten through December thirty-first, two thousand
ten;
(x) two million eight hundred thousand dollars for the period January
first, two thousand eleven through March thirty-first, two thousand
eleven;
(xi) up to eleven million two hundred thousand dollars each state
fiscal year for the period April first, two thousand eleven through
March thirty-first, two thousand fourteen;
(xii) up to eleven million two hundred thousand dollars each state
fiscal year for the period April first, two thousand fourteen through
March thirty-first, two thousand seventeen;
(xiii) up to eleven million two hundred thousand dollars each state
fiscal year for the period April first, two thousand seventeen through
March thirty-first, two thousand twenty;
(xiv) up to eleven million two hundred thousand dollars each state
fiscal year for the period April first, two thousand twenty through
March thirty-first, two thousand twenty-three; [and]
(xv) up to eleven million two hundred thousand dollars each state
fiscal year for the period April first, two thousand twenty-three
through March thirty-first, two thousand twenty-six[.]; AND
(XVI) UP TO ELEVEN MILLION TWO HUNDRED THOUSAND DOLLARS EACH STATE
FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-SIX THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-NINE.
(dd) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any successor fund or account, for purposes of funding the state share
of Medicaid expenditures for physician services from the tobacco control
and insurance initiatives pool established for the following periods in
the following amounts:
(i) up to fifty-two million dollars for the period January first, two
thousand two through December thirty-first, two thousand two;
(ii) eighty-one million two hundred thousand dollars for the period
January first, two thousand three through December thirty-first, two
thousand three;
(iii) eighty-five million two hundred thousand dollars for the period
January first, two thousand four through December thirty-first, two
thousand four;
(iv) eighty-five million two hundred thousand dollars for the period
January first, two thousand five through December thirty-first, two
thousand five;
(v) eighty-five million two hundred thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six;
S. 9007--C 62 A. 10007--C
(vi) eighty-five million two hundred thousand dollars for the period
January first, two thousand seven through December thirty-first, two
thousand seven;
(vii) eighty-five million two hundred thousand dollars for the period
January first, two thousand eight through December thirty-first, two
thousand eight;
(viii) eighty-five million two hundred thousand dollars for the period
January first, two thousand nine through December thirty-first, two
thousand nine;
(ix) eighty-five million two hundred thousand dollars for the period
January first, two thousand ten through December thirty-first, two thou-
sand ten;
(x) twenty-one million three hundred thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven; and
(xi) eighty-five million two hundred thousand dollars each state
fiscal year for the period April first, two thousand eleven through
March thirty-first, two thousand fourteen.
(ee) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any successor fund or account, for purposes of funding the state share
of the free-standing diagnostic and treatment center rate increases for
recruitment and retention of health care workers pursuant to subdivision
seventeen of section twenty-eight hundred seven of this article from the
tobacco control and insurance initiatives pool established for the
following periods in the following amounts:
(i) three million two hundred fifty thousand dollars for the period
April first, two thousand two through December thirty-first, two thou-
sand two;
(ii) three million two hundred fifty thousand dollars on an annualized
basis for the period January first, two thousand three through December
thirty-first, two thousand three;
(iii) three million two hundred fifty thousand dollars on an annual-
ized basis for the period January first, two thousand four through
December thirty-first, two thousand four;
(iv) three million two hundred fifty thousand dollars for the period
January first, two thousand five through December thirty-first, two
thousand five;
(v) three million two hundred fifty thousand dollars for the period
January first, two thousand six through December thirty-first, two thou-
sand six;
(vi) three million two hundred fifty thousand dollars for the period
January first, two thousand seven through December thirty-first, two
thousand seven;
(vii) three million four hundred thirty-eight thousand dollars for the
period January first, two thousand eight through December thirty-first,
two thousand eight;
(viii) two million four hundred fifty thousand dollars for the period
January first, two thousand nine through December thirty-first, two
thousand nine;
(ix) one million five hundred thousand dollars for the period January
first, two thousand ten through December thirty-first, two thousand ten;
and
S. 9007--C 63 A. 10007--C
(x) three hundred twenty-five thousand dollars for the period January
first, two thousand eleven through March thirty-first, two thousand
eleven.
(ff) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any successor fund or account, for purposes of funding the state share
of Medicaid expenditures for disabled persons as authorized pursuant to
former subparagraphs twelve and thirteen of paragraph (a) of subdivision
one of section three hundred sixty-six of the social services law from
the tobacco control and insurance initiatives pool established for the
following periods in the following amounts:
(i) one million eight hundred thousand dollars for the period April
first, two thousand two through December thirty-first, two thousand two;
(ii) sixteen million four hundred thousand dollars on an annualized
basis for the period January first, two thousand three through December
thirty-first, two thousand three;
(iii) eighteen million seven hundred thousand dollars on an annualized
basis for the period January first, two thousand four through December
thirty-first, two thousand four;
(iv) thirty million six hundred thousand dollars for the period Janu-
ary first, two thousand five through December thirty-first, two thousand
five;
(v) thirty million six hundred thousand dollars for the period January
first, two thousand six through December thirty-first, two thousand six;
(vi) thirty million six hundred thousand dollars for the period Janu-
ary first, two thousand seven through December thirty-first, two thou-
sand seven;
(vii) fifteen million dollars for the period January first, two thou-
sand eight through December thirty-first, two thousand eight;
(viii) fifteen million dollars for the period January first, two thou-
sand nine through December thirty-first, two thousand nine;
(ix) fifteen million dollars for the period January first, two thou-
sand ten through December thirty-first, two thousand ten;
(x) three million seven hundred fifty thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven;
(xi) fifteen million dollars each state fiscal year for the period
April first, two thousand eleven through March thirty-first, two thou-
sand fourteen;
(xii) fifteen million dollars each state fiscal year for the period
April first, two thousand fourteen through March thirty-first, two thou-
sand seventeen;
(xiii) fifteen million dollars each state fiscal year for the period
April first, two thousand seventeen through March thirty-first, two
thousand twenty;
(xiv) fifteen million dollars each state fiscal year for the period
April first, two thousand twenty through March thirty-first, two thou-
sand twenty-three; [and]
(xv) fifteen million dollars each state fiscal year for the period
April first, two thousand twenty-three through March thirty-first, two
thousand twenty-six[.]; AND
(XVI) FIFTEEN MILLION DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD
APRIL FIRST, TWO THOUSAND TWENTY-SIX THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND TWENTY-NINE.
S. 9007--C 64 A. 10007--C
(gg) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for purposes
of grants to non-public general hospitals pursuant to paragraph (c) of
subdivision thirty of section twenty-eight hundred seven-c of this arti-
cle from the tobacco control and insurance initiatives pool established
for the following periods in the following amounts:
(i) up to one million three hundred thousand dollars on an annualized
basis for the period January first, two thousand two through December
thirty-first, two thousand two;
(ii) up to three million two hundred thousand dollars on an annualized
basis for the period January first, two thousand three through December
thirty-first, two thousand three;
(iii) up to five million six hundred thousand dollars on an annualized
basis for the period January first, two thousand four through December
thirty-first, two thousand four;
(iv) up to eight million six hundred thousand dollars for the period
January first, two thousand five through December thirty-first, two
thousand five;
(v) up to eight million six hundred thousand dollars on an annualized
basis for the period January first, two thousand six through December
thirty-first, two thousand six;
(vi) up to two million six hundred thousand dollars for the period
January first, two thousand seven through December thirty-first, two
thousand seven;
(vii) up to two million six hundred thousand dollars for the period
January first, two thousand eight through December thirty-first, two
thousand eight;
(viii) up to two million six hundred thousand dollars for the period
January first, two thousand nine through December thirty-first, two
thousand nine;
(ix) up to two million six hundred thousand dollars for the period
January first, two thousand ten through December thirty-first, two thou-
sand ten; and
(x) up to six hundred fifty thousand dollars for the period January
first, two thousand eleven through March thirty-first, two thousand
eleven.
(hh) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the special revenue
fund - other, HCRA transfer fund, medical assistance account for
purposes of providing financial assistance to residential health care
facilities pursuant to subdivisions nineteen and twenty-one of section
twenty-eight hundred eight of this article, from the tobacco control and
insurance initiatives pool established for the following periods in the
following amounts:
(i) for the period April first, two thousand two through December
thirty-first, two thousand two, ten million dollars;
(ii) for the period January first, two thousand three through December
thirty-first, two thousand three, nine million four hundred fifty thou-
sand dollars;
(iii) for the period January first, two thousand four through December
thirty-first, two thousand four, nine million three hundred fifty thou-
sand dollars;
(iv) up to fifteen million dollars for the period January first, two
thousand five through December thirty-first, two thousand five;
S. 9007--C 65 A. 10007--C
(v) up to fifteen million dollars for the period January first, two
thousand six through December thirty-first, two thousand six;
(vi) up to fifteen million dollars for the period January first, two
thousand seven through December thirty-first, two thousand seven;
(vii) up to fifteen million dollars for the period January first, two
thousand eight through December thirty-first, two thousand eight;
(viii) up to fifteen million dollars for the period January first, two
thousand nine through December thirty-first, two thousand nine;
(ix) up to fifteen million dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten;
(x) up to three million seven hundred fifty thousand dollars for the
period January first, two thousand eleven through March thirty-first,
two thousand eleven; and
(xi) fifteen million dollars each state fiscal year for the period
April first, two thousand eleven through March thirty-first, two thou-
sand fourteen.
(ii) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for the purpose of supporting the
state share of Medicaid expenditures for disabled persons as authorized
by sections 1619 (a) and (b) of the federal social security act pursuant
to the tobacco control and insurance initiatives pool established for
the following periods in the following amounts:
(i) six million four hundred thousand dollars for the period April
first, two thousand two through December thirty-first, two thousand two;
(ii) eight million five hundred thousand dollars, for the period Janu-
ary first, two thousand three through December thirty-first, two thou-
sand three;
(iii) eight million five hundred thousand dollars for the period Janu-
ary first, two thousand four through December thirty-first, two thousand
four;
(iv) eight million five hundred thousand dollars for the period Janu-
ary first, two thousand five through December thirty-first, two thousand
five;
(v) eight million five hundred thousand dollars for the period January
first, two thousand six through December thirty-first, two thousand six;
(vi) eight million six hundred thousand dollars for the period January
first, two thousand seven through December thirty-first, two thousand
seven;
(vii) eight million five hundred thousand dollars for the period Janu-
ary first, two thousand eight through December thirty-first, two thou-
sand eight;
(viii) eight million five hundred thousand dollars for the period
January first, two thousand nine through December thirty-first, two
thousand nine;
(ix) eight million five hundred thousand dollars for the period Janu-
ary first, two thousand ten through December thirty-first, two thousand
ten;
(x) two million one hundred twenty-five thousand dollars for the peri-
od January first, two thousand eleven through March thirty-first, two
thousand eleven;
(xi) eight million five hundred thousand dollars each state fiscal
year for the period April first, two thousand eleven through March thir-
ty-first, two thousand fourteen;
S. 9007--C 66 A. 10007--C
(xii) eight million five hundred thousand dollars each state fiscal
year for the period April first, two thousand fourteen through March
thirty-first, two thousand seventeen;
(xiii) eight million five hundred thousand dollars each state fiscal
year for the period April first, two thousand seventeen through March
thirty-first, two thousand twenty;
(xiv) eight million five hundred thousand dollars each state fiscal
year for the period April first, two thousand twenty through March thir-
ty-first, two thousand twenty-three; [and]
(xv) eight million five hundred thousand dollars each state fiscal
year for the period April first, two thousand twenty-three through March
thirty-first, two thousand twenty-six[.]; AND
(XVI) EIGHT MILLION FIVE HUNDRED THOUSAND DOLLARS EACH STATE FISCAL
YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-SIX THROUGH MARCH
THIRTY-FIRST, TWO THOUSAND TWENTY-NINE.
(jj) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for the
purposes of a grant program to improve access to infertility services,
treatments and procedures, from the tobacco control and insurance initi-
atives pool established for the period January first, two thousand two
through December thirty-first, two thousand two in the amount of nine
million one hundred seventy-five thousand dollars, for the period April
first, two thousand six through March thirty-first, two thousand seven
in the amount of five million dollars, for the period April first, two
thousand seven through March thirty-first, two thousand eight in the
amount of five million dollars, for the period April first, two thousand
eight through March thirty-first, two thousand nine in the amount of
five million dollars, and for the period April first, two thousand nine
through March thirty-first, two thousand ten in the amount of five
million dollars, for the period April first, two thousand ten through
March thirty-first, two thousand eleven in the amount of two million two
hundred thousand dollars, and for the period April first, two thousand
eleven through March thirty-first, two thousand twelve up to one million
one hundred thousand dollars.
(kk) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue funds -- other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for purposes of funding the state
share of Medical Assistance Program expenditures from the tobacco
control and insurance initiatives pool established for the following
periods in the following amounts:
(i) thirty-eight million eight hundred thousand dollars for the period
January first, two thousand two through December thirty-first, two thou-
sand two;
(ii) up to two hundred ninety-five million dollars for the period
January first, two thousand three through December thirty-first, two
thousand three;
(iii) up to four hundred seventy-two million dollars for the period
January first, two thousand four through December thirty-first, two
thousand four;
(iv) up to nine hundred million dollars for the period January first,
two thousand five through December thirty-first, two thousand five;
(v) up to eight hundred sixty-six million three hundred thousand
dollars for the period January first, two thousand six through December
thirty-first, two thousand six;
S. 9007--C 67 A. 10007--C
(vi) up to six hundred sixteen million seven hundred thousand dollars
for the period January first, two thousand seven through December thir-
ty-first, two thousand seven;
(vii) up to five hundred seventy-eight million nine hundred twenty-
five thousand dollars for the period January first, two thousand eight
through December thirty-first, two thousand eight; and
(viii) within amounts appropriated on and after January first, two
thousand nine.
(ll) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue funds -- other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for purposes of funding the state
share of Medicaid expenditures related to the city of New York from the
tobacco control and insurance initiatives pool established for the
following periods in the following amounts:
(i) eighty-two million seven hundred thousand dollars for the period
January first, two thousand two through December thirty-first, two thou-
sand two;
(ii) one hundred twenty-four million six hundred thousand dollars for
the period January first, two thousand three through December thirty-
first, two thousand three;
(iii) one hundred twenty-four million seven hundred thousand dollars
for the period January first, two thousand four through December thir-
ty-first, two thousand four;
(iv) one hundred twenty-four million seven hundred thousand dollars
for the period January first, two thousand five through December thir-
ty-first, two thousand five;
(v) one hundred twenty-four million seven hundred thousand dollars for
the period January first, two thousand six through December thirty-
first, two thousand six;
(vi) one hundred twenty-four million seven hundred thousand dollars
for the period January first, two thousand seven through December thir-
ty-first, two thousand seven;
(vii) one hundred twenty-four million seven hundred thousand dollars
for the period January first, two thousand eight through December thir-
ty-first, two thousand eight;
(viii) one hundred twenty-four million seven hundred thousand dollars
for the period January first, two thousand nine through December thir-
ty-first, two thousand nine;
(ix) one hundred twenty-four million seven hundred thousand dollars
for the period January first, two thousand ten through December thirty-
first, two thousand ten;
(x) thirty-one million one hundred seventy-five thousand dollars for
the period January first, two thousand eleven through March thirty-
first, two thousand eleven; and
(xi) one hundred twenty-four million seven hundred thousand dollars
each state fiscal year for the period April first, two thousand eleven
through March thirty-first, two thousand fourteen.
(mm) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for purposes of funding specified
percentages of the state share of services and expenses related to the
family health plus program in accordance with the following schedule:
S. 9007--C 68 A. 10007--C
(i) (A) for the period January first, two thousand three through
December thirty-first, two thousand four, one hundred percent of the
state share;
(B) for the period January first, two thousand five through December
thirty-first, two thousand five, seventy-five percent of the state
share; and
(C) for periods beginning on and after January first, two thousand
six, fifty percent of the state share.
(ii) Funding for the family health plus program will include up to
five million dollars annually for the period January first, two thousand
three through December thirty-first, two thousand six, up to five
million dollars for the period January first, two thousand seven through
December thirty-first, two thousand seven, up to seven million two
hundred thousand dollars for the period January first, two thousand
eight through December thirty-first, two thousand eight, up to seven
million two hundred thousand dollars for the period January first, two
thousand nine through December thirty-first, two thousand nine, up to
seven million two hundred thousand dollars for the period January first,
two thousand ten through December thirty-first, two thousand ten, up to
one million eight hundred thousand dollars for the period January first,
two thousand eleven through March thirty-first, two thousand eleven, up
to six million forty-nine thousand dollars for the period April first,
two thousand eleven through March thirty-first, two thousand twelve, up
to six million two hundred eighty-nine thousand dollars for the period
April first, two thousand twelve through March thirty-first, two thou-
sand thirteen, and up to six million four hundred sixty-one thousand
dollars for the period April first, two thousand thirteen through March
thirty-first, two thousand fourteen, for administration and marketing
costs associated with such program established pursuant to clauses (A)
and (B) of subparagraph (v) of paragraph (a) of subdivision two of the
former section three hundred sixty-nine-ee of the social services law
from the tobacco control and insurance initiatives pool established for
the following periods in the following amounts:
(A) one hundred ninety million six hundred thousand dollars for the
period January first, two thousand three through December thirty-first,
two thousand three;
(B) three hundred seventy-four million dollars for the period January
first, two thousand four through December thirty-first, two thousand
four;
(C) five hundred thirty-eight million four hundred thousand dollars
for the period January first, two thousand five through December thir-
ty-first, two thousand five;
(D) three hundred eighteen million seven hundred seventy-five thousand
dollars for the period January first, two thousand six through December
thirty-first, two thousand six;
(E) four hundred eighty-two million eight hundred thousand dollars for
the period January first, two thousand seven through December thirty-
first, two thousand seven;
(F) five hundred seventy million twenty-five thousand dollars for the
period January first, two thousand eight through December thirty-first,
two thousand eight;
(G) six hundred ten million seven hundred twenty-five thousand dollars
for the period January first, two thousand nine through December thir-
ty-first, two thousand nine;
S. 9007--C 69 A. 10007--C
(H) six hundred twenty-seven million two hundred seventy-five thousand
dollars for the period January first, two thousand ten through December
thirty-first, two thousand ten;
(I) one hundred fifty-seven million eight hundred seventy-five thou-
sand dollars for the period January first, two thousand eleven through
March thirty-first, two thousand eleven;
(J) six hundred twenty-eight million four hundred thousand dollars for
the period April first, two thousand eleven through March thirty-first,
two thousand twelve;
(K) six hundred fifty million four hundred thousand dollars for the
period April first, two thousand twelve through March thirty-first, two
thousand thirteen;
(L) six hundred fifty million four hundred thousand dollars for the
period April first, two thousand thirteen through March thirty-first,
two thousand fourteen; and
(M) up to three hundred ten million five hundred ninety-five thousand
dollars for the period April first, two thousand fourteen through March
thirty-first, two thousand fifteen.
(nn) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue fund - other, HCRA transfer fund, health care services account,
or any successor fund or account, for purposes related to adult home
initiatives for medicaid eligible residents of residential facilities
licensed pursuant to section four hundred sixty-b of the social services
law from the tobacco control and insurance initiatives pool established
for the following periods in the following amounts:
(i) up to four million dollars for the period January first, two thou-
sand three through December thirty-first, two thousand three;
(ii) up to six million dollars for the period January first, two thou-
sand four through December thirty-first, two thousand four;
(iii) up to eight million dollars for the period January first, two
thousand five through December thirty-first, two thousand five,
provided, however, that up to five million two hundred fifty thousand
dollars of such funds shall be received by the comptroller and deposited
to the credit of the special revenue fund - other / aid to localities,
HCRA transfer fund - 061, enhanced community services account - 05, or
any successor fund or account, for the purposes set forth in this para-
graph;
(iv) up to eight million dollars for the period January first, two
thousand six through December thirty-first, two thousand six, provided,
however, that up to five million two hundred fifty thousand dollars of
such funds shall be received by the comptroller and deposited to the
credit of the special revenue fund - other / aid to localities, HCRA
transfer fund - 061, enhanced community services account - 05, or any
successor fund or account, for the purposes set forth in this paragraph;
(v) up to eight million dollars for the period January first, two
thousand seven through December thirty-first, two thousand seven,
provided, however, that up to five million two hundred fifty thousand
dollars of such funds shall be received by the comptroller and deposited
to the credit of the special revenue fund - other / aid to localities,
HCRA transfer fund - 061, enhanced community services account - 05, or
any successor fund or account, for the purposes set forth in this para-
graph;
S. 9007--C 70 A. 10007--C
(vi) up to two million seven hundred fifty thousand dollars for the
period January first, two thousand eight through December thirty-first,
two thousand eight;
(vii) up to two million seven hundred fifty thousand dollars for the
period January first, two thousand nine through December thirty-first,
two thousand nine;
(viii) up to two million seven hundred fifty thousand dollars for the
period January first, two thousand ten through December thirty-first,
two thousand ten; and
(ix) up to six hundred eighty-eight thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven.
(oo) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for purposes
of grants to non-public general hospitals pursuant to paragraph (e) of
subdivision twenty-five of section twenty-eight hundred seven-c of this
article from the tobacco control and insurance initiatives pool estab-
lished for the following periods in the following amounts:
(i) up to five million dollars on an annualized basis for the period
January first, two thousand four through December thirty-first, two
thousand four;
(ii) up to five million dollars for the period January first, two
thousand five through December thirty-first, two thousand five;
(iii) up to five million dollars for the period January first, two
thousand six through December thirty-first, two thousand six;
(iv) up to five million dollars for the period January first, two
thousand seven through December thirty-first, two thousand seven;
(v) up to five million dollars for the period January first, two thou-
sand eight through December thirty-first, two thousand eight;
(vi) up to five million dollars for the period January first, two
thousand nine through December thirty-first, two thousand nine;
(vii) up to five million dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten; and
(viii) up to one million two hundred fifty thousand dollars for the
period January first, two thousand eleven through March thirty-first,
two thousand eleven.
(pp) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for the
purpose of supporting the provision of tax credits for long term care
insurance pursuant to subdivision one of section one hundred ninety of
the tax law, paragraph (a) of subdivision fourteen of section two
hundred ten-B of such law, subsection (aa) of section six hundred six of
such law and paragraph one of subdivision (m) of section fifteen hundred
eleven of such law, in the following amounts:
(i) ten million dollars for the period January first, two thousand
four through December thirty-first, two thousand four;
(ii) ten million dollars for the period January first, two thousand
five through December thirty-first, two thousand five;
(iii) ten million dollars for the period January first, two thousand
six through December thirty-first, two thousand six; and
(iv) five million dollars for the period January first, two thousand
seven through June thirtieth, two thousand seven.
(qq) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for the
purpose of supporting the long-term care insurance education and
S. 9007--C 71 A. 10007--C
outreach program established pursuant to section two hundred seventeen-a
of the elder law for the following periods in the following amounts:
(i) up to five million dollars for the period January first, two thou-
sand four through December thirty-first, two thousand four; of such
funds one million nine hundred fifty thousand dollars shall be made
available to the department for the purpose of developing, implementing
and administering the long-term care insurance education and outreach
program and three million fifty thousand dollars shall be deposited by
the commissioner, within amounts appropriated, and the comptroller is
hereby authorized and directed to receive for deposit to the credit of
the special revenue funds - other, HCRA transfer fund, long term care
insurance resource center account of the state office for the aging or
any future account designated for the purpose of implementing the long
term care insurance education and outreach program and providing the
long term care insurance resource centers with the necessary resources
to carry out their operations;
(ii) up to five million dollars for the period January first, two
thousand five through December thirty-first, two thousand five; of such
funds one million nine hundred fifty thousand dollars shall be made
available to the department for the purpose of developing, implementing
and administering the long-term care insurance education and outreach
program and three million fifty thousand dollars shall be deposited by
the commissioner, within amounts appropriated, and the comptroller is
hereby authorized and directed to receive for deposit to the credit of
the special revenue funds - other, HCRA transfer fund, long term care
insurance resource center account of the state office for the aging or
any future account designated for the purpose of implementing the long
term care insurance education and outreach program and providing the
long term care insurance resource centers with the necessary resources
to carry out their operations;
(iii) up to five million dollars for the period January first, two
thousand six through December thirty-first, two thousand six; of such
funds one million nine hundred fifty thousand dollars shall be made
available to the department for the purpose of developing, implementing
and administering the long-term care insurance education and outreach
program and three million fifty thousand dollars shall be made available
to the office for the aging for the purpose of providing the long term
care insurance resource centers with the necessary resources to carry
out their operations;
(iv) up to five million dollars for the period January first, two
thousand seven through December thirty-first, two thousand seven; of
such funds one million nine hundred fifty thousand dollars shall be made
available to the department for the purpose of developing, implementing
and administering the long-term care insurance education and outreach
program and three million fifty thousand dollars shall be made available
to the office for the aging for the purpose of providing the long term
care insurance resource centers with the necessary resources to carry
out their operations;
(v) up to five million dollars for the period January first, two thou-
sand eight through December thirty-first, two thousand eight; of such
funds one million nine hundred fifty thousand dollars shall be made
available to the department for the purpose of developing, implementing
and administering the long term care insurance education and outreach
program and three million fifty thousand dollars shall be made available
to the office for the aging for the purpose of providing the long term
S. 9007--C 72 A. 10007--C
care insurance resource centers with the necessary resources to carry
out their operations;
(vi) up to five million dollars for the period January first, two
thousand nine through December thirty-first, two thousand nine; of such
funds one million nine hundred fifty thousand dollars shall be made
available to the department for the purpose of developing, implementing
and administering the long-term care insurance education and outreach
program and three million fifty thousand dollars shall be made available
to the office for the aging for the purpose of providing the long-term
care insurance resource centers with the necessary resources to carry
out their operations;
(vii) up to four hundred eighty-eight thousand dollars for the period
January first, two thousand ten through March thirty-first, two thousand
ten; of such funds four hundred eighty-eight thousand dollars shall be
made available to the department for the purpose of developing, imple-
menting and administering the long-term care insurance education and
outreach program.
(rr) Funds shall be reserved and accumulated from the tobacco control
and insurance initiatives pool and shall be available, including income
from invested funds, for the purpose of supporting expenses related to
implementation of the provisions of title three of article twenty-nine-D
of this chapter, for the following periods and in the following amounts:
(i) up to ten million dollars for the period January first, two thou-
sand six through December thirty-first, two thousand six;
(ii) up to ten million dollars for the period January first, two thou-
sand seven through December thirty-first, two thousand seven;
(iii) up to ten million dollars for the period January first, two
thousand eight through December thirty-first, two thousand eight;
(iv) up to ten million dollars for the period January first, two thou-
sand nine through December thirty-first, two thousand nine;
(v) up to ten million dollars for the period January first, two thou-
sand ten through December thirty-first, two thousand ten; and
(vi) up to two million five hundred thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven.
(ss) Funds shall be reserved and accumulated from the tobacco control
and insurance initiatives pool and used for a health care stabilization
program established by the commissioner for the purposes of stabilizing
critical health care providers and health care programs whose ability to
continue to provide appropriate services are threatened by financial or
other challenges, in the amount of up to twenty-eight million dollars
for the period July first, two thousand four through June thirtieth, two
thousand five. Notwithstanding the provisions of section one hundred
twelve of the state finance law or any other inconsistent provision of
the state finance law or any other law, funds available for distribution
pursuant to this paragraph may be allocated and distributed by the
commissioner, or the state comptroller as applicable without a compet-
itive bid or request for proposal process. Considerations relied upon by
the commissioner in determining the allocation and distribution of these
funds shall include, but not be limited to, the following: (i) the
importance of the provider or program in meeting critical health care
needs in the community in which it operates; (ii) the provider or
program provision of care to under-served populations; (iii) the quality
of the care or services the provider or program delivers; (iv) the abil-
ity of the provider or program to continue to deliver an appropriate
level of care or services if additional funding is made available; (v)
S. 9007--C 73 A. 10007--C
the ability of the provider or program to access, in a timely manner,
alternative sources of funding, including other sources of government
funding; (vi) the ability of other providers or programs in the communi-
ty to meet the community health care needs; (vii) whether the provider
or program has an appropriate plan to improve its financial condition;
and (viii) whether additional funding would permit the provider or
program to consolidate, relocate, or close programs or services where
such actions would result in greater stability and efficiency in the
delivery of needed health care services or programs.
(tt) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for purposes
of providing grants for two long term care demonstration projects
designed to test new models for the delivery of long term care services
established pursuant to section twenty-eight hundred seven-x of this
[chapter] ARTICLE, for the following periods and in the following
amounts:
(i) up to five hundred thousand dollars for the period January first,
two thousand four through December thirty-first, two thousand four;
(ii) up to five hundred thousand dollars for the period January first,
two thousand five through December thirty-first, two thousand five;
(iii) up to five hundred thousand dollars for the period January
first, two thousand six through December thirty-first, two thousand six;
(iv) up to one million dollars for the period January first, two thou-
sand seven through December thirty-first, two thousand seven; and
(v) up to two hundred fifty thousand dollars for the period January
first, two thousand eight through March thirty-first, two thousand
eight.
(uu) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for the
purpose of supporting disease management and telemedicine demonstration
programs authorized pursuant to section twenty-one hundred eleven of
this chapter for the following periods in the following amounts:
(i) five million dollars for the period January first, two thousand
four through December thirty-first, two thousand four, of which three
million dollars shall be available for disease management demonstration
programs and two million dollars shall be available for telemedicine
demonstration programs;
(ii) five million dollars for the period January first, two thousand
five through December thirty-first, two thousand five, of which three
million dollars shall be available for disease management demonstration
programs and two million dollars shall be available for telemedicine
demonstration programs;
(iii) nine million five hundred thousand dollars for the period Janu-
ary first, two thousand six through December thirty-first, two thousand
six, of which seven million five hundred thousand dollars shall be
available for disease management demonstration programs and two million
dollars shall be available for telemedicine demonstration programs;
(iv) nine million five hundred thousand dollars for the period January
first, two thousand seven through December thirty-first, two thousand
seven, of which seven million five hundred thousand dollars shall be
available for disease management demonstration programs and one million
dollars shall be available for telemedicine demonstration programs;
(v) nine million five hundred thousand dollars for the period January
first, two thousand eight through December thirty-first, two thousand
eight, of which seven million five hundred thousand dollars shall be
S. 9007--C 74 A. 10007--C
available for disease management demonstration programs and two million
dollars shall be available for telemedicine demonstration programs;
(vi) seven million eight hundred thirty-three thousand three hundred
thirty-three dollars for the period January first, two thousand nine
through December thirty-first, two thousand nine, of which seven million
five hundred thousand dollars shall be available for disease management
demonstration programs and three hundred thirty-three thousand three
hundred thirty-three dollars shall be available for telemedicine demon-
stration programs for the period January first, two thousand nine
through March first, two thousand nine;
(vii) one million eight hundred seventy-five thousand dollars for the
period January first, two thousand ten through March thirty-first, two
thousand ten shall be available for disease management demonstration
programs.
(ww) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for the deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for purposes of funding the state
share of the general hospital rates increases for recruitment and
retention of health care workers pursuant to paragraph (e) of subdivi-
sion thirty of section twenty-eight hundred seven-c of this article from
the tobacco control and insurance initiatives pool established for the
following periods in the following amounts:
(i) sixty million five hundred thousand dollars for the period January
first, two thousand five through December thirty-first, two thousand
five; and
(ii) sixty million five hundred thousand dollars for the period Janu-
ary first, two thousand six through December thirty-first, two thousand
six.
(xx) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for the deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for purposes of funding the state
share of the general hospital rates increases for rural hospitals pursu-
ant to subdivision thirty-two of section twenty-eight hundred seven-c of
this article from the tobacco control and insurance initiatives pool
established for the following periods in the following amounts:
(i) three million five hundred thousand dollars for the period January
first, two thousand five through December thirty-first, two thousand
five;
(ii) three million five hundred thousand dollars for the period Janu-
ary first, two thousand six through December thirty-first, two thousand
six;
(iii) three million five hundred thousand dollars for the period Janu-
ary first, two thousand seven through December thirty-first, two thou-
sand seven;
(iv) three million five hundred thousand dollars for the period Janu-
ary first, two thousand eight through December thirty-first, two thou-
sand eight; and
(v) three million two hundred eight thousand dollars for the period
January first, two thousand nine through November thirtieth, two thou-
sand nine.
(yy) Funds shall be reserved and accumulated from year to year and
shall be available, within amounts appropriated and notwithstanding
S. 9007--C 75 A. 10007--C
section one hundred twelve of the state finance law and any other
contrary provision of law, for the purpose of supporting grants not to
exceed five million dollars to be made by the commissioner without a
competitive bid or request for proposal process, in support of the
delivery of critically needed health care services, to health care
providers located in the counties of Erie and Niagara which executed a
memorandum of closing and conducted a merger closing in escrow on Novem-
ber twenty-fourth, nineteen hundred ninety-seven and which entered into
a settlement dated December thirtieth, two thousand four for a loss on
disposal of assets under the provisions of title XVIII of the federal
social security act applicable to mergers occurring prior to December
first, nineteen hundred ninety-seven.
(zz) Funds shall be reserved and accumulated from year to year and
shall be available, within amounts appropriated, for the purpose of
supporting expenditures authorized pursuant to section twenty-eight
hundred eighteen of this article from the tobacco control and insurance
initiatives pool established for the following periods in the following
amounts:
(i) six million five hundred thousand dollars for the period January
first, two thousand five through December thirty-first, two thousand
five;
(ii) one hundred eight million three hundred thousand dollars for the
period January first, two thousand six through December thirty-first,
two thousand six, provided, however, that within amounts appropriated in
the two thousand six through two thousand seven state fiscal year, a
portion of such funds may be transferred to the Roswell Park Cancer
Institute Corporation to fund capital costs;
(iii) one hundred seventy-one million dollars for the period January
first, two thousand seven through December thirty-first, two thousand
seven, provided, however, that within amounts appropriated in the two
thousand six through two thousand seven state fiscal year, a portion of
such funds may be transferred to the Roswell Park Cancer Institute
Corporation to fund capital costs;
(iv) one hundred seventy-one million five hundred thousand dollars for
the period January first, two thousand eight through December thirty-
first, two thousand eight;
(v) one hundred twenty-eight million seven hundred fifty thousand
dollars for the period January first, two thousand nine through December
thirty-first, two thousand nine;
(vi) one hundred thirty-one million three hundred seventy-five thou-
sand dollars for the period January first, two thousand ten through
December thirty-first, two thousand ten;
(vii) thirty-four million two hundred fifty thousand dollars for the
period January first, two thousand eleven through March thirty-first,
two thousand eleven;
(viii) four hundred thirty-three million three hundred sixty-six thou-
sand dollars for the period April first, two thousand eleven through
March thirty-first, two thousand twelve;
(ix) one hundred fifty million eight hundred six thousand dollars for
the period April first, two thousand twelve through March thirty-first,
two thousand thirteen;
(x) seventy-eight million seventy-one thousand dollars for the period
April first, two thousand thirteen through March thirty-first, two thou-
sand fourteen.
(aaa) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for services
S. 9007--C 76 A. 10007--C
and expenses related to school based health centers, in an amount up to
three million five hundred thousand dollars for the period April first,
two thousand six through March thirty-first, two thousand seven, up to
three million five hundred thousand dollars for the period April first,
two thousand seven through March thirty-first, two thousand eight, up to
three million five hundred thousand dollars for the period April first,
two thousand eight through March thirty-first, two thousand nine, up to
three million five hundred thousand dollars for the period April first,
two thousand nine through March thirty-first, two thousand ten, up to
three million five hundred thousand dollars for the period April first,
two thousand ten through March thirty-first, two thousand eleven, up to
two million eight hundred thousand dollars each state fiscal year for
the period April first, two thousand eleven through March thirty-first,
two thousand fourteen, up to two million six hundred forty-four thousand
dollars each state fiscal year for the period April first, two thousand
fourteen through March thirty-first, two thousand seventeen, up to two
million six hundred forty-four thousand dollars each state fiscal year
for the period April first, two thousand seventeen through March thir-
ty-first, two thousand twenty, up to two million six hundred forty-four
thousand dollars each state fiscal year for the period April first, two
thousand twenty through March thirty-first, two thousand twenty-three,
[and] up to two million six hundred forty-four thousand dollars each
state fiscal year for the period April first, two thousand twenty-three
through March thirty-first, two thousand twenty-six, AND UP TO TWO
MILLION SIX HUNDRED FORTY-FOUR THOUSAND DOLLARS EACH STATE FISCAL YEAR
FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-SIX THROUGH MARCH THIR-
TY-FIRST, TWO THOUSAND TWENTY-NINE. The total amount of funds provided
herein shall be distributed as grants based on the ratio of each provid-
er's total enrollment for all sites to the total enrollment of all
providers. This formula shall be applied to the total amount provided
herein.
(bbb) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for purposes
of awarding grants to operators of adult homes, enriched housing
programs and residences through the enhancing abilities and life experi-
ence (EnAbLe) program to provide for the installation, operation and
maintenance of air conditioning in resident rooms, consistent with this
paragraph, in an amount up to two million dollars for the period April
first, two thousand six through March thirty-first, two thousand seven,
up to three million eight hundred thousand dollars for the period April
first, two thousand seven through March thirty-first, two thousand
eight, up to three million eight hundred thousand dollars for the period
April first, two thousand eight through March thirty-first, two thousand
nine, up to three million eight hundred thousand dollars for the period
April first, two thousand nine through March thirty-first, two thousand
ten, and up to three million eight hundred thousand dollars for the
period April first, two thousand ten through March thirty-first, two
thousand eleven. Residents shall not be charged utility cost for the use
of air conditioners supplied under the EnAbLe program. All such air
conditioners must be operated in occupied resident rooms consistent with
requirements applicable to common areas.
(ccc) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for the deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for purposes of funding the state
S. 9007--C 77 A. 10007--C
share of increases in the rates for certified home health agencies, long
term home health care programs, AIDS home care programs, hospice
programs and managed long term care plans and approved managed long term
care operating demonstrations as defined in section forty-four hundred
three-f of this chapter for recruitment and retention of health care
workers pursuant to subdivisions nine and ten of section thirty-six
hundred fourteen of this chapter from the tobacco control and insurance
initiatives pool established for the following periods in the following
amounts:
(i) twenty-five million dollars for the period June first, two thou-
sand six through December thirty-first, two thousand six;
(ii) fifty million dollars for the period January first, two thousand
seven through December thirty-first, two thousand seven;
(iii) fifty million dollars for the period January first, two thousand
eight through December thirty-first, two thousand eight;
(iv) fifty million dollars for the period January first, two thousand
nine through December thirty-first, two thousand nine;
(v) fifty million dollars for the period January first, two thousand
ten through December thirty-first, two thousand ten;
(vi) twelve million five hundred thousand dollars for the period Janu-
ary first, two thousand eleven through March thirty-first, two thousand
eleven;
(vii) up to fifty million dollars each state fiscal year for the peri-
od April first, two thousand eleven through March thirty-first, two
thousand fourteen;
(viii) up to fifty million dollars each state fiscal year for the
period April first, two thousand fourteen through March thirty-first,
two thousand seventeen;
(ix) up to fifty million dollars each state fiscal year for the period
April first, two thousand seventeen through March thirty-first, two
thousand twenty;
(x) up to fifty million dollars each state fiscal year for the period
April first, two thousand twenty through March thirty-first, two thou-
sand twenty-three; [and]
(xi) up to fifty million dollars each state fiscal year for the period
April first, two thousand twenty-three through March thirty-first, two
thousand twenty-six[.]; AND
(XII) UP TO FIFTY MILLION DOLLARS EACH STATE FISCAL YEAR FOR THE PERI-
OD APRIL FIRST, TWO THOUSAND TWENTY-SIX THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND TWENTY-NINE.
(ddd) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for the deposit to the credit of the state special
revenue funds - other, HCRA transfer fund, medical assistance account,
or any successor fund or account, for purposes of funding the state
share of increases in the medical assistance rates for providers for
purposes of enhancing the provision, quality and/or efficiency of home
care services pursuant to subdivision eleven of section thirty-six
hundred fourteen of this chapter from the tobacco control and insurance
initiatives pool established for the following period in the amount of
eight million dollars for the period April first, two thousand six
through December thirty-first, two thousand six.
(eee) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, to the Center
for Functional Genomics at the State University of New York at Albany,
for the purposes of the Adirondack network for cancer education and
S. 9007--C 78 A. 10007--C
research in rural communities grant program to improve access to health
care and shall be made available from the tobacco control and insurance
initiatives pool established for the following period in the amount of
up to five million dollars for the period January first, two thousand
six through December thirty-first, two thousand six.
(fff) Funds shall be made available to the empire state stem cell
trust fund established by section ninety-nine-p of the state finance law
within amounts appropriated up to fifty million dollars annually and
shall not exceed five hundred million dollars in total.
(ggg) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any successor fund or account, for the purpose of supporting the state
share of Medicaid expenditures for hospital translation services as
authorized pursuant to paragraph (k) of subdivision one of section twen-
ty-eight hundred seven-c of this article from the tobacco control and
initiatives pool established for the following periods in the following
amounts:
(i) sixteen million dollars for the period July first, two thousand
eight through December thirty-first, two thousand eight; and
(ii) fourteen million seven hundred thousand dollars for the period
January first, two thousand nine through November thirtieth, two thou-
sand nine.
(hhh) Funds shall be deposited by the commissioner, within amounts
appropriated, and the state comptroller is hereby authorized and
directed to receive for deposit to the credit of the state special
revenue fund - other, HCRA transfer fund, medical assistance account, or
any successor fund or account, for the purpose of supporting the state
share of Medicaid expenditures for adjustments to inpatient rates of
payment for general hospitals located in the counties of Nassau and
Suffolk as authorized pursuant to paragraph (l) of subdivision one of
section twenty-eight hundred seven-c of this article from the tobacco
control and initiatives pool established for the following periods in
the following amounts:
(i) two million five hundred thousand dollars for the period April
first, two thousand eight through December thirty-first, two thousand
eight; and
(ii) two million two hundred ninety-two thousand dollars for the peri-
od January first, two thousand nine through November thirtieth, two
thousand nine.
(iii) Funds shall be reserved and set aside and accumulated from year
to year and shall be made available, including income from investment
funds, for the purpose of supporting the New York state medical indem-
nity fund as authorized pursuant to title four of article twenty-nine-D
of this chapter, for the following periods and in the following amounts,
provided, however, that the commissioner is authorized to seek waiver
authority from the federal centers for medicare and Medicaid for the
purpose of securing Medicaid federal financial participation for such
program, in which case the funding authorized pursuant to this paragraph
shall be utilized as the non-federal share for such payments:
Thirty million dollars for the period April first, two thousand eleven
through March thirty-first, two thousand twelve.
2. (a) For periods prior to January first, two thousand five, the
commissioner is authorized to contract with the article forty-three
insurance law plans, or such other contractors as the commissioner shall
S. 9007--C 79 A. 10007--C
designate, to receive and distribute funds from the tobacco control and
insurance initiatives pool established pursuant to this section. In the
event contracts with the article forty-three insurance law plans or
other commissioner's designees are effectuated, the commissioner shall
conduct annual audits of the receipt and distribution of such funds. The
reasonable costs and expenses of an administrator as approved by the
commissioner, not to exceed for personnel services on an annual basis
five hundred thousand dollars, for collection and distribution of funds
pursuant to this section shall be paid from such funds.
(b) Notwithstanding any inconsistent provision of section one hundred
twelve or one hundred sixty-three of the state finance law or any other
law, at the discretion of the commissioner without a competitive bid or
request for proposal process, contracts in effect for administration of
pools established pursuant to sections twenty-eight hundred seven-k,
twenty-eight hundred seven-l and twenty-eight hundred seven-m of this
article for the period January first, nineteen hundred ninety-nine
through December thirty-first, nineteen hundred ninety-nine may be
extended to provide for administration pursuant to this section and may
be amended as may be necessary.
§ 18. Paragraph (a) of subdivision 12 of section 367-b of the social
services law, as amended by section 13 of part C of chapter 57 of the
laws of 2023, is amended to read as follows:
(a) For the purpose of regulating cash flow for general hospitals, the
department shall develop and implement a payment methodology to provide
for timely payments for inpatient hospital services eligible for case
based payments per discharge based on diagnosis-related groups provided
during the period January first, nineteen hundred eighty-eight through
March thirty-first two thousand [twenty-six] TWENTY-NINE, by such hospi-
tals which elect to participate in the system.
§ 19. Paragraph (u) of subdivision 9 of section 3614 of the public
health law, as added by section 14 of part C of chapter 57 of the laws
of 2023, is amended and three new paragraphs (v), (w) and (x) are added
to read as follows:
(u) for the period April first, two thousand twenty-five through March
thirty-first, two thousand twenty-six, up to one hundred million
dollars[.];
(V) FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-SIX THROUGH MARCH
THIRTY-FIRST, TWO THOUSAND TWENTY-SEVEN, UP TO ONE HUNDRED MILLION
DOLLARS;
(W) FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-SEVEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-EIGHT, UP TO ONE HUNDRED MILLION
DOLLARS;
(X) FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-EIGHT THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-NINE, UP TO ONE HUNDRED MILLION
DOLLARS.
§ 20. Paragraph (y) of subdivision 1 of section 367-q of the social
services law, as added by section 15 of part C of chapter 57 of the laws
of 2023, is amended and three new paragraphs (z), (aa) and (bb) are
added to read as follows:
(y) for the period April first, two thousand twenty-five through March
thirty-first, two thousand twenty-six, up to twenty-eight million five
hundred thousand dollars[.];
(Z) FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-SIX THROUGH MARCH
THIRTY-FIRST, TWO THOUSAND TWENTY-SEVEN, UP TO TWENTY-EIGHT MILLION FIVE
HUNDRED THOUSAND DOLLARS;
S. 9007--C 80 A. 10007--C
(AA) FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-SEVEN THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-EIGHT, UP TO TWENTY-EIGHT
MILLION FIVE HUNDRED THOUSAND DOLLARS;
(BB) FOR THE PERIOD APRIL FIRST, TWO THOUSAND TWENTY-EIGHT THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-NINE, UP TO TWENTY-EIGHT MILLION
FIVE HUNDRED THOUSAND DOLLARS.
§ 21. This act shall take effect April 1, 2026; provided, however, if
this act shall become a law after such date it shall take effect imme-
diately and shall be deemed to have been in full force and effect on and
after April 1, 2026; and further provided, that:
(a) the amendments to sections 2807-j and 2807-s of the public health
law made by sections two, fourteen and fifteen of this act shall not
affect the expiration of such sections and shall expire therewith;
(b) the amendments to subdivision 6 of section 2807-t of the public
health law made by section sixteen of this act shall not affect the
expiration of such section and shall be deemed to expire therewith; and
(c) the amendments to paragraph (i-1) of subdivision 1 of section
2807-v of the public health law made by section seventeen of this act
shall not affect the repeal of such paragraph and shall be deemed
repealed therewith.
PART D
Section 1. Paragraph (a) of subdivision 1 of section 18 of chapter 266
of the laws of 1986, amending the civil practice law and rules and other
laws relating to malpractice and professional medical conduct, as
amended by section 1 of part G of chapter 57 of the laws of 2025, is
amended to read as follows:
(a) The superintendent of financial services and the commissioner of
health or their designee shall, from funds available in the hospital
excess liability pool created pursuant to subdivision 5 of this section,
purchase a policy or policies for excess insurance coverage, as author-
ized by paragraph 1 of subsection (e) of section 5502 of the insurance
law; or from an insurer, other than an insurer described in section 5502
of the insurance law, duly authorized to write such coverage and actual-
ly writing medical malpractice insurance in this state; or shall
purchase equivalent excess coverage in a form previously approved by the
superintendent of financial services for purposes of providing equiv-
alent excess coverage in accordance with section 19 of chapter 294 of
the laws of 1985, for medical or dental malpractice occurrences between
July 1, 1986 and June 30, 1987, between July 1, 1987 and June 30, 1988,
between July 1, 1988 and June 30, 1989, between July 1, 1989 and June
30, 1990, between July 1, 1990 and June 30, 1991, between July 1, 1991
and June 30, 1992, between July 1, 1992 and June 30, 1993, between July
1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995,
between July 1, 1995 and June 30, 1996, between July 1, 1996 and June
30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998
and June 30, 1999, between July 1, 1999 and June 30, 2000, between July
1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002,
between July 1, 2002 and June 30, 2003, between July 1, 2003 and June
30, 2004, between July 1, 2004 and June 30, 2005, between July 1, 2005
and June 30, 2006, between July 1, 2006 and June 30, 2007, between July
1, 2007 and June 30, 2008, between July 1, 2008 and June 30, 2009,
between July 1, 2009 and June 30, 2010, between July 1, 2010 and June
30, 2011, between July 1, 2011 and June 30, 2012, between July 1, 2012
and June 30, 2013, between July 1, 2013 and June 30, 2014, between July
S. 9007--C 81 A. 10007--C
1, 2014 and June 30, 2015, between July 1, 2015 and June 30, 2016,
between July 1, 2016 and June 30, 2017, between July 1, 2017 and June
30, 2018, between July 1, 2018 and June 30, 2019, between July 1, 2019
and June 30, 2020, between July 1, 2020 and June 30, 2021, between July
1, 2021 and June 30, 2022, between July 1, 2022 and June 30, 2023,
between July 1, 2023 and June 30, 2024, between July 1, 2024 and June
30, 2025, [and] between July 1, 2025 and June 30, 2026, AND BETWEEN JULY
1, 2026 AND JUNE 30, 2027 or reimburse the hospital where the hospital
purchases equivalent excess coverage as defined in subparagraph (i) of
paragraph (a) of subdivision 1-a of this section for medical or dental
malpractice occurrences between July 1, 1987 and June 30, 1988, between
July 1, 1988 and June 30, 1989, between July 1, 1989 and June 30, 1990,
between July 1, 1990 and June 30, 1991, between July 1, 1991 and June
30, 1992, between July 1, 1992 and June 30, 1993, between July 1, 1993
and June 30, 1994, between July 1, 1994 and June 30, 1995, between July
1, 1995 and June 30, 1996, between July 1, 1996 and June 30, 1997,
between July 1, 1997 and June 30, 1998, between July 1, 1998 and June
30, 1999, between July 1, 1999 and June 30, 2000, between July 1, 2000
and June 30, 2001, between July 1, 2001 and June 30, 2002, between July
1, 2002 and June 30, 2003, between July 1, 2003 and June 30, 2004,
between July 1, 2004 and June 30, 2005, between July 1, 2005 and June
30, 2006, between July 1, 2006 and June 30, 2007, between July 1, 2007
and June 30, 2008, between July 1, 2008 and June 30, 2009, between July
1, 2009 and June 30, 2010, between July 1, 2010 and June 30, 2011,
between July 1, 2011 and June 30, 2012, between July 1, 2012 and June
30, 2013, between July 1, 2013 and June 30, 2014, between July 1, 2014
and June 30, 2015, between July 1, 2015 and June 30, 2016, between July
1, 2016 and June 30, 2017, between July 1, 2017 and June 30, 2018,
between July 1, 2018 and June 30, 2019, between July 1, 2019 and June
30, 2020, between July 1, 2020 and June 30, 2021, between July 1, 2021
and June 30, 2022, between July 1, 2022 and June 30, 2023, between July
1, 2023 and June 30, 2024, between July 1, 2024 and June 30, 2025, [and]
between July 1, 2025 and June 30, 2026, AND BETWEEN JULY 1, 2026 AND
JUNE 30, 2027 for physicians or dentists certified as eligible for each
such period or periods pursuant to subdivision 2 of this section by a
general hospital licensed pursuant to article 28 of the public health
law; provided that no single insurer shall write more than fifty percent
of the total excess premium for a given policy year; and provided,
however, that such eligible physicians or dentists must have in force an
individual policy, from an insurer licensed in this state of primary
malpractice insurance coverage in amounts of no less than one million
three hundred thousand dollars for each claimant and three million nine
hundred thousand dollars for all claimants under that policy during the
period of such excess coverage for such occurrences or be endorsed as
additional insureds under a hospital professional liability policy which
is offered through a voluntary attending physician ("channeling")
program previously permitted by the superintendent of financial services
during the period of such excess coverage for such occurrences. During
such period, such policy for excess coverage or such equivalent excess
coverage shall, when combined with the physician's or dentist's primary
malpractice insurance coverage or coverage provided through a voluntary
attending physician ("channeling") program, total an aggregate level of
two million three hundred thousand dollars for each claimant and six
million nine hundred thousand dollars for all claimants from all such
policies with respect to occurrences in each of such years provided,
however, if the cost of primary malpractice insurance coverage in excess
S. 9007--C 82 A. 10007--C
of one million dollars, but below the excess medical malpractice insur-
ance coverage provided pursuant to this act, exceeds the rate of nine
percent per annum, then the required level of primary malpractice insur-
ance coverage in excess of one million dollars for each claimant shall
be in an amount of not less than the dollar amount of such coverage
available at nine percent per annum; the required level of such coverage
for all claimants under that policy shall be in an amount not less than
three times the dollar amount of coverage for each claimant; and excess
coverage, when combined with such primary malpractice insurance cover-
age, shall increase the aggregate level for each claimant by one million
dollars and three million dollars for all claimants; and provided
further, that, with respect to policies of primary medical malpractice
coverage that include occurrences between April 1, 2002 and June 30,
2002, such requirement that coverage be in amounts no less than one
million three hundred thousand dollars for each claimant and three
million nine hundred thousand dollars for all claimants for such occur-
rences shall be effective April 1, 2002.
§ 2. Subdivision 3 of section 18 of chapter 266 of the laws of 1986,
amending the civil practice law and rules and other laws relating to
malpractice and professional medical conduct, as amended by section 2 of
part G of chapter 57 of the laws of 2025, is amended to read as follows:
(3)(a) The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
cost of excess malpractice insurance for medical or dental malpractice
occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988
and June 30, 1989, between July 1, 1989 and June 30, 1990, between July
1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992,
between July 1, 1992 and June 30, 1993, between July 1, 1993 and June
30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995
and June 30, 1996, between July 1, 1996 and June 30, 1997, between July
1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999,
between July 1, 1999 and June 30, 2000, between July 1, 2000 and June
30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002
and June 30, 2003, between July 1, 2003 and June 30, 2004, between July
1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006,
between July 1, 2006 and June 30, 2007, between July 1, 2007 and June
30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009
and June 30, 2010, between July 1, 2010 and June 30, 2011, between July
1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013,
between July 1, 2013 and June 30, 2014, between July 1, 2014 and June
30, 2015, between July 1, 2015 and June 30, 2016, between July 1, 2016
and June 30, 2017, between July 1, 2017 and June 30, 2018, between July
1, 2018 and June 30, 2019, between July 1, 2019 and June 30, 2020,
between July 1, 2020 and June 30, 2021, between July 1, 2021 and June
30, 2022, between July 1, 2022 and June 30, 2023, between July 1, 2023
and June 30, 2024, between July 1, 2024 and June 30, 2025, [and] between
July 1, 2025 and June 30, 2026, AND BETWEEN JULY 1, 2026 AND JUNE 30,
2027 allocable to each general hospital for physicians or dentists
certified as eligible for purchase of a policy for excess insurance
coverage by such general hospital in accordance with subdivision 2 of
this section, and may amend such determination and certification as
necessary.
(b) The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
cost of excess malpractice insurance or equivalent excess coverage for
medical or dental malpractice occurrences between July 1, 1987 and June
S. 9007--C 83 A. 10007--C
30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989
and June 30, 1990, between July 1, 1990 and June 30, 1991, between July
1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993,
between July 1, 1993 and June 30, 1994, between July 1, 1994 and June
30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996
and June 30, 1997, between July 1, 1997 and June 30, 1998, between July
1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000,
between July 1, 2000 and June 30, 2001, between July 1, 2001 and June
30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003
and June 30, 2004, between July 1, 2004 and June 30, 2005, between July
1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007,
between July 1, 2007 and June 30, 2008, between July 1, 2008 and June
30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010
and June 30, 2011, between July 1, 2011 and June 30, 2012, between July
1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014,
between July 1, 2014 and June 30, 2015, between July 1, 2015 and June
30, 2016, between July 1, 2016 and June 30, 2017, between July 1, 2017
and June 30, 2018, between July 1, 2018 and June 30, 2019, between July
1, 2019 and June 30, 2020, between July 1, 2020 and June 30, 2021,
between July 1, 2021 and June 30, 2022, between July 1, 2022 and June
30, 2023, between July 1, 2023 and June 30, 2024, between July 1, 2024
and June 30, 2025, [and] between July 1, 2025 and June 30, 2026, AND
BETWEEN JULY 1, 2026 AND JUNE 30, 2027 allocable to each general hospi-
tal for physicians or dentists certified as eligible for purchase of a
policy for excess insurance coverage or equivalent excess coverage by
such general hospital in accordance with subdivision 2 of this section,
and may amend such determination and certification as necessary. The
superintendent of financial services shall determine and certify to each
general hospital and to the commissioner of health the ratable share of
such cost allocable to the period July 1, 1987 to December 31, 1987, to
the period January 1, 1988 to June 30, 1988, to the period July 1, 1988
to December 31, 1988, to the period January 1, 1989 to June 30, 1989, to
the period July 1, 1989 to December 31, 1989, to the period January 1,
1990 to June 30, 1990, to the period July 1, 1990 to December 31, 1990,
to the period January 1, 1991 to June 30, 1991, to the period July 1,
1991 to December 31, 1991, to the period January 1, 1992 to June 30,
1992, to the period July 1, 1992 to December 31, 1992, to the period
January 1, 1993 to June 30, 1993, to the period July 1, 1993 to December
31, 1993, to the period January 1, 1994 to June 30, 1994, to the period
July 1, 1994 to December 31, 1994, to the period January 1, 1995 to June
30, 1995, to the period July 1, 1995 to December 31, 1995, to the period
January 1, 1996 to June 30, 1996, to the period July 1, 1996 to December
31, 1996, to the period January 1, 1997 to June 30, 1997, to the period
July 1, 1997 to December 31, 1997, to the period January 1, 1998 to June
30, 1998, to the period July 1, 1998 to December 31, 1998, to the period
January 1, 1999 to June 30, 1999, to the period July 1, 1999 to December
31, 1999, to the period January 1, 2000 to June 30, 2000, to the period
July 1, 2000 to December 31, 2000, to the period January 1, 2001 to June
30, 2001, to the period July 1, 2001 to June 30, 2002, to the period
July 1, 2002 to June 30, 2003, to the period July 1, 2003 to June 30,
2004, to the period July 1, 2004 to June 30, 2005, to the period July 1,
2005 and June 30, 2006, to the period July 1, 2006 and June 30, 2007, to
the period July 1, 2007 and June 30, 2008, to the period July 1, 2008
and June 30, 2009, to the period July 1, 2009 and June 30, 2010, to the
period July 1, 2010 and June 30, 2011, to the period July 1, 2011 and
June 30, 2012, to the period July 1, 2012 and June 30, 2013, to the
S. 9007--C 84 A. 10007--C
period July 1, 2013 and June 30, 2014, to the period July 1, 2014 and
June 30, 2015, to the period July 1, 2015 and June 30, 2016, to the
period July 1, 2016 and June 30, 2017, to the period July 1, 2017 to
June 30, 2018, to the period July 1, 2018 to June 30, 2019, to the peri-
od July 1, 2019 to June 30, 2020, to the period July 1, 2020 to June 30,
2021, to the period July 1, 2021 to June 30, 2022, to the period July 1,
2022 to June 30, 2023, to the period July 1, 2023 to June 30, 2024, to
the period July 1, 2024 to June 30, 2025, [and] to the period July 1,
2025 to June 30, 2026, AND TO THE PERIOD JULY 1, 2026 TO JUNE 30, 2027.
§ 3. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
18 of chapter 266 of the laws of 1986, amending the civil practice law
and rules and other laws relating to malpractice and professional
medical conduct, as amended by section 3 of part G of chapter 57 of the
laws of 2025, are amended to read as follows:
(a) To the extent funds available to the hospital excess liability
pool pursuant to subdivision 5 of this section as amended, and pursuant
to section 6 of part J of chapter 63 of the laws of 2001, as may from
time to time be amended, which amended this subdivision, are insuffi-
cient to meet the costs of excess insurance coverage or equivalent
excess coverage for coverage periods during the period July 1, 1992 to
June 30, 1993, during the period July 1, 1993 to June 30, 1994, during
the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
to June 30, 1996, during the period July 1, 1996 to June 30, 1997,
during the period July 1, 1997 to June 30, 1998, during the period July
1, 1998 to June 30, 1999, during the period July 1, 1999 to June 30,
2000, during the period July 1, 2000 to June 30, 2001, during the period
July 1, 2001 to October 29, 2001, during the period April 1, 2002 to
June 30, 2002, during the period July 1, 2002 to June 30, 2003, during
the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
to June 30, 2005, during the period July 1, 2005 to June 30, 2006,
during the period July 1, 2006 to June 30, 2007, during the period July
1, 2007 to June 30, 2008, during the period July 1, 2008 to June 30,
2009, during the period July 1, 2009 to June 30, 2010, during the period
July 1, 2010 to June 30, 2011, during the period July 1, 2011 to June
30, 2012, during the period July 1, 2012 to June 30, 2013, during the
period July 1, 2013 to June 30, 2014, during the period July 1, 2014 to
June 30, 2015, during the period July 1, 2015 to June 30, 2016, during
the period July 1, 2016 to June 30, 2017, during the period July 1, 2017
to June 30, 2018, during the period July 1, 2018 to June 30, 2019,
during the period July 1, 2019 to June 30, 2020, during the period July
1, 2020 to June 30, 2021, during the period July 1, 2021 to June 30,
2022, during the period July 1, 2022 to June 30, 2023, during the period
July 1, 2023 to June 30, 2024, during the period July 1, 2024 to June
30, 2025, [and] during the period July 1, 2025 to June 30, 2026, AND
DURING THE PERIOD JULY 1, 2026 TO JUNE 30, 2027 allocated or reallocated
in accordance with paragraph (a) of subdivision 4-a of this section to
rates of payment applicable to state governmental agencies, each physi-
cian or dentist for whom a policy for excess insurance coverage or
equivalent excess coverage is purchased for such period shall be respon-
sible for payment to the provider of excess insurance coverage or equiv-
alent excess coverage of an allocable share of such insufficiency, based
on the ratio of the total cost of such coverage for such physician to
the sum of the total cost of such coverage for all physicians applied to
such insufficiency.
(b) Each provider of excess insurance coverage or equivalent excess
coverage covering the period July 1, 1992 to June 30, 1993, or covering
S. 9007--C 85 A. 10007--C
the period July 1, 1993 to June 30, 1994, or covering the period July 1,
1994 to June 30, 1995, or covering the period July 1, 1995 to June 30,
1996, or covering the period July 1, 1996 to June 30, 1997, or covering
the period July 1, 1997 to June 30, 1998, or covering the period July 1,
1998 to June 30, 1999, or covering the period July 1, 1999 to June 30,
2000, or covering the period July 1, 2000 to June 30, 2001, or covering
the period July 1, 2001 to October 29, 2001, or covering the period
April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to
June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
covering the period July 1, 2004 to June 30, 2005, or covering the peri-
od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
June 30, 2007, or covering the period July 1, 2007 to June 30, 2008, or
covering the period July 1, 2008 to June 30, 2009, or covering the peri-
od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
June 30, 2011, or covering the period July 1, 2011 to June 30, 2012, or
covering the period July 1, 2012 to June 30, 2013, or covering the peri-
od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to
June 30, 2015, or covering the period July 1, 2015 to June 30, 2016, or
covering the period July 1, 2016 to June 30, 2017, or covering the peri-
od July 1, 2017 to June 30, 2018, or covering the period July 1, 2018 to
June 30, 2019, or covering the period July 1, 2019 to June 30, 2020, or
covering the period July 1, 2020 to June 30, 2021, or covering the peri-
od July 1, 2021 to June 30, 2022, or covering the period July 1, 2022 to
June 30, 2023, or covering the period July 1, 2023 to June 30, 2024, or
covering the period July 1, 2024 to June 30, 2025, or covering the peri-
od July 1, 2025 to June 30, 2026, OR COVERING THE PERIOD JULY 1, 2026 TO
JUNE 30, 2027 shall notify a covered physician or dentist by mail,
mailed to the address shown on the last application for excess insurance
coverage or equivalent excess coverage, of the amount due to such
provider from such physician or dentist for such coverage period deter-
mined in accordance with paragraph (a) of this subdivision. Such amount
shall be due from such physician or dentist to such provider of excess
insurance coverage or equivalent excess coverage in a time and manner
determined by the superintendent of financial services.
(c) If a physician or dentist liable for payment of a portion of the
costs of excess insurance coverage or equivalent excess coverage cover-
ing the period July 1, 1992 to June 30, 1993, or covering the period
July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to
June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
covering the period July 1, 1996 to June 30, 1997, or covering the peri-
od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or
covering the period July 1, 2000 to June 30, 2001, or covering the peri-
od July 1, 2001 to October 29, 2001, or covering the period April 1,
2002 to June 30, 2002, or covering the period July 1, 2002 to June 30,
2003, or covering the period July 1, 2003 to June 30, 2004, or covering
the period July 1, 2004 to June 30, 2005, or covering the period July 1,
2005 to June 30, 2006, or covering the period July 1, 2006 to June 30,
2007, or covering the period July 1, 2007 to June 30, 2008, or covering
the period July 1, 2008 to June 30, 2009, or covering the period July 1,
2009 to June 30, 2010, or covering the period July 1, 2010 to June 30,
2011, or covering the period July 1, 2011 to June 30, 2012, or covering
the period July 1, 2012 to June 30, 2013, or covering the period July 1,
2013 to June 30, 2014, or covering the period July 1, 2014 to June 30,
2015, or covering the period July 1, 2015 to June 30, 2016, or covering
the period July 1, 2016 to June 30, 2017, or covering the period July 1,
S. 9007--C 86 A. 10007--C
2017 to June 30, 2018, or covering the period July 1, 2018 to June 30,
2019, or covering the period July 1, 2019 to June 30, 2020, or covering
the period July 1, 2020 to June 30, 2021, or covering the period July 1,
2021 to June 30, 2022, or covering the period July 1, 2022 to June 30,
2023, or covering the period July 1, 2023 to June 30, 2024, or covering
the period July 1, 2024 to June 30, 2025, or covering the period July 1,
2025 to June 30, 2026, OR COVERING THE PERIOD JULY 1, 2026 TO JUNE 30,
2027 determined in accordance with paragraph (a) of this subdivision
fails, refuses or neglects to make payment to the provider of excess
insurance coverage or equivalent excess coverage in such time and manner
as determined by the superintendent of financial services pursuant to
paragraph (b) of this subdivision, excess insurance coverage or equiv-
alent excess coverage purchased for such physician or dentist in accord-
ance with this section for such coverage period shall be cancelled and
shall be null and void as of the first day on or after the commencement
of a policy period where the liability for payment pursuant to this
subdivision has not been met.
(d) Each provider of excess insurance coverage or equivalent excess
coverage shall notify the superintendent of financial services and the
commissioner of health or their designee of each physician and dentist
eligible for purchase of a policy for excess insurance coverage or
equivalent excess coverage covering the period July 1, 1992 to June 30,
1993, or covering the period July 1, 1993 to June 30, 1994, or covering
the period July 1, 1994 to June 30, 1995, or covering the period July 1,
1995 to June 30, 1996, or covering the period July 1, 1996 to June 30,
1997, or covering the period July 1, 1997 to June 30, 1998, or covering
the period July 1, 1998 to June 30, 1999, or covering the period July 1,
1999 to June 30, 2000, or covering the period July 1, 2000 to June 30,
2001, or covering the period July 1, 2001 to October 29, 2001, or cover-
ing the period April 1, 2002 to June 30, 2002, or covering the period
July 1, 2002 to June 30, 2003, or covering the period July 1, 2003 to
June 30, 2004, or covering the period July 1, 2004 to June 30, 2005, or
covering the period July 1, 2005 to June 30, 2006, or covering the peri-
od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to
June 30, 2008, or covering the period July 1, 2008 to June 30, 2009, or
covering the period July 1, 2009 to June 30, 2010, or covering the peri-
od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to
June 30, 2012, or covering the period July 1, 2012 to June 30, 2013, or
covering the period July 1, 2013 to June 30, 2014, or covering the peri-
od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to
June 30, 2016, or covering the period July 1, 2016 to June 30, 2017, or
covering the period July 1, 2017 to June 30, 2018, or covering the peri-
od July 1, 2018 to June 30, 2019, or covering the period July 1, 2019 to
June 30, 2020, or covering the period July 1, 2020 to June 30, 2021, or
covering the period July 1, 2021 to June 30, 2022, or covering the peri-
od July 1, 2022 to June 30, 2023, or covering the period July 1, 2023 to
June 30, 2024, or covering the period July 1, 2024 to June 30, 2025, or
covering the period July 1, 2025 to June 30, 2026, OR COVERING THE PERI-
OD JULY 1, 2026 TO JUNE 30, 2027 that has made payment to such provider
of excess insurance coverage or equivalent excess coverage in accordance
with paragraph (b) of this subdivision and of each physician and dentist
who has failed, refused or neglected to make such payment.
(e) A provider of excess insurance coverage or equivalent excess
coverage shall refund to the hospital excess liability pool any amount
allocable to the period July 1, 1992 to June 30, 1993, and to the period
July 1, 1993 to June 30, 1994, and to the period July 1, 1994 to June
S. 9007--C 87 A. 10007--C
30, 1995, and to the period July 1, 1995 to June 30, 1996, and to the
period July 1, 1996 to June 30, 1997, and to the period July 1, 1997 to
June 30, 1998, and to the period July 1, 1998 to June 30, 1999, and to
the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
to June 30, 2001, and to the period July 1, 2001 to October 29, 2001,
and to the period April 1, 2002 to June 30, 2002, and to the period July
1, 2002 to June 30, 2003, and to the period July 1, 2003 to June 30,
2004, and to the period July 1, 2004 to June 30, 2005, and to the period
July 1, 2005 to June 30, 2006, and to the period July 1, 2006 to June
30, 2007, and to the period July 1, 2007 to June 30, 2008, and to the
period July 1, 2008 to June 30, 2009, and to the period July 1, 2009 to
June 30, 2010, and to the period July 1, 2010 to June 30, 2011, and to
the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
to June 30, 2013, and to the period July 1, 2013 to June 30, 2014, and
to the period July 1, 2014 to June 30, 2015, and to the period July 1,
2015 to June 30, 2016, to the period July 1, 2016 to June 30, 2017, and
to the period July 1, 2017 to June 30, 2018, and to the period July 1,
2018 to June 30, 2019, and to the period July 1, 2019 to June 30, 2020,
and to the period July 1, 2020 to June 30, 2021, and to the period July
1, 2021 to June 30, 2022, and to the period July 1, 2022 to June 30,
2023, and to the period July 1, 2023 to June 30, 2024, and to the period
July 1, 2024 to June 30, 2025, and to the period July 1, 2025 to June
30, 2026, AND TO THE PERIOD JULY 1, 2026 TO JUNE 30, 2027 received from
the hospital excess liability pool for purchase of excess insurance
coverage or equivalent excess coverage covering the period July 1, 1992
to June 30, 1993, and covering the period July 1, 1993 to June 30, 1994,
and covering the period July 1, 1994 to June 30, 1995, and covering the
period July 1, 1995 to June 30, 1996, and covering the period July 1,
1996 to June 30, 1997, and covering the period July 1, 1997 to June 30,
1998, and covering the period July 1, 1998 to June 30, 1999, and cover-
ing the period July 1, 1999 to June 30, 2000, and covering the period
July 1, 2000 to June 30, 2001, and covering the period July 1, 2001 to
October 29, 2001, and covering the period April 1, 2002 to June 30,
2002, and covering the period July 1, 2002 to June 30, 2003, and cover-
ing the period July 1, 2003 to June 30, 2004, and covering the period
July 1, 2004 to June 30, 2005, and covering the period July 1, 2005 to
June 30, 2006, and covering the period July 1, 2006 to June 30, 2007,
and covering the period July 1, 2007 to June 30, 2008, and covering the
period July 1, 2008 to June 30, 2009, and covering the period July 1,
2009 to June 30, 2010, and covering the period July 1, 2010 to June 30,
2011, and covering the period July 1, 2011 to June 30, 2012, and cover-
ing the period July 1, 2012 to June 30, 2013, and covering the period
July 1, 2013 to June 30, 2014, and covering the period July 1, 2014 to
June 30, 2015, and covering the period July 1, 2015 to June 30, 2016,
and covering the period July 1, 2016 to June 30, 2017, and covering the
period July 1, 2017 to June 30, 2018, and covering the period July 1,
2018 to June 30, 2019, and covering the period July 1, 2019 to June 30,
2020, and covering the period July 1, 2020 to June 30, 2021, and cover-
ing the period July 1, 2021 to June 30, 2022, and covering the period
July 1, 2022 to June 30, 2023 for, and covering the period July 1, 2023
to June 30, 2024, and covering the period July 1, 2024 to June 30, 2025,
and covering the period July 1, 2025 to June 30, 2026, AND COVERING THE
PERIOD JULY 1, 2026 TO JUNE 30, 2027 a physician or dentist where such
excess insurance coverage or equivalent excess coverage is cancelled in
accordance with paragraph (c) of this subdivision.
S. 9007--C 88 A. 10007--C
§ 4. Section 40 of chapter 266 of the laws of 1986, amending the civil
practice law and rules and other laws relating to malpractice and
professional medical conduct, as amended by section 4 of part G of chap-
ter 57 of the laws of 2025, is amended to read as follows:
§ 40. The superintendent of financial services shall establish rates
for policies providing coverage for physicians and surgeons medical
malpractice for the periods commencing July 1, 1985 and ending June 30,
[2026] 2027; provided, however, that notwithstanding any other provision
of law, the superintendent shall not establish or approve any increase
in rates for the period commencing July 1, 2009 and ending June 30,
2010. The superintendent shall direct insurers to establish segregated
accounts for premiums, payments, reserves and investment income attrib-
utable to such premium periods and shall require periodic reports by the
insurers regarding claims and expenses attributable to such periods to
monitor whether such accounts will be sufficient to meet incurred claims
and expenses. On or after July 1, 1989, the superintendent shall impose
a surcharge on premiums to satisfy a projected deficiency that is
attributable to the premium levels established pursuant to this section
for such periods; provided, however, that such annual surcharge shall
not exceed eight percent of the established rate until July 1, [2026]
2027, at which time and thereafter such surcharge shall not exceed twen-
ty-five percent of the approved adequate rate, and that such annual
surcharges shall continue for such period of time as shall be sufficient
to satisfy such deficiency. The superintendent shall not impose such
surcharge during the period commencing July 1, 2009 and ending June 30,
2010. On and after July 1, 1989, the surcharge prescribed by this
section shall be retained by insurers to the extent that they insured
physicians and surgeons during the July 1, 1985 through June 30, [2026]
2027 policy periods; in the event and to the extent physicians and
surgeons were insured by another insurer during such periods, all or a
pro rata share of the surcharge, as the case may be, shall be remitted
to such other insurer in accordance with rules and regulations to be
promulgated by the superintendent. Surcharges collected from physicians
and surgeons who were not insured during such policy periods shall be
apportioned among all insurers in proportion to the premium written by
each insurer during such policy periods; if a physician or surgeon was
insured by an insurer subject to rates established by the superintendent
during such policy periods, and at any time thereafter a hospital,
health maintenance organization, employer or institution is responsible
for responding in damages for liability arising out of such physician's
or surgeon's practice of medicine, such responsible entity shall also
remit to such prior insurer the equivalent amount that would then be
collected as a surcharge if the physician or surgeon had continued to
remain insured by such prior insurer. In the event any insurer that
provided coverage during such policy periods is in liquidation, the
property/casualty insurance security fund shall receive the portion of
surcharges to which the insurer in liquidation would have been entitled.
The surcharges authorized herein shall be deemed to be income earned for
the purposes of section 2303 of the insurance law. The superintendent,
in establishing adequate rates and in determining any projected defi-
ciency pursuant to the requirements of this section and the insurance
law, shall give substantial weight, determined in [his] THEIR discretion
and judgment, to the prospective anticipated effect of any regulations
promulgated and laws enacted and the public benefit of stabilizing
malpractice rates and minimizing rate level fluctuation during the peri-
od of time necessary for the development of more reliable statistical
S. 9007--C 89 A. 10007--C
experience as to the efficacy of such laws and regulations affecting
medical, dental or podiatric malpractice enacted or promulgated in 1985,
1986, by this act and at any other time. Notwithstanding any provision
of the insurance law, rates already established and to be established by
the superintendent pursuant to this section are deemed adequate if such
rates would be adequate when taken together with the maximum authorized
annual surcharges to be imposed for a reasonable period of time whether
or not any such annual surcharge has been actually imposed as of the
establishment of such rates.
§ 5. Section 5 and subdivisions (a) and (e) of section 6 of 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, as amended by section 5
of part G of chapter 57 of the laws of 2025, are amended to read as
follows:
§ 5. The superintendent of financial services and the commissioner of
health shall determine, no later than June 15, 2002, June 15, 2003, June
15, 2004, June 15, 2005, June 15, 2006, June 15, 2007, June 15, 2008,
June 15, 2009, June 15, 2010, June 15, 2011, June 15, 2012, June 15,
2013, June 15, 2014, June 15, 2015, June 15, 2016, June 15, 2017, June
15, 2018, June 15, 2019, June 15, 2020, June 15, 2021, June 15, 2022,
June 15, 2023, June 15, 2024, June 15, 2025, [and] June 15, 2026, AND
JUNE 15, 2027 the amount of funds available in the hospital excess
liability pool, created pursuant to section 18 of chapter 266 of the
laws of 1986, and whether such funds are sufficient for purposes of
purchasing excess insurance coverage for eligible participating physi-
cians and dentists during the period July 1, 2001 to June 30, 2002, or
July 1, 2002 to June 30, 2003, or July 1, 2003 to June 30, 2004, or July
1, 2004 to June 30, 2005, or July 1, 2005 to June 30, 2006, or July 1,
2006 to June 30, 2007, or July 1, 2007 to June 30, 2008, or July 1, 2008
to June 30, 2009, or July 1, 2009 to June 30, 2010, or July 1, 2010 to
June 30, 2011, or July 1, 2011 to June 30, 2012, or July 1, 2012 to June
30, 2013, or July 1, 2013 to June 30, 2014, or July 1, 2014 to June 30,
2015, or July 1, 2015 to June 30, 2016, or July 1, 2016 to June 30,
2017, or July 1, 2017 to June 30, 2018, or July 1, 2018 to June 30,
2019, or July 1, 2019 to June 30, 2020, or July 1, 2020 to June 30,
2021, or July 1, 2021 to June 30, 2022, or July 1, 2022 to June 30,
2023, or July 1, 2023 to June 30, 2024, or July 1, 2024 to June 30,
2025, or July 1, 2025 to June 30, 2026, OR JULY 1, 2026 TO JUNE 30, 2027
as applicable.
(a) This section shall be effective only upon a determination, pursu-
ant to section five of this act, by the superintendent of financial
services and the commissioner of health, and a certification of such
determination to the state director of the budget, the chair of the
senate committee on finance and the chair of the assembly committee on
ways and means, that the amount of funds in the hospital excess liabil-
ity pool, created pursuant to section 18 of chapter 266 of the laws of
1986, is insufficient for purposes of purchasing excess insurance cover-
age for eligible participating physicians and dentists during the period
July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July
1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1,
2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007
to June 30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to
June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June
30, 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30,
2014, or July 1, 2014 to June 30, 2015, or July 1, 2015 to June 30,
S. 9007--C 90 A. 10007--C
2016, or July 1, 2016 to June 30, 2017, or July 1, 2017 to June 30,
2018, or July 1, 2018 to June 30, 2019, or July 1, 2019 to June 30,
2020, or July 1, 2020 to June 30, 2021, or July 1, 2021 to June 30,
2022, or July 1, 2022 to June 30, 2023, or July 1, 2023 to June 30,
2024, or July 1, 2024 to June 30, 2025, or July 1, 2025 to June 30,
2026, OR JULY 1, 2026 TO JUNE 30, 2027 as applicable.
(e) The commissioner of health shall transfer for deposit to the
hospital excess liability pool created pursuant to section 18 of chapter
266 of the laws of 1986 such amounts as directed by the superintendent
of financial services for the purchase of excess liability insurance
coverage for eligible participating physicians and dentists for the
policy year July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30,
2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30,
2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
2007, as applicable, and the cost of administering the hospital excess
liability pool for such applicable policy year, pursuant to the program
established in chapter 266 of the laws of 1986, as amended, no later
than June 15, 2002, June 15, 2003, June 15, 2004, June 15, 2005, June
15, 2006, June 15, 2007, June 15, 2008, June 15, 2009, June 15, 2010,
June 15, 2011, June 15, 2012, June 15, 2013, June 15, 2014, June 15,
2015, June 15, 2016, June 15, 2017, June 15, 2018, June 15, 2019, June
15, 2020, June 15, 2021, June 15, 2022, June 15, 2023, June 15, 2024,
June 15, 2025, [and] June 15, 2026, AND JUNE 15, 2027 as applicable.
§ 6. Section 20 of part H of chapter 57 of the laws of 2017, amending
the New York Health Care Reform Act of 1996 and other laws relating to
extending certain provisions thereto, as amended by section 6 of part G
of chapter 57 of the laws of 2025, is amended to read as follows:
§ 20. Notwithstanding any law, rule or regulation to the contrary,
only physicians or dentists who were eligible, and for whom the super-
intendent of financial services and the commissioner of health, or their
designee, purchased, with funds available in the hospital excess liabil-
ity pool, a full or partial policy for excess coverage or equivalent
excess coverage for the coverage period ending the thirtieth of June,
two thousand [twenty-five] TWENTY-SIX, shall be eligible to apply for
such coverage for the coverage period beginning the first of July, two
thousand [twenty-five] TWENTY-SIX; provided, however, if the total
number of physicians or dentists for whom such excess coverage or equiv-
alent excess coverage was purchased for the policy year ending the thir-
tieth of June, two thousand [twenty-five] TWENTY-SIX exceeds the total
number of physicians or dentists certified as eligible for the coverage
period beginning the first of July, two thousand [twenty-five] TWENTY-
SIX, then the general hospitals may certify additional eligible physi-
cians or dentists in a number equal to such general hospital's propor-
tional share of the total number of physicians or dentists for whom
excess coverage or equivalent excess coverage was purchased with funds
available in the hospital excess liability pool as of the thirtieth of
June, two thousand [twenty-five] TWENTY-SIX, as applied to the differ-
ence between the number of eligible physicians or dentists for whom a
policy for excess coverage or equivalent excess coverage was purchased
for the coverage period ending the thirtieth of June, two thousand
[twenty-five] TWENTY-SIX and the number of such eligible physicians or
dentists who have applied for excess coverage or equivalent excess
coverage for the coverage period beginning the first of July, two thou-
sand [twenty-five] TWENTY-SIX.
§ 7. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2026.
S. 9007--C 91 A. 10007--C
PART E
Intentionally Omitted
PART F
Section 1. The section heading and subdivisions 1 and 3 of section
97-www of the state finance law, as added by chapter 586 of the laws of
2000, are amended to read as follows:
[Percy T. Phillips educational foundation of the Dental Society of the
state of] New York STATE DENTAL FOUNDATION fund. 1. There is hereby
established in the joint custody of the state comptroller and the
commissioner of taxation and finance a fund to be known as the "[Percy
T. Phillips Educational Foundation of The Dental Society of the State
of] New York STATE DENTAL FOUNDATION Fund".
3. Moneys of the fund shall be expended for the benefit of the dental
education and public access programs of the [Percy T. Phillips educa-
tional foundation of the Dental Society of the state of] New York STATE
DENTAL FOUNDATION. Moneys shall be paid out of the fund on the audit
and warrant of the state comptroller on vouchers [approved by the chair-
man of the board of trustees of the Percy T. Phillips educational foun-
dation of the Dental Society of the state of New York or by the treasur-
er or the executive director of the Percy T. Phillips educational
foundation of the Dental Society of the state of New York] APPROVED AND
CERTIFIED BY THE COMMISSIONER OF HEALTH. Any interest received by the
comptroller on moneys on deposit in the [Percy T. Phillips educational
foundation of the Dental Society of the state of] New York STATE DENTAL
FOUNDATION fund shall be retained in and become part of such fund. No
money from such fund may be withdrawn, transferred, or used by any
person for any purpose other than as permitted in this section.
§ 1-a. Subdivision 3 of section 404-r of the vehicle and traffic law,
as added by chapter 586 of the laws of 2000, is amended to read as
follows:
3. A distinctive plate issued pursuant to this section shall be issued
in the same manner as other number plates upon payment of the regular
registration fee prescribed by section four hundred one of this article
and an additional annual service charge of thirty dollars. Twenty
dollars from each thirty dollars received as annual service charges
under this section shall be deposited to a fund for the credit of the
[Percy T. Phillips Educational Foundation of The Dental Society of the
State of] New York STATE DENTAL FOUNDATION, said fund established as a
revolving fund pursuant to section ninety-seven-www of the state finance
law; provided, however, that one year after the effective date of this
section, funds in the amount of five thousand dollars, or so much there-
of as may be available shall be allocated from such fund to the depart-
ment to offset costs associated with the production of such license
plates.
§ 2. Section 9 of part JJ of chapter 57 of the laws of 2025 amending
the public health law relating to reporting pregnancy losses and clari-
fying which agencies are responsible for such reports, is amended to
read as follows:
§ 9. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2025; provided,
however that [the amendments to subdivision 2 of section 4160 of the
public health law made by] section [two] THREE of this act shall [expire
S. 9007--C 92 A. 10007--C
and be deemed repealed] TAKE EFFECT March 30, 2027[, when upon such date
the provisions of section three of this act shall take effect].
§ 3. Section 5 of part P of chapter 57 of the laws of 2025 amending
the public health law relating to requiring hospitals to provide stabi-
lizing care to pregnant individuals, is amended to read as follows:
§ 5. This act shall take effect immediately; provided, however, that
the amendments to subdivision 3 of section 2805-b of the public health
law [made by] AS DESIGNATED SUBDIVISION 5 IN section one of this act
shall be subject to the expiration and reversion of such subdivision
pursuant to section 21 of chapter 723 of the laws of 1989, as amended,
when upon such date the provisions of section two of this act shall take
effect.
§ 4. Section 11 of part GG of chapter 56 of the laws of 2020 amending
the social services law and the public health law relating to creating a
single preferred-drug list for medication assisted treatment, is amended
to read as follows:
§ 11. This act shall take effect immediately, provided however, that:
a. the amendments to paragraph (e) of subdivision 7 of section 367-a
of the social services law made by section one of this act shall not
affect the repeal of such paragraph and shall be deemed expired there-
with;
b. [the provisions of section two of this act shall expire March 31,
2026, when upon such date the provisions of such section shall be deemed
repealed;
c.] the amendments to section 364-j of the social services law made by
sections five and six of this act shall not affect the repeal of such
section and shall be deemed repealed therewith;
[d.] C. the statewide formulary of opioid dependence agents and opioid
antagonists authorized by this act shall be implemented within six
months after it shall have become a law;
[e.] D. Provided further, however, that the director of the budget
may, in consultation with the commissioner of health, delay the
effective dates prescribed herein for a period of time which shall not
exceed 90 days following the conclusion or termination of an executive
order issued pursuant to section 28 of the executive law declaring a
state disaster emergency for the entire state of New York, upon such
delay the director of the budget shall notify the chairs of the assembly
ways and means committee and senate finance committee and the chairs of
the assembly and senate health committee; provided further, however,
that the director of the budget shall notify the legislative bill draft-
ing commission upon the occurrence of a delay in the effective date of
this act in order that the commission may maintain an accurate and time-
ly effective data base of the official text of the laws of the state of
New York in furtherance of effectuating the provisions of section 44 of
the legislative law and section 70-b of the public officers law.
§ 5. Subdivision 6 of section 3331 of the public health law, as
amended by chapter 178 of the laws of 2010, is amended to read as
follows:
6. A practitioner dispensing a controlled substance shall file infor-
mation pursuant to such dispensing with the department by electronic
means in such manner and detail as the commissioner shall, by regu-
lation, require. This requirement shall not apply to the dispensing by a
practitioner pursuant to subdivision [five] SIX of section thirty-three
hundred fifty-one of this article.
S. 9007--C 93 A. 10007--C
§ 6. Subparagraph (ii) of paragraph (a) of subdivision 2 of section
3343-a of the public health law, as added by section 2 of part A of
chapter 447 of the laws of 2012, is amended to read as follows:
(ii) a practitioner dispensing pursuant to subdivision [three] FOUR of
section thirty-three hundred fifty-one of this article;
§ 7. Clause (vi) of subparagraph 1 of paragraph (e) of subdivision 5
of section 366 of the social services law, as amended by section 13 of
part MM of chapter 56 of the laws of 2020, is amended to read as
follows:
(vi) "look-back period" means the sixty-month period immediately
preceding the date that an institutionalized individual is both institu-
tionalized and has applied for medical assistance, or in the case of a
non-institutionalized individual, subject to federal approval, the thir-
ty-month period immediately preceding the date that such non-institu-
tionalized individual applies for medical assistance coverage of long
term care services. Nothing herein precludes a review of eligibility for
retroactive authorization for medical expenses incurred during the
[three months prior to the month of application for medical assistance]
MAXIMUM ALLOWABLE RETROACTIVE ELIGIBILITY PERIOD UNDER FEDERAL LAW.
§ 8. Subsection (c) of section 1119 of the insurance law, as amended
by chapter 76 of the laws of 2026, is amended to read as follows:
(c) Such organization shall be subject to the provisions of article
seventy-four of this chapter. Prior to commencing action under such
article seventy-four, the superintendent shall consult with the continu-
ing care retirement community council established pursuant to section
[forty-six hundred two] FORTY-SIX HUNDRED THREE of the public health
law.
§ 9. This act shall take effect immediately; provided, however, that:
a. sections five and six of this act shall take effect on the same
date and in the same manner as chapter 546 of the laws of 2025 took
effect;
b. section seven of this act shall take effect January 1, 2027; and
c. section eight of this act shall take effect on the same date and in
the same manner as chapter 76 of the laws of 2026 took effect.
PART G
Section 1. Section 3000-b of the public health law, as added by chap-
ter 552 of the laws of 1998, paragraph (b) of subdivision 1 as amended
by chapter 119 of the laws of 2017, subdivision 2 as amended by chapter
583 of the laws of 1999, paragraph (a) of subdivision 3 as amended by
chapter 243 of the laws of 2010, and paragraph (f) of subdivision 3 as
added by chapter 236 of the laws of 2007, is amended and a new subdivi-
sion 5 is added to read as follows:
§ 3000-b. Automated external defibrillators: Public access providers.
1. [Definitions.] As used in this section, unless the context clearly
requires otherwise, the following terms shall have the following mean-
ings:
(a) "Automated external defibrillator" means a medical device,
approved by the United States food and drug administration, that[: (i)]
is capable WITH OR WITHOUT INTERVENTION BY AN OPERATOR of: recognizing
the presence or absence, in a patient, of ventricular fibrillation and
rapid ventricular tachycardia; [(ii) is capable of] determining[, with-
out intervention by an operator,] whether defibrillation should be
performed on the patient; [(iii)] upon determining that defibrillation
should be performed, automatically [charges and requests delivery of an
S. 9007--C 94 A. 10007--C
electrical impulse to the patient's heart] CHARGING; and [(iv) then;
upon action by an operator, delivers] DELIVERING an appropriate elec-
trical impulse to the patient's heart to perform defibrillation.
(b) ["Emergency health care provider" means (i) a physician with know-
ledge and experience in the delivery of emergency cardiac care; (ii) a
physician assistant or nurse practitioner with knowledge and experience
in the delivery of emergency cardiac care, and who is acting within his
or her scope of practice; or (iii) a hospital licensed under article
twenty-eight of this chapter that provides emergency cardiac care.
(c)] "Public access defibrillation provider" means a person, firm,
organization or other entity possessing or operating an automated
external defibrillator pursuant to [a collaborative agreement under]
this section.
[(d) "Nationally-recognized organization" means a national organiza-
tion approved by the department for the purpose of training people in
use of an automated external defibrillator.]
2. [Collaborative agreement.] A person, firm, organization or other
entity may purchase, acquire, possess and operate an automated external
defibrillator pursuant to [a collaborative agreement with an emergency
health care provider] THIS SECTION. [The collaborative agreement shall
include a written agreement and written practice protocols, and policies
and procedures that shall assure compliance with this section. The
public access defibrillation provider shall file a copy of the collabo-
rative agreement with the department and with the appropriate regional
council prior to operating the] OPERATION OF AN automated external defi-
brillator UNDER THIS SECTION SHALL BE AUTHORIZED IN ACCORDANCE WITH
REGULATIONS PROMULGATED BY THE DEPARTMENT.
3. [Possession and operation of automated external defibrillator.
Possession and operation of an automated external defibrillator by a] A
public access defibrillation provider IN POSSESSION OF AN AUTOMATED
EXTERNAL DEFIBRILLATOR shall comply with the following REQUIREMENTS, IN
A MANNER PRESCRIBED BY THE DEPARTMENT:
(a) [No person may operate an automated external defibrillator unless
the person has successfully completed a training course in the operation
of an automated external defibrillator approved by a nationally-recog-
nized organization or the state emergency medical services council.
However, this section shall not prohibit operation of an automated
external defibrillator, (i) by a health care practitioner licensed or
certified under title VIII of the education law or a person certified
under this article acting within his or her lawful scope of practice;
(ii) by a person acting pursuant to a lawful prescription; or (iii) by a
person who operates the automated external defibrillator other than as
part of or incidental to his or her employment or regular duties, who is
acting in good faith, with reasonable care, and without expectation of
monetary compensation, to provide first aid that includes operation of
an automated external defibrillator; nor shall this section limit any
good samaritan protections provided in section three thousand-a of this
article] THE PUBLIC ACCESS DEFIBRILLATION PROVIDER SHALL PROVIDE TRAIN-
ING IN THE USE OF AN AUTOMATED EXTERNAL DEFIBRILLATOR AND CARDIOPULMO-
NARY RESUSCITATION CONSISTENT WITH STANDARDS APPROVED BY THE DEPARTMENT,
INCLUDING BUT NOT LIMITED TO PROGRAMS DEVELOPED OR AUTHORIZED BY THE
DEPARTMENT OR DETERMINED BY THE DEPARTMENT TO BE CONSISTENT WITH
ACCEPTED STANDARDS OF PRACTICE. AT LEAST ONE INDIVIDUAL ASSOCIATED WITH
THE PUBLIC ACCESS DEFIBRILLATION PROVIDER SHALL BE DESIGNATED TO RECEIVE
SUCH TRAINING AND TO BE FAMILIAR WITH THE OPERATION AND ROUTINE MAINTE-
NANCE OF THE AUTOMATED EXTERNAL DEFIBRILLATOR.
S. 9007--C 95 A. 10007--C
(b) The public access defibrillation provider shall cause the auto-
mated external defibrillator to be maintained and tested according to
applicable standards of the manufacturer and any appropriate government
agency.
(c) (I) The public access defibrillation provider shall [notify the
regional council of] REGISTER the existence, location and type of any
automated external defibrillator it possesses WITH THE DEPARTMENT.
(II) THE DEPARTMENT SHALL ESTABLISH AND MAINTAIN AN ELECTRONIC DATA-
BASE, ACCESSIBLE TO THE PUBLIC, CONTAINING INFORMATION COLLECTED UNDER
THIS PARAGRAPH. THE DATABASE SHALL INCLUDE THE LOCATION AND TYPE OF EACH
AUTOMATED EXTERNAL DEFIBRILLATOR REPORTED TO THE DEPARTMENT.
(d) Every use of an automated external defibrillator on a patient
shall be immediately reported to the appropriate local emergency medical
services system[, emergency communications center or emergency vehicle
dispatch center as appropriate and promptly reported to the emergency
health care provider] OR PUBLIC SAFETY ANSWERING POINT.
(e) The [emergency health care] PUBLIC ACCESS DEFIBRILLATOR provider
shall [participate in the regional quality improvement program pursuant
to subdivision one of section three thousand four-a of this article]
REPORT DATA RELATED TO THE USE OF AUTOMATED EXTERNAL DEFIBRILLATORS TO
THE DEPARTMENT. WHEN AVAILABLE, THE DEPARTMENT SHALL INCORPORATE DATA
RELATED TO PATIENT HEALTH OUTCOMES, RESPONSE TIMES, WHETHER A BYSTANDER
ADMINISTERED CPR OR USED AN AUTOMATED EXTERNAL DEFIBRILLATOR, AND ANY
OTHER INFORMATION DEEMED APPROPRIATE BY THE COMMISSIONER INTO STATEWIDE
OR REGIONAL QUALITY IMPROVEMENT AND CARDIAC ARREST SURVEILLANCE
PROGRAMS, INCLUDING PARTICIPATION IN NATIONALLY RECOGNIZED REGISTRIES,
AS DETERMINED BY THE DEPARTMENT. CONFIDENTIAL PATIENT INFORMATION SHALL
BE DEIDENTIFIED PRIOR TO INCORPORATION.
(f) The public access defibrillation provider shall post a sign or
notice at the main entrance to the facility or building in which the
automated external defibrillator is stored, indicating the location
where any such automated external defibrillator is stored or maintained
in such building or facility on a regular basis.
4. [Application of other laws. (a)] Operation of an automated external
defibrillator pursuant to this section shall be considered first aid or
emergency treatment for the purpose of any statute relating to liabil-
ity[.
(b) Operation of an automated external defibrillator pursuant to this
section] AND shall not constitute the unlawful practice of a profession
under title VIII of the education law.
5. ANY MANUFACTURER, DISTRIBUTOR, RETAILER, OR RESELLER THAT SELLS OR
OTHERWISE TRANSFERS AN AUTOMATED EXTERNAL DEFIBRILLATOR FOR USE IN THIS
STATE SHALL, AT THE TIME OF SALE OR TRANSFER, PROVIDE THE PURCHASER WITH
WRITTEN OR ELECTRONIC NOTICE OF APPLICABLE REQUIREMENTS UNDER THIS
SECTION, INCLUDING REGISTRATION, MAINTENANCE, AND REPORTING OBLIGATIONS,
IN A FORM PRESCRIBED BY THE DEPARTMENT.
§ 2. Subdivision 2 of section 3000-a of the public health law, as
amended by chapter 502 of the laws of 2025, is amended to read as
follows:
2. (i) Any person or entity that purchases, operates, facilitates
implementation or makes available resuscitation equipment that facili-
tates first aid, an automated external defibrillator or an epinephrine
device as required by or pursuant to law or local law, or that conducts
training under section three thousand-c of this article, or (ii) [an
emergency health care provider under a collaborative agreement pursuant
to section three thousand-b of this article with respect to an automated
S. 9007--C 96 A. 10007--C
external defibrillator, or (iii)] a health care practitioner that
prescribes, dispenses or provides an epinephrine device under section
three thousand-c of this article, shall not be liable for damages aris-
ing either from the use of that equipment by a person who voluntarily
and without expectation of monetary compensation renders first aid or
emergency treatment at the scene of an accident or medical emergency, or
from the use of defectively manufactured equipment; provided that this
subdivision shall not limit the person's or entity's, the emergency
health care provider's, or other health care practitioner's liability
for their own negligence, gross negligence or intentional misconduct.
§ 2-a. Section 3000-f of the public health law, as added by chapter
681 of the laws of 2023, paragraph (d) of subdivision 1 and subdivision
2 as amended by chapter 9 of the laws of 2024, is amended to read as
follows:
§ 3000-f. Automated external defibrillator; camps and youth sports
programs. 1. [Definitions.] As used in this section, unless the context
clearly requires otherwise, the following terms have the following mean-
ings:
(a) "Automated external defibrillator" [means a medical device,
approved by the United States food and drug administration, that: (i) is
capable of recognizing the presence or absence in a patient of ventricu-
lar fibrillation and rapid ventricular tachycardia; (ii) is capable of
determining, without intervention by an operator, whether defibrillation
should be performed on a patient; (iii) upon determining that defibril-
lation should be performed, automatically charges and requests delivery
of an electrical impulse to a patient's heart; and (iv) then, upon
action by an operator, delivers an appropriate electrical impulse to a
patient's heart to perform defibrillation] SHALL HAVE THE MEANING SET
FORTH IN SECTION THREE THOUSAND-B OF THIS ARTICLE.
(b) ["Training course" means a course approved by a nationally-recog-
nized organization or the state emergency medical services council in
the operation of automated external defibrillators.
(c) "Nationally-recognized organization" means a national organization
approved by the department for the purpose of training people in use of
an automated external defibrillator.
(d)] "Camp" means a children's overnight camp, summer day camp, or
traveling summer day camp, as such terms are defined in section thirteen
hundred ninety-two of this chapter, that is subject to regulation by the
department.
[(e)] (C) "Youth sports program" means any league or recreation
program organized to provide group athletic activity to individuals
under seventeen years old or programs providing athletic activity for
high school students regardless of the age of the participants of such
programs. Public school athletic programs subject to the requirements of
section nine hundred seventeen of the education law shall not be subject
to the requirements of this section.
2. Within one hundred eighty days of the effective date of this
section, each camp, and each youth sports program that either hosts or
participates in games, matches, tournaments, leagues, or similar activ-
ities in which at least five teams are participating, shall establish an
automated external defibrillator implementation plan describing how the
camp or program will:
(a) make available an automated external defibrillator or describe
reasonable access to an automated external defibrillator at every camp,
game and practice; and
S. 9007--C 97 A. 10007--C
(b) use best efforts to ensure that there is at least one employee,
volunteer, coach, umpire or other qualified adult who is present at each
such camp, game and practice who has successfully completed a training
course CONSISTENT WITH THE STANDARDS APPROVED BY THE DEPARTMENT UNDER
THE AUTHORITY OF SECTION 3000-B OF THIS ARTICLE, within the preceding
twenty-four months of each such camp session, game and practice, AND IS
FAMILIAR WITH THE OPERATION AND ROUTINE MAINTENANCE OF THE AUTOMATED
EXTERNAL DEFIBRILLATOR.
(c) Each camp and youth sports program shall maintain records that
such camp or youth sports program possesses at least one automated
external defibrillator.
(d) Implementation plans shall include an equipment checklist and
cardiac emergency protocol for when cardiac emergency incidents occur.
(e) Implementation plans can include automated external defibrillator
access provided by athletic facilities, playing fields or site for games
or practices where the operator of the facility provides automated
external defibrillator access at their location.
3. Implementation of automated external defibrillator plans shall be
done in accordance with the requirements and protections of section
3000-b of this article, INCLUDING REQUIREMENTS AS TO MAINTENANCE, TEST-
ING, AND REPORTING USAGE AND USE-RELATED DATA.
§ 2-b. Subdivision 3 of section 917 of the education law, as amended
by chapter 61 of the laws of 2002, is amended to read as follows:
3. Public school facilities and staff pursuant to subdivisions one and
two of this section shall be deemed a "public access defibrillation
provider" as defined in paragraph [(c)] (B) of subdivision one of
section three thousand-b of the public health law and shall be subject
to the requirements and limitations of such section.
§ 2-c. Subdivisions 3, 4 and 5 of section 917-a of the education law,
as added by chapter 422 of the laws of 2025, are amended to read as
follows:
3. No person may operate an AED in a nonpublic school facility unless
the person has successfully completed a training course in the operation
of an AED [approved by a nationally-recognized organization as defined
in paragraph (d) of subdivision one of] CONSISTENT WITH THE STANDARDS
APPROVED BY THE DEPARTMENT OF HEALTH UNDER section three thousand-b of
the public health law or the state emergency medical services council.
However, this section shall not prohibit operation of an AED:
(a) by a health care practitioner licensed or certified under title
eight of this chapter or a person certified under article thirty of the
public health law acting within their lawful scope of practice;
(b) by a person acting pursuant to a lawful prescription; or
(c) by a person who operates the AED other than as part of or inci-
dental to their employment or regular duties, who is acting in good
faith, with reasonable care, and without expectation of monetary compen-
sation, to provide first aid that includes operation of an AED; nor
shall this section limit any good samaritan protections provided in
section three thousand-a of the public health law.
4. Every use of an AED on a patient in a nonpublic school shall be
immediately reported to the appropriate local emergency medical services
system[, emergency communications center or emergency vehicle dispatch
center, as appropriate] OR PUBLIC SAFETY ANSWERING POINT.
5. Nonpublic schools shall [notify the appropriate regional emergency
services council of] REGISTER the existence, location and type of any
AED they possess WITH THE DEPARTMENT OF HEALTH.
S. 9007--C 98 A. 10007--C
§ 3. This act shall take effect June 1, 2026; provided, however the
amendments to section 917-a of the education law made by section two-c
of this act shall take effect on the same date and in the same manner as
chapter 422 of the laws of 2025, takes effect. Effective immediately,
the addition, amendment, and/or repeal of any rule or regulation neces-
sary for the implementation of this act on its effective date are
authorized to be made and completed on or before such effective date.
PART H
Intentionally Omitted
PART I
Section 1. Section 5 of chapter 517 of the laws of 2016, amending the
public health law relating to payments from the New York state medical
indemnity fund, as amended by section 1 of part MM of chapter 57 of the
laws of 2025, is amended to read as follows:
§ 5. This act shall take effect on the forty-fifth day after it shall
have become a law, provided that the amendments to subdivision 4 of
section 2999-j of the public health law made by section two of this act
shall take effect on June 30, 2017 and shall expire and be deemed
repealed June 1, [2026] 2027.
§ 2. This act shall take effect immediately.
PART J
Section 1. Subdivisions 2 and 8 of section 2999-ii of the public
health law, subdivision 2 as added by section 1 of part X of chapter 57
of the laws of 2023 and subdivision 8 as amended by chapter 598 of the
laws of 2025, are amended to read as follows:
2. "Controlling person" means a person, officer, program administra-
tor, or director whose responsibilities include the direction of the
management or policies of a temporary health care services agency.
"Controlling person" also means [an individual] A PERSON who[,] directly
owns at least ten percent voting interest in a corporation, partnership,
or other business entity that is a controlling person.
8. "Temporary health care services agency" or "agency" means a person,
firm, corporation, partnership, association or other entity in the busi-
ness of providing or procuring temporary employment or engaging individ-
uals to provide health care services for health care entities, or of
enabling health care entities, DIRECTLY OR INDIRECTLY, to engage indi-
viduals to perform health care services. Temporary health care services
agency shall include a nurses' registry licensed under article eleven of
the general business law and entities that utilize apps or other tech-
nology-based solutions to provide, procure or enable health care enti-
ties to engage individuals to perform health care services, INCLUDING
VENDOR MANAGEMENT SYSTEMS AND SUBCONTRACTING ARRANGEMENTS WITH OTHER
AGENCIES THAT RESULT IN THE ENGAGEMENT OF INDIVIDUALS. Temporary health
care services agency shall not include: (a) an individual who only
engages in providing the individual's own services on a temporary basis
to health care entities; or (b) a home care agency licensed under arti-
cle thirty-six of this chapter.
§ 2. Subdivision 3 of section 2999-jj of the public health law, as
added by section 1 of part X of chapter 57 of the laws of 2023 and para-
S. 9007--C 99 A. 10007--C
graph (a) as amended by chapter 598 of the laws of 2025, is amended to
read as follows:
3. As a condition of registration, a temporary health care services
agency:
(a) Shall document that each individual engaged to provide health care
services to health care entities currently meets the minimum licensing,
training, and continuing education standards for the position in which
the [health care personnel] INDIVIDUAL will be working.
(b) Shall comply with all pertinent requirements and qualifications
for personnel employed in health care entities.
(c) Shall not restrict in any manner the employment opportunities of
[its health care personnel] INDIVIDUALS IT CONNECTS WITH HEALTH CARE
ENTITIES TO PROVIDE HEALTH CARE SERVICES.
(d) Shall not require the payment of liquidated damages, employment
fees, or other compensation should the [health care personnel] INDIVID-
UALS IT CONNECTS WITH HEALTH CARE ENTITIES TO PROVIDE HEALTH CARE
SERVICES be hired as a permanent employee, CONTRACTOR, OR CONTINGENT
WORKER of a health care entity in any contract with any [health care
personnel] INDIVIDUAL ENGAGED TO PROVIDE HEALTH CARE SERVICES or health
care entity or otherwise.
(e) SHALL NOT REQUIRE THE PAYMENT OF FEES OR OTHER COMPENSATION FROM
THE INDIVIDUAL ENGAGED TO PROVIDE HEALTH CARE SERVICES FOR PLACEMENT OR
CONNECTION WITH A HEALTH CARE ENTITY.
(F) Shall retain all records related to [health care personnel] INDI-
VIDUALS ENGAGED TO PROVIDE HEALTH CARE SERVICES for six [calendar] years
and make them available to the department upon request.
[(f)] (G) Shall comply with any requests made by the department to
examine the books and records of the agency, subpoena witnesses and
documents and make such other investigation as is necessary in the event
that the department has reason to believe that the books or records do
not accurately reflect the financial condition or financial transactions
of the agency.
[(g)] (H) Shall comply with any additional requirements the department
may deem necessary.
§ 3. Subdivisions 2 and 3 of section 2999-kk of the public health law,
subdivision 2 as added by section 1 of part X of chapter 57 of the laws
of 2023, paragraphs (a), (b), (f) and (h) of subdivision 2 and subdivi-
sion 3 as amended by chapter 598 of the laws of 2025, are amended to
read as follows:
2. A temporary health care services agency shall maintain, AND REQUIRE
SUBCONTRACTING ARRANGEMENTS WITH OTHER AGENCIES TO MAINTAIN, a written
agreement or contract with each health care entity, which shall include,
at a minimum:
(a) The required minimum licensing, training, and continuing education
requirements for each individual engaged in a health care position.
(b) Any requirement for minimum advance notice in order to ensure
prompt arrival of individuals engaged to provide health care services.
(c) The maximum rates that can be billed or charged by the temporary
health care services agency pursuant to section twenty-nine hundred
ninety-nine-mm of this article and any applicable regulations.
(d) The rates to be charged by the temporary health care services
agency.
(e) Procedures for the investigation and resolution of complaints
about the performance of [temporary health care services agency person-
nel] INDIVIDUALS ENGAGED TO PROVIDE HEALTH CARE SERVICES.
S. 9007--C 100 A. 10007--C
(f) Procedures for notice from health care entities of failure of
individuals engaged to provide health care services to report to an
agreed upon scheduled shift.
(g) Procedures for notice of actual or suspected abuse, theft, tamper-
ing or other diversion of controlled substances by [medical personnel]
INDIVIDUALS ENGAGED TO PROVIDE HEALTH CARE SERVICES.
(h) The types and qualifications of individuals engaged to provide
health care services available through the temporary health care
services agency.
3. A temporary health care services agency shall [submit to the
department] RETAIN FOR SIX YEARS AND MAKE AVAILABLE TO THE DEPARTMENT
UPON REQUEST copies of all contracts between the agency OR A THIRD PARTY
WITH WHOM THE AGENCY IS SUBCONTRACTING and a health care entity to which
it assigns or otherwise connects individuals engaged to provide health
care services, and copies of all invoices to health care entities
[personnel]. Executed contracts [must be sent to the department within
five business days of their effective date and] SUBMITTED UPON REQUEST
TO THE DEPARTMENT are not subject to disclosure under article six of
the public officers law.
§ 4. Section 2999-ll of the public health law, as added by section 1
of part X of chapter 57 of the laws of 2023, is amended to read as
follows:
§ 2999-ll. Violations; penalties. In addition to other remedies avail-
able by law, violations of the provisions of this article and any regu-
lations promulgated thereunder shall be subject to penalties and fines
pursuant to section twelve of this chapter; provided, however, that each
violation committed by [any health care personnel of] a temporary health
care services agency shall be considered a separate violation.
§ 5. Section 2999-mm of the public health law, as added by section 1
of part X of chapter 57 of the laws of 2023, is amended to read as
follows:
§ 2999-mm. Rates for temporary health care services; reports. 1. A
temporary health care services agency shall report quarterly to the
department a full disclosure of charges and compensation, including a
schedule of all hourly bill rates per category of [health care person-
nel] INDIVIDUALS ENGAGED TO PROVIDE HEALTH CARE SERVICES, a full
description of administrative charges, and a schedule of rates of all
compensation per category of [health care personnel] INDIVIDUALS ENGAGED
TO PROVIDE HEALTH CARE SERVICES including, but not limited to:
[1.] (A) hourly regular pay rate, shift differential, weekend differ-
ential, hazard pay, charge nurse add-on, overtime, holiday pay, travel
or mileage pay, and any health or other fringe benefits provided;
[2.] (B) the percentage of health care entity dollars that the agency
expended on [temporary personnel wages and benefits] COMPENSATION,
INCLUDING, AS APPLICABLE, BENEFITS, TO INDIVIDUALS ENGAGED TO PROVIDE
HEALTH CARE SERVICES compared to the temporary health care services
agency's profits and other administrative costs;
[3.] (C) a list of the states and zip codes of [their health care
personnels'] THE primary residences OF INDIVIDUALS ENGAGED TO PROVIDE
HEALTH CARE SERVICES;
[4.] (D) the names of all health care entities they OR A THIRD PARTY
WITH WHOM THE AGENCY IS SUBCONTRACTING have contracted within New York
state;
[5.] (E) the number of [health care personnel of] INDIVIDUALS ENGAGED
TO PROVIDE HEALTH CARE SERVICES BY the temporary health care services
agency working at each entity; and
S. 9007--C 101 A. 10007--C
[6.] (F) any other information prescribed by the commissioner.
2. THE COMMISSIONER IS HEREBY AUTHORIZED TO PROMULGATE REGULATIONS TO
ESTABLISH, MONITOR, AND ENFORCE A LIMITATION ON THE AMOUNT THAT TEMPO-
RARY HEALTH CARE SERVICES AGENCIES OR CERTAIN TYPES OR CLASSES OF SUCH
AGENCIES MAY RETAIN AS PROFIT FROM PROVIDING, PROCURING, OR ENABLING
HEALTH CARE ENTITIES TO ENGAGE AN INDIVIDUAL TO PROVIDE HEALTH CARE
SERVICES, WHICH FOR THE PURPOSES OF THIS SECTION SHALL BE REFERRED TO AS
THE "AGENCY RATE." IN SETTING ONE OR MORE AGENCY RATES, WHICH CAN BE
EXPRESSED AS A PERCENTAGE OR IN ANOTHER MANNER AS DETERMINED BY THE
DEPARTMENT, THE DEPARTMENT SHALL TAKE INTO CONSIDERATION FACTORS INCLUD-
ING BUT NOT LIMITED TO THE ABILITY TO MAINTAIN SUFFICIENT STAFFING OF
THE HEALTH CARE WORKFORCE, WHETHER ON A CONTRACT OR PERMANENT BASIS AND
ACROSS THE RANGE OF NEEDED PROFESSIONAL TITLES AND ROLES, IN ALL
GEOGRAPHIC AREAS ACROSS THE STATE. THE DEPARTMENT SHALL ALSO ENGAGE IN A
PERIODIC REASSESSMENT OF ANY AGENCY RATES TO ENSURE THAT THEY REFLECT
CURRENT CONDITIONS AND REMAIN EFFECTIVE.
3. THE COMMISSIONER SHALL PUBLISH GUIDELINES ESTABLISHING THE FORMS
AND PROCEDURES FOR VERIFICATION OF COMPLIANCE WITH AN AGENCY RATE. IN
ADDITION, A TEMPORARY HEALTH CARE SERVICES AGENCY SHALL RETAIN FOR SIX
YEARS AND MAKE AVAILABLE TO THE DEPARTMENT UPON REQUEST COPIES OF ALL
CONTRACTS, INVOICES, RECORDS, PAYROLL INFORMATION, AND OTHER DOCUMENTS
NECESSARY TO DETERMINE COMPLIANCE WITH THE AGENCY RATE. THE DEPARTMENT
IS AUTHORIZED TO CONDUCT AUDITS OF TEMPORARY HEALTH CARE SERVICES AGEN-
CIES AS WELL AS TARGETED INVESTIGATIONS BASED ON COMPLAINTS OR ATYPICAL
REPORTING PATTERNS.
4. NOTHING IN THIS ARTICLE SHALL DISPLACE ANY GENERALLY APPLICABLE LAW
RELEVANT TO TEMPORARY HEALTH CARE SERVICES AGENCIES, INCLUDING BUT NOT
LIMITED TO SECTIONS THREE HUNDRED FORTY-NINE AND THREE HUNDRED NINETY-
SIX-R OF THE GENERAL BUSINESS LAW.
§ 6. This act shall take effect one year after it shall have become a
law. Effective immediately, the addition, amendment and/or repeal of any
rule or regulation necessary for the implementation of this act on its
effective date are authorized to be made and completed on or before such
effective date.
PART K
Intentionally Omitted
PART L
Section 1. Subparagraph (iv) of paragraph (b) of subdivision 2-b of
section 2808 of the public health law, as amended by section 2 of part E
of chapter 57 of the laws of 2024, is amended to read as follows:
(iv) The capital cost component of rates on and after January first,
two thousand nine shall: (A) fully reflect the cost of local property
taxes and payments made in lieu of local property taxes, as reported in
each facility's cost report submitted for the year two years prior to
the rate year; (B) provided, however, notwithstanding any inconsistent
provision of this article, commencing April first, two thousand twenty
for rates of payment for patients eligible for payments made by state
governmental agencies, the capital cost component determined in accord-
ance with this subparagraph and inclusive of any shared savings for
eligible facilities that elect to refinance their mortgage loans pursu-
ant to paragraph (d) of subdivision two-a of this section, shall be
S. 9007--C 102 A. 10007--C
reduced by the commissioner by five percent; and (C) provided, however,
notwithstanding any inconsistent provision of this article, commencing
April first, two thousand twenty-four AND ENDING MARCH THIRTY-FIRST, TWO
THOUSAND TWENTY-SIX for rates of payment for patients eligible for
payments made by state governmental agencies, the capital cost component
determined in accordance with this subparagraph and inclusive of any
shared savings for eligible facilities that elect to refinance their
mortgage loans pursuant to paragraph (d) of subdivision two-a of this
section, shall be reduced by the commissioner by an additional ten
percent, provided, however, that such reduction shall not apply to rates
of payment for patients in pediatric residential health care facilities
as defined in paragraph (c) of subdivision two of section twenty-eight
hundred eight-e of this article.
§ 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2026.
PART M
Section 1. Subparagraphs (iii) and (iv) of paragraph (d) of subdivi-
sion 1 of section 367-a of the social services law, subparagraph (iii)
as amended by section 31 of part B of chapter 57 of the laws of 2015 and
subparagraph (iv) as added by section 16 of part B of chapter 59 of the
laws of 2016, are amended to read as follows:
(iii) With respect to items and services provided to eligible persons
who are also beneficiaries under part B of title XVIII of the federal
social security act and items and services provided to qualified medi-
care beneficiaries under part B of title XVIII of the federal social
security act, the amount payable for services covered under this title
shall be the amount of any co-insurance liability of such eligible
persons pursuant to federal law were they not eligible for medical
assistance or were they not qualified medicare beneficiaries with
respect to such benefits under such part B, but shall not exceed the
amount that otherwise would be made under this title if provided to an
eligible person other than a person who is also a beneficiary under part
B or is a qualified medicare beneficiary minus the amount payable under
part B; provided, however, amounts payable under this title for items
and services provided to eligible persons who are also beneficiaries
under part B or to qualified medicare beneficiaries by an ambulance
service under the authority of an operating certificate issued pursuant
to article thirty of the public health law, [a psychologist licensed
under article one hundred fifty-three of the education law,] or a facil-
ity under the authority of an operating certificate issued pursuant to
article sixteen, thirty-one or thirty-two of the mental hygiene law and
with respect to outpatient hospital and clinic items and services
provided by a facility under the authority of an operating certificate
issued pursuant to article twenty-eight of the public health law, shall
not be less than the amount of any co-insurance liability of such eligi-
ble persons or such qualified medicare beneficiaries, or for which such
eligible persons or such qualified medicare beneficiaries would be
liable under federal law were they not eligible for medical assistance
or were they not qualified medicare beneficiaries with respect to such
benefits under part B.
(iv) If a health plan participating in part C of title XVIII of the
federal social security act pays for items and services provided to
eligible persons who are also beneficiaries under part B of title XVIII
of the federal social security act or to qualified medicare benefici-
S. 9007--C 103 A. 10007--C
aries, the amount payable for services under this title shall be [eight-
y-five percent of] the amount of any co-insurance liability of such
eligible persons pursuant to federal law if they were not eligible for
medical assistance or were not qualified medicare beneficiaries with
respect to such benefits under such part B[; provided, however, amounts
payable under this title for items and services provided to eligible
persons who are also beneficiaries under part B or to qualified medicare
beneficiaries by an ambulance service under the authority of an operat-
ing certificate issued pursuant to article thirty of the public health
law, or a psychologist licensed under article one hundred fifty-three of
the education law, shall not be less than the amount of any co-insurance
liability of such eligible persons or such qualified medicare benefici-
aries, or for which such eligible persons or such qualified medicare
beneficiaries would be liable under federal law were they not eligible
for medical assistance or were they not qualified medicare beneficiaries
with respect to such benefits under part B], BUT SHALL NOT EXCEED
THE AMOUNT THAT OTHERWISE WOULD BE MADE UNDER THIS TITLE IF PROVIDED TO
AN ELIGIBLE PERSON OTHER THAN A PERSON WHO IS ALSO A BENEFICIARY UNDER
PART B OR IS A QUALIFIED MEDICARE BENEFICIARY MINUS THE AMOUNT PAYABLE
UNDER PART B; PROVIDED, HOWEVER, AMOUNTS PAYABLE UNDER THIS TITLE FOR
ITEMS AND SERVICES PROVIDED TO ELIGIBLE PERSONS WHO ARE ALSO BENEFICI-
ARIES UNDER PART B OR TO QUALIFIED MEDICARE BENEFICIARIES BY AN AMBU-
LANCE SERVICE UNDER THE AUTHORITY OF AN OPERATING CERTIFICATE ISSUED
PURSUANT TO ARTICLE THIRTY OF THE PUBLIC HEALTH LAW SHALL NOT BE LESS
THAN THE AMOUNT OF ANY COINSURANCE LIABILITY OF SUCH ELIGIBLE PERSONS OR
SUCH QUALIFIED MEDICARE BENEFICIARIES, OR FOR WHICH SUCH ELIGIBLE
PERSONS OR SUCH QUALIFIED MEDICARE BENEFICIARIES WOULD BE LIABLE UNDER
FEDERAL LAW WERE THEY NOT ELIGIBLE FOR MEDICAL ASSISTANCE OR WERE THEY
NOT QUALIFIED MEDICARE BENEFICIARIES WITH RESPECT TO SUCH BENEFITS UNDER
PART B.
§ 2. Paragraph (c) of subdivision 1 of section 369-gg of the social
services law is REPEALED.
§ 3. Subdivision 1 of section 369-gg of the social services law is
amended by adding a new paragraph (c) to read as follows:
(C) "HEALTH CARE SERVICES" MEANS (I) THE SERVICES AND SUPPLIES AS
DEFINED BY THE COMMISSIONER IN CONSULTATION WITH THE SUPERINTENDENT OF
FINANCIAL SERVICES, AND SHALL BE CONSISTENT WITH AND SUBJECT TO THE
ESSENTIAL HEALTH BENEFITS AS DEFINED BY THE COMMISSIONER IN ACCORDANCE
WITH THE PROVISIONS OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT
(P.L. 111-148) AND CONSISTENT WITH THE BENEFITS PROVIDED BY THE REFER-
ENCE PLAN SELECTED BY THE COMMISSIONER FOR THE PURPOSES OF DEFINING SUCH
BENEFITS, AND SHALL INCLUDE COVERAGE OF AND ACCESS TO THE SERVICES OF
ANY NATIONAL CANCER INSTITUTE-DESIGNATED CANCER CENTER LICENSED BY THE
DEPARTMENT OF HEALTH WITHIN THE SERVICE AREA OF THE APPROVED ORGANIZA-
TION THAT IS WILLING TO AGREE TO PROVIDE CANCER-RELATED INPATIENT,
OUTPATIENT AND MEDICAL SERVICES TO ALL ENROLLEES IN APPROVED ORGANIZA-
TIONS' PLANS IN SUCH CANCER CENTER'S SERVICE AREA UNDER THE PREVAILING
TERMS AND CONDITIONS THAT THE APPROVED ORGANIZATION REQUIRES OF OTHER
SIMILAR PROVIDERS TO BE INCLUDED IN THE APPROVED ORGANIZATION'S NETWORK,
PROVIDED THAT SUCH TERMS SHALL INCLUDE REIMBURSEMENT OF SUCH CENTER AT
NO LESS THAN THE FEE-FOR-SERVICE MEDICAID PAYMENT RATE AND METHODOLOGY
APPLICABLE TO THE CENTER'S INPATIENT AND OUTPATIENT SERVICES; AND (II)
DENTAL AND VISION SERVICES AS DEFINED BY THE COMMISSIONER;
§ 3-a. Paragraph (c) of subdivision 1 of section 369-gg of the social
services law, as added by section three of this act, is amended to read
as follows:
S. 9007--C 104 A. 10007--C
(c) "Health care services" means (i) the services and supplies as
defined by the commissioner in consultation with the superintendent of
financial services, and shall be consistent with and subject to the
essential health benefits as defined by the commissioner in accordance
with the provisions of the patient protection and affordable care act
(P.L. 111-148) and consistent with the benefits provided by the refer-
ence plan selected by the commissioner for the purposes of defining such
benefits, and shall include coverage of and access to the services of
any national cancer institute-designated cancer center licensed by the
department of health within the service area of the approved organiza-
tion that is willing to agree to provide cancer-related inpatient,
outpatient and medical services to all enrollees in approved organiza-
tions' plans in such cancer center's service area under the prevailing
terms and conditions that the approved organization requires of other
similar providers to be included in the approved organization's network,
provided that such terms shall include reimbursement of such center at
no less than the fee-for-service medicaid payment rate and methodology
applicable to the center's inpatient and outpatient services; [and] (ii)
dental and vision services as defined by the commissioner; AND (III) AS
DEFINED BY THE COMMISSIONER AND SUBJECT TO FEDERAL APPROVAL, CERTAIN
SERVICES AND SUPPORTS PROVIDED TO ENROLLEES ELIGIBLE PURSUANT TO SUBPAR-
AGRAPH ONE OF PARAGRAPH (G) OF SUBDIVISION ONE OF SECTION THREE HUNDRED
SIXTY-SIX OF THIS ARTICLE WHO HAVE FUNCTIONAL LIMITATIONS AND/OR CHRONIC
ILLNESSES THAT HAVE THE PRIMARY PURPOSE OF SUPPORTING THE ABILITY OF THE
ENROLLEE TO LIVE OR WORK IN THE SETTING OF THEIR CHOICE, WHICH MAY
INCLUDE THE INDIVIDUAL'S HOME, A WORKSITE, OR A PROVIDER-OWNED OR
CONTROLLED RESIDENTIAL SETTING;
§ 4. Subdivision 4 of section 364-i of the social services law is
REPEALED and subdivisions 5, 6, 7 and 8 are renumbered subdivisions 4,
5, 6 and 7.
§ 5. Subparagraphs 2 and 3 of paragraph (b) of subdivision 1 of
section 366 of the social services law, as added by section 1 of part D
of chapter 56 of the laws of 2013, are amended to read as follows:
(2) A pregnant [woman] PERSON or an infant younger than one year of
age is eligible for standard coverage if [his or her] THEIR MAGI house-
hold income does not exceed the MAGI-equivalent of two hundred percent
of the federal poverty line for the applicable family size, which shall
be calculated in accordance with guidance issued by the secretary of the
United States department of health and human services[, or an infant
younger than one year of age who meets the presumptive eligibility
requirements of subdivision four of section three hundred sixty-four-i
of this title].
(3) A child who is at least one year of age but younger than nineteen
years of age is eligible for standard coverage if [his or her] SUCH
CHILD'S MAGI household income does not exceed the MAGI-equivalent of one
hundred thirty-three percent of the federal poverty line for the appli-
cable family size, which shall be calculated in accordance with guidance
issued by the Secretary of the United States department of health and
human services[, or a child who is at least one year of age but younger
than nineteen years of age who meets the presumptive eligibility
requirements of subdivision four of section three hundred sixty-four-i
of this title].
§ 6. Subparagraphs 7 and 8 of paragraph (c) of subdivision 1 of
section 366 of the social services law, as added by section 1 of part D
of chapter 56 of the laws of 2013, are amended to read as follows:
S. 9007--C 105 A. 10007--C
(7) An individual receiving treatment for breast or cervical cancer
who meets the eligibility requirements of paragraph (d) of subdivision
four of this section or the presumptive eligibility requirements of
subdivision [five] FOUR of section three hundred sixty-four-i of this
title.
(8) An individual receiving treatment for colon or prostate cancer who
meets the eligibility requirements of paragraph (e) of subdivision four
of this section or the presumptive eligibility requirements of subdivi-
sion [five] FOUR of section three hundred sixty-four-i of this title.
§ 7. Clause (iii) of subparagraph 4 of paragraph (d) of subdivision 4
of section 366 of the social services law, as added by section 2 of part
D of chapter 56 of the laws of 2013, is amended to read as follows:
(iii) An individual shall be eligible for presumptive eligibility for
medical assistance under this paragraph in accordance with subdivision
[five] FOUR of section three hundred sixty-four-i of this title.
§ 8. Subparagraph 3 of paragraph (e) of subdivision 4 of section 366
of the social services law, as added by section 2 of part D of chapter
56 of the laws of 2013, is amended to read as follows:
(3) An individual shall be eligible for presumptive eligibility for
medical assistance under this paragraph in accordance with subdivision
[five] FOUR of section three hundred sixty-four-i of this title.
§ 9. Subdivision 6 of section 365-a of the social services law, as
amended by chapter 484 of the laws of 2009, is amended to read as
follows:
6. Any inconsistent provision of law notwithstanding, medical assist-
ance shall also include payment for medical care, services or supplies
furnished to eligible pregnant [women] PERSONS pursuant to [paragraph
(o) of subdivision four of] section three hundred sixty-six and subdivi-
sion [six] FIVE of section three hundred sixty-four-i of this title, to
the extent that and for so long as federal financial participation is
available therefor; provided, however, that nothing in this section
shall be deemed to affect payment for such medical care, services or
supplies if federal financial participation is not available for such
care, services and supplies solely by reason of the immigration status
of the otherwise eligible pregnant [woman] PERSON.
§ 10. Paragraph (mm) of subdivision 2 of section 365-a of the social
services law, as amended by chapter 29 of the laws of 2024, is amended
to read as follows:
(mm) (i) biomarker precision medical testing for the purposes of diag-
nosis, treatment, or appropriate management of, or ongoing monitoring to
guide treatment decisions for, a recipient's disease or condition when
one or more of the following recognizes the efficacy and appropriateness
of biomarker precision medical testing for diagnosis, treatment, appro-
priate management, or guiding treatment decisions for a recipient's
disease or condition:
(1) labeled indications for a test approved or cleared by the federal
food and drug administration or indicated tests for a food and drug
administration approved drug;
(2) centers for medicare and medicaid services national coverage
determinations or medicare administrative contractor local coverage
determinations; OR
(3) nationally recognized clinical practice guidelines[; or
(4) peer-reviewed literature and peer-reviewed scientific studies
published in or accepted for publication by medical journals that meet
nationally recognized requirements for scientific manuscripts and that
S. 9007--C 106 A. 10007--C
submit most of their published articles for review by experts who are
not part of the editorial staff].
(ii) As used in this paragraph, the following terms shall have the
following meanings:
(1) "Biomarker" means a characteristic that is measured as an indica-
tor of normal biological processes, pathogenic processes, or responses
to an exposure or intervention, including therapeutic interventions.
(2) "Biomarker precision medical testing" means the analysis of a
patient's tissue, blood, or other biospecimen for the presence of a
biomarker. Biomarker testing includes but is not limited to single-ana-
lyte tests and multi-plex panel tests performed at a participating
in-network laboratory facility that is either CLIA certified or CLIA
waived by the federal food and drug administration.
(3) "Nationally recognized clinical practice guidelines" means
evidence-based clinical practice guidelines informed by a systematic
review of evidence and an assessment of the benefits, and risks of
alternative care options intended to optimize patient care developed by
independent organizations or medical professional societies utilizing a
transparent methodology and reporting structure and with a conflict of
interest policy.
(III) COVERAGE OF BIOMARKER PRECISION MEDICAL TESTING PROVIDED UNDER
THIS PARAGRAPH SHALL NOT REQUIRE A DEVIATION FROM THE REVIEW FOR STAND-
ARD COVERAGE OR ANY EXISTING PROCESS USED TO DETERMINE MEDICAL NECESSI-
TY.
§ 11. Subparagraph 3 of paragraph (b) of subdivision 4 of section 366
of the social services law, as amended by section 1 of part M of chapter
57 of the laws of 2024, is amended to read as follows:
(3) [(A)] A child [between] UNDER the [ages] AGE of [six and] nineteen
who is determined eligible for medical assistance under the provisions
of this section, shall, consistent with applicable federal requirements,
remain eligible for such assistance until THE EARLIER OF:
(A) the last day of the month which is twelve months following the
determination or renewal of eligibility for such assistance; OR
(B) THE LAST DAY OF THE MONTH IN WHICH THE CHILD REACHES THE AGE OF
NINETEEN.
[(B) A child under the age of six who is determined eligible for
medical assistance under the provisions of this section, shall, consist-
ent with applicable federal requirements, remain continuously eligible
for medical assistance coverage until the later of:
(i) the last day of the twelfth month following the determination or
renewal of eligibility for such assistance; or
(ii) the last day of the month in which the child reaches the age of
six.]
§ 12. Paragraph (e) of subdivision 6 of section 2510 of the public
health law is REPEALED.
§ 13. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2026; provided,
however:
a. section one of this act shall take effect April 1, 2027;
b. section three-a of this act shall take effect January 1, 2031; and
c. sections eleven and twelve of this act shall take effect July 1,
2026.
PART N
Intentionally Omitted
S. 9007--C 107 A. 10007--C
PART O
Section 1. Section 1-c of part I of chapter 57 of the laws of 2022
providing a one percent across the board payment increase to all quali-
fying fee-for-service Medicaid rates, as added by section 5 of part F of
chapter 57 of the laws of 2025, is amended to read as follows:
§ 1-c. [Notwithstanding any provision of law to the contrary, for the
period April 1, 2025 through March 31, 2026 Medicaid payments made for
clinic service provided by federally qualified health centers and diag-
nostic and treatment centers licensed pursuant to article 28 of the
public health law shall be increased by an aggregate amount of up to
$40,000,000 in addition to any applicable increase contained in section
one of this act subject to the approval of the commissioner of health
and the director of the budget.] Notwithstanding any provision of law to
the contrary, for the [period] STATE FISCAL YEARS BEGINNING April 1,
2026, and thereafter, Medicaid payments made for clinic service provided
by federally qualified health centers [and diagnostic and treatment
centers licensed pursuant to article twenty-eight of the public health
law] shall be increased by an aggregate amount of up to [$20,000,000]
$80,000,000 in addition to any applicable increase contained in section
one of this act subject to the approval of the commissioner of health
and the director of the budget. Such rate increases shall be subject to
federal financial participation and the provisions established under
section one-f of this act.
§ 2. Section 1-e of 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, as amended by section 7 of part F of chapter
57 of the laws of 2025, is amended to read as follows:
§ 1-e. Such increases as added by [the] PART NN OF chapter 57 of the
laws of 2024 [that added this section], PART F OF CHAPTER 57 OF THE LAWS
OF 2025, OR THE CHAPTER OF THE LAWS OF 2026 THAT ADDED SECTION ONE-G TO
THIS ACT may take the form of increased rates of payment in Medicaid
fee-for-service and/or Medicaid managed care, lump sum payments, or
state directed payments under 42 CFR 438.6(c). Such rate increases shall
be subject to federal financial participation and the provisions estab-
lished under section one-f of this act.
§ 3. Section 1-f of 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, as added by section 7 of part F of chapter
57 of the laws of 2025, is amended and a new section 1-g is added to
read as follows:
§ 1-f. Such increases as added by [the] PART F OF chapter 57 of the
laws of 2025 [that added this section] AND THE CHAPTER OF THE LAWS OF
2026 THAT ADDED SECTION ONE-G TO THIS ACT shall be contingent upon the
availability of funds within the healthcare stability fund established
by section 99-ss of the state finance law, AS ADDED BY SECTION 2 OF PART
II OF CHAPTER 57 OF THE LAWS OF 2024 AND LATER RENUMBERED AND AMENDED BY
SECTION 2 OF PART F OF CHAPTER 57 OF THE LAWS OF 2025. Upon a determi-
nation by the director of the budget that the balance of such fund is
projected to be insufficient to support the continuation of such
increases, the commissioner of health, subject to the approval of the
director of the budget, shall take steps necessary to suspend or termi-
nate such increases, until a determination is made that there are suffi-
cient balances to support these increases.
§ 1-G. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, FOR STATE
FISCAL YEARS BEGINNING APRIL 1, 2026 AND THEREAFTER, MEDICAID PAYMENTS
S. 9007--C 108 A. 10007--C
MADE FOR HOSPITAL SERVICES SHALL BE INCREASED BY AN AGGREGATE AMOUNT OF
UP TO $706,000,000, NURSING HOME SERVICES SHALL BE INCREASED BY AN
AGGREGATE AMOUNT OF UP TO $480,000,000, AND ASSISTED LIVING PROGRAM
SERVICES SHALL BE INCREASED BY AN AGGREGATE AMOUNT OF UP TO $20,000,000
IN ADDITION TO THE INCREASE CONTAINED IN SECTION ONE, ONE-A, ONE-B AND
ONE-C OF THIS ACT, SUBJECT TO THE APPROVAL OF THE COMMISSIONER OF HEALTH
AND THE DIRECTOR OF THE BUDGET. SUCH RATE INCREASES SHALL BE SUBJECT TO
FEDERAL FINANCIAL PARTICIPATION AND THE PROVISIONS ESTABLISHED UNDER
SECTION ONE-F OF THIS ACT.
§ 4. Paragraph (c) of subdivision 8 of section 2807-c of the public
health law, as amended by section 1 of part D of chapter 57 of the laws
of 2024, is amended to read as follows:
(c) (I) In order to reconcile capital related inpatient expenses
included in rates of payment based on a budget to actual expenses and
statistics for the rate period for a general hospital, rates of payment
for a general hospital shall be adjusted to reflect the dollar value of
the difference between capital related inpatient expenses included in
the computation of rates of payment for a prior rate period based on a
budget and actual capital related inpatient expenses for such prior rate
period, each as determined in accordance with paragraph (a) of this
subdivision, adjusted to reflect increases or decreases in volume of
service in such prior rate period compared to statistics applied in
determining the capital related inpatient expenses component of rates of
payment based on a budget for such prior rate period.
(II) For rates effective April first, two thousand twenty through
March thirty-first, two thousand twenty-one, the budgeted capital-relat-
ed expenses add-on as described in paragraph (a) of this subdivision,
based on a budget submitted in accordance to paragraph (a) of this
subdivision, shall be reduced by five percent relative to the rate in
effect on such date; and the actual capital expenses add-on as described
in paragraph (a) of this subdivision, based on actual expenses and
statistics through appropriate audit procedures in accordance with para-
graph (a) of this subdivision shall be reduced by five percent relative
to the rate in effect on such date.
(III) For rates effective April first, two thousand twenty-one through
September thirtieth, two thousand twenty-four, the budgeted capital-re-
lated expenses add-on as described in paragraph (a) of this subdivision,
based on a budget submitted in accordance to paragraph (a) of this
subdivision, shall be reduced by ten percent relative to the rate in
effect on such date; and the actual capital expenses add-on as described
in paragraph (a) of this subdivision, based on actual expenses and
statistics through appropriate audit procedures in accordance with para-
graph (a) of this subdivision shall be reduced by ten percent relative
to the rate in effect on such date.
(IV) For rates effective [on and after] October first, two thousand
twenty-four THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-SIX, the
budgeted capital-related expenses add-on as described in paragraph (a)
of this subdivision, based on a budget submitted in accordance with
paragraph (a) of this subdivision, shall be reduced by twenty percent
relative to the rate in effect on such date; and the actual capital
expenses add-on as described in paragraph (a) of this subdivision shall
be reduced by twenty percent relative to the rate in effect on such
date.
(V) FOR RATES EFFECTIVE ON AND AFTER APRIL FIRST, TWO THOUSAND TWEN-
TY-SIX, THE BUDGETED CAPITAL-RELATED EXPENSES ADD-ON AS DESCRIBED IN
PARAGRAPH (A) OF THIS SUBDIVISION, BASED ON A BUDGET SUBMITTED IN
S. 9007--C 109 A. 10007--C
ACCORDANCE WITH PARAGRAPH (A) OF THIS SUBDIVISION, SHALL BE REDUCED BY
TEN PERCENT RELATIVE TO THE RATE IN EFFECT ON SUCH DATE; AND THE ACTUAL
CAPITAL EXPENSES ADD-ON AS DESCRIBED IN PARAGRAPH (A) OF THIS SUBDIVI-
SION SHALL BE REDUCED BY TEN PERCENT RELATIVE TO THE RATE IN EFFECT ON
SUCH DATE. SUCH RATE ADJUSTMENTS SHALL BE SUBJECT TO FEDERAL FINANCIAL
PARTICIPATION.
(VI) For any rate year, all reconciliation add-on amounts calculated
for the period of April first, two thousand twenty through September
thirtieth, two thousand twenty-four shall be reduced by ten percent, and
all reconciliation recoupment amounts calculated for the period of April
first, two thousand twenty through September thirtieth, two thousand
twenty-four shall increase by ten percent.
(VII) For any rate year, all reconciliation add-on amounts calculated
[on and after] FOR THE PERIOD October first, two thousand twenty-four
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-SIX shall be reduced by
twenty percent, and all reconciliation recoupment amounts calculated [on
or after] FOR THE PERIOD October first, two thousand twenty-four THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-SIX, shall increase by twenty
percent. SUCH RATE ADJUSTMENTS SHALL BE SUBJECT TO FEDERAL FINANCIAL
PARTICIPATION.
(VIII) FOR ANY RATE YEAR, ALL RECONCILIATION ADD-ON AMOUNTS CALCULATED
ON AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-SIX SHALL BE REDUCED BY
TEN PERCENT, AND ALL RECONCILIATION RECOUPMENT AMOUNTS CALCULATED ON OR
AFTER APRIL FIRST, TWO THOUSAND TWENTY-SIX SHALL INCREASE BY TEN
PERCENT. SUCH RATE ADJUSTMENTS SHALL BE SUBJECT TO FEDERAL FINANCIAL
PARTICIPATION.
(IX) Notwithstanding any inconsistent provision of subparagraph (i) of
paragraph (e) of subdivision nine of this section, capital related inpa-
tient expenses of a general hospital included in the computation of
rates of payment based on a budget shall not be included in the computa-
tion of a volume adjustment made in accordance with such subparagraph.
Adjustments to rates of payment for a general hospital made pursuant to
this paragraph shall be made in accordance with paragraph (c) of subdi-
vision eleven of this section. Such adjustments shall not be carried
forward except for such volume adjustment as may be authorized in
accordance with subparagraph (i) of paragraph (e) of subdivision nine of
this section for such general hospital.
§ 5. This act shall take effect immediately.
PART P
Section 1. 1. Subject to available appropriations and approval of the
director of the budget, the commissioners of the office of mental
health, office for people with developmental disabilities, office of
addiction services and supports, office of temporary and disability
assistance, office of children and family services, and the director of
the state office for the aging (hereinafter "the commissioners") shall
establish a state fiscal year 2026-2027 targeted inflationary increase,
effective April 1, 2026, for projecting for the effects of inflation
upon rates of payments, contracts, or any other form of reimbursement
for the programs and services listed in subdivision four of this
section. The targeted inflationary increase established herein shall be
applied to the appropriate portion of reimbursable costs or contract
amounts. Where appropriate, transfers to the department of health (DOH)
shall be made as reimbursement for the state and/or local share of
medical assistance.
S. 9007--C 110 A. 10007--C
2. Notwithstanding any inconsistent provision of law, subject to the
approval of the director of the budget and available appropriations
therefor, for the period of April 1, 2026 through March 31, 2027, the
commissioners shall provide funding to support a two and seven-tenths
percent (2.7%) targeted inflationary increase under this section for all
eligible programs and services as determined pursuant to subdivision
four of this section.
3. Notwithstanding any inconsistent provision of law, and as approved
by the director of the budget, the 2.7 percent targeted inflationary
increase established herein shall be inclusive of all other inflationary
increases, cost of living type increases, inflation factors, or trend
factors that are newly applied effective April 1, 2026. Except for the
2.7 percent targeted inflationary increase established herein, for the
period commencing on April 1, 2026 and ending March 31, 2027 the commis-
sioners shall not apply any other new targeted inflationary increases or
cost of living adjustments for the purpose of establishing rates of
payments, contracts or any other form of reimbursement. The phrase "all
other inflationary increases, cost of living type increases, inflation
factors, or trend factors" as defined in this subdivision shall not
include payments made pursuant to the American Rescue Plan Act or other
federal relief programs related to the Coronavirus Disease 2019 (COVID-
19) pandemic public health emergency. This subdivision shall not prevent
the office of children and family services from applying additional
trend factors or staff retention factors to eligible programs and
services under paragraph (v) of subdivision four of this section.
4. Eligible programs and services. (i) Programs and services funded,
licensed, or certified by the office of mental health (OMH) eligible for
the targeted inflationary increase established herein, pending federal
approval where applicable, include: office of mental health licensed
outpatient programs, pursuant to parts 587 and 599 of title 14 CRR-NY of
the office of mental health regulations including clinic (mental health
outpatient treatment and rehabilitative services programs), continuing
day treatment, day treatment, intensive outpatient programs and partial
hospitalization; outreach; crisis residence; crisis stabilization,
crisis/respite beds; mobile crisis, part 590 comprehensive psychiatric
emergency program services; crisis intervention; home based crisis
intervention; family care; residential program services, excluding prop-
erty costs, for supported single room occupancy and community residence
single room occupancy; supported housing programs/services excluding
rent; treatment congregate; supported congregate; community residence -
children and youth; treatment/apartment; supported apartment; on-site
rehabilitation; employment programs; recreation; respite care; transpor-
tation; psychosocial club; assertive community treatment; case manage-
ment; care coordination, including health home plus services; local
government unit administration; monitoring and evaluation; children and
youth vocational services; single point of access; school-based mental
health program; family support children and youth; advocacy/support
services; drop in centers; recovery centers; transition management
services; bridger; home and community based waiver services; behavioral
health waiver services authorized pursuant to the section 1115 MRT waiv-
er; self-help programs; consumer service dollars; conference of local
mental hygiene directors; multicultural initiative; ongoing integrated
supported employment services; supported education; mentally
ill/chemical abuse (MICA) network; personalized recovery oriented
services; children and family treatment and support services; residen-
tial treatment facilities operating pursuant to part 584 of title
S. 9007--C 111 A. 10007--C
14-NYCRR; geriatric demonstration programs; community-based mental
health family treatment and support; coordinated children's service
initiative; homeless services; and promise zones.
(ii) Programs and services funded, licensed, or certified by the
office for people with developmental disabilities (OPWDD) eligible for
the targeted inflationary increase established herein, pending federal
approval where applicable, include: local/unified services; chapter 620
services; voluntary operated community residential services; article 16
clinics; day treatment services; family support services; 100% day
training; epilepsy services; traumatic brain injury services; hepatitis
B services; independent practitioner services for individuals with
intellectual and/or developmental disabilities; crisis services for
individuals with intellectual and/or developmental disabilities; family
care residential habilitation; supervised residential habilitation;
supportive residential habilitation; respite; day habilitation; prevoca-
tional services; supported employment; community habilitation; interme-
diate care facility day and residential services; specialty hospital;
pathways to employment; intensive behavioral services; community transi-
tion services; family education and training; fiscal intermediary;
support broker; and personal resource accounts.
(iii) Programs and services funded, licensed, or certified by the
office of addiction services and supports (OASAS) eligible for the
targeted inflationary increase established herein, pending federal
approval where applicable, include: medically supervised withdrawal
services - residential; medically supervised withdrawal services -
outpatient; medically managed detoxification; inpatient rehabilitation
services; outpatient opioid treatment; residential opioid treatment;
residential opioid treatment to abstinence; problem gambling treatment;
medically supervised outpatient; outpatient rehabilitation; specialized
services substance abuse programs; home and community based waiver
services pursuant to subdivision 9 of section 366 of the social services
law; children and family treatment and support services; continuum of
care rental assistance case management; supported housing services,
excluding rent, for the following programs: NY/NY III post-treatment
housing, NY/NY III housing for persons at risk for homelessness, and
permanent supported housing; youth clubhouse; recovery community
centers; recovery community organizing initiative; residential rehabili-
tation services for youth (RRSY); intensive residential; community resi-
dential; supportive living; residential services; job placement initi-
ative; case management; family support navigator; local government unit
administration; peer engagement; vocational rehabilitation; HIV early
intervention services; dual diagnosis coordinator; problem gambling
resource centers; problem gambling prevention; prevention resource
centers; primary prevention services; other prevention services; compre-
hensive outpatient clinic; jail-based supports; and regional addiction
resource centers.
(iv) Programs and services funded, licensed, or certified by the
office of temporary and disability assistance (OTDA) eligible for the
targeted inflationary increase established herein, pending federal
approval where applicable, include: the nutrition outreach and education
program (NOEP).
(v) Programs and services funded, licensed, or certified by the office
of children and family services (OCFS) eligible for the targeted infla-
tionary increase established herein, pending federal approval where
applicable, include: programs for which the office of children and fami-
ly services establishes maximum state aid rates pursuant to section
S. 9007--C 112 A. 10007--C
398-a of the social services law and section 4003 of the education law;
emergency foster homes; foster family boarding homes and therapeutic
foster homes; supervised settings as defined by subdivision 22 of
section 371 of the social services law; adoptive parents receiving
adoption subsidy pursuant to section 453 of the social services law; and
congregate and scattered supportive housing programs and supportive
services provided under the NY/NY III supportive housing agreement to
young adults leaving or having recently left foster care.
(vi) Programs and services funded, licensed, or certified by the state
office for the aging (SOFA) eligible for the targeted inflationary
increase established herein, pending federal approval where applicable,
include: community services for the elderly; expanded in-home services
for the elderly; and the wellness in nutrition program.
5. Each local government unit or direct contract provider receiving
funding for the targeted inflationary increase established herein shall
submit a written certification, in such form and at such time as each
commissioner shall prescribe, attesting how such funding will be or was
used to first promote the recruitment and retention of support staff,
direct care staff, clinical staff, non-executive administrative staff,
or respond to other critical non-personal service costs prior to
supporting any salary increases or other compensation for executive
level job titles.
6. Notwithstanding any inconsistent provision of law to the contrary,
agency commissioners shall be authorized to recoup funding from a local
governmental unit or direct contract provider for the targeted infla-
tionary increase established herein determined to have been used in a
manner inconsistent with the appropriation, or any other provision of
this section. Such agency commissioners shall be authorized to employ
any legal mechanism to recoup such funds, including an offset of other
funds that are owed to such local governmental unit or direct contract
provider.
§ 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2026.
PART Q
Intentionally Omitted
PART R
Section 1. Subsection (c) of section 309 of the insurance law, as
added by chapter 41 of the laws of 2014, is amended to read as follows:
(c) As part of an examination, the superintendent shall review deter-
minations of coverage for [substance use disorder treatment] SUBSTANCE-
RELATED AND ADDICTIVE DISORDER SERVICES and shall ensure that such
determinations are issued in compliance with sections three thousand two
hundred sixteen, three thousand two hundred twenty-one, four thousand
three hundred three, and title one of article forty-nine of this chap-
ter.
§ 2. Section 343 of the insurance law, as added by chapter 207 of the
laws of 2019, is amended to read as follows:
§ 343. Mental health and [substance use] SUBSTANCE-RELATED AND ADDIC-
TIVE disorder SERVICES parity report. (a) Beginning July first, two
thousand nineteen and every two years thereafter, each insurer providing
managed care products, individual comprehensive accident and health
S. 9007--C 113 A. 10007--C
insurance or group or blanket comprehensive accident and health insur-
ance, each corporation organized pursuant to article forty-three of this
chapter providing comprehensive health insurance and each entity
licensed pursuant to article forty-four of the public health law provid-
ing comprehensive health service plans shall submit to the superinten-
dent, in a form and manner prescribed by the superintendent, a report
detailing the entity's compliance with federal and state mental health
and [substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder SERVICES
parity laws based on the entity's record during the preceding two calen-
dar years. The superintendent shall publish on the department's website
on or before October first, two thousand nineteen, and every two years
thereafter, the reports submitted pursuant to this section.
(b) Each person required to submit a report under this section shall
include in the report the following information:
(1) Rates of utilization review for mental health and [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder claims as compared to medical
and surgical claims, including rates of approval and denial, categorized
by benefits provided under the following classifications: inpatient
in-network, inpatient out-of-network, outpatient in-network, outpatient
out-of-network, emergency care, and prescription drugs;
(2) The number of prior or concurrent authorization requests for
mental health services and for [substance use] SUBSTANCE-RELATED AND
ADDICTIVE disorder services and the number of denials for such requests,
compared with the number of prior or concurrent authorization requests
for medical and surgical services and the number of denials for such
requests, categorized by the same classifications identified in para-
graph one of this subsection;
(3) The rates of appeals of adverse determinations, including the
rates of adverse determinations upheld and overturned, for mental health
claims and [substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder
claims compared with the rates of appeals of adverse determinations,
including the rates of adverse determinations upheld and overturned, for
medical and surgical claims;
(4) The percentage of claims paid for in-network mental health
services and for [substance use] SUBSTANCE-RELATED AND ADDICTIVE disor-
der services compared with the percentage of claims paid for in-network
medical and surgical services and the percentage of claims paid for
out-of-network mental health services and [substance use] SUBSTANCE-RE-
LATED AND ADDICTIVE disorder services compared with the percentage of
claims paid for out-of-network medical and surgical services;
(5) The number of behavioral health advocates, pursuant to an agree-
ment with the office of the attorney general if applicable, or staff
available to assist policyholders with mental health benefits and
[substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder benefits;
(6) A comparison of the cost sharing requirements including but not
limited to co-pays and coinsurance, and the benefit limitations includ-
ing limitations on the scope and duration of coverage, for medical and
surgical services, and mental health services and [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder services for coverage in the
individual, small group, and large group markets, provided that the
comparison captures at least seventy-five percent of a company's enrol-
lees in each market;
(7) The number by type of providers licensed to practice in this state
that provide services for the treatment and diagnosis of [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder who are in-network, and the
number by type of providers licensed to practice in this state that
S. 9007--C 114 A. 10007--C
provide services for the diagnosis and treatment of mental, nervous or
emotional disorders and ailments, however defined in a company's policy,
who are in-network;
(8) The percentage of providers of services for the treatment and
diagnosis of [substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder
who remained participating providers, and the percentage of providers of
services for the diagnosis and treatment of mental, nervous or emotional
disorders and ailments, however defined in a company's policy, who
remained participating providers; and
(9) Any other data, information, or metric the superintendent deems
necessary or useful to measure compliance with mental health and
[substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder parity includ-
ing, but not limited to an evaluation and assessment of: (i) the adequa-
cy of the company's in-network mental health services and [substance
use] SUBSTANCE-RELATED AND ADDICTIVE disorder provider panels pursuant
to provisions of the insurance law and public health law; and (ii) the
company's reimbursement for in-network and out-of-network mental health
services and [substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder
services as compared to the reimbursement for in-network and out-of-net-
work medical and surgical services.
§ 3. Section 344 of the insurance law, as added by section 1 of part
QQQ of chapter 58 of the laws of 2020, is amended to read as follows:
§ 344. Mental health and [substance use] SUBSTANCE-RELATED AND ADDIC-
TIVE disorder parity compliance programs. Penalties collected for
violations of section three thousand two hundred sixteen, three thousand
two hundred twenty-one and four thousand three hundred three of this
chapter related to mental health and [substance use] SUBSTANCE-RELATED
AND ADDICTIVE disorder parity compliance shall be deposited in a fund
established pursuant to section ninety-nine-hh of the state finance law.
§ 4. Paragraph 30 of subsection (i) of section 3216 of the insurance
law, as amended by section 5 of subpart A of part BB of chapter 57 of
the laws of 2019, is amended to read as follows:
(30)(A) Every policy that provides hospital, major medical or similar
comprehensive coverage shall provide inpatient coverage for the diagno-
sis and treatment of [substance use] SUBSTANCE-RELATED AND ADDICTIVE
disorder, including detoxification and rehabilitation services. Such
inpatient coverage shall include unlimited medically necessary treatment
for [substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder treatment
services provided in residential settings. Further, such inpatient
coverage shall not apply financial requirements or treatment limita-
tions, including utilization review requirements, to inpatient
[substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder benefits that
are more restrictive than the predominant financial requirements and
treatment limitations applied to substantially all medical and surgical
benefits covered by the policy.
(B) Coverage provided under this paragraph may be limited to facili-
ties in New York state that are licensed, certified or otherwise author-
ized by the office of [alcoholism and substance abuse services]
ADDICTION SERVICES AND SUPPORTS and, in other states, to those which are
accredited by the joint commission as alcoholism, ADDICTION, substance
abuse, or chemical dependence treatment programs and are similarly
licensed, certified or otherwise authorized in the state in which the
facility is located.
(C) Coverage provided under this paragraph may be subject to annual
deductibles and co-insurance as deemed appropriate by the superintendent
S. 9007--C 115 A. 10007--C
and that are consistent with those imposed on other benefits within a
given policy.
(D) This subparagraph shall apply to facilities in this state that are
licensed, certified or otherwise authorized by the office of [alcoholism
and substance abuse services] ADDICTION SERVICES AND SUPPORTS that are
participating in the insurer's provider network. Coverage provided under
this paragraph shall not be subject to preauthorization. Coverage
provided under this paragraph shall also not be subject to concurrent
utilization review during the first twenty-eight days of the inpatient
admission provided that the facility notifies the insurer of both the
admission and the initial treatment plan within two business days of the
admission. The facility shall perform daily clinical review of the
patient, including periodic consultation with the insurer at or just
prior to the fourteenth day of treatment to ensure that the facility is
using the evidence-based and peer reviewed clinical review tool utilized
by the insurer which is designated by the office of [alcoholism and
substance abuse services] ADDICTION SERVICES AND SUPPORTS and appropri-
ate to the age of the patient, to ensure that the inpatient treatment is
medically necessary for the patient. Prior to discharge, the facility
shall provide the patient and the insurer with a written discharge plan
which shall describe arrangements for additional services needed follow-
ing discharge from the inpatient facility as determined using the
evidence-based and peer-reviewed clinical review tool utilized by the
insurer which is designated by the office of [alcoholism and substance
abuse services] ADDICTION SERVICES AND SUPPORTS. Prior to discharge,
the facility shall indicate to the insurer whether services included in
the discharge plan are secured or determined to be reasonably available.
Any utilization review of treatment provided under this subparagraph may
include a review of all services provided during such inpatient treat-
ment, including all services provided during the first twenty-eight days
of such inpatient treatment. Provided, however, the insurer shall only
deny coverage for any portion of the initial twenty-eight day inpatient
treatment on the basis that such treatment was not medically necessary
if such inpatient treatment was contrary to the evidence-based and peer
reviewed clinical review tool utilized by the insurer which is desig-
nated by the office of [alcoholism and substance abuse services]
ADDICTION SERVICES AND SUPPORTS. An insured shall not have any finan-
cial obligation to the facility for any treatment under this subpara-
graph other than any copayment, coinsurance, or deductible otherwise
required under the policy.
(E) An insurer shall make available to any insured, prospective
insured, or in-network provider, upon request, the criteria for medical
necessity determinations under the policy with respect to inpatient
[substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder benefits.
(F) For purposes of this paragraph:
(i) "financial requirement" means deductible, copayments, coinsurance
and out-of-pocket expenses;
(ii) "predominant" means that a financial requirement or treatment
limitation is the most common or frequent of such type of limit or
requirement;
(iii) "treatment limitation" means limits on the frequency of treat-
ment, number of visits, days of coverage, or other similar limits on the
scope or duration of treatment and includes nonquantitative treatment
limitations such as: medical management standards limiting or excluding
benefits based on medical necessity, or based on whether the treatment
is experimental or investigational; formulary design for prescription
S. 9007--C 116 A. 10007--C
drugs; network tier design; standards for provider admission to partic-
ipate in a network, including reimbursement rates; methods for determin-
ing usual, customary, and reasonable charges; fail-first or step therapy
protocols; exclusions based on failure to complete a course of treat-
ment; and restrictions based on geographic location, facility type,
provider specialty, and other criteria that limit the scope or duration
of benefits for services provided under the policy; and
(iv) "[substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder" shall
have the meaning set forth in the most recent edition of the diagnostic
and statistical manual of mental disorders or the most recent edition of
another generally recognized independent standard of current medical
practice, such as the international classification of diseases.
(G) An insurer shall provide coverage under this paragraph, at a mini-
mum, consistent with the federal Paul Wellstone and Pete Domenici Mental
Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a).
§ 5. Paragraph 31 of subsection (i) of section 3216 of the insurance
law, as amended by section 6 of subpart A of part BB of chapter 57 of
the laws of 2019, subparagraph (B) as amended by section 10 and subpara-
graph (I) as added by section 11 of part AA of chapter 57 of the laws of
2021, and subparagraph (J) as amended by chapter 75 of the laws of 2026,
is amended to read as follows:
(31) (A) Every policy that provides medical, major medical or similar
comprehensive-type coverage shall provide outpatient coverage for the
diagnosis and treatment of [substance use] SUBSTANCE-RELATED AND ADDIC-
TIVE disorder, including detoxification and rehabilitation services.
Such coverage shall not apply financial requirements or treatment limi-
tations to outpatient [substance use] SUBSTANCE-RELATED AND ADDICTIVE
disorder benefits that are more restrictive than the predominant finan-
cial requirements and treatment limitations applied to substantially all
medical and surgical benefits covered by the policy.
(B) Coverage under this paragraph may be limited to facilities in this
state that are licensed, certified or otherwise authorized by the office
of addiction services and supports to provide outpatient [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder services and crisis stabiliza-
tion centers licensed pursuant to section 36.01 of the mental hygiene
law, and, in other states, to those which are accredited by the joint
commission as alcoholism, ADDICTION or chemical dependence substance
abuse treatment programs and are similarly licensed, certified, or
otherwise authorized in the state in which the facility is located.
(C) Coverage provided under this paragraph may be subject to annual
deductibles and co-insurance as deemed appropriate by the superintendent
and that are consistent with those imposed on other benefits within a
given policy.
(D) A policy providing coverage for [substance use] SUBSTANCE-RELATED
AND ADDICTIVE disorder services pursuant to this paragraph shall provide
up to twenty outpatient visits per policy or calendar year to an indi-
vidual who identifies [him or herself] THEMSELVES as a family member of
a person suffering from [substance use] SUBSTANCE-RELATED AND ADDICTIVE
disorder and who seeks treatment as a family member who is otherwise
covered by the applicable policy pursuant to this paragraph. The cover-
age required by this paragraph shall include treatment as a family
member pursuant to such family member's own policy provided such family
member:
(i) does not exceed the allowable number of family visits provided by
the applicable policy pursuant to this paragraph; and
S. 9007--C 117 A. 10007--C
(ii) is otherwise entitled to coverage pursuant to this paragraph and
such family member's applicable policy.
(E) This subparagraph shall apply to facilities in this state that are
licensed, certified or otherwise authorized by the office of [alcoholism
and substance abuse services] ADDICTION SERVICES AND SUPPORTS for the
provision of outpatient, intensive outpatient, outpatient rehabilitation
and opioid treatment that are participating in the insurer's provider
network. Coverage provided under this paragraph shall not be subject to
preauthorization. Coverage provided under this paragraph shall not be
subject to concurrent review for the first four weeks of continuous
treatment, not to exceed twenty-eight visits, provided the facility
notifies the insurer of both the start of treatment and the initial
treatment plan within two business days. The facility shall perform
clinical assessment of the patient at each visit, including periodic
consultation with the insurer at or just prior to the fourteenth day of
treatment to ensure that the facility is using the evidence-based and
peer reviewed clinical review tool utilized by the insurer which is
designated by the office of [alcoholism and substance abuse services]
ADDICTION SERVICES AND SUPPORTS and appropriate to the age of the
patient, to ensure that the outpatient treatment is medically necessary
for the patient. Any utilization review of the treatment provided under
this subparagraph may include a review of all services provided during
such outpatient treatment, including all services provided during the
first four weeks of continuous treatment, not to exceed twenty-eight
visits, of such outpatient treatment. Provided, however, the insurer
shall only deny coverage for any portion of the initial four weeks of
continuous treatment, not to exceed twenty-eight visits, for outpatient
treatment on the basis that such treatment was not medically necessary
if such outpatient treatment was contrary to the evidence-based and peer
reviewed clinical review tool utilized by the insurer which is desig-
nated by the office of [alcoholism and substance abuse services]
ADDICTION SERVICES AND SUPPORTS. An insured shall not have any finan-
cial obligation to the facility for any treatment under this subpara-
graph other than any copayment, coinsurance, or deductible otherwise
required under the policy.
(F) The criteria for medical necessity determinations under the policy
with respect to outpatient [substance use] SUBSTANCE-RELATED AND ADDIC-
TIVE disorder benefits shall be made available by the insurer to any
insured, prospective insured, or in-network provider upon request.
(G) For purposes of this paragraph:
(i) "financial requirement" means deductible, copayments, coinsurance
and out-of-pocket expenses;
(ii) "predominant" means that a financial requirement or treatment
limitation is the most common or frequent of such type of limit or
requirement;
(iii) "treatment limitation" means limits on the frequency of treat-
ment, number of visits, days of coverage, or other similar limits on the
scope or duration of treatment and includes nonquantitative treatment
limitations such as: medical management standards limiting or excluding
benefits based on medical necessity, or based on whether the treatment
is experimental or investigational; formulary design for prescription
drugs; network tier design; standards for provider admission to partic-
ipate in a network, including reimbursement rates; methods for determin-
ing usual, customary, and reasonable charges; fail-first or step therapy
protocols; exclusions based on failure to complete a course of treat-
ment; and restrictions based on geographic location, facility type,
S. 9007--C 118 A. 10007--C
provider specialty, and other criteria that limit the scope or duration
of benefits for services provided under the policy; and
(iv) ["substance use] "SUBSTANCE-RELATED AND ADDICTIVE disorder" shall
have the meaning set forth in the most recent edition of the diagnostic
and statistical manual of mental disorders or the most recent edition of
another generally recognized independent standard of current medical
practice such as the international classification of diseases.
(H) An insurer shall provide coverage under this paragraph, at a mini-
mum, consistent with the federal Paul Wellstone and Pete Domenici Mental
Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a).
(I) This subparagraph shall apply to crisis stabilization centers in
this state that are licensed pursuant to section 36.01 of the mental
hygiene law and participate in the insurer's provider network. Benefits
for care in a crisis stabilization center shall not be subject to preau-
thorization. All treatment provided under this subparagraph may be
reviewed retrospectively. Where care is denied retrospectively, an
insured shall not have any financial obligation to the facility for any
treatment under this subparagraph other than any copayment, coinsurance,
or deductible otherwise required under the policy.
(J) (i) This clause shall apply to facilities in this state that are
licensed, certified, or otherwise authorized by the office of addiction
services and supports for the provision of outpatient, intensive outpa-
tient, outpatient rehabilitation and opioid treatment that are partic-
ipating in the insurer's provider network. Reimbursement for covered
outpatient treatment provided by such facilities shall be at rates nego-
tiated between the insurer and the participating facility, provided that
such rates are not less than the rates that would be paid for such
treatment pursuant to the medical assistance program under title eleven
of article five of the social services law. For the purposes of this
clause, the rates that would be paid for such treatment pursuant to the
medical assistance program under title eleven of article five of the
social services law shall be the rates with an effective date of April
first of the preceding year, which shall be established prior to October
first of the preceding calendar year.
(ii) The office of addiction services and supports shall publish
information adequate to calculate the rates that would be paid for such
treatment pursuant to the medical assistance program under title eleven
of article five of the social services law. Such information shall be
provided in a form and manner to be determined by the commissioner of
addiction services and supports. Nothing in this clause shall be
construed to relieve an insurer of the obligation to reimburse at no
less than the applicable minimum rate set forth in clause (i) of this
subparagraph. Prior to the submission of premium rate filings and appli-
cations, the superintendent shall provide insurers with guidance on
factors to consider in calculating the impact of rate changes for the
purposes of submitting premium rate filings and applications to the
superintendent for the subsequent policy year. To the extent that the
rates with an effective date of April first differ from the estimated
rates incorporated in premium rate filings and applications, insurers
may account for such differences in future premium rate filings and
applications submitted to the superintendent for approval.
§ 6. Paragraph 31-a of subsection (i) of section 3216 of the insurance
law, as added by chapter 748 of the laws of 2019, and subparagraph (A)
as amended by section 1 of subpart E of part II of chapter 57 of the
laws of 2023, is amended to read as follows:
S. 9007--C 119 A. 10007--C
(31-a) (A) No policy that provides medical, major medical or similar
comprehensive-type coverage and provides coverage for prescription drugs
for medication for the treatment of a [substance use] SUBSTANCE-RELATED
AND ADDICTIVE disorder shall require prior authorization for an initial
or renewal prescription for the detoxification or maintenance treatment
of a [substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder, including
all buprenorphine products, methadone, long acting injectable naltrex-
one, or medication for opioid overdose reversal prescribed or dispensed
to an insured covered under the policy, including federal food and drug
administration-approved over-the-counter opioid overdose reversal medi-
cation as prescribed, dispensed or as otherwise authorized under state
or federal law, except where otherwise prohibited by law.
(B) Coverage provided under this paragraph may be subject to copay-
ments, coinsurance, and annual deductibles that are consistent with
those imposed on other benefits within the policy.
§ 7. Paragraph 17 of subsection (a) of section 3217-a of the insurance
law, as amended by section 2 of subpart B of part AA of chapter 57 of
the laws of 2022, is amended to read as follows:
(17) where applicable, a listing by specialty, which may be in a sepa-
rate document that is updated annually, of the name, address, telephone
number, and digital contact information of all participating providers,
including facilities, and: (A) whether the provider is accepting new
patients; (B) in the case of mental health or [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder services providers, any affil-
iations with participating facilities certified or authorized by the
office of mental health or the office of addiction services and
supports, and any restrictions regarding the availability of the indi-
vidual provider's services; and (C) in the case of physicians, board
certification, languages spoken and any affiliations with participating
hospitals. The listing shall also be posted on the insurer's website and
the insurer shall update the website within fifteen days of the addition
or termination of a provider from the insurer's network or a change in a
physician's hospital affiliation;
§ 8. Subsection (m) of section 3217-b of the insurance law, as added
by section 3 of subpart B of part AA of chapter 57 of the laws of 2022,
is amended to read as follows:
(m) A contract between an insurer and a health care provider shall
include a provision that requires the health care provider to have in
place business processes to ensure the timely provision of provider
directory information to the insurer. A health care provider shall
submit such provider directory information to an insurer, at a minimum,
when a provider begins or terminates a network agreement with an insur-
er, when there are material changes to the content of the provider
directory information of the health care provider, and at any other
time, including upon the insurer's request, as the health care provider
determines to be appropriate. For purposes of this subsection, "provider
directory information" shall include the name, address, specialty, tele-
phone number, and digital contact information of such health care
provider; whether the provider is accepting new patients; for mental
health and [substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder
services providers, any affiliations with participating facilities
certified or authorized by the office of mental health or the office of
addiction services and supports, and any restrictions regarding the
availability of the individual provider's services; and in the case of
physicians, board certification, languages spoken, and any affiliations
with participating hospitals.
S. 9007--C 120 A. 10007--C
§ 9. Subparagraphs (A), (B), (D), (E) and (F) of paragraph 6 of
subsection (l) of section 3221 of the insurance law, subparagraphs (A),
(B), and (D) as amended and subparagraphs (E) and (F) as added by
section 15 of subpart A of part BB of chapter 57 of the laws of 2019,
are amended to read as follows:
(A) Every policy that provides hospital, major medical or similar
comprehensive coverage shall provide inpatient coverage for the diagno-
sis and treatment of [substance use] SUBSTANCE-RELATED AND ADDICTIVE
disorder, including detoxification and rehabilitation services. Such
inpatient coverage shall include unlimited medically necessary treatment
for [substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder treatment
services provided in residential settings. Further, such inpatient
coverage shall not apply financial requirements or treatment limita-
tions, including utilization review requirements, to inpatient
[substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder benefits that
are more restrictive than the predominant financial requirements and
treatment limitations applied to substantially all medical and surgical
benefits covered by the policy.
(B) Coverage provided under this paragraph may be limited to facili-
ties in New York state that are licensed, certified or otherwise author-
ized by the office of [alcoholism and substance abuse services]
ADDICTION SERVICES AND SUPPORTS and, in other states, to those which are
accredited by the joint commission as alcoholism, ADDICTION, substance
abuse or chemical dependence treatment programs and are similarly
licensed, certified, or otherwise authorized in the state in which the
facility is located.
(D) This subparagraph shall apply to facilities in this state that are
licensed, certified or otherwise authorized by the office of [alcoholism
and substance abuse services] ADDICTION SERVICES AND SUPPORTS that are
participating in the insurer's provider network. Coverage provided under
this paragraph shall not be subject to preauthorization. Coverage
provided under this paragraph shall also not be subject to concurrent
utilization review during the first twenty-eight days of the inpatient
admission provided that the facility notifies the insurer of both the
admission and the initial treatment plan within two business days of the
admission. The facility shall perform daily clinical review of the
patient, including periodic consultation with the insurer at or just
prior to the fourteenth day of treatment to ensure that the facility is
using the evidence-based and peer reviewed clinical review tool utilized
by the insurer which is designated by the office of [alcoholism and
substance abuse services] ADDICTION SERVICES AND SUPPORTS and appropri-
ate to the age of the patient, to ensure that the inpatient treatment is
medically necessary for the patient. Prior to discharge, the facility
shall provide the patient and the insurer with a written discharge plan
which shall describe arrangements for additional services needed follow-
ing discharge from the inpatient facility as determined using the
evidence-based and peer-reviewed clinical review tool utilized by the
insurer which is designated by the office of [alcoholism and substance
abuse services] ADDICTION SERVICES AND SUPPORTS. Prior to discharge,
the facility shall indicate to the insurer whether services included in
the discharge plan are secured or determined to be reasonably available.
Any utilization review of treatment provided under this subparagraph may
include a review of all services provided during such inpatient treat-
ment, including all services provided during the first twenty-eight days
of such inpatient treatment. Provided, however, the insurer shall only
deny coverage for any portion of the initial twenty-eight day inpatient
S. 9007--C 121 A. 10007--C
treatment on the basis that such treatment was not medically necessary
if such inpatient treatment was contrary to the evidence-based and peer
reviewed clinical review tool utilized by the insurer which is desig-
nated by the office of [alcoholism and substance abuse services]
ADDICTION SERVICES AND SUPPORTS. An insured shall not have any finan-
cial obligation to the facility for any treatment under this subpara-
graph other than any copayment, coinsurance, or deductible otherwise
required under the policy.
(E) The criteria for medical necessity determinations under the policy
with respect to inpatient [substance use] SUBSTANCE-RELATED AND ADDIC-
TIVE disorder benefits shall be made available by the insurer to any
insured, prospective insured, or in-network provider upon request.
(F) For purposes of this paragraph:
(i) "financial requirement" means deductible, copayments, coinsurance
and out-of-pocket expenses;
(ii) "predominant" means that a financial requirement or treatment
limitation is the most common or frequent of such type of limit or
requirement;
(iii) "treatment limitation" means limits on the frequency of treat-
ment, number of visits, days of coverage, or other similar limits on the
scope or duration of treatment and includes nonquantitative treatment
limitations such as: medical management standards limiting or excluding
benefits based on medical necessity, or based on whether the treatment
is experimental or investigational; formulary design for prescription
drugs; network tier design; standards for provider admission to partic-
ipate in a network, including reimbursement rates; methods for determin-
ing usual, customary, and reasonable charges; fail-first or step therapy
protocols; exclusions based on failure to complete a course of treat-
ment; and restrictions based on geographic location, facility type,
provider specialty, and other criteria that limit the scope or duration
of benefits for services provided under the policy; and
(iv) ["substance use] "SUBSTANCE-RELATED AND ADDICTIVE disorder" shall
have the meaning set forth in the most recent edition of the diagnostic
and statistical manual of mental disorders or the most recent edition of
another generally recognized independent standard of current medical
practice such as the international classification of diseases.
§ 10. Paragraph 7 of subsection (l) of section 3221 of the insurance
law, as amended by chapter 41 of the laws of 2014, subparagraph (A) as
amended and subparagraph (C-1) as added by section 16 and subparagraph
(E) as amended, and subparagraphs (F), (G), and (H) as added by section
17 of subpart A of part BB of chapter 57 of the laws of 2019, subpara-
graph (B) as amended by section 16 and subparagraph (I) as added by
section 17 of part AA of chapter 57 of the laws of 2021, and subpara-
graph (J) as amended by chapter 75 of the laws of 2026, is amended to
read as follows:
(7) (A) Every policy that provides medical, major medical or similar
comprehensive-type coverage shall provide outpatient coverage for the
diagnosis and treatment of [substance use] SUBSTANCE-RELATED AND ADDIC-
TIVE disorder, including detoxification and rehabilitation services.
Such coverage shall not apply financial requirements or treatment limi-
tations to outpatient [substance use] SUBSTANCE-RELATED AND ADDICTIVE
disorder benefits that are more restrictive than the predominant finan-
cial requirements and treatment limitations applied to substantially all
medical and surgical benefits covered by the policy.
(B) Coverage under this paragraph may be limited to facilities in this
state that are licensed, certified or otherwise authorized by the office
S. 9007--C 122 A. 10007--C
of addiction services and supports to provide outpatient [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder services and crisis stabiliza-
tion centers licensed pursuant to section 36.01 of the mental hygiene
law, and, in other states, to those which are accredited by the joint
commission as alcoholism, ADDICTION or chemical dependence treatment
programs and similarly licensed, certified or otherwise authorized in
the state in which the facility is located.
(C) Coverage provided under this paragraph may be subject to annual
deductibles and co-insurance as deemed appropriate by the superintendent
and that are consistent with those imposed on other benefits within a
given policy.
(C-1) A large group policy that provides coverage under this paragraph
shall not impose copayments or coinsurance for outpatient [substance
use] SUBSTANCE-RELATED AND ADDICTIVE disorder services that exceeds the
copayment or coinsurance imposed for a primary care office visit.
Provided that no greater than one such copayment may be imposed for all
services provided in a single day by a facility licensed, certified or
otherwise authorized by the office of [alcoholism and substance abuse
services] ADDICTION SERVICES AND SUPPORTS to provide outpatient
[substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder services.
(D) A policy providing coverage for [substance use] SUBSTANCE-RELATED
AND ADDICTIVE disorder services pursuant to this paragraph shall provide
up to twenty outpatient visits per policy or calendar year to an indi-
vidual who identifies [him or herself] THEMSELVES as a family member of
a person suffering from [substance use] A SUBSTANCE-RELATED AND ADDIC-
TIVE disorder and who seeks treatment as a family member who is other-
wise covered by the applicable policy pursuant to this paragraph. The
coverage required by this paragraph shall include treatment as a family
member pursuant to such family member's own policy provided such family
member:
(i) does not exceed the allowable number of family visits provided by
the applicable policy pursuant to this paragraph; and
(ii) is otherwise entitled to coverage pursuant to this paragraph and
such family member's applicable policy.
(E) This subparagraph shall apply to facilities in this state that are
licensed, certified or otherwise authorized by the office of [alcoholism
and substance abuse services] ADDICTION SERVICES AND SUPPORTS for the
provision of outpatient, intensive outpatient, outpatient rehabilitation
and opioid treatment that are participating in the insurer's provider
network. Coverage provided under this paragraph shall not be subject to
preauthorization. Coverage provided under this paragraph shall not be
subject to concurrent review for the first four weeks of continuous
treatment, not to exceed twenty-eight visits, provided the facility
notifies the insurer of both the start of treatment and the initial
treatment plan within two business days. The facility shall perform
clinical assessment of the patient at each visit, including periodic
consultation with the insurer at or just prior to the fourteenth day of
treatment to ensure that the facility is using the evidence-based and
peer reviewed clinical review tool utilized by the insurer which is
designated by the office of [alcoholism and substance abuse services]
ADDICTION SERVICES AND SUPPORTS and appropriate to the age of the
patient, to ensure that the outpatient treatment is medically necessary
for the patient. Any utilization review of the treatment provided under
this subparagraph may include a review of all services provided during
such outpatient treatment, including all services provided during the
first four weeks of continuous treatment, not to exceed twenty-eight
S. 9007--C 123 A. 10007--C
visits, of such outpatient treatment. Provided, however, the insurer
shall only deny coverage for any portion of the initial four weeks of
continuous treatment, not to exceed twenty-eight visits, for outpatient
treatment on the basis that such treatment was not medically necessary
if such outpatient treatment was contrary to the evidence-based and peer
reviewed clinical review tool utilized by the insurer which is desig-
nated by the office of [alcoholism and substance abuse services]
ADDICTION SERVICES AND SUPPORTS. An insured shall not have any finan-
cial obligation to the facility for any treatment under this subpara-
graph other than any copayment, coinsurance, or deductible otherwise
required under the policy.
(F) The criteria for medical necessity determinations under the policy
with respect to outpatient [substance use] SUBSTANCE-RELATED AND ADDIC-
TIVE disorder benefits shall be made available by the insurer to any
insured, prospective insured, or in-network provider upon request.
(G) For purposes of this paragraph:
(i) "financial requirement" means deductible, copayments, coinsurance
and out-of-pocket expenses;
(ii) "predominant" means that a financial requirement or treatment
limitation is the most common or frequent of such type of limit or
requirement;
(iii) "treatment limitation" means limits on the frequency of treat-
ment, number of visits, days of coverage, or other similar limits on the
scope or duration of treatment and includes nonquantitative treatment
limitations such as: medical management standards limiting or excluding
benefits based on medical necessity, or based on whether the treatment
is experimental or investigational; formulary design for prescription
drugs; network tier design; standards for provider admission to partic-
ipate in a network, including reimbursement rates; methods for determin-
ing usual, customary, and reasonable charges; fail-first or step therapy
protocols; exclusions based on failure to complete a course of treat-
ment; and restrictions based on geographic location, facility type,
provider specialty, and other criteria that limit the scope or duration
of benefits for services provided under the policy; and
(iv) ["substance use] "SUBSTANCE-RELATED AND ADDICTIVE disorder" shall
have the meaning set forth in the most recent edition of the diagnostic
and statistical manual of mental disorders or the most recent edition of
another generally recognized independent standard of current medical
practice such as the international classification of diseases.
(H) An insurer shall provide coverage under this paragraph, at a mini-
mum, consistent with the federal Paul Wellstone and Pete Domenici Mental
Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a).
(I) This subparagraph shall apply to crisis stabilization centers in
this state that are licensed pursuant to section 36.01 of the mental
hygiene law and participate in the insurer's provider network. Benefits
for care in a crisis stabilization center shall not be subject to preau-
thorization. All treatment provided under this subparagraph may be
reviewed retrospectively. Where care is denied retrospectively, an
insured shall not have any financial obligation to the facility for any
treatment under this subparagraph other than any copayment, coinsurance,
or deductible otherwise required under the policy.
(J) (i) This clause shall apply to facilities in this state that are
licensed, certified, or otherwise authorized by the office of addiction
services and supports for the provision of outpatient, intensive outpa-
tient, outpatient rehabilitation and opioid treatment that are partic-
ipating in the insurer's provider network. Reimbursement for covered
S. 9007--C 124 A. 10007--C
outpatient treatment provided by such facilities shall be at rates nego-
tiated between the insurer and the participating facility, provided that
such rates are not less than the rates that would be paid for such
treatment pursuant to the medical assistance program under title eleven
of article five of the social services law. For the purposes of this
clause, the rates that would be paid for such treatment pursuant to the
medical assistance program under title eleven of article five of the
social services law shall be the rates with an effective date of April
first of the preceding year, which shall be established prior to October
first of the preceding calendar year.
(ii) The office of addiction services and supports shall publish
information adequate to calculate the rates that would be paid for such
treatment pursuant to the medical assistance program under title eleven
of article five of the social services law. Such information shall be
provided in a form and manner to be determined by the commissioner of
addiction services and supports. Nothing in this clause shall be
construed to relieve an insurer of the obligation to reimburse at no
less than the applicable minimum rate set forth in clause (i) of this
subparagraph. Prior to the submission of premium rate filings and appli-
cations, the superintendent shall provide insurers with guidance on
factors to consider in calculating the impact of rate changes for the
purposes of submitting premium rate filings and applications to the
superintendent for the subsequent policy year. To the extent that the
rates with an effective date of April first differ from the estimated
rates incorporated in premium rate filings and applications, insurers
may account for such differences in future premium rate filings and
applications submitted to the superintendent for approval.
§ 11. Subparagraph (A) of paragraph 7-a of subsection (l) of section
3221 of the insurance law, as amended by section 2 of subpart E of part
II of chapter 57 of the laws of 2023, is amended to read as follows:
(A) No policy that provides medical, major medical or similar compre-
hensive-type small group coverage and provides coverage for prescription
drugs for medication for the treatment of a [substance use] SUBSTANCE-
RELATED AND ADDICTIVE disorder shall require prior authorization for an
initial or renewal prescription for the detoxification or maintenance
treatment of a [substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder,
including all buprenorphine products, methadone, long acting injectable
naltrexone, or medication for opioid overdose reversal prescribed or
dispensed to an insured covered under the policy, including federal food
and drug administration-approved over-the-counter opioid overdose
reversal medication as prescribed, dispensed or as otherwise authorized
under state or federal law, except where otherwise prohibited by law.
Every policy that provides medical, major medical or similar comprehen-
sive-type large group coverage shall provide coverage for prescription
drugs for medication for the treatment of a [substance use] SUBSTANCE-
RELATED AND ADDICTIVE disorder and shall not require prior authorization
for an initial or renewal prescription for the detoxification or mainte-
nance treatment of a [substance use] SUBSTANCE-RELATED AND ADDICTIVE
disorder, including all buprenorphine products, methadone, long acting
injectable naltrexone, or medication for opioid overdose reversal
prescribed or dispensed to an insured covered under the policy, includ-
ing federal food and drug administration-approved over-the-counter
opioid overdose reversal medication as prescribed, dispensed or as
otherwise authorized under state or federal law, except where otherwise
prohibited by law.
S. 9007--C 125 A. 10007--C
§ 12. Subsection (a) of section 3241 of the insurance law, as amended
by section 1 of subpart F of part II of chapter 57 of the laws of 2023,
is amended to read as follows:
(a) (1) An insurer, a corporation organized pursuant to article
forty-three of this chapter, a municipal cooperative health benefit plan
certified pursuant to article forty-seven of this chapter, or a student
health plan established or maintained pursuant to section one thousand
one hundred twenty-four of this chapter, that issues a health insurance
policy or contract with a network of health care providers shall ensure
that the network is adequate to meet the health, SUBSTANCE-RELATED AND
ADDICTIVE DISORDER and mental health needs of insureds and provide an
appropriate choice of providers sufficient to render the services
covered under the policy or contract. The superintendent shall review
the network of health care providers for adequacy at the time of the
superintendent's initial approval of a health insurance policy or
contract; at least every three years thereafter; and upon application
for expansion of any service area associated with the policy or contract
in conformance with the standards set forth in subdivision five of
section four thousand four hundred three of the public health law. The
superintendent shall determine standards for network adequacy for mental
health and [substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder
treatment services, including sub-acute care in a residential facility,
assertive community treatment services, critical time intervention
services and mobile crisis intervention services, in consultation with
the commissioner of the office of mental health and the commissioner of
the office of addiction services and supports. To the extent that the
network has been determined by the commissioner of health to meet the
standards set forth in subdivision five of section four thousand four
hundred three of the public health law, such network shall be deemed
adequate by the superintendent.
(2) The superintendent, in consultation with the commissioner of
health, the commissioner of the office of mental health, and the commis-
sioner of the office of addiction services and supports, shall propose
regulations setting forth standards for network adequacy for mental
health and [substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder
treatment services, including sub-acute care in a residential facility,
assertive community treatment services, critical time intervention
services and mobile crisis intervention services, by December thirty-
first, two thousand twenty-three.
§ 13. Subsection (k) of section 4303 of the insurance law, as amended
by section 26 of subpart A of part BB of chapter 57 of the laws of 2019,
is amended to read as follows:
(k)(1) Every contract that provides hospital, major medical or similar
comprehensive coverage shall provide inpatient coverage for the diagno-
sis and treatment of [substance use] SUBSTANCE-RELATED AND ADDICTIVE
disorder, including detoxification and rehabilitation services. Such
inpatient coverage shall include unlimited medically necessary treatment
for [substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder treatment
services provided in residential settings. Further, such inpatient
coverage shall not apply financial requirements or treatment limita-
tions, including utilization review requirements, to inpatient
[substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder benefits that
are more restrictive than the predominant financial requirements and
treatment limitations applied to substantially all medical and surgical
benefits covered by the contract.
S. 9007--C 126 A. 10007--C
(2) Coverage provided under this subsection may be limited to facili-
ties in New York state that are licensed, certified or otherwise author-
ized by the office of [alcoholism and substance abuse services]
ADDICTION SERVICES AND SUPPORTS and, in other states, to those which are
accredited by the joint commission as alcoholism, ADDICTION, substance
abuse, or chemical dependence treatment programs and are similarly
licensed, certified or otherwise authorized in the state in which the
facility is located.
(3) Coverage provided under this subsection may be subject to annual
deductibles and co-insurance as deemed appropriate by the superintendent
and that are consistent with those imposed on other benefits within a
given contract.
(4) This paragraph shall apply to facilities in this state that are
licensed, certified or otherwise authorized by the office of [alcoholism
and substance abuse services] ADDICTION SERVICES AND SUPPORTS that are
participating in the corporation's provider network. Coverage provided
under this subsection shall not be subject to preauthorization. Coverage
provided under this subsection shall also not be subject to concurrent
utilization review during the first twenty-eight days of the inpatient
admission provided that the facility notifies the corporation of both
the admission and the initial treatment plan within two business days of
the admission. The facility shall perform daily clinical review of the
patient, including periodic consultation with the corporation at or just
prior to the fourteenth day of treatment to ensure that the facility is
using the evidence-based and peer reviewed clinical review tool utilized
by the corporation which is designated by the office of [alcoholism and
substance abuse services] ADDICTION SERVICES AND SUPPORTS and appropri-
ate to the age of the patient, to ensure that the inpatient treatment is
medically necessary for the patient. Prior to discharge, the facility
shall provide the patient and the corporation with a written discharge
plan which shall describe arrangements for additional services needed
following discharge from the inpatient facility as determined using the
evidence-based and peer-reviewed clinical review tool utilized by the
corporation which is designated by the office of [alcoholism and
substance abuse services] ADDICTION SERVICES AND SUPPORTS. Prior to
discharge, the facility shall indicate to the corporation whether
services included in the discharge plan are secured or determined to be
reasonably available. Any utilization review of treatment provided
under this paragraph may include a review of all services provided
during such inpatient treatment, including all services provided during
the first twenty-eight days of such inpatient treatment. Provided,
however, the corporation shall only deny coverage for any portion of the
initial twenty-eight day inpatient treatment on the basis that such
treatment was not medically necessary if such inpatient treatment was
contrary to the evidence-based and peer reviewed clinical review tool
utilized by the corporation which is designated by the office of [alco-
holism and substance abuse services] ADDICTION SERVICES AND SUPPORTS.
An insured shall not have any financial obligation to the facility for
any treatment under this paragraph other than any copayment, coinsu-
rance, or deductible otherwise required under the contract.
(5) The criteria for medical necessity determinations under the
contract with respect to inpatient [substance use] SUBSTANCE-RELATED AND
ADDICTIVE disorder benefits shall be made available by the corporation
to any insured, prospective insured or in-network provider upon request.
(6) For purposes of this subsection:
S. 9007--C 127 A. 10007--C
(A) "financial requirement" means deductible, copayments, coinsurance
and out-of-pocket expenses;
(B) "predominant" means that a financial requirement or treatment
limitation is the most common or frequent of such type of limit or
requirement;
(C) "treatment limitation" means limits on the frequency of treatment,
number of visits, days of coverage, or other similar limits on the scope
or duration of treatment and includes nonquantitative treatment limita-
tions such as: medical management standards limiting or excluding bene-
fits based on medical necessity, or based on whether the treatment is
experimental or investigational; formulary design for prescription
drugs; network tier design; standards for provider admission to partic-
ipate in a network, including reimbursement rates; methods for determin-
ing usual, customary, and reasonable charges; fail-first or step therapy
protocols; exclusions based on failure to complete a course of treat-
ment; and restrictions based on geographic location, facility type,
provider specialty, and other criteria that limit the scope or duration
of benefits for services provided under the contract; and
(D) ["substance use] "SUBSTANCE-RELATED AND ADDICTIVE disorder" shall
have the meaning set forth in the most recent edition of the diagnostic
and statistical manual of mental disorders or the most recent edition of
another generally recognized independent standard of current medical
practice such as the international classification of diseases.
(7) A corporation shall provide coverage under this subsection, at a
minimum, consistent with the federal Paul Wellstone and Pete Domenici
Mental Health Parity and Addiction Equity Act of 2008 (29 U.S.C. §
1185a).
§ 14. Subsection (l) of section 4303 of the insurance law, as amended
by chapter 41 of the laws of 2014, paragraph 1 as amended and paragraph
3-a as added by section 27, paragraph 5 as amended and paragraphs 6, 7
and 8 as added by section 28 of subpart A of part BB of chapter 57 of
the laws of 2019, paragraph 2 as amended by section 20 and paragraph 9
as added by section 21 of part AA of chapter 57 of the laws of 2021, and
paragraph 10 as amended by chapter 75 of the laws of 2026, is amended to
read as follows:
(l) (1) Every contract that provides medical, major medical or similar
comprehensive-type coverage shall provide outpatient coverage for the
diagnosis and treatment of [substance use] SUBSTANCE-RELATED AND ADDIC-
TIVE disorder, including detoxification and rehabilitation services.
Such coverage shall not apply financial requirements or treatment limi-
tations to outpatient [substance use] SUBSTANCE-RELATED AND ADDICTIVE
disorder benefits that are more restrictive than the predominant finan-
cial requirements and treatment limitations applied to substantially all
medical and surgical benefits covered by the contract.
(2) Coverage under this subsection may be limited to facilities in
this state that are licensed, certified or otherwise authorized by the
office of addiction services and supports to provide outpatient
[substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder services and
crisis stabilization centers licensed pursuant to section 36.01 of the
mental hygiene law, and, in other states, to those which are accredited
by the joint commission as alcoholism, ADDICTION or chemical dependence
substance abuse treatment programs and are similarly licensed, certified
or otherwise authorized in the state in which the facility is located.
(3) Coverage provided under this subsection may be subject to annual
deductibles and co-insurance as deemed appropriate by the superintendent
S. 9007--C 128 A. 10007--C
and that are consistent with those imposed on other benefits within a
given contract.
(3-a) A contract that provides large group coverage under this
subsection shall not impose copayments or coinsurance for outpatient
[substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder services that
exceed the copayment or coinsurance imposed for a primary care office
visit. Provided that no greater than one such copayment may be imposed
for all services provided in a single day by a facility licensed, certi-
fied or otherwise authorized by the office of [alcoholism and substance
abuse services] ADDICTION SERVICES AND SUPPORTS to provide outpatient
[substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder services.
(4) A contract providing coverage for [substance use] SUBSTANCE-RELAT-
ED AND ADDICTIVE disorder services pursuant to this subsection shall
provide up to twenty outpatient visits per contract or calendar year to
an individual who identifies [him or herself] THEMSELVES as a family
member of a person suffering from [substance use] SUBSTANCE-RELATED AND
ADDICTIVE disorder and who seeks treatment as a family member who is
otherwise covered by the applicable contract pursuant to this
subsection. The coverage required by this subsection shall include
treatment as a family member pursuant to such family member's own
contract provided such family member:
(A) does not exceed the allowable number of family visits provided by
the applicable contract pursuant to this subsection; and
(B) is otherwise entitled to coverage pursuant to this subsection and
such family member's applicable contract.
(5) This paragraph shall apply to facilities in this state that are
licensed, certified or otherwise authorized by the office of [alcoholism
and substance abuse services] ADDICTION SERVICES AND SUPPORTS for the
provision of outpatient, intensive outpatient, outpatient rehabilitation
and opioid treatment that are participating in the corporation's provid-
er network. Coverage provided under this subsection shall not be subject
to preauthorization. Coverage provided under this subsection shall not
be subject to concurrent review for the first four weeks of continuous
treatment, not to exceed twenty-eight visits, provided the facility
notifies the corporation of both the start of treatment and the initial
treatment plan within two business days. The facility shall perform
clinical assessment of the patient at each visit, including periodic
consultation with the corporation at or just prior to the fourteenth day
of treatment to ensure that the facility is using the evidence-based and
peer reviewed clinical review tool utilized by the corporation which is
designated by the office of [alcoholism and substance abuse services]
ADDICTION SERVICES AND SUPPORTS and appropriate to the age of the
patient, to ensure that the outpatient treatment is medically necessary
for the patient. Any utilization review of the treatment provided under
this paragraph may include a review of all services provided during such
outpatient treatment, including all services provided during the first
four weeks of continuous treatment, not to exceed twenty-eight visits,
of such outpatient treatment. Provided, however, the corporation shall
only deny coverage for any portion of the initial four weeks of contin-
uous treatment, not to exceed twenty-eight visits, for outpatient treat-
ment on the basis that such treatment was not medically necessary if
such outpatient treatment was contrary to the evidence-based and peer
reviewed clinical review tool utilized by the corporation which is
designated by the office of [alcoholism and substance abuse services]
ADDICTION SERVICES AND SUPPORTS. A subscriber shall not have any finan-
cial obligation to the facility for any treatment under this paragraph
S. 9007--C 129 A. 10007--C
other than any copayment, coinsurance, or deductible otherwise required
under the contract.
(6) The criteria for medical necessity determinations under the
contract with respect to outpatient [substance use] SUBSTANCE-RELATED
AND ADDICTIVE disorder benefits shall be made available by the corpo-
ration to any insured, prospective insured, or in-network provider upon
request.
(7) For purposes of this subsection:
(A) "financial requirement" means deductible, copayments, coinsurance
and out-of-pocket expenses;
(B) "predominant" means that a financial requirement or treatment
limitation is the most common or frequent of such type of limit or
requirement.
(C) "treatment limitation" means limits on the frequency of treatment,
number of visits, days of coverage, or other similar limits on the scope
or duration of treatment and includes nonquantitative treatment limita-
tions such as: medical management standards limiting or excluding bene-
fits based on medical necessity, or based on whether the treatment is
experimental or investigational; formulary design for prescription
drugs; network tier design; standards for provider admission to partic-
ipate in a network, including reimbursement rates; methods for determin-
ing usual, customary, and reasonable charges; fail-first or step therapy
protocols; exclusions based on failure to complete a course of treat-
ment; and restrictions based on geographic location, facility type,
provider specialty, and other criteria that limit the scope or duration
of benefits for services provided under the contract; and
(D) ["substance use] "SUBSTANCE-RELATED AND ADDICTIVE disorder" shall
have the meaning set forth in the most recent edition of the diagnostic
and statistical manual of mental disorders or the most recent edition of
another generally recognized independent standard of current medical
practice such as the international classification of diseases.
(8) A corporation shall provide coverage under this subsection, at a
minimum, consistent with the federal Paul Wellstone and Pete Domenici
Mental Health Parity and Addiction Equity Act of 2008 (29 U.S.C. §
1185a).
(9) This paragraph shall apply to crisis stabilization centers in this
state that are licensed pursuant to section 36.01 of the mental hygiene
law and participate in the corporation's provider network. Benefits for
care in a crisis stabilization center shall not be subject to preauthor-
ization. All treatment provided under this paragraph may be reviewed
retrospectively. Where care is denied retrospectively, an insured shall
not have any financial obligation to the facility for any treatment
under this paragraph other than any copayment, coinsurance, or deduct-
ible otherwise required under the contract.
(10) (A) This subparagraph shall apply to facilities in this state
that are licensed, certified, or otherwise authorized by the office of
addiction services and supports for the provision of outpatient, inten-
sive outpatient, outpatient rehabilitation and opioid treatment that are
participating in the corporation's provider network. Reimbursement for
covered outpatient treatment provided by such facilities shall be at
rates negotiated between the corporation and the participating facility,
provided that such rates are not less than the rates that would be paid
for such treatment pursuant to the medical assistance program under
title eleven of article five of the social services law. For the
purposes of this subparagraph, the rates that would be paid for such
treatment pursuant to the medical assistance program under title eleven
S. 9007--C 130 A. 10007--C
of article five of the social services law shall be the rates with an
effective date of April first of the preceding year, which shall be
established prior to October first of the preceding calendar year.
(B) The office of addiction services and supports shall publish infor-
mation adequate to calculate the rates that would be paid for such
treatment pursuant to the medical assistance program under title eleven
of article five of the social services law. Such information shall be
provided in a form and manner to be determined by the commissioner of
addiction services and supports. Nothing in this subparagraph shall be
construed to relieve an insurer of the obligation to reimburse at no
less than the applicable minimum rate set forth in subparagraph (A) of
this paragraph. Prior to the submission of premium rate filings and
applications, the superintendent shall provide corporations with guid-
ance on factors to consider in calculating the impact of rate changes
for the purposes of submitting premium rate filings and applications to
the superintendent for the subsequent policy year. To the extent that
the rates with an effective date of April first differ from the esti-
mated rates incorporated in premium rate filings and applications,
corporations may account for such differences in future premium rate
filings and applications submitted to the superintendent for approval.
§ 15. Paragraph (A) of subsection (l-1) of section 4303 of the insur-
ance law, as amended by section 3 of subpart E of part II of chapter 57
of the laws of 2023, is amended to read as follows:
(A) No contract that provides medical, major medical or similar
comprehensive-type individual or small group coverage and provides
coverage for prescription drugs for medication for the treatment of a
[substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder shall require
prior authorization for an initial or renewal prescription for the
detoxification or maintenance treatment of a [substance use] SUBSTANCE-
RELATED AND ADDICTIVE disorder, including all buprenorphine products,
methadone, long acting injectable naltrexone, or medication for opioid
overdose reversal prescribed or dispensed to an insured covered under
the contract, including federal food and drug administration-approved
over-the-counter opioid overdose reversal medication as prescribed,
dispensed or as otherwise authorized under state or federal law, except
where otherwise prohibited by law. Every contract that provides medical,
major medical, or similar comprehensive-type large group coverage shall
provide coverage for prescription drugs for medication for the treatment
of a [substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder and shall
not require prior authorization for an initial or renewal prescription
for the detoxification of maintenance treatment of a [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder, including all buprenorphine
products, methadone, long acting injectable naltrexone, or medication
for opioid overdose reversal prescribed or dispensed to an individual
covered under the contract, including federal food and drug administra-
tion-approved over-the-counter opioid overdose reversal medication as
prescribed, dispensed or as otherwise authorized under state or federal
law, except where otherwise prohibited by law.
§ 16. Subparagraph (E) of paragraph 1 of subsection (a) of section
4306-h of the insurance law, as added by section 35 of subpart B of part
J of chapter 57 of the laws of 2019, is amended to read as follows:
(E) mental health and [substance use] SUBSTANCE-RELATED AND ADDICTIVE
disorder services, including behavioral health treatment;
§ 17. Paragraph 17 of subsection (a) of section 4324 of the insurance
law, as amended by section 4 of subpart B of part AA of chapter 57 of
the laws of 2022, is amended to read as follows:
S. 9007--C 131 A. 10007--C
(17) where applicable, a listing by specialty, which may be in a sepa-
rate document that is updated annually, of the name, address, telephone
number, and digital contact information of all participating providers,
including facilities, and: (A) whether the provider is accepting new
patients; (B) in the case of mental health or [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder services providers, any affil-
iations with participating facilities certified or authorized by the
office of mental health or the office of addiction services and
supports, and any restrictions regarding the availability of the indi-
vidual provider's services; (C) in the case of physicians, board certif-
ication, languages spoken and any affiliations with participating hospi-
tals. The listing shall also be posted on the corporation's website and
the corporation shall update the website within fifteen days of the
addition or termination of a provider from the corporation's network or
a change in a physician's hospital affiliation;
§ 18. Subsection (n) of section 4325 of the insurance law, as added by
section 5 of subpart B of part AA of chapter 57 of the laws of 2022, is
amended to read as follows:
(n) A contract between a corporation and a health care provider shall
include a provision that requires the health care provider to have in
place business processes to ensure the timely provision of provider
directory information to the corporation. A health care provider shall
submit such provider directory information to a corporation, at a mini-
mum, when a provider begins or terminates a network agreement with a
corporation, when there are material changes to the content of the
provider directory information of the health care provider, and at any
other time, including upon the corporation's request, as the health care
provider determines to be appropriate. For purposes of this subsection,
"provider directory information" shall include the name, address,
specialty, telephone number, and digital contact information of such
health care provider; whether the provider is accepting new patients;
for mental health and [substance use] SUBSTANCE-RELATED AND ADDICTIVE
disorder services providers, any affiliations with participating facili-
ties certified or authorized by the office of mental health or the
office of addiction services and supports, and any restrictions regard-
ing the availability of the individual provider's services; and in the
case of physicians, board certification, languages spoken, and any
affiliations with participating hospitals.
§ 19. Subparagraph (C) of paragraph 1 of subsection (b) of section
4900 of the insurance law, as amended by section 2 of part MM of chapter
57 of the laws of 2023, is amended to read as follows:
(C) for purposes of a determination involving [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder treatment:
(i) a physician who possesses a current and valid non-restricted
license to practice medicine and who specializes in behavioral health
and has experience in the delivery of [substance use] SUBSTANCE-RELATED
AND ADDICTIVE disorder courses of treatment; or
(ii) a health care professional other than a licensed physician who
specializes in behavioral health and has experience in the delivery of
[substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder courses of
treatment and, where applicable, possesses a current and valid non-res-
tricted license, certificate or registration or, where no provision for
a license, certificate or registration exists, is credentialed by the
national accrediting body appropriate to the profession; or
§ 20. Clause (iv) of subparagraph (A) of paragraph 2 of subsection (b)
of section 4900 of the insurance law, as separately amended by section 2
S. 9007--C 132 A. 10007--C
of part MM of chapter 57 and chapter 170 of the laws of 2023, is amended
to read as follows:
(iv) for purposes of a determination involving [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder treatment, possesses a current
and valid non-restricted license to practice medicine and who special-
izes in behavioral health and has experience in the delivery of
[substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder courses of
treatment;
§ 21. Clause (iv) of subparagraph (B) of paragraph 2 of subsection (b)
of section 4900 of the insurance law, as separately amended by section 2
of part MM of chapter 57 and chapter 170 of the laws of 2023, is amended
to read as follows:
(iv) for purposes of a determination involving [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder treatment, specializes in
behavioral health and has experience in the delivery of [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder courses of treatment and, where
applicable, possesses a current and valid non-restricted license,
certificate or registration or, where no provision for a license,
certificate or registration exists, is credentialed by the national
accrediting body appropriate to the profession;
§ 22. Paragraph 9 of subsection (a) of section 4902 of the insurance
law, as amended by section 37 of subpart A of part BB of chapter 57 of
the laws of 2019, is amended to read as follows:
(9) When conducting utilization review for purposes of determining
health care coverage for [substance use] SUBSTANCE-RELATED AND ADDICTIVE
disorder treatment, a utilization review agent shall utilize an
evidence-based and peer reviewed clinical review tool that is appropri-
ate to the age of the patient. When conducting such utilization review
for treatment provided in this state, a utilization review agent shall
utilize an evidence-based and peer reviewed clinical tool designated by
the office of [alcoholism and substance abuse services] ADDICTION
SERVICES AND SUPPORTS that is consistent with the treatment service
levels within the office of [alcoholism and substance abuse services]
ADDICTION SERVICES AND SUPPORTS system. All approved tools shall have
inter rater reliability testing completed by December thirty-first, two
thousand sixteen.
§ 23. Paragraph 2 of subsection (b) of section 4903 of the insurance
law, as added by chapter 371 of the laws of 2015, is amended to read as
follows:
(2) With regard to individual or group contracts authorized pursuant
to article thirty-two, forty-three or forty-seven of this chapter or
article forty-four of the public health law, for utilization and review
determinations involving proposed mental health and/or [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder services where the insured or
the insured's designee has, in a format prescribed by the superinten-
dent, certified in the request that the proposed services are for an
individual who will be appearing, or has appeared, before a court of
competent jurisdiction and may be subject to a court order requiring
such services, the utilization review agent shall make a determination
and provide notice of such determination to the insured or the insured's
designee by telephone within seventy-two hours of receipt of the
request. Written notice of the determination to the insured or insured's
designee shall follow within three business days. Where feasible, such
telephonic and written notice shall also be provided to the court.
§ 24. Subsection (c) of section 4903 of the insurance law, as amended
by chapter 41 of the laws of 2014, is amended to read as follows:
S. 9007--C 133 A. 10007--C
(c) (1) A utilization review agent shall make a determination involv-
ing continued or extended health care services, additional services for
an insured undergoing a course of continued treatment prescribed by a
health care provider, or requests for inpatient [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder treatment, or home health care
services following an inpatient hospital admission, and shall provide
notice of such determination to the insured or the insured's designee,
which may be satisfied by notice to the insured's health care provider,
by telephone and in writing within one business day of receipt of the
necessary information except, with respect to home health care services
following an inpatient hospital admission, within seventy-two hours of
receipt of the necessary information when the day subsequent to the
request falls on a weekend or holiday and except, with respect to inpa-
tient [substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder treat-
ment, within twenty-four hours of receipt of the request for services
when the request is submitted at least twenty-four hours prior to
discharge from an inpatient admission. Notification of continued or
extended services shall include the number of extended services
approved, the new total of approved services, the date of onset of
services and the next review date.
(2) Provided that a request for home health care services and all
necessary information is submitted to the utilization review agent prior
to discharge from an inpatient hospital admission pursuant to this
subsection, a utilization review agent shall not deny, on the basis of
medical necessity or lack of prior authorization, coverage for home
health care services while a determination by the utilization review
agent is pending.
(3) Provided that a request for inpatient treatment for [substance
use] SUBSTANCE-RELATED AND ADDICTIVE disorder is submitted to the utili-
zation review agent at least twenty-four hours prior to discharge from
an inpatient admission pursuant to this subsection, a utilization review
agent shall not deny, on the basis of medical necessity or lack of prior
authorization, coverage for the inpatient [substance use] SUBSTANCE-RE-
LATED AND ADDICTIVE disorder treatment while a determination by the
utilization review agent is pending.
§ 25. Subsection (b) of section 4904 of the insurance law, as amended
by chapter 371 of the laws of 2015, is amended to read as follows:
(b) A utilization review agent shall establish an expedited appeal
process for appeal of an adverse determination involving (1) continued
or extended health care services, procedures or treatments or additional
services for an insured undergoing a course of continued treatment
prescribed by a health care provider or home health care services
following discharge from an inpatient hospital admission pursuant to
subsection (c) of section four thousand nine hundred three of this
title; (2) an adverse determination in which the health care provider
believes an immediate appeal is warranted except any retrospective
determination; or (3) potential court-ordered mental health and/or
[substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder services pursu-
ant to paragraph two of subsection (b) of section four thousand nine
hundred three of this title. Such process shall include mechanisms which
facilitate resolution of the appeal including but not limited to the
sharing of information from the insured's health care provider and the
utilization review agent by telephonic means or by facsimile. The utili-
zation review agent shall provide reasonable access to its clinical peer
reviewer within one business day of receiving notice of the taking of an
expedited appeal. Expedited appeals shall be determined within two
S. 9007--C 134 A. 10007--C
business days of receipt of necessary information to conduct such appeal
except, with respect to inpatient [substance use] SUBSTANCE-RELATED AND
ADDICTIVE disorder treatment provided pursuant to paragraph three of
subsection (c) of section four thousand nine hundred three of this
title, expedited appeals shall be determined within twenty-four hours of
receipt of such appeal. Expedited appeals which do not result in a
resolution satisfactory to the appealing party may be further appealed
through the standard appeal process, or through the external appeal
process pursuant to section four thousand nine hundred fourteen of this
article as applicable. Provided that the insured or the insured's health
care provider files an expedited internal and external appeal within
twenty-four hours from receipt of an adverse determination for inpatient
[substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder treatment for
which coverage was provided while the initial utilization review deter-
mination was pending pursuant to paragraph three of subsection (c) of
section four thousand nine hundred three of this title, a utilization
review agent shall not deny on the basis of medical necessity or lack of
prior authorization such [substance use] SUBSTANCE-RELATED AND ADDICTIVE
disorder treatment while a determination by the utilization review agent
or external appeal agent is pending.
§ 26. Subparagraph (iii) of paragraph (a) of subdivision 2 of section
4900 of the public health law, as amended by section 1 of part MM of
chapter 57 of the laws of 2023, is amended to read as follows:
(iii) for purposes of a determination involving [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder treatment:
(A) a physician who possesses a current and valid non-restricted
license to practice medicine and who specializes in behavioral health
and has experience in the delivery of [substance use] SUBSTANCE-RELATED
AND ADDICTIVE disorder courses of treatment; or
(B) a health care professional other than a licensed physician who
specializes in behavioral health and has experience in the delivery of
[substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder courses of
treatment and, where applicable, possesses a current and valid non-res-
tricted license, certificate or registration or, where no provision for
a license, certificate or registration exists, is credentialed by the
national accrediting body appropriate to the profession; or
§ 27. Clause (D) of subparagraph (i) of paragraph (b) of subdivision 2
of section 4900 of the public health law, as separately amended by
section 1 of part MM of chapter 57 and chapter 170 of the laws of 2023,
is amended to read as follows:
(D) for purposes of a determination involving [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder treatment, possesses a current
and valid non-restricted license to practice medicine and specializes in
behavioral health and has experience in the delivery of [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder courses of treatment;
§ 28. Clause (E) of subparagraph (ii) of paragraph (b) of subdivision
2 of section 4900 of the public health law, as separately amended by
section 1 of part MM of chapter 57 and chapter 170 of the laws of 2023,
is amended to read as follows:
(E) for purposes of a determination involving [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder, specializes in behavioral
health and has experience in the delivery of [substance use] SUBSTANCE-
RELATED AND ADDICTIVE disorder courses of treatment and, where applica-
ble, possesses a current and valid non-restricted license, certificate
or registration or, where no provision for a license, certificate or
S. 9007--C 135 A. 10007--C
registration exists, is credentialed by the national accrediting body
appropriate to the profession;
§ 29. Paragraph (i) of subdivision 1 of section 4902 of the public
health law, as amended by section 43 of subpart A of part BB of chapter
57 of the laws of 2019, is amended to read as follows:
(i) When conducting utilization review for purposes of determining
health care coverage for [substance use] SUBSTANCE-RELATED AND ADDICTIVE
disorder treatment, a utilization review agent shall utilize an
evidence-based and peer reviewed clinical review tool that is appropri-
ate to the age of the patient. When conducting such utilization review
for treatment provided in this state, a utilization review agent shall
utilize an evidence-based and peer reviewed clinical tool designated by
the office of [alcoholism and substance abuse services] ADDICTION
SERVICES AND SUPPORTS that is consistent with the treatment service
levels within the office of [alcoholism and substance abuse services]
ADDICTION SERVICES AND SUPPORTS system. All approved tools shall have
inter rater reliability testing completed by December thirty-first, two
thousand sixteen.
§ 30. Paragraph (b) of subdivision 2 of section 4903 of the public
health law, as added by chapter 371 of the laws of 2015, is amended to
read as follows:
(b) With regard to individual or group contracts authorized pursuant
to article forty-four of this chapter, for utilization review determi-
nations involving proposed mental health and/or [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder services where the enrollee or
the enrollee's designee has, in a format prescribed by the superinten-
dent of financial services, certified in the request that the proposed
services are for an individual who will be appearing, or has appeared,
before a court of competent jurisdiction and may be subject to a court
order requiring such services, the utilization review agent shall make a
determination and provide notice of such determination to the enrollee
or the enrollee's designee by telephone within seventy-two hours of
receipt of the request. Written notice of the determination to the
enrollee or enrollee's designee shall follow within three business days.
Where feasible, such telephonic and written notice shall also be
provided to the court.
§ 31. Subdivision 3 of section 4903 of the public health law, as
amended by chapter 41 of the laws of 2014, is amended to read as
follows:
3. (a) A utilization review agent shall make a determination involving
continued or extended health care services, additional services for an
enrollee undergoing a course of continued treatment prescribed by a
health care provider, or requests for inpatient [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder treatment, or home health care
services following an inpatient hospital admission, and shall provide
notice of such determination to the enrollee or the enrollee's designee,
which may be satisfied by notice to the enrollee's health care provider,
by telephone and in writing within one business day of receipt of the
necessary information except, with respect to home health care services
following an inpatient hospital admission, within seventy-two hours of
receipt of the necessary information when the day subsequent to the
request falls on a weekend or holiday and except, with respect to inpa-
tient [substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder treat-
ment, within twenty-four hours of receipt of the request for services
when the request is submitted at least twenty-four hours prior to
discharge from an inpatient admission. Notification of continued or
S. 9007--C 136 A. 10007--C
extended services shall include the number of extended services
approved, the new total of approved services, the date of onset of
services and the next review date.
(b) Provided that a request for home health care services and all
necessary information is submitted to the utilization review agent prior
to discharge from an inpatient hospital admission pursuant to this
subdivision, a utilization review agent shall not deny, on the basis of
medical necessity or lack of prior authorization, coverage for home
health care services while a determination by the utilization review
agent is pending.
(c) Provided that a request for inpatient treatment for [substance
use] SUBSTANCE-RELATED AND ADDICTIVE disorder is submitted to the utili-
zation review agent at least twenty-four hours prior to discharge from
an inpatient admission pursuant to this subdivision, a utilization
review agent shall not deny, on the basis of medical necessity or lack
of prior authorization, coverage for the inpatient [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder treatment while a determination
by the utilization review agent is pending.
§ 32. Paragraph (c) of subdivision 2 of section 4904 of the public
health law, as amended by chapter 371 of the laws of 2015, is amended to
read as follows:
(c) potential court-ordered mental health and/or [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder services pursuant to paragraph
(b) of subdivision two of section forty-nine hundred three of this
title. Such process shall include mechanisms which facilitate resolution
of the appeal including but not limited to the sharing of information
from the enrollee's health care provider and the utilization review
agent by telephonic means or by facsimile. The utilization review agent
shall provide reasonable access to its clinical peer reviewer within one
business day of receiving notice of the taking of an expedited appeal.
Expedited appeals shall be determined within two business days of
receipt of necessary information to conduct such appeal except, with
respect to inpatient [substance use] SUBSTANCE-RELATED AND ADDICTIVE
disorder treatment provided pursuant to paragraph (c) of subdivision
three of section forty-nine hundred three of this title, expedited
appeals shall be determined within twenty-four hours of receipt of such
appeal. Expedited appeals which do not result in a resolution satisfac-
tory to the appealing party may be further appealed through the standard
appeal process, or through the external appeal process pursuant to
section forty-nine hundred fourteen of this article as applicable.
Provided that the enrollee or the enrollee's health care provider files
an expedited internal and external appeal within twenty-four hours from
receipt of an adverse determination for inpatient [substance use]
SUBSTANCE-RELATED AND ADDICTIVE disorder treatment for which coverage
was provided while the initial utilization review determination was
pending pursuant to paragraph (c) of subdivision three of section
forty-nine hundred three of this title, a utilization review agent shall
not deny on the basis of medical necessity or lack of prior authori-
zation such [substance use] SUBSTANCE-RELATED AND ADDICTIVE disorder
treatment while a determination by the utilization review agent or
external appeal agent is pending.
§ 33. This act shall take effect January 1, 2027 and shall apply to
policies issued, renewed or modified on or after such date.
PART S
S. 9007--C 137 A. 10007--C
Intentionally Omitted
PART T
Section 1. Section 5 of part ZZ of chapter 56 of the laws of 2020
amending the tax law and the social services law relating to certain
Medicaid management, as amended by section 2 of part D of chapter 57 of
the laws of 2024, is amended to read as follows:
§ 5. This act shall take effect immediately [and]; PROVIDED, HOWEVER,
THAT SECTIONS TWO AND THREE OF THIS ACT shall be deemed repealed [eight
years after such effective date] MARCH 31, 2026.
§ 2. Subdivision 2 of section 605 of the public health law, as amended
by section 2 of part E of chapter 57 of the laws of 2022, is amended to
read as follows:
2. State aid reimbursement for public health services provided by a
municipality under this title, shall be made if the municipality is
providing some or all of the core public health services identified in
section six hundred two of this title, pursuant to an approved applica-
tion for state aid, at a rate of no less than thirty-six per centum[,
except for the city of New York which shall receive no less than twenty
per centum,] of the difference between the amount of moneys expended by
the municipality for public health services required by section six
hundred two of this title during the fiscal year and the base grant
provided pursuant to subdivision one of this section. Provided, howev-
er, that a municipality's documented fringe benefit costs submitted
under an application for state aid and otherwise eligible for reimburse-
ment under this article shall not exceed fifty per centum of the munici-
pality's eligible personnel services. No such reimbursement shall be
provided for services that are not eligible for state aid pursuant to
this article.
§ 3. Subdivision 1 of section 616 of the public health law, as amended
by section 2 of part O of chapter 57 of the laws of 2019, is amended to
read as follows:
1. The total amount of state aid provided pursuant to this article
shall be limited to the amount of the annual appropriation made by the
legislature. In no event, however, shall such state aid be less than an
amount to provide the full base grant and, as otherwise provided by
subdivision two of section six hundred five of this article, no less
than thirty-six per centum[, except for the city of New York which shall
receive no less than twenty per centum,] of the difference between the
amount of moneys expended by the municipality for eligible public health
services pursuant to an approved application for state aid during the
fiscal year and the base grant provided pursuant to subdivision one of
section six hundred five of this article.
§ 4. This act shall take effect immediately.
PART U
Section 1. Section 48-a of part A of chapter 56 of the laws of 2013
amending the public health law and other laws relating to general hospi-
tal reimbursement for annual rates, as amended by section 1 of part LL
of chapter 57 of the laws of 2022, is amended to read as follows:
§ 48-a. 1. Notwithstanding any contrary provision of law, the commis-
sioners of the office of addiction services and supports and the office
of mental health are authorized, subject to the approval of the director
S. 9007--C 138 A. 10007--C
of the budget, to transfer to the commissioner of health state funds to
be utilized as the state share for the purpose of increasing payments
under the medicaid program to managed care organizations licensed under
article 44 of the public health law or under article 43 of the insurance
law. Such managed care organizations shall utilize such funds for the
purpose of reimbursing providers licensed pursuant to article 28 of the
public health law or article 36, 31 or 32 of the mental hygiene law for
ambulatory behavioral health services, as determined by the commissioner
of health, in consultation with the commissioner of addiction services
and supports and the commissioner of the office of mental health,
provided to medicaid enrolled outpatients and for all other behavioral
health services except inpatient included in New York state's Medicaid
redesign waiver approved by the centers for medicare and Medicaid
services (CMS). Such reimbursement shall be in the form of fees for
such services which are equivalent to the payments established for such
services under the ambulatory patient group (APG) rate-setting methodol-
ogy as utilized by the department of health, the office of addiction
services and supports, or the office of mental health for rate-setting
purposes or any such other fees pursuant to the Medicaid state plan or
otherwise approved by CMS in the Medicaid redesign waiver; provided,
however, that the increase to such fees that shall result from the
provisions of this section shall not, in the aggregate and as determined
by the commissioner of health, in consultation with the commissioner of
addiction services and supports and the commissioner of the office of
mental health, be greater than the increased funds made available pursu-
ant to this section. The increase of such ambulatory behavioral health
fees to providers available under this section shall be for all rate
periods on and after the effective date of section [18] 1 of part [E] LL
of chapter 57 of the laws of [2019] 2022 through March 31, [2027] 2031
for patients in the city of New York, for all rate periods on and after
the effective date of section [18] 1 of part [E] LL of chapter 57 of the
laws of [2019] 2022 through March 31, [2027] 2031 for patients outside
the city of New York, and for all rate periods on and after the effec-
tive date of such chapter through March 31, [2027] 2031 for all services
provided to persons under the age of twenty-one; provided, however, the
commissioner of health, in consultation with the commissioner of
addiction services and supports and the commissioner of mental health,
may require, as a condition of approval of such ambulatory behavioral
health fees, that aggregate managed care expenditures to eligible
providers meet the alternative payment methodology requirements as set
forth in attachment I of the New York state medicaid section one thou-
sand one hundred fifteen medicaid redesign team waiver as approved by
the centers for medicare and medicaid services. The commissioner of
health shall, in consultation with the commissioner of addiction
services and supports and the commissioner of mental health, waive such
conditions if a sufficient number of providers, as determined by the
commissioner, suffer a financial hardship as a consequence of such
alternative payment methodology requirements, or if [he or she] SUCH
COMMISSIONER shall determine that such alternative payment methodologies
significantly threaten individuals access to ambulatory behavioral
health services. Such waiver may be applied on a provider specific or
industry wide basis. Further, such conditions may be waived, as the
commissioner determines necessary, to comply with federal rules or regu-
lations governing these payment methodologies. Nothing in this section
shall prohibit managed care organizations and providers from negotiating
different rates and methods of payment during such periods described
S. 9007--C 139 A. 10007--C
above, subject to the approval of the department of health. The depart-
ment of health shall consult with the office of addiction services and
supports and the office of mental health in determining whether such
alternative rates shall be approved. The commissioner of health may, in
consultation with the commissioner of addiction services and supports
and the commissioner of the office of mental health, promulgate regu-
lations, including emergency regulations promulgated prior to October 1,
2015 to establish rates for ambulatory behavioral health services, as
are necessary to implement the provisions of this section. Rates promul-
gated under this section shall be included in the report required under
section 45-c of part A of this chapter.
2. Notwithstanding any contrary provision of law, the fees paid by
managed care organizations licensed under article 44 of the public
health law or under article 43 of the insurance law, to providers
licensed pursuant to article 28 of the public health law or article 36,
31 or 32 of the mental hygiene law, for ambulatory behavioral health
services provided to patients enrolled in the child health insurance
program pursuant to title 1-A of article 25 of the public health law,
shall be in the form of fees for such services which are equivalent to
the payments established for such services under the ambulatory patient
group (APG) rate-setting methodology or any such other fees established
pursuant to the Medicaid state plan. The commissioner of health shall
consult with the commissioner of addiction services and supports and the
commissioner of the office of mental health in determining such services
and establishing such fees. Such ambulatory behavioral health fees to
providers available under this section shall be for all rate periods on
and after the effective date of this chapter through March 31, [2027]
2031, provided, however, that managed care organizations and providers
may negotiate different rates and methods of payment during such periods
described above, subject to the approval of the department of health.
The department of health shall consult with the office of addiction
services and supports and the office of mental health in determining
whether such alternative rates shall be approved. The report required
under section 16-a of part C of chapter 60 of the laws of 2014 shall
also include the population of patients enrolled in the child health
insurance program pursuant to title 1-A of article 25 of the public
health law in its examination on the transition of behavioral health
services into managed care.
§ 2. Section 1 of part H of chapter 111 of the laws of 2010 relating
to increasing Medicaid payments to providers through managed care organ-
izations and providing equivalent fees through an ambulatory patient
group methodology, as amended by section 2 of part LL of chapter 57 of
the laws of 2022, is amended to read as follows:
Section 1. a. Notwithstanding any contrary provision of law, the
commissioners of mental health and addiction services and supports are
authorized, subject to the approval of the director of the budget, to
transfer to the commissioner of health state funds to be utilized as the
state share for the purpose of increasing payments under the medicaid
program to managed care organizations licensed under article 44 of the
public health law or under article 43 of the insurance law. Such managed
care organizations shall utilize such funds for the purpose of reimburs-
ing providers licensed pursuant to article 28 of the public health law,
or pursuant to article 36, 31 or article 32 of the mental hygiene law
for ambulatory behavioral health services, as determined by the commis-
sioner of health in consultation with the commissioner of mental health
and commissioner of addiction services and supports, provided to medi-
S. 9007--C 140 A. 10007--C
caid enrolled outpatients and for all other behavioral health services
except inpatient included in New York state's Medicaid redesign waiver
approved by the centers for medicare and Medicaid services (CMS). Such
reimbursement shall be in the form of fees for such services which are
equivalent to the payments established for such services under the ambu-
latory patient group (APG) rate-setting methodology as utilized by the
department of health or by the office of mental health or office of
addiction services and supports for rate-setting purposes or any such
other fees pursuant to the Medicaid state plan or otherwise approved by
CMS in the Medicaid redesign waiver; provided, however, that the
increase to such fees that shall result from the provisions of this
section shall not, in the aggregate and as determined by the commission-
er of health in consultation with the commissioners of mental health and
addiction services and supports, be greater than the increased funds
made available pursuant to this section. The increase of such behavioral
health fees to providers available under this section shall be for all
rate periods on and after the effective date of section [19] 2 of part
[E] LL of chapter 57 of the laws of [2019] 2022 through March 31, [2027]
2031 for patients in the city of New York, for all rate periods on and
after the effective date of section [19] 2 of part [E] LL of chapter 57
of the laws of [2019] 2022 through March 31, [2027] 2031 for patients
outside the city of New York, and for all rate periods on and after the
effective date of section [19] 2 of part [E] LL of chapter 57 of the
laws of [2019] 2022 through March 31, [2027] 2031 for all services
provided to persons under the age of twenty-one; provided, however, the
commissioner of health, in consultation with the commissioner of
addiction services and supports and the commissioner of mental health,
may require, as a condition of approval of such ambulatory behavioral
health fees, that aggregate managed care expenditures to eligible
providers meet the alternative payment methodology requirements as set
forth in attachment I of the New York state medicaid section one thou-
sand one hundred fifteen medicaid redesign team waiver as approved by
the centers for medicare and medicaid services. The commissioner of
health shall, in consultation with the commissioner of addiction
services and supports and the commissioner of mental health, waive such
conditions if a sufficient number of providers, as determined by the
commissioner, suffer a financial hardship as a consequence of such
alternative payment methodology requirements, or if [he or she] SUCH
COMMISSIONER shall determine that such alternative payment methodologies
significantly threaten individuals access to ambulatory behavioral
health services. Such waiver may be applied on a provider specific or
industry wide basis. Further, such conditions may be waived, as the
commissioner determines necessary, to comply with federal rules or regu-
lations governing these payment methodologies. Nothing in this section
shall prohibit managed care organizations and providers from negotiating
different rates and methods of payment during such periods described,
subject to the approval of the department of health. The department of
health shall consult with the office of addiction services and supports
and the office of mental health in determining whether such alternative
rates shall be approved. The commissioner of health may, in consultation
with the commissioners of mental health and addiction services and
supports, promulgate regulations, including emergency regulations
promulgated prior to October 1, 2013 that establish rates for behavioral
health services, as are necessary to implement the provisions of this
section. Rates promulgated under this section shall be included in the
S. 9007--C 141 A. 10007--C
report required under section 45-c of part A of chapter 56 of the laws
of 2013.
b. Notwithstanding any contrary provision of law, the fees paid by
managed care organizations licensed under article 44 of the public
health law or under article 43 of the insurance law, to providers
licensed pursuant to article 28 of the public health law or article 36,
31 or 32 of the mental hygiene law, for ambulatory behavioral health
services provided to patients enrolled in the child health insurance
program pursuant to title 1-A of article 25 of the public health law,
shall be in the form of fees for such services which are equivalent to
the payments established for such services under the ambulatory patient
group (APG) rate-setting methodology. The commissioner of health shall
consult with the commissioner of addiction services and supports and the
commissioner of the office of mental health in determining such services
and establishing such fees. Such ambulatory behavioral health fees to
providers available under this section shall be for all rate periods on
and after the effective date of this chapter through March 31, [2027]
2031, provided, however, that managed care organizations and providers
may negotiate different rates and methods of payment during such periods
described above, subject to the approval of the department of health.
The department of health shall consult with the office of addiction
services and supports and the office of mental health in determining
whether such alternative rates shall be approved. The report required
under section 16-a of part C of chapter 60 of the laws of 2014 shall
also include the population of patients enrolled in the child health
insurance program pursuant to title 1-A of article 25 of the public
health law in its examination on the transition of behavioral health
services into managed care.
§ 3. Section 2 of part H of chapter 111 of the laws of 2010 relating
to increasing Medicaid payments to providers through managed care organ-
izations and providing equivalent fees through an ambulatory patient
group methodology, as amended by section 3 of part LL of chapter 57 of
the laws of 2022, is amended to read as follows:
§ 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2010, and shall
expire on March 31, [2027] 2031.
§ 4. This act shall take effect immediately; provided, however that
the amendments to section 1 of part H of chapter 111 of the laws of 2010
relating to increasing Medicaid payments to providers through managed
care organizations and providing equivalent fees through an ambulatory
patient group methodology, made by section two of this act shall not
affect the expiration of such section and shall expire therewith.
PART V
Section 1. Section 2 of part Q of chapter 59 of the laws of 2016,
amending the mental hygiene law relating to the closure or transfer of a
state-operated individualized residential alternative, as amended by
section 11 of part B of chapter 57 of the laws of 2024, is amended to
read as follows:
§ 2. This act shall take effect immediately and shall expire and be
deemed repealed March 31, [2026] 2028.
§ 2. This act shall take effect immediately.
PART W
S. 9007--C 142 A. 10007--C
Section 1. Section 3 of chapter 670 of the laws of 2021, requiring the
office for people with developmental disabilities to establish the care
demonstration program, as amended by section 13 of part B of chapter 57
of the laws of 2024, is amended to read as follows:
§ 3. This act shall take effect immediately and shall expire and be
deemed repealed March 31, [2026] 2028.
§ 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after March 31, 2026.
PART X
Section 1. Clause (b) of subparagraph 4 of paragraph (g) of subdivi-
sion 1 of section 366 of the social services law, as added by section 2
of part AAA of chapter 56 of the laws of 2022, is amended to read as
follows:
(b) individuals eligible for medical assistance pursuant to [subpara-
graph] CLAUSE (a) of this [paragraph] SUBPARAGRAPH shall [participate in
and] receive THE EQUIVALENT OF THE covered benefits available through a
managed care provider under section three hundred sixty-four-j of this
article that is certified pursuant to section forty-four hundred three
of the public health law[; provided, however, to the extent that]
THROUGH THE FEE-FOR-SERVICE PROGRAM, INCLUDING any covered benefits
available through such managed care providers as of January first, two
thousand twenty-three [are] THAT WERE SUBSEQUENTLY transitioned to fee-
for-service coverage[, then such individuals shall continue to be enti-
tled to these benefits in the fee-for-service program, rather than
through a managed care provider].
§ 2. This act shall take effect January 1, 2027.
PART Y
Section 1. Section 2807-ff of the public health law is amended by
adding a new subdivision 1-a to read as follows:
1-A. ON OR AFTER APRIL FIRST, TWO THOUSAND TWENTY-SIX, THE COMMISSION-
ER, SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE BUDGET, SHALL APPLY
FOR AN AMENDMENT OF THE MCO PROVIDER TAX, SUBJECT TO APPROVAL BY THE
CENTERS FOR MEDICARE AND MEDICAID SERVICES, TO IMPOSE AN AMENDED MCO
PROVIDER TAX AS AN ASSESSMENT UPON HEALTH PLANS NO SOONER THAN JANUARY
FIRST, TWO THOUSAND TWENTY-SEVEN, AS ESTABLISHED IN PARAGRAPH (B) OF
SUBDIVISION FOUR OF THIS SECTION.
§ 2. Subdivision 4 of section 2807-ff of the public health law, as
added by section 1 of part F of chapter 57 of the laws of 2025, is
amended to read as follows:
4. [A] (A) PRIOR TO JANUARY FIRST, TWO THOUSAND TWENTY-SEVEN, A health
plan, as defined in subdivision one of this section, shall pay the MCO
provider tax for each calendar year as follows:
[(a)] (I) For Medicaid member months below two hundred fifty thousand
member months, a health plan shall pay one hundred twenty-six dollars
per member month;
[(b)] (II) For Medicaid member months greater than or equal to two
hundred fifty thousand member months but less than five hundred thousand
member months, a health plan shall pay eighty-eight dollars per member
month;
[(c)] (III) For Medicaid member months greater than or equal to five
hundred thousand member months, a health plan shall pay twenty-five
dollars per member month;
S. 9007--C 143 A. 10007--C
[(d)] (IV) For essential plan member months less than two hundred
fifty thousand member months, a health plan shall pay thirteen dollars
per member month;
[(e)] (V) For essential plan member months greater than or equal to
two hundred fifty thousand member months, a health plan shall pay seven
dollars per member month;
[(f)] (VI) For non-essential plan non-Medicaid member months, consist-
ing of the populations covered by the products described in paragraphs
(b), (d), and (e) of subdivision one of this section, less than two
hundred fifty thousand member months, a health plan shall pay two
dollars per member month; and
[(g)] (VII) For non-essential plan non-Medicaid member months greater
than or equal to two hundred fifty thousand member months, a health plan
shall pay one dollar and fifty cents per member month.
(B) EFFECTIVE JANUARY FIRST, TWO THOUSAND TWENTY-SEVEN, SUBJECT TO ANY
REQUIRED APPROVALS BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES, A
HEALTH PLAN, AS DEFINED IN SUBDIVISION ONE OF THIS SECTION, SHALL PAY
THE MCO PROVIDER TAX FOR EACH CALENDAR YEAR AT A RATE OF 0.35% OF THE
HEALTH PLAN'S TOTAL PREMIUM REVENUE.
§ 3. This act shall take effect April 1, 2026; provided, however, if
this act shall become a law after such date it shall take effect imme-
diately and shall be deemed to have been in full force and effect on and
after April 1, 2026.
PART Z
Section 1. Paragraph (d-3) of subdivision 3 of section 364-j of the
social services law, as amended by section 1 of part HH of chapter 57 of
the laws of 2025, is amended to read as follows:
(d-3) Services provided in school-based health centers shall not be
provided to medical assistance recipients through managed care programs
established pursuant to this section [until at least April first, two
thousand twenty-six].
§ 2. This act shall take effect immediately; provided, however, that
the amendments to section 364-j of the social services law made by
section one of this act shall not affect the repeal of such section and
shall be deemed repealed therewith.
PART AA
Section 1. Section 2 of part LL of chapter 57 of the laws of 2024
amending the public health law relating to reimbursement rates for
medically fragile children and pediatric diagnostic and treatment
centers, is amended to read as follows:
§ 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2024; provided,
however, that the provisions of this act shall expire and be deemed
repealed April 1, [2027] 2029.
§ 2. This act shall take effect immediately.
PART BB
Section 1. Section 602 of the financial services law, as added by
section 26 of part H of chapter 60 of the laws of 2014, is amended to
read as follows:
S. 9007--C 144 A. 10007--C
§ 602. Applicability. [(a)] This article shall not apply to health
care services, including emergency services, where physician fees are
subject to schedules or other monetary limitations under any other law,
including the workers' compensation law and article fifty-one of the
insurance law, and shall not preempt any such law. THIS ARTICLE ALSO
SHALL NOT APPLY TO HEALTH CARE SERVICES, INCLUDING EMERGENCY SERVICES,
SUBJECT TO MEDICAL ASSISTANCE PROGRAM COVERAGE PROVIDED PURSUANT TO
SECTION THREE HUNDRED SIXTY-FOUR-J OF THE SOCIAL SERVICES LAW.
§ 2. Subsection (c) of section 603 of the financial services law, as
added by section 26 of part H of chapter 60 of the laws of 2014, is
amended and two new subsections (j) and (k) are added to read as
follows:
(c) "Health care plan" means an insurer licensed to write accident and
health insurance pursuant to article thirty-two of the insurance law; a
corporation organized pursuant to article forty-three of the insurance
law; a municipal cooperative health benefit plan certified pursuant to
article forty-seven of the insurance law; a health maintenance organiza-
tion certified pursuant to article forty-four of the public health law;
[or] a student health plan established or maintained pursuant to section
one thousand one hundred twenty-four of the insurance law; OR A HEALTH
BENEFIT PLAN OPERATED PURSUANT TO ARTICLE ELEVEN OF THE CIVIL SERVICE
LAW.
(J) "ALLOWED BENCHMARK" MEANS THE FIFTIETH PERCENTILE OF ALL ALLOWED
AMOUNTS FOR THE PARTICULAR HEALTH CARE SERVICE PERFORMED BY A PARTIC-
IPATING PROVIDER IN THE SAME OR SIMILAR SPECIALTY AND PROVIDED IN THE
SAME GEOGRAPHICAL AREA AS REPORTED IN A BENCHMARKING DATABASE MAINTAINED
BY A NONPROFIT ORGANIZATION SPECIFIED BY THE SUPERINTENDENT. THE
NONPROFIT ORGANIZATION SHALL NOT BE AFFILIATED WITH AN INSURER, A CORPO-
RATION SUBJECT TO ARTICLE FORTY-THREE OF THE INSURANCE LAW, A MUNICIPAL
COOPERATIVE HEALTH BENEFIT PLAN CERTIFIED PURSUANT TO ARTICLE FORTY-SEV-
EN OF THE INSURANCE LAW, OR A HEALTH MAINTENANCE ORGANIZATION CERTIFIED
PURSUANT TO ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW.
(K) "MAXIMUM FEE" MEANS THE EIGHTIETH PERCENTILE OF ALL ALLOWED
AMOUNTS FOR THE PARTICULAR HEALTH CARE SERVICE PERFORMED BY A PARTIC-
IPATING PROVIDER IN THE SAME OR SIMILAR SPECIALTY AND PROVIDED IN THE
SAME GEOGRAPHICAL AREA AS REPORTED IN A BENCHMARKING DATABASE MAINTAINED
BY A NONPROFIT ORGANIZATION SPECIFIED BY THE SUPERINTENDENT. THE NONPRO-
FIT ORGANIZATION SHALL NOT BE AFFILIATED WITH AN INSURER, A CORPORATION
SUBJECT TO ARTICLE FORTY-THREE OF THE INSURANCE LAW, A MUNICIPAL COOPER-
ATIVE HEALTH BENEFIT PLAN CERTIFIED PURSUANT TO ARTICLE FORTY-SEVEN OF
THE INSURANCE LAW, OR A HEALTH MAINTENANCE ORGANIZATION CERTIFIED PURSU-
ANT TO ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW.
§ 3. Section 604 of the financial services law, as amended by section
4 of subpart A of part AA of chapter 57 of the laws of 2022, is amended
to read as follows:
§ 604. Criteria for determining a reasonable fee. (A) In determining
the appropriate amount FOR A HEALTH CARE PLAN OTHER THAN A HEALTH BENE-
FIT PLAN OPERATED PURSUANT TO ARTICLE ELEVEN OF THE CIVIL SERVICE LAW to
pay for a health care service, an independent dispute resolution entity
shall consider all relevant factors, including:
[(a)] (1) whether there is a gross disparity between the fee charged
by the provider for services rendered as compared to:
[(1)] (A) fees paid to the involved provider for the same services
rendered by the provider to other patients in health care plans in which
the provider is not participating, and
S. 9007--C 145 A. 10007--C
[(2)] (B) in the case of a dispute involving a health care plan, fees
paid by the health care plan to reimburse similarly qualified providers
for the same services in the same region who are not participating with
the health care plan;
[(b)] (2) the level of training, education and experience of the
health care professional, and in the case of a hospital, the teaching
staff, scope of services and case mix;
[(c)] (3) the provider's usual charge for comparable services with
regard to patients in health care plans in which the provider is not
participating;
[(d)] (4) the circumstances and complexity of the particular case,
including time and place of the service;
[(e)] (5) individual patient characteristics;
[(f)] (6) the median of the rate recognized by the health care plan to
reimburse similarly qualified providers for the same or similar services
in the same region that are participating with the health care plan; and
[(g)] (7) with regard to physician services, the usual and customary
cost of the service.
(B) (1) IN DETERMINING THE APPROPRIATE AMOUNT FOR A HEALTH BENEFIT
PLAN OPERATED PURSUANT TO ARTICLE ELEVEN OF THE CIVIL SERVICE LAW TO PAY
FOR A HEALTH CARE SERVICE, AN INDEPENDENT DISPUTE RESOLUTION ENTITY
SHALL SELECT EITHER THE HEALTH CARE PLAN'S PAYMENT OR THE NON-PARTICI-
PATING PROVIDER'S FEE DEPENDING ON WHICH ONE IS CLOSEST TO THE ALLOWED
BENCHMARK, PROVIDED, HOWEVER, THAT THE INDEPENDENT DISPUTE RESOLUTION
ENTITY MAY CHOOSE THE HEALTH CARE PLAN'S PAYMENT OR THE NON-PARTICIPAT-
ING PROVIDER'S FEE IF IT IS NOT CLOSEST TO THE ALLOWED BENCHMARK IF:
(A) THE HEALTH CARE PLAN'S PAYMENT OR THE NON-PARTICIPATING PROVIDER'S
FEE ARE EQUALLY DISTANT FROM THE ALLOWED BENCHMARK; OR
(B) THE INDEPENDENT DISPUTE RESOLUTION ENTITY DETERMINES THAT ANY OF
THE FOLLOWING INFORMATION SUBMITTED BY EITHER PARTY CLEARLY DEMONSTRATES
THAT THE ALLOWED BENCHMARK IS NOT APPROPRIATE:
(I) THE LEVEL OF TRAINING, EDUCATION AND EXPERIENCE OF THE HEALTH CARE
PROFESSIONAL, AND IN THE CASE OF A HOSPITAL, THE TEACHING STAFF, SCOPE
OF SERVICES AND CASE MIX;
(II) THE CIRCUMSTANCES AND COMPLEXITY OF THE PARTICULAR CASE, INCLUD-
ING TIME AND PLACE OF THE SERVICE; OR
(III) INDIVIDUAL PATIENT CHARACTERISTICS.
(2) IF THE INDEPENDENT DISPUTE RESOLUTION ENTITY SELECTS THE HEALTH
CARE PLAN'S PAYMENT OR THE NON-PARTICIPATING PROVIDER'S FEE THAT IS NOT
CLOSEST TO THE ALLOWED BENCHMARK, SUCH DECISION SHALL NOT BE ON THE
BASIS OF:
(A) WHETHER THERE IS A GROSS DISPARITY BETWEEN THE FEE CHARGED BY THE
PROVIDER FOR SERVICES RENDERED AS COMPARED TO:
(I) FEES PAID TO THE INVOLVED PROVIDER FOR THE SAME SERVICES RENDERED
BY THE PROVIDER TO OTHER PATIENTS IN HEALTH CARE PLANS IN WHICH THE
PROVIDER IS NOT PARTICIPATING; OR
(II) IN THE CASE OF A DISPUTE INVOLVING A HEALTH CARE PLAN, FEES PAID
BY THE HEALTH CARE PLAN TO REIMBURSE SIMILARLY QUALIFIED PROVIDERS FOR
THE SAME SERVICES IN THE SAME REGION WHO ARE NOT PARTICIPATING WITH THE
HEALTH CARE PLAN;
(B) THE PROVIDER'S USUAL CHARGE FOR COMPARABLE SERVICES WITH REGARD TO
PATIENTS IN HEALTH CARE PLANS IN WHICH THE PROVIDER IS NOT PARTICIPAT-
ING; OR
(C) WITH REGARD TO PHYSICIAN SERVICES, THE USUAL AND CUSTOMARY COST OF
THE SERVICE.
S. 9007--C 146 A. 10007--C
(3) IF AN INDEPENDENT DISPUTE RESOLUTION ENTITY MAKES A DETERMINATION
PURSUANT TO SUBPARAGRAPH (B) OF PARAGRAPH ONE OF SUBSECTION (B) OF THIS
SECTION, ITS WRITTEN DECISION SHALL INCLUDE AN EXPLANATION OF THE
FACTORS IN SUBPARAGRAPH (B) OF PARAGRAPH ONE OF SUBSECTION (B) OF THIS
SECTION THAT DEMONSTRATED THE HEALTH CARE PLAN'S PAYMENT OR NON-PARTICI-
PATING PROVIDER'S FEE CLOSEST TO THE ALLOWED BENCHMARK WAS MATERIALLY
DIFFERENT FROM THE APPROPRIATE PAYMENT FOR THE HEALTH CARE SERVICE.
(4) IF THE INDEPENDENT DISPUTE RESOLUTION ENTITY DETERMINES THE NON-
PARTICIPATING PROVIDER'S FEE IS A REASONABLE FEE FOR THE SERVICES
RENDERED, IN NO CIRCUMSTANCES SHALL THE AMOUNT OWED BY A HEALTH CARE
PLAN EXCEED THE MAXIMUM FEE.
(5) NOTWITHSTANDING THE FOREGOING, DISPUTES INVOLVING HEALTH CARE
SERVICES PROVIDED BY A PHYSICIAN EMPLOYED BY A GENERAL HOSPITAL LICENSED
UNDER ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW OR SUCH HOSPITAL'S
AFFILIATED MEDICAL SCHOOL, OR IS PART OF A GROUP PRACTICE THAT IS ESTAB-
LISHED AS A CAPTIVE PROFESSIONAL SERVICES CORPORATION WHOSE SHAREHOLDERS
ARE EMPLOYEES OF SUCH HOSPITAL, SHALL BE SUBJECT TO SUBSECTION (A) OF
THIS SECTION EVEN IF PAID FOR BY A HEALTH BENEFIT PLAN OPERATED PURSUANT
TO ARTICLE ELEVEN OF THE CIVIL SERVICE LAW.
(C) NO FEE FOR SERVICES RENDERED SHALL BE AWARDED PURSUANT TO THIS
ARTICLE:
(1) IF THE HEALTH CARE PLAN CAN DEMONSTRATE THAT IT HAS A CONTRACT
WITH THE PROVIDER OR A SUBSIDIARY OR OTHER ENTITY OWNED OR OPERATED BY
THE PROVIDER THAT IS IN EFFECT AT THE TIME THE DISPUTED SERVICE OR
SERVICES WERE PROVIDED TO PROVIDE THE SAME SERVICE OR SERVICES AT THE
SAME LOCATION; OR
(2) IF THE HEALTH CARE PLAN CAN DEMONSTRATE THAT A NOTICE OF DETERMI-
NATION FOR PRIOR AUTHORIZATION HAS BEEN ISSUED TO THE PATIENT'S HEALTH
CARE PROVIDER PURSUANT TO SECTION FORTY-NINE HUNDRED THREE OF THE
INSURANCE LAW AND SECTION FORTY-NINE HUNDRED THREE OF THE PUBLIC HEALTH
LAW IDENTIFYING THE HEALTH CARE SERVICE OR SERVICES IN DISPUTE AS OUT-
OF-NETWORK, OR, FOR PATIENTS COVERED BY A HEALTH CARE PLAN NOT SUBJECT
TO SECTION FORTY-NINE HUNDRED THREE OF THE INSURANCE LAW OR SECTION
FORTY-NINE HUNDRED THREE OF THE PUBLIC HEALTH LAW, IF A NOTICE OF DETER-
MINATION FOR PRIOR AUTHORIZATION HAS BEEN ISSUED TO THE PATIENT'S HEALTH
CARE PROVIDER THAT INCLUDES ALL OF THE DISCLOSURES SET FORTH IN SUCH
LAWS AND THAT CLEARLY IDENTIFIES THE HEALTH CARE SERVICE OR SERVICES IN
DISPUTE AS OUT-OF-NETWORK.
§ 4. Subsection (b) of section 608 of the financial services law, as
added by section 26 of part H of chapter 60 of the laws of 2014, is
amended to read as follows:
(b) (1) A NON-PARTICIPATING PROVIDER AND A HEALTH CARE PLAN SHALL
SUBMIT FULL PAYMENT FOR THE DISPUTE RESOLUTION PROCESS UPON SUBMISSION
OF THE DISPUTE RESOLUTION APPLICATION OR, IF THE RESPONDING PARTY, WHEN
RESPONDING TO THE INDEPENDENT DISPUTE RESOLUTION ENTITY'S REQUEST FOR
ELIGIBILITY INFORMATION AND SUPPORTING DOCUMENTS.
(2) AN INDEPENDENT DISPUTE RESOLUTION ENTITY SHALL NOT COMINGLE THE
PAYMENTS FOR THE DISPUTE RESOLUTION PROCESS WITH ANY OTHER FUNDS HELD BY
THE ENTITY AND SHALL HOLD ALL PAYMENTS IN A SEPARATE ACCOUNT.
(3) AN INDEPENDENT DISPUTE RESOLUTION ENTITY SHALL ISSUE A REFUND OF
THE DISPUTE RESOLUTION PROCESS PAYMENT TO THE PREVAILING PARTY WITHIN
THIRTY DAYS OF RENDERING A DETERMINATION ON THE DISPUTE OR REJECTING THE
DISPUTE AS INELIGIBLE.
(C) For disputes involving a patient that is not an insured, when the
independent dispute resolution entity determines the physician's fee is
reasonable, payment for the dispute resolution process shall be the
S. 9007--C 147 A. 10007--C
responsibility of the patient unless payment for the dispute resolution
process would pose a hardship to the patient. The superintendent shall
promulgate a regulation to determine payment for the dispute resolution
process in cases of hardship. When the independent dispute resolution
entity determines the physician's fee is unreasonable, payment for the
dispute resolution process shall be the responsibility of the physician.
§ 5. Paragraph 3 of subsection (a) of section 605 of the financial
services law, as amended by section 5 of subpart A of part AA of chapter
57 of the laws of 2022, is amended to read as follows:
(3) The independent dispute resolution entity shall make a determi-
nation within [thirty] FORTY-FIVE business days of receipt of ALL INFOR-
MATION THE INDEPENDENT DISPUTE RESOLUTION ENTITY DETERMINES THAT IT
NEEDS TO REVIEW the dispute [for review].
§ 6. Paragraph 5 of subsection (a) of section 607 of the financial
services law, as amended by section 8 of subpart A of part AA of chapter
57 of the laws of 2022, is amended to read as follows:
(5) The independent dispute resolution entity shall make a determi-
nation within [thirty] FORTY-FIVE business days of receipt of ALL INFOR-
MATION THE INDEPENDENT DISPUTE RESOLUTION ENTITY DETERMINES THAT IT
NEEDS TO REVIEW the dispute [for review].
§ 7. The financial services law is amended by adding a new section 609
to read as follows:
§ 609. REPORTING ON NEW CRITERIA FOR DETERMINING A REASONABLE FEE.
FOUR YEARS AFTER THE EFFECTIVE DATE OF THIS SECTION THE SUPERINTENDENT
OF THE DEPARTMENT OF FINANCIAL SERVICES SHALL SUBMIT A REPORT TO THE
GOVERNOR, THE SPEAKER OF THE ASSEMBLY, THE TEMPORARY PRESIDENT OF THE
SENATE, THE CHAIR OF THE ASSEMBLY INSURANCE COMMITTEE, AND THE CHAIR OF
THE SENATE INSURANCE COMMITTEE THAT PROVIDES INFORMATION ABOUT DISPUTES
INVOLVING A HEALTH BENEFIT PLAN OPERATED PURSUANT TO ARTICLE ELEVEN OF
THE CIVIL SERVICE LAW SINCE THE EFFECTIVE DATE OF THE CHAPTER OF THE
LAWS OF TWO THOUSAND TWENTY-SIX THAT ADDED THIS SECTION AND THAT
INCLUDES THE OUTCOMES OF ALL SUCH DISPUTES IN THE AGGREGATE AND BROKEN
DOWN BY REGION AND PROVIDER SPECIALTY.
§ 8. This act shall take effect immediately and shall apply to
disputes submitted on or after such effective date; provided, however,
that sections two, three, four, five and six of this act shall take
effect on the ninetieth day after it shall have become a law and shall
apply to disputes submitted on or after such effective date; and
provided further, however, that the amendments to subsection (c) of
section 603 of the financial services law made by section two of this
act, subsection (b) of section 604 of the financial services law as
added by section three of this act, and section seven of this act shall
expire five years after it shall have become a law, when upon such date
the provisions of such subsections and section shall be deemed repealed.
§ 2. Severability clause. If any clause, sentence, paragraph, subdivi-
sion, section or part of this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment shall not affect,
impair, or invalidate the remainder thereof, but shall be confined in
its operation to the clause, sentence, paragraph, subdivision, section
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the legislature that this act would have been enacted even if such
invalid provisions had not been included herein.
§ 3. This act shall take effect immediately provided, however, that
the applicable effective date of Parts A through BB of this act shall be
as specifically set forth in the last section of such Parts.Every fact on this page links to its source, starting with the official bill record.