§ 365-n. Department of health assumption of program administration. 1.
Notwithstanding the provisions of title two of article three of this
chapter or of section three hundred sixty-five of this title or of any
other law to the contrary, the commissioner of health (commissioner) is
authorized to take actions explicitly authorized by this section that
are necessary to transfer responsibility for the administration of the
medical assistance program from local social services districts to the
department of health (department) by March thirty-first, two thousand
eighteen.
2. For purposes of this section, the administration of the medical
assistance program includes: processing applications for benefits and
services available under this title and title eleven-D of this article;
making determinations of initial and ongoing eligibility for such
benefits and services; making coverage determinations with respect to
benefits and services requiring prior authorization; notifying
applicants and recipients of these determinations and of their rights
and responsibilities, authorizing benefits and services for persons
found eligible; exercising subrogation rights with respect to amounts
received from insurance carriers or other liable third parties; imposing
liens and pursuing recoveries; and any other such tasks and functions
identified by the commissioner.
3. Notwithstanding sections sixty-one, sixty-three, seventy,
seventy-eight, seventy-nine, eighty-one and eighty-one-a of the civil
service law or any provisions to the contrary contained in any general,
special, or local laws, all lawful appointees of a county performing the
functions established in subdivision two of this section as of the
effective date of this section or any such appointees who meet the open
competitive qualifications for positions established to perform these
functions will be eligible for voluntary transfer to appropriate
positions, in the department, that are classified to perform such
functions without further examination, qualification, or probationary
period; and, upon such transfer, will have all the rights and privileges
of the jurisdictional classification to which such positions are
allocated in the classified service of the state.
4. Within one hundred twenty days of the effective date of this
section, the department shall develop and implement a local department
of social services statement of interest. The statement of interest will
elicit from local departments of social services their interest in and
capacity to contract with the department to perform the functions
established in subdivision two of this section. To the extent
practicable and in the best interest of the medical assistance program,
the department shall contract with local social services districts to
perform all or a portion of the functions described in subdivision two
of this section. In no event, however, shall the department, by means
of such a contract, delegate its authority to exercise administrative
discretion in the administration or supervision of the state plan for
medical assistance submitted pursuant to section three hundred
sixty-three-a of this title, or to issue policies, rules, and
regulations on program matters nor may any contracted entity be given
the authority to change or disapprove any administrative decision of the
department, or otherwise substitute such entity's judgment for that of
the department with respect to the application of policies, rules, and
regulations issued by the department. Notwithstanding any inconsistent
provision of sections one hundred twelve and one hundred sixty-three of
the state finance law, or sections one hundred forty-two and one hundred
forty-three of the economic development law, or any other contrary
provision of law, the commissioner is authorized to enter into a
contract with local departments of social services without a competitive
bid or request for proposal process.
5-a. (a) The commissioner may take necessary action to review the
accuracy of determinations of initial and ongoing eligibility under the
medical assistance program, and to identify and eliminate inappropriate
instances of concurrent or duplicate benefits and authorizations. The
commissioner is authorized to contract with one or more entities to
assist the state in implementing the provisions of this subdivision.
(b) Notwithstanding the provisions of sections one hundred twelve and
one hundred sixty-three of the state finance law, or section one hundred
forty-two of the economic development law, or any contrary provision of
law, the commissioner is authorized to enter into a contract or
contracts under paragraph (a) of this subdivision without a competitive
bid or request for proposal process, provided, however, that:
(i) The department of health shall post on its website, for a period
of no less than thirty days:
(1) A description of the proposed services to be provided pursuant to
the contract or contracts;
(2) The criteria for selection of a contractor or contractors;
(3) The period of time during which a prospective contractor may seek
selection, which shall be no less than thirty days after such
information is first posted on the website; and
(4) The manner by which a prospective contractor may seek such
selection, which may include submission by electronic means;
(ii) All reasonable and responsive submissions that are received from
prospective contractors in timely fashion shall be reviewed by the
commissioner; and
(iii) The commissioner shall select such contractor or contractors
that, in his or her discretion, are best suited to serve the purposes of
this section; and
(iv) No contract entered pursuant to this paragraph shall have a term
that ends later than March thirty-first, two thousand seventeen.
6. The commissioner shall submit an annual report to the governor,
temporary president of the senate, speaker of the assembly, the chair of
the senate health committee and the chair of the assembly health
committee by December thirty-first, beginning in two thousand twelve and
for each year thereafter until the year following full implementation.
The initial report shall consist of modifications to the plan developed
pursuant to section forty-seven-b of part B of chapter fifty-eight of
the laws of two thousand ten, and shall include anticipated
implementation of the revised plan, its elements, a timeline for such
implementation, recommendations for legislative action, and such other
matters as may be pertinent.
The report shall include a plan and timeline for the state to:
(i) assume specific functions related to the administration of the
medical assistance program; (ii) coordinate the implementation of
provisions of federal law with the assumption of the administration of
the medical assistance program; and (iii) address the financing of the
medical assistance program administration and any associated
administrative cost relief to local social services districts. The
report shall also indicate any function that the state intends to enter
into a contract with a public and/or private entity to perform, and the
date in which the state anticipates entering into any such contract. In
addition, reports shall, at a minimum, indicate: (i) any progress the
department has made regarding its proposed timeline, including a summary
of all functions assumed by the state during the previous year; (ii) any
anticipated and/or actual delay from the proposed timeline; (iii) the
reason for any such delay; and (iv) actions the department has
undertaken to mitigate any such delay.
7. The commissioner shall promulgate such regulations that are
necessary to carry out the provisions of this section. In addition, the
commissioner shall make any amendments to the state plan for medical
assistance, or develop and submit an application for any waiver or
approval under the federal social security act, that are necessary and
required to carry out the provisions of this section.