§ 365-N — Department of health assumption of program administration

§ 365-n. Department of health assumption of program administration. 1.\nNotwithstanding the provisions of title two of article three of this\nchapter or of section three hundred sixty-five of this title or of any\nother law to the contrary, the commissioner of health (commissioner) is\nauthorized to take actions explicitly authorized by this section that\nare necessary to transfer responsibility for the administration of the\nmedical assistance program from local social services districts to the\ndepartment of health (department) by March thirty-first, two thousand\neighteen.\n 2. For purposes of this section, the administration of the medical\nassistance program includes: processing applications for benefits and\nservices available under this title and title eleven-D of this article;\nmaking determinations of initial and ongoing eligibility for such\nbenefits and services; making coverage determinations with respect to\nbenefits and services requiring prior authorization; notifying\napplicants and recipients of these determinations and of their rights\nand responsibilities, authorizing benefits and services for persons\nfound eligible; exercising subrogation rights with respect to amounts\nreceived from insurance carriers or other liable third parties; imposing\nliens and pursuing recoveries; and any other such tasks and functions\nidentified by the commissioner.\n 3. Notwithstanding sections sixty-one, sixty-three, seventy,\nseventy-eight, seventy-nine, eighty-one and eighty-one-a of the civil\nservice law or any provisions to the contrary contained in any general,\nspecial, or local laws, all lawful appointees of a county performing the\nfunctions established in subdivision two of this section as of the\neffective date of this section or any such appointees who meet the open\ncompetitive qualifications for positions established to perform these\nfunctions will be eligible for voluntary transfer to appropriate\npositions, in the department, that are classified to perform such\nfunctions without further examination, qualification, or probationary\nperiod; and, upon such transfer, will have all the rights and privileges\nof the jurisdictional classification to which such positions are\nallocated in the classified service of the state.\n 4. Within one hundred twenty days of the effective date of this\nsection, the department shall develop and implement a local department\nof social services statement of interest. The statement of interest will\nelicit from local departments of social services their interest in and\ncapacity to contract with the department to perform the functions\nestablished in subdivision two of this section. To the extent\npracticable and in the best interest of the medical assistance program,\nthe department shall contract with local social services districts to\nperform all or a portion of the functions described in subdivision two\nof this section. In no event, however, shall the department, by means\nof such a contract, delegate its authority to exercise administrative\ndiscretion in the administration or supervision of the state plan for\nmedical assistance submitted pursuant to section three hundred\nsixty-three-a of this title, or to issue policies, rules, and\nregulations on program matters nor may any contracted entity be given\nthe authority to change or disapprove any administrative decision of the\ndepartment, or otherwise substitute such entity's judgment for that of\nthe department with respect to the application of policies, rules, and\nregulations issued by the department. Notwithstanding any inconsistent\nprovision of sections one hundred twelve and one hundred sixty-three of\nthe state finance law, or sections one hundred forty-two and one hundred\nforty-three of the economic development law, or any other contrary\nprovision of law, the commissioner is authorized to enter into a\ncontract with local departments of social services without a competitive\nbid or request for proposal process.\n 5-a. (a) The commissioner may take necessary action to review the\naccuracy of determinations of initial and ongoing eligibility under the\nmedical assistance program, and to identify and eliminate inappropriate\ninstances of concurrent or duplicate benefits and authorizations. The\ncommissioner is authorized to contract with one or more entities to\nassist the state in implementing the provisions of this subdivision.\n (b) Notwithstanding the provisions of sections one hundred twelve and\none hundred sixty-three of the state finance law, or section one hundred\nforty-two of the economic development law, or any contrary provision of\nlaw, the commissioner is authorized to enter into a contract or\ncontracts under paragraph (a) of this subdivision without a competitive\nbid or request for proposal process, provided, however, that:\n (i) The department of health shall post on its website, for a period\nof no less than thirty days:\n (1) A description of the proposed services to be provided pursuant to\nthe contract or contracts;\n (2) The criteria for selection of a contractor or contractors;\n (3) The period of time during which a prospective contractor may seek\nselection, which shall be no less than thirty days after such\ninformation is first posted on the website; and\n (4) The manner by which a prospective contractor may seek such\nselection, which may include submission by electronic means;\n (ii) All reasonable and responsive submissions that are received from\nprospective contractors in timely fashion shall be reviewed by the\ncommissioner; and\n (iii) The commissioner shall select such contractor or contractors\nthat, in his or her discretion, are best suited to serve the purposes of\nthis section; and\n (iv) No contract entered pursuant to this paragraph shall have a term\nthat ends later than March thirty-first, two thousand seventeen.\n 6. The commissioner shall submit an annual report to the governor,\ntemporary president of the senate, speaker of the assembly, the chair of\nthe senate health committee and the chair of the assembly health\ncommittee by December thirty-first, beginning in two thousand twelve and\nfor each year thereafter until the year following full implementation.\nThe initial report shall consist of modifications to the plan developed\npursuant to section forty-seven-b of part B of chapter fifty-eight of\nthe laws of two thousand ten, and shall include anticipated\nimplementation of the revised plan, its elements, a timeline for such\nimplementation, recommendations for legislative action, and such other\nmatters as may be pertinent.\n The report shall include a plan and timeline for the state to:\n (i) assume specific functions related to the administration of the\nmedical assistance program; (ii) coordinate the implementation of\nprovisions of federal law with the assumption of the administration of\nthe medical assistance program; and (iii) address the financing of the\nmedical assistance program administration and any associated\nadministrative cost relief to local social services districts. The\nreport shall also indicate any function that the state intends to enter\ninto a contract with a public and/or private entity to perform, and the\ndate in which the state anticipates entering into any such contract. In\naddition, reports shall, at a minimum, indicate: (i) any progress the\ndepartment has made regarding its proposed timeline, including a summary\nof all functions assumed by the state during the previous year; (ii) any\nanticipated and/or actual delay from the proposed timeline; (iii) the\nreason for any such delay; and (iv) actions the department has\nundertaken to mitigate any such delay.\n 7. The commissioner shall promulgate such regulations that are\nnecessary to carry out the provisions of this section. In addition, the\ncommissioner shall make any amendments to the state plan for medical\nassistance, or develop and submit an application for any waiver or\napproval under the federal social security act, that are necessary and\nrequired to carry out the provisions of this section.\n