Source: https://www.nysenate.gov/legislation/bills/2017/S2885
Timestamp: 2019-03-21 15:36:05
Document Index: 71248496

Matched Legal Cases: ['§270', '§ 270', '§ 271', '§  272', '§ 273', '§ 274', '§   2', '§  271', '§  2']

NY State Senate Bill S2885A
senate Bill S2885A
Establishes an elderly dental insurance coverage program; appropriation
Get Status Alerts for S2885A
Jan 31, 2018 print number 2885a
Jan 31, 2018 amend and recommit to finance
Feb 01, 2017 committee discharged and committed to finance
S2885 (ACTIVE) - Details
Add Title 4 §§270 - 274, Eld L
S2885 (ACTIVE) - Summary
Establishes an elderly dental insurance coverage program; appropriates $20,000,000 therefor.
S2885 (ACTIVE) - Sponsor Memo
BILL NUMBER:  S2885
establishing an elderly dental insurance coverage program; and making
Directs the Commissioner of Civil Service to establish an Elderly
Dental Insurance Coverage (EDIC) pilot program, within the
state-employee dental insurance plan, that provides comprehensive and
routine dental care services to qualified New York State senior
Section 1: Amends Article 2 of the Elder Law by adding new Title 5:
Elderly Dental Insurance Coverage. Such program shall be established
in the following counties: Dutchess, Kings, Saratoga, Schenectady,
Ulster, Warren and Washington. Outlines program eligibility,
regulations and penalties for fraud and abuse. Eligibility: Married
and single New York State residents 65 and older, who are not
currently covered under a private dental care plan or other government
subsidized dental plan, are eligible for EDIC. Income levels for
single residents may not exceed $22,000 per year and for married
residents combined income may not exceed $25,000 per year.
Establishes that the Director shall create a sliding scale such that
the more income a person has, the higher such person's premium and
program costs will be. Income: Income shall mean "household gross
income" as defined in the real property tax circuit breaker credit
program, pursuant to subparagraph (c) of paragraph one of subsection
(e) of section six hundred six of the Tax Law, but only shall include
the income of program applicants and spouse and shall exclude the
income of other members of the household. Regulations: Provides for a
fair hearing process, for individuals and participating dentists, to
appeal determinations or actions of contractors. Establishes
procedures to ensure that all information obtained on persons pursuant
to the title remain confidential. Penalties for Fraud and Abuse: Makes
falsification of information a violation punishable by a fine not to
exceed $250. Makes intent to defraud the system on the part of a
dentist a class A misdemeanor.
Section 2: Appropriates $20 million to the Department of Civil Service
out of the General Fund for the purposes of carrying out the
According to Columbia University Medical Center "...For too many older
Americans, oral health care is a luxury. Limited access to oral
healthcare poses one of the greatest crises for the health and
well-being of America's elderly." After retirement dental insurance
becomes an extra benefit most seniors cannot afford. Moreover, the
Medicare system was not designed to cover routine dental care which
often leaves seniors with only one option-not going to the dentist at
all. Lack of routine dental care can cause significant health problems
including gum disease, mouth cancers and loss of teeth, all of which
can lead to greater health risks if not treated. The EDIC program is
designed to help seniors gain access to much needed routine and
comprehensive dental care. The program will be conducted as a pilot
project at first but may be expanded to include additional counties as
determined by the Director of Civil Service. By establishing an avenue
for seniors to obtain much needed dental care now we can alleviate
potential health risks in the future.
Makes an appropriation of $20 million to the Department of Civil
Service out of the General Fund for the purposes of carrying out the
S2885 (ACTIVE) - Bill Text download pdf
AN ACT to amend the elder law, in relation to  establishing  an  elderly
dental  insurance coverage program; and making an appropriation there-
ELDERLY DENTAL INSURANCE
271. ELDERLY DENTAL INSURANCE COVERAGE PROGRAM.
272. PROGRAM ELIGIBILITY.
273. REGULATIONS.
274. PENALTIES FOR FRAUD AND ABUSE.
§ 270. DEFINITIONS. FOR PURPOSES OF THIS TITLE, THE TERMS:
1. "INCOME" SHALL MEAN "HOUSEHOLD GROSS INCOME" AS DEFINED IN THE REAL
(C) OF PARAGRAPH ONE OF SUBSECTION (E) OF SECTION SIX HUNDRED SIX OF THE
TAX LAW, BUT ONLY SHALL INCLUDE THE INCOME  OF  PROGRAM  APPLICANTS  AND
SPOUSES AND SHALL EXCLUDE THE INCOME OF OTHER MEMBERS OF THE HOUSEHOLD.
2.  "RESIDENT"  SHALL  MEAN AN INDIVIDUAL LEGALLY DOMICILED WITHIN THE
§ 271. ELDERLY DENTAL INSURANCE COVERAGE PROGRAM. THE  DIRECTOR  SHALL
ESTABLISH  AN ELDERLY DENTAL INSURANCE COVERAGE PROGRAM, IN CONSULTATION
WITH THE COMMISSIONER OF CIVIL SERVICE, WITHIN THE STATE EMPLOYEE DENTAL
INSURANCE PLAN.  SUCH PROGRAM SHALL PROVIDE  COMPREHENSIVE  AND  ROUTINE
DENTAL  CARE SERVICES TO SENIOR RESIDENTS WHO MEET THE PROGRAM ELIGIBIL-
ITY REQUIREMENTS ESTABLISHED IN SECTION TWO HUNDRED SEVENTY-TWO OF  THIS
LBD06383-01-7
TITLE.  SUCH PROGRAM SHALL ONLY BE AVAILABLE IN DUTCHESS, KINGS, SARATO-
GA, SCHENECTADY, ULSTER, WARREN AND WASHINGTON COUNTIES UNTIL SUCH  DATE
THAT THE DIRECTOR DETERMINES THAT EXPANDING SUCH PROGRAM SHALL BE APPRO-
§  272.  PROGRAM  ELIGIBILITY.  1. PERSONS ELIGIBLE FOR COVERAGE UNDER
SECTION TWO HUNDRED SEVENTY-ONE OF THIS TITLE SHALL INCLUDE:
DATE  OF  THIS  TITLE,  IS  LESS  THAN  OR  EQUAL TO TWENTY-TWO THOUSAND
DOLLARS. AFTER THE INITIAL DETERMINATION OF ELIGIBILITY,  EACH  ELIGIBLE
INDIVIDUAL  MUST  BE  REDETERMINED  ELIGIBLE  AT LEAST EVERY TWENTY-FOUR
(B) ANY MARRIED RESIDENT WHO IS AT LEAST SIXTY-FIVE YEARS OF  AGE  AND
DATE OF THE ANNUAL COVERAGE PERIOD WHEN COMBINED WITH THE INCOME IN  THE
JANUARY  FIRST,  TWO THOUSAND EIGHTEEN, IS LESS THAN OR EQUAL TO TWENTY-
FIVE THOUSAND DOLLARS. AFTER THE INITIAL DETERMINATION  OF  ELIGIBILITY,
EACH  ELIGIBLE  INDIVIDUAL  MUST BE REDETERMINED ELIGIBLE AT LEAST EVERY
2. ELIGIBILITY FOR ASSISTANCE UNDER THIS TITLE SHALL NOT BE GRANTED TO
ANY PERSON WHO AT THE TIME AN APPLICATION IS MADE  IS  RECEIVING  EQUIV-
ALENT  OR  BETTER  COVERAGE FROM ANY OTHER PUBLIC OR PRIVATE THIRD PARTY
PAYMENT SOURCE OR INSURANCE PLAN THAN THOSE BENEFITS PROVIDED FOR  UNDER
3.  THE  DIRECTOR  SHALL  ESTABLISH A SLIDING SCALE SUCH THAT THE MORE
INCOME A PERSON ELIGIBLE FOR COVERAGE PURSUANT TO THIS  TITLE  HAS,  THE
HIGHER  SUCH  PERSON'S  PREMIUM  AND  PROGRAM  COSTS SHALL BE. THE EXACT
AMOUNT OF PREMIUM EXPENSE PER ELIGIBLE PERSON SHALL BE DETERMINED BY THE
CURRENT NEGOTIATED PREMIUM BETWEEN THE  STATE  AND  THE  STATE  EMPLOYEE
§ 273. REGULATIONS. PROGRAM REGULATIONS SHALL:
1.  PROVIDE FOR A PROCESS OF DETERMINING AND REDETERMINING ELIGIBILITY
FOR PARTICIPATION IN THIS PROGRAM INCLUDING PROVISIONS FOR SUBMISSION OF
PROOF OF INCOME, AGE, AND RESIDENCY AND INFORMATION ON EXISTING COMPLETE
OR PARTIAL COVERAGE OF DENTAL EXPENSES UNDER A THIRD PARTY ASSISTANCE OR
2. PROVIDE FOR A FAIR HEARING PROCESS FOR INDIVIDUALS AND  PARTICIPAT-
ING DENTISTS TO APPEAL DETERMINATIONS OR ACTIONS OF THE CONTRACTORS;
3. ESTABLISH PROCEDURES FOR THE STATE TO RECOVER THE VALUE OF BENEFITS
OR  PAYMENTS  MADE UNDER THIS TITLE, IF ANY, THAT WERE BASED ON APPLICA-
TIONS OR CLAIMS SUBMITTED IN VIOLATION OF ANY PROVISION OF  THIS  TITLE;
4.  ESTABLISH  PROCEDURES  TO  ENSURE THAT ALL INFORMATION OBTAINED ON
PERSONS PURSUANT TO THIS TITLE SHALL REMAIN CONFIDENTIAL AND  SHALL  NOT
BE  DISCLOSED  TO  PERSONS OR AGENCIES OTHER THAN THOSE ENTITLED TO SUCH
INFORMATION BECAUSE SUCH DISCLOSURE IS NECESSARY FOR THE PROPER ADMINIS-
TRATION OF THE PROGRAM ESTABLISHED PURSUANT TO THIS TITLE.
§ 274. PENALTIES FOR FRAUD AND ABUSE.  1.  ANY  PERSON  WHO  KNOWINGLY
MAKES A FALSE STATEMENT OR REPRESENTATION, OR WHO BY DELIBERATE CONCEAL-
MENT  OF  ANY  MATERIAL  FACT,  OR  BY IMPERSONATION OR OTHER FRAUDULENT
DEVICE, OBTAINS OR ATTEMPTS TO OBTAIN OR AIDS OR  ABETS  ANY  PERSON  TO
OBTAIN  ANY BENEFIT UNDER THIS TITLE TO WHICH HE OR SHE IS NOT ENTITLED,
HUNDRED FIFTY DOLLARS PER OCCURRENCE.
2. ANY PERSON WHO, HAVING MADE  APPLICATION  TO  RECEIVE  ANY  BENEFIT
UNDER  THIS TITLE FOR THE USE AND BENEFIT OF ANOTHER AND HAVING RECEIVED
IT, KNOWINGLY AND WILLFULLY CONVERTS SUCH BENEFIT OR ANY PART THEREOF TO
A USE OTHER THAN FOR THE USE AND BENEFIT OF SUCH OTHER PERSON, SHALL  BE
GUILTY  OF A VIOLATION PUNISHABLE BY A FINE OF NOT MORE THAN TWO HUNDRED
FIFTY DOLLARS PER OCCURRENCE.
3. ANY PERSON WHO, WITH INTENT TO DEFRAUD, PRESENTS FOR  ALLOWANCE  OR
PAYMENT  ANY  FALSE  OR  FRAUDULENT  CLAIM  FOR  FURNISHING  SERVICES OR
MERCHANDISE, OR KNOWINGLY SUBMITS FALSE INFORMATION FOR THE  PURPOSE  OF
OBTAINING  GREATER  COMPENSATION THAN THAT TO WHICH HE OR SHE IS LEGALLY
ENTITLED FOR FURNISHING SERVICES OR MERCHANDISE,  OR  KNOWINGLY  SUBMITS
FALSE  INFORMATION  FOR  THE  PURPOSE  OF  OBTAINING  AUTHORIZATION  FOR
FURNISHING SERVICES OR MERCHANDISE UNDER THIS TITLE, SHALL BE GUILTY  OF
§   2.  The  sum  of  twenty  million  dollars  ($20,000,000),  or  so
much  thereof as may be necessary, is hereby appropriated to the depart-
ment of civil service out of any moneys in the  state  treasury  in  the
general  fund  to the credit of the local assistance account, not other-
wise appropriated, and made immediately available, for  the  purpose  of
approved by the president of the department  of  civil  service  in  the
S2885A (ACTIVE) - Details
S2885A (ACTIVE) - Summary
S2885A (ACTIVE) - Sponsor Memo
BILL NUMBER: S2885A
An act to amend the elder law, in relation to establishing an elderly
dental insurance coverage program; and making an appropriation therefor
Directs the Commissioner of Civil Service to establish an Elderly Dental
Insurance Coverage (EDIC) pilot program, within the state-employee
dental insurance plan, that provides comprehensive and routine dental
care services to qualified New York State senior residents.
Elderly Dental Insurance Coverage. Such program shall be established in
the following counties: Dutchess, Kings, Saratoga, Schenectady, Ulster,
Warren and Washington. Outlines program eligibility, regulations and
penalties for fraud and abuse. Eligibility: Married and single New York
State residents 65 and older, who are not currently covered under a
private dental care plan or other government subsidized dental plan, are
eligible for EDIC. Income levels for single residents may not exceed
$22,000 per year and for married residents combined income may not
exceed $25,000 per year. Establishes that the Director shall create a
sliding scale such that the more income a person has, the higher such
person's premium and program costs will be. Income: Income shall mean
"household gross income" as defined in the real property tax circuit
breaker credit program, pursuant to subparagraph (c) of paragraph one of
subsection (e) of section six hundred six of the Tax Law, but only shall
include the income of program applicants and spouse and shall exclude
the income of other members of the household. Regulations:  Provides for
a fair hearing process, for individuals and participating dentists, to
appeal determinations or actions of contractors. Establishes procedures
to ensure that all information obtained on persons pursuant to the title
remain confidential.  Penalties for Fraud and Abuse: Makes falsification
of information a violation punishable by a fine not to exceed $250.
Makes intent to defraud the system on the part of a dentist a class A
out of the General Fund for the purposes of carrying out the provisions
Americans, oral health care is a luxury. Limited access to oral health-
care poses one of the greatest crises for the health and well-being of
America's elderly." After retirement dental insurance becomes an extra
benefit most seniors cannot afford. Moreover, the Medicare system was
not designed to cover routine dental care which often leaves seniors
with only one option-not going to the dentist at all. Lack of routine
dental care can cause significant health problems including gum disease,
mouth cancers and loss of teeth, all of which can lead to greater health
risks if not treated. The EDIC program is designed to help seniors gain
access to much needed routine and comprehensive dental care. The program
will be conducted as a pilot project at first but may be expanded to
include additional counties as determined by the Director of Civil
Service. By establishing an avenue for seniors to obtain much needed
dental care now we can alleviate potential health risks in the future.
Makes an appropriation of $20 million to the Department of Civil Service
tation of this act on its effective date is authorized and directed to
S2885A (ACTIVE) - Bill Text download pdf
2885--A
AN  ACT  to  amend the elder law, in relation to establishing an elderly
dental insurance coverage program; and making an appropriation  there-
TAX  LAW,  BUT  ONLY  SHALL INCLUDE THE INCOME OF PROGRAM APPLICANTS AND
2. "RESIDENT" SHALL MEAN AN INDIVIDUAL LEGALLY  DOMICILED  WITHIN  THE
§  271.  ELDERLY DENTAL INSURANCE COVERAGE PROGRAM. THE DIRECTOR SHALL
ESTABLISH AN ELDERLY DENTAL INSURANCE COVERAGE PROGRAM, IN  CONSULTATION
LBD06383-02-8
S. 2885--A                          2
INSURANCE  PLAN.    SUCH PROGRAM SHALL PROVIDE COMPREHENSIVE AND ROUTINE
DENTAL CARE SERVICES TO SENIOR RESIDENTS WHO MEET THE PROGRAM  ELIGIBIL-
ITY  REQUIREMENTS ESTABLISHED IN SECTION TWO HUNDRED SEVENTY-TWO OF THIS
JANUARY  FIRST,  TWO THOUSAND NINETEEN, IS LESS THAN OR EQUAL TO TWENTY-
S. 2885--A                          3
2.  ANY  PERSON  WHO,  HAVING  MADE APPLICATION TO RECEIVE ANY BENEFIT
UNDER THIS TITLE FOR THE USE AND BENEFIT OF ANOTHER AND HAVING  RECEIVED
A  USE OTHER THAN FOR THE USE AND BENEFIT OF SUCH OTHER PERSON, SHALL BE
GUILTY OF A VIOLATION PUNISHABLE BY A FINE OF NOT MORE THAN TWO  HUNDRED
3.  ANY  PERSON WHO, WITH INTENT TO DEFRAUD, PRESENTS FOR ALLOWANCE OR
PAYMENT ANY  FALSE  OR  FRAUDULENT  CLAIM  FOR  FURNISHING  SERVICES  OR
MERCHANDISE,  OR  KNOWINGLY SUBMITS FALSE INFORMATION FOR THE PURPOSE OF
OBTAINING GREATER COMPENSATION THAN THAT TO WHICH HE OR SHE  IS  LEGALLY
ENTITLED  FOR  FURNISHING  SERVICES OR MERCHANDISE, OR KNOWINGLY SUBMITS
FURNISHING  SERVICES OR MERCHANDISE UNDER THIS TITLE, SHALL BE GUILTY OF
§  2.  The  sum  of  twenty  million  dollars  ($20,000,000),  or   so
ment  of  civil  service  out of any moneys in the state treasury in the
general fund to the credit of the local assistance account,  not  other-
approved  by  the  president  of  the department of civil service in the