2023 New York Laws › SOS - Social Services › Article 5 - Assistance and Care › Title 11 - Medical Assistance for Needy Persons › 365-N - Department of Health Assumption of Program Administration.

§ 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.