GOVERNOR'S PROGRAM BILL 2010 MEMORANDUM PROGRAM BILL # 27 ¢ AN ACT to amend the public health law, the state finance law, and the elder law, in relation to various public health programs; to amend the elder law, in relation to the elderly pharmaceutical insurance program; and to repeal cerlain provisions of the public health law, the elder law and the state finance law retating thereto (Part A); in relation to general hospital indigent care pools, and | preferred drug programs; to amend the public | health iaw, in relation to reimbursements; to amend the social services law and the public health law, in relation to prescription drug coverage for needy persons; to amend the | general business law and the social services law, in relation to authorizing moneys paid in advance for funeral merchandise or services for family members; to amend social services law, in relation to authorizing the commissioner of health to assume responsibilty for transportation costs; to amend the public health law, in relation to covering medically necessary orthodontia; to amend the social services law, in relation to | eligibility for medical assistance; to amend the public health law, in relation to general hospital reimbursement rate periods; to amend part C of. ‘chapter 58 of the laws of 2005 amending the public health law and other laws relating to authorizing reimbursements for expenditures made by social services districts for medical assistance, in relation to medicaid services; to amend part A of chapter 57 of the laws of 2006 amending the social services law relating to medically fragile children, in relation to the effectiveness of provisions; to amend the social services law, In relation to participation in certain, federal medical assistance programs; to amend chapter 33 of the laws of 1998 amending the social services law relating to authorizing payment of Medicare part B premiums for certain Medicaid recipients, in relation to making the provisions of such chapter permanent; to amend the public health law, in relation to residential health care facilities; to amend part D of chapter 58 of the laws of 2009 amending the public health law and other laws relating to residential health care facilities, in relation to hospital reimbursement provisions; to repeal paragraph (f)of subdivision 9 of section 367-a of the social services law relating to payment of prescription drugs: and providing for the repeal of certain provisions upon expiration thereof (Part B); to authorize funding for the Consolidated Local Street and Highway Improvernent Program (CHIPS) and Marchiselli program for state fiscal year 2010-2011; and to amend chapter 329 of the iaws of 1991, amending the state finance law and other laws relating to the establishment of the dedicated highway and bridge trust fund, in relation to funding therefor (Part C); to amend the navigation law, in relation to the authorized reimbursement rate paid to governmental entities {Part D); to amend the executive law, in relation to reimbursement for expenditures made by the office of children and family services and providing for the repeal of such provisions upon expiration thereof (Part E); and to provide for the administration of certain funds and accounts related to the 2010-2011 budget; to authorize certain transfers; to amend the state finance law, inrelation to the schoo! tax relief fund (Part F) Purpose: This bill contains provisions that provide enhanced fiscal management and generate fiscal savings for the 2010-11 State Fiscal Year. ‘Summary of Provision: Part A — Modify coverage requirements in the Elderly Pharmaceutical Insurance Program (EPIC) beginning October 1, 2010, and reform various public health programs beginning April 1, 2010. This bill would: Consolidate several specific cancer programs and authorize the Commissioner of Health (Commissioner) to make grants without consulting with the Breast Cancer Detection and Education Program Advisory Council Repeal various public health programs, including the Public and Private Umbilical Cord Blood Banking Program, Shaken Baby Syndrome Public Education Campaign, Reflex Sympathetic Dystrophy Program, and the Congregate ‘Services Initiative Program within the State Office of the Aging (SOFA). Reform various public health program provisions related to the development of Comprehensive Care Centers for Eating Disorders.* Modify the Elderly Pharmaceutical Insurance Program (EPIC) to require prescribers to file an intent to appeal a Part D denial of drugs while allowing for Up to a 90 day emergency supply during the appeals process. Enactment of this bill is necessary to generate $15.2 milion in savings in the 2010-11 State Fiscal Year: $411.9 million in savings from EPIC, and $3.3 millon in savings from various other public health programs. Part B — Implement cost savings proposals for Medicaid and the Health Care Reform Act (HCRA). This bill would: * Discontinue the remaining portion of the Calendar Year 2010 trend factor adjustment — projected at 1.7 percent — for hospitals, nursing homes (excluding pediatric nursing homes, home and personal care providers, (2010-111 Savings: $99M). * Modify the distribution of indigent care reimbursement to hospitals. (2010-11 Savings: $72M). * Eliminate funding for innovations in Graduate Medical Education. (2010-11 Savings: $37M). + Limit reimbursement for preventable readmissions to hospitals, nursing home rate appeals and drug costs and payments to nursing homes to hold beds vacant. (2010-11 Savings: $36M). + Change pharmaceutical reimbursement to maximize Federal Medicare Part D reimbursement, improve rebate collections and discontinue special reimbursement for a single provider. (2010-11 Savings: $6M). ‘* Allow for a contractor to manage transportation services; establishes prior approval for physical and occupational therapy services; requires all pre-need funeral accounts to be irrevocable for the purposes of establishing Medicaid eligibility, consolidates poison control centers; and discontinues HCRA funding for anti-tobacco research at Roswell Park Cancer Institute, the infertility grant program, disease management demonstration and long term care education and outreach, (2010-11 Savings: $30M) Enactment of this bill is necessary to achieve $280 million in savings in the 2010-11 State Fiscal Year. Part C — Provide the annual authorization for the CHIPS and Marchiselli programs. This bill would authorize $363,097,000 of funding for the Consolidated Local Street and Highway Improvement Program (CHIPS) and $39,700,000 for the Marchiselli program for state fiscal year 2010-11. Spending is from bond proceeds and is maintained at 32009-10 levels. This bill would also increase the statutory cap for bonds issued by the Thruway Authority in order to support the newly authorized funding for these programs. This action is necessary to provide reimbursement to local governments for capital project expenditures on local highways and bridges, including Federal-aid projects. Part D - Reduce the authorized reimbursement rate paid to governmental entities that voluntarily enforce the provisions of the Navigation Law. This bill would reduce the authorized reimbursement raté paid to governmental entities that voluntarily enforce the provisions of the Navigation Law from 75 percent to 50, percent. Reducing the reimbursement rate for enforcing provisions of the Navigation Law will generate $1.2 million annual savings. Part E — Clarify the State’s authority to withhold payments to districts for past due youth facility reimbursement. This bill would clarify the State's authority to withhold payments to local social services districts for past due youth facility reimbursement, and authorize the transfer of up to $27 million from the Youth Facility Per Diem account to the General Fund. The transfer from the Youth Facility Per Diem account to the General Fund will generate $27 million in revenue. Part F - Authorize a transfer of monies into Fund 053, Schoo! Tax Relief (STAR) This bill would allow the State Comptroller (OSC) to make deposits into the School Tax Relief Fund for State fiscal year 2010-11. This deposit authorization will allow OSC to make the necessary June 15" STAR payment to New York City. ‘Statement in Support: Enactment of these provisions will maintain continuity in State services and financial management in the absence of an enacted 2010-11 Budget. Budgetary Implications: Enactment of this bill is necessary to ensure the fiscal stability of the State.