New York Social Services Code § 367-O

Health insurance demonstration programs
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§ 367-o. Health insurance demonstration programs. 1. Notwithstanding\nany inconsistent provision of law, the commissioner of health is\nauthorized to establish one or more demonstration programs for the\npurposes of providing additional knowledge and experience in mechanisms\nto provide, maintain or subsidize health insurance coverage for\nunemployed and underemployed health care workers.\n  2. Health insurance continuation demonstration.  (a) The commissioner\nof health is hereby authorized to establish mechanisms to improve the\nprocess of authorizing medical assistance payment of health insurance\npremiums, pursuant to paragraph (c) of subdivision one of section three\nhundred sixty-seven-a of this title, on behalf of personal care and home\nhealth care workers who reside in any city with a population of one\nmillion or more and any county with a population of nine hundred\nthousand or more if such city or county is located within the\nmetropolitan commuter transportation district created pursuant to\nsection twelve hundred sixty-two of the public authorities law, and\nwhose employment is irregular, episodic, or cyclical, and whose health\ninsurance coverage therefore is frequently disrupted.  Notwithstanding\nthe provisions of section three hundred sixty-five of this title, the\ncommissioner of health shall exercise discretion to determine whether\nmedical assistance payment of such premiums is cost effective. If the\ncommissioner of health determines that the test of cost effectiveness of\ninsurance premiums is based on other than a case-by-case basis, no\nmedical assistance payment for such premiums will be made until the\ncommissioner of health obtains all necessary approvals under federal law\nand regulation to receive federal financial participation in the costs\nof such medical assistance.\n  (b) The commissioner of health is authorized in consultation with the\nsuperintendent of financial services to require group health insurance\nplans and employer-based group health plans to report to the department\nor its designee, insofar as such reporting does not violate any\nprovisions of the federal Employee Retirement Income Security Act of\n1974 (ERISA), at such times and in such manner as the commissioner of\nhealth shall decide, any information needed to operate such a\ndemonstration project, including, but not limited to, the number of\npersons in such plans who become ineligible each month for the\ncontinuation coverage described in paragraph (a) of this subdivision. In\naddition, every health maintenance organization certified under article\nforty-four of the public health law and every insurer licensed by the\nsuperintendent of financial services shall submit reports to the\nsuperintendent and to the commissioner of health in such form and at\nsuch times as may be required to implement the provisions of this\nsubdivision.\n  3. Rate incentive demonstration.  With respect to a demonstration\nprogram authorized by subdivision one of this section, the commissioner\nof health may solicit and accept applications for participation in the\ndemonstration program from any employer, or group of employers, of\npersonal care workers or home health workers, who are employed in any\ncity with a population of one million or more and any county with a\npopulation of nine hundred thousand or more if such city or county is\nlocated within the metropolitan commuter transportation district created\npursuant to section twelve hundred sixty-two of the public authorities\nlaw, and whose employers provide services primarily to medical\nassistance recipients, if the following conditions are met:\n  (a) at least fifty percent of the persons receiving services from such\nemployers are recipients of medical assistance;\n  (b) the employer contributes to a group health insurance plan or\nemployer based group health plan on behalf of such employees; and\n  (c) no benefits are provided under the group health insurance plan or\nemployer based gro

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