BILL NUMBER: S229
SPONSOR: TEDISCO
 
TITLE OF BILL:
An act to amend the elder law, in relation to establishing an elderly
dental insurance coverage program; and making an appropriation therefor
 
PURPOSE OR GENERAL IDEA OF BILL:
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.
 
SUMMARY OF SPECIFIC PROVISIONS:
Section 1: Amends Article 2 of the Elder Law by adding new Title 4:
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. Estab-
lishes 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.provisions
of this act.
 
JUSTIFICATION:
According to Columbia University Medical Center "...For too many older
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.
 
PRIOR LEGISLATIVE HISTORY:
01/18/17: S.2885 REFERRED TO AGING
02/01/17: S.2885 COMMITTEE DISCHARGED AND COMMITTED TO FINANCE
01/03/18: S.2885 REFERRED TO FINANCE
01/31/18: S.2885 AMEND AND RECOMMIT TO FINANCE
01/31/18: S.2885 PRINT NUMBER 2885A
01/09/19: S.533 REFERRED TO FINANCE
02/11/19: S.533 COMMITTEE DISCHARGED AND COMMITTED TO AGING
01/08/20: S.533 REFERRED TO AGING
01/06/21: S.225 REFERRED TO FINANCE
01/05/22: S.225 REFERRED TO FINANCE
01/04/23: S.45 REFERRED TO FINANCE
01/03/24: S.45 REFERRED TO FINANCE
 
FISCAL IMPLICATIONS:
Makes an appropriation of $20 million to the Department of Civil Service
out of the General Fund for the purposes of carrying out the provisions
of this act.
 
EFFECTIVE DATE:
This act shall take effect on the 180th day after it shall have become a
law; provided, however, that effective immediately, the addition, amend-
ment and/or repeal of any rule or regulation necessary for the implemen-
tation of this act on its effective date is authorized and directed to
be made and completed on or before such effective date.