2013 New York Consolidated Laws
PBH - Public Health
Article 40 - (4000 - 4015) HOSPICE
4012-A - Hospice supplemental financial assistance program for persons with special needs.

 
    §  4012-a.  Hospice  supplemental  financial  assistance  program  for
  persons with special needs. 1. Notwithstanding any provision of  law  or
  regulation  to  the  contrary,  an  additional  amount may be added to a
  hospice's rate pursuant to the medical assistance  program,  subject  to
  approval  by  the state director of the budget, for purposes of enabling
  such hospice to provide care and services to persons with special needs,
  after a determination that such care cannot be appropriately provided at
  the rates of payment established pursuant to federal criteria.
    2. "Persons with special needs" as used herein shall  include  persons
  with   acquired  immune  deficiency  syndrome  and  other  illnesses  or
  conditions, which require a more costly or intensive level of care  than
  typically  provided,  and persons receiving care in a hospice residence.
  Such other illnesses or conditions shall be specified in  regulation  by
  the state hospital review and planning council.
    3.  In  order  for  a hospice to obtain additional medicaid payment as
  provided for in this section, the hospice shall submit cost  information
  as  required  by the commissioner, in consultation with the commissioner
  of social services, which justifies  additional  medicaid  expenditures,
  including  a  demonstration  that  adequate care to persons with special
  needs cannot  be  provided  within  the  rates  of  payment  established
  pursuant  to  federal  criteria.  In  addition to demonstrating that the
  hospice  is  certified  and  in  good  standing  with   all   applicable
  regulations and requirements, the hospice shall also demonstrate that it
  shall:
    (a)  utilize  such  additional  payment to provide services to persons
  with special needs;
    (b) shall undertake reasonable efforts to maintain  financial  support
  from public and community contributed funding sources;
    (c)  shall  make  every  reasonable  effort  to  collect  payments for
  services from third party  insurance  payers,  governmental  payers  and
  self-paying patients; and
    (d)  shall  establish  a  reasonable  relationship  between  costs and
  charges, or establish charges at approximate costs.
    4. The commissioner, in consultation with the commissioner  of  social
  services, is authorized to submit for approval and adoption by the state
  hospital  review  and  planning council such regulations as necessary to
  effectuate the provisions of this section.
    5. The commissioner shall establish a rate for persons receiving  care
  in  a  hospice  residence,  and  may  by  regulation  specify additional
  standards necessary to  ensure  that  the  provisions  of  this  section
  promote  medical  assistance recipients access to hospice residence care
  including;  (a)  that  such   recipients   are   otherwise   unable   to
  appropriately  receive  hospice  care  in  their  own  home; and (b) the
  provision  of  supplemental  financial  assistance  will   promote   the
  efficient delivery of appropriate, quality, cost-effective services.