There is a newer version of the New York Consolidated Laws
2010 New York Code
PBH - Public Health
Article 28 - (2800 - 2822) HOSPITALS
2807-P - Comprehensive diagnostic and treatment centers indigent care program.
§ 2807-p. Comprehensive diagnostic and treatment centers indigent care
program. 1. (a) For periods prior to July first, two thousand three, and
on and after July first, two thousand five the commissioner is
authorized to make payments to eligible diagnostic and treatment
centers, to the extent of funds available therefor, up to forty-eight
million dollars annually, to assist in meeting losses resulting from
uncompensated care. The amount of funds available for such payments
pursuant to subdivision four of this section shall be the amount
remaining after the allocation provided in section seven of chapter four
hundred thirty-three of the laws of nineteen hundred ninety-seven as
amended by section seventy-five of chapter one of the laws of nineteen
hundred ninety-nine.
(b) For periods on and after July first, two thousand three, through
June thirtieth, two thousand five, the commissioner shall, subject to
the availability of federal financial participation, adjust medical
assistance rates of payment to assist in meeting losses resulting from
uncompensated care, provided, however, in the event federal financial
participation is not available, the commissioner is authorized to
continue to make payments to eligible diagnostic and treatment centers,
to the extent of funds available therefor, in accordance with provisions
of paragraph (a) of this subdivision and without regard to the
provisions of subdivisions four-a and four-b of this section.
(c) Notwithstanding paragraph (a) of this subdivision, subdivision
four-c of this section or any other inconsistent provision of this
section, distributions made pursuant to this section for annual periods
on and after July first, two thousand nine shall be subject to a uniform
reduction of two percent.
(d) The commissioner may require facilities receiving distributions
pursuant to this section as a condition of participating in such
distributions, to provide reports and data to the department as the
commissioner deems necessary to adequately implement the provisions of
this section.
2. Definitions. (a) "Eligible diagnostic and treatment centers", for
purposes of this section, shall mean voluntary non-profit and publicly
sponsored diagnostic and treatment centers providing a comprehensive
range of primary health care services which can demonstrate losses from
disproportionate share of uncompensated care during a base period two
years prior to the grant period; provided that for periods on and after
January first, two thousand four an eligible diagnostic and treatment
center shall not include any voluntary non-profit diagnostic and
treatment center controlling, controlled by or under common control with
a health maintenance organization, as defined by subdivision one of
section forty-four hundred one of this chapter; provided further that
for purposes of this section, a health maintenance organization shall
not include a prepaid health services plan licensed pursuant to section
forty-four hundred three-a of this chapter. For periods on and after
July first, two thousand three, the base period and the grant period
shall be the calendar year.
(b) "Uncompensated care need", for purposes of this section, means
losses from reported self-pay and free visits multiplied by the
facility's medical assistance payment rate for the applicable
distribution year, offset by payments received from such patients during
the reporting period.
3. (a) During the period January first, nineteen hundred ninety-seven
through September thirtieth, nineteen hundred ninety-seven and for each
fiscal year period commencing on October first thereafter through
December thirty-first, nineteen hundred ninety-nine and for periods on
and after January first, two thousand, diagnostic and treatment centers
shall be eligible for allocations of funds or for rate adjustments
determined in accordance with this section to reflect the needs of the
diagnostic and treatment center for the financing of losses resulting
from uncompensated care.
(b) A diagnostic and treatment center qualifying for a distribution or
a rate adjustment pursuant to this section shall provide assurances
satisfactory to the commissioner that it shall undertake reasonable
efforts to maintain financial support from community and public funding
sources and reasonable efforts to collect payments for services from
third-party insurance payors, governmental payors and self-paying
patients.
(c) To be eligible for an allocation of funds or a rate adjustment
pursuant to this section, a diagnostic and treatment center must provide
a comprehensive range of primary health care services and must
demonstrate that a minimum of five percent of total clinic visits
reported during the applicable base year period were to uninsured
individuals. The commissioner may retrospectively reduce the allocations
of funds or the rate adjustments to a diagnostic and treatment center if
it is determined that provider management actions or decisions have
caused a significant reduction for the grant period in the delivery of
comprehensive primary health care services to uncompensated care
residents of the community.
4. (a) (i) The total amount of funds to be allocated and distributed
for uncompensated care to eligible voluntary non-profit diagnostic and
treatment centers for a distribution period prior to July first, two
thousand three, and on and after July first, two thousand five through
December thirty-first, two thousand six, in accordance with this
subdivision shall be limited to thirty-three percent of the funds
available therefor pursuant to paragraph (a) of subdivision one of this
section and, for the period January first, two thousand seven through
December thirty-first, two thousand seven, such distributions shall be
limited to sixteen and one-half percent of the funds available therefor.
(ii) The total amount of funds to be allocated and distributed for
uncompensated care to eligible publicly sponsored diagnostic and
treatment centers for a grant period prior to July first, two thousand
three, and on and after July first, two thousand five through December
thirty-first, two thousand six, in accordance with this subdivision
shall be limited to sixty-seven percent of funds available therefor
pursuant to paragraph (a) of subdivision one of this section and, for
the period January first, two thousand seven through December
thirty-first, two thousand seven, such distributions shall be limited to
thirty-three and one-half percent of the funds available therefor;
provided, however, that for periods up through December thirty-first,
two thousand seven, forty-one percent of the amount of funds allocated
for distribution to eligible publicly sponsored diagnostic and treatment
centers shall be available for clinics operating under the auspices of
the New York city health and hospitals corporation as established by
chapter one thousand sixteen of the laws of nineteen hundred sixty-nine
as amended.
(iii) (A) Notwithstanding any inconsistent provision of this
paragraph, for the period January first, nineteen hundred ninety-seven
through December thirty-first, nineteen hundred ninety-nine and for
periods on and after January first, two thousand through December
thirty-first, two thousand two, and for periods on and after January
first, two thousand four through December thirty-first, two thousand
seven, in the event that federal financial participation is not
available for rate adjustments pursuant to this section, diagnostic and
treatment centers which received an allowance pursuant to paragraph (f)
of subdivision two of section twenty-eight hundred seven of this article
for the period through December thirty-first, nineteen hundred
ninety-six shall receive an annual uncompensated care distribution
allocation of funds of not less than the amount that would have been
received for any losses associated with the delivery of bad debt and
charity care for nineteen hundred ninety-five had the provisions of
paragraph (f) of subdivision two of section twenty-eight hundred seven
of this article remained in effect, provided, however, that for the
period January first, two thousand seven through December thirty-first,
two thousand seven, the dollar value of the application of the
provisions of this subparagraph for any such diagnostic and treatment
center shall be reduced by fifty percent.
(B) For the period January first, two thousand three through June
thirtieth, two thousand three, and for the period July first, two
thousand three through December thirty-first, two thousand three and in
the event that federal financial participation is not available for rate
adjustments pursuant to this section, each such diagnostic and treatment
center shall receive an uncompensated care distribution allocation of
funds of not less than one-half the amount calculated pursuant to clause
(A) of this subparagraph.
(b) (i) A nominal payment amount for the financing of losses
associated with the delivery of uncompensated care will be established
for each eligible diagnostic and treatment center. The nominal payment
amount shall be calculated as the sum of the dollars attributable to the
application of an incrementally increasing nominal coverage percentage
of base year period losses associated with the delivery of uncompensated
care for percentage increases in the relationship between base year
period eligible uninsured care clinic visits and base year period total
clinic visits according to the following scale:
% of eligible bad debt and charity care % of nominal financial
clinic visits to total visits loss coverage
up to 15% 50%
15 - 30% 75%
30%+ 100%
(ii) For periods prior to January first, two thousand eight, if the
sum of the nominal payment amounts for all eligible voluntary non-profit
diagnostic and treatment centers or for all eligible public diagnostic
and treatment centers or for all clinics operating under the auspices of
the New York city health and hospitals corporation is less than the
amount allocated for uncompensated care allowances pursuant to paragraph
(a) of this subdivision for such diagnostic and treatment centers
respectively, the nominal coverage percentages of base year period
losses associated with the delivery of uncompensated care pursuant to
this scale may be increased to not more than one hundred percent for
voluntary non-profit diagnostic and treatment centers or for public
diagnostic and treatment centers or for all clinics operating under the
auspices of the New York city health and hospitals corporation in
accordance with rules and regulations adopted by the council and
approved by the commissioner.
(c) For periods prior to January first, two thousand eight, the
uncompensated care allocations of funds for each eligible voluntary
non-profit diagnostic and treatment center, as computed in accordance
with paragraph (a) of this subdivision, shall be based on the dollar
value of the result of the ratio of total funds allocated for
distributions for voluntary non-profit diagnostic and treatment centers
pursuant to paragraph (a) of this subdivision to the total statewide
nominal payment amounts for all eligible voluntary non-profit diagnostic
and treatment centers determined in accordance with paragraph (b) of
this subdivision applied to the nominal payment amount for each such
diagnostic and treatment center.
(d) For periods prior to January first, two thousand eight, the
uncompensated care allocations of funds for each eligible public
diagnostic and treatment center, other than clinics operating under the
auspices of the New York city health and hospitals corporation and as
computed in accordance with paragraph (a) of this subdivision, shall be
based on the dollar value of the result of the ratio of total funds
allocated for distributions for public diagnostic and treatment centers,
other than clinics operating under the auspices of the New York city
health and hospitals corporation, pursuant to paragraph (a) of this
subdivision to the total statewide nominal payment amounts for all
eligible public diagnostic and treatment centers, other than clinics
operating under the auspices of the New York city health and hospitals
corporation, determined in accordance with paragraph (b) of this
subdivision applied to the nominal payment amount for each such
diagnostic and treatment center.
(e) For periods prior to January first, two thousand eight, the
uncompensated care grant allocations of funds for each eligible public
diagnostic and treatment center operating under the auspices of the New
York city health and hospitals corporation, as computed in accordance
with paragraph (a) of this subdivision, shall be based on the dollar
value of the result of the ratio of total funds allocated for
distributions for public diagnostic and treatment centers operating
under the auspices of the New York city health and hospitals corporation
pursuant to paragraph (a) of this subdivision to the total statewide
nominal payment amounts for all eligible public diagnostic and treatment
centers operating under the auspices of the New York city health and
hospitals corporation determined in accordance with paragraph (b) of
this subdivision applied to the nominal payment amount for each such
diagnostic and treatment center.
(f) For periods prior to January first, two thousand eight, any
residual amount allocated for distribution to a classification of
diagnostic and treatment centers in accordance with this subdivision
shall be reallocated by the commissioner for distributions to the other
classifications based on remaining need.
(g) For periods on and after January first, two thousand seven, the
uncompensated care allocations of funds for each eligible diagnostic and
treatment center, other than allocations made pursuant to paragraphs
(c), (d), (e) or (f) of this subdivision, shall be based on the dollar
value of the result of the ratio of total funds allocated for
distributions for all eligible diagnostic and treatment centers to the
total statewide nominal payment amounts for all eligible diagnostic and
treatment centers determined in accordance with paragraph (b) of this
subdivision applied to the nominal payment amount for each such
diagnostic and treatment center.
4-a. (a)(i) For periods on and after July first, two thousand three,
through June thirtieth, two thousand five, funds shall be made available
for adjustments to rates of payments made pursuant to paragraph (b) of
subdivision one of this section for eligible voluntary non-profit
diagnostic and treatment centers in accordance with subparagraphs (ii)
and (iii) of this paragraph, for the following periods in the following
aggregate amounts:
(A) For the period July first, two thousand three through December
thirty-first, two thousand three, up to seven million five hundred
thousand dollars;
(B) For the period January first, two thousand four through December
thirty-first, two thousand four, up to fifteen million dollars;
(C) For the period January first, two thousand five through June
thirtieth, two thousand five, up to seven million five hundred thousand
dollars.
(ii) A nominal payment amount for the financing of losses associated
with the delivery of uncompensated care will be established for each
eligible diagnostic and treatment center. The nominal payment amount
shall be calculated as the sum of the dollars attributable to the
application of an incrementally increasing nominal coverage percentage
of base year period losses associated with the delivery of uncompensated
care for percentage increases in the relationship between base year
period eligible uninsured care clinic visits and base year period total
clinic visits according to the following scale:
% of eligible bad debt and charity care % of nominal financial
clinic visits to total visits loss coverage
up to 15% 50%
15 - 30% 75%
30%+ 100%
(iii) The uncompensated care rate adjustments for each eligible
voluntary non-profit diagnostic and treatment center shall be based on
the dollar value of the result of the ratio of total funds allocated for
distributions for voluntary non-profit diagnostic and treatment centers
pursuant to subparagraph (i) of this paragraph, to the total statewide
nominal payment amounts for all eligible voluntary non-profit diagnostic
and treatment centers determined in accordance with subparagraph (ii) of
this paragraph applied to the nominal payment amount for each such
diagnostic and treatment center.
(b)(i) For periods on and after July first, two thousand three through
June thirtieth, two thousand five, funds shall be made available for
adjustments to rates of payments made pursuant to paragraph (b) of
subdivision one of this section for eligible public diagnostic and
treatment centers, other than clinics operated under the auspices of the
New York city health and hospitals corporation, in accordance with
subparagraphs (ii) and (iii) of this paragraph, for the following
periods in the following aggregate amounts:
(A) For the period July first, two thousand three through December
thirty-first, two thousand three, up to nine million dollars;
(B) For the period January first, two thousand four through December
thirty-first, two thousand four, up to eighteen million dollars;
(C) For the period January first, two thousand five through June
thirtieth, two thousand five, up to nine million dollars.
(ii) A nominal payment amount for the financing of losses associated
with the delivery of uncompensated care will be established for each
eligible diagnostic and treatment center. The nominal payment amount
shall be calculated as the sum of the dollars attributable to the
application of an incrementally increasing nominal coverage percentage
of base year period losses associated with the delivery of uncompensated
care for percentage increases in the relationship between base year
period eligible uninsured care clinic visits and base year period total
clinic visits according to the following scale:
% of eligible bad debt and charity care % of nominal financial
clinic visits to total visits loss coverage
up to 15% 50%
15 - 30% 75%
30%+ 100%
(iii) The uncompensated care rate adjustments for each eligible public
diagnostic and treatment center, other than clinics operating under the
auspices of the New York city health and hospitals corporation, shall be
based on the dollar value of the result of the ratio of total funds
allocated for distributions for public diagnostic and treatment centers,
other than clinics operating under the auspices of the New York city
health and hospitals corporation, pursuant to subparagraph (i) of this
paragraph to the total statewide nominal payment amounts for all
eligible public diagnostic and treatment centers, other than clinics
operating under the auspices of the New York city health and hospitals
corporation, determined in accordance with subparagraph (ii) of this
paragraph applied to the nominal payment amount for each such diagnostic
and treatment center.
(c)(i) For periods on and after July first, two thousand three,
through June thirtieth, two thousand five, funds shall be made available
for adjustments to rates of payments made pursuant to paragraph (b) of
subdivision one of this section for eligible public diagnostic and
treatment centers operating under the auspices of the New York city
health and hospitals corporation, in accordance with subparagraphs (ii)
and (iii) of this paragraph, for the following periods in the following
aggregate amounts:
(A) For the period July first, two thousand three through December
thirty-first, two thousand three, up to six million dollars;
(B) For the period January first, two thousand four through December
thirty-first, two thousand four, up to twelve million dollars;
(C) For the period January first, two thousand five through June
thirtieth, two thousand five, up to six million dollars.
(ii) A nominal payment amount for the financing of losses associated
with the delivery of uncompensated care will be established for each
eligible diagnostic and treatment center. The nominal payment amount
shall be calculated as the sum of the dollars attributable to the
application of an incrementally increasing nominal coverage percentage
of base year period losses associated with the delivery of uncompensated
care for percentage increases in the relationship between base year
period eligible uninsured care clinic visits and base year period total
clinic visits according to the following scale:
% of eligible bad debt and charity care % of nominal financial
clinic visits to total visits loss coverage
up to 15% 50%
15 - 30% 75%
30%+ 100%
(iii) The uncompensated care rate adjustment, for each eligible public
diagnostic and treatment center operating under the auspices of the New
York city health and hospitals corporation shall be based on the dollar
value of the result of the ratio of total funds allocated for
distributions for public diagnostic and treatment centers operating
under the auspices of the New York city health and hospitals corporation
pursuant to subparagraph (i) of this paragraph to the total statewide
nominal payment amounts for all eligible public diagnostic and treatment
centers operating under the auspices of the New York city health and
hospitals corporation determined in accordance with subparagraph (ii) of
this paragraph applied to the nominal payment amount for each such
diagnostic and treatment center.
(d) (i) Notwithstanding the provisions of paragraph (b) of this
subdivision and any other provisions of this chapter, municipalities
which received state aid pursuant to article two of this chapter for the
nineteen hundred eighty-nine--nineteen hundred ninety state fiscal year
in support of non-hospital based free-standing or local health
department operated general medical clinics shall receive an
uncompensated care rate adjustment for the period July first, two
thousand three through December thirty-first, two thousand three, of not
less than one-half the amount received in the nineteen hundred
eighty-nine--nineteen hundred ninety state fiscal year for general
medical clinics.
(ii) For the period January first, two thousand four through December
thirty-first, two thousand four, each such municipality shall receive an
uncompensated care rate adjustment of not less than twice the amount
calculated pursuant to subparagraph (i) of this paragraph.
(iii) For the period January first, two thousand five through June
thirtieth, two thousand five, each such municipality shall receive an
annual uncompensated care rate adjustment of not less than the amount
calculated pursuant to subparagraph (i) of this paragraph.
(e) (i) Notwithstanding any inconsistent provision of this
subdivision, for the period July first, two thousand three through
December thirty-first, two thousand three, diagnostic and treatment
centers which received an allowance pursuant to paragraph (f) of
subdivision two of section twenty-eight hundred seven of this article
for the period through December thirty-first, nineteen hundred
ninety-six shall receive an uncompensated care rate adjustment of not
less than one-half the amount that would have been received for any
losses associated with the delivery of bad debt and charity care for
nineteen hundred ninety-five had the provisions of paragraph (f) of
subdivision two of section twenty-eight hundred seven of this article
remained in effect.
(ii) For the period January first, two thousand four through December
thirty-first, two thousand four, each such diagnostic and treatment
center shall receive an uncompensated care rate adjustment of not less
than twice the amount calculated pursuant to subparagraph (i) of this
paragraph.
(iii) For the period January first, two thousand five through June
thirtieth, two thousand five, each such diagnostic and treatment center
shall receive an annual uncompensated care rate adjustment of not less
than the amount calculated pursuant to subparagraph (i) of this
paragraph, and shall be subject to subsequent adjustment or
reconciliation.
(f) Any residual amount allocated for distribution to a classification
of diagnostic and treatment centers in accordance with this subdivision
shall be reallocated by the commissioner for distributions to the other
classifications based on remaining need.
4-b. (a) For periods on and after July first, two thousand three,
through June thirtieth, two thousand five, funds shall be made available
for adjustments to rates of payment made pursuant to paragraph (b) of
subdivision one of this section for eligible diagnostic and treatment
centers with less than two years of operating experience, and diagnostic
and treatment centers which have received certificate of need approval
on applications which indicate a significant increase in uninsured
visits, for the following periods and in the following aggregate
amounts:
(i) For the period July first, two thousand three through December
thirty-first, two thousand three, up to one million five hundred
thousand dollars;
(ii) For the period January first, two thousand four through December
thirty-first, two thousand four, up to three million dollars;
(iii) For the period January first, two thousand five through June
thirtieth, two thousand five, up to one million five hundred thousand
dollars.
(b) To be eligible for a rate adjustment pursuant to this section, a
diagnostic and treatment center shall be a voluntary, non-profit or
publicly sponsored diagnostic and treatment center providing a
comprehensive range of primary health care services and be eligible to
receive a medicaid budgeted rate prior to April first of the applicable
rate adjustment period after which time, the department shall issue rate
adjustments pursuant to this subdivision for such periods. Rate
adjustments made pursuant to this subdivision shall be allocated based
upon each eligible facility's proportional share of costs for services
rendered to uninsured patients which have otherwise not been used for
establishing distributions pursuant to subdivision four-a of this
section. For the purposes of this subdivision costs shall be measured by
multiplying each facility's medicaid budgeted rate by the estimated
number of visits reported for services anticipated to be rendered to
uninsured patients meeting the aforementioned criteria, less any
anticipated patient service revenues received from such uninsured
patients, during the applicable rate adjustment period.
4-c. Notwithstanding any provision of law to the contrary, the
commissioner shall make additional payments for uncompensated care to
voluntary non-profit diagnostic and treatment centers that are eligible
for distributions under subdivision four of this section in the
following amounts: for the period June first, two thousand six through
December thirty-first, two thousand six, in the amount of seven million
five hundred thousand dollars, for the period January first, two
thousand seven through December thirty-first, two thousand seven, seven
million five hundred thousand dollars, for the period January first, two
thousand eight through December thirty-first, two thousand eight, seven
million five hundred thousand dollars, for the period January first, two
thousand nine through December thirty-first, two thousand nine, fifteen
million five hundred thousand dollars, for the period January first, two
thousand ten through December thirty-first, two thousand ten, seven
million five hundred thousand dollars, and for the period January first,
two thousand eleven through March thirty-first, two thousand eleven, in
the amount of one million eight hundred seventy-five thousand dollars,
provided, however, that for periods on and after January first, two
thousand eight, such additional payments shall be distributed to
voluntary, non-profit diagnostic and treatment centers and to public
diagnostic and treatment centers in accordance with paragraph (g) of
subdivision four of this section. In the event that federal financial
participation is available for rate adjustments pursuant to this
section, the commissioner shall make such payments as additional
adjustments to rates of payment for voluntary non-profit diagnostic and
treatment centers that are eligible for distributions under subdivision
four-a of this section in the following amounts: for the period June
first, two thousand six through December thirty-first, two thousand six,
fifteen million dollars in the aggregate, and for the period January
first, two thousand seven through June thirtieth, two thousand seven,
seven million five hundred thousand dollars in the aggregate. The
amounts allocated pursuant to this paragraph shall be aggregated with
and distributed pursuant to the same methodology applicable to the
amounts allocated to such diagnostic and treatment centers for such
periods pursuant to subdivision four of this section if federal
financial participation is not available, or pursuant to subdivision
four-a of this section if federal financial participation is available.
Notwithstanding section three hundred sixty-eight-a of the social
services law, there shall be no local share in a medical assistance
payment adjustment under this subdivision.
5. Diagnostic and treatment centers shall furnish to the department
such reports and information as may be required by the commissioner to
assess the cost, quality, access to, effectiveness and efficiency of
uncompensated care provided. The council shall adopt rules and
regulations, subject to the approval of the commissioner, to establish
uniform reporting and accounting principles designed to enable
diagnostic and treatment centers to fairly and accurately determine and
report uncompensated care visits and the costs of uncompensated care. In
order to be eligible for an allocation of funds pursuant to this
section, a diagnostic and treatment center must be in compliance with
uncompensated care reporting requirements.
6. Notwithstanding any inconsistent provision of law to the contrary,
the availability or payment of funds to a diagnostic and treatment
center pursuant to this section shall not be admissible as a defense,
offset or reduction in any action or proceeding relating to any bill or
claim for amounts due for services provided by a diagnostic and
treatment center.
7. Revenue from distributions to a diagnostic and treatment center
pursuant to this section shall not be included in gross revenue received
for purposes of the assessments pursuant to section twenty-eight hundred
seven-d of this article, subject to the provisions of subdivision twelve
of section twenty-eight hundred seven-d of this article.
8. (a) For periods on or after January first, two thousand through
June thirtieth, two thousand three, payments made to an eligible
diagnostic and treatment center pursuant to this section shall be
reduced or increased by an amount equal to the amount of any
overpayments or underpayments made against grants awarded pursuant to
section seven of chapter four hundred thirty-three of the laws of
nineteen hundred ninety-seven for the period three years prior to the
annual awards made pursuant to this section.
(b) The determination of such overpayments or underpayments shall be
based on the submission by eligible facilities of reports reflecting
actual uncompensated care data, as required by the commissioner, which
are attributable to prior periods. Submission of such reports is a
condition for an eligible facility's receipt of payments pursuant to
this section.
(c) For any periods in which a facility does not receive payments
pursuant to this section, the amount of any prior period overpayment may
be offset against payments for medical assistance made to such facility
pursuant to title eleven of article five of the social services law and
credited to funds allocated pursuant to this section. Any prior period
underpayment to an eligible facility may be paid to such facility in a
subsequent period.
9. Adjustments to rates of payment made pursuant to this section may
be added to rates of payment or made as aggregate payments to eligible
diagnostic and treatment centers and shall not be subject to subsequent
adjustment or reconciliation, provided, however, that in the event such
adjustments are made as aggregate payments, then notwithstanding any
law, rule or regulation to the contrary responsibility for the local
share of such aggregate payments shall be apportioned to a local social
services district based on the most recent geographic utilization data
available to the department for eligible diagnostic and treatment center
services for payments in accordance with subdivisions four-a and four-b
of this section for all diagnostic and treatment center services
provided in accordance with section three hundred sixty-five-a of the
social services law, regardless of whether another social services
district or the department may otherwise be responsible for furnishing
medical assistance to the eligible persons receiving such services.
10. (a) Notwithstanding any inconsistent provision of this section or
any other contrary provision of law, the commissioner is authorized to
seek a waiver from the federal department of health and human services
pursuant to section eleven hundred fifteen of the federal social
security act, or such other federal law provision as may be deemed
appropriate, seeking federal financial participation in payments made
pursuant to this section, in which case the state funding made available
pursuant to this section shall be utilized as the non-federal share of
such payments. To the extent as may be required, payments made pursuant
to this section and in accordance with this subdivision, may be deemed
to be disproportionate share hospital payments in accordance with the
provisions of the federal social security act.
(b) If federal financial participation in payments made pursuant to
this section are made available in accordance with the provisions of
this subdivision, free-standing clinics licensed solely pursuant to
article thirty-one of the mental hygiene law shall also be deemed
eligible for participation in such payments to the same degree and in
accordance with the same distribution methodology otherwise provided in
this section, provided, however, that only those units of service
provided by such free-standing clinics that constitute medical services
that are otherwise eligible for consideration for Medicaid payments
shall be reflected in distributions made pursuant to this section, and
further provided, however, that the commissioner may, in consultation
with the commissioner of the office of mental health, require such
clinics, as a condition of receiving such distributions, to provide
reports and data to the department as the commissioner deems necessary
to adequately implement the provisions of this subdivision with regard
to such clinics.
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