N.Y. PBH Law § 3614-A — New York Code / Act PBH / Article 36 / Section 3614-A
Home care provider assessments
Status: in_force

§ 3614-a. Home care provider assessments. 1. Certified home health\nagencies and providers of long term home health care programs are\ncharged assessments on their gross receipts received from all patient\ncare services and other operating income on a cash basis in the\npercentage amounts and for the periods specified in subdivision two of\nthis section. Such assessments shall be submitted by or on behalf of\ncertified home health agencies or providers of long term home health\ncare programs to the commissioner or his designee.\n  2. (a) (i) For certified home health agencies the assessment shall be\nsix-tenths of one percent of each certified home health agency's gross\nreceipts received from all patient care services and other operating\nincome on a cash basis beginning January first, nineteen hundred\nninety-one for home care services; provided, however, that for all such\ngross receipts received on or after April first, nineteen hundred\nninety-nine, such assessment shall be two-tenths of one percent, and\nfurther provided that such assessment shall expire and be of no further\neffect for all such gross receipts received on or after January first,\ntwo thousand.\n  (ii) For certified home health agencies there shall be an additional\nassessment which shall be three-tenths of one percent of each certified\nhome health agency's gross receipts received from all patient care\nservices and other operating income on a cash basis. The assessment year\nshall be April first, nineteen hundred ninety-two to March thirty-first,\nnineteen hundred ninety-three. The agencies shall file the assessment\nreturn with any balance due or any refund claimed by May first, nineteen\nhundred ninety-three. The agencies shall make estimated payments on a\nmonthly basis starting August fifteenth, nineteen hundred ninety-two and\ncontinuing on the fifteenth of each month through March fifteenth,\nnineteen hundred ninety-three. Each estimated payment shall equal\none-eighth of the total estimated for the assessment year. If the total\nof estimated payments is less than ninety-five percent of the actual\npayment due, the agency shall pay a penalty of fifteen percent of the\ndifference due for each month in addition to the amount due.\n  (iii) For certified home health agencies, an additional assessment\nshall be three-tenths of one percent of each certified home health\nagency's gross receipts received from all patient care services and\nother operating income on a cash basis during the period April first,\nnineteen hundred ninety-three through June thirtieth, nineteen hundred\nninety-four for home care services.\n  (b) (i) For providers of long term home health care programs the\nassessment shall be six-tenths of one percent of each provider's gross\nreceipts received from all patient care services and other operating\nincome on a cash basis beginning January first, nineteen hundred\nninety-one for long term home health care services; provided, however,\nthat for all such gross receipts received on or after April first,\nnineteen hundred ninety-nine, such assessment shall be two-tenths of one\npercent, and further provided that such assessment shall expire and be\nof no further effect for all such gross receipts received on or after\nJanuary first, two thousand.\n  (ii) For providers of long term home health programs there shall be an\nadditional assessment which shall be three-tenths of one percent of each\nprovider of long term home health care's gross receipts received from\nall patient care services and other operating income on a cash basis.\nThe assessment year shall be April first, nineteen hundred ninety-two to\nMarch thirty-first, nineteen hundred ninety-three. The providers shall\nfile the assessment return with any balance due or any refund claimed by\nMay first, nineteen hundred ninety-three. The providers shall make\nestimated payments on a monthly basis starting August fifteenth,\nnineteen hundred ninety-two and continuing on the fifteenth of each\nmonth through March fifteenth, nineteen hundred ninety-three. Each\nestimated payment shall equal one-eighth of the total estimated for the\nassessment year. If the total of estimated payments is less than\nninety-five percent of the actual payment due, the provider shall pay a\npenalty of fifteen percent of the difference due for each month in\naddition to the amount due.\n  (iii) For providers of long term home health care programs, an\nadditional assessment shall be three tenths of one percent of each\nprovider's gross receipts received from all patient care services and\nother operating income on a cash basis during the period April first,\nnineteen hundred ninety-three through June thirtieth nineteenth hundred\nninety-four for long term home health care services.\n  (c) Notwithstanding any contrary provisions of this section or any\nother contrary provision of law or regulation, for certified home health\nagencies and for providers of long term home health care programs the\nassessment shall be thirty-five hundredths of one percent of each\nagency's or provider's gross receipts received from all home health care\nservices and other operating income on a cash basis for periods on and\nafter April first, two thousand nine.\n  3. Gross receipts received from all patient care services and other\noperating income for purposes of the assessments pursuant to this\nsection shall include, but not be limited to:\n  (a) for certified home health agencies, all monies received for or on\naccount of home care services, including personal care services,\nexcluding subject to the provisions of subdivision twelve of this\nsection the component of rates of payment related to the allowance\nprovided in accordance with subdivision five of section thirty-six\nhundred fourteen of this article;\n  (b) for providers of long term home health care programs, all monies\nreceived for or on account of long term home health care services,\nincluding personal care services;\n  (c) provided, however, that subject to the provisions of subdivision\ntwelve of this section income received from grants, charitable\ncontributions, donations and bequests and governmental deficit financing\nshall not be included.\n  4. The commissioner is authorized to contract with the article\nforty-three insurance law plans, or such other administrators as the\ncommissioner shall designate, to receive and distribute home care\nprovider assessment funds and personal care services provider assessment\nfunds assessed pursuant to section three hundred sixty-seven-i of the\nsocial services law. In the event contracts with the article forty-three\ninsurance law plans or other commissioner's designees are effectuated,\nthe commissioner shall conduct annual audits of the receipt and\ndistribution of the assessment funds. The reasonable costs and expenses\nof an administrator as approved by the commissioner, not to exceed for\npersonnel services on an annual basis two hundred thousand dollars for\nall assessments established pursuant to this section and the personal\ncare services provider assessment established pursuant to section three\nhundred sixty-seven-i of the social services law, shall be paid from the\nassessment funds.\n  5. Estimated payments by or on behalf of certified home health\nagencies and providers of long term home health care programs to the\ncommissioner or his designee of funds due from the assessments pursuant\nto subdivision two of this section shall be made on a monthly basis.\nEstimated payments shall be due on or before the fifteenth day following\nthe end of a calendar month to which an assessment applies.\n  6. (a) If an estimated payment made for a month to which an assessment\napplies is less than seventy percent of an amount the commissioner\ndetermines is due, based on evidence of prior period moneys received by\na certified home health agency or provider of a long term home health\ncare program or evidence of moneys received by such entity for that\nmonth, the commissioner may estimate the amount due from such entity and\nmay collect the deficiency pursuant to paragraph (c) of this\nsubdivision.\n  (b) If an estimated payment made for a month to which an assessment\napplies is less than ninety percent of an amount the commissioner\ndetermines is due, based on evidence of prior period moneys received by\na certified home health agency or provider of a long term home health\ncare program or evidence of moneys received by such certified home\nhealth agency or provider of a long term home health care program for\nthat month, and at least two previous estimated payments within the\npreceding six months were less than ninety percent of the amount due,\nbased on similar evidence, the commissioner may estimate the amount due\nfrom such entity and may collect the deficiency pursuant to paragraph\n(c) of this subdivision.\n  (c) Upon receipt of notification from the commissioner of an entity's\ndeficiency under this section, the comptroller or a fiscal intermediary\ndesignated by the director of the budget, or the commissioner of social\nservices, or a corporation organized and operating in accordance with\narticle forty-three of the insurance law, or an organization operating\nin accordance with article forty-four of this chapter shall withhold\nfrom the amount of any payment to be made by the state or by such\narticle forty-three corporation or article forty-four organization to\nthe entity the amount of the deficiency determined under paragraph (a)\nor (b) of this subdivision or paragraph (e) of subdivision seven of this\nsection. Upon withholding such amount, the comptroller or a designated\nfiscal intermediary, or the commissioner of social services, or\ncorporation organized and operating in accordance with article\nforty-three of the insurance law or organization operating in accordance\nwith article forty-four of this chapter shall pay the commissioner, or\nhis designee, such amount withheld on behalf of the entity.\n  (d) The commissioner shall provide an entity with notice of any\nestimate of an amount due for an assessment pursuant to paragraph (a) or\n(b) of this subdivision or paragraph (e) of subdivision seven of this\nsection at least three days prior to collection of such amount by the\ncommissioner. Such notice shall contain the financial basis for the\ncommissioner's estimate.\n  (e) In the event the certified home health agency or provider of a\nlong term home health care program objects to an estimate by the\ncommissioner pursuant to paragraph (a) or (b) of this subdivision or\nparagraph (e) of subdivision seven of this section of the amount due for\nan assessment, the entity, within sixty days of notice of an amount due,\nmay request a public hearing. If a hearing is requested, the\ncommissioner shall provide the entity an opportunity to be heard and to\npresent evidence bearing on the amount due for an assessment within\nthirty days after collection of an amount due or receipt of a request\nfor a hearing, whichever is later. An administrative hearing is not a\nprerequisite to seeking judicial relief.\n  (f) The commissioner may direct that a hearing be held without any\nrequest by the entity.\n  7. (a) Every certified home health agency or provider of a long term\nhome health care program shall submit reports on a cash basis of actual\ngross receipts received from all patient care services and operating\nincome for each month as follows:\n  (i) for the period January first, nineteen hundred ninety-one through\nJanuary thirty-first, nineteen hundred ninety-one, the report shall be\nfiled on or before March fifteenth, nineteen hundred ninety-one; and\n  (ii) for the quarter year ending March thirty-first, nineteen hundred\nninety-one and for each quarter thereafter, the report shall be filed on\nor before the forty-fifth day after the end of such quarter.\n  (b) Every certified home health agency or provider of a long term home\nhealth care program shall submit a certified annual report on a cash\nbasis of gross receipts received in such calendar year from all patient\ncare services and operating income.\n  (c) The reports shall be in such form as may be prescribed by the\ncommissioner to accurately disclose information required to implement\nthis section.\n  (d) Final payments shall be due for all certified home health agencies\nor providers of long term home health care programs for assessments\npursuant to subdivision two of this section upon the due date for\nsubmission of the applicable quarterly report.\n  (e) The commissioner may recoup deficiencies in final payments\npursuant to paragraph (c) of subdivision six of this section.\n  8. (a) If an estimated payment made for a month to which an assessment\napplies is less than ninety percent of the actual amount due for such\nmonth, interest shall be due and payable to the commissioner on the\ndifference between the amount paid and the amount due from the day of\nthe month the estimated payment was due until the date of payment. The\nrate of interest shall be twelve percent per annum or at the rate of\ninterest set by the commissioner of taxation and finance with respect to\nunderpayments of tax pursuant to subsection (e) of section one thousand\nninety-six of the tax law minus four percentage points. Interest under\nthis paragraph shall not be paid if the amount thereof is less than one\ndollar. Interest, if not paid by the due date of the following month's\nestimated payment, may be collected by the commissioner pursuant to\nparagraph (c) of subdivision six of this section in the same manner as\nan assessment pursuant to subdivision two of this section.\n  (b) If an estimated payment made for a month to which an assessment\napplies is less than seventy percent of the actual amount due for such\nmonth, a penalty shall be due and payable to the commissioner of five\npercent of the difference between the amount paid and the amount due for\nsuch month when the failure to pay is for a duration of not more than\none month after the due date of the payment with an additional five\npercent for each additional month or fraction thereof during which such\nfailure continues, not exceeding twenty-five percent in the aggregate. A\npenalty may be collected by the commissioner pursuant to paragraph (c)\nof subdivision six of this section in the same manner as an assessment\npursuant to subdivision two of this section.\n  (c) Overpayment by a certified home health agency or provider of a\nlong term home health care program of an estimated payment shall be\napplied to any other payment due from the entity pursuant to this\nsection, or, if no payment is due, at the election of the entity shall\nbe applied to future estimated payments or refunded to the entity.\nInterest shall be paid on overpayments from the date of overpayment to\nthe date of crediting or refund at the rate determined in accordance\nwith paragraph (a) of this subdivision if the overpayment was made at\nthe direction of the commissioner. Interest under this paragraph shall\nnot be paid if the amount thereof is less than one dollar.\n  9. Funds accumulated, including income from invested funds, from the\nassessments specified in this section, including interest and penalties,\nshall be deposited by the commissioner and credited to the general fund.\n  10. Notwithstanding any inconsistent provision of law or regulation to\nthe contrary, the assessments pursuant to this section shall not be an\nallowable cost in the determination of reimbursement rates pursuant to\nthis article.\n  11. (c) The assessment shall not be collected in excess of twenty\nmillion four hundred thousand dollars from certified home health\nagencies and long term home health care programs pursuant to subdivision\ntwo of this section, licensed home care services agencies pursuant to\nsubdivision two of section thirty-six hundred fourteen-b of this article\nand personal care services providers pursuant to subdivision two of\nsection three hundred sixty-seven-i of the social services law for the\nperiod of April first, nineteen hundred ninety-seven through March\nthirty-first, nineteen hundred ninety-eight. The amount of the\nassessment collected in excess of twenty million four hundred thousand\ndollars for the period April first, nineteen hundred ninety-seven\nthrough March thirty-first, nineteen hundred ninety-eight shall be\nrefunded by the commissioner based on the ratio which a certified home\nhealth agency's, long term home health care program's, licensed home\ncare services agency's or personal care services provider's assessment\nfor such period bears to the total of the assessments for such period\npaid by such providers of services.\n  12. Each exclusion of sources of gross receipts received from the\nassessments effective on or after April first, nineteen hundred\nninety-two established pursuant to this section shall be contingent upon\neither: (a) qualification of the assessments for waiver pursuant to\nfederal law and regulation; or (b) consistent with federal law and\nregulation, not requiring a waiver by the secretary of the department of\nhealth and human services related to such exclusion; in order for the\nassessments under this section to be qualified as a broad-based health\ncare related tax for purposes of the revenues received by the state\npursuant to the assessments not reducing the amount expended by the\nstate as medical assistance for purposes of federal financial\nparticipation. The commissioner shall collect the assessments relying on\nsuch exclusions, pending any contrary action by the secretary of the\ndepartment of health and human services. In the event the secretary of\nthe department of health and human services determines that the\nassessments do not so qualify based on any such exclusion, the exclusion\nshall be deemed to have been null and void as of April first, nineteen\nhundred ninety-two, and the commissioner shall collect any retroactive\namount due as a result, without interest or penalty provided the\ncertified home health agency or provider of a long term home health care\nprogram pays the retroactive amount due within ninety days of notice\nfrom the commissioner of health to the provider of services that an\nexclusion is null and void. Interest and penalties shall be measured\nfrom the due date of ninety days following notice from the commissioner\nto the provider of services.\n