NY Soc Serv L § 364-J-2 (2021)
2021 New York Laws SOS - Social Services Article 5 - Assistance and Care Title 11 - Medical Assistance for Needy Persons 364-J-2 - Transitional Supplemental Payments.

§  364-j-2.  Transitional  supplemental  payments.  1. As used in this section, "covered provider" shall mean a voluntary not-for-profit health care provider that is any of the following:  (a) a freestanding diagnostic  and  treatment  center  licensed  under article  twenty-eight  of  the  public  health  law that qualifies for a distribution pursuant to section twenty-eight hundred  seven-p  of  such article,  or  section  seven of chapter four hundred thirty-three of the laws of nineteen hundred ninety-seven, or receives funding under section three hundred thirty-three of the federal public health services act for health care for the homeless; or  (b) a freestanding diagnostic and treatment center which  operates  an approved  program under the prenatal care assistance program established pursuant to article twenty-five of the public health law; or  (c) a facility licensed  under  article  twenty-eight  of  the  public health  law that is sponsored by a university or dental school which has been granted an operating certificate pursuant to  article  twenty-eight of the public health law to provide dental services; or  (d)  a  freestanding  family  planning  clinic  licensed under article twenty-eight of the public health law.   2. (a) Notwithstanding paragraphs (b) and (h) of  subdivision  two  of section  twenty-eight  hundred  seven  of  the  public  health  law, the commissioner of health shall make supplemental payments of nine  million eight  hundred  twenty-four  thousand  dollars  ($9,824,000), to covered providers described in subdivision one of this section who are qualified providers as described in paragraph (a) of  subdivision  three  of  this section,  based  on  adjustments to fee-for-service rates for the period February first through March thirty-first, two  thousand  two  and  nine million  eight hundred twenty-four thousand dollars ($9,824,000) for the period October first through December thirty-first, two thousand two and four million nine hundred twelve thousand dollars ($4,912,000)  for  the period  October  first through December thirty-first, two thousand three and an additional amount of four million nine  hundred  twelve  thousand dollars  ($4,912,000)  for  the  period  October  first through December thirty-first,  two  thousand  three  and  nine  million  eight   hundred twenty-four  thousand  dollars  ($9,824,000)  for the period April first through June thirtieth,  two  thousand  five,  and  nine  million  eight hundred twenty-four thousand dollars ($9,824,000) for the period October first through December thirty-first, two thousand six, and an additional nine million eight hundred twenty-four thousand dollars ($9,824,000) for the  period  October  first  through December thirty-first, two thousand six,  and  nine  million  eight  hundred  twenty-four  thousand  dollars ($9,824,000) for the period October first through December thirty-first, two thousand seven, as medical assistance payments for services provided pursuant  to  this  title  for  persons  eligible  for federal financial participation under title XIX of the  federal  social  security  act  to reflect  additional  costs  associated  with the transition to a managed care environment, and nine million eight  hundred  twenty-four  thousand dollars  ($9,824,000)  for  the  period  October  first through December thirty-first, two  thousand  eight,  and  seven  million  three  hundred eighty-eight  thousand dollars ($7,388,000) for the period October first through December thirty-first, two thousand nine, as medical  assistance payments  for  services  provided  pursuant  to  this  title for persons eligible for federal financial participation  under  title  XIX  of  the federal  social security act to reflect additional costs associated with the operation  of  electronic  health  record  systems  that  meet  such standards  as  may  be  established by the commissioner of health. There shall be no local share in these payments. The director  of  the  budget shall   allocate   the  non-federal  share  of  such  payments  from  an  appropriation for the miscellaneous special revenue fund - 339 community service  provider  assistance  program  account  for  the  two  thousand one--two  thousand  two state fiscal year for adjustments for the period February first through March thirty-first, two thousand two. Adjustments for  the  period  October  first,  two  thousand  two  through  December thirty-first, two thousand two shall be within amounts appropriated  for the   two  thousand  two--two  thousand  three  state  fiscal  year  and adjustments for the period October first,  two  thousand  three  through December  thirty-first,  two  thousand  three  shall  be  within amounts appropriated for the two thousand three--two thousand four state  fiscal year  and adjustments for the non-federal share of the additional amount of four million nine hundred twelve thousand  dollars  ($4,912,000)  for such  period  shall  be  allocated by the director of the budget from an appropriation  for  maintenance  undistributed  general  fund  community projects  fund  -  007  account for the two thousand three--two thousand four state fiscal year. The director of the budget  shall  allocate  the non-federal  share  of  adjustments  for  the  period  April  first, two thousand  five  through  June  thirtieth,  two  thousand  five  from  an appropriation  for  the maintenance undistributed general fund community projects fund - 007 - cc account for the two thousand four--two thousand five state fiscal year. The director of the budget  shall  allocate  the non-federal  share  of  adjustments  for  the  period October first, two thousand six through December thirty-first, two  thousand  six  from  an appropriation for the maintenance undistributed, general fund, community projects  fund  - 007-cc account for the two thousand five--two thousand six state fiscal year. The director of the  budget  shall  allocate  the non-federal  share  of the additional adjustments for the period October first, two thousand six through December thirty-first, two thousand  six from  such  funds as may be made available from an appropriation for the maintenance undistributed,  general  fund,  community  projects  fund  - 007-cc account for the two thousand six--two thousand seven state fiscal year. The director of the budget shall allocate the non-federal share of the adjustments for the period October first, two thousand seven through December  thirty-first, two thousand seven from an appropriation for the medical assistance program, general fund, local assistance account - 001 for the two thousand seven--two thousand eight state  fiscal  year.  The director  of  the  budget  shall  allocate  the non-federal share of the adjustments for the period October first,  two  thousand  eight  through December  thirty-first, two thousand eight from an appropriation for the medical assistance program, general fund, local assistance account - 001 for the two thousand eight--two thousand nine  state  fiscal  year.  The director  of  the  budget  shall  allocate  the non-federal share of the adjustments for the period October  first,  two  thousand  nine  through December  thirty-first,  two thousand nine from an appropriation for the medical assistance program, general fund, local assistance account - 001 for the two thousand nine--two thousand  ten  state  fiscal  year.  Such adjustments  to fee for service rates shall not be subject to subsequent adjustment or reconciliation. Alternatively, such payments may  be  made as aggregate payments to eligible providers.  (a-1)   Notwithstanding  the  provisions  of  paragraph  (a)  of  this subdivision, for facilities licensed under article twenty-eight  of  the public  health  law  that are sponsored by a university or dental school which has been granted an  operating  certificate  pursuant  to  article twenty-eight of the public health law and which provides dental services as  its  principal  mission,  two  hundred  twenty-four thousand dollars ($224,000) in the aggregate for use pursuant to this  section  shall  be allocated   for   distribution   to  such  facilities  pursuant  to  the methodology  described  in  paragraph  (b)  of   subdivision   two   and  subparagraph  (i)  of  paragraph  (b) of subdivision four of section two thousand eight hundred seven-p of the public  health  law  for  services provided  for  the period February first, two thousand two through March thirty-first, two thousand two to persons eligible for federal financial participation  under  title  XIX  of  the  federal  social security act, provided, however, that the amount paid pursuant to this  paragraph  for each  such facility shall equal the facility's proportional share of the total nominal payment amounts calculated under this section of all  such facilities  multiplied  by  the total funds allocated for such payments. There shall be no local share in these payments.  The  director  of  the budget  shall  allocate  the  non-federal share of such payments from an appropriation for the miscellaneous special revenue fund - 339 community service  provider  assistance  program  account  for  the  two  thousand one--two  thousand  two  state  fiscal year. Such adjustments to fee for service  rates  shall  not  be  subject  to  subsequent  adjustment   or reconciliation.  Alternatively,  such  payments may be made as aggregate payments to eligible providers.  (a-2) (i) Notwithstanding the provisions  of  paragraph  (a)  of  this subdivision,  for  facilities licensed under article twenty-eight of the public health law that are sponsored by a university  or  dental  school which  has  been  granted  an  operating certificate pursuant to article twenty-eight of the public health law and which provides dental services as its principal  mission,  two  hundred  twenty-four  thousand  dollars ($224,000)  in  the  aggregate  of  the  amount appropriated for the two thousand two--two thousand three state fiscal year for use  pursuant  to this  section  shall  be  allocated for the period October first through December thirty-first, two thousand two and one hundred twelve  thousand dollars  ($112,000)  in the aggregate of the amount appropriated for the two  thousand  three--two  thousand  four  state  fiscal  year,  and  an additional  amount  of one hundred twelve thousand dollars ($112,000) in the aggregate for use pursuant to this section shall  be  allocated  for the  period  October  first  through December thirty-first, two thousand three and two hundred twenty-four thousand  dollars  ($224,000)  in  the aggregate  of  the  amount  appropriated  for the two thousand four--two thousand five state fiscal year shall be allocated for the period  April first,  two thousand five through June thirtieth, two thousand five, and two hundred twenty-four thousand dollars ($224,000) in the aggregate  of the  amount  appropriated  for  the  two thousand five--two thousand six state fiscal year shall be allocated for the period October  first,  two thousand  six  through  December  thirty-first, two thousand six, and an additional two hundred twenty-four thousand dollars  ($224,000)  in  the aggregate  of  the  amount  appropriated  for  the two thousand six--two thousand seven state fiscal year  shall  be  allocated  for  the  period October  first,  two  thousand  six  through  December thirty-first, two thousand six, and two hundred twenty-four thousand dollars ($224,000) in the aggregate of the amount appropriated for the two thousand seven--two thousand eight state fiscal year  shall  be  allocated  for  the  period October  first,  two  thousand  seven through December thirty-first, two thousand seven, and two hundred twenty-four thousand dollars  ($224,000) in  the  aggregate  of  the  amount  appropriated  for  the two thousand eight--two thousand nine state fiscal year shall be  allocated  for  the period  October first, two thousand eight through December thirty-first, two  thousand  eight  and  two  hundred  twenty-four  thousand   dollars ($224,000)  in  the  aggregate  of  the  amount appropriated for the two thousand nine--two thousand ten state fiscal year shall be allocated for the  period  October  first,  two   thousand   nine   through   December thirty-first,  two  thousand  nine  for  distribution to such facilities pursuant to subparagraphs (ii) and (iii) of this paragraph.  Adjustments  for the non-federal share of the additional amount of one hundred twelve thousand  dollars  ($112,000) for the period October first, two thousand three  through  December  thirty-first,  two  thousand  three  shall  be allocated  by  the  director  of  the  budget  from an appropriation for maintenance undistributed general fund community  projects  fund  -  007 account for the two thousand three--two thousand four state fiscal year. The  non-federal  share  of  adjustments for the period April first, two thousand five  through  June  thirtieth,  two  thousand  five  shall  be allocated  by  the  director of the budget from an appropriation for the maintenance undistributed general fund community  projects  fund  -  007 account  for the two thousand four--two thousand five state fiscal year. The non-federal share of adjustments for the period October  first,  two thousand  six  through  December thirty-first, two thousand six shall be allocated by the director of the budget from an  appropriation  for  the maintenance  undistributed,  general  fund,  community  projects  fund - 007-cc account for the two thousand five--two thousand six state  fiscal year. The non-federal share of the additional adjustments for the period October  first,  two  thousand  six  through  December thirty-first, two thousand six shall, subject to the availability of funds,  be  allocated by  the  director  of  the  budget  from  the  medical  assistance local assistance appropriation for the two thousand  six--two  thousand  seven state  fiscal  year.  The  non-federal  share of the adjustments for the period October first, two thousand seven through December  thirty-first, two thousand seven shall be allocated by the director of the budget from an appropriation for the medical assistance program, general fund, local assistance  account - 001 for the two thousand seven--two thousand eight state fiscal year. The non-federal share  of  the  adjustments  for  the period  October first, two thousand eight through December thirty-first, two thousand eight shall be allocated by the director of the budget from an appropriation for the medical assistance program, general fund, local assistance account - 001 for the two thousand eight--two  thousand  nine state  fiscal  year.  The  non-federal  share of the adjustments for the period October first, two thousand nine through  December  thirty-first, two  thousand nine shall be allocated by the director of the budget from an appropriation for the medical assistance program, general fund, local assistance account - 001 for the two  thousand  nine--two  thousand  ten state fiscal year.  (ii)  Forty  percent shall be allocated for equal distribution to such facilities, reduced by the amount, if any, that a  distribution  exceeds forty  percent  of  a  facility's  uncompensated care need as defined in paragraph (b) of subdivision two of section two thousand  eight  hundred seven-p   of  the  public  health  law.  Any  funds  allocated  but  not distributed in accordance with this subparagraph shall be added to those amounts distributed  in  accordance  with  subparagraph  (iii)  of  this paragraph.  (iii)  Sixty  percent, plus any funds allocated and not distributed in accordance with subparagraph (ii) of this paragraph, shall be  allocated for   distribution  to  such  facilities  pursuant  to  the  methodology described in paragraph (b) of subdivision two and  subparagraph  (i)  of paragraph  (b) of subdivision four of section two thousand eight hundred seven-p of the public health law, provided,  however,  that  the  amount paid  pursuant to this allocation for each such facility shall equal the facility's proportional share  of  the  total  nominal  payment  amounts calculated  under  this section of all such facilities multiplied by the total funds allocated for such payments.  (iv) There shall be no local share in these payments.  (b) Notwithstanding the provisions of subdivision one of section three hundred sixty-eight-a of this title, there shall be paid to each  social  services  district  the full amount expended on behalf of the department of health for medical assistance furnished pursuant to the provisions of this section, after first deducting therefrom any federal funds properly received or to be received on account thereof.   3.  (a)  For  periods  prior  to  January first, two thousand eight, a covered provider described in subdivision one of this section  shall  be qualified  to  receive  a  supplemental  payment  only  if its number of medicaid visits for patient care services in the base year described  in subparagraph (ii) of paragraph (b) of this subdivision equals or exceeds twenty-five  percent  of  its  total  number  of visits for patient care services and its number of medicaid visits for patient care services for medicaid managed care enrollees equals or exceeds three percent  of  its total number of medicaid visits during the base year. For periods on and after January first, two thousand eight, a covered provider described in subdivision  one  of  this  section  shall  be  qualified  to  receive a supplemental payment only if it has  in  place  during  such  period  an operational electronic health record system that meets such standards as may  be  established  by  the  commissioner  of health and its number of medicaid visits for patient care services in the base year described  in subparagraph (ii) of paragraph (b) of this subdivision equals or exceeds twenty-five  percent  of  its  total  number  of visits for patient care services during the base year or its number of medicaid visits  combined with  its  number  of  uninsured visits for patient care services in the base year described in  subparagraph  (ii)  of  paragraph  (b)  of  this subdivision  equals  or  exceeds  thirty  percent of its total number of visits for patient care services during the base year.  (b) (i) For periods prior to January first, two thousand  eight,  each qualified  provider described in paragraph (a) of this subdivision shall receive a supplemental payment equal  to  such  provider's  proportional share  of the total funds allocated pursuant to this section, based upon the ratio of its visits from medical assistance recipients  enrolled  in managed  care  during the base year to the total number of visits to all such qualified providers by medical assistance  recipients  enrolled  in managed  care  during  the  base  year. For periods on and after January first,  two  thousand  eight,  each  qualified  provider  described   in paragraph  (a)  of this subdivision shall receive a supplemental payment equal to such provider's proportional share of the total funds allocated pursuant to this section, based  upon  the  ratio  of  its  visits  from medical  assistance  recipients during the base year to the total number of visits from medical  assistance  recipients  to  all  such  qualified providers during the base year.  (ii)  For  periods  prior  to  January  first, two thousand eight, for purposes of the calculation described in this subdivision, the base year will be two thousand, and the commissioner of health shall utilize  data as  reported  on  the  2000  AHCF-1  cost  report initially submitted by covered providers to  the  department  of  health  on  or  about  August seventeenth,  two  thousand one. For periods on and after January first, two thousand eight, for purposes of the calculation  described  in  this subdivision,  the  base  year will be two years prior to the grant year, and the commissioner of health shall utilize data as reported on  AHCF-1 cost  report  submitted by covered providers to the department of health for such base year.   4. Payments made pursuant to this section shall constitute  additional reimbursement  to  qualified  providers  and shall not be used to reduce levels of other funding provided to qualified providers by  governmental agencies.   5.  (a)  The  commissioner  of  health  shall  make medical assistance payments to qualified providers from funds made  available  pursuant  to  the  provisions  of  this  section  contingent  upon  the receipt of all federal approvals necessary and subject to the availability  of  federal financial  participation  under title XIX of the federal social security act  for  the  transitional  supplemental  payments.  In  the event such federal approval is  not  received  prior  to  March  thirty-first,  two thousand  two,  for  adjustments  for  the  period  February  first, two thousand two through March thirty-first, two thousand two and  prior  to October  first,  two thousand two for adjustments for the period October first, two thousand two through December thirty-first, two thousand  two and  prior  to October first, two thousand three for adjustments for the period October first, two thousand three through December  thirty-first, two  thousand  three,  and prior to October first, two thousand five for adjustments for the period April first, two thousand five  through  June thirtieth,  two  thousand five, and prior to October first, two thousand six for adjustments for the  period  October  first,  two  thousand  six through  December  thirty-first,  two thousand six, and prior to October first, two thousand seven for adjustments for the period October  first, two  thousand  seven  through December thirty-first, two thousand seven, and prior to October first, two thousand eight for adjustments  for  the period  October first, two thousand eight through December thirty-first, two thousand eight, and prior to October first, two  thousand  nine  for adjustments  for  the  period  October  first, two thousand nine through December thirty-first, two thousand nine,  the  commissioner  of  health shall make medical assistance payments to qualified providers consisting of  the  state  share  amount available for purposes of this section and apportioned in accordance  with  subdivisions  two  and  three  of  this section.  In the event such federal approval is denied, such state share amount payments shall be deemed to be grants to such qualified providers and such qualified providers shall not be eligible to receive any  other payments pursuant to this section.  (b)  The  commissioner  of  health  shall take all steps necessary and shall use best efforts to secure federal financial  participation  under title  XIX of the social security act, for the purposes of this section, including the prompt submission of appropriate amendments to  the  title XIX state plan.