NY Pub Health L § 3605-C (2021)
2021 New York Laws PBH - Public Health Article 36 - Home Care Services 3605-C - Authorization to Enroll and Provide Medical Assistance.

§ 3605-c. Authorization to enroll and provide medical assistance. 1. A licensed  home  care  services  agency  (LHCSA)  shall  not  enroll as a provider in the medical assistance program operated  pursuant  to  title eleven  of  article  five of the social services law or provide or claim for services pursuant thereto, whether provided under the state plan,  a waiver  thereto  or  through  a managed care organization, without being authorized to do  so  by  contract  with  the  department  entered  into pursuant  to  this  section.  Authorization under this section shall not substitute for or duplicate the requirements  of  licensure  under  this article   or   the   screening   and  enrollment  process  required  for participation in the medical assistance program.   2. Notwithstanding any inconsistent provision of section  one  hundred sixty-three  of the state finance law, or sections one hundred forty-two and one  hundred  forty-three  of  the  economic  development  law,  the commissioner  shall  enter  into  a  sufficient number of contracts with LHCSAs to ensure medical assistance recipients have access to  care  and services, provided, however, that:  (a)  the  department shall post on its website for a period of no less than thirty days:  (i) a description of the proposed services to be provided pursuant  to the contract or contracts;  (ii)  the  criteria  for selection of LHCSA contractors, including but not  limited  to:  licensure  under  this  article,   the   ability   to appropriately  serve  medical assistance recipients as determined by the commissioner, a geographic  distribution  of  LHCSAs  to  ensure  access statewide   including  in  rural  and  underserved  areas,  demonstrated cultural  and  language  competencies  specific  to  the  population  of recipients  and  those  of  the  available workforce, ability to provide timely assistance to recipients,  experience  serving  individuals  with disabilities,  efficient  and economic administration of LHCSA services, and demonstrated compliance with all applicable federal and  state  laws and  regulations  including,  but  not  limited to, past compliance with labor law and existing wage and labor  standards,  and  compliance  with equal employment opportunity requirements and anti-discrimination laws;  (iii)  the  period  of  time during which a prospective contractor may seek selection, which shall be no  less  than  thirty  days  after  such information is first posted on the website; and  (iv)  the  manner  by  which  a  prospective  contractor  may submit a proposal for selection,  which  may  include  submission  by  electronic means;  (b)  the  commissioner shall review in a timely fashion all reasonable and  responsive  submissions  that   are   received   from   prospective contractors;  (c)  the  commissioner  shall  select  such  contractors  that, in the commissioner's  discretion,  are  best   suited   to   efficiently   and economically administer medical assistance services;  (d)  all  decisions made and approaches taken pursuant to this section shall be documented in a procurement record as defined  in  section  one hundred sixty-three of the state finance law;  (e)  the  commissioner  may institute a continuous recruitment process provided that the information  required  under  paragraph  (a)  of  this subdivision  remains on the department's website for the entire duration of the recruitment process, until such  date  as  the  commissioner  may determine upon no less than ten days notice being posted on the website; and  (f)  the  commissioner  may  reoffer contracts under the same terms of this subdivision, if determined necessary  by  the  commissioner,  on  a statewide or regional basis.    3.  (a)  The  department  may  terminate a LHCSA's contract under this section or suspend or limit the LHCSA's rights and privileges under  the contract   upon  thirty  day's  written  notice  to  the  LHCSA  if  the commissioner finds  that  the  LHCSA  has  failed  to  comply  with  the provisions of this section or any regulations promulgated hereunder. The written notice shall include:  (i)  a  description of the conduct and the issues related thereto that have been identified as failure of compliance; and  (ii) the time frame of the conduct that fails compliance.  (b)  Notwithstanding  paragraph  (a)   of   this   subdivision,   upon determining that a medical assistance recipient's health or safety would be  imminently  endangered  by the continued operation or actions of the LHCSA, the commissioner may terminate the LHCSA's contract or suspend or limit the LHCSA's rights and privileges under the  contract  immediately upon written notice.  (c)  All  orders  or  determinations  under  this subdivision shall be subject to review as provided in  article  seventy-eight  of  the  civil practice law and rules.  (d)  Any  procedural  rights  or  privileges afforded pursuant to this subdivision shall apply only to actions  taken  under  this  subdivision with respect to compliance with the terms of the contract. Actions taken under  this  subdivision shall not constitute and shall not be construed to  constitute  an  action  with  respect  to  a  LHCSA's  licensure  or enrollment  in  the medical assistance program, which the department may undertake separately or in conjunction with an action pursuant  to  this subdivision.   4.  The  provisions of this section shall not apply unless any and all necessary approvals under federal law and regulation have been  obtained to receive federal financial participation in the costs of services that would  be  provided  by LHCSAs in accordance with the terms of contracts entered into pursuant to this section.