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

§  364.  Responsibility for standards. To assure that the medical care and services rendered pursuant to this title are of the highest  quality and  are  available  to  all  who  are  in  need, the responsibility for establishing and maintaining standards for medical care and  eligibility shall be as follows:   1. The department of social services shall be responsible for  (a)  determining  eligibility  for  care and services pursuant to this title and consistent with standards established by the  commissioner  of the  department  of  health and, as authorized by such commissioner, for hearing  appeals  and  making  findings  and  recommendations   relating thereto;  (b)  auditing  payments  to  providers  of care, services and supplies under the medical assistance program; and  (c) publishing and distributing to the public, from time to  time  and in  consultation  with the department of health, information relating to the medical assistance program, to promote maximum public  awareness  of the availability of, and the procedure for obtaining, such assistance.   2. The department of health shall be responsible for  (a)  establishing  and  maintaining  standards  for  all  hospital and related services pursuant to article twenty-eight of the  public  health law,  and  for all medical care and services furnished in an institution operated by the department of health pursuant to other provisions of the public health law;  (b) establishing and maintaining standards for  all  non-institutional health  care and services rendered pursuant to this title, including but not  limited  to  procedural  standards  relating  to  the   revocation, suspension,  limitation  or annulment of qualification for participation as a provider of care and services, on a determination that the provider is an incompetent provider of  specific  services  or  has  exhibited  a course  of  conduct  which is either inconsistent with program standards and  regulations  or  which  exhibits  an  unwillingness  to  meet  such standards and regulations, or is a potential threat to the public health or safety pursuant to section two hundred six of the public health law;  (c) reviewing and approving local social services medical plans;  (d)  establishing  by  regulation requirements for a uniform system of reports relating to the quality of medical care and  services  furnished pursuant to this title;  (e)  reviewing  the  quality  and  availability  of  medical  care and services furnished under local social services medical plans, to  assure that the quality of medical care and services is in the best interest of the recipients;  (f)  providing consultative services to hospitals, nursing homes, home health agencies, clinics, laboratories, and such other  institutions  as the secretary of the federal department of health and human services may specify  in  order  to  assist  them:  to qualify for payments under the provisions of this title and title XIX of the  federal  social  security act;  in  providing  information  needed  to determine such payments; in establishing and maintaining such fiscal records as may be necessary for the proper and efficient administration of medical assistance;  (g) establishing standards  of  eligibility  for  medical  assistance, consistent with the provisions of this title; and  (h)  making  policy, rules and regulations for maintaining a system of hearings for applicants and recipients of medical  assistance  adversely affected  by  the  actions of the department or social service districts and for making final administrative  determinations  and  issuing  final decisions concerning such matters.   3.  Each  office  within  the  department  of  mental hygiene shall be responsible for establishing and maintaining standards for medical  care  and  services  received in institutions operated by it or subject to its supervision pursuant to the mental hygiene law.   4.  The public health and health planning council shall be responsible for establishing and maintaining qualifications for persons employed  by social services districts as professional directors.