NY Pub Health L § 2557 (2021)
2021 New York Laws PBH - Public Health Article 25 - Maternal and Child Health Title 2-A - Early Intervention Program for Infants and Toddlers With Disabilities and Their Families 2557 - Financial Responsibility and Reimbursement.

§  2557.  Financial responsibility and reimbursement.  1. The approved costs for an  eligible  child  who  receives  an  evaluation  and  early intervention  services pursuant to this title shall be a charge upon the municipality wherein the eligible child resides or, where  the  services are  covered by the medical assistance program, upon the social services district  of  fiscal  responsibility  with  respect  to  those  eligible children  who  are  also  eligible  for medical assistance. All approved costs shall be paid in the first instance and at least quarterly by  the appropriate  governing body or officer of the municipality upon vouchers presented and audited in the same manner as the  case  of  other  claims against   the   municipality.   Notwithstanding  the  insurance  law  or regulations thereunder relating to the permissible exclusion of payments for services under governmental programs, no such exclusion shall  apply with  respect  to  payments made pursuant to this title. Notwithstanding the insurance law or  any  other  law  or  agreement  to  the  contrary, benefits  under  this title shall be considered secondary to any plan of insurance or state government benefit program under  which  an  eligible child  may  have  coverage.  Nothing  in  this section shall increase or enhance coverages provided for within an insurance contract  subject  to the provisions of this title.   2.  The  department  shall  reimburse  the  approved  costs  paid by a municipality  for  the  purposes  of  this  title,  other   than   those reimbursable by the medical assistance program or by third party payors, in  an amount of fifty percent of the amount expended in accordance with the rules and regulations of the commissioner; provided,  however,  that in  the  discretion  of  the  department  and  with  the approval of the director of the division of the budget,  the  department  may  reimburse municipalities  in  an  amount  greater than fifty percent of the amount expended. Such state reimbursement to the municipality shall not be paid prior to April first of the year in which the approved costs are paid by the municipality, provided, however that, subject to the approval of the director  of  the  budget,  the  department  may  pay  such  state   aid reimbursement to the municipality prior to such date.   3.   The  department  may  perform  audits,  which  may  include  site visitation, to all or any  of  the  following:  municipalities;  service coordinators;  evaluators  or  providers of early intervention services. The department shall provide the  municipalities  with  a  copy  of  the findings   of   such   audits.  Early  intervention  program  state  aid reimbursement or portion thereof may be withheld if, on  post-audit  and review, the commissioner finds that the early intervention services were not  provided or those provided were not in substantial conformance with the rules and regulations established by the commissioner  or  that  the recipient  of  such  services  was  not  an eligible child as defined in section twenty-five hundred forty-one of this title. In the  event  that the  commissioner  determines  that  there may be a withholding of state reimbursement to any municipality under this section,  he  shall  inform the state early intervention coordinating council and the relevant local early  intervention  coordinating council and shall consider alternative courses of action recommended within sixty days by either body prior  to withholding state reimbursement.   3-a.  Each  municipality  may perform an audit, which may include site visitation, of evaluators and providers  of  such  services  within  its municipality   in   accordance   with   standards   established  by  the commissioner. The municipality shall submit  the  results  of  any  such audit  to  the commissioner for review and, if warranted, adjustments in state aid reimbursement pursuant to subdivision three of  this  section, as  well  as  for  recovery  by  the  municipality  of  its share of any disallowances identified in such audit.    5. (a) The commissioner, in his or her discretion,  is  authorized  to contract  with  one  or more entities to act as the fiscal agent for the department and municipalities with  respect  to  fiscal  management  and payment   of  early  intervention  claims.  Municipalities  shall  grant sufficient  authority  to  the  fiscal  agent  to  act  on their behalf. Municipalities, and individual and agency providers as  defined  by  the commissioner  in  regulation shall utilize such fiscal agent for payment of early intervention claims as determined by the department  and  shall provide such information and documentation as required by the department and necessary for the fiscal agent to carry out its duties.  (b)  Notwithstanding any inconsistent provision of section one hundred twelve or one hundred sixty-three of the state finance law, sections one hundred  forty-two  and  one  hundred  forty-three   of   the   economic development   law,   or   any  other  contrary  provision  of  law,  the commissioner is authorized to enter into a contract or  contracts  under paragraph  (a)  of this subdivision without a competitive bid or request for proposal process, provided, however, that:  (i) The department shall post on its website, for a period of no  less than thirty days:  (1)  A description of the proposed services to be provided pursuant to the contract or contracts;  (2) The criteria for selection of a contractor or contractors;  (3) 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  (4) The manner  by  which  a  prospective  contractor  may  seek  such selection, which may include submission by electronic means;  (ii)  All reasonable and responsive submissions that are received from prospective contractors in a timely fashion shall  be  reviewed  by  the commissioner; and  (iii)  The  commissioner  shall  select such contractor or contractors that, in his or her discretion, are best suited to serve the purposes of this section.  (c) Paragraph (b) of this subdivision shall apply only to the  initial contract or contracts necessary to obtain the services of a fiscal agent for  early  intervention  program fiscal management and payment of early intervention claims and shall not apply to subsequent  contracts  needed to  maintain  such services, as determined by the commissioner in his or her discretion.