NY Soc Serv L § 368-E (2021)
2021 New York Laws SOS - Social Services Article 5 - Assistance and Care Title 11 - Medical Assistance for Needy Persons 368-E - Reimbursement to Counties for Pre-School Children With Handicapping Conditions.

§  368-e.  Reimbursement  to  counties  for  pre-school  children with handicapping conditions. 1. The department of health shall review claims for expenditures made by counties and the city of New York  for  medical care,  services  and  supplies which are furnished to preschool children with handicapping conditions or such  preschool  children  suspected  of having  handicapping  conditions,  as  such  children are defined in the education law. If approved by the department, payment for  such  medical care,   services   and   supplies  which  would  otherwise  qualify  for reimbursement under this title and which  are  furnished  in  accordance with  this title and the regulations of the department to such children, shall be made in  accordance  with  the  department's  approved  medical assistance  fee  schedules  by  payment  to  such  county  or city which furnished the care, services or supplies either directly or by contract. Notwithstanding any  provisions  of  law,  rule  or  regulation  to  the contrary,  any  clinic or diagnostic and treatment center licensed under article twenty-eight of the public health law, which  as  determined  by the  state  education  department, in conjunction with the department of health, has a less than  arms  length  relationship  with  the  provider approved  under  section  forty-four  hundred  ten  of the education law shall, subject to the approval of the department and based on  standards developed  by  the  department,  be  authorized  to directly submit such claims for medical assistance, services or supplies so furnished for any period beginning on or after July first, nineteen hundred  ninety-seven. The  actual  full  cost  of  the  individualized education program (IEP) related services incurred by the clinic shall be  reported  on  the  New York  State  Consolidated  Fiscal  Report  in  the education law section forty-four hundred ten program cost  center  in  which  the  student  is placed  and  the associated medical assistance revenue shall be reported in the same manner.   2. Claims for payment under this section shall be made  in  such  form and  manner,  at  such times, and for such periods as the department may require.   3. The commissioner of health is authorized to contract  with  one  or more entities to conduct a study to determine actual direct and indirect costs  incurred  by  counties  for  medical care, services and supplies, including related special education services and special transportation, furnished to pre-school children with handicapping conditions.   4. Notwithstanding any inconsistent provision of sections one  hundred twelve  and one hundred sixty-three of the state finance law, or section one hundred forty-two of the economic development law, or any other law, the commissioner of health is authorized to enter  into  a  contract  or contracts  under subdivision three of this section without a competitive bid or request for proposal process, provided, however, that:  (a) The department of health 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 a contractor or contractors;  (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  seek  such selection, which may include submission by electronic means;  (b)  All  reasonable and responsive submissions that are received from prospective contractors in timely  fashion  shall  be  reviewed  by  the commissioner of health; and  (c)  The  commissioner  of  health  shall  select  such  contractor or contractors that, in his or her discretion, are best suited to serve the purposes of this section.  (d)  Upon  selection of a contractor or contractors, the department of health shall provide  written  notification  of  such  selection  and  a summary  of  the criteria employed in such selection to the chair of the senate finance committee and the chair of the assembly  ways  and  means committee.   5.  The commissioner shall evaluate the results of the study conducted pursuant to subdivision  three  of  this  section  to  determine,  after identification  of actual direct and indirect costs incurred by counties for  medical  care,  services,  and  supplies  furnished  to  pre-school children  with handicapping conditions, whether it is advisable to claim federal reimbursement for expenditures under this section  as  certified public  expenditures. In the event such claims are submitted, if federal reimbursement received for certified public expenditures  on  behalf  of medical   assistance  recipients  whose  assistance  and  care  are  the responsibility of a social services district, results in a  decrease  in the state share of annual expenditures pursuant to this section for such recipients, then to the extent that the amount of any such decrease when combined  with  any  decrease  in the state share of annual expenditures described in subdivision six of section three hundred  sixty-eight-d  of this  title  exceeds  one  hundred  fifty million dollars for the period April 1, 2011 through March 31, 2013, or  exceeds  one  hundred  million dollars  in  state  fiscal  years 2013-14 and 2014-15, the excess amount shall be transferred to such counties in amounts proportional  to  their percentage  contribution  to  the  statewide savings; an amount equal to thirteen and five hundredths percent of any decrease in the state  share of  annual  expenditures pursuant to this section for such recipients in state fiscal year 2015-16  and  any  fiscal  year  thereafter  shall  be transferred to such counties in amounts proportional to their percentage contribution  to  the statewide savings. Any amount transferred pursuant to this section shall not be  considered  a  revenue  received  by  such social  services  district  in determining the district's actual medical assistance expenditures for purposes of paragraph (b) of section one  of part C of chapter fifty-eight of the laws of two thousand five.   The  provisions of this section shall be of no force and effect unless all necessary approvals under  federal  law  and  regulation  have  been obtained  to  receive  federal  financial  participation in the costs of health care services provided pursuant to this section.