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

*  §  364-g. Medical assistance capitation rate demonstration project.   1. The department and the county of Monroe are authorized to participate   in the "Monroe County Medicap Plan" research and demonstration  project,   for  the purpose of testing the feasibility of converting from a fee for   service payment system to a capitation payment  system  as  a  means  of   financing  health  care  services  for  medicaid  recipients residing in   Monroe county.2. The department  shall  undertake  the  research  and  demonstration   project  authorized by this section only if it has determined that there   is a reasonable expectation that the total cost of benefits  under  such   project would be less than the total cost of benefits if the project was   not in effect.3. Expenditures made in connection with the research and demonstration   project   authorized   by   this  section  shall  be  subject  to  state   reimbursement in accordance with  a  schedule  of  reimbursable  amounts   approved by the department, the department of health and the director of   the budget.4.  The  department  shall,  in  a  manner  to  be decided upon by the   commissioner, determine what portion  of  the  total  expenditures  made   under  the research and demonstration project authorized by this section   are attributable to the provision of the services specified in paragraph   (g) of subdivision one of section three hundred  sixty-eight-a  of  this   title, and shall ensure that the increased state reimbursement available   for such services shall be provided.5.  Notwithstanding  any inconsistent provision of this chapter or any   other law to the contrary, the commissioner may, subject to the approval   of the director of the budget, apply for appropriate waivers of  federal   law  and  regulation, and shall be authorized to waive any provisions of   sections three hundred sixty-six, three hundred sixty-seven-b and  three   hundred  sixty-eight-a of this title and accompanying regulations of the   department, consistent with waivers approved by the  federal  department   of  health  and  human  services, when such action would be necessary to   assist in promoting the objectives of this section;  provided,  however,   that in the event that the research and demonstration project authorized   by  this section requires a waiver of article twenty-eight or forty-four   of the public health law or accompanying regulations of  the  department   of health, the project shall be conducted jointly with the department of   health,  and the commissioner of health may waive such provisions of the   public health law or department of health regulations with the  approval   of the commissioner and the director of the budget.6.  Every  person  eligible  for  or  receiving medical assistance who   resides in the county of Monroe shall participate in  the  demonstration   project  authorized  by this section except for good cause as defined by   the commissioner in regulation.7.  Notwithstanding  any  inconsistent  provisions  of  this  section,   participation in the project authorized by this section shall not affect   a  recipient's  medical assistance eligibility or the scope of available   medical services to which he or she is entitled.8. The department and the county of Monroe shall jointly submit to the   governor and the legislature a long term care capitation  implementation   plan by March thirty-first, nineteen hundred eighty-five.9.  Providers  participating in the research and demonstration project   authorized by this section shall submit reports to the commissioner,  at   such times as he may require, evaluating the results of such project.10. The department shall submit to the governor and the legislature an   interim  report  and  a  final report evaluating the project's impact on   medicaid costs, access to services, quality of services rendered and any   other subjects which the commissioner shall deem relevant.  The  interim    report  shall  be due January first, nineteen hundred eighty-six and the   final report shall be due at the conclusion of the project.11.  This  section  shall  be  effective  if,  and as long as, federal   financial participation is  available  for  expenditures  made  for  the   project conducted pursuant to the provisions of this section.* NB Expired March 31, 1988 per sub 11