2023 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.