2023 New York Laws › SOS - Social Services › Article 5 - Assistance and Care › Title 11 - Medical Assistance for Needy Persons › 364-J-2 - Transitional Supplemental Payments.

§  364-j-2.  Transitional  supplemental  payments.  1. As used in this
section, "covered provider" shall mean a voluntary not-for-profit health
care provider that is any of the following:
(a) a freestanding diagnostic  and  treatment  center  licensed  under
article  twenty-eight  of  the  public  health  law that qualifies for a
distribution pursuant to section twenty-eight hundred  seven-p  of  such
article,  or  section  seven of chapter four hundred thirty-three of the
laws of nineteen hundred ninety-seven, or receives funding under section
three hundred thirty-three of the federal public health services act for
health care for the homeless; or
(b) a freestanding diagnostic and treatment center which  operates  an
approved  program under the prenatal care assistance program established
pursuant to article twenty-five of the public health law; or
(c) a facility licensed  under  article  twenty-eight  of  the  public
health  law that is sponsored by a university or dental school which has
been granted an operating certificate pursuant to  article  twenty-eight
of the public health law to provide dental services; or
(d)  a  freestanding  family  planning  clinic  licensed under article
twenty-eight of the public health law.
2. (a) Notwithstanding paragraphs (b) and (h) of  subdivision  two  of
section  twenty-eight  hundred  seven  of  the  public  health  law, the
commissioner of health shall make supplemental payments of nine  million
eight  hundred  twenty-four  thousand  dollars  ($9,824,000), to covered
providers described in subdivision one of this section who are qualified
providers as described in paragraph (a) of  subdivision  three  of  this
section,  based  on  adjustments to fee-for-service rates for the period
February first through March thirty-first, two  thousand  two  and  nine
million  eight hundred twenty-four thousand dollars ($9,824,000) for the
period October first through December thirty-first, two thousand two and
four million nine hundred twelve thousand dollars ($4,912,000)  for  the
period  October  first through December thirty-first, two thousand three
and an additional amount of four million nine  hundred  twelve  thousand
dollars  ($4,912,000)  for  the  period  October  first through December
thirty-first,  two  thousand  three  and  nine  million  eight   hundred
twenty-four  thousand  dollars  ($9,824,000)  for the period April first
through June thirtieth,  two  thousand  five,  and  nine  million  eight
hundred twenty-four thousand dollars ($9,824,000) for the period October
first through December thirty-first, two thousand six, and an additional
nine million eight hundred twenty-four thousand dollars ($9,824,000) for
the  period  October  first  through December thirty-first, two thousand
six,  and  nine  million  eight  hundred  twenty-four  thousand  dollars
($9,824,000) for the period October first through December thirty-first,
two thousand seven, as medical assistance payments for services provided
pursuant  to  this  title  for  persons  eligible  for federal financial
participation under title XIX of the  federal  social  security  act  to
reflect  additional  costs  associated  with the transition to a managed
care environment, and nine million eight  hundred  twenty-four  thousand
dollars  ($9,824,000)  for  the  period  October  first through December
thirty-first, two  thousand  eight,  and  seven  million  three  hundred
eighty-eight  thousand dollars ($7,388,000) for the period October first
through December thirty-first, two thousand nine, as medical  assistance
payments  for  services  provided  pursuant  to  this  title for persons
eligible for federal financial participation  under  title  XIX  of  the
federal  social security act to reflect additional costs associated with
the operation  of  electronic  health  record  systems  that  meet  such
standards  as  may  be  established by the commissioner of health. There
shall be no local share in these payments. The director  of  the  budget
shall   allocate   the  non-federal  share  of  such  payments  from  an

appropriation for the miscellaneous special revenue fund - 339 community
service  provider  assistance  program  account  for  the  two  thousand
one--two  thousand  two state fiscal year for adjustments for the period
February first through March thirty-first, two thousand two. Adjustments
for  the  period  October  first,  two  thousand  two  through  December
thirty-first, two thousand two shall be within amounts appropriated  for
the   two  thousand  two--two  thousand  three  state  fiscal  year  and
adjustments for the period October first,  two  thousand  three  through
December  thirty-first,  two  thousand  three  shall  be  within amounts
appropriated for the two thousand three--two thousand four state  fiscal
year  and adjustments for the non-federal share of the additional amount
of four million nine hundred twelve thousand  dollars  ($4,912,000)  for
such  period  shall  be  allocated by the director of the budget from an
appropriation  for  maintenance  undistributed  general  fund  community
projects  fund  -  007  account for the two thousand three--two thousand
four state fiscal year. The director of the budget  shall  allocate  the
non-federal  share  of  adjustments  for  the  period  April  first, two
thousand  five  through  June  thirtieth,  two  thousand  five  from  an
appropriation  for  the maintenance undistributed general fund community
projects fund - 007 - cc account for the two thousand four--two thousand
five state fiscal year. The director of the budget  shall  allocate  the
non-federal  share  of  adjustments  for  the  period October first, two
thousand six through December thirty-first, two  thousand  six  from  an
appropriation for the maintenance undistributed, general fund, community
projects  fund  - 007-cc account for the two thousand five--two thousand
six state fiscal year. The director of the  budget  shall  allocate  the
non-federal  share  of the additional adjustments for the period October
first, two thousand six through December thirty-first, two thousand  six
from  such  funds as may be made available from an appropriation for the
maintenance undistributed,  general  fund,  community  projects  fund  -
007-cc account for the two thousand six--two thousand seven state fiscal
year. The director of the budget shall allocate the non-federal share of
the adjustments for the period October first, two thousand seven through
December  thirty-first, two thousand seven from an appropriation for the
medical assistance program, general fund, local assistance account - 001
for the two thousand seven--two thousand eight state  fiscal  year.  The
director  of  the  budget  shall  allocate  the non-federal share of the
adjustments for the period October first,  two  thousand  eight  through
December  thirty-first, two thousand eight from an appropriation for the
medical assistance program, general fund, local assistance account - 001
for the two thousand eight--two thousand nine  state  fiscal  year.  The
director  of  the  budget  shall  allocate  the non-federal share of the
adjustments for the period October  first,  two  thousand  nine  through
December  thirty-first,  two thousand nine from an appropriation for the
medical assistance program, general fund, local assistance account - 001
for the two thousand nine--two thousand  ten  state  fiscal  year.  Such
adjustments  to fee for service rates shall not be subject to subsequent
adjustment or reconciliation. Alternatively, such payments may  be  made
as aggregate payments to eligible providers.
(a-1)   Notwithstanding  the  provisions  of  paragraph  (a)  of  this
subdivision, for facilities licensed under article twenty-eight  of  the
public  health  law  that are sponsored by a university or dental school
which has been granted an  operating  certificate  pursuant  to  article
twenty-eight of the public health law and which provides dental services
as  its  principal  mission,  two  hundred  twenty-four thousand dollars
($224,000) in the aggregate for use pursuant to this  section  shall  be
allocated   for   distribution   to  such  facilities  pursuant  to  the
methodology  described  in  paragraph  (b)  of   subdivision   two   and

subparagraph  (i)  of  paragraph  (b) of subdivision four of section two
thousand eight hundred seven-p of the public  health  law  for  services
provided  for  the period February first, two thousand two through March
thirty-first, two thousand two to persons eligible for federal financial
participation  under  title  XIX  of  the  federal  social security act,
provided, however, that the amount paid pursuant to this  paragraph  for
each  such facility shall equal the facility's proportional share of the
total nominal payment amounts calculated under this section of all  such
facilities  multiplied  by  the total funds allocated for such payments.
There shall be no local share in these payments.  The  director  of  the
budget  shall  allocate  the  non-federal share of such payments from an
appropriation for the miscellaneous special revenue fund - 339 community
service  provider  assistance  program  account  for  the  two  thousand
one--two  thousand  two  state  fiscal year. Such adjustments to fee for
service  rates  shall  not  be  subject  to  subsequent  adjustment   or
reconciliation.  Alternatively,  such  payments may be made as aggregate
payments to eligible providers.
(a-2) (i) Notwithstanding the provisions  of  paragraph  (a)  of  this
subdivision,  for  facilities licensed under article twenty-eight of the
public health law that are sponsored by a university  or  dental  school
which  has  been  granted  an  operating certificate pursuant to article
twenty-eight of the public health law and which provides dental services
as its principal  mission,  two  hundred  twenty-four  thousand  dollars
($224,000)  in  the  aggregate  of  the  amount appropriated for the two
thousand two--two thousand three state fiscal year for use  pursuant  to
this  section  shall  be  allocated for the period October first through
December thirty-first, two thousand two and one hundred twelve  thousand
dollars  ($112,000)  in the aggregate of the amount appropriated for the
two  thousand  three--two  thousand  four  state  fiscal  year,  and  an
additional  amount  of one hundred twelve thousand dollars ($112,000) in
the aggregate for use pursuant to this section shall  be  allocated  for
the  period  October  first  through December thirty-first, two thousand
three and two hundred twenty-four thousand  dollars  ($224,000)  in  the
aggregate  of  the  amount  appropriated  for the two thousand four--two
thousand five state fiscal year shall be allocated for the period  April
first,  two thousand five through June thirtieth, two thousand five, and
two hundred twenty-four thousand dollars ($224,000) in the aggregate  of
the  amount  appropriated  for  the  two thousand five--two thousand six
state fiscal year shall be allocated for the period October  first,  two
thousand  six  through  December  thirty-first, two thousand six, and an
additional two hundred twenty-four thousand dollars  ($224,000)  in  the
aggregate  of  the  amount  appropriated  for  the two thousand six--two
thousand seven state fiscal year  shall  be  allocated  for  the  period
October  first,  two  thousand  six  through  December thirty-first, two
thousand six, and two hundred twenty-four thousand dollars ($224,000) in
the aggregate of the amount appropriated for the two thousand seven--two
thousand eight state fiscal year  shall  be  allocated  for  the  period
October  first,  two  thousand  seven through December thirty-first, two
thousand seven, and two hundred twenty-four thousand dollars  ($224,000)
in  the  aggregate  of  the  amount  appropriated  for  the two thousand
eight--two thousand nine state fiscal year shall be  allocated  for  the
period  October first, two thousand eight through December thirty-first,
two  thousand  eight  and  two  hundred  twenty-four  thousand   dollars
($224,000)  in  the  aggregate  of  the  amount appropriated for the two
thousand nine--two thousand ten state fiscal year shall be allocated for
the  period  October  first,  two   thousand   nine   through   December
thirty-first,  two  thousand  nine  for  distribution to such facilities
pursuant to subparagraphs (ii) and (iii) of this paragraph.  Adjustments

for the non-federal share of the additional amount of one hundred twelve
thousand  dollars  ($112,000) for the period October first, two thousand
three  through  December  thirty-first,  two  thousand  three  shall  be
allocated  by  the  director  of  the  budget  from an appropriation for
maintenance undistributed general fund community  projects  fund  -  007
account for the two thousand three--two thousand four state fiscal year.
The  non-federal  share  of  adjustments for the period April first, two
thousand five  through  June  thirtieth,  two  thousand  five  shall  be
allocated  by  the  director of the budget from an appropriation for the
maintenance undistributed general fund community  projects  fund  -  007
account  for the two thousand four--two thousand five state fiscal year.
The non-federal share of adjustments for the period October  first,  two
thousand  six  through  December thirty-first, two thousand six shall be
allocated by the director of the budget from an  appropriation  for  the
maintenance  undistributed,  general  fund,  community  projects  fund -
007-cc account for the two thousand five--two thousand six state  fiscal
year. The non-federal share of the additional adjustments for the period
October  first,  two  thousand  six  through  December thirty-first, two
thousand six shall, subject to the availability of funds,  be  allocated
by  the  director  of  the  budget  from  the  medical  assistance local
assistance appropriation for the two thousand  six--two  thousand  seven
state  fiscal  year.  The  non-federal  share of the adjustments for the
period October first, two thousand seven through December  thirty-first,
two thousand seven shall be allocated by the director of the budget from
an appropriation for the medical assistance program, general fund, local
assistance  account - 001 for the two thousand seven--two thousand eight
state fiscal year. The non-federal share  of  the  adjustments  for  the
period  October first, two thousand eight through December thirty-first,
two thousand eight shall be allocated by the director of the budget from
an appropriation for the medical assistance program, general fund, local
assistance account - 001 for the two thousand eight--two  thousand  nine
state  fiscal  year.  The  non-federal  share of the adjustments for the
period October first, two thousand nine through  December  thirty-first,
two  thousand nine shall be allocated by the director of the budget from
an appropriation for the medical assistance program, general fund, local
assistance account - 001 for the two  thousand  nine--two  thousand  ten
state fiscal year.
(ii)  Forty  percent shall be allocated for equal distribution to such
facilities, reduced by the amount, if any, that a  distribution  exceeds
forty  percent  of  a  facility's  uncompensated care need as defined in
paragraph (b) of subdivision two of section two thousand  eight  hundred
seven-p   of  the  public  health  law.  Any  funds  allocated  but  not
distributed in accordance with this subparagraph shall be added to those
amounts distributed  in  accordance  with  subparagraph  (iii)  of  this
paragraph.
(iii)  Sixty  percent, plus any funds allocated and not distributed in
accordance with subparagraph (ii) of this paragraph, shall be  allocated
for   distribution  to  such  facilities  pursuant  to  the  methodology
described in paragraph (b) of subdivision two and  subparagraph  (i)  of
paragraph  (b) of subdivision four of section two thousand eight hundred
seven-p of the public health law, provided,  however,  that  the  amount
paid  pursuant to this allocation for each such facility shall equal the
facility's proportional share  of  the  total  nominal  payment  amounts
calculated  under  this section of all such facilities multiplied by the
total funds allocated for such payments.
(iv) There shall be no local share in these payments.
(b) Notwithstanding the provisions of subdivision one of section three
hundred sixty-eight-a of this title, there shall be paid to each  social

services  district  the full amount expended on behalf of the department
of health for medical assistance furnished pursuant to the provisions of
this section, after first deducting therefrom any federal funds properly
received or to be received on account thereof.
3.  (a)  For  periods  prior  to  January first, two thousand eight, a
covered provider described in subdivision one of this section  shall  be
qualified  to  receive  a  supplemental  payment  only  if its number of
medicaid visits for patient care services in the base year described  in
subparagraph (ii) of paragraph (b) of this subdivision equals or exceeds
twenty-five  percent  of  its  total  number  of visits for patient care
services and its number of medicaid visits for patient care services for
medicaid managed care enrollees equals or exceeds three percent  of  its
total number of medicaid visits during the base year. For periods on and
after January first, two thousand eight, a covered provider described in
subdivision  one  of  this  section  shall  be  qualified  to  receive a
supplemental payment only if it has  in  place  during  such  period  an
operational electronic health record system that meets such standards as
may  be  established  by  the  commissioner  of health and its number of
medicaid visits for patient care services in the base year described  in
subparagraph (ii) of paragraph (b) of this subdivision equals or exceeds
twenty-five  percent  of  its  total  number  of visits for patient care
services during the base year or its number of medicaid visits  combined
with  its  number  of  uninsured visits for patient care services in the
base year described in  subparagraph  (ii)  of  paragraph  (b)  of  this
subdivision  equals  or  exceeds  thirty  percent of its total number of
visits for patient care services during the base year.
(b) (i) For periods prior to January first, two thousand  eight,  each
qualified  provider described in paragraph (a) of this subdivision shall
receive a supplemental payment equal  to  such  provider's  proportional
share  of the total funds allocated pursuant to this section, based upon
the ratio of its visits from medical assistance recipients  enrolled  in
managed  care  during the base year to the total number of visits to all
such qualified providers by medical assistance  recipients  enrolled  in
managed  care  during  the  base  year. For periods on and after January
first,  two  thousand  eight,  each  qualified  provider  described   in
paragraph  (a)  of this subdivision shall receive a supplemental payment
equal to such provider's proportional share of the total funds allocated
pursuant to this section, based  upon  the  ratio  of  its  visits  from
medical  assistance  recipients during the base year to the total number
of visits from medical  assistance  recipients  to  all  such  qualified
providers during the base year.
(ii)  For  periods  prior  to  January  first, two thousand eight, for
purposes of the calculation described in this subdivision, the base year
will be two thousand, and the commissioner of health shall utilize  data
as  reported  on  the  2000  AHCF-1  cost  report initially submitted by
covered providers to  the  department  of  health  on  or  about  August
seventeenth,  two  thousand one. For periods on and after January first,
two thousand eight, for purposes of the calculation  described  in  this
subdivision,  the  base  year will be two years prior to the grant year,
and the commissioner of health shall utilize data as reported on  AHCF-1
cost  report  submitted by covered providers to the department of health
for such base year.
4. Payments made pursuant to this section shall constitute  additional
reimbursement  to  qualified  providers  and shall not be used to reduce
levels of other funding provided to qualified providers by  governmental
agencies.
5.  (a)  The  commissioner  of  health  shall  make medical assistance
payments to qualified providers from funds made  available  pursuant  to

the  provisions  of  this  section  contingent  upon  the receipt of all
federal approvals necessary and subject to the availability  of  federal
financial  participation  under title XIX of the federal social security
act  for  the  transitional  supplemental  payments.  In  the event such
federal approval is  not  received  prior  to  March  thirty-first,  two
thousand  two,  for  adjustments  for  the  period  February  first, two
thousand two through March thirty-first, two thousand two and  prior  to
October  first,  two thousand two for adjustments for the period October
first, two thousand two through December thirty-first, two thousand  two
and  prior  to October first, two thousand three for adjustments for the
period October first, two thousand three through December  thirty-first,
two  thousand  three,  and prior to October first, two thousand five for
adjustments for the period April first, two thousand five  through  June
thirtieth,  two  thousand five, and prior to October first, two thousand
six for adjustments for the  period  October  first,  two  thousand  six
through  December  thirty-first,  two thousand six, and prior to October
first, two thousand seven for adjustments for the period October  first,
two  thousand  seven  through December thirty-first, two thousand seven,
and prior to October first, two thousand eight for adjustments  for  the
period  October first, two thousand eight through December thirty-first,
two thousand eight, and prior to October first, two  thousand  nine  for
adjustments  for  the  period  October  first, two thousand nine through
December thirty-first, two thousand nine,  the  commissioner  of  health
shall make medical assistance payments to qualified providers consisting
of  the  state  share  amount available for purposes of this section and
apportioned in accordance  with  subdivisions  two  and  three  of  this
section.  In the event such federal approval is denied, such state share
amount payments shall be deemed to be grants to such qualified providers
and such qualified providers shall not be eligible to receive any  other
payments pursuant to this section.
(b)  The  commissioner  of  health  shall take all steps necessary and
shall use best efforts to secure federal financial  participation  under
title  XIX of the social security act, for the purposes of this section,
including the prompt submission of appropriate amendments to  the  title
XIX state plan.