2023 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.