New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter II - Administrative Rules and Regulations › Subchapter L - Hospitals and Related Facilities › Part 86 - Reporting and Rate Certifications for Facilities › Subpart 86-1 - Medical Facilities › Section 86-1.6 - Allowable costs

Current through Register Vol. 46, No. 28, July 10, 2024
(a) To be
					 considered as allowable in determining reimbursement rates, costs must be
					 properly chargeable to necessary patient care. Except as otherwise provided in
					 this Part, or in accordance with specific determination by the commissioner,
					 allowable costs shall be determined by the application of the principles of
					 reimbursement developed for determining payments under the title XVIII
					 (Medicare) program.
(b) Allowable
					 costs may not include costs for services that have not been approved by the
					 commissioner.
(c) Allowable cost
					 shall include a monetary value assigned to services provided by religious
					 orders and for services rendered by an owner and operator of a
					 facility.
(d) Allowable costs may
					 not include amounts in excess of reasonable or maximum title XVIII (Medicare)
					 costs or in excess of customary charges to the general public. This provision
					 shall not apply to services furnished by public providers free of charge or at
					 a nominal fee.
(e) Allowable costs
					 shall not include expenses or portions of expenses reported by individual
					 facilities which are determined by the commissioner not to be reasonably
					 related to the efficient production of service because of either the nature or
					 amount of the particular item.
(f)
					 Any general ceilings applied by the commissioner, as to allowable costs in the
					 computation of reimbursement rates, shall be published in a hospital memorandum
					 or other appropriate manner.
(g)
					 [
Reserved
]
(h)
					 Allowable costs shall not include costs which principally afford diversion,
					 entertainment or amusement to their owners, operators or employees.
(i) Allowable costs shall not include any
					 interest charged or penalty imposed by governmental agencies or courts, and the
					 costs of policies obtained solely to insure against the imposition of such a
					 penalty.
(j) Allowable costs shall
					 not include the direct or indirect costs of advertising, public relations and
					 promotion except in those instances where the advertising is specifically
					 related to the operation of the facility and not for the purpose of attracting
					 patients.
(k) Allowable costs shall
					 not include costs of contributions or other payments to political parties,
					 candidates or organizations.
(l)
					 Allowable costs shall include only that portion of the dues paid to any
					 professional association which has been demonstrated, to the satisfaction of
					 the commissioner, to be allocable to expenditures other than for public
					 relations, advertising and political contributions. Any such costs shall also
					 be subject to any cost ceilings that may be promulgated by the commissioner
					 pursuant to subdivision (f) of this section.
(m) [
Reserved
]
(n) Allowable costs shall not include any
					 element of cost, as determined by the commissioner, to have been created by the
					 sale of a medical facility.