New York Codes, Rules and Regulations › Title 18 - DEPARTMENT OF SOCIAL SERVICES › Chapter II - Regulations of the Department of Social Services › Subchapter F - Finance; Claims for Reimbursement by Social Services Districts › Article 1 - Reimbursement and Claims › Part 601 - Procedures Of Reimbursement Claiming › Section 601.3 - Reimbursement claiming time limits

Current through Register Vol. 46, No. 28, July 10, 2024
Except as otherwise provided, to be eligible for State
			   reimbursement, expenditures for public assistance, care and services, or for
			   any other activity which is subject to reimbursement by the department, must be
			   made within the time limits set forth in this section and must be included in a
			   claim submitted by the social services district to the department for the time
			   period in which such expenditures are claimed to have been made.
(a) Claims for expenditures which are subject
			 to reimbursement by the Federal government or entities other than the
			 department must be submitted to the department in sufficient time so that the
			 department can submit claims to the other claiming sources within the time
			 required by such sources. Claims submitted less than 40 days prior to the time
			 by which the department must submit claims for Federal reimbursement may be
			 considered to be submitted without sufficient time for the department to submit
			 such claims to other claiming sources.
(b) All claims for expenditures for which
			 Federal financial participation is available under the Social Security Act must
			 be submitted to the department so that such claim can be included in any claim
			 submissions by the department to the Secretary of the United States Department
			 of Health and Human Services within the two-year period which begins on the
			 first day of the calendar quarter immediately following the calendar quarter in
			 which such expenditures were made, except with respect to any expenditure
			 involving court-ordered retroactive payments on audit exceptions, or
			 adjustments to prior year costs, unless a waiver for good cause has been made
			 by such Secretary for the particular expenditures submitted.
(c) Except as otherwise provided within the
			 requirements for any particular activity, expenditures made by a social
			 services district may not be reimbursed if such costs are related to
			 expenditures, services, supplies or other costs incurred on behalf of a
			 recipient or an individual more than 12 months prior to the month in which the
			 claim for reimbursement is made, unless such costs are specifically approved by
			 the department.
(d) Claims which
			 are rejected will be reexamined only if resubmitted within six months following
			 the date of rejection, provided (1) the initial submittal was made in
			 accordance with the provisions of subdivision (a) of this section, and (2) the
			 costs or expenditures subject to reimbursement in the resubmitted claim are
			 submitted to the department in sufficient time so that the department can
			 submit such claims to any other claiming source within the time required by
			 such source.
(e) The provisions of
			 this section shall not prevent the department from approving and certifying a
			 claim for State reimbursement when in its judgment the claim has merit and, for
			 good cause, could not have been submitted within the time limits prescribed.
			 The provisions of this subdivision may not be interpreted to require the
			 department to approve such claim.