New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter II - Administrative Rules and Regulations › Subchapter H - Family Health › Part 69 - Family Health › Subpart 69-10 - NYS Medical Indemnity Fund › Section 69-10.9 - Prior approval requests for vehicle modifications

Current through Register Vol. 46, No. 28, July 10, 2024
(a) A vehicle modification request may only
					 be made for a vehicle owned by the enrollee or a member of the enrollee's
					 household who has consistent and ongoing contact with the enrollee and provides
					 unpaid primary, long-term support to the enrollee. Proof of ownership of the
					 vehicle by the enrollee or the enrollee's legal representative must be provided
					 to the fund administrator. A modification will be approved only if the vehicle
					 is the primary source of transportation for the participant and is used to
					 access services and supports in the community and to improve the enrollee's
					 independence and inclusion in the community.
(b) The vehicle modification request must be
					 accompanied by a vehicle modifications and equipment evaluation, based on the
					 enrollee's needs, that has been obtained from a driver rehabilitation
					 specialist who has been certified by the Association of Driver Rehabilitation
					 Specialists. The evaluation must specify the most cost effective and least
					 complicated vehicle modification that will ensure safe transportation, and exit
					 from and entrance into the vehicle for the participant, and include a detailed
					 scope of work and specifications.
(c) Modifications can only be made to
					 vehicles that are registered, insured and meet State inspection standards
					 before and after the modifications are completed.
(d) Modifications maybe made either to a
					 vehicle that is being purchased by the enrollee or a member of the enrollee's
					 household, or to a vehicle that is structurally sound, not in need of
					 mechanical repair as determined by the vehicle modifier, and is less than five
					 years old or registers less than 50,000 miles.
(e) Modifications to a vehicle that the
					 enrollee will not be driving are limited to modifications that are necessary to
					 ensure safe transportation and safe access into and out of the
					 vehicle.
(f) Only contractors that
					 meet Acces-VR's qualifications or if the enrollee lives in the District of
					 Columbia or a state other than New York, the qualifications required by the
					 district or other state for performing vehicle modifications may submit bids
					 for modifications.
(g) Once the
					 initial request has been reviewed by the fund administrator, the fund
					 administrator shall notify the enrollee or person authorized to act on the
					 enrollee's behalf in writing which services or items have been approved and/or
					 denied and inform the enrollee or person authorized to act on the enrollee's
					 behalf of the bidding process that is required prior to the fund administrator
					 approving payment for the vehicle modification. The enrollee or person
					 authorized to act on the enrollee's behalf is then required to obtain a minimum
					 of three acceptable bids from qualified contractors.
(h) Once the fund administrator receives from
					 the enrollee or person authorized to act on the enrollee's behalf a minimum of
					 three acceptable bids from qualified contractors, the fund administrator shall
					 evaluate the qualifications of each bidder and the content of each bid to
					 determine whether each bid is acceptable. If less than three are submitted, a
					 written explanation of why three accepted bids were not obtained must be
					 provided, as well as a written explanation of how the determination was made
					 that the one or two bids being considered are reasonably priced. In order to be
					 acceptable, a bid must:
(1) be signed by the
					 contractor or a person duly authorized to sign on behalf of the
					 contractor;
(2) specify the scope
					 of work and specifications of the work; and
(3) state that all work will be done in a
					 workmanlike manner, using materials suitable for purposes of the
					 modification.