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 86-5 - Long-term Home Health Care Programs › Section 86-5.17 - Allowable costs

Current through Register Vol. 46, No. 28, July 10, 2024
(a) To be
					 considered as allowable in determining reimbursement rates, costs shall be
					 properly chargeable to necessary patient care. Except as otherwise provided in
					 this Subpart, 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 title XVIII of the
					 Federal Social Security Act (Medicare) program.
(b) Allowable costs shall include a monetary
					 value assigned to services provided by religious orders and for services
					 rendered by an owner and operator of a LTHHCP.
(c) Allowable costs shall not include amounts
					 in excess of reasonable or maximum title XVIII of the Federal Social Security
					 Act (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.
(d)
					 Allowable costs shall not include expenses or portions of expenses reported by
					 individual LTHHCP which are determined by the commissioner not to be reasonably
					 related to the efficient production of long-term home health care services
					 because of either the nature or the amount of the particular item.
(e) Allowable costs shall not include costs
					 not properly related to patient care or treatment which principally afford
					 diversion, entertainment or amusement to owners, operators or employees of
					 LTHHCPs.
(f) Allowable costs shall
					 not include any interest charged related to rate determination or penalty
					 imposed by governmental agencies or courts, and the costs of policies obtained
					 solely to insure against the imposition of such a penalty.
(g) Allowable costs shall not include costs
					 of contributions or other payments to political parties, candidates or
					 organizations.
(h) 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 or political contributions.
(i) Allowable costs shall not include the
					 interest paid to a lender related through control, ownership, affiliation, or
					 personal relationship to the borrower, except in instances where the prior
					 approval of the Commissioner of Health has been obtained.
(j) Allowable costs shall be reduced by
					 income earned for Medicare Part B eligible services.
(k) Allowable costs shall include those costs
					 allocated to the LTHHCP from a related organization to the extent that:
(1) those costs are reasonably related to the
					 efficient production of long-term home health care services; and
(2) the bases of allocation of such costs are
					 consistent with regulations applicable to the cost reporting of the related
					 organization.