reglab/statecodes huggingface dataset:
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 574 - Standards Pertaining To Payment For Hospitals Licensed By The Office Of Mental Health › Section 574.2 - Legal base

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Sections 7.09 and
				31.04  of the Mental Hygiene Law grant the
				Commissioner of Mental Health the power and responsibility to adopt regulations
				that are necessary and proper to implement matters under his or her
				jurisdiction.
(b) Sections 364 and
				364-a  of the Social Services Law gives the
				Office of Mental Health responsibility for establishing and maintaining
				standards for medical care and services in facilities operated by it or subject
				to its supervision pursuant to the Mental Hygiene Law.
(c) Section 43.02  of the Mental Hygiene Law provides
				that payments under the Medical Assistance Program for services at facilities
				licensed by the Office of Mental Health shall be at rates certified by the
				Commissioner of Mental Health and approved by the Director of the
				Budget.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 574 - Standards Pertaining To Payment For Hospitals Licensed By The Office Of Mental Health › Section 574.3 - Applicability

Current through Register Vol. 46, No. 28, July 10, 2024
(a) These
				regulations apply to hospitals licensed pursuant to article 31 of the Mental
				Hygiene Law and issued operating certificates in accordance with Part 582 of
				this Title.
(b) These regulations
				apply to payments made by government agencies pursuant to title 11 of article 5
				of the Social Services Law for services provided by a hospital licensed by the
				Office of Mental Health in accordance with the provisions of Part 582 of this
				Title.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 574 - Standards Pertaining To Payment For Hospitals Licensed By The Office Of Mental Health › Section 574.4 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Alternate level
				of care services shall mean services provided by a hospital to a patient for
				whom it has been determined that hospital services are not medically necessary,
				but that skilled nursing or health-related services are medically necessary,
				and are being provided by the hospital and are not otherwise
				available.
(b) Commissioner shall
				mean the Commissioner of Mental Health.
(c) Hospital shall mean a facility providing
				inpatient care or treatment of persons with mental illness which has been
				issued an operating certificate by the Office of Mental Health pursuant to
				article 31 of the Mental Hygiene Law and in accordance with Part 582 of this
				Title. For purposes of this Part, the term hospital shall not include hospitals
				licensed pursuant to article 28 of the Public Health Law, residential treatment
				facilities for children and youth issued an operating certificate in accordance
				with Part 584 of this Title and hospitals within the Office of Mental
				Health.
(d) Medical Assistance
				Program shall mean the program of medical assistance to needy persons
				authorized under title 11 of article 5 of the Social Services Law, and
				regulations, as identified in section
				502.2(d) 
				of this Title, promulgated thereunder and title XIX of the Social Security Act,
				as identified in section
				502.2(c) 
				of this Title and regulations promulgated thereunder.
(e) Patient day shall mean the unit of
				measure denoting lodging provided and services rendered to one patient between
				the census-taking hour on two successive days. A patient day is counted on the
				day of admission but not on the day of discharge. A patient day is counted when
				a patient is admitted as an inpatient with the expectation of remaining
				overnight but is discharged on the same day.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 574 - Standards Pertaining To Payment For Hospitals Licensed By The Office Of Mental Health › Section 574.5 - Standards pertaining to eligibility for payment

Current through Register Vol. 46, No. 28, July 10, 2024
(a) A hospital is eligible for payment under
				the Medical Assistance Program under the following conditions:
(1) The hospital has a valid operating
				certificate issued by the Office of Mental Health, in accordance with Part 582
				of this Title.
(2) The hospital
				complies with applicable requirements of title XIX of the Social Security Act,
				as identified in section
				502.2(c) 
				of this Title and regulations, as identified in section
				502.2(d) 
				of this Title, promulgated thereunder.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 575 - Community Support Services For The Mentally Ill › Section 575.1 - Background and intent

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The purpose
				of the community support services program, is to provide comprehensive support
				services within the community setting for those individuals who are seriously
				and chronically mentally ill and living in the community.
(b) The purpose of these regulations is to
				establish the community support services program under the jurisdiction of the
				Commissioner of Mental Health.
(c)
				The purpose of these regulations is to establish standards and describe the
				eligibility criteria for the community support services program by defining the
				characteristics of seriously and chronically mentally ill
				individuals.
(d) These regulations
				reinforce the State and local partnership in the provision of community support
				services for seriously and chronically mentally ill individuals.
(e) These regulations do not establish an
				entitlement program.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 575 - Community Support Services For The Mentally Ill › Section 575.2 - Legal base

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Section 7.09  of the Mental Hygiene Law grants the
				Commissioner of Mental Health the power and responsibility to adopt regulations
				that are necessary and proper to implement matters under his or her
				jurisdiction.
(b) Section 41.47  of the Mental Hygiene Law grants the
				Commissioner of Mental Health the power and responsibility to promulgate
				regulations to implement provisions of the community support services
				program.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 575 - Community Support Services For The Mentally Ill › Section 575.3 - Applicability

Current through Register Vol. 46, No. 28, July 10, 2024
(a) These
				regulations apply to a local governmental unit which elects to participate in
				the community support services program.
(b) These regulations apply to a provider of
				services which has contracted with a local governmental unit to provide a
				community support service.
(c)
				These regulations apply to any provider of services which has a direct contract
				with the Office of Mental Health to provide a community support
				service.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 575 - Community Support Services For The Mentally Ill › Section 575.5 - Participation in the community support services program

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Participation by a local governmental
				unit in the community support services program shall be contingent upon an
				affirmative election by the local governmental unit prior to May 1, 1987 or May
				1st of any year. Such participation shall take effect in the following local
				fiscal year.
(b) A local
				governmental unit which elects to participate in the community support services
				program shall have responsibility for the coordination of the community support
				services program within its defined geographical area in accordance with the
				local government plan. Such responsibilities shall include:
(1) incorporating the community support
				services program into the local government plan pursuant to article 41 of the
				Mental Hygiene Law;
(2) providing
				community support services and core services to eligible individuals directly
				or through contract with a provider of services;
(3) providing community support services and
				core services to eligible individuals, who were formerly served through direct
				contracts prior to election by the local governmental unit to participate in
				the community support services program. Such provision of community support
				services shall begin with the local fiscal year following the election to
				participate in the community support services program; except as provided in
				subdivision (a) of this section; and
(4) assuring that a provider of services
				which has satisfactorily provided community support services pursuant to the
				regulations of the commissioner in the last complete local fiscal year
				preceding April 1, 1987 shall have the opportunity to continue to provide the
				same level of such service for a period of at least two local fiscal years,
				beginning with the initial year of participation by the local governmental unit
				in the community support services program.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 575 - Community Support Services For The Mentally Ill › Section 575.6 - Standards pertaining to eligibility

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Eligibility of an individual to receive
				services of the community support services program shall be certified by a
				nurse, psychiatrist, psychologist or social worker as defined in section
				575.4  of
				this Part.
(b) Eligibility of an
				individual to receive services of the community support services program shall
				be determined in accordance with the following criteria:
(1) the individual is at least 18 years of
				age; and
(2) is functionally
				disabled as a result of mental illness as defined in section
				575.4  of
				this Part; and
(3) is in serious
				jeopardy to remain in the community without the provision of community support
				services; and
(4) meets one of the
				permanent criteria of subdivision (c) of this section; or
(5) meets one of the categorical criteria of
				subdivision (d) of this section.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 575 - Community Support Services For The Mentally Ill › Section 575.7 - Standards pertaining to waiver of eligibility

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Eligibility criteria may be waived for an
				individual who is determined to be eligible pursuant to section
				575.6(b) 
				of this Part, but who does not qualify for community support services under the
				permanent eligibility criteria of section
				575.6(c) 
				of this Part or the categorical eligibility criteria of section
				575.6(d) 
				of this Part.
(b) Waivers
				authorized pursuant to this section shall be permitted if it is determined by a
				nurse, psychiatrist, psychologist or social worker, as defined in section
				575.4  of
				this Part, that exclusion from the community support services program shall
				result in:
(1) admission to an inpatient
				psychiatric facility;
(2)
				inappropriate removal of the individual from his or her current residential
				setting; or
(3) a marked decline in
				the individual's mental or physical condition.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 575 - Community Support Services For The Mentally Ill › Section 575.8 - Responsibilities of the office of mental health for the provision of community support services

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The Office
				of Mental Health shall be responsible for the maintenance and development of
				the community support services program, as appropriate, in areas where the
				local governmental unit has not elected to participate in the community support
				services program.
(b) The Office of
				Mental Health shall be responsible for the continuation of direct contracts
				with providers of services, where appropriate, when the local governmental unit
				has not elected to participate in the community support services
				program.
(c) Prior to entering into
				contracts for the provision of community support services with providers of
				services or local governmental units, the Office of Mental Health and the local
				governmental unit shall consider the following:
(1) the service needs of seriously and
				chronically mentally ill individuals in the geographical area in which the
				community support services program is located;
(2) the capacity of the program to meet
				identified service needs;
(3) the
				current availability of services for seriously and chronically mentally ill
				individuals in the area, including the special needs of ethnic minorities and
				non-English speaking mentally ill individuals;
(4) the extent to which community support
				services authorized by the contract will be integrated with other available
				services in the area to more effectively maintain seriously and chronically
				mentally ill individuals in the community;
(5) the availability of resources for such
				services;
(6) the extent to which
				the community support services authorized by the contract are consistent with
				and integrated with the local government plan of the geographical area to be
				served; and
(7) the extent to which
				such contracts conform with the minimum contractual requirements as established
				by the commissioner.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 575 - Community Support Services For The Mentally Ill › Section 575.9 - Standards pertaining to recordkeeping

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Providers of services shall maintain
				records for verification of all eligible individuals receiving community
				support services, including individuals who have an eligibility waiver pursuant
				to section
				575.7 
				of this Part, in accordance with reporting forms as prescribed by the Office of
				Mental Health.
(b) The records of
				all eligible individuals receiving community support services, including
				individuals who have an eligibility waiver pursuant to section
				575.7 
				of this Part, shall be confidential and access shall be governed by the
				requirements of section 33.13  of the Mental Hygiene Law.
(c) Providers of services shall maintain
				records for verification of eligibility. Such records shall include but not be
				limited to:
(1) hospitalization
				history;
(2) psychiatric
				diagnosis;
(3) outpatient
				history;
(4) functional disability
				assessment;
(5) residential history
				or current residence for both permanent or categorical eligibility as
				applicable; and
(6) record of
				receipt of supplemental security income or social security disability insurance
				benefits.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 576 - Standards Pertaining To Payment For Residential Treatment Facilities For Children And Youth › Section 576.1 - Background and intent

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The purpose
				of these regulations is to establish standards pertaining to payments made by
				government agencies pursuant to title 11 of article 5 of the Social Services
				Law for services provided to residents of residential treatment facilities for
				children and youth licensed by the Office of Mental Health in accordance with
				the provisions of Part 584 of this Title.
(b) In order to be eligible for payments
				pursuant to title 11 of article 5 of the Social Services Law, a residential
				treatment facility for children and youth must comply with the requirements of
				the Mental Hygiene Law, this Title, 18 NYCRR, and title XIX of the Social
				Security Act as identified in section
				502.2(c) 
				of this Title, applicable to inpatient psychiatric services for individuals
				under age 21.
(c) The Medical
				Assistance Program in New York State is administered by the New York State
				Department of Social Services by and through local social services districts in
				cooperation with various State agencies including the Office of Mental Health;
				and by the New York State Department of Social Services by and through various
				State agencies, including the Office of Mental Health.
(d) The standards for payment established by
				these regulations are intended to limit residential treatment facilities for
				children and youth eligible for payment to those that meet State and Federal
				requirements and to limit days eligible for payment to those on which services
				are rendered or for which a bed has been appropriately reserved.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 576 - Standards Pertaining To Payment For Residential Treatment Facilities For Children And Youth › Section 576.2 - Legal base

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Sections 7.09 and
				31.04  of the Mental Hygiene Law grant the
				Commissioner of Mental Health the power and responsibility to adopt regulations
				that are necessary and proper to implement matters under his or her
				jurisdiction.
(b) Sections 364 and
				364-a  of the Social Services Law gives the
				Office of Mental Health responsibility for establishing and maintaining
				standards for medical care and services in facilities operated by it or subject
				to its supervision pursuant to the Mental Hygiene Law.
(c) Section 43.02  of the Mental Hygiene Law provides
				that payments under the Medical Assistance Program for services at facilities
				licensed by the Office of Mental Health shall be at rates certified by the
				Commissioner of Mental Health and approved by the Director of the
				Budget.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 576 - Standards Pertaining To Payment For Residential Treatment Facilities For Children And Youth › Section 576.3 - Applicability

Current through Register Vol. 46, No. 28, July 10, 2024
(a) These
				regulations apply to residential treatment facilities for children and youth
				licensed pursuant to article 31 of the Mental Hygiene Law and issued operating
				certificates in accordance with Part 584 of this Title.
(b) These regulations apply to payments made
				by government agencies pursuant to title 11 of article 5 of the Social Services
				Law for services provided by a residential treatment facility for children and
				youth licensed by the Office of Mental Health in accordance with the provisions
				of Part 584 of this Title.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 576 - Standards Pertaining To Payment For Residential Treatment Facilities For Children And Youth › Section 576.4 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Commissioner
				shall mean the Commissioner of Mental Health.
(b) Medical assistance program shall mean the
				program of medical assistance to needy persons authorized under title 11 of
				article 5 of the Social Services Law and regulations promulgated thereunder and
				title XIX of the Social Security Act, as identified in section
				502.2(c) 
				of this Title and regulations, as identified in section
				502.2(d) 
				of this Title, promulgated thereunder.
(c) Patient day shall mean the unit of
				measure denoting lodging provided and services rendered to one resident between
				the census-taking hour on two successive days. A patient day is counted on the
				day of admission but not on the day of discharge. A patient day is counted when
				a resident is admitted with the expectation of remaining overnight but is
				discharged on the same day. A patient day is counted on the day a resident
				returns from temporary hospitalization or leave of absence for a therapy day,
				but not on the day a resident departs.
(d) Reserved bed day shall mean the unit of
				measure between the census-taking hour on two successive days during which a
				bed is reserved for a resident who is temporarily hospitalized or is on leave
				of absence for a therapy day in accordance with the provisions of section
				576.6 
				of this Part. A reserved bed day is counted on the day a resident departs for
				temporary hospitalization or leave of absence for a therapy day but not on the
				day a resident returns. A reserved bed day is counted on the day telephone
				notification is received of circumstances requiring termination of the bed
				reservation but not on any subsequent days. In no event may a reserved bed day
				be counted on a day for which a patient day is counted.
(e) Residential treatment facility shall mean
				an inpatient psychiatric facility which provides active treatment under the
				direction of a physician for children who are under 21 years of age and which
				is issued an operating certificate pursuant to Part 584 of this
				Title.
(f) A therapy day is a day
				when a resident is not receiving residential treatment facility services
				on-site between the census-taking hour on two successive days due to being away
				from the residential treatment facility to spend time with family or friends in
				accordance with the implementation of the resident's individual treatment
				plan.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 576 - Standards Pertaining To Payment For Residential Treatment Facilities For Children And Youth › Section 576.5 - Standards pertaining to eligibility for payment

Current through Register Vol. 46, No. 28, July 10, 2024
(a) A residential treatment facility is
				eligible for payment under the Medical Assistance Program under the following
				conditions:
(1) The residential treatment
				facility has a valid operating certificate issued by the Office of Mental
				Health, in accordance with Part 584 of this Title.
(2) The residential treatment facility
				complies with applicable requirements of title XIX of the Social Security Act
				and regulations promulgated thereunder.
(3) The residential treatment facility
				complies with applicable requirements of title 11 of article 5 of the Social
				Services Law and regulations promulgated thereunder.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 576 - Standards Pertaining To Payment For Residential Treatment Facilities For Children And Youth › Section 576.7 - Documentation requirements for reserved bed days

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The residential treatment facility shall
				maintain a register of each resident who is absent from the residential
				treatment facility for 24 hours beyond the normal census-taking hour. Such
				register shall include, at a minimum, the resident's name, the reason for the
				absence and the final disposition of the absence.
(b) The temporary hospitalization or leave of
				absence for a therapy day shall be documented in the case record. At a minimum,
				progress notes shall be written describing the reason for the temporary
				hospitalization or leave of absence for a therapy day; the duration; any
				significant events that occurred; and the effects, if any, on the resident's
				condition or course of treatment.
(c) The residential treatment facility shall
				document, in accordance with procedures prescribed by the Office of Mental
				Health all actions required to demonstrate compliance with the requirements of
				this Part, including telephone notification and correspondence with hospitals,
				requests for extensions and approvals of extensions. Such documentation shall
				be retained by the residential treatment facility.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 577 - Rates Of Reimbursement-hospitals Licensed By The Office Of Mental Health › Section 577.1 - Background and intent

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The purpose
				of this Part is to establish standards and methods for determining rates of
				payment made by government agencies pursuant to title 11 of article 5 of the
				Social Services Law for services provided by hospitals licensed by the Office
				of Mental Health, other than hospitals licensed pursuant to article 28 of the
				Public Health Law and issued an operating certificate in accordance with Part
				580 of this Title, residential treatment facilities for children and youth
				issued an operating certificate in accordance with Part 584 of this Title and
				hospitals within the Office of Mental Health.
(b) The rates of payment determined under the
				standards and methods established by this Part are intended to be reasonable
				and adequate to meet the costs which must be incurred by efficiently and
				economically operated hospitals in order to provide care and services in
				conformity with applicable State and Federal law, regulations and quality and
				safety standards.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 577 - Rates Of Reimbursement-hospitals Licensed By The Office Of Mental Health › Section 577.2 - Legal base

Current through Register Vol. 46, No. 28, July 10, 2024
Sections 7.09 and
				  43.02  of the Mental Hygiene Law grant the
				  commissioner the power and responsibility to adopt regulations that are
				  necessary and proper to implement matters under his/her jurisdiction and to
				  establish standards and methods for determining rates of payment made by
				  government agencies pursuant to title 11 of article 5 of the Social Services
				  Law for services provided by facilities, including hospitals, licensed by the
				  Office of Mental Health pursuant to article 31 of the Mental Hygiene
				  Law.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 577 - Rates Of Reimbursement-hospitals Licensed By The Office Of Mental Health › Section 577.3 - Applicability

Current through Register Vol. 46, No. 28, July 10, 2024
(a) These
				regulations apply to any hospital licensed pursuant to article 31 of the Mental
				Hygiene Law and issued an operating certificate in accordance with Part 582 of
				this Title.
(b) These regulations
				establish rates of payment made by government agencies pursuant to title 11 of
				article 5 of the Social Services Law for services provided by hospitals, as
				defined herein. All payments by such agencies shall be at rates certified by
				the commissioner and approved by the Director of the Budget in accordance with
				section
				577.8 
				of this Part.
(c) These regulations
				do not apply to hospitals licensed pursuant to article 28 of the Public Health
				Law and issued an operating certificate in accordance with Part 580 of this
				Title, residential treatment facilities for children and youth issued an
				operating certificate in accordance with Part 584 of this Title, and hospitals
				within the Office of Mental Health.
(d) In the event that the State cannot
				provide assurances satisfactory to the secretary of the Department of Health
				and Human Services that the rates of payment comply with the Medicare upper
				limit requirement, such rates of payment shall be adjusted proportionally as
				necessary to meet Federal requirements for securing Federal financial
				participation.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 577 - Rates Of Reimbursement-hospitals Licensed By The Office Of Mental Health › Section 577.4 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Allowable costs
				shall mean costs incurred by a hospital which are eligible for payment by
				government agencies in accordance with title 11 of article 5 of the Social
				Services Law. To be allowable, costs must be reasonable and must relate to
				patient care. Allowable costs shall not include costs for services which have
				not been approved by the commissioner.
(b) Commissioner shall mean the Commissioner
				of Mental Health.
(c) Hospital
				shall mean a facility providing inpatient care or treatment of the mentally ill
				which has been issued an operating certificate by the Office of Mental Health
				pursuant to article 31 of the Mental Hygiene Law and in accordance with Part
				582 of this Title. New hospital shall mean a facility providing inpatient care
				for the treatment of the mentally ill, pursuant to this subdivision, which has
				no previous cost experience or operating experience. For purposes of this Part,
				the term hospital shall not include hospitals licensed pursuant to article 28
				of the Public Health Law, residential treatment facilities for children and
				youth issued an operating certificate in accordance with Part 584 of this
				Title, and hospitals within the Office of Mental Health.
(d) Hospital fiscal year shall mean the
				12-month period between settlements by the hospital of its financial accounts.
				Effective January 1, 1993, the hospital fiscal year shall mean the 12-month
				period January through December.
(e) Medicare program shall mean the Federal
				program of health insurance for the aged and disabled established by title
				XVIII of the Social Security Act, as identified in section
				502.2(b) 
				of this Title, and regulations, as identified in section
				502.2(d) 
				of this Title, promulgated thereunder.
(f) Patient day shall mean the unit of
				measure denoting lodging provided and services rendered to one patient between
				the census-taking hours on two successive days. A patient day is counted on the
				day of admission but not on the day of discharge. A patient day is counted when
				a patient is admitted as an inpatient, with the expectation of remaining
				overnight, but is discharged on the same day.
(g) Rate year shall mean the 12-month period
				during which a rate established in accordance with section
				577.7  of this
				Part is in effect.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 577 - Rates Of Reimbursement-hospitals Licensed By The Office Of Mental Health › Section 577.5 - Financial reports

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Each
				hospital shall maintain records, and shall prepare and submit to the
				commissioner financial and statistical reports in accordance with the
				requirements of the commissioner.
(b) All reports required to be prepared and
				submitted to the commissioner:
(1) shall be
				prepared in accordance with generally accepted accounting principles, unless
				otherwise required by the commissioner;
(2) shall be certified by an officer or
				administrator of the hospital; and
(3) shall be subject to audit pursuant to
				section
				577.6  of this
				Part.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 577 - Rates Of Reimbursement-hospitals Licensed By The Office Of Mental Health › Section 577.6 - Audits

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Each hospital
				shall maintain the statistical and financial records which formed the basis of
				the reports submitted to the commissioner for six years from the date on which
				the reports were submitted to the commissioner, or for such longer period as
				may be required under Federal law.
(b) All such records shall be subject to
				audit for a period of six years from the later of the date on which all
				required reports were filed with the commissioner or the date on which such
				reports were due.
(c) The
				commissioner may enter into agreements with the Department of Health or other
				organizations or other agencies having audit responsibilities to audit the
				financial and statistical records of hospitals. The conduct of such audits by
				the Department of Health shall be done in accordance with procedures as set
				forth in applicable regulations of the Department of Health and shall be
				subject to any fees that may be set for the purpose of funding such audits as
				may be established pursuant to said regulations. Audits of Medicaid by the
				Office of Mental Health shall also be conducted in accordance with procedures
				as set forth in applicable Department of Health regulations or as set forth in
				agreement(s) between the Office of Mental Health and the Department of Health.
				All other audits shall be done in accordance with this Part.
(d) Audits which are conducted by the Office
				of Mental Health, or by its designee, other than audits conducted by the
				Department of Health pursuant to subdivision (c) of this section, shall be
				conducted in accordance with Part 552 of this Title and the following
				procedures:
(1) In addition to the draft audit
				report issued in accordance with section
				552.6(a) 
				of this Title a notice of the proposed rate revision shall be sent to the
				hospital.
(2) In addition to the
				provider's response to the final audit report required in section
				552.7(e) 
				of this Title, proposed rate revisions resulting from the implementation of
				audit findings shall be final unless within 45 days of receipt of the proposed
				rate revision, the hospital requests a hearing on factual issues. Requests for
				hearings, and the conduct of such hearings, shall be pursuant to Part 503 of
				this Title.
(3) Revisions to rates
				determined in accordance with the provisions of this paragraph shall be
				retroactive to the rate year covered by the audit. Any resulting overpayment
				shall be satisfied by either retroactive adjustments of the provisional rate
				paid, based on the period audited, or prospective adjustment of the current
				certified rate at the discretion of the commissioner.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 577 - Rates Of Reimbursement-hospitals Licensed By The Office Of Mental Health › Section 577.7 - Rates

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Payment rates
				shall be established on a prospective basis effective January 1, 1992 and each
				January 1st thereafter, except that the rate of payment effective January 1,
				2012 through December 31, 2012, and January 1, 2013 through December 31, 2013,
				shall be a continuance of the rate of payment effective December 31, 2011, and
				shall be provisional pending the completion of an audit in accordance with
				section
				577.6  of this
				Part.
(b) Payment rates are
				computed on a per diem basis by dividing allowable costs by allowable patient
				days. Allowable patient days shall not exceed a maximum utilization of 98
				percent of certified capacity. The allowable costs and patient days shall
				include the cost of psychiatric inpatient and related ancillary services, and
				as applicable, the cost of alcoholism inpatient and related ancillary
				services.
(c) Allowable costs are
				determined from hospital cost reports, as defined in section
				577.5  of this
				Part, subject to the following priority of definitions of allowable cost:
(1) this Part;
(2) allowable costs under Federal Medical
				Assistance Program;
(3) allowable
				cost under the Medicare Program;
(4) generally accepted accounting principles;
				and
(5) as determined by audit in
				accordance with section
				577.6  of this
				Part.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 577 - Rates Of Reimbursement-hospitals Licensed By The Office Of Mental Health › Section 577.8 - Certification and approval of rates

Current through Register Vol. 46, No. 28, July 10, 2024
Payment rates established in accordance with the provisions
				  of section
				  577.7  of this
				  Part, or revised in accordance with the provisions of section
				  577.9  of this
				  Part, shall be certified by the commissioner and shall be approved by the
				  Director of the Budget.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 577 - Rates Of Reimbursement-hospitals Licensed By The Office Of Mental Health › Section 577.9 - Revisions to rates

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The
				commissioner may consider only those requests for revisions to certified rates
				which are based on:
(1) errors made by the
				Office of Mental Health in the calculation of the rate;
(2) errors in the financial or statistical
				data submitted to the commissioner by the hospital;
(3) significant changes in the overall
				operating costs of a hospital resulting from the implementation of substantial
				changes in programs or services approved for implementation under applicable
				provisions of the Mental Hygiene Law, Part 366, Part 551, and Part 1010 of this
				Title; and
(4) significant changes
				in the overall capital costs of a hospital resulting from substantial capital
				projects approved under applicable provisions of the Mental Hygiene Law, Part
				366, Part 551, and Part 1010 of this Title.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 578 - Medical Assistance Rates Of Payment For Residential Treatment Facilities For Children And Youth › Section 578.1 - Background and intent

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The purpose
				of these regulations is to establish standards and methods for determining
				rates of payment made by government agencies pursuant to title 11 of article 5
				of the Social Services Law for services provided by a residential treatment
				facility for children and youth licensed by the Office of Mental Health in
				accordance with the provisions of Part 584 of this Title.
(b) In order to be eligible for payments
				pursuant to title 11 of article 5 of the Social Services Law, a residential
				treatment facility for children and youth must meet the requirements of the
				Mental Hygiene Law and the requirements of title XIX of the Social Security
				Act, as identified in section
				502.2(d) 
				of this Title.
(c) The rates of
				payment established according to these regulations are intended to be adequate
				to meet the costs of an efficiently operated facility.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 578 - Medical Assistance Rates Of Payment For Residential Treatment Facilities For Children And Youth › Section 578.2 - Legal base

Current through Register Vol. 46, No. 28, July 10, 2024
Sections 7.09, 41.41 and
				  43.02  of the Mental Hygiene Law grant the
				  commissioner the power and responsibility to adopt regulations that are
				  necessary and proper to implement matters under his jurisdiction and to
				  establish standards and methods for determining rates of payment made by
				  government agencies pursuant to title 11 of article 5 of the Social Services
				  Law for services provided by facilities, including residential treatment
				  facilities for children and youth licensed by the Office of Mental
				  Health.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 578 - Medical Assistance Rates Of Payment For Residential Treatment Facilities For Children And Youth › Section 578.3 - Applicability

Current through Register Vol. 46, No. 28, July 10, 2024
(a) These
				regulations apply to any residential treatment facility for children and youth
				licensed pursuant to article 31 of the Mental Hygiene Law and issued an
				operating certificate in accordance with Part 584 of this Title.
(b) These regulations apply to the
				establishment of rates of payment made by government agencies pursuant to title
				11 of article 5 of the Social Services Law for services provided by a
				residential treatment facility for children and youth. All payments by such
				agencies shall be at rates of payment certified by the commissioner and
				approved by the Director of the Budget pursuant to section
				578.10 
				of this Part.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 578 - Medical Assistance Rates Of Payment For Residential Treatment Facilities For Children And Youth › Section 578.4 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Allowable costs
				shall mean those costs incurred by a residential treatment facility for
				children and youth. To be allowable, costs must be reasonable and must relate
				to patient care.
(b) Allowable days
				shall mean the total of patient days and reserve bed days provided by a
				residential treatment facility for children and youth subject to a minimum and
				maximum utilization standard pursuant to section
				578.13  of
				this Part.
(c) Commissioner shall
				mean the Commissioner of Mental Health.
(d) Fiscal year of a residential treatment
				facility for children and youth shall mean the 12-month period beginning on
				July 1st and ending on June 30th.
(e) Medicare program shall mean the Federal
				program of health insurance for the aged and disabled established by title
				XVIII of the Social Security Act.
(f) Patient day shall mean the unit of
				measure denoting lodging provided and services rendered to one resident between
				the census-taking hour on two successive days. A patient day is counted on the
				day of admission, but not on the day of discharge. A patient day is counted
				when a resident is admitted with the expectation of remaining overnight but is
				discharged on the same day. A patient day is counted on the day a resident
				returns from temporary hospitalization or leave of absence for a therapy day,
				but not on the day a resident departs.
(g) Provider of services means the
				organization which is legally responsible for the operation of a program. The
				organization may be an individual, partnership, association, corporation,
				public agency or a psychiatric center or institute operated by the Office of
				Mental Health.
(h) Reserved bed day
				shall mean the unit of measure between the census-taking hour on two successive
				days during which a bed is reserved for a resident who is temporarily
				hospitalized or is on leave of absence for a therapy day pursuant to Part 576
				of this Title. A reserved bed day is counted on the day a resident departs for
				a temporary hospitalization or leave of absence for a therapy day, but not on
				the day a resident returns. In no event may a reserved bed day be counted on a
				day for which a patient day is counted. A reserved bed day is counted on the
				day telephone notification is received of circumstances requiring termination
				of the bed reservation but not on any subsequent days.
(i) Residential treatment facility is an
				inpatient psychiatric facility which provides active treatment under the
				direction of a physician for children who are under 21 years of age and is
				issued an operating certificate pursuant to Part 584 of this Title.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 578 - Medical Assistance Rates Of Payment For Residential Treatment Facilities For Children And Youth › Section 578.5 - Financial reports

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Each
				residential treatment facility shall maintain records, and shall prepare and
				submit to the commissioner financial and statistical reports in accordance with
				the requirements of the commissioner.
(b) The accrual method of accounting shall be
				used.
(c) All reports required to
				be prepared and submitted to the commissioner:
(1) shall be prepared in accordance with
				generally accepted accounting principles, unless otherwise required by the
				commissioner; and
(2) shall be
				certified by an independent certified public accountant or an independent
				licensed public accountant and the operator or director of the residential
				treatment facility.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 578 - Medical Assistance Rates Of Payment For Residential Treatment Facilities For Children And Youth › Section 578.6 - Audits

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Each
				residential treatment facility shall maintain the statistical and financial
				records which formed the basis of the reports submitted to the commissioner for
				six years from the date on which the reports were submitted to the
				commissioner, or for such longer period as may be required under Federal
				law.
(b) All such records shall be
				subject to audit for a period of six years from the later of the date on which
				all required reports were filed with the commissioner or the date on which such
				reports were due.
(c) The
				commissioner may enter into agreements with the Department of Social Services
				or other organizations or agencies having audit responsibilities to audit the
				financial and statistical records of any residential treatment facility. The
				conduct of such audits by the Department of Social Services shall be done in
				accordance with procedures as set forth in applicable regulations of the
				Department of Social Services. Audits of Medicaid by the Office of Mental
				Health shall also be conducted in accordance with procedures as set forth in
				applicable Department of Social Services regulations or as set forth in
				agreement(s) between the Office of Mental Health and the Department of Social
				Services. All other audits shall be done in accordance with this
				Part.
(d) Audits which are
				conducted by the Office of Mental Health, or its designee, shall be conducted
				in accordance with Part 552 of this Title and the following procedures:
(1) In addition to the draft audit report
				issued in accordance with section
				552.6(a) 
				of this Title a notice of the proposed rate revision shall be sent to the
				residential treatment facility.
(2)
				In addition to the provider's response to the final audit report required in
				section
				552.7(e) 
				of this Title, proposed rate revisions resulting from the implementation of
				audit findings shall be final unless within 45 days of receipt of the proposed
				rate revision, the residential treatment facility requests a hearing on factual
				issues. Requests for hearings, and the conduct of such hearings, shall be
				pursuant to Part 503 of this Title.
(3) Revisions to rates determined in
				accordance with the provisions of this paragraph shall be retroactive to the
				rate year covered by the audit. Any resulting overpayment shall be satisfied by
				either retroactive adjustments of the provisional rate paid, based on the
				period audited, or prospective adjustment of the current certified rate at the
				discretion of the commissioner.