Legislation
SECTION 43.02
Rates or methods of payment for services at facilities subject to licensure or certification by the office of mental health, the office f...
Mental Hygiene (MHY) CHAPTER 27, TITLE E, ARTICLE 43
§ 43.02 Rates or methods of payment for services at facilities subject
to licensure or certification by the office of mental health,
the office for people with developmental disabilities or the
office of alcoholism and substance abuse services.
(a) Notwithstanding any inconsistent provision of law, payment made by
government agencies pursuant to title eleven of article five of the
social services law for services provided by any facility licensed by
the office of mental health pursuant to article thirty-one of this
chapter or certified by the office of alcoholism and substance abuse
services pursuant to this chapter to provide inpatient chemical
dependence services, as defined in section 1.03 of this chapter, shall
be at rates or fees certified by the commissioner of the respective
office and approved by the director of the division of the budget,
provided, however, the commissioner of mental health shall annually
certify such rates or fees which may vary for distinct geographical
areas of the state and, provided, further, that rates or fees for
service for inpatient psychiatric services or inpatient chemical
dependence services, at hospitals otherwise licensed pursuant to article
twenty-eight of the public health law shall be established in accordance
with section two thousand eight hundred seven of the public health law
and, provided, further, that rates or fees for services provided by any
facility or program licensed, operated or approved by the office for
people with developmental disabilities, shall be certified by the
commissioner of health; provided, however, that such methodologies shall
be subject to approval by the office for people with developmental
disabilities and shall take into account the policies and goals of such
office.
(b) Operators of facilities licensed by the office of mental health
pursuant to article thirty-one of this chapter, licensed by the office
for people with developmental disabilities pursuant to article sixteen
of this chapter or certified by the office of alcoholism and substance
abuse services pursuant to this chapter to provide inpatient chemical
dependence services shall provide to the commissioner of the respective
office such financial, statistical and program information as the
commissioner may determine to be necessary. The commissioner of the
appropriate office shall have the power to conduct on-site audits of
books and records of such facilities.
(c) The commissioner of the office of mental health, the commissioner
of the office for people with developmental disabilities and the
commissioner of the office of alcoholism and substance abuse services
shall adopt rules and regulations to effectuate the provisions of this
section. Such rules and regulations shall include, but not be limited
to, provisions relating to:
(i) the establishment of a uniform statewide system of reports and
audits relating to the quality of care provided, facility utilization
and costs of providing services; such a uniform statewide system may
provide for appropriate variation in the application of the system to
different classes or subclasses of facilities licensed by the office of
mental health pursuant to article thirty-one of this chapter or licensed
or operated by the office for people with developmental disabilities
pursuant to article sixteen of this chapter, or certified by the office
of alcoholism and substance abuse services pursuant to this chapter to
provide inpatient chemical dependence services; and
(ii) methodologies used in the establishment of the schedules of rates
or fees pursuant to this section provided, however, that the
commissioner of health shall adopt rules and regulations including
methodologies developed by him or her for services provided by any
facility or program licensed, operated or approved by the office for
people with developmental disabilities; provided, however, that such
rules and regulations shall be subject to the approval of the office for
people with developmental disabilities and shall take into account the
policies and goals of such office.
to licensure or certification by the office of mental health,
the office for people with developmental disabilities or the
office of alcoholism and substance abuse services.
(a) Notwithstanding any inconsistent provision of law, payment made by
government agencies pursuant to title eleven of article five of the
social services law for services provided by any facility licensed by
the office of mental health pursuant to article thirty-one of this
chapter or certified by the office of alcoholism and substance abuse
services pursuant to this chapter to provide inpatient chemical
dependence services, as defined in section 1.03 of this chapter, shall
be at rates or fees certified by the commissioner of the respective
office and approved by the director of the division of the budget,
provided, however, the commissioner of mental health shall annually
certify such rates or fees which may vary for distinct geographical
areas of the state and, provided, further, that rates or fees for
service for inpatient psychiatric services or inpatient chemical
dependence services, at hospitals otherwise licensed pursuant to article
twenty-eight of the public health law shall be established in accordance
with section two thousand eight hundred seven of the public health law
and, provided, further, that rates or fees for services provided by any
facility or program licensed, operated or approved by the office for
people with developmental disabilities, shall be certified by the
commissioner of health; provided, however, that such methodologies shall
be subject to approval by the office for people with developmental
disabilities and shall take into account the policies and goals of such
office.
(b) Operators of facilities licensed by the office of mental health
pursuant to article thirty-one of this chapter, licensed by the office
for people with developmental disabilities pursuant to article sixteen
of this chapter or certified by the office of alcoholism and substance
abuse services pursuant to this chapter to provide inpatient chemical
dependence services shall provide to the commissioner of the respective
office such financial, statistical and program information as the
commissioner may determine to be necessary. The commissioner of the
appropriate office shall have the power to conduct on-site audits of
books and records of such facilities.
(c) The commissioner of the office of mental health, the commissioner
of the office for people with developmental disabilities and the
commissioner of the office of alcoholism and substance abuse services
shall adopt rules and regulations to effectuate the provisions of this
section. Such rules and regulations shall include, but not be limited
to, provisions relating to:
(i) the establishment of a uniform statewide system of reports and
audits relating to the quality of care provided, facility utilization
and costs of providing services; such a uniform statewide system may
provide for appropriate variation in the application of the system to
different classes or subclasses of facilities licensed by the office of
mental health pursuant to article thirty-one of this chapter or licensed
or operated by the office for people with developmental disabilities
pursuant to article sixteen of this chapter, or certified by the office
of alcoholism and substance abuse services pursuant to this chapter to
provide inpatient chemical dependence services; and
(ii) methodologies used in the establishment of the schedules of rates
or fees pursuant to this section provided, however, that the
commissioner of health shall adopt rules and regulations including
methodologies developed by him or her for services provided by any
facility or program licensed, operated or approved by the office for
people with developmental disabilities; provided, however, that such
rules and regulations shall be subject to the approval of the office for
people with developmental disabilities and shall take into account the
policies and goals of such office.