Графични страници
PDF файл
ePub

of

to the sponsoring facility. The department shall survey adult day

day care providers to determine the type and cost of services provided.

§ 2. The commissioner of health shall convene a work group to review and make recommendations regarding the provision of and payment for adult day services provided through residential health care facilities. Such work group shall consist of representatives from the departments of health and social services, provider associations, adult day services programs and consumers. Such review shall include an examination of issues related to: (a) establishment of a payment mechanism which integrates payment for services, registrant functional needs, and service utilization; or assessment of other alternative payment methodology; (b) development of an appropriate assessment instrument for determining reg; istrant social and health needs and estimated incremental costs related to staff time to complete the form provided however that the Minimum Data Set (MDS+), or its successor, shall not be used as the registrant assessment instrument for adult day services programs sponsored by residential health care facilities; (c) review of admission and retention regulatory requirements; and (d) assessment cost-effective methods for capital reimbursement. On or before January 15, 1993, the commis sioner of health shall submit a report to the governor, the majority leader of the senate and the speaker of the assembly on the progress of such work group, and related recommendations regarding the provision of and payment for adult day services.

§ 3. Notwithstanding any inconsistent provision of law or regulation to the contrary, with regard to rates of payment for personal care services, including

personal care services provided under the long term home health care program, for rate periods beginning on or after January 1, 1992, reimbursement for provider administrative and general expenses shall not exceed twenty-eight percent of the total rates of payment, excluding capital cost reimbursement, authorized for such services provided, however, that this limitation shall not apply to initial payment rates authorized for new providers in the first rate year of operation, and provided further that for any provider of services the ratio of administrative and general expenses divided by the total rates of payment, , excluding capital cost reimbursement, expressed a percentage shall be reduced according to the following scale: administrative and

percentage point general percentage

reduction 26+ 31%

4 percentage points 22+ 26%

3 percentage points 20+ 22%

2 percentage points but not to

be lower than 20%

as

as

care

§
4.
Subdivision 1 of

section 2807-d of the public health law, as added by chapter 938 of the laws of 1990, is amended to read as follows:

1. (a) Hospitals, defined in this article, excluding [voluntary nonprofit and private proprietary general hospitals, which qualify for distributions made in accordance with paragraph. (c) of subdivision nineteen of section twenty-eight hundred seven-c of this article] hospitals specified in paragraph (b) of this subdivision, are charged assessments on their gross receipts received from all patient

services and other operating, income, less personal needs allowances and refunds on a cash basis in the percentage amounts and for the periods specified in subdivision two of this section. Such assessments shall be submitted by or on behalf of hospitals to the commissioner or his designee.

(b) Subject to the provisions of subdivision twelve of this section, the following categories of hospitals shall not be charged assessments pursuant to this section: (i) voluntary nonprofit and private proprietary general hospitals which qualify for distributions made accordance with paragraph (c) of subdivision nineteen of section twenty-eight hundred seven-c of this article; (ii) voluntary nonprofit hospitals totally financed by charitable contributions or, by the income thereon dedicated to free care of low income patients; and (iii) any facility dedicated solely to the care of police, firefighters, volunteer firefighters, and emergency service personnel.

§ 5. Subdivision 2 of section 2807-d of the public health law, as added by chapter 938 of the laws of 1990, paragraph (a) amended by chapter 266 of the laws of 1991, is amended to read as follows:

2. (a) (i) For general hospitals the overall assessment shall be sixtenths of one percent and the assessment shall vary from 0,5% to 0.675% of each general hospital's gross receipts received from all patient care

in

as

be

one

services and other operating income on a cash basis during the period January first,, nineteen hundred ninety-one through March thirty-first, nineteen hundred ninety-two for hospital or health-related services, including but

not limited to inpatient service, outpatient service, emergency service, referred ambulatory service and ambulatory surgical service. The assessment shall vary according to the percentage of [1989] nineteen hundred eighty-nine medicaid inpatient revenues as a percentage of total [1989] nineteen hundred eighty-nine inpatient revenues as reported on the institutional cost report submitted to the department for [1989] nineteen hundred eighty-nine according to the following: for hospitals with medicaid revenue up to and including 10%, the assessment shall be .5%, for hospitals with medicaid revenue greater than 10% up to and including 15%, the assessment shall be .525%, for hospitals with medicaid revenue greater than 15% up to and including 20%, 'the assessment shall be .65%, and for hospitals with medicaid revenue over 20%, the assessment shall be .675%. In the event that the provisions relating to the additional supplementary low income patient adjustment established in accordance with subdivision fourteen-d of section twenty-eight hundred seven-c of this [chapter] article cannot implemented, then the general hospital assessment established in accordance with this paragraph shall be calculated without variation specified in this paragraph and the assessment for each general hospital whose assessment was greater than six-tenths of one percent shall become six-tenths of percent.

(ii) For general hospitals the assessment shall be six-tenths of one percent of each general hospital's gross receipts received from all patient care services and other operating income on a cash basis beginning April first, nineteen hundred ninety-two for hospital or healthrelated services, including, but not limited to inpatient service, outpatient service, emergency service, referred ambulatory service and anbulatory surgical şeryice.

(iii) For general hospitals an additional assessment shall be onetenth of one percent of each general hospital's gross receipts received from all

all patient care services and other operating income on a cash basis beginning April first, nineteen hundred ninety-two for hospital or health-related services, including, but not limited to inpatient service, outpatient service, emergency service, referred ambulatory service and ambulatory surgical service:

(b)(i). For residential health care facilities, the assessment shall be six-tenths of one percent of each residential health care facility's gross receipts received from all patient care services and other operating income on a cash basis (during the period] beginning January

first, nineteen hundred ninety-one [through March thirty-first, nineteen hundred ninety-two] for hospital or health-related services, including adult day services.

(ii) For residential health care facilities an additional assessment shall be one and two-tenths percent of each residential health care facility's gross receipts received from all patient care services and other operating income on a cash basis beginning April first, nineteen hundred ninety-two for hospital or health-related services, including adult day services.

(0) For all other facilities issued an operating certificate pursuant to section twenty-eight hundred five of this article, including diagnostic and treatment centers, the assessment shall bé six-tenths of one percent of each facility's gross receipts received from all patient care services and other operating income on a cash basis [during the period] beginning January first, nineteen hundred ninety-one [through March thirty-first, nineteen hundred ninety-two) for hospital or healthrelated services, including diagnostic and treatment center services.

§ 6. Paragraphs (a), (c) and (d) of subdivision 3 of section 2807-d of the public health law as added by chapter 938 of the laws of 1990, amended to read as follows:

(a) for general hospitals, all monies received for or on account of inpatient hospital service, outpatient service, emergency service, (referral] referred ambulatory service and ambulatory surgical service, or other hospital or health-related services, excluding subject to the provisions of subdivision twelve of this section distributions from bad debt and charity care regional regional pools, primary health

services EXPLANATION—Matter in italics is new; matter in brackets [ ] is old law

are as

to be omitted.

care

a

to the sponsoring facility. The department shall survey adult day care providers to determine the type and cost of services provided.

§ 2. The commissioner of health shall convene a work group to review and make recommendations regarding the provision of and

payment for adult day services provided through residential health care facilities. Such work group shall consist of representatives from the departments of health and social services, provider associations, adult day services programs and consumers. Such review shall include an examination of issues related to: (a) establishment of a payment mechanism which integrates payment for services, registrant functional needs, and service utilization; or assessment of other alternative payment methodology; (b) development of an appropriate assessment instrument for determining reg; istrant social and health needs and estimated incremental costs related to staff time to complete the form provided however that the Minimum Data Set (MDS+), or its successor, shall not be used as the registrant assessment instrument for adult day services programs sponsored by residential health care facilities; (c) review of admission and retention regulatory requirements; and (d) assessment of cost-effective methods for capital reimbursement. On or before January 15, 1993,, the commis sioner of health shall submit a report to the governor, the majority leader of the senate and the speaker of the assembly on the progress of such work group, and related recommendations regarding the provision of and payment for adult day services.

§ 3. Notwithstanding any inconsistent provision of law or regulation to the contrary, with regard to rates of payment for personal care services, including personal care services provided under the long term home health care program, for rate periods beginning on or after January 1, 1992, reimbursement for provider administrative and general expenses shall not exceed twenty-eight percent of the total rates of payment, excluding capital cost reimbursement, authorized for such services provided, however, that this limitation shall not apply to initial payment rates authorized for new providers in the first rate year of operation, and provided further that for any provider of services the ratio of administrative and general expenses divided by the total rates of payment, excluding capital cost reimbursement, expressed

percentage shall be reduced according to the following scale: administrative and

percentage point general percentage

reduction 26+ 31%

4 percentage points 22+ 26%

3 percentage points 20+ 22%

2 percentage points but not to

be lower than 20% $ 4. Subdivision 1 of section 2807-d of the public health law, as added by chapter 938 of the laws of 1990, is amended to read as follows:

1. (a) Hospitals, defined in this article, excluding [voluntary nonprofit and private proprietary general hospitals, which qualify for distributions made

in

accordance with paragraph. (c) of subdivision nineteen of section twenty-eight hundred seven-c of this article] hospitals specified in paragraph (b) of this subdivision, are charged assessments on their gross receipts received from all patient care services and other operating income, less personal needs allowances and refunds on a cash basis in the percentage amounts and for the periods specified in subdivision two of this section. Such assessments shall be submitted by or on behalf of hospitals to the commissioner or his designee.

(b) Subject to the provisions of subdivisio twelve of this section, the following categories of hospitals shall not be charged assessments pursuant to this section : (i) voluntary nonprofit and private proprietary general hospitals which qualify for distributions made in accordance with paragraph (c) of subdivision nineteen of section twenty-eight hundred seven-c of this article; (ii) voluntary nonprofit

nonprofit hospitals totally financed by charitable contributions or by the income thereon dedicated to free care of low income patients; and (iii) any facility dedicated solely to the care of police, firefighters, volunteer firefighters, and emergency service personnel.

§ 5. Subdivision 2 of section 2807-d of the public health law, as added by chapter 938 of the laws of 1990, paragraph (a) amended by chapter 266 of the laws of 1991, is amended to read as follows:

2. (a) (i) For general hospitals the overall assessment shall be sixtenths of one percent and the assessment shall vary from 0.5% to 0.675% of each general hospital's gross receipts received from all patient care

as

as

para

one

services and other operating income on a cash basis during the period January first,, nineteen hundred ninety-one through March thirty-first, nineteen hundred ninety-two for hospital or health-related services, including but not limited to inpatient service, outpatient service emergency service, referred ambulatory service and' ambulatory surgical service. The assessment shall vary according to the percentage of (1989) nineteen hundred eighty-nine medicaid inpatient revenues as a percentage of total [1989) nineteen hundred eighty-nine inpatient revenues as reported on the institutional cost report submitted to the department for [1989] nineteen hundred eighty-nine according to the following: for hospitals with medicaid revenue up to and including 10%, the assessment shall be .5%, for hospitals with medicaid revenue greater than 10% up to and including 15%, the assessment shall be .525%, for hospitals with medicaid revenue' greater than 15% up to and including 20%, the assess ment shall be .65%, and for hospitals with medicaid revenue over 20%, the assessment shall be .675%. In the event that the provisions relating to the additional supplementary low income patient adjustment established in accordance with subdivision fourteen-d of section twenty-eight hundred seven-c of this [chapter] article cannot be implemented, then the general hospital assessment established in accordance with this paragraph shall be calculated without variation specified in this graph and the assessment for each general hospital whose assessment was greater than six-tenths of one percent shall become six-tenths of percent.

(ii) For general hospitals the assessment shall be six-tenths of one percent of each general hospital's gross receipts received from all patient care services and other operating income on a cash basis beginning April first, nineteen hundred ninety-two for hospital

or

healthrelated services, including, but not limited to inpatient service, out, patient service, emergency service, referred ambulatory service and ambulatory surgical service.

(iii) For general hospitals an additional assessment shall be onetenth of one percent of each general hospital's gross receipts received from all patient care services and other operating income on a cash basis beginning April first, nineteen hundred ninety-two for hospital or health-related services,

including, but not limited to inpatient service, outpatient service, emergency service, referred ambulatory service and ambulatory surgical service.

(b)(i) For residential health care facilities the assessment shall be six-tenths of one percent of each residential health care facility's gross receipts received from all patient care services and other operating income on a cash basis [during the period] beginning January first, nineteen hundred ninety-one (through March thirty-first, nineteen hundred ninety-two] for hospital or health-related services, including adult day services.

(ii) For residential health care facilities an additional assessment shall be one and two-tenths percent of each residential health care facility's gross receipts received from all patient care services and other operating income on a cash basis beginning April first, nineteen hundred ninety-two for hospital or health-related services, including adult day services.

(c) For all other facilities issued an operating certificate pursuant to section twenty-eight hundred five of this article, including diagnostic and treatment centers, the assessment shall bé six-tenths of one percent of each facility's gross receipts received from all patient care services and other operating income on a cash basis [during the period] beginning January first, nineteen hundred ninety-one (through March thirty-first, nineteen hundred ninety-two] for hospital or healthrelated services, including diagnostic and treatment center services.

§ 6. Paragraphs (a), (c) and (d) of subdivision 3 of section 2807-d of the d

as added by chapter 938 of the laws of 1990, are amended to read as follows:

(a) for general hospitals, all monies received for or on account of inpatient hospital service, outpatient service, emergency service, (referral] referred ambulatory service and ambulatory surgical service, or other hospital or health-related services, excluding subject to the provisions of subdivision twelve of this section distributions from bad debt and charity care regional pools, primary health

services EXPLANATION—Matter in italics is new; matter in brackets [] is old law

aw

to be omitted.

care

a

or

regional pools, bad debt and charity care for financially distressed hospitals statewide pools and bad debt and charity care and capital statewide pools created in accordance with section twenty-eight hundred seven-c of this article and the components of rates of payment or charges related to the allowances provided in accordance with subdivisions fourteen, fourteen-b and fourteen-c, the adjustment provided in accordance with subdivision fourteen-a, the adjustment provided in accordance with subdivision fourteen-d, thé ad justment for health maintenance organization reimbursement rates provided in accordance with subdivision two-a, the adjustment for commerical* insurer reimbursement rates provided in accordance with paragraph (i) of subdivision eleven or, if effective, the adjustment provided in accordance with subdivision fifteen of section twenty-eight' hundred seven-c of this article or the adjustment provided in accordance with section eighteen of chapter two hundred sixty-six of the laws of nineteen hundred eighty-six as amended and physician practice or faculty practice plan revenue received by a general hospital based on discrete billing's for private practicing physician services and revenue received by a general hospital from a public hospital pursuant to an affiliation agreement contract for the delivery of health care services to such public hospital;

(c) for all other facilities issued an operating certificate pursuant to section twenty-eight hundred five of this article, including diagnostic and treatment centers, all monies received for or on account of hospital or health-related services, however, subject to the provisions of subdivision twelve of this section, excluding the component of rates of payment related to the allowance provided in accordance with paragraph (f), of subdivision two of section twenty-eight hundred seven of this article [and], excluding for diagnostic and treatment center operated by health maintenance organization operating in accordance with the provisions of article forty-four of this chapter article forty-three of the insurance law monies received for or on account of services provided to subscribers of such health maintenance organization and excluding patient care services which if provided to persons eligible for medical assistance pursuant to title eleven of article five of the social services law would be eligible for ninety percent federal funds as set forth in section nineteen hundred three of the federal social security act; and

(d) for all hospitals, excluding diagnostic and treatment centers operated by a health maintenance organization operating in accordance with the provisions of article forty-four of this chapter or article forty-three of the insurance law, shall include monies received for or on account of such revenue sources as investment income, parking lots, cafeterias, gift shops and rental income, provided, however, that subject to the provisions of subdivision twelve of this section income received from grants, charitable contributions, donations and bequests and governmental deficit financing and the component of rates of payment reflecting any cost of the assessment reimbursable pursuant to subdivision ten of this section shall not be included.

§ 7. Subdivision 4 of section 2807-d of the public health law, as added by chapter 938 of the laws of 1990, is amended to read as follows:

4. The commissioner is authorized to contract with the article fortythree insurance law plans, or if not available such other administrators

the commissioner shall designate, to receive and distribute hospital assessment funds. In the event contracts with the article forty-three insurance law plans or other commissioner's designees are effectuated, the commissioner shall conduct annual audits of the receipt and distribution of the assessment funds. The reasonable costs and expenses of an administrator as approved by the commissioner, not to exceed for personnel services on an annual basis [two] four hundred thousand dollars for all assessments established pursuant to this section, shall be paid from the assessment funds.

$ 8. The opening paragraph of paragraph (a) and paragraph (d), of subdivision 7 of section 2807-d of the public health law, as added by chapter 938 of the laws of 1990, are amended to read as follows:

Every hospital shall submít reports on a cash basis of (estimated) actual gross receipts received from all patient care services and operating income for each month as follows:

Yd) Final payments shall be due for all hospitals for the assessments pursuant to subdivision two of this section upon the due date for submission of the applicable quarterly report.

* So in original. (Word misspelled. )

as

« ПредишнаНапред »