N.Y. Comp. Codes R. & Regs. Tit. 10 § 86-4.38 - Computation of basic rates of payment for services provided to medicaid patients by specialty clinics
(a)
Notwithstanding other provisions of this Subpart or Subpart 86-1, rates of
reimbursement for specialty services, including but not limited to hemo and
peritonial dialysis and outpatient rehabilitative services, shall be calculated
in the manner described in section
86-4.37(a)
through (h) of this Subpart. Rates of
reimbursement for methadone maintenance treatment services shall be calculated
in the manner described in section
86-4.39.
Rates of reimbursement for day health care services provided to patients with
acquired immune deficiency syndrome (AIDS) and other human immunodeficiency
virus (HIV) related illnesses by free-standing ambulatory care facilities shall
be calculated in the manner described in section
86-4.41
of this Subpart. Such payment levels will be made available to providers who
document in writing and through site inspection or records review that they
are, in fact, organized and providing specialty services.
(b) The criteria for recognition as a
specialty service include but are not limited to: requirement for highly
specialized staff, equipment or facilities; whether the facility presently
provides the services to the population in need; whether the services may be
provided safely and effectively on an outpatient basis; and whether the
services are structured to address extensive and complex needs for patients
with chronic or infectious medical conditions.
(c) In addition to complying with the
requirements for recording and reporting financial and statistical data in
sections
86-4.3,
86-4.4
and
86-4.5
of this Subpart, facilities shall complete surveys of patient characteristics,
treatment patterns, health care organization factors, costs associated with
patient care, and other factors as undertaken from time to time by the
commissioner.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.