N.Y. Comp. Codes R. & Regs. Tit. 10§ 58-3.1 - Definitions
(a) Gross annual
receipts for clinical laboratories able to segregate income. For independent
laboratories or laboratories operated within facilities which can segregate
their laboratory income from total facility income, gross annual receipts shall
mean the total income of the laboratory from all sources for all clinical
laboratory tests performed pursuant to its permit, less any amounts paid to
reference laboratories for such tests which are referred.
(b) Gross annual receipts for clinical
laboratories unable to segregate laboratory income.
(1) For laboratories operated by health
maintenance organizations, facilities with operating certificates issued
pursuant to section 2805 of the Public Health Law, and other
similar facilities which are reimbursed by third-party payors for laboratory
services as part of an all inclusive facility per diem rate and which cannot
segregate laboratory income from total facility income, gross annual receipts
shall mean the amount computed by multiplying the total annual cost of the
laboratory, by a fraction, the numerator of which is the gross revenue of the
facility and the denominator of which is the gross cost of operating the
facility. This amount must be further adjusted by subtracting any amounts paid
to reference laboratories for such tests which are referred. Laboratories must
obtain prior department approval to use this method by documenting that they
are unable to segregate income.
(2)
For all other clinical laboratories unable to segregate their annual income
from tests performed pursuant to their New York State permit, gross annual
receipts shall mean the amount the laboratory would have received had it billed
the prevailing rate for these services. The prevailing rate shall mean the fee
schedule for clinical laboratory services as listed on pages 5-1 through 5-14
of the Medicaid Management Information System Provider Manual for Laboratories,
March 1982 edition, as published by the New York State Department of Social
Services. Copies of this publication are available from the Department of
Social Services, 40 North Pearl Street, Albany, NY 12243, and a copy is
available for inspection and copying from the records access officer of the
Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237.
Laboratories must obtain prior department approval to use this method by
documenting that they are unable to identify laboratory income.
(c) Inspection and reference fee
shall mean the fee charged to a clinical laboratory calculated by multiplying
the total operating expenses of the clinical laboratory evaluation program of
the Department of Health by a fraction, the numerator of which is the gross
annual receipts of such laboratory and the denominator of which is the total
gross annual receipts of all laboratories issued permits.
(d) Permit year shall mean July 1st to June
30th.
Notes
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