N.Y. Mental Hygiene Law § 36.05: Certified community behavioral health clinics indigent care program

§ 36.05 Certified community behavioral health clinics indigent care

program.

(a) (1) For periods on and after July first, two thousand

twenty-three, the commissioners are authorized to make payment to

eligible certified community behavioral health clinics, to the extent of

funds appropriated therefor to assist in meeting losses resulting from

uncompensated care. In the event federal financial participation is not

available for such payments to eligible certified community behavioral

health clinics, payments shall be made solely on the basis of available

state general fund appropriations for this purpose in amounts to be

determined by the director of the division of the budget.

(2) For purposes of this section, "eligible certified community

behavioral health clinics" shall mean voluntary non-profit certified

community behavioral health clinics participating in the federal

certified community behavioral health clinic demonstration awarded to

the state by the United States department of health and human services

substance abuse and mental health services administration and other

certified community behavioral health clinics certified pursuant to

section 36.04 of this article, which demonstrate that a minimum of three

percent of total visits reported during the applicable base year period,

as determined by the commissioners, were to uninsured individuals.

(3) For purposes of this section, "losses resulting from uncompensated

care" shall mean losses from reported self-pay and free visits

multiplied by the clinic's medical assistance payment rate for the

applicable distribution year, offset by payments received from such

patients during the reporting period.

(b) A certified community behavioral health clinic qualifying for a

distribution pursuant to this section shall provide assurances

satisfactory to the commissioners that it shall undertake reasonable

efforts to maintain financial support from community and public funding

sources and reasonable efforts to collect payments for services from

third-party insurance payors, governmental payors and self-paying

patients.

(c) (1) Funding pursuant to this section shall be allocated to

eligible certified community behavioral health clinics based on actual,

reported losses resulting from uncompensated care in a given base year

period and shall not exceed one hundred percent of an eligible clinic's

losses in the same period.

(2) If the sum of actual, reported losses resulting from uncompensated

care for all certified community behavioral health clinics exceeds the

amount appropriated therefor in a given base year period, allocations of

funds for each eligible certified community behavioral health clinic

shall be assessed proportionately based upon the percentage of the total

number of uncompensated care visits for all clinics that each clinic

provided during the base year and shall not exceed amounts appropriated

in the aggregate.

(d) Except as provided in subdivision (e) of this section, for periods

on and after July first, two thousand twenty-three through June

thirtieth, two thousand twenty-six, funds shall be made available for

payments pursuant to this section for eligible certified community

behavioral health clinics for the following periods in the following

aggregate amounts:

(1) For the period of July first, two thousand twenty-three through

June thirtieth, two thousand twenty-four, up to twenty-two million five

hundred thousand dollars;

(2) For the period of July first, two thousand twenty-four through

June thirtieth, two thousand twenty-five, up to forty-one million two

hundred fifty thousand dollars; and

(3) For the period of July first, two thousand twenty-five through

June thirtieth, two thousand twenty-six, up to forty-five million

dollars.

(e) In the event that federal financial participation is not available

for rate adjustments pursuant to this section, funds available for

payments pursuant to this section for each eligible certified community

behavioral health clinic shall be limited to the non-federal share

equivalent of the amounts specified in subdivision (d) of this section.

(f) Eligible certified community behavioral health clinics receiving

funding under this section shall not be eligible for comprehensive

diagnostic and treatment centers indigent care program funding pursuant

to section two thousand eight hundred seven-p of the public health law.

(g) The commissioners may require facilities receiving distributions

pursuant to this section as a condition of participating in such

distributions, to provide reports and data to the office of mental

health and the office of addiction services and supports as the

commissioners deem necessary to adequately implement the provisions of

this section.