N.Y. Public Health Law § 2807-p: Comprehensive diagnostic and treatment centers indigent care program

§ 2807-p. Comprehensive diagnostic and treatment centers indigent care

program. 1. (a) For periods prior to July first, two thousand three, and

on and after July first, two thousand five the commissioner is

authorized to make payments to eligible diagnostic and treatment

centers, to the extent of funds available therefor, up to forty-eight

million dollars annually, to assist in meeting losses resulting from

uncompensated care. The amount of funds available for such payments

pursuant to subdivision four of this section shall be the amount

remaining after the allocation provided in section seven of chapter four

hundred thirty-three of the laws of nineteen hundred ninety-seven as

amended by section seventy-five of chapter one of the laws of nineteen

hundred ninety-nine.

(b) For periods on and after July first, two thousand three, through

June thirtieth, two thousand five, the commissioner shall, subject to

the availability of federal financial participation, adjust medical

assistance rates of payment to assist in meeting losses resulting from

uncompensated care, provided, however, in the event federal financial

participation is not available, the commissioner is authorized to

continue to make payments to eligible diagnostic and treatment centers,

to the extent of funds available therefor, in accordance with provisions

of paragraph (a) of this subdivision and without regard to the

provisions of subdivisions four-a and four-b of this section.

(c) Notwithstanding paragraph (a) of this subdivision, subdivision

four-c of this section or any other inconsistent provision of this

section, distributions made pursuant to this section for annual periods

on and after July first, two thousand nine shall be subject to a uniform

reduction of two percent.

(d) The commissioner may require facilities receiving distributions

pursuant to this section as a condition of participating in such

distributions, to provide reports and data to the department as the

commissioner deems necessary to adequately implement the provisions of

this section.

2. Definitions. (a) "Eligible diagnostic and treatment centers", for

purposes of this section, shall mean voluntary non-profit and publicly

sponsored diagnostic and treatment centers providing a comprehensive

range of primary health care services which can demonstrate losses from

disproportionate share of uncompensated care during a base period two

years prior to the grant period; provided that for periods on and after

January first, two thousand four an eligible diagnostic and treatment

center shall not include any voluntary non-profit diagnostic and

treatment center controlling, controlled by or under common control with

a health maintenance organization, as defined by subdivision one of

section forty-four hundred one of this chapter; provided further that

for purposes of this section, a health maintenance organization shall

not include a prepaid health services plan licensed pursuant to section

forty-four hundred three-a of this chapter. For periods on and after

July first, two thousand three, the base period and the grant period

shall be the calendar year.

(b) "Uncompensated care need", for purposes of this section, means

losses from reported self-pay and free visits multiplied by the

facility's medical assistance payment rate for the applicable

distribution year, offset by payments received from such patients during

the reporting period.

3. (a) During the period January first, nineteen hundred ninety-seven

through September thirtieth, nineteen hundred ninety-seven and for each

fiscal year period commencing on October first thereafter through

December thirty-first, nineteen hundred ninety-nine and for periods on

and after January first, two thousand, diagnostic and treatment centers

shall be eligible for allocations of funds or for rate adjustments

determined in accordance with this section to reflect the needs of the

diagnostic and treatment center for the financing of losses resulting

from uncompensated care.

(b) A diagnostic and treatment center qualifying for a distribution or

a rate adjustment pursuant to this section shall provide assurances

satisfactory to the commissioner 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) To be eligible for an allocation of funds or a rate adjustment

pursuant to this section, a diagnostic and treatment center must provide

a comprehensive range of primary health care services and must

demonstrate that a minimum of five percent of total clinic visits

reported during the applicable base year period were to uninsured

individuals. The commissioner may retrospectively reduce the allocations

of funds or the rate adjustments to a diagnostic and treatment center if

it is determined that provider management actions or decisions have

caused a significant reduction for the grant period in the delivery of

comprehensive primary health care services to uncompensated care

residents of the community.

4. (a) (i) The total amount of funds to be allocated and distributed

for uncompensated care to eligible voluntary non-profit diagnostic and

treatment centers for a distribution period prior to July first, two

thousand three, and on and after July first, two thousand five through

December thirty-first, two thousand six, in accordance with this

subdivision shall be limited to thirty-three percent of the funds

available therefor pursuant to paragraph (a) of subdivision one of this

section and, for the period January first, two thousand seven through

December thirty-first, two thousand seven, such distributions shall be

limited to sixteen and one-half percent of the funds available therefor.

(ii) The total amount of funds to be allocated and distributed for

uncompensated care to eligible publicly sponsored diagnostic and

treatment centers for a grant period prior to July first, two thousand

three, and on and after July first, two thousand five through December

thirty-first, two thousand six, in accordance with this subdivision

shall be limited to sixty-seven percent of funds available therefor

pursuant to paragraph (a) of subdivision one of this section and, for

the period January first, two thousand seven through December

thirty-first, two thousand seven, such distributions shall be limited to

thirty-three and one-half percent of the funds available therefor;

provided, however, that for periods up through December thirty-first,

two thousand seven, forty-one percent of the amount of funds allocated

for distribution to eligible publicly sponsored diagnostic and treatment

centers shall be available for clinics operating under the auspices of

the New York city health and hospitals corporation as established by

chapter one thousand sixteen of the laws of nineteen hundred sixty-nine

as amended.

(iii) (A) Notwithstanding any inconsistent provision of this

paragraph, for the period January first, nineteen hundred ninety-seven

through December thirty-first, nineteen hundred ninety-nine and for

periods on and after January first, two thousand through December

thirty-first, two thousand two, and for periods on and after January

first, two thousand four through December thirty-first, two thousand

seven, in the event that federal financial participation is not

available for rate adjustments pursuant to this section, diagnostic and

treatment centers which received an allowance pursuant to paragraph (f)

of subdivision two of section twenty-eight hundred seven of this article

for the period through December thirty-first, nineteen hundred

ninety-six shall receive an annual uncompensated care distribution

allocation of funds of not less than the amount that would have been

received for any losses associated with the delivery of bad debt and

charity care for nineteen hundred ninety-five had the provisions of

paragraph (f) of subdivision two of section twenty-eight hundred seven

of this article remained in effect, provided, however, that for the

period January first, two thousand seven through December thirty-first,

two thousand seven, the dollar value of the application of the

provisions of this subparagraph for any such diagnostic and treatment

center shall be reduced by fifty percent.

(B) For the period January first, two thousand three through June

thirtieth, two thousand three, and for the period July first, two

thousand three through December thirty-first, two thousand three and in

the event that federal financial participation is not available for rate

adjustments pursuant to this section, each such diagnostic and treatment

center shall receive an uncompensated care distribution allocation of

funds of not less than one-half the amount calculated pursuant to clause

(A) of this subparagraph.

(b) (i) A nominal payment amount for the financing of losses

associated with the delivery of uncompensated care will be established

for each eligible diagnostic and treatment center. The nominal payment

amount shall be calculated as the sum of the dollars attributable to the

application of an incrementally increasing nominal coverage percentage

of base year period losses associated with the delivery of uncompensated

care for percentage increases in the relationship between base year

period eligible uninsured care clinic visits and base year period total

clinic visits according to the following scale:

% of eligible bad debt and charity care % of nominal financial

clinic visits to total visits loss coverage

up to 15% 50%

15 - 30% 75%

30%+ 100%

(ii) For periods prior to January first, two thousand eight, if the

sum of the nominal payment amounts for all eligible voluntary non-profit

diagnostic and treatment centers or for all eligible public diagnostic

and treatment centers or for all clinics operating under the auspices of

the New York city health and hospitals corporation is less than the

amount allocated for uncompensated care allowances pursuant to paragraph

(a) of this subdivision for such diagnostic and treatment centers

respectively, the nominal coverage percentages of base year period

losses associated with the delivery of uncompensated care pursuant to

this scale may be increased to not more than one hundred percent for

voluntary non-profit diagnostic and treatment centers or for public

diagnostic and treatment centers or for all clinics operating under the

auspices of the New York city health and hospitals corporation in

accordance with rules and regulations adopted by the council and

approved by the commissioner.

(c) For periods prior to January first, two thousand eight, the

uncompensated care allocations of funds for each eligible voluntary

non-profit diagnostic and treatment center, as computed in accordance

with paragraph (a) of this subdivision, shall be based on the dollar

value of the result of the ratio of total funds allocated for

distributions for voluntary non-profit diagnostic and treatment centers

pursuant to paragraph (a) of this subdivision to the total statewide

nominal payment amounts for all eligible voluntary non-profit diagnostic

and treatment centers determined in accordance with paragraph (b) of

this subdivision applied to the nominal payment amount for each such

diagnostic and treatment center.

(d) For periods prior to January first, two thousand eight, the

uncompensated care allocations of funds for each eligible public

diagnostic and treatment center, other than clinics operating under the

auspices of the New York city health and hospitals corporation and as

computed in accordance with paragraph (a) of this subdivision, shall be

based on the dollar value of the result of the ratio of total funds

allocated for distributions for public diagnostic and treatment centers,

other than clinics operating under the auspices of the New York city

health and hospitals corporation, pursuant to paragraph (a) of this

subdivision to the total statewide nominal payment amounts for all

eligible public diagnostic and treatment centers, other than clinics

operating under the auspices of the New York city health and hospitals

corporation, determined in accordance with paragraph (b) of this

subdivision applied to the nominal payment amount for each such

diagnostic and treatment center.

(e) For periods prior to January first, two thousand eight, the

uncompensated care grant allocations of funds for each eligible public

diagnostic and treatment center operating under the auspices of the New

York city health and hospitals corporation, as computed in accordance

with paragraph (a) of this subdivision, shall be based on the dollar

value of the result of the ratio of total funds allocated for

distributions for public diagnostic and treatment centers operating

under the auspices of the New York city health and hospitals corporation

pursuant to paragraph (a) of this subdivision to the total statewide

nominal payment amounts for all eligible public diagnostic and treatment

centers operating under the auspices of the New York city health and

hospitals corporation determined in accordance with paragraph (b) of

this subdivision applied to the nominal payment amount for each such

diagnostic and treatment center.

(f) For periods prior to January first, two thousand eight, any

residual amount allocated for distribution to a classification of

diagnostic and treatment centers in accordance with this subdivision

shall be reallocated by the commissioner for distributions to the other

classifications based on remaining need.

(g) For periods on and after January first, two thousand seven, the

uncompensated care allocations of funds for each eligible diagnostic and

treatment center, other than allocations made pursuant to paragraphs

(c), (d), (e) or (f) of this subdivision, shall be based on the dollar

value of the result of the ratio of total funds allocated for

distributions for all eligible diagnostic and treatment centers to the

total statewide nominal payment amounts for all eligible diagnostic and

treatment centers determined in accordance with paragraph (b) of this

subdivision applied to the nominal payment amount for each such

diagnostic and treatment center.

4-a. (a)(i) For periods on and after July first, two thousand three,

through June thirtieth, two thousand five, funds shall be made available

for adjustments to rates of payments made pursuant to paragraph (b) of

subdivision one of this section for eligible voluntary non-profit

diagnostic and treatment centers in accordance with subparagraphs (ii)

and (iii) of this paragraph, for the following periods in the following

aggregate amounts:

(A) For the period July first, two thousand three through December

thirty-first, two thousand three, up to seven million five hundred

thousand dollars;

(B) For the period January first, two thousand four through December

thirty-first, two thousand four, up to fifteen million dollars;

(C) For the period January first, two thousand five through June

thirtieth, two thousand five, up to seven million five hundred thousand

dollars.

(ii) A nominal payment amount for the financing of losses associated

with the delivery of uncompensated care will be established for each

eligible diagnostic and treatment center. The nominal payment amount

shall be calculated as the sum of the dollars attributable to the

application of an incrementally increasing nominal coverage percentage

of base year period losses associated with the delivery of uncompensated

care for percentage increases in the relationship between base year

period eligible uninsured care clinic visits and base year period total

clinic visits according to the following scale:

% of eligible bad debt and charity care % of nominal financial

clinic visits to total visits loss coverage

up to 15% 50%

15 - 30% 75%

30%+ 100%

(iii) The uncompensated care rate adjustments for each eligible

voluntary non-profit diagnostic and treatment center shall be based on

the dollar value of the result of the ratio of total funds allocated for

distributions for voluntary non-profit diagnostic and treatment centers

pursuant to subparagraph (i) of this paragraph, to the total statewide

nominal payment amounts for all eligible voluntary non-profit diagnostic

and treatment centers determined in accordance with subparagraph (ii) of

this paragraph applied to the nominal payment amount for each such

diagnostic and treatment center.

(b)(i) For periods on and after July first, two thousand three through

June thirtieth, two thousand five, funds shall be made available for

adjustments to rates of payments made pursuant to paragraph (b) of

subdivision one of this section for eligible public diagnostic and

treatment centers, other than clinics operated under the auspices of the

New York city health and hospitals corporation, in accordance with

subparagraphs (ii) and (iii) of this paragraph, for the following

periods in the following aggregate amounts:

(A) For the period July first, two thousand three through December

thirty-first, two thousand three, up to nine million dollars;

(B) For the period January first, two thousand four through December

thirty-first, two thousand four, up to eighteen million dollars;

(C) For the period January first, two thousand five through June

thirtieth, two thousand five, up to nine million dollars.

(ii) A nominal payment amount for the financing of losses associated

with the delivery of uncompensated care will be established for each

eligible diagnostic and treatment center. The nominal payment amount

shall be calculated as the sum of the dollars attributable to the

application of an incrementally increasing nominal coverage percentage

of base year period losses associated with the delivery of uncompensated

care for percentage increases in the relationship between base year

period eligible uninsured care clinic visits and base year period total

clinic visits according to the following scale:

% of eligible bad debt and charity care % of nominal financial

clinic visits to total visits loss coverage

up to 15% 50%

15 - 30% 75%

30%+ 100%

(iii) The uncompensated care rate adjustments for each eligible public

diagnostic and treatment center, other than clinics operating under the

auspices of the New York city health and hospitals corporation, shall be

based on the dollar value of the result of the ratio of total funds

allocated for distributions for public diagnostic and treatment centers,

other than clinics operating under the auspices of the New York city

health and hospitals corporation, pursuant to subparagraph (i) of this

paragraph to the total statewide nominal payment amounts for all

eligible public diagnostic and treatment centers, other than clinics

operating under the auspices of the New York city health and hospitals

corporation, determined in accordance with subparagraph (ii) of this

paragraph applied to the nominal payment amount for each such diagnostic

and treatment center.

(c)(i) For periods on and after July first, two thousand three,

through June thirtieth, two thousand five, funds shall be made available

for adjustments to rates of payments made pursuant to paragraph (b) of

subdivision one of this section for eligible public diagnostic and

treatment centers operating under the auspices of the New York city

health and hospitals corporation, in accordance with subparagraphs (ii)

and (iii) of this paragraph, for the following periods in the following

aggregate amounts:

(A) For the period July first, two thousand three through December

thirty-first, two thousand three, up to six million dollars;

(B) For the period January first, two thousand four through December

thirty-first, two thousand four, up to twelve million dollars;

(C) For the period January first, two thousand five through June

thirtieth, two thousand five, up to six million dollars.

(ii) A nominal payment amount for the financing of losses associated

with the delivery of uncompensated care will be established for each

eligible diagnostic and treatment center. The nominal payment amount

shall be calculated as the sum of the dollars attributable to the

application of an incrementally increasing nominal coverage percentage

of base year period losses associated with the delivery of uncompensated

care for percentage increases in the relationship between base year

period eligible uninsured care clinic visits and base year period total

clinic visits according to the following scale:

% of eligible bad debt and charity care % of nominal financial

clinic visits to total visits loss coverage

up to 15% 50%

15 - 30% 75%

30%+ 100%

(iii) The uncompensated care rate adjustment, for each eligible public

diagnostic and treatment center operating under the auspices of the New

York city health and hospitals corporation shall be based on the dollar

value of the result of the ratio of total funds allocated for

distributions for public diagnostic and treatment centers operating

under the auspices of the New York city health and hospitals corporation

pursuant to subparagraph (i) of this paragraph to the total statewide

nominal payment amounts for all eligible public diagnostic and treatment

centers operating under the auspices of the New York city health and

hospitals corporation determined in accordance with subparagraph (ii) of

this paragraph applied to the nominal payment amount for each such

diagnostic and treatment center.

(d) (i) Notwithstanding the provisions of paragraph (b) of this

subdivision and any other provisions of this chapter, municipalities

which received state aid pursuant to article two of this chapter for the

nineteen hundred eighty-nine--nineteen hundred ninety state fiscal year

in support of non-hospital based free-standing or local health

department operated general medical clinics shall receive an

uncompensated care rate adjustment for the period July first, two

thousand three through December thirty-first, two thousand three, of not

less than one-half the amount received in the nineteen hundred

eighty-nine--nineteen hundred ninety state fiscal year for general

medical clinics.

(ii) For the period January first, two thousand four through December

thirty-first, two thousand four, each such municipality shall receive an

uncompensated care rate adjustment of not less than twice the amount

calculated pursuant to subparagraph (i) of this paragraph.

(iii) For the period January first, two thousand five through June

thirtieth, two thousand five, each such municipality shall receive an

annual uncompensated care rate adjustment of not less than the amount

calculated pursuant to subparagraph (i) of this paragraph.

(e) (i) Notwithstanding any inconsistent provision of this

subdivision, for the period July first, two thousand three through

December thirty-first, two thousand three, diagnostic and treatment

centers which received an allowance pursuant to paragraph (f) of

subdivision two of section twenty-eight hundred seven of this article

for the period through December thirty-first, nineteen hundred

ninety-six shall receive an uncompensated care rate adjustment of not

less than one-half the amount that would have been received for any

losses associated with the delivery of bad debt and charity care for

nineteen hundred ninety-five had the provisions of paragraph (f) of

subdivision two of section twenty-eight hundred seven of this article

remained in effect.

(ii) For the period January first, two thousand four through December

thirty-first, two thousand four, each such diagnostic and treatment

center shall receive an uncompensated care rate adjustment of not less

than twice the amount calculated pursuant to subparagraph (i) of this

paragraph.

(iii) For the period January first, two thousand five through June

thirtieth, two thousand five, each such diagnostic and treatment center

shall receive an annual uncompensated care rate adjustment of not less

than the amount calculated pursuant to subparagraph (i) of this

paragraph, and shall be subject to subsequent adjustment or

reconciliation.

(f) Any residual amount allocated for distribution to a classification

of diagnostic and treatment centers in accordance with this subdivision

shall be reallocated by the commissioner for distributions to the other

classifications based on remaining need.

4-b. (a) For periods on and after July first, two thousand three,

through June thirtieth, two thousand five, funds shall be made available

for adjustments to rates of payment made pursuant to paragraph (b) of

subdivision one of this section for eligible diagnostic and treatment

centers with less than two years of operating experience, and diagnostic

and treatment centers which have received certificate of need approval

on applications which indicate a significant increase in uninsured

visits, for the following periods and in the following aggregate

amounts:

(i) For the period July first, two thousand three through December

thirty-first, two thousand three, up to one million five hundred

thousand dollars;

(ii) For the period January first, two thousand four through December

thirty-first, two thousand four, up to three million dollars;

(iii) For the period January first, two thousand five through June

thirtieth, two thousand five, up to one million five hundred thousand

dollars.

(b) To be eligible for a rate adjustment pursuant to this section, a

diagnostic and treatment center shall be a voluntary, non-profit or

publicly sponsored diagnostic and treatment center providing a

comprehensive range of primary health care services and be eligible to

receive a medicaid budgeted rate prior to April first of the applicable

rate adjustment period after which time, the department shall issue rate

adjustments pursuant to this subdivision for such periods. Rate

adjustments made pursuant to this subdivision shall be allocated based

upon each eligible facility's proportional share of costs for services

rendered to uninsured patients which have otherwise not been used for

establishing distributions pursuant to subdivision four-a of this

section. For the purposes of this subdivision costs shall be measured by

multiplying each facility's medicaid budgeted rate by the estimated

number of visits reported for services anticipated to be rendered to

uninsured patients meeting the aforementioned criteria, less any

anticipated patient service revenues received from such uninsured

patients, during the applicable rate adjustment period.

4-c. Notwithstanding any provision of law to the contrary, the

commissioner shall make additional payments for uncompensated care to

voluntary non-profit diagnostic and treatment centers that are eligible

for distributions under subdivision four of this section in the

following amounts: for the period June first, two thousand six through

December thirty-first, two thousand six, in the amount of seven million

five hundred thousand dollars, for the period January first, two

thousand seven through December thirty-first, two thousand seven, seven

million five hundred thousand dollars, for the period January first, two

thousand eight through December thirty-first, two thousand eight, seven

million five hundred thousand dollars, for the period January first, two

thousand nine through December thirty-first, two thousand nine, fifteen

million five hundred thousand dollars, for the period January first, two

thousand ten through December thirty-first, two thousand ten, seven

million five hundred thousand dollars, for the period January first, two

thousand eleven though December thirty-first, two thousand eleven, seven

million five hundred thousand dollars, for the period January first, two

thousand twelve through December thirty-first, two thousand twelve,

seven million five hundred thousand dollars, for the period January

first, two thousand thirteen through December thirty-first, two thousand

thirteen, seven million five hundred thousand dollars, for the period

January first, two thousand fourteen through December thirty-first, two

thousand fourteen, seven million five hundred thousand dollars, for the

period January first, two thousand fifteen through December

thirty-first, two thousand fifteen, seven million five hundred thousand

dollars, for the period January first two thousand sixteen through

December thirty-first, two thousand sixteen, seven million five hundred

thousand dollars, for the period January first, two thousand seventeen

through December thirty-first, two thousand seventeen, seven million

five hundred thousand dollars, for the period January first, two

thousand eighteen through December thirty-first, two thousand eighteen,

seven million five hundred thousand dollars, for the period January

first, two thousand nineteen through December thirty-first, two thousand

nineteen, seven million five hundred thousand dollars, for the period

January first, two thousand twenty through December thirty-first, two

thousand twenty, seven million five hundred thousand dollars, for the

period January first, two thousand twenty-one through December

thirty-first, two thousand twenty-one, seven million five hundred

thousand dollars, for the period January first, two thousand twenty-two

through December thirty-first, two thousand twenty-two, seven million

five hundred thousand dollars, for the period January first, two

thousand twenty-three through December thirty-first, two thousand

twenty-three, seven million five hundred thousand dollars, for the

period January first, two thousand twenty-four through December

thirty-first, two thousand twenty-four, seven million five hundred

thousand dollars, for the period January first, two thousand twenty-five

through December thirty-first, two thousand twenty-five, seven million

five hundred thousand dollars, for the period January first, two

thousand twenty-six through December thirty-first, two thousand

twenty-six, seven million five hundred thousand dollars, for the period

January first, two thousand twenty-seven through December thirty-first,

two thousand twenty-seven, seven million five hundred thousand dollars,

for the period January first, two thousand twenty-eight through December

thirty-first, two thousand twenty-eight, seven million five hundred

thousand dollars, and for the period January first, two thousand

twenty-nine through March thirty-first, two thousand twenty-nine, in the

amount of one million six hundred thousand dollars, provided, however,

that for periods on and after January first, two thousand eight, such

additional payments shall be distributed to voluntary, non-profit

diagnostic and treatment centers and to public diagnostic and treatment

centers in accordance with paragraph (g) of subdivision four of this

section. In the event that federal financial participation is available

for rate adjustments pursuant to this section, the commissioner shall

make such payments as additional adjustments to rates of payment for

voluntary non-profit diagnostic and treatment centers that are eligible

for distributions under subdivision four-a of this section in the

following amounts: for the period June first, two thousand six through

December thirty-first, two thousand six, fifteen million dollars in the

aggregate, and for the period January first, two thousand seven through

June thirtieth, two thousand seven, seven million five hundred thousand

dollars in the aggregate. The amounts allocated pursuant to this

paragraph shall be aggregated with and distributed pursuant to the same

methodology applicable to the amounts allocated to such diagnostic and

treatment centers for such periods pursuant to subdivision four of this

section if federal financial participation is not available, or pursuant

to subdivision four-a of this section if federal financial participation

is available. Notwithstanding section three hundred sixty-eight-a of the

social services law, there shall be no local share in a medical

assistance payment adjustment under this subdivision.

5. Diagnostic and treatment centers shall furnish to the department

such reports and information as may be required by the commissioner to

assess the cost, quality, access to, effectiveness and efficiency of

uncompensated care provided. The council shall adopt rules and

regulations, subject to the approval of the commissioner, to establish

uniform reporting and accounting principles designed to enable

diagnostic and treatment centers to fairly and accurately determine and

report uncompensated care visits and the costs of uncompensated care. In

order to be eligible for an allocation of funds pursuant to this

section, a diagnostic and treatment center must be in compliance with

uncompensated care reporting requirements.

6. Notwithstanding any inconsistent provision of law to the contrary,

the availability or payment of funds to a diagnostic and treatment

center pursuant to this section shall not be admissible as a defense,

offset or reduction in any action or proceeding relating to any bill or

claim for amounts due for services provided by a diagnostic and

treatment center.

7. Revenue from distributions to a diagnostic and treatment center

pursuant to this section shall not be included in gross revenue received

for purposes of the assessments pursuant to section twenty-eight hundred

seven-d of this article, subject to the provisions of subdivision twelve

of section twenty-eight hundred seven-d of this article.

8. (a) For periods on or after January first, two thousand through

June thirtieth, two thousand three, payments made to an eligible

diagnostic and treatment center pursuant to this section shall be

reduced or increased by an amount equal to the amount of any

overpayments or underpayments made against grants awarded pursuant to

section seven of chapter four hundred thirty-three of the laws of

nineteen hundred ninety-seven for the period three years prior to the

annual awards made pursuant to this section.

(b) The determination of such overpayments or underpayments shall be

based on the submission by eligible facilities of reports reflecting

actual uncompensated care data, as required by the commissioner, which

are attributable to prior periods. Submission of such reports is a

condition for an eligible facility's receipt of payments pursuant to

this section.

(c) For any periods in which a facility does not receive payments

pursuant to this section, the amount of any prior period overpayment may

be offset against payments for medical assistance made to such facility

pursuant to title eleven of article five of the social services law and

credited to funds allocated pursuant to this section. Any prior period

underpayment to an eligible facility may be paid to such facility in a

subsequent period.

9. Adjustments to rates of payment made pursuant to this section may

be added to rates of payment or made as aggregate payments to eligible

diagnostic and treatment centers and shall not be subject to subsequent

adjustment or reconciliation, provided, however, that in the event such

adjustments are made as aggregate payments, then notwithstanding any

law, rule or regulation to the contrary responsibility for the local

share of such aggregate payments shall be apportioned to a local social

services district based on the most recent geographic utilization data

available to the department for eligible diagnostic and treatment center

services for payments in accordance with subdivisions four-a and four-b

of this section for all diagnostic and treatment center services

provided in accordance with section three hundred sixty-five-a of the

social services law, regardless of whether another social services

district or the department may otherwise be responsible for furnishing

medical assistance to the eligible persons receiving such services.

10. (a) Notwithstanding any inconsistent provision of this section or

any other contrary provision of law, the commissioner is authorized to

seek a waiver from the federal department of health and human services

pursuant to section eleven hundred fifteen of the federal social

security act, or such other federal law provision as may be deemed

appropriate, seeking federal financial participation in payments made

pursuant to this section, in which case the state funding made available

pursuant to this section shall be utilized as the non-federal share of

such payments. To the extent as may be required, payments made pursuant

to this section and in accordance with this subdivision, may be deemed

to be disproportionate share hospital payments in accordance with the

provisions of the federal social security act.

(b) If federal financial participation in payments made pursuant to

this section are made available in accordance with the provisions of

this subdivision, free-standing clinics licensed solely pursuant to

article thirty-one of the mental hygiene law shall also be deemed

eligible for participation in such payments to the same degree and in

accordance with the same distribution methodology otherwise provided in

this section, provided, however, that only those units of service

provided by such free-standing clinics that constitute medical services

that are otherwise eligible for consideration for Medicaid payments

shall be reflected in distributions made pursuant to this section, and

further provided, however, that the commissioner may, in consultation

with the commissioner of the office of mental health, require such

clinics, as a condition of receiving such distributions, to provide

reports and data to the department as the commissioner deems necessary

to adequately implement the provisions of this subdivision with regard

to such clinics.