N.Y. Public Health Law § 3612: Powers and duties of commissioner and state hospital review and planning council

§ 3612. Powers and duties of commissioner and state hospital review

and planning council. 1. The commissioner shall have the power to

conduct periodic inspections of facilities of certified home health

agencies, providers of long term home health care programs and of

providers of AIDS home care programs with respect to the fitness and

adequacy of equipment, personnel, rules and bylaws, standards of service

and medical care, system of accounts, records, and the adequacy of

financial resources and sources of future revenues.

2. The commissioner shall have the power to conduct periodic

inspections of licensed home care services agencies with respect to the

standards of service and care, qualifications of personnel and the

clinical records maintained by such agency.

3. Any organization which provides or makes available any home care

services to the public in this state, in any organized program developed

or rendered under its auspices or provided under contract with any such

organization, shall submit annually to the commissioner a complete

description of its operation, including name, address, location or

principal place of business, ownership, identification of administrative

personnel responsible for home care services programs, the nature and

extent of such programs, and such other information as the commissioner

shall require. For certified home health agencies and licensed home care

services agencies such annual report shall include reports on the type,

frequency and reimbursement for services provided, including

reimbursement from federal and state governmental agencies. The

commissioner shall determine the form and content of the information

compiled and the annual date for submission of such information. The

commissioner shall require certified home health agencies to provide all

information necessary to a licensed home care services agency

sub-contracting with such certified home health agency, to allow such

licensed home care services agency to file its annual report. The

commissioner shall make such information available to the appropriate

governmental agencies of the state, the counties and the city of New

York so as to make known the availability of home care services to

provide data for planning for health needs of the people of the state.

This information shall be available to the public and to the health

systems agencies.

4. The commissioner shall establish within the department a unit for

home care services to assist him in carrying out the provisions of this

article.

5. The public health and health planning council, by a majority vote

of its members, shall adopt and amend rules and regulations, subject to

the approval of the commissioner, to effectuate the provisions and

purposes of this article with respect to certified home health agencies,

providers of long term home health care programs and providers of AIDS

home care programs, including, but not limited to, (a) the establishment

of requirements for a uniform statewide system of reports and audits

relating to the quality of services provided and their utilization and

costs; (b) establishment by the department of schedules of rates,

payments, reimbursements, grants and other charges; (c) standards and

procedures relating to certificates of approval and authorization to

provide long term home health care programs and AIDS home care programs;

(d) uniform standards for quality of care and services to be provided by

certified home health agencies, providers of long term home health care

programs and providers of AIDS home care programs; (e) requirements for

minimum levels of staffing, taking into consideration the size of the

agency, provider of a long term home health care program or provider of

an AIDS home care program, the type of care and service provided, and

the special needs of the persons served; (f) standards and procedures

relating to contractual arrangements between home care services

agencies; (g) requirements for the establishment of plans for the

coordination of home care services and discharge planning for former

patients or residents of facilities under the regulatory jurisdiction of

the department, the departments of social services or mental hygiene,

the board of social welfare, or the office for the aging; (h)

requirements for uniform review of the appropriate utilization of

services; and (i) requirements for minimum qualifications and standards

of training for personnel as appropriate. The commissioner may propose

rules and regulations and amendments thereto for consideration by the

council.

6. The commissioner shall adopt rules and regulations for licensed

home care services agencies which establishes a cap on administrative

and general costs for such agencies equal to the cap on administrative

and general costs applied to certified home health agencies in

accordance with subdivision seven of section thirty-six hundred fourteen

of this article.

7. The commissioner shall adopt and may amend rules and regulations to

effectuate the provisions and purposes of this article as to licensed

home care services agencies with regard to (a) uniform standards for

quality of care and services to be provided and (b) the establishment of

a uniform statewide system of reports relating to the quality of

services offered.

8. (a) The commissioner may require a health home or licensed home

care services agency to report on the costs incurred by the health home

or licensed home care services agency in rendering health care services

to Medicaid beneficiaries. The department of health may specify the

frequency and format of such reports, determine the type and amount of

information to be submitted, and require the submission of supporting

documentation, provided, however, that the department shall provide no

less than ninety calendar days' notice before such reports are due.

(b) If the department determines that the cost report submitted by a

provider is inaccurate or incomplete, the department shall notify the

provider in writing and advise the provider of the correction or

additional information that the provider must submit. The provider must

submit the corrected or additional information within thirty calendar

days from the date the provider receives the notice.

(c) The department shall grant a provider an additional thirty

calendar days to submit the original, corrected or additional cost

report when the provider, prior to the date the report is due, submits a

written request to the department for an extension and establishes to

the department's satisfaction that the provider cannot submit the report

by the date due for reasons beyond the provider's control.

(d) All reports shall be certified by the owner, administrator, chief

executive officer, or public official responsible for the operation of

the provider. The cost report form shall include a certification form,

which shall specify who must certify the report.