N.Y. Public Health Law § 4012: Payment for hospice

§ 4012. Payment for hospice. 1. No government agency shall purchase,

pay for or make reimbursement or grants-in-aid for services provided by

a hospice unless, at the time the services were provided, the hospice

possessed a valid certificate of approval.

2. Payments for hospice care made by government agencies shall be at

rates approved by the state director of the budget.

3. Prior to the approval of hospice rates, the commissioner shall

determine and certify to the state director of the budget that the

proposed rate schedules for payments for hospice services are reasonable

and adequate to meet the costs which must be incurred by efficiently and

economically operated programs. In making such certification, the

commissioner shall take into consideration the elements of cost,

geographical differentials in the elements of cost considered, economic

factors in the area in which the hospice is located, costs of hospice

programs of comparable size, the need for incentives to improve services

and institute economies, and applicable medicare reimbursement

regulations.

4. Eligible individuals shall be permitted to receive hospice services

from a provider under this article while continuing to reside in an

adult care facility under title two of article seven of the social

services law and enrolled in the assisted living program, subject to the

availability of federal financial participation. The commissioner shall

make regulations and take other actions reasonably necessary and

appropriate to implement this subdivision.

5. The commissioner shall establish a methodology as of July first,

two thousand eighteen subject to federal financial participation that

shall ensure a prospective ten-percent increase in the medicaid

reimbursement rates for hospice providers, relative to the reimbursement

rate, as of March thirty-first, two thousand eighteen, for services

provided by such providers on and after April first, two thousand

eighteen.