N.Y. Social Services Law Section 368-E
Reimbursement to counties for pre-school children with handicapping conditions


1.

The department of health shall review claims for expenditures made by counties and the city of New York for medical care, services and supplies which are furnished to preschool children with handicapping conditions or such preschool children suspected of having handicapping conditions, as such children are defined in the education law. If approved by the department, payment for such medical care, services and supplies which would otherwise qualify for reimbursement under this title and which are furnished in accordance with this title and the regulations of the department to such children, shall be made in accordance with the department’s approved medical assistance fee schedules by payment to such county or city which furnished the care, services or supplies either directly or by contract. Notwithstanding any provisions of law, rule or regulation to the contrary, any clinic or diagnostic and treatment center licensed under article twenty-eight of the public health law, which as determined by the state education department, in conjunction with the department of health, has a less than arms length relationship with the provider approved under Education Law § 4410 (Special education services and programs for preschool children with disabilities)section forty-four hundred ten of the education law shall, subject to the approval of the department and based on standards developed by the department, be authorized to directly submit such claims for medical assistance, services or supplies so furnished for any period beginning on or after July first, nineteen hundred ninety-seven. The actual full cost of the individualized education program (IEP) related services incurred by the clinic shall be reported on the New York State Consolidated Fiscal Report in the education law section forty-four hundred ten program cost center in which the student is placed and the associated medical assistance revenue shall be reported in the same manner.

2.

Claims for payment under this section shall be made in such form and manner, at such times, and for such periods as the department may require.

3.

The commissioner of health is authorized to contract with one or more entities to conduct a study to determine actual direct and indirect costs incurred by counties for medical care, services and supplies, including related special education services and special transportation, furnished to pre-school children with handicapping conditions.

4.

Notwithstanding any inconsistent provision of sections one hundred twelve and one hundred sixty-three of the state finance law, or Economic Development Law § 142 (Procurement opportunities newsletter)section one hundred forty-two of the economic development law, or any other law, the commissioner of health is authorized to enter into a contract or contracts under subdivision three of this section without a competitive bid or request for proposal process, provided, however, that:

(a)

The department of health shall post on its website, for a period of no less than thirty days:

(i)

A description of the proposed services to be provided pursuant to the contract or contracts;

(ii)

The criteria for selection of a contractor or contractors;

(iii)

The period of time during which a prospective contractor may seek selection, which shall be no less than thirty days after such information is first posted on the website; and

(iv)

The manner by which a prospective contractor may seek such selection, which may include submission by electronic means;

(b)

All reasonable and responsive submissions that are received from prospective contractors in timely fashion shall be reviewed by the commissioner of health; and

(c)

The commissioner of health shall select such contractor or contractors that, in his or her discretion, are best suited to serve the purposes of this section.

(d)

Upon selection of a contractor or contractors, the department of health shall provide written notification of such selection and a summary of the criteria employed in such selection to the chair of the senate finance committee and the chair of the assembly ways and means committee.

5.

The commissioner shall evaluate the results of the study conducted pursuant to subdivision three of this section to determine, after identification of actual direct and indirect costs incurred by counties for medical care, services, and supplies furnished to pre-school children with handicapping conditions, whether it is advisable to claim federal reimbursement for expenditures under this section as certified public expenditures. In the event such claims are submitted, if federal reimbursement received for certified public expenditures on behalf of medical assistance recipients whose assistance and care are the responsibility of a social services district, results in a decrease in the state share of annual expenditures pursuant to this section for such recipients, then to the extent that the amount of any such decrease when combined with any decrease in the state share of annual expenditures described in subdivision six of § 368-D (Reimbursement to public school districts and state operated/state supported schools which operate pursuant to article eighty-five, eighty...)section three hundred sixty-eight-d of this title exceeds one hundred fifty million dollars for the period April 1, 2011 through March 31, 2013, or exceeds one hundred million dollars in state fiscal years 2013-14 and 2014-15, the excess amount shall be transferred to such counties in amounts proportional to their percentage contribution to the statewide savings; an amount equal to thirteen and five hundredths percent of any decrease in the state share of annual expenditures pursuant to this section for such recipients in state fiscal year 2015-16 and any fiscal year thereafter shall be transferred to such counties in amounts proportional to their percentage contribution to the statewide savings. Any amount transferred pursuant to this section shall not be considered a revenue received by such social services district in determining the district’s actual medical assistance expenditures for purposes of paragraph (b) of section one of part C of chapter fifty-eight of the laws of two thousand five. The provisions of this section shall be of no force and effect unless all necessary approvals under federal law and regulation have been obtained to receive federal financial participation in the costs of health care services provided pursuant to this section.

Source: Section 368-E — Reimbursement to counties for pre-school children with handicapping conditions, https://www.­nysenate.­gov/legislation/laws/SOS/368-E (updated Sep. 22, 2014; accessed Oct. 26, 2024).

363
Declaration of objects
363‑A
Federal aid
363‑B
Agreements for federal determination of eligibility of aged, blind and disabled persons for medical assistance
363‑C
Medicaid management
363‑D
Provider compliance program
363‑E
Medicaid plan, applications for waivers and plan amendments
363‑F
Electronic visit verification for personal care and home health providers
364
Responsibility for standards
364‑A
Cooperation of state departments
364‑B
Residential and medical care placement demonstration projects
364‑C
National long term care channeling demonstration project
364‑D
Medical assistance research and demonstration projects
364‑E
Aid to families with dependent children homemaker/home health aide demonstration projects
364‑F
Primary care case management programs
364‑G
Medical assistance capitation rate demonstration project
364‑H
Foster family care demonstration programs for elderly or disabled persons
364‑I
Medical assistance presumptive eligibility program
364‑J
Managed care programs
364‑J‑2
Transitional supplemental payments
364‑JJ
Special advisory review panel on Medicaid managed care
364‑KK
Condition of Participation
364‑M
Statewide patient centered medical home program
364‑N
Diabetes and chronic disease self-management pilot program
365
Responsibility for assistance
365‑A
Character and adequacy of assistance
365‑B
Local medical plans: professional directors
365‑C
Medical advisory committee
365‑D
Medicaid evidence based benefit review advisory committee
365‑E
Optional or continued membership in entities offering comprehensive health services plans
365‑F
Consumer directed personal assistance program
365‑G
Utilization review for certain care, services and supplies
365‑H
Provision and reimbursement of transportation costs
365‑J
Advisory opinions
365‑K
Provision of prenatal care services
365‑L
Health homes
365‑M
Administration and management of behavioral health services
365‑N
Department of health assumption of program administration
365‑O
Provision and coverage of services for living organ donors
365‑P
Doulas for Medicaid
366
Eligibility
366‑A
Applications for assistance
366‑B
Penalties for fraudulent practices
366‑C
Treatment of income and resources of institutionalized persons
366‑D
Medical assistance provider
366‑E
Certified home health agency medicare billing
366‑F
Persons acting in concert with a medical assistance provider
366‑G
Newborn enrollment for medical assistance
366‑H
Automated system
366‑I
Long-term care financing demonstration program
367
Authorization for hospital care
367‑A
Payments
367‑B
Medical assistance information and payment system
367‑C
Payment for long term home health care programs
367‑D
Personal care need determination
367‑E
Payment for AIDS home care programs
367‑F
Partnership for long term care program
367‑G
Authorization and provision of personal emergency response services
367‑H
Payment for assisted living programs
367‑I
Personal care services provider assessments
367‑O
Health insurance demonstration programs
367‑P
Responsibilities of local districts for personal care services, home care services and private duty nursing
367‑P*2
Payment for limited home care services agencies
367‑Q
Personal care services worker recruitment and retention program
367‑R
Private duty nursing services worker recruitment and retention program
367‑S
Long term care demonstration program
367‑S*2
Emergency medical transportation services
367‑T
Payment for emergency physician services
367‑U
Payment for home telehealth services
367‑V
County long-term care financing demonstration program
367‑W
Health care and mental hygiene worker bonuses
367‑X
Payment for violence prevention programs
367‑Y
Reimbursement for treatment in place and transportation to alternative health care settings
368
Quarterly estimates
368‑A
State reimbursement
368‑B
State reimbursement to local health districts
368‑C
Audit of state rates of payment to providers of health care services
368‑D
Reimbursement to public school districts and state operated/state supported schools which operate pursuant to article eighty-five, eighty...
368‑E
Reimbursement to counties for pre-school children with handicapping conditions
368‑F
Reimbursement of costs under the early intervention program
369
Application of other provisions

Accessed:
Oct. 26, 2024

Last modified:
Sep. 22, 2014

§ 368-E’s source at nysenate​.gov

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