HLT-31-09-00013-P Rate Methodology for Non-public Hospitals to Ensure Access for All Medicaid Patients Requiring Language Assistance

8/5/09 N.Y. St. Reg. HLT-31-09-00013-P

NEW YORK STATE REGISTER

VOLUME XXXI, ISSUE 31

August 05, 2009

RULE MAKING ACTIVITIES

DEPARTMENT OF HEALTH

PROPOSED RULE MAKING

NO HEARING(S) SCHEDULED

 

I.D No. HLT-31-09-00013-P

Rate Methodology for Non-public Hospitals to Ensure Access for All Medicaid Patients Requiring Language Assistance

PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following proposed rule:

Proposed Action:

This is a consensus rule making to add section 86-1.11(v) to Title 10 NYCRR.

Statutory authority:

Public Health Law, section 2807-c(1)(k)

Subject:

Rate methodology for non-public hospitals to ensure access for all Medicaid patients requiring language assistance.

Purpose:

Rate methodology for non-public hospitals to ensure access for all Medicaid patients requiring language assistance.

Text of proposed rule:

Proposed new subdivision (v) of Section 86-1.11:

(v) Within amounts made available pursuant to paragraph (k) of subdivision 1 of section 2807-c of the public health law, for rate periods on and after April 1, 2008, payment rates for non-public general hospitals located in a city with a population of more than one million persons shall be adjusted for the purpose of ensuring and enhancing access to hospital services for Medicaid patients requiring language assistance in accordance with the following:

(1) 70% of total available funds shall be distributed in accordance with the following:

(i) 50% of such funding will be allocated proportionally to such hospitals based on the relative number of each hospital’s general clinic Medicaid visits as reflected in the facility’s most recently available institutional cost report data as submitted to the department; and

(ii) 50% of such funding shall be allocated proportionally based on the relative number of each hospital’s Medicaid inpatient discharges as reflected in the facility’s most recently available institutional cost report data as submitted to the department.

(2) 30% of total available funds shall be allocated proportionally based on the number of foreign languages, as certified to by each hospital an annual basis, spoken by one percent or more of the persons residing within each hospital’s service area. Such certifications shall be submitted in a form and at such times as designated by the commissioner. The commissioner is authorized to audit the basis of such certifications and may recoup any funds determined to have been allocated based on inaccurate or unsubstantiated certifications.

(3) General hospitals which have their rates adjusted pursuant to this subdivision shall use such funds solely for the purpose of providing language assistance and are prohibited from using such funds for any other purpose. Each such general hospital shall submit, at a time and in a manner to be determined by the commissioner, a written certification attesting that such funds will be used solely for such purpose and the commissioner is authorized to audit each such general hospital to confirm compliance with such certification and shall recoup any funds determined to have been used for other purposes. Such recoupment shall be in addition to any other applicable penalties under sections twelve and twelve-b of this chapter.

Text of proposed rule and any required statements and analyses may be obtained from:

Katherine Ceroalo, DOH, Bureau of House Counsel, Regulatory Affairs Unit, Room 2438, ESP, Tower Building, Albany, NY 12237, [phone], email: [e-mail]

Data, views or arguments may be submitted to:

Same as above.

Public comment will be received until:

45 days after publication of this notice.

This action was not under consideration at the time this agency's regulatory agenda was submitted.

Consensus Rule Making Determination

Statutory Authority:

The statutory authority for these regulations is contained in Section 2807-c of the Public Health Law, which authorizes the State Hospital Review and Planning Council to adopt and amend rules and regulations, subject to the approval of the Commissioner of Health. The proposed regulation establishes the methodology for determining the language assistance rate adjustment as required by Public Health Law Section 2807-c(1)(k)(ii).

Basis:

Chapter 58 of the Laws of 2007 created a new paragraph (k) to subdivision 1 of Section 2807-c that authorized an adjustment to inpatient rates of payment for non-public general hospitals located in a city with a population greater than one million persons to provide funding for Medicaid patients who require language assistance. Subparagraph (ii) of the statute requires the Commissioner to promulgate regulations detailing the methodology to be used for determining the rate adjustment amount for rate periods on and after April 1, 2008. The statute further requires that the rate adjustment methodology include a provision that up to thirty percent of such available funds be allocated based on the number of foreign languages utilized by one or more percent of the residents in the eligible hospital’s service area.

The proposed regulation provides the methodology for determining the language assistance rate adjustment wherein seventy percent of available funds shall be distributed proportionally to eligible hospitals based on the relative number of each such hospital’s general clinic Medicaid visits and Medicaid inpatient discharges, as reflected in the facility’s most recently available cost report data as submitted to the Department. The remaining thirty percent shall be allocated based on the number of foreign languages spoken by one percent or more of persons living in the hospital’s service area, as certified to by each hospital on an annual basis. The regulation incorporates a provision that such funds be used solely for the purpose of providing language assistance. This requirement will ensuring that the funds are being applied specifically to enhance access to hospital services for Medicaid patients requiring language assistance, as intended by the statute.

Job Impact Statement

No Job Impact Statement is required pursuant to Section 201-a(2)(a) of the State Administrative Procedure Act. It is apparent, from the nature of the proposed amendment, that it will not have a substantial adverse impact on jobs and employment opportunities. The proposed regulation establishes the language assistance rate adjustment methodology, as required under PHL Section 2807-c(1)(k)(ii) which was added by Chapter 58 of the Laws of 2007. The language assistance rate adjustment is intended to provide funding to eligible non-public hospitals for the purpose of ensuring access to provided services and reasonable accommodation for all Medicaid patients who require language assistance.