Reimbursement Methodologies for Various Facilities and Services
NY-ADR
12/26/07 N.Y. St. Reg. MRD-41-07-00019-A
NEW YORK STATE REGISTER
VOLUME XXIX, ISSUE 52
December 26, 2007
RULE MAKING ACTIVITIES
OFFICE OF MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES
NOTICE OF ADOPTION
I.D No. MRD-41-07-00019-A
Filing No. 1364
Filing Date. Dec. 11, 2007
Effective Date. Jan. 01, 2008
Reimbursement Methodologies for Various Facilities and Services
PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following action:
Action taken:
Amendment of sections 635-10.5, 671.7, 679.6, 680.12, 681.14, 686.13 and 690.7 of Title 14 NYCRR.
Statutory authority:
Mental Hygiene Law, sections 13.07, 13.09(b) and 43.02
Subject:
Revision of the reimbursement methodologies for various facilities and services provided under the auspices of OMRDD to include a health care enhancement (HCE III) funding initiative.
Purpose:
To implement the third phase of a funding initiative that will enable agencies which operate facilities and provide services under the auspices of OMRDD to address the health care costs of their employees.
Text or summary was published
in the notice of proposed rule making, I.D. No. MRD-41-07-00019-P, Issue of October 10, 2007.
Final rule as compared with last published rule:
No changes.
Text of rule and any required statements and analyses may be obtained from:
Barbara Brundage, Director, Regulatory Affairs Unit, Office of Mental Retardation and Developmental Disabilities, 44 Holland Ave., Albany, NY 12229, (518) 474-1830; e-mail: [email protected]
Additional matter required by statute:
Pursuant to the requirements of the State Environmental Quality Review Act (SEQRA) and in accordance with 14 NYCRR Part 622, OMRDD has on file a negative declaration with respect to this action. Thus, consistent with the requirements of 6 NYCRR Part 617, OMRDD, as lead agency, has determined that the action described herein will not have a significant effect on the environment, and an environmental impact statement will not be prepared.
Assessment of Public Comment
OMRDD received one letter of comment from a service provider agency. The comments and OMRDD's response thereto are as follows.
Comment: The OMRDD provider submitted comments primarily addressing the methodology used to determine those agencies entitled to Health Care Enhancement III (HCE III) funding at the benchmark level. This provider asked for an explanation of why the benchmark was raised for HCE III. This provider also stated that the revised threshold is unreasonable because the provider's current health care benefits are more generous than those of providers above the benchmark.
Response: After working with Provider Associations and reviewing their comments as well as the terms of the previous Health Care Enhancements, OMRDD made the decision to raise the benchmark for HCE III. This decision has the effect of allowing more monies to be distributed to those agencies which are not currently offering optimal health care benefits. In so doing, OMRDD is enabling those agencies to afford more improvements in their health care plans than would have been possible without the benchmark threshold revision. OMRDD believes this strategy is in keeping with the intent of the initiative.
In opting not to resurvey providers, OMRDD was influenced by its experiences with the earlier survey and previous enhancement implementation. With an aim to streamline the process for providers as well as for central office, OMRDD modified a number of components. For example, the application was simplified for providers' ease of completion. In HCE III, specific dollar entitlements are predicated on operating budgets, thus eliminating the need for providers to identify eligible employees and produce counts, by program for OMRDD, as in the earlier enhancements. This change also facilitates data management for OMRDD. Because the survey was complex, demanding resources of time and labor on the part of providers and OMRDD, practicality dictated the decision to use the existing survey. The objective of these measures was to better manage the process and to minimize the time span between delivering the news of HCE III to providers and delivering the actual funds to them.
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