New York Codes, Rules and Regulations
Title 14 - DEPARTMENT OF MENTAL HYGIENE
Chapter XIV - Office for People With Developmental Disabilities
Part 635 - General Quality Control and Administrative Requirements Applicable to Programs, services or Facilities Funded or Certified by the Office for People With Developmental Disabilities
Subpart 635-12 - Liability for Services
Section 635-12.10 - Denial, discharge or discontinuation of services
Universal Citation: 14 NY Comp Codes Rules and Regs § 635-12.10
Current through Register Vol. 47, No. 12, March 26, 2025
(a) Preexisting services.
A provider may not discharge an individual from preexisting services or otherwise discontinue preexisting services to an individual because of failure to pay.
(b) Services other than preexisting services-denial of services.
(1) The provider may deny the request for
services:
(i) if the individual does not have
full Medicaid coverage; and
(ii) if
the provider has not received reasonable assurance that the individual or other
liable party will pay for the services in accordance with this Subpart;
and
(iii) if the fees have not been
waived.
(2)
Notwithstanding the provisions of paragraph (1) of this subdivision, a provider
may not deny services to an individual if the provision of services is
otherwise required by law or court order.
(c) Services other than preexisting services-discharge or discontinuance of services.
(1) A provider may discharge an individual
from services or otherwise discontinue services because of failure to
pay.
(2) Providers must adhere to
the provisions of section
633.12 of this Title and any law
or regulation that applies to the discharge or discontinuation of
services.
(3) Notwithstanding the
provisions of paragraph (1) of this subdivision, a provider may not discharge
an individual from services or discontinue services if the continuation of
services is otherwise required by law or court order.
(d) Effect on liability for services.
(1) The responsibility of
individuals and other liable parties to pay for services is not affected by any
requirement in this section that providers continue to provide services to the
individual despite failure to pay.
(2) The responsibility of individuals and
other liable parties to pay for services continues during the time that
proceedings are underway to discharge the individual or otherwise discontinue
services.
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