New York Codes, Rules and Regulations
Title 14 - DEPARTMENT OF MENTAL HYGIENE
Chapter XIV - Office for People With Developmental Disabilities
Part 679 - Clinic Treatment Facilities
Section 679.6 - Financial reporting

Universal Citation: 14 NY Comp Codes Rules and Regs ยง 679.6

Current through Register Vol. 46, No. 39, September 25, 2024

(a) Cost report.

Each agency that operates a clinic treatment facility certified by OPWDD shall, on an annual basis, be required to submit a cost report prepared in accordance with Subpart 635-4 of this Title, for each certified site including costs associated with any certified satellite sites, and, as allowed prior to April 1, 2016, costs associated with service delivery off-site.

(b) Each agency that operates a clinic treatment facility shall provide OPWDD information it requests, including but not limited to the following: services provided by CPT/HCPCS and/or CDT codes, where such services were delivered, including the location of both the provider and the individual when services are delivered via telehealth, (i.e., on-site or at a certified satellite site, or, prior to April 1, 2016, of f-site) and revenues by funding source or payee. These data shall correspond to the identical time period of the cost report.

(c) Each clinic treatment facility shall maintain financial records in accordance with the requirements of section 635-4.5 of this Title.

(d) The agency/facility shall complete an annual audit of its financial circumstances and condition, certified by a certified or licensed public accountant. Said audit report shall be completed and submitted in a manner and on a schedule acceptable to the commissioner.

(e) Allowable costs.

General conditions.

(1) To be considered allowable, costs must be properly chargeable to necessary care rendered in accordance with the requirements of this Part and any applicable codes, rules, regulations and laws.

(2) Except where specific rules concerning allowability of costs are stated herein, the Medicare Provider Reimbursement Manual, commonly referred to as HIM-15, shall be used to determine the allowability of costs. Said guidelines are published by the U.S. Department of Health and Human Services' Health Care Financing Administration (HCFA). The HIM-15 document is available from:
(i) Health Care Financing Administration

Division of Communication Services

Production and Distribution Branch

Room 577, East High Rise Building

6325 Security Boulevard

Baltimore, MD 21207......................................................................

(ii) It may also be reviewed in person during regular business hours at the:
(a) NYS Department of State, 99 Washington Avenue, Albany, NY 12231; or by appointment at the:

(b) NYS Office for People with Developmental Disabilities, Counsel's Office, 44 Holland Avenue, Albany, NY 12229.

(3) Costs incurred as a result of requests for criminal history record checks under section 16.33 of the Mental Hygiene Law and section 845-b of the Executive Law shall be allowable costs and shall be considered part of the fee.

(4) Where specific rules stated herein or HIM-15 are silent concerning the allowability of costs, the commissioner shall determine allowability of costs based on reasonableness and relationship to the provision of care and generally accepted accounting principles.

(5) As determined by the commissioner, expenses or portions of expenses reported by an individual clinic treatment facility that are not reasonably related to the efficient and economical provision of care in accordance with any applicable certification standards, because of either the nature or amount of the item, shall not be allowed.

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