New York Codes, Rules and Regulations
Title 14 - DEPARTMENT OF MENTAL HYGIENE
Chapter XXI - OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES
Part 841 - Medical Assistance for Chemical Dependence Services
Section 841.4 - Definitions

Universal Citation: 14 NY Comp Codes Rules and Regs ยง 841.4

Current through Register Vol. 46, No. 12, March 20, 2024

(a) "Medicaid program" shall mean the medical assistance program, under Title XIX of the federal Social Security Act, in accordance with a state plan approved by the United States Department of Health and Human Services.

(b) "Eligible provider" shall operate an addiction services program and shall be approved by the single state agency to provide services and operate as a Medicaid provider; and is one of the following:

(1) a substance use disorder withdrawal and stabilization services program which is certified under Part 816 of this Title; or

(2) a substance use disorder residential rehabilitation services for youth program certified under Part 817 of this Title; or

(3) a substance use disorder inpatient rehabilitation services program which is certified under Part 818 of this Title; or

(4) a residential services program certified under Part 820 of this Title by the Office; or

(5) a substance use disorder outpatient program certified under Part 822 of this Title; or

(6) a children and family treatment and support services program certified or designated under Part 823 of this Title.

(c) "Single state agency" shall mean the New York State Department of Health.

(d) "Allowable costs" shall mean those costs incurred by an eligible inpatient provider which are eligible for payment by government agencies in accordance with title 11 of article 5 of the Social Services Law. To be allowable, costs must be reasonable and necessary for efficient provision of addiction services, related to patient care, and approved by the commissioner.

(e) "Per diem" or "patient day" shall mean the unit of measure denoting services rendered to one patient between the census taking hours on two successive days. In computing patient days, the day of admission shall be counted but not the day of discharge. When a patient is admitted and discharged on the same day, this period shall be counted as one patient day.

(f) "Base year" shall mean the cost reporting period for which fiscal and patient data are utilized to calculate rates of payment.

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