New York Codes, Rules and Regulations
Title 18 - DEPARTMENT OF SOCIAL SERVICES
Chapter II - Regulations of the Department of Social Services
Subchapter E - Medical Care
Article 3 - Policies and Standards Governing Provision of Medical and Dental Care
Part 505 - Charges For Professional Health Services
Section 505.22 - Shared health facilities
Current through Register Vol. 46, No. 39, September 25, 2024
(a) A shared health facility means any arrangement or operation for the delivery of medical or health care, or services meeting the criteria set forth in subdivision 2 of section 4702 of the Public Health Law, as implemented by appropriate sections of 10 NYCRR Part 83 (regulations of the State Department of Health).
(b) Effective September 1, 1977, providers and purveyors who engage in any arrangement or operation for the delivery of medical or health care or services in facilities which have been determined by the State Department of Health, pursuant to the provisions of article 47 of the Public Health Law or 10 NYCRR Part 83, to be a shared health facility will be reimbursed only if that shared health facility is currently registered with the State Department of Health.
(c) Effective September 1, 1977, shared health facilities participating in the medical assistance program shall be operated in compliance with 10 NYCRR Part 83.
(d) In addition to the applicable billing requirements set forth in section 540.7 of this Title, each provider and purveyor who provides services in a shared health facility shall include in their claims submitted for payment, under the medical assistance program, the registration number assigned to such facility by the State Department of Health.
(e) All third-party insurance benefits covering a recipient, including benefits under title XVIII of the Social Security Act, shall be applied against the cost of medical care and services provided in a shared health facility in accordance with the provisions of section 360.9 of this Title.
(f) The provisions of Part 515 of this Title shall apply to shared health facilities and to any provider, purveyor or operator receiving payments under the medical assistance program, as those terms are defined in 10 NYCRR 83.2.
