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 5 - Procedures and Forms
Part 540 - Authorization Of Medical Care
Section 540.10 - Claims for State aid
Universal Citation: 18 NY Comp Codes Rules and Regs ยง 540.10
Current through Register Vol. 46, No. 39, September 25, 2024
(a) General.
(1) Claims for State (and Federal)
aid in behalf of expenditures for medical care shall be prepared and submitted
in accordance with departmental regulations with respect thereto.
(2) The internal controls established by the
public welfare official for the examination and verification prior to payment
of bills for medical services rendered shall identify and isolate any payments
or portions of payments that exceed limits stipulated by State regulations and
the claims for State (and Federal) aid prepared and submitted by the agency
shall exclude from calculations of such aid any such amounts, as require by
departmental regulations governing the preparation and submission of claims.
Other elements requiring case expenditure analysis entering into the
development of proper claims, such as program and residence status, shall also
be provided for in the internal analysis and processing of medical services
payments.
(3) Where claims and
rolls for State aid purposes must be supported by vouchers or statements of
services paid for medical care, the public welfare agency must ensure, in its
operating procedures, that sufficient copies of the appropiate documents are
developed to meet both its internal needs and the roll and claim
requirements.
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