New York Codes, Rules and Regulations
Title 18 - DEPARTMENT OF SOCIAL SERVICES
Chapter II - Regulations of the Department of Social Services
Subchapter F - Finance; Claims for Reimbursement by Social Services Districts
Article 4 - Supplementary Assistance Reimbursement Claiming
Part 635 - Medical Assistance Reimbursement Claiming
Section 635.5 - Federal participation in payments for MA
Universal Citation: 18 NY Comp Codes Rules and Regs ยง 635.5
Current through Register Vol. 46, No. 39, September 25, 2024
(a) Payments for medical care, services and supplies shall not be eligible for Federal participation if the recipient was not eligible for MA in the period during which care, services and supplies were received.
(b) The determination of eligibility for Federal participation in the cost of medical care, services and/or supplies rendered to recipients shall be made by the local social services districts prior to submission of any claim for reimbursement.
(c)
(1) Federal reimbursement for expenditures
allocable to medical services provided by or in private child-caring
institutions and agencies is available on the basis of a per capita, per diem
rate established by the department, based upon medical cost reports submitted
by such instructions and agencies.
(2) Federal reimbursement is also available
for expenditures made by local social services districts to hospitals for
hospital care provided to children placed in private nonmedical institutions or
agencies.
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