N.Y. Public Health Law § 2826 – Temporary adjustment to reimbursement rates

(a) Notwithstanding any provision of law to the contrary, within funds appropriated and subject to the availability of federal financial participation, the commissioner may grant approval of a temporary adjustment to the non-capital components of rates, or make temporary lump-sum Medicaid payments, to eligible general hospitals, skilled nursing facilities, clinics and home care providers, provided however, that should federal financial participation not be available for any eligible provider, then payments pursuant to this subdivision may be made as grants and shall not be deemed to be medical assistance payments.
(b) Eligible providers shall include:
1. (i) providers undergoing closure;
2. (ii) providers impacted by the closure of other health care providers;
3. (iii) providers subject to mergers, acquisitions, consolidations or restructuring; or
4. (iv) providers impacted by the merger, acquisition, consolidation or restructuring of other health care providers.
(c) Providers seeking temporary rate adjustments under this section shall demonstrate through submission of a written proposal to the commissioner that the additional resources provided by a temporary rate adjustment will achieve one or more of the following:
1. (i) protect or enhance access to care;
2. (ii) protect or enhance quality of care;
3. (iii) improve the cost effectiveness of the delivery of health care services; or
4. (iv) otherwise protect or enhance the health care delivery system, as determined by the commissioner.
(d)
1. (i) Such written proposal shall be submitted to the commissioner at least sixty days prior to the requested effective date of the temporary rate adjustment, and shall include a proposed budget to achieve the goals of the proposal. Any Medicaid payment issued pursuant to this section shall be in effect for a specified period of time as determined by the commissioner, of up to three years. At the end of the specified timeframe such payments or adjustments to the non-capital component of rates shall cease, and the provider shall be reimbursed in accordance with the otherwise applicable rate-setting methodology as set forth in applicable statutes and regulations. The commissioner may establish, as a condition of receiving such temporary rate adjustments or grants, benchmarks and goals to be achieved in conformity with the provider's written proposal as approved by the commissioner and may also require that the facility submit such periodic reports concerning the achievement of such benchmarks and goals as the commissioner deems necessary. Failure to achieve satisfactory progress, as determined by the commissioner, in accomplishing such benchmarks and goals shall be a basis for ending the facility's temporary rate adjustment or grant prior to the end of the specified timeframe. (ii) The commissioner may require that applications submitted pursuant to this section be submitted in response to and in accordance with a Request For Applications or a Request For Proposals issued by the commissioner.
(e) Notwithstanding any law to the contrary, general hospitals defined as critical access hospitals pursuant to title XVIII of the federal social security act shall be allocated no less than five million dollars annually pursuant to this section. The department of health shall provide a report to the governor and legislature no later than December first, two thousand fourteen providing recommendations on how to ensure the financial stability of, and preserve patient access to, critical access hospitals.