New York Laws
Article 40 - Hospice
4012 - Payment for Hospice.

§ 4012. Payment for hospice. 1. No government agency shall purchase,
pay for or make reimbursement or grants-in-aid for services provided by
a hospice unless, at the time the services were provided, the hospice
possessed a valid certificate of approval.

2. Payments for hospice care made by government agencies shall be at
rates approved by the state director of the budget.

3. Prior to the approval of hospice rates, the commissioner shall
determine and certify to the state director of the budget that the
proposed rate schedules for payments for hospice services are reasonable
and adequate to meet the costs which must be incurred by efficiently and
economically operated programs. In making such certification, the
commissioner shall take into consideration the elements of cost,
geographical differentials in the elements of cost considered, economic
factors in the area in which the hospice is located, costs of hospice
programs of comparable size, the need for incentives to improve services
and institute economies, and applicable medicare reimbursement
regulations.

4. Eligible individuals shall be permitted to receive hospice services
from a provider under this article while continuing to reside in an
adult care facility under title two of article seven of the social
services law and enrolled in the assisted living program, subject to the
availability of federal financial participation. The commissioner shall
make regulations and take other actions reasonably necessary and
appropriate to implement this subdivision.

5. The commissioner shall establish a methodology as of July first,
two thousand eighteen subject to federal financial participation that
shall ensure a prospective ten-percent increase in the medicaid
reimbursement rates for hospice providers, relative to the reimbursement
rate, as of March thirty-first, two thousand eighteen, for services
provided by such providers on and after April first, two thousand
eighteen.