N.Y. Comp. Codes R. & Regs. tit. 14 § 802.4

Current through Register Vol. 46, No. 50, December 11, 2024

Section 802.4 - Vital Access Program

(a)Program.

The Vital Access Program is a program of ongoing supplement to the non-capital component of service reimbursement rates calculated pursuant to Part 841 of this Title, or exemption from payment reductions, as long as the designation as a vital access provider, as determined pursuant to this section, applies.

(b) Eligibility.

The commissioner may grant approval of temporary adjustments to OASAS certified inpatient rehabilitation (IPRs) programs, or such other programs as may be designated by the commissioner, which demonstrate through submission of a written application that the additional resources provided by a temporary rate adjustment will achieve one or more of the following:

(1) protect or enhance access to care;

(2) protect or enhance quality of care;

(3) improve the cost effectiveness of the delivery of health care services; or

(4) otherwise protect or enhance the health care delivery system, as determined by the commissioner.

(c)Application.

(1) The written application pursuant to subdivision (a) of this section shall be submitted to the commissioner at least 60 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.

(2) 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.

(3) In rural communities, Federal designation as critical access, essential access, or sole community provider will serve to meet the threshold criteria as a vital access provider.

(d)Conditions on approval.

(1) Any temporary rate adjustment 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, the facility shall be reimbursed in accordance with the otherwise applicable rate-setting methodology as set forth in applicable statutes and Part 841 of this Title.

(2) The commissioner may establish, as a condition of receiving such a temporary rate adjustment, benchmarks and goals to be achieved in conformity with the facility's written application as approved by the commissioner and may also require that the facility submit such periodic reports concerning the achievement of 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 prior to the end of the specified timeframe.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 802.4

Adopted, New York State Register October 1, 2014/Volume XXXVI, Issue 39, eff. 9/10/2014