§ 2557 — Financial responsibility and reimbursement

§ 2557. Financial responsibility and reimbursement. 1. The approved\ncosts for an eligible child who receives an evaluation and early\nintervention services pursuant to this title shall be a charge upon the\nmunicipality wherein the eligible child resides or, where the services\nare covered by the medical assistance program, upon the social services\ndistrict of fiscal responsibility with respect to those eligible\nchildren who are also eligible for medical assistance. All approved\ncosts shall be paid in the first instance and at least quarterly by the\nappropriate governing body or officer of the municipality upon vouchers\npresented and audited in the same manner as the case of other claims\nagainst the municipality. Notwithstanding the insurance law or\nregulations thereunder relating to the permissible exclusion of payments\nfor services under governmental programs, no such exclusion shall apply\nwith respect to payments made pursuant to this title. Notwithstanding\nthe insurance law or any other law or agreement to the contrary,\nbenefits under this title shall be considered secondary to the medical\nassistance program under which an eligible child may have coverage.\n 2. The department shall reimburse the approved costs paid by a\nmunicipality for the purposes of this title, other than those\nreimbursable by the medical assistance program, in an amount of fifty\npercent of the amount expended in accordance with the rules and\nregulations of the commissioner; provided, however, that in the\ndiscretion of the department and with the approval of the director of\nthe division of the budget, the department may reimburse municipalities\nin an amount greater than fifty percent of the amount expended. Such\nstate reimbursement to the municipality shall not be paid prior to April\nfirst of the year in which the approved costs are paid by the\nmunicipality, provided, however that, subject to the approval of the\ndirector of the budget, the department may pay such state aid\nreimbursement to the municipality prior to such date.\n 3. The department may perform audits, which may include site\nvisitation, to all or any of the following: municipalities; service\ncoordinators; evaluators or providers of early intervention services.\nThe department shall provide the municipalities with a copy of the\nfindings of such audits. Early intervention program state aid\nreimbursement or portion thereof may be withheld if, on post-audit and\nreview, the commissioner finds that the early intervention services were\nnot provided or those provided were not in substantial conformance with\nthe rules and regulations established by the commissioner or that the\nrecipient of such services was not an eligible child as defined in\nsection twenty-five hundred forty-one of this title. In the event that\nthe commissioner determines that there may be a withholding of state\nreimbursement to any municipality under this section, he shall inform\nthe state early intervention coordinating council and the relevant local\nearly intervention coordinating council and shall consider alternative\ncourses of action recommended within sixty days by either body prior to\nwithholding state reimbursement.\n 3-a. Each municipality may perform an audit, which may include site\nvisitation, of evaluators and providers of such services within its\nmunicipality in accordance with standards established by the\ncommissioner. The municipality shall submit the results of any such\naudit to the commissioner for review and, if warranted, adjustments in\nstate aid reimbursement pursuant to subdivision three of this section,\nas well as for recovery by the municipality of its share of any\ndisallowances identified in such audit.\n 5. (a) The commissioner, in his or her discretion, is authorized to\ncontract with one or more entities to act as the fiscal agent for the\ndepartment and municipalities with respect to fiscal management and\npayment of early intervention claims. Municipalities shall grant\nsufficient authority to the fiscal agent to act on their behalf.\nMunicipalities, and individual and agency providers as defined by the\ncommissioner in regulation shall utilize such fiscal agent for payment\nof early intervention claims as determined by the department and shall\nprovide such information and documentation as required by the department\nand necessary for the fiscal agent to carry out its duties.\n (b) Notwithstanding any inconsistent provision of section one hundred\ntwelve or one hundred sixty-three of the state finance law, sections one\nhundred forty-two and one hundred forty-three of the economic\ndevelopment law, or any other contrary provision of law, the\ncommissioner is authorized to enter into a contract or contracts under\nparagraph (a) of this subdivision without a competitive bid or request\nfor proposal process, provided, however, that:\n (i) The department shall post on its website, for a period of no less\nthan thirty days:\n (1) A description of the proposed services to be provided pursuant to\nthe contract or contracts;\n (2) The criteria for selection of a contractor or contractors;\n (3) The period of time during which a prospective contractor may seek\nselection, which shall be no less than thirty days after such\ninformation is first posted on the website; and\n (4) The manner by which a prospective contractor may seek such\nselection, which may include submission by electronic means;\n (ii) All reasonable and responsive submissions that are received from\nprospective contractors in a timely fashion shall be reviewed by the\ncommissioner; and\n (iii) The commissioner shall select such contractor or contractors\nthat, in his or her discretion, are best suited to serve the purposes of\nthis section.\n (c) Paragraph (b) of this subdivision shall apply only to the initial\ncontract or contracts necessary to obtain the services of a fiscal agent\nfor early intervention program fiscal management and payment of early\nintervention claims and shall not apply to subsequent contracts needed\nto maintain such services, as determined by the commissioner in his or\nher discretion.\n