§ 2807-P — Comprehensive diagnostic and treatment centers indigent care program

§ 2807-p. Comprehensive diagnostic and treatment centers indigent care\nprogram. 1. (a) For periods prior to July first, two thousand three, and\non and after July first, two thousand five the commissioner is\nauthorized to make payments to eligible diagnostic and treatment\ncenters, to the extent of funds available therefor, up to forty-eight\nmillion dollars annually, to assist in meeting losses resulting from\nuncompensated care. The amount of funds available for such payments\npursuant to subdivision four of this section shall be the amount\nremaining after the allocation provided in section seven of chapter four\nhundred thirty-three of the laws of nineteen hundred ninety-seven as\namended by section seventy-five of chapter one of the laws of nineteen\nhundred ninety-nine.\n (b) For periods on and after July first, two thousand three, through\nJune thirtieth, two thousand five, the commissioner shall, subject to\nthe availability of federal financial participation, adjust medical\nassistance rates of payment to assist in meeting losses resulting from\nuncompensated care, provided, however, in the event federal financial\nparticipation is not available, the commissioner is authorized to\ncontinue to make payments to eligible diagnostic and treatment centers,\nto the extent of funds available therefor, in accordance with provisions\nof paragraph (a) of this subdivision and without regard to the\nprovisions of subdivisions four-a and four-b of this section.\n (c) Notwithstanding paragraph (a) of this subdivision, subdivision\nfour-c of this section or any other inconsistent provision of this\nsection, distributions made pursuant to this section for annual periods\non and after July first, two thousand nine shall be subject to a uniform\nreduction of two percent.\n (d) The commissioner may require facilities receiving distributions\npursuant to this section as a condition of participating in such\ndistributions, to provide reports and data to the department as the\ncommissioner deems necessary to adequately implement the provisions of\nthis section.\n 2. Definitions. (a) "Eligible diagnostic and treatment centers", for\npurposes of this section, shall mean voluntary non-profit and publicly\nsponsored diagnostic and treatment centers providing a comprehensive\nrange of primary health care services which can demonstrate losses from\ndisproportionate share of uncompensated care during a base period two\nyears prior to the grant period; provided that for periods on and after\nJanuary first, two thousand four an eligible diagnostic and treatment\ncenter shall not include any voluntary non-profit diagnostic and\ntreatment center controlling, controlled by or under common control with\na health maintenance organization, as defined by subdivision one of\nsection forty-four hundred one of this chapter; provided further that\nfor purposes of this section, a health maintenance organization shall\nnot include a prepaid health services plan licensed pursuant to section\nforty-four hundred three-a of this chapter. For periods on and after\nJuly first, two thousand three, the base period and the grant period\nshall be the calendar year.\n (b) "Uncompensated care need", for purposes of this section, means\nlosses from reported self-pay and free visits multiplied by the\nfacility's medical assistance payment rate for the applicable\ndistribution year, offset by payments received from such patients during\nthe reporting period.\n 3. (a) During the period January first, nineteen hundred ninety-seven\nthrough September thirtieth, nineteen hundred ninety-seven and for each\nfiscal year period commencing on October first thereafter through\nDecember thirty-first, nineteen hundred ninety-nine and for periods on\nand after January first, two thousand, diagnostic and treatment centers\nshall be eligible for allocations of funds or for rate adjustments\ndetermined in accordance with this section to reflect the needs of the\ndiagnostic and treatment center for the financing of losses resulting\nfrom uncompensated care.\n (b) A diagnostic and treatment center qualifying for a distribution or\na rate adjustment pursuant to this section shall provide assurances\nsatisfactory to the commissioner that it shall undertake reasonable\nefforts to maintain financial support from community and public funding\nsources and reasonable efforts to collect payments for services from\nthird-party insurance payors, governmental payors and self-paying\npatients.\n (c) To be eligible for an allocation of funds or a rate adjustment\npursuant to this section, a diagnostic and treatment center must provide\na comprehensive range of primary health care services and must\ndemonstrate that a minimum of five percent of total clinic visits\nreported during the applicable base year period were to uninsured\nindividuals. The commissioner may retrospectively reduce the allocations\nof funds or the rate adjustments to a diagnostic and treatment center if\nit is determined that provider management actions or decisions have\ncaused a significant reduction for the grant period in the delivery of\ncomprehensive primary health care services to uncompensated care\nresidents of the community.\n 4. (a) (i) The total amount of funds to be allocated and distributed\nfor uncompensated care to eligible voluntary non-profit diagnostic and\ntreatment centers for a distribution period prior to July first, two\nthousand three, and on and after July first, two thousand five through\nDecember thirty-first, two thousand six, in accordance with this\nsubdivision shall be limited to thirty-three percent of the funds\navailable therefor pursuant to paragraph (a) of subdivision one of this\nsection and, for the period January first, two thousand seven through\nDecember thirty-first, two thousand seven, such distributions shall be\nlimited to sixteen and one-half percent of the funds available therefor.\n (ii) The total amount of funds to be allocated and distributed for\nuncompensated care to eligible publicly sponsored diagnostic and\ntreatment centers for a grant period prior to July first, two thousand\nthree, and on and after July first, two thousand five through December\nthirty-first, two thousand six, in accordance with this subdivision\nshall be limited to sixty-seven percent of funds available therefor\npursuant to paragraph (a) of subdivision one of this section and, for\nthe period January first, two thousand seven through December\nthirty-first, two thousand seven, such distributions shall be limited to\nthirty-three and one-half percent of the funds available therefor;\nprovided, however, that for periods up through December thirty-first,\ntwo thousand seven, forty-one percent of the amount of funds allocated\nfor distribution to eligible publicly sponsored diagnostic and treatment\ncenters shall be available for clinics operating under the auspices of\nthe New York city health and hospitals corporation as established by\nchapter one thousand sixteen of the laws of nineteen hundred sixty-nine\nas amended.\n (iii) (A) Notwithstanding any inconsistent provision of this\nparagraph, for the period January first, nineteen hundred ninety-seven\nthrough December thirty-first, nineteen hundred ninety-nine and for\nperiods on and after January first, two thousand through December\nthirty-first, two thousand two, and for periods on and after January\nfirst, two thousand four through December thirty-first, two thousand\nseven, in the event that federal financial participation is not\navailable for rate adjustments pursuant to this section, diagnostic and\ntreatment centers which received an allowance pursuant to paragraph (f)\nof subdivision two of section twenty-eight hundred seven of this article\nfor the period through December thirty-first, nineteen hundred\nninety-six shall receive an annual uncompensated care distribution\nallocation of funds of not less than the amount that would have been\nreceived for any losses associated with the delivery of bad debt and\ncharity care for nineteen hundred ninety-five had the provisions of\nparagraph (f) of subdivision two of section twenty-eight hundred seven\nof this article remained in effect, provided, however, that for the\nperiod January first, two thousand seven through December thirty-first,\ntwo thousand seven, the dollar value of the application of the\nprovisions of this subparagraph for any such diagnostic and treatment\ncenter shall be reduced by fifty percent.\n (B) For the period January first, two thousand three through June\nthirtieth, two thousand three, and for the period July first, two\nthousand three through December thirty-first, two thousand three and in\nthe event that federal financial participation is not available for rate\nadjustments pursuant to this section, each such diagnostic and treatment\ncenter shall receive an uncompensated care distribution allocation of\nfunds of not less than one-half the amount calculated pursuant to clause\n(A) of this subparagraph.\n (b) (i) A nominal payment amount for the financing of losses\nassociated with the delivery of uncompensated care will be established\nfor each eligible diagnostic and treatment center. The nominal payment\namount shall be calculated as the sum of the dollars attributable to the\napplication of an incrementally increasing nominal coverage percentage\nof base year period losses associated with the delivery of uncompensated\ncare for percentage increases in the relationship between base year\nperiod eligible uninsured care clinic visits and base year period total\nclinic visits according to the following scale:\n % of eligible bad debt and charity care % of nominal financial\n clinic visits to total visits loss coverage\n up to 15% 50%\n 15 - 30% 75%\n 30%+ 100%\n (ii) For periods prior to January first, two thousand eight, if the\nsum of the nominal payment amounts for all eligible voluntary non-profit\ndiagnostic and treatment centers or for all eligible public diagnostic\nand treatment centers or for all clinics operating under the auspices of\nthe New York city health and hospitals corporation is less than the\namount allocated for uncompensated care allowances pursuant to paragraph\n(a) of this subdivision for such diagnostic and treatment centers\nrespectively, the nominal coverage percentages of base year period\nlosses associated with the delivery of uncompensated care pursuant to\nthis scale may be increased to not more than one hundred percent for\nvoluntary non-profit diagnostic and treatment centers or for public\ndiagnostic and treatment centers or for all clinics operating under the\nauspices of the New York city health and hospitals corporation in\naccordance with rules and regulations adopted by the council and\napproved by the commissioner.\n (c) For periods prior to January first, two thousand eight, the\nuncompensated care allocations of funds for each eligible voluntary\nnon-profit diagnostic and treatment center, as computed in accordance\nwith paragraph (a) of this subdivision, shall be based on the dollar\nvalue of the result of the ratio of total funds allocated for\ndistributions for voluntary non-profit diagnostic and treatment centers\npursuant to paragraph (a) of this subdivision to the total statewide\nnominal payment amounts for all eligible voluntary non-profit diagnostic\nand treatment centers determined in accordance with paragraph (b) of\nthis subdivision applied to the nominal payment amount for each such\ndiagnostic and treatment center.\n (d) For periods prior to January first, two thousand eight, the\nuncompensated care allocations of funds for each eligible public\ndiagnostic and treatment center, other than clinics operating under the\nauspices of the New York city health and hospitals corporation and as\ncomputed in accordance with paragraph (a) of this subdivision, shall be\nbased on the dollar value of the result of the ratio of total funds\nallocated for distributions for public diagnostic and treatment centers,\nother than clinics operating under the auspices of the New York city\nhealth and hospitals corporation, pursuant to paragraph (a) of this\nsubdivision to the total statewide nominal payment amounts for all\neligible public diagnostic and treatment centers, other than clinics\noperating under the auspices of the New York city health and hospitals\ncorporation, determined in accordance with paragraph (b) of this\nsubdivision applied to the nominal payment amount for each such\ndiagnostic and treatment center.\n (e) For periods prior to January first, two thousand eight, the\nuncompensated care grant allocations of funds for each eligible public\ndiagnostic and treatment center operating under the auspices of the New\nYork city health and hospitals corporation, as computed in accordance\nwith paragraph (a) of this subdivision, shall be based on the dollar\nvalue of the result of the ratio of total funds allocated for\ndistributions for public diagnostic and treatment centers operating\nunder the auspices of the New York city health and hospitals corporation\npursuant to paragraph (a) of this subdivision to the total statewide\nnominal payment amounts for all eligible public diagnostic and treatment\ncenters operating under the auspices of the New York city health and\nhospitals corporation determined in accordance with paragraph (b) of\nthis subdivision applied to the nominal payment amount for each such\ndiagnostic and treatment center.\n (f) For periods prior to January first, two thousand eight, any\nresidual amount allocated for distribution to a classification of\ndiagnostic and treatment centers in accordance with this subdivision\nshall be reallocated by the commissioner for distributions to the other\nclassifications based on remaining need.\n (g) For periods on and after January first, two thousand seven, the\nuncompensated care allocations of funds for each eligible diagnostic and\ntreatment center, other than allocations made pursuant to paragraphs\n(c), (d), (e) or (f) of this subdivision, shall be based on the dollar\nvalue of the result of the ratio of total funds allocated for\ndistributions for all eligible diagnostic and treatment centers to the\ntotal statewide nominal payment amounts for all eligible diagnostic and\ntreatment centers determined in accordance with paragraph (b) of this\nsubdivision applied to the nominal payment amount for each such\ndiagnostic and treatment center.\n 4-a. (a)(i) For periods on and after July first, two thousand three,\nthrough June thirtieth, two thousand five, funds shall be made available\nfor adjustments to rates of payments made pursuant to paragraph (b) of\nsubdivision one of this section for eligible voluntary non-profit\ndiagnostic and treatment centers in accordance with subparagraphs (ii)\nand (iii) of this paragraph, for the following periods in the following\naggregate amounts:\n (A) For the period July first, two thousand three through December\nthirty-first, two thousand three, up to seven million five hundred\nthousand dollars;\n (B) For the period January first, two thousand four through December\nthirty-first, two thousand four, up to fifteen million dollars;\n (C) For the period January first, two thousand five through June\nthirtieth, two thousand five, up to seven million five hundred thousand\ndollars.\n (ii) A nominal payment amount for the financing of losses associated\nwith the delivery of uncompensated care will be established for each\neligible diagnostic and treatment center. The nominal payment amount\nshall be calculated as the sum of the dollars attributable to the\napplication of an incrementally increasing nominal coverage percentage\nof base year period losses associated with the delivery of uncompensated\ncare for percentage increases in the relationship between base year\nperiod eligible uninsured care clinic visits and base year period total\nclinic visits according to the following scale:\n % of eligible bad debt and charity care % of nominal financial\n clinic visits to total visits loss coverage\n up to 15% 50%\n 15 - 30% 75%\n 30%+ 100%\n (iii) The uncompensated care rate adjustments for each eligible\nvoluntary non-profit diagnostic and treatment center shall be based on\nthe dollar value of the result of the ratio of total funds allocated for\ndistributions for voluntary non-profit diagnostic and treatment centers\npursuant to subparagraph (i) of this paragraph, to the total statewide\nnominal payment amounts for all eligible voluntary non-profit diagnostic\nand treatment centers determined in accordance with subparagraph (ii) of\nthis paragraph applied to the nominal payment amount for each such\ndiagnostic and treatment center.\n (b)(i) For periods on and after July first, two thousand three through\nJune thirtieth, two thousand five, funds shall be made available for\nadjustments to rates of payments made pursuant to paragraph (b) of\nsubdivision one of this section for eligible public diagnostic and\ntreatment centers, other than clinics operated under the auspices of the\nNew York city health and hospitals corporation, in accordance with\nsubparagraphs (ii) and (iii) of this paragraph, for the following\nperiods in the following aggregate amounts:\n (A) For the period July first, two thousand three through December\nthirty-first, two thousand three, up to nine million dollars;\n (B) For the period January first, two thousand four through December\nthirty-first, two thousand four, up to eighteen million dollars;\n (C) For the period January first, two thousand five through June\nthirtieth, two thousand five, up to nine million dollars.\n (ii) A nominal payment amount for the financing of losses associated\nwith the delivery of uncompensated care will be established for each\neligible diagnostic and treatment center. The nominal payment amount\nshall be calculated as the sum of the dollars attributable to the\napplication of an incrementally increasing nominal coverage percentage\nof base year period losses associated with the delivery of uncompensated\ncare for percentage increases in the relationship between base year\nperiod eligible uninsured care clinic visits and base year period total\nclinic visits according to the following scale:\n % of eligible bad debt and charity care % of nominal financial\n clinic visits to total visits loss coverage\n up to 15% 50%\n 15 - 30% 75%\n 30%+ 100%\n (iii) The uncompensated care rate adjustments for each eligible public\ndiagnostic and treatment center, other than clinics operating under the\nauspices of the New York city health and hospitals corporation, shall be\nbased on the dollar value of the result of the ratio of total funds\nallocated for distributions for public diagnostic and treatment centers,\nother than clinics operating under the auspices of the New York city\nhealth and hospitals corporation, pursuant to subparagraph (i) of this\nparagraph to the total statewide nominal payment amounts for all\neligible public diagnostic and treatment centers, other than clinics\noperating under the auspices of the New York city health and hospitals\ncorporation, determined in accordance with subparagraph (ii) of this\nparagraph applied to the nominal payment amount for each such diagnostic\nand treatment center.\n (c)(i) For periods on and after July first, two thousand three,\nthrough June thirtieth, two thousand five, funds shall be made available\nfor adjustments to rates of payments made pursuant to paragraph (b) of\nsubdivision one of this section for eligible public diagnostic and\ntreatment centers operating under the auspices of the New York city\nhealth and hospitals corporation, in accordance with subparagraphs (ii)\nand (iii) of this paragraph, for the following periods in the following\naggregate amounts:\n (A) For the period July first, two thousand three through December\nthirty-first, two thousand three, up to six million dollars;\n (B) For the period January first, two thousand four through December\nthirty-first, two thousand four, up to twelve million dollars;\n (C) For the period January first, two thousand five through June\nthirtieth, two thousand five, up to six million dollars.\n (ii) A nominal payment amount for the financing of losses associated\nwith the delivery of uncompensated care will be established for each\neligible diagnostic and treatment center. The nominal payment amount\nshall be calculated as the sum of the dollars attributable to the\napplication of an incrementally increasing nominal coverage percentage\nof base year period losses associated with the delivery of uncompensated\ncare for percentage increases in the relationship between base year\nperiod eligible uninsured care clinic visits and base year period total\nclinic visits according to the following scale:\n % of eligible bad debt and charity care % of nominal financial\n clinic visits to total visits loss coverage\n up to 15% 50%\n 15 - 30% 75%\n 30%+ 100%\n (iii) The uncompensated care rate adjustment, for each eligible public\ndiagnostic and treatment center operating under the auspices of the New\nYork city health and hospitals corporation shall be based on the dollar\nvalue of the result of the ratio of total funds allocated for\ndistributions for public diagnostic and treatment centers operating\nunder the auspices of the New York city health and hospitals corporation\npursuant to subparagraph (i) of this paragraph to the total statewide\nnominal payment amounts for all eligible public diagnostic and treatment\ncenters operating under the auspices of the New York city health and\nhospitals corporation determined in accordance with subparagraph (ii) of\nthis paragraph applied to the nominal payment amount for each such\ndiagnostic and treatment center.\n (d) (i) Notwithstanding the provisions of paragraph (b) of this\nsubdivision and any other provisions of this chapter, municipalities\nwhich received state aid pursuant to article two of this chapter for the\nnineteen hundred eighty-nine--nineteen hundred ninety state fiscal year\nin support of non-hospital based free-standing or local health\ndepartment operated general medical clinics shall receive an\nuncompensated care rate adjustment for the period July first, two\nthousand three through December thirty-first, two thousand three, of not\nless than one-half the amount received in the nineteen hundred\neighty-nine--nineteen hundred ninety state fiscal year for general\nmedical clinics.\n (ii) For the period January first, two thousand four through December\nthirty-first, two thousand four, each such municipality shall receive an\nuncompensated care rate adjustment of not less than twice the amount\ncalculated pursuant to subparagraph (i) of this paragraph.\n (iii) For the period January first, two thousand five through June\nthirtieth, two thousand five, each such municipality shall receive an\nannual uncompensated care rate adjustment of not less than the amount\ncalculated pursuant to subparagraph (i) of this paragraph.\n (e) (i) Notwithstanding any inconsistent provision of this\nsubdivision, for the period July first, two thousand three through\nDecember thirty-first, two thousand three, diagnostic and treatment\ncenters which received an allowance pursuant to paragraph (f) of\nsubdivision two of section twenty-eight hundred seven of this article\nfor the period through December thirty-first, nineteen hundred\nninety-six shall receive an uncompensated care rate adjustment of not\nless than one-half the amount that would have been received for any\nlosses associated with the delivery of bad debt and charity care for\nnineteen hundred ninety-five had the provisions of paragraph (f) of\nsubdivision two of section twenty-eight hundred seven of this article\nremained in effect.\n (ii) For the period January first, two thousand four through December\nthirty-first, two thousand four, each such diagnostic and treatment\ncenter shall receive an uncompensated care rate adjustment of not less\nthan twice the amount calculated pursuant to subparagraph (i) of this\nparagraph.\n (iii) For the period January first, two thousand five through June\nthirtieth, two thousand five, each such diagnostic and treatment center\nshall receive an annual uncompensated care rate adjustment of not less\nthan the amount calculated pursuant to subparagraph (i) of this\nparagraph, and shall be subject to subsequent adjustment or\nreconciliation.\n (f) Any residual amount allocated for distribution to a classification\nof diagnostic and treatment centers in accordance with this subdivision\nshall be reallocated by the commissioner for distributions to the other\nclassifications based on remaining need.\n 4-b. (a) For periods on and after July first, two thousand three,\nthrough June thirtieth, two thousand five, funds shall be made available\nfor adjustments to rates of payment made pursuant to paragraph (b) of\nsubdivision one of this section for eligible diagnostic and treatment\ncenters with less than two years of operating experience, and diagnostic\nand treatment centers which have received certificate of need approval\non applications which indicate a significant increase in uninsured\nvisits, for the following periods and in the following aggregate\namounts:\n (i) For the period July first, two thousand three through December\nthirty-first, two thousand three, up to one million five hundred\nthousand dollars;\n (ii) For the period January first, two thousand four through December\nthirty-first, two thousand four, up to three million dollars;\n (iii) For the period January first, two thousand five through June\nthirtieth, two thousand five, up to one million five hundred thousand\ndollars.\n (b) To be eligible for a rate adjustment pursuant to this section, a\ndiagnostic and treatment center shall be a voluntary, non-profit or\npublicly sponsored diagnostic and treatment center providing a\ncomprehensive range of primary health care services and be eligible to\nreceive a medicaid budgeted rate prior to April first of the applicable\nrate adjustment period after which time, the department shall issue rate\nadjustments pursuant to this subdivision for such periods. Rate\nadjustments made pursuant to this subdivision shall be allocated based\nupon each eligible facility's proportional share of costs for services\nrendered to uninsured patients which have otherwise not been used for\nestablishing distributions pursuant to subdivision four-a of this\nsection. For the purposes of this subdivision costs shall be measured by\nmultiplying each facility's medicaid budgeted rate by the estimated\nnumber of visits reported for services anticipated to be rendered to\nuninsured patients meeting the aforementioned criteria, less any\nanticipated patient service revenues received from such uninsured\npatients, during the applicable rate adjustment period.\n 4-c. Notwithstanding any provision of law to the contrary, the\ncommissioner shall make additional payments for uncompensated care to\nvoluntary non-profit diagnostic and treatment centers that are eligible\nfor distributions under subdivision four of this section in the\nfollowing amounts: for the period June first, two thousand six through\nDecember thirty-first, two thousand six, in the amount of seven million\nfive hundred thousand dollars, for the period January first, two\nthousand seven through December thirty-first, two thousand seven, seven\nmillion five hundred thousand dollars, for the period January first, two\nthousand eight through December thirty-first, two thousand eight, seven\nmillion five hundred thousand dollars, for the period January first, two\nthousand nine through December thirty-first, two thousand nine, fifteen\nmillion five hundred thousand dollars, for the period January first, two\nthousand ten through December thirty-first, two thousand ten, seven\nmillion five hundred thousand dollars, for the period January first, two\nthousand eleven though December thirty-first, two thousand eleven, seven\nmillion five hundred thousand dollars, for the period January first, two\nthousand twelve through December thirty-first, two thousand twelve,\nseven million five hundred thousand dollars, for the period January\nfirst, two thousand thirteen through December thirty-first, two thousand\nthirteen, seven million five hundred thousand dollars, for the period\nJanuary first, two thousand fourteen through December thirty-first, two\nthousand fourteen, seven million five hundred thousand dollars, for the\nperiod January first, two thousand fifteen through December\nthirty-first, two thousand fifteen, seven million five hundred thousand\ndollars, for the period January first two thousand sixteen through\nDecember thirty-first, two thousand sixteen, seven million five hundred\nthousand dollars, for the period January first, two thousand seventeen\nthrough December thirty-first, two thousand seventeen, seven million\nfive hundred thousand dollars, for the period January first, two\nthousand eighteen through December thirty-first, two thousand eighteen,\nseven million five hundred thousand dollars, for the period January\nfirst, two thousand nineteen through December thirty-first, two thousand\nnineteen, seven million five hundred thousand dollars, for the period\nJanuary first, two thousand twenty through December thirty-first, two\nthousand twenty, seven million five hundred thousand dollars, for the\nperiod January first, two thousand twenty-one through December\nthirty-first, two thousand twenty-one, seven million five hundred\nthousand dollars, for the period January first, two thousand twenty-two\nthrough December thirty-first, two thousand twenty-two, seven million\nfive hundred thousand dollars, for the period January first, two\nthousand twenty-three through December thirty-first, two thousand\ntwenty-three, seven million five hundred thousand dollars, for the\nperiod January first, two thousand twenty-four through December\nthirty-first, two thousand twenty-four, seven million five hundred\nthousand dollars, for the period January first, two thousand twenty-five\nthrough December thirty-first, two thousand twenty-five, seven million\nfive hundred thousand dollars, and for the period January first, two\nthousand twenty-six through March thirty-first, two thousand twenty-six,\nin the amount of one million six hundred thousand dollars, provided,\nhowever, that for periods on and after January first, two thousand\neight, such additional payments shall be distributed to voluntary,\nnon-profit diagnostic and treatment centers and to public diagnostic and\ntreatment centers in accordance with paragraph (g) of subdivision four\nof this section. In the event that federal financial participation is\navailable for rate adjustments pursuant to this section, the\ncommissioner shall make such payments as additional adjustments to rates\nof payment for voluntary non-profit diagnostic and treatment centers\nthat are eligible for distributions under subdivision four-a of this\nsection in the following amounts: for the period June first, two\nthousand six through December thirty-first, two thousand six, fifteen\nmillion dollars in the aggregate, and for the period January first, two\nthousand seven through June thirtieth, two thousand seven, seven million\nfive hundred thousand dollars in the aggregate. The amounts allocated\npursuant to this paragraph shall be aggregated with and distributed\npursuant to the same methodology applicable to the amounts allocated to\nsuch diagnostic and treatment centers for such periods pursuant to\nsubdivision four of this section if federal financial participation is\nnot available, or pursuant to subdivision four-a of this section if\nfederal financial participation is available. Notwithstanding section\nthree hundred sixty-eight-a of the social services law, there shall be\nno local share in a medical assistance payment adjustment under this\nsubdivision.\n 5. Diagnostic and treatment centers shall furnish to the department\nsuch reports and information as may be required by the commissioner to\nassess the cost, quality, access to, effectiveness and efficiency of\nuncompensated care provided. The council shall adopt rules and\nregulations, subject to the approval of the commissioner, to establish\nuniform reporting and accounting principles designed to enable\ndiagnostic and treatment centers to fairly and accurately determine and\nreport uncompensated care visits and the costs of uncompensated care. In\norder to be eligible for an allocation of funds pursuant to this\nsection, a diagnostic and treatment center must be in compliance with\nuncompensated care reporting requirements.\n 6. Notwithstanding any inconsistent provision of law to the contrary,\nthe availability or payment of funds to a diagnostic and treatment\ncenter pursuant to this section shall not be admissible as a defense,\noffset or reduction in any action or proceeding relating to any bill or\nclaim for amounts due for services provided by a diagnostic and\ntreatment center.\n 7. Revenue from distributions to a diagnostic and treatment center\npursuant to this section shall not be included in gross revenue received\nfor purposes of the assessments pursuant to section twenty-eight hundred\nseven-d of this article, subject to the provisions of subdivision twelve\nof section twenty-eight hundred seven-d of this article.\n 8. (a) For periods on or after January first, two thousand through\nJune thirtieth, two thousand three, payments made to an eligible\ndiagnostic and treatment center pursuant to this section shall be\nreduced or increased by an amount equal to the amount of any\noverpayments or underpayments made against grants awarded pursuant to\nsection seven of chapter four hundred thirty-three of the laws of\nnineteen hundred ninety-seven for the period three years prior to the\nannual awards made pursuant to this section.\n (b) The determination of such overpayments or underpayments shall be\nbased on the submission by eligible facilities of reports reflecting\nactual uncompensated care data, as required by the commissioner, which\nare attributable to prior periods. Submission of such reports is a\ncondition for an eligible facility's receipt of payments pursuant to\nthis section.\n (c) For any periods in which a facility does not receive payments\npursuant to this section, the amount of any prior period overpayment may\nbe offset against payments for medical assistance made to such facility\npursuant to title eleven of article five of the social services law and\ncredited to funds allocated pursuant to this section. Any prior period\nunderpayment to an eligible facility may be paid to such facility in a\nsubsequent period.\n 9. Adjustments to rates of payment made pursuant to this section may\nbe added to rates of payment or made as aggregate payments to eligible\ndiagnostic and treatment centers and shall not be subject to subsequent\nadjustment or reconciliation, provided, however, that in the event such\nadjustments are made as aggregate payments, then notwithstanding any\nlaw, rule or regulation to the contrary responsibility for the local\nshare of such aggregate payments shall be apportioned to a local social\nservices district based on the most recent geographic utilization data\navailable to the department for eligible diagnostic and treatment center\nservices for payments in accordance with subdivisions four-a and four-b\nof this section for all diagnostic and treatment center services\nprovided in accordance with section three hundred sixty-five-a of the\nsocial services law, regardless of whether another social services\ndistrict or the department may otherwise be responsible for furnishing\nmedical assistance to the eligible persons receiving such services.\n 10. (a) Notwithstanding any inconsistent provision of this section or\nany other contrary provision of law, the commissioner is authorized to\nseek a waiver from the federal department of health and human services\npursuant to section eleven hundred fifteen of the federal social\nsecurity act, or such other federal law provision as may be deemed\nappropriate, seeking federal financial participation in payments made\npursuant to this section, in which case the state funding made available\npursuant to this section shall be utilized as the non-federal share of\nsuch payments. To the extent as may be required, payments made pursuant\nto this section and in accordance with this subdivision, may be deemed\nto be disproportionate share hospital payments in accordance with the\nprovisions of the federal social security act.\n (b) If federal financial participation in payments made pursuant to\nthis section are made available in accordance with the provisions of\nthis subdivision, free-standing clinics licensed solely pursuant to\narticle thirty-one of the mental hygiene law shall also be deemed\neligible for participation in such payments to the same degree and in\naccordance with the same distribution methodology otherwise provided in\nthis section, provided, however, that only those units of service\nprovided by such free-standing clinics that constitute medical services\nthat are otherwise eligible for consideration for Medicaid payments\nshall be reflected in distributions made pursuant to this section, and\nfurther provided, however, that the commissioner may, in consultation\nwith the commissioner of the office of mental health, require such\nclinics, as a condition of receiving such distributions, to provide\nreports and data to the department as the commissioner deems necessary\nto adequately implement the provisions of this subdivision with regard\nto such clinics.\n