§ 4012 — Payment for hospice

§ 4012. Payment for hospice. 1. No government agency shall purchase,\npay for or make reimbursement or grants-in-aid for services provided by\na hospice unless, at the time the services were provided, the hospice\npossessed a valid certificate of approval.\n 2. Payments for hospice care made by government agencies shall be at\nrates approved by the state director of the budget.\n 3. Prior to the approval of hospice rates, the commissioner shall\ndetermine and certify to the state director of the budget that the\nproposed rate schedules for payments for hospice services are reasonable\nand adequate to meet the costs which must be incurred by efficiently and\neconomically operated programs. In making such certification, the\ncommissioner shall take into consideration the elements of cost,\ngeographical differentials in the elements of cost considered, economic\nfactors in the area in which the hospice is located, costs of hospice\nprograms of comparable size, the need for incentives to improve services\nand institute economies, and applicable medicare reimbursement\nregulations.\n 4. Eligible individuals shall be permitted to receive hospice services\nfrom a provider under this article while continuing to reside in an\nadult care facility under title two of article seven of the social\nservices law and enrolled in the assisted living program, subject to the\navailability of federal financial participation. The commissioner shall\nmake regulations and take other actions reasonably necessary and\nappropriate to implement this subdivision.\n 5. The commissioner shall establish a methodology as of July first,\ntwo thousand eighteen subject to federal financial participation that\nshall ensure a prospective ten-percent increase in the medicaid\nreimbursement rates for hospice providers, relative to the reimbursement\nrate, as of March thirty-first, two thousand eighteen, for services\nprovided by such providers on and after April first, two thousand\neighteen.\n