§ 364-G — Medical assistance capitation rate demonstration project

* § 364-g. Medical assistance capitation rate demonstration project.\n1. The department and the county of Monroe are authorized to participate\nin the "Monroe County Medicap Plan" research and demonstration project,\nfor the purpose of testing the feasibility of converting from a fee for\nservice payment system to a capitation payment system as a means of\nfinancing health care services for medicaid recipients residing in\nMonroe county.\n 2. The department shall undertake the research and demonstration\nproject authorized by this section only if it has determined that there\nis a reasonable expectation that the total cost of benefits under such\nproject would be less than the total cost of benefits if the project was\nnot in effect.\n 3. Expenditures made in connection with the research and demonstration\nproject authorized by this section shall be subject to state\nreimbursement in accordance with a schedule of reimbursable amounts\napproved by the department, the department of health and the director of\nthe budget.\n 4. The department shall, in a manner to be decided upon by the\ncommissioner, determine what portion of the total expenditures made\nunder the research and demonstration project authorized by this section\nare attributable to the provision of the services specified in paragraph\n(g) of subdivision one of section three hundred sixty-eight-a of this\ntitle, and shall ensure that the increased state reimbursement available\nfor such services shall be provided.\n 5. Notwithstanding any inconsistent provision of this chapter or any\nother law to the contrary, the commissioner may, subject to the approval\nof the director of the budget, apply for appropriate waivers of federal\nlaw and regulation, and shall be authorized to waive any provisions of\nsections three hundred sixty-six, three hundred sixty-seven-b and three\nhundred sixty-eight-a of this title and accompanying regulations of the\ndepartment, consistent with waivers approved by the federal department\nof health and human services, when such action would be necessary to\nassist in promoting the objectives of this section; provided, however,\nthat in the event that the research and demonstration project authorized\nby this section requires a waiver of article twenty-eight or forty-four\nof the public health law or accompanying regulations of the department\nof health, the project shall be conducted jointly with the department of\nhealth, and the commissioner of health may waive such provisions of the\npublic health law or department of health regulations with the approval\nof the commissioner and the director of the budget.\n 6. Every person eligible for or receiving medical assistance who\nresides in the county of Monroe shall participate in the demonstration\nproject authorized by this section except for good cause as defined by\nthe commissioner in regulation.\n 7. Notwithstanding any inconsistent provisions of this section,\nparticipation in the project authorized by this section shall not affect\na recipient's medical assistance eligibility or the scope of available\nmedical services to which he or she is entitled.\n 8. The department and the county of Monroe shall jointly submit to the\ngovernor and the legislature a long term care capitation implementation\nplan by March thirty-first, nineteen hundred eighty-five.\n 9. Providers participating in the research and demonstration project\nauthorized by this section shall submit reports to the commissioner, at\nsuch times as he may require, evaluating the results of such project.\n 10. The department shall submit to the governor and the legislature an\ninterim report and a final report evaluating the project's impact on\nmedicaid costs, access to services, quality of services rendered and any\nother subjects which the commissioner shall deem relevant. The interim\nreport shall be due January first, nineteen hundred eighty-six and the\nfinal report shall be due at the conclusion of the project.\n 11. This section shall be effective if, and as long as, federal\nfinancial participation is available for expenditures made for the\nproject conducted pursuant to the provisions of this section.\n * NB Expired March 31, 1988 per sub 11\n