Section 2807-P. Comprehensive diagnostic and treatment centers indigent care program  


Latest version.
  • 1. (a) For periods prior to July first, two thousand three, and
      on  and  after  July  first,  two  thousand  five  the  commissioner  is
      authorized  to  make  payments  to  eligible  diagnostic  and  treatment
      centers,  to  the  extent of funds available therefor, up to forty-eight
      million dollars annually, to assist in  meeting  losses  resulting  from
      uncompensated  care.  The  amount  of  funds available for such payments
      pursuant to subdivision  four  of  this  section  shall  be  the  amount
      remaining after the allocation provided in section seven of chapter four
      hundred  thirty-three  of  the  laws of nineteen hundred ninety-seven as
      amended by section seventy-five of chapter one of the laws  of  nineteen
      hundred ninety-nine.
        (b)  For  periods on and after July first, two thousand three, through
      June thirtieth, two thousand five, the commissioner  shall,  subject  to
      the  availability  of  federal  financial  participation, adjust medical
      assistance rates of payment to assist in meeting losses  resulting  from
      uncompensated  care,  provided,  however, in the event federal financial
      participation is  not  available,  the  commissioner  is  authorized  to
      continue  to make payments to eligible diagnostic and treatment centers,
      to the extent of funds available therefor, in accordance with provisions
      of  paragraph  (a)  of  this  subdivision  and  without  regard  to  the
      provisions of subdivisions four-a and four-b of this section.
        (c)  Notwithstanding  paragraph  (a)  of this subdivision, subdivision
      four-c of this section or  any  other  inconsistent  provision  of  this
      section,  distributions made pursuant to this section for annual periods
      on and after July first, two thousand nine shall be subject to a uniform
      reduction of two percent.
        (d) The commissioner may require  facilities  receiving  distributions
      pursuant  to  this  section  as  a  condition  of  participating in such
      distributions, to provide reports and data  to  the  department  as  the
      commissioner  deems  necessary to adequately implement the provisions of
      this section.
        2. Definitions. (a) "Eligible diagnostic and treatment  centers",  for
      purposes  of  this section, shall mean voluntary non-profit and publicly
      sponsored diagnostic and treatment  centers  providing  a  comprehensive
      range  of primary health care services which can demonstrate losses from
      disproportionate share of uncompensated care during a  base  period  two
      years  prior to the grant period; provided that for periods on and after
      January first, two thousand four an eligible  diagnostic  and  treatment
      center  shall  not  include  any  voluntary  non-profit  diagnostic  and
      treatment center controlling, controlled by or under common control with
      a health maintenance organization, as  defined  by  subdivision  one  of
      section  forty-four  hundred  one of this chapter; provided further that
      for purposes of this section, a health  maintenance  organization  shall
      not  include a prepaid health services plan licensed pursuant to section
      forty-four hundred three-a of this chapter. For  periods  on  and  after
      July  first,  two  thousand  three, the base period and the grant period
      shall be the calendar year.
        (b) "Uncompensated care need", for purposes  of  this  section,  means
      losses  from  reported  self-pay  and  free  visits  multiplied  by  the
      facility's  medical  assistance  payment   rate   for   the   applicable
      distribution year, offset by payments received from such patients during
      the reporting period.
        3.  (a) During the period January first, nineteen hundred ninety-seven
      through September thirtieth, nineteen hundred ninety-seven and for  each
      fiscal  year  period  commencing  on  October  first  thereafter through
      December thirty-first, nineteen hundred ninety-nine and for  periods  on
      and  after January first, two thousand, diagnostic and treatment centers
    
      shall be eligible for allocations  of  funds  or  for  rate  adjustments
      determined  in  accordance with this section to reflect the needs of the
      diagnostic and treatment center for the financing  of  losses  resulting
      from uncompensated care.
        (b) A diagnostic and treatment center qualifying for a distribution or
      a  rate  adjustment  pursuant  to  this section shall provide assurances
      satisfactory to the commissioner  that  it  shall  undertake  reasonable
      efforts  to maintain financial support from community and public funding
      sources and reasonable efforts to collect  payments  for  services  from
      third-party   insurance  payors,  governmental  payors  and  self-paying
      patients.
        (c) To be eligible for an allocation of funds  or  a  rate  adjustment
      pursuant to this section, a diagnostic and treatment center must provide
      a   comprehensive  range  of  primary  health  care  services  and  must
      demonstrate that a minimum  of  five  percent  of  total  clinic  visits
      reported  during  the  applicable  base  year  period  were to uninsured
      individuals. The commissioner may retrospectively reduce the allocations
      of funds or the rate adjustments to a diagnostic and treatment center if
      it is determined that provider  management  actions  or  decisions  have
      caused  a  significant reduction for the grant period in the delivery of
      comprehensive  primary  health  care  services  to  uncompensated   care
      residents of the community.
        4.  (a)  (i) The total amount of funds to be allocated and distributed
      for uncompensated care to eligible voluntary non-profit  diagnostic  and
      treatment  centers  for  a  distribution period prior to July first, two
      thousand three, and on and after July first, two thousand  five  through
      December  thirty-first,  two  thousand  six,  in  accordance  with  this
      subdivision shall be  limited  to  thirty-three  percent  of  the  funds
      available  therefor pursuant to paragraph (a) of subdivision one of this
      section and, for the period January first, two  thousand  seven  through
      December  thirty-first,  two thousand seven, such distributions shall be
      limited to sixteen and one-half percent of the funds available therefor.
        (ii) The total amount of funds to be  allocated  and  distributed  for
      uncompensated   care  to  eligible  publicly  sponsored  diagnostic  and
      treatment centers for a grant period prior to July first,  two  thousand
      three,  and  on and after July first, two thousand five through December
      thirty-first, two thousand six,  in  accordance  with  this  subdivision
      shall  be  limited  to  sixty-seven  percent of funds available therefor
      pursuant to paragraph (a) of subdivision one of this  section  and,  for
      the   period   January   first,  two  thousand  seven  through  December
      thirty-first, two thousand seven, such distributions shall be limited to
      thirty-three and one-half  percent  of  the  funds  available  therefor;
      provided,  however,  that  for periods up through December thirty-first,
      two thousand seven, forty-one percent of the amount of  funds  allocated
      for distribution to eligible publicly sponsored diagnostic and treatment
      centers  shall  be available for clinics operating under the auspices of
      the New York city health and hospitals  corporation  as  established  by
      chapter  one thousand sixteen of the laws of nineteen hundred sixty-nine
      as amended.
        (iii)  (A)  Notwithstanding  any  inconsistent   provision   of   this
      paragraph,  for  the period January first, nineteen hundred ninety-seven
      through December thirty-first,  nineteen  hundred  ninety-nine  and  for
      periods  on  and  after  January  first,  two  thousand through December
      thirty-first, two thousand two, and for periods  on  and  after  January
      first,  two  thousand  four  through December thirty-first, two thousand
      seven,  in  the  event  that  federal  financial  participation  is  not
      available  for rate adjustments pursuant to this section, diagnostic and
      treatment centers which received an allowance pursuant to paragraph  (f)
    
      of subdivision two of section twenty-eight hundred seven of this article
      for   the   period   through  December  thirty-first,  nineteen  hundred
      ninety-six shall  receive  an  annual  uncompensated  care  distribution
      allocation  of  funds  of  not less than the amount that would have been
      received for any losses associated with the delivery  of  bad  debt  and
      charity  care  for  nineteen  hundred  ninety-five had the provisions of
      paragraph (f) of subdivision two of section twenty-eight  hundred  seven
      of  this  article  remained  in  effect, provided, however, that for the
      period January first, two thousand seven through December  thirty-first,
      two  thousand  seven,  the  dollar  value  of  the  application  of  the
      provisions of this subparagraph for any such  diagnostic  and  treatment
      center shall be reduced by fifty percent.
        (B)  For  the  period  January  first, two thousand three through June
      thirtieth, two thousand three,  and  for  the  period  July  first,  two
      thousand  three through December thirty-first, two thousand three and in
      the event that federal financial participation is not available for rate
      adjustments pursuant to this section, each such diagnostic and treatment
      center shall receive an uncompensated care  distribution  allocation  of
      funds of not less than one-half the amount calculated pursuant to clause
      (A) of this subparagraph.
        (b)  (i)  A  nominal  payment  amount  for  the  financing  of  losses
      associated with the delivery of uncompensated care will  be  established
      for  each  eligible diagnostic and treatment center. The nominal payment
      amount shall be calculated as the sum of the dollars attributable to the
      application of an incrementally increasing nominal  coverage  percentage
      of base year period losses associated with the delivery of uncompensated
      care  for  percentage  increases  in  the relationship between base year
      period eligible uninsured care clinic visits and base year period  total
      clinic visits according to the following scale:
     
        % of eligible bad debt and charity care      % of nominal financial
              clinic visits to total visits               loss coverage
                      up to 15%                                50%
                       15 - 30%                                75%
                            30%+                              100%
     
        (ii)  For  periods  prior to January first, two thousand eight, if the
      sum of the nominal payment amounts for all eligible voluntary non-profit
      diagnostic and treatment centers or for all eligible  public  diagnostic
      and treatment centers or for all clinics operating under the auspices of
      the  New  York  city  health  and hospitals corporation is less than the
      amount allocated for uncompensated care allowances pursuant to paragraph
      (a) of this  subdivision  for  such  diagnostic  and  treatment  centers
      respectively,  the  nominal  coverage  percentages  of  base year period
      losses associated with the delivery of uncompensated  care  pursuant  to
      this  scale  may  be  increased to not more than one hundred percent for
      voluntary non-profit diagnostic and  treatment  centers  or  for  public
      diagnostic  and treatment centers or for all clinics operating under the
      auspices of the New  York  city  health  and  hospitals  corporation  in
      accordance  with  rules  and  regulations  adopted  by  the  council and
      approved by the commissioner.
        (c) For periods prior  to  January  first,  two  thousand  eight,  the
      uncompensated  care  allocations  of  funds  for each eligible voluntary
      non-profit diagnostic and treatment center, as  computed  in  accordance
      with  paragraph  (a)  of  this subdivision, shall be based on the dollar
      value  of  the  result  of  the  ratio  of  total  funds  allocated  for
      distributions  for voluntary non-profit diagnostic and treatment centers
      pursuant to paragraph (a) of this subdivision  to  the  total  statewide
    
      nominal payment amounts for all eligible voluntary non-profit diagnostic
      and  treatment  centers  determined  in accordance with paragraph (b) of
      this subdivision applied to the nominal payment  amount  for  each  such
      diagnostic and treatment center.
        (d)  For  periods  prior  to  January  first,  two thousand eight, the
      uncompensated  care  allocations  of  funds  for  each  eligible  public
      diagnostic  and treatment center, other than clinics operating under the
      auspices of the New York city health and hospitals  corporation  and  as
      computed  in accordance with paragraph (a) of this subdivision, shall be
      based on the dollar value of the result of  the  ratio  of  total  funds
      allocated for distributions for public diagnostic and treatment centers,
      other  than  clinics  operating  under the auspices of the New York city
      health and hospitals corporation, pursuant  to  paragraph  (a)  of  this
      subdivision  to  the  total  statewide  nominal  payment amounts for all
      eligible public diagnostic and treatment  centers,  other  than  clinics
      operating  under  the auspices of the New York city health and hospitals
      corporation,  determined  in  accordance  with  paragraph  (b)  of  this
      subdivision  applied  to  the  nominal  payment  amount  for  each  such
      diagnostic and treatment center.
        (e) For periods prior  to  January  first,  two  thousand  eight,  the
      uncompensated  care  grant allocations of funds for each eligible public
      diagnostic and treatment center operating under the auspices of the  New
      York  city  health  and hospitals corporation, as computed in accordance
      with paragraph (a) of this subdivision, shall be  based  on  the  dollar
      value  of  the  result  of  the  ratio  of  total  funds  allocated  for
      distributions for public  diagnostic  and  treatment  centers  operating
      under the auspices of the New York city health and hospitals corporation
      pursuant  to  paragraph  (a)  of this subdivision to the total statewide
      nominal payment amounts for all eligible public diagnostic and treatment
      centers operating under the auspices of the New  York  city  health  and
      hospitals  corporation  determined  in  accordance with paragraph (b) of
      this subdivision applied to the nominal payment  amount  for  each  such
      diagnostic and treatment center.
        (f)  For  periods  prior  to  January  first,  two thousand eight, any
      residual amount  allocated  for  distribution  to  a  classification  of
      diagnostic  and  treatment  centers  in accordance with this subdivision
      shall be reallocated by the commissioner for distributions to the  other
      classifications based on remaining need.
        (g)  For  periods  on and after January first, two thousand seven, the
      uncompensated care allocations of funds for each eligible diagnostic and
      treatment center, other than allocations  made  pursuant  to  paragraphs
      (c),  (d),  (e) or (f) of this subdivision, shall be based on the dollar
      value  of  the  result  of  the  ratio  of  total  funds  allocated  for
      distributions  for  all eligible diagnostic and treatment centers to the
      total statewide nominal payment amounts for all eligible diagnostic  and
      treatment  centers  determined  in accordance with paragraph (b) of this
      subdivision  applied  to  the  nominal  payment  amount  for  each  such
      diagnostic and treatment center.
        4-a.  (a)(i)  For periods on and after July first, two thousand three,
      through June thirtieth, two thousand five, funds shall be made available
      for adjustments to rates of payments made pursuant to paragraph  (b)  of
      subdivision  one  of  this  section  for  eligible  voluntary non-profit
      diagnostic and treatment centers in accordance with  subparagraphs  (ii)
      and  (iii) of this paragraph, for the following periods in the following
      aggregate amounts:
        (A) For the period July first, two  thousand  three  through  December
      thirty-first,  two  thousand  three,  up  to  seven million five hundred
      thousand dollars;
    
        (B) For the period January first, two thousand four  through  December
      thirty-first, two thousand four, up to fifteen million dollars;
        (C)  For  the  period  January  first,  two thousand five through June
      thirtieth, two thousand five, up to seven million five hundred  thousand
      dollars.
        (ii)  A  nominal payment amount for the financing of losses associated
      with the delivery of uncompensated care will  be  established  for  each
      eligible  diagnostic  and  treatment  center. The nominal payment amount
      shall be calculated as the  sum  of  the  dollars  attributable  to  the
      application  of  an incrementally increasing nominal coverage percentage
      of base year period losses associated with the delivery of uncompensated
      care for percentage increases in  the  relationship  between  base  year
      period  eligible uninsured care clinic visits and base year period total
      clinic visits according to the following scale:
     
        % of eligible bad debt and charity care      % of nominal financial
              clinic visits to total visits               loss coverage
                      up to 15%                                50%
                       15 - 30%                                75%
                            30%+                              100%
     
        (iii) The  uncompensated  care  rate  adjustments  for  each  eligible
      voluntary  non-profit  diagnostic and treatment center shall be based on
      the dollar value of the result of the ratio of total funds allocated for
      distributions for voluntary non-profit diagnostic and treatment  centers
      pursuant  to  subparagraph (i) of this paragraph, to the total statewide
      nominal payment amounts for all eligible voluntary non-profit diagnostic
      and treatment centers determined in accordance with subparagraph (ii) of
      this paragraph applied to the  nominal  payment  amount  for  each  such
      diagnostic and treatment center.
        (b)(i) For periods on and after July first, two thousand three through
      June  thirtieth,  two  thousand  five, funds shall be made available for
      adjustments to rates of payments  made  pursuant  to  paragraph  (b)  of
      subdivision  one  of  this  section  for  eligible public diagnostic and
      treatment centers, other than clinics operated under the auspices of the
      New York city health  and  hospitals  corporation,  in  accordance  with
      subparagraphs  (ii)  and  (iii)  of  this  paragraph,  for the following
      periods in the following aggregate amounts:
        (A) For the period July first, two  thousand  three  through  December
      thirty-first, two thousand three, up to nine million dollars;
        (B)  For  the period January first, two thousand four through December
      thirty-first, two thousand four, up to eighteen million dollars;
        (C) For the period January  first,  two  thousand  five  through  June
      thirtieth, two thousand five, up to nine million dollars.
        (ii)  A  nominal payment amount for the financing of losses associated
      with the delivery of uncompensated care will  be  established  for  each
      eligible  diagnostic  and  treatment  center. The nominal payment amount
      shall be calculated as the  sum  of  the  dollars  attributable  to  the
      application  of  an incrementally increasing nominal coverage percentage
      of base year period losses associated with the delivery of uncompensated
      care for percentage increases in  the  relationship  between  base  year
      period  eligible uninsured care clinic visits and base year period total
      clinic visits according to the following scale:
     
        % of eligible bad debt and charity care      % of nominal financial
              clinic visits to total visits               loss coverage
                      up to 15%                                50%
                       15 - 30%                                75%
    
                            30%+                              100%
     
        (iii) The uncompensated care rate adjustments for each eligible public
      diagnostic  and treatment center, other than clinics operating under the
      auspices of the New York city health and hospitals corporation, shall be
      based on the dollar value of the result of  the  ratio  of  total  funds
      allocated for distributions for public diagnostic and treatment centers,
      other  than  clinics  operating  under the auspices of the New York city
      health and hospitals corporation, pursuant to subparagraph (i)  of  this
      paragraph  to  the  total  statewide  nominal  payment  amounts  for all
      eligible public diagnostic and treatment  centers,  other  than  clinics
      operating  under  the auspices of the New York city health and hospitals
      corporation, determined in accordance with  subparagraph  (ii)  of  this
      paragraph applied to the nominal payment amount for each such diagnostic
      and treatment center.
        (c)(i)  For  periods  on  and  after  July  first, two thousand three,
      through June thirtieth, two thousand five, funds shall be made available
      for adjustments to rates of payments made pursuant to paragraph  (b)  of
      subdivision  one  of  this  section  for  eligible public diagnostic and
      treatment centers operating under the auspices  of  the  New  York  city
      health  and hospitals corporation, in accordance with subparagraphs (ii)
      and (iii) of this paragraph, for the following periods in the  following
      aggregate amounts:
        (A)  For  the  period  July first, two thousand three through December
      thirty-first, two thousand three, up to six million dollars;
        (B) For the period January first, two thousand four  through  December
      thirty-first, two thousand four, up to twelve million dollars;
        (C)  For  the  period  January  first,  two thousand five through June
      thirtieth, two thousand five, up to six million dollars.
        (ii) A nominal payment amount for the financing of  losses  associated
      with  the  delivery  of  uncompensated care will be established for each
      eligible diagnostic and treatment center.  The  nominal  payment  amount
      shall  be  calculated  as  the  sum  of  the dollars attributable to the
      application of an incrementally increasing nominal  coverage  percentage
      of base year period losses associated with the delivery of uncompensated
      care  for  percentage  increases  in  the relationship between base year
      period eligible uninsured care clinic visits and base year period  total
      clinic visits according to the following scale:
     
        % of eligible bad debt and charity care      % of nominal financial
              clinic visits to total visits               loss coverage
                      up to 15%                                50%
                       15 - 30%                                75%
                            30%+                              100%
     
        (iii) The uncompensated care rate adjustment, for each eligible public
      diagnostic  and treatment center operating under the auspices of the New
      York city health and hospitals corporation shall be based on the  dollar
      value  of  the  result  of  the  ratio  of  total  funds  allocated  for
      distributions for public  diagnostic  and  treatment  centers  operating
      under the auspices of the New York city health and hospitals corporation
      pursuant  to  subparagraph  (i) of this paragraph to the total statewide
      nominal payment amounts for all eligible public diagnostic and treatment
      centers operating under the auspices of the New  York  city  health  and
      hospitals corporation determined in accordance with subparagraph (ii) of
      this  paragraph  applied  to  the  nominal  payment amount for each such
      diagnostic and treatment center.
    
        (d) (i) Notwithstanding  the  provisions  of  paragraph  (b)  of  this
      subdivision  and  any  other  provisions of this chapter, municipalities
      which received state aid pursuant to article two of this chapter for the
      nineteen hundred eighty-nine--nineteen hundred ninety state fiscal  year
      in   support   of  non-hospital  based  free-standing  or  local  health
      department  operated  general   medical   clinics   shall   receive   an
      uncompensated  care  rate  adjustment  for  the  period  July first, two
      thousand three through December thirty-first, two thousand three, of not
      less  than  one-half  the  amount  received  in  the  nineteen   hundred
      eighty-nine--nineteen  hundred  ninety  state  fiscal  year  for general
      medical clinics.
        (ii) For the period January first, two thousand four through  December
      thirty-first, two thousand four, each such municipality shall receive an
      uncompensated  care  rate  adjustment  of not less than twice the amount
      calculated pursuant to subparagraph (i) of this paragraph.
        (iii) For the period January first, two  thousand  five  through  June
      thirtieth,  two  thousand  five, each such municipality shall receive an
      annual uncompensated care rate adjustment of not less  than  the  amount
      calculated pursuant to subparagraph (i) of this paragraph.
        (e)   (i)   Notwithstanding   any   inconsistent   provision  of  this
      subdivision, for the period  July  first,  two  thousand  three  through
      December  thirty-first,  two  thousand  three,  diagnostic and treatment
      centers which  received  an  allowance  pursuant  to  paragraph  (f)  of
      subdivision  two  of  section twenty-eight hundred seven of this article
      for  the  period  through  December   thirty-first,   nineteen   hundred
      ninety-six  shall  receive  an uncompensated care rate adjustment of not
      less than one-half the amount that would  have  been  received  for  any
      losses  associated  with  the  delivery of bad debt and charity care for
      nineteen hundred ninety-five had the  provisions  of  paragraph  (f)  of
      subdivision  two  of  section twenty-eight hundred seven of this article
      remained in effect.
        (ii) For the period January first, two thousand four through  December
      thirty-first,  two  thousand  four,  each  such diagnostic and treatment
      center shall receive an uncompensated care rate adjustment of  not  less
      than  twice  the  amount calculated pursuant to subparagraph (i) of this
      paragraph.
        (iii) For the period January first, two  thousand  five  through  June
      thirtieth,  two thousand five, each such diagnostic and treatment center
      shall receive an annual uncompensated care rate adjustment of  not  less
      than  the  amount  calculated  pursuant  to  subparagraph  (i)  of  this
      paragraph,  and  shall  be   subject   to   subsequent   adjustment   or
      reconciliation.
        (f) Any residual amount allocated for distribution to a classification
      of  diagnostic and treatment centers in accordance with this subdivision
      shall be reallocated by the commissioner for distributions to the  other
      classifications based on remaining need.
        4-b.  (a)  For  periods  on  and after July first, two thousand three,
      through June thirtieth, two thousand five, funds shall be made available
      for adjustments to rates of payment made pursuant to  paragraph  (b)  of
      subdivision  one  of  this section for eligible diagnostic and treatment
      centers with less than two years of operating experience, and diagnostic
      and treatment centers which have received certificate of  need  approval
      on  applications  which  indicate  a  significant  increase in uninsured
      visits, for  the  following  periods  and  in  the  following  aggregate
      amounts:
        (i)  For  the  period  July first, two thousand three through December
      thirty-first, two  thousand  three,  up  to  one  million  five  hundred
      thousand dollars;
    
        (ii)  For the period January first, two thousand four through December
      thirty-first, two thousand four, up to three million dollars;
        (iii)  For  the  period  January first, two thousand five through June
      thirtieth, two thousand five, up to one million  five  hundred  thousand
      dollars.
        (b)  To  be eligible for a rate adjustment pursuant to this section, a
      diagnostic and treatment center shall  be  a  voluntary,  non-profit  or
      publicly   sponsored   diagnostic   and  treatment  center  providing  a
      comprehensive range of primary health care services and be  eligible  to
      receive  a medicaid budgeted rate prior to April first of the applicable
      rate adjustment period after which time, the department shall issue rate
      adjustments  pursuant  to  this  subdivision  for  such  periods.   Rate
      adjustments  made  pursuant to this subdivision shall be allocated based
      upon each eligible facility's proportional share of costs  for  services
      rendered  to  uninsured  patients which have otherwise not been used for
      establishing  distributions  pursuant  to  subdivision  four-a  of  this
      section. For the purposes of this subdivision costs shall be measured by
      multiplying  each  facility's  medicaid  budgeted  rate by the estimated
      number of visits reported for services anticipated  to  be  rendered  to
      uninsured   patients  meeting  the  aforementioned  criteria,  less  any
      anticipated  patient  service  revenues  received  from  such  uninsured
      patients, during the applicable rate adjustment period.
        4-c.  Notwithstanding  any  provision  of  law  to  the  contrary, the
      commissioner shall make additional payments for  uncompensated  care  to
      voluntary  non-profit diagnostic and treatment centers that are eligible
      for  distributions  under  subdivision  four  of  this  section  in  the
      following  amounts:  for the period June first, two thousand six through
      December thirty-first, two thousand six, in the amount of seven  million
      five  hundred  thousand  dollars,  for  the  period  January  first, two
      thousand seven through December thirty-first, two thousand seven,  seven
      million five hundred thousand dollars, for the period January first, two
      thousand  eight through December thirty-first, two thousand eight, seven
      million five hundred thousand dollars, for the period January first, two
      thousand nine through December thirty-first, two thousand nine,  fifteen
      million five hundred thousand dollars, for the period January first, two
      thousand  ten  through  December  thirty-first,  two thousand ten, seven
      million five hundred thousand dollars, and for the period January first,
      two thousand eleven through March thirty-first, two thousand eleven,  in
      the  amount  of one million eight hundred seventy-five thousand dollars,
      provided, however, that for periods on  and  after  January  first,  two
      thousand  eight,  such  additional  payments  shall  be  distributed  to
      voluntary, non-profit diagnostic and treatment  centers  and  to  public
      diagnostic  and  treatment  centers  in accordance with paragraph (g) of
      subdivision four of this section. In the event  that  federal  financial
      participation  is  available  for  rate  adjustments  pursuant  to  this
      section,  the  commissioner  shall  make  such  payments  as  additional
      adjustments  to rates of payment for voluntary non-profit diagnostic and
      treatment centers that are eligible for distributions under  subdivision
      four-a  of  this  section  in the following amounts: for the period June
      first, two thousand six through December thirty-first, two thousand six,
      fifteen million dollars in the aggregate, and  for  the  period  January
      first,  two  thousand  seven through June thirtieth, two thousand seven,
      seven million five  hundred  thousand  dollars  in  the  aggregate.  The
      amounts  allocated  pursuant  to this paragraph shall be aggregated with
      and distributed pursuant to  the  same  methodology  applicable  to  the
      amounts  allocated  to  such  diagnostic  and treatment centers for such
      periods  pursuant  to  subdivision  four  of  this  section  if  federal
      financial  participation  is  not  available, or pursuant to subdivision
    
      four-a of this section if federal financial participation is  available.
      Notwithstanding  section  three  hundred  sixty-eight-a  of  the  social
      services law, there shall be no local  share  in  a  medical  assistance
      payment adjustment under this subdivision.
        5.  Diagnostic  and  treatment centers shall furnish to the department
      such reports and information as may be required by the  commissioner  to
      assess  the  cost,  quality,  access to, effectiveness and efficiency of
      uncompensated  care  provided.  The  council  shall  adopt   rules   and
      regulations,  subject  to the approval of the commissioner, to establish
      uniform  reporting  and  accounting  principles   designed   to   enable
      diagnostic  and treatment centers to fairly and accurately determine and
      report uncompensated care visits and the costs of uncompensated care. In
      order to be eligible  for  an  allocation  of  funds  pursuant  to  this
      section,  a  diagnostic  and treatment center must be in compliance with
      uncompensated care reporting requirements.
        6. Notwithstanding any inconsistent provision of law to the  contrary,
      the  availability  or  payment  of  funds  to a diagnostic and treatment
      center pursuant to this section shall not be admissible  as  a  defense,
      offset  or reduction in any action or proceeding relating to any bill or
      claim for  amounts  due  for  services  provided  by  a  diagnostic  and
      treatment center.
        7.  Revenue  from  distributions  to a diagnostic and treatment center
      pursuant to this section shall not be included in gross revenue received
      for purposes of the assessments pursuant to section twenty-eight hundred
      seven-d of this article, subject to the provisions of subdivision twelve
      of section twenty-eight hundred seven-d of this article.
        8. (a) For periods on or after January  first,  two  thousand  through
      June  thirtieth,  two  thousand  three,  payments  made  to  an eligible
      diagnostic and treatment  center  pursuant  to  this  section  shall  be
      reduced   or  increased  by  an  amount  equal  to  the  amount  of  any
      overpayments or underpayments made against grants  awarded  pursuant  to
      section  seven  of  chapter  four  hundred  thirty-three  of the laws of
      nineteen hundred ninety-seven for the period three years  prior  to  the
      annual awards made pursuant to this section.
        (b)  The  determination of such overpayments or underpayments shall be
      based on the submission by eligible  facilities  of  reports  reflecting
      actual  uncompensated  care data, as required by the commissioner, which
      are attributable to prior periods.  Submission  of  such  reports  is  a
      condition  for  an  eligible  facility's receipt of payments pursuant to
      this section.
        (c) For any periods in which a  facility  does  not  receive  payments
      pursuant to this section, the amount of any prior period overpayment may
      be  offset against payments for medical assistance made to such facility
      pursuant to title eleven of article five of the social services law  and
      credited  to  funds allocated pursuant to this section. Any prior period
      underpayment to an eligible facility may be paid to such facility  in  a
      subsequent period.
        9.  Adjustments  to rates of payment made pursuant to this section may
      be added to rates of payment or made as aggregate payments  to  eligible
      diagnostic  and treatment centers and shall not be subject to subsequent
      adjustment or reconciliation, provided, however, that in the event  such
      adjustments  are  made  as  aggregate payments, then notwithstanding any
      law, rule or regulation to the contrary  responsibility  for  the  local
      share  of such aggregate payments shall be apportioned to a local social
      services district based on the most recent geographic  utilization  data
      available to the department for eligible diagnostic and treatment center
      services  for payments in accordance with subdivisions four-a and four-b
      of this  section  for  all  diagnostic  and  treatment  center  services
    
      provided  in  accordance  with section three hundred sixty-five-a of the
      social services law,  regardless  of  whether  another  social  services
      district  or  the department may otherwise be responsible for furnishing
      medical assistance to the eligible persons receiving such services.
        10.  (a) Notwithstanding any inconsistent provision of this section or
      any other contrary provision of law, the commissioner is  authorized  to
      seek  a  waiver from the federal department of health and human services
      pursuant to  section  eleven  hundred  fifteen  of  the  federal  social
      security  act,  or  such  other  federal  law provision as may be deemed
      appropriate, seeking federal financial participation  in  payments  made
      pursuant to this section, in which case the state funding made available
      pursuant  to  this section shall be utilized as the non-federal share of
      such payments. To the extent as may be required, payments made  pursuant
      to  this  section and in accordance with this subdivision, may be deemed
      to be disproportionate share hospital payments in  accordance  with  the
      provisions of the federal social security act.
        (b)  If  federal  financial participation in payments made pursuant to
      this section are made available in accordance  with  the  provisions  of
      this  subdivision,  free-standing  clinics  licensed  solely pursuant to
      article thirty-one of the  mental  hygiene  law  shall  also  be  deemed
      eligible  for  participation  in such payments to the same degree and in
      accordance with the same distribution methodology otherwise provided  in
      this  section,  provided,  however,  that  only  those  units of service
      provided by such free-standing clinics that constitute medical  services
      that  are  otherwise  eligible  for  consideration for Medicaid payments
      shall be reflected in distributions made pursuant to this  section,  and
      further  provided,  however,  that the commissioner may, in consultation
      with the commissioner of the  office  of  mental  health,  require  such
      clinics,  as  a  condition  of  receiving such distributions, to provide
      reports and data to the department as the commissioner  deems  necessary
      to  adequately  implement the provisions of this subdivision with regard
      to such clinics.