Section 367-B. Medical assistance information and payment system

1. The
  department shall design and implement  a  statewide  medical  assistance
  information  and payments system for the purpose of providing individual
  and aggregate data to social services districts to assist them in making
  basic management decisions, to the department and other  state  agencies
  to  assist  in the administration of the medical assistance program, and
  to the governor and the legislature as may be  necessary  to  assist  in
  making major administrative and policy decisions affecting such program.
  Such system shall be designed so as to be capable of the following:
    a. receiving and processing information relating to the eligibility of
  each  person  applying  for  medical assistance and of issuing a medical
  assistance  identification  card  to  persons  determined  by  a  social
  services official to be eligible for such assistance;
    b.  receiving  and  processing  information relating to each qualified
  provider of medical assistance furnishing care, services or supplies for
  which claims for payment are made pursuant to this title;
    c. receiving and processing, in a form and manner  prescribed  by  the
  department,  all  claims  for  medical  care, services and supplies, and
  making payments for valid claims to providers of medical care,  services
  and supplies on behalf of social services districts;
    d.   maintaining   information  necessary  to  allow  the  department,
  consistent with the powers and duties of the department  of  health,  to
  review the appropriateness, scope and duration of medical care, services
  and  supplies  provided to any eligible person pursuant to this chapter;
  and
    e. initiating  implementation  of  such  a  system  for  the  district
  comprising  the  city of New York, in a manner compatible with expansion
  of such system to districts other than the district comprising the  city
  of New York.
    2. Consistent with the capabilities of the system established pursuant
  to  subdivision one of this section, the department shall assume payment
  responsibilities on behalf of social services districts by  promulgation
  of  regulations approved by the director of the budget. Such regulations
  shall specify the providers of medical assistance and the medical  care,
  services  and/or  supplies  for  the district or districts for which the
  department will assume payment responsibilities and the  date  on  which
  such  responsibilities  shall  be  assumed.  Such  regulations  shall be
  published  for  comment  at  least  thirty  days  in  advance  of  their
  promulgation  and  shall  be  filed with the secretary of state at least
  sixty days in advance of the date  of  assumption  of  responsibilities;
  provided,  however,  that  with  respect  to  a  particular district the
  requirements for advance publications and/or filing may  be  waived,  or
  the  time  limits  reduced,  with the written consent of the district to
  such waiver or reduction. Providers of medical care and  services  shall
  submit  claims  to  the  social services district for all items of care,
  services and supplies furnished prior to the date of state assumption of
  payment responsibilities and to the state for all such  items  furnished
  subsequent  to  such  date.  Such regulations shall also specify a final
  transition date after which any claiming submitted shall be  enforceable
  by  such provider only against the state and shall not be enforceable by
  such provider against the social services district;  provided,  however,
  that  the department and the district may enter into a written agreement
  by which the department agrees on the basis of  eligibility  information
  provided by such district to pay claims submitted to such district prior
  to the final transition date.
    3.  Upon  notice  to  a  social  services  district in accordance with
  subdivision  two,  that  the  department  intends  to   assume   payment
  responsibilities  on  behalf  of  such district, (a) such district shall

  promptly submit to the department requested information  regarding  each
  person  who  applies  for  or  has  been determined eligible for medical
  assistance and each provider of medical assistance in such district; and
  (b) notwithstanding the provisions of paragraph (b) of subdivision three
  of  section  three  hundred  sixty-six-a of this chapter, the department
  shall provide each person found by such  district  to  be  eligible  for
  medical   assistance   under   this  title  with  a  medical  assistance
  identification card.
    4. Information relating to persons applying for or  receiving  medical
  assistance  shall  be considered confidential and shall not be disclosed
  to persons or agencies other than  those  considered  entitled  to  such
  information  in accordance with section one hundred thirty-six when such
  disclosure  is  necessary  for  the  proper  administration  of   public
  assistance programs.
    5. By no later than forty-five days following the end of each calendar
  quarter  after  the  second  quarter  of  calendar year nineteen hundred
  seventy-six, the department shall, until full  implementation  has  been
  achieved  in  all  social services districts, report to the governor and
  the legislature regarding the current status of the  medical  assistance
  information and payment system, summarizing the progress achieved during
  the  previous  quarter  and  the  anticipated  major achievements of the
  succeeding two calendar quarters. The report shall include  the  current
  and  anticipated  overall  expenditure and staffing levels for functions
  relating to the system, and shall  specify  each  district  affected  or
  anticipated  to  be affected during the succeeding two calendar quarters
  and summarize  the  manner  in  which  each  such  district  is,  or  is
  anticipated  to  be, affected. In addition, the department shall prepare
  and submit  to  the  governor  and  the  legislature  a  special  report
  demonstrating  the  appropriateness  and  relative cost-effectiveness of
  utilizing a fiscal intermediary.
    In addition, for the purpose of  insuring  the  compatability  of  the
  system  servicing  the district comprising the city of New York with the
  system servicing all other social services districts in the  state,  the
  department  shall prepare and submit to the governor and the legislature
  on or before March first,  nineteen  hundred  seventy-eight,  a  special
  report and recommendation covering the appropriateness and relative cost
  effectiveness of utilizing a fiscal intermediary or fiscal agent for all
  districts other than the district comprising the city of New York.
    6.  Each  social  services district shall be responsible for paying to
  the state a share of the state's expenditures for claims of providers of
  medical assistance attributable to such district, which shall  be  equal
  to  the  share of such expenditures such district would have borne after
  reimbursement from state and federal funds in  accordance  with  section
  three  hundred  sixty-eight-a  of this chapter, had the expenditure been
  made by such district; provided, however,  that  no  district  shall  be
  responsible for the state's expenditures for the administrative costs of
  developing,  maintaining  or  operating the statewide medical assistance
  information and payment system; and provided, further, that no  district
  shall  be responsible for paying to the state any portion of the cost of
  medical assistance which the department is  responsible  for  furnishing
  pursuant to section three hundred sixty-five of this chapter.
    7.  In  any case in which the department has made payments for medical
  assistance on behalf of a social  services  district  pursuant  to  this
  section,  the  commissioner  on  behalf  of the social services official
  shall be empowered  to  bring  actions  to  recover  the  cost  of  such
  assistance, pursuant to this subdivision and the provisions of title six
  of article three of this chapter.

    8.  (a)  For  the  purpose of orderly and timely implementation of the
  medical assistance information and payment  system,  the  department  is
  hereby authorized to enter into agreements with fiscal intermediaries or
  fiscal  agents  for  the design, development, implementation, operation,
  processing,  auditing  and  making  of payments, subject to audits being
  conducted by the state in accordance with the terms of such  agreements,
  for medical assistance claims under the system described by this section
  in  any  social  services  district.  Such agreements shall specifically
  provide that the state shall have complete oversight responsibility  for
  the  fiscal  intermediaries'  or fiscal agents' performance and shall be
  solely  responsible  for  establishing  eligibility   requirements   for
  recipients,  provider qualifications, rates of payment, investigation of
  suspected  fraud  and   abuse,   issuance   of   identification   cards,
  establishing  and  maintaining  recipient  eligibility  files,  provider
  profiles, and conducting state audits of the fiscal  intermediaries'  or
  agents' at least once annually. The system described in this subdivision
  shall be operated by a fiscal intermediary or fiscal agent in accordance
  with this subdivision unless the department is otherwise authorized by a
  law  enacted  subsequent  to  the  effective date of this subdivision to
  operate  the  system  in  another  manner.  In  no  event   shall   such
  intermediary  or  agent  be  a political subdivision of the state or any
  other governmental agency or entity. The department shall  consult  with
  the  office  of  Medicaid  inspector  general  regarding  any activities
  undertaken by the  fiscal  intermediaries  or  fiscal  agents  regarding
  investigation of suspected fraud and abuse.
    (b)  The  department  of  health,  in  consultation with the office of
  Medicaid inspector  general,  shall  develop,  test  and  implement  new
  methods   to   strengthen  the  capability  of  the  medical  assistance
  information and payment system to detect and control fraud  and  improve
  expenditure  accountability,  and  is  hereby  authorized  to enter into
  further agreements with fiscal and/or information technology agents  for
  the  development,  testing  and  implementation of such new methods. Any
  such agreements shall be with agents which have  demonstrated  expertise
  in  the  areas  addressed  by  the  agreement.  Such methods shall, at a
  minimum, address the following areas:
    (1) Prepayment claims review. Develop, test and implement an automated
  claims review process which, prior to  payment,  shall  subject  medical
  assistance  program services claims to review for proper coding and such
  other review as may be deemed  necessary.  Services  subject  to  review
  shall  be  based  on:  the expected cost-effectiveness of reviewing such
  service; the capabilities of the automated system for conducting such  a
  review;  and  the  potential  to  implement  such review with negligible
  effect on the turnaround of claims for provider payment or on  recipient
  access  to  necessary  services.  Such  initiative  shall be designed to
  provide for  the  efficient  and  effective  operation  of  the  medical
  assistance   program  claims  payment  system  by  performing  functions
  including, but not limited to, capturing  coding  errors,  misjudgments,
  incorrect or multiple billing for the same service and possible excesses
  in billing or service use, whether intentional or unintentional.
    (2) Coordination of benefits. Develop, test and implement an automated
  process  to  improve  the  coordination  of benefits between the medical
  assistance program and other sources of coverage for medical  assistance
  recipients.   Such   initiative  shall  initially  examine  the  savings
  potential to the medical assistance program through retrospective review
  of  claims  paid  which  shall  be  completed  not  later  than  January
  thirty-first,   two   thousand   seven.  If,  based  upon  such  initial
  experience, the Medicaid inspector general deems the  automated  process
  to  be  capable  of  including  or  moving to a prospective review, with

  negligible effect on the turnaround of claims for provider payment or on
  recipient access to services, then the  Medicaid  inspector  general  in
  subsequent   tests   shall   examine   the   savings  potential  through
  prospective, pre-claims payment review.
    (3)  Comprehensive  review  of  paid  claims.  Take all reasonable and
  necessary actions to intensify the state's current level of  monitoring,
  analyzing, reporting and responding to medical assistance program claims
  data  maintained  by  the  state's  medical  assistance  information and
  payment  system  contract  agents.  Pursuant  to  this  initiative,  the
  department  of  health,  in  collaboration  with  the office of Medicaid
  inspector general, shall make efforts to improve the utilization of such
  data in order to better identify fraud  and  abuse  within  the  medical
  assistance  program  and  to  identify and implement further program and
  patient care reforms for the improvement of such program.  In  addition,
  the  department of health, in consultation with such contract agents and
  the office of Medicaid inspector general, shall identify additional data
  elements that are maintained and  otherwise  accessible  by  the  state,
  directly  or  through any of its contractors, that would, if coordinated
  with medical assistance data, further increase the effectiveness of data
  analysis for the  management  of  the  medical  assistance  program.  To
  further  the  objectives of this subparagraph, the department of health,
  in collaboration with the office of Medicaid  inspector  general,  shall
  provide  or  arrange  in-service  training  for state and county medical
  assistance personnel to increase the capability for state and local data
  analysis, leading to a more  cost-effective  operation  of  the  medical
  assistance program.
    (4)   Targeted  claims  and  utilization  review.  Develop,  test  and
  implement an automated  process  for  the  targeted  review  of  claims,
  services  and/or  populations  not  later than January thirty-first, two
  thousand seven.  Such review shall be for the  purposes  of  identifying
  statistical  aberrations  in the use or billing of such services and for
  assisting in the development and implementation of  measures  to  ensure
  that service use and billing are appropriate to recipients' needs.
    (c)  The  commissioner  of  health shall prepare and submit an interim
  report to the governor and legislature  on  the  implementation  of  the
  initiatives specified in paragraph (b) of this subdivision no later than
  December  first,  two  thousand  seven.  Such  report shall also include
  recommendations for any revisions  that  would  further  facilitate  the
  goals  of  such  paragraph,  including recommendations for expansion. In
  addition, the commissioner of health shall submit  a  final  report  not
  later than December first, two thousand eight. In preparing such interim
  and  final  reports,  the  commissioner of health shall consult with the
  Medicaid inspector general, third-party agents, providers and recipients
  associated with the implementation of paragraph (b) of this subdivision.
    9. (a) In order to accomplish a more orderly transition to the medical
  assistance information and payment system authorized  by  this  section,
  and  to  continue  for  a  limited  transition  period the rate at which
  advanced revenues have been made available by local  governmental  units
  to  certain hospitals providing services to persons eligible for medical
  assistance, the  department  is  authorized  to  promulgate  regulations
  establishing  a  system of accelerated payments to hospitals meeting the
  criteria set forth in this section.
    (b) Such system of accelerated payments shall only be available  to  a
  general hospital, other than a public general hospital:
    (i)  which  prior  to  January  first,  nineteen hundred seventy-eight
  received regular, periodic and recurring advanced revenues from a  local
  governmental  unit, the amount of which was based on anticipated medical
  assistance claims payments; and

    (ii) which has demonstrated that  its  continued  financial  viability
  depends  in substantial part on the rate at which such advanced revenues
  were made available by local governmental units prior to  the  time  the
  department,  pursuant to this section, assumed payment for such hospital
  responsibilities  on  behalf of the social services district in which it
  is located, taking into account any funds remaining available  from  the
  local  governmental  unit  under  its  system  of advanced revenues. For
  purposes of this subdivision, it shall be presumed that a hospital  does
  not  depend  in  substantial part on the rate at which advanced revenues
  were made available by a local governmental unit  if  it  received  such
  revenues  for  a  period of less than nine months preceding the month in
  which the department assumed payment responsibilities for such hospital;
    (iii) for which payment responsibility is  initially  assumed  by  the
  department  pursuant  to  this  section during the period beginning June
  first, nineteen hundred seventy-eight  and  ending  November  thirtieth,
  nineteen hundred seventy-eight; and
    (iv)  which  meets  performance  criteria  established  by  department
  regulation relating to the ratio of acceptable claims for  patient  days
  submitted  for  medical assistance payment compared to the total patient
  days of the hospital and compared to such claims  submitted  in  one  or
  more  previous  months,  and the time lapse between the date the service
  was provided and the date the claim was submitted.
    (c)  The  regulations  promulgated  by  the  department  pursuant   to
  paragraph  (a)  of this subdivision shall provide that the amount of the
  accelerated payment for any month shall be determined for each  hospital
  meeting  the  criteria  set  forth  in  this  section  on  the  basis of
  acceptable medical assistance claims submitted by the hospital in one or
  more previous  months  and  the  amount  of  accelerated  revenues  made
  available to the hospital by a local governmental unit prior to the time
  the  department  assumed  payment responsibilities for the hospital. The
  amount of the accelerated payment for any given month shall  not  exceed
  the  amount of a monthly aggregate claim to be submitted by the hospital
  to the department, which claim shall reflect items of care, services and
  supplies authorized under the medical  assistance  program  pursuant  to
  this title which are in fact provided prior to the date of the aggregate
  claim   to  persons  who  have  been  determined  eligible  for  medical
  assistance, or based on the past performance of the hospital are  likely
  to  be  determined eligible for medical assistance, when no other source
  of payment including third party health insurance and payments  pursuant
  to  title  eighteen of the Federal Social Security Act are available for
  such items of care, service and supplies. Such aggregate claims shall be
  subject to the audit and warrant of the state comptroller.
    (d) Any schedule of accelerated payments established by the department
  pursuant to this section shall assure that such payments are made for  a
  period of no more than six months from the month in which the department
  assumes  payment  responsibility for the hospital, and shall provide for
  repayment of any amounts in excess of current  audited  claims,  through
  reductions  in current claims, at a rate that will assure full repayment
  at the earliest time consistent with the purposes of this  section,  but
  in  no  event  more than twenty-four months following the month in which
  the  department  assumes  payment  responsibilities  for  the  hospital.
  However,  where  the  commissioner  of  health  has  determined with the
  concurrence of the state hospital review and  planning  council  that  a
  hospital  has  satisfied  the department of health regulations and is or
  has  been  authorized  to  participate   in   the   emergency   hospital
  reimbursement  program pursuant to which repayment of all or part of any
  accelerated payments made  by  the  department  have  been  deferred  in
  accordance  with  such regulations, notwithstanding the time limitations

  set forth above repayment of such deferred  amounts  shall  be  made  in
  accordance  with  an  orderly  schedule  of repayment established by the
  commissioner of health after consultation with the commissioner.  In  no
  event shall any reduction be made against current claims, grant funds or
  any  amounts  due said hospital in settlement of rate appeals, claims or
  lawsuits to satisfy such repayment obligations.
    (e) In making accelerated payments pursuant to  this  subdivision  and
  department  regulations, the department shall utilize federal funds made
  available, and local funds, for such purposes or for purposes of payment
  by the department  of  medical  assistance  payments  pursuant  to  this
  section.
    * 10.  a.  For the purpose of timely payment, the department is hereby
  authorized to develop a concurrent payment system for general  hospitals
  which  elect  to  participate in the concurrent payment system and which
  are  included  in  the  payment  component  of  the  medical  assistance
  information  and payment system, and to promulgate regulations to govern
  such a system. The  department  may  implement  the  concurrent  payment
  system for any general hospital which has elected to participate and for
  which the department has chosen to implement the system.
    b.  For  all  participating  general  hospitals  the  department shall
  determine  a  biweekly  concurrent  payment  which   shall   equal   one
  twenty-sixth  of  the  portion  of  the  hospital's imputed or certified
  inpatient revenue  cap  (as  defined  in  section  twenty-eight  hundred
  seven-a  of  the  public  health  law)  allocated for medical assistance
  payments. The concurrent payment shall be reviewed at the  beginning  of
  each  quarter  and  adjusted  to  reflect  any  changes to the inpatient
  revenue cap or portion allocated for medical assistance payments.
    c.  The  department  shall  promulgate  regulations,  consistent  with
  federal requirements for participation, governing the concurrent payment
  system.    The regulations shall address, among other things, the method
  of calculating the concurrent payment, the method of reconciliation, the
  adjustment of the concurrent payment for the calculated difference,  the
  manner  of  eliminating  underpayments  or  overpayments to hospitals in
  exceptional circumstances such as  significantly  changing  utilization,
  changes  in  bed  or  service  capacity,  or  imminent  insolvency.  The
  department shall promulgate regulations  establishing  a  procedure  for
  recognizing  open cases as of the date of reconciliation. The department
  shall also  promulgate  regulations  setting  forth  standards  for  the
  timeliness  and quality of billings and may lower the concurrent payment
  calculated in accordance  with  paragraph  b  of  this  subdivision  for
  noncompliance with such regulations.
    d.  Any  payment  claims  made to the department for days of inpatient
  care provided prior to the effective date of this subdivision  shall  be
  paid  or denied in accordance with department regulations in effect when
  the care was provided.
    e. For any general hospital which is not afforded the  opportunity  of
  participating   in  the  concurrent  payment  system  and  which  is  in
  compliance  with  the  billing  requirements  of  the  department,   the
  department  shall  pay any financing or working capital charge levied by
  the hospital as authorized in section twenty-eight  hundred  seven-a  of
  the public health law.
    f.  This  subdivision shall be effective only if federal participation
  is available.
    * NB Expires January 1, 1986
    11. a. For the purpose of timely payment,  the  department  is  hereby
  authorized  to develop a concurrent payment system for general hospitals
  which elect to participate in the concurrent payment  system  and  which
  are  included  in  the  payment  component  of  the  medical  assistance

  information and payment system, and to promulgate regulations to  govern
  such  a  system.  The  department  may  implement the concurrent payment
  system for any general hospital which has elected to participate and for
  which the department has chosen to implement the system.
    b.  For  all  participating  general  hospitals  the  department shall
  determine  a  biweekly  concurrent  payment  which   shall   equal   one
  twenty-sixth  of  the hospital's estimated yearly inpatient revenue from
  medical assistance payments. The concurrent payment shall be reviewed at
  the beginning of each quarter and adjusted to reflect any changes to the
  rates for medical assistance payments.
    c.  The  department  shall  promulgate  regulations,  consistent  with
  federal requirements for participation, governing the concurrent payment
  system.    The regulations shall address, among other things, the method
  of calculating the concurrent payment, the method of reconciliation, the
  adjustment of the concurrent payment for the calculated difference,  the
  manner  of  eliminating  underpayments  or  overpayments to hospitals in
  exceptional circumstances such as  significantly  changing  utilization,
  changes  in  bed  or  service  capacity,  or  imminent  insolvency.  The
  department shall promulgate regulations  establishing  a  procedure  for
  recognizing  open cases as of the date of reconciliation. The department
  shall promulgate regulations setting forth standards for the  timeliness
  and  quality of billings and may lower the concurrent payment calculated
  in accordance with paragraph b of  this  subdivision  for  noncompliance
  with such regulations.
    d.  Any  payment  claims  made to the department for days of inpatient
  care provided prior to the effective date of this subdivision  shall  be
  paid  or denied in accordance with department regulations in effect when
  the care was provided.
    e. For any general hospital which is not afforded the  opportunity  of
  participating   in  the  concurrent  payment  system  and  which  is  in
  compliance  with  the  billing  requirements  of  the  department,   the
  department  shall  pay any financing or working capital charge levied by
  the hospital as authorized in section twenty-eight  hundred  seven-a  of
  the public health law.
    f.  This  subdivision shall be effective only if federal participation
  is available.
    12. (a) For the purpose of regulating cash flow for general hospitals,
  the department shall develop and  implement  a  payment  methodology  to
  provide for timely payments for inpatient hospital services eligible for
  case  based  payments  per  discharge  based on diagnosis-related groups
  provided during the period January first, nineteen hundred  eighty-eight
  through  March thirty-first two thousand eleven, by such hospitals which
  elect to participate in the system.
    (b) In developing a payment methodology the department shall  consider
  a  system  under  which  hospitals  may  be  reimbursed  on the basis of
  inpatient admissions, adjusted to payment  on  the  basis  of  discharge
  data,  with reconciliations established at time periods specified by the
  department.  Under such a system variances between amounts  paid  on  an
  admission  basis  and  actual  amounts due and to be paid on a discharge
  basis may be reflected in the amounts to be paid in a subsequent period.
    13. Notwithstanding any inconsistent provision  of  law,  in  lieu  of
  payments  authorized  by  this chapter and/or any of the general fund or
  special revenue other appropriations made to the office of temporary and
  disability assistance and the office of children  and  family  services,
  from  funds  otherwise due to local social services districts or in lieu
  of payments of federal funds otherwise  due  to  local  social  services
  districts for programs provided under the federal social security act or
  the  federal  food  stamp  act  or the low income home energy assistance

  program, funds in amounts certified by the commissioner of the office of
  temporary and disability assistance or the commissioner of the office of
  children and family services or the commissioner of health as  due  from
  local social services districts as their share of payments made pursuant
  to  this  section,  may  be  set-aside  by  the  state comptroller in an
  interest-bearing account with such interest accruing to  the  credit  of
  the  locality,  pursuant  to an estimate provided by the commissioner of
  health of a local social services district's share of medical assistance
  payments, except that in  the  case  of  the  city  of  New  York,  such
  set-aside shall be subject first to the requirements of a section of the
  chapter  of  the  laws of two thousand one which enacted this provision,
  and then subject to the requirements of paragraph (i) of subdivision (b)
  of section two hundred twenty-two-a of chapter four hundred seventy-four
  of the laws of nineteen hundred ninety-six prior to the  application  of
  this  subdivision.  Should  funds  otherwise  payable  to a local social
  services district from appropriations made to the  office  of  temporary
  and  disability  assistance, the office of children and family services,
  and the department of health be insufficient to fully fund  the  amounts
  identified  by  the commissioner of health as necessary to liquidate the
  local share of payments to be made pursuant to this section on behalf of
  the local social services  district,  the  commissioner  of  health  may
  identify  other  state  or federal payments payable to that local social
  services district or any other county agency including, but not  limited
  to  the  county  department  of  health, from appropriations made to the
  state department of health, and may  authorize  the  state  comptroller,
  upon no less than five days written notice to such local social services
  district  or such other county agency, to set-aside such payments in the
  interest-bearing account with such interest accruing to  the  credit  of
  the locality. Upon such determination by the commissioner of health that
  insufficient  funds  are payable to a local social services district and
  any other county agency receiving payments from the office of  temporary
  and  disability  assistance, the office of children and family services,
  and the state department of health from  appropriations  made  to  these
  agencies,  the  state  comptroller  shall,  upon  no less than five days
  written notice to such local social  services  district  or  such  other
  county  agency,  withhold  payments from any of the general fund - local
  assistance accounts or payments made from any of the special  revenue  -
  federal  local assistance accounts, provided, however, that such federal
  payments shall be withheld only after such federal  funds  are  properly
  credited  to  the  county  through  vouchers,  claims  or other warrants
  properly received, approved, and paid  by  the  state  comptroller,  and
  set-aside  such  disbursements in the interest-bearing account with such
  interest accruing to the credit of the locality until such time that the
  amount withheld from each county is determined by  the  commissioner  of
  health  to be sufficient to fully liquidate the local share of payments,
  as estimated by the commissioner of health, to be made pursuant to  this
  section on behalf of that local social services district.
    14. Notwithstanding any other provision of law, effective on or before
  January  first,  two  thousand  one,  the local social services district
  share of medical assistance payments made by the state on behalf of  the
  local  social  services district shall be paid to the state by the local
  social services district  using  electronic  funds  transfer  under  the
  supervision   of  the  state  comptroller  and  pursuant  to  rules  and
  regulations of the commissioner of health. The state  comptroller  shall
  deposit  such  funds  in  the  medicaid  management  information  system
  statewide escrow fund to the credit of each local district. In the event
  that the state comptroller and commissioner  of  health  determine  that
  there  are  insufficient  funds  available  from  the  local district to

  liquidate  their  local  share  of  medical  assistance  payments,   the
  commissioner  of  health  shall  issue a repayment schedule to the state
  comptroller for purposes of reducing reimbursement from other sources of
  payment  from  the state to the city or county of which the local social
  services district is a part in accordance with subdivision  thirteen  of
  this  section,  until  the  amounts  due  from  the  local  district are
  recovered in full plus any interest that would have otherwise accrued to
  the fund had such fund had sufficient balances from the local  district.
  Upon determination by the state comptroller that insufficient sources of
  payment  are  available  to  fully  liquidate  the local social services
  district share of  medical  assistance  payments,  the  commissioner  of
  health  shall  include  in such schedule a charge to the county equal to
  the amount of interest otherwise earned by the state short-term interest
  pool, plus any interest  penalty  as  the  commissioner  of  health  may
  determine,  until  such  time  as  the district has fully liquidated its
  liability pursuant to the provisions of this chapter.