Part 603 - REDISTRIBUTION ADJUSTMENT PROCESS FOR REIMBURSEMENT CLAIMING

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Statutory Authority: 
Social Services Law, Sections 20, 34, 153

Section 603.1 - Adjustment by redistribution of reimbursement claims.

Section 603.1 Adjustment by redistribution of reimbursement claims. When reimbursement methodologies are altered as the result of State or Federal legislation, regulation or instructions, adjustments to claims to reflect the revised methodologies must be submitted as instructed by the department. Except as otherwise prescribed by the department, such adjustments must be stated or claimed in a manner that does not adversely affect any claim for reimbursement prepared and/or submitted to a reimbursement source by the department. Adjustments by redistribution may be required for:

(a) State charges for which there is no local share;

(b) certain releasees from institutions regulated by the State Department of Mental Hygiene for which there is no local share;

(c) administration of public assistance and care for needy Indians for which there is no local share;

(d) long-term medical assistance provided in accordance with paragraph

(g) of subdivision 1 of section 368-a of the Social Services Law;

(e) certain refugees for whom increased Federal financial participation is available;

(f) certain Home Energy Assistance Program expenditures which may be included in other public assistance grants; or

(g) such other classifications as may be specified in State or Federal law, regulation or instructions of the department.

 

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Section 603.2 - Redistribution and adjustment.

603.2 Redistribution and adjustment. Adjustments of claims reflecting revised reimbursement methodologies must be made using formats approved by the department. Any information required by the department to properly verify or consider the adjusted claim must be provided as instructed by the department. Redistribution and adjustment of claims must be submitted together with the claims to which the adjustments are applicable.

 

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Section 603.3 - Program or activity redistribution.

603.3 Program or activity redistribution. If the reimbursement claiming requirements for a particular program or activity allow reimbursement of a specified classification at a special reimbursement rate, any reflection of the special rate shown upon the schedule or format for the particular program or activity must not be also reflected in a separate adjustment schedule or format except as specifically instructed by the department.

 

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Section 603.4 - Other redistribution and adjustment requirements.

603.4 Other redistribution and adjustment requirements. A district must comply with such other procedures which the department may require for the purpose of accurately ascertaining the appropriate rates or amounts of reimbursement to which a district is entitled or for which the State is liable.

 

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