REQUIREMENTS APPLYING TO LOCAL HEALTH OFFICIALS FOR RECEIVING STATE AID FOR TUBERCULOSIS HEALTH CARE SERVICES

Section 43-1.11 - State aid for tuberculosis

REQUIREMENTS APPLYING TO LOCAL HEALTH OFFICIALS FOR RECEIVING STATE AID FOR TUBERCULOSIS HEALTH CARE SERVICES

43-1.11 State aid for tuberculosis.

(a) Expenses incurred by a local health official for health care services rendered to tuberculosis patients in accordance with the terms of this Subpart shall be eligible for State aid reimbursement.

(b) Such aid shall be provided to local health officials through the same procedures and at the same rate as State aid for general public health work, pursuant to Part 40 of this Subchapter.
 

Effective Date: 
Wednesday, December 31, 2014
Doc Status: 
Complete

Section 43-1.12 - Limitations on State aid

43-1.12 Limitations on State aid.

(a) No State aid is available to local health officials or providers for tuberculosis health care services which do not meet the terms of this Subpart or:

(1) if payment of a claim is available from any other third-party payer which equals or exceeds the per diem rate or fee for services;

(2) for tuberculosis health care services for persons listed in subdivision (b) of section 43-1.3 of this Subpart; or

(3) for services for which payment by a local health official is not required under this Subpart.

(b) If a local health official pays a provider more than it was responsible to pay under section 43-1.9 of this Subpart, State aid shall not exceed the amount that would have been due if the local health official had so limited payment in accordance with said section.
 

Effective Date: 
Wednesday, February 8, 1989
Doc Status: 
Complete

Section 43-1.13 - Audits by local health officials

43-1.13 Audits by local health officials.

Local health officials shall audit a sufficient number of provider reports, medical records, and if necessary, interview physicians and other personnel to determine whether a provider has furnished or is furnishing tuberculosis health care services in accordance with the requirements of this Subpart.
 

Effective Date: 
Wednesday, February 8, 1989
Doc Status: 
Complete

Section 43-1.14 - Recovery

43-1.14 Recovery.

Local health officials shall oversee all provider efforts to identify third-party coverage and to be able to demonstrate on audit that such third-party coverage was identified and fully utilized and that the providers adhered to the terms of this Subpart. Upon receipt of audit information by the State Health Department showing State aid overpayment, the Commissioner shall deduct from the next State aid voucher the amount previously overpaid.
 

Effective Date: 
Wednesday, February 8, 1989
Doc Status: 
Complete