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VOLUME A-2 (Title 10)
Part 86 - Reporting And Rate Certifications For Facilities
Title: SubPart 86-1 - Medical Facilities
Title: SubPart 86-1 - Medical Facilities
Effective Date
02/02/2022
SubPart 86-1 - Medical Facilities
Section 86-1.1 - Definition
Section 86-1.2 - Financial and statistical data required
Section 86-1.3 - Uniform system of accounting and reporting
Section 86-1.4 - Audits
Section 86-1.5 - Effective period of reimbursement rates
Section 86-1.6 - Allowable costs
Section 86-1.7 - Recoveries of expense
Section 86-1.8 - Research and educational activities
Section 86-1.9 - Compensation of operators and relatives of operators
Section 86-1.10 - Related organizations
Section 86-1.11 - Termination of service
Section 86-1.12 - Federal financial participation
Section 86-1.13 - Certified home health agency rates
Section 86-1.14 - Allowance for certified home health agencies providing a disproportionate share of bad debt and charity care
Section 86-1.15 - Definitions
Section 86-1.16 - Statewide base price
Section 86-1.17 - Exclusion of outlier and transfer costs
Section 86-1.18 - Service Intensity Weights (SIW) and average length-of-stay (LOS)
Section 86-1.19 - Wage Equalization Factor (WEF)
Section 86-1.20 - Add-ons to the case payment rate per discharge
Section 86-1.21 - Outlier and transfer cases rates of payment
Section 86-1.22 - Alternate level of care payments
Section 86-1.23 - Exempt units and hospitals
Section 86-1.24 - Trend factor
Section 86-1.25 - Capital expense reimbursement
Section 86-1.26 - Statewide Planning and Research Cooperative System (SPARCS)
Section 86-1.27 - Federal upper limit compliance
Section 86-1.28 - Adding or deleting hospital services or units
Section 86-1.29 - New hospitals and hospitals on budgeted rates
Section 86-1.30 - Swing bed reimbursement
Section 86-1.31 - Mergers, acquisitions and consolidations
Section 86-1.32 - Administrative rate appeals
Section 86-1.33 - Out-of-state providers
Section 86-1.34 - Supplemental indigent care distributions
Section 86-1.35 - Disproportionate share limitations
Section 86-1.36 - Hospital physician billing
Section 86-1.37 - Readmissions
Section 86-1.38 - Transition pool for 2010-2013 period
Section 86-1.39 - Inpatient psychiatric services
Section 86-1.41 - Hospital Quality Contribution
Section 86-1.42 - Potentially preventable negative outcomes
Section 86-1.43 - Certified home health care agency ceilings
Section 86-1.44 - Episodic Payments for Certified Home Health Agency Services
Section 86-1.45 - Reimbursement for language assistance services in hospital inpatient settings
Section 86-1.46 - Empire Clinical Research Investigator Program (ECRIP)
Section 86-1.47 - Hospital indigent care pool payments
Section 86-1.50 Repealed
Section 86-1.51 Repealed
Section 86-1.52 Repealed
Section 86-1.53 Repealed
Section 86-1.54 Repealed
Section 86-1.55 Repealed
Section 86-1.57 Repealed
Section 86-1.60 Repealed
Section 86-1.61 Repealed
Section 86-1.62 Repealed
Section 86-1.63 Repealed
Section 86-1.64 Repealed
Section 86-1.65 Repealed
Section 86-1.66 Repealed
Section 86-1.70 Repealed
Section 86-1.71 Repealed
Section 86-1.74 Repealed
Section 86-1.75 Repealed
Section 86-1.80 Repealed
Section 86-1.81 Repealed
Section 86-1.82 Repealed
Section 86-1.83 Repealed
Section 86-1.84 Repealed
Section 86-1.86 Repealed
Section 86-1.88 Repealed
Section 86-1.89 Repealed
Statutory Authority
Public Health Law, Secs. 2803, 2807, 2807-a, 2807-c, 2807-c(35), 2807-m, 2808-c, 3612; 3614; L. 1983, ch. 758, Sec. 7; L. 1993, ch. 731; L. 1996, ch. 639
Volume
VOLUME A-2 (Title 10)
Outline
VOLUME A-2 (Title 10)
Part 86 - Reporting And Rate Certifications For Facilities
SubPart 86-1 - Medical Facilities
Section 86-1.1 - Definition
Section 86-1.2 - Financial and statistical data required
Section 86-1.3 - Uniform system of accounting and reporting
Section 86-1.4 - Audits
Section 86-1.5 - Effective period of reimbursement rates
Section 86-1.6 - Allowable costs
Section 86-1.7 - Recoveries of expense
Section 86-1.8 - Research and educational activities
Section 86-1.9 - Compensation of operators and relatives of operators
Section 86-1.10 - Related organizations
Section 86-1.11 - Termination of service
Section 86-1.12 - Federal financial participation
Section 86-1.13 - Certified home health agency rates
Section 86-1.14 - Allowance for certified home health agencies providing a disproportionate share of bad debt and charity care
Section 86-1.15 - Definitions
Section 86-1.16 - Statewide base price
Section 86-1.17 - Exclusion of outlier and transfer costs
Section 86-1.18 - Service Intensity Weights (SIW) and average length-of-stay (LOS)
Section 86-1.19 - Wage Equalization Factor (WEF)
Section 86-1.20 - Add-ons to the case payment rate per discharge
Section 86-1.21 - Outlier and transfer cases rates of payment
Section 86-1.22 - Alternate level of care payments
Section 86-1.23 - Exempt units and hospitals
Section 86-1.24 - Trend factor
Section 86-1.25 - Capital expense reimbursement
Section 86-1.26 - Statewide Planning and Research Cooperative System (SPARCS)
Section 86-1.27 - Federal upper limit compliance
Section 86-1.28 - Adding or deleting hospital services or units
Section 86-1.29 - New hospitals and hospitals on budgeted rates
Section 86-1.30 - Swing bed reimbursement
Section 86-1.31 - Mergers, acquisitions and consolidations
Section 86-1.32 - Administrative rate appeals
Section 86-1.33 - Out-of-state providers
Section 86-1.34 - Supplemental indigent care distributions
Section 86-1.35 - Disproportionate share limitations
Section 86-1.36 - Hospital physician billing
Section 86-1.37 - Readmissions
Section 86-1.38 - Transition pool for 2010-2013 period
Section 86-1.39 - Inpatient psychiatric services
Section 86-1.41 - Hospital Quality Contribution
Section 86-1.42 - Potentially preventable negative outcomes
Section 86-1.43 - Certified home health care agency ceilings
Section 86-1.44 - Episodic Payments for Certified Home Health Agency Services
Section 86-1.45 - Reimbursement for language assistance services in hospital inpatient settings
Section 86-1.46 - Empire Clinical Research Investigator Program (ECRIP)
Section 86-1.47 - Hospital indigent care pool payments
Section 86-1.50 Repealed
Section 86-1.51 Repealed
Section 86-1.52 Repealed
Section 86-1.53 Repealed
Section 86-1.54 Repealed
Section 86-1.55 Repealed
Section 86-1.57 Repealed
Section 86-1.60 Repealed
Section 86-1.61 Repealed
Section 86-1.62 Repealed
Section 86-1.63 Repealed
Section 86-1.64 Repealed
Section 86-1.65 Repealed
Section 86-1.66 Repealed
Section 86-1.70 Repealed
Section 86-1.71 Repealed
Section 86-1.74 Repealed
Section 86-1.75 Repealed
Section 86-1.80 Repealed
Section 86-1.81 Repealed
Section 86-1.82 Repealed
Section 86-1.83 Repealed
Section 86-1.84 Repealed
Section 86-1.86 Repealed
Section 86-1.88 Repealed
Section 86-1.89 Repealed
SubPart 86-2 - Residential Health Care Facilities
Section 86-2.1 - Definitions
Section 86-2.2 - Financial and statistical data required
Section 86-2.3 - Uniform system of accounting and reporting
Section 86-2.4 - Generally accepted accounting principles
Section 86-2.5 - Accountant's certification
Section 86-2.6 - Certification by operator or officer
Section 86-2.7 - Audits
Section 86-2.8 - Patient days
Section 86-2.9 - Adult day health care in residential health care facilities
Section 86-2.10 - Computation of basic rate
Section 86-2.11 - Adjustments to direct component of the rate
Section 86-2.12 - Adjustments to basic rate
Section 86-2.13 - Adjustments to provisional rates based on errors
Section 86-2.14 - Revisions in certified rates
Section 86-2.15 - Rates for residential health care facilities without adequate cost experience
Section 86-2.16 - Less expensive alternatives
Section 86-2.17 - Allowable costs
Section 86-2.18 - Recoveries of expense
Section 86-2.19 - Depreciation for voluntary and public residential health care facilities
Section 86-2.20 - Interest for all residential health care facilities
Section 86-2.21 - Capital cost reimbursement for proprietary residential health care facilities
Section 86-2.22 - Movable equipment
Section 86-2.23 - Research
Section 86-2.24 - Educational activities
Section 86-2.25 - Compensation of operators or relatives of operators
Section 86-2.26 - Related organizations
Section 86-2.27 - Termination of service
Section 86-2.28 - Return on investment
Section 86-2.29 - Payments to receivers
Section 86-2.30 - Residential health care facilities patient assessment for certified rates
Section 86-2.31 - Recalibration
Section 86-2.32 - Nurse aide competency exam
Section 86-2.33 - Dementia pilot demonstration projects
Section 86-2.34 - Affiliation changes
Section 86-2.36 - Scheduled short term care
Section 86-2.37 - Submission of resident assessments
Section 86-2.38 - Nursing home incentive payment
Section 86-2.39 - Closures, mergers, acquisitions, consolidations and restructurings
Section 86-2.35 - Reserved
Section 86-2.40 - Statewide prices for non-capital reimbursement.
Section 86-2.41 - Sprinkler systems
Section 86-2.42 - Residential health care facility quality pool
SubPart 86-3 - Health Maintenance Organizations
Section 86-3.1 - Definitions
Section 86-3.2 - Applicability of Subpart
Section 86-3.3 - Rates for hospital services
Section 86-3.4 - Administrative procedures
Section 86-3.5 - Health maintenance organization differential
SubPart 86-4 - Free-standing Ambulatory Care Facilities
Section 86-4.1 - Definitions
Section 86-4.2 - Facility rates
Section 86-4.3 - Recording and reporting of financial and statistical data
Section 86-4.4 - Certification of reports
Section 86-4.5 - Correction and supplementation of reports
Section 86-4.6 - Audits
Section 86-4.7 - Title XVIII (Medicare) certification
Section 86-4.8 Reserved
Section 86-4.9 - Units of service
Section 86-4.10 - Minimum utilization standards
Section 86-4.11 - Computation of basic rate for facilities other than licensed free-standing ambulatory surgery centers
Section 86-4.12 - Allowance for diagnostic and/or treatment centers providing a disproportionate share of bad debt and charity care
Section 86-4.13 - Groupings
Section 86-4.14 - Ceilings on payments
Section 86-4.15 - Calculation of trend factor
Section 86-4.16 - Revisions in certified rates
Section 86-4.17 - Appeal process
Section 86-4.18 Reserved
Section 86-4.19 - Rates for facilities without adequate cost experience
Section 86-4.20 - Capital cost reimbursement
Section 86-4.21 - Allowable costs
Section 86-4.22 - Recoveries of expense
Section 86-4.23 - Depreciation
Section 86-4.24 - Interest
Section 86-4.25 - Return on investment
Section 86-4.26 - Sales, leases and realty transactions
Section 86-4.27 - Compensation of operators and relatives of operators
Section 86-4.28 - Related organizations
Section 86-4.29 Reserved
Section 86-4.30 Reserved
Section 86-4.31 - Termination of service
Section 86-4.32 Reserved
Section 86-4.33 Reserved
Section 86-4.34 - Pilot reimbursement projects
Section 86-4.35 - Computation of basic rates for clinic services provided to Acquired Immune Deficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV) sero-positive patients by freestanding ambulatory care facilities and hospital clinic outpatient
Section 86-4.36 REPEALED
Section 86-4.37 - Computation of basic rates of payment for services provided to Medicaid patients by preferred primary care providers
Section 86-4.38 - Computation of basic rates of payment for services provided to Medicaid patients by specialty clinics
Section 86-4.39 - Computation of basic rates for methadone maintenance treatment services provided by freestanding ambulatory care facilities and hospital outpatient clinic services.
Section 86-4.40 - Computation of case-based rates of payment for licensed free-standing ambulatory surgery centers and hospital based ambulatory surgery services
Section 86-4.41 - Computation of basic rates for day health care services provided by freestanding ambulatory care facilities to patients with acquired immune deficiency syndrome (AIDS) and other human immunodeficiency (HIV) related illnesses
SubPart 86-5 - Long-term Home Health Care Programs
Section 86-5.1 - Definitions
Section 86-5.2 - Financial and statistical data required
Section 86-5.3 - Patient assessment
Section 86-5.4 - Generally accepted accounting principles
Section 86-5.5 - Accountant's certification
Section 86-5.6 - Certification by operator or officer
Section 86-5.7 - Audits
Section 86-5.8 - Patient visits/hourly rate
Section 86-5.9 - Determining patient eligibility
Section 86-5.10 - Computation of average monthly nursing home rates
Section 86-5.11 - Computation of individual hourly or per-visit service rate
Section 86-5.12 - Cost guidelines for reimbursement purposes
Section 86-5.13 - Adjustments to provisional rates based on errors
Section 86-5.14 - Revisions in certified rates
Section 86-5.15 - Rates for LTHHCP without adequate cost experience
Section 86-5.16 - Less expensive alternatives
Section 86-5.17 - Allowable costs
Section 86-5.18 - Recoveries of expense
Section 86-5.19 - Depreciation for voluntary and public LTHHCP
Section 86-5.20 - Interest for all LTHHCPs
Section 86-5.21 - Capital cost reimbursement for proprietary LTHHCPs
Section 86-5.22 - Return on investment for proprietary LTHHCPs
Section 86-5.23 - Movable equipment
Section 86-5.24 - Research
Section 86-5.25 - Education activities
Section 86-5.26 - Termination of services
Section 86-5.27 - AIDS home care programs
Section 86-5.28 - Related organizations.
SubPart 86-6 - Hospices
Section 86-6.1 - Definitions
Section 86-6.2 - Hospice rates of reimbursement
Section 86-6.3 - Reimbursement for attending and consulting physician services
Section 86-6.4 - Reporting requirements
Section 86-6.5 - Trend factor
Section 86-6.6 - Supplemental financial assistance program
Section 86-6.7 - Hospice reimbursement for room and board provided to patients residing in a nursing facility
SubPart 86-7 - Assisted Living Program
Section 86-7.1 - Definitions
Section 86-7.2 - Computation of the rate of payment
Section 86-7.3 - Adjustments to rate of payment
Section 86-7.4 - Federal financial participation
SubPart 86-8 - Outpatient Services: Ambulatory Patient Group
Section 86-8.1 - Scope
Section 86-8.2 - Definitions
Section 86-8.3 - Record keeping, reports and audits
Section 86-8.4 - Capital reimbursement and rate add-ons
Section 86-8.5 - Administrative rate appeals
Section 86-8.6 - Rates for new facilities during the transition period
Section 86-8.7 - APGs and relative weights
Section 86-8.8 - Base rates
Section 86-8.9 - Diagnostic coding and rate computation
Section 86-8.10 - Exclusions from payment
Section 86-8.11 - System updating and incorporation by reference
Section 86-8.12 - Payments for extended hours of operation
Section 86-8.13 - Out-of-state providers
Section 86-8.14 - Non-APG payments
Section 86-8.15 - Closures, mergers, acquisitions, consolidations, restructurings and inpatient bed de-certifications
SubPart 86-9 - Limited Home Care Services Agencies
Section 86-9.1 - Services
Section 86-9.2 - Computation of the rates of payment
SubPart 86-10 - Rates for Non-State Providers of Residential Habilitation in Community Residences, Including Individualized Residential Alternatives (IRAs) and for Non-State Providers of Day Habilitation
Section 86-10.1 - Applicability
Section 86-10.2 - Definitions
Section 86-10.3 - Rates for residential habilitation services and for day habilitation services
Section 86-10.4 - Reporting requirements
Section 86-10.5 - Trend Factor, Increases to Compensation and Other Adjustments
Section 86-10.6 - Transition periods and reimbursement
Section 86-10.7 - Rate corrections
Section 86-10.8 - Specialized template populations
Section 86-10.9 - Severability
SubPart 86-11 - Rate Setting for Non-State Providers: Intermediate Care Facilities for Persons with Developmental Disabilities
Section 86-11.1 - Applicability
Section 86-11.2 - Definitions
Section 86-11.3 - Rates for providers of ICF/DD services
Section 86-11.4 - Assessment
Section 86-11.5 - Reporting requirements.
Section 86-11.6 - Trend Factor, Increases to Compensation and Other Adjustments
Section 86-11.7 - Transition to new methodology
Section 86-11.8 - Rate corrections
Section 86-11.9 - Specialized template populations
Section 86-11.10 - Severability
SubPart 86-12 - Outpatient Services Licensed Under the Mental Hygiene Law
Section 86-12.1 - Utilization limits on OPWDD licensed clinics
Section 86-12.2 - Utilization limits on OMH licensed clinics
Section 86-12.3 - Utilization limits on OASAS licensed clinics
SubPart 86-13 - Rates for Non-State Providers of Prevocational Services (Site-based) and Respite (Hourly and Free-standing), and fees for Prevocational Services (Community-based), Residential Habilitation (Family Care) and Supported Employment
Section 86-13.1 - Applicability
Section 86-13.2 - Definitions
Section 86-13.3 - Rates for prevocational services (site-based), respite (hourly and free-standing), prevocational services (community-based), supported employment, and residential habilitation (family care)
Section 86-13.4 - Reporting requirements
Section 86-13.5 - Trend Factor
Section 86-13.6 - Transition periods and reimbursement
Section 86-13.7 - Rate corrections for prevocational services (site-based) and respite (hourly and free-standing) rates
Section 86-13.8 - Specialized template populations
Section 86-13.9 - Severability
Appendix 1 - Performance review of M/C faculty term appointments
Part 87 - Nursing Home Company And Hospital Mortgage Loans
NURSING HOME COMPANIES
Section 87.1 - General requirements
Section 87.2 - Corporate organization
Section 87.3 - Project development
Section 87.4 - Project construction
Section 87.5 - Development period records and reports
Section 87.6 - Insurance
Section 87.7 - Initial occupancy
Section 87.8 - Operational period
Section 87.9 - Real and personal tangible property
Section 87.10 - Escrow funds
Section 87.11 - Use of funds of the company
Section 87.12 - Salaries or fees to officers or directors
Section 87.13 - Purchases and contracts
Section 87.14 - Default avoidance method
MORTGAGE LOAN CHARGES
Section 87.20 - General
Section 87.21 - Charges for development period
Section 87.22 RESERVED
HOSPITAL MORTGAGE LOANS
Section 87.30 - General requirements
Section 87.31 - Project development
Section 87.32 - Project construction
Section 87.33 - Development period records and reports
Section 87.34 - Insurance
Section 87.35 - Initial occupancy
Section 87.36 - Operational period
Section 87.37 - Personal tangible property
Section 87.38 - Escrow funds
Section 87.39 - Salaries or fees to officers or directors
Section 87.40 - Purchases and contracts
Part 88 - Helen Hayes Hospital, New York State Veterans' Home and Roswell Park Memorial Institute
SubPart 88-1 - Helen Hayes Hospital
ADMISSION OF PATIENTS
Section 88-1.1 - Eligibility for admission
Section 88-1.2 - Priority of admissions
Section 88-1.3 - Emergencies
Section 88-1.4 - Vacancies
Section 88-1.5 - Procedure for filing application
Section 88-1.6 - Reports
FISCAL RESPONSIBILITIES
Section 88-1.10 - Guarantee of expense
Section 88-1.11 - Expenses prior to admission
Section 88-1.12 - Charge for maintenance and treatment
Section 88-1.13 - Payment of maintenance charges
DISCHARGE OF PATIENTS
Section 88-1.20 - Discharges
Section 88-1.21 - Supervision after discharge
SubPart 88-2 - New York State Veterans' Homes
Section 88-2.1 - Applicability
Section 88-2.2 - Application for admission
Section 88-2.3 - Emergencies
Section 88-2.4 - Claims for cost of care and maintenance
Section 88-2.5 - Reports
Section 88-2.6 - Limitations of care and discharges
SubPart 88-3 - Roswell Park Memorial Institute
ADMISSION OF PATIENTS
Section 88-3.1 - Eligibility for admission
Section 88-3.2 - Emergencies
Section 88-3.3 - Vacancies
Section 88-3.4 - Procedure for filing application
Section 88-3.5 - Reports
FISCAL RESPONSIBILITIES
Section 88-3.10 - Guarantee of expense
Section 88-3.11 - Expenses prior to admission
Section 88-3.12 - Charge for treatment
Section 88-3.13 - Payment of maintenance charges
DISCHARGE OF PATIENTS
Section 88-3.20 - Discharges
SubPart 88-4 - RESERVED
SubPart 88-5 - Purchasing and Contracting
Section 88-5.1 - Purpose
Section 88-5.2 - Requirements
SubChapter M - Practice of Radiologic Technology
Part 89 - Practice of Radiologic Technology
PRACTICE OF RADIOLOGIC TECHNOLOGY
Section 89.0 - Purpose and scope
Section 89.1 - Definitions
Section 89.2 - Practice of radiologic technology
EDUCATIONAL PROGRAMS IN RADIOLOGIC TECHNOLOGY
Section 89.3 - Registration
Section 89.4 - Educational Program Standards
Section 89.5 - Students
Section 89.6 Repealed
Section 89.7 Repealed
Section 89.8 Repealed
Section 89.9 Repealed
LICENSURE
Section 89.10 - General Provisions
Section 89.11 - Denial of licensure
Section 89.12 - Issuance of a temporary permit
Section 89.15 Repealed
Section 89.16 Repealed
Section 89.17 Repealed
Section 89.18 Repealed
Section 89.19 Repealed
REGISTRATION AND CONTINUING EDUCATION
Section 89.20 - Registration and continuing education
Section 89.25 Repealed
Section 89.26 Repealed
Section 89.27 Repealed
Section 89.28 Repealed
Section 89.29 Repealed
EXEMPT PERSONS
Section 89.30 - Persons exempt
Section 89.31 Repealed
Section 89.32 Repealed
Section 89.35 Repealed
Section 89.36 Repealed
INTRAVASCULAR CONTRAST MEDIA INJECTION
Section 89.40 - Intravascular contrast media injection
Section 89.45 Repealed
Section 89.46 Repealed
Section 89.47 Repealed
Section 89.48 Repealed
Section 89.49 Repealed
Section 89.50 Repealed
Part 91 - Excess Liability Insurance Pool: Physicians And Dentists
Section 91.1 - Required excess malpractice coverage
Section 91.2 - Reporting requirements
Section 91.3 - Determination of cost and reimbursement of excess medical malpractice coverage
Section 91.4 - Pool administration
SubChapter O - Physician's Assistants; Prohibited Discrimination in Hospital Staff Appointments and Privileges
Part 92 - Infection Control Requirements
SubPart 92-1 - Physician's, Registered Physician Assistants and Specialist Assistants: Required Course Work or Training in Infection Control and Barrier Precautions Every Four Years
Section 92-1.1 - Course work or training
Section 92-1.2 - Application
Section 92-1.3 - Provider competency
Section 92-1.4 - Approval period
Section 92-1.5 - Denial or termination
Section 92-1.6 - Certificate of completion
Section 92-1.7 - Certificate of retention
Section 92-1.8 - Submission of documentation to the department
Section 92-1.9 - Exemptions
Section 92-1.10 - Equivalencies
SubPart 92-2 - Physicians, Registered Physician Assistants and Specialist Assistants Required Use of Infection Control Practices
Section 92-2.1 - Required use of infection control practices
Part 93 - Improper Practices in Hospital Staff Appointments and Extension of Professional Privileges
Section 93.1 - Filing of complaint
Section 93.2 - Contents of complaint
Section 93.3 - Investigation
Section 93.4 - Response by the hospital
Section 93.5 - Action by the Public Health Council
Part 94 - Physician Assistants And Specialist Assistants
Section 94.1 - Definitions
Section 94.2 - Supervision and scope of duties
Part 95 - Discrimination In Physician Staff Appointments And Privileges Based On Participation In A Medical Group Practice Or Non-Profit Health Insurance Plan
Section 95.1 - Filing of complaint
Section 95.2 - Contents of complaint
Section 95.3 - Initial investigation
Section 95.4 - Preliminary conference
Section 95.5 - Notice of complaint
Section 95.6 - Time for answer
Section 95.7 - Pre-hearing procedures
Section 95.8 - Subpoenas
Section 95.9 - Conduct of the hearing
Section 95.10 - Stenographic record
Section 95.11 - Decision of hearing officer
Section 95.12 - Order of commissioner
SubChapter P - Licensure and Practice of Nursing Home Administration
Part 96 - Licensure And Practice Of Nursing Home Administration
Section 96.1 - Definitions
Section 96.2 - Board of examiners; general powers
Section 96.3 - Board of examiners; officers and duties
Section 96.4 - Licenses and registrations
Section 96.5 - Admission to the examination
Section 96.6 - Grading of examination
Section 96.7 - Petition for admission to examination
Section 96.8 - Courses of study; standards for approval
Section 96.9 - Approved courses of study
Section 96.10 - Training agencies; administration, organization and faculty
Section 96.11 - Continuing education requirements
Section 96.12 - Applicants holding an out-of-state nursing home administrators license.
Section 96.13 - Notification of change of address or employment
SubChapter Q - State Environmental Quality Review
Part 97 - Regulations Implementing State Environmental Quality Review
Section 97.1 - Authority, purpose and policy
Section 97.2 - Definitions
Section 97.3 - Applicability
Section 97.4 - General rule
Section 97.5 - Responsibilities of applicants
Section 97.6 - Initial review of actions
Section 97.7 - Designation of lead agency and determination of significance for type I actions
Section 97.8 - Designation of lead agency and determination of significance for unlisted actions
Section 97.9 - Environmental impact statement procedures
Section 97.10 - Decisionmaking and findings requirements
Section 97.11 - Notice and filing requirements
Section 97.12 - Contents of environmental impact statements
Section 97.13 - Criteria for determining what actions may have a significant effect on the environment
Section 97.14 - Lists of department actions
Section 97.15 - Actions involving a Federal agency
Section 97.16 - Fees and costs
Section 97.17 - Programmatic or generic environmental impact statements
Section 97.18 - Confidentiality
Section 97.19 - Effective date
SubChapter R - Managed Care Organizations
Part 98 - Managed Care Organizations
SubPart 98-1 - Managed Care Organizations
Section 98-1.1 - Applicability
Section 98-1.2 - Managed Care Organizations
Section 98-1.3 - RESERVED
Section 98-1.4 - Certificate of incorporation or articles of organization
Section 98-1.5 - Application for a certificate of authority
Section 98-1.6 - Issuance of a certificate of authority
Section 98-1.7 - Limitations of a certificate of authority
Section 98-1.8 - Continuance of a certificate of authority
Section 98-1.9 - Acquisition or retention of control of HMO's
Section 98-1.10 - Transactions within a holding company system affecting controlled HMO's
Section 98-1.11 - Operational and financial requirements for MCOs
Section 98-1.12 - Quality management program
Section 98-1.13 - Assurance of access to care
Section 98-1.14 - Enrollee services and grievance procedures
Section 98-1.15 - Employer requirements
Section 98-1.16 - Audited Financial Statements for Managed Care Organizations
Section 98-1.17 - Audits and examinations
Section 98-1.18 - Relationship between an MCO and an IPA
Section 98-1.19 - Marketing by MLTCPs
Section 98-1.20 - Waived requirements for MLTCPs
Section 98-1.21 - Fraud and abuse prevention plans and special investigation units
Section 98-1.22 - Warning Statements
SubChapter S - Land Acquisition
SubPart 98-2 - External Appeals of Adverse Determinations
Section 98-2.1 - Preamble
Section 98-2.2 - Definitions
Section 98-2.3 - Standard description of the external appeal process
Section 98-2.4 - Certification of external appeal agents
Section 98-2.5 - Certification requirements
Section 98-2.6 - Conflict of interest
Section 98-2.7 - Screening of requests for external appeal
Section 98-2.8 - Random assignment of external appeals
Section 98-2.9 - Responsibilities of health care plans
Section 98-2.10 - Responsibilities of certified external appeal agents
Section 98-2.11 - Enrollee rights and responsibilities
Section 98-2.12 - Confidentiality
Section 98-2.13 - Audits and examinations
Subpart 98-3 - Audited Financial Statements for Managed Care Organizations
Section 98-3.1 - Purpose
Section 98-3.2 - Definitions
Section 98-3.3 - General requirements related to filing of annual audited financial reports and audit committee appointment
Section 98-3.4 - Contents of annual audited financial report
Section 98-3.5 - Designation of CPA
Section 98-3.6 - Qualifications of CPA
Section 98-3.7 - Consolidated or combined audits
Section 98-3.8 - Scope of audit and report of CPA
Section 98-3.9 - Notification of adverse financial condition
Section 98-3.10 - Communication of internal control related matters noted in an audit
Section 98-3.11 - CPA’s letter of qualifications
Section 98-3.12 - Availability and maintenance of CPA work papers
Section 98-3.13 - Requirements for audit committees
Section 98-3.14 - Conduct of MCO in connection with the preparation of required reports and documents
Section 98-3.15 - Management’s report of internal control over financial reporting
Section 98-3.16 - Effective date and special rules
Subpart 98-4 - Mental Health and Substance Use Disorder Treatment Parity Compliance Program
Section 98-4.1 - Purpose
Section 98-4.2 - Applicability
Section 98-4.3 - Definitions
Section 98-4.4 - Mental health and substance use disorder parity compliance program
Part 99 - Payments To An Owner Or Tenant Of Residential Property Or Commercial Property Upon Application For Allowance Of Moving Expenses In Vacating Property Acquired By The Department Of Health
Section 99.1 - Purpose
Section 99.2 - Definitions
Section 99.3 - General provisions
Section 99.4 - Fixed moving expenses for residential individuals and families
Section 99.5 - Actual moving expenses for business concerns
SubChapter N - Professional Medical and Dental Services
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