N.Y. Comp. Codes R. & Regs. tit. 14 § 100.3

Current through Register Vol. 46, No. 51, December 18, 2024

Section 100.3 - Services and facilities for which state aid will be granted

(a) Subject to the requirements set forth in article 11 of the Mental Hygiene Law and in this Part, reimbursement will be made for costs incurred for all services provided in accordance with an approved county plan.

(b) Reimbursement for inpatient care in a general hospital shall be limited to 30 days in any spell of illness. A spell of illness is a period of consecutive days that begins with the first day (not included in a previous spell of illness) on which a patient is furnished inpatient psychiatric hospital services and ends with the close of a period of 60 consecutive days during which the patient was not an inpatient in a psychiatric hospital or psychiatric unit of a general hospital. The first day of the 60 consecutive day period begins on the day of discharge. The 30 days eligible for reimbursement need not be consecutive. The hospital utilization review committee may waive this limitation on reimbursement by the State for one additional period of up to 30 days (total 60 days). An additional extension of reimbursement for a maximum period of up to 30 days may be made by the director of community mental health services, based on a recommendation of the hospital utilization review committee. (Total 90 days.) Subsequent 30-day extensions by the director of community mental health services based on utilization review committee reports may be made only with prior approval of the Commissioner of Mental Hygiene. Periods of partial hospitalization treatment, such as psychiatric day care and psychiatric night care, shall not be considered to be part of the inpatient stay.

(c) Reimbursement for inpatient care in a general hospital may include therapeutic leaves of not more than 48 hours in any week, but such leaves may not be in the nature of terminal leaves, nor may they extend into another week.

(d) Expenditures for inpatient care for persons eligible for assistance under the programs of medical assistance for the aged and old age assistance under the rules and regulations of the State Department of Social Services shall not be reimbursable under this program.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 100.3