N.Y. Comp. Codes R. & Regs. tit. 14 § 635-12.10

Current through Register Vol. 46, No. 25, June 18, 2024
Section 635-12.10 - Denial, discharge or discontinuation of services
(a) Preexisting services.

A provider may not discharge an individual from preexisting services or otherwise discontinue preexisting services to an individual because of failure to pay.

(b)Services other than preexisting services-denial of services.
(1) The provider may deny the request for services:
(i) if the individual does not have full Medicaid coverage; and
(ii) if the provider has not received reasonable assurance that the individual or other liable party will pay for the services in accordance with this Subpart; and
(iii) if the fees have not been waived.
(2) Notwithstanding the provisions of paragraph (1) of this subdivision, a provider may not deny services to an individual if the provision of services is otherwise required by law or court order.
(c)Services other than preexisting services-discharge or discontinuance of services.
(1) A provider may discharge an individual from services or otherwise discontinue services because of failure to pay.
(2) Providers must adhere to the provisions of section 633.12 of this Title and any law or regulation that applies to the discharge or discontinuation of services.
(3) Notwithstanding the provisions of paragraph (1) of this subdivision, a provider may not discharge an individual from services or discontinue services if the continuation of services is otherwise required by law or court order.
(d)Effect on liability for services.
(1) The responsibility of individuals and other liable parties to pay for services is not affected by any requirement in this section that providers continue to provide services to the individual despite failure to pay.
(2) The responsibility of individuals and other liable parties to pay for services continues during the time that proceedings are underway to discharge the individual or otherwise discontinue services.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 635-12.10

Amended New York State Register July 1, 2015/Volume XXXVII, Issue 26, eff.7/1/2015
Amended New York State Register October 28, 2015/Volume XXXVII, Issue 43, eff.11/1/2015
Amended New York State Register April 20, 2016/Volume XXXVIII, Issue 16, eff.4/20/2016
Amended New York State Register September 21, 2016/Volume XXXVIII, Issue 38, eff. 9/21/2016