N.Y. Comp. Codes R. & Regs. tit. 14 § 801.4

Current through Register Vol. 46, No. 25, June 18, 2024

Section 801.4 - Provider obligations for part 816 and part 818 of this title services

Providers of Part 816 Medically Managed Detoxification Services and Inpatient Medically Supervised Withdrawal Services and Part 818 Chemical Dependence Inpatient Rehabilitation Services of this Title shall cooperate with their designated regional behavioral health organization. At a minimum, such cooperation shall include:

(a) notifying the appropriate behavioral health organization of an admission for a behavioral health condition for which coverage is provided by Medicaid on a fee-for-service basis to an individual who is not also enrolled in the Medicare program. Such notification shall be provided within 24 hours of such admission or, for an admission occurring on a Friday, Saturday, Sunday or public holiday, by 5:00 p.m. on the next business day following such admission. When Medicaid coverage cannot be determined at the time of admission, notification shall be provided as soon as practicably possible after confirmation of Medicaid eligibility, but in no event more than 24 hours after such confirmation or, for a confirmation made on a Friday, Saturday, Sunday or public holiday, later than 5:00 p.m. on the next business day following such confirmation;

(b) cooperating with concurrent review activities;

(c) ensuring that the discharge plan for such an individual includes consideration of physical health needs and services;

(d) notifying such behavioral health organization no later than 24 hours subsequent to the discharge of such an individual or, for a discharge occurring on a Friday, Saturday, Sunday or public holiday, by 5:00 p.m. on the next business day following such discharge; and

(e) seeking to obtain, as needed, such individual's consent to receive and provide information in a manner that is consistent with Federal and State confidentiality laws.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 801.4