N.Y. Comp. Codes R. & Regs. tit. 10 § 85.10

Current through Register Vol. 46, No. 50, December 11, 2024

Section 85.10 - Responsibilities of hospitals

(a) In addition to their responsibilities specified under other sections of this Part, hospitals shall provide such information, facilities and services as requested by the persons designated by the Commissioner of Health to make determinations of coverability or decisions on appeal under sections 85.1 through 85.9 and section 85.13 of this Part.

(b) Hospitals shall designate an employee of the hospital to serve as liaison with the persons designated by the Commissioner of Health to make determinations of coverability or noncoverability or decisions on appeal under sections 85.1 through 85.9 and section 85.13 of this Part.

(c) Hospitals shall maintain copies of all notices of determinations of benefit coverability and noncoverability and notifications of decisions on appeal made by the commissioner's designees under this Part and given to the hospital. The hospital shall make such copies available for review by persons designated by the Commissioner of Health, the State Department of Social Services or local social services districts.

(d) Hospitals shall record on each claim for reimbursement under medical assistance for the needy for inpatient hospital care the period or periods of time approved as covered benefits by the commissioner's designee under this Part and shall certify on each claim that reimbursement is being requested only for inpatient hospital care determined to be a covered benefit by the commissioner's designee or that a determination is not required under this Part.

N.Y. Comp. Codes R. & Regs. Tit. 10 § 85.10