N.Y. Comp. Codes R. & Regs. tit. 18 § 633.1

Current through Register Vol. 46, No. 45, November 2, 2024

Section 633.1 - Reimbursement for services

(a) Reimbursement for services provided to recipients of assistance and care or other eligible individuals shall be claimed on schedules and formats prescribed by the department and in accordance with instructions of the department. Amounts subject to reimbursement pursuant to title XX of the Federal Social Security Act (Title XX services) or which may be claimed under other programs for which there is Federal participation shall be claimed in a manner that results in the greatest proportion of Federal participation or alternatively shall be claimed in a manner that does not increase the amount of State reimbursement which would be available if Federal participation were also available.

(b) Expenditures made by social services districts for services provided to recipients of assistance and care or other eligible individuals shall be subject to reimbursement by the State in accordance with the provisions of sections 153, 258, 370-b and 409-d (5) of the Social Services Law. Such claims shall be submitted in a manner that results in the greatest proportion of Federal participation. Such claims shall be made in accordance with department instructions or directions, including the following:

(1) Except as otherwise specifically provided by law, expenditures for services made by or on behalf of, or directly related to the operations of a social services district may, if approved by the department, be subject to reimbursement by the State, if and so long as such expenditures are subject to Federal reimbursement and only to the extent of such Federal reimbursement.

(2) No cash assistance paid to a recipient of services, an individual eligible to receive services or a representative of such individual shall be claimed for reimbursement as services unless such direct payment is authorized by law, regulation or department directive or order.

(3) Amounts spent in excess of any expenditure ceiling for services funded pursuant to title XX of the Social Security Act shall be reported but not claimed as State reimbursement. However, reimbursement is available with respect to any expenditures for protective or preventive services authorized by law, notwithstanding that expenditures for such services exceed a social services district's expenditure ceiling. Such reimbursement shall be available only to the extent that a social services district has exhausted its entitlement to or is ineligible for funds appropriated or apportioned for such services and any other services authorized by law in accordance with instructions of the department.

(4) Reimbursement from the department shall not be available to a social services district with respect to any services for which State aid or reimbursement may be paid pursuant to the provisions of a law outside the provisions of Social Services Law.

(5) Services subject to reimbursement under this Part shall not include any services which are required to be furnished as medical assistance pursuant to the Social Services Law.

(6) Amounts that may be claimed for services expenditures for which there is an equal or greater proportion of Federal participation available from another program or activity not subject to a funding ceiling or limit shall not be claimed for reimbursement under this Part.

(7) Services which may be provided to persons who are under care in private or public institutions or facilities shall be furnished only in institutions and facilities which are operated in compliance with applicable provisions of law and regulation.

(8) Any other expenditures designated as expenditures for services shall be claimed in accordance with instructions and directions of the department.

N.Y. Comp. Codes R. & Regs. Tit. 18 § 633.1