This section provides guidelines
and procedures for processing payments of State funds to
hospitals and other health service providers for care provided
to wards, clients, inmates, etc, of State agencies.
The statutory authority for
these payments are Section 109 of the State Finance Law
and Section 2807 of the Public Health Law.
The Public Health Law provides
that payments by government agencies to hospitals and
health related service providers shall be at a rate approved
by the State Director of the Budget and certified by the
Commissioner of Health. These rates are published in the
New York State Physician Procedure Code and Fees Schedule
for health providers. The hospital rates are published
in the Hospital In Patient-Out Patient Rate Schedule.
They are reasonable in relation to the efficient cost
of providing the services.
Vouchers submitted by hospitals
must be at the approved daily rate for the particular
hospital. These daily rates are inclusive of all services
provided by the hospitals. Vouchers must contain the patient's
name, the dates the services were rendered, the total
number of days billed and the hospital rate.
Vouchers submitted by other
health service providers, doctors, etc., must include
the patient's name, the medical Fee Schedule code for
the service and the Medical Fee Schedule Rate for the
Payments made by State agencies
to hospitals and providers cannot exceed the amounts in
the schedules. Payments to a hospital or provider by State
agencies are not affected by payments made by other health
insurance plans for the ward, client, or inmate. Agencies
should be aware if other payments are being made to the
providers. State agencies should ensure that a provider
is not being paid an unreasonable or excessive amount
for services rendered to clients, etc.
Vouchers should be prepared
and processed in accordance with current procedures in
the User Procedure Manual,
Volume III, Encumbrances and Expenditures, Section 4.
Vouchers making payment for
medical services must have a "H" code in the