XVI. Financial Reporting

Guide to Financial Operations

XVI.4.E Patient Revenues

XVI. Financial Reporting
Guide to Financial Operations

INTRODUCTION

The State receives patient revenues from four agencies: the Office of Mental Health, the Office for People with Developmental Disabilities, the Office of Addiction Services and Supports and the Department of Health. In addition, patient revenues generated by the State University of New York (SUNY) teaching hospitals are reported in the audited financial statements prepared by SUNY. (See Section 4.T - College and University Reporting of this Chapter).

Patient revenues include Medicaid payments—which represent the largest portion of patient revenues—as well as Medicare and client and third-party provider payments. Medicaid revenues are collected by the State from the federal Department of Health and Human Services Fund. Medicare revenues are collected directly from the federal government. Client revenues are collected directly from patients and/or third-party providers.

OFFICE OF MENTAL HEALTH

The Office of Mental Health (OMH) is responsible for the State's efforts to prevent and treat mental illness. Such efforts include State hospitals, a variety of State operated residential and community-based programs, as well as local assistance programs to help localities and nonprofit agencies finance their mental health programs. The OMH also establishes the cost standards for providing care to clients and obtains certain reimbursements from governmental, third-party and private sources.

  • Medicaid and Medicare

    Since Medicaid and Medicare billings are administered directly by OMH, accounts receivable accruals will be provided by OMH for preparation of interim and annual reports. The Office of the State Comptroller's (OSC) staff, upon receipt of this receivable information, will prepare the appropriate entries. These entries are immediately reversed at the beginning of the new accounting period. Generally, an account receivable is uncollectible if it has been inactive (no payments received) for a period of one year or longer.
     
  • Patient/Third-Party Providers

    Patient/third-party provider transactions are processed initially through the OMH central office much the same way as Medicaid/Medicare. The departure in procedure occurs in the distribution process; client billings are sent to the facilities providing services and care and third-party provider billings are sent directly to the providers. Since client and third-party provider billings are also administered by OMH, accounts receivable and an allowance for uncollectible accruals will be provided by OMH for preparation of interim and annual reports. Generally, an account receivable is uncollectible if it has been inactive (no payments or correspondence received) for a period of one year or longer. OSC staff, upon receipt of this receivable information, will prepare the appropriate entries. These entries are immediately reversed at the beginning of the new accounting period.

OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES

The Office for People with Developmental Disabilities (OPWDD) is responsible for the State's efforts for support and treatment of people with developmental disabilities. OPWDD supports developmental centers, a variety of State operated residential and community-based programs and a local assistance program to help localities and nonprofit agencies finance treatment programs. OPWDD also sets the rates for providing services to clients and obtains certain reimbursements from governmental, third-party and private sources.

The accounting policy to be applied to OPWDD for Medicaid/Medicare and client and third-party provider revenue accruals is exactly the same as specified for OMH.

OFFICE OF ADDICTION SERVICES AND SUPPORTS 

The Office of Addiction Services and Supports (OASAS) oversees prevention, treatment and recovery programs for chemical and gaming addiction. OASAS supports twelve Addiction Treatment Centers, a variety of community-based programs and a local assistance program to help localities and nonprofit agencies finance treatment programs. OASAS also sets the rates for providing services to clients and obtains certain reimbursements from governmental, third-party and private sources.

The accounting policy to be applied to OASAS for Medicaid/Medicare and client and third-party provider revenue accruals is exactly the same as specified for OMH.

DEPARTMENT OF HEALTH

The main purpose of the Department of Health (DOH) is to assure the provision of high quality and appropriate health services at a reasonable cost to all who need them. DOH has five sites that generate patient revenues. A research and rehabilitation program at Helen Hayes Hospital provides in-patient and outpatient services for chronically disabled children and adults. The New York State Veterans Homes at Oxford, St. Albans, Batavia and Montrose provide care for certain war veterans and their dependents.

Revenue accrual data from all sources relative to the operations described above will be provided by the respective facilities. Each facility will report to the OSC both accounts receivable and the related allowance for uncollectibles for preparation of interim and annual reports. Generally, an account receivable is uncollectible if it has been inactive (no payment or correspondence received) for a period of one year or longer. OSC staff will then, upon receipt of this information, prepare the necessary entries. These entries are immediately reversed at the beginning of the new accounting period.

Guide to Financial Operations

REV. 12/26/2023