Revised Part 86-4.16(d) due to amended CON Legislation for FQHCs

August 29, 2013

Dear Administrator/Controller:

In the 2012-2013 State Budget (Chapter 56 of the Laws of 2012), Section 2807-z of the Public Health Law was amended for the FQHC Certificate of Need (CON) review process. Information regarding this amendment can be found on the Department of Health's website at http://www.health.ny.gov/facilities/cons/construction_notices/2012-07-31_dear_administrator_fqhc_law_announcement.htm

Due to the amendment of Section 2807-z, Part 86-4.16 (d) of the Commissioner of Health's Rules and Regulations has also been revised. Prior to the revised regulation, in order for an FQHC provider to receive a revision to its certified reimbursement rate resulting from a capital renovation, expansion or replacement, an approved CON was required. This regulation has been revised to incorporate the amendment of Section 2807-z.

Part 86-4.16(d) was revised by emergency adoption and filed with the Department of State for publishing in the State Register. The revised regulation is effective May 30, 2013 with a 90 day public comment period while the emergency regulation is in effect. The regular adoption process is in progress.

For further information regarding the revised CON process, please refer to the above referenced link to the Department of Health's CON website.

For information regarding a reimbursement rate revision:

  • Hospitals should submit their inquiry to the hospffsunit@health.state.ny.us email address and an analyst from the hospital fee-for-service unit will respond.
  • Freestanding Clinics should submit their inquiry to the dtcffsunit@health.state.ny.us email address and an analyst from the Freestanding fee-for-service unit will respond.

Sincerely,

Stephanie Fargnoli
Director
Bureau of Acute and Managed Care Reimbursement
Division of Finance and Rate Setting
Office of Health Insurance Programs