Statutory Changes to New York Health Care Reform Act (HCRA) of 2000

August 5, 2010

Re: Statutory Changes to New York Health Care Reform Act (HCRA) of 2000

Dear Payor/Provider:

This letter provides a summary of the major statutory changes made to the New York State Health Care Reform Act (HCRA) of 2000 as part of the recently enacted 2010-2011 State Fiscal Year Budget. These changes are as follows:

  • Interest and Penalty HCRA Amnesty for Resolution of Delinquent Pool Obligations

    Recently enacted amendments to the HCRA include an amnesty provision which waives statutorily required interest and penalty if delinquent obligations due (based on estimated or actual amounts) to the Public Goods Pool (PGP) under Public Health Law (PHL) §2807-j, §2807-s, and §2807-t for reporting periods prior to January 1, 2010, are filed and paid in full between the dates of April 1, 2010, and December 31, 2010. Modifications are currently being made to the 2009 and prior years´ electronic reports to accept estimated payments under this new amnesty provision. These changes are expected to be available by mid August. If we have a current email address on file, you will be notified by email when these modifications are available for use. You may also check the "What´s New" section of our web site for availability and further information on the amnesty provision at: www.nyhealth.gov/nysdoh/hcra/hcrahome.htm

    Please note that this provision does not apply to the following:
    • 1% Statewide Assessment Program
    • Any interest and penalty amount which has been paid to, or collected previously by, the Department
    • Any underpayments which are discovered during the course of a PGP audit conducted by the Department or its designee
    • Any delinquent amounts (whether estimated or actual) that have been referred for NYS Medicaid recoupment, or collections proceedings to the NYS Attorney General´s Office
  • HCRA Compliance Audits - Settlement of Future Years

    Sections 2807-j(8-a)(f) and 2807-t(10)(f) of the PHL have been amended to authorize the Department to enter into agreements with designated providers of services and third-party payors to use audit findings that have already been reached to settle potential audit liabilities for subsequent unaudited years through the calendar year 2009. Additionally, the Department may take into consideration any evidence provided by the auditee to determine such settlement amounts, subject to verification by the Department. The Department may reduce or waive the payment of interest and penalties otherwise applicable to the settlement amount if the agreement is paid in full within sixty days of the billing date.

Further clarification concerning the foregoing may be obtained by contacting a HCRA representative at (518) 474-1673.

Sincerely,

John E. Ulberg, Jr.,
Director
Division of Health Care Financing