New York State Health Care Reform Act (HCRA)
September 11, 1997
Enclosed are revised monthly reporting forms and instructions for your use in calculating and remitting payments to the 1997 Public Goods Pools for your clinical laboratory. The Certification form and instructions have been revised based on comments we received from providers. The changes to the instructions have been highlighted to assist you in identifying those that may affect your monthly reporting submittal. The major changes include the following:
- The Certification form (DOH-4074, Part A) has been revised to allow a laboratory that is a parent company with a number of subsidiaries to submit a consolidated reporting submission. The represented subsidiaries should be listed on the Summary of Consolidated Report Submission (DOH-4074, Part A, Page 2 of 2).
- The instructions were revised to reflect information provided in a transmittal jointly issued by the Departments of Health and Insurance dated May 27, 1997. The transmittal provided clarification regarding two major issues: 1) revenues subject to the surcharges, and 2) governmental payments exempt from the surcharges.
- Laboratories located outside New York State only may report total revenue and net patient services revenue received during the report month from New York State drawn specimens only on lines 1 and 2, respectively.
All providers are reminded that reports must be filed each month, regardless of whether there is any liability for the reporting month.
Finally, since each HCRA service year stands on its own for purposes of the level of funds available for specific programs, providers should be aware that commencing on January 1, 1998, revenues and surcharges will need to be egregated by service year 1997 and 1998. In essence, monthly reports filed by providers during 1998 will be segregated into 1997 and 1998 service year portions. These kinds of service year segregations are already being performed by providers and payors to distinguish between assessable receipts (those relating to billings with a service date on or after January 1, 1997) and non-assessable receipts (December 31, 1996 and prior service dates).
Should you have any questions concerning the foregoing or the enclosed forms, please contact the Bureau of Financial Management and Information Support at (518) 473-4653.
Mark H. Van Guysling
Division of Health Care Financing