New York State Health Care Reform Act (HCRA)
July 20, 2005
Re: New York Health Care Reform Acts (HCRA) of 1996 and 2000
Since the inception of HCRA in 1997, the Department has provided a website listing of providers whose services are potentially subject to HCRA surcharge requirements. The listing is currently subdivided by provider type (i.e. Freestanding Ambulatory Surgery Centers, Freestanding Clinical Laboratories, Comprehensive Diagnostic and Treatment Centers, and General Hospitals).
Payors who use this list for confirming HCRA surcharge obligations have raised concerns that billings received for otherwise surchargeable services are at times received by a billing entity which is not reflected on our website listing. This is largely due to separate billings made by extension or satellite clinics operated by a general hospital or comprehensive diagnostic and treatment center whose name and/or address is different than the main facility that appears on the Department's website. Since the services rendered through these extension/satellite clinics are licensed through the sponsoring facility's operating certificate, payments made for such services are subject to HCRA surcharge obligations.
To alleviate this problem, the Department will be expanding the provider list shown on our website to include the name and addresses of general hospital and comprehensive diagnostic and treatment center sponsored extension and satellite clinics. As an initial step to populate the database to be used to generate this expanded website listing, enclosed is an attachment indicating what Department records currently show in terms of your facility's affiliations.
Please review this information and indicate on the form if the information, as listed, is correct or if modifications are needed. An Attachment 2.10E, which is also enclosed, must be completed for each affiliate where modifications are needed.
The above information must be reviewed and returned by August 31, 2005 to the:
Office of Pool Administration
Excellus BlueCross BlueShield, Central New York Region
P.O. Box 4757
Syracuse, New York 13221-4757
Attention: Ms. Roxanne Falitico
Upon implementation of the expanded website listing, providers will be required to confirm the accuracy of their portion of this listing and provide necessary modifications as part of the monthly electronic Public Goods Pool reporting process. Information regarding this upgrade will be forthcoming on the electronic filing website, www.hcrapools.org.
If you have any questions concerning the content of this letter, please feel free to contact Ms. Dee McCumber of my staff at (518) 473-4653. Any questions concerning the electronic filing application should be directed to the help desk at (315) 671-3800 or through e-mail at firstname.lastname@example.org.
Mark H. Van Guysling
Division of Health Care Financing