§ 4012-a. Hospice supplemental financial assistance program for
persons with special needs. 1. Notwithstanding any provision of law or
regulation to the contrary, an additional amount may be added to a
hospice's rate pursuant to the medical assistance program, subject to
approval by the state director of the budget, for purposes of enabling
such hospice to provide care and services to persons with special needs,
after a determination that such care cannot be appropriately provided at
the rates of payment established pursuant to federal criteria.

2. "Persons with special needs" as used herein shall include persons
with acquired immune deficiency syndrome and other illnesses or
conditions, which require a more costly or intensive level of care than
typically provided, and persons receiving care in a hospice residence.
Such other illnesses or conditions shall be specified in regulation by
the state hospital review and planning council.

3. In order for a hospice to obtain additional medicaid payment as
provided for in this section, the hospice shall submit cost information
as required by the commissioner, in consultation with the commissioner
of social services, which justifies additional medicaid expenditures,
including a demonstration that adequate care to persons with special
needs cannot be provided within the rates of payment established
pursuant to federal criteria. In addition to demonstrating that the
hospice is certified and in good standing with all applicable
regulations and requirements, the hospice shall also demonstrate that it
shall:

(a) utilize such additional payment to provide services to persons
with special needs;

(b) shall undertake reasonable efforts to maintain financial support
from public and community contributed funding sources;

(c) shall make every reasonable effort to collect payments for
services from third party insurance payers, governmental payers and
self-paying patients; and

(d) shall establish a reasonable relationship between costs and
charges, or establish charges at approximate costs.

4. The commissioner, in consultation with the commissioner of social
services, is authorized to submit for approval and adoption by the state
hospital review and planning council such regulations as necessary to
effectuate the provisions of this section.

5. The commissioner shall establish a rate for persons receiving care
in a hospice residence, and may by regulation specify additional
standards necessary to ensure that the provisions of this section
promote medical assistance recipients access to hospice residence care
including; (a) that such recipients are otherwise unable to
appropriately receive hospice care in their own home; and (b) the
provision of supplemental financial assistance will promote the
efficient delivery of appropriate, quality, cost-effective services.