§ 366-e. Certified home health agency medicare billing. (a) Certified
home health agencies shall bill under title XVIII of the federal social
security act for services provided to all patients eligible for such
program who, as defined by federal law and regulations, are: (i)
homebound; (ii) receiving skilled services; and (iii) are receiving such
services on an intermittent basis. The department, in consultation with
the department of health and representatives of certified home health
agencies with demonstrated ability to maximize medicare revenue, may
promulgate regulations to implement this subdivision. Nothing contained
herein shall be construed to prohibit agencies from billing for medical
assistance reimbursement for eligible services provided to such patients
which are not covered under title XVIII of the federal social security
act meeting the standards established by the department pursuant to this
section. Patient cases that meet the criteria established pursuant to
this subdivision, where coverage has been denied under title XVIII of
the federal social security act for the cost of care provided by a
certified home health agency shall be referred by such agency to an
organization pursuant to subdivision (b) of this section.

(b) The commissioner shall enter into agreements with persons or
entities to provide for representation of persons meeting the criteria
specified in subdivision (a) of this section who have been denied
reimbursement, under title XVIII of the federal social security act, for
services provided by a certified home health agency.