December 31: New York’s Medicaid Compliance Certification Deadline

The days are counting down to December 31 where certain New York providers and suppliers must certify that they have adopted and implemented “effective compliance programs” to be eligible to receive Medicaid payments (for a more detailed explanation of the requirements under the Medicaid Provider Compliance Programs can be found in our June 26, 2009 entry). The Office of the Medicaid Inspector General (OMIG) has the responsibility of determining that these compliance programs meet the requirements enumerated in the New York Social Services Law ยง363-d and the corresponding regulations at 18 NYCRR Part 521. Specifically, 18 NYCRR 521.3(b) provides that “upon applying for enrollment in the Medical Assistance Program, and during the month of December each year after, a required provider shall certify to the department, using a form provided by Office of the Medicaid Inspector General on its website, that a compliance program meeting the requirements of this Part is in place.” The New York Office of the Medicaid Inspector General (OMIG) has provided the online Certification of Compliance form. While this is the second year in which certifications have been required since the implementation of this new requirement, each required provider must submit a certification form by December 31 of every year.

For more information, please contact Abby Pendleton, Esq., Jessica L. Gustafson, Esq., Adrienne Dresevic, Esq., or Carey F. Kalmowitz, Esq. at (212) 734-0128 or visit the Compliance specialty page on the HLP website.