Update to New York OMIG and DRA Certification Requirements

The New York State Department of Health (NYSDOH), in its October 2020 Medicaid Update (published last week on November 2, 2020), announced that the annual December certifications (i.e., the Office of the Medicaid Inspector General (OMIG) and Deficit Reduction Act (DRA) certifications (commonly referred to as the SSL Certification and DRA Certification, respectively)) required by providers to certify that they meet the requirements set forth under New York State Social Services Law (SOS) §363-d  are no longer required.

Instead, “a provider adopting and maintaining an effective compliance program will now record (attest to) SSL Certification as part of their annual “Certification Statement for Provider Billing Medicaid.” This annual certification shall occur on the anniversary date of the provider’s enrollment in Medicaid” (see https://omig.ny.gov/compliance/compliance-certification). A provider’s anniversary date of enrollment in Medicaid can be found in their initial Medicaid enrollment welcome letters.

The NYSDOH indicates that approximately 45-60 days before the anniversary of a provider’s enrollment, it sends materials, including the Certification of Statement for Provider Billing Medicaid Form (referenced above), by mail to the provider, which is due by or before the provider’s enrollment date anniversary.

Because DRA requirements have been incorporated into SOS §363-d, no separate DRA certification requirement must be met. It should be noted that compliance with the requirements of SOS §363-d continues to be a condition of payment from the Medicaid program.

For any questions regarding the change to the OMIG and DRA certification requirements, please contact your regular HLP attorney, or Partners@thehlp.com, or call (212) 734-0128 or (248) 996-8510.

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