Changes To New York State Compliance Program Certification Requirements

November 11, 2020


Separate Annual SSL and DRA Certifications On OMIG’s Website No Longer Required; Replaced By Annual Certification Statements

Effective immediately, providers that are subject to New York State’s mandatory compliance program requirements found in New York State Social Services Law (“SSL”) § 363-d are no longer required to complete the annual December certification form previously found on the New York State Office of the Medicaid Inspector General’s (“OMIG”) website, often referred to as the “SSL Certification.”

Instead, providers are now required to attest that they have adopted and are maintaining an effective compliance program as part of their annual “Certification Statement for Provider Billing Medicaid.” This annual Certification is to occur on the anniversary date of the provider’s enrollment in the Medicaid program. Providers may find their anniversary dates on their initial Medicaid enrollment welcome letters and, OMIG advises, reminders are mailed to providers in advance of this annual date for compliance certification.

In addition, earlier this year, changes were made to SSL § 363-d. One of those changes incorporated the requirements of the federal Deficit Reduction Act of 2005 (DRA) into SSL § 363-d. As a result, there is no longer a separate DRA certification requirement. Instead, by submitting the annual “Certification Statement for Provider Billing Medicaid,” providers are attesting to satisfactorily meeting all of the SSL § 363-d requirements, including the DRA.

As a reminder, for providers that are required to adopt and maintain an effective compliance program under New York law, compliance with the requirements of SSL §363-d is a condition of payment from the Medicaid program.

GW attorneys are available to assist in the creation and implementation of compliance programs, and to review existing compliance programs to help ensure they meet the law’s requirements.

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Should you have any questions regarding the above, please contact the Garfunkel Wild attorney with whom you regularly work.

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