We wish to remind our clients who receive more than $500,000 from New York Medicaid that they are obligated to adopt a written compliance plan and certify to the New York Office of the Medicaid Inspector General ("OMIG") that the plan has been adopted and is effective. The deadline to certify to OMIG was December 31, 2011, but providers are encouraged to certify as soon as possible even if they missed the deadline. Certification is mandatory, and providers who fail to certify are subject to sanctions up to and including exclusion from the Medicaid program. Providers must certify the following with OMIG:
- Effective Provider Compliance Certification Form
This form must be completed in December of each year by all Medicaid providers who order, receive or bill $500,000 or more in Medicaid services or supplies within a 12-month period, as well as any Medicaid provider operating under Articles 28 or 36 of the Public Health Law or Articles 16 or 31 of the Mental Hygiene Law. By submitting this certification, a provider attests that it has adopted, implemented and maintained an effective compliance program that meets the requirements of New York State Social Services Law § 363-d and 18 NYCRR Part 521.
- Federal Deficit Reduction Act Certification Form - January 1, 2012 Deadline
Providers who receive or make $5 million or more in Medicaid payments during the federal fiscal year are required to annually certify that they are in compliance with the Federal Deficit Reduction Act (DRA) of 2005, which requires such providers to establish and implement written policies and procedures informing their employees, contractors and agents about federal and state false claim acts and whistleblower protections.