Medicaid Update - August 2020 Volume 36 - Number 13
Legislative Update – Amendments to New York
Social Services Law §363-d: Changes in Compliance Program Requirements
Effective
April 1, 2020, Social Services Law (SOS) §363-d was amended to make changes
to the mandatory compliance program requirements and permit the imposition of a
monetary penalty for failing to adopt and implement an effective compliance
program. Compliance with the requirements of SOS §363-d is a condition of
payment of the medical assistance program.
All providers who are subject to the mandatory compliance program
requirements in SOS §363-d will be impacted by these changes and should take the
steps necessary to review the changes, then comply.
It is the
provider's responsibility to ascertain whether or not they are required to
implement and operate an effective compliance program under the statute [see
SOS §363-d(4)]. Providers subject to the provisions of this section include
those for which the medical assistance program is a substantial portion of
their business operations. "Substantial portion of business
operations" is defined in 18 New York Consolidated Rules and Regulations
(NYCRR) Part 521. The Office of the Medicaid Inspector General (OMIG) will
issue updated guidance in the coming months.
OMIG
monitors providers' adherence to the requirements found in SOS §363-d and Part
521. Providers are advised to review the amendments made to SOS §363-d, in Part
QQ of Chapter 56 of the Laws of 2020 which can be found at: https://omig.ny.gov/compliance/compliance-library.
In the interim, providers subject to the mandatory compliance program
requirements must continue to maintain and operate their compliance programs.
There will
be guidance in the future regarding the changes to SOS 363-d. Please
monitor our website, www.omig.ny.gov;
the “compliance library” on our website, and Medicaid Updates, available on the
NYS Department of Health website. In the interim, Providers should
continue their compliance programs.
Questions
regarding the information presented in this article should be directed to
OMIG's Bureau of Compliance at (518) 408‑0401 or via email at compliance@omig.ny.gov.