OMIG Update: Notification to Providers Regarding Changes to Compliance Certification Requirements
Pursuant to New York State Social Services Law (SOS) §363-d, providers are required to certify to the Department upon enrollment in the Medicaid program that they are satisfactorily meeting the requirements of SOS §363-d. Furthermore, compliance with the requirements of SOS §363-d is a condition of payment from the Medicaid program.
Effective immediately, providers are no longer required to complete the annual December certification, commonly referred to as the “SSL Certification,” using the form located on the Office of the Medicaid Inspector General’s (OMIG) website. Instead, a provider adopting and maintaining an effective compliance program will now record (attest to) this 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.
Providers can find their anniversary dates on their initial Medicaid enrollment welcome letters. Additionally, each year, approximately 45-60 days before the anniversary of a provider’s enrollment, the NYS Department of Health (NYSDOH) sends by mail a package of information and materials to the provider, which includes the Certification of Statement for Provider Billing Medicaid Form. This Form must be completed and returned to NYSDOH by the enrollment anniversary date.
The Deficit Reduction Act (DRA) requirements have been incorporated into SOS §363-d. As a result, there is no longer a separate DRA certification requirement. By submitting the annual “Certification Statement for Provider Billing Medicaid,” providers are attesting to satisfactorily meeting the requirements of SOS §363-d, which includes the DRA.
All providers who are subject to the mandatory compliance program requirements in SOS §363-d will be impacted by these changes.
Questions regarding this notice should be directed to OMIG’s Bureau of Compliance at compliance@omig.ny.gov.