New York Medicaid: Annual Compliance Program Certification Requirement for Providers

The Office of the Medicaid Inspector General (OMIG) mandates that particular vendors collaborating in New York Medicaid keep a compliance application and yearly attest to meeting those requirements with each Medicaid plan they participate in. This regulatory measure ensures adherence to requirements mentioned in Section 521.1 of the New York Codes, Rules, and Regulations.

Eligibility Criteria

Providers required to adopt and enforce powerful compliance packages encompass:

• Individuals or entities ruled through Articles 28 or 36 of the Public Health Law.
• Individuals or entities ruled by Articles sixteen or 31 of the Mental Hygiene Law.
• Other individuals, carriers, or affiliates presenting services, care, or substances below Medicaid, in which Medicaid represents a substantial element of their business operations or revenue.

Next Steps for Providers

Eligible companies must entire the annual certification shape, testifying that they have mounted and are retaining the required compliance program. The finished attestation needs to be emailed to UnitedHealthcare at uhc_provider_compliance@uhc.com.

Support and Resources

Providers can get entry to guidance on the compliance software necessities and certification method via the New York Medicaid internet site. For extra help, companies can use UnitedHealthcare’s 24/7 chat guide on the Provider Portal or consult with the Contact Us web page.

This compliance program requirement underscores OMIG’s commitment to keeping responsibility and first-class within the Medicaid software, helping carriers make sure they meet the best operational standards while persevering to serve Medicaid beneficiaries.