For those who provide Medicaid care, services, or supplies in New York State, the NYS Mandatory Provider Compliance Program certification and the Federal Deficit Reduction Act of 2005 (DRA) certifications can be completed and submitted electronically on the New York State Office of the Medicaid Inspector General's Web site. Each certification is separate and has different obligations and criteria for its application. Some providers of Medicaid care, services, or supplies are required to complete one certification, while others are required to complete both certifications. Please reference the two sections below to determine if each certification applies to the Medicaid provider. Certifications can only be submitted electronically through the links below.New York State Social Services Law Section 363-d and 18 NYCRR Part 521 Certification – NYS Mandatory Provider Compliance Programs
Providers who are unsure of whether the mandatory compliance obligation applies to them are encouraged to reference the chart ARE YOU REQUIRED TO HAVE A COMPLIANCE PROGRAM? accessible through this link.
New York State Medicaid providers who are subject to the mandatory compliance program obligation set out in NYS Social Services Law Section 363-d and 18 NYCRR Part 521 must also certify on OMIG’s Web site that their compliance program has been adopted, implemented and meets the statutory and regulatory requirements. Please see the Frequently Asked Questions (FAQs) – NYS Mandatory Provider Compliance Programs for details and information on the mandatory compliance program obligation. Please use the following link that will identify the Enrollment Categories relevant to the certification process.
- NYS OMIG Social Services Law – Certification of Compliance with the Social Services Law § 363-d and 18 NYCRR Part 521 Form
- 18 New York Code of Rules and Regulations Part 521 – Provider Compliance Programs, effective on July 1, 2009
- Frequently Asked Questions (FAQs) - NYS Mandatory Provider Compliance Programs
- Frequently Asked Questions (FAQs) – NYS Mandatory Compliance Program Certification Process
The DRA generally applies to Medicaid providers who are receiving or paying $5 million or more in Medicaid funds during the federal fiscal year (October through September). Please see the Federal Deficit Reduction Act Frequently Asked Questions ("FAQs") to determine if the provider is subject to the DRA requirements, what must be done in order to meet the DRA obligations, and the DRA certification requirements.
- NYS OMIG Deficit Reduction Act Certification – Certification of Compliance with the Federal Deficit Reduction Act of 2005 Form
- 42 United States Code § 1396a(a)(68)
- Employee Education Requirement Regarding False Claims Recoveries – Summary
- Federal Deficit Reduction Act Frequently Asked Questions ("FAQs")
- Federal Deficit Reduction Act Frequently Asked Questions ("FAQs") Certification Process